[Heparin for clearance of peripherally inserted central venous catheter in newborns: an in vitro study]. / Heparina para desobstrução de cateter venoso central de inserção periférica no recém-nascido: estudo in vitro.

OBJECTIVE: To compare the efficacy of two concentrations of heparin to clear the lumen of in vitro clotted neonatal peripherally inserted central catheters (PICCs). METHODS: This is an in vitro, experimental quantitative study of 76 neonatal 2.0Fr PICCs coagulated in vitro. The catheters were divided into two groups of 38 PICCs each. In both groups an infusion of low molecular weight heparin was administered with a dose of 25IU/mL for Group 1 and 50IU/mL for Group 2. The negative pressure technique was applied to the catheters of both groups at 5, 15 and 30minutes and at 4hours to test their permeability. Kaplan-Meier survival analysis was used to verify the outcome of the groups according to time intervals. RESULTS: The comparison between both groups in the first five minutes showed that more catheters from Group 2 were cleared compared to Group 1 (57.9 vs. 21.1%, respectively). Kaplan-Meier survival analysis showed that less time was needed to clear catheters treated with 50IU/mL of heparin (p<0.001). CONCLUSIONS: The use of low-molecular weight heparin at a concentration of 50IU/mL was more effective in restoring the permeability of neonatal PICCs occluded in vitro by a clot, and the use of this concentration is within the safety margin indicated by scientific literature.

[The cancer diagnosis disclosure for the patient and healthcare professionals]. / A revelação do diagnóstico de câncer para profissionais e pacientes.

The disclosure of the cancer diagnosis is considered a crucial moment and the way healthcare professionals communicate it interferes directly in patient's relationship with his/her diagnosis. The study aims to discuss about the importance of the disclosure of the cancer diagnosis for the patient and for the health professionals. The methodology is an essay. The discussion begins with works perspectives which involves health professionals' interaction with the patient and cancer diagnosis disclosure presenting the difficulties lived by both as well as nursing performance in this process. The difficult task of revealing the diagnosis can diverge in each one's experience field and health professionals should be prepared to act in an effective way by taking into account patient's cultural, social and psychological background related to the way the information is communicated to them.