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1.
Braz Dent J ; 29(4): 374-380, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30462764

RESUMO

A caries-epidemiological study using the ICDASepi-merged system was conducted in Colombian young children. This study aimed at associating the time needed for the clinical examination of caries and caries risk in 1 to 5-year-old children according to age and caries risk, and to assess behavior and child pain self-perception during examination according to age. After IRB approval and given parents/caregivers' informed consent, seven trained examiners assessed 1 to 5-year olds in kindergartens under local field conditions. ICDASepi-merged caries experience (depiMEmf) was assessed as follows: Initial-depi (ICDAS 1/2 without air-drying); Moderate-dM (ICDAS 3,4); Extensive-dE (ICDAS 5,6) lesions; due-to-caries fillings-f and missing-m surfaces/teeth. Caries risk was assessed with Cariogram®. Child's behavior (Frankl-Behavior-Rating-Scale) and self-perceived pain (Visual-Analogue-Scale-of-Faces) during examination were evaluated. Clinical examination time was recorded with a stopwatch. A total of 592 children participated (1-yr.: n=31; 2-yrs.: n=96; 3-yrs.: n=155; 4-yrs.: n=209, 5-yrs.: n=101). The depiMEmfs prevalence was of 79.9% and the mean 8.4±10.4. Most were high-caries-risk children (68.9%). The majority (58.9%) showed ≥ positive-behavior and ≤ light-pain self-perception (88.4%). Mean clinical examination time was around 3.5 minutes (216.9±133.9 seconds). For 5-yr. olds it corresponded to 4 minutes (240.4±145.0 seconds) vs. 2 minutes (122.8±80.1 seconds) for 1-yr. olds (Kruskal-Wallis; p=0.00). For high- and low-caries risk children it was around 4.3 minutes (255.7±118.5 seconds) and 3.3 minutes (201.3±129.4 seconds), respectively (ANOVA; p=0.01). This study demonstrates using the ICDAS system in young children is feasible, taking less than 4 minutes for the clinical examination without children behavior/pain self-perception issues.


Assuntos
Cárie Dentária/diagnóstico , Comportamento Infantil , Pré-Escolar , Colômbia/epidemiologia , Cárie Dentária/complicações , Cárie Dentária/epidemiologia , Humanos , Lactente , Dor/etiologia , Prevalência , Fatores de Risco
2.
Braz. dent. j ; 29(4): 374-380, July-Aug. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-974168

RESUMO

Abstract A caries-epidemiological study using the ICDASepi-merged system was conducted in Colombian young children. This study aimed at associating the time needed for the clinical examination of caries and caries risk in 1 to 5-year-old children according to age and caries risk, and to assess behavior and child pain self-perception during examination according to age. After IRB approval and given parents/caregivers' informed consent, seven trained examiners assessed 1 to 5-year olds in kindergartens under local field conditions. ICDASepi-merged caries experience (depiMEmf) was assessed as follows: Initial-depi (ICDAS 1/2 without air-drying); Moderate-dM (ICDAS 3,4); Extensive-dE (ICDAS 5,6) lesions; due-to-caries fillings-f and missing-m surfaces/teeth. Caries risk was assessed with Cariogram®. Child's behavior (Frankl-Behavior-Rating-Scale) and self-perceived pain (Visual-Analogue-Scale-of-Faces) during examination were evaluated. Clinical examination time was recorded with a stopwatch. A total of 592 children participated (1-yr.: n=31; 2-yrs.: n=96; 3-yrs.: n=155; 4-yrs.: n=209, 5-yrs.: n=101). The depiMEmfs prevalence was of 79.9% and the mean 8.4±10.4. Most were high-caries-risk children (68.9%). The majority (58.9%) showed ≥ positive-behavior and ≤ light-pain self-perception (88.4%). Mean clinical examination time was around 3.5 minutes (216.9±133.9 seconds). For 5-yr. olds it corresponded to 4 minutes (240.4±145.0 seconds) vs. 2 minutes (122.8±80.1 seconds) for 1-yr. olds (Kruskal-Wallis; p=0.00). For high- and low-caries risk children it was around 4.3 minutes (255.7±118.5 seconds) and 3.3 minutes (201.3±129.4 seconds), respectively (ANOVA; p=0.01). This study demonstrates using the ICDAS system in young children is feasible, taking less than 4 minutes for the clinical examination without children behavior/pain self-perception issues.


Resumo Um estudo epidemiológico de cárie usando o sistema ICDAS foi realizado em crianças pequenas colombianas. O objetivo deste estudo foi associar o tempo necessário para o exame clínico da cárie e o risco de cárie em crianças de 1 a 5 anos de acordo com a idade e o risco de cárie e avaliar a autopercepção do comportamento e da dor na criança durante o exame, de acordo com a idade. Após a aprovação do comitê de ética e do consentimento informado dos pais/responsáveis, sete examinadores treinados avaliaram crianças de 1 a 5 anos em creches em condições locais de campo. A experiência de cárie do ICDAS (depiMEmf) foi avaliada da seguinte forma: Epi-depi inicial (ICDAS 1/2 sem secagem ao ar); Moderado-dM (ICDAS 3,4); lesões extensas de dE (ICDAS 5,6); restaurações devido a cárie -f e superfícies/dentes ausentes-m. O risco de cárie foi avaliado com Cariogram®. O comportamento de crianças (Frankl-Behavior-Rating-Scale) e a autopercepção de dor (Escala Visual-Analógica-de-Rostos) durante o exame foram avaliados. O tempo de exame clínico foi registrado com um cronômetro. 592 crianças participaram (1 ano: n = 31; 2 anos: n = 96; 3 anos: n = 155; 4 anos: n = 209, 5 anos: n = 101 ). A prevalência do depiMEmfs foi de 79,9% e a média de 8,4 ± 10,4. A maioria era de crianças com alto risco de cárie (68,9%). A maioria (58,9%) apresentou ≥ comportamento positivo e ≤ autopercepção de dor leve (88,4%). O tempo médio de exame clínico foi em torno de 3,5 min (216,9 ± 133,9 s). Para crianças de 5 anos, correspondeu a 4 min (240,4 ± 145,0 s) vs. 2 min (122,8 ± 80,1 s) para crianças de 1 ano de idade (Kruskal-Wallis; p = 0,00). Para crianças com alto e baixo risco de cárie, foi em torno de 4,3 min (255,7 ± 118,5 s) e 3,3 min (201,3 ± 129,4 s), respectivamente (ANOVA; p = 0,01). Este estudo demonstra que a utilização do sistema ICDAS em crianças pequenas é viável, levando menos de 4 min para o exame clínico sem problemas de autopercepção de comportamento/ dor em crianças.

3.
Clin Cancer Res ; 24(6): 1355-1363, 2018 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-29351917

RESUMO

Purpose: The classification of medulloblastoma into WNT, SHH, group 3, and group 4 subgroups has become of critical importance for patient risk stratification and subgroup-tailored clinical trials. Here, we aimed to develop a simplified, clinically applicable classification approach that can be implemented in the majority of centers treating patients with medulloblastoma.Experimental Design: We analyzed 1,577 samples comprising previously published DNA methylation microarray data (913 medulloblastomas, 457 non-medulloblastoma tumors, 85 normal tissues), and 122 frozen and formalin-fixed paraffin-embedded medulloblastoma samples. Biomarkers were identified applying stringent selection filters and Linear Discriminant Analysis (LDA) method, and validated using DNA methylation microarray data, bisulfite pyrosequencing, and direct-bisulfite sequencing.Results: Using a LDA-based approach, we developed and validated a prediction method (EpiWNT-SHH classifier) based on six epigenetic biomarkers that allowed for rapid classification of medulloblastoma into the clinically relevant subgroups WNT, SHH, and non-WNT/non-SHH with excellent concordance (>99%) with current gold-standard methods, DNA methylation microarray, and gene signature profiling analysis. The EpiWNT-SHH classifier showed high prediction capacity using both frozen and formalin-fixed material, as well as diverse DNA methylation detection methods. Similarly, we developed a classifier specific for group 3 and group 4 tumors, based on five biomarkers (EpiG3-G4) with good discriminatory capacity, allowing for correct assignment of more than 92% of tumors. EpiWNT-SHH and EpiG3-G4 methylation profiles remained stable across tumor primary, metastasis, and relapse samples.Conclusions: The EpiWNT-SHH and EpiG3-G4 classifiers represent a new simplified approach for accurate, rapid, and cost-effective molecular classification of single medulloblastoma DNA samples, using clinically applicable DNA methylation detection methods. Clin Cancer Res; 24(6); 1355-63. ©2018 AACR.


Assuntos
Biomarcadores Tumorais , Neoplasias Cerebelares/diagnóstico , Neoplasias Cerebelares/genética , Estudos de Associação Genética , Predisposição Genética para Doença , Meduloblastoma/diagnóstico , Meduloblastoma/genética , Biópsia , Ilhas de CpG , Metilação de DNA , Epigênese Genética , Epigenômica/métodos , Feminino , Perfilação da Expressão Gênica , Humanos , Masculino , Reprodutibilidade dos Testes
4.
Genom Data ; 5: 360-3, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26484286

RESUMO

Neuroblastoma (NB) is one of the most frequently occurring extracranial solid tumors of childhood (Maris et al., 2007 [1]; Brodeur, 2003 [2]). Probability of cure varies according to patient's age, extent of disease and tumor biology (Maris et al., 2007 [1]; Brodeur, 2003 [2]; Cohn et al., 2009 [3]). However, the etiology of this developmental tumor is unknown. Recent evidence has shown that pediatric solid tumors, including NB, harbor a paucity of recurrent genetic mutations, with a significant proportion of recurrent events converging on epigenetic mechanisms (Cheung et al., 2012 [4]; Molenaar et al., 2012 [5]; Pugh et al., 2013 [6]; Sausen et al., 2013 [7]. We have analyzed the DNA methylome of neuroblastoma using high-density microarrays (Infinium Human Methylation 450k BeadChip) to define the epigenetic landscape of this pediatric tumor and its potential clinicopathological impact. Here, we provide the detail of methods and quality control parameters of the microarray data used for the study. Methylation data has been deposited at NCBI Gene Expression Omnibus data repository, accession number GSE54719; superseries record GSE54721.

5.
Epigenomics ; 7(7): 1137-53, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26067621

RESUMO

AIM: To define the DNA methylation landscape of neuroblastoma and its clinicopathological impact. MATERIALS & METHODS: Microarray DNA methylation data were analyzed and associated with functional/regulatory genome annotation data, transcriptional profiles and clinicobiological parameters. RESULTS: DNA methylation changes in neuroblastoma affect not only promoters but also intragenic and intergenic regions at cytosine-phosphate-guanine (CpG) and non-CpG sites, and target functional chromatin domains of development and cancer-related genes such as CCND1. Tumors with diverse clinical risk showed differences affecting CpG and, remarkably, non-CpG sites. Non-CpG methylation observed essentially in clinically favorable cases was associated with the differentiation status of neuroblastoma and expression of key genes such as ALK. CONCLUSION: This epigenetic fingerprint of neuroblastoma provides new insights into the pathogenesis and clinical behavior of this pediatric tumor.


Assuntos
Neoplasias Encefálicas/genética , Ciclina D1/genética , Epigênese Genética , Regulação Neoplásica da Expressão Gênica , Neuroblastoma/genética , Receptores Proteína Tirosina Quinases/genética , Quinase do Linfoma Anaplásico , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/mortalidade , Linhagem Celular Tumoral , Criança , Pré-Escolar , Cromatina/química , Cromatina/metabolismo , Ilhas de CpG , Ciclina D1/metabolismo , Impressões Digitais de DNA , Metilação de DNA , DNA Intergênico , Feminino , Perfilação da Expressão Gênica , Genoma Humano , Humanos , Lactente , Masculino , Neuroblastoma/diagnóstico , Neuroblastoma/metabolismo , Neuroblastoma/mortalidade , Análise de Sequência com Séries de Oligonucleotídeos , Prognóstico , Regiões Promotoras Genéticas , Receptores Proteína Tirosina Quinases/metabolismo , Análise de Sobrevida
6.
Acta Odontol Latinoam ; 28(1): 3-12, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25950157

RESUMO

Dental caries is an infectious disease which still constitutes a public health concern. It begins at an early age and is caused mainly Streptococcus mutans (S. mutans). The aim of this study was to characterize the salivary humor immune response to S. mutans proteins in patients with caries, with history of caries and without caries, in order to determine which S. mutans proteins participate in the immunological response in subjects with different caries experience. Saliva was collected by spontaneous salivation for 5 minutes from 60 subjects aged 18 to 30 years, classified according to their caries experience as: without caries (Group I), with active caries (Group II) and with history of caries (Group III). The antigens derived from S. mutans by sonication were recognized by salivary IgA and IgG by Western Blot. The results showed that all the individuals studied recognized S. mutans proteins with molecular weights in the range of 8 to 191 kDa, with similar recognition profiles for salivary IgA and IgG. Subjects without caries recognized the 29 kDa protein, also known as S. mutans Antigen A, via salivary IgA, differing from patients with caries and history of caries, who recognized it via IgG. The protective response against S. mutans is mediated by IgA. To conclude, a differential response to the 29 kDa protein between study individuals may be indicative of resistance to dental caries and may have a protective role in the induction of IgA antibodies against dental caries, as found in the group without caries, in contrast to subjects with active caries and history of caries.


Assuntos
Streptococcus mutans , Anticorpos Antibacterianos , Cárie Dentária , Humanos , Imunoglobulina A , Imunoglobulina G , Saliva
7.
Acta odontol. latinoam ; 28(1): 3-12, Apr. 2015. graf, tab
Artigo em Inglês | LILACS-Express | ID: biblio-949683

RESUMO

Dental caries is an infectious disease which still constitutes a public health concern. It begins at an early age and is caused mainly Streptococcus mutans (S. mutans). The aim of this study was to characterize the salivary humor immune response to S. mutans proteins in patients with caries, with history of caries and without caries, in order to determine which S. mutans proteins participate in the immunological response in subjects with different caries experience. Saliva was collected by spontaneous salivation for 5 minutes from 60 subjects aged 18 to 30 years, classified according to their caries experience as: without caries (Group I), with active caries (Group II) and with history of caries (Group III). The antigens derived from S. mutans by sonication were recognized by salivary IgA and IgG by Western Blot. The results showed that all the individuals studied recognized S. mutans proteins with molecular weights in the range of 8 to 191 kDa, with similar recognition profiles for salivary IgA and IgG. Subjects without caries recognized the 29 kDa protein, also known as S. mutans Antigen A, via salivary IgA, differing from patients with caries and history of caries, who recognized it via IgG. The protective response against S. mutans is mediated by IgA. To conclude, a differential response to the 29 kDa protein between study individuals may be indicative of resistance to dental caries and may have a protective role in the induction of IgA antibodies against dental caries, as found in the group without caries, in contrast to subjects with active caries and history of caries.


La caries dental es una enfermedad infecciosa que continua siendo un problema de salud publica, inicia a temprana edad y es causada principalmente por Streptococcus mutans (S. mutans). El objetivo de este estudio fue caracterizar la respuesta inmune humoral salival, ante las proteinas de S. mutans, en pacientes con caries, historia de caries e individuos libres de caries, para asi establecer que proteinas de S. mutans participan en la respuesta inmunologica en los diferentes estadios de caries. La saliva de 60 individuos entre 18 y 30 anos de edad, clasificados de acuerdo al estado de caries: libres de caries (grupo I), caries activa (grupo II) e historia de caries (grupo III), se colecto por salivacion espontanea durante 5 minutos. Los antigenos derivados de S. mutans por sonicacion, fueron reconocidos por IgA e IgG salivales por Western Blot. Los resultados mostraron que todos los individuos estudiados reconocen las proteinas de S. mutans en el rango de 8 a 191 kDa de peso molecular con perfiles de reconocimiento similares para IgA e IgG salival. Se encontro que los sujetos libres de caries reconocen por IgA salival la proteina de 29 kDa, tambien llamada Antigeno A de S. mutans, de manera diferente que los pacientes con caries e historia de caries quienes reconocieron la proteina via IgG. La respuesta protectora frente a S. mutans es mediada por IgA. En conclusion, una respuesta diferencial a la proteina de 29 kDa entre los individuos estudiados, puede ser indicativo de resistencia a la caries dental y tener un papel protector en la induccion de anticuerpos IgA frente a la caries dental, como se encontro en el grupo libre de caries, a diferencia de los sujetos con historia de caries y caries activa.

8.
PLoS One ; 7(11): e48401, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23144874

RESUMO

Neuroblastoma (NB) pathogenesis has been reported to be closely associated with numerous genetic alterations. However, underlying DNA methylation patterns have not been extensively studied in this developmental malignancy. Here, we generated microarray-based DNA methylation profiles of primary neuroblastic tumors. Stringent supervised differential methylation analyses allowed us to identify epigenetic changes characteristic for NB tumors as well as for clinical and biological subtypes of NB. We observed that gene-specific loss of DNA methylation is more prevalent than promoter hypermethylation. Remarkably, such hypomethylation affected cancer-related biological functions and genes relevant to NB pathogenesis such as CCND1, SPRR3, BTC, EGF and FGF6. In particular, differential methylation in CCND1 affected mostly an evolutionary conserved functionally relevant 3' untranslated region, suggesting that hypomethylation outside promoter regions may play a role in NB pathogenesis. Hypermethylation targeted genes involved in cell development and proliferation such as RASSF1A, POU2F2 or HOXD3, among others. The results derived from this study provide new candidate epigenetic biomarkers associated with NB as well as insights into the molecular pathogenesis of this tumor, which involves a marked gene-specific hypomethylation.


Assuntos
Metilação de DNA/genética , Genes Neoplásicos/genética , Neuroblastoma/genética , Criança , Pré-Escolar , Ciclina D1/genética , Ciclina D1/metabolismo , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Lactente , Recém-Nascido , Reprodutibilidade dos Testes , Análise de Sequência de DNA , Temperatura Ambiente
9.
Emerg Radiol ; 18(3): 267-9, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21221696

RESUMO

We report the case of a 65-year-old woman who was treated with low-molecular-weight heparin and suffered spontaneous rupture of an ovarian cystadenocarcinoma. We present the computed tomography findings and make a review of the literature. Spontaneous hemoperitoneum is an infrequent complication of ovarian neoplasms and, to the best of our knowledge, this is the first-described case report of peritoneal bleeding secondary to a cystadenocarcinoma in the recent English literature.


Assuntos
Adenocarcinoma/complicações , Adenocarcinoma/patologia , Hemoperitônio/etiologia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/patologia , Idoso , Anticoagulantes/uso terapêutico , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Ruptura Espontânea , Tomografia Computadorizada por Raios X
10.
Acta Odontol Latinoam ; 21(2): 153-8, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19177852

RESUMO

Streptococcus mutans (S. mutans) is the main etiological agent in dental caries. Its virulence factors are the proteins PAc and glucosyltransferase (GTF), which are related to its physiopathogenia and have been used in research for a dental caries vaccine. It was reported that using experimental animal models, GTF-I(1301-1322) synthetic peptide from the GLU region of the GTFs has Tepitopes, induces production of serum antibodies in saliva and reduces the presence of caries, but little is known about the cellular response in naturally sensitized humans. The aim of this study was to observe whether GTF-I(1301-1322) peptide is capable of activating CD4+ T cells in PBMC from naturally sensitized humans, to classify the response and to establish the relationship with dental caries. The study was conducted on 30 individuals classified into the following 3 groups: active caries (AC), History of Caries (HC), and free of caries (H). A blood sample was drawn from each individual. Specific antigen stimulation and flow cytometry analyses were used to determine cells producing the cytokines IFN-gamma (type 1 cytokine) and IL-13 (type 2 cytokine). Cell memory response to GTF-I(1301-1322) peptide was found in naturally sensitized humans. Three different responses were detected: TH0, TH1, and NR. The percentage of CD4+ T cells producing the cytokines IFN-gamma (type 1 cytokine) was greater than the percentage producing IL-13 (p=0.006). No statistically significant differences were found among the three groups for the other variables studied (p < or = 0.05). In conclusion, specific cellular immune responses against the GTF-I(1301-1322) peptide of S. mutans does not differ between individuals who are naturally sensitized, caries- resistant or with caries.


Assuntos
Proteínas de Bactérias/imunologia , Linfócitos T CD4-Positivos/imunologia , Citocinas/imunologia , Cárie Dentária/imunologia , Adolescente , Adulto , Antígenos CD/imunologia , Antígenos de Diferenciação de Linfócitos T/imunologia , Antígenos CD28/imunologia , Cárie Dentária/microbiologia , Humanos , Imunização , Memória Imunológica , Integrina alfa4/imunologia , Interferon-alfa/imunologia , Interleucina-13/análise , Lectinas Tipo C , Leucócitos Mononucleares/imunologia , Ativação Linfocitária/imunologia , Fragmentos de Peptídeos/imunologia , Linfócitos T/imunologia , Células Th1/imunologia , Adulto Jovem
11.
Rev. calid. asist ; 16(8): 706-713, nov. 2001. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-143573

RESUMO

Objetivo: El Consentimiento Informado (C.I.) cada vez está más implantado por lo que decidimos estudiar la opinión de los médicos y pacientes sobre él y su proceso de realización. Material y métodos: Estudio observacional, descriptivo y transversal mediante dos encuestas diferentes, de forma personal y telefónica, a 89 profesionales de un Hospital Universitario y a 210 pacientes sometidos a algún procedimiento diagnóstico y/o terapéutico en noviembre de 1998. Se realizó un muestreo aleatorio simple. Los datos fueron analizados mediante la χ2. Resultados: El 25,8% de los profesionales consideran que la utilización de formularios es imprescindible. Aunque el 36% (IC 95%: 26,1-45,9) de los médicos consideran que los pacientes comprenden la información recibida, el 93,4% (IC 95%: 90-96,8) refirieron haberla entendido adecuadamente. El 79,8% (IC 95%: 71,5-88,1) de los médicos refieren ofrecer explicaciones, pero sólo el 44,3% (IC 95%: 37,6-51) de los pacientes confirmaron esta oferta. El 63,3% de los pacientes se quedaron indiferentes tras recibir la información. Según el 61,8% de los profesionales y el 68% de los pacientes, el proceso del C.I. se realiza mediante la lectura del documento por el paciente. Para el 66,7% (IC 95%: 73,1-60,3) de los pacientes el objetivo de los formularios es proteger al médico. Conclusiones: Se encuentran deficiencias en aspectos como la necesidad de los documentos y su utilización, comprensión de los documentos, falta de entrega de los mismos, oferta de explicaciones, persona que lo entrega, proceso de realización, tiempo del que dispone el paciente y objetivo del documento. La información transmitida, en la mayoría de las ocasiones, no causó más ansiedad en los pacientes (AU)


Background: The Informed Consent (I.C.) every time is more implanted so that we decide to study the opinion of the doctors and patient on him and its realization process. Method: The study is observational, descriptive and traverse by means of two surveys (personal and phone) to 89 professionals of a University Hospital and 210 subjected patients to some procedure diagnostic and/or therapeutic in November 1998. It was carried out a simple aleatory sampling. The data were analyzed by means of the χ2. Results: The 25,8% of the professionals considers that the use of formularies is indispensable. Although 36% (CI 95%: 26,1-45,9) of the doctors they consider that the patients understand the received information, 93,4% (CI 95%: 90-96,8) they referred to have her appropriately expert. 79,8% (CI 95%: 71,5-88,1) of the doctors they refer to offer explanations, but only 44,3% (CI 95%: 37,6-51) of the patients they confirmed this offer. 63,3% of the patients was indifferent after receiving the information. According to 61,8% of the professionals and 68% of the patients, the process of the I.C. It is carried out by means of the reading of the document for the patient. For 66,7% (CI 95%: 73,1-60,3) of the patients the objective of the formularies is to protect the doctor. Conclusions: There are some deficiencies in aspects like the necessity of the documents and their use, understanding of the documents, lacks of delivery of them, offer of explanations, person that gives it, realization process, time of which prepares the patient and objective of the document. The transmitted information, in most of the occasions, it didn’t cause more anxiety in the patients (AU)


Assuntos
Humanos , Consentimento Livre e Esclarecido/ética , Adesão a Diretivas Antecipadas/tendências , Temas Bioéticos , Termos de Consentimento , Satisfação do Paciente
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