Search

Background: Congenital heart disease (CHD) is the leading cause of death from malformations in infants and has a significant psychological impact on families. This scoping review explored the role of spirituality in supporting families of children with CHD. It also sought to identify gaps in the existing literature and suggest directions for future research., Methods: A synthesis review was conducted following the framework of Arksey and O'Malley, incorporating the principles of the Joanna Briggs Institute. We systematically searched four databases-Medline, Embase, Lilacs, and Scielo-selecting studies based on inclusion criteria focused on spirituality in families of children with CHD. Articles without full text, book chapters, lectures, conference abstracts, review articles, and editorials were excluded. We analyzed the year of publication, study location, objectives, methodology, participants of the study, and main results., Results: A total of 17 studies were included in the review, most of which were conducted in the past 10 years. The studies were conducted in various regions of the world, including Japan, the USA, China, Iran, Sweden, and Brazil, and they examined different religious traditions, including Christianity, Islam, Buddhism, and non-denominational spiritual practices. Twelve qualitative studies, three descriptive studies, one cross-sectional study, and one case report were included. The articles were categorized based on several themes: the influence of spirituality on mental and emotional well-being, cultural and religious diversity, integration of spirituality into health care, and its assistance in decision-making., Conclusions: Spirituality plays a crucial role in addressing the emotional and psychological challenges of CHD. There is a need for structured models of spiritual counseling and more research in diverse cultural and socioeconomic contexts. Identifying these gaps can help guide future studies to enhance our understanding and improve the support provided to these families, thereby promoting more holistic and patient-centered healthcare., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-24-134/coif). E.A.J. serves as an unpaid editorial board member of Translational Pediatrics from October 2023 to September 2025. The other authors have no conflicts of interest to declare., (2024 Translational Pediatrics. All rights reserved.)

Objective  To compare the techniques for the osteosynthesis of intertrochanteric fractures with dynamic hip screws (DHSs) through the Hardinge and minimally-invasive access routes of the hip, evaluating the operative time, the degree of pain in the immediate postoperative period, the hematimetric loss, and the functional aspects of active mobility. Methods  A randomized, double-blinded clinical trial in which 66 patients with intertrochanteric fractures were submitted to osteosynthesis by DHS. The patients were divided into a test group, submitted to the minimally-invasive access, and a control group, in whom the surgery was performed through the Hardinge route. Results  Patients submitted to the minimally-invasive treatment presented a lower degree of postoperative pain compared to the group treated by the Hardinge lateral route ( p  < 0.001), as well as lower hematimetric loss ( p  < 0.001), shorter operative time ( p  < 0.001), and improvement in immediate postoperative active mobility tests ( p <0.05). Conclusion  The study demonstrated the clinical superiority of the minimally-invasive access route parameters analyzed in relation to the Hardinge access for the fixation of intertrochanteric fractures when DHS is the choice osteosynthesis method. Level of evidence I., Competing Interests: Conflito de Interesses Os autores declaram não haver conflito de interesses., (Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

The management of patients, such as Jehovah's Witnesses, who refuse to receive blood transfusions, is often a medical challenge, not only because of the ethical dilemma, but also because it creates a major obstacle to rapid hemorrhage control in a setting of trauma. This article explores the reasons for this conflict between the physician's duty of care and the respect for the patient's autonomy, and draws a panorama of the main understandings of the Judiciary on the subject. Finally, it is concluded that the manifestation of the patient's will, although free, is not enough to release the doctor from his (her) duty of care. In case of danger to life, the doctor must carry out a blood transfusion, regardless of the patient's consent or the permission of those responsible for the patient.