جستجوی مقالات مرتبط با کلیدواژه « مرگ مغزی » در نشریات گروه « پزشکی »

The aims of this study were to compare the effects of two doses of 0.4 and 0.6 mg/kg mannitol on the rate of diuresis, residual renal function, hemodynamic changes and creatine phosphokinase changes in brain death patients.

In a single-blind randomized clinical trial study on brain death patients hospitalized in the intensive care units of Al-Zahra Hospital in Isfahan, 30 brain death patients were divided into two groups of 15, the first group was given 0.4 g/kg mannitol and the second group was given 0.6 g/kg mannitol with 1 mEq of sodium bicarbonate per kg for 20 minutes. And these values were repeated up to three times every 8 hours. Creatine phosphokinase levels were measured 8 hours after each dose of mannitol and urinary output 2 and 8 hours after each dose of mannitol and renal function, 8 hours after the last dose, and the mean changes were compared between the two groups.

Mean changes in serum creatine phosphokinase level were significantly decreased in the two groups, but the rate of reduction was not significantly different between the two groups. Glomerular filtration rate was significantly increased in both groups, but the rate of change was not different between the two groups. Also, changes in urinary output were significantly different between the two groups.

The use of 0.6 g / kg of mannitol is not superior to the dose of 0.4 g / kg of this drug in improving renal function and reducing creatinine phosphokinase levels.

The COVID-19 pandemic caused changes in daily life and disrupted hospital performance and the provision of medical services, especially in the organ transplant departments.

This study aims to compare the frequency of organ donation and transplantation before and after the COVID-19 outbreak in the transplant centers of northern Iran.

This cross-sectional study was conducted on 75 donors with brain death from 2018 to 2021 in Rasht. Demographic data, underlying diseases, history of smoking and drug use, causes of brain death, type of donated organ, number of donated organs per patient, type of transplanted organ, and the location of transplantation (in or out of the province) were recorded. Then, these factors were compared between two time periods: Before the pandemic (from July 2018 to February 2020) and during the pandemic (from February 2020 to August 2021). The recorded data was analyzed in SPSS software, version 21. The significance level was set at 0.05.

The mean age of donors during the pandemic was significantly higher than that of patients before the pandemic (P<0.001). The most common cause of brain death in donors before the pandemic was trauma; after the pandemic, cerebrovascular causes were more common (P=0.01). The frequency of organ donation and the mean number of donated organs per donor during the pandemic were significantly lower than before the pandemic (P<0.001).

The COVID-19 pandemic has significant impact on the process of organ donation and transplantation in northern Iran.

One of the most important barriers to organ transplantation and the consequent mortality of people on the waiting list for transplants in most countries is family refusal. As a result, recognizing the effective factors in family consent will provide a bridge to increase the rate of supply of organs needed for transplantation. Due to the various factors affecting organ donation, including cultural, religious, scientific, social, moral, religious, and legal dimensions, there is a need for comprehensive and up-to-date studies in this field. Therefore, in this narrative review article, we gathered and summarized the major and influential causes of family refusal among the next of kin of brain death cases It is suggested that some ceremonies and social activities be considered to familiarize the community with brain death and the process of organ donation. Also, it is necessary to organize meetings with religious authorities to present the humanitarian aspects of organ donation.

Considering the high death rate of patients on the transplant waiting list, one of the most important ethical challenges of organ transplantation is the lack of transplant organs and different approaches to cover it.

The ethical issues of organ transplantation have been frequently reviewed recently.

Currently, there are 4 sources for organ transplants, which are: a) organ transplant from animal to human b) transplant from a living donor c) transplant from a brain-dead donor d) transplant from a cardiac-dead donor or donors without a heartbeat, and tissue engineering research continues to prepare a transplantable organ. Each of them has its own limitation and specific consideration. In Iran, organ procurement from brain-dead donors and living donors are the most important sources. Many approaches have been considered to increase the number of procured organs from brain-death cases in the world, but have not yet been able to reduce the gap between supply and demand. Therefore, since the 1980s, the program of organ transplantation from cardiac death (donors with irreversible cardiac arrest) in the world has been reviewed again. Based on the classification of cardiac arrest patients, they are placed in two general categories: uncontrolled and controlled. In a controlled condition, death is predictable, and organ removal is possible by eliminating planned medical interventions and patient support. But in the uncontrolled state, death occurs accidentally, which is more likely to prolong the duration of hot ischemia. Italy's organ donation group has recently introduced type 6 deaths in patients on ECMO, which is mentioned as a semi-controlled group. This group is called donors with abnormal blood flow versus brain-dead donors with normal blood flow. In this study, ethical considerations for organ donation from NHBD were discussed. Regarding the procurement of organs from non-heart beating donors, there are many ethical considerations that include both the donors and the recipients. Considering that the clinical conditions of the brain-dead donors are sometimes very unstable, cardiac arrest may occur before organ harvesting. In these cases, donation after cardiac death is an option.

It is necessary to regulate the ethical considerations for organ procurement from NHBD

Brain death refers to the irreversible state of all brain functions and is one of the definitive criteria for determining death.At the time of brain death, some of the organs in which life is established can be donated and transplanted to patients in need.Because the knowledge and attitudes of influential people in the field of treatment are very important, this study was conducted to determine the evaluation of medical students' knowledge and attitudes about brain death and organ donation.

This cross-sectional study was conducted randomly in 1398 on medical students of Tabriz University of Medical Sciences.A questionnaire containing 45 questions was distributed among 150 students. Cronbach's alpha was used for the reliability of the questionnaire. Independent t-test or analysis of variance was used to compare the scores of attitude and knowledge between the levels of variables. Independent t-test or analysis of variance was used to compare the scores of attitude and knowledge between the levels of variables.Pearson correlation coefficient was used to investigate the relationship between attitude and advertising. SPSS software version 17 was used for data analysis.

In this process, the knowledge and positive attitude of the test subjects play an essential role. Therefore, it is suggested that medical students be made aware of the nature of brain death and the importance of organ donation in regular educational programs. On the other hand, considering the challenges in people with brain death, it is better to complete the

COVID 19 pandemic and the confusion of the world at the beginning of the epidemic affected many aspects of the life and health care. In this regard, organdonation as a vital approach for life saving in patients on the waiting list was influenced too. This essential treatment requires the provision of vital organs from the brain death cases, which is a sensitive, accurate and lengthy process. This process begins with the identification of Glasgow Coma Scale (GCS) cases less than 5 and is followed by organ harvesting and assignment to waiting list patients.Organ donation and factors related to its process have been fluctuated during three specific time periods, including the first and second year of the epidemic with the year before the epidemic. This decrease in the number of donations has been felt worldwide and it has been reported that this number has decreased significantly even in the amount of blood donation.Numerous barriers to the treatment system during the epidemic, limitations of surgeries except in emergencies, asymptomatic patients, and many unknown aspects of the disease have shown that the policies and approaches of procurement centers need to be changed to continue efforts in this situation. New protocols (according to the needs of these days) should be developed and implemented according to the conditions ahead.

 Caring for patients with the diagnosis of brain death is one of the heaviest duties for nurses. The importance of organ donation is one of the biggest challenges of nursing in the intensive care unit. This qualitative research aimed to investigate the experience of nurses in care for brain death patients.

The study was qualitative research using a content analysis method. Purposive sampling started with in-depth semi-structured interviews with 20 participants and continued until the data saturation stage. Data were analyzed using conventional qualitative content analysis.

Qualitative analysis of data content led to the extraction of themes reflecting the research of nurses’ experiences in the care of the brain dead patients and including “organ donation; a distinct care element” and “’facing increased tensions and conflicts.” Finally, the main themes of “Care stress resonance following a distinct donation situation; a distinct care element” were abstracted.

Due to the importance of maintaining the health of donation organs, nurses’ experiences have shown that they face many challenges while caring for brain death patients. But the issue of organ donation is one of the significant issues affecting the care of organ donors, so managers can take practical proceedings by identifying nurses’ challenges in this field to improve the quality of care for these patients.

different negative and positive reactions to this issue. The present study claims that by putting forward this proposed and innovative method, it meets many of the existing scientific and social needs in this field. Therefore, we decided to present a relatively comprehensive and completely new research in this regard and during it, to give the appropriate questions based on important jurisprudential, legal and, consequently, medical sources, appropriate and as strategic as possible: 1. Examining the different aspects of the hypothesis of approving and confirming the cause of brain death as one of the types of execution methods; 2. Examining the epistemological, sociological and psychological foundations of Islam regarding the permission or non-permission of donating a prisoner organ sentenced to self-sacrifice; 3. Examining the views of the proponents and opponents of the donation and transplantation of organs of prisoners sentenced to self-immolation through brain death.

This descriptive-analytical study has been written to investigate the possibility of brain death with the aim of donating organs to death row inmates, which is done using library resources and based on logical reasoning and analysis and valid jurisprudential, legal and medical criteria.

This research is written based on ethical principles and trustworthiness.

The findings of this study indicate that; By exploring jurisprudential and legal arguments and inferences and legal materials and advances in medical knowledge, we proved that: brain death as one of the types of execution has intellectual, scientific, logical and laboratory possibilities, but in In case of its practical possibility, the consent of the executed person as well as the conditions of the national and international environment should be considered.

According to the results and criteria desired by the Shari'a in relation to partial execution and retribution, including the role of time and place in execution or openly and secretly or precedence and latency of being a lesson, learning or forgiveness, equality and proportionality of crime (murder) and punishment Nafs), no excessive harassment of the sentence, etc. It is possible to vote for such a possibility with the correct and approved methods of the medical community as a type of execution that has many of these conditions in order to eliminate some buts and ifs and completes The above-mentioned legal article came into force.Please cite this article as:Avazpour SH, Sayyah R, Hosseini SH, Barati F. Jurisprudential and Legal Study of Brain Death as Execution in the Idea of Proof. Medical Law Journal. 2022; 16(57): e19.

Brain injurie in pregnant women is one of the important issues due to the relationship with the life of the fetus. In some brain injuries, it is possible to keep the fetus alive medically until delivery. In addition to the situation of pregnant women, attention to the need for medical support in order to preserve the life of the fetus is one of the issues that should be considered. Among the different types of brain injuries, in this study, Coma, Vegetative status and Brain death are considered as important brain injuries that the loss of patient's consciousness is comon point in all of them and by examining the legal status of patients in each of these types of brain injury, we seek to answer the question, if there is no medical hope for the mother's treatment, but continuing the treatment is effective in keeping the fetus alive, will be a task to continue? The issue of discontinuation or continuation of treatment of patients with brain injuries has not been considered generally or sepecially in relation to pregnant women in the statute and legal doctrine of Iran. In some legal systems, such as United States and United Kingdom, doctrine and precedent explain the issue by providing criteria. Considering the importance of the right of life in Iranian jurisprudence and law and lack of attention to the subject in domestic writings, the present research has been done with a comparative approach by considering two dynamic and pioneering legal system in this field, the issue has been studied from various dimensions such as the right of life of the fetus, the ethical aspects of the action, the will, interests and rights of the mother and the fetus.

This research is a theory and the research method is descriptive-analytical. And the method of collection is library and it is information by referring to documents, books and articles.

In order to organize this research, while observing the authenticity of the texts, hoesty and fidelity have been observed.

In different legal systems, depending on the accepted legal position regarding the legal status of the fetus, there are different criteria to decide about the discontinuation or continuation of the treatment of the pregnant mother until the time of delivery. Despite the difference in some fundamentals between the legal systems, the moral fundamentals and the importance of the right of life have pproximated the accepted solutions and in practice, with different justifications there is a desire to preserve the life of the fetus in the studied systems.

In the legal system of Iran, in deciding about the discontinuation or continuation of the treatment of a pregnant mother until delivery, considering the human personality of the and the importance of the right of life, in the assumption of conflict between the rights of the mother and the fetus, due to the primacy of the right of life, the necessity of continuing the mother's treatment until delivery should be defended. Unlike other legal systems, sometimes by resorting to the criteria of the mother's desire and will or the mother's interests, termination of treatment may be allowed in certain circumstances, in Iranian law, in terms of the importance of the life of the fetus, the will of the mother is not considered a criterion for terminating the life of the fetus. Regarding the criterion of the mother's interests, due to the uncertainty of the existence of harm to the mother, the rights of the fetus have priority and prevent the termination of the mother's treatment.Please cite this article as:Safari N. Comparative Study of Legal Aspects of Discontinuation or Continuation of Treatment of Brain Injury in Pregnant Women. Medical Law Journal. 2022; 16(57): e33.

Timely donation of transplantable organs of brain dead patients is the main source for supplying organs needed by patients waiting for a transplant. Training healthcare staff involved in managing brain dead patients is a major priority of the Iranian Society of Organ Donation. This study determined the effectiveness of the training course of organ donation following brain death on the Knowledge, Attitude, and Practice (KAP) of healthcare staff in Hormozgan.

This quasi-experimental (single group pre-post test) study was conducted in Bandar Abbas in autumn of 2018. Totally, 117 staff involved in managing brain dead patients participated in the study. KAP was assessed by a researcher-made questionnaire in three stages: before and after training, and 2 months later. We used t-independent parametric tests for two-group comparison, repeated measurement for a three-step comparison of KAP, and post-hoc analysis for pairwise comparison of the stages

Eighty-five participants (72.6%) returned the questionnaires in all the stages. They included 67% female, 75.3% married, and 88.2% with bachelor degrees. The mean age was 36.95±7.71 years old. KAP assessed in the 2nd and 3rd stages were significantly higher than the 1st stage. The KAP of men and women improved but not significantly. KAP of participants with bachelor degrees improved significantly, but not for those with higher degrees.

The assessment in the three stages proved that the training course effectively improved KAP of the participants

Anencephaly is one of the fetal malformations caused by neural tube defects in the fetal head. It often results in the death of a baby or a baby during pregnancy and sometimes after birth. Therefore, the disease, as opposed to anomalies in life, is one of the cases of abortion before 4 months of age. However, given that abortion licenses are limited in time (up to the ensoulment at four months of age), we may face legal and legal bans on abortion if we diagnose this disease late. The present study seeks to assess the jurisprudential and legal feasibility of abortion of such embryos after four months, considering the science and termination of death of these embryos after this time.

This research has been prepared by descriptive analytical method and its data has been collected by Library Tool.

Among the incurable fetal diseases, anencephaly, which is a defect in the physiological structure of the brain, is one of the cases of fetal abnormalities that make it difficult for the mother due to retardation or deformity, subject to abortion law. Is treated. One of the problems that pregnant women with abnormal fetuses face is getting an abortion permit for only 4 months. The resulting problems are significant in mothers with anencephaly fetus. Given the certainty of medical science in the inability of these embryos to survive even after birth, the issue of overcoming this time limit for obtaining an abortion permit after 4 months is a significant issue. The jurisprudential support of the laws in the Iranian legal system makes the researcher inevitably examine the arguments that can be used in Islamic jurisprudence in order to achieve a solution based on rational and narrative arguments in this field.Ethical considerations: In order to organize this research, observing the authenticity of the texts, honesty and fidelity have been observed.

This study shows that by invoking reasons such as the analogy of priority (analogy with brain death) and the application of la zarar and la haraj rules, it is possible to prove the ruling on the permission of anencephaly abortion even after 4 months.

Brain death involves the complete and irreversible destruction of brain activity characterized by profound coma, apnea and the absence of all brainstem reflexes. The issue of organ transplantation is a very important issue in the field of jurisprudence and law in addition to being one of the issues to be considered and analyzed in the medical world, especially in jurisprudence and the issue has been raised with great sensitivity and since this practice is entirely sensible. Individuals are physically related and in the fulfillment of the sacred duty of the human being and his/ her physical integrity as Ashraf the creatures and the caliphate is of particular importance. The ethical roots of organ donation in brain death patients are that different religions and cultures cannot easily accept that a person who has vital symptoms can be dead and accepted, especially by close relatives. Very difficult. The ambiguity and fears are not due to the precise diagnosis of the time of brain death, but to the early detection of death and early donation of organs. Since organ transplantation plays a vital role in saving human lives and the sacred law has made human life and health as its essential concern, it can be said that with proper understanding of human beings, the limits and scope of research, education and treatment. Human beings will be identified and the health of society and the survival of the human race will depend on this knowledge. It is also recommended to consider necessary educational programs in order to increase the knowledge and positive attitude of medical staff and community members towards organ donation. In this article, we will try to articulate the legal principles of organ transplantation while expressing the arguments of supporters and dissidents of the brain dead.

Infertility treatment is a problem that has opened new windows in the medical sciences and since the conventional methods of infertility treatment such as and Alternative and from the religious point of view, it seems to have some drawbacks, whichseems to have to be considered for the continuation of infertility treatmentwork. The progress of progress in the field of medicine and the problems with itin the field of jurisprudence is such that it has to review new methods andtherapeutic innovation in order to find scientific solutions based on theprinciples and principles of jurisprudence. From the legal and legal point ofview of the link of reproductive power plants as regards to its role in infertilitytreatment, it deserves a serious look. this method of experimental therapy inmedical centers, even in the west, is undergoing the importance of attention to this issue is that the preservation of thegeneration for the Homo sapiens, as well as the improvement and health oftheir lives, may cause severe psychological and psychological harm to thewife, couple or both and may sometimes lead to divorce - which is a majorsocial harm and is considered the most controversial of sacred theology. The need for testicular and ovarian transplantation, the examination and explanation of the legal and legal bases of the license and the lack of authorization and the effects and achievement of this type of coupling for couples, testicular and ovarian hyperstimulation as the main organ of the body, thus resulting in a born child, a legitimate child. According to which all the legal and legal rights and duties of the parent towards the child and the child towards the parents, such as the childchr('39')s origin, the veracity of the will for this type of carriage, the responsibility of the parents against the acts and behaviors of the children and the enjoyment of the children of the benefits Alimony, surname, right of residence, right to citizenship and... Make a difference.

There are a number of factors that are involved in causing the brain death chain. Understanding these factors can help us understand the cause of this chain and prevent it From the perspective of the patients’ families with brain death. Therefore, this study aims to explain the family memberschr('39') experiences of patients with brain death regarding the cause of   brain death chain as a qualitative study.

This qualitative research was conducted as a content analysis. Fourteen first-degree family members of patients with brain death were interviewed using in-depth semi-structured interviews to the point of data saturation. Purposive sampling was conducted on the families of patients with brain death admitted to the intensive care unit of Ayatollah Mousavi Hospital in Zanjan. Conventional content analysis method was used to analyze the data.

In data analysis, the main theme is “brain death chain" and " brain death due to head   trauma", "poor pre-hospital measures", "heavy bleeding in accident", "patient to blame in the accidents "and "brain death due to family disputes"were sub-themes.

Identifying the main causes of brain death chain is very important from the perspective of patientschr('39') families. Because it can create a good mental background for medical staff, especially nurses when cope with such situation.Understanding the condition of the patient and their families and identifying the factors causing the brain death chain by the health care staff can lead to quick and appropriate care to reduce the damage.