Background
Major advances have been made in heart transplantation, but there is a discrepancy between the number of patients potentially treatable by transplantation and the limited number of viable ...grafts. The aim of this study was to evaluate the reasons for refusal of donor hearts.
Methods
This was a retrospective analysis of donor data from an organ procurement organization in the state of São Paulo (Brazil) between 2010 and 2012. Fisher's exact test, Student's t‐test, and the Mann–Whitney U‐test were used in the statistical analysis.
Results
Only 26 (7.9%) of 328 potential heart donors actually became donors. Most donors were men (18/26, 69.2%), Caucasians (14/26, 53.8%), and had a mean age of 23.5 yr. There were significant associations of use of donor hearts with the variables: brain death after trauma (p = 0.002), history of hypertension (p = 0.001), electrocardiographic changes (p = 0.007), and age (p = 0.001). Older age (n = 101, 33.4%) was the main reason for refusal of donor hearts, followed by poor medical history (n = 44, 14.6%), cardiac arrest of the donor during donor care (n = 25, 8.3%), use of vasopressor drugs (n = 23, 7.6%), and hemodynamic instability (n = 20, 6.6%).
Conclusions
Age, poor medical history, cardiac arrest, use of vasopressors, and hemodynamic instability were the most prevalent reasons for refusal of donor hearts. Echocardiogram evaluation is a potential intervention to improve heart transplantation conversion in Brazil.
RESUMO O objetivo deste artigo é reintroduzir o problema teórico da estratégia política emancipatória e do sujeito social no debate contemporâneo em torno dos novos movimentos sociais e de seus usos ...das novas tecnologias de informação e comunicação. Com o foco voltado para os grandes eventos que ocorreram nas ruas do Brasil em junho de 2013, o artigo discute a legislação brasileira e sul-americana de mídia e analisa a cobertura desses eventos pelos meios comerciais e alternativos, pela lente das teorias da luta cultural e da guerra de posição, de Gramsci.Palavras-chave: Estratégia; Mídia Comercial e Alternativa; Internet; “Jornadas de Junho”.ABSTRACT The aim of this paper is to re-introduce, in the contemporary debate about new social movements and their use of new information and communication technologies, the theoretical problem of political emancipatory strategy and of the social subject. Focusing on the big events that happened in the streets of Brazil in June 2013, the paper discusses Brazilian and South-American legislation on media and analyzes the coverage of these events by commercial and alternative media, through the lens of Gramsci's theories of cultural struggle and war of position.Keywords: Strategy; Commercial and Alternative Media; Internet; “June Journeys”.
Abdominal aortic aneurysm (AAA) is a pathological enlargement of infrarenal aorta close to the aortic bifurcation, and it is an important cause of mortality in the elderly. Therefore, the biomarker ...identification for early diagnosis is of great interest for clinical benefit. It is known that microRNAs (miRNAs) have important roles via target genes regulation in many diseases. This study aimed to identify miRNAs and their target genes involved in the pathogenesis of AAA.
Tissue samples were obtained from patients who underwent AAA surgery and from organ donors (control group). Quantitative PCR Array was applied to assess 84 genes and 384 miRNAs aiming to identify differentially expressed targets (AAA n = 6, control n = 6), followed by validation in a new cohort (AAA n = 18, control n = 6) by regular qPCR. The functional interaction between validated miRNAs and target genes was performed by the Ingenuity Pathway Analysis (IPA) software.
The screening cohort assessed by PCR array identified 10 genes and 59 miRNAs differentially expressed (≥2-fold change, p<0.05). Among these, IPA identified 5 genes and 9 miRNAs with paired interaction. ALOX5, PTGIS, CX3CL1 genes, and miR-193a-3p, 125b-5p, 150-5p maintained a statistical significance in the validation cohort. IPA analysis based on the validated genes and miRNAs revealed that eicosanoid and metalloproteinase/TIMP synthesis are potentially involved in AAA.
Paired interactions of differentially expressed ALOX5, PTGIS, CX3CL1 genes, and miR-193b-3p, 125b-5p, 150-5p revealed a potentially significant role of the eicosanoid synthesis and metalloproteinase/TIMP pathways in the AAA pathogenesis.
During pregnancy, it is not expected for pregnant women to experience a heart attack, considering their age group and the incidence of comorbidities in this population. However, we should always be ...mindful of relevant precautions because, although rare, a heart attack can indeed occur in pregnant women. The classic symptom of a heart attack is chest pain, and it is not uncommon to face diagnostic challenges since numerous more common conditions during pregnancy can mimic this symptom, such as reflux, anxiety, and musculoskeletal pain. If a pregnant woman experiences any episode of chest pain during pregnancy, clinical evaluation is necessary, bearing in mind that although rare, it is among the possible types of heart attacks. The treatment of a heart attack during pregnancy is extremely complex due to the scarcity of clinical data, challenges in drug management, and the physiological changes of pregnancy, as well as the stress of child birth leading to an increase in cardiac effort. Adequate prenatal care and support from referral hospital scan make a difference. In this report, we present a case of a pregnant patient with ST-segment Elevation Myocardial Infarction (STEMI).
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