RESUMO
BACKGROUND: The increase in the waiting list for a liver and the high mortality rate of patients with terminal liver disease represent serious public health problems in Brazil. OBJECTIVE: To analyze donations and liver transplants in the State of Paraná, Brazil. METHOD: A cross-sectional study was carried out with data from 3931 reports of deaths due to brain death and 8146 solid organ transplants made available by the State Transplant System of Paraná between 2011 and 2016. The data related to donation and liver transplantation were analyzed using descriptive statistics and inference. RESULTS: A total of 751 (28.9%) liver donations were carried out. Of these, the greatest chance of effectiveness occurred in patients younger than 50 years OR: 1.94 (CI: 1.60-2.34; P < .01) and male OR: 1.27 (CI: 1.06-1.52; P < .01). A total of 720 (8.8%) liver transplants were performed, most of which were funded by the Unified Health System. There was a significant increase in donations and liver transplants over the years. CONCLUSION: Donor numbers and liver transplants increased in the State but did not meet the need for the waiting list within the analyzed period.
Assuntos
Transplante de Fígado/estatística & dados numéricos , Doadores de Tecidos/provisão & distribuição , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/organização & administração , Transplantes/provisão & distribuição , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Listas de Espera , Adulto JovemRESUMO
BACKGROUND: Few studies have analyzed the results of the organ and tissue donation process for transplants. OBJECTIVES: To analyze donations of organs and tissues for transplants in the Macroregional North of Paraná. MATERIAL AND METHODS: Cross-sectional and retrospective study, using data from 7383 death certificates of eligible donors notified in 2015 by 16 hospitals accredited to the Organ Procurement Organization. The data were analyzed using the prevalence ratio (PR) and the Wald test. RESULTS: Among the 934 eligible donors, the prevalence of effective donations was 23.4% (219) Among the 582 organs and tissues donated, corneas were predominant. Organs became available for donation from younger individuals (PR = 0.992), due to brain death (PR = 2.482), notified by the type III Intra-Hospital Organ and Tissue Donation Commissions for Transplants (PR = 2.016), which took place in intensive care units (PR = 1.471). The relatives interviewed were the partners and/or children (PR = 0.469), and the interviews were held by the nurse (PR = 1.324). CONCLUSION: Effective donations were able to take place through proper organizational structure and trained human resources, highlighting the role of the nurse in the optimization of the organ and tissue donation process for transplants.
Assuntos
Doadores de Tecidos/provisão & distribuição , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/métodos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Estudos Retrospectivos , Obtenção de Tecidos e Órgãos/organização & administraçãoRESUMO
INTRODUCTION: The high morbidity and mortality caused by chronic kidney disease, and consequently, the increase in the need for kidney transplants, makes the evaluation of the kidney donation process relevant to verifying the service's fragility with the goal of optimizing this process. OBJECTIVE: This study analyzed the process of kidney donation in the Northern Macroregional area of Paraná, Brazil. METHOD: This was a cross-sectional and retrospective evaluation study based on 586 reports of deaths provided by the Intra-Hospital Organ Donation and Transplant Tissue Commissions to the Organ Procurement Organization of the Northern Macroregional area of Paraná in Brazil between 2011 and 2015. Data were analyzed by descriptive statistics, prevalence ratio, and Poisson regression. RESULTS: The prevalence of kidney donation was higher among the deaths of individuals younger than 61 years of age (P = .018) due to traumatic brain injury and hemorrhagic cardiovascular accident (P < .001), assisted in private institutions (P = .037), and occurring in the second half of the year (P = .015). CONCLUSION: The process of kidney donation was mainly compromised due to the refusal of the family and was associated with clinical and organizational aspects.
Assuntos
Transplante de Rim , Obtenção de Tecidos e Órgãos/organização & administração , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Transplante de Rim/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Coleta de Tecidos e Órgãos/psicologia , Obtenção de Tecidos e Órgãos/estatística & dados numéricosRESUMO
This article presents an Evolution Strategy (ES)--based algorithm, designed to self-adapt its mutation operators, guiding the search into the solution space using a Self-Adaptive Reduced Variable Neighborhood Search procedure. In view of the specific local search operators for each individual, the proposed population-based approach also fits into the context of the Memetic Algorithms. The proposed variant uses the Greedy Randomized Adaptive Search Procedure with different greedy parameters for generating its initial population, providing an interesting exploration-exploitation balance. To validate the proposal, this framework is applied to solve three different [Formula: see text]-Hard combinatorial optimization problems: an Open-Pit-Mining Operational Planning Problem with dynamic allocation of trucks, an Unrelated Parallel Machine Scheduling Problem with Setup Times, and the calibration of a hybrid fuzzy model for Short-Term Load Forecasting. Computational results point out the convergence of the proposed model and highlight its ability in combining the application of move operations from distinct neighborhood structures along the optimization. The results gathered and reported in this article represent a collective evidence of the performance of the method in challenging combinatorial optimization problems from different application domains. The proposed evolution strategy demonstrates an ability of adapting the strength of the mutation disturbance during the generations of its evolution process. The effectiveness of the proposal motivates the application of this novel evolutionary framework for solving other combinatorial optimization problems.
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Algoritmos , Evolução Biológica , Heurística Computacional , Simulação por Computador , Humanos , Aprendizado de Máquina , Mineração , Mutação , Admissão e Escalonamento de PessoalRESUMO
Retinitis pigmentosa (RP) is a clinically and genetically heterogeneous disease causing progressive degeneration of retinal photoreceptor cells. X-linked RP (XLRP), in which photoreceptor degeneration begins in early childhood and complete blindness often occurs by the fourth decade of life, constitutes the most severe form of this disease. Two genes commonly associated with XLRP have previously been cloned: retinitis pigmentosa GTPase regulator (RPGR) and retinitis pigmentosa 2 (RP2). We sought to identify mutations in these genes in Jordanian families suffering from this disease. Five unrelated Jordanian families with confirmed XLRP were screened for such mutations using direct sequencing. Three mutations were identified in the ORF15 exon of RPGR. The silent g.ORF15+470G>A substitution and the g.ORF15+1822insA insertion in the 3ê-untranslated region were found in both normal and affected male family members at comparable frequencies, and thus were considered normal variants. The third mutation, g.ORF15+588G>A, in which alanine is substituted by threonine, was found in all affected men and one unaffected man in the two families harboring this variant. Thus, this mutation may be pathogenic, but with incomplete penetrance. No RP2 mutations were found among the examined families. Mutation screening of RP patients is essential to understand the mechanism behind this disease and develop treatments. A complete family history is required to identify its inheritance pattern and provide genetic counseling for patients and their families.
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Proteínas do Olho/genética , Doenças Genéticas Ligadas ao Cromossomo X , Peptídeos e Proteínas de Sinalização Intracelular/genética , Proteínas de Membrana/genética , Retinose Pigmentar/genética , Adolescente , Adulto , Criança , Análise Mutacional de DNA , Éxons/genética , Feminino , Proteínas de Ligação ao GTP , Aconselhamento Genético , Ligação Genética , Humanos , Masculino , Mutação , Fases de Leitura Aberta , Linhagem , Fenótipo , Retinose Pigmentar/patologiaRESUMO
One new 5-alkylresorcinol glucoside (1) was isolated from leaves of Cybianthus magnus, along with 12 known compounds (2-13), isolated from four plants belonging to Myrsinaceae family. Their structures were determined on the basis of spectroscopic analysis and by comparison of their spectral data with those reported in the literature. Among the tested molecules, only compound 2 displayed a strong cytotoxic activity with IC50 values ranging between 22 and 100 µM for all cell lines tested. One new 5-alkylresorcinol glucoside (1) was isolated from leaves of Cybianthus magnus, along with 12 known compounds, isolated from four plants belonging to Myrsinaceae family (2, 3 isolated from C. magnus; 4-7, 10 and 11 isolated from Myrsine latifolia; 4, 8 and 9 isolated from Myrsine sessiflora; 6, 7, 10, 12 and 13 isolated from Myrsine congesta). Their structures were determined on the basis of spectroscopic analysis and by comparison of their spectral data with those reported in the literature. So far, only nine 5-alkylresorcinol glucosides were isolated from leaves of Grevillea robusta. Since resorcinols are known to exhibit strong cytotoxic activity, compounds 1 and 2 were tested against cell lines 3T3, H460, DU145 and MCF-7 for cytotoxicity in vitro and compounds 3-13 were tested for their antileishmanial activity. Compound 2 displayed a strong cytotoxic activity with IC50 values ranging between 22 and 100 µM for all tested cell lines. Compounds 3-13 were not active against Leishmania amazonensis amastigotes.
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Glucosídeos/química , Glucosídeos/farmacologia , Primulaceae/química , Resorcinóis/química , Resorcinóis/farmacologia , Animais , Antineoplásicos Fitogênicos/isolamento & purificação , Antineoplásicos Fitogênicos/farmacologia , Linhagem Celular Tumoral , Sobrevivência Celular , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Leishmania/efeitos dos fármacos , Espectroscopia de Ressonância Magnética , Folhas de Planta/química , Raízes de Plantas/química , Espectrometria de Massas por Ionização por ElectrosprayRESUMO
En el presente trabajo se enmarca dentro de la siguiente beca Culminación de Doctorado UBACyT (2012-2014) de la Facultad de Psicología UBA: El concepto de rasgo unario y su relación con la lógica del Uno en el Seminario 20, Aun de J. Lacan, dirigida por el Profesor Roberto Mazzuca. El primero tiene como objetivo principal circunscribir la especificidad del concepto de rasgo unario a la altura del Seminario IX, La Identificación (1961-1962). Para cumplir con el mismo en primer lugar, destacaremos la importancia y la originalidad del concepto mencionado para pensar la identificación propia de la constitución del sujeto. Luego definiremos las siguientes nociones: significante, letra y nombre propio. Al mismo tiempo, distinguiremos estas nociones del rasgo unario...
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Humanos , Identificação Psicológica , Teoria Psicanalítica , PsicanáliseRESUMO
The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ(2) tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation.
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Anoftalmia/reabilitação , Olho Artificial/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ira , Anoftalmia/psicologia , Atitude Frente a Saúde , Criança , Escolaridade , Emoções , Emprego/psicologia , Oftalmopatias/psicologia , Oftalmopatias/reabilitação , Traumatismos Oculares/psicologia , Traumatismos Oculares/reabilitação , Medo , Feminino , Seguimentos , Humanos , Renda , Relações Interpessoais , Masculino , Estado Civil , Pessoa de Meia-Idade , Relações Profissional-Paciente , Qualidade de Vida , Autoimagem , Vergonha , Timidez , Adulto JovemRESUMO
To study whether treatment with adenosine (ADO), an agonist of adenosine receptors, attenuates intestinal dysfunction caused by ischemia (I) and reperfusion (R), we treated rats with ADO (15 mg/kg or saline solution (SS) intravenously before 60 minutes occlusion of the superior mesenteric artery (I) and/or 120 minutes after its release (R). After I or I/R, isolated jejunal segments (2 cm) were mounted in an organ bath to study nerve-mediated contractions stimulated by electrical pulses or KCI with the use of a digital recording system. Thin jejunal slices were stained with hematoxylin and eosin for optical microscopy. Compared with the sham group, jejunal contractions were reduced in I+SS and IR+SS but similar after treatment with ADO (I+ADO and IR+ADO groups). We concluded that rat jejunal enteric nerves were damaged in I+SS and IR+SS but not in the I+ADO and IR+ADO groups. These results suggested that ADO attenuated intestinal dysfunction due to I and R.
Assuntos
Adenosina/farmacologia , Fármacos Gastrointestinais/farmacologia , Jejuno/irrigação sanguínea , Jejuno/efeitos dos fármacos , Traumatismo por Reperfusão/prevenção & controle , Animais , Citoproteção , Modelos Animais de Doenças , Estimulação Elétrica , Sistema Nervoso Entérico/efeitos dos fármacos , Sistema Nervoso Entérico/fisiopatologia , Motilidade Gastrointestinal/efeitos dos fármacos , Jejuno/inervação , Jejuno/patologia , Jejuno/fisiopatologia , Cloreto de Potássio/farmacologia , Ratos , Ratos Wistar , Traumatismo por Reperfusão/patologia , Traumatismo por Reperfusão/fisiopatologiaRESUMO
Colour stability of resin and silicone is an important factor for longevity of facial prostheses. The aim of this study was to evaluate the colour stability of resins and silicone for facial prostheses. Three brands of acrylic resin and one of facial silicone were evaluated considering pigment incorporation for the colourless materials. Ten samples of each material were fabricated and submitted to measurements of chromatic alteration initially and after 90 and 180 days of weathering natural through visual analysis and spectrophotometry. Data were evaluated by ANOVA and Tukey test (p < 0.05). Statistically significant colour alteration was observed among some materials regardless of the period. The materials did not present a statistical difference between 90 and 180 days except for the pigmented heat-polymerized resin. The colour difference between pigmented Silastic MDX4-4210 and colourless Silastic was statistically significant (p < 0.01) in both periods as well as between pigmented and colourless heat-polymerized resin, and between the resins Rapidaflex and Lentaflex. The visual method demonstrated colour alteration in all materials evaluated during the first 90 days of ageing. All materials exhibited colour alteration due to exposure to environment.