II Diretriz Brasileira de Transplante Cardíaco

Universidade de São Paulo Faculdade de Medicina Hospital das ClínicasIIHospital de Messejana Dr. Carlos Alberto Studart GomesUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaInstituto Dante Pazzanese de CardiologiaUniversidade Federal de Minas Gerais Hospital das ClínicasFaculdade de Medicina de São José do Rio PretoPontifícia Universidade Católica do ParanáIHospital Israelita Albert EinsteinInstituto Nacional de Cardiologia, Fundação Universitária do Rio Grande do Sul Instituto de CardiologiaReal e Benemérita Sociedade de Beneficência Portuguesa, São PauloHospital Pró-Cardíaco do Rio de JaneiroSanta Casa do Rio de JaneiroUNIFESP, EPMSciEL

Selective Decrease of Components of the Creatine Kinase System and ATP Synthase Complex in Chronic Chagas Disease Cardiomyopathy

Chronic Chagas disease cardiomyopathy (CCC) affects millions in endemic areas and is presenting in growing numbers in the USA and European countries due to migration currents. Clinical progression, length of survival and overall prognosis are significantly worse in CCC patients when compared to patients with dilated cardiomyopathy of non-inflammatory etiology. Impairment of energy metabolism seems to play a role in heart failure due to cardiomyopathies. Herein, we have analyzed energy metabolism enzymes in myocardium samples of CCC patients comparing to other non-inflammatory cardiomyopathies. We found that myocardial tissue from CCC patients displays a significant reduction of both myocardial protein levels of ATP synthase alpha and creatine kinase enzyme activity, in comparison to control heart samples, as well as idiopathic dilated cardiomyopathy and ischemic cardiomyopathy. Our results suggest that CCC myocardium displays a selective energetic deficit, which may play a role in the reduced heart function observed in such patients

Diverse Applications of Nanomedicine

The design and use of materials in the nanoscale size range for addressing medical and health-related issues continues to receive increasing interest. Research in nanomedicine spans a multitude of areas, including drug delivery, vaccine development, antibacterial, diagnosis and imaging tools, wearable devices, implants, high-throughput screening platforms, etc. using biological, nonbiological, biomimetic, or hybrid materials. Many of these developments are starting to be translated into viable clinical products. Here, we provide an overview of recent developments in nanomedicine and highlight the current challenges and upcoming opportunities for the field and translation to the clinic. \ua9 2017 American Chemical Society

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Diagnostic and prognostic role of myocardial perfusion scintigraphy in kidney transplant candidates: narrative review

PurposeCardiac screening in adult kidney transplant candidates with myocardial perfusion scintigraphy (MPS) can reveal findings associated with increased risk for coronary heart disease events, but the exact value of this screening test is still undetermined.MethodsNarrative review based on the available literature and guidelines on the yield, benefits, and harms of MPS screening in kidney transplant candidates.ResultsAlthough coronary angiography carries low risk in general population, it is not without risk particularly in patients with complex comorbid disease and the use of intravenous contrast media may precipitate a need for hospitalization and death. We could avoid invasive coronary angiography in patients with chronic kidney disease, although with high coronary calcium score, but good left ventricle function and normal perfusion, evaluated by Gated single-photon emission computed tomographic (SPECT) MPS. In fact, although Gated SPECT MPS has not a high sensitivity, it provides some variables that are closely related to sudden death: post-stress and rest-ejection fraction and left ventricular volumes, left ventricle muscle mass, extent of ischemia and scar.ConclusionsGated SPECT MPS is a valid noninvasive cardiac screening test. It can be used as alternative to stress echocardiography in kidney transplant candidates with high cardiovascular risk and a positive or inconclusive exercise tolerance ECG test.Patients with abnormal perfusion and cardiac dysfunction should undergo invasive coronary artery imaging and endovascular treatment, while angiography could be avoided in patients with normal MPI, having good long-term prognosis

Microstructure, texture evolution, mechanical properties and corrosion behavior of ECAP processed ZK60 magnesium alloy for biodegradable applications

Ultra-fine grained ZK60 Mg alloy was obtained by multi-pass equal-channel angular pressing at different temperatures of 250. \ub0C, 200. \ub0C and 150. \ub0C. Microstructural observations showed a significant grain refinement after ECAP, leading to an equiaxed and ultrafine grain (UFG) structure with average size of 600. nm. The original extrusion fiber texture with planes oriented parallel to extrusion direction was gradually undermined during ECAP process and eventually it was substituted by a newly stronger texture component with considerably higher intensity, coinciding with ECAP shear plane. A combination of texture modification and grain refinement in UFG samples led to a marked reduction in mechanical asymmetric behavior compared to the as-received alloy, as well as adequate mechanical properties with about 100% improvement in elongation to failure while keeping relatively high tensile strength. Open circuit potential, potentiodynamic and weight loss measurements in a phosphate buffer solution electrolyte revealed an improved corrosion resistance of UFG alloy compared to the extruded one, stemming from a shift of corrosion regime from localized pitting in the as-received sample to a more uniform corrosion mode with reduced localized attack in ECAP processed alloy. Compression tests on immersed samples showed that the rate of loss of mechanical integrity in the UFG sample was lower than that in the as-received sample

Ni-Doped Titanium Dioxide Films Obtained by Plasma Electrolytic Oxidation in Refrigerated Electrolytes

Porous crystalline Ni-doped TiO2 films were produced using DC plasma electrolytic oxidation in refrigerated H2SO4 aqueous solutions containing NiSO4. The crystalline phase structure consisted of a mixture of anatase and rutile, ranging from ~30 to ~80 wt % rutile. The oxide films obtained at low NiSO4 concentration showed the highest photocurrent values under monochromatic irradiation in the UV-vis range, outperforming pure TiO2. By increasing NiSO4 concentration above a threshold value, the photoelectrochemical activity of the films decreased below that of undoped TiO2. Similar results were obtained using cyclic voltammetry upon polychromatic UV-vis irradiation. Glow discharge optical emission spectrometry (GD-OES) analysis evidenced a sulfur signal peaking at the TiO2/Ti interface. XPS spectra revealed that oxidized Ni2+, S4+ and S6+ ions were included in the oxide films. In agreement with photocurrent measurements, photoluminescence (PL) spectra confirmed that less intense PL emission, i.e., a lower electron-hole recombination rate, was observed for Ni-doped samples, though overdoping was detrimental