Transplante hepático infantil: As contra indicações sociais trabalhadas pelo serviço social no processo de avaliação junto às famílias de crianças candidatas ao transplante

OBJECTIVE: To identify the nature of the main social side-effects of 89 families ofchildren who require liver transplant, and who were evaluated by the social servicewith the program for hepatic transplant in children at Hospital de Clínicas de PortoAlegre. MATERIALS AND METHODS: A quantitative research project was designed usingexisting data from the registration form of social service, which contains informationregarding children who are candidates to transplant. RESULTS: From a total of 89 families that were evaluated, there was an indication ofimmediate social side-effects in 55 families, or 61.8% of the total; there was also anindication of deficit in the category family relationships in 69.1% of these 55 families;and 25.4% of these 55 families indicated a deficit in the category family cultural aspects.Only one family did not indicate deficit in the category social and economic organization. CONCLUSION: The results indicate the importance of the work of social servicepersonnel for the program of hepatic transplant in children at Hospital de Clínicas dePorto Alegre. Of the 55 families that were evaluated the social service, and thatpresented immediate social side-effects, 34 families, or 61%, were socially preparedto have their child submitted to transplant as a result of the work performed by socialservice.OBJETIVO: Identificar a natureza das principais contra-indicações sociaisapresentadas por 89 famílias de crianças candidatas a transplante de fígado queforam avaliadas pelo Serviço Social no Programa de Transplante Hepático Infantil doHCPA. MATERIAIS E MÉTODOS: Trata-se de uma pesquisa documentada de cunhoquantitativo elaborada a partir de dados existentes no protocolo de atendimento doServiço Social, onde são cadastrados crianças candidatas ao procedimento. RESULTADOS: Do total de 89 famílias avaliadas, 55 delas, equivalente à 61,8%apresentam alguma contra-indicação social imediata. Deste total de 55 famílias, 69,1%apresentaram déficit na categoria relações familiares; 25,4% destas 55 famíliasapresentaram déficit aspecto cultural-familiar. Na categoria organização sócioeconômica apenas uma família não apresentou déficit. CONCLUSÃO: Os resultados indicam a importância do trabalho do assistente socialjunto à equipe do programa de Transplante Hepático Infantil, pois das 55 famíliasavaliadas socialmente e que apresentaram contra-indicação social imediata, 34 delas,equivalente a 61% , estão aptas socialmente para a realização do transplante, a partirdo trabalho desenvolvido pelo serviço socia

Levosimendan beyond inotropy and acute heart failure: Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper

Peer reviewe

Transplante hepático infantil: As contra indicações sociais trabalhadas pelo serviço social no processo de avaliação junto às famílias de crianças candidatas ao transplante

OBJECTIVE: To identify the nature of the main social side-effects of 89 families ofchildren who require liver transplant, and who were evaluated by the social servicewith the program for hepatic transplant in children at Hospital de Clínicas de PortoAlegre. MATERIALS AND METHODS: A quantitative research project was designed usingexisting data from the registration form of social service, which contains informationregarding children who are candidates to transplant. RESULTS: From a total of 89 families that were evaluated, there was an indication ofimmediate social side-effects in 55 families, or 61.8% of the total; there was also anindication of deficit in the category family relationships in 69.1% of these 55 families;and 25.4% of these 55 families indicated a deficit in the category family cultural aspects.Only one family did not indicate deficit in the category social and economic organization. CONCLUSION: The results indicate the importance of the work of social servicepersonnel for the program of hepatic transplant in children at Hospital de Clínicas dePorto Alegre. Of the 55 families that were evaluated the social service, and thatpresented immediate social side-effects, 34 families, or 61%, were socially preparedto have their child submitted to transplant as a result of the work performed by socialservice.OBJETIVO: Identificar a natureza das principais contra-indicações sociaisapresentadas por 89 famílias de crianças candidatas a transplante de fígado queforam avaliadas pelo Serviço Social no Programa de Transplante Hepático Infantil doHCPA. MATERIAIS E MÉTODOS: Trata-se de uma pesquisa documentada de cunhoquantitativo elaborada a partir de dados existentes no protocolo de atendimento doServiço Social, onde são cadastrados crianças candidatas ao procedimento. RESULTADOS: Do total de 89 famílias avaliadas, 55 delas, equivalente à 61,8%apresentam alguma contra-indicação social imediata. Deste total de 55 famílias, 69,1%apresentaram déficit na categoria relações familiares; 25,4% destas 55 famíliasapresentaram déficit aspecto cultural-familiar. Na categoria organização sócioeconômica apenas uma família não apresentou déficit. CONCLUSÃO: Os resultados indicam a importância do trabalho do assistente socialjunto à equipe do programa de Transplante Hepático Infantil, pois das 55 famíliasavaliadas socialmente e que apresentaram contra-indicação social imediata, 34 delas,equivalente a 61% , estão aptas socialmente para a realização do transplante, a partirdo trabalho desenvolvido pelo serviço socia

Different expression and function of the endocannabinoid system in human epicardial adipose tissue in relation to heart disease

BACKGROUND: The endocannabinoid system reportedly plays a role in the pathogenesis of cardiovascular diseases. This system is expressed also in adipose tissue, which could thus be involved in cardiac disorders through modulation of metabolically triggered inflammation. The current study aims to determine the relevance of the endocannabinoid system in epicardial adipose tissue in heart disease. METHODS: Expression of the endocannabinoid receptors CB1 and CB2, and of the endocannabinoid-degrading enzyme, fatty acid amidohydrolase, and activation of protein kinase A (PKA), phospholipase C (PLC), protein kinase C (PKC), endothelial nitric oxide synthase (eNOS) and inducible (i)NOS, and extracellular signal-regulated kinases 1 and 2 (ERK1/2) (a member of the reperfusion-injury salvage kinase pathway), were analyzed by Western blot in patients after coronary artery bypass surgery (ischemics; N = 18) or valve surgery (nonischemics; N = 15) and in preadipocytes isolated from epicardial adipose tissue. RESULTS: In ischemics, the CB1-to-CB2 expression ratio shifted toward CB1 and was accompanied by higher PKA activation. In contrast, in nonischemics, CB2, fatty acid amidohydrolase, PLC and PKC, and ERK1/2 were upregulated. Moreover, NO production and iNOS-to-eNOS ratios were higher in preadipocytes from ischemics. CONCLUSIONS: These results show a different modulation and functioning of the endocannabinoid system in ischemics compared with nonischemics. Hence, while CB2, PLC and PKC, ERK1/2, and eNOS are more strongly expressed in patients without ischemic heart disease, high CB1 and PKA expression is associated with low survival intracellular pathway activation and high iNOS activation in ischemic heart disease patients. The changes in the endocannabinoid system in ischemics may contribute to cardiac dysfunction and therefore represents a potential therapeutic target