Spirituality in Medical Education: Global Reality?

We aim to evaluate studies dealing with the incorporation of spirituality in medical education and to list the most scientific productive countries in this field. A bibliographical review was carried out. the final sample comprised 38 articles, which were divided into sub-topics for a clearer description. From these articles, 31 (81.5%) were provided by US medical schools, 3 (7.8%) by Canadian medical schools and 4 (10.5%) from other countries. the studies in this review indicate a predominance of studies related to health/medicine and spirituality in US and Canadian medical schools. New studies outside North America are needed in order to address what is being taught, whether courses are evaluated and what is the student and faculty opinions regarding this educational topic in multiple cultures.São Paulo Med Spiritist Assoc, BR-04520000 São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilGeorge Washington Univ, Washington, DC USAUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Lysophosphatidic Acid Enhances Stromal Cell-Directed Angiogenesis

Ischemic diseases such as peripheral vascular disease (PVD) affect more than 15% of the general population and in severe cases result in ulcers, necrosis, and limb loss. While the therapeutic delivery of growth factors to promote angiogenesis has been widely investigated, large-scale implementation is limited by strategies to effectively deliver costly recombinant proteins. Multipotent adipose-derived stromal cells (ASC) and progenitor cells from other tissue compartments secrete bioactive concentrations of angiogenic molecules, making cell-based strategies for in situ delivery of angiogenic cytokines an exciting alternative to the use of recombinant proteins. Here, we show that the phospholipid lysophosphatidic acid (LPA) synergistically improves the proangiogenic effects of ASC in ischemia. We found that LPA upregulates angiogenic growth factor production by ASC under two- and three-dimensional in vitro models of serum deprivation and hypoxia (SD/H), and that these factors significantly enhance endothelial cell migration. The concurrent delivery of LPA and ASC in fibrin gels significantly improves vascularization in a murine critical hindlimb ischemia model compared to LPA or ASC alone, thus exhibiting the translational potential of this method. Furthermore, these results are achieved using an inexpensive lipid molecule, which is orders-of-magnitude less costly than recombinant growth factors that are under investigation for similar use. Our results demonstrate a novel strategy for enhancing cell-based strategies for therapeutic angiogenesis, with significant applications for treating ischemic diseases