Remote cardiac ischemic conditioning: Underlying mechanisms and clinical applications

Despite a significant improvement in the care of acute coronary disease, mortality and morbidity remain important. One explanation for this lies in the fact that the very coronary reperfusion may paradoxically result in additional myocardial injury, through the so-called ischemia-reperfusion injury, partially mitigating the beneficial effects of myocardial reperfusion. Over the past two decades, numerous pharmacological interventions (such as the use of antioxidants, anti-inflammatory, magnesium, glucose/insulin/potassium, rapid normalization of pH) were studied in order to prevent ischemia-reperfusion injury. Despite the promising results obtained in animal experiments, attempts to transpose these results to humans, and consequently to clinical practice, have been disappointing. On the other hand, cardiac ischemic conditioning is an intervention that has produced positive results. Ischemic conditioning refers to the protection induced by short periods of ischemia followed by reperfusion, prior to a major ischemic event. Ischemic stimulus can be applied before (pre-conditioning), during (per-conditioning) or after (post-conditioning) the major ischemic event. An important finding regarding cardiac ischemic conditioning, was that protection could be induced remotely, introducing the concept of remote ischemic conditioning. In this paper, we proposed to review the mechanisms underlying remote ischemic cardiac conditioning and the possible clinical applications, considering more specifically pre and per-conditionin

Physiologic Basis and Pathophysiologic Implications of the Diastolic Properties of the Cardiac Muscle

Although systole was for long considered the core of cardiac function, hemodynamic performance is evenly dependent on appropriate systolic and diastolic functions. The recognition that isolated diastolic dysfunction is the major culprit for approximately fifty percent of all heart failure cases imposes a deeper understanding of its underlying mechanisms so that better diagnostic and therapeutic strategies can be designed. Risk factors leading to diastolic dysfunction affect myocardial relaxation and/or its material properties by disrupting the homeostasis of cardiomyocytes as well as their relation with surrounding matrix and vascular structures. As a consequence, slower ventricular relaxation and higher myocardial stiffness may result in higher ventricular filling pressures and in the risk of hemodynamic decompensation. Thus, determining the mechanisms of diastolic function and their implications in the pathophysiology of heart failure with normal ejection fraction has become a prominent field in basic and clinical research

ADMINISTRAÇÃO COMPLEXA: UMA ANÁLISE TEÓRICO-EMPÍRICA A PARTIR DAS PRÁTICAS EMPREENDIDAS PELOS PRÓ-REITORES DA UNIVERSIDADE FEDERAL DE RONDÔNIA

O presente estudo tem como objetivo fazer uma análise teórico-empírica da teoria da Administração Complexa na Universidade Federal de Rondônia, a partir da atuação dos Pró-Reitores que se encontravam em exercício durante o período de realização da pesquisa (entre abril e maio de 2016). Para atingimento dos fins da pesquisa foram aplicadas entrevistas semiestruturadas com o quadro de pró-reitores em exercício na Universidade Federal de Rondônia no período supracitado e para coleta e tratamento dos dados, a técnica utilizada foi análise de discurso. Metodologicamente a pesquisa pode ser classificada como descritiva de abordagem qualitativa. Os resultados encontrados apontam que há no discurso dos pró-reitores evidências que demonstram proximidade em relação a alguns princípios estabelecidos na teoria da Administração Complexa, porém, muito ainda pode ser feito para que os recursos humanos, financeiros e materiais utilizados na Universidade sejam melhor aproveitados. Ações simples que podem fazer a diferença no dia a dia dos pró-reitores, os quais têm o desafio de empreender políticas e estratégias na Instituição e que consequentemente influenciam no resultado final do trabalho desenvolvido na Universidade, que tem como foco oferecer um ensino superior com qualidade à sociedade