Avaliação da hemodinâmica em pacientes com doença cardíaca persistente: uma revisão bibliográfica

Introdução: A avaliação da hemodinâmica em pacientes com cardiopatia persistente é um tópico complexo e multifacetado que requer uma compreensão abrangente da fisiopatologia subjacente e dos fatores de risco associados. Esta revisão bibliográfica fornece um resumo valioso da pesquisa atual no campo e destaca vários temas-chave que surgiram de estudos recentes. Metodologia: foi realizada uma revisão de literatura conduzida para investigar os aspectos clínicos, fisiológicos, patológicos e hemodinâmicos em pacientes com cardiopatia persistente. Foram realizadas buscas em várias bases de dados entre 2010 e 2022, utilizando termos específicos. Os critérios de inclusão foram estudos de coorte, estudos de caso-controle e revisões sistemáticas com amostras maiores que 10 indivíduos. Após uma triagem inicial, 33 artigos foram selecionados para análise. Os artigos foram avaliados quanto à qualidade metodológica e os dados foram agrupados e analisados qualitativamente. Os resultados foram apresentados de forma descritiva, destacando as principais informações encontradas sobre os aspectos clínicos, fisiológicos, patológicos e hemodinâmicos em pacientes cardiopatas resistentes.  Discussão: Uma descoberta notável é que a insuficiência cardíaca crônica continua sendo um grande problema de saúde pública, com quase 5 milhões de casos relatados apenas nos EUA. Apesar dos avanços no tratamento, a taxa de mortalidade dessa condição permanece alta, enfatizando a necessidade de pesquisas contínuas sobre os mecanismos subjacentes e intervenções mais eficazes. Além disso, a revisão identifica vários fatores de risco potenciais para doença cardíaca persistente, incluindo doença renal crônica, obesidade e inflamação. Esses achados sugerem que uma abordagem multidisciplinar para o manejo da doença, incorporando intervenções médicas e de estilo de vida, pode ser mais eficaz para melhorar os resultados dos pacientes. Conclusão: No geral, esta revisão ressalta a necessidade crítica de pesquisas contínuas sobre a fisiopatologia, fatores de risco e tratamento de doenças cardíacas persistentes e fornece informações valiosas sobre possíveis caminhos para futuras investigações

Prudentia Iuris, 1980, n° 01 (número completo)

Contenido: Presentación – Prudentia Iuris / Tomás D. Casares – Jurisdicción internacional directa e indirecta / Werner Goldschmidt – El conocimiento práctico : introducción a sus cuestiones fundamentales / Carlos Ignacio Massini – Ius fasque est : estudio sobre las relaciones entre lo jurídico y lo sagrado en el primitivo derecho romano / Alfredo Di Pietro – El derecho internacional privado actual a la luz del iusnaturalismo clásico / Antonio Boggiano – Documentos – Notas bibliográfica

Prudentia Iuris, 1980, n° 01 (número completo)

Contenido: Presentación – Prudentia Iuris / Tomás D. Casares – Jurisdicción internacional directa e indirecta / Werner Goldschmidt – El conocimiento práctico : introducción a sus cuestiones fundamentales / Carlos Ignacio Massini – Ius fasque est : estudio sobre las relaciones entre lo jurídico y lo sagrado en el primitivo derecho romano / Alfredo Di Pietro – El derecho internacional privado actual a la luz del iusnaturalismo clásico / Antonio Boggiano – Documentos – Notas bibliográfica

Elements for an Analysis of the Genesis and the Significance of the Theology of Politics and the Theory of Totalitarianism of Joseph Ratzinger/Benedict XVI

How far have we come putting into practice what was declared in the Universal Declaration of Human Rights, which this year marks its 70th anniversary? How can the Church respond today to the new challenges threatening these rights, whether relativism, fundamentalism, and persecution or new types of poverty and oppression? And with whom can the Church engage on these issues? With states, religious leaders, international institutions, cultural institutions, or first and foremost with global civil society?In addition, what are the roots of fundamental rights, and what response can there be to the danger of a multiplication of rights that can paradoxically threaten concepts on the rule of law and human dignity

Fundamental Rights and Conflict Among Rights

How far have we come putting into practice what was declared in the Universal Declaration of Human Rights, which this year marks its 70th anniversary? How can the Church respond today to the new challenges threatening these rights, whether relativism, fundamentalism, and persecution or new types of poverty and oppression? And with whom can the Church engage on these issues? With states, religious leaders, international institutions, cultural institutions, or first and foremost with global civil society?In addition, what are the roots of fundamental rights, and what response can there be to the danger of a multiplication of rights that can paradoxically threaten concepts on the rule of law and human dignity? These are the fundamental questions addressedand debated by the experts whose essays appear in this book. Fundamental Rights and Conflicts among Rights is divided into four parts: Genesis and Meaning of the Idea of Religious Liberty, Laicit\ue0 and Natural Law, Birth and Transformation of the Culture of Liberty and Human Rights, and the Multiplication of Rights and the Risk of Destruction of the Idea of Right. Throughout the volume, prestigious international experts analyze these issues

Randomized trial of bilateral gene therapy injection for m.11778G>A MT-ND4 Leber optic neuropathy

Leber hereditary optic neuropathy (LHON) is an important example of mitochondrial blindness with the m.11778G>A mutation in the MT-ND4 gene being the most common disease-causing mtDNA variant worldwide. The REFLECT phase 3 pivotal study is a randomized, double-masked, placebo-controlled trial investigating the efficacy and safety of bilateral intravitreal injection of lenadogene nolparvovec in patients with a confirmed m.11778G>A mutation, using a recombinant adeno-associated virus vector 2, serotype 2 (rAAV2/2-ND4). The first-affected eye received gene therapy; the fellow (affected/not-yet-affected) eye was randomly injected with gene therapy or placebo. The primary end point was the difference in change from baseline of best-corrected visual acuity (BCVA) in second-affected/not-yet-affected eyes treated with lenadogene nolparvovec versus placebo at 1.5 years post-treatment, expressed in logarithm of the minimal angle of resolution (LogMAR). Forty-eight patients were treated bilaterally and 50 unilaterally. At 1.5 years, the change from baseline in BCVA was not statistically different between second-affected/not-yet-affected eyes receiving lenadogene nolparvovec and placebo (primary end point). A statistically significant improvement in BCVA was reported from baseline to 1.5 years in lenadogene nolparvovec-treated eyes: -0.23 LogMAR for the first-affected eyes of bilaterally treated patients (P < 0.01); and -0.15 LogMAR for second-affected/not-yet-affected eyes of bilaterally treated patients and the first-affected eyes of unilaterally treated patients (P < 0.05). The mean improvement in BCVA from nadir to 1.5 years was -0.38 (0.052) LogMAR and -0.33 (0.052) LogMAR in first-affected and second-affected/not-yet-affected eyes treated with lenadogene nolparvovec, respectively (bilateral treatment group). A mean improvement of -0.33 (0.051) LogMAR and -0.26 (0.051) LogMAR was observed in first-affected lenadogene nolparvovec-treated eyes and second-affected/not-yet-affected placebo-treated eyes, respectively (unilateral treatment group). The proportion of patients with one or both eyes on-chart at 1.5 years was 85.4% and 72.0% for bilaterally and unilaterally treated patients, respectively. The gene therapy was well tolerated, with no systemic issues. Intraocular inflammation, which was mostly mild and well controlled with topical corticosteroids, occurred in 70.7% of lenadogene nolparvovec-treated eyes versus 10.2% of placebo-treated eyes. Among eyes treated with lenadogene nolparvovec, there was no difference in the incidence of intraocular inflammation between bilaterally and unilaterally treated patients. Overall, the REFLECT trial demonstrated an improvement of BCVA in LHON eyes carrying the m.11778G>A mtDNA mutation treated with lenadogene nolparvovec or placebo to a degree not reported in natural history studies and supports an improved benefit/risk profile for bilateral injections of lenadogene nolparvovec relative to unilateral injections