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INTRODUCTION: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. METHODOLOGY: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. RESULTS: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. CONCLUSION: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.
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INTRODUCTION: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. METHODOLOGY: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. RESULTS: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. CONCLUSION: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.
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Introducción Las úlceras porpresión representan un significativo problema para pacientes, profesionales y sistemas sanitarios. Presentan una incidencia y una prevalencia importantes a nivel mundial. Su carácter iatrogénico plantea que su aparición es evitable y su incidencia es un indicador de calidad científico-técnica tanto en el ámbito de la atención primaria como en el de la especializada. El objetivo de esta revisión ha sido identificar los factores de riesgo relacionados con la aparición de úlceras por presión en pacientes críticos. Metodología Se siguieron las recomendaciones de la declaración PRISMA adaptadas a la identificación de estudios sobre factores de riesgo. Se ha realizado una revisión sistemática cualitativa de estudios primarios a través de una búsqueda en Pubmed, The Cochrane Library, Scopus y Web of Science. Se consideraron las limitaciones metodológicas en estudios observacionales. Resultados De 200 referencias bibliográficas, 17 cumplieron nuestros criterios de selección. Estos estudios incluyeron 19.363 pacientes ingresados en unidades de cuidados intensivos. Seis se clasificaron como de calidad fuerte y 11 de calidad moderada. Los factores de riesgo que aparecieron más frecuentemente asociados al desarrollo de úlceras por presión incluyeron: edad, tiempo de estancia en UCI, diabetes, tiempo de PAM <60-70mmHg, ventilación mecánica, duración de la ventilación mecánica, terapia de hemofiltración venovenosa continua o diálisis intermitente, tratamiento con drogas vasoactivas, con sedantes y cambios posturales. Conclusiones No aparecen factores de riesgo que por sí mismos puedan predecir la aparición de la úlcera por presión. Más bien se trata de una interrelación de factores que incrementan la probabilidad de su desarrollo.
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Úlcera , Cuidados Críticos , IdosoRESUMO
Maternal low protein (MLP) diets in pregnancy and lactation impair offspring brain development and modify offspring behavior. We hypothesized multigenerational passage of altered behavioral outcomes as has been demonstrated following other developmental programming challenges. We investigated potential multigenerational effects of MLP in rat pregnancy and/or lactation on offspring risk assessment behavior. Founder generation mothers (F0) ate 20% casein (C) or restricted (R) 10% casein diet, providing four groups: CC, RR, CR, and RC (first letter pregnancy, second letter lactation diet) to evaluate offspring (F1) effects influenced by MLP in F0. On postnatal day (PND 250), F1 males were mated to non-colony siblings producing F2. On PND 90, F2 females (in diestrous) and F2 males were tested in the elevated plus maze (EPM) and open field. Corticosterone was measured at PND 110. Female but not male CR and RC F2 made more entries and spent more time in EPM open arms than CC females. Overall activity was unchanged as observed in male F1 fathers. There were no open field differences in F2 of either sex, indicating that multigenerational MLP effects are due to altered risk assessment, not locomotion. MLP in pregnancy reduced F1 male and F2 female corticosterone. We conclude that MLP in pregnancy and/or lactation increases the innate tendency to explore novel environments in F2 females via the paternal linage, suggesting lower levels of caution and/or higher impulsiveness to explore unknown spaces. Further studies will be necessary to identify the epigenetic modifications in the germ line through the paternal linage.
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Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/genética , Dieta com Restrição de Proteínas/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Caracteres Sexuais , Fatores Etários , Análise de Variância , Animais , Corticosterona , Comportamento Exploratório/fisiologia , Feminino , Lactação , Masculino , Aprendizagem em Labirinto/fisiologia , Gravidez , Ratos , Medição de Risco , Assunção de RiscosRESUMO
INTRODUCTION: Current liver donation rates are insufficient to cover transplant needs. Therefore, it is essential to promote living liver donation (LLD) given the ever decreasing morbidity and mortality in the donor and the improving results in the recipient. LLD is becoming increasingly accepted. However, in the health care system, a percentage of the personnel are not in favor. OBJECTIVE: To analyze the attitude of personnel in surgical services in Spain and Latin-America hospitals toward LLD. MATERIALS AND METHODS: As part of the "International Collaborative Donor Project," a random sample was taken and stratified according to surgical service and job category in 10 hospitals; three in Spain, five in Mexico, and two in Cuba (n = 496). Attitude was evaluated using a validated survey that was completed anonymously and self-administered. RESULTS: Eighty-six percent (n = 425) of respondents were in favor of related living liver donation, and 30% (n = 147) were in favor if it were not related. According to country, 88% of the Mexican respondents were in favor of living liver donation, 85% of the Cubans, and 82% of the Spanish (P > .05). In the multivariate analysis of the variables with most weight affecting attitude toward LLD, the following significant associations were found: (1) a favourable attitude toward living kidney donation (odds ratio [OR] = 91; P < .001); (2) acceptance of a donated living liver if one were needed (OR = 11; P < .001); and (3) family discussion about donation and transplantation (OR = 2.581; P = .037). CONCLUSIONS: Attitude toward related living liver donation was very favorable among hospital personnel in Spanish and Latin American surgical services.
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Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Transplante de Fígado/psicologia , Doadores Vivos/psicologia , Centro Cirúrgico Hospitalar , Obtenção de Tecidos e Órgãos , Adulto , Altruísmo , Distribuição de Qui-Quadrado , Compreensão , Cuba , Características Culturais , Feminino , Doações , Humanos , Transplante de Rim/psicologia , Masculino , México , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Espanha , Inquéritos e Questionários , Recursos HumanosRESUMO
BACKGROUND: Healthcare assistants are an important group of workers who can influence public opinion. Their attitudes toward organ donation may influence public awareness of healthcare matters; negative attitudes toward donation and transplantation could have a negative impact on public attitudes. Our objective was analyze the attitudes of healthcare assistants, in Spanish and Mexican healthcare centers toward organ donation and determine factors affecting them using a multivariate analysis. MATERIAL AND METHODS: As part of the "International Collaborative Donor Project," 32 primary care centers and 4 hospitals were selected in Spain and 5 hospitals in Mexico. A randomized sample of healthcare assistants was stratified according to healthcare services. Attitudes were evaluated using a validated questionnaire of the psychosocial aspects of donation, which was self-completed anonymously by the respondent. Statistical analysis used the chi-square test, Student t test, and logistic regression analysis. RESULTS: Of 532 respondents, 66% in favored donation and 34% were against it or undecided. Upon multivariate analysis, the following variables had the most weight: 1) country of origin (Mexicans were more in favor than Spanish; odds ratio [OR]) = 1.964; P = .014); 2) a partner with a favorable attitude (OR = 2.597; P = .013); 3) not being concerned about possible bodily mutilation after donation (OR = 2.631; P = .006); 4) preference for options apart from burial for handling the body after death (OR = 4.694; P < .001) and 5) accepting an autopsy if one was needed (OR = 3.584; P < .001). CONCLUSIONS: The attitudes of healthcare assistants toward organ donation varied considerably according to the respondent's country of origin. The psycho-social profile of a person with a positive attitude to donation was similar to that described within the general public.
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Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos , Altruísmo , Atitude Frente a Morte , Autopsia , Sepultamento , Distribuição de Qui-Quadrado , Compreensão , Características Culturais , Medo , Doações , Humanos , Modelos Logísticos , México , Análise Multivariada , Razão de Chances , Espanha , Inquéritos e QuestionáriosRESUMO
Developmental programming resulting from a suboptimal intrauterine environment can predispose offspring to a wide-range of lifelong health complications. Little is known about the effects maternal protein restriction during pregnancy and/or lactation has on offspring neurodevelopment. We hypothesized that maternal isocaloric low protein diet during pregnancy and/or lactation would negatively influence male offspring affect and risk assessment behaviors as measured by elevated plus maze and open field tests. Control mothers received 20% casein (C) and restricted mothers (R) 10% casein to provide four groups: CC, RR, CR, and RC (first letter pregnancy diet and second letter lactation diet) to evaluate effects of maternal diet on offspring risk assessment, anxiety and exploratory behaviors. Elevated plus maze results showed an effect of pre- and/or postnatal diet manipulation in open arm time (p<0.05) with increases seen in the RR (157±22.7s), CR (137±23.2s) and RC (146.8±10.8s) offspring relative to CC (52±8.6s) offspring. This behavior indicates decreased avoidance (less anxiety) and increased exploration by experimental groups. However, in the open field test the RR (17±4.2 entries) offspring entered the center zone less than the CC (35±6.6 entries) offspring thus exhibiting increased anxiety with no other groups showing effects. Elevated levels of corticosterone were measured before, during and after immobilization in the RR compared to CC offspring. These findings show protein restriction during critical periods of development negatively program offspring behavior. The underlying anatomical structures affected remain to be elucidated.
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Ansiedade/fisiopatologia , Comportamento Animal/fisiologia , Dieta com Restrição de Proteínas , Comportamento Exploratório/fisiologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Animais , Animais Recém-Nascidos , Feminino , Masculino , Atividade Motora/fisiologia , Gravidez , RatosRESUMO
Maternal protein deficiencies can developmentally program offspring to lifelong dysfunction of many physiological systems. We hypothesized that maternal isocaloric low protein diet during fetal and early postnatal development would negatively affect female offspring anxiety, exploration, associative learning and motivation as measured by the elevated plus maze (EPM), open field test (OFT), operant conditioning and the progressive ratio task, respectively. Control mothers (C) received a 20% casein diet and restricted mothers (R) a 10% casein diet to provide four groups: CC, RR, CR, and RC (first letter pregnancy diet and second lactation diet) to enable evaluation of offspring effects influenced by maternal diet during pregnancy and lactation. Maternal protein restriction decreased open arm time and distance in RR and RC offspring, increased anxiety behavior, in the EPM. In the OFT, the RR and RC offspring displayed decreased exploration (increased stress) as indexed by decreased distance in the center zone. These behaviors in the EPM and OFT was associated with increased corticosterone levels during an immobilization test in the RR offspring with intermediary effects in the RC offspring. Learning impairment was observed in the RR, CR and RC offspring during fixed ratio 5 schedule of reinforcement. Motivational effects were measured in RR offspring responding less, decreased motivation, and CR offspring making more responses, increased motivation, than CC offspring. These findings reveal the negative effects of developmental protein restriction on female offspring behavior. The underlying basis for these negative outcomes remains to be elucidated.
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Transtornos de Ansiedade/fisiopatologia , Transtornos da Nutrição Fetal/fisiopatologia , Deficiências da Aprendizagem/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Deficiência de Proteína/fisiopatologia , Animais , Transtornos de Ansiedade/etiologia , Comportamento Animal/fisiologia , Modelos Animais de Doenças , Feminino , Lactação/fisiologia , Deficiências da Aprendizagem/etiologia , Gravidez , RatosRESUMO
INTRODUCTION: The promotion of different means of procuring both deceased and living organs (kidney and liver) is a necessity given the current organ shortage. Emergency department personnel are involved in the donation and transplantation process. Our objective was to analyze the attitude to the different kinds of organ donation of emergency services personnel in hospital centers in Spain and Mexico. MATERIALS AND METHODS: A randomized sample was obtained from the "International Collaborative Donor Project" and was stratified according to emergency services and job category in nine hospitals, in Spain and in Mexico (n = 22). Attitude was evaluated using a validated survey. RESULTS: Of the respondents, 76% were in favor of deceased organ donation and 24% were not in favor. This attitude toward deceased donation was associated with the respondent's country of origin, age, and job category; Mexicans (P = .036), younger respondents (P = .023), and physicians were most in favor (P < .001). With regard to attitude toward living kidney donation, 89% were in favor of related donation. Regarding living liver donation, 85% were in favor of related donation. In attitude toward living kidney and liver donation, relevant factors were related to donation and transplantation. CONCLUSIONS: Professionals in emergency departments in hospital centers in Spain and Mexico had a favorable attitude toward the different kinds of donation, although it was less favorable than the attitude reported in other professional hospital groups.
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Serviço Hospitalar de Emergência , Transplante de Órgãos , Recursos Humanos em Hospital/psicologia , Obtenção de Tecidos e Órgãos , Atitude Frente a Saúde , Humanos , Doadores Vivos , Recursos HumanosRESUMO
Suboptimal developmental environments program offspring to lifelong health complications including affective and cognitive disorders. Little is known about the effects of suboptimal intra-uterine environments on associative learning and motivational behavior. We hypothesized that maternal isocaloric low protein diet during pregnancy and lactation would impair offspring associative learning and motivation as measured by operant conditioning and the progressive ratio task, respectively. Control mothers were fed 20% casein (C) and restricted mothers (R) 10% casein to provide four groups: CC, RR, CR, and RC (first letter pregnancy diet and second letter lactation diet), to evaluate effects of maternal diet on male offspring behavior. Impaired learning was observed during fixed ratio-1 operant conditioning in RC offspring that required more sessions to learn vs. the CC offspring (9.4±0.8 and 3.8±0.3 sessions, respectively, p<0.05). Performance in fixed ratio-5 conditioning showed the RR (5.4±1.1), CR (4.0±0.8), and RC (5.0±0.8) offspring required more sessions to reach performance criterion than CC offspring (2.5±0.5, p<0.05). Furthermore, motivational effects during the progressive ratio test revealed less responding in the RR (48.1±17), CR (74.7±8.4), and RC (65.9±11.2) for positive reinforcement vs. the CC offspring (131.5±7.5, p<0.05). These findings demonstrate negative developmental programming effects due to perinatal isocaloric low protein diet on learning and motivation behavior with the nutritional challenge in the prenatal period showing more vulnerability in offspring behavior.
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Dieta com Restrição de Proteínas/efeitos adversos , Aprendizagem/fisiologia , Motivação , Animais , Animais Recém-Nascidos , Condicionamento Operante , Feminino , Humanos , Lactação , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Ratos , Ratos WistarRESUMO
INTRODUCTION: Administrative personnel from healthcare centers are an important opinion group given their direct relationship to patients and the general public. OBJECTIVE: The objective of this study was to analyze the attitudes of administrative personnel in Spanish and Mexican healthcare centers toward various kinds of donation. MATERIAL AND METHODS: A random selection of 418 administrative staff from 32 primary care centers and 9 hospitals in Spain and Mexico ("Proyecto Donante, Murcia") used a validated questionnaire to explore attitudes. RESULTS: Most (76%) respondents favored deceased donation. Mexican workers had the most favorable attitude (P<.001). Factors influencing this attitude (P<.05) were as follows: type of healthcare center, clinical service, personal experience of organ donation and transplantation (ODT), attitude toward living donation, attitude toward the donation of a family member's organs, discussion of ODT, partner's attitude toward ODT, participation in pro-social activities, and variables related to attitudes toward the body. Most respondents (89%) favored related living kidney donation (LKD) and 87% favored living liver donation (LLD). Mexican respondents showed the most favorable attitudes (P<.05). Factors influencing this attitude (P<.05) were as follows: personal experience of ODT, belief that a transplant is needed, willingness to accept a living organ, family discussion about ODT, partner's attitude about the matter, and respondent's awareness of the view of his or her religion toward ODT. CONCLUSION: Attitudes toward deceased organ donation were not favorable among administrative personnel from Spanish compared with Mexican centers, although attitudes toward LKD and LLD were favorable in both countries.
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Pessoal Administrativo , Atenção Primária à Saúde/organização & administração , Obtenção de Tecidos e Órgãos , Transplante , Atitude , Família/psicologia , Humanos , Internacionalidade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Transplantation hospitals have played a key role in developing deceased organ donation and transplantation (ODT). To reduce the number of deaths on the transplant waiting list, it is essential to encourage living liver donation (LLD). Involvement of personnel in these hospitals is crucial. PURPOSE: We analyzed the attitudes toward LLD among hospital personnel in Spain, Mexico, and Cuba. MATERIALS AND METHODS: Data were obtained from 5 transplant hospitals in Spain, Mexico, and Cuba. The sample was stratified according to job category and type of service (n=2273). A validated questionnaire about living donation was used as the instrument. RESULTS: Most respondents (82%) were in favor of related LLD. If the LLD was not related, acceptance fell to 21%. A total of 85% of physicians, 79% of nursing personnel, 74% of nursing assistants, and 83% of auxiliary staff were in favor (p<.001). A favorable attitude toward LLD was associated (P<.05) with age (37±10 y vs 39±10 y), a favorable attitude toward deceased donation, a belief that a possible transplant is needed, acceptance of LLD if necessary, a favorable attitude toward living kidney donation, family discussion about ODT, a partner's favorable attitude toward ODT, an intention to participate in prosocial activities, being a Catholic, and a belief that one's religion is in favor of ODT. CONCLUSIONS: Personnel from Spanish, Mexican, and Cuban transplantation hospitals have favorable attitudes toward LLD. This suggests that there may be an increase in LLD in the future, provided that there is the necessary sociopolitical and economic support.
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Atitude Frente a Saúde , Hospitais Especializados/organização & administração , Doadores Vivos , Cuba , Humanos , México , Análise Multivariada , EspanhaRESUMO
INTRODUCTION: Xenotransplantation is far from becoming a clinical reality. However, in vital organs it could be used as a bridge until a human organ becomes available, in an emergency situation. We analyzed the attitude toward xenotransplantation among personnel in transplant-related services in several hospitals in Spain and Latin America. METHODS: A random sample stratified by type of service and job category (n = 738), in transplant-related services (procurement units, transplant units, and transplant patient follow-up units) was examined in eight hospital centers from three different countries: Spain (n = 349), Mexico (n = 269), and Cuba (n = 120). A self-administered validated questionnaire was completed anonymously. RESULTS: Based on the assumption that all the results of xenotransplantation were similar to those achieved with human donors, most respondents [66% (n = 484)] would be in favor. The employees from Cuban centers had the most favorable attitudes (72% in favor), followed by the Spanish (64%) and the Mexicans (61%; P = .013). However, the differences were mainly determined by job category: Physicians showed the most favorable attitudes and auxiliary staff the least (67% vs 40%; P = .010). Attitudes were significantly related to beliefs about different types of human donation [deceased (P < .001) and living (P < .001)], the possibility of needing a transplant for oneself (P < .001), and a favorable attitude toward donating the organs of a deceased family member (P = .004). CONCLUSIONS: Currently, a third of health care employees working in transplant-related services are not in favor of xenotransplantation. More information should be provided about the subject, especially in centers with preclinical xenotransplantation programs.
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Recursos Humanos em Hospital/psicologia , Transplante Heterólogo/psicologia , Fatores Etários , Animais , Atitude Frente a Saúde , Cadáver , Cuba , Cultura , Feminino , Humanos , Doadores Vivos , Masculino , Corpo Clínico Hospitalar/psicologia , México , Recursos Humanos de Enfermagem Hospitalar/psicologia , Caracteres Sexuais , Espanha , Inquéritos e Questionários , Doadores de Tecidos , Transplante/psicologiaRESUMO
INTRODUCTION: Living donor kidney (LKD) transplantation provides better results than deceased donor donation, involving minimum risk for the donor. However, LKD donation rates are low in most countries. We analyzed attitudes toward LKD in transplant hospitals in Spain, Mexico, and Cuba. MATERIALS AND METHODS: Data were obtained from five transplant hospitals through the International Collaborative Program "Proyecto Donante Vivo, Murcia" in three countries: Spain (n = 1168), Mexico (n = 903), and Cuba (n = 202). The random sample (2273 employees) was stratified according to job category. The instrument used to evaluate attitude was a validated questionnaire. Statistical analysis included Student t test, the chi(2) test, and multivariate analysis. RESULTS: Eighty eight percent (n = 2002) of Spanish, Mexican, and Cuban transplant hospital personnel were in favor of related LKD and 24% nonrelated LKD (n = 555). Attitudes were more favorable among centers in Cuba 97% (n = 195), followed by Mexico 88% (n = 793) and by Spain 87% (n = 1014; P < .001). According to job category, 91% (n = 617) of physicians were in favor, 88% (n = 543) of nurses, 85% (n = 198) of health care assistants, and 85% (n = 198) of auxiliary personnel. Attitudes were related to variables of: attitude toward deceased donation (P < .001), discussion about organ donation and transplantation (P < .001), concern about body mutilation after donation (P = .001), a possible need for a transplant in the future (P < .001), and attitude toward living liver donation (P < .001). CONCLUSIONS: Attitudes toward LKD in Hispanic/Latin Transplant Hospitals were favorable and could encourage an increase in LKD in the coming years assuming suitable sociopolitical and economic condition, as well as support from nephrologists.
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Atitude Frente a Saúde , Transplante de Rim/psicologia , Doadores Vivos , Recursos Humanos em Hospital/psicologia , Atitude , Cuba , Feminino , Hospitais Especializados/estatística & dados numéricos , Humanos , Transplante de Rim/métodos , Laparoscopia , Masculino , Estado Civil , México , Religião , Comportamento Social , Espanha , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: The attitudes of specialist physicians toward organ donation and transplantation are of great interest because promotion of this activity depends on them. Our objective was to analyze the attitudes of residents in health centers in Spain (MIR) and in Mexico (ENARM). MATERIALS AND METHODS: A random stratified sample was obtained in six teaching hospitals: two in Spain (n = 246) and four in Mexico (n = 139) as part of the International Collaborative Program "Proyecto Donante, Murcia." The sample consisting of 385 trainee physicians completed a psychosocial questionnaire as the instrument to test their opinions. RESULTS: Most residents (93%; n = 359), were in favor of deceased organ donation with 90% (n = 348) in favor of living kidney donation and 87% (n = 335) in favor of liver donation. Attitudes toward donation were similar among Spanish and Mexican residents regarding deceased donation (93% vs 94%; P > .05), living kidney donation (88% vs 94%; P > .05), and living liver donation (86% vs 89%; P > .05). None of the attitudes toward donation was associated with the classic psychosocial factors related to attitudes toward donation or job factors. Discussion within the family was associated with more positive attitudes toward deceased donation (P < .001), living donation of the kidney (P = .01), and of the liver (P = .019). CONCLUSION: Attitudes toward various types of donation were favorable among both Spanish and Mexican trainee physicians, so that they could potentially act as a group to promote this activity, raising hopes for increased donation rates in the future.
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Atitude Frente a Saúde , Hospitais de Ensino , Internato e Residência , Médicos/psicologia , Inquéritos e Questionários , Fatores Etários , Cadáver , Cultura , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Transplante de Rim/psicologia , Transplante de Fígado/psicologia , Doadores Vivos , Masculino , Estado Civil , México , Análise Multivariada , Espanha , Doadores de TecidosRESUMO
OBJECTIVE: To evaluate in a canine model the induction of tolerance to renal transplantation after splenectomy and splenosis. MATERIALS AND METHODS: This prospective, experimental, comparative, longitudinal study included 4 experimental groups, each comprising 4 dogs. Group 1 (control group) underwent renal transplantation only; group 2 underwent renal transplantation and splenectomy; group 3 underwent renal transplantation and splenosis; and group 4 underwent renal transplantation, splenectomy, and splenosis. Survival and degree of rejection were compared between the 4 groups. RESULTS: Splenosis improved renal function after transplantation, as indicated by increased serum creatinine concentration (group 3, 6.2 mg/dL vs group 1, 12.9 mg/dL). Comparison of weighted survival curves (corrected for degree of rejection) demonstrated a significant difference between group 2 (66.0 days) and group 4 (66.2 days) vs group 1 (52.7 days) and group 3 (41.2 days) (P = .05, Wilcoxon rank sum test). CONCLUSION: These results suggest that in this experimental model of renal transplantation, splenosis and splenectomy induce clinical tolerance, as indicated by improved renal function and prolonged recipient survival.
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Tolerância Imunológica , Transplante de Rim/imunologia , Baço/transplante , Esplenose/imunologia , Animais , Peso Corporal , Creatinina/sangue , Cães , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/mortalidade , Hemoglobinas/metabolismo , Transplante de Rim/mortalidade , Contagem de Leucócitos , Masculino , Modelos Animais , Estudos Prospectivos , Esplenectomia , Análise de SobrevidaRESUMO
The membrane permeability transition (MPT) induced by Ca2+ and Pi or Asi was studied in rat kidney mitochondria. Membrane potential, Ca2+ transport and swelling were used to monitor the MPT. Asi promoted a faster and more extensive collapse of membrane potential, Ca2+ release and swelling than Pi. The MPT induced by Pi was fully blocked by Mg(2+)+ADP, spermine+ADP, Mg(2+)+ cyclosporin A (CSA), and ADP+CSA. In contrast, the MPT induced by Asi was only prevented, although not completely, by CSA+Mg2+ or ADP+CSA. Asi, but not Pi, was able to cause collapse of membrane potential in the presence of Sr2+. Carboxyatractyloside (CAT) produced collapse of membrane potential at a lower concentration in the presence of Asi+Ca(2+)+ADP than with Pi+Ca(2+)+ADP. The addition of Pi+Ca2+ to [14C]-ADP loaded mitochondria brought about a greater ADP release than Asi+Ca2+. The ADP release was CAT-sensitive with Pi but it was only partially blocked by Asi. The diminution of external pH did not inhibit the MPT induced by Pi or Asi. The results of this study suggest that the adenine nucleotide translocase does not have an essential role in the MPT induced by Asi+Ca2+.