Everton Fernando Alves

Organ and Tissue Donation for Transplantation From Fatal Trauma Victims

INTRODUCTION The aim of this study was to analyze multiple aspects of organ donation after mortality owing to trauma-related causes. METHODS We completed a cross-sectional, retrospective, descriptive study that used data were extracted from monthly death reports and clinical records of fatal external injury victims 2-70 years of age who were assisted at 1 of 4 hospitals in the municipality of Maringá and the surrounding metropolitan area in Paraná state, Brazil, in 2012. RESULTS A total of 871 individuals within the age range for donation died, 15.4% owing to external causes of injury. Of these 134 cases, 80.6% were male and 52.23% were 18-40 years old. A total of 57% of deaths were owing to traffic accidents, 58% of which involved motorcycles. Aggression was a factor in 25% of deaths, with 55% owing to firearm wounds. Approximately 52% of families consented to organ donation when asked. A total of 58% of families who refused consent did not indicate a specific reason. At 62%, the majority of refusals involved brain-dead patients. Approximately 58% of the families did not receive a request for consent. Out of these 78 cases, 83% showed contraindications, 44% had sepsis, 40% hemodilution, and 10% logistical/infrastructural problems. CONCLUSIONS The highest proportion of non donor cases was owing to the lack of a formal request for consent from the family. Thus, continued training for health care professionals on the donation-transplantation process and early identification of potential donors and appropriate organ maintenance is necessary.

Autosomal dominant polycystic kidney disease in hemodialysis patients in southern Brazil

INTRODUCTION Autosomal dominant polycystic kidney disease is the most common hereditary renal disease in humans. OBJECTIVE To examine the prevalence, clinical and laboratory characteristics of patients with polycystic kidneys and relate disease manifestations by gender. METHODS This was an observational and retrospective study. All the medical records of patients with polycystic kidneys who initiated hemodialysis between 1995 and 2012, in four centers that treat patients of the coverage area of the 15th regional health Paraná (Brazil), were analyzed. RESULTS The study included 48 patients with polycystic kidneys, the primary cause of stage 5 CKD. Disease prevalence was one in 10,912 people. The average age of dialysis initiation was 50.7 years and the follow-up time on dialysis until transplantation (36.5 months) was lower among men. Hypertension was the most frequent diagnosis in 73% of patients, predominantly in women (51.4%). The liver cyst was the most frequent extrarenal manifestations in men (60.0%). The death occurred in 10.4% of patients using hemodialysis, and 60% of men. The class of antihypertensive drug used was that acts on the renin-angiotensin system with higher frequency of use among women (53.3%). The post-dialysis urea was significantly higher in men. CONCLUSION The prevalence of the disease is low among hemodialysis patients in southern Brazil. The differences observed between genders, with the exception of the post-dialysis urea, were not significant. The findings are different from those reported in North America and Europe.

A orientação homossexual e as investigações acerca da existência de componentes biológicos e genéticos determinantes

The male and female homosexual orientation has substantial prevalence in humans and can be explained by determinants of various levels: biological, genetic, psychological, social and cultural. However, the biological and genetic evidence have been the main hypotheses tested in scientific research in the world. This article aims to review research studies about the existence of genetic and biological evidence that determine homosexual orientation. Was conducted a review of the literature, using the database MedLine/PubMed and Google scholar. The papers and books were searched in Portuguese and English, using the following keywords: sexual orientation, sexual behavior, homosexuality, developmental Biology and genetics. Was selected papers of the last 22 years. Were found five main theories about the biological components: (1) fraternal birth order, (2) brain androgenization and 2D:4D ratio; (3) brain activation by pheromones; and (4) epigenetic inheritance; and four theories about the genetic components: (1) genetic polymorphism; (2) pattern of X-linked inheritance; (3) monozygotic twins; and (4) sexual antagonistic selection. Concluded that there were many scientific evidence found over time to explain some of biological and genetic components of homosexuality, especially in males. However, today, there is no definitive explanation about what are the determinants of homosexual orientation components.

Qualidade de vida do cuidador de enfermagem e sua relação com o cuidar - doi:10.5020/18061230.2013.p36

Objective: To identify aspects that affect the quality of life of nursing caregivers and their relationship with care in an Intensive Care Unit for Adults (A-ICU). Methods: This was a descriptive study with qualitative approach, taking as subjects 21 professionals who constitute the nursing staff of the A-ICU of a school hospital in Maringa-PR. Unstructured interview was used as a strategy to collect data, conducted between May and June 2009. Data analysis was based on the method of content analysis. The categories identified were: overlooking improvement in quality of life related to the resources in an A-ICU; the quality of life influencing the form of care; interpersonal relationships into the health team reflecting on the quality of life and care. Results: The analysis of caregivers’ speech and the results of the observation showed that there is correlation between the aspects they consider influential in their quality of life and the way of caring for patients in an A-ICU. Conclusion: The findings indicate that, among the influential aspects, the stressful factors overlap the enhancing ones. From this perspective, dealing with caregiver’s suffering might be the starting point for the improvement in quality of care in an A-ICU.