ABSTRACT
BACKGROUND: The number of liver transplantations is increasing worldwide, and Brazil ranks in the second position. It has one of the biggest public health care systems, which is responsible for the coordination and financial funding of transplantation procedures. Meeting the demands of such a large system of transplantation has become a challenge, particularly when attempting to minimize costs of scarce and expensive resources. The aim of this study was to investigate the process of donation, the retrieval of organs, and the transplantation itself using engineering methods based on logistics analyses. METHODS: Three steps were used: study planning, data gathering, and data analysis. Researchers surveyed professionals to acquire raw information based on their observations, experience, and knowledge. Then, a data analysis was conducted, putting together all the information gathered during the previous steps. Bias was removed, and conflicting perceptions were resolved in order to have a standard view on the transplantation process. RESULTS: Data was gathered between 2014 and 2018 and included 5502 liver donors and 2678 (48.7%) patients who received liver transplants organs. A total of 2824 organs were refused because of logistics issues (transport and handling). Interviews of health care professionals enabled the design of a process map in which 4 stakeholders were identified: patient, physician, organ, and information. CONCLUSIONS: The liver transplantation process is analyzed based on a supply chain methodology applying this knowledge and putting together medical and engineering sciences to promote better efficiency and outcomes for the transplantation program. Future studies should focus on the implementation of these ideas aiming to promote optimization gains in any step of the process.
Subject(s)
End Stage Liver Disease/surgery , Liver Transplantation/economics , Tissue and Organ Procurement/organization & administration , Transplants/supply & distribution , Brazil , Humans , Models, Organizational , Outcome and Process Assessment, Health Care , Postoperative Period , Tissue and Organ Procurement/economics , Waiting ListsABSTRACT
Calendula officinalis is a phytopharmaceutical believed to inhibit gastric emptying and to have hypoglycemic and gastroprotective effects. We aimed to study the putative effect of an infusion of Calendula officinalis on indomethacin-induced gastric lesions. 30 adult male Wistar rats, divided in 2 groups, received indomethacin 20 mg/kg through gavage. Group A (Study) further received 1 mL of 10 % doses of Calendula officinalis, and group B (Control) received saline, for 2 days. After this period, the stomachs were extracted and examined for lymphocytic and neutrophylic infiltrates, and for mucosal lesions such as ulcers and erosions. We concluded that Calendula officinalis did not significantly influence the appearance of such alterations in the indomethacin-injured gastric mucosa.
La Calendula officinalis es un fitofármaco que se considera inhibe el vaciamiento gástrico y tiene efectos hipoglicémicos y gastroprotectores. En el presente trabajo se estudia el posible efecto de una infusión de Calendula officinalis sobre las lesiones gástricas provocadas por indometacina (dosis de 20 mg/kg) a través de un lavado. El grupo A (estudio) recibió además 1 ml de infusión de Calendula officinalis y al grupo B (control) se le administró solución salina al 10 % durante dos días. Después de este período, se procedió a la extracción de los estómagos y se examinaron en busca de infiltrados linfocíticos y neutrofílicos y de lesiones mucosas, tales como úlceras y erosiones. Se concluye que la Calendula officinalis no influye de manera significativa en la aparición de estas alteraciones en la mucosa gástrica dañada por indometacina.
