Intentionality of organ/tissues donation for transplantation within a Brazilian hospital complex.

OBJECTIVE: Considering the challenges faced by members of the Intrahospital Committee of Organ and Tissue Donation for Transplantation (CIHDOTT) of a Brazilian hospital complex in Santa Casa of Belo Horizonte in the execution of multiple donations of organs and tissues, this study aimed to investigate the issues involved in the intention to donate within this population. This research sought to promote the work of CIHDOTT by planning strategies for conducting of family interviews to best meet the needs of this population, thereby contributing to reduce the wait-list for transplantations in this state hospital of Minas Gerais. METHODS: The survey was performed by applying a standard questionnaire to 602 respondents comprising patients and families/caregivers. The analysis of the collected data was developed from studies of contingency tables based on chi- square and Fisher exact tests. RESULTS: The analysis revealed that 94% of the population to be favorable to donation. It also showed a significant influence of the following factors to determining the likelihood of organ donation: knowledge of religion (35%), spouse's opinion (17%), as well as belief in the possibility of interference or delay of the funeral as a result of donation (6%). CONCLUSION: Although the population expressed a willingness to donate, there were significant contravening factors that may be addressed by professional training and informational activities.

Properties of novel hydroxypropyl methylcellulose films containing chitosan nanoparticles.

In this study, chitosan nanoparticles were prepared and incorporated in hydroxypropyl methylcellulose (HPMC) films under different conditions. Mechanical properties, water vapor and oxygen permeability, water solubility, and scanning and transmission electron microscopy (SEM and TEM) results were analyzed. Incorporation of chitosan nanoparticles in the films improved their mechanical properties significantly, while also improving film barrier properties significantly. The chitosan poly(methacrylic acid) (CS-PMAA) nanoparticles tend to occupy the empty spaces in the pores of the HPMC matrix, inducing the collapse of the pores and thereby improving film tensile and barrier properties. This study is the first to investigate the use of nanoparticles for the purpose of strengthening HPMC films.

Single center experience with a new commercially available thoracic endovascular graft.

PURPOSE: To evaluate the intra-operative performance and clinical outcome of a new commercially available stent-graft for the treatment of thoracic aortic diseases. METHODS AND PATIENTS: From January 2003 to October 2004, 45 consecutive patients received endovascular treatment with the Zenith TX1 device for diseases of the thoracic aorta at a single center in northern Italy. Indications included disease of the descending thoracic aorta in 26 cases, of the aortic arch in 17 cases and of the thoraco-abdominal aorta in two cases. We treated 38 atherosclerotic aneurysms, two post-traumatic aortic ruptures, two penetrating ulcers, two chronic dissections and one case was treated for aortic bleeding after voluntary acid ingestion for attempted suicide. General anesthesia was used in 20 cases. Combined or hybrid endovascular and open surgical repair was performed in 11 patients. Mean follow-up was 7 months (range 1-22 months). RESULTS: Technical success was obtained in 44 patients (98%). One primary type I endoleak occurred (2%). ICU was used in 12 cases with a mean stay of 1 day. The mean hospital stay was 6 days (range 4-13 days). There were no hospital deaths or strokes but one transient paraplegia (2%). A type II endoleak was observed in one case and resolved spontaneously 1 month later. No aneurysm enlargement, endograft migration or structural failures were observed during follow-up. Two late unrelated-deaths were observed. CONCLUSIONS: This stent-graft does not fulfill all the characteristics of the ideal graft, however, it proved to be safe and allowed satisfactory short term results in this group of patients treated at a single center.

Visceral artery aneurysms.

Visceral artery aneurysms (VAA) frequently present as life-threatening emergencies. The purpose of this study was to review our experience with VAA treatment. Between 1988 and April 2002, 31 VAA were treated in 28 patients (14 males, 14 females) with average age of 55 +/- 15 years. The most common locations were the splenic artery (16) and the hepatic artery (7). Three patients underwent emergency surgery, 22 patients had elective open surgery, and 7 patients underwent endovascular treatment. In the surgical group the perioperative mortality rate was 3.6%. The perioperative morbidity rate was 7.1% (one case of respiratory distress manifested in the immediate postoperative period and one urgent case of bilious fistula). In the endovascular group none of the patients died; the perioperative morbidity rate was of 14.3% (one case of hepatic artery thrombosis after failure of gastroduodenal artery aneurysm embolization). Failure of the procedure was 42.9% (3 cases of aneurysm recanalization). In conclusion, we believe that an aggressive surgical approach is justified, even in the case of asymptomatic VAA, because of the low morbidity and mortality rates. Endovascular treatment should be reserved for selected cases.

Surface modification of polystyrene and poly(ethylene terephtalate) by grafting poly(N-isopropylacrylamide).

In this work, poly(N-isopropylacrylamide) (PNIPAAm) was incorporated into previously oxidized PS and PET surfaces by grafting using two photo-initiation pathways. The incorporation of PNIPAAm was observed by drop water contact angle measurements, dyeing with Methylene Blue and AFM images analysis of the virgin and modified polymers. It was verified that the grafting process depends on the chemical surface environment. The grafted surfaces are hydrophilic below 32 degrees C and hydrophobic above this temperature. The transition is due to the incorporated PNIPAAm. This characteristic gives to the grafted materials potential to be applied as biomaterials.