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Resumo O infarto agudo do miocárdio é o agravo que mais acomete a população, sendo o tempo entre a ocorrência do evento e a assistência decisivo para um melhor prognóstico. As tecnologias de informação e comunicação associadas a um aplicativo móvel podem auxiliar na brevidade no atendimento, especialmente se o indivíduo acometido pelo infarto entender esses sinais e sintomas rapidamente. Objetivo: Relatar o desenvolvimento de um aplicativo móvel em saúde para apoio ao paciente com sinais de Infarto Agudo do Miocárdio. Pesquisa do tipo desenvolvimento tecnológico realizado em duas etapas: pré-produção (levantamento bibliográfico sobre os fatores de risco e comorbidades relacionadas ao infarto e análise de aplicativos similares) e produção, baseada na estratégia do Design Thinking. Para o desenvolvimento do aplicativo, S.O.S Infarto, utilizou-se dos frameworks Apache Cordova e Ionic. A elaboração do escore de avaliação de risco de IAM, considerou as variáveis dor, história clínica e presença de sinais e sintomas de IAM. As funcionalidades do aplicativo são, cadastro, história clínica, sinais e sintomas relacionados ao IAM, chat, risco de IAM, lista de contatos, geolocalização, identificação de Unidades de Atendimento de Urgência, e o Saiba Mais. Conclusão: O S.O.S Infarto é uma ferramenta estratégica na assistência à saúde de pessoas com risco para IAM, a fim de provocar uma diminuição nas sequelas e aumento das chances de sobrevida da população.
Abstract Acute myocardial infarction is the disease that most affects the population and the time between its occurrence and the assistance is crucial for a better prognosis. Information and communication technologies linked to a mobile application can assist in the care brevity, especially if the affected individual understand these signs and symptoms quickly. Objective: To develop a health mobile application in first-aid support of acute myocardial infarction. A survey of the technological-development type carried out in two stages: pre-production (bibliographic survey on risk factors and comorbidities related to myocardial infarction and analysis of similar applications) and production, based on the Design Thinking strategy. For the development of the application, S.O.S infarction, we used the Apache Cordova frameworks and Ionic. The elaboration of risk assessment score of AMI considered the pain, clinical history, presence of signs and symptoms of AMI variables. The functionality of the application are registry, clinical history, AMI-related signs and symptoms, chat, AMI risk, list of contacts, geolocation, identification of Urgency Care Units and Learn More. Conclusion: The S.O.S infarction is a strategic tool in health care for people at risk for AMI, aiming to decrease the sequels and increase the chances of survival of the population.
Resumen Infarto agudo del miocardio es la enfermedad que más afecta a la población y el tiempo entre la ocurrencia del evento y la asistencia es crucial para un mejor pronóstico. Las tecnologías de la información y la comunicación vinculadas a una aplicación móvil pueden ayudar a la brevedad en la atención, especialmente si la persona afectada por un infarto comprender estos signos y síntomas rápidamente. Objetivo: Desarrollar una aplicación móvil en la salud de apoyo a los primeros auxilios del infarto agudo del miocardio. Es un estudio del tipo de desarrollo tecnológico llevado a cabo en dos fases: fase de preproducción (revisión bibliográfica sobre los factores de riesgo y comorbilidades relacionados con infarto de miocardio y el análisis de aplicaciones similares) y producción, con base en la estrategia Design Thinking. Para el desarrollo de la aplicación, S.O.S infarto, se utilizaron los frameworks Apache Cordova e Ionic. La elaboración de puntuación de evaluación del riesgo de IAM consideró las variables dolor, historia clínica, presencia de signos y síntomas de IAM. La funcionalidad de la aplicación son catastro, historia clínica, signos y síntomas relacionados con el IAM, chat, riesgo de IAM, lista de contactos, geolocalización, identificación de las Unidades de Atención de Urgencia y Aprenda Más. Conclusión: El S.O.S infarto es una herramienta estratégica para la salud de las personas en riesgo de IAM, con el fin de provocar una disminución de las secuelas y aumentar las posibilidades de supervivencia de la población.
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Nursing Informatics , Mobile Applications , Myocardial InfarctionABSTRACT
Objective ToexplorethevalueofMRIinthediagnosisofcoronaryarteryandmyocardiallesionsinchildrenwithKawasaki disease.Methods CardiacMRIof38patientswithKawasakidiseasewereretrospectivelyanalyzed.MRIsequencesincludedthree dimensionalsteady-statefreeprecession (3D-SSFP)coronaryarteryimaging,first-passperfusiontoassessmyocardialischemia,late gadolinium-enhancedmagneticresonanceimaging(LGE-MRI)toassessmyocardialhistologyfeatures,and2D-SSFPcinesequenceto evaluatecardiacfunction.Themaximumdiametersofcoronaryaneurysmsmeasuredin3D-SSFPwerecomparedwiththosemeasured inechocardiography(ECHO)byBland-Altmananalysis.Results Amongthe38cases,therewere28cases(73.7%)withaneurysmal dilatationinrightcoronaryartery(RCA)orleftcoronaryartery (LCA).Thehighestincidenceofaneurysmaldilatationwasinleft anteriordescendingbranch (LAD)in23cases,andfollowedbyRCAin19cases.ThemaximumdiameterofRCAaneurysm (7.66± 2.10)mm washigherthanthatofLADaneurysm (6.11±1.96)mm withP＜0.05.Myocardialfirst-passperfusionin5casesshowed leftventricularandventricularseptumsubendocardialischemia,LGE-MRIin5casesshowedmyocardialdelayedenhancementinleft ventricularfreewallandventricularseptum,andtheleftventricularejectionfractionsin4caseswerelessthan50%,withanaverage of(34.0±15.9)%.3D-SSFPandECHOshowedgoodconsistencyinthemaximaldiametermeasurementofRCAandLADaneurysm. Conclusion TheimagingfeaturesindifferentsequencesofMRIcanbeusedtocomprehensivelyevaluatethecoronaryarteryand myocardialhistologicalcharacteristicsofKawasakidisease,includingcoronaryaneurysms,thrombosis,myocardialfibrosisandchanges ofventricularfunction.
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Objective:To explore risk factors for no‐reflow after emergency coronary intervention in aged patients with a‐cute ST elevation myocardial infarction (STEMI) . Methods:According to presence of no -reflow (≤TIMI grade Ⅲwas considered as no-reflow) after operation or not ,a total of 700 aged STEMI patients hospitalized in our hospital during 2010-2013 were divided into no-reflow group (n=190 ,27. 14% ) and reflow group (n=510 ,72. 86% ) . Clinical data , PCI and coronary angiography data were collected ,compared and analyzed between two groups . Results:Compared with reflow group ,there were significant rise in percentages of patients with TIMI grade 0-1 (61.17% vs. 82.11% ) ,coro‐nary collateral blood flow grade 0 (64.12% vs. 74.21% ) ,5 thrombus scores before PCI (58.83% vs. 80.00% );signifi‐cant reduction in systolic blood pressure (SBP) at hospitalization [ (111.2 ± 24.6) mmHg vs. (101.7 ± 25.9) mmHg] in no-reflow group , P<0. 01 all. Multi-factor Logistic regression analysis indicated that SBP<101 mmHg at hospitaliza‐tion ,collateral blood flow grade 0 before PCI and 5 thrombus scores before PCI were risk factors for no‐reflow after emer‐gency PCI (OR=1.006~4.398 , P<0.05 or <0.01) .Conclusion:In aged acute STEMI patients ,those with risk factors for no-reflow after emergency PCI should take corresponding preventive and therapeutic measures in order to improve their prognosis .
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AIM:Toobservetheeffectsofmicroparticlesderivedfrombonemarrowmesenchymalstemcells ( MSC-MPs) on angiogenesis and cardiac function in a rat myocardial infarction model .METHODS:MSCs were obtained from Sprague-Dawley rats.MSCs were treated under serum-free condition in hypoxia for 72 h, and the microparticles were isolated from the supernatants .The phenotypic profile of MSC-MPs was determined by bead-based flow cytometry and the morphology was observed under a transmission electron microscope .The rat myocardial infarction model was established . The cardiac function was evaluated by echocardiography after the intramyocardial injection of MSC -MPs.The myocardial in-farct size was observed by Masson staining .The blood vessel density in the peri-infarcted area was measured using immuno-histochemical staining for von Willebrand factor and α-smooth muscle actin.The expression of vascular endothelial growth factor ( VEGF) was analyzed by real-time PCR.RESULTS: Apoptotic MSCs released a large quantity of microparticles which were phenotypically similar to the parent MSCs and 100~1 000 nm in diameter.The cardiac functions of myocardial infarction rat model were improved at 7 d and 28 d after intramyocardial injection of MSC-MPs compared with control group . The myocardial infarct size was reduced and angiogenesis was promoted significantly in the infarcted heart injected with MSC-MPs 28 d after treatment .MSC-MPs treatment also increased the expression level of VEGF within 7 d.CONCLU-SION:MSC-MPs protect cardiac tissue from ischemic injury and improve cardiac function by promoting angiogenesis after myocardial infarction .
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AIM:Todeterminetheeffectofsalviaextractonangiogenesisofthemyocardiumintheratswith myocardial infarction (MI) and to analyze its possible mechanism .METHODS: Left coronary artery of Sprague-Dawley rats was ligated to establish a MI model .The rats were randomly divided into MI model group , 3 different dose groups of salvia (10, 20 and 40 mg? kg-1? d-1), and sham operation group.Each group consisted of 8 rats.The rats in all treat-ment groups were orally administered with the salvia extract , and the rats in MI group and sham operation group were fed with the same volume of saline .The rats were sacrificed 4 weeks later .The hemodynamic changes of the rats were deter-mined , and the segmental heart samples were used for morphological observation by hematoxylin and eosin staining , Masson staining, or electron microscopic analysis.The expression of vascular endothelial growth factor (VEGF) and cluster of dif-ferentiation 34 ( CD34 ) was analyzed according to immunohistochemistry .RESULTS: Compared with sham operation group, the morphological changes of the myocardium in MI group were disordered , part of myocardial cell outline disap-peared , and obvious fibrosis in the necrosis myocardial tissue and fuzzy or disappearing microvascular ultrastructure were al -so observed .Compared with MI group , the number of new microvessels in all the treatment groups increased obviously , and the morphological changes of the endothelial cells were relatively complete according to electron microscopy .Compared with sham operation group , the protein expression of VEGF and CD 34 in the cytoplasm of the myocardial tissues in MI group in-creased only a little .Compared with MI group , the protein expression of VEGF and CD 34 in the cytoplasm of the myocardi-al tissues in all treatment groups increased significantly ( P<0.01 ) .CONCLUSION: Salvia extract obviously promotes angiogenesis of the myocardial tissues in the rats after myocardial infarction .
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Objective To investigate the effects of mesenchymul stem cells(MSCs) transfected with human home oxygenase- 1 gene on the inflammatory cytokines and the ventricular remodeling after myocardial infarction in rats.Method MSCs were acquired from the hone marrow of adults rats.They were isolated,purified cultured,and transfected with Adv-HO-1,or Adv-GFP in vitro before transplantation.At 1 hours after left coronary artery ligation,Adv-HO-1-MSCs or Adv-GFP-MSCs marked with DAPI were directly injected into the horder of cardiac infarction in rats.At 4 days after transplantation,western blot analysis was used to measure HO-1 protein expression in the the horder of cardiac infarction.The levels of VEGF,bFGF,HGF protein expression were measured by ELISA,and the levels of TNF-α,IL-1β,IL-6,IL-10 mRNA expression were measured by RT-PCR.The rat heart function was measured by echocardiography.At 4 weeks after transplantation,ventricular remodeling and pathological changes were measured by HE and Masson staining.Results The Adv-HO-1-MSCa treated group showed marked increase of HO-1 rotein (P<0.05),and displayed significant increase of montioned cytokines above,P <0.05,compared with other groups.The Adv-HO-1-MSCs treated group displayed significant reduction of mRNAs expreesion of TNF-α,IL-1β,IL-6,and significant increase in IL-10 mRNA expression,with P<0.05,compared with others.Conclusions HO-1-MSCs could secrete multiple cytokines in infarction hearts,and had beneficial effects on inflammatory cytokines,remodeling processes and cardiac function.
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98%.Thick myofibers were observed by transmission electron microscopy after induction with 5-aza.Four weeks after transplantation,the left ventricle ejection fraction,the movement extent of left ventricle,left ventricle systolic wall thickening and dp/dt of rabbits were all higher than those of the control group and cardiac infarction model group(P