ABSTRACT
Abstract: The study aimed to analyze the actions of the Professional Councils in relation to 966 professional-ethical complaints addressed to the Regional Council of Medicine of Minas Gerais between 2012 and 2017. The number of cases, gender, articles violated of the Code of Medical Ethics and decisions made in the lawsuits were considered. An expressive result was observed in terms of acquittal (535 cases) by the Regional Council of Medicine of Minas Gerais. There was a divergence when the same cases were evaluated by the Federal Council of Medicine, which upheld the acquittal in only 29% of the cases. Due to the methodology applied, it was not possible to go beyond speculation on the subject, being necessary a better analysis of the scientific community on this issue.
Resumen: El estudio tuvo como objetivo analizar las acciones de los Consejos Profesionales en relación con 966 quejas ético-profesionales dirigidas al Consejo Regional de Medicina de Minas Gerais entre 2012 y 2017. Se consideró el número de casos, el género, los artículos violados del Código de Ética Médica y las decisiones tomadas en los juicios. Se observó un resultado expresivo en cuanto a la absolución (535 casos) por parte del Consejo Regional de Medicina de Minas Gerais. Hubo una divergencia cuando los mismos casos fueron evaluados por el Consejo Federal de Medicina, que mantuvo la absolución sólo en el 29% de los casos. Debido a la metodología aplicada, no fue posible ir más allá de la especulación sobre el tema, siendo necesario un mejor análisis de la comunidad científica sobre esta cuestión.
Resumo: O estudo visava analisar as acções dos Conselhos Profissionais em relação a 966 queixas de ética profissional dirigidas ao Conselho Regional de Medicina de Minas Gerais entre 2012 e 2017. Considerou o número de casos, género, artigos violados do Código de Ética Médica e as decisões tomadas nos julgamentos. Um resultado expressivo foi observado em termos de absolvição (535 casos) pelo Conselho Regional de Medicina de Minas Gerais. Houve uma divergência quando os mesmos casos foram avaliados pelo Conselho Federal de Medicina, que manteve a absolvição em apenas 29% dos casos. Devido à metodologia aplicada, não foi possível ir além da especulação sobre o assunto, sendo necessária uma melhor análise da comunidade científica sobre esta questão.
Subject(s)
Humans , Male , Female , Health Councils , Whistleblowing , Brazil , Cross-Sectional Studies , Ethics, ProfessionalABSTRACT
Peripheral arterial disease is diagnosed by measuring the ankle-brachial index. Values lower than 0.90 define the disease being usually related to its severity. Patients with peripheral arterial disease may show a hypercoagulability state. The aim of this study was to assess hemostatic variables and to correlate them with the presence of peripheral arterial disease and its severity as assessed by ankle-brachial index values. Plasma levels of D dimer, plasminogen, prothrombin fragment 1+2, plasminogen activator inhibitor and thrombomodulin were measured in 36 patients with peripheral arterial disease (group 1) and 30 without disease (group 2). Significant differences for D dimer, plasminogen, prothrombin fragment 1+2 and plasminogen activator inhibitor type 1 between the 2 groups were found (P<0.05). Significant and inverse correlations were also observed (Pearson correlation, P<0.05) between ankle-brachial index values and levels of both plasminogen and plasminogen activator inhibitor type 1. Although there was no significant correlation between ankle-brachial index and levels of D dimer, higher D dimer values were observed in patients with lower ankle-brachial index values. The results confirm a trend to hypercoagulability and hypofibrinolysis in patients with peripheral arterial disease. Increased levels of plasminogen activator inhibitor type 1 seem to be associated with the severity of the disease, considering the inverse correlation between this inhibitor and ankle-brachial index.
Subject(s)
Ankle/blood supply , Blood Coagulation , Blood Pressure , Brachial Artery/physiopathology , Peripheral Vascular Diseases/blood , Plasminogen Activator Inhibitor 1/blood , Thrombophilia/blood , Aged , Biomarkers/blood , Brachial Artery/diagnostic imaging , Brazil , Case-Control Studies , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Male , Middle Aged , Peptide Fragments/blood , Peripheral Vascular Diseases/complications , Peripheral Vascular Diseases/diagnostic imaging , Peripheral Vascular Diseases/physiopathology , Plasminogen/analysis , Predictive Value of Tests , Prothrombin , Severity of Illness Index , Thrombomodulin/blood , Thrombophilia/etiology , Thrombophilia/physiopathology , Ultrasonography, Doppler , Up-RegulationABSTRACT
BACKGROUND: Diabetes is associated with a pro-inflammatory status characterized by an increased production of inflammatory molecules. Reactive oxygen species (ROS) and cAMP elevating agents represent two molecular systems, normally generated during inflammation. These molecules could be responsible for the alteration of signaling pathways. In the present paper we have studied the correlation between ROS generation and inositolpolyphosphates (InsP(1), InsP(2) InsP(3) and InsP(4)) released by granulocytes from Type 1 diabetic patients (DM1) in the presence or in the absence of cyclic AMP-elevating agents. METHODS: The effect of cAMP on ROS production was quantified in a chemoluminescence assay luminol-dependent (RLU/min). InsP(1), InsP(2) InsP(3) and InsP(4) were quantified by inositol-H(3) in a Beta-counter and the results were expressed as count per minute (CPM). RESULTS: The elevation of intracellular level of cAMP inhibited both InsP(3) and ROS production in granulocytes from healthy subjects and activated in the cells from Type 1 diabetic patients. InsP(1), InsP(2) and InsP(4) did not show significant alteration in both studied cells. There was a significant correlation between InsP(3) and ROS in the presence of elevated content of cAMP. This correlation was observed in a 15 minutes reaction for healthy subjects and in 120 minutes for DM1. CONCLUSIONS: The importance of both InsP(3) release and ROS production in an inflammatory process and tissue pathophysiology in Type 1 diabetic patients is still under debate because hyperglycemia accelerates generation of oxidative stress and may play an important role in the development of complications in diabetes. Thus, our results demonstrated alteration in metabolic response in granulocytes from Type 1 diabetic patients and it may be important for the development of therapeutic processes and drugs that interfere with signaling of ROS generation and may contribute to the improvement of the severe complications of diabetes.
