Left or bilateral internal mammary artery employment in coronary artery bypass grafting: midterm results.

BACKGROUND: The gold standard for coronary artery bypass grafting to the left anterior descending artery is use of the left internal mammary artery. Better long-term survival has been reported using bilateral internal mammary arteries compared to left internal mammary artery only, but many surgeons are reluctant to employ bilateral internal mammary arteries in coronary artery bypass grafting. This study aimed to evaluate the effectiveness and safety of bilateral internal mammary artery use. METHODS: From 2014 to 2017, 1703 patients underwent coronary artery bypass grafting in our institute. Of these, 772 met the inclusion criteria and were randomly assigned to receive bilateral (n = 387) or left (n = 385) internal mammary artery grafts. The mean age was 67.1 ± 6.0 years (range 48-85 years) and 474 (61.4%) were male. The mean number of diseased vessels was 3.1 ± 0.9, and mean EuroSCORE II was 3.4% ± 1.1%. RESULTS: Hospital mortality was 1.2% in the left internal mammary artery group vs. 1.8% in the bilateral internal mammary artery group (p = 0.55). There was no difference in procedure-related complications between groups. Mean follow-up was 65.9 months. Survival in the bilateral internal mammary artery group at 1, 3, and 5 years was 98.7%, 98.7%, and 94.8% vs. 98.1%, 98.1%, and 90.9%, respectively, in the left internal mammary artery group (p = 0.63). CONCLUSION: Application of bilateral internal mammary arteries in coronary artery bypass grafting is safe and effective, with comparable midterm results to those with the left internal mammary artery only.

Políticas públicas de efetivação do direito social à saúde: Programa Mais Médicos sob uma análise da ponderação de princípios / Public policies and the social right to effective health: Program More Doctors under the analysis of constitutional principles

A presente pesquisa trata da efetivação do direito constitucional social à saúde, previsto no art. 6º e reprisado no art. 196 da CF/88, que prevê que saúde é direito de todos e dever do Estado, por meio de políticas públicas do Estado, representado pelos três entes da federação (União, estados, Distrito Federal e municípios). Mostra aspectos relacionados à criação do SUS na década de 90, com o intuito de promover condições para a promoção, proteção e recuperação da saúde. Além disso, refere-se a última política pública de âmbito nacional com vistas à implementação do direito constitucional à saúde, que é o Programa Mais Médicos, trazendo um aparato dos pontos positivos e negativos do programa. Por fim, pretende-se aplicar a ponderação de princípios, da Teoria dos Direitos Fundamentais de Robert Alexy para identificar se o Programa Mais Médicos foi uma norma de política panfletária ou um meio de efetivação do direito social à saúde.

This research deals with the concretionof the social constitutional right to health, provided for in art. 6 and reprisedin art. 196 of CF / 88, which states that health is everyone's right andduty of the state through state public policies, represented by the threefederal entities (Union, states, Federal District and municipalities). The paper takes in account aspects related to the creation of the SUS in the 90s, in order to foster conditions for the promotion, protection and recovery of health. Also, it refers tothe last nationwide public policy with a view to implementing the constitutional right to health, which is the“Mais Médicos”Program, exposing of the strengths and weaknesses of the program. Finally, we intend to apply the weighting principles, Theory ofFundamental Rights of Robert Alexy to identify the“Mais Médicos”Program was a norm of political pamphleteering or a means of realization of the social right to health.

Genetic variability of 15 autosomal STR loci in Russian populations.

Allele frequencies for 15 STRs (CSF1PO, D3S1358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, D21S11, FGA, Penta D, Penta E, THO1, TPOX, and vWA) in the PowerPlex 16 System (Promega Corporation) were assessed in 386 individuals from five Russian urban populations. No significant between-population differences in frequencies and molecular variance of 15 microsatellites were revealed. For all 15 loci, the combined matching probability is 3.19 x 10(-18) and the power of exclusion is 99.99989%.