Therapeutic Potential of Pretreatment with Allograft Sertoli Cells Transplantation in Brain Ischemia by Improving Oxidative Defenses

Brain ischemia is one of the most common causes of death and disability worldwide, which usually happens through diminished blood supply to the tissue. Cell therapy and treatments using trophic factors are some of the new methods to protect brain cells against damage. Specific properties of Sertoli cells (SCs) make them suitable for improving neurological disorders. This study is to evaluate possible neuroprotective effects of SCs transplantation on ischemic damage. Rats were divided into three experimental groups including sham, control, and SCs-treated group. In this study, SCs were isolated from testis of rats and were transplanted into the right striatum by using stereotaxic surgery. After a week, ischemic surgery was performed. Twenty-four hours later, rats were scarified and different regions of the brain including the cortex, the piriform cortex-amygdala (Pir-Amy), and the striatum were collected and preserved in ??80 °C for further investigations. This study demonstrates that SCs transplantation can reduce brain ischemia deficits and increase superoxide dismutase (SOD) and catalase (CAT) activities. It also decreases malondialdehyde production, which is the main product of lipid peroxidation. SCs improve ischemic behavioral disorder and reduce brain edema, blood-brain barrier permeability, and infarct volume. It seems that transplantation of SCs can protect neural cells against ischemia by decreasing oxidative stress.     

Long-term outcomes after 1000 heart transplantations in six different eras of innovation in a single center

The objective of this study was to evaluate long-term outcomes of cardiac transplantation (HTx) in different eras of innovation at a single center during a period of 27 years. We performed a retrospective analysis of 960 cardiac allograft recipients (40 re-HTx) between 1981 and 2008. The results of six different eras based on milestones in HTx were analysed: Era 1: the early years ( n  = 222, 1981–1992); era 2: introduction of inhalative nitric oxide, prostanoids, University of Wisconsin solution (UW) replacing Bretschneider's solution (HTK, n  = 118, 1992–1994); era 3: statins ( n  = 102, 1994–1995); era 4: tacrolimus ( n  = 115, 1995–1996); era 5: mycophenolate mofetil (MMF, n  = 143, 1997–2000) and era 6: sirolimus ( n  = 300, 2000–2008). Outcome variables were survival, freedom from cardiac allograft vasculopathy (CAV) and from acute rejection episodes (AREs). Differences in survival was found comparing era 1 and era 2 with era 4 and era 6 ( P  < 0.001). Organ preservation through UW demonstrated a significantly better survival as compared with HTK ( P  < 0.001). Less AREs occurred in patients receiving tacrolimus-sirolimus or tacrolimus-MMF ( P  < 0.001). Patients receiving tacrolimus-MMF showed less CAV than when treated with cyclosporine-MMF ( P  < 0.005). There were more ventricular assist device implantations and more re-HTx in era 6 ( P  < 0.0001) than when compared with other eras. Although the causes for improvement in survival over time are multifactorial, we believe that changes in immunosuppressive therapy have had a major impact on survival.     

Successful pulmonary thromboendarterectomy for right atrial thrombosis in a heart transplant recipient: a case report

Acute massive or submassive pulmonary embolism is a life-threatening condition with a poor prognosis. It causes sudden hemodynamic deterioration and warrants immediate surgery. We report the case of a 41-year-old male heart transplant recipient who had not been treated prophylactically for thrombosis, who was referred to our center because of exertional dyspnea after immobilization owing to an injury in one of his legs. Transesophageal echocardiography revealed a large, mobile, right atrial mass originating from a pacemaker lead. Furthermore, contrast-enhanced computed tomography scanning of the chest revealed multiple pulmonary emboli resulting in subtotal occlusion of both pulmonary arteries. Although typically reserved for patients with chronic thromboembolic pulmonary hypertension, surgical thromboendarterectomy was successfully performed. Six months after discharge, the patient is well and has a New York Heart Association class 1 rating. This is the first report of a successful pulmonary thromboendarterectomy in a heart transplant recipient.     

Effect of Face-to-Face Education on Anxiety and Pain in Children with Minor Extremity Injuries Undergoing Outpatient Suturing in Emergency Department

Objective

To assess the effect of face-to-face education on anxiety and pain in children with minor extremity injuries undergoing outpatient suturing.

Methods

Children in intervention and control groups received face-to-face education (10 minutes) and no specific education, respectively. The anxiety and pain was measured using Modified-Yale Preoperative Anxiety Scale, and pain by Faces Pain Scale–Revised, respectively in 3 stages viz, pre-procedure and pre-intervention, post-procedure.

Results

Children in the intervention group were less anxious than the control at pre-procedure and post-intervention stage (41.1 (13.8) vs. 46.3 (19.1), respectively, P=0.03) and post-procedure and post-intervention stage (32.3 (17.2) vs. 40.2 (12.9), respectively, P=0.01). Children in the intervention group experienced less pain than the control at pre-procedure and post-intervention stage (3.9 (3.8) vs. 4.9 (3.1), respectively, P<0.001) and post-procedure and post-intervention stage (3.1 (1.2) vs. 4.0 (2.1), respectively, P=0.001).

Conclusions

Face-to-face education could reduce anxiety and pain in children undergoing suturing in the emergency department.