Exploring Horizons in the Treatment of Vasoplegia in Shock Syndromes.

Vasoplegic endothelial dysfunction stands out as one of the most prominent shock syndromes in the intensive care unit, and despite continual therapeutic advances, it is still associated with poor prognosis in critical cases. This scenario is compatible with a significant inflammatory disturbance, with a propensity for increased vascular permeability and deterioration of endothelial response to modulators: a microcirculation disaster. The hemodynamic support's backbone is based primarily on fluid replacement and the use of vasopressor and inotropic agents in nonresponsive patients, aiming to establish a mean arterial pressure of at least 65 mmHg and therefore promote adequate tissue reperfusion.

Methylene blue and the NO/cGMP pathway in solid organs transplants.

The nitric oxide/cyclic guanosine monophosphate (NO/cGMP) pathway has a significative influence in hemodynamic changes that occur in transplants. Classically, the ischemia-reperfusion syndrome (IRS) is characterized by hypotension and low vascular resistance, when cGMP and nitric oxide (NO) are increased, contributing to oxidative stress, within an inflammatory context. These mechanisms occur in several types of transplants, such as liver, heart, lungs, kidney, which are a therapeutic choice in several clinical conditions when conventional treatments failed.

The chronic gastrointestinal manifestations of Chagas disease.

Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease.

Penetrating cardiac injuries: a 13-year retrospective evaluation from a Brazilian trauma center.

To present our experience with penetrating cardiac injuries. We have retrospectively reviewed the records of 70 victims of penetrating cardiac injuries. A logistic regression has been performed in order to determine the association between death and clinical predictors.