Objetivos: Avaliar o impacto da pandemia COVID-19 nas admissões de doentes com síndromes coronárias agudas (SCA) e angioplastia coronária primária (PPCI) em países que participam da iniciativa global Stent-Save a Life (SSL). Métodos e resultados: realizámos estudo observacional multicêntrico para coletar dados sobre admissões de doentes por ACS, STEMI e PPCI nos países participantes no SSL durante um período do surto COVID-19 (março e abril de 2020) em comparação com o período homólogo de 2019. Dos 32 países membros da iniciativa global SSL, 17 aceitaram participar no estudo (3 de África, 5 da Ásia, 6 da Europa e 3 da América Latina (LATAM)). Observámos uma redução global de 27,5% e 20,0% nos internamentos com SCA e STEMI, respetivamente. A diminuição do PPCI foi de 26,7%. Essa tendência foi observada em todos os países, exceto dois. Nestes dois países, a pandemia atingiu o pico mais tarde do que nos restantes. Conclusões: Este estudo mostra que o surto de COVID-19 foi associado a uma redução significativa de admissões hospitalares por SCA e STEMI, bem como uma redução de PPCI, o que pode ser explicado por fatores relacionados com o doente e com o sistema.

Summar\/-Urological complications were studied in 310 live donor kidney transplants. All recipients and donors were investigated for urinary schistosomiasis by examining tissue obtained intra-operatively from the donor's ureter or the patient's bladder. Schistosomiasis was histologically documented in 76 cases (patient's bladder (46), donor's ureter (9), both (21)). The incidence of urological complications was 11/76 (1 5%) in the schistosomal group and 14/234 (6%) in the nonschistosomal group; this was statistically significant. Among the schistosomal patients, the site of infestation had no statistically significant effect on the incidence of urological complications. No deaths or graft losses were directly attributable either to these complications or to their surgical correction.

Two consecutive prospective randomized trials were performed to study three immunosuppressive protocols in 195 kidney transplant recipients. Only adult primary renal transplant recipients with one haplotype HLA mismatch were included. All patients received kidneys from living related donors and had previous donor non-specific blood transfusions. Study I included 112 recipients who were randomly assigned to receive either azathioprine (Aza) and prednisolone (P) (n = 54) or cyclosporin (CsA) and P (n = 58). Patients in this study were followed up for 3-6 years (mean 50 +/- 8 months). Study II included 83 recipients who were randomly assigned to receive either triple therapy of Aza-CsA-P (n = 41) or conventional therapy of Aza-P (n = 42). Patients in this study were followed up for a period of 32 +/- 10 (range 26-43) months. Analysis of data in the two studies demonstrated the absence of statistically significant differences in graft or patient survival rates over short- and long-term follow-up periods among recipients of the conventional immunotherapy and those receiving the CsA-P or the triple therapy. The overall frequency of acute rejection episodes was not significantly different between the two treatment groups of each study. Serum creatinine was significantly higher in the CsA-P group while the incidence of infection was significantly lower in the triple group. When switching from one regimen to another is considered, at least 75% of the one-haplotype HLA mismatched live-related donor renal transplants could be maintained on conventional immunotherapy with comparable degree of success to those treated with the CsA-P or the triple therapy. However, in at least 15% of patients with conventional immunotherapy, CsA could reverse ongoing rejections and can therefore be considered as a rescue treatment.

Background: The description of polymorphisms in many of the key immunoregulatory molecules involved in the rejection process has offered a possible explanation for the individual variation in susceptibility to rejection and differences in allograft survival independent of the many known contributory factors. The aim of this work is to study the impact of IL-10 cytokine gene polymorphism on renal transplant clinical course and outcome. Methods: This work studied 50 transplant recipients maintained on sirolimus based immunosuppression for IL-10 cytokine gene polymorphisms. After transplantation patients were divided into two groups. Group (A) patients (12 patients) received sirolimus, tacrolimus and steroid, while Group (B) patients (38 patients) received sirolimus, mycophenolate mofetil and steroid. Results were correlated with acute and chronic rejection episodes as well as graft and patient outcome. Results: In our study, we found no impact of IL-10 on incidence and degree of acute rejection episodes, incidence of chronic allograft nephropathy, pathological changes in protocol biopsies, graft function and graft and patient survivals. Conclusion: From this work, we can conclude that the potential impact of IL-10 cytokine gene polymorphisms on renal transplant clinical course and outcome have shown no influence, and probably other genes rather than IL-10 could be involved as key molecules for graft function.

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