OBJETIVO: avaliar as taxas de mortalidade e morbidade de doentes submetidos à revascularização do miocárdio (RVM) com circulação extracorpórea (CEC) que utilizaram rotineiramente o ecocardiograma transesofágico intraoperatório (ETEio). MÉTODOS: estudo retrospectivo, observacional com avaliação de prontuários de 360 doentes no período entre abril de 2010 a abril de 2012. Foram analisados: idade, peso, altura sexo, EUROscore, diabete melito, fração de ejeção e artérias acometidas. Os desfechos foram compilados no intra e no pós-operatório (infarto do miocárdio, acidente vascular cerebral, disfunção renal, hemodiálise, fibrilação atrial, tempo de internação no centro de tratamento intensivo). RESULTADOS: foram incluídos 53 doentes, com 27 recebendo a monitoração. Foram excluídos 307 porque não foram operados pela mesma equipe cirúrgica. Os dois grupos foram homogêneos quanto a idade, peso e sexo, porém, a fração ejeção foi menor no grupo que recebeu o ecotransesofágico (G ETEio: 56,3%; G Não ETEio: 65,9% ± 11; p=0,01). Nos doentes em que não foi utilizado o ETEio, a mortalidade foi maior (G ETEio: 0% e G Não ETEio: 7,6%; p=0,01). Não houve diferença significativa entre os grupos quanto à incidência de acidente vascular encefálico, infarto agudo do miocárdio, fibrilação atrial aguda e lesão renal. CONCLUSÃO: a utilização do ecocardiograma transesofágico intraoperatório em pacientes submetidos à revascularização do miocárdio, com circulação extracorpórea, diminuiu a mortalidade perioperatória; orientou quanto a utilização dos fármacos inotrópicos e vasodilatadores e contribuiu para uma melhor evolução dos doentes.

OBJECTIVE: To evaluate the rates of mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) using routine intraoperative transesophageal echocardiography (ITEE). METHODS: We conducted a retrospective, observational review of medical records of 360 patients from April 2010 to April 2012. We analyzed: age, weight, height, gender, EuroSCORE, diabetes mellitus, ejection fraction and number of diseased vessels. Outcomes were compiled in intraoperative and postoperative (myocardial infarction, stroke, renal failure, hemodialysis, atrial fibrillation, length of stay in the intensive care unit). RESULTS: 53 patients were included, with 27 receiving monitoring; we excluded 307 individuals, as they were not operated by the same surgical team. The two groups were homogeneous for age, weight and gender. However, the ejection fraction was lower in the group submitted to ITEE (ITEE group 56.3% versus Non-ITEE group 65.9 ± 11%, p = 0.01). In patients not subjected to ITEE, mortality was higher (ITEE group 0% versus Non-ITEE group 7.6%, p = 0.01). There was no significant difference between groups as for the incidence of stroke, myocardial infarction, atrial fibrillation and acute kidney injury. CONCLUSION: The use of intraoperative transesophageal echocardiography in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass decreased perioperative mortality, warranted the use of inotropic drugs and vasodilators and contributed to a better patient outcome.

O sistema nervoso central (SNC) é o sítio extramedular mais acometido na leucemia linfoide aguda. A avaliação morfológica do líquido cefalorraquidiano (LCR), apesar de ser o exame tradicional para o diagnóstico da infiltração leucêmica no SNC, é um método pouco sensível. O presente estudo pretendeu avaliar a imunofenotipagem como método auxiliar na detecção de blastos no LCR em crianças e adolescentes com leucemia linfoide aguda.

The central nervous system is the most commonly affected extramedullary site in acute lymphoblastic leukemia. Although morphologic evaluation of the cerebrospinal fluid has been traditionally used for diagnosing central nervous system involvement, it is a method of low sensitivity. The present study aimed at evaluating the use of immunophenotyping in the detection of blasts in the cerebrospinal fluid from children and adolescents with acute lymphoblastic leukemia.

OBJECTIVE To detect markers for minimal residual disease monitoring based on conventional polymerase chain reaction for immunoglobulin, T-cell receptor rearrangements and the Sil-Tal1 deletion in patients with acute lymphocytic leukemia. METHODS Fifty-nine children with acute lymphocytic leukemia from three institutions in Minas Gerais, Brazil, were prospectively studied. Clonal rearrangements were detected by polymerase chain reaction followed by homo/heteroduplex clonality analysis in DNA samples from diagnostic bone marrow. Follow-up samples were collected on Days 14 and 28-35 of the induction phase. The Kaplan-Meier and multivariate Cox methods were used for survival analysis. RESULTS Immunoglobulin/T-cell receptor rearrangements were not detected in 5/55 children screened (9.0%). For precursor-B acute lymphocytic leukemia, the most frequent rearrangement was IgH (72.7%), then TCRG (61.4%), and TCRD and IgK (47.7%); for T-acute lymphocytic leukemia, TCRG (80.0%), and TCRD and Sil-Tal deletion (20.0%) were the most common. Minimal residual disease was detected in 35% of the cases on Day 14 and in 22.5% on Day 28-35. Minimal residual disease on Day 28-35, T-acute lymphocytic leukemia, and leukocyte count above 50 x 109/L at diagnosis were bad prognostic factors for leukemia-free survival in univariate analysis. Relapse risk for minimal residual disease positive relative to minimal residual disease negative children was 8.5 times higher (95% confidence interval: 1.02-70.7). CONCLUSION Immunoglobulin/T-cell receptor rearrangement frequencies were similar to those reported before. Minimal residual disease is an independent prognostic factor for leukemia-free survival, even when based on a non-quantitative technique, but longer follow-ups are needed.

Soil organic matter (SOM) plays an important role in physical, chemical and biological properties of soil. Therefore, the amount of SOM is important for soil management for sustainable agriculture. The objective of this work was to evaluate the amount of SOM in oxisols by different methods and compare them, using principal component analysis, regarding their limitations. The methods used in this work were Walkley-Black, elemental analysis, total organic carbon (TOC) and thermogravimetry. According to our results, TOC and elemental analysis were the most satisfactory methods for carbon quantification, due to their better accuracy and reproducibility.