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Resumo Objetivo: Este estudo com acompanhamento de longo prazo visou a avaliar o quadro clínico, os achados laboratoriais, o perfil histológico, os tratamentos e os resultados de crianças e adolescentes com hepatite autoimune. Métodos: Foram analisados os prontuários médicos de 828 crianças e adolescentes com HAI. Foi usado um questionário para coletar os dados anônimos sobre o quadro clínico, os achados bioquímicos e histológicos e os tratamentos. Resultados: De todos os pacientes, 89,6% tinham hepatite autoimune-1 e 10,4% hepatite autoimune-2. O sexo feminino foi predominante nos dois grupos. A idade média no início dos sintomas foi 111,5 (6; 210) e 53,5 (8; 165) meses nos pacientes com hepatite autoimune-1 e hepatite autoimune-2, respectivamente. Foi observado início clínico agudo em 56,1% e 58,8% e sintomas insidiosos em 43,9% e 41,2% dos pacientes com hepatite autoimune-1 e hepatite autoimune-2, respectivamente. A probabilidade de insuficiência hepática foi 1,6 vezes maior para hepatite autoimune-2; 3,6% e 10,6% dos pacientes com hepatite autoimune-1 e hepatite autoimune-2, respectivamente, apresentaram insuficiência hepática fulminante; o risco foi 3,1 vezes maior para hepatite autoimune-2. Os níveis de gamaglobulina e imunoglobulina G foram significativamente maiores nos pacientes com hepatite autoimune-1, ao passo que os níveis de imunoglobulina A e C3 foram menores em pacientes com hepatite autoimune-2; 22,4% dos pacientes apresentaram cirrose e a remissão bioquímica foi atingida em 76,2%. A taxa de sobrevida atuarial foi de 93,0%. Um total de 4,6% pacientes foram submetidos a transplante de fígado e 6,9% morreram (hepatite autoimune-1: 7,5%; hepatite autoimune-2: 2,4%). Conclusões: Nesta grande série clínica de crianças e adolescentes brasileiros, a hepatite autoimune-1 foi mais frequente e os pacientes com hepatite autoimune-2 mostraram maiores taxas de remissão da doença com respostas mais rápidas aos tratamentos. Os pacientes com hepatite autoimune-1 apresentaram maior risco de óbito.

Abstract Objective: This large study with a long-term follow-up aimed to evaluate the clinical presentation, laboratory findings, histological profile, treatments, and outcomes of children and adolescents with autoimmune hepatitis. Methods: The medical records of 828 children and adolescents with autoimmune hepatitis were reviewed. A questionnaire was used to collect anonymous data on clinical presentation, biochemical and histological findings, and treatments. Results: Of all patients, 89.6% had autoimmune hepatitis-1 and 10.4% had autoimmune hepatitis-2. The female sex was predominant in both groups. The median age at symptom onset was 111.5 (6; 210) and 53.5 (8; 165) months in the patients with autoimmune hepatitis 1 and autoimmune hepatitis-2, respectively. Acute clinical onset was observed in 56.1% and 58.8% and insidious symptoms in 43.9% and 41.2% of the patients with autoimmune hepatitis-1 and autoimmune hepatitis-2, respectively. The risk of hepatic failure was 1.6-fold higher for autoimmune hepatitis-2. Fulminant hepatic failure occurred in 3.6% and 10.6% of the patients with autoimmune hepatitis-1 and autoimmune hepatitis-2, respectively; the risk was 3.1-fold higher for autoimmune hepatitis-2. The gamma globulin and immunoglobulin G levels were significantly higher in autoimmune hepatitis-1, while the immunoglobulin A and C3 levels were lower in autoimmune hepatitis-2. Cirrhosis was observed in 22.4% of the patients; biochemical remission was achieved in 76.2%. The actuarial survival rate was 93.0%. A total of 4.6% underwent liver transplantation, and 6.9% died (autoimmune hepatitis-1: 7.5%; autoimmune hepatitis-2: 2.4%). Conclusions: In this large clinical series of Brazilian children and adolescents, autoimmune hepatitis-1 was more frequent, and patients with autoimmune hepatitis-2 exhibited higher disease remission rates with earlier response to treatment. Patients with autoimmune hepatitis-1 had a higher risk of death.

https://doi.org/10.1016/j.jped.2018.04.007 1614 downloads

New Synthesis Method for a Core-Shell Composite Based on α-Bi2O3 @PPy and its Electrochemical Behavior as Supercapacitor Electrode
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Xavier, Fárlon F. S.

; Bruziquesi, Carlos G. O.

; Fagundes, Wélique S.

; Matsubara, Elaine Y.

; Rosolen, José M.

; Silva, Adilson C.

; Canobre, Sheila C.

; Amaral, Fábio A.

Journal of the Brazilian Chemical Society

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apr 2019, Volume 30 N. 4 Pages 727 - 735

Abstract: En | Text: En | PDF: En

New composite based on polypyrrole (PPy) and bismuth oxide (α-Bi2O3) was investigated as supercapacitor electrode. The α-Bi2O3 was obtained by hydrothermal route at 500 ºC for 2 h. Cyclic voltammetry was used to electropolymerize PPy on graphite electrode (GE) or on GE/α-Bi2O3. The X-ray diffraction profile of Bi2O3 revealed the α-Bi2O3 monoclinic structure with space group P21/c.The scanning and transmission electron microscopy images showed that PPy coated α-Bi2O3. Raman spectra showed that PPy inhomogeneously coated α-Bi2O3, but it was still possible to obtain a α-Bi2O3 @PPy core-shell hybrid composite with highly ordered α-Bi2O3 with electronic interaction between the oxide and the polymer chain of the polymer. The GE/α-Bi2O3@PPy composite electrode (type I supercapacitor) displayed a predominantly capacitive profile with low impedance values and good electrochemical stability after 50 charge and discharge cycles. The specific capacitance of α-Bi2O3 @PPy composite was found in the range of 634 to 301 F g-1 to gravimetric current of 3 and 10 A g-1, respectively.

https://doi.org/10.21577/0103-5053.20180192 819 downloads

Instituições de longa permanência como alternativa no acolhimento das pessoas idosas
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Fagundes, Karolina Vitorelli Diniz Lima

; Esteves, Michelly Ribeiro

; Ribeiro, João Henrique de Morais

; Siepierski, Carlos Tadeu

; Silva, José Vitor da

; Mendes, Maria A.

Revista de Salud Pública

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apr 2017, Volume 19 N. 2 Pages 210 - 214

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Estudo reflexivo que enfatiza a Instituição de Longa Permanência para Idosos. Considerando a carga contextual em que se dá o processo de institucionalização em uma Instituição de Longa Permanência para Idosos, o qual é escoltado por transformações na vivência da pessoa idosa. Nessa perspectiva este estudo tem como propósito refletir sobre as Instituições de Longa Permanência como alternativa no acolhimento das pessoas idosas brasileiras. Primeiramente, expõe-se sobre o envelhecimento populacional, seguido por uma breve perspectiva histórica das Instituições de Longa Permanência e o finaliza com o processo de institucionalização da pessoa idosa nas mesmas. Embora existam definições a respeito das funções e obrigações da Instituição de Longa Permanência, a influência dos aspectos negativos na vivência das pessoas idosas institucionalizadas encontra-se implícita na maioria delas, solicitando uma reestruturação desse ambiente que tem se tornado o mundo-vida de uma demanda crescente de pessoas idosas. O processo de institucionalização e a vivência do idoso na instituição são elementos de estudo fundamentais para o alcance de um entendimento aprofundado da realidade intrínseca dessa pessoa que está escrevendo o epílogo da sua história de vida.

ABSTRACT This is a reflective study on long stay institutions for elderly population. Considering the context in which the process of institutionalization in a long-stay institution for the elderly occurs, which is escorted by changes in every-day life of the elderly population, this study aims to reflect on the long-stay institutions as an alternative of sheltering for the Brazilian elderly. First, demographic aging is analyzed, followed by a brief historical account regarding long-stay institutions, and an approach to the institutionalization process of the elderly population in these places. Although the functions and duties of long-stay institutions have been previously defined, the negative aspects that influence the experience of institutionalized elderly are evident; therefore, restructuring the environment of these type of places is necessary considering the growing demand. The institutionalization process and the experience of the elderly population admitted to these institutions are key study elements to comprehend the intrinsic reality of this population.

RESUMEN El presente es un estudio reflexivo sobre las instituciones de larga permanencia para adultos mayores. Con base en la carga contextual que se genera alrededor del proceso de institucionalización de estas personas, el cual implica una serie de cambios en su vida cotidiana, este estudio tiene como objetivo hacer una reflexión sobre la pertinencia de estos lugares como alternativa para acoger adultos mayores brasileños. En primer lugar, se hace un análisis sobre el proceso de envejecimiento de la población, seguido de un breve recuento histórico de las instituciones de larga permanencia, para finalizar con una descripción sobre el proceso de institucionalización. Si bien hay definiciones acerca de las funciones y obligaciones de este tipo de instituciones, los aspectos negativos que influyen en las experiencias de las personas mayores ya institucionalizadas son evidentes. En este sentido, es necesario reestructurar ese ambiente que se convierte en el diario vivir de estas personas, de el cual tiene una demanda cada vez mayor. El proceso de institucionalización y las experiencias de las personas mayores dentro la institución son elementos de estudio fundamentales para comprender a profundidad la realidad intrínseca de esta población.

https://doi.org/10.15446/rsap.v19n2.41541 12 downloads

Instituições de longa permanência como alternativa no acolhimento das pessoas idosas
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Vitorelli Diniz Lima Fagundes, Karolina

; Ribeiro Esteves, Michelly

; de Morais Ribeiro, João Henrique

; Siepierski, Carlos Tadeu

; da Silva, José Vitor

; Mendes, Maria A.

Revista de Salud Pública

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apr 2017, Volume 19 N. 2 Pages 210 - 214

Abstract: Es En Pt | Text: Es En Pt | PDF: Es | PDF: En | PDF: Pt

https://doi.org/10.15446/rsap.v19n2.41541 2260 downloads

Antifungal activity of extracts from Atacama Desert fungi againstParacoccidioides brasiliensis and identification ofAspergillus felis as a promising source of natural bioactive compounds
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Mendes, Graziele

; Gonçalves, Vívian N

; Souza-Fagundes, Elaine M

; Kohlhoff, Markus

; Rosa, Carlos A

; Zani, Carlos L

; Cota, Betania B

; Rosa, Luiz H

; Johann, Susana

Memórias do Instituto Oswaldo Cruz

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mar 2016, Volume 111 N. 3 Pages 209 - 217

Abstract: En | Text: En | PDF: En

Fungi of the genus Paracoccidioides are responsible for paracoccidioidomycosis. The occurrence of drug toxicity and relapse in this disease justify the development of new antifungal agents. Compounds extracted from fungal extract have showing antifungal activity. Extracts of 78 fungi isolated from rocks of the Atacama Desert were tested in a microdilution assay against Paracoccidioides brasiliensis Pb18. Approximately 18% (5) of the extracts showed minimum inhibitory concentration (MIC) values≤ 125.0 µg/mL. Among these, extract from the fungus UFMGCB 8030 demonstrated the best results, with an MIC of 15.6 µg/mL. This isolate was identified as Aspergillus felis (by macro and micromorphologies, and internal transcribed spacer, β-tubulin, and ribosomal polymerase II gene analyses) and was grown in five different culture media and extracted with various solvents to optimise its antifungal activity. Potato dextrose agar culture and dichloromethane extraction resulted in an MIC of 1.9 µg/mL against P. brasiliensis and did not show cytotoxicity at the concentrations tested in normal mammalian cell (Vero). This extract was subjected to bioassay-guided fractionation using analytical C18RP-high-performance liquid chromatography (HPLC) and an antifungal assay using P. brasiliensis. Analysis of the active fractions by HPLC-high resolution mass spectrometry allowed us to identify the antifungal agents present in the A. felis extracts cytochalasins. These results reveal the potential of A. felis as a producer of bioactive compounds with antifungal activity.

https://doi.org/10.1590/0074-02760150451 2534 downloads

Distribution of pesticide residues in rice grain and in its coproducts
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Dors, Giniani C.

; Primel, Ednei G.

; Fagundes, Carlos A. A.

; Mariot, Carlos H. P.

; Badiale-Furlong, Eliana

Journal of the Brazilian Chemical Society

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oct 2011, Volume 22 N. 10 Pages 1921 - 1930

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Os agrotóxicos são usados em muitas culturas para prevenir e preservar os grãos de possíveis ataques de pragas. O objetivo deste trabalho foi avaliar a distribuição dos agrotóxicos bispiribaque de sódio, carbofurano, clomazona e tebuconazol nas diferentes frações do arroz beneficiado (arroz branco, farelo de arroz, arroz com casca, arroz parboilizado beneficiado, farelo de arroz parboilizado e arroz parboilizado com casca), o qual foi cultivado em campos experimentais sob condições controladas de aplicação. Para tanto, o método QuEChERS foi otimizado para a extração dos agrotóxicos e validou-se um método utilizando CLAE-DAD para quantificação e CL-EM para confirmação. O método QuEChERS modificado foi adequado na extração dos agrotóxicos, bem como as condições cromatográficas para identificação e quantificação, conforme os indicativos de eficiência determinados: LOD de 0,07 mg kg-1 e LOQ de 0,2 mg kg-1 para a mistura dos agrotóxicos, e recuperação para arroz e farelo de arroz de 119 e 116%, 84 e 119%, 113 e 96%, 103 e 97% para carbofurano, bispiribaque de sódio, clomazona e tebuconazol, respectivamente. O método desenvolvido foi aplicado nas frações do beneficiamento e o farelo apresentou maior concentração de resíduo dos agrotóxicos, quando comparado ao arroz beneficiado, sendo 8,0, 2,3, 2,2 e 1,6 vezes mais contaminado, em média, para tebuconazol, clomazona, carbofurano e bispiribaque de sódio, respectivamente. Apenas o clomazona e o tebuconazol apresentaram concentrações dentro do limite aceitável estabelecidos pelo Codex Alimentarius (0,1 mg kg-1) para o arroz beneficiado nas safras analisadas.

Pesticides are used to prevent pests from attacking grains in order to preserve the crops. This paper aims at evaluating the distribution of the pesticides bispyribac-sodium, carbofuran, clomazone and tebuconazole in different fractions of milled rice (white rice, rice bran, husked rice, parboiled rice, parboiled rice bran, and husked parboiled rice) which is planted on experimental fields under controlled conditions. The QuEChERS method was adapted to the extraction of pesticides and validated by using HPLC-DAD for quantification and LC-MS for confirmation. The analytical method of extracting pesticides, as well as the chromatographic conditions for identification and quantification, were suitable, according to certain efficiency indicators: 0.07 mg kg-1 LOD and 0.2 mg kg-1 LOQ for the mixture of pesticides and rice and rice bran recoveries of 119 and 116%, 84 and 119%, 113 and 96%, 103 and 97% for carbofuran, bispyribac-sodium, clomazone and tebuconazole, respectively. The method under development was applied to rice fractions: bran had the highest residue concentration of the studied pesticides, when compared to milled rice, showing 8.0, 2.3, 2.2 and 1.6 times more contamination, in average, with tebuconazole, clomazone, carbofuran and bispyribac-sodium, respectively. Only clomazone and tebuconazole were in the acceptable limits established by Codex Alimentarius (0.1 mg kg-1) for milled rice.

7936 downloads

Biological potential of Stillingia oppositifolia
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Cota, Betania Barros

; Johann, Susana

; Oliveira, Djalma M.

; Siqueira, Ezequias P.

; Souza-Fagundes, Elaine M.

; Cisalpino, Patrícia S.

; Alves, Tânia M. A.

; Zani, Carlos Leomar

Revista Brasileira de Farmacognosia

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feb 2011, Volume 21 N. 1 Pages 70 - 77

Abstract: En | Text: En | PDF: En

Organic extracts from leaves and stems of Stillingia oppositifolia Baill. ex Müll. Arg., Euphorbiaceae, were screened for antifungal and cytotoxic properties. The extracts presented Minimum Inhibitory Concentration values around 250 µg.mL-1 against Candida krusei and Candida tropicalis, and around 63 µg.mL-1 for Paracoccidioides brasiliensis. They were tested on three human cell lines (UACC-62, MCF-7, and TK-10), disclosing GI50 values, (concentration able to inhibit 50% of the cell growth) ranging from 50 to 100 µg.mL-1. Organic extract from stems furnished hexanic, dichloromethanic and aqueous phases after partition. Chromatographic fractionation of the hexanic soluble phase of the stems yielded aleuritolic acid 3-acetate, β-sitosterol, 3-epi-β-amyrin, β-amyrone and palmitic acid. These compounds showed antifungal and cytotoxic activities in the same range as the organic crude extract and low toxic effect against mononuclear cells obtained from human peripheral blood. This is the first report on chemical and biological potential of S. oppositifolia.

2940 downloads

Micobiota e micotoxinas em amostras de arroz coletadas durante o sistema estacionário de secagem e armazenamento
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Hoeltz, Michele

; Fagundes, Carlos Alberto

; Alcayaga, Eduardo Aléxis Lobo

; Noll, Isa Beatriz

Ciência Rural

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jun 2009, Volume 39 N. 3 Pages 803 - 808

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Considerando as perdas qualitativas e quantitativas no período pós-colheita de grãos, neste trabalho foram avaliadas a contaminação fúngica e as micotoxinas em arroz com casca, durante o sistema estacionário de secagem e armazenamento. As amostras foram coletadas em intervalos de 60 dias durante o armazenamento, em duas alturas do silo-secador. A amostra inicial apresentou 5,4x10(4)UFC g-1, sendo que a contagem aumentou significativamente durante a secagem e o armazenamento, chegando a 10(5)UFC g-1. A contaminação fúngica diferiu no interior do silo-secador, com maior contaminação na porção superior do silo. Os gêneros predominantes foram Aspergillus e Penicillium, com maior ocorrência de A. flavus (26,3%) e P. commune (19,1%). Quatro isolados de A. flavus produziram aflatoxina B1, mas não foram detectadas micotoxinas nas amostras.

Considering the qualitative and quantitative losses in post-harvest of grain, in this research was evaluated fungi and mycotoxins contamination in whole rice (Oryza sativa L.) during the stationary drying and storage system. Samples were collected in a period of sixty days in two heights of the warehouse during storage. The initial sample presented 5.4x10(4)CFU g-1; the contamination increased significantly during drying and storage, up to 10(5)CFU g-1. Fungi contamination was different inside the warehouse with higher contamination in the upper portion. The more abundant fungi genera were Aspergillus and Penicillium, A. flavus (26.3%) and P. commune (19.1%) which presented higher incidence. Aflatoxin B1 was produced by four A. flavus isolates, but mycotoxins were not detected in the samples.

3627 downloads

Variação sazonal das trocas gasosas em folhas de mamoeiro cultivado em condições de campo
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Machado Filho, José Altino

; Campostrini, Eliemar

; Yamanishi, Osvaldo Kiyoshi

; Fagundes, Geni Rodrigues

Bragantia

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2006, Volume 65 N. 2 Pages 185 - 196

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Na região do cerrado baiano, que se caracteriza por apresentar duas estações definidas: estação das secas (maio a setembro) e estação chuvosa (outubro a março), foi efetuado um estudo em um plantio comercial de Carica papaya L. com plantas do grupo 'Solo' (Sunrise Solo) e do grupo 'Formosa' (Tainung 01). Foram realizadas em duas épocas, sendo uma considerada época seca (julho e setembro) e a outra época considerada chuvosa (novembro e janeiro), medidas da taxa fotossintética líquida (A), condutância estomática (g s) e transpiração instantânea (E) em folhas completamente expandidas e crescidas a pleno sol. Nestes horários, foi possível medir a densidade de fluxo de fótons fotossintéticos (DFFF) e a temperatura do ar dentro da câmara (Tar ). A partir dos valores de A e g s, obteve-se a eficiência intrínseca no uso da água (A/g s). Em julho e setembro, nos dois genótipos estudados, foi verificado que os altos valores de DPVar causaram redução de g s e conseqüentemente redução de A quando comparado à estação chuvosa. A redução em g s causou elevação na eficiência intrínseca no uso da água. A ação do DPVar nas trocas gasosas foi semelhante nos dois genótipos.

This study was carried out in a commercial orchard of papaya in the Savanna region of Bahia state where there are two distinct seasons: dry season, from May to September and a rainy one from October to March. Two genotypes, one from 'Solo' group (Sunrise Solo) and another from 'Formosa' group (Tainung 01) were used. Net CO2 assimilation rate (A), stomatal conductance (g s), instantaneous transpiration (E), air temperature inside the chamber (Tar) and photosynthetic photon flux density (PPFD) were measured at one hour interval in a fully expanded sun-exposed leaves in two season, one characterized as dry season (July and September) and another one as rainy season (November and January). Intrinsic water use efficiency (IWUE) was calculated using A and g s (A/g s). In both genotypes, the reduced g s due to high VPD in July and September contributed to reduce A. The behavior was similar in the two studied genotypes. In the dry season, reduced g s triggered a higher IWUE.

2729 downloads

10.

Diretriz de fibrilação atrial
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Martinelli Filho, Martino

; Moreira, Dalmo A. Ribeiro

; Lorga, Adalberto M

; Sosa, Eduardo

; Atié, Jacob

; Pimenta, João

; Andrade, José Carlos S. de

; Fagundes, Márcio Luis A.

; Kuniyoshi, Ricardo Ryoshim

; Lorga Filho, Adalberto

; Lorga, Adalberto Menezes

; Lopes, Alberto Nicodemus G

; Paola, Ângelo A. V. de

; Costa, Álvaro Barros da

; Péres, Ayrton Klier

; Grupi, César J.

; Halperin, Cídio

; Moreira, Dalmo A. Ribeiro

; Sousa, Eduardo A.

; Sternick, Eduardo

; Cruz, Fernando Eugênio S.

; Darrieux, Francisco Carlos C.

; Lima, Gustavo Glotz

; Atié, Jacob

; Jorge, José Carlos Moura

; Andrade, José Carlos S. de

; Mateos, José Carlos Pachón

; Pimenta, João

; Oliveira, Júlio Cesar de

; Zimerman, Leandro I.

; Fagundes, Márcio Luis A.

; Martinelli Filho, Martino

; Scanavacca, Maurício I.

; Medeiros, Paulo de Tarso J.

; Miranda, Reynaldo Castro

; Costa, Roberto

; Kunyioshi, Ricardo Ryoshim

; Rassi, Sérgio Gabriel

; Galvão Filho, Silas S

; Seixas, Tamer N.

; Rodrigues, Thiago da Rocha

; Guimarães, Jorge Ilha

Arquivos Brasileiros de Cardiologia

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nov 2003, Volume 81 Suppl. 6 Pages 2 - 24

Abstract: Pt | Text: Pt | PDF: Pt

218420 downloads

11.

Diretrizes para Avaliação e Tratamento de Pacientes com Arritmias Cardíacas
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Feitosa, Gilson Soares

; Nicolau, José Carlos

; Lorga, Adalberto

; Lorga Filho, Adalberto

; D'Ávila, André

; Rassi Jr, Anis

; Paola, Angelo A. V. de

; Pedrosa, Anísio

; Costa, Álvaro Barros da

; Peres, Ayrton

; Grupi, César

; Cirenza, Cláudio

; Moreira, Dalmo

; Sobral, Dário

; Hachul, Denise

; D'Andréa, Eduardo

; Sosa, Eduardo

; God, Epotamênides M. Good

; Brito, Fábio Sândoli de

; Cruz, Fernando

; Fenelon, Guilherme

; Lima, Gustavo Glotz

; Brito, Hélio

; Maia, Ivan G.

; Atié, Jacob

; Jorge, José Carlos Moura

; Andrade, José Carlos de

; Mateos, José Carlos Pachón

; Ribeiro, José Carlos

; Pimenta, João

; Vasconcelos, José Tarcísio de

; Gizzi, Júlio

; Zimerman, Leandro

; Castilho, Luiz Antonio Teno

; Fagundes, Márcio

; Figueiredo, Márcio

; Martinelli Filho, Martino

; Scanavacca, Maurício I.

; Valente, Ney

; Medeiros, Paulo

; Brofman, Paulo

; Miranda, Reynaldo Castro

; Costa, Roberto

; Kunyioshi, Ricardo

; Sá, Roberto

; Rassi, Sérgio G.

; Siqueira, Sérgio

; Galvão, Silas

; Nishioka, Silvana

; Grillo, Tereza

; Rodrigues, Thiago da Rocha

; Maciel, Washington

Arquivos Brasileiros de Cardiologia

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2002, Volume 79 Suppl. 5 Pages 1 - 50

Abstract: Pt | Text: Pt | PDF: Pt

119261 downloads

12.

Arrhythmogenic cardiomyopathy of the right ventricle. Predictive value of QT interval dispersion to assess arrhythmogenic risk and sudden death
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Fagundes, Márcio L. A.

; Maia, Ivan G.

; Cruz Fº, Fernando E. S.

; Alves, Paulo A. G.

; Boghossian, Silvia H.

; Ribeiro, José Carlos

; Sá, Roberto

Arquivos Brasileiros de Cardiologia

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aug 2000, Volume 75 N. 2 Pages 120 - 124

Abstract: En | Text: En | PDF: En

OBJECTIVE: To determine in arrhythmogenic right ventricular cardiomyopathy the value of QT interval dispersion for identifying the induction of sustained ventricular tachycardia in the electrophysiological study or the risk of sudden cardiac death. METHODS: We assessed QT interval dispersion in the 12-lead electrocardiogram of 26 patients with arrhythmogenic right ventricular cardiomyopathy. We analyzed its association with sustained ventricular tachycardia and sudden cardiac death, and in 16 controls similar in age and sex. RESULTS: (mean ± SD). QT interval dispersion: patients = 53.8±14.1ms; control group = 35.0±10.6ms, p=0.001. Patients with induction of ventricular tachycardia: 52.5±13.8ms; without induction of ventricular tachycardia: 57.5±12.8ms, p=0.420. In a mean follow-up period of 41±11 months, five sudden cardiac deaths occurred. QT interval dispersion in this group was 62.0±17.8, and in the others it was 51.9±12.8ms, p=0.852. Using a cutoff > or = 60ms to define an increase in the degree of the QT interval dispersion, we were able to identify patients at risk of sudden cardiac death with a sensitivity of 60%, a specificity of 57%, and positive and negative predictive values of 25% and 85%, respectively. CONCLUSION: Patients with arrhythmogenic right ventricular cardiomyopathy have a significant increase in the degree of QT interval dispersion when compared with the healthy population. However it, did not identify patients with induction of ventricular tachycardia in the electrophysiological study, showing a very low predictive value for defining the risk of sudden cardiac death in the population studied.

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Modificação do nódulo sinusal via cateter por energia de radiofreqüência em paciente com taquicardia sinusal inapropriada. Avaliação dos resultados imediatos e tardios
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Cruz Fº, Fernando E. S.

; Maia, Ivan G.

; Fagundes, Marcio L. A.

; Boghossian, Silvia

; Ribeiro, José Carlos

Arquivos Brasileiros de Cardiologia

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mar 1998, Volume 70 N. 3 Pages 173 - 176

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

São apresentados os resultados imediatos e tardios, observados com a modificação do nódulo sinusal via cateter, usando-se energia de radiofreqüência, em portadora de taquicardia sinusal inapropriada. O procedimento normalizou os níveis de freqüência cardíaca nas 24h seguintes e após seis meses, mostrando-se, portanto, efetivo e seguro. Apesar da redução da freqüência cardíaca a níveis normais, houve manutenção dos sintomas apresentados pela paciente, sugerindo que não são decorridos, exclusivamente, do processo taquicárdico.

This article reports the early and late results of a patient in whom radiofrequency current was used to ablate an incessant inappropriate sinus tachycardia. During successful radiofrequency application there was a sudden change of rate and subsequent emergence of a stable rhythm with the same sinus node P wave characteristics. During follow-up, normal cardiac cycles were still present after six months of the procedure, although the patient still complained of palpitations, suggesting no correlation with the heart rate.

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