Abstract Based on the current increase in levels of citizen violence, it is relevant to standardize instruments for identifying crime-related risk factors in youth population. Therefore, this work aims to analyze the psychometric properties of Plutchik’s Violence Risk Scale (PVRS). The PVRS Spanish version was linguistically adapted to local terminology, and subsequently examined by eight judges. It was administered to 1052 university students from Lima, who ranged from 16 to 37 years old. The exploratory factor analysis showed a single-factor structure, which differs from the three-factor Spanish version. It was applied the Rasch model of Andrich’s Rating Scale because of its unidimensionality, identifying sex differential functioning of three items. Reliability was obtained through coefficient omega, whose value was .70; 95% CI [.63, .77]. In conclusion, the PVRS has suitable psychometric properties and appears to be a good alternative to screen the risk of violence in populations similar to the one studied.

Resumen Ante el incremento de los niveles de violencia ciudadana, resulta relevante adaptar instrumentos para identificar factores de riesgo en población juvenil. Por ello, el objetivo fue analizar las propiedades psicométricas de la Escala de Riesgo de Violencia de Plutchik (ERVP). Se realizó una adaptación lingüística de la versión española de la ERVP, ajustándola a la terminología local. Dicha adaptación fue examinada por ocho jueces. Se administró a 1052 universitarios limeños, entre los 16 y 37 años de edad. La unidimensionalidad permitió aplicar un modelo Rasch de Escala de Valoración de Andrich, considerando el funcionamiento diferencial de tres ítems en función al sexo. La confiabilidad se obtuvo a través del coeficiente omega, cuyo valor es de .70, 95% IC [.63, .77]. La ERVP cuenta con adecuadas propiedades psicométricas y es una buena alternativa para el tamizaje del riesgo de violencia en poblaciones similares.

Abstract There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective.

Objectives: To assess a bundled Antimicrobial Stewardship Program and its effect on mortality. Data:Eight months of clinical electronic medical records and Antimicrobial Stewardship Program registries were used as source of data.Method: This is a historical cohort study conducted in a Brazilian University Hospital. Eligible patients were admitted to general wards or intensive care units and had an antimicrobial therapy prescribed and assessed by different strategies: Bundled Antimicrobial Stewardship Program (bundled intervention consisted of clinical pharmacist chart review, discussion with microbiologist and infectious disease physicians, local education and continuous follow-up) or Conventional Antimicrobial Stewardship Program (clinical pharmacist chart review and discussion with infectious disease physician). Primary outcome from this study was 30-day mortality, which was compared between groups, by using Kaplan-Meier survival curve and log-rank test. Other outcomes included Defined Daily Doses per 1000 patient-days and occurrence of resistant bacteria.Results: From 533 patients, 491 were eligible for the study, of which 191 patients were included to Antimicrobial Stewardship Program and 300 to Conventional strategy. In general, they were likely to be male and age was similar in groups (58.9 vs 55.5 years, p= 0.38). Likewise, Charlson Comorbidity Index was not statistically different between groups (2.6 vs 2.7, p= 0.2). Bloodstream site infections were frequently diagnosed in both groups (30.89% vs 26%, p= 0.24). Other less common sites of infections were central nervous system and lungs. The ASP group had higher survival rates (p< 0.01) and the risk difference was 10.8% (95% CI: 2.41-19.14). There were less Defined Daily Doses per 1000 patient-days (417 vs 557.2, p< 0.05) and higher rates of resistant bacteria identified in the ASP group (83% vs 17%).Conclusion: Bundled ASP was the most effective strategy, with reduced mortality and Defined Daily Doses per 1000 patient-days.

Um método eletroanalítico foi desenvolvido para determinação simultânea de íons cobre e chumbo em cachaça empregando eletrodo de pasta de carbono modificado com ácido ascórbico e nanotubos de carbono (CPE-AaCNT). A técnica de voltametria de onda quadrada (SWV) com redissolução anódica foi empregada e otimizada com relação aos seguintes parâmetros: frequência (50 Hz), amplitude (100 mV) e incremento de varredura (9 mV). As curvas analíticas apresentaram intervalo linear de 0,09 a 7,00 mg L- 1 para o chumbo e para o cobre. Os limites de detecção foram de 48,5 e 23,9 µg L- 1 para o chumbo e o cobre, respectivamente. O método desenvolvido foi aplicado na determinação simultânea de chumbo e cobre em cinco amostras comerciais de cachaça. Os resultados apresentaram-se concordantes com os obtidos por F AAS/GF AAS (espectrometria de absorção atômica com chama/espectrometria de absorção atômica com forno de grafite) e revelaram que CPE-AaCNT podem ser empregados com êxito na quantificação de cobre e chumbo em amostras comerciais de cachaça.

The development of an electroanalytical method for simultaneous determination of copper and lead ions in sugar cane spirit (cachaça) using carbon paste electrode modified with ascorbic acid and carbon nanotubes (CPE-AaCNT) is described. Squarewave voltammetry (SWV) with anodic stripping was employed, and this technique was optimized with respect to the following parameters: frequency (50 Hz), amplitude (100 mV) and scan increment (9 mV). The analytical curves were linear in the range from 0.0900 to 7.00 mg L- 1 for lead and copper. The limits of detection were 48.5 and 23.9 µg L- 1 for lead and copper, respectively. The developed method was applied to the simultaneous determination of copper and lead in five commercial samples of sugar cane spirit. The results were in good agreement with those obtained by F AAS/GF AAS (flame atomic absorption spectrometry/graphite furnace atomic absorption spectrometry) and showed that CPE-AaCNT can be successfully employed in the simultaneous determination of these metals in real sugar cane spirit samples.

INTRODUÇÃO: Anteriormente, a alta prevalência de hipertensão arterial em alunos do Ensino Médio de Sorocaba, em São Paulo, foi descrita. Neste estudo, em nova amostra de alunos da mesma faixa etária, oriundos de escolas públicas e privadas, foi avaliado se as diferenças socioeconômicas e o modo de vida podem influenciar os valores da pressão arterial. MÉTODOS: Trata-se de um estudo epidemiológico, inserido entre as atividades de um trabalho comunitário, em que estudantes de Medicina fazem palestras para alunos do Ensino Médio, objetivando estimular hábitos de vida saudáveis e a prevenção primária da hipertensão arterial. Em amostra aleatória de 410 alunos do segundo ano do Ensino Médio (209 de escolas públicas e 201 de escolas privadas), foram determinados o peso, a altura e a pressão arterial, e foi aplicado um questionário epidemiológico e socioeconômico. RESULTADOS: Não há diferenças estatísticas entre os alunos das escolas públicas e privadas quanto à distribuição de sexo, ao índice de massa corporal (IMC), à pressão arterial sistólica e diastólica, à prevalência de hipertensão arterial (16,3%), à porcentagem de fumantes (5,9%), à atividade física regular e aos antecedentes familiares de hipertensão arterial. Nas escolas públicas há maior porcentagem de afro-descendentes, os alunos trabalham fora de casa com maior frequência e têm menor renda familiar. Nas escolas públicas e privadas, os homens têm maior prevalência de hipertensão arterial e a média da pressão arterial é maior que nas mulheres. O IMC tem correlação positiva com a pressão arterial sistólica e diastólica. CONCLUSÕES: A hipertensão arterial e outros fatores de risco cardiovasculares têm início precoce e necessitam de intervenções educativas para a prevenção primária. Fatores socioeconômicos não influenciam a pressão arterial na adolescência.

INTRODUCTION: The high prevalence of hypertension in high school students in Sorocaba, São Paulo, Brazil, has already been described. In this study, within a new sample of high school students from public and private schools, we evaluated if socioeconomic and lifestyle influence on blood pressure values. METHODS: This is an epidemiological study, which is part of the activities of a community-based work conducted by medical students. They give speeches to high school students aiming at stimulating a healthy lifestyle and primary prevention of hypertension. In a random sample of 410 students in junior high school (209 from public schools and 201 from private schools), we determined the weight, height, and blood pressure, furthermore, a questionnaire identifying epidemiological and socioeconomic status was applied. RESULTS: No statistical differences were found among students from public and private schools regarding the distribution of gender, body mass index (BMI), systolic and diastolic blood pressure, prevalence of hypertension (16.3%), percentage of smokers (5.9%), regular physical activity, and family history of hypertension. In public schools, there is a higher percentage of African descendents students and a higher percentage of students who also work due to low family income. Men from public and private schools have higher prevalence of hypertension, and their mean blood pressure is higher than in women. BMI has a positive correlation with systolic and diastolic blood pressure. CONCLUSIONS: Hypertension and other cardiovascular risk factors have an early beginning and require educational interventions for primary prevention. Socioeconomic factors do not affect blood pressure in adolescence.

Embora associada à adoção de tecnologias de conservação do solo, a intensificação dos sistemas de produção agropecuária tem induzido a um dos principais problemas enfrentados pelos agricultores, a compactação do solo, seja em sistemas de plantio direto ou em sistemas de plantio convencional e pastagem. Este estudo foi realizado em Rio Verde, GO, em Latossolo Vermelho Amarelo, nos seguintes sistemas: plantio direto há 14 anos (SD14); plantio direto há oito anos (SD8); plantio direto há dois anos (SD2); preparo convencional (PC); pastagem (P) e floresta (F). A resistência à penetração do solo foi determinada utilizando-se o penetrômetro de Impacto Modelo IAA/Planalsucar - Stolf, a partir da superfície do solo até a profundidade de 0,40 m; determinaram-se, também, a densidade do solo e a granulometria. O plantio convencional apresentou menor resistência à penetração, na profundidade 0-0,10 m, enquanto o SD2 indicou maior resistência à penetração até 0,40 m de profundidade. Abaixo da profundidade de 0,15 m não houve diferença significativa entre os tratamentos PC, SD8, SD14. Os dois primeiros anos de adoção do sistema de plantio direto são críticos quanto à resistência a penetração nas camadas superficiais do solo.

The intensification of agricultural production systems has caused soil compaction even when soil conservation technologies are adopted. Soil compaction is one of the main problems for farmers, both in no-tillage and in conventional-tillage systems, as well as in pasture. This study was conducted in Rio Verde, (State of Goias), on Red-Yellow Latosol under the following systems: no-tillage for 14 years (SD14); no-tillage for 8 years (SD8); no-tillage for 2 years (SD2); conventional tillage (CT); pasture (P) and forest (F). The soil resistance to penetration was measured by the impact penetrometer Model IAA/Planalsucar - Stolf, from soil surface to the soil depth of 0.40 m. Soil bulk density and granulometry were also determined. Conventional tillage had lower resistance to penetration at the 0-0.10 m depth, whereas SD2 had more resistance up to 0.40 m in depth. There were no significant differences below 0.15 m in depth among treatments CT, SD8, and SD14. The first two years under the no-tillage system are critical, with regard to the resistance to penetration in to the soil surface layers.

Até meados da década de 1990, predominava na literatura especializada que o Novo Mundo teria sido colonizado por três levas distintas, todas com origem no nordeste asiático. Na segunda metade da década, dois modelos alternativos começaram a desfrutar de grande popularidade entre a comunidade acadêmica internacional. O primeiro deles, denominado "Modelo dos Dois Componentes Biológicos Principais", baseado na variabilidade craniométrica de populações nativas americanas extintas, sugere que a América teria sido colonizada por pelo menos duas populações morfologicamente distintas vindas do nordeste asiático. O segundo, gerado por pesquisas sobre a variabilidade do DNA mitocondrial e do cromossomo Y de populações indígenas atuais, defende que o continente americano teria sido colonizado por apenas uma migração, também de origem asiática. Alguns especialistas acreditam que a compatibilização desses dois modelos é simples: as duas morfologias que se sucederam no tempo no Novo Mundo são resultado de um processo microevolutivo local, independente daquele que ocorreu, em paralelo, na Ásia. Uma outra maneira de compatibilizar os dois cenários é assumir que morfologia craniana e linhagens de DNA são entidades evolutivamente independentes, com histórias, modos, tempos e tendências próprias. Este trabalho apresenta novas evidências de que dois padrões morfológicos cranianos de fato se sucederam no Novo Mundo. Um relacionado às populações mais antigas (paleoíndias) e um relacionado a populações arcaicas e agrocerâmicas. Esses resultados são analisados à luz da discussão acima caracterizada.

Until mid 1990s the prevailing model to explain the early colonization of the Americas rested on the assumption that three different migrations were involved in the process. The first migration would have given rise to most of the modern Native Americans, and is known as "Amerind"; the second migration would have given rise only to the Na-Dene Indians of the northern pacific; while the third would have given rise to the Eskimos and Aleuts. Known as the Three Migrations Model, the model was said to rest on convergent evidences coming from dental morphology, linguistics and the gene pool of living Native Americans. By the time the model was formulated, genetic diversity of living humans was studied by means of gene products, like serum proteins, and not by means of DNA itself. From mid 1990s on, two other models to explain the origin of Native Americans started competing with the Three Migration Model. They are known today as The Two Main Biological Components Model, and The Single Migration Model. The first one rests on the analysis of the cranial morphology of extinct and extant Native Americans along time, while the second has emerged from the study of DNA polymorphisms of living populations, mainly from mitochondrial and Y chromosome DNA sequencing. In other words, evidence coming from cranial morphology and its variation along time sustains that two Northern Asian populations entered the continent: the first one exhibiting a more generalized cranial pattern, and a second one exhibiting a more specialized architecture. On the other hand, the distribution of DNA haplogroups in modern Native American populations is easily explained by the entrance of only one mother population from Northern Asia. In this study we present new evidence that two very distinct cranial morphologies are indeed found among extinct Native Americans along time: a more generalized cranial pattern typifying the first newcomers, known in the literature as Paleoindians (12 to 8 thousand years ago), and a more specialized pattern typifying latter groups, since the Archaic period (<8 thousand years). Although exceptions to this temporal logic have already been found, the chronology proposed seems to work in the vast majority of the American continent. The results obtained are discussed under the light of those generated by Molecular Biology of extant Native Americans.

Apesar da existência de contatos entre planalto e litoral brasileiros ser atualmente quase um consenso entre os arqueólogos nacionais, não há muita certeza de como teria se dado tal contato e qual seria o fluxo entre interior e costa. O vale do Ribeira de Iguape (SP) é uma das raras regiões do Sul-Sudeste do país onde tal comunicação seria bastante facilitada devido a peculiaridades de sua geomorfologia. Neste trabalho, apresentamos os resultados de uma análise craniométrica comparativa entre 12 esqueletos provenientes de sambaquis fluviais do vale do Ribeira datados entre 6.000 e 1.200 anos AP e 225 esqueletos oriundos de diversas séries pré-históricas brasileiras do interior e do litoral. Ao contrário do que se observa no início do Holoceno nesse vale, não há qualquer afinidade biológica entre os ribeirinhos mais tardios e os paleoíndios de Lagoa Santa ou qualquer outra série interiorana. Os grupos fluviais (ambos os sexos) associam-se aos sambaquis da costa de São Paulo e do Paraná, mostrando que houve realmente um contato considerável entre a planície costeira e o planalto, ao menos no estado de São Paulo a partir da segunda metade do Holoceno.

Although there is no doubt about human contacts between inland and coast in Southern Brazil during archaic times, these contacts remains unknown. Due to its geomorphologic idiosyncrasies, the Ribeira de Iguape valley, in the State of São Paulo, is one of few regions in Southeastern Brazil where this communication could be easily performed. Here we present results of a craniometric analysis using 12 human skeletons from riverine shellmounds from Ribeira de Iguape valley, dated to between 6,000 and 1,200 years before present (non calibrated). These specimens were compared to 225 human skeletons from several Brazilian pre-historic sites from inland and coast. The biological affinity found in early Holocene individuals from this valley and Paleoamericans was not observed for the archaic riverine shellmound groups. No affinities were found between them and other inland series, as well. The riverine shellmound groups are close to the coastal shellmound groups from São Paulo and Paraná, which can be interpreted as evidence of a relevant contact between coast and inland, at least in Southern São Paulo State in the middle Holocene.

Objetivo: avaliar o prognóstico fetal dos casos de onfalocele com diagnóstico pré-natal. Métodos: foram analisados 51 casos de onfalocele com diagnóstico pré-natal e divididos em 3 grupos: grupo 1, onfalocele isolada; grupo 2, onfalocele com malformações estruturais associadas e cariótipo normal; grupo 3, onfalocele associada à cromossomopatia. As análises foram realizadas em relação à sobrevida geral e pós-correção cirúrgica, considerando as malformações associadas, idade gestacional no parto, peso no nascimento e tamanho da onfalocele. Resultados: o grupo 1 correspondeu a 21% (n = 11), o grupo 2 a 55% (n = 28) e o grupo 3 a 24% (n = 12). Todos os casos do grupo 3 evoluíram para óbito, e a cromossomopatia mais freqüente foi a trissomia do 18. A sobrevida foi de 80% no grupo 1 e de 25% no grupo 2. Dezesseis casos foram submetidos à correção cirúrgica (10 isoladas e 6 associadas) e 81% sobreviveram (8 isoladas e 5 associadas). A mediana do peso no nascimento dos sobreviventes pós-correção cirúrgica foi 3.140 g e dos que morreram foi de 2.000 g (p = 0,148) e a idade gestacional do parto foi de 37 e de 36 semanas (p = 0,836), respectivamente. A relação das circunferências onfalocele/abdominal diminuiu com a idade gestacional, 0,88 entre 25-29 semanas e 0,65 entre 30-35 semanas (p = 0,043). Não foi observada diferença significativa no tamanho da onfalocele nos 3 grupos (p = 0,988) e influência deste prognóstico pós-correção cirúrgica (p = 0,553). Conclusão: a sobrevida geral e pós-correção cirúrgica foi de 25 e 81%, respectivamente. As malformações associadas representam o principal fator prognóstico das onfaloceles com diagnóstico pré-natal, visto que se associam com prematuridade e baixo peso.

Purpose: to evaluate the prognosis of fetal omphalocele after prenatal diagnosis. Methods: fifty-one cases with prenatal diagnosis of fetal omphalocele were divided into three groups: group 1, isolated omphalocele; group 2, omphalocele associated with structural abnormalities and normal karyotype; group 3, omphalocele with abnormal karyotype. The data were analyzed for overall survival rate and postsurgery survival, considering associated malformations, gestational age at delivery, birth weight and size of omphalocele. Results: group 1 corresponded to 21% (n = 11), group 2, 55% (n = 28) and group 3,24% (n = 12). All of Group 3 died, and trisomy 18 was the most frequent chromosomal abnormality. The survival rate was 80% for group 1 and 25% for group 2. Sixteen cases underwent surgery (10 isolated and 6 associated), 81% survived (8 isolated and 5 associated). The median birth weight was 3,140 g and 2,000 g for survivals and non-survivals after surgery, respectively (p = 0.148), and the corresponding gestational age at delivery was 37 and 36 weeks (p = 0.836). The ratio of omphalocele/abdominal circumference decreased with gestation, 0.88 between 25-29 weeks and 0.65 between 30-35 weeks (p = 0.043). The size of omphalocele was not significantly different between the 3 groups (p = 0.988), and it was not associated to postsurgery prognosis (p = 0.553). Conclusion: the overall and postsurgery survival rates were 25 and 81%, respectively. Associated malformations were the main prognostic factor in prenatally diagnosed omphaloceles, since they are associated with prematurity and low birth weight.

Objetivo: determinar curvas e tabelas de crescimento do diâmetro biparietal médio e da circunferência cefálica média em relação à idade gestacional de gestações gemelares e analisar eventuais diferenças com as existentes para fetos únicos e gêmeos. Métodos: por meio de exames ultra-sonográficos realizados a cada duas ou três semanas por um único observador em 34 pacientes com gestação gemelar sem patologias feto-maternas foi possível estabelecer curvas e tabelas do diâmetro biparietal médio e da circunferência cefálica média em relação a idade gestacional. Os valores destes parâmetros biométricos foram comparados aos descritos pela literatura para fetos únicos e gêmeos. Resultados: foram obtidas curvas e tabelas do diâmetro biparietal e da circunferência cefálica em relação a idade gestacional. O crescimento do diâmetro biparietal e da circunferência cefálica se revelou menor no terceiro trimestre em relação aos observados por Hadlock et al.15 para gestação única. A diferença entre os valores médios foi 6 mm (diâmetro biparietal) e 2,0 cm (circunferência cefálica) na 39ª semana de gestação. Foram observadas também algumas diferenças em relação a outros estudos de gestações gemelares. Conclusão: este estudo sugeriu que as curvas e tabelas de crescimento do diâmetro biparietal médio e da circunferência cefálica média de gestações únicas não são apropriadas para avaliação de gestações gemelares da população analisada principalmente no terceiro trimestre.

Purpose: to estimate growth curves and tables of average biparietal diameter and average head circumference of twin gestations and to compare them with published growth curves for singletons and twins. Methods: growth curves and tables of average biparietal diameter and average head circumference were obtained from sonographic examinations of 34 patients with twin gestations without maternal and fetal complications. Sonographic examinations were performed each 2 or 3 weeks by a single observer. The parameters were compared with existing growth curves for singletons and twins. Results: curves and tables of biparietal diameter and head circumference in relation to gestational age were obtained. The study revealed difference in growth pattern mainly regarding the 3rd trimester in relation to singletons (Hadlock et al.15). The difference between the average values were 6 mm (biparietal diameter) and 2.0 cm (head circumference) at the 39th week of gestation. Also, some differences were observed relative to the twin studies. Conclusion: this study revealed that growth curves for average biparietal diameter and average head circumference of singletons are not appropriate to determine gestational age in twin gestations of the studiced population principally at the 3rd trimester

O estudo foi realizado com o objetivo de avaliar a eventual utilidade de raios gama na profilaxia da malária transmissível por transfusão de sangue, tendo sido, para isso, usados camundongos infectados pelo Plasmodium berghei. Na primeira fase, quando submetemos sangue deles retirado a 2.500 e 5.000rad, com associação ou não de metronidazol, não obtivemos sucesso, já que todos os animais antes sem a parasitose apresentaram parasitemia e morreram após inoculação do sangue irradiado. Porém, ocorreu êxito parcial na segunda fase, ao serem empregados 10.000 e 15.000rad, porquanto 20% e 40% dos roedores, respectivamente, embora tenham ficado infectados, sobreviveram, com posterior negativação quanto à presença do P. berghei.

This study was carried out to evaluate the fortuitons advantage of using gamma irradiation in the prophylaxis of transmissible malaria by blood transfusion, with mice as the experimental model. In the first step, when the infected blood with Plasmodium berghei was submitted to 2,500rad and 5,000rad, with or without metronidazol, there was no success, because the animals presented parasitaemia and died after inoculation of irradiated blood. However, there was partial success in the second step, when the infected blood received 10,000 and 15,000rad, and was inoculated in mice, which showed infection, and presented a survival rate of 20% and 40%, respectively, with later negativation of blood infected by P. berghei.

A autotransfusão (AT) que utiliza a reposição de sangue autógeno constitui uma alternativa para a redução das complicações da transfusão de sangue homólogo, já que, em cirurgias eletivas, existe a possibilidade da coleta de sangue no período pré-operatório. Foi realizado um estudo comparativo prospectivo para tentar estabelecer os parâmetros ideais da AT pré-operatória, referentes ao volume, intervalo de tempo prévio à cirurgia e benefício aos pacientes, entre outros. Foram considerados, para o estudo, 96 pacientes consecutivos a serem submetidos a revascularização miocárdica. As cirurgias foram eletivas e os pacientes não apresentavam hipoproteinemia, anemia, infecções, operações cardíacas prévias, outras cirurgias recentes, ou, então, mais de 70 anos de idade. Foram divididos em 4 grupos; Grupo I: sem AT pré (controle, 41 pacientes); Grupo II: Coleta de 500 a 600 ml, sendo Grupo II-A até 7 dias antes da operação (35 pacientes) e Grupo II B de 8 a 15 dias antes (14 pacientes) e Grupo III com coleta realizada acima de 30 dias da operação, com reinfusão e nova coleta a cada 15 dias (6 pacientes). A idade média e o hematócrito foram comparáveis, nos 4 grupos. Em alguns pacientes, utilizou-se, também, a AT no pós-operatório. Os resultados revelaram que 63% do Grupo I, 26% no Grupo II-A, 43% no Grupo II-B e 67% no Grupo III receberam sangue homólogo. A média de sangue autógeno recebido foi de 534 ml/paciente no Grupo II-A, 539 ml/paciente no Grupo II-B e 908 ml/paciente no Grupo III. O hematócrito, no pós-operatório, foi comparável nos 4 grupos, por ocasião da alta. Não houve óbitos. Os autores concluem que um menor número de pacientes do Grupo II-A recebeu sangue homólogo (ES p = 0,008) e não houve diferença estatística (ES) entre os grupos II-A, II-B e III, com relação ao volume de sangue homólogo recebido. Além disto, não houve aumento de complicações, particularmente sangramento, em nenhum dos grupos em relação ao grupo controle.

Autotransfusion (AT) is an alternative to reduce the incidence of complications following homologous blood transfusion. The utilization of autogenous blood is feasible in elective surgical procedures (Pre-AT). A prospective comparative study was carried out in order to establish the ideal parameters for pre-AT, concerning volume, time interval prior to surgery and benefits to the patient, among others. Ninety-six consecutive patients candidates for myocardial revascularization, were analized in the present study. These patients did not present hypoproteinemia, anemia, infections or more than 70 years of age; cardiac reoperations were discarded. Four groups (G) were considered: GI - control group, without pre-AT (41 patients); GII - collection of 500 to 600 ml, comprizing the groups; GII-A - until 7 days before surgery (35 patients); GII-B - from 8 to 15 days before surgery (14 patients); GIII - collection of 1000 ml more than 30 days before operation, with reinfusion and a new collection after 15 days (6 patients). Mean age and hemotocrit were comparable in the different groups. In a few patients postoperative AT was utilized. The results indicated that homologous blood transfusion were necessary in 63% of GI, 26% of GII-A, 43% of GII-B and 67% of GIII patients. The mean amount of autogenous blood reinfused was 534 ml/patient in GII-A, 539 ml/patient in GII-B, and 908 ml/patient in GIII. The postoperative hematocrit at discharge from the hospital was comparable in the four groups. There were no deaths. A smaller number of patients in GII-A received homologous blood (p = 0,008) and there was no statistically significant difference in the groups II-A, II-B and III concerning the volume of homologous blood received. There was no higher incidence of complications, specially bleeding, in the different groups when compared with the control group.