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Abstract Background International publications have shown that the COVID-19 pandemic has negatively impacted the indicators of care for ST-segment elevation acute myocardial infarction (STEMI), with a potential increase in morbidity and mortality. Objectives To compare mortality, time from symptom onset to primary angioplasty (total delay [TD]), time from symptom onset to initial medical contact (patient delay [PD]), and time from initial medical contact to guidewire insertion in the hemodynamics laboratory (system delay [SD]) among patients admitted for STEMI at the Hemodynamics Service of Santa Casa de Passos, Minas Gerais, Brazil before and after the declaration of the COVID-19 pandemic by the World Health Organization, assessing the impact of the COVID-19 pandemic on STEMI care indicators. Methods This is a before-and-after study involving patients hospitalized with STEMI undergoing primary angioplasty. Data were collected retrospectively through medical record review. Clinical and demographic profiles and outcomes between the pre-pandemic and pandemic groups were compared using the chi-square test for categorical variables or Student's t-test for continuous variables. A significance level of p < 0.05 was adopted. Results There were no differences in TD (pre-pandemic: 300 min [± 159 min], 95% CI 277.1 to 322.6; pandemic: 300 min [± 148 min], 95% CI 274.3 to 326.6, p = 0.97). However, there was an increase in SD (pre-pandemic: 145 min [± 97 min], 95% CI 122.7 to 167.9; pandemic: 178 min [± 96 min], 95% CI 157.4 to 197.9, p = 0.037). There was no increase in PD (pre-pandemic: 145 min ± 133 min; pandemic: 130 min ± 117 min, p = 0.44), and no differences in mortality were observed (pre-pandemic: 9.7%; pandemic: 12%, p = 0.49). Conclusion The COVID-19 pandemic increased SD in the management of STEMI in the region of Passos, Minas Gerais. There were no differences in PD, TD, and in-hospital mortality. COVID19 COVID 19 COVID-1 STsegment ST segment STEMI, , (STEMI) total [TD]) patient [PD]) system [SD] Passos Gerais Organization beforeandafter review prepandemic pre chisquare chi square Students Student s ttest t 005 0 05 0.0 adopted (pre-pandemic 30 [ 15 min] 95 2771 277 1 277. 322.6 3226 322 6 14 2743 274 3 274. 3266 326 326.6 0.97. 097 0.97 . 0.97) However 9 1227 122 7 122. 167.9 1679 167 17 1574 157 4 157. 1979 197 197.9 0.037. 0037 0.037 037 0.037) 13 11 0.44, 044 0.44 44 0.44) 9.7% 12 12% 0.49. 049 0.49 49 0.49) inhospital hospital COVID1 COVID- (STEMI [TD] [PD] [SD 00 0. 27 322. 32 326. 09 0.9 167. 16 197. 003 0.03 03 04 0.4 9.7 [TD [PD 2 9.

https://doi.org/10.36660/ijcs.20220009

Ressonância Magnética Cardíaca como Ferramenta Diagnóstica Etiológica em Pacientes Recuperados de Morte Súbita Cardíaca ou Arritmias Ventriculares Instáveis
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Marçal, Paula C.

; Braggion-Santos, Maria Fernanda

; Wada, Danilo Tadao

; Santos, Marcel Koenigkam

; Moreira, Henrique Turin

; Volpe, Gustavo Jardim

; Schmidt, André

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 4 elocation e20220411

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

Resumo Fundamento A ressonância magnética cardíaca (RMC) tem relevância diagnóstica crescente em sobreviventes de morte súbita cardíaca (MSC) ou arritmia ventricular instável (AVI) em países desenvolvidos. Objetivo Procuramos avaliar retrospectivamente o papel adicional da RMC em um país em desenvolvimento com poucos recursos disponíveis e que pode direcionar um uso mais eficaz desses recursos. Métodos Foram incluídos sobreviventes de MSC ou AVI admitidos entre 2009 e 2019 em uma instituição acadêmica terciária após a realização de RMC. Dados demográficos, clínicos e laboratoriais foram coletados dos prontuários. Imagens e laudos de RMC foram analisados e o impacto disso no diagnóstico etiológico final foi afirmado. Realizou-se análise descritiva e definiu-se p<0,05 como significativo. Resultados Sessenta e quatro pacientes, 54,9±15,4 anos, sendo 42 (71,9%) do sexo masculino. A maioria dos eventos (81,3%) foi extra-hospitalar e a taquicardia ventricular foi o ritmo mais comum. Medicamentos cardiovasculares foram utilizados anteriormente por 55 pacientes, sendo os betabloqueadores os medicamentos mais utilizados (37,5%). O eletrocardiograma apresentava áreas elétricas inativas em 21,9% e todos apresentavam fibrose na RMC. A média da fração de ejeção do ventrículo esquerdo (FEVE) foi de 44±14%, com 60,9% ≤50% e apenas 29,7% ≤35%. Identificou-se realce tardio com gadolínio em 71,9%, com padrão transmural em 43,8%. A miocardiopatia chagásica foi a etiologia mais comum (28,1%), seguida da miocardiopatia isquêmica (17,2%). Entre 26 sem etiologia previamente identificada, foi possível definir com RMC (15 pacientes - 57%). Conclusão De acordo com estudos anteriores em países desenvolvidos, a RMC foi capaz de aumentar o diagnóstico etiológico e identificar o substrato arritmogênico, permitindo melhor atendimento em metade dos pacientes subdiagnosticados. (RMC (MSC (AVI desenvolvidos 200 201 demográficos prontuários afirmado Realizouse Realizou se definiuse definiu p005 p 0 05 p<0,0 significativo 549154 54 9 15 4 54,9±15, anos 71,9% 719 71 (71,9% masculino 81,3% 813 81 3 (81,3% extrahospitalar extra hospitalar 5 37,5%. 375 37,5% . 37 (37,5%) 219 21 21,9 FEVE (FEVE 4414 44 14 44±14% 609 60 60,9 50 ≤50 297 29 7 29,7 35 ≤35% Identificouse Identificou 438 43 8 43,8% 28,1%, 281 28,1% , 28 1 (28,1%) 17,2%. 172 17,2% 17 2 (17,2%) identificada (1 57%. 57 57% 57%) arritmogênico subdiagnosticados 20 p00 p<0, 54915 54,9±15 71,9 (71,9 81,3 (81,3 37,5 (37,5% 21, 441 44±14 6 60, ≤5 29, ≤35 43,8 28,1 (28,1% 17,2 (17,2% ( p0 p<0 5491 54,9±1 71, (71, 81, (81, 37, (37,5 44±1 ≤ ≤3 43, 28, (28,1 17, (17,2 p< 549 54,9± (71 (81 (37, 44± (28, (17, 54,9 (7 (8 (37 (28 (17 54, (3 (2

Abstract Background Cardiac magnetic resonance (CMR) has an increasing diagnostic relevance in survivors of sudden cardiac death (SCD) or unstable ventricular arrhythmia (UVA) in developed countries. Objective To evaluate retrospectively the additional role of CMR in a developing country where few resources are available, and should be used more effectively. Methods The study included SCD or UVA survivors admitted between 2009 and 2019 at a tertiary academic institution referred to CMR. Demographic, clinical, and laboratory data were collected from the medical records. CMR images and reports were reviewed and their impact on the final etiological diagnosis was determined. A descriptive analysis was performed and p<0.05 established as significant. Results Sixty-four patients, 54.9±15.4 years old, and 42 (71.9%) males. Most events (81.3%) were out of the hospital and ventricular tachycardia was the most common rhythm. Cardiovascular medications were previously used by 55 patients, and beta-blockers were the most used medications (37.5%). Electrocardiogram had electrical inactive areas in 21.9% and all of them had fibrosis at CMR. Mean left ventricular ejection fraction (LVEF) was 44±14%, with 60.9% ≤50% and only 29.7% ≤35%. Late gadolinium enhancement was identified in 71.9%, with a transmural pattern in 43.8%. Chagas cardiomyopathy was the most common etiology (28.1%), followed by ischemic cardiomyopathy (17.2%). Among 26 without a previously identified etiology, CMR could define it (15 patients – 57%). Conclusion In accordance with previous studies in developed countries, CMR was capable of increasing etiological diagnosis and identifying the arrhythmogenic substrate, allowing better care in half of the underdiagnosed patients. (CMR (SCD (UVA countries available effectively 200 201 Demographic clinical records determined p005 p 0 05 p<0.0 significant Sixtyfour Sixty four 549154 54 9 15 4 54.9±15. old 71.9% 719 71 (71.9% males 81.3% 813 81 3 (81.3% rhythm 5 betablockers beta blockers 37.5%. 375 37.5% . 37 (37.5%) 219 21 21.9 LVEF (LVEF 4414 44 14 44±14% 609 60 60.9 50 ≤50 297 29 7 29.7 35 ≤35% 438 43 8 43.8% 28.1%, 281 28.1% , 28 1 (28.1%) 17.2%. 172 17.2% 17 2 (17.2%) (1 57%. 57 57% 57%) substrate 20 p00 p<0. 54915 54.9±15 71.9 (71.9 81.3 (81.3 37.5 (37.5% 21. 441 44±14 6 60. ≤5 29. ≤35 43.8 28.1 (28.1% 17.2 (17.2% ( p0 p<0 5491 54.9±1 71. (71. 81. (81. 37. (37.5 44±1 ≤ ≤3 43. 28. (28.1 17. (17.2 p< 549 54.9± (71 (81 (37. 44± (28. (17. 54.9 (7 (8 (37 (28 (17 54. (3 (2

https://doi.org/10.36660/abc.20220411

Videolaryngoscopy in anesthesia and perioperative medicine: innovations, challenges, and best practices medicine innovations challenges
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Quintao, Vinícius Caldeira

; Carvalho, Vanessa Henriques

; Costa, Luiz Guilherme Villares da

; Germano-Filho, Paulo Alipio

; Nascimento, José Carlos R.

; Lima, Rodrigo Moreira e

; Nunes, Rogean Rodrigues

; Brandão, Antônio Carlos

; Schmidt, André P.

Brazilian Journal of Anesthesiology

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2023, Volume 73 N. 5 Pages 525 - 528

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2023.08.003

10.

Registration of clinical trials in anesthesiology: promoting transparency in clinical research
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Schmidt, André P.

; Carmona, Maria José C.

Brazilian Journal of Anesthesiology

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dec 2022, Volume 72 N. 6 Pages 685 - 687

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.09.002

11.

Teste de Limiar de Desfibrilação e Seguimento a Longo Prazo de Pacientes com Cardiopatia Crônica da Doença de Chagas
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Campos, Marco Paulo Cunha

; Bernardes, Luiz Fernando Gouveia

; Melo, João Paulo Chaves de

; Santos, Lucas Corsino dos

; Teixeira, Cristiano Honório Ribeiro

; Pavão, Maria Licia Ribeiro Cury

; Arfelli, Elerson

; Scorzoni Filho, Adilson

; Rassi Jr, Anis

; Marin-Neto, José A.

; Schmidt, André

Arquivos Brasileiros de Cardiologia

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dec 2022, Volume 119 N. 6 Pages 923 - 928

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

Resumo Fundamento A morte súbita cardíaca (MSC) é a causa mais comum de óbito na cardiomiopatia crônica da doença de Chagas (CCDC). Visto que muitos pacientes com CCDC que são candidatos a receber um cardioversor desfibrilador implantável (CDI) atendem a critérios que sugerem alto risco de apresentarem limiares de desfibrilação elevados, sugere-se realizar um teste de limite de desfibrilação (LDF). Objetivos Investigamos o uso do teste de LDF em pacientes com CCDC, com enfoque nos óbitos relacionados ao implante do CDI e na ocorrência de eventos arrítmicos e o tratamento oferecido durante o seguimento de longo prazo. Métodos Avaliações retrospectivas de 133 pacientes com CCDC que receberam CDI, principalmente para prevenção secundária. Foram coletados dados demográficos, clínicos e laboratoriais, escore de Rassi e dados do teste de LDF. Adotou-se p<0,05 como estatisticamente significativo. Resultados A média de idade foi 61±13 anos, e 72% da amostra era do sexo masculino. A fração de ejeção basal do ventrículo esquerdo foi 40±15%, e o escore de Rassi médio foi 10±4 pontos. Não ocorreram óbitos durante o teste de LDF, e não foram documentadas falhas do CDI. Foi identificada relação entre escore de Rassi basal mais elevado e LDFs mais elevados (ANOVA =0,007). O tempo médio até o primeiro choque foi de 474±628 dias, mas a aplicação de choque foi necessária em apenas 28 (35%) pacientes com TV, visto que a maioria dos casos se resolveu espontaneamente ou através da programação de ATP. Após seguimento clínico de 1728±1189 dias, em média, ocorreram 43 óbitos, relacionados principalmente a insuficiência cardíaca progressiva e sepse. Conclusões Um teste de LDF de rotina pode não ser necessário para pacientes com CCDCs que receberam CDI para prevenção secundária. LDFs elevados parecem ser incomuns e podem estar relacionados a escore de Rassi elevado.

Abstract Background Sudden cardiac death is the most common cause of death in chronic Chagas cardiomyopathy (CCC). Because most CCC patients who are candidates for implantable cardioverter-defibrillators (ICD) meet criteria for high defibrillation threshold values, a defibrillator threshold test (DTT) is suggested. Objectives We investigated the use of DTT in CCC patients, focusing on deaths related to ICD and arrhythmic events, as well as treatment during long-term follow-up. Methods We retrospectively evaluated 133 CCC patients who received an ICD mainly for secondary prevention. Demographic, clinical, laboratory data, Rassi score, and DTT data were collected, with p < 0.05 considered significant. Results The mean patient age was 61 (SD, 13) years and 72% were men. The baseline left ventricular ejection fraction was 40 (SD, 15%) and the mean Rassi score was 10 (SD, 4). No deaths occurred during DTT and no ICD failures were documented. There was a relationship between higher baseline Rassi scores and higher DTT scores (ANOVA = 0.007). The mean time to first shock was 474 (SD, 628) days, although shock was only necessary for 28 (35%) patients with ventricular tachycardia, since most cases resolved spontaneously or through antitachycardia pacing. After a mean clinical follow-up of 1728 (SD, 1189) days, 43 deaths occurred, mainly related to progressive heart failure and sepsis. Conclusions A routine DTT may not be necessary for CCC patients who receive an ICD for secondary prevention. High DTT values seem to be unusual and may be related to high Rassi scores.

https://doi.org/10.36660/abc.20210770

12.

[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio Rassi Jr., Anis Moraes Oliveira, Gláucia M. Lemos Correia, Luís Claudio Novaes Ramos Jr., Alberto Hasslocher-Moreno, Alejandro Marcel Luquetti Ostermayer, Alejandro Sousa, Andréa Silvestre de Amato Vincenzo de Paola, Angelo Sobral de Sousa, Antonio Carlos Pinho Ribeiro, Antonio Luiz Correia Filho, Dalmo Moraes de Souza, Dilma do Socorro Cunha-Neto, Edecio J. A. Ramires, Felix Bacal, Fernando Pereira Nunes, Maria do Carmo Martinelli Filho, Martino Ibrahim Scanavacca, Maurício Magalhães Saraiva, Roberto Alves de Oliveira Júnior, Wilson M. Lorga-Filho, Adalberto de Jesus Benevides de Almeida Guimarães, Adriana Lopes Latado Braga, Adriana Sarmento de Oliveira, Adriana V. L. Sarabanda, Alvaro Yecê das Neves Pinto, Ana Assis Lopes do Carmo, André Schmidt, André Costa, Andréa Rodrigues da Ianni, Barbara Maria Markman Filho, Brivaldo Eduardo Rochitte, Carlos Thé Macedo, Carolina Mady, Charles Chevillard, Christophe Bittencourt das Virgens, Cláudio Marcelo Nery de Castro, Cleudson De Paoli de Carvalho Britto, Constança Felícia Pisani, Cristiano do Carmo Rassi, Daniela C. Sobral Filho, Dario Rodrigues Almeida, Dirceu A. Bocchi, Edimar T. Mesquita, Evandro de Souza Nogueira Sardinha Mendes, Fernanda Pereira, Francisca Tatiana Sperandio da Silva, Gilberto Marcelo de Lima Peixoto, Giselle Glotz de Lima, Gustavo H. Veloso, Henrique Turin Moreira, Henrique Bellotti Lopes, Hugo Masciarelli Francisco Pinto, Ibraim Pinto Dias, João Carlos Bemfica, João Marcos Silva-Nunes, João Paulo Soares Barreto-Filho, José Augusto Kerr Saraiva, José Francisco Lannes-Vieira, Joseli Menezes Oliveira, Joselina Luzia V. Armaganijan, Luciana Martins, Luiz Cláudio C. Sangenis, Luiz Henrique Barbosa, Marco Paulo Almeida-Santos, Marcos Antônio Simões, Marcos Vinicius Shikanai-Yasuda, Maria Aparecida Vieira Moreira, Maria da Consolação Higuchi, Maria de Lourdes Costa Monteiro, Maria Rita de Cássia Felix Mediano, Mauro Felippe Maia Lima, Mayara T. Oliveira, Maykon Moreira Dias Romano , Minna Nitz, Nadjar de Tarso Jorge Medeiros, Paulo Vieira Alves, Renato Alkmim Teixeira, Ricardo Coury Pedrosa, Roberto Aras, Roque Morais Torres, Rosália dos Santos Povoa, Rui Manoel Rassi, Sérgio Gabriel Salles Xavier, Sérgio Marinho Martins Alves , Silvia B. N. Tavares, Suelene Lima Palmeira, Swamy da Silva Junior, Telêmaco Luiz da Rocha Rodrigues, Thiago Madrini Junior, Vagner Maia da Costa , Veruska Dutra, Walderez

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Publication date: 2022-10-11

Abstract: En Pt

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp; Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities. nbsp; Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp; The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp; The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp; Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.

Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp; Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;

https://doi.org/10.1590/SciELOPreprints.4820

13.

Revisões Sistemáticas e Metanálises: Faróis na Tempestade de Informação da COVID-19
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Moreira, Henrique Turin

; Schmidt, André

Arquivos Brasileiros de Cardiologia

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aug 2022, Volume 119 N. 2 Pages 280 - 281

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

https://doi.org/10.36660/abc.20220442

14.

Congenitally Corrected Transposition of the Great Arteries in the Adult
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Amaral, Fernando

; Valente, Anne Marie

; Manso, Paulo Henrique

; Gali, Luiz Gustavo

; Braggion-Santos, Maria Fernanda

; Rocha, Julia Mignot

; Vicente, Walter Vilella de Andrade

; Schmidt, André

Brazilian Journal of Cardiovascular Surgery

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aug 2022, Volume 37 N. 4 Pages 534 - 545

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Congenitally corrected transposition of the great arteries (CCTGA) is a rare anomaly. Current data available regarding adult cases is derived from small series, information simultaneously presented in pediatric publications, and one classical multicenter study. This review, not aimed to exhaust the subject, has the purpose to examine the literature addressing presentation, diagnostic methodology, and management of afflicted adult patients. Methods: A comprehensive search was undertaken in three major databases (PubMed, Cochrane, SciELO), using the keywords “congenitally corrected transposition of the great arteries” and “adults”. Relevant articles in English, Spanish, and Portuguese were extracted and critically appraised in this review. Steps for study selection were: (1) identification of titles of records through databases searching, (2) removal of duplicates, (3) screening and selection of abstracts, (4) final inclusion in the study. Results: Four hundred sixty-five publications on CCTGA in adult patients were retrieved, and 166 were excluded; 299 studies were used for this review including 76 full-text articles, 70 studies related to general aspects of the subject, and, due to the small number of publications, 153 case reports. Sixty-one articles referring to combined experiences in pediatric and adult patients and judged to be relevant, but retrieved from another sources, were also included. Conclusion: Albeit clinical presentation and diagnostic criteria have been well stablished, there seems to be room for discussion related to clinical and surgical management of CCTGA in adults. Considering the rarity of the disease, well designed multicenter studies may provide answers. Introduction (CCTGA anomaly series subject methodology Methods PubMed, PubMed (PubMed Cochrane SciELO, SciELO , SciELO) congenitally adults . “adults” English Spanish 1 (1 searching 2 (2 duplicates 3 (3 abstracts 4 (4 Results sixtyfive sixty five 16 excluded 29 7 fulltext full text 15 reports Sixtyone Sixty relevant sources included Conclusion stablished disease answers “adults (

https://doi.org/10.21470/1678-9741-2021-0528

15.

Obstetric anesthesia: pearls and pitfalls in anesthesia for cesarean delivery
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Carvalho, Vanessa H.

; Azi, Liana M.T.A.

; Carvalho, Lorena I.M. de

; Schmidt, André P.

Brazilian Journal of Anesthesiology

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jul 2022, Volume 72 N. 4 Pages 441 - 443

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.05.006

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ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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