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Abstract Objective: To determine the prevalence of vitamin A deficiency (VAD) and serum concentrations of retinol, correlating them with IGF-1 concentrations in preschoolers with DS. Methods: Cross-sectional study was conducted on 47 children with DS aged 24 to 72 months, in Ribeirão Preto, Brazil. VAD was determined by the relative dose-response (RDR) test. Retinol serum concentration ≤ 0.70 μmol/L and IGF-1 serum concentration below the 3rd percentile for sex and age were considered to represent deficiency. C-reactive protein (CRP) was determined at the beginning of the study. Weight, height, and information about fever and/or diarrhea were obtained at the beginning of the study. Results: VAD prevalence was 25.5% (12/47), and 74.5% (35/47) of the children had deficient retinol before the intervention. CRP was not associated with VAD. Mean IGF-1 were 103.5 ng/mL (SD = 913) for the group with VAD and 116.3 ng/mL (SD = 54.9) for the group with no VAD (p-value = 0.85); 8.5% (4/47) of the children showed deficient IGF-1, but without VAD. No association was observed between VAD and IGF-1 deficiency. A moderate positive correlation was observed between pre-intervention retinol and IGF-1 (ρ = 0.37; p-value = 0.01). Conclusion: a high prevalence of VAD and deficient retinol was observed and there was a positive correlation between serum retinol and IGF-1.

https://doi.org/10.1016/j.jped.2021.04.003

Bixinoids Derived from Bixa orellana as a Potential Zika Virus Inhibitor Using Molecular Simulations. Antiviral Effect on the Zika Virus of Bixinoids
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Nogueira Sobrinho, Antonio Carlos

; Roberto, Caio Henrique Alexandre

; Lima, Danielle Malta

; Fonseca, Aluisio Marques da

; Marinho, Emmanuel Silva

Brazilian Archives of Biology and Technology

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2022, Volume 65 elocation e22210032

Abstract: En | Text: En | PDF: En

Abstract Zika fever is a viral infection of great relevance in public health, especially in tropic regions, in which there is a predominance of mosquitoes of the genus Aedes, vectors of the disease. Microcephaly in neonatal children and Guillain-Barré syndrome in adults can be caused by the action of the Zika virus (ZIKV). Non-structural proteins, such as NS2B, NS3 and NS5, are important pharmacological targets, due to their action in the life cycle. The absence of anti-Zika drugs raises new research, including prospecting for natural products. This work investigated the in silico antiviral activity of bixin and six other derived molecules against the Zika viral proteins NS2B-NS3 and NS5. The optimized structure was subjected to molecular docking to characterize the interaction between bixinoids and ZIKV non-structural proteins, where significant interactions were observed with amino acid residues in the catalytic site in each enzyme. These results suggest that bixin and ethyl bixin has the potential to interfere with the enzymatic activity of NS2B, NS3 and NS5, thus being an indication of being a promising anti-Zika agent.

https://doi.org/10.1590/1678-4324-2022210032

Bioactive compounds and leaf anatomy of yerba mate morphotypes
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Duarte, Manoela Mendes

; Gabira, Mônica Moreno

; Tomasi, Jéssica de Cássia

; Amano, Erika

; Nogueira, Antonio Carlos

; Wendling, Ivar

Pesquisa Agropecuária Brasileira

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2022, Volume 57 elocation e02441

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

Abstract The objective of this work was to evaluate the bioactive compounds and foliar anatomy of yerba mate (Ilex paraguariensis) morphotypes. The antioxidant capacity, total phenolic compounds, methylxanthines, and caffeoylquinic acids were determined from the aqueous extract of leaves of the following yerba mate morphotypes: “sassafras”, dark green, dull green, gray, and “peludinha”. Light microscopy and scanning electron microscopy were used to observe the anatomical differentiations. The dark-green morphotype showed the highest contents of caffeine (20.4 mg g-1), differing significantly only from the “peludinha” morphotype (8.8 mg g-1). All morphotypes showed similar and high antioxidant activity (886.0 and 588.1 μmol Trolox equivalent antioxidant activity per gram of sample for ABTS and DPPH, respectively), as well as high total phenolic compounds content (73.9 mg gallic acid equivalent per gram of sample). Although the anatomy of the leaf mesophyll is similar, the wax deposition and cuticle striation configuration on the adaxial surface differ between all five morphotypes.

Resumo O objetivo deste trabalho foi avaliar os compostos bioativos e a anatomia foliar de morfotipos de erva-mate (Ilex paraguariensis). A capacidade antioxidante, os compostos fenólicos totais, as metilxantinas e os ácidos cafeoilquínicos foram determinados a partir do extrato aquoso das folhas dos seguintes morfotipos de erva-mate: sassafrás, verde-escuro, verde fosco, cinza e peludinha. A microscopia de luz e a microscopia eletrônica de varredura foram utilizadas para observar a diferenciação anatômica. O morfotipo verde-escuro apresenta os maiores teores de cafeína (20,4 mg g-1) e difere significativamente apenas do morfotipo peludinha (8,8 mg g-1). Todos os morfotipos apresentaram atividade antioxidante semelhante e alta (886,0 e 588,1 μmol de atividade antioxidante equivalente a Trolox por grama de amostra, para ABTS e DPPH, respectivamente) e elevado conteúdo de compostos fenólicos totais (73,9 mg de equivalente a ácido gálico por grama de amostra). Embora a anatomia do mesofilo da folha seja semelhante, a deposição de cera e a configuração do estriamento da cutícula na superfície adaxial diferem entre os cinco morfotipos.

https://doi.org/10.1590/s1678-3921.pab2022.v57.02441

Cashew Rootstock Production Using Spirulina platensis Biomass
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Ferreira, Kaikí Nogueira

; Araújo, Railene Hérica Carlos Rocha

; Oliveira, Agda Malany Forte de

; Barbosa, Rodolfo dos Santos

; Onias, Elny Alves

; Teodosio, Albert Einstein Mathias de Medeiros

; Lima, Francileide do Nascimento

; Nogueira, Antonio Elizeneudo Peixoto

; Ribeiro, Wellington Souto

; Lima, José Franciraldo de

; Ribeiro, João Everthon da Silva

Brazilian Archives of Biology and Technology

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2022, Volume 65 elocation e22220042

Abstract: En | Text: En | PDF: En

Abstract Microalgae are considered a rich source of biostimulants for plants, as an excellent business opportunity for the agricultural sector, as they can activate plant metabolism, contributing to the improvement in physiological performance, phytomass and, subsequently, vigor and quality of seedlings. The objective of this work was to evaluate the potential of Spirulina platensis biomass, in enabling improvements in physiological performance, phytomass and, subsequently, vigor and quality of cashew rootstock seedlings. The experiment was carried out in a greenhouse in a completely randomized design, in a 4 x 2 factorial scheme (concentrations x rootstock), with three replications. The concentrations used were 0%, 0.04%, 0.08%, and 0.12% and the FAGA and CCP 76 genotypes. The seeds were immersed in the solutions for 12 hours. Applications were made via the leaves at 30 days after sowing (DAS), with an interval of seven days between each application and at 90 DAS evaluations were made. The FAGA and CCP 76 genotypes showed a positive response to the supply of S. platensis, with concentrations 0.04% and 0.08% which provided greater root length, aerial part length, number of leaves, diameter and leaf area. Concentrations 0.04% and 0.08% also promoted better percentages in the physiology of the CCP 76 genotype, while the FAGA genotype showed opposite action, which may be related to the mode of action of the microalgae on the different genetic and phenotypic characteristics of each genotype. The 0.12% concentration provided greater accumulations of aerial part and total dry mass to the genotypes.

https://doi.org/10.1590/1678-4324-2022220042

Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de

; Hammond, Naomi

; Li, Yang

; Azevedo, Luciano Cesar Pontes de

; Cavalcanti, Alexandre Biasi

; Taniguchi, Leandro

; Gobatto, André

; Japiassú, André Miguel

; Bafi, Antonio Tonete

; Mazza, Bruno Franco

; Noritomi, Danilo Teixeira

; Dal-Pizzol, Felipe

; Bozza, Fernando

; Salluh, Jorge Ibrahin Figueira

; Westphal, Glauco Adrieno

; Soares, Márcio

; Assunção, Murillo Santucci César de

; Lisboa, Thiago

; Lobo, Suzana Margarete Ajeje

; Barbosa, Achilles Rohlfs

; Ventura, Adriana Fonseca

; Souza, Ailson Faria de

; Silva, Alexandre Francisco

; Toledo, Alexandre

; Reis, Aline

; Cembranel, Allan

; Rea Neto, Alvaro

; Gut, Ana Lúcia

; Justo, Ana Patricia Pierre

; Santos, Ana Paula

; Albuquerque, André Campos D. de

; Scazufka, André

; Rodrigues, Antonio Babo

; Fernandino, Bruno Bonaccorsi

; Silva, Bruno Goncalves

; Vidal, Bruno Sarno

; Pinheiro, Bruno Valle

; Pinto, Bruno Vilela Costa

; Feijo, Carlos Augusto Ramos

; Abreu Filho, Carlos de

; Bosso, Carlos Eduardo da Costa Nunes

; Moreira, Carlos Eduardo Nassif

; Ramos, Carlos Henrique Ferreira

; Tavares, Carmen

; Arantes, Cidamaiá

; Grion, Cintia

; Mendes, Ciro Leite

; Kmohan, Claudio

; Piras, Claudio

; Castro, Cristine Pilati Pileggi

; Lins, Cyntia

; Beraldo, Daniel

; Fontes, Daniel

; Boni, Daniela

; Castiglioni, Débora

; Paisani, Denise de Moraes

; Pedroso, Durval Ferreira Fonseca

; Mattos, Ederson Roberto

; Brito Sobrinho, Edgar de

; Troncoso, Edgar M. V.

; Rodrigues Filho, Edison Moraes

; Nogueira, Eduardo Enrico Ferrari

; Ferreira, Eduardo Leme

; Pacheco, Eduardo Souza

; Jodar, Euzebio

; Ferreira, Evandro L. A.

; Araujo, Fabiana Fernandes de

; Trevisol, Fabiana Schuelter

; Amorim, Fábio Ferreira

; Giannini, Fabio Poianas

; Santos, Fabrício Primitivo Matos

; Buarque, Fátima

; Lima, Felipe Gallego

; Costa, Fernando Antonio Alvares da

; Sad, Fernando Cesar dos Anjos

; Aranha, Fernando G.

; Ganem, Fernando

; Callil, Flavio

; Costa Filho, Francisco Flávio

; Dall´Arto, Frederico Toledo Campo

; Moreno, Geovani

; Friedman, Gilberto

; Moralez, Giulliana Martines

; Silva, Guilherme Abdalla da

; Costa, Guilherme

; Cavalcanti, Guilherme Silva

; Betônico, Gustavo Navarro

; Reis, Hélder

; Araujo, Helia Beatriz N.

; Hortiz Júnior, Helio Anjos

; Guimaraes, Helio Penna

; Urbano, Hugo

; Maia, Israel

; Santiago Filho, Ivan Lopes

; Farhat Júnior, Jamil

; Alvarez, Janu Rangel

; Passos, Joel Tavares

; Paranhos, Jorge Eduardo da Rocha

; Marques, José Aurelio

; Moreira Filho, José Gonçalves

; Andrade, Jose Neto

; Sobrinho, José Onofre de C

; Bezerra, Jose Terceiro de Paiva

; Alves, Juliana Apolônio

; Ferreira, Juliana

; Gomes, Jussara

; Sato, Karina Midori

; Gerent, Karine

; Teixeira, Kathia Margarida Costa

; Conde, Katia Aparecida Pessoa

; Martins, Laércia Ferreira

; Figueirêdo, Lanese

; Rezegue, Leila

; Tcherniacovsk, Leonardo

; Ferraz, Leone Oliveira

; Cavalcante, Liane

; Rabelo, Ligia

; Miilher, Lilian

; Garcia, Lisiane

; Tannous, Luana

; Hajjar, Ludhmila Abrahão

; Paciência, Luís Eduardo Miranda

; Cruz Neto, Luiz Monteiro da

; Bley, Macia Valeria

; Sousa, Marcelo Ferreira

; Puga, Marcelo Lourencini

; Romano, Marcelo Luz Pereira

; Nobrega, Marciano

; Arbex, Marcio

; Rodrigues, Márcio Leite

; Guerreiro, Márcio Osório

; Rocha, Marcone

; Alves, Maria Angela Pangoni

; Rosa, Maria Doroti

; Dias, Mariza D’Agostino

; Martins, Miquéias

; Oliveira, Mirella de

; Moretti, Miriane Melo Silveira

; Matsui, Mirna

; Messender, Octavio

; Santarém, Orlando Luís de Andrade

; Silveira, Patricio Júnior Henrique da

; Vassallo, Paula Frizera

; Antoniazzi, Paulo

; Gottardo, Paulo César

; Correia, Paulo

; Ferreira, Paulo

; Torres, Paulo

; Silva, Pedro Gabrile M. de Barros e

; Foernges, Rafael

; Gomes, Rafael

; Moraes, Rafael

; Nonato filho, Raimundo

; Borba, Renato Luis

; Gomes, Renato V

; Cordioli, Ricardo

; Lima, Ricardo

; López, Ricardo Pérez

; Gargioni, Ricardo Rath de Oliveira

; Rosenblat, Richard

; Souza, Roberta Machado de

; Almeida, Roberto

; Narciso, Roberto Camargo

; Marco, Roberto

; waltrick, Roberto

; Biondi, Rodrigo

; Figueiredo, Rodrigo

; Dutra, Rodrigo Santana

; Batista, Roseane

; Felipe, Rouge

; Franco, Rubens Sergio da Silva

; Houly, Sandra

; Faria, Sara Socorro

; Pinto, Sergio Felix

; Luzzi, Sergio

; Sant’ana, Sergio

; Fernandes, Sergio Sonego

; Yamada, Sérgio

; Zajac, Sérgio

; Vaz, Sidiner Mesquita

; Bezerra, Silvia Aparecida Bezerra

; Farhat, Tatiana Bueno Tardivo

; Santos, Thiago Martins

; Smith, Tiago

; Silva, Ulysses V. A.

; Damasceno, Valnei Bento

; Nobre, Vandack

; Dantas, Vicente Cés de Souza

; Irineu, Vivian Menezes

; Bogado, Viviane

; Nedel, Wagner

; Campos Filho, Walther

; Dantas, Weidson

; Viana, William

; Oliveira Filho, Wilson de

; Delgadinho, Wilson Martins

; Finfer, Simon

; Machado, Flavia Ribeiro

Revista Brasileira de Terapia Intensiva

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apr 2021, Volume 33 N. 2 Pages 206 - 218

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

Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.

RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.

https://doi.org/10.5935/0103-507x.20210028

Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba

; Rodrigues, Cibele Isaac Saad

; Bortolotto, Luiz Aparecido

; Mota-Gomes, Marco Antônio

; Brandão, Andréa Araujo

; Feitosa, Audes Diógenes de Magalhães

; Machado, Carlos Alberto

; Poli-de-Figueiredo, Carlos Eduardo

; Amodeo, Celso

; Mion Júnior, Décio

; Barbosa, Eduardo Costa Duarte

; Nobre, Fernando

; Guimarães, Isabel Cristina Britto

; Vilela-Martin, José Fernando

; Yugar-Toledo, Juan Carlos

; Magalhães, Maria Eliane Campos

; Neves, Mário Fritsch Toros

; Jardim, Paulo César Brandão Veiga

; Miranda, Roberto Dischinger

; Póvoa, Rui Manuel dos Santos

; Fuchs, Sandra C

; Alessi, Alexandre

; Lucena, Alexandre Jorge Gomes de

; Avezum, Alvaro

; Sousa, Ana Luiza Lima

; Pio-Abreu, Andrea

; Sposito, Andrei Carvalho

; Pierin, Angela Maria Geraldo

; Paiva, Annelise Machado Gomes de

; Spinelli, Antonio Carlos de Souza

; Nogueira, Armando da Rocha

; Dinamarco, Nelson

; Eibel, Bruna

; Forjaz, Cláudia Lúcia de Moraes

; Zanini, Claudia Regina de Oliveira

; Souza, Cristiane Bueno de

; Souza, Dilma do Socorro Moraes de

; Nilson, Eduardo Augusto Fernandes

; Costa, Elisa Franco de Assis

; Freitas, Elizabete Viana de

; Duarte, Elizabeth da Rosa

; Muxfeldt, Elizabeth Silaid

; Lima Júnior, Emilton

; Campana, Erika Maria Gonçalves

; Cesarino, Evandro José

; Marques, Fabiana

; Argenta, Fábio

; Consolim-Colombo, Fernanda Marciano

; Baptista, Fernanda Spadotto

; Almeida, Fernando Antonio de

; Borelli, Flávio Antonio de Oliveira

; Fuchs, Flávio Danni

; Plavnik, Frida Liane

; Salles, Gil Fernando

; Feitosa, Gilson Soares

; Silva, Giovanio Vieira da

; Guerra, Grazia Maria

; Moreno Júnior, Heitor

; Finimundi, Helius Carlos

; Back, Isabela de Carlos

; Oliveira Filho, João Bosco de

; Gemelli, João Roberto

; Mill, José Geraldo

; Ribeiro, José Marcio

; Lotaif, Leda A. Daud

; Costa, Lilian Soares da

; Magalhães, Lucélia Batista Neves Cunha

; Drager, Luciano Ferreira

; Martin, Luis Cuadrado

; Scala, Luiz César Nazário

; Almeida, Madson Q.

; Gowdak, Marcia Maria Godoy

; Klein, Marcia Regina Simas Torres

; Malachias, Marcus Vinícius Bolívar

; Kuschnir, Maria Cristina Caetano

; Pinheiro, Maria Eliete

; Borba, Mario Henrique Elesbão de

; Moreira Filho, Osni

; Passarelli Júnior, Oswaldo

; Coelho, Otavio Rizzi

; Vitorino, Priscila Valverde de Oliveira

; Ribeiro Junior, Renault Mattos

; Esporcatte, Roberto

; Franco, Roberto

; Pedrosa, Rodrigo

; Mulinari, Rogerio Andrade

; Paula, Rogério Baumgratz de

; Okawa, Rogério Toshiro Passos

; Rosa, Ronaldo Fernandes

; Amaral, Sandra Lia do

; Ferreira-Filho, Sebastião R.

; Kaiser, Sergio Emanuel

; Jardim, Thiago de Souza Veiga

; Guimarães, Vanildo

; Koch, Vera H.

; Oigman, Wille

; Nadruz, Wilson

Arquivos Brasileiros de Cardiologia

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mar 2021, Volume 116 N. 3 Pages 516 - 658

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

https://doi.org/10.36660/abc.20201238

Soil spiders (Arachnida: Araneae) in native and reforested Araucaria forests
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Pereira, Jamil de Morais

; Cardoso, Elke Jurandy Bran Nogueira

; Brescovit, Antonio Domingos

; Oliveira Filho, Luís Carlos Iuñes de

; Segat, Julia Corá

; Baretta, Carolina Riviera Duarte Maluche

; Baretta, Dilmar

Scientia Agricola

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2021, Volume 78 N. 3 elocation e20190198

Abstract: En | Text: En | PDF: En

ABSTRACT: Spiders are part of the soil biodiversity, considered fundamental to the food chain hierarchy, directly and indirectly influencing several services in agricultural and forest ecosystems. The present study aimed to evaluate the biodiversity of soil spider families and identify which soil properties influence their presence, as well as proposing families as potential bioindicators. Native forest (NF) and reforested sites (RF) with Araucaria angustifolia (Bertol.) Kuntze were evaluated in three regions of the state São Paulo, both in the winter and summer. Fifteen soil samples were collected from each forest to evaluate the biological (spiders and microbiological), chemical and physical soil properties, in addition to properties of the litter (dry matter and C, N and S contents). For soil spiders, two sampling methods were used: pitfall traps and soil monoliths. In total, 591 individuals were collected, and distributed in 30 families, of which 306 individuals (22 families) came from pitfall traps and 285 individuals (26 families) from monoliths. Only samples obtained by the monolith method revealed seasonal differences in the mean density and richness of spiders between NF and RF. Canonical discriminant analysis showed the separation of these forests of Araucaria. Principal Component Analysis demonstrated the correlation of a number of spider families with certain soil properties (organic carbon, basal respiration, metabolic quotient, litter carbon, total porosity, bulk density and soil moisture). We identified 10 families (Anapidae, Corinnidae, Dipluridae, Hahniidae, Linyphiidae, Lycosidae, Nemesiidae, Palpimanidae, Salticidae, Scytodidae) that contributed most to separating native forest from the replanted forest, indicating the possibility of the spiders being used as bioindicators.

https://doi.org/10.1590/1678-992x-2019-0198

Isolation, fractionation and anticoagulant activity of a sulfated galactan extracted from the green algae Penicillus capitatus
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Moreira, Thamyris Almeida

; Costa, Bianca Barros da

; Celestino, Regina Célia Alves

; Faria, Caroline Nogueira

; Gianelli, Jéssica Lopes D’Dego

; Santos, Gustavo Ramalho Cardoso dos

; Glauser, Bianca Fernandes

; Soares, Angélica Ribeiro

; Mourão, Paulo Antônio de Souza

; Rodrigues, Carlos Rangel

; Cinelli, Leonardo Paes

Ciência Rural

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2021, Volume 51 N. 8 elocation e20200138

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

ABSTRACT: Marine algae are natural sources of macromolecules known as sulfated polysaccharides. This class of compounds has attracted the interest of Pharmaceutical Sciences due to its pharmacological anticoagulant, antiplatelet and antithrombotic properties. Therefore, this study evaluated the anticoagulant potential of sulfated polysaccharides extracted from the algae Penicillus capitatus. The extracted sulfated polysaccharides were purified, partially characterized and their anticoagulant activity was evaluated. The extraction process followed by ethanol precipitation resulted in five fractions. Among the analyzed fractions, F44 contained highest concentration of sulfated polysaccharides. After the purified fraction F23, F44 displayed in vitro anticoagulant activity in a time testing for activated partial thromboplastin time and prothrombin time. The preferential mechanism effect was based on interactions between thrombin and factor Xa. Additional studies on structure pharmacological are required to test the viability of the use of sulfated polysaccharides as therapeutic agents.

RESUMO: As algas marinhas são fontes naturais de macromoléculas conhecidas como polissacarídeos sulfatados. Esta classe de compostos atraiu o interesse das Ciências Farmacêuticas devido às suas propriedades farmacológicas como anticoagulante, antiplaquetária e antitrombótica. Portanto, este estudo tem como objetivo avaliar o potencial anticoagulante de polissacarídeos sulfatados extraídos de algas de Penicillus capitatus. Os polissacarídeos sulfatados extraídos foram purificados, parcialmente caracterizados e sua atividade anticoagulante foi avaliada. O processo de extração seguido pela precipitação com etanol resultou em cinco frações. Entre as frações analisadas, F44 foi a maior concentração de polissacarídeos sulfatados. Após a purificação, as frações F23 e F44 mostraram atividade anticoagulante in vitro em um teste de tempo de tromboplastina parcialmente ativada e tempo de protrombina. Seu mecanismo preferencial é baseado nas interações entre trombina e fator Xa. Estudos adicionais sobre a estrutura farmacológica são necessários para testar a viabilidade do uso como agente terapêutico.

https://doi.org/10.1590/0103-8478cr20200138

Pediatric multisystem inflammatory syndrome associated with COVID-19: urgent attention required
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Nogueira-de-Almeida, Carlos Alberto

; Ciampo, Luiz Antonio Del

; Ferraz, Ivan Savioli

; Ciampo, Ieda Regina Lopes Del

; Contini, Andrea Aparecida

; Ued, Fábio da Veiga

Revista da Associação Médica Brasileira

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2021, Volume 67 Suppl. 1 Pages 115 - 120

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: To identify epidemiological and clinical characteristics of multisystemic inflammatory syndrome associated with coronavirus infection as one of the severe forms of COVID-19 involvement in children and adolescents. METHODS: review was based on articles published in 2020 in the PubMed, Medline, Scopus, SciELO and Cochrane databases. SUMMARY: Multisystemic inflammatory syndrome is a serious clinical disorder that affects children and adolescents and is associated with the detection of previous exposure to SARS-CoV-2. It is characterized by the installation of a shock picture, with a significant increase in inflammatory markers such as presentations of Kawasaki Disease or shock syndrome related to Kawasaki Disease, or even toxic shock syndrome, with the clinical picture being characterized by fever of difficult control, rash, conjunctivitis, peripheral edema, generalized pain in the extremities and gastrointestinal symptoms. CONCLUSIONS: Although the vast majority of children with COVID-19 have mild symptoms, it is necessary to consider that some have a hyperinflammatory response. It is essential that health professionals receive information that can assist in the recognition of this clinical condition, differentiating it from other diagnoses, so that early and appropriate treatment is instituted.

https://doi.org/10.1590/1806-9282.67.suppl1.20200691

10.

Antifungal and antioxidant effect of the lachnophyllum ester, isolated from the essential oil of Baccharis trinervis (Lam.) Pers., against dermatophytes fungi
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SOBRINHO, Antônio Carlos Nogueira

; FONTENELLE, Raquel Oliveira dos Santos

; SOUZA, Elnatan Bezerra de

; MORAIS, Selene Maia de

Revista Brasileira de Saúde e Produção Animal

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2021, Volume 22 elocation e2122542021

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

ABSTRACT Dermatophytes are hyaline fungi that parasitize the keratinized tissue of humans and animals causing mycotic infections. Natural products are promising molecules for the development of new antifungal drugs, due to the phenomenon of resistance and toxicity. This study reports the isolation and identification of lachnophyllum ester and evaluates its antioxidant, antifungal and modulatory activities against dermatophytes fungi. Lachnophyllum ester was obtained using a silica gel column chromatography of the essential oil from the aerial parts of Baccharis trinervis and analyzed by gas chromatography/mass spectrometry. Antimicrobial activity was determined by the broth microdilution method. The modulatory activity assays were performed by the checkerboard technique using lachnophyllum ester and ketoconazole as standard. The lachnophyllum ester exhibited good antioxidant activity as measured by a β-carotene/linoleic acid bleaching system, with 71.43% ± 0.01% inhibition rate. In addition, it showed antifungal activity against Trichophyton rubrum and Microsporum canis strains. In the modulatory assay, interaction between lachnophyllum ester and ketoconazole was synergistic, reducing the minimum inhibitory concentration (MIC) values of the antifungal drug and modulating its antifungal action against dermatophyte strains. In conclusion, lachnophyllum ester has been shown to act as a natural antioxidant compound, as well as an antimicrobial alternative against dermatophyte fungi of the genus Trichophyton and Microsporum.

RESUMO Dermatófitos são fungos hialinos que parasitam o tecido queratinizado de humanos e animais causando infecções fúngicas. Os produtos naturais são moléculas promissoras para o desenvolvimento de novos fármacos antifúngicos, devido ao fenômeno de resistência e a toxicidade. Este estudo relata o isolamento e a identificação do éster lacnofilum e avalia sua atividade antioxidante, antifúngica e modulatória contra fungos dermatófitos. O éster lacnofilum foi obtido por cromatografia em coluna de sílica gel do óleo essencial das partes aéreas da Baccharis trinervis e analisado por cromatografia gasosa/espectrometria de massa. A atividade antimicrobiana foi determinada pelo método de microdiluição em caldo. Os ensaios de atividade modulatória foram realizados pela técnica de checkerboard, utilizando éster lacnofilum e cetoconazol como padrão. O éster lacnofilum exibiu boa atividade antioxidante, medida pelo sistema β-caroteno/ácido linoléico, com taxa de inibição de 71,43% ± 0,01%. Além disso, mostrou atividade antifúngica contra as cepas de Trichophyton rubrum e Microsporum canis. No ensaio modulatório, a interação entre éster lacnofilum e cetoconazol foi sinérgica, reduzindo os valores concentração inibitória mínima (CIM) do antifúngico e modulando sua ação antifúngica contra cepas de dermatófitos. Em conclusão, o éster lacnofilum demonstrou atuar como um composto antioxidante natural, bem como uma alternativa antimicrobiana contra fungos dermatófitos do gênero Trichophyton e Microsporum.

https://doi.org/10.1590/s1519-99402122542021

11.

Immunological impact of tetrahydrobiopterin on the central nervous system in a murine model of rabies virus infection
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Brito, Caio Vinicius Botelho

; Rodrigues, Érika Dayane Leal

; Martins, Fernanda Monik Silva

; Tavares, Lavinia Dias

; Lima, André Luis de Sousa Nogueira

; Ferreira, Lucas Carvalho

; Santana, Carlos Junior Lopes

; Brito, João Augusto Gomes de Souza Monteiro de

; Casseb, Lívia Medeiros Neves

; Diniz Junior, José Antonio Picanço

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e28

Abstract: En | Text: En | PDF: En

ABSTRACT Currently, the Milwaukee protocol presents healing results in human beings affected by the rabies virus. However, there are many points to clarify on the action of drugs and the immune mechanism involved in the evolution of the disease. One of the drugs used is biopterin, which is an important cofactor for nitric oxide, important for preventing vasospasm. Thus, we describe the effect of biopterin on some inflammatory factors in a rabies virus infection developed in an animal model. The immunological mediators studied in animals infected with rabies virus submitted to doses of sapropterin were Anti-RABV, IL-6, IL-2, IL-17a, INF-gamma and Anti-iNOS. It is suggested that the medication in the context of a RABV infection already installed, had the effect of modulating the inflammatory mechanisms mainly linked to the permeability of the blood-brain barrier and the migration of cytotoxic cells.

https://doi.org/10.1590/s1678-9946202163028

12.

Thousand-seed weight determination in forest species by image analysis
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Felix, Francival Cardoso

; Mocelim, Felipe Ligeski

; Torres, Salvador Barros

; Kratz, Dagma

; Ribeiro, Richardson

; Nogueira, Antônio Carlos

Journal of Seed Science

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2021, Volume 43 elocation e202143040

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

Abstract: Thousand-seed weight (TSW) is used to calculate the sowing density, number of seeds present in a sample, and predict seed size. Our aim was to establish an alternative methodology for thousand-seed weight determination in forest species using image analysis techniques. The traditional methodology was compared with the alternative one, testing them on seeds from 16 forest species. The traditional method was performed by manually counting eight repetitions of 100 seeds, weighing of samples, and computation of thousand-seed weight. The alternative methodology was performed by counting seed samples captured by images and processing in ImageJ® software, followed by weighing a single sample, and computation. All steps were timed, and each methodology was repeated ten times per species. The TSW obtained by the alternative methodology was similar to that obtained by the traditional one, and the average execution time of the activities was reduced by 62%. The proposed thousand-seed weight determination by image analysis is an efficient and optimized alternative to the traditional method. Thousand-seed weight determination from image analysis reduces execution time for the seed analyst and forest seedling producer.

Resumo: O peso de mil sementes (PMS) é utilizado para calcular a densidade de semeadura, estimar o número de sementes presente em uma amostra e predizer o tamanho das sementes. Objetivou-se estabelecer uma metodologia alternativa para determinação do peso de mil sementes em espécies florestais usando técnicas de análise de imagens. A metodologia tradicional foi comparada com a alternativa, testando-as em sementes de 16 espécies florestais. O método tradicional foi feito com a contagem manual de oito repetições de 100 sementes, pesagem das amostras e cálculo do peso de mil sementes. A metodologia alternativa foi executada por meio da contagem de amostras de sementes capturadas por imagens e processamento no software ImageJ®, seguido da pesagem de uma amostra única e cálculo. Todas as etapas foram cronometradas e cada metodologia foi repetida dez vezes por espécie. O PMS obtido pela metodologia alternativa foi semelhante à tradicional, e o tempo médio de execução das atividades foi reduzido em 62%. Portanto, a determinação do peso de mil sementes proposto por análise de imagens constitui-se em alternativa eficiente e otimizada em relação ao método tradicional. A determinação do peso de mil sementes a partir da análise de imagens proporciona redução do tempo de execução para o analista de sementes, produtor de sementes e de mudas florestais.

https://doi.org/10.1590/2317-1545v43254684

13.

Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides

; Moreira, Henrique Turin

; Nakamuta, Juliana Sanajotti

; Simões, Marcus Vinicius

; Casas, Alberto de Almeida Las

; Costa, Altamiro Reis da

; Assis, Amberson Vieira de

; Durães, André Rodrigues

; Pereira-Barretto, Antonio Carlos

; Ravessa, Antonio Delduque de Araujo

; Macedo, Ariane Vieira Scarlatelli

; Biselli, Bruno

; Pinto, Carolina Maria Nogueira

; Filho, Conrado Roberto Hoffmann

; Costantini, Costantino Roberto

; Almeida, Dirceu Rodrigues

; Santos Jr, Edval Gomes dos

; Soliva Junior, Erwin

; Figueiredo, Estevão Lanna

; Albuquerque, Felipe Neves de

; Paulitsch, Felipe

; Neuenschwander, Fernando Carvalho

; Figueiredo Neto, José Albuquerque de

; Brito, Flavio de Souza

; Lopes, Heno Ferreira

; Villacorta, Humberto

; Souza Neto, João David de

; Sepulveda, João Mariano

; Ayoub, José Carlos Aidar

; Vilela-Martin, José F.

; Cardoso, Juliano Novaes

; Uemura, Laercio

; Moura, Lidia Zytynski

; Maia, Lilia Nigro

; Oliveira, Lucia Brandão de

; Maia, Lucimir

; Silva, Luís Beck da

; Gowdak, Luís Henrique Wolff

; Danzmann, Luiz Claudio

; Andrade, Marcus

; Braile-Sternieri, Maria Christiane Valeria Braga

; Moreira, Maria da Consolação Vieira

; França Neto, Olimpio R

; Filho, Otavio Rizzi Coelho

; Esteves, Paulo Frederico

; Raupp-da-Rosa, Priscila

; Silva, Ricardo Jorge de Queiroz e

; Mourilhe-Rocha, Ricardo

; Viégas, Ruy Felipe Melo

; Rassi, Salvador

; Mangili, Sandrigo

; Kaiser, Sergio Emanuel

; Martins, Silvia Marinho

; Kawabata, Vitor Sergio

Clinics

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2021, Volume 76 elocation e1991

Abstract: En | Text: En | PDF: En

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991

14.

Cerebellar infarction after sneezing
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Camilo, Gustavo Bittencourt

; Riccio, Marco Antônio

; Nogueira, Anna Luíza Machado

; Querubino, Amanda Campos

; Maciel, Ana Luísa dos Santos

; Rodrigues, Daniela Girardi Pereira Linhares

; Sá Júnior, Carlos Alberto Corrêa de

Revista da Associação Médica Brasileira

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oct 2020, Volume 66 N. 10 Pages 1351 - 1354

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

SUMMARY Vertebral Artery Dissection (VAD) is a rare condition that can be caused by a wide amplitude of neck movement, which injures the vessel wall and can cause ischemia in the cerebellum. We present a 37-year-old man with herniated lumbar disc and allergic rhinosinusitis, which caused sneezing spells. After one of these bouts with a ricochet of the head, he presented C3 misalignment with local pain. Twenty-one days later, affected by a new crisis, he presented left temporal headache, nystagmus, and vertigo. After 3 days, Magnetic Resonance Imaging (MRI) identified 2 regions of cerebellar ischemia and filling failure of the right vertebral artery. After 2 days, Computed Angiotomography (CT Angiography) was performed and showed right VAD with a local thrombus, without aneurysmal signs. Transcranial Doppler did not indicate an increase in blood flow from this artery. The suggested treatment involved administration of anticoagulant Apixabana 5mg, 12/12h, for 3 months, until the condition was reevaluated with new Angio CT and MRI. It was recommended that the patient was released from work for 1 month and forbidden from doing intense physical exercises for 3 months; however, due to setbacks, these deadlines were extended until a new appointment, 4 months after the first visit. The new tests showed no changes, indicating that the condition was stable. This case aims to indicate the possible investigations of the diagnosis and therapeutic options of the rare association between VAD with cerebellar infarction in a well-documented case.

RESUMO A Dissecção da Artéria Vertebral (DAV) é quadro raro que pode ser causado por movimentação de grande amplitude do pescoço, que lesiona a parede desse vaso, podendo provocar isquemia no cerebelo. Apresentamos um homem de 37 anos, com hérnia de disco e rinossinusite alérgica que lhe causava crises de espirros em salva (CE). Após uma dessas crises com ricocheteamento da cabeça, apresentou desalinhamento de C3 com dor local. Vinte e um dias depois, acometido por nova crise, apresentou cefaleia temporal esquerda, nistagmo e vertigem. Decorridos 3 dias, o paciente foi submetido a Ressoânncia Magnética (RM), que identificou 2 regiões de isquemia cerebelar e enchimento comprometido da artéria vertebral direita. Após 2 dias, foram feitos Angiotomografia Computadorizada (Angio TC), que constatou DAV direita com trombo local, sem sinais aneurismáticos, e Doppler Transcraniano, que não indicou aumento do fluxo sanguíneo dessa artéria. O tratamento sugerido envolvia administração de anticoagulante Apixabana 5mg, 12/12h, por 3 meses, até que o quadro fosse reavaliado com novas Angio TC e RM. Foi recomendado que o paciente ficasse afastado do trabalho por 1 mês e de exercícios físicos intensos por 3 meses, porém devido a contratempos, esses prazos foram prorrogados até nova consulta, 4 meses após a primeira. Os novos exames não apresentaram alterações, indicando que o quadro estava estável. Esse caso tem como objetivo indicar as possíveis investigações do diagnóstico e opções terapêuticas da rara associação entre DAV com infarto cerebelar em caso bem documentado.

https://doi.org/10.1590/1806-9282.66.10.1351

15.

Implante Percutâneo Transeptal de Bioprótese em Disfunção de Prótese Valvar Cirúrgica Mitral – Experiência Multicêntrica Brasileira
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Nicz, Pedro Felipe Gomes

; Melo, Pedro Henrique M. Craveiro de

; Brito, Pedro Henrique Ferro de

; Lima, Eliane Nogueira

; Silva, Ricardo Cavalcante e

; Prudente, Maurício Lopes

; Fernandes, Fernando Henrique

; Deininger, Maurilio Onofre

; Lopes, Marcelo Antônio Cartaxo Queiroga

; Petrucci, Fúlvio Soares

; Reis Filho, Fernando Roquette

; Marino, Marcos Antonio

; Bernardes, Rodrigo de Castro

; Melo, Eduardo Pessoa de

; Oliveira, Marco Antonio Praça

; Mangione, José Armando

; Mangione, Fernanda Marinho

; Falcão, Carlos Henrique Eiras

; Martins, Estêvão Carvalho de Campos

; Lunardi, Walter

; Bacal, Fernando

; Tarasoutchi, Flávio

; Brito Jr, Fábio Sândoli de

Arquivos Brasileiros de Cardiologia

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sep 2020, Volume 115 N. 3 Pages 515 - 524

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

Abstract Background Percutaneous intervention in patients with bioprosthetic mitral valve dysfunction is an alternative to conventional surgical treatment. Objectives To report the first Brazilian experience with transseptal transcatheter bioprosthetic mitral valve-in-valve implantation (transseptal-TMVIV). Methods Patients with surgical bioprosthetic dysfunction submitted to transseptal-TMVIV in 12 Brazilian hospitals were included. The significance level adopted was p<0.05. Results From June/2016 to February/2019, 17 patients underwent transseptal-TMVIV. Their median age was 77 years (IQR,70-82) and median Society of Thoracic Surgeons predicted risk of mortality (STS-PROM) score was 8.7% (IQR,7.2-17.8). All patients had limiting symptoms of heart failure (FC≥III) and 5 (29.4%) had undergone more than one previous thoracotomy. Transseptal-TMVIV was successful in all patients. Echocardiographic assessment showed a significant reduction in mean mitral valve gradient (pre-intervention, 12±3.8 mmHg; post-intervention, 5.3±2.6 mmHg; p<0.001), in addition to an increase in mitral valve area (pre-intervention, 1.06±0.59 cm2; post-intervention, 2.18±0.36 cm2; p<0.001) sustained for 30 days. There was a significant and immediate reduction in the pulmonary artery systolic pressure, with an additional reduction in 30 days (pre-intervention, 68.9±16.4 mmHg; post-intervention, 57.7±16.5 mmHg; 30 days, 50.9±18.7 mmHg; p<0.001). During follow-up (median, 162 days; IQR, 102-411), significant clinical improvement (FC≤II) was observed in 87.5% of the patients. One patient (5.9%) had left ventricular outflow tract (LVOT) obstruction and died right after the procedure, and another died at 161 days of follow-up. Conclusion The first Brazilian experience with transseptal-TMVIV shows the safety and effectivity of the new technique. The LVOT obstruction is a potentially fatal complication, reinforcing the importance of patients’ selection and of procedural planning. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Resumo Fundamento A intervenção percutânea em pacientes com disfunção de prótese biológica mitral apresenta-se como uma alternativa ao tratamento cirúrgico convencional. Objetivo Relatar a primeira experiência brasileira de implante transcateter de bioprótese valve-in-valve mitral via transeptal (TMVIV-via transeptal). Métodos Foram incluídos pacientes portadores de disfunção de bioprótese cirúrgica submetidos ao TMVIV-transeptal em 12 hospitais brasileiros. Foram considerados estatisticamente significativos valores de p<0,05. Resultados Entre junho/2016 e fevereiro/2019, 17 pacientes foram submetidos ao TMVIV-via transeptal. A mediana de idade foi 77 anos (IIQ,70-82), a mediana do escore STS-PROM foi 8,7% (IIQ,7,2-17,8). Todos os pacientes tinham sintomas limitantes de insuficiência cardíaca (CF≥III), tendo 5 (29,4%) sido submetidos a mais de uma toracotomia prévia. Obteve-se sucesso do TMVIV-via transeptal em todos os pacientes. A avaliação ecocardiográfica demonstrou redução significativa do gradiente médio (pré-intervenção, 12±3,8 mmHg; pós-intervenção, 5,3±2,6 mmHg; p<0,001), assim como aumento da área valvar mitral (pré-intervenção, 1,06±0,59 cm2; pós-intervenção, 2,18±0,36 cm2; p<0,001) sustentados em 30 dias. Houve redução significativa e imediata da pressão sistólica de artéria pulmonar, com redução adicional em 30 dias (pré-intervenção, 68,9±16,4 mmHg; pós-intervenção, 57,7±16,5 mmHg; 30 dias, 50,9±18,7 mmHg; p<0,001). Durante o seguimento, com mediana de 162 dias (IIQ, 102-411), observou-se marcada melhora clínica (CF≤II) em 87,5%. Um paciente (5,9%) apresentou obstrução de via de saída de ventrículo esquerdo (VSVE), evoluindo para óbito logo após o procedimento, e outro morreu aos 161 dias de seguimento.Conclusão: A primeira experiência brasileira de TMVIV-transeptal demonstra a segurança e a efetividade dessa nova técnica. A obstrução da VSVE é uma complicação potencialmente fatal, reforçando a importância da seleção dos pacientes e do planejamento do procedimento. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

https://doi.org/10.36660/abc.20190252

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