Repositório RCAAP

OBJECTIVE: To detect the prevalence of systemic hypertension in children and to establish the relation between blood pressure levels and sex, age, ethnicity, weight, and height. METHODS: The prevalence of systemic hypertension and its relation to sex, age, ethnicity, weight, and height were studied in 611 students aged 7 to 14 years out of 19.928 students classified according to age, ethnicity, and sex, who underwent anthropometric evaluation and blood pressure measurement. Hypertensive individuals were considered those whose blood pressure level was > the 95th percentile for age and sex, confirmed on 3 examinations. RESULTS: The prevalence of hypertension was 16.6% in the first evaluation, and 4.6% and 2.5% in the subsequent evaluations. The mean blood pressure levels increased with age. Weight was important, not only to determine blood pressure in healthy children, but also to determine systemic hypertension in children, which was not observed with height despite the different studies. The prevalence of systemic hypertension in the different ethnic groups and the mean blood pressure levels according to sex were similar. CONCLUSION: In addition to routine physical examinations, age, weight, and appropriate cuff size should be considered when assessing blood pressure in children to prevent hypertension, morbidity and mortality, and to avoid placing a financial burden on health care providers.

OBJECTIVE: To assess the short- and long-term results of the use of streptokinase (SK) for the treatment of thromboses in cardiac valvular prostheses. METHODS: Seventeen patients with cardiac prosthetic thrombosis diagnosed by clinical, echocardiographic, and radioscopic findings underwent fibrinolytic treatment with a streptokinase bolus of 250,000 U followed by 100.000 U/hour. Short- and long-term results were assessed by radioscopy and echocardiography. RESULTS: Of the 17 patients, 12 had mechanical double-disk prostheses (4 aortic, 6 mitral, 2 tricuspid), 4 had single-disk prostheses (2 aortic, 1 mitral, and 1 tricuspid), and 1 had a tricuspid bioprosthesis. The success rate was 64.8%, the partial success rate was 17.6%, and the nonsuccess rate was 17.6%. All patients with a double-disk prosthesis responded, completely or partially, to the treatment. None of the patients with a single-disk prosthesis had complete resolution of the thrombosis. The time of streptokinase infusion ranged from 6 to 80 hours (mean of 56 h). The mortality rate due to the use of streptokinase was 5.8% and was secondary to cerebral bleeding. During streptokinase infusion, 3 (17.6%) embolic episodes occurred as follows: 1 cerebral, 1 peripheral, and 1 coronary. The rethrombosis index was 33% in a mean follow-up of 42 months. CONCLUSION: The use of fibrinolytic agents was effective and relatively safe in patients with primary thrombosis of a double-disk prosthesis. A fatal hemorrhagic complication occurred in 1 (5.8%) patient, and embolic complications occurred in 3 (17.6%) patients. In a mean 42-month follow-up, 67% of the patients were free from rethrombosis.

OBJECTIVE: To describe the relative incidence, presentation, and evolvement of fetuses with early ductus constriction. METHODS: Twenty fetal echocardiograms indicating ductus constriction were reviewed in a population of 7000 pregnants. RESULTS: The cases were divided into group A (related to maternal use of cyclooxygenase inhibitors [n=7] and group B (idiopathics [n=13]). Mean gestational age was 32.5±3.1 (27-38) weeks and maternal age was 28.2±8.5 (17-42) years. Mean systolic velocity in the ductus was 2.22±0.34 (1.66-2.81) m/s, diastolic velocity 0.79±0.28 (0.45-1.5) m/s, and pulsatility index 1.33±0.36 (0.52-1.83). Two cases of ductal occlusion were noted. In 65% of the cases, an increase occurred in the right cavities; in 90% of the cases, tricuspid or pulmonary regurgitation, or both, occurred, with functional pulmonary atresia in 1 case. Diastolic velocity was greater in group A (1.13±0.33) than in group B (0.68±0.15) (P=0.008). The other data were similar in the 2 groups. The evolvement was not favorable in 4 patients from group B, including 1 death and 2 cases of persistent pulmonary hypertension. CONCLUSION: The high incidence of idiopathic constriction of the ductus arteriosus suggests that its diagnosis is underestimated and that many cases of persistence of fetal circulation in newborns may be related to constriction of the ductus arteriosus not diagnosed during intrauterine life. Group B had a lower severity but a risk of an unfavorable evolvement, suggesting a distinct alteration.

OBJECTIVE: To determine the frequency of encephalic infarction and its contribution to lethality in patients with Chagas' disease and heart failure. METHODS: Medical records and autopsy reports of patients with Chagas' disease complicated by heart failure, who died at the Professor Edgar Santos Hospital of the Federal University of Bahia in the past 45 years were retrospectively analyzed. Data comprised information regarding the clinical history on hospital admission, complementary and anatomicopathological examinations, including the presence of encephalic infarction, the impaired region, and the cause of death. RESULTS: Of the 5,447 autopsies performed, 524 were in patients with heart failure due to Chagas' disease. The mean age was 45.7 years, and 51 (63%) patients were of the male sex. The frequency of encephalic infarction was 17.5%, corresponding to 92 events in 92 individuals, 82 (15.8%) of which involved the brain, 8 (1.5%) involved the cerebellum, and 2 (0.4%) involved the hypophysis. CONCLUSION: Cerebral infarction has been a frequent finding in autopsies of chagasic patients with heart failure, and it has been an important cause of death in our region. The presence of cerebral infarction and its complications have been associated with death in 52% of the cases studied.

We report the case of implantation of metallic mitral and aortic valve prostheses 6 months earlier, with subsequent multiple embolic episodes. The anatomicopathological examination of the thrombus of the third embolic episode was compatible with Aspergillus sp, which was treated with amphotericin B, followed by oral itraconazole. On the fourth embolism, vegetations were visualized in the ascending aorta on echocardiography and resonance imaging, and the patient underwent replacement of the aortic segment by a Haemashield tube and exploration of the aortic prosthesis, which was preserved, because no signs of endocarditis were found. Four months later, the patient died due to cardiogenic shock secondary to acute myocardial infarction caused by probable coronary embolism and partial dysfunction of the aortic prosthesis.

OBJECTIVE: To evaluate the initial clinical experience with the Helex septal occluder for percutaneous closure of atrial septal defects. METHODS: Ten patients underwent the procedure, 7 patients with ostium secundum atrial septal defects (ASD) with hemodynamic repercussions and 3 patients with pervious foramen ovale (PFO) and a history of stroke. Mean age was 33.8 years and mean weight was 55.4 kg. Mean diameter by transesophageal echocardiography and mean stretched ASD diameter were 11.33 ± 3.3mm, and 15.2 ± 3.8mm, respectively. The Qp/Qs ratio was 1.9 ± 0.3 in patients with ASD. RESULTS: Eleven occluders were placed because a patient with 2 holes needed 2 devices. It was necessary to retrieve and replace 4 devices in 3 patients. We observed immediate residual shunt (< 2mm) in 4 patients with ASD, and in those with patent foramen ovale total occlusion of the defect occurred. No complications were noted, and all patients were discharged on the following day. After 1 month, 2 patients with ASD experienced trivial residual shunts (1mm). In 1 patient, we observed mild prolapse in the proximal disk in the right atrium, without consequences. CONCLUSION: The Helex septal occluder was safe and effective for occluding small to moderate atrial septal defects. Because the implantation technique is demanding, it requires specific training of the operator. Even so, small technical failures may occur in the beginning of the learning curve, but they do not involve patient safety.

OBJECTIVE: To identify the variables that may be involved in the persistence of symptoms (functional class II, III, or IV vs. I) in patients being followed up for 30 years after surgical repair of tetralogy of Fallot. METHODS: Fifty-three patients (27 women), who underwent corrective surgery for tetralogy of Fallot between 1960 and 1970, were studied. Their ages ranged from 7 months to 26 years. At the end of follow-up, 13 patients were asymptomatic and the remaining were in functional class II (N=24), III (N=15), and IV (N=1). To differentiate asymptomatic from symptomatic patients, the following variables were analyzed: age at surgery, need for widening the pulmonary ring and trunk, need for a second (2nd OP) or 3rd operation, residual defect of the interventricular septum, residual regurgitation of the pulmonary valve, systolic gradient through the right ventricular outflow tract, right ventricular dilation or hypertrophy (RVH), cardiothoracic index (CTI), right and left ventricular ejection fraction (RVEF/LVEF), and arrhythmias. RESULTS: The univariate analysis showed an association between the presence of symptoms and the 2nd OP (P=0.03), an increase in the CTI (P=0.0001), moderate to severe RVH (P=0.002), and dilation (P=0.0003). In the logistic regression model, the combination of the 2nd OP (P=0.008), the RVH (P=0.002), and the reduction in RVEF (P=0.01) determined the presence of symptoms. CONCLUSION: Despite the surgical treatment, right ventricular remodeling and performance were the major determinants in the late follow-up of tetralogy of Fallot.

OBJECTIVE: To evaluate the cardiovascular findings and clinical follow-up of patients with Williams-Beuren syndrome. METHODS: We studied 20 patients (11 males, mean age at diagnosis: 5.9 years old), assessed for cardiovascular abnormalities with electrocardiography and Doppler echocardiography. Fluorescence in situ hybridization (FISH) was used to confirm the diagnosis of the syndrome. RESULTS: Elastin gene locus microdeletion was detected in 17 patients (85%) (positive FISH), and in 3 patients deletion was not detected (negative FISH). Sixteen patients with a positive FISH (94%) had congenital cardiovascular disease (mean age at diagnosis: 2,3 years old). We observed isolated (2/16) supravalvular aortic stenosis and supravalvular aortic stenosis associated (11/16) with pulmonary artery stenosis (4/11); mitral valve prolapse (3/11); bicuspid aortic valve (3/11); aortic coarctation (2/11), thickened pulmonary valve (2/11); pulmonary valvular stenosis (1/11); supravalvular pulmonary stenosis (1/11); valvular aortic stenosis (1/11); fixed subaortic stenosis (1/11); pulmonary artery stenosis (2/16) associated with pulmonary valvar stenosis (1/2) and with mitral valve prolapse (1/2); and isolated mitral valve prolapse (1/16). Four patients with severe supravalvular aortic stenosis underwent surgery (mean age: 5.7 years old), and 2 patients had normal pressure gradients (mean follow-up: 8.4 years). CONCLUSION: A detailed cardiac evaluation must be performed in all patients with Williams-Beuren syndrome due to the high frequency of cardiovascular abnormalities.

OBJECTIVE: To assess the clinical significance of transient ischemic dilation of the left ventricle during myocardial perfusion scintigraphy with stress/rest sestamibi. METHODS: The study retrospectively analyzed 378 patients who underwent myocardial perfusion scintigraphy with stress/rest sestamibi, 340 of whom had a low probability of having ischemia and 38 had significant transient defects. Transient ischemic dilation was automatically calculated using Autoquant software. Sensitivity, specificity, and the positive and negative predictive values were established for each value of transient ischemic dilation. RESULTS: The values of transient ischemic dilation for the groups of low probability and significant transient defects were, respectively, 1.01 ± 0.13 and 1.18 ± 0.17. The values of transient ischemic dilation for the group with significant transient defects were significantly greater than those obtained for the group with a low probability (P<0.001). The greatest positive predictive values, around 50%, were obtained for the values of transient ischemic dilation above 1.25. CONCLUSION: The results suggest that transient ischemic dilation assessed using the stress/rest sestamibi protocol may be useful to separate patients with extensive myocardial ischemia from those without ischemia.

OBJECTIVE: Noninvasive cardiac assessment of newborns and infants of women with systemic lupus erythematosus. The children had no congenital total atrioventricular block and were compared with the children of healthy women. METHODS: We prospectively assessed 13 newborns and infants aged 1 to 60 days, children of women with systemic lupus erythematosus and without congenital total atrioventricular block. These children were compared with 30 children of women who had no lupus or anti-Ro/SSA antibodies, and no risk factors for congenital heart disease either. Their age groups matched. The following examinations were performed: cardiological physical examination, electrocardiography, echocardiography, and signal-averaged electrocardiography. RESULTS: The statistical analysis showed no significant difference in ventricular function or in the cardiac conduction system between the groups. CONCLUSION: In regard to the conduction system and ventricular function in the absence of total atrioventricular block, no statistically significant difference was observed between the children of women with systemic lupus erythematosus and children of healthy women.

Abstract A total of 38 freshwater brachyuran species occur in Brazil, of which 79% are distributed in the northern region. However, for only two species of freshwater crabs are descriptions available for their juveniles. The importance of these studies lies in understanding of life-cycle aspects as well the potential elucidation of phylogenetic relationships within the group because the characters are usually solely based on adult specimens. The morphology of the first juvenile stage of the Dilocarcinus septemdentatus (Herbst, 1783) is described and illustrated for the first time based on specimens hatched by an ovigerous female collected in the northeastern region of the Brazilian Amazon. Juveniles of Dilocarcinus pagei Stimpson, 1861 and D. septemdentatus have one flagellar segment on the exopod of the first maxilliped while the only described juvenile of an unidentified species of Trichodactylus Latreille, 1828 has two. Dilocarcinus septemdentatus differs from other congeneric species mainly in the number of setae on the antennae and number of segments of the mandibular palp. Variations in the number of segments and aesthetascs enable the comparison between the juveniles of D. septemdentatus with those of other Brachyuran species previously studied and suggest possible adaptations to freshwater environments.

Abstract Predatory behavior of the crab Eriphia verrucosa (Forskål, 1775) on the oyster Magallana angulata (Lamarck, 1819), the mussel Mytilus galloprovincialis Lamarck, 1819, the limpet Patella depressa Pennant, 1777, the hermit crab Clibanarius erythropus (Latreille, 1818), the gastropod Phorcus lineatus (da Costa, 1778) and the sea urchin Paracentrotus lividus (Lamarck, 1816) was experimentally studied. Taken into account that the sampled population of E. verrucosa was infected with the parasitic barnacle Sacculina eriphiae Smith, 1906, four predator categories were established regarding crab sex and parasite presence: uninfected and infected males and females, respectively. These four crab categories were fed on the six preys offered, but prey remains suggest that the crab obtains the flesh of each prey using different methods of attack. Irrespective of the prey species, uninfected females consistently presented lower percentages of crab feeding and total consumption. On average, it was found that a significantly higher percentage of crabs feed on M. galloprovincialis, P. depressa and Ph. lineatus than on the other three prey species (chi-squared test, p < 0.05). In terms of mean eaten biomass, the preys most eaten were P. lividus and P. depressa and the least eaten was C. erythropus (ANOVA test, p < 0.05). For crabs feeding on M. galloprovincialis and Ph. lineatus there was a significant positive correlation (p < 0.05) between the predator size and prey size, as well as between the predator size and total prey consumption. According to these results, potential effects of this top predator on intertidal communities are also discussed.

Abstract Until recently, three subspecies had traditionally been recognized in the astacid species Pacifastacus leniusculus (Dana, 1852): Pacifastacus leniusculus leniusculus, Pacifastacus leniusculus klamathensis (Stimpson, 1857), and Pacifastacus leniusculus trowbridgii (Stimpson, 1857). The type specimens attributed to these taxa were re-described with detailed illustrations of taxonomic characteristics for further taxonomic works.

Abstract Flavalona asymmetrica sp. nov. belongs to the costata-clade. This species has two main head pores, a feature shared only with Flavalona setigera (Brehm, 1931). Morphological differences between them are related to main and lateral head pores, armature of scrapers on the second limb, and proportion of setae on the third and fourth limbs, number of denticles on the postabdomen. Males of F. asymmetrica sp. nov. has genital process about ten times shorter than length of postabdominal claw, which is an exclusive morphological trait. Flavalona asymmetrica sp. nov. is a Neotropical species, so far, it occurs only in Brazil and can be found together with Flavalona iheringula (Sinev & Kotov, 2004) and Flavalona margipluma (Sousa, Santos, Güntzel, Diniz-Filho, de Melo-Júnior & Elmoor-Loureiro, 2015).

Abstract Shell occupation by the land hermit crab Coenobita violascens Heller, 1862 was investigated from January 2011 to March 2012 on Phuket Island in the Andaman Coast of Thailand. The samples of C. violascens were collected monthly using multiple quadrat sampling. Twenty shell species from 11 families were found occupying by C. violascens, which were mainly marine gastropods (90%). The three most common occupied shell species were Chicoreus brunneus (Link, 1807) (21.3% of hermits), followed by Filifusus filamentosus (Röding, 1798) (14.9%) and Laevistrombus canarium (Linnaeus, 1758) (14.9%). Biconical shells and those with ovate apertures were the most commonly occupied shell types. Furthermore, individual C. violascens probably occupy the shells of at least three different gastropod species during their lifetime. Interestingly, C. violascens shows a tendency of occupying specific categories of shells in relation to shell species, shape and aperture shape. Other aspects of shell occupation by C. violascens compared to congeneric species are also discussed.

ABSTRACT The present study provides information on the morphology of stomatopod larvae found in two different reef systems which are also considered national parks: the Sistema Arrecifal Veracruzano (SAVNP) and Arrecife Puerto Morelos (APMNP). Zooplankton samples were collected at 26 stations of the SAVNP and four stations of the APMNP. Stomatopod larvae were identified and classified by their larval stage. We found representatives of three stomatopod superfamilies: the superfamily Gonodactyloidea Giesbrecht, 1910 was represented by Neogonodactylus oerstedii (Hansen, 1895), Neogonodactylus wennerae Manning and Heard, 1997, and Pseudosquillidae genus and species indeterminate; the superfamily Lysiosquilloidea Giesbrecht, 1910 was represented by Lysiosquilloidea genus and species indeterminate, Lysiosquilla sp., Lysiosquilla scabricauda (Lamarck, 1818) and Nannosquilla adkisoni Camp and Manning, 1982; the superfamily Squilloidea was represented by larvae of Alima neptuni (Linnaeus, 1768), Squilla spp., and Squilla empusa Say, 1818. We were able to identify and describe four stages of larval development for representatives of these superfamilies. This is the first study describing several stages of larval development of different species of the stomatopods from the Gulf of Mexico and Caribbean Sea.

Abstract Five species of cladocerans are reported from the Tomo River, Vichada, Colombia. Zooplankton samples were collected from the littoral zone with vegetation (Campsiandra comosa Benth). Three of them, namely Streblocerus pygmaeus Sars, 1901, Disparalona cf. hamata (Birge, 1879) and Alona isabellae Sousa, Elmoor-Loureiro and Santos, 2016 are new to the Colombian cladoceran fauna. Descriptive notes, comparative comments on morphology and variability and illustrations are also provided for some remarkable taxa. This is the first report on the cladoceran fauna in the Tomo River.

Abstract Ludwig Buckup holds a Bachelor’s degree in Natural History in 1954 from the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, and a Ph.D. in Zoology from the University of Tübingen, Germany, in 1958. He joined UFRGS as a Professor in 1958, from where he retired in 1990. During this period he was fully devoted to his career of professor and scientist. His investigations in the area of Carcinology covered mainly the Parastacidae and Aeglidae families. Even after he retired, Professor Buckup participated in numerous research and extension activities inside and outside the University. Always engaged in environmental causes, he actively takes part in debates and lectures about the environment and conservation in the city of Porto Alegre and other cities in the state of Rio Grande do Sul. His career is highlighted by important steps for the construction of academic spaces and the development and consolidation of Carcinology, in particular for the Brazilian Crustacean Society.

ABSTRACT: We examined the individual growth of the burrowing crayfish Parastacus nicoleti (Philippi, 1882) based on a sample of 1,425 specimens. Individuals were collected monthly from November 1981 to December 1982, in the marshy wetlands of the “Pangal” homestead in Reumen, southern Chile. The Cephalothorax Length (CL) and Body Weight (BW) were recorded for all specimens. The asymptotic length parameters (L ∞) and the growth coefficient (k) were established using the Gulland and Holt method (1959). The t 0 parameter was obtained through the inverse von Bertalanffy equation and the length-weight relationship was determined according to the equation proposed by Ricker (1975). The asymptotic size and weight were 45.754 mm and 18.50 g, respectively. The growth constant was 0.703/year. Estimated longevity was 4.32 years. We concluded that P. nicoleti is a relatively small species with poor growth indicators for size and weight and, consequently, is not an attractive species for commercial aquaculture purposes.

ABSTRACT: The species composition and distribution of the pseudothelphusid and trichodactylid freshwater crabs from the state of Roraima, Brazil, are updated based mainly on documented records deposited in the collections of the Instituto Nacional de Pesquisas da Amazônia (Manaus) and the Museu Integrado de Roraima (Boa Vista). This paper provides records for the occurrence of ten species (six Pseudothelphusidae, four Trichodactylidae). Three species are recorded from Roraima for the first time: the pseudothelphusids Fredius beccarii (Coifmann, 1939) and Fredius fittkaui (Bott, 1967), and the trichodactylid Moreirocarcinus laevifrons (Moreira, 1901). The records of F. beccarii also represent the first documented occurrence of the species in Brazil. All species in the state are presented in maps that document their geographic distribution. Comments are made on the diversity of the Branco River crab fauna in comparision with diversity in other sub-basins of the Amazon River.