RCAAP Repository
A new species of Trichorhina Budde-Lund, 1908 (Isopoda: Oniscidea: Platyarthridae) from Paraná caves, southern Brazil
ABSTRACT The genus Trichorhina Budde-Lund, 1908 in Brazil includes 22 described species, four of which occur in caves. The present work aims at describing the first cave species for the state of Paraná. Trichorhina kaingangi n. sp. was collected in Água Boa cave, municipally of Almirante Tamandaré, and Ermida Paiol do Alto cave, municipally of Adrianópolis, both in the Açungui karst area.
2015
Campos-Filho,Ivanklin Soares Mise,Kleber Makoto Sessegolo,Gisele Cristina
Comparative study of the use of diltiazem as an antispasmodic drug in coronary angiography via the transradial approach
OBJECTIVE: To evaluate the impact of the use, prior to the procedure, of injectable diltiazem to prevent complications. METHODS: Between September 2000 and July 2001, 50 patients underwent transradial coronary angiography and were randomized to receive placebo (GI) or diltiazem (GII) through a catheter inserted into the radial artery. All patients received isosorbide mononitrate. Ultrasound analyses of the radial artery were performed before examination, 30 minutes afterwards, and 7 days afterwards to evaluate the flow, the diameter, and the artery output. RESULTS: The radial artery diameter of GI was 2.4± 0.5 mm before the procedure and 2.3±0.5 mm after 30 minutes (NS), whereas in GII the diameter was 2.2±0.3 mm before the examination and 2.5±0.4 mm 30 minutes after it (P<0.001). Radial artery output in group 1 was 7.3±5.l2 mL/min before the examination and 6.1±3.5 mL/min 30 minutes after the examination (NS), and GII had an increase of 5.9±2.5 mL/min before examination to 9.05± 7.78 mL/min after the examination (P=0.04). Complications (spasm, occlusion, and partial obstruction) occurred in 4 patients (17.4%) in GI and did not occur in GII (P=0.04). CONCLUSION: The study suggests a decrease in vascular complications through the transradial access for coronary angiography with the use of diltiazem as an antispasmodic drug, resulting in the significant increase in the diameter of the radial artery and radial artery output.
2003
Mont'Alverne Filho,José Ronaldo Assad,João Alexandre Rezende Zago,Alexandre do Canto Costa,Ricardo Leite Vieira da Pierre,Antonio Guarany Mont'Alverne Saleh,Mohamed Hassan Barretto,Rodrigo Braga,Sérgio Luiz Navarro Feres,Fausto Sousa,Amanda Guerra Moraes Rego Sousa,José Eduardo Moraes Rego
Conquering new territories in the "new world": the alien shrimp Athanas dimorphus Ortmann, 1894 (Decapoda: Alpheidae) on the coast of Pernambuco, northeastern Brazil
ABSTRACT The occurrence of the alien alpheid shrimp Athanas dimorphus Ortmann, 1894 is reported for the first time for the state of Pernambuco, northeastern Brazil, based on two ovigerous females collected at Praia do Paraíso, near the Suape Harbor (08º21'29.9"S 34º57'00.9"W). The species, native from the Indo-West Pacific region, was previously reported from two other Brazilian states (Ceará and São Paulo), also occurring in localities with nearby harbors. The presence of ovigerous females suggests that the species was successfully introduced into the area. The main possible introduction vectors for A. dimorphus in Pernambuco and the dispersal potential of the species along the Brazilian coast are discussed.
2015
Almeida,Alexandre Oliveira Costa-Souza,Ana Carla Soledade,Guidomar Oliveira Santos,Patricia Souza
Enalapril alters the formation of the collagen matrix in spontaneously hypertensive rats
OBJECTIVE: To assess the effect of the inhibition of the angiotensin-converting enzyme on the collagen matrix (CM) of the heart of newborn spontaneously hypertensive rats (SHR) during embryonic development. METHODS: The study comprised the 2 following groups of SHR (n=5 each): treated group - rats conceived from SHR females treated with enalapril maleate (15 mg. kg-1.day-1) during gestation; and nontreated group - offspring of nontreated females. The newborns were euthanized within the first 24 hours after birth and their hearts were removed and processed for histological study. Three fields per animal were considered for computer-assisted digital analysis and determination of the volume densities (Vv) of the nuclei and CM. The images were segmented with the aid of Image Pro Plus® 4.5.029 software (Media Cybernetics). RESULTS: No difference was observed between the treated and nontreated groups in regard to body mass, cardiac mass, and the relation between cardiac and body mass. A significant reduction in the Vv[matrix] and a concomitant increase in the Vv[nuclei] were observed in the treated group as compared with those in the nontreated group. CONCLUSION: The treatment with enalapril of hypertensive rats during pregnancy alters the collagen content and structure of the myocardium of newborns.
2003
Bomfim,Alfredo de Souza Mandarim-de-Lacerda,Carlos Alberto
Primitive decapods from the deep sea: first record of blind lobsters (Crustacea: Decapoda: Polychelidae) in northeastern Brazil
ABSTRACT We report herein the occurrence of the infraorder Polychelida in Potiguar Basin, northeastern Brazil. Specimens were collected by the project "Avaliação da Biota Bentônica e Planctônica na porção offshore das Bacias Potiguar e Ceará", developed by the Brazilian Oil Company (PETROBRAS). Three species were recorded for the first time in this region: Pentacheles validus A. Milne-Edwards, 1880, Polycheles typhlops Heller, 1862, and Stereomastis sculpta (Smith, 1880) at 2000 m, 400 m and 2057 m depth, respectively. The Brazilian deep-sea floor remains poorly known, but progress has been made as a result of collections obtained by oceanographic expeditions and research projects developed by PETROBRAS in Campos Basin (Rio de Janeiro) and Potiguar Basin (Rio Grande do Norte), expanding the knowledge of the distribution area of Polychelidae in Brazilian deep sea waters.
2015
Bezerra,Luis Ernesto Arruda Ribeiro,Felipe Bezerra
Detection of incipient left ventricular hypertrophy in mild to moderate arterial hypertension with normal electrocardiogram and echocardiogram: a new use for signal-averaged electrocardiography
OBJECTIVE: To assess signal-averaged electrocardiogram (SAECG) for diagnosing incipient left ventricular hypertrophy (LVH). METHODS: A study with 115 individuals was carried out. The individuals were divided as follows: GI - 38 healthy individuals; GII - 47 individuals with mild to moderate hypertension and normal findings on echocardiogram and ECG; and GIII - 30 individuals with hypertension and documented LVH. The magnitude vector of the SAECG was analyzed with the high-pass cutoff frequency of 40 Hz through the bidirectional four-pole Butterworth high-pass digital filter. The mean quadratic root of the total QRS voltage (RMST) and the two-dimensional integral of the QRS area of the spectro-temporal map were analyzed between 0 and 30 Hz for the frequency domain (Int FD), and between 40 and 250 Hz for the time domain (Int TD). The electrocardiographic criterion for LVH was based on the Cornell Product. Left ventricular mass was calculated with the Devereux formula. RESULTS: All parameters analyzed increased from GI to GIII, except for Int FD (GII vs GIII) and RMST log (GII vs GIII). Int TD showed greater accuracy for detecting LVH with an appropriate cutoff > 8 (sensitivity of 55%, specificity of 81%). Positive values (> 8) were found in 56.5% of the G II patients and in 18.4% of the GI patients (p< 0.0005). CONCLUSION: SAECG can be used in the early diagnosis of LVH in hypertensive patients with normal ECG and echocardiogram.
2003
Ginefra,Paulo Barbosa,Eduardo C. Benchimol-Barbosa,P. R. Bomfim,Alfredo S. Boghossian,Sílvia H. Salgado,Angelo A. Brasil,Flávia G. Freitas,Elizabete A. Albanesi Filho,Francisco M.
Abundance and distribution of Portunidae larval phases (Crustacea: Brachyura) in the estuarine and coastal region of the Patos Lagoon, southern Brazil
ABSTRACT: The abundance and distribution of larval phases of the Portunidae found in the estuary of the Patos Lagoon and the coastal region were studied during two years (1995 and 1999). A conical net (165 cm long, 60 cm mouth, and 330 µm mesh) equipped with a flowmeter was towed for three minutes at 2 knots at six stations within the estuary and four stations in the coastal region. Samplings were carried out on the surface and near the bottom. At each sampling location, the salinity and temperature were also recorded. In 1995, the zoeae of Arenaeus cribrarius (Lamarck, 1818), Callinectes sapidus Rathbun, 1896 and Achelous spinicarpus Stimpson, 1871 were caught, resulting in a total abundance of 121.98 ind.100 m-3 (90.95 ind.100 m-3 on the surface and 31.03 ind.100 m-3 near the bottom). A total of 452.27 ind.100 m-3 were caught in the megalopa phase (13.49 ind.100 m-3 on the surface and 438.78 ind.100 m-3 near the bottom). In 1999, only zoeae of C. sapidus were caught, resulting in a total abundance of 419.78 ind.100 m-3 (386.98 ind.100 m-3 on the surface and 32.8 ind.100 m-3 near the bottom). Megalopae of these three species were caught, resulting in a total abundance of 179.91 ind.100 m-3 (25.38 ind.100 m-3 on surface and 154.53 ind.100 m-3 near the bottom). Summer was the season with the highest abundance of larvae in both years. During spring and summer, spawning was observed in the estuarine region of the Patos Lagoon.
2015
Vieira,Rony Roberto Ramos Calazans,Danilo Koetz de
Length-weight relationship and condition factor of Macrobrachium amazonicum (Heller, 1862) (Decapoda, Palaemonidae) from a reservoir in Bahia, Brazil
ABSTRACT Macrobrachium amazonicum (Heller, 1862) is a freshwater prawn occurring in rivers and reservoirs of Central and South America. Given its broad geographical distribution, the species shows great intraspecific morphological, reproductive, physiological and ecological plasticity. Furthermore, it also stands out for its economic importance, especially in the states of North (Pará and Amapá) and Northeast Brazil. Despite the wide geographic distribution and economic importance of M. amazonicum, the biology of this species is poorly known, particularly in Northeast Brazil. We analyzed the length-weight relationships and condition factor of males and females of M. amazonicum. Specimens were collected monthly from September 2008 to August 2009 at the Pedra do Cavalo Reservoir, city of Cabaceiras do Paraguaçu, State of Bahia. All specimens were sexed, measured and weighted. After that, length-weight relationships and the allometric (K) and relative (Kr) condition factors were calculated. Altogether 2,974 specimens were analyzed, 334 of which were males (11%) and 2,640 were females (89%). Females were larger and heavier than males. Males and females showed isometric and negative allometric growth, respectively. Monthly variations in the condition factor were similar for both sexes, and correlated strongly with rainfall regime and temperature in the region. Such variations are not correlated with the reproductive cycle of the species, but are probably correlated with food availability and somatic growth.
2015
Rocha,Sérgio Schwarz da Silva,Ricardo Loreno Souza da Santos,Jayane de Lima Oliveira,Guilherme de
Reproductive aspects of Hyalella carstica (Amphipoda: Hyalellidae) in a natural environment in southeastern Brazil
Abstract The reproductive aspects of populations are important determinants of their ability to maintain themselves throughout time. In the case of amphipods from the genus Hyalella Smith, 1874, the reproductive period is easily determined by the presence of ovigerous females and pre-copula pairs in the population. This study evaluated the fecundity, pairing patterns and reproduction period of Hyalella carstica Bastos-Pereira and Bueno, 2012 in a karst environment in the West of Minas Gerais, Brazil. Monthly, from April, 2010 to April, 2011, amphipods were sampled using a hand net with 15 cm diameter and 250 µm mesh size. In the laboratory, animals were sexed and measured, and the ovigerous state of females was evaluated. Couples in pre-copula and ovigerous females were found throughout the year, with the exception of the dry months (September−November). During drought, the stream's superficial water dried out, and only a few refuges for the population remained. Although couples were found in all months with a water flow, a higher number of unpaired males and females was found after the dry season. In all months, ovigerous females were more abundant than non-ovigerous, and the relationship between head length and the number of eggs in the marsupium was positive. Most eggs were in the first developmental stage, although all other stages were found before the dry season. Considering the frequency of pre-copula pairs, as well as ovigerous females, the reproduction in this H. carstica population seems to be continuous throughout the year, without a distinct peak.
2015
Torres,Silvia Helena Soares Bastos-Pereira,Rafaela Bueno,Alessandra Angélica de Pádua
Three new species of terrestrial isopods (Crustacea, Isopoda, Oniscidea) from Brazilian caves
ABSTRACT A second amphibian species of terrestrial isopods in the genusXangoniscus Campos-Filho, Araujo & Taiti, 2014 and two new species of Trichorhina Budde-Lund, 1908 are described from the Bambuí karst area in the state of Minas Gerais. Xangoniscus odara n. sp. and Trichorhina cipoensis n. sp. were collected in Lapa do Cipó cave, municipality of Itacarambi, andTrichorhina pataxosi n. sp. in Gruta do Sufoco and Gruta do Nei, municipality of Pedro Leopoldo.
2016
Campos-Filho,Ivanklin Soares Bichuette,Maria Elina Taiti,Stefano
Evidence-based medicine. A lesson for electrocardiography?
No summary/description provided
2003
Bacharova,Ljuba
Taxonomy and distribution of Talitroides alluaudi (Chevreux, 1896) and T. topitotum (Burt, 1934) (Amphipoda, Talitridae) in Atlantic rain forests of southeastern Brazil
ABSTRACT The family Talitridae Rafinesque, 1815 is the only group, among the amphipods, that colonized the terrestrial environment, and more than half of its species live in tropical and subtropical forests. Nowadays, the family has approximately 270 species described in 64 genera. Leaf litter samples from Atlantic forests and urban areas of the states of Rio de Janeiro, São Paulo, Minas Gerais, Paraná, Santa Catarina, and Rio Grande do Sul, provided material to redescribe the two terrestrial species known to Brazil, Talitroides alluaudi (Chevreux, 1896) and Talitroides topitotum (Burt, 1934), and enlarge their known distribution. These species have a worldwide distribution, as they are commonly dispersed in a synanthropic way. Talitroides topitotum seems to be well established in Brazilian Atlantic forests: 96% of the 1787 individuals examined (51 samples) corresponded to this species. Also, females dominated the samples and only six males were found: four from T. alluaudi and two from T. topitotum. A detailed comparison of these two species, as well as their geographical distribution, is given.
2016
Nascimento,Priscila S. do Serejo,Cristiana S.
Aspects of the reproductive biology of the freshwater/brackish amphipod Quadrivisio lutzi (Crustacea, Amphipoda) from an unstable coastal lagoon of southeastern Brazil
ABSTRACT The amphipod Quadrivisio lutzi (Shoemaker, 1933) (Maeridae) inhabits the coastal lagoons of southeastern Brazil, which are highly unstable environments. Drastic reduction in the abundance and distribution of this amphipod on these lagoons has been observed. The constant recovery of its populations suggests that this species may show a reproductive strategy that helps it to persist on these environments. Therefore, our aim was to study the reproductive biology of this species in Carapebus lagoon and to answer the question if its reproductive strategy contributes to a rapid population recovery. The size-range at sexual maturity was determined by the relative growth of the gnathopods and by the number of articles in antennal flagella. Brood size, egg diameter, size at first maturity and other relative reproductive parameters were obtained, which were compared to other species using a multivariate Principal Component Analysis (PCA). Females reach maturity at smaller size-range (2.9-3.9 mm body length (BL) than males (4.9 -5.9 mm BL). Mean egg diameter was small (0.35 ± 0.08 mm) and fecundity was high (20.2 ± 9.2 eggs/female; maximum 48 eggs). The relative reproductive parameters observed in Q. lutzi suggest it as iteroparous species. The PCA situated Q. lutzi within the species of high reproductive potential, characterized by small female size at first maturity, small egg diameter, large brood size and iteroparity, which have been largely considered adaptations that allow rapid recovery of population sizes. Therefore, we concluded that the reproductive strategy of this species contributes to its survival in the highly unstable Carapebus lagoon at southeastern Brazil.
2016
Medeiros,Taiane Barreiro Weber,Laura Isabel
Short- and midterm follow-up results of valvuloplasty with balloon catheter for congenital aortic stenosis
OBJECTIVE: To report short and midtem follow-up results of balloon aortic valvuloplasty to treat congenital aortic stenosis. METHODS: Seventy-five patients (median age: 8 years) underwent the procedure through the retrograde femoral or carotid route. RESULTS: The procedure was completed in 74 patients (98.6%). The peak-to-peak systolic gradient dropped from 79.6±27.7 to 22.3±17.8 mmHg (P<0.001), the left ventricular systolic pressure dropped from 164±39.1 to 110±24.8 mmHg (P<0.001), and the left ventricular end diastolic pressure dropped from 13.3±5.5 to 8.5±8.3 mmHg (P< 0.01). Four patients (5.3%) died due to the procedure. Aortic regurgitation (AoR) appeared or worsened in 27/71 (38%) patients, and no immediate surgical intervention was required. A mean follow-up of 50±38 months was obtained in 37 patients. Restenosis and significant AoR were observed in 16.6% of the patients. The estimates for being restenosis-free and for having significant AoR in 90 months were 60% and 50%, respectively. CONCLUSION: Aortic valvuloplasty was considered the initial palliative method of choice in managing congenital aortic stenosis, with satisfactory short- and midterm results.
2003
Pedra,Carlos A. C. Pedra,Simone R. F. Braga,Sérgio L. N. Esteves,César A. Moreira,Samuel M. Santos,Magali A. dos Bosisio,Ieda J. Silva,Maria Aparecida P. Elias,Patrícia F. Santana,Maria Virgínia T. Fontes,Valmir F.
Habitat heterogeneity in the assemblages and shell use by the most abundant hermit crabs (Anomura: Diogenidae and Paguridae): does the occupied shell species differ according to gender and species?
Abstract The goal of this study was to identify patterns of shell occupation by different species of hermit crabs from the southern Brazilian coast. In total, 644 individuals were collected, represented by six hermit species. Isocheles sawayai Forest & Saint Laurent, 1968 showed the highest abundance, with 575 individuals, followed by Loxopagurus loxochelis (Moreira, 1901) (n = 56). The other species were Petrochirus diogenes (Linnaeus, 1758), Dardanus insignis (Saussure, 1858), Pagurus exilis (Benedict, 1892) and Pagurus leptonyx Forest & Saint Laurent, 1968. Loxopagurus loxochelis was found associated with shells of 12 gastropod species, with 75% of males occupying shells of Olivancilaria urceus (Roding, 1798) and 78% of females inhabiting shells of Semicassis granulata (Born, 1778). Shells of Semicassis granulata were the lightest of all gastropod shells, demonstrating differential resource utilization. Additionally, I. sawayai occupied shells of 10 species, highlighting Stramonita haemastoma (Linnaeus, 1767) with the highest occupation percentage in all demographic classes, confirming a pattern of occupation with a strong relationship to the availability of the resource. The comparison of our results with those of other studies corroborated the influence of region and gastropod diversity on gastropod shell occupation.
2016
Stanski,Gilson L. Mantelatto,Fernando Leão Castilho,Antonio
Correlation between turbidimetric and nephelometric methods of measuring C-reactive protein in patients with unstable angina or non-ST elevation acute myocardial infarction
OBJECTIVE: To evaluate the performance of the turbidimetric method of C-reactive protein (CRP) as a measure of low-grade inflammation in patients admitted with non-ST elevation acute coronary syndromes (ACS). METHODS: Serum samples obtained at hospital arrival from 68 patients (66±11 years, 40 men), admitted with unstable angina or non-ST elevation acute myocardial infarction were used to measure CRP by the methods of nephelometry and turbidimetry. RESULTS: The medians of C-reactive protein by the turbidimetric and nephelometric methods were 0.5 mg/dL and 0.47 mg/dL, respectively. A strong linear association existed between the 2 methods, according to the regression coefficient (b=0.75; 95% C.I.=0.70-0.80) and correlation coefficient (r=0.96; P<0.001). The mean difference between the nephelometric and turbidimetric CRP was 0.02 ± 0.91 mg/dL, and 100% agreement between the methods in the detection of high CRP was observed. CONCLUSION: In patients with non-ST elevation ACS, CRP values obtained by turbidimetry show a strong linear association with the method of nephelometry and perfect agreement in the detection of high CRP.
2003
Correia,Luis C. L. Lima,José C. Gerstenblith,Gary Magalhães,Luis P. Moreira,Agnaluce Barbosa Jr.,Octávio Dumet,Juliana Passos,Luiz Carlos S. D'Oliveira Júnior,Argemiro Esteves,José Péricles
A review of the Leptostraca of the British Isles with discussion of the genus Sarsinebalia Dahl
Abstract A survey of the Leptostracan fauna of the British Isles collected from routine environmental monitoring samples revealed six species of Nebaliidae to be present in shallow waters. These species were identified as Nebalia herbstii Leach, 1814, Nebalia strausi Risso, 1826, Nebalia borealis Dahl, 1985, Nebalia kocatasi Moreira, Koçak and Katagan, 2007, Nebalia reboredae Moreira and Urgorri, 2009 in Moreira et al., 2009a and Sarsinebalia urgorrii Moreira, Gestoso and Troncoso, 2003. The presence of N. strausi , N. kocatasi , N. reboredae and S. urgorrii is reported from the British Isles for the first time. Three further species have been previously reported from the waters surrounding Britain and Ireland but were not recorded in the current study. Thus, the number of species recorded in the British Isles now stands at nine and the range of several species is extended northwards from previous records in the Mediterranean and the Iberian Peninsula. The diagnostic characters of Sarsinebalia Dahl, 1985 are discussed and it is suggested that a formal reappraisal of the genus be conducted. A key to European Leptostraca is provided based on adult females.
2016
McCormack,Edward Ashelby,Christopher W. McGrath,David
Hypertensive diabetic patients: guidelines for conduct and their difficulties
OBJECTIVE: To assess the effect of blood pressure (BP) control and other cardiovascular risk factors in patients with diabetes mellitus in a referral service for the treatment of hypertension. METHODS: A retrospective study where diabetic patients (at least 2 fasting glucose levels above 126 mg/dL, use of hypoglycemic agents or insulin, or both of these) were included. They were evaluated at the first appointment (M1) and at the last appointment (M2), regarding blood pressure, body mass index (BMI), use of hypertensive drugs, glycemia, total cholesterol (TC), creatinine, and potassium. RESULTS: Of 1,032 patients studied, 146 patients with a mean age of 61.6 years had diabetes, and 27 were men (18.5%). Mean follow-up was 5.5 years. BP values were 161.6 x 99.9 mmHg in M1 and 146.3 x 89.5 mmHg in M2. In M1, 10.4% of the patients did not use medications, 50.6% used just 1 drug, 30.8% used 2 drugs, and 8.2% used 3 or more drugs. In M2, these values were 10.9%, 39%, 39.7%, and 10.4%, respectively. Diuretics were the most commonly used medication, whereas angiotensin-converting enzyme inhibitors (ACE inhibitors) were those drugs which presented greater increase when comparing M1 to M2 (24.6% and 41.7%, respectively). Only 17,1% reached the recommended goal (BP<130x85 mmhg). The other cardiovascular risk factors did not change significantly. CONCLUSION: Our data reinforce the necessity of a more aggressive approach in the treatment of these patients, despite the social and economic difficulties in adhering to treatment.
2003
Barroso,Weimar K. S. Jardim,Paulo César B. V. Jardim,Thiago S. V. Souza,Cláudio T. S. Magalhães,Alessandro L. A. Ibrahim,Fuad M. Couto,Priscila V. O. Silveira,Andrea Monego,Estelamaris T.
Morphological review of the freshwater fairy shrimp Dendrocephalus brasiliensis Pesta, 1921 (Anostraca: Thamnocephalidae)
Abstract Information concerning the morphology of Dendrocephalus brasiliensis Pesta, 1921 is currently fragmented. This study reviewed the morphological structures described previously and new features (e.g., antenna-like structures and gonopod). We review the distribution of this species and also expand the geographic distribution of D. brasiliensis in the state of Alagoas. The specimens were obtained from fish-breeding tanks in Porto Real do Colégio, Alagoas, Brazil, in November 2012. Several morphological structures of D. brasiliensis are described in greater detail, including all branches and sub-branches from the frontal appendage and thoracopods from one population and compared to other species.
2016
Barros-Alves,Samara de Paiva Alves,Douglas Fernandes Rodrigues Bolla Jr,Eduardo Antônio Rabet,Nicolas Hirose,Gustavo Luis
Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences
OBJECTIVE: To access the incidence of diagnostic errors in the initial evaluation of children with cardiac murmurs. METHODS: We evaluated our 7-years of experience in a public pediatric cardiology outpatient clinic. Of 3692 patients who were sent to the hospital, 2603 presented with a heart murmur and were investigated. Patients for whom a disagreement existed between the initial and final diagnoses were divided into the following 2 groups: G1 (n=17) with an initial diagnosis of an innocent murmur and a final diagnosis of cardiopathy, and G2 (n=161) with an initial diagnosis of cardiopathy and a final diagnosis of a normal heart. RESULTS: In G1, the great majority of patients had cardiac defects with mild hemodynamic repercussions, such as small ventricular septal defect and mild pulmonary stenosis. In G2, the great majority of structural defects were interventricular communication, atrial septal defect and pulmonary valve stenosis. CONCLUSION: A global analysis demonstrated that diagnostic error in the initial evaluation of children with cardiac murmurs is real, reaching approximately 6% of cases. The majority of these misdiagnoses were in patients with an initial diagnosis of cardiopathy, which was not confirmed through later complementary examinations. Clinical cardiovascular examination is an excellent resource in the evaluation of children suspected of having cardiopathy. Immediate outpatient discharge of children with an initial diagnosis of an innocent heart murmur seems to be a suitable approach.
2003
Amaral,Fernando Granzotti,João A.