ABSTRACT
This work compiled Brazilian articles regarding medicinal plant use by local communities in order to analyze the most common sampling problems and if research characteristics can influence the presence of sampling irregularities. We focused on studies about medicinal plants that present a species-indications list and had a quantitative nature. The proportion of works with and without sampling problems was evaluated considering the journal impact factor, period of publication, community status (urban x rural), sample type, presence of testing hypothesis and presence of research questions. We found that an alarming proportion of papers had some kind of sampling problems (48.39% serious and 19.35% moderate). The most common problems were related to: lack of information regarding the sample size or the universe, small sample sizes and selection of specialists based on obscure criteria. We could not find a significant influence between our tested variables and the occurrence of sampling problems, except for the community status (urban x rural). Results indicate that a significant amount of intracultural diversity is not properly captured, taking into consideration both the population as a whole and a group of interest in the community (= healers).
ABSTRACT
Objetivo: Avaliar o resultado imediato da operação de Norwood modificado com nova técnica de perfusão regional cerebral (PRCeA) anterógrada associado a perfusão regional coronariana (PRCoR) retrógrada em substituição à parada circulatória total com hipotermia profunda em crianças portadoras da Síndrome da Hipoplasia do Coração Esquerdo (SHCE) com aorta ascendente extremamente hipoplásica (AH). Métodos: No período de dezembro de 2006 a fevereiro de 2008, a operação de Norwood modificado com tubo entre o ventrículo direito e as artérias pulmonares ou shunt tipo Sano foi realizada em oito crianças portadoras de SHCE e aorta ascendente com diâmetro inferior a 3 mm, (quatro do sexo masculino e quatro do sexo feminino) com idade média de 9,2 dias (variando de 1 a 29 dias) e peso médio de 3,3 kg (variando de 2,7 a 3,8 kg). Utilizada CEC e hipotermia a 25ºC com duas cânulas venosas e anastomose de um enxerto de politetrafluoretileno com a artéria inominada utilizado como linha arterial e para PRCeA. A PRCoR foi realizada por meio de um desvio na linha arterial e colocação de um cateter na aorta ascendente. Foram analisados o resultado cirúrgico imediato e a presença de alterações neurológicas nesse período. Resultados: O resultado cirúrgico imediato revelou mortalidade de 25 por cento e ausência de comprometimento neurológico ao exame clínico. Conclusão: A operação de Norwood modificado pode ser realizada com PRCeA e PRCoR em crianças com SHCE e AH com resultado cirúrgico imediato satisfatório e ausência de complicações neurológicas.
Objective: To assess the immediate result of the modified Norwood procedure with new technique of anterograde regional cerebral perfusion (ARCeP) and retrograde regional coronary perfusion (RRCoP) in substitution of profound hypothermia and circulatory arrest in children with hypoplastic left heart syndrome (HLHS) with extremely hypoplastic ascending aorta (HA). Methods: In the period of December of 2006 to February 2008 the modified Norwood procedure with tube between the right ventricle and pulmonary arteries or Sano shunt was performed in eight children with HLHS and with ascending aorta diameter less than 3 mm, (four male and four female) with median age of 9.2 days (ranging from 1 to 29 days) and median weigh of 3.3 kg (ranging from 2.7 to 3.8 kg). We used cardiopulmonary bypass and hypothermia at 25ºC with two venous cannulas and suture with a polytetrafluoroethylene graft sutured to the innominate artery as an arterial line and used to ARCeP. The RRCoP was performed by a deviation in the arterial line and placement of a catheter in the ascending aorta. The immediate surgical results and the clinical neurological manifestation were assessed. Results: The immediate surgical results revealed mortality of 25 percent and there were absence of neurological injury at clinical examination. Conclusions: The modified Norwood procedure can be accomplished with ARCeP and RRCoP in children with HLHS with HA with satisfactory immediate surgical result and without neurological complications.