Resveratrol atenua o estresse oxidativo e a lesão muscular de ratos sedentários submetidos ao exercício físico / Resveratrol attenuates oxidative stress and muscle damage in sedentary rats subjected to physical exercise

O sedentarismo é um problema de saúde pública e um dos maiores males da sociedade moderna. Já está bem estabelecido que esforço físico em excesso ou em indivíduos não condicionados acarreta estresse oxidativo e lesões musculares. No presente estudo, foi testada a hipótese de que um único esforço físico é capaz de causar estresse oxidativo e lesão muscular em indivíduos sedentários. Aditivamente foi avaliado efeito antioxidante do polifenol resveratrol (RV) quanto a sua capacidade de atenuar o estresse oxidativo e a lesão muscular causados pelo esforço físico. Para tal, 40 ratos (Rattus norvegicus albinus, Wistar), machos, adultos e sedentários foram aleatoriamente submetidos ou não a 90 minutos de natação, com e sem tratamento com RV (100mg/kg/PV/14dias): N-RV- (n=10) grupo mantido em repouso e não tratado com RV; N-RV+ (n=10) grupo mantido em repouso e tratado com RV; N+RV- (n=10) grupo submetido ao esforço físico de natação e não tratado com RV e N+RV+ (n=10) grupo submetido ao esforço físico de natação e tratado com RV. Em ratos sedentários, o esforço físico da natação promoveu estresse oxidativo (aumento da peroxidação lipídica e diminuição da capacidade antioxidante total do plasma) e aumento significativo da atividade plasmática de creatina quinase (CK) e lactato desidrogenase (LDH). O tratamento com RV diminuiu a peroxidação lipídica e a concentração dos marcadores de lesão muscular (CK e LDH) de ratos sedentários submetidos à natação. Essa é uma das primeiras evidências de que um único esforço físico pode causar estresse oxidativo em indivíduos sedentários e que o RV pode ser uma alternativa para atenuar a lesão muscular causada por esse estresse.(AU)

Physical inactivity is a public health problem when a sedentary population practices physical activity sporadically. Exercise in unconditioned individuals causes oxidative stress and muscle damage. This study tested the hypothesis that a single physical exertion can cause muscle damage and oxidative stress in sedentary individuals, and resveratrol can attenuate it. For this, 40 sedentary adult male rats were equally and randomized into four groups subjected to 90min swimming or rest and administered aqueous resveratrol (100mg/kg/day) or saline for 14 days: N-RV-, rats maintained at rest and administered saline; N-RV+, rats maintained at rest and treated with resveratrol; N+RV-, rats subjected to physical exercise and administered saline; and N+RV+, rats subjected to physical exercise and treated with resveratrol. In sedentary rats, the physical exertion of swimming promoted oxidative stress, i.e. increased lipid peroxidation and decreased plasma total antioxidant capacity, and significant increases in CK and LDH plasma activities. Resveratrol diminished lipid peroxidation and the concentrations of muscle damage markers (CK and LDH) in sedentary rats subjected to swimming. The results provide evidence that a single sudden physical exertion can cause oxidative stress in sedentary rats. Resveratrol showed good results as a treatment for minimizing muscle damage caused by this stress.(AU)

Resveratrol atenua o estresse oxidativo e a lesão muscular de ratos sedentários submetidos ao exercício físico / Resveratrol attenuates oxidative stress and muscle damage in sedentary rats subjected to physical exercise

O sedentarismo é um problema de saúde pública e um dos maiores males da sociedade moderna. Já está bem estabelecido que esforço físico em excesso ou em indivíduos não condicionados acarreta estresse oxidativo e lesões musculares. No presente estudo, foi testada a hipótese de que um único esforço físico é capaz de causar estresse oxidativo e lesão muscular em indivíduos sedentários. Aditivamente foi avaliado efeito antioxidante do polifenol resveratrol (RV) quanto a sua capacidade de atenuar o estresse oxidativo e a lesão muscular causados pelo esforço físico. Para tal, 40 ratos (Rattus norvegicus albinus, Wistar), machos, adultos e sedentários foram aleatoriamente submetidos ou não a 90 minutos de natação, com e sem tratamento com RV (100mg/kg/PV/14dias): N-RV- (n=10) grupo mantido em repouso e não tratado com RV; N-RV+ (n=10) grupo mantido em repouso e tratado com RV; N+RV- (n=10) grupo submetido ao esforço físico de natação e não tratado com RV e N+RV+ (n=10) grupo submetido ao esforço físico de natação e tratado com RV. Em ratos sedentários, o esforço físico da natação promoveu estresse oxidativo (aumento da peroxidação lipídica e diminuição da capacidade antioxidante total do plasma) e aumento significativo da atividade plasmática de creatina quinase (CK) e lactato desidrogenase (LDH). O tratamento com RV diminuiu a peroxidação lipídica e a concentração dos marcadores de lesão muscular (CK e LDH) de ratos sedentários submetidos à natação. Essa é uma das primeiras evidências de que um único esforço físico pode causar estresse oxidativo em indivíduos sedentários e que o RV pode ser uma alternativa para atenuar a lesão muscular causada por esse estresse.(AU)

Physical inactivity is a public health problem when a sedentary population practices physical activity sporadically. Exercise in unconditioned individuals causes oxidative stress and muscle damage. This study tested the hypothesis that a single physical exertion can cause muscle damage and oxidative stress in sedentary individuals, and resveratrol can attenuate it. For this, 40 sedentary adult male rats were equally and randomized into four groups subjected to 90min swimming or rest and administered aqueous resveratrol (100mg/kg/day) or saline for 14 days: N-RV-, rats maintained at rest and administered saline; N-RV+, rats maintained at rest and treated with resveratrol; N+RV-, rats subjected to physical exercise and administered saline; and N+RV+, rats subjected to physical exercise and treated with resveratrol. In sedentary rats, the physical exertion of swimming promoted oxidative stress, i.e. increased lipid peroxidation and decreased plasma total antioxidant capacity, and significant increases in CK and LDH plasma activities. Resveratrol diminished lipid peroxidation and the concentrations of muscle damage markers (CK and LDH) in sedentary rats subjected to swimming. The results provide evidence that a single sudden physical exertion can cause oxidative stress in sedentary rats. Resveratrol showed good results as a treatment for minimizing muscle damage caused by this stress.(AU)

Correlations between peripheral parasite load and common clinical and laboratory alterations in dogs with visceral leishmaniasis.

Intensity of peripheral parasite infection has an important role in the transmission of Leishmania spp. from one host to another. As parasite load quantification is still an expensive procedure to be used routinely in epidemiological surveillance, the use of surrogate predictors may be an important asset in the identification of dogs with high transmitting ability. The present study examined whether common clinical and laboratory alterations can serve as predictors of peripheral parasitism in dogs naturally infected with Leishmania spp. Thirty-seven dogs were examined in order to establish correlations between parasite load (PL) in multiple peripheral tissues and common clinical and laboratory findings in canine visceral leishmaniasis (CVL). Quantitative polymerase chain reaction was employed to determine PL in conjunctival swabs, ear skin, peripheral blood and buffy coat. Additionally, a series of hematological, biochemical and oxidative stress markers were quantified. Correlations between net peripheral infection and severity of clinical alterations and variation in laboratory parameters were assessed through a new analytical approach, namely Compressed Parasite Load Data (CPLD), which uses dimension reduction techniques from multivariate statistics to summarize PL across tissues into a single variable. The analysis revealed that elevation in PL is positively correlated with severity of clinical sings commonly observed in CVL, such as skin lesions, ophthalmic alterations, onycogriphosis, popliteal lymphadenomegaly and low body mass. Furthermore, increase in PL was found to be followed by intensification of non-regenerative anemia, neutrophilia, eosinopenia, hepatic injury and oxidative imbalance. These results suggest that routinely used clinical and laboratory exams can be predictive of intensity of peripheral parasite infection, which has an important implication in the identification of dogs with high transmitting ability.

Neutrophil dysfunction varies with the stage of canine visceral leishmaniosis.

Canine visceral leishmaniosis (CVL) causes a dependent-stage alteration in neutrophil oxidative metabolism. When production of reactive oxygen species (ROS) exceeds the antioxidant capacity of neutrophils, apoptosis is triggered, impairing the viability and function of these cells, which can predispose dogs to infection. However, the uremic condition observed in late-stage CVL can also alter the viability and function of human neutrophils. To more clearly understand this relationship, the apoptosis rate and oxidative metabolism of neutrophils from control dogs (n=20) were compared to dogs in moderate (n=15) and very severe (n=15) stage CVL, classified according to LeishVet Consensus. To assess neutrophil oxidative metabolism, superoxide production was measured using the nitroblue tetrazolium reduction test (NBT) in isolated neutrophils. The apoptosis rate of neutrophils was estimated using the morphological method. Moderate-stage dogs presented increased superoxide production, while dogs with very severe stage CVL presented decreased superoxide production and an increase neutrophil apoptosis rate. Leishmaniosis causes differential neutrophil dysfunction according to disease stage. In moderate stage CVL, increased superoxide production is observed with no change in neutrophil viability. However, in very severe stage CVL, decreased superoxide production and increased apoptosis occur associated with uremia.

Prevention of accidental exposure in radiotherapy: the risk matrix approach.

Knowledge and lessons from past accidental exposures in radiotherapy are very helpful in finding safety provisions to prevent recurrence. Disseminating lessons is necessary but not sufficient. There may be additional latent risks for other accidental exposures, which have not been reported or have not occurred, but are possible and may occur in the future if not identified, analyzed, and prevented by safety provisions. Proactive methods are available for anticipating and quantifying risk from potential event sequences. In this work, proactive methods, successfully used in industry, have been adapted and used in radiotherapy. Risk matrix is a tool that can be used in individual hospitals to classify event sequences in levels of risk. As with any anticipative method, the risk matrix involves a systematic search for potential risks; that is, any situation that can cause an accidental exposure. The method contributes new insights: The application of the risk matrix approach has identified that another group of less catastrophic but still severe single-patient events may have a higher probability, resulting in higher risk. The use of the risk matrix approach for safety assessment in individual hospitals would provide an opportunity for self-evaluation and managing the safety measures that are most suitable to the hospital's own conditions.

Valor do teste de redução do tetrazólio nitroazul (nbt) no diagnóstico de processos inflamatórios caninos / Clinical value of nitroblue tetrazolium test (nbt) in the diagnosis of canine inflammatory processes

Objetivou-se estimar o valor clínico do teste de redução do tetrazólio nitroazul (NBT) no diagnóstico dos processos inflamatórios de cães, comparando-o com o leucograma e a concentração plasmática de fibrinogênio. Para tal, determinou-se a porcentagem de neutrófilos redutores de NBT, a concentração plasmática de fibrinogênio e o leucograma de 242 cães, incluindo animais sadios e com quadro inflamatório, portadores ou não de hepatopatias, azotemia ou hipogamaglobulinemias. O uso do teste de redução do NBT permitiu confirmar 30,43% dos processos inflamatórios em cães. O uso associado do teste de redução do NBT com a determinação do fibrinogênio plasmático e leucograma possibilitou uma maior eficiência diagnóstica, identificando-se 84,35% dos processos inflamatórios. Não foi verificado um efeito significativo da hipogamaglobulinemia e da hepatopatia sobre a capacidade do neutrófilo reduzir o NBT em cães com doenças inflamatórias, porém os resultados obtidos sugerem que a azotemia possa afetar a capacidade do neutrófilo em reduzir o NBT. Conclui-se que o teste de redução de NBT é pouco sensível para o diagnóstico dos processos inflamatórios em cães, porém útil nos casos em que o fibrinogênio e o leucograma não são capazes de detectar a inflamação.(AU)

The purpose of the present study is to determine the clinical value of nitroblue tetrazolium reduction test (NBT) to diagnose inflammatory processes in dogs, and compare to white blood cell count (WBC) and concentration of plasma fibrinogen. To this end, we determined the percentage of NBT reducing neutrophils, concentration of plasma fibrinogen and WBC of 242 dogs, including both healthy dogs and animals with inflammation processes, with or without liver disease, azotemia or hypogammaglobulinemias. The NBT reduction test confirmed 30.43% of inflammatory diseases in dogs. The combined use of NBT reduction test, plasma fibrinogen and WBC was more efficient and identified 84.35% of inflammatory processes. Hypogammaglobulinemia and liver disease did not alter the ability of neutrophils to reduce NBT in dogs with inflammatory diseases, but results suggest that azotemia may affect the ability of neutrophils to reduce NBT. It can be concluded that NBT reduction test has low sensitivity for the diagnosis of inflammatory diseases in dogs, but it is useful in cases where the fibrinogen and WBC are not able to detect inflammation.(AU)

CLINICAL VALUE OF NITROBLUE TETRAZOLIUM TEST (NBT) IN THE DIAGNOSIS OF CANINE INFLAMMATORY PROCESSES / Valor do teste de redução do Tetrazólio Nitroazul (NBT) no diagnóstico de processos inflamatórios caninos.

Objetivou-se estimar o valor clínico do teste de redução do tetrazólio nitroazul (NBT) no diagnóstico dos processos inflamatórios de cães, comparando-o com o leucograma e a concentração plasmática de fibrinogênio. Para tal, determinou-se a porcentagem de neutrófilos redutores de NBT, a concentração plasmática de fibrinogênio e o leucograma de 242 cães, incluindo animais sadios e com quadro inflamatório, portadores ou não de hepatopatias, azotemia ou hipogamaglobulinemias. O uso do teste de redução do NBT permitiu confirmar 30,43% dos processos inflamatórios em cães.  O uso associado do teste de redução do NBT com a determinação do fibrinogênio plasmático e leucograma possibilitou uma maior eficiência diagnóstica, identificando-se 84,35% dos processos inflamatórios. Não foi verificado um efeito significativo da hipogamaglobulinemia e da hepatopatia sobre a capacidade do neutrófilo reduzir o NBT em cães com doenças inflamatórias, porém os resultados obtidos sugerem

Valor do teste de redução do tetrazólio nitroazul (nbt) no diagnóstico de processos inflamatórios caninos / Clinical value of nitroblue tetrazolium test (nbt) in the diagnosis of canine inflammatory processes

Objetivou-se estimar o valor clínico do teste de redução do tetrazólio nitroazul (NBT) no diagnóstico dos processos inflamatórios de cães, comparando-o com o leucograma e a concentração plasmática de fibrinogênio. Para tal, determinou-se a porcentagem de neutrófilos redutores de NBT, a concentração plasmática de fibrinogênio e o leucograma de 242 cães, incluindo animais sadios e com quadro inflamatório, portadores ou não de hepatopatias, azotemia ou hipogamaglobulinemias. O uso do teste de redução do NBT permitiu confirmar 30,43% dos processos inflamatórios em cães. O uso associado do teste de redução do NBT com a determinação do fibrinogênio plasmático e leucograma possibilitou uma maior eficiência diagnóstica, identificando-se 84,35% dos processos inflamatórios. Não foi verificado um efeito significativo da hipogamaglobulinemia e da hepatopatia sobre a capacidade do neutrófilo reduzir o NBT em cães com doenças inflamatórias, porém os resultados obtidos sugerem que a azotemia possa afetar a capacidade do neutrófilo em reduzir o NBT. Conclui-se que o teste de redução de NBT é pouco sensível para o diagnóstico dos processos inflamatórios em cães, porém útil nos casos em que o fibrinogênio e o leucograma não são capazes de detectar a inflamação.

The purpose of the present study is to determine the clinical value of nitroblue tetrazolium reduction test (NBT) to diagnose inflammatory processes in dogs, and compare to white blood cell count (WBC) and concentration of plasma fibrinogen. To this end, we determined the percentage of NBT reducing neutrophils, concentration of plasma fibrinogen and WBC of 242 dogs, including both healthy dogs and animals with inflammation processes, with or without liver disease, azotemia or hypogammaglobulinemias. The NBT reduction test confirmed 30.43% of inflammatory diseases in dogs. The combined use of NBT reduction test, plasma fibrinogen and WBC was more efficient and identified 84.35% of inflammatory processes. Hypogammaglobulinemia and liver disease did not alter the ability of neutrophils to reduce NBT in dogs with inflammatory diseases, but results suggest that azotemia may affect the ability of neutrophils to reduce NBT. It can be concluded that NBT reduction test has low sensitivity for the diagnosis of inflammatory diseases in dogs, but it is useful in cases where the fibrinogen and WBC are not able to detect inflammation.

CLINICAL VALUE OF NITROBLUE TETRAZOLIUM TEST (NBT) IN THE DIAGNOSIS OF CANINE INFLAMMATORY PROCESSES / Valor do teste de redução do Tetrazólio Nitroazul (NBT) no diagnóstico de processos inflamatórios caninos

Objetivou-se estimar o valor clínico do teste de redução do tetrazólio nitroazul (NBT) no diagnóstico dos processos inflamatórios de cães, comparando-o com o leucograma e a concentração plasmática de fibrinogênio. Para tal, determinou-se a porcentagem de neutrófilos redutores de NBT, a concentração plasmática de fibrinogênio e o leucograma de 242 cães, incluindo animais sadios e com quadro inflamatório, portadores ou não de hepatopatias, azotemia ou hipogamaglobulinemias. O uso do teste de redução do NBT permitiu confirmar 30,43% dos processos inflamatórios em cães.  O uso associado do teste de redução do NBT com a determinação do fibrinogênio plasmático e leucograma possibilitou uma maior eficiência diagnóstica, identificando-se 84,35% dos processos inflamatórios. Não foi verificado um efeito significativo da hipogamaglobulinemia e da hepatopatia sobre a capacidade do neutrófilo reduzir o NBT em cães com doenças inflamatórias, porém os resultados obtidos sugerem

Quality evaluation of banana skin extract jellies.

Due to the great volume of banana skin resulting from the industrialization of banana and to their high pectin content, the objectives of the present study were to evaluate the effect of the following factors: extract/sugar, pectin and citric acid on the chemical, physical and sensory qualities of the jellies obtained. A complete factorial experimental design was used (2(3)) with 3 central points to evaluate the influence of the factors on the dependent variables, testing the linear models. The chemical properties underwent few alterations and the instrumental and sensory texture attributes were mainly affected by the extract/sugar ratio and the pectin level. The brittleness, elasticity and gumminess increased with increases in the extract/ sugar ratio and pectin level. According to the sensory analysis and the purchasing intention, the best formulations were those obtained using a higher extract/sugar ratio (60/40) and lower pectin level (0.5 g/ 100), combined with the highest (20 mL) or lowest volumes of citric acid (15 mL), with scores for all the attributes in the range from 'I liked slightly' to 'I liked moderately'.

Interferon-gamma and interleukin-4 single nucleotide gene polymorphisms in Paracoccidioidomycosis.

The gene polymorphisms interferon-gamma (IFN-gamma) +874 T/A and interleukin (IL)-4 -590 C/T have been associated with the altered production of cytokines. Therefore, they might be indicative of the occurrence of Paracoccidioidomycosis (PCM) caused by Paracoccidioides brasiliensis. The analysis of single nucleotide polymorphism (SNP) at position+874 IFN-gamma showed an increase occurrence of A/T genotype in both PCM patients and healthy individuals as control (HIC) (56% and 45%, respectively), while the allelic distribution showed 82% of A allele in the patients and 80% in the controls. The SNP of -590 IL-4 showed that C/T genotype was significantly (p<0.05) more prevalent (39%) in PCM group compared to the HIC group (19%), while IL-4 C/C genotype was significantly less frequent (59%) in the patient group compared to the control group (81%). Otherwise, 41% of PCM patients and 19% of HIC individuals carried the IL-4 T allele. Stimulation of peripheral blood mononuclear cells (PBMC) from PCM patients with cell extract antigenic preparations (PbAg) as well as secreted and surface antigens (MEXO) of P. brasiliensis evidenced that there is no difference in the IFN-gamma production related to A and T alleles between PCM and HIC individuals. However, with IL-4 production, PCM patients classified as C phenotype showed two times more IL-4 production than PCM patients classified as T phenotype and HIC controls. In conclusion, our results suggest that functional genetic variants in the IL-4 promoter could influence the production of IL-4 in PCM.

Association between ultrasound findings and extent of trophoblastic invasion into the tubal wall in ampullary pregnancy.

OBJECTIVE: Predictive factors of damage to the Fallopian tube may guide the treatment of patients with tubal pregnancy. The aim of the present study was to investigate the association between the depth of trophoblastic invasion into the tubal wall, assessed on postoperative histological examination, with the findings obtained on transvaginal sonography (TVS) in women with ampullary pregnancy. METHODS: Women with ampullary pregnancy undergoing salpingectomy were enrolled into the study. Only women with a finding of either an embryo with cardiac activity or a tubal ring on TVS were included in the analysis, a total of 85 patients. Trophoblastic invasion was assessed postoperatively and was histologically classified as Stage I when limited to the tubal mucosa, Stage II when extending to the muscle layer and Stage III in the case of complete tubal wall infiltration. The association between findings on TVS and the stage of trophoblastic invasion was evaluated. RESULTS: There was a significant association between the findings on TVS and the depth of trophoblastic invasion (P < 0.001). All patients in whom an embryo with cardiac activity had been identified were found to have Stage II (17.9%) or Stage III (82.1%) invasion, whereas in those patients who showed a tubal ring on TVS, Stage I invasion was the most frequent finding (41.3%). CONCLUSIONS: In ampullary pregnancy, the finding on TVS of an embryo with cardiac activity is associated with deeper penetration of trophoblastic tissue into the tubal wall than is the finding of a tubal ring.

Interleukin-10 and tumor necrosis factor-alpha single nucleotide gene polymorphism frequency in paracoccidioidomycosis.

Allelic variants of cytokine genes seem to be involved in mechanisms of resistance or susceptibility to several diseases. The aim of this study was to investigate the frequency of genotypes with the tumor necrosis factor-alpha TNF-alpha gene polymorphism G/A at position -308 and the IL-10 gene polymorphism G/A at position -1082, and to verify a possible association of these polymorphisms with paracoccidioidomycosis (PCM) caused by Paracoccidioides brasiliensis. Genotyping was performed by allele-specific polymerase chain reaction (ASPCR) and restriction fragment length polymorphism (RFLP) on genomic DNA isolated of granulocytes from 54 PCM patients and 31 noninfected individuals. The analysis of SNP at position -1082 IL-10 showed a high frequency of GA genotype in both patients and controls (51% and 55%, respectively), while the allelic frequency showed 54% of G allele in the patients and 66% of A allele in the controls. The GG genotype was more frequent in patients (85%) and controls (68%) when we analyze the SNP at position -308 of TNF-alpha gene. Otherwise, 91% of PCM patients and 84% of noninfected individuals carried the G allele in -308 TNF-alpha SNP. Stimulation of cells from individuals with PCM phenotyped as A+ (GA or AA genotypes) presented elevation of TNF-alpha producing cells when compared with IL-10-producer cells. These findings reinforce the critical role of IL-10 and TNF-alpha in the paracoccidioidomycosis and can strongly suggest that the genetic screening of the -308G/A and -1082G/A polymorphisms may be a valid tool for identification of subjects needing a more appropriate therapy.

Predictive factors of trophoblastic invasion into the ampullary region of the tubal wall in ectopic pregnancy.

BACKGROUND: Predictive factors of damage to the Fallopian tube may guide the treatment for patients with tubal pregnancy. The aim of this study was to assess the predictive value of the following parameters: gestational age, serum beta-hCG concentrations and ultrasound findings. METHODS: A total of 105 patients with ampullary pregnancy undergoing salpingectomy were analysed. Trophoblastic invasion was histologically classified as stage I when limited to the tubal mucosa, stage II when extending to the muscle layer and stage III in the case of complete tubal wall infiltration. We correlated the depth of trophoblastic infiltration into the tubal wall with gestational age, beta-hCG concentration on the day of surgery and the type and size of the ectopic mass upon ultrasound. RESULTS: No association was observed between the depth of trophoblastic invasion and gestational age (P = 0.53) or tubal mass diameter (P = 0.43). Trophoblastic invasion was, however, associated with beta-hCG concentration (P < 0.001) and with the type of ultrasonographic image (P = 0.001). Beta-hCG levels of 2400 mIU/ml showed 82.8% sensitivity and 85.5% specificity for stage I, and levels of 5990 mIU/ml showed 82.6% sensitivity and 74.6% specificity for stage III. CONCLUSIONS: Depth of trophoblastic penetration into the tubal wall of the ampullary region of Fallopian tube is correlated with beta-hCG concentration and the type of ultrasonographic image; serum beta-hCG is the best predictor of the depth of penetration.

Microlaparoscopy for an intact ectopic pregnancy and endometriosis with the use of a diode laser: case report.

Microlaparoscopy is a development of endoscopic surgery which further reduces invasiveness of surgical procedures. The use of a diode laser in microlaparoscopy for the treatment of a patient with an intact ectopic pregnancy and endometriosis is described for the first time. As the diode laser has easy management and widely recognized precision, its use could be highly advantageous in such situations. The success achieved in this case contributes to the wider use of micro-endoscopic procedures.

Bloqueio átrio-ventricular congênito: características neonatais e evoluçäo / Congenital complete heart block

Säo apresentados 9 casos de RN portadores de bloqueio átrio-ventricular congênito (BAVC) com detecçäo da anomalia no terceiro trimestre de gestaçäo através de ecocardiografia fetal. Todos os RNs foram de termo ou limítrofes e a maioria nasceu de parto cesáreo, em boas condiçöes. Imediatamente após o nascimento, foi realizado avaliaçäo cardiológica completa, através de exame clínico, ECG, Rx de tórax, ecocardiografia e monitorizaçäo de FC pelo Holter contínuo de 24 horas. Cinco RNs apresentaram BAVC com FC basal ao redor de 60 bat/min e, em destes, a sorologia para LES (anti SS-AA/Rô) foi positiva. Os 5 evoluiram bem, tendo recebido alta antes do primeiro mês de vida sem medicaçäo e com acompanhamento ambulatorial. Um RN apresentou BAVC com FC basal ao redor de 50 bat/min, tendo evoluido para ICC ao final do primeiro mês, compensada com o uso de digitálico e diurético. Três casos eram associados com cardiopatia congênita complexa, sendo 2 do tipo átrio-ventricular communis (AVC) e um do tipo transposiçäo corrigida dos grandes vasos da base. Os 2 casos com AVC foram os únicos que descompensaram precocemente (primeira semana de vida). Estes casos mostram que a detecçäo precoce de alteraçöes de ritmo cardíaco no pré-natal, um preparo adequado para a recepçäo do RN ao nascimento, avaliaçäo cardiológica completa, säo fatores decisivos para uma boa evoluçäo pós-natal