Endoscopic and histopathological assessment of individuals undergoing one anastomosis gastric bypass: a 2-year follow-up.

BACKGROUND: There is much debate over the occurrence of biliary reflux to the gastric pouch after one anastomosis gastric bypass (OAGB) and its potential risks. OBJECTIVE: To assess endoscopic and histopathological findings following a standardized protocol of biopsy collection two years after OAGB. METHODS: A historical cohort study was conducted, based on a prospectively collected database, which involved 39 participants who underwent OAGB. Participants underwent clinical evaluation and esophagogastroduodenoscopy at the time of surgery and 24 months afterward. Post-operatively, biopsy specimens in esophagogastric junction, pouch, and anastomosis were systematically collected. RESULTS: 92.3% of the participants were female and the mean age was 37 ± 8.5 years. The mean body mass index (BMI) significantly decreased from 37.6 ± 5.7 kg/m2 to 27 ± 4.1 kg/m2 after 2 years (p < 0.001). The mean %TWL was 27.2 ± 10.5%. The prevalence of non-erosive gastritis significantly increased from 25.6 to 51.3% (p = 0.02). Erosive gastritis significantly decreased from 28.2 to 10.3% (p = 0.04). Four cases of marginal ulcers were identified (10.3%). The commonest histopathological finding was mild inflammation in 74.3% (esophagogastric junction), 58.9% (pouch), and 71.8% (anastomosis). There was one case of focal intestinal metaplasia in each site of interest and no cases of dysplasia or severe inflammation. CONCLUSIONS: Using a standardized protocol of post-operative biopsy collection, low rates of severe endoscopic and histopathological abnormalities were observed two years after OAGB. Nevertheless, as most patients have histologically proven inflammation, bile in the gastric pouch, and endoscopic gastritis, long-term surveillance is essential because of the uncertain risk of these abnormalities.

High-accuracy DMBE potential energy surface for CNO(A''4) and the rate coefficients for the C + NO reaction in the A'2, A''2, and A''4 states.

An accurate potential energy surface (PES) for the lowest lying A''4 state of the CNO system is presented based on explicitly correlated multi-reference configuration interaction calculations with quadruple zeta basis set (MRCI-F12/cc-pVQZ-F12). The ab initio energies are fitted using the double many-body expansion method, thus incorporating long-range energy terms that can accurately describe the electrostatic and dispersion interactions with physically motivated decaying functions. Together with the previously fitted lowest A'2 and A''2 states using the same theoretical framework, this constitutes a new set of PESs that are suitable to predict rate coefficients for all atom-diatom reactions of the CNO system. We use this set of PESs to calculate thermal rate coefficients for the C(P3) + NO(Π2) reaction and compare the temperature dependence and product branching ratios with experimental results. The comparison between theory and experiment is shown to be improved over previous theoretical studies. We highlight the importance of the long-range interactions for low-temperature rate coefficients.

Association of mycoheterotrophic Gentianaceae with specific Glomus lineages.

Some plant species took an alternative evolutionary pathway in which they lost their photosynthetic capacity to depend exclusively on carbon supplied by arbuscular mycorrhizal fungi (AMF) in an association called mycoheterotrophy. Among them is Voyriella parviflora, a species of the family Gentianaceae, which is found in tropical regions such as the Amazon basin. Here, we assessed the identity of AMF symbionts associated with this species. DNA was isolated from eight Gentianaceae specimens and from litter and surrounding roots of photosynthetic plants. The atp1 gene was amplified by Sanger sequencing to determine the taxonomic affiliation of the mycoheterotrophic plants. A 280 bp region of the 18S rRNA gene of AMF was amplified with primers NS31/AML2 by high-throughput sequencing. The mycoheterotrophic specimens were assigned to V. parviflora with a bootstrap support of 72%. Glomus was the most abundant AMF genus, both in the mycoheterotrophic plants and in the litter and roots of photosynthetic plants. In addition, a few Glomus genotypes were abundantly enriched in the mycoheterotrophic plants, with only a few specimens colonized by Gigaspora, Acaulospora, and Scutellospora in a low proportion. These genotypes formed a cluster within a larger clade, suggesting that V. parviflora shows a preferential association with a narrow Glomus lineage which is not phylogenetically close to a previously identified V. parviflora's associated lineage. Furthermore, detecting fungi from other families suggests that V. parviflora is colonized by other genera, although with low frequency. These findings provide new insights into the association between AMF and mycoheterotrophic species and highlight the importance of considering trap culture-independent approaches in understanding this symbiosis.

Parasitic plant, from inside out: endophytic development in Lathrophytum peckoltii (Balanophoraceae) in host liana roots from tribe Paullineae (Sapindaceae).

BACKGROUND AND AIMS: Balanophoraceae is one of the most bizarre and biologically interesting plant clades. It groups species with peculiar features that offers an opportunity for investigating several aspects of parasite plant development and morphogenesis. We analysed the development and the mature vegetative body of Lathrophytum peckoltii Eichler, focusing on the formation of the host-parasite interface. Additionally, we analysed how this parasitic interaction causes modifications to the anatomy of Paullinia uloptera Radlk and Serjania clematidifolia Cambess host roots. METHODS: Vegetative bodies of the parasite at different developmental stages were collected while infesting the roots of Sapindaceae vines. Non-parasitized host roots were also collected for comparison. Light, epifluorescence, confocal and scanning electron microscopy were used for the analysis. KEY RESULTS: The initial cells of the vegetative axis divide repeatedly, originating a parenchymatous matrix, which occupies the space from the cortex to the vascular cylinder of the host's root. In the peripheral layers of the matrix, located near the xylem of the host's roots, a few cells initiate the process of wall lignification, originating the parasitic bundle. The vascular cambium of the host's root changes the division plane and becomes composed of fusiform initials, forming the vascular bundle. The vegetative axis presents a dermal tissue similar to a phellem, a parenchymatous matrix and a vascular system with different origins. CONCLUSION: The parasite reproduces by endophytic development, in a manner similar to that observed for endoparasites. The strategy of late cell differentiation could aid the parasite in avoiding early detection and triggering of defence responses by the host. This development causes changes to the host root cambial activity, leading to the establishment of direct, vessel to vessel connection between host and parasite. We associate these changes with the cambium modularity and an influx of parasite-derived hormones into the host cambium.

Remnant oral biofilm and microorganisms after autoclaving sterilization of retrieved healing abutments.

OBJECTIVE: The purpose of this study was to evaluate the sterilization effectiveness against biofilms on retrieved healing abutments used in implant dentistry. BACKGROUND: A large number of clinicians reuse healing abutments to decrease treatment costs although it can promote infection due to the presence of remnant biofilm biomass. METHODS: One hundred and eighty-five titanium healing abutments previously used for 3 months in oral cavity were assessed in this study. Abutments were submitted to cleaning, chemical disinfection, and autoclave sterilization according to clinical guidelines. The abutments were aseptically placed into glass tubes containing specific bacterial growth medium and then incubated for 10 days. From glass tubes with bacterial growth, 100 µl medium was transferred to Schaedler's agar for morphological identification and counting of strict anaerobes and to Columbia blood agar for presumptive identification of facultative anaerobes after incubation. Isolated strains were then identified at species level by enzymatic and biochemical tests within API microorganism detection platform. Also, polymerase chain reaction (PCR) was performed for identification of undefined strains. RESULTS: After the standard cleaning and sterilization procedures, fifty-six (approximately 30%) retrieved abutments showed the presence of remnant biofilm biomass. The bacteria identified into the remnant biofilms covering the abutments were representative of the commensal oral microbiota including Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Enterococcus faecalis. CONCLUSION: Although some healing abutments did not reveal the existence of bacteria, organic components from biofilm biomass are still strongly adhered on the retentive micro-regions and surfaces of abutments and therefore that would support the accumulation of biofilm including pathogenic species leading to patients' cross-infections. Further studies should be performed on the assessment of different materials, design, and connections of the healing abutments associated with clinical disinfection procedures in implant dentistry.

The spatial scaling of food web structure across European biogeographical regions.

The species-area relationship (SAR) is one of the most well-established scaling patterns in ecology. Its implications for understanding how communities change across spatial gradients are numerous, including the effects of habitat loss on biodiversity. However, ecological communities are not mere collections of species. They are the result of interactions between these species forming complex networks that tie them together. Should we aim to grasp the spatial scaling of biodiversity as a whole, it is fundamental to understand the changes in the structure of interaction networks with area. In spite of a few empirical and theoretical studies that address this challenge, we still do not know much about how network structure changes with area, or what are the main environmental drivers of these changes. Here, using the meta-network of potential interactions between all terrestrial vertebrates in Europe (1140 species and 67 201 feeding interactions), we analysed network-area relationships (NARs) that summarize how network properties scale with area. We do this across ten biogeographical regions, which differ in environmental characteristics. We found that the spatial scaling of network complexity strongly varied across biogeographical regions. However, once the variation in SARs was accounted for, differences in the shape of NARs vanished. On the other hand, the proportion of species across trophic levels remained remarkably constant across biogeographical regions and spatial scales, despite the great variation in species richness. Spatial variation in mean annual temperature and habitat clustering were the main environmental determinants of the shape of both SARs and NARs across Europe. Our results suggest new avenues in the exploration of the effects of environmental factors on the spatial scaling of biodiversity. We argue that NARs can provide new insights to analyse and understand ecological communities.

Integrating spatial and phylogenetic information in the fourth-corner analysis to test trait-environment relationships.

The fourth-corner analysis aims to quantify and test for relationships between species traits and site-specific environmental variables, mediated by site-specific species abundances. Since there is no common unit of observation, the significance of the relationships is tested using a double permutation procedure (site based and species based). This method implies that all species and sites are independent of each other. However, this fundamental hypothesis might be flawed because of phylogenetic relatedness between species and spatial autocorrelation in the environmental data. Here, using a simulation-based experiment, we demonstrate how the presence of spatial and phylogenetic autocorrelations can, in some circumstances, lead to inflated type I error rates, suggesting that significant associations can be misidentified. As an alternative, we propose a new randomization approach designed to avoid this issue, based on Moran's spectral randomization. In this approach, standard permutations are replaced by constrained randomizations so that the distribution of the statistic under the null hypothesis is built with additional constraints to preserve the phylogenetic and spatial structures of the observed data. The inclusion of this new randomization approach provides total control over type I error rates and should be used in real studies where spatial and phylogenetic autocorrelations often occur.

Memory and conceptual learning of relevant and non-relevant items in item-method directed forgetting.

The present research investigates the fate of non-target information when people are trying to either intentionally memorise or forget target information. By using an object-based attentional manipulation within a directed forgetting paradigm (item-method), we show a directed forgetting effect (DFE, i.e., better memory for to-be-remembered (TBR) than for to-be-forgotten (TBF) items) for items that participants are explicitly instructed to attend but not for irrelevant items that happen to be part of the context. Alongside the classic DFE, we investigate how the category of the attended and unattended items are learned. The results obtained in three experiments, show that people can successfully learn only the category of the TBR attended items and that the DFE extends to new items that are related to the old TBR and TBF items (an effect that we call conceptual DFE). These results give us new insight about how TBR and TBF items are processed and conceptually learned.

Fruits of the Brazilian Atlantic Forest: allying biodiversity conservation and food security.

Supplying food to growing human populations without depleting natural resources is a challenge for modern human societies. Considering this, the present study has addressed the use of native arboreal species as sources of food for rural populations in the Brazilian Atlantic Forest. The aim was to reveal species composition of edible plants, as well as to evaluate the practices used to manage and conserve them. Ethnobotanical indices show the importance of many native trees as local sources of fruits while highlighting the preponderance of the Myrtaceae family. Conservation analysis allowed to identify Campomanesia hirsuta Gardner and Plinia edulis (Vell.) Sobral as being of high Biological Value and Conservation Priority. In spite of that, the local management practices of native fruits appear to be sustainable and contribute to the maintenance and dissemination of valuable species. These results suggest a number of recommended future conservation actions and show the potential of Myrtaceae species for future agronomical development in Neotropical regions.

A conceptual model for generating and validating in-session clinical judgments.

OBJECTIVE: Little attention has been paid to the nuanced and complex decisions made in the clinical session context and how these decisions influence therapy effectiveness. Despite decades of research on the dual-processing systems, it remains unclear when and how intuitive and analytical reasoning influence the direction of the clinical session. METHOD: This paper puts forth a testable conceptual model, guided by an interdisciplinary integration of the literature, that posits that the clinical session context moderates the use of intuitive versus analytical reasoning. RESULTS: A synthesis of studies examining professional best practices in clinical decision-making, empirical evidence from clinical judgment research, and the application of decision science theories indicate that intuitive and analytical reasoning may have profoundly different impacts on clinical practice and outcomes. CONCLUSIONS: The proposed model is discussed with respect to its implications for clinical practice and future research.

Motivated reasoning in the prediction of sports outcomes and the belief in the "hot hand".

The present paper explores the role of motivation to observe a certain outcome in people's predictions, causal attributions, and beliefs about a streak of binary outcomes (basketball scoring shots). In two studies we found that positive streaks (points scored by the participants' favourite team) lead participants to predict the streak's continuation (belief in the hot hand), but negative streaks lead to predictions of its end (gambler's fallacy). More importantly, these wishful predictions are supported by strategic attributions and beliefs about how and why a streak might unfold. Results suggest that the effect of motivation on predictions is mediated by a serial path via causal attributions to the teams at play and belief in the hot hand.

Endogenous endophthalmitis due to Escherichia coli: a case report.

Endophthalmitis is a severe form of purulent inflammation caused by the infection of the intraocular tissues or fluids. This infection infrequently occurs through endogenous routes, which are often correlated with major risk factors. Escherichia coli, a gram-negative rod, can cause endophthalmitis through hematogenous spread. We here report a 59-year-old man who presented to our service with acute visual impairment in his left eye, preceded by floaters. He was taking sirolimus and azathioprine for a transplanted kidney, had undergone catheterization for bladder atresia, and had a history of recurrent E. coli urinary tract infections. On evaluation, the left eye exhibited visual acuity of hand motion, anterior chamber reaction (3+/4+), and intense vitritis (4+/4+) with white flake clusters, which prevented appropriate retinal evaluation. Pars plana vitrectomy was performed, and the culture yielded E. coli. The present case highlights the importance of identifying the signs and symptoms of infection early so that diagnosis and treatment of endophthalmitis can be promptly initiated.

Abnormal Unilateral Dilated Perifoveal Venule Found During Observation of a Transient Vitreomacular Traction.

This case report describes a new type of perifoveal retinal vascular abnormality (RVA) incidentally discovered during a posterior vitreous detachment (PVD) investigation. A 65-year-old woman with sudden central visual loss displayed a unilateral focal telangiectatic venule in the perifoveal area. Multimodal imaging documented the vascular abnormality and associated retinal changes. Despite symptom resolution, the RVA persisted. This case represents a unique presentation of perifoveal RVA, likely an atypical form of macular telangiectasia. The sequential imaging documentation during a process of PVD with central bouquet traction provides insights into the underlying mechanisms in addition to diagnosing and monitoring perifoveal RVAs. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].

Historical and practical aspects of macular buckle surgery in the treatment of myopic tractional maculopathy: case series and literature review.

BACKGROUND: Uncorrected myopia is a leading cause of blindness globally, with a rising prevalence in recent decades. Pathological myopia, often seen in individuals with increased axial length (AXL), can result in severe structural changes in the posterior pole, including myopic tractional maculopathy (MTM). MTM arises from tractional forces at the vitreoretinal interface, leading to progressive macular retinoschisis, macular holes, and retinal detachment (RD). This study aims to outline preoperative evaluation and surgical indication criteria for MTM, based on the MTM staging system, and to share our Brazilian experience with three cases of macular buckle (MB) surgery, all with over a year of follow-up. METHODS: We conducted a retrospective analysis of three cases of MTM-associated RD treated with MB surgery, with or without pars plana vitrectomy. Preoperative evaluations included optical coherence tomography (OCT) and ultrasonography (USG) to assess the extent of macular involvement and retinal detachment. Surgical indications were determined based on the MTM staging system. The MB was assembled using customizable and accessible materials. Surgical procedures varied according to the specific needs of each case. An informed consent form regarding the surgical procedure was appropriately obtained for each case. The study was conducted with the proper approval of the institution's ethics committee. RESULTS: All three cases demonstrated successful retinal attachment during the mean follow-up of eighteen months. In the first case, combined phacoemulsification, vitrectomy, and MB were performed for MTM with macular hole and RD. The second case required MB and vitrectomy after two failed RD surgeries. In the third case, a macular detachment with an internal lamellar hole was treated with MB alone. These cases highlight the efficacy of MB surgery in managing MTM in highly myopic eyes. CONCLUSIONS: MB surgery is an effective treatment option for MTM-associated RD in highly myopic eyes, providing long-term retinal attachment. Our experience demonstrates that with proper preoperative evaluation and surgical planning, MB can be successfully implemented using accessible materials, offering a viable solution in resource-limited settings. Further studies with larger sample sizes are warranted to validate these findings and refine surgical techniques.

Serous maculopathy with absence of retinal pigment epithelium (SMARPE) associated with large drusen.

PURPOSE: To describe the association of serous maculopathy with absence of retinal pigment epithelium (SMARPE) and large drusen in patients with non-neovascular age-related macular degeneration (AMD). METHODS: A retrospective study of ophthalmic examination and multimodal imaging data of individuals with SMARPE and large drusen observed over a period of 12-month was accomplished. SMARPE was defined as subretinal accumulation of fluid within the macular area due to retinal pigment epithelium (RPE) aperture. Large drusen were identified by the presence of sub-RPE deposits using multimodal imaging analysis (color fundus photography, fundus autofluorescence, and spectral-domain optical coherence tomography). RESULTS: Twelve eyes of 7 white patients with a mean age of 77 years were observed to have SMARPE associated with large drusen. The median visual acuity was 20/100. Bilateral SMARPE lesions were observed in 71% of study patients. All SMARPE lesions were hypoautofluorescent, located in the subretinal space between the RPE and the ellipsoid zone, and presented as complete or incomplete RPE apertures associated with subretinal fluid. The SMARPE in this study had coincident multimodal imaging features as the SMARPE described in other reports in the literature. CONCLUSIONS: Bilateral SMARPE can occur in association with typical AMD large drusen. Anomalisms resulting in drusen biogenesis or mechanisms that act alongside to these may be related to SMARPE development.

WEIGHT LOSS AND QUALITY OF LIFE AFTER ONE ANASTOMOSIS GASTRIC BYPASS: A 2-YEAR FOLLOW-UP STUDY.

•One anastomosis gastric bypass (OAGB) led to significant weight loss after 2 years. •OAGB associated was well-succeeded in regards to weight loss in most individuals. •OAGB led to significant improvement of quality of life (QoL) assessed by the BAROS system. •"Self-steem" and "work capacity" were the most positively affected QoL domains after OAGB. Background - Studies assessing quality of life (QoL) after one anastomosis gastric bypass (OAGB) are currently scarce. Objective - To analyze the main weight loss outcomes and QoL in individuals undergoing OAGB during a 2-year follow-up. Methods - This is a retrospective study based on a prospectively collected database including individuals which underwent OAGB at a tertiary-level university hospital. After 2-years, excess weight loss was assessed, and post-surgical therapeutical success was determined using Reinhold's criteria. QoL was assessed through the Bariatric Analysis and Reporting Outcomes System (BAROS). Results - Out of 41 participants, 90.2% were female and the average age was 38±8.3 years old. The average body mass index significantly decreased from 37.1±5.6 kg/m2 to 27±4.5 kg/m2 after 2-years (P< 0.001). The mean percentage of excess weight loss was 84.6±32.5%. Regarding weight loss outcomes, 61% were considered "excellent", while 26.8% were "good" according to Reinhold's criteria. With regards to QoL assessed by BAROS, most individuals achieved a score classified as either "excellent" (26.8%), "very good" (36.6%), or "good" (31.7%). The highest degrees of satisfaction achieved were in the domains "self-esteem" and "work capacity", in which 75.6% and 61%, respectively, were classified as "much better". Conclusion - OAGB associated with significant weight loss and resolution of obesity-related medical conditions, as well as relevant QoL improvement assessed by the BAROS system.

Lifestyle and Sense of Coherence: A comparative analysis among university students in different areas of knowledge.

BACKGROUND: The concept of health has undergone profound changes. Lifestyle Medicine consists of therapeutic approaches that focus on the prevention and treatment of diseases. It follows that the quality of life of university students directly affects their health and educational progress. EXPERIMENTAL METHODOLOGY: Socioeconomic, lifestyle (LS), and Salutogenesis Theory/sense of coherence (SOC) questionnaires were administered to college students from three different areas. The results were analyzed for normality and homogeneity, followed by ANOVA variance analysis and Dunn and Tukey post hoc test for multiple comparisons. Spearman's correlation coefficient evaluated the correlation between lifestyle and sense of coherence; p values < 0.05 were considered statistically significant. RESULTS: The correlation between LS and SOC was higher among males and higher among Medical and Human sciences students compared to Exact sciences. Medical students' scores were higher than Applied sciences and Human sciences students on the LS questionnaire. Exact science students' scores on the SOC questionnaire were higher than Human sciences students. In the LS areas related to alcohol intake, sleeping quality, and behavior, there were no differences between the areas. However, women scored better in the nutrition domain and alcohol intake. The SOC was also higher in men compared to women. CONCLUSION: The results obtained demonstrate in an unprecedented way in the literature that the correlation between the LS and SOC of college students varies according to gender and areas of knowledge, reflecting the importance of actions on improving students' quality of life and enabling better academic performance.

Situational analysis of the smoking cessation program in a Brazilian capital during the COVID-19 pandemic. / Análise situacional do programa de cessação tabágica em uma capital brasileira na pandemia da COVID-19.

Smoking is a public health problem associated with high morbimortality. Smoking cessation services, although effective, have limited reach and have been compromised by the pandemic. This study aimed to analyze the care for smokers in João Pessoa (PB), Brazil, during the COVID-19 pandemic. A descriptive, exploratory, and quantitative study was conducted in two phases: a survey of health indicators and an evaluation of sociodemographic profiles of professionals and service clients during the study years. Seven professionals, smoking group coordinators, and 20 clients participated in the research. The results showed low program coverage, with a declining number of smokers treated during the pandemic, down from 419 in 2019 to 129 in 2020. Interviews identified the program's positive aspects and limitations, good effectiveness, and low access, especially in primary health care. Tobacco consumption and risk reduction strategies during the COVID-19 pandemic originated from services and professionals involved. We can conclude that the National Tobacco Control Program has an incipient implementation in primary health care in this region and that the number of services offered was reduced during the pandemic, decreasing demand and actions.

O tabagismo é um problema de saúde pública, está associado a uma elevada morbimortalidade. Os serviços de saúde vigentes para a cessação tabágica, apesar de efetivos, apresentam alcance limitado e foram comprometidos pela pandemia. O estudo teve como objetivo analisar o cuidado com a pessoa tabagista em João Pessoa (PB), na pandemia de COVID-19. Foi realizado um estudo descritivo, exploratório e quantitativo com duas fases: levantamento dos indicadores de saúde e avaliação dos perfis sociodemográficos dos profissionais e usuários dos serviços nos anos do estudo. Participaram da pesquisa sete profissionais, coordenadores de grupo de tabagismo e 20 usuários. Os resultados apontaram para uma baixa cobertura do programa, além de revelar queda no número de fumantes atendidos na pandemia, de 419 em 2019 para 129 em 2020. As entrevistas identificaram pontos positivos e limitações do programa, boa efetividade e baixo acesso, especialmente na APS, e que as estratégias utilizadas para conter o consumo do tabaco e seus riscos durante a pandemia partiram dos serviços e dos profissionais envolvidos. É possível concluir que, nessa região, o Programa Nacional de Controle do Tabagismo (PNCT) apresenta implantação incipiente na APS e que, durante a pandemia, o número de serviços ofertados foi reduzido, diminuindo a procura e as ações realizadas.

Ventricular systolic reserve in asymptomatic children previously treated with low doses of anthracyclines: a longitudinal, prospective exercise echocardiography study.

BACKGROUND: The time course of mild cardiotoxicity induced by anthracycline remains unknown. The aim of this study was to evaluate the long-term evolution of decreased myocardial reserve in children previously treated with a cumulative dose of anthracycline up to 100 mg/m(2). PATIENTS AND METHODS: Twenty-seven asymptomatic cancer survival patients (25 with lymphoblastic leukemia), in continuous remission and off treatment for >12 months with no alterations in conventional echocardiograms were evaluated by exercise echocardiography at 37 ± 15.4 months (T1) and 101 ± 24 months (T2) after finishing treatment (ADRIA group). This group was compared with 25 healthy individuals (control group) similar to the ADRIA group with respect to age and body surface area (BSA). All individuals underwent treadmill exercise testing according to Bruce protocol. Echocardiograms were performed before and immediately after exercise. RESULTS: The groups were similar regarding cardiac structure and left ventricular (LV) systolic function at rest at T1 and T2. The growth of LV posterior wall thickness related to BSA was lower in the ADRIA group at T2. Post exercise, smaller LV ejection indexes and attenuated changes in the afterload in ADRIA group were observed at T1 and T2. CONCLUSION: The decreased systolic reserve induced by a low dose of anthracycline in asymptomatic children and adolescents remains unaffected over a 5-year period, suggesting that positive outcomes in chronic cardiotoxicity would be expected in patients with mild impairment after anthracycline treatment.