Perfil dos pacientes com fibrose cística atendidos em um hospital universitário de referência de Minas Gerais/Brasil / Profile of patient with cystic fibrosis treated in a reference university hospital of Minas Gerais/Brasil

Introdução: Os avanços no manejo da fibrose cística (FC) permitiram um aumento significativo da expectativa de vida dos indivíduos fibrocísticos Objetivo: Caracterizar o perfil epidemiológico e clínico dos pacientes com FC assistidos no ambulatório de um hospital universitário de referência no tratamento da doença. Métodos: Por meio da consulta aos prontuários dos pacientes em acompanhamento, foi realizada uma pesquisa descritiva, retrospectiva, entre janeiro a agosto de 2015. Resultados: A média de idade dos pacientes no período da avaliação e a média de idade ao diagnóstico foram de 10,06±6,93 e 1,71±3,28 anos, respectivamente. A maior parte da população era do sexo feminino, caucasiana, eutróficos, residentes fora do município de referência, possuía insuficiência pancreática, apresentava colonização bacteriana e realizava exercícios respiratórios, conforme orientados no ambulatório. A média do escore de Shwachman-Kulczycki foi de 88,63±11,09. Conclusão: Este perfil favorável evidencia que uma boa adesão ao tratamento e a compreensão acerca das orientações oferecidas pela equipe multiprofissional contribuíram para a manutenção do bom estado geral e estabilização dos sintomas.

Introduction: Advances in the management of cystic fibrosis (CF) allowed a significant increase in life expectancy of fibrocystic individuals. Objective: To characterize the epidemiological and clinical profile of CF patients assisted by the outpatient clinic of a reference university hospital in the treatment of the disease. Methods: A retrospective descriptive study was carried out from January to August 2015. Results: The mean age of the patients in the evaluation period and the mean age at diagnosis were 10.06 ± 6.93 and 1.71 ± 3.28 years, respectively. The majority of the population was female, caucasian, eutrophic, resident outside the reference municipality, had pancreatic insufficiency, bacterial colonization and performed respiratory exercises, as oriented in the outpatient clinic. The mean of the Shwachman-Kulczycki score was 88.63 ± 11.09. Conclusion: This favorable profile shows that a good adherence to the treatment and understanding about the guidelines offered by the multiprofessional team contributed to the maintenance of good general condition and stabilization of the symptoms.

Comparison between Radionuclide Ventriculography and Echocardiography for Quantification of Left Ventricular Systolic Function in Rats Exposed to Doxorubicin.

BACKGROUND: Radionuclide ventriculography (RV) is a validated method to evaluate the left ventricular systolic function (LVSF) in small rodents. However, no prior study has compared the results of RV with those obtained by other imaging methods in this context. OBJECTIVES: To compare the results of LVSF obtained by RV and echocardiography (ECHO) in an experimental model of cardiotoxicity due to doxorubicin (DXR) in rats. METHODS: Adult male Wistar rats serving as controls (n = 7) or receiving DXR (n = 22) in accumulated doses of 8, 12, and 16 mg/kg were evaluated with ECHO performed with a Sonos 5500 Philips equipment (12-MHz transducer) and RV obtained with an Orbiter-Siemens gamma camera using a pinhole collimator with a 4-mm aperture. Histopathological quantification of myocardial fibrosis was performed after euthanasia. RESULTS: The control animals showed comparable results in the LVSF analysis obtained with ECHO and RV (83.5 ± 5% and 82.8 ± 2.8%, respectively, p > 0.05). The animals that received DXR presented lower LVSF values when compared with controls (p < 0.05); however, the LVSF values obtained by RV (60.6 ± 12.5%) were lower than those obtained by ECHO (71.8 ± 10.1%, p = 0.0004) in this group. An analysis of the correlation between the LVSF and myocardial fibrosis showed a moderate correlation when the LVSF was assessed by ECHO (r = -0.69, p = 0.0002) and a stronger correlation when it was assessed by RV (r = -0.79, p < 0.0001). On multiple regression analysis, only RV correlated independently with myocardial fibrosis. CONCLUSION: RV is an alternative method to assess the left ventricular function in small rodents in vivo. When compared with ECHO, RV showed a better correlation with the degree of myocardial injury in a model of DXR-induced cardiotoxicity.

Comparison between Radionuclide Ventriculography and Echocardiography for Quantification of Left Ventricular Systolic Function in Rats Exposed to Doxorubicin / Comparação entre a Ventriculografia Radioisotópica e a Ecocardiografia na Quantificação da Função Sistólica Ventricular Esquerda em Ratos Expostos à Doxorrubicina

Abstract Background: Radionuclide ventriculography (RV) is a validated method to evaluate the left ventricular systolic function (LVSF) in small rodents. However, no prior study has compared the results of RV with those obtained by other imaging methods in this context. Objectives: To compare the results of LVSF obtained by RV and echocardiography (ECHO) in an experimental model of cardiotoxicity due to doxorubicin (DXR) in rats. Methods: Adult male Wistar rats serving as controls (n = 7) or receiving DXR (n = 22) in accumulated doses of 8, 12, and 16 mg/kg were evaluated with ECHO performed with a Sonos 5500 Philips equipment (12-MHz transducer) and RV obtained with an Orbiter-Siemens gamma camera using a pinhole collimator with a 4-mm aperture. Histopathological quantification of myocardial fibrosis was performed after euthanasia. Results: The control animals showed comparable results in the LVSF analysis obtained with ECHO and RV (83.5 ± 5% and 82.8 ± 2.8%, respectively, p > 0.05). The animals that received DXR presented lower LVSF values when compared with controls (p < 0.05); however, the LVSF values obtained by RV (60.6 ± 12.5%) were lower than those obtained by ECHO (71.8 ± 10.1%, p = 0.0004) in this group. An analysis of the correlation between the LVSF and myocardial fibrosis showed a moderate correlation when the LVSF was assessed by ECHO (r = -0.69, p = 0.0002) and a stronger correlation when it was assessed by RV (r = -0.79, p < 0.0001). On multiple regression analysis, only RV correlated independently with myocardial fibrosis. Conclusion: RV is an alternative method to assess the left ventricular function in small rodents in vivo. When compared with ECHO, RV showed a better correlation with the degree of myocardial injury in a model of DXR-induced cardiotoxicity.

Resumo Fundamento: A ventriculografia radioisotópica (VRI) é um método validado para avaliação da função sistólica do ventrículo esquerdo (FSVE) em pequenos roedores. Contudo, nenhum estudo prévio comparou os resultados obtidos com VRI com os obtidos por outros métodos de imagem neste contexto. Objetivos: Comparar os resultados de FSVE obtidos por VRI e por ecocardiografia (ECO) em modelo experimental de cardiotoxicidade por doxorrubicina (DXR) em ratos. Métodos: Ratos Wistar machos adultos controles (n = 7) e tratados com DXR (n = 22) em doses acumuladas de 8, 12 e 16 mg/kg, foram avaliados com ECO com equipamento Sonos 5500 Philips (transdutor de 12 MHz) e VRI adquirida em gama-câmara Orbiter-Siemens com colimador pinhole de 4 mm de abertura. Após eutanásia, foi realizada a quantificação histopatológica da fibrose miocárdica. Resultados: Os animais controles apresentaram valores comparáveis na análise da FSVE à ECO e à VRI (83,5 ± 5% e 82,8 ± 2,8%, respectivamente, p > 0,05). Os animais que receberam DXR apresentaram valores menores de FSVE quando comparados aos dos controles (p < 0,05); entretanto, observou-se neste grupo menores valores de FSVE obtidos por VRI (60,6 ± 12,5%) quando comparados aos obtidos pela ECO (71,8 ± 10,1%, p = 0,0004). A análise da correlação entre a FSVE e a fibrose miocárdica mostrou uma correlação moderada quando a FSVE foi estimada com a ECO (r = -0,69, p = 0,0002) e mais forte quando a FSVE foi obtida por VRI (r = -0,79, p < 0,0001). Apenas a VRI apresentou correlação de forma independente com a fibrose miocárdica à análise de regressão múltipla. Conclusão: A VRI é um método alternativo para avaliação da função ventricular esquerda in vivo em pequenos roedores, exibindo comparativamente à ECO melhor correlação com o grau de lesão miocárdica no modelo de cardiotoxicidade por DXR.