Hepatoblastomas with carcinoma features represent a biological spectrum of aggressive neoplasms in children and young adults.

BACKGROUND & AIMS: Hepatoblastoma (HB) and hepatocellular carcinoma (HCC) are the predominant liver cancers in children, though their respective treatment options and associated outcomes differ dramatically. Risk stratification using a combination of clinical, histological, and molecular parameters can improve treatment selection, but it is particularly challenging for tumors with mixed histological features, including those in the recently created hepatocellular neoplasm not otherwise specified (HCN NOS) provisional category. We aimed to perform the first molecular characterization of clinically annotated cases of HCN NOS. METHODS: We tested whether these histological features are associated with genetic alterations, cancer gene dysregulation, and outcomes. Namely, we compared the molecular features of HCN NOS, including copy number alterations, mutations, and gene expression profiles, with those in other pediatric hepatocellular neoplasms, including HBs and HCCs, as well as HBs demonstrating focal atypia or pleomorphism (HB FPAs), and HBs diagnosed in older children (>8). RESULTS: Molecular profiles of HCN NOS and HB FPAs revealed common underlying biological features that were previously observed in HCCs. Consequently, we designated these tumor types collectively as HBs with HCC features (HBCs). These tumors were associated with high mutation rates (∼3 somatic mutations/Mb) and were enriched with mutations and alterations in key cancer genes and pathways. In addition, recurrent large-scale chromosomal gains, including gains of chromosomal arms 2q (80%), 6p (70%), and 20p (70%), were observed. Overall, HBCs were associated with poor clinical outcomes. CONCLUSIONS: Our study indicates that histological features seen in HBCs are associated with combined molecular features of HB and HCC, that HBCs are associated with poor outcomes irrespective of patient age, and that transplanted patients are more likely to have good outcomes than those treated with chemotherapy and surgery alone. These findings highlight the importance of molecular testing and early therapeutic intervention for aggressive childhood hepatocellular neoplasms. LAY SUMMARY: We molecularly characterized a class of histologically aggressive childhood liver cancers and showed that these tumors are clinically aggressive and that their observed histological features are associated with underlying recurrent molecular features. We proposed a diagnostic algorithm to identify these cancers using a combination of histological and molecular features, and our analysis suggested that these cancers may benefit from specialized treatment strategies that may differ from treatment guidelines for other childhood liver cancers.

How Will Artificial Intelligence Shape the Future of Decision-Making in Congenital Heart Disease?

Improvements in medical technology have significantly changed the management of congenital heart disease (CHD), offering novel tools to predict outcomes and personalize follow-up care. By using sophisticated imaging modalities, computational models and machine learning algorithms, clinicians can experiment with unprecedented insights into the complex anatomy and physiology of CHD. These tools enable early identification of high-risk patients, thus allowing timely, tailored interventions and improved outcomes. Additionally, the integration of genetic testing offers valuable prognostic information, helping in risk stratification and treatment optimisation. The birth of telemedicine platforms and remote monitoring devices facilitates customised follow-up care, enhancing patient engagement and reducing healthcare disparities. Taking into consideration challenges and ethical issues, clinicians can make the most of the full potential of artificial intelligence (AI) to further refine prognostic models, personalize care and improve long-term outcomes for patients with CHD. This narrative review aims to provide a comprehensive illustration of how AI has been implemented as a new technological method for enhancing the management of CHD.

Importance of Cardiovascular Magnetic Resonance Applied to Congenital Heart Diseases in Pediatric Age: A Narrative Review.

Congenital heart diseases (CHDs) represent a heterogeneous group of congenital defects, with high prevalence worldwide. Non-invasive imaging is essential to guide medical and surgical planning, to follow the patient over time in the evolution of the disease, and to reveal potential complications of the chosen treatment. The application of cardiac magnetic resonance imaging (CMRI) in this population allows for obtaining detailed information on the defects without the necessity of ionizing radiations. This review emphasizes the central role of CMR in the overall assessment of CHDs, considering also the limitations and challenges of this imaging technique. CMR, with the application of two-dimensional (2D) and tri-dimensional (3D) steady-state free precession (SSFP), permits the obtaining of very detailed and accurate images about the cardiac anatomy, global function, and volumes' chambers, giving essential information in the intervention planning and optimal awareness of the postoperative anatomy. Nevertheless, CMR supplies tissue characterization, identifying the presence of fat, fibrosis, or oedema in the myocardial tissue. Using a contrast agent for angiography sequences or 2D/four-dimensional (4D) flows offers information about the vascular, valvular blood flow, and, in general, the cardiovascular system hemodynamics. Furthermore, 3D SSFP CMR acquisitions allow the identification of coronary artery abnormalities as an alternative to invasive angiography and cardiovascular computed tomography (CCT). However, CMR requires expertise in CHDs, and it can be contraindicated in patients with non-conditional devices. Furthermore, its relatively longer acquisition time and the necessity of breath-holding may limit its use, particularly in children under eight years old, sometimes requiring anesthesia. The purpose of this review is to elucidate the application of CMR during the pediatric age.

Repaired Tetralogy of Fallot: Have We Understood the Right Timing of PVR?

Despite many advances in surgical repair during the past few decades, the majority of tetralogy of Fallot patients continue to experience residual hemodynamic and electrophysiological abnormalities. The actual issue, which has yet to be solved, is understanding how this disease evolves in each individual patient and, as a result, who is truly at risk of sudden death, as well as the proper timing of pulmonary valve replacement (PVR). Our responsibility should be to select the most appropriate time for each patient, going above and beyond imaging criteria used up to now to make such a clinically crucial decision. Despite several studies on timing, indications, procedures, and outcomes of PVR, there is still much uncertainty about whether PVR reduces arrhythmia burden or improves survival in these patients and how to appropriately manage this population. This review summarizes the most recent research on the evolution of repaired tetralogy of Fallot (from adolescence onwards) and risk factor variables that may favor or delay PVR.

Feasibility, Safety, and Efficacy of the Atrial Flow Regulator in Pediatric Patients: A Single-Center Experience.

Background: The Atrial Flow Regulator (AFR; Occlutech) can be used to create interatrial communication with a predetermined diameter in various pathophysiological settings. In the pediatric population, the experience is limited to a few case reports. We aim to report the initial single-center experience of AFR implantation in children with congenital and acquired heart disease. Methods: From December 2021 to June 2023, we enrolled 10 patients (aged 6 months-16 years). Indications to treatment were: left ventricular systolic dysfunction (n = 6), restrictive cardiomyopathy with pulmonary hypertension (n = 2), postoperative right ventricle dysfunction after surgical repair of a native Tetralogy of Fallot in a 12-year-old child (n = 1), and failure Fontan (n = 1). AFR implantation was successfully performed in all patients. Transseptal puncture was needed in 8 cases; in the other 2 cases, preexisting patent foramen ovale and fenestrated atrial septal defect were used. Balloon predilation was performed in 9 cases. An 8 mm device was implanted in all cases. The mean time of the procedure was 50 minutes, the median fluoroscopy time was 17 minutes, and median radiation exposure dose was 2.3 Gy × cm2. Results: No complications were reported during the procedure. Three patients died during the follow-up: 1 due to sepsis (16 days after the procedure), 1 due to disease progression (8 months after), and 1 due to failure of ECMO decannulation 7 days after the atrial venting. In the remaining patients, a reduction of LA dilation, postcapillary pulmonary hypertension, and heart failure symptoms were observed. Conclusions: AFR is safe and feasible in children and critical settings, allowing right/left cavities unloading and improvement of hemodynamics and symptoms.

Utility of Fetal Cardiac Resonance Imaging in Prenatal Clinical Practice: Current State of the Art.

The field of prenatal cardiac imaging has revolutionized the way we understand and manage congenital heart diseases (CHD) in the developing fetus. In the prenatal period, cardiac imaging plays a pivotal role in the diagnostic pathway, from screening to classification and follow-up of CHD. The ability to visualize the fetal heart in utero allows healthcare professionals to detect abnormalities early, thus enabling timely interventions and informed decision-making processes for both the mother and the medical team. Early CHD detection improves preparation for delivery, postnatal care, and postnatal outcomes. Advancements in medical technology and imaging techniques have provided clinicians with insights into the fascinating workings of the fetal heart. Several imaging modalities have proven to be helpful in this field, with echocardiography undoubtedly representing the primary modality for evaluating the fetus. By providing detailed anatomical and functional information, fetal cardiac magnetic resonance (CMR) imaging contributes to better prenatal counseling and enhances the coordination of care between obstetricians, maternal-fetal medicine specialists, and pediatric cardiologists. Shortcomings of fetal CMR are due to technical concerns related to the intrauterine position of the fetus and subsequent challenges to following a standard scan protocol. The aim of this paper was to revise the current state-of-the-art in the field of fetal CMR and its clinical applications and to delve into methods, challenges, and future directions of fetal CMR in prenatal imaging.

Late left ventricular myocardial remodeling after pulmonary artery banding for end-stage dilated cardiomyopathy in infants: an imaging study.

BACKGROUND: Understanding the macroscopic biventricular changes induced by pulmonary artery banding (PAB) in children with dilated cardiomyopathy (DCM) represents the first step to unraveling the regenerative potential of the myocardium. We herein investigated the phases of left ventricular (LV) rehabilitation in PAB responders, using a systematic echocardiographic and cardiac magnetic imaging (CMRI) surveillance protocol. METHODS: We prospectively enrolled all patients with DCM treated with PAB from September-2015 at our institution. Among 9 patients, 7 positively responded to PAB and were selected. Transthoracic 2D echocardiography was performed before PAB; and 30, 60, 90, and 120 days after PAB; and at the last available follow-up. CMRI was performed before PAB (whenever possible) and one year after PAB. RESULTS: In PAB responders, LV ejection fraction showed a modest 10% increase 30-60 days after PAB, followed by its almost complete normalization after 120  days (median of 20[10-26]% vs 56[44.5-63.5]%, at baseline and 120 days after PAB, respectively). Parallelly, the LV end-diastolic volume decreased from a median of 146(87-204)ml/m2 to 48(40-50)ml/m2. At the last available follow-up (median of 1.5 years from PAB), both echocardiography and CMRI showed a sustained positive LV response, although myocardial fibrosis was detected in all patients. CONCLUSIONS: Echocardiography and CMRI show that PAB can promote a LV remodeling process, which starts slowly and can culminate in the normalization of LV contractility and dimensions 4 months later. These results are maintained up to 1.5 years. However, CMRI showed residual fibrosis as evidence of a past inflammatory injury whose prognostic significance is still uncertain.

Childhood Obesity and Congenital Heart Disease: A Lifelong Struggle.

Congenital heart disease (CHD) affects approximately one in every one hundred infants worldwide, making it one of the most prevalent birth abnormalities globally. Despite advances in medical technology and treatment choices, CHD remains a significant health issue and necessitates specialized care throughout an individual's life. Childhood obesity has emerged as a novel global epidemic, becoming a major public health issue, particularly in individuals with lifelong conditions such as CHD. Obesity has profound effects on cardiac hemodynamics and morphology, emphasizing the importance of addressing obesity as a significant risk factor for cardiovascular health. Obesity-induced alterations in cardiac function can have significant implications for cardiovascular health and may contribute to the increased risk of heart-related complications in obese individuals. Moreover, while diastolic dysfunction may be less apparent in obese children compared to adults, certain parameters do indicate changes in early left ventricular relaxation, suggesting that obesity can cause cardiac dysfunction even in pediatric populations. As most children with CHD now survive into adulthood, there is also concern about environmental and behavioral health risk factors in this particular patient group. Addressing obesity in individuals with CHD is essential to optimize their cardiovascular health and overall quality of life. This review aims to succinctly present the data on the impact of obesity on CHD and to enhance awareness of this perilous association among patients, families, and healthcare providers.

Vitamin D serum levels and the risk of digital ulcers in systemic sclerosis: A longitudinal study.

AIM: Low levels of vitamin D (25OHD) have been found to associated with digital ulcers (DUs) in systemic sclerosis (SSc), although only cross-sectional studies have been performed. We aimed to investigate if variations in vitamin D serum levels over time affect DU in SSc. METHODS: This is a retrospective study on 65 patients. 25OHD was measured in 2011 and 2016 and its variations correlated with DU. RESULTS: The mean age of our cohort was 58 (SD 12) years with a mean disease duration of 9.5 (5.3) years. Most of our patients had a limited SSc (69.2%). At baseline 50.8% and 41.5% after 5 years had 25OHD <30 ng/mL. Patients receiving supplementation (8750 IU/wk) at baseline numbered 39 (60.0%) and 45 (69.2%) at the end of follow up. Nevertheless, 31 (47.7%) had a decrease of 25OHD in 5 years. In univariate analysis, patients with incident DU had a decrease in 25OHD as compared to patients with no incident DU (-17.4 [37.0] vs 13.0 [89.5], P = 0.018). No differences in 25OHD variations were found for other disease characteristics. In multivariate analysis correcting for previous DU and modified Rodnan Skin Score at baseline, patients with a decrease in 25OHD had an increased risk of developing DU (odds ratio 16.6; 95% CI 1.7-164.5, P = 0.017). CONCLUSIONS: A decrease in 25OHD is associated with the risk of developing DUs. In addition, vitamin D supplementation with the doses currently recommended may be insufficient in SSc. Further studies in wider cohorts are needed to confirm these results.

Contracaecum spp. (Nematoda: Anisakidae) and Eustrongylidesspp. (Nematoda: Dioctophymatidae) nematode larvae with zoonotic potencial found in two fish species from Tramandaí river basin, Southern Brazil / Contracaecum spp. (Nematoda: Anisakidae) e Eustrongylides spp. (Nematoda: Dioctophymatidae) larvas de nematódeos com potencial zoonótico encontradas em duas espécies de peixes da bacia do rio Tramandaí, Sul do Brasil

Parasitic nematodes can infect both wild and cultivated fish species and may be the source of many diseases. The consumption of raw fish meat in many countries has been the responsible of nematode related zoonosis. Knowing the risk of consumption of contaminated fish by the local communities, the main goal of this paper is to quantify and report the presence of larvae with zoonotic potential of Contracaecum spp. and Eustrongylides spp. found in two exotic fish species from the Tramandaí River Basin in southern Brazil. The sample sites were two lagoons of the basin, the Itapeva lagoon and Palmital lagoon, sampled in the period of April 2018. Forty specimens of Acestrorhynchus pantaneiro and twenty specimens of Trachelyopterus lucenai were examined. A. pantaneiro presented a 58% and 4% prevalence and a mean intensity of 3.17 and 1 for Contracaecum spp. and Eustrongylides spp., respectively. Meanwhile T. lucenai presented a prevalence of 70% and 5% and a mean intensity of 1.92 and 1 of Contracaecum spp. larvae and Eustrongylides spp. larvae, respectively. Although larvae of Contracaeucum spp. are reported only in the literature in experimental infections, they were able to complete their biological cycle in some mammals with certain pathogeneses. However, larvae of Eustrongylides spp. infect humans, as reported in the literature, causing severe damage to the intestinal tract. Knowing that local populations may be at risk, we recommend that all prophylactic measures be taken in relation to fish consumption. This study also contributes to the knowledge concerning the parasitic fauna of the host species studied.

Nematódeos são parasitas quem podem infectar tanto espécies de peixes silvestres como cultivados, no entanto, em altas intensidades podem ser origem de várias doenças. O consumo de carne crua de peixe em diversos países tem sido responsável por zoonoses relacionadas com nematódeos. Sabendo do risco do consumo de pescado contaminado pelas populações locais da área de estudo, o objetivo desse trabalho foi quantificar e reportar o primeiro registro de larvas com potencial zoonótico dos gêneros Contracaecum e Eustrongylides em duas espécies de peixes exóticas na Bacia do Rio Tramandaí, sul do Brasil. As coletas dos peixes ocorreram em duas lagoas da bacia, Lagoa Itapeva e Lagoa Palmital no período de abril de 2018. Foram necropsiados 50 exemplares de Acestrorhynchus pantaneiro e 20 de Trachelyopterus lucenai. A. pantaneiro apresentou 58% de prevalência e 3,17 de intensidade média de Contracaecum spp. e 4% e 1 de Eustrongylides spp., T. lucenai apresentou 70% de prevalência e 1,92 de intensidade média de Contracaecum spp. e 5% e 1 de Eustrongylides spp. Embora larvas Contracaeucum spp. só sejam reportadas na literatura em infecções experimentais, mostraram completar seu ciclo biológico em alguns mamíferos com certa patogenia. No entanto, larvas de Eustrongylides spp. já foram reportadas na literatura infectando humanos, causando danos severos na parte intestinal. Sabendo disso as populações locais podem estar em risco, recomenda-se então que todas medidas profiláticas sejam tomadas quanto ao consumo de peixe. O trabalho também contribui para o conhecimento da fauna parasitária das espécies hospedeiras estudadas.

Contracaecum spp. (Nematoda: Anisakidae) and Eustrongylidesspp. (Nematoda: Dioctophymatidae) nematode larvae with zoonotic potencial found in two fish species from Tramandaí river basin, Southern Brazil / Contracaecum spp. (Nematoda: Anisakidae) e Eustrongylides spp. (Nematoda: Dioctophymatidae) larvas de nematódeos com potencial zoonótico encontradas em duas espécies de peixes da bacia do rio Tramandaí, Sul do Brasil

Parasitic nematodes can infect both wild and cultivated fish species and may be the source of many diseases. The consumption of raw fish meat in many countries has been the responsible of nematode related zoonosis. Knowing the risk of consumption of contaminated fish by the local communities, the main goal of this paper is to quantify and report the presence of larvae with zoonotic potential of Contracaecum spp. and Eustrongylides spp. found in two exotic fish species from the Tramandaí River Basin in southern Brazil. The sample sites were two lagoons of the basin, the Itapeva lagoon and Palmital lagoon, sampled in the period of April 2018. Forty specimens of Acestrorhynchus pantaneiro and twenty specimens of Trachelyopterus lucenai were examined. A. pantaneiro presented a 58% and 4% prevalence and a mean intensity of 3.17 and 1 for Contracaecum spp. and Eustrongylides spp., respectively. Meanwhile T. lucenai presented a prevalence of 70% and 5% and a mean intensity of 1.92 and 1 of Contracaecum spp. larvae and Eustrongylides spp. larvae, respectively. Although larvae of Contracaeucum spp. are reported only in the literature in experimental infections, they were able to complete their biological cycle in some mammals with certain pathogeneses. However, larvae of Eustrongylides spp. infect humans, as reported in the literature, causing severe damage to the intestinal tract. Knowing that local populations may be at risk, we recommend that all prophylactic measures be taken in relation to fish consumption. This study also contributes to the knowledge concerning the parasitic fauna of the host species studied.(AU)

Nematódeos são parasitas quem podem infectar tanto espécies de peixes silvestres como cultivados, no entanto, em altas intensidades podem ser origem de várias doenças. O consumo de carne crua de peixe em diversos países tem sido responsável por zoonoses relacionadas com nematódeos. Sabendo do risco do consumo de pescado contaminado pelas populações locais da área de estudo, o objetivo desse trabalho foi quantificar e reportar o primeiro registro de larvas com potencial zoonótico dos gêneros Contracaecum e Eustrongylides em duas espécies de peixes exóticas na Bacia do Rio Tramandaí, sul do Brasil. As coletas dos peixes ocorreram em duas lagoas da bacia, Lagoa Itapeva e Lagoa Palmital no período de abril de 2018. Foram necropsiados 50 exemplares de Acestrorhynchus pantaneiro e 20 de Trachelyopterus lucenai. A. pantaneiro apresentou 58% de prevalência e 3,17 de intensidade média de Contracaecum spp. e 4% e 1 de Eustrongylides spp., T. lucenai apresentou 70% de prevalência e 1,92 de intensidade média de Contracaecum spp. e 5% e 1 de Eustrongylides spp. Embora larvas Contracaeucum spp. só sejam reportadas na literatura em infecções experimentais, mostraram completar seu ciclo biológico em alguns mamíferos com certa patogenia. No entanto, larvas de Eustrongylides spp. já foram reportadas na literatura infectando humanos, causando danos severos na parte intestinal. Sabendo disso as populações locais podem estar em risco, recomenda-se então que todas medidas profiláticas sejam tomadas quanto ao consumo de peixe. O trabalho também contribui para o conhecimento da fauna parasitária das espécies hospedeiras estudadas.(AU)

Clinostomum sp. (Digenea: Clinostomidae) and Ascocotyle sp. (Digenea: Heterophyidae): metacercariae with zoonotic potential in fishes from Tramandaí River basin, southern Brazil / Clinostomum sp. (Digenea: Clinostomidae) e Ascocotyle sp. (digenea: Heterophyidae): metacercárias com potencial zoonótico em peixes da bacia do Rio Tramandaí, sul do Brasil

The helminths belonging to the class Trematoda have great importance in ichthyoparasitology, and the subclass Digenea includes parasites with zoonotic potential. The family Heterophyidae is responsible for the heterophyiasis and, in Brazil, this disease is caused by the trematode genera Ascocotyle (Phagicola), commonly known as phagicolosis, both related to the fish-to-birds/mammals cycle. Clinostomum (belonging to the family Clinostomidae) has its larval stage in fish musculature and piscivorous birds as definitive hosts. It may parasitize humans accidentally, causing parasitic laryngopharyngitis and death by asphyxia. This study aims to quantify the presence of digenetic Heterophyidae and Clinostomidae parasites with zoonotic potential in fish from the Tramandaí River basin, in the state of Rio Grande do Sul, Brazil. The fish were purchased from fishermen from Terra de Areia/RS, from July 2016 to May 2017. The search for parasites was carried out by performing a necropsy on the fish. The digenetic parasites were preserved, stained and mounted on microscope slides for identification. Parasitological indices were calculated. Astyanax spp. were positive for Ascocotyle whereas Geophagus brasiliensis was infected by Clinostomum sp. Therefore, the results suggest a risk of infection to the consumer population in the region.

Os helmintos pertencentes à Classe Trematoda têm grande importância na ictioparasitologia, onde a Subclasse Digenea apresenta parasitos com potencial zoonótico. A família Heterophyidae é responsável pela heterofidíase e no Brasil essa doença é causada por trematódeos do gênero Ascocotyle (Phagicola), comumente conhecida como fagicolose, transmitida de peixes às aves e mamíferos. Já as larvas de Clinostomum, presentes na musculatura de peixes, tem aves piscívoras como seus hospedeiros definitivos, e podem parasitar seres humanos acidentalmente, causando laringofaringite parasitária e morte por asfixia. Este estudo busca quantificar a presença de parasitos digenéticos das famílias Heterophyidae e Clinostomidae com potencial zoonótico em peixes da bacia do rio Tramandaí/RS. Os peixes foram adquiridos de pescadores do município de Terra de Areia/RS, entre julho de 2016 e maio de 2017 e necropsiados à procura de parasitas. Os digenéticos foram fixados, corados e montados em lâminas para identificação. Índices parasitológicos foram calculados. Astyanax spp. foram positivos para Ascocotyle enquanto Geophagus brasiliensis apresentou-se infectado por Clinostomum sp. Sendo assim, os resultados obtidos sugerem risco de infecção para a população regional consumidora.

Clinostomum sp. (Digenea: Clinostomidae) and Ascocotyle sp. (Digenea: Heterophyidae): metacercariae with zoonotic potential in fishes from Tramandaí River basin, southern Brazil / Clinostomum sp. (Digenea: Clinostomidae) e Ascocotyle sp. (digenea: Heterophyidae): metacercárias com potencial zoonótico em peixes da bacia do Rio Tramandaí, sul do Brasil

The helminths belonging to the class Trematoda have great importance in ichthyoparasitology, and the subclass Digenea includes parasites with zoonotic potential. The family Heterophyidae is responsible for the heterophyiasis and, in Brazil, this disease is caused by the trematode genera Ascocotyle (Phagicola), commonly known as phagicolosis, both related to the fish-to-birds/mammals cycle. Clinostomum (belonging to the family Clinostomidae) has its larval stage in fish musculature and piscivorous birds as definitive hosts. It may parasitize humans accidentally, causing parasitic laryngopharyngitis and death by asphyxia. This study aims to quantify the presence of digenetic Heterophyidae and Clinostomidae parasites with zoonotic potential in fish from the Tramandaí River basin, in the state of Rio Grande do Sul, Brazil. The fish were purchased from fishermen from Terra de Areia/RS, from July 2016 to May 2017. The search for parasites was carried out by performing a necropsy on the fish. The digenetic parasites were preserved, stained and mounted on microscope slides for identification. Parasitological indices were calculated. Astyanax spp. were positive for Ascocotyle whereas Geophagus brasiliensis was infected by Clinostomum sp. Therefore, the results suggest a risk of infection to the consumer population in the region.(AU)

Os helmintos pertencentes à Classe Trematoda têm grande importância na ictioparasitologia, onde a Subclasse Digenea apresenta parasitos com potencial zoonótico. A família Heterophyidae é responsável pela heterofidíase e no Brasil essa doença é causada por trematódeos do gênero Ascocotyle (Phagicola), comumente conhecida como fagicolose, transmitida de peixes às aves e mamíferos. Já as larvas de Clinostomum, presentes na musculatura de peixes, tem aves piscívoras como seus hospedeiros definitivos, e podem parasitar seres humanos acidentalmente, causando laringofaringite parasitária e morte por asfixia. Este estudo busca quantificar a presença de parasitos digenéticos das famílias Heterophyidae e Clinostomidae com potencial zoonótico em peixes da bacia do rio Tramandaí/RS. Os peixes foram adquiridos de pescadores do município de Terra de Areia/RS, entre julho de 2016 e maio de 2017 e necropsiados à procura de parasitas. Os digenéticos foram fixados, corados e montados em lâminas para identificação. Índices parasitológicos foram calculados. Astyanax spp. foram positivos para Ascocotyle enquanto Geophagus brasiliensis apresentou-se infectado por Clinostomum sp. Sendo assim, os resultados obtidos sugerem risco de infecção para a população regional consumidora.(AU)