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Purpose:To evaluate the role of ARDT after surgical resection of ACC.Materials and Methods:Records of patients from our institutional ACC database were retrospectively assessed. A paired comparison analysis was used to evaluate the oncological outcomes between patients treated with surgery followed by ARDT or surgery only (control). The endpoints were LRFS, RFS, and OS. A systematic review of the literature and meta-analysis was also performed to evaluate local recurrence of ACC when ARDT was used.Results:Ten patients were included in each Group. The median follow-up times were 32 months and 35 months for the ARDT and control Groups, respectively. The results for LRFS (p=0.11), RFS (p=0.92), and OS (p=0.47) were similar among subsets. The mean time to present with local recurrence was significantly longer in the ARDT group compared with the control Group (419±206 days vs. 181±86 days, respectively; p=0.03). ARDT was well tolerated by the patients; there were no reports of late toxicity. The meta-analysis, which included four retrospective series, revealed that ARDT had a protective effect on LRFS (HR=0.4; CI=0.17-0.94).Conclusions:ARDT may reduce the chance and prolong the time to ACC local recurrence. However, there were no benefits for disease recurrence control or overall survival for patients who underwent this complementary therapy.

Both EuroSCORE I and II satisfactorily stratify risk in active infective endocarditis; however, EuroSCORE II performed better in the overall comparison. Specific endocarditis features will increase model complexity without an unequivocal improvement in predictive ability.

Coronary artery anomalies (CAAs) are a rare entity but their true incidence in the general population has yet to be determined. Most CAAs are asymptomatic, but they are nevertheless the second leading cause of sudden death in apparently healthy young athletes. The new imaging methods available to cardiologists, including CT angiography and MRI, now enable noninvasive diagnosis and characterization of these anomalies. The authors review the literature and present a retrospective study of 360 consecutive patients who underwent cardiac CT angiography. Demographic, clinical and angiographic characteristics were studied. The incidence of CAAs in this population was 2.69%. In order to better characterize this disorder, including diagnostic strategy, screening, treatment and prognosis, the authors suggest the establishment of a national registry of cardiac CT angiography. Such a registry would fill the existing gap in information on exams performed in the country, enriching current knowledge about this disease and noninvasive cardiac imaging in Portugal.

AV calcium volume was an independent predictor of PVR and BPD in patients submitted to TAVI. Our results support a systematic assessment of AV calcium volume to identify patients at increased risk of post-procedural PVR.

IntroduçãoA doença falciforme caracteriza-se por uma alteração geneticamente determinada na produção da hemoglobina, formando a hemoglobina S (HbS)A. 1 HbS sofre polimerização em situações de estresse oxidativo, alterando a capacidade de deformabilidade e a plasticidade da hemácia, que assume o formato de foice. 2 Com isto, há maior risco de provocarem fenômenos vasooclusivos, principais responsáveis pela sintomatologia apresentada pelos homozigotos. 1 As manifestações clínicas envolvem crises dolorosas, síndrome torá-cica aguda, AVC, alterações esplênicas, crise aplásica, úlce-ras de perna, manifestações osteoarticulares, hepatobiliares e oculares, síndrome renal, complicações cardiovasculares e infecções. 3 Além da HbS, outra hemoglobina variante, também de origem africana, a HbC, ocorre devido a uma mutação no gene da cadeia beta. As manifestações clínicas na homozigose (HbCC) envolvem anemia hemolítica e esplenomegalia leves. 2,4 Pode ocorrer, entretanto, interação entre os genes da HbS e HbC e talassemias, determinando os genótipos SC e ST, respectivamente. 5 Nas síndromes falciformes (SS, SC e ST), os eritrócitos apresentam concentração de HbS superior a 50%. Dentre estas, destaca-se a anemia falciforme, definida pela homozigose (HbSS), em função de sua maior prevalência e gravidade clí-nica. 3 O indivíduo heterozigoto é portador do traço falcêmico e não apresenta, portanto, alterações eritrocitárias, tampouco manifestações clínicas importantes.

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Objective To define transvaginal ultrasound reference ranges for uterine cervix measurements according to gestational age (GA) in low-risk pregnancies. Methods Cohort of low-risk pregnant women undergoing transvaginal ultrasound exams every 4 weeks, comprising measurements of the cervical length and volume, the transverse and anteroposterior diameters of the cervix, and distance from the entrance of the uterine artery into the cervix until the internal os. The inter-and intraobserver variabilities were assessed with the linear correlation coefficient and the Student t-test. Within each period of GA, 2.5, 10, 50, 90 and 97.5 percentiles were estimated, and the variation by GA was assessed with analysis of variance for dependent samples. Mean values and Student t-test were used to compare the values stratified by control variables. Results After confirming the high reproducibility of the method, 172 women followed in this cohort presented a reduction in cervical length, with an increase in volume and in the anteroposterior and transverse diameters during pregnancy. Smaller cervical lengths were associated with younger age, lower parity, and absence of previous cesarean section (C-section). Conclusion In the studied population, we observed cervical length shortening throughout pregnancy, suggesting a physiological reduction mainly in the vaginal portion of the cervix. In order to better predict preterm birth, cervical insufficiency and premature rupture of membranes, reference curves and specific cut-off values need to be validated. ResumoObjetivo Elaborar curvas de referências de medidas ultrassonográficas de colo uterino por idade gestacional (IG) em gestações de baixo risco. Métodos Coorte de gestantes de baixo risco, submetidas a ultrassom transvaginal repetido a cada 4 semanas, com medida do comprimento, dos diâmetros antero-