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Ohta K, Okanishi T, Sasaki M, Kawaguchi T, Murakami J, Maegaki Y. Tendency and risk factors of acute pancreatitis in children with severe motor and intellectual disabilities: A single-center study. Brain Dev 2023; 45:126-133. [PMID: 36357258 DOI: 10.1016/j.braindev.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Acute pancreatitis (AP) is a life-threatening disease in children with severe motor and intellectual disabilities (SMID). This study aimed to determine the clinical characteristics and causes of AP in children with SMID. METHODS We enrolled 29 children with AP admitted to our hospital. Patients were divided into children with SMID (AP with SMID group) and the remaining patients (AP without SMID group). All patients in the AP without SMID group had no pre-existing neurological disabilities. We obtained data on the clinical background of patients, severity of AP, treatments, and outcomes. We enrolled 34 children with SMID without a history of AP (SMID control group) to compare their clinical characteristics with the AP with SMID group. We statistically compared the data between the AP with SMID and AP without SMID groups and between the AP with SMID and SMID control groups. RESULT Compared to the AP without SMID group, the AP with SMID group showed significantly more severe pancreatitis (50% vs 12%) and recurrent pancreatitis (58% vs 18%). Moreover, compared with the SMID control group, the AP with SMID group showed significantly more frequent absence of voluntary movement (83% vs 26%), requirement of respiratory devices (75% vs 35%), panhypopituitarism (33% vs 6%), thermoregulatory dysfunction (58% vs 18%), and low serum albumin levels (3.6 vs 4.1 g/dL). CONCLUSION AP in children with SMID tended to be associated with severe and recurrent pancreatitis. Children with SMID who had a history of AP had more severe neurological impairment among children with SMID. Hypothalamic-pituitary system dysfunction caused by severe cerebral damage may contribute to the development of AP.
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Affiliation(s)
- Kento Ohta
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Tohru Okanishi
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan.
| | - Michiru Sasaki
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Tatsuya Kawaguchi
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Jun Murakami
- Division of Perinatology and Pediatrics, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
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Inoue H, Harada K, Narimatsu E, Uemura S, Aisaka W, Bunya N, Nomura K, Katayama Y. Pathophysiologic Mechanisms of Hypothermia-Induced Pancreatic Injury in a Rat Model of Body Surface Cooling. Pancreas 2021; 50:235-242. [PMID: 33565801 DOI: 10.1097/mpa.0000000000001738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE The mechanisms underlying hypothermia-induced pancreatic injury are unclear. Thus, we investigated the pathophysiology of hypothermia-induced pancreatic injury. METHODS We created a normal circulatory model with body surface cooling in rats. We divided the rats into control (36°C-38°C), mild hypothermia (33°C-35°C), moderate hypothermia (30°C-32°C), and severe hypothermia (27°C-29°C) (n = 5 per group) groups. Then, we induced circulatory failure with a cooling model using high-dose inhalation anesthesia and divided the rats into control (36°C-38°C) and severe hypothermia (27°C-29°C) (n = 5 per group) groups. Serum samples were collected before the introduction of hypothermia. Serum and pancreatic tissue were collected after maintaining the target body temperature for 1 hour. RESULTS Hematoxylin and eosin staining of the pancreas revealed vacuoles and edema in the hypothermia group. Serum amylase (P = 0.056), lactic acid (P < 0.05), interleukin 1β (P < 0.05), interleukin 6 (P < 0.05), and tumor necrosis factor α (P = 0.13) levels were suppressed by hypothermia. The circulatory failure model exhibited pancreatic injury. CONCLUSIONS Hypothermia induced bilateral effects on the pancreas. Morphologically, hypothermia induced pancreatic injury based on characteristic pathology typified by vacuoles. Serologically, hypothermia induced protective effects on the pancreas by suppressing amylase and inflammatory cytokine levels.
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Affiliation(s)
| | | | | | | | - Wakiko Aisaka
- Intensive Care Medicine, Sapporo Medical University, Sapporo, Japan
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Trevisan AM, Cogliati B, Homem AR, Aloiav TPA, de Aquino N, Moreira JM, Reno LDC, Naumann AM, Galvão FHF, Andraus W, D'Albuquerque LAC. The liver injury following ischemia and reperfusion is worse in experimental knockout heterozygote mouse model for expression of connexin 431. Acta Cir Bras 2019; 34:e201901003. [PMID: 31851211 PMCID: PMC6912844 DOI: 10.1590/s0102-865020190100000003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/12/2019] [Accepted: 09/16/2019] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To evaluate that Connexin (Cx43) plays a role in lesions after hepatic ischemia/reperfusion (IR) injury. METHODS We use Cx43 deficient model (heterozygotes mice) and compared to a wild group. The groups underwent 1 hour ischemia and 24 hours reperfusion. The heterozygote genotype was confirmed by PCR. We analyzed the hepatic enzymes (AST, ALT, GGT) and histology. RESULTS The mice with Cx43 deficiency showed an ALT mean value of 4166 vs. 307 in the control group (p<0.001); AST mean value of 7231 vs. 471 in the control group (p<0.001); GGT mean value of 9.4 vs. 1.7 in the control group (p=0.001); histology showed necrosis and inflammation in the knockout group. CONCLUSIONS This research demonstrated that the deficiency of Cx43 worses the prognosis for liver injury. The topic is a promising target for therapeutics advancements in liver diseases and procedures.
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Affiliation(s)
- Alexandre Maximiliano Trevisan
- Fellow PhD degree and MSc degree, Postgraduate Program in
Medicine Science in Gastroenterology, Department of Gastroenterology, School of
Medicine, Medical Investigation Laboratory (LIM 37), Universidade de São Paulo
(USP), Brazil. Technical procedures, acquisition of data, statistical analysis,
manuscript writing
| | - Bruno Cogliati
- PhD, Department of Pathology, School of Veterinary Medicine and
Animal Science, USP, Sao Paulo-SP, Brazil. Technical procedures
| | - Adriana Ribeiro Homem
- PhD, Department of Gastroenterology, School of Medicine,
Medical Investigation Laboratory (LIM 37), USP, Sao Paulo-SP, Brazil. Manuscript
writing
| | | | - Nelson de Aquino
- Fellow Master degree, Postgraduate Program in Medicine Surgical
Gastroenterology, School of Medicine, USP, Sao Paulo-SP, Brazil. Statistical
analysis, manuscript writing
| | - Jairo Marques Moreira
- Biologist, Hospital Albert Einstein, Sao Paulo-SP, Brazil.
Technical procedures, acquisition of data
| | - Leonardo da Cruz Reno
- Fellow Master degree, Postgraduate Program in Medicine
Surgical Gastroenterology, School of Medicine, USP, Sao Paulo-SP, Brazil.
Technical procedures, acquisition of data, manuscript writing
| | - Alexandre Moulin Naumann
- Fellow Master degree, Postgraduate Program in Medicine
Surgical Gastroenterology, School of Medicine, USP, Sao Paulo-SP, Brazil.
Technical procedures, acquisition of data, manuscript writing
| | - Flavio Henrique Ferreira Galvão
- Assistant Professor, Liver and Gastrointestinal Transplant
Division, Department of Gastroenterology, School of Medicine, Coordinator,
Medical Investigation Laboratory (LIM 37), USP, Sao Paulo-SP, Brazil. Surgical
procedures, manuscript writing, critical revision
| | - Wellington Andraus
- Assistant Professor, Coordinator, Liver and Gastrointestinal
Transplant Division, Department of Gastroenterology, School of Medicine, Medical
Investigation Laboratory (LIM 37), USP, Sao Paulo-SP, Brazil. Surgical
procedures, manuscript writing, critical revision
| | - Luiz Augusto Carneiro D'Albuquerque
- Full Professor, Chairman, Liver and Gastrointestinal Transplant
Division, Department of Gastroenterology, School of Medicine, Medical
Investigation Laboratory (LIM 37), USP, Sao Paulo-SP, Brazil. Conception and
design of the study, manuscript writing, critical revision
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de Oliveira C, Khatua B, Bag A, El-Kurdi B, Patel K, Mishra V, Navina S, Singh VP. Multimodal Transgastric Local Pancreatic Hypothermia Reduces Severity of Acute Pancreatitis in Rats and Increases Survival. Gastroenterology 2019; 156:735-747.e10. [PMID: 30518512 PMCID: PMC6368865 DOI: 10.1053/j.gastro.2018.10.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/11/2018] [Accepted: 10/20/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Acute pancreatitis (AP) of different etiologies is associated with the activation of different signaling pathways in pancreatic cells, posing challenges to the development of targeted therapies. We investigated whether local pancreatic hypothermia, without systemic hypothermia, could lessen the severity of AP induced by different methods in rats. METHODS A urethane balloon with 2 polyurethane tubes was placed inside the stomach of rats. AP was induced in Wistar rats by the administration of cerulein or glyceryl tri-linoleate (GTL). Then, cold water was infused into the balloon to cool the pancreas. Pancreatic temperatures were selected based on those found to decrease acinar cell injury. An un-perfused balloon was used as a control. Pancreatic and rectal temperatures were monitored, and an infrared lamp or heating pad was used to avoid generalized hypothermia. We collected blood, pancreas, kidney, and lung tissues and analyzed them by histology, immunofluorescence, immunoblot, cytokine and chemokine magnetic bead, and DNA damage assays. The effect of hypothermia on signaling pathways initiated by cerulein and GTL was studied in acinar cells. RESULTS Rats with pancreatic cooling developed less severe GTL-induced AP compared with rats that received the control balloon. In acinar cells, cooling decreased the lipolysis induced by GTL, increased the micellar form of its fatty acid, lowered the increase in cytosolic calcium, prevented the loss of mitochondrial membrane potential (by 70%-80%), and resulted in a 40%-50% decrease in the uptake of a fatty acid tracer. In rats with AP, cooling decreased pancreatic necrosis by 48%, decreased serum levels of cytokines and markers of cell damage, and decreased markers of lung and renal damage. Pancreatic cooling increased the proportions of rats surviving 6 hours after induction of AP (to 90%, from <10% of rats that received the control balloon). In rats with cerulein-induced AP, pancreatic cooling decreased pancreatic markers of apoptosis and inflammation. CONCLUSIONS In rats with AP, transgastric local pancreatic hypothermia decreases pancreatic necrosis, apoptosis, inflammation, and markers of pancreatitis severity and increases survival.
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Affiliation(s)
- Cristiane de Oliveira
- Department of Medicine, Mayo Clinic, Scottsdale, AZ, University of Pittsburgh, Pittsburgh, PA
| | - Biswajit Khatua
- Department of Medicine, Mayo Clinic, Scottsdale, AZ, University of Pittsburgh, Pittsburgh, PA
| | - Arup Bag
- Department of Medicine, Mayo Clinic, Scottsdale, AZ, University of Pittsburgh, Pittsburgh, PA
| | - Bara El-Kurdi
- Department of Medicine, Mayo Clinic, Scottsdale, AZ, University of Pittsburgh, Pittsburgh, PA
| | - Krutika Patel
- Department of Medicine, Mayo Clinic, Scottsdale, AZ, University of Pittsburgh, Pittsburgh, PA
| | - Vivek Mishra
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Sarah Navina
- Pathology, University of Pittsburgh, Pittsburgh, PA
| | - Vijay P. Singh
- Department of Medicine, Mayo Clinic, Scottsdale, AZ, University of Pittsburgh, Pittsburgh, PA
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Inoue H, Uemura S, Harada K, Mizuno H, Bunya N, Nomura K, Kakizaki R, Narimatsu E. Risk factors for acute pancreatitis in patients with accidental hypothermia. Am J Emerg Med 2019; 37:189-193. [DOI: 10.1016/j.ajem.2018.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 01/01/2023] Open
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Oxidative stress and NO generation in the rat pancreatitis induced by pancreatic duct ligation. Acta Histochem 2017; 119:252-256. [PMID: 28168994 DOI: 10.1016/j.acthis.2017.01.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/23/2017] [Accepted: 01/27/2017] [Indexed: 12/28/2022]
Abstract
The interaction between nitric oxide (NO) and superoxides is critical in the development of an acute pancreatitis. Previously, we reported that the expression of superoxides and of the NO-generating enzyme (NO synthase, NOS) was up-regulated in the human pancreatitis, especially within the exocrine compartment indicating an exceptional susceptibility of the exocrine parenchyma to oxidative stress. The aim of the present study was to compare the regulation of NO signalling pathways in the human pancreatitis and in an animal model of an acute pancreatitis induced by pancreatic duct ligation (PDL) in rats. In the PDL-induced rat pancreatitis, we revealed a similar pattern of oxidative stress and NOS up-regulation in acinar and in ductal compartments, like in the human pancreatitis. This demonstrates that the PDL-induced rat pancreatitis is a proper model for further studies of acute pancreatitis development in humans.
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Andraus W, Souza GFPD, Oliveira MGD, Haddad LBP, Coelho AMM, Galvão FH, Leitão RMC, D'Albuquerque LAC, Machado MCC. S-nitroso-N-acetylcysteine ameliorates ischemia-reperfusion injury in the steatotic liver. Clinics (Sao Paulo) 2010; 65:715-21. [PMID: 20668630 PMCID: PMC2910861 DOI: 10.1590/s1807-59322010000700011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 03/30/2010] [Accepted: 04/30/2010] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Steatosis is currently the most common chronic liver disease and it can aggravate ischemia-reperfusion (IR) lesions. We hypothesized that S-nitroso-N-acetylcysteine (SNAC), an NO donor component, can ameliorate cell damage from IR injury. In this paper, we report the effect of SNAC on liver IR in rats with normal livers compared to those with steatotic livers. METHODS Thirty-four rats were divided into five groups: I (n=8), IR in normal liver; II (n=8), IR in normal liver with SNAC; III (n=9), IR in steatotic liver; IV (n=9), IR in steatotic liver with SNAC; and V (n=10), SHAN. Liver steatosis was achieved by administration of a protein-free diet. A SNAC solution was infused intraperitoneally for one hour, beginning 30 min. after partial (70%) liver ischemia. The volume of solution infused was 1 ml/100 g body weight. The animals were sacrificed four hours after reperfusion, and the liver and lung were removed for analysis. We assessed hepatic histology, mitochondrial respiration, oxidative stress (MDA), and pulmonary myeloperoxidase. RESULTS All groups showed significant alterations compared with the group that received SHAN. The results from the steatotic SNAC group revealed a significant improvement in liver mitochondrial respiration and oxidative stress compared to the steatotic group without SNAC. No difference in myeloperoxidase was observed. Histological analysis revealed no difference between the non-steatotic groups. However, the SNAC groups showed less intraparenchymal hemorrhage than groups without SNAC (p=0.02). CONCLUSION This study suggests that SNAC effectively protects against IR injury in the steatotic liver but not in the normal liver.
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Ferreira M, de Abreu LC, Valenti VE, Meneghini A, Murad N, Ferreira C. Electric countershock and cold stress effects on liver and adrenal gland. Clinics (Sao Paulo) 2010; 65:291-6. [PMID: 20360920 PMCID: PMC2845770 DOI: 10.1590/s1807-59322010000300009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Accepted: 11/26/2009] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Cold exposure induces glycogen and lipid depletion in the liver and the adrenal gland, respectively. However, no previous study has determined the effects of electrical countershock on those tissues. We aimed to evaluate the effects of electrical countershock on lipid depletion in the adrenal gland and on glycogen depletion in the liver. METHODS We used 40 male Wistar rats divided into four groups: the control group, in which the animals were subjected to a resting period of seven days; the electrical discharge group, in which the animals were subjected to a resting period followed by administration of ten 300-mV electrical discharges; the electrical post-discharge group, in which the animals received ten electrical shocks (300 mV) followed by rest for seven consecutive days; and the cold stress group, in which the animals were subjected to a resting period and were then exposed to -8 degrees C temperatures for four hours. All animals underwent a laparotomy after treatment. The lipid and glycogen depletions are presented using intensity levels (where + = low intensity and ++++ = high intensity, with intermediate levels in between). RESULTS The rats exposed to the cold stress presented the highest glycogen and lipid depletion in the liver and the adrenal gland, respectively. Furthermore, we noted that the electrical countershock significantly increased lipid depletion in the adrenal gland and glycogen depletion in the liver. One week after the electrical countershock, the liver and adrenal gland profiles were similar to that of the control group. CONCLUSION Electrical countershock immediately increased the glycogen depletion in the liver and the lipid depletion in the adrenal gland of rats.
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Affiliation(s)
- Marcelo Ferreira
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brazil
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo (UNIFESP) - São Paulo/SP, Brazil
| | - Luiz Carlos de Abreu
- Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC - Santo André/SP, Brazil
| | - Vitor E. Valenti
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo (UNIFESP) - São Paulo/SP, Brazil
| | - Adriano Meneghini
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brazil
| | - Neif Murad
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brazil
| | - Celso Ferreira
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brazil
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo (UNIFESP) - São Paulo/SP, Brazil
- , Tel.: 55 11 4993.5403
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Meneghini A, Ferreira C, de Abreu LC, Valenti VE, Ferreira M, Filho CF, Murad N. Memantine prevents cardiomyocytes nuclear size reduction in the left ventricle of rats exposed to cold stress. Clinics (Sao Paulo) 2009; 64:921-6. [PMID: 19759887 PMCID: PMC2745134 DOI: 10.1590/s1807-59322009000900014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Accepted: 06/24/2009] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Memantine is an N-methyl-d-aspartate (NMDA) glutamate receptor antagonist used to treat Alzheimer's disease. Previous studies have suggested that receptor blockers act as neuroprotective agents; however, no study has specifically investigated the impact that these drugs have on the heart. We sought to evaluate the effects of memantine on nuclear size reduction in cardiac cells exposed to cold stress. METHOD We used male EPM-Wistar rats (n=40) divided into 4 groups: 1) Matched control (CON); 2) Memantine-treated rats (MEM); 3) Rats undergoing induced hypothermia (IH) and 4) Rats undergoing induced hypothermia that were also treated with memantine (IHM). Animals in the MEM and IHM groups were treated by oral gavage administration of 20 mg/kg/day memantine over an eight-day period. Animals in the IH and IHM groups were submitted to 4 hours of hypothermia in a controlled environment with a temperature of -8 degrees C on the last day of the study. RESULTS The MEM group had the largest cardiomyocyte nuclear size (151 +/- 3.5 microm(3) vs. CON: 142 +/- 2.3 microm(3); p<0.05), while the IH group had the smallest mean value of nuclear size. The nuclear size of the IHM group was preserved (125 +/- 2.9 microm(3)) compared to the IH group (108 +/- 1.7 microm(3); p<0.05). CONCLUSION Memantine prevented the nuclear size reduction of cardiomyocytes in rats exposed to cold stress.
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Affiliation(s)
- Adriano Meneghini
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brasil
| | - Celso Ferreira
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brasil
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo (UNIFESP) - São Paulo/SP, Brazil
| | - Luiz Carlos de Abreu
- Departamento de Saúde Pública, Universidade de São Paulo - São Paulo/SP, Brasil.
, Tel: 55 11 4993.5403
| | - Vitor E. Valenti
- Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo (UNIFESP) - São Paulo/SP, Brazil
| | - Marcelo Ferreira
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brasil
| | - Celso F. Filho
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brasil
| | - Neif Murad
- Departamento de Clínica Médica, Disciplina de Cardiologia, Faculdade de Medicina do ABC - Santo André/SP, Brasil
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