Species, genera et ordines algarum : seu descriptiones succinctae specierum, generum et rodinum, quibus algarum regnum constituitur / auctore Jacobo Georgio Agardh.

v.2 pt.1

Species, genera et ordines algarum : seu descriptiones succinctae specierum, generum et rodinum, quibus algarum regnum constituitur / auctore Jacobo Georgio Agardh.

v.2 pt.3

A biological survey of the waters of Woods Hole and vicinity / By Francis B. Sumner, Raymond C. Osburn, and Leon J. Cole.

Pt.2

Algae Maris Mediterranei et Adriatici : observationes in diagnosin [i.e. diagnosem] specierum et dispositionem generum / auctore Jacobo G. Agardh.

copy 2

Species, genera et ordines algarum : seu descriptiones succinctae specierum, generum et rodinum, quibus algarum regnum constituitur / auctore Jacobo Georgio Agardh.

v.3 pt.2

Species, genera et ordines algarum : seu descriptiones succinctae specierum, generum et rodinum, quibus algarum regnum constituitur / auctore Jacobo Georgio Agardh.

v.3 pt.1

Species, genera et ordines algarum : seu descriptiones succinctae specierum, generum et rodinum, quibus algarum regnum constituitur / auctore Jacobo Georgio Agardh.

v.2 pt.2

Osmotischer Druck und Ionenlehre in den medicinischen Wissenschaften. Zugleich Lehrbuch physikalisch-chemischer Methoden, von H.J. Hamburger.

Vol. 3

Species, genera et ordines algarum : seu descriptiones succinctae specierum, generum et rodinum, quibus algarum regnum constituitur / auctore Jacobo Georgio Agardh.

v.3 pt.4

Species, genera et ordines algarum : seu descriptiones succinctae specierum, generum et rodinum, quibus algarum regnum constituitur / auctore Jacobo Georgio Agardh.

v.3 pt.3

Atrial Fibrillation in Decompensated Heart Failure: Associated Factors and In-Hospital Outcome

Background: Studies on atrial fibrillation (AF) in decompensated heart failure (DHF) are scarce in Brazil. Objectives: To determine AF prevalence, its types and associated factors in patients hospitalized due to DHF; to assess their thromboembolic risk profile and anticoagulation rate; and to assess the impact of AF on in-hospital mortality and hospital length of stay. Methods: Retrospective, observational, cross-sectional study of incident cases including 659 consecutive hospitalizations due to DHF, from 01/01/2006 to 12/31/2011. The thromboembolic risk was assessed by using CHADSVASc score. On univariate analysis, the chi-square, Student t and Mann Whitney tests were used. On multivariate analysis, logistic regression was used. Results: The prevalence of AF was 40%, and the permanent type predominated (73.5%). On multivariate model, AF associated with advanced age (p < 0.0001), non-ischemic etiology (p = 0.02), right ventricular dysfunction (p = 0.03), lower systolic blood pressure (SBP) (p = 0.02), higher ejection fraction (EF) (p < 0.0001) and enlarged left atrium (LA) (p < 0.0001). The median CHADSVASc score was 4, and 90% of the cases had it ≥ 2. The anticoagulation rate was 52.8% on admission and 66.8% on discharge, being lower for higher scores. The group with AF had higher in-hospital mortality (11.0% versus 8.1%, p = 0.21) and longer hospital length of stay (20.5 ± 16 versus 16.3 ± 12, p = 0.001). Conclusions: Atrial fibrillation is frequent in DHF, the most prevalent type being permanent AF. Atrial fibrillation is associated with more advanced age, non-ischemic etiology, right ventricular dysfunction, lower SBP, higher EF and enlarged LA. Despite the high thromboembolic risk profile, anticoagulation is underutilized. The presence of AF is associated with longer hospital length of stay and high mortality.

Congenital Heart Disease as a Warning Sign for the Diagnosis of the 22q11.2 Deletion

Background: To alert for the diagnosis of the 22q11.2 deletion syndrome (22q11.2DS) in patients with congenital heart disease (CHD). Objective: To describe the main CHDs, as well as phenotypic, metabolic and immunological findings in a series of 60 patients diagnosed with 22q11.2DS. Methods: The study included 60 patients with 22q11.2DS evaluated between 2007 and 2013 (M:F=1.3, age range 14 days to 20 years and 3 months) at a pediatric reference center for primary immunodeficiencies. The diagnosis was established by detection of the 22q11.2 microdeletion using FISH (n = 18) and/or MLPA (n = 42), in association with clinical and laboratory information. Associated CHDs, progression of phenotypic facial features, hypocalcemia and immunological changes were analyzed. Results: CHDs were detected in 77% of the patients and the most frequent type was tetralogy of Fallot (38.3%). Surgical correction of CHD was performed in 34 patients. Craniofacial dysmorphisms were detected in 41 patients: elongated face (60%) and/or elongated nose (53.3%), narrow palpebral fissure (50%), dysplastic, overfolded ears (48.3%), thin lips (41.6%), elongated fingers (38.3%) and short stature (36.6%). Hypocalcemia was detected in 64.2% and decreased parathyroid hormone (PTH) level in 25.9%. Decrease in total lymphocytes, CD4 and CD8 counts were present in 40%, 53.3% and 33.3%, respectively. Hypogammaglobulinemia was detected in one patient and decreased concentrations of immunoglobulin M (IgM) in two other patients. Conclusion: Suspicion for 22q11.2DS should be raised in all patients with CHD associated with hypocalcemia and/or facial dysmorphisms, considering that many of these changes may evolve with age. The 22q11.2 microdeletion should be confirmed by molecular testing in all patients.