Carta ‐ Investigação
Comparação da cardiotoxicidade entre N‐metil‐glucamina e miltefosina no tratamento da leishmaniose tegumentar americana
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Capa; 2. Sumário; 3. O que é isotretinoína?; 4. O que é acne inflamatória grave?; 5. O que devo contar ao meu médico antes de usar isotretinoína?; 6. Como devo tomar isotretinoína?; 7. O que devo evitar enquanto estou usando isotretinoína?; 8. Quais os efeitos colaterais mais comuns da isotretinoína?; 9. O que devo contar imediatamente ao meu médico enquanto uso isotretinoína?; 10. Teratogenicidade; 11. Exames laboratoriais; 12. Guarda do medicamento; 13. Perguntas frequentes; 14. 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"https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621001203?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001211?idApp=UINPBA00008Z" "url" => "/26662752/0000009600000004/v1_202107170646/S2666275221001211/v1_202107170646/pt/main.assets" ] "pt" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta ‐ Investigação</span>" "titulo" => "Comparação da cardiotoxicidade entre N‐metil‐glucamina e miltefosina no tratamento da leishmaniose tegumentar americana" "tieneTextoCompleto" => true "saludo" => "Prezado Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "502" "paginaFinal" => "504" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Daniel Holanda Barroso, Ciro Martins Gomes, Antônia Marilene da Silva, Raimunda Nonata Ribeiro Sampaio" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Daniel Holanda" "apellidos" => "Barroso" "email" => array:1 [ 0 => "Danielhbarroso@unb.br" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Ciro Martins" "apellidos" => "Gomes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Antônia Marilene da" "apellidos" => "Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Raimunda Nonata Ribeiro" "apellidos" => "Sampaio" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Universidade de Brasília, Brasília, DF, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Universitário de Brasília, Universidade de Brasília, Brasília, DF , Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondência." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A N‐metil‐glucamina (NMG) constitui a primeira opção terapêutica para a leishmaniose tegumentar americana (LTA), mas causa muitos efeitos adversos. Uma das complicações mais graves e temidas é a morte súbita, causada por alterações eletrofisiológicas cardíacas associadas no eletrocardiograma (ECG) ao prolongamento do QT corrigido pela fórmula de Bazeett (QTc).<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1–3</span></a>A toxicidade dos antimoniais, a ocorrências de recidivas da doença e a resistência a essas substâncias estimularam a busca por outros fármacos ou esquemas terapêuticos mais eficazes para o tratamento da LTA.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> Dessa situação surgiu a miltefosina (hexadecilfosfocolina), que se mostrou efetiva contra várias espécies de <span class="elsevierStyleItalic">Leishmania</span> e outros protozoários.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5,6</span></a> O medicamento ativa o mecanismo de morte celular programada, inibindo a síntese de fosfatidilcolina, importante para a síntese e integridade da membrana celular.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Esse medicamento tem potencial teratogênico, o que requer controle da natalidade durante a gestação e até dois meses após o tratamento.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Realizou‐se um estudo de coorte retrospectivo em dados dos registros de ECG de pacientes tratados para LTA (20<span class="elsevierStyleHsp" style=""></span>mg SbV/kg/dia durante 20 dias para leishmaniose cutânea e 30 dias para a leishmaniose mucosa) ou miltefosina (1,3 a 2<span class="elsevierStyleHsp" style=""></span>mg/kg/dia – duas cápsulas por dia por 28 dias), acompanhados com ECG semanal em Serviço de Dermatologia entre 2008 e 2013.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Os critérios de inclusão foram pacientes tratados para LTA com idade entre 18 e 85 anos, sem uso de quaisquer outras medicações no momento e que não tivessem sido tratados para LTA nos últimos seis meses. Os critérios de exclusão foram gestantes, portadores de doença renal ou hepática crônicas, cardiopatias graves ou outras doenças ou uso de substâncias que pudessem interferir no ECG.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Os pacientes incluídos foram divididos em dois grupos: 1 – tratados com NMG; 2 – tratados com miltefosina (M). Foram comparados nos grupos o risco relativo e o percentual de alterações no EGC durante o tratamento (ritmo e frequência cardíaca, onda P, complexo QRS, intervalo de risco relativo <span class="elsevierStyleSup">RR</span>, presença ou ausência de arritmias e intervalo QTc). Foi adotada para a frequência cardíaca a faixa de normalidade entre 60 bpm e 100 bpm, e o limite para o QTc de 440<span class="elsevierStyleHsp" style=""></span>ms para ambos os sexos (<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>).<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">As variáveis foram expressas em frequência, e a comparação entre os grupos foi feita pelo uso do teste de Qui‐Quadrado ou pelo teste exato de Fisher quando mais de 20% das caselas apresentaram frequência esperada inferior a 5. Considerou‐se significativo p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05. Empregou‐se um modelo multivariado e RR com intervalo de confiança (IC) de 95%, calculados para analisar a intensidade da associação entre cada variável independente e a proporção de efeitos adversos.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foram analisados os prontuários de 111 pacientes com recuperação dos dados epidemiológicos e eletrocardiográficos de 53 indivíduos, dos quais 38 foram tratados com NMG e 15 com M.</p><p id="par0040" class="elsevierStylePara elsevierViewall">A média de idade no grupo NMG foi de 48,4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>16,29 anos, enquanto no grupo M foi de 58,4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9,16 anos, e mostrou‐se diferente entre os grupos (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,033). No grupo NMG, 23 (60,5%) pacientes eram do sexo masculino, e no grupo M foram sete (46,7%) (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,37).</p><p id="par0045" class="elsevierStylePara elsevierViewall">No sétimo dia de tratamento (D7), 11,4% dos integrantes do grupo NMG e 33,3% do grupo M apresentaram QTc alargado. No décimo quarto dia (D14), 26,6% do grupo NMG apresentavam QTc alargado, mas nenhum do grupo M. A tendência se manteve no vigésimo primeiro dia (D21), já que 35,3% do grupo NMG apresentaram QTc alterado enquanto não houve alterações no grupo M. Quanto à frequência cardíaca, 28,9% dos pacientes do grupo NMG e 26,6% do grupo MTF apresentaram bradicardia durante o tratamento.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Antes do tratamento, 16 (21%) pacientes do grupo NMG e 37,5% do grupo da M apresentavam bradicardia (RR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,59; IC 95%: 0,17 a 1,99; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,44). O QTc encontrava‐se alargado em 13,51% do grupo NMG e em 6,66% do grupo M (RR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2,02; IC 95%: 0,26 a 15,93; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,5495).</p><p id="par0055" class="elsevierStylePara elsevierViewall">A única diferença significativa entre os grupos foi evidenciada no D7 de tratamento, quando os pacientes tratados com miltefosina apresentaram mais frequentemente QTc<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>440 (RR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,25; IC 95%: 0,07 a 0,94); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,04 (<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>).</p><p id="par0060" class="elsevierStylePara elsevierViewall">Estudos anteriores já haviam mostrado que a miltefosina pode aumentar o intervalo QT durante o tratamento, quando comparado como os valores basais.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> O prolongamento QT ≥ 440 ms traduz um aumento exagerado do potencial de ação, levando a não homogeneidade da matriz elétrica ventricular, favorecendo o aparecimento de fenômenos de reentrada, além de favorecer despolarizações diastólicas precoces e atividade “trigada”. Esse prolongamento do QT se associa ao <span class="elsevierStyleItalic">Torsades de pointes</span>, uma taquicardia ventricular polimórfica que pode exibir degeneração em fibrilação ventricular, configurando o mecanismo arrítmico de morte súbita.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">3,9</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Ao contrário do esperado, uma proporção maior de pacientes que fez uso de miltefosina apresentou QTc<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>440<span class="elsevierStyleHsp" style=""></span>ms no D7, mas essa diferença não se manteve nas segunda e terceira semanas.</p><p id="par0070" class="elsevierStylePara elsevierViewall">O envelhecimento é fator de alterações eletrocardiográficas, e os pacientes do grupo M tinham maior média de idade.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Mas, por outro lado, essas alterações já estavam presentes no pré‐tratamento, o que nos leva a crer que a idade não tenha tido papel determinante nas alterações. Outra limitação é a realização de múltiplos testes, que pode aumentar a taxa de erros do tipo 1.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Diante do resultado que sugere cardiotoxicidade da M no contexto da atual tendência do tratamento da LTA com a associação de substâncias potencialmente cardiotóxicas (antimoniais, anfotericina), esse achado deve ser mais bem estudado em esquemas com combinações de fármacos. Este parece ser o primeiro estudo a evidenciar alterações de ECG da M ao longo do tratamento.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> Esses achados, entretanto, têm caráter exploratório e merecem ser confirmados por estudos com maior número de pacientes.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0080" class="elsevierStylePara elsevierViewall">A Sociedade Brasileira de Dermatologia, por meio da Funaderme e da Fundação de Apoio à Pesquisa do Distrito Federal (FAP‐DF), número 0193.001447/2016, agradece pelo apoio financeiro.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribuição dos autores</span><p id="par0085" class="elsevierStylePara elsevierViewall">Daniel Holanda Barroso: Escreveu o manuscrito análise dos dados.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Ciro Martins Gomes: Revisou o manuscrito; realizou exames de biologia molecular e analisou os dados.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Antônia Marilene da Silva: Escreveu o manuscrito e analisou os dados cardiológicos.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Raimunda Nonata Ribeiro Sampaio: Analisou os dados; escreveu e revisou o manuscrito.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0105" class="elsevierStylePara elsevierViewall">Nenhum.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Suporte financeiro" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Contribuição dos autores" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflito de interesses" ] 3 => array:2 [ "identificador" => "xack546160" "titulo" => "Agradecimentos" ] 4 => array:1 [ "titulo" => "Referências" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-11-29" "fechaAceptado" => "2021-02-26" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Como citar este artigo: Barroso DH, Gomes CM, Silva AM, Sampaio RNR. Comparison of cardiotoxicity between N‐methyl‐glucamine and miltefosine in the treatment of American cutaneous leishmaniasis. An Bras Dermatol. 2021;96:502–4.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Trabalho realizado no Hospital Universitário de Brasília e no Laboratório de Dermatomicologia, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Tabela 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Tabela " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">IC, intervalo de confiança; RR, risco relativo.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Bradicardia</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">QTC<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>440 ms</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Arritmias<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RR (IC 95%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RR (IC 95%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RR (IC 95%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Dia 7</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NMG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,14 (0,31–4,23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,87 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,25 (0,07–0,94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,04 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,85 (0,08–8,74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,87 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Dia 14</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NMG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,53 (0,07–3,66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6,58 (0,41–105,36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,93 (0,10–37,44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,66 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Dia 21</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NMG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,94 (0,12–31,74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7,22 (0,45–115,33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2,94 (0,16–55,31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,47 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Dia 28</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NMG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,36 (0,03–4,54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,54 (0,04–7,25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,13 (0,006–2,86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2658518.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Arritmias encontradas: extrassístoles ventriculares isoladas.</p>" ] ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Riscos relativos comparando pacientes tratados com NMG e M</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Referências" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0060" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ministério da Saúde, Departamento de Vigilância, Epidemiológica., Manual de Vigilância e Controle da Leishmaniose Tegumentar Americana, atualizada., Brasília: Ministério da Saúde;. 2017" ] ] ] 1 => array:3 [ "identificador" => "bib0065" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electrocardiographic alterations during treatment of mucocutaneous leishmaniasis with meglumine antimoniate and allopurinol" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Antezana" 1 => "R. Zeballos" 2 => "C. Mendoza" 3 => "P. Lyevre" 4 => "L. Valda" 5 => "F. Cardenas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0035-9203(92)90427-e" "Revista" => array:6 [ "tituloSerie" => "Trans R Soc Trop Med Hyg." "fecha" => "1992" "volumen" => "86" "paginaInicial" => "31" "paginaFinal" => "33" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1566297" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0070" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sudden death caused by glucantine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.N.R. Sampaio" 1 => "E. Martins Netto" 2 => "E.A. Faria" 3 => "J.H.D. Sampaio" 4 => "L.C.F. Freitas" 5 => "P.D. Marsden" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Bras Dermatol." "fecha" => "1988" "volumen" => "63" "paginaInicial" => "35" "paginaFinal" => "37" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0075" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Miltefosine: oral treatment of leishmaniasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Soto" 1 => "P. Soto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1586/14787210.4.2.177" "Revista" => array:6 [ "tituloSerie" => "Expert Rev Anti Infect Ther." "fecha" => "2006" "volumen" => "4" "paginaInicial" => "177" "paginaFinal" => "185" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16597200" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0080" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Miltefosine in the treatment of leishmaniasis: clinical evidence for informed clinical risk management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Sundar" 1 => "P.L. Olliaro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ther Clin Risk Manag." "fecha" => "2007" "volumen" => "3" "paginaInicial" => "733" "paginaFinal" => "740" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18472998" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0085" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized controlled clinical trial to access efficacy and safety of miltefosine in the treatment of cutaneous leishmaniasis Caused by Leishmania (Viannia) guyanensis in Manaus, Brazil" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Chrusciak Talhari" 1 => "R. Dietze" 2 => "C. Chrusciak Talhari" 3 => "R.M. Silva" 4 => "E.P.G. Yamashita" 5 => "G.O. Penna" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4269/ajtmh.2011.10-0155" "Revista" => array:6 [ "tituloSerie" => "Am J Trop Med Hyg." "fecha" => "2011" "volumen" => "84" "paginaInicial" => "255" "paginaFinal" => "260" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21292895" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0090" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital long QT syndrome: considerations for primary care physicians" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Levine" 1 => "S.Z. Rosero" 2 => "A.S. Budzikowski" 3 => "A.J. Moss" 4 => "W. Zareba" 5 => "J.P. Daubert" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clevel Clin J Med." "fecha" => "2008" "volumen" => "75" "paginaInicial" => "591" "paginaFinal" => "600" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0095" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Oral miltefosine for Indian visceral leishmaniasis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Sundar" 1 => "T.K. Jha" 2 => "C.P. Thakur" 3 => "J. Engel" 4 => "H. Sindermann" 5 => "C. Fischer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa021556" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med." "fecha" => "2002" "volumen" => "347" "paginaInicial" => "1739" "paginaFinal" => "1746" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12456849" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0100" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "O Eletrocardiograma e a Síndrome de QT Longo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N.A. Oliveira Jr." 1 => "E.M. Andréa" 2 => "W.A. Maciel" 3 => "L.R. Siqueira" 4 => "J. Atié" 5 => "R. Cosenza" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev SOCERJ." "fecha" => "2004" "volumen" => "3" "paginaInicial" => "177" "paginaFinal" => "182" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0105" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changes in ECG pattern with advancing age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.S. Khane" 1 => "A.D. Surdi" 2 => "R.S. Bhatkar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1515/JBCPP.2011.017" "Revista" => array:6 [ "tituloSerie" => "J Basic Clin Physiol Pharmacol." "fecha" => "2011" "volumen" => "22" "paginaInicial" => "97" "paginaFinal" => "101" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22865429" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0110" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Motulsky H. Intuitive biostatistics: a nonmathematical guide to statistical thinking. 4th ed. USA: Oxford University Press; 2018." ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack546160" "titulo" => "Agradecimentos" "texto" => "<p id="par0110" class="elsevierStylePara elsevierViewall">A Sofia Salles Martins e Camille Bresolin Pompeu, pelo apoio operacional.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "pt" "url" => "/26662752/0000009600000004/v1_202107170646/S2666275221001077/v1_202107170646/pt/main.assets" "Apartado" => array:4 [ "identificador" => "82068" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Carta - Investigação" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/26662752/0000009600000004/v1_202107170646/S2666275221001077/v1_202107170646/pt/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001077?idApp=UINPBA00008Z" ]
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ISSN: 26662752Original language: Portuguese
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