array:24 [
  "pii" => "S2666275221001077"
  "issn" => "26662752"
  "doi" => "10.1016/j.abdp.2021.02.003"
  "estado" => "S300"
  "fechaPublicacion" => "2021-07-01"
  "aid" => "366"
  "copyright" => "Sociedade Brasileira de Dermatologia"
  "copyrightAnyo" => "2021"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by/4.0/"
  "subdocumento" => "sco"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S0365059621001069"
      "issn" => "03650596"
      "doi" => "10.1016/j.abd.2021.02.002"
      "estado" => "S300"
      "fechaPublicacion" => "2021-07-01"
      "aid" => "366"
      "copyright" => "Sociedade Brasileira de Dermatologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by/4.0/"
      "subdocumento" => "sco"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:9 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Research Letter</span>"
        "titulo" => "Comparison of cardiotoxicity between N-methyl-glucamine and miltefosine in the treatment of American cutaneous leishmaniasis"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "502"
            "paginaFinal" => "504"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Daniel Holanda Barroso, Ciro Martins Gomes, Ant&#244;nia Marilene da Silva, Raimunda Nonata Ribeiro Sampaio"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Daniel Holanda"
                "apellidos" => "Barroso"
              ]
              1 => array:2 [
                "nombre" => "Ciro Martins"
                "apellidos" => "Gomes"
              ]
              2 => array:2 [
                "nombre" => "Ant&#244;nia Marilene da"
                "apellidos" => "Silva"
              ]
              3 => array:2 [
                "nombre" => "Raimunda Nonata Ribeiro"
                "apellidos" => "Sampaio"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2666275221001077"
          "doi" => "10.1016/j.abdp.2021.02.003"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001077?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621001069?idApp=UINPBA00008Z"
      "url" => "/03650596/0000009600000004/v4_202107160617/S0365059621001069/v4_202107160617/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2666275221001223"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2020.08.018"
    "estado" => "S300"
    "fechaPublicacion" => "2021-07-01"
    "aid" => "381"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by/4.0/"
    "subdocumento" => "sco"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Elabora&#231;&#227;o e valida&#231;&#227;o de material educativo impresso para utiliza&#231;&#227;o dos usu&#225;rios de isotretino&#237;na"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "504"
          "paginaFinal" => "507"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 905
              "Ancho" => 2341
              "Tamanyo" => 276690
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Manual completo&#44; ap&#243;s valida&#231;&#227;o &#40;tamanho reduzido&#41;&#46; 1&#46; Capa&#59; 2&#46; Sum&#225;rio&#59; 3&#46; O que &#233; isotretino&#237;na&#63;&#59; 4&#46; O que &#233; acne inflamat&#243;ria grave&#63;&#59; 5&#46; O que devo contar ao meu m&#233;dico antes de usar isotretino&#237;na&#63;&#59; 6&#46; Como devo tomar isotretino&#237;na&#63;&#59; 7&#46; O que devo evitar enquanto estou usando isotretino&#237;na&#63;&#59; 8&#46; Quais os efeitos colaterais mais comuns da isotretino&#237;na&#63;&#59; 9&#46; O que devo contar imediatamente ao meu m&#233;dico enquanto uso isotretino&#237;na&#63;&#59; 10&#46; Teratogenicidade&#59; 11&#46; Exames laboratoriais&#59; 12&#46; Guarda do medicamento&#59; 13&#46; Perguntas frequentes&#59; 14&#46; Contracapa&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Let&#237;cia Santos Dexheimer, Camila Boff, Cec&#237;lia Cassal, Renan Rangel Bonamigo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Let&#237;cia Santos"
              "apellidos" => "Dexheimer"
            ]
            1 => array:2 [
              "nombre" => "Camila"
              "apellidos" => "Boff"
            ]
            2 => array:2 [
              "nombre" => "Cec&#237;lia"
              "apellidos" => "Cassal"
            ]
            3 => array:2 [
              "nombre" => "Renan Rangel"
              "apellidos" => "Bonamigo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059621001215"
        "doi" => "10.1016/j.abd.2020.08.018"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621001215?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001223?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009600000004/v1_202107170646/S2666275221001223/v1_202107170646/pt/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2666275221001211"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2020.07.023"
    "estado" => "S300"
    "fechaPublicacion" => "2021-07-01"
    "aid" => "380"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by/4.0/"
    "subdocumento" => "sco"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Evolu&#231;&#227;o cl&#237;nica da fun&#231;&#227;o neural em s&#233;rie de casos de neuropatia hans&#234;nica ap&#243;s neur&#243;lise ulnar"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "500"
          "paginaFinal" => "502"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Juliana Barroso&#8208;Freitas, Pedro Arthur da Rocha Ribas, Paula Frassinetti Bessa Rebello, Silmara Navarro&#8208;Pennini"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Juliana"
              "apellidos" => "Barroso&#8208;Freitas"
            ]
            1 => array:2 [
              "nombre" => "Pedro Arthur da Rocha"
              "apellidos" => "Ribas"
            ]
            2 => array:2 [
              "nombre" => "Paula Frassinetti Bessa"
              "apellidos" => "Rebello"
            ]
            3 => array:2 [
              "nombre" => "Silmara"
              "apellidos" => "Navarro&#8208;Pennini"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059621001203"
        "doi" => "10.1016/j.abd.2020.07.015"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "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 &#8208; Investiga&#231;&#227;o</span>"
    "titulo" => "Compara&#231;&#227;o da cardiotoxicidade entre N&#8208;metil&#8208;glucamina e miltefosina no tratamento da leishmaniose tegumentar americana"
    "tieneTextoCompleto" => true
    "saludo" => "Prezado Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "502"
        "paginaFinal" => "504"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Daniel Holanda Barroso, Ciro Martins Gomes, Ant&#244;nia 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">&#42;</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" => "Ant&#244;nia 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 Bras&#237;lia&#44; Bras&#237;lia&#44; DF&#44; Brazil"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Hospital Universit&#225;rio de Bras&#237;lia&#44; Universidade de Bras&#237;lia&#44; Bras&#237;lia&#44; DF &#44; Brazil"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A N&#8208;metil&#8208;glucamina &#40;NMG&#41; constitui a primeira op&#231;&#227;o terap&#234;utica para a leishmaniose tegumentar americana &#40;LTA&#41;&#44; mas causa muitos efeitos adversos&#46; Uma das complica&#231;&#245;es mais graves e temidas &#233; a morte s&#250;bita&#44; causada por altera&#231;&#245;es eletrofisiol&#243;gicas card&#237;acas associadas no eletrocardiograma &#40;ECG&#41; ao prolongamento do QT corrigido pela f&#243;rmula de Bazeett &#40;QTc&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#8211;3</span></a>A toxicidade dos antimoniais&#44; a ocorr&#234;ncias de recidivas da doen&#231;a e a resist&#234;ncia a essas subst&#226;ncias estimularam a busca por outros f&#225;rmacos ou esquemas terap&#234;uticos mais eficazes para o tratamento da LTA&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> Dessa situa&#231;&#227;o surgiu a miltefosina &#40;hexadecilfosfocolina&#41;&#44; que se mostrou efetiva contra v&#225;rias esp&#233;cies de <span class="elsevierStyleItalic">Leishmania</span> e outros protozo&#225;rios&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;6</span></a> O medicamento ativa o mecanismo de morte celular programada&#44; inibindo a s&#237;ntese de fosfatidilcolina&#44; importante para a s&#237;ntese e integridade da membrana celular&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Esse medicamento tem potencial teratog&#234;nico&#44; o que requer controle da natalidade durante a gesta&#231;&#227;o e at&#233; dois meses ap&#243;s o tratamento&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Realizou&#8208;se um estudo de coorte retrospectivo em dados dos registros de ECG de pacientes tratados para LTA &#40;20<span class="elsevierStyleHsp" style=""></span>mg SbV&#47;kg&#47;dia durante 20 dias para leishmaniose cut&#226;nea e 30 dias para a leishmaniose mucosa&#41; ou miltefosina &#40;1&#44;3 a 2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;dia &#8211; duas c&#225;psulas por dia por 28 dias&#41;&#44; acompanhados com ECG semanal em Servi&#231;o de Dermatologia entre&#160;2008 e&#160;2013&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Os crit&#233;rios de inclus&#227;o foram pacientes tratados para LTA com idade entre 18 e 85 anos&#44; sem uso de quaisquer outras medica&#231;&#245;es no momento e que n&#227;o tivessem sido tratados para LTA nos &#250;ltimos&#160;seis&#160;meses&#46; Os crit&#233;rios de exclus&#227;o foram gestantes&#44; portadores de doen&#231;a renal ou hep&#225;tica cr&#244;nicas&#44; cardiopatias graves ou outras doen&#231;as ou uso de subst&#226;ncias que pudessem interferir no ECG&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Os pacientes inclu&#237;dos foram divididos em dois grupos&#58; 1&#160;&#8211;&#160;tratados com NMG&#59; 2&#160;&#8211;&#160;tratados com miltefosina &#40;M&#41;&#46; Foram comparados nos grupos o risco relativo e o percentual de altera&#231;&#245;es no EGC durante o tratamento &#40;ritmo e frequ&#234;ncia card&#237;aca&#44; onda&#160;P&#44; complexo QRS&#44; intervalo de risco relativo <span class="elsevierStyleSup">RR</span>&#44; presen&#231;a ou aus&#234;ncia de arritmias e intervalo QTc&#41;&#46; Foi adotada para a frequ&#234;ncia card&#237;aca a faixa de normalidade entre 60 bpm e 100 bpm&#44; e o limite para o QTc de 440<span class="elsevierStyleHsp" style=""></span>ms para ambos os sexos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">As vari&#225;veis foram expressas em frequ&#234;ncia&#44; e a compara&#231;&#227;o entre os grupos foi feita pelo uso do teste de Qui&#8208;Quadrado ou pelo teste exato de Fisher quando mais de 20&#37; das caselas apresentaram frequ&#234;ncia esperada inferior a 5&#46; Considerou&#8208;se significativo p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Empregou&#8208;se um modelo multivariado e RR com intervalo de confian&#231;a &#40;IC&#41; de&#160;95&#37;&#44; calculados para analisar a intensidade da associa&#231;&#227;o entre cada vari&#225;vel independente e a propor&#231;&#227;o de efeitos adversos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foram analisados os prontu&#225;rios de&#160;111&#160;pacientes com recupera&#231;&#227;o dos dados epidemiol&#243;gicos e eletrocardiogr&#225;ficos de&#160;53&#160;indiv&#237;duos&#44; dos quais 38&#160;foram tratados com NMG e 15&#160;com M&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">A m&#233;dia de idade no grupo NMG foi de 48&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;29 anos&#44; enquanto no grupo M foi de&#160;58&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;16 anos&#44; e mostrou&#8208;se diferente entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;033&#41;&#46; No grupo NMG&#44; 23&#160;&#40;60&#44;5&#37;&#41; pacientes eram do sexo masculino&#44; e no grupo M foram&#160;sete&#160;&#40;46&#44;7&#37;&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;37&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">No s&#233;timo dia de tratamento &#40;D7&#41;&#44; 11&#44;4&#37; dos integrantes do grupo NMG e 33&#44;3&#37; do grupo&#160;M apresentaram QTc alargado&#46; No d&#233;cimo quarto dia &#40;D14&#41;&#44; 26&#44;6&#37; do grupo NMG apresentavam QTc alargado&#44; mas nenhum do grupo M&#46; A tend&#234;ncia se manteve no vig&#233;simo primeiro dia &#40;D21&#41;&#44; j&#225; que 35&#44;3&#37; do grupo NMG apresentaram QTc alterado enquanto n&#227;o houve altera&#231;&#245;es no grupo M&#46; Quanto &#224; frequ&#234;ncia card&#237;aca&#44; 28&#44;9&#37; dos pacientes do grupo NMG e 26&#44;6&#37; do grupo MTF apresentaram bradicardia durante o tratamento&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Antes do tratamento&#44;&#160;16&#160;&#40;21&#37;&#41; pacientes do grupo NMG e 37&#44;5&#37; do grupo da M apresentavam bradicardia &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;59&#59; IC 95&#37;&#58;&#160;0&#44;17&#160;a&#160;1&#44;99&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;44&#41;&#46; O QTc encontrava&#8208;se alargado em&#160;13&#44;51&#37; do grupo NMG e em 6&#44;66&#37; do grupo M &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;02&#59; IC 95&#37;&#58; 0&#44;26&#160;a&#160;15&#44;93&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;5495&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A &#250;nica diferen&#231;a significativa entre os grupos foi evidenciada no D7 de tratamento&#44; quando os pacientes tratados com miltefosina apresentaram mais frequentemente QTc<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>440 &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;25&#59; IC&#160;95&#37;&#58;&#160;0&#44;07&#160;a&#160;0&#44;94&#41;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04 &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Estudos anteriores j&#225; haviam mostrado que a miltefosina pode aumentar o intervalo QT durante o tratamento&#44; quando comparado como os valores basais&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> O prolongamento QT&#160;&#8805; 440&#160;ms traduz um aumento exagerado do potencial de a&#231;&#227;o&#44; levando a n&#227;o homogeneidade da matriz el&#233;trica ventricular&#44; favorecendo o aparecimento de fen&#244;menos de reentrada&#44; al&#233;m de favorecer despolariza&#231;&#245;es diast&#243;licas precoces e atividade &#8220;trigada&#8221;&#46; Esse prolongamento do QT se associa ao <span class="elsevierStyleItalic">Torsades de pointes</span>&#44; uma taquicardia ventricular polim&#243;rfica que pode exibir degenera&#231;&#227;o em fibrila&#231;&#227;o ventricular&#44; configurando o mecanismo arr&#237;tmico de morte s&#250;bita&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">3&#44;9</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Ao contr&#225;rio do esperado&#44; uma propor&#231;&#227;o maior de pacientes que fez uso de miltefosina apresentou QTc<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>440<span class="elsevierStyleHsp" style=""></span>ms no D7&#44; mas essa diferen&#231;a n&#227;o se manteve nas segunda e terceira semanas&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">O envelhecimento &#233; fator de altera&#231;&#245;es eletrocardiogr&#225;ficas&#44; e os pacientes do grupo M tinham maior m&#233;dia de idade&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Mas&#44; por outro lado&#44; essas altera&#231;&#245;es j&#225; estavam presentes no pr&#233;&#8208;tratamento&#44; o que nos leva a crer que a idade n&#227;o tenha tido papel determinante nas altera&#231;&#245;es&#46; Outra limita&#231;&#227;o &#233; a realiza&#231;&#227;o de m&#250;ltiplos testes&#44; que pode aumentar a taxa de erros do tipo&#160;1&#46;<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 tend&#234;ncia do tratamento da LTA com a associa&#231;&#227;o de subst&#226;ncias potencialmente cardiot&#243;xicas &#40;antimoniais&#44; anfotericina&#41;&#44; esse achado deve ser mais bem estudado em esquemas com combina&#231;&#245;es de f&#225;rmacos&#46; Este parece ser o primeiro estudo a evidenciar altera&#231;&#245;es de ECG da M ao longo do tratamento&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> Esses achados&#44; entretanto&#44; t&#234;m car&#225;ter explorat&#243;rio e merecem ser confirmados por estudos com maior n&#250;mero de pacientes&#46;</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&#44; por meio da Funaderme e da Funda&#231;&#227;o de Apoio &#224; Pesquisa do Distrito Federal &#40;FAP&#8208;DF&#41;&#44; n&#250;mero&#160;0193&#46;001447&#47;2016&#44; agradece pelo apoio financeiro&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0085" class="elsevierStylePara elsevierViewall">Daniel Holanda Barroso&#58; Escreveu o manuscrito an&#225;lise dos dados&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Ciro Martins Gomes&#58; Revisou o manuscrito&#59; realizou exames de biologia molecular e analisou os dados&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Ant&#244;nia Marilene da Silva&#58; Escreveu o manuscrito e analisou os dados cardiol&#243;gicos&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Raimunda Nonata Ribeiro Sampaio&#58; Analisou os dados&#59; escreveu e revisou o manuscrito&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0105" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:5 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Suporte financeiro"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Contribui&#231;&#227;o dos autores"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflito de interesses"
        ]
        3 => array:2 [
          "identificador" => "xack546160"
          "titulo" => "Agradecimentos"
        ]
        4 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-11-29"
    "fechaAceptado" => "2021-02-26"
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Como citar este artigo&#58; Barroso DH&#44; Gomes CM&#44; Silva AM&#44; Sampaio RNR&#46; Comparison of cardiotoxicity between N&#8208;methyl&#8208;glucamine and miltefosine in the treatment of American cutaneous leishmaniasis&#46; An Bras Dermatol&#46; 2021&#59;96&#58;502&#8211;4&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Trabalho realizado no Hospital Universit&#225;rio de Bras&#237;lia e no Laborat&#243;rio de Dermatomicologia&#44; Faculdade de Medicina&#44; Universidade de Bras&#237;lia&#44; Bras&#237;lia&#44; DF&#44; Brasil&#46;</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&#44; intervalo de confian&#231;a&#59; RR&#44; risco relativo&#46;</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">&nbsp;\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>&#62;<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">&nbsp;\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 &#40;IC 95&#37;&#41;&nbsp;\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&nbsp;\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 &#40;IC 95&#37;&#41;&nbsp;\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&nbsp;\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 &#40;IC 95&#37;&#41;&nbsp;\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&nbsp;\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>&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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&nbsp;\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&#44;14 &#40;0&#44;31&#8211;4&#44;23&#41;&nbsp;\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&#44;87&nbsp;\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&#44;25 &#40;0&#44;07&#8211;0&#44;94&#41;&nbsp;\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&#44;04&nbsp;\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&#44;85 &#40;0&#44;08&#8211;8&#44;74&#41;&nbsp;\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&#44;87&nbsp;\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&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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>&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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&nbsp;\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&#44;53 &#40;0&#44;07&#8211;3&#44;66&#41;&nbsp;\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&#44;58&nbsp;\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&#44;58 &#40;0&#44;41&#8211;105&#44;36&#41;&nbsp;\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&#44;18&nbsp;\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&#44;93 &#40;0&#44;10&#8211;37&#44;44&#41;&nbsp;\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&#44;66&nbsp;\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&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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>&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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&nbsp;\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&#44;94 &#40;0&#44;12&#8211;31&#44;74&#41;&nbsp;\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&#44;64&nbsp;\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&#44;22 &#40;0&#44;45&#8211;115&#44;33&#41;&nbsp;\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&#44;16&nbsp;\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&#44;94 &#40;0&#44;16&#8211;55&#44;31&#41;&nbsp;\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&#44;47&nbsp;\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&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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>&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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&nbsp;\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&#44;36 &#40;0&#44;03&#8211;4&#44;54&#41;&nbsp;\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&#44;53&nbsp;\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&#44;54 &#40;0&#44;04&#8211;7&#44;25&#41;&nbsp;\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&#44;70&nbsp;\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&#44;13 &#40;0&#44;006&#8211;2&#44;86&#41;&nbsp;\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&#44;20&nbsp;\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&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&#58; extrass&#237;stoles ventriculares isoladas&#46;</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" => "Refer&#234;ncias"
      "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" => "Minist&#233;rio da Sa&#250;de&#44; Departamento de Vigil&#226;ncia&#44; Epidemiol&#243;gica&#46;&#44; Manual de Vigil&#226;ncia e Controle da Leishmaniose Tegumentar Americana&#44; atualizada&#46;&#44; Bras&#237;lia&#58; Minist&#233;rio da Sa&#250;de&#59;&#46; 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&#46; Antezana"
                            1 => "R&#46; Zeballos"
                            2 => "C&#46; Mendoza"
                            3 => "P&#46; Lyevre"
                            4 => "L&#46; Valda"
                            5 => "F&#46; 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&#46;"
                        "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&#46;N&#46;R&#46; Sampaio"
                            1 => "E&#46; Martins Netto"
                            2 => "E&#46;A&#46; Faria"
                            3 => "J&#46;H&#46;D&#46; Sampaio"
                            4 => "L&#46;C&#46;F&#46; Freitas"
                            5 => "P&#46;D&#46; Marsden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "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&#58; oral treatment of leishmaniasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Soto"
                            1 => "P&#46; Soto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1586/14787210.4.2.177"
                      "Revista" => array:6 [
                        "tituloSerie" => "Expert Rev Anti Infect Ther&#46;"
                        "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&#58; clinical evidence for informed clinical risk management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Sundar"
                            1 => "P&#46;L&#46; Olliaro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ther Clin Risk Manag&#46;"
                        "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 &#40;Viannia&#41; guyanensis in Manaus&#44; Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Chrusciak Talhari"
                            1 => "R&#46; Dietze"
                            2 => "C&#46; Chrusciak Talhari"
                            3 => "R&#46;M&#46; Silva"
                            4 => "E&#46;P&#46;G&#46; Yamashita"
                            5 => "G&#46;O&#46; Penna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4269/ajtmh.2011.10-0155"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Trop Med Hyg&#46;"
                        "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&#58; considerations for primary care physicians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Levine"
                            1 => "S&#46;Z&#46; Rosero"
                            2 => "A&#46;S&#46; Budzikowski"
                            3 => "A&#46;J&#46; Moss"
                            4 => "W&#46; Zareba"
                            5 => "J&#46;P&#46; Daubert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clevel Clin J Med&#46;"
                        "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&#46; Sundar"
                            1 => "T&#46;K&#46; Jha"
                            2 => "C&#46;P&#46; Thakur"
                            3 => "J&#46; Engel"
                            4 => "H&#46; Sindermann"
                            5 => "C&#46; Fischer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa021556"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med&#46;"
                        "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 S&#237;ndrome de QT Longo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46;A&#46; Oliveira Jr&#46;"
                            1 => "E&#46;M&#46; Andr&#233;a"
                            2 => "W&#46;A&#46; Maciel"
                            3 => "L&#46;R&#46; Siqueira"
                            4 => "J&#46; Ati&#233;"
                            5 => "R&#46; Cosenza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev SOCERJ&#46;"
                        "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&#46;S&#46; Khane"
                            1 => "A&#46;D&#46; Surdi"
                            2 => "R&#46;S&#46; Bhatkar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/JBCPP.2011.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Basic Clin Physiol Pharmacol&#46;"
                        "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&#46; Intuitive biostatistics&#58; a nonmathematical guide to statistical thinking&#46; 4th ed&#46; USA&#58; Oxford University Press&#59; 2018&#46;"
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "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&#44; pelo apoio operacional&#46;</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 - Investiga&#231;&#227;o"
      "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"
]
Compartilhar
Informação da revista

Estatísticas

Siga este link para acessar o texto completo do artigo

Carta ‐ Investigação
Comparação da cardiotoxicidade entre N‐metil‐glucamina e miltefosina no tratamento da leishmaniose tegumentar americana
Daniel Holanda Barrosoa,
Autor para correspondência
Danielhbarroso@unb.br

Autor para correspondência.
, Ciro Martins Gomesa, Antônia Marilene da Silvaa, Raimunda Nonata Ribeiro Sampaioa,b
a Universidade de Brasília, Brasília, DF, Brazil
b Hospital Universitário de Brasília, Universidade de Brasília, Brasília, DF , Brazil
Lido
6257
Vezes
que se leu este artigo
2538
Total PDF
3719
Total HTML
Compartilhar estatísticas
 array:24 [
  "pii" => "S2666275221001077"
  "issn" => "26662752"
  "doi" => "10.1016/j.abdp.2021.02.003"
  "estado" => "S300"
  "fechaPublicacion" => "2021-07-01"
  "aid" => "366"
  "copyright" => "Sociedade Brasileira de Dermatologia"
  "copyrightAnyo" => "2021"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by/4.0/"
  "subdocumento" => "sco"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S0365059621001069"
      "issn" => "03650596"
      "doi" => "10.1016/j.abd.2021.02.002"
      "estado" => "S300"
      "fechaPublicacion" => "2021-07-01"
      "aid" => "366"
      "copyright" => "Sociedade Brasileira de Dermatologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by/4.0/"
      "subdocumento" => "sco"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:9 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Research Letter</span>"
        "titulo" => "Comparison of cardiotoxicity between N-methyl-glucamine and miltefosine in the treatment of American cutaneous leishmaniasis"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "502"
            "paginaFinal" => "504"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Daniel Holanda Barroso, Ciro Martins Gomes, Ant&#244;nia Marilene da Silva, Raimunda Nonata Ribeiro Sampaio"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Daniel Holanda"
                "apellidos" => "Barroso"
              ]
              1 => array:2 [
                "nombre" => "Ciro Martins"
                "apellidos" => "Gomes"
              ]
              2 => array:2 [
                "nombre" => "Ant&#244;nia Marilene da"
                "apellidos" => "Silva"
              ]
              3 => array:2 [
                "nombre" => "Raimunda Nonata Ribeiro"
                "apellidos" => "Sampaio"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2666275221001077"
          "doi" => "10.1016/j.abdp.2021.02.003"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001077?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621001069?idApp=UINPBA00008Z"
      "url" => "/03650596/0000009600000004/v4_202107160617/S0365059621001069/v4_202107160617/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2666275221001223"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2020.08.018"
    "estado" => "S300"
    "fechaPublicacion" => "2021-07-01"
    "aid" => "381"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by/4.0/"
    "subdocumento" => "sco"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Elabora&#231;&#227;o e valida&#231;&#227;o de material educativo impresso para utiliza&#231;&#227;o dos usu&#225;rios de isotretino&#237;na"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "504"
          "paginaFinal" => "507"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 905
              "Ancho" => 2341
              "Tamanyo" => 276690
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Manual completo&#44; ap&#243;s valida&#231;&#227;o &#40;tamanho reduzido&#41;&#46; 1&#46; Capa&#59; 2&#46; Sum&#225;rio&#59; 3&#46; O que &#233; isotretino&#237;na&#63;&#59; 4&#46; O que &#233; acne inflamat&#243;ria grave&#63;&#59; 5&#46; O que devo contar ao meu m&#233;dico antes de usar isotretino&#237;na&#63;&#59; 6&#46; Como devo tomar isotretino&#237;na&#63;&#59; 7&#46; O que devo evitar enquanto estou usando isotretino&#237;na&#63;&#59; 8&#46; Quais os efeitos colaterais mais comuns da isotretino&#237;na&#63;&#59; 9&#46; O que devo contar imediatamente ao meu m&#233;dico enquanto uso isotretino&#237;na&#63;&#59; 10&#46; Teratogenicidade&#59; 11&#46; Exames laboratoriais&#59; 12&#46; Guarda do medicamento&#59; 13&#46; Perguntas frequentes&#59; 14&#46; Contracapa&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Let&#237;cia Santos Dexheimer, Camila Boff, Cec&#237;lia Cassal, Renan Rangel Bonamigo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Let&#237;cia Santos"
              "apellidos" => "Dexheimer"
            ]
            1 => array:2 [
              "nombre" => "Camila"
              "apellidos" => "Boff"
            ]
            2 => array:2 [
              "nombre" => "Cec&#237;lia"
              "apellidos" => "Cassal"
            ]
            3 => array:2 [
              "nombre" => "Renan Rangel"
              "apellidos" => "Bonamigo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059621001215"
        "doi" => "10.1016/j.abd.2020.08.018"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621001215?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275221001223?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009600000004/v1_202107170646/S2666275221001223/v1_202107170646/pt/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2666275221001211"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2020.07.023"
    "estado" => "S300"
    "fechaPublicacion" => "2021-07-01"
    "aid" => "380"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by/4.0/"
    "subdocumento" => "sco"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:9 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Evolu&#231;&#227;o cl&#237;nica da fun&#231;&#227;o neural em s&#233;rie de casos de neuropatia hans&#234;nica ap&#243;s neur&#243;lise ulnar"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "500"
          "paginaFinal" => "502"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Juliana Barroso&#8208;Freitas, Pedro Arthur da Rocha Ribas, Paula Frassinetti Bessa Rebello, Silmara Navarro&#8208;Pennini"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Juliana"
              "apellidos" => "Barroso&#8208;Freitas"
            ]
            1 => array:2 [
              "nombre" => "Pedro Arthur da Rocha"
              "apellidos" => "Ribas"
            ]
            2 => array:2 [
              "nombre" => "Paula Frassinetti Bessa"
              "apellidos" => "Rebello"
            ]
            3 => array:2 [
              "nombre" => "Silmara"
              "apellidos" => "Navarro&#8208;Pennini"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059621001203"
        "doi" => "10.1016/j.abd.2020.07.015"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "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 &#8208; Investiga&#231;&#227;o</span>"
    "titulo" => "Compara&#231;&#227;o da cardiotoxicidade entre N&#8208;metil&#8208;glucamina e miltefosina no tratamento da leishmaniose tegumentar americana"
    "tieneTextoCompleto" => true
    "saludo" => "Prezado Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "502"
        "paginaFinal" => "504"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Daniel Holanda Barroso, Ciro Martins Gomes, Ant&#244;nia 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">&#42;</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" => "Ant&#244;nia 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 Bras&#237;lia&#44; Bras&#237;lia&#44; DF&#44; Brazil"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Hospital Universit&#225;rio de Bras&#237;lia&#44; Universidade de Bras&#237;lia&#44; Bras&#237;lia&#44; DF &#44; Brazil"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A N&#8208;metil&#8208;glucamina &#40;NMG&#41; constitui a primeira op&#231;&#227;o terap&#234;utica para a leishmaniose tegumentar americana &#40;LTA&#41;&#44; mas causa muitos efeitos adversos&#46; Uma das complica&#231;&#245;es mais graves e temidas &#233; a morte s&#250;bita&#44; causada por altera&#231;&#245;es eletrofisiol&#243;gicas card&#237;acas associadas no eletrocardiograma &#40;ECG&#41; ao prolongamento do QT corrigido pela f&#243;rmula de Bazeett &#40;QTc&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#8211;3</span></a>A toxicidade dos antimoniais&#44; a ocorr&#234;ncias de recidivas da doen&#231;a e a resist&#234;ncia a essas subst&#226;ncias estimularam a busca por outros f&#225;rmacos ou esquemas terap&#234;uticos mais eficazes para o tratamento da LTA&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> Dessa situa&#231;&#227;o surgiu a miltefosina &#40;hexadecilfosfocolina&#41;&#44; que se mostrou efetiva contra v&#225;rias esp&#233;cies de <span class="elsevierStyleItalic">Leishmania</span> e outros protozo&#225;rios&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;6</span></a> O medicamento ativa o mecanismo de morte celular programada&#44; inibindo a s&#237;ntese de fosfatidilcolina&#44; importante para a s&#237;ntese e integridade da membrana celular&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Esse medicamento tem potencial teratog&#234;nico&#44; o que requer controle da natalidade durante a gesta&#231;&#227;o e at&#233; dois meses ap&#243;s o tratamento&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Realizou&#8208;se um estudo de coorte retrospectivo em dados dos registros de ECG de pacientes tratados para LTA &#40;20<span class="elsevierStyleHsp" style=""></span>mg SbV&#47;kg&#47;dia durante 20 dias para leishmaniose cut&#226;nea e 30 dias para a leishmaniose mucosa&#41; ou miltefosina &#40;1&#44;3 a 2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;dia &#8211; duas c&#225;psulas por dia por 28 dias&#41;&#44; acompanhados com ECG semanal em Servi&#231;o de Dermatologia entre&#160;2008 e&#160;2013&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Os crit&#233;rios de inclus&#227;o foram pacientes tratados para LTA com idade entre 18 e 85 anos&#44; sem uso de quaisquer outras medica&#231;&#245;es no momento e que n&#227;o tivessem sido tratados para LTA nos &#250;ltimos&#160;seis&#160;meses&#46; Os crit&#233;rios de exclus&#227;o foram gestantes&#44; portadores de doen&#231;a renal ou hep&#225;tica cr&#244;nicas&#44; cardiopatias graves ou outras doen&#231;as ou uso de subst&#226;ncias que pudessem interferir no ECG&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Os pacientes inclu&#237;dos foram divididos em dois grupos&#58; 1&#160;&#8211;&#160;tratados com NMG&#59; 2&#160;&#8211;&#160;tratados com miltefosina &#40;M&#41;&#46; Foram comparados nos grupos o risco relativo e o percentual de altera&#231;&#245;es no EGC durante o tratamento &#40;ritmo e frequ&#234;ncia card&#237;aca&#44; onda&#160;P&#44; complexo QRS&#44; intervalo de risco relativo <span class="elsevierStyleSup">RR</span>&#44; presen&#231;a ou aus&#234;ncia de arritmias e intervalo QTc&#41;&#46; Foi adotada para a frequ&#234;ncia card&#237;aca a faixa de normalidade entre 60 bpm e 100 bpm&#44; e o limite para o QTc de 440<span class="elsevierStyleHsp" style=""></span>ms para ambos os sexos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">As vari&#225;veis foram expressas em frequ&#234;ncia&#44; e a compara&#231;&#227;o entre os grupos foi feita pelo uso do teste de Qui&#8208;Quadrado ou pelo teste exato de Fisher quando mais de 20&#37; das caselas apresentaram frequ&#234;ncia esperada inferior a 5&#46; Considerou&#8208;se significativo p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Empregou&#8208;se um modelo multivariado e RR com intervalo de confian&#231;a &#40;IC&#41; de&#160;95&#37;&#44; calculados para analisar a intensidade da associa&#231;&#227;o entre cada vari&#225;vel independente e a propor&#231;&#227;o de efeitos adversos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foram analisados os prontu&#225;rios de&#160;111&#160;pacientes com recupera&#231;&#227;o dos dados epidemiol&#243;gicos e eletrocardiogr&#225;ficos de&#160;53&#160;indiv&#237;duos&#44; dos quais 38&#160;foram tratados com NMG e 15&#160;com M&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">A m&#233;dia de idade no grupo NMG foi de 48&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;29 anos&#44; enquanto no grupo M foi de&#160;58&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;16 anos&#44; e mostrou&#8208;se diferente entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;033&#41;&#46; No grupo NMG&#44; 23&#160;&#40;60&#44;5&#37;&#41; pacientes eram do sexo masculino&#44; e no grupo M foram&#160;sete&#160;&#40;46&#44;7&#37;&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;37&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">No s&#233;timo dia de tratamento &#40;D7&#41;&#44; 11&#44;4&#37; dos integrantes do grupo NMG e 33&#44;3&#37; do grupo&#160;M apresentaram QTc alargado&#46; No d&#233;cimo quarto dia &#40;D14&#41;&#44; 26&#44;6&#37; do grupo NMG apresentavam QTc alargado&#44; mas nenhum do grupo M&#46; A tend&#234;ncia se manteve no vig&#233;simo primeiro dia &#40;D21&#41;&#44; j&#225; que 35&#44;3&#37; do grupo NMG apresentaram QTc alterado enquanto n&#227;o houve altera&#231;&#245;es no grupo M&#46; Quanto &#224; frequ&#234;ncia card&#237;aca&#44; 28&#44;9&#37; dos pacientes do grupo NMG e 26&#44;6&#37; do grupo MTF apresentaram bradicardia durante o tratamento&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Antes do tratamento&#44;&#160;16&#160;&#40;21&#37;&#41; pacientes do grupo NMG e 37&#44;5&#37; do grupo da M apresentavam bradicardia &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;59&#59; IC 95&#37;&#58;&#160;0&#44;17&#160;a&#160;1&#44;99&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;44&#41;&#46; O QTc encontrava&#8208;se alargado em&#160;13&#44;51&#37; do grupo NMG e em 6&#44;66&#37; do grupo M &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;02&#59; IC 95&#37;&#58; 0&#44;26&#160;a&#160;15&#44;93&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;5495&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A &#250;nica diferen&#231;a significativa entre os grupos foi evidenciada no D7 de tratamento&#44; quando os pacientes tratados com miltefosina apresentaram mais frequentemente QTc<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>440 &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;25&#59; IC&#160;95&#37;&#58;&#160;0&#44;07&#160;a&#160;0&#44;94&#41;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04 &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Estudos anteriores j&#225; haviam mostrado que a miltefosina pode aumentar o intervalo QT durante o tratamento&#44; quando comparado como os valores basais&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> O prolongamento QT&#160;&#8805; 440&#160;ms traduz um aumento exagerado do potencial de a&#231;&#227;o&#44; levando a n&#227;o homogeneidade da matriz el&#233;trica ventricular&#44; favorecendo o aparecimento de fen&#244;menos de reentrada&#44; al&#233;m de favorecer despolariza&#231;&#245;es diast&#243;licas precoces e atividade &#8220;trigada&#8221;&#46; Esse prolongamento do QT se associa ao <span class="elsevierStyleItalic">Torsades de pointes</span>&#44; uma taquicardia ventricular polim&#243;rfica que pode exibir degenera&#231;&#227;o em fibrila&#231;&#227;o ventricular&#44; configurando o mecanismo arr&#237;tmico de morte s&#250;bita&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">3&#44;9</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Ao contr&#225;rio do esperado&#44; uma propor&#231;&#227;o maior de pacientes que fez uso de miltefosina apresentou QTc<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>440<span class="elsevierStyleHsp" style=""></span>ms no D7&#44; mas essa diferen&#231;a n&#227;o se manteve nas segunda e terceira semanas&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">O envelhecimento &#233; fator de altera&#231;&#245;es eletrocardiogr&#225;ficas&#44; e os pacientes do grupo M tinham maior m&#233;dia de idade&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Mas&#44; por outro lado&#44; essas altera&#231;&#245;es j&#225; estavam presentes no pr&#233;&#8208;tratamento&#44; o que nos leva a crer que a idade n&#227;o tenha tido papel determinante nas altera&#231;&#245;es&#46; Outra limita&#231;&#227;o &#233; a realiza&#231;&#227;o de m&#250;ltiplos testes&#44; que pode aumentar a taxa de erros do tipo&#160;1&#46;<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 tend&#234;ncia do tratamento da LTA com a associa&#231;&#227;o de subst&#226;ncias potencialmente cardiot&#243;xicas &#40;antimoniais&#44; anfotericina&#41;&#44; esse achado deve ser mais bem estudado em esquemas com combina&#231;&#245;es de f&#225;rmacos&#46; Este parece ser o primeiro estudo a evidenciar altera&#231;&#245;es de ECG da M ao longo do tratamento&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> Esses achados&#44; entretanto&#44; t&#234;m car&#225;ter explorat&#243;rio e merecem ser confirmados por estudos com maior n&#250;mero de pacientes&#46;</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&#44; por meio da Funaderme e da Funda&#231;&#227;o de Apoio &#224; Pesquisa do Distrito Federal &#40;FAP&#8208;DF&#41;&#44; n&#250;mero&#160;0193&#46;001447&#47;2016&#44; agradece pelo apoio financeiro&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0085" class="elsevierStylePara elsevierViewall">Daniel Holanda Barroso&#58; Escreveu o manuscrito an&#225;lise dos dados&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Ciro Martins Gomes&#58; Revisou o manuscrito&#59; realizou exames de biologia molecular e analisou os dados&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Ant&#244;nia Marilene da Silva&#58; Escreveu o manuscrito e analisou os dados cardiol&#243;gicos&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Raimunda Nonata Ribeiro Sampaio&#58; Analisou os dados&#59; escreveu e revisou o manuscrito&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0105" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:5 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Suporte financeiro"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Contribui&#231;&#227;o dos autores"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflito de interesses"
        ]
        3 => array:2 [
          "identificador" => "xack546160"
          "titulo" => "Agradecimentos"
        ]
        4 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-11-29"
    "fechaAceptado" => "2021-02-26"
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Como citar este artigo&#58; Barroso DH&#44; Gomes CM&#44; Silva AM&#44; Sampaio RNR&#46; Comparison of cardiotoxicity between N&#8208;methyl&#8208;glucamine and miltefosine in the treatment of American cutaneous leishmaniasis&#46; An Bras Dermatol&#46; 2021&#59;96&#58;502&#8211;4&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Trabalho realizado no Hospital Universit&#225;rio de Bras&#237;lia e no Laborat&#243;rio de Dermatomicologia&#44; Faculdade de Medicina&#44; Universidade de Bras&#237;lia&#44; Bras&#237;lia&#44; DF&#44; Brasil&#46;</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&#44; intervalo de confian&#231;a&#59; RR&#44; risco relativo&#46;</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">&nbsp;\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>&#62;<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">&nbsp;\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 &#40;IC 95&#37;&#41;&nbsp;\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&nbsp;\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 &#40;IC 95&#37;&#41;&nbsp;\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&nbsp;\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 &#40;IC 95&#37;&#41;&nbsp;\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&nbsp;\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>&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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&nbsp;\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&#44;14 &#40;0&#44;31&#8211;4&#44;23&#41;&nbsp;\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&#44;87&nbsp;\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&#44;25 &#40;0&#44;07&#8211;0&#44;94&#41;&nbsp;\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&#44;04&nbsp;\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&#44;85 &#40;0&#44;08&#8211;8&#44;74&#41;&nbsp;\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&#44;87&nbsp;\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&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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>&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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&nbsp;\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&#44;53 &#40;0&#44;07&#8211;3&#44;66&#41;&nbsp;\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&#44;58&nbsp;\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&#44;58 &#40;0&#44;41&#8211;105&#44;36&#41;&nbsp;\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&#44;18&nbsp;\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&#44;93 &#40;0&#44;10&#8211;37&#44;44&#41;&nbsp;\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&#44;66&nbsp;\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&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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>&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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&nbsp;\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&#44;94 &#40;0&#44;12&#8211;31&#44;74&#41;&nbsp;\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&#44;64&nbsp;\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&#44;22 &#40;0&#44;45&#8211;115&#44;33&#41;&nbsp;\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&#44;16&nbsp;\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&#44;94 &#40;0&#44;16&#8211;55&#44;31&#41;&nbsp;\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&#44;47&nbsp;\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&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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>&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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">&nbsp;\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&nbsp;\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&#44;36 &#40;0&#44;03&#8211;4&#44;54&#41;&nbsp;\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&#44;53&nbsp;\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&#44;54 &#40;0&#44;04&#8211;7&#44;25&#41;&nbsp;\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&#44;70&nbsp;\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&#44;13 &#40;0&#44;006&#8211;2&#44;86&#41;&nbsp;\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&#44;20&nbsp;\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&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\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">&nbsp;\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&#58; extrass&#237;stoles ventriculares isoladas&#46;</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" => "Refer&#234;ncias"
      "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" => "Minist&#233;rio da Sa&#250;de&#44; Departamento de Vigil&#226;ncia&#44; Epidemiol&#243;gica&#46;&#44; Manual de Vigil&#226;ncia e Controle da Leishmaniose Tegumentar Americana&#44; atualizada&#46;&#44; Bras&#237;lia&#58; Minist&#233;rio da Sa&#250;de&#59;&#46; 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&#46; Antezana"
                            1 => "R&#46; Zeballos"
                            2 => "C&#46; Mendoza"
                            3 => "P&#46; Lyevre"
                            4 => "L&#46; Valda"
                            5 => "F&#46; 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&#46;"
                        "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&#46;N&#46;R&#46; Sampaio"
                            1 => "E&#46; Martins Netto"
                            2 => "E&#46;A&#46; Faria"
                            3 => "J&#46;H&#46;D&#46; Sampaio"
                            4 => "L&#46;C&#46;F&#46; Freitas"
                            5 => "P&#46;D&#46; Marsden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "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&#58; oral treatment of leishmaniasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Soto"
                            1 => "P&#46; Soto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1586/14787210.4.2.177"
                      "Revista" => array:6 [
                        "tituloSerie" => "Expert Rev Anti Infect Ther&#46;"
                        "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&#58; clinical evidence for informed clinical risk management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Sundar"
                            1 => "P&#46;L&#46; Olliaro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ther Clin Risk Manag&#46;"
                        "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 &#40;Viannia&#41; guyanensis in Manaus&#44; Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Chrusciak Talhari"
                            1 => "R&#46; Dietze"
                            2 => "C&#46; Chrusciak Talhari"
                            3 => "R&#46;M&#46; Silva"
                            4 => "E&#46;P&#46;G&#46; Yamashita"
                            5 => "G&#46;O&#46; Penna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4269/ajtmh.2011.10-0155"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Trop Med Hyg&#46;"
                        "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&#58; considerations for primary care physicians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Levine"
                            1 => "S&#46;Z&#46; Rosero"
                            2 => "A&#46;S&#46; Budzikowski"
                            3 => "A&#46;J&#46; Moss"
                            4 => "W&#46; Zareba"
                            5 => "J&#46;P&#46; Daubert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clevel Clin J Med&#46;"
                        "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&#46; Sundar"
                            1 => "T&#46;K&#46; Jha"
                            2 => "C&#46;P&#46; Thakur"
                            3 => "J&#46; Engel"
                            4 => "H&#46; Sindermann"
                            5 => "C&#46; Fischer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa021556"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med&#46;"
                        "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 S&#237;ndrome de QT Longo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46;A&#46; Oliveira Jr&#46;"
                            1 => "E&#46;M&#46; Andr&#233;a"
                            2 => "W&#46;A&#46; Maciel"
                            3 => "L&#46;R&#46; Siqueira"
                            4 => "J&#46; Ati&#233;"
                            5 => "R&#46; Cosenza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev SOCERJ&#46;"
                        "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&#46;S&#46; Khane"
                            1 => "A&#46;D&#46; Surdi"
                            2 => "R&#46;S&#46; Bhatkar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/JBCPP.2011.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Basic Clin Physiol Pharmacol&#46;"
                        "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&#46; Intuitive biostatistics&#58; a nonmathematical guide to statistical thinking&#46; 4th ed&#46; USA&#58; Oxford University Press&#59; 2018&#46;"
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "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&#44; pelo apoio operacional&#46;</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 - Investiga&#231;&#227;o"
      "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"
]
Informação do artigo
ISSN: 26662752
Idioma original: Português
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Novembro 24 7 31
2024 Outubro 116 69 185
2024 Setembro 143 88 231
2024 Agosto 171 116 287
2024 Julho 154 107 261
2024 Junho 138 63 201
2024 Maio 145 55 200
2024 Abril 114 70 184
2024 Março 114 64 178
2024 Fevereiro 120 84 204
2024 Janeiro 99 48 147
2023 Dezembro 76 47 123
2023 Novembro 96 82 178
2023 Outubro 137 58 195
2023 Setembro 121 61 182
2023 Agosto 101 42 143
2023 Julho 130 22 152
2023 Junho 105 49 154
2023 Maio 93 27 120
2023 Abril 56 13 69
2023 Março 71 33 104
2023 Fevereiro 64 32 96
2023 Janeiro 51 47 98
2022 Dezembro 56 31 87
2022 Novembro 74 55 129
2022 Outubro 113 52 165
2022 Setembro 64 66 130
2022 Agosto 56 61 117
2022 Julho 50 58 108
2022 Junho 61 69 130
2022 Maio 52 55 107
2022 Abril 83 53 136
2022 Março 71 88 159
2022 Fevereiro 44 55 99
2022 Janeiro 77 95 172
2021 Dezembro 53 56 109
2021 Novembro 59 77 136
2021 Outubro 64 96 160
2021 Setembro 79 84 163
2021 Agosto 102 102 204
2021 Julho 95 75 170
2021 Junho 27 26 53
Mostrar tudo

Siga este link para acessar o texto completo do artigo

Idiomas
Anais Brasileiros de Dermatologia (Portuguese)
en pt
Cookies policy Política de cookies
To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.