Asunto(s)
Paracoccidioides , Paracoccidioidomicosis , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/microbiología , Paracoccidioidomicosis/patología , Humanos , Paracoccidioides/aislamiento & purificación , Paracoccidioides/genética , Masculino , Enfermedades de la Boca/microbiología , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/patología , Antifúngicos/uso terapéutico , Histocitoquímica , Microscopía , Persona de Mediana EdadRESUMEN
BACKGROUND: We aimed to analyze recent infant and neonatal mortality from congenital heart defects (CHD) in Costa Rica, a middle-income country where CHD mortality was above expectations. METHODS: A descriptive analysis of infant and neonatal mortality rates from CHD (IMR-CHD and NMR-CHD) during 2000-2019 was performed, according to province, sex, specific CHD, and sub-period, using data from the National Institute of Statistics and Censuses. We used joinpoint regression to identify any calendar-year where a significant change in trend occurred; the average annual percent change (AAPC) was determined. Using Poisson regression, marginal means and mortality ratios (MR) for IMR-CHD and NMR-CHD by sub-period (2000-2006-referent-, 2007-2013, 2014-2019) were estimated and compared using Wald's chi-square tests (α ≤ .05). RESULTS: During 2000-2019, CHD accounted for 12% of overall infant mortality. IMR-CHD and NMR-CHD decreased linearly over the study period (AAPC = -3.4; p < .01). IMR-CHD decreased by 41%, from 13.6 per 10,000 in 2000-2006 (13.4% of infant mortality) to 8.1 per 10,000 in 2014-2019 (10% of infant mortality) (MR = 0.59; 95% confidence intervals [CI] = 0.52-0.68). NMR-CHD decreased by 38%, from 7.9 per 10,000 in 2000-2006 (11.1% of neonatal mortality) to 4.9 per 10,000 in 2014-2019 (7.9% of infant mortality) (MR = 0.59; 95% CI = 0.52-0.68). Male presented significantly higher NMR-CHD. The main causes of mortality (2014-2019) were total anomalous pulmonary venous connections, hypoplastic left heart syndrome, and double inlet ventricle. CONCLUSIONS: IMR-CHD, NMR-CHD, and their proportional contribution to mortality by all causes and by birth defects decreased significantly, demonstrating that all improvements implemented in the last decades have yielded favorable results.
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Cardiopatías Congénitas , Mortalidad Infantil , Lactante , Recién Nacido , Humanos , Masculino , Costa Rica/epidemiología , RentaRESUMEN
ABSTRACT: The aim of this research was to investigate the radiographic, clinical, and histological features of cases of ameloblastoma from a period of 17 years in a Brazilian center and to explore potential differences in children and adolescen ts in relation to adults. Seventy-five patients diagnosed with ameloblastoma from 2001 to 2018 were included. Data from each patient including gender, age, histologic type, location, and radiographic characteristics were reviewed and analyzed retrospectively. The association between the clinical, radiographic, and histologic findings was investigated. No differences regarding the histological pattern of the lesions were observed between groups. Children and adolescents presented well- defined lesions associated with an unerupted tooth compared to adults (p<0.05). The presence of an unerupted tooth was associated with cortical erosion and expansion and MC displacement (p<0.05). Despite similar histologic characteristics, differential radiographic appearance was observed between young patients and adults.
RESUMEN: El objetivo de este trabajo fue investigar las características radiográficas, clínicas e histológicas de casos de ameloblastoma en un período de 17 años, en un centro brasileño y explorar las posibles diferencias en niños y adolescentes en relación con los adultos. Se incluyeron 75 pacientes diagnosticados con ameloblastoma desde 2001 hasta 2018. Los datos de cada paciente, incluyendo el sexo, la edad, el tipo histológico, la ubicación y las características radiográficas, se revisaron y analizaron retrospectivamente. Se investigó la asociación entre los hallazgos clínicos, radiográficos e histológicos. No se observaron diferencias en cuanto al patrón histológico de las lesiones entre los grupos. Los niños y adolescentes presentaron lesiones bien definidas asociadas a un diente no erupcionado en comparación con los adultos (p<0,05). La presencia de un diente no erupcionado se asoció con erosión y expansión cortical y desplazamiento de MC (p<0,05). A pesar de las características histológicas similares, se observó una apariencia radiográfica diferente entre pacientes jóvenes y adultos.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Ameloblastoma/epidemiología , Neoplasias Maxilomandibulares/epidemiología , Heridas y Lesiones , Radiografía Dental , Estudios Retrospectivos , Diagnóstico DiferencialRESUMEN
Synovial sarcoma (SS) is a rare malignant mesenchymal tumor that mainly occurs in body extremities, being uncommon in the head and neck region. In the present study, we described a case of primary intraosseous SS arising in the mandible of a 22-year-old young male. The patient reported a painful swelling on the left side of the mandible for the last 7 months. Imaging exams showed the presence of an expansive and multilocular radiolucent lesion, extending from the left condyle to the mandibular body. The clinic diagnostic hypotheses were ameloblastoma or malignant neoplasm. Histologically, the lesion was characterized by a proliferation of spindle cells exhibiting vesicular nuclei and evident nucleolus. Neoplastic cells were positive for AE1/AE3, cytokeratin 7, vimentin, CD-99, and TLE-1 and negative for CD-34, S-100, SMA, and HHF-35. A combination of clinical, histologic, and immunohistochemical characteristics supported the diagnosis of SS. The patient was referred for treatment, and preoperative exams did not reveal any other tumor foci in the body of the patient. The final diagnosis was of a primary intraosseous SS of the mandible.
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Aim: The purpose of this study was to assess the antifungal effect of ß-lapachone (ß-lap) on azole-resistant strains of Candida spp. in both planktonic and biofilm form. Materials & methods: The antifungal activity of ß-lap was evaluated by broth microdilution, flow cytometry and the comet assay. The cell viability of the biofilms was assessed using the MTT assay. Results: ß-lap showed antifungal activity against resistant strains of Candida spp. in planktonic form. In addition, ß-lap decreased the viability of mature biofilms and inhibited the formation of biofilms in vitro. Conclusion: ß-lap showed antifungal activity against Candida spp., suggesting that the compound can be utilized as an adjunct agent in the treatment of candidiasis.
Asunto(s)
Antifúngicos/farmacología , Azoles/farmacología , Biopelículas/efectos de los fármacos , Candida/efectos de los fármacos , Farmacorresistencia Fúngica , Naftoquinonas/farmacología , Candida/fisiología , Candidiasis/tratamiento farmacológico , Candidiasis/microbiología , Humanos , Pruebas de Sensibilidad MicrobianaRESUMEN
OBJECTIVES: To assess if morphine pharmacokinetics are different in children with Down syndrome when compared with children without Down syndrome. DESIGN: Prospective single-center study including subjects with Down syndrome undergoing cardiac surgery (neonate to 18 yr old) matched by age and cardiac lesion with non-Down syndrome controls. Subjects were placed on a postoperative morphine infusion that was adjusted as clinically necessary, and blood was sampled to measure morphine and its metabolites concentrations. Morphine bolus dosing was used as needed, and total dose was tracked. Infusions were continued for 24 hours or until patients were extubated, whichever came first. Postinfusion, blood samples were continued for 24 hours for further evaluation of kinetics. If patients continued to require opioid, a nonmorphine alternative was used. Morphine concentrations were determined using a unique validated liquid chromatography tandem-mass spectrometry assay using dried blood spotting as opposed to large whole blood samples. Morphine concentration versus time data was modeled using population pharmacokinetics. SETTING: A 16-bed cardiac ICU at an university-affiliated hospital. PATIENTS: Forty-two patients (20 Down syndrome, 22 controls) were enrolled. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The pharmacokinetics of morphine in pediatric patients with and without Down syndrome following cardiac surgery were analyzed. No significant difference was found in the patient characteristics or variables assessed including morphine total dose or time on infusion. Time mechanically ventilated was longer in children with Down syndrome, and regarding morphine pharmacokinetics, the covariates analyzed were age, weight, presence of Down syndrome, and gender. Only age was found to be significant. CONCLUSIONS: This study did not detect a significant difference in morphine pharmacokinetics between Down syndrome and non-Down syndrome children with congenital heart disease.
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Analgésicos Opioides/farmacocinética , Procedimientos Quirúrgicos Cardíacos , Síndrome de Down/complicaciones , Cardiopatías Congénitas/cirugía , Morfina/farmacocinética , Dolor Postoperatorio/tratamiento farmacológico , Adolescente , Analgésicos Opioides/sangre , Analgésicos Opioides/uso terapéutico , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Estudios de Seguimiento , Cardiopatías Congénitas/complicaciones , Humanos , Lactante , Recién Nacido , Infusiones Intravenosas , Masculino , Morfina/sangre , Morfina/uso terapéutico , Estudios ProspectivosRESUMEN
In continuation of our quest for new redox-modulating catalytic antitumor molecules, selenium-containing quinone-based 1,2,3-triazoles were synthesized using rhodium-catalyzed C-H bond activation and click reactions. All compounds were evaluated against five types of cancer cell lines: HL-60 (human promyelocytic leukemia cells), HCT-116 (human colon carcinoma cells), SF295 (human glioblastoma cells), NCIH-460 (human lung cells) and PC3 (human prostate cancer cells). Some compounds showed good activity with IC50 values below 1 µM. The cytotoxic potential of the naphthoquinoidal derivatives was also evaluated in non-tumor cells, exemplified by L929 cells. Overall, these compounds represent promising new lead derivatives and stand for a new class of chalcogenium-containing derivatives with potential antitumor activity.
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Antineoplásicos/síntesis química , Compuestos de Organoselenio/síntesis química , Quinonas/química , Rodio/química , Triazoles/síntesis química , Antineoplásicos/uso terapéutico , Catálisis , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Química Clic , Ensayos de Selección de Medicamentos Antitumorales , Humanos , Compuestos de Organoselenio/farmacología , Relación Estructura-Actividad , Triazoles/farmacologíaRESUMEN
Selenium-containing quinone-based 1,2,3-triazoles were synthesized using click chemistry, the copper catalyzed azide-alkyne 1,3-dipolar cycloaddition, and evaluated against six types of cancer cell lines: HL-60 (human promyelocytic leukemia cells), HCT-116 (human colon carcinoma cells), PC3 (human prostate cells), SF295 (human glioblastoma cells), MDA-MB-435 (melanoma cells) and OVCAR-8 (human ovarian carcinoma cells). Some compounds showed IC50 values < 0.3 µM. The cytotoxic potential of the quinones evaluated was also assayed using non-tumor cells, exemplified by peripheral blood mononuclear (PBMC), V79 and L929 cells. Mechanistic role for NAD(P)H: Quinone Oxidoreductase 1 (NQO1) was also elucidated. These compounds could provide promising new lead derivatives for more potent anticancer drug development and delivery, and represent one of the most active classes of lapachones reported.
Asunto(s)
Antineoplásicos/síntesis química , Antineoplásicos/farmacología , Benzoquinonas/química , Selenio/química , Triazoles/química , Triazoles/síntesis química , Triazoles/farmacología , Antineoplásicos/química , Antineoplásicos/toxicidad , Muerte Celular/efectos de los fármacos , Línea Celular Tumoral , Técnicas de Química Sintética , Diseño de Fármacos , Humanos , Leucocitos Mononucleares/efectos de los fármacos , Oxidación-Reducción , Relación Estructura-Actividad , Triazoles/toxicidadRESUMEN
This experiment aimed to describe the effects of Oregano extract (OE) inclusion into the concentrate fed to dairy heifers on physiological parameters, feeding behavior, intake, and performance. Thirty-two Holstein heifers were randomly distributed into four treatments: C = control, without addition of OE; OE2.5 = 2.5 g; OE5.0 = 5.0 g and OE7.5 = 7.5 g of Oregano extract per heifer/day. Feeding behavior and concentrate intake were assessed individually every day and total dry matter intake (DMI) was determined on the last week of the trial. Compared to control group, OE7.5 reduced by 32% the latency time to approach the feed bunk but increased by 6% the time spent eating the concentrate. Each inclusion of 2.5 grams of OE into the concentrate increased the occurrence of postingestive licking the feed bunk with abundant saliva production 1.2 times (P < 0.01) and tended to increase the occurrence of sneeze events 1.2 times (P < 0.10). No statistical difference was detected between treatments for total DMI, but concentrate DMI was 9% lower for OE7.5 when compared to control and OE2.5. The inclusion of 7.5 grams/day of OE causes small but negative effects in feeding behavior and concentrate intake, without change on total dry matter intake.
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Alimentación Animal/análisis , Conducta Alimentaria , Origanum/química , Extractos Vegetales/química , Animales , Bovinos , Dieta/veterinaria , FemeninoRESUMEN
This study aimed to evaluate the digestive power of waste of cassava starch extraction dried (WCSEd) and corn, in addition to determining the appropriate level of WCSEd to replace corn in the diet of cattle. Studies to evaluate the in vitro digestibility and in situ degradability were performed. The study used four cattle with rumen cannula, individually fed with diets containing increasing levels (0, 33, 66 and 100%) of WCSEd to replace corn, to evaluate the dry matter and nutrient intake and digestibility, pH and ammonia concentration of rumen fluid. The WCSEd showed differences in the in vitro digestibility of DM, OM and NDF (P 0.05) compared to corn, but did not change the NDT and in situ degradability. As for in vivo reviews, the DM and nutrient intake was influenced by treatments in decreasing order, resulting in changes in the digestibility of DM, OM and NDT of diet, and a decreased concentration of N-NH3, but the pH was not affected. The residue from the extraction of cassava starch showed lower in vitro digestibility; however, ruminal degradability did not differ from corn. Their use in ruminant feed reduces the intake and degradation of feed, but improves the use of N-NH3 in the rumen.
Objetivou-se avaliar a degradabilidade potencial do REAMs e do milho e de determinar o nível adequado de REAMs, em substituição ao milho na ração de bovinos. Foram realizados estudos para avaliação da digestibilidade in vitro e degradabilidade in situ. Utilizou-se quatro bois castrados, canulados no rúmen, alimentados individualmente, com dietas contendo níveis crescentes (0%, 33%, 66% e 100%) de REAMs em substituição ao milho, para avaliação da ingestão e digestibilidade da matéria seca e nutrientes, avaliação do pH e nitrogênio amoniacal do líquido ruminal. O REAMs apresentou diferenças quanto à digestibilidade in vitro da MS, MO e FDN (P 0,05), quando comparado ao milho, mas não apresentou alteração quanto ao NDT e a degradabilidade in situ. Quanto às avaliações in vivo a ingestão de MS e dos nutrientes foi influenciada de forma decrescente pelos tratamentos, resultando em redução na digestibilidade da MS, MO e no NDT das dietas in vivo, ocorrendo redução na concentração de N-NH3, mas o pH não foi influenciado. O resíduo da extração do amido da mandioca apresentou menor digestibilidade in vitro porem não diferiu do milho quanto a degradabilidade ruminal. Sua utilização na alimentação de ruminantes reduz a ingestão e degradação da ração, porém melhora o aproveitamento do N-NH3 no rúmen.s.
RESUMEN
This study aimed to evaluate the digestive power of waste of cassava starch extraction dried (WCSEd) and corn, in addition to determining the appropriate level of WCSEd to replace corn in the diet of cattle. Studies to evaluate the in vitro digestibility and in situ degradability were performed. The study used four cattle with rumen cannula, individually fed with diets containing increasing levels (0, 33, 66 and 100%) of WCSEd to replace corn, to evaluate the dry matter and nutrient intake and digestibility, pH and ammonia concentration of rumen fluid. The WCSEd showed differences in the in vitro digestibility of DM, OM and NDF (P 0.05) compared to corn, but did not change the NDT and in situ degradability. As for in vivo reviews, the DM and nutrient intake was influenced by treatments in decreasing order, resulting in changes in the digestibility of DM, OM and NDT of diet, and a decreased concentration of N-NH3, but the pH was not affected. The residue from the extraction of cassava starch showed lower in vitro digestibility; however, ruminal degradability did not differ from corn. Their use in ruminant feed reduces the intake and degradation of feed, but improves the use of N-NH3 in the rumen.
Objetivou-se avaliar a degradabilidade potencial do REAMs e do milho e de determinar o nível adequado de REAMs, em substituição ao milho na ração de bovinos. Foram realizados estudos para avaliação da digestibilidade in vitro e degradabilidade in situ. Utilizou-se quatro bois castrados, canulados no rúmen, alimentados individualmente, com dietas contendo níveis crescentes (0%, 33%, 66% e 100%) de REAMs em substituição ao milho, para avaliação da ingestão e digestibilidade da matéria seca e nutrientes, avaliação do pH e nitrogênio amoniacal do líquido ruminal. O REAMs apresentou diferenças quanto à digestibilidade in vitro da MS, MO e FDN (P 0,05), quando comparado ao milho, mas não apresentou alteração quanto ao NDT e a degradabilidade in situ. Quanto às avaliações in vivo a ingestão de MS e dos nutrientes foi influenciada de forma decrescente pelos tratamentos, resultando em redução na digestibilidade da MS, MO e no NDT das dietas in vivo, ocorrendo redução na concentração de N-NH3, mas o pH não foi influenciado. O resíduo da extração do amido da mandioca apresentou menor digestibilidade in vitro porem não diferiu do milho quanto a degradabilidade ruminal. Sua utilização na alimentação de ruminantes reduz a ingestão e degradação da ração, porém melhora o aproveitamento do N-NH3 no rúmen.s.
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SUMMARY With aimto evaluate the effect of replacing the ground grain corn for silage of waste resulting from the extraction of cassava starch in diets for sheep in confinement, was measured the consumption, the digestibility of dry matter and nutrients, and the rumen pH. Were used five cannulated sheep, distributed in outline Latin square (5 x 5), composed of five animals, five diets and five experimental periods of 21 days, for a total of 105 days of experiment. The treatments were different levels of substitution (0, 25, 50, 75, 100%) of maize for silage of waste resulting from the extraction of cassava starch. The replacement levels obtained significant difference, obtaining cubic variation for the intake of dry matter (DM), crude protein (CP), organic matter (OM), ether extract (EE)and total carbohydrates (TC), and quadratic effect for neutral detergent fiber (NDF) and acid detergent fiber (ADF). But there were not significant differences in nutrient digestibility as the substitution of corn for silage of waste resulting from the extraction of cassava starch intake as well as not interfered in ruminal pH values. It is recommended the replacement of corn for silage 75% of residue of cassava starch extraction.
RESUMO Com objetivo de avaliar o efeito da substituição do milho grão moído pela silagem de resíduo da extração de amido da mandioca, em dietas para ovinos em confinamento, foi mensurado o consumo, a digestibilidade da matéria seca (MS) e dos nutrientes, e o pH ruminal. Foram utilizados cinco ovinos, canulados, distribuídos em delineamento de quadrado latino (5x5), composto de cinco animais, cinco dietas e cinco períodos experimentais de 21 dias cada, em um total de 105 dias de experimento. Os tratamentos foram diferentes níveis de substituição (0, 25, 50, 75 e 100%) do milho pela silagem de resíduo da extração de amido da mandioca. Os níveis de substituição interferiram de forma significativa, obtendo variação cubica para a ingestão de MS, proteína bruta (PB), matéria orgânica (MO), extrato etéreo (EE) e carboidratos totais (CT), e efeito quadrático para a ingestão de fibra em detergente neutro (FDN) e fibra em detergente ácido (FDA). Porém não houve diferenças significativas na digestibilidadede nutrientes conforme a substituição do milho pela silagem de resíduo da extração de amido da mandioca, assim como não interferiram nos valores de pH ruminal. Recomenda-se a substituição de 75% do milho pela silagem de resíduo da extração de amido da mandioca.
RESUMEN
SUMMARY With aimto evaluate the effect of replacing the ground grain corn for silage of waste resulting from the extraction of cassava starch in diets for sheep in confinement, was measured the consumption, the digestibility of dry matter and nutrients, and the rumen pH. Were used five cannulated sheep, distributed in outline Latin square (5 x 5), composed of five animals, five diets and five experimental periods of 21 days, for a total of 105 days of experiment. The treatments were different levels of substitution (0, 25, 50, 75, 100%) of maize for silage of waste resulting from the extraction of cassava starch. The replacement levels obtained significant difference, obtaining cubic variation for the intake of dry matter (DM), crude protein (CP), organic matter (OM), ether extract (EE)and total carbohydrates (TC), and quadratic effect for neutral detergent fiber (NDF) and acid detergent fiber (ADF). But there were not significant differences in nutrient digestibility as the substitution of corn for silage of waste resulting from the extraction of cassava starch intake as well as not interfered in ruminal pH values. It is recommended the replacement of corn for silage 75% of residue of cassava starch extraction.
RESUMO Com objetivo de avaliar o efeito da substituição do milho grão moído pela silagem de resíduo da extração de amido da mandioca, em dietas para ovinos em confinamento, foi mensurado o consumo, a digestibilidade da matéria seca (MS) e dos nutrientes, e o pH ruminal. Foram utilizados cinco ovinos, canulados, distribuídos em delineamento de quadrado latino (5x5), composto de cinco animais, cinco dietas e cinco períodos experimentais de 21 dias cada, em um total de 105 dias de experimento. Os tratamentos foram diferentes níveis de substituição (0, 25, 50, 75 e 100%) do milho pela silagem de resíduo da extração de amido da mandioca. Os níveis de substituição interferiram de forma significativa, obtendo variação cubica para a ingestão de MS, proteína bruta (PB), matéria orgânica (MO), extrato etéreo (EE) e carboidratos totais (CT), e efeito quadrático para a ingestão de fibra em detergente neutro (FDN) e fibra em detergente ácido (FDA). Porém não houve diferenças significativas na digestibilidadede nutrientes conforme a substituição do milho pela silagem de resíduo da extração de amido da mandioca, assim como não interferiram nos valores de pH ruminal. Recomenda-se a substituição de 75% do milho pela silagem de resíduo da extração de amido da mandioca.
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1,2,3-Triazole-, arylamino- and thio-substituted naphthoquinones (24, 8, and 2 representatives, respectively) were synthesized in moderate yields and evaluated against several human cancer cell lines (blood, ovarian, breast, central nervous system, colon, and prostate cancers and melanoma), showing, for some of them, IC50 values below 2 µM. The cytotoxic potential of the tested naphthoquinones was also assayed on non-tumor cells such as human peripheral blood mononucluear cells (PBMC) and two murine fibroblast lines (L929 and V79 cells). α-Lapachone- and nor-α-lapachone-based 1,2,3-triazoles and arylamino-substituted naphthoquinones showed potent cytotoxicity against different cancer cell lines. The compounds may represent promising new lead derivatives for anticancer drug development. The electrochemical properties of selected compounds were evaluated in an attempt to correlate them with antitumor activity.
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Naftoquinonas/química , Triazoles/química , Proliferación Celular , Química Clic , Humanos , Modelos Moleculares , Estructura Molecular , Relación Estructura-ActividadRESUMEN
In many centers presurgical term neonates with prostaglandin-dependent cardiac lesions experience nutritional deficiency because of postponed enteral feeds. We recently adopted early enteral feeding in these infants. This retrospective study demonstrates feeding tolerance in 33 of 34 neonates fed enterally while receiving prostaglandin, suggesting the safety of this practice.
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Alprostadil/uso terapéutico , Nutrición Enteral/efectos adversos , Enterocolitis Necrotizante/etiología , Cardiopatías Congénitas/tratamiento farmacológico , Cuidados Preoperatorios , Vasodilatadores/uso terapéutico , Alprostadil/administración & dosificación , Femenino , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/cirugía , Humanos , Recién Nacido , Unidades de Cuidados Intensivos , Masculino , Estudios Retrospectivos , Vasodilatadores/administración & dosificaciónRESUMEN
OBJECTIVES: To characterize correlations between clinical classifications of heart failure and diagnostic workup. STUDY DESIGN: Pre- and postoperative characteristics of 20 children with heart failure secondary to valvular rheumatic disease were studied. RESULTS: Both scoring systems correlated with N-terminal pro-brain natriuretic peptide (N-proBNP) but not with troponin I (TnI). The PHFI correlated with N-proBNP, end-systolic wall stress, left ventricular mass index and left atrium to aorta diameter ratio. No correlation could be established between modified Ross score, or the New York Heart Association (NYHA) grade and echocardiographic measurements. Cardiothoracic and Sokolow indexes were correlated with the PHFI as well as to the NYHA classification. CONCLUSION: In this study, PHFI seems better correlated with radiologic, electrocardiographic, echocardiographic, and biologic assessment of heart failure in children. Clinical severity was correlated with N-proBNP but not with TnI.