Transradial Approach for Left Ventricular Endomyocardial Biopsy

Background Left ventricular endomyocardial biopsy (LV-EMB) may offer a superior diagnostic yield compared with right ventricular endomyocardial biopsy (RV-EMB) in conditions predominantly affecting the LV but is underused compared with RV-EMB. Despite the steep uptake of radial approach in coronary interventions, LV-EMB is usually performed via the femoral artery in contemporary practice. Therefore, the aim of this study was to assess the safety and feasibility of LV-EMB via a transradial approach in a multicentre registry. Methods One-hundred and two patients who underwent LV-EMB via transradial approach were included. Clinical characteristics, procedural, safety and feasibility data were evaluated. Results LV-EMB was successfully performed via transradial access in 101 (99%) patients. Mild or moderate radial artery spasm occurred in 12 (12%) patients, but only 1 (0.98%) patient required conversion to femoral access due to severe spasm. A total of 80 (78%) patients had LV-EMB via a sheathless guide catheter. Among those, 77 (96.3%) patients had 7.5-French sheathless guides, and 3 (3.8%) patients had 8.5-French sheathless guides inserted. Radial sheaths were used in the remaining 22 patients, with 5-French sheaths in 21 of 22 patients. Heparin was administered to 93.1% of patients at a median dose of 5000 (3000-5000) IU. The remaining patients followed a provisional strategy upon patent hemostasis achievement. No access site-related complications were reported. There were no major complications (pericardial tamponade, life-threatening arrhythmia, cerebrovascular accident or death). Conclusions In a population of patients undergoing transradial LV-EMB, the procedural success rate was high and showed an excellent safety profile. Further studies comparing transradial and transfemoral routes may help expand the use of transradial access for LV-EMB

As representações mentais das crianças acerca das figuras parentais

Este artigo apresenta uma investigação, realizada em Portugal, sobre a relação entre as representações mentais das crianças acerca dos pais, enquanto figuras de afecto e de disciplina, e a competência social dessas crianças. Participaram no estudo 59 crianças de 8 e 9 anos. As suas representações foram analisadas a partir do conteúdo e da estrutura das narrativas construídas em resposta à Entrevista de Avaliação das Representações das Crianças acerca das Figuras Parentais; a competência social foi avaliada a partir da adaptação portuguesa do Social Skills Rating System - form for teachers, que permite obter valores de habilidades sociais, problemas de comportamento e realização escolar. Os resultados revelam uma relação entre as representações que as crianças têm dos pais como figuras rejeitantes e como figuras punitivas e as habilidades sociais, os problemas internalizados de comportamento e a realização acadêmica, bem como uma relação entre a coerência das representações e a competência social das crianças