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14 atrav&#233;s do servi&#231;o de urg&#234;ncia pedi&#225;trica do nosso centro hospitalar e os restantes foram transferidos de hospitais abrangidos na &#225;rea de referencia&#231;&#227;o do nosso hospital&#46; Quarenta doentes &#40;80&#37;&#41; eram do sexo masculino e 10 &#40;20&#37;&#41; do sexo feminino&#46; A mediana de idades calculada foi de 14 anos&#44; com uma amplitude interquartil entre os 9 e os 15 anos&#46; Dos antecedentes pessoais relevantes&#44; destacam&#8208;se as cardiopatias cong&#233;nitas&#44; presentes em sete &#40;14&#37;&#41; casos&#44; a patologia imunol&#243;gica&#44; presente em seis &#40;12&#37;&#41; casos&#44; a patologia metab&#243;lica e gen&#233;tica&#44; ambas com tr&#234;s &#40;6&#37;&#41; casos e um doente com patologia neopl&#225;sica &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">A forma de apresenta&#231;&#227;o mais frequente foi a dor tor&#225;cica em 35 doentes &#40;75&#37;&#41;&#44; seguida da febre em 13 casos &#40;26&#37;&#41;&#44; do cansa&#231;o em nove casos &#40;18&#37;&#41; e da dispneia em seis casos &#40;12&#37;&#41;&#46; Prostra&#231;&#227;o e sintomas gastrointestinais&#44; como recusa alimentar e v&#243;mitos foram relatados pontualmente&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Os resultados dos exames complementares realizados para orienta&#231;&#227;o diagn&#243;stica encontram&#8208;se apresentados nas <a class="elsevierStyleCrossRefs" href="#tbl0010">tabelas 2&#44; 3 e 4</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Na avalia&#231;&#227;o laboratorial&#44; 36 doentes &#40;72&#37;&#41; tinham eleva&#231;&#227;o dos par&#226;metros de infe&#231;&#227;o&#47;inflama&#231;&#227;o e em 17 casos &#40;35&#37;&#41; houve aumento dos marcadores de les&#227;o mioc&#225;rdica &#40;troponina I e CK&#41;&#44; indicando o envolvimento concomitante do mioc&#225;rdio no processo patol&#243;gico&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Da pesquisa etiol&#243;gica&#44; foi atribu&#237;da uma causa infeciosa em 24 casos &#40;48&#37;&#41;&#44; tanto atrav&#233;s de uma anamnese detalhada com hist&#243;ria de infe&#231;&#227;o respirat&#243;ria ou gastrointestinal recente&#44; bem como atrav&#233;s da identifica&#231;&#227;o do microrganismo associado&#44; por exames laboratoriais &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabela 5</a>&#41;&#46; Em oito doentes &#40;16&#37;&#41; foi encontrada uma etiologia n&#227;o infeciosa&#44; sendo que em cinco crian&#231;as foi diagnosticada S&#237;ndrome P&#243;s&#8208;Pericardiotomia&#44; duas crian&#231;as tinham causas metab&#243;licas subjacentes e em uma crian&#231;a a etiologia foi atribu&#237;da &#224; doen&#231;a neopl&#225;sica&#46; Em 18 doentes &#40;36&#37;&#41; foi considerado apresentarem uma doen&#231;a idiop&#225;tica&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Quanto &#224;s complica&#231;&#245;es&#44; oito doentes &#40;16&#37;&#41; apresentaram tamponamento card&#237;aco&#44; quatro doentes &#40;8&#37;&#41; evolu&#237;ram com constri&#231;&#227;o peric&#225;rdica e em sete casos &#40;14&#37;&#41; houve recorr&#234;ncia dos sintomas ap&#243;s o epis&#243;dio inaugural&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A terap&#234;utica m&#233;dica institu&#237;da centrou&#8208;se no uso de f&#225;rmacos com efeito anti&#8208;inflamat&#243;rio&#44; nomeadamente o &#225;cido acetilsalic&#237;lico em 25 casos &#40;50&#37;&#41; e o ibuprofeno em 21 casos &#40;42&#37;&#41;&#46; Em casos selecionados&#44; utilizou&#8208;se terap&#234;utica com corticoides &#40;quatro doentes&#41; e com colchicina &#40;dois doentes&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Em 14 doentes &#40;28&#37;&#41; houve necessidade de recorrer a terap&#234;utica cir&#250;rgica&#44; nos quais foram efetuadas 12 pericardiocenteses e duas pericardiectomias&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">O diagn&#243;stico de pericardite aguda foi feito na maioria dos doentes&#44; 40 &#40;80&#37;&#41;&#44; com base na avalia&#231;&#227;o global&#46; No decorrer do seguimento dos doentes a longo prazo&#44; foi estabelecido o diagn&#243;stico definitivo&#44; listado na <a class="elsevierStyleCrossRef" href="#tbl0030">tabela 6</a>&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discuss&#227;o</span><p id="par0065" class="elsevierStylePara elsevierViewall">A pericardite pode ter uma causa infeciosa&#44; sendo a etiologia viral a mais frequente em idade pedi&#225;trica<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a>&#46; Neste estudo&#44; 42&#37; das crian&#231;as tiveram o diagn&#243;stico de pericardite viral&#44; com identifica&#231;&#227;o do agente infecioso em mais de um quarto dos doentes&#46; Os agentes bacterianos s&#227;o etiologias menos comuns de pericardite<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a>&#46; Nesta s&#233;rie verificaram&#8208;se dois casos de pericardite tuberculosa&#44; sendo que um ocorreu em contexto de imunodefici&#234;ncia secund&#225;ria por infe&#231;&#227;o VIH 2&#46; A pericardite tuberculosa apresenta uma forte associa&#231;&#227;o com a infe&#231;&#227;o por VIH&#44; sobretudo nos pa&#237;ses em vias de desenvolvimento&#44; sendo que a evolu&#231;&#227;o para constri&#231;&#227;o &#233; menos comum no grupo de doentes imunodeprimidos<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a>&#46; Apesar de em ambos os casos ter ocorrido derrame peric&#225;rdico com necessidade de pericardiocentese&#44; nenhum evoluiu com pericardite constritiva&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Em 36&#37; dos casos n&#227;o foi poss&#237;vel atribuir uma causa&#44; estando de acordo com os dados de Shakti&#44; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">6</span></a>&#44; em que cerca de 37&#8208;68&#37; dos doentes s&#227;o considerados de causa idiop&#225;tica&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Na nossa s&#233;rie&#44; a pericardite viral ou idiop&#225;tica foi a etiologia mais frequente durante o per&#237;odo da adolesc&#234;ncia&#44; com predomin&#226;ncia do sexo masculino&#44; sendo estas&#44; tamb&#233;m&#44; as causas relatadas como mais frequentes por diversos autores<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;7</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A pericardite pode&#44; ainda&#44; ocorrer em contexto n&#227;o infecioso&#44; subjacente a uma doen&#231;a sist&#233;mica<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a> ou em doentes com cardiopatia submetidos a cirurgia card&#237;aca<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;8</span></a>&#46; Dos sete doentes com cardiopatia cong&#233;nita&#44; cinco tiveram o diagn&#243;stico de S&#237;ndrome P&#243;s&#8208;Pericardiotomia no p&#243;s&#8208;operat&#243;rio&#46; Em idade pedi&#225;trica&#44; existe uma preval&#234;ncia maior desta entidade relativamente &#224; idade adulta&#44; particularmente nos casos de encerramento de defeitos do septo interauricular<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">8&#44;9</span></a>&#44; o que se verificou em dois casos deste estudo&#46; A probabilidade de recorr&#234;ncia &#233;&#44; tamb&#233;m&#44; superior nestas situa&#231;&#245;es<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">8&#44;10</span></a>&#44; mas no grupo estudado apenas um doente desenvolveu cronicidade&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">A miopericardite ocorre quando existe algum grau de envolvimento do mioc&#225;rdio no processo inflamat&#243;rio subjacente &#224; pericardite&#44; uma vez que ambas as entidades partilham agentes etiol&#243;gicos comuns&#44; nomeadamente os v&#237;rus cardiotr&#243;picos&#44; como os enterov&#237;rus<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">1&#44;11</span></a>&#46; O quadro caracteriza&#8208;se pelos crit&#233;rios cl&#237;nicos da pericardite&#44; com aumento dos marcadores de les&#227;o card&#237;aca &#40;Ex&#46; troponina I&#41;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">1&#44;12</span></a>&#46; A incid&#234;ncia de miopericardite neste estudo foi de 34&#37;&#44; superior ao descrito por Imazio&#44; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">13</span></a> que refere uma incid&#234;ncia de 10&#8208;15&#37;&#44; o que pode estar relacionado com o aumento da sensibilidade da an&#225;lise da troponina I de alta sensibilidade<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a>&#44; ou com enviesamento de referencia&#231;&#227;o de doentes para um centro terci&#225;rio de cardiologia pedi&#225;trica&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A taxa de complica&#231;&#245;es n&#227;o foi desprez&#237;vel&#44; com 30&#37; das crian&#231;as a desenvolverem algum tipo de evolu&#231;&#227;o desfavor&#225;vel&#46; A maioria dos casos recorrentes ocorreu no contexto de pericardite idiop&#225;tica&#46; A incid&#234;ncia de complica&#231;&#245;es varia consoante a etiologia da pericardite e existem par&#226;metros cl&#237;nicos que predizem pior progn&#243;stico&#44; como a temperatura superior a 38<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; in&#237;cio subagudo da doen&#231;a&#44; presen&#231;a de tamponamento card&#237;aco e aus&#234;ncia de resposta aos anti&#8208;inflamat&#243;rios n&#227;o esteroides&#44; ap&#243;s uma semana de terap&#234;utica<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">A abordagem terap&#234;utica assenta na causa subjacente de pericardite&#46; Nos casos de etiologia viral&#44; idiop&#225;tica e n&#227;o complicada&#44; o tratamento &#233; sintom&#225;tico e consiste na administra&#231;&#227;o de anti&#8208;inflamat&#243;rios n&#227;o esteroides como f&#225;rmacos de primeira linha<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a>&#46; Durante o per&#237;odo que compreendeu este estudo&#44; o &#225;cido acetilsalic&#237;lico e o ibuprofeno foram prescritos em percentagens muito semelhantes e como primeira linha terap&#234;utica&#46; Dos casos em que foi prescrito corticoide sist&#233;mico&#44; dois foram em contexto de pericardite aguda e dois no contexto de pericardite recorrente&#46; A colchicina foi usada num caso de pericardite recorrente e num caso de pericardite cr&#243;nica&#44; sem efeito significativo&#46; Parece haver evid&#234;ncia de que a colchicina&#44; como terap&#234;utica adjuvante aos anti&#8208;inflamat&#243;rios&#44; diminui a persist&#234;ncia de sintomas a curto&#8208;prazo e diminui o risco de recidiva&#44; nos doentes com pericardite aguda ou recorrente<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a>&#46; As &#250;ltimas recomenda&#231;&#245;es pedi&#225;tricas<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a> sugerem o uso de ibuprofeno em detrimento do &#225;cido acetilsalic&#237;lico para o tratamento de primeira linha em idade pedi&#225;trica&#44; bem como a prescri&#231;&#227;o de colchicina&#44; como agente adjuvante&#44; nos casos refrat&#225;rios ou recorrentes<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Apesar das recomenda&#231;&#245;es&#44; a falta de consist&#234;ncia nos resultados relativamente ao uso da colchicina demonstra a necessidade de estudos controlados e aleatorizados<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a>&#46; A corticoterapia dever&#225; ser evitada em crian&#231;as&#44; pelos efeitos secund&#225;rios&#44; nomeadamente as altera&#231;&#245;es no crescimento&#44; ficando restrita aos casos associados a patologia autoimune<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a>&#46; Como nova op&#231;&#227;o terap&#234;utica&#44; o anakinra&#44; um antagonista do recetor humano da interleucina&#8208;1&#44; tem demonstrado efic&#225;cia em casos de pericardite recorrente e dependente de corticoide<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">1&#44;17</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Nos casos complicados com tamponamento card&#237;aco ou constri&#231;&#227;o mioc&#225;rdica&#44; &#233; necess&#225;ria uma abordagem cir&#250;rgica para controlo dos sintomas&#46; Os casos de tamponamento habitualmente resolvem com a realiza&#231;&#227;o de pericardiocentese&#46; Relativamente &#224; pericardite constritiva&#44; est&#225; preconizada a pericardiectomia como &#250;nico tratamento definitivo<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">18</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclus&#245;es</span><p id="par0105" class="elsevierStylePara elsevierViewall">A pericardite &#233; uma entidade pouco frequente em crian&#231;as&#44; sendo escassos os estudos publicados em idade pedi&#225;trica&#44; pelo que &#233; necess&#225;rio um elevado &#237;ndice de suspei&#231;&#227;o para fazer o diagn&#243;stico&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">O envolvimento do mioc&#225;rdio e a avalia&#231;&#227;o do grau de persist&#234;ncia das les&#245;es ser&#227;o importantes para definir um valor progn&#243;stico nos casos de miopericardite&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">A introdu&#231;&#227;o das novas op&#231;&#245;es terap&#234;uticas poder&#225; ter um impacto significativo na recorr&#234;ncia dos epis&#243;dios&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflito de interesses</span><p id="par0120" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introdu&#231;&#227;o e objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A pericardite &#233; uma doen&#231;a inflamat&#243;ria que ocorre de forma isolada ou em contexto de doen&#231;a sist&#233;mica&#46; Neste trabalho pretende&#8208;se caracterizar a forma de apresenta&#231;&#227;o&#44; orienta&#231;&#227;o diagn&#243;stica e terap&#234;utica&#44; e o seguimento dos doentes internados com este diagn&#243;stico&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise descritiva retrospetiva de doentes internados num &#250;nico Servi&#231;o de Cardiologia Pedi&#225;trica&#44; com o diagn&#243;stico de pericardite&#44; entre 2003 e 2015&#46; As caracter&#237;sticas da popula&#231;&#227;o s&#227;o expressas em frequ&#234;ncia e percentagem nas vari&#225;veis categ&#243;ricas e em mediana e percentis nas vari&#225;veis cont&#237;nuas&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Identificaram&#8208;se cinquenta doentes&#44; sendo predominante o sexo masculino &#40;80&#37;&#41; e com uma mediana de idades de 14 anos&#46; A pericardite aguda foi o diagn&#243;stico mais frequente &#40;80&#37;&#41;&#46; Na avalia&#231;&#227;o inicial&#44; 35 doentes &#40;70&#37;&#41; apresentaram toracalgia e 13 &#40;26&#37;&#41; relataram febre&#46; Em 11 doentes &#40;22&#37;&#41; verificou&#8208;se cardiomeg&#225;lia na radiografia do t&#243;rax&#44; em 30 &#40;60&#37;&#41; registaram&#8208;se altera&#231;&#245;es do ECG e em 44 &#40;88&#37;&#41; observaram&#8208;se altera&#231;&#245;es no ecocardiograma transtor&#225;cico&#46; Em 17 casos &#40;34&#37;&#41; foi diagnosticada miopericardite&#46; A etiologia mais comum foi a infeciosa &#40;48&#37;&#41;&#44; com agente identificado em metade dos casos&#46; Houve cinco casos de S&#237;ndrome P&#243;s&#8208;Pericardiotomia&#46; A primeira linha terap&#234;utica foi o &#225;cido acetilsalic&#237;lico &#40;50&#37;&#41;&#46; Em 12 doentes &#40;24&#37;&#41; realizou&#8208;se pericardiocentese&#46; A dura&#231;&#227;o do internamento teve uma mediana de nove dias&#46; Em sete crian&#231;as &#40;14&#37;&#41; houve recorr&#234;ncia dos sintomas ap&#243;s o epis&#243;dio inaugural&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclus&#245;es</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nesta casu&#237;stica verificou&#8208;se que a causa mais frequente de pericardite foi a infeciosa&#46; Em um ter&#231;o dos doentes decorreu com componente de miocardite e a recidiva n&#227;o &#233; desprez&#237;vel com a terap&#234;utica cl&#225;ssica&#46;</p></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pericarditis is an inflammation of the pericardium&#46; It may be infectious or secondary to a systemic disease&#46; The aim of this study was to analyze the clinical findings&#44; course&#44; treatment and follow&#8208;up of children diagnosed with pericarditis at our center&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective analysis of all children admitted to our pediatric cardiology unit with pericarditis between 2003 and 2015&#46; Patient characteristics were summarized using frequencies and percentages for categorical variables and medians with percentiles for continuous variables&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Fifty patients were analyzed &#40;40 male&#44; 10 female&#41; with a median age of 14 years&#46; The most common diagnosis was acute pericarditis &#40;80&#37;&#41;&#46; Thirty&#8208;five patients &#40;70&#37;&#41; presented with chest pain and 26&#37; reported fever&#46; Cardiomegaly was identified on chest X&#8208;ray in 11 patients &#40;22&#37;&#41;&#44; 30 patients &#40;60&#37;&#41; had an abnormal ECG and 44 patients &#40;80&#37;&#41; had alterations on the transthoracic echocardiogram&#46; In 17 cases &#40;34&#37;&#41; there was myocardial involvement&#46; Forty&#8208;eight percent of patients presented with infectious pericarditis and the pathologic agent was identified in half of them&#46; Postpericardiotomy syndrome was diagnosed in five cases&#46; The first&#8208;line therapy was aspirin in 50&#37; of cases&#46; Pericardiocentesis was performed in 12 patients&#46; The median length of stay was nine days&#46; There was symptom recurrence in seven children&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">In this study&#44; acute infectious pericarditis was the most common presentation and about one third of patients also had myocarditis&#46; The symptom recurrence rate was not negligible and is probably related to the type of therapy employed&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
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        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
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        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
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              "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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patologia&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagn&#243;stico&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiopatia cong&#233;nita</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">Atr&#233;sia da pulmonar com septo intacto&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></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">Comunica&#231;&#227;o interauricular&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&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">Cora&#231;&#227;o univentricular tipo direito&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></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">Comunica&#231;&#227;o interventricular&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></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">Canal arterial patente&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></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">Estenose subvalvular a&#243;rtica&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></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Imunol&#243;gica</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">VIH 2&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></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">Asma&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">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Metab&#243;lica</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">Mixedema&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></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">Uremia &#40;les&#227;o renal cr&#243;nica&#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">1&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">Anorexia&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></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">Neopl&#225;sica&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">Linfoma de Hodgkin&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></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gen&#233;tica</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">S&#237;ndrome polimalformativo&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></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">S&#237;ndrome Kleine&#8208;Levin&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></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">S&#237;ndrome de Greig&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></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Antecedentes pessoais</p>"
        ]
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        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
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        "tabla" => array:1 [
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                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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Resultado&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&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">Normal&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">34 &#40;68&#37;&#41;&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">Cardiomeg&#225;lia&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">11 &#40;22&#37;&#41;&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">Derrame pleural&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 &#40;14&#37;&#41;&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">Calcifica&#231;&#245;es&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 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          ]
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Radiografia de t&#243;rax</p>"
        ]
      ]
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        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
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            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
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        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Resultado&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&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">Normal&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">20 &#40;40&#37;&#41;&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">Altera&#231;&#245;es da repolariza&#231;&#227;o&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">27 &#40;54&#37;&#41;&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">Complexos QRS de baixa voltagem&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">3 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Eletrocardiograma de 12 deriva&#231;&#245;es</p>"
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      3 => array:8 [
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Resultado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&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">Normal&nbsp;\t\t\t\t\t\t\n
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                  \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 &#40;12&#37;&#41;&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">Derrame peric&#225;rdico&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">35 &#40;70&#37;&#41;&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">Hiperecogenicidade do peric&#225;rdio&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">13 &#40;26&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              ]
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          ]
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Ecocardiograma transtor&#225;cico</p>"
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                0 => """
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                  \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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Microrganismos identificados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \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">Enterov&#237;rus&nbsp;\t\t\t\t\t\t\n
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                  \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">3&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
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                  \t\t\t\t">V&#237;rus <span class="elsevierStyleItalic">Parainfluenza</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="left" valign="\n
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                  \t\t\t\t">2&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">V&#237;rus <span class="elsevierStyleItalic">Epstein&#8208;Barr</span>&nbsp;\t\t\t\t\t\t\n
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                  \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></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">Mycobacterium tuberculosis</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&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">Neisseria meningitidis</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&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
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                  \t\t\t\t">Pericardite aguda&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">40 &#40;80&#37;&#41;&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
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                  \t\t\t\t">Pericardite cr&#243;nica&nbsp;\t\t\t\t\t\t\n
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                  \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">3 &#40;6&#37;&#41;&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
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                  \t\t\t\t">Pericardite recorrente&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7 &#40;14&#37;&#41;&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
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Miopericardite&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">17 &#40;34&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Diagn&#243;sticos</p>"
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      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:18 [
            0 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2015 ESC Guidelines for the diagnosis and management of pericardial diseases&#58; The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology &#40;ESC&#41; Endorsed by&#58; The European Association for Cardio&#8208;Thoracic Surgery &#40;EACTS&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "Y&#46; Adler"
                            1 => "P&#46; Charron"
                            2 => "M&#46; Imazio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehv318"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J&#46;"
                        "fecha" => "2015"
                        "volumen" => "36"
                        "paginaInicial" => "2921"
                        "paginaFinal" => "2964"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26320112"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pericarditis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;C&#46; Blanco"
                            1 => "J&#46;B&#46; Parekh"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/pir.31-2-83"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Rev"
                        "fecha" => "2010"
                        "volumen" => "31"
                        "paginaInicial" => "83"
                        "paginaFinal" => "84"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20124280"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent pericarditis in children and adolescents&#58; a multicentre cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Imazio"
                            1 => "A&#46; Brucato"
                            2 => "N&#46; Pluymaekers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Cardiovasc Med&#46;"
                        "fecha" => "2016"
                        "volumen" => "17"
                        "paginaInicial" => "707"
                        "paginaFinal" => "712"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Myocarditis And Pericarditis In The Pediatric Patient&#58; Validated Management Strategies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;R&#46; Bergmann"
                            1 => "A&#46; Kharbanda"
                            2 => "L&#46; Haveman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Emerg Med Pract&#46;"
                        "fecha" => "2015"
                        "volumen" => "12"
                        "paginaInicial" => "1"
                        "paginaFinal" => "23"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26682501"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pericardite Constritiva de Etiologia Tuberculosa no Doente VIH&#8208;Positivo&#58; Caso Cl&#237;nico e Revis&#227;o Bibliogr&#225;fica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "I&#46; S&#225;"
                            1 => "R&#46; M&#244;&#231;o"
                            2 => "S&#46; Cabral"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol&#46;"
                        "fecha" => "2006"
                        "volumen" => "25"
                        "paginaInicial" => "1029"
                        "paginaFinal" => "1038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17274459"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Idiopathic pericarditis and pericardial effusion in children&#58; Contemporary epidemiology and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Shakti"
                            1 => "R&#46; Hehn"
                            2 => "K&#46; Gauvreau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/JAHA.114.001483"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Heart Assoc&#46;"
                        "fecha" => "2014"
                        "volumen" => "3"
                        "paginaInicial" => "e001483"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25380671"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Baskar S&#46; Pediatric Pericarditis &#91;Internet&#93;&#46; 2016 Dispon&#237;vel em&#58; http&#58;&#47;&#47;www&#46;acc&#46;org&#47;latest&#8208;in&#8208;cardiology&#47;articles&#47;2016&#47;06&#47;08&#47;11&#47;43&#47;pediatric&#8208;pericarditis"
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            ]
            7 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent pericarditis in children and adolescents&#58; Report of 15 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Raatikka"
                            1 => "P&#46;M&#46; Pelkonen"
                            2 => "J&#46; Karjalainen"
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                        ]
                      ]
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