Search

In patients with TENIS syndrome (Thyroglobulin-Elevated Negative Iodine Scintigraphy), PET/CT radiotracers, such FDG PET/CT and somatostatin analogs (SSTR PET/CT), can identify disease localization. Therefore, the objective of this paper is to compare the capability of identifying lesions in TENIS Syndrome using FDG PET/CT and SSTR PET/CT through a systematic review and meta-analysis. A literature search was performed in electronic databases until February 2020 to identify relevant studies on FDG and 68 Ga-somatostatin analogs tracers in patients with TENIS Syndrome. A total of 3551 abstracts reviewed from electronic databases and bibliographic references identified 13 candidates for the full-text analysis, and six articles were included in the qualitative and quantitative analyses. A total of 179 patients submitted to both SSTR PET/CT and FDG PET/CT to evaluate the performance of these radiotracers were analyzed. FDG PET/CT images identified significantly (p = 0.006) more patients with metastases when compared to SSTR PET/CT (143 vs. 103, respectively). Even though FDG PET/CT outperformed SSTR PET/CT, SSTR PET/CT was able to detect metastases in approximately 16% of FDG PET/CT negative cases. FDG PET/CT has a higher capability to detect metastases than SSTR PET/CT in patients with TENIS Syndrome.

68 Ga-PSMA-PET has an increasing importance in the evaluation of prostate cancer patients due to its high sensitivity and specificity in identifying neoplastic lesions in the clinical setting of elevated prostate-specific antigen (PSA). The objective of this study was to calculate the whole-body tumor burden using volumetric quantification of lesions detected in 68Ga-PSMA-PET of prostate cancer patients with biochemical recurrence and correlate these findings with clinical and image parameters. Each patient had their 68Ga-PSMA-PET analyzed for the presence of neoplastic lesions. Their PSA levels and clinical information were recorded. In positive cases, the tumor burden (TL-PSMA) was calculated with a semi-automatic software and manually, and the results are analyzed and tested. We analyzed 100 prostate cancer patients, mean age of 69.9 ± 9.7 years and a median PSA of 1.73 ng/dL. 68Ga-PSMA-PET identified neoplastic lesions in 72% of them. The median TL-PSMA was 55.95 ml (1.1–28,080 ml). TL-PSMA and PSA were strongly correlated (rho = 0.71, p

Background: Fontan circulation can be associated with significant morbidity, especially Protein-Losing Enteropathy (PLE). Echocardiographic parameters can provide valuable diagnostic information about a patient's risk of developing PLE after Fontan surgery. Objectives: To describe echocardiographic/ultrasonographic parameters associated with PLE in patients after Fontan surgery through a systematic review with meta-analysis. Methods: A literature search was performed in electronic databases to identify relevant studies about echocardiographic parameters and PLE prediction in children after Fontan surgery. The search terms used were: “echocardiography”, “ultrasonography”, “Fontan,” and “protein-losing enteropathy”. A p < 0.05 was considered statistically significant. Results: A total of 653 abstracts were obtained from electronic databases and bibliographic references. From these, six articles met criteria to be included in the qualitative analysis and three in the quantitative (meta-analysis). The resistance index in the superior mesenteric artery was described in three studies, and the quantitative analysis showed statistical significance (p < 0.001). Other echocardiographic and ultrasonographic parameters were also described, albeit in single studies not allowing a meta-analysis. Conclusion: This systematic review with meta-analysis identified echocardiographic and ultrasonographic parameters related to PLE in patients with Fontan physiology. Vascular ultrasonography seems to play a prominent role in this aspect, but additional studies are needed to increase the degree of evidence.

Background: Congenital heart disease (CHD) affects 1% of all newborns and is a major public health problem. Most children with CHD benefit from early diagnosis to optimize management. However, in m...

Our purpose was to validate a semiautomatic quantification of the skeletal tumor burden on 18F-fluoride PET/CT using manual quantification as a reference. Methods: We quantified 51 18F-fluoride PET/CT examinations performed on female breast cancer patients. Clinical information (age; time of disease presentation; presence of visceral metastases; and time to death, progression, or a bone event) was recorded. The total volume of 18F-fluoride-avid skeletal metastases and the total activity of 18F-fluoride-avid metastases were calculated manually and semiautomatically. Results: Manual and semiautomatic metrics correlated strongly (P < 0.0001; 95% confidence interval, 0.9300-0.9769). On multivariable analysis, the semiautomatic measures of total activity for 18F-fluoride-avid metastasis correlated significantly with overall survival (P = 0.0001) and progression-free survival (P = 0.0006). Approximate times for calculating skeletal tumor burden (semiautomatic vs. manual) were, respectively, 30 s versus 321 s in patients with fewer than 5 metastases, 120 s versus 640 s in patients with 5-10 metastases, and 240 s versus 1207s in patients with more than 10 metastases. Conclusion: Semiautomatic quantification of whole-body 18F-fluoride PET/CT skeletal tumor burden can replace manual quantification in breast cancer patients and is a strong independent biomarker of prognosis.

Background High blood pressure (BP) is usually underdiagnosed in children and adolescents, particularly due to its complex diagnosis process. This study describes novel height-based equations for the detection of BP disorders (BP > 90th percentile) and compares the accuracy of this approach with previously described screening methods to identify BP disorders. Methods Height-based equations were built using the 90th percentile values for systolic and diastolic BP and respective height values from the current guideline of high-BP management in children. This guideline was also used as the gold standard method for identification of BP disorders. The equations were tested in Brazilian (n = 2,936) and American (n = 6,541) populations of children with 8–13 years old. Results The obtained equations were 70 + 0.3 × height (in cm) for systolic BP and 35 + 0.25 × height (in cm) for diastolic BP. The new equations presented sensitivity and negative predictive value of near 100% and specificity > 91% and showed higher specificity and positive predictive value when compared with other screening tools. Importantly, height-based equations had greater agreement (kappa coefficient = 0.75–0.81) with the gold standard method than the other methods (kappa coefficient = 0.53–0.73). Further analysis showed that alternative height-based equations designed to identify hypertension (BP ≥ 95th percentile) also showed superior performance (kappa coefficient = 0.89–0.92) compared with other screening methods (kappa coefficient = 0.43–0.85). Conclusions These findings suggest that the use of height-based equations may be a simple and feasible approach to improve the detection of high BP in the pediatric population.

This paper proposes a new method for automatic segmentation of neonates’s trunks in thermal images. The method is based on an algorithm that use a threshold, associated with an active contour technique. The hypothesis is that it is possible to correlate a given temperature map, presented in a thermal image, with the persistence of the heart ductus arteriosus of a newborn. From this region of interest (ROI), it is possible to capture quantitative and statistical information on the pathology’s temperature map, in order to use them as input in a machine learning applications to, in addition to aiding early diagnosis, to enable its automation. However, the presence of clothing, bandages, sheets, and other objects during the catches may alter the temperature to be considered in the diagnosis. Thus, in order to guarantee the consistency of the data extracted from such images, the region of interest must be segmented and analyzed separately. The proposed automatic segmentation obtained low error rates, generating outputs very similar to those obtained in manual segmentation.

We present a case of a newborn from a remote, underserved area in the inland of Paraíba, a state from Northeast Brazil. She presented with clinical cyanosis at birth. With the aid of telemedicine, a neonatologist under online cardiology supervision performed a screening echocardiogram. The session established the diagnosis of simple transposition of the great vessels in the baby’s first few hours of life. During the same telemedicine session, the necessary arrangements for transferal to a larger maternity center took place. The baby was maintained stable on prostaglandins and was subsequently transferred to a tertiary cardiac center in the neighboring State, Pernambuco. She underwent anatomical correction at day 10, presented no surgical or postoperative complications, and was discharged home at the age of 21 days. She is now over three years old and continues her follow-up care mostly at her hometown, with local pediatricians under online supervision by a cardiologist in a virtual outpatient clinic. The establishment of a Pediatric Cardiology Network, with the aid of telemedicine, can produce a major impact on the access to specialized health care for poor regions of developing countries.

Background Down’s syndrome (DS) affects one per 700 live births and congenital heart disease (CHD) occurs in 40–60% of these patients. Contributing factors to the association between DS and CHD are being unraveled. Gender could be one of them. Methods We performed a meta-analysis of CHD prevalence in DS, separated by gender. Three search engines were used and 578 articles were reviewed. Twelve articles were included. Results Quantitative analysis showed a higher prevalence of CHD, particularly atrioventricular septal defects (AVSD), in female patients. No differences were found in others forms of CHD. Conclusion CHD, particularly AVSD, are more common in the female gender of Down’s syndrome patients. Electronic supplementary material The online version of this article (10.1186/s12881-017-0475-7) contains supplementary material, which is available to authorized users.

A new modified blood pressure-to-height ratio also simplifies the identification of high blood pressure in American children

The observation of poor nutrition in childhood and the development of disease in later life date from far back in Medicine. Ando so does the use of somatic growth, as a surrogate measure of nutrition. However, both the definition and meaning of adequate growth, particularly during intrauterine life, remain controversial.

Introduction. Congenital heart diseases (CHD) affect approximately 1% of live births and is an important cause of neonatal morbidity and mortality. Despite that, there is a shortage of paediatric cardiologists in Brazil, mainly in the northern and northeastern regions. In this context, the implementation of virtual outpatient clinics with the aid of different telemedicine resources may help in the care of children with heart defects.Methods. Patients under 18 years of age treated in virtual outpatient clinics between January 2013 and May 2014 were selected. They were divided into 2 groups: those who had and those who had not undergone a screening process for CHD in the neonatal period. Clinical and demographic characteristics were collected for further statistical analysis.Results. A total of 653 children and teenagers were treated in the virtual outpatient clinics. From these, 229 had undergone a neonatal screening process. Fewer abnormalities were observed on the physical examination of the screened patients.Conclusion. The implementation of pediatric cardiology virtual outpatient clinics can have a positive impact in the care provided to people in areas with lack of skilled professionals.

Background: Many studies have shown that arterial-pulse oximetry is an effective tool for screening congenital heart defects (CHD), and most of these studies have been carried out in developed countries. Objective: Analyze primary data from the CHD screening performed through clinical examination and arterialpulse oximetry in a maternity hospital, in the Brazilian Northeast. Methods: Neonates born after 34 weeks of pregnancy and in good clinical conditions were screened for CHD through clinical examination (CE) and arterial-pulse oximetry (APO) after 24 hours of life and before hospital discharge. Results: Screening techniques increased the detection of CHD at the maternity hospital. However, most cases were detected through clinical examination. Underperformance of arterial-pulse oximetry. Conclusion: The combination of arterial-pulse oximetry and clinical examination is crucial in the detection of congenital heart defects. Arterial-pulse oximetry alone, although useful to detect critical cases, has underperformed against clinical examination.

Manuscript received on February 9, 2015; approved on March 7, 2015; revised on March 20, 2015. ORIGINAL MANUSCRIPT Introduction Heart diseases in children are divided into two main groups: congenital and acquired. Congenital heart diseases affect about 1.0% of the total number of live newborns and it is an important morbidity and mortality factor in newborns 1 . Acquired heart diseases include rheumatic fever and the Kawasaki disease. The former is a serious public health problem in poor regions 2 . What both groups have in common is the need of echocardiography for diagnosing or evaluating cardiac after-pains for properly managing the patient.Despite the importance of heart diseases in childhood, poor regions still have great difficulty in diagnosing and properly treating the patients 3 . This can be explained by the lack of specialized professionals in remote areas and the difficulties of access to health services by the population, leading to the false indication of low incidence

Providing health care for children with congenital heart diseases remains a major challenge in low- and middle-income countries.In October 2011, the Government of Paraíba, Brazil, established a paediatric cardiology network in partnership with the nongovernmental organization Círculo do Coração. A cardiology team supervised all network activities, using the Internet to keep in contact with remote health facilities. The network developed protocols for screening heart defects. Echocardiograms were performed by physicians under direct online supervision of a cardiologist; alternatively, a video recording of the examination was subsequently reviewed by a cardiologist. Cardiovascular surgeons came to a paediatric hospital in the state capital once a week to perform heart surgeries.Until 2011, the State of Paraíba had no structured programme to care for children with heart disease. This often resulted in missed or late diagnosis, with adverse health consequences for the children.From 2012 to 2014, 73,751 babies were screened for heart defects and 857 abnormalities were identified. Detection of congenital heart diseases increased from 4.09 to 11.62 per 1000 live births (P 0.001). Over 6000 consultations and echocardiograms were supervised via the Internet. Time to diagnosis, transfers and hospital stays were greatly reduced. A total of 330 operations were carried out with 6.7% (22/330) mortality.Access to an echocardiography machine with remote supervision by a cardiologist improves the detection of congenital heart disease by neonatologists; virtual outpatient clinics facilitate clinical management; the use of Internet technology with simple screening techniques allows resources to be allocated more efficiently.Offrir une couverture médicale aux enfants atteints de cardiopathies congénitales reste un problème majeur dans les pays à revenu faible et intermédiaire.En octobre 2011, le gouvernement de l'État de Paraíba, au Brésil, a mis en place un réseau de cardiologie pédiatrique en partenariat avec l'organisation non gouvernementale Círculo do Coração. Une équipe de cardiologie a supervisé toutes les activités du réseau, en restant en contact avec les établissements de santé distants grâce à Internet. Le réseau a mis au point des protocoles pour détecter les malformations cardiaques. Des médecins ont réalisé des échocardiogrammes sous la supervision directe en ligne d'un cardiologue; dans d'autres cas, un cardiologue a visionné l'enregistrement vidéo des examens. Des chirurgiens cardiovasculaires se sont rendus une fois par semaine dans un hôpital pédiatrique de la capitale de l'État afin de pratiquer des interventions de chirurgie cardiaque.Jusqu'en 2011, l'État de Paraíba n'avait pas de programme structuré de prise en charge des enfants atteints de cardiopathies. Cela entraînait souvent des diagnostics erronés ou tardifs, qui avaient des conséquences négatives sur la santé des enfants.De 2012 à 2014, 73 751 bébés ont fait l'objet d'un examen visant à détecter des malformations cardiaques; 957 ont été découvertes. La détection de cardiopathies congénitales est passée de 4,09 à 11,62 pour 1000 naissances vivantes (P 0,001). Plus de 6000 consultations et échocardiogrammes ont été supervisés via Internet. Les délais de diagnostic, les transferts et les séjours à l'hôpital ont été fortement réduits. Un total de 330 opérations a été pratiqué, avec un taux de mortalité de 6,7% (22/330).L'accès à un échocardiographe avec supervision à distance par un cardiologue améliore la détection des cardiopathies congénitales par les néonatologistes; les cliniques ambulatoires virtuelles facilitent la prise en charge clinique; l'utilisation d'Internet associée à des techniques de détection simples permet une affectation plus efficace des ressources.Proporcionar atención sanitaria a los niños con cardiopatías congénitas sigue siendo uno de los principales desafíos en los países de ingresos bajos y medios.En octubre de 2011, el Gobierno de Paraíba, Brasil, estableció una red de cardiología pediátrica en asociación con la organización no gubernamental Círculo do Coração. Un equipo de cardiología supervisó todas las actividades de la red mediante el uso de Internet para mantenerse en contacto con los centros sanitarios remotos. La red desarrolló protocolos para revisar defectos cardíacos. Los médicos llevaron a cabo ecocardiogramas bajo la directa supervisión online por parte de un cardiólogo; como alternativa, un cardiólogo podía revisar la grabación del examen posteriormente. Los cirujanos cardiovasculares acudían al hospital pediátrico de la capital una vez por semana para llevar a cabo cirugías cardíacas.Hasta 2011, el Estado de Paraíba no contaba con un programa estructurado para tratar a los niños con enfermedades cardíacas. Esto se traducía en diagnósticos erróneos o tardíos, con consecuencias adversas en la salud de los niños.De 2012 a 2014, se examinaron 73.751 bebés en busca de defectos cardiacos y se identificaron 957 anomalías. La detección de enfermedades cardíacas congénitas subió de 4,09 a 11,62 por cada 1.000 nacimientos (El acceso a una máquina de ecocardiogramas con supervisión remota por parte de un cardiólogo mejora la detección de enfermedades cardíacas congénitas por parte de neonatólogos; las clínicas ambulatorias virtuales facilitan la gestión clínica; el uso de Internet con simples técnicas de revisión permite que los recursos se distribuyan con mayor eficacia.يظل تقديم الرعاية الصحية للأطفال الذين يعانون من أمراض القلب الخلقية يمثل تحديًا رئيسيًا في البلدان منخفضة ومتوسطةأنشأت حكومة بارايبا، في البرازيل شبكة لعلاج أمراض القلب لدى الأطفال بالشراكة مع المنظمة غير الحكومية Círculo do Coração في أكتوبر/تشرين الأوللم يتوفر في ولاية بارايبا حتى عامتم فحص 73751إن الاستفادة من جهاز رسم القلب بالموجات فوق الصوتية تحت إشراف مختص في أمراض القلب عن بُعد أدى إلى رفع مستوى اكتشاف أمراض القلب الخلقية على يد مختصي طب الأطفال حديثي الولادة؛ كما أن العيادات الخارجية الافتراضية تُيسِّر من الإدارة السريرية؛ فضلًا عن أن استخدام تقنية الإنترنت فيما يتعلق بأساليب الفحص البسيطة يتيح تخصيص الموارد على نحو أكثر在低收入和中等收入国家，为患有先天性心脏病的儿童提供医疗保健服务仍然是一项重大挑战。.在 2011 年 10 月，巴西帕拉伊巴州政府与非政府组织 Círculo do Coração 合作，创立了儿科心脏病网络。心脏病学团队使用互联网与远程医疗设施保持联系，监督所有的网络活动。该网络制定出筛查心脏缺陷的协议。内科医生直接在心脏病专家的在线监督下完成超声波心动图；或者随后由心脏病专家审查检查的视频录像。心血管外科医生一周来州立儿科医院一次，进行心脏手术。.在 2011 年之前，帕拉伊巴州没有具备组织性的项目来关怀患有心脏病的儿童。这经常导致错过或延误诊断，给孩子的健康带来不利的结果。.从 2012 年至 2014 年，73751 名婴儿被筛查出具有心脏缺陷，且鉴定出 957 例畸形。先天性心脏病的检测从每 1000 名新生儿中 4.09 增加至至 11.62 (通过使用心脏病专家远程监督的超声波心动描记术机器，改进新生儿学专家对先天性心脏病的检测；虚拟门诊促进了临床管理；利用含简单筛查技术的互联网技术，可实现更高效的资源分配。.Обеспечение медико-санитарного обслуживания для детей с врожденными заболеваниями сердца остается одной из серьезных проблем в странах с низким и средним уровнем дохода.В октябре 2011 года правительство штата Параиба, Бразилия, создало сеть детской кардиологии в сотрудничестве с неправительственной организацией Círculo do Coração. Группа кардиологов осуществляла надзор над всей деятельностью сети, используя Интернет для связи с отдаленными лечебными учреждениями. Сеть разработала протоколы для выявления нарушения сердечной деятельности. Врачи выполняли эхокардиографию под непосредственным контролем кардиологов в режиме онлайн; в качестве альтернативы велась видеозапись обследования, которую затем просматривал кардиолог. Раз в неделю для проведения операций на сердце в педиатрическую больницу столицы штата приезжали врачи, специализирующиеся на сердечно-сосудистой хирургии.До 2011 года в штате Параиба отсутствовала структурированная программа лечения детей с заболеваниями сердца. Из-за этого диагноз ребенку часто не ставился или ставился с опозданием, что приводило к неблагоприятным последствиям для его здоровья.В период с 2012 по 2014 год было проведено обследование 73 751 ребенка с целью выявления заболеваний сердца, в результате которого было обнаружено 957 отклонений. Количество выявленных врожденных заболеваний сердца выросло с 4,09 до 11,62 на 1 000 живорожденных младенцев (Возможность использования эхокардиографа при дистанционной консультации кардиолога позволяет неонатологам выявить больше врожденных заболеваний сердца; виртуальные амбулатории содействуют клиническому лечению; использование интернет-технологий в сочетании с простыми методиками скринингового обследования позволяет более эффективно распределять ресурсы.

BACKGROUND The blood pressure to height ratio (BP:HT) has been proposed as a simple method for identifying children with elevated BP. This procedure shows good accuracy for the screening of hypertension in adolescents but less so in younger children. Our aim in this study was to modify the BP:HT ratio and determine if this change would increase accuracy when measuring hypertension during childhood. METHODS BP levels of 4,327 children (aged 5-12 years) were retrospectively obtained from medical charts. The modified ratio (BT:eHT13) was calculated as: BP/(HT + 7 × (13 - age in years)). Receiver operating characteristic curves were used to estimate cutoff points and the accuracy of the conventional and modified ratio to detect prehypertension and hypertension. RESULTS The prevalences of prehypertension and hypertension were 3.91% and 5.44%, respectively. In general, BP:eHT13 showed higher sensitivity (ranging from 0.95 to 1.00) and specificity (ranging from 0.80 to 0.98) in detecting prehypertension, level I hypertension, and level II hypertension than BP:HT (sensitivity ranging from 0.91 to 1.00; specificity ranging from 0.59 to 0.89). CONCLUSIONS The modified BP:eHT13 ratio showed better sensitivity and specificity for the screening of BP abnormalities in children aged 5-12 years.

Um modelo de triagem das cardiopatias congenitas foi criado associando a telemedicina com a captacao de imagens ecocardiograficas basicas por neonatologistas. Foi baseado num treinamento presencial e na orientacao dos casos via internet. Esse modelo e viavel, desde que sob tutela de um cardiologista pediatrico, pois reduz custos e distâncias no contexto do diagnostico das cardiopatias congenitas.

OBJETIVO: Determinar a frequencia e o perfil das cardiopatias congenitas em portadores de sindrome de Down atendidos em servico de referencia de cardiologia pediatrica, considerando-se a idade do encaminhamento, o sexo, o tipo de cardiopatia diagnosticada ao ecocardiograma transtoracico e sua associacao com hipertensao pulmonar ao diagnostico inicial.METODOS:Estudo de corte transversal com coleta retrospectiva de dados de 138 pacientes portadores de sindrome de Down de um total de 17.873 prontuarios. Os dados foram submetidos a analise descritiva, utilizando-se o programa Epi-Info, versao 7.RESULTADOS: Entre os 138 pacientes com sindrome de Down, houve maior prevalencia do sexo feminino (56,1%) e 112 (81,2%) foram diagnosticados com cardiopatia congenita. Entre as cardiopatias, a mais comum foi a comunicacao interatrial ostium secundum, com frequencia de 51,8%, seguida pelo defeito do septo atrioventricular, com 46,4%. A comunicacao interventricular estava presente em 27,7%, enquanto a tetralogia de Fallot representou 6,3% dos casos. Outras cardiopatias totalizaram 12,5%. A hipertensao pulmonar associou-se a 37,5% das cardiopatias. Apenas 35,5% dos pacientes foram encaminhados ao servico ate os seis meses de idade.CONCLUSOES: O baixo percentual de encaminhamento ate os seis meses chama atencao para a necessidade de um melhor rastreamento dos portadores da sindrome no contexto das cardiopatias congenitas, tendo em vista a alta frequencia e a progressao da hipertensao pulmonar.

OBJECTIVES To describe the incidence of congenital heart disease before and after the establishment of a telemedicine screening program, in a reference center from Northeast Brazil. METHODS This is a descriptive, retrospective and comparative study based on the institutional data from a reference center in perinatology for a period of 16 years. Institutional data were collected from a 16-year period (2001-15). Data were divided into two periods: prior to (2001-11) and after (2012-15) the establishment of a telemedicine screening program. RESULTS After the implementation of the screening process, almost all kinds of heart disease showed a significant increase in their incidence (p < 0.05). With this, the incidence of major heart diseases approached those specified in developed regions. CONCLUSION The implementation of a screening process model for congenital heart diseases can change the context of patients with congenital heart diseases in poor regions.

The DigiScope project aims at developing a digitally enhanced stethoscope capable of using state of the art technology in order to help physicians in their daily medical routine. One of the main tasks of DigiScope is to build a repository of auscultations (sound and medical related data). In this work, we present a preliminary analysis and study of the first auscultations performed on children of a Brazilian hospital. Results indicate that classifiers can be obtained that distinguish reasonably well patients with cardiac pathologies from those that do not have pathologies.

Objective: To compare different methods of screening for blood pressure disorders in children and adolescents. Method: A database with 17,083 medical records of patients from a pediatric cardiology clinic was used. After analyzing the inclusion and exclusion criteria, 5,650 were selected. These were divided into two age groups: between 5 and 13 years and between 13 and 18 years. The blood pressure measurement was classified as normal, pre-hypertensive, or hypertensive, consistent with recent guidelines and the selected screening methods. Sensitivity, specificity, and accuracy were then calculated according to gender and age range. Results: The formulas proposed by Somu and Ardissino's table showed low sensitivity in identifying pre-hypertension in all age groups, whereas the table proposed by Kaelber showed the best results. The ratio between blood pressure and height showed low specificity in the younger age group, but showed good performance in adolescents. Conclusion: Screening tools used for the assessment of blood pressure disorders in children and adolescents may be useful to decrease the current rate of underdiagnosis of this condition. The table proposed by Kaelber showed the best results; however, the ratio between BP and height demonstrated specific advantages, as it does not require tables. Resumo: Objetivo: comparar diferentes métodos de rastreamento para distúrbios da pressão arterial em crianças e adolescentes. Método: foi utilizado um banco de dados com 17083 prontuários de pacientes de uma clínica de cardiologia pediátrica. Após análise dos critérios de inclusão e exclusão, 5650 foram selecionados. Estes foram divididos em duas faixas etárias: entre cinco e 13 anos e entre 13 e 18 anos De acordo com a aferição da pressão arterial, a mesma era classificada como normal, pré-hipertensiva ou hipertensiva de acordo com guidelines recentes e dos métodos de rastreamento selecionados. Posteriormente, foram calculadas a sensibilidade, especificidade e acurácia de cada um de acordo com o gênero e faixa etária. Resultados: as fórmulas de Somu e a tabela proposta por Ardissino apresentaram baixa sensibilidade na identificação de pré-hipertensão em todas as faixas etárias, enquanto a tabela proposta por Kaelber apresentou os melhores resultados. A razão entre pressão arterial e altura apresentou baixa especificidade na faixa etária menor, mas apresentou bom desempenho em adolescentes. Conclusão: as ferramentas de rastreamento para distúrbios da pressão arterial em crianças e adolescentes podem ser úteis para diminuir o subdiagnóstico que ocorre atualmente nessa condição. A tabela proposta por Kaelber apresentou os melhores resultados, entretanto a razão entre PA e altura apresenta vantagens específicas, como a não necessidade de tabelas. Keywords: Hypertension, Screening programs, Pediatrics, : Hipertensão, Programas de rastreamento, Pediatria

We evaluated a population of 7199 children between 2 and 19 years old to study the relations between the observed demographic and physiological features in the occurrence of a pathological/non-pathological heart condition. The data was collected at the Real Hospital Portugues, Pernambuco, Brazil. We performed a feature importance study, with the aim of categorizing the most relevant variables, indicative of abnormalities. Results show that second heart sound, weight, heart rate, height and secondary reason for consultation are important features, but not nearly as decisive as the presence of heart murmurs. Quantitatively speaking, systolic murmurs and a hyperphonetic second heart sound increase the odds of having a pathology by a factor of 320 and 6, respectively.