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RESUMEN Objetivo: Distintas alteraciones del electrocardiograma (ECG) han sido asociadas a disfunción sistólica ventricular izquierda (DSVI), si bien la asociación con el infradesnivel del segmento ST (IST) del plano frontal del ECG estándar no se encuentra establecida. El objetivo del presente trabajo fue evaluar si el IST de la derivación DI (IST-1) permite predecir la presencia de DSVI. Material y métodos: Se incluyeron de forma prospectiva pacientes portadores factores de riesgo o cardiopatías crónicas estables, con ECG basal y ecocardiograma que aportara evaluación de la fracción de eyección (FEVI), motilidad ventricular izquierda y evaluación dicotómica sobre la presencia de hipertrofia ventricular izquierda (HVI). Evaluamos la morfología del segmento ST en derivaciones DI y V6, definiéndose como anormal (IST-1; IST-6) al ST infradesnivelado (≥1mm a 80mseg del punto J) o descendente. Resultados: Se analizaron en forma prospectiva 691 pacientes, edad media 69,8 ± 12 años, 61,6% hombres. Se identificó IST-1 e IST-6 en 250 (36,2%) y 199 (28,8%) casos, respectivamente. La presencia de IST-1 e IST-6 se asoció a una FEVI significativamente menor comparado con la ausencia de dicho hallazgo: 44,8 ± 13,9% vs. 55,6 ± 8,9%, (p <0,0001) y 45,8 ± 14,1% vs. 54,1 ± 10,4% (p <0,0001) respectivamente. Ambos se asociaron a la presencia de DSVI, definida como FEVI <50%, aunque el IST-1 mostró mejor rendimiento diagnóstico que el IST-6 [área bajo la curva 0,72 (IC 95% 0,69-0,76) vs. 0,64 (IC 95% 0,610,68), p = 0,0001]. Conclusiones: Este estudio mostró que la depresión del segmento ST de la derivación DI permite predecir la presencia de DSVI mejor que IST-6. La potencial relevancia de dichos hallazgos debería situarse en el contexto actual de la emergente utilización de dispositivos wearables que analizan la información electrocardiográfica mediante una única derivación.
ABSTRACT Background: Different electrocardiographic abnormalities have been associated with left ventricular systolic dysfunction (LVSD), although the association with standard electrocardiographic frontal plane ST-segment depression (STD) has not been established. Objective: The aim of this study was to evaluate whether lead I STD (STD-I) allows predicting the presence of LVSD. Methods: Patients with risk factors or stable chronic heart disease, and baseline electrocardiogram (ECG) and echocardiogram that provided evaluation of left ventricular ejection fraction (LVEF), left ventricular wall motility, and dichotomous evaluation of left ventricular hypertrophy (LVH), were prospectively included in the study. ST-segment morphology in leads I and V6 was evaluated, defining horizontal (≥1mm at 80 ms from the J point) or downsloping STD as abnormal STD-I and STD-6. Results: A total of 691 patients; with mean age of 69.8 ± 12 years and 61.6% men, were prospectively analyzed. STD-I and STD-6 were identified in 250 (36.2%) and 199 (28.8%) cases, respectively. Presence of STD-I and STD-6 was associated with a significantly lower LVEF compared with the absence of this finding: 44.8 ± 13.9% vs. 55.6 ± 8.9% (p <0.0001) and 45.8 ± 14.1% vs. 54.1±10.4% (p <0.0001), respectively. Both were associated with the presence of LVSD, defined as LVEF <50%, although STD-I showed better diagnostic performance than STD-6 [area under the ROC curve 0.72 (95% CI 0.69-0.76) vs. 0.64 (95% CI 0.61-0.68), p = 0.0001]. Conclusions: This study showed that STD-I predicts the presence of LVSD better than STD-6. The potential relevance of these findings should be placed in the current context of the emerging use of wearable devices that analyze electrocardiographic information through a single lead.
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RESUMEN Introducción: El score de calcio coronario (SCC) es una herramienta de prevención subutilizada, en parte debido a su elevado costo, que no debería diferir del de una tomografía computarizada (TC) de tórax. El SCC puede ser evaluado mediante una TC de tórax convencional, generalmente utilizando escalas visuales o semicuantitativas, y con valor pronóstico similar al gatillado. Material y métodos: En este estudio observacional retrospectivo, incluimos pacientes (n = 35) en quienes se realizó dentro de la misma internación una TC de tórax no gatillada de baja dosis y un SCC gatillado. Resultados: Identificamos una buena concordancia entre los métodos tanto en su valoración cualitativa como cuantitativa, con una media de 3,86 ± 0,7 segmentos con calcificaciones arteriales coronarias mediante SCC gatillado, comparado con 3,79 ± 0,6 segmentos mediante TC de tórax no gatillada de baja dosis (coeficiente de correlación de concordancia 0,98 [IC 95% 0,95-0,99]) y una subestimación del SCC evaluado mediante unidades Agatston del 9,8 %. Conclusión: En este estudio, demostramos que el SCC podría ser evaluado con precisión de forma tanto cualitativa como cuantitativa mediante estudios de TC de tórax no gatillada de baja dosis.
ABSTRACT Background: Coronary calcium scoring (CCS) is an underused prevention tool, possibly due to its high cost, which should not differ from a chest computed tomography (CT) scan. CCS can be assessed using conventional chest CT, generally through a visual or semiquantitative approach, and with a similar prognostic value compared to ECG-gated CCS. Methods: In this retrospective observational study, we included patients (n = 35) who underwent a low-dose non-gated chest CT (LDCT) and an ECG-gated CCS within the same hospitalization. Results: We identified a good agreement between techniques both in their qualitative and quantitative assessment, with a mean of 3.86 ± 0.7 segments with calcifications by ECG-gated compared to 3.79 ± 0.6 segments by LDCT (concordance correlation coefficient 0.98 (95% CI 0.95-0.99), and a 9.8% underestimation of the Agatston score. Conclusions: In this study, we showed that the CCS might be accurately assessed both qualitatively and quantitatively by LDCT studies.
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RESUMEN Objetivo: Evaluar la utilidad de la angiotomografía computada (TC) espectral cardíaca en pacientes con ataque cerebrovascular isquémico (ACVi). Material y métodos: En el contexto de pandemia de COVID-19 incorporamos la utilización de la TC espectral cardíaca en pacientes con ACVi para descartar en una única sesión, tanto fuentes cardioembólicas (FCE) como la presencia de complicaciones trombóticas o daño miocárdico. A partir de julio de 2020 incorporamos una adquisición tardía a las TC cardíacas en contexto de ACVi. Se presentan cuatro casos representativos sobre su utilidad y hallazgos cardiovasculares. Resultados: Se presentan cuatro casos registrados en un lapso de 40 días. Dos pacientes con FCE (aorta y orejuela izquierda) y dos con ACVi de origen indeterminado donde se evidenció miocardiopatía (isquémica y no isquémica). Conclusiones: En el contexto del ACVi, la TC espectral cardíaca, que incluía adquisición tardía, permitiría, eventualmente, descartar la presencia de FCE e identificar la etiología subyacente.
ABSTRACT Objective: The aim of this study was to evaluate the usefulness of spectral cardiac computed tomography (CT) angiography in patients with ischemic stroke. Methods: In the setting of COVID-19 pandemic, we incorporated the use of spectral cardiac CT in patients with ischemic stroke to rule out the presence of cardioembolic sources, thrombotic complications or myocardial damage in a single session. Since July 2020, a delayed-phase image acquisition was incorporated to cardiac CT scans in the context of ischemic stroke. We describe four representative cases of the usefulness of the method and the cardiovascular findings. Results: We present four cases recorded recorded within a 40-day period. Two patients with patients with cardioembolic source (aorta and left atrial appendage) and two with ischemic stroke of undetermined source with evidence of cardiomyopathy (ischemic and non-ischemic). Conclusions: In the setting of ischemic stroke, spectral cardiac CT with delayed acquisition could be useful to rule out the presence of cardioembolic sources and identify the underlying etiology.
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ABSTRACT: The aim of this study was to measure the nitrogen (N) balance of pigs fed with lysine-limiting diets containing practical levels of wheat bran (WB) or soybean hulls (SH). Twelve pigs with average weights of 57.36±2.01 and 72.68±3.24 kg were used in trials 1 and 2, respectively. In trial 1, treatments were CT1 - control diet and WB - diet with inclusion of 15% WB. In trial 2, CT2 - control diet and SH - diet with inclusion of 6% SH. Fibrous diets increased (P<0.05) the fecal N in 63.54 and 60.55% in relation to CT1 and CT2, respectively. The urinary N was higher (P<0.05) in pigs receiving the WB diet, but was not influenced in the trial with SH. The N retention (NRET) was higher (P>0.05) in pigs ingesting the WB diet; although, when the proportion of NRET was expressed relative to N ingested (NING) there was no difference (P>0.05) between treatments. Inclusion of SH did not affect (P>0.05) the NRET when the result was expressed in absolute or proportional terms. In conclusion, inclusion of practical levels of WB and SH does not significantly affect the metabolic costs involved with nitrogen metabolism. However, only WB was able to contribute to the N balance of pigs, while the relative amount of N added by SH was fully recovered in feces.
RESUMO: O objetivo deste estudo foi medir o balanço de nitrogênio (N) de suínos alimentados com dietas limitantes em lisina contendo níveis práticos de inclusão de farelo de trigo (FT) ou casca de soja (CS). Foram utilizados 24 suínos machos castrados com peso médio inicial de 57,36±2,01 kg e 72,68±3,24 kg nos experimentos 1 e 2, respectivamente. No experimento 1 os tratamentos foram CT1 - dieta controle, e FT - dieta com inclusão de 15% de FT. No experimento 2 CT2 - dieta controle, e CS - dieta com inclusão de 6% CS. As dietas fibrosas aumentaram (P<0,05) o N fecal em 64,54 e 60,55% em relação a CT1 e CT2, respectivamente. O N urinário foi maior (P<0,05) nos suínos que receberam a dieta FT, mas não foi afetado no experimento com CS. A retenção de N (NRET) foi maior (P<0,05) nos suínos alimentados com a dieta FT, entretanto quando a proporção do NRET foi expressa em relação ao N ingerido (NING) não houve diferença entre os tratamentos (P<0,05). A inclusão de CS não afetou (P<0,05) a NRET quando os resultados foram expressos em termos absolutos ou proporcionais. Em conclusão, a inclusão de níveis práticos de FT ou CS não afeta significativamente o custo metabólico envolvido no metabolismo de N. Entretanto, apenas o FT foi capaz de contribuir para o balanço de N dos suínos, enquanto a quantidade N relativa a adição de CS foi totalmente recuperada nas fezes.
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Objective. This study aimed to determine the marginal efficiency of threonine utilization in growing pigs by using the nitrogen balance technique. Materials and methods. Twelve castrated pigs with an average live weight of 72±2 kg were housed in metabolic cages maintained in a temperature controlled room of 22±3°C. The treatments consisted of four diets calculated to meet 30, 45, 60 and 70% of the nutritional requirements of standardized ileal digestible threonine. The amino acids others than threonine were maintained at least 15% above threonine requirements, expressed in terms of ideal levels. The amount of feed supplied was calculate to provide 2.6 times the metabolizable energy requirements for maintenance and adjusted daily according to an expected daily gain rate of 0.8 kg. Results. Pigs consumed 1.65 g kg-1 BW0.75 nitrogen daily, on average and 61% was retained and, as a result, 39% was excreted, being 31% through the feces and the remainder (69%) in the urine. The pigs showed a linear retention of threonine in response to the increase of standardized threonine intake. For each gram of standardized threonine intake 0.37 g were lost during the metabolism. Conclusions. It is concluded that for calculating nutritional requirements of standardized threonine of pigs by the factorial method, it is possible to use the utilization marginal efficiency of 0.63.
Objetivo. El objetivo de este estudio fue determinar la eficiencia marginal del uso de treonina para cerdos en fase de crecimiento, por medio de la técnica de balance de nitrógeno. Material y métodos. Fueron utilizados doce cerdos machos castrados con peso promedio de 72±2 kg alojados en jaulas metabólicas climatizadas a una temperatura ambiente de 22±3°C. Los tratamientos consistieron en cuatro dietas calculadas para 30, 45, 60 y 70% de las necesidades nutricionales de treonina digestible estandarizada. Los demás aminoácidos se añadieron a las dietas para lograr una proporción de al menos 15% de sus necesidades expresadas con relación a la treonina. La cantidad de alimento proporcionado se calculó para suministrar 2.6 veces la energía metabolizable y ajustada todos los dias, según una tasa de ganancia media diaria de 0.8 kg. Resultados. Los cerdos consumieron 1.65 g kg-1 PV0.75 de nitrógeno por dia. En promedio 61% de nitrógeno ingerido se conservó y 39% fue excretado por el animal. El 31% se excretó en las heces y el resto (69%) en la orina. Los cerdos mostraron una retención lineal de treonina, con relación al aumento en la ingesta de treonina digestible estandarizada. Por cada gramo de treonina digestible estandarizada ingerido 0.37 g se perdieron durante el metabolismo. Conclusiones. Se concluye que, para el cálculo de las necesidades nutricionales de treonina digestible estandarizada para cerdos por método factorial, es posible utilizar la eficiencia marginal del uso de treonina a 0.63.
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Diet , Amino Acids, Essential , Livestock Industry , Nitrogen , Nutritional Requirements , ProteinsABSTRACT
O objetivo deste trabalho foi avaliar o desempenho animal, as características de carcaça e os custos para suínos alimentados com dietas ajustadas, para condições brasileiras, através do modelo InraPorc®. Foram utilizados 36 suínos castrados e 36 fêmeas, nas fases de crescimento e terminação, em um delineamento inteiramente casualizado. Os tratamentos foram dietas controles e dietas ajustadas para machos e fêmeas. O programa alimentar e o perfil animal foram adicionados ao modelo para parametrização e definição das estratégias nutricionais e alimentares nas dietas ajustadas. O desempenho e as características de carcaça não foram influenciados pelos tratamentos. O custo médio de alimentação para os animais que receberam a dieta controle foi 3,4% e 2,4% superior para os machos e para as fêmeas, respectivamente. Na comparação entre as dietas, o custo médio de alimentação para os animais que receberam a dieta controle foi 2,9% superior. A receita líquida foi R$0,19 e R$0,66 superior para os machos e fêmeas que receberam a dieta ajustada, respectivamente. As dietas ajustadas através do InraPorc® para suínos em crescimento e terminação não influenciam no desempenho e nas características de carcaça, contudo reduzem os custos de alimentação, o que gera aumento da receita líquida de produção.
The objective of this study was to evaluate animal performance, carcass characteristics and costs for pigs fed diets adjusted to Brazilian conditions, through the model InraPorc®. We used 36 barrows and 36 females, during the growing and finishing in a completely randomized design. The treatments were control diets and diets adjusted for both males and females. The feeding program and the animal profile were added to the model parameterization and define strategies and nutritional feed in the diets adjusted. The performance and carcass traits were not affected by treatments. The average cost to feed the animals that received the control diet was higher in 3.4% and 2.4% for the males and females respectively. Comparing the diets, the average cost to feed the animals that received the control diet was 2.9% higher. Net income was R$0.19 and R$0.66 higher for males and females which received the diet adjusted, respectively. Diets adjusted through InraPorc® for the growing and finishing pigs did not influence the performance and carcass traits, however reduced feed costs which generates higher net production.
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Um experimento avaliou a adição de ractopamina e extratos cítricos a dietas de suínos em terminação. Foram utilizados 108 suínos (54 machos e 54 fêmeas) em um delineamento de blocos completos ao acaso, sendo o sexo o fator de bloqueamento e nove os tratamentos: T1. controle (C) (0ppm de ractopamina e 0ppm de extratos cítricos), T2. C+10RAC (ractopamina, em ppm), T3. C+20RAC, T4. C+250EC (extratos cítricos, em ppm), T5. C+500EC, T6. C+250EC+10RAC, T7. C+250EC+20RAC, T8. C+500EC+10RAC e T9. C+500EC+20RAC. O peso vivo final (109,9±3,6kg), consumo de ração (2,6±0,2kgd-1), ganho de peso (1,0±0,1kgd-1), conversão alimentar (2,7±0,2), comprimento de carcaça (97,0±2,7cm), profundidade de músculo (56,1±5,6mm) e pH (5,9±0,3) não foram influenciados pelos tratamentos. Sobre o peso de carcaça, o efeito foi somente do tratamento com 20ppm de ractopamina em relação a 10ppm de ractopamina, sendo 5,7 por cento superior. A espessura de toucinho do grupo controle foi 35 por cento superior aos níveis de ractopamina, e a interação foi 500ppm de extratos cítricos e 10ppm de ractopamina. A carne magra do controle foi 5,3 por cento inferior em relação aos níveis de ractopamina. A alimentação de suínos em terminação com dietas contendo ractopamina, extratos cítricos e suas interações não altera o desempenho, mas influencia algumas características de carcaça.
This study was carried out to evaluate the effect of the addition of the citrus extracts and ractopamine in finishing pig diets. A Hundred eight pigs were used (54 males and 54 females) in a completely randomized design, blocked by sex and distributed in nine treatments: T1. control (C) (0ppm of the ractopamine e 0ppm of the citrus extracts), T2. C+10RAC (ractopamine, ppm), T3. C+20RAC, T4. C+250EC (citrus extracts, ppm), T5. C+500EC, T6. C+250EC+10RAC, T7. C+250EC+20RAC, T8. C+500EC+10RAC and T9. C+500EC+20RAC. The final body weight (109.9±3.60kg), feed intake (2.6±0.24kg d-1), body weight gain (1.01±0.09kg d-1), feed conversion ratio (2.7±0.25), carcass length (97±2.71cm), depth muscle (56.1±5.63mm), and pH (5.9±0.33) were not affected by treatments. There was a significant effect for the treatment with 20ppm of ractopamine, which was 5.7 higher, in relation to the treatment with 10ppm of ractopamine. The backfat thickness of control group was 35 percent higher than the ractopamine levels and the interaction was of 10ppm of ractopamine and 500ppm of citrus extracts. The lean meat in the control group was on average, 5.3 percent lower in relation to the ractopamine levels. Feeding of finishing pigs with diets containing ractopamine, citrus extracts and their interactions didn't affect performance, however affected some carcass characteristics.
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Uma metanálise foi realizada para avaliar a relação entre a espessura de toicinho e as variáveis nutricionais de porcas gestantes e lactantes. A base de dados contemplou 14 artigos publicados de 2000 a 2006 em revistas indexadas. A metanálise foi realizada através de análises gráfica, de correlação e de variância. A correlação entre espessura de toicinho na gestação (ETg) com consumo de alimento na gestação (CAl G) foi de -0,09 (P=0,04), com CAl na lactação (CAl L) baseado na tabela NRC (1998) foi de -0,09 (P=0,06), com CAl na lactação baseado na tabela Rostagno (2000) foi de -0,08 (P=0,06) e com consumo de proteína bruta na lactação (CAl L PB) foi de -0,08 (P=0,06). A correlação entre espessura de toicinho na lactação (ETl) com CAl na gestação foi de 0,29 (P<0,01), com CAl na gestação NRC (1998) foi de 0,20 (P<0,01), com CAl na gestação Rostagno (2000) foi de 0,20 (P<0,01), com CAl na lactação foi de -0,21 (P<0,01), com consumo na lactação NRC (1998) foi de -0,24 (P<0,01) e com consumo na lactação Rostagno (2000) foi de 0,24 (P<0,01). O CAl de PB na gestação foi de 0,20 (P<0,01) e o CAl de PB na lactação foi de -0,26 (P<0,01). A variação da espessura de toicinho durante a lactação é influenciada pelos níveis de proteína e lisina da dieta e pela gordura e proteína no leite. A variação da espessura de toicinho na gestação e na lactação foi semelhante para as tabelas do NRC (1998) e de Rostagno (2000). Há relação significativa entre espessura de toicinho e variáveis nutricionais em porcas gestantes e lactantes.
A meta-analysis was undertaken to evaluate the relationship between backfat thickness and nutritional variables of sows during gestation and lactation. The database was developed from 14 studies published between 2000 and 2006. The meta-analysis was carried out trough by graphical analysis, correlation and variance. The correlation between backfat thickness at gestation (BTg) and feed intake (FI) at this phase was -0.09 (P=0.04). The correlation between backfat thickness at gestation (BTg) and lactation FI NRC (1998) was -0.09 (P=0.06); BTg and FI at lactation Rostagno (2000) presented a correlation of-0.08 (P=0.06). In the same way the correlation between BTg and crude protein (CP) intake at lactation was -0.08 (P=0.06). The correlation between backfat thickness at lactation (BTl) and FI at gestation was 0.29 (P<0.01). BTl and FI at gestation NRC (1998) presented a correlation of 0.20 (P<0.01). For BTl and gestation feed intake Rostagno (2000) a correlation of 0.20 (P<0.01) was reported. The correlation between BTl and lactation FI was -0.21 (P<0.01), the correlations between BTl and lactation FI NRC (1998) were -0.24 (P<0.01) and lactation FI Rostagno (2000) 0.24 (P<0.01). Correlations of 0.20 (P<0.01) and -0.26 (P<0.01) were observed between BTl and CP intake at gestation and CP intake at lactation respectively. The backfat thickness variation at lactation is influenced by protein and lysine levels in the diet and fat and protein of the milk. Gestation and lactation backfat thickness variation was similar to NRC (1998) and Rostagno (2000). There is a significant relationship between backfat thickness and nutritional variables in pregnant and farrowing sows.