Cáncer de vesícula en colecistectomías de la región de Tarapacá. Análisis según pertenencia étnica / Prevalence of gallbladder cancer in a Northern Chilean region

BACKGROUND: Gallbladder Cancer (GBC) prevalence varies among countries, associated with different geographical and genetic factors. The Mapuche ethnicity (Ethnia mostly located between the VIII and X Chilean regions) stands out in Chile due to its high GBC prevalence. Aim: To estimate the GBC prevalence in patients undergoing cholecystectomy at a public hospital in the Northern region of Chile (Tarapaca), where other ethnical groups are common. MATERIAL AND METHODS: Pathological reports of 3270 patients (72% women) who underwent cholecystectomy between January 2016 and December 2019 were revised. Subsequently, the accreditation of ethnic belonging for each patient to one of the ten native communities in Chile was requested to the National Corporation for Native Communities Development (CONADI). RESULTS: According to the analysis of pathological reports, the global GBC prevalence was 0.3 %. The prevalence in Aymaras was 0.4% and 0% in Mapuches. The distribution of ethnic origins among analyzed patients was Aymara in 14.3, Mapuche in 2.7%, Diaguita in 1.7%, Quechua in 1.3%, Atacameña in 0.2%, and Colla in 0.2%. No specific ethnic origin was found in 79% of patients. Conclusions: There was a low GBC prevalence rate in Northern Chile and among the Aymara population.

Atención de las necesidades espirituales y religiosas de pacientes por personal de salud: un modelo basado en el acompañamiento espiritual / Attention to the spiritual and religious needs of patients by health personnel: a model based on spiritual accompaniment

Resumen Los aspectos espirituales y religiosos han retomado su importancia en la atención de salud, en la búsqueda de una atención integral, digna y más humana, teniendo en cuenta además, los múltiples beneficios clínicos asociados. Sin embargo, el cuidado de las necesidades espirituales y religiosas, históricamente asumidas por capellanes religiosos y guías espirituales, actualmente, en forma paulatina, son considerados parte de las obligaciones de los equipos de salud, no sin la reticencia de los mismos y sin una manera clara de cómo hacerlo. El objetivo del presente trabajo es presentar la importancia de la atención de las necesidades espirituales y religiosas en el cuidado de salud y un modelo de atención basado en el acompañamiento espiritual.

In the search for comprehensive, dignified and more humane care, the spiritual and religious aspects have regained their importance in health care. Furthermore, the múltiple associated clinical benefits must also be taken into account. However, the care of spiritual and religious needs, historically undertaken by religious chaplains and spiritual guides, have gradually become considered part of the obligations of the health teams, in spite of their reluctance and without a clear way on how to do it. The objective of this work is to present the importance of attending to the spiritual and religious needs in health care and a care model based on spiritual accompaniment.

Procuramiento y uso de aloinjertos cutáneos de piel total criopreservados obtenidos de pacientes sometidas a abdominoplastía / Procurement and use of cryopreserved whole skin cutaneous allografts obtained from patients undergoing abdominoplasty

Resumen Introducción: Los aloinjerto cutáneos (AC) son excelentes sustitutos cutáneos temporales, sin embargo, la donación y procura de piel cadavérica, fuente habitual de AC, es baja. Objetivo: Evaluar la factibilidad de utilizar la piel proveniente de abdominoplastías como fuente de AC y su eficacia clínica. Materiales y Método: Entre el 17 de agosto de 2020 al 28 de febrero de 2021 se analizó una cohorte prospectiva de 14 pacientes femeninas sometidas a abdominoplastía por motivos estéticos, que aceptaron donar la piel del colgajo cutáneo abdominal redundante, la cual fue criopreservada. Se utilizaron los AC de piel total criopreservados (ACPTC) en 10 pacientes con diagnósticos de: pie diabético (4), laparostomía contenida (2) herida compleja extremidad inferior (2), sarcoma de cuero cabelludo recidivado (1) y melanoma (1). Resultados: Se obtuvieron 14 colgajos de piel total, los cuales fueron procesados obteniendo una superficie promedio de 302 cm2 y 8,3 láminas de distintos tamaños de utilidad clínica por paciente. En todos los pacientes en que se utilizó ACPTC hubo un prendimiento inicial del AC para posteriormente, en promedio 21 días, presentar una escara necrótica que al ser retirada presentaba un tejido vital adherido al receptor rico en fibroblastos, siendo algunos pacientes auto injertados y otros manejados con cicatrización por segunda intención como tratamiento definitivo. Discusión: Los ACPTC proporcionan una cobertura intermedia, pues una parte se integra en forma definitiva, actuando como un andamiaje biológico para la formación de una interfase sobre la cual se puede autoinjertar o dejar evolucionar con cicatrización por segunda intención y una parte es rechazada. Conclusión: La procura de piel de donante vivo, en pacientes sometidos a cirugías de contorno corporal es un proceso factible, fuente de ACPTC, los cuales permiten una nueva cobertura intermedia con múltiples aplicaciones clínicas.

Introduction: Skin allografts (SA) are outstanding temporary skin substitutes; however, cadaveric skin donation and procurement, a common source of SA, remains low. Aim: To evaluate the feasibility and clinical efficacy of using skin from abdominoplasties as a source of SA. Materials and Method: A prospective cohort was analyzed from August 17th, 2020 and February 28th, 2021, with 14 female patients submitted to abdominoplasty surgeries for aesthetic motives, who authorized skin donation from the redundant abdominal flap which was posteriorly cryopreserved. Cryopreserved total skin allografts (CTSA) was used in 10 patients with the following diagnoses: diabetic foot (4), contained laparostomy (2) complex wound of the lower limb (2), relapsing sarcoma of the scalp (1), and melanoma (1). Results: 14 CTSA were obtained, which were processed, obtaining an average area of 302 cm2 and 8.3 sheets of different sizes and clinical applications from each patient. In all patients who received CTSA, an initial attachment was observed, followed by the appearance of a necrotic scar in an average of21 days. The peeling of the latter revealed a vital tissue tightly adhered to the receptor and rich in fibroblasts. Some of the patients received autografts, and others were managed with secondary intention scarring as a definite treatment. Discussion: CTSA provide an intermediate coverage since one part is definitely adhered to, acting as a biologic scaffolding for the formation of an interface that can be autografted or left for a secondary intention scarring, and the host rejects the other portion. Conclusión: skin procurement from a living donor in patients submitted to body contour surgeries is a feasible process and significant source of CTSA, which permits a new intermediate coverage with multiple clinical uses.

Renoprotective effect of N-acetylcysteine depends upon the severity of the ischemia reperfusion injury

Acute kidney injury (AKI) is a common complication in seriously ill patients, while renal ischemia-reperfusion (I/R) injury is the most frequent event in this oxidative renal injury. N-acetylcysteine (NAC) is a small molecule containing a thiol group that has antioxidant properties, promoting detoxification and acting directly as a free radical scavenger. In this study, the protective effect of NAC was investigated in short-term (30 min) and long-term (45 min) ischemic AKI. This was achieved via clamping of the renal artery for 30 or 45 min in Wistar rats to induce I/R injury. AKI worsened with a longer period of ischemia (45 compared to 30 min) due to probable irreversible damage. Preconditioning with NAC in short-term ischemia improved renal blood flow and increased creatinine clearance by reducing oxidative metabolites and increasing antioxidant capacity. Otherwise, NAC did not change these parameters in the long-term ischemia. Therefore, this study demonstrated that the period of ischemia determines the severity of the AKI, and NAC presented antioxidant effects in short-term ischemia but not in long-term ischemia, confirming that there is a possible therapeutic window for its renoprotective effect.

Prevalencia de colecistolitiasis y cáncer de vesícula en una población rural aymara de Chile

Background: The prevalence of cholelithiasis and gallbladder cancer may be different across ethnic groups. Aim: To study the prevalence of cholelithiasis and gallbladder cancer among Aymara individuals. Material and Methods: An abdominal ultrasound was carried out in a sample of 182 Aymara women aged 46 ± 16 years and 76 Aymara men aged 55 ± 16 years. In addition, the histopathological reports of both patients with a history of previous cholecystectomy and those operated after the study were reviewed. Results: Ultrasound was normal in 150 participants (58%), 76 had cholelithiasis (30%) and 32 (12%) had a history of cholecystectomy. Pathological reports of the excised gallbladder were available for 106 cases and showed a chronic cholecystitis in 98% of cases. Gallbladder cancer was not reported. Conclusions: There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.

Biomechanical and biochemical investigation of erythrocytes in late stage human leptospirosis

Leptospirosis is a zoonotic disease caused by bacteria of the genus Leptospira, which can cause lipid changes in the erythrocyte membrane. Optical tweezers were used to characterize rheological changes in erythrocytes from patients with leptospirosis in the late stage. Biochemical methods were also used for quantification of plasma lipid, erythrocyte membrane lipid, and evaluation of liver function. Our data showed that the mean elastic constant of erythrocytes from patients with leptospirosis was around 67% higher than the control (healthy individuals), indicating that patient's erythrocytes were less elastic. In individuals with leptospirosis, several alterations in relation to control were observed in the plasma lipids, however, in the erythrocyte membrane, only phosphatidylcholine showed a significant difference compared to control, increasing around 41%. With respect to the evaluation of liver function of individuals with leptospirosis, there was a significant increase in levels of alanine transaminase (154%) and aspartate transaminase (150%), whereas albumin was 43.8% lower than control (P<0.01). The lecithin-cholesterol acyltransferase fractional activity was 3.6 times lower in individuals with leptospirosis than in the healthy individuals (P<0.01). The decrease of the erythrocyte elasticity may be related to the changes of erythrocyte membrane phospholipids composition caused by disturbances that occur during human leptospirosis, with phosphatidylcholine being a strong candidate in the erythrocyte rheological changes.

Endothelin-1 receptor antagonists protect the kidney against the nephrotoxicity induced by cyclosporine-A in normotensive and hypertensive rats

Cyclosporin-A (CsA) is an immunosuppressant associated with acute kidney injury and chronic kidney disease. Nephrotoxicity associated with CsA involves the increase in afferent and efferent arteriole resistance, decreased renal blood flow (RBF) and glomerular filtration. The aim of this study was to evaluate the effect of Endothelin-1 (ET-1) receptor blockade with bosentan (BOS) and macitentan (MAC) antagonists on altered renal function induced by CsA in normotensive and hypertensive animals. Wistar and genetically hypertensive rats (SHR) were separated into control group, CsA group that received intraperitoneal injections of CsA (40 mg/kg) for 15 days, CsA+BOS and CsA+MAC that received CsA and BOS (5 mg/kg) or MAC (25 mg/kg) by gavage for 15 days. Plasma creatinine and urea, mean arterial pressure (MAP), RBF and renal vascular resistance (RVR), and immunohistochemistry for ET-1 in the kidney cortex were measured. CsA decreased renal function, as shown by increased creatinine and urea. There was a decrease in RBF and an increase in MAP and RVR in normotensive and hypertensive animals. These effects were partially reversed by ET-1 antagonists, especially in SHR where increased ET-1 production was observed in the kidney. Most MAC effects were similar to BOS, but BOS seemed to be better at reversing cyclosporine-induced changes in renal function in hypertensive animals. The results of this work suggested the direct participation of ET-1 in renal hemodynamics changes induced by cyclosporin in normotensive and hypertensive rats. The antagonists of ET-1 MAC and BOS reversed part of these effects.

Consumo de bocadillos y exceso de peso en niños colombianos / Snack intake and overweight among Colombian children

Four hundred ninety-five children between 0 and 17 years old provided information about their dietary intake in 966 24-hour dietary recall. Their nutritional status was established based on anthropometry using the growth patterns of WHO. Energy and macronutrients in 27 categories of dietary intake of snacks was determined. The aim was to establish the relationship between excess weight, snacking and consumption of energy derived from them. Based on models of linear regression and binomial where excess weight was the dependent variable and the explanatory power consumption, prevalence ratios (RP) and adjusted differences were calculated. Although energy from snack consumption increases with socioeconomic status, 751 (717, 786) kcal more in quintile 5 versus quintile 1, p <0.0001, the risk of excess in those taking snack is not statistically significant compared to those who did not consume, RP 1.05 (0.40 to 2.76). In conclusion, we established that consumption of snacks is not a determinant of overweight in Colombian children and that the main determinant of overweight and consumption of snacks is urban planning, social development, economic and level of wealth.

Cuatrocientos noventa y cinco niños entre 0 y 17 años aportaron información sobre su consumo dietario en 966 formatos de recordatorios de las últimas 24 horas. En todos se estableció su estado de nutrición con base en antropometría utilizando los patrones de crecimiento de la OMS. Se determinó el consumo de energía y macronutrientes en 27 categorías del consumo dietario de bocadillos con base en evidencia científica. El objetivo fue establecer la relación entre el exceso de peso, el consumo de bocadillos y el consumo de energía derivada de ellos. Con base en modelos de regresión lineal y binomial donde el exceso de peso era la variable dependiente y el consumo de energía la explicatoria, se calcularon Razones de Prevalencia (RP) y diferencias ajustadas. A pesar de que la energía derivada de consumo de bocadillos aumenta con el nivel socioeconómico, 751 (717, 786) kcal más en el quintil 5 versus el quintil 1, p<0,0001, el riesgo de exceso en aquellos que consumen bocadillos no es estadísticamente significativo con respecto a los que no consumen, RP 1,05 (0,40 a 2,76). En conclusión, establecimos que el consumo de bocadillos no es al parecer, determinante del exceso de peso en menores colombianos y que el principal determinante del exceso de peso y del consumo de bocadillos es el urbanismo, el desarrollo social, el económico y el nivel de riqueza.

¿Cuántos días se debe medir la dieta?: Variabilidad de la ingesta dietaria en Colombia / Woy many days must be measured diet?: Variability of dietary intake in Colombia

During 2009-2011, information on dietary intake of 822 subjects between 18-59 years of age were collected. Each subject answered two 24-hours dietary recall (R24H) with a minimum interval of one week to avoid responses based on memory. In total, 1616 R24H were analyzed. The aim of this study was to describe the characteristics of the variability of twenty nutritional variables (Vn), establish the sources and their contribution to the variability of the Vn, determine the number of days required to approach accurately the true average Vn and finally to establish the feasibility study of the relationship between diet-health events disease in Colombia. The ratio of variances (Sw2/ Sb2) was consistently higher in rural areas, except for energy and sodium. Calcium in rural areas and copper in urban areas had the lowest ratio Sw2/ Sb2, 0.36 and 0.12 respectively Vitamin A in rural areas and sodium in urban areas, showed the largest ratio, 0.98 and 0.91 respectively. Socioeconomic status and geographic area are the main determinants of variability. For energy intake sex is the main source of variation. For macronutrients five repeated measurements are necessary to obtain the true average intake of these, with levels of error between 15% and 40%. With the exception of vitamin A, all Sw2/ Sb2 reasons are within values <1, which would still allow the development of nutritional epidemiology in Colombia.

Durante 2009-2011, se recolectó información sobre el consumo dietario de 822 sujetos entre 18-59 años de edad. Cada sujeto contesto dos recordatorios del consumo de las últimas 24 horas (R24H) con un intervalo mínimo de una semana para evitar respuestas en base a la memoria. En total se analizaron 1 616 R24H. El objetivo fue describir las características de la variabilidad de veintisiete variables nutricionales (Vn), establecer las fuentes relativas que aportan a la variabilidad en éstas, determinar el número de días necesarios para acercarse con precisión al verdadero promedio de las Vn y finalmente, establecer la viabilidad del estudio de las relaciones entre dieta-eventos de salud enfermedad en Colombia. La razón entre varianzas (Sw2/Sb2) fue consistentemente mayor en la zona rural, excepto para la energía y el sodio. El calcio en la zona rural y el cobre en la urbana presentaron la menor razón Sw2/Sb2, 0,36 y 0,12 respectivamente. La vitamina A en la zona rural y el sodio en la urbana, la mayor razón, 0,98 y 0,91 respectivamente. El nivel socioeconómico y el área geográfica fueron los principales determinantes de la variabilidad. Para el consumo de energía, el sexo fue la principal fuente de variación. Para los macronutrientes son necesarios hasta cinco mediciones repetidas para obtener el verdadero promedio de la ingesta de éstos con niveles de error entre 15% y 40%. Con excepción de la vitamina A, todas las razones Sw2/Sb2 se encontraron dentro de valores<1, lo que permitiría aún el desarrollo de la epidemiología nutricional en Colombia.

Wolbachia spp. interfere na detecção molecular de Ehrlichia canis e Anaplasma platys em cães com microfilaremia / Wolbachia spp. interferes with molecular detection of Ehrlichia canis and Anaplasma platys in microfilaremic dogs

This report aimed to study the interference in molecular testing for Ehrlichia canis and Anaplasma platys in blood of 155 dogs from the coastal region of Rio de Janeiro. Five Anaplasmataceae positive samples but negative for E. canis and A. platys, from microfilaremic animals, were chosen for sequencing. These sequences, when compared to Gen et Bank database, showed 88% to 100% similarity with Wolbachia spp. denoting an interference in the detection of DNA from other members of Anaplasmataceae, possibly due to a high concentration of Wolbachia spp. DNA.(AU)

La caries dental y los factores relacionados en una población de adultos de la ciudad de la rioja, Argentina / The dental caries and related factors in adult population of the city of rioja, Argentina

La caries dental es un proceso patológico post-eruptivo, localizado, externo, involucra un reblandecimiento de los tejidos duros del diente procediendo a la formación de una cavidad1. Se determinó la presencia de caries dental, su relación con factores patológicos y preventivos en adultos de La Rioja, Argentina. A partir de 183 adultos de 25 a 35 años de edad se estudiaron los dientes con caries, obturaciones, perdidos e índice CPOD y se registraron en una ficha dental. Por cada adulto se obtuvo una historia clínica. El 77% de los adultos presentó un promedio de 3,73±4,28 caries, 4,75±4,61 obturaciones, 1,91±2,92 perdidos e índice CPOD 10,39±5,90. El CPOD para el género femenino fue mayor que para el masculino (p=0,042). La caries se relacionó con bajo nivel de educación (p=0,0001), ingreso económico (p=0,0086), cepillado dental diario (p=0,0340), cepillado nocturno (p=0,0018), con consulta prevalente por dolor (p<0,0001), falta de visita bucal anual (p=0,0003) y de obra social (p=0,0064). La caries dental es una enfermedad presente en la población adulta se asocia con bajo nivel de educación, económico y preventivo dental. Necesita del abordaje económico cultural integrado de la sociedad para mejorar la salud bucal del adulto y asegurar su calidad de vida en su senectud.

The dental caries is defined a post eruptive pathological process of external origin located tooth involves softening of the hard tissues of the tooth proceeding consequently to the formation of a tooth cavity1. The presence of dental caries was determined, its relationship with pathological and preventive factors in adults of La Rioja, Argentina. From 183 adults from 25-35 years of age, were studied decayed, fillings, missing teeth and index DMFT and recorded on a dental chart. For each adult, a clinic history was obtained. The 77% of adults had a mean of 3,73 ±4,28 caries, 4,75 ±4,61 filling, 1,91 ±2,92 missing and DMFT 10,39 ±5,90. The DMFT was higher for the female gender than for males (p=0,042). Caries was associated with low level of education (p=0,0001), low income (p=0,0086) lack tooth daily brushing (p<0,0340), lack of night brushing (p=0,018), check only for pain (p< 0,0001), lack of annual dental visit (p=0,0003) and absence of coverage social (p=0,0064). Dental caries is a disease present in the population of adults, is associated with low level education, economic and lack of prevention dental. Requires a socio cultural economic work of society to improve the oral health of adults and ensure their senescence.

Malnutrición y seguridad alimentaria: un estudio multinivel / Malnutrition and food security: a multilevel study

En 1488 sujetos y 432 hogares se establecieron las variables asociadas al estado de nutrición (EN) de los sujetos y malnutrición del hogar, y el efecto de la inseguridad alimentaria (INSA) sobre estos estados. El EN se estableció mediante antropometría. La malnutrición del hogar con base en el EN. La INSA con base en el consumo de calorías durante 24 horas además de la percepción del jefe del hogar. Mediante regresiones logística multinomial y binomial se establecieron razones de prevalencia (RP) para las variables y el EN y la malnutrición. En sujetos el riesgo de déficit de peso es 3,9 veces mayor en el ámbito rural, y 4,4 veces más en los que apenas han cursado primaria o menos. Las mujeres tienen 1,4 más riesgo de exceso de peso, por cada cinco años de edad el exceso de peso aumenta en 30%, en los sujetos sin apoyo alimentario 1,7 veces. En hogares el nivel socioeconómico bajo tiene 1,9 veces más riesgo de malnutrición, los hogares sin menores de edad 3,1 y los urbanos 1,6 veces más riesgo. La INSA no esta asociada al EN, ni a la malnutrición. El apoyo alimentario a sujetos aparentemente protege contra el exceso de peso. Sujetos y hogares urbanos tiene mayor riesgo de exceso y malnutrición.

The variables associated with nutritional status (EN), household malnutrition, and food insecurity (INSA) was evaluated in 1488 subjects living in 432 homes. The NE was determined by anthropometric measures and the INSA was based on the calorie intake of 24 hours and on the perception of the household head. Prevalence ratios (PR) were established using binomial and multinomial logistic regressions. The risk of weight deficit in subjects was 3.9 (CI 95%: 1.2 to 11.9) times higher in the rural than in the urban areas, and 4.4 (CI 95%: 1.3 to 14.8) times more when they had primary school or less. Women had 1.4 times (CI 95%: 1.0 to 1.8) higher risk of overweight for each five years of age increase. Households with low socioeconomic level had 1.9 (CI 95%: 1.2 to 2.9) times more risk of malnutrition when children were not present. The INSA was not associated with the EN or malnutrition. Food support in subjects apparently protected against excess weight. Urban subjects and households were at greater risk of having excess weight and malnutrition.

Evaluación de la calidad de vida en pacientes con cáncer terminal / Assessment of quality of life in patients with terminal cancer

Introduction: research on life quality of cancer patients allows giving the attention back to the patient and his/her needs. Materials and Methods: FACT-G survey was performed to 77 terminal cancer patients on the Palliative Care and Pain Relief unit from Iquique's General Hospital. Results: physical welfare was evaluated with a 21.22 out of a maximum of 28, social/familiar welfare had a 12.57 over 28, emotional welfare was 16 over 24 and functional welfare had 17.33 over 28. Final score, which represents the sum of the four prior divisions, with a scale from 0 to 108, was 67.62 percent of the maximum score. Conclusions: performance of life quality surveys is feasible for cancer patients, and allows us to make specific interventions on the patient and his/her close ones to improve his/her life quality.

Introducción: los estudios de calidad de vida en pacientes oncológicos permiten devolver la atención al paciente y a sus necesidades. Material y Método: se realiza la encuesta FACT-G (Functional Assessment of Cancer Treatment) a 77 pacientes con diagnóstico de cáncer terminal pertenecientes al policlínico de cuidados paliativos y alivio del dolor del Hospital Ernesto Torres Galdames de Iquique. Resultados: el bienestar físico fue evaluado con 21,22 sobre un máximo de 28, el bienestar Social/Familiar obtuvo 12,57 de 28; el bienestar emocional obtuvo 16 sobre 24; el bienestar funcional obtuvo 17,33 sobre 28. El Score final, que representa la suma de las cuatro divisiones anteriores, con una escala de 0 a 108, fue de 67, que representa el 62 por ciento del puntaje máximo. Conclusiones: es factible la realización de encuestas de calidad de vida en pacientes con cáncer, las cuales nos permiten realizar intervenciones puntuales sobre el paciente y sus cercanos que mejoren su calidad de vida.

Comportamento alimentar de cabras alimentadas com diferentes teores de fibra em detergente neutro / Feeding behavior of goats fed with different NDF levels

Avaliou-se o comportamento alimentar de cabras alimentadas com dietas que continham diferentes teores de fibra em detergente neutro (FDN) - 49, 54, 59, 64 e 69 por cento -, em função de diferentes teores de inclusão de resíduo úmido de cervejaria (RUC), em substituição ao concentrado da dieta - 0, 25, 50, 75 e 100 por cento. Foram utilizadas cinco cabras mestiças Boer x Saanen e cinco cabras Saanen distribuídas em dois quadrados latinos 5x5. O volumoso utilizado foi feno de tifton, com relação volumoso: concentrado de 40:60. As observações foram feitas em períodos de 20 minutos até o tempo total de 24 horas. Os animais dos diferentes genótipos não apresentaram diferenças no comportamento alimentar. Os tempos gastos com alimentação e com ociosidade não diferiram quanto aos teores de FDN na dieta, no entanto resposta linear crescente foi observada para os tempos despendidos com ruminação e com a mastigação total com o aumento dos teores de FDN e RUC na dieta. As dietas com os teores de 49 e 64 por cento apresentaram menor tempo de ruminação quando comparadas com a dieta com teor de 69 por cento de FDN, com resultados respectivos de 218, 268 e 366 minutos de ruminação. Isso contribuiu para diminuir a eficiência (min/kg MS e FDN) de alimentação, ruminação e mastigação. Conclui-se que o resíduo úmido de cervejaria pode ser usado como fonte de fibra efetiva na dieta de cabras.

The feeding behavior was evaluated in lactating goats fed diets with different levels of NDF (neutral detergent fiber) 49, 54, 59, 64, and 69 percent, in function of different levels of WBG (wet brewery grains) 0, 25, 50, 75, and 100 percent. Five goats Boer x Saanen and five Saanen goats were randomly distributed in two 5x5 latin squares. The used roughage tifton hay in a roughage:concentrate rate of 60:40. The feeding times, idle time, and rumination time were evaluated each 20 minutes during 24 hours. The feeding behavior was not influenced by genotypes. The feeding times and idles times were not affected by increasing NDF levels, however, the rumination time and total chewing time had growing linear effect with increase of NDF levels in which the levels 49 and 64 percent showed shorter rumination time than 69 percent NDF, 218, 268, and 366min respectively. It decreased the feeding, rumination and chewing efficiency (min/kg DM and NDF). It was concluded that WBG can be used as a source of effective fiber in diets of goats.

Obstrucción intestinal por hernia obturatriz: caso clínico / Intestinal obstruction caused by an obturator hernia: report of one case

We report a 76 years old female presenting in the emergency room with a history of abdominal pain lasting seven days. A plain abdominal X ray showed few fluid filled loops. Due to persistence of pain and appearance of vomiting, an abdominal CAT sean showed a short bowel obstruction caused by an obturator hernia. The patient was operated, correcting the defect with a mesh. The postoperative evolution was uneventful.

La hernia obturatriz es una rara causa de obstrucción intestinal, se presenta en pacientes mujeres adultos mayores, desnutridos y postrados; se asocia a una elevada mortalidad por los antecedentes mórbidos de los pacientes y al bajo índice de sospecha. Se recomienda el uso de la tomografía axial computada como técnica de elección para el diagnóstico en pacientes con sospecha clínica. El objetivo de este trabajo es presentar un caso clínico de una paciente con hernia obturatriz que consultó en nuestro servicio de urgencia y se solicitó tomografía de abdomen y pelvis para completar estudio que requirió laparotomía exploradora ante el cuadro clínico y los hallazgos imagenológicos.

Noninvasive assessment of endothelial function and ST segment changes during exercise testing in coronary artery disease

Endothelial function (EF) plays an important role in the onset and clinical course of atherosclerosis, although its relationship with the presence and extent of coronary artery disease (CAD) has not been well defined. We evaluated EF and the ST segment response to an exercise test in patients with a broad spectrum of CAD defined by coronary angiography. Sixty-two patients submitted to diagnostic catheterization for the evaluation of chest pain or ischemia in a provocative test were divided into three groups according to the presence and severity of atherosclerotic lesions (AL): group 1: normal coronaries (N = 19); group 2: CAD with AL <70 percent (N = 17); group 3: CAD with AL ¡Ý70 percent (N = 26). EF was evaluated by the percentage of flow-mediated dilatation ( percentFMD) in the brachial artery during reactive hyperemia induced by occlusion of the forearm with a pneumatic cuff for 5 min. Fifty-four patients were subjected to an exercise test. Gender and age were not significantly correlated with percentFMD. EF was markedly reduced in both groups with CAD (76.5 and 73.1 percent vs 31.6 percent in group 1) and a higher frequency of ischemic alterations in the ST segment (70.8 percent) was observed in the group with obstructive CAD with AL ¡Ý70 percent during the exercise test. Endothelial dysfunction was observed in patients with CAD, irrespective of the severity of injury. A significantly higher frequency of ischemic alterations in the ST segment was observed in the group with obstructive CAD. EF and exercise ECG differed among the three groups and may provide complementary information for the assessment of CAD.

Efeitos genéticos e não-genéticos sobre o intervalo de parto em fêmeas suínas no Sudeste do Brasil / Genetic and environmental effects on the farrowing interval in sows in the southeastern region of Brazil

The effect of environmental and genetic effects on the farrowing interval in Dalland (C-40) sows in the Southeast of Brazil was studied. Data consisting of 1,013 farrowing intervals recorded in two herds were analyzed, using a model that included the sire and the dam as random effects and the year of farrowing, the herd and the farrowing season as fixed effects, plus the covariables sow's age at farrowing, litter size at birth, lactation length and weaning-estrus interval. For the farrowing interval first only, variance components were estimated by REML, with an animal model that included, as fixed effect, a contemporary group and, as random effects, the additive genetic variance and the error. The mean farrowing interval was 140.9+5.7 days, with a 4.0 percent coefficient of variation. Variance analysis showed no effect of either year, season of farrowing or herd on the farrowing interval. The sire effect was not important for the farrowing interval, but the dam represented an important source of variation. The total number of piglets born and the sow's age at farrowing had no influence on the farrowing interval. The length of lactation exerted an influence on the farrowing interval, accounting for 19.4 percent of the total variation of this trait. Likewise, the linear regression of the weaning-estrus interval in relation to the farrowing interval was highly significant, accounting for 51.7 percent of the total variation. The heritability estimate was 0.00, suggesting that no genetic gain can be obtained by selection for a shorter farrowing interval.