Effect of thyme essential oil on rumen parameters, nutrient digestibility, and nitrogen balance in wethers fed high concentrate diets / Efeito do óleo essencial de tomilho sobre os parâmetros ruminais, a digestibilidade dos nutrientes e o balanço de nitrogênio em borregos alimentados com elevado teor de concentrado

This trial aimed to evaluate the effects of thyme essential oils (EO) on rumen parameters, nutrient digestibility and nitrogen balance in wethers fed with high-concentrate diet. Twenty rumen-cannulated wethers were blocked according to body weight (BW= 64.0±2.1kg), and received one of the following treatments: 25mg of monensin/kg of dry matter (DM; MON) or doses of thyme EO (1.25, 2.50 or 3.75g/kg of DM). The diet was composed of 90% concentrate. Thyme EO was composed mainly by thymol (46.6% of DM) and p-cymene (38.9% of DM). The nutrient intake and apparent digestibility were similar among treatments. The inclusion of 3.75g of thyme EO tended (P= 0.07) to increase butyrate compared to MON and 1.25OE and wethers fed with 1.25g of thyme EO tended (P= 0.07) to decrease ruminal pH on the 14th day compared to MON. The treatments did not affect acetate:propionate ratio, total short chain fatty acids (SCFA) and nitrogen retention. Results from this study suggest that adding thyme EO to high-concentrate diets may be used as an alternative to monensin as feed additive in feedlot lambs.(AU)

O objetivo do estudo foi avaliar os efeitos do óleo essencial (OE) de tomilho nos parâmetros ruminais, na digestibilidade e no balanço de nitrogênio em borregos alimentados com elevado teor de concentrado. Vinte borregos providos de cânulas ruminais foram blocados de acordo com o peso corporal (PC=64,0±2,1kg) e receberam um dos tratamentos: 25mg de monensina/kg de matéria seca (MS; MON) ou doses de OE de tomilho (1,25; 2,50 ou 3,75g/kg de MS). A dieta foi composta por 90% de concentrado. A composição do OE de tomilho foi principalmente timol (46,6% da MS) e p-cimeno (38,9% da MS). A ingestão e a digestibilidade dos nutrientes foram semelhantes entre os tratamentos. A inclusão de 3,75g de OE de tomilho tendeu (P=0,07) a aumentar o butirato em relação aos tratamentos MON e 1,25OE. Os borregos alimentados com 1,25g de OE tenderam (P=0,07) a apresentar menor pH ruminal no 14º dia comparado a MON. No entanto, os tratamentos não afetaram a relação acetato:propionato, concentração total de ácidos graxos de cadeia curta e retenção de nitrogênio. Os resultados sugerem que a adição de OE de tomilho em dietas com elevado teor de concentrado pode ser uma alternativa à monensina como aditivo alimentar para cordeiros em confinamento.(AU)

Brazilian consensus on vesicoureteral reflux-recommendations for clinical practice

ABSTRACT Introduction Vesicoureteral Reflux (VUR) is characterized by a retrograde flow of urine from the bladder into the ureters and kidneys. It is one of the most common urinary tract anomalies and the major cause of urinary tract infection (UTI) in the first years of life. If not properly diagnosed and treated can lead to recurrent UTI, renal scar and, in severe cases, to end stage renal disease. Despite recent advances in scientific and technological knowledge, evaluation and treatment of VUR is still controversial and there is still considerable heterogeneity in evaluation methods and therapeutic approaches. The aim of the present consensus is to give a practical orientation on how to evaluate and treat VUR. Methods The board of Pediatric Urology of the Brazilian Society of Urology joined a group of experts and reviewed all important issues on Vesicoureteral Reflux evaluation and treatment and elaborated a draft of the document. On November 2017 the panel met to review, discuss and write a consensus document. Results and Discussion Vesicoureteral Reflux is a common and challenging problem in children. Children presenting with Vesicoureteral Reflux require careful evaluation and treatment to avoid future urinary tract infections and kidney scars. The panel addressed recommendations on up to date choice of diagnosis evaluation and therapies.

Thyme essential oil for sheep: effect on rumen fermentation, nutrient digestibility, nitrogen metabolism, and growth / Óleo essencial de tomilho para ovinos: efeito na fermentação ruminal, na digestibilidade dos nutrientes, no metabolismo de nitrogênio e no crescimento

Two experiments were conducted to evaluate the effect of thyme (Thymus vulgaris) essential oil (EO) doses on rumen fermentation, nutrient digestibility, and nitrogen metabolism, as well as performance and coccidia oocyst discharge. In experiment I, 20 rumen-cannulated wethers received the experimental diets containing 80% dry matter (DM) of haylage and 20% DM of concentrate. Treatments were 25mg of monensin/kg DM or doses of 1.25, 2.50, or 3.75g of thyme EO/kg DM. In experiment II, 50 ewe lambs received the same diets from experiment I, including a diet without feed additives. Wethers fed with diets containing 1.25g/kg DM of thyme EO had higher molar proportion of propionate (P= 0.03) and butyrate (P< 0.01), and lower (P= 0.04) acetate to propionate ratio than other treatments. Adding thyme EO to diets increased (P= 0.02) nitrogen retention compared to monensin. The performance of ewe lambs was not affected (P≥ 0.05) by treatments. However, lambs fed monensin had a lower (P= 0.04) number of coccidia oocyst discharge than others. Adding 1.25g/kg DM of thyme EO in high-forage diet improved ruminal fermentation. Thyme EO enhanced nitrogen metabolism, however, it did not improve performance.(AU)

Dois experimentos foram conduzidos para avaliar o efeito de doses de óleo essencial (OE) de tomilho (Thymus vulgaris) sobre a fermentação ruminal, a digestibilidade de nutrientes e o metabolismo de nitrogênio, bem como sobre o desempenho e a descarga de oocistos de coccídeos. No experimento I, 20 ovinos canulados receberam dietas experimentais contendo 80% de matéria seca (MS) de pré-secado e 20% de MS de concentrado. Os tratamentos foram 25mg de monensina/kg de MS ou doses de 1,25, 2,50 ou 3,75g de OE de tomilho/kg de MS. No experimento II, 50 borregas receberam as mesmas dietas do experimento I, incluindo uma dieta sem aditivos. Os animais alimentados com dietas contendo 1,25g de OE de tomilho apresentaram maior proporção molar de propionato (P=0,03) e de butirato (P<0,01) e menor (P=0,04) relação acetato/propionato do que outros tratamentos. A adição de OE de tomilho nas dietas aumentou (P=0,02) a retenção de nitrogênio em comparação com a monensina. O desempenho de cordeiros não foi afetado (P≥0,05) pelos tratamentos. No entanto, cordeiros alimentados com monensina apresentaram menor (P=0,04) número de oocistos de coccídeos. A adição de 1,25g/kg de MS de OE de tomilho na dieta forrageira melhorou o perfil da fermentação ruminal. O OE de tomilho aumentou a retenção de nitrogênio, no entanto não melhorou o desempenho.(AU)

Brazilian consensus in enuresis-recomendations for clinical practice

ABSTRACT Introduction Enuresis, defined as an intermittent urinary incontinence that occurs during sleep, is a frequent condition, occurring in about 10% of children at 7 years of age. However, it is frequently neglected by the family and by the primary care provider, leaving many of those children without treatment. Despite of many studies in Enuresis and recent advances in scientific and technological knowledge there is still considerable heterogeneity in evaluation methods and therapeutic approaches. Materials and Methods The board of Pediatric Urology of the Brazilian Society of Urology joined a group of experts and reviewed all important issues on Enuresis and elaborated a draft of the document. On September 2018 the panel met to review, discuss and write a consensus document. Results and Discussion Enuresis is a multifactorial disease that can lead to a diversity of problems for the child and family. Children presenting with Enuresis require careful evaluation and treatment to avoid future psychological and behavioral problems. The panel addressed recommendations on up to date choice of diagnosis evaluation and therapies.

A continuous fall of PSA use for prostate cancer screening among Brazilian doctors since 2001. Good or bad notice?

ABSTRACT Purpose: To evaluate the trend of use of Prostate Specific Antigen (PSA) for screening of prostate cancer (PC) among Brazilian doctors, from the beginning of its regular availability in clinical laboratories. Material and Methods: A serial cross-sectional study was performed using data obtained from a large database between 1997 and 2016. The general PSA screening trend during this period, adjusted for the total number of exams performed in men, was analyzed. Time-series analysis was performed through observation of the general regression curve using the generalized least squares method, and the impact of the recommendations was assessed with autoregressive integrated moving average (ARIMA) models. Results: During the period studied 2,521,383 PSA determinations were done. The age of the participants ranged from 21 to 111 years, with an average of 56.7 ± 22.7 years. The relative number of PSA tests/100.000 exams in males showed a constant reduction since 2001, and this trend was more evident in the group aged 55-69 years. Although statistically significant, the impact of reduced PSA screening after the 2012 USPSTF publication was clinically irrelevant. Conclusions: Our results indicated a continuous reduction in the use of PSA screening over time, regardless of the publication of recommendations or clinical guidelines. The fact that this trend was more pronounced among those with a greater benefit potential (55-69 years), relative to groups with a greater damage potential due to overdiagnosis and overtreatment (aged >74 years and <40 years), is a matter of concern. Follow-up studies of these trends are advisable.

Risk factors for urinary tract infection in children with urinary urgency

ABSTRACT Purpose To identify which independent variable would be strong predictor of febrile urinary tract infection (UTI) in children and adolescents with overactive bladder. Materials and Methods A search was made of the institute's database for all patients diagnosed with overactive bladder over the preceding four years. Children and adolescents under 18 years of age with overactive bladder and no neurological or anatomical alterations of the lower urinary tract were included in the study. The independent variables were: sex, age, ethnicity (Brazilians of African descendence/others), the presence of urinary urgency, daytime incontinence, enuresis, frequent urination, infrequent voiding (≤3 voids/day), nocturia, holding maneuvers, straining to void, intermittent urinary flow, constipation and encopresis. An analysis was conducted to identify patients with febrile UTI and subsequently determine predictors of this condition. Univariate and multivariate analyses were performed. Results Overall, 326 patients (214 girls/112 boys) were evaluated. The mean age of the patients was 7.7±3.19 years (± standard deviation). The incidence of febrile UTI was 39.2%. Being female and infrequent voiding were factors significantly associated with febrile UTI, both in the univariate and multivariate analyses. Conclusions These results show that being female and infrequent voiding constituted significant risk factors for a diagnosis of febrile UTI in these children.

Abuso sexual contra a crian�a: desafios no campo da pesquisa, avan�os do combate no Brasil e no mundo e o papel do pediatra / Sexual abuse against children: challenges in the of research, advances of the fight in Brazil and the world and the role of the pediatrician

Introdu��o: Abuso sexual contra a crian�a � uma das formas de maus-tratos infantis que inclui tamb�m a viol�ncia f�sica, maus-tratos psicol�gicos e neglig�ncia. A cada ano, milh�es de crian�as ao redor do mundo s�o v�timas de viol�ncia f�sica, sexual e emocional, com um impacto grave sobre seu desenvolvimento e bem-estar e tamb�m na sa�de f�sica e mental. Objetivo: Atualiza��o do tema proposto atrav�s de revis�o narrativa da literatura. M�todos: Revis�o narrativa que incluiu artigos selecionados das bases de dados da Literatura Latino-Americana e do Caribe em Ci�ncias da Sa�de (Lilacs), Literatura Internacional em Ci�ncias da Sa�de (Medline) e Scientific Electronic Library Online (SciELO). Conclus�o: Apesar das dificuldades encontradas no campo da pesquisa e no campo assistencial, nas �ltimas tr�s d�cadas tem ocorrido um esfor�o crescente no combate ao abuso sexual no Brasil e no Mundo e o pediatra tem importante papel a desempenhar neste esfor�o, que � multidisciplinar.

Tratamiento de la impotencia post traumática con alprostadil intracavernoso / Treatment of the post-traumatic impotence with intracavernous alprostadil

Con el fin de tratar la impotencia sexual post-traumática se inició en 1995, el tratamiento con alprostadil intracavernoso. Se realizó diagnóstico con doppler de arteria cavernosa, potenciales evocados del nervio cavernoso y test de tumescencia peneana nocturna. Aquellos pacientes con impotencia orgánica se realizó una titulación progresiva; una vez conocida la dósis óptima se instruyó al paciente para la autoinyección. Un total de 15 pacientes entraron a este protocolo, con un seguimiento promedio de 12 meses. Después del análisis de los resultados, podemos concluir, que el tratamiento con alprostadil en este tipo de pacientes resulta ser eficiente; seguro y con gran satisfacción para los enfermos