Manejo odontológico del paciente en tratamiento de anticoagulante oral sometido a cirugía oral: una revisión narrativa / Stomatological management of anticoagulated patients undergoing oral surgery: a narrative review

Resumen Los pacientes que se encuentran bajo tratamiento de anticoagulantes orales, presentan alteraciones en distintas etapas de la hemostasia, lo que conlleva a tener implicancias y consideraciones médico/quirúrgicas durante su atención. En la actualidad, no existe un consenso en relación con el manejo odontológico de estos pacientes que serán sometidos a procedimientos quirúrgicos, llevando a protocolos clínicos que siguen diversas posturas, como la de disminuir la ingesta farmacológica del anticoagulante, sustituir con heparina y la de mantener el tratamiento bajo control. Objetivo Establecer el manejo estomatológico del paciente que se encuentra en tratamiento de anticoagulante oral mediante una revisión profunda de la literatura Materiales y método Se realizó una búsqueda de revisión bibliográfica manualmente de artículos indexados a las bases de datos de PUBMED y EBSCO que correspondiesen a las palabras "cirugía bucal", "anticoagulantes", "atención dental" y "hemorragia oral". En cuanto a los criterios de inclusión, se consideraron revisiones bibliográficas, estudios observacionales, ensayos clínicos, guías, revisiones sistemáticas y metaanálisis publicados entre noviembre de 2005 y 2022, en idiomas inglés o español. Conclusiones Existen múltiples protocolos para la atención del paciente anticoagulado que será sometido bajo procedimiento de cirugía oral menor. Es importante considerar el anticoagulante utilizado, motivo, control de este, el procedimiento a realizar en el paciente y medidas hemostáticas tanto intra como postoperatorias por realizar, tras analizar lo anterior, se advierte que disminuir la ingesta del fármaco para realizar el procedimiento, puede ser más perjudicial al paciente como al clínico, por lo tanto se sugiere mantener el tratamiento antitrombótico y realizar un correcto manejo médico/quirúrgico.

Abstract Patients undertaking oral anticoagulant treatment may experience alterations in different stages of hemostasis, which lead to medical/surgical implications and considerations during their care. Currently, there is no consensus regarding the dental management of these patients, as they go through surgical procedures. This leads to clinical protocols that follow numerous approaches, such as reducing the pharmacological intake of the anticoagulant, replacing it with heparin, and maintaining the controlled treatment. Objective: To establish the stomatological management of the patient undergoing oral anticoagulant treatment through an in depth review of the literature. Materials and Method: A manual bibliographic review search of articles indexed to the PUBMED and EBSCO databases corresponding to the words "oral surgery", "oral bleeding", "anticoagulants" and "dental management" was performed. Regarding the inclusion criteria: bibliographic reviews, observational studies, clinical trials, guidelines, systematic reviews, and meta-analyses published between November 2005 and 2022, in English or Spanish, were considered. Conclusion: There are multiple protocols for the care of the anticoagulated patient who will undergo a minor oral surgery procedure. It is important to reflect on the anticoagulant used, the reason for it, its supervision, the surgical procedure that will be undertaken by the patient, and both intraoperative and postoperative hemostatic measures to be implemented. After analyzing the above, it is noted that reducing the intake of the drug to perform the surgical procedure may be harmful to the patient and to the clinician, therefore it is suggested to maintain the antithrombotic treatment and carry out a correct medical/surgical management.

Histological risk score and its role in predicting recurrence in early-stage oral squamous cell carcinomas

Context: Oral squamous cell carcinoma (OSCC) comprises more than 90% of oral cancers and is the most common carcinoma affecting the oral cavity. Early stage T1/T2 OSCC have a heterogeneous prognosis and a significant number of patients develop loco regional recurrence (LRR) and have reduced disease free survival (DFS) with increased disease related mortality. Aims and Objectives: To assess the impact of the three parameters used in Brandwein-Gensler risk model along with lympho-vascular invasion (LVI), depth of invasion (DOI) and lymph node metastases in predicting LRR in early stage OSCC. Materials and Methods: This was a retrospective study on early stage T1/2 OSCC patients over a period of 2 years who received treatment by surgical resection and had follow-up data. LRR was assessed based on recurrence of OSCC at the initial site or in regional lymph nodes. Results: Out of 1135 OSCC cases during our study period a total of 207 cases befitted our inclusion criteria. Recurrence was noted in 113 (54.6%) cases. Univariate analysis identified LVI (P < 0.00001), DOI (P < 0.00001), nodal involvement (P < 0.00001), worst pattern of invasion (WPOI) (P < 0.00001), lymphocytic host response (LHR) (P = 0.004), perineural invasion (PNI) (P = 0.012) as strong statistically significant risk factors for LRR. Conclusion: Adequate assessment of simple parameters on routine H and E by incorporating Brandwein-Gensler histological risk scoring model at the initial presentation can help prognosticate and predict LRR and select patients for post-surgical adjuvant therapy.

The importance of updated criteria in breeding soundness examination of commercial Nellore bulls for the herd reproductive improvement / [Importância de critérios atualizados na avaliação andrológica de touros Nelore a campo para a evolução reprodutiva do rebanho]

The aim of this work was to compare results of breeding soundness examination (BSE) of Nellore bulls (n=1257) according to evaluation criteria from two different classification tables (traditional-Table1 used since 1997 and an updated-Table2-proposed in 2020). Data were separated into 3 categories: questionable animals in Table1 and Table2 (Q1Q2), animals approved in Table1 and questionable in Table2 (A1Q2) and animals approved in Table1 and Table2 (A1A2). BSE parameters were submitted to ANOVA (P<005), according to age groups. Higher (P<0.0001) scrotal perimeter (PE) were observed in A1A2 category (18-24m=33.4±2.4cm; 24-36m=34.5±2.2cm; 36-48m=36.6±1.7cm; >48m=38.6±1.7cm) compared to A1Q2 (18-24m=29.05±0.98cm; 24-36m=30.3±0.6cm; 36-48m=32.9±1.0cm; >48m=34.8±1.0cm) and to Q1Q2 (24-36m=26.8±2.0cm; 36-48m=30.0±0.1cm; >48m=31.3±1.1cm), for all age groups. At the age of 36-48months (Q1Q2=2.7±0.3; A1Q2=3.2±0.3; A1A2=3.3±0.6) and >48months (Q1Q2=3.0±0.4; A1Q2=3.3±0.5; A1A2=3.4±0.5), animals with better andrological classifications presented higher (P<0.05) body condition score (BCS). Additionally, at age >48m, higher sperm Motility (P=0.0250) and Vigor (P=0.0335) were observed in animals A1Q2 (Mot=55.5±14.7%; V=3.21±0.82) and A1A2 (Mot=55.8±12.2%; V=3.23±0.81) compared to Q1Q2 (Mot=50.2±17.4%; V=2.77±0.82). It was concluded that bulls approved using strict selection criteria demonstrated higher PE and BCS, regardless of the age. The utilization of updated classification tables is highly recommended for further reproductive potential development of Nellore bulls in the field.(AU)

O objetivo deste estudo foi comparar os resultados obtidos no exame andrológico a campo de touros Nelore (n=1257) de acordo com os critérios de avaliação de duas tabelas de classificação (uma tabela tradicional - tabela 1 - proposta em 1997 e uma nova tabela atualizada - tabela 2 - proposta em 2020). Os dados foram separados em três categorias: animais questionáveis nas tabelas 1 e 2 (Q1Q2), animais aprovados na tabela 1 e questionáveis na tabela 2 (A1Q2) e animais aprovados nas tabelas 1 e 2 (A1A2). Os parâmetros foram submetidos à análise de variância (P<0,05), por faixa etária. Observou-se maior (P<0,0001) PE no grupo A1A2 (18-24m=33,4±2,4cm; 24-36m=34,5±2,2cm; 36-48m=36,6±1,7cm; >48m=38,6±1,7cm) em comparação ao grupo A1Q2 (18-24m=29,05±0,98cm; 24-36m=30,3±0,6cm; 36-48m=32,9±1,0cm; >48m=34,8±1,0cm) e este maior (P<0,0001) que Q1Q2 (24-36m=26,8±2,0cm; 36-48m=30,0±0,1cm; >48m=31,3±1,1cm) em todas as idades. Nas faixas etárias 36-48m (Q1Q2=2,7±0,3; A1Q2=3,2±0,3; A1A2=3,3±0,6) e >48m (Q1Q2=3,0±0,4;A1Q2=3,3±0,5; A1A2=3,4±0,5), animais com melhor classificação andrológica apresentaram melhor (P<0,05) escore de condição corporal (ECC). Adicionalmente, na idade >48m, maiores motilidade (P=0,0250) e vigor (P=0,0335) foram observados nos animais A1Q2 (Mot=55,5±14,7%; V=3,21±0,82) e A1A2 (Mot=55,8±12,2%; V=3,23±0,81) comparados aos animais Q1Q2 (Mot=50,2±17,4%; V=2,77±0,82). Concluiu-se que touros aprovados na tabela com critérios mais rigorosos de classificação (tabela 2) apresentaram maior PE e ECC, independentemente da idade. Assim, a utilização de tabelas classificatórias atualizadas é fundamental para maior desenvolvimento do potencial reprodutivo de touros Nelore a campo.(AU)

Características estruturais e produção de forragem do capim-piatã submetido a regimes de desfolhação intermitente / [Structural characteristics and forage production of piata grass submitted to intermittent defoliation management]

Objetivou-se avaliar as características estruturais e a produção de forragem do capim-piatã submetido à combinação de duas frequências de corte (95% e máxima interceptação de luz pelo dossel forrageiro, ILmax) e duas alturas pós-corte (15 e 20cm), no período de janeiro de 2012 a março de 2013. O delineamento utilizado foi em blocos ao acaso, com três repetições, em esquema fatorial 2x2, totalizando 12 unidades experimentais de 14m2 cada. Foram avaliadas as seguintes variáveis-respostas: altura do dossel no pré-corte, intervalo de corte, índice de área foliar pré e pós-corte, taxa de produção de forragem e as percentagens de colmo, folha e forragem morta na forragem produzida. A altura pré-corte decresceu durante o experimento (de 65,81 para 34,03cm), sendo a menor altura observada no dossel sob alta frequência de desfolhação (95% de IL). A taxa de produção de forragem foi maior nas épocas favoráveis ao crescimento da gramínea forrageira. As percentagens de folha, colmo e forragem morta foram semelhantes entre as frequências de corte. Assim, o capim-piatã sob manejo de desfolhação intermitente pode ser colhido com qualquer combinação de frequências de corte de 95% e ou máxima interceptação de luz, e alturas pós-corte de 15 ou 20cm.(AU)

The objective of this study was to evaluate the structural characteristics and forage production of the piatã grass submitted to the combination of two cutting frequencies (95% and maximum interception of light by the forage canopy, ILmax) and two post cutting heights (15 and 20cm) in the period from January 2012 to March 2013. The design was a randomized complete block with three replications, in a 2x2 factorial scheme, totaling 12 experimental units of 14m2 each. The following variables were evaluated: pre-cut canopy height, cut interval, pre and post-cut leaf area index, forage yield rate, and percentage of stem, leaf and dead forage in the forage produced. The pre-cut height decreased during the experiment (from 65.81 to 34.03cm), with the lowest height observed in the canopy under high frequency of defoliation (95% IL). The rate of forage production was higher in the seasons favorable to forage grass growth. The percentages of leaf, stem and dead fodder were similar between cut-off frequencies. Thus, piatã grass under intermittent defoliation management can be harvested with any combination of 95% and maximum light interception cut frequencies, and post cutting heights of 15 or 20cm.(AU)

Diagnostic utility of immunohistochemical marker prostein for evaluation of primary and metastatic prostatic carcinomas

Context: The diagnosis of prostatic adenocarcinoma on histopathology depends on architectural and cytomorphological features supported by immunohistochemistry (IHC). Though all the prostate markers show excellent specificity, the sensitivity and percentage positivity vary. Aims: In this study, we aim to study the expression of prostein in normal, benign, and malignant (primary and metastatic) lesions with particular emphasis on its utility in the differential diagnosis of poorly differentiated and metastatic prostatic adenocarcinoma along with a standard panel of IHC markers. Settings and Design: This was both a prospective and retrospective as well as descriptive and observational study. Subjects and Methods: All samples from patients with clinically suspected carcinoma prostate from both primary and metastatic sites from June 2015 to May 2016 were included in the study. Samples with difficulty in diagnosis on hematoxylin and eosin staining were subjected to a panel of IHC markers along with prostein. Statistical Analysis Used: Receiver operating curve analysis and Chi-square test. Results: Prostein showed a 100% sensitivity and specificity to identify normal prostatic epithelium, benign and premalignant lesions, and prostatic adenocarcinoma. Prostein showed a specificity of 100% in differentiating prostatic carcinoma from poorly differentiated urothelial carcinoma and in differentiating metastatic prostatic carcinoma from adenocarcinoma of nonprostatic origin. Conclusions: Prostein is a new and promising prostate-specific marker that showed slightly more sensitivity and specificity than prostate-specific antigen. Thus, adding prostein to the IHC panel will greatly improve the detection of poorly differentiated primary and metastatic lesions of the prostate.

Perfilhamento do capim-piatã submetido a regimes de desfolhação intermitente / Tillering of piatã grass subject intermittent cutting

Objetivou-se avaliar o perfilhamento da Brachiaria brizantha cv. Piatã, como base para identificação das frequências e alturas pós-corte mais adequadas para essa gramínea forrageira. Em um esquema fatorial 2 x 2, foram estudadas combinações entre duas frequências de corte (95% e máxima interceptação de luz, ILmax) e duas alturas pós-corte (15 e 20cm). O delineamento foi em blocos ao acaso, com três repetições, totalizando 12 unidades experimentais de 14m2 cada. Foram avaliadas as taxas de aparecimento (TApP) e de mortalidade (TMoP) de perfilhos, o índice de estabilidade (IE) e a densidade populacional de perfilhos. A maior TApP no dossel sob IL de 95% ocorreu no Verão 1, em comparação às demais épocas. Nos dosséis manejados com ILmax, a TApP foi superior no Verão 1 e no Outono, quando comparados às outras épocas. No Verão 1 e no Final da Primavera e Verão 2, houve as maiores TMoP para as duas frequências de corte avaliadas. No Outono, a TMoP também foi alta no dossel cortado com ILmáx. O IE foi menor durante o Verão 1 no dossel sob ILmax e com 15cm de resíduo (0,995). Porém, nas demais épocas, os valores de índice de estabilidade foram maiores que uma unidade e não foram influenciados pela frequência e altura pós-corte. A densidade populacional de perfilhos foi menor no Verão 1, em comparação às demais épocas. O capim-piatã pode ser desfolhado com qualquer combinação entre as interceptações de luz, 95% e ILmax, e alturas pós-corte, 15 ou 20cm, sem prejudicar a persistência do pasto.(AU)

The aim of this study was to evaluate the tillering of Brachiaria brizantha cv. Piatã, as a basis for identifying the frequencies and post-cutting heights most suitable for this grass. In a 2 x 2 factorial scheme, combinations between two cut frequencies (95% and maximum light interception, IL max ) and two post-cut heights (15 and 20cm) were studied. The experimental design was in randomized blocks with 3 replicates, totaling 12 experimental units of 14m 2 each. Rates of appearance (TAR) and mortality (TMR) of tillers, the stability index and the population density of tillers were evaluated. The highest TAR in the canopy under 95% IL occurred in Summer 1, in comparison to the other seasons. In the canopies managed with IL max , TAR was higher in summer 1 and in autumn, when compared to other seasons. In summer 1 and at the end of spring and summer 2, there were the highest TMR for the two cutoff frequencies evaluated. In autumn, TMR was also high in the canopy cut with IL max . IE was lower during summer 1 in the canopy under IL max and 15cm of residue (0.995). However, at other times, stability index values were greater than one unit and were not influenced by post-cut frequency and height. The population density of tillers was lower in Summer 1, when compared to the other seasons. The piata grass may be defoliated with any combination of light intercepts, 95% and ILmax, and post-cut heights, 15 or 20cm, without impairing the persistence of pasture.(AU)

Beef cattle performance on signal grass pastures deferred and fertilized with nitrogen / Desempenho de bovinos em pastos de capim-braquiária diferidos e adubados com nitrogênio

The effect of four nitrogen levels (0, 40, 80 and 120kg N ha-1), applied before deferment on the beef cattle production and structural variables on Urochloa decumbens (signal grass) were assessed from January to October 2012 and from January to September 2013. A randomized block design with three replicates was adopted, in an arrangement of repeated measures in time (grazing period). An interaction effect between nitrogen level and grazing period was observed on extended-plant height and herbage mass. As the nitrogen levels were increased, extended-plant height, herbage mass, total herbage allowance, and efficiency of conversion of fertilizer into herbage were increased. Throughout the grazing period, pasture height, extended-plant height, percentage of leaves, herbage and morphological components allowance, and percentages of leaves and stems in the herbage apparently selected by the animal decreased. Nitrogen levels had no effect on average daily gain or gain per area in the first year. A fixed deferment period with increasing levels of nitrogen fertilization on signal grass pastures does not influence the average daily gain per animal, reduces the efficiency of the nitrogen fertilizer and negatively changes the structural characteristics of the pasture.(AU)

Foi avaliado o efeito de quatro doses de nitrogênio (0, 40, 80 e 120kg N ha -1 ), aplicadas antes do diferimento, sobre o desempenho de bovinos e as características estruturais de Urochloa decumbens (capim-braquiária), de janeiro a outubro de 2012 e de janeiro a setembro de 2013. Um delineamento de blocos ao acaso foi utilizado em arranjo de medidas repetidas no tempo (período de pastejo). Foi observada interação entre doses de nitrogênio e período de pastejo na altura da planta estendida e na massa de forragem. As doses de nitrogênio incrementaram a altura da planta estendida, a massa de forragem, a oferta de forragem e a eficiência de conversão do nitrogênio em forragem. No decorrer do período de pastejo, a altura do pasto, a altura da planta estendida, a porcentagem de lâminas foliares, a oferta de forragem e dos seus componentes morfológicos e a porcentagem de lâminas e colmos da forragem aparentemente selecionada pelos animais diminuíram. As doses de nitrogênio não exerceram efeito sobre o ganho diário e o ganho diário por área no primeiro ano. O período de diferimento fixo com aumento das doses de nitrogênio em pastos de capim-braquiária não influencia o ganho diário por animal, reduz a eficiência da adubação nitrogenada e afeta negativamente a estrutura do pasto.(AU)

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: A distinct clinicopathologic entity

Objective: The objective of this study is to retrospectively evaluate follicular variant of papillary thyroid carcinoma (FVPTC) and reclassify encapsulated FVPTC as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) according to the criteria proposed by The Endocrine Pathology Society working group in 2015 to correlate with outcome. Materials and Methods: Retrospective review of case records of all patients diagnosed as carcinoma of thyroid between 2015 and 2016 was done for the histologic subtype. Gross and microscopic features on resected specimens of FVPTC were reviewed and subtyped as invasive and encapsulated based on capsular/vascular invasion; the encapsulated forms were further studied for size, number, follicular architecture, nuclear features, presence of psammoma bodies, stromal fibrosis, necrosis, mitoses, and lymph node status. Results: Out of the 383 patients with thyroid carcinomas in the study period, 349 were PTC which included 106 FVPTC. Thirty-three patients fulfilled the criteria to be labeled as NIFTP. Total thyroidectomy was performed in 8 patients and hemithyroidectomy in 25 patients. Lymph node dissection along with total thyroidectomy was done in 3 and completion thyroidectomy following hemithyroidectomy was done in 9. There were 29 single and 4 multiple lesions with size varying from 0.2 to 7 cm including 5 lesions measuring <1 cm. The involvement was confined to one lobe in 31 and both lobes in 2 specimens. Patients are on follow-up with no recurrence till date. Conclusion: Thyroid carcinomas currently diagnosed as FVPTC should be evaluated for criteria of NIFTP to avoid overtreatment as they have an indolent behavior.

Sheep production during the rainy season in marandu palisadegrass swards previously utilized under deferred grazing / Produção de ovinos no período das águas em pastagens com capim-marandu previamente utilizadas sob pastejo diferido

The objective of this study was to evaluate the effects of Brachiaria brizantha cv. Marandu syn. Urochloa brizantha cv. Marandu (Marandu palisadegrass) in late winter on pasture structure, apparent selectivity, and sheep production during spring and early summer. The conditions of deferred pastures at the end of winter were: low (15.1cm and 4600kg/ha of DM), medium (23.2cm and 5940kg/ha of DM), high (31.4cm and 7640kg/ha of DM) and high/mowed (31.3cm and 7200kg/ha of DM, mowed to 8cm). The experiment was conducted in split plot design (sward conditions at the end of winter: low, medium, tall and tall/lowered) during time (early, middle and late spring/summer) and completely randomized design with three replications. The percentages of live leaf laminae in available forage and in simulated grazing samples were higher in tall/lowered sward and lower in high sward, oppositely to percentage of dead tissue. Only at the beginning of the grazing period the high/lowered sward had lower forage mass and bulk density. This remained high in high sward during all the grazing period. The sheep performance and the animal production per area were higher in low sward and lower in tall swards. The low sward has better structure and higher sheep production starting at spring. The lower of the marandu palisade grass at late winter improves this structure and increases sheep production during spring and early summer.(AU)

Objetivou-se avaliar os efeitos da condição do pasto diferido de Brachiaria brizantha cv. Marandu syn. Urochloa brizantha cv. Marandu (capim-marandu) no fim do inverno sobre a estrutura do pasto, a seletividade aparente e a produção de ovinos durante a primavera e o início do verão. As condições dos pastos diferidos no fim do inverno foram: baixo (15,1cm e 4.600kg/ha de MS), médio (23,2cm e 5.940kg/ha de MS), alto (31,4cm e 7.640kg/ha de MS) e alto/roçado (31,3cm e 7.200kg/ha de MS, rebaixado para 8cm). O experimento foi conduzido em esquema de parcela (condições dos pastos ao fim do inverno: baixo, médio, alto e alto/roçado) subdividida no tempo (início, meio e fim da primavera/verão) e delineamento inteiramente ao acaso, com três repetições. Os percentuais de lâmina foliar viva na forragem disponível e na amostra de simulação de pastejo foram maiores no pasto alto/roçado e menores no pasto alto, contrariamente ao percentual de tecido morto. Apenas no início do período de pastejo, o pasto alto/roçado apresentou menores massa e densidade volumétrica de forragem. Esta se manteve alta no pasto alto durante todo o período de pastejo. No início do período de pastejo, os pastos apresentaram pior composição morfológica na FD. O desempenho dos ovinos e a produção animal por área foram maiores no pasto baixo e menores no pasto alto. O pasto baixo, no fim do inverno, apresenta melhor estrutura e maior produção de ovinos a partir da primavera. A roçada do pasto de capim-marandu no fim do inverno melhora sua estrutura e aumenta a produção animal durante a primavera e o início do verão.(AU)

O capim-marandu baixo no início do diferimento melhora a morfologia do pasto e aumenta o desempenho dos ovinos no inverno / The low marandu palisadegrass at the beginning of stockpiling improves pasture morphology and increases sheep performance in winter

Objetivou-se avaliar os efeitos de quatro alturas (15, 25, 35 e 45cm) da Urochloa brizantha cv. Marandu (capim-marandu) no início do diferimento sobre a morfologia do pasto, a seletividade e o desempenho de ovinos no início, meio e fim do período de pastejo, no inverno. Foi utilizado o delineamento inteiramente ao acaso, com três repetições. Os pastos diferidos com 35 e 45cm apresentaram maiores massas de forragem do que aqueles diferidos com 15 e 25cm. O pasto diferido com 15cm apresentou maior porcentagem de folha e menor percentual de colmo morto, em comparação aos demais pastos. A seleção por folha morta aumentou no período de pastejo. Em geral, nos pastos diferidos mais altos, os percentuais de folha viva foram menores e os de colmo morto, maiores nas amostras de pastejo simulado. O desempenho dos ovinos foi superior no pasto diferido com 15cm, intermediário nos pastos diferidos com 25 e 35cm, e inferior no pasto diferido com 45cm. A manutenção do capim-marandu com 15cm no início do diferimento resulta em pasto com melhor morfologia, otimiza a seletividade e aumenta o desempenho dos ovinos no inverno.(AU)

The objective of this study was to evaluate the effects of four heights (15, 25, 35, and 45cm) of Urochloa brizantha cv. Marandu (marandu palisadegrass) at the beginning of the deferment period on the pasture morphology, selectivity, and performance of sheep during the beginning, middle and end of the grazing period in winter. A completely randomized design with three replications was used. Deferred pastures with 35 and 45cm presented larger forage masses than those deferred with 15 and 25cm. Deferred pasture with 15cm presented a higher percentage of live leaf and a lower percentage of dead stem. Dead leaf selection increased during the grazing period. In general, in the higher deferred pastures, the percentages of live leaf were lower and those of dead stalk, higher in the samples of simulated grazing. The sheep performance was higher in the 15cm pasture, intermediate in the 25 and 35cm pastures, and inferior in the 45cm pasture. The maintenance of marandu palisadegrass with 15cm at the beginning of the deferment period results in deferred pasture with better morphology, optimizes the selectivity and the increase the performance of the sheep in the pasture deferred during the winter.(AU)

Quantification of Treg cells in peripheral blood and lymph nodes of dogs with multicentric lymphoma / Quantificação de células Treg no sangue periférico e linfonodos de cães com linfoma multicêntrico

Lymphoma is a malignant tumor characterized by cell proliferation of lymphoid origin and corresponds to 90% of all hematopoietic neoplasms of dogs. Regulatory T cells (Tregs) have been the target of many investigations in oncology due to their potential of down-regulating immune responses, as well as ensuring the maintenance of active mechanisms of tumor suppression. The aims of the present study were to compare the percentage of Tregs in peripheral blood between dogs with multicentric lymphoma and healthy animals, together with the percentage of Tregs in peripheral blood and lymph nodes of dogs with multicentric lymphoma. Twenty-six animals were enrolled in the study: 10 healthy dogs comprised the control group (CG) and 16 dogs with multicentric lymphoma comprised the Lymphoma Group (LG). We observed that dogs in the LG showed a significantly higher Tregs expression in peripheral blood compared to the CG. No significant difference was observed between Tregs expression in lymph nodes and peripheral blood of the LG, however. With these results, it is possible to conclude that multicentric lymphoma is a neoplasm with high Tregs expression, which poses this as a condition of interest when investigating treatments that can suppress Regulatory T cells.(AU)

O linfoma é uma neoplasia maligna caracterizada pela proliferação neoplásica de células originadas de tecido linfoide e corresponde a cerca de 90% das neoplasias hematopoiéticas em cães. Células T reguladoras (Tregs) têm sido alvo de diversas investigações na área da oncologia devido ao potencial de regulação negativa da resposta do sistema imune e à manutenção ativa do mecanismo de imunossupressão tumoral. O objetivo do presente estudo foi a comparação da porcentagem de Tregs no sangue periférico entre cães com linfoma multicêntrico e animais saudáveis e a porcentagem de Tregs no sangue periférico e nos linfonodos de cães com linfoma multicêntrico. Foram utilizados 26 animais: 10 cães saudáveis, como grupo controle (CG), e 16 cães com linfoma multicêntrico, como grupo linfoma (LG). Observou-se maior expressão de Tregs no sangue periférico de cães do LG em comparação ao CG. Entretanto, não foi observada diferença significativa entre as expressões de Treg nos linfonodos e no sangue periférico do LG. Com esses resultados, foi possível concluir que o linfoma multicêntrico apresenta alta expressão de Tregs, tornando-se condição interessante para o estudo de tratamentos capazes de suprimir as células T reguladoras.(AU)

Seletividade aparente de bovinos em pastos de capim-braquiária sob períodos de diferimento / Apparent selectivity of cattle on signalgrass pasture under deferring periods

Objetivou-se compreender o efeito do período de diferimento sobre a seletividade aparente de bovinos pelos componentes morfológicos e de valor nutritivo do pasto de Brachiaria decumbens cv. Basilisk. Adotaram-se o esquema de parcela subdividida e o delineamento em blocos ao acaso com duas repetições. Foram estudados quatro períodos de diferimento (73, 103, 131 e 163 dias) e duas amostras de forragem (disponível na pastagem (DP) e obtida pela simulação de pastejo (SP)). As percentagens de lâmina foliar viva (LFV), matéria seca potencialmente digestível (MSPD) e proteína bruta (PB) foram maiores na amostra de SP, quando esta foi comparada à forragem DP. Padrão de resposta contrário ocorreu com os percentuais de colmo vivo (CV), colmo morto (CM) e fibra em detergente neutro (FDN). De modo geral, o maior período de diferimento resultou em pior composição morfológica e valor nutritivo das forragens. Os índices de seletividade aparente (ISA) da LFV, do CV e da lâmina foliar morta (LFM) aumentaram linearmente com o período de diferimento. O ISA do CM apresentou maiores valores em pastos sob períodos intermediários de diferimento. Com o aumento do período de diferimento, os ISA da FDN e da MSPD permaneceram constantes, os ISP da FDN potencialmente digestível e da PB reduziram linearmente, e o ISP da FDN indigestível incrementou de maneira linear. O ISA permite a compreensão da seletividade dos componentes morfológicos e das entidades nutricionais do pasto pelos bovinos. A redução do período de diferimento melhora a estrutura do pasto e otimiza a seletividade dos bovinos.(AU)

The experiment was carried out aiming to understand the effect of deferring period on morphology and nutritive value of Brachiaria decumbens cv. Basilisk pasture and on hand-plucking sample with cattle. Subdivided plots were used according to a randomized block design with two replicates. Four deferring periods (73, 103, 131 and 163 days) and two forage samples (available in pasture (AP) and obtained by hand-plucking (HP)) were studied. The live leaf laminae (LLL), potentially digestible dry matter (PDDM) and crude protein (CP) percentages were higher in HP samples, when compared to AP forage. The opposite response pattern occurred for live stem (LS), dead stem (DS) and neutral detergent fiber (NDF) percentages. In general, the longest deferring period resulted in a worse morphological composition and nutritive value of forages. The potential selectivity index (PSI) of LLL, LS and dead leaf lamina (DLL) increased linearly with deferring period. The PSI of DS was highest in grasslands under interim deferring periods. With increase in deferring period, the PSI of the NDF and PDDM remained constant, the PSI of potentially digestible NDF and CP decreased linearly and the PSI of indigestible NDF increased linearly. The PSI allows the understanding of selectivity of morphological components and nutritional entities for cattle grazing. The deferring period reduction improves the sward structure and optimizes the cattle selectivity.(AU)

Regulatory T cells in dogs with multicentric lymphoma: peripheral blood quantification at diagnosis and after initial stage chemotherapy / Células T reguladoras em cães com linfoma multicêntrico: quantificação, em sangue periférico, no momento do diagnóstico e após etapa inicial do tratamento quimioterápico

Lymphoma is the most common hematopoietic malignancy in dogs and one of the most frequent among all neoplastic diseases in this species. It can occur in several anatomical locations with distinct histological and immunophenotypes. Depending on the host immune response towards the tumor, prognosis information could be collected. Because its well established immunosuppressant, antitumor activity, the function of regulatory T cells (Tregs) in canine neoplasias has been investigated. In this study, we sought to quantify, using flow cytometry, the Tregs subpopulation in peripheral blood of healthy dogs (10) and in those diagnosed with type-B (14) and type-T (8) multicentric lymphoma before (at diagnosis) and after the first cycle (5-week) of 19-week Madison-Wisconsin (MW) protocol of chemotherapy. Our results indicated that dogs with lymphoma showed higher percentage of Tregs (18,84±2,56) when compared to healthy dogs (4,70±0,50) (P<0,01). In addition, 5-week chemotherapy treatment reduced the Tregs subpopulation (7,54±1,08) to levels similar to control (4,70±0,50) (P>0,05). There was no difference in Tregs percentage between B-type (17,45±2,77) and T-type (21,27±5,27) lymphoma (P>0,05). With this, we conclude that canine lymphoma increases Tregs in the peripheral blood and the MW protocol of chemotherapy reduces this cell subpopulation to control values.

O linfoma é a neoplasia hematopoiética mais comum nos cães e uma das mais frequentes, dentre todas as neoplasias, nesta espécie. Apresenta-se em diversas localizações anatômicas e pode apresentar classificações histológicas e imunofenotipos distintos. Dependendo da resposta imune do paciente frente à instalação de um tumor, algumas informações sobre o prognóstico podem ser obtidas. Atualmente, as células T reguladoras (Tregs) vêm sendo estudadas em algumas neoplasias caninas, por seu comprovado potencial imunossupressor, principalmente por inibir a resposta antitumoral. Neste contexto, o presente trabalho teve como objetivos quantificar, por citometria de fluxo, as células Tregs em sangue periférico de cães com linfoma multicêntrico de imunofenótipos B e T, respectivamente 14 e 8 cães, no momento do diagnóstico e após o primeiro ciclo de quimioterapia antineoplásica com o protocolo Madison-Wisconsin (MW) de 19 semanas adaptado, e comparar com cães saudáveis (n=10), buscando quantificá-las em cães com linfoma de diferentes imunofenótipos antes e após a 5ª semana do protocolo MW. Os resultados mostraram que cães com linfoma apresentaram uma porcentagem significativamente maior de Tregs (18,84±2,56) quando comparada aos cães sem neoplasia (4,70±0,50) (P<0,01). Além disso, após a quinta semana de tratamento houve uma significante redução da população de Tregs (7,54±1,08), atingindo valores semelhantes a dos cães controle (4,70±0,50) (P>0,05). Não houve diferença nas Tregs em relação aos imunofenotipos B (17,45±2,77) e T (21,27±5,27) (P>0,05). Concluiu-se que o linfoma em cães leva a um aumento de células Tregs e que o tratamento com o protocolo quimioterápico MW reduz significativamente as células Tregs em sangue periférico, atingindo valores próximos aos dos cães saudáveis.

Desempenho de vacas mestiças em função de suplementação energética e proteica em dietas à base de silagem de milho / Performance of crossbred cows as a result of energetic and protein supplementation in corn silage based diets

Objetivou-se avaliar níveis de concentrados energéticos e proteicos sobre o desempenho de vacas leiteiras Holandês x Zebu, com peso corporal de 452±77kg, de terceira e quarta lactação, 80 dias pós-parto e produção de 12,8kg de leite/dia. Nove vacas foram distribuídas em três quadrados latinos 3x3, em períodos experimentais de 10 dias, distribuídas segundo número de lactações, sendo os tratamentos níveis de farelo de soja (FS) em substituição ao fubá de milho (FM) (0,8; 1,6 e 2,4kg/vaca dia, completando para 3,2kg/vaca dia com FM), níveis de FS ou de FM (0,8; 1,6 e 3,2kg/vaca/dia) e silagem de milho como volumoso. Somente o consumo de proteína bruta se elevou com o aumento nos níveis de FS em dietas contendo FM+FS, ao passo que os consumos diários de matéria seca (MS) e das frações nutricionais aumentaram com a elevação do FS ou FM. Os coeficientes de digestibilidade da MS e dos nutrientes não diferiram em dietas contendo FM+FS. A digestibilidade da proteína bruta (PB) aumentou ao passar de 1,6 para 3,2kg/dia de FS. Houve diminuição da digestibilidade da MS, MO e CNF ao passar de 0,8 para 3,2kg/dia de FM e diminuição do NDT ao passar de 1,6 para 3,2kg/dia de FM. As exigências de NDT e PB só foram satisfeitas plenamente com 0,8+2,4kg (FM+FS) e 3,2kg de FS. As dietas contendo FM não atenderam sequer às exigências de NDT. A produção de leite e a sua composição bem como o peso corporal e a eficiência alimentar relacionada ao CMS não foram influenciados pelos tratamentos. A eficiência alimentar em relação ao fornecimento de concentrado decresceu quando se adicionaram níveis crescentes de FS ou FM. Tendo como volumoso a silagem de milho, o fornecimento de fubá de milho ou farelo de soja, nas quantidades analisadas neste experimento, não promove aumento da produção de leite ou de seus constituintes, sendo que a eficiência do uso do concentrado diminui ao se elevar o nível de suplementação.

The aim was to evaluate levels of energy and protein concentrates on performance of crossbred Holstein x Zebu dairy cows, with body weight of 452 ± 77kg, third and fourth lactation, 80 days post-partum and with a production of 12.8kg of milk per day. Nine cows were distributed in three 3 x 3 Latin squares, with experimental periods of 10 days, distributed according to the number of lactations, with treatment levels of soybean meal (SBM) replacing corn meal (CM) (0.8; 1.6 and 2.4kg/cow/day completing 3.2kg/cow/day with CM); CM or SBM levels (0.8; 1.6 and 3.2kg/cow/day) and corn silage as forage. Only crude protein consumption rose with the increase in levels of SBM in diets containing CM + SBM, while the daily consumption of dry mass (DM) and the nutrient fractions increased with the elevation of CM or SBM. The coefficients of digestibility of DM and nutrients did not differ in diets containing CM + SBM. The crude protein (CP) digestibility increased when changing from 1.6 to 3.2kg/day of SBM. There was reduction of digestibility of DM, OM, and NFC when passing from 0.8 to 3.2kg/day of CM and decrease of TDN when changing from 1.6 to 3.2kg/day of CM. The requirements for TDN and CP were only fully satisfied fully in diets containing 0.8+2.4kg (CM+SBM) and 3.2kg of SBM. Diets containing CM did not attend even the demands of TDN. Milk production and composition, as well as the body weight and food efficiency related to the DMI were not influenced by the treatments. Feed efficiency in relation to the supply of concentrate decreased when increasing levels of CM or SBM were added. Having corn silage as forage, the supply of corn meal or soybean meal in quantities analyzed in this experiment does not promote increase in production of milk or their constituents, and the efficiency of the use of concentrate decreases when raising the level of supplementation.

Produção animal em pastagem de capim-braquiária adubada com nitrogênio / Animal production on nitrogen fertilized signalgrass pasture

O experimento foi realizado em dois anos para avaliar o potencial de produção de bovinos em pastagens de Brachiaria decumbens adubadas com nitrogênio (N). Foram determinadas as massas de forragem total (MFT) e de forragem verde (MFV), a composição morfológica e o valor nutritivo da forragem potencialmente consumível, bem como o desempenho animal e a taxa de lotação (TL) das pastagens. Os tratamentos consistiram de quatro doses de N - 75, 150, 225 e 300kg/ha.ano -, em delineamento de blocos ao acaso, com duas repetições. Nos dois anos, as MFT e MFV aumentaram linearmente em função da aplicação de N. A composição química da forragem potencialmente consumível foi pouco alterada pela aplicação de N. A adubação nitrogenada não influenciou o ganho de peso individual dos novilhos, mas aumentou a TL - de 3,6 para 5,3 e de 3,7 para 5,2UA/ha no primeiro e segundo ano, respectivamente - e a produção animal por área da pastagem - de 404,2 para 737,9 e de 619,7 para 1008,4kg/ha no primeiro e segundo anos, respectivamente.

The experiment which aimed to evaluate the potential of cattle production on nitrogen-fertilized Brachiaria decumbens pastures was carried out in two years. The total forage mass (TFM), green forage mass (GFM), morphological composition and nutritive value of the potentially consumed forage were determined, as well as the animal performance and the stocking rate (SR). The treatments encompassed four doses of N, being 75, 150, 225 and 300kg/ha.year. A randomized block design with two repetitions was used. The chemical composition of the potentially consumable forage was little altered by the N application. N-fertilization did not influence the weight gain of steers, but increased the SR from 3.6 to 5.3 in the first year and from 3.7 to 5.2 animal units per hectare in the second year, and the production by area of pasture from 404.2 to 737.9kg/ha in the first year and from 619.7 to 1008.4kg/ha in the second year. N-fertilization increases forage mass, stocking rate and animal production by area of pasture on B. decumbens cv. Basilisk pastures managed under continuous stocking with varying stocking rate.

Leukotrienes are not essential for the efficacy of a heterologous vaccine against Mycobacterium tuberculosis infection

Leukotrienes are reported to be potent proinflammatory mediators that play a role in the development of several inflammatory diseases such as asthma, rheumatoid arthritis and periodontal disease. Leukotrienes have also been associated with protection against infectious diseases. However, the role of leukotrienes in Mycobacterium tuberculosis infection is not understood. To answer this question, we studied the role of leukotrienes in the protective immune response conferred by prime-boost heterologous immunization against tuberculosis. We immunized BALB/c mice (4-11/group) with subcutaneous BCG vaccine (1 x 10(5) M. bovis BCG) (prime) followed by intramuscular DNA-HSP65 vaccine (100 µg) (boost). During the 30 days following the challenge, the animals were treated by gavage daily with MK-886 (5 mg·kg-1·day-1) to inhibit leukotriene synthesis. We showed that MK-886-treated mice were more susceptible to M. tuberculosis infection by counting the number of M. tuberculosis colony-forming units in lungs. The histopathological analysis showed an impaired influx of leukocytes to the lungs of MK-886-treated mice after infection, confirming the involvement of leukotrienes in the protective immune response against experimental tuberculosis. However, prime-boost-immunized mice treated with MK-886 remained protected after challenge with M. tuberculosis, suggesting that leukotrienes are not required for the protective effect elicited by immunization. Protection against M. tuberculosis challenge achieved by prime-boost immunization in the absence of leukotrienes was accompanied by an increase in IL-17 production in the lungs of these animals, as measured by ELISA. Therefore, these data suggest that the production of IL-17 in MK-886-treated, immunized mice could contribute to the generation of a protective immune response after infection with M. tuberculosis.

Escala D'el Rey de medo de falar em público: Elaboração de um instrumento de auto-avaliação / D'el rey public speaking fear scale: Elaboration of a self-rating scale

O medo de falar em público constitui um subtipo pouco reconhecido da fobia social em estudos epidemiológicos. Este tipo de ansiedade social tem um impacto negativo na vida de muitas pessoas. Aqui em nosso país não existe até o momento nenhuma escala de auto-avaliação que avalie especificamente o medo severo de falar em público, relacionando-o com a fobia social. Por causa desta limitação, foi desenvolvida a Escala D’El Rey de Medo de Falar em Público (EDMF), uma escala de auto-avaliação com 10 itens. Este artigo descreve a elaboração teórica e a análise semântica da EDMF. Trinta e nove sujeitos de ambos os sexos e com diversos níveis educacionais (25 controles e 14 pessoas com fobia social circunscrita – medo de falar em público) participaram do estudo de análise semântica. Nenhuma das pessoas apresentou dificuldades de compreensão dos itens da EDMF. A escala está pronta para a validação psicométrica.

The public speaking fear constitutes a recognizable subtype of social phobia in epidemiologicstudies. This type of social anxiety may have a negative impact on the lives of many individuals.Here in our country, not exist at the moment none self-rating scale who evaluate the severepublic speaking fear relate with the social phobia diagnosis. Because of this limitation, wedeveloped the D'El Rey Public Speaking Fear Scale (EDMF), a 10-item self-rating scale. Thisreport describes theoretical elaboration and semantic analysis of the EDMF. Thirty nine personsof both sexes and diverses educational levels (25 controls and 14 non-generalized social phobics­ public speaking fear) participed of the semantic analysis study. None person show comprehensiondifficulties of EDMF item. The scale now read to psychometric validation

Th1 polarized response induced by intramuscular DNA-HSP65 immunization is preserved in experimental atherosclerosis

We previously reported that a DNA vaccine constructed with the heat shock protein (HSP65) gene from Mycobacterium leprae (DNA-HSP65) was protective and also therapeutic in experimental tuberculosis. By the intramuscular route, this vaccine elicited a predominant Th1 response that was consistent with its protective efficacy against tuberculosis. It has been suggested that the immune response to Hsp60/65 may be the link between exposure to microorganisms and increased cardiovascular risk. Additionally, the high cholesterol levels found in atherosclerosis could modulate host immunity. In this context, we evaluated if an atherogenic diet could modulate the immune response induced by the DNA-HSP65 vaccine. C57BL/6 mice (4-6 animals per group) were initially submitted to a protocol of atherosclerosis induction and then immunized by the intramuscular or intradermal route with 4 doses of 100 mug DNA-HSP65. On day 150 (15 days after the last immunization), the animals were sacrificed and antibodies and cytokines were determined. Vaccination by the intramuscular route induced high levels of anti-Hsp65 IgG2a antibodies, but not anti-Hsp65 IgG1 antibodies and a significant production of IL-6, IFN-g and IL-10, but not IL-5, indicating a Th1 profile. Immunization by the intradermal route triggered a mixed pattern (Th1/Th2) characterized by synthesis of anti-Hsp65 IgG2a and IgG1 antibodies and production of high levels of IL-5, IL-6, IL-10, and IFN-g. These results indicate that experimentally induced atherosclerosis did not affect the ability of DNA-HSP65 to induce a predominant Th1 response that is potentially protective against tuberculosis.

Terapia cognitivo-comportamental de grupo no tratamento da fobia social generalizada / Cognitive-behavioral group therapy in the treatment of generalized social phobia

Este estudo teve como objetivo verificar a efetividade da terapia cognitivo-comportamental de grupo em pacientes com fobia social generalizada. Vinte e nove pacientes com diagnóstico de fobia social generalizada foram randomicamente distribuídos em dois grupos de tratamento. Um grupo de terapia cognitivo-comportamental de grupo (TCCG) e outro grupo de controle placebo com credibilidade (CPC). Os pacientes preencheram 3 escalas de avaliaçã (Inventário de Fobia Social, Inventário de Ansiedade Beck e Escala de Impressão Clínica Global) na semana 1 de tratamento e na semana 12. Em todas as medidas de avaliações, ao final de 12 semanas, os pacientes que receberam TCCG apresentaram melhoras superioras ao grupo de CPC. Neste ensaio clínico randomizado, simples-cego, a TCCG foi superior ao CPC no tratamento da fobia social generalizada

The aim of this study is to assess the effectiveness of cognitive-behavioral group therapy in patientswith generalized social phobia. Twenty nine patients with diagnosis of generalized social phobiawere randomly allocated in two groups of treatments. One group of cognitive-behavioral grouptherapy (CBGT) and another group of credible placebo control (CPC). The patients completed 3evaluation scales (Social Phobia Inventory, Beck Anxiety Inventory and Clinical Global ImpressionScale) in the weeks 1 and 12. In all evaluation scales in the week 12 of treatment, the CBGTpatients were rated as more improved than CPC patients. In this randomized single-blind clinicaltrial, the CBGT was superior to a CPC in the treatment of generalized social phobia