ABSTRACT
The diagnosis of pure neural leprosy is more challenging because patients share characteristics with other common pathologies, such as ulnar compression, which should be taken into consideration for differential diagnosis. In this study, we identify ulnar nerve conduction characteristics to aid in the differential diagnosis of ulnar neuropathy (UN) in leprosy and that of non-leprosy etiology. In addition, we include putative markers to better understand the inflammatory process that may occur in the nerve. Data were extracted from a database of people affected by leprosy (leprosy group) diagnosed with UN at leprosy diagnosis. A non-leprosy group of patients diagnosed with mechanical neuropathy (compressive, traumatic) was also included. Both groups were submitted to clinical, neurological, neurophysiological and immunological studies. Nerve enlargement and sensory impairment were significantly higher in leprosy patients than in patients with compressive UN. Bilateral impairment was significantly higher in the leprosy group than in the non-leprosy group. Leprosy reactions were associated to focal demyelinating lesions at the elbow and to temporal dispersion (TD). Clinical signs such as sensory impairment, nerve enlargement and bilateral ulnar nerve injury associated with eletrodiagnostic criteria such as demyelinating finds, specifically temporal dispersion, could be tools to help us decided on the best conduct in patients with elbow ulnar neuropathy and specifically decide if we should perform a nerve biopsy for diagnosis of pure neural leprosy.
Subject(s)
Leprosy/diagnosis , Leprosy/metabolism , Ulnar Neuropathies/diagnosis , Adolescent , Adult , Aged , Biomarkers , Brazil/epidemiology , Cross-Sectional Studies , Data Management , Databases, Factual , Diagnosis, Differential , Elbow Joint , Female , Humans , Leprosy, Tuberculoid , Male , Middle Aged , Neural Conduction , Ulnar Nerve/metabolism , Ulnar Neuropathies/physiopathologyABSTRACT
It was evaluated the microbial production by urine purine derivatives and plasmatic urea concentration (PUC) and urea excretion in lactation cows, receiving diets containing four levels of coffee hulls in total dry matter (0; 6; 12 and 18% of DM), in substitution for corn silage. Twelve Holstein cows were distributed according to the lactation period in three latin squares 4 x 4 Diets were isoproteic, with 15% of crude protein (CP), constituted of 60% of roughage (corn silage and coffee hulls) and 40% of concentrate, in dry matter basis. A linear decrease (P 0.05) were observed for the urinary excretion of alantoin, absorbed purins and microbial nitrogen compounds, being estimated a reduction of 6.48 and 6.51 mM/day and 4.7 g/day with each unit of coffee hulls added, respectively. The estimated uric acid excretion, microbial efficiency and the relation between CP and CP consumption were not influenced (P>0.05) by the coffee hulls levels in the diet, with mean values of 19.06 mM/day; 133.88 g CP/kg of TDN and 54.83, respectively. Plasmatic N-urea and daily urea and N excretion (mg/kg BW and g/day) decreased linearly (P 0.05) with coffee hulls addition, with decreases observed of 0.26 mg/dL, 5.6 g/day, 4.95 mg/ kg BW and 3.08 g/day for each unit of coffee hulls added, respectively. The inclusion of coffee hulls up to 18% on lactation dairy cows diets reduced the alantoin
Avaliaram-se a produção de proteína microbiana através dos derivados de purinas na urina e a concentração de uréia plasmática (NUP) e excreções de uréia em vacas em lactação, recebendo dietas contendo quatro níveis de casca de café na matéria seca total (0; 6; 12 e 18% da MS), em substituição à silagem de milho. Foram utilizadas 12 vacas da raça Holandesa, em três quadrados latinos 4 x 4, distribuídas de acordo com o período de lactação. As dietas foram isoprotéicas, com 15% de proteína bruta (PB), sendo constituídas de 60% de volumoso (silagem de milho e casca de café) e 40% de ração concentrada, em base da MS. Observou-se decréscimo linear (P 0,05) para as excreções urinárias de alantoína, purinas absorvidas e compostos nitrogenados microbianos, estimando-se redução de 6,48 e 6,51 mmol dia-1 e de 4,70 g dia-1 por unidade de casca de café adicionada, respectivamente. A excreção estimada de acido úrico, eficiência microbiana e a relação entre PB e consumo de PB não foram influenciadas (P>0,05) pelos níveis de casca de café nas dietas, registrando valores médios de 19,06 mmol dia-1; 133,88 g PB kg-1 de NDT e 54,83, respectivamente. O N-uréia plasmático e as excreções diárias de uréia e N na forma de uréia na urina (mg kg-1 PV e g dia-1) decresceu linearmente (P 0,05) com adição de casca de café nas dietas, sendo observados decréscimos de 0,26 mg dL-1, 5,60 g dia-1, 4,95
ABSTRACT
It was evaluated the microbial production by urine purine derivatives and plasmatic urea concentration (PUC) and urea excretion in lactation cows, receiving diets containing four levels of coffee hulls in total dry matter (0; 6; 12 and 18% of DM), in substitution for corn silage. Twelve Holstein cows were distributed according to the lactation period in three latin squares 4 x 4 Diets were isoproteic, with 15% of crude protein (CP), constituted of 60% of roughage (corn silage and coffee hulls) and 40% of concentrate, in dry matter basis. A linear decrease (P 0.05) were observed for the urinary excretion of alantoin, absorbed purins and microbial nitrogen compounds, being estimated a reduction of 6.48 and 6.51 mM/day and 4.7 g/day with each unit of coffee hulls added, respectively. The estimated uric acid excretion, microbial efficiency and the relation between CP and CP consumption were not influenced (P>0.05) by the coffee hulls levels in the diet, with mean values of 19.06 mM/day; 133.88 g CP/kg of TDN and 54.83, respectively. Plasmatic N-urea and daily urea and N excretion (mg/kg BW and g/day) decreased linearly (P 0.05) with coffee hulls addition, with decreases observed of 0.26 mg/dL, 5.6 g/day, 4.95 mg/ kg BW and 3.08 g/day for each unit of coffee hulls added, respectively. The inclusion of coffee hulls up to 18% on lactation dairy cows diets reduced the alantoin
Avaliaram-se a produção de proteína microbiana através dos derivados de purinas na urina e a concentração de uréia plasmática (NUP) e excreções de uréia em vacas em lactação, recebendo dietas contendo quatro níveis de casca de café na matéria seca total (0; 6; 12 e 18% da MS), em substituição à silagem de milho. Foram utilizadas 12 vacas da raça Holandesa, em três quadrados latinos 4 x 4, distribuídas de acordo com o período de lactação. As dietas foram isoprotéicas, com 15% de proteína bruta (PB), sendo constituídas de 60% de volumoso (silagem de milho e casca de café) e 40% de ração concentrada, em base da MS. Observou-se decréscimo linear (P 0,05) para as excreções urinárias de alantoína, purinas absorvidas e compostos nitrogenados microbianos, estimando-se redução de 6,48 e 6,51 mmol dia-1 e de 4,70 g dia-1 por unidade de casca de café adicionada, respectivamente. A excreção estimada de acido úrico, eficiência microbiana e a relação entre PB e consumo de PB não foram influenciadas (P>0,05) pelos níveis de casca de café nas dietas, registrando valores médios de 19,06 mmol dia-1; 133,88 g PB kg-1 de NDT e 54,83, respectivamente. O N-uréia plasmático e as excreções diárias de uréia e N na forma de uréia na urina (mg kg-1 PV e g dia-1) decresceu linearmente (P 0,05) com adição de casca de café nas dietas, sendo observados decréscimos de 0,26 mg dL-1, 5,60 g dia-1, 4,95