Underserved groups could be better considered within population-based eye health surveys: A methodological study.

OBJECTIVE: In pursuit of health equity, the World Health Organization has recently called for more extensive monitoring of inequalities in eye health. Population-based eye health surveys can provide this information, but whether underserved groups are considered in the design, implementation, and reporting of surveys is unknown. We conducted a systematic methodological review of surveys published since 2000 to examine how many population-based eye health surveys have considered underserved groups in their design, reporting, or implementation. STUDY DESIGN AND SETTING: We identified all population-based cross-sectional surveys reporting the prevalence of objectively measured vision impairment or blindness. Using the PROGRESS+ framework to identify underserved groups, we assessed whether each study considered underserved groups within 15 items across the rationale, sampling or recruitment methods, or the reporting of participation and prevalence rates. RESULTS: 388 eye health surveys were included in this review. Few studies prospectively considered underserved groups during study planning or implementation, for example within their sample size calculations (n=5, ∼1%) or recruitment strategies (n=70, 18%). The most common way that studies considered underserved groups was in the reporting of prevalence estimates (n=374, 96%). We observed a modest increase in the number of distinct PROGRESS+ factors considered by a publication over the study period. Gender/sex was considered within at least one item by 95% (n=267) of studies. Forty-three percent (n=166) of included studies were conducted primarily on underserved population groups, particularly for sub-national studies of people living in rural areas, and we identified examples of robust population-based studies in socially excluded groups. CONCLUSION: More effort is needed to improve the design, implementation, and reporting of surveys to monitor inequality and promote equity in eye health. Ideally, national-level monitoring of vision impairment and service coverage would be supplemented with smaller-scale studies to understand the disparities experienced by the most underserved groups.

Síndrome de leiomiomatose cutânea e uterina múltipla: relato de três casos clínicos / Multiple cutaneous and uterine leiomyomatosis syndrome: report of three clinical cases

A síndrome de Reed ocorre em mulheres com múltiplos leiomiomas cutâneos e leiomiomatose uterina. Relatam-se três casos de pacientes do sexo feminino, acompanhadas em hospital universitário, com pápulas e nódulos eritêmato-acas- tanhados dolorosos em membros superiores e tórax, agravados por frio, pressão e estresse, e associados a miomatose uterina. Foram realizados diversos tratamentos prévios, sem sucesso, tais como: aplicação de corticoterapia e toxina botulínica intralesional, bloqueadores de canais de cálcio, neuromoduladores e analgésicos orais. Foi, então, realizado tratamento cirúrgico, com melhora dos sintomas. O co- nhecimento e o esclarecimento dessa síndrome é fundamental para estabelecer a relação com miomatose uterina e câncer de células renais, para que, então, a partir da lesão de pele, se faça o rastreio das demais neoplasias, diagnóstico precoce e a educação em saúde.

Reed syndrome occurs in women with multiple cutaneous leiomyomas and uterine leiomyomatosis. We report the case of three female patients followed at a university hospital with painful erythematous-brown papules and nodules on the upper limbs and chest, aggravated by cold, pressure, stress, and associated with uterine myoma- tosis. Several previous unsuccessful treatments were performed, such as the applica- tion of corticotherapy and intralesional botulinum toxin, calcium channel blockers, neuromodulators, and analgesics. Surgical treatment was performed with the im- provement of symptoms. Knowledge and clarification of this syndrome are essential to establish a relationship between uterine myomatosis and renal cell neoplasm, so that, after the skin lesion, screening for other neoplasms, early diagnosis, and health education can be carried out.

Primary glaucomas in adults: Epidemiology and public health-A review.

Glaucoma is a mixed group of optic neuropathies that lead to irreversible visual field loss and blindness if left untreated. It is estimated that 3.5% of the global population aged 40 to 80 years have any glaucoma, being the primary open-angle and the primary angle-closure glaucoma the most prevalent forms. Although the age-standardised prevalence of blindness caused by glaucoma has decreased substantially over the last decades, population growth and ageing impose many challenges in preventing glaucoma-related morbidities on a global level. In addition, difficulties in diagnoses and treatment, along with its chronic and irreversible nature, urge the development and implementation of innovative approaches in confronting the disease. This manuscript reviews recent literature related to the epidemiology of primary glaucomas in adults, the risk factors attributed to the development of the disease, and discuss challenges and potential solutions from a public health perspective.

Cataract as a Cause of Blindness and Vision Impairment in Latin America: Progress Made and Challenges Beyond 2020.

PURPOSE: To provide an update of cataract as a cause of vision loss in Latin America and to analyze sex inequalities in cataract surgical coverage (CSC) and effective CSC (eCSC) in the region. DESIGN: Population-based systematic review with longitudinal comparisons. METHODS: The Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databased were searched for population-based studies reporting cataract blindness, surgical coverage, and outcomes published between January 2014 and December 2019. Information on the number of surgeries performed from the 2014-2016 period was obtained from ministries of health and was used for calculation of the cataract surgical rate (CSR). Sources such as Rapid Assessment of Avoidable Blindness (RAAB) and Rapid Assessment of Cataract Surgical Services data were reanalyzed to calculate sex inequality in CSC and eCSC by subtracting the rate in women from the rate in men. RESULTS: Cataract was the cause of 29.8%-77.6% of cases of blindness in the included studies; the CSR improved in 10 countries. The CSC pinhole visual acuity of 3/60 varied from 24.1% in Peru to 97.1% in Argentina, and the median absolute gender inequality CSC pinhole visual acuity 3/60 was -0.7%. The eCSC pinhole visual acuity 3/60 varied from 14.8% in Guatemala to 92.1% in Argentina, and the median absolute gender inequality eCSC pinhole visual acuity 3/60 was -0.8%. CONCLUSIONS: Cataract remains a leading cause of blindness in Latin America. Coverage is suboptimal, and surgical results are also below target levels in many countries. Incentives for a better distribution of human resources, adequate training of ophthalmologists, and the inclusion of vision services in universal health care coverage could reduce the burden of cataract in Latin America.

Inclusion of kaolin in the diet of brown egg layers at the end of the production cycle / Caulim na alimentação de poedeiras semipesadas ao final do ciclo produtivo

ABSTRACT: This study investigated the inclusion of kaolin levels in the diet of brown egg layers at the end of the production cycle. A completely randomized design involved the distribution of 288 brown egg layers into six treatments of eight replications, with six birds per replication. When the birds reached the age of 63 weeks, the feeding of the experimental diets began. Diets differed by the inclusion of increasing levels of kaolin: Control (no additive), and the inclusion of 1%, 2%, 3%, 4%, and 5% kaolin. The performance, egg quality, intestinal morphometry, and excreta moisture were evaluated. The inclusion of kaolin promoted improvement in the jejunum villus height, enabling less feed intake; however, there were no significant differences in egg quality. The excreta moisture decreased linearly as the kaolin level in the diet increased. The inclusion of 5% kaolin in the diet of brown egg layers at the end of the production cycle improved intestinal morphometry and the quality of excreta through a reduction of moisture.

RESUMO: O objetivo deste trabalho foi investigar a inclusão de níveis de caulim na dieta de poedeiras semipesadas ao final do ciclo de produção. Foram utilizadas 288 galinhas semipesadas distribuídas em delineamento inteiramente casualizado com seis tratamentos de oito repetições, contendo seis aves por repetição. Quando as aves atingiram a idade de 63 semanas, foi iniciada a alimentação com as dietas experimentais. As dietas diferiam entre si pela inclusão de níveis crescentes de caulim: controle (sem aditivo); e a inclusão de 1, 2, 3, 4 e 5% de caulim na dieta. Foram avaliados o desempenho, a qualidade dos ovos, a morfologia intestinal e a umidade das excretas. A inclusão de caulim promoveu melhora na altura das vilosidades do jejuno, possibilitando menor consumo de ração. Não houve diferenças significativas para a qualidade dos ovos. A umidade das excretas diminuiu com o aumento do nível de caulim na dieta, respondendo de forma linear. A inclusão de caulim ao nível de 5% nas rações de poedeiras semipesadas ao final do ciclo de produção melhorou a morfometria intestinal e a qualidade dos excrementos por meio da redução de sua umidade.

Fiber levels in laying quail diets.

The objective of this work was to determine the effect of inclusion levels of dietary fiber in the Japanese quail diets. 480 Japanese quail were distributed in a completely randomized design, with 5 treatments and 12 replicates composed of 8 birds each. The treatments were constituted by five increasing levels of fiber in the diet: 2.78; 3.08; 3.38; 3.68; 3.98%. The parameters of productive performance, water consumption, egg quality, total lipids in the egg, excreta humidity, weight of digestive organs and intestinal morphology were evaluated. There was no significant effect of the use of different fiber levels on feed intake, egg production, viability, live weight, relative and absolute weight of gizzard, small intestine and cecum, and in excreta moisture of Japanese quais. Higher dietary fiber levels resulted in improvements in feed conversion per mass and per dozen eggs and higher water consumption. There was no significant difference for egg quality, except fot the color of the yolk where it was observed higher pigmentation of this structure with higher levels of fiber inclusion, and the lipid concentration in the buds was influenced in a quadratic manner. The inclusion of fiber promoted improvement in the villi of the duodenum and cecum.

Gestational gigantomastia complicated with mastitis

Gestational gigantomastia (GG) is a disease defined by rapid and disproportionate breast enlargement in pregnancy. Its complications may lead to emergency mastectomy or induced miscarriage. We present a case report in which pregnancy had a favorable evolution after the surgical intervention of the breasts.

Inclusion of kaolin in the feed of Japanese quails during the production phase / Inclusión de caolín en el alimento de codornices japonesas durante la fase de producción / Inclusão de caulim na alimentação de codornas japonesas durante a fase de produção

Abstract Background: Kaolin may improve quail performance by maintaining intestinal integrity and improving nutrient absorption. Objective: To evaluate the overall performance, egg quality, moisture, nitrogen and calcium content in the excreta, intestinal morphology and financial analysis of kaolin in Japanese quail feed during the production phase. Methods: A total of 192 Japanese quails, distributed in a completely randomized design with four treatments and six repetitions with eight birds each, were used. Kaolin levels added to the diet were 0, 1.5, 3.0, and 4.5%. Results: Kaolin reduced feed consumption. Additionally, egg production, feed conversion and viability increased. Moisture, nitrogen and calcium in the excreta decreased. Height and width of the intestinal villi increased with increasing levels of kaolin in the diet. Kaolin had no effect on egg quality. Inclusion level of 1.5% kaolin allowed for greater economic gains. Conclusion: Kaolin improved performance, intestinal morphology, and reduced the moisture, nitrogen and calcium contents in the excreta. Egg quality remained unchanged with the addition of kaolin, and the best economic response resulted with the addition 1.5% kaolin.

Resumen Antecedentes: El caolín puede mejorar el rendimiento de la codorniz al mantener la integridad intestinal y una mayor absorción de nutrientes. Objetivo: Evaluar el rendimiento general, calidad del huevo, humedad, contenido de nitrógeno y calcio en la excreta, morfología intestinal, y realizar un análisis financiero de la inclusion de caolín en el alimento de codorniz japonesa durante la fase de producción. Métodos: Se utilizaron un total de 192 codornices japonesas, distribuidas en un diseño completamente al azar con cuatro tratamientos y seis repeticiones con ocho aves cada una. Los niveles de caolín agregado a la dieta fueron 0; 1,5; 3,0; y 4,5%. Resultados: El caolin redujo el consumo de alimento, hubo una mejora en el porcentaje de huevos producidos, la conversión del alimento y la viabilidad, Los niveles de humedad, nitrógeno y calcio en la excreta disminuyeron, la altura y el ancho de las vellosidades intestinales aumentaron con la inclusión de niveles crecientes de caolín. No hubo efecto sobre la calidad del huevo. Los niveles de inclusión de 1,5% de caolín permitieron mayores ganancias económicas. Conclusión: El caolín mejoró el rendimiento, la morfología intestinal y redujo los contenidos de humedad, nitrógeno y calcio en las excretas. La calidad de los huevos producidos se mantuvo sin cambios con la adición de diferentes niveles de caolín, y el mejor nivel de inclusion de caolín -según el análisis económico- fue de 1,5%.

Resumo Antecedentes: O caulim pode melhorar o desempenho de codornas mantendo a integridade intestinal e maior absorção de nutrientes. Objetivo: Avaliar o desempenho global, a qualidade do ovo, a umidade, o teor de nitrogênio e cálcio na excreta, a morfologia intestinal e a análise financeira do caulim em codornas japonesas durante a fase de produção. Métodos: Foram utilizadas 192 codornas japonesas, distribuídas em delineamento inteiramente casualizado, com quatro tratamentos e seis repetições, com oito aves cada. Os níveis de caulim adicionados à dieta foram 0; 1,5; 3,0; 4,5%. Resultados: O consumo de ração foi reduzido, houve melhora na porcentagem de ovos produzidos, conversão alimentar e viabilidade, os níveis de umidade, nitrogênio e cálcio nas excretas diminuíram, a altura e a largura das vilosidades intestinais aumentaram com a inclusão de níveis crescentes de caulim. Não houve efeito na qualidade do ovo. Os níveis de inclusão de 1,5% de caulim permitiram maiores ganhos econômicos. Conclusão: O caulim melhorou o desempenho, a morfologia intestinal e reduziu os teores de umidade, nitrogênio e cálcio na excreta. A qualidade dos ovos produzidos permaneceu inalterada com a adição de diferentes níveis de caulim, e o melhor nível de caulim, de acordo com a análise econômica, foi de 1,5% como aditivo para as codornas japonesas.

Comparative Effect of The Inclusion of Zootechnical Additives in the Feed of Japanese Quails in Two Productive Phases.

This study aimed to evaluate the intestinal morphology, performance and financial analysis of the inclusion of additives in the feed during the productive period of 360 Japanese quails distributed in a completely randomized design in a split plot scheme in time with five treatments and eight repetitions of nine birds each. The treatments were: control, antibiotic, prebiotic, probiotic and synbiotic. The variables were: height, width and width/height ratio of the villi, crypt depth and villus/crypt ratio, feed intake, egg production, egg weight average, egg mass, feed conversion per mass and per dozen eggs and viability, internal rate of return, net present value and cost benefit. The additives in the feed increased height and width of the villi, decreased crypt depth and increased villus/ crypt ratio compared to the control. Feed intake was lower after the inclusion of antibiotics and synbiotics in the feed. Egg production and feed conversion improved after the inclusion of additives in the feed compared with the control. The reduction of feed intake was more pronounced with the addition of antibiotic and synbiotic in the final stage of the productive period of the Japanese quails. The inclusion of antibiotics and synbiotic proved to be more financially viable.

Decreased levels of vitamin D3 and supplementation with 1,25-dihydroxyvitamin D3-glycoside on performance, carcass yield and bone quality in broilers / Diminuição dos níveis de vitamina D3 e suplementação com 1,25-dihidroxivitamina D3 glicosídeo sobre o desempenho, o rendimento da carcaça e a qualidade dos ossos em frangos de corte

ABSTRACT: An experiment was performed to evaluate the effect of decreased levels of vitamin D3 in the premix and 1,25-dyhydroxyvitamin D3-glycoside (1,25(OH)2D3-glycoside) supplementation on performance, carcass yield and bone quality in 42d old broilers. Seven-d-old male chickens Cobb500® were distributed in a randomized design with six treatments: a control diet with inclusion of vitamin D3 in the premix, without supplementation of 1,25(OH)2D3-glycoside, and five diets with decreased levels of vitamin D3 (100%, 75%, 50%, 25% and 0% about the control) plus the addition of 1,25(OH)2D3-glycoside, 50g ton-1 of diet. The main results were to reduce the tenor of Vitamin D3 in the premix when the addition of 1,25(OH)2D3-glycoside did not affect (P>0.05) the performance, carcass yield and bone quality variables. However, performance (feed intake, gain weight, feed conversion), yield (warm carcass weight) and bone quality (dry weight, length, mineral matter and breaking strength) of broilers fed with diets without vitamin D3 in the premix and with addition of 1,25(OH)2D3-glycoside, which was the single source of vitamin D, had as a result very low (P<0.05) values comparing to the control. For the purposes of the present research, it was concluded that is possible the reduction of vitamin D3 tenor in the premix up to 75% when the diet of male broilers is supplemented with 1,25(OH)2D3-glycoside. However, the use of 1,25(OH)2D3-glycoside as a single source of vitamin D, as tested here, is not recommended for broilers diets.

RESUMO: Um experimento foi realizado para avaliar o efeito da diminuição dos níveis de vitamina D3 no premix e a suplementação de 1,25-dihidroxivitamina D3-glicosídeo (1,25(OH)2D3-glicosídeo) sobre o desempenho, rendimento de carcaça e qualidade óssea em frangos de corte de 42 dias. Machos Cobb500® de sete dias de idade foram distribuídos em delineamento inteiramente casualizado com seis tratamentos: uma dieta controle com inclusão de vitamina D3 no premix, sem suplementação de 1,25(OH)2D3-glicosídeo, e cinco dietas com níveis decrescentes de vitamina D3 (100%, 75%, 50%, 25% e 0% em relação ao controle) mais a adição de 1,25(OH)2D3-glicosídeo (50g ton-1 de dieta). Entre os principais resultados, foi observado que a redução do teor de vitamina D3 no premix quando adicionado 1,25(OH)2D3-glicosídeo não afetou (P>0,05) o desempenho, o rendimento da carcaça e as variáveis da qualidade óssea. No entanto, as variáveis do desempenho e o rendimento (consumo de ração, ganho de peso, conversão alimentar, peso da carcaça quente) e da qualidade dos ossos (peso seco, comprimento, matéria mineral e resistência à ruptura) de frangos alimentados com dietas sem vitamina D3 no premix, com a adição de 1,25(OH)2D3-glicosídeo como a única fonte de vitamina D, teve como resultado valores muito baixos (P<0,05) em comparação ao controle. Para os propósitos da presente pesquisa, concluiu-se que é possível a redução do teor de vitamina D3 no premix até 75% quando a dieta de frangos de corte machos é suplementada com 1,25(OH)2D3-glicosídeo. No entanto, o uso de 1,25(OH)2D3-glicosídeo como única fonte de vitamina D, conforme testado aqui, não é recomendado para dietas de frangos de corte.

A case of atypical nocardia asteroides sclerouveitis resistant to fourth-generation fluoroquinolones / Um caso atípico de esclero-uveíte por Nocardia Asteroides resistente a fluorquinolona de quarta-geração

ABSTRACT We describe an unusual case of Nocardia spp scleritis in a health girl resistant to topical fourth-generation fluoroquinolones. Clinically, there was only partial response of the scleritis to initial therapy. Treatment was changed to meropenem intravenously and topical amikacin. Following several weeks of antibiotic treatment, the patient's infection resolved but her vision was reduced to no light perception. Nocardia asteroides must be considered as a possible agent in cases of necrotizing scleritis in patients without a clear source. Antibiotic sensitivity testing has a definitive role in view of the resistance to these new medications.

RESUMO Nós descrevemos um raro caso de esclerite por Nocardia spp em uma criança sadia resistente a utilização tópica de fluorquinolona de quarta-geração. Clinicamente, a paciente apresentou apenas uma resposta parcial do quadro de esclerite a terapêutica inicial. O tratamento foi então modificado para meropenem intravenoso e amicacina tópica. Após várias semanas de tratamento com antibiótico, o quadro infeccioso regrediu porém a visao da pacientes evoluiu para perda da percepção luminosa. Em casos de esclerite necrotizante em pacientes sem fatores de risco aparente é necessário considerer a Nocardia Asteroides como possível agente causador. Os testes de sensibilidade medicamentosa apresentam importância significativa em virtude do aparecimento de resistência aos novos medicamentos.

Profile of pediatric eye trauma at Hospital de Base do Distrito Federal (HBDF), Brasília, Brazil.

OBJECTIVE: To describe the epidemiological profile of ocular trauma in children at the HBDF emergency department. METHOD: Descriptive, cross-sectional study. We evaluated 103 cases of ocular trauma in children less than 15 years between July 2012 and January 2013. The factors evaluated through semi-structured questionnaire available online were: age, gender, adult supervision, mechanism, type of trauma, time and place, site and nature of injury, visual acuity, need for hospitalization and/or surgery, type of surgery, mother's level of education, and family income. RESULTS: The average age of patients studied was 7.5 years. Boys (68%) predominate in all age groups. Blunt trauma prevailed (55.3%), followed by open (20%). Most of the cases occurred at home, 14 to 20 hours before seeking hospital care. The most common causes were: wood, stone, bicycle, broken glass, and falls. The cornea was affected in 54%. Visual acuity was ≥20/40 in 68.9%. Primary repair of the eye wall was indicated in 70.37% (p-value=0.022). Open traumas were more severe (p-value=0.005) and had more need for intervention (p-value=0.000). The injuries occurred despite the presence of adult supervision in 54% (p-value=0.002). The most severe injuries predominated in the age range 7-15 years (p=0.001). CONCLUSION: Ocular trauma was more frequent among boys. The mechanisms of injury are the most diverse, and prevail at home. Blunt trauma prevails, but the visual impact is due to open trauma. Programs of prevention and education on child ocular trauma are needed.

Profile of pediatric eye trauma at Hospital de Base do Distrito Federal (HBDF), Brasília, Brazil / Perfil do trauma ocular pediátrico no Hospital de Base do Distrito Federal (HBDF), Brasília, Brasil

Summary Objective: To describe the epidemiological profile of ocular trauma in children at the HBDF emergency department. Method: Descriptive, cross-sectional study. We evaluated 103 cases of ocular trauma in children less than 15 years between July 2012 and January 2013. The factors evaluated through semi-structured questionnaire available online were: age, gender, adult supervision, mechanism, type of trauma, time and place, site and nature of injury, visual acuity, need for hospitalization and/or surgery, type of surgery, mother’s level of education, and family income. Results: The average age of patients studied was 7.5 years. Boys (68%) predominate in all age groups. Blunt trauma prevailed (55.3%), followed by open (20%). Most of the cases occurred at home, 14 to 20 hours before seeking hospital care. The most common causes were: wood, stone, bicycle, broken glass, and falls. The cornea was affected in 54%. Visual acuity was ≥20/40 in 68.9%. Primary repair of the eye wall was indicated in 70.37% (p-value=0.022). Open traumas were more severe (p-value=0.005) and had more need for intervention (p-value=0.000). The injuries occurred despite the presence of adult supervision in 54% (p-value=0.002). The most severe injuries predominated in the age range 7-15 years (p=0.001). Conclusion: Ocular trauma was more frequent among boys. The mechanisms of injury are the most diverse, and prevail at home. Blunt trauma prevails, but the visual impact is due to open trauma. Programs of prevention and education on child ocular trauma are needed.

Resumo Objetivo: descrever o perfil epidemiológico do trauma ocular infantil na urgência do HBDF. Método: estudo transversal, descritivo. Avaliaram-se 103 casos de trauma ocular em menores de 15 anos entre julho de 2012 e janeiro de 2013, por meio de aplicação de questionário semiestruturado disponível online: idade, sexo, presença de supervisão, mecanismo, tipo do trauma, local e hora, sítio e natureza da injúria, acuidade visual, necessidade de internação e/ou cirurgia, tipo de cirurgia, escolaridade materna e renda familiar. Resultados: a média de idade dos pacientes analisados foi 7,5 anos. Os meninos (68%) predominaram em todas as faixas etárias. O trauma fechado prevaleceu (55,3%), seguido do aberto (20%). A maioria dos casos ocorreram em casa, no período de 14 às 20 horas. As causas mais comuns foram: madeira, pedra, bicicleta, caco de vidro e quedas. A córnea foi acometida em 54%. A acuidade visual foi ≥20/40 em 68,9%. Indicou-se sutura primária da parede em 70,37% (p-valor=0,022). O trauma mais grave (p-valor=0,005) e que mais necessitou de intervenção (p-valor=0,000) foi o aberto. As injúrias ocorreram, apesar da presença de supervisão de um adulto, em 54% (p-valor=0,002). Os traumas mais graves predominaram entre 7-15 anos (p-valor=0,001). Conclusão: o trauma ocular infantil foi mais frequente nos meninos. Os mecanismos de lesão são os mais diversos e predominaram no domicílio. O trauma fechado prevaleceu; porém, o maior impacto visual decorreu do trauma aberto. São necessários programas de prevenção e educação em trauma ocular infantil.

Fraction of exhaled nitric oxide measurements in the diagnoses of asthma in elderly patients.

OBJECTIVE: To assess the value of fraction of exhaled nitric oxide (FeNO) measurements in the diagnosis of asthma in elderly patients. METHODS: The clinical symptoms of 202 elderly patients were assessed with the asthma module of the International Study of Asthma and Allergies in Childhood test, which had been modified for the elderly patients, and the diagnostic routine for chronic obstructive pulmonary disease (COPD), which was based on the Global initiative for chronic Obstructive Lung Disease criteria. Of the 202 patients assessed, 43 were subjected to pulmonary function evaluations (spirometry) and FeNO measurements. RESULTS: Of the 202 elderly patients, 34 had asthma (23 definite and eleven probable), 20 met COPD criteria, 13 presented with an overlap of asthma and COPD, and 135 did not fit the criteria for obstructive pulmonary disease. Among the 43 elderly patients who were subjected to FeNO measurements, ten showed altered results (23.2%) and 33 had normal results (76.7%). The average value of FeNO in patients with definite and probable asthma undergoing this procedure was 29.2 parts per billion whereas that in nonasthmatic patients was 17.5 parts per billion (P=0.0002). CONCLUSION: We show a clear relationship between FeNO levels and asthma symptoms and previous asthma diagnoses in elderly patients.

Uso de aditivo alimentar equilibrador da flora intestinal em aves de corte e de postura / Use of a balancing food additive of the intestinal flora for broilers and laying

Aspectos gerais sobre a utilização de aditivos zootécnicos equilibradores da flora intestinal em rações de aves de corte e de postura foram abordados nesta revisão, destacando-se a utilização de prebióticos, especialmente dos mananoligossacarídeos (MOSs), os quais promovem o crescimento das populações microbianas que melhoram as condições luminais. A utilização de aditivos equilibradores da flora intestinal tem revelado melhorias na integridade do epitélio intestinal (aumento da altura e largura das vilosidades), no desempenho (melhora na produção e conversão alimentar) e na qualidade do produto final (qualidade da casca dos ovos). Esta revisão objetivou abordar também aspectos relacionados às características, ao mecanismo de ação, além dos efeitos benéficos da utilização desses aditivos alternativos aos antibióticos na avicultura de corte e de postura, incluindo codornas japonesas.(AU)

The general aspects on the use of zootechnical additives that balance the intestinal flora in diets of broilers and laying were reviewed, highlighting the use of prebiotics, mainly Mannan-oligosaccharides (MOS). These promote the growth of microbial population, thus improving luminal conditions. The use of additives balancing the intestinal flora has been shown to improve the integrity of the intestinal epithelium (increased villus height and width), performance (improvement in production and feed conversion), and quality of the final product (quality of shell eggs). This review also addresses issues related to the characteristics, mechanism of action, in addition to the beneficial effects of using these additives as an alternative to antibiotics in the poultry production, including Japanese quail.(AU)

Kaolin in the diet and its effects on performance, litter moisture and intestinal morphology of broiler chickens / O caulim na ração e seus efeitos sobre desempenho, umidade da cama e morfologia intestinal de frangos de corte

The objective of this study was to evaluate the effect of the addition of kaolin in the diet on performance, litter moisture and intestinal morphology of broiler chickens. Four hundred ninety-two broiler chickens distributed in a completely randomized design with three treatments and four replicates of 41 birds each, divided into three periods (15-21; 22-34; 35-52 days) were used. The following treatments were: Control - reference diet without added kaolin; treatment 1 - reference diet + 0.75% kaolin; Treatment 2 - reference diet + 1.5% kaolin. The variables analyzed were: feed intake, average weight, average weight gain, feed conversion, litter moisture, villus height and crypt depth. The inclusion of kaolin in the diet significantly reduced feed intake, increased weight and average weight gain and improved feed conversion of broilers. The litter moisture decreased significantly after the inclusion of kaolin in the diet. The height of the duodenal villi of broilers increased significantly after inclusion of kaolin, while crypt depth was not influenced. The inclusion 0.75% of kaolin in the diet improved the performance, decreased litter moisture and benefited the intestinal integrity of broilers.

Objetivou-se com este trabalho avaliar o efeito da adição de caulim na ração sobre o desempenho, a umidade da cama e a morfologia intestinal de frangos de corte. Foram utilizados 492 frangos de corte, distribuídos em um delineamento inteiramente casualizado com três tratamentos e quatro repetições de 41 aves cada, dividido em 3 períodos (15-21 dias; 22-34 dias; 35-52 dias). Os tratamentos adotados foram os seguintes: Controle - ração referência sem adição de caulim; tratamento 1- ração referência + 0,75% de caulim; tratamento 2 - ração referência + 1,5% de caulim. As variáveis analisadas foram: consumo de ração, peso médio, ganho médio de peso, conversão alimentar, umidade da cama, altura das vilosidades e profundidade de cripta. A inclusão de caulim na ração reduziu significativamente o consumo, aumentou o peso e o ganho médio de peso e melhorou a conversão alimentar dos frangos. A umidade da cama diminuiu significativamente após inclusão de caulim na ração. A altura das vilosidades duodenais dos frangos aumentou significativamente após inclusão do caulim, enquanto que a profundidade das criptas não foi influenciada. A inclusão de 0,75% de caulim na dieta melhorou o desempenho, diminuiu a umidade da cama e beneficiou a integridade intestinal de frangos de corte.