Nutritional and metabolic parameters of sheep on deferred pasture with different strategy changes during the dry season / [Parâmetros nutricionais e metabólicos de ovinos em pasto diferido com diferentes estratégias mudam ao longo do período seco]

To verify if strategies to reduce the height of Marandu grass pasture at beginning of the deferral period change intake and metabolic parameters in sheep during the dry season, 18 crossbred females, ½ Dorper + ½ Santa Inês were used, distributed in 9 Marandu grass paddock handles to 3 drawdown strategies at the beginning of deferral period: 1) maintenance of grass with 15cm for 5 months before deferral start (15/15cm); 2) maintenance of marandu grass with 25 cm for 5 months, but at the beginning of deferral it was reduced to 15cm (25/15cm); 3) maintenance of 35 cm grass for 5 months, but at the beginning of deferral it was reduced to 15cm (35/15cm). The experiment was conducted in a completely randomized design (CRD), with 6 repetitions and repeated measures over time. Strategies to reduce the height of Marandu grass pasture, at the beginning of the deferral period, do not change nutrient intake and energy and protein metabolism. However, changes occurring in the pasture during the dry season alter these variables, and deferral is an interesting strategy to be used for forage production in winter, however, to optimize its use, it is necessary to use supplementation with concentrated rich in fermentable carbohydrates.

Para verificar se estratégias de redução da altura do pasto de capim-marandu, no início do período de diferimento, alteram consumo e parâmetros metabólicos em ovinos durante o período seco, foram utilizadas 18 fêmeas, mestiças, ½ Dorper + ½ Santa Inês, que foram distribuídas em nove piquetes de capim-marandu, com três estratégias de rebaixamento no início do período de diferimento: 1) manutenção do capim com 15cm, por cinco meses, antes do início do diferimento (15/15cm); 2) manutenção do capim-marandu com 25cm, por cinco meses, rebaixado, no início do diferimento, para 15cm (25/15cm); e 3) manutenção do capim com 35cm durante cinco meses, rebaixado, no início do diferimento, para 15cm (35/15cm). O experimento foi conduzido em delineamento inteiramente ao acaso (DIC), com seis repetições e medidas repetidas no tempo. Estratégias de redução da altura do pasto, no início do período de diferimento, não alteram o consumo de nutrientes e metabolismo energético e proteico. Porém, as mudanças no pasto durante o período seco alteram essas variáveis, sendo o diferimento uma estratégia interessante para utilizar na produção de forragem no inverno. Para otimizar seu uso, faz-se necessária, entretanto, a utilização da suplementação com concentrados ricos em carboidratos rapidamente fermentáveis.

Influence of Short and Medium Distance Road Transport on the Acute Phase Proteins in Horses.

Horse transport is a common practice and is usually associated as a cause of stress in animals, with consequences for their well-being. There are several of evidence that stress can increase an acute phase response. The aim of this study was to verify whether the road transport of horses over distances of 50 and 300 kilometers induces changes in the values of acute phase proteins. To do this, the serum SDS-PAGE was performed and the bands obtained were identified by mass spectrometry (MALDI-TOF). The blood samples were collected in tubes without anticoagulant to obtain the serum, and the evaluations occurred before the road transportation (T0), immediately after the journey (T1), six hours later (T2), and 24 hours (T3), 48 hours (T4), 72 hours (T5), 96 hours (T6), 120 hours (T7) and 144 hours (T8) after the end of the trip. All analyzes were performed using the Minitab 17 statistical package, and significance was considered when P<0.05. The APPs found through SDS-PAGE and properly identified were α2-macroglobulin, ceruloplasmin, transferrin, albumin, α1-antitrypsin, haptoglobin, apolipoprotein alpha 1, and α1-acid glycoprotein. No differences were observed in the concentration values between 50 and 300 km or between the moments after each route. The distances covered with the horses were not challenging enough to provoke an acute phase response reflected in changes in APPs.

Fructose and methylglyoxal-induced glycation alters structural and functional properties of salivary proteins, albumin and lysozyme.

Glycation process refers to reactions between reduction sugars and amino acids that can lead to formation of advanced glycation end products (AGEs) which are related to changes in chemical and functional properties of biological structures that accumulate during aging and diseases. The aim of this study was to perform and analyze in vitro glycation by fructose and methylglyoxal (MGO) using salivary fluid, albumin, lysozyme, and salivary α-amylase (sAA). Glycation effect was analyzed by biochemical and spectroscopic methods. The results were obtained by fluorescence analysis, infrared spectroscopy (total attenuated reflection-Fourier transform, ATR-FTIR) followed by multivariate analysis of principal components (PCA), protein profile, immunodetection, enzymatic activity and oxidative damage to proteins. Fluorescence increased in all glycated samples, except in saliva with fructose. The ATR-FTIR spectra and PCA analysis showed structural changes related to the vibrational mode of glycation of albumin, lysozyme, and salivary proteins. Glycation increased the relative molecular mass (Mr) in protein profile of albumin and lysozyme. Saliva showed a decrease in band intensity when glycated. The analysis of sAA immunoblotting indicated a relative reduction in intensity of its correspondent Mr after sAA glycation; and a decrease in its enzymatic activity was observed. Carbonylation levels increased in all glycated samples, except for saliva with fructose. Thiol content decreased only for glycated lysozyme and saliva with MGO. Therefore, glycation of salivary fluid and sAA may have the potential to identify products derived by glycation process. This opens perspectives for further studies on the use of saliva, an easy and non-invasive collection fluid, to monitor glycated proteins in the aging process and evolution of diseases.

Comparison of C-reactive protein and C-reactive protein-to-albumin ratio in predicting mortality among geriatric coronavirus disease 2019 patients

SUMMARY OBJECTIVE: The aim of this study was to evaluate and compare C-reactive protein and C-reactive protein-to-albumin ratio performances in predicting mortality of geriatric patients who visited the emergency department. METHODS: The data of patients with COVID-19 and aged 65 years and above, who visited emergency department during the study period, were retrospectively analyzed. The data were obtained from an electronic-based hospital information system. The area under the receiver operating characteristic curve and the area under the curve were used to assess each cutoff value discriminatory for predicting mortality. RESULTS: The mean age of the population included in this study was 76 (71-82) years, while 52.7% were males. The sensitivity, specificity, and area under the curve values for C-reactive protein in terms of mortality were calculated as 71.01, 52.34, and 0.635%, respectively, while the sensitivity, specificity, and area under the curve values for C-reactive protein-to-albumin ratio were calculated as 75.74, 47.66, and 0.645%, respectively (p<0.001). In the pairwise comparison for the receiver operating characteristic curves of C-reactive protein and C-reactive protein-to-albumin ratio, no statistically significant difference was found. CONCLUSIONS: Geriatric patients are the "most vulnerable" patient group against the COVID-19. In this study, both C-reactive protein and C-reactive protein-to-albumin ratio were found to be successful in predicting mortality for geriatric COVID-19 patients.

Comparison of C-reactive protein and C-reactive protein-to-albumin ratio in predicting mortality among geriatric coronavirus disease 2019 patients.

OBJECTIVE: The aim of this study was to evaluate and compare C-reactive protein and C-reactive protein-to-albumin ratio performances in predicting mortality of geriatric patients who visited the emergency department. METHODS: The data of patients with COVID-19 and aged 65 years and above, who visited emergency department during the study period, were retrospectively analyzed. The data were obtained from an electronic-based hospital information system. The area under the receiver operating characteristic curve and the area under the curve were used to assess each cutoff value discriminatory for predicting mortality. RESULTS: The mean age of the population included in this study was 76 (71-82) years, while 52.7% were males. The sensitivity, specificity, and area under the curve values for C-reactive protein in terms of mortality were calculated as 71.01, 52.34, and 0.635%, respectively, while the sensitivity, specificity, and area under the curve values for C-reactive protein-to-albumin ratio were calculated as 75.74, 47.66, and 0.645%, respectively (p<0.001). In the pairwise comparison for the receiver operating characteristic curves of C-reactive protein and C-reactive protein-to-albumin ratio, no statistically significant difference was found. CONCLUSIONS: Geriatric patients are the "most vulnerable" patient group against the COVID-19. In this study, both C-reactive protein and C-reactive protein-to-albumin ratio were found to be successful in predicting mortality for geriatric COVID-19 patients.

Marcadores hematológicos y bioquímicos para el diagnóstico precoz de bacteriemiascausadas por Enterobacteriaceae resistentes a los carbapenémicos / Haematological and biochemical markers for the early diagnosis of bacteremias caused bycarbapenem-resistant Enterobacteriaceae

INTRODUCCIÓN. Las bacteriemias causadas por Enterobacteriaceae resistentes a carbapenémicos se asocian con altas tasas de mortalidad a diferencia de las bacteriemias causadas por Enterobacteriaceae sensibles a carbapenémicos. Los hallazgos clínicos y de laboratorio son importantes para determinar los esquemas terapéuticos y su pronóstico; su diagnóstico precoz resulta esencial para un manejo adecuado. OBJETIVO. Relacionar valores de marcadores sanguíneos y bioquímicos en bacteriemias causadas por Enterobacteriaceae resistentes a carbapenémicos. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 427 y muestra de 224 datos de hemocultivos positivos para Enterobacteriaceae de pacientes atendidos en el Hospital de Especialidades Carlos Andrade Marín en el periodo mayo 2016 a julio 2018. Criterios de inclusión: i) al menos un hemocultivo positivo; ii) recuperación del aislado de CRE o CSE y iii) recolección simultanea de muestras de sangre y pruebas de laboratorio. Criterios de exclusión: i) bacteriemias polimicrobianas; ii) valores fuera de rango y iii) reportes sin valores numéricos. El análisis de datos se realizó mediante el programa estadístico International Business Machines Statistical Package for the Social Sciences versión 24.0. RESULTADOS. Se demostró que el recuento de leucocitos [OR 1,21 (95% IC: 1,03-1,43)], el recuento de plaquetas [OR 1,65 (95% IC: 1,37-1,98)] y el tiempo parcial de tromboplastina [OR 1,29 (95% IC: 1,04-1,60)] fueron buenas variables predictoras independientes, mediante análisis de regresión logística multivariante. CONCLUSIÓN. La trombocitopenia y el tiempo parcial de tromboplastina prolongado se asociaron con bacteremia causada por Enterobacteriaceae resistentes a carbapenémicos.

INTRODUCTION. Bacteremias caused by carbapenem-resistant Enterobacteriaceae are associated with high mortality rates in contrast to bacteremias caused by carbapenem-sensitive Enterobacteriaceae. Clinical and laboratory findings are important in determining therapeutic regimens and prognosis; early diagnosis is essential for appropriate management. OBJECTIVE. To relate blood and biochemical marker values in bacteremia caused by carbapenem-resistant Enterobacteriaceae. MATERIALS AND METHODS. Cross-sectional analytical study. Population of 427 and sample of 224 blood culture data positive for Enterobacteriaceae from patients attended at the Carlos Andrade Marín Specialties Hospital in the period May 2016 to July 2018. Inclusion criteria: i) at least one positive blood culture; ii) recovery of CRE or CSE isolate and iii) simultaneous collection of blood samples and laboratory tests. Exclusion criteria: i) polymicrobial bacteremia; ii) out-of-range values and iii) reports without numerical values. Data analysis was performed using the statistical program International Business Machines Statistical Package for the Social Sciences version 24.0. RESULTS. Leukocyte count [OR 1.21 (95% CI: 1.03-1.43)], platelet count [OR 1.65 (95% CI: 1.37- 1.98)] and partial thromboplastin time [OR 1.29 (95% CI: 1.04-1.60)] were shown to be good independent predictor variables, by multivariate logistic regression analysis. CONCLUSION. Thrombocytopenia and prolonged partial thromboplastin time were associated with bacteremia caused by carbapenem-resistant Enterobacteriaceae.

An enzyme immunoassay for determining albumin in human urine samples using an ultra-microanalytical system.

Microalbuminuria is a term to describe a moderate increase in the level of albumin in urine. It is an important prognostic marker for kidney damage in diseases such as diabetes mellitus and hypertension. A simple sandwich-type ultramicroELISA assay (UMELISA) has been developed for the measurement of albumin in human urine samples. Strips coated with a high affinity monoclonal antibody directed against albumin are used as solid phase, to ensure the specificity of the assay. The albumin assay was completed in 1 hr and 30 min, with a measuring range of 1.44-200 ng/mL. The intra- and inter-assay coefficients of variation were 3.98-4.35% and 7.59-8.92%, respectively, depending on the albumin concentrations evaluated. Percentage recovery ranged from 94.26 to 98.50%. Regression analysis showed a good correlation with the commercial quantitative turbidimetric test Microalbumin-turbilatex (n = 240, r = 0.994, p < .01). The analytical performance characteristics of our UMELISA MICROALBUMINA endorse its use for the quantification of albumin in human urine samples. This test will make a cost-effective diagnostic kit accessible to low-income countries such as Latin American countries and is now available in the Cuban Public Health System.

Induction of lactation in dairy heifers: milk production, inflammatory and metabolic aspects / Indução de lactação em novilhas leiteiras: produção de leite, aspectos inflamatórios e metabólicos

The aim of this study was to evaluate the metabolic, inflammatory, and hepatic aspects, as well as the milk yield in heifers submitted to protocol for induction of lactation compared to primiparous cows. Sixty Holstein heifers were selected and enrolled into two groups: Control (n= 30), pregnant heifers and Induction heifers (n= 30), non-pregnant femeales, submitted to a lactation induction protocol. Blood samples were collected at: pre-lactation period (weeks -3, -2 and -1) and post-lactation period (weeks 1, 2 and 3), aiming to evaluate glucose, non-esterified fatty acids, paraoxonase-1, albumin, ALT, GGT and cortisol. The protocol efficiently induced lactation in all the heifers, which produced 74.54% of the total production of milk from primiparous cows. In the pre-lactation period, induced animals presented higher concentrations of non-esterified fatty acids than the Control heifers, and the opposite was observed in the post lactation period. In both moments albumin and ALT were lower in the Induction group, and paraoxonase-1 activity and GGT concentrations were higher, compared to the Control. Thus, lactation induction protocol is efficient to initiate milk production in dairy heifers with no considerable changes in energetic, metabolic and hepatic profile when compared to heifers in physiological lactation.(AU)

O objetivo deste estudo foi avaliar os perfis metabólico, inflamatório, hepático e a produção de leite de novilhas induzidas à lactação comparadas a primíparas. Sessenta novilhas da raça Holandês foram selecionadas e alocadas em grupos: controle (n=30), novilhas prenhas, e indução (n=30), novilhas vazias submetidas a um protocolo de indução de lactação. As amostras de sangue foram coletadas nas semanas -3, -2 e -1 (pré-lactação) e nas semanas 1, 2 e 3 (pós-início de lactação) para avaliação de glicose, ácidos graxos não esterificados, paraoxonase-1, albumina, ALT, GGT e cortisol. O protocolo induziu eficientemente a lactação em todas as novilhas, que produziram 74,54% da produção total de leite do controle. No período pré-lactação, o grupo indução apresentou maiores concentrações de ácidos graxos não esterificados que o controle, e o oposto foi observado pós-lactação. Em ambos os momentos, albumina e ALT foram menores no grupo indução, e a atividade da paraoxonase-1 e as concentrações de GGT foram maiores, em comparação ao controle. Assim, o protocolo de indução de lactação foi eficiente para iniciar a produção de leite em novilhas induzidas, além de terem sido observadas alterações nos perfis energético, metabólico e hepático em comparação a novilhas em lactação fisiológica.(AU)

Induction of lactation in dairy heifers: milk production, inflammatory and metabolic aspects / Indução de lactação em novilhas leiteiras: produção de leite, aspectos inflamatórios e metabólicos

The aim of this study was to evaluate the metabolic, inflammatory, and hepatic aspects, as well as the milk yield in heifers submitted to protocol for induction of lactation compared to primiparous cows. Sixty Holstein heifers were selected and enrolled into two groups: Control (n= 30), pregnant heifers and Induction heifers (n= 30), non-pregnant femeales, submitted to a lactation induction protocol. Blood samples were collected at: pre-lactation period (weeks -3, -2 and -1) and post-lactation period (weeks 1, 2 and 3), aiming to evaluate glucose, non-esterified fatty acids, paraoxonase-1, albumin, ALT, GGT and cortisol. The protocol efficiently induced lactation in all the heifers, which produced 74.54% of the total production of milk from primiparous cows. In the pre-lactation period, induced animals presented higher concentrations of non-esterified fatty acids than the Control heifers, and the opposite was observed in the post lactation period. In both moments albumin and ALT were lower in the Induction group, and paraoxonase-1 activity and GGT concentrations were higher, compared to the Control. Thus, lactation induction protocol is efficient to initiate milk production in dairy heifers with no considerable changes in energetic, metabolic and hepatic profile when compared to heifers in physiological lactation.(AU)

O objetivo deste estudo foi avaliar os perfis metabólico, inflamatório, hepático e a produção de leite de novilhas induzidas à lactação comparadas a primíparas. Sessenta novilhas da raça Holandês foram selecionadas e alocadas em grupos: controle (n=30), novilhas prenhas, e indução (n=30), novilhas vazias submetidas a um protocolo de indução de lactação. As amostras de sangue foram coletadas nas semanas -3, -2 e -1 (pré-lactação) e nas semanas 1, 2 e 3 (pós-início de lactação) para avaliação de glicose, ácidos graxos não esterificados, paraoxonase-1, albumina, ALT, GGT e cortisol. O protocolo induziu eficientemente a lactação em todas as novilhas, que produziram 74,54% da produção total de leite do controle. No período pré-lactação, o grupo indução apresentou maiores concentrações de ácidos graxos não esterificados que o controle, e o oposto foi observado pós-lactação. Em ambos os momentos, albumina e ALT foram menores no grupo indução, e a atividade da paraoxonase-1 e as concentrações de GGT foram maiores, em comparação ao controle. Assim, o protocolo de indução de lactação foi eficiente para iniciar a produção de leite em novilhas induzidas, além de terem sido observadas alterações nos perfis energético, metabólico e hepático em comparação a novilhas em lactação fisiológica.(AU)

Effect of low-fat diets enriched with fruit purees on the biochemical markers of metabolic syndrome analogy induced-rats / Efecto de dietas bajas en grasa enriquecida con purés de frutas sobre marcadores bioquímicos en ratas inducidas con analogia a sindrome metabólico

Fruit purees can be added to diet as alternative sources of bioactive compounds for the prevention and/or improvement of the complications of metabolic syndrome. In this work we evaluated the effect of the intake of low-fat diets enriched with fruit purees (guava-strawberry, guava-blackberry, guava-soursop, guava-passion fruit) on the body weight and biochemical markers in metabolic syndrome analogy (MSA)-induced rats. The rats (n=6 for each treatment) were induced with a high fat diet and were injected with streptozotocin, one dose every week for 4 consecutive weeks after fasting overnight, then healthy rats were fed with standard diet and MS rats were fed with standard diet plus each of the fruit puree, for 4 weeks. As novel findings, the diet enriched with fruit purees was associated with a reduction in body weight (~13-21 %) and a control in the metabolism of glucose by decreasing plasma glucose (~5963 %). Also, there was a reduction in the total cholesterol, triacylglycerols, low-density lipoproteins, and low enzymatic activities of alanine aminotransferase, alkaline phosphatase and γ-glutamyl transferase, useful metabolites in the control of inflammatory processes in the liver. A notable improvement in the liver morphology was observed indicating that the treatments had a hepatoprotective effect. The diet enriched with guava-blackberry puree caused the best results on most biochemical markers of MS rats. Therefore, diets enriched with fruit purees can be an alternative for MS individuals for the control and improvement of the complications caused by this syndrome.

Los purés de frutas se pueden agregar a la dieta como fuentes alternativas de compuestos bioactivos para la prevención y / o mejora de las complicaciones del síndrome metabólico. En este trabajo evaluamos el efecto de la ingesta de dietas bajas en grasas, enriquecidas con purés de frutas (guayaba-fresa, guayaba-mora, guayaba-guanábana, guayaba-maracuyá) sobre el peso corporal y los marcadores bioquímicos en el síndrome metabólico (SM) inducido en ratas. Las ratas (n = 6 para cada tratamiento) fueron inducidas con una dieta alta en grasas y se les inyectó estreptozotocina, una dosis cada semana durante 4 semanas consecutivas después de ayunar durante la noche. Luego, las ratas sanas fueron alimentadas con una dieta estándar; y las ratas con SM fueron alimentadas con dieta estándar más cada uno de los purés de frutas, durante 4 semanas. Como hallazgos novedosos, la dieta enriquecida con purés de frutas se asoció con una reducción en el peso corporal (~ 13-21 %) y un control en el metabolismo de la glucosa al disminuir la glucosa en plasma (~ 59-63 %). Además, hubo una reducción en el colesterol total, triacilgliceroles, lipoproteínas de baja densidad, y bajas actividades enzimáticas de alanina aminotransferasa, fosfatasa alcalina y gama-glutamil transferasa, metabolitos útiles en el control de los procesos inflamatorios en el hígado. Se observó una mejora notable en la morfología del hígado, lo que indica que los tratamientos tuvieron un efecto hepatoprotector. La dieta enriquecida con puré de guayaba y mora causó los mejores resultados en la mayoría de los marcadores bioquímicos de las ratas con SM. Por lo tanto, las dietas enriquecidas con purés de frutas pueden ser una alternativa para las personas con SM, para el control y la mejora de las complicaciones causadas por este síndrome.

Lupus eritematoso sistémico en actividad y cociente albúmina/globulina invertido, ¿hallazgo propio de la enfermedad? / Systemic Erythematosus Lupus and Albumin-Globulin Index, a specific finding in lupus flares?

Introducción: El lupus eritematoso sistémico es el modelo clásico de enfermedad autoinmune. En el desarrollo de la enfermedad intervienen varios tipos de inmunoglobulinas, con predominio de la IgG, IgM e IgA. Objetivo: Describir la utilidad del cociente albúmina/globulina como un indicador de actividad en el lupus eritematoso sistémico. Desarrollo: Se estima que el 50 por ciento de los pacientes con lupus eritematoso sistémico muestran una hipoalbuminemia con una hipergammaglobulinemia. La hipoalbuminemia en mayor medida está relacionada con la presencia de nefritis lúpica. La mitad de los pacientes con nefritis lúpica presentan proteinuria en el orden del síndrome nefrótico. Esta proteinuria iguala o invierte parcialmente el valor del cociente albúmina/globulina. El cociente albúmina/globulina invertido por sí solo es insuficiente para afirmar la presencia de actividad en el lupus eritematoso sistémico. Se deben excluir otras entidades clínicas causantes de hipergammaglobulinemia policlonal. Los criterios de actividad del lupus eritematoso sistémico incrementan la sensibilidad del cociente albúmina/globulina invertido. Conclusiones: La interpretación del cociente albúmina/globulina debe ir aparejada a la estimación de actividad por los criterios clínicos de mayor uso (SLICC, SLEDAI, BILAG). No en todos los pacientes con lupus eritematoso sistémico puede interpretarse como criterio de actividad, por lo que es necesario excluir otras entidades clínicas(AU)

Introduction: Systemic lupus erythematosus is the model of autoimmune disease. Several types of immunoglobulins are involved in the development of the disease, mainly IgG, IgM and IgA. Objective: To describe the potential use of the albumin/globulin ratio as an indicator of activity in systemic lupus erythematosus. Development: fifty percent of patients with systemic lupus erythematosus exhibit hypoalbuminemia with hypergammaglobulinemia. Hypoalbuminemia is mainly related to the presence of lupus nephritis. The half of patients with lupus nephritis develops proteinuria with values of nephrotic syndrome. The proteinuria equals or partially reverses the albumin/globulin ratio. The inverted albumin/globulin ratio is insufficient to establish the presence of lupus activity. Other clinical entities producing polyclonal hypergammaglobulinaemia should be excluded. The systemic lupus erythematosus activity criteria increase the sensitivity of the inverted albumin/globulin ratio. Conclusions: The interpretation of the albumin/globulin ratio requires the activity estimation by different clinical criteria (SLICC, SLEDAI, BILAG). The inverted albumin/globulin ratio cannot be interpreted as a stand-alone indicator of disease activity in every systemic lupus erythematosus patients(AU)

A dúvida: tireotoxicose versus hipertireoidismo descompensado / The doubt: Thyrotoxicosis X Decompensated Hyperthyroidism

Relata-se o caso de paciente do sexo masculino, atendido em um hospital universitário, após quadro duvidoso e arrastado de alteração cardíaca e hipertireoidiana, com a propedêutica sequencial própria para crise tireotóxica. Destaca-se a necessidade de identificação precoce da apresentação clínica, com atendimento de emergência, e a capacidade da realização de diagnósticos diferenciais com alterações cardíacas primárias, evitando-se sequelas e desfechos inesperados.

We report the case of a male patient seen in a University Hospital after a dubious and protracted picture of cardiac and hyperthyroid alteration, with adequate sequential propaedeutic for thyrotoxic crisis. The need for early identification of clinical presentation with emergency care, and the ability to perform differential diagnoses with primary cardiac changes are highlighted, to avoid unexpected sequelae and outcomes.

Incidence and risk factors for major infections in hospitalized children with nephrotic syndrome / Incidência e fatores de risco para infecções graves em crianças hospitalizadas com síndrome nefróticas

ABSTRACT Introduction: Children with nephrotic syndrome are at increased risk of infections because of disease status itself and use of various immunosuppressive agents. In majority, infections trigger relapses requiring hospitalization with increased risk of morbidity and mortality. This study aimed to determine the incidence, spectrum, and risk factors for major infections in hospitalized children with nephrotic syndrome. Methods: All consecutive hospitalized children between 1-12 years of age with nephrotic syndrome were enrolled in the study. Children with acute nephritis, secondary nephrotic syndrome as well as those admitted for diagnostic renal biopsy and intravenous cyclophosphamide or rituximab infusion were excluded. Results: A total of 148 children with 162 admissions were enrolled. Incidence of major infections in hospitalized children with nephrotic syndrome was 43.8%. Peritonitis was the commonest infection (24%), followed by pneumonia (18%), urinary tract infection (15%), and cellulitis (14%), contributing with two thirds of major infections. Streptococcus pneumoniae (n = 9) was the predominant organism isolated in children with peritonitis and pneumonia. On logistic regression analysis, serum albumin < 1.5gm/dL was the only independent risk factor for all infections (OR 2.6; 95% CI, 1.2-6; p = 0.01), especially for peritonitis (OR 29; 95% CI, 3-270; p = 0.003). There were four deaths (2.5%) in our study, all due to sepsis and multiorgan failure. Conclusions: Infection remains an important cause of morbidity and mortality in children with nephrotic syndrome. As Pneumococcus was the most prevalent cause of infection in those children, attention should be paid to the pneumococcal immunization in children with nephrotic syndrome.

RESUMO Introdução: Crianças com síndrome nefrótica apresentam maior risco de infecções devido ao próprio status da doença e ao uso de vários agentes imunossupressores. Em grande parte, as infecções desencadeiam recidivas que exigem hospitalização, com risco aumentado de morbidade e mortalidade. Este estudo teve como objetivo determinar a incidência, o espectro e os fatores de risco para infecções graves em crianças hospitalizadas com síndrome nefrótica. Métodos: Todas as crianças hospitalizadas consecutivamente entre 1 e 12 anos de idade com síndrome nefrótica foram incluídas no estudo. Crianças com nefrite aguda, síndrome nefrótica secundária, bem como aquelas admitidas para biópsia renal diagnóstica e infusão intravenosa de ciclofosfamida ou rituximabe foram excluídas. Resultados: Foram cadastradas 148 crianças com 162 internações. A incidência de infecções graves em crianças hospitalizadas com síndrome nefrótica foi de 43,8%. A peritonite foi a infecção mais comum (24%), seguida por pneumonia (18%), infecção do trato urinário (15%) e celulite (14%), contribuindo com dois terços das principais infecções. Streptococcus pneumoniae (n = 9) foi o organismo predominantemente isolado em crianças com peritonite e pneumonia. Na análise de regressão logística, a albumina sérica < 1,5gm / dL foi o único fator de risco independente para todas as infecções (OR 2,6; 95% CI, 1,2-6; p = 0,01), especialmente para peritonite (OR 29; IC95% 3 -270, p = 0,003). Houve quatro mortes (2,5%) em nosso estudo, todas devido a sepse e falência de múltiplos órgãos. Conclusões: A infecção continua sendo uma importante causa de morbimortalidade em crianças com síndrome nefrótica. Como o Pneumococo foi a causa mais prevalente de infecção nessas crianças, deve-se atentar para a imunização pneumocócica em crianças com síndrome nefrótica.

Jaboticaba yoghurts enriched with whey protein or albumin: evaluation of phenolic content and color / Iogurtes de jabuticaba adicionados de proteína do soro do leite ou albumina: avaliação do conteúdo fenólico e cor

In the present study, nonfat yoghurt made with whey protein isolate (WPI) or pasteurized egg white powder (albumin) was added with syrup containing jaboticaba pulp and lyophilized jaboticaba peel flour and six experimental groups were made: control yoghurt (CY); WPI yoghurt (WY); albumin yoghurt (AY), syrup yoghurt and WPI (WSY); syrup and albumin yoghurt (ASY) and syrup yoghurt (SY). This study aimed to verify the influence of the addition of fruit syrup on the phenolics compounds and on the instrumental color parameters of yoghurts made with proteins on the 1st and 28th day of storage. There was a significant decrease in total phenolics content in yoghurt containing WPI and syrup (from 1408.14mg GAE.L-1 to 686.73mg GAE.L-1), as well as total anthocyanin content. However, yoghurt containing syrup and albumin showed an increase in total flavonoid content on day 28 of storage (from 28.30mg QE.100g-1 to 38.29mg QE.100g-1). Regarding color, there was an increase in L* and b* values in yoghurt containing syrup and WPI and in yoghurt containing syrup and albumin. For a* values, a decrease was observed at the end of the storage period in samples containing protein (WPI or albumin) and syrup. The data showed that the addition of jaboticaba syrup to yoghurts containing different proteins provided different phenolics compounds contents at the end of the storage period, and different color parameters to the final product.

No presente estudo, iogurtes desnatados feitos com proteína isolada do soro do leite (PIS) ou albumina isolada da clara do ovo pasteurizada em pó (albumina) foram adicionados de xarope contendo a polpa da jabuticaba e a farinha liofilizada da casca da jabuticaba, obtendo-se seis grupos experimentais: iogurte controle (CY); iogurte PIS (WY); iogurte albumina (AY); iogurte xarope e PIS (WSY); iogurte xarope e albumina (ASY) e iogurte com xarope (SY). Neste estudo objetivou-se verificar a influência da adição do xarope da fruta nos compostos fenólicos e nos parâmetros instrumentais de cor dos iogurtes elaborados com proteínas no 1oe 28o dia de armazenamento. Houve uma diminuição significativa no teor de fenólicos totais no iogurte contendo PIS e xarope (de 1408.14mg GAE.L-1para 686.73mg GAE.L-1), bem como no teor de antocianinas (de 158.45mg cyanidin-3-glucoside.L-1para 56.45mg cyanidin-3-glucoside.L-1). No entanto, os iogurtes contendo xarope e albumina apresentaram um aumento no teor de flavonóides totais no 28o dia de armazenamento (de 28.30mg QE.100g-1para 38.29mg QE.100g-1). Em relação a cor houve um aumento dos valores de L* e no valor de b* no iogurte contendo xarope e PIS e no iogurte contendo xarope e albumina. Já para os valores de a* foi observado uma diminuição ao final do período de armazenamento nas amostras contendo proteína (PIS ou albumina) e xarope. Os dados demonstraram que a adição do xarope de jabuticaba a iogurtes contendo diferentes proteínas proporcionaram diferentes conteúdos de compostos fenólicos ao final do período de estocagem, e diferentes parâmetros de cor ao produto final.

Incidence and risk factors for major infections in hospitalized children with nephrotic syndrome.

INTRODUCTION: Children with nephrotic syndrome are at increased risk of infections because of disease status itself and use of various immunosuppressive agents. In majority, infections trigger relapses requiring hospitalization with increased risk of morbidity and mortality. This study aimed to determine the incidence, spectrum, and risk factors for major infections in hospitalized children with nephrotic syndrome. METHODS: All consecutive hospitalized children between 1-12 years of age with nephrotic syndrome were enrolled in the study. Children with acute nephritis, secondary nephrotic syndrome as well as those admitted for diagnostic renal biopsy and intravenous cyclophosphamide or rituximab infusion were excluded. RESULTS: A total of 148 children with 162 admissions were enrolled. Incidence of major infections in hospitalized children with nephrotic syndrome was 43.8%. Peritonitis was the commonest infection (24%), followed by pneumonia (18%), urinary tract infection (15%), and cellulitis (14%), contributing with two thirds of major infections. Streptococcus pneumoniae (n = 9) was the predominant organism isolated in children with peritonitis and pneumonia. On logistic regression analysis, serum albumin < 1.5gm/dL was the only independent risk factor for all infections (OR 2.6; 95% CI, 1.2-6; p = 0.01), especially for peritonitis (OR 29; 95% CI, 3-270; p = 0.003). There were four deaths (2.5%) in our study, all due to sepsis and multiorgan failure. CONCLUSIONS: Infection remains an important cause of morbidity and mortality in children with nephrotic syndrome. As Pneumococcus was the most prevalent cause of infection in those children, attention should be paid to the pneumococcal immunization in children with nephrotic syndrome.

Relationship between performance, metabolic profile, and feed efficiency of lactating beef cows.

Twenty-seven Nellore cow-calf pairs were submitted for feed efficiency testing. The animals were weighed every 21 ± 5 days to obtain metabolic body weight (BW0.75) and average daily gain (ADG). Subcutaneous fat thickness (SFT; at 20, 83, 146, and 176 days post-calving); milk yield and components (63, 85, and 151 days); levels of glucose, cholesterol, triglycerides, ß-hydroxybutyrate, albumin, urea, creatinine, calcium, phosphorus, magnesium, insulin, and cortisol (15, 41, 62, and 124 days); and ingestive behavior were evaluated. Residual feed intake was calculated for the first stage (RFI1; 21 to 100 days post-calving) and the second stage of lactation (RFI2; 100 to 188 days post-calving), and the cows were classified based on RFI1 as most efficient (RFI1 < 0) and least efficient (RFI1 > 0). Negative RFI1 cows consumed 1.3 kg/day of dry matter, or 9.77%, less than positive RFI1 cows. Most- and least-efficient cows did not differ in terms of subcutaneous fat thickness traits and milk yield or energy-corrected milk (ECM). Glucose (P = 0.0785), triglycerides (P = 0.0795), and phosphorus (P = 0.0597) concentrations were higher in the first stage of lactation in most-efficient cows. Maternal characteristics such as calf weight at birth and at 205 days and ADG were similar in most- and least-efficient cows. The most-efficient cows are more economic as they consume less feed for the same level of production.

Relationship between periodontal outcomes and serum biomarkers changes after non-surgical periodontal therapy.

The systemic effect of chronic periodontitis (CP) has been suggested by several studies as an etiologic factor and modulator of diseases based on the changes in the inflammatory marker levels. This study aimed to investigate the relationship between the changes in clinical periodontal outcomes and serum biomarkers (CRP, IL-6, albumin and percentage of leukocytes) after non-surgical periodontal therapy in systemically healthy adults. An interventional study was conducted with a sample of 29 individuals without CP (control group) and 33 with CP (CP group). Periodontal clinical variables were recorded, and the serum levels of inflammatory markers were measured. Statistical analysis included the chi-square and Student's t-tests and Pearson's correlation analysis. After 90 days of non-surgical periodontal treatment, a reduction of periodontal parameters and IL-6 in both groups could be observed (P < 0.001). The correlation analysis revealed a directly proportional correlation between changes in the probing depth (r = 0.349, P = 0.049) and clinical attachment level (r = 0.374, P = 0.034) with CRP in the CP group. The findings suggest a reduction of IL-6 serum concentration and periodontal clinical measures 90 days after periodontal therapy in both groups.

Comparison of Physicochemical and Functional Properties of Chicken and Duck Egg Albumens

The aim of this research was to investigate the physicochemical and functional properties of fresh and pasteurized chicken and duck egg albumens. The results showed that pasteurization of both chicken and duck albumens significantly decreased (p0.05) viscosity, but had no impact (p>0.05) on pH or free sulfhydryl groups. Chicken albumen was shown to have higher (p0.05) foam expansion, but lower (p0.05) foam stability than duck albumen. Pasteurization decreased (p0.05) the foam expansion of both albumens while decreasing (p0.05) the foam stability only of duck albumen. Investigation of the gel properties showed that duck albumen has greater hardness and lower expressible water (p0.05) than chicken albumen. Pasteurization increased the hardness and decreased the expressible water of both the chicken and duck albumen gels. This study suggests that the superior gel properties of duck albumen offer potential approaches to improving the quality of gel food products.

Comparison of Physicochemical and Functional Properties of Chicken and Duck Egg Albumens

The aim of this research was to investigate the physicochemical and functional properties of fresh and pasteurized chicken and duck egg albumens. The results showed that pasteurization of both chicken and duck albumens significantly decreased (p0.05) viscosity, but had no impact (p>0.05) on pH or free sulfhydryl groups. Chicken albumen was shown to have higher (p0.05) foam expansion, but lower (p0.05) foam stability than duck albumen. Pasteurization decreased (p0.05) the foam expansion of both albumens while decreasing (p0.05) the foam stability only of duck albumen. Investigation of the gel properties showed that duck albumen has greater hardness and lower expressible water (p0.05) than chicken albumen. Pasteurization increased the hardness and decreased the expressible water of both the chicken and duck albumen gels. This study suggests that the superior gel properties of duck albumen offer potential approaches to improving the quality of gel food products.(AU)

Protein mass spectrometry extends temporal blood meal detection over polymerase chain reaction in mouse-fed Chagas disease vectors.

BACKGROUND: Chagas disease is highly prevalent in Latin America, and vector control is the most effective control strategy to date. We have previously shown that liquid chromatography tandem mass spectrometry (LC-MS/MS) is a valuable tool for identifying triatomine vector blood meals. OBJECTIVES: The purpose of this study was to determine blood meal detection ability as a function of method [polymerase chain reaction (PCR) vs. LC-MS/MS], time since feeding, and the effect of molting in mouse-fed triatomine insect vectors targeting hemoglobin and albumin proteins with LC-MS/MS and short interspersed nuclear elements (SINE)-based PCR. METHODS: We experimentally fed Triatoma protracta on mice and used LC-MS/MS to detect hemoglobin and albumin peptides over time post-feeding and post-molting (≤ 12 weeks). We compared LC-MS/MS results with those of a standard PCR method based on SINEs. FINDINGS: Hemoglobin-based LC-MS/MS detected blood meals most robustly at all time points post-feeding. Post-molting, no blood meals were detected with PCR, whereas LC-MS/MS detected mouse hemoglobin and albumin up to 12 weeks. MAIN CONCLUSIONS: In our study, the hemoglobin signature in the insect abdomen lasted longer than that of albumin and DNA. LC-MS/MS using hemoglobin shows promise for identifying triatomine blood meals over long temporal scales and even post-molting. Clarifying the frequency of blood-feeding on different hosts can foster our understanding of vector behavior and may help devise sounder disease-control strategies, including Ecohealth (community based ecosystem management) approaches.