The impact of different levels of functional oil supplementation in combination with salinomycin on growth performance and intestinal microbiota of broilers undergoing Eimeria challenge: An analysis of dynamics.

The effect of salinomycin sodium alone and in combination with functional oils on performance and microbiota of broiler infected Eimeria were evaluated. 512 broilers were randomly assigned to 4 treatments (8 replicates, 16 birds/pen): a Control group (any additives); Ionophore group: salinomycin supplementation at 66 ppm (SS66); Ionophore +0.075% Functional oil (FO) group (SS66 + FO supplementation at 750 ppm); and Ionophore +0.10% FO group (SS66 + FO supplementation at 1000 ppm). At 14 days of age, birds were gavaged with 1 mL of a saline solution containing sporulated oocysts of E. tenella, E. acervulina and E. maxima. Performance indices were measured weekly. At 28 days, intestinal content was collected for microbiota analysis. Broilers of Control group presented the worst performance indices. Broilers of Ionophore + FO (0.075% and 0.10%) groups exhibited a higher BW at 28 days of age. The supplementation of Ionophore +0.075% FO resulted in a higher relative proportion of Firmicutes and a lower proportion of Actinobacteria in the ileum-jejunum. Lactobacillaceae was the dominant family in the jejunal, and ileal microbiotas of broilers fed diets supplemented with Ionophore, Ionophore +0.075% FO and Ionophore +0.10% FO. The supplementation of ionophore yielded higher numbers of Lactobacillaceae, Enterobactereaceae and Cloritridiaceae in the cecal. Ionophore associated with FO controlled the Lactobacillaceae, Enterobactereaceae and Cloritridiaceae families present in the cecum. Therefore, the combination of salinomycin with functional oil showed synergistic effect on performance and modulation of intestinal microbiota of broilers challenged with Eimeria.

Trace Minerals in Laying Hen Diets and Their Effects on Egg Quality.

With the advancement in the egg industry sector, egg quality has assumed great significance in certain countries. Enhancements in the nutritional value of eggs may have direct affirmative consequences for daily nutrient intake and therefore for human health. Thus, affirmative improvement in egg quality boosts consumer preferences for eggs. Also, the improvement in eggshell quality can avoid the disposal of broken eggs and consequently economic losses. Therefore, poultry nutrition and mineral supplements have a significant impact on egg quality. Minerals are crucial in poultry feed for a number of biological processes, including catalytic, physiologic, and structural processes. For instance, they contribute to the biological processes necessary for forming and developing eggshells. To produce high-quality eggs for sale, diets must therefore contain the right amount of minerals. This review aims to highlight the role of both organic and inorganic minerals in improving egg quality, in addition to reviewing the interactions of mineral supplements with intestinal microbiota and subsequent effects on the egg quality.

Ferrous sulfate microparticles obtained by spray chilling: characterization, stability and in vitro digestion simulation.

The use of microencapsulated ferrous-sulfate is among the various options recommended for food fortification, as the protective wall material surrounding the compound can preserve it from undesirable alterations and also protect the food. Microencapsulated iron can be produced using different wall materials and encapsulation methods. Thus, a microparticle was developed through spray chilling, containing ferrous sulfate (FS), as active compound, and a fat mixture as the coating material. The resulting samples analyzed to determine encapsulation efficiency, particle size distribution, and morphology. Furthermore, the oxidative stability and bioaccessibility of FS microparticles were investigated by simulating in vitro digestion. The findings indicated that the encapsulation technique effectively retained FS, resulting in microparticles physically stable at room temperature with typical morphology. The encapsulation efficiency revealed that lower concentrations of FS led to reduced superficial iron content. However, the oxidative stability demonstrated that the presence of iron in the microparticles accelerated the lipid oxidation process. The in vitro digestion test demonstrated that the microparticles with lower iron content exhibited a higher percentage of bioaccessibility, even when compared to non-encapsulated FS. Additionally, the coating material successfully released FS during the simulation of gastrointestinal digestion, resulting in a bioaccessibility of 7.98%. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05820-1.

The Clinical and Molecular Profile of Lung Cancer Patients Harboring the TP53 R337H Germline Variant in a Brazilian Cancer Center: The Possible Mechanism of Carcinogenesis.

In southern and southeastern Brazil, the TP53 founder variant c.1010G>A (R337H) has been previously documented with a prevalence of 0.3% within the general population and linked to a heightened incidence of lung adenocarcinomas (LUADs). In the present investigation, we cover clinical and molecular characterizations of lung cancer patients from the Brazilian Li-Fraumeni Syndrome Study (BLISS) database. Among the 175 diagnosed malignant neoplasms, 28 (16%) were classified as LUADs, predominantly occurring in females (68%), aged above 50 years, and never-smokers (78.6%). Significantly, LUADs manifested as the initial clinical presentation of Li-Fraumeni Syndrome in 78.6% of cases. Molecular profiling was available for 20 patients, with 14 (70%) revealing EGFR family alterations. In total, 23 alterations in cancer driver genes were identified, comprising 7 actionable mutations and 4 linked to resistance against systemic treatments. In conclusion, the carriers of TP53 R337H demonstrate a predisposition to LUAD development. Furthermore, our results indicate that environmental pollution potentially impacts the carcinogenesis of lung tumors in the carriers of TP53 R337H.

Intestinal health of broilers challenged with Eimeria spp. using functional oil blends in two physical forms with or without anticoccidials.

This study aimed to assess the impact of a commercial blend of functional oils, specifically cashew nutshell liquid and castor oil (FO), in two physical forms (solid: P; liquid: S), in comparison to a combination of virginiamycin and anticoccidials on the gut health of broilers challenged with coccidiosis. A total of 1760 1-day-old male chicks were randomly distributed in a study design with eight treatments. The treatments included: a control group (without additive), OFS_0.75_kg/t (FO spray), OFP_1.0_kg/t (FO powder), OFP_1.5_kg/t (FO liquid spray), Sal (anticoccidials), Sal_Vir (virginiamycin and anticoccidials), Sal_OFS_0.5_ kg/t (anticoccidials plus FO spray), and Sal_OFP_1.0_kg/t (anticoccidials plus FO powder). All birds were challenged with Eimeria spp. at 14 days. The physical form of FO did not affect performance and intestinal health parameters. At 42 days, broilers from the control and OFS_0.75 treatments were the lightest, while those from the Sal_Vir and Sal_OFP_1.0 treatments were the heaviest (P < 0.05). FO reduced the presence of Clostridium perfringens. The individual phytogenic additives did not prevent weight loss in birds challenged with Eimeria, but they mitigated the effects of the infection by modulating the intestinal microbiota. A synergistic effect was observed between the FO and anticoccidials, yielding satisfactory results in substituting virginiamycin.

Comparison of functional-oil blend and anticoccidial antibiotics effects on performance and microbiota of broiler chickens challenged by coccidiosis.

This study aimed to compare the effects of different levels of cashew nutshell liquid (CNSL) and castor oil (CNSL-castor oil) with growth-promoting antibiotics associated with anticoccidials in broiler chickens challenged with coccidiosis. In this work, 2520 one-day-old male broiler chicks (Cobb) were randomly assigned to 84 pens, containing 30 birds each. The experimental design was completely randomized, with seven treatments: enramycin (8 ppm), virginiamycin (16.5 ppm), and tylosin (55 ppm); different doses of CNSL-castor oil (0.5, 0.75, and 1.00 kg/t); and a control diet (without additives). All treatments received semduramicin + nicarbazin (500 g/t; Aviax® Plus) from 0 to 28 d and monensin sodium (100 ppm; Elanco) from 29 to 35 days of age, when the feed was without antibiotics. The challenge was introduced at 14 days of age by inoculating broiler chickens with sporulated Eimeria tenella, Eimeria acervulina, and Eimeria maxima oocysts via oral gavage. In addition to performance parameters, intestinal contents were collected at 28 and 42 days of age for microbiota analysis by sequencing the 16s rRNA in V3 and V4 regions using the Illumina MiSeq platform. Taxonomy was assigned using the SILVA database (v. 138) with QIIME2 software (v. 2020.11). After one week of challenge, the broilers that received tylosin had a higher body weight gain (BWG) than those in the control group (p < 0.05), while the other treatments presented intermediate values. At 28 d, the BWG was lower for the control, CNSL-Castor oil 0.5 kg/t, enramycin, and virginiamycin treatments than that in the tylosin treatment. The inclusion of CNSL-Castor oil at concentrations of 0.75 and 1 kg/t acted as an intermediate treatment (p < 0.05). For alpha diversity, using the Shannon index, it was possible to observe the effect of age, with substantial diversity at 42 d. The Firmicutes phylum had the highest abundance, with values between 84.33% and 95.16% at 42 d. Tylosin showed better performance indices than other treatments. CNSL-castor oil treatments with concentrations of 0.75 and 1 kg/t showed similar results to those of enramycin and virginiamycin. Furthermore, CNSL-castor oil acted as a modulator of intestinal microbiota, reducing the abundance of pathogenic bacteria.

Static in vitro digestion methods for assessing essential minerals in processed meat products.

The consumption of processed meat products has increased due to its convenient preparation and characteristics related to taste and consumer acceptance. In this study, we evaluated the content and bioaccessibility of iron (Fe), zinc (Zn), calcium (Ca) and magnesium (Mg) in processed pork and beef products by dialysis assay. In addition, different assays of static in vitro digestion (traditional solubility and INFOGEST) were applied to verify the results on the bioaccessibility of these essential elements. The average content of essential elements (expressed in mg/100 g) were 0.78 ± 0.24 and 1.51 ± 0.51 for Fe; 1.79 ± 0.55 and 3.57 ± 1.42 for Zn; 13.24 ± 9.99 and 20.29 ± 10.45 for Ca and 19.43 ± 2.78 and 26.15 ± 7.33 for Mg, in pork and beef products, respectively. However, we observed high variation between brands and batches. The dialysis assay presented variations in bioaccessibility for all essential elements evaluated in the samples. The results for dialyzable Fe were lower than expected (in vivo assays), probably due to the mechanism simulated in dialysis. This assay was considered inadequate for the simulation of in vitro digestion for meat samples that contain heme-Fe. When comparing the different static in vitro digestion assays employed, the dialysis test showed the lowest bioaccessibility percentages for all essential elements evaluated, when compared with the other in vitro digestion methods. The highest bioaccessible fractions were obtained by applying the INFOGEST protocol. We found that according to the in vitro digestion simulation assay used, the results for bioaccessible percentage displayed high variation. These observations highlight the importance of the assay type used for this purpose. These results did not indicate which is the better assay, but demonstrated the differences of each and their relevance for estimating bioaccessibility of essential elements in meat products.

The Use of a Thermal Process to Produce Black Garlic: Differences in the Physicochemical and Sensory Characteristics Using Seven Varieties of Fresh Garlic.

Black garlic (BG) is a product originating from fresh garlic (FG) and substantially differs in many aspects from FG due to the process called ageing. During this thermal process, the health-promoting properties of FG are enhanced, and the sensory traits are altered. However, very little is known about how the physicochemical properties of different FG varieties affect these properties of BG. Thus, the aim of this study was to investigate the influence of seven FG varieties subjected to the thermal process on the physicochemical parameters of BG. To prepare the BG samples, a fifteen-day ageing process involving a temperature gradient ranging from 30 to 82 °C was used. It was found that the antioxidant activity, the total polyphenol content, and the total soluble solids increased during ageing, while the pH level, moisture content, and lightness decreased in all the garlic varieties. The varieties of garlic differed in the studied traits significantly, both before (FG) and after ageing (BG). In the sensory analysis, significant differences between the BG varieties were observed only in the pleasantness of texture, while the remaining sensory descriptors (pleasantness of color, odor, taste and intensity of the garlic aroma, and overall acceptability) were not affected by variety. The correlations suggest that most of the FG's studied parameters in this study do not correlate with the properties of BG and cannot be used for the prediction of the quality of BG. Additionally, HPLC-MS/MS analysis revealed substantial changes in the composition of low molecular compounds.

Effect of functional oils or probiotics on performance and microbiota profile of newly weaned piglets.

The study aimed to evaluate a commercial blend of functional oils based on liquid from the cashew nutshell and castor oil as a growth promoter in newly weaned piglets. A total of 225 piglets, castrated males and females with 28 days of age were randomly distributed in pens with 15 animals composing three treatments and five repetitions. The treatments were: control (without the inclusion of additives), probiotics, or functional oils. The performance was evaluated. At 50 days of age, a pool of fresh feces from 3 animals/repetition was collected to perform the sequencing of microbiota using the Illumina MiSeq platform. Supplementation with functional oils improved the piglets' daily weight gain and feed conversion ratio (P < 0.05) in the first weeks of the experiment, which resulted in higher final live weight (P < 0.05) in the phase when compared to the control treatment (24.34 kg and 21.55 kg, respectively). The animals that received probiotics showed an intermediate performance (23.66 kg final live weight) at the end of the 38 experimental days. Both additives were effective in increasing groups essential for intestinal health, such as Ruminococcaceae and Lachnospiraceae. The functional oils were more effective in reducing pathogenic bacteria, such as Campylobacter and Escherichia coli. In conclusion, the use of functional oils optimized performance and effectively modulated the microbiota of newly weaned piglets.

Real-world Data for High-risk Stage II Colorectal Cancer - The Role of Tumor Side in the Adjuvant Setting.

BACKGROUND: The impact of sidedness in the high-risk stage II colorectal cancer (CRC) setting is uncertain. Although controversial, available data suggest a possible modest benefit of adjuvant chemotherapy (CT) in the adjuvant scenario. The aim of this study is to analyze the overall survival (OS) and recurrence-free survival (RFS) according to the tumor side. PATIENTS AND METHODS: In this single-center retrospective cohort, we analyzed patients treated between January 2011 and December 2018. We evaluated OS and RFS of high-risk patients according to the tumor side and considering adjuvant CT exposure and clinical and molecular features. RESULTS: A total of 1047 patients with stage II CRC were evaluated. Of these, 540 had high-risk criteria and microsatellite stability (MSS) or unknown status. One hundred fifty-seven (29%) patients had right-sided tumors, and 352 (65.2%) had left-sided tumors. Most patients received adjuvant CT, and the majority of them had T3 stage tumors, ≥ 12 lymph node resection, left tumor, MSS, and moderate differentiation. OS did not differ according to tumor side (5-year OS rates: 81.9% for right-sided tumors vs. 83% for left-sided tumors; hazard ratio, 0.91; 95% confidence interval, 0.55-1.53; P = .744). Adjuvant CT was associated with a superior RFS and OS, with 5-year OS rates of 87.7% versus 76.1% in the no-adjuvant group (hazard ratio, 0.46; 95% CI, 0.28-0.73; P = .001). CONCLUSION: The tumor side did not influence the outcomes in this study. Adjuvant CT was associated with improved RFS and OS in patients with high-risk stage II CRC, with a total gain of 11.6% in 5-year OS.

Correction of INRAPORC® prediction errors for a commercial pig system / Correção de erros de predição do INRAPORC ® para um sistema comercial de suínos

ABSTRACT: INRAPORC® is a mechanistic, dynamic, and deterministic model system that is used in commercial pig production. However, its use is limited as it requires performance information for animals under ad libitum (AL) feed management, which is not provided at all stages of production. Verification of the INRAPORC® calibrations were conducted in this investigation using data from a small group of animals fed with AL in a laboratory situation, to simulate the mean kinetics of a larger commercial population and generate the correction equations for the predicted body weight (BW), and backfat thickness (BT). Analyses were performed by comparing the predicted and observed data, and by submitting them to prediction calibration curve tests (b0 = 0, and b1 = 1). The obtained curves presented a systematic, fixed effect error (+2.37 mm) for BT. The predicted BW and BT values were corrected using the values of the systematic errors obtained. As a result, 100% of the BW averages observed were contained in the confidence intervals (CI) of the INRAPORC® predicted averages, without the need for corrections, and 78.5% of the actual BT averages were contained in the CI of the averages predicted by the system, after corrections. The INRAPORC® calibrations, based on a small population of animals in laboratory conditions could thus be utilized to make predictions for commercial pig production systems and for value correction procedures for the BW and BT of pig populations that have systematic errors in their prediction validations.

RESUMO: O INRAPORC® é um sistema de modelos mecanicista, dinâmico e determinista. Seu uso em sistemas comerciais de produção de suínos é restrito, pois necessita de informações de desempenho de animais sob manejo alimentar à vontade (AV), uma vez que este manejo não é utilizado em todas as fases de produção. Por isso é interessante verificar se a calibração do INRAPORC® baseada em um pequeno grupo de animais AV em situação laboratorial é capaz de simular a cinética média de uma população comercial maior e de subsidiar equações de correção de dados preditos de peso vivo (PV) e espessura de toucinho (ET). As análises foram realizadas comparando os dados preditos e observados sob o teste da curva de calibração da predição (b0=0 e b1=1), as curvas obtidas apresentaram erro sistemático de efeito fixo para a ET de +2,37mm. Os valores preditos de PV e ET foram corrigidos utilizando os valores dos erros sistemáticos obtidos. Como resultado, 100% das médias observadas de PV, estavam contidas nos intervalos de confiança (IC) das médias preditas pelo INRAPORC®, sem necessidade de correções e 78,5% das médias reais de ET estavam contidas nos IC das médias preditas pelo sistema, após as correções. A calibração do INRAPORC® baseada em uma pequena população de animais em situação laboratorial pode ser aplicada para predições de um sistema comercial de criação de suínos, bem como a aplicação do procedimento de correção dos dados preditos de PV e ET nas populações suínas que apresentem erros sistemáticos nas validações preditivas do sistema.

Modulation of the intestinal microbiota of broilers supplemented with monensin or functional oils in response to challenge by Eimeria spp.

The objective of this study was to evaluate the effect of supplementation with 100ppm sodium monensin or 0.15% of a blend of functional oils (cashew nut oil + castor oil) on the intestinal microbiota of broilers challenged with three different Eimeria spp. The challenge was accomplished by inoculating broiler chicks with sporulated oocysts of Eimeria tenella, Eimeria acervulina, and Eimeria maxima via oral gavage. A total of 864, day-old male broiler chicks (Cobb) were randomly assigned to six treatments (eight pens/treatment; 18 broilers/pen) in a 3 × 2 factorial arrangement, composed of three additives (control, monensin or blend), with or without Eimeria challenge. Intestinal contents was collected at 28 days of age for microbiota analysis by sequencing 16s rRNA in V3 and V4 regions using the Illumina MiSeq platform. Taxonomy was assigned through the SILVA database version 132, using the QIIME 2 software version 2019.1. No treatment effects (p > 0.05) were observed in the microbial richness at the family level estimated by Chao1 and the biodiversity assessed by Simpson's index, except for Shannon's index (p < 0.05). The intestinal microbiota was dominated by members of the order Clostridiales and Lactobacillales, followed by the families Ruminococcaceae, Bacteroidaceae, and Lactobacillaceae, regardless of treatment. When the controls were compared, in the challenged control group there was an increase in Erysipelotrichaceae, Lactobacillaceae, Bacteroidaceae, Streptococcaceae, and Peptostreptococcaceae, and a decrease in Ruminococcaceae. Similar results were found for a challenged group that received monensin, while the blend partially mitigated this variation. Therefore, the blend alleviated the impact of coccidiosis challenge on the microbiome of broilers compared to monensin.

Parent-teacher report reliability on the fourth edition of the Swanson, Nolan and Pelham scale in a Brazilian clinical sample of children and adolescents with attention-deficit/hyperactivity disorder

Abstract Background Parents and teachers can be valuable sources of information for characterizing children's ADHD-related impairments in different environments. However, evidence indicated that those categories of informants often provide conflicting responses in formal assessment scales, which may challenge diagnostic decisions regarding the condition. Objective: We aimed to investigate reliability rates between parents and teachers of children and adolescents with and without ADHD using SNAP IV. Methods 199 children and adolescents aged 6 to 17 years were evaluated for ADHD symptoms using parent-rated and teacher-rated SNAP IV scales. Intraclass correlation coefficients were analyzed for ADHD domains (inattention and hyperactivity/impulsivity), as well as for defiant-oppositional behavior. Results Reports from parents and teachers showed low reliability for all ADHD domains. Parents' scores on the SNAP IV were higher than those of teachers. Parents and teachers provided highly discrepant responses concerning to the presence and severity of ADHD in children and adolescents, which might result from intrinsic aspects related to their daily functioning in different settings. Discussion Clinicians should consider those trends in parental and teachers' responses when interpreting results from informant-based instruments for detecting ADHD.

Efeitos adversos do uso de ciclosporina em pacientes com dermatite atópica grave / Adverse effects of using cyclosporine in patients with severe atopic dermatitis

Introdução: A dermatite atópica (DA) é uma doença inflamatória da pele, multifatorial, crônica e recorrente, caracterizada por lesões eczematosas e prurido intenso. Nos casos graves refratários aos tratamentos tópicos, tem se utilizado imunossupressão sistêmica para o controle da doença, sendo a ciclosporina considerada por muitos como terapia de escolha. Este estudo visa avaliar a incidência e gravidade dos eventos adversos relacionados ao uso de ciclosporina em pacientes com DA grave. Métodos: Estudo retrospectivo observacional com análise de prontuários de pacientes com dermatite atópica grave em uso de ciclosporina atendidos em hospital terciário no período de 3 anos. Resultados: Avaliados 80 pacientes com dermatite atópica grave usando ciclosporina, com média de idade de 25,5 anos e 41 do sexo feminino (51,3%). Foram relatados eventos adversos em 25 pacientes. O tempo médio de uso de ciclosporina no grupo com eventos adversos foi de 29,3 meses. Os eventos de maior gravidade foram alteração da função renal e hipertensão, sendo mais observados nos casos de doença mais refratária, quando o uso de ciclosporina foi muito prolongado, superior a 60 meses. As reações evidenciadas foram: hipertensão arterial 40%, alteração renal 20%, náuseas/vômitos 16%, cefaleia 12%, herpes de repetição 12% e outros 4%. Os eventos adversos normalizaram após suspensão da ciclosporina. Conclusão: Pacientes com dermatite atópica grave que usaram ciclosporina por tempo prolongado tiveram maior frequência de eventos adversos potencialmente graves. Todos os efeitos adversos normalizaram após a suspensão de medicação.

Rationale: Atopic dermatitis (AD) is an inflammatory, multifactorial, chronic, recurrent skin disease characterized by eczematous lesions and intense itching. In severe cases refractory to topical treatments, systemic immunosuppression has been used to control the disease, and cyclosporine is largely considered firstline therapy. This study aims to assess the incidence and severity of adverse events related to the use of cyclosporine in patients with severe AD. Methods: This retrospective observational study analyzed medical records of patients with severe atopic dermatitis using cyclosporine treated at a tertiary hospital over a 3-year period. Results: Eighty patients with severe atopic dermatitis using cyclosporine were evaluated. Their mean age was 25.5 years, and 41 (51.3%) were female. Adverse events were reported in 25 patients. The mean duration of cyclosporine treatment in the group with adverse events was 29.3 months. The most serious events were changes in renal function and hypertension, which were most often observed in cases of more refractory disease, when the use of cyclosporine was very prolonged (over 60 months). The adverse reactions were hypertension (40%), renal changes (20%), nausea/vomiting (16%), headache (12%), recurrent herpes (12%) and others (4%). Adverse events were under control after cyclosporine was discontinued. Conclusion: Patients with severe atopic dermatitis who used cyclosporine for a long time had a higher frequency of potentially serious adverse events. All adverse effects were under control after discontinuation of medication.

Accuracy of the median channel shift in the flow cytometry for predicting complement dependent cytotoxicity crossmatching in kidney transplant candidates.

Crossmatching either by complement-dependent cytotoxicity (CDC) and/or by flow cytometry (FCXM) are routinely used for assessing anti-HLA donor antibodies before kidney transplantation. FCXM has demonstrated greater sensitivity and many transplant centers have opted for its use without the concomitant CDC assay. The objective of this study was to evaluate the accuracy of the median channel shift (MCS) in the FCXM in predicting the CDC assay results. A total of 1516 T cell FCXM and 1408 B cell FCXM were studied in deceased donors lymphocytes between January/2016 and March/2017. The high detection rate of CDC+ results by FCXM+ resulted in 87% (FCXM-T) and 90% (FCXM-B) sensitivity, and 98% negative predictive value, for both. The low specificity of FCXM B (43%) is atributed to cases of CDC-/FCXMB+. FCXM T and B were able to detect 53% and 76% of cases with donor specific antibodies of classes I and II with intensity of fluorescence ≥5001. The MCS differentiated CDC+ (Md, P25 and P75) results: MCS-T 390 (245-469) and MCS-B 282 (180-350). Through ROC curve analysis (AUC), the MCS showed satisfactory performance in detecting CDC+: MCS-T 0.909 (0.886-0.933) and MCS-B 0.775 (0.724-0.826). Considering the accuracy and sensitivity evaluation, the MCS-T 245 and MCS-B 282 cutoffs showed a better prediction of CDC+. This study showed that it is possible to calibrate MCS based on CDC+ with accuracy >90%, however, that leads to a risk in terms of non-detection of low-titer anti-HLA antibodies.

Aplicabilidade do peso ideal na titulação do volume corrente em pacientes no pós operatório imediato de cirurgia cardíaca / Ideal weight applicability in tidal volume titration in immediate postoperative cardiac surgery patients

INTRODUÇÃO: A ventilação mecânica (vm) é indispensável nas intervenções cirúrgicas; porém mesmo que por curto período de tempo, a vm pode causar prejuízo pulmonar com lesões do parênquima pulmonar por excesso de pressão e/ou volume nas vias aéreas. Na titulação do volume corrente (vc) é comum utilizar o peso (p.) real e não o p. ideal, aquele calculado baseando-se pela altura, o que poderia gerar alterações gasométricas e na mecânica pulmonar. OBJETIVO: Comparar a titulação do vc pelo p. ideal e pelo p. real durante o uso da vm no pós-operatório imediato de cirurgia cardíaca (cc). MÉTODOS: Ensaio clínico prospectivo, randomizado, aprovado pelo CEP da instituição. Incluímos pacientes (pc) de ambos os sexos, idade entre 18 e 80 anos e foram divididos em dois grupos: peso real (PR) e peso ideal (PI) e analisados em quatro grupos: PR com IMC adequado; PR com IMC alto; PI com IMC adequado e PI com IMC alto. O exame gasométrico era realizado no ato de admissão (M0), 30 minutos após a mesma (M1) e extubação (M2). Foram comparados entre os grupos resultados gasométricos, pressão platô, pressão de pico, complacência estática e complacência dinâmica...(AU)

Comparative analysis of two methods to detect donor-specific anti-HLA antibodies after kidney transplant.

Preformed anti-human leukocyte antigen (HLA) antibodies may be present in the blood of kidney transplant candidates. The production of these antibodies may occur in the post-transplant period, with the possible development of donor-specific antibodies (DSA). Luminex-based tests, such as the single antigen (SA) assay and the Luminex crossmatch (Xm-DSA) assay are the most commonly used tools to detect anti-HLA antibodies, due to their high sensitivity and specificity. This cross-sectional study aimed to compare the findings of two methods for the detection of DSAs after kidney transplant: SA and Xm-DSA. A total of 122 patients who underwent deceased donor kidney transplant at Hospital de Clínicas de Porto Alegre were included. The SA assay detected anti-class I HLA DSAs in 17 patients (13.9%) and anti-class II HLA DSAs in 22 patients (19.6%), whereas the Xm-DSA detected DSAs in 18 patients (14.8%) both against class I and class II antigens. There was agreement between the two methods for class I (kappa = 0.66, p = 0.001) and class II (kappa = 0.54, p = 0.025) antigens. The incidence of DSAs as obtained by the SA assay was 15.57%, and the most prevalent DSAs were those against HLA-DR antigens. Patient survival at 3 years was 92%. The two techniques assessed in this study provide important information on the presence of DSAs and may help in the post-transplant patient monitoring and in immunosuppressive strategy.

A trajetória do câncer de mama no Brasil: uma análise do Jornal "O Globo" (1925-1999) / The history of breast cancer in Brazi: an analysis of the newspaper "O Globo" (1925-1999)

O câncer de mama só começa a ser percebidos como um problema de saúde de elevada importância a partir da década de 1970, quando no âmbito das transformações sociais que passava o país, o papel social das mulheres começou a se modificar, ao mesmo tempo em que novas tecnologias médicas de exames e tratamentos pareceram dar novos alentos na luta contra a doença. Tais pressões acabam se refletindo nas políticas públicas de ampliação do número de mamógrafos por habitantes, leis, portarias, nas campanhas e documentos educativos do Ministério da Saúde.Nesse turbilhão de informações, os movimentos sociais se tornam mais um ator de cobrança do Estado para aquisição e implementação das novidades tecnológicas. Este trabalho busca analisar como foi construída a percepção da mídia jornalística sobre o câncer de mama e a mamografia no Brasil. Objetivamos compreender como o processo de difusão da ideia de diagnóstico precoce e do risco foi tratada nas reportagens do jornal O Globo no período de 1925 a 1999. A metodologia empregada para esta pesquisa consiste no levantamento de material do jornal O Globo relacionado ao câncer de mama e a mamografia. Nesse sentido, partimos do pressuposto que existe uma relação entre a percepção das mulheres acerca do câncer de mama, a divulgação midiática sob uma perspectiva de consumo da tecnologia e da produção científica, o que permite uma melhor compreensão do papel das mulheres como atores sociais no processo do controle do câncer de mama. (AU)

Perfil das internações de crianças em um centro de tratamento para queimados / Profile of children hospitalized in a burn treatment center / Perfil de internaciones de niños en un centro de tratamiento del quemado

Estudo quantitativo, retrospectivo e transversal para caracterizar as internações pediátricas de um Centro de Tratamento para Queimados entre 2007 e 2011. Ocorreram 248 internações de crianças vítimas de queimadura, das quais 65,7% eram do sexo masculino e 50,4% com idade inferior a três anos. Aproximadamente 58,0% dos acidentes ocorreram no outono/inverno. O principal agente causador nos menores de três anos foi escaldadura (72,1%) e, entre quatro e 12 anos, chama direta (52,5%). 86,0% das queimaduras foram classificadas como de 2º e 3º graus, com predomínio nos membros superiores, tronco e cabeça. O tempo médio de internação foi de 14,8 dias. A alta melhorada ocorreu em 58,0% dos casos, 38,0% necessitaram de encaminhamento para reabilitação e 4,0% evoluíram a óbito. A queimadura na população infantil pode ser evitada por meio de investimentos em campanhas preventivas, principalmente para conscientização familiar sobre o risco de morbimortalidade infantil e sequelas por essa causa

A quantitative, retrospective and cross-sectional study to define the characteristics of pediatric hospitalization in a Burn Treatment Center between 2007 and 2011. There were 248 children burn victims hospitalized, of which 65.7% were male and 50.4% younger than three years of age. Approximately 58.0% of accidents occurred in autumn/winter. The main causative agent for those younger than three years was scalding (72.1%), and for those between 4 and 12 years old, direct flame contact (52.5%). 86.0% of burns were classified as second and third degree, predominately on upper limbs, torso and head. Mean hospitalization time was 14.8 days. Patients were discharged with improvement in 58.0% of cases, 38.0% were referred to rehabilitation and 4.0% died. Burns among the pediatric population can be avoided by investing in prevention campaigns, aimed especially at bringing awareness to families about the risk of child morbimortality and repercussions due to burns

Estudio cuantitativo, retrospectivo, transversal, objetivando caracterizar las internaciones pediátricas de un Centro de Tratamiento del Quemado entre 2007 y 2011. Hubieron 248 internaciones de niños víctima de quemaduras, 65,7% eran de sexo masculino, 50,4% con edad inferior a tres años. Aproximadamente 58,0% de los accidentes sucedieron en otoño/invierno. El principal agente causante en menores de tres años fue la escaldadura (72,1%), y entre 4 y 12 años la llama directa (52,5%). El 86,2% de quemaduras fue clasificado como de 2° y 3° grado, con predominio en miembros superiores, tronco y cabeza. El tiempo promedio de internación fue de 14,8 días. El alta con mejoría se dio en 58,0% de casos, 38.0% necesitaron seguimiento para rehabilitación y 4,0% acabaron en fallecimientos. La quemadura en la población infantil puede evitarse mediante inversión en campañas preventivas, particularmente de concientización familiar sobre el riesgo de morbilidad y mortalidad infantil, y secuelas por dicha causa.

Consulta de enfermagem: aspectos epidemiológicos de crianças atendidas na atenção primária de saúde / Nursing consultation: epidemiological aspects of children attended in the primary health care / Consulta de enfermería: aspectos epidemiológicos de los niños acompañados en la atención primaria de salud

O acompanhamento de crianças na atenção primária à saúde é imprescindível para identificação e articulação multiprofissional do processo saúde-doença. Este estudo buscou caracterizar o perfil epidemiológico de crianças de zero a 12 anos atendidas em consultas de enfermagem numa Unidade de Saúde da Família, Londrina-PR, entre 2006 e 2008. Tratou-se de pesquisa quantitativa, descritiva e exploratória, utilizando como fonte de dados os prontuários. No total, foram realizadas 442 consultas, das quais 63,8% ocorreram no período neonatal, prevalecendo o atendimento na unidade. Em relação aos achados clínicos, verificou-se maior frequência de problemas alimentares (30,9%), seguidos pelos dermatológicos (15,9%), gastrointestinais (14,7%) e respiratórios (12,9%). Foram registradas 634 orientações no decorrer das consultas, sendo 41,8% relacionadas às especificidades dos achados clínicos. Quanto aos encaminhamentos, 39,4% das crianças foram direcionadas ao pediatra e 9,3% diretamente ao hospital por se tratarem de casos graves. A sistematização da assistência de enfermagem na saúde infantil ainda deve ser aperfeiçoada. Entretanto, a consulta de enfermagem permite detecção precoce de sinais e sintomas de doenças prevalentes na população pediátrica, fornecendo subsídios para redução da morbimortalidade por causas evitáveis mediante ações preventivas e de promoção da saúde.

The monitoring of children in primary care is essential for the identification and articulation of multidisciplinary disease process. This study aimed to characterize the epidemiological profile of children from birth to 12 years of age attended in nursing consultations in a Family Health Unit of Londrina-PR between 2006 and 2008. This was a descriptive quantitative exploratory research, using as source of data records. In total, there were 442 appointments, of which 63.8% occurred in the neonatal period, and being in the health unit the prevalent site of care. In relation to identified clinical findings, there was a higher frequency of eating disorders (30.9%), followed by dermatologic (15.9%), gastrointestinal (14.7%) and respiratory (12.9%). 634 professional orientations were recorded during the consultations, 41.8% related to specific clinical findings. As for referrals, 39.4% of children were directed to the pediatrician and 9.3% went directly to hospital because they were severe cases. The systematization of nursing care in child health should still be improved. However, the nursing consultation allows early detection of signs and symptoms of prevalent diseases in pediatric population, providing subsidies to reduce morbidity and mortality from preventable causes through preventive and health promotion.

El acompañamiento de niños en la atención primaria a la salud es imprescindible para la identificación y articulación multiprofesional del proceso salud-enfermedad. Este estudio buscó caracterizar el perfil epidemiológico de niños de cero a 12 años atendidos en las consultas de enfermería en la Unidad de Salud de la Familia, Londrina-PR, entre 2006 y 2008. Se trató de una investigación cuantitativa, descriptiva y exploratoria, utilizando como fuente de datos los historiales médicos. En total, fueron realizadas 442 consultas, de las cuales 63,8% ocurrieron en el período neonatal, mediante el atendimiento en la unidad. En relación a los hallazgos clínicos, se observó una mayor frecuencia de problemas alimentarios (30,9%), seguida de los dermatológicos (15,9%), gastrointestinales (14,7%) y respiratorios (12,9%). Se registraron 634 orientaciones en el transcurrir de las consultas, siendo 41,8% relacionadas a las especificidades de los hallazgos clínicos. En cuanto a los encaminamientos, 39,4% de los niños fueron dirigidos a la pediatría y 9,3% directamente al hospital por tratarse de casos graves. La sistematización de la asistencia de enfermería en la salud infantil aún debe perfeccionarse. Sin embargo, la consulta de enfermería permite la detección precoz de los indicios y síntomas de las enfermedades prevalentes en la población pediátrica, proporcionando contribuciones para la reducción de la morbimortalidad por causas evitables mediante acciones preventivas y de promoción de la salud.