The usefulness of SAGE score in predicting high pulse wave velocity in hypertensive patients: a retrospective cohort study.

Introduction: Aortic stiffness assessed by pulse wave velocity (PWV) is an important predictor to evaluate the risk of hypertensive patients. However, it is underutilized in clinical practice. We aimed to identify the optimal cutoff SAGE score that would indicate a risk PWV ≥ 10 m/s in Brazilian ambulatory hypertensive patients. Materials and methods: A retrospective cohort study. Patients underwent central blood pressure measurement using a validated oscillometric device from August 2020 to December 2021. A ROC curve was constructed using the Youden statistic to define the best score to identify those at high risk for PWV ≥ 10 m/s. Results: A total of 212 hypertensive individuals were selected. The mean age was 64.0 ± 12.4 years and 57.5% were female. The following comorbidities were present: overweight (47.6%), obesity (34.3%), and diabetes (25.0%). Most of the sample (68.9%) had PWV < 10 m/s. According to Youden's statistic, a cutoff point of 6 provided the optimal combination of sensitivity and specificity for identifying patients with a PWV ≥ 10 m/s. This cutoff achieved sensitivity of 97.0%, and specificity of 82.9%. In clinical practice, however, a cutoff point of 7 (where score values of at least 7 were considered to indicate high risk) had a positive likelihood ratio of 8.2 and a negative likelihood ration of 0.346, making this the ideal choice by accurately excluding patients who are less likely to have PWV ≥ 10 m/s. Conclusion: A SAGE score ≥7 identified Brazilian hypertensive patients with a high risk of PWV ≥ 10 m/s.

Acute effect of different resistance training loads on perceived effort and affectivity in older women: a cross-over and randomized study.

AIMS: The main purpose of the present study was to investigate the acute effects of different resistance training loads on the session rating of perceived exertion (sRPE) and feelings of pleasure displeasure (sFPD) of the session in older women. METHODS: In a randomized, counterbalanced, and cross-over design, 16 older women (66.1 ± 3.9 years, 67.0 ± 8.4 kg, 154.1 ± 6.8 cm, 28.3 ± 4.4 kg/m2) performed 3 sets of 8 exercises in three experimental conditions, 1 session with a heavy load (HEV), one with a moderate load (MOD), and one session with a light load (LIT), all performed until momentary muscle failure. The sRPE and sFPD were assessed 15 min after the end of each session using specific scales. RESULTS: A significant difference (P < 0.05) was observed among conditions for sFPD in which HEV produced feelings of displeasure, and MOD produced greater feelings of pleasure (HEV = -1.38 ± 1.7, MOD = 3.38 ± 1.2, LIT = 0.69 ± 1.04). For sRPE, a significant (P < 0.05) difference was observed between MOD and LIT; whereby the LIT load induced a greater score compared to the MOD load (HEV = 4.56 ± 1.4, MOD = 4.31 ± 1.7, LIT = 5.75 ± 1.2). CONCLUSION: Our results suggest that the training load affects perceived effort and feelings of pleasure/displeasure when exercise is performed until concentric failure. The use of moderate loads induces greater pleasure feelings and a reduced degree of effort in older women.

Massive thrombosis and phlegmasia cerulea dolens while taking rivaroxaban: case report and review.

Our study describes a fatal case of phlegmasia cerulea dolens and massive venous thrombosis in a patient taking rivaroxaban regularly to treat cerebral venous sinus thrombosis. Blood tests samples were positive for lupus anticoagulant. The unique evolution of the case, as well as the positivity for lupus anticoagulant, raises the possibility of an acquired hypercoagulation syndrome. We highlight the fact that the test recommended as the first line for lupus anticoagulant diagnosis (dilute Russell viper venom time) is the most affected by rivaroxaban, leading to a high prevalence of false-positive results. We also discuss potential diagnoses for the current case and review the current state-of-the-art of use of the novel oral anticoagulation agents in this unusual situation. So far, there are no recommendations to use such agents as first options in cerebral venous sinus thrombosis or in hypercoagulation syndromes.

Nosso estudo descreve um caso fatal de flegmasia cerúlea dolens e trombose venosa maciça em um paciente usando regularmente rivaroxabana para o tratamento de trombose de seio venoso cerebral. A investigação laboratorial foi positiva para o anticoagulante lúpico. A evolução única do caso aumenta a possibilidade de uma síndrome de hipercoagulabilidade adquirida, bem como a positividade para o anticoagulante lúpico. Destacamos o fato de que o teste recomendado como primeira linha para o diagnóstico de anticoagulante lúpico (veneno de víbora de Russel diluído) é o mais afetado pela rivaroxabana, levando a uma alta prevalência de resultados falso-positivos. Também discutimos os potenciais diagnósticos para o presente caso e revisamos o estado da arte atual dos novos agentes de anticoagulação oral usados nessa situação incomum. Até o presente momento, não há recomendações para o uso de tais agentes como primeira opção na trombose de seios venosos cerebrais ou nas síndromes de hipercoagulação.

Massive thrombosis and phlegmasia cerulea dolens while taking rivaroxaban: case report and review / Trombose maciça e flegmasia cerúlea dolens durante o uso de rivaroxabana: relato de caso e revisão

Abstract Our study describes a fatal case of phlegmasia cerulea dolens and massive venous thrombosis in a patient taking rivaroxaban regularly to treat cerebral venous sinus thrombosis. Blood tests samples were positive for lupus anticoagulant. The unique evolution of the case, as well as the positivity for lupus anticoagulant, raises the possibility of an acquired hypercoagulation syndrome. We highlight the fact that the test recommended as the first line for lupus anticoagulant diagnosis (dilute Russell viper venom time) is the most affected by rivaroxaban, leading to a high prevalence of false-positive results. We also discuss potential diagnoses for the current case and review the current state-of-the-art of use of the novel oral anticoagulation agents in this unusual situation. So far, there are no recommendations to use such agents as first options in cerebral venous sinus thrombosis or in hypercoagulation syndromes.

Resumo Nosso estudo descreve um caso fatal de flegmasia cerúlea dolens e trombose venosa maciça em um paciente usando regularmente rivaroxabana para o tratamento de trombose de seio venoso cerebral. A investigação laboratorial foi positiva para o anticoagulante lúpico. A evolução única do caso aumenta a possibilidade de uma síndrome de hipercoagulabilidade adquirida, bem como a positividade para o anticoagulante lúpico. Destacamos o fato de que o teste recomendado como primeira linha para o diagnóstico de anticoagulante lúpico (veneno de víbora de Russel diluído) é o mais afetado pela rivaroxabana, levando a uma alta prevalência de resultados falso-positivos. Também discutimos os potenciais diagnósticos para o presente caso e revisamos o estado da arte atual dos novos agentes de anticoagulação oral usados nessa situação incomum. Até o presente momento, não há recomendações para o uso de tais agentes como primeira opção na trombose de seios venosos cerebrais ou nas síndromes de hipercoagulação.

Aerial parts of cassava as partial replacement for feed concentrates in the diet of lambs raised in semi-confinement / Parte aérea da mandioca em substituição parcial a alimentos concentrados na dieta de cordeiros

This study aimed to evaluate the performance and economic viability of including the aerial parts of cassava (PAM) in the feed of semi-confined lambs for partial reduction of food concentrates. Fifty-six sheep, including males and females of the Pantaneira genetic group weighing 18.84 ± 2.02 kg on an average were used. The experiment was conducted in a factorial randomized complete block design with four treatments, each with seven females and seven males. Each group of 14 animals received one of four treatments: control, 10% of food concentrate in diet replaced with PAM, 20% replaced with PAM, and 30% replaced with PAM. The average total gain in weight (GWT) of the male lambs was 26.89% higher than the gains observed in females. Based on the cost analysis, we observed a linear effect (P < 0.01), i.e., a decrease in the feed cost for male and female groups with increase in PAM content. For the study period, the expenditure for the control male group was the highest at $ 17.60 per animal. Expenditure for the PAM 30 male group was the lowest at $ 12.74 per animal. These figures reflect the actual operating costs (COE), i.e., the power is 75.78% and 74.77%, for male and female groups respectively. The total cost, decreased linearly (P < 0.05) with PAM 30 treatment costing the least at $ 47.90, which was $ 7.02 lower than the control. When assessing the net margin per kilogram among the female groups, we observed a quadratic effect (P < 0.01) with a maximum gain of 23.98% when adding PAM and $ 0.50 kg-1. Our results show that the raising of lambs in semi-confinement was economically viable, and the addition of the aerial part of processed cassava in the feed presented a higher economic return. Further, the addition of aerial parts of cassava did not affect the performance of the lambs.(AU)

Objetivou-se avaliar o desempenho produtivo e viabilidade econômica da inclusão da parte aérea de mandioca in natura na ração de cordeiros semi-confinados, em busca da redução parcial de alimentos concentrados. Foram utilizados 56 ovinos da raça Pantaneira, sendo 28 machos e 28 fêmeas, com idade média de 75 dias, pesos médios de 18,84kg ± 2,02, avaliados durante os meses de janeiro a março de 2015, totalizando 65 dias. O delineamento experimental foi em blocos inteiramente casualizados com quatro tratamentos, cada um com 7 fêmeas e 7 machos, sendo que foram divididos de forma que os pesos e os animais fossem o mais homogêneos. Cada grupo de 14 animais recebeu um dos quatro tratamentos: Controle; tratamento com adição de 10% PAM em substituição ao concentrado; tratamento com adição de 20% de PAM em substituição ao concentrado e tratamento com adição de 30% de PAM em substituição ao concentrado. O valor de ganho médio total (GPT) dos cordeiros machos foi 26,89% superior aos ganhos observados no grupamento de fêmeas. Com base no centro de custos foi observado efeito linear (P < 0,01) decrescente no valor da alimentação para os grupamentos de macho e fêmea. Sendo o tratamento controle o maior dispêndio no período com R$ 56,86 animal-1 e o tratamento PAM 30 o menor valor com R$ 41,17 animal-1 no grupamento de machos. Estes valores refletiram no custo operacional efetivo (COE), ou seja, a alimentação representa 75,78% e 74,77%, do COE para os grupamentos de macho e fêmea respectivamente. O custo total apresentou efeito linear (P < 0,05) decrescente, o tratamento PAM 30 o menor valor apurado R$ 154,72. Resultando em redução no custo total em R$ 22,69 em relação ao tratamento controle (R$ 177,41). Ao se avaliar a margem liquida por quilo dentre o grupamento de fêmeas observou efeito quadrático (P < 0,01) com ponto de máxima em 23,98% de adição de PAM e valor em R$ 1,61 Kg ganho-1. [...](AU)

Evaluation of sheep fed on multinutritional blocks with garlic extract

The aim of this study was to evaluate the effects of supplementation with three formulations of nutritional blocks and its consumption by 60 sheep from the Pantaneiro genetic group. The animals were weighed (35 kg ± 4.69) and separated into three groups of 20 each: G1 (control block), G2 (block with palatalising), and G3 (block + garlic extract). The solidified mineral supplement of silage of pearl millet (Pennisetum glaucum) provided ad libitum had an estimated consumption of 0.6%/kg/day. The sheep were kept in pastures in a grazing system cultivated with the grass Brachiaria brizantha Marandu. The best performance was obtained by G2 (P < 0.05) for weight gain, with 105 g of feed conversion ratio 75% more efficient than G1 and 107% more efficient than G3. The provision of multinutrient blocks for sheep kept in pastures of U. brizantha Marandu contributed to the improvement of the animal"s nutritional status. Among the formulations tested, the block with palatalising showed the highest rate of food conversion. The block with garlic extract had an inhibitory effect on reinfection by gastrointestinal nematodes after 30 days.(AU)

Evaluation of sheep fed on multinutritional blocks with garlic extract

The aim of this study was to evaluate the effects of supplementation with three formulations of nutritional blocks and its consumption by 60 sheep from the Pantaneiro genetic group. The animals were weighed (35 kg ± 4.69) and separated into three groups of 20 each: G1 (control block), G2 (block with palatalising), and G3 (block + garlic extract). The solidified mineral supplement of silage of pearl millet (Pennisetum glaucum) provided ad libitum had an estimated consumption of 0.6%/kg/day. The sheep were kept in pastures in a grazing system cultivated with the grass Brachiaria brizantha Marandu. The best performance was obtained by G2 (P < 0.05) for weight gain, with 105 g of feed conversion ratio 75% more efficient than G1 and 107% more efficient than G3. The provision of multinutrient blocks for sheep kept in pastures of U. brizantha Marandu contributed to the improvement of the animal"s nutritional status. Among the formulations tested, the block with palatalising showed the highest rate of food conversion. The block with garlic extract had an inhibitory effect on reinfection by gastrointestinal nematodes after 30 days.

Aerial parts of cassava as partial replacement for feed concentrates in the diet of lambs raised in semi-confinement / Parte aérea da mandioca em substituição parcial a alimentos concentrados na dieta de cordeiros

This study aimed to evaluate the performance and economic viability of including the aerial parts of cassava (PAM) in the feed of semi-confined lambs for partial reduction of food concentrates. Fifty-six sheep, including males and females of the Pantaneira genetic group weighing 18.84 ± 2.02 kg on an average were used. The experiment was conducted in a factorial randomized complete block design with four treatments, each with seven females and seven males. Each group of 14 animals received one of four treatments: control, 10% of food concentrate in diet replaced with PAM, 20% replaced with PAM, and 30% replaced with PAM. The average total gain in weight (GWT) of the male lambs was 26.89% higher than the gains observed in females. Based on the cost analysis, we observed a linear effect (P < 0.01), i.e., a decrease in the feed cost for male and female groups with increase in PAM content. For the study period, the expenditure for the control male group was the highest at $ 17.60 per animal. Expenditure for the PAM 30 male group was the lowest at $ 12.74 per animal. These figures reflect the actual operating costs (COE), i.e., the power is 75.78% and 74.77%, for male and female groups respectively. The total cost, decreased linearly (P < 0.05) with PAM 30 treatment costing the least at $ 47.90, which was $ 7.02 lower than the control. When assessing the net margin per kilogram among the female groups, we observed a quadratic effect (P < 0.01) with a maximum gain of 23.98% when adding PAM and $ 0.50 kg-1. Our results show that the raising of lambs in semi-confinement was economically viable, and the addition of the aerial part of processed cassava in the feed presented a higher economic return. Further, the addition of aerial parts of cassava did not affect the performance of the lambs.

Objetivou-se avaliar o desempenho produtivo e viabilidade econômica da inclusão da parte aérea de mandioca in natura na ração de cordeiros semi-confinados, em busca da redução parcial de alimentos concentrados. Foram utilizados 56 ovinos da raça Pantaneira, sendo 28 machos e 28 fêmeas, com idade média de 75 dias, pesos médios de 18,84kg ± 2,02, avaliados durante os meses de janeiro a março de 2015, totalizando 65 dias. O delineamento experimental foi em blocos inteiramente casualizados com quatro tratamentos, cada um com 7 fêmeas e 7 machos, sendo que foram divididos de forma que os pesos e os animais fossem o mais homogêneos. Cada grupo de 14 animais recebeu um dos quatro tratamentos: Controle; tratamento com adição de 10% PAM em substituição ao concentrado; tratamento com adição de 20% de PAM em substituição ao concentrado e tratamento com adição de 30% de PAM em substituição ao concentrado. O valor de ganho médio total (GPT) dos cordeiros machos foi 26,89% superior aos ganhos observados no grupamento de fêmeas. Com base no centro de custos foi observado efeito linear (P < 0,01) decrescente no valor da alimentação para os grupamentos de macho e fêmea. Sendo o tratamento controle o maior dispêndio no período com R$ 56,86 animal-1 e o tratamento PAM 30 o menor valor com R$ 41,17 animal-1 no grupamento de machos. Estes valores refletiram no custo operacional efetivo (COE), ou seja, a alimentação representa 75,78% e 74,77%, do COE para os grupamentos de macho e fêmea respectivamente. O custo total apresentou efeito linear (P < 0,05) decrescente, o tratamento PAM 30 o menor valor apurado R$ 154,72. Resultando em redução no custo total em R$ 22,69 em relação ao tratamento controle (R$ 177,41). Ao se avaliar a margem liquida por quilo dentre o grupamento de fêmeas observou efeito quadrático (P < 0,01) com ponto de máxima em 23,98% de adição de PAM e valor em R$ 1,61 Kg ganho-1. [...]

Análise econômica da alimentação de cordeiros confinados pela substituição parcial de concentrado pela parte aérea da mandioca / Economic analysis of feeding lambs confined by partial replacement of the concentrated by air part of cassava

Objetivou-se com este trabalho avaliar a influência da inclusão da rama de mandioca na dieta de cordeiros confinados, substituindo-se parcialmente de alimentos concentrados, a fim de reduzir custos de produção. O experimento foi conduzido no Centro de Tecnologia de Ovinos (CTO), no município de Campo Grande - MS. Foram utilizados 28 ovinos da raça Pantaneira, sendo 14 machos e 14 fêmeas, com idade média de 75 dias, pesos médios de 18,84 kg ± 2,02 durante 65 dias. O delineamento experimental utilizado foi em blocos inteiramente casualizados em método fatorial (2x2), com dois fatores, distribuídos em 7 fêmeas e 7 machos. As dietas recebidas foram: tratamento 1 Controle e tratamento 2 10% Parte Aérea da Mandioca (PAM 10) em substituição ao concentrado, compondo dois fatores. A análise econômica do desempenho dos animais demonstrou os menores custos de alimentação, menores juros sobre o capital de giro e maior margem líquida para o tratamento PAM 10. Esse resultado permite concluir que inclusão da rama de mandioca na dieta de cordeiros confinados, em substituição parcial de alimentos concentrados pode resultar em maior lucratividade.(AU)

The objective of this study was to evaluate the influence of inclusion of cassava raw in the diet of lambs, partially replacing concentrate food in order to reduce production costs. The experiment was conducted at Sheep Technology Centre, in Campo Grande - MS. 28 sheep were used in the Pantaneira race, 14 males and 14 females, mean age of 75 days, average weight 18.84 kg ± 2.02 for 65 days. The experimental design were in randomized blocks in a factorial method (2x2) with two factors, distributed in 7 females and 7 males. Received diets were: treatment 1 control and treatment 2 10% Air Part of Cassava (PAM 10) replacing concentrate, comprising two factors. The economic analysis of animal performance demonstrated the lowest feeding costs, lower interest on working capital and higher net margin for the treatment PAM 10. These results allow us to conclude that inclusion of raw cassava in the diet of lambs in partial replacement of concentrate can result in higher profitability.(AU)

Combinations of non-protein nitrogen sources in supplements for Nellore steers grazing / Combinações de fontes de nitrogênio não proteico em suplementos para novilhos Nelore em pastejo

The objective of evaluating sources of non-protein nitrogen (NPN) combined for supplementation of Nelore steers in deferred pasture. After  the deferral of four pickets of Brachiaria brizantha cv. MG4 (20 ha each) of 60 days, 80 Nellore steers, with average body weight 280.40 ± 19.59 kg, were evaluated for 120 days. The management adopted was rotational grazing, with pickets changes every 15 days. We evaluated four treatments with different combinations of NNP sources: Urea +Urea extruded + Urea coated; Urea + Urea coated; Urea + Urea extruded and Urea extruded. In all treatments were provided protein supplement-mineral energy ad libitum, with 30% of crude protein and 40% of total digestibility nutrient. When evaluated individually, the NPN sources presented different solubility in water and buffer, and lowest value observed for coated urea (P 0.05).The animals of the treatments Urea + Ureaextruded + Urea coated and Urea extruded showed average daily gain (0.4 kg/day; P 0.05) of animals treatments Urea + Urea extrudedthe animals(0.34 kg/day).The animals of the Urea extruded treatment higher carcass gain (1.71 @/animal) compared to other (P 0.05).The net margin of the Urea extruded treatment (R $ 158,20/animal) was superior in 10.8%, 8.2% and 35.8% to treatments Urea + Urea + Urea coated, Urea + Ureaextruded and Urea + Ureacoated, respectively. It is recommended t(AU)

Objetivou-se avaliar fontes de nitrogênio não-proteico (NNP) combinadas para suplementação de novilhos Nelore na recria mantidos em pastagens diferidas. Após o deferimento de quatro piquetes de Brachiaria brizantha cv. MG4 por 60 dias (20 ha cada) 80 novilhos Nelore castrados, com peso corporal médio de 280,40±19,59kg, foram avaliados durante 120 dias. O manejo adotado foi pastejo rotacionado, com mudanças de piquetes a cada 15 dias. Foram avaliados quatro tratamentos com diferentes combinações de fontes de NNP: Ureia + Ureia extrusada + Ureia revestida; Ureia + Ureia revestida; Ureia + Ureia extrusada; Ureia extrusada. Em todos os tratamentos foram fornecidos suplemento proteico-energético-mineral ad libitum, com 30% de proteína bruta e 40% de nutrientes digestíveis totais.Quando avaliadas individualmente, as fontes de NNP apresentaram solubilidades distintas em água e solução tampão, sendo o menor valor observado para ureia revestida (P 0,05). Os animais dos tratamentos Ureia + Ureia extrusada + Ureia revestida e Ureia extrusa da apresentaram ganho médio diário superior (0,4kg/dia; P 0,05) aos animais dos tratamentos Ureia + Ureia extrusada (0,34kg/dia). Os animais do tratamento Ureia extrusada apresentaram maior ganho de carcaça (1,71 @/animal) em relação aos demais (P 0,05). A margem líquida do tratamento Ureia extrusada (R$ 158,20/animal) foi superior em 10(AU)

Análise econômica da alimentação de cordeiros confinados pela substituição parcial de concentrado pela parte aérea da mandioca / Economic analysis of feeding lambs confined by partial replacement of the concentrated by air part of cassava

Objetivou-se com este trabalho avaliar a influência da inclusão da rama de mandioca na dieta de cordeiros confinados, substituindo-se parcialmente de alimentos concentrados, a fim de reduzir custos de produção. O experimento foi conduzido no Centro de Tecnologia de Ovinos (CTO), no município de Campo Grande - MS. Foram utilizados 28 ovinos da raça Pantaneira, sendo 14 machos e 14 fêmeas, com idade média de 75 dias, pesos médios de 18,84 kg ± 2,02 durante 65 dias. O delineamento experimental utilizado foi em blocos inteiramente casualizados em método fatorial (2x2), com dois fatores, distribuídos em 7 fêmeas e 7 machos. As dietas recebidas foram: tratamento 1 – Controle e tratamento 2 – 10% Parte Aérea da Mandioca (PAM 10) em substituição ao concentrado, compondo dois fatores. A análise econômica do desempenho dos animais demonstrou os menores custos de alimentação, menores juros sobre o capital de giro e maior margem líquida para o tratamento PAM 10. Esse resultado permite concluir que inclusão da rama de mandioca na dieta de cordeiros confinados, em substituição parcial de alimentos concentrados pode resultar em maior lucratividade.

The objective of this study was to evaluate the influence of inclusion of cassava raw in the diet of lambs, partially replacing concentrate food in order to reduce production costs. The experiment was conducted at Sheep Technology Centre, in Campo Grande - MS. 28 sheep were used in the Pantaneira race, 14 males and 14 females, mean age of 75 days, average weight 18.84 kg ± 2.02 for 65 days. The experimental design were in randomized blocks in a factorial method (2x2) with two factors, distributed in 7 females and 7 males. Received diets were: treatment 1 – control and treatment 2 – 10% Air Part of Cassava (PAM 10) replacing concentrate, comprising two factors. The economic analysis of animal performance demonstrated the lowest feeding costs, lower interest on working capital and higher net margin for the treatment PAM 10. These results allow us to conclude that inclusion of raw cassava in the diet of lambs in partial replacement of concentrate can result in higher profitability.

Combinations of non-protein nitrogen sources in supplements for Nellore steers grazing / Combinações de fontes de nitrogênio não proteico em suplementos para novilhos Nelore em pastejo

The objective of evaluating sources of non-protein nitrogen (NPN) combined for supplementation of Nelore steers in deferred pasture. After  the deferral of four pickets of Brachiaria brizantha cv. MG4 (20 ha each) of 60 days, 80 Nellore steers, with average body weight 280.40 ± 19.59 kg, were evaluated for 120 days. The management adopted was rotational grazing, with pickets changes every 15 days. We evaluated four treatments with different combinations of NNP sources: Urea +Urea extruded + Urea coated; Urea + Urea coated; Urea + Urea extruded and Urea extruded. In all treatments were provided protein supplement-mineral energy ad libitum, with 30% of crude protein and 40% of total digestibility nutrient. When evaluated individually, the NPN sources presented different solubility in water and buffer, and lowest value observed for coated urea (P 0.05).The animals of the treatments Urea + Ureaextruded + Urea coated and Urea extruded showed average daily gain (0.4 kg/day; P 0.05) of animals treatments Urea + Urea extrudedthe animals(0.34 kg/day).The animals of the Urea extruded treatment higher carcass gain (1.71 @/animal) compared to other (P 0.05).The net margin of the Urea extruded treatment (R $ 158,20/animal) was superior in 10.8%, 8.2% and 35.8% to treatments Urea + Urea + Urea coated, Urea + Ureaextruded and Urea + Ureacoated, respectively. It is recommended t

Objetivou-se avaliar fontes de nitrogênio não-proteico (NNP) combinadas para suplementação de novilhos Nelore na recria mantidos em pastagens diferidas. Após o deferimento de quatro piquetes de Brachiaria brizantha cv. MG4 por 60 dias (20 ha cada) 80 novilhos Nelore castrados, com peso corporal médio de 280,40±19,59kg, foram avaliados durante 120 dias. O manejo adotado foi pastejo rotacionado, com mudanças de piquetes a cada 15 dias. Foram avaliados quatro tratamentos com diferentes combinações de fontes de NNP: Ureia + Ureia extrusada + Ureia revestida; Ureia + Ureia revestida; Ureia + Ureia extrusada; Ureia extrusada. Em todos os tratamentos foram fornecidos suplemento proteico-energético-mineral ad libitum, com 30% de proteína bruta e 40% de nutrientes digestíveis totais.Quando avaliadas individualmente, as fontes de NNP apresentaram solubilidades distintas em água e solução tampão, sendo o menor valor observado para ureia revestida (P 0,05). Os animais dos tratamentos Ureia + Ureia extrusada + Ureia revestida e Ureia extrusa da apresentaram ganho médio diário superior (0,4kg/dia; P 0,05) aos animais dos tratamentos Ureia + Ureia extrusada (0,34kg/dia). Os animais do tratamento Ureia extrusada apresentaram maior ganho de carcaça (1,71 @/animal) em relação aos demais (P 0,05). A margem líquida do tratamento Ureia extrusada (R$ 158,20/animal) foi superior em 10

Abordagem diagnóstica e terapêutica de pectus excavatum em gata - relato de caso / Diagnosis and treatment of pectus excavatum in a cat - case report / Diagnóstico y tratamiento de pectus excavatum en gata - reporte de un caso

Pectus excavatum (PE) é o termo utilizado para caracterizar uma deformidade esternal rara em pequenos animais, que resulta em estreitamento dorsoventral do tórax. A etiologia parece ser congênita, e o diagnóstico é clínico, com base em observação visual. Os sinais clínicos, quando presentes, consistem em alterações cardíacas e respiratórias. As radiografias torácicas são úteis para estabelecer o grau de deformidade esternal, por meio dos índices frontossagital e vertebral. O tratamento para o PE pode ser conservativo ou cirúrgico, de acordo com os sinais clínicos, o grau de deformidade e a evolução da doença. O objetivo do presente trabalho é relatar a ocorrência de PE em uma gata de dois meses de idade, com ênfase na abordagem diagnóstica e terapêutica. O tratamento executado foi a colocação cirúrgica de tala externa, que demonstrou resultado satisfatório.(AU)

Pectus excavatum (PE) is the term used to characterize a rare sternal deformity in small animals, which results in dorsoventral narrowing of the chest. The etiology appears to be congenital and the clinical diagnosis is based on visual observation. Clinical signs, if present, consist of cardiac and respiratory disorders. Chest x-rays are useful to establish the degree of sternal abnormality, by means of frontosagittal and vertebral indexes. Treatment for PE can be conservative or surgical, according to clinical signs, degree of deformity and disease progression. The purpose of this article is to report the occurrence of PE in a two-month-old female cat, with emphasis on the diagnostic and therapeutic approaches. Treatment consisted of surgical placement of an external splint, which yielded satisfactory results.(AU)

Pectus excavatum (PE) es el término utilizado para caracterizar una rara deformación esternal en pequeños animales, que provoca un estrechamiento dorsoventral del tórax. Su etiología parece ser congénita y el diagnóstico es clínico, a través de la observación del paciente. Los signos clínicos, cuando están presentes, se relacionan con alteraciones cardíacas y respiratorias. Las radiografías de tórax son útiles para establecer el grado de deformación esternal, a través de los índices frontosagital y vertebral. El tratamiento para el PE puede ser conservador o quirúrgico, de acuerdo a los signos clínicos, el grado de deformación y la evolución de la enfermedad. El objetivo del presente trabajo es relatar un caso de PE en una gata de dos meses de edad, haciendo hincapié en el diagnóstico y tratamiento. El tratamiento realizado consistió en la colocación de una estructura rígida externa, mediante un procedimiento quirúrgico que mostró resultados satisfactorios.(AU)

Abordagem diagnóstica e terapêutica de pectus excavatum em gata - relato de caso / Diagnosis and treatment of pectus excavatum in a cat - case report / Diagnóstico y tratamiento de pectus excavatum en gata - reporte de un caso

Pectus excavatum (PE) é o termo utilizado para caracterizar uma deformidade esternal rara em pequenos animais, que resulta em estreitamento dorsoventral do tórax. A etiologia parece ser congênita, e o diagnóstico é clínico, com base em observação visual. Os sinais clínicos, quando presentes, consistem em alterações cardíacas e respiratórias. As radiografias torácicas são úteis para estabelecer o grau de deformidade esternal, por meio dos índices frontossagital e vertebral. O tratamento para o PE pode ser conservativo ou cirúrgico, de acordo com os sinais clínicos, o grau de deformidade e a evolução da doença. O objetivo do presente trabalho é relatar a ocorrência de PE em uma gata de dois meses de idade, com ênfase na abordagem diagnóstica e terapêutica. O tratamento executado foi a colocação cirúrgica de tala externa, que demonstrou resultado satisfatório.

Pectus excavatum (PE) is the term used to characterize a rare sternal deformity in small animals, which results in dorsoventral narrowing of the chest. The etiology appears to be congenital and the clinical diagnosis is based on visual observation. Clinical signs, if present, consist of cardiac and respiratory disorders. Chest x-rays are useful to establish the degree of sternal abnormality, by means of frontosagittal and vertebral indexes. Treatment for PE can be conservative or surgical, according to clinical signs, degree of deformity and disease progression. The purpose of this article is to report the occurrence of PE in a two-month-old female cat, with emphasis on the diagnostic and therapeutic approaches. Treatment consisted of surgical placement of an external splint, which yielded satisfactory results.

Pectus excavatum (PE) es el término utilizado para caracterizar una rara deformación esternal en pequeños animales, que provoca un estrechamiento dorsoventral del tórax. Su etiología parece ser congénita y el diagnóstico es clínico, a través de la observación del paciente. Los signos clínicos, cuando están presentes, se relacionan con alteraciones cardíacas y respiratorias. Las radiografías de tórax son útiles para establecer el grado de deformación esternal, a través de los índices frontosagital y vertebral. El tratamiento para el PE puede ser conservador o quirúrgico, de acuerdo a los signos clínicos, el grado de deformación y la evolución de la enfermedad. El objetivo del presente trabajo es relatar un caso de PE en una gata de dos meses de edad, haciendo hincapié en el diagnóstico y tratamiento. El tratamiento realizado consistió en la colocación de una estructura rígida externa, mediante un procedimiento quirúrgico que mostró resultados satisfactorios.

Consensus of the Brazilian Society of Infectious Diseases and Brazilian Society of Clinical Oncology on the management and treatment of Kaposi's sarcoma.

Kaposi's sarcoma is a multifocal vascular lesion of low-grade potential that is most often present in mucocutaneous sites and usually also affects lymph nodes and visceral organs. The condition may manifest through purplish lesions, flat or raised with an irregular shape, gastrointestinal bleeding due to lesions located in the digestive system, and dyspnea and hemoptysis associated with pulmonary lesions. In the early 1980s, the appearance of several cases of Kaposi's sarcoma in homosexual men was the first alarm about a newly identified epidemic, acquired immunodeficiency syndrome. In 1994, it was finally demonstrated that the presence of a herpes virus associated with Kaposi's sarcoma called HHV-8 or Kaposi's sarcoma herpes virus and its genetic sequence was rapidly deciphered. The prevalence of this virus is very high (about 50%) in some African populations, but stands between 2% and 8% for the entire world population. Kaposi's sarcoma only develops when the immune system is depressed, as in acquired immunodeficiency syndrome, which appears to be associated with a specific variant of the Kaposi's sarcoma herpes virus. There are no treatment guidelines for Kaposi's sarcoma established in Brazil, and thus the Brazilian Society of Clinical Oncology and the Brazilian Society of Infectious Diseases developed the treatment consensus presented here.

Influence of substructure design and occlusal reduction on the stress distribution in metal ceramic complete crowns: 3D finite element analysis.

PURPOSE: Occlusal reduction is considered a fundamental step for providing adequate and uniform space for the ceramic prosthesis; however, a flat occlusal surface is usually found. The prosthesis design influences the resistance to deformation and the stress state within the ceramic. This finite element (FE) study analyzes the influence of changing the substructure design on the stress distribution of a metal-ceramic crown in a premolar tooth with three types of occlusal reduction. MATERIALS AND METHODS: Each part of three-dimensional metal ceramic complete crown models was designed according to the space provided by different levels of occlusal reduction and the same external morphology of the tooth. Three models were designed: (1) correct occlusal reduction with a uniform thickness of the substructure (0.3 mm) and the veneering porcelain (1.5 mm); (2) flat occlusal reduction with different thicknesses of veneering porcelain to produce a uniform substructure; and (3) a flat occlusal reduction with different thicknesses of substructure for a uniform thickness of veneering porcelain. RESULTS: Stress distributions were very similar in the three models. The highest tensile stresses were concentrated immediately below the midline fissure in both the veneering porcelain and the metal alloy substructure. Although models with flat occlusal reduction had lower stress values, this preparation results from a reduction that removes a greater amount of sound tissue, which may increase the probability of dental pulp injury. CONCLUSIONS: Occlusal reduction must be anatomic; however, when a flat occlusal reduction already exists, the substructure must reproduce the correct anatomic form to allow a uniform thickness of the veneering porcelain.

Splendore-Hoeppli phenomenon in a cat with osteomyelitis caused by Streptococcus species.

A 9-month-old male neutered mixed-breed cat had a history of chronic lameness of the right hind limb, which was non-responsive to antibiotic treatment. Hematologic analysis revealed marked neutrophilia and mild monocytosis. Radiography revealed extensive loss of cortical bone, and replacement with irregular and disorganized bone. There was loss of the normal cortico-medullary distinction, and the medullary cavity had an irregular radiodensity suggestive of osteomyelitis. Surgical curettage and antibiotics did not improve the clinical condition, and amputation was performed. Grossly, the skin over the right tibia was ulcerated with a viscous and granular exudate. At histopathology, there was marked diffuse pyogranulomatous dermatitis, myositis, periostitis and osteomyelitis associated with Splendore-Hoeppli phenomenon. In addition, there was marrow osteoproliferation and multifocal cortical loss, reabsorption, fibroplasia and endosteal bone formation. Gram staining revealed myriad slightly elongated Gram-positive bacteria, arranged in pairs or single chains, confirmed by polymerase chain reaction as Streptococcus species.

Detection of toxins A/B and isolation of Clostridium difficile and Clostridium perfringens from dogs in Minas Gerais, Brazil.

The objective of this study was to detect C. difficile A/B toxins and to isolate strains of C. perfringens and C. difficile from diarrheic and non-diarrheic dogs in Brazil. Stool samples were collected from 57 dogs, 35 of which were apparently healthy, and 22 of which were diarrheic. C. difficile A/B toxins were detected by ELISA, and C. perfringens and C. difficile were identified by multiplex PCR. C. difficile A/B toxins were detected in 21 samples (36.8%). Of these, 16 (76.2%) were from diarrheic dogs, and five (23.8%) were from non-diarrheic dogs. Twelve C. difficile strains (21.1%) were isolated, of which ten were A(+)B(+) and two were A(-)B(-). All non-toxigenic strains were isolated from non-diarrheic animals. The binary toxin gene cdtB was found in one strain, which was A(+)B(+) and was derived from a non-diarrheic dog. C. perfringens strains were isolated from 40 samples (70.2%). Of these, 18 (45%) were from the diarrheic group, and 22 (55%) belonged to the non-diarrheic group. All isolates were classified as C. perfringens type A and there was an association between the detection of the cpe gene and the presence of diarrhea. Interestingly, ten strains (25%) were positive for the presence of the cpb2 gene. The high rate of detection of the A/B toxins in non-diarrheic dogs suggests the occurrence of subclinical disease in dogs or carriage of its toxins without disease. More studies are needed to elucidate the epidemiology of C. difficile and C. perfringens in dogs and to better our understanding of C. difficile as a zoonotic agent. This is the first study to report the binary toxin gene in C. difficile strains isolated from dogs in Brazil.

Prevalence of thyroid dysfunction in patients with diabetes mellitus.

BACKGROUND: Diabetes mellitus (DM) and thyroid dysfunction (TD) are the two most common endocrine disorders in clinical practice. The unrecognized TD may adversely affect the metabolic control and add more risk to an already predisposing scenario for cardiovascular diseases. The objective of this study was to investigate the prevalence of TD in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM). METHODS: This is an observational cross-sectional study. Three hundred eighty-six (386) patients with T1DM or T2DM that regularly attended the outpatient clinic of the Diabetes unit, Hospital Universitário Pedro Ernesto, participated in the study. All patients underwent a clinical and laboratory evaluation. Thyroid dysfunction was classified as clinical hypothyroidism (C-Hypo) if TSH > 4.20 µUI/mL and FT4 < 0.93 ng/dL; Subclinical hypothyroidism (SC-Hypo) if TSH > 4.20 µUI/ml and FT4 ranged from 0.93 to 1.7 ng/dL; Subclinical hyperthyroidism (SC-Hyper) if TSH < 0.27 µUI/ml and FT4 in the normal range (0.93 and 1.7 ng/dL) and Clinical hyperthyroidism (C-Hyper) if TSH < 0.27 µUI/ml and FT4 > 1.7 µUI/mL. Autoimmunity were diagnosed when anti-TPO levels were greater than 34 IU/mL. The positive autoimmunity was not considered as a criterion of thyroid dysfunction. RESULTS: The prevalence of TD in all diabetic patients was 14,7%. In patients who had not or denied prior TD the frequency of TD was 13%. The most frequently TD was subclinical hypothyroidism, in 13% of patients with T1DM and in 12% of patients with T2DM. The prevalence of anti-TPO antibodies was 10.8%. Forty-four (11.2%) new cases of TD were diagnosed during the clinical evaluation. The forty-nine patients with prior TD, 50% with T1DM and 76% with T2DM were with normal TSH levels. CONCLUSIONS: We conclude that screening for thyroid disease among patients with diabetes mellitus should be routinely performed considering the prevalence of new cases diagnosed and the possible aggravation the classical risk factors such as hypertension and dyslipidemia, arising from an undiagnosed thyroid dysfunction.

Detection of toxins A/B and isolation of Clostridium difficile and Clostridium perfringens from dogs in Minas Gerais, Brazil

The objective of this study was to detect C. difficileA/B toxins and to isolate strains of C. perfringensand C. difficile from diarrheic and non-diarrheic dogs in Brazil. Stool samples were collected from 57 dogs, 35 of which were apparently healthy, and 22 of which were diarrheic. C. difficileA/B toxins were detected by ELISA, and C. perfringensand C. difficilewere identified by multiplex PCR. C. difficileA/B toxins were detected in 21 samples (36.8%). Of these, 16 (76.2%) were from diarrheic dogs, and five (23.8%) were from non-diarrheic dogs. Twelve C. difficile strains (21.1%) were isolated, of which ten were A+B+and two were A-B-. All non-toxigenic strains were isolated from non-diarrheic animals. The binary toxin gene cdtBwas found in one strain, which was A+B+and was derived from a non-diarrheic dog. C. perfringensstrains were isolated from 40 samples (70.2%). Of these, 18 (45%) were from the diarrheic group, and 22 (55%) belonged to the non-diarrheic group. All isolates were classified as C. perfringenstype A and there was an association between the detection of the cpegene and the presence of diarrhea. Interestingly, ten strains (25%) were positive for the presence of the cpb2gene. The high rate of detection of the A/B toxins in non-diarrheic dogs suggests the occurrence of subclinical disease in dogs or carriage of its toxins without disease. More studies are needed to elucidate the epidemiology of C. difficileand C. perfringensin dogs and to better our understanding of C. difficileas a zoonotic agent. This is the first study to report the binary toxin gene in C. difficilestrains isolated from dogs in Brazil.(AU)