Effects of cashew nut shell liquid (CNSL) on the performance of broiler chickens / Efeitos do líquido da casca da castanha de caju (LCC) sobre o desempenho de frangos de corte

The effects of cashew nut shell liquid (CNSL) on growth performance, carcass yield, relative weight of internal organs and microbiology of digestive tract of broiler chickens were investigated. Five hundred and forty male broiler chicks at one day of age were arranged in a completely randomized design with six treatments and six repetitions with 15 broiler chicks each. The treatments were: control (T1 - without growth promoter virginiamycin and CNSL); inclusion levels of 0.10mL (T2), 0.20mL (T3), 0.30mL (T4) and 0.40mL (T5) of CNSL/kg of feed; and commercial promoter virginiamycin (T6). At 21 and 40 days of age, body weight, feed intake, feed conversion and viability of birds were similar in all treatments. Carcass yield was higher in the treatment with the growth promoter when compared to the control treatment. There was a linear increase in carcass yield when the level of CNSL was increased in the diet. The relative weight of the intestine was lower in the treatment containing virginiamycin when compared to the treatment without the inclusion of additives. The relative weight of the intestines decreased when the levels of inclusion of CNSL were increased. There was a gradual reduction of Escherichia coli concentration reaching the lowest number on the CNSL level of 0.30mL/kg. It was concluded that CNSL showed similar performance and slaughter yield as the growth promoter and reduced the concentration of Escherichia coli in the intestinal contents.

Um estudo foi conduzido para investigar os efeitos do líquido da casca da castanha de caju (LCC) sobre o desempenho, o rendimento de carcaça, o peso relativo dos órgãos internos e a microbiologia do trato digestivo de frangos de corte. Foram utilizados 540 pintos machos de um dia de idade, distribuídos num delineamento inteiramente casualizado, com seis tratamentos e seis repetições de 15 aves cada. Os tratamentos consistiram em: controle (T1 - sem promotor comercial e sem LCC), níveis de inclusão de 0,10mL (T2), 0,20mL (T3), 0,30mL (T4) e 0,40mL (T5) de LCC/kg de ração e T6 (promotor comercial - virginiamicina). Aos 21 e 40 dias de idade, o peso corporal, o consumo de ração, a conversão alimentar e a viabilidade das aves foram semelhantes em todos os tratamentos. O rendimento de carcaça foi superior no tratamento com promotor de crescimento em relação ao tratamento-controle. Ocorreu uma resposta linear de incremento no rendimento de carcaça com o aumento do nível de LCC na dieta. O peso relativo dos intestinos foi menor no tratamento com virginiamicina em relação ao tratamento-controle. O peso relativo dos intestinos diminuiu com o aumento do nível de inclusão do LCC. Houve uma redução gradual da concentração de Escherichia coli, cuja menor concentração atingiu o nível de 0,30mL/kg. Conclui-se que o LCC mostrou desempenho e rendimento de abate semelhantes ao promotor de crescimento e reduziu a concentração de Escherichia Coli no conteúdo intestinal.

Genetic and clinical predictors of warfarin dose requirements in African Americans.

The objective of this study was to determine whether, in African-American patients, additional vitamin K oxidoreductase complex subunit 1 (VKORC1), cytochrome P450 2C9 (CYP2C9), CYP4F2, or apolipoprotein E (APOE) polymorphisms contribute to variability in the warfarin maintenance dose beyond what is attributable to the CYP2C9*2 and *3 alleles and the VKORC1 -1639G>A genotype. In a cohort of 226 African-American patients, weekly warfarin dose requirements were lower in those with the CYP2C9*8 allele (34 (30-47) mg; P = 0.023) and the CYP2C9 *2, *3, *5, *6, or *11 allele (33(28-40 mg); P < 0.001) as compared with those with the CYP2C9*1/*1 genotype (43 (35-56) mg). The combination of CYP2C9 alleles, VKORC1 -1639G>A genotype, and clinical variables explained 36% of the interpatient variability in warfarin dose requirements. By comparison, a model without the CYP2C9*5, *6, *8, and *11 alleles explained 30% of the variability in dose. No other VKORC1, CYP4F2, or APOE polymorphism contributed to the variance. The inclusion of additional CYP2C9 variants may improve the predictive ability of warfarin dosing algorithms for African Americans.

Cytochrome P450 2C9 mediated metabolism in people with and without cancer.

OBJECTIVES: To compare cytochrome P450 activity in people with and without cancer and examine the relationship between CYP2C9 activity and serum cytokine levels. PATIENTS AND METHODS: 10 subjects with cancer who were currently receiving treatment and 10 additional subjects without cancer who were matched to the subjects with cancer based on gender and race were enrolled into the study. Serial blood samples were drawn to measure tolbutamide in the plasma before and after oral tolbutamide 500 mg. Total urine excreted was collected from 0 to 12 h following the dose. Tolbutamide and its metabolites were measured in plasma and urine by HPLC. CYP2C9 genotype was determined by PCR and pyrosequencing and cytokine values were determined by ELISA. RESULTS: The mean apparent oral clearance (cancer, 19.5 +/- 10.5 vs. non-cancer, 15.8 +/- 5.0 ml/min) and the mean urinary metabolic ratio from 0 to 12 h were similar (838 +/- 693 vs. 775 +/- 390). Neither age nor genotype statistically affected the outcomes. Mean interleukin-6 (7.2 +/- 9.4 vs. 1.5 +/- 1.3 pg/ml) and tissue necrosis factor-a (26.2 +/- 71.2 vs. 1.5 +/- 1.3 pg/ml) were 5- to 7-fold higher, respectively, in subjects with cancer. No statistically significant correlation between cytokine values and oral clearance or urinary metabolic ratio was found. CONCLUSIONS: CYP2C9 activity as measured by apparent oral clearance and urinary metabolic ratio following oral tolbutamide appear similar in people with and without cancer. Serum cytokine values appear higher in patients with cancer, although the differences did not reach statistical significance.

Estudo de confiabilidade da aplicação da escala de Fugl-Meyer no Brasil / Reliability study on the application of the Fugl-Meyer scale in Brazil

OBJETIVOS: Os objetivos do estudo foram realizar uma versão brasileira da escala original de Fugl-Meyer e verificar a confiabilidade da aplicação inter e intra-observador desta versão em pacientes crônicos pós AVC. MÉTODO: Participaram do estudo 50 pacientes portadores de hemiparesia, os quais foram submetidos a duas avaliações (confiabilidade intra-observador), realizadas por três fisioterapeutas (confiabilidade interobservador), procedentes de três centros de reabilitação. RESULTADOS: Os resultados demonstraram alta confiabilidade inter e intra-observador da EFM total (IC = 0,99 e 0,98; respectivamente), assim como para todas as subescalas (interobservador IC = 0,99 a 0,94; intra-observador IC = 0,98 a 0,87). CONCLUSÃO: Conclui-se neste artigo que não foi verificado conflitos de interpretação na versão brasileira da escala de Fugl-Meyer. Obtivemos alto índice de confiabilidade, tanto intra como interobservador, permitindo assim seu uso como instrumento de avaliação clínica e de pesquisa no Brasil.

Pseudotumoural hemicerebellitis: imaging findings in two cases.

Pseudotumoural hemicerebellitis is exceedingly rare. It may closely resemble a tumour either clinically or on imaging, and a high index of suspicion is required to avoid unnecessary surgical procedures. MRI is the most useful diagnostic tool, and reveals a swollen cerebellar hemisphere, hyperintense in T(2) weighted images. A pattern of predominantly pial contrast enhancement, absence of a well-defined mass and regression of the abnormalities in follow up examinations help to rule out malignancy. We report two cases of pseudotumoural cerebellitis (an 11-year-old girl and a 9-year-old boy) studied with CT and MRI.

Laryngeal electromyography: contribution to vocal fold immobility diagnosis.

Laryngeal Electromyography (LEMG) is a diagnostic test commonly used in patients with vocal fold movement disorder. The aim of this study is to describe LEMG in patients with vocal fold immobility. A total of 55 dysphonic patients with vocal fold immobility diagnosed by laryngeal endoscopy were grouped according to probable clinical cause: 1) unknown; 2) traumatic; or 3) tumoral compression. They were submitted to LEMG by percutaneous insertion of concentric needle electrode. LEMG was conclusive in all patients and showed a majority with peripheral nerve injury. LEMG diagnosed peripheral nerve damage in 25 group 1, 12 group 2, and 11 group 3 patients. LEMG was normal in 4 patients, suggesting cricoarytenoid joint fixation. Central nervous system disorders was suggested in 2 and myopathic pattern in 1. As the major cause of vocal fold immobility is peripheral nerve damage, LEMG is an important test to confirm diagnosis.

Laryngeal electromyography in normal Brazilian population.

Quantitative analysis of normal values of motor unit action potentials duration and amplitude of muscles tireoaritenoideus (TA), cricotireoideus (CT), cricoaritenoideus lateralis (CAL), and cricoaritenoideus posterioris (CAP) was performed in 14 adult normal Brazilian volunteers. The recordings were obtained by percutaneously inserted concentric needle electrode. Different motor unit action potentials were manually selected in each muscle for quantitative computerized analysis of duration and amplitude. The mean values for duration and amplitude were respectively 3.8 ms and 413 microV for TA, 4.9 ms and 585 microV for CT 4.1 ms and 388 microV for CAL and 4.5 ms and 475 microV in CAP. There were no similar reports of normal values of motor unit action potentials in Brazilian subjects.

Laryngeal electromyography: technical features.

Laryngeal Electromyography (LEMG) is an auxiliary diagnostic method used for the comprehension and diagnosis of different neurological diseases that compromise laryngeal function. The most common LEMG technique is the percutaneous insertion of needle electrodes guided by surface anatomical references. We describe techniques for inserting needle electrodes into the tireoaritenoideus (TA), cricotireoideus (CT), cricoaritenoideus lateralis (CAL) and cricoaritenoideus posterioris (CAP) muscles; these are used at UNICAMP laryngology ambulatory, we discuss difficulties found and their proposed solutions. All patients were submitted to otorhinolaryngological, phonoaudiological and laryngeal endoscopy before LEMG. The CAP approach, by digital rotation of the thyroid cartilage was found to be the most difficult, followed by the CAL approach. TA and CT approaches gave no major problems, except with some older and obese patients. A significant complication of the TA approach via thyroid cartilage was a hematoma in one patient which partially obstructed the laryngeal lumen.

Rhombencephalosynapsis: CT and MRI findings.

An unusual disorder of cerebellar development, rhombencephalosynapsis is a unique entity which presents with cerebellar fusion and absence of cerebellar vermis on imaging studies, often associated with supratentorial findings. No specific clinical syndrome has been described in these patients so far, and most cases are found in infancy and childhood. MRI and its multiplanar capabilities and high spatial and contrast resolution increased its recognition. Two cases are reported, with emphasis on imaging findings.

An imbalance of naive and memory/effector subsets and altered expression of CD38 on T lymphocytes in two girls with hyper-IgM syndrome.

In this report we evaluated CD4(+) T, CD8(+) T and natural killer (NK) cell counts, the levels of naive/memory subsets within the CD4(+) T lymphocyte population, expression of CD38 on T lymphocytes, and CD4(+) and CD8(+) T cell cytokine production in two girls with hyper-IgM (HIM) syndrome. Both girls developed recurrent infections early in infancy, presenting a wide spectrum of clinical manifestations, with a strikingly different disease severity between them. CD4(+) T cell counts were low in both children (patient 1: 214 cells/mm(3) and patient 2: 392 cells/mm(3)), and the CD4/CD8 T cell ratio was 0.4 for patient 1, the patient with the more severe disease, and 1.4 for patient 2. NK cell numbers were low in patient 1 (60 cells/mm(3)) and borderline (286 cells/mm(3)) with regard to normal levels in patient 2. An imbalance of naive and memory/effector cell subsets was found in both girls, with the percentage of CD45RA(+) 27(+) (naive) CD4(+) T lymphocytes being 5.8 and 12.4 for patients 1 and 2, respectively. Expression of CD38 on the surface of T lymphocytes was low in patient 1. Detection of intracellular interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha in CD4(+) and CD8(+) T lymphocytes upon PMA-Io stimulus was preserved in both children. In conclusion, we found low numbers of CD4(+) T lymphocytes and a dramatic redistribution of naive and memory/effector CD4(+) T lymphocytes in two girls with non-X-linked HIM syndrome. Furthermore, we found low expression of CD38 on T lymphocytes and low numbers of NK cells in the patient with the more severe disease, indicating a possible role for these cells in the pathogenesis of this immunodeficiency.

The effectiveness of protraction face mask therapy: a meta-analysis.

This study examined the effectiveness of maxillary protraction with orthopedic appliances in Class III patients. A meta-analysis of relevant literature was performed to determine whether a consensus exists regarding controversial issues such as the timing of treatment and the use of adjunctive intraoral appliances. An initial search identified 440 articles relating to Class III malocclusion. Among those articles, 11 studies in English and 3 studies in foreign languages met the previously established selection criteria. Data from the selected studies were categorized by age and appliance groups for the meta-analysis. The sample sizes were comparable between the groups. The statistical synthesis of changes before and after treatment in selected cephalometric landmarks showed no distinct difference between the palatal expansion group and nonexpansion group except for 1 variable, upper incisor angulation, which increased to a greater degree in the nonexpansion group. This finding implies that more skeletal effect and less dental change are produced in the expansion appliance group. Examination of the effects of age revealed greater treatment changes in the younger group. Results indicate that protraction face mask therapy is effective in patients who are growing, but to a lesser degree in patients who are older than 10 years of age, and that protraction in combination with an initial period of expansion may provide more significant skeletal effects. Overall mean values and corresponding standard deviations for the studies selected can also be used to estimate mean treatment effects expected from the use of protraction face mask.

Detection of group B streptococcus: comparison of an optical immunoassay with direct plating and broth-enhanced culture methods.

The aim of this study was to compare the diagnostic accuracy of an optical immunoassay (STREP B OIA, Biostar) to direct plating and broth-enhanced culture for the detection of group B streptococcus (GBS) colonization of the lower genital tract in pregnant women. GBS cultures from the lower genital tract were obtained in a prospective fashion using a dual swab transport system from patients with risk factors for perinatal GBS infection. One swab was used to inoculate a trypticase soy agar plate with 5% sheep blood (TSA) and then placed in Lim broth. The other swab was used to perform the Strep B OIA. Growth of GBS by either direct plating or broth-enhanced culture was used as the gold standard for determining GBS colonization. Of the 524 women in the study, 90 women had positive cultures (either TSA or Lim broth). The sensitivity, specificity, positive predictive value, and negative predictive value of the Strep B OIA were 47% (42/90), 96% (416/434), 70% (42/60), 90% (416/464). The sensitivity, specificity, positive predictive value, and negative predictive value of the TSA were 61% (55/90), 100% (434/434), 100% (55/55), 93% (434/469). The sensitivity, specificity, positive predictive value, and negative predictive value of Lim broth were 97% (87/90), 100% (434/434), 100% (87/87), and 97% (434/437). The sensitivity of the Strep B OIA to detect light GBS colonization and heavy GBS colonization, as determined by the TSA, was 53% (19/36) and 90% (17/19), respectively. The Strep B OIA and direct agar plate culture appear to be of limited clinical value due to their poor sensitivities. This study also demonstrates the need to use a selective medium such as Lim broth when assessing for GBS colonization of the lower genital tract.

The effect of hyperthyroidism on Müller's muscle contractility in rats.

The objective of this study was to determine if hyperthyroidism affects the responses of Müller's muscle to alpha-1 adrenoceptor agonists and consequently, if these responses might explain thyroid eyelid retraction. Sprague-Dawley adult rats (n = 37) were divided into control and treated groups and given either placebo or intraperitoneal triiodothyronine (250 micrograms/kg/d) for 1, 2, or 3 weeks. A suture was passed through their upper eyelid and connected to a force transducer that measured Müller's muscle contractions. Responses to phenylephrine (0.015-0.61 mmol) were compared with respect to peak amplitude and 50% duration of action. Mean maximum force values [+/-1 standard error of the mean (SEM)] in response to phenylephrine were 1.254 +/- 0.071 gr for controls and 0.963 +/- 0.062 gr for thyroid-treated subjects (p = 0.005). Mean 50% duration of response values (+/-1 SEM) were 9.143 +/- 1.108 min for controls and 5.763 +/- 0.973 min for thyroid-treated subjects (p = 0.014). Hyperthyroid rats had a significantly lower Müller's muscle response amplitude than control rats; however, duration of response was not significantly different between the groups. We believe that hyperthyroidism caused intrinsic changes in Müller's muscle that resulted in eyelid retraction. Based on hypotheses discussed in this article, we expect that further studies will localize these changes to the thyroid hormone receptor on Müller's muscle or calcium-triggered intracellular second messengers. Clinical significance would then be the ability to treat hyperthyroid eyelid retraction with drugs. This study provides the first evidence of functional impairment of Müller's muscle due to hyperthyroidism in an animal model.

Long-term follow-up of initially successful trabeculectomy.

OBJECTIVE: The purpose was to study the long-term outcomes of primary trabeculectomies that were successful at 1 year. DESIGN: A retrospective study of patients with various types of glaucoma who had trabeculectomies that were successful at 1 year and who had a follow-up of at least 10 years. PARTICIPANTS: There were 40 patients (40 eyes) who had primary trabeculectomies that were successful at 1 year and who had a follow-up range of 10 to 21 years. INTERVENTION: Control of intraocular pressure (IOP) and disease progression was evaluated at 5, 10, and 15 years and at the last obtainable follow-up. MAIN OUTCOME MEASURES: Successful control of IOP was defined as IOP less than 21 mmHg or a reduction of 33% if preoperative IOP was less than 21 mmHg. Successful control of disease progression was defined as stable cup-disc ratios determined by examination, or color photographs or both, as well as stable visual fields. RESULTS: If an eye was considered successful by IOP at 1 year, the probability of successful control of IOP was 82% at 5 years and 67% at 10 and 15 years. If an eye was considered successful by IOP at 1 year, the probability of successful control of disease progression at 5 years was 77%, at 10 years 61%, and at 15 years 48%. If an eye did not require further glaucoma surgery at 1 year, the probability that it still would not need further surgery at 5 years was 90%, at 10 years 75%, and at 15 years 67%. Forty percent of eyes had cataract extraction by the time of last follow-up examination. CONCLUSIONS: Loss of IOP control and progression of glaucomatous damage occurs over time despite initial success at 1 year.

Evaluation of genotype data in clinical risk assessment: methods and application to BRCA1, BRCA2, and N-acetyl transferase-2 genotypes in breast cancer.

Associations of numerous susceptibility genes with disease risk have been reported. However, objective methods have not been developed to evaluate the conditions under which translation of knowledge about susceptibility genotypes may be clinically informative. We describe and apply a statistical approach to evaluate when genotype information may be clinically informative in disease risk assessment. We estimate an interval of cumulative cancer incidences where it may be appropriate to use these genes in disease risk assessment. We also estimate the magnitude of a log odds ratio (H) that measures genotype-disease association. We illustrate this method with three breast cancer susceptibility genotypes: population screening data evaluating the 185delAG mutation at BRCA1 and the 6174delT mutation at BRCA2 in a Ashkenazi Jewish population, and case control data for the slow acetylation genotype at the N-acetyl transferase 2 (NAT2) gene in combination with smoking. Knowledge of the 185delAG mutation in BRCA1 (HdelAG = 3.42; 95% CI: 3.04, 3.79) or the 6174delT mutation in BRCA2 (HdelT = 1.98; 95% CI: 1.16, 2.30) can be clinically informative in distinguishing individuals who are and are not at breast cancer risk in populations with cumulative breast cancer incidences of > or = 4% and > or = 13%, respectively. NAT2 genotypes alone are much less clinically informative in predicting breast cancer risk (HNAT2 = 0.10). However, knowledge of both heavy smoking 20 years ago and NAT2 genotype is a more clinically informative predictor of postmenopausal breast cancer risk with HNAT2 = 2.19, when the cumulative breast cancer incidence in the target population is at least 31%. These results indicate that knowledge of the 185delG mutation-status may be clinically informative even in populations with low cumulative breast cancer incidences, whereas the 6174delT mutation and NAT2 genotypes may only be clinically informative in a population with higher cumulative breast cancer incidence. The proposed approach can be used to objectively evaluate the conditions under which susceptibility genotypes may be applied for risk assessment or genetic screening.

[De novo absence status: case report]. / Status epilepticus ausência de novo. Relato de caso.

There are few descriptions about middle-aged patients who have nonconvulsive status epilepticus, absence status. We reported the clinical case of a woman, 52-year-old, diabetic, referred to the emergency room in a confusional state. Initial electroencephalogram showed continuous typical, bilateral, symmetric and synchronous spike-and-wave discharges. Clinical and electroencephalogram normalization occurred immediately following intravenous injection of benzodiazepine. Computerized axial tomography was normal. The recognition of this entity is essential because of its similarity to psychiatric disturbance and its prompt response to proper treatment.

Differential care of corneal ulcers in the community based on apparent severity.

PURPOSE: To describe current practice patterns in treating infectious keratitis. METHODS: A questionnaire was designed that asked ophthalmologists to describe the diagnostic equipment accessible to their practice for performing smears and obtaining scrapings for microbial culture and sensitivity testing. The questionnaire also presented two hypothetical cases of patients with infectious keratitis. Bacterial keratitis was relatively early and less severe in the first patient, and it was more advanced and more severe in the second patient. Recipients were asked about their diagnostic and therapeutic approach. The survey was mailed to 300 ophthalmologists in Florida, Illinois, and New York. RESULTS: One hundred twenty-four completed surveys (45%) were returned. Six surveys were from cornea specialists, who were excluded from the analysis. Only 18 practices (15%) maintained access to Gram stain supplies, and 58 (50%) maintained culture supplies. Whereas 56% of respondents would treat the patient with the less severe bacterial keratitis without obtaining samples for cultures, only 13% would treat the patient with the more severe condition in this manner (P<0.00001). Of the respondents, 82% would treat the patient with the less severe bacterial keratitis with a fluoroquinolone, compared with 62% for the patient with the more severe infection (P=0.002). The mean frequency of fluoroquinolone administration for the patient with more-severe bacterial keratitis was one drop every 0.88 hours, compared with one drop every 1.48 hours for the patient with the less severe infection. CONCLUSIONS: Ophthalmologists appear to treat suspected infectious keratitis differently, depending on perceived severity; they choose different antibiotic regimens; and are more likely to forgo scrapings for Gram staining and cultures for ulcers that appear less severe. The justification for this approach should be established.