Association of patient-practitioner sex concordance with specialist referral in primary hyperparathyroidism.

BACKGROUND: Prior research has demonstrated barriers to the workup and management of primary hyperparathyroidism. As recent data have suggested that patient and practitioner sex concordance is associated with lower surgical complications, we sought to evaluate the effect of sex concordance on referral for primary hyperparathyroidism. METHODS: We queried an institutional database for patients with first-incident hypercalcemia and subsequent biochemical evidence of primary hyperparathyroidism between 2010 and 2018. Primary care practitioner and endocrinologist sex, laboratory values, and complications of primary hyperparathyroidism were collected. Sex concordance (male patient/male practitioner or female patient/female practitioner) was evaluated as a binary predictor of specialist evaluation using logistic regression and Cox proportional hazards modeling. RESULTS: Among 1,100 patients, mean age was 62.5 (standard deviation 13.6), and 74% were female sex. Primary care practitioner sex was 52% female, and 63% of patients had sex concordance with their primary care practitioner. Endocrinologist sex was 59% female, and 45% of patients had sex concordance with their endocrinologist. Patients with sex concordance with their primary care practitioner (70 vs 80%, P = .001) and endocrinologist (71 vs 82%, P < .001) were less likely to be female sex compared to those with discordance. After adjusting for demographics and clinical covariates, those patients with primary care practitioner sex concordance had 32% higher odds of endocrinologist evaluation (odds ratio 1.32, 95% confidence interval 1.003-1.734, P = .047). Similarly, those patients with endocrinologist sex concordance had a 48% higher rate of surgeon evaluation (hazard ratio 1.48, confidence interval 1.1-2.0, P = .009). Stratified analysis revealed that sex discordance reduced the rate of surgeon referral for female patients (hazard ratio 0.63, confidence interval 0.44-0.89, P = .008) but not male patients (hazard ratio 1.06, CI 0.58-1.93, P = .861). CONCLUSION: Sex discordance between patients and their health care professionals may contribute to under-referral in primary hyperparathyroidism. Further evaluation of the effect of patient and practitioner identities on communication and decision-making in surgery are needed.

Social vulnerability and time to surgeon evaluation for primary hyperparathyroidism in a Massachusetts cohort.

BACKGROUND: Identifying patients at risk for under-evaluation of primary hyperparathyroidism is essential to minimizing long-term sequelae, including osteoporosis, nephrolithiasis, and cardiovascular disease. This study assessed the impact of social vulnerability on time-to-surgery evaluation among patients with primary hyperparathyroidism in a Massachusetts cohort. METHODS: This is a retrospective review of patients from an institutional database with the first incident of hypercalcemia between 2010 and 2018 and subsequent biochemical diagnosis of primary hyperparathyroidism. The overall social vulnerability index and social vulnerability index subthemes were merged with the institutional data via patient ZIP code. Patients were stratified into social vulnerability index quartiles, where quartile 4 represented the highest vulnerability. Baseline sociodemographic and clinical characteristics were compared, and Cox regression was used to assess the association between social vulnerability index and time to surgeon evaluation. RESULTS: Of 1,082 patients included, those with a higher social vulnerability index were less likely to be evaluated by a surgeon (quartile 1 social vulnerability index: 31.1% vs. quartile 2 social vulnerability index: 31.41% vs. quartile 3 social vulnerability index: 25.93% vs. quartile 4 social vulnerability index: 21.92%, P = .03). On adjusted analysis, patients with the highest vulnerability had a 33% lower estimated rate of surgeon evaluation and were seen 67 days later compared with patients with the lowest vulnerability (hazard ratio: 0.67, confidence interval 0.47-0.97, P = .032). Differential rates of surgical evaluation by vulnerability persisted for the social vulnerability index subthemes for socioeconomic status, minority status and language, and housing type and transportation. CONCLUSION: Among a Massachusetts cohort, highly vulnerable populations with primary hyperparathyroidism are at greater risk for under-evaluation by a surgeon, which may contribute to the development of long-term sequelae of their disease.

Formulation of diets for slow-growing broilers slaughtered at different ages on carcass characteristics and composition of commercial cuts.

This study was conducted to examine the effects of a diet formulated with industrial amino acids and a commercial vitamin-mineral mixture on the characteristics of carcass and meat cuts of slow-growing broilers slaughtered at different ages. The experiment involved 600 one-day-old male and female white Naked Neck chicks. The chicks were allotted randomly to a 2 × 3 factorial arrangement consisting of two diets and three slaughter ages, in a completely randomized experimental design with five replicates of 20 birds each. The experimental period was 84 days. Six chicks were selected and slaughtered on the first day, and then at 56, 70 and 84 days of age 10 birds unit was selected and slaughtered per experimental period. Weight and yield of carcass, abdominal fat and breast, thigh and drumstick meat were determined. Additionally, moisture, protein, fat and mineral matter contents and protein and fat deposition in the breast, drumstick and thigh muscles were determined. The diet did not influence the yields of carcass, abdominal fat, or meat cuts or the nutritional composition of meat. Slaughter age influenced the yields of breast and thigh meat and abdominal fat; the protein content of breast meat; and the moisture, crude protein, fat, and mineral matter contents of drumstick and thigh meat. There was an interaction effect between diet and slaughter age for protein deposition in breast meat. The age factor influenced fat deposition in the drumstick muscles. Protein deposition in the thigh muscles was influenced by the diet. Moreover, a difference was observed between the ages for protein and fat deposition in the thigh muscle. In conclusion, the use of a commercial mixture in the diet results in decreased protein deposition in the breast and thigh muscles, although this difference does not affect the characteristics of carcass or meat cuts. Birds slaughtered at 70 days exhibit similar carcass characteristics to those of birds slaughtered at 84 days, indicating the possibility of an earlier slaughter age.

Organic or Inorganic Zinc for Laying Hens? A Systematic Review and Meta-analysis of the Effects of Zinc Sources on Laying Performance, Egg Quality, and Zinc Excretion.

The higher availability of zinc (Zn) from organic than inorganic sources is already established, but more assertive and cost-friendly protocols on the total replacement of inorganic with organic Zn sources for laying hens still need to be developed. Because some discrepancy in the effects of this replacement in laying hen diets is noticeable in the literature, the objective of this meta-analysis was to properly quantify the effect size of total replacing inorganic Zn with organic Zn in the diet of laying hens on their laying performance, egg quality, and Zn excretion. A total of 2340 results were retrieved from Pubmed, Scielo, Scopus, WOS, and Science Direct databases. Of these, 18 primary studies met all the eligibility criteria and were included in this meta-analysis. Overall, the replacement of inorganic Zn with organic Zn, regardless of other factors, improved (p < 0.01) egg production by 1.46%, eggshell thickness by 0.01 mm, and eggshell resistance by 0.11 kgf/cm2. Positive results of the same nutritional strategy on egg weight and Zn excretion were only observed at specific conditions, especially when organic Zn was supplemented alone in the feed, not combined with other organic minerals. Therefore, there is evidence in the literature that the total replacement of inorganic Zn with organic Zn improves egg production, eggshell thickness, and eggshell resistance. Factors such as hen age and genetics, organic Zn source, concentration of Zn in the feed, and the strategy of its supplementation have to be more carefully considered in protocols designed to address egg weight and Zn excretion by the hen.

Urban and Rural Surgical Practice Patterns for Papillary Thyroid Carcinoma.

Background: The 2015 American Thyroid Association (ATA) guidelines shifted recommendations toward less aggressive management of papillary thyroid cancer (PTC). Subsequently, several studies demonstrated a trend in performing thyroid lobectomy (TL) over total thyroidectomy (TT). However, regional variation has persisted without a clear indication of what factors may be influencing practice variation. We aimed to evaluate the surgical management of PTC in patients in rural and urban settings to assess trends of TL compared with TT following the implementation of the 2015 ATA guidelines. Methods: A retrospective cohort analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2019 of patients with localized PTC <4 cm who underwent TT or TL. Patients were classified as living in urban or rural counties based on the 2013 Rural-Urban Continuum Codes. Procedures performed from 2004 to 2015 were categorized as preguidelines, while those performed from 2016 to 2019 were categorized as postguidelines. Chi-square, Student's t-test, logistic regression, and Cochran-Mantel-Haenszel test were used. Results: A total of 89,294 cases were included in the study. Eighty thousand one hundred and fifty (89.8%) were from urban settings and 9144 (9.2%) were from rural settings. Patients from rural settings were older (52 vs. 50 years, p < 0.001) and had smaller nodules (p < 0.001). On adjusted analysis, patients in rural areas were less likely to undergo TT (adjusted odds ratio 0.81, confidence interval [CI] 0.76-0.87). Before the 2015 guidelines, patients in urban settings had a 24% higher odds of undergoing TT compared with those in rural settings (odds ratio 1.24, CI 1.16-1.32, p < 0.001). There was no difference in the proportions of TT and TL based on setting following guideline implementation (p = 0.185). Conclusions: The 2015 ATA guidelines led to a change in overall practice in surgical management of PTC toward increasing TL. While urban and rural practice variation existed before 2015, both settings had an increase in TL following the guideline change, emphasizing the importance of clinical practice guidelines to ensure best practice in both rural and urban settings.

Delay in Surgery and Papillary Thyroid Cancer Survival in the United States: A SEER-Medicare Analysis.

INTRODUCTION: Delays in surgery and their impact on survival in papillary thyroid cancer (PTC) is unclear. We sought to investigate the association between time to surgery and survival in patients with PTC. METHODS: A total of 8170 Medicare beneficiaries with PTC who underwent thyroidectomy were identified within the Surveillance, Epidemiology, and End Results-Medicare linked data files between 1999 and 2018. Disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meir analysis, and Cox proportional hazards models were specified to estimate the association between time to surgery and survival. RESULTS: Among 8170 patients with PTC, mean age 69.3 (SD+/- 11.4), 89.8% had surgery within the first 90 days, 7.8% had surgery 91 to 180 days from diagnosis, and 2.4% had surgery after 180 days. Increasing time to surgery was associated with increased mortality for OS in the >180-day group [adjusted hazard ratio (aHR) 1.24; 95% CI, 1.01-1.53]. Moreover, on stratification by summary stage, those with localized disease in the 91- to 180-day group increased risk by 25% (aHR 1.25; 95%CI, 1.05-1.51), and delaying over 180 days increased risk by 61% (aHR 1.61; 95%CI, 1.19-2.18) in OS. Those with localized disease in the >180-day group had almost 4 times the estimated rate of DSS mortality (aHR3.51; 95%CI, 1.68-7.32). When stratified by T stage, those with T2 disease in the >180 days group had double the estimated rate of all-cause mortality (aHR 2.0; 95% CI, 1.1-3.3) and almost triple the estimated rate of disease-specific mortality (aHR 2.7; 95% CI, 1.05-6.8). CONCLUSIONS: Delays in surgery for PTC may impact OS and DSS in localized disease, prior to nodal metastasis.

Are patients with limited English proficiency less likely to undergo parathyroidectomy for primary hyperparathyoidism?

BACKGROUND: Despite meeting operative indications for primary hyperparathyroidism (PHPT), many patients never undergo parathyroidectomy. We hypothesized that patients with limited English proficiency (LEP) would be less likely to undergo parathyroidectomy than English-proficient (EP) patients. STUDY DESIGN: We retrospectively analyzed patients with PHPT from an institution-wide registry who met operative criteria between 2010 and 2018. The cohort was stratified by English proficiency. Univariate associations between sociodemographic and clinical factors with parathyroidectomy were assessed. A multivariable logistic regression model was created to assess independent predictors of parathyroidectomy. RESULTS: Among a cohort of 1,104 patients, 262 (24%) underwent parathyroidectomy. LEP patients (n = 135, 12%) were significantly younger (mean age 62 vs. 69, p < 0.001), more likely non-white race and ethnicity (p < 0.001), and less likely to have private insurance (p < 0.001). After adjusting for covariates, non-English and non-Spanish preferred language was an independent negative predictor of undergoing parathyroidectomy (OR 0.46, 95% CI 0.21-0.95, p = 0.037). CONCLUSIONS: Limited English proficiency may be an independent barrier to appropriate surgical management of PHPT. Systems-level and disease-specific interventions are needed to address this disparity faced by patients with LEP.

Limited disease progression in endocrine surgery patients with treatment delays due to COVID-19.

BACKGROUND: The COVID-19 pandemic profoundly impacted the delivery of care and timing of elective surgical procedures. Most endocrine-related operations were considered elective and safe to postpone, providing a unique opportunity to assess clinical outcomes under protracted treatment plans. METHODS: American Association of Endocrine Surgeon members were surveyed for participation. A Research Electronic Data Capture survey was developed and distributed to 27 institutions to assess the impact of COVID-19-related delays. The information collected included patient demographics, primary diagnosis, resumption of care, and assessment of disease progression by the surgeon. RESULTS: Twelve out of 27 institutions completed the survey (44.4%). Of 850 patients, 74.8% (636) were female; median age was 56 (interquartile range, 44-66) years. Forty percent (34) of patients had not been seen since their original surgical appointment was delayed; 86.2% (733) of patients had a delay in care with women more likely to have a delay (87.6% vs 82.2% of men, χ2 = 3.84, P = .05). Median duration of delay was 70 (interquartile range, 42-118) days. Among patients with a delay in care, primary disease site included thyroid (54.2%), parathyroid (37.2%), adrenal (6.5%), and pancreatic/gastrointestinal neuroendocrine tumors (1.3%). In addition, 4.0% (26) of patients experienced disease progression and 4.1% (24) had a change from the initial operative plan. The duration of delay was not associated with disease progression (P = .96) or a change in operative plan (P = .66). CONCLUSION: Although some patients experienced disease progression during COVID-19 delays to endocrine disease-related care, most patients with follow-up did not. Our analysis indicated that temporary delay may be an acceptable course of action in extreme circumstances for most endocrine-related surgical disease.

Disparities in Time to Surgeon Evaluation Among Patients with Primary Hyperparathyroidism.

BACKGROUND: A majority of patients with primary hyperparathyroidism are not referred for surgical evaluation. We hypothesized that disparities in the rate of surgeon evaluation by language, race and ethnicity, and insurance contribute to this deficit. METHODS: We queried our institutional electronic health record registry for patients with first-incident hypercalcemia between 2010 and 2018 and subsequent biochemical diagnosis of primary hyperparathyroidism. We used the Kaplan-Meier method and Cox proportional hazards modeling to investigate estimated time to surgeon evaluation by language, race and ethnicity, and insurance status. RESULTS: Of 1,333 patients with a diagnosis of primary hyperparathyroidism, 74% were female, 67% were White, 44% were privately insured, and 88% preferred English. Fewer than one third (n = 377; 28%) were evaluated by a surgeon. After adjusting for demographic and clinical factors, Asian (hazard ratio = 0.38; 95% confidence interval, 0.18-0.84; P = .016) and Black or African American patients (hazard ratio = 0.59; 95% confidence interval, 0.39-0.90; P = .014) had a lower rate of surgeon evaluation compared to White patients. Although patients with Medicaid had a lower rate of surgeon evaluation compared to privately insured patients (hazard ratio = 0.52; 95% confidence interval, 0.35-0.77; P = .001), there was no difference in rate for those with Medicare or who were uninsured. Patients with non-English and non-Spanish language had a lower rate of evaluation compared to those who preferred English (hazard ratio = 0.47; 95% confidence interval, 0.23-0.98; P = .043). CONCLUSION: Rates of surgeon evaluation vary by race and ethnicity, insurance status, and preferred language. Evaluation of factors contributing to these disparities is needed to improve access to surgeon referral.

Association Between Size of Dominant Candidate Lesion on Four-Dimensional CT and Four-Gland Hyperplasia among Patients with Primary Hyperparathyroidism.

BACKGROUND: Four-dimensional (4D) CT localization allows minimally invasive parathyroidectomy as treatment for primary hyperparathyroidism (PHPT), but false positive localization is frequent. We sought to characterize the ability of 4D CT to predict four-gland hyperplasia (HP) based on the size of candidate lesions. STUDY DESIGN: We retrospectively analyzed patients with PHPT who underwent 4D CT imaging and parathyroidectomy between 2014 and 2020 from a prospectively collected institutional database. The cohort was stratified into two groups, HP vs single adenoma (SA) and double adenoma (DA), based on operative findings and pathology. Logistic regression models assessed the association between the greatest diameter of the dominant candidate lesion on 4D CT and the outcomes of four-gland hyperplasia vs SA and DA. RESULTS: Among a cohort of 240 patients, 41 were found to have HP, and 199 had adenomas (SA = 155, DA = 44). Patients with HP were less likely to have a preoperative calcium level greater than 1 mg/dL above the upper limit of normal compared with patients with adenomas (63% vs 81%, p = 0.02) and more likely to report symptoms (61% vs 43%, p = 0.04). After adjusting for BMI, we found an estimated 13% reduction in odds of HP for every 1-mm increase in the greatest diameter of dominant candidate lesions identified on 4D CT scan (odds ratio 0.87, 95% CI 0.78 to 0.96, p = 0.009). CONCLUSIONS: A smaller size of the dominant lesion on 4D CT scan is associated with an increased risk of HP in PHPT. Use of 4D CT imaging localization may provide evidence for differentiating HP from adenomas.

Quality of Life in Patients with Benign Non-Toxic Goiter After Surgical Intervention: A Systematic Review and Meta-Analysis.

BACKGROUND: Prior studies evaluating health-related quality of life (HR-QoL) outcomes in patients undergoing surgery for benign non-toxic goiter have used different instruments and time points, leading to conflicting results. We sought to systematically review the differences in HR-QoL among patients with BNTG at baseline and 6 months after surgery, using exclusively the ThyPRO questionnaire. METHODS: A systematic search was performed using PubMed, Embase, Web of Science, Cochrane Central, CINAHL, and PsycINFO for papers reporting the assessment of HR-QoL utilizing ThyPRO. Data were meta-analyzed using a random-effects model, and pooled estimates were calculated using weighted mean differences (WMD) between baseline and 6 months after surgery. We assessed the quality and risk of bias of the studies using the Robins-I tool and previously published minimally important change (MIC) values to assess clinical significance. RESULTS: Six papers met the predefined inclusion criteria, describing a total of 496 patients. Meta-analysis demonstrated improved QoL in all thirteen domains of ThyPRO six months post-surgical intervention compared to baseline. Specifically, the largest improvement in QoL was seen in the domains of overall QoL, WMD -25.84 (95% CI -29.70, -21.98, p < 0.001, I2 = 23%), goiter symptoms, 23.96 (95% CI -30.29, -17.64, p < 0.001, I2 = 91%), and tiredness, -16.20 (95% CI -19.23, -13.16, p < 0.001, I2 = 3%). The differences in scores 9 of 13 domains were clinically significant based on MIC. CONCLUSIONS: Disease-specific HR-QoL improved in all ThyPRO domains after surgery in patients with BNTG. Future studies of QoL in thyroid surgery patients will benefit from a standard questionnaire and improved reporting of covariates including complications to ensure comparability across studies.

Patient-Reported Financial Burden in Thyroid Cancer.

BACKGROUND: The incidence of thyroid cancer is increasing at a rapid rate. Prior studies have demonstrated financial burden and decreased quality of life in patients with thyroid cancer. Here, we characterize patient-reported financial burden in patients with thyroid cancer over a 28y period. MATERIALS AND METHODS: Patients who underwent thyroidectomy for thyroid cancer from 1990-2018 completed a phone survey assessing financial burden and its related psychological financial hardship. Descriptive statistics were performed to characterize these outcomes and correlation with sociodemographic data was assessed. RESULTS: Respondents (N = 147) were 73% female, 75% white, and had a median follow up of 7 y. The majority had a full-time job (59%) and private insurance (81%) at the time of diagnosis. Overall, 16% of respondents reported financial burden and 50% reported psychological financial hardship. Those reporting financial burden were disproportionately impacted by psychological financial hardship (87% versus 43%, P < 0.001). One in four (25%) respondents reported not being adequately informed about costs. CONCLUSIONS: Financial burdens are important outcomes of thyroid cancer which occur even among patients with protective financial factors, suggesting an even greater impact on the general population of patients with thyroid cancer. Further research is needed to explore the intersection of financial burden, cost, and quality of life.

Metabolizable energy levels in diets with a fixed nutrient: calorie ratio for free-range broilers / Níveis de energia metabolizável com manutenção da relação nutriente: caloria em dietas para frangos de corte tipo caipira

The present study proposes to examine the effect of dietary levels of metabolizable energy, under a fixed nutrient:calorie ratio, on the production performance; body fat and protein deposition; and carcass characteristics of free-range broilers from 1 to 84 days of age. Nine hundred unsexed chicks were allocated to six treatments in a completely randomized design with six replicates of 25 birds each. Treatments consisted of diets with varying levels of metabolizable energy (2700, 2800, 2900, 3000, 3100 and 3200 Kcal ME/kg of diet) and a fixed proportion of nutrients relative to the energy level according to the nutritional requirements for each rearing phase. Body weight, weight gain, feed intake, feed conversion, production viability, metabolizable energy intake, protein intake, lysine intake, body fat deposition, body protein deposition and carcass characteristics were evaluated. Data were subjected to analysis of variance and, later, to regression analysis. Increasing levels of metabolizable energy, coupled with a fixed nutrient:calorie ratio, reduced feed intake, increased body weight and weight gain, improved feed conversion and did not affect carcass characteristics. In conclusion, adjusting the nutrient supply according to the dietary energy level improves production performance by improving feed conversion, ensuring adequate nutrient intake and preserving fat and protein deposition in the carcass when the metabolizable energy level is raised up to 3200 Kcal/kg in all rearing stages.(AU)

O objetivo do presente estudo foi avaliar os níveis de energia metabolizável, sob uma relação nutriente:caloria fixa, no desempenho produtivo; deposição de gordura e proteína corporal e características de carcaça de frangos de corte tipo caipiras. Foram utilizados novecentos pintainhos não sexados, distribuidos em seis tratamentos em delineamento inteiramente casualizado com seis repetições de 25 aves cada. Os tratamentos consistiram em dietas com diferentes níveis de energia metabolizável (2700, 2800, 2900, 3000, 3100 e 3200 Kcal EM / kg de dieta) e uma proporção fixa de nutrientes em relação ao nível de energia de acordo com as necessidades nutricionais de cada fase de criação. Foram avaliados o peso corporal, ganho de peso, consumo de ração, conversão alimentar, viabilidade criatória, consumo de energia metabolizável, consumo de proteína, consumo de lisina, deposição de gordura corporal, deposição de proteína corporal e características de carcaça. Os dados foram submetidos à análise de variância e posteriormente à análise de regressão. O aumento dos níveis de energia metabolizável juntamente com a manutenção da relação nutriente:caloria reduziu o consumo de ração, aumentou o peso corporal e o ganho de peso, melhorou a conversão alimentar e não afetou as características da carcaça. Em conclusão, o ajuste da oferta de nutrientes de acordo com o nível de energia da dieta melhora o desempenho da produção, melhorando a conversão alimentar, garantindo a ingestão adequada de nutrientes e preservando a deposição de gordura e proteína na carcaça quando o nível de energia metabolizável é elevado até 3200 Kcal/kg em todas as fases de criação.(AU)

Late Cardiac Tamponade in a Patient Victim of Penetrating Trauma - Case Report.

CASE PRESENTATION: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit clinical management, with hospital discharge in the 7th postoperative day.

Late cardiac tamponade in a patient victim of penetrating trauma - case report

Abstract Case Presentation: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit clinical management, with hospital discharge in the 7th postoperative day.

Phytase and xylanase in diets with nutritional adjustments and their effects on serum biochemistry, morphometry and intestinal health of broilers.

To examine the association between phytase and xylanase in diets with nutritional adjustments on intestinal morphometry, serum biochemistry and microbiology of broilers, 250 broilers were evaluated in a completely randomized design with five treatments and five replicates. The following treatments were tested: positive control diet - without phytase or xylanase; negative control diet - with an energy reduction of 100 kcal/kg, without phytase or xylanase; and three diets containing xylanase and phytase and energy reductions of 50, 100 and 150 Kcal/kg. For all energy-reduced diets, the nutritional matrix of phytase with phosphorus (0.15%), calcium (0.165%) and sodium (0.035%) was considered. An effect of the association between enzyme inclusion and metabolizable energy reduction in the diets was observed only by contrast analysis, for villus height. Intestinal health was not changed. Only the serum phosphorus concentration was altered by the treatments at the different evaluated ages. The association of phytase (500 FTU/kg) with xylanase (16000 BXU/kg) in diets with reductions of up to 150 Kcal/kg metabolizable energy, 0.15% digestible P, 0.165% Ca and 0.035% Na does not alter the intestinal morphometry, serum biochemistry or microbiology of broilers.

Corn with different particle sizes in laying hens feeding: performance, egg quality and intestinal morphology / Milho com diferentes tamanhos de partículas na alimentação de poedeiras: desempenho, qualidade dos ovos e morfologia intestinal / Maíz con diferentes tamaños de partículas en la alimentación de ponedoras: rendimiento, calidad de los huevos y morfología intestinal

This work was carried out to evaluate the effect of different particle size corn on the performance, egg quality and intestinal morphology of Hisex Brown laying hens. A total of 128 birds were used, in a completely randomized design with four treatments, four replicates and eight birds per experimental unit. Experimental rations had corn with different particle size: 565, 620, 781 and 1085 µm of mean geometric diameter (MGD). Feeding was ad libitum at 8:00 am and 4:00 p.m. The variables analyzed were: feed consumption, laying percentage, egg mass and weight, food conversion (was calculated by dividing the feed consumed by the total egg weight (kg.kg-1) and the number of eggs produced (kg.dozen-1)), shell percentage and thickness, Haugh unit, yolk color index and morphometry analysis of the intestinal mucosa. The use of corn with MGD until to 1085 µm in rations does not affect the performance and eggs quality of Hisex Bronw laying hens. However, there are indications that the intestinal morphometry of laying hens is negatively influenced by the increase in particle size of corn.(AU)

Este trabalho foi realizado com o objetivo de avaliar o efeito de diferentes tamanhos de partículas de milho no desempenho, qualidade dos ovos e morfologia intestinal de poedeiras Hisex Brown. Foram utilizadas 128 aves, distribuídas em delineamento inteiramente casualizado, com quatro tratamentos, quatro repetições e oito aves por unidade experimental. As rações experimentais apresentaram milho de diferentes tamanhos de partículas: 565, 620, 781 e 1085 µm de diâmetro geométrico médio (DGM). A alimentação foi ad libitum às 8:00 e 16:00h. As variáveis analisadas foram: consumo de ração, porcentagem de postura, massa e peso dos ovos, conversão alimentar (calculada dividindo-se a ração consumida pelo peso total de ovos (kg/kg) e número de ovos produzidos (kg/dúzia)), porcentagem e espessura da casca, unidade de Haugh, índice e coloração de gema e análise morfométrica da mucosa intestinal. O uso de milho com DGM até 1085 µm nas rações não afeta o desempenho e a qualidade dos ovos de poedeiras Hisex Brown. No entanto, há indicações de que a morfometria intestinal de poedeiras é influenciada negativamente pelo aumento no tamanho das partículas do milho.(AU)

Este estudio ha sido desarrollado con el objetivo de evaluar el efecto de diferentes tamaños de partículas de maíz en el rendimiento, calidad de los huevos y la morfología intestinal de gallinas ponedoras Hisex Brown. Se utilizaron 128 aves, distribuidas en un experimento completamente al azar, con cuatro tratamientos, cuatro repeticiones y ocho aves por unidad experimental. Las raciones experimentales fueron elaboradas con maíz de diferentes tamaños de partículas: 565, 620, 781, 1085 µm de diámetro geométrico medio (DGM). La alimentación fue ad libitum a las 8:00 y a las 16:00h. Las variables analizadas fueron: consumo de ración, porcentaje de postura, masa y peso de los huevos, conversión alimenticia (se calculó dividiendo el alimento consumido por el peso total de huevos (kg/kg) y el número de huevos producidos (kg/docena)), porcentaje y espesor de cáscara, unidad Haugh, índice y coloración de yema, y análisis morfométrica de la mucosa intestinal. La utilización de maíz con DGM de hasta 1085 µm en las raciones no perjudica el rendimiento y la calidad de los huevos de las ponedoras Hisex Brown. Sin embargo, hay indicaciones de que la morfometría intestinal de gallinas ponedoras es influenciada de forma negativa por el aumento del tamaño de las partículas del maíz.(AU)

Performance and egg quality of laying hens fed with mineral sources and rosemary oil.

In order to evaluate the effect of rosemary oil and micro mineral sources on the performance and egg quality of laying hens, 288 hens were used and distributed in a completely randomized design using a 2x3 factorial (mineral sources x rosemary oil) with six different diets and six replications. Diets were formulated containing inorganic or organic minerals, with or without added rosemary oil (100 and 200 mg kg-1). The treatments showed interaction for average egg weight, yolk color, albumen and yolk percentage, with significant results from the use of organic minerals compared to inorganic minerals. The addition of 200 mg kg-1 rosemary oil in diets improved laying rate, egg mass, specific gravity, number of pores on the shell when compared to other treatments. In conclusion, the use of 200 mg kg-1 of rosemary oil improves the performance of red laying hen eggs. The association between organic minerals and 100 mg kg-1 rosemary oil in laying hen diets increases yolk color and percentage of albumen. The use of organic minerals is superior to inorganic minerals as to improve the quality of eggs, increasing average egg weight, yolk color and percentage of albumen.

Exploring cellular uptake of iron oxide nanoparticles associated with rhodium citrate in breast cancer cells.

Nanocarriers have the potential to improve the therapeutic index of currently available drugs by improving their efficacy and achieving therapeutic steady-state levels over an extended period. The association of maghemite-rhodium citrate (MRC) nanoparticles (NPs) has the potential to increase specificity of the cytotoxic action. However, the interaction of these NPs with cells, their uptake mechanism, and subcellular localization need to be elucidated. This work evaluates the uptake mechanism of MRC NPs in metastatic and nonmetastatic breast cancer-cell models, comparing them to a nontumor cell line. MRC NPs uptake in breast cancer cells was more effective than in normal cells, with regard to both the amount of internalized material and the achievement of more strategic intracellular distribution. Moreover, this process occurred through a clathrin-dependent endocytosis pathway with different basal expression levels of this protein in the cell lines tested.