Association between oral and fecal microbiome dysbiosis and treatment complications in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation.

The oral and gastrointestinal mucosae represent the main targets of the toxic effect of chemo and/or radiotherapy administered during the conditioning regimen before hematopoietic stem cell transplant (HSCT). These harmful consequences and the immunological complications that may occur after the transplant (such as Graft versus Host Disease, GvHD) are responsible for the clinical symptoms associated with mucositis during the aplasia phase, like pain, nausea, vomiting, and diarrhea. These toxicities could play a critical role in the oral and gastrointestinal microbiomes during the post-transplant phase, and the degree of microbial dysbiosis and dysregulation among different bacterial species could also be crucial in intestinal mucosa homeostasis, altering the host's innate and adaptive immune responses and favoring abnormal immune responses responsible for the occurrence of GvHD. This prospective pediatric study aims to analyze longitudinally oral and gut microbiomes in 17 pediatric patients who received allogeneic HSCT for malignant and non-malignant diseases. The oral mucositis was mainly associated with an increased relative abundance of Fusobacteria, and Prevotella species, while Streptococcus descendants showed a negative correlation. The fecal microbiome of subjects affected by cutaneous acute GvHD (aGvHD) correlated with Proteobacteria. Oral mucosal microbiota undergoes changes after HSCT, Fusobacteria, and Prevotella represent bacterial species associated with mucositis and they could be the target for future therapeutic approaches, while fecal microbiome in patients with acute GvHD (aGvHD) revealed an increase of different class of Proteobacteria (Alphaproteobacteria and Deltaproteobacteria) and a negative correlation with the class of Gammaproteobacteria.

[Current status of requirements in the design of healthcare facilities to ensure accessibility for patients with disabilities]. / Estado actual de los requerimientos en el diseño de centros sanitarios para asegurar accesibilidad a pacientes con discapacidad.

BACKGROUND AND OBJECTIVE: People with disabilities are one of the groups that usually frequent healthcare centers, so it is essential to attend to their specific needs, especially from the point of view of universal accessibility, safety and healthcare quality. The aim of the study is to summarize the available evidence on the needs of groups of patients with some type of disability in access, navigation and stay during the reception of healthcare in various health centers and to identify successful solutions. MATERIALS AND METHODS: A scoping review had been designed, based on a literature review without time limit in three databases (PubMed, WOS, and Embase). RESULTS: Of the 2562 articles identified, 11 were included. Recommendations for improvement in the design of healthcare services focused on the following aspects: improving access to primary care centers; navigation, signage, and orientation in the hospital environment; elevator design; hospital room bathroom design; meeting the needs of wheelchair users; importance of the participation of the patient with a disability; involvement of stakeholders in the design process; and the need for appropriate policies to ensure accessibility to buildings. CONCLUSIONS: The promotion of artistic programs in healthcare settings and the participation of people with disabilities in the design process of healthcare settings could provide beneficial solutions. More studies are needed, given the scarcity of evidence found, to ensure that care for this group is based on criteria of patient safety, universal accessibility, healthcare quality and humanization.

Defoliation heights for palisade grass cv. Marandu in silvopastoral system / [Alturas de desfolhação para capim-marandu em sistema silvipastoril]

The objective was to test the response of Urochloa brizantha cv. Marandu in monoculture and in silvopastoral system (SPS), at two distances from the trees, and define the best defoliation height for SPS. Four intermittent defoliation heights (25, 35, 45 and 55cm) and two distances from tree lines (2.5 and 5.0m) were evaluated in the SPS with a control defoliated with 25cm in full sun. The experiment was performed in a randomized block design with 3 replicates in a 4 × 2 + 1 split plot scheme. The control had higher forage accumulation (46.9kg/ha. day) than the SPS (31.1kg/ha. day). The bulk density was also higher in the control (0.89mg/cm³) than in SPS (0.48mg/cm³). The percentage of leaves (78.06%) and leaf/stem ratio (6.04) did not differ among the treatments. In the SPS, there was an increase of 31.07% in forage accumulation from 25 to 55cm. The forage accumulation and bulk density of Urochloa brizantha cv. Marandu in monoculture is greater than in the SPS regardless of the management goal and the distance from trees. The goal of 55cm in the SPS presented greater forage accumulation.(AU)

O objetivo foi testar a resposta de pastos de Urochloa brizantha cv. Marandu em monocultivo e em sistema silvipastoril (SSP), a diferentes distâncias das árvores, bem como definir qual altura de desfolhação é a mais indicada para manejo em SPS. Foram avaliadas quatro alturas de desfolhação intermitente (25, 35, 45 e 55cm) e duas distâncias das linhas de árvores (2,5 e 5,0m), no SPS, e uma testemunha desfolhada com 25cm, em pleno sol. O delineamento foi em blocos ao acaso, com três repetições, em esquema de parcelas subdivididas 4 × 2 + 1. O controle apresentou maior acúmulo de forragem (46,9kg/ha.dia) que a média do SSP (31,1kg/ha.dia). A densidade volumétrica da forragem do controle (0,89mg/cm³) foi maior que a do SSP (0,48mg/cm³). A porcentagem de folhas (78,06%) e a relação folha/colmo (6,04) não diferiram entre os tratamentos. O aumento das alturas de 25 para 55cm no SSP resultou em aumento de 31,07% no acúmulo de forragem. O acúmulo e a densidade volumétrica da forragem são maiores no monocultivo, independentemente da meta de manejo e da distância das árvores no sistema silvipastoril. A meta de 55cm no silvipastoril apresenta maior acúmulo de forragem.(AU)

Effect of protein supplementation on yield and milk composition of F1 Holstein x Zebu cows kept in deferred pasture of brachiaria grass / [Efeito da suplementação de proteína na produção e na composição do leite de F1 vacas Holandês x Zebu mantidas em pasto diferido de capim-braquiária]

The objective of this study was to evaluate different supplementation strategies concentrated to F1 Holstein x Zebu lactating cows managed in deferred signal grass pasture on the yield and composition of milk and body weight gain. Thirty six F1 Holstein x Zebu cows with an average lactation period of 267 ± 10 days, mean body weight of 548 ± 19kg were used following a completely randomized design in a 4 x 5 factorial scheme, being four feeding strategies and five days under evaluation. The treatments consisted of four nutritional strategies: deferred pasture as a source of roughage without supplementation (PDSS); deferred pasture as a source of roughage with protein supplement offer (PDCS); deferred pasture supplemented with 15 kilos of corn silage (natural base) + 1,200 grams of protein supplement (PDSP) and corn silage (ad libitum) + 700 grams of protein supplement (SMP). There was no interaction (P> 0.05) between the nutritional plans and days under evaluation for any of the variables. It was found that cows fed SMP showed milk production 26.06% higher than the other nutritional plans (mean of 11.46kg/day). F1 Holstein/Zebu cows handled in deferred pasture in a traditional way supplemented with protein maintains milk yield.(AU)

Objetivou-se avaliar diferentes planos nutricionais para vacas F1 Holandês/Zebu mantidas em pasto diferido de capim-braquiária sobre a produção e a composição do leite e no ganho em peso corporal. Foram utilizadas 36 vacas F1 Holandês/Zebu com período médio de lactação de 267 ± 10 dias, peso corporal médio de 548 ± 19kg, seguindo o delineamento inteiramente ao acaso, em esquema fatorial 4 x 5, sendo quatro estratégias de alimentação e cinco dias em avaliação. Os tratamentos consistiram de quatro planos nutricionais: pasto diferida como fonte de forragem sem suplementação (PDSS); pastagem diferida como fonte de forragem com oferta de suplemento de proteico (PDCS); pasto diferido suplementado com 15 quilos de silagem de milho (base natural) + 1.200 gramas de suplemento proteico (PDSP) e silagem de milho (ad libitum) + 700 gramas de suplemento de proteína (SMP). Verificou-se que as vacas alimentadas com SMP apresentaram produção de leite 26,06% superior aos demais planos nutricionais (média de 11,46kg/dia). Vacas F1 Holandês/Zebu tratadas em pastagem diferida de maneira tradicional, suplementada com proteína, mantêm o rendimento de leite.(AU)

Effects of short-term feed restriction on the physiological parameters and metabolites of F1 Holstein x Zebu cows in different stages of lactation / [Efeitos da restrição alimentar de curto prazo sobre os parâmetros fisiológicos e metabólicos de vacas F1 Holstein x Zebu em diferentes estágios da lactação]

This study aimed to evaluate the effects of different nutritional plans on the productive, physiological and metabolic parameters of F1 ½ Holstein x ½ Zebu cows in different stages of lactation. Sixty lactating cows were allotted to a completely randomized 5 x 3 factorial design with five feed allowances and three lactation periods. The dry matter intake, milk yield and heart rate were reduced by 5.69kg, 2.41kg and 10.36 beats/min (morning) and 10.25 beats/min (afternoon) for each 1% feed restriction, respectively. There was no difference in the concentration of glucose, total protein, albumin, cholesterol and non-esterified fatty acids for cows subjected to different feed allowances, with means of 95.25, 7.98, 2.95, 121.68 and 0.45mg/dL, respectively. Feed restriction of up to 2.50% BW is a cost reduction strategy that does not alter milk yield, regardless of the stage of lactation.(AU)

Objetivou-se avaliar os efeitos de diferentes planos nutricionais sobre as características produtivas, fisiológicas e metabólicas de vacas F1 ½ Holandês x ½ Zebu. Foram utilizadas 60 vacas em lactação, seguindo-se o delineamento inteiramente ao acaso, em esquema fatorial 5 x 3, com cinco níveis de oferta de dieta e três períodos de lactação. À medida que se aumentou 1% na restrição da oferta da dieta, houve redução linear de 5,69kg no consumo de matéria seca pelos animais, 2,41kg na produção de leite, bem como de 10,36bat/min (manhã) e 10,25 bat/min (tarde) na frequência cardíaca dos animais. Não houve diferença para a concentração de glicose, proteínas totais, albumina, colesterol e NEFA com a restrição na oferta da dieta dos animais, sendo a média de 95,25, 7,98, 2,95, 121,68 e 0,45mg/dL, respectivamente. Recomenda-se a restrição de até 2,50% de peso corporal como estratégia de redução dos custos em todos os estágios em lactação, visando não alterar, economicamente, a produção de leite.(AU)

Quantitative and qualitative traits of carcass and meat of goats fed diets with cactus meal replacing corn.

The purpose of this study was to evaluate the quantitative and qualitative characteristics of the carcass and meat of goats fed diets containing cactus meal (pectin source) replacing corn (starch source). Twenty-eight goats with an average initial weight of 16 ± 2.02 kg were confined in a completely randomized design with four treatments (the replacement levels of 0, 330, 660, and 1000 g kg-1 of dry matter) and seven replicates. The productive performance of the animals was not affected by the replacement of corn by cactus meal. The carcass commercial yield and the dressing percentage decreased with the addition of cactus meal levels in the diets. The commercial cuts, however, especially prime cuts like hind limbs and loin, were not changed by the use of cactus meal. Muscle:bone and fat:bone ratios and muscularity index of hind limbs were influenced by the substitution. The protein and ash contents of the longissimus lumborum muscle decreased while cholesterol levels increased with the presence of cactus meal. Sensory traits of goats' meat fed cactus meal in the diets were not affected. The substitution of corn for cactus meal reduced carcass yield but did not change the yield of commercial cuts or the qualitative characteristics of the meat.

Clinical, histomorphological and therapeutic features of the Van der Woude Syndrome: literature review and presentation of an unusual case.

BACKGROUND: Van der Woude syndrome (VWS), an autosomal dominant condition associated with lower lip pits and/or cleft palate, is caused by mutations in the interferon regulatory factor 6 gene (lRF6 gene). The genetic alterations identified to date that contribute to expression of the syndrome are chiefly mutations located on chromosome 1 (the largest of our chromosomes), mutations at p36 that codifies the gene GRHL (grainy-head transcriptor factor) and mutations involving IRF6 (interferon regulatory factor). With frequency ranging from 1:35,000 to 1:100,000, depending on ethnicity, gender, and socio-economic status, the syndrome accounts for about 2% of orofacial clefts. The clinical and histomorphological aspects of VWS are studied, and a case of heterozygous female twins of whom only one was affected with VWS is reported. CONCLUSION: This very rare case (no similar case has been reported to date) contributes further evidence on modifying factors in the expression of this condition.

Palm kernel cake obtained from biodiesel production in diets for goats: feeding behavior and physiological parameters.

The objective of this study was to evaluate the effects of the inclusion of palm kernel (Elaeis guineensis) cake in diets for goats on feeding behaviors, rectal temperature, and cardiac and respiratory frequencies. Forty crossbred Boer male, non-castrated goats (ten animals per treatment), with an average age of 90 days and an initial body weight of 15.01 ± 1.76 kg, were used. The goats were fed Tifton 85 (Cynodon spp.) hay and palm kernel supplemented at the rates of 0, 7, 14, and 21% of dry matter (DM). The feeding behaviors (rumination, feeding, and idling times) were observed for three 24-h periods. DM and neutral detergent fiber (NDF) intake values were estimated as the difference between the total DM and NDF contents of the feed offered and the total DM and NDF contents of the orts. There was no effect of palm kernel cake inclusion in goat diets on DM intake (P > 0.05). However, palm kernel cake promoted a linear increase (P < 0.05) in NDF intake and time spent feeding and ruminating (min/day; %; period) and a linear decrease in time spent idling. Palm kernel cakes had no effects (P > 0.05) on the chewing, feeding, and rumination efficiency (DM and NDF) or on physiological variables. The use up to 21% palm kernel cake in the diet of crossbred Boer goats maintained the feeding behaviors and did not change the physiological parameters of goats; therefore, its use is recommended in the diet of these animals.

[Highlighting Service Excellence in Lorma].

Service excellence Training is an important continuing priority in Lorma Medical Center. Its design and contents are modified as needed to respond to patients' comments on the quality of service by Lorma staff. Noted inadequacies in customer satisfaction were bared in the Patient Surveys of Lorma in 2013. Floating of Satisfaction Assessments is done monthly by the Patient Relations Officer and summaries of the same are submitted by the Executive Secretary to the Department Heads concerned for immediate action, monitoring and reporting on improvements made. The premise is that process improvements should be based on data (1).

Effect of protein supplementation on ruminal parameters and microbial community fingerprint of Nellore steers fed tropical forages.

In tropical regions, protein supplementation is a common practice in dairy and beef farming. However, the effect of highly degradable protein in ruminal fermentation and microbial community composition has not yet been investigated in a systematic manner. In this work, we aimed to investigate the impact of casein supplementation on volatile fatty acids (VFA) production, specific activity of deamination (SAD), ammonia concentration and bacterial and archaeal community composition. The experimental design was a 4×4 Latin square balanced for residual effects, with four animals (average initial weight of 280±10 kg) and four experimental periods, each with duration of 29 days. The diet comprised Tifton 85 (Cynodon sp.) hay with an average CP content of 9.8%, on a dry matter basis. Animals received basal forage (control) or infusions of pure casein (230 g) administered direct into the rumen, abomasum or divided (50 : 50 ratio) in the rumen/abomasum. There was no differences (P>0.05) in ruminal pH and microbial protein concentration between supplemented v. non-supplemented animals. However, in steers receiving ruminal infusion of casein the SAD and ruminal ammonia concentration increased 33% and 76%, respectively, compared with the control. The total concentration of VFA increased (P0.05) in species richness and diversity of γ-proteobacteria, firmicutes and archaea between non-supplemented Nellore steers and steers receiving casein supplementation in the rumen. However, species richness and the Shannon-Wiener index were lower (P<0.05) for the phylum bacteroidetes in steers supplemented with casein in the rumen compared with non-supplemented animals. Venn diagrams indicated that the number of unique bands varied considerably among individual animals and was usually higher in number for non-supplemented steers compared with supplemented animals. These results add new knowledge about the effects of ruminal and postruminal protein supplementation on metabolic activities of rumen microbes and the composition of bacterial and archaeal communities in the rumen of steers.

Atividade Antimicrobiana da Uncaria Tomentosa (Willd) D. C. / Antimicrobial activity of Uncaria tomentosa (Willd) DC

A Uncaria tomentosa (Willd) D. C. (unha de gato) é uma planta amplamente utilizada na medicina popular, originária da Amazônia. Possui atividades biológicas, como anti-inflamatória, antimutagênica e antioxidante. O objetivo deste trabalho foi avaliar a atividade antimicrobiana do extrato de U. tomentosa, seco e hidroalcoólico, obtido comercialmente, utilizando-se 12 cepas de microrganismos (6 Gram-positvas e 6 Gram-negativas). Os testes antimicrobianos foram realizados em ágar BHI pela técnica de difusão em ágar. Também foram determinadas a Concentração Inibitória Mínima (CIM) e Concentração Microbicida Mínima (CMM). Os testes demonstraram que os extratos inibiram o crescimento de bactérias Gram-positivas e Gram-negativas, sendo o extrato hidroalcoólico mais eficiente que o extrato seco. Conclui-se que o extrato de U. tomentosa possui atividade antimicrobiana podendo ser utilizado como uma alternativa terapêutica de baixo custo...

The plant Uncaria tomentosa (Willd) DC. (cat's claw), found in the Amazon region and widely used in popular medicine, has anti-inflammatory, antimutagenic and antioxidant activities. The aim of this study was to test the antimicrobial activity of two commercially prepared extracts of U. tomentosa, one dried extract of bark and the other hydroalcoholic leaf extract, against 12 strains of bacteria (6 Gram-positive and 6 Gram-negative). The antimicrobial tests were conducted by diffusion in BHI agar. The Minimum Inhibitory Concentration (MIC) and the Minimum Microbicidal Concentration (MMC) were also determined. The tests showed that both extracts inhibited the growth of Gram-positive bacteria, but the hydroalcoholic extract was more effective and also inhibited Gram-negative bacteria. It is concluded that the U. tomentosa extract has an antimicrobial activity and can be used as a low-cost alternative treatment...

Atividade biológica do extrato hidroalcoólico de Bauhinia forficata Link sobre Herpetomonas samuelpessoai (Galvão. ) Roitman / Biologic activity of the hydroalcoholic extract of Bauhinia forficata Link on Herpetomonas samuelpessoai (Galvão. ) Roitman

Inúmeros esforços têm sido dirigidos para conferir às plantas seu real papel e valor na terapia. Este estudo teve como objetivo avaliar a atividade antimicrobiana, mutagênica, toxicidade, e os efeitos no crescimento e diferenciação de Herpetomonas samuelpessoai, do extrato hidroalcoólico de Bauhinia forficata. Para avaliar a atividade antimicrobiana foi realizado o teste de difusão em ágar, bem como a determinação das concentrações inibitória (CIM) e microbicida mínimas (CMM). O potencial clastogênico e/ou aneugênico, in vivo, foi avaliado usando o teste do micronúcleo em medula óssea de camundongos Swiss albinus. Foi determinada também a dose letal média (DL50). O extrato inibiu o crescimento de oito bactérias, mostrando-se mais ativo para Gram-positivas e não foi eficiente para os fungos, tendo sido ativo nas concentrações de 2000, 1000, 500 e 250 mg/mL contra os microrganismos testados. Os resultados mostraram que nas concentrações administradas (500, 1000 e 2000 mg/Kg), não houve aumento estatisticamente significativo de micronúcleos. Não houve ação no crescimento e diferenciação de Herpetomonas samuelpessoai nas concentrações testadas. Com relação a DL50, o extrato não apresentou toxicidade.

Numerous efforts have been directed to discover the role and the value of plants in therapy. This work aimed to evaluate the antimicrobial activity, mutagenicity, toxicity and effects on growth and differentiation of Herpetomonas samuelpessoai of the hydroalcoholic extract of Bauhinia forficata. To evaluate the antimicrobial activity it was performed the agar diffusion test, minimum inhibitory (MIC) and microbicidal (MMC) concentrations. The in vivo clastogenic and / or aneugênic potential was evaluated using the micronucleus test in mice bone marrow Swiss albinus. It was also determined the median lethal dose (LD50). The extract inhibited the growth of eight bacteria, being more active against Gram-positiveones, and was not active against fungi. The microorganisms tested had MIC concentrations of 2000, 1000, 500 and 250 mg / mL. The results showed that the tested concentrations (500, 1000 and 2000 mg / kg) had no statistically significant increasedthe micronucleus. There was no action on the growth and differentiation of Herpetomonas samuelpessoai at the concentrations tested. In respect to the LD50, the extract showed no toxicity.

Comportamento ingestivo de cordeiros alimentados com torta de macaúba / Ingestive behavior of lambs fed with macauba meal

Avaliaram-se os efeitos de diferentes porcentagens (0, 10, 20 e 30%) de inclusão da torta de macaúba (TM) no comportamento ingestivo de 24 cordeiros Santa Inês, com média de cinco meses de idade e peso vivo de 23,9kg, distribuídos em delineamento em blocos ao acaso, com quatro tratamentos e seis repetições, durante 60 dias de confinamento. Foram avaliados os tempos médios despendidos com alimentação, ruminação (TR), ócio (TO), tempo de mastigação total (TMT), eficiência de alimentação (EA MS e EA FDN) e eficiência de ruminação, além do número de bolos ruminados (NBR) e número diário de mastigações merícicas (MMnd). A adição de TM à dieta aumentou linearmente o TR, TMT, NBR, MMnd e EA FDN e reduziu de forma linear o TO, em consequência do maior teor de fibra em detergente neutro das dietas com o coproduto. Mesmo com o aumento no TMT, não foi verificada diferença no consumo e na eficiência de ruminação e alimentação da matéria seca, possivelmente em razão da baixa efetividade de fibra da TM, demonstrando o potencial de utilização desse coproduto na dieta de ovinos em crescimento.

The effects of different percentages (0, 10, 20 and 30%) of inclusion of macauba meal (MM) on the ingestive behavior of 24 Santa Inês male lambs, averaging five months of age and 23.9kg of initial body weight were studied. The animals were allotted to a completely randomized block design with four treatments and six replications during 60 days of confinement. The variables measured were time spent in rumination (TR), idle time (IT), total chewing (TC), power efficiency (PE DM and PE NDF) and efficiency of rumination, as well as the number of ruminated bolus (NRB) and daily number of chews (Cnd). The addition of MM to the diet increased TR, TC, NRB, Cnb and PE NDF linearly, and reduced IT linearly, as a result of higher content of neutral detergent fiber in the diet. Although there was an increase in TC, no difference was verified in the consumption and efficiency of rumination and feeding of DM, possibly due to the low efficiency of fiber, which demonstrates the potential use of this coproduct in the diet of growing sheep.