Composição química e cinética de degradação ruminal in vitro de aveia branca cv. URS guapa sob diferentes níveis de adubação nitrogenada / Chemical compounds and kinects of in vitro ruminal degradation of white oats URS Guapa under distinct levels of nitrogen fertilization

Avaliaram-se as doses de nitrogênio 0, 60, 120 e 240kg ha-1 sobre a composição bromatológica e os parâmetros da cinética de degradação ruminal da aveia branca obtida de dois anos de cultivo (2013-2014). Foram realizadas as análises de matéria seca, matéria mineral (MM), proteína bruta (PB), extrato etéreo, fibra em detergente neutro (aFDNmo), lignina, carboidratos solúveis (CHOs) e proteína insolúvel em detergente ácido (PIDA). Não foi observado efeito da adubação nitrogenada sobre as variáveis em nenhum dos anos de cultivo. As variáveis bromatológicas foram influenciadas pelos fatores ambientais. A cinética de degradação ruminal foi correspondente à composição bromatológica. No ano de 2013, foram observados valores superiores para as variáveis PB, MM, PIDA, CHOs e carboidratos não fibrosos, o que influenciou positivamente nos parâmetros da cinética de produção de gás in vitro, Vf 1 e k 2. A composição da cultivar em 2014 tendeu a maiores teores de aFDNmo, lignina e carboidratos totais e a valores superiores para os parâmetros Vf 2 e L. O parâmetro k 1 não foi significativo nos períodos avaliados. Em 2014 o valor nutritivo foi negativamente influenciado pelo atraso na semeadura e pela soma de períodos de restrição hídrica combinados com a elevação da temperatura.(AU)

Doses of Nitrogen were evaluated: 0, 60, 120 and 240kg ha-1 on the chemical composition and rumen degradation kinetics of white oats obtained from two consecutive years (2013-2014). For nutritional characterization the following parameters were analyzed: dry matter; ash, crude protein, ethereal extract, neutral detergent fiber, lignin, soluble carbohydrates and insoluble acid detergent protein. No effect of nitrogen fertilization was observed on the variables analyzed in any of the growing years. The nutritional variables were influenced by environmental factors that occurred in the respective experimental periods and the parameters of ruminal degradation kinetics corresponded to the effects in these compounds. In year 2013, higher values were observed for the variables crude protein, ash, insoluble acid detergent protein, soluble CHO and no fibrous carbohydrates, resulting in higher values also for the in vitro gas production kinetics, Vf1 and k2. Nutritional contents in 2014 tended to higher levels of NDF, lignin and total carbohydrates, and higher values for the parameters Vf2 and L. The parameter k1 was not significant in any of the experimental periods evaluated. In 2014 the forage has its nutritive value negatively influenced by the delay in sowing and the periods of water restriction combined with higher temperatures.(AU)

Association of sedentary behavior and metabolic syndrome.

OBJECTIVES: To examine the association of sedentary behavior (SB) with metabolic syndrome (MetS) in adults, as well as to identify the impact of physical inactivity and economic condition on such association. STUDY DESIGN: This is a cross-sectional study. METHODS: This study was conducted in the city of Bauru, São Paulo State, Brazil (n = 970). Television (TV) viewing and physical activity (PA) were assessed by questionnaire. MetS was assessed via medical records. Descriptive statistics and binary logistic regression were used in data analyses. RESULTS: Participants with moderate TV viewing were associated with MetS when compared with low TV viewing group, even after adjustments for age, sex, economic status, smoking, and PA (odds ratio [OR] = 1.49 [95% confidence interval {CI}: 1.01-2.20]). The fully adjusted model showed an association between high exposure to TV viewing with MetS (OR = 1.77 [95%CI: 1.11-2.82]). The combination of physical inactivity and high TV viewing boosted the likelihood of having MetS (OR = 1.89 [95%CI: 1.08-3.29]). CONCLUSION: The results of the present study suggest that moderate and high TV viewing time is associated with the presence of MetS, mainly in insufficiently active adults and those living in lower economic condition.

Arterial Thickness and Immunometabolism: The Mediating role of Chronic Exercise.

Metabolic alterations and cardiovascular diseases, such as atherosclerosis, are associated with lifestyle modifications, particularly the increase of physical inactivity and poor eating habits, which contribute to one of the main causes of death in modern times. Cardiovascular diseases are positively correlated with several illnesses, such as obesity, hypertension and dyslipidemia, and these disorders are known to contribute to changes in immune cells, cytokines and metabolism. Atherosclerosis is a chronic inflammatory disease characterized by the formation of lipid plaques and fibrous tissue (atheroma) in the artery walls and this process is related to the oxidation of LDL-c (low density lipoprotein) and the formation of a particle, termed LDLox, which can generate toxic injury to the vessel wall. In this atherogenic process there is an inflammatory response generated by the injury in the vascular endothelium, which in itself is able to express and secrete a variety of molecules, such as myeloid colony-stimulating factors (M-CSF), monocyte chemotactic protein-1 (MCP-1) and tumor necrosis factor alpha (TNF-α), that act as activators of the immune system. Therefore, the main purpose of this review is to highlight the immuno-metabolic alterations involving the thickening and stiffness of arteries observed in atherosclerosis, and how chronic exercise can act as an anti-inflammatory and anti-atherogenic approach.

The relationship between inflammation, dyslipidemia and physical exercise: from the epidemiological to molecular approach.

Dyslipidemia and inflammation are frequently found in some diseases, such as obesity, type 2 diabetes mellitus, and cancer cachexia. Recent literature has identified that lipids have a pivotal role in the activation of inflammatory pathways, increasing the production of inflammatory cytokines, mainly tumor necrosis factor alpha, interleukin 6 and 1ß. On the other hand, cytokines can promote disruption of lipid metabolism, in special cholesterol reverse transport, which is linked to development of atherosclerosis. With this in mind, acute and chronic exercise trainings have been pointed as important tools to counteract both dyslipidemia symptoms and systemic inflammation. Moreover, physical activity has been recommended in the prevention/treatment of the above mentioned outcomes by important health organizations around the world, mainly because it costs less and generates fewer side effects than isolated medicine. Despite the well-documented capacity of acute and chronic exercise training to counteract sustained disease-related immunometabolism, we have chosen to take a look from a current perspective in molecular pathways and in the field of epidemiology. The aim of the present review was therefore to discuss the results of dyslipidemia and inflammatory conditions with acute and chronic exercise training, which underlies the field of molecular pathways and epidemiology. The mechanisms underlying the response to the treatment are considered.

Viability of mesenchymal stem cells during electrospinning

Tissue engineering is a technique by which a live tissue can be re-constructed and one of its main goals is to associate cells with biomaterials. Electrospinning is a technique that facilitates the production of nanofibers and is commonly used to develop fibrous scaffolds to be used in tissue engineering. In the present study, a different approach for cell incorporation into fibrous scaffolds was tested. Mesenchymal stem cells were extracted from the wall of the umbilical cord and mononuclear cells from umbilical cord blood. Cells were re-suspended in a 10 percent polyvinyl alcohol solution and subjected to electrospinning for 30 min under a voltage of 21 kV. Cell viability was assessed before and after the procedure by exclusion of dead cells using trypan blue staining. Fiber diameter was observed by scanning electron microscopy and the presence of cells within the scaffolds was analyzed by confocal laser scanning microscopy. After electrospinning, the viability of mesenchymal stem cells was reduced from 88 to 19.6 percent and the viability of mononuclear cells from 99 to 8.38 percent. The loss of viability was possibly due to the high viscosity of the polymer solution, which reduced the access to nutrients associated with electric and mechanical stress during electrospinning. These results suggest that the incorporation of cells during fiber formation by electrospinning is a viable process that needs more investigation in order to find ways to protect cells from damage.

Viability of mesenchymal stem cells during electrospinning.

Tissue engineering is a technique by which a live tissue can be re-constructed and one of its main goals is to associate cells with biomaterials. Electrospinning is a technique that facilitates the production of nanofibers and is commonly used to develop fibrous scaffolds to be used in tissue engineering. In the present study, a different approach for cell incorporation into fibrous scaffolds was tested. Mesenchymal stem cells were extracted from the wall of the umbilical cord and mononuclear cells from umbilical cord blood. Cells were re-suspended in a 10% polyvinyl alcohol solution and subjected to electrospinning for 30 min under a voltage of 21 kV. Cell viability was assessed before and after the procedure by exclusion of dead cells using trypan blue staining. Fiber diameter was observed by scanning electron microscopy and the presence of cells within the scaffolds was analyzed by confocal laser scanning microscopy. After electrospinning, the viability of mesenchymal stem cells was reduced from 88 to 19.6% and the viability of mononuclear cells from 99 to 8.38%. The loss of viability was possibly due to the high viscosity of the polymer solution, which reduced the access to nutrients associated with electric and mechanical stress during electrospinning. These results suggest that the incorporation of cells during fiber formation by electrospinning is a viable process that needs more investigation in order to find ways to protect cells from damage.

Health care resource use and costs in opioid-treated patients with and without constipation in Brazil.

OBJECTIVE: To estimate the prevalence of constipation concomitant to opioid treatment and related resource use and costs from the private payer perspective. METHODS: In this retrospective database analysis, patients receiving opioid therapy were identified from a longitudinal insurance claims database. An algorithm was used to identify patients receiving opioid therapy with coincident constipation-related claims according to ICD-10 codes, targeted procedures, and opioid use criteria. Resource use and costs were determined for these individuals and compared with patients receiving opioid therapy without constipation, without opioid therapy with constipation, and without both conditions. Results were compared using analysis of variance with a significance level of 0.05. RESULTS: A total of 23,313 patients were classified as opioid-treated patients (2.2%) and 6678 of them had events related to constipation (29.0%). Compared with opioid-treated patients without constipation, incremental mean total costs per month per patient were 261.18 BRL (P < 0.001). The average cost per month for opioid-related constipation patients was 787.84 BRL, significantly higher than other patients (P < 0.001 for all comparisons). Among cancer patients, 24.4% was receiving opioids and 27.0% of those had constipation-related claims. As expected, the opioid therapy prevalence was significantly higher when compared to all patients (2.2% vs. 24.4%, P < 0.001). Cancer patients had, in average, higher costs than did noncancer patients in all four subgroups. CONCLUSIONS: Patients with constipation coincident with opioid treatment exhibited a significantly higher economic burden than did patients without the condition. These results indicate that reducing opioid-induced constipation could lead to potential cost savings for the health care system.

Ectopic placement of Sengstaken-Blakemore device to correct outflow obstruction in liver transplantation: case reports.

Liver transplantation is a complex procedure that has become the treatment for some end-stage liver diseases. Some technical features are important for the success of the transplantation, including the patency of the vascular anastomoses. In cadaveric whole organ liver transplantation, a large right subphrenic space may contribute to a twist of the inferior vena cava, leading to outflow obstruction, simulating an acute Budd-Chiari syndrome. Some devices can be used to correct this drainage problem. Herein, we have described 2 cases in which the Sengstaken-Blakemore balloon was safely used, in an ectopic position, to fix drainage complications in whole liver orthotopic transplantation.

Low socioeconomic status is a strong independent predictor of relapse in childhood acute lymphoblastic leukemia.

The results of the treatment of acute lymphoblastic leukemia (ALL) in children depend not only on the biologic diversity of the leukemia cell, the multi-drug treatment schedule and the individual variability of drug metabolism, but also on the socioeconomic and cultural background of the leukemic child. Social and cultural disparity is very marked in underdeveloped countries and has been increasing in industrialized nations. The prognostic influences of these factors are poorly documented and sometimes mistakenly attributed to differences in ethnic origin. We have investigated in Brazil the relative impact of malnutrition and socioeconomic status on the outcome of ALL, adjusting for the known influence of biologic factors. Children with ALL (n = 167) treated with a Berlin-Frankfurt-Munster-based protocol were studied prospectively. At a median follow-up of 1623 days, the estimated probability of disease-free survival was 43 +/- 4%. The main cause for interruption of remission was bone-marrow relapse. Socioeconomic indicators of poverty (poor housing conditions, low per capita income and energy consumption) were significantly associated with a greater risk of relapse in univariate analysis. They were consolidated in a single index, socioeconomic status (SES), defined by the product of monthly per capita income times mean familial daily energy consumption. Other unfavorable findings included age, z score for the height for age at diagnosis (HAZ) below-1.28 and the z score for weight for age below-1.28. After adjustment in Cox's multivariate model, only HAZ and poor SES remained as predictive factors for relapse. Poor prognosis for leukemic children of low SES is just another indicator of social inequality.

[Giant hemangioma treated with interferon alpha-2a]. / Hemangioma gigante tratado com Interferon Alfa-2a.

OBJECTIVE: The authors describe a case of giant hemangioma treated with interferon alpha-2a and review the role of this drug and other therapeutic modalities in the management of vascular lesions. METHODS: A seven month-old child with giant hemangioma and persistent bleeding, anemia and repeated infections was treated with interferon alpha-2a. The drug was administered at the dosage of 3 million units/m(2)/day, subcutaneously, for nine months. RESULTS: Response to treatment was considered excellent, with regression of 90% of the lesion, control of bleeding, infection and anemia, and catch-up growth. No untoward effects were observed. CONCLUSION: Interferon alpha-2a should be considered as a valid therapeutic option in selected cases of hemangioma in children.

Derivaçäo fêmoro-axilar direita para rrevascularizaçäo cerebral e do membro superior direito: relato de um caso / Femoral-axillary bypass for cerebral and right upper limb revascularization - report of a case

Com o objetivo de aumentar a irrigaçäo sanguínea cerebral e do membro superior direito, foi rrealizada uma derivaçäo fêmoro-axilar direita em uma paciente portadora de oclusöes e estenoses dos ramos supra-aórticos outras doenças associadas que näo permitiam a toracotomia. Embora os resultados näo tenham sido plenamente satisfatórios, este procedimento mostrou-se hemodinamicamente viável e uma alternativa válida para o tratamento da insuficiência vascular cerebral e de membros superiores, em casos eecíficos.

Anotacoes de enfermagem. / Nursing notes

As autoras sugeram normas gerais para o procedimento das anotacoes de enfermagem, visando a homogeneizar o ensino e facilitar a sedimentacao do aprendizado dos alunos de enfermagem