Application of fluorescein sodium videoangiography in aneurysm surgery.

BACKGROUND: The use of fluorescent technologies in vascular neurosurgery emerged after indocyanine green video angiography (ICG-VA) was first described in 2003. As data supporting the efficiency of ICG in preventing postoperative complications has grown substantially, it has now established itself as the standard of care. However, the predominant literature centers on ICG techniques, leaving the evaluation of cost-effective fluorescein tools pending. We report the results of a prospective study in which we demonstrated the impact of intraoperative fluorescein videoangiography (FL-VA) in aneurysm surgery. METHODS: Between December 2021 and September 2022, a total of 57 patients underwent craniotomy for intracranial aneurysm surgery. After aneurysm clipping, we administered a 0.5 mg/Kg of sodium fluorescein, and the intracranial area of interest was inspected through the microscope integrated module. The following data were collected: patient age and sex; number of clipped aneurysms; aneurysm location, size, and rupture status; Hunt Hess grade; intraoperative rupture; aneurysm calcification and thrombosed aneurysm; visualization of blood flow in perforating arteries; need for a clip adjustment after FL-VA analysis by neurosurgeon. RESULTS: For the surgical clipping of 64 aneurysms in 57 patients, 80 FL-VA studies were performed. Clip adjustments were performed following FL-VA in 13 aneurysms. FL-VA had an impact on 20 % of the clipping. In seven aneurysms, clip adjustment was due to the "presence of residual aneurysm", in three cases due to the "presence of neck", and in three cases due to "adjacent vessel stenosis". Regarding the evaluation of flow in the perforating vessels, it was possible, with a good and detailed image in all cases. CONCLUSION: The use of FL-VA has a significant impact in aneurysm surgery, enhancing effectiveness and safety. The dosage of 0.5 mg/kg administered is sufficient for assessing both aneurysm occlusion and the presence of flow in adjacent vessels.

Fluorescein-Guided Surgery for Arteriovenous Malformation.

Microscopes with fluorescence modality for videoangiography (VAG) using indocyanine green or sodium fluorescein (FL) have been used in cerebrovascular surgeries as tools for brain blood flow assessment in vascular diseases, especially in brain aneurysms, extracranial-intracranial bypass, and arteriovenous malformations (AVMs). Indocyanine green-VAG is a well-documented tool frequently employed as an adjunct to microsurgery for AVM treatment. Nevertheless, it's worth noting that the use of FL-VAG has been significantly underrepresented in medical literature, with only a few studies addressing its application in this context.1,2 We report a case of a 33-year-old woman with a grade 1 frontal unruptured AVM, admitted because of recurrent headache. The AVM was exposed with a centered craniotomy (Video 1). Three FL injections were administered at different timing: 1) at the procedure's outset (before any dissection), 2) when the surgeon estimated most feeders had been disconnected, and 3) after the removal of the nidus. FL-VAG allowed visualization of the superficial AVM vessels and its draining veins. After identification and disconnection of feeding arteries, diminished blood flow was visualized and the AVM was completely removed, confirming no residual lesion by absence of FL on the surgical bed. Postoperative digital angiography showed complete removal of the AVM. FL-VAG represents a valuable adjunct in the AVM resection by facilitating the assessment of blood flow within cerebral vessels. This can be helpful to modify surgical strategies in some circumstances (e.g., selection of the main feeders vs. arteries in passage) and to save time making decisions about draining vein division and nidus removal.

Dermatological evaluation in dogs with atopic dermatitis treated with full-spectrum high cannabidiol oil: a pre study part 1.

Introduction: Dermatological consultations represent a great part of the small animal medical clinic routine. Canine atopic dermatitis (CAD) is a common skin disease that affects a significant amount of dogs, making it a relevant consideration in clinical practice. The role of the endocannabinoid system on skin homeostasis has been described and its deregulation contributes to dermatopathies. Its function in specialized skin cells reveals an expressive therapeutic potential. Due to the difficulties and the growing scientific evidence of the therapeutic benefits of cannabis on animals, this work aimed to evaluate the anti-inflammatory effects of cannabis-derived oil in the treatment of CAD. Methods: Fourteen canines diagnosed with CAD were divided into two groups: T: full spectrum high cannabidiol (CBD) cannabis oil, 2,5 mg/kg; and C: control group (treated with olive oil alone). The effectiveness was evaluated based on the degree of pruritus, dermatological evaluation (CADESI-4) and histopathological evaluation of the skin including mast cell count. Results: Despite the theoretical basis, there were no significant results obtained between the compared treatments. Discussion: Thus, it can be concluded that although full spectrum high cannabinoids therapy presents a promising approach to immunological diseases, further research is required in order to establish the actual effective cannabinoid ratio within the myriad possible combinations and for multi-target therapy of CAD.

Implantação do Time de Resposta Rápida em um Hospital Público Pediátrico

Este artigo tem por objetivo descrever a experiência na implantação e condução do trabalho do Time Reposta Rápida em um hospital público pediátrico 100% Sistema Único de Saúde, indicando fatores que funcionaram como facilitadores e dificultadores desta implantação. Realizado estudo descritivo, qualitativo, do tipo relato de experiência. Na implantação do Time Reposta Rápida na enfermaria A do Hospital Infantil Nossa Senhora da Glória (Milena Gottardi), foram identificados vários fatores que funcionaram como facilitadores para esta implantação, dentre eles o envolvimento de grande parte da equipe em todas as etapas. Quanto aos dificultadores cita-se a demora na aquisição dos equipamentos, materiais e insumos, face às questões legais e burocráticas no processo de licitação e compras; grande esforço para adaptar as escalas dos profissionais a realidade do serviço; demora no processo de capacitação dos médicos da equipe; resistência de alguns profissionais por não compreenderem a magnitude do Time Reposta Rápida na realidade local. A implantação do Time Reposta Rápida pode oferecer subsídios para reorganização dos processos de trabalho.

Nasopharyngeal carcinoma in a non-endemic country-Validation of the new NPC staging system.

BACKGROUND: Nasopharyngeal carcinoma (NPC) staging has recently been updated, with the eighth edition of the AJCC/UICC. In the last ten years, Intensity Modulated Radiotherapy (IMRT) has become a standard treatment for NPC. The authors aim to assess the benefits of the new AJCC staging system in predicting prognosis, as well as the improvement in survival outcomes in the IMRT era, in non-edemic population. METHODS: Retrospective study selecting patients treated for NPC between January 2009 and December 2019 in a cancer treatment center in Portugal. Initial TNM staging (according to the seventh edition of the AJCC/UICC) was collected and each patient was restaged according to the new TNM staging system. Overall survival (OS) and Distant Metastasis Free Survival (DMFS) stratified by T and N classification and stage (according to the both TNM staging systems) were analyzed. Univariate and multivariate analysis was performed to evaluate which factors influence OS and DMFS. Data in this series was compared with a previous report from the same institution, before IMRT standard use. RESULTS: 113 patients were included, averaging 53.74 (±1.4) years old. With the new TNM staging, 5 patients were downstaged and 3 patients were upstaged. Over a median follow-up time of 41 months, the 5-year OS and DMFS were 77% and 79.8%, respectively. Neither the seventh nor the eighth editions of the AJCC/UICC staging system had good overall discrimination between each T classification OS and DMFS curves. Both the seventh and the eighth editions of the AJCC/UICC staging system had statistically significant overall discrimination between each N group and each stage group classification OS curves. Only N classification predicted OS in multivariate analysis. When comparing to a previous report from the same institution, OS has not improved majorly, especially in locoregionally advanced disease. CONCLUSIONS: TNM staging still presents limitations in adequately predicting OS and DMFS.

Combined Omics Approach Reveals Key Differences between Aerobic and Microaerobic Xylene-Degrading Enrichment Bacterial Communities: Rhodoferax─A Hitherto Unknown Player Emerges from the Microbial Dark Matter.

Among monoaromatic hydrocarbons, xylenes, especially the ortho and para isomers, are the least biodegradable compounds in oxygen-limited subsurface environments. Although much knowledge has been gained regarding the anaerobic degradation of xylene isomers in the past 2 decades, the diversity of those bacteria which are able to degrade them under microaerobic conditions is still unknown. To overcome this limitation, aerobic and microaerobic xylene-degrading enrichment cultures were established using groundwater taken from a xylene-contaminated site, and the associated bacterial communities were investigated using a polyphasic approach. Our results show that the xylene-degrading bacterial communities were distinctly different between aerobic and microaerobic enrichment conditions. Although members of the genus Pseudomonas were the most dominant in both types of enrichments, the Rhodoferax and Azovibrio lineages were only abundant under microaerobic conditions, while Sphingobium entirely replaced them under aerobic conditions. Analysis of a metagenome-assembled genome of a Rhodoferax-related bacterium revealed aromatic hydrocarbon-degrading ability by identifying two catechol 2,3-dioxygenases in the genome. Moreover, phylogenetic analysis indicated that both enzymes belonged to a newly defined subfamily of type I.2 extradiol dioxygenases (EDOs). Aerobic and microaerobic xylene-degradation experiments were conducted on strains Sphingobium sp. AS12 and Pseudomonas sp. MAP12, isolated from the aerobic and microaerobic enrichments, respectively. The obtained results, together with the whole-genome sequence data of the strains, confirmed the observation that members of the genus Sphingobium are excellent aromatic hydrocarbon degraders but effective only under clear aerobic conditions. Overall, it was concluded that the observed differences between the bacterial communities of aerobic and microaerobic xylene-degrading enrichments were driven primarily by (i) the method of aromatic ring activation (monooxygenation vs dioxygenation), (ii) the type of EDO enzymes, and (iii) the ability of degraders to respire utilizing nitrate.

Validity, reliability and measurement error of quadriceps femoris muscle thickness obtained by ultrasound in healthy adults: a systematic review / Validade, confiabilidade e erro da medida da espessura muscular do quadríceps femoral obtida pela ultrassonografia em adultos saudáveis: uma revisão sistemática

Abstract Due to its low cost and operational simplicity, ultrasound has been used to monitor muscle thickness in laboratory environments, rehabilitation clinics, and sports clubs. However, it is necessary to determine the measurement's quality to infer whether the possible changes observed are derived from the treatment or the measurement error. Therefore, we performed a systematic review to determine the validity, reliability, and measurement error of quadriceps femoris muscle thickness obtained by ultrasound in healthy adults. A search was conducted in the Pubmed, Scopus, and Web of Science databases until April 2022. The study selection process was carried out by two independent researchers, with the presence of a third researcher in case of disagreements. Twenty-six studies were eligible for the review, being 4 of validity, 4 of reliability only, and 18 of reliability and measurement error. The intraclass correlation coefficient ranged from 0.60 to 0.99 in validity studies and from 0.44 to 0.99 in reliability studies. The typical error of measurement ranged from 0.01 to 0.47 cm, and the coefficient of variation was from 0.5 to 17.9%. Four studies received "very good" classification in all the risk of bias analysis criteria. Therefore, it is concluded that the quadriceps femoris muscle thickness obtained by ultrasound was shown to be valid, reliable, and to have low measurement errors in healthy adults. The weighted average of the relative error was 6.5%, less than typical increases in resistance training studies. The raters' experience and methodological care for repeated measurements were necessary to observe low measurement errors.

Resumo Devido ao baixo custo e simplicidade operacional, a ultrassonografia tem sido utilizada para monitorar a espessura muscular em ambientes laboratoriais, clínicas de reabilitação e clubes desportivos. Porém, é necessário determinar a qualidade da medida para inferir se as possíveis modificações observadas são decorrentes do tratamento ou do erro da medida. Portanto, realizamos uma revisão sistemática para determinar a validade, confiabilidade e erro da medida da espessura muscular do quadríceps femoral obtida pela ultrassonografia em adultos saudáveis. Foi realizada busca nas bases de dados Pubmed, Scopus e Web of Science até abril de 2022. O processo de seleção dos estudos foi realizado por dois pesquisadores independentes, com a presença de um terceiro pesquisador em caso de divergências. Vinte e seis estudos foram elegíveis para a revisão, sendo 4 de validade, 4 apenas de confiabilidade e 18 de confiabilidade e erro de medida. O coeficiente de correlação intraclasse variou de 0,60 a 0,99 em estudos de validade e 0,44 a 0,99 em estudos de confiabilidade. O erro típico da medida variou de 0,01 a 0,47 cm e o coeficiente de variação foi de 0,5 a 17,9%. Quatro estudos receberam classificação "muito bom" em todos os critérios na análise de risco de viés. Portanto, concluiu-se que a espessura muscular do quadríceps femoral obtida pela ultrassonografia se mostrou válida, confiável e com baixos erros de medida em adultos saudáveis. A média ponderada do erro relativo foi de 6,5%, menor do que os aumentos típicos em estudos de treinamento resistido. A experiência dos avaliadores e o cuidado metodológico com as medidas repetidas foram necessários para observar baixos erros de medida.

Isolation of Pseudomonas aromaticivorans sp. nov from a hydrocarbon-contaminated groundwater capable of degrading benzene-, toluene-, m- and p-xylene under microaerobic conditions.

Members of the genus Pseudomonas are known to be widespread in hydrocarbon contaminated environments because of their remarkable ability to degrade a variety of petroleum hydrocarbons, including BTEX (benzene, toluene, ethylbenzene and xylene) compounds. During an enrichment investigation which aimed to study microaerobic xylene degradation in a legacy petroleum hydrocarbon-contaminated groundwater, a novel Gram-stain-negative, aerobic, motile and rod-shaped bacterial strain, designated as MAP12T was isolated. It was capable of degrading benzene, toluene, meta- and para- xylene effectively under both aerobic and microaerobic conditions. The 16S rRNA gene sequence analysis revealed that strain MAP12T belongs to the genus Pseudomonas, with the highest 16S rRNA gene similarity to Pseudomonas linyingensis LYBRD3-7 T (98.42%), followed by Pseudomonas sagittaria JCM 18195 T (98.29%) and Pseudomonas alcaliphila JCM 10630 T (98.08%). Phylogenomic tree constructed using a concatenated alignment of 92 core genes indicated that strain MAP12T is distinct from any known Pseudomonas species. The draft genome sequence of strain MAP12T is 4.36 Mb long, and the G+C content of MAP12T genome is 65.8%. Orthologous average nucleotide identity (OrthoANI) and digital DNA-DNA hybridization (dDDH) analyses confirmed that strain MAP12T is distinctly separated from its closest neighbors (OrthoANI < 89 %; dDDH < 36%). Though several members of the genus Pseudomonas are well known for their aerobic BTEX degradation capability, this is the first report of a novel Pseudomonas species capable of degrading xylene under microaerobic conditions. By applying genome-resolved metagenomics, we were able to partially reconstruct the genome of strain MAP12 T from metagenomics sequence data and showed that strain MAP12 T was an abundant member of the xylene-degrading bacterial community under microaerobic conditions. Strain MAP12T contains ubiquinone 9 (Q9) as the major respiratory quinone and diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine as major polar lipids. The major cellular fatty acids of strain MAP12T are summed feature 3 (C16:1ω6c and/or C16:1ω7c), C16:0 and summed feature 8 (C18:1ω6c and/or C18:1ω7c). The results of this polyphasic study support that strain MAP12T represents a novel species of the genus Pseudomonas, hence the name of Pseudomonas aromaticivorans sp. nov. is proposed for this strain considering its aromatic hydrocarbon degradation capability. The type strain is MAP12T (=LMG 32466, =NCAIM B.02668).

Ancient DNA from a 2700-year-old goitered gazelle (Gazella subgutturosa) supports gazelle hunting in Iron Age Central Asia.

Central Asia has been an important region connecting the different parts of Eurasia throughout history and prehistory, with large states developing in this region during the Iron Age. Archaeogenomics is a powerful addition to the zooarchaeological toolkit for understanding the relation of these societies to animals. Here, we present the genetic identification of a goitered gazelle specimen (Gazella subgutturosa) at the site Gazimulla-Tepa, in modern-day Uzbekistan, supporting hunting of the species in the region during the Iron Age. The sample was directly radiocarbon dated to 2724-2439 calBP. A phylogenetic analysis of the mitochondrial genome places the individual into the modern variation of G. subgutturosa. Our data do represent both the first ancient DNA and the first nuclear DNA sequences of this species. The lack of genomic resources available for this gazelle and related species prevented us from performing a more in-depth analysis of the nuclear sequences generated. Therefore, we are making our sequence data available to the research community to facilitate other research of this nowadays threatened species which has been subject to human hunting for several millennia across its entire range on the Asian continent.

Grapiprant or carprofen following ovariohysterectomy in the cat: analgesic efficacy, hematological, biochemical and urinalysis evaluation.

OBJECTIVES: This study aimed to compare the analgesic effect between carprofen and grapiprant every 12 or 24 h on postoperative pain in cats undergoing ovariohysterectomy, in addition to the effects on the hematological, biochemical and urinalysis variables. METHODS: A total of 32 female cats were randomly divided into three groups, according to the treatment administered with the first dose given orally 90 mins before surgery, as follows: CAR (cats received 4 mg/kg carprofen, n = 11); GRA1 (cats received 2 mg/kg grapiprant, n = 10); and GRA2 (cats received 2 mg/kg grapiprant q12h, n = 11). Pain was assessed by UNESP-Botucatu Multidimensional Composite Pain Scale (UNESP) and Glasgow Feline Composite Measure Pain Scale (GLASGOW) for cats preoperatively (baseline) and at 1, 3, 6, 8, 12 and 24 h after extubation. Venous blood was collected at baseline, and 12 and 24 h after the administration of carprofen or grapiprant to perform a complete blood count (CBC), the percentage of Heinz bodies and serum biochemistry (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltransferase, creatinine and urea). Urinalysis was performed at baseline and 24 h after extubation. Glucose levels were evaluated at baseline and 1 h postoperatively. RESULTS: Pain scores were not significantly different among groups in both scales, although pain was higher at 3 h in comparison with 24 h in all groups. In the GRA1 and GRA2 groups, 67% (14/21) of cats needed rescue analgesia compared with 18% (2/11) in the CAR group. Glucose increased from baseline to 1 h in the GRA1 and GRA2 groups. None of the CBC, serum biochemistry and urinalysis variables differed among groups. CONCLUSIONS AND RELEVANCE: Grapiprant did not promote adequate analgesia during the first 3 h postoperatively in cats undergoing ovariohysterectomy compared with carprofen, and no benefits were observed by administering grapiprant every 12 h.

The variability of isokinetic ankle strength is different in healthy older men and women

Abstract Context In the elderly, weak lower limb muscles impair functional tasks' performance. Objective To evaluate the healthy elderly's ankle dorsiflexion and plantarflexion maximum torque and its variability in two sets of 5 RM isokinetics evaluation. Method 50 women (68.0 ± 4.6 years old) and 50 men (72.7 ± 8.5 years old) did two sets of ankle plantar flexor and dorsiflexor isokinetic tests at 30°/s. Peak torque, total work, and coefficient of variation were analyzed. Results Men did the strongest plantarflexion torque (p < 0.05) and dorsiflexion torque (p < 0.05); their highest peak torque occurred at set 2 (p < 0.05), while the largest plantarflexion torque variability (p < 0.05), dorsiflexion torque variability (p < 0.05), and the largest plantarflexion torque variability occurred at set 1 (p < 0.05). Men did the highest plantarflexion and dorsiflexion total work (p < 0.05) at set 2 (p < 0.05). Conclusion Older men are stronger than older women. The torque variability, in men, was higher during the first set, suggesting an adaptation to the isokinetics evaluation. Clinicians and researchers should consider that different muscles might need different numbers of sets and trials to measure their maximal muscle strength.

Contribuições da teoria do reconhecimento para o cuidado em saúde / Contributions of the theory of recognition to healthcare / Contribuciones de la teoría del reconocimiento para el cuidado en salud

Resumo Embasado em Axel Honneth, este estudo teórico descreve elementos da teoria do reconhecimento e suas interfaces com a autonomia de usuários(as) no cuidado em saúde, retratando as esferas do direito, do amor e da solidariedade em suas interfaces com a autonomia. A partir de considerações reflexivas sobre a prática profissional e o cuidado ofertado, conclui-se que a teoria do reconhecimento pode servir como estrutura que amplia a compreensão de situações do contexto de saúde, especialmente aquelas em que os elementos da esfera de reconhecimento são suprimidos ou prejudicados. A translação da teoria para o campo do cuidado de saúde abre perspectivas interessantes para compreender o valor do direito, do amor, da solidariedade na saúde e de possíveis consequências de sua inobservância.

Abstract Based on Axel Honneth, this theoretical study describes elements of the theory of recognition and its interfaces with user autonomy in healthcare, describing how the spheres of rights, love, and solidarity intersect with autonomy. From reflections on professional practice and the care offered, one concludes that the theory of recognition can serve as a framework that expands the understanding of healthcare situations, especially those in which elements of recognition are suppressed or impaired. Applying the theory to the field of healthcare opens interesting perspectives for understanding the value of rights, love, and solidarity in healthcare and the possible consequences of their non-observance.

Resumen Basado en Axel Honneth, este estudio teórico describe elementos de la teoría del reconocimiento y sus interfaces con la autonomía de los(las) usuarios(as) en el cuidado en salud, retratando las esferas del derecho, del amor y de la solidaridad en sus interfaces con la autonomía. Con base en las consideraciones reflexivas sobre la práctica profesional y el cuidado ofrecido, se concluye que la teoría del reconocimiento puede servir como un marco que amplíe la comprensión de las situaciones en el contexto sanitario, especialmente aquellas en las que los elementos de la esfera del reconocimiento están suprimidos o perjudicados. La traslación de la teoría al ámbito del cuidado de la salud abre interesantes perspectivas para comprender el valor del derecho, del amor, de la solidaridad en la salud, y las posibles consecuencias de su desconocimiento.

Assessment methods of vastus lateralis muscle architecture using panoramic ultrasound: a new approach, test-retest reliability and measurement error / Métodos de avaliação da arquitetura do músculo vasto lateral usando ultrassonografia panorâmica: nova abordagem, confiabilidade teste-reteste e erro da medida

Abstract Extended-field-of-view ultrasonography is a valid alternative to determine the dimensions of the skeletal striated muscle; however, some factors may influence the final measurement. The aim of this study was to determine the test-retest reliability and measurement error of vastus lateralis muscle architecture variables through internal anatomical landmarks and to compare three fixed determined points using extended-field-of-view ultrasonography. Twelve young (24 ± 6 years) adult university male students participated in the study. Images were obtained through extended-field-of-view ultrasonography of the vastus lateralis muscle. Measurements were made for muscle thickness (MT), fascicle length (FL), and fascicle pennation angle (FA) using a method that identifies internal anatomical landmarks. MT was also measured at predetermined distances of 2 cm proximal, 6 cm proximal, and 2 cm distal. One-way ANOVA with repeated measures did not identify any test-retest significant differences for all variables measured. Typical measurement error in centimeters (cm) or degrees (º), coefficient of variation in percentage (%) and intraclass correlation coefficient were MT = 0.07 cm, 2.93%, 0.964; FL = 0.31 cm, 2.89%, 0.947; FA = 0.92°, 4.08%, 0.942; MT 2 cm proximal = 0.10 cm, 3.77%, 0.910; MT 6 cm proximal = 0.27 cm, 9.66%, 0.576; MT 2 cm distal = 0.35 cm, 19.76%, 0.564. MT, FL and FA showed high reliability and low measurement error. Internal anatomical landmarks proved to be more reliable and presented smaller measurement errors when compared to the predetermined distances method.

Resumo A ultrassonografia panorâmica é uma alternativa válida para determinar as dimensões da musculatura estriada esquelética, entretanto alguns fatores podem influenciar a medida final. Objetivou-se determinar a confiabilidade e o erro da medida das variáveis da arquitetura do músculo vasto lateral através de marcações anatômicas internas, bem como comparar dois métodos de avaliação diferentes através da ultrassonografia panorâmica. Doze homens (idade: 24 ± 6 anos) participaram do estudo. As imagens foram obtidas através da ultrassonografia panorâmica do músculo vasto lateral. Foram realizadas as medidas da espessura muscular (EM), comprimento do fascículo (CF) e ângulo de penação do fascículo (AP) através do método que identifica marcações anatômicas internas. A EM também foi medida através de distâncias predeterminadas de 2 cm proximal, 6 cm proximal e 2 cm distal. A ANOVA de uma via com medidas repetidas não identificou diferença significativa para todas as variáveis mensuradas, o erro típico de medida em centímetros (cm) ou graus (º), o coeficiente de variação em percentual (%) e o coeficiente de correlação intraclasse foram respectivamente: EM = 0,07 cm, 2,93%, 0,964; CF = 0,31 cm, 2,89%, 0,947; AP = 0,92º; 4,08%; 0,942; EM 2 cm proximal = 0,10 cm, 3,77%, 0,910; EM 6 cm proximal = 0,27 cm, 9,66%, 0,576; EM 2 cm distal = 0,35 cm, 19,76%, 0,564. EM, CF e AP apresentaram alta confiabilidade e baixo erro de medida. As marcações anatômicas internas demonstraram ser mais confiáveis e apresentam menores erros de medida quando comparados ao método de distâncias predeterminadas.

Does the residual effect of n-fertilization applied on corn phase maintain forage production of the following pasture phase in an integrated crop-livestock system? / O efeito residual da adubação nitrogenada aplicada na fase de milho mantém a produção de forragem da fase pastagem em sucessão em um sistema de integração lavoura-pecuária?

Nutrient cycling represents an important nutrient source in the Integrated Crop-Livestock Systems (ICLS). In general, only the crop phase of the ICLS is fertilized, however little is known about this residual effect of nitrogen fertilization from summer crop to succeeding winter pasture. This research aimed to evaluate the forage growth dynamic and botanical composition of a mixed pasture of black oat (Avena strigosa Schreb) and ryegrass (Lolium multiflorum Lam.) affected by two canopy height managements (high and low) and nitrogen fertilization applied to either the summer crop (corn) or winter pasture phase of an ICLS. The experiment was established in 2012 in southern Brazil. Black oat and ryegrass were growing during winter season and corn (Zea mays L.) during summer season, being this paper related to the 2014 pasture period. Treatments were composed by two canopy heights (25 and 10 cm) and two N-Fertilization Times (N-Pasture or N-Corn) of 200 kg of N ha-1. Canopy height was regulated by beef steers grazing through continuous stocking with a variable stocking rate. Forage mass was lower in the 10 cm canopy height on average, however this forage mass was composed by greater proportion of ryegrass leaves and lower proportion of dead material in relation to the treatment with 25 cm canopy height. The N-fertilization applied directly on pasture phase (N-Pasture) increased forage mass, tiller population density, participation of ryegrass and ryegrass leaf proportion in the forage mass. Furthermore, when pasture was fertilized with N, the forage accumulation rate increased about 69%, highlighting that the corn N-fertilization did not present significant effect on forage productivity. The residual effect of corn N-fertilization was not enough to maintain high forage accumulation. Thus, the pasture N-fertilization is fundamental to keep high-productive crop-livestock system. (AU)

A ciclagem de nutrientes representa uma importante fonte de nutrientes em sistemas de Integração Lavoura-Pecuária (ILP). Em geral, apenas a fase de lavoura é fertilizada, entretanto pouco se sabe sobre esse efeito residual da adubação nitrogenada realizada na lavoura de verão para as pastagens de inverno em sucessão. Esse trabalho objetivou avaliar a dinâmica de acúmulo de forragem e a composição botânica de uma pastagem mista de aveia preta (Avena strigosa Schreb) e azevém (Lolium multiflorum Lam.) manejada com duas alturas do pasto (alta e baixa) e com adubação nitrogenada realizada na cultura de grãos (milho) ou na fase pastagem de um sistema ILP. O experimento foi estabelecido em 2012 no sul do Brasil. Aveia preta e azevém eram cultivados durante o inverno e milho para grãos (Zea mays L.) era cultivado durante o verão, sendo esse trabalho relacionado ao período de pastagem em 2014. Os tratamentos foram compostos por duas alturas de manejo do pasto (25 e 10 cm) e duas épocas de adubação nitrogenada no sistema ILP (N-Pastagem ou N-Milho), na dose de 200 kg de N ha-1. A altura do pasto foi regulada por meio de pastejo com lotação contínua e taxa de lotação variável de novilhos de corte. Em média, a massa de forragem foi menor na altura do pasto de 10 cm, entretanto essa massa de forragem foi composta por uma maior proporção de folhas de azevém e menor proporção de material morto em relação ao tratamento com 25 cm. A adubação nitrogenada realizada diretamente na fase pastagem (N-Pastagem) aumentou a massa de forragem, a densidade populacional de perfilhos, a participação de azevém e a porcentagem de folhas de azevém na massa de forragem. Além disso, a adubação nitrogenada na fase pastagem aumentou a taxa de acúmulo de forragem em 69%, evidenciando que não há efeito significativo da adubação feita na lavoura de milho sobre a produtividade de forragem. O efeito residual da adubação nitrogenada na fase lavoura (milho) não foi suficiente para manter o alto acúmulo de forragem. Dessa forma, a adubação nitrogenada da fase pastagem em sistema ILP é fundamental para manter esses sistemas de produção agrícola e pecuária altamente produtivos. (AU)

Clinical validation of a graphical method for radiation therapy plan quality assessment.

BACKGROUND: This work aims at clinically validating a graphical tool developed for treatment plan assessment, named SPIDERplan, by comparing the plan choices based on its scoring with the radiation oncologists (RO) clinical preferences. METHODS: SPIDERplan validation was performed for nasopharynx pathology in two steps. In the first step, three ROs from three Portuguese radiotherapy departments were asked to blindly evaluate and rank the dose distributions of twenty pairs of treatment plans. For plan ranking, the best plan from each pair was selected. For plan evaluation, the qualitative classification of 'Good', 'Admissible with minor deviations' and 'Not Admissible' were assigned to each plan. In the second step, SPIDERplan was applied to the same twenty patient cases. The tool was configured for two sets of structures groups: the local clinical set and the groups of structures suggested in international guidelines for nasopharynx cancer. Group weights, quantifying the importance of each group and incorporated in SPIDERplan, were defined according to RO clinical preferences and determined automatically by applying a mixed linear programming model for implicit elicitation of preferences. Intra- and inter-rater ROs plan selection and evaluation were assessed using Brennan-Prediger kappa coefficient. RESULTS: Two-thirds of the plans were qualitatively evaluated by the ROs as 'Good'. Concerning intra- and inter-rater variabilities of plan selection, fair agreements were obtained for most of the ROs. For plan evaluation, substantial agreements were verified in most cases. The choice of the best plan made by SPIDERplan was identical for all sets of groups and, in most cases, agreed with RO plan selection. Differences between RO choice and SPIDERplan analysis only occurred in cases for which the score differences between the plans was very low. A score difference threshold of 0.005 was defined as the value below which two plans are considered of equivalent quality. CONCLUSION: Generally, SPIDERplan response successfully reproduced the ROs plan selection. SPIDERplan assessment performance can represent clinical preferences based either on manual or automatic group weight assignment. For nasopharynx cases, SPIDERplan was robust in terms of the definitions of structure groups, being able to support different configurations without losing accuracy.

Software mTEA: do Desenho Computacional à Aplicação por Profissionais com Estudantes com Autismo / Software mTEA: from Computer Design to Application by Professionals with Students with Autism

RESUMO: Uma forma viável de sistematização e personalização da intervenção delineada em Análise do Comportamento Aplicada (ABA), com estudantes com Transtorno do Espectro Autista (TEA), pode ser por meio de recursos computacionais. Assim sendo, este estudo teve como objetivo elaborar um ambiente digital denominado como mTEA para aplicação de programas de ensino por tentativas discretas, fundamentados na perspectiva comportamental, assim como avaliar o uso do mTEA, em relação à elaboração e à aplicação das atividades por duas profissionais com estudantes com TEA. Participaram duas profissionais e cinco crianças com TEA. O procedimento foi organizado da seguinte forma: desenvolvimento do sistema; na sequência, as duas profissionais elaboraram e aplicaram as atividades com cinco estudantes com TEA e responderam a um questionário sobre o uso do mTEA. Os resultados foram agrupados em relação ao desempenho dos estudantes com TEA nas atividades e ao uso do sistema pelas profissionais. Os resultados identificaram que o mTEA atingiu o objetivo proposto para personalizar as atividades propostas em cada currículo de ensino de cada estudante, apesar de ainda carecer de melhorias a serem implantadas futuramente.

ABSTRACT: A viable way to systematize and customize the intervention in Applied Behavior Analysis (ABA) with students with Autistic Spectrum Disorder (ASD) may be through computational resources. Thus, the objective of this study was to prepare a digital environment called mTEA for application of behavioral teaching programs by discrete trial, based on the behavioral perspective, as well as to evaluate the use of mTEA, in relation to the elaboration and application of the activities conducted by two professionals with students with ASD. The participants were two professionals and five students with ASD. The procedure was organized as follows: development of the system; then, the two professionals elaborated and applied the activities with five students with ASD and answered a questionnaire about the use of mTEA. The results were analyzed in relation to the performance of students with ASD in the activities and to the use of the system by the professionals. The results identified that mTEA reached the objective to customize the activities in each student's teaching curriculum, although it still lacks improvements to be implemented in the future.

Evaluation of postoperative pain and toxicological aspects of the use of dipyrone and tramadol in cats.

OBJECTIVES: The aim of this study was to evaluate the effects of dipyrone and tramadol, used for 5 days, on postoperative pain, hematological and biochemical parameters, and oxidative markers on erythrocytes. METHODS: Twenty-eight healthy cats underwent ovariohysterectomy and were randomly allocated to four groups (each n = 7), according to the postoperative treatment administered intravenously: control (saline 1 ml q8h), DIP1 (dipyrone 25 mg/kg q24h), DIP2 (dipyrone 25 mg/kg q12h) and DIP3 (dipyrone 25 mg/kg q8h). All animals received tramadol (2 mg/kg q8h). Pain was assessed by visual analog (VAS), multidimensional UNESP and Glasgow pain scales for cats preoperatively and at 3, 6, 12, 24, 36 and 48 h after extubation. Venous blood was collected daily for 5 days, and on day 10, to perform a complete blood count (CBC) and determine the percentage of Heinz bodies (HBs). Serum biochemistry was evaluated preoperatively and on days 5 and 10; superoxide dismutase (SOD), catalase (CAT), myeloperoxidase (MPO) and lipoperoxidation were evaluated preoperatively and on days 3, 5 and 10. RESULTS: Control cats had higher pain scores than DIP3 cats by UNESP (P = 0.0065), and DIP2 (P = 0.0035) and DIP3 cats (P = 0.0108) by VAS 3 h postoperatively. Rescue analgesia was required by two animals in the control group and one each in the DIP1 and DIP2 groups. There was no difference in SOD or CAT among groups. On day 5, MPO was more active in DIP2 than in DIP3 cats (P = 0.0274). No difference in lipoperoxidation among treatment and control cats was found. CBC remained constant and without statistical difference among groups. Control, DIP2 and DIP3 cats presented a similar percentage of HBs on day 10. Biochemical variables were similar among groups and times. CONCLUSIONS AND RELEVANCE: The administration of dipyrone in cats, when used in combination with tramadol, did not ensure better analgesia than tramadol alone. Dipyrone did not significantly affect biochemical variables and oxidative markers, despite minimal, clinically irrelevant, hematological differences between groups.

Grazing height targets for Alexandergrass pastures under continuous stocking in integrated crop-livestock system / Alturas de manejo para pastos de papuã sob lotação contínua em sistema de integração lavoura-pecuária

ABSTRACT: The aim of this experiment was to identify grazing height targets for Alexandergrass pastures under continuous stocking in integrated crop-livestock system (ICLS). For this purpose, twelve pastures were cultivated into an ICLS area, and maintained at 10, 20, 30, or 40 cm using grazing goats. The following variables were analyzed: leaf and herbage mass, accumulation rate, and allowance; leaf:stem ratio; chemical composition of hand-plucked samples; stocking rate; average daily gain and gain per area. The data were submitted to regression and correlation analysis. Significance was set at 5% (P≤0.05). The main results were: i) herbage and leaf lamina mass increased linearly with grazing height, and pastures maintained at 20 cm already presented the minimum amount recommended for soil cover in ICLS; ii) animal performance achieved an upper asymptotic plateau in pastures maintained around 30-40 cm and it was highly correlated with both grazing height and forage availability (mass and allowance). Alexandergrass pastures under continuous stocking in ICLS should be maintained between 30-40 cm to improve both cover crop biomass and animal performance.

RESUMO: O objetivo deste trabalho foi identificar alturas de manejo para pastos de papuã sob lotação contínua em sistemas de integração lavoura-pecuária (ILP). Para tanto, doze pastos foram cultivados em uma área de ILP e mantidos em 10, 20, 30 ou 40 cm por meio de lotação contínua com caprinos. As seguintes variáveis foram analisadas: massa; taxa de acúmulo e oferta de forragem e de folhas; relação lâmina:colmo; composição química de amostras de simulação de pastejo; carga animal; ganho médio diário e produção animal por área. Os dados foram submetidos a análises de regressão e correlação. A significância adotada foi de 5% (P≤0,05). Os principais resultados foram: i) houve um aumento linear na massa de forragem e folhas com o aumento da altura de manejo e pastos com mais de 20 cm já apresentavam a quantidade mínima recomendada para cobertura de solo em ILP ii) o desempenho animal atingiu um platô assintótico nos pastos manejados entre 30-40 cm e foi altamente correlacionado com a altura de manejo e a disponibilidade de forragem (massa e oferta). Pastos de Papuã manejados sob lotação contínua em ILP devem ser mantidos entre 30-40 cm para favorecer a produção de biomassa de cobertura e o desempenho animal.

Milk quality in small farms from Southern Region of Brazil / Qualidade do leite em pequenas propriedades da Região Sul do Brasil

ABSTRACT: This study aimed to evaluates some physical chemical aspects of chilled raw milk that meet Brazilian quality standards in smallholder farms from southern Region of Brazil. The fat content, crude protein (CP), total solids (TS), somatic cell count (SCC), and total plate count (TPC) of the chilled raw milk from 78 smallholder farms was analyzed between Oct 2014 and Feb 2017. It was found that 96% of the samples met the Brazilian regulations for fat content, 87% for CP, and 91% for TS. The mean values of TPC and SCC were higher than the maximum limits established by Brazilian regulations. Smallholder farms from Southern Region of Brazil produce milk with an adequate standard for the main chemical indicators. However, there is an important gap in compliance with hygienic-sanitary practices, leading to high levels of chilled raw milk that does not meet the limits of Brazilian regulations.

RESUMO: Objetivou-se avaliar alguns padrões físico-quimicos do leite cru refrigerado em relação ao atendimento aos padrões de qualidade brasileiros em pequenas propriedades da Região Sul do Brasil. O teor de gordura, proteína bruta (PB), sólidos totais (ST), contagem de células somáticas (CCS) e contagem total em placas (CTP) do leite cru refrigerado de 78 pequenas propriedades foram analisadas mensalmente entre outubro de 2014 e fevereiro de 2017. Verificou-se que 96% das amostras atenderam às regulamentações brasileiras para teor de gordura, 87% para PB e 91% para ST. Os valores médios de CTP e CCS foram superiores aos limites máximos estabelecidos pela regulamentação brasileira. Pequenas propriedades da Região Sul do Brasil produzem leite com adequado padrão para os principais indicadores químicos. No entanto, existe uma lacuna importante no cumprimento das práticas higiênico-sanitárias, levando a altos níveis de leite cru refrigerado que não atendem os limites da regulamentação brasileira.

Management of Locally Advanced Esthesioneuroblastoma in a Pregnant Woman.

Esthesioneuroblastoma (ENB) is a rare malignant tumor that commonly develops in the upper nasal cavity. Standard treatment is not established, especially in locally advanced disease which portends the worse prognosis. Hereby, we report a case of a 27-year-old, 23-week pregnant woman, with a 2-month history of progressively growing right cervical lymphadenopathy, nasal obstruction, anosmia, frequent episodes of epistaxis, and right frontal headache. Imagiological evaluation revealed a lesion with 7×5,2×3,2 cm in the nasal fossae with extension to the ethmoidal complex and right olfactive fend and invasion of the endocranial compartment associated with lymphadenopathy. The biopsy revealed a high-grade EBN. Neoadjuvant chemotherapy with cisplatin and etoposide was administrated during pregnancy and continued after delivery up to 6 cycles of treatment with partial response. Radiotherapy followed, with complete response. This case report is intended to highlight that a high grade of suspicion should be kept in the presence of nonspecific symptoms of nasal obstruction, anosmia, facial pain, and/or headache and focus that chemotherapy is an important component of a combined-treatment modality for locally advanced ENB that can be used during pregnancy in a lifesaving situation.