GASMoC method: a phenol-free technique to detect acid-fast bacilli.

The genre Mycobacterium includes a series of pathological species, such as M. tuberculosis, which is important for pathology laboratories to detect for a correct diagnosis. The Ziehl-Neelsen technique (ZNT) is the most commonly histochemical method used to detect these bacilli and uses a heated mixture of carbol-fuchsine, which contains basic fuchsine and phenol. Whereas the former component is responsible for the pinkish staining of acid-fast mycobacteria, the role of phenol is not completely understood and it has been suggested that its exclusion does not impact the detection ability of the ZNT. Since phenol is highly toxic and induces several injuries, the goal of this study is to determine the detection capacity of mycobacteria through a method that excludes the use of phenol. Accordingly, the GASMoC method, a modified ZNT that employs a solution of aqueous basic fuchsine heated at 37 °C, was tested on histological samples positive for mycobacteria and the results were compared to that of the ZNT. Data demonstrated that the GASMoC method was able to detect acid-fast bacilli (AFB) in all analyzed cases. Remarkably, microscopic inspection of mycobacteria was easier when the GASMoC method was applied. In conclusion, our study demonstrates that AFB detection does not require phenol and that the GASMoC method, a phenol-free technique, may substitute the ZNT in pathology laboratories.

Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

OBJECTIVES: Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). STUDY DESIGN: Cross-sectional ecological study. METHODS: Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. RESULTS: More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. CONCLUSION: Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances.

Cord lipoma in minimally invasive surgical repairs of inguinal hernias: a prospective study.

Cord lipomas are frequent findings in laparoscopic inguinal hernia surgeries in male patients. The symptoms of lipoma and the potential benefits of removing them are often overlooked because the focus is on the primary pathology of the hernia itself. Current recommendations are to reduce this fatty content, when present. When inguinal cord lipomas are left untreated in inguinal hernia surgery they can potentially cause symptoms and be detected in follow-up imaging exams. The objective of this study was to study incidence of cord lipomas in a cohort operated on by a single group specializing in abdominal wall surgery, as well as to analyze the possible relationship of this finding with the patient's symptoms, the characteristics of the operated hernia and postoperative outcome. This is a prospective study of male patients operated on for inguinal hernia laparoscopically or robotically in a single reference center. Of the total of 141 hernias, the distribution according to European Hernia Society classification showed that 45.4% were lateral, 19.1% medial and 35.5% mixed, highlighting a variety in the presentation of hernias. Analysis of the size of the hernias revealed that the majority (35.5%) were ≤ 1.5 cm. Inguinal cord lipoma was present in 64.5% of the samples, with no statistically significant association between the presence of the lipoma and an indirect hernia sac or obesity. The incidence of surgical site occurrences (SSO) was 9,2%, with seroma and hematoma. No recurrences were observed during follow-up, indicating a successful approach. There were no statistically significant relationships between SSO, the presence of lipoma and indirect hernial sac.

Volumetry after botulinum toxin A: the impact on abdominal wall compliance and endotracheal pressure.

PURPOSE: Botulinum toxin type A (BTA) is an adjuvant tool used in the preoperative optimization of complex hernias before abdominal wall reconstruction (AWR). This study aims to investigate changes in the abdominal cavity and hernia sac dimensions after BTA application. METHOD: A prospective study with 27 patients with a hernia defect of ≥ 10 cm and loss of domain (LOD) ≥ 20% underwent AWR. Computed tomography (CT) measurements and volumetry before and after the application of BTA were performed. Intraoperative and postoperative outcomes were evaluated. RESULTS: Imaging post-BTA revealed hernia width reduction of 1.9 cm (p = 0.002), lateral abdominal wall muscle elongation of 3.1 cm (p < 0.001), hernia volume reduction (HV) from 2.9 ± 0.9L to 2.4 ± 0.8L (p < 0.001), increase in abdominal cavity volume (ACV) from 9.7 ± 2.5L to 10.3L ± 2.4L (p = 0.003), and a reduction in the HV/ACV ratio from 30.2 ± 5% to 23.4 ± 6% (p < 0.001). Fascial closure was achieved in 92.6% of cases and component separation was required in 78%. The average variation in pulmonary plateau pressure was 3.53 cmH2O, and there were no postoperative respiratory failure recorded. At the 90-day follow-up, the wound morbidity rate was 25%, unplanned readmissions were 11%, and hernia recurrence 7.4%. CONCLUSION: BTA produces measurable volumetric changes in abdominal wall and appears to facilitate fascial closure. Further studies are required to determine the role of BTA in the surgical armamentarium for complex hernia repair.

Systematic review and meta-analysis of the pre-operative application of botulinum toxin for ventral hernia repair.

PURPOSE: Surgical repair of large hernia defects requires detailed pre-operative planning, particularly in cases with loss of domain. This situation often hampers mid-line reconstruction, even after component separation, when the size of the hernia is disproportional to the volume of the abdominal area. In this case, other strategies may be needed to place the viscera back into the abdominal cavity after reducing the hernia sac. The administration of botulinum toxin prior to the surgical procedure has been indicated as an adjunct for more complex cases. This results in stretching of the lateral musculature of the abdomen, allowing midline approximation. In addition, the application of botulinum toxin alone has been investigated as a means of downstaging in the management of ventral hernias, thereby precluding component separation and enabling primary closure of the midline by placement of mesh within the retromuscular space using the Rives Stoppa technique. METHODS: Systematic review of the literature for observational studies involving patients undergoing pre-operative application of botulinum toxin for ventral hernia repair was conducted according to the PRISMA guidelines. RESULTS: Advance of the lateral musculature of the abdomen by an average of 4.11 cm with low heterogeneity, as well as low rates of surgical site infection (SSI), surgical site occurrences (SSO) and recurrence, was shown. CONCLUSION: Pre-operative application of botulinum toxin for ventral hernia repair promoted an increase in the length of the lateral musculature of the abdomen which can help improve the outcomes of morbidity and recurrence.

Prolactinoma: a condition associated with hypoadiponectinemia.

Prolactinomas are prolactin-secreting neoplasias accounting for 40% of the pituitary adenomas. Much is known about the effects of prolactinomas on the reproductive system, but few data are yet available regarding their induced changes on metabolism. This study was aimed at evaluating patients with prolactinomas for insulin resistance and adiponectinemia. Forty patients with prolactinoma were allocated to 2 different groups according to disease control: 20 with uncontrolled disease (UPRL) and 20 with controlled disease in the last 6 months (CPRL). Forty healthy individuals (CG) matched for age, sex, and body mass index were taken as controls. Patients with prolactinoma were compared both as a one group and according to disease control with CG. All subjects were evaluated for waist/hip ratio (WHR), blood pressure, lipid profile, fasting glucose, homeostasis assessment model of insulin resistance (HOMAIR), and adiponectin. Patients with prolactinomas (UPRL+CPRL) showed higher insulin (p<0.05) and HOMAIR (p<0.05), alongside with lower adiponectin levels (p<0.01) than matched controls. When UPRL was compared to CPRL and CG, UPRL was disclosed as a subgroup of significant altered metabolic profile as related to WHR (p<0.01 for comparisons), high-density lipoprotein cholesterol (p<0.05 for comparisons), triglycerides (p<0.05 for comparisons), HOMAIR (p<0.05 and p<0.01, respectively), and adiponectin (p<0.01 for comparisons). All these metabolic abnormalities, except hypoadiponectinemia (p<0.01), were not observed in CPRL. These data suggest that prolactinomas are associated with hypoadiponectinemia, which is further exacerbated in uncontrolled patients when insulin resistance is also prominent.

Metabolizable amino acids and energy requirements of Nellore and crossbred Angus × Nellore bulls fed rations of different crude protein concentrations.

Growth rate of cattle depends on their genetic makeup and nutrient intake. Moreover, increased growth rate may lead to increased amino acid (AA) requirements. Therefore, we evaluated the AA content of the empty body and estimated the net AA and energy requirements of purebred and crossbred beef bulls fed rations of different dietary CP concentrations. We performed a comparative slaughter experiment with 24 Nellore and 24 Angus × Nellore (A × N) bulls (8 months; initial shrunk BW: Nellore = 208.0 ±â€¯12.78 kg; A × N = 221.9 ±â€¯14.16 kg). Eight bulls (four Nellore and four A × N) were designated as the reference group, eight bulls (four Nellore and four A × N) were fed to maintenance level and 32 bulls (16 Nellore and 16 A × N) were fed ad libitum. The 32 bulls fed ad libitum were distributed using a completely randomized design in a 2 × 3 factorial scheme with two genetic groups (Nellore or A × N) and three dietary CP contents (100, 120 or 140 g CP/kg DM), being four groups with five bulls and two groups with six bulls. The experimental period lasted for 224 days. There were no interactions (P ≥ 0.056) between the dietary CP contents and genetic groups for any of the response variables. The dietary CP contents did not affect (P ≥ 0.062) the AA content in the empty body (g/kg empty BW [EBW]), with exception for Tryptophan (P = 0.027, linear effect). The dietary CP contents did not affect (P ≥ 0.051) AA content in the empty body (g/100 g of CP), with exception for Alanine (P = 0.013) that responded quadratically to dietary CP increase. The equations to estimate the net Lysine (Lys) and Methionine (Met) requirements (g/100 g of CP) were: Lys = 5.1 × EBW0.0594 and Met = 1.7 × EBW0.0255. Metabolizable Lys and Met to metabolizable energy (ME) ratios decreased as bulls EBW increased. Also, the metabolizable protein to ME ratio decreased as bulls EBW increased. In conclusion, the present study provides useful information regarding net and metabolizable requirements of AA of purebred and crossbred beef bulls. In the future, after the validation of the equations, these results can be used to calculate the AA requirements for growth of purebred and crossbred beef bulls. Nevertheless, it is important to highlight that the small sample size was one limitation of this present experiment.

Introversion/extroversion, time stress, and caffeine: effect on verbal performance.

Time pressure and caffeine differentially affected the performance of introverts on verbal ability tests similar to the Graduate Record Examination. With time pressure and 200 milligrams of caffeine, the performance of introverts fell by 0.63 standard deviation, but extroverts by 0.44 standard deviation.

Chronic arthritis directly induces quantitative and qualitative bone disturbances leading to compromised biomechanical properties.

OBJECTIVES: Rheumatoid arthritis (RA) is associated with an increased risk of fragility fractures. In RA patients, the direct effect of inflammation on bone is difficult to study because their skeleton is also affected by medication with corticosteroids and other drugs as well as aging and menopause, which contribute to bone fragility. This study used an animal model of chronic arthritis to evaluate the direct impact of chronic inflammation on biomechanical properties and structure of bone. METHODS: In the SKG mouse chronic arthritis model three point bending tests were performed on femoral bones and compression tests on vertebral bodies. Collagen structure was analysed using second-harmonic generation (SHG) imaging with a two-photon microscope, ultramorphology by scanning electron microscopy (SEM) coupled with energy dispersive x-ray spectroscopy (EDS) and bone density using water pycnometer. RESULTS: Arthritic bones had poor biomechanical quality compared to control bones. SHG, SEM and pycnometry disclosed variable signs of impaired collagen organization, poor trabecular architecture and low bone density. CONCLUSION: Present data demonstrate for the first time that chronic inflammation per se, without confounding influence of drugs and aging, leads to impairment of bone biomechanics in terms of stiffness, ductility and ultimate strength (fracture).

Combined open and laparoscopic approach for repair of flank hernias: technique description and medium-term outcomes of a single surgeon.

PURPOSE: A residual bulge in the lateral abdominal wall is a reason for patient dissatisfaction after flank hernia repair (FHR). We hypothesized that combining a laparoscopically-placed intraperitoneal mesh (IPOM) with onlay hernia repair performed through a small open incision would increase repair durability and decrease such residual bulges. We aim to report our medium-term outcomes with this technique. METHODS: Patients who have undergone FHR using the technique described above from March 2013 through June 2017 were identified in a prospectively maintained database. Outcomes of interest included surgical site infections (SSI), surgical site occurrences (SSO), surgical site occurrences requiring procedural intervention (SSOPI) and hernia recurrence. RESULTS: Sixteen patients were identified (62% females; mean age 59 ± 8 years, mean body mass index 29.5 kg/m2). Mean hernia width was. 6.4 ± 3 cm and 31% were recurrent hernias previously repaired through an onlay approach. Mean operative time was 159 ± 40 min, fascial closure was achieved in all cases, and there were no intraoperative complications. Median length of stay was 3 days (IQR 3-4), and there were no unplanned readmissions or reoperations. At a median 37-month follow-up (IQR 21-55), wound morbidity rate was 12.5% (2 seromas). There were no SSI/SSOPI and one hernia recurrence (6%) was detected at 12 months postoperatively. CONCLUSION: Combining laparoscopic IPOM with open onlay hernia repair resulted in low recurrence and acceptable wound morbidity rates, with no residual bulges noted at medium-term follow-up. Further studies with larger number of patients and other surgeon's experiences are necessary to determine the role of such technique in the surgical armamentarium for flank hernia repair.

Phylogenetic studies of the genus Cebus (Cebidae-Primates) using chromosome painting and G-banding.

BACKGROUND: Chromosomal painting, using whole chromosome probes from humans and Saguinus oedipus, was used to establish karyotypic divergence among species of the genus Cebus, including C. olivaceus, C. albifrons, C. apella robustus and C. apella paraguayanus. Cytogenetic studies suggested that the species of this genus have conservative karyotypes, with diploid numbers ranging from 2n = 52 to 2n = 54. RESULTS: Banding studies revealed morphological divergence among some chromosomes, owing to variations in the size of heterochromatic blocks. This analysis demonstrated that Cebus species have five conserved human associations (i.e., 5/7, 2/16, 10/16, 14/15, 8/18 and 3/21) when compared with the putative ancestral Platyrrhini karyotype. CONCLUSION: The autapomorphies 8/15/8 in C. albifrons and 12/15 in C. olivaceus explain the changes in chromosome number from 54 to 52. The association 5/16/7, which has not previously been reported in Platyrrhini, was also found in C. olivaceus. These data corroborate previous FISH results, suggesting that the genus Cebus has a very similar karyotype to the putative ancestral Platyrrhini.

Conceptual schematic for capture of biomethane released from hydroelectric power facilities.

Though dam-related biomethane was identified in the 1960s, its capture has not been sufficiently discussed. Captured biomethane could be burned to produce energy, and the burning of biomethane turns the carbon in it into CO(2) that is far less potent as a greenhouse gas; this paper therefore aims to technically discuss the capture/use of dam-related biomethane. A great amount of bubbles would be formed by the rapid drop in water pressure (i.e. cavitation) after turbine passage, so it is proposed to capture methane-bearing bubbles by means of a flow tube for adjusting residence time and hydrophilic screens for trapping these bubbles. The results from the performed calculation show that biomethane can be trapped in a yield of 60%.

Protein requirements for Blue-fronted Amazon (Amazona aestiva) growth.

The objective of this study was to evaluate the protein requirements for hand-rearing Blue-fronted Amazon parrots (Amazona aestiva). Forty hatchlings were fed semi-purified diets containing one of four (as-fed basis) protein levels: 13%, 18%, 23% and 28%. The experiment was carried out in a randomized block design with the initial weight of the nestling as the blocking factor and 10 parrots per protein level. Regression analysis was used to determine relationships between protein level and biometric measurements. The data indicated that 13% crude protein supported nestling growth with 18% being the minimum tested level required for maximum development. The optimal protein concentration for maximum weight gain was 24.4% (p = 0.08; r(2) = 0.25), tail length 23.7% (p = 0.09; r(2) = 0.19), wing length 23.0% (p = 0.07; r(2) = 0.17), tarsus length 21.3% (p = 0.06; r(2) = 0.10) and tarsus width 21.4% (p = 0.07; r(2) = 0.09). Tarsus measurements were larger in males (p < 0.05), indicating that sex must be considered when studying developing psittacines. These results were obtained using a highly digestible protein and a diet with moderate metabolizable energy levels.

Dietary protein reduction on microbial protein, amino acid digestibility, and body retention in beef cattle: 2. Amino acid intestinal absorption and their efficiency for whole-body deposition.

The objective of this study was to determine the apparent and true intestinal digestibility of total and individual AA, and to estimate the efficiency of whole-body AA retention from individual and total absorbed AA. Four Nellore animals (241.3 kg initial BW) and four crossbred Angus × Nellore (263.4 kg initial BW) cannulated in rumen and ileum were randomly allocated in two 4 × 4 Latin squares. The experiment lasted four 17 d periods, with 10 d for adaptation to diets and another 7 d for data collection. The diets consisted of increasing CP levels: 100, 120, or 140 g/kg of DM offered ad libitum, and restricted intake diet with 120 g CP/kg DM (experiment 1). In experiment 2, forty-four bulls (22 Nellore and 22 crossbred F1 Angus × Nellore) with 8 months and initial shrunk BW 215.0 ± 15.0 kg (Nellore = 208.0 ± 12.78 kg; Angus × Nellore = 221.9 ± 14.16 kg) were used. Eight of those animals were slaughtered at the beginning of the experiment. The remaining 36 bulls were allocated in a completely randomized design with six replicates, in a 2 (genetic groups) × 3 (CP contents) factorial scheme. The amount of essential AA (EAA) and nonessential AA (NEAA) reaching the small intestine increased linearly (P < 0.05) in response to CP content. The apparent digestibility of EAA was not affected (P > 0.05) by CP content, with exception for histidine (P = 0.07, linear effect), leucine (P = 0.01, linear effect), and methionine (P = 0.05, linear effect). Differences existed among AA when compared the apparent digestibility of NEAA. The apparent digestibility of alanine (P = 0.05), aspartic acid (P = 0.07), glutamic acid (P = 0.02), glycine (P = 0.05), proline (P = 0.02), and serine (P = 0.04) responded quadratically to CP content increase. However, the apparent digestibility of cystine and tyrosine was not affected (P > 0.05) by increasing dietary CP. The true intestinal digestibilities of total, essential, nonessential AA, lysine, and methionine were 75.0%, 77.0%, 74.0%, 77.0%, and 86%, respectively. The true intestinal digestibility of total microbial AA was 80%. The efficiency of utilization of total AA for whole-body protein deposition was 40%. The efficiency of utilization of lysine and methionine was 37% and 58%, respectively. It was concluded that the AA flow to the omasum increases in response to dietary CP content. In addition, there are differences among AA in the efficiency that they are used by beef cattle.

Effects of carbohydrate and nitrogen supplementation on fermentation of cheatgrass () in a dual-flow continuous culture system.

Cheatgrass (CG; ), an introduced winter annual grass, is an aggressive invader of the sagebrush community in the Western United States. Because of its greater flammability, mature CG constitutes a fire hazard leading to repeated wildfires. One fuel-reduction strategy is livestock grazing. The objective of this study was to evaluate the effects of urea, molasses, or a combination of urea and molasses supplementation of a CG-based diet on digestibility, microbial fermentation, bacterial protein synthesis, and nutrient flow using a dual-flow continuous culture system. Eight fermenters were used in a replicate 4 × 4 Latin square design with four 10-d experimental periods. Experimental treatments (DM basis) were 1) forage only (CON), 2) CG plus urea alone (URE; 1.36% urea), 3) CG plus molasses alone (MOL; 15.9% molasses), and 4) CG plus urea and molasses combined (URE+MOL; 1.28% urea plus 19.3% molasses). Each fermenter was fed 72 g/d of DM, and data were analyzed using the GLIMMIX procedure of SAS (SAS Inst. Inc., Cary, NC). The true digestibilities of NDF and ADF were not affected by diets ( > 0.05). Molasses-containing diets had greater true digestibility of OM ( = 0.02). However, true digestibility of CP was increased when molasses was fed alone ( < 0.01). Molasses-containing diets had lower pH ( < 0.01) and greater VFA concentrations ( < 0.01) compared to those of the other diets. The URE+MOL diet resulted in a greater VFA concentration ( < 0.01). Propionate concentration increased ( < 0.01), whereas acetate concentration decreased ( < 0.01) when molasses alone or in combination with urea was added to the diets. Supplying molasses alone resulted in greater ( = 0.03) total branched-chain VFA compared to the other diets. The concentration of NH-N and total N flow increased ( < 0.01) in response to urea supplementation and was greater ( < 0.01) when urea alone was supplemented in the diet. On the other hand, molasses-supplemented diets yielded more non-ammonia N ( < 0.01) and bacterial N ( = 0.04). Supplementation had no effect ( = 0.83) on bacterial efficiency. Results from this study indicate that the addition of urea and molasses in a CG-based diet could improve nutrient supply to animals, notably VFA supply and microbial N supply; however, in the levels tested in this study, it did not improve CG utilization as assessed by NDF digestion.

Reducing mineral usage in feedlot diets for Nellore cattle: I. Impacts of calcium, phosphorus, copper, manganese, and zinc contents on microbial efficiency and ruminal, intestinal, and total digestibility of dietary constituents.

This study evaluated intake, microbial efficiency, and ruminal, small and large intestinal, and total digestibility of DM, OM, CP, and NDF, as well as availability of Ca, P, Mg, Na, K, Cu, Mn, and Zn in Zebu cattle fed with or without supplemental sources of Ca and P or a micromineral premix. Five rumen- and ileum-cannulated Nellore bulls (BW = 200 ± 10.5 kg; 9 mo) were used in the experiment, distributed in a 5 × 5 Latin square design. The experiment was developed in a 2 × 2 + 1 factorial design to measure the effects of mineral supplementation on intake, digestibility, and site of nutrient absorption. The factors consisted of 2 Ca and P levels (macromineral factor; CaP+ or CaP-) and 2 microminerals levels (micromineral factor; CuMnZn+ or CuMnZn-). In addition, a treatment with alimentary restriction (REST) was evaluated at 1.7% of BW. Nutrient fluxes were measured in the omasum and ileum, in addition to intake and fecal excretion. Microbial efficiency was estimated using purine derivative excretion. Dry matter, OM, NDF, CP intake, and total digestibility were not affected ( ≥ 0.058) by the absence of Ca, P, Cu, Mn, and Zn supplementation. Intake of Ca, P, and Mg were reduced ( < 0.01) by CaP-. The absence of CuMnZn reduced ( < 0.01) Cu, Mn, and Zn intake. Ruminal recycling of P, Na, and K is significant for increasing the influx of these minerals to the digestive tract; however, influences of treatments were not observed. The small and large intestines contributed to mineral absorption in different proportions ( < 0.05), according to minerals and treatments. Because of the similarity ( > 0.05) of OM, NDF, and CP digestion sites and coefficients, we assume that omitting supplemental sources of Ca, P, Cu, Mn, and Zn may be an option in raising cattle on feedlots. If supplementation is viable, knowledge about the specific absorption site of each mineral could positively impact choices about the supplemental source.

Technical note: Prediction of chemical rib section composition by dual energy X-ray absorptiometry in Zebu beef cattle.

It is expensive and laborious to evaluate carcass composition in beef cattle. The objective of this study was to evaluate a method to predict the 9th to 11th rib section (rib) composition through empirical equations using dual energy X-ray absorptiometry (DXA). Dual energy X-ray absorptiometry is a validated method used to describe tissue composition in humans and other animals, but few studies have evaluated this technique in beef cattle, and especially in the Zebu genotype. A total of 116 rib were used to evaluate published prediction equations for rib composition and to develop new regression models using a cross-validation procedure. For the proposed models, 93 ribs were randomly selected to calculate the new regression equations, and 23 different ribs were randomly selected to validate the regressions. The rib from left carcasses were taken from Nellore and Nellore × Angus bulls from 3 different studies and scanned using DXA equipment (GE Healthcare, Madison, WI) in the Health Division at Universidade Federal de Viçosa (Viçosa, Brazil). The outputs of the DXA report were DXA lean (g), DXA fat free mass (g), DXA fat mass (g), and DXA bone mineral content (BMC; g). After being scanned, the rib were dissected, ground, and chemically analyzed for total ether extract (EE), CP, water, and ash content. The predictions of rib fat and protein from previous published equations were different ( < 0.01) from the observed composition. New equations were established through leave-one-out cross-validation using the REG procedure in SAS. The equations were as follows: lean (g) = 37.082 + 0.907× DXA lean ( = 0.95); fat free mass (g) = 103.224 + 0.869 × DXA fat free mass ( = 0.93); EE mass (g) = 122.404 + 1.119 × DXA fat mass ( = 0.86); and ash mass (g) = 18.722 + 1.016 × DXA BMC ( = 0.39). The equations were validated using Mayer's test, the concordance correlation coefficient, and the mean square error of prediction for decomposition. For both equations, Mayer's test indicated that if the intercept and the slope were equal to 0 and 1 ( > 0.05), respectively, then the equation correctly estimated the rib composition. Comparing observed and predicted values using the new equations, Mayer's test was not significant for lean mass ( = 0.26), fat free mass ( = 0.67), EE mass ( = 0.054), and ash mass ( = 0.14). We concluded that the rib composition of Nellore and Nellore × Angus bulls can be estimated from DXA using the proposed equations.

Donor risk index does not predict graft survival after pancreas transplantation in Brazil.

BACKGROUND: Pancreas donor risk index (DRI) was developed by using large multicenter American data to predict the risk of adverse outcomes in pancreas transplantation based on donor and technical/logistical characteristics. AIM: The goal of this study was to evaluate the usefulness of the DRI in predicting graft survival in a Brazilian population of pancreas transplant recipients. METHOD: We conducted a retrospective analysis of the 570 procedures performed by the same surgical team between 1996 and 2011. Because of the lack of sufficient data for the calculation of DRI values, only 154 cases were studied (27%), of which 105 underwent simultaneous pancreas-kidney transplantation, 33 underwent pancreas after kidney transplantation, and 16 underwent pancreas transplantation alone. Donor cause of death was classified as cerebrovascular accident (CVA) and non-CVA. Graft origin was divided into three groups: local, if the graft was obtained in the metropolitan area of the city of São Paulo; regional, if collected in other cities of the state of São Paulo; and national, if obtained outside the state. RESULTS: Logistic regression analysis did not find a statistically significant association between DRI values and 1-year graft survival (odds ratio = 0.676; 95% confidence interval 0.152 to 3.014; P = .60). One-year graft survival calculated by the Kaplan-Meier method was 89.8% in transplants with DRI ≤ 1, 77.9% in those with 1 < DRI < 1.5, and 93.3% in those with DRI ≥ 1.5 (P = .106). CONCLUSION: The pancreas DRI model did not prove effective in predicting pancreas graft survival in a Brazilian sample of recipients.

Videolaparoscopic approach of the splenic cyst: a case report.

The authors report a case of an asymptomatic 30-year-old female patient with an extensive cystic lesion continuous with the splenic parenchyma. A review of the literature and use of a videolaparoscopic approach to the treatment of these lesions is presented.

Videolaparocholecystectomy: casuistry of 1000 cases.

Despite the ongoing evolution in the medical treatment of biliary pathology, the standard of treatment for gallstones remains cholecystectomy. There are no alternative treatments that have shown the same efficacy as surgery. Current alternative treatments have shown high recurrence and failure rates. Cholecystectomy remains the gold standard for management of gallstones. The surgical access of laparoscopic cholecystectomy accomplished by Mouret in 1987 allows for a reduction in operative trauma, hospital stay, postoperative pain and convalescence. These factors permit a faster return to normal activities. Today, laparoscopic cholecystectomy is performed in almost all medical centers around the world; however, the procedure is not free of complications. The objective of this study was to analyze our first 1000 cases of laparoscopic cholecystectomy, giving emphasis to the morbidity and mortality of the procedure.