Effects of supplementing cassava root silage to grazing dairy cows on nutrient utilization, milk production and composition in the tropics.

The current study evaluated the effects of supplementing cassava root silage (CRS) to dairy cows grazing on Megathyrsus maximus cv Mombasa on nutrient intake and digestibility, as well as on milk production and composition. Ten primiparous Girolando cows with average body weight ± (SEM) of 373.45 ± (63.55) kg were used in a replicated 5 × 5 Latin square. Animals were subjected to five treatments: (I) grazing cows without supplementation (WCS); (II) grazing cows provided with 5 kg DM of supplement without CRS (0 g/kg DM of CRS) or including (III) 260, (IV) 520, and (V) 780 g/kg DM of CRS. Statistical analyses were performed using the PROC MIXED of SAS with significance at P < 0.05. Intake of neutral detergent fiber (NDF) and ether extract decreased (P < 0.01), while intake of non-fiber carbohydrates increased (P < 0.01), with increased CRS in the diets. Total DM intake and digestibility of DM, and digestibility of nutritional components were lower (P < 0.03) in WCS animals compared to supplemented animals, except for intake and digestibility of NDF, which was the opposite. Milk yield (MY) and fat corrected milk (FCM), as well as all milk components were unaffected (P > 0.05) by CRS inclusion. In contrast, MY, FCM, protein, lactose, casein, and non-fat milk solids (NFMS) were greater for animals that received supplementation (P < 0.05), compared to animals WCS. Milk fat and total dry extract (TMS) did not differ (P > 0.11) between two groups. In conclusion, CRS may be a potential corn meal replacer in the supplement of dairy cows under tropical conditions.

Exiguobacterium sp. as a bioinoculant for plant-growth promotion and Selenium biofortification strategies in horticultural plants.

Plant growth-promoting rhizobacteria (PGPR) have a positive effect on plant development and being a promising way to enhance crop productivity and as substitution of chemical fertilizers. Selenium (Se) is an important trace element and its intake is usually lower than the daily minimum amount required for humans; hence, there is a demand on the design of Se biofortification strategies. Here, the genetic traits known to be associated with Plant-Growth Promotion (PGP) and Se biotransformation of Exiguobacterium sp. S17 were evaluated through genome analysis. Its growth-promoting capacity was tested through plant-growth promotion assays in laboratory and field conditions, using Brassica juncea (indian mustard), Beta vulgaris (chard), and Lactuca sativa (lettuce). Additionally, the Se biotransformation ability of Exiguobacterium sp. S17 was evaluated and the obtained selenized bacteria were tested in mustard plants. The sequenced bacteria genome revealed the presence of multiple genes involved in important functions regarding soil and plant colonization, PGP and Se biotransformation. Moreover, it was demonstrated that Exiguobacterium sp. S17 enhanced plant growth and could be useful to produce Se accumulation and biofortification in accumulator plants such as mustard. Thereby, Exiguobacterium sp. S17 might be used for developing new, sustainable, and environmentally friendly agro-technological strategies.

Alternative additives associated in the feeding of laying hens: performance, biometrics, bone traits, and economic evaluation-an unsupervised machine learning approach.

Given the current bans on the use of some growth promoting antibiotics in poultry nutrition, the need to use alternative additives which could replace traditional promoters in diets has arisen. The objective of this study was to evaluate the effect of alternative additives, associated or not, in replacing the antibiotic growth promoter in the diets of laying hens on performance, egg quality, biometry, bone characteristics, and economic viability. A total of 378 birds at 97 weeks of age, weighing 1691 ± 80g with an average production of 79.96 ± 4.9%, were randomly distributed and submitted to different diets: negative control - NC (no additive); positive control - PC, conventional growth promoter (Enramycin); associated organic acids (OA); symbiotic (S); Essential oil (EO); OA + S; and S+EO. The diet did not influence (P > 0.05) performance, egg quality, biometry, and bone traits. However, the use of alternative additives and their associations with the exception of S+OA, provided better economic indices when compared to NC and CP. The first component showed a negative relationship between feed conversion per mass and dozen eggs with gut length, Seedor index, egg production, and egg mass; the second component showed a positive relationship between yolk, pancreas, proventriculus, and gizzard; and, finally, the third component showed that feed consumption has a negative relationship with bone strength and deformity. The first two canonical functions were significant and discriminated 100% of the differences between the diets. Moreover, 50% of the birds were correctly classified in their group of origin, in which the positive control group (83.3%) and OA+S presented the highest rates of correct responses (66.7%). Bone deformity and bowel length were the only two variables with discriminatory power. Natural growth promoters alone or in association do not harm performance, egg quality, digestive organs biometry or bird bone characteristics, in addition to promoting greater economic return. Thus, they can be considered possible substitutes for traditional antibiotics. Finally, unsupervised machine learning methods are useful statistical techniques to study the relationship of variables and point out the main biomarkers of poultry production.

Enhanced Cd(II) biomineralization induced by microalgae after cultivating modification in high-phosphorus culture.

In this study, high-phosphorus beared microalgae was prepared by cultivating modification in high-phosphorus culture, and used for the enhanced Cd(II) biomineralization in soil. Batch experiment results showed that Chlorella sorokiniana FK was modified successfully in highly phosphate culture. Both intracellular P (Poly-P, 29.7 mg/kg) and surface P (phosphoryl based functional groups, 3.7 mol/kg) were greatly enhanced, and the Cd(II) removal capacity surged to 45.98 mg/g at equilibrium in the Langmuir simulation. The EXAFS analysis indicated that Cd tended to form a more stable bidentate complex (RPO4)2Cd when bounding with phosphate groups on the surface of the high-phosphorus microalgae. Moreover, high-phosphorus beared microalgae not only had higher immobilization amount of Cd(II), but also promoted immobilized Cd from adsorbed state to mineralized state. After high-phosphate cultured, increased density of P-related groups provided more adsorption sites, while the decomposition of intracellular Poly-P released phosphate ions into cell surface microenvironment, which combined and promoted the formation of Cd3(PO4)2/Cd(H2PO4)2 on cell surface. Cd-contaminated soil remediation experiments applying high-surface-phosphate beared microalgae further showed that more Cd stabilized as a residue fraction within 49 days. This study proposes that the high-phosphate culture strategy is a good way to improve the immobilization of heavy metals in soil induced by microorganisms.

Investigação do potencial erosivo de gomas de mascar não convencionais / Investigation the erosive potential of unconventional chewing gums

Objetivo: mensurar o potencial erosivo de gomas de mascar não convencionais disponíveis no mercado brasileiro. Material e método: estudo experimental (in vitro) de caráter quantitativo. Foram adquiridos oito sabores de gomas de mascar: Poosh® (pinta língua); Plutonita® (abraço congelante, dentada ardente, baba de bruxa e língua ácida); e TNT® (sangue, lava e tumba). Para análise da acidez, foram realizadas leituras em triplicata do pH e acidez titulável (AT), utilizando um potenciômetro e eletrodo combinado de vidro em soluções obtidas após a maceração das gomas de mascar em água duplamente deionizada. Nas soluções com valores de pH inferiores a 5,5, foi mensurada a AT adicionando-se alíquotas de 100 µLNaOH 0,1 M, até alcançar pH 5,5. Os resultados foram submetidos à Análise de Variância (ANOVA). As comparações das médias de pH e acidez titulável foram realizadas pelo teste de Tukey, com um nível de 5% de significância (p<0,05). Resultados: os valores de pH variaram entre 2,4 (abraço congelante) e 3,5 (baba de bruxa), diferin-do significantemente do controle (água mineral/pH=6,2). Os valores de acidez titulável variaram entre 628µL de NaOH 0,1 M (sangue) e 10700µL de NaOH 0,1 M (abraço congelante). A goma de mascar sabor abraço congelante apresentou o pH mais baixo e a mais elevada acidez titulável, diferindo significantemente dos demais sabores. Conclusões: as gomas de mascar avaliadas são ácidas, mas diferem quanto ao seu potencial erosivo. Seu consumo abusivo pode constituir um fator de risco para erosão dental.(AU)

Objective: to measure the erosive potential of non- -conventional chewing gums available in the Brazilian market. Material and methods: this is an in vitro study using the following flavors of chewing gums from the Brazilian market: Poosh® (tongue cleaner); Plutonita® (freezing hug, burning bite, witch slime and acid tongue); TNT® (blood, lava and tomb). For acidity analysis, pH and titratable acidity (TA) readings were performed in triplicate using a potentiometer and combined glass electrode in solutions obtained after maceration of the chewing gums in double deionized water. In solutions with pH values below 5.5, the TA was measured by adding aliquots of 100 µL 0.1 M NaOH, until pH 5.5 was reached. The results were submitted to Analysis of Variance (ANOVA). Comparisons of pH and titratable acidity means were performed by Tukey test at a 5% significance level (p<0.05). Results: the pH values that ranged from 2.4 (freezing hug) to 3.5 (witch's slime) differed significantly from the control (mineral water/ pH=6.2). Titratable acidity values ranged from 628µL of 0.1 M NaOH (blood) to 10700µL of 0.1 M NaOH (freezing hug). The freezing hug flavor chewing gum had the lowest pH and the highest titratable acidity differing significantly from the other flavors. Conclusions: the evaluated chewing gums are acidic, but differ in their erosive potential. Their abusive consumption may constitute a risk factor for dental erosion.(AU)

Thermoregulatory, behavioral and productive responses of laying hens supplemented with different types and dosages of phytases raised in a hot environment: An integrative approach.

This study had the following objectives: (i) to evaluate the thermoregulatory and behavioral responses of light laying hens supplemented with different types and dosages of phytases in the two day shifts; and (ii) to integrate the thermoregulatory and behavioral responses with performance of these birds raised in a hot environment. 270 light laying hens of the Hy-Line White lineage, with a body weight of 1.60 ± 0.092 kg were distributed in a completely randomized design in a 2 × 2 + 1 factorial model with two types of phytases (bacterial and fungal) and two dosages (450 and 900 FTU), and a control diet. The day shift (morning and afternoon) was considered as a fixed effect in the factorial arrangement. Principal component analysis (PCA), correspondence analysis (CA) and canonical discriminant analysis (CDA) were used. There was no interaction (P > 0.05) between phytases and dosages for thermoregulatory responses. Respiratory rate (RR), cloacal temperature (CT), and surface temperature with feathers (STWF) and featherless (STF) were higher (P < 0.001) in the afternoon. Birds show different thermoregulatory and behavioral responses in the two shifts of the day. We also observed that birds supplemented with bacterial and fungal phytase showed similar thermoregulatory and behavioral responses to the control group in both day shifts. Expression of the "eating" activity was greater in the morning, while the birds remained sitting longer in the afternoon. Egg production was higher (P < 0.001) in birds supplemented with bacterial phytase. The phytase dosages had no effect on thermoregulatory, behavioral or performance responses. Egg production, feed conversion per dozen eggs corresponded to 81.1% of the differences between bacterial and fungal phytase supplementation and group control. Thus, we conclude that: (i) phytase dietary supplementation has no effect on the thermoregulatory responses of laying hens reared in a hot environment; (ii) birds supplemented with bacterial phytase showed higher egg production; and (iii) phytases (450 and 900 FTU) do not interfere with productive, behavioral and thermoregulatory responses.

Does dietary supplementation with phytases affect the thermoregulatory and behavioral responses of pullets in a tropical environment?

Dietary supplementation of two types of phytases (fungal and bacterial) with different dosages (300 and 900 FTUs) was evaluated in the thermoregulatory and behavioral responses of replacement pullets in a tropical environment. 288 Hy-Line White laying birds with a mean weight of 639.60 ± 6.05 g, clinically healthy, and eight weeks old were used in the study. Respiratory rate (RR, breaths. min-1), Cloacal temperature (CT, °C), Surface temperature with feathers (STWF, °C), and Surface temperature featherless (STF, °C) were measured in the morning and afternoon. Behavioral data were observed through the following activities: sitting, eating, drinking, exploring feathers (EF), non-aggressive pecking (NAP), and object pecking (OP) recorded every 10 min from 6 a.m. to 5 p.m. Environmental variables were measured along with thermoregulatory and behavioral responses. There was an interaction for RR between phytase and period of the day (P < 0.05). The lowest RR (morning) was observed in fungal phytase. STF and STWF were higher (P < 0.05) in the afternoon. Birds supplemented with fungal phytase showed lower STWF (P < 0.05). The variables that contributed to explain physiological and behavioral responses are shown in order of importance for (i) periods of day: morning (sitting, STWF, drinking, eating, and CT) and afternoon (STF, STWF, OP, drinking, eating, RR and sitting); (ii) phytases: fungal (STF, STWF, RR, sitting, eating and drinking); and bacterial (RR, STF, STWF, CT and sitting). Thermoregulatory and behavioral responses were similar between dosages, but different between types of phytases. Birds supplemented with fungal phytase used sensible heat dissipation mechanisms and exhibited thermal comfort behaviors. The 300 and 900 FTUs phytase doses did not influence the thermoregulatory and behavioral responses of birds, while they showed natural heat dissipation and heat stress behaviors in the afternoon. We recommend a dietary supplementation of 300 FTUs fungal phytases.

Vitamin D Deficiency and Its Influence on Bone Metabolism and Density in a Brazilian Population of Healthy Men.

Vitamin D supplementation is universal for postmenopausal women, but not for elderly men, in whom osteoporosis is also commonly neglected. This study aimed to evaluate vitamin D deficiency and its association with secondary hyperparathyroidism, bone resorption, and bone density in Brazilian men. A total of 120 men, 20-93 years, were evaluated for serum calcium, phosphorus, creatinine, 25-hydroxyvitamin D (25(OH)D), parathyroid hormone, biochemical markers of bone resorption (carboxy-terminal telopeptide, carboxy-terminal peptide of type I collagen), and bone mineral density (dual-energy X-ray absorptiometry). Glomerular filtration rate (GFR) below 30 mL/min/1.73 m2, chronic diseases, and medications affecting bone were the exclusion criteria. No participant reported previous low-impact fractures. In the overall population, 25(OH)D levels were below 30 ng/mL in 46.7%, and below 20 ng/mL in 27.6%. Among the 93 patients 50 years and older, 28 had osteoporosis. In those 70 years and older, the prevalence of vitamin D deficiency (42.1%), secondary hyperparathyroidism (46.4%), high bone resorption (39.6%), decreased GFR (39.2%), and osteoporosis (41.4%) was significantly higher than in the younger subjects (p < 0.005 for all comparisons). Serum parathyroid hormone increased with aging and declining GFR, but was not significantly associated with 25(OH)D or bone mineral density. There was a clear contribution of vitamin D deficiency to increased bone resorption and osteoporosis. Binary logistic regression model considering age, 25(OH)D, and bone resorption identified age ≥70 years as the main determinant of osteoporosis. Our data demonstrate a high prevalence of vitamin D deficiency in a male population living in Rio de Janeiro, and emphasize its participation on the pathogenesis of age-related bone loss. (Vitamin D deficiency and osteoporosis are common in elderly Brazilian men.).

Calcium intake: good for the bones but bad for the heart? An analysis of clinical studies.

The proper dietary calcium intake and calcium supplementation, when indicated, are important factors in the acquisition of peak bone mass during youth and in the prevention of fractures in old age. In addition to its deposition in bone, calcium confers an increase in its resistance and exhibits important activities in different enzymatic pathways in the body (e.g., neural, hormonal, muscle-related and blood clotting pathways). Thus, calcium supplementation can directly or indirectly affect important functions in the body, such as the control of blood pressure, plasma glucose, body weight, lipid profile and endothelial function. Since one publication reported increased cardiovascular risk due to calcium supplementation, many researchers have studied whether this risk actually exists; the results are conflicting, and the involved mechanisms are uncertain. However, studies that have evaluated the influence of the consumption of foods rich in calcium have reported no increase in the cardiovascular risk, which suggests that nutritional intake should be prioritized as a method for supplementation and that the use of calcium supplements should be reserved for patients who truly need supplementation and are unable to achieve the recommended daily nutritional intake of calcium.

Calcium intake: good for the bones but bad for the heart? An analysis of clinical studies

ABSTRACT The proper dietary calcium intake and calcium supplementation, when indicated, are important factors in the acquisition of peak bone mass during youth and in the prevention of fractures in old age. In addition to its deposition in bone, calcium confers an increase in its resistance and exhibits important activities in different enzymatic pathways in the body (e.g., neural, hormonal, muscle-related and blood clotting pathways). Thus, calcium supplementation can directly or indirectly affect important functions in the body, such as the control of blood pressure, plasma glucose, body weight, lipid profile and endothelial function. Since one publication reported increased cardiovascular risk due to calcium supplementation, many researchers have studied whether this risk actually exists; the results are conflicting, and the involved mechanisms are uncertain. However, studies that have evaluated the influence of the consumption of foods rich in calcium have reported no increase in the cardiovascular risk, which suggests that nutritional intake should be prioritized as a method for supplementation and that the use of calcium supplements should be reserved for patients who truly need supplementation and are unable to achieve the recommended daily nutritional intake of calcium.

Vivências de mães de bebês prematuros no contexto da espiritualidade / Experiencias de las madres de niños prematuros en el contexto de la espiritualidad / Experiences of mothers of premature infants in the context of spirituality

Objective: to understand how mothers of preterm infants perceive the relationship between health and spirituality and its benefits on the severity health picture of their children. Method: qualitative research with 32 mothers whose children were admitted to a Neonatal Intensive Care Unit of a maternity hospital in Natal/RN/Brazil. There were semi-structured interviews and focus groups between February and May 2012, after a favorable opinion from the Ethics Committee in Research of UFRN and CAAE 0336.0.051.000.1. Data analysis was thematic analysis. Results: the relationship between health and spirituality was unveiled in the study as a positive phenomenon helping mothers avoiding discouragement and keeping hope in restoring the health of the child in the Intensive Care Unit. Conclusion: it is suggested after the results, actions and projects that promote soft technologies, aiming at promoting and completeness in health care.

Objetivo: compreender como mães de bebês prematuros percebem a relação entre saúde e espiritualidade e seus benefícios diante da gravidade do quadro de saúde de seus filhos. Método: pesquisa qualitativa realizada com 32 mães, cujos filhos estavam internados em uma Unidade de Terapia Intensiva Neonatal de uma Maternidade Escola em Natal/RN/Brasil. Realizaram-se entrevistas semiestruturadas em grupos focaisno período de fevereiro a maio de 2012. A pesquisa teve parecer favorável do Comitê de Ética em Pesquisada UFRN com CAAE 0336.0.051.000.1. Para análise dos dados, optou-se pela técnica de análise temática. Resultados: a relação entre saúde e espiritualidade desvelou-se no estudo como fenômeno positivo que auxilia as mães a evitar o desânimo e a manter a esperança no restabelecimento da saúde do filho na Unidade de Terapia Intensiva. Conclusão: após os resultados, sugere-se ações e projetos que promovam tecnologias leves, visando promoção e integralidade do cuidar em saúde.

Objetivo: entender cómo las madres de bebés prematuros perciben la relación entre la salud y la espiritualidad y los beneficios de la gravedad de la salud de sus hijos. Método: investigación cualitativa con 32 madres, cuyos niños fueron ingresados en una Unidad de Cuidados Intensivos Neonatal de una Maternidad Escuela en Natal/RN/Brasil. Hubo entrevistas semi-estructuradas y grupos focales entre febrero y mayo de2012, luego de la aceptación favorable del Comité de Ética en Investigación de UFRN y CAAE0336.0.051.000.1 Para análisis de datos se eligió técnica de análisis temática. Resultados: la relación entre la salud y la espiritualidad dio a conocer en el estudio como un fenómeno positivo ayudando a las madres evitar el desánimo y mantener la esperanza en la restauración de la salud del niño en la Unidad de Cuidados Intensivos. Conclusión: se sugiere después de los resultados, las acciones y proyectos que promuevan tecnologías leves, con miras a la promoción y la integridad en la atención de la salud.

Nutritional implications for the patient undergoing extracorporeal membrane oxygenation / Aspectos nutricionales del paciente sometido a ECMO (extracorporeal membrane oxygenation)

Extracorporeal membrane oxygenation (ECMO) for cardiovascular collapse or catastrophic respiratory failure in the critically ill patient imposes a multidisciplinary approach. Nutritional support is one of the issues that must be faced, as this population presents a state of increased metabolic activity, elevated catabolism of protein and rapid accumulating energy deficiency. Provision of adequate nutritional therapy is hard to achieve due to different factors. This article provides a brief overview of the current literature regarding nutritional support during ECMO in adult patients, as no current guidelines address this issue (AU)

La oxigenación por membrana extracorpórea (OMEC) en casos de colapso cardiovascular o falla respiratoria catastrófica en pacientes críticos impone un planteamiento multidisciplinar. El soporte nutricional es uno de los problemas a afrontar, ya que esta población presenta un estado de actividad metabólica aumentada, un elevado catabolismo proteico, y una deficiencia de energía de rápida acumulación. Es difícil conseguir una provisión de terapia nutricional adecuada debido a distintos factores. Este artículo ofrece una breve presentación de la bibliografía actual relativa al soporte nutricional durante la OMEC en pacientes adultos, ya que actualmente no contamos con directrices que aborden este tema (AU)

Short-term skin reactions associated to sleeve gastrectomy in eight patients.

BACKGROUND: Bariatric procedures have beneficial effects on metabolic disturbances, including dermatological conditions. Short-term skin reactions associated with sleeve gastrectomy are not described in the literature. METHODS: We reviewed our database for patients who underwent bariatric surgery between May and October 2013 who reported a cutaneous rash during the short-term post-surgical period. RESULTS: Of a total of 195 patients, 8 (0.02 %) developed acute skin reactions during the first 3 months. Case 1 was compatible with reticulated papillomatosis. Case 2 was diagnosed as recurrent angioedema. Cases 3, 4, and 7 presented a cutaneous drug reaction to vitamin supplementation. Cases 5, 6, and 8 seemed to be secondary to xerosis and responded to lubrication. CONCLUSION: Acute cutaneous skin reactions after bariatric surgery are unusual. When they do occur, they appear to be benign conditions.

[Micronutrient deficiencies one year after sleeve gastrectomy]. / Déficit de micronutrientes a más de un año postoperatorio de gastrectomía en manga.

INTRODUCTION: Obesity is one of the largest problems in public health worldwide today. For patients with severe obesity and associated comorbidities, surgical treatment is recommended. OBJECTIVE: To analyze the frequency of micronutrient deficiencies and food intake at least 12 months after sleeve gastrectomy (SG). MATERIALS AND METHODS: This is a cross sectional study carried out between October and December 2009 with measure of serum levels of vitamin B12, vitamin D, folate, calcium, ferritin, zinc, parathyroid hormone and bone mineral density on patients underwent SG at least 12 months before the study. A food intake questionnaire was also performed. For the statistical analysis, the Pearson or Spearman tests was used. RESULTS: Forty patients were evaluated with a mean age of 40 ± 10 years and mean time post surgery of 26 ± 6 months. Mean plasma level of 25 OH-vitamin D was 20.9 ± 10.5 ng/ml. Forty-three percent had low levels of vitamin D (< 20 ng/ml), and 68% showed low levels of calcium (< 1,1 mmol/L) without secondary hyperparathyroidism. Anemia was present in 28% and iron deficiency occurred in 38% of these patients. Deficit of folic acid and vitamin B12 were observed in 13% of the patients. Average daily food intake was 1,256 kcal, 54% of total calories as carbohydrates, 26% as fat and 21% as protein. CONCLUSION: Iron, calcium and vitamin D are the most prevalent micronutrient deficiencies after SG. Long-term vitamin and mineral supplementation should be considered on every patient. Additional long-term studies are needed to establish specific supplementation recommendations after SG.

Déficit de micronutrientes a más de un año de postoperatorio en gastrectomía en manga / Micronutrient deficiencies one year after sleeve gastrectomy

Introducción: La obesidad es uno de los principales problemas de salud pública a nivel mundial. Para aquellos pacientes con obesidad severa asociada a comorbilidades, se recomienda el tratamiento quirúrgico. Objetivo: Analizar la frecuencia de déficit de micronutrientes e ingesta alimentaria en pacientes sometidos a gastrectomía en manga (GM) en un tiempo post operatorio del al menos 12 meses. Material y métodos: Se realizó un estudio transversal entre los meses de octubre y diciembre de 2009. Se estudió a pacientes que habían sido sometidos a GM al menos 12 atrás y se les midió niveles séricos de vitamina B 12, vitamina D, folato, calcio, ferritina, zinc, paratohormona y densidad mineral ósea. Además se aplicó un cuestionario de ingesta alimentaria. Se utilizó el test de Pearson o Spearman para el análisis estadístico. Resultados: Se evaluó un total de 40 pacientes con una edad promedio de 40 ± 10 años y un tiempo post operatorio de 26 ± 6 meses. El nivel promedio de vitamina D fue de 20.9 ± 10.5 ng/ml. El 43% presentó nivel bajo de vitamina D (< 20 ng/ml), un 68% presentó nivel disminuido de calcio (< 1,1 mmol/L) sin hiperparatoroidismo secundario. Se encontró anemia en un 28% y déficit de hierro en el 38% de la muestra. El déficit de ácido fólico y vitamina B12 se observó en un 13% de los pacientes. El consumo calórico promedio fue de 1.256 kcal/día, de las cuales un 54% correspondió a hidratos de carbono, un 26% a grasa y un 21% a proteínas. Conclusión: El déficit de hierro, calcio y vitamina D son los más prevalentes luego de la GM. La suplementación de vitaminas y minerales debiera ser considerada en todo paciente. Se requiere mayor estudio a largo plazo para establecer las recomendaciones específicas de suplementación luego de la GM (AU)

Introduction: Obesity is one of the largest problems in public health worldwide today. For patients with severe obesity and associated comorbidities, surgical treatment is recommended. Objective: To analyze the frequency of micronutrient deficiencies and food intake at least 12 months after sleeve gastrectomy (SG). Materials and methods: This is a cross sectional study carried out between October and December 2009 with measure of serum levels of vitamin B12, vitamin D, folate, calcium, ferritin, zinc, parathyroid hormone and bone mineral density on patients underwent SG at least 12 months before the study. A food intake questionnaire was also performed. For the statistical analysis, the Pearson or Spearman tests was used. Results: Forty patients were evaluated with a mean age of 40 ± 10 years and mean time post surgery of 26 ± 6 months. Mean plasma level of 25 OH-vitamin D was 20.9 ± 10.5 ng/ml. Forty-three percent had low levels of vitamin D (< 20 ng/ml), and 68% showed low levels of calcium (< 1,1 mmol/L) without secondary hyperparathyroidism. Anemia was present in 28% and iron deficiency occurred in 38% of these patients. Deficit of folic acid and vitamin B12 were observed in 13% of the patients. Average daily food intake was 1,256 kcal, 54% of total calories as carbohydrates, 26% as fat and 21% as protein. Conclusion: Iron, calcium and vitamin D are the most prevalent micronutrient deficiencies after SG. Long-term vitamin and mineral supplementation should be considered on every patient. Additional long-term studies are needed to establish specific supplementation recommendations after SG (AU)

What is and how can be explained pregnancy in adolescence

INTRODUCTION: The inconsequential exercise of sexuality may generate innumerous conflicts and interfere wityh each adolescent's plans for the future, resulting in early pregnancy, for example. OBJECTIVE: Describe the ideas associated to the subject pregnancy in adolescence. METHODS: This is a systematic revision with scientific production about pregnancy in adolescence disseminated in health science journals, in the period of 2006 to 2010. It has a quantitative and qualitative approach to the data. The total analyzed samples were 20 articles. The data collection instrument was a structured script containing objective and subjective questions. The quantitative data was presented in tables, the subjective, in charts, reflected through thematic analysis (Bardin). RESULTS: The findings revealed negative feelings, among others, associated to the pregnancy during adolescence and its occurrence to psychological and socio-economic factors. DISCUSSIONS: The pregnancy in adolescence can be seen as a period of search for identity, occurring due to rebelliousness, many times experienced in relation to their families and to the historical and social context. However, its explanation is multifactorial. CONCLUSION: This phenomenon may be something that is experienced positively or negatively, in a desired or undesired form, with or without family support. Therefore, it is necessary a holistic view of the fact. Hopefully this study may clarify questions regarding pregnancy in adolescence and may cooperate to establish preventive and educational actions...

INTRODUÇÃO: O exercício da sexualidade de forma inconsequente pode gerar inúmeros conflitos e interferir nos planos futuros de cada adolescente, resultando em gravidez precoce, por exemplo. OBJETIVO: Descrever as ideias associadas à temática gravidez na adolescência. MÉTODO: Trata-se de uma revisão sistemática com produção científica acerca da gravidez na adolescência divulgada em periódicos da área da saúde, no período 2006 a 2010. Tem abordagem quantitativa e qualitativa dos dados. A amostra analisada totalizou 20 artigos. O instrumento de coleta de dados foi um roteiro estruturado contendo questões objetivas e subjetivas. Os dados quantitativos foram apresentados em tabela, os subjetivos, em quadros, refletidos através da análise temática (Bardin). RESULTADOS: Os achados revelam sentimentos negativos, dentre outros, associados à gravidez na adolescência e a sua ocorrência a fatores psicológicos e socioeconômicos. DISCUSSÕES: A gravidez na adolescência pode ser vista como um período de busca da identidade, ocorrendo em virtude da rebeldia, muitas vezes vivenciada em relação a sua família e ao contexto histórico-social. Portanto, sua explicação é multifatorial. CONCLUSÃO: Este fenômeno pode ser algo vivenciado positivamente ou negativamente, de forma desejada ou indesejada, com apoio familiar ou não. Por isso, faz-se necessário uma visão holística do fato. Espera-se que este estudo elucide questões acerca da gravidez na adolescência e coopere para ações preventivas e educativas...

What is and how can be explained pregnancy in adolescence

INTRODUCTION: The inconsequential exercise of sexuality may generate innumerous conflicts and interfere wityh each adolescent's plans for the future, resulting in early pregnancy, for example. OBJECTIVE: Describe the ideas associated to the subject pregnancy in adolescence. METHODS: This is a systematic revision with scientific production about pregnancy in adolescence disseminated in health science journals, in the period of 2006 to 2010. It has a quantitative and qualitative approach to the data. The total analyzed samples were 20 articles. The data collection instrument was a structured script containing objective and subjective questions. The quantitative data was presented in tables, the subjective, in charts, reflected through thematic analysis (Bardin). RESULTS: The findings revealed negative feelings, among others, associated to the pregnancy during adolescence and its occurrence to psychological and socio-economic factors. DISCUSSIONS: The pregnancy in adolescence can be seen as a period of search for identity, occurring due to rebelliousness, many times experienced in relation to their families and to the historical and social context. However, its explanation is multifactorial. CONCLUSION: This phenomenon may be something that is experienced positively or negatively, in a desired or undesired form, with or without family support. Therefore, it is necessary a holistic view of the fact. Hopefully this study may clarify questions regarding pregnancy in adolescence and may cooperate to establish preventive and educational actions...(AU)

INTRODUÇÃO: O exercício da sexualidade de forma inconsequente pode gerar inúmeros conflitos e interferir nos planos futuros de cada adolescente, resultando em gravidez precoce, por exemplo. OBJETIVO: Descrever as ideias associadas à temática gravidez na adolescência. MÉTODO: Trata-se de uma revisão sistemática com produção científica acerca da gravidez na adolescência divulgada em periódicos da área da saúde, no período 2006 a 2010. Tem abordagem quantitativa e qualitativa dos dados. A amostra analisada totalizou 20 artigos. O instrumento de coleta de dados foi um roteiro estruturado contendo questões objetivas e subjetivas. Os dados quantitativos foram apresentados em tabela, os subjetivos, em quadros, refletidos através da análise temática (Bardin). RESULTADOS: Os achados revelam sentimentos negativos, dentre outros, associados à gravidez na adolescência e a sua ocorrência a fatores psicológicos e socioeconômicos. DISCUSSÕES: A gravidez na adolescência pode ser vista como um período de busca da identidade, ocorrendo em virtude da rebeldia, muitas vezes vivenciada em relação a sua família e ao contexto histórico-social. Portanto, sua explicação é multifatorial. CONCLUSÃO: Este fenômeno pode ser algo vivenciado positivamente ou negativamente, de forma desejada ou indesejada, com apoio familiar ou não. Por isso, faz-se necessário uma visão holística do fato. Espera-se que este estudo elucide questões acerca da gravidez na adolescência e coopere para ações preventivas e educativas...(AU)

Parathyroid carcinoma and oxyphil parathyroid adenoma: an uncommon case of misinterpretation in clinical practice.

A 46 year-old male presented with persistently high level of serum parathyroid hormone (PTH), despite successful resection of an oxyphilic cell parathyroid adenoma of the left lower gland. Renal function and serum calcium were normal, leading to vitamin D deficiency being considered. Tc99m-sestamibi parathyroid scintigraphy showed no capitation, but a cervical ultrasound demonstrated an increase in the lower parathyroids. Surgery confirmed that the right gland was normal but the left corresponded to parathyroid carcinoma. The patient developed severe hypocalcemia, with PTH values being consistent with hypoparathyroidism for a few months. However, a progressive increase in calcium and PTH serum levels indicated recurrence of disease. Tc99m-sestamibi scintigraphy demonstrated hyperfixation in topography of the left inferior parathyroid and the patient was subjected to a third and more extensive surgery, with removal of lymph nodes and adjacent thyroid tissue. Serum calcium and PTH remained elevated, requiring loop diuretics and intravenous bisphosphonates to control hypercalcemia. Cervical radiotherapy was implemented as adjuvant therapy. After two months the patient complained of dyspnea, and a CT scan of the chest demonstrated areas of parenchymal condensation, suggestive of actinic pneumonitis. At the 2-year follow-up no major issues were evident.