Efficacy of topical agents in oral mucositis prevention: Systematic review and network meta-analysis.

BACKGROUND: Oral mucositis (OM) is considered one of the most common side effects of patients undergoing cancer therapy. OM prevention plays a crucial role in the effectiveness of cancer treatment and the patient's quality of life. Different preventive treatments have been proposed in clinical trials, however with inconclusive results. MATERIALS AND METHODS: A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: in cancer patients, do specific topical agents compared to standard treatments or placebo reduce the onset and severity of oral mucositis? The risk of bias was assessed, and a network meta-analysis was conducted. RESULTS: Of 2913 results, 30 randomized clinical trials were considered suitable for inclusion. A total of 2564 patients were analyzed, of which 1284 belonged to the test group and 1280 belonged to the control group. Natural products were the most used, followed mainly by antimicrobial agents, coating agents, and basic oral care measures. Topical sucralfate resulted in the most powerful intervention for the OM prevention (OR = 0.04, 95%C.I. = 0.01-0.25, p-value = 0.001). CONCLUSION: Due to its cytoprotective action, low cost, ease of administration, and safety, sucralfate could become a potential ally to prevent the onset of OM during cancer therapy.

Mortality by avoidable causes in Brazil from 1990 to 2019: data from the Global Burden of Disease Study.

OBJECTIVES: The aim of this study was to analyse the trends of avoidable mortality in Brazil from 1990 to 2019 and its correlation with sociodemographic indexes (SDIs). STUDY DESIGN: Epidemiological mortality trends. METHODS: This study analysed data from the Global Burden of Disease database. The list of causes of avoidable death, as proposed by Nolte and McKee, was applied and included 32 causes. The current study used age-standardised mortality rates and the rates of change, in addition to a correlation analysis between avoidable death and the SDI. RESULTS: Mortality rates decreased from 343.90/100,000 inhabitants in 1990 to 155.80/100,000 inhabitants in 2019. Infectious diseases showed the largest decline in mortality rates, but notable decreases were also found for diarrhoeal diseases (-94.9%), maternal conditions (-66.5%) and neonatal conditions (-60.5%). Mortality rates for non-communicable diseases (NCDs) also decreased (-48%) but maintained a similar absolute number of deaths in 2019 compared with 1990. Decreased mortality rates were also found for ischaemic heart disease (-49.1%), stroke (-61.4%) and deaths due to adverse effects caused by medical treatments (-26.2%). Avoidable mortality rates declined in all of the 27 Brazilian states, and a high correlation was found between deaths and SDI (R = -0.74; P < 0.000001). CONCLUSIONS: A reduction in avoidable deaths was found throughout Brazil over the study period, although major regional inequalities were revealed. Richer states presented the best overall reduction in mortality rates. The biggest decreases in mortality were seen in maternal and paediatric infectious diseases in the poorest states due to the expansion of the Primary Health System and improvements in sanitation. Today, NCDs predominate and efforts should be made to formulate public policies for the prevention and control of NCDs.

Understanding consumer food choices & promotion of healthy and sustainable Mediterranean diet and lifestyle in children and adolescents through behavioural change actions: the DELICIOUS project.

Over the last decades, the abandonment of traditional dietary patterns, such as the Mediterranean diet, represents an important threat for human health and environmental safeguard. The DELICIOUS project aims to promote healthy lifestyles among children and adolescents by implementing activities and tools to increase the adherence to the Mediterranean Diet with an attention to the environmental impacts of the diet. This study protocol describes the DELICIOUS project as a single-arm, uncontrolled behavioural intervention providing formal and non-formal education activities, development of new snacks and recipe reformulation, web/mobile app development, and physical activities to school children and adolescents in five European countries. The project aims to increase awareness of the nutritional benefits and the sustainability aspects of the Mediterranean Diet and to promote consumers' empowerment through an online platform for sustainable and healthy meal planning in the school canteen.

Regeneration of periodontal intrabony defects using platelet-rich fibrin (PRF): a systematic review and network meta-analysis.

One of the most promising approaches to correct periodontal bone defects and achieve periodontal regeneration is platelet-rich fibrin (PRF). This systematic review and meta-analysis aimed to evaluate the regeneration of periodontal bone defects using PRF compared to other regenerative treatments. The data search and retrieval process followed the PRISMA guidelines. An electronic search of MEDLINE, Cochrane, and PubMed databases was performed, selecting exclusively randomized clinical trials where the following were measured: probing depth reduction (PD), clinical attachment level gain (CAL), and radiographic bone fill (RBF). Out of 284 selected articles, 32 were chosen based on inclusion criteria. The use of platelet-rich fibrin (PRF) + open flap debridement (OFD), PRF + metformin, PRF + platelet-rich plasma (PRP), and PRF + OFD/bone graft (BG) significantly reduced PD and improved CAL and RBF. However, the combination of PRF + BG, PRF + metformin, and PRF + STATINS reduced CAL. The intervention of PRF combined with different treatments such as metformin, OFD, PRP, BG, and STATINS has a significant impact on improving PD and CAL. The use of PRF significantly improved the regeneration of periodontal bone defects compared to other treatments.

Pyrosequencing Analysis of O-6-Methylguanine-DNA Methyltransferase Methylation at Different Cut-Offs of Positivity Associated with Treatment Response and Disease-Specific Survival in Isocitrate Dehydrogenase-Wildtype Grade 4 Glioblastoma.

The O-6-methylguanine-DNA methyltransferase (MGMT) gene is a critical guardian of genomic integrity. MGMT methylation in diffuse gliomas serves as an important determinant of patients' prognostic outcomes, more specifically in glioblastomas (GBMs). In GBMs, the absence of MGMT methylation, known as MGMT promoter unmethylation, often translates into a more challenging clinical scenario, tending to present resistance to chemotherapy and a worse prognosis. A pyrosequencing (PSQ) technique was used to analyze MGMT methylation status at different cut-offs (5%, 9%, and 11%) in a sample of 78 patients diagnosed with IDH-wildtype grade 4 GBM. A retrospective analysis was provided to collect clinicopathological and prognostic data. A statistical analysis was used to establish an association between methylation status and treatment response (TR) and disease-specific survival (DSS). The patients with methylated MGMT status experienced progressive disease rates of 84.6%, 80%, and 78.4% at the respective cut-offs of 5%, 9%, and 11%. The number was considerably higher when considering unmethylated patients, as all patients (100%), regardless of the cut-off, presented progressive disease. Regarding disease-specific survival (DSS), the Hazard Ratio (HR) was HR = 0.74 (0.45-1.24; p = 0.251); HR = 0.82 (0.51-1.33; p = 0.425); and HR = 0.79 (0.49-1.29; p = 0.350), respectively. Our study concludes that there is an association between MGMT unmethylation and worse TR and DSS. The 9% cut-off demonstrated a greater potential for patient survival as a function of time, which may shed light on the future need for standardization of MGMT methylation positivity parameters in PSQ.

IS THE PHOTOBIOMODULATION THERAPY EFFECTIVE IN CONTROLLING POST-SURGICAL SIDE EFFECTS AFTER THE EXTRACTION OF MANDIBULAR THIRD MOLARS? A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: The extraction of third molars is one of the most performed surgical procedures in oral and maxillofacial surgery. Pain, oedema, and trismus are the most frequently complications related in the surgical postoperative period. The literature has indicated PBM as a potential adjuvant method to reduce these complications. The aim of this review and meta-analysis is evaluate the PBM, as an optimal method to improve patient experience and minimize postoperative morbidity. Additionally, we seek to determine which wavelength, site, and frequency of application are most effective. METHODS: This review was registered in PROSPERO (CRD42023429966) and followed PRISMA guidelines. The search was carried out in the main databases, PubMed/MEDLINE, Cochrane Library, Embase, Scopus, and Lilacs, including reviews in the most important journals in the area of oral surgery and laser applied to oral surgery. In addition, all article references and also gray literature were reviewed. After the studies selection, the relevant data was collected. All the studies were randomized controlled trials and the patients were allocated into two groups: active PBM and inactive PBM. The statistical analysis was carried out using Stata v.16, and the methodological quality and risk of bias were assessed by the Jadad scale and RoB 2.0, respectively. RESULTS: Where included 22 studies and 989 subjects, to all with a minimum follow-up of 7 days. Pain and oedema showed statistically significant results in favor to the active PBM group. Especially when laser applied in infrared mode, for pain and oedema at 48 h, MD = -1.80 (CI95% -2.88, -0.72) I²â€¯= 92.13% and MD = -1.45 (CI95% -2.42, -0.48) I²â€¯= 65.01%, respectively. The same is not true for trismus at 48 h, MD = 0.07 (CI95% -0.06, 0.21) I²â€¯= 3.26%. The meta-analysis also presented results in respect of laser site of application and number of PBM sessions. CONCLUSIONS: PBM with infrared laser, in a combination intraoral and extraoral application, in one session in the immediate postoperative period, has been shown to be effective to achieve the objectives of reducing pain and oedema after third molar extraction.

Dietary Patterns During Pregnancy and Their Association with Gestational Weight Gain and Anthropometric Measurements at Birth.

BACKGROUND: Dietary patterns can influence maternal and child health outcomes. The study aims to characterize dietary patterns during pregnancy as well as to identify their associations with gestational weight gain (GWG) and anthropometric measurements at birth. METHODS: A minimum sample size of 95 nursing mothers was estimated for this work. Socioeconomic, anthropometric, physical activity, obstetric and food consumption (food frequency questionnaire) data was collected from mothers and their newborns in immediate postpartum (n = 260) at the maternity hospital. Maternal pregestational weight and GWG were self-reported and the neonatal data was obtained from their records. The patterns were derived posteriori by Principal Component Analysis (PCA). Multinomial Logistic Regression and Poisson Regression with Robust Variance were applied. FINDINGS: Four dietary patterns were derived: "pattern 1", characterized by the consumption of meat and eggs, processed meat, vegetables and olive oil; "pattern 2", consisting of sweets, snacks and cookies; "pattern 3", which includes cereals and breads, coffee and tea, and processed fats; and "pattern 4", characterized by soft drinks, tubers and instant noodles. Together, the dietary patterns account for 49.16% of the total variance for food intake. Higher adherence to "pattern 3" was associated with inadequate birth weight (low and excessive birth weight); while greater adherence to "pattern 2" was associated with lower chances of inadequate GWG. CONCLUSION: The dietary patterns presented mixed composition and predominance of ultra-processed foods. They were associated with the investigated outcomes, denoting the importance of strategies to promote healthy eating habits during pregnancy in order to avoid possible complications.

Effects of partially replacing dietary corn with molasses, condensed whey permeate, or treated condensed whey permeate on ruminal microbial fermentation.

Corn is a feedstuff commonly fed to dairy cows as a source of energy. The objective of this study was to evaluate whether partially replacing dietary corn with molasses or condensed whey permeate, in lactating dairy cow diets in a dual-flow continuous culture system, can maintain nutrient digestibility by ruminal microorganisms. Furthermore, this study evaluated whether treating condensed whey permeate before feeding could aid the fermentation of the condensed whey permeate in the rumen. Eight fermentors were used in a 4 × 4 replicated Latin square with 4 periods of 10 d each. The control diet (CON) was formulated with corn grain, and the other diets were formulated by replacing corn grain with either sugarcane molasses (MOL), condensed whey permeate (CWP), or treated condensed whey permeate (TCWP). Diets were formulated by replacing 4% of the diet dry matter (DM) in the form of starch from corn with sugars from the byproducts. Sugars were defined as water-soluble carbohydrates (WSC) in the rations. The fermentors were fed 52 g of DM twice daily of diets containing 17% crude protein, 28% neutral detergent fiber, and 45% nonfiber carbohydrates. Liquid treatments were pipetted into each fermentor. After 7 d of adaptation, samples were collected for analyses of volatile fatty acids (VFA), lactate, and ammonia, and fermentors' pH were measured at time points after the morning feeding for 3 d. Pooled samples from effluent containers were collected for similar analyses, nutrient flow, and N metabolism. Data were statistically analyzed using Proc MIXED of SAS version 9.4 (SAS Institute Inc.); fixed effects included treatment and time, and random effects included fermentor, period, and square. The interaction of treatment and time was included for the kinetics samples. The TCWP and MOL treatments maintained greater fermentor pH compared with CWP. Total VFA concentration was increased in CWP compared with MOL. The acetate:propionate ratio was increased in TCWP compared with CON, due to tendencies of increased acetate molar proportion and decreased propionate molar proportion in TCWP. Lactate concentration was increased in MOL. Digestibility of WSC was increased in the diets that replaced corn with byproducts. The partial replacement of 4% of DM from corn starch with the sugars in byproducts had minimal effects on ruminal microbial fermentation and increased pH. Treated CWP had similar effects to molasses.

Effects of replacing magnesium oxide with calcium-magnesium carbonate with or without sodium bicarbonate on ruminal fermentation and nutrient flow in vitro.

The objective of this study was to evaluate the effects of replacing magnesium oxide (MgO) with calcium-magnesium carbonate [CaMg(CO3)2] on ruminal fermentation with or without the addition of sodium bicarbonate (NaHCO3). Eight fermentors of a dual-flow continuous-culture system were distributed in a replicated (2) 4 × 4 Latin square design in a 2 × 2 factorial arrangement of treatments (magnesium sources × NaHCO3). The treatments tested were 0.21% MgO [MgO; dry matter (DM) basis; 144.8 mEq of dietary cation-anion difference (DCAD)]; 0.21% MgO + 0.50% NaHCO3 (MgO+NaHCO3; DM basis; 205.6 mEq of DCAD); 1.00% CaMg(CO3)2 [CaMg(CO3)2; DM basis; 144.8 mEq of DCAD]; and 1.00% CaMg(CO3)2 + 0.50% NaHCO3 [CaMg(CO3)2+NaHCO3; DM basis; 205.6 mEq of DCAD]. Diets were formulated to have a total of 0.28% of Mg (DM basis). The experiment consisted of 40 d, which was divided into 4 periods of 10 d each, where 7 d were used for adaptation and 3 d for sampling to determine pH, volatile fatty acids (VFA), ammonia (NH3-N), lactate, mineral solubility, N metabolism, and nutrient digestibility. The effects of Mg source [MgO vs. CaMg(CO3)2], NaHCO3 (with vs. without), and the interaction were tested with the MIXED procedure of SAS version 9.4 (SAS Institute). There was no Mg source × NaHCO3 interaction in the pH variables and mineral solubility, and Mg sources evaluated did not affect the variables related to ruminal pH and solubility of Mg. On the other hand, the inclusion of NaHCO3 increased the pH daily average, independent of Mg source, which led to a reduced time that pH was below 5.8 and decreased area under the curve. Total VFA and lactate concentration were similar among treatments regardless of NaHCO3 and Mg source; however, the molar proportion of isobutyrate and NH3-N concentration were lower in diets with CaMg(CO3)2 compared with MgO. Moreover, NaHCO3 inclusion increased NH3-N, total daily NH3-N flow, isobutyrate concentration, and acid detergent fiber digestibility. Our results showed that CaMg(CO3)2 leads to a lower NH3-N concentration and isobutyrate proportion. Therefore, because most of the tested variables were not significantly different between MgO and CaMg(CO3)2 when combined or not with NaHCO3, CaMg(CO3)2 can be a viable alternative source to replace MgO in dairy cow diets without affecting mineral solubility, ruminal pH, nutrient digestibility, total VFA, and the main ruminal VFA. Although Mg sources are known to have an alkalizing effect, NaHCO3 inclusion in diets with Mg supplementation allowed an increase in ruminal pH, as well as an increase in isobutyrate and NH3-N flow.

Phytocosmetic Containing Pink Pepper Extracts Obtained by Sustainable Extraction.

Pink pepper (Schinus terebinthifolius Raddi) has high potential for commercial use because of its biological activities (anti-inflammatory, antitumor, and antioxidant activities, among others). Herein, the antioxidant activity of a topical formulation containing pink pepper extract obtained by supercritical carbon dioxide extraction is reported. The effects of extraction pressure (100-300 bar) and temperature (40-60 °C) on its antioxidant activity were investigated. The extracts obtained at 50-60 °C showed a higher inhibition percentage in the α,α-diphenyl-ß-picrylhydrazyl (DPPH) assay (80.16-91.27 %), regardless of pressure. The extract obtained under optimized conditions (200 bar and 50 °C) was incorporated into an oil-in-water emulsion containing 2 % (m/m) pink pepper extract. The product presented a creamy texture, light rose color, mild spicy odor, and desirable pH for a topical formulation. Furthermore, the product was stable and remained effective when stored and protected from heat and light, showing 35.38 % inhibition of DPPH.

Caspase 3 and Cleaved Caspase 3 Expression in Tumorogenesis and Its Correlations with Prognosis in Head and Neck Cancer: A Systematic Review and Meta-Analysis.

Head and neck cancer (HNC) is an ascending and agressive disease. The search for new molecular markers is emerging to solve difficulties in diagnosis, risk management, prognosis and effectiveness of treatments. Proteins related to apoptotic machinery have been identified as potential biomarkers. Caspase 3 is the main effector caspase and has a key role in apoptosis. The objective of this systematic review and meta-analysis is to review studies that analyze changes in Caspase 3 and Cleaved Caspase 3 expression both in oral premalignant disorders (OPMD) as well as in head and neck cancer (HNC). This study also proposes to review the prognostic values associated with HNC according to the expression of Caspase 3. Medline (via PubMed), EMBASE, Scopus, Cochrane, Web of Science and Grey Literature Database were screened from inception to june of 2022 and 18 studies were selected and 8 were included in the prognostic meta-analysis. Results related to the comparison of Caspase 3 expression demonstrated similar expression of Caspase 3 in HNC, with an average of 51.9% (9.5-98.1) showing high/moderate expression compared to 45.7% (14.6-84.7) in OPMD. Of interest, Cleaved Caspase 3 resulted incresed in HNC when compared with OPMD, being 73.3% (38.6-88.3) versus 22.9% (7.1-38.7). Pooled Fixed effect of HR values (95% CI) for OS related to Caspase 3 IHC expression in HNC patients was 1.48 (95% CI 0.95-2.28); also, the rate of heterogeneity was low, as revealed by I2 = 31%. For DFS was 1.07 (95% CI 0.79-1.45) with I2 = 0% and DSS showed a HR of 0.88 (95% CI 0.69-1.12) with I2 = 37%. Caspase 3 and Cleaved Caspase 3 expression could be linked with malignancy progression, but the expression of Caspase 3 did not influence the prognosis of patients with HNC.

Effects of by-product from biscuit industry on performance and carcass traits of fattening Morada Nova lambs.

This research evaluated the effects of using by-product from biscuit industry (BBI) in the diet of fattening lambs of Morada Nova breed. Lamb growth performances and carcass traits were investigated. Twenty Morada Nova breed male lambs body weight (BW) 17.1 ± 3.74 kg, single born, and age 141 ± 7 days were divided into four homogeneous groups (n = 5) fed for 8.5 weeks with four experimental diets replacing corn with BBI at 0, 150, 300, and 450 g/kg. Experimental diets were consisted of 30% Tifton-85 hay and 70% concentrate on dry matter (DM) basis. Diets were formulated to be isonitrogenous and isoenergetic in order to supply nutrient requirements of growing lambs with an average daily gain of 200 g/day. Increased feeding levels of BBI partially replacing corn did not affect dry matter intake, organic matter, and crude protein intake (P > 0.05). Animal performance was not affected by the dietary treatments (P > 0.05). BBI addition to the concentrate did not influence carcass traits, carcass measurements, quali-quantitative of Longissimus lumborum muscle, and meat cuts (P > 0.05). Partially replacing corn with a by-product from biscuit industry does not affect performance and carcass traits of fattening lambs. The BBI can partially replace up to 450 g/kg DM of corn on lambs' diets as a suitable agro-industrial by-product.

Comparing the effects of whey and casein supplementation on nutritional status and immune parameters in patients with chronic liver disease: a randomised double-blind controlled trial.

Protein supplementation may be beneficial for patients with chronic liver disease (CLD). This study compared the effects of whey protein isolate (WP) and casein (CA) supplementation on nutritional status and immune parameters of CLD patients who were randomly assigned to take 20 g of WP or CA twice per d as a supplement for 15 d. Body composition, muscle functionality and plasmatic immunomarkers were assessed before and after supplementation. Patients were also classified according to the model for end-stage liver disease (MELD) into less (MELD < 15) and more (MELD ≥ 15) severe disease groups. Malnutrition, determined by the Subjective Global Assessment at baseline, was observed in 57·4 % and 54·2 % of patients in the WP and CA groups, respectively (P = 0·649). Protein intake was lower at baseline in the WP group than in the CA group (P = 0·035), with no difference after supplementation (P = 0·410). Both the WP and CA MELD < 15 groups increased protein intake after supplementation according to the intragroup analysis. No differences were observed in body composition, muscle functionality, most plasma cytokines (TNF, IL-6, IL-1ß and interferon-γ), immunomodulatory proteins (sTNFR1, sTNFR2, brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor) or immunomodulatory hormones (adiponectin, insulin and leptin) after supplementation in the WP groups at the two assessed moments. WP supplementation increased the levels of interferon-γ-induced protein-10/CXCL10 (P = 0·022), eotaxin-1/CCL11 (P = 0·031) and monocyte chemoattractant protein-1/CCL2 (P = 0·018) and decreased IL-5 (P = 0·027), including among those in the MELD ≥ 15 group, for whom IL-10 was also increased (P = 0·008). Thus, WP consumption by patients with CLD impacted the immunomodulatory responses when compared with CA with no impact on nutritional status.

Ozonated oil effect for prevention of medication-related osteonecrosis of the jaw (MRONJ) in rats undergoing zoledronic acid therapy.

OBJECTIVES: The aim of this study was to evaluate the preventive effect of ozonated oil on the development of MRONJ-like lesions at tooth extraction sites in rats submitted to zoledronic acid treatment. MATERIALS AND METHODS: Twelve rats were divided into two groups. Each rat received an injection of zoledronic acid solution once a week for 5 weeks before having its upper first molar extracted. In group 1, the clotted socket was maintained, while in the group 2, the socket was treated with ozonated oil for 10 min/day during 3 days. After euthanasia, block resection was performed for histological analysis. Necrotic bone was defined as the area of the bone with empty osteocyte lacunae and vital bone as the area with osteocyte-occupied lacunae. RESULTS: There was no statistically significant difference between the groups in the average area of vital bone (p = 0.2248) and the average area of necrotic bone (p = 0.1208). However, the average area of vital bone in group 1 was smaller (24.1 ± 2.9 cells/cm2) than in group 2 (26.8 ± 4.2 cells/cm2), and the average area of necrotic bone in group 1 was higher (7.0 ± 2.5 cells/cm2) than in group 2 (4.0 ± 1.1 cells/cm2), indicating that ozonated oil may reduce the development of osteonecrosis. CONCLUSIONS: Our findings suggest that ozonated oil might prevent MRONJ-like lesions at tooth extraction sites in rats submitted to a disease induction protocol. Further research should be conducted to confirm this hypothesis. CLINICAL RELEVANCE: MRONJ has been reported as a complication of surgical dental procedures, and there are currently no predictable preventive therapies.

The Influence of Nutrients Intake during Pregnancy on Baby's Birth Weight: A Systematic Review.

BACKGROUND AND OBJECTIVE: Maternal food intake during pregnancy can substantially interfere in the baby's anthropometric measurements at birth. Our objective was to perform a systematic review that investigate the influence of nutrient intake via food during pregnancy on the baby's anthropometric measurements at birth. METHODS: A search was performed without time limits on CINAHL, Embase, PubMed, Scopus and Web of Science databases and manual on studies references. All nutrients and baby's anthropometric measurements at birth were included as descriptors. RESULTS: Thirty articles were included, the majority of prospective cohort studies, with 15.39 (2.36) quality points (maximum value: 22). Thirty-six results of associations were found, of which 17 studies had direct associations between nutrient intake and birth outcomes. Inverse associations were identified in 8 studies and 11 articles showed no significant associations in all analyses. Maternal food intake of vitamin C, calcium and magnesium during pregnancy seems to have a positive influence on the baby's birth weight, while carbohydrates intake have an inverse association with the same outcome. CONCLUSION: It is suggested that vitamin C, calcium, magnesium and carbohydrates influence on baby's birth weight. So, these specific nutrients need more attention to the consumption, in addition to carried out new studies, with robust methodologies for measuring maternal food consumption and considering the several factors that can interfere in this assessment. REGISTRATION: This review has been registered to the PROSPERO (International prospective register of systematic reviews) (ID: CRD42020167889).

Effects of different banana crop wastes on nutrient intake and digestibility, microbial protein synthesis, feeding behavior, and animal performance of ¾ Holstein × Zebu heifers in a semiarid rangeland.

The objective of this study was to evaluate the use of banana crop wastes in diets of ¾ Holstein × » Zebu heifers on the intake and digestibility of nutrients, microbial protein synthesis, feeding behavior, and animal performance. Eight ¾ Holstein × » Zebu heifers were utilized with an average age of 18 ± 1.0 months and an average body weight (BW) of 298 ± 3.06 kg. The experiment was distributed in two simultaneous 4 × 4 Latin squares. The treatments were as follows: Diet 1 (SS)-sorghum silage as exclusive dietary roughage; diet 2 (SSL)-sorghum silage (50%) associated with 50% leaf hay of banana trees (on a DM basis); diet 3 (SSBP)-sorghum silage (50%) associated with 50% banana peel hay; and diet 4 (SSPS)-sorghum silage (50%) associated with 50% pseudostem hay of banana trees. The roughage:concentrate ratio was 75:25. The greatest dry matter intake (DMI; p < 0.01) was found in heifers that received the SS and SSBP diet, mean of 10.19 kg/day. The SS diet showed greatest dry matter digestibility (DMD; p < 0.01) and crude protein digestibility (CPD; p < 0.01). The concentration of total purines (p < 0.01) and absorbed purines (p < 0.01), microbial protein synthesis (p < 0.01), and microbial efficiency (p < 0.01) was higher in the SSBP diet in comparison with SS and SSL diets. The longest eating time was observed in animals that received the SSL diet, being 17.79% higher (p = 0.01) than the SSBP diet. The final BW (p = 0.39) and BW gain (p = 0.39) were similar, with averages of 319.84 kg and 1.08 kg/day, respectively. Biometric measurements were not altered as a function of bedtime (p > 0.05). Banana wastes can be used to feed ¾ Holstein × » Zebu heifers in partial replacement for sorghum silage as they do not alter the animals' weight gain and body development.

Nutritional efficiency of feed-restricted F1 Holstein/Zebu cows during the middle third of lactation.

OBJECTIVE: The objective of this study was to evaluate the effects of different levels of quantitative feed restriction on nutrient intake and digestibility, nitrogen balance, efficiency and feeding behavior, and productive performance in F1 Holstein/Zebu cows during the middle third of their lactation. METHODS: Sixty F1 Holstein/Zebu cows with 111.5 ± 11.75 days of lactation and an initial body weight (BW) of 499 ± 30 kg (mean ± SEM) were used. The experimental design was completely randomized with the following diet levels of feed restriction: 3.39%, 2.75%, 2.50%, 2.25% and 2.00% of BW, with 12 replications for each level.The experiment lasted for 63 days, of which each period lasted 21 days with the first 16 days for diet adaptation followed by 5 days for collection of data and samples. RESULTS: For each 1% of BW diet restriction, there was a decrease in dry matter intake of 5.26 kg/day (p &lt;0.01). There was no difference in daily milk production (p = 0.09) under the restriction levels of 3.39% to 2.0% of BW. When corrected for 3.5% fat, milk production declined (p = 0.05) 3.46 kg/day for each percentage unit of feed restriction. CONCLUSION: Restricting the feed supply for F1 Holstein/Zebu cows in the middle third of their lactation period altered nutrient intake, nitrogen balance and ingestive behavior but did not affect milk production or feed efficiency. However, considering the observed body weight loss and decrease in milk production corrected for 3.5% fat, restriction of no less than 2.5% BW is recommended.

Dietary chia (Salvia hispanica L.) improves the nutritional quality of broiler meat.

OBJECTIVE: The current study was conducted to evaluate the quality and profile of fatty acid in the breast and thigh, and the performance of broilers fed diets containing seed or oil of chia (Salvia hispanica L.) as a replacement for soybean, in the rearing period from 29 to 42 days of age. METHODS: On the 29th day of age, 120 broilers were distributed in four treatments evaluated in five replicates of six birds. The grain or oil of soybean was respectively replaced on a weightto-weight basis in the formulation by the seed or oil of chia, constituting the experimental diets. The roasted whole soybean and chia seed were included in the feed at 16.4%, whereas the soybean and chia oils were included at 2.5%. RESULTS: The dietary chia oil increased the lipid peroxidation in the thigh meat, and the dietary chia seed increased the cooking loss of the thigh. However, for the other physicochemical parameters evaluated and for the proximate composition of the breast and thigh, in general, the inclusion of chia seed or oil in the diet provided similar or better results than those observed when the diets contained soybean oil or roasted whole soybean. With regard to the fatty acid profile and associated parameters, dietary chia increased the concentrations of α-linolenic, eicosapentaenoic, and docosahexaenoic acids and reduced the Σω-6:Σω-3 ratio and the atherogenicity and thrombogenicity indices of the broiler meat. However, the dietary chia seed worsened the feed conversion ratio. CONCLUSION: Diet containing 2.5% chia oil supplied to broilers during the period from 29 to 42 days of age improves the feed conversion ratio, increases the deposition of the ω-3 fatty acids in the breast and thigh, in addition to reducing the Σω-6:Σω-3 ratio and the atherogenicity and thrombogenicity indices, thereby resulting in meat with higher nutritional quality.

Sacral neuromodulation for fecal incontinence in Latin America: initial results of a multicenter study.

BACKGROUND: Sacral neuromodulation (SNM) is a widely used therapeutic option for fecal incontinence (FI). Larger series are mainly from Western countries, while few reports address the results of SNM in less developed or less wealthy countries. The aim of the present study was to evaluate the efficacy of SNM in patients with FI in Latin America. METHODS: A retrospective study was conducted on patients with FI who had SNM between 2009 and 2016 at 15 specialized colorectal surgery centers in Latin America. Main outcomes measures were functional outcomes, postoperative complications, requirement of revisional surgery, and requirement of device removal. All patients had failed conservative management and had clinical assessment including recording of the validated Cleveland Clinic Florida Fecal Incontinence Score (CCF-FIS) and, when available, anal manometry and endoanal ultrasound. Patients were followed up for a median of 36.7 (1-84) months. RESULTS: One hundred and thirty-one patients [119 females, median age of 62.2 (range 19-87) years] were included. The most common etiology of FI was obstetric injury (n = 60; 45.8%). After successful test lead implantation, the stimulator was permanently placed in 129 patients (98.5%). One patient failed to respond in the test phase and one patient did not proceed to permanent implantation for insurance reasons. Nineteen patients (14.7%) had 19 complications including infection (n = 5, 3.8%), persistent implant site pain (n = 5, 3.8%), generator/lead dislodgment (n = 5, 3.8%), malfunctioning device (n = 3, 2.3%), and hematoma (n = 1, 0.7%). Reimplantation after the first and second stages was necessary in 2 (1.5%) and 3 patients (2.3%), respectively. The device removal rate was 2.2%. At a median follow-up of 36.7 (range 1-84) months, the CCF-FIS significantly improved from a preoperative baseline of 15.9 ± 2.98 to 5.2 ± 3.92 (95%CI: 15.46 vs 4.43; p < 0.0001). Overall, 90% of patients rated their improvement as "significant". CONCLUSIONS: Sacral nerve stimulation for FI is safe and efficient, even in less wealthy or less developed countries.

Nutritional and productive parameters of Holstein/Zebu cows fed diets containing cactus pear

Objective: This study ascertained effects of cactus pear in association with different roughage in the diet of F1 Holstein/Zebu cows on intake, nutrient digestibility, nitrogen balance, ingestive behavior and performance. Methods: Eight cows with 72 ± 11 days of lactation were used. The experimental design was simultaneous in two 4 x 4 Latin squares. Four experimental diets were used: Diet 1 - sorghum silage as exclusive roughage; Diet 2 - sorghum silage associated with cactus pear in a proportion of 50% of the roughage (dry basis); Diet 3 - elephant grass (Pennisetum purpureum cv. Roxo) as exclusive roughage; Diet 4 - elephant grass associated with cactus pear in a proportion of 50% of the roughage. The roughage:concentrate ratio was 75:25. Dry matter intake (P = 0.01) was higher with sorghum silage. Results: There were differences in dry matter intake (P = 0.01), crude protein (P <0.01), ether extract (P = 0.01), non-fibrous carbohydrates (P <0.01) and total digestible nutrients (P = 0.01) among the diets. Cactus pear in the diet reduced water intake by 44.52% (P < 0.01). The nitrogen balance was 59.71% and 27.49% lower in animals treated with exclusive sorghum silage and sorghum silage associated with cactus pear in relation to diets with elephant grass and elephant grass associated with cactus pear, respectively (P < 0.01). The diets did not influence the milk production (P = 0.70), 3.5% fat corrected milk production (P = 0.72) or feed efficiency (P = 0.61). Conclusion: The association of cactus pear with sorghum or elephant grass silage does not alter milk production, reduces the intake of dry matter and water and improves the digestibility of nutrients.