Characteristics and Risk Factors of Central Nervous System Infection in Children With Febrile Seizures.

OBJECTIVE: The aim of the present study is to evaluate the necessity of performing lumbar puncture in patients experiencing febrile seizures, considering the epidemiology specific to Brazil. METHODS: A retrospective cross-sectional study was performed from January 2017 to December 2021. RESULTS: A total of 469 children with seizure and fever were analyzed. The identified event was the first in 65.9% (n = 309). A total of 54.2% (n = 254) of patients had a simple febrile seizure. Infectious focus, excluding previous central nervous system (CNS) infection, was identified in 35.6% (n = 167) patients. Meningitis was identified in 7.7% (n = 36) patients, all of them were viral. Patients with CNS infection had a higher frequency of symptoms such as nausea and vomiting, drowsiness, headache, and higher level of leukocytosis. A longer duration of fever was found to be more strongly associated with CNS infection. CONCLUSIONS: When considering the use of lumbar puncture in febrile seizure, it is important to conduct a comprehensive evaluation that considers multiple factors, including clinical signs, symptoms, and the overall clinical context. Meningeal signs may be less prominent, and other symptoms such as lethargy, irritability, and vomiting may serve as more reliable indicators. Although clinical examination suggestive of meningitis remains an important factor, the recurrence of febrile seizures and a longer length of fever can provide additional insights and aid in decision-making regarding lumbar puncture.

Toxicological Profile and Anti-Inflammatory Effect of Mucoadhesive Gel from Residues of Agave sisalana and Punica granatum.

Inflammation is a natural protective reaction of the body against endogenous and exogenous damage, such as tissue injuries, trauma, and infections. Thus, when the response is adequate, inflammation becomes a defense mechanism to repair damaged tissue, whereas when the response is inadequate and persistent, the increase in inflammatory cells, cytosines, and chymosins impair tissue regeneration and promote a response harmful to the organism. One example is chronic tissue inflammation, in which a simple lesion can progress to ulcers and even necrosis. In this situation, the anti-inflammatory medications available in therapy are not always effective. For this reason, the search for new treatments, developed from medicinal plants, has increased. In this direction, the plants Agave sisalana (sisal) and Punica granatum (pomegranate) are rich in saponins, which are secondary metabolites known for their therapeutic properties, including anti-inflammatory effects. Although Brazil is the world's leading sisal producer, approximately 95% of the leaves are discarded after fiber extraction. Similarly, pomegranate peel waste is abundant in Brazil. To address the need for safe and effective anti-inflammatory treatments, this study aimed to create a topical mucoadhesive gel containing a combination of sisal (RS) and pomegranate residue (PR) extracts. In vitro experiments examined isolated and combined extracts, as well as the resulting formulation, focusing on (1) a phytochemical analysis (total saponin content); (2) cytotoxicity (MTT assay); and (3) a pharmacological assessment of anti-inflammatory activity (phagocytosis, macrophage spreading, and membrane stability). The results revealed saponin concentrations in grams per 100 g of dry extract as follows: SR-29.91 ± 0.33, PR-15.83 ± 0.93, association (A)-22.99 ± 0.01, base gel (G1)-0.00 ± 0.00, and association gel (G2)-0.52 ± 0.05. In MTT tests for isolated extracts, cytotoxicity values (µg/mL) were 3757.00 for SR and 2064.91 for PR. Conversely, A and G2 exhibited no cytotoxicity, with increased cell viability over time. All three anti-inflammatory tests confirmed the presence of this activity in SR, PR, and A. Notably, G2 demonstrated an anti-inflammatory effect comparable to dexamethasone. In conclusion, the gel containing SR and PR (i.e., A) holds promise as a novel herbal anti-inflammatory treatment. Its development could yield economic, social, and environmental benefits by utilizing discarded materials in Brazil.

Toxicity and Anti-Inflammatory Effects of Agave sisalana Extract Derived from Agroindustrial Residue.

BACKGROUND: In several countries, the leaf juice of Agave sisalana (also known as sisal) is widely used topically, especially as an antiseptic, and orally for the treatment of different pathologies. However, in Brazil, which is the largest producer of Agave sisalana, its residue, which represents the majority of its weight, has been thrown away. For this reason, the determination of the pharmacological and toxicological potentials of sisal residue and its possible therapeutic use is seen as a way to contribute to the sustainable development and social promotion of the largest producer of sisal in Brazil, the interior of Bahia State, which is among the poorest areas in the country. Given the scarcity of available scientific studies on the pharmacological and toxicological properties of sisal residue juice, this study aimed to promote the acid hydrolysis of this juice to potentiate the anti-inflammatory effect already described in the literature. Furthermore, it aimed to evaluate the toxicological profile of the hydrolyzed extract (EAH) and to determine its acute toxicity, as well as its side effects on the reproductive aspects of rats. METHOD: The anti-inflammatory effect of EAH was evaluated in vitro using the induction of hemolysis by hypotonic solution and in vivo in rats using the carrageenan-induced paw edema test and the xylene-induced ear edema test. The acute toxicity, resulting from a single-dose administration, was investigated for some manifestation of toxic symptoms related to motor control and consciousness in rats. At a concentration of 100 mg/kg, by repeated doses, the reproductive toxicity effects of EAH in rats were assessed. RESULTS: In vitro anti-inflammatory activity was positive using the human red blood cell membrane stabilization method. In both in vivo tests used to assess the anti-inflammatory activity, EAH (at three doses) significantly inhibited edema when compared to the control group. At a dose of 50 mg/kg, EAH exhibited a greater effect than indomethacin, a nonsteroidal anti-inflammatory drug with known activity. In vivo toxicological studies have shown that EAH does not present toxic effects when administered orally in a single dose, up to 1000 mg/kg. Finally, EAH promoted a gonadotoxic effect and increased the embryonic mortality rate after implantation. CONCLUSIONS: It is suggested that the anti-edematogenic effect of the acid hydrolysis extract from sisal juice is due to the high concentration of steroidal sapogenins. Therefore, this extract can be considered a potential new anti-inflammatory or even an important sapogenin source for the development of steroidal glucocorticoids. However, further studies are needed to elucidate the chemical composition of sisal juice. Regarding toxicology studies, EAH did not show cytotoxic and clastogenic potentials, but it presented a powerful reproductive toxic effect in rats.

Anti-Inflammatory Effect and Toxicological Profile of Pulp Residue from the Caryocar Brasiliense, a Sustainable Raw Material.

Caryocar brasiliense Cambess is a plant species typical of the Cerrado, a Brazilian biome. The fruit of this species is popularly known as pequi, and its oil is used in traditional medicine. However, an important factor hindering the use of pequi oil is its low yield when extracted from the pulp of this fruit. Therefore, in this study, with aim of developing a new herbal medicine, we an-alyzed the toxicity and anti-inflammatory activity of an extract of pequi pulp residue (EPPR), fol-lowing the mechanical extraction of the oil from its pulp. For this purpose, EPPR was prepared and encapsulated in chitosan. The nanoparticles were analyzed, and the cytotoxicity of the encapsu-lated EPPR was evaluated in vitro. After confirming the cytotoxicity of the encapsulated EPPR, the following evaluations were performed with non-encapsulated EPPR: in vitro anti-inflammatory activity, quantification of cytokines, and acute toxicity in vivo. Once the anti-inflammatory activity and absence of toxicity of EPPR were verified, a gel formulation of EPPR was developed for topical use and analyzed for its in vivo anti-inflammatory potential, ocular toxicity, and previous stability assessment. EPPR and the gel containing EPPR showed effective anti-inflammatory activity and lack of toxicity. The formulation was stable. Thus, a new herbal medicine with anti-inflammatory activity can be developed from discarded pequi residue.

Management of Psoriatic Arthritis in Patients With Comorbidities: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations.

OBJECTIVE: The 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations provide an evidence-based guide for selecting therapy based on the individual's disease features. Beyond the disease features and associated conditions (eg, uveitis and inflammatory bowel disease), comorbidities play an important role in selecting therapy for an individual patient. METHODS: We performed a systematic literature review. We examined the available evidence to inform treatment selection based on the presence or absence of comorbidities in psoriatic arthritis (PsA). RESULTS: Common comorbidities in PsA that may affect treatment selection include presence of baseline cardiovascular disease (CVD) or high risk for CVD, obesity and metabolic syndrome, liver disease, mood disorders, including depression in particular, chronic infections, malignancies, osteoporosis, and fibromyalgia and/or central sensitization. CONCLUSION: Comorbidities may influence both the effectiveness of a given therapy but also the potential for adverse events. It is important to assess for the presence of comorbidities prior to therapy selection.

Saccharomyces cerevisiae as a yeast culture with a fermentation medium improves the performance of feedlot cattle / Saccharomyces cerevisiae como cultura de levedura com meio fermentativo melhora o desempenho de bovinos confinados

Increasing the energy content of animal feed aims to enhance productive performance and improve carcass finishing. However, when randomly performed, this action can result in gastrointestinal dysfunctions that impair performance. One way to avoid such dysfunctions is to supplement the animal feed with Saccharomyces cerevisiae yeast. The present study aimed to evaluate the effect of Saccharomyces cerevisiae, as a yeast culture or autolyzed yeast, on ingestive behavior, apparent feed digestibility, productive performance, and carcass traits of feedlot finished steers. Thirty-six ½ Angus x ½ Nellore animals with 369 ± 4 kg average initial body weight were used. The experiment lasted 133 days: 28 days for adaptation to the experimental diets and facilities, four evaluation periods, three of which with 28 days, and a fourth period with 21 days. The experimental design was a completely randomized block with three treatments and six replications. The treatments were a yeast-free diet (Control), a diet with yeast culture (7 g animal-1 day-1), and a diet with autolyzed yeast (7 g animal-1 day-1). The experimental diet consisted of 400 g kg-1 corn silage and 600 g kg-1 concentrate on a dry matter basis. Animals supplemented with yeast culture spent more time ruminating and showed higher apparent digestibility of dry matter (5.94 hours day-1 and 74.67%, respectively). Supplementation with yeast culture resulted in greater daily weight gains in animals from 0-56, 0-84, and 0-105 experimental days (1.661, 1655, and 1.667 kg day-1, respectively) than animals that received autolyzed yeast, and those that received no additive, as well as feed conversion was better for these animals. Daily and experimental carcass gains were higher for animals that received yeast culture (1.119 kg day-1, and 117.5 kg, respectively). Animals supplemented with yeast culture had greater fat thickness in the Longissimus dorsi, in the rib region, and greater subcutaneous fat gain throughout the finishing period (5.61, 6.25, and 3.04 mm, respectively). The supply of yeast culture is recommended during the finishing phase as it improves feed digestibility and promotes greater weight gain, carcass gain, and greater subcutaneous fat deposition.(AU)

Elevar o teor energético da ração dos animais tem por intuito potencializar o desempenho produtivo e promover melhor acabamento nas carcaças. No entanto, esta ação quando realizada ao acaso pode gerar disfunções no trato gastrointestinal que comprometem o desempenho. Uma forma de evitar tais disfunções é administrar leveduras Saccharomyces cerevisiae de forma suplementar na ração dos animais. O objetivo do presente estudo foi avaliar o efeito do uso de Saccharomyces cerevisiae, como cultura de leveduras ou como levedura autolisada, no comportamento ingestivo, digestibilidade aparente da ração, desempenho produtivo e as características de carcaça de novilhos terminados em confinamento. Foram utilizados 36 animais ½ Angus x ½ Nelore com peso corporal médio inicial de 369 ± 4 kg. O experimento teve duração de 133 dias divididos em 28 dias de adaptação às rações e instalações experimentais, e quatro períodos de avaliação, sendo três períodos de 28 dias e um quarto período de 21 dias. O delineamento experimental foi de blocos inteiramente casualizados com três tratamentos e seis repetições. Os tratamentos foram: ração sem leveduras (Controle); ração com cultura de leveduras (7 g animal-1 dia-1); e ração com levedura autolisada (7 g animal-1 dia-1). A ração experimental foi constituída por 400 g kg-1 silagem de milho e 600 g kg-1 concentrado em base de matéria seca. Os animais suplementados com cultura de leveduras permaneceram mais tempo ruminando e apresentaram maior digestibilidade aparente da matéria seca em relação aos demais (5,94 horas dia-1 e 74,67%, respectivamente). O uso de cultura de leveduras promoveu maiores ganhos de peso diário de 0-56, 0-84 e de 0-105 dias (1,661, 1655 e 1,667 kg dia-1, respectivamente) em relação aos animais que receberam levedura autolisada e aos que não receberam nenhum aditivo, assim como a conversão alimentar foi melhor para estes animais. Os ganhos de carcaça diário e do período experimental foram superiores para os animais que receberam cultura de leveduras em suas rações (1,119 kg dia-1 e 117,5 kg respectivamente). Os animais suplementados com cultura de leveduras possuíram maior espessura de gordura no Longissimus dorsi, na região do costilhar e maior ganho de gordura subcutânea ao longo do período de terminação (5,61, 6,25 e 3,04 mm, respectivamente). O uso da cultura de leveduras na fase de terminação é recomendado, pois melhora a digestibilidade da ração e promove maior ganho de peso, ganho de carcaça e maior deposição de gordura subcutânea.(AU)

Supplementation of yeast culture combined with an enzyme complex in the diet for confined steers / Suplementação de cultura de leveduras em associação com complexo enzimático na dieta de novilhos confinados

The objective was to evaluate the productive performance, apparent digestibility of the diet and ingestive behavior of beef cattle finished in feedlot under the effect of the inclusion of yeast culture or enzyme complex. The treatments were: diet without additives (control); diet with enzyme complex (7 g animal day-1); diet with yeast culture (7g animal day-1) and diet with the association of enzymatic complex (7 g animal day-1) and yeast culture (7g animal day-1). The experimental design was completely randomized, with five replications. Forty ½ Angus ½ Nellore steers, with an average initial body weight of 362 kg ± 6 kg, were used. Regardless of the evaluation period, non-supplementation caused the animals to gain less weight (0 to 21 days: 1.267 kg day-1; 0 to 42 days: 1.377 kg day-1; 0 to 63 days: 1.368 kg day-1) compared to supplemented animals, feed conversion for non-supplemented animals was also worse. Starch apparent digestibility showed higher averages when steers were supplemented with yeast culture alone and yeast culture combined with enzyme complex (97.30% and 97.07%, respectively). Supplementation using a combination of yeast culture with enzyme complex did not cause additional effects on weight gain, but resulted in the lowest averages for feed conversion.(AU)

Objetivou-se avaliar o desempenho produtivo, digestibilidade aparente da dieta e comportamento ingestivo de bovinos de corte terminados em confinamento sob efeito da inclusão de cultura de leveduras ou de complexo enzimático. Os tratamentos foram assim constituídos: dieta sem aditivos (controle); dieta com complexo enzimático (7 g animal dia-1); dieta com cultura de levedura (7g animal dia-1) e dieta com a associação de complexo enzimático (7 g animal dia-1) e cultura de levedura (7g animal dia-1). O delineamento experimental foi o inteiramente casualizado, com cinco repetições. Utilizou-se 40 novilhos inteiros, ½ sangue Angus ½ sangue Nelore, com peso vivo médio inicial de 362 kg ± 6kg. Independente do período de avaliação, a não suplementação fez com que os animais ganhassem menos peso (0 a 21 dias: 1,267 kg dia-1; 0 a 42 dias: 1,377 kg dia-1; 0 a 63 dias: 1,368 kg dia-1) em relação aos animais suplementados, a conversão alimentar para os animais não suplementados também foi pior. A digestibilidade aparente do amido apresentou maiores médias quando os novilhos foram suplementados com cultura de levedura isolada e com cultura de levedura associada com complexo enzimático (97,30% e 97,07% respectivamente). A suplementação na forma de associação da cultura de leveduras ao complexo enzimático não apresentou efeitos adicionais sobre o ganho de peso, mas possui as menores médias para conversão alimentar.(AU)

Associative effect of essential oils, tannins, and sodium monensin on the performance of steers finished in feedlot / Efeito associativo de óleos essenciais, taninos e monensina sódica sobre o desempenho de novilhos terminados em confinamento

The objective was to evaluate the productive performance, ingestive behavior, apparent digestibility of the diet and carcass traits of beef steers finished in feedlot under the effect of including tannins and essential oils (TAN+EO) alone or combined with sodium monensin (MO) in the feed. For this purpose, 30 ½ blood Angus steers from the same herd, with an average age of 12 months and an average initial body weight of 367.8 kg were used. The experimental design was randomized blocks, consisting of three treatments: MO - diet with sodium monensin (25 mg kg DM-1); TAN+EO - diet with tannins and essential oils (1.5 g kg DM-1); and MO+TAN+EO - diet with sodium monensin + tannins and essential oils (25 mg kg DM-1 + 1.5 g kg DM-1), with five repetitions, where each repetition was represented by a stall with two animals. Diets were formulated and consisted of a mixture of 40% corn silage and 60% concentrate, which was fed to the animals twice a day, at 06h00 am and 05h30 pm. There was no difference (P>0.05) in average daily weight gain of animals between treatments, with an average of 1.392 kg day-1. Carcass yield was higher for animals that received the compound of essential oils and tannins (55.72%), compared to animals fed the combination of tannins, essential oils and monensin (54.54%) but did not differ from those supplemented with sodium monensin alone (55.58%). Supplementation with essential oils and tannins improved the apparent digestibility of the diet, however, did not promote changes in the ingestive behavior and carcass traits of steers. The combination of essential oils and tannins with sodium monensin did not show a potentiated effect on animal performance, digestibility of DM, digestive and ingestive behavior and carcass traits of feedlot finished steers compared to the combined use of essential oils with tannins.(AU)

Objetivou-se avaliar o desempenho produtivo, o comportamento ingestivo, a digestibilidade aparente da dieta e as características de carcaça de novilhos de corte terminados em confinamento sob efeito da inclusão de taninos e óleos essenciais (TAN+OE) de forma isolada ou associada a monensina sódica (MO) na ração. Para tal utilizou-se 30 novilhos, ½ sangue Angus, provenientes de mesmo rebanho, com idade média de 12 meses e peso vivo médio inicial de 367,8 kg. O delineamento experimental foi o de blocos casualizados, constituído de três tratamentos sendo: MO - dieta com monensina sódica (25 mg kg MS-1); TAN+OE - dieta com taninos e óleos essenciais (1,5 g kg MS-1); e MO+TAN+OE - dieta com monensina sódica + taninos e óleos essenciais (25 mg kg MS-1 + 1,5 g kg MS-1), com cinco repetições, onde cada repetição foi representada por uma baia com dois animais. As dietas foram formuladas e constituídas por uma mistura de 40% de silagem de milho e 60% de concentrado, a qual foi fornecida aos animais duas vezes ao dia, às 06h00 e às 17h30 horas. Não ocorreu diferença (P>0,05) no ganho de peso médio diário dos animais entre os tratamentos, apresentando média de 1,392 kg dia-1. O rendimento de carcaça foi superior para os animais que receberam composto de óleos essenciais e taninos (55,72%), em relação aos animais que receberam a associação de taninos, óleos essências e monensina (54,54%) no entanto não diferiram dos suplementados com monensina sódica isolada (55,58%). A suplementação com óleos essenciais e taninos melhorou a digestibilidade aparente da dieta, entretanto, não promoveu alterações no comportamento ingestivo e nas características de carcaça de novilhos. A associação de óleos essenciais e taninos à monensina sódica não apresentou efeito potencializado no desempenho animal, digestibilidade da MS, comportamento digestivo e ingestivo e características de carcaça de novilhos terminados em confinamento frente ao uso de óleos essenciais com taninos.(AU)

On the efficacy, innocuity and residual depletion of flavomycin in confined steers / Avaliação da eficácia, inocuidade e depleção residual da flavomicina em novilhos confinados

Flavomycin is a non-ionophore additive little studied in finishing confined cattle. Therefore, this study aimed to evaluate the effectiveness of flavomycin on productive performance, ingestive behavior, carcass traits and biochemical parameters of steers finished in confinement. 32 whole steers, ½ Angus e ½ Nellore blood, from the same herd, with a mean age of 11 ± 1.5 months and initial body weight of 337 ± 6 kg were evaluated. The experiment was a randomized block design, consisting of two treatments and eight replications, as follows: Diet without flavomycin (control) and Diet with flavomycin (0.5 g FLAVIMPEX®80 animal day-1). There was no difference between treatments, the average dry matter intake of the animals was 10.03 kg day-1, feed efficiency was 0.158 kg, average daily gain was 1.593 kg day-1, apparent diet digestibility was 61.69%. The use of flavomycin was not effective in animal performance, and caused no changes in ingestive behavior and carcass traits of the animals. Total Plasma Protein, Aspartate amino-transferase and creatinine were lower for animals supplemented with flavomycin compared to the control group. In relation to the experimental period, there was a reduction in the levels of Total Plasma Protein, an increase in albumin, Gamma-Glutamyl Transferase and urea in cattle, but all remained within the reference range for the species.(AU)

A flavomicina é um aditivo que pertence à classe dos não ionóforos, contudo, com poucos estudos realizados com bovinos confinados em fase de terminação. Diante disso, o objetivo do presente estudo foi avaliar a eficácia da flavomicina sobre o desempenho produtivo, comportamento ingestivo, características de carcaça e os parâmetros bioquímicos de novilhos terminados em confinamento. Foram avaliados 32 novilhos inteiros, ½ sangue Angus ½ sangue Nelore, provenientes do mesmo rebanho, com idade média de 11 meses ± 1,5 meses e peso corporal inicial de 337 kg ± 6 kg. O delineamento experimental foi o de blocos casualizados, composto por dois tratamentos e oito repetições, sendo: Dieta sem flavomicina (controle) e Dieta com flavomicina (0,5 g animal dia-1 do produto FLAVIMPEX®80). Não ocorrendo diferença entre os tratamentos, o consumo de matéria seca médio dos animais foi de 10,03 kg dia-1, eficiência alimentar de 0,158 kg, ganho médio diário de 1,593 kg dia-1, digestibilidade aparente da dieta de 61,69%. O uso da flavomicina não foi eficaz no desempenho animal, assim como não trouxe alterações no comportamento ingestivo e melhorias nas características de carcaça dos animais. A Proteína Plasmática Total, Aspartato amino-transferase e creatinina foram inferiores para os animais suplementados com flavomicina em relação ao grupo controle. Em relação ao período experimental houve redução nos índices de Proteína Plasmática Total, aumento na albumina, Gama-Glutamil Transferase e ureia dos bovinos, mas todos se mantiveram dentro dos valores de referência para a espécie.(AU)

Efeito de diferentes filmes plásticos dupla face sobre características quimíco-fermentativas da silagem de milho / Effect of different double-sided plastic films on chemical and fermentation characteristics of corn silage

O objetivo deste trabalho foi avaliar a eficiência de diferentes filmes plásticos dupla face sobre as características quimiofermentativas, digestibilidade da matéria seca, estabilidade aeróbica, perdas físicas e de matéria seca de silagens de milho armazenadas em silos trincheira. O delineamento experimental utilizado foi inteiramente casualizado, compostos por três tratamentos: DF110µm - polietileno dupla face com espessura de 110 µm; DF200µm - polietileno dupla face com espessura de 200 µm; e DFBO - película impermeável ao oxigênio composta de polietileno dupla face com espessura de 80 µm sobreposta a uma película de poliamida translúcida a vácuo com espessura de 20 µm. O uso do filme DF200µm aumentou em 4,58% a digestibilidade ruminal da matéria seca e reduziu em 3,1 °C a temperatura da silagem, assim como as perdas físicas da silagem de milho foram reduzidas em 118,9 g kg-¹ da MS pela utilização do DFBO e 95 g kg-1 da MS com o DF200µm, o DFBO apresentou a maior estabilidade aeróbica (127 horas) da silagem de milho. O uso de filme DF200µm e DFBO é recomendado para conservação de silagem de milho em silos do tipo trincheira.

The objective of this study was to evaluate the efficiency of different double-sided plastic films on chemical and fermentation characteristics, dry matter digestibility, aerobic stability, physical and dry matter losses in corn silages stored in bunker silos. This was a completely randomized experimental design consisting of three treatments: DF110µm - double-sided polyethylene with 110 µm thickness; DF200µm - double-sided polyethylene with 200 µm thickness; and DFBO - oxygen-impermeable film consisted of double-sided polyethylene with 80 µm thickness overlaid with a translucent vacuum polyamide film with 20 µm thickness. The use of DF200µm film increased the ruminal dry matter digestibility by 4.58% and reduced the silage temperature by 3.1 °C, as well as the physical losses of the corn silage were reduced by 118.9 g kg-1 DM using DFBO and 95 g kg-¹ DM with DF200µm; DFBO resulted in the highest aerobic stability (127 hours) of corn silage. The use of DF200µm and DFBO is recommended for preserving corn silage in bunker silos.

Pathogenic implications, incidence, and outcomes of COVID-19 in autoimmune inflammatory joint diseases and autoinflammatory disorders

Abstract As the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread rapidly, there are still many unresolved questions of how this virus would impact on autoimmune inflammatory joint diseases and autoinflammatory disorders. The main aim of this paper is to describe the main studies focusing their attention on COVID-19 incidence and outcomes of rheumatoid arthritis (RA), spondylarthritis (SpA), and autoinflammatory disease cohorts. We also revised possible pathogenic mechanisms associated with. Available data suggest that, in patients with RA and SpA, the immunosuppressive therapy, older age, male sex, and the presence of comorbidities (hypertension, lung disease, diabetes, CVD, and chronic renal insufficiency/end-stage renal disease) could be associated with an increased risk of infections and high rate of hospitalization. Other studies have shown that lower odds of hospitalization were associated with bDMARD or tsDMARDs monotherapy, driven largely by anti-TNF therapies. For autoinflammatory diseases, considering the possibility that COVID-19 could be associated with a cytokine storm syndrome, the question of the susceptibility and severity of SARS-CoV-2 infection in patients displaying innate immunity disorders has been raised. In this context, data are very scarce and studies available did not clarify if having an autoinflammatory disorder could be or not a risk factor to develop a more severe COVID-19. Taking together these observations, further studies are likely to be needed to fully characterize these specific patient groups and associated SARS-CoV-2 infection.

SCHISTOSOMAL MYELORADICULOPATHY IN A NON-ENDEMIC AREA.

OBJECTIVE: To report a schistosomal myeloradiculopathy case in a non-endemic area. CASE DESCRIPTION: A previously healthy 11-year-old boy, stricken by an acute loss of strength on his lower limbs, followed by a loss of strength on his upper limbs and upper body, associated with altered sensitivity of the vesical globe formation. The patient's cerebrospinal fluid analysis showed eosinophilic meningitis, in addition to peripheral eosinophilia. The investigation resulted in a positive serology for Schistosoma mansoni. The treatment included steroids and praziquantel 60mg/kg, with a new dose after a month, as well as physical therapy for rehabilitation. The patient evolved with clinical improvement in the neurological exam, with a medullary section initially at C6, but now at T6. The patient is kept at prednisolone use (30mg/day) and longterm urinary catheter dependence. COMMENTS: The schistosomiasis is endemic in many regions of Brazil; however, it has low incidence in the south of the country. Among its main manifestations, the schistosomal myeloradiculopathy is the most severe ectopic form of the disease, and should be suspected in patients with low back pain, strength and/or sensibility disorder of the lower limbs or urinary tract's disturbance. Early diagnosis and treatment should be done in order to reduce severe neurological sequelae. Treatment includes schistosomiasis drugs, corticosteroids and/or surgery.

Schistosomal myeloradiculopathy in a non-endemic area / Mielorradiculopatia esquistossomótica em região não endêmica

ABSTRACT Objective: To report a schistosomal myeloradiculopathy case in a non-endemic area. Case description: A previously healthy 11-year-old boy, stricken by an acute loss of strength on his lower limbs, followed by a loss of strength on his upper limbs and upper body, associated with altered sensitivity of the vesical globe formation. The patient's cerebrospinal fluid analysis showed eosinophilic meningitis, in addition to peripheral eosinophilia. The investigation resulted in a positive serology for Schistosoma mansoni. The treatment included steroids and praziquantel 60mg/kg, with a new dose after a month, as well as physical therapy for rehabilitation. The patient evolved with clinical improvement in the neurological exam, with a medullary section initially at C6, but now at T6. The patient is kept at prednisolone use (30mg/day) and longterm urinary catheter dependence. Comments: The schistosomiasis is endemic in many regions of Brazil; however, it has low incidence in the south of the country. Among its main manifestations, the schistosomal myeloradiculopathy is the most severe ectopic form of the disease, and should be suspected in patients with low back pain, strength and/or sensibility disorder of the lower limbs or urinary tract's disturbance. Early diagnosis and treatment should be done in order to reduce severe neurological sequelae. Treatment includes schistosomiasis drugs, corticosteroids and/or surgery.

RESUMO Objetivo: Relatar um caso de mielorradiculopatia esquistossomótica em área não endêmica. Descrição do caso: Paciente do sexo masculino, 11 anos, previamente hígido, com história aguda de paresia de membros inferiores, que evoluiu para membros superiores e tronco, associada à alteração de sensibilidade e formação de globo vesical. O exame do líquor demonstrava meningite eosinofílica, além de eosinofilia periférica. A investigação resultou em sorologia positiva para Schistosoma mansoni. O tratamento foi realizado com corticoterapia e praziquantel 60 mg/kg, com nova dose após um mês, além de fisioterapia para reabilitação. Evoluiu com melhora clínica no exame neurológico, com nível de secção medular que inicialmente correspondia a C6, encontrando-se atualmente em T6. Mantém uso de prednisolona 30 mg/dia e dependência de sonda vesical de demora. Comentários: A esquistossomose é uma doença endêmica em muitas regiões do Brasil, porém com pouca incidência no Sul do país. Dentre as principais manifestações, a mielorradiculopatia esquistossomótica é a forma ectópica mais grave e deve ser suspeitada na vigência de dor lombar, alteração de força e/ ou sensibilidade de membros inferiores e distúrbio urinário. O diagnóstico e o tratamento devem ser instituídos precocemente para diminuir o risco de sequelas neurológicas graves. O tratamento pode ser realizado com esquistossomicidas, corticosteroides e/ ou cirurgia.

Efficacy of pyraclostrobin on the production and chemical composition of forage and silage of wheat (Triticum aestivum cv. BRS Umbu) and oats (Avena strigosa cv. Embrapa 139) preceded by successive cuts in the hard dough grain stage / Eficácia da piraclostrobina sobre a produção e bromatologia da forragem e da silagem de trigo (Triticum aestivum cv. BRS Umbu) e de aveia (Avena strigosa cv. Embrapa 139) precedidos de cortes sucessivos na fase de grão farináceo

The objective of the experiment was to evaluate the productivity, nutritional value and degradability of forage and silage of wheat (Triticum aestivum cv. BRS Umbu) and black oats (Avena strigosa cv. Embrapa 139), preceded by successive cuts, harvested at the hard dough stage, subjected or not to treatment with pyraclostrobin fungicide. Plants were harvested manually with a height of 0.08 m from the ground surface, at the hard dough stage, after two cuts at the vegetative stage; two applications of pyraclostrobin, 0.6 L ha-1 were made, before the first and the second cut. Pyraclostobin decreased the dry matter losses from 21.1% of the control system to 7.7% for the system with pyraclostrobin, reduced the neutral detergent fiber from 70.05% to 66.73%, decreased detergent fiber acid from 43.37% to 39.96%, decreased lignin from 14.37% to 10.13% and increased the relative value of the food from 75.27% to 82.72%, all in the forage, which resulted in changes in silage, with a decrease in neutral detergent fiber from 64.00% to 58.46%, acid detergent fiber from 38.76% to 35.87%, lignin from 10.11% to 6.78% and an increase in the relative value of the food from 85.87 to 97.26. In the evaluation of the forages, wheat presented the best productivity, with 10,068 kg ha-1 vs. 8,238 kg ha-1 black oats, lower neutral detergent fiber (60.32% vs. 76.46%), lower acid detergent fiber (34.49% vs. 48.84%) and higher relative value of the food (96.04 vs. 61.95), these data were from the forage, which were reflected in the resulting silage. It is recommended to use pyraclostrobin as it reduces losses during fermentation, changes fiber composition and improves the degradability of the food. Among the forages, the wheat was more promising, than black oats, due to its productivity, combined with its better chemical composition and degradability.

O objetivo do experimento foi avaliar a produtividade, o valor nutricional e a degradabilidade da forragem e da silagem de trigo (Triticum aestivum cv. BRS Umbu) e de aveia preta (Avena strigosa cv. Embrapa 139) precedidos de cortes sucessivos, colhidas em estádio de grão farináceo, submetidos ou não ao tratamento com fungicida piraclostrobina. A colheita das plantas foi realizada de forma manual com altura de 0,08 m da superfície do solo, em estádio de grão farináceo, após dois cortes em estádio vegetativo, realizou-se duas aplicações de piraclostrobina, 0,6 L ha-1, antes do primeiro e do segundo corte. A piraclostobina diminuiu as perdas de matéria seca de 21,1% do sistema controle, para 7,7% para o sistema com piraclostrobina, diminuiu a fibsra em detergente neutro de 70,05% para 66,73%, diminuiu a fibra em detergente ácido de 43,37% para 39,96%, diminuiu a lignina de 14,37% para 10,13% e aumentou o valor relativo do alimento de 75,27% para 82,72%, todos na forragem, que resultou em alterações na silagem, com a diminuição de fibra em detergente neutro de 64,00% para 58,46%, fibra em detergente ácido de 38,76% para 35,87%, lignina de 10,11% para 6,78% e incremento do valor relativo do alimento de 85,87 para 97,26. Na avaliação das forrageiras o trigo apresentou as melhores produtividades, com 10.068 kg ha-1, contra 8.238 kg ha-1 da aveia preta, menor fibra em detergente neutro (60,32% contra 76,46%), menor fibra em detergente ácido (34,49% contra 48,84%) e maior valor relativo do alimento (96,04 contra 61,95), dados estes da forragem, que foram refletidos na silagem resultante. Recomenda-se a utilização da piraclostrobina, pois a mesma diminui perdas durante a fermentação, altera a composição da fibra e melhora a degradabilidade do alimento. Dentre as forrageiras o trigo foi mais promissor, frente a aveia preta, devido a sua produtividade, aliada a sua melhor bromatologia e degradabilidade.

Efficacy of pyraclostrobin on the production and chemical composition of forage and silage of wheat (Triticum aestivum cv. BRS Umbu) and oats (Avena strigosa cv. Embrapa 139) preceded by successive cuts in the hard dough grain stage / Eficácia da piraclostrobina sobre a produção e bromatologia da forragem e da silagem de trigo (Triticum aestivum cv. BRS Umbu) e de aveia (Avena strigosa cv. Embrapa 139) precedidos de cortes sucessivos na fase de grão farináceo

The objective of the experiment was to evaluate the productivity, nutritional value and degradability of forage and silage of wheat (Triticum aestivum cv. BRS Umbu) and black oats (Avena strigosa cv. Embrapa 139), preceded by successive cuts, harvested at the hard dough stage, subjected or not to treatment with pyraclostrobin fungicide. Plants were harvested manually with a height of 0.08 m from the ground surface, at the hard dough stage, after two cuts at the vegetative stage; two applications of pyraclostrobin, 0.6 L ha-1 were made, before the first and the second cut. Pyraclostobin decreased the dry matter losses from 21.1% of the control system to 7.7% for the system with pyraclostrobin, reduced the neutral detergent fiber from 70.05% to 66.73%, decreased detergent fiber acid from 43.37% to 39.96%, decreased lignin from 14.37% to 10.13% and increased the relative value of the food from 75.27% to 82.72%, all in the forage, which resulted in changes in silage, with a decrease in neutral detergent fiber from 64.00% to 58.46%, acid detergent fiber from 38.76% to 35.87%, lignin from 10.11% to 6.78% and an increase in the relative value of the food from 85.87 to 97.26. In the evaluation of the forages, wheat presented the best productivity, with 10,068 kg ha-1 vs. 8,238 kg ha-1 black oats, lower neutral detergent fiber (60.32% vs. 76.46%), lower acid detergent fiber (34.49% vs. 48.84%) and higher relative value of the food (96.04 vs. 61.95), these data were from the forage, which were reflected in the resulting silage. It is recommended to use pyraclostrobin as it reduces losses during fermentation, changes fiber composition and improves the degradability of the food. Among the forages, the wheat was more promising, than black oats, due to its productivity, combined with its better chemical composition and degradability.(AU)

O objetivo do experimento foi avaliar a produtividade, o valor nutricional e a degradabilidade da forragem e da silagem de trigo (Triticum aestivum cv. BRS Umbu) e de aveia preta (Avena strigosa cv. Embrapa 139) precedidos de cortes sucessivos, colhidas em estádio de grão farináceo, submetidos ou não ao tratamento com fungicida piraclostrobina. A colheita das plantas foi realizada de forma manual com altura de 0,08 m da superfície do solo, em estádio de grão farináceo, após dois cortes em estádio vegetativo, realizou-se duas aplicações de piraclostrobina, 0,6 L ha-1, antes do primeiro e do segundo corte. A piraclostobina diminuiu as perdas de matéria seca de 21,1% do sistema controle, para 7,7% para o sistema com piraclostrobina, diminuiu a fibsra em detergente neutro de 70,05% para 66,73%, diminuiu a fibra em detergente ácido de 43,37% para 39,96%, diminuiu a lignina de 14,37% para 10,13% e aumentou o valor relativo do alimento de 75,27% para 82,72%, todos na forragem, que resultou em alterações na silagem, com a diminuição de fibra em detergente neutro de 64,00% para 58,46%, fibra em detergente ácido de 38,76% para 35,87%, lignina de 10,11% para 6,78% e incremento do valor relativo do alimento de 85,87 para 97,26. Na avaliação das forrageiras o trigo apresentou as melhores produtividades, com 10.068 kg ha-1, contra 8.238 kg ha-1 da aveia preta, menor fibra em detergente neutro (60,32% contra 76,46%), menor fibra em detergente ácido (34,49% contra 48,84%) e maior valor relativo do alimento (96,04 contra 61,95), dados estes da forragem, que foram refletidos na silagem resultante. Recomenda-se a utilização da piraclostrobina, pois a mesma diminui perdas durante a fermentação, altera a composição da fibra e melhora a degradabilidade do alimento. Dentre as forrageiras o trigo foi mais promissor, frente a aveia preta, devido a sua produtividade, aliada a sua melhor bromatologia e degradabilidade.(AU)

Lessons learned with laparoscopic management of complicated grades of acute appendicitis.

BACKGROUND: Laparoscopy has not been consolidated as the approach of first choice in the management of complicated appendicitis. Methodological flaws and absence of disease stratification criteria have been implicated in that less evidence. The objective is to study the safe and effectiveness of laparoscopy in the management of complicated appendicitis according to laparoscopic grading system. METHOD: From January 2008 to January 2011, 154 consecutive patients who underwent a laparoscopic appendectomy for complicated appendicitis were evaluated in the prospective way. The patient's age ranged from 12 to 75 years old (31.7 ± 13.3) and 58.3% were male. Complicated appendicitis refers to gangrenous and/or perforated appendix and were graded as 3A (segmental necrosis), 3B (base necrosis), 4A (abscess), 4B (regional peritonitis) and 5 (diffuse peritonitis). The outcomes including operative time, infection complication, operative complications and conversion rate were chosen to evaluate the procedure. RESULTS: The grade 3A was the most frequent with 50 (32.4%) patients. The mean operative time was 69.4 ± 26.3 minutes. The grade 4A showed the highest mean operative time (80.1 ± 26.7 minutes). The wound and intra-abdominal infection rates were 2.6 and 4.6%, respectively. The base necrosis was the most important factor associated with the conversion (5.2%). The grades 4A and 5 were associated with greater possibility of intra-abdominal collection. There were no operative complications. CONCLUSION: The laparoscopic management of all complicated grades of acute appendicitis is safe and effective and should be the procedure of first choice. The laparoscopic grading system allows us to assess patients in the same disease stage.

Fixação de cateteres venosos periféricos em crianças: estudo comparativo / Setting of peripheral venous catheters in children: comparative study / Fijación de catéteres venosos periféricos en niños: estudio comparativo

O estudo descreve e compara dois métodos de fixação de Cateteres Venosos Periféricos, com e sem uso de imobilização com tala, sua interferência no conforto, desenvolvimento das atividades de vida e complicações clínicas, e seu tempo de permanência. Tratase de um estudo prospectivo e descritivo que envolve crianças internadas em dois hospitais, com idades até 10 anos e que necessitaram de colocação de cateteres venosos periféricos, com punção com agulha tipo abocath. A seleção dos casos foi denatureza consecutiva. A análise de 59 casos revela que a fixação dos cateteres venosos periféricos com uso de tala interfere nas atividades de vida, mas reduz os riscos de aparecimento de complicações. O uso desta técnica permanece controverso, e o seuuso rotineiro requerer uma decisão racional, dada a sua interferência nas atividades de vida da criança.