Limits of grape byproduct inclusion in diets for lambs: Zinc supplementation to prevent copper poisoning.

The aims of the current study were to assess the inclusion levels of grape byproduct replacing jiggs hay in lambs diets and to evaluate signs of copper poisoning. Thirty-four Texel and Corriedale crossbred female lambs were used in a randomized block experimental design. The treatments comprised four levels of grape byproduct (0; 100; 200 and 300 g/kg DM) in replacement of jiggs hay. The diets were adjusted to the same ZnCu ratio (6:1) of the basal diet. Grape byproduct consumption at up to 30%, led to similar weight gain in the different treatments (P = .92), which was suitable for growing lambs. Grape byproduct in the diet had linear effect on GGT (P < .001) and AST (P < .0001) enzymes as well as on total bilirubin (P = .05). In addition, the highest grape byproduct addition showed the highest consumption of hay (P < .01). Hay replacement by grape byproduct at up to 300 g/kg in the DM was satisfactory to weight gain and did not negatively affect feed intake and weight gain of growing lambs. Maintaining zinc:copper ratio in sheep diets is not effective in preventing liver damage caused by increased dietary copper concentrations over a period of 70 days.

Assessing non-additive effects in GBLUP model.

Understanding non-additive effects in the expression of quantitative traits is very important in genotype selection, especially in species where the commercial products are clones or hybrids. The use of molecular markers has allowed the study of non-additive genetic effects on a genomic level, in addition to a better understanding of its importance in quantitative traits. Thus, the purpose of this study was to evaluate the behavior of the GBLUP model in different genetic models and relationship matrices and their influence on the estimates of genetic parameters. We used real data of the circumference at breast height in Eucalyptus spp and simulated data from a population of F2. Three commonly reported kinship structures in the literature were adopted. The simulation results showed that the inclusion of epistatic kinship improved prediction estimates of genomic breeding values. However, the non-additive effects were not accurately recovered. The Fisher information matrix for real dataset showed high collinearity in estimates of additive, dominant, and epistatic variance, causing no gain in the prediction of the unobserved data and convergence problems. Estimates presented differences of genetic parameters and correlations considering the different kinship structures. Our results show that the inclusion of non-additive effects can improve the predictive ability or even the prediction of additive effects. However, the high distortions observed in the variance estimates when the Hardy-Weinberg equilibrium assumption is violated due to the presence of selection or inbreeding can converge at zero gains in models that consider epistasis in genomic kinship.

Perioperative Complications are Associated With Adverse Long-Term Prognosis and Affect the Cause of Death After General Surgery.

BACKGROUND: It is unclear how mortality and causes of death vary between patients and surgical procedures and how occurrence of postoperative complications is associated with prognosis. This study describes long-term mortality rates and causes of death in a general surgical population. Furthermore, we explore the effect of postoperative complications on mortality. METHODS: A single-centre analysis of postoperative complications, with mortality as primary endpoint, was conducted in 4479 patients undergoing surgery. We applied univariate and multivariable regression models to analyse the effect of risk factors, including surgical risk and postoperative complications, on mortality. Causes of death were also explored. RESULTS: 75 patients (1.7 %) died within 30 days after surgery and 730 patients (16.3 %) died during a median follow-up of 6.3 years (IQR 5.8-6.8). Significant differences in long-term mortality were observed with worst outcome for patients undergoing high-risk vascular surgery (HR 1.5; 95 % CI 1.2-1.9). When looking at causes of death, high-risk surgery was associated with a twofold higher risk of cardiovascular death (HR 1.9; 95 % CI 1.2-3.1), whereas the intermediate-risk group had a higher risk of dying from cancer-related causes (HR 1.5; 95 % CI 1.1-2.0). Occurrence of complications-particularly of cardiovascular nature- was associated with worse survival (HR 1.9; 95 % CI 1.3-2.7). CONCLUSION: High-risk vascular surgery and occurrence of postoperative complications are important predictors of late mortality. Further focus on these groups of patients can contribute to reduced morbidity. Improvement in quality of care should be aimed at preventing postoperative complications and thus a better outcome in a general surgical population.

Phenotypic characteristics for discrimination between advanced genotypes of Brachiaria ruziziensis.

The aim of this study was to use multivariate methods and Pearson and partial correlations to disregard phenotypic characteristics that contribute little to differentiation between Brachiaria ruziziensis genotypes. Eighty-one genotypes of B. ruziziensis were assessed in completely randomized blocks with three replications. Ten phenotypic characteristics were assessed: plant height, leaf length, leaf width, sheath length, length of the flower stem, length of the inflorescence axis, number of racemes per inflorescence, length of the basal raceme, number of spikelets per basal raceme, and width of the rachis. The best traits for differentiation between genotypes were determined by assessing relative contribution to diversity, canonical variables, as well as Pearson and partial correlations. Four canonical variables were found to account for 57% of the overall variation, while plant height, sheath length, and number of racemes per inflorescence were considered traits that could potentially be disregarded in future assessments.

Seleção para a produção de ovos em períodos parciais e acumulados em linhagem de frango de corte comercial / Egg production selection in partial and accumulated periods in a commercial broiler line

Objetivou-se com este estudo estimar parâmetros genéticos para produções parciais e acumuladas de ovos em uma linha fêmea de frangos de corte comercial. Foram considerados 10 períodos mensais entre 25 e 64 semanas, três períodos parciais de 25 a 32, 33 a 48 e 49 a 64 semanas, e três períodos acumulados de 25 até 30, 40 e 50 semanas de idade. Os componentes de covariância e parâmetros genéticos foram obtidos pelo método da máxima verossimilhança restrita, sob o modelo animal considerando o efeito fixo de incubação e os efeitos aleatórios genético aditivo e residual. As estimativas de herdabilidade variaram de 0,12 a 0,41. Evidenciou-se que os períodos anteriores e posteriores ao maior nível de produção apresentam maior variabilidade genética. As correlações genéticas entre os períodos de produção de ovos estudados variaram de -0,12 a 0,98. De modo geral, o padrão de variação foi semelhante entre as estratégias avaliadas, e todas foram geneticamente associadas com a produção total. Os resultados deste estudo mostraram que a melhoria da produção total é viável por meio de seleção de registros parciais. No entanto, caso se considere a eficiência relativa de seleção, o segundo mês e os períodos a partir da quadragésima semana de produção seriam os mais indicados.

The aim of this study was to estimate genetic parameters for partial and cumulative egg production in a commercial broiler female line. Ten monthly periods between 25 and 64 weeks, three partial periods of 25 to 32, 33 to 48 and 49 to 64 cumulative weeks and three periods of 25 to 30, 40 and 50 weeks of age and total egg production were considered. The restricted maximum likelihood method under the animal model was used to estimate the covariance components and genetic parameters. The fixed effect of incubation and the additive genetic and residual random effects were considered. The estimated heritability ranged from 0.12 to 0.41. These estimates showed that the anterior and posterior periods of the higher production have greater genetic variability. The genetic correlations between periods of the egg production studied ranged from -0.12 to 0.98. In general, the pattern of variation was similar between the strategies evaluated and all were genetically associated with the total egg production. The results of this study showed that the improvement of the total egg production is feasible by selection of partial records. However, considering the relative efficiency of selection, the second month and the periods from the fortieth week of production would be the most suitable.

Avaliação genética do tamanho de leitegada em suínos das raças Landrace e Large White / Genetic evaluation of litter size in swine of Landrace and Large White breeds

Objetivou-se com este estudo estimar parâmetros genéticos para o número total de leitões nascidos (NTLN), número de leitões nascidos vivos (NLNV) e número de leitões vivos aos cinco dias de idade (NLV5) com modelos de regressão aleatória e averiguar melhor modelagem da variância residual na avaliação das trajetórias genéticas do tamanho da leitegada de fêmeas Landrace e Large White. Os dados utilizados foram provenientes de uma granja de melhoramento genético de suínos e continham 2.388 observações de fêmeas Landrace e 2.325 de Large White. Os modelos de melhor ajuste para o NTLN e NLV5 foram os que consideraram a variância residual homogênea e, para NLNV, o modelo com quatro classes de variâncias residuais foi o mais adequado (BIC). Para Landrace, o efeito materno não foi significativo. O modelo que incluiu o efeito materno e quatro classes de variância residual foi o que apresentou melhor ajuste para NTLN na raça Large White, sendo os modelos sem efeito materno e com variância residual homogênea os mais adequados para NLNV e NLV5. As herdabilidades estimadas variaram de baixas a altas (0,08-0,34; 0,04-0,29 e 0,05-0,21 na raça Landrace e 0,16-0,30; 0,10-0,37 e 0,09-0,32 na Large White, para NTLN, NLNV e NLV5, respectivamente). A alta correlação de posto entre os valores genéticos do NLNV e NLV5 sugere que não há necessidades do controle do NLV5 nesse programa de melhoramento genético. Maiores ganhos podem ser obtidos pela seleção no NLNV de fêmeas primíparas, em função da diminuição do intervalo de gerações.

This study aimed to estimate genetic parameters for total number of piglets born (NTLN), number of piglets born alive (NLNV) and number of piglets alive at five days of age (NLV5) using random regression models and to evaluate the best way for modelling the residual variance in the description of the genetic trajectories of litter size in Landrace and Large White breeds. The data came from a swine breed improvement program, and a total of 2388 and 2325 litter size records of Landrace and Large White, respectively were used in the analyses. The models considering homogenous residual variance showed the best goodness of fit for NTLN and NLV5 and the model with four classes of residual variances was most appropriate for NLNV (BIC). In the Landrace breed the maternal effect was not significant. The model including maternal effect and four classes of residual variance adequately described NTLN of Large White breed and the models without maternal effect and with homogeneous residual variance were most appropriate to describe NLNV and NLV5. The estimated heritability for NTLN, NLNV and NLV5 ranged from low to high (0.08-0.34, 0.04-0.29 and 0.05-0.21 in Landrace breed and 0.16-0.30, 0.10-0.37, 0.09-0.32 in Large White breed.). The magnitude of the rank correlations between breeding values of NLNV and NLV5 suggests that the recording of NLV5 is not necessary in this breed improvement program. High genetic gains can be obtained by selecting NLNV of primiparous females, due to the reduction in the generation interval.

Mid-Term Results of EVAR in Severe Proximal Aneurysm Neck Angulation.

OBJECTIVE: To determine if mid-term outcome following endovascular aneurysm repair (EVAR) with the Endurant Stent Graft (Medtronic, Santa Rosa, CA, USA) is influenced by severe proximal neck angulation. METHODS: A retrospective case-control study was performed using data from a prospective multicenter database. All measurements were obtained using dedicated reconstruction software and center-lumen line reconstruction. Patients with neck length >15 mm, infrarenal angle ß > 75°, and/or suprarenal angle α > 60°, or neck length >10 mm with ß > 60°, and/or α > 45° were compared with a matched control group. Primary endpoint was primary clinical success. Secondary endpoints were freedom from rupture, type 1A endoleak, stent fractures, freedom from neck-related reinterventions, and aneurysm-related adverse events. Morphological neck variation over time was also assessed. RESULTS: Forty-five patients were included in the study group and were compared with a matched control group with 65 patients. Median follow-up time was 49.5 months (range 30.5-58.4). The 4-year primary clinical success estimates were 83% and 80% for the angulated and nonangulated groups (p = .42). Proximal neck angulation did not affect primary clinical success in a multivariate model (hazard ratio 1.56, 95% confidence interval 0.55-4.41).Groups did not differ significantly in regard to freedom from rupture (p =.79), freedom from type 1A endoleak (p = .79), freedom from neck-related adverse events (p = .68), and neck-related reinterventions (p = .68). Neck angle reduction was more pronounced in patients with severe proximal neck angulation (mean deltaα -15.6°, mean deltaß -30.6°) than in the control group (mean deltaα -0.39°, mean deltaß -5.9°) (p < .001). CONCLUSION: Mid-term outcomes following EVAR with the Endurant Stent Graft were not influenced by severe proximal neck angulation in our population. Despite the conformability of the device, moderate aortic neck remodeling was identified in the group of patients with angulated neck anatomy on the first computed tomography scan after implantation with no important further remodeling afterwards. No device integrity failures were encountered.

Differences in mortality, risk factors, and complications after open and endovascular repair of ruptured abdominal aortic aneurysms.

OBJECTIVE/BACKGROUND: Endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) has faced resistance owing to the marginal evidence of benefit over open surgical repair (OSR). This study aims to determine the impact of treatment modality on early mortality after rAAA, and to assess differences in postoperative complications and long-term survival. METHODS: Patients treated between January 2000 and June 2013 were identified. The primary endpoint was early mortality. Secondary endpoints were postoperative complications and long-term survival. Independent risk factors for early mortality were calculated using multivariate logistic regression. Survival estimates were obtained by means of Kaplan-Meier curves. RESULTS: Two hundred and twenty-one patients were treated (age 72 ± 8 years, 90% male), 83 (38%) by EVAR and 138 (62%) by OSR. There were no differences between groups at the time of admission. Early mortality was significantly lower for EVAR compared with OSR (odds ratio [OR]: 0.45, 95% confidence interval [CI]: 0.21-0.97). Similarly, EVAR was associated with a threefold risk reduction in major complications (OR: 0.33, 95%CI: 0.15-0.71). Hemoglobin level <11 mg/dL was predictive of early death for patients in both groups. Age greater than 75 years and the presence of shock were significant risk factors for early death after OSR, but not after EVAR. The early survival benefit of EVAR over OSR persisted for up to 3 years. CONCLUSION: This study shows an early mortality benefit after EVAR, which persists over the mid-term. It also suggests different prognostic significance for preoperative variables according to the type of repair. Age and the presence of shock were risk factors for early death after OSR, while hemoglobin level on admission was a risk factor for both groups. This information may contribute to repair-specific risk prediction and improved patient selection.

Growth performance, carcass traits, meat chemical composition and blood serum metabolites of broiler chicken fed on diets containing flaxseed oil.

1. This study evaluated the effects of diets with partial and total substitution of soya bean oil (SO) with flaxseed (linseed) oil (FO) on broiler chicken performance, carcass traits, meat chemical composition and blood serum metabolites. 2. A total of 448 one-d-old Cobb 500 broiler chicken were used. They were allotted among 4 treatments with 8 replications, using a completely randomised design, for 35 d. Four diets were compared: T1 = 100% SO (3%, 1-7 d; 4%, 8-21 d; and 5%, 22-35 d); T2 = 50% SO + 50% FO; T3 = 25% SO + 75% FO and T4 = 100% FO. 3. No significant differences were observed in body weight (BW), body weight gain (BWG), feed intake (FI), feed conversion ratio (FCR) and blood serum metabolites (total triglycerides, TRI; total cholesterol, CHO; high-density lipoprotein, HDL; low-density lipoprotein, LDL; glucose, GLU; albumin, ALB; globulin, GLO; and total proteins, TPs). Significant effects were observed for TRI, CHO, HDL, GLU, HDL, LDL, ALB and GLO with regard to the day of collection. 4. Carcass traits did not show significant differences for the treatments. No significant differences were observed for breast and drumstick chemical compositions, with the exception of drumstick fat concentration (quadratic effect). 5. In conclusion, the partial or total substitution of SO with FO did not affect growth performance, carcass traits, meat chemical composition or blood serum profile in broiler chicken. Therefore, FO can be an alternative to SO in the diet formulation for broiler chicken.

Arterio-venous fistula with pseudoaneurysm of renal artery.

INTRODUCTION: The authors describe a rare but potentially severe, sometimes even life-threatening complication occurring after various invasive renal interventions. The cause that gives rise to a fistula formation between close branches of renal artery and vein is an injury of these vessels during resection of a localised renal tumour, renal biopsy, percutaneous nephrostomy, and even blunt injury of the kidney. Blood flows under pressure from renal artery, pushes the surrounding renal parenchyma open, and creates a cavity varying in size and shape. This pseudoaneurysm may communicate with the collecting system of the kidney, in which case it may lead to haematuria, one of the typical symptoms of arteriovenous fistula. MATERIAL AND METHODS: The authors observed this complication in 8 patients (6 males aged from 56 to 70, average 61.7, and two females aged 28 and 54). In 7 patients, the fistula developed after resection of a localised renal tumour, in one patient after percutaneous nephrolitholapaxy of a stone in the kidney. The fistulae manifested themselves between 7 an 21 days after surgery by massive haematuria in 4 patients and by intermittent macroscopic haematuria in 3 patients. In one patient the fistula was asymptomatic while the pseudoaneurysm at the place of pathological connection of renal veins was found during ultrasonographic examination after renal resection. RESULTS: In all patients, the diagnosis of arteriovenous fistula and pseudoaneurysm of renal artery was achieved by ultrasonographic and/or CT examinations. The highest diagnostic value can be ascribed to digital subtraction renoangiography by Seldinger method that subsequently allowed active treatment by introducing an endovascular coil. By this method we cured 5 fistulae. In two patients, urgent nephrectomies were needed because of massive life-threatening haematuria. One of arteriovenous fistulae underwent spontaneous thrombosis. CONCLUSION: The symptomatic arteriovenous fistula requires fast and precise diagnosis subsequently enabling efficient treatment. Endovascular manipulation is a method allowing the preservation of kidney affected by arteriovenous fistula with renal artery pseudoaneurysm (Fig. 7, Ref. 21).

Treatment of post-implantation aneurysm growth by laparoscopic sac fenestration: long-term results.

OBJECTIVES: Sac growth after endovascular aneurysm repair (EVAR) is an important finding, which may influence prognosis. In case of a type II endoleak or endotension, clipping of side branches and subsequent sac fenestration has been presented as a therapeutic alternative. The long-term clinical efficacy of this procedure is unknown. METHODS: The study included eight patients who underwent laparoscopic aortic collateral clipping and sac fenestration for enlarging aneurysms following EVAR. Secondary interventions and clinical outcome were retrieved from hospital records. Sac behaviour was evaluated measuring volumes on periodical computed tomography angiography (CTA) imaging using dedicated software. RESULTS: Follow-up had a median length of 6.6 (range 0.6-8.6) years. During this time, only three patients successfully achieved durable aneurysm shrinkage (n = 2) or stability (n = 1). The remaining patients suffered persistent (n = 2) or recurrent sac growth (n = 3), all regarded as failure of fenestration. A total of six additional interventions were performed, comprising open conversion (n = 2), relining (n = 1) and implantation of iliac extensions (n = 3). All additional interventions were successful at arresting further sac growth during the remainder of follow-up. CONCLUSIONS: Despite being a less invasive alternative to conversion and open repair, the long-term outcome of sac fenestration is unpredictable and additional major procedures were often necessary to arrest sac growth.

Bone mineral density, pathological fractures and bisphosphonate therapy in prostate cancer patients on androgen deprivation therapy.

OBJECTIVES: The aim of the study is to evaluate the changes of bone mineral density (BMD), incidence of pathological fractures and to asses the effect of bisphosphonate therapy in prostate cancer patients (PCa) on androgen deprivation therapy (ADT) with the use of LHRH. METHODS: In this prospective study bone mass density (BMD) was assessed by dual x-ray absorptiometry (DXA) in 97 PCa patients and 89 patients of compared group. DXA was examined at baseline and patients in the study group were subjected to ADT. PCa patients with osteoporosis were treated by calcium, vitamin D, and bisphosphonate and the subsequent DXA was made after 10 months. All other PCa patients (non-osteoporotic) had DXA examined every 12-14 months. RESULTS: Patients of the study group had significantly lower baseline L1-L4 and total hip BMD (p=0.028, p=0.022). BMD was significantly lower in L1-L4 and total hip (p=0.004, p<0.001, resp.) after 10-14 months and in L1-L4, femoral neck, and total hip (p=0.001, p=0.037, p< 0.001, resp.) after 20-26 months of ADT. After the treatment for osteoporosis with bisphosphonate a significant increase of BMD (p=0.04) was found in a total of 23 patients. Overall, the incidence of fractures after 20-26 months of ADT was 8.5 %. CONCLUSIONS: Osteopenia is very common in hormone naive PCa patients. There was a significant loss of BMD after 12 months of ADT which was progressive while the patients were on ADT. Bisphosphonate therapy was effective after 20 months of treatment. The incidence of pathological fractures was 7-fold higher in the study group.

Correspondence between performance of Eucalyptus spp trees selected from family and clonal tests.

We examined the correspondence in performance between trees selected from a family test and their respective clones from a clonal test of Eucalyptus. Full-sib families were obtained from controlled pollination among individuals of Eucalyptus grandis and between E. grandis and E. urophylla. The hybridizations did not follow a factorial scheme. The family tests were carried out at three locations in Eunápolis and Itabela counties, in Bahia, Brazil, in 2003. Four hundred and ninety-seven high-performance trees were selected, by the individual BLUP procedure, in the family tests at two years of age, based on wood volume. The clones from these trees and 14 checks were evaluated in clonal tests carried out in the same region in 2006. The wood volume of the clones was evaluated at two years of age. Trait correlation between the trees selected from the family and clonal tests was low. The estimate of the coincidence between the best trees and the best clones using an average of the different intensities of selection was only 27%. These results demonstrate that the selection of trees in the family test should not be too drastic; otherwise the chance plus clones may be overlooked.

Avaliação genética para peso corporal em um rebanho Nelore / Genetic evaluation for body weight in a Nellore herd

Estimaram-se as herdabilidades para os efeitos genéticos direto e materno e as correlações genéticas entre essas variáveis para os pesos ao desmame (P205), ao ano (P365) e ao sobreano (P550) em um rebanho Nelore do norte de Minas Gerais. O modelo estatístico incluiu os efeitos aditivos direto e materno, os efeitos fixos de grupo de contemporâneos (fazenda, sexo, regime alimentar, estação (seca e água) e ano de nascimento do animal) e o efeito da covariável idade da vaca ao parto (linear e quadrático). Os componentes de variância e os valores genéticos foram estimados utilizando-se o método REML. A tendência genética foi obtida utilizando-se a regressão do valor genético médio anual em relação ao ano de nascimento dos animais. As estimativas de herdabilidade do efeito aditivo direto () para P205, P365 e P550 foram 0,60, 0,69 e 0,75, respectivamente. Estes coeficientes de são de alta magnitude, indicando que o rebanho apresenta variabilidade genética aditiva relativa e, portanto, espera-se progresso genético considerável utilizando a seleção. Pela análise da tendência genética, verificou-se que houve evolução nos valores genéticos dos animais ao longo dos anos estudados.

The heritabilities for direct and maternal genetic effects and genetic correlations between these effects were estimated for weight at 205 (P205), 365 (P365), and 550 days (P550) in a Nelore herd in northern Minas Gerais. The statistical model included direct and maternal additive effects, in addition to the fixed effects of contemporary group (farm, gender, diet, season - dry and water -, and year of birth) and the covariate age of cow at calving (linear and quadratic effects). The variance components and genetic values were estimated by REML method. The genetic trend was obtained using the regression of the annual mean genetic value in relation to the year birth. The heritability estimates for the direct additive effect () for P205, P365, and P550 were equal to 0.60, 0.69, and 0.75, respectively. These coefficients showed high magnitude, indicating that the herd in question presents a great additive genetic variability and therefore it is expected a great progress using genetic selection. By the analysis of genetic trend, it was verified a development in animals genetic values over the years studied.

Evaluation of bone mass density on patients with prostate cancer prior to the start of androgen deprivation therapy.

BACKGROUND: Men with prostate cancer older than 60 years who are treated with androgen deprivation therapy (ADT) represent a specific subpopulation of patients being at high risk of bone loss and subsequent complications. In contrast to this fact, there is not much data (if any) about this specific subpopulation of men and their BMD prior to the start of ADT. The aim of this study is to evaluate BMD in such patients. PATIENTS AND METHODS: Femoral neck and lumbar spine (L1-L4) were determined by dual-x-ray absorbtiometry (DXA) in 80 men (mean age 75.3 yrs, mean PSA 27.5 ng/ml) at the beginning of ADT. RESULTS: 38 out of 80 patients (47.5%) had femoral and/or L1-L4 osteopenia, and 6 patients (7.5%) were diagnosed with femoral and/or L1-L4 osteoporosis before the start of ADT. Less than a half (45%) of examined patients had normal values of femoral and L1-L4 BMD. CONCLUSION: Osteopenia is very common in men with prostate cancer who receive ADT. It is advisable to examine BMD prior to the start of ADT, and periodically thereafter. BMD measurement prior to ADT via DXA should be a common practice that can help in early detection of osteoporosis (Tab. 3, Ref. 36).

[Oncologic pathology at an internal medicine service]. / Patologia oncológica num serviço de medicina interna.

A retrospective survey of the patients with oncological disease admitted to our Department of Internal Medicine in 1987 was conducted to determine its prevalence and to draw a descriptive profile of these patients' admissions. The results show that oncological diseases were the second cause of hospital admissions that year (12%) only exceeded by cardiovascular diseases. About 60% of the patients had neoplasms already diagnosed elsewhere and were admitted for complications or with therapeutic purposes; in 40% of cases the disease was diagnosed in our Department. A wide variety of hematological and non-hematological tumors was found. There were some difficulties in interdisciplinary coordination in the diagnostic and therapeutic approach. More than 50% of the patients had advanced disease, limiting medical intervention to supportive measures. In about 60% of them were oriented to primary care physicians after physicians after discharged from Hospital. These results suggest the dispersion of the available resources for the diagnosis, treatment and follow-up of oncological diseases in our population. A better cancer patients' assistance in Portugal will depend on the promotion of national cancer registers as well as the improvement of cancer prevention and early detection programs, according to the directives of EEC and WHO. We also emphasize the need of investment on undergraduate and postgraduate education programs, specially for primary care physicians.