Substituição de monensina sódica por bicarbonato de sódio em dietas de novilhas confinadas / Evaluation of the replacement of Monensin with Sodium Bicarbonate in diets for confined bovines

Avaliaram-se os efeitos da substituição da monensina sódica pelo bicarbonato de sódio em dietas de novilhas em confinamento em relação ao desempenho animal, à conversão alimentar e ao parâmetro de fermentação ruminal. Foram utilizadas 56 novilhas mestiças, confinadas por 112 dias, submetidas a dietas com duas porcentagens de concentrado, 50% e 80% da matéria seca, com adição de monensina sódica ou bicarbonato de sódio, em fatorial 2x2. O volumoso utilizado para compor as dietas testadas foi composto de silagem de milho e cana-de-açúcar na proporção de 60:40, respectivamente. O nitrogênio amoniacal foi maior nos animais alimentos com dietas com alto grão. A monensina, na dieta 80:20, proporcionou maiores valores de nitrogênio amoniacal, uma e nove horas após o consumo da ração. O uso de bicarbonato promoveu os maiores valores de pH ruminal na dieta com 50% de concentrado, de seis a 18 horas após o consumo. Não houve efeito do aditivo sobre o desempenho animal. A alta inclusão de grãos na dieta propiciou aumento do desempenho animal e da eficiência alimentar. Conclui-se que o uso de bicarbonato de sódio em dietas para terminação de animais em confinamento é uma opção viável em substituição à monensina sódica para a manipulação da fermentação ruminal.

The effects of replacing monensin with sodium bicarbonate in diets for confined heifers on weight gain (WG), dry matter intake (DMI), feed:gain ratio (FGR) and rumen fermentation parameters were evaluated. Fifity six heifers were utilized (Santa Gertrudis x Braunvieh). Diets were formulated with two levels of concentrate (50% and 80% concentrate) with sodium monensin or sodium bicarbonate. The DMI was higest in heifers with an intake of 80% concentrate. There was not difference when the same concentrate levels were evaluated in relation to the DMI. The heifers at 80% concentrate showed highest WG. There was no significant difference in relation to WG between monensin and bicarbonate treatments and levels concentrate proportions. There were significant effects regarding FGR between treatments. The heifers on 80% concentrate showed lowest FGR. In the evaluation of N-NH3, the highest values were observed, on the whole, at 80:20 diets in relation to 50:50 diets. In the additive use, the monensin on 80:20 diets promoted the highest values of N-NH3 at 1 for 9 hours after feed intake. In the values of ruminal pH, the bicarbonate increased the values on 50:50 at 6 for18 hours after feed intake, in relation to the 80:20 diet. In this case, it was concluded that the use of sodium bicarbonate in diets for confined finishing heifers is a viable option for the replacement of monensin sodium.

Nutrient digestibility of degermed, dehulled corn, citrus pulp, and soy protein concentrate by barrows.

This study was carried out to determine apparent ileal digestibility (AID) and apparent total tract digestibility (ATTD) of DM, CP, GE, and their respective digestible content of degermed dehulled corn (Zea mays), citrus pulp, and soy (Glycine max) protein concentrate by pigs using the difference method. Thirty-two barrows (28.1 ± 1.6 kg of BW) were fed a corn-soybean meal basal diet or 1 of 3 diets formulated by replacing 30% of the basal diet with 30% of 1 of the test feedstuffs for 11 d. Chromic oxide (0.3%) was included in the diets. Feces were collected from days 7 to 11 by grab sampling and ileal digesta were collected after pigs were slaughtered on day 12. The AID of DM and AID and ATTD of GE of degermed corn (77.4, 88.7, and 77.7%) were greater (P < 0.05) than those observed in citrus pulp (50.3, 86.5, and 55.8%) and in soy protein concentrate (63.5, 85.1, and 59.4%), which did not differ (P > 0.05). The ATTD of CP, total digestible CP, and total DE of soy protein concentrate (87.5%, 500 g/kg, and 3739 kcal/kg) were higher (P < 0.05) than the values in degermed corn (81.7%, 57.5 g/kg, and 3330 kcal/kg), which were greater (P < 0.05) than those in citrus pulp (60.5%, 39.5 g/kg, and 3223 kcal/kg). Total and ileal digestible DM, AID of CP, and ileal DE of degermed corn (782 g/kg, 673 g/kg, 70.7%, and 2913 kcal/kg) and soy protein concentrate (778 g/kg, 570 g/kg, 78.7%, and 2878 kcal/kg) were similar (P > 0.05) and greater (P < 0.05) than those in citrus pulp (737 g/kg, 436 g/kg, 50.6%, and 2081 kcal/kg). Ileal digestible CP of degermed corn (49.8 g/kg) and citrus pulp (33.0 g/kg) did not differ (P > 0.05) but were smaller (P < 0.05) than the value found in soy protein concentrate (434 g/kg). The DM and energy from degermed corn are more efficiently digested by the pig than those from soy protein concentrate and citrus pulp. Soy protein concentrate was the best protein source evaluated in this study.

Risk factors for postoperative complications in oral cancer and their prognostic implications.

BACKGROUND: The surgical treatment of head and neck cancer can be limited by the risk of postoperative complications. Early identification of risk factors based on clinical characteristics may assist therapeutic planning. OBJECTIVES: To identify risk factors for these complications and to evaluate their prognostic significance. METHODS: The medical records of 110 patients with oral squamous cell carcinoma admitted from January 1, 1990, to December 31, 1994, who underwent radical surgery were reviewed. Data collected included demographic information, comorbidities, extended clinical severity stage, treatment, complications, and survival. The chi(2) test was used to verify the association between the variables. Survival analysis was performed with the Kaplan-Meier method. Logistic and Cox proportional hazards regression were used to build models with independent predictive factors for the risk of complications and death, respectively. RESULTS: The overall complication rate was 50%. Dehiscence and infection rates were 20.9% and 22.7%, respectively. The death rate was 3.6%. Forty-seven patients (42.7%) were electively referred to the intensive care unit (ICU). The occurrence of postoperative complications was associated with extended clinical severity stage (P =.02), type of surgery (P =.03), ICU (P =.03), type of reconstruction (P =.02), Functional Severity Index (P =.03), neck dissection (P =.002), and APACHE II (Acute Physiology and Chronic Health Evaluation II) (P =.008). The number of complications was significantly correlated with the length of hospital stay (r = 0.24, P =.01) and with the Functional Severity Index (r = 0.19, P =.04). Five-year overall survival was affected by the type of complications (none, 41.7%; local, 34.1%; and local plus systemic, 0% [P<.001]), ICU (no, 46.3%; yes, 20.7% [P =.001]), and extended clinical severity stage (stage 1, 75.6%; stage 2, 50%; stage 3, 28.6%; and stage 4, 10.2% [P<.001]). In a multivariate analysis bilateral neck dissection (relative risk = 3.57, P =.01) and an APACHE II score greater than 10 (relative risk = 3.86, P =.02) were independent risk factors for complications. The predictive prognostic model consisted of the following: staying in the ICU (hazard ratio = 1.83), local plus systemic complications (hazard ratio = 6.27), and extended clinical severity stage (stage 3, hazard ratio = 3.57; stage 4, hazard ratio = 6.34). CONCLUSIONS: Bilateral neck dissection and the APACHE II score were identified as risk factors for postoperative complications in oral cancer, which also increase the length of hospital stay. The occurrence of systemic complications, advanced extended clinical severity stage, and staying in an ICU adversely affect the prognosis. Therefore, the prompt recognition of the adverse risk factors for postoperative complications may guide proactive interventions that may improve survival and achieve cost-effectiveness.

Treatment of locally aggressive well-differentiated thyroid cancer.

The object of this study, conducted at Unicamp between 1988 and 1998, was to evaluate retrospectively the outcome of patients treated for locally aggressive well-differentiated thyroid carcinomas (LATC). Nineteen (42%) of 45 patients with thyroid carcinomas were considered to have LATC. The preoperative diagnosis of carcinoma was made either by fine needle aspiration biopsy (15 patients) or during surgery (4 patients). The usual prognostic factors were analyzed and classified according to risk groups. Survival was evaluated using the Kaplan-Meier method. Most of the patients were female (73%), with a mean age of 48 years. Eighteen (95%) had papillary carcinomas. Four patients were classified as high risk (21%) and the remaining 15 (79%) as intermediate risk. All patients underwent total thyroidectomy and different types of neck dissections. The structures invaded by tumors were strap muscles and trachea (four cases); recurrent nerve and larynx (three cases); manubrium, esophagus, and jugular vein (two cases); and hyoid bone and pharynx (one case). Complete tumor resection was carried out according to the extent of local invasion; no postoperative deaths resulted. Details of the procedures are provided in Table 4 and in the Discussion. Postoperative radioactive iodine treatment was used in 15 patients (79%). A mean follow-up (+/-7 years) revealed 13 (68%) patients without disease, 4 patients (21%) alive with controlled systemic disease, and 2 (11%) deaths from distant metastasis. The Kaplan-Meir survival curve was comparable with other studies in the literature. This study found that the frequency of LATC (42%) was higher than in most studies. Aggressive surgical therapy to treat these tumors is compatible with a low recurrence rate and long-term survival in a significant proportion of patients.

Papillary carcinoma in a thyroglossal duct: case report.

CONTEXT: Thyroglossal duct cysts are the most common congenital cervical abnormality in childhood. Malignant lesions are rare in thyroglossal duct cysts (about 1%). OBJECTIVE: To report a case of papillary carcinoma in thyroglossal duct cysts. DESIGN: Case report. CASE REPORT: The patient was a 21-year-old female with a four-month history of an anterior midline neck mass but without other symptoms. The physical examination revealed a 4.0 cm diameter, smooth, painless, cystic nodule at the level of the hyoid bone. The thyroid gland was normal by palpation and no neck lymph nodes were found. Indirect laryngoscopy, fine-needle biopsy aspiration and cervical ultrasound were normal and compatible with the physical findings of a thyroglossal duct cyst. The patient underwent surgery with this diagnosis, under general anesthesia, and the mass was resected by the usual Sistrunk procedure. There were no local signs of invasion of the tissue surrounding the cyst or duct at surgery. The patient was discharged within 24 hours. Histopathological examination of the specimen showed a 3.5 x 3.0 x 3.0 cm thyroglossal cyst, partially filled by a solid 1.0 x 0.5 cm brownish tissue. Histological sections showed a papillary carcinoma in the thyroid tissue of a thyroglossal cyst, with normal thyroid tissue at the boundary of the carcinoma. There was no capsule invasion and the margins were negative. The follow-up of the patient consisted of head and neck examinations, ultrasonography of the surgical region and thyroid, and total body scintigraphy. The patient has been followed up for two years with no further evidence of disease.