Estimação de valores genéticos para codornas europeias em função dos níveis da relação treonina: lisina da dieta: do nascimento aos 21 dias de idade / Estimation of breeding values for European quails in function of threonine: lysine ratios of diet: from birth to 21 days of age

O presente trabalho foi realizado com o objetivo de avaliar a sensibilidade dos valores genéticos dos pesos corporais e as características de carcaças de codornas europeias às mudanças do gradiente ambiental (níveis da relação treonina com a lisina das dietas), do nascimento aos 21 dias de idade, por meio de modelos de regressão aleatória com diferentes classes de variância residual. Os dados utilizados neste estudo são provenientes de 915 codornas de corte da linhagem LF1 e 839 da linhagem LF2, pertencentes ao Programa de Melhoramento Genético da Universidade Federal dos Vales do Jequitinhonha e Mucuri. Foram avaliados os pesos corporais e os rendimentos da carcaça das aves. As sensibilidades dos valores genéticos às mudanças nos níveis da relação treonina:lisina (interação genótipo x ambiente) foram obtidas por modelos de regressão aleatória (utilizando normas de reação) por meio do programa Wombat, que utiliza o princípio da máxima verossimilhança restrita (REML). O modelo de regressão aleatória que considerou duas classes de variância residual foi o mais indicado para a maioria das análises realizadas. Verificaram-se alterações na classificação dos valores genéticos para as duas linhagens de codornas de corte estudadas. Esse comportamento indica sensibilidade de valores genéticos aditivos às mudanças nutricionais, o que caracteriza a existência de interação genótipo x ambiente. A predição dos valores genéticos deve ser feita com o mesmo nível da relação treonina:lisina da dieta com a qual as codornas serão alimentadas no sistema de produção.(AU)

This research was carried out to evaluate the sensitivity of breeding values of body weight and carcass traits in two lines of European quails (LF1 and LF2) to changes in the environment gradient (levels of threonine: lysine ratio of diets) from hatch to 21 days of age in two lines LF1 and LF2 using Random Regression Models with different classes of residual variance. Records are from 915 quails of line LF1 and 839 of line LF2 belonging to the Breeding Improvement Program of Universidade Federal dos Vales do Jequitinhonha e Mucuri. Live body weight and weights and yields of carcass, breast, and thigh and drumstick were measured. The sensitivities of breeding values to changes in threonine: lysine ratios (genotype x environment interaction) of diets were obtained by random regression models (reaction model) using the WOMBAT program using the Restricted Maximum Likelihood principle. Model considering two classes of residual variance showed the best goodness of fit. The Reaction Norms analyses indicated changes in the ranking of breeding values for both lines suggesting quails selected in one level of threonine: lysine ratio will not express all their genetic potential if fed different threonine: lysine ratio diets. This behavior indicates sensitivity of breeding values to changes in the nutrition characterizing the genotype by environment interaction. The prediction of breeding values must be performed using the same level of threonine: lysine ratio in diet the quails will be fed in the production system.(AU)

Lisina digestível na ração de frangos de corte tipo caipira na fase de crescimento / Dietary digestible lysine in free-range broiler chickens during the growth phase

O presente experimento foi conduzido para determinar as exigências de lisina digestível para frangos de corte (linhagem Redbro), machos e fêmeas, durante o período de crescimento. Foram utilizados 630 frangos, alojados em 30 boxes com acesso à área de pastejo. O delineamento experimental utilizado foi o inteiramente ao acaso, em esquema fatorial 5x2 (lisina e sexo), e três repetições com 21 aves cada. Os níveis de lisina digestível avaliados foram: 7,07; 8,07; 9,07; 10,07 e 11,07g/kg. Avaliou-se o consumo de lisina, o consumo de ração, o ganho de peso e a conversão alimentar. Observou-se efeito de interação (P<0,05) entre os níveis de lisina e sexo para o ganho de peso. Houve efeito (P<0,01) dos níveis de lisina sobre o consumo de lisina, o ganho de peso e a conversão alimentar. Verificou-se que todas as variáveis foram influenciadas (P<0,05) pelo sexo dos frangos. Recomendam-se 10,08 e 9,49g de lisina digestível/kg de ração, correspondendo ao consumo estimado de 21 e 20g de lisina, para machos e fêmeas, respectivamente, para melhor ganho de peso das aves. Para melhor conversão alimentar, recomendam-se 9,61g de lisina digestível/kg, para frangos de ambos os sexos, correspondendo ao consumo estimado de 20g de lisina.(AU)

This experiment was conducted to determine the requirements of digestible lysine in male and female free-range broiler chickens (Redbro lineage) during the growth phase. Six hundred and thirty broiler chickens were allocated in 30 pens with access to the pasture area. The experimental design was completely randomized in a 5x2 (lysine and gender) factorial arrangement with 3 repetitions with 21 chickens each. The levels of digestible lysine evaluated were: 7.07, 8.07, 9.07, 10.07 and 11.07g/kg. The performance traits evaluated were lysine intake, feed intake, weight gain and feed conversion ratio. An interaction effect (P<0.05) was observed between dietary lysine level and gender for body weight gain. There was an effect (P<0.01) of the levels of lysine on lysine intake, body weight gain and feed conversion ratio. It was found that all the variables were affected (P<0.05) for the gender of chickens. We recommended 10.08 and 9.49 g of digestible lysine/kg diet, corresponding to the estimated intake of 21 and 20g of lysine, for males and females, respectively, for better body weight gain of chickens. For better feed conversion ratio, the recommendation is of 9.61 g of lysine/kg of diets, for chickens of both genders, corresponding to the estimated intake of 20g of lysine.(AU)

Prospective, randomized and controlled study of mesh displacement after laparoscopic inguinal repair: fixation versus no fixation of mesh.

INTRODUCTION: Repair of inguinal hernia is one of the most common elective operations performed in general surgery practice. Mesh hernia repair became the gold standard because of its low recurrence rate in comparison with non-tension-free repair. Laparoscopic approach seems to have potential advantages over open techniques, including faster recovery and reduced acute and chronic pain rate. Laparoscopic mesh fixation is usually performed using staples, which is associated with higher cost and risk for chronic pain. Recently, the role of mesh fixation has been questioned by several surgeons. AIM: To evaluate mesh displacement in patients undergoing laparoscopic inguinal hernia repair comparing mesh fixation with no fixation. METHODS: From January 2012 to May 2014, 60 consecutive patients with unilateral inguinal hernia were randomized into two groups: control group--10 patients underwent totally extraperitoneal (TEP) repair with mesh fixation; NO FIX group-50 patients underwent TEP repair with no mesh fixation. Mesh was marked with three 3-mm surgical clips at its medial inferior, medial superior and lateral inferior corners. Mesh displacement was measured by comparing an initial X-ray, performed in the immediate postoperative period, with a second X-ray obtained 30 days later. RESULTS: The mean displacement of all three clips in control group was 0.1-0.35 cm (range 0-1.2 cm), while in NO FIX group was 0.1-0.3 cm (range 0-1.3 cm). The overall displacement of control and NO FIX group did not show any difference (p = 0.50). CONCLUSION: Fixation of the mesh for TEP repair is unnecessary. TEP repair with no mesh fixation is safe and is not associated with increased risk of mesh displacement.

Congenital Diaphragmatic Hernia. The Post-neonatal period. Part II.

AIM: The aim of the study was to review our experience in the management of newborns with congenital diaphragmatic hernia (CDH). METHODS: A retrospective study including all infants with CDH at the Hospital de São João, a center that does not provide ECMO support, for the period from 1997 to 2006. Since 2003, a new treatment protocol has been used. RESULTS: There were 61 newborns (30 male/31 female) with a birth weight of 2800 g (880 - 3770), and a gestational age of 38 weeks (28 - 41); 46 (75 %) were inborn and 42 (69 %) had a prenatal diagnosis of CDH. There were 2 (3 %) chromosomal anomalies, 3 (5 %) with other congenital anomalies and 1 (2 %) with nonimmune hydrops fetalis. The diaphragmatic defect was left sided in 55 (90 %) cases. Corrective surgery was performed in 43 (70 %) patients. New therapies were used: HFOV 13 % (n = 8); inhaled nitric oxide 13 % (n = 8); and sildenafil 7 % (n = 4). We found that systemic arterial hypotension (p = 0.001), the severity of pulmonary hypertension (p = 0.001), prenatal diagnosis (p = 0.006), birth weight (p = 0.022), female gender (p = 0.029), inborn birth (p = 0.030), arterial pH < 7.35 at admission (p = 0.030), right-sided defect (p = 0.033) and pneumothorax (p = 0.033) to be predictive of mortality. The overall survival rate was 43 % (n = 26), and since 2003 this rate has improved to 61 % for term neonates without other congenital or chromosomal anomalies. CONCLUSIONS: Our survival rate for infants with CDH has improved over the last ten years, and this improvement is associated with the use of new therapies such as HFOV, inhaled nitric oxide and sildenafil.

Congenital diaphragmatic hernia - the neonatal period (part I).

AIM: The aim of the study was to review our experience in the management of newborns with congenital diaphragmatic hernia (CDH). METHODS: A retrospective study including all infants with CDH at the Hospital de São João, a center that does not provide ECMO support, for the period from 1997 to 2006. Since 2003, a new treatment protocol has been used. RESULTS: There were 61 newborns (30 male/31 female) with a birth weight of 2800 g (880 - 3770), and a gestational age of 38 weeks (28 - 41); 46 (75 %) were inborn and 42 (69 %) had a prenatal diagnosis of CDH. There were 2 (3 %) chromosomal anomalies, 3 (5 %) with other congenital anomalies and 1 (2 %) with nonimmune hydrops fetalis. The diaphragmatic defect was left sided in 55 (90 %) cases. Corrective surgery was performed in 43 (70 %) patients. New therapies were used: HFOV 13 % (n = 8); inhaled nitric oxide 13 % (n = 8); and sildenafil 7 % (n = 4). We found that systemic arterial hypotension (p = 0.001), the severity of pulmonary hypertension (p = 0.001), prenatal diagnosis (p = 0.006), birth weight (p = 0.022), female gender (p = 0.029), inborn birth (p = 0.030), arterial pH < 7.35 at admission (p = 0.030), right-sided defect (p = 0.033) and pneumothorax (p = 0.033) to be predictive of mortality. The overall survival rate was 43 % (n = 26), and since 2003 this rate has improved to 61 % for term neonates without other congenital or chromosomal anomalies. CONCLUSIONS: Our survival rate for infants with CDH has improved over the last ten years, and this improvement is associated with the use of new therapies such as HFOV, inhaled nitric oxide and sildenafil.

[Preventive practices of the residents over 25 years of age in Monterrey and its metropolitan area (Mexico)]. / Prácticas preventivas de los habitantes mayores de 25 años en Monterrey y su zona metropolitana (México).

BACKGROUND: Chronic and degenerative disorders are the leading causes of morbidity-mortality in Mexico, as a result of which the Health Sector has implemented preventive and suitable detection measures. The use of the health services is a dynamic behavior on the part of the population. In order for people to use these preventive measures, the barriers to accessing these services must be lessened. Hence, the objective of this study was that of ascertaining the use of the services for the detection of diabetes mellitus, high blood pressure, cervical-uterine and breast cancer and tetanus and diphtheria toxoide vaccinations. METHODS: The sample size was that of 254 individuals age 25 and over living in Monterrey or in the greater Monterrey metropolitan area. Those having employed preventive measures during the year immediately prior to the study were taken into account with regard to the use of preventive measures. The analysis consisted of descriptive statistics and bivariate analysis. RESULTS: Over 60% of the population was female, the average age being 42.3 + 14 years of age, three fourths of the population being on the social security rolls. A total 37% mentioned having undergone the diabetes test, and 44.5 the test for high blood pressure, while 31.1% had been vaccinated with the tetanus and diphtheria toxoide. Regarding specifically female checkups, 34.3% of all females had undergone the corresponding cervical-uterine cancer test, 29.5% having been screened for breast cancer. No relationship was found to exist between the use of measures and family histories and the perception of the importance of the checks. CONCLUSIONS: The use of preventive measures fall below some international standards. Individuals exposed to the risk must be sought in order to fittingly detect any chronic disorder.

[Impact of primary care on hospitalization of type 2 diabetics with equal conditions of health insurance]. / Impacto de la atención ambulatoria del primer nivel de atención en la hospitalización de población asegurada con diabetes mellitus tipo 2.

OBJECTIVE: To determine the impact of primary care on hospitalization of type 2 diabetics with equal conditions of health insurance. DESIGN: A case-control study. Case = diabetic hospitalized by a disease related condition. Control = diabetic without hospitalization during the last 12 months. SETTING: Urban primary care centers. PARTICIPANTS: Cases were consecutively selected from four out of five urban hospitals (n=123). Controls were chosen at random from primary care units matched by primary care source (n=135). Women with gestational diabetes were excluded as well as individuals with missing medical charts (approximately 15%). MEASUREMENTS: A primary care index was constructed with process and outcome indicators recommended by the American Medical Association, the Joint Commission on Accreditation of Healthcare Organizations, the National Committee for Quality Assurance, the American Diabetes Association and the Official Mexican Standards. Compliance to less than 60% of recommendations was considered unsatisfactory primary care. RESULTS: The following were hospitalization risk factors: less than 2 visits to family physician during the last year (OR adjusted, 16,2; 95% CI, 1,5-174,2), glucose level (OR adjusted, 1,006; 95% CI, 1,002-1,010) and cognitive level (OR adjusted, 0,98; 95% CI, 0,96-0,99), in addition to exercising and year of diagnosis. Sixty-five percent of cases observed unsatisfactory primary care compared with 49,1% of controls (P=0,03). Unsatisfactory primary care increased 2,5 times the risk of hospitalization (95% CI, 1,2-5,0) (pseudo R2=0,279; P<0,001). CONCLUSIONS: Primary care is a potential factor for reducing hospitalization of type 2 diabetics. Effective primary care programs would contribute to a better disease control and less unnecessary hospitalizations.

Occurrence and severity of infections caused by subgroup A and B respiratory syncytial virus in children in southeast Brazil.

The frequency and severity of infections caused by respiratory syncytial virus (RSV) were assessed in children <2 years of age seen at the emergency department. The frequency of RSV detection in the clinical virology laboratory during the past 3 years was also analyzed retrospectively. RSV was found in 21.6% (188/869) of the samples collected from children seen at the emergency department and was found to be more frequent during the autumn, being less frequent or negligible by midwinter. RSV subgroups A and B co-circulated within the same time period in children seen at the emergency department, with varying predominance of either subgroup. There was no significant association of RSV subgroup with disease severity, but only a trend for RSV subgroup B being more frequent in children with risk factors for severe disease.

[Health needs of the diabetic user of primary care]. / Necesidades en salud del diabético usuario del primer nivel de atención.

OBJECTIVE: To determine the extent and importance of unmet health needs of type 2 diabetic patients seen at primary care services. MATERIAL AND METHODS: A cross-sectional study was conducted in 1999, among rural and urban patients of the Mexican Institute of Social Security, in Nuevo Leon, Mexico. The study population consisted of 256 subjects selected at random, diagnosed with type-II diabetes for at least two years. Data were obtained by interview and complemented with medical charts and provider interviews. Five health areas and four health determinants were evaluated, through Mexican Official Standards and American Diabetes Association standards of medical care for diabetic patients. Analysis consisted of descriptive statistics and estimation of z scores. RESULTS: Health needs were met in 49% of cases. A lower mean of health need satisfaction was found in rural regions as compared to urban regions (36.8% vs. 53.3%, p < .01). Nutrition was the most affected health area (z score = -6), followed by the physical exercise (z score = -1), the metabolic health area (z score = +1), the non-smoking health area (z score = +2), the prevention and early detection of complications health area (z score = +2), and the cognitive health area (z score = +3). The health determinant with the highest requirement corresponded to utilization (z score = -5), followed by resource availability (z score = -4), perceived health need (z score = +4), and access barriers (z score = +6). CONCLUSIONS: Health need measurement allows evaluating the effectiveness of existing interventions, in addition to identifying areas with higher unmet health needs. These findings facilitate analysis and decision-making to devise specific health policies and actions directed at improving the quality of care for diabetic patients. The English version of this paper is available at: http://www.insp.mx/salud/index.html

Direct toxicity of nonsteroidal antiinflammatory drugs for renal medullary cells.

Antipyretic analgesics, taken in large doses over a prolonged period, cause a specific form of kidney disease, characterized by papillary necrosis and interstitial scarring. Epidemiological evidence incriminated mixtures of drugs including aspirin (ASA), phenacetin, and caffeine. The mechanism of toxicity is unclear. We tested the effects of ASA, acetaminophen (APAF, the active metabolite of phenacetin), caffeine, and other related drugs individually and in combination on mouse inner medullary collecting duct cells (mIMCD3). The number of rapidly proliferating cells was reduced by approximately 50% by 0.5 mM ASA, salicylic acid, or APAF. The drugs had less effect on confluent cells, which proliferate slowly. Thus, the slow in vivo turnover of IMCD cells could explain why clinical toxicity requires very high doses of these drugs over a very long period. Caffeine greatly potentiated the effect of acetaminophen, pointing to a potential danger of the mixture. Cyclooxygenase (COX) inhibitors, indomethacin and NS-398, did not reduce cell number except at concentrations greatly in excess of those that inhibit COX. Therefore, COX inhibition alone is not toxic. APAF arrests most cells in late G(1) and S and produces a mixed form of cell death with both oncosis (swollen cells and nuclei) and apoptosis. APAF is known to inhibit the synthesis of DNA and cause chromosomal aberrations due to inhibition of ribonucleotide reductase. Such effects of APAF might account for renal medullary cell death in vivo and development of uroepithelial tumors from surviving cells that have chromosomal aberrations.

Cell cycle delay and apoptosis in response to osmotic stress.

As part of the urinary concentrating mechanism, renal inner medulla cells may be exposed to extremely variable NaCl and urea concentrations that can reach very high levels. A number of studies, reviewed herein, aim to understand how such osmotic stress affects the cells and what protective mechanisms might exist. The majority of these studies are done on inner medullary epithelial cells that grow continuously in tissue culture (mIMCD3). Cells grown at 300 mosmol/kg survive increase to 500 mosmol/kg by adding NaCl or urea, but only after a growth arrest of approximately 24 h. At a higher osmolality (650-700 mosmol/kg) most cells die within hours by apoptosis. The cells both in vitro and in vivo adapt to high osmolality by a number of mechanisms, including accumulation of variety of organic osmolytes and induction of heat shock proteins. The cell cycle delay results from blocks at the G1 and G2/M checkpoints and slowing during S. After adding NaCl, but not urea, the amount and transcriptional activity of p53 (the tumor suppressor protein) increases. The p53 is phosphorylated on ser-15 and is transcriptionally active at 500 mosmol/kg (associated with cell survival), but not at 700 mosmol/kg (associated with apoptosis). Reduction of p53 expression by p53 antisense oligonucleotide increases sensitivity of renal cells in culture to hyperosmotic stress caused by NaCl. The possible mechanisms of the protection action of p53 against hypertonic stress are discussed.

[Nutritional risk in patients with pulmonary tuberculosis: the patient's or the health services' problem?]. / Riesgo nutricional en pacientes con tuberculosis pulmonar: cuestión del paciente o de los servicios de salud?

OBJECTIVE: To determine nutritional risk factors in a population of patients with pulmonary tuberculosis (PT). MATERIAL AND METHODS: During 1997, one-hundred and eighty-five patients with PT were chosen at random from two health institutions in Monterrey, Nuevo León, México. Variables analyzed were: anthropometric measures, socioeconomic status, utilization of the nutrition clinic, access to foodstuffs, adverse reactions to drugs, and disease attributable to malnutrition. Statistical analysis consisted of descriptive, bivariate, and multivariate logistic regression, in addition to prevalence ratios and 95% confidence intervals. RESULTS: The mean age was 42.4 +/- 19.9 years. The mean body mass index was 19.8 +/- 3.2; 57% of patients presented malnutrition; 26% of them were referred to the nutrition clinic, 24.3% of whom actually attended it. Multivariate analysis showed that adverse reactions of tuberculosis drugs were risk factors for malnutrition, independent of age, gender, education, occupation, year of diagnosis and access to foodstuffs, disease attributable, and utilization of the nutrition clinic. (chi 2 = 10.58; p = 0.051, R2 = 0.42). CONCLUSIONS: Nutritional risk in patients with pulmonary tuberculosis is both a patient and a health services issue. The high prevalence of malnutrition, the low utilization rate of nutritional services, and the effect of adverse reactions to therapeutic drugs, justify the need to focus attention on this particular group of patients.

[Malnutrition in pre-school infants in migrant families]. / Desnutrición en prescolares de familias migrantes.

OBJECTIVE: To compare malnutrition rates between migrant and non-migrant children. MATERIAL AND METHODS: One-hundred and sixty children 1-6 years old were selected at random from schools located in highly marginated areas. Excluded were infants with congenital malformations or under nutritional intervention. Migration was defined as any geographical movement during the last 6 years. Malnutrition was assessed through the weight/height and height/age indicators, as recommended by the World Health Organization. RESULTS: Fifty-nine percent of the infants belonged to families whose father had a non-qualified occupation, 27.5% of them did not finish elementary school. Fifty-three referred migration; malnutrition rate was 51.3% among migrant infants and 28.8%, among non-migrant infants (OR = 2.6, CI 95% = 1.2, 5.2, p = 0.006). Migrant children registered a mean Z score of -2.4 +/- .40 and non-migrant children, -2.3 +/- .33, based on the indicator height for age. CONCLUSIONS: Chronic malnutrition among migrant infants justifies a nutritional intervention, they constitute a specific group at risk. Migration should be considered for health planning.