Osimertinib treatment for patients with EGFR exon 20 mutation positive non-small cell lung cancer.

OBJECTIVES: Epidermal growth factor receptor (EGFR) exon 20 insertions comprise 4-10 % of EGFR mutations in non-small cell lung cancer (NSCLC) and are associated with primary resistance to first and second generation EGFR tyrosine kinase inhibitors (TKIs). In vitro and preclinical animal studies have shown that osimertinib exerts antitumor activity against EGFR exon 20 mutation positive NSCLC. We report on a cohort of advanced stage NSCLC patients who harbor an EGFR exon 20 mutation and received osimertinib treatment. MATERIAL AND METHODS: Twenty-one patients were treated with osimertinib 80 or 160 mg once daily from April 2016 to June 2018, in four institutions in the Netherlands. Data were obtained retrospectively. Progression free survival (PFS), disease control rate (DCR), overall survival (OS) and objective response rate (ORR) were assessed using RECIST v1.1. RESULTS: Thirteen patients received prior platinum-based chemotherapy, and three patients a first - or second generation EGFR TKI. We observed 1 partial response, 17 patients with stable disease and 3 with progressive disease as best response to osimertinib (ORR 5 %). Median PFS was 3.6 (95 % CI, 2.6-4.5) months. PFS did not differ for patients with co-occurring TP53 mutations (p = 0.937). The DCR at three months was 71 %. Median OS was 8.7 (95 % CI, 1.1-16.4) months. CONCLUSION: Osimertinib has limited antitumor activity in patients with EGFR exon 20 mutated NSCLC, with an ORR of 5 %.

Corpectomia lateral parcial para o tratamento de compressão ventral extradural crônica entre T9-T10 em um cão / Partial lateral corpectomy for treatment of chronic ventral extradural compression between T9-T10 in a dog

Objetivou-se relatar um caso de protrusão do disco intervertebral com localização atípica e descrever a técnica cirúrgica de corpectomia lateral parcial no tratamento da afecção em um cão. Um cão de sete anos de idade, macho, raça Pug, foi atendido com ataxia proprioceptiva dos membros pélvicos havia três meses, associada à doença do disco intervertebral entre a nona e 10ª vértebras torácicas. Após um mês de tratamento conservativo sem melhora, o paciente foi encaminhado para o tratamento cirúrgico, quando foi realizada corpectomia lateral parcial esquerda para descompressão da medula espinhal. Após a cirurgia, o paciente apresentou melhora considerável do quadro, sendo a técnica eficaz na remoção da compressão extradural, sem manipulação da medula espinhal ou outras complicações.(AU)

The aim of this study is to report a case of intervertebral disc protrusion with atypical location and describe the surgical technique of partial lateral corpectomy in the treatment of this disease in a dog. A dog, seven -years-old, male, Pug breed was attended with proprioceptive ataxia of the hind limbs for three months correlated with intervertebral disc disease between the 9th and 10th thoracic vertebrae. After a month of conservative treatment without improvements, the patient was referred for surgical treatment, which was performed as a partial left lateral corpectomy for decompression of the spinal cord. After surgery, the patient showed considerable improvement, this technique being shown to be effective in the removal of extradural compression, without manipulation of the spinal cord or other complications.(AU)

Transferência de autoenxerto osteocondral para tratamento de osteocondrite dissecante em côndilo femoral de cão / Osteochondral autograft transfer for treatment of osteochondritis dissecans of the femoral condyle in a dog

Na osteocondrite dissecante (OCD), a articulação do ombro é mais comumente afetada, mas o joelho é ocasionalmente lesionado, o que, muitas vezes, passa desapercebido. O tratamento cirúrgico precoce é indicado para remover cartilagem solta, aliviar a dor e minimizar a artrose. Benefícios putativos da transferência de autoenxerto osteocondral em relação às técnicas convencionais incluem a reconstrução exata do contorno subcondral e articular, recobrimento da superfície com cartilagem hialina e criação de uma barreira imediata entre o líquido sinovial e o osso subcondral. O objetivo deste trabalho é relatar a técnica de transferência de autoenxerto osteocondral para o tratamento da osteocondrite do côndilo femoral. Um cão da raça Bull Terrier foi tratado cirurgicamente por meio da técnica de transferência de autoenxerto osteocondral, após ter sido diagnosticado com OCD do côndilo femoral, apresentando melhora clínica significativa e completa recuperação aos 30 dias de pós-operatório.(AU)

In osteochondritis dissecans (OCD), the shoulder joint is most commonly involved, but the stifle is occasionally involved and often goes unnoticed. Early surgical treatment is indicated to remove loose cartilage and minimize osteoartrosis. Putative benefits of Osteochondral Autograft Transfer (OAT) over conventional techniques include accurate reconstruction of subchondral and articular contour, resurfacing with hyaline or hyaline-like cartilage, and creation of an immediate barrier between synovial fluid and subchondral bone. The purpose of this work is to report the technique of OATs for the treatment of osteochondritis of the femoral condyle. A canine attended the Laboratory of Comparative Orthopedics and Traumatology USP-FMVZ underwent surgery after being diagnosed with OCD of the femoral condyle, with significant clinical improvement at 30 days postoperatively.(AU)

Genetic variability among elite popcorn lines based on molecular and morphoagronomic characteristics.

Knowledge of genetic diversity among genotypes and relationships among elite lines is of great importance for the development of breeding programs. Therefore, the objective of this study was to evaluate genetic variability based on the morphoagronomic and molecular characterization of 18 elite popcorn (Zea mays var. everta) lines to be used by Universidade Estadual de Maringá breeding programs. We used 31 microsatellite primers (widely distributed in the genome), and 16 morphological descriptors (including the resistance to maize white spot, common rust, polysora rust of maize, cercospora and leaf blights). The molecular data revealed variability among the lines, which were divided into four groups that were partially concordant with unweighted pair group method with arithmetic mean (UPMGA) and Bayesian clusters. The lines G3, G4, G11, and G13 exhibited favorable morphological characters and low disease incidence rates. The four groups were confirmed using the Gower distance in the UPGMA cluster; however, there was no association with the dissimilarity patterns obtained using the molecular data. The absence of a correlation suggests that both characterizations (morphoagronomic and molecular) are important for discriminating among elite popcorn lines.

Uso do Clamp and Rod Internal Fixation pedicular na estabilização da coluna lombossacra em felino: relato de caso / The Clamp and Rod Internal Fixation pedicular stabilization of the lumbosacral spine in feline: case report

Objetivou-se reportar, pela primeira vez descrita até então, a fixação de uma fratura de sétima vértebra lombar (L7) com luxação de L7-S1, por meio de fixação pedicular, utilizando-se Clamp and Rod Internal Fixation (CRIF) em um gato. Um felino de um ano de idade, macho, SRD, foi atendido com histórico de atropelamento havia sete dias, apresentando paraparesia não ambulatória secundária à fratura da sétima vértebra lombar e compressão da cauda equina. Após avaliação geral do paciente, no dia seguinte, ele foi submetido à cirurgia descompressiva por meio de laminectomia dorsal e posterior estabilização pedicular entre L7 e S1, utilizando-se CRIF bilateralmente. O paciente apresentou evolução favorável com deambulação normal após 15 dias do procedimento cirúrgico.(AU)

The aim was to report the establishment of a seventh lumbar vertebra fracture (L7), the first described so far, with L7 -S1 luxation through pedicle fixation using Clamp and Rod Internal Fixation (CRIF) on a cat. A 1 year old male mongrel feline was attended with a history of being hit by car seven days prior, with no ambulatory paraparesis secondary to fracture of the seventh lumbar vertebrae and compression of the cauda equina. After general evaluation of the patient, the next day, the patient was submitted to decompressive surgery through dorsal laminectomy and posterior pedicle stabilization between L7 and S1 using CRIF bilaterally. The patient presented a favorable outcome with normal ambulation after 15 days of surgery.(AU)

Short Communication A small B chromosome in the grasshopper Ommexecha virens (Ommexechidae).

B chromosomes, also called supernumerary or accessory chromosomes, have been characterized as extra elements found in the karyotypes of different eukaryotic species. B chromosomes are nonvital and only occur in some individuals within a species. Moreover, the chromosomes contain silenced genes, and they exhibit heterochromatinization and the accumulation of repetitive DNA and transposons. In the present study, we describe an extra chromosome in the grasshopper Ommexecha virens for the first time, using conventional staining and fluorescent in situ hybridization techniques, and we discuss the possible origin of the B chromosome.

Physical mapping of the Period gene on meiotic chromosomes of South American grasshoppers (Acridomorpha, Orthoptera).

The single-copy gene Period was located in five grasshopper species belonging to the Acridomorpha group through permanent in situ hybridization (PISH). The mapping revealed one copy of this gene in the L1 chromosome pair in Ommexecha virens, Xyleus discoideus angulatus, Tropidacris collaris, Schistocerca pallens, and Stiphra robusta. A possible second copy was mapped on the L2 chromosome pair in S. robusta, which should be confirmed by further studies. Except for the latter case, the chromosomal position of the Period gene was highly conserved among the four families studied. The S. robusta karyotype also differs from the others both in chromosome number and morphology. The position conservation of the single-copy gene Period contrasts with the location diversification of multigene families in these species. The localization of single-copy genes by PISH can provide new insights about the genomic content and chromosomal evolution of grasshoppers and others insects.

Variáveis agronômicas e químicas e degradabilidade ruminal da cana-de-açúcar / Agronomic and chemical variables and sugarcane ruminal degradability

Objetivou-se avaliar a variabilidade do valor nutritivo entre cultivares de cana-de-açúcar, estimar a correlação entre digestibilidade e produtividade da planta e definir características químicas e agronômicas mais correlacionadas ao valor nutritivo. Vinte cultivares de cana-de-açúcar foram cultivados em delineamento em blocos ao acaso, com quatro repetições, em Campos, RJ, Brasil. As plantas foram colhidas com Brix superior a 18 por cento, a partir de 370 dias do corte da segunda soca. Características agronômicas e químicas e as degradabilidades ruminais in situ da FDN e da MS foram avaliadas. A produtividade foi 21,2±5,7t de MS/ha, e a degradabilidade ruminal da MS (DEG MS) foi 57,1±2,6 por cento do incubado (média±DP). A degradabilidade ruminal da FDN foi 19,8±2,42 por cento do incubado. Nenhuma variável avaliada foi correlacionada à degradabilidade da FDN (P>0,10). Obter cultivares que conciliam alta produtividade com alta DEG MS é viável, pois a correlação tanto fenotípica quanto genética entre esses caracteres foi pequena. A h2 para a DEG MS foi superior a 85 por cento. Variáveis indiretamente correlacionadas à DEG MS tiveram menor h2 que o desta variável. Canas com baixo conteúdo de fibra, com colmos curtos e com alta relação entre colmos e folhas, foram mais digestíveis...

The objective was to evaluate the variability of nutritive value among sugarcane cultivars, to estimate the correlation between plant digestibility and productivity, and to define agronomical and chemical traits most correlated with nutritive value. Twenty sugarcane cultivars were cultivated in a completely randomized block design with four replicates in Campos, RJ, Brazil. Plants were harvested when the Brix was superior to 18 percent, starting at 370 days after the second ratoon cut. Agronomical and chemical traits and the ruminal NDF and DM in situ degradability were evaluated. Productivity was 21.2±5.7t of DM/ha and ruminal DM degradability (DM DEG) was 57.1±2.6 percent of incubated (mean±SD). Ruminal NDF degradability was 19.8±2.42 percent of incubated, and none of the variables evaluated were correlated to the NDF degradability (P>0.10). Obtaining cultivars that conciliate high productivity to high digestibility is feasible, since the phenotypic and the genetic correlation between these traits were low. The estimated h2 for the DM DEG was superior to 85 percent. Variables indirectly correlated to the digestibility had smaller h2 than the one for this variable. Sugarcane with low fiber content, short stalk length and high stalk to leaves ratio were more digestible...

Silagem de grãos úmidos de milho de textura dura ou macia em dietas com polpa cítrica para vacas em lactação / High moisture silage of hard or soft corn grain in citrus pulp diets for lactating cows

Avaliou-se o desempenho de vacas leiteiras que consumiram polpa cítrica e dois teores dietéticos de silagem de grão úmido de milho. Os tratamentos foram: milho de textura dura ou milho de textura macia ensilado na linha negra, em fatorial com 9% ou 18% de milho na dieta. O teor de polpa cítrica na dieta foi de 16,2% ou 25,6%, com alto e baixo milho, respectivamente. Doze vacas receberam os tratamentos em quadrados latinos 4x4. A produção diária de leite foi 27,9kg no milho duro e 28,8 no macio (P=0,19). Alto milho diminuiu o teor de gordura do leite de 3,38 para 3,26% (P=0,04) e aumentou o teor de proteína de 2,99 para 3,03% (P=0,05) e a eficiência alimentar de 1,50 para 1,57kg de leite/kg de consumo (P=0,03). Aumento no teor de milho induziu maior queda no pH ruminal na dieta com milho macio do que na dieta com milho duro (P=0,05 para a interação textura versus teor de milho). O milho macio aumentou o consumo diário de matéria orgânica digestível de 11,7 para 12,3kg (P=0,05). Os parâmetros digestivos sugerem que a ensilagem não eliminou totalmente o efeito da textura do endosperma sobre a digestibilidade do milho.

Lactating cow performance on diets containing citrus pulp and two levels of high moisture corn silage was evaluated. Treatments were: hard texture corn or soft texture corn ensiled at the black layer, with a 9% or 18% factorial corn in the diet. Dietary citrus pulp content was 16.2% or 25.6%, for high and low corn, respectively. Twelve cows received the treatments in 4x4 Latin Squares. Daily milk yield was 27.9kg for hard corn and 28.8 for soft (P=0.19). High corn decreased milk fat content from 3.38 to 3.26% (P=0.04), and increased protein content from 2.99 to 3.03% (P=0.05) and feed efficiency from 1.50 to 1.57kg of milk/kg of intake (P=0.03). The increase of corn content generated a greater decrease in ruminal pH in the soft corn diet than in the hard corn diet (P=0.05 for the interaction of texture versus corn content). Soft corn increased the daily intake of digestible organic matter from 11.7 to 12.3kg (P=0.05). Digestive parameters suggest that ensilaging did not totally eliminate the endosperm texture effect on corn digestibility.

Correlation of previous experience, patient expectation and the number of post-delivery adjustments of complete dentures with patient satisfaction in a Brazilian population.

A number of variables may influence the outcome of complete denture therapy. The objective of this study was to verify possible correlations between previous experience with dentures, patient expectation and the number of post-delivery adjustments with patient satisfaction after treatment. One hundred patients (mean age 61·9 ± 10·3) rated their previous experiences with complete dentures and their expectations before and satisfaction after treatment on a visual analogue scale (VAS) using scores from 0 (worst results) to 10 (best results). The number of post-delivery adjustments and other patient-related clinical variables was also noted. Patient expectation scores were higher than previous experience scores and satisfaction after treatment scores. Positive and weak correlations were found between previous chewing experiences with complete dentures, with regard to chewing expectations and comfort of use. Phonetics and comfort of use in previous experiences presented a positive correlation with expectations for chewing, aesthetics, phonetics and comfort of use. Groups of patients with different levels of education presented significant differences in expectation scores regarding comfort of use as well. A negative and weak correlation was found between phonetics satisfaction and the number of post-delivery adjustments. Patients' expectations for the therapy were higher than their satisfaction after treatment. Previous experiences with complete dentures could slightly influence patients' expectations and satisfaction, whereas lower scores for previous experience with complete dentures caused lower scores for both expectation and satisfaction. Patients' educational levels and the number of post-delivery adjustments influenced negatively the expectations about comfort of use and patient satisfaction, respectively.

Resposta de vacas leiteiras à substituição parcial de farelo de soja por ureia encapsulada / Response of lactating cows to the partial replacement of soybean meal by encapsulated urea

Avaliou-se a substituição parcial de farelo de soja na dieta-controle por ureia encapsulada ou por ureia, ambos acrescidos de polpa cítrica. Dezoito vacas foram alocadas a uma sequência de três tratamentos, em seis quadrados latinos 3x3, com períodos de 21 dias. O teor de proteína bruta nas dietas foi 15,5 por cento, cerca de 1,5 por cento oriundo de nitrogênio não proteico (NNP). O uso de NNP reduziu o consumo diário de matéria seca em 0,8kg (P=0,04), sem influenciar a produção de leite (31,5kg, P=0,98). A conversão do alimento em leite foi menor na dieta-controle (P<0,09). As fontes de NNP aumentaram o teor de N-ureico no plasma (NUP) duas horas após a alimentação da manhã (P=0,06). A frequência de NUP acima de 22,0mg/dL foi maior com ureia (P<0,01), similarmente ao observado para o teor e a secreção diária de N-ureico no leite (P<0,01). A substituição de farelo de soja por NNP e polpa cítrica melhorou a eficiência alimentar, sem afetar o balanço de nitrogênio.

The partial replacement of the soybean meal in the control diet for encapsulated urea or urea, both with added citrus pulp was evaluated. Eighteen Holstein cows were allocated to a sequence of the three treatments, in six 3x3 latin squares, with 21-day periods. The dietary level of crude protein was 15.5 percent, around 1.5 percent from non-protein nitrogen (NPN). The use of NPN reduced 0.8kg of daily dry matter intake (P=0.04), without affecting milk yield (31.5kg, P=0.98). The conversion of feed into milk decreased for the control diet (P<0.09). The NPN sources increased plasma urea-N (PUN) two hours after the morning feeding (P=0.06). The frequency of PUN above 22.0mg/dL was increased by urea (P<0.01), similarly to the observed for milk urea-N content and daily secretion (P<0.01). The replacement of soybean meal for NPN and citrus pulp improved feed efficiency, without affecting the nitrogen balance.

Algoritmo que identifica la dificultad en el retorno al domicilio del hemipléjico agudo / Decision algorithm that identifies delay in discharge of stroke patients

Introducción. El retorno al domicilio del paciente que ha sufrido un accidente cerebrovascular agudo (ACVA) es fundamental para el alta hospitalaria y su integración en la sociedad. Se establece un algoritmo que permita identificar a los pacientes con ACVA que sufrirán demora en la reinserción al domicilio al alta. Material y métodos. Se procede a un estudio retrospectivo en 214 hemipléjicos que ingresan en el Servicio de Rehabilitación (SMFR) de un Hospital General. Se recogen 17 variables clínicas y sociodemográficas al ingreso en rehabilitación (a los 14 días de media desde el ictus) y se relacionan con la demora en la vuelta a su domicilio (DRD). Material y métodos. Mediante análisis de regresión logística múltiple, se calcula la fórmula del modelo de predicción y se confecciona un árbol de probabilidades de DRD. Resultados. La probabilidad de DRD está determinada por tres variables: FIM inicial (menor o mayor a 50 puntos), edad (mayor o menor a 75 años) y soledad (vivir solo o no previamente al ACVA). La combinación de estas variables permite confeccionar un algoritmo con ocho grupos de diferente probabilidad de DRD, entre el 3,6 y el 79,6%. Tiene una especificidad del 89%, sensibilidad del 40% y valor de predicción del 76%. Conclusiones. Se ha construido un algoritmo para decidir a priori la probabilidad de DRD utilizando las tres variables de mayor capacidad de predicción: capacidad funcional al ingreso (por Functional Independence Measure [FIM]), edad y la circunstancia de vivir en soledad. Este algoritmo incluye ocho grupos diferentes de probabilidad de DRD(AU)

Introduction. The return home of patients who have suffered an acute cerebrovascular accident (ACVA) is fundamental if they are to be discharged from hospital and integrated into society. Our aim is to design an algorithm that can identify those patients with ACVA who will undergo a delay in discharge to their home. Patients and method. A total of 214 hemiplegic patients admitted to the Rehabilitation Service (SMRF) of the General Hospital were retrospectively studied. On admittance (a mean of 14 days after the stroke), 17 clinical and sociodemographic variables were collected and their relationship with delay in the return home (DRD) was studied. Multiple logistic regression analysis was used to calculate the formula of the prediction model and the probability tree for presenting DRD was drawn up. Results. Likelihood of DRD is determined by three variables: initial functional independence measurement (FIM) (above or below 50 points), age (older or younger than 75) and living alone (whether or not the patient lived alone before the ACVA). The combination of these variables makes it possible to construct an algorithm with eight different likelihood groups of DRD, between 3.6 and 79.6%. It has an 89% specificity, 40% sensitivity and 76% prediction value. Conclusions. An algorithm has been constructed to make a priori decisions about the probability of DRD. It uses the three variables with the greatest prediction ability: functional capacity on admittance (FIM), age and whether or not the patient lived alone. The algorithm considers eight different groups of DRD likelihood(AU)

Deterioro de la calidad de vida en cuidadores familiares de pacientes con discapacidad por ictus: una entidad a considerar / Loss of quality of life in family caregivers of stroke patients: an entity to be considered

Objetivos. Detectar los aspectos más afectados en la calidad de vida relacionada con la salud de dichos cuidadores y conocer las posibles relaciones con variables dependientes del paciente y del cuidador. Métodos. Estudio transversal de 215 cuidadores familiares de pacientes con discapacidad por ictus (1:3 hombre/mujer, edad media 63,6 (±11,03) años). La principal variable de resultado fue la percepción de salud medida con el cuestionario Short Form 36 (SF-36). También se recogieron datos demográficos y de comorbilidad, así como variables dependientes del individuo cuidado. Las pruebas estadísticas utilizadas fueron: χ2, t-Student y el coeficiente de correlación de Spearman. Resultados. La vitalidad y la salud general fueron las dimensiones peor valoradas por todos los cuidadores. En comparación con la población general, las mujeres cuidadoras entre 45 y 54 años presentaron una disminución significativa en las subescalas de vitalidad (p=0,003), función social (p=0,01), rol emocional (p=0,038) y salud mental (p=0,002). Las mujeres cuidadoras entre 55 y 64 años también mostraron una disminución de la función social (p=0,027) y el rol emocional (p=0,024). Los hombres cuidadores no presentaron una afectación significativa de su CVRS. Conclusiones. Cuidar tiene un impacto negativo en la CVRS, especialmente para las mujeres cuidadoras de mediana edad. La presencia de depresión y dolor musculoesquelético en el cuidador, el tiempo dedicado al cuidado y la discapacidad del paciente influyen en este deterioro de la calidad de vida. Los cuidadores juegan un papel determinante en la recuperación del ictus, por lo que identificar estrategias para mejorar el manejo de la situación es útil para evitar que el rol del cuidador resulte en una pérdida de su calidad de vida(AU)

Introduction. Among stroke consequences highlights the negative impact on the informal carers’ health related quality of life (HRQoL). Objectives. To identify HRQoL dimensions most greatly affected in stroke caregivers and stablish relations with dependent variables of survivors and caregivers. Methods. Transversal study of 215 informal caregivers of stroke survivors (1:3 man/woman, mean age 63.6 (±11.03) years). Main outcome measure was health perception assessed with the Short Fom 36 (SF-36). Clinical and demographic data of stroke patients were also registered. Statistical tests used were Chi-square, t-Student test and Spearman correlation coefficient. Results. Vitality and general health were the most affected dimensions perceived by caregivers. In comparaison with the Spanish general population, female caregivers aged 45–54 years presented a significant reduction in the SF-36 subscales of vitality (p=0.003), social function (p=0.01), emotional role (p=0.038) and mental health (p=0.002). Female caregivers aged 55–64 years also showed a significant reduction in social function (p=0.027) and emotional role (p=0.024). Male caregivers did not present significant lower HRQoL. Conclusions. Caregiving experience has a negative impact on HRQoL, specially middle-aged female caregivers. Some carer physical and psychological characteristics (depression, musculoskeletal pain, time spent on caring) and survivor disability shown to influence carers outcomes. Caregivers play an important role in the recovery of stroke patients, so that the identification of strategies which help them to cope with the stroke might avoid that the role of caring results in a loss of quality of life(AU)

Overdenture retained by teeth using a definitive denture base technique: a case report.

This paper presents a technique involving the use of a definitive denture base to make overdentures. Cores with ball attachments were cemented over remaining lower teeth. Impressions of the edentulous maxilla and mandible were taken to obtain a definitive acrylic resin base. The definitive base of the mandible was perforated at the location of ball attachments and its female components were fixed to the base using acrylic resin directly in the patient's mouth. Wax rims were then made, jaw relationships recorded, teeth mounted and tried in, and the dentures were cured. This technique allowed for easy fixing of female components and better retention during the recording of jaw relationships, and can also be used in the construction of implant retained dentures.

[Loss of quality of life in family caregivers of stroke patients: an entity to be considered]. / Deterioro de la calidad de vida en cuidadores familiares de pacientes con discapacidad por ictus: una entidad a considerar.

INTRODUCTION: Among stroke consequences highlights the negative impact on the informal carers' health related quality of life (HRQoL). OBJECTIVES: To identify HRQoL dimensions most greatly affected in stroke caregivers and establish relations with dependent variables of survivors and caregivers. METHODS: Transversal study of 215 informal caregivers of stroke survivors (1:3 man/woman, mean age 63.6 (±11.03) years). Main outcome measure was health perception assessed with the Short Fom 36 (SF-36). Clinical and demographic data of stroke patients were also registered. Statistical tests used were Chi-square, t-Student test and Spearman correlation coefficient. RESULTS: Vitality and general health were the most affected dimensions perceived by caregivers. In comparison with the Spanish general population, female caregivers aged 45-54 years presented a significant reduction in the SF-36 subscales of vitality (p=0.003), social function (p=0.01), emotional role (p=0.038) and mental health (p=0.002). Female caregivers aged 55-64 years also showed a significant reduction in social function (p=0.027) and emotional role (p=0.024). Male caregivers did not present significant lower HRQoL. CONCLUSIONS: Caregiving experience has a negative impact on HRQoL, specially middle-aged female caregivers. Some carer physical and psychological characteristics (depression, musculoskeletal pain, time spent on caring) and survivor disability shown to influence carers outcomes. Caregivers play an important role in the recovery of stroke patients, so that the identification of strategies which help them to cope with the stroke might avoid that the role of caring results in a loss of quality of life.

Expectations and final evaluation of complete dentures by patients, dentist and dental technician.

There is a poor association between the dentist's evaluation of denture quality and patients' satisfaction with their dentures. Possible differences between dental professionals and patients' expectations might help explain differences in outcome evaluations. This study compared scores given by a dentist, a dental technician and patients for their expectations before and their final evaluation after complete dentures treatment. Twenty completely edentulous patients, a prosthodontist and a dental technician provided scores for the expected aesthetic and functional results of their dentures based on a visual analogue scale at baseline. Post-treatment completion ratings were given after adjustments, by dentist and patients. The dental technician provided post-treatment completion ratings after completing the dentures. The patients had higher expectations than the dental technician and the dentist perceived for both aesthetic and function (P < 0.001). The patients also presented higher post-treatment completion ratings than the dental professionals perceived for final aesthetics (P = 0.016, Kendall's W = 0.207) and function (P = 0.002, Kendall's W = 0.303). Only the dentist presented a statistically significant difference between expectations (lower) and final (higher) outcomes for aesthetics (P = 0.017) and function (P = 0.003). There was no correlation between expectations and post-treatment completion ratings according to the patients' age. There was also no correlation between the patients' gender and expectation scores. Patients presented higher expectations regarding their dentures than dental professionals. The dentist believed that dentures would bring fewer benefits than patients did, but his perception of denture benefits post-treatment was significantly higher than his expectations.

Simultaneous presence of bovine papillomavirus in blood and in short-term lymphocyte cultures from dairy cattle in Pernambuco, Brazil.

Bovine papillomaviruses (BPV) are the causal agents of benign and malignant lesions; they can cause dramatic economic losses in cattle. Although 10 virus types have been described, three types are most common in tumors, namely BPV-1, -2 and -4. Previous studies have reported BPV in blood cells and the possibility of blood acting as a latent virus site and/or transmission agent of virus dissemination. We studied a Holstein dairy herd in Pernambuco, Brazil, in which several animals showed severe cutaneous papillomatosis, without previous determination of BPV types. Blood samples and short-term lymphocyte cultures were collected from 54 cows. We compared the BPV types detected in peripheral blood to those identified in the respective lymphocyte cultures: BPV-1 was detected in 74% and BPV-2 in 87% of the whole blood samples. Simultaneous virus presence (BPV-1 and BPV-2) was found in 65% of the blood samples. BPV-1 or BPV-2 were detected in the lymphocyte cultures in 93% of the samples, and both in 89%. The detection of viral DNA in whole blood and in lymphocyte cultures is evidence that this virus is carried by lymphocytes.

Resposta de vacas leiteiras à substituição total de milho por polpa cítrica e à suplementação com microminerais orgânicos II: desempenho e economia / Response of lactating cows to the total replacement of corn by citrus pulp and to the supplementation of organic trace minerals II: performance and savings

Avaliaram-se o desempenho e a eficiência financeira de vacas leiteiras alimentadas com dietas com substituição total de milho por polpa cítrica. O teor dietético do milho foi 10 por cento e o de polpa 24 por cento nos tratamentos com milho, e o de polpa foi 33 por cento nas dietas exclusivas com polpa. A substituição total das fontes inorgânicas Cu, Mn, Se, Zn e Cr por fontes orgânicas foi avaliada simultaneamente. As quatro dietas geradas por arranjo fatorial dos dois fatores foram fornecidas a 16 vacas em Quadrado Latino 4x4. As produções de leite foram 27,5kg para vacas alimentadas com polpa e 28,4kg para aquelas que receberam milho (P=0,04). A substituição total de milho por polpa cítrica reduziu o teor e a produção de proteína no leite (P<0,03), e não afetou a secreção de gordura (P>0,24). Dietas formuladas exclusivamente com polpa cítrica podem ser indicadas quando o pagamento do leite for baseado apenas no volume. A inclusão de milho pode aumentar a renda bruta subtraída do custo alimentar quando a produção de sólidos for valorizada.

The performance and financial efficiency of dairy cows fed diets formulated by total replacement of corn by citrus pulp was evaluated. Treatments with corn contained 10 percent corn and 24 percent citrus pulp while citrus diets contained 33 percent citrus pulp. The complete replacement of inorganic sources of Cu, Mn, Se, Zn, and Cr by organic sources was simultaneously evaluated. The four diets generated by the factorial arrangement of the two factors were fed to 16 cows in 4x4 Latin Squares. Means of milk production were 27.5kg and 28.4kg for cows fed citrus pulp and corn (P=0.04) diets, respectively. The complete replacement of corn by citrus pulp decreased milk protein production and content (P<0.03) and had no effect on milk fat (P>0.24). Diets formulated exclusively with citrus pulp may be recommended when milk payment is based exclusively on volume, but the inclusion of corn may increase income over feed cost when milk solids are valued.

Genetic characterization of Brazilian strains of Aspergillus flavus using DNA markers.

The Aspergillus genus belongs to a filamentous fungal group characterized by wide dispersion in the environment. Some species are associated with diseases, especially in immunocompromised patients, while others are of economical importance due to aflatoxin production or biotechnological applications. Its species identification is nowadays performed by traditional techniques combined with molecular markers, resulting in a higher efficiency of isolate characterization. In the present study, internal transcribed spacer, inter-simple sequence repeats (ISSR), and random amplified polymorphic DNA (RAPD) molecular markers were used, with the aim of genetically characterizing strains of Aspergillus flavus and strains of other species of the A. flavus group. High genetic diversity was revealed by RAPD and by ISSR, in which the use of the (GACA)4 primer yielded a higher diversity than with the (GTG)5 primer, although the latter showed a characteristic banding profile for each species. These data were used to create a similarity matrix for the construction of dendrograms by means of the UPGMA method. The ISSR and RAPD profiles showed that among the strains previously identificated as A. flavus, one should be A. oryzae, one A. parasiticus and two A. tamarii. On the other hand, a strain previously identified as A. parasiticus should be A. flavus. All these strains were retested by traditional methods and their new species identification was confirmed. These results strongly support the need for using molecular markers as an auxiliary tool in differentiating fungal species and strains.