Efficacy and safety of hypofractionated radiotherapy versus conventional fractionated radiotherapy in diffuse intrinsic pontine glioma: A systematic review and meta-analysis.

Background: Diffuse intrinsic pontine glioma (DIPG) stands as the predominant type of brainstem glioma. It is characterized by a notably brief median survival period, with the majority of patients experiencing disease progression within six months following radiation therapy. This systematic review and meta-analysis aims to assess the efficacy and safety of hypofractionated radiotherapy (HFRT) compared to conventionally fractionated radiotherapy (CFRT) in DIPG treatment. Materials and methods: A systematic literature search was conducted in four databases, and relevant studies comparing HFRT and CFRT in DIPG were included. Data were extracted and analyzed for overall survival (OS), progression-free survival (PFS), and treatment-related toxicities. Statistical analysis was performed using random-effects models with heterogeneity assessment. Results: Five studies met the inclusion criteria, comprising 518 patients. No significant difference in one-year OS was observed between HFRT and CFRT (29% vs. 22%, p = 0.94). The median OS was similar in both treatment groups (9.7 vs. 9.3 months, p = 0.324). Similarly, no significant difference in one-year PFS was found between HFRT and CFRT (19.8% vs. 16.6%, p = 0.82), with comparable median PFS (9.3 vs. 9.4 months, p = 0.20). In meta-regression analysis, there was no association of chemotherapy (p > 0.05) or radiation biologically effective dose (BED) (p > 0.05) regarding OS or PFS outcomes. There were no significant differences in treatment-related toxicities. Conclusions: HFRT yields one-year OS and PFS rates similar to CFRT in DIPG, with no significant differences in treatment-related toxicities. Chemotherapy and BED did not affect OS or PFS.

Exacerbated Renal and Hematologic Toxicities to Ifosfamide and Doxorubicin-Based Chemotherapy in a Patient with Retroperitoneal Liposarcoma Harboring a Germline Mutation in the WRN Gene.

Werner's syndrome is caused by the inactivation of both WRN alleles and is characterized by premature aging and increased risk of neoplasms, especially those of mesenchymal origins, such as sarcomas. Given the characteristic genomic instability, patients with this syndrome are more susceptible to develop toxicities when exposed to cytotoxic agents, such as alkylators and anthracyclines. The impact of the monoallelic WRN mutation on treatment-associated toxicities is poorly understood. Here, we report a patient with locally advanced dedifferentiated liposarcoma of the retroperitoneum harboring a heterozygous germline inactivation mutation in the WRN gene, who was treated with a classic regimen of ifosfamide and doxorubicin and developed exacerbated and prolonged hematological and renal toxicities.

Avaliação do tratamento quimioterápico paliativo com o esquema LDE- paclitaxel em pacientes portadores de metástases ósseas por neoplasia maligna / Evaluation of palliative chemotherapy treatment with the LDEpaclitaxel regimen in patients with bone metastases from malignant neoplas

Introdução: Pacientes com câncer em estádios avançados e metástases ósseas frequentemente não apresentam condições clínicas para a realização de esquemas quimioterápicos convencionais subsequentes, restringindo as opções de tratamento. Anteriormente, demonstramos que nanopartículas artificiais lipídicas (LDE), semelhantes à lipoproteína de baixa densidade (LDL) rica em colesterol, são captadas por tecidos malignos, e quando associadas aos quimioterápicos, após injeção pela via endovenosa, reduz drasticamente a toxicidade do tratamento. Os objetivos deste presente estudo foram avaliar a resposta clínica ao tratamento quimioterápico com paclitaxel (PTX) associado à LDE; avaliar as toxicidades clínicas e laboratorial, e a capacidade da associação LDE-PTX em reduzir a dor oncológica relacionada às metástases ósseas em pacientes com carcinoma de mama, próstata e pulmão, previamente tratados e não elegíveis para tratamento quimioterápico convencional subsequente. Métodos: Dezoito pacientes (8 com câncer de mama, 5 de próstata e 5 de pulmão) com metástases ósseas foram incluídos. O tratamento consistiu no esquema LDE-PTX na dose convencional do PTX (175 mg/m2 de superfície corpórea de 3/3 semanas) e os pacientes foram avaliados por resposta clínica, redução da dor óssea, uso de medicamentos opióides, e ocorrência de fraturas ósseas patológicas. Resultados: No total, 104 ciclos de quimioterapia foram realizados, e nenhum paciente apresentou toxicidade clínica, laboratorial, assim como não houve fraturas patológicas. Dos 18 pacientes incluídos, 9 tiveram sobrevida livre de progressão de doença 6 meses. Houve em todos os pacientes redução da dor óssea, permitindo substituição da medicação opióide por analgésico não opióide. Conclusão: A melhora significativa na dor óssea sem que tenha ocorrido toxicidade do tratamento, e o tempo de não progressão de doença 6 meses na metade dos pacientes sugere que esses pacientes tenham se beneficiado consistentemente do tratamento com a LDE-PTX. Portanto, a LDE-PTX pode tornar- se uma opção terapêutica interessante em pacientes com carcinomas de próstata, mama ou pulmão em estágios avançados e sem condições clínicas de se submeterem a outros esquemas quimioterápicos convencionais

Introduction: Patients with advanced cancer and bone metastases usually do not have clinical conditions to perform additional conventional chemotherapy regimens, restricting treatment options. Previously, we showed that lipid core nanoparticles (LDE), similar to cholesterol-rich low-density lipoprotein (LDL), are taken up by malignant tissues, and when associated to chemotherapy, after endovenous injection, it drastically decreases the toxicity of the treatment. The objectives of this study were to evaluate the clinical response to chemotherapy treatment with paclitaxel (PTX) associated with LDE; to evaluate the clinical and laboratorial toxicities, and the ability of the LDE-PTX to reduce cancer pain related to bone metastases in patients with breast, prostate or lung carcinoma, previously treated and not eligible for subsequent conventional chemotherapy treatment. Methods: Eighteen patients (8 with breast cancer, 5 with prostate and 5 with lung) with bone metastases were included. Treatment consisted of the LDE-PTX regimen at a conventional dose of PTX (175 mg/m2 body surface area, 3/3 weeks) and patients were evaluated for clinical response, reduction in bone pain, use of opioid medications, and the occurrence of pathological bone fractures. Results: In total, 104 chemotherapy cycles were performed, and none of the patients showed clinical or laboratorial toxicities, as well as there were no pathological fractures. Of the 18 patients evaluated, 9 had progression-fee survival 6 months. Patients had decrease in bone pain allowing replacement of opioid medication by another non-opioid analgesic. Conclusion: Significant improvement in bone pain without treatment toxicity, and time to disease progression of 6 months in half of the patients suggest that these patients have consistently benefited with LDE-PTX treatment. Therefore, LDE-PTX may become an interesting therapeutic option in patients with advanced stage of prostate, breast or lung carcinomas and without clinical conditions to undergo other conventional chemotherapy regimens

Complications after breast reconstruction with alloplastic material in breast cancer patients submitted or not to post mastectomy radiotherapy.

BACKGROUND AND PURPOSE: Breast reconstruction following mastectomy is a relevant element of breast cancer treatment. The purpose of this study was to evaluate the influence of radiotherapy (RT) on local complications in patients with breast cancer that had undergone breast reconstruction with alloplastic material. MATERIALS AND METHODS: Retrospective study of breast cancer patients submitted to mastectomy and breast reconstruction from 2009 to 2013. Clinical and treatment variables were correlated with early and late complications. RESULTS: 251 patients were included; mean age was 49.7 (25 to 78) years. Reconstruction was immediate in 94% of the patients, with 88% performed with a temporary tissue expander. Postoperative radiotherapy (RT) was delivered to 167 patients (66.5%). Early complications were present in 26.3% of the patients. Irradiated patients presented 5.4% incidence of late complications versus 2.4% for non-irradiated patients (p = 0.327). Diabetes (OR = 3.41 95% CI: 1.23-9.45, p = 0.018) and high body mass index (BMI) (OR = 2.65; 95% CI: 1.60-4.37, p < 0.0001) were the main risk factors. The overall incidence of late complications was 4.4%, with predominance of severe capsular contracture (8/11). Arterial hypertension (OR = 4.78; 95% CI: 1.97-11.63, p = 0.001), BMI (OR = 0.170; 95% CI: 0.048-0.607, p = 0.006) and implant placement (OR = 3.55; 95% CI: 1.26-9.99, p = 0.016) were related to late complications. CONCLUSIONS: The overall rate of complications was low in this population. Radiotherapy delivery translated into a higher but not statistically significant risk of late complications when compared with the non-irradiated patients. Already well-known clinical risk factors for complications after breast reconstruction were identified.

Cost-effectiveness of photobiomodulation therapy for the prevention and management of cancer treatment toxicities: a systematic review.

PURPOSE: To identify and summarize the evidence on the cost-effectiveness of photobiomodulation (PBM) therapy for the prevention and treatment of cancer treatment-related toxicities. METHODS: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE). Scopus, MEDLINE/PubMed, and Embase were searched electronically. RESULTS: A total of 1490 studies were identified, and after a two-step review, 4 articles met the inclusion criteria. The included studies analyzed the cost-effectiveness of PBM therapy used in the context of lymphedema for breast cancer and oral mucositis (OM) induced by chemotherapy and radiotherapy. Better outcomes were associated with PBM therapy. The incremental cost-effectiveness ratio ranged from 3050.75 USD to 5592.10 USD per grade 3-4 OM case prevented. PBM therapy cost 21.47 USD per percentage point reduction in lymphedema in comparison with 80.51 USD for manual lymph drainage and physical therapy. CONCLUSION: There is limited evidence that PBM therapy is cost-effective in the prevention and treatment of specific cancer treatment-related toxicities, namely, OM and breast cancer-related lymphedema. Studies may have underreported the benefits due to a lack of a comprehensive cost evaluation. This suggests a wider acceptance of PBM therapy at cancer treatment centers, which has thus far been limited by the number of robust clinical studies that demonstrate cost-effectiveness for the prevention and treatment of toxicities.

Tumor safety and side effects of photobiomodulation therapy used for prevention and management of cancer treatment toxicities. A systematic review.

Photobiomodulation therapy (PBMT), also known as low-level laser therapy (LLLT), has been increasingly used for the treatment of toxicities related to cancer treatment. One of the challenges for the universal acceptance of PBMT use in cancer patients is whether or not there is a potential for the light to stimulate the growth of residual malignant cells that evaded oncologic treatment, increasing the risk for tumor recurrences and development of a second primary tumor. Current science suggests promising effects of PBMT in the prevention and treatment of breast cancer-related lymphedema and oral mucositis, among other cancer treatment toxicities. Nevertheless, this seems to be the first systematic review to analyze the safety of the use of PBMT for the management of cancer-related toxicities. Scopus, MEDLINE/PubMed, and Embase were searched electronically. A total of 27 articles met the search criteria. Selected studies included the use of PBMT for prevention and treatment of oral mucositis, lymphedema, radiodermatitis, and peripheral neuropathy. Most studies showed that no side effects were observed with the use of PBMT. The results of this systematic review, based on current literature, suggest that the use of PBMT in the prevention and management of cancer treatment toxicities does not lead to the development of tumor safety issues.

Can acetylcysteine ameliorate cisplatin-induced toxicities and oxidative stress without decreasing antitumor efficacy? A randomized, double-blind, placebo-controlled trial involving patients with head and neck cancer.

The protective antioxidant activity of acetylcysteine (NAC) against toxicity due to cisplatin has been reported in experimental models; however, its efficacy in patients has not been elucidated. The aim of this study was to investigate the possible protective effect of NAC on cisplatin-induced toxicity and the effect of NAC on clinical response and oxidative stress in patients treated for head and neck cancer. This was a randomized, double-blind, placebo-controlled trial conducted in patients receiving high-dose cisplatin chemotherapy concomitant to radiotherapy. Patients were randomly assigned to groups and received: (a) 600 mg NAC syrup, orally once daily at night for 7 consecutive days or (b) placebo, administered similarly to NAC. Nephro-, oto-, hepato-, myelo-, and gastrointestinal toxicities, clinical responses, and plasma and cellular markers of oxidative stress were evaluated. Fifty-seven patients were included (n = 28, NAC arm; and n = 29, placebo arm). A high prevalence of most types of toxicities was observed after cisplatin chemotherapy; however, the parameters were similar between the two groups. There was a predominance of partial response to treatment. In the cellular and plasmatic oxidative stress analyses, minor differences were observed. Overall, there was no statistically significant difference between the groups for all outcomes. These findings show that low-dose oral NAC does not protect patients with head and neck cancer from cisplatin-induced toxicities and oxidative stress. The antitumor efficacy of cisplatin was apparently not impaired by NAC.

Macroscopic locoregional relapse from prostate cancer: which role for salvage radiotherapy?

INTRODUCTION: Salvage radiotherapy (SRT) after radical prostatectomy for prostate cancer (PCa) is recommended as soon as PSA rises above 0.20 ng/ml, but many patients (pts) still experience local macroscopic relapse. The aim of this multicentric retrospective analysis was to evaluate the role of SRT in pts with macroscopic relapse. MATERIALS AND METHODS: From 2001 to 2016, 105 consecutive pts with macroscopic PCa relapse underwent SRT ± androgen deprivation therapy (ADT). Mean age was 72 years. At time of relapse, 29 pts had a PSA value < 1.0 ng/mL, 50 from 1.1 to 5, and 25 pts > 5. Before SRT, 23 pts had undergone 18F-choline PET and 15 pts pelvic MRI. Ninety-four pts had prostatic bed relapse only, and four nodal involvement. Fifty-one pts were previously submitted to first-line ADT, while 6 pts received ≥ 2 lines. RESULTS: At a median follow-up of 52 months, 89 pts were alive, while 16 were dead. Total RT dose to macroscopic lesions was > 70 Gy in 58 pts, 66-70 Gy in 43, and < 66 Gy in 4 pts. In 72 pts, target volume encompassed only the prostatic bed with sequential boost to macroscopic site; 33 pts received prophylactic pelvic RT. Ten-year overall survival was 76.1%, while distant metastasis-free survival was 73.3%. No grade 4-5 toxicities were found. CONCLUSIONS: SRT ± ADT for macroscopic relapse showed a favorable oncological outcome supporting its important role in this scenario. Data from this series suggest that SRT may either postpone ADT or improve results over ADT alone in appropriately selected pts.

Feasibility of two schedules of weekly paclitaxel in HER2-negative early breast cancer in a Brazilian community setting.

BACKGROUND: Weekly paclitaxel has been shown more effective and less toxic than the conventional three-weekly administration. The GEICAM 9906 demonstrated effectiveness and safety of a dose-dense schedule of 100 mg/m(2) of paclitaxel given over 8 weeks (w). This schedule has been adopted at our institution in 2009 for HER2-negative disease, and herein, we present the first off-trial experience and compare its safety profile with that of a historical cohort of patients treated with the conventional 80 mg/m(2) over 12 w schedule. METHODS: Retrospective single-center chart review of patients with locally advanced breast cancer treated with (neo)adjuvant paclitaxel-based therapy from 2008 to 2012 with (1) 80 mg/m(2) for 12 w or (2) 100 mg/m(2) for 8 w. Adverse events were graded according to common terminology criteria for adverse events (CTCAE) 4.0. RESULTS: A total of 326 patients were analyzed. Median age was 52 (±10.9). Seventy and 256 patients received schedule (1) and (2), respectively. No significant difference was observed in the incidence of grade (G) 3/4 toxicity: pneumonitis (2.8 vs 0.3 % p = 0.097); neuropathy (2.8 vs 0.7 % p = 0.303); hand-foot syndrome (1.4 vs 0.3 % p = 0.538); anemia (0 vs 0.6 % p = 0.624); and neutropenia (5.7 vs 6.2 % p = 0.408). Also, no significant difference was seen when comparing all grades toxicity. Schedule (2) had higher dose intensity: 97.72 vs 77.07 mg/m(2) per week (p < 0.0001). CONCLUSIONS: Weekly paclitaxel given according to GEICAM 9906 is pragmatic and well tolerated, with safety profile consistent with the conventional schedule. In addition to being convenient to patients, it may also be cost-effective because of a lower number of clinic visits and infusions.

Toxicological evaluation of hydroethanolic extract of Helicteres sacarolha A. St.- Hil. et al.

ETHNOPHARMACOLOGICAL RELEVANCE: Helicteres sacarolha, popularly known in Brazil as 'rosquinha', 'sacarolhas', 'semente-de-macaco', is widely distributed in different phytogeographic zones in Brazil. Preparations from its roots and leaves are employed in popular Brazilian medicine in the treatments of ailments such as peptic ulcer, hypertension among others. Cytotoxicity, acute oral and subchronic toxicity of the hydroethanolic extract of Helicteres sacrolha was investigated as well as the classes of phytochemical present in the extract. MATERIALS AND METHODS: Hydroethanolic (70%) extract of Helicteres sacarolha (HEHs) was prepared by maceration. Potential cytotoxicity was evaluated in CHO-k1 cells. Acute administration of HEHs was done in mice as a single dose up to 5000mg/kg and subchronic oral toxicity study for 30 days in Wistar rats at daily oral doses of 0, 250 and 750mg/kg b.w. Clinical observations and toxicological related parameters were determined every 6 days. Blood was collected for biochemical and hematological analyses, while histological examinations were performed on selected organs. Selected secondary metabolites detected were quantified by UV-spectrophotometry and high performance liquid chromatography (HPLC). RESULTS: The extract was non-cytotoxic to CHO-k1 cells. In acute oral toxicity, there was no mortality or clinical alterations in the female mice, at all doses, except for the transient diarrhea observed at 5000mg/kg acute. Doses up to 2000mg/kg caused no mortality or treatment-related clinical manifestations in the male mice, but treatment-related alterations were however observed at 4000mg/kg, with mortalities recorded at 5000mg/kg. During the subchronic oral toxicity study, no mortality or treatment-related clinical signs were observed. Differences in relative organ weight, hematological parameters and histopathology observations between the treated and the control groups were considered not to be treatment-related. Spectrophotometric analysis revealed the presence of relatively high content of phenolics and flavonoids in HEHs. HPLC analysis confirmed the presence of the quantified compounds and demonstrated the presence of ellagic acid, morin and naringin. CONCLUSION: Our results confirmed that HEHs have a broad safety margin for therapeutic use.

Fatal pneumonitis induced by oxaliplatin: description of three cases.

We describe 3 fatal cases of interstitial pneumonitis rapidly evolving to pulmonary fibrosis and death after the administration of oxaliplatin as part of the FOLFOX regimen. Due to the widespread use of oxaliplatin in oncology, clinicians should be aware of the risk and severity of oxalipatin-induced interstitial pneumonia.

Estudo farmacognóstico, farmacológico e toxicológico de Anacardium occidentale Linn. (Anacardiaceae) clone CCP-76 / Pharmacognostic and toxicological study of Anacardium occidentale (Anacardiaceae) clone CCP76

Os extratos totais, assim como os compostos fenólicos isolados de diferentes partes de Anacardium occidentale conhecido popularmente no Brasil como cajueiro mostraram atividades antiúlcera e antibacteríana. O objetivo deste trabalho foi a verificação destas atividades nas folhas após estudo farmacobotânico, químico e toxicológico. Para a analise anatômica foram utilizados cortes do terço mediano inferior da lâmina foliar. Nesta, as epidermes em vista frontal apresentam cutrcula estriada, na face abaxial, a epiderme é constituída de células de formato poligonal, com paredes bem justapostas. Na face adaxial, as células são de paredes espessas, ligeiramente onduladas. A mesma é constituída de estômatos de tipo anomocítico e de tricomas glandulares de forma ovóide. O mesófilo é constituído de duas camadas de parênquima paliçádico, espessas, de forma quase regular e de parênquima lacunoso com células de forma irregular, envolvendo os feixes vasculares de nervuras secundarias. Extensões de fibras são observadas no mesófilo. A nervura mediana possui um colênquima desenvolvido e ductos são encontrados no floema assim como no parênquima medular. Drusas são encontradas no parênquima lacunoso assim como no parênquima fundamental e no colênquima. A partir da triagem fitoquímica, da cromatografia em camada delgada, cromatografia liquida de alta eficiência e cromatografia liquida acoplada a espectrometria de massa, verificou-se a presença nas folhas de cajueiro de compostos polifenólicos, particularmente de heterosfdeos flavonóidicos. As estruturas de flavon6ide que parecem ser mais evidentes, de acordo com a cromatografia liquida acoplada a massa, são principalmente os heterosídeos da quercetina...

Crude extracts as well as phenolics isolated from the bark or the fruit of Anacardium occidentale popularly known as cajueiro in Brazil, showed antiulcer and antibacterial effects. The aim of this work was to verify those effects in the leaf, botanical, chemical and toxicological studies. Ultrastructure of the leaf was carried on. Cross-sections from the third inferior part of the leaf blade were used. Cashew leaf contains uniseriate epidermis with a sub-eperdimic layer, anomocytic stomata and glandular ovoid trichomes on the inferior surface. The mesophyll exhibits two cell layers of palisadic parenchyma and a lacunose parenchyma containing vascular bundles of the secondary nervures. The median nervure contains a developed collenchyma. Several druses of calcium oxalate are present in the fundamental parenchyma, lacunose parenchyma and in the collenchyma. Resin ducts are also observed in the phloem as well as in the medullar parenchyma. Extensions of sclerenchymatous fibres are observed in the mesophyll. By phytochemical analyses using TLC, HPLC-DAD and positive ions LC-ESIMS, we verified the presence of polyphenols in cashew leaves particularly heterosids of flavonoids. From LC-ESI-MS, evident structures of flavonoids seemed to be heterosids of quercetin. Ethanol 70% extract of cashew leaves was used for antiulcer and antibacterial essays. With extract dose 400mg/kg, ulcer lesions induced by HCL/ethanol 60% in rats, decreased about 98%. By a dose-response effect study, ED50 was evaluated about 150 mg/kg. Extract doses higher than 100mg/kg showed potential of lesion inhibition superior to lansoprazol 30mg. Extract methanolic fraction that gave 88,20% of ulcer inhibition likely contains the principie active of the antiulcer effect. Using bacterial strains, Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 35218 and ATCC 25922, Pseudomonas aeruginosa ATCC 27853 and a clinical isolate Campylobacter coli, for antibacterial essay, the ethanolic extract and one fraction rich in flavonoids were only active in S. aureus with MIC and MBC equal to 320 µg/mL. Acute, 30-day and 90-day subacute toxicity studies were carried out. Crude extract DL50 was superior to 2000mg/kg. Based on biochemical analyses for the evaluation of renal and hepato-biliary functions, level of urea, creatinine, transaminases, total protein, albumin, bilirubin, cholesterol and calcium proved that the extract is biologically tolerated by rat organismo This result was also confirmed by studies in hematology and histopathology. Genotoxity was accessed by Ames test in Salmonella typhimurium strains TA97, TA98, TA100, TA102 and bone marrow micronucleus test in mice. The extract exhibited sign of frameshift and base pairs substitution. Extract dose 2000mglkg seemed to induce damage in the chromosomes however; the activity was extremely inferior to the c1astogenic effect induced by ciclophosphamide.

Deficiências e desequilíbrios minerais em bovinos e ovinos FONT FACE=Symbol>¾ /FONT> revisão dos estudos realizados no Brasil de 1987 a 1998

This review follows on from two previous ones on the subject covering the periods from 1943 to 1976 and 1976 to 1987. They are all based on the chemical analyses of liver or other animal tissues or fluids and/or experimentation, complemented or not by analyses of pasture and soil samples. They do not include studies based only on chemical analyses of plant and soil samples. Regarding macroelements, noteworthy are the studies on phosphorus deficiency, the most important mineral deficiency shown previusly. Copper and cobalt deficiencies were the most frequent microelement deficiencies. There were several reports on copper poisoning in sheep. Subclinical deficiency of zinc was frequently verified. Subclinical manganese deficiency was rarely recognized and to the contrary, elevated values of this element occasionaly were found. There was little data on selenium, so its importance in Brazil remains unclear; nutritional miopathy was diagnosed for the first time in calves, but only once. Low iron values were found in the liver samples of cattle affected by enzootic hematuria. This is easily explained by the continuous loss of blood leading to severe anemia. High iron values were found in the liver samples from some areas; sometimes associated with low copper values. Among the investigations made during the last decade, special mention should be made of two diseases in which the etiology has not yet been established. These are "ronca" (snoring disease) and "doença do peito inchado" (brisket disease), both of which have a chronic course in adult cattle. In "ronca", liver copper is very low and iron particularly high. Presumably the latter is caused by poor utilization due to the copper deficiency. In "doença do peito inchado", the liver values for manganese and cobalt were low and those for iron very high. In this case, the high iron probably comes from the severe liver congestion caused by the chronic cardiac insufficiency seen in this disease. Mention also should be made of "morte subita" (sudden death) in cattle in the State of Rio Grande do Sul. In this case, liver copper levels were extremely low and no poisonous plant could be blamed. Congenital hypomyelinogenesis in calves was diagnosed in the same area.The mineral deficiencies diagnosed during the period of this review are shown on a map, together with the respective bibliographic references.

É apresentada uma revisão dos estudos realizados no Brasil sobre distúrbios no metabolismo mineral em bovinos, sobretudo deficiências minerais, no período de 1987-1998. Esta revisão foi feita em continuação de duas revisões prévias sobre o assunto, que abrangeram os períodos de 1943-1976 e 1976-1987. Nessas revisões são omitidos os estudos realizados apenas através de dosagens químicas de amostras de pastagem e de solo, sendo referidos aqueles baseados em análises de amostras de fígado ou outros tecidos ou fluidos dos animais e/ou experimentação, complementados ou não por análises químicas de pastagem e de solo. Em relação aos macroelementos, destacam-se os estudos sobre a deficiência de fósforo, já estabelecida anteriormente como a deficiência mineral mais importante no Brasil. Valores baixos de ferro em amostras de fígado foram constatados em bovinos afetados pela hematúria enzoótica, o que é compreensível, já que os animais apresentam marcada anemia devido a perda contínua de sangue. Destacaram-se, por outro lado, os valores elevados de ferro em diversas regiões; em algumas delas foi demonstrado que os níveis desse elemento estavam associados a valores baixos de cobre. As deficiências de cobre e cobalto foram as mais frequentes entre as de microelementos. Diversas ocorrências de intoxicação por cobre em ovinos foram comunicadas. A deficiência subclínica de zinco tem sido verificada com bastante frequência. A deficiência subclínica de manganês foi raramente constatada; ao contrário, houve verificações de valores elevados deste elemento. Em relação ao selênio, os dados continuam escassos, insuficientes para se saber qual a importância da deficiência desse elemento em bovinos e ovinos no Brasil; a miopatia nutricional em bezerros foi diagnosticada uma única vez. Entre os estudos realizados neste último período devem ser mencionados, especialmente, aqueles que abordam duas doenças cuja etiologia ainda não foi estabelecida, vulgarmente conhecidas como "ronca" e "doença do peito inchado", ambas de evolução crônica, afetando bovinos adultos. Na enfermidade conhecida como "ronca", os valores hepáticos de cobre são muito baixos e os de ferrro extremamente altos; deve-se considerar a hipótese de que os níveis hepáticos de ferro estão muito elevados em decorrência da sua não-utilização em função da deficiência de cobre. Na "doença do peito inchado", os valores hepáticos de manganês e de cobalto são baixos e os de ferro são muito elevados; é possível que as alterações nos níveis hepáticos de ferro sejam apenas o reflexo do acúmulo de sangue no fígado, uma vez que essa enfermidade é caracterizada por insuficiência cardíaca crônica que cursa com acentuada congestão hepática. Ainda deve ser destacada, no Rio Grande do Sul, a ocorrência de "morte súbita" em bovinos, cujos valores hepáticos para cobre foram muito baixos; nenhuma planta tóxica pode ser responsabilizada por essas ocorrências. Nesta mesma área, a hipomielinogênese congênita em bovinos foi diagnosticada. A ocorrência das deficiências minerais diagnosticadas durante o período correspondente a esta revisão foram lançadas em um mapa, com as respectivas referências bibliográficas.

Deficiências e desequilíbrios minerais em bovinos e ovinos FONT FACE=Symbol>¾ /FONT> revisão dos estudos realizados no Brasil de 1987 a 1998

This review follows on from two previous ones on the subject covering the periods from 1943 to 1976 and 1976 to 1987. They are all based on the chemical analyses of liver or other animal tissues or fluids and/or experimentation, complemented or not by analyses of pasture and soil samples. They do not include studies based only on chemical analyses of plant and soil samples. Regarding macroelements, noteworthy are the studies on phosphorus deficiency, the most important mineral deficiency shown previusly. Copper and cobalt deficiencies were the most frequent microelement deficiencies. There were several reports on copper poisoning in sheep. Subclinical deficiency of zinc was frequently verified. Subclinical manganese deficiency was rarely recognized and to the contrary, elevated values of this element occasionaly were found. There was little data on selenium, so its importance in Brazil remains unclear; nutritional miopathy was diagnosed for the first time in calves, but only once. Low iron values were found in the liver samples of cattle affected by enzootic hematuria. This is easily explained by the continuous loss of blood leading to severe anemia. High iron values were found in the liver samples from some areas; sometimes associated with low copper values. Among the investigations made during the last decade, special mention should be made of two diseases in which the etiology has not yet been established. These are "ronca" (snoring disease) and "doença do peito inchado" (brisket disease), both of which have a chronic course in adult cattle. In "ronca", liver copper is very low and iron particularly high. Presumably the latter is caused by poor utilization due to the copper deficiency. In "doença do peito inchado", the liver values for manganese and cobalt were low and those for iron very high. In this case, the high iron probably comes from the severe liver congestion caused by the chronic cardiac insufficiency seen in this disease. Mention also should be made of "morte subita" (sudden death) in cattle in the State of Rio Grande do Sul. In this case, liver copper levels were extremely low and no poisonous plant could be blamed. Congenital hypomyelinogenesis in calves was diagnosed in the same area.The mineral deficiencies diagnosed during the period of this review are shown on a map, together with the respective bibliographic references.

É apresentada uma revisão dos estudos realizados no Brasil sobre distúrbios no metabolismo mineral em bovinos, sobretudo deficiências minerais, no período de 1987-1998. Esta revisão foi feita em continuação de duas revisões prévias sobre o assunto, que abrangeram os períodos de 1943-1976 e 1976-1987. Nessas revisões são omitidos os estudos realizados apenas através de dosagens químicas de amostras de pastagem e de solo, sendo referidos aqueles baseados em análises de amostras de fígado ou outros tecidos ou fluidos dos animais e/ou experimentação, complementados ou não por análises químicas de pastagem e de solo. Em relação aos macroelementos, destacam-se os estudos sobre a deficiência de fósforo, já estabelecida anteriormente como a deficiência mineral mais importante no Brasil. Valores baixos de ferro em amostras de fígado foram constatados em bovinos afetados pela hematúria enzoótica, o que é compreensível, já que os animais apresentam marcada anemia devido a perda contínua de sangue. Destacaram-se, por outro lado, os valores elevados de ferro em diversas regiões; em algumas delas foi demonstrado que os níveis desse elemento estavam associados a valores baixos de cobre. As deficiências de cobre e cobalto foram as mais frequentes entre as de microelementos. Diversas ocorrências de intoxicação por cobre em ovinos foram comunicadas. A deficiência subclínica de zinco tem sido verificada com bastante frequência. A deficiência subclínica de manganês foi raramente constatada; ao contrário, houve verificações de valores elevados deste elemento. Em relação ao selênio, os dados continuam escassos, insuficientes para se saber qual a importância da deficiência desse elemento em bovinos e ovinos no Brasil; a miopatia nutricional em bezerros foi diagnosticada uma única vez. Entre os estudos realizados neste último período devem ser mencionados, especialmente, aqueles que abordam duas doenças cuja etiologia ainda não foi estabelecida, vulgarmente conhecidas como "ronca" e "doença do peito inchado", ambas de evolução crônica, afetando bovinos adultos. Na enfermidade conhecida como "ronca", os valores hepáticos de cobre são muito baixos e os de ferrro extremamente altos; deve-se considerar a hipótese de que os níveis hepáticos de ferro estão muito elevados em decorrência da sua não-utilização em função da deficiência de cobre. Na "doença do peito inchado", os valores hepáticos de manganês e de cobalto são baixos e os de ferro são muito elevados; é possível que as alterações nos níveis hepáticos de ferro sejam apenas o reflexo do acúmulo de sangue no fígado, uma vez que essa enfermidade é caracterizada por insuficiência cardíaca crônica que cursa com acentuada congestão hepática. Ainda deve ser destacada, no Rio Grande do Sul, a ocorrência de "morte súbita" em bovinos, cujos valores hepáticos para cobre foram muito baixos; nenhuma planta tóxica pode ser responsabilizada por essas ocorrências. Nesta mesma área, a hipomielinogênese congênita em bovinos foi diagnosticada. A ocorrência das deficiências minerais diagnosticadas durante o período correspondente a esta revisão foram lançadas em um mapa, com as respectivas referências bibliográficas.