Sugarcane yeast with urea in replace of soybean meal in the diet of Murrah buffaloes does not cause metabolic, endocrine, and mineral disorders.

The aim of this study was to evaluate the effect of the replacement of soybean meal by increasing levels of sugarcane yeast and urea on the energy, enzymatic, protein, mineral, and hormonal profiles of buffalo heifers. Twenty Murrah heifers with an average body weight of 168 ± 2.0 kg and 1 year old were used in a completely randomized design. The treatments consisted of the replacement of soybean meal by increasing levels of sugarcane yeast and urea (0, 33, 67, and 100% dry matter). The animals were weighed at the beginning and end of the experimental period, and blood was collected on the final day. The replacement of soybean meal with sugarcane yeast influenced the performance and metabolic dynamics, with total weight gain (P = 0.005) and average daily gain (P = 0.015), presenting, for both variables, a quadratic effect. Considering the biochemical profile, there was an influence on the serum concentration of triglycerides (P = 0.055), the serum activities of aspartate aminotransferase, gamma-glutamyl transferase, and alkaline phosphatase (P < 0.05), in addition to the serum concentration of phosphorus (P = 0.007) and potassium (P = 0.053), which showed positive linear effects. The hormonal profile was not influenced by diets (P > 0.05). The elements copper, iron, and zinc were able to be quantified at all levels of sugarcane yeast and urea in the diets offered. The use of sugarcane yeast with urea promotes adequate metabolic response of buffalo heifers and can replace up to 100% of soybean meal in the concentrate.

Intake, performance, and carcass characteristics of lambs fed spineless cactus replacing wheat bran.

To assess the intake, digestibility of nutrients, ingestive behavior, performance, and carcass characteristics of feedlot lambs, 36 F1 Santa Ines × Dorper male lambs with an initial average weight of 19.5 ± 0.27 kg were fed with different levels of spineless cactus (0, 33, 66, and 100 %) as a replacement of the wheat bran. The replacement diets had no effect on the intake of dry matter (DM) or crude protein (CP), whose average values were 962 and 140 g/day, respectively. There was a quadratic effect on the intake of digestible organic matter (OM) and the digestibility of DM, CP, neutral detergent fiber (NDF), and non-fiber carbohydrates (NFC). The highest average daily gain (ADG) of 168 g/day was achieved at 58.7 % replacement level. The highest hot and cold carcass weights of 15.4 and 14.5 kg were achieved at 62.4 and 56.9 % replacement levels. For lambs in the feedlot, we recommend replacing wheat bran with up to 58.7 % spineless cactus.

Ex vivo and simulator models teaching therapeutic ERCP and EUS: description of SOBED's first course.

Teaching models in endoscopy are important tools to minimize risks derived from endoscopic procedures, taking into account that therapeutic endoscopy, also known as surgical endoscopy, has greatly developed during the last decade. This results from the fact that minimally invasive procedures present relevant contributions and promote more comfort to patients. In this context, ex vivo teaching models and virtual simulators are important tools to the safe acquisition of abilities. In this article, the Brazilian Society of Digestive Endoscopy presents and describes its first course of therapeutic ERCP and EUS in models of laboratory teaching.

Influência da infecção por Helicobacter pylori e de sua erradicação sobre o consumo alimentar e estado nutricional.

Infection by Helicobacter pylori affects over half of the world's population and is a public health issue. Its prevalence is significantly higher in developing countries such as Brazil. It has been suggested that infection by H pylori can impact calorie intake and homeostasis. AIM: Analyze the influence of infection by H pylori and of its eradication on nutritional status and dietary intake. MATERIAL AND METHODS: The study included 124 patients (48 of whom H pylori positive, 45 H pylori negative, and 31 eradicated). Weight and height were measured to calculate the body mass index (BMI). Dietary intake was assessed using a 24-hour diet recall (24hR) in two occasions. RESULTS: Pre-obesity was the highest among the eradicated patients (p = 0.011). Homogenicity was found in the dietary intake for the nutrients studied, except for saccharose, whose intake was the lowest among the eradicated group (p < 0.001). CONCLUSIONS: Patients eradicated for H pylori had a higher rate of pre-obesity. The dietary intake was similar among the groups for nearly all nutrients assessed, except for saccharose, whose intake by eradicated patients was lower. This entails discussions about possibly including the investigation of nutritional status and diet in the routine procedures towards those who seek a diagnosis of infection by H pylori.

Nutritive Value and Degradation Kinetic Parameters of Three Plants for Feeding Bradypus variegatus Schinz, In Vitro Evaluation.

This study aimed to evaluate the nutritive value of three feeds (Cecropia sp., Pterodon sp., and Inga sp.) for sloths (Bradypus variegatus), based on nutritional composition and in vitro gas production. After a 14-day adaptation period to these feeds, approximately 500 g of gastric contents were collected from three female sloths, processed, and incubated with the food samples to evaluate digestibility and in vitro degradation kinetics. Regarding the nutritional composition, the neutral detergent fiber (NDFcp) content was higher with 404 g kg-1 DM (p = 0.001) in the leaves of Cecropia sp. The non-fibrous carbohydrate contents were greater with 499 g kg-1 DM in Pterodon sp. (p = 0.002). The greatest cellulose content (211 g kg-1 DM) was found in the leaves of C. pachystachya, as well as the lowest value of 143 g kg-1 DM for hemicellulose. Significant differences in the in vitro digestibility of crude protein (p = 0.041) were observed, with Inga sp. showing the highest value at 547 g kg-1 DM. In terms of kinetic parameters, Pterodon sp. exhibited higher total gas production (Vt) at 99 mL (p = 0.023) and digestion rates of fibrous carbohydrates (kdFC) at 0.0223%/h (p = 0.020) (p < 0.05). The leaves of Pterodon sp. and Inga sp. showed potential as suitable feeds for B. variegatus, while Cecropia sp. may have negative effects on dry matter intake due to its high NDF content, because of possible repletion effects on the stomach.

III BRAZILIAN CONSENSUS STATEMENT ON ENDOSCOPIC ULTRASOUND.

BACKGROUND: •Since its inception in the 1980s, endoscopic ultrasound has increased relevance and usefulness in clinical practice. BACKGROUND: •Endoscopic ultrasound has evolved from solely diagnostic imaging to a valuable method for tissue sampling and therapeutic procedures, such as drainage of pancreatic fluid collections and creating gastrointestinal anastomoses under EUS guidance. BACKGROUND: •Given the rapid advancements in EUS and new devices, an update to the last Consensus must include recent developments. BACKGROUND: •Experts evaluated and discussed the best evidence on EUS-guided procedures and devices for tissue sampling, pancreatic and liver disease management, and biliary drainage. BACKGROUND: In the past decades, endoscopic ultrasound has developed from a diagnostic tool to a platform for many therapeutic interventions. Various technological advancements have emerged since the last Brazilian Consensus, demanding a review and update of the recommendations based on the best scientific evidence. METHODS: A group of 32 renowned echoendoscopists selected eight relevant topics to be discussed to generate clinical questions. After that, a literature review was conducted to answer these questions based on the most updated evidence. RESULTS: Thirty-three statements were formulated and voted on by the experts to reach a consensus. The Oxford System was used to grade the level of evidence. CONCLUSION: There is mo-derate evidence to support that the needle shape, gauge, or aspiration technique does not influence the yield of endoscopic ultrasound (EUS)-guided tissue sampling of pancreatic solid lesions. There is moderate evidence to support using EUS-TTNB of the cyst wall to differentiate between mucinous and non-mucinous cystic neoplasms. There is little evidence to support the EUS-guided treatment of gastric varices. There is a high level of evidence to support that EUS-guided biliary drainage and ERCP present similar outcomes in patients with distal malignant biliary obstruction. There is a high level of evidence for using EUS to diagnose neoplastic pancreatic cysts and detect necrosis before indicating drainage. There is moderate evidence to support EUS-GE over duodenal stent for malignant gastric outlet obstruction in patients with a life expectancy higher than 2 months. There is a high level of evidence to support the use of RFA in treating both functioning and non-functioning types of NET.

Tifton hay, soybean hulls, and whole cottonseed as fiber source in spineless cactus diets for sheep.

The objective of this paper was to evaluate the effect of three different sources of fiber (tifton hay, soybean hulls, and whole cottonseed) in spineless cactus diets for sheep in the semiarid region of northeastern Brazil. Twenty-one sheep in finishing phase with indeterminate breed, non-castrated, and with initial weight of 18.90 ± 1.07 kg were randomly distributed to individual stalls where they were confined for the duration of the experiment. The intakes of dry and organic matter, total carbohydrates, and total digestive nutrients were not influenced (P > 0.10) by the different fiber sources (1.10, 0.97, 0.73, and 0.80 kg/day, respectively). However, sheep which received the whole cottonseed diet were characterized by a lower (P < 0.10) intake of crude protein and neutral detergent fiber and greater (P < 0.10) intake of ether extract (0.11, 0.29, and 0.048 kg/day, respectively). The different sources of fiber resulted in similar times spent feeding (P > 0.10), although the rumination time was greater for tifton hay (P < 0.10) (429.05 min/day). The digestibility coefficient of dry and organic matter differed between the treatments (P < 0.10), with the soybean hull diet showing a higher level of digestion (83.23 and 86.72 %, respectively). The whole cottonseed diet gave the smallest digestibility coefficient of crude protein (68.95 %) and greatest for ether extract (85.94 %). The daily weight gain of animals fed on whole cottonseed was significantly lower (P < 0.10). On the basis of these findings, we recommend the use of tifton hay or soybean hulls as important additional source of fiber in forage spineless cactus diets for sheep in finishing phase.

Carcass and meat traits of bubaline finished on sugarcane-based diets supplemented with spineless cactus as a replacement for wheat bran.

OBJECTIVE: An experiment was conducted to evaluate the effects of increasing levels of spineless cactus (0%, 33%, 66%, and 100%) used as a substitute for wheat bran in buffalo diets on quantitative and qualitative traits of the meat and carcass. METHODS: Twenty Murrah buffaloes at 18 months of age, with a mean initial weight of 292.9±57.3 kg, were randomly allocated to four treatments with five replicates. The animals were slaughtered after 90 days in the feedlot. The effects of spineless cactus as a replacement for wheat bran in the diet of the buffaloes on the carcass and meat traits, slaughter weight, carcass yield and carcass measurements were studied. RESULTS: Increased spineless cactus levels led to linear reduction in average daily gain, slaughter weight, hot and cold carcass weight, compactness index and in the amount of muscle in the carcass, and there is no difference between the control treatment and the 33% replacing level for these parameters. The quality of the meat was not influenced by the treatments. CONCLUSION: Spineless cactus can replace wheat bran by up to 33% in sugarcane-based diets for buffaloes, without influencing quantitative and qualitative traits of the meat and carcass.

Endoscopic management of biliary complications after liver transplantation.

BACKGROUND: Liver transplantation is the only effective treatment for chronic liver diseases and terminal survival rate has increased in recent decades. However, biliary complications have high incidence and remain as the "Achilles heel" for liver transplantation. AIM: To evaluate retrospectively endoscopic treatment outcomes of biliary complications in post-liver transplantations. METHODS: The sample consisted of post-liver transplantation patients for endoscopic retrograde cholangiopancreatography due to suspected biliary complications. RESULTS: Fifteen patients were included (10 male, mean age of 49.57 years) and 36 endoscopic retrograde cholangiopancreatographies were undertaken (2.4/patient). Biliary stricture was diagnosed in 13 patients and endoscopic treatment was successful in 56% (38,46% still in treatment). Biliary leaks were found in one patient and dysfunction of the hepatobilliary ampulla with choledocholithiasis was diagnosed in one patient, both cured by endoscopic treatment. CONCLUSIONS: Post-liver transplantation biliary complications are relatively common and endoscopic treatment may result in satisfactory outcome. Stenosis was the more frequent complication in this series.

Perfil epidemiológico de 702 pacientes submetidos à endoscopia digestiva baixa no serviço de endoscopia do Hospital Geral César Calls / Epidemiological profile of 702 patients undergoing lower gastrintestinal endoscopy in Cesar Calls General Hospital

Objetivo: descrever o perfil epidemiológico dos pacientes submetidos à endoscopia digestiva baixa em um centro terciário do Nordeste brasileiro, ressaltando a sua importância como método diagnóstico e terapêutico. Método: análise retrospectiva de 702 laudos de pacientes submetidos à colonoscopia e retossigmidoscopia em ambiente de hospital terciário no período de abril de 2002 a abril de 2009. Resultados: a idade média foi de 54,55 anos, e houve predomínio do sexo feminino (59,12%). Hemorragia Digestiva Baixa (14,39%), alteração do hábito intestinal (12,39%) e diarreia (11,82%) foram as indicações para realização de endoscopia digestiva baixa mais frequentes. As endoscopias digestivas baixas foram normais em 57,51%. Foram identificadas a doença inflamatória intestinal em 11,14% e a neoplasia maligna do trato gastrintestinal em 6,3% dos exames. Dentre os pacientes com neoplasia maligna do trato gastrintestinal, 23,07% dos pacientes realizaram o exame por apresentarem hemorragia digestiva baixa ou sangue oculto nas fezes. Utilizando-se do teste do Qui-quadrado, não houve uma relação significativa entre a idade dos pacientes e as alterações encontradas nos laudos de endoscopia digestiva baixa (P=0,2754, (x2: 1,189, DF=1). Conclusão: a colonoscopia e retossigmoidoscopia são excelentes métodos tanto diagnósticos como terapêuticos na investigação das doenças digestivas.

Purpose: to describe the epidemiological profile of patients undergoing lower gastrintestinal endoscopy in a teciary health service in Northeast Brazil, emphasizing their importance as diagnostic and therapeutic method. Materials and methods: retrospective analysis of 702 reports of patients undergoing to colonoscopy and retossigmoidoscopy in a teciary health service in the period april 2002 to april 2009. Results: the mean age was 54.55 years, and there was a predominance of females (59.12%). Lower gastrointestinal bleeding (14.39%), altered bowel habits (12.39%) and diarrhea (11.82%) were the indications for lower gastrointestinal endoscopy conducting more frequent. The lower gastrintestinal endoscopy were normal in 57.51% of the diagnoses identified in the reports and inflamatory bowel disease were identified in 11.14%.The malignancy of the gastrointestinal tract was identified in 6.3%. Among patients with malignancy of the gastrointestinal tract, 23.07% of the patients were examined because they have lower gastrointestinal bleeding, or fecal occult blood Using the chi-square, there was a significant relationship between patient age and the changes found in the reports of lower gastrintestnal endoscopy (P=0.2754, (x2: 1.189, DF=1). Conclusion: the flexible sigmoidoscopy and colonoscopy are excellent whether diagnostic or therapeutic methods in digestive disease research.

Terapêutica endoscópica nas complicações biliares pós-transplante hepático / Endoscopic management of biliary complications after liver transplantation

Introdução: o transplante hepático é o único tratamento efetivo para as hepatopatias crônicas terminais e a taxa de sobrevida tem aumentado nas últimas décadas. No entanto, as complicações biliares têm alta incidência e permanecem como o 'calcanhar de Aquiles do transplante de fígado'. Objetivo: avaliar retrospectivamente os resultados do tratamento endoscópico das complicações biliares em pacientes submetidos a transplante hepático. Métodos: foram avaliados pacientes transplantados hepáticos encaminhados ao Serviço de Endoscopia do Hospital Geral César Calls e a uma clínica particular de endoscopia, no período de dezembro de 2004 a julho de 2011, para realização de colangiopancreatografia retrógrada endoscópica por suspeita de complicação biliar. Resultados: quinze pacientes (11 homens, média de idade de 49,57 anos) foram estudados retrospectivamente entre dezembro de 2004 a julho de 2011. Nesse período foram realizadas 36 colangiopancreatografias retrógradas endoscópicas (2,4/ pacientes). Neste grupo, 100% receberam órgão de doador falecido. Estenose da anastomose colédoco-coledocociana foi diagnosticada em 13 pacientes e o sucesso da terapêutica endoscópica nestes casos foi de 53,84% (38,46% ainda em tratamento). Fístula biliar foi diagnosticada em 1 paciente, sendo resolvida pelo tratamento endoscópico. Disfunção da ampola da Vater com coledocolitíase foi diagnosticada em 1 paciente, também resolvida pela terapêutica endoscópica. Conclusões: complicações biliares pós-transplante hepático são relativamente comuns e o tratamento endoscópico mostra bons resultados.

Introduction: liver transplantation is the only effective treatment for chronic liver diseases and terminal survival rate has increased in recent decades. However, biliary complications have high incidence and remain the 'Achilles heel of liver transplantation'. Objective: to retrospectively evaluate endoscopic treatment outcomes of biliary complications in post-liver transplants. Methods: the sample consisted of post-liver transplantation patients referred to the Endoscopy Unit of Hospital Geral Cesar Calls and to the endoscopy private clinic, from December 2004 to July 2011, for endoscopic retrograde cholangiopancreatography due to suspected biliary complications. Results: Fifteen patients were retrospectively assessed from December 2004 to July 2011 (10 male, mean age of 49.57 years) were reviewed and 36 endoscopic retrograde cholangiopancreatographies were undertaken (2.4/ patient). Biliary stricture was diagnosed in 13 patients and endoscopic treatment was successful in 56% (38.46% still in treatment). Biliary leaks were found in one patient and dysfunction of the ampulla of Vater with choledocholithiasis was diagnosed in one patient, both resolved by endoscopic treatment. Conclusions: post-liver transplantation biliary complications were relatively common and endoscopic treatment had a satisfactory outcome.

Tumor de células granulares de esôfago: relato de 3 casos / Granular cell tumors of the esophagus: report of three cases

O esôfago é o local mais comum de tumor de células granulares de origem no trato gastrintestinal. Cerca de 270 casos de tumores de células granulares do esôfago têm sido relatados na literatura. A maioria é encontrada incidentalmente durante a endoscopia. Apesar de ser reconhecido facilmente por suas características endoscópicas, tem que ser diferenciado de outras lesões benignas e malignas da mucosa e submucosa. A maioria dos tumores de células granulares é assintomática e benigna, e o acompanhamento endoscópico pode ser considerado suficiente como manejo terapêutico. Novas opções terapêuticas devem ser consideradas especialmente para lesões maiores. Três casos são relatados de paciente com tumores de células granulares de esôfago inferior, diagnosticados por endoscopia digestiva alta.

The esophagus is the most common site of origin of gastrointestinal tract granular cell tumors. Approximately 270 cases of esophageal granular cell tumors have been reported in the literature. Most esophageal granular cell tumors are found incidentally during endoscopy. Although granular cell tumor of the esophagus has become easily recognizable by its endoscopic features, it has to be differentiated from other benign and malignant mucosal and submucosal lesions. The majority of esophageal granular cell tumors are asymptomatic and benign; thus, close follow-up of the patients with endoscopy could be considered sufficient as a therapeutic management. New therapeutic options should be considered especially for larger lesions. Three cases of granular cell tumors with complaints of epigastric discomfort, regurgitation, nausea, and vomiting, which were detected in the lower part of the esophagus on upper gastrointestinal tract endoscopy, are discussed.

A terapêutica endoscópica nas complicações biliares pós-transplante hepático / Endoscopic management of biliary complications after liver transplantation

RACIONAL: O transplante hepático é o único tratamento efetivo para as hepatopatias crônicas terminais e a taxa de sobrevida tem aumentado nas últimas décadas. No entanto, as complicações biliares têm alta incidência e permanecem como o "calcanhar de Aquiles" do transplante de fígado. OBJETIVO: Avaliar retrospectivamente os resultados do tratamento endoscópico das complicações biliares em pacientes submetidos à transplante hepático. MÉTODOS: Foram avaliados pacientes transplantados hepáticos para realização de colangiopancreatografia retrógrada endoscópica por suspeita de complicação biliar. RESULTADOS: Quinze pacientes (11 homens, média de idade de 49,57 anos) foram estudados. Nesse período foram realizadas 36 colangiopancreatografias retrógradas endoscópicas (2,4/paciente). Neste grupo, 100% receberam órgão de doador falecido. Estenose da anastomose coledococoledocociana foi diagnosticada em 13 pacientes e o sucesso da terapêutica endoscópica foi de 53,84% (38,46% ainda em tratamento). Fístula biliar foi diagnosticada em um paciente, sendo resolvida pelo tratamento endoscópico. Disfunção da âmpola hepatopancreaticobiliar com coledocolitíase foi diagnosticada em um paciente, também resolvida pela terapêutica endoscópica. CONCLUSÕES: As complicações biliares pós-transplante hepático são relativamente comuns, com predominância de estenoses. O tratamento endoscópico foi eficaz na maioria dos pacientes desta série.

BACKGROUND: Liver transplantation is the only effective treatment for chronic liver diseases and terminal survival rate has increased in recent decades. However, biliary complications have high incidence and remain as the "Achilles heel" for liver transplantation. AIM: To evaluate retrospectively endoscopic treatment outcomes of biliary complications in post-liver transplantations. METHODS: The sample consisted of post-liver transplantation patients for endoscopic retrograde cholangiopancreatography due to suspected biliary complications. RESULTS: Fifteen patients were included (10 male, mean age of 49.57 years) and 36 endoscopic retrograde cholangiopancreatographies were undertaken (2.4/patient). Biliary stricture was diagnosed in 13 patients and endoscopic treatment was successful in 56% (38,46% still in treatment). Biliary leaks were found in one patient and dysfunction of the hepatobilliary ampulla with choledocholithiasis was diagnosed in one patient, both cured by endoscopic treatment. CONCLUSIONS: Post-liver transplantation biliary complications are relatively common and endoscopic treatment may result in satisfactory outcome. Stenosis was the more frequent complication in this series.