ABSTRACT: The use of nitrogen (N) in pastoral ecosystems leads to increased productivity, as it allows the plant to elongate its leaves and, therefore, grazing herbivores harvest the green leaves. However, there are very volatile N sources, which can be replaced by ammonium nitrate, which is less volatile and less dependent on the application in rainy days. The treatments are compound of Marandu palisade grass pastures managed under continuous stocking at a canopy height of 25 cm, with different levels of N fertilizer: 0, 75, and 150 kg ha-1year-1, as ammonium nitrate (32% of N), with four replicates (pastures) in a completely randomized design. Nitrogen uptake (54.9, 96.5, 113.8 kg N ha-1) and N nutrition index (0.67, 0.98, 1.15) were different between N level, respectively, 0, 75 and 150 kg ha-1 year-1. The N recovery (58.3, 40.9 %) differed between 75 and 150 kg ha-1 year-1, respectively. The dose of 75 kg N kg ha-1 year-1 results in better N utilization, while the dose of 150 kg N ha-1 year-1 enables greater stocking rate; therefore, requiring less grazing area.

RESUMO: O uso de nitrogênio (N) em ecossistemas pastoris leva ao aumento da produtividade, pois permite que a planta alongue suas folhas e, portanto, os herbívoros colham as folhas verdes. Porém, existem fontes de nitrogênio muito voláteis, que devem ser substituídas por nitrato de amônio, que é menos volátil e menos dependente da aplicação em dias chuvosos. Os tratamentos foram compostos por pastagens de capim-marandu, manejadas sob lotação contínua, na altura do dossel a 25 cm, com diferentes doses de N: 0, 75 e 150 kg ha-1 ano-1, na forma de nitrato de amônio (32% de N), com quatro repetições (piquetes), em delineamento inteiramente casualizado. A absorção de nitrogênio (54,9; 96,5; 113,8 kg N ha-1) e o índice nutricional de N (0,67; 0,98; 1,15) foram diferentes entre as doses de N, respectivamente, 0, 75 e 150 kg ha-1 ano-1. A recuperação de N (58,3; 40,9%) diferiu entre 75 e 150 kg ha-1 ano-1, respectivamente. A dose de 75 kg N kg ha-1 ano-1 resultou em melhor aproveitamento do N, enquanto a dose de 150 kg N ha-1 ano-1 possibilita maior taxa de lotação; portanto, exigindo menos área de pastagem.

Abstract Cervical cancer (CC) is caused by persistent infection of human papillomavirus of high oncogenic risk (hr-HPV); however, several cofactors are important in its carcinogenesis, such as smoking, multiparity, and prolonged use of oral hormonal contraceptives (COCs). Worldwide, 16% of women use COCs, whereas in Brazil this rate is of ~ 30%. The safety and adverse effects of COCs are widely discussed in the literature, including the increase in carcinogenic risk. Due to the existence of several drugs, combinations, and dosages of COCs, it is hard to have uniform information in epidemiological studies. Our objective was to perform a narrative review on the role of COCs use in the carcinogenesis of cervical cancer. Several populational studies have suggested an increase in the incidence of cervical cancer for those who have used COCs for > 5 years, but other available studies reach controversial and contradictory results regarding the action of COCs in the development of CC.

Resumo O câncer cervical (CC) é causado pela infecção persistente pelo papilomavírus humano de alto risco oncogênico (hr-HPV); entretanto, vários cofatores são importantes na sua carcinogênese, como tabagismo, multiparidade e uso prolongado de contraceptivos hormonais orais (COCs). No mundo, 16% das mulheres usam AOCs, enquanto no Brasil essa taxa é de ~ 30%. A segurança e os efeitos adversos dos COCs são amplamente discutidos na literatura, incluindo o aumento do risco carcinogênico. Devido à existência de várias drogas, combinações e dosagens de COCs, é difícil ter informações uniformes em estudos epidemiológicos. Nosso objetivo foi realizar uma revisão narrativa sobre o papel do uso de COCs na carcinogênese do câncer cervical. Vários estudos populacionais têm sugerido aumento da incidência de câncer de colo uterino para aquelas que usam COCs há mais de 5 anos, mas outros estudos disponíveis chegam a resultados controversos e contraditórios quanto à ação dos COCs no desenvolvimento do CCU.

ABSTRACT The objectives were to evaluate the effects of monensin and virginiamycin, alone or combined, on supplemented Nellore cattle grazing tropical grass during the rainy season. Two experiments were conducted simultaneously to evaluate intake, digestibility, CH4 emissions, blood parameters, performance, and carcass characteristics (Exp. 1), and ruminal fermentation and relative abundance of ruminal microorganisms (Exp. 2). Animals (n = 92 Exp. 1 and n = 12 Exp. 2) were distributed in a completely randomized design and allocated in twelve paddocks composed of Urochloa brizantha (A. Rich.) Stapf. cv. Xaraés. A protein-energetic supplementation of 3 g/kg of BW per day was provided to all animals. Supplements were: without additives (WA), monensin alone at 80 mg/kg of product (MN), virginiamycin alone at 150 mg/kg of product (VM), and monensin (80 mg/kg of product) combined with virginiamycin (150 mg/kg of product; MNVM). Treatments did not affect intakes of total dry matter (DM), supplement DM, and nutrients. However, the intakes of forage DM and crude protein decreased in cattle fed MNVM compared with animals fed WA, MN, and VM. Total volatile fatty acids increased in animals fed VM. Ruminal NH3-N decreased, and pH increased in animals fed MN, VM, and MNVM. Relative abundance of total F. succinogenes and S. ruminantium decreased and R. flavefaciens increased in animals fed MN and VM at d 118. Treatments had no effect on enteric CH4 emissions. The average daily gain (ADG) and total gain were greater in cattle fed MNVM than in cattle fed MN. Combination of monensin and virginiamycin altered the rumen microbial populations but did not decrease enteric CH4 emissions. However, it decreased forage dry matter intake without altering the ADG and total weight gain, leading to an increase in feed efficiency. Results from this study indicate an advantage in including feed additives combined in the diet of supplemented Nellore cattle grazing tropical grass during the rainy season.

Abstract Objectives: to evaluate the nutritional status and body composition of women with gynecological tumors and evaluate the fat mass index (FMI) as a complementary indicator for addressing the nutrition status. Methods: a cross-sectional study with women recently diagnosed with gynecological tumors. Nutritional status was assessed using conventional anthropometry and the Patient-Generated Subjective Global Assessment. For body composition, bioelectrical impedance was used. Results: a total of 158 women participated, most of them with excess weight and high body fat. The FMI showed a positive and significant correlation with body mass index, arm circumference, tricipital skinfold, and arm muscle circumference. Conclusion: women recently diagnosed with gynecological tumors had excess weight and high body fat. The FMI may be a potentially useful indicator to complement the assessment of nutritional status and help the multidisciplinary team to perform early clinical and nutritional interventions.

Resumen Objetivos: evaluar el estado Nutricional y la composición corporal de mujeres con tumores ginecológicos, y evaluar el índice de masa grasa (IMG) como indicador Nutricional complementario. Métodos: estudio transversal con mujeres diagnosticadas recientemente de tumores ginecológicos. El estado Nutricional se evaluó mediante la antropometría convencional y la Evaluación Global Subjetiva Generada por el Paciente. Para la composición corporal se utilizó la impedancia bioeléctrica. Resultados: participaron 158 mujeres, la mayoría con exceso de peso y grasa corporal alta. El IMG mostró una correlación positiva y significativa con el índice de masa corporal, la circunferencia del brazo, el pliegue cutáneo tricipital y la circunferencia de los músculos del brazo. Conclusión: las mujeres diagnosticadas recientemente con tumores ginecológicos presentaron exceso de peso y grasa corporal alta. El IMG puede ser un indicador potencialmente útil para complementar la evaluación del estado Nutricional y ayudar al equipo multidisciplinario a realizar intervenciones clínicas y Nutricionales tempranas.

ABSTRACT. The aim of this study was to characterize four corn and sorghum co-products (DDG) in terms of their protein and carbohydrate fractions; we also evaluated the effects of substituting the protein source of the conventional supplement by DDG on consumption and nutrient digestibility in confined finishing cattle. Thirty-six male Nellore cattle with a mean age of 24 months were used. The treatments were: FA: concentrate with corn as an energy source and cottonseed meal as a protein source; DDG50: concentrate with a 50% substitution of the FA protein source by DDG; DDG100: concentrate with 100% substitution of the FA protein source by DDG. The experimental design was completely randomized with three treatments and three replicates (pens) containing four animals per pen. We found that the use of DDG in the finishing phase did not interfere with the animals’ food intake or the digestibility of the nutrients (p > 0.05). Nutrients were used by the animals; therefore, DDGs may be viable substitutes of cottonseed meal. We conclude that the bromatological composition of this co-product is influenced a lot during processing; therefore, the nutritional values of this co-product present in the composition tables may not be true.

Resumo Apresentamos um caso de distrofia macular oculta bilateral, em paciente de 70 anos com queixa de baixa acuidade visual progressiva, sem achados fundoscópicos ou angiográficos justificáveis. Foram realizados exames de imagem do sistema nervoso central que afastaram lesões expansivas e testes eletrofisiológicos que sugeriram diagnóstico.

Abstract We report a case of bilateral occult macular dystrophy in a 70-year-old woman with progressive low visual acuity, without justifiable fundoscopic or angiographic findings. Imaging tests were done to excluding expansive lesions and electrophysiological tests that suggested the diagnosis.

The aim of this work was to study the influence of varying nitrogen potential during plasma nitriding of stainless steel ISO 5832-1. The control of nitrogen potential was achieved by pulsing the nitrogen flow for different times (01/19, 02/18, and 05/15), where the numbers represent the time (in minutes) of nitrogen flow on/off, thus creating an intermittent flow of nitrogen during the treatment. For all tested conditions - continuous and pulsed flow of nitrogen - the treatment temperature was kept at 425ºC during 2 and 8 hours. Specimens were characterized by means of X-ray diffraction, scanning electron microscopy, optical microscopy, energy-dispersive X-ray spectroscopy, and nanohardness. Results showed that the layer thickness increases with the increase of total treatment time, and decreased for shorter times of pulsed nitrogen flow. Smaller expansion of the austenite phase, as well as less precipitation of chromium nitrides, were also observed for shorter times of pulsed nitrogen flow. Hence, the use of intermittent nitrogen flow appears to be an efficient approach in order to control the nitrogen concentration within the layer, reducing its brittleness.

Abstract ISO 5832-1 stainless steel specimens were plasma nitrided at different nitrogen potentials. The main goal was to obtain the S-phase with different nitrogen concentrations and free of chromium-based precipitates. The control of nitrogen potential was made by pulsing the gas at predetermined times: 10/10, 05/15, 02/18, and 01/19, where the numbers represent the time in minutes that the nitrogen flow was kept on/off, respectively. For all pulsing conditions, the nitriding was carried out at 450 °C for 2 hours. After nitriding, specimens were characterized by means of optical (OM) and electron microscopy (SEM), energy-dispersive spectroscopy (EDS), X-ray diffraction (XRD) and microhardness. Results show that the nitrided layer thickness decreases with decreasing times of nitrogen pulse, and that lower times of nitrogen flow lead to lower precipitation of chromium nitrides. It can be thus concluded that the use of intermittent nitrogen flow is an alternative to control the nitrided layer in terms of thickness, hardness, and the amount of nitrogen present in phase ɣN (S-phase).

ABSTRACT We aimed to evaluate the effects of crude glycerine purity and levels of glycerol on the fermentative profile, microorganisms counting, and nutritional value of Piatã grass silage. The experiment was carried out in a 3×3+1 completely randomized factorial design using three different types of crude glycerine [low purity (40% of glycerol), medium purity (60% glycerol), and high purity (80% glycerol)], three doses of glycerol (20, 40, and 60 g/kg DM), and a control (no crude glycerine added) as an additional treatment, which were stored for 80 days. Statistical differences were not observed on fermentative losses of the treatments tested. The increase of glycerol doses resulted in higher levels of non-fibrous carbohydrates and lower levels of fibre components. The addition of low-purity crude glycerine increased the levels of fat and in vitro digestibility of silages. The highest levels of lactic acid and acetic acid occurred in the treatments with 60 g/kg of glycerol when using crude glycerine with a low purity. The lowest lactic acid content was observed in the control treatment and in the lowest dose of glycerol. The highest glycerol dose (60 g/kg), associated with the lowest degree of crude glycerine purity (40%) resulted in the greatest nutritional value and provided the best silage conservation.

ABSTRACT Introduction Penile cancer (PC) occurs less frequently in Europe and in the United States than in South America and parts of Africa. Lymph node (LN) involvement is the most important prognostic factor, and inguinal LN (ILN) dissection can be curative; however, ILN dissection has high morbidity. A nomogram was previously developed based on clinicopathological features of PC to predict ILN metastases. Our objective was to conduct an external validation of the previously developed nomogram based on our population. Materials and methods We included men with cN0 ILNs who underwent ILN dissection for penile carcinoma between 2000 and 2014. We performed external validation of the nomogram considering three different external validation methods: k-fold, leave-one-out, and bootstrap. We also analyzed prognostic variables. Performance was quantified in terms of calibration and discrimination (receiver operator characteristic curve). A logistic regression model for positive ILNs was developed based on clinicopathological features of PC. Results We analyzed 65 men who underwent ILN dissection (cN0). The mean age was 56.8 years. Of 65 men, 24 (36.9%) presented with positive LNs. A median 21 ILNs were removed. Considering the three different methods used, we concluded that the previously developed nomogram was not suitable for our sample. Conclusions In our study, the previously developed nomogram that was applied to our population had low accuracy and low precision for correctly identifying patients with PC who have positive ILNs.

Resumo Objetivo Descrever uma série de casos de tumores de células de Sertoli-Leydig (TCSLs) ovarianos. Métodos Revisão retrospectiva de 12 casos de TCSL tratados no Hospital de Câncer de Barretos entre outubro de 2009 e agosto de 2017. Resultados A mediana de idade foi 31 anos (15-71 anos). Um total de 9 pacientes (75,0%) apresentaram sintomas: 8 (66,7%) apresentaram dor abdominal, 5 (41,7%) apresentaram aumento abdominal, 2 (16,7%) apresentaram virilização, 2 (16,7%) apresentaram sangramento uterino anormal, 1 (8,3%) apresentou dispareunia, e 1 (8,3%) apresentou emagrecimento. A mediana de desidrogenase láctica (DHL) foi 504,5 U/L (138-569 U/L), alfafetoproteína (AFP) foi 2,0 ng/ml (1,1-11,3 ng/ml), gonadotrofina coriônica humana (β-hCG) foi 0,6 mUI/ml (0,0-2,3 mUI/ml), antígeno carcinoembrionário (CEA) foi 0,9 ng/ml (0,7-3,4) ng/ml, e antígeno cancerígeno 125 (CA-125) foi 26,0 U/ml (19,1-147,0 U/ml), todos pré-operatórios. Todos os tumores foram unilaterais e tratados cirurgicamente. Realizou-se linfadenectomia em 3 (25,0%) pacientes, por em, nenhuma das tr^es apresentou acometimento linfonodal. No exame anatomopatológico, 1 tumor (8,3%) era bem diferenciado, 8 (66,7%) eram moderadamente diferenciados, e 3 (25,0%) eram pouco diferenciados. Um total de 5 (55,6%) tumores eram sólido-císticos, 2 (22,2%) eram puramente císticos, 1 (11,1%) era cístico com vegetações, e 1 (11,1%) era puramente sólido, mas para 3 pacientes estas informações não estavam disponíveis. A mediana da dimensão da lesão foi 14,2 cm (3,2-23,5 cm). Todos os tumores eram estádio IA de acordo com a classificação de 2014 da Federação Internacional de Ginecologia e Obstetrícia (FIGO, na sigla em inglês). Duas (16,7%) pacientes receberam adjuvância; uma realizou 3 ciclos de paclitaxel e carboplatina a cada 21 dias, e a outra 4 ciclos de ifosfamida, cisplatina e etoposide a cada 21 dias. Dentre todas as pacientes, nenhuma apresentou recidiva e houve um óbito relacionado a complicações após estadiamento cirúrgico. Conclusão Dor abdominal foi a apresentação mais frequente. Todos os TCSLs eram estádio IA e a maioria era moderadamente diferenciada. Não ocorreram recidivas, mas ocorreu um óbito relacionado ao estadiamento cirúrgico.

Abstract Objective To describe a series of cases of ovarian Sertoli-Leydig cell tumors (SLCTs). Methods Retrospective review of 12 cases of SLCT treated at the Hospital do Câncer de Barretos, Barretos, state of São Paulo, Brazil, between October 2009 and August 2017. Results The median age of the patients was 31 years old (15-71 years old). A total of 9 patients (75.0%) presented symptoms: 8 (66.7%) presented with abdominal pain, 5 (41.7%) presented with abdominal enlargement, 2 (16.7%) presentedwith virilizing signs, 2 (16.7%) presented with abnormal uterine bleeding, 1 (8.3%) presented with dyspareunia, and 1 (8.3%) presented with weight loss. The median preoperative lactate dehydrogenase (LDH) was 504.5 U/L (138-569 U/L), alpha-fetoprotein (AFP) was 2.0 ng/ml (1.1-11.3 ng/ml), human chorionic gonadotropin (β-hCG) was 0.6 mUI/ml (0.0-2.3 mUI/ml), carcinoembryonic antigen (CEA) was 0.9 ng/ml (0.7-3.4 ng/ml), and cancer antigen 125 (CA-125) was 26.0 U/ml (19.1-147.0 U/ml). All of the tumors were unilateral and surgically treated. Lymphadenectomy was performed in 3 (25.0%) patients, but none of the three patients submitted to lymphadenectomy presented lymph node involvement. In the anatomopathological exam, 1 (8.3%) tumor was well-differentiated, 8 (66.7%) were moderately differentiated, and 3 (25.0%) were poorly differentiated. A total of 5 (55.6%) tumors were solid-cystic, 2 (22.2%) were purely cystic, 1 (11.1%) was cystic with vegetations, and 1 (11.1%) was purely solid, but for 3 patients this information was not available. The median lesion size was 14.2 cm (3.2-23.5 cm). All of the tumors were at stage IA of the 2014 classification of the International Federation ofGynecology andObstetrics (FIGO). A total of 2 (16.7%) patients received adjuvant treatment; 1 of themunderwent 3 cycles of paclitaxel and carboplatin every 21days, and the other underwent 4 cycles of ifosfamide, cisplatin and etoposide every 21 days. None of all of the patients had recurrence, and one death related to complications after surgical staging occurred. Conclusion Abdominal pain was the most frequent presentation. There was no ultrasonographic pattern. All of the SLCTs were at stage IA, and most of them were moderately differentiated. Relapses did not occur, but one death related to the surgical staging occurred.

Resumo Objetivo Opresente estudotemcomo objetivo obter informações demográficas básicas, o nível de interesse e de treinamento em ginecologia oncológica entre obstetras e ginecologistas (OB-GYNs) brasileiros para criar um perfil destes profissionais. Métodos Umquestionário online foi enviado a 16.008 ginecologistas filiados à Federação Brasileira de Associações de Ginecologia e Obstetrícia (FEBRASGO). Nós consideramos ginecologistas dedicados à oncologia ginecológica (OB-GYNsONCO) aqueles que referiram atuar em > 50% de sua prática diária com o tratamento do câncer feminino. Resultados Um total de 1.608 (10%) dos 16.008 membros da FEBRASGO responderam ao questionário. Os OB-GYNs estão concentrados nos estados do sul e sudeste do Brasil. A oncologia ginecológica foi considerada a 8ª área de maior interesse em ginecologia entre os OB-GYNs. Um total de 95 (5,9%) dos OB-GYNs foram considerados ginecologistas dedicados à oncologia ginecológica (OB-GYNs ONCO). Obstetras e ginecologistas estão ativamente envolvidos no tratamento do câncer: > 60% deles dedicam até 25% de sua prática diária à oncologia. O papel dosmédicos na triageme na prevenção, no diagnóstico, no tratamento de lesões pré-cancerosas e em procedimentos cirúrgicos de baixa complexidade é notavelmente alto. Ginecologistas dedicados à oncologia ginecológica no Brasil têm umperíodo de treinamento emoncologia ginecológica heterogêneo, não padronizado e curto. Estes profissionais tiveram um papel mais significativo na realização de operações de média e alta complexidade em comparação com OB-GYNs (65,2% versus 34%, e 47,3% versus 8,4%, respectivamente). Conclusão Os papéis dos OB-GYN e dos OB-GYNs ONCO parecem ser complementares. Os OB-GYNs frequentemente atuam emtriageme prevenção e em procedimentos cirúrgicos de baixa complexidade, enquanto os OB-GYNs ONCO estão mais envolvidos em casos demais alta complexidade. Estratégias para elevar os padrões de treinamento em oncoginecologia e incentivar o reconhecimento da oncologia ginecológica como uma subespecialidade devem ser adotadas no Brasil.

Abstract Objective The present study aims to obtain basic demographic information, the level of interest and of training in gynecology oncology among Brazilian obstetricians and gynecologists (OB-GYNs) to create a professional profile. Methods An online questionnaire was sent to 16,008 gynecologists affiliated to the Brazilian Federation of Associations of Gynecology and Obstetrics (FEBRASGO, in the Portuguese acronym). We considered gynecologists dedicated to gynecologic oncology (OB-GYNs ONCO) those who self-reported that > 50% of their daily practice consists in working with women’s cancer care. Results A total of 1,608 (10%) of 16,008 FEBRASGO members responded. The OBGYNs are concentrated in the southern and southeastern states of Brazil. Gynecologic oncology was considered the 8th greatest area of interest in gynecology among the OBGYNs. A total of 95 (5.9%) of the OB-GYNs were considered OB-GYNs ONCO. Obstetricians and gynecologists are actively engaged in cancer care: > 60% of them dedicate up to 25% of their daily practice to oncology. The role of the physicians in screening and prevention, diagnosis, in the treatment of precancerous lesions, and in low complexity surgical procedures is notably high. Gynecologists dedicated to gynecologic oncology in Brazil have a heterogeneous, nonstandardized and short training period in gynecologic oncology. These professionals had a more significantly role in performing medium- and high-complexity operations compared with OB-GYNs (65.2% versus 34%, and 47.3% versus 8.4%, respectively). Conclusion The role of OB-GYNs and of OB-GYNs ONCO appears to be complementary. Obstetricians and gynecologists actmore often in screening and prevention and in low-complexity surgical procedures, whereas OB-GYNs ONCO are more involved in highly complex cases. Strategies to raise standards in cancer training and to encourage the recognition of gynecologic oncology as a subspecialty should be adopted in Brazil.

Resumo Os sistemas de drenagem na fonte vêm ganhando espaço como soluções de desenvolvimento de baixo impacto implantadas em edifícios urbanos. Apesar disso, são poucas as pesquisas que avaliam a influência das condições das instalações dos sistemas prediais de águas pluviais sobre seu desempenho. Este trabalho avalia a influência da adoção de diferentes componentes da instalação do sistema predial de água pluvial no desempenho de sistemas de infiltração. Para tanto, foram executados dois sistemas experimentais, poço de infiltração e jardim de chuva, contendo condutores verticais e horizontais, montados conforme instalações que representam uma edificação vertical. Foram avaliados o escoamento no ramal que direciona a água de chuva para o sistema de infiltração e a ocorrência de retorno de água para pontos de captação posicionados próximos aos sistemas de infiltração. Verificou-se que parte da água passa direto para a tubulação que deságua no sistema urbano de drenagem em determinadas configurações de montagem do ramal que direciona a água de chuva para o sistema de infiltração, reduzindo a eficiência do sistema como um todo. Além disso, ocorreu refluxo em caixas drenantes posicionadas a montante dos sistemas de infiltração, o que indica a necessidade de cautela no posicionamento desses componentes.

Abstract Source drainage systems are gaining importance as low-impact development solutions deployed in built-up areas. However, only limited number of research studies have evaluated the influence of the installation conditions of stormwater drainage building systems on these systems' performance. This paper evaluates the influence of the adoption of different components of installation of stormwater drainage systems on the performance of infiltration systems. With that purpose, two experimental systems were executed: a dry-well and a rain garden, containing vertical and horizontal conductors mounted according to installations that represent a vertical building. The study evaluated the flow in the conductor branch that directs the stormwater to the infiltration system and the occurrence of water return to catchment points positioned near the infiltration systems. The experiment showed that part of the drained volume of stormwater passes directly to the piping that flows into the urban drainage system in certain plumbing fittings configurations that direct the stormwater to the infiltration system, reducing the overall efficiency of the system. In addition, reflux occurred in drainage boxes positioned upstream of the infiltration systems, indicating the need for caution in the positioning of these components.