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ABSTRACT Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2020 the updated recommendations for the diagnosis and treatment of HCC. Since then, new data have emerged in the literature, including new drugs approved for the systemic treatment of HCC that were not available at the time. The SBH board conducted an online single-topic meeting to discuss and review the recommendations on the systemic treatment of HCC. The invited experts were asked to conduct a systematic review of the literature on each topic related to systemic treatment and to present the summary data and recommendations during the meeting. All panelists gathered together for discussion of the topics and elaboration of the updated recommendations. The present document is the final version of the reviewed manuscript containing the recommendations of SBH and its aim is to assist healthcare professionals, policy-makers, and planners in Brazil and Latin America with systemic treatment decision-making of patients with HCC.

RESUMO O carcinoma hepatocelular (CHC) é uma das principais causas de mortalidade relacionada a câncer no Brasil e no mundo. A Sociedade Brasileira de Hepatologia (SBH) publicou em 2020 a atualização das recomendações da SBH para o diagnóstico e tratamento do CHC. Desde então, novas evidências científicas sobre o tratamento sistêmico do CHC foram relatadas na literatura médica, incluindo novos medicamentos aprovados que não estavam disponíveis na época do último consenso, levando a diretoria da SBH a promover uma reunião monotemática on-line para discutir e rever as recomendações sobre o tratamento sistêmico do CHC. Um grupo de experts foi convidado para realizar uma revisão sistemática da literatura e apresentar uma atualização, baseada em evidências científicas, sobre cada tópico relacionado ao tratamento sistêmico e a apresentar os dados e recomendações resumidas durante a reunião. Todos os painelistas se reuniram para discutir os tópicos e elaborar as recomendações atualizadas. O presente documento é a versão final do manuscrito revisado, contendo as recomendações da SBH, e seu objetivo é auxiliar os profissionais de saúde, formuladores de políticas e planejadores no Brasil e na América Latina na tomada de decisões sobre o tratamento sistêmico de pacientes com CHC.

https://doi.org/10.1590/s0004-2803.202301000-14

Dietary lipid sources for growing rabbits: A review on animal health and productivity
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Almeida, Alexander Alexandre de

; Valentim, Jean Kaique

; Silva, Aline Cristina Diniz

; Moraleco, Debora Duarte

; Zanella, Joyce

; Fonseca, Leonardo da Silva

Ciência Animal Brasileira

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2023, Volume 24 elocation e-75704E

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Studies that explore the use of lipids and their effects on animal nutrition have become increasingly abundant, producing a mass of information. The review was carried out on a parity basis through a survey of articles in the bibliographic databases: Web of Science and Periodicals Capes, using search terms associated or not, in the plural or singular, in English and Portuguese, such as: “lipids” AND “rabbits" AND "nutrition". After analyzing the files in the two scientific databases, certain files were excluded because they did not fit the theme or because they did not meet the inclusion criteria and repeated articles. A relevance test was carried out for the use of the articles, where they should deal with the subject: articles that report the use of lipids in the nutrition of non-ruminant animals; articles made available in complete form; articles that had at least one of the keywords; articles where the main subject is related to lipids. The articles were selected and tabulated in an Excel® spreadsheet with relevant information for exploration in the review. The use of oils and fats is a favorable point in the nutrition of non-ruminant animals, presenting benefits in the enrichment of final products such as: providing higher levels of omega-3 and omega-6, and thus obtaining meat products with lower levels of saturated fat and higher unsaturated fat contents promoting benefits to human health through its consumption, reduction of food costs, improvement in palatability and appearance of foods. These are nutritional strategies used in hot seasons of the year due to the low calorific increment produced.

Resumo Estudos que exploram o uso de lipídios e seus efeitos na nutrição animal têm se tornado cada vez mais abundantes, produzindo uma grande quantidade de informações. A revisão foi realizada de forma paritária por meio de uma pesquisa de artigos nas bases bibliográficas: Web of Science e Periódicos Capes, utilizando termos de busca associados ou não, no plural ou no singular, em inglês e português, tais como: "lipídios" E "coelhos" E "nutrição". Após analisar os arquivos nas duas bases científicas, determinados arquivos foram excluídos porque não se adequavam ao tema ou não atendiam aos critérios de inclusão, além de artigos repetidos. Um teste de relevância foi realizado para a seleção dos artigos, nos quais eles deveriam tratar do assunto: artigos que relatam o uso de lipídios na nutrição de animais não-ruminantes; artigos disponibilizados na forma completa; artigos que possuíam pelo menos uma das palavras-chave; artigos nos quais o assunto principal está relacionado a lipídios. Os artigos foram selecionados e tabulados em uma planilha do Excel® com informações relevantes para exploração na revisão. O uso de óleos e gorduras é um ponto favorável na nutrição de animais não-ruminantes, apresentando benefícios no enriquecimento de produtos finais, tais como: fornecer níveis mais altos de ômega-3 e ômega-6, e assim obter produtos de carne com menores teores de gordura saturada e maiores teores de gordura insaturada, promovendo benefícios para a saúde humana por meio do consumo, redução dos custos alimentares, melhoria na palatabilidade e aparência dos alimentos. Essas são estratégias nutricionais usadas nas estações quentes do ano devido ao baixo incremento calórico produzido.

https://doi.org/10.1590/1809-6891v24e-75704e

Hepatocellular carcinoma (HCC) in patients with Non-Alcoholic Fatty Liver Disease (NAFLD): screening, treatment and survival analysis in a Brazilian series
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Alencar, Regiane Saraiva de Souza Melo

; Oliveira, Claudia P.

; Chagas, Aline Lopes

; Fonseca, Leonardo Gomes da

; Maccali, Claudia

; Saud, Lisa Rodrigues da Cunha

; Xerfan, Mariana Pinheiro

; Stefano, Jose Tadeu

; Herman, Paulo

; D'Albuquerque, Luiz Augusto Carneiro

; Alves, Venâncio Avancini Ferreira

; Carrilho, Flair Jose

Clinics

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2022, Volume 77 elocation 100097

Resumo: En | Texto: En | PDF: En

Abstract Objective: The aim of the present study was to evaluate the clinical features, Hepatocellular Carcinoma (HCC) screening, treatment modalities, and Overall Survival (OS) in a series of Non-Alcoholic Fatty Liver Disease-Related Hepatocellular Carcinoma (NAFLD-HCC) Brazilian patients. Methods: This was a cross-sectional study at the Instituto do Cancer do Estado de São Paulo, at the Faculdade de Medicina da Universidade de São Paulo with the approval of the local research ethics committee. NAFLD patients with HCC diagnosed, from May 2010 to May 2019, were included. Results: A total of 131 patients were included. Risk factors for NAFLD were present in 94.7% of the patients. Only 29% of patients were in the HCC screening program before diagnosis. HCC treatment was performed in 84.7% of patients. Cumulative survival at the end of the first year was 72%, second-year 52%, and fifth-year 32%. HCC screening before diagnosis was not significantly associated with higher cumulative survival. The independent factors associated with shorter general survival were BCLC C-D, p < 0.001, and the size of the largest nodule > 42 mm, p = 0.039. Conclusions: Although the efficacy of screening in our population regarding overall survival was hampered due to the sample size (29% had screening), BCLC stages C‒D and the size of the largest nodule larger than 42 mm were identified as independent factors of worse prognosis.

https://doi.org/10.1016/j.clinsp.2022.100097

Cardiovascular Physiotherapy on Respiratory Sinus Arrhythmia of Patients Undergoing Coronary Artery Bypass Grafting
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Silva, Bianca Lopes

; Silva, Roberto Ribeiro da

; Reis, Hugo Valverde

; Rodriguez, Ana Carolina Accosio

; Souza, Priscila Souza e

; Andrade, Isabela de

; Fonseca, Leonardo

; Guizillini, Solange

; Reis, Michel Silva

Brazilian Journal of Cardiovascular Surgery

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Jun 2021, Volume 36 Nº 3 Páginas 424 - 428

Resumo: En | Texto: En | PDF: En

Abstract Introduction: Patients in the postoperative period of coronary artery bypass grafting (CABG) present respiratory and autonomic dysfunctions. In this sense, cardiovascular physiotherapy has been offered as an indispensable differential for the improvement of the prognosis of this population. Heart rate variability is a simple, noninvasive method to analyze autonomic modulation, as well as the accentuation maneuver of respiratory sinus arrhythmia, which demonstrates the parasympathetic autonomic control over the heart. Five patients undergoing cardiac surgery performed a protocol of cardiovascular physiotherapy in the postoperative period and had their data referring to the preoperative period, the 1st and 4th postoperative days analyzed.

https://doi.org/10.21470/1678-9741-2020-0276 5 downloads

Efficacy and safety of sorafenib in elderly patients with advanced hepatocellular carcinoma
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Marta, Guilherme Nader

; da Fonseca, Leonardo G.

; Braghiroli, Maria Ignez

; Moura, Fernando

; Hoff, Paulo M.

; Sabbaga, Jorge

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2021, Volume 76 elocation e2498

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To evaluate the efficacy and safety of sorafenib in elderly patients with advanced hepatocellular carcinoma (HCC). METHODS: We analyzed data from a cohort of patients with advanced HCC treated using systemic treatment according to the local institutional protocol. Patients were divided into two groups, Group A, individuals <70 years of age, and Group B, individuals 70 years of age or older at the time of treatment initiation. Efficacy, measured based on overall survival (OS) and time to treatment failure (TTF), and toxicity were compared between groups. RESULTS: A total of 238 patients with advanced HCC who received sorafenib between 2007 and 2018 were evaluated. The median age for Group A was 59.1 years and that for Group B 73.6 years. The major prognostic characteristics were balanced between the groups. There were no significant differences in OS between Group A (8.0 months, 95%CI 6.34-9.3) and Group B (9.0 months, 95%CI 5.38-12.62), p=0.433, or in TTF between Group A (3.0 months, 95%CI 2.39-3.60) and Group B (3.0 months, 95%CI 1.68-4.32), p=0.936. There were no significant differences between Groups A and B with respect to the incidence of adverse events or treatment discontinuation because of toxicity. CONCLUSION: Efficacy and safety of sorafenib did not differ significantly between younger and older patients with HCC. Our data suggest that age alone should not restrict clinical decision-making for patients with advanced HCC.

https://doi.org/10.6061/clinics/2021/e2498 515 downloads

Methylene tetrahydrofolate reductase (MTHFR) and vascular endothelial growth factor (VEGF) polymorphisms in Brazilian patients with Hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC)
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Carvalho, Sylene C.R.

; Vasconcelos, Luydson R.S.

; Fonseca, Leonardo da

; Carmo, Rodrigo F.

; Tomitão, Michele T.

; Aroucha, Dayse C.B.L.

; Pereira, Leila M.M.B.

; Stefano, José Tadeu

; Ribeiro-Júnior, Ulysses

; Oliveira, Claudia P.

; Carrilho, Flair J.

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2021, Volume 76 elocation e2881

Resumo: En | Texto: En | PDF: En

OBJECTIVE: The folate pathway is involved in hepatic carcinogenesis and angiogenesis. Polymorphisms in genes related to such processes, including methylene tetrahydrofolate reductase (MTHFR) and vascular endothelial growth factor (VEGF)] may play an important role in the development of hepatocellular carcinoma (HCC). The objective of this study was to evaluate MTHFR and VEGF polymorphisms in Brazilian patients with hepatitis C virus (HCV)-related HCC. METHODS: A total of 119 patients diagnosed with confirmed HCC and HCV were included in the study. SNP genotyping assays were performed using real-time PCR. VEGFA (rs2010963, rs3025039, and rs833061) and MTHFRC677T (rs1801133, rs1801131) polymorphisms were evaluated. RESULTS: The C alleles of MTHFR (rs1801131) and VEGF (rs2010963) were associated with protection against the development of multinodular HCC, while the T allele of MTHFR (rs1801133) was associated with a higher risk of multinodular presentation [p=0.04 OR 1.835 CI (1.022-3.297)]. Multivariate analysis revealed that the GG/GC genotypes of VEGF rs2010963 were independently associated with multinodular tumors at diagnosis (p=0.013; OR 4.78 CI (1.38-16.67)]. CONCLUSION: Our results suggest that these polymorphisms may increase the risk of rapid tumor progression in patients with HCV infection. This subgroup of patients with HCC and who present polymorphism is more likely to be diagnosed with multinodular disease and not be amenable to receiving curative treatments. These data must be validated in larger cohorts, and the screening intervals can be customized based on genetic history.

https://doi.org/10.6061/clinics/2021/e2881 141 downloads

Effect of crude propolis on the performance and feed digestibility of new zealand white rabbits
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Piza, Paola Cristina de

; Moreira, Bruna Leonel

; Silva, Nhayandra Chistina Dias

; Sodré, Pedro Ivo

; Fonseca, Leonardo da Silva

; Leite, Rafael Fernandes

Acta Scientiarum. Animal Sciences

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2021, Volume 43 elocation e52593

Resumo: En | Texto: En | PDF: En

ABSTRACT. The objective of this study was to evaluate the performance and digestibility of diets containing different levels of crude propolis for growing rabbits. Forty-eight New Zealand White rabbits, 43 days old, of both genders, were used, distributed in a completely randomized design. There were four diets with different inclusion levels of crude propolis (0.0; 0.5; 1.0 and 1.5%). There was no statistical difference for performance regarding the inclusion levels of crude propolis (p = 0.85), as well as for the variables dry matter consumption, neutral detergent fiber and acid detergent fiber (p ≥ 0.07). Crude protein consumption showed a statistical difference in relation to gender (p = 0.04): males showed higher consumption. However, final weight, total weight gain, daily weight gain and feed efficiency were not influenced by the addition of crude propolis (p ≥ 0.37). Dry matter digestibility, crude protein, neutral detergent fiber and acid detergent fiber were not influenced by the inclusion levels of crude propolis in the diets (p ≥ 0.12). This study indicates that the inclusion of raw propolis up to 1.5% in the diets does not affect the performance parameters of rabbits.

https://doi.org/10.4025/actascianimsci.v43i1.52593 84 downloads

On the stability and adaptability of human physiology: Gaussians meet heavy-tailed distributions
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Fossion, Ruben

; Sáenz-Burrola, Ariel

; Zapata-Fonseca, Leonardo

Inter disciplina

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Abr 2020, Volume 8 Nº 20 Páginas 55 - 81

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Recent technological advances allow to monitor in baka non-invasive and continuous way a wide variety of physiological variables. A surprise of the last few decades is that most - if not all - of these variables are always fluctuating, even when the monitored subject is in resting conditions, and the general interpretation is that the statistics of these fluctuations reflect the dynamics of the underlying regulatory mechanisms. The objective of the present contribution is to offer an explanation why a large variability may be a signature of good health for some variables, e.g., heart rate variability, whereas it is interpreted as a risk factor for other variables, like blood pressure variability. Control theory suggests that variables may be classified into 2 categories, depending on the roles they play in the regulatory mechanism, and we argue that the statistics of the corresponding time series may reflect these different functions. We illustrate with experimental time series that regulated variables, such as blood pressure and core temperature, which are to be maintained within a restricted range around a predefined setpoint, correspond to time series that obey a normal (Gaussian) distribution with small variability around a representative average value. On the other hand, effector variables, such as heart rate and skin temperature, oppose or adapt to a multitude of perturbations from the environment, and we show that the corresponding time series exhibit a large variability and obey heavy- tailed distributions that may span various scales. With ageing and/or chronic degenerative disease, effector variables lose variability and adaptive capacity and consequently regulated variables lose stability and become more variable. Although the above results on the variability of time series have been obtained for the specific case of human physiology, they may be applicable as well to other complex dynamical systems where regulatory control mechanisms are active.

Resumen Los avances tecnológicos recientes permiten monitorizar de forma continua y no invasiva una amplia variedad de variables fisiológicas. Una sorpresa de las últimas décadas es que la mayoría si no todas de estas variables siempre fluctúan, incluso cuando el sujeto monitoreado se encuentra en condiciones de reposo, y la interpretación general es que las estadísticas de estas fluctuaciones reflejan la dinámica de los mecanismos subyacentes. El objetivo de la presente contribución es ofrecer una explicación de por qué una gran variabilidad puede ser una firma de buena salud para algunas variables, por ejemplo, la variabilidad de la frecuencia cardíaca, mientras que se interpreta como un factor de riesgo para otras variables, por caso, la variabilidad de la presión arterial. La teoría de control sugiere que las variables se pueden clasificar en 2 categorías, dependiendo de los roles que desempeñan en el mecanismo regulatorio, y argumentamos que las estadísticas de las series de tiempo correspondientes pueden reflejar estas funciones diferentes. Ilustramos con series temporales experimentales que las variables reguladas, como la presión arterial y la temperatura central, que deben mantenerse dentro de un rango restringido alrededor de un punto de ajuste predefinido, corresponden a series temporales que obedecen a una distribución normal (gaussiana) con una pequeña variabilidad alrededor de un representante valor promedio. Por otro lado, las variables efectoras, como la frecuencia cardíaca y la temperatura de la piel, se oponen o se adaptan a una multitud de perturbaciones del entorno, y mostramos que las series de tiempo correspondientes muestran una gran variabilidad y obedecen a las distribuciones de cola pesada que pueden abarcar varias escamas. Con el envejecimiento y/o la enfermedad degenerativa crónica, las variables efectoras pierden variabilidad y capacidad de adaptación y, por consiguiente, las variables reguladas pierden estabilidad y se vuelven más variables. Aunque los resultados anteriores sobre la variabilidad de las series de tiempo se han obtenido para el caso específico de la fisiología humana, pueden ser aplicables también a otros sistemas dinámicos complejos donde los mecanismos de control regulatorio están activos.

https://doi.org/10.22201/ceiich.24485705e.2020.20.71195 550 downloads

Management of Hepatocellular Carcinoma during the COVID-19 Pandemic - São Paulo Clínicas Liver Cancer Group Multidisciplinary Consensus Statement
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Chagas, Aline Lopes

; da Fonseca, Leonardo Gomes

; Coelho, Fabricio Ferreira

; da Cunha Saud, Lisa Rodrigues

; Abdala, Edson

; Andraus, Wellington

; Fiore, Lucas

; Moreira, Airton Mota

; Menezes, Marcos Roberto

; Carnevale, Francisco César

; Tani, Claudia Megumi

; Alencar, Regiane S.S.M

; D'Albuquerque, Luiz Augusto Carneiro

; Herman, Paulo

; Carrilho, Flair José

Clinics

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2020, Volume 75 elocation e2192

Resumo: En | Texto: En | PDF: En

More than 18 million people in 188 countries have been diagnosed as having coronavirus disease (COVID-19), and COVID-19 has been responsible for more than 600,000 deaths worldwide. Brazil is now the second most affected country globally. Faced with this scenario, various public health measures and changes in the daily routines of hospitals were implemented to stop the pandemic. Patients with hepatocellular carcinoma (HCC) are at an increased risk for severe COVID-19 as they present with two major diseases: cancer and concomitant chronic liver disease. The COVID-19 pandemic can significantly impact the management of HCC patients from diagnosis to treatment strategies. These patients need special attention and assistance at this time, especially since treatment for tumors cannot be delayed in most cases. The aim of this guideline was to standardize the management of HCC patients during the COVID-19 pandemic. This document was developed, on the basis of the best evidence available, by a multidisciplinary team from Instituto do Câncer do Estado de São Paulo (ICESP), and Instituto Central of the Hospital das Clínicas da Universidade de São Paulo (HC-FMUSP), which are members of the São Paulo Clínicas Liver Cancer Group.

https://doi.org/10.6061/clinics/2020/e2192 361 downloads

10.

Season effects on the suckling behavior of piglets
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MOREIRA, RENNAN H.R.

; OLIVEIRA, RODRIGO F.

; PALENCIA, JORGE Y.P.

; FONSECA, LEONARDO S.

; GARBOSSA, CESAR AUGUSTO P.

; ABREU, MÁRVIO L.T.

; FERREIRA, RONY A.

Anais da Academia Brasileira de Ciências

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2020, Volume 92 Nº 3 elocation e20190155

Resumo: En | Texto: En | PDF: En

Abstract The suckling behavior of piglets was evaluated in summer and winter, using 21 sows of the same genetic line. Data were collected in July (winter) and in January (summer). The experimental design was a randomized complete block (age of piglets) in a 2x2 factorial scheme, with season of the year (winter and summer) and shift (day, from 06 h to 1h:59min and night from 18h to 05h:59min) as factors. The behavioral variables analyzed were number, interval, and frequency of suckling. The behaviors were monitored on day 7 and 15 of lactation, for 24 hours. In winter, the farrowing room had a mean temperature of 20.32 ±2.17°C and a relative humidity (RH) of 58.63 ±2.99%. In the summer, the mean temperature was 26.65 ±4.02°C, with an RH of 62.22 ±12.06%. During winter, the piglets presented longer sucklings during the night, dedicating 1.84 minutes more to suckling compared to the daytime. Nighttime sucklings were 3.13 minutes longer in winter than in summer. However, in summer, piglets suckled more often during the night, with greater interval between feeds during the day. Based on our results, the season influences the suckling behavior of piglets, with shorter feedings and greater frequencies in summer.

https://doi.org/10.1590/0001-3765202020190155 530 downloads

11.

The economic viability of L-arginine supplementation in diets for sows in the lactation phase
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RIBEIRO, Débora Virginia

; FONSECA, Leonardo da Silva

; MOREIRA, Rennan Herculano Rufino

; CHAIN, Caio Peixoto

; ABREU, Márvio Lobão Teixeira

; DALÓLIO, Felipe Santos

; OLIVEIRA, Altamir Fernandes

; GARBOSSA, Cesar Augusto Pospissil

Revista Brasileira de Saúde e Produção Animal

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2020, Volume 21 elocation e210412020

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO O objetivo com o trabalho foi avaliar a viabilidade econômica da suplementação de L-arginina em dietas para matrizes suínas durante a fase de lactação. Um estudo de caso descritivo foi realizado para identificar a viabilidade econômica da suplementação de L-arginina na ração de lactação, em relação à dieta controle, sobre o desempenho produtivo de matrizes suínas hiperprolíficas e suas leitegadas. O estudo foi realizado em uma granja comercial localizada no estado de Minas Gerais. Analisou critérios de viabilidade como o produto físico marginal (MPPg) e margem bruta (GM) no cenário de eficiência técnica e econômica, que foram comparados com o GM no grupo controle. A eficiência técnica foi estabelecida em 0,71% de L-arginina no consumo diário de ração de acordo com trabalho de campo prévio realizado pelos autores, enquanto a eficiência econômica obtida neste estudo foi de 0,43% de suplementação. A relação entre o preço da L-arginina e o preço de venda dos leitões determinou diretamente a viabilidade econômica, comparado ao grupo controle. Assim, considerando inicialmente o preço de um leitão como R$ 9,76/kg, o custo da L-arginina não deve exceder 6,61 vezes esse valor; isto é, estima-se em até R$ 64,50. Portanto, ao preço final de L-arginina de R$ 54,88, um leitão deve ser vendido ao preço de R$ 8,30/kg para tornar a suplementação de L-arginina na dieta de matrizes suínas em fase de lactação economicamente viáveis.

ABSTRACT The objective of this study was to evaluate the economic viability of L-arginine supplementation in diets for sows during the lactation phase. A descriptive case study was carried out to identify the economic viability of the supplementation of L-arginine in the lactation ration, in relation to the control diet, on the productive performance of hyper prolific sows and their litters. The study was carried out on a commercial farm located in the state of Minas Gerais. It analyzed feasibility criteria such as the marginal physical product (MPPg) and gross margin (GM) in the scenario of technical and economic efficiency, which were compared to the GM in the control group. Technical efficiency was established at 0.71% of L-arginine in daily feed intake according to previous fieldwork by the authors, while economic efficiency obtained in this study was 0.43% supplementation. The relationship between the L-arginine price and the sale price of the piglets directly determined the economic viability, compared to the control group. Thus, initially considering the price of a piglet as R$ 9.76/kg, the cost of L-arginine should not exceed 6.61 times this value; that is, it is estimated at up to R$ 64.50. Therefore, at the final price of L-arginine of R$ 54.88, a piglet should be sold at a price of R$ 8.30/kg to make the supplementation of L-arginine in the diet of lactation-phase swine economically possible.

https://doi.org/10.1590/s1519-9940210412020 1012 downloads

12.

Sodium sulfate attack on Portland cement structures: experimental and analytical approach
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Costa, Laís Cristina Barbosa

; Escoqui, João Mário Roque

; Oliveira, Thais Mayra

; Fonseca, Leonardo Goliatt da

; Farage, Michèle Cristina Resende

REM - International Engineering Journal

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Dez 2018, Volume 71 Nº 4 Páginas 531 - 542

Resumo: En | Texto: En | PDF: En

Abstract The industrial development and the advance of the primary sector in Brazil generated an increase in the cases of structures damaged by sulfate attacks. A reduction in material lifetime is one of the most costly factors in the construction field. Therefore, it is necessary to understand the sulfate attack mechanism in order to provide repairs and prevent further attacks. This article aims to understand how the environmental condition and the material properties influence the attack’s severity. Hence, it combined an experimental program and analytical model to measure those parameter effects. Experiments show that cement with a higher amount of tricalcium aluminate (C3A), as the CP V ARI, presented a more pronounced deterioration. Visual changes such as cracking, crystallization of expansive products and a complete disintegration were also observed. In addition, loss of resistance occurred in the specimens with low slag content. Moreover, the model is useful to predict the delamination depth and to identify the most critical factors influencing the attack through sensitive analysis. Its results were compared with real cases based on literature and verifying the model reliability.

https://doi.org/10.1590/0370-44672018710009 2033 downloads

13.

Peritoneal carcinomatosis treated with cytoreductive surgery and intraperitoneal chemotherapy
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Hanan, Bernardo

; Fonseca, Leonardo Maciel

; Profeta da Luz, Magda Maria

; Lacerda-Filho, Antônio

; Cabral, Mônica Maria Demas Álvares

; Gomes da Silva, Rodrigo

Journal of Coloproctology (Rio de Janeiro)

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Jun 2018, Volume 38 Nº 2 Páginas 172 - 178

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: O objetivo foi avaliar o tratamento combinado da cirurgia citorredutora e quimioterapia intraperitoneal em pacientes com carcinomatose peritoneal secundária ao câncer colorretal, pseudomixoma peritoneal e mesotelioma. Métodos: Foram obtidos dados de 73 pacientes com carcinomatose peritoneal secundária ao cirurgia citorredutora (52.1%), pseudomixoma peritoneal (41,1%) ou mesotelioma (6,8%). Foram avaliados o grau de morbidade, a taxa de mortalidade e as taxas de sobrevida após a cirurgia citorredutora e quimioterapia intraperitoneal. Resultados: 41 (56,2%) pacientes do sexo feminino participaram, com média de idade de 50 anos. 39 pacientes (53,4%) foram submetidos a cirurgia citorredutora completa e quimioterapia intraperitoneal. Todos esses receberam Mitomicina C, sendo 16/39 (41%) quimioterapia intraperitoneal hipertérmica (41–42°C). A morbidade global foi 23,3%, com taxa de mortalidade global de 5,5%. A análise univariada mostrou que câncer colorretal e quimioterapia intraperitoneal (p = .029), transfusão sanguínea (p = .002) e tempo operatório (p = .001) foram associados com complicações pós-operatórias. Pacientes com carcinomatose peritoneal secundária ao cirurgia citorredutora submetidos a cirurgia citorredutora completa e quimioterapia intraperitoneal tiveram sobrevida global de 81,3%; 12,5% e 12,5% em 1, 3 e 5 anos, respectivamente. Os pacientes com pseudomixoma peritoneal que foram submetidos a cirurgia citorredutora completa e quimioterapia intraperitoneal tiveram sobrevida global de 84,2%; 77,7% e 77.7% em 1, 3 e 5 anos, respectivamente. Conclusão: O tratamento combinado para carcinomatose peritoneal é seguro quando realizado em centros terciários com experiência no procedimento. Embora mais da metade dos pacientes tenham sido submetidos a quimioterapia intraperitoneal normotérmica após a cirurgia citorredutora completa, os resultados podem ser comparados a de outros centros que utilizam exclusivamente a quimioterapia hipertérmica.

ABSTRACT Introduction: To evaluate the combined treatment with cytoreductive surgery and intraperitoneal chemotherapy for peritoneal carcinomatosis arising from colorectal cancer, pseudomyxoma peritonei and mesothelioma. Methods: Data were obtained from 73 patients with peritoneal carcinomatosis arising from colorectal cancer (52.1%), pseudomyxoma peritonei (41.1%) or mesothelioma (6.8%) between 2002 and 2011. We reported the morbidity grade (II, III and IV), mortality and survival rates of the candidates after cytoreductive surgery and intraperitoneal chemotherapy. Results: 41 (56.2%) women participated, and the median age was 50 years. Thirty-nine patients (53.4%) underwent complete cytoreductive surgery and intraperitoneal chemotherapy. Patients who underwent a complete cytoreduction received intraperitoneal chemotherapy with mitomycin C, from which only 16/39 (41%) had hyperthermic intraperitoneal chemotherapy (41–42 °C). The overall morbidity rate was 23.3% and the grade III/IV complication rate was 12.3%. The overall mortality rate was 5.5%. The univariate analysis showed that cytoreductive surgery and intraperitoneal chemotherapy (p = .029), a blood transfusion (p = .002) and the operative time (p = .001) were significant for the occurrence of postoperative complications. Patients with peritoneal carcinomatosis from colorectal cancer who underwent complete cytoreductive surgery and intraperitoneal chemotherapy had overall survival rates of 81.3%, 12.5% and 12.5% at 1, 3 and 5 years, respectively. Patients with peritoneal carcinomatosis from pseudomyxoma peritonei who underwent complete cytoreductive surgery and intraperitoneal chemotherapy had overall survival rates of 84.2%, 77.7% and 77.7% at 1, 3 and 5 years, respectively. Conclusion: The combined treatment for peritoneal carcinomatosis may be performed safely with acceptable morbidity and mortality in a specialized unit setting. Although over half of patients underwent normothermic intraperitoneal chemotherapy, our results were comparable to results from others centers.

https://doi.org/10.1016/j.jcol.2017.11.006 993 downloads

14.

Arginine improves nutritional quality of sow milk and piglet performance
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Moreira, Rennan Herculano Rufino

; Lanferdini, Eloiza

; Fonseca, Leonardo da Silva

; Chaves, Rhuan Filipe

; Garbossa, Cesar Augusto Pospissil

; Saraiva, Alysson

; Nogueira, Eduardo Terra

; Abreu, Márvio Lobão Teixeira de

Revista Brasileira de Zootecnia

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2018, Volume 47 elocation e20170283

Resumo: En | Texto: En | PDF: En

ABSTRACT The objective of this study was to evaluate the effect of L-arginine supplementation in lactation diets on the productive and reproductive performance of pluriparous sows and their litters. Seventy-six sows of the same genetic line were assigned to four treatments in a completely randomized design with 19 replicates. The experimental unit was the sow and its respective litter. Treatments comprised a control diet (no L-arginine supplementation) and other three diets obtained by top dressing the control diet with 0.5, 1.0, and 1.5% of L-arginine. L-arginine supplementation had no effect on any performance variables, body condition, milk production, or weaning-estrus interval. There was a quadratic effect on percentage of protein and fat in milk as well as on the daily production of these components. Protein and fat percentage declined during lactation. Adding L-arginine to the diet had a quadratic effect on piglet weight at 13 and 21 days, the optimal level of L-arginine supplementation being estimated as 0.64% and 0.71%, respectively. L-arginine supplementation had a quadratic effect on the weight gain of piglets during the first 13 days and on total period of lactation, the optimal level of L-arginine supplementation being estimated as 0.60% and 0.70%, respectively. Supplementing lactation diets with 0.70% of L-arginine, corresponding to 45 g day−1, improves the weight gain of piglets by improving the nutritional quality of sow milk.

https://doi.org/10.1590/rbz4720170283 1033 downloads

15.

Fatores associados a não reconstrução do trânsito intestinal em pacientes com câncer retal submetidos à ressecção anterior do reto e ileostomia de proteção.
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da-Fonseca, Leonardo Maciel

; Buzatti, Kelly Cristine de Lacerda Rodrigues

; Castro, Luísa Lima

; Lacerda Filho, Antônio

; Correia, Maria Isabel Toulson Davisson

; da-Silva, Rodrigo Gomes

Revista do Colégio Brasileiro de Cirurgiões

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2018, Volume 45 Nº 6 elocation e1998

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RESUMO Objetivo: avaliar os fatores associados ao não fechamento de ileostomia protetora após ressecção anterior do reto com excisão total do mesorreto por câncer retal, a morbidade associada ao fechamento destas ileostomias e a taxa de estomia permanente em pacientes com adenocarcinoma retal. Métodos: estudo retrospectivo de 174 pacientes consecutivos com diagnóstico de tumores retais, dos quais 92 foram submetidos à ressecção anterior do reto com intenção curativa, anastomose coloanal ou colorretal e ileostomia de proteção. Foi realizada análise multivariada visando a determinar os fatores associados à permanência definitiva da estomia, assim como o estudo da morbidade nos que se submeteram à reconstrução do trânsito. Resultados: no período de seguimento de 84 meses, 54 dos 92 pacientes avaliados (58,7%) tiveram a ileostomia fechada e 38 (41,3%) permaneceram com a estomia. Entre os 62 pacientes que tiveram a ileostomia fechada, 11 (17,7%) apresentaram algum tipo de complicação pós-operatória: três com deiscência de anastomose ileal, cinco com obstrução intestinal, dois com infecção de ferida operatória e um com pneumonia. Oito destes pacientes necessitaram de um novo estoma. Conclusão: de acordo com a análise multivariada, os fatores associados à permanência da estomia foram fístula de anastomose, presença de metástases e fechamento da ileostomia durante quimioterapia.

ABSTRACT Objective: to evaluate the factors associated with non-closure of protective ileostomy after anterior resection of the rectum with total mesorectum excision for rectal cancer, the morbidity associated with the closure of ileostomies and the rate of permanent ileostomy in patients with rectal adenocarcinoma. Methods: we conducted a retrospective study with 174 consecutive patients diagnosed with rectal tumors, of whom 92 underwent anterior resection of the rectum with coloanal or colorectal anastomosis and protective ileostomy, with curative intent. We carried out a multivariate analysis to determine the factors associated with definite permanence of the stoma, as well as studied the morbidity of patients who underwent bowel continuity restoration. Results: In the 84-month follow-up period, 54 of the 92 patients evaluated (58.7%) had the ileostomy closed and 38 (41.3%) remained with the stoma. Among the 62 patients who had the ileostomy closed, 11 (17.7%) presented some type of postoperative complication: three had ileal anastomosis dehiscence, five had intestinal obstruction, two had surgical wound infection, and one, pneumonia. Eight of these patients required a new stoma. Conclusion: according to the multivariate analysis, the factors associated with stoma permanence were anastomotic fistula, presence of metastases and closure of the ileostomy during chemotherapy.

https://doi.org/10.1590/0100-6991e-20181998 1946 downloads

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