Abstract Objective To analyze the knowledge of older individuals in a municipality in the Midwestern region of Santa Catarina regarding the development of Advance Directives, their preferences regarding the available models, and the selection of a representative to make decisions on their behalf. Method Cross-sectional study carried out by providing participants with two models of Advance Directives were made available to the participants for completion and applied a questionnaire on knowledge, acceptance, and evaluation of the device. Results There were 85.63% of the participants who were unaware of the Advance Directives, 98.13% who were unaware of document models, 100% who considered model 1, more complete, to be good or acceptable, and 66.88% who indicated an adult child as its representative. When asked about the importance of preparing, making available to the population, and passing a law that regulates this right, the participants were assertive respectively by 91.88%, 91.25% and 91.25%. Conclusion Most older people were unaware of the AD models, but mentioned model 1, considering it good or acceptable. Most had no difficulties in understanding and recognized the importance of preparing and making AD available to the population, as well as the need for a law to regulate this right. There was a high proportion of participants indicating an adult child as a legal representative, emphasizing the importance of involving the family in this process. These results highlight the need to make older people aware of AD and provide clear and comprehensive models.

Resumo Objetivo Analisar o conhecimento da pessoa idosa em um município do meio oeste catarinense acerca da elaboração das Diretivas Antecipadas de Vontade (DAV), a sua preferência em relação aos modelos de preenchimento e a escolha do representante que irá substitui-la na tomada de decisão. Método Estudo transversal realizado por meio da disponibilização aos participantes de dois modelos de DAV para preenchimento e aplicação de um questionário sobre conhecimento, aceitação e avaliação do dispositivo. Resultados A maioria dos participantes (85,63%) desconhecia as DAV; 98,13% desconheciam os modelos do documento; 100% consideraram bom ou aceitável o modelo 1, mais completo; 66,88% indicaram um filho como representante legal. Questionados sobre a importância da elaboração, disponibilização à população e aprovação de lei que regulamente esse direito, as respostas foram afirmativas, respectivamente, para 91,88%, 91,25% e 91,25% dos participantes. Apenas 5% dos respondentes apontaram dificuldades no entendimento dos modelos, sendo a “linguagem” o item de maior dificuldade. Conclusão A maioria das pessoas idosas desconhecia os modelos de DAV, mas referiram o modelo 1, considerando-o bom ou aceitável. A maioria não teve dificuldades no entendimento e reconheceu a importância da elaboração e disponibilização das DAV à população, assim como a necessidade de uma lei para regulamentar esse direito. Observou-se uma alta proporção de participantes indicando um filho como representante legal, enfatizando a importância de envolver a família nesse processo. Esses resultados ressaltam a necessidade de conscientizar as pessoas idosas sobre as DAV e disponibilizar modelos claros e abrangentes.

RESUMO OBJETIVO Sumarizar as principais evidências de intervenções educativas delineadas para o aumento dos níveis de atividade física (AF) em adultos brasileiros. MÉTODOS Revisão sistemática de estudos de intervenção conduzidos no Brasil, que implementaram componentes educativos com a finalidade de promover o aumento dos níveis de AF em populações de adultos (18 a 65 anos). Em outubro de 2020, buscas sistemáticas foram conduzidas em seis bases de dados e nas listas de referências dos artigos avaliados. RESULTADOS Dos 2.511 artigos iniciais, nove compuseram a síntese. Foram observadas amostras com características específicas (como vulnerabilidade social, inatividade física e sobrepeso ou obesidade), com maior número de mulheres. Cinco intervenções (55,6%) ocorreram nos cenários da atenção primária à saúde (APS) do Sistema Único de Saúde (SUS). Apenas em quatro estudos (44,4%) houve descrição dos referenciais pedagógicos estruturantes das abordagens educativas, dentro os quais o aconselhamento se configurou como a estratégia mais utilizada, como aquelas realizadas por meio de encontros presenciais, visitas domiciliares, palestras e chamadas telefônicas (n = 8; 88,9%). Resultados positivos foram observados em três distintos indicadores: aumento do volume semanal de AF (n = 4); aumento do índice de AF no lazer (n = 1); e aumento da proporção de mulheres classificadas como “muito ativas/ativas” (n = 1). Visto as especificidades amostrais, o domínio “seleção dos participantes” apresentou elevado número de intervenções com alto risco de viés. CONCLUSÕES As abordagens educativas produziram alguns efeitos positivos em distintos indicadores de AF, destacando-se o aconselhamento como principal estratégia utilizada e as abordagens que envolveram outras temáticas de saúde, como nutrição e estresse. Contudo, frente aos diversos determinantes da AF no Brasil, é importante que futuras intervenções sejam conduzidas em variadas localizações do país, de forma que avaliem, de maneira mais ampla, seus processos de implementação e articulação com os distintos profissionais que atuam na APS.

ABSTRACT OBJECTIVE To summarize the main evidence from educational interventions designed to increase levels of physical activity (PA) among Brazilian adults. METHODS Systematic review of intervention studies carried out in Brazil that implemented educational components aimed at promoting increased levels of PA among adult populations (18 to 65 years old). In October 2020, systematic searches were conducted in six databases, and in the reference lists of the assessed studies. RESULTS Of the initial 2,511 studies, nine were included in the synthesis. Samples with specific characteristics (such as social vulnerability, physical inactivity, and overweight or obesity) were observed, with a greater number of women. Five interventions (55.6%) occurred in primary healthcare settings (PHC) of the Brazilian Unified Health System (SUS). Only four studies (44.4%) described the pedagogical frameworks structuring the educational approaches, among which counseling was the most used strategy, such as those carried out through face-to-face meetings, home visits, lectures, and phone calls (n = 8; 88.9%). Positive results were observed in three different indicators: increase in weekly PA volume (n = 4); increase in leisure-time PA rate (n = 1); and increase in the proportion of women classified as “very active/active” (n = 1). Given the sampling specificities, the domain “participant selection” showed a high number of interventions with high risk of bias. CONCLUSIONS Educational approaches engendered some positive effects on different PA indicators, notably counseling as the main strategy used and approaches involving other health themes, such as nutrition and stress. However, considering the several determinants of PA in Brazil, future interventions should be conducted in different locations of Brazil in order to evaluate, in a broader way, their implementation processes and articulation with the many professionals working in PHC.

RESUMO OBJETIVO Sumarizar as principais evidências de intervenções educativas delineadas para o aumento dos níveis de atividade física (AF) em adultos brasileiros. MÉTODOS Revisão sistemática de estudos de intervenção conduzidos no Brasil, que implementaram componentes educativos com a finalidade de promover o aumento dos níveis de AF em populações de adultos (18 a 65 anos). Em outubro de 2020, buscas sistemáticas foram conduzidas em seis bases de dados e nas listas de referências dos artigos avaliados. RESULTADOS Dos 2.511 artigos iniciais, nove compuseram a síntese. Foram observadas amostras com características específicas (como vulnerabilidade social, inatividade física e sobrepeso ou obesidade), com maior número de mulheres. Cinco intervenções (55,6%) ocorreram nos cenários da atenção primária à saúde (APS) do Sistema Único de Saúde (SUS). Apenas em quatro estudos (44,4%) houve descrição dos referenciais pedagógicos estruturantes das abordagens educativas, dentro os quais o aconselhamento se configurou como a estratégia mais utilizada, como aquelas realizadas por meio de encontros presenciais, visitas domiciliares, palestras e chamadas telefônicas (n = 8; 88,9%). Resultados positivos foram observados em três distintos indicadores: aumento do volume semanal de AF (n = 4); aumento do índice de AF no lazer (n = 1); e aumento da proporção de mulheres classificadas como “muito ativas/ativas” (n = 1). Visto as especificidades amostrais, o domínio “seleção dos participantes” apresentou elevado número de intervenções com alto risco de viés. CONCLUSÕES As abordagens educativas produziram alguns efeitos positivos em distintos indicadores de AF, destacando-se o aconselhamento como principal estratégia utilizada e as abordagens que envolveram outras temáticas de saúde, como nutrição e estresse. Contudo, frente aos diversos determinantes da AF no Brasil, é importante que futuras intervenções sejam conduzidas em variadas localizações do país, de forma que avaliem, de maneira mais ampla, seus processos de implementação e articulação com os distintos profissionais que atuam na APS.

ABSTRACT OBJECTIVE To summarize the main evidence from educational interventions designed to increase levels of physical activity (PA) among Brazilian adults. METHODS Systematic review of intervention studies carried out in Brazil that implemented educational components aimed at promoting increased levels of PA among adult populations (18 to 65 years old). In October 2020, systematic searches were conducted in six databases, and in the reference lists of the assessed studies. RESULTS Of the initial 2,511 studies, nine were included in the synthesis. Samples with specific characteristics (such as social vulnerability, physical inactivity, and overweight or obesity) were observed, with a greater number of women. Five interventions (55.6%) occurred in primary healthcare settings (PHC) of the Brazilian Unified Health System (SUS). Only four studies (44.4%) described the pedagogical frameworks structuring the educational approaches, among which counseling was the most used strategy, such as those carried out through face-to-face meetings, home visits, lectures, and phone calls (n = 8; 88.9%). Positive results were observed in three different indicators: increase in weekly PA volume (n = 4); increase in leisure-time PA rate (n = 1); and increase in the proportion of women classified as “very active/active” (n = 1). Given the sampling specificities, the domain “participant selection” showed a high number of interventions with high risk of bias. CONCLUSIONS Educational approaches engendered some positive effects on different PA indicators, notably counseling as the main strategy used and approaches involving other health themes, such as nutrition and stress. However, considering the several determinants of PA in Brazil, future interventions should be conducted in different locations of Brazil in order to evaluate, in a broader way, their implementation processes and articulation with the many professionals working in PHC.

ABSTRACT The objective with this study was to determine the lysine maintenance requirements (LMR) of male and female broilers as animal models. A total of 252 birds were used for nitrogen balance trials during three periods (I: 6-21, II: 22-37, and III: 38-53 days). Six lysine levels were used (2.76, 5.88, 8.99, 12.1, 15.2, and 18.3 g kg−1) with six replications. A control group also included, totalizing seven treatments for males and females for each assay. The experimental period was 15 days. The response variables included nitrogen intake (NI) and excretion (NEX), and their difference was assumed to be deposited as nitrogen. An exponential regression between NEX and lysine intake (LI) was fitted, and LMR was estimated when LI = 0. The daily values for LMR were 9.29, 33.4, and 40.2 mg BW0.67 kg−1 for males and 9.36, 30.0, and 39.4 mg BW0.67 kg−1 for females. The final value for both sexes were 10.1 (period I), 31.5 (period II), and 39.8 mg BW0.67 kg−1 (period III). Expressed as body protein weight at maturity (BPm), the LMR were 172 and 148 (period I), 216 and 207 (period II), and 189 and 180 mg BPm0.73 kg−1 (period III) for males and females, respectively. The results provided ranges of LMR values recommended in previous studies, validating this procedure. The procedure to estimate the requirements presented here provides new insights into the model of amino acid requirement estimations.

RESUMO O intuito desta pesquisa foi analisar o ajuste da função Gompertz fixando, ou não alguns parâmetros para descrever o crescimento corporal e dos principais constituintes químicos corporais de frangas de postura em crescimento. Foram coletados semanalmente os dados de peso corporal e os componentes químicos da carcaça depenada e penas de 1.200 pintainhas de quatro linhagens de postura: Hisex marrom, Hisex branca, Hy Line marrom e Hy Line branca W36, até a 18ª semana de idade. As variáveis foram submetidas a dois ajustes, fixando-se ou não alguns parâmetros da função Gompertz. Foram calculados os parâmetros de um modelo alométrico para os componentes químicos. Lipídeo e proteína foram os componentes da carcaça depenada com maior variação nas últimas semanas. Por outro lado, a composição química da pena apresentou pouca variação. Os parâmetros da função Gompertz assumiram valores de acordo com o ajuste empregado, sobretudo para proteína e gordura da carcaça depenada. O ajuste da função Gompertz, fixando os dois parâmetros, permitiu coerência e significado biológico. Os coeficientes alométricos indicaram que à medida que aumentou o peso proteico, aumentou a proporção de gordura e reduziu a proporção de água e cinzas no corpo. O ajuste do modelo, fixando os parâmetros, possibilita coerência com significado biológico, sem perder a precisão nas estimativas.

ABSTRACT The purpose of this research was analyze the fit of Gompertz function with or without fixing some of the parameters to describe body growth and major bodily chemical constituents of growing pullets. Weekly, data of body weight and chemical components of body free of feathers and feathers were collected from 1,200 chicks of four laying strains (Hisex Brown, Hisex White, Hy Line Brown and Hy Line White W36) until 18 weeks of age. The variables were subjected to two adjustments fixing, or not, some parameters of Gompertz function. The allometric model parameters were calculated for the chemical components. The lipid and protein composition of the body free of feathers were the components with the biggest change in the last weeks. Moreover, the chemical composition of the feather showed small variation. The parameters of the Gompertz function assumed values according to the employed adjustment, especially for protein and fat of the body free of feathers carcass. The adjustment of the Gompertz function by fixing the two parameters allowed coherence and biological significance. The allometric coefficients indicate that as the protein weight increased, the proportion of fat increased and the proportion of water and ashes in the body decreased. The fit of the model allows setting the parameters with consistency and biological significance without losing accuracy in the estimates.

RESUMO: Objetivou-se avaliar o efeito da inclusão de glicerina na dieta de cabritos sobre o consumo, desempenho e características de carcaça. Foram utilizados 20 cabritos não castrados, mestiços Boer, com peso corporal médio de 25,06±4,15 kg e 8,00±0,66 meses de idade, distribuídos em blocos ao acaso, com quatro tratamentos e cinco repetições. Os tratamentos consistiram da inclusão de glicerina (87% de glicerol) na dieta, em substituição ao milho, em quatro níveis de concentração: zero, cinco, 10 e 15% na matéria seca (MS). Não foi encontrada influência (P>0,05) da glicerina na dieta sobre o consumo de volumoso e a conversão alimentar. Os consumos de concentrado e de MS total foram afetados (P<0,05) pelo nível de glicerina na MS, com redução nos animais que receberam o mais alto nível. Não houve efeito (P>0,05) dos níveis de glicerina para ganho de peso, rendimento de carcaça e perdas por resfriamento. Entretanto, houve efeito (P<0,05) para peso da carcaça quente e fria para os animais alimentados com 15% de glicerina. A inclusão de até 15% de glicerina na dieta de cabritos mestiços Boer, embora não afete a conversão alimentar e o desempenho, compromete o consumo e o peso da carcaça dos animais.

ABSTRACT: This experiment aimed to evaluate the effect of including glycerin in kid goats diet on intake, performance and carcass traits. Twenty intact male kid goats Boer crossbred were used, with body weight of 25.06±4.15kg and 8.00±0.66 months old, allocated in block design, with four treatments and five replicates. The treatments consisted on including dry matter basis (DM) of the diet of four levels of glycerin: zero, five, 10 and 15%, in replacing corn. It was not reported influence (P>0.05) of level of glycerin on intake of forage and feed conversion of animals. The concentrate and total DM intake were affected (P<0.05) for the level of glycerin in DM, with reduction in the animals that received the highest level. It was not reported influence (P>0.05) of level of glycerin on weight gain, carcass yield and percentage of cooling losses. However, the hot and cold carcass weight was lower (P<0.05) to the animals feed with 15% of glycerin. The inclusion up to 15% of glycerin in the diet of kid goats Boer crossbred, although did not affect feed conversion and performance, compromised the intake and carcass weight.

ABSTRACT Objectives To evaluate the clinical practice of non-muscle invasive bladder cancer (NMIBC) treatment in Brazil in relation to international guidelines: Sociedade Brasileira de Urologia (SBU), European Association of Urology (EAU) and American Urological Association (AUA). Materials and Methods Cross-sectional study using questionnaires about urological practice on treatment of NMIBC during the 32nd Brazilian Congress of Urology. A total of 650 question forms were answered. Results There were 73% of complete answers (total of 476 question forms). In total, 246 urologists (51.68%) lived in the southeast region and 310 (65.13%) treat 1 to 3 cases of NMIBC per month. Low risk cancer: Only 35 urologists (7.5%) apply the single intravesical dose of immediate chemotherapy with Mitomicin C recommended by the above guidelines. Adjuvant therapy with BCG 2 to 4 weeks after TUR is used by 167 participants (35.1%) and 271 urologists (56.9%) use only TUR. High risk tumors: 397 urologists (83.4%) use adjuvant therapy, 375 (78.8%) use BCG 2 to 4 weeks after TUR, of which 306 (64.3%) referred the use for at least one year. Intravesical chemotherapy with Mitomicin C (a controversial recommendation) was used by 22 urologists (4.6%). BCG dose raised a lot of discrepancies. Induction doses of 40, 80 and 120mg were referred by 105 (22%), 193 (40.4%) and 54 (11.3%) respectively. Maintenance doses of 40, 80 and 120mg were referred by 190 (48.7%), 144 (37.0%) and 32 (8.2%) urologists, respectively. Schemes of administration were also varied and the one cited by SWOG protocol was the most used: 142 (29.8%). Conclusion SBU, EAU and AUA guidelines are partially respected by Brazilian urologists, particularly in low risk tumors. In high risk tumors, concordance rates are comparable to international data. Further studies are necessary to fully understand the reasons of such disagreement.

The objective of this study was to measure the response of Dekalb White laying hens to different intakes of digestible methionine + cystine (met+cys) to optimise their performance. Two hundred eighty-eight Dekalb White laying hens, ranging in age from 33 to 48 weeks, were used in the study. The birds were randomly allocated into eight treatment (levels of met+cys and the control treatment) groups with six replicates of six hens per unit. The experimental diets consisted of seven increasing levels of met+cys (1.37, 2.75, 4.14, 5.51, 6.89, 7.92 and 8.95 g kg−1) and were prepared using a dilution technique. A control treatment was used to confirm that the limiting response was due to met+cys intake. Egg production, feed intake, egg weight, egg mass and feed conversion per mass were measured. The data were analysed with repeated measures and regression analyses using Broken Line and Quadratic models, as well as using the combination of both models. The different met+cys intakes influenced the studied variables; all the variables except feed conversion per mass were significantly different between the periods and levels. The digestible met+cys intakes based on the association of the Broken Line and Quadratic models to optimise the birds' response to egg mass are 671 mg/bird d for 33 to 36 weeks, 728 mg/bird d for 37 to 40 weeks, 743 mg/bird d for 41 to 44 weeks, and 770 mg/bird d for 45 to 48 weeks.

O objetivo deste estudo foi desenvolver um procedimento baseado na função Gompertz para determinar a eficiência de utilização do aminoácido. O procedimento foi aplicado para determinar a eficiência de utilização da lisina, metionina+cistina e treonina da dieta de frangas de postura em crescimento, e com base nas eficiências foram estimadas as exigências para fase de crescimento das aves. A função Gompertz foi ajustada aos dados de consumo de ração, peso corporal, peso proteico do corpo depenado e peso de penas de quatro linhagens de aves de postura na fase de crescimento. As taxas de consumo e deposição diária de proteína (DP) foram calculadas. A deposição do aminoácido foi obtida multiplicando a DP pela concentração do aminoácido nas penas e corpo depenado. Os resultados obtidos demonstraram que as eficiências de utilização dos aminoácidos diminuíram com a maturidade e, inversamente, houve um aumento proporcional da exigência por kg de ganho de peso. O procedimento baseado na função Gompertz para determinar a eficiência de utilização do aminoácido mostrou ser adequado para avaliar a eficiência de utilização do aminoácido e pode ser uma ferramenta útil para diagnosticar a eficácia do manejo nutricional auxiliando na tomada de decisões sobre o manejo nutricional.

The aim of this study was to develop a procedure based on Gompertz function to determine the efficiency of utilization of amino acid. The procedure was applied to determine the efficiency of utilization of dietary lysine, methionine+cystine and threonine by growing pullets and based on the efficiencies were estimated the requirements for the growth phase of birds. The Gompertz function was fitted to the data of feed intake, body weight, feather-free body protein weight and feather protein weight of four strains of laying hens in the growth phase. The rates of consumption and daily protein deposition (PD) were calculated. The amino acid deposition was obtained by multiplying the PD by the amino acid concentration in feather protein and feather-free body protein. The results showed that the efficiency of utilization of amino acid decreased with maturity and, conversely, there was a proportional increase of the requirement per kg of weight gain. The procedure based on the Gompertz function to determine the efficiency of utilization of amino acid proved to be suitable to evaluate the efficiency of utilization of amino acid and can be a useful tool to diagnose the effectiveness of the nutritional management, aiding in decision-making on the nutritional management.

Broiler strains available in the poultry industry present different requirements for dietary lysine due to their different growth potentials as a result of their genetic makeup. This study aimed to determine the model parameters for maximum nitrogen retention (NRmaxT), the nitrogen maintenance requirement (NMR) and the efficiency of lysine utilization (bc-1) to reevaluate the lysine (Lys) requirements of male and female broilers. Nitrogen balance trials were performed during three periods (I: 6-21 days, II: 22-37 days, and III: 38-53 days). Seven treatments were used for males and females; the treatments consisted of seven diets with protein levels ranging from 61 to 364 g kg-1 dry matter, with Lys being limiting in the dietary nitrogen (4.91 g of Lys in 16 g of N). Nitrogen intake (NI), excretion (NEX), deposition (ND, ND=NI-NEX) and retention (NR, NR=ND+NMR) values were obtained. The NMR was represented by the exponential relationship between NEX and NI. The NRmax T and bc-1 were estimated by the exponential fit between ND and NI. The NRmax T, bc-1, and NMR values were combined in a model to estimate Lys intake by simulating different percentages of the NRmaxT. The Lys intake estimates were 581, 1,538, and 2,171 mg day-1 for males and 512, 1,340, and 1674 mg day-1 for females during periods I, II, and III, respectively. Due to the flexibility of the model, it is possible to calculate the Lys intake for percentages of NR in the range of practical performance data.

Foram avaliados 24 touros da raça Guzerá, de 24 a 34 meses de idade, com o objetivo de estudar o perfil da concentração sérica de testosterona e sua variação relativa à idade, peso corporal e características andrológicas. A concentração média de testosterona foi de 1,36 ng/mL, com influência do horário de coleta nos níveis circulantes. A equação de regressão da concentração sérica de testosterona em função do peso corporal dos animais apresentou efeito linear, sugerindo que, para cada quilograma a mais no peso corporal, ocorre acréscimo de 0,0082 ng/mL nas concentrações de testosterona. A regressão da concentração sérica de testosterona e a circunferência escrotal (CE) também apresentou efeito linear indicando que, para cada centímetro a mais na CE nos touros Guzerá, ocorreu aumento de 0,2319 ng/mL na concentração de testosterona. A regressão da concentração espermática do sêmen em função da concentração sérica de testosterona apresentou efeito linear, os resultados mostram que, para cada 0,1 ng/mL a mais na concentração de testosterona circulante, ocorreu aumento de 9,29 x 10(6) espermatozoides/mL de sêmen. Os resultados indicam que os níveis circulantes de testosterona podem auxiliar na identificação e seleção de touros Guzerá, com maior potencial reprodutivo.

Twenty-four Guzerat bulls were evaluated from 24 to 34 months of age, aiming to determinate the bulls serum testosterone concentration profile and their variation according to age, body weight and andrologic traits. The average of testosterone concentration was 1.36 ng/mL, with effect of time at harvest on circulating levels. The regression equation of testosterone according to body weight showed linear effect, suggesting that for each kilogram added to the body weight, an increase of 0.0082 ng/mL on serum testosterone concentrations occurs; and the regression of testosterone according to scrotal circumference (SC) also showed a linear effect. The results show that for each centimeter added to SC in Guzerat bulls, an increase of 0.2319 ng/mL on testosterone concentrations occurs. The regression of sperm concentration according to serum testosterone showed a linear effect, the results show that for each 0.1 ng/mL added to serum testosterone concentration, an increase of 9.29x10(6) spermatozoa/mL of semen occurs. The results indicate that circulating levels of testosterone may help on identification and selection of Guzerat bulls with major reproductive potential.

Introduction Open inguinal lymphadenectomy is the gold standard for the treatment of inguinal metastasis in patients with penile cancer (PC). Recently the Video Endoscopic Inguinal Lymphadenectomy (VEIL) was proposed as an option to reduce the morbidity of the procedure in patients without palpable inguinal lymph nodes (PILN), however the oncological equivalency in patients with PILN remains poorly studied. The aims of this video are the demonstration of VEIL in patients with PILN and present the preliminary experience comparing patients with and without PILN. Materials and Methods The video illustrates the procedure performed in two cases that were previously underwent partial penectomy for PC with PILN. Data from the series of 15 patients (22 limbs operated) with PILN underwent VEIL were compared with our series of VEIL in 25 clinically N0 patients (35 limbs operated). Results The comparison between the groups with and without PILN found, respectively, these outcomes: age 52,45 × 53,2 years, operative time 126,8 × 95,5 minutes, hospital stay 5. × 3.1 days, drainage time 6.7 × 5.7 days, 9 resected lymph nodes on average in both groups, global complications 32% × 26%, cellulitis 4.5% × 0%, lymphocele 23% in both groups, skin necrosis 0% × 3%, myocutaneous necrosis 4.5% × 0%, pN+ 33% × 32%, cancer specific mortality 7% × 5% and mean follow-up 17.3 × 35.3 months. None of the variables presented p < 0.05. Conclusions VEIL is a safe complementary procedure for treatment of PC, even in patients with PILN. Oncological results in patients with PILN seem to be appropriate but are still very premature. Prospective multicenter studies with larger samples and long-term follow-up should be conducted to determine the oncological equivalence of VEIL compared with open surgery in patients with PILN.

Since the first laparoendoscopic single-site (LESS) surgery report in urology in 2007 (1) (Rane A e Cadeddu JA), the few reports of LESS extraperitoneal access in the literature were mainly described for less complex cases. The aim of this video is to demonstrate the feasibility of LESS extraperitoneal access in a morbid obese patient presenting a malignant tumor in the renal pelvis. The patient is positioned in 90-degree lateral decubitus. An incision is made below the abdominal skin crease on the left side of the patient and the anterior rectus fascia is vertically incised with manual dissection of the extra/retroperitoneal space. We use an Alexis® retractor to retract the skin maximizing the incision orifice. Three trocars (12, 10 and 5 mm) are inserted through a sigle-port. The pedicle was controlled “en bloc” with a vascular stapler and the bladder cuff treated by the conventional open approach through the same incision. Operative time was 126 minutes with minimal blood loss. The pathology reported high grade papillary urothelial carcinoma in the pelvis (pT3N0M0) and in the ureter (pTa). LESS extraperitoneal nephroureterectomy is feasible and safe, even in more complex cases. It is a good alternative for morbid obese patients and for patients with synchronous distal ureteral tumors for whom an open approach to the bladder cuff is proposed to avoid incisions in two compartments of the abdominal wall.

Objetivou-se descrever o máximo potencial de deposição de nitrogênio e estimar a ingestão de metionina+cistina pela técnica do balanço de nitrogênio e abate comparativo. Foram realizados ensaios no período de 14 a 28, 56 a 70 e 98 a 112 dias de idade, utilizando 168 frangas Dekalb White, distribuídas em sete tratamentos e oito repetições. Os tratamentos consistiram de níveis de proteína na dieta, variando de 75 a 435 g kg-1 de matéria seca, em que a metionina+cistina foi o primeiro aminoácido limitante. As variáveis coletadas pelo abate comparativo foram nitrogênio ingerido e depositado e, nos ensaios de balanço de nitrogênio, coletaram-se ingestão e excreção de nitrogênio. Por meio da relação exponencial entre ingestão e deposição de nitrogênio, determinou-se a máxima deposição de nitrogênio. As técnicas foram comparadas pelo teste da razão de máxima verossimilhança. As técnicas descrevem de forma diferente o máximo potencial de deposição pela ave, mas são similares na estimativa da exigência de metionina+cistina. Com base em 60% do máximo potencial, as ingestões de metionina+cistina digestível foram estimadas em 163, 243 e 343 mg dia-1 para os período de 14 a 28, 56 a 70 e 98 a 112 dias de idade, respectivamente.

This study aimed to describe the maximum potential of nitrogen deposition and to estimate the intake of methionine+cystine by nitrogen balance and comparative slaughter. Assays were performed in the periodsof 14 to 28, 56 to 70 and 98 to 112 days of age, using 168 Dekalb White pullets, distributed in seven treatments and eight replications. Treatments consisted of protein levels in the diets ranging from 75 to 435 g kg-1 dry matter in which methionine+cystine was the first limiting amino acid. The variables collected by comparative slaughter were nitrogen intake and deposition and, in nitrogen balance trials were collected nitrogen intake and excretion. With the exponential relationship between nitrogen intake and deposition was determined the maximum nitrogen deposition. The techniques were compared by the test of maximum likelihood ratio. The techniques described differently the maximum potential for deposition by the bird, but were similar in the estimation of methionine+cystine. Based on 60% of the maximum potential the intakes of digestible methionine+cystine were estimated at 163, 243 and 343mg day-1 for the period of 14 to 28, 56 to70 and 98 to 112 days of age, respectively.