Abstract Background Argon plasma coagulation (APC) is a non-tactile ablative therapy that helps to stop rectal bleeding in patients who have developed actinic proctitis after exposure to radiotherapy. This approach seems to be more effective than medications or surgical procedures. Objective To review the literature to verify the effectiveness of APC in the treatment of patients with actinic proctitis induced by radiation therapies. Methods A systematic search was conducted on the following databases: MEDLINE/PubMed, LILACS, SCIELO, and the Cochrane Central Register of Controlled Trials. We identified 81 studies, and 5 of them fulfilled the inclusion criteria. Results In the articles included, a total of 236 patients were evaluated. Most of them were men (67.7%) with a mean age of 66.6 years. Prostate cancer was the main cause of actinic proctitis (67.3%), and control of the bleeding was achieved in 83.3% of the cases, after a mean of 1.67 session of APC. Moreover, 66 patients had complications with the treatment, and rectal pain was the most referred. Conclusions Argon plasma coagulation is a well-tolerated and effective treatment to control rectal bleeding in patients who underwent radiotherapy, and the number of sessions varies from 1 to 2, according to the case.

Resumo Fundamento A classificação funcional da New York Heart Association (NYHA) é o sistema de classificação mais utilizado para a insuficiência cardíaca (IC), enquanto o teste de exercício cardiopulmonar (TECP) é o padrão ouro para a avaliação do estado funcional na IC. Objetivo Analisar a correlação e a concordância entre as classes da NYHA e as variáveis do TECP. Métodos Foram selecionados pacientes com IC com indicação clínica para TECP e fração de ejeção (FE) < 50%. A correlação (coeficiente de Spearman) e a concordância (kappa) entre a classificação da NYHA e as classificações baseadas no TECP foram analisadas. Um valor de p < 0,05 foi considerado significativo. Resultados No total, foram incluídos 244 pacientes no estudo. A idade média foi de 56±14 anos, e a FE média foi de 35,5%±10%. A distribuição de pacientes de acordo com a classificação da NYHA foi a seguinte: classe I (31,2%), classe II (48,3%), classe III (19,2%) e classe IV (1,3%). A correlação (r) entre as classes da NYHA e de Weber foi de 0,489 (p < 0,001), e a concordância foi de 0,231 (p < 0,001). A correlação (r) entre as classes da NYHA e ventilatórias (inclinação da ventilação minuto/produção de dióxido de carbono [VE/VCO2]) foi de 0,218 (p < 0,001), e a concordância foi de 0,002 (p = 0,959). A correlação de Spearman entre as classes da NYHA e do escore TECP foi de 0,223 (p = 0,004), e a concordância kappa foi de 0,027 (p = 0,606). Conclusão Foi identificada uma associação moderada entre as classes da NYHA e de Webber, embora a concordância tenha sido baixa. As classes ventilatórias (inclinação VE/VCO2) e do escore TECP apresentaram uma associação fraca e uma baixa concordância com as classes da NYHA.

Abstract Background The New York Heart Association (NYHA) functional classification is the most commonly used classification system for heart failure (HF), whereas cardiopulmonary exercise testing (CPET) is the gold standard for functional status evaluation in HF. Objective This study aimed to analyze correlation and concordance between NYHA classes and CPET variables. Methods HF patients with clinical indication for CPET and ejection fraction (EF) < 50% were selected. Correlation (Spearman coefficient) and concordance (kappa) between NYHA classification and CPET-based classifications were analyzed. A p < 0.05 was accepted as significant. Results In total, 244 patients were included. Mean age was 56 ± 14 years, and mean EF was 35.5% ± 10%. Distribution of patients according to NYHA classification was 31.2%% class I, 48.3% class II, 19.2% class III, and 1.3% class IV. Correlation (r) between NYHA and Weber classes was 0.489 (p < 0.001), and concordance was 0.231 (p < 0.001). Correlation (r) between NYHA and ventilatory classes (minute ventilation/carbon dioxide production [VE/VCO2] slope) was 0.218 (p < 0.001), and concordance was 0.002 (p = 0.959). Spearman correlation between NYHA and CPET score classes was 0.223 (p = 0.004), and kappa concordance was 0.027 (p = 0.606). Conclusion There was a moderate association between NYHA and Weber classes, although concordance was low. Ventilatory (VE/VCO2slope) and CPET score classes had a weak association and a low concordance with NYHA classes.

ABSTRACT The objective was to determine the optimal dehydrated passion fruit pulp replacing ground corn in diets for goat kids. We used 24 crossbred castrated goat kids with initial body weight of 26.6±0.3 kg. The experimental period was 23 days, with 15 days of adjustment and acclimatization (mostly to the installation and diet). Kids were distributed in a randomized experimental design with four treatments of 0, 80, 160, or 240 g/kg of dehydrated passion fruit residue as a supplementary inclusion in the dry matter (DM) content of the diet. The statistical model considered the fixed effect of the included amount of residue from dehydrated passion fruit. Analysis of variance was conducted using the PROC GLM of SAS. Intakes of DM and total digestible nutrients (TDN) were not affected by residue inclusion. However, neutral detergent fiber (NDF) intake increased linearly. The inclusion linearly decreased intake of ether extract (EE) and non-fibrous carbohydrates (NFC). Crude protein (CP) intake was quadratically affected, with a greater value under treatment of 160 g/kg passion fruit. Dry matter and NFC digestibility decreased linearly with the amount of passion fruit included in diet. Fecal N and total N excretion values (in g/d and %N intake) increased linearly. Nitrogen balance and N retained values showed a quadratic increase, with greater values under the 160 g/kg inclusion. Time spent ruminating, DM and NDF eating efficiency, and g DM/bolus chewed were affected quadratically by inclusion of passion fruit residue. The replacement of ground corn with dehydrated passion fruit residue at a level of 160 g/kg is recommended for diets of goat kids to improve their NDF and CP intake and their N balance without affecting DM and TDN intakes.

RESUMO CONTEXTO: Recentemente foi demonstrada associação entre sintomas do trato urinário inferior entre mães e filhos. No entanto, o papel da constipação funcional neste binômio não é claro. OBJETIVO: Avaliar a disfunção vésico-intestinal entre mães e filhos. MÉTODOS: Estudo transversal de base populacional. As mães e os filhos responderam a um questionário de autorresposta, composto pelos critérios de Roma IV, International Consultation on Incontinence Questionnaire - Overactive Bladder, Dysfunctional Voiding Scoring System e perguntas sociodemográficas. RESULTADOS: Foram estudados 441 pares mãe-filho. A idade média dos filhos foi de 9,1±2,7 anos, sendo 249 (56,5%) do sexo feminino. A idade média das mães foi de 35,7±6,1 anos. A constipação sem sintomas do trato urinário inferior estava presente em 35 (7,9%) crianças e 74 (16,8%) mães. Sintomas do trato urinário inferior isolados estavam presentes em 139 (31,5%) crianças e 92 (20,9%) mães e a disfunção vésico-intestinal ocorreu em 51 (11,6%) crianças e 78 (17,7%) mães. Não houve associação entre sintomas isolados do trato urinário inferior em crianças e sintomas isolados do trato urinário inferior em mães (P=0,31). Na análise univariada, houve associação entre disfunção vésico-intestinal em crianças e disfunção vésico-intestinal em mães (OR=4,8 IC 95% 2,6-9,6; P<0,001) e constipação isolada em crianças e constipação isolada em mães (OR=3,0 IC 95 % 1,4-6,4; P=0,003). Na análise multivariada, mães com disfunção vésico-intestinal foi o único fator de associação independente para disfunção vésico-intestinal em crianças (OR=5,4 IC 95% 2,5-11,6; P<0,001). CONCLUSÃO: Mães com disfunção vésico-intestinal têm maior probabilidade de ter filhos com disfunção vésico-intestinal. A associação entre constipação e sintomas do trato urinário inferior desempenha um papel importante nesta apresentação familiar.

ABSTRACT BACKGROUND: Recently it was shown an association between lower urinary tract symptoms in mothers and their children. However, the role of functional constipation in this binomial is unclear. OBJECTIVE: To evaluate bladder and bowel dysfunction between mothers and children. METHODS: A population-based cross-sectional study. Mothers and their children responded a self-administrated questionnaire composed by Rome IV criteria, International Consultation on Incontinence Questionnaire - Overactive Bladder, Dysfunctional Voiding Scoring System and demographic questions. RESULTS: A total of 441 mother-child pairs was obtained. Children’s mean age was 9.1±2.7 years, with 249 (56.5%) female. Mothers’ mean age was 35.7±6.1 years. Isolated constipation was present at 35 (7.9%) children and 74 (16.8%) mothers. Isolated lower urinary tract symptoms were present in 139 (31.5%) children and 92 (20.9%) mothers and bladder bowel dysfunction occurred in 51 (11.6%) children and 78 (17.7%) mothers. There wasn’t any association between isolated lower urinary tract symptoms in children and isolated lower urinary tract symptoms in mothers (P=0.31). In univariate analysis there were an association between bladder bowel dysfunction in children and bladder bowel dysfunction in mothers (OR=4.8 IC 95% 2.6-9.6, P<0.001) and isolated constipation in children and isolated constipation in mothers (OR=3.0 IC 95% 1.4-6.4, P=0.003). In multivariate analysis mothers with bladder bowel dysfunction was the only independent factor associated with bladder bowel dysfunction in children (OR=5.4 IC 95% 2.5-11.6, P<0.001). CONCLUSION: Mothers with bladder bowel dysfunction are more likely to have a child with bladder bowel dysfunction. Association between these two dysfunctions plays an important role in this familiar presentation.

RESUMO Objetivou-se determinar o impacto da inclusão datorta de licuri na dieta de cordeiros em terminação, mestiços de Santa Inês, com base na analise econômica.Utilizou-se 44 cordeiros, não-castrados, vacinados e vermifugados, com média de seis meses de idade e peso corporal médio de 21,2 kg ± 2,7 Kg. Os cordeiros foram alimentados com 40% feno de Tifton-85 e 60% de uma mistura concentrada composta por grão de milho moído, farelo de soja, premix mineral e inclusão de torta de licuri nos níveis 0; 8; 16 e 24% com base na matéria seca em substituição ao farelo de soja egrão de milho moído, com esses níveis constituindo os tratamentos, utilizando-se 11 cordeiros por tratamento em delineamento inteiramente casualizado. Os animais foram confinados por 70 dias. O menor custo operacional e consequente maior lucratividade quando se incluiu a torta de licuri até o nível de 24%. No entanto, a decisão de seu emprego na alimentação de cordeiros vai depender de seu custo no momento da utilização, considerando as possíveis variações de preços dos ingredientes utilizados para formulação das dietas e modelode produção da propriedade rural.

SUMMARY The present study endeavors to determine the impact of the inclusion of licuri tart in the diet of finishing lambs, Santa Inês mestizos, by evaluating the economic parameters. For this purpose, a total of 44 lambs, including both uncastrated as well as vaccinated and wormed lambs, with an average age of six months and a mean body weight of 21.2 kg ± 2.7 kg, were employed. Initially, the lambs were fed on the diet which consisted of 40% Tifton-85 hay and 60% of a concentrated mixture, mainly composed of ground corn grain, soybean meal, mineral premix, being further followed by the inclusion of the licuri cake at four different levels (a) 0.0, (b) 8.0,(c) 16.0, and (d) 24% with respect to the dry matter. Principally, the soybean meal and milled corn were replaced by the licuri cake with these levels, thereby constituting four treatments and 11 replicates (11 lambs per treatment) in a completely randomized design. Further, for subjecting the lambs to the above mentioned four different levels of treatment, the lambs were confined for 70 days. The analysis of various economic parameters revealed that upon including the licuri cake up to the level of 24%, the operation cost decreases, which in turn results in higher profitability. However, its cost at the time of use will eventually determine its use for feeding lambs, because of the possible price variations of the ingredients used to formulate the diets along with the model of production of the rural property.

ABSTRACT Objective Leptin has been suggested as a potential biomarker of cardiovascular risk. This paper aims to ascertain, based on a sample of prepubertal children, which serum leptin value best suited to identify metabolic syndrome (MS). Subjects and methods This observational, cross-sectional study recruited children from the outpatient pediatrics clinic, with the purpose of validating serum leptin level cutoffs to identify MS. All obese and overweight children who met eligibility criteria were included in the study, as was a sample of normal-weight children. The sample underwent clinical assessment and blood fasting glucose, lipid profile, insulin, and leptin were measured. Sensitivity and specificity were estimated for each leptin measurement, using MS as the outcome. These values were used to construct a receiver operating characteristic (ROC) curve. The association between MS and leptin was assessed using logistic models to predict MS. Results A total of 65 normal weight, 46 overweight, and 164 obese children were analyzed (160 boys, 115 girls; age: 93.7 ± 17.8 months). The most appropriate leptin cutoff was 13.4 ng/mL (sensitivity 67.6%; specificity 68.9%; accuracy 72.1%). The logistic model indicated that leptin levels above 13.4 ng/dL were significantly associated with MS and that, for every 1 ng/dL increase in leptin levels, the odds of MS increase by 3% (p = 0.002; OR 1.03; 95% CI 1.01-1.05). Conclusions Leptin may be a useful biomarker of cardiovascular risk in prepubertal children, with an optimal cutoff of 13.4 ng/mL. Identification of potential new risk markers for cardiovascular disease in children could contribute to the development of preventive strategies.

The intake of the dry matter (DM), the crude protein (CP) and the metabolizable energy intake (ME) in megacalories per day (Mcal/day) were not affected by the diets. In contrast, the intake of neutral detergent fiber (NDF), in g/kg BW, increased linearly. An increasing linear effect was also observed for the ether extract (EE) intake, whereas a decreasing linear performance was observed for the non-fibrous carbohydrate (NFC) intake. The digestibility of DM, organic matter and NFC decreased linearly with the sunflower cake inclusion, whereas the digestibility of CP, NDF, and EE were not influenced by the diets. No effect was observed for the concentration of serum glucose or urea nitrogen serum. No effect was observed on the urea nitrogen serum in the hours after feeding; however, including sunflower cake in the diets resulted in a quadratic performance for the serum glucose concentrations in the hours after feeding. The average daily gain (ADG) had a decreasing linear effect, and the food conversions of the DM, CP, NDF, NFC and ME had increasing linear effects. The feeding costs decreased with the level of sunflower cake.