ABSTRACT Objective Determining the etiology of hyperprolactinemia is fundamental for selecting the most appropriate treatment strategy. The aim of this study was to evaluate the usefulness and accuracy of prolactin levels in predicting the etiology of nonphysiological hyperprolactinemia. Subjects and methods In this retrospective study, we reviewed medical records of patients with nonphysiological hyperprolactinemia seen at two neuroendocrine reference centers located in Recife, Brazil, from January 2000 to December 2019. Results The study included 770 patients aged 12-73 years (65% female). The three most frequent etiologies of hyperprolactinemia were prolactinomas (n = 263; 34.2%), drug-induced hyperprolactinemia (n = 160; 20.8%), and macroprolactinemia (n = 120; 15.6%). The highest mean prolactin levels were observed in cases of prolactinomas and idiopathic hyperprolactinemia. Most patients with hyperprolactinemia due to other etiologies had prolactin levels < 100 ng/mL, but these levels were also found in 16.5% of patients with microproplactinomas and in 20% of those with idiopathic hyperprolactinemia. Likewise, prolactin levels largely overlapped among patients with microprolactinomas, macroprolactinemia, and drug-induced hyperprolactinemia. Notably, prolactin levels > 250 ng/mL enabled a clear distinction between the etiologies of macroprolactinoma and nonfunctioning pituitary adenoma. Moreover, prolactin levels > 500 ng/mL were highly suggestive of macroprolactinomas, although they were also found in very few patients (<2%) with microprolactinomas or drug-induced hyperprolactinemia. Conclusion Despite considerable overlap in prolactin levels among the different etiologies of hyperprolactinemia, values > 250 ng/mL allowed a clear distinction between macroprolactinomas and nonfunctioning pituitary adenomas. Furthermore, prolactin levels > 500 ng/mL were almost exclusively found in patients with prolactinomas. strategy Recife Brazil 200 2019 77 1273 12 73 12-7 65% 65 (65 female. female . female) n 263 34.2%, 342 34.2% , 34 2 34.2%) druginduced drug induced 160 20.8%, 208 20.8% 20 8 20.8%) 120 15.6%. 156 15.6% 15 6 15.6%) 10 ngmL ng mL 165 16 5 16.5 Likewise Notably 25 adenoma Moreover 50 <2% (<2% adenomas Furthermore 201 7 127 1 12- (6 26 34.2 3 20.8 15.6 16. <2 (<2 ( 34. 20. 15. (<

ABSTRACT The objective of this study was to evaluate the L-arginine supplemental effects for broilers in the final rearing phase (29 and 42 days), during which they were exposed to heat stress and fed diets with different metabolizable energy levels. Performance, carcass parameters, and physiological and biochemical parameters related to lipid metabolism were evaluated. A completely randomized design was used, in a 3 × 2 factorial arrangement, corresponding to three metabolizable energy levels (3000, 3150, and 3300 kcal/kg) in diets supplemented or not with L-arginine (0.66%). Eight replicates composed by eight broilers each (experimental units; boxes) per treatment were evaluated, totaling 48 experimental units. Performance was evaluated in the period from 29 to 42 days old, and carcass and blood parameters were measured at 42 days old. L-arginine supplementation improved feed conversion and blood profile, mainly due to the reduction of total and LDL-cholesterol levels. Broilers that received 3300 kcal/kg of metabolizable energy showed the greatest weight gain, regardless of supplementation or not with arginine. The dietary supplementation with 0.66% of L-arginine for heat-stressed broilers can be recommended, regardless of the feed energy level. Larginine L arginine (2 4 days, , days) used arrangement 3000, 3000 (3000 3150 330 kcalkg kcal kg 0.66%. 066 . 0 66 (0.66%) units boxes old profile LDLcholesterol LDL cholesterol gain 0.66 heatstressed stressed recommended level ( 300 (300 315 33 06 6 (0.66% 0.6 30 (30 31 (0.66 0. (3 (0.6 (0. (0

Abstract Nutrition in rabbit farming accounts for about 70% of all costs; in this sense, C. argentea is an excellent alternative as a feed, due to its bromatological composition. Our goal is to evaluate the nutritional value of diets formulated with the dried leaves of C. argentea to feed growing rabbits. Twenty-eight white rabbits of the New Zealand breed, 55 days old, of both sexes, were used. Two treatments (n = 14, 7 males, and 7 females) were evaluated in a randomized block experimental design in a 2 x 2 factorial scheme. The control diet (CTRL) was formulated to meet the nutritional requirements of growing rabbits, and the test diet (DRY) was obtained by replacing 20% of the CTRL diet with dried leaves of C. argentea. The experimental period was comprised of 11 days, with seven days of adaptation and four days of total feces collection. The average daily gain, dry matter intake, feed conversion, and final body weight were not affected by replacing the CTRL diet with the dried leaves of C. argentea. The coefficient of dry matter digestibility showed better results in CTRL rabbits (female: 72.19%, male: 72.48%). Rabbits fed with the CTRL diet exhibited a higher consumption of crude protein compared to those fed with the DRY diet, however, these rabbits showed higher elimination and lower retention of crude protein. It is concluded that C. argentea presents values of 1,400.67 kcal per kg of dry matter, digestible energy, and 3.34% digestible protein per kg of dry matter. 70 costs sense C composition Twentyeight Twenty eight breed 5 old sexes used n 14 males females scheme (CTRL (DRY 20 1 collection gain intake conversion female (female 7219 72 19 72.19% male 72.48%. 7248 72.48% . 48 72.48%) however 140067 400 67 1,400.6 energy 334 3 34 3.34 721 72.19 724 72.48 4 14006 40 6 1,400. 33 3.3 72.1 72.4 1400 1,400 3. 72. 140 1,40 1,4 1,

Resumo A nutrição na criação de coelhos representa cerca de 70% de todos os custos; nesse sentido, a Cratylia argentea é uma excelente alternativa como alimento devido à sua composição bromatológica. Nosso objetivo foi avaliar o valor nutricional de dietas formuladas com folhas secas de C. argentea na alimentação de coelhos em crescimento. Foram utilizados 28 coelhos brancos da raça Nova Zelândia, com 55 dias de idade, de ambos os sexos. Dois tratamentos (n = 14, 7 machos e 7 fêmeas) foram avaliados em delineamento experimental de blocos casualizados em esquema fatorial 2 x 2. A dieta controle (CTRL) foi formulada para atender às exigências nutricionais de coelhos em crescimento, e a dieta teste (DRY) foi obtida substituindo 20% da dieta CTRL por folhas secas de C. argentea. O período experimental compreendeu 11 dias, sendo sete dias de adaptação e quatro dias de coleta total de fezes. O ganho médio diário, o consumo de matéria seca, a conversão alimentar e o peso corporal final não foram afetados pela substituição da dieta CTRL por folhas secas de C. argentea. O coeficiente de digestibilidade da matéria seca apresentou melhores resultados nos coelhos CTRL (Fêmea: 72,19%, Macho: 72,48%). Coelhos alimentados com a dieta CTRL apresentaram maior consumo de proteína bruta do que os alimentados com a dieta DRY, porém esses coelhos tiveram maior excreção e menor retenção de proteína bruta. Conclui-se que Cratylia argentea apresenta valores de 1.400,67 kcal de energia digestível por kg de matéria seca e 3,34% de proteína digestível por kg de matéria seca. 70 custos sentido bromatológica C crescimento Zelândia 5 idade sexos n 14 fêmeas (CTRL DRY (DRY 20 1 fezes diário Fêmea (Fêmea 7219 72 19 72,19% Macho 72,48%. 7248 72,48% . 48 72,48%) Concluise Conclui se 140067 400 67 1.400,6 334 3 34 3,34 721 72,19 724 72,48 4 14006 40 6 1.400, 33 3,3 72,1 72,4 1400 1.400 3, 72, 140 1.40 1.4 1.

Abstract Background In the context of rheumatoid arthritis and its systemic inflammatory implications, there is an increasing interest in investigating the role of prolactin in the clinical and metabolic aspects of the disease. This study aimed to explore the potential links between serum prolactin levels, serum glucose levels, and the clinical manifestations of arthritis. Methods This exploratory, cross-sectional, observational study focused on women diagnosed with rheumatoid arthritis. The research involved assessing prolactin and blood glucose concentrations, alongside specific clinical traits such as disease-related inflammation, morning stiffness, and fatigue intensity. The presence of changes in serum prolactin (PRL) was initially compared among the groups based on disease activity intensity. Using a multinomial regression analysis, the study analyzed the impact of predetermined clinical and metabolic factors on various categories of prolactin concentration. Results Out of the 72 participants included in the study, hyperprolactinemia was detected in 9.1% of the sample. No differences in serum PRL were identified among the evaluated groups based on disease activity. Following multivariate analysis, no statistically significant differences were identified for the outcomes of inflammatory activity and morning stiffness within each PRL category when compared to the reference category for PRL. There was no increased likelihood of encountering blood glucose levels below 100 mg/dl among individuals with higher prolactin concentrations compared to those in the lowest prolactin category (OR 5.43, 95% CI 0.51–58.28). The presence of clinically significant fatigue revealed a higher likelihood of encountering this outcome among patients with intermediate PRL values (prolactin categories 7.76–10.35 with OR 5.18, 95% CI 1.01–26.38 and 10.36–15.29 with OR 6.25, 95% CI 1.2–32.51) when compared to the reference category. Conclusions The study found no discernible correlation between prolactin concentrations and worse scores for inflammatory activity of the disease, nor between prolactin concentrations and serum glucose levels. The findings regarding fatigue should be approached with caution given the exploratory nature of this study. implications crosssectional, crosssectional cross sectional, sectional cross-sectional diseaserelated related inflammation intensity (PRL analysis concentration 7 91 9 1 9.1 sample 10 mgdl mg dl 543 5 43 5.43 95 0.51–58.28. 0515828 0.51–58.28 . 0 51 58 28 0.51–58.28) 7761035 76 35 7.76–10.3 518 18 5.18 1012638 01 26 38 1.01–26.3 10361529 36 15 29 10.36–15.2 625 6 25 6.25 1.2–32.51 123251 2 32 9. 54 4 5.4 051582 0.51–58.2 776103 3 7.76–10. 5.1 101263 1.01–26. 1036152 10.36–15. 62 6.2 1.2–32.5 12325 5. 05158 0.51–58. 77610 7.76–10 10126 1.01–26 103615 10.36–15 6. 1.2–32. 1232 0515 0.51–58 7761 7.76–1 1012 1.01–2 10361 10.36–1 1.2–32 123 051 0.51–5 776 7.76– 101 1.01– 1036 10.36– 1.2–3 12 05 0.51– 77 7.76 1.01 103 10.36 1.2– 0.51 7.7 1.0 10.3 1.2 0.5 7. 1. 10. 0.

RESUMO: Este estudo foi conduzido com o objetivo de avaliar os efeitos da suplementação dietética com selênio e cromo biocomplexados sobre o perfil de ácidos graxos do peito e da coxa de frangos de corte machos e fêmeas da linhagem Label Rouge. O delineamento experimental foi inteiramente casualizado em esquema fatorial 3 x 2 correspondendo a três dietas (controle; 0,40 ppm de cromo; 0,50 ppm de selênio) e dois sexos. Cada tratamento foi composto por três parcelas de cinco frangos de corte. O perfil de ácidos graxos foi avaliado nas amostras de peito e coxa. A adição de selênio biocomplexado na dieta de frangos de corte aumentou o teor de ácidos graxos de cadeia longa das séries ômega 3 e 6 (ácido docosahexaenóico - DHA e araquidônico, respectivamente), o total de ômega 6 e o conteúdo de ácido esteárico no peito (músculo pectoralis major). Além disso, a suplementação com selênio causou redução no teor de ácido oleico e no total de monoinsaturados no mesmo músculo. Os machos apresentaram maiores teores dos ácidos linoléico e linolênico e total de poliinsaturados; e menor conteúdo de ácido oleico, total de monoinsaturados e saturados na coxa. Os frangos suplementados com selênio biocomplexado e os machos apresentaram melhor qualidade lipídica no músculo do peito e coxa, respectivamente.

ABSTRACT: This study was conducted to evaluate the effects of dietary supplementation with biocomplexed selenium and chromium on the fatty acid profile of the breast and thigh of males and females broilers of the Label Rouge lineage. The experimental design was completely randomized arranged in a 3 x 2 factorial scheme corresponding to three diets (control; 0.40 ppm of chromium; 0.50 ppm of selenium) and two sexes. Each treatment consisted of three plots of five broilers. The fatty acid profile was evaluated in the breast and thigh samples. The addition of biocomplexed selenium in the broilers diets increased the content of long chain fatty acid of the omega 3 and 6 series (docosahexaenoic - DHA and arachidonic acids, respectively), the total of omega 6 and the stearic acid content on the breast (pectoralis major muscle). In addition, selenium supplementation caused a reduction in oleic acid content and in total of monounsaturated in the same muscle. Males had higher contents of linoleic and linolenic acids, and total of polyunsaturated; and lower content of oleic acid, total of monounsaturated and saturated in the thigh. The broilers supplemented with biocomplexed selenium and males presented better lipid quality in the muscle by breast and thigh, respectively.

ABSTRACT Two experiments were carried with broilers from 29 to 42 days of age for the nutritional evaluation of dietary chia. Thus, the nitrogen-corrected apparent metabolizable energy (AMEn) and the apparent metabolizability coefficients of gross energy and ether extract of chia seeds and oil, toasted soybean grain (TSG), and soybean oil were determined in the experiment I, by total excreta collection method, using 120 broilers. Each experimental diet (reference diet [RD] and four diets with the tested feedstuffs) was evaluated in eight replicates of three broilers. The TSG and chia seeds replaced the RD in 250 g/kg, whereas soybean and chia oils replaced the RD in 100 g/kg. Simultaneously, a second experiment was carried subdivided into two trials. In the performance trial, we evaluated the dietary feedstuffs effects on performance, carcass and cut yields, blood parameters, and activity of lipogenic enzymes. The nutrient metabolizability coefficients and AMEn were evaluated in the metabolism trial. The AMEn values of 37.49, 37.35, 15.85, and 8.43 MJ/kg of dry matter were determined for chia oil, soybean oil, TSG, and chia seeds, respectively (experiment I). In the second experiment, the best feed conversion was observed in broilers fed diets containing chia oil and TSG. However, the diet formulated with chia seeds worsened broiler feed conversion, exhibited the smaller energy value and apparent metabolizability coefficient of the ether extract, and increased the activity of the malic enzyme and serum total cholesterol level. There was no difference for glucose-6-phosphate dehydrogenase activity and high-density lipoprotein cholesterol level. In general, chia oil showed to be efficient in replacing soybean oil in broiler diets.

Abstract An experiment was conducted to evaluate the effects of increasing concentrations of crude glycerin, with or without ractopamine, in the diet of finishing barrows on carcass characteristics and pork quality. The experimental design was a randomized complete block, in a 4 x 2 factorial scheme, with four concentrations of crude glycerin (0, 100, 150, or 200 g/kg) and two concentrations of ractopamine (0 or 10 mg/kg). There was no interaction between the crude glycerin concentrations and the ractopamine use as well as there was no isolated effect of the dietary crude glycerin concentration for all the evaluated traits. However, the dietary ractopamine increased the hot (p = 0.021) and cold (p=0.020) carcass weight, the hot carcass yield (p = 0.038), the shear force (p = < 0.0001), lightness (L* index) (p = 0.043), hue angle (h*) (p = 0.026), and C16:1 (p = 0.023) concentration in the loin. Moreover, the dietary ractopamine decreased the red content (a* value) (p = 0.043), the activity of C16-C18 elongase (p = 0.037) and the C18:0 (p = 0.021) concentration in the loin. The inclusion of up to 200 g/kg crude glycerin in the diet of finishing pigs may be used as a partial substitute for dietary corn, combined or not with 10 mg/kg ractopamine, without impair the evaluated carcass characteristics and the quality of the loin.

ABSTRACT Hypopituitarism is a disorder characterized by insufficient secretion of one or more pituitary hormones. New etiologies of hypopituitarism have been recently described, including head trauma, cerebral hemorrhage, and drug-induced hypophysitis. The investigation of patients with these new disorders, in addition to advances in diagnosis and treatment of hypopituitarism, has increased the prevalence of this condition. Pituitary hormone deficiencies can induce significant clinical changes with consequent increased morbidity and mortality rates, while hormone replacement based on current guidelines protects these patients. In this review, we will first discuss the different etiologies of hypopituitarism and then address one by one the clinical aspects, diagnostic evaluation, and therapeutic options for deficiencies of TSH, ACTH, gonadotropin, and GH. Finally, we will detail the hormonal interactions that occur during replacement of pituitary hormones.

ABSTRACT Objective Investigate the therapeutic response of acromegaly patients to pegvisomant (PEGV) in a real-life, Brazilian multicenter study. Subjects and methods Characteristics of acromegaly patients treated with PEGV were reviewed at diagnosis, just before and during treatment. All patients with at least two IGF-I measurements on PEGV were included. Efficacy was defined as any normal IGF-I measurement during treatment. Safety data were reviewed. Predictors of response were determined by comparing controlled versus uncontrolled patients. Results 109 patients [61 women; median age at diagnosis 34 years; 95.3% macroadenomas] from 10 Brazilian centers were studied. Previous treatment included surgery (89%), radiotherapy (34%), somatostatin receptor ligands (99%), and cabergoline (67%). Before PEGV, median levels of GH, IGF-I and IGF-I % of upper limit of normal were 4.3 µg/L, 613 ng/mL, and 209%, respectively. Pre-diabetes/diabetes was present in 48.6% and tumor remnant in 71% of patients. Initial dose was 10 mg/day in all except 4 cases, maximum dose was 30 mg/day, and median exposure time was 30.5 months. PEGV was used as monotherapy in 11% of cases. Normal IGF-I levels was obtained in 74.1% of patients. Glycemic control improved in 56.6% of patients with pre-diabetes/diabetes. Exposure time, pre-treatment GH and IGF-I levels were predictors of response. Tumor enlargement occurred in 6.5% and elevation of liver enzymes in 9.2%. PEGV was discontinued in 6 patients and 3 deaths unrelated to the drug were reported. Conclusions In a real-life scenario, PEGV is a highly effective and safe treatment for acromegaly patients not controlled with other therapies.

Resumo: O objetivo deste estudo foi analisar as relações existentes entre as empresas compradoras de leite e os produtores rurais de oito cidades do Sul de Minas Gerais e verificar a influência dessas relações em diversos fatores de produção nos resultados econômicos provenientes da produção leiteira e outras áreas da atividade necessárias para a produção láctea. Para isso, foram realizadas entrevistas de campo com 115 produtores rurais das cidades de Campestre, Caldas, Elói Mendes, Paraguaçu, Poço Fundo, Poços de Caldas, Ipuiuna e Machado. Após a coleta de dados, foram realizadas análises para verificar a relação existente entre diversos fatores de produção que sofrem impactos a partir das relações de comercialização entre os produtores de leite e as empresas compradoras do produto na região. Os resultados permitem concluir que diversos fatores necessários para o processo produtivo são influenciados pelo relacionamento entre os agentes citados, e o resultado dos processos de comercialização podem impactar não somente os lucros, mas também outras áreas da atividade leiteira necessárias para o processo produtivo.

Abstract: The objective of this study was to analyze the existing correlations of milk buyers with rural producers in eight cities in the South of Minas Gerais and to verify the influence of these relationships on several factors of production in the economic results from dairy production and other areas of activity required for dairy production. For this, field interviews were conducted with 115 rural producers from the cities of Campestre, Caldas, Elói Mendes, Paraguaçu, Poço Fundo, Poços de Caldas, Ipuiuna and Machado. After the data collection, analyzes were carried out to verify the relationship between several factors of production that are impacted by the commercial relations between milk producers and the companies purchasing the product in the region. The results allow us to conclude that several factors necessary for the productive process are influenced by the relationship between the mentioned agents and the result of the commercialization processes can impact not only the economic results but also on other areas of the dairy activity required for the productive process.

Resumen: El objetivo de este estúdio fue analizar las correlaciones existentes de las empresas compradoras de leche com los productores rurales de ocho ciudadesdelsur de Minas Gerais y verificar La influencia de estas relaciones en diversos factores de producción em los resultados económicos provenientes de laproducción lechera y otras áreas de La actividad necesarias para la producción láctea. Para esto, se realizaron entrevistas de campo con 115 productores rurales de lãs ciudades de Campestre, Caldas, Elói Mendes, Paraguaçu, Poço Fundo, Poços de Caldas, Ipuiuna y Machado. Después de La recolección de datos, se realizaron análisis para verificar La relación existente entre diversos factores de producción que sufren impacto a partir de las relaciones de comercialización entre productores de leche y las empresas compradoras Del producto en La región. Los resultados permiten concluir que diversos factores necesarios para El proceso productivo son influenciados por La relación entre los agentes citados y el resultado de los procesos de comercialización pueden impactar no solo los resultados económicos, sino también otras áreas de La actividad lechera necesarias para el proceso productivo.

Résumé: Le but de cette étude était d'analyser la corrélation du lait d'acheter des entreprises avec les agriculteurs de 8 villes dans le sud du Minas Gerais et l'influence de ces relations dans divers facteurs de production dans les résultats économiques de la production de lait et d'autres domaines d'activité nécessaire pour la production laitière. Pour ce faire, des interviews sur le terrain ont été menées auprès de 115 agriculteurs des villes de Campestre, Caldas, Elói Mendes, Paraguaçu, Poço Fundo, Pocos de Caldas, Ipuiúna et Machado. Après la collecte des données, des analyses ont été réalisées pour étudier la relation entre les différents facteurs de production qui sont impactés de la commercialisation des relations entre les producteurs de lait et les sociétés d'achat du produit dans la région. Les résultats suggèrent que plusieurs facteurs nécessaires au processus de production sont influencés par la relation entre les agents ci-dessus et le résultat des processus de marketing peut avoir un impact non seulement économique, mais aussi d'autres secteurs de l'élevage laitier nécessaires au processus de production.

Resumo: O objetivo deste trabalho foi determinar a digestibilidade ileal aparente do cálcio e do fósforo em frangos de corte alimentados com rações com diferentes fitases e relações cálcio:fósforo disponível (Ca:Pd). Foram realizados dois experimentos: um com frangos de 22 a 33 dias de idade, e outro com frangos de 35 a 42 dias. As relações Ca:Pd usadas foram de 4,5:1,0, 6,0:1,0 e 7,5:1,0, no primeiro período, e de 3,5:1,0, 5,0:1,0 e 6,5:1,0, no segundo. Todas as dietas foram suplementadas com 1.500 unidades de atividade de fitase por quilograma de seis diferentes fontes de fitase microbiana. Ao final de cada experimento, duas aves por repetição foram abatidas para a coleta do conteúdo ileal. Nas amostras de digestas, foram determinados os teores de Ca e P para posterior cálculo do coeficiente de digestibilidade ileal aparente destes minerais. A relação Ca:Pd influenciou a atividade das fitases, e a maior digestibilidade foi observada nas menores relações, em ambos os experimentos. As fitases que proporcionaram os maiores coeficientes de digestibilidade foram A, D e E. Em ambas as idades avaliadas, a inclusão de fitases às dietas aumentou a digestibilidade de Ca e P, a qual também foi afetada pelo teor de cálcio e pela fonte de fitase utilizada.

Abstract: The objective of this work was to determine the apparent ileal digestibility of calcium and phosphorus in broilers fed diets with different phytases and calcium:available phosphorus (Ca:aP) ratios. Two experiments were carried out: one with broilers with 22 to 33 days of age, and the other with broilers with 35 to 42 days. The Ca:aP ratios used were 4.5:1.0, 6.0:1.0, and 7.5:1.0 in the first period, and 3.5:1.0, 5.0:1.0, and 6.5:1.0 in the second. All diets were supplemented with 1,500 units of phytase activity per kilogram of six different sources of microbial phytase. At the end of each experiment, two broilers per replicate were slaughtered to collect the ileal content. In the samples of digested food, the Ca and P contents were determined for later calculation of the apparent ileal digestibility coefficients of these minerals. The Ca:aP ratio influenced the activity of phytases, and the highest digestibility was observed with lower ratios, in both experiments. The phytases that provided greater digestibility coefficients were A, D, and E. In both ages evaluated, the inclusion of phytases in the feed improved the digestibility of Ca and P, which was also affected by the content of calcium and by the phytase source used.

Objetivou-se analisar a viabilidade de uso do pó da rocha fonolito em Urochloa brizantha cv. Marandu e se a inoculação com bactérias diazotróficas solubilizadoras de potássio (K) contribui para o maior desenvolvimento e características bromatológicas desta forrageira. O experimento foi conduzido em vasos contendo 15 dm³ de solo, durante três períodos de cortes. Foi utilizado o delineamento em blocos casualizados em esquema fatorial e um tratamento adicional (4x3+1), sendo quatro doses do fonolito (100%, 75%, 50% e 25%) e três variáveis inoculantes (UNIFENAS 100-13, UNIFENAS 100-94 e o controle sem inoculação), além do tratamento adicional com cloreto de potássio (KCl), com quatro repetições por tratamento. Na época de cada corte foram avaliados os parâmetros morfológicos e bromatológicos da forrageira. As diferentes doses de fonolito associadas à inoculação com as estirpes bacterianas não conduziram a diferenças significativas nos parâmetros morfológicos, como largura e comprimento de folha, densidade de perfilhos e matéria seca. No entanto, o fonolito promoveu uma melhoria nas características bromatológicas nos parâmetros de fibra em detergente ácido, hemicelulose, digestibilidade da matéria seca, nutrientes digestíveis totais, energia digestível e metabolizável, contribuindo, portanto, para a melhoria no valor nutricional, indicando o potencial de utilização desta rocha silicatada como fonte alternativa ao cloreto de potássio (KCl).

The objective of this study was to analyze the feasibility of using phonolite rock powder in Urochloa brizantha cv. Marandu and whether the inoculation with potassium solubilizing diazotrophic bacteria (K) contributes to a greater development and bromatological characteristics of this forage. The experiment was conducted in pots containing 15 dm³ of soil, during three cutting periods. A randomized block design in a factorial scheme and an additional treatment (4x3 + 1) were used, with four doses of phonolite (100%, 75%, 50% and 25%) and three inoculant variables (UNIFENAS 100-13, UNIFENAS 100-94 and a control without inoculation), further, was added the additional treatment with potassium chloride (KCl), with four replicates per treatment. At the time of each cut, the morphological and bromatological parameters of the forage were evaluated. The different doses of phonolite associated with inoculation with the bacterial strains showed no significant differences in morphological parameters, such as leaf width and length, tillers density and dry matter. However, phonolite promoted an improvement in the bromatological characteristics in the parameters of acid detergent fiber, hemicellulose, dry matter digestibility, total digestible nutrients, digestible and metabolizable energy, thus contributing to the improvement in nutritional value, indicating the potential of this rock as an alternative source to potassium chloride (KCl).

ABSTRACT Prolactinomas are the most common pituitary adenomas (approximately 40% of cases), and they represent an important cause of hypogonadism and infertility in both sexes. The magnitude of prolactin (PRL) elevation can be useful in determining the etiology of hyperprolactinemia. Indeed, PRL levels > 250 ng/mL are highly suggestive of the presence of a prolactinoma. In contrast, most patients with stalk dysfunction, drug-induced hyperprolactinemia or systemic diseases present with PRL levels < 100 ng/mL. However, exceptions to these rules are not rare. On the other hand, among patients with macroprolactinomas (MACs), artificially low PRL levels may result from the so-called “hook effect”. Patients harboring cystic MACs may also present with a mild PRL elevation. The screening for macroprolactin is mostly indicated for asymptomatic patients and those with apparent idiopathic hyperprolactinemia. Dopamine agonists (DAs) are the treatment of choice for prolactinomas, particularly cabergoline, which is more effective and better tolerated than bromocriptine. After 2 years of successful treatment, DA withdrawal should be considered in all cases of microprolactinomas and in selected cases of MACs. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) is to provide a review of the diagnosis and treatment of hyperprolactinemia and prolactinomas, emphasizing controversial issues regarding these topics. This review is based on data published in the literature and the authors' experience.

ABSTRACT The treatment objectives for a patient with Cushing's disease (CD) are remission of hypercortisolism, adequate management of co-morbidities, restoration of the hypothalamic-pituitary-adrenal axis, preservation of fertility and pituitary function, and improvement of visual defects in cases of macroadenomas with suprasellar extension. Transsphenoidal pituitary surgery is the main treatment option for the majority of cases, even in macroadenomas with low probability of remission. In cases of surgical failure, another subsequent pituitary surgery might be indicated in cases with persistent tumor imaging at post surgical magnetic resonance imaging (MRI) and/or pathology analysis of adrenocorticotropic hormone-positive (ACTH+) positive pituitary adenoma in the first procedure. Medical treatment, radiotherapy and adrenalectomy are the other options when transsphenoidal pituitary surgery fails. There are several options of medical treatment, although cabergoline and ketoconazole are the most commonly used alone or in combination. Novel treatments are also addressed in this review. Different therapeutic approaches are frequently needed on an individual basis, both before and, particularly, after surgery, and they should be individualized. The objective of the present review is to provide the necessary information to achieve a more effective treatment for CD. It is recommended that patients with CD be followed at tertiary care centers with experience in treating this condition.