RESUMO O presente relato de caso identificou a maculopatia média aguda paracentral como a causa de baixa de acuidade visual severa e irreversível após cirurgia de catarata. Existem fatores de risco bem estabelecidos para o desenvolvimento da maculopatia média aguda paracentral que devem ser conhecidos pelos cirurgiões de catarata. Nesse contexto cirúrgico, precauções extras no tocante a procedimentos anestésicos, pressão intraocular e alguns outros aspectos da cirurgia devem ser consideradas. A maculopatia média aguda paracentral é descrita como um sinal clínico observado no exame de tomografia de coerência óptica por domínio espectral e se trata, provavelmente, da evidência de um evento isquêmico no tecido vascular retiniano. Esse diagnóstico deve ser cogitado nos casos de perda de acuidade visual súbita no pós-operatório imediato associada com exame fundoscópico normal, como evidenciado no caso apresentado. catarata cirúrgico anestésicos consideradas trata provavelmente retiniano pósoperatório pós operatório normal apresentado

ABSTRACT This case report identified paracentral acute middle maculopathy as the cause of severe and irreversible vision loss after cataract surgery. Cataract surgeons should be aware of known risk factors for the development of paracentral acute middle maculopathy. In those patients, extra care regarding anesthesia, intraocular pressure, and some other aspects of cataract surgery must be taken. Paracentral acute middle maculopathy is currently understood as a clinical sign evident on spectral-domain optical coherence tomography, and it is probably evidence of deep ischemic insult to the retina. It should be a differential diagnosis in cases of marked low vision acuity associated with no fundus abnormalities in the immediate postoperative period, as demonstrated in the presented case. patients anesthesia pressure taken spectraldomain spectral domain tomography retina period

RESUMO O presente relato de caso identificou a maculopatia média aguda paracentral como a causa de baixa de acuidade visual severa e irreversível após cirurgia de catarata. Existem fatores de risco bem estabelecidos para o desenvolvimento da maculopatia média aguda paracentral que devem ser conhecidos pelos cirurgiões de catarata. Nesse contexto cirúrgico, precauções extras no tocante a procedimentos anestésicos, pressão intraocular e alguns outros aspectos da cirurgia devem ser consideradas. A maculopatia média aguda paracentral é descrita como um sinal clínico observado no exame de tomografia de coerência óptica por domínio espectral e se trata, provavelmente, da evidência de um evento isquêmico no tecido vascular retiniano. Esse diagnóstico deve ser cogitado nos casos de perda de acuidade visual súbita no pós-operatório imediato associada com exame fundoscópico normal, como evidenciado no caso apresentado.

ABSTRACT This case report identified paracentral acute middle maculopathy as the cause of severe and irreversible vision loss after cataract surgery. Cataract surgeons should be aware of known risk factors for the development of paracentral acute middle maculopathy. In those patients, extra care regarding anesthesia, intraocular pressure, and some other aspects of cataract surgery must be taken. Paracentral acute middle maculopathy is currently understood as a clinical sign evident on spectral-domain optical coherence tomography, and it is probably evidence of deep ischemic insult to the retina. It should be a differential diagnosis in cases of marked low vision acuity associated with no fundus abnormalities in the immediate postoperative period, as demonstrated in the presented case.

Abstract The article problematizes gender violence in the field of planning and territorial studies from a snapshot of the first year of the COVID-19 pandemic (2020) in the municipality of São Paulo. The first section deals with a theoretical discussion on the thematic that considers the reflection on the practice in health and planning. In this section, we point out the territorialities of care, making use of the WHO Ecological Model. In the following section, the theoretical approach is explored in a portrait of the first year of the COVID Pandemic, based on three approaches to territorialities in the confrontation of violence against women: from the main instrument of territorial planning (Master Plan), by the network of specialized equipment to confront violence, by the social equipment that contribute to prevention and by the support to daily social relations. As a result, it was identified that the Master Plans of 2002 and 2014 did not incorporate the bases of policies to address violence, which represents a certain precondition for the territories when the pandemic period. We identified blackouts of welfare equipment and social distance that represented the decline in the confrontation of violence during the first year of the pandemic.

Resumo O artigo problematiza a violência de gênero no campo do planejamento e dos estudos territoriais a partir de uma fotografia do primeiro ano da pandemia da COVID-19 (2020) no município de São Paulo. A primeira seção trata de uma discussão teórica sobre o recorte temático que considera a reflexão sobre a prática na saúde e no planejamento. Desta seção, apontamos as territorialidades do cuidado, valendo-se do Modelo Ecológico da OMS. Na seção seguinte, a abordagem teórica é explorada em um retrato do primeiro ano da Pandemia de COVID, com base em três abordagens para as territorialidades no enfrentamento da violência contra a mulher: a partir do principal instrumento de planejamento territorial (Plano Diretor), pela rede de equipamentos especializados ao enfrentamento da violência, pelos equipamentos sociais que contribuem para a prevenção e pelo suporte às relações sociais cotidianas. Como resultado foi identificado que os Planos Diretores de 2002 e 2014 não incorporaram as bases das políticas de enfrentamento da violência, o que representa uma determinada condição prévia para os territórios quando do período da pandemia. Foram identificados apagões de equipamentos assistenciais e o distanciamento social, que representaram a queda no enfrentamento da violência durante o primeiro ano da pandemia.

Abstract The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.

ABSTRACT This study aimed to evaluate the effects of sunflower meal (SFM) inclusion on the performance, nutrient digestibility, and respirometric parameters in sheep. Twenty-four Dorper × Santa Inês uncastrated males, with an average age of 5 mo and initial body weight (BW) of 27.91±6.0 kg, were distributed in a randomized block design with four treatment diets containing 0, 100, 200, and 300 g of SFM/kg of total dry matter, replacing soybean meal. Intake, weight gain, ingestive behavior, and in vitro digestibility were evaluated according to the SFM inclusion. The respirometric parameters were evaluated in an open-circuit respirometric chamber. There was a quadratic response in dry matter intake expressed according to the SFM inclusion, with minimum points of 90.56 g/kg 0.75 BW for inclusion levels of 96 g of SFM/kg. A linear decrease in the in vivo digestibility of dry matter, neutral detergent fiber, and non-fibrous carbohydrate and in vitro fermentation of dry matter and fibrous carbohydrates was observed in response to SFM inclusion. These results reflect the higher fiber content of the byproduct, which reduced the non-fibrous carbohydrates in the diets. Despite the change in nutrient availability, average daily gain (299 g/day), O 2 consumption (26.24 L/kg 0.75 BW), and CH 4 production (2.25 L/kg 0.75 BW) were not influenced by the SFM inclusion, indicating that changes in the nutritional value of the diet did not affect the animals’ energetic metabolism. Sunflower meal inclusion decreased the digestibility but did not affect the animal gain and the respirometric parameters. The SFM can replace soybean meal in the diet of growing lambs; however, it has a maximum inclusion point of 88 g SFM/kg for feed conversion, which is a necessary factor for evaluating the replacement cost.

Abstract Objectives: microbiological quality of raw human milk (HM) from donors at the HMB (Human Milk Bank) of Santa Casa de Misericórdia de Ouro Preto was evaluated. Methods: the microbiological quality of milk from each of 10 donors in triplicate (30 samples) was evaluated by enumeration of Staphylococcus aureus and total aerobic mesophiles (surface plating) and total and thermotolerant coliforms (Most Probable Number - MPN). A questionnaire and a checklist were applied after the end of sample collection to verify the compliance of milk extraction and storage procedures by the donors. Results: inadequacies in the procedures for expression and storage of donated HM were observed. The presence of all microorganisms studied were verified in the milk of all donors, and in some cases exceeded the safety limits. The checklist indicated that some necessary hygienic-sanitary procedures were not carefully performed, making it important to properly guide the donors. Conclusions: this study points to an unfavorable scenario for the safety and quality of donated HM, and it is important to encourage further studies to be conducted so that the Brazilian network of HMB adopts stricter criteria for instructions on procedures and support for HM donors.

Resumo Objetivos: avaliou-se a qualidade microbiológica do leite humano (LH) cru de doadoras do Banco de Leite Humano (BLH) da Santa Casa de Misericórdia de Ouro Preto. Métodos: a qualidade microbiológica do leite de cada uma das 10 doadoras em triplicata (30 amostras) foi avaliada por meio da enumeração de Staphylococcus aureus e mesóflos aeróbios totais (plaqueamento em superfície) e coliformes totais e termotolerantes (Número Mais Provável -NMP). Para verificar a conformidade dos procedimentos de extração e armazenamento do leite pelas doadoras, aplicou-se um questionário e um checklist após o término da coleta das amostras. Resultados: observou-se inadequações nos procedimentos de expressão e armazenamento do LH doado. A presença de todos os microrganismos estudados foram verificados no leite de todas as doadoras e, em alguns casos, excedeu os limites de segurança. O checklist indicou que alguns procedimentos higiênico-sanitários necessários não foram realizados criteriosamente, tornando importante orientar adequadamente as doadoras. Conclusões: este estudo aponta um cenário desfavorável para a segurança e a qualidade do LH doado, sendo importante incentivar mais estudos a serem realizados para que a rede brasileira de BLH adote critérios mais rigorosos de instruções sobre procedimentos e suporte para doadoras de LH.

Abstract This study aimed to evaluate the effect of synchronization with prostaglandin F2α in Baixadeiro mares during the rainy and dry seasons. Fourteen mares were synchronized by administering two doses of 1 mL prostaglandin PGF 2α and monitored by rectal palpation and ultrasound for the assessment of follicular development and uterine echotexture. Of this total, nine mares allowed the collection of blood, in which the blood was collected by venipuncture of the jugular vein to determine progesterone (P4) by ELISA. Mares showed no differences (P > 0.05) in weight, body score condition (BSC), tone, uterine edema, frequency of ovulation, synchronization interval, estrus, and the total number of follicles between periods. However, there was a difference in large increased follicle diameter (P < 0.05) during the dry season. The average concentrations of P4 in mares differed (P < 0.05) between the pre- and post-ovulatory phases for both seasons and after ovulation, with higher concentrations in the rainy season. Furthermore, statistical differences in daily light (P < 0.05) were observed between the dry and rainy periods. Thus, we conclude that mares from the genetic grouping Baixadeiro showed no reproductive seasonality, though there was a difference in luminosity between the rainy and dry seasons. The treatment with two doses of PGF 2α was effective in synchronizing the mares, promoting the return of estrus in the dry and rainy periods. The mares remaining cyclically active throughout the year provided there were appropriate forage availability and quality levels to allow for normal values of body weight and condition.

RESUMO O sono é essencial para o adequado funcionamento de todos os indivíduos. Os distúrbios respiratórios do sono ocorrem em todas as faixas etárias, constituindo motivo frequente de consulta médica. O objetivo deste consenso foi atualizar os conhecimentos sobre os principais distúrbios respiratórios do sono tanto na população adulta quanto na pediátrica, com ênfase na apneia obstrutiva do sono. A apneia obstrutiva do sono é uma doença extremamente prevalente, porém frequentemente subdiagnosticada. Associa-se frequentemente a uma série de comorbidades, notadamente cardiovasculares, metabólicas e neurocognitivas, que impactam significativamente na qualidade de vida e na mortalidade. Por conta disso, o Departamento de Distúrbios Respiratórios do Sono da Sociedade Brasileira de Pneumologia e Tisiologia reuniu 14 especialistas com reconhecida e comprovada experiência em distúrbios respiratórios do sono para a elaboração deste documento.

ABSTRACT Sleep is essential for the proper functioning of all individuals. Sleep-disordered breathing can occur at any age and is a common reason for medical visits. The objective of this consensus is to update knowledge about the main causes of sleep-disordered breathing in adult and pediatric populations, with an emphasis on obstructive sleep apnea. Obstructive sleep apnea is an extremely prevalent but often underdiagnosed disease. It is often accompanied by comorbidities, notably cardiovascular, metabolic, and neurocognitive disorders, which have a significant impact on quality of life and mortality rates. Therefore, to create this consensus, the Sleep-Disordered Breathing Department of the Brazilian Thoracic Association brought together 14 experts with recognized, proven experience in sleep-disordered breathing.

Abstract Samanea tubulosa Benth. it has been widely used in traditional medicine to treat inflammatory processes. The present study aimed to investigate the antinociceptive effect and mechanism of action of the fractions obtained from the Samanea tubulosa pods in mice. The antinociceptive activity was evaluated in formalin, capsaicin and glutamate tests and the. The possible mechanisms of action involved in the antinociceptive effect of the hexane and ethyl acetate fraction in the opioid system, also the the K + ATP channels and the L-arigine pathways of nitric oxide were evaluated. The chemical characterization analysis revealed in the hexane fraction the presence of triterpenes such as lupenone and lupeol. In the glutamate test, the hexane and ethyl acetate fractions showed antinociceptive activity at the dose of 12.5 and 25 mg kg-1. The antinociception produced by the hexane and ethyl acetate fractions was significantly reversed by naloxone, indicating that the fractions act through the opioid pathway. Antinociceptive response of the ethyl acetate fraction was blocked by glibenclamide, indicating that this fraction acts via the K + ATP channels activation. It is concluded that the fractions under study exert antinociceptive activity possibly related to the opioid route and through K+ ATP channels activation.

ABSTRACT This study aimed at analyzing and comparing the phenotypic characteristics of height, body length, and fleece wool fineness with the liquidity and final price sold in auctions in the city of Uruguaiana, RS, Brazil, for three consecutive years (2015 to 2017). A total of 412 one-year-old (two teeth) male sheep, of the Australian Merino (n = 50), Polwarth (n = 130), and Corriedale (n = 232) breeds were evaluated. Height and length of the animals were measured on the day of the auction with a measuring tape, and animals were grouped into small or tall and short or long categories, as defined in this study. Wool fineness was measured using an Optical-based Fibre Diameter Analyser (FDA 2000) device and classified according to official wool classification standards (the Bradford System). There was no statistical difference in the average selling price of different breeds. There was a correlation between the breed and liquidity, in which Corriedale lambs were sold more than the Polwarth lambs, as expected; however, there was no such correlation for Merino lambs. The tall Merino lambs were sold at a higher selling price (R$ 2,449.11) than the small ones (R$ 1,826.59). Polwarth lambs exhibited positive correlations among height, length, and liquidity. Long and tall Corriedale lambs had a higher selling price (R$ 1,963.40 and R$ 1,915.02) than the short (R$ 1,656.38) and small (R$ 1,698.20) ones, respectively. In the case of Corriedale lambs, there was a positive correlation between length and liquidity. Wool fineness did not influence the selling price and liquidity in the three studied breeds. Conclusively, buyers of the Polwarth and Corriedale lambs prefer tall and long animals, regardless of the fleece wool fineness; only the height (taller lambs) seems to be a relevant factor for choosing the Merino breeders.

ABSTRACT Background: The inflammatory response plays a significant role in the outcome of coronavirus disease (COVID-19). Methods: We investigated plasma cytokine and chemokine concentrations in non-infected (NI), asymptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-infected blood donors (AS), and patients with severe COVID-19 (SC). Results: The SC group showed significantly higher levels of interleukin 6 (IL-6), IL-10, and CCL5 than the AS and NI groups. The SC and AS groups had considerably greater CXCL9 and CXCL10 concentrations than the NI group. Only NI and infected people showed separate clusters in the principal component analysis. Conclusions: SC, as well as AS was characterized by an inflammatory profile.

Resumo: O objetivo deste estudo foi analisar os fatores associados aos casos de anomalias congênitas na perspectiva dos determinantes sociais da saúde no Estado do Rio Grande do Sul, Brasil. Trata-se de um estudo do tipo caso-controle, com todas as duplas de mães e nascidos vivos no período de 2012 a 2015 no estado, sendo considerado o total de nascidos vivos com anomalia congênita (5.250), e realizada amostragem aleatória de 21 mil sem anomalia congênita, conforme as informações das Declarações de Nascidos Vivos. Para análise estatística, foram realizados testes qui-quadrado e modelos de regressão logística com o SPSS. O modelo de Dahlgren & Whitehead foi utilizado como base para agrupamento e discussão das variáveis. No modelo multivariado, todas variáveis que se mostraram associadas significativamente com o desfecho foram no sentido de aumentar a chance de nascimentos com anomalia congênita: as mulheres pretas tiveram 20% mais chance, comparadas às brancas (OR = 1,20; valor de p = 0,013); ter mais de 40 anos aumentou em 97% a chance, quando comparadas às de 18 a 29 anos; as mulheres com menos de quatro anos de estudo apresentaram 50% mais chance, comparadas às mulheres com 12 anos ou mais de estudo (OR = 1,50; valor de p = 0,001); as mulheres que não realizaram nenhuma consulta de pré-natal tiveram 97% mais chance, comparadas às mulheres que realizaram sete ou mais consultas (OR = 1,97; valor de p = 0,001); e a ocorrência de abortos/perdas fetais aumentou em 17% a chance, em relação a nunca ter tido abortos/perdas fetais prévios (OR = 1,17; valor de p = 0,001). Os resultados trazem à discussão as desigualdades raciais e sociais, relacionando-as às iniquidades em saúde.

Abstract: The objective of this study was to analyze factors associated with cases of congenital anomalies from the perspective of social determinants of health in the State of Rio Grande do Sul, Brazil. This is a case-control study with all the pairs of mothers and liveborn infants from 2012 to 2015 in the state, based on the total number of liveborn infants with congenital anomalies (5,250) and a random sample of 21,000 without congenital anomalies, according to data on the live birth certificates. The statistical analyses included chi-square tests and logistic regression models with SPSS. The Dahlgren & Whitehead model was used as the basis for grouping and discussing the variables. In the multivariate model, all the variables that were significantly associated with the outcome were in the sense of increasing the odds of births with congenital anomalies: black women had 20% higher odds than white women (OR = 1.20; p-value = 0.013); age over 40 years increased the odds by 97% when compared to women 18 to 29 years of age; women with less than four years of schooling showed 50% higher odds when compared to women with 12 or more years of schooling (OR = 1.50; p-value = 0.001); women with no prenatal visits had 97% higher odds than women with seven or more prenatal visits (OR = 1.97; p-value = 0.001); and prior history of miscarriages/stillbirths increased the odds by 17% (OR = 1.17; p-value = 0.001). The results raise the issue of racial and social inequalities, related to health inequities.

Resumen: El objetivo de este estudio fue analizar los factores asociados con los casos de anomalías congénitas desde la perspectiva de los determinantes sociales en salud del estado de Rio Grande do Sul, Brasil. Se trata de un estudio de tipo caso-control, con todas las parejas de madres y nacidos vivos en el período de 2012 a 2015 en el estado, considerando el total de nacidos vivos con anomalía congénita (5.250), y realizando una muestra aleatoria con 21.000 sin anomalía congénita, conforme la información de las Declaraciones de Nacidos Vivos. Para el análisis estadístico, se realizaron tests chi-cuadrado y modelos de regresión logística mediante el SPSS. El modelo de Dahlgren & Whitehead se utilizó como base para el agrupamiento y discusión de las variables. En el modelo multivariado, todas las variables que se mostraron asociadas significativamente con el resultado fueron en el sentido de aumentar la oportunidad de nacimientos con anomalía congénita: las mujeres negras tuvieron un 20% más de oportunidad, comparadas con las blancas (OR = 1,20; valor de p = 0,013); tener más de 40 años aumentó en un 97% la oportunidad, cuando se comparan con las de 18 a 29 años; las mujeres con menos de cuatro años de estudio presentaron un 50% más de oportunidades, comparadas con las mujeres con 12 años o más de estudio (OR = 1,50; valor de p = 0,001); las mujeres que no realizaron ninguna consulta prenatal tuvieron 97% más oportunidades, comparadas con las mujeres que realizaron siete o más consultas (OR = 1,97; valor de p = 0,001); y la ocurrencia de abortos/pérdidas fetales aumentó en un 17% la oportunidad, en relación a nunca haber sufrido abortos/pérdidas fetales previas (OR = 1,17; valor de p = 0,001). Los resultados plantean la discusión de las desigualdades raciales y sociales, relacionándolas con las inequidades en salud.

Resumo: O objetivo deste estudo foi analisar os fatores associados aos casos de anomalias congênitas na perspectiva dos determinantes sociais da saúde no Estado do Rio Grande do Sul, Brasil. Trata-se de um estudo do tipo caso-controle, com todas as duplas de mães e nascidos vivos no período de 2012 a 2015 no estado, sendo considerado o total de nascidos vivos com anomalia congênita (5.250), e realizada amostragem aleatória de 21 mil sem anomalia congênita, conforme as informações das Declarações de Nascidos Vivos. Para análise estatística, foram realizados testes qui-quadrado e modelos de regressão logística com o SPSS. O modelo de Dahlgren & Whitehead foi utilizado como base para agrupamento e discussão das variáveis. No modelo multivariado, todas variáveis que se mostraram associadas significativamente com o desfecho foram no sentido de aumentar a chance de nascimentos com anomalia congênita: as mulheres pretas tiveram 20% mais chance, comparadas às brancas (OR = 1,20; valor de p = 0,013); ter mais de 40 anos aumentou em 97% a chance, quando comparadas às de 18 a 29 anos; as mulheres com menos de quatro anos de estudo apresentaram 50% mais chance, comparadas às mulheres com 12 anos ou mais de estudo (OR = 1,50; valor de p = 0,001); as mulheres que não realizaram nenhuma consulta de pré-natal tiveram 97% mais chance, comparadas às mulheres que realizaram sete ou mais consultas (OR = 1,97; valor de p = 0,001); e a ocorrência de abortos/perdas fetais aumentou em 17% a chance, em relação a nunca ter tido abortos/perdas fetais prévios (OR = 1,17; valor de p = 0,001). Os resultados trazem à discussão as desigualdades raciais e sociais, relacionando-as às iniquidades em saúde.

Abstract: The objective of this study was to analyze factors associated with cases of congenital anomalies from the perspective of social determinants of health in the State of Rio Grande do Sul, Brazil. This is a case-control study with all the pairs of mothers and liveborn infants from 2012 to 2015 in the state, based on the total number of liveborn infants with congenital anomalies (5,250) and a random sample of 21,000 without congenital anomalies, according to data on the live birth certificates. The statistical analyses included chi-square tests and logistic regression models with SPSS. The Dahlgren & Whitehead model was used as the basis for grouping and discussing the variables. In the multivariate model, all the variables that were significantly associated with the outcome were in the sense of increasing the odds of births with congenital anomalies: black women had 20% higher odds than white women (OR = 1.20; p-value = 0.013); age over 40 years increased the odds by 97% when compared to women 18 to 29 years of age; women with less than four years of schooling showed 50% higher odds when compared to women with 12 or more years of schooling (OR = 1.50; p-value = 0.001); women with no prenatal visits had 97% higher odds than women with seven or more prenatal visits (OR = 1.97; p-value = 0.001); and prior history of miscarriages/stillbirths increased the odds by 17% (OR = 1.17; p-value = 0.001). The results raise the issue of racial and social inequalities, related to health inequities.

Resumen: El objetivo de este estudio fue analizar los factores asociados con los casos de anomalías congénitas desde la perspectiva de los determinantes sociales en salud del estado de Rio Grande do Sul, Brasil. Se trata de un estudio de tipo caso-control, con todas las parejas de madres y nacidos vivos en el período de 2012 a 2015 en el estado, considerando el total de nacidos vivos con anomalía congénita (5.250), y realizando una muestra aleatoria con 21.000 sin anomalía congénita, conforme la información de las Declaraciones de Nacidos Vivos. Para el análisis estadístico, se realizaron tests chi-cuadrado y modelos de regresión logística mediante el SPSS. El modelo de Dahlgren & Whitehead se utilizó como base para el agrupamiento y discusión de las variables. En el modelo multivariado, todas las variables que se mostraron asociadas significativamente con el resultado fueron en el sentido de aumentar la oportunidad de nacimientos con anomalía congénita: las mujeres negras tuvieron un 20% más de oportunidad, comparadas con las blancas (OR = 1,20; valor de p = 0,013); tener más de 40 años aumentó en un 97% la oportunidad, cuando se comparan con las de 18 a 29 años; las mujeres con menos de cuatro años de estudio presentaron un 50% más de oportunidades, comparadas con las mujeres con 12 años o más de estudio (OR = 1,50; valor de p = 0,001); las mujeres que no realizaron ninguna consulta prenatal tuvieron 97% más oportunidades, comparadas con las mujeres que realizaron siete o más consultas (OR = 1,97; valor de p = 0,001); y la ocurrencia de abortos/pérdidas fetales aumentó en un 17% la oportunidad, en relación a nunca haber sufrido abortos/pérdidas fetales previas (OR = 1,17; valor de p = 0,001). Los resultados plantean la discusión de las desigualdades raciales y sociales, relacionándolas con las inequidades en salud.

RESUMO: O objetivo desse estudo foi avaliar o teor de fibra fisicamente efetiva (FDNfe) de dietas totais e seus efeitos nos nutrientes da dieta, das sobras e nos parâmetros fecais de bovinos de corte em 15 confinamentos comerciais. As amostras da dieta foram separadas utilizando a peneira Penn State Particle Size Separator (PSPS). As amostras foram analisadas quanto aos teores de matéria seca (MS), matéria mineral (MM), extrato etéreo (EE), proteína bruta (PB), fibra em detergente neutro (FDN), fibra em detergente ácido (FDA) e amido. Nas amostras de fezes também foram avaliadas o escore e pH fecal. Os confinamentos foram categorizados em dois tratamentos: FDNfe<20% e FDNfe≥20%. Os dados foram analisados por um modelo que incluiu os efeitos de grupo e covariável (sexo e grupo genético). Os teores de MS, PB, EE e amido foram menores nas dietas com FDNfe≥20%(P<0,05). A MS fecal foi maior e pH fecal matinal foi menor nas dietas com FDNfe<20% (P<0,05). Sendo assim a efetividade da fibra alterou os nutrientes da dieta total e sobras, bem como as variáveis pH e MS fecal. Com isso, o uso de PSPS e parâmetros fecais são ferramentas práticas e indiretas para medir o amido fecal e a efetividade da dieta em confinamentos de bovinos comerciais.

ABSTRACT: This study evaluated the effects of the physically effective fiber (peNDF) content on nutrient composition of the total mixed ration (TMR), orts and fecal parameters in 15 commercial beef feedlots. The particle size distribution of TMR was measured adopting Penn State Particle Size Separator (PSPS). Samples were evaluated for dry matter (DM), ash, ether extract (EE), crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF) and starch content. Fecal samples were also evaluated for pH and score. The feedlots were categorized into peNDF<20% and peNDF ≥ 20%. Data were analyzed by a model that included fixed effects of treatment and covariates (sex and genetic groups). Levels of DM, CP, EE and starch were lower in TMR with peNDF ≥ 20% (P<0.05). Fecal dry matter was higher and morning fecal pH was lower for TMR with peNDF<20% (P<0.05). Physically effective fiber changed nutrient levels in TMR, orts, fecal pH and DM. So, using PSPS and fecal parameters are practical and indirect tools for measuring fecal starch and assessing the effectiveness of the diet supplied to ruminants.