ABSTRACT BACKGROUND: A possible direct link between nonalcoholic fatty liver disease (NAFLD) and Helicobacter pylori (H. pylori) infection has recently emerged. OBJECTIVE: This study aimed to analyze associations between the presence of histologically demonstrated NAFLD aspects with H. pylori infection in individuals with obesity undergoing bariatric surgery. DESIGN AND SETTING: An observational analytical cross-sectional study was conducted based on data collected from the medical records of individuals undergoing bariatric surgery at a tertiary university hospital in 2019. METHODS: NAFLD was assessed through histological examination of wedge liver biopsies collected during the proceedings. H. pylori infection was analyzed through the association of the urease test and histological examination performed in biopsies routinely collected during preoperative esophagogastroduodenoscopy. RESULTS: Of the 88 participants, 85% were female, and the average age was 39.1 ± 8.4 years. H. pylori infection was present in 61.4% of the patients. The mean body mass index was 36.6 ± 3.4 kg/m2. The most prevalent histopathological aspects of NAFLD were macrovesicular steatosis (92%), hepatocellular ballooning (92%), lobular inflammation (93.2%), portal inflammation (96.6%), and fibrosis (93.2%). No histopathological aspect of NAFLD was found to be significantly associated with H. pylori infection. CONCLUSION: In this study population, H. pylori infection was not significantly associated with the histopathological aspects of NAFLD in individuals with obesity undergoing bariatric surgery.

Abstract Dunbar syndrome is diagnosed by excluding other possible causes of abdominal pains. Surgical treatment comprises complete dissection of the ligament and the surrounding nerve ganglion. This report describes the case of a previously healthy 45-year-old male patient who presented with epigastric abdominal pain irradiating to the back and weakness. Initially, abdominal computed tomography was ordered, showing arteriopathy of the celiac trunk and mesenteric artery with stenosis. The patient underwent surgical treatment because of the refractory pain, but findings were nonspecific. It was necessary to continue workup with serial angiotomography to follow the case. After around 6 months, thickening of the arcuate ligament was found, with compression of the proximal third of the celiac trunk and 80% stenosis. The patient therefore underwent laparoscopy to relieve celiac trunk compression, with satisfactory postoperative recovery.

Resumo A síndrome de Dunbar constitui um diagnóstico de exclusão dentro dos quadros de dor abdominal. O tratamento cirúrgico consiste na dissecção completa do ligamento e do gânglio nervoso circundante. Dessa forma, o presente caso refere-se a um paciente do sexo masculino, 45 anos, previamente hígido, com queixa de dor abdominal epigástrica com irradiação para o dorso e fraqueza. Inicialmente, foi realizada tomografia computadorizada de abdome para complementação do quadro, que evidenciou arteriopatia do tronco celíaco e da artéria mesentérica em associação com estenose. Optou-se por tratamento cirúrgico devido à refratariedade da dor, mas os achados foram inespecíficos. Houve necessidade de complementação da propedêutica com angiotomografia seriada para acompanhamento do caso. Após cerca de 6 meses, notou-se espessamento do ligamento arqueado, com compressão do terço proximal do tronco celíaco e estenose de 80%. Em meio a esse cenário, o paciente foi submetido a laparoscopia para descompressão do tronco celíaco, evoluindo satisfatoriamente no pós-operatório.

Ursolic acid (UA) is being investigated due to its anti-inflammatory potential, and structural modifications can enhance its biological activities. The aim of this study was to evaluate the immunomodulatory effect of the ursolic acid derivatives (UAD) in macrophages and in the carrageenan-induced paw edema model. RAW264.7 cells were cultured in the presence or absence of UA or UAD (1-18). Nitric oxide (NO), nuclear factor kappa B (NF-κB), tumor necrosis factor (TNF), and cellular viability were measured. 30 min before the carrageenan-induced paw edema, the UAD1 and UAD2 (200 mg kg-1) were administered intraperitoneally. The results showed that UAD2-4, UAD7, UAD9-11 had half maximal inhibitory concentration (IC50) greater than 90 µM and were able to reduce NO, NF-κB and TNF production. Moreover, UAD1 and UAD2 reduced paw edema and IL-6 production. In conclusion, the results obtained demonstrated a variation in the response between the derivatives due to the chemical modifications, showing potential to reduce the inflammatory mediators, deserving further investigations.

ABSTRACT Objective: To evaluate the association between the risk of death from COPD and air temperature events in ten major Brazilian microregions. Methods: This was a time series analysis of daily COPD deaths and daily mean air temperatures between 1996 and 2017. Using distributed nonlinear lag models, we estimated the cumulative relative risks of COPD mortality for four temperature percentiles (representing moderate and extreme cold and heat events) in relation to a minimum mortality temperature, with a lag of 21 days, in each microregion. Results: Significant associations were found between extreme air temperature events and the risk of death from COPD in the southern and southeastern microregions in Brazil. There was an association of extreme cold and an increased mortality risk in the following microregions: 36% (95% CI, 1.12-1.65), in Porto Alegre; 27% (95% CI, 1.03-1.58), in Curitiba; and 34% (95% CI, 1.19-1.52), in São Paulo; whereas moderate cold was associated with an increased risk of 20% (95% CI, 1.01-1.41), 33% (95% CI, 1.09-1.62), and 24% (95% CI, 1.12-1.38) in the same microregions, respectively. There was an increased COPD mortality risk in the São Paulo and Rio de Janeiro microregions: 17% (95% CI, 1.05-1.31) and 12% (95% CI, 1,02-1,23), respectively, due to moderate heat, and 23% (95% CI, 1,09-1,38) and 32% (95% CI, 1,15-1,50) due to extreme heat. Conclusions: Non-optimal air temperature events were associated with an increased risk of death from COPD in tropical and subtropical areas of Brazil.

RESUMO Objetivo: Avaliar a associação entre o risco de morte por DPOC e eventos de temperatura do ar em dez grandes microrregiões brasileiras. Métodos: Esta foi uma análise de série temporal de mortes diárias por DPOC e temperaturas médias diárias do ar entre 1996 e 2017. Utilizando modelos de defasagem não linear distribuídos, estimamos os riscos relativos cumulativos de mortalidade por DPOC para quatro percentis de temperatura (representando eventos moderados e extremos de frio e calor) em relação a uma temperatura mínima de mortalidade, com defasagem de 21 dias, em cada microrregião. Resultados: Foram encontradas associações significativas entre eventos extremos de temperatura do ar e o risco de morte por DPOC nas microrregiões Sul e Sudeste do Brasil. Houve associação de frio extremo e aumento do risco de mortalidade nas seguintes microrregiões: 36% (IC 95%, 1,12-1,65), em Porto Alegre; 27% (IC 95%, 1,03-1,58), em Curitiba; e 34% (IC 95%, 1,19-1,52), em São Paulo; enquanto o frio moderado foi associado a um risco aumentado de 20% (IC 95%, 1,01-1,41), 33% (IC 95%, 1,09-1,62) e 24% (IC 95%, 1,12-1,38) nas mesmas microrregiões, respectivamente. Houve aumento do risco de mortalidade por DPOC nas microrregiões de São Paulo e Rio de Janeiro: 17% (IC 95%, 1,05-1,31) e 12% (IC 95%, 1,02-1,23), respectivamente, devido ao calor moderado e 23% (IC 95%, 1,09-1,38) e 32% (IC 95%, 1,15-1,50) devido ao calor extremo. Conclusões: Eventos de temperatura do ar não ideal foram associados a um risco aumentado de morte por DPOC em áreas tropicais e subtropicais do Brasil.

Resumo Produtos derivados de plantas podem auxiliar no processo de cicatrização de feridas cutâneas. Foi demonstrado que o látex de Hancornia speciosa apresenta atividades angiogênicas, osteogênicas, antiinflamatórias e antioxidantes. Então, este biomaterial pode contribuir para o processo de cicatrização de feridas. No entanto, produtos naturais em contato com a pele podem causar dermatites. O objetivo deste trabalho foi avaliar o potencial alérgico e irritante do látex da fração soro de H. speciosa por meio de ensaios in vitro. Os resultados obtidos mostraram que o látex da fração do soro de H. speciosa possui um potencial pouco irritante e não é citotóxico nem alergênico para células humanas. Além disso, foi identificado uma notável baixa quantidade de proteínas neste material em comparação ao látex de Hevea brasiliensis. Esse resultado poderia explicar o potencial não alergênico do látex da fração soro de H. speciosa, pois as proteínas presentes no látex são as principais responsáveis pela alergia. Este biomaterial pode ser utilizado como fonte não alergênica para desenvolvimento de novos medicamentos.

Abstract Plant-derived products can assist in the healing process of dermal wounds. It has been demonstrated that Hancornia speciosa latex present angiogenic, osteogenic, anti-inflammatory, and antioxidant activities. Then, it could contribute to the wound healing process. However, natural products in contact with skin may cause dermatitis. The objective of this work was to evaluate the allergic and irritant potential of H. speciosa serum fraction latex using in vitro assays. The obtained results showed that the H. speciosa serum fraction latex has a slightly irritant potential and is not cytotoxic neither allergenic for human cells. Moreover, we identified a remarkable low amount of proteins in this material in comparison to Hevea brasiliensis latex. This result could explain the non-allergenic potential of H. speciosa serum fraction latex because proteins present in latex are the main responsible for allergy. This biomaterial could be used as a non-allergenic source for development of new medicines.

ABSTRACT The objective was to evaluate the digestive tract characteristics, metabolizability and nutrient retention of broilers fed diets supplemented with enzyme complex (EC). To evaluate the characteristics of the digestive tract 600 female Cobb 500 birds were used, distributed in a completely randomized design, with 5 inclusion levels of the EC (0; 100, 200, 300 and 400 g/ton) and 6 replicates of 20 birds each. To evaluate the metabolizability and the retention of nutrients 200 female Cobb 500 birds at 15 days of age were used, distributed in a completely randomized design with 5 levels of supplementation of the EC and 4 replicates of 10 birds each. No significant effects (P>0.05) were observed for the supplementation of the EC in the intestinal pH, digestive organ weight, intestinal length and metabolizable coefficients of dry matter and crude protein. The metabolizable coefficient of ethereal extract was influenced in a quadratic decreasing form (P<0.01). The metabolizable coefficients of calcium (Ca) and phosphorus (P) were influenced in a quadratic increase (P<0.01), resulting in increased Ca retention in 21.39% and P in 9.56%. Supplementation of the EC in broiler diets improves the metabolizability and retention of P and Ca, without affecting the other parameters evaluated.

Abstract This study described a broad clinical characterization of classical homocystinuria (HCU) in Brazil. This was a cross-sectional, observational study including clinical and biochemical data from 72 patients (60 families) from Brazil (South, n = 13; Southeast, n = 37; Northeast, n = 8; North, n = 1; and Midwest, n = 1). Parental consanguinity was reported in 42% of families. Ocular manifestations were the earliest detected symptom (53% of cases), the main reason for diagnostic suspicion (63% of cases), and the most prevalent manifestation at diagnosis (67% of cases). Pyridoxine responsiveness was observed in 14% of patients. Only 22% of nonresponsive patients on treatment had total homocysteine levels <100 mmol/L. Most commonly used treatment strategies were pyridoxine (93% of patients), folic acid (90%), betaine (74%), vitamin B12 (27%), and low-methionine diet + metabolic formula (17%). Most patients diagnosed with HCU in Brazil are late diagnosed, express a severe phenotype, and poor metabolic control. Milder forms of HCU are likely underrepresented due to underdiagnosis.

OBJETIVOS: determinar fatores prognósticos com possível impacto na morbimortalidade e sobrevida de pacientes submetidos ao tratamento cirúrgico das metástases hepáticas de tumores neuroendócrinos. MÉTODOS: foram estudados 22 pacientes submetidos à ressecção hepática por metástases de tumores neuroendócrinos entre 1997 e 2007. Dados epidemiológicos e clínicos foram correlacionados com morbimortalidade e sobrevidas global e livre de doença. RESULTADOS: doze pacientes eram do sexo masculino e dez do feminino com média de idade de 48,5 anos. Doença bilobar esteve presente em 17 pacientes (77,3%). Em dez pacientes (45,5%) o tumor primário se originou no pâncreas, em oito no íleo terminal, em dois no duodeno, em um no reto e em um no jejuno. Ressecção cirúrgica completa (R0) foi alcançada em 59,1% dos pacientes. Oito pacientes (36,3%) evoluíram com complicações no pós-operatório imediato, com um paciente evoluindo ao óbito por septicemia. Todos os pacientes submetidos à re-hepatectomia e/ou hepatectomia em dois tempos evoluíram com complicações no período pós-operatório. A sobrevida global em um e cinco anos foi 77,3% e 44,2%. A sobrevida livre de doença em cinco anos foi 13,6%. O tumor neuroendócrino primário do pâncreas (p=0,006) foi associado à redução na sobrevida global. Os pacientes com número de nódulos metastáticos <10 (p=0,03) e os assintomáticos ao diagnóstico (p=0,015), apresentaram maior sobrevida livre de doença. CONCLUSÃO: metástases hepáticas oriundas de tumores neuroendócrinos pancreáticos demonstraram ser um fator prognóstico negativo. Pacientes sintomáticos e com múltiplos nódulos metastáticos apresentam redução significativa na sobrevida livre de doença.

OBJECTIVES: to determine the prognostic factors that may impact on morbidity and mortality and survival of patients undergoing surgical treatment of liver metastases from neuroendocrine tumors. METHODS: We studied 22 patients undergoing liver resection for metastases from neuroendocrine tumors between 1997 and 2007. Epidemiological and clinical data were correlated with morbidity and mortality and overall and disease-free survivals. RESULTS: twelve patients were male and ten female, with a mean age of 48.5 years. Bilobar disease was present in 17 patients (77.3%). In ten patients (45.5%) the primary tumor originated in the pancreas, terminal ileum in eight, duodenum in two, rectum in one and jejunum in one. Complete surgical resection (R0) was achieved in 59.1% of patients. Eight patients (36.3%) developed complications in the immediate postoperative period, one of them dying from septicemia. All patients undergoing re-hepatectomy and/or two-stage hepatectomy had complications in the postoperative period. The overall survival at one and five years was 77.3% and 44.2%. The disease-free survival at five years was 13.6%. The primary pancreatic neuroendocrine tumor (p = 0.006) was associated with reduced overall survival. Patients with number of metastatic nodules < 10 (p = 0.03) and asymptomatic at diagnosis (p = 0.015) had higher disease-free survival. CONCLUSION: liver metastases originating from pancreatic neuroendocrine tumors proved to be a negative prognostic factor. Symptomatic patients with multiple metastatic nodules showed a significant reduction in disease-free survival.

OBJECTIVE: To evaluate the prevalence of sexual dysfunction and its associated factors in middle-aged women with 11 years or more of formal education. METHODS: A cross-sectional, population-based study was carried out using an anonymous, self-response questionnaire. A total of 315 Brazilian-born women, 40-65 years of age with 11 years or more of schooling, participated in the study. The instrument used in the evaluation was based on the Short Personal Experiences Questionnaire. Sexual dysfunction was calculated from the mean score of sexual responsiveness (pleasure in sexual activities, excitation and orgasm), frequency of sexual activities and libido. Sociodemographic and clinical factors were evaluated. Poisson multiple regression analysis was carried out and the prevalence ratios with respective 95% confidence intervals (95%CI) were calculated. RESULTS: The prevalence of sexual dysfunction was 35.9% among our study population. Multiple regression analysis showed that sexual dysfunction was positively associated with older age (prevalence ratios=1.04; 95%CI:1.01-1.07) and with the presence of hot flashes (prevalence ratios=1.37; 95%CI:1.04-1.80). Having a sexual partner (PR=0.47; 95%CI:0.34-0.65) and feeling well or excellent (prevalence ratios= 0.68; 95%CI: 0.52-0.88) were factors associated with lower sexual dysfunction scores. CONCLUSIONS: Sexual dysfunction was present in more than one-third of women that were 40-65 years of age with 11 years or more of formal education. Within that age group, older age and hot flashes were associated with higher sexual dysfunction scores, whereas feeling well and having a sexual partner were associated with better sexuality.

Em experimento de casa de vegetação, realizado em Campinas (SP), no período de janeiro a maio de 1980, estudaram-se os efeitos da peletização do lodo de esgoto, nas doses 0, 1 e 5% (v/v) do material seco, na produção de matéria seca e na absorção de Zn, Cu e Ni pela parte aérea do milho (Zea mays L.), em latossolo roxo (LR), latossolo vermelho-escuro (LE) e latossolo vermelho-amarelo (LV), que receberam ou não adição de CaCO3 suficiente para elevação do pH em água para 6,0. O experimento foi realizado em vasos com dois litros de capacidade, delineados em blocos ao acaso, com três repetições, e os tratamentos arranjados num esquema fatorial. Após 200 dias de incubação dos solos com o lodo e CaCO3, cultivaram-se quatro plantas de milho em cada vaso. A parte aérea foi quantificada 56 dias após a germinação, sendo cortada, seca, pesada e analisada para os elementos Zn, Cu e Ni. Amostras de terra de cada tratamento foram retiradas e tiveram os metais extraídos pelo DTPA. A peletização do lodo de esgoto resultou em diminuição significativa na produção de matéria seca pela parte aérea do milho, nos três solos estudados, em comparação com o lodo não peletizado. A adição de CaCO3 proporcionou aumento significativo na produção de matéria seca do milho apenas nos dois solos mais ácidos (LE e LV) e diminuiu o acúmulo de Zn na parte aérea desse vegetal cultivado no LE, sem distinção quanto ao tipo de lodo aplicado, não se observando diferenças significativas na absorção de Ni, em todos os solos analisados. A incorporação do lodo peletizado , que continha 19% menos Zn e Ni que o não peletizado, resultou em menor absorção de Zn, Cu e Ni nos três solos, exceto para o Ni no LR. Para todos os solos investigados, o método do DTPA mostrou-se mais adequado em prognosticar as quantidades disponíveis de Zn e de Cu para o milho, independentemente do tipo de lodo de esgoto aplicado e da elevação ou não do pH do solo pela adição de CaCO3.

The effect of sewage sludge pelletization added at rates of 0, 1 and 5% (v/v) of dry material was studied on corn growth and absorption of Zn, Cu and Ni, with or without the addition of CaCO3 to increase soil pH to 6.0. Three Hapludox soil samples from the State of São Paulo, Brazil, "latossolo roxo", "latossolo vermelho-escuro" e "latossolo vermelho-amarelo" (LR , LE and LV, respectively) were used in a greenhouse experiment conducted in Campinas, State of São Paulo, Brazil, from January to May, 1980. Treatments were placed into plastic bags and, after a 200-day incubation period, were transferred to 2 litter pots in which four corn (Zea mays L.) plants were cultivated in each one. Plant tops were harvested 56 days after emergence, dried, weighted and analysed for Ni, Cu and Zn. Soil samples were taken for DTPA extraction of Ni, Zn and Cu, which were correlated with tissue amounts of these elements by regression analysis. Addition of sewage sludge as pellets significantly decreased corn dry matter production in all soils. Calcium carbonate addition significantly increased dry matter production only in the LE and LV soils, and decreased plant top Zn accumulation when corn was cropped on the LE soil with any kind of sewage sludge. Calcium carbonate addition also did not affect Ni absorption in all soils under investigation. Pelletized sewage sludge addition, which contained 19% less Zn and Ni than the nonpelletized one, decreased the absorption of Zn, Cu and Ni in all soils, except for Ni in the LR. DTPA extraction was more suitable for predicting Zn and Cu availability to corn in the three soils treated or not with CaCO3 and with any kind of sewage sludge applied.

Foram estudadas no período 1973/78, em Latossolo roxo distrófico da Alta Mojiana (SP), as respostas de soja à aplicação de cinco níveis de adubação potássica, sendo o fertilizante aplicado apenas no primeiro ano. Em nenhuma localidade se observou efeito significativo do potássio na produção de sementes de soja nem nos teores desses elementos determinados nas folhas no período de florescimento das plantas em qualquer dos anos estudados. Em vista dessa não-resposta, foram determinados, em 1978, os teores de potássio trocável extraível com HNO3 IN a quente e do potássio total em amostras dos três latossolos. Pela análise mineralógica da fração grosseira, verificou-se a não-existência de minerais que possam apresentar reservas ponderáveis de potássio. Os baixos teores de potássio trocável e extraível pelo HNO3 a quente e as boas produções de soja obtidas nesses solos mostram que a soja tem grande poder de extração para o potássio do solo e que o nível de 0,12 meq/l00g, normalmente apresentado como limite inferior para a disponibilidade do potássio trocável do solo para o caso de soja, em solos de cerrado, e quando se utilizam cultivares de ciclo de 140 dias ou mais, pode ser provavelmente rebaixado para valores ao redor de 0,08 meq/100g de solo.

A study was carried out in the North of the State of São Paulo during a five year period (1973/78) in the cerrado soil at three localities to study yields of soybeans with the application of different levels of potassium. The potassium in the form of potassium chloride was applied in the rows at planting time only in the first year and in subsequent years only residual effect was studied. At the three localities no significant increase in yield of soybeans was observed nor were there differences in concentration of K in leaves in any of the years. Chemical analysis were made to determine exchangeable K, nonexchangeable K with could be released and total soil K. The soil mineralogical analysis showed the nonexistance of potassium reserves. Low exchangeable K and nonexchangeable K and good yields of soybeans indicated that soybeans have great capacity to extract potassium from the soil and the critical level usually established at 0.12 meq/100 g in the soil for soybean crop could probably be lowered to approximately 0.08 meq/100 g in cerrado soil for cultivars with 140 or more days maturity.

O presente trabalho descreve o levantamento de solos ao nível de série, efetuado na Estação Experimental de Itararé, SP, que ocupa uma área de 495 ha. O relevo regional é representado por superfícies suavizadas esculpidas em material do Devoniano. O tipo climático é Cfa, segundo Koppen, e a vegetação primitiva, campos altimontanos. Foram observados 118 pontos em 50 dos quais foi coletado material para análise granulométrica e/ou química. Foram coletados, descritos e analisados 10 perfis e estabelecidas sete unidades de mapeamento pertencentes aos grandes grupos Inceptisol e Oxisol, e a um complexo indiscriminado.

In this paper a description of a detailed soil survey in the Agricultural Experiment Station at Itararé, SP is given. The soil survey of the 495 ha of the Experiment Station was done at the series level. Seven soil units were identified and the description and analysis of four Inceptisols, and two Oxisols are presented. A soil map at 1:10,000 scale is also presented.

Neste trabalho descreve-se o levantamento detalhado dos solos da Estação Experimental de Pindorama, São Paulo, que ocupa área de 532,8 ha. O levantamento foi executado ao nível de série e foram identificadas, cartografadas e caracterizadas sete unidades de mapeamento, duas pertencentes ao grande grupo Tropudalf, uma ao grande grupo Tropudult, três ao grande grupo Paleudult e ainda um complexo de solos hidromórficos. Os solos da Unidade Pindorama, classificados como Tropudalf e correlacionados com os solos podzolizados de Lins e Marília, da Comissão de Solos são os que predominam na Estação, com 56,8% de sua área.

In this paper the detailed soil survey of the Agricultural Experiment Station at Pindorama, State of São Paulo is described. The soil survey was done at the series level for the 532.8 ha of the Agricultural Experiment Station. Seven soil units were identified and the descripton and analysis of two Tropudalf, one Tropudult, three Paleudult, and a soils complex are given. A soil map at 1:10.000 scale is also presented.