ABSTRACT Background: Alpha 1-antitrypsin deficiency (AATD) is a hereditary codominant autosomal disease. This liver disease ranges from asymptomatic cases to terminal illness, which makes early recognition and diagnosis challenging. It is the main cause of pediatric liver transplantation after biliary atresia. Objective: To describe the clinical characteristics, as well as those of histologic and laboratory tests, phenotypic and/or genetic evaluation and evolution of a cohort of pediatric patients with AATD. Methods: This is a retrospective observational study of 39 patients with confirmed or probable AATD (without phenotyping or genotyping, but with suggestive clinical features, low serum alpha 1-antitrypsin (AAT) level and liver biopsy with PAS granules, resistant diastasis). Clinical, laboratory and histological variables, presence of portal hypertension (PH) and survival with native liver have been analyzed. Results: A total of 66.7% of 39 patients were male (26/39). The initial manifestation was cholestatic jaundice in 79.5% (31/39). Liver transplantation was performed in 28.2% (11/39) of patients. Diagnosis occurred at an average of 3.1 years old and liver transplantation at 4.1 years of age. 89.2% (25/28) of the patients with confirmed AATD were PI*ZZ or ZZ. The average AAT value on admission for PI*ZZ or ZZ patients was 41.6 mg/dL. All transplanted patients with phenotyping or genotyping were PI*ZZ (or ZZ). Those who were jaundiced on admission were earlier referred to the specialized service and had higher levels of GGT and platelets on admission. There was no significant difference in the survival curve when comparing cholestatic jaundiced to non-cholestatic jaundiced patients on admission. Comparing patients who did or did not progress to PH, higher levels of AST and APRI score at diagnosis (P=0.011 and P=0.026, respectively) were observed and in the survival curves patients with PH showed impairment, with 20.2% survival with native liver in 15 years. Conclusion: Jaundice is an important clinical sign that motivates referral to a specialist, but it does not seem to compromise survival with native liver. Patients progressing to PH had higher AST, APRi score on admission and significantly impaired survival with native liver. It is important to pay attention to these signs in the follow-up of patients with AATD.

RESUMO Contexto: Deficiência de alfa 1-antitripsina (DAAT) é uma doença hereditária, de caráter autossômico codominante. A apresentação da doença hepática varia desde casos assintomáticos até doença terminal, o que dificulta reconhecimento e diagnóstico precoces. É a principal causa de transplante hepático pediátrico após atresia de vias biliares. Objetivo: Descrever as características clínicas, de exames laboratoriais, histológicos, avaliação fenotípica e/ou genética e sobrevida de uma coorte de pacientes pediátricos com DAAT. Métodos: Estudo observacional retrospectivo de 39 pacientes com diagnóstico de DAAT confirmada ou provável (sem fenotipagem ou genotipagem, mas com clínica sugestiva, baixo nível sérico de alfa 1-antitripsina (A1AT) e biópsia hepática com grânulos PAS, diástase resistentes). Variáveis clínicas, laboratoriais, histológicas, presença de hipertensão portal (HP) e sobrevida com fígado nativo foram analisadas. Resultados: Dos 39 pacientes, 66,7% eram do sexo masculino (26/39). A manifestação inicial foi icterícia colestática em 79,5% (31/39). Em 28,2% (11/39) houve necessidade de transplante hepático. O diagnóstico ocorreu com uma idade média de 3,1 anos e, o transplante hepático, 4,1 anos. Dos pacientes com DAAT confirmada, 89,2% (25/28) eram PI*ZZ ou ZZ. O valor médio de A1AT na admissão de pacientes PI*ZZ ou ZZ foi 41,6 mg/dL. Todos os transplantados com fenotipagem ou genotipagem eram PI*ZZ (ou ZZ). Os ictéricos à admissão foram referenciados mais cedo ao serviço especializado e apresentaram níveis mais elevados de GGT e plaquetas à admissão. Não houve diferença significativa na curva de sobrevida ao compararmos icterícia colestática ou não à admissão. Ao comparar os pacientes que progrediram ou não para HP, observou-se níveis mais elevados de AST e APRI escore ao diagnóstico (P=0,011 e P=0,026, respectivamente) e, nas curvas de sobrevida, pacientes com HP apresentaram comprometimento, com 20,2% de sobrevida com fígado nativo em 15 anos. Conclusão: Icterícia é um sinal clínico importante que motiva o encaminhamento ao especialista, mas parece não comprometer a sobrevida com fígado nativo. Pacientes com evolução para HP tiveram AST e escore APRi mais elevados à admissão e comprometimento significativo da sobrevida com fígado nativo. Importante atentar a esses sinais no seguimento de pacientes com DAAT.

Resumo Introdução: O cancro do cólon e reto é a neoplasia mais frequente considerando os dois géneros. . A deteção de lesões pré-malignas por colonoscopia está associada a uma redução da incidência e da mortalidade. Estudos sobre a utilização da luz de banda estreita (NBI) na deteção de lesões serreadas tiveram resultados promissores, mas heterogéneos. Métodos: Realizámos um ensaio clínico randomizado para comparar o número médio de lesões serreadas e lesões hiperplásicas ≥10 mm com NBI ou luz branca de alta-definição (HD-WL). Como resultados secundários comparámos a prevalência e as taxas de deteção de lesões serreadas sésseis, adenomas e todas as lesões. Resultados: Foram randomizados 782 doentes (392 no grupo HD-WL e 390 no grupo NBI). O número médio de lesões serreadas e hiperplásicas ≥10 mm não apresentou diferença estatisticamente significativa entre dois grupos (0.118 vs. 0.156, p = 0.44). A taxa de deteção de adenomas (55.2% vs. 53.2%, p = 0.58) e a taxa de deteção de lesões serreadas sésseis (6.8% vs. 7.5%, p = 0.502) também não foram diferentes. O tempo de retirada foi maior no grupo NBI (10.88 vs. 9.47 min, p = 0.004) e o tempo total de procedimento teve um ligeiro aumento não atingindo significância estatística (20.97 vs. 19.30 min, p = 0.052). Conclusão: A utilização da luz NBI por rotina não aumenta a deteção de lesões serreadas nem de qualquer lesão pré-maligna e aumenta o tempo de retirada na colo-noscopia.

Abstract Background: Colorectal cancer (CRC) is a leading cause of cancer. The detection of premalignant lesions by colonoscopy is associated with reduced CRC incidence and mortality. Narrow band imaging has shown promising but conflicting results for the detection of serrated lesions. Methods: We performed a randomized clinical trial to compare the mean detection of serrated lesions and hyperplastic polyps ≥10 mm with NBI or high-definition white light (HD-WL) withdrawal. We also compared all sessile serrated lesions (SSLs), adenoma, and polyp prevalence and rates. Results: Overall, 782 patients were randomized (WL group 392 patients; NBI group 390 patients). The average number of serrated lesions and hyperplastic polyps ≥10 mm detected per colonoscopy (primary endpoint) was similar between the HD-WL and NBI group (0.118 vs. 0.156, p = 0.44). Likewise, the adenoma detection rate (55.2% vs. 53.2%, p = 0.58) and SSL detection rate (6.8% vs. 7.5%, p = 0.502) were not different between the two study groups. Withdrawal time was higher in the NBI group (10.88 vs. 9.47 min, p = 0.004), with a statistically nonsignificant higher total procedure time (20.97 vs. 19.30 min, p = 0.052). Conclusions: The routine utilization of narrow band imaging does not improve the detection of serrated class lesions or any pre-malignant lesion and increases the with-drawal time.

ABSTRACT Background: Most data on the natural history of portal hypertension come from studies in adults. The morbidity rate of upper gastrointestinal bleeding (UGIB) in children with portal hypertension has not been systematically characterized. Objective: To describe the morbidity and mortality of UGIB in pediatric patients with portal hypertension and identify predictive factors for the occurrence of its main complications. Methods: This retrospective study included pediatric patients with cirrhotic portal hypertension or with extrahepatic portal vein obstruction (EHPVO). Mortality and UGIB complications within a period of up to 6 weeks of the bleeding were investigated. To determine the predictive factors of morbidity, a multivariate analysis was performed using logistic regression; all results were considered significant at P<0.05. Results: A total of 86 patients (51.2% with EHPVO and 48.8% with cirrhosis) had 174 bleeding events. Ascites was the most common complication (43.1% of all cases), being more prevalent in patients with cirrhosis (P<0.001). Cirrhosis was a predictor of the occurrence of any morbidity (OR 20.3). The need for blood transfusion was predictor of at least one complication (OR 5.8), ascites (OR 7.2) and infections (OR 3.8) in the general group and at least one complication (OR 11.3) and ascites (OR 5.8) in cirrhotic patients. The need for expansion was a predictor of any morbidity (OR 4.6) and infections (OR 3.9) in the general group, in addition to being predictor of infection in cirrhotic patients (OR 5.4). There were no deaths from UGIB in the six weeks post-bleeding. Conclusion: The study showed the relevance of morbidity after UGIB in pediatric patients with portal hypertension, especially in those with cirrhosis. The patients with hemodynamic instability requiring blood transfusion or expansion on admission are at increased risk of complications related to upper gastrointestinal bleeding and should be closely monitored.

RESUMO Contexto: A maioria dos dados sobre a história natural da hipertensão porta provém de estudos em adultos. A morbidade associada à hemorragia digestiva alta (HDA) em crianças com hipertensão porta ainda não foi sistematicamente estudada. Objetivo: Descrever a morbimortalidade da HDA em pacientes pediátricos com hipertensão porta e identificar fatores preditivos para a ocorrência de suas principais complicações. Métodos: Este estudo retrospectivo incluiu pacientes pediátricos com hipertensão porta cirrótica ou com obstrução extra-hepática da veia porta (OEHVP). A mortalidade e as complicações da HDA foram estudadas até seis semanas após o sangramento. Para determinar os fatores preditivos de morbidade, foi realizada análise multivariada por meio de regressão logística; todos os resultados foram considerados significativos com P<0,05. Resultados: Oitenta e seis pacientes (51,2% com OEHVP e 48,8% com cirrose) tiveram 174 eventos hemorrágicos. A ascite foi a complicação mais comum (43,1% de todos os casos), sendo mais prevalente em pacientes com cirrose (P<0,001). A cirrose foi preditor da ocorrência de pelo menos uma complicação (OR 20,3). A necessidade de transfusão sanguínea foi preditora de pelo menos uma complicação (OR 5,8), ascite (OR 7,2) e infecções (OR 3,8) no grupo geral e pelo menos uma complicação (OR 11,3) e ascite (OR 5,8) nos cirróticos. A necessidade de expansão foi preditor de qualquer morbidade (OR 4,6) e infecções (OR 3,9) no grupo geral, além de ser preditor de infecção em cirróticos (OR 5,4). Não houve óbitos por HDA nas 6 semanas pós-sangramento. Conclusão: O estudo mostrou a relevância da morbidade após HDA em pacientes pediátricos com hipertensão porta, principalmente naqueles com cirrose. Os pacientes com instabilidade hemodinâmica que necessitam de transfusão de sangue ou expansão na admissão têm risco aumentado de complicações relacionadas à hemorragia digestiva alta e devem ser monitorados de perto.

ABSTRACT The cultivation of cover plants is a strategy for improving the agricultural production environment and providing straw for soil cover in the no-tillage system, in addition to cycling and providing nutrients to succeeding crops. This study aimed to assess the dry matter yield and nutrients accumulation by cover plants grown alone or intercropped in the second crop after soybean and their effects on cotton grown in succession. The treatments were: Urochloa ruziziensis; Pennisetum glaucum (millet); Zea mays (corn); Crotalaria spectabilis; Crotalaria ochroleuca; Cajanus cajan (pigeon pea); corn + U. ruziziensis; C. spectabilis + U. ruziziensis; C. ochroleuca + U. ruziziensis; pigeon pea + U. ruziziensis; corn + C. spectabilis; corn + C. ochroleuca; and corn + pigeon pea. The experimental design consisted of randomized blocks, with four replications, and the experiment was carried out in two crop seasons. In the cotton pre-seeding, the maximum amount of corn straw dry matter was 2,699 kg ha-1, with low macronutrient contents. The pigeon pea intercropped with U. ruziziensis produced between 8,400 and 12,941 kg ha-1 of dry matter, with a maximum content of 223 and 323 kg ha-1 of nitrogen and potassium, respectively. The U. ruziziensis, grown alone or intercropped, provided between 140 and 323 kg ha-1 of potassium in the straw. A high yield is obtained by cotton grown in the no-tillage system in succession to C. spectabilis.

RESUMO O cultivo de plantas de cobertura é uma estratégia para a melhoria do ambiente de produção agrícola e aporte de palhada para cobertura do solo no sistema plantio direto, além de ciclar e disponibilizar nutrientes às culturas sucessoras. Objetivou-se avaliar a produtividade de matéria seca e o acúmulo de nutrientes por plantas de cobertura cultivadas de forma solteira ou consorciada em segunda safra após a soja e seus efeitos sobre o algodoeiro cultivado em sucessão. Os tratamentos foram: Urochloa ruziziensis; Pennisetum glaucum (milheto); Zea mays (milho); Crotalaria spectabilis; Crotalaria ochroleuca; Cajanus cajan (guandu); milho + U. ruziziensis; C. spectabilis + U. ruziziensis; C. ochroleuca + U. ruziziensis; guandu + U. ruziziensis; milho + C. spectabilis; milho + C. ochroleuca; e milho + guandu. O delineamento experimental foi o de blocos ao acaso, com quatro repetições, e o experimento realizado em duas safras agrícolas. Na pré-semeadura do algodão, a quantidade máxima de matéria seca da palhada de milho foi de 2.699 kg ha-1, com baixos conteúdos de macronutrientes. O guandu consorciado com U. ruziziensis produziu entre 8.400 e 12.941 kg ha-1 de matéria seca, com conteúdo máximo de 223 e 323 kg ha-1 de nitrogênio e potássio, respectivamente. A U. ruziziensis, cultivada de forma solteira ou consorciada, disponibilizou na palhada entre 140 e 323 kg ha-1 de potássio. Alta produtividade é obtida pelo algodoeiro cultivado sob sistema plantio direto em sucessão a C. spectabilis.

Abstract Background: Left isomerism (LI) is a common finding in patients with biliary atresia (BA), and it can be identified by echocardiography. Several comorbidities may be present in patients with LI, including heart disease. Objective: To investigate the prevalence of LI and heart disease in children (< 18 years of age) with BA followed-up at Hospital das Clínicas, UFMG. Methods: This is a cross-sectional study involving patients diagnosed with BA between February 2016 and April 2020 who underwent transthoracic echocardiography and, in case of situs abnormalities, also electrocardiography. Results: Our study recruited 58 patients (mean age: 3.08 years; female/male ratio: 1.5:1). The general prevalence of situs abnormalities was 8.6% (5/58) and the most common one was LI (4/5 or 80%). One patient had situs inversus. Among patients with situs abnormalities, the general prevalence of heart disease was 80% (4/5), apart from anomalies of the inferior vena cava), with pulmonary valve stenosis (PVS) as the only change seen (75% of mild forms and 25% of moderate forms). Among patients with situs abnormalities, the prevalence of rhythm changes was 80% (4/5), and low atrial rhythm was the most common finding (3/4 or 75%). Conclusion: The prevalence of situs abnormalities in our sample was similar to that described in the literature. We observed an exclusive prevalence of PVS and a high prevalence of rhythm changes among patients with LI. Although the diagnosis of isomerism does not initially add much cardiovascular risk to the sample, possible late deterioration should be considered.

Resumo A valoração ambiental é uma ferramenta importante para a tomada de decisão na gestão ambiental, porém, ainda carece de aplicações em contextos diversos, viabilizando a consolidação das suas diferentes abordagens metodológicas. Desse modo, o presente estudo objetivou estimar o valor econômico de uso recreativo do Parque Nacional de Brasília, capital do Brasil, e determinar a elasticidade preço-demanda dos visitantes residentes no Distrito Federal. Utilizou-se a abordagem zonal do método do custo de viagem. Para tanto, foram aplicados questionários dentro do parque nos meses de fevereiro e março de 2020 com o intuito de obter informações sobre custo de viagem, quantidade de visitas e dados socioeconômicos dos visitantes residentes no Distrito Federal. Em seguida, por meio de análise de regressão característica do método do custo de viagem, obteve-se o valor econômico do parque. O valor econômico de uso recreativo do Parque Nacional de Brasília foi de R$ 137.667.504,14/ano, com intervalo de confiança a 95% entre R$ 55.762.205,7 a R$ 219.552.680,9/ano. Verificou-se, pela abordagem zonal, que a demanda por visitas dos residentes na capital brasileira foi elástica, pois um aumento no preço do ingresso afetou negativamente o bem-estar dos usuários do parque, reduzindo a frequência de visitas e o valor recreativo do parque. A relevância dessas informações demonstrou que existe um potencial valor econômico de uso direto do Parque Nacional de Brasília.

Abstract The environmental valuation is an important tool for the decision making in environmental management but it still needs applications in different contexts, enabling the consolidation of its different methodological approaches. Thus, the present study aimed to estimate the economic value of the recreational use of Brasília National Park in the capital of Brazil, Brasília, and to determine the price-demand elasticity of visitors who are resident in the Federal District. It was used the zonal approach of the travel cost method, for this purpose, questionnaires were applied within the park, from February to March of 2020, in order to obtain information on the travel costs, the number of visits and the socioeconomic data of resident visitors of the Federal District. Then, through regression analysis characteristic of the travel cost method, the economic value of the park is obtained. The economic value of the recreational use of Brasília National Park was BRL 137,667,504.14/year, with a 95% confidence interval between BRL 55,762,205.7 to BRL 219,552,680.9/year. It was found that demand for visits by park visitors residing in the Brazilian capital was elastic due to the zonal approach, an increase in the entrance price negatively affected the well-being of park users, which reduced the frequency of visits and also the recreational value of the park. The relevance of this information demonstrates that there is a potential economic value of direct use of Brasília National Park.

Abstract The directional solidification technique allows the study of growth of the solid phase, as-cast structure and, finally, its mechanical characteristics as a consequence of thermal parameters. On the other hand, in the last decade, a process called equal-channel angular pressing (ECAP) has emerged as a widely-known technique in fabrication of ultrafine-grained metals and alloys. Applicability of the ECAP technique affords an excellent potential for changing, in a controlled and beneficial manner, the resulting properties of metals and alloys. For this paper, an experimental research has been conducted to study the effects of solidification parameter (cooling rate) on resulting microhardness in hypoeutectic Al-Si alloys, upon use of an ECAP procedure. The influence of cooling on the scale of the dendritic patterns is presented and discussed with recourse to equations. The resulting microhardness variation with position throughout the as-cast materials and cooling rate were characterized by experimental power laws. Results determined after the solidification experiments have revealed microhardness as a function of both cooling rate and position (P) of the as-cast materials to be dependent on alloy composition. In the ECAP process via route C with three passes, “as-solidified” microstructures have been found to be distorted and fragmented during the severe plastic deformation. This deformation imposed on the billets during the ECAP process facilitated obtaining a fine microstructure and high levels of microhardness were observed. However, even with the ECAP process, it was shown that microhardness is strongly dependent of the cooling rates.

RESUMO A maioria dos estudos sobre mudanças no estoque de carbono orgânico do solo no bioma Cerrado está relacionada a dados coletados em Latossolos argilosos ou sob diferentes usos da terra, como se estivessem em equilíbrio. Objetivou-se avaliar os efeitos de tipos de preparo do solo e de sequência de culturas sobre o estoque de carbono orgânico do solo e a produtividade das culturas, em Latossolo arenoso, na Bahia. O delineamento experimental foi o de blocos casualizados, com quatro repetições. Amostras de solo foram coletadas após cinco anos de monocultivo de algodão, soja e milho e de uso de grade de discos pesada e grade niveladora (preparo convencional), e de rotação das culturas do algodão, soja e milho com adubo verde ou planta de cobertura (plantio direto). Amostras adicionais foram coletadas em área não cultivada (Cerrado sensu stricto). Práticas de conservação do solo como o não revolvimento e rotação de culturas com planta de cobertura e adubo verde favoreceram o estoque de carbono orgânico do solo na camada de 0-40 cm, com os maiores valores atingindo 36,03 Mg ha−1. O acúmulo de carbono no solo sob preparo convencional e monocultivo de algodão, milho e soja foi menor do que sob plantio direto, que variou de 30,9 a 54,9 %, com o estoque no plantio direto aumentando à taxa anual de 2,36 Mg ha−1 durante cinco anos. O plantio direto, com a rotação soja-milho-algodão, combinada com planta de cobertura e adubo verde, aumentou a produtividade do algodão e da soja e acumulou carbono orgânico no solo arenoso.

ABSTRACT Most studies about soil organic carbon stock changes in the Cerrado (Brazilian Savanna) biome are either related to field data collected in clayey Ferralsols or different land uses, as if they were in equilibrium. This study aimed to evaluate the effect of tillage systems and crop sequences on the soil organic carbon stock and crop yield, in a sandy Ferralsol from Bahia, Brazil. The experimental design was randomized blocks, with four replicates. Soil samples were collected after fve years of cotton, soybean and maize monocropping under heavy disk harrow and leveling harrow (conventional tillage), and of crop rotation of cotton, soybean and maize with green manure or cover crop (no-tillage). Additional samples were collected from a non-cultivated site (Neotropical Savanna, Cerrado sensu stricto). Soil conservation practices such as no-tillage and crop rotation with cover crop and green manure favored the soil organic carbon stock at the 0-40 cm layer, with the highest values reaching 36.03 Mg ha−1. The accrued soil carbon stock under conventional tillage and monoculture of cotton, maize and soybean was lower than under no-tillage, which ranged from 30.9 to 54.9 %, with the soil organic carbon stock increasing at the annual rate of 2.36 Mg ha−1 during fve years. The no-tillage, with the soybean-maize-cotton rotation, in combination with cover crop and green manure, increased the cotton and soybean yields, with a simultaneous organic carbon accumulation in the sandy soil.

Resumo O objetivo deste trabalho foi avaliar a dinâmica populacional do percevejo-castanho (Scaptocoris castanea) em área com algodão (Gossypium hirsutum) cultivado após plantas de cobertura. Os insetos foram contados em amostras de solo coletadas a 0-40 cm de profundidade. A incidência de insetos foi documentada em 18 espécies de cobertura, isoladas ou consorciadas, em cada estágio da planta. A distribuição das chuvas foi comparada com a flutuação populacional do inseto. Espécies de crotalária apresentam efeito supressivo sobre a população do percevejo-castanho, enquanto algumas espécies de gramíneas favorecem o seu aumento. A distribuição das chuvas influencia diretamente a população de insetos.

Abstract The objective of this work was to evaluate the population dynamics of the burrower bug (Scaptocoris castanea) in an area with cotton (Gossypium hirsutum) cultivated after cover crops. The insects were counted in soil samples collected at 0-40 cm depth. Insect incidence was documented in 18 cover crops, alone or intercropped, in each plant stage. Rainfall distribution was compared with fluctuations in the burrower bug population. Crotalaria species have a suppressive effect on the insect population, whereas some grass species favor its increase. Rainfall distribution directly influences the insect population.

Al-Fe alloys are usually used as packaging and structural materials, but in the recent years, there have been considered for possible applications in aerospace field. The solidification sequence in pure aluminum containing 1 wt.% Fe is described in term of the formation of macrostructure, microstructure, microsegregation, porosity and mechanical properties. This material was studied in the upward unidirectional solidification system under transient heat flow conditions. Differences in microstructure, microsegregation, porosity and mechanical properties such as ultimate tensile strength, elongation and microhardness, due to the thermal parameter effects were observed and discussed. Experimental growth laws relating cellular spacing to the cooling rate and solidification speed have been determined, indicating that the increase in thermal parameter have induced a refinement effect on cell morphology. Microsegregation profiles of Fe solute were experimentally determined from the central region of the cell to the intercellular region under different solidification speeds. The Fe microsegregation determined from central region of the cell (FS = 0) to the intercellular region (FS = 1) show a growing profile, in any case considered. However, the profiles move upward with the increase in solidification speed, which indicates that Fe solubility in solid, increases with the increase in solidification speed. The effect of the solidification thermal parameters and cellular spacing on the porosity content were experimentally investigated. The value of porosity content increased along the casting. These results have pointed out that porosity content is affected by solidification parameters and cellular patterns. Further, measurable effects of the thermal parameters, cellular spacing and porosity content on the mechanical properties were experimentally determined. It stands out among experimental results the influence of porosity on the mechanical properties of as-cast material. In any case analyzed, mechanical properties increase with decreasing porosity content.

ABSTRACT We aimed to evaluate the effects of the addition of oregano (Origanum vulgare) or green tea (Camellia sinensis L.) extracts (separately and associated) on feed intake, milk production, and hematological and antioxidant profiles of dairy cows. For that purpose, 16 Holstein and 16 Holstein-Gyr cows with 526.3±10.2 kg and within the first third of lactation were distributed according to a complete block design with measurements repeated in time. Treatments were control (CON), addition of 0.056% of oregano extract (OR), addition of 0.028% of green tea extract (GT), addition of a mixture of OR and GT extract (0.056% each) in the diet (MIX). Hematological and antioxidant profiles were monitored. Data were subjected to ANOVA, with block, treatment, days, and their interactions considered as fixed effects and animal and the residue as random effects. In Holstein cows, GT increased feed intake and milk yield compared with CON; in Holstein-Gyr crossbred cows, OR showed increased intake and GT increased milk yield compared with CON. Compared with CON, GT and OR decreased eosinophils concentration; OR showed the highest neutrophils concentration and neutrophils to leukocyte ratio. Compared with CON, OR presented increased catalase (CAT) activity, while GT increased the reduced glutathione concentration. The MIX treatment reduced CAT activity compared with OR, presented the lowest concentration of oxidized dichlorofluorescein in the erythrocytes (DCFER) and plasma (DCFPLA), and increased eosinophils concentration compared with GT and OR. Extracts differently affected feed intake and milk yield depending on genetic group. Feeding green tea and oregano extracts separately or associated distinctly affects the antioxidant indicators of lactating dairy cows.

ABSTRACT Adequate potassium (K) fertilization is essential for agricultural production in soils of the Brazilian Savanna (Cerrado biome) due to the high demand by crops (especially cotton), likelihood of leaching losses, and the dependence on fertilizer importations. Therefore, sustainability requires improvements in the soil efficiency management. This study evaluated the influence of soil management and crop succession or rotation combinations with cotton on K dynamics and exchangeable reserves in the soil profile, and the partial balance of K after nine years of cultivation in a clayey Oxisol in the Cerrado. The soil was sampled in layers up to 100 cm depth in four cotton production systems treatments: 1) conventional soil tillage (CST) with cotton monoculture; 2) CST with annual cotton-soybean-cotton succession; 3) CST with cotton/soybean/maize rotation; and 4) no-tillage system (NTS) with cotton/soybean/maize rotation and Urochloa ruziziensis (ruzigrass) as a cover crop in the off-season after grain crops. The experiment was conducted using a randomized block design with four replications. CST with cotton monoculture favored the leaching of K surplus from fertilization. Crop rotation including ruzigrass in the NTS allowed better control of K dynamics, ensuring its circulation in the soil-plant compartments and reducing leaching. The increased organic matter (OM) in this system enlarges the storage capacity of K in the topsoil. The adoption of no-tillage crop systems integrating ruzigrass is viable to improve the efficiency of K fertilizers in cotton cultivation in highly weathered tropical soils.

This study searched for a new pre-formulation based on the natural compound from the class of the avermectins, named abamectin (ABA), in order to improve its action against Aedes aegypti larvae by complexation with β-cyclodextrin (βCD). Concerning the low aqueous solubility of ABA, even in the presence of βCD, it was also invoked the strategy of working with hydrophobic nanoprecipitates (HNPs). For these purposes, molecular and supramolecular characterizations of 1:1 ABA/βCD complex and evaluation of its toxicity against A. aegypti larvae were performed. In the physical-chemistry characterizations, changes in the infrared spectra and thermal profiles in relation to precursors confirmed the occurrence of interactions between ABA and βCD in solid state. Nuclear magnetic resonance (NMR) data suggest the inclusion of ABA in βCD via benzofuran ring. Isothermal titration calorimetry (ITC) experiments allowed to verify the formation of complex with a 1:1 stoichiometry, which was entropy driven. The dynamic light scattering and zeta potential data from inclusion compounds demonstrated changes in the size of the ABA/βCD HNP if compared with the ABA HNP. Finally, the results for biological assays demonstrate that the strategy to prepare the inclusion compound led to an increase in the larvicidal activity in relation to free ABA.

RESUMO CONTEXTO: A gastrostomia endoscópica percutânea (GEP) é uma importante opção de nutrição enteral para crianças e adultos, sendo considerada uma técnica segura, eficaz e vantajosa em comparação às outras vias de alimentação complementar. Permite a alimentação contínua, a alimentação em pacientes com distúrbios de deglutição de causa neurológica ou outros, a administração de dietas ou medicamentos não palatáveis, todos com baixos índices de complicações e mortalidade. OBJETIVO: Avaliar as principais indicações e complicações de pacientes pediátricos submetidos à GEP e o impacto no estado nutricional de pacientes submetidos à GEP para suplementação nutricional, comparando peso, índice de massa corporal (IMC) e estatura com referências da Organização Mundial de Saúde. MÉTODOS: Estudo observacional e retrospectivo de 152 crianças e adolescentes submetidos à GEP, no período de janeiro/2003 a dezembro/2018. Foram incluídos pacientes até 18 anos de idade na época do procedimento. As complicações relacionadas ao procedimento foram divididas em menores e maiores. Pacientes com indicação de GEP para suplementação nutricional foram avaliados quanto ao ganho de peso, altura e IMC, por meio do escore Z no dia do procedimento e 6 meses; 1 ano; e 2 anos após o procedimento. RESULTADOS: As indicações para GEP foram distúrbio de deglutição de causa neurológica (67,1%), necessidade de suplementação nutricional (25%), distúrbio de deglutição de origem mecânica (6,6%), e indicação de descompressão gástrica (1,3%). Complicações menores ocorreram em 57,8% dos pacientes e complicações maiores em 9,8%. A técnica de tração correspondeu a 92,1% e a punção, 7,9%. A taxa de mortalidade foi de 1,3%. Trinta e oito pacientes tinham indicação de suplementação nutricional. Nestes, houve aumento gradativo tanto do IMC quanto do peso, com variação estatisticamente significativa da mediana P=0,0340 e P=0,0105, respectivamente, mais evidente nos pacientes renais crônicos. A altura não variou significativamente (P=0,543). CONCLUSÃO: A GEP mostrou-se uma opção vantajosa como forma auxiliar de alimentação em pacientes pediátricos, tendo como principais indicações a disfagia de causa neurológica e a necessidade de suplementação nutricional, com baixa prevalência de complicações maiores e mortalidade. Este estudo também mostrou a importância da GEP em pacientes com necessidade de suplementação nutricional, possibilitando a passagem dos pacientes desnutridos para escores nutricionais de peso adequados à idade.

ABSTRACT BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is an important option for enteral nutrition for both children and adults. It is considered a safe, effective, and advantageous technique in comparison to other complementary feeding routes. It allows continuous feeding, the feeding of patients with swallowing disorders due to neurological causes or others, and the administration of non-palatable diets or medications, all with low rates of complications and mortality. OBJECTIVE: This study aimed to evaluate the main indications and complications of PEG in pediatric patients. In addition, the impact on the nutritional status of patients undergoing PEG was also compared with weight, body mass index (BMI), and height according to references from the World Health Organization. METHODS: This observational and retrospective study included 152 children and adolescents who underwent PEG between January/2003 and December/2018. Patients up to 18 years of age at the time of the procedure were included. Complications related to the procedure were classified as minor or major. Patients with PEG indication for nutritional supplementation were evaluated for weight gain, height, and BMI, using the Z score at the day of the procedure and six months, 1 year, and 2 years after the procedure. RESULTS: Indications for PEG were: swallowing disorder of neurological cause (67.1%), need for nutritional supplementation (25%), swallowing disorder of mechanical origin (6.6%), and indication of gastric decompression (1.3%). Minor complications occurred in 57.8% of patients and major complications in 9.8% of patients. The traction technique corresponded to 92.1% and puncture to 7.9%. The death rate was 1.3%. Thirty-eight patients had an indication for nutritional supplementation. In these patients, there was a gradual increase in both BMI and weight, reaching statistically significant differences (P=0.0340 and P= 0.0105, respectively). These differences were more evident in chronic renal disease patients. Height did not vary significantly (P=0.543). CONCLUSION: PEG proved to be an advantageous option as an auxiliary feeding method in pediatric patients. Dysphagia of neurological origin was the main indication followed by the need for nutritional supplementation. PEG has low frequency of major complications and mortality. This study also showed the importance of PEG in patients who need nutritional supplementation, as it enabled patients to move from undernutrition to normal weight ranges.

Abstract Objective To assess the prevalence of acute kidney injury in pediatric intensive care unit according to diagnostic criteria - pediatric risk, injury, failure, loss, end-stage renal disease, Acute Kidney Injury Network and Acute Kidney Injury Work Group, or Kidney Disease: Improving Global Outcomes -, and determining factors associated with acute kidney injury as well as its outcome. Methodology This was a cross-sectional monocentric observational study, including patients aged between 29 days and 17 years who were admitted to the pediatric intensive care unit between January 1, 2012 and December 31, 2016. To evaluate the association between the study variables and acute kidney injury, the log-binomial generalized univariate and multivariate linear models were adjusted. Results The study included 1131 patients, with prevalence of acute kidney injury according to the Acute Kidney Injury Network and Kidney Disease: Improving Global Outcomes criteria of 12.6% and of 12.9% according to the pediatric risk, injury, failure, loss, end-stage renal disease. In the multivariate analysis of older children (PR 1.007, 95% CI: 1.005-1.009), sepsis (PR 1.641, 95% CI: 1.128-2.387), demand for ventilatory support (PR 1.547, 95% CI: 1.095-2.186), and use of vasoactive amines (PR 2.298, 95% CI: 1.681-3.142) constituted factors associated with statistical significance to the development of acute kidney injury. The mortality rate among those with acute kidney injury was 28.7%. Conclusion Older children, diagnosis of sepsis, demand for ventilatory support, and use of vasoactive amines were correlated with a higher risk of developing acute kidney injury. The mortality associated with acute kidney injury was elevated; it is crucial that all measures that ensure adequate renal perfusion are taken for patients with risk factors, to avoid the installation of the disease.