First determination of the prevalence of celiac disease in a Portuguese population

The prevalence of celiac disease is unknown in Portugal. In European countries the prevalence is between 1:200 and 1:400. The incidence obtained through diagnosed cases in the paediatric gastroenterology units in Portugal was 1:3648. To determine the best current celiac disease screening method and its prevalence in a portuguese population, 536 sera of teenagers with 14 years +/- 6 months from Braga town schools were tested as follows: a) total IgA, b) anti-tissue transglutaminase antibodies c) anti-endomysium antibodies (AEA). One female adolescent, with negative AEA and anti-transglutaminase antibodies had a diagnosed celiac disease; this patient was under appropriate diet. Eleven adolescents had positive anti-transglutaminase antibodies and 4 of these had also positive AEA. A jejunal biopsy was carried out on the latter adolescents. Three presented intestinal villous atrophy, 2 a flat mucosa and 1 a moderate atrophy. One female adolescent had a normal mucosa. The prevalence was 1:134, [confidence interval at 95%, 1:53-1:500]. Conclusions: Presently, total IgA with determination of anti-tissue transglutaminase antibodies is apparently the best screening method; it is less expensive test and, given the use of ELISA, less dependent on the observer. The celiac disease prevalence found in the present study falls within the range of prevalence recently found in other European populations, which implies that the celiac disease is under-diagnosed in Portugal

Locally advanced penile carcinoma: classic emasculation or testis-sparing surgery?

Purpose The study evaluates the clinical and pathological findings of 16 patients with locally advanced penile carcinoma (PC) submitted to emasculation, and discusses questions related to the usefulness of bilateral orchiectomy. Materials and Methods Between 1999 and 2010, 172 patients with PC were treated. Sixteen (9%) underwent emasculation. Data were retrieved from the institution's database including age, ethnicity, date of surgery, residential setting, level of schooling, time to diagnosis, type of reconstruction, complications, tumor stage and grade, vascular and perineural invasion along with invasion of corpus cavernosum, corpus spongiosum, testicles, scrotum and urethra. Results A total of 16 patients (average: 63.1 years) with locally advanced PC were included. All were illiterate or semiliterate rural dwellers and 87% were white. The time to diagnosis was 8-12 months. The mean follow-up time was 31.9 months (1-119). By the time of the last follow-up, only seven patients (43.75%) were alive. Tumors were pT4 (n = 6), pT3 (n = 8), pT2 (n = 2), Grade I (n = 5) and Grade II (n = 11). The histopathological examination revealed invasion of the urethra (n = 13), scrotum (n = 5) and testicles (n = 1). The surgical margin was positive in one patient. Six patients (37.5%) had vascular invasion and 11 (68.7%) had perineural invasion. Currently, only one of the former is alive. Conclusions The finding of focal microscopic testicular infiltration in only one of 32 testicles, even in the presence of clinically apparent scrotal invasion, suggests that emasculation without bilateral orchiectomy is a safe treatment option for patients with locally advanced PC

Efeito de diferentes aditivos sobre a qualidade fermentativa da silagem de resíduo de maracujá amarelo Effects of different additives on the quality of yellow passion fruit residue silage

Com o objetivo de estudar o efeito da inclusão de resíduos em diferentes níveis, sobre a qualidade fermentativa da silagem do resíduo de maracujá amarelo, foi conduzido este estudo. Os resíduos foram ensilados em silos experimentais de PVC, adaptados com válvula tipo Bünsen e com capacidade para aproximadamente 3 kg cada. Os tratamentos constituíram-se de três aditivos (bagaço de cana (BC), casca de café (CC) e sabugo de milho (SM)), em quatro níveis (10, 15, 20 e 25%) mais um tratamento testemunha, sem aditivos. O delineamento experimental utilizado foi o inteiramente casualizado, constituindo um esquema fatorial com tratamento adicional [(3 x 4) + 1] com 4 repetições. As silagens em que se adicionou BC e as silagens com 100% de resíduo do fruto de maracujá apresentaram teor de MS inferior aos recomendados para uma silagem. O aditivo CC foi o único que aumentou o teor protéico das silagens. Todas as silagens apresentaram valores de pH e N-NH3(%N total) de acordo com os padrões que caracterizam uma fermentação adequada, sendo os valores de pH inferiores a 4,2 e N-NH3(%N total) menores que 10%. As silagens com 100% de resíduo do fruto de maracujá, e as com BC ou CC adicionados nos diferentes níveis, apresentaram valores de MS, PB, pH e N-NH3 que caracterizam uma silagem de adequada qualidade fermentativa.<br>Aiming to evaluate the effect the addition of residues in different levels on the quality of passion fruit residue silage, this study was undertaken. The residues were ensiled in experimental PVC silos, fitted with Bunsen-type valves with a capacity of about 3 kg each. The treatments consisted of three additives (sugar-cane bagasse (SCB), coffee hulls (CH) and corn cob (CC)) at four levels (10, 15, 20 and 25%) plus a control treatment without additive. The experimental design used was the completely randomized, in a factorial scheme with an additional treatment [(3 x 4) + 1] with four replicates. The silages in which SCB was added and the silages with 100% of yellow passion fruit residue had a less DM content to the recommended for a good silage. The additive CH was the only that increased the protein content of the silages. All the silages showed values of pH and N-NH3 (% total N) according to the standards which characterize a good fermentation process. The silages with 100% of passion fruit residue and with SCB or with CC added at the different levels, showed good values of DM, CP, pH and N-NH3, indicating to be an alternative in ruminant feeding in regions where passion fruit by-product is available