Supplementation with nutraceuticals produces changes in working horse’s blood parameters but not in their body composition

Background:  :  :  : There is little scientific data about the effects of continuous supplementation with nutraceuticals over horse’s health and performance. Horse owners and veterinarians are still using supplements for horses without any kind of evaluations. At the Brazilian market is possible to buy hundreds of different products, but there is not private or state regulation over production and quality of these products. The absence of information about quality and efficacy of these products may contribute to mistakes in horse’s nutrition program. The objective of this research was to determine the effect of supplementation with a combination of nutraceuticals over some blood parameters (red cell count, total plasma proteins, free plasma glutamine and glutamate) and components of body composition in working horses. Materials, Methods & Results: There were 19 gelding horses, divided in two groups: nutraceutical (NUTR; n=10) and placebo (PLAC; n=9). Both groups received equivalent feeding regimens in regard to concentrate and grass, and did similar exercise program. NUTR group received their pellets with nutraceuticals, and PLAC group received a placebo during the morning meal. There is no visual difference between nutraceutical and placebo pellets. Body composition determination and blood collection were taken in three periods: pre-test, after 4 and 12 weeks of supplementation. Body composition was determined after evaluation of horse’s body mass by electronic scale associated with measurement of rump fat by ultrasound. Results showed that there were no significant changes in body composition during 12 weeks of supplementation in both groups, which had percentage of body fat around 13%. However, supplementation with nutraceutical produced significant changes (P7%) and free plasma glutamine (>20%) observed in NUTR group will contribute to horse’s performance since it is positive action on red blood indexes and plasma amino acid concentration, contributing to the well-being of this horse group. Increase in blood glutamine concentration observed in NUTR group without improvement of body composition was not expected because this amino acid is produced mainly by skeletal muscle. Increase in fat-free mass frequently is associated with improvement of blood glutamine concentration. Finally, initial elevation in few parameters in PLAC group at 4 weeks of supplementation probably was associated with improvement of general management practices. In conclusion, Supplementation with a nutraceutical combination, for 12 weeks, produces changes in the concentration of some blood parameters, but it didn’t modify the corporal composition. The elevation of those components can favor the transport of oxygen and nutrients in tissues leading to improvement in the horse performance

TRANSFUSION GAME, A PLAYFUL RESOURCE FOR TEACHING NURSING STUDENS HEMOTHERAPY

Hemotherapy is a multidisciplinary practice in which the nursing staff has a central role in patient safety. Numerous risks are associated with this therapy, and these can be potentiated when the professional who performs this procedure does not have specific knowledge and skills for immediate interventions. Thus, it is believed that the nurse must receive in their training information on procedures that will be part of their daily professional practice. Increasingly, leisure activities strategies have been employed in the teaching of health sciences, with the goal of developing the learner professional skills and competencies necessary for their appropriation of knowledge. To this end, games are very valuable elements, since they allow the development of skills in communication, interpersonal relations, leadership and teamwork, using the relationship between cooperation and competition in an educational context. This paper proposes the use of a board game called "Transfusion Game” developed on the role of the nurse in hemotherapy, based upon current legislation in Brazil and aimed for the teaching and learning of hemotherapy to undergraduate nursing students of more advanced stages. This game includes, broadly, the actions of the nurse in transfusion procedures as well as their attitude toward possible adverse events, and current legislation. It is expected that the Transfusion Game can be a useful tool for the nurse’s meaningful learning of hemotherapy procedures, since it focus on questions of their practice. It is also expected that the proposed game can foster the development of critical thinking for the student / professional nurse, resulting in greater safety in their working processes

Bacterial cellulose as a support for the growth of retinal pigment epithelium

The feasibility of bacterial cellulose (BC) as a novel substrate for retinal pigment epithelium (RPE) culture was evaluated. Thin (41.6 ± 2.2 m of average thickness) and heatdried BC substrates were surface modified via acetylation and polysaccharide adsorption, using chitosan and carboxymethyl cellulose. All substrates were characterized according to their surface chemistry, wettability, energy, topography and also regarding their permeability, dimensional stability, mechanical properties and endotoxin content. Then, their ability to promote RPE cell adhesion and proliferation in vitro was assessed. All surface-modified BC substrates presented similar permeation coefficients with solutes of up to 300 kDa. Acetylation of BC decreased its swelling and the amount of endotoxins. Surface modification of BC greatly enhanced the adhesion and proliferation of RPE cells. All samples showed similar stress-strain behavior; BC and acetylated BC showed the highest elastic modulus, but the latter exhibited a slightly smaller tensile strength and elongation at break as compared to pristine BC. Although similar proliferation rates were observed among the modified substrates, the acetylated ones showed higher initial cell adhesion. This difference may be mainly due to the moderately hydrophilic surface obtained after acetylation.The authors acknowledge the Portuguese Foundation for Science and Technology (FCT, Portugal) for the financial support provided by the Research Grants SERH/BD/63578/2009, SFRH/BD/64901/2009, SFRH/BPD/64958/2009, and SFRH/BPD/63148/2009 for S.G., J.P., J.P.S., and V.S., respectively. The authors also acknowledge the Projects PEst-OE/EQB/LA0004/2013, PEst-OE/EQB/LA0023/2013, PTDC/BBB-BQB/2450/2012, and RECI/BBB-EBI/0179/2012 (Number: FCOMP-01-0124-FEDER-027462), cofunded by QREN, FEDER

Postmenopausal Urinary Disorders: Clinical And Urodynamic Evaluation

Purpose: to evaluate the frequency of urinary disorders and variation of the urodynamic parameters according to the time of post-menopause. Method: two hundred forty-two post-menopausal women with urinary complaints were studied at the Division of Gynecology, Escola Paulista de Medicina, UNIFESP. They were grouped according to the time of post-menopause: group A - up to 4 years; group B - 5 to 9 years and group C - more than 10 years. They were submitted to anamnesis, gynecological examination and urodynamic study. The frequency of urinary alterations and the variation of the urodynamic parameters were analyzed, such as voiding volume; flow time; maximum flow rate, average flow rate; residual urine; vesical capacity at the first desire to void; maximum bladder capacity; maximum urethral closure pressure and functional profile length, with full and empty bladder. The data were statistically analyzed. Results: the most common clinical diagnosis was stress urinary incontinence in the three groups, but the longer the time of post-menopause, the more frequently urinary urgency was observed. Regarding urodynamic diagnosis, 93.6%, 84.6% and 90.7% of the patients of the groups A, B and C, respectively, presented stress urinary incontinence, while 4.8%, 13.5% and 6.2% revealed detrusor instability. There was a decrease in the following urodynamic parameters, according to the time of post-menopause: flow time, maximum flow rate and vesical capacity at the first desire to void, and an increase of the residual urine. Conclusion: in spite of the high incidence of urinary symptoms such as urgency incontinence, stress urinary incontinence was the main urinary problem we have found in post-menopause.Objetivos: avaliar a freqüência dos distúrbios urinários e a variação dos parâmetros urodinâmicos segundo o tempo de pós-menopausa. Métodos: foram estudadas 242 mulheres menopausadas atendidas nos Setores de Climatério e de Uroginecologia e Cirurgia Vaginal da Disciplina de Ginecologia da Escola Paulista de Medicina, UNIFESP, que apresentavam queixas urinárias. As pacientes foram agrupadas segundo o tempo de pós-menopausa em: grupo A - até 4 anos; grupo B - de 5 a 9 anos e grupo C - mais de 10 anos. Todas foram submetidas a anamnese, exame ginecológico e estudo urodinâmico. Analisamos a freqüência de alterações urinárias e a variação dos parâmetros urodinâmicos, como volume urinário (VOL); tempo total de micção (TTM); fluxos urinário máximo (FMAX) e médio (FM); resíduo pós-miccional (RES); capacidade vesical no primeiro desejo miccional (CV1D); capacidade vesical máxima (CVM); pressão máxima de fechamento uretral e comprimento funcional da uretra, com bexiga cheia e vazia (PMCH, PMV, CFUCH, CFV). Os dados foram analisados estatisticamente. Resultados: o diagnóstico clínico mais comum foi de incontinência urinária de esforço (IUE) nos três grupos, porém observou-se maior incidência de urgência miccional com o evoluir do tempo de pós-menopausa. Em relação ao diagnóstico urodinâmico, 93,6%, 84,6% e 90,7%, respectivamente, das pacientes dos grupos A, B e C apresentaram IUE, ao passo que 4,8%, 13,5% e 6,2% revelaram instabilidade vesical. Houve diminuição dos seguintes parâmetros urodinâmicos, segundo o tempo de pós-menopausa: TTM, FMAX e CV1D, além de aumento do resíduo pós-miccional. Conclusões: apesar da elevada incidência de sintomas urinários irritativos, como urgência incontinência, a IUE foi a principal afecção urinária nesta faixa etária.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Setor de Uroginecologia e Cirurgia VaginalUNIFESP, EPM, Setor de Uroginecologia e Cirurgia VaginalSciEL

Performance of the Bethesda system for reporting thyroid cytology in multi-institutional large cohort of pediatric thyroid nodules: a detailed analysis

Background: To evaluate the performance of TBSRTC through multi-institutional experience in the paediatric population and questioning the management recommendation of ATA Guidelines Task Force on Paediatric Thyroid Cancer; Methods: A retrospective search was conducted in 4 institutions to identify consecutive thyroid FNAC cases in paediatric population between 2000 and 2018. Following the 2nd TBSRTC, the risk of malignancy ratios (ROMs) was given in ranges and calculated by 2 different ways. Sensitivity, specificity, PPV, NPV and DA ratios were calculated using histologic diagnosis as the gold standard; Results: Among a total of 405 specimens, the distribution of cases for each category was, 44 (11%) for ND, 204 (50%) for B category, 40 (10%) for AUS/FLUS, 36 (9%) for FN/SFN, 24 (6%) for SFM and 57 (14%) for M categories. 153 cases have a histological diagnosis. The ratio of surgery was 23% in ND, 16% in the B, 45% for AUS/FLUS, 75% for SFN/FN and 92% for SFM and 75% in M categories; Conclusions: The data underlines the high ROM values in paediatric population which might be clinically meaningful. The high rate of malignancy of the cohort of operated patients (50%) also underlines the need of better preoperative indicators for stratification. Considering that more than half of the nodules in AUS/FLUS category were benign, direct surgery recommendation could be questionable as proposed in ATA 2015 guidelines.info:eu-repo/semantics/publishedVersio

Efeito da suplementação com concentrados ricos em óleo sobre biomarcadores metabólicos para cavalos

A performance dos cavalos atletas tem melhorando com a elevação da percentagem do extrato etéreo (EE) nos concentrados. Assim, avaliou-se a suplementação de concentrados com diferentes percentagens de EE sobre biomarcadores metabólicos em cavalos atletas, através de um fatorial com cinco equinos e cincos tratamentos [6,5% EE (T6,5%), 8% EE (T8,0%), 12% EE (T12,0%), 14% EE (T14,0%) e 20% EE (T20,0%)]. Os animais receberam suplementação isocalórica por 15 dias e no 16o dia colheu-se sangue nas fases inicial e jejum e após ½ hora, 1, 2, 3, 4, 5 e 6 horas da ingestão dos alimentos. O sangue total foi utilizado para determinar hematrócrito, glicose, proteína plasmática total, ureia, creatinina, triglicérides e colesterol total. Os resultados demonstraram que ocorreu variação na [glicose] (P<0,05) na fase da colheita de sangue, mas sem diferenças (P>0,05) entre os tratamentos e na interação concentrado x fase. Também não ocorreram diferenças (P>0,05) no pico da [glicose] entre tratamentos e entre área sob a curva. Os demais biomarcadores analisados não sofreram modificação (P>0,05). Concluiu-se que a suplementação isoenergética com concentrados utilizando diferentes percentagens de EE não produzem modificações nos biomarcadores analisados, indicando que variações no EE podem ser utilizados, entre 6,5 e 20%, para equinos atletas de forma similar

Protocolo de manejo de suspeita de infecção viral de vias respiratórias em pacientes com neoplasia hematológica do serviço de hematologia e transplante de medula óssea do Hospital Universitário Walter Cantídio (HUWC)

Infecção respiratória viral é causa significativa de morbi-mortalidade em paciente com doenças hematológicas. Deve ser suspeitado sempre que houver sintomas como coriza, obstrução nasal, odinofagia, tosse e dispnéia e deve-se seguir à identificação viral, quando possível. Os casos podem ser classificados como possível, provável ou confirmado. E observando-se o risco de progressão da infecção para vias aéreas inferiores, o diagnóstico deve ser precoce e as medidas terapêuticas específicas aos vírus bem como medidas de controle da infecção no ambiente hospitalar devem ser prontamente tomadas. O presente trabalho visa descrever um protocolo de manejo da infecção viral de vias respiratórias em pacientes com neoplasia hematológica dentro do Serviço de Hematologia e Transplante de medula do Hospital Universitário Walter Cantídio