The frequency of lung cancer in patients with pulmonary hamartomas: An evaluation of clinical, radiological, and pathological features and follow-up data of 96 patients with pulmonary hamartomas

Purpose: To investigate the frequency of lung cancer in patients with pulmonary hamartomas and to evaluate clinical, radiological, and pathological characteristics of pulmonary hamartomas. Basic procedures: We reviewed pathology records of pulmonary hamartomas diagnosed between 2003 and 2014. Medical records and the hospital electronic database were also reviewed for each patient to obtain clinical, radiological, and pathological characteristics of pulmonary hamartomas and accompanying malignancies. Main findings: Ninety-six patients with pulmonary hamartomas were identified. There were 26 females (27%) and 70 males (73%), with a mean age of 56.2 years (range 22â87 years). Malignancies were detected in 23 patients (24%), which developed previously in five patients (1 synchronous, 4 metachronous lesions), and concomitantly in 18 patients (with origin from the lung in 17 patients and from the pleura in 1 patient). Principal conclusions: Our results show that patients with pulmonary hamartomas may have coexisting lung malignancies. Keywords: Hamartoma, Lung neoplasms, Diagnosi

Uréia para vacas em lactação: 1. Consumo, digestibilidade, produção e composição do leite Urea for dairy cows: 1. Intake, digestibility, milk production and composition

Este trabalho foi conduzido, utilizando 15 vacas lactantes (Holandês x Gir) alimentadas à vontade com rações isoprotéicas, constituídas na base da matéria seca (MS) de 60% de silagem e 40% de concentrado, contendo 0; 0,7; 1,4; e 2,1% de uréia, correspondentes aos teores de 2,08; 4,01; 5,76; e 8,07% de proteína bruta na forma de compostos nitrogenados não-protéicos (NNP), com o objetivo de avaliar os consumos e as digestibilidades aparentes de matéria seca (MS), matéria orgânica (MO), proteína bruta (PB), extrato etéreo (EE), carboidratos totais (CHO) e fibra em detergente neutro (FDN) e os consumos de nutrientes digestíveis totais (NDT). Também foram avaliadas possíveis alterações na produção e composição do leite. As vacas apresentaram peso vivo médio inicial de 511,8 kg e foram distribuídas ao acaso entre tratamentos. O período experimental teve duração de 90 dias para cada vaca, iniciando-se imediatamente após o parto. A fibra em detergente ácido indigestível (FDAI) foi usada como indicador para a determinação da digestibilidade aparente dos nutrientes. Os resultados obtidos foram interpretados estatisticamente por análises de variância e regressão. A adição de quantidades crescentes de NNP à dieta apresentou efeito linear decrescente sobre os consumos de MS, MO, FDN, PB, EE, CHO e NDT. Não foram observados efeitos dos níveis de NNP sobre as digestibilidades aparentes de MS, MO, PB, CHO e FDN. Para o EE, foi observado efeito quadrático, sendo a máxima digestibilidade de 89,12% obtida com teor estimado de 4,73% de NNP na MS. A produção máxima de leite, de 20,10 kg/dia, foi obtida com o teor estimado de 4,79% de NNP, ou 0,7% de uréia na MS total das rações. Observou-se redução linear do teor de gordura com o aumento dos teores de NNP nas rações, enquanto a proteína se comportou de forma quadrática, sendo o teor máximo de 3,4% estimado com 3,88% de NNP.<br>This work was carried out, using 15 dairy cows (Holstein x Gyr) full fed isoproteic diets with 60% silage and 40% concentrate in the dry matter (DM) basis and 0, 0.7, 1.4, and 2.1% urea, correspondent to 2.08, 4.01, 5.76, and 8.07% of crude protein levels in the form of non protein nitrogen compounds (NNP), with the objectives to evaluate the intakes and the apparent digestibilities of dry matter (DM), organic matter (OM), crude protein (CP), ether extract (EE), total carbohydrates (CHO) and neutral detergent fiber (NDF) and the total digestible nutrients (TDN) intakes. Possible changes on the milk production and composition were also evaluated. Cows averaging initial live weight of 511.8 kg were randomized allotted to the treatments. The experimental period last 90 days for each cow, starting immediately after calving. The indigestible acid detergent fiber (IADF) was used as marker to determine the nutrients apparent digestibility. The results were interpreted by variance and regression analyses. The addition of increasing NNP to the diet showed decreasing linear effect on the intakes of DM, OM, NDF, CP, EE, CHO and TDN. NNP levels did not affect the apparent digestibilities of DM, OM, CP, CHO and NDF. There was quadratic effect for EE, and the maximum digestibility of 89.12% was obtained with the estimated NNP content of 4.73% in DM. The maximum milk production, of 20.10 kg/day, was obtained with the estimated NNP content of 4.79%, or 0.7% urea in dietary total DM. Linear reduction of fat content was observed as the dietary NNP contents increased, while there was a quadratic behavior for protein, with the maximum content of 3.4% estimated with 3.88% NNP

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease