Can the combination of internal iliac temporary occlusion and uterine artery embolization reduce bleeding and the need for intraoperative blood transfusion in cases of invasive placentation?

OBJECTIVES: Women with invasive placentation (IP) are at high risk of life-threatening hemorrhage. In the last two decades, less invasive surgical approaches combined with endovascular procedures have proven to be safe. Most case series describe the use of temporary balloon occlusion and embolization, either combined or not. Concerning hemorrhage rates, each separate interventional approach performs better than surgery alone does, yet it is not clear whether the combination of multiple interventional techniques can be beneficial and promote a lower incidence of intrapartum bleeding. We aim to evaluate whether combining temporary balloon occlusion of the internal iliac artery and uterine artery embolization promotes better hemorrhage control than do other individual interventional approaches reported in the scientific literature in the context of cesarean birth followed by hysterectomy in patients with IP. METHODS: This is a retrospective analysis of patients with confirmed IP who underwent temporary balloon occlusion and embolization of the internal iliac arteries followed by puerperal hysterectomy. We compared patient results to data extracted from a recent systematic review and meta-analysis of the current literature that focused on interventional procedures in patients with IP. RESULTS: A total of 35 patients underwent the procedure during the study period in our institution. The mean volume of packed red blood cells and the estimated blood loss were 487.9 mL and 1193 mL, respectively. Four patients experienced complications that were attributed to the endovascular procedure. CONCLUSION: The combination of temporary balloon occlusion and uterine artery embolization does not seem to promote better hemorrhage control than each procedure performed individually does

Digestion of feed fractions and intake of heifers fed hydrolyzed sugarcane stored for different periods

The objective of this study was to evaluate, in Nellore heifers, intake and digestibility of hydrolyzed sugarcane stored for different periods. The experimental design used was a 4 × 4 Latin square, four diets, four Nellore heifers with ruminal cannulas (initial body weight 285.4±23.08 kg and average initial age 14 months) and four periods of 21 days. The diets were composed by fresh sugarcane (time zero) or hydrolyzed sugarcane with addition of 0.5% of hydrated lime, stored for 24, 48 or 72 hours, as the unique forage. Intake and digestibility of feed fractions, nitrogen balance, microbial synthesis efficiency, total number of ruminal protozoans and ammoniacal nitrogen did not significantly change by storing sugarcane with addition of 0.5% of hydrated lime. Sugarcane pH varied quadratically for storage time, with maximum pH of 7.02 after 24 hours from lime addition. Ruminal liquid pH values were higher for heifers fed fresh sugarcane, in comparison with those fed hydrolyzed sugarcane. Sugarcane treated with 0.5% of hydrated lime stored for up to 72 hours does not change ruminal digestion to alter the amount of feed consumed by pubescent Nellore heifers. Thus, lime is a viable technology, once it allows long-duration storage and bee control on treated forage, which contributes to animal feeding logistics

Os museus históricos e pedagógicos do estado de São Paulo

This paper analyzes the creation of the Historical and Pedagogical Museums network in the State of São Paulo between 1956 and 1973, mainly taking into consideration the concept for creation, the program, and the role of the museum in society. This work covers a period until the end of the 1990's, when the curators of the museums, which belonged to the State until that time, was transferred to the municipalities by means of a "municipalization" process coordinated by the Department of Museums and Archives of the State Department of Cultural Affairs (DEMA-SEC). It also shows that the implementation of this museums network - among other initiatives in the fields of education and of culture - addressed earlier needs of asserting an identity, emphasizing through projects of this type the hegemonic character of the State. This allowed to align the initiative of creating the museums with others actions carried out by the State before, and also enabled that this topic was take out from its long isolation from the study of State history. It also considers the web of relationships existing among the various sectors with which museums were connected, such as education, culture, and the São Paulo Historical and Geographical Institute, the Government, and Society. The implementation of Historical and Pedagogical Museums by means of State action, through its Departments of Education (from 1956 to 1968) and Cultural Affairs (from 1968 to 1998) was one of the ways through which the Government orientated its activities during those years in the fields of history, education and culture. The central thesis is that the implementation of these museums has fully addressed the aspirations of society at the time, while, at the same time, underscoring the logic behind the ideation that has oriented the characteristic mode of operation of museums during the years in which their curatorship was exercised by the Government, and proposes to consider them as a paradigm for "historical museums of the State of São Paulo".Este estudo analisa a criação da rede de museus históricos e pedagógicos do estado de São Paulo entre os anos de 1956 e 1973, sobretudo quanto ao conceito de criação, de programa e de função de museu na sociedade. Tal análise estende-se ao final da década de 1990, quando a tutela dos museus, até então estadual, é transferida às cidades por meio do processo de municipalização, coordenado pelo Departamento de Museus e Arquivos, da Secretaria de Estado da Cultura (Dema-SEC). Em meio a outras iniciativas nos campos da educação e da cultura, aborda a correspondência existente entre a implantação da rede desses museus e antigas necessidades de afirmação identitária, ao evidenciar, por meio de projetos desta natureza, o caráter hegemônico do Estado e sua atuação em campos como o da história, o da educação e o da cultura. Isso permitiu alinhar a iniciativa de criação dos museus a outras anteriormente promovidas pelo estado de São Paulo e possibilitar que o tema escapasse de um prolongado isolamento no estudo da história paulista. Trata, também, da trama de relações existentes entre diversos setores ligados aos museus - educação, cultura, Instituto Histórico e Geográfico de São Paulo (IHGSP), poder público e sociedade. A hipótese central é de que a implantação desses museus correspondeu plenamente às aspirações da sociedade de uma época, ao mesmo tempo em que evidencia a lógica da ideação que determinou o modo característico de atuação dos museus nos anos em que estiveram sob a tutela do governo estadual, propondo, assim, entendê-los como paradigma de "museu histórico do estado de São Paulo"

Levedura (Saccharomyces cerevisiae) na alimentação de vacas da raça Holandesa

Objetivou-se avaliar o desempenho de vacas leiteiras, suplementadas com a levedura de cana-de-açúcar Saccharomyces cerevisiae. Foram avaliados o consumo de nutrientes, produção e composição do leite, e análise parcial de custos. Os tratamentos tinham como volumoso a silagem de milho, juntamente com o concentrado e diferentes doses de levedura (0g, 3g, 6g e 9g). Utilizaram-se oito vacas da raça holandesa, pós-pico de lactação, delineadas em dois quadrados latinos 4x4, com períodos de 19 dias. O consumo de matéria seca (CMS) foi em média 20,70; 21,62; 22,19; e 20,94 kg para o tratamento com 0g, 3g, 6g e 9g de leveduras, respectivamente (P<0,05). O consumo de proteína, fibra em detergente neutro, fibra em detergente ácido, extrato etéreo não sofreram ação dos tratamentos, não diferindo estatisticamente (P<0,05). Considerando-se a composição química do leite, notou-se que somente houve efeito da levedura sobre as médias dos sólidos totais (p<0,05), sendo que o tratamento de 3g não diferiu do de 0g e 6g, diferindo do de 9g. Os tratamentos de 0g e 6g não diferiram, por sua vez, do tratamento de 9g (p<0,05). Vacas submetidas ao tratamento de 3g de leite, produziram mais leite, porém com um acréscimo de ingestão, justificando sua margem bruta menor. O tratamento de 6g foi o que propiciou o maior ganho, sendo esse o recomendável ao produtorThe objective was to evaluate the performance of dairy cows, supplemented with live yeast culture Saccharomyces cerevisiae. Were evaluated the intake of nutrients, production and composition of milk and partial analysis of costs. The treatments were corn silage with concentrate and yeast (0g, 3g, 6g and 9g). Eight Holstein cows, post-peak lactation, were used outlined in Latin square 4x4, with periods of 19 days. The dry matter intake was on averaged 20.70, 21.62, 22.19 and 20.94 kg for the treatment with 0g, 3g, 6g and 9g of yeast, respectively (P<0.05). The consumption of protein, neutral detergent fiber, acid detergent fiber, ether extract did not suffer any of the treatments and did not differ statistically (P <0.05). Considering the chemical composition of milk, it was noted that the yeast had no effect on the averages of total solids (p <0.05) and the treatment of 3g did not differ from to 6g and 0g, differing from that of 9g . The treatments of 0g and 6g did not differ of 9g (p <0.05). Cows under treatment of 3g of milk, produced more milk, but with an increased intake, justifying its lower gross margin. Treatment of 6g was what provided the largest gain, which is the recommended to the dairy farmerConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Consumo de matéria seca e desempenho de novilhas Nelore alimentadas com dietas contendo cana-de-açúcar hidrolisada

Objetivou-se avaliar o consumo de nutrientes e o desempenho de novilhas Nelore alimentadas com dietas contendo cana-de-açúcar in natura (CN) ou hidrolisada (CH) com 0,5% de Ca(OH)2 armazenada por 24, 48 e 72 horas. Foram utilizadas 24 novilhas com nove meses de idade e 119,6±8,1kg de peso corporal inicial. O delineamento experimental utilizado foi o inteiramente casualisado com quatro tratamentos e seis repetições. O consumo de matéria seca foi reduzido em 29% pela adição de Ca(OH)2, não sendo alterado pelo período de armazenamento da CH. O consumo de cálcio foi incrementado (P<0,05) pela utilização de CH nas dietas, mantendo níveis de ingestão aceitáveis. Novilhas alimentadas com CH armazenada por 24, 48 e 72 horas apresentaram, respectivamente, ganhos de peso 41, 30 e 35% inferior (P<0,05) àquelas alimentadas com CN. O tratamento da cana-de-açúcar com Ca(OH)2 não é recomendado para alimentação de novilhas Nelore, em virtude de limitar a ingestão e reduzir o ganho de peso.The study aimed to evaluate the nutrients intake and performance of Nellore heifers fed with chopped sugarcane, fresh (FS) or treated (HS) with 0.5% of Ca(OH)2 and stored during 24, 48 or 72 hours. It was used twenty-four heifers with nine months age and 119.6±8.1kg of initial body weight. The experimental design was completely randomized with four treatments and six replications. The dry matter intake showed an average reduction of 29% by adding Ca(OH)2, and didn't change with the storage period. Calcium intake was increased by the use of HS in the diet, while maintaining acceptable levels of intake. Heifers fed with HS stored during 24, 48 and 72 hours had, respectively, average daily weight gain of 41, 30 and 35% lower than those fed with FS. The treatment of sugarcane with Ca(OH)2 is not recommended for feeding Nellore heifers, due to limited intake and lower weight gain

Characteristics of forage and feeding behavior of Nellore heifers fed hydrolyzed sugarcane

The objective of this study was to evaluate the chemical characteristics of the forage and ingestive behavior of Nellore heifers fed hydrolyzed sugarcane in different periods of storage. Twenty-four heifers with initial body weight of 119.6±8.1 kg were utilized. The experimental design was completely randomized, in which the treatments were diets with fresh sugarcane and hydrolyzed sugarcane (5 g of lime kg-1 of chopped sugarcane) stored for 24, 48 or 72 hours as the only roughage. The addition of lime to sugarcane associated with its storage up to 72 hours provided an increase of 20% of the potentially degradable cell wall of carbohydrates, from 382.4 to 458.8 g kg-1 of total carbohydrates. The in vitro digestibility of dry matter was altered by the storage of hydrolyzed sugarcane, increasing 7.08% when the storage time was increased from 24 to 72 hours. Heifers fed fresh sugarcane remained more time consuming compared with heifers fed other diets. The time used for water intake was not influenced by the diet. The rumination time presented a quadratic variation in relation to storage time of the hydrolyzed sugarcane, with higher values for the of hydrolyzed sugarcane diets stored for 48 hours. Heifers fed hydrolyzed sugarcane spent more time on other activities than those fed fresh sugarcane. The supply of hydrolyzed sugarcane stored up to 72 hours in the proportion of 600 g kg-1 of dry matter in the diet, alters the intake patterns, reducing the feed intake in Nellore heifers