Hiperplasia adrenal congênita: dosagem da 17-hidroxiprogesterona basal para seleção e casos para realização do teste de estímulo com ACTH sintético Congenital adrenal hyperplasia: measurement of basal 17-hydroxyprogesterone as a screening test to select patients for the synthetic ACTH provocative test

OBJETIVOS: avaliar se os níveis de 17-hidroxiprogesterona podem predizer o resultado do teste de estímulo como diagnóstico de hiperplasia adrenal congênita, forma tardia. MÉTODOS: foram incluídas no estudo e avaliadas retrospectivamente 122 pacientes com suspeita clínica de hiperplasia adrenal congênita forma tardia. Essa suspeita clínica incluía sinais e/ou sintomas de hiperandrogenismo (hirsutismo, acne, pele oleosa, irregularidade menstrual, etc.). Todas as pacientes foram submetidas ao teste de estímulo da adrenal com ACTH sintético 0,25 mg (Synacthen®). Após repouso de 60 minutos as amostras foram colhidas nos tempos basal e 60 minutos após a administração de 0,25 mg de ACTH sintético para dosagem de 17-hidroxiprogesterona, sendo mantido o acesso venoso com catéter heparinizado. Foi utilizado o método de radioimunoensaio para realizar as dosagens séricas da 17-hidroxiprogesterona. A sensibilidade e a especificidade da 17-hidroxiprogesterona basal como teste de rastreamento para hiperplasia adrenal congênita foram medidas, avaliando vários pontos de corte. Curvas ROC foram feitas para analisar a performance do teste, utilizando o software Medcalc®. RESULTADOS: a análise por curva ROC mostrou um ponto de corte de 181 ng/dl acima do qual dever-se-ia realizar o teste de estímulo, bem próximo a 200 ng/dl, mais comumente aceito pela literatura. Níveis séricos da 17-hidroxiprogesterona mais altos que 200 ng/dl têm valores preditivo positivo e negativo de 75% e 100% e acurácia de 98,4% como diagnóstico de hiperplasia adrenal não-clássica. CONCLUSÕES: considerando os dados, sugerimos que pacientes com hiperandrogenismo clínico devam iniciar a investigação com 17-hidroxiprogesterona basal e, caso esta se mostre acima de 181 ng/dl, sigam a investigação com o teste de estímulo com ACTH sintético.INTRODUCTION: adrenal hyperplasia is a common genetic disorder and 95% of the cases are due to a 21-hydroxylase deficiency. Clinical presentation varies from life-threatening salt-losing adrenal hyperplasia to simple androgenic states, which can be of late-onset and very similar to polycystic ovary syndrome. Diagnosis is usually made by synthetic ACTH provocative tests but efforts are being made to simplify this investigation. OBJECTIVE: to evaluate basal 17-hydroxyprogesterone as a predictor of the provocative test for the diagnosis of late-onset congenial adrenal hyperplasia. METHODS: A total of 122 patients under clinical suspicion of diagnosis of late-onset congenial adrenal hyperplasia were included and retrospectively evaluated in the study. Such suspicion included signs and/or symptoms of hyperandrogenism (hirsutism, acne, oily skin, menstrual irregularity etc.). All the patients were submitted to the 0.25mg synthetic ACTH provocative test (Synacthen®). After resting for 60 minutes, the samples were taken in the basal time and 60 minutes after the administration of 0.25mg synthetic ACTH, in order to assay 17-hydroxiprogesteron, the venous access being kept through a heparinized catheter. Radioimmuoessay was the method used to accomplish the assay of seric 17-hydroxiprogesteron. The sensitivity and specificity of the basal 17-hydroxiprogesteron were measured, assessing several cutoff points. ROC curves were made to analyze the test performance, using the software Medcalc®. RESULTS: ROC curve analysis showed that the best cutoff point was 181 ng/dl, which was very similar to the most common recommendation of 200 ng/dl of the literature. The cutoff point of 200 ng/dl shows positive and negative predictive values of 75 and 100%, and accuracy of 98,4% as a diagnostic test for late-onset adrenal hyperplasia. CONCLUSIONS: considering our data, we suggest that all hyperandrogenic patients should start the investigation with basal 17-hydroxyprogesteron and in case it is above 181 ng/dl, then they should do the synthetic 17-hydroxyprogesteron provocative test

Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura Pregnancy after gastroplasty for treatment of morbid obesity: a case series and review of the literature

OBJETIVO: relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. MÉTODOS: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. RESULTADOS: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. CONCLUSÃO: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações.<br>PURPOSE: we report a small series of pregnant women who underwent gastric bypass surgery for severe obesity, with a review of the literature on this topic. METHODS: five consecutive cases of pregnancy after gastroplasty between 2001 and 2004 were evaluated, and clinical, laboratory and therapeutic features were considered. Patients were 30 to 34 years old and all had been submitted to gastroplasty by the Capella technique. The outcomes for both the pregnant woman and the fetus were evaluated. A search of the English language literature was done through MEDLINE and Web of Science databases with the following terms: gastroplasty, gastric bypass surgery, bariatric surgery, and pregnancy. RESULTS: all 5 pregnancies were singleton. No major obstetric complications were observed and there were no premature or lowbirth weight infants. CONCLUSION: our data suggest that pregnancy following gastroplasty is safe for mother and fetus. However, since information about this topic is limited, further investigations are required to establish appropriate recommendations concerning the follow-up of these pregnancies

Action of dwarf mucuna, pigeon pea and stylos anthes on weed under field and laboratory conditions

The quality and allelopathy properties of dwarf mucuna, dwarf pigeon pea and stylosanthes as cover crops on corn and weed species were evaluated. Seeds were sown in October 2007, with a control treatment, in 20 plots of 4×5m, with five replicates. Weed population was determined 30 and 60 days after sowing. At 90 days, plants were mowed and the residues left to remain on the plot. Fresh and dry mass of the cover crops were determined and the allelopathic potential of aqueous extract of their aerial part was tested. The extract was chemically characterized and applied on seeds of weeds and corn. The experimental design was completely randomized and averages compared by the Scott-Knott test at 5% significance. The cover crops showed to be effective in the control of weeds. The highest values in fresh and dry mass were obtained for dwarf pigeon pea, followed by dwarf mucuna; fresh mass increased 72 and 34%, respectively, compared to the control. The extract with dwarf mucuna affected arrowleaf sida germination. The use of green manure in the summer or between harvests ensures that crop rotation is carried out properly and warrants its benefits

The Brazilian Soil Spectral Library (BSSL): A general view, application and challenges

Made available in DSpace on 2019-10-06T16:42:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-11-15Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)The present study was developed in a joint partnership with the Brazilian pedometrics community to standardize and evaluate spectra within the 350–2500 nm range of Brazilian soils. The Brazilian Soil Spectral Library (BSSL) began in 1995, creating a protocol to gather soil samples from different locations in Brazil. The BSSL reached 39,284 soil samples from 65 contributors representing 41 institutions from all 26 states. Through the BSSL spectra database, it was possible to estimate important soil attributes, such as clay, sand, soil organic carbon, cation exchange capacity, pH and base saturation, resulting in differences among the multi-scale models taking Brazil (overall), regional and state scale. In general, spectral descriptive and quantitative behavior indicated important relationship with physical, chemical and mineralogical properties. Statistical analyses showed that six basic patterns of spectral signatures represent the Brazilian soils types and that environmental conditions explain the differences in spectra. This study demonstrates that spectroscopy analyses along with the establishment of soil spectral libraries are a powerful technique for providing information on a national and regional levels. We also developed an interactive online platform showing soil sample locations and their contributors. As soil spectroscopy is considered a fast, simple, accurate and nondestructive analytical procedure, its application may be integrated with wet analysis as an alternative to support the sustainable management of soils.Department of Soil Science Luiz de Queiroz College of Agriculture (ESALQ) University of São Paulo (USP), Ave. Pádua Dias 11, Cx. Postal 9Department of Soil Federal University of Santa Maria, Av. Roraima 1000Geographical Sciences Department Federal University of Pernambuco, Av. Ac. Hélio Ramos, s/nDepartment of Agronomy State University of Maringá, Av. Colombo 5790Department of Agriculture Biodiversity and Forestry Federal University of Santa Catarina, Rodovia Ulysses Gaboardi 3000 - Km 3Federal Rural University of Amazon, Ave. Presidente Tancredo Neves 2501Faculty of Agronomy and Veterinary Medicine University of BrasíliaEMBRAPA - Solos, R. Antônio Falcão, 402, Boa ViagemCenter of Nuclear Energy in Agriculture (CENA) USP, Av. Centenário 303CDRS/Secretary of Agriculture of São Paulo State, R. Campos Salles 507Department of Soils Federal University of Viçosa, Ave. Peter Henry Rolfs s/nEMBRAPA – Informática Agropecuária, Ave. André Tosello, 209Department of Nuclear Energy Federal University of Pernambuco, Av. Prof. Luis Freire 1000Department of Geography Federal University of Rio Grande do Norte, R. Joaquim Gregório s/nAgronomic Institute of Campinas (IAC), Ave. Barão de Itapura 1481Institute of Agricultural Sciences Federal Rural University of Amazônia, Ave. Presidente Tancredo Neves 2501, 66.077-830Department of Soil Science Federal University of LavrasFederal University of Mato Grosso, Cuiabá, Av. Fernando Corrêa da Costa 2367Department of Soils Federal Rural University of Rio de Janeiro, Rodovia BR 465, Km 07 s/nSoil and Water Sciences Department University of Florida, 2181 McCarty Hallr, PO Box 110290EMBRAPA - Solos, R. Jardim Botânico, 1024Department of Soils and Fertilizers School of Agricultural and Veterinary Studies São Paulo State University (FCAV-UNESP), Via de Acesso Prof. Paulo Donato Castellane s/nFederal University of Sergipe, Av. Marechal Rondon s/nGraduate Program in Earth Sciences (Geochemistry) Department of Geochemistry Federal Fluminense University, Outeiro São João Batista, s/nFederal Institute of the Southeast of Minas Gerais, R. Monsenhor José Augusto 204Federal University of Rio Grande do Norte, R. Joaquim Gregório s/nFederal University of PiauíEMBRAPA Milho e Sorgo, Rod MG 424 Km 45Institute of Agricultural Sciences Federal University of Jequitinhonha e Mucuri Valleys, Ave. Ver. João Narciso 1380Department of Biosystems Engineering ESALQ USP, Ave. Pádua Dias 11, Cx. Postal 9Federal University of Acre, Rodovia BR 364 Km 04Federal University of Amazonas, Av. General Rodrigo O. J. Ramos 1200EMBRAPA Clima Temperado, BR-392, km 78Department of Agronomy Federal Rural University of Pernambuco, R. Manuel de Medeiros s/nEMBRAPA Cocais, Quadra 11, Av. São Luís Rei de França 4Paraense Emílio Goeldi Museum, Av. Gov. Magalhães Barata 376Exata Laboratory, Rua Silvestre Carvalho Q 11Federal University of Rondônia, BR 364, Km 9.5Nacional Institute for Amazonian Research, Ave. André Araújo 2936Department of Forestry Sciences ESALQ-USP, Ave. Pádua Dias 11, Cx. Postal 9Department of Soils and Fertilizers School of Agricultural and Veterinary Studies São Paulo State University (FCAV-UNESP), Via de Acesso Prof. Paulo Donato Castellane s/nFAPESP: 2014/22262-0FAPESP: 2016/26176-6FAPESP: 2017/03207-