Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.  Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.   Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.  The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.  The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.     Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.    Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

Inclusion of guava wastes in feed for broiler chickens

The objective of this study was to evaluate the effect of including guava wastes in the feed on the performance and carcass yield of broiler chickens. An experiment was carried out with 300 male Cobb strain chicks, in a randomized complete design with five levels of waste and five replications. A reference diet based on corn and soybean meal and four feeds with 3, 6, 9 or 12% guava waste were evaluated. The feed intake, weight gain and feed conversion were assessed weekly; the weight at slaughter and the weight and yield of eviscerated carcass, carcass without feet and head, breast, drumstick, thigh, wing, back, edible viscera and abdominal fat were assessed. The inclusion of guava waste in the feed promotes performance and carcass yield similar to that obtained with the feed based on corn and soybean meal, therefore this agro-industrial by-product can be used at levels of up to 12% in feeds for broiler chickens

Efeito da utilização de farelo de girassol na dieta sobre o desempenho de frangos de corte

Foi realizado um experimento para avaliar os efeitos da inclusão de farelo de girassol em rações para frangos de corte sobre o desempenho, o rendimento de carcaça e dos cortes e a viabilidade econômica. O delineamento experimental foi em blocos casualizados com cinco níveis de farelo de girassol (0, 5, 10, 15 e 20% da dieta basal), oito repetições e 20 aves por unidade experimental. As aves e as rações foram pesadas no início e ao final de cada fase do período experimental (1 a 21 dias e 22 a 42 dias) para obtenção do consumo de ração, do ganho de peso e da conversão alimentar. Duas aves de cada repetição foram abatidas aos 42 dias de idade para avaliação da carcaça. Com a inclusão do farelo de girassol, o consumo diminuiu linearmente na fase inicial (y = 1185,1 - 2,1x; R2 = 0,97), enquanto a conversão alimentar melhorou de forma linear no período total (y = 1,6404 - 0,0018x; R2 = 0,62) e de forma quadrática na fase inicial (y = 1,3943 - 0,0069x + 0,0002x2; R2 = 0,96). Não foi encontrada diferença significativa no rendimento de carcaça e dos cortes. Os melhores desempenhos econômicos foram obtidos quando as aves foram alimentadas com rações contendo 5% de farelo de girassol na fase inicial e 0% na fase de crescimento e no período total. A adição de 20% de farelo de girassol em rações para frangos de corte até os 42 dias de idade não prejudica o desempenho produtivo das aves.A trial was carried out to evaluate the effect of sunflower meal inclusion in the broiler diets on the performance, carcass yield and cuts and the economics viability. A randomized block experimental design was used, with five treatments and eight replications of 20 birds per experimental unit. Treatments consisted of including 0, 5, 10, 15, or 20% sunflower meal in a basal diet. Birds and diets were weighed at the beginning and at the end of each experimental phase (1 to 21 days and 22 to 42 days) to determine feed intake, weight gain, and the feed:gain ratio. Two birds per replication were slaughtered at 42 days of age for carcass evaluation. Feed intake was linearly reduced in the starter phase (y = 1185.1 - 2.1x; R2 = 0.97), with sunflower meal inclusion in the basal diet, and the feed:gain ratio linearly improved in the total period (y = 1.6404 - 0.0018x; R2 = 0.62), whereas a quadratic effect on the feed:gain ratio was observed in the starter phase (y = 1.3943 - 0.0069x + 0.0002x2; R2 = 0.96). No significant differences were observed for carcass yield and cuts. The best economic performances were achieved when the birds were fed diets containing 5% sunflower meal in the starter phase, and 0% in the grower phase and total period. The inclusion of 20% sunflower meal in the diet of broilers up to 42 days of age did not show harmful effects on performance

VALOR NUTRICIONAL DA FARINHA DA CABEÇA DO CAMARÃO MARINHO Litopenaeus Vannamei PARA FRANGOS DE CORTE

In aim to evaluate the nutritional value of shrimp meal its proximate chemical analyzed and a metabolism trial were done. The analyses performed on shrimp meal were dry mater (DM), ash, crude protein (CP), ether extract (EE), crude fiber (CF), gross energy (GE), calcium (Ca), and phosphorous (P). In the digestibility trial sixty broilers with fourteen days old were allocated in a completely randomized experimental design composed by three treatments, four replicates and five broilers per experimental unit. Treatments were a reference standard diet and two trial diets with 30 or 40% of substitution on the reference standard diet. Shrimp meal analyses resulted in 91.81 % DM, 16.31 % ASH, 66.01 % CP, 17.31 % EE, 9.38 % CF, 4726.51 kcal/kg GE, 4.70 % calcium and 1.44 % phosphorus in dry matter. Digestibility coefficient of DM from diets and shrimp meal does not differ but values for EE digestibility differed. In the levels of 30 and 40 % inclusion the mean calculated values of Apparent Metabolizable Energy (AME) for shrimp meal were 3,690 and 3,800, for AME nitrogen corrected (AMEn) the values were 3,478 and 3,554 kcal/kg, respectively

Desempenho e características de carcaça de bovinos mestiços de origem leiteira em condições de pastejo, restrito ou “ad libitum”, período das águas = Performance and carcass characteristics of dairy crossbreds bulls in grazing, restricted or “ad libitum”, during rainy season

Este trabalho objetivou avaliar o desempenho e as características de carcaça de bovinos mestiços (5/8 Holandês/Zebu) em pastejo de “Brachiaria decumbens” com acesso restrito ou “ad libitum”. Utilizaram-se 16 animais com idade e peso médios de 10 meses e 180kg, respectivamente. Os animais foram distribuídos em delineamento de blocos casualizados, nos seguintes tratamentos: PAV = pastejo à vontade e PR = pastejo restrito (4 horas/dia). O período experimental teve duração de 114 dias. Observaram-se diferença entre os tratamentos(PThe aim of this work was to evaluate the performance and carcass characteristic of crossbred bulls (5/8 holstein/zebu) in grazing of “Brachiaria decumbens” with restrict access or "ad libitum". 16 animals with an average of age and live weight of 10 months and 180kg respectively were used. The animals were assigned in a randomized block design, according to the following treatments: “ad libitium” grazing (AG) and restricted grazing (RG) (4 hours/day). The experimental period lasted 114 days. There were statistical differences between the treatments (P<0.05) on final live weight (FLW): 229.83 and 207.42 kg for unlimited grazing and restricted grazing, respectively, as well as for average daily gain (ADG): 0.618 and 0.230 kg. There were also statistical differences between the treatments (P<0.05) to final empty body weight, daily empty body weight gain, hot and cold carcass weight, cold carcass yield (CCY/FLW) and loin eye area according to the two methods used. The performance of the animals in restricted grazing had satisfactory results to the rainy season in pasture of Brachiaria decumbens. Themethods to determine the loin eye area did not differ. However, the "plastic grid" is more recommended

Avaliação nutricional do farelo de algodão de alta energia no desempenho produtivo e características de carcaças de frangos de corte Nutritional evaluation of cottonseed meal in high energy performance and carcass characteristics of broilers

O trabalho teve como objetivos determinar a composição química e energética do farelo de algodão produzido pela BUNGE Alimentos S/A, marca registrada como Farelo de algodão de alta energia (FAAE®) e avaliar a inclusão deste no desempenho de frangos de corte. Determinou-se a composição química, aminoacídica e energética (utilizando-se o método de coleta total de excretas, com duas coletas ao dia). Foi utilizado óxido férrico para marcar o início e o final da coleta. O nível de inclusão do alimento de teste na ração referência foi de 20%. O desempenho foi avaliado com a inclusão do farelo de algodão no período de nove a 42 dias. Durante os primeiros nove dias, os pintinhos receberam ração pré-inicial comum a todas as aves. A partir do nono dia, as aves foram submetidas à dieta experimental com níveis de 3, 6, 9 e 12% de inclusão do farelo de algodão. O farelo de algodão apresentou 95,91% de matéria seca, 9,8% de gordura, 27% de proteína bruta, 4,6% de cinza, 4.867kcal kg-1 de energia bruta, 1,32% de lisina e 0,35% de metionina. O valor de energia metabolizável aparente corrigida para nitrogênio determinado foi 1.188 kcal kg-1. Não se observou efeito no desempenho e no rendimento de carcaça dos frangos aos 42 dias de idade.The objective of the research was to determine the chemical and energetic composition of cottonseed meal produced by BUNGE Foods Company, trademark as high energy cottonseed meal (FAAE ®) and to evaluate its inclusion in the performance of broilers. The chemical, energetic and aminoacidic composition was determined using the total excretion gathering method, with two gathers a day. It was used ferric oxide to mark the beginning and the end of the gathering. The level of inclusion of the food testing in the reference diet was 20%. The performance was evaluated with the inclusion of cottonseed meal in a period of 9 to 42 days. During the first nine days the poultries received pre-initial feed that were common to all birds. From the ninth day, the birds received an experimental diet with substitution levels of 3%, 6%, 9% and 12% inclusion of cottonseed meal . The cottonseed meal presented 95.91% of dry matter, 9.8% of fat, 27% of crude protein, 4.6% of ash, 4.867 kcal kg-1 of crude energy, 1.32% of lysine and 0.35% of metionine. The determined value of apparent metabolizable energy corrected to nitrogen was 1.188 kcal kg-1. It was not observed effect in the performance and carcass return of the poultry at 42 days of age