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BACKGROUND: Human colostrum has been used in a number of investigations when preterm human infants cannot, for any reason, breastfeed directly from their mothers. One of the growing fields in these investigations is colostrum therapy, which consists of exposing the oropharyngeal mucosa of these preterm newborns to small amounts of raw colostrum. RESEARCH AIM: To critically review the scientific evidence about colostrum therapy in premature infants and to explore its influences on the immune system. METHODS: This systematic review was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA statement). The following databases were searched for potentially eligible studies up to March 10, 2021: Medline, Scopus, Web of Science, Cochrane Library, Embase. Two reviewers independently screened all titles, abstracts, and full texts for eligibility. RESULTS: A total of 12 studies with 996 participants were included. A significant difference in lactoferrin levels in the urine was found (SMD 0.70; 95% CI [0.03,1.36]; p = .04; I² = 65% two studies, 112 participants, very low-quality evidence). CONCLUSION: Colostrum seems to result in increasing lactoferrin levels in the urine of premature newborns after 1 week of intervention. CLINICAL TRIAL REGISTRATION: The study was registered at PROSPERO with the number CRD42017073624, submitted on August 9, 2017.

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o presente trabalho foi conduzido com o objetivo de comparar a qualidade microbiológica do leite cru obtido por ordenha manual e após pasteurização lenta, sendo a técnica reproduzida em ambiente caseiro, como uma alternativa ao consumo para a população que possui o hábito de ingestão do leite em propriedades rurais. Analisaram-se dez amostras de leite in natura obtidas por ordenha manual, coletadas em pequenas propriedades rurais no município de Campo Grande, MS. Nesses estabelecimentos foram observadas as Boas Práticas e as condições higiênicos sanitárias. Dentre as amostras de leite in natura, 70% apresentaram valores superiores a 105 UFC/ml, para contagem padrão (aeróbios mesófilos), concordando com a não aplicação das Boas Práticas de Manipulação verificada nos locais de coleta. Esse valor foi reduzido consideravelmente após o processo de pasteurização lenta. Não há padrões microbiológicos para o leite in natura, estabelecidos em legislação, porém, em 100% das amostras observou-se uma alta contagem de Coliformes Totais e Termotolerantes indicando falta de higiene na ordenha e estocagem inadequada do produto. De acordo com Brasil (2001), o limite estabelecido para Coliformes a 45°C é de 104NMP/ml em leite pasteurizado, portanto todas as amostras encontram-se dentro dos limites estabelecido pela legislação após a pasteurização caseira. Em 60% das amostras foi detectada a presença de Salmonella sp. A mesma fonte citada anteriormente, estabelece a ausência em 25mL para amostras de leite pasteurizado, portanto houve redução em 100% das amostras após o tratamento térmico. Devido à manipulação do produto e o controle ineficiente sobre a mastite nas propriedades, as dez amostras foram analisadas em relação à presença ou não de Estafilococos coagulase positiva. [...]. (AU)

This work was carried out to compare the microbiological quality of raw milk obtained by hand milking and after LTLT Pasteurization (Low Temperature Long Time method), which the technique was reproduced in home as an alternative to consumption in the population that has the habit of milk intake in rural properties. A total of ten samples of raw milk obtained by hand milking, collected in small rural properties in the municipality of Campo Grande, MS, were analysed. These properties were availed by Good Practices and hygienic and sanitary conditions. The results shoed that 70% of the samples of raw milk had values greater than 1()5 UFC/ml for counting standard (aerobic mesophiles), agreeing with the non-application of Good Practice for handling checked at points of collection. This value was reduced considerably after the LTLT Pasteurization. There are no microbiological standards for raw milk established in legislation, but in 100% of the samples there was a high count of total and thermotolerant coliforms indicating lack of hygiene in milking and inappropriate storage of the product. According to Brasil (2001), the limit set for Coliforms at 45°C is 10" NMP/ml in pasteurized milk, so all samples are within the limits set by law after pasteurization. In 60% of samples showed the presence of Salmonella sp. The same source cited above, provides for the absence in 25mL samples of pasteurized milk, then decreased in 100% of the samples after heat treatment. Because the handling of the product and inefficient on mastitis control in the properties, the ten samples were analyzed for the presence or absence of Coagulase positive Staphylococci.[…]. (AU)

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Objetivo: Analisar a taxa e as principais causas de conversão de colecistectomia videolaparoscópica para cirurgia aberta entre colecistites agudas e crônicas. Métodos: Estudo retrospectivo, analisando 1359 prontuários de pacientes submetidos à colecistectomiano Serviço de Cirurgia Geral do Hospital Universitário Cajuru no período de janeiro de 2000 à outubro de 2006. Resultados: Realizaram-se 1066 colecistectomias videolaparoscópicas, sendo, 701(65,75%) por colecistopatia crônica calculosa, 356 (33,39%) por colecistopatia aguda calculosa, sete 0,65%) por pólipos de vesícula, duas (0,21%) por vesícula hidrópica. A taxa de conversão na colecistopatia aguda foi de 7,86%, e na colecistite crônica ,85% (p=0,0003). A média de idade das taxas de conversão foi de 50,96 ± 17,49 anos para colecistopatia aguda e de 56,45 ± 12,28 anos para crônica (p=0,234). O tempo cirúrgico mediano foi de 152,5 (30 – 36) minutos para aguda e 157,5 (90 – 240) para crônica (p=0,959). As principais causas de conversão nas colecistopatias crônicas foram: anatomia obscura (16 pacientes) e aderências (14 pacientes), sendo que em 10 casos as duas causas estavam associadas. Já na forma aguda, as principais causas foram aderência (13 pacientes) e dificuldades técnicas (8 pacientes); com diferença significativa(p=0,008). Conclusão: A taxa de conversão de cirurgia videolaparoscópica para cirurgia aberta é maior nos casos de colecistopatiacalculosa aguda do que na crônica. Nesta, o fator que mais dificultou a realização do procedimento videolaparoscópico em nosso serviço foi a alteração anatômica; já naquela, foi a presença de aderências.

Objectives: to analyze the rate and main causes for conversion to open surgery among acute and chronic cholecystitis. Methods: a retrospective analysis of 1359 patient medical charts submitted to cholecystectomy in hospital universitário cajuru’s general surgerydepartment was done during the period from january 2000 to october 2006. Results: one thousand and sixty six laparoscopic cholecystectomies were performed, 701 (65.75%) due to chronic cholecystolithiasis, 356 (33.39%) due to acute cholecystolithiasis, seven (0.65%) had gallbladder polyps and two (0.21%) cases had hydropic gallbladder. The conversion rate in acute cases was 7.86%, and in chronic cases were 2.85% (p=0.0003). The average age for conversion was 50.96 ± 17.49 years-old for acute cases and 56.45 ± 12.28 years-old for chronic cases. The operative meantime was 152.5 minutes (30 – 36) for acute and 157.5 minutes(90 – 240) for chronic holecystolithiasis (p=0.959). The conversion reasons for chronic cholecystolithiasis were: obscure anatomy in 16 cases (80%) and adhesions in 14 cases (70%), considering that in ten cases both causes were associated. For acute presentation, conversions were due to adhesions in 13 (46.42%) patients and technical difficulties were found in 8 (28.57%) patients (p=0.008). Conclusion: the rate for conversion of laparoscopic cholecystectomy to open surgery is higher in acute cholecystolithiasis when in comparison to chronic ones. Both, the presence of adhesions in acute cases, and difficult anatomy identification in chronic cases,were the most common reasons to impair the laparoscopic procedures performance in our department.

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OBJECTIVES: To analyze the rate and main causes for conversion to open surgery among acute and chronic cholecystitis. METHODS: A retrospective analysis of 1359 patient medical charts submitted to cholecystectomy in hospitalUniversitário Cajuru's general surgery department was done during the period from january 2000 to october 2006. RESULTS: One thousand and sixty six laparoscopic cholecystectomies were performed, 701 (65.75%) due to chronic cholecystolithiasis, 356 (33.39%) due to acute cholecystolithiasis, seven (0.65%) had gallbladder polyps and two (0.21%) cases had hydropic gallbladder. The conversion rate in acute cases was 7.86%, and in chronic cases were 2.85% (p=0.0003). The average age for conversion was 50.96 +/- 17.49 years-old for acute cases and 56.45 +/- 12.28 years-old for chronic cases. The operative meantime was 152.5 minutes (30 - 36) for acute and 157.5 minutes (90 - 240) for chronic cholecystolithiasis (p=0.959). The conversion reasons for chronic cholecystolithiasis were: obscure anatomy in 16 cases (80%) and adhesions in 14 cases (70%), considering that in ten cases both causes were associated. For acute presentation, conversions were due to adhesions in 13 (46.42%) patients and technical difficulties were found in 8 (28.57%) patients (p=0.008). CONCLUSION: The rate for conversion of laparoscopic cholecystectomy to open surgery is higher in acute cholecystolithiasis when in comparison to chronic ones. Both, the presence of adhesions in acute cases, and difficult anatomy identification in chronic cases, were the most common reasons to impair the laparoscopic procedures performance in our department.

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