RESUMO
Supplementation of rumen-protected amino acids may improve dairy cow performance but few studies have evaluated the implications of supplementing low-forage diets. Our objective was to evaluate the effects of supplementing rumen-protected methionine (Met) and lysine (Lys) on milk production and composition as well as on mammary gland health of mid-lactating Holstein cows from a commercial dairy farm feeding a high by-product low-forage diet. A total of 314 multiparous cows were randomly assigned to control (CON; 107 g of dry distillers' grains) or rumen-protected Met and Lys (RPML; 107 g dry distillers' grains + 107 g of RPML). All study cows were grouped in a single dry-lot pen and fed the same total mixed ration diet twice a day for a total of 7 weeks. Treatments were top-dressed on the total mix ration immediately after morning delivery with 107 g of dry distillers' grains for 1 week (adaptation period) and then with CON and RPML treatments for 6 weeks. Blood samples were taken from a subset of 22 cows per treatment to determine plasma AA (d 0 and 14) and plasma urea nitrogen and minerals (d 0, 14, and 42). Milk yield and clinical mastitis cases were recorded daily, and milk components were determined bi-weekly. Body condition score change was evaluated from d 0 to 42 of the study. Milk yield and components were analyzed by multiple linear regression. Treatment effects were evaluated at the cow level considering parity and milk yield and composition taken at baseline as a covariate in the models. Clinical mastitis risk was assessed by Poisson regression. Plasma Met increased (26.9 vs 36.0 µmol/L), Lys tended to increase (102.5 vs 121.1 µmol/L), and Ca increased (2.39 vs 2.46 mmol/L) with RPML supplementation. Cows supplemented with RPML had higher milk yield (45.4 vs 46.0 kg/d) and a lower risk of clinical mastitis (risk ratio = 0.39; 95% CI = 0.17-0.90) compared to CON cows. Milk components yield and concentrations, somatic cell count, body condition score change, plasma urea nitrogen, and plasma minerals other than Ca were not affected by RPML supplementation. Results suggest that RPML supplementation increases milk yield and decreases the risk of clinical mastitis in mid-lactation cows fed a high by-product low-forage diet. Further studies are needed to clarify the biological mechanisms for mammary gland responses to RPML supplementation.
Assuntos
Lactação , Lisina , Gravidez , Feminino , Bovinos , Animais , Lisina/metabolismo , Lactação/fisiologia , Metionina/metabolismo , Paridade , Rúmen/metabolismo , Dieta/veterinária , Suplementos Nutricionais , Leite/metabolismo , Racemetionina/metabolismo , Nitrogênio/metabolismo , Minerais/metabolismo , Ureia/metabolismo , Ração Animal/análiseRESUMO
Genital infection by human papillomavirus (HPV) tends to occur more frequently in patients with conditions associated with immune suppression. Systemic lupus erythematosus (SLE) is an immunological disorder characterized by generalized inflammation and a number of clinical manifestations and circulating autoantibodies. The aim of the present study was to determine the prevalence of genital HPV infection among female SLE patients. Women diagnosed with SLE based on American College of Rheumatology classification criteria followed at rheumatology outpatient clinic of the Escola Bahiana de Medicina e Saude Publica, Salvador, Brazil, were included in the study. As a comparison group, clinically healthy women who were attending the gynecology outpatient clinic for routine examination at the same institution were recruited. Testing for cervical HPV infection was performed using the nested polymerase chain reaction technique. Eighty-eight female SLE patients (mean age, 41.4 ± 11.6 years) and seventy healthy female subjects (control group) were studied. The prevalence of HPV infection was 80.7 % (71/88) in the SLE group and 35.7 % (25/70) in the control group (p < 0.0001). After adjustment of the variables (early sexual activity, number of partners and obstetric history), the odds ratio (OR) for genital HPV infection in women with SLE was 7.2 (95 % CI, 2.9 to 17.8; p = 0.0001). The use of immunosuppressive drugs was not associated with a higher prevalence of HPV infection. This study demonstrated that SLE patients have a higher prevalence of genital HPV infection, even when exposed to less potential risk factors for the virus.
Assuntos
Lúpus Eritematoso Sistêmico/complicações , Infecções por Papillomavirus/epidemiologia , Doenças do Colo do Útero/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Imunossupressores/efeitos adversos , Lúpus Eritematoso Sistêmico/dietoterapia , Pessoa de Meia-Idade , Infecções por Papillomavirus/etiologia , Prevalência , Doenças do Colo do Útero/etiologiaRESUMO
BACKGROUND: Vulvovaginal candidiasis (VVC) is the second most common vaginal infection. HIV-infection is a risk factor for this infection. OBJECTIVE: To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patients, compared to HIV-uninfected women in Salvador, Brazil. METHODS: Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil). RESULTS: Frequency of Candida spp. was higher in HIV-infected women (29.7%) than in HIV-uninfected controls (14.5%) (p = 0.02). The odds ratio value for vulvovaginal candidiasis in HIV-infected patients was 2.6 (95% CI: 1.07 - 6.32 p = 0.03). Candida albicans was the most commonly isolated species in both HIV-infected (52.3%) and uninfected women (85.7%), followed by C. parapsolis in 17.6% and 14.3%, respectively. In HIV-infected women, C. glabrata, C. parapsilosis, and a coinfection of C. albicans and C. glabrata were also identified. There was no significant difference between Candida species isolated from the vaginal mucosa of women with VVC and colonization of the vaginal mucosa of HIV-infected and HIV-uninfected women. One C. glabrata isolate from an HIV-infected patient was resistant to fluconazole and other two isolates exhibited a dose-dependent susceptibility. CONCLUSION: Our results confirm a higher frequency of Candida spp. isolated from the vaginal mucosa of HIV-infected women and a broader spectrum of species involved. Only Candida glabrata isolates showed decreased susceptibility to fluconazole.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Candida/isolamento & purificação , Candidíase Vulvovaginal/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Adulto , Antifúngicos/farmacologia , Brasil , Candida/classificação , Candida/efeitos dos fármacos , Candidíase Vulvovaginal/diagnóstico , Feminino , Humanos , Testes de Sensibilidade Microbiana , Mucosa/microbiologia , Prevalência , Vagina/microbiologiaRESUMO
BACKGROUND: Vulvovaginal candidiasis (VVC) is the second most common vaginal infection. HIV-infection is a risk factor for this infection. OBJECTIVE: To determine the frequency of VVC and to describe the main Candida species isolated and their susceptibility to antifungal drugs in HIV-infected patients, compared to HIV-uninfected women in Salvador, Brazil. METHODS: Cross-sectional study including a group of 64 HIV-infected women and 76 uninfected women, followed up at the AIDS reference center and at the Gynecological Clinic of Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia, Brazil). RESULTS: Frequency of Candida spp. was higher in HIV-infected women (29.7 percent) than in HIV-uninfected controls (14.5 percent) (p = 0.02). The odds ratio value for vulvovaginal candidiasis in HIV-infected patients was 2.6 (95 percent CI: 1.07 - 6.32 p = 0.03). Candida albicans was the most commonly isolated species in both HIV-infected (52.3 percent) and uninfected women (85.7 percent), followed by C. parapsolis in 17.6 percent and 14.3 percent, respectively. In HIV-infected women, C. glabrata, C. parapsilosis, and a coinfection of C. albicans and C. glabrata were also identified. There was no significant difference between Candida species isolated from the vaginal mucosa of women with VVC and colonization of the vaginal mucosa of HIV-infected and HIV-uninfected women. One C. glabrata isolate from an HIV-infected patient was resistant to fluconazole and other two isolates exhibited a dose-dependent susceptibility. CONCLUSION: Our results confirm a higher frequency of Candida spp. isolated from the vaginal mucosa of HIV-infected women and a broader spectrum of species involved. Only Candida glabrata isolates showed decreased susceptibility to fluconazole.
Assuntos
Adulto , Feminino , Humanos , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Candida/isolamento & purificação , Candidíase Vulvovaginal/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Antifúngicos/farmacologia , Brasil , Candida/classificação , Candida/efeitos dos fármacos , Candidíase Vulvovaginal/diagnóstico , Testes de Sensibilidade Microbiana , Mucosa/microbiologia , Prevalência , Vagina/microbiologiaRESUMO
The winter wheat (Triticum aestivum L.) producing region of the US Pacific Northwest (PNW) is often subject to water deficits at sowing and during grain filling. Improved genetic adaptation of wheat cultivars to drought stress is one objective of breeding efforts in the region. Consequently, there is interest in identifying molecular markers associated with drought tolerance. Dehydrins, a family of proteins that accumulate in response to dehydrative stress, may provide a suitable marker for use in breeding programs. Seven cultivars (Connie, Gene, TAM105, Rod, Hiller, Rhode and Stephens) were evaluated in two experiments in which dehydrin accumulation and their association to stress tolerance during grain filling were characterized during progressive drought stress. A24-kDa dehydrin was present in leaves at each sampling date in all seven cultivars. Quantitative differences in accumulation of this protein were observed between cultivars on the third sampling date (4 d of stress). This differential accumulation was associated with stress tolerance characterized by a lower yield reduction and a lowered rate of decrease in leaf water potential in Connie, TAM105 and Gene. In contrast to leaves, an increased number of dehydrins were observed in grains under stress and non-stress treatments. Despite the number of dehydrins detected, there was no apparent association between drought stress and dehydrin expression in grains. Although the specific role of these proteins remains unknown, their association with stress tolerance suggests that dehydrins have utility in improving adaptation to drought and as markers for drought tolerance.
RESUMO
The Pacific Northwest (PNW), an important region for wheat production in the USA, is often subject to water deficits during sowing and grain filling. These deficits reduce the quality and yield of the crop. As a consequence, an important objective of breeding programs in the region is improving the genetic adaptation of wheat cultivars to drought stress. One response to dehydrative stresses is the accumulation of proteins called dehydrins, which are believed to protect membranes and macromolecules against denaturation. We characterized dehydrin accumulation in seedlings during drought stress and its correlation with stress tolerance during grain filling in seven wheat cultivars, 'Connie', 'Gene', 'TAM105', 'Rod', 'Hiller', 'Rhode', and 'Stephens'. A 24-kd dehydrin accumulated in seedlings under stress, but not in irrigated control plants. Connie, TAM105, and Gene started to accumulate dehydrins at the fourth day of stress, while the other cultivars showed dehydrins after twelve days of stress. This differential accumulation in seedlings was associated with stress tolerance at grain filling, characterized by a lower reduction in yield and in the rate of decrease in leaf water potential per day of stress. Connie, TAM105, Gene and Rod where the most tolerant cultivars. The results indicate that expression of this 24-kd dehydrin might serve as a rapid and non-destructive screening technique at the seedling stage. Even though the results are promising, selection experiments using a population segregating for stress tolerance are needed to test more conclusively whether this dehydrin can serve as a genetic marker for cultivars with tolerance to drought stress.
Assuntos
Proteínas de Plantas/biossíntese , Proteínas de Plantas/genética , Triticum/genética , Água/fisiologia , Aclimatação/genética , Análise de Variância , Desidratação , Desastres , Folhas de Planta/metabolismo , Fatores de Tempo , Triticum/metabolismoRESUMO
OBJECTIVE: To examine the efficacy of a combination of 4 blood markers of alcohol use in detecting alcohol-abusing pregnant women. STUDY DESIGN: Two new markers of alcohol use, whole blood-associated acetaldehyde and carbohydrate-deficient transferrin, and 2 traditional markers of alcohol use, gamma-glutamyl transpeptidase and mean red blood cell volume, were measured in the blood of pregnant women. Each woman was interviewed about alcohol and drug use, medical and obstetric histories, and nutrition. Each infant was examined by a clinician who was blinded to exposure status. RESULTS: All of the women who reported drinking an average of 1 or more ounces of absolute alcohol per day had at least 1 positive blood marker. The infants of mothers with 2 or more positive markers had significantly smaller birth weights, lengths, and head circumferences than the infants with negative maternal screens. The presence of 2 or more positive markers was more predictive of infant outcome than any self-reporting measure. CONCLUSIONS: These markers, which detect more at-risk pregnant women than self-reporting methods, could lead to better efforts at detection and prevention of alcohol-induced fetal damage.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Etanol/intoxicação , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Gravidez/sangue , Diagnóstico Pré-Natal , Efeitos Tardios da Exposição Pré-Natal , Acetaldeído/sangue , Adulto , Biomarcadores/sangue , Peso ao Nascer , Estatura , Índices de Eritrócitos , Etanol/efeitos adversos , Feminino , Transtornos do Espectro Alcoólico Fetal/prevenção & controle , Cabeça/anatomia & histologia , Humanos , Recém-Nascido , Anamnese , Fenômenos Fisiológicos da Nutrição , Valor Preditivo dos Testes , Resultado da Gravidez , História Reprodutiva , Método Simples-Cego , Transtornos Relacionados ao Uso de Substâncias/sangue , Transferrina/análise , gama-Glutamiltransferase/sangueRESUMO
The author analyzes medical slang in Rio de Janeiro based on the view of interactive or live metaphor proposed by such authors as Black and Ricoeur, applied to puns and other jokes from medical work, with the goal of unveiling what physicians mean by this linguistic register. The article classifies medical slang in three broad areas, pertaining to the physician's relations with professional training and knowledge, patients, and health care services. Comparing his empirical material with previous studies focusing on hospital slang for patients, the author identifies, in addition, a range of slang terms for health care services themselves. The article points to interfaces between medical slang and the Brazilian "health hypercrisis" identified by Schramm.
Assuntos
Terminologia como Assunto , Comportamento Verbal , Brasil , Ética Médica , Humanos , Metáfora , Relações Médico-Paciente , Sociologia , Senso de Humor e Humor como AssuntoRESUMO
OBJECTIVES: To describe varicella complications in healthy and previously ill children hospitalized for varicella and to explore trends in group A beta-hemolytic streptococcus complications of varicella. METHODS: A retrospective record review of children hospitalized for varicella between January 1, 1990, and March 31, 1994, was conducted in nine large acute care hospitals in Los Angeles County, California. RESULTS: We identified 574 children hospitalized for varicella in study hospitals during the 4.25-year study period (estimated risk of hospitalization, approximately 1 in 550 cases of varicella); 53% of the children were healthy before the onset of varicella and 47% were previously ill with underlying cancers or other chronic illnesses. Children were hospitalized for treatment of complications (n = 427, 74%) or for prophylactic antiviral therapy or observation (n = 147, 26%). Systems involved in complications included skin/soft tissue (45%), neurologic (18%), respiratory (14%), gastrointestinal (10%), and hematologic, renal, or hepatic (8% or less). The mean age of children with skin/soft tissue infections was 2.7 years (range < 1 to 16 years) compared with 4.7 years (< 1 to 18 years) for other complications. Children with skin/soft tissue and neurologic complications were more often previously healthy (p < 0.05), whereas those with respiratory complications were more often previously ill (p < 0.001). Hospitalizations for skin/soft tissue infections increased during the study period. The proportion of complications as a result of group A beta-hemolytic streptococcus infection increased from 4.7% before 1993 to 12.2% for the remainder of the study period (p = 0.02). CONCLUSIONS: Prior health status was predictive of the type of complications experienced by children with varicella requiring hospitalization. Our data suggest a recent increase in skin/soft tissue complications of varicella requiring hospitalization and an increase in the proportion of complications related to group A beta-hemolytic streptococcus. Wide-scale vaccine use should reverse this trend and reduce the overall impact of varicella on both healthy and previously ill children.
Assuntos
Varicela/complicações , Adolescente , Doenças do Sistema Nervoso Central/complicações , Varicela/imunologia , Criança , Pré-Escolar , Gastroenteropatias/complicações , Nível de Saúde , Hospitalização , Humanos , Hospedeiro Imunocomprometido , Lactente , Doenças Respiratórias/complicações , Dermatopatias Bacterianas/complicações , Infecções dos Tecidos Moles/complicações , Infecções Estreptocócicas/complicações , Streptococcus pyogenesRESUMO
PIP: In Brazil, the Prostitution and Civil Rights Program works to fight against stigma and violence against sex workers and to foster self-esteem, self-determination, and greater access to civil rights. It sponsors the Brazilian Prostitutes' Network. In 1988, the Ministry of Health asked the program to join the Ministry to produce sexually transmitted disease/AIDS prevention materials. The materials were ready for distribution in early 1991 when the program began recruiting prostitutes and transvestites for its Health Education Project. The aforementioned groups and the Brazilian chapter of International Planned Parenthood Federation are working together on this project. By mid-1992, the project recruited 17 community-based health agents (15 female and 2 male prostitutes) from different prostitution areas and through a network of contacts from these areas of Rio de Janeiro. After informal training in April or June 1991, they went into their communities to inform people of their health agent role, distributed free condoms and AIDS education material, and promoted the project. Health agents maintain a weekly report of condom and education material distribution. This allows them to monitor their progress. Health agents now meet with their peers to discuss sex and health issues. The communities have opened their doors to the groups. The project is also geographically mapping the sex trade to target health care and other resources in each area. It is pursuing a reference/counterreference relationship within the existing public health system in Rio de Janeiro. Involvement of sex workers in all phases contributes to the success of the project so far. Future research is needed to determine whether the project is reducing risk of HIV transmission, however.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Agentes Comunitários de Saúde/organização & administração , Trabalho Sexual , Síndrome da Imunodeficiência Adquirida/epidemiologia , Brasil , Agentes Comunitários de Saúde/educação , Agentes Comunitários de Saúde/normas , Educação em Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Negociação , Objetivos Organizacionais , Seleção de Pessoal , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Comportamento SexualRESUMO
With the induction of ovulation, clomiphene citrate and human menopausal gonadotropin have the potential to stimulate the endocervical glands. We have found that the degree of mucus production can occasionally be quite large and hence is detectable by sonographic evaluation as an anechoic cervical mass. The incidence of this specific ultrasonic finding was found to be approximately 5%. This physiologic process should be differentiated from disease states affecting the cervix.
Assuntos
Muco do Colo Uterino/efeitos dos fármacos , Colo do Útero/anatomia & histologia , Indução da Ovulação , Ultrassonografia , Adulto , Clomifeno/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Menotropinas/uso terapêutico , Estimulação Química , Doenças do Colo do Útero/diagnósticoRESUMO
To evaluate the effects of megadoses of vitamins with minerals on the cognitive intelligence of children with Down syndrome, a two-group double-blind clinical trial was carried out with 56 school-aged children with Down syndrome. Children were evaluated at baseline, 4 months, and 8 months with a battery of standard psychologic tests, physical examinations, and blood tests. The two groups, which were well-matched is cognitive intelligence and other important subject characteristics at baseline, were not significantly different in intelligence and other test scores at the 4- or 8-month test periods. The particular megadoses of vitamins with minerals used in the study did not produce increased intelligence in the study population.
Assuntos
Síndrome de Down/tratamento farmacológico , Inteligência/efeitos dos fármacos , Minerais/uso terapêutico , Terapia Ortomolecular , Adolescente , Criança , Ensaios Clínicos como Assunto , Método Duplo-Cego , Síndrome de Down/psicologia , Humanos , Escalas de WechslerRESUMO
Thirty-three prospectively studied neonates born to mothers using methadone plus other drugs developed significant thrombocytosis by the second week of life compared to platelet counts performed during the first week. This increase persisted for over 16 weeks, with a further short-lived significant peak at 10 weeks of age. Platelet counts exceeding 1,000,000/mm3 were found in seven infants. Thrombocytosis was not related to withdrawal symptoms or treatment (phenobarbital or paregoric). No thrombocytosis was found in 36 normal control infants up to eight weeks of life. Twenty-eight of the study group infants were evaluated for circulating platelet aggregates. Thirteen patients had a normal aggregate index and a mean platelet count of 468,000/mm3; 15 patients had increased aggregates and mean platelet count of 754,000/mm3. The risk for increased circulating platelet aggregates correlated directly with an increase in platelet count. Thrombocytosis and increased circulating platelet aggregates may be factors in the pathogenesis of the focal infarcts, and subarachnoid and germinal plate hemorrhages, described at autopsy in infants of addicted mothers.