RESUMEN Introducción y objetivos: El tratamiento de los pacientes con fibrilación auricular no valvular (FANV) que requieren implante de stents coronarios es un desafío. El objetivo del estudio fue investigar si el cierre de la orejuela izquierda (COI) podría ser una opción posible y beneficiosa para estos pacientes. Para ello, se analiza el impacto del COI más tratamiento antiagregante plaquetario (AP) en comparación con la combinación de anticoagulantes orales (ACO), incluidos los ACO directos, y tratamiento AP en los resultados a largo plazo de estos pacientes Métodos: Se analizaron los resultados de 207 pacientes con FANV sometidos consecutivamente a implante de stents coronarios. Recibieron ACO 146 pacientes (74 acenocumarol, 71 ACO de acción directa) y en 61 se realizó COI. La mediana de seguimiento fue de 35 meses. Los pacientes también recibieron tratamiento AP por prescripción de su cardiólogo. El estudio recibió la debida supervisión ética. Resultados: La edad (media: 75,7 años) y el antecedente de accidente vascular cerebral fueron similares en ambos grupos, aunque el grupo de COI presentó más características desfavorables (antecedente de enfermedad de las arterias coronarias [CHA2DS2-VASc], antecedente de hemorragias significativas [BARC ≥ 2] y HAS-BLED). La aparición de acontecimientos adversos graves (muerte, accidente vascular cerebral, accidente isquémico transitorio, hemorragia grave) y cardiovasculares graves (muerte de causa cardiaca, accidente vascular cerebral, accidente isquémico transitorio, infarto de miocardio) fue significativamente mayor en el grupo de ACO que en el de COI: 19,75 frente a 9,06% (HR = 2,18; p = 0,008) y 6,37 frente a 1,91% (HR = 3,34; p = 0,037), respectivamente. Conclusiones: La combinación de COI y tratamiento AP en pacientes con FANV conlleva mejor pronóstico clínico a largo plazo que el tratamiento con ACO y terapia AP, a pesar de las características basales desfavorables del grupo de COI.

ABSTRACT Introduction and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients' long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Resumen Objetivo: Determinar la eficacia de la procalcitonina (PCT) y la proteína C reactiva (PCR) séricas en el diagnóstico de fuga anastomótica (FA) en los pacientes sometidos a cirugía colorrectal. Método: Prueba diagnóstica en un hospital de tercer nivel. Se excluyeron los pacientes que no tuvieron mediciones preoperatorias de PCT y PCR. Se eliminaron los que cursaron con infección posoperatoria no relacionada con FA. Las medidas de eficacia diagnóstica fueron sensibilidad (S), especificidad (E), valores predictivos positivo (VPP) y negativo (VPN), razones de verosimilitud positiva (RV+) y negativa (RV−), y área bajo la curva característica operativa del receptor (AUROC). Resultados: Se analizaron 39 pacientes, de los cuales 6 (15.4%) tuvieron FA. La PCT y la PCR aumentaron al segundo día posoperatorio solo en los pacientes con FA. Los puntos de corte al día 2 fueron 1.55 ng/ml para PCT y 11.25 mg/l para PCR. La prueba más eficaz fue la PCR al día 2 (AUROC: 1.00; S: 100%; E: 96.7%; VPP: 85.7%; VPN: 100%; RV+: 33.0). Conclusiones: La PCR en el segundo día posoperatorio fue la prueba más eficaz en el diagnóstico temprano de FA en los pacientes sometidos a cirugía colorrectal, con un punto de corte inferior a lo reportado en la literatura internacional.

Abstract Objective: To determine the efficacy of serum procalcitonin (PCT) and C-reactive protein (CRP) in the early diagnosis of anastomotic leak (AL) in patients undergoing colorectal surgery. Method: Diagnostic test in a tertiary care hospital. Patients who did not have preoperative measurements of PCT and CRP were excluded. Those with postoperative infection not related to AL were eliminated. The diagnostic efficacy measures were sensitivity (Sn), specificity (Sp), positive (PPV) and negative (NPV) predictive values, positive (LR+) and negative (LR−) likelihood ratios, and area under the receiver operating characteristic curve (AUROC). Results: Thirty-nine patients were analyzed; six had AL (15.4%). PCT and CRP increased on the second postoperative day, only in patients with AL. The cut-off points at the second postoperative day were 1.55 ng/mL for PCT and 11.25 mg/L for CRP. The most efficacious test was PCR at second postoperative day (AUROC: 1.00; Sn: 100%; Sp: 96.7%; PPV: 85.7%; NPV: 100%; LR+: 33.0). Conclusions: CRP at second postoperative day was the most effective test in the early diagnosis of AL in patients undergoing colorectal surgery, with a cut-off point lower than that reported in the international literature.

RESUMEN El principio nemini res sua servit iure servitutis y sus consecuencias generan diversas dificultades prácticas en perjuicio de los propietarios. El tra bajo descarta a las servidumbres de propietario y la constitución de servidum bres mediante acto jurídico unilateral condicional como vías para su solución. plantea, en cambio, que esta se logra mediante una relectura del concepto de "enajenación" utilizado por los artículos 881 c.c.ch. y 938 c.c.col., adecuando su contenido a las exigencias del principio citado, al reconocimiento actual de la propiedad sobre cosas incorporales y a la ampliación que modernamente existe del concepto de predio.

ABSTRACT The principle nemini res sua servit iure servitutis and its effects have created several practical difficulties against the owners. This paper discards as ways of solving these difficulties, the servitude over own-property and the cons titution of easements by unilateral-conditional acts. In contrast, this paper states that the solution of such difficulties may be achieved through the reinterpre tation of the "alienation" concept included in article 881 of the c.c.ch. and in article 938 of the c.c.col., in light of the requirements of the abovementioned principle, the recognition of property rights over intangibles and the ample in terpretation of the "land" concept existing nowadays.

The aim of this trial was to evaluate the effect of dietary supplementation of extruded linseed on the milk and cheese fatty acid (FA) profiles of ewes under extensive grazing conditions. Over 26 days, a group of nine lactating ewes (Latxa × Milchschaf × Corriedale) in mid-lactation were managed under grazing conditions and given supplements during each manual milking (0830 and 1800 h) of 50% corn and 50% oats (500 g ewe-1 milking-1; control, TC) for the first 6 days. From day 7 to 20, the supplement was 25% corn, 25% oats and 50% extruded linseed (500 g ewe-1 milking-1) (extruded linseed; TEL). From day 21 to 26, the ewes were fed TC. The saturated FA content in milk was reduced (3.6%), and the monounsaturated, polyunsaturated and n-3 FA (7, 10 and 25%, respectively) were increased when the ewes were supplemented with extruded linseed. A correlation between rumenic acid with vaccenic acid (R²=0.68) was found in the milk fat from ewes fed TEL. In cheese obtained from TEL, the contents of n-3 and polyunsaturated FA were increased (21 and 7%, respectively). In conclusion, a supplement of extruded linseed in ewes under grazing conditions could be an alternative lipid source to produce cheese with additional nutritional value. However, the effect of extruded linseed supplementation in ewes under the same conditions with longer experimental periods and a more suitable statistical design must be investigated.

El objetivo de este ensayo fue evaluar el efecto de suplementar extruido de linaza en el perfil de ácidos grasos de leche y queso de ovejas en pastoreo extensivo. Durante 26 días, un grupo de nueve ovejas lactantes (Latxa × Milchschaf × Corriedale) fueron manejadas en pastoreo extensivo y suplementadas durante cada ordeño manual (830 y 1800 h) con 50% maíz + 50% avena (500 g oveja-1 ordeño-1) durante los primeros 6 días (control; TC), de los días 7 al 20 se suplementaron con 25% maíz + 25% avena + 50% extruido de linaza (500 g oveja-1 ordeño-1) (extruido de linaza; TEL), y finalmente, del día 21 al 26 las ovejas fueron alimentadas con TC. El contenido de ácidos grasos saturados en leche fue reducido (3,6%) mientras que los ácido grasos monoinsaturados, polinsaturados y n-3 fueron incrementados (7, 10 y 25%) en aquellas ovejas alimentadas con TEL. Se observó una correlación de ácido ruménico con ácido vaccénico (R²=0,68) en leche de ovejas alimentadas con TEL. Los quesos elaborados de ovejas alimentadas con TEL, aumentaron su contenido de n-3 y ácidos grasos poliinsaturados (21 y 7%). En conclusión, el suplementar ovejas en pastoreo extensivo con extruido de linaza puede ser una alternativa que puede resultar en la elaboración de quesos con un valor nutricional más saludable desde el punto de vista humano. Además resulta necesario investigar más sobre el uso del extruido de linaza bajo las mismas condiciones con periodos más largos de experimentación usando un diseño estadístico más apropiado.

Este ensaio traz elementos da medicina ocidental, da medicina tradicional chinesa e da sociologia do trabalho para reflexão sobre o Qi Gong - exercícios terapêuticos, um dos pilares da Medicina Tradicional Chinesa (MTC) - como importante meio de prevenção da LER/DORT e recuperação da saúde. Considerando a natureza interdisciplinar e diversos níveis de prevenção, aborda aspectos sociológicos sobre as condições de trabalho frequentemente relacionadas com este tipo de adoecimento e categorias de trabalhadores mais acometidos. Focaliza aspectos médicos sobre a LER/DORT e as Síndromes de Bloqueio na MTC, estabelecendo canais de articulação e contribuição entre esses campos de conhecimento sobre a saúde humana. Ressalta o Qi Gong como importante prática terapêutica e preventiva na MTC e sua adequação à LER/DORT. No âmbito do Qi Gong, focaliza o Lian Gong Shi Ba Fa - Lian Gong em 18 Terapias, já amplamente experimentado na China e divulgado, inclusive no Brasil, para tratar e prevenir síndromes de dor em região cervical, ombros, membros superiores, membros inferiores e região lombar. À guisa de conclusão, são apresentadas algumas reflexões sobre a propriedade e a importância do Qi Gong na reabilitação e na prevenção da LER/DORT.

This paper evaluates Qi Gong - therapeutic exercises, one of the pillars of the Traditional Chinese Medicine (TCM) - as an important tool of preventing Cumulative Trauma Disorders (CTD) and healing, using allopathic medicine, TCM, and sociology of work elements. Considering its interdisciplinary nature and various levels of CTD prevention, this study examines the sociological aspects of work conditions that are usually associated with CTD and with groups that most frequently report symptoms. It focuses on CTD medical aspects and on TCM Blocking Syndromes, opening channels of communication and contribution between these fields of knowledge. It emphasizes that Qi Gong is an important therapeutic and preventive practice within TCM, and that is suitable for treating CTD. Within Qi Gong, it emphasizes Lian Gong Shi Ba Fa - Lian Gong in 18 therapies, which has been broadly experienced in China, and also publicized in Brazil, for treatment and prevention of pain syndromes in the upper and lower limbs, as well as in the cervical and lumbar regions. It finalizes by presenting considerations on the suitability and importance of Qi Gong for rehabilitation and prevention of CTD.

One hundred fifteen cachaça samples derived from distillation in copper stills (73) or in stainless steels (42) were analyzed for thirty five itens by chromatography and inductively coupled plasma optical emission spectrometry. The analytical data were treated through Factor Analysis (FA), Partial Least Square Discriminant Analysis (PLS-DA) and Quadratic Discriminant Analysis (QDA). The FA explained 66.0% of the database variance. PLS-DA showed that it is possible to distinguish between the two groups of cachaças with 52.8% of the database variance. QDA was used to build up a classification model using acetaldehyde, ethyl carbamate, isobutyl alcohol, benzaldehyde, acetic acid and formaldehyde as chemical descriptors. The model presented 91.7% of accuracy on predicting the apparatus in which unknown samples were distilled.

SUMMARY<A NAME="OLE_LINK2">: The reduced intake of dietary fiber (DF) has been associated with the increase in the incidence of several non-transmissible chronic diseases. Recently many researchers from Iberian-American countries have been studying DF of food and industrial residues in order to improve technological knowledge about concentrates production as well as the development and test of enriched products originated from regional food. The present study aimed to evaluate the regional DF potential based on compilation of data about this nutrient. There is great availability of regional and traditional food with considerable DF amounts as we may find in fruits, vegetables and cereals and legumes. Concentrated sources of DF obtained from different industrial residues were characterized and evaluated making possible their utilization in food enrichment. Cookies added to corn residues (16,8% DF in integral weight) in Colombia, and pasta added to lupine fiber in Chile (11,2%) are examples of tested enriched products. Products like bread with whole wheat (12%), products for especial uses as well as pills of citric DF (55%) and food for enteral diets (1-1,9%) are already available on Cuba market. The dietary fiber contents presented in this work allow us to have an idea of the potential of such nutrient in Iberian-American countries. Such potential has been proved to be considerably representative. It is worth to inform that the complete DF database is available on the CYTED XI.6/CNPq Project Web site (http://www.fcf.usp.br/cytedxi6). It provides data on 817 regional, traditional and not conventional foods, that can be searched and utilized by professional from different areas.</A>

RESUMO: A reduzida ingestão de fibra alimentar (FA) vem sendo associada ao aumento de inúmeras doenças crônico não transmissíveis. Nos últimos anos, muitos pesquisadores de países ibero-americanos vêm caracterizando adequadamente a FA em alimentos e em resíduos industriais, buscando tecnologia para produzir concentrados, desenvolvendo e testando produtos enriquecidos, a partir de alimentos regionais. O presente estudo visou, através da compilação de informações sobre FA, avaliar o potencial deste nutriente na região. Há uma grande disponibilidade de alimentos regionais e tradicionais com teor significativo de fibra alimentar como frutas, hortaliças e, principalmente, cereais e leguminosas. Fontes concentradas de FA, obtidas a partir de diferentes resíduos industriais, foram caracterizadas e avaliadas, podendo ser utilizadas no enriquecimento de alimentos. Alguns produtos enriquecidos vêm sendo testados, como biscoitos com torta de milho na Colômbia (produto contendo 16,8% de FA na base integral) e macarrão com fibra de tremoço no Chile (11,2%). No mercado cubano já se encontram produtos como pão de trigo integral (12%); produtos para fins especiais, como comprimidos de fibra de cítricos (55%) e alimentos para dieta enteral (1-1,9%). Os dados sobre conteúdo de FA apresentados neste trabalho representam alguns exemplos sobre o potencial deste nutriente nos países ibero-americanos, potencial este, que se mostrou bastante significativo. Cabe salientar, que a completa base de dados está disponível no web site do Projeto CYTED XI.6/CNPq (http://www.fcf.usp.br/cytedxi6) a qual apresenta o conteúdo de FA em 817 alimentos regionais, tradicionais e não convencionais, que podem ser conhecidos e utilizados por profissionais de diversas áreas.

To determine whether Didelphis albiventris is naturally infected with Paracoccidioides brasiliensis, 20 specimens of this mammal were studied by both direct cultivation of their viscera (spleen, liver and lungs) and by inoculation of Swiss mice by the intraperitoneal route with a suspension of fragments of these viscera. No fungal growth or structures similar to this fungus were detected. Probably D. albiventris is not frequently infected with P. brasiliensis.

A atividade compensatória mitocondrial é um mecanismo que permite a alguns orgãos manter seu nível energético em situações adversas. Este presente estudo visa analisar a função mitocondrial hepática em ratos submetidos à OBEH. Foram estudados 10 ratos Wistar machos (180 a 230 g), divididos em dois grupos. Grupo operação simulada - OS e grupo obstrução biliar extra hepática (OBEH). Após 24 h. foram coletadas amostras de sangue e biópsia hepática para a dosagem do nível sérico das enzimas hepáticas e a atividade mitocondrial. Houve aumento significativo das aminotranferases, da FA e BT (tabela 1).Verificou-se aumento do Estado 3 da respiração mitocondrial. Analisando os resultados, observou-se que as mitocôndrias hepáticas apresentaram atividade compensatória no sentido de preservação da função hepatocelular

Os cultivares de porte anão Tordo, Vicam-71 e Olesen e o semi-anão 'Siete Cerros' foram cruzados com o cultivar de porte alto IAC-5. Os cultivares pais, os F1's, F2's e retrocruzamentos para ambos os pais foram plantados em um ensaio em delineamento de blocos ao acaso com quatro repetições na Estação Experimental de Itararé. Os dados de altura e produção foram obtidos na base de plantas individuais. Os cultivares escolhidos para este estudo representaram um largo espectro de diversidade genética para altura das plantas para as nossas condições. Foi observada dominãncia parcial para porte alto quando os cultivares Siete Cerros, Vicam-71 e Olesen foram cruzados com o 'IAC-5' e dominância parcial para porte baixo quando o 'Tordo' foi cruzado com 'IAC-5'. Os valores da herdabilidade no sentido amplo para a altura e produção de grãos foram alto e baixo respectivamente, ocorrendo o mesmo com os valores da herdabilidade no sentido restrito. Esses dados sugeriram que a seleção para altura seria efetiva nas gerações F2 ou F3 e, para produção, deveria ser postergada para gerações mais avançadas onde testes de progênies poderiam ser realizados. As correlações entre altura e produção dentro de cada cruzamento, devidas ao ambiente, fenotípica e genética, foram positivas, mostrando haver uma associação entre os dois caracteres, requerendo, portanto, grandes populações F2 para assegurar maior freqüência de recombinantes desejáveis. Todas as fontes de porte baixo foram eficientes em reduzir o porte do cultivar IAC-5, porém Tordo seria a melhor fonte pela ocorrência de maior freqüência de indivíduos de porte baixo e com altas produções, nas populações estudadas.

Standard height cultivar IAC-5 was crossed with the semidwarf cultivar Siete Cerros and the dwarf cultivars Tordo, Vicam-71 and Olesen. Parents, F1's, F2's and reciprocal backcrosses were tested for grain yield and height in an experiment carried out at Itararé Experimental Station. All data were determined on an individual plant basis. It was observed partial dominance for tall plants when Siete Cerros, Vicam-71 and Olesen were crossed with IAC-5 and partial dominance for short plants when Tordo was crossed with IAC-5. Broad sense herltability for plant height and grain yield showed high and low values, respectively. Narrow sense heritability and coefficient of determination for plant height were high. Narrow sense heritability for grain yield was low. Results suggest it would be possible to select plant types with semi-dwarf and dwarf height levels in the F2 or Fa populations and for yield in later generations where progeny tests would be possible. Height and yield correlations were also computed for all crosses. In general the magnitude of the environmental, phenotypic and genetic correlations were high and consistent for all crosses. Segregating populations from crosses between the tall cultivar IAC-5 and different sources of dwarfism indicated that the short stature sources could be used efficiently in a breeding program toward the development of semi-dwarf or dwarf wheat cultivars with high yield potential. However, large F2 populations would be required to ensure the frequency of desired recombinants. Tordo would be the best source due to the heigher frequency of short statured individuals.