Abstract Background and objectives Oral anticoagulants prevent thromboembolic events but expose patients to a significant risk of bleeding due to the treatment itself, after trauma, or during surgery. Any physician working in the emergency department or involved in the perioperative care of a patient should be aware of the best reversal approach according to the type of drug and the patient's clinical condition. This paper presents a concise review and proposes clinical protocols for the reversal of oral anticoagulants in emergency settings, such as bleeding or surgery. Contents The authors searched for relevant studies in PubMed, LILACS, and the Cochrane Library database and identified 82 articles published up to September 2020 to generate a review and algorithms as clinical protocols for practical use. Hemodynamic status and the implementation of general supportive measures should be the first approach under emergency conditions. The drug type, dose, time of last intake, and laboratory evaluations of anticoagulant activity and renal function provide an estimation of drug clearance and should be taken into consideration. The reversal agents for vitamin K antagonists are 4-factor prothrombin complex concentrate and vitamin K, followed by fresh frozen plasma as a second-line treatment. Direct oral anticoagulants have specific reversal agents, such as andexanet alfa and idarucizumab, but are not widely available. Another possibility in this situation, but with less evidence, is prothrombin complex concentrates. Conclusion The present algorithms propose a tool to help healthcare providers in the best decision making for patients under emergency conditions.

ABSTRACT The present study was conducted to investigate the effects of dietary fiber source levels on the fecal ammonia nitrogen, growth performance, carcass traits, gastrointestinal tract development, and intestinal morphology of broilers. A total of 420 one-day-old unsexed broiler chicks were individually weighed and randomly divided into 5 groups, each with seven replicates of twelve chicks. Rice hulls (RH) and soybean hulls (SH) were ground through a hammer mill with a 2-mm screen. The RH and SH experimental diets were as follows: 0% (control); 2.5% RH; 2.5% SH; 5% RH; and 5% SH. No significant differences were found in growth performance and fecal ammonia nitrogen among the dietary treatment groups (p>0.05). Compared with the control, the experimental diets with 2.5% SH significantly decreased the wing weight of chickens (p<0.05), while no significant differences in the weight of the other visceral organs were observed. Compared with the control, broilers in the 5% SH group had a longer jejunum and ileum (p<0.05). Feeding the broilers SH and RH had no effect on the villus area and crypt depth of the intestine. Compared with the control, the experimental diet with 2.5% RH significantly increased the duodenal villus height of chickens (p<0.05). These findings suggest that the inclusion of 5% SH in the diets resulted in improved intestinal morphology without negatively affecting growth performance and carcass traits.

O experimento foi conduzido com o objetivo de analisar o crescimento e a distribuição de matéria seca e os teores e acúmulos dos macronutrientes em plantas de Urochloa arrecta cultivadas em condições padronizadas de nutrição mineral. As plantas cresceram em vasos de sete litros com substrato de areia, irrigados diariamente com solução nutritiva, e foram mantidas em casa de vegetação. Os tratamentos corresponderam às épocas de avaliação (21, 35, 49, 63, 77, 91, 105, 119, 133, 147 e 161 dias após a emergência – DAE) e foram arranjados em delineamento inteiramente casualizado com quatro repetições. Plantas de U. arrecta apresentaram baixo acúmulo (menor que 7% dos valores máximos acumulados aos 161 DAE) de matéria seca (5,1 g MS por planta) e de macronutrientes (57,7 mg N por planta; 8,9 mg P por planta; 167,8 mg K por planta; 21,3 mg Ca por planta; 14,7 mg Mg por planta; e 9,2 mg S por planta) até 49 DAE. Esses acúmulos se intensificaram principalmente após 91 DAE; a taxa diária de acúmulo foi crescente até 130 DAE (MS e S), 137 DAE (N), 125 DAE (P), 119 DAE (K), 144 DAE (Ca) e 128 DAE (Mg), quando houve acúmulo de 87,7 g MS por planta; 918,0 mg N por planta; 105,8 mg P por planta; 1.643,9 mg K por planta; 390,4 mg Ca por planta; 200,0 mg Mg por planta; e 103,5 mg S por planta. K e N foram os macronutrientes com os maiores teores e, consequentemente, mais requeridos e acumulados em maior quantidade nos tecidos vegetais de plantas de U. arrecta.

The experiment was carried out aiming to analyze dry mass production and distribution, and the content and accumulation of macronutrients in Urochloa arrecta plants cultivated under mineral nutrition standard conditions. Plants grew in seven-liter pots filled with sand substrate, were daily irrigated with nutrient solution, and maintained under greenhouse conditions. Treatments corresponded to assessment periods (21, 35, 49, 63, 77, 91, 105, 119, 133, 147, and 161 days after emergence – DAE) and were arranged in a completely randomized design with four replicates. Plants of U. arrecta showed low accumulation (less than 7% of the maximum accumulation at 161 DAE) of dry mass (5.1 g DM per planta) and of macronutrients (57.7 mg N per planta, 8.9 mg P per planta, 167.8 mg K per planta, 21.3 mg Ca per planta, 14.7 mg Mg per planta, and 9.2 mg S per planta) up to 49 DAE. Such accumulations increased mainly after 91 DAE. Daily accumulation rate was crescent up to 130 DAE (DM and S), 137 DAE (N), 125 DAE (P), 119 DAE (K), 144 DAE (Ca), and 128 DAE (Mg), when there was accumulation of 87.7 g DM per planta, 918.0 mg N per planta, 105.8 mg P per planta, 1,643.9 K per planta, 390.4 mg Ca per planta, 200.0 mg Mg per planta, and 103.5 mg S per planta. K and N were found to have the highest rates and, hence, they were the most demanded and accumulated in the greatest amounts in U. arrecta plant tissues.

The genus Phytomonas comprises trypanosomatids that can parasitize a broad range of plant species. These fagellates can cause diseases in some plant families with a wide geographic distribution, which can result in great economic losses. We have demonstrated previously that Phytomonas serpens 15T, a tomato trypanosomatid, shares antigens with Trypanosoma cruzi, the agent of human Chagas disease. Herein, two-dimensional gel electrophoresis (2-DE) and mass spectrometry (MS) were used to identify proteins of P. serpens 15T that are recognized by sera from patients with Chagas disease. After 2D-electrophoresis of whole-cell lysates, 31 peptides were selected and analyzed by tandem mass spectrometry. Twenty-eight polypeptides were identifed, resulting in 22 different putative proteins. The identifed proteins were classifed into 8 groups according to biological process, most of which were clustered into a cellular metabolic process category. These results generated a collection of proteins that can provide a starting point to obtain insights into antigenic cross reactivity among trypanosomatids and to explore P. serpens antigens as candidates for vaccine and immunologic diagnosis studies.