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Edição Dossiê — Janeiro/2024 Dossiê Moda e Emoções na Cultura do Consumo

This study assesses the financial viability of a 4-hectare sugarcane farming enterprise operated by Perhutani, an Indonesian State-Owned Enterprise. The farm is situated in the geographical limits of Pemalang City, which is located in the Central Java Province of Indonesia. This study employs a financial feasibility analysis approach that involves the computation of key financial indicators such as Net Present Value (NPV), Internal Rate of Return (IRR), Pay Back Period (PBP), Benefit Cost Ratio (BCR), and the application of sensitivity analysis. Overall, the assessment of the viability of a 4-hectare sugarcane farming enterprise indicates that it is financially feasible and has the potential to operate as a sustainable business. This conclusion is drawn from the positive numerical values obtained through various financial analysis techniques. Nevertheless, it is evident from the conducted sensitivity analysis that sugarcane farming is a highly susceptible business to fluctuations in prevailing conditions. When molasses production experienced reductions of 10% and 15%, most financial feasibility analysis estimates yielded negative values. The issue of production vulnerability extending beyond economic feasibility has been rendered inconspicuous by many reasons, including climate change.

A field study was carried out to examine the effects of organic amendment on the morpho-physiology, growth indices, and fruiting of pumpkin (Cucurbita moschata) plants. The pumpkin seedlings were raised in polybags and treated without fertilizer (control), cow dung, goat dung, poultry dung, vermicompost, compost, and inorganic fertilizer (NPK). The results showed that poultry dung and cow dung treatments significantly increased the length of vine, leaf number, leaf area, and leaf dry weight of pumpkin plants. Poultry dung treatment increased the absolute growth rate (AGR), relative growth rate (RGR), leaf area index (LAI), leaf area ratio (LAR), leaf area duration (LAD), and fresh plant biomass by 345%, 287%, 770%, 384%, 415%, and 1139%, respectively over the control plants. Poultry dung treatment also increased the internode length and initiated flowers earlier than the control. Petiole length, stomatal conductance, and chlorophyll content were 5.59, 1.49, and 1.41 times higher with NPK treatment compared to the control group. In addition, poultry dung treatment increased the female flower number, male-female flower ratio, number of fruits, fruit weight, fruit diameter, fruit circumference, fruit length, and flesh thickness by 350%, 30%, 300%, 100%, 80%, 80%, 67%, and 105%, respectively, over the control plants. From this study, it can be concluded that poultry dung treatment enhanced the vegetative and reproductive growth, plant physiology, fruiting, and quality of pumpkin.

The aim of this study was to evaluate the effects of early postpartum PGF2α treatment on reproductive performance in dairy cows synchronized with targeted breeding and natural mating after voluntary waiting period. In this experiment, 120 cows were assigned to three groups irrespective of presence or absence of luteal tissue. Cows in PG-14 group were treated with PGF2α from day 14 postpartum, cows in PG-28 group were treated with PGF2α from day 28 postpartum and cows in PG-42 group were not treated with PGF2α until the end of voluntary waiting period (d 42). After day 42 postpartum, cows in three groups were treated with PGF2α within 14-day intervals until natural mating after voluntary waiting period. Recorded reproductive parameters included days to first heat, days to first mating, days open, service per conception, conception rate, percentage of repeat breeder animals and pregnancy loss. Early PGF2α treatment from day 14 postpartum significantly decreased days to first estrus (34.9 ± 0.74, P < 0.003), days to first mating (62.35 ± 1.53, P < 0.04), days open (117.23 ± 3.1, P < 0.001) and service per conception (1.9 ± 0.09, P < 0.02); and PG-14 group presented increased conception rate (52.5%, P < 0.05). The proportion of repeat breeder syndrome tended to be affected by treatment with PGF2α from day 14 postpartum. In conclusion, treatment of cows with PGF2α from day 14 postpartum improved reproductive performance.

Background: Matrix metalloproteinases (MMPs) can affect myocardial extracellular volume (ECV) and its compartments, and this can provide more detailed information about the mechanism of adverse left ventricular (LV) remodeling (AR) after acute myocardial infarction (MI)., Objectives: To investigate the role of changes (Δ) in ECV compartments (matrix volume (MVi) and cell volume (CVi)) in the development of AR after MI, and their relationship with MMP-2 expressions., Methods: Ninety-two first MI patients who underwent 3 Tesla cardiovascular magnetic resonance imaging performed 2 weeks (baseline) and 6 months post-MI. We measured T1 mapping with MOLLI sequences. ECV was performed post-gadolinium enhancement. ECV and LV mass were used to calculate MVi and CVi. AR was defined as an increase of ≥ 12% in LV end-diastolic volume in 6 months. MMPs were measured using a bead-based multiplex immunoassay system at first day (baseline) and 2 weeks post-MI. P <0.05 was accepted as statistically significant., Results: Mean ECV and mean MVi baseline levels were higher in AR group compared to without AR group (42.9±6.4 vs 39.3±8.2%, p= 0.037; 65.2±13.7 vs 56.7±14.7 mL/m2, p=0.010; respectively). CVi levels was similar between groups. A positive correlation was found between baseline levels of MMP-2 and baseline levels of ECV (r=0.535, p<0.001) and MVi (r=0.549, p<0.001). Increased ΔMVi levels was independently predictor of AR (OR=1.03, p=0.010). ΔMVi had superior diagnostic performance compared to ΔECV in predicting AR (ΔAUC: 0.215±0.07, p<0.001)., Conclusion: High MVi levels are associated with AR, and ΔMVi was independently predictor of AR. This may be associated with MMP-2 release due to increased inflammatory response.

Background: Body mass index (BMI) is the most commonly used index to categorize a person as obese or non-obese, which is subject to important limitations., Objective: To evaluate the direct effect of BMI on cardiovascular outcomes among participants without central obesity., Methods: This analysis included 14,983 males and females aged 45-75 years from the Atherosclerosis Risk in Communities Study (ARIC). BMI was measured as general obesity, and waist circumference (WC), waist-to-hip ratio (WHR) and hip circumference as central obesity. Targeted maximum likelihood estimation (TMLE) was used to estimate the total effects (TEs) and the controlled direct effects (CDEs). The proportion of TE that would be eliminated if all participants were non-obese regarding central obesity was computed using the proportion eliminated (PE) index. P <0.05 was considered statistically significant. Analyses were performed in the TMLE R package., Results: The risk of cardiovascular outcomes attributed to BMI was significantly reversed by eliminating WHR obesity (p<0.001). The proportion eliminated of BMI effects was more tangible for non-obese participants regarding WC (PE=127%; 95%CI (126,128)) and WHR (PE=97%; 95%CI (96,98)) for coronary heart disease (CHD), and WHR (PE=92%; 95%CI (91,94)) for stroke, respectively. With respect to sex, the proportion eliminated of BMI effects was more tangible for non-obese participants regarding WHR (PE=428%; 95%CI (408,439)) for CHD in males, and WC (PE=99%; 95%CI (89,111)) for stroke in females, respectively., Conclusion: These results indicate different potential effects of eliminating central obesity on the association between BMI and cardiovascular outcomes for males and females. (Arq Bras Cardiol. 2021; 116(5):879-886).

Background and Objectives: Calcitonin is a polypeptide hormone regulating the metabolism calcium in the body. For many years calcitonin has been used to maintain and improve bone mineral density and to reduce the fracture rate. Many studies showed that calcitonin had analgesic role in several painful circumstances. This pain-ameliorating effect is irrelevant to its osteoclastic inhibitory effect and mechanisms like altering Na+ channel and serotonin receptor expression or hypothesis including the endorphin-mediated mechanism were used to explain this effect. In this study we performed a thorough review on the role of calcitonin as an analgesic agent in different scenarios and investigated the fact that calcitonin can be a feasible medication to relieve pain., Method: Many studies focused on the analgesic effect of calcitonin in several painful circumstances, including acute pains related to vertebral fractures, metastasis, migraine and reflex sympathetic dystrophy as well as neuropathic pains related to spinal injuries or diabetes, and phantom pain. Also, calcitonin was showed to be a useful additive to local anesthesia in the case of controlling postoperative pain or trigeminal neuralgia more effectively. However we faced some contradictory data for conditions like lumbar canal stenosis, complex regional pain syndrome, phantom pain and malignancies., Conclusion: This study showed that calcitonin could be helpful analgesic agent in different painful situations. Calcitonin can be considered an eligible treatment for acute pains related to vertebral fractures and a feasible alternative for the treatment of the acute and chronic neuropathic pains where other medications might fail., (Copyright © 2019 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Background and Objectives: There are different ultrasound probe positions used for internal jugular venous catheter placement. Also, in-plane or out of plane needle approach may be used for catheterization. Transverse short-axis classic approach is the most popular performed approach in literature. "Syringe-Free" is a new described technique that is performed with oblique long-axis approach. We aimed to compare performance of these two approaches., Methods: This study was conducted as a prospective and randomized study. 80 patients were included the study and divided into two groups that were named Group C (transverse short-axis classic approach) and Group SF (oblique long-axis syringe-free approach) by a computer-generated randomization. The primary outcome was mean time that guidewire is seen in the internal jugular vein (performing time). The secondary outcomes were to compare number of needle pass, number of skin puncture and complications between two groups., Results: Demographic and hemodynamic data were not significantly different. The mean performing time was 54.9±19.1s in Group C and 43.9±15.8s in Group SF. Significant differences were found between the groups (p=0.006). Mean number of needle pass was 3.2(±2.1) in Group C and 2.1(±1.6) in Group SF. There were statistically significant differences between two groups (p=0.002). The number of skin puncture was 1.6(±0.8) and 1.2(±0.5) in Group C and SF, respectively (p=0.027)., Conclusion: "Syringe-Free" technique has lower performing time, number of needle pass and skin puncture. Also, it allows to follow progress of guide-wire under continuous ultrasound visualization and the procedure does not need assistance during catheter insertion. Namely, "Syringe-Free" is effective, safe and fast technique that may be used to place internal jugular venous catheter., (Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Background:: According to common belief, most myocardial infarctions (MIs) are due to the rupture of nonsevere, vulnerable plaques with < 70% obstruction. Data from recent trials challenge this belief, suggesting that the risk of coronary occlusion is, in fact, much higher after severe stenosis. The aim of this study was to investigate whether or not acute ST-elevation MIs result from high-grade stenoses by evaluating the presence of coronary collateral circulation (CCC)., Methods:: We retrospectively included 207 consecutive patients who had undergone primary percutaneous coronary intervention for acute ST-elevation MI. Collateral blood flow distal to the culprit lesion was assessed by two investigators using the Rentrop scoring system., Results:: Out of the 207 patients included in the study, 153 (73.9%) had coronary collateral vessels (Rentrop 1-3). The Rentrop scores were 0, 1, 2, and 3 in 54 (26.1%), 50 (24.2%), 51 (24.6%), and 52 (25.1%) patients, respectively. Triglycerides, mean platelet volume (MPV), white cell (WBC) count, and neutrophil count were significantly lower in the group with good collateral vessels (p = 0.013, p = 0.002, p = 0.003, and p = 0.021, respectively)., Conclusion:: More than 70% of the patients with acute MI had CCC with Rentrop scores of 1-3 during primary coronary angiography. This shows that most cases of acute MI in our study originated from underlying high-grade stenoses, challenging the common believe. Higher serum triglycerides levels, greater MPV, and increased WBC and neutrophil counts were independently associated with impaired development of collateral vessels., Fundamento:: Há uma crença geral de que a maioria dos infartos agudos do miocárdio (IAM) ocorrem devido à ruptura de placas vulneráveis, não graves, com obstrução < 70%. Dados de ensaios recentes desafiam esta crença, sugerindo que o risco de oclusão coronariana é, na realidade, muito maior após estenose grave. O objetivo deste estudo foi investigar se a presença ou não de IAM com supradesnível do segmento ST resulta de estenoses de alto grau através da avaliação da presença de circulação colateral coronariana (CCC)., Métodos:: Nós incluímos retrospectivamente 207 pacientes consecutivos submetidos à intervenção coronariana percutânea primária devido à ocorrência de IAM com supradesnível do segmento ST. O fluxo sanguíneo colateral distal à lesão culpada foi avaliado por dois investigadores com utilização do sistema de escores de Rentrop., Resultados:: Dos 207 pacientes incluídos no estudo, 153 (73,9%) apresentavam vasos coronarianos colaterais (Rentrop 1-3). Os escores Rentrop foram de 0, 1, 2 e 3 em 54 (26,1%), 50 (24,2%), 51 (24,6%) e 52 (25,1%) pacientes, respectivamente. Triglicérides, volume plaquetário médio (VPM), contagem de células brancas (CCB) e contagem de neutrófilos estiveram significativamente mais baixos no grupo com bons vasos colaterais (p = 0,013, p = 0,002, p = 0,003 e p = 0,021, respectivamente)., Conclusão:: Mais de 70% dos pacientes com IAM apresentaram CCC com escores de Rentrop de 1-3 durante angiografia coronariana primária. Isto demonstra que a maioria dos casos de IAM em nosso estudo originou a partir de estenoses subjacentes de alto grau, contrariamente à sabedoria comum. Níveis séricos mais elevados de triglicérides, maior VPM e elevação na CCB e na contagem de neutrófilos estiveram independentemente associados com comprometimento no desenvolvimento de vasos colaterais.

Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients., Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies., Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion. Patients were monitored with Bispectral IndexTM (BIS) and propofol serum levels were collected at three different timepoints. The development of an original dilution of propofol and an inventive capnography catheter were necessary., Results: Regarding clinical outcomes, statistical differences in agitation (higher in group 1, p=0.001) and initial blood pressure (p=0.008) were found. As for propofol serum levels, findings were similar in consumption per minute (p=0.748) and over time (p=0.830). In terms of cost analysis, group 1 cost was R$7.00 (approximately US$2,25); group2, R$17.50 (approximately US$5,64); and group 3, R$112.70 (approximately US$36,35, p<0.001). Capnography was able to predict 100% of the oxygen saturation drop (below 90%)., Conclusion: The use of propofol bolus administration for colonoscopies, through continuous manually controlled infusion or automatic infusion are similar regarding propofolemia and the clinical outcomes evaluated. The use of an innovative capnography catheter is liable and low-cost solution for the early detection of airway obstruction., Competing Interests: none

Aims: to carry out a retrospective analysis of myringoplasty results in children in our institute., Materials and Methods: Thirty five children, 9 to 14 years old, who underwent myringoplasty in our hospital between April 2002 and May 2004, formed the study group. Data regarding successful perforation closure, factors influencing success rates and hearing improvement were recorded., Results: Closure of perforation was successful in 30 (85.7%) of the 35 patients. Graft take failure occurred in 5 patients. Audiological improvement was seen in 27 (77%) patients, out of which 23 cases had 10-15 db and 4 cases had 15-20 db air-bone gap. Hearing was found to be worse postoperatively in 3 patients, while no change was noted in the remaining 5 patients. There was no case of profound hearing loss., Conclusion: Myringoplasty is a beneficial procedure in the pediatric population in the hands of a skilled and experienced surgeons. If performed properly, it has a good chance of restoring a child's hearing. However, a large study with a long follow up is warranted in order to come to a definitive conclusion.

Purpose: Inflammatory breast carcinoma (IBC) is a rare clinicopathological cancer type with unique clinical features and a poor prognosis. In this disease, there is generally no palpable mass in the breast. IBC can be mistakenly diagnosed as mastitis and patients may receive a delayed diagnosis and treatment, since these two disorders cause similar pathological appearences on the breast. Clinical suspicion of the disease followed by histopathological observation of occluded dermal lympthatics by tumor emboli leads to definitive diagnosis of IBC., Methods: Here, we report our experiences in diagnosing IBC using Thick-Needle Aspiration Biopsy (TNAB)., Results: Eight patients having clinically suspected IBC, received TNAB. IBC was definitively diagnosed upon observation in histopathological examination of occluded dermal lymphatics by tumor emboli since TNAB allowed adequate tissue sampling., Conclusion: In this study, we showed that IBC can be reliably diagnosed using TNAB.