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Foram realizados dois ensaios com o objetivo de avaliar a digestibilidade aparente de nutrientes em dietas para eqüinos, utilizando o método da coleta total de fezes e os indicadores óxido crômico, fibra em detergente ácido indigestível (FDAi), fibra em detergente neutro indigestível (FDNi), celulose indigestível (CELi), lignina (LIG) e cinzas insolúveis em detergente ácido (CIDA). No primeiro ensaio, foram utilizados cinco potros mestiços, alimentados com cinco dietas contendo níveis diferenciados de proteína bruta, mantendo a relação concentrado e volumoso em 50:50. O óxido crômico foi utilizado como indicador externo. No segundo ensaio, foram utilizados quatro potros mestiços, alimentados com dietas compostas por feno de coastcross como volumoso e concentrado nas proporções de 40:60, 60:40, 80:20 e 100:00. Nos dois ensaios, os teores de fibra em detergente ácido indigestível, fibra em detergente neutro indigestível, celulose indigestível, lignina e cinzas insolúveis em detergente ácido foram obtidos após incubação in vitro. No primeiro ensaio, a FDAi mostrou-se adequada como indicador interno para estimar a digestibilidade; a CELi, em ambos os ensaios, foi adequada como indicador interno para a estimativa da digestibilidade aparente de nutrientes em dietas para eqüinos. O óxido crômico apresentou baixa recuperação fecal no primeiro ensaio e a LIG, baixa recuperação fecal nos dois ensaios, subestimando os coeficientes de digestibilidade dos nutrientes, sendo inadequada sua utilização para estimativa da digestibilidade. A CIDA, em função da metodologia de coleta fecal, também mostrou-se inadequada para as estimativas de digestibilidade em eqüinos.

Introduction: Hypertensive nephroangiosclerosis is a major cause of chronic kidney disease requiring dialysis. Clinical characteristics that distinguish a patient with hypertension that evolves to nephroangiosclerosis from another that keeps stable renal function are not well established because of the difficulty in ensuring that the carriers of that disease are not actually suffering from glomerulonephritis or other kidney diseases. Thus, our objective was to identify clinical or laboratory features that distinguish the patients who developed chronic renal failure from hypertension, confirmed by renal biopsy, of those who, even with arterial hypertension, did not develop nephroangiosclerosis., Methods: We conducted a retrospective comparison of clinical and laboratory data of 15 patients with hypertensive nephroangiosclerosis confirmed by renal biopsy and 15 hypertensive patients from the outpatient clinic of the Hypertension Center, whose lack of nephroangiosclerosis was defined as absence of proteinuria. The groups were matched for age and gender., Results: Among the evaluated variables, duration of hypertension, pulse pressure, blood glucose, uric acid, creatinine and frequency of use of diuretics and sympatholytic differed statistically between the two groups. All these variables were higher in nephroangiosclerosis patients., Conclusion: This study links biopsy proven hypertensive nephroangiosclerosis with metabolic features, hypertension intensity and duration, corroborating the idea that primary prevention of hypertension, postponing its initiation, a more intensive hemodynamic control (when hypertension is well established) and metabolic control of these patients have the potential to prevent hypertensive nephroangiosclerosis.

Conventional assessment of glycemic control in diabetes mellitus (DM) includes blood glucose attention to glycemia and glycated hemoglobin levels. Recently, we introduced the continuous glucose-monitoring test (CGM) (Medtronic Minimed-CGMS System Gold). Here we describe our experience with this methodology over the year 2004. A total of 141 CGM tests were performed over this period of time. Overall, 88% (n= 124) patients were diabetics (DM), 99 of them were insulin users. We found a strong correlation between glucose values obtained by CGM and capillary glucose measures (r= 0.926; p< 0.005). In diabetic patients, nocturnal hypoglycemia (< 50 mg/dL) was identified in approximately 35% (n= 44), hyperglycemic patterns (> 220 mg/dL) at specific times of day in approximately 44% and sustained hyperglycemia throughout the whole monitoring period in thirteen cases (10%). Twelve tests were performed to investigate the occurrence of hypoglycemia in non-diabetic subjects. Two tests came out very suggestive of "dumping", and in one case the CGMS supported the hypothesis of insulinoma. Partial monitoring interruptions have occurred in 15% of all tests. We concluded that CGMS is a useful methodology to investigate glycemic fluctuations, and it is also an important tool to adjust therapy in diabetic patients.

Clonidine stimulation test is widely used to evaluate growth hormone secretion. Side effects are somnolence (35%) and arterial hypotension (AH) (5%). The aims of this paper were to evaluate the tolerance to this test regarding blood pressure (BP) decrease, sedation and the efficacy of saline resuscitation to prevent AH. BP was measured at basal, 60 and 120 min. Sedation was determined by the Ramsay scale. Patients were divided into two groups: Group 1 (n = 80) received saline resuscitation only upon severe AH (drop of mean BP [MBP] > 20% from initial MBP) and/or postural hypotension; Group 2 (n = 100) received saline resuscitation from the beginning of the test. Both groups presented a significant MBP fall and 75% presented somnolence at 60 min. MBP drop did not correlate with either sedation or the clonidine dose. Group 1 presented more hypotension (59% x 28%) and greater MBP drop at 60 min. Only one patient had an asthma attack. We conclude that the hypotension effects caused by oral clonidine diminish with saline resuscitation since the beginning of the test. This test must have specialized medical support with strict BP evaluation and precocious intervention when needed.