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The extra pyramidal effects related to the use of neuroleptics are a limiting factor in schizophrenia treatment.
The aim of this study was to identify the neuroleptics prescribed for schizophrenic patients in a public health service, the extra pyramidal symptoms (EPS) incidence and its treatment.
Our restrospective study included 40 patients with mean age of 39.13 ± 2.19 in a treatment period of of 134.17 ± 16.83 days. The data were randomly collected from medical records of these patients.
The patients under study received typical neuroleptics (31.03%),atypical agents (37.93%) or association of both (31.03%). EPS was observed in 65.52% patients of which, 44.83% even though receiving biperiden 2mg, still have EPS. 20.69% were not receiving anticolinergic drug treatment for EPS, but promethazine or anticonvulsants. From the 34.48% who did not showed EPS, 20.69% had biperiden prescription and 13.79 % had been treated with olanzapine, clozapine or risperidone associated or not to clonazepam 2mg. Weigth gain of 5.20 ± 1.14 kg was observed in our total sample.
We suggest the use of EPS evaluation scale (Sympson - Angus or Barnes). 65.52 % of the patients under study had EPS and 20.69% of them had no prescription of central acting anticholinergic drug. 44.83% even though receiving biperiden 2mg, still have EPS.
Olfactory reference syndrome (ORS), first described by Pryse-Phillips in 1971, is a rare psychiatric condition whose defining characteristic is a preoccupation with the belief that one emits a foul or offensive body odor, which is not perceived by others. Although the existence of ORS is now widely accepted, current classifications do not explicitly mention ORS as an independent category, but consider it as a delusional disorder, somatic type. Nonetheless, given this syndrome's consistent description along time and cultures, and the associated substancial distress and disability, many authors debate the possibility of a new classification in order to establish its nosological status.
The aim of this paper is to show and discuss some troublesome and complex issues of diagnosis and management of patients with ORS.
Herein we report a case of a 38-year-old woman who presented with ORS.
Improvement in ORS can take place, in some extent, with a variety of different modalities of treatment, with the disorder responding to antidepressants and psychotherapy more frequently than to neuroleptics. Data on ORS are still limited and more research in this field is needed. Awareness of this particular diagnosis allows appropriate treatment to be administered.
Psychogenic polydipsia associated with hyponatremia is a potentially dangerous and fatal condition observed on patients with psychiatric illness, specially schizophrenia. This results on a peripheral oedema and can lead to cerebral oedema, mental status deterioration and intracranial hypertension if not identified and treated urgently. We present a case of polydipsia as first signal of psychosis.
20-year-old man without significant past medical or psychiatric history attended to emergency service presenting exuberant lower limbs oedemas. The analytical study stated an hyponatremia and hipo-osmotic urine. A psychiatric evaluation was made after organic illness exclusion. The patient presented serious behaviour changes, delusions and eating disturbances (“eat raw meat to recover the red cells that they had stolen from him”), polydipsia and auditory hallucinations with 2 weeks of evolution. The patient was compulsory hospitalized, treated with risperidone and lorazepam and discharged 28 days after admission without psychotic symptoms.
The recognition and management of the polydipsia as a first signal of psychosis are difficult because sometimes patients are uncooperative and tend to hide their water intake, but is important to be awhare to this signal to prevent the morbidity and mortality associated with this disease.
Psychogenic excoriations are also called neurotic excoriations, dermatillomania or skin picking syndrome. Psychogenic excoriations are lesions caused by scratching, picking, lancing, rubbing or squeezing, usually, in areas that patient can easily reach (face, upper back and upper and lower extremities). They are initiated because an urge to excoriate an irregularity of the skin or by a disturbing sensation in the skin. The classic lesions are characterized by clean, linear erosions, scabs and scars that can be hypopigmented or hyperpigmented and are usually similar in size and shape. Association with psychiatric comorbidities are common, particularly mood and anxiety disorders. It is estimated to occur in 2% of dermatology clinic patients and is associated with functional impairment, medical complications (e.g. infection) or substantial distress. Psychotropic medications (e.g. SSRIs) and appropriate counseling can be effective treatments.
The purpose of the poster is to highlight the existence and characteristics of psychogenic excoriations. A
condition that can be chronic, causes significant impairment and is believed to be common but unreported.
Here we report the case of a 27 year-old woman, with a 10 years history of self-inflicted excoriations, associated to high anxiety levels, treated with an SSRI with good response.
Although it does not appear as a diagnostic category in DSM- IV, psycogenic excoriations is indeed a treatable condition that, isolated or associated with psychiatric comorbidity can cause marked distress, impairment and psychological suffering.
The psychiatric conditions secondary to substance use (whether legal or illegal drugs) are well characterized and include psychosis, mania, depression and behavior changes.
We present a case of metformin-induced psychosis in a 79 years-old patient without any previous psychiatric history.
She was brought to emergency room after suicide attempt by hanging. She had a one-month history of altered behavioral and presented paranoid delusional though. Hallucinations were excluded. A detailed clinical evaluation excluded dementia, late-onset chronic psychosis and primary mood disorders with psychotic symptoms and revealed that symptoms initiate few days after the introduction of metformin to treat her diabetes. After Metformin suspension, total remission of psychotic symptoms was obtained in one week and patient return to previous functionality.
Psychosis secondary to metformin use is a very rare complication of oral antidiabetic drugs use but the awareness of this condition can lead to an earlier recognition and diagnosis.
Paraphrenia is a disorder similar to paranoid schizophrenia characterized by phantastic, paralogical and extraordinary imaginative delusions, with better-preserved affect and rapport and much less personality and cognitive deterioration. Most affected patients are women, with onset of symptoms in late adulthood. It was firstly systematically described by Kraepelin in 1913 in order to define a group of psychotic patients who exhibited characteristic symptoms of dementia praecox, but with minimal disturbances of emotion and volition, and marked delusions. Later, it was considered to be unfounded and the term paraphrenia was not included in the current DSM-IV-TR and ICD-10 diagnostic criteria. However, several authors suggest that the concept of paraphrenia has not lost its usefulness and it seems to be that some psychiatrists recognize the illness, but labelled it as atypical psychosis or delusional disorder for the lack of a better diagnostic category.
The aim of this poster is to underline the modernity of Kraepelin's paraphrenia concept, suggesting that it could be possible to define and recognize the illness if practitioners would be induced to use a viable diagnostic entity.
Herein we report a case of a 51-year-old woman who presented three years ago with a psychotic disorder whose clinical features resemble de classical description of paraphrenia.
Very few systematic studies on paraphrenia have been carried out in the past 70 years. Further research in this field is needed in order to recognize the viability of this diagnosis and provide patients a better care and therapeutic management.
Capgras syndrome is a misidentification syndrome typically characterized by the delusional belief that a close relative has been replaced by an impostor. This monothematic delusion can be found in numerous disorders such as paranoid schizophrenia, schizoaffective disorder, affective disorders, Alzheimer's disease, Lewy body dementia, head trauma, epilepsy, cerebrovascular disease and dementia, pituitary tumor, multiple myeloma, multiple sclerosis, viral encephalitis, frontal lobe pathology and AIDS. We present a case of a patient that presents Capgras Syndrome at the first psychiatric evaluation in the context of three-decades untreated paranoid schizophrenia.
A 56-year-old woman was brought to the psychiatric department for evaluation for aggressive behavior directed to relatives. She has a history of auditory hallucinations, experiences of self-reference and paranoid delusions with more than 30 years of evolution. More recently, she started becoming aggressive with relatives, saying her real family members had been taken by strangers to an unknown hospital. She also said that her ID photo had been replaced by another person's photo. After detailed psychiatric evaluation, blood analysis and imaging study, the diagnosis of Paranoid Schizophrenia was established. She was treated with olanzapine 20mg/day with behavioral improvement.
Although Capgras Syndrome is not a psychiatric diagnosis but a feature of several different conditions, psychiatrists should be aware of this syndrome as it can signalize underlying psychiatric disorders and is usually associated with violent behaviors that should be managed.
Intervention with informal caregivers (IC) of psychiatric patients is internationally recognized as relevant and a priority. However, the existing responses in this area are still insufficient, especially regarding caregivers of individuals with mood disorders (MD). Mindfulness and compassion focused therapy have proven to be an effective approach in stress reduction and in improving emotional and social well-being of caregivers of patients with other conditions. However, no studies testing these new approaches in IC of patients with MD have been carried out. The objective of this work is to present a research project that aims to develop, implement and empirically test the effectiveness of an innovative group program to help informal caregivers of individuals with mood disorders to cope with the negative impact of the disease and reduce caregiver burdens.
The design of this experimental study to test the program's efficacy is a non-randomised controlled trial (nrct) with 12 months follow-up, with a mixed assessment methodology (quantitative and qualitative analysis). A sample of 60 informal caregivers of individuals with chronic MD will be constituted (n = 30 Control group; n= 30 Experimental group).
We expect the program to promote significant changes in participants in terms of several emotional variables (eg: burden, stress, resilience, compassion and quality of life).
Further efforts to continue studying the impact of interventions in caregivers should be carried out, as a way to improve the quality of life of caregivers and their ability to provide informal care to MD patients.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
In recent years, researchers and clinicians have shown an increasing interest in self-compassion. Indeed, several studies have suggested that self-compassion is a positive factor for mental and physical health. The Self-Compassion Scale (SCS; Neff, 2003) has been widely used to assess six dimensions of self-compassion (self-kindness, self-judgment, common humanity, isolation, mindfulness and over-identification) among diverse populations. Recently, it has also been used in perinatal samples but its psychometric properties in pregnant women is still unexplored.
This study aims was to investigate the reliability and the validity of the SCS using Confirmatory Factor Analysis in a sample of Portuguese pregnant women.
Participants were 417 pregnant women with a mean age of 33 years old (SD = 4.74) in their second trimester of pregnancy (M = 17.26, SD = 4.78, weeks of gestation). Participants completed the Portuguese version of the SCS while waiting for the routine prenatal consultation in Maternity Hospital, Portugal.
A was tested and results showed that the six-factor model had a good fit to the data (TLI = 0.93, CFI = 0.94, RMSEA = 0.06). The total SCS presented a good internal reliability (α = 0.91) and their subscales showed Cronbach's alphas ranging between adequate (α = 0.77) and good (α = 0.87).
Overall, these findings suggest that the Portuguese version of the SCS is a valid and reliable measure to assess self-compassion among pregnant women. Thus, SCS could be useful in diverse settings in the perinatal period.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
According to the World Health Organization obesity it's the result of an abnormal or excessive body fat accumulation, which presents a high risk for the health. Bariatric surgery appears as an alternative to the conventional treatment for the morbid obese individuals. However, this type of intervention causes changes in the anatomy and physiology of the gastrointestinal tract, which may lead to the development of nutritional deficiencies in patients, in particular anemia.
To evaluate micronutrient deficiencies in patients submitted to bariatric surgery in preoperative and postoperative periods, in particular iron, ferritin, and B12 vitamin.
In this longitudinal study, we evaluated, retrospectively and prospectively, patients who attended the nutrition appointment at a central hospital. We completed a preexisting database containing anthropometric and biochemical data, adding biochemical data, at various periods: pre at 6th, 12th, 18th, 24th, 30th and 36th months post-surgery.
from the 121 patients submitted to bariatric surgery, 79,3% were female. The prevalence or iron deficiency reached 15%, ferritin deficiency reached almost 10% and B12 vitamin deficiency reached 18%. Furthermore there were deficiencies in other nutrients, e.g., vitamin D, magnesium and zinc. There was more than 85% adhesion to take the multivitamin supplementation and frequent use of specific supplementation.
The prevalence of nutritional deficiencies is high, with a tendency to persist over time even with use of multivitamin supplementation, leading to the need for complementary supplementation, in particular to prevent the risk of anemia. Hence, periodic and long term monitoring is fundamental.
The current study was carried out to examine the effect of cottonseed processing and chitosan supplementation on lamb performance, digestibility and nitrogen digestion. Eighty uncastrated Santa Inês lambs (23 ± 2.2 kg average weight, 4 months old) were distributed in a completely randomized design in a 2 × 2 factorial arrangement that consisted of two cottonseed processing forms (whole or ground) and two chitosan levels (0 or 136 mg/kg live weight). Higher dry matter and organic matter apparent digestibility coefficient (ADC) was achieved with the diets containing the whole cottonseed. Ether extract ADC was higher in the animals fed the chitosan-containing diet. There was an interaction effect on the ADC of neutral detergent fibre corrected for ash and protein, which increased with chitosan inclusion associated with the whole cottonseed. The lambs that received the treatment containing the whole cottonseed showed higher microbial protein synthesis. Chitosan addition increased nitrogen retention. The animals fed chitosan-containing diets showed higher microbial protein synthesis. There was an interaction effect on microbial protein synthesis. Whole cottonseed associated with chitosan in lamb diets increases ether extract ADC and microbial protein synthesis.
The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
Intake, digestibility, nitrogen (N) balance, microbial protein synthesis, weight gain, yields of the main commercial cuts and carcass morphometric measurements were evaluated in lambs fed diets containing different levels of chitosan. Sixty Santa Inês crossbred sheep with an average body weight (BW) of 24 ± 2.2 kg were assigned to three treatments (diets containing 0, 136 or 272 mg chitosan/kg BW) in a completely randomized design. There was no effect of chitosan on dry matter (DM) intake. Ingested and retained N showed a quadratic response, with the highest values estimated at the chitosan levels of 142 and 152 mg/kg BW, respectively. Similar to N balance, microbial protein synthesis showed the same quadratic response, in which the level of 136 mg/kg BW resulted in higher synthesis when compared with the other levels. No effect of chitosan was detected on average daily gain, final weight, or carcass variables (hot carcass weight, cold carcass weight, yield of commercial cuts and morphometric measurements of the carcass). Conformation, visceral fat content and fatness of carcasses were also not altered by the use of chitosan. Chitosan improves the digestibility of DM, crude protein and neutral detergent fibre, and increases N balance and microbial protein synthesis but does not change the production performance of feedlot lambs.
In some chikungunya epidemics, deaths are not completely captured by traditional surveillance systems, which record case and death reports. We evaluated excess deaths associated with the 2014 chikungunya virus (CHIKV) epidemic in Guadeloupe and Martinique, Antilles. Population (784 097 inhabitants) and mortality data, estimated by sex and age, were accessed from the Institut National de la Statistique et des Études Économiques in France. Epidemiological data, cases, hospitalisations and deaths on CHIKV were obtained from the official epidemiological reports of the Cellule de Institut de Veille Sanitaire in France. Excess deaths were calculated as the difference between the expected and observed deaths for all age groups for each month in 2014 and 2015, considering the upper limit of 99% confidence interval. The Pearson correlation coefficient showed a strong correlation between monthly excess deaths and reported cases of chikungunya (R = 0.81, p < 0.005) and with a 1-month lag (R = 0.87, p < 0.001); and a strong correlation was also observed between monthly rates of hospitalisation for CHIKV and excess deaths with a delay of 1 month (R = 0.87, p < 0.0005). The peak of the epidemic occurred in the month with the highest mortality, returning to normal soon after the end of the CHIKV epidemic. There were excess deaths in almost all age groups, and excess mortality rate was higher among the elderly but was similar between male and female individuals. The overall mortality estimated in the current study (639 deaths) was about four times greater than that obtained through death declarations (160 deaths). Although the aetiological diagnosis of all deaths associated with CHIKV infection is not always possible, already well-known statistical tools can contribute to the evaluation of the impact of CHIKV on mortality and morbidity in the different age groups.
Electroejaculation (EE) is stressful and probably painful; thus the administration of anaesthesia is recommended to decrease those negative effects. However, anaesthesia has a direct risk of provoking death, but sedation is less risky than anaesthesia. At the same time, α2-adrenergic agonists may improve semen quality. Therefore, the aim of the present study was to compare the physiological and behavioural responses indicative of stress and possibly pain, and the semen quality in electroejaculated untreated, anaesthetised or sedated goat bucks. Semen was collected from eight bucks using three different procedures in all them (EE in untreated bucks, EE under sedation or EE under general anaesthesia). The number of vocalizations during EE and the behavioural pattern before and after procedures were recorded. Pain visual analogue scale (VAS) score was also determined during EE. Rectal temperature, heart rate, serum cortisol concentration, biochemical and haematological parameters were measured before and after each procedure, and sperm characteristics were determined. Bucks vocalised more often when untreated than sedated or anaesthetised (P<0.02). The pain VAS score was greater when bucks were untreated than sedated or anaesthetised (P<0.002). The rectal temperature, heart rate, total protein, albumin and haemoglobin concentrations were greater when bucks were untreated than anaesthetised or sedated (P<0.02). Serum cortisol increased after EE (P=0.0006), without differences between procedures. The frequency and duration of lying down after EE were greater when bucks were anaesthetised than sedated or untreated (P<0.05), and were also greater when bucks were sedated than untreated (P<0.05). The number of times that the animal tried to stand up after EE was greater when bucks were anaesthetised than sedated or untreated (P<0.02). The sperm mass motility was greater when bucks were anaesthetised or sedated than when they were untreated (P=0.048). When animals were sedated, the ejaculate contained more spermatozoa with functional plasma membrane (P=0.03) and morphologically normal (P=0.05) than when they were untreated. In conclusion, general anaesthesia and sedation decreased the stress and probably the pain response provoked by EE and especially sedation improved the quality of the semen collected.
Background and Objective Pain is a frequent symptom in Parkinson’s disease (PD), and the therapeutic alternatives are scarce. The goal of this trial was to measure the effects of botulinum toxin type A (BTXA) in the treatment of limb pain in advanced PD. Methods A randomized double-blind crossover versus placebo study of BTXA for limb pain in advanced Parkinson’s disease was conducted. Subjects received individualized BTXA/placebo dosing per pain distribution in limbs. The primary outcome was a measure of change in global pain on a numeric rating scale (NRS) at 4 and 12 weeks postinjection and on a visual analogue scale 12 weeks after treatment. Secondary outcomes included the percentage of responders, physician-rated clinical global impressions, MDS–UPDRS and PDQ–39 scores, and adverse events. Results A total of 12 subjects completed the trial. Treatment with BTXA (average dose=241.66 U) produced a significant reduction in NRS score 4 weeks after the injections (–1.75 points, range from –3 to 7, p=0.033). However, there was no significant difference compared to placebo (p=0.70). Participants with dystonic pain showed a greater reduction in NRS score after 4 weeks when treated with BTXA (2.66 points vs. 0.75 for placebo). There were no significant differences for any of the secondary outcomes or significant adverse events. Conclusions Targeted BTXA injections were safe in patients with limb pain and advanced PD; however, the present study failed to show a significant effect when compared to placebo. Further studies may be focused on evaluating the effect of BTXA particularly in dystonic pain.
Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.
Mastitis is a major disease affecting the herds of dairy farmers worldwide. One of the indicators directly related to the widespread infection of this disease in herds is the bulk tank somatic cell count (BTSCC). Recent studies have shown that one of the risk factors associated with mastitis is the human factor. Therefore, understanding the influence of humans is essential to control and prevent the disease. The main goal of this study was to determine whether the motivations and barriers perceived by farmers could explain the variation in the BTSCC. This study was conducted at 75 dairy farms in southern Brazil. In the interviews with farmers, a survey based on Likert scale items was used to collect data. Structural equation models were used to explain the subjectivity in the ratio of observed variables and latent variables elucidating the possible causal relationships between the variables. The model indicated that some of the variation in the BTSCC can be explained by the farmer’s behavior, which is elucidated by his/her motivations and barriers. The correlations between motivations and the BTSCC and between barriers and the BTSCC were positive. These findings suggest that variations in the BTSCC can be explained by the motivations and barriers perceived by farmers and that the Fogg Behavior Model used in this study can be used to explain how human behaviors influence mastitis control. This study also indicates that consulting companies focused on improving milk quality should pay attention to the human factor to reduce these barriers.
It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults.
We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity.
Greater grip strength, longer education, higher cognitive level of job, and greater engaging in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength.
Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.
Licuri (Syagrus coronate) cake is a biodiesel by-product used in ruminant feed as a beneficial energy source for supplementation in managed pastures. The objective was to evaluate the performance, digestibility, nitrogen balance, blood metabolites, ingestive behavior and diet profitability of eight crossbred Holstein (3/4)×Gyr (5/8) multiparous cows (480±25 kg BW and 100 days milking) grazing and supplemented with licuri cake partially replacing ground corn and soybean meal in concentrate (0, 200, 400 and 600 g/kg in dry matter (DM)), distributed in an experimental duplicated 4×4 Latin square design. Licuri cake partially replacing ground corn and soybean meal increased (P<0.01) the intake and digestibility of ether extract and decreased the non-fiber carbohydrates; however, there were no influences on the intakes of DM, CP, NDF and total digestible nutrients (TDN). The digestibilities of DM, CP and NDF were not influenced by licuri cake addition. There was a decrease trend on TDN digestibility (P=0.08). Licuri cake replacing ground corn and soybean meal in concentrate did not affect the intake; fecal, urinary and mammary excretions; N balance; and triglycerides concentrations. However, the blood urea nitrogen (P=0.04) concentration decreased with the licuri cakes inclusion in cow supplementation. There was an increasing trend for serum creatinine (P=0.07). Licuri cake inclusion did not affect body condition score, production, yield, protein, lactose, total solids and solid non-fat contents of milk and Minas frescal cheese. There was a linear decrease in average daily weight gain (g/day). The milk fat concentration and cheese fat production (P<0.1) presented a linear increase with partial replacement of ground corn and soybean meal with licuri cakes. The addition of licuri cake did not alter the time spent feeding, ruminating or idling. There was an increasing trend in NDF feeding efficiency (P=0.09). The replacing of ground corn and soybean meal with licuri cake up to 600 g/kg decreased the concentrate cost by US$0.45/cow per day. Licuri cake replacing corn and soybeans (400 g/kg) in concentrate promoted a profit of US$0.07/animal per day. Licuri cake is indicated to concentrate the supplementation of dairy cows with average productions of 10 kg/day at levels up to 400 g/kg in the concentrate supplement because it provides an additional profit of US$0.07/animal per day and increased milk and Minas frescal cheese fat without negative effects on productive parameters.