225 resultados para TRACTO URINARIO


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"Con la implementación estandarizada de la ecografía uretral se pretende tener un efecto directo en el diagnóstico oportuno, no invasivo y sin complicaciones inherentes a la instrumentación del tracto urinario bajo en los pacientes que padecen de estenosis uretral; que finalmente redundará en disminución de costos a corto y largo plazo gracias a la eliminación de estudios innecesarios y procedimientos terapéuticos infructuosos, beneficiando al paciente y al sistema de salud vigente en nuestro medio. Los sujetos con estenosis uretrales complejas podrían ser diagnosticados de manera rápida, sencilla y minimamente invasiva sin importar la localización de la anomalía y su complejidad". (Extracto de la introducción)

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O entendimento da produção da fala tem sido ampla mente procurado, recorrendo à imagem por ressonância magnética (IRM), mas não é totalmente conhecido, particularmente no que diz respeito aos sons do Português Europeu (PE). O principal objectivo deste estudo foi a caracterização das vogais do PE. Com base na IRM recolheram-se conjuntos de imagens bidimensionais, em cinco posições articulatórias distintas, durante a produção sustentada do som. Após extracção de contornos do tracto vocal procedeu-se à reconstrução tridimensional, constatando-se que a IRM fornece in formação morfológica útil e com considerável precisão acerca da posição e forma dos diferentes articuladores da fala.

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Introdução: As anomalias do tracto urinário são detectadas com uma frequência cada vez maior devido à sistematização da vigilância ecográfica durante a gravidez aliada à sofisticação técnica e à experiência dos ecografistas. Objectivo: Analisar os principais diagnósticos pós-natais investigados na sequência do estudo evolutivo prolongado das uropatias fetais seguidas no ambulatório da nefrologia pediátrica do Hospital de Dona Estefânia. Doentes e Métodos: Estudo retrospectivo dos 392 casos de uropatia fetal observados num período de dez anos e submetidos ao protocolo de investigação em uso na unidade. Resultados: O estudo inclui 362 casos; excluímos 30 processos que não completaram a investigação. A relação sexo masculino: feminino foi de 2: 1. O diagnóstico pré-natal foi realizado em média às 28.9 semanas e a idade média de admissão foi de 68 dias. No estudo evolutivo pós-natal verificou-se a formulação de um diagnóstico definitivo em 349 (96.4%) das crianças. Em 109 crianças (30%) a anomalia fetal foi transitória. Em 75 (20.7%) a dilatação era funcional. Confirmou-se a existência de uropatia em 165/362 crianças: refluxo vesico-ureteral 70/165 (42.4%), displasia multiquística 21%, síndroma da junção pielo-ureteral 16.4%, entre os principais. Nenhum caso evoluiu para insuficiência renal e há a registar, apenas, um caso de hipertensão arterial por poliquistose renal. Conclusão: A planificação da investigação pós-natal reveste-se ainda de alguma controvérsia e continua a evoluir principalmente no grupo das anomalias unilaterais e assintomáticas.

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A utilização sistemática da cistouretrografia miccional, no âmbito da investigação pós-natal das anomalias fetais do aparelho urinário, é controversa. A possibilidade de diagnosticar refluxo vesico-ureteral (RVU) antes de surgir infecção urinária é aliciante pela influência que pode ter na história natural da nefropatia do refluxo. Neste artigo, partindo de uma série de 116 casos de anomalia fetal do aparelho urinário num período de 5 anos, apresentam-se as características e evolução de 19 casos de RVU. A cistouretrografia miccional (CUM) efectuada em 109 casos (94%) identificou RVU em 19 (17.4%). Predominou o sexo masculino (5:1). Em 13 casos (19 unidades renais refluentes) o RVU era a única anomalia urinária detectada (grupo I); em 6 casos (8 unidades refluentes) o RVU estava associado a outras anomalias do tracto urinário (grupo II). Em 10 unidades refluentes do grupo I (55%) a avaliação ecográfica pós-natal foi considerada normal. Uma ecografia pós-natal normal não exclui a existência de RVU e, de acordo com os nossos resultados, todos os casos de dilatação da pélvis renal fetal beneficiam, no período pós-natal, de controlos ecográficos seriados e da realização de CUM. A confirmação precoce de RVU e a consequente instituição de quimioprofilaxia podem contribuir para a redução da morbilidade associada à infecção urinária e à nefropatia de refluxo.

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Hoy se conoce que los lípidos de la dieta son factores ambientales importantes en el desarrollo del cáncer. En efecto, tanto el cáncer de mama como el de colon han sido relacionados con alto consumo de grasas saturadas. Por otra parte, hay evidencias clínicas y experimentales que señalan que la deficiencia en ácidos grasos esenciales (DAGE) está asociada a lesiones tumorigénicas, tales como elevada proliferación celular y anormal diferenciación especialmente en epitelios queratinizantes y urinario. (...) La patobiología del cáncer de vejiga, de alta incidencia en nuestro medio, es un enigma. Varios fenómenos de membrana relacionados al cáncer (interacción intercelular, transducción transmembrana, metástasis) son sensibles a cambios en la rigidez de membrana. Este proyecto contempla el estudio de parámetros dinámicos de lípidos de membrana plasmática de epitelio de vejiga con variada composición de ácidos grasos. Se determinará: a) La depolarización de la fluorescencia de sondas fluorescentes que predominantemente reflejan el orden estructural de los lípidos de membrana. b) La anisotropia de la fluorescencia de fluoroforos que por su ubicación dentro de la bicapa lipídica reflejan gradientes de fluidez a través de la membrana. Los datos permitirán caracterizar las condiciones dietarias en ácidos grasos que determinan propiedades de membrana que pueden influenciar la promoción y/o desarrollo del cáncer de vejiga.

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El transtorn de l’olfacte a la malaltia d’Alzheimer (MA) és freqüent i precoç. Per determinar la relació entre la MA i el volum del bulb i tracte olfactori, és necessari un instrument que ens permeti realitzar el càlcul d’aquest volum a partir d’imatges obtingudes per ressonància magnètica. S’ha desenvolupat un software específic i s’ha realitzat un estudi observacional i transversal de fiabilitat en una mostra de pacients. S’ha calculat el volum de forma semiautomàtica per dos observadors independents. El coeficient de correlació intraclasse obtingut ens permet concloure que la fiabilitat interexaminador és apropiada.

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Estudiem l’efecte de l’atorvastatina sobre perfil lipídic, funció renal, marcadors d’inflamació, peptidoma plasmàtic i urinari de 54 pacients trasplantats renals. L’estudi proteòmic es basa en tecnologia d’esferes magnètiques combinada amb espectrometria de masses MALDI-TOF. L’atorvastatina va millorar el perfil lipídic dels pacients i va provocar canvis significatius al peptidoma plasmàtic. Es va observar la disminució en plasma de pèptids derivats de fragments del quininogen i de C4. Atès que bradiquinina i C4a, que s’alliberen de quininogen i C4, son potents mediadors de la inflamació, els nostres resultats poden aclarir els efectes antiinflamatoris atribuïts a les estatines.

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As infeções do trato urinário associadas à cateterização são muito frequentes no contexto comunitário e hospitalar. Existem atualmente várias recomendações para sua prevenção, contudo, quando abordado o soluto a utilizar no meato urinário previamente à algaliação continuam a persistir dúvidas. Assim, este estudo procurou determinar a eficácia da limpeza do meato urinário com água ou soro fisiológico comparativamente à sua assepsia por meio de uma revisão sistemática com metanálise. Para isso foram seguidos os princípios propostos pelo Cochrane Handbook , a análise crítica realizada por dois investigadores e a análise estatística com recurso ao programa STATA 11.1. Podemos concluir que a limpeza ou desinfeção do meato urinário previamente à cateterização vesical não é estatisticamente significativa (OR=1,07, IC 95%=0,68-1,68, p=0,779), existindo alguma evidência de que a utilização de água/soro fisiológico reduz as taxas de ITU.

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INTRODUCTION – In human medicine, diabetes mellitus (DM), hypertension, proteinuria and nephropathy are often associated although it is still not clear whether hypertension is the consequence or the cause of nephropathy and albuminuria. Microalbuminuria, in humans, is an early and sensitive marker which permits timely and effective therapy in the early phase of renal damage. Conversely, in dogs, these relationships were not fully investigated, even though hypertension has been associated with many diseases (Bodey and Michell, 1996). In a previous study, 20% of diabetic dogs were found proteinuric based on a U:P/C > 1 and 46% were hypertensive; this latter finding is similar to the prevalence of hypertension in diabetic people (40-80%) (Struble et al., 1998). In the same canine study, hypertension was also positively correlated with the duration of the disease, as is the case in human beings. Hypertension was also found to be a common complication of hypercortisolism (HC) in dogs, with a prevalence which varies from 50 (Goy-Thollot et al., 2002) to 80% (Danese and Aron, 1994).The aim of our study was to evaluate the urinary albumin to creatinine ratio (U:A/C) in dogs affected by Diabetes Mellitus and HC in order to ascertain if, as in human beings, it could represent an early and more sensitive marker of renal damage than U:P/C. Furthermore, the relationship between proteinuria and hypertension in DM and HC was also investigated. MATERIALS AND METHODS – Twenty dogs with DM, 14 with HC and 21 healthy dogs (control group) were included in the prospective case-control study. Inclusion criteria were hyperglycaemia, glicosuria and serum fructosamine above the reference range for DM dogs and a positive ACTH stimulation test and/or low-dose dexamethasone test and consistent findings of HC on abdominal ultrasonography in HC dogs. Dogs were excluded if affected by urinary tract infections and if the serum creatinine or urea values were above the reference range. At the moment of inclusion, an appropriate therapy had already been instituted less than 1 month earlier in 12 diabetic dogs. The control dogs were considered healthy based on clinical exam and clinicopathological findings. All dogs underwent urine sample collection by cystocentesis and systemic blood pressure measurement by means of either an oscillometric device (BP-88 Next, Colin Corporation, Japan) or by Doppler ultrasonic traducer (Minidop ES-100VX, Hadeco, Japan). The choice of method depended on the dog’s body weight: Doppler ultrasonography was employed in dogs < 20 kg of body weight and the oscillometric method in the other subjects. Dogs were considered hypertensive whenever systemic blood pressure was found ≥ 160 mmHg. The urine was assayed for U:P/C and U:A/C (Gentilini et al., 2005). The data between groups were compared using the Mann-Whitney U test. The reference ranges for U:P/C and U:A/C had already been established by our laboratory as 0.6 and 0.05, respectively. U:P/C and U:A/C findings were correlated to systemic blood pressure and Spearman R correlation coefficients were calculated. In all cases, p < 0.05 was considered statistically significant. RESULTS – The mean ± sd urinary albumin concentration in the three groups was 1.79 mg/dl ± 2.18; 20.02 mg/dl ± 43.25; 52.02 mg/dl ± 98.27, in healthy, diabetic and hypercortisolemic dogs, respectively. The urine albumin concentration differed significantly between healthy and diabetic dogs (p = 0.008) and between healthy and HC dogs (p = 0.011). U:A/C values ranged from 0.00 to 0.34 (mean ± sd 0.02 ± 0.07), 0.00 to 6.72 (mean ± sd 0.62 ± 1.52) and 0.00 to 5.52 (mean ± sd 1.27 ± 1.70) in the control, DM and HC groups, respectively; U:P/C values ranged from 0.1 to 0.6 (mean ± sd 0.17 ± 0.15) 0.1 to 6.6 (mean ± sd 0.93 ± 1.15) and 0.2 to 7.1 (mean ± sd 1.90 ± 2.11) in the control, DM and HC groups, respectively. In diabetic dogs, U:A/C was above the reference range in 11 out of 20 dogs (55%). Among these, 5/20 (25%) showed an increase only in the U:A/C ratio while, in 6/20 (30%), both the U:P/C and the U:A/C were abnormal. Among the latter, 4 dogs had already undergone therapy. In subjects affected with HC, U:P/C and U:A/C were both increased in 10/14 (71%) while in 2/14 (14%) only U:A/C was above the reference range. Overall, by comparing U:P/C and U:A/C in the various groups, a significant increase in protein excretion in disease-affected animals compared to healthy dogs was found. Blood pressure (BP) in diabetic subjects ranged from 88 to 203 mmHg (mean ± sd 143 ± 33 mmHg) and 7/20 (35%) dogs were found to be hypertensive. In HC dogs, BP ranged from 116 to 200 mmHg (mean ± sd 167 ± 26 mmHg) and 9/14 (64%) dogs were hypertensive. Blood pressure and proteinuria were not significantly correlated. Furthermore, in the DM group, U:P/C and U:A/C were both increased in 3 hypertensive dogs and 2 normotensive dogs while the only increase of U:A/C was observed in 2 hypertensive and 3 normotensive dogs. In the HC group, the U:P/C and the U:A/C were both increased in 6 hypertensive and 2 normotensive dogs; the U:A/C was the sole increased parameter in 1 hypertensive dog and in 1 dog with normal pressure. DISCUSSION AND CONCLUSION- The findings of this study suggest that, in dogs affected by DM and HC, an increase in U:P/C, U:A/C and systemic hypertension is frequently present. Remarkably, some dogs affected by both DM and HC showed an U:A/C but not U:P/C above the reference range. In diabetic dogs, albuminuria was observed in 25% of the subjects, suggesting the possibility that this parameter could be employed for detecting renal damage at an early phase when common semiquantiative tests and even U:P/C fall inside the reference range. In HC dogs, a higher number of subjects with overt proteinuria was found while only 14% presented an increase only in the U:A/C. This fact, associated with a greater number of hypertensive dogs having HC rather than DM, could suggest a greater influence on renal function by the mechanisms involved in hypertension secondary to hypercortisolemia. Furthermore, it is possible that, in HC dogs, the diagnosis was more delayed than in DM dogs. However, the lack of a statistically significant correlation between hypertension and increased protein excretion as well as the apparently random distribution of proteinuric subjects in normotensive and hypertensive cases, imply that other factors besides hypertension are involved in causing proteinuria. Longitudinal studies are needed to further investigate the relationship between hypertension and proteinuria.

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El objetivo general de esta Tesis doctoral fue estudiar la influencia de diversos factores nutricionales sobre los parámetros productivos y el desarrollo del tracto digestivo de pollitas rubias destinadas a la producción de huevos comerciales. Para alcanzar este objetivo se realizaron tres experimentos donde se estudió el cereal principal, el tamaño de partícula del cereal y el nivel de energía y la presentación de los piensos. En el experimento 1 se estudió la influencia del cereal (piensos con enzimas) y la presentación del pienso sobre los parámetros productivos y las características del tracto digestivo en 576 pollitas rubias de 1 a 120 d de edad. De 1 a 45 d de la edad, se utilizaron 4 piensos experimentales organizados de forma factorial con 2 cereales al 50% de inclusión (maíz vs. trigo) y 2 presentaciones del pienso (harina vs. gránulo de 2- mm de diámetro). Cada tratamiento se replicó 6 veces (24 pollitas por réplica). De 46 a 120 d de edad todas las dietas (maíz o trigo) se ofrecieron en harina y por tanto, la única diferencia entre tratamientos fue el cereal utilizado. De 1 a 120 d de edad, las pollitas que recibieron los piensos basados en maíz tuvieron una ganancia de peso vivo (PV) superior (P < 0,05) que las que recibieron los piensos basados en trigo, pero el índice de conversión (IC) fue similar para ambos grupos. De 1 a 45 d de edad, las pollitas alimentadas con gránulo consumieron más pienso (P < 0,001) y tuvieron una ganancia de peso superior (P < 0,001) que las pollitas alimentadas con harina. Gran parte de los efectos beneficiosos de la granulación sobre los parámetros productivos se mantuvieron al final de la prueba (120 d de edad). A los 45 d de edad, el peso relativo de la molleja (PR; g/kg PV) fue superior (P < 0,01) en pollitas alimentadas con maíz que en pollitas alimentadas con trigo. La alimentación en gránulo redujo el PR del tracto gastro intestinal (TGI) y de la molleja (P < 0,001), así como la longitud relativa (LR; cm/kg PV) del intestino delgado (P< 0.01) a ambas edades (45 y 120 d de edad). El tipo de cereal utilizado no afectó al pH del contenido de la molleja a 120 d de edad pero fué inferior (P < 0,01) en las pollitas que recibieron el pienso en harina de 1 a 45 d de la edad que en las que recibieron el pienso en gránulo. Se concluye que el trigo puede substituir al maíz en piensos para pollitas si se acepta una ligera reducción en la ganancia de peso. Asímismo, la alimentación en gránulo de 1 a 45 d de edad aumentó la ganancia de peso a esta edad y al final de la prueba, así como el pH de la molleja a 120 d de edad. La presentación del pienso en gránulo redujo el PR de la molleja y la LR del TGI a 120 d de edad. En el experimento 2 se utilizaron un total de 864 pollitas rubias Hy-Line de 1 d de edad para estudiar la influencia del cereal de la dieta (500 g de maíz o trigo/kg) y el tamaño de partícula del mismo (molienda con molino de martillos con un diámetro de criba de 6, 8, o 10-mm) sobre los parámetros productivos y las características del TGI de 1 a 120 d de edad. Cada uno de los 6 tratamientos se replicó 6 veces (24 pollitas por réplica). De 1 a 45 d de edad, la ganancia de PV aumentó (P< 0,001) y el IC se mejoró (P < 0,05) al reducir el tamaño de partícula del cereal, pero no se observaron diferencias en el periodo crecimiento de 45 a 120 d de edad. A los 45 d de vida, las pollitas alimentadas con maíz tendieron (P < 0,10) a tener un mayor PR del TGI y del proventrículo y una mayor LR del intestino delgado que las pollitas alimentadas con trigo. Asímismo, el PR del TGI a esta edad, aumentó (P < 0,05) a medida que aumentaba el tamaño de partícula del cereal utilizado. A los 120 d de edad, el tratamiento no afectó el PR de ninguno de los órganos del TGI ni al pH de la molleja. Sin embargo, la LR del intestino delgado fue superior (P < 0,05) para las pollitas alimentadas con trigo que para las pollitas alimentadas con maíz. La LR del TGI se redujó (P < 0,05) al aumentar el tamaño de partícula del cereal. Se concluye que el trigo puede incluirse 500 g/kg en piensos de pollitas de 1 a 120 días de edad y que el tamaño de partícula de los cereales afecta el crecimiento de las pollitas durante los primeros 45 d de vida, pero no después. Por lo tanto, se recomienda moler el cereal utilizado al inicio del período de recría (1 a 45 d de edad) con una criba de diámetro igual o inferior a 8 mm. En el experimento 3 se utilizaron un total de 1.152 pollitas rubias Hy-Line de 1 d de edad para estudiar la influencia del nivel de energía de la dieta y la presentación del pienso sobre la productividad y las características del TGI. De 1 a 45 d de edad se utilizaron 6 piensos organizados de forma factorial con 3 concentraciones energéticas (baja: 11,44 MJ; media: 12,05 MJ y alta: 12,66 MJ/kg) y 2 presentaciones del pienso (harina vs. gránulo). De 45 a 120 d todos los piensos experimentales se suministraron en forma de harina y por tanto, la única diferencia entre tratamientos fue el nivel de EMAn utilizado. Cada uno de los 6 tratamientos se replicó 8 veces y la unidad experimental fue la jaula con 24 pollitas. De 1 a 120 d de edad, la ganancia de PV y el IC mejoraron a medida que aumentó la EMAn del pienso (P < 0,001). Las pollitas alimentadas con gránulo de 1 a 45 d de edad comieron mas y tuvieron una ganancia de peso superior (P < 0,001) que las alimentadas con harina. En el global de la prueba, la ganancia de PV fue mayor (P < 0,01) para las pollitas alimentadas con piensos en gránulo. A los 45 d de edad, el PR de todos los segmentos del TGI estudiados fue inferior para las pollitas alimentadas con piensos de alta energía que para las pollitas alimentadas con piensos de media o baja energía. A 120 d de edad, el PR de la molleja fue superior (P < 0,01) para las pollitas alimentadas con piensos de baja energía que con los otros piensos. Sin embargo, la LR del TGI no se vió afectada por el nivel de energía de los piensos. A los 45 d de edad, la alimentación con gránulo redujo el PR del proventrículo (P < 0,05), de la molleja (P < 0,001) y del TGI (P < 0.001), así como la LR del intestino delgado (P < 0,05) y de los ciegos (P < 0,001). A pesar de que las pollitas solo recibieron los piensos en gránulo durante los primeros 45 d de vida, la alimentación con gránulos redujo el PR de la molleja y del proventrículo a 120 d de edad. Se concluye que la alimentación con gránulos durante los primeros 45 d de vida mejora el consumo de pienso y el PV de las pollitas a 120 d de edad. Un aumento del nivel de energía de la dieta de 12,0 a 12,7 MJ/kg mejora los parámetros productivos de 1 a 120 d de edad pero reduce el tamaño del proventrículo y de la molleja. En base de estos resultados concluimos que maíz y trigo con enzimas pueden utilizarse indistintamente en piensos para pollitas de 1 a 120 d de edad con sólo una ligera disminución del PV final con trigo. La granulación y la reducción del tamaño de partícula del cereal del pienso de primera edad (1 a 45 d de vida) y el uso de piensos de alta densidad energética, mejoran los PV a 120 d de edad. Por lo tanto, es recomendable moler los cereales con cribas de no más de 8-mm de diámetro. También, la granulación del pienso y el uso de piensos de alta energía (pobres en fibra bruta) pueden reducir el desarrollo del TGI especialmente de la molleja, lo que puede perjudicar el consumo posterior de pienso durante el inicio del ciclo de puesta. ABSTRACT The general objective of this Thesis was to study the effect of different nutritional factors on productive performance and the development of the gastrointestinal tract (GIT) of commercial brown egg-laying pullets from 1 to 120 d of age. In this respect, the influence of type and particle size of the cereal, and feed form, and energy content of the die,t were studied in 3 experiments. In experiment 1, the influence of the main cereal and feed form of the diet on performance and GIT traits was studied in 576 brown-egg laying pullets from 1 to 120 d of age. From 1 to 45 d of age, 4 diets arranged factorially with 2 cereals (maize vs. wheat) and 2 feed forms (mash vs. pellets) were used. Each treatment was replicated 6 times (24 pullets per replicate). From 46 to 120 d of age, all diets were offered in mash form and therefore, the only difference among diets was the cereal used. Cumulatively, pullets fed the maize diets had higher body weight (BW) gain (P< 0.05) but similar feed conversion ratio (FCR) than pullets fed the wheat diets. From 1 to 45 d of age, pullets fed pellets consumed more feed (P < 0.001) and had higher BW gain (P < 0.001) than pullets fed mash. Most of the beneficial effects of pelleting on productive performance of the birds were still evident at 120 d of age. At 45 d of age, gizzard relative weight (RW; g/kg BW) was higher (P < 0.01) in pullets fed maize than in pullets fed wheat. Feeding pellets reduced the RW of the GIT and the gizzard (P < 0.001) as well as the relative length (RL; cm/kg BW) of the small intestine (SI, P < 0.01) at both ages. The pH of the gizzard contents at 120 d of age was not affected by the main cereal of the diet, but was lower in pullets fed mash from 1 to 45 d of age (P < 0.01) than in pullets fed pellets. We conclude that wheat supplemented with enzymes can be used in substitution of maize in pullet diets with only a slight reduction in BW gain at 120 d of age. Also, feeding pellets from 1 to 45 d of age increased BW gain and pH of the gizzard, and reduced the RW of the gizzard and the RL of the GIT at 120 d of age. In experiment 2, a total of 864 brown-egg laying pullets was used to study the effects of the main cereal of the diet (500 g maize or wheat/kg) and particle size of the cereal (hammer milled to pass through a 6, 8, and 10-mm screen) on growth performance and GIT traits from 1 to 120 d of age. Each of the 6 treatments was replicated 6 times (24 pullets per replicate). Type of cereal did not affect pullet performance at any age. From 1 to 45 d of age, BW gain was increased (P < 0.001) and FCR was improved (P < 0.05) as the particle size of the cereal was reduced, but no effects were observed after this age. At 45 d of age, pullets fed maize tended (P < 0.10) to have a heavier RW of the GIT and proventriculus and a higher relative length (RL, cm/kg BW) of the SI than pullets fed wheat. Also at this age, the RW of the GIT increased (P < 0.05) with increases in particle size of the cereal. At 120 d of age, dietary treatment did not affect the RW of any of the organs studied or gizzard pH, but the RL of the SI was higher (P < 0.05) for pullets fed wheat than for pullets fed maize. Also, the RL of the SI was reduced (P < 0.05) as the particle size of the cereal increased. We conclude that 500 g wheat/kg can be included in pullet feeds from 1 to 120 d of age, and that particle size of the cereal affects pullet performance during the first 45 d of life but not thereafter. Therefore, it is recommended to grind the cereal used in this period with a screen size of no more than 8-mm. In experiment 3, a total of 1,152 one-day-old Hy-Line Brown egg laying pullets were used to study the influence of the energy content of the diet and feed form on productive performance and on several GIT traits. From 1 to 45 d of age, there were 6 diets arranged factorially with 3 concentrations of AMEn (low: 11.66 MJ/kg, medium: 12.05 MJ/kg and high: 12.66 MJ/kg) of the diet and 2 feed forms (mash vs. pellets). From 45 to 120 d all diets were fed in mash form and therefore, the only difference among treatments in this period was the energy content of the diets. Each of the 6 treatments was replicated 8 times and the experimental unit was formed by 24 pullets. Cumulatively, BW gain and FCR improved as the AMEn of the diet increased (P < 0.001). Also, pullets fed pellets from 1 to 45 d of age had higher feed intake and BW gain (P < 0.001) in this period and higher cumulative BW gain (P < 0.01) than pullets fed mash. At 45 d of age, the RWof all the segments of the GIT was lower for pullets fed the high- than for pullets fed the medium- or low- energy diets. At 120 d of age, the RW of the gizzard was higher (P < 0.01) for pullets fed the low energy diets than for pullets fed the other diets. However, the RL of the GIT was not affected by the energy content of the diet. Feeding pellets reduced the RW of the proventriculus (P < 0.05), gizzard (P < 0.001), and GIT (P < 0.001), as well as the RL of the small intestine (P < 0.05) and the ceaca (P < 0.001) at 45 d of age. The effects of feeding pellets on RW of gizzard and proventriculus were still evident at 120 d of age. We concluded that feeding pellets from 1 to 45 d of age improved feed intake and BW of pullets at 120 d of age and that an increase in the energy content of the diet increased pullet performance at all ages but reduced the RW of the proventriculus and gizzard. We conclude that maize and wheat can be used indistinctly in diets for egg laying pullets from 1 to 120 d of age, with only a slight reduction in final BW when wheat is used. Also, particle size of the cereal affects pullet performance during the first 45 d of life but not thereafter. Pelleting of the feeds, and grinding the cereal with a screen size of no more than 8-mm from 1 to 45 d of age, and the use of high density energy diets are recommended in order to achieve adequate target BW at 120 d of age. However, pelleting of the feed, very fine grinding, and the use of high AMEn diets might hinder the development of the GIT, especially that of the gizzard, which might affect feed intake of laying hens especially at the beginning of the production cycle.