Diet quality and associated factors in Brazilian undergraduates during the COVID-19 pandemic.

Background: Diet quality is associated with psychobiological, psychological, biological, and physiological factors of individuals, and in the context of prolonged stress, such as the COVID-19 pandemic, it can lead to a worsening of the quality of food for undergraduates. This study aimed to analyze diet quality and associated factors in Brazilian undergraduates. Methods: Data were collected from 4,799 undergraduate students from all Brazilian regions, from August 2020 to February 2021. The online questionnaire contained socioeconomic variables, the ESQUADA scale to assess diet quality, self-referred changes in weight, the Brazilian food insecurity scale (EBIA), sleep assessment and the perceived stress scale. Unconditional multiple logistic regression analysis was performed to study variables associated with poor and very poor diet quality. Results: Most of participants presented a good diet quality (51.7%), while 9.8% had a poor or very poor diet quality and only 1.1% had an excellent diet quality. 58.2% of undergraduates reported to have an increase in weight during the pandemic and 74.3% of the students presented elevated stress during the pandemic. Logistic regressions showed students who gained weight during the pandemic presented the highest AOR = 1.56 (95% CI = 1.12-2.20) for poor or very poor diet quality. The elevated perceived stress was also associated with a higher AOR = 2.85 (95% CI = 1.71-4.74) for poor or very poor diet quality. Conclusion: Most of the studied undergraduates presented a good diet quality. Nevertheless, poor/very poor diet quality was associated with higher perceived stress and weight gain. Our study indicated that policies should beaimed at the socioeconomically most vulnerable undergraduates, those in a situation of food and nutritional insecurity, high perceived stress, and who gained weight during the pandemic.

Ideal Cardiovascular Health in adolescents: Findings from Study of Cardiovascular Risks in Adolescents.

BACKGROUND AND AIM: We assessed the Ideal Cardiovascular Health (CVH) in Brazilian adolescents according to demographics and socioeconomic characteristics. METHODS AND RESULTS: This is a cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), with a nationwide representative sample of 36,956 Brazilian adolescents, aged 12-17 years, enrolled in public and private schools. The CVH metrics considered were body mass index (BMI), physical activity, smoking, healthy diet score, blood pressure, fasting plasma glucose, and total cholesterol. The demographics and socioeconomic characteristics analyzed were sex, age, race/skin color, and type of school attended. The study design was considered, and the significant difference determined by the non-overlapping of 95% Confidence Interval. The mean ideal CVH score was 4.0, higher for females, adolescents aged 15-17 years, and students from private schools. The prevalence of ideal fasting plasma glucose was 96%, of non-smoking 95.6%, of ideal blood pressure 75.5%, of ideal BMI 73.2%, of ideal total cholesterol 55.4%, of ideal physical activity 45.2%, and only 0.5% had an ideal diet. The prevalence of ideal CVH metrics varied according to demographics and socioeconomic characteristics. CONCLUSION: Females, older adolescents, and students who attended private school had a better CVH. Demographics and socioeconomic characteristics were associated with CVH metrics. The low ideal proportions found for diet and physical activity are of concern and reinforce the need for food and nutritional educational actions designed to promote healthy behaviors in adolescence to prevent the development of cardiovascular diseases.

Clodronate for treatment of bone metastases in hormone refractory prostate cancer

INTRODUCTION: Approximately 85 percent of patients who die from prostate cancer have bone metastases. Even though the radiological aspect of such metastases is osteoblastic, we currently know that these lesions are mixed, with coexisting blastic and lytic lesions, always beginning with bone lysis by osteoclast proliferation. Treatment options are palliative and have poor response, and when there is an improvement it is usually short-lived. This work intends to study the effect of clodronate in the treatment of skeletal complications of prostate cancer. MATERIALS AND METHODS: In an open prospective study 32 patients with hormone refractory prostate cancer with metastases to bones were assessed, in the period between November 2000 and September 2002. Mean age was 69 years (51 to 83 years). Patients were previously assessed by a pain scale and Karnofsky index. They underwent bone scintigraphy, X-ray, dosage of prostate specific antigen (PSA) and biochemical tests before and following treatment (administration of intravenous clodronate every 28 days). The Student's t-test was used for statistical analysis. RESULTS: Twenty-nine patients (90.6 percent) showed improvement after the first and the 2nd cycles, which persisted for at least 4 months. Average on the pain scale improved from 7.7 to 2.1 and Karnofsky index raised from 42 to 71. Radiological aspect of the metastases improved in 15 patients (46.8 percent) and side effects were low (only 2 patients - 6.2 percent). CONCLUSION: Bisphosphonate was effective in the treatment of skeletal complications of prostate cancer, presenting an objective response in 90.6 percent of treated patients, with a marked improvement in the pain scale, Karnofsky index and consequently in the quality of life of patients, and with low side effects.

Clodronate for treatment of bone metastases in hormone refractory prostate cancer.

INTRODUCTION: Approximately 85% of patients who die from prostate cancer have bone metastases. Even though the radiological aspect of such metastases is osteoblastic, we currently know that these lesions are mixed, with coexisting blastic and lytic lesions, always beginning with bone lysis by osteoclast proliferation. Treatment options are palliative and have poor response, and when there is an improvement it is usually short-lived. This work intends to study the effect of clodronate in the treatment of skeletal complications of prostate cancer. MATERIALS AND METHODS: In an open prospective study 32 patients with hormone refractory prostate cancer with metastases to bones were assessed, in the period between November 2000 and September 2002. Mean age was 69 years (51 to 83 years). Patients were previously assessed by a pain scale and Karnofsky index. They underwent bone scintigraphy, X-ray, dosage of prostate specific antigen (PSA) and biochemical tests before and following treatment (administration of intravenous clodronate every 28 days). The Student's t-test was used for statistical analysis. RESULTS: Twenty-nine patients (90.6%) showed improvement after the first and the 2nd cycles, which persisted for at least 4 months. Average on the pain scale improved from 7.7 to 2.1 and Karnofsky index raised from 42 to 71. Radiological aspect of the metastases improved in 15 patients (46.8%) and side effects were low (only 2 patients - 6.2%). CONCLUSION: Bisphosphonate was effective in the treatment of skeletal complications of prostate cancer, presenting an objective response in 90.6% of treated patients, with a marked improvement in the pain scale, Karnofsky index and consequently in the quality of life of patients, and with low side effects.

Localized prostatic cancer in patients submitted to renal transplant.

OBJECTIVE: An attempt is made to evaluate the incidence of prostate cancer in patients who have previously undergone a kidney transplant surgery and to determine the best therapeutic approach to this target group. MATERIAL AND METHODS: All kidney transplant male patients over 40 years of age were studied with respect to diseases unrelated to the transplants, which later affected them, mainly focusing on neoplastic disease and, more specifically, prostate cancer. RESULTS: Of 397 kidney-transplanted patients, 146 (37%) were males, at least 40 years old. Among the 10 of them (6.8%) who developed neoplastic diseases, there were two cases (1.4%) of prostatic cancer. Both were treated with a radical retropubic prostatectomy with no technical difficulty, in spite of the presence of a graft in one of the iliac fossa. CONCLUSIONS: Prostate cancer incidence in kidney transplant patients is still low (1.8%), but it will certainly heighten as transplants are performed in increasingly older people and as better immunosuppressive drugs are introduced to lengthen the survival of grafts and patients. Because these cancers are expected to be more aggressive as a consequence of continuous immunosuppression, early diagnosis is of critical importance, and those patients should be made aware of the need for frequent screening for prostate cancer.

Orquiectomia total versus orquiectomia subcapsular para tratamento de câncer de próstata metastático: comparaçäo dos níveis pré e pós operatórios de testosterona total e PSA / Total versus subcapsular orchiectomy for treatment of advanced prostatic carcinoma: comparison of serum testosterone and PSA levels

No momento do diagnóstico do câncer prostático, grande parte dos pacientes já tem doença disseminada. O tratamento com deprivaçäo androgênica é o mais indicado nesses casos, sendo a orquiectomia um método muito eficaz, que porém pode trazer consequências psicológicas. Alguns autores defendem a orquiectomia total (OT) com o argumento de que células de Leydig podem permanecer na albugínea quando a orquiectomia subcapsular (OS) é realizada, podendo comprometer a deprivaçäo hormonal. Com o objetivo de comparar a OT com a OS foi realizado um estudo com 58 pacientes com câncer de próstata estádio-D2, divididos em 2 grupos randomizados (grupo A: pacientes submetidos a OT e grupo B: 30 pacientes com OS). Dosou-se a testosterona total e o PSA imediatamente antes da cirurgia e 6 meses após. Utilizou-se o teste "t" de student para comparaçäo entre os grupos, näo sendo encontrada diferença entre eles. Conclui-se que as duas técnicas säo semelhantes sendo que a OS tem a vantagem de diminuir os traumas psicológicos e diminuir custos com a colocaçäo de próteses

Associaçao doença de Crohn e cancer: relato de 4 casos / Crohn's disease and cancer: report of four cases

Sao apresentados quatro casos de doença de Crohn e neoplasia de colon operados no periodo de 1985 a 1988 na Real e Benemeria Sociedade Portuguesa de Beneficiencia e Hospital Osvaldo Cruz de Sao Paulo. Um dos pacientes era portador de ilecolite de Crohn e fistula lombar; o diagnostico de tumor so foi realizado pelo estudo histologico da peça ressecada, sendo detectado tumor de ceco classificaçao Astler Coller B2 (Pac.1). Dois tinham doença de Crohn de colon esquerdo e havia suspeita radiologica de presença de tumor de sigmoide. O diagnostico foi confirmado e o tumor era do tipo Astler Coller B2. O quarto paciente havia sido submetido a ressecçao por doença de Crohn do ileo terminal. Dez anos apos, foi atendido com quadro agudo de diarreia, sendo feito diagnostico de recidiva externa emileo terminal e metastases hepaticas. Na laparotomia foi evidenciada a presença de tumor na anastomose ileo-colica, metastases hepaticas e carcinomatose. Os AA chamam atençao para a possibilidade de associaçao de doença de Crohn a neoplasia e para adificuldade na detecçao precoce. Enfatizam a importancia doseguimento cuidadoso dos doentes com doença de Crohn de longa evoluçao a semelhança da conduta adotada para a retocolite ulcerativa