Sex and gender disparities in patients with advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry.

BACKGROUND: Recommendations for research articles include the use of the term sex when reporting biological factors and gender for identities or psychosocial or cultural factors. There is an increasing awareness of incorporating the effect of sex and gender on cancer outcomes. Thus, these types of analyses for advanced gastroesophageal adenocarcinoma are relevant. PATIENTS AND METHODS: Patients with advanced gastroesophageal adenocarcinoma from the Spanish AGAMENON-SEOM registry treated with first-line combination chemotherapy were selected. Epidemiology, characteristics of the disease, treatment selection, and results were examined according to sex. RESULTS: This analysis included 3274 advanced gastroesophageal adenocarcinoma patients treated with combination chemotherapy between 2008 and 2021: 2313 (70.7%) men and 961 (29.3%) women. Tumors in females were more frequently HER2-negative (67.8% versus 60.8%; P < 0.0001), grade 3 (45.4% versus 36.8%; P < 0.001), diffuse (43.3% versus 26.5%; P < 0.0001), and signet ring cell histology (40.5 versus 23.9%; P < 0.0001). Peritoneal spread was more common in women (58.6% versus 38.9%; P < 0.0001), while liver burden was lower (58.9% versus 71.1%; P < 0.0001). There were no significant differences in treatment recommendation. Treatment doses, density, and duration were comparable between sexes. Women experienced more diarrhea (46% versus 37%; P < 0.0001), neutropenia (51% versus 43%; P < 0.0001), and anemia (62% versus 57%; P < 0.0001). After a median 59.6-month follow-up [95% confidence interval (CI) 54.5-70.8], there were no statistically significant differences between the sexes in progression-free survival [6.21 months (95% CI 5.8-6.5 months) versus 6.08 months (95% CI 5.8-6.3 months); log-rank test, χ2 = 0.1, 1 df, P = 0.8] or in overall survival [10.6 months (95% CI 9.8-11.1 months) versus 10.9 months (95% CI 10.4-11.4 months); log-rank test: χ2 = 0.6, 1 df, P = 0.5]. CONCLUSION: This sex analysis of patients with advanced gastroesophageal adenocarcinoma from the AGAMENON-SEOM registry receiving first-line polychemotherapy found no differences in survival. Although women had worse prognostic histopathology, metastatic disease pattern, and greater toxicity, treatment allocation and compliance were equivalent.

Intake, digestibility, ingestive behavior, and nitrogen balance of goats fed with diets containing residue from tamarind fruit.

This study is aimed at determining the maximum inclusion level of tamarind (Tamarindus indica) residues in the diet of goats on intake, digestibility, ingestive behavior, and nitrogen (N) balance. Twenty-four crossbred (Boer × undefined breed) castrated goat kids (5 months old and with an initial weight of 23.9 ± 0.3 kg) were assigned in a completely randomized design (4 treatments and 6 replicates). Diets consisted of Tifton 85 (Cynodon sp.) hay as the roughage (400 g/kg) source and concentrate (600 g/kg); the levels of tamarind residue inclusion were 0.0, 7.0, 14.0, and 21.0% on a dry matter (DM) basis. The experimental period lasted 23 days (15 of adaptation and 8 of sampling). Inclusion of tamarind residue in the goat kid diets did not affect (P > 0.05) the intake and digestibility of DM, crude protein, neutral detergent fiber (NDF), and total digestible nutrient; intake of N, urinary N, and retained N (g/day); time spent ruminating; numbers of times/day feeding, ruminating, or idling; eating efficiency of DM and NDF; number of boluses/day; and amount (g) of DM/bolus. However, there were a linear reduction in ether extract digestibility (P = 0.011) and a linear decreasing trend in non-fibrous carbohydrate digestibility (P = 0.083). The addition of tamarind residue had a positive linear effect (P = 0.041) on the time spent feeding and promoted a decreasing linear trend for the time spent idling (P = 0.063). It is recommended to include the residue from tamarind fruit at a level of 21% in diets for goat kids, as it does not affect nutrient intake and digestibility and the N balance.

Comportamento ingestivo de cordeiros Santa Inês alimentados com resíduo de cervejaria desidratado / Ingestive behavior of Santa Ines lambs fed rations containing dehydrated brewery residue

Objetivou-se avaliar o comportamento ingestivo de cordeiros Santa Inês alimentados com resíduo de cervejaria desidratado (RCD). Foram utilizados 35 cordeiros, machos, não castrados, com peso médio inicial de 16,00±1,69kg e, aproximadamente, 70 dias de idade. Adotou-se o delineamento inteiramente ao acaso, com cinco tratamentos e sete repetições, consistindo os tratamentos em: 0; 20; 40; 60 e 80% de inclusão de RCD na porção concentrada da ração. A inclusão de RCD na ração não influenciou o tempo de alimentação (TAL; h/dia) e a eficiência de alimentação (gFDN/h; P>0,05). O TAL obtido neste estudo apresentou valor médio de 4,90h/dia. Observou-se efeito linear decrescente (P<0,05) com a inclusão do RCD, para as eficiências de alimentação (gMS/h) e ruminação (gMS/h e gFDN/h). Contudo, efeito linear crescente (P<0,05) foi constatado para tempo de ruminação e mastigação total, bem como para o número de mastigações merícicas por dia para os animais alimentados com o subproduto. A inclusão de resíduo de cervejaria desidratado influencia o comportamento ingestivo de cordeiros Santa Inês, diminuindo a eficiência de alimentação, quando relacionada ao consumo de matéria seca por hora, e aumentando o tempo de ruminação, podendo ser adicionado em até 20% na porção concentrada da ração.(AU)

The aim of this study was to evaluate the ingestive behavior of Santa Ines lambs fed dehydrated brewer's residue (DBR). Thirty-five male lambs were used, with an initial mean weight of 16.00±1.69kg and, approximately, 70 days of age. A completely randomized design was used, with five treatments and seven replicates, the treatments being: 0; 20; 40; 60 and 80% of inclusion of DBR in the concentrated portion of the ration. The inclusion of DBR in the ration did not influence feeding time (FT; h/day) and feeding efficiency (gNDF/h; P> 0.05). The FT obtained in this study had an average value of 4.90h/day. There was a decreasing linear effect (P< 0.05) for feed efficiency (gDM/h) and rumination efficiency (gDM/h and gNDF/h). However, linear increasing effect (P< 0.05) was observed for rumination and total chewing time, as well as for the number of chews per day for animals fed with the byproduct. The inclusion of dehydrated brewer's residue in the concentrate can influence the ingestive behavior of Santa Ines lambs, reducing feed efficiency, when related to the dry matter intake per hour, and increasing the total rumination time in Santa Ines lambs, it can be added up to 20% in the concentrated portion of the ration.(AU)

Trifluridine/Tipiracil (TAS-102) for refractory metastatic colorectal cancer in clinical practice: a feasible alternative for patients with good performance status.

INTRODUCTION: Our aim was to assess efficacy and safety and prognostic factors associated with TAS-102 in clinical practice. METHOD: Retrospective, multicenter, and observational study including patients with advanced refractory colorectal cancer who started TAS-102 between March 2016 and August 2018. The primary end point was overall survival (OS). Secondary end points included progression-free survival, toxicity and analyze prognostic factors present at the beginning of TAS-102. RESULT: 84 patients were evaluable. The median OS was 8.30 (95% CI 6.23-9.87) months and PFS was 2.62 (95% CI 2.36-3.05) months. In multivariate analysis, ECOG 0 and reduced dose combined with more cycles were associated with better prognosis. Patients with an ECOG > 0 had worse prognosis (HR 3.34, 95% CI 1.09-10.27, p = 0.035). 95.2% experienced some type of adverse effect and 45.2% had grade ≥ 3 toxicities. CONCLUSION: Results suggest reconsidering TAS-102 in patients with ECOG > 0, something that should be investigated in prospective randomized clinical trials.

Características y calidad de las guías de práctica clínica en el Seguro Social de Salud del Perú / Characteristics and quality of the of clinical practice guidelines in the Social Security of Health of Peru

Objetivo: Elaborar una línea de base al describir las características y calidad de las guías de práctica clínica (GPC) del Seguro Social de Salud del Perú (EsSalud) producidas hasta diciembre de 2015. Material y métodos: Estudio de corte transversal. Se solicitaron las GPC de las 33 redes asistenciales de EsSalud hasta diciembre de 2015. Se evaluó la calidad metodológica con el instrumento AGREE II. Resultados: Se recibieron 710 GPC; el 79% de estas fueron desarrolladas en Lima y Callao, siendo la mayoría del área clínica (62%) y con una antigüedad mayor de 5 años (52%). Se realizó la evaluación de calidad de 31 GPC; se obtuvieron puntuaciones bajas en los 6 dominios, siendo los referidos al rigor metodológico (6%) y aplicabilidad (8%) los que menor promedio obtuvieron. Las GPC elaboradas en regiones diferentes a Lima y Callao obtuvieron puntajes promedios aún menores. Conclusiones: Existe una creciente producción de GPC, pero de baja calidad y poco recomendables para ser usadas

Objective: To describe the characteristics and quality of the clinical practice guidelines (CPG) of the Social Security of Health (EsSalud) of Peru. Material and methods: A cross-sectional study was conducted on the CPGs of the 33 EsSalud networks. The methodological quality of 31 CPGs was evaluated using the AGREE II tool. Results: A total of 710 CPGs were assessed, of which 79% were developed in Lima and Callao, with the majority being from the clinical area (62%), and more than 5 years in use (52%). In the quality evaluation of 31 CPGs, low scores were obtained in the 6 domains, with those referring to the methodological rigour (6%) and applicability (8%) obtaining the lowest mean scores. The CPGs developed in regions other than those of Lima and Callao obtained even lower mean scores. Conclusions: There is an increasing production of CPGs, but of low quality and not really recommended for use

[Characteristics and quality of the of clinical practice guidelines in the Social Security of Health of Peru]. / Características y calidad de las guías de práctica clínica en el Seguro Social de Salud del Perú.

OBJECTIVE: To describe the characteristics and quality of the clinical practice guidelines (CPG) of the Social Security of Health (EsSalud) of Peru. MATERIAL AND METHODS: A cross-sectional study was conducted on the CPGs of the 33 EsSalud networks. The methodological quality of 31 CPGs was evaluated using the AGREE II tool. RESULTS: A total of 710 CPGs were assessed, of which 79% were developed in Lima and Callao, with the majority being from the clinical area (62%), and more than 5 years in use (52%). In the quality evaluation of 31 CPGs, low scores were obtained in the 6 domains, with those referring to the methodological rigour (6%) and applicability (8%) obtaining the lowest mean scores. The CPGs developed in regions other than those of Lima and Callao obtained even lower mean scores. CONCLUSIONS: There is an increasing production of CPGs, but of low quality and not really recommended for use.

Composição de ácidos graxos do queijo e leite de vacas alimentadas com casca de banana / Fatty acid composition of cheese and milk of cows fed with banana peel

Objetivou-se avaliar os níveis de casca de banana seca ao sol na dieta de vacas F1 Holandês x Zebu sobre o perfil de ácidos graxos do leite e do queijo minas frescal. Os tratamentos foram constituídos de 0, 15, 30, 45 e 60% de substituição da silagem de sorgo pela casca de banana. O delineamento experimental foi em dois quadrados latinos 5 x 5 simultâneos. As amostras de leite e queijo foram analisadas quanto ao perfil de ácidos graxos por cromatografia gasosa. Observou-se efeito quadrático para o somatório de ácidos graxos poli-insaturados do leite, com valor máximo no nível de 23,54% de substituição. Houve efeito linear decrescente para os ácidos graxos C15:0 iso e C16:0 iso. Os ácidos graxos heneicosanoico, linoleico, linoleico conjugado e araquidônico apresentaram efeito quadrático. Não houve efeito das dietas sobre os ácidos graxos no queijo. A substituição de até 60% da silagem de sorgo por casca de banana na dieta de vacas em lactação pode ser alternativa para produção e processamento do leite, quando se considera a melhora no valor nutricional da fração lipídica do leite e o aumento dos teores de ácido linoleico conjugado.(AU)

This study aimed to evaluate the inclusion levels of dry banana peel in the sun in the diet of F1 Holstein x Zebu cows on the profile of fatty acids of milk and Minas fresh cheese. The diets were composed of 0, 15, 30, 45, and 60% replacement of sorghum silage by banana peel. The experimental design was Latin squares, simultaneous, 5 x 5. Samples of milk and cheese were analyzed for fatty acid composition by gas chromatography. Quadratic effect for the sum of milk polyunsaturated fatty acids, with the maximum level of 23,54% replacement. There was a decreasing linear effect for C15:0 iso fatty acids and C16: 0 iso. The heneicosanoic fatty acids, linoleic, conjugated linoleic and arachidonic presented quadratic effect. There was no effect of diets on fatty acids in cheese. Replacement of up to 60% of the sorghum silage of a banana peel in the diet of cows can be an alternative to milk production and processing when considering the improvement in the nutritional value of the milk lipid fraction and increase of the levels of conjugated linoleic acid.(AU)

Foramen oval permeable diagnosticado con comprobación ecocardiográfica de catéter venoso central / Patent foramen ovale diagnosed with echocardiographic checking of the positioning of a central venous catheter

No disponible

Taponamiento cardíaco por neumopericardio debido a lesión de arma blanca / Cardiac tamponade by pneumopericardium due to stab injury

No disponible

Dolicoectasia del tronco braquiocefálico objetivada en la valoración ecográfica previa traqueostomía percutánea / Innominate artery dolichoectasia identified during ultrasound assessment prior to percutaneous tracheostomy

No disponible

Dentin Optical Density in Molars Subjected to Partial Carious Dentin Removal.

AIM: This study aimed to evaluate changes in the optical density of dentin in primary molars with deep caries three to six months after they were subjected to partial carious dentin removal. STUDY DESIGN: This was a blind controlled, clinical therapy study. Standardized digitalized bitewing radiographs of 42 teeth were analyzed using Adobe Photoshop(®) to quantitatively determine the gray scale of the affected dentin beneath the restoration, in comparison with healthy dentin. A mixed-effects model was used for statistical analysis. The gray tone level was considered a dependent variable; the tooth region and the time, in addition to the interaction between them, were the independent variables. Values of p < 0.05 were significant. RESULTS: During the interval between time zero and three months, the gray tone levels of affected dentin varied from 80.99 ± 3.17 to 98.57 ± 3.17; i.e., an estimated increase of 18 (p < 0.0001). The values for healthy dentin ranged from 118.22 ± 3.17 to 122.02 ± 3.17; i.e., a mean increase of four in the gray tone levels (p = 0.0003). During the interval between three and six months, both healthy and affected dentin showed similar behavior (98.57 ± 3.17 to 103.32 ± 3.20 and 122.02 ± 3.7 to 126.56 ± 3.20, respectively) (p = 0.0001). CONCLUSIONS: Significant increments were observed in the optical density of the affected dentin after three months compared to that of healthy dentin in primary molars treated using the partial carious dentin removal technique.

Parâmetros nutricionais e padrões nictemeral do comportamento ingestivo de cordeiros Somalis Brasileira alimentados com diferentes níveis de energia metabolizável / Nutritional parameters and nycterohemeral patterns of ingestive behavior of Brazilian Somali lambs fed different levels of metabolizable energy

O presente estudo foi conduzido para determinar o consumo e a digestibilidade dos nutrientes, bem como o comportamento ingestivo de cordeiros Somalis Brasileira, alimentados com diferentes níveis de energia metabolizável (EM). Foram utilizados 40 animais, não castrados, com peso vivo médio de 13,47±1,76kg. Os animais foram distribuídos em delineamento em blocos ao acaso, com cinco dietas com diferentes níveis de energia metabolizável (1,18; 2,07; 2,25; 2,42 e 2,69Mcal/kg de MS). O consumo de MS, PB, FDN, CF (g/dia), MS (g/kg0,75) e FDN (%PC e g/kg0,75) apresentaram efeito quadrático (P<0,05), assim como os coeficientes de digestibilidade (P<0,05) da PB, da FDN e dos CF. Foi averiguado efeito linear crescente (P<0,05) para digestibilidade da MS, da MO e dos CNF com o aumento da EM na dieta. Os tempos de alimentação e ócio (h/dia) foram influenciados pelos níveis de energia (P<0,05), e as eficiências de alimentação e ruminação (g FDN/h) apresentaram efeito quadrático (P<0,05). Conclui-se que o aumento dos níveis de EM das rações influencia o consumo e a digestibilidade dos nutrientes, bem como o comportamento ingestivo de cordeiros Somalis Brasileira...

The study was conducted to determine the intake, nutrient digestibility and ingestive behavior of Brazilian Somali lambs fed different levels of metabolizable energy (ME). Forty non-castrated Brazilian Somali lambs with average weight of 13.47±1.76kg were used. The animals were assigned to a randomized block design with eight replications per block and five diets with increasing metabolizable energy (1.18, 2.07, 2.25, 2.42 and 2.69 Mcal/kg DM). The quadratic effect (P<0.05) of the ME level was determined for DM, CP, NDF and FC (g/day) and DM (g/kg0,75) and NDF(%PC and g/kg0,75) intake, as well as the digestibility coefficients (P<0.05) for CP, NDF and CF. A linear effect (P<0.05) was observed for digestibility of DM, OM and NFC with the increase of ME in the diet. Eating and idle results (hours/day) were influenced by the energy levels (P<0.05) and efficiencies of feeding and rumination (g NDF/h) showed a quadratic effect (P<0.05). It is concluded that the increase of ME levels in the diet influences intatke, nutrient digestibility and ingestive behavior of Brazilian Somali lambs...

Genetic damage induced by CrO3 can be reduced by low doses of Protoporphyrin-IX in somatic cells of Drosophila melanogaster.

Several epidemiological studies have reported the relation between chromium exposure (used in different industrial processes) and cancer risk. Evidence indicates that the hexavalent form is mutagenic and carcinogenic. Chemoprevention has emerged as a good strategy for reducing the risk from exposure to heavy metals. There is evidence that some tetrapyrrols such as protoporphyrin IX (PP-IX), a porphyrin without a metal center and which is a precursor of hemoglobin and cytochrome, acts as an antioxidant modulating the induction of antioxidant enzymes. The present study was performed to evaluate their antimutagenic potential of PP-IX against genetic damage induced by chromium trioxide (CrO3). The wing spot test was used. Groups of 48 h-old larvae were pretreated for 24 h with 0, 0.69, 6.9, or 69 mM of PP-IX, after which groups of larvae were fed 0.025-2.5 mM CrO3 solution in Drosophila instant medium. The results indicated that the lower PP-IX concentration (0.69 mM) significantly reduced the genetic damage induced by all CrO3 concentrations tested. In contrast, 6.9 and 69 mM only inhibited the damage induced by CrO3 2.5 mM. Absence of an inhibitor effect of PP-IX against 20 Gy gamma rays suggested that this porphyrin acted primarily by forming complexes with chromium at low doses, inactivating its genotoxic action rather than capturing or inactivating the reactive oxygen species generated by the chromium.

Parâmetros da fermentação ruminal e concentração de derivados de purina de vacas em lactação alimentadas com castanha de caju / Ruminal fermentative parameters and concentration of purine derivatives in lactating dairy cows fed cashew nut

Avaliaram-se os parâmetros de fermentação ruminal e a concentração de derivados de purinas na urina de vacas leiteiras alimentadas com teores crescentes de castanha de caju na dieta. Foram utilizadas oito vacas Holandesas multíparas, sendo quatro fistuladas no rúmen, com produção média de 28±4kg de leite/dia. O delineamento experimental adotado foi o quadrado latino 4x4, com parcelas subdivididas para os parâmetros ruminais e duplo para determinação dos derivados de purina. Os tratamentos avaliados consistiram na inclusão de 0; 8; 16 e 24% de castanha de caju moída na porção concentrada da dieta. O comportamento do pH ruminal foi semelhante entre as dietas avaliadas segundo os tempos após alimentação. A concentração média de nitrogênio amoniacal foi 12,70mg/100mL de líquido ruminal. Os valores médios de acetato e butirato apresentaram padrão linear de resposta, contudo a relação acetato:propionato não foi alterada pela adição do coproduto. As excreções de derivados de purina na urina não variaram significativamente (P>0,05) com a adição de castanha de caju. A inclusão de castanha de caju não afetou os parâmetros de fermentação ruminal nem as concentrações de derivados de purinas; dessa forma, pode ser recomendada como alternativa potencial na alimentação de vacas leiteiras em lactação.

The parameters of rumen fermentation and the concentration of purine derivatives in the urine of dairy cows fed with increasing levels of cashew nut in the diet were evaluated. Eight multiparous holstein cows were used, being four rumen cannulated, with average production of 28±4kg of milk/day. The experimental design adopted was a 4x4 Latin square with split plots for the ruminal parameters and double for the determination of purine derivatives. The treatments consisted of the inclusion of 0; 8; 16 and 24% of cashew nut in the concentrate portion of the diet. The behavior of the ruminal pH was similar between the evaluated diets according to the time after feeding. The average concentration of ammonia nitrogen was 12.70mg/100mL of rumen fluid. The average values of acetate and butyrate showed a linear response, but the acetate:propionate ratio wasnot altered by the addition of the coproduct. The excretions of purine derivatives in urine did not differ significantly (P>0.05) with the addition of cashew nut. The inclusion of cashew nut did not affect ruminal fermentation parameters neither the concentrations of purine derivatives, so it can be recommended as a potential alternative for feeding dairy cows.

Consumo, digestibilidade dos nutrientes e comportamento ingestivo de vacas leiteiras alimentadas com castanha de caju / Intake, digestibility of nutrients and ingestive behavior of dairy cows fed with cashew nut

Avaliou-se o efeito da inclusão de castanha de caju (CC) - 0, 8, 16 e 24% - na porção concentrada da ração sobre o consumo, a digestibilidade aparente dos nutrientes e o comportamento ingestivo em oito vacas Holandesas pluríparas, com produção média de 28±4kg de leite/dia, dispostas em delineamento quadrado latino 4x4, duplo. A silagem de milho foi utilizada como alimento volumoso único. A CC contribuiu com, aproximadamente, 46,0; 61,8 e 67,7% do total de extrato etéreo presente no concentrado quando a inclusão foi de 8, 16 e 24%, respectivamente. O consumo de matéria seca não foi alterado em função da inclusão de CC na ração, apresentando valor médio de 21,29kg/dia. A digestibilidade da matéria seca e dos nutrientes apresentaram variações que não foram relacionadas ao aumento no teor de lipídeos das dietas. Embora tenha sido observada redução no tempo de ingestão de matéria seca, o tempo despendido com a ruminação possibilitou que a atividade mastigatória não fosse afetada pela suplementação lipídica. A maior proporção de CC adicionada ao concentrado, 24%, não influenciou o consumo, a digestibilidade aparente dos nutrientes e o comportamento ingestivo, dessa forma pode ser recomendada como alternativa potencial na alimentação de vacas leiteiras em lactação.

The effect of the inclusion of cashew nut (CN) at the amounts of 0, 8, 16 e 24% in the concentrate portion of the ration on the intake, apparent digestibility of nutrients and ingestive behavior was evaluated, using eight Holstein dairy cows, producing 28±4kg milk/day, allocated in a 4x4 double Latin Square Design. Corn silage was used as main forage. The CN contributed with approximately 46.0; 61.8 and 67.7% of total ether extract present in the concentrate when the inclusion levels were 8, 16 and 24%, respectively. The dry matter intake was not altered by the inclusion of CN in the rations, showing mean value of 21.29kg/day. The digestibility of dry matter and nutrients showed variations that were not related to the increased lipid content of the rations. Although reductions have been observed in the time spent with dry matter intake, the time spent ruminating enabled the chewing activity to not be affected by fat supplementation. The highest proportion of CN added to the concentrate (24%) did not influence the intake, apparent digestibility and ingestive behavior, so it can be recommended as a potential alternative for feeding dairy cows.

Multi-elemental analysis of produced water by synchrotron radiation total reflection X-ray fluorescence.

The synchrotron radiation total reflection X-ray fluorescence (SRTXRF) technique was used for the analysis of heavy metals in produced water samples from oil field in Rio Grande do Norte, in order to determine potential sources of pollution. Since the inorganic components in produced water generally resembling sea water, pre-concentration procedures have been applied to increase the concentration of the analyte of interest and to minimize the salt matrix effects. This technique allows us to determine the contents of V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Hg and Pb in 20 produced water samples. The great majority of the sampling points presented low elemental concentration value. However, in some sample, the Fe, Ni, Cu, Zn and Hg concentration were higher than the established limits by the Brazilian legislation.