Perioperative, Oncological, and Functional Outcomes Between Robot-Assisted Laparoscopic Prostatectomy and Open Radical Retropubic Prostatectomy: A Randomized Clinical Trial.

PURPOSE: Limited high-quality studies have compared robot-assisted laparoscopic prostatectomy (RALP) vs open retropubic radical prostatectomy. We sought to compare their postoperative outcomes in a randomized setting. MATERIALS AND METHODS: In a single center, 354 men with newly diagnosed prostate cancer were assessed for eligibility; 342 were randomized (1:1). The primary outcome was 90-day complication rates. Functional outcomes and quality of life were assessed over 18 months, and oncological outcomes, biochemical recurrence-free survival, and additional treatment over 36 months. RESULTS: From 2014 to 18, 327 patients underwent surgery (retropubic radical prostatectomy = 156, RALP = 171). Complications occurred in 27 (17.3%) vs 19 (11.1%; P = .107). Patients undergoing RALP experienced lower median bleeding (250.0 vs 719.5 mL; P < .001) and shorter hospitalization time. Urinary EPIC (Expanded Prostate Cancer Index Composite) median scores were better for RALP over 18 months, with higher continence rate at 3 months (80.5% vs 64.7%; P = .002), 6 months (90.1% vs 81.6%; P = .036) and 18 months (95.4% vs 78.8%; P < .001). Sexual EPIC and Sexual Health Inventory for Men median scores were higher with RALP up to 12 months, while the potency rate was superior at 3 months (23.9% vs 5.3%; P = .001) and 6 months (30.6% vs 6.9%; P < .001). Quality of life over the 18 months and oncological outcomes over 36 months were not significantly different between arms. CONCLUSIONS: Complications at 90 days were similar. RALP showed superior sexual outcomes at 1 year, improved urinary outcomes at 18 months, and comparable oncological outcomes at 36 months.

Multiple Stool Sampling and Specific Parasitological Technique are Crucial to Diagnose Strongyloidiasis in Alcoholic Patients.

PURPOSE: Chronic alcoholism is a well-known risk factor for strongyloidiasis, in these patients the disease is potentially more severe, probably due to the breakdown of local protective barriers and immunosuppression caused by alcohol, which can lead to autoinfection and dissemination. The aim of this study was to evaluate multiple stool sampling and a specific parasitological assay agar plate culture (APC) for the diagnosis of Strongyloides stercoralis in alcoholics. METHODS: APC was compared to sedimentation technique (HPJ; Hoffman, Pons and Janer), as parasitological methods to detect S. stercoralis infection in alcoholic individuals. Three stool samples from 60 alcoholic and 60 non-alcoholic individuals were analyzed. RESULTS: S. stercoralis larvae were observed in 11 (18.3%) alcoholic individuals and 1 (1.7%) nonalcoholic individual (P = 0.0042). In view of the combined results, sensitivity for the APC method was 63.6% (CI 31.6-87.6%) with the first sample reaching 100% (CI 67.8-100%) after analyzing three fecal samples. The HPJ sensitivity was 36.4% (CI 12.4-68.4) in the first sample, reaching 72.7% (CI 39.3-92.7) after three samples analyzed. CONCLUSION: The present results suggest that in alcoholic patients, it is important to repeat stool sampling with specific techniques, especially using the APC method, to avoid misdiagnosis in cases that could evolve to disseminated strongyloidiasis.

Lymph node microcalcifications after neoadjuvant chemotherapy: A therapeutic response marker.

Lymph node microcalcifications are rare events, and when they are accompanied by neoplasia, they usually seem to be associated with a metastatic condition. We present a case of a patient with breast cancer and lymph node microcalcifications undergoing neoadjuvant chemotherapy (NCT). A change in the calcification pattern towards becoming coarse was observed. Calcification represented a marker of axillary disease, and it was resected after NCT. This is the first report of a patient with lymph node microcalcification undergoing NCT. We observed a change in the calcification format, which facilitated lymph node sentinel identification. Pathological evaluation indicated metastatic disease.

Bleaching effectiveness and cytotoxicity of new experimental formulation of niobium-based bleaching gel.

OBJECTIVES: The development of new bleaching agents with minimum concentration of hydrogen peroxide (HP), without adverse effects, and with bleaching effectiveness, has great clinical relevance. The aim of this study was to evaluate the bleaching efficacy and cytotoxicity of a new niobium-based bleaching gel, compared to already available HP-based gels. MATERIALS AND METHODS: For the bleaching efficacy analysis, 40 bovine incisors were randomly divided into 4 groups according to the established bleaching protocol: control, untreated; 35HP, 35% HP bleaching gel; 6HP, 6% HP bleaching gel; NbHP, niobium gel associated with 3% HP gel. The color variation was measured in a spectrophotometer and the values of ΔL, Δa, Δb, and ΔE obtained. For the cell viability assay by MTT, MC3T3 cells were exposed to bleaching gel extracts (1:500, 1:250, 1:125 dilutions; immediately and 24 h). Statistical tests were performed (P < 0.05). RESULTS: The color alteration for all bleaching gels was significant compared to control (P < 0.05), but the NbHP gel showed a significant ΔE than other gels, with expressive color alteration at 14 days (P < 0.05). The 35HP showed high cytotoxicity regarding control and the most groups in all periods and extracts analyzed (P < 0.05), while the NbHP showed greater cell viability than control in the immediate period, dilution of the 1:500 and superior to 6HP in the most extracts at 24 h. CONCLUSION: The new experimental niobium-based gel has bleaching efficacy similar to that of gels with a high concentration of HP, and it has high cytocompatibility. CLINICAL RELEVANCE: The use of this new generation of niobium-based whitening gel associated with a low concentration of hydrogen peroxide represents the possibility of a tooth whitening with lower dentin sensitivity.

Sequels associated with breast cancer treatment: what is important to measure in a report

Breast cancer treatment is associated with functional sequelae that limit patients in their daily activities or work, impacting their quality of life. This fact becomes more noticeable in the Public System, the tumors are more advanced, leading to more aggressive treatments. Women with low education generally perform menial activities, playing an important role in family income. After cancer treatment, many are unable to carry out their usual activities, having difficulties with their work activities, requiring rehabilitation. These dysfunctions make it difficult or unfeasible to return to work, limiting family income. Knowledge of the Laws, the main sequelae and evaluation methodologies facilitates a more accurate diagnosis of functional conditions, determining the need for rehabilitation. Social Security provides economic support, but to have access to the benefit, a good report is necessary. This, well directed, helps the social security expert and the patients, who are generally so fragile by the disease and the treatment. In this article we discuss the main functional sequelae, how to evaluate them, and how to make a good report to be sent to an expert (AU)

Bioengineered Carboxymethylcellulose-Peptide Hybrid Nanozyme Cascade for Targeted Intracellular Biocatalytic-Magnetothermal Therapy of Brain Cancer Cells.

Glioblastoma remains the most lethal form of brain cancer, where hybrid nanomaterials biofunctionalized with polysaccharide peptides offer disruptive strategies relying on passive/active targeting and multimodal therapy for killing cancer cells. Thus, in this research, we report for the first time the rational design and synthesis of novel hybrid colloidal nanostructures composed of gold nanoparticles stabilized by trisodium citrate (AuNP@TSC) as the oxidase-like nanozyme, coupled with cobalt-doped superparamagnetic iron oxide nanoparticles stabilized by carboxymethylcellulose ligands (Co-MION@CMC) as the peroxidase-like nanozyme. They formed inorganic-inorganic dual-nanozyme systems functionalized by a carboxymethylcellulose biopolymer organic shell, which can trigger a biocatalytic cascade reaction in the cancer tumor microenvironment for the combination of magnetothermal-chemodynamic therapy. These nanoassemblies were produced through a green aqueous process under mild conditions and chemically biofunctionalized with integrin-targeting peptide (iRDG), creating bioengineered nanocarriers. The results demonstrated that the oxidase-like nanozyme (AuNP) was produced with a crystalline face-centered cubic nanostructure, spherical morphology (diameter = 16 ± 3 nm), zeta potential (ZP) of -50 ± 5 mV, and hydrodynamic diameter (DH) of 15 ± 1 nm. The peroxide-like nanostructure (POD, Co-MION@CMC) contained an inorganic crystalline core of magnetite and had a uniform spherical shape (2R = 7 ± 1 nm) which, summed to the contribution of the CMC shell, rendered a hydrodynamic diameter of 45 ± 4 nm and a negative surface charge (ZP = -41 ± 5 mV). Upon coupling both nanozymes, water-dispersible colloidal supramolecular vesicle-like organic-inorganic nanostructures were produced (AuNP//Co-MION@CMC, ZP = -45 ± 4 mV and DH = 28 ± 3 nm). They confirmed dual-nanozyme cascade biocatalytic activity targeted by polymer-peptide conjugates (AuNP//Co-MION@CMC_iRGD, ZP = -29 ± 3 mV and DH = 60 ± 4 nm) to kill brain cancer cells (i.e., bioenergy "starvation" by glucose deprivation and oxidative stress through reactive oxygen species generation), which was boosted by the magneto-hyperthermotherapy effect when submitted to the alternating magnetic field (i.e., induced local thermal stress by "nanoheaters"). This groundwork offers a wide avenue of opportunities to develop innovative theranostic nanoplatforms with multiple integrated functionalities for fighting cancer and reducing the harsh side effects of conventional chemotherapy.

Effect of pH, ionic strength, and temperature on the adsorption behavior of Acid Blue 113 onto mesoporous carbon.

Mesoporous carbon (MC) derived from cassava starch was used to remove Acid Blue 113 azo dye from aqueous solutions. The influence of temperature, pH, ionic strength, and the adsorbent dose was investigated in a set of batch experiments. Experimental data showed that Acid Blue 113 adsorption was higher in the acid pH range than in the alkaline one, that dye adsorption increases when the ionic strength and temperature increase, and that adsorption results presented a good correlation with the Langmuir isotherm model. The adsorption capacity of MC was 295 mg g-1, at pH = 7.0 and 298 K, respectively. Zeta potential (ζ) showed the compression of the diffuse double layer of adsorbent with an increase in temperature and ionic strength, promoting the decrease of electrostatic repulsion between the negatively charged surface of the carbon particles and the anionic dye. Thermodynamic results demonstrate that the adsorption process was spontaneous and endothermic. Moreover, for the first time, this work has demonstrated that the pH, temperature, and ionic strength of the aqueous medium are also able to change the surface charge of carbon-based adsorbents and surely influence the adsorption capacity. Finally, the regeneration of the adsorbent by the photo-Fenton reaction regenerated the adsorption capacity of the adsorbent without generating secondary pollution to the environment.

Use of Double Myocutaneous Flap after Extended Resection of Locally Advanced Ulcerated Breast Carcinoma.

Locally advanced ulcerated breast neoplasm is a condition that frequently occurs in developing countries. Generally, it is centrally localized and submitted to neoadjuvant therapy; thereafter, upon disappearance of the ulceration, it is submitted to radical mastectomy. Presence of axillary infiltration and ulceration with incomplete response makes it necessary for the use of surgical flaps for skin closure. We report a case in which primary reconstructive surgical procedure and skin closure was necessary, where we used double myocutaneous flaps-the latissimus dorsi and VRAM (vertical rectus abdominis myocutaneous) flap. We discussed treatment of the ulcerated lesions, possible surgical solutions, and the conditions associated with the use of double flaps. For primary closure of extensive areas, double myocutaneous flaps can be used as a solution in cases where skin grafts or surgical microsurgical flaps are not able to serve as a surgical solution. Myocutaneous flaps are associated with lower rates of complication, allowing for rapid recovery without increasing the time necessary before the next adjuvant therapy.

Lymphedema secondary to bartonellosis as a differential diagnosis of breast cancer

In the presence of unilateral axillary lymphadenopathy associated with a breast radiological finding, breast cancer should constitute the main differential diagnosis. This fact is intensified when there is associated lymphedema. We present a case of a patient in these conditions, for whom breast cancer was not confirmed, and a subsequent evaluation showed that it was cat-scratch disease. This report constitutes the second case of association between lymphedema and bartollenosis.

Iron Oxide Nanomaterials for the Removal of Cr(VI) and Pb(II) from Contaminated River After Mariana Mining Disaster.

If not properly treated, water contaminated with chromium (Cr(VI)) and lead (Pb(II)) can cause severe damage to health due to the accumulation of those toxic metals in the human body. Therefore, in this work, three iron oxides, i.e., δ-FeOOH, cystine-functionalized δ-FeOOH (Cys-δ-FeOOH), and Fe3O4, were synthesized and used as adsorbents for Cr(VI) and Pb(II) in water. The results indicated that the Cr(VI) is best adsorbed on cys-δ-FeOOH followed by δ-FeOOH and Fe3O4. It was because of the enhanced interaction between Cr(VI) and the cysteine functional groups on the δ-FeOOH surface. The Cr(VI) adsorption capacity of cys-δ-FeOOH, δ-FeOOH, and Fe3O4 was 217, 14, and 8 mg g-1, respectively. On the other hand, Pb(II) was preferentially adsorbed directly on δ-FeOOH achieving a maximum Pb(II) adsorption capacity of 174 mg g-1. The Pb(II) adsorption capacity of cys-δ-FeOOH and Fe3O4 was 97 and 74 mg g-1, respectively. The Cr(VI) adsorption on cys-δ-FeOOH was best described by the Langmuir-Freundlich model, whereas Pb(II) adsorption on δ-FeOOH followed the Langmuir model. Both Cr(VI) and Pb(II) adsorption on the adsorbents was well-fitted to pseudo-second-order kinetics. The Cr(VI) was more quickly adsorbed by cys-δ-FeOOH (h0 = 0.10 mg g-1 min-1) while the initial adsorption rate of Pb(II) onto δ-FeOOH was significantly faster (h0 = 16.34 mg g-1 min-1). Finally, the synthesized adsorbents were efficient to remove Cr(VI) and Pb(II) from water samples of the Doce river after the environmental disaster of Mariana city, Brazil, thus showing its applicability to remediate real water samples.

Removal of mercury(II) from contaminated water by gold-functionalised Fe3O4 magnetic nanoparticles.

Fe3O4 nanoparticles were prepared by co-precipitation of Fe2+ and Fe3+ and then modified with Au to produce an effective adsorbent (Fe3O4/Au) for aqueous Hg(II) in contaminated water. Rietveld refinement on the XRD pattern confirmed that the Fe3O4/Au was synthesised. Mössbauer spectra exhibited broad and asymmetric resonance lines with two sextets which can be assigned to tetrahedral Fe3+; and octahedral Fe3+/Fe2+. The quantitative analysis of magnetite confirms that the sample shows around 3 wt.% Au and 97 wt.% partially oxidised Fe3O4. High surface area: 121 m2 g-1, average pore sizes: 6.3 nm and pore volume: 1.64 cm3 g-1. The kinetics data were better fitted with a pseudo-second-order and Dubinin-Radushkevich isotherm suggests the Hg(II) adsorption onto Fe3O4/Au nanoparticles was mainly by chemical adsorption forming complex with the Au metal immobilised on Fe3O4 surfaces. Adsorption capacity of 79.59 mg g-1. Ionic strength and co-existing ions had a slight influence on the adsorption capacity.

Requisitos para o desenvolvimento de aplicações para dispositivos móveis na saúde para pessoas cegas, surdas e idosos / Requirements for applications' development for mobile devices in health for blind, deaf and elderly people

O presente estudo trata-se de uma revisão integrativa de literatura realizada com o objetivo de sintetizar o conhecimento acerca dos requisitos que têm sido utilizados para o desenvolvimento de aplicações móveis e/ou aplicações para dispositivos móveis na saúde para pessoas cegas, surdas e idosas. A busca dos estudos primários foi realizada no mês de setembro de 2019, nas bases de dados eletrônicas Pubmed, CINHAL, Web of Science e LILACS. A amostra foi constituída por 9 estudos, publicados no período de 2015 a 2019. Os dados foram extraídos com o auxílio de um instrumento validado, e posteriormente agrupados para discussão em duas categorias de acordo com os requisitos levantados e a população de interesse: Requisitos para deficientes visuais e Requisitos para pessoas idosas. Não foram localizados estudos que levantaram requisitos para pessoas com deficiência auditiva e surdos. Os estudos incluídos que levantaram requisitos para o desenvolvimento de aplicações na saúde para deficientes visuais abordaram a necessidade de recursos de leitura de tela (objetos e textos) com saída de voz ou feedback por voz, navegação por Global Positioning System (GPS) e ferramentas de auxílio em situações de emergência. Os requisitos levantados para pessoas idosas foram divididos em subcategorias: Linguagem e vocabulário compreensível; Treinamento para o uso de tecnologia e oferta de ajuda; Interface amigável e menos complexa; Configurações de texto (tamanho, fonte e estilos especiais); Cor e contraste (Textos, imagens e planos entre telas); Tamanho de botões e ícones; Interação por voz e áudio; Interações motoras, cognitivas e uso da memória do idoso; Segurança (situações de emergência e segurança de dados) e; Preferencia no desenvolvimento de aplicações em saúde e uso de smartphones. As evidências do estudo permitiram identificar requisitos para que profissionais da saúde, desenvolvedores de softwares, designers e outros profissionais interessados, possam desenvolver aplicações para diferentes dispositivos móveis na saúde atendendo as necessidades de pessoas com deficiência visual e idosos e dessa forma melhorar, problemas de uso, de interação e aceitabilidade.

This study is an integrative literature review carried out with the aim of synthesizing knowledge about the requirements that have been used for the development of mobile applications and / or applications for mobile devices in health for blind, deaf and elderly people. The search for primary studies was carried out in September 2019, in the electronic databases Pubmed, CINHAL, Web of Science and LILACS. The sample consisted of 9 studies, published in the period from 2015 to 2019. The data were extracted with the aid of a validated instrument, and later grouped for discussion in two categories according to the requirements raised and the population of interest: Requirements for visually impaired and Requirements for the elderly. No studies were found that raised requirements for hearing impaired and deaf people. The included studies that raised requirements for the development of health applications for the visually impaired addressed the need for screen reading resources (objects and texts) with voice output or voice feedback, Global Positioning System (GPS) navigation and assistance in emergency situations. The requirements raised for elderly people were divided into subcategories: Understandable language and vocabulary; Training in the use of technology and offering help; Friendly and less complex interface; Text settings (size, font and special styles); Color and contrast (Texts, images and plans between screens); Size of buttons and icons; Voice and audio interaction; Motor, cognitive interactions and memory use of the elderly; Security (emergency situations and data security) and; Preference in the development of health applications and use of smartphones. The evidence from the study allowed to identify requirements so that health professionals, software developers, designers and other interested professionals, can develop applications for different mobile devices in health, meeting the needs of people with visual impairments and the elderly and thus improving usage problems, interaction and acceptability.

Carbon/FexOy magnetic composites obtained from PET and red mud residues: paracetamol and dye oxidation.

Composite materials from PET and red mud (RM) wastes were used as catalysts for environmental application such as the wastewater treatment. The PET-RM catalysts were obtained by a mechanical mixture of the residues followed by thermal treatment under an N2 atmosphere (300°C/1 h). An additional activation of the composites with CO2 was investigated (at 800-900°C) to reduce the red mud basicity. The CO2 activation affected the composites surface area and reduced their carbon content. XRD revealed that the haematite (α-Fe2O3) and maghemite/magnetite are the main iron oxides present in the composites. Mössbauer characterization indicated the formation of reduced iron species (Fe2+), highly reactive, after the composites heat treatment. The materials were very active catalysts for methylene blue (MB) and paracetamol (PRC) removal from aqueous solution. The catalytic activity revealed to be dependent on the surface area and mainly of the presence of reduced iron species in the catalysts. The MB removal reached 97% for both PET-RM 800/2 h and PET-RM 800/5 h, after 1 h of reaction. In the case of PRC, the highest removal was also obtained for PET-RM 800/2 h and PET-RM 800/5 h, of ≈25% and 40%, respectively. The contaminants removal mechanism likely occurred through combined adsorption and Fenton-like oxidation processes.

Use of iron ore tailing from tailing dam as catalyst in a fenton-like process for methylene blue oxidation in continuous flow mode.

The global demand for iron ore with high iron contents to supply the steel industry is associated, in most countries, with the generation of tailings from mineral processing. The chemical compositions of iron ore tailings (basically Fe2O3 and SiO2) make them an excellent candidate as a catalyst for advanced oxidation processes (AOPs), especially the Fenton process and its derivatives. Therefore, this paper aimed to transform iron ore tailings from tailing dams into catalysts able to activate H2O2 for the purpose of treating, in a continuous flow, effluents contaminated with organic dyes, employing methylene blue as a model molecule. The mineralogical characteristics of in natura tailings, such as the associations between iron oxides and quartz and the particle sizes of iron oxides, are favourable points for their transformation into catalysts by Fenton-like processes. Different pellet geometries and binding agents were evaluated to optimize the dye removal. Pellet pretreatment in a CH4 atmosphere at 550 °C for 2 h with 10% bentonite as a binding agent (RCSP sample) resulted in the removal of approximately 80% of dye. Kinetic removal data show the good stability of the catalyst in the flow system. Significant catalytic activity loss was not observed after four runs, and data from TG-MS indicate that there is a synergetic mechanism between the adsorption, radical attack and desorption processes of the substrate on the catalyst surface.

Detection of immune complexes and evaluation of alcoholic individuals' serological profile in the diagnosis of strongyloidiasis.

Strongyloidiasis is a human parasitosis that is considered a public health problem. Early diagnosis of this infection is extremely important in immunocompromised patients (i.e. subjects with alcoholism). This study aimed to evaluate anti-Strongyloides immunoglobulin G (IgG) and immunoglobulin A (IgA), assess levels of circulating immune complexes (IC) and determine IgG avidity in serum samples from alcoholic and nonalcoholic individuals. A total of 140 blood samples were collected from male individuals (70 alcoholic and 70 nonalcoholic subjects). Serum was obtained and analysed by enzyme-linked immunosorbent assay for IgG, IgA, IC detection and avidity determination. Anti-Strongyloides IgG was detected in 55.7% of alcoholic subjects and 32.8% nonalcoholics, while IC levels showed frequencies of 38.6% and 17.1% in these groups, respectively. Anti-Strongyloides IgA was lower among alcoholics (4.3%) than nonalcoholics (34.3%). Spearman's correlation coefficient reported a positive correlation between IgG, IC and IgA in alcoholic individuals and no correlation in nonalcoholics. The median avidity index was higher in alcoholics (83.8%) than nonalcoholic subjects (73.2%). In conclusion, this study shows that alcoholic subjects produced specific antibodies against S. stercoralis regardless of the possible immunosuppression caused by chronic alcoholism. Considering that alcoholics are more susceptible to the severe forms of strongyloidiasis, the implementation of immunological methods as a complementary approach to parasitological diagnostics (i.e. detection of IgG, IC and antibody avidity) appears to be an alternative method for early diagnosis in these individuals.

Bioengineered carboxymethyl cellulose-doxorubicin prodrug hydrogels for topical chemotherapy of melanoma skin cancer.

Melanoma is the most aggressive type of skin cancer with high rates of mortality. Despite encouraging advances demonstrated by anticancer drug carriers in recent years, developing ideal drug delivery systems to target tumor microenvironment by overcoming physiological barriers and chemotherapy side effects still remain intimidating challenges. Herein, we designed and developed a novel carbohydrate-based prodrug composed of carboxymethylcellulose (CMC) polymer bioconjugated with anticancer drug doxorubicin hydrochloride (DOX) by covalent amide bonds and crosslinked with citric acid for producing advanced hydrogels. The results demonstrated the effect of CMC hydrogel network structure with distinct degree of substitution of carboxymethyl groups of the cellulose backbone regarding to the process of bioconjugation and on tailoring the DOX release kinetics in vitro and the cytotoxicity towards melanoma cancer cells in vitro. To this end, an innovative platform was developed based on polysaccharide-drug hydrogels offering promising perspectives for skin disease applications associated with topical chemotherapy of melanoma.

Alcohol consumption among students of a brazilian public university and consequences associated with this consumption / Consumo de álcool entre estudantes de uma universidade pública brasileira e consequências associadas a esse consumo

The present study aimed to evaluate the alcohol consumption profile and behaviors and consequences associated with this consumption among university students. This cross-sectional, observational, and predictive correlational study was conducted with students from a public university in Southeastern Brazil in different course periods (first-year, middle-year and last-year students). Socio-demographic data; prevalence of use of alcohol and other drugs in the previous 12 months and in the previous 30 days; information about academic behavior; information about the negative consequences resulting from alcohol use; risk behaviors; depressive symptoms; and symptoms of psychological distress were collected. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was also used. Of all 1139 students, 91% used alcohol in their lifetime. Last-year students consumed alcohol more often than first-year students in their lifetime (93% vs 88%), in the previous 12 months (86% vs 78%) and in the previous 30 days (75% vs 66%). The prevalence of alcohol use with risk of dependence was similar among firs-year (31%), middle-year (25%) and last-year (25%) students; 84% of them did not consider this consumption to be harmful to health. The use of other drugs; the use of tobacco, marijuana or cocaine with risk of dependence; depression; psychological distress; risk behavior; and low interest in academic activities were more prevalent among students who consumed alcohol with risk of dependence, compared to those who consumed it without such risk. In conclusion, it was observed alarming frequencies and patterns of alcohol use among university students as well as negative consequences and risk behaviors associated with this consumption. Policies on alcohol use prevention should include students as soon as they enter university.

O presente estudo teve por objetivos avaliar os perfis do consumo alcoólico e os comportamentos e consequências associados a esse consumo entre universitários. Este estudo transversal, observacional e preditivo correlacional foi realizado com estudantes de uma universidade pública brasileira, de diferentes períodos da graduação. Foram coletados dados sociodemográficos, a prevalência do uso de álcool e de outras drogas nos prévios 12 meses e nos prévios 30 dias, informações sobre o comportamento acadêmico, informações sobre consequências negativas resultantes do uso do álcool, comportamentos de risco, sintomas de depressão e de sofrimento psicológico. Também foi utilizado o Teste para Triagem do Uso de Álcool, Tabaco e Outras Substâncias (ASSIST). Entre os 1139 universitários avaliados, 91% fizeram uso de álcool na vida. Alunos concluintes mais frequentemente do que os iniciantes, respectivamente, fizeram uso de álcool na vida (93% vs. 88%), nos últimos 12 meses (86% vs. 78%) e nos últimos 30 dias (75% vs. 66%). A prevalência de consumo com risco para dependência de álcool foi semelhante entre alunos iniciantes (31%), intermediários (25%) e concluintes (25%), e 84% deles não consideravam esse consumo prejudicial à saúde. Consumo de outras drogas; consumo com risco para dependência de tabaco, de maconha e de cocaína; depressão; sofrimento psicológico; comportamentos de risco, e menores interesses pelas atividades acadêmicas foram mais prevalentes entre os que faziam consumo com risco para dependência de álcool do que entre aqueles que faziam consumo sem risco. Em conclusão, foram observadas preocupantes frequências e padrões de consumos de álcool entre os universitários avaliados, bem como de consequências negativas e de comportamentos de risco associados a esse consumo. Os resultados deste estudo mostram que políticas de prevenção ao uso de álcool devem incluir os estudantes assim que ingressam na universidade.

Impact of alcohol consumption among patients in hepatitis C virus treatment.

BACKGROUND:: Recent studies have questioned the recommendation of abstinence from alcohol for at least 6 months for alcoholic patients to be treated for hepatitis C. OBJECTIVE:: The present study aimed to assess the impact of alcohol consumption among patients undergoing hepatitis C treatment. METHODS:: In this cross-sectional study, 121 patients [78 (64.5%) men; 28-70 years] were evaluated. They were divided as follows: patients who consumed <12 g of ethanol/day throughout life (Group 1), 12-59 g/day (Group 2) and ≥60 g/day (Group 3). Patients were treated with pegyla-ted-interferon plus ribavirin. RESULTS:: These three groups could not be distinguished in terms of the severity of liver fibrosis and frequency of HCV genotype-1 infection. In Group 3, treatment discontinuation (32.4%) was higher than in the Group 1 (9.4%) or Group 2 (0%), it was higher among patients who drank during treatment (66.7% vs 21.4%) and among those who had not been abstinent for at least 6 months (72.7% vs 15.4%). Moderate alcohol drinkers showed good adherence and did not discontinue the treatment. The frequencies of sustained viral response among patients in Group 3 (44.4%) were similar to those in Group 1 (61%) and Group 2 (68.4%). CONCLUSION:: Heavy drinkers more often discontinued treatment for hepatitis C, but those that received this treatment had acceptable sustained viral response rates. These results suggest that heavy drinkers should not be systematically excluded from the treatment, but they should be monitored to avoid drinking and abandoning treatment, mainly those who have not been abstinent for at least 6 months.

Impact of alcohol consumption among patients in hepatitis C virus treatment / Impacto do consumo alcoólico entre pacientes em tratamento da hepatite C

ABSTRACT BACKGROUND: Recent studies have questioned the recommendation of abstinence from alcohol for at least 6 months for alcoholic patients to be treated for hepatitis C. OBJECTIVE: The present study aimed to assess the impact of alcohol consumption among patients undergoing hepatitis C treatment. METHODS: In this cross-sectional study, 121 patients [78 (64.5%) men; 28-70 years] were evaluated. They were divided as follows: patients who consumed <12 g of ethanol/day throughout life (Group 1), 12-59 g/day (Group 2) and ≥60 g/day (Group 3). Patients were treated with pegyla­ted-interferon plus ribavirin. RESULTS: These three groups could not be distinguished in terms of the severity of liver fibrosis and frequency of HCV genotype-1 infection. In Group 3, treatment discontinuation (32.4%) was higher than in the Group 1 (9.4%) or Group 2 (0%), it was higher among patients who drank during treatment (66.7% vs 21.4%) and among those who had not been abstinent for at least 6 months (72.7% vs 15.4%). Moderate alcohol drinkers showed good adherence and did not discontinue the treatment. The frequencies of sustained viral response among patients in Group 3 (44.4%) were similar to those in Group 1 (61%) and Group 2 (68.4%). CONCLUSION: Heavy drinkers more often discontinued treatment for hepatitis C, but those that received this treatment had acceptable sustained viral response rates. These results suggest that heavy drinkers should not be systematically excluded from the treatment, but they should be monitored to avoid drinking and abandoning treatment, mainly those who have not been abstinent for at least 6 months.

RESUMO CONTEXTO: Estudos recentes têm questionado a recomendação de abstinência do álcool por pelo menos 6 meses para pacientes alcoolistas serem tratados para hepatite C. OBJETIVO: Este estudo objetivou avaliar o impacto do consumo de álcool entre pacientes submetidos ao tratamento para a hepatite C. MÉTODOS: Neste estudo transversal, avaliou-se 121 pacientes [78 (64,5%) homens; 28-70 anos). Eles foram divididos em três grupos: pacientes que consumiam <12 g de etanol/dia na vida (Grupo 1); 12-59 g/dia (Grupo 2) e ≥60 g/dia (Grupo 3). Pacientes foram tratados com interfe­ron-peguilado mais ribavirina. RESULTADOS: Os três grupos não puderam ser distinguidos em relação à gravidade da fibrose hepática e das frequências de infecção pelo genótipo-1 do HCV. No Grupo 3, descontinuação do tratamento (32,4%) foi maior do que no Grupo 1 (9,4%) ou Grupo 2 (0%), foi maior entre pacientes que beberam durante o tratamento (66,7% vs 21,4%) e entre aqueles que não estavam em abstinência por pelo menos 6 meses (72,7% vs 15,4%). Pacientes do Grupo 2 tiveram boa aderência e não descontinuaram o tratamento. As frequências de resposta virológica sustentada entre pacientes do Grupo-3 (44,4%) foi semelhante àquelas do Grupo 1 (61%) e do Grupo 2 (68,4%). CONCLUSÃO: Bebedores pesados mais frequentemente descontinuaram o tratamento da hepatite C, mas aqueles que foram tratados tiveram aceitáveis taxas de resposta virológica sustentada. Esses resultados sugerem que bebedores pesados não deveriam ser sistematicamente excluídos do tratamento, mas sim serem monitorados para evitar beber e abandonar o tratamento, principalmente aqueles que não estão abstinentes por pelo menos 6 meses.