Use of near-infrared reflectance spectroscopy on feces to estimate digestibility and dry matter intake of dietary nutritional characteristics under grazing conditions in Colombian creole steers.

Digestibility and intake are parameters difficult and expensive to estimate under grazing conditions; therefore, the aim of this study was to develop near-infrared reflectance spectroscopy (NIRS) calibrations applied to feces (F-NIRS) and evaluate their accuracy to predict dry matter digestibility (DMD) and dry matter intake (DMI) of Colombian creole cattle. Five digestibility trials using creole steers were conducted; indigestible neutral detergent fiber (iNDF) was used as internal marker and Cr2O3 and TiO2 as external markers. A total of 249 forage and 396 fecal samples from individual animals were collected, dried, and grinded for conventional chemical analysis. For spectral analysis, fecal samples were pooled across collection periods (77 samples). Chemometric analysis was performed using WinISI V4.10 software applying the modified partial least squares method. Cross-validation was performed to avoid overfitting the models. The goodness-of-fit statistics considered were the coefficient of determination in cross-validation and prediction sets (R2cv and r2, respectively) and the ratio performance deviation (RPD). Fecal NIRS calibrations developed for forage and supplement DMD showed a satisfactory fit (R2cv =0.87 and RPD=2.77 and R2cv=0.92 and RPD=3.50, respectively). The accuracy of fecal output equations using chromium (Cr) and titanium (Ti) was similar in terms of R2cv (0.92) and RPD (3.63 vs. 3.57). Total DMI equations using Ti performed better compared to Cr (R2cv = 0.82 vs. 0.78; RPD=2.41 vs. 2.17, respectively). The F-NIRS models were validated using a completely independent set of fecal samples showing a moderate fit (r2>0.8 and RPD>2.0). This study showed that F-NIRS is a feasible tool to predict DMD and DMI of creole steers under grazing conditions. However, previous to socialization, this requires an improvement in accuracy of the calibrated equations related to grazing animals in different production contexts.

Carbonic anhydrase IX and hypoxia-inducible factor 1 attenuate cardiac dysfunction after myocardial infarction.

Myocardial infarction (MI) is one of the leading causes of death worldwide. Prognosis and mortality rate are directly related to infarct size and post-infarction pathological heart remodeling, which can lead to heart failure. Hypoxic MI-affected areas increase the expression of hypoxia-inducible factor (HIF-1), inducing infarct size reduction and improving cardiac function. Hypoxia translocates HIF-1 to the nucleus, activating carbonic anhydrase IX (CAIX) transcription. CAIX regulates myocardial intracellular pH, critical for heart performance. Our objective was to investigate CAIX participation and relation with sodium bicarbonate transporters 1 (NBC1) and HIF-1 in cardiac remodeling after MI. We analyzed this pathway in an "in vivo" rat coronary artery ligation model and isolated cardiomyocytes maintained under hypoxia. Immunohistochemical studies revealed an increase in HIF-1 levels after 2 h of infarction. Similar results were observed in 2-h infarcted cardiac tissue (immunoblotting) and in hypoxic cardiomyocytes with a nuclear distribution (confocal microscopy). Immunohistochemical studies showed an increase CAIX in the infarcted area at 2 h, mainly distributed throughout the cell and localized in the plasma membrane at 24 h. Similar results were observed in 2 h in infarcted cardiac tissue (immunoblotting) and in hypoxic cardiomyocytes (confocal microscopy). NBC1 expression increased in cardiac tissue after 2 h of infarction (immunoblotting). CAIX and NBC1 interaction increases in cardiac tissue subjected to MI for 2h when CAIX is present (immunoprecipitation). These results suggest that CAIX interacts with NBC1 in our infarct model as a mechanism to prevent acidic damage in hypoxic tissue, making it a promising therapeutic target.

Efficacy and safety of Dentoxol® in the prevention of radiation-induced oral mucositis in head and neck cancer patients (ESDOM): a randomized, multicenter, double-blind, placebo-controlled, phase II trial.

PURPOSE: The aim of this study was to assess the efficacy and safety of Dentoxol mouthrinse in reducing the severity of oral mucositis (OM) secondary to radiation therapy (RT) for head and neck cancer. METHODS: A randomized, double-blind, placebo-controlled, multicenter phase II clinical trial was conducted. Subjects were asked to use Dentoxol (n = 55) or control (n = 53) mouthrinse 5 times/day during RT. Twice a week, OM was assessed clinically using the WHO scale and the Oral Mucositis Daily Questionnaire (OMDQ) was completed. RESULTS: The incidence of severe OM was 40.7% in the Dentoxol group and 51% in the control group (p = 0.265). Comparing all recorded clinical assessments, severe OM was seen in 13.3% of all assessments in the Dentoxol group vs. 21.8% in the control group (p = 0.000). There was a statistically significant lower proportion of assessments showing severe OM in the Dentoxol group at weeks 4, 5, and 6 of RT. The mean duration of severe OM was 11.95 days in the Dentoxol group vs. 14.59 days in the control group (p = 0.502). There was no difference between groups in mouth pain and its impact on function. The use of Dentoxol was safe and was not linked to any serious adverse events. CONCLUSION: The use of Dentoxol 5 times/day is safe and resulted in significantly fewer time-points with severe OM and a delay in the onset of severe OM, compared with a control rinse. A phase III clinical trial is warranted to confirm efficacy and address the limitations of this study.

Retraction Note to: Compensatory role of the NBCn1 sodium/bicarbonate cotransporter on Ca2+-induced mitochondrial swelling in hypertrophic hearts.

The authors have retracted this article [1] because of modifications in the control lanes of Figs. 2a and 8a of the COX1 blot obtained for 18-week-old rats (rotation, horizontal flipping and re-use of the control lanes for the 35-week-old rats blot). In light of the concerns raised, the conclusions drawn in this article cannot be relied upon.

Compensatory role of the NBCn1 sodium/bicarbonate cotransporter on Ca2+-induced mitochondrial swelling in hypertrophic hearts.

NBC Na+/HCO3- cotransporter (NBCn1) and NHE1 Na+/H+ exchanger have been associated with cardiac disorders and recently located in coronary endothelial cells (CEC) and cardiomyocytes mitochondria, respectively. Mitochondrial NHE1 blockade delays permeability transition pore (MPTP) opening and reduces superoxide levels, two critical events exacerbated in cells of diseased hearts. Conversely, activation of NBCn1 prevented apoptosis in CEC subjected to ischemic stress. We characterized the role of the NHE1 and NBCn1 transporters in heart mitochondria from hypertrophic (SHR) and control (Wistar) rats. Expression of NHE1 was analyzed in left ventricular mitochondrial lysates (LVML), by immunoblots. NHE1 expression increased by ~40% in SHR compared to control (P < 0.05, n = 4). To examine NHE1-mediated Na+/H+ exchange activity in cardiac hypertrophy, mitochondria were loaded with BCECF-AM dye and the maximal rate of pHm change measured after the addition of 50 mM NaCl. SHR mitochondria had greater changes in pHm compared to Wistar, 0.10 ± 0.01 vs. 0.06 ± 0.01, respectively (P < 0.05, n = 5). In addition, mitochondrial suspensions from SHR and control myocardium were exposed to 200 µM CaCl2 to induce MPTP opening (light-scattering decrease, LSD) and swelling. Surprisingly, SHR rats showed smaller LSD and a reduction in mitochondrial swelling, 67 ± 10% (n = 15), compared to control, 100 ± 8% (n = 13). NBC inhibition with S0859 (1 µM) significantly increased swelling in both control 139 ± 10% (n = 8) and SHR 115 ± 10% (n = 4). Finally, NBCn1 Na+/HCO3- cotransporter increased by twofold its expression in SHR LVML, compared to normal (P < 0.05, n = 5). We conclude that increased NBCn1 activity may play a compensatory role in hypertrophic hearts, protecting mitochondria from Ca2+-induced MPTP opening and swelling.

Depression and Oral FTC/TDF Pre-exposure Prophylaxis (PrEP) Among Men and Transgender Women Who Have Sex With Men (MSM/TGW).

We conducted a longitudinal and cross-sectional analysis of depressive symptomology in iPrEx, a randomized, placebo-controlled trial of daily, oral FTC/TDF HIV pre-exposure prophylaxis (PrEP) in men and transgender women who have sex with men. Depression-related adverse events (AEs) were the most frequently reported severe or life-threatening AEs and were not associated with being randomized to the FTC/TDF arm (152 vs. 144 respectively OR 0.66 95 % CI 0.35-1.25). Center for Epidemiologic Studies Depression scale (CES-D) and a four questions suicidal ideation scale scores did not differ by arm. Participants reporting forced sex at anal sexual debut had higher CES-D scores (coeff: 3.23; 95 % CI 1.24-5.23) and were more likely to have suicidal ideation (OR 2.2; 95 % CI 1.09-4.26). CES-D scores were higher among people reporting non-condom receptive anal intercourse (ncRAI) (OR 1.46; 95 % CI 1.09-1.94). We recommend continuing PrEP during periods of depression in conjunction with provision of mental health services.

Application of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) instrument: an integrative review. / Aplicação do instrumento Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): uma revisão integrativa.

Objective To systematize the knowledge and the learning of how the instrument Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) has been applied. Method Integrative review, performed from May to July 2014, searching the databases Latin American and Caribbean Health Science Literature (LILACS), Medical Literature Analysis and Retrieval System Online (Medline), PubMed and Scientific Electronic Library Online (SciELO), as well as in the search system of the Portal of Journals of the Coordination for the Improvement of Higher Education Personnel (CAPES). We selected 26 articles. Results ASSIST focused on helping the identification and classification of psychoactive substances use, and it has proved to be important in screening the involvement with alcohol and other drugs, and effectiveness in primary health care. Conclusion It was confirmed as an instrument to be used in Health Care.

Elevated carbon dioxide upregulates NBCn1 Na+/HCO3(-) cotransporter in human embryonic kidney cells.

The NBCn1 Na(+)/HCO3(-) cotransporter catalyzes the electroneutral movement of 1 Na(+):1 HCO3(-) into kidney cells. We characterized the intracellular pH (pHi) regulation in human embryonic kidney cells (HEK) subjected to NH4Cl prepulse acid loading, and we examined the NBCn1 expression and function in HEK cells subjected to 24-h elevated Pco2 (10-15%). After acid loading, in the presence of HCO3(-), ∼50% of the pHi recovery phase was blocked by the Na(+)/H(+) exchanger inhibitors EIPA (10-50 µM) and amiloride (1 mM) and was fully cancelled by 30 µM EIPA under nominally HCO3(-)-free conditions. In addition, in the presence of HCO3(-), pHi recovery after acid loading was completely blocked when Na(+) was omitted in the buffer. pHi recovery after acidification in HEK cells was repeated in the presence of the NBC inhibitor S0859, and the pHi recovery was inhibited by S0859 in a dose-dependent manner (Ki = 30 µM, full inhibition at 60 µM), which confirmed NBC Na(+)/HCO3(-) cotransporter activation. NBCn1 expression increased threefold after 24-h exposure of cultured HEK cells to 10% CO2 and sevenfold after exposure to 15% CO2, examined by immunoblots. Finally, exposure of HEK cells to high CO2 significantly increased the HCO3(-)-dependent recovery of pHi after acid loading. We conclude that HEK cells expressed the NBCn1 Na(+)/HCO3(-) cotransporter as the only HCO3(-)-dependent mechanism responsible for cellular alkaline loading. NBCn1, which expresses in different kidney cell types, was upregulated by 24-h high-Pco2 exposure of HEK cells, and this upregulation was accompanied by increased NBCn1-mediated HCO3(-) transport.

Preexposure chemoprophylaxis for HIV prevention in men who have sex with men.

BACKGROUND: Antiretroviral chemoprophylaxis before exposure is a promising approach for the prevention of human immunodeficiency virus (HIV) acquisition. METHODS: We randomly assigned 2499 HIV-seronegative men or transgender women who have sex with men to receive a combination of two oral antiretroviral drugs, emtricitabine and tenofovir disoproxil fumarate (FTC-TDF), or placebo once daily. All subjects received HIV testing, risk-reduction counseling, condoms, and management of sexually transmitted infections. RESULTS: The study subjects were followed for 3324 person-years (median, 1.2 years; maximum, 2.8 years). Of these subjects, 10 were found to have been infected with HIV at enrollment, and 100 became infected during follow-up (36 in the FTC-TDF group and 64 in the placebo group), indicating a 44% reduction in the incidence of HIV (95% confidence interval, 15 to 63; P=0.005). In the FTC-TDF group, the study drug was detected in 22 of 43 of seronegative subjects (51%) and in 3 of 34 HIV-infected subjects (9%) (P<0.001). Nausea was reported more frequently during the first 4 weeks in the FTC-TDF group than in the placebo group (P<0.001). The two groups had similar rates of serious adverse events (P=0.57). CONCLUSIONS: Oral FTC-TDF provided protection against the acquisition of HIV infection among the subjects. Detectable blood levels strongly correlated with the prophylactic effect. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; ClinicalTrials.gov number, NCT00458393.).

Inhibition of carbonic anhydrase prevents the Na(+)/H(+) exchanger 1-dependent slow force response to rat myocardial stretch.

Myocardial stretch is an established signal that leads to hypertrophy. Myocardial stretch induces a first immediate force increase followed by a slow force response (SFR), which is a consequence of an increased Ca(2+) transient that follows the NHE1 Na(+)/H(+) exchanger activation. Carbonic anhydrase II (CAII) binds to the extreme COOH terminus of NHE1 and regulates its transport activity. We aimed to test the role of CAII bound to NHE1 in the SFR. The SFR and changes in intracellular pH (pHi) were evaluated in rat papillary muscle bathed with CO2/HCO3(-) buffer and stretched from 92% to 98% of the muscle maximal force development length for 10 min in the presence of the CA inhibitor 6-ethoxzolamide (ETZ, 100 µM). SFR control was 120 ± 3% (n = 8) of the rapid initial phase and was fully blocked by ETZ (99 ± 4%, n = 6). The SFR corresponded to a maximal increase in pHi of 0.18 ± 0.02 pH units (n = 4), and pHi changes were blocked by ETZ (0.04 ± 0.04, n = 6), as monitored by epifluorescence. NHE1/CAII physical association was examined in the SFR by coimmunoprecipitation, using muscle lysates. CAII immunoprecipitated with an anti-NHE1 antibody and the CAII immunoprecipitated protein levels increased 58 ± 9% (n = 6) upon stretch of muscles, assessed by immunoblots. The p90(RSK) kinase inhibitor SL0101-1 (10 µM) blocked the SFR of heart muscles after stretch 102 ± 2% (n = 4) and reduced the binding of CAII to NHE1, suggesting that the stretch-induced phosphorylation of NHE1 increases its binding to CAII. CAII/NHE1 interaction constitutes a component of the SFR to heart muscle stretch, which potentiates NHE1-mediated H(+) transport in the myocardium.

Carbonic anhydrase XIV in the normal and hypertrophic myocardium.

Two AE3 transcripts, full-length (AE3fl) and cardiac (AE3c) are expressed in the heart. AE3 catalyzes electroneutral Cl(-)/HCO(3)(-) exchange across cardiomyocyte sarcolemma. AE proteins associate with carbonic anhydrases (CA), including CAII and CAIV, forming a HCO(3)(-) transport metabolon (BTM), increasing HCO(3)(-) fluxes and regulating cardiomyocytes pH. CAXIV, which is also expressed in the heart's sarcolemma, is a transmembrane enzyme with an extracellular catalytic domain. Herein, AE3/CAXIV physical association was examined by coimmunoprecipitation using rodent heart lysates. CAXIV immunoprecipitated with anti-AE3 antibody and both AE3fl and AE3c were reciprocally immunoprecipitated using anti-CAXIV antibody, indicating AE3fl-AE3c/CAXIV interaction in the myocardium. Coimmunoprecipitation experiments on heart lysates from a mouse with targeted disruption of the ae3 gene, failed to pull down AE3 with the CAXIV antibody. Confocal images demonstrated colocalization of CAXIV and AE3 in mouse ventricular myocytes. Functional association of AE3fl and CAXIV was examined in isolated hypertrophic rat cardiomyocytes, using fluorescence measurements of BCECF to monitor cytosolic pH. Hypertrophic cardiomyocytes of spontaneously hypertensive rats (SHR) presented elevated myocardial AE-mediated Cl(-)/HCO(3)(-) exchange activity (J(HCO3-) mM.min(-1)) compared to normal (Wistar) rats (7.5±1.3, n=4 versus 2.9±0.1, n=6, respectively). AE3fl, AE3c, CAII, CAIV, and CAIX protein expressions were similar in SHR and Wistar rat hearts. However, immunoblots revealed a twofold increase of CAXIV protein expression in the SHR myocardium compared to normal hearts (n=11). Furthermore, the CA-inhibitor, benzolamide, neutralized the stimulatory effect of extracellular CA on AE3 transport activity (3.7±1.5, n=3), normalizing AE3-dependent HCO(3)(-) fluxes in SHR. CAXIV/AE3 interaction constitutes an extracellular component of a BTM which potentiates AE3-mediated HCO(3)(-) transport in the heart. Increased CAXIV expression and consequent AE3/CAXIV complex formation would render AE3 hyperactive in the SHR heart.

Supporting study product use and accuracy in self-report in the iPrEx study: next step counseling and neutral assessment.

The recent successes of biomedical HIV prevention approaches have sparked considerable debate over the scalability, feasibility, and acceptability of pre-exposure prophylaxis (PrEP) as a widespread prevention strategy for men who have sex with men and trans-gender. Anticipated difficulties with PrEP adherence and concerns about resources required to best support it have tempered enthusiasm of PrEP demonstration projects and roll-out. While no evidence-based approach for supporting PrEP use is presently available, a number of approaches have been developed in the context of double-blind, randomized, placebo-controlled trials of PrEP that can provide guidance in moving forward with real world support of open label PrEP use. We present the development, implementation and evaluation of feasibility and acceptability of next-step counseling (NSC) and neutral assessment (NA), the adherence support and promotion of accurate reporting approaches used in the late phases of the iPrEx study. Evaluation of the approach from the perspective of implementers of over 15,000 NSC sessions in seven different countries with almost 2,000 iPrEx participants provided support for NSC, its brevity (averaging ~14 min per follow-up session) and overall acceptability and feasibility. NA also was generally well supported, with a majority of study staff believing this approach was feasible and acceptable; however, lower acceptability for certain aspects of NA was noted amongst staff reporting NA was different from their previous interview approach. Quantitative and qualitative data gathered from implementers were used to make modifications for supporting PrEP use in the open-label extension of iPrEx.

Differences in cortical processing of facial emotions in broader autism phenotype.

Autism Spectrum Disorder (ASD) is a heterogeneous condition that affects face perception. Evidence shows that there are differences in face perception associated with the processing of low spatial frequency (LSF) and high spatial frequency (HSF) of visual stimuli between non-symptomatic relatives of individuals with autism (broader autism phenotype, BAP) and typically developing individuals. However, the neural mechanisms involved in these differences are not fully understood. Here we tested whether face-sensitive event related potentials could serve as neuronal markers of differential spatial frequency processing, and whether these potentials could differentiate non-symptomatic parents of children with autism (pASD) from parents of typically developing children (pTD). To this end, we performed electroencephalographic recordings of both groups of parents while they had to recognize emotions of face pictures composed of the same or different emotions (happiness or anger) presented in different spatial frequencies. We found no significant differences in the accuracy between groups but lower amplitude modulation in the Late Positive Potential activity in pASD. Source analysis showed a difference in the right posterior part of the superior temporal region that correlated with ASD symptomatology of the child. These results reveal differences in brain processing of recognition of facial emotion in BAP that could be a precursor of ASD.

Clinical relevance of the use of Dentoxol® for oral mucositis induced by radiotherapy: A phase II clinical trial.

BACKGROUND: Severe oral mucositis associated with cancer therapy is a frequent complication that may affect a patient's systemic condition, resulting in interruption and/or prolongation of cancer therapy. Dentoxol® is a medical solution in the form of a mouthwash that has been shown to result in statistically significant improvement in the prevention of severe oral mucositis. However, knowing the measures of the clinical significance of this therapy is important for accurate decision-making. AIM: To describe the clinical impact of Dentoxol® use in severe oral mucositis. METHODS: Clinical significance was measured using the results obtained in a randomized controlled clinical trial previously conducted by the same group of researchers. The measures of clinical significance evaluated were the absolute risk or incidence, relative risk, absolute risk reduction, relative risk reduction, number needed to treat, and odds ratio. RESULTS: The data obtained show that the impact of Dentoxol® on reducing the severity of oral mucositis has important clinical relevance. CONCLUSION: The results of this study justify the incorporation of Dentoxol® mouth rinse into clinical protocols as a complement to cancer therapy to prevent and/or treat oral mucositis secondary to radiotherapy.

Comparative Analysis of the Chloroplast Genomes of Quercus × morehus and the Presumptive Parents Q. wislizeni and Q. kelloggii (Fagaceae) from California.

Here, we present the complete chloroplast genomes of Quercus × morehus, Q. wislizeni, and Q. kelloggii from California. The genomes are 161,119 to 161,130 bp and encode 132 genes. Quercus × morehus and Q. wislizeni are identical in sequence but differ from Q. kelloggii by three indels and eight SNPs.

Better overall survival in patients who achieve pathological complete response after neoadjuvant chemotherapy for breast cancer in a Chilean public hospital.

INTRODUCTION: There is extensive evidence associating the response to neoadjuvant chemotherapy (NeoCT) with breast cancer (BC) survival. However, to the author's knowledge, there is no published data in Chile. The objective of the study is to evaluate whether achieving pathological complete response (pCR) after NeoCT is associated with greater survival and lower risk of recurrence in a Chilean Public Health Service. METHODS: Retrospective analysis of a database. Patients with a diagnosis of Stages I-III BC who received NeoCT between 2009 and 2019 were included. Clinical and pathological information were extracted from the clinical records. BC subtypes were defined using hormone receptor (HR) information (HR: oestrogen and/or progesterone) and epidermal growth factor type 2 (HER2), being divided into four groups: HR+/HER2-, HR+/HER2+, HR-/HER2+, HR-/HER2-. pCR was defined as the absence of invasive cancer in the breast and axilla (ypT0/is N0) after NeoCT. RESULTS: Of 3,092 patients, 17.2% received NeoCT. Of these, 40.2% corresponded to HR+/HER2-, 20.9% HR+/HER2+, 18.2% HR-/HER2+ and 20.7% HR-/HER2-. Overall, 24.8% achieved pCR, being the lowest for HR+/HER2- (10.3%) and the highest for HR-/HER2+ (53.2%). In the multivariable analysis, family history, HER2+ and type of chemotherapy were associated with a greater probability of pCR. With a median follow-up of 40 months, the overall survival and metastasis-free survival (MFS) at 3 years were greater for the group with pCR compared to that which did not achieve it (90.5% versus 76.7%, p = 0.03 and 88.5% versus 71.4%, p = 0.003, respectively). The multivariable analysis confirmed this finding. Brain MFS was similar in both groups. CONCLUSION: NeoCT is associated with greater pCR in aggressive BC subtypes. In those, achieving pCR was associated with better survival in our study. To the author's knowledge, this is the first study which evaluates the relation between pCR and BC subtypes in a Chilean public hospital.

Beta oscillations precede joint attention and correlate with mentalization in typical development and autism.

A precursor of adult social functioning is joint attention (JA), which is the capacity to share attention on an object with another person. JA precedes the development of the capacity to attribute mental states to others (i.e., mentalization or theory of mind). The neural mechanisms involved in the development of mentalization are not fully understood. Electroencephalographic recordings were made of children while they watched stimuli on a screen and their interaction with the experimenter was assessed. We tested whether neuronal activity preceding JA correlates with mentalization in typically developing (TD) children and whether this activity is impaired in children with autistic spectrum disorder (ASD) who evidence deficits in JA and mentalization skills. Both groups exhibited JA behavior with comparable frequency. TD children displayed a higher amplitude of negative central (Nc) event-related potential preceding JA behavior (∼500 msec after stimuli presentation), than did the ASD group. Previous to JA behavior, TD children demonstrated beta oscillatory activity in the temporoparietal region, while ASD children did not show an increase in beta activity. In both groups, the beta power correlated with mentalization, suggesting that this specific neuronal mechanism is involved in mentalization, which used during social interaction.

Cosmesis after early stage breast cancer treatment with surgery and radiation therapy: experience of patients treated in a Chilean radiotherapy centre.

AIM: To analyse the overall cosmetic outcome according to patient self-assessment in relation to the fractionation received. MATERIALS AND METHODS: A questionnaire, drawn up on the basis of subjective rating scales of cosmesis and of acute and late toxicity RTOG/EORTC, EORTC QLQ-C30 (v3) and LENT SOMA, was applied to patients with early-stage breast cancer who received radiotherapy with tangential fields between June 2014 and July 2015. Self-perception of cosmesis, changes in the treated breast, pain and fractionation used (hypofractionation (HF) 42.56 Gy in 16 fractions or conventional fractionation (CF) 50 Gy in 25 fractions) were evaluated. RESULTS: Three hundred and fifty-two questionnaires were obtained. The median age was 58 years. 45% of patients reported 'excellent' cosmesis, 53% 'good', and 2% 'poor' cosmesis. Cosmesis was considered 'excellent/good' by 98% of patients. No statistically significant difference was found in overall cosmesis according to fractionation received (p = 0.6).The most frequent alteration was 'difference between both breasts' (77%), and 48% reported change in normal breast colour.Fifteen percent of patients who are younger than 58 years reported a change of normal breast colour affecting cosmesis compared to 9% of patients older than 58 years (p = 0.04).Complications affecting breast cosmesis were reported by 9% of patients with stages I-II compared with 2% with cancer in situ (DCIS) (p = 0.04); 14% in stages I-II referred colour change affecting cosmesis compared to 6% of those with DCIS (p = 0.03).Ninety-four percent of patients stated that they would accept treatment again. CONCLUSIONS: No difference in cosmetic results was found between HF and CF in our patients. Great satisfaction regarding cosmetic outcome of cancer treatment was reported, given by 98% of excellent/good cosmesis, and 94% of patients who would receive treatment again.

Determinants of tobacco use by students.

OBJECTIVE: Estimate the prevalence and determinants of tobacco use by students. METHODS: This cross-sectional study, carried out between 2013 and 2014, evaluates 701 public school students between 10 and 79 years of age living in a city in the countryside of the State of Goias, Midwest of Brazil. A structured questionnaire collected the data and the predictor variables were demographic data, family nucleus, religion, physical activity practice, family functionality and parental smoking. Two multivariable models were implemented, the first for occasional tobacco use and the second for regular use, acquiring the measure of prevalence ratio (PR) and their respective 95%CI. Variables with p < 0.10 were included in Poisson regression models with robust variance to obtain the adjusted PR (adPR) and 95%CI. The Wald Chi-Squared test examined the differences between proportions, and values with p < 0.05 were statistically significant. RESULTS: The prevalence of occasional and regular tobacco use were 33.4% (95%CI 29.8-36.9) and 6.7% (95%CI 5.0-8.8), respectively. The factors associated with occasional tobacco consumption were age of 15 to 17 years (adPR = 1.98) and above 18 years (adPR = 3.87), male gender (adPR = 1.23), moderate family dysfunction (adPR = 1.30), high family dysfunction (adPR = 1.97) and parental smoking (adPR = 1.60). In regards to regular consumption of tobacco, age above 18 years (adPR = 4.63), lack of religion (adPR = 2.08), high family dysfunction (adPR = 2.35) and parental smoking (adPR = 2.89) remained associated. CONCLUSIONS: Students exhibit a high prevalence of occasional and regular tobacco use. This consumption relates to sociodemographic variables and family dysfunction. OBJETIVO: Estimar a prevalência e determinantes do consumo de tabaco por estudantes. MÉTODOS: Neste estudo de corte transversal, realizado entre 2013 e 2014, avaliamos 701 estudantes entre 10 e 79 anos de escolas públicas de um município do interior do estado de Goiás, Centro-Oeste do Brasil. Os dados foram coletados por meio de um questionário estruturado, cujas variáveis preditoras foram: dados sociodemográficos, núcleo familiar, religião, prática de atividade física, funcionalidade familiar e pai ou mãe fumante. Foram implementados dois modelos multivariáveis, o primeiro para uso de tabaco na vida e o segundo para uso regular, obtendo-se como medida de efeito razão de prevalência (RP) e seus respectivos IC95%. Variáveis com p < 0,10 foram incluídas em modelos de regressão de Poisson com variância robusta, para obtenção da RP ajustada (RPaj) e IC95%. O teste Qui-quadrado de Wald foi utilizado para testar as diferenças entre as proporções, e valores com p < 0,05 foram considerados estatisticamente significantes. RESULTADOS: As prevalências de consumo de tabaco na vida e regular foram de 33,4% (IC95% 29,8-36,9) e 6,7% (IC95% 5,0-8,8), respectivamente. Os fatores associados ao consumo de tabaco na vida foram: idade de 15 a 17 anos (RPaj = 1,98) e superior a 18 anos (RPaj = 3,87), sexo masculino (RPaj = 1,23), moderada disfuncionalidade familiar (RPaj = 1,30), elevada disfuncionalidade familiar (RPaj = 1,97) e pai ou mãe fumante (RPaj = 1,60). Em relação ao consumo regular de tabaco, permaneceram associados a idade superior a 18 anos (RPaj = 4,63), não possuir religião (RPaj = 2,08), elevada disfuncionalidade familiar (RPaj = 2,35) e pai ou mãe fumante (RPaj = 2,89). CONCLUSÕES: Estudantes apresentam elevada prevalência de consumo de tabaco na vida e regular. Esse consumo associa-se com variáveis sociodemográficas e disfuncionalidade familiar.