Optimization in the Selection of Sugarcane Varieties in a Sucro Energy Plant Located in the State of Sao Paulo,Brazil

Sugarcane crops have undergone several changes with the intensification of agricultural machinery in Brazil in the last years.This occurs,mainly,due to the transfer of the semi-mechanized system to the mechanized one during harvest operations.Thus,studies are needed on the optimization of sugarcane production in relation to mechanized processes,since it is necessary to verify the adaptability of sugarcane varieties to the mechanization of the plantation.This study aimed to develop and apply a mathematical model of optimization to select sugarcane varieties that maximize production and meet the quality standards required by the industry for sugar and fiber contents.The data were collected in a sugarcane mill located in the interior of S?o Paulo state.The result obtained by the optimization process evinced an increase of 16.65%when compared to the productivity of the initial scenario.

Corn Water Variables Assessments from Earth Observation Data in the Sao Paulo State, Southeast Brazil

Landsat satellite images and agrometeorological data were used together for modelling the crop coefficient （Kc） in irrigation pivots composed by a mixture of corn hybrids from a commercial farm for grains and silage, located at the northwestern side of Sao Paulo state, Brazil. After developing relationships between Kc and the accumulated degree-days （DDac） and having yield data for 2012 available, they were applied in the whole state, to upscale the crop water variables, during the GS （growing seasons） of a second-harvest crop from March to August. Spatial thermohydrological differences among the main corn growing regions were clear. The largest CWP （crop water productivity） values and SD （standard deviations） were for Itapetininga with an average value of 1.60 ± 0.43 kg m-3, while the lowest ones were for Presidente Prudente （0.81±0.21 kg m-3）. As corn is important for these growing regions, being inside of the priorities from the Brazilian Ministry of Agriculture, these results should be considered for a rational exploration, including both, irrigation and rainfed conditions, as the actual water scarcity can bring much competition with other non-agricultural sectors.

Health-Related Quality of Life of Experts Who Worked in Air Disasters in Sao Paulo, Brazil

Aim: To evaluate the influence of identifying victims of air disasters in São Paulo on experts’ quality of life (QoL). Methods: QoL was evaluated using the abbreviated version of the World Health Organization (WHO) quality of life questionnaire (WHOQOL-bref). We assessed 29 forensic experts who worked in air disasters in São Paulo and 29 experts who have not worked. The results were analyzed with Student’s t-tests;we compared the QoL scores of individuals at the time of the accident with their current QoL scores, and the scores of the control group were compared with the current scores of the disaster group. Results: Statistical analyses revealed a significant decrease in forensic expert QoL when they worked at the accident site, and this result was evident in all WHOQOL-bref domains. No significant difference was observed between the experts’ current QoL scores and those of the control group. Conclusions: The identification of air disaster victims in the city of São Paulo significantly decreased expert health-related QoL (HRQoL) with regard to physical and psychological aspects, social relationships and environment domains. This disturbance on the QoL was not persistent over the years.

Extreme Events Assessment Methodology Coupling Debris Flow,Flooding and Tidal Levels in the Coastal Floodplain of the Sao Paulo North Coast(Brazil)

The North Coastal Region of the State of S?o Paulo, which comprises the Municipalities of Caraguatatuba, S?o Sebasti?o, Ilhabela and Ubatuba, is one of the most prone to flooding and debris flow deposition Brazilian areas, owing to hydrological extreme rainfall events usually coupled with extreme tidal levels. This risk is also high due to human lives and material assets, with increasing population rates and the establishment of large companies such as the Oil industry, with reduced defense/prevention measures and works.The catastrophic scenario of the city of Caraguatatuba, in March 1967, resulting from one of the most serious natural disasters in Brazil, fosters discussions about probabilities of heavy rainfall-caused events and rise in the sea level in coastal areas. Hence, this research is a consequence of this reality. The research is founded on an innovative methodology based on the analysis of past data of rainfall and tidal stations, complemented with debris flow registers in the region of the north coastal zone of the State of S?o Paulo (Brazil). The anaysis developed involved the meteorological, hydraulic, geotechnical and statistical knowledge areas.Practical results are intended to be used for urban planning, designs of macro-drainage, fluvial, maritime projects and debris flow retention structures. These practical applications will then associate the probability of occurrence of certain types of heavy rainfall-caused events such as flooding or debris flow coupled with a corresponding increase in tidal levels.

Cerebral and muscle tissue oxygenation during exercise in healthy adults: A systematic review

Background:Near-infrared spectroscopy(NIRS)technology has allowed for the measurement of cerebral and skeletal muscle oxygenation simultaneously during exercise.Since this technology has been growing and is now successfully used in laboratory and sports settings,this systematic review aimed to synthesize the evidence and enhance an integrative understanding of bloodflow adjustments and oxygen(O_(2))changes(i.e.,the balance between O_(2) delivery and O_(2) consumption)within the cerebral and muscle systems during exercise.Methods:A systematic review was conducted using PubMed,Embase,Scopus,and Web of Science databases to search for relevant studies that simultaneously investigated cerebral and muscle hemodynamic changes using the near-infrared spectroscopy system during exercise.This review considered manuscripts written in English and available before February 9,2023.Each step of screening involved evaluation by 2 inde-pendent authors,with disagreements resolved by a third author.The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the methodological quality of the studies.Results:Twenty studies were included,of which 80%had good methodological quality,and involved 290 young or middle-aged adults.Different types of exercises were used to assess cerebral and muscle hemodynamic changes,such as cycling(n=11),treadmill(n=1),knee extension(n=5),isometric contraction of biceps brachii(n=3),and duet swim routines(n=1).The cerebral hemodynamics anal-ysis was focused on the frontal cortex(n=20),while in the muscle,the analysis involved vastus lateralis(n=18),gastrocnemius(n=3),biceps brachii(n=5),deltoid(n=1),and intercostal muscle(n=1).Overall,muscle deoxygenation increases during exercise,reaching a plateau in voluntary exhaustion,while in the brain,oxyhemoglobin concentration increases with exercise intensity,reaching a plateau or declining at the exhaustion point.Conclusion:Muscle and cerebral oxygenation respond differently to exercise,with muscle increasing O_(2) utilization and cerebral tissue increasing O_(2) delivery during exercise.However,at the exhaustion point,both muscle and cerebral oxygenation become compromised.This is characterized by a reduction in bloodflow and a decrease in O_(2) extraction in the muscle,while in the brain,oxygenation reaches a plateau or decline,potentially resulting in motor failure during exercise.

There is more to the knee joint than just the quadriceps:A systematic review with meta-analysis and evidence gap map of hamstring strength,flexibility,and morphology in individuals with gradual-onset knee disorders

Background:Impairments in hamstring strength,flexibility,and morphology have been associated with altered knee biomechanics,pain,and function.Determining the presence of these impairments in individuals with gradual-onset knee disorders is important and may indicate targets for assessment and rehabilitation.This systematic review aimed to synthesize the literature to determine the presence of impairments in hamstring strength,flexibility,and morphology in individuals with gradual-onset knee disorders.Methods:Five databases(MEDLINE,Embase,CINAHL,SPORTDiscus,and Web of Science)were searched from inception to September 2022.Only studies comparing hamstring outcomes(e.g.,strength,flexibility,and/or morphology)between individuals with gradual-onset knee disorders and their unaffected limbs or pain-free controls were included.Meta-analyses for each knee disorder were performed.Outcome-level certainty was assessed using the Grading of Recommendations Assessment,Development,and Evaluation,and evidence gap maps were created.Results:Seventy-nine studies across 4 different gradual-onset knee disorders(i.e.,knee osteoarthritis(OA),patellofemoral pain(PFP),chondromalacia patellae,and patellar tendinopathy)were included.Individuals with knee OA presented with reduced hamstring strength compared to pain-free controls during isometric(standard mean difference(SMD)=-0.76,95%confidence interval(95%CI):-1.32 to-0.21)and concentric contractions(SMD=-0.97,95%CI:-1.49 to-0.45).Individuals with PFP presented with reduced hamstring strength compared to painfree controls during isometric(SMD=-0.48,95%CI:-0.82 to-0.14),concentric(SMD=-1.07,95%CI:-2.08 to-0.06),and eccentric contractions(SMD=-0.59,95%CI:-0.97 to-0.21).No differences were observed in individuals with patellar tendinopathy.Individuals with PFP presented with reduced hamstring flexibility when compared to pain-free controls(SMD=-0.76,95%CI:-1.15 to-0.36).Evidence gap maps identified insufficient evidence for chondromalacia patellae and hamstring morphology across all gradual-onset knee disorders.Conclusion:Our findings suggest that assessing and targeting impairments in hamstring strength and flexibility during rehabilitation may be recommended for individuals with knee OA or PFP.

Interaction between diet and genetics in patients with inflammatory bowel disease

In this editorial,we comment on the article by Marangoni et al,published in the recent issue of the World Journal of Gastroenterology 2023;29:5618-5629,about“Diet as an epigenetic factor in inflammatory bowel disease”.The authors emphasized the role of diet,especially the interaction with genetics,in promoting the inflam-matory process in inflammatory bowel disease(IBD)patients,focusing on DNA methylation,histone modifications,and the influence of microRNAs.In this editorial,we explore the interaction between genetics,gut microbiota,and diet,in an only way.Furthermore,we provided dietary recommendations for patients with IBD.The Western diet,characterized by a low fiber content and deficiency the micronutrients,impacts short-chain fatty acids production and may be related to the pathogenesis of IBD.On the other hand,the consumption of the Mediter-ranean diet and dietary fibers are associated with reduced risk of IBD flares,particularly in Crohn’s disease(CD)patients.According to the dietary guidance from the International Organization for the Study of Inflammatory Bowel Diseases(IOIBD),the regular consumption of fruits and vegetables while reducing the consumption of saturated,trans,dairy fat,additives,processed foods rich in maltodextrins,and artificial sweeteners containing sucralose or saccharine is recommended to CD patients.For patients with ulcerative colitis,the IOIBD recommends the increased intake of natural sources of omega-3 fatty acids and follows the same restrictive recommendations aimed at CD patients,with the possible inclusion of red meats.In conclusion,IBD is a complex and hetero-geneous disease,and future studies are needed to elucidate the influence of epigenetics on diet and microbiota in IBD patients.

Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

Metabolomics in chronic hepatitis C:Decoding fibrosis grading and underlying pathways

BACKGROUND Chronic Hepatitis C(CHC)affects 71 million people globally and leads to liver issues such as fibrosis,cirrhosis,cancer,and death.A better understanding and prognosis of liver involvement are vital to reduce morbidity and mortality.The accurate identification of the fibrosis stage is crucial for making treatment decisions and predicting outcomes.Tests used to grade fibrosis include histological analysis and imaging but have limitations.Blood markers such as molecular biomarkers can offer valuable insights into fibrosis.AIM To identify potential biomarkers that might stratify these lesions and add information about the molecular mechanisms involved in the disease.METHODS Plasma samples were collected from 46 patients with hepatitis C and classified into fibrosis grades F1(n=13),F2(n=12),F3(n=6),and F4(n=15).To ensure that the identified biomarkers were exclusive to liver lesions(CHC fibrosis),healthy volunteer participants(n=50)were also included.An untargeted metabolomic technique was used to analyze the plasma metabolites using mass spectrometry and database verification.Statistical analyses were performed to identify differential biomarkers among groups.RESULTS Six differential metabolites were identified in each grade of fibrosis.This six-metabolite profile was able to establish a clustering tendency in patients with the same grade of fibrosis;thus,they showed greater efficiency in discriminating grades.CONCLUSION This study suggests that some of the observed biomarkers,once validated,have the potential to be applied as prognostic biomarkers.Furthermore,it suggests that liquid biopsy analyses of plasma metabolites are a good source of molecular biomarkers capable of stratifying patients with CHC according to fibrosis grade.

Exploring overweight and obesity beyond body mass index:A body composition analysis in people with and without patellofemoral pain

Background:We compared body mass index(BMI),body fat,and skeletal muscle mass between(1) a mixed-sex nonathletic cohort of people with patellofemoral pain(PFP) and pain-free people,and(2) a nonathletic cohort of people with PFP and pain-free people subgrouped by sex(i.e.,men and women with PFP vs.pain-free men and women).Methods:This cross-sectional study included 114 people with PFP(71 women,43 men) and 54 pain-free controls(32 women,22 men).All participants attended a single testing session to assess body composition measures,which included BMI,percentage of body fat(%BFBioimpedance),and skeletal muscle mass(both assessed by bioelectrical impedance analysis),and percentage of body fat(%BFskinfoid)(assessed by skinfold caliper analysis).A one-way univariate analysis of covariance(age and physical activity levels as covariates) was used to compare body composition measures between groups(i.e.,PFP vs.pain-free group;women with PFP vs.pain-free women;men with PFP vs.pain-free men).Results:Women with PFP presented significantly higher BMI,%BFBiompedance,and %BFSkinfold,and lower skeletal muscle mass compared to pain-free women(p≤0.04;effect size:-0.47 to 0.85).Men with PFP and men and women combined had no differences in BMI,%BFBioimpedance,%BFSkinfold,and skeletal muscle mass compared to their respective pain-free groups(p> 0.05).Conclusion:Our findings indicate that BMI and body composition measures should be considered as part of the evaluation and management of people with PFP,especially in women,who have demonstrated higher BMI and body fat and lower skeletal muscle mass compared to pain-free controls.Future studies should not assess body composition measures in a mixed-sex population without distinguishing men participants from women participants.

Abiotic stress on seed germination and plant growth of Zeyheria tuberculosa

Zeyheria tuberculosa(Vell.)Bureau ex Verl.is among the Brazilian flora threatened with extinction.It has high-quality wood and can be used to recover herbicidecontaminated areas.However,abiotic stresses can harm seed germination and seedling development under adverse conditions and need to be understood to improve autochthonous or indigenous biodiversity conservation and strengthen reforestation projects.This study evaluated the effects of temperature,water and saline stress on Z.tuberculosa seed germination and water stress on seedling growth.Three laboratory experiments evaluated germination under:(1)different temperatures(20,25,30,35 and 40℃);(2)different water potentials simulated with polyethylene glycol(PEG6000)at 25 and 30℃;and,(3)different osmotic potentials simulated with NaCl at 25 and 30℃.In addition,a greenhouse experiment subjected seedlings to five water regimes(20%,35%,50%,65%and 80%of maximum substrate water holding capacity).In the laboratory,seedling biometry and germination were evaluated,while physiological and morphological parameters were assessed in the greenhouse.Physiological potential of seeds increased at 25 and 30℃.Germination and vigor decreased as water and saline stresses increased.Germination tolerance thresholds for water and salt stresses were-0.6 and-0.4 MPa,respectively.In the greenhouse,the most restrictive water regimes reduced seedling physiological and morphological parameters.Seedling development was compromised at moisture levels below50%field capacity.

Overweight and obesity in young adults with patellofemoral pain:Impact on functional capacity and strength

Purpose:This study aimed to(a)investigate the proportion of overweight/obesity in a cohort of young adults with patellofemoral pain(PFP)and(b)explore the association of body mass index(BMI),body fat,and lean mass with functional capacity and hip and knee strength in people with PFP.Methods:We included a mixed-sex sample of young adults(18-35 years old)with PFP(n=100).Measurements for BMI,percentage of body fat,and lean mass(assessed by bioelectrical impedance)were obtained.Functional capacity was assessed by the Anterior Knee Pain Scale,plank test,and single-leg hop test.Strength of the knee extensors,knee flexors,and hip abductors was evaluated isometrically using an isokinetic dynamometer.The proportion of overweight/obesity was calculated based on BMI.The association between BMI,body fat,and lean mass and functional capacity and strength was investigated using partial correlations,followed by hierarchical regression analysis,adjusted for covariates(sex,bilateral pain,and current pain level).Results:A total of 38%of our cohort had their BMI categorized as overweight/obese.Higher BMI was associated with poor functional capacity(ΔR^(2)=0.06-0.12,p<0.001)and with knee flexion strength only(ΔR^(2)=0.04,p=0.030).Higher body fat was associated with poor functional capacity(ΔR^(2)=0.05-0.15,p≤0.015)and reduced strength(ΔR^(2)=0.15-0.23,p<0.001).Lower lean mass was associated with poor functional capacity(ΔR^(2)=0.04-0.13,p≤0.032)and reduced strength(ΔR^(2)=0.29-0.31,p<0.001).Conclusion:BMI,body fat,and lean mass should be considered in the assessment and management of young people with PFP because it may be detrimental to function and strength.

Intestinal complications in Brazilian patients with ulcerative colitis treated with conventional therapy between 2011 and 2020

BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database.AIM To describe the intestinal complications(IC) of patients with ulcerative colitis(UC) who started conventional therapies in Brazil’s public Healthcare system.METHODS Patients ≥ 18 years of age who had at least one claim related to UC 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes(malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate(IR) [per 100 patient-years(PY)] over the available follow-up period were calculated.RESULTS In total, 41229 UC patients were included(median age, 48 years;65% women) and the median(interquartile range) follow-up period was 3.3(1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine(87%), sulfasalazine(15%), azathioprine(16%) or methotrexate(1%) with a median duration of 1.9(0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy(index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%;associated diseases from 0.9% to 1.2%-in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported;and procedure events from 0.6% to 0.7%, being intestinal resection and polyp removal the most frequent ones.CONCLUSION Study shows that UC patients under conventional therapy seem to present progression of disease developing some IC, which may have a negative impact on patients and the burden on the health system.

改进的各向异性标准化方差探测斜磁化磁异常源边界

针对存在强剩磁作用磁化方向不明的磁异常,本项研究探索直接处理斜磁化磁异常的识别,提出了基于磁力梯度张量模的各向异性边界探测方法.首先利用各向异性尺度改进了各向异性标准差的核函数,突出各向异性高斯函数的作用;结合磁力梯度张量模来消弱斜磁化的影响.数值实验模拟了一组复杂磁异常模型,在斜磁化条件下分析该研究方法的边界探测效果.实验表明:改进方法,即磁力梯度张量模的各向异性标准化方差,它可以探测非垂直磁化磁异常的磁源边界;同时指出,改进方法比基于三维解析信号振幅的各向异性标准化方差对磁化方向的依赖性更小.将该方法应用于中国西部某磁铁矿集区的精细探测,在非垂直磁化条件下对实测磁异常直接进行边界探测,获得了较为理想的处理结果.

全日制放牧BMY牛的活体采卵-体外胚胎生产-胚胎移植研究

为建立BMY牛的活体采卵(OPU)-体外胚胎生产(IVP)-胚胎移植(ET)快速扩繁技术体系,从人工草地全放牧牛群中选择健康的经产空怀BMY牛作为供体(n=14)集中OPU一次;卵母细胞经TCM-199体外成熟培养(IVM)、Fert-TALP液体外受精(IVF),受精卵用合成输卵管液(SOF)体外培养(IVC)生产胚胎;BMY牛受体(n=81)用CUE-MATETM孕酮阴道栓+EB+FSH+PG方法同期发情处理,对黄体合格的移植OPU-IVP来源鲜胚。研究结果表明:①OPU头均获卵母细胞23.50枚,获10枚以上卵母细胞的供体占85.7%;IVP的平均囊胚数和可用胚数分别为5.21和4.00枚;OPU前8～9d卵巢上有黄体(CL)的供体,头均获卵母细胞数及IVP的囊胚数、可移植胚数、囊胚率和可移植胚率分别比对照组高7.28枚(P<0.05)、7.29枚(P<0.05)、6.00枚(P<0.05)、27.3%(P<0.01)和23.2%(P<0.01);②受体黄体合格率69.1%(56/81),胚胎移植妊娠率37.5%(21/56),产犊率35.7%(20/56);③受体在胚胎移植时注射GnRH,其妊娠率比对照组高16.2%(P>0.05)。结果显示,BMY母牛具有良好的OPU潜力,但个体间差异较大;可通过严格供体选择及改善IVP技术等措施,实现OPU-IVP效率最大化。CUE-MATETM+EB+FSH+PG同期发情处理方法适于在牛规模化胚胎移植(ET)和人工授精(AI)中应用。综合应用OPU、IVP、同期发情和ET技术是加快优良BMY牛扩繁的重要途径之一。

Effects of acupuncture and moxa treatment in patients with semen abnormalities

<abstract>Aim: To evaluate the effect of Chinese Traditional Medicine, acupuncture and moxa treatment, on the semen quality in patients with semen abnormalities. Methods: In a prospective, controlled and blind study, nineteen patients, aged 24 years-42 years and married for 3 years-11 years without children with semen abnormalities in concentration, morphology and/or progressive motility without apparent cause, were randomized into two groups and submitted to acupuncture and moxa treatment at the therapeutic (Study Group) and the indifferent points (Control Group), respectively, for 10 weeks. Semen analyses were performed before and after the treatment course. Results: The patients of the Study Group presented a significant increase in the percentage of normal-form sperm compared to the Control Group (calculated U=16.0, critical U=17.0). Conclusion: The Chinese Traditional Medicine acupuncture and moxa techniques significantly increase the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause.

Gut microbiota,inflammatory bowel disease and colorectal cancer

The gut microbiota is a complex community of microorganisms that inhabit the digestive tracts of humans,living in symbiosis with the host.Dysbiosis,characterized by an imbalance between the beneficial and opportunistic gut microbiota,is associated with several gastrointestinal disorders,such as irritable bowel syndrome(IBS);inflammatory bowel disease(IBD),represented by ulcerative colitis and Crohn’s disease;and colorectal cancer(CRC).Dysbiosis can disrupt the mucosal barrier,resulting in perpetuation of inflammation and carcinogenesis.The increase in some specific groups of harmful bacteria,such as Escherichia coli(E.coli)and enterotoxigenic Bacteroides fragilis(ETBF),has been associated with chronic tissue inflammation and the release of pro-inflammatory and carcinogenic mediators,increasing the chance of developing CRC,following the inflammationdysplasia-cancer sequence in IBD patients.Therefore,the aim of the present review was to analyze the correlation between changes in the gut microbiota and the development and maintenance of IBD,CRC,and IBD-associated CRC.Patients with IBD and CRC have shown reduced bacterial diversity and abundance compared to healthy individuals,with enrichment of Firmicute sand Bacteroidetes.Specific bacteria are also associated with the onset and progression of CRC,such as Fusobacterium nucleatum,E.coli,Enterococcus faecalis,Streptococcus gallolyticus,and ETBF.Future research can evaluate the advantages of modulating the gut microbiota as preventive measures in CRC high-risk patients,directly affecting the prognosis of the disease and the quality of life of patients.

Atrophic gastritis: Risk factor for esophageal squamous cell carcinoma in a Latin-American population

AIM: To study the association between atrophic gastritis (AG) and esophageal squamous cell carcinoma (ESCC) in a Latin-America population. METHODS: A case-control study was performed at two reference Brazilian hospitals including patients diagnosed with advanced ESCC and dyspeptic patients who had been subjected to upper gastrointestinal endoscopy, with biopsies of the gastric antrum and body.All cases with ESCC were reviewed by a single pathologist, who applied standard criteria for the diagnosis of mucosal atrophy, intestinal metaplasia, and dysplasia, all classified as AG. The data on the patients' age, sex, smoking status, and alcohol consumption were collected from clinical records, and any missing information was completed by telephone interview. The association between AG and ESCC was assessed by means of univariate and multiple conditional logistic regressions. RESULTS: Most patients were male, and the median age was 59 years (range: 37-79 years) in both the ESCC and control groups. Univariate analysis showed that an intake of ethanol greater than 32 g/d was an independent risk factor that increased the odds of ESCC 7.57 times (P = 0.014); upon multiple analysis, alcohol intake of ethanol greater than 32 g/d exhibited a risk of 4.54 (P = 0.081), as adjusted for AG and smoking. Smoking was shown to be an independent risk factor that increased the odds of ESCC 14.55 times (P = 0.011) for individuals who smoked 0 to 51 packs/year and 21.40 times (P = 0.006) for those who smoked more than 51 packs/year. Upon multiple analyses, those who smoked up to 51 packs/year exhibited a risk of 7.85 (P = 0.058), and those who smoked more than 51 packs/ year had a risk 11.57 times higher (P = 0.04), as adjusted for AG and alcohol consumption. AG proved to be a risk factor that increased the odds of ESCC 5.33 times (95%CI: 1.55-18.30, P = 0.008) according to the results of univariate conditional logistic regression. CONCLUSION: There was an association by univariate conditional logistic regression between AG and ECSS in this sample of Latin-American population.