Arquivos de Gastroenterologia最新文献

{"title":"INFLUENCE OF NEOADJUVANT THERAPY ON THE RATIO OF LYMPH NODES.","authors":"Laura Credidio, Carlos Augusto Real Martinez, Daniéla Oliveira Magro, Rita Barbosa de Carvalho, Maria de Lourdes Setsuko Ayrizono, Cláudio Saddy Rodrigues Coy","doi":"10.1590/S0004-2803.24612023-131","DOIUrl":"10.1590/S0004-2803.24612023-131","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the relationship between the ratio of affected lymph nodes (LNR) and clinical and anatomopathological variables in patients with rectal adenocarcinoma submitted or not to neoadjuvant chemoradiotherapy.</p><p><strong>Methods: </strong>The LNR was determined by dividing the number of compromised LNR by the total number of LNR dissected in the surgical specimen. Patients were divided into two groups: with QRT and without QRT. In each group, the relationship between LNR and the following variables was evaluated: degree of cell differentiation, depth of invasion in the rectal wall, angiolymphatic /perineural invasion, degree of tumor regression and occurrence of metastases. The LNR was evaluated in patients with more than 1, LNR (LNR >12) or less (LNR<12) in the surgical specimen with overall survival (OS) and disease-free survival (DFS). The results were expressed as the mean with the respective standard deviation. Qualitative variables were analyzed using Fisher's exact test, while quantitative variables were analyzed using the Kruskal -Wallis and Mann-Whitney tests. The significance level was 5%.</p><p><strong>Results: </strong>We evaluated 282 patients with QRT and 114 without QRT, between 1995-2011. In the QRT Group, LNR showed a significant association with mucinous tumors (P=0.007) and degree of tumor regression (P=0.003). In both groups, LNR was associated with poorly differentiated tumors (P=0.001, P=0.02), presence of angiolymphatic invasion (P<0.0001 and P=0.01), perineural (P=0.0007, P=0.02), degree of rectal wall invasion (T3>T2; P<0.0001, P=0.02); Compromised LNR (P<0.0001, P<0.01), metastases (P<0.0001, P<0.01). In patients with QRT, LNR<12 was associated with DFS (5.889; 95%CI1.935-19.687; P=0.018) and LNR>12 with DFS and OS (17.984; 95%CI5.931-54.351; P<0.001 and 10.286; 95%CI 2.654-39.854; P=0.007, respectively).</p><p><strong>Conclusion: </strong>LNR was associated with histological aspects of poor prognosis, regardless of the use of QRT. In the occurrence of less than 12 evaluated LNR, the LNR was associated only with the DFS.</p><p><strong>Background: </strong>• Assessment of the lymph nodes during pathological analysis of the surgical specimen is crucial to determine treatment and prognosis.</p><p><strong>Background: </strong>• Neoadjuvance therapy reduces the number of lymph nodes, being lower than recommended, therefore the lymph node ratio can be an alternative analysis for a better prognosis.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"61 ","pages":"e23131"},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLINICAL, LABORATORIAL AND EVOLUTIONARY ASPECTS OF PEDIATRIC PATIENTS WITH LIVER DISEASE DUE TO ALPHA 1-ANTITRYPSIN DEFICIENCY.","authors":"Mariana Pena Costa, Alexandre Rodrigues Ferreira, Adriana Teixeira Rodrigues, Eleonora Druve Tavares Fagundes, Thais Costa Nascentes Queiroz","doi":"10.1590/S0004-2803.230402023-71","DOIUrl":"10.1590/S0004-2803.230402023-71","url":null,"abstract":"<p><strong>Background: </strong>Alpha 1-antitrypsin deficiency (AATD) is a hereditary codominant autosomal disease. This liver disease ranges from asymptomatic cases to terminal illness, which makes early recognition and diagnosis challenging. It is the main cause of pediatric liver transplantation after biliary atresia.</p><p><strong>Objective: </strong>To describe the clinical characteristics, as well as those of histologic and laboratory tests, phenotypic and/or genetic evaluation and evolution of a cohort of pediatric patients with AATD.</p><p><strong>Methods: </strong>This is a retrospective observational study of 39 patients with confirmed or probable AATD (without phenotyping or genotyping, but with suggestive clinical features, low serum alpha 1-antitrypsin (AAT) level and liver biopsy with PAS granules, resistant diastasis). Clinical, laboratory and histological varia-bles, presence of portal hypertension (PH) and survival with native liver have been analyzed.</p><p><strong>Results: </strong>A total of 66.7% of 39 patients were male (26/39). The initial manifestation was cholestatic jaundice in 79.5% (31/39). Liver transplantation was performed in 28.2% (11/39) of patients. Diagnosis occurred at an average of 3.1 years old and liver transplantation at 4.1 years of age. 89.2% (25/28) of the patients with confirmed AATD were PI*ZZ or ZZ. The average AAT value on admission for PI*ZZ or ZZ patients was 41.6 mg/dL. All transplanted patients with phenotyping or genotyping were PI*ZZ (or ZZ). Those who were jaundiced on admission were earlier referred to the specialized service and had higher levels of GGT and platelets on admission. There was no significant difference in the survival curve when comparing cholestatic jaundiced to non-cholestatic jaundiced patients on admission. Comparing patients who did or did not progress to PH, higher levels of AST and APRI score at diagnosis (P=0.011 and P=0.026, respectively) were observed and in the survival curves patients with PH showed impairment, with 20.2% survival with native liver in 15 years.</p><p><strong>Conclusion: </strong>Jaundice is an important clinical sign that motivates referral to a specialist, but it does not seem to compromise survival with native liver. Patients progressing to PH had higher AST, APRi score on admission and significantly impaired survival with native liver. It is important to pay attention to these signs in the follow-up of patients with AATD.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"438-449"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIMINISHED HAND GRIP STRENGTH AND CIRRHOSIS: PREVALENCE AND ASSOCIATED FACTORS.","authors":"Carolina Pretti Tumang de Andrade, Lara Ferrari Dalcumune, Núbia Mesquita Fiorese, Livia Zardo Trindade, Felipe Bertollo Ferreira, Mariana Poltronieri Pacheco","doi":"10.1590/S0004-2803.230402023-69","DOIUrl":"10.1590/S0004-2803.230402023-69","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a syndrome characterized by progressive and generalized loss of muscle mass and strength, observed to varying degrees in patients with various chronic conditions. In cirrhotic patients, it reflects protein-energy malnutrition due to metabolic protein imbalance and is associated with worsened prognosis and reduced post-liver transplantation survival.</p><p><strong>Objective: </strong>To evaluate the epidemiological distribution of diminished hand grip (HG) strength in cirrhotic patients at an outpatient clinic of Santa Casa de Misericórdia in Vitória-ES, Brazil, seeking its association with liver function and cirrhosis complications.</p><p><strong>Methods: </strong>Cross-sectional, epidemiological, and single-center study. A questionnaire was administered to patients and HG strength was measured using a dynamometer, with three interval measures taken for 3 seconds each.</p><p><strong>Results: </strong>The study's total population was 64 cirrhotic patients, with a mean age of 58 years and alcohol as the most prevalent etiology. Reduced HG strength was defined based on two reference values: using cutoff point 1, reduced HG strength was identified in 33 patients (51.6%); according to cutoff point 2, 23 (35.9%) had reduced HG strength. The study showed that, among the parameters observed, there was an association between the female gender and diminished HG strength in both cutoff points. Additionally, it was noted that patients with a score of 15 or more on the Model for End-Stage Liver Disease (MELD) had decreased HG strength at cutoff point 2. The study showed no association between decreased HG strength and the occurrence of cirrhosis complications in the population studied.</p><p><strong>Conclusion: </strong>In our study, we obtained a diminished HG strength variation of 35-52%, which was related to higher MELD scores, suggesting an association with worse clinical outcomes. Therefore, the presence of reduced muscle strength in cirrhotic patients may be linked to prognostic factors and should be valued as clinical data in the management of these patients.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"431-437"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PERIOD OF SIGNIFICANT TRANSFORMATIONS.","authors":"Ricardo Guilherme Viebig, Fernando Pardini","doi":"10.1590/S0004-2803.230400000-01","DOIUrl":"10.1590/S0004-2803.230400000-01","url":null,"abstract":"","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"407-409"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FISTULIZING PERIANAL CROHN'S DISEASE: IS THE PATIENT'S SEX A BURDEN? A SYSTEMATIC REVIEW.","authors":"Leticia Rosevics, Mariane Cristina Savio, Emilton Lima Júnior, Odery Ramos Júnior","doi":"10.1590/S0004-2803.230402023-28","DOIUrl":"10.1590/S0004-2803.230402023-28","url":null,"abstract":"<p><strong>Background: </strong>Fistulizing perianal Crohn's disease poses a treatment challenge, and researchers postulate that this phenotype in young male patients could have a worst outcome.</p><p><strong>Objective: </strong>Thus, the aim of this study was to assess whether sex influences the response to treatment for these patients.</p><p><strong>Methods: </strong>This systematic review (PROSPERO CRD42022319629) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. We selected articles published in English, Spanish, Portuguese, and Italian between 2010 and 2020 in the PubMed and Science Direct databases. According to the PICO acronym, prospective studies in patients older than 18 years with the objective of treating fistulizing perianal Crohn's disease were selected. Studies in pediatric populations, retrospective, without treatment objectives, and that included only rectovaginal fistulas or a single sex were excluded. Study quality was assessed using the Cochrane risk of bias tool and Newcastle-Ottawa scale.</p><p><strong>Results: </strong>Of the 1887 articles found, 33 were included. Most studies used anti-TNF drugs as treatment (n=11). Ten studies had subgroup analyses; of them, the two studies reporting sex differences used infliximab and adalimumab as treatment and showed that women had a longer fistula closure time than men.</p><p><strong>Conclusion: </strong>This systematic review showed that few data corroborate the difference between sexes in the treatment of fistulizing perianal Crohn's disease, possibly having a greater relationship with the phenotype. However, considering the lack of results, further studies with this objective and with standardization of fistulas and response assessment methods are needed.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"490-524"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LOGISTICS AND RESULTS OF A COLORECTAL CANCER SCREENING PROGRAM IN A MUNICIPALITY IN THE HINTERLAND OF ALAGOAS.","authors":"Gabriela Mendes Toledo, Daniel Galvão Araújo Monteiro, Tiago Torres Melo, Herbeth José Toledo Silva, Marcelo Averbach","doi":"10.1590/S0004-2803.23042023-111","DOIUrl":"10.1590/S0004-2803.23042023-111","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) has high mortality rates worldwide. In Brazil, it is the second most common cancer in both sexes. Delay in detecting premalignant lesions contributes to increased morbidity and mortality. In this scenario, the Piranhas project was created to track CRC in a low-income population in the hinterland of Alagoas.</p><p><strong>Objective: </strong>The study aimed to establish the main strategies and verify the feasibility of implementing a CRC tracking program and demonstrate the results obtained in the CRC Prevention Campaign in Piranhas/AL.</p><p><strong>Methods: </strong>The program took place in Piranhas, Alagoas, Brazil, through public-private partnerships. Individuals aged between 50 and 70 years of age were included for screening with a fecal occult blood test (FOBT) and colonoscopy in positive cases. Patient data were collected on standard forms.</p><p><strong>Results: </strong>A total of 2152 patients, aged between 50 and 70 years, were screened, 130 of which underwent colonoscopy. Several preneoplastic lesions were detected in 58 patients. The adenoma detection rate (ADR) was 33.85%.</p><p><strong>Conclusion: </strong>The study proved to be effective and viable since 44.6% of the program participants, who underwent screening with FOBT, followed by colonoscopy in positive cases, had some type of preneoplastic lesion. In addition, the program generated a significant social impact on the population of Piranhas due to the opportunity to diagnose and treat CRC precursor lesions.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"463-469"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OCCULT AND SEMI-OCCULT CONSTIPATION IN CHILDREN WITH MONOSYMPTOMATIC OR NON MONOSYMPTOMATIC ENURESIS.","authors":"Helga Verena L Maffei, Eliana Vidolin, Joceara Neves Dos Reis, Marcia de Freitas, Beatriz Helena Cabral, Flavio Trigo-Rocha","doi":"10.1590/S0004-2803.230402023-07","DOIUrl":"10.1590/S0004-2803.230402023-07","url":null,"abstract":"<p><strong>Background: </strong>Functional constipation and enuresis frequently coexist. Constipation treatment often results in resolution or improvement of the enuresis. However, besides the classical presentation, patients can present with occult constipation (OC) diagnosed in complementary evaluation; in addition, semi-occult constipation (SOC) can be detected by means of a detailed questionnaire.</p><p><strong>Objective: </strong>To quantify OC and SOC frequency in children with monosymptomatic or non monosymptomatic enuresis (MNE or NMNE).</p><p><strong>Methods: </strong>Otherwise healthy children/adolescents, with enuresis refractory to behavioral therapy and denying constipation after simple questions, answered a structured bowel habit questionnaire and were submitted to a plain abdominal radiological exam. Constipation was classified considering the Boston diagnostic criteria (to allow diagnosis at initial stages), and fecal loading in the X-ray quantified ≥10 by the Barr score. Children with constipation received a standardized treatment (except 26 \"pilot\" children).</p><p><strong>Results: </strong>Out of 81 children, 80 aged 9.34±2.07 years, 52.5% male, were diagnosed with constipation: 30 OC, 50 SOC; 63.75% had MNE, 36.25% NMNE (six NMNE without behavioral therapy). Demographic data and the Barr score were similar for OC and SOC, but SOC children experienced significantly more constipation complications (retentive fecal incontinence and/or recurrent abdominal pain). Not showing the Bristol Stool Scale (BSS) to 24 \"pilot\" children, or absence of constipation symptoms accompanying BSS predominantly type 3, in 13 children, did not significantly impact the detection of constipation by the Barr score. Children identifying BSS 3 or ≤2 had similar results. Twenty-eight children, with adequate follow-up after treatment, improved or recovered from constipation at 44 of their 52 follow-up visits.</p><p><strong>Conclusion: </strong>In patients with MNE or NMNE refractory to behavioral therapy, and who initially denied constipation after simple questions, a detailed questionnaire based on the Boston diagnostic criteria detected SOC in 61.7%, and the radiological Barr score revealed fecal loading (OC) in 37.0% of them.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"410-418"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE ROLE OF ELASTOGRAPHY IN CLINICALLY SIGNIFICANT PORTAL HYPERTENSION.","authors":"Angelo Alves de Mattos, Angelo Zambam de Mattos, Giovana Dal Pozzo Sartori, Gustavo Tovo Both, Cristiane Valle Tovo","doi":"10.1590/S0004-2803.230402023-64","DOIUrl":"10.1590/S0004-2803.230402023-64","url":null,"abstract":"<p><p>• In compensated cirrhosis, using non-invasive methods would exempt the patient from the need of an endoscopy. • The Baveno VII presented the \"rule of 5\" for Vibration-Controlled Transient Elastography; liver stiffness measurement ≤15 kPa and platelets >150.000/mm3 exclude clinically significant portal hypertension (CSPH), while when ≥25 kPa is highly suggestive of CSPH. • Spleen stiffness measurement has been proposed as a more specific technique to predict the presence of CSPH. • Elastography has gained prestige in the non-invasive evaluation of patients with advanced chronic liver disease by allowing prophylactic measures to be taken when suggesting the presence of CSPH. This is a narrative review that aims to discuss the importance of elastographic methods in the evaluation of clinically significant portal hypertension (CSPH) in cirrhotic patients, where the authors propose an algorithm for evaluating these patients. In compensated advanced chronic liver disease, the goal is to prevent the development of CSPH and, in those already with CSPH, prevent the appearance of gastroesophageal varices (GEV) and other complications of portal hypertension. In compensated cirrhosis, the prevalence of GEV is 30-40%, of which 10-20% are at risk of bleeding. Therefore, using non-invasive methods would exempt the patient from the need of an endoscopy. Hepatic Elastography is a non-invasive, safe, reproducible method, available through many techniques: Vibration-Controlled Transient Elastography (VCTE), Shear Wave Elastography (SWE) and Magnetic Resonance Elastography (MRE). The Baveno VII presented the \"rule of 5\" for VCTE: liver stiffness measurement (LSM) ≤15 kPa and platelets >150.000/mm3 exclude CSPH, while an LSM ≥25 kPa is highly suggestive of CSPH. Also, the \"rule of 4\" for SWE has been proposed: patients with ≥17 kPa could be considered as having CSPH. At last, spleen stiffness measurement (SSM) has been proposed as a more specific technique to predict the presence of CSPH. In conclusion, elastography has gained prestige in the non-invasive evaluation of patients with advanced chronic liver disease by allowing prophylactic measures to be taken when suggesting the presence of CSPH.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"525-535"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXPLORATORY ANALYSIS OF DIETARY PATTERNS OF PATIENTS WITH GASTRIC ADENOCARCINOMA: A CASE-CONTROL STUDY IN CENTRAL BRAZIL.","authors":"Silvana Barbosa Santiago, Gabriela Rodrigues de Sousa, Amanda Ferreira Paes Landim Ramos, Gisele Aparecida Fernandes, Maria Paula Curado, Mônica Santiago Barbosa","doi":"10.1590/S0004-2803.230402023-67","DOIUrl":"10.1590/S0004-2803.230402023-67","url":null,"abstract":"<p><strong>Background: </strong>Diet is one of the most important modifiable risk factors for the incidence of gastric cancer.</p><p><strong>Objective: </strong>To carry out an exploratory analysis on the dietary patterns of individuals with gastric adenocarcinoma (AdG) in the Central Brazil region.</p><p><strong>Methods: </strong>This is a case-control study carried out from April 2019 to July 2022, in three reference centers for cancer treatment in Goiânia-GO. The cases were patients diagnosed with AdG, the control 1 dyspeptic patients submitted to upper digestive endoscopy and the control 2 patients without gastric complaints. In the three groups, patients aged 18 to 75 years and of both sexes were recruited. To assess food consumption, a Food Frequency Questionnaire validated for the Brazilian population was used. Dietary patterns were identified by Exploratory Factor Analysis (EFA), using principal component analysis as the extraction method, followed by Varimax rotation.</p><p><strong>Results: </strong>The commonality values in the EFA for the foods/food groups consumed by the cases and controls were above 0.30 for all variables. The variance explained by the model was 66.7% for cases, 60.3% for control 1 and 59.7% for control 2. Three eating patterns were identified in cases, control 1 and control 2 that explained 34, 87%, 35.41% and 33.25% respectively of the total variance. The first pattern (\"healthy\") was characterized by the consumption of vegetables, fruits, meat and cheese; the second (\"unhealthy\") for sausages, pizzas, snacks, ketchup, sweet drinks and instant noodles and the third (\"prudent\") rice, beans, meat and fried fish and pasta.</p><p><strong>Conclusion: </strong>This study identified three dietary patterns among patients with AdG and controls in the Central Brazil region. According to the identified patterns, it will be possible to establish a relationship between diet and other epidemiological measures aimed at the prevention of gastric cancer.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"419-430"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANALYSIS OF THE TRACKING INITIATIVES OF COLORECTAL CANCER IN BRAZIL.","authors":"Camila Mendes Toledo, Letícia Maria Perrelli Ramalho de Almeida, Marcelo Averbach, Joanny de Lima E Silva Barbosa","doi":"10.1590/S0004-2803.230402023-93","DOIUrl":"10.1590/S0004-2803.230402023-93","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is an important public health problem, as it represents the world's third most diagnosed neoplasm and the fourth cause of mortality. Its prevention can be divided into primary, secondary, demonstrated by tracking techniques, and tertiary, which consists of cancer diagnosis in symptomatic patients. Despite presenting a high incidence, the mortality rates decreased in the past two decades in developed countries, while the opposite happened in underdeveloped countries. That is attributed to the increase of colorectal cancer tracking programs in developed countries, which allows the precocious diagnosis and treatment of precancerous injuries and CRC. In that manner, the American Cancer Society divides the secondary tracking methods in exams based on feces samples and visual analysis of the colon and rectum, indicating its initiation starting at 45 years old in lower-risk patients.</p><p><strong>Objective: </strong>Verify in an analytical way the actions of colorectal cancer tracking held in Brazil, as to evaluate the necessity of implementation of a national tracking program of CRC.</p><p><strong>Methods: </strong>The methodology was based on a descriptive-quantitative secondary study that correlated the incidence of CRC, its morbidity and mortality, and the impact of the precocious tracking programs. It included activities not reported in medical literature through personal contacts with coordinators of regional programs to compare with the existent data in the literature. It was used as a variable for the tracking strategies the exams held, and their respective results.</p><p><strong>Results: </strong>It described nine programs held in different regions in Brazil, using two screening methods for CRC: a noninvasive method that consists of the research of blood hidden in feces, being the majority through the FIT method, and an invasive method, having the colonoscopy as its representant. These initiatives were effective in the detection of early forms of this disease.</p><p><strong>Conclusion: </strong>Despite the existence of several private tracking programs and the broad divulgation of the importance of the tracking and the early diagnosis of colorectal cancer, it was demonstrated that Brazil lacks a national program that patronizes the tracking methods, which reflects in the major prevalence of late diagnosis in the population.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"60 4","pages":"450-462"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}