Repositório RCAAP

Foram instalados no Centro Experimental de Campinas e na Estação Experimental de Tietê, nos anos agrícolas de 1970/71 a 1972/73, ensaios para avaliar o efeito da competição de plantas daninhas com o algodoeiro. Em 1970/71 foram estudados oito trata-mentos com seis. repetições: competição durante 10, 20, 30, 60, 90 e 120 dias após a emergência do algodoeiro e dois tratamentos testemunhas, sendo um sempre no limpo e outro sempre com mato. Os tratamentos foram mantidos no limpo após a respectiva primeira capina. Baseado nos resultados obtidos, foram estudados, nos anos agrícolas de 1971/72 e 1972/73, nove tratamentos, com cinco repetições: sempre. no limpo, capinas aos 10, 20, 30 e 40 dias após a emergência do algodoeiro. Após as capinas o algodoeiro foi mantido livre de competição. Os tratamentos restantes foram: capinas até os 10, 20, 30 ou 40 dias. As parcelas apresentavam quatro linhas lie cinco metros de comprimento. Em cada tratamento determinaram-se o número e o peso de matéria fresca e seca das plantas daninhas, ao final do respectivo período de competição, bem como a produção do algodão e as características econômicas de porcentagem de fibra, peso de um capulho, peso de 100 sementes, comprimento de fibra, uniformidade de comprimento, índice Micronaire, índice Pressley e maturidade. Os resultados mostraram que houve menor produção de algodão quando, após o período de 20 dias sem mato, mantiveram-se em competição o algodoeiro e plantas dani-nhas. Não houve efeito estatístico significativo na produção quando se manteve o algodoeiro até 40 dias sem a competição de plantas daninhas, embora esse tratamento tenha provocado uma queda de 30% de produção. Houve efeito negativo das plantas daninhas, pelo menos em um dos locais estudados, ou em um dos anos estudados, nas seguintes características: porcentagem de fibra, peso de um capulho, peso de 100 sementes, índice Micronaire, uniformidade de comprimento e índice Pressley.

São relatados os resultados obtidos no melhoramento do cultivar de milho IAC-1 pela introdução de linhagens prolíficas nesta população, que já vinha sendo melhorada há oito ciclos pelo método de seleção entre e dentro de famílias de meios irmãos. Para produção de grãos foi observado um progresso genético médio de 3,3% por ciclo, comparado com um progresso genético esperado de 7,2% por ciclo. Para índice-de-espigas foi observado um progresso genético de 8,9% e um progresso genético espe-rado de 1,9% por ciclo. Com a introdução de fatores de prolificidade, o índice-de-espigas aumentou consideravelmente superando inclusive o do híbrido duplo comercial utilizado como controle. Houve pequeno aumento da porcentagem de plantas acamadas e quebra-das, com o decorrer dos ciclos de seleção. Computando-se os ganhos obtidos inicialmente neste cultivar, houve em 10 ciclos de seleção um progresso acumulado de 28% para produção de grãos e de 10% para índice-de-espigas, sendo este último obtido quase exclusivamente após a introdução das linha-gens prolíficas.

São discutidos os resultados obtidos em um ensaio de uniformidade, constituído de 432 unidades básicas de 0,54 m², para determinação de tamanho, forma de parcelas e número de repetições para experimentos com morangueiro. As unidades básicas foram agrupadas de modo a permitir o estudo de 32 diferentes formatos de parcelas. A partir dos dados de produção foram calculados, para cada formato, os coeficientes de variação, cujos valores praticamente independeram da forma de parcela até agrupamentos de seis unidades básicas. A medida de variabilidade do solo foi o índice b calculado através da fórmula empírica desenvolvida por Faírfield Smith, Vx = V/x b. O valor 0,2214 obtido para b indicou que o solo onde o ensaio foi conduzido era bastante homogêneo. O tamanho ótimo da parcela, determinado para diferentes relações de preços de custo do ensaio associados ao índice b, variou de 0,28 a 2,55 unidades básicas com áreas de 0,15 a 1,38 m². Utilizando o método de Hatheway determinou-se que em área total fixa, parcelas menores e maior número de repetições permitem detectar diferenças menores entre médias de tratamentos.

Efetuaram-se em Campinas, SP, dois experimentos, procurando conhecer peculiaridades da germinação de sementes de maçã, de acordo com os cultivares e os processos de preparo. No primeiro, sementes de 30 cultivares foram estratificadas em substrato úmido e a baixa temperatura (5-10°C), para a quebra de dormência. De modo geral, as porcentagens de germinação foram bastante elevadas, sendo que 26 daqueles cultivares apresentaram-se com mais de 93%. No entanto, os cultivares estudados mostraram sensíveis variações quanto à velocidade de germinação; no ambiente de estratificação, a germinação teve inicio por volta do terceiro mês, continuou rapidamente no quarto e quinto, completando-se no sexto mês. No segundo experimento, sementes de três cultivares locais foram extraídas de frutos armazenados em ambiente de laboratório e em câmara frigorífica, durante diferentes períodos de tempo, e semeadas imediatamente ou depois de 90 dias de estratificação a frio. Naquelas extraídas de frutos mantidos ao ambiente, as porcentagens de germinação decresceram com o aumento do tempo de armazenamento, provavelmente devido aos efeitos perniciosos da deterioração da polpa. Os melhores resultados foram obtidos com sementes extraídas de frutos recém-colhidos e semeadas após um período de estratificação a frio úmido. Sementes extraídas de frutos conservados no frigorífico semeadas após estratificação, exibiram também altas porcentagens de germinação.

Com a finalidade de determinar cultivares mais adequados para plantio nas condições do Vale do Paraíba, no Estado de São Paulo, foram instalados experimentos de competição de linhagens e cultivares em três locais no município de Pindamonhangaba. Durante o período de 1973 a 1976, notou-se a ocorrência de granizo em 1974, prejudicando um dos ensaios, e de geada em 1975, a qual destruiu dois dos três ensaios plantados. Entre as moléstias que ocorrem no feijoeiro, observaram-se a antracnose e a ferrugem. As melhores produções médias foram obtidas pelas linhagens H38C1727 (Mulatinho), H38C1723 (Bico-de-ouro), H40C1722 (Chumbinho) e H40C1725 (Preto), e pelos cultivares piratã-2 e piratã-1, com 2.475, 2.308, 2.218, 2.195, 2.177 e 2.164 kg/ha respectivamente. Os cultivares carioca (Diversos) e rosinha G-2 (Rosinha) tiveram produções de 2.094 e 1.677 kg/ha. Levando-se em consideração a alta capacidade produtiva demonstrada nesses experimentos e em outras regiões do Estado, bem como a disponibilidade de sementes, os cultivares aroana (H40C1722), moruna (H40C1725), piratã-1 e carioca podem ser indicados para plantio em larga escala na região do Vale do Paraíba.

Este trabalho teve por objetivo a indução de mutação através da irradiação de sementes e sua aplicação prática no melhoramento do trigo. Foram utilizadas as variedades IAC-5 e BH-1146 que, apesar de apresentarem algumas características de interesse, possuem certos defeitos: a primeira possui porte relativamente elevado (100 a 120 cm), e a segunda é suscetível à ferrugem-do-colmo. A correção dessas deficiências, através da obtenção de mutantes, constitui o objetivo principal desta pesquisa. Várias seleções individuais foram efetuadas na geração M2 para as características mencionadas. Estas plantas foram semeadas em progênies, constituindo a geração M3, onde novas observações foram feitas. Notou-se que algumas das plantas selecionadas em M2 não eram mutantes, mas várias progênies confirmaram que mutantes com porte baixo ou com resistência à ferrugem foram obtidos. Para o cultivar IAC-5, foram obtidos três mutantes (TIACENA-1, TIACENA-2 e TIACENA-3). Tal material caracteriza-se pelo baixo porte das plantas e um deles mostrou-se oito dias mais precoce que IAC-5. Para BH-1146, a geração M3 confirmou a obtenção de mutante, denominado TIACENA-4, em que não se notou sintoma de ferrugem, apesar de se haver efetuado a inoculação artificial, em contraste com o controle, que foi altamente suscetível.

São relatados os resultados de experiência de irrigação e adubação de mandioca (Manihot esculenta, Crantz), realizada em área do Centro Experimental de Campinas, SP. A necessidade de irrigação só ocorreu quando as plantas já se encontravam no início e durante o "repouso fisiológico". Não se verificou influência da irrigação sobre a produção de raízes, ramas ou amido; observou-se, entretanto, ser a variedade IAC 105-66, mais resistente à seca que a branca-de-santa-catarina. Aquela Variedade, quando adubada, também apresentou cerca de 2% a mais de amido. A adubação provocou efeito negativo na produção de raízes, para ambas as Variedades, irrigadas ou não.

Com a finalidade de estudar o comportamento em duas regiões tritícolas do Estado de São Paulo foram instalados seis ensaios com trigo, sendo dois com cultivares sem tolerância ao Al+++ (comprovada), três com cultivares tolerante ao Al+++ e um com cultivares já em cultivo. BH-1146, IAC-5 (maringá) tobari-F-66, LA-1434 e super X foram considerados cultivares preferenciais para a semeadura na região do Vale do Paranapanema, e IAC-5 (maringá) foi considerado preferencial para a região sul do Estado de São Paulo. Os cultivares de origem mexicana têm-se mostrado suscetíveis a Puccinia graminis tritici.

Analisaram-se, em experimento localizado em Campinas, a produção e características das plantas e das sementes de progénies S2 e S3 dos cultivares mundo novo e burbom amarelo de Coffea arabica, algumas progênies de mundo novo amarelo, duas séries de híbridos simples e dois híbridos duplos entre cafeeiros selecionados de mundo novo e burbom amarelo. As progênies estudadas são derivadas de cafeeiros selecionados nas localidades de Campinas, Mococa, Ribeirão Preto, Pindorama e Jaú, no Estado de São Paulo. Os dados de produções foram obtidos, anualmente, no período de 1965 a 1974. Verificou-se que as progênies de mundo novo mostraram-se em média 22% mais produtivas do que as de burbom amarelo e que todas as progênies de mundo novo amarelo produziram menos do que a melhor progênie de mundo novo MP 388-6-20. Os híbridos simples sintetizados pelo método de cruzamento em cadeia, bem como os híbridos duplos, não se mostraram mais produtivos do que as progênies de mundo novo. Também não foram observadas diferenças significativas entre as progênies e os híbridos analisados quanto às demais características estudadas. Os dados obtidos indicaram que as progênies derivadas das plantas matrizes P 388, P 376 e P 386 mostraram alto potencial produtivo, o que justificaria a sua multiplicação e emprego em futuros programas de melhoramento.

São relatados resultados do estudo da variação de matéria seca, HCN, amido, carboidratos solúveis totais e açúcares redutores em raízes de mandioca (Manihot esculenta, Crantz) nos dias que sucederam à poda ou remoção total da parte aérea. Na amostragem foi utilizado o método convencional: raízes tomadas ao acaso e representativas da população. Diferentes tipos de raízes (da base e meio da maniva e da base das hastes) coletadas 17 dias após a poda apresentaram teores de carboidratos bem diferentes, seja pela mobi-lização mais acentuada de reservas, seja pela sua constituição originalmente diversa, o que sugere pesquisas mais detalhadas sobre o método de amostragem das raízes para análise de laboratório. Verificou-se que, num período de quatorze dias após a poda de plantas com treze meses de idade e em época quente e chuvosa, as transformações mais profundas ocorreram no teor de amido, que decresceu de 79,06% para 62,52%, e nos carboidratos solúveis totais e açúcares redutores, que tiveram um incremento na matéria seca das raízes, respectiva-mente de 7,65% e 1,55% para 17,56% e 5,03%. 0 teor de carboidratos totais foi pouco afetado pela poda, Indicando perda pequena destinada a nova brotação ou a outros processos fisiológicos. O teor de HCN decresceu de 67 para 35 ppm.

Infrutíferos todos os trabalhos visando ao melhoramento de Agave sisalana Perr., por meio de propagação sexual, os estudos voltaram-se para outras espécies, dentre elas duas diplóides: o A. amaniensis e o A. angustifolia: a primeira se caracteriza por apresentar folhas grandes e de boa conformação e, a segunda, por produzir elevado número de folhas. Nesse estudo utilizou-se A. amaniensis e seu híbrido com A. angustifolia. Os indivíduos obtidos (F2) apresentaram grande variação nas suas características, mas só foram estudadas as plantas de porte semelhante ao de A. sisalana. Dentre esses indivíduos, alguns se destacaram por apresentar produção total e produção média anual de fibras bem superiores àquela obtida normalmente com o sisal comum.

ABSTRACT BACKGROUND: Peutz-Jeghers Syndrome (PJS) is a rare, autosomal dominant disease, caused by deletions in the chromosome 19p33.3/ gene LKB1/STK11. These mutations inactivate a serine/threonine kinase and predispose to carcinogenesis. In PJS, tumors of the gastrointestinal, testicles, pulmonary, breast, pancreas, uterus and ovaries can be found. OBJECTIVE: To evaluate demographics, clinical presentation and complication/outcomes of pediatric patients presenting with Peutz-Jeghers syndrome (PJS), as well as to present and discuss management in the context of limited resources. METHODS: We conducted a retrospective chart review of a cohort of six patients, who were diagnosed and/or followed at the Clinics Hospital, University of Campinas - Sao Paulo/Brazil, between 2000 and 2018. Data analyzed included gender, age of presentation, age of diagnosis, family history, PJS complications. RESULTS: Median age of diagnosis of 6.7 years, with a mean time of follow-up of 8.1 years. Mucocutaneous pigmentation was universally present. Half of the patients had a known family history at the time of diagnosis. On follow up, intestinal intussusception was documented in four out of six patients, in most (three), in different locations and in multiple occasions. The active investigation of siblings and parents of the index case led to the diagnosis of three first-degree relatives in the present case series. CONCLUSION: In this first pediatric PJS Brazilian case series, we report a wide spectrum of PJS manifestations and complications. In a resource limited scenario, despite limitations for the surveillance of complications, the relative frequency of complications was not higher than historically reported.

ABSTRACT BACKGROUND: Biologics have revolutionized the treatment of inflammatory bowel disease (IBD). However, these drugs had a significant influence on treatment-related costs, which resulted in the development of biosimilars. OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the drug discontinuation rate in the IBD population who switched from originator to biosimilars in real-world switching studies and address potential nocebo effects as reasons for drug discontinuation. METHODS: Medline (via PubMed), EMBASE, Cochrane Library, and abstract databases of selected congresses were screened for reports of monoclonal antibody (mAb) switching with a minimum post-switch follow-up of >6 months or three infusions. All available information on discontinuation rates was assessed. RESULTS: A total of 30 observational studies were included, involving 3,594 patients with IBD. Twenty-six studies reported a switch from infliximab to CT-P13, two studies involved a switch to SB2, and switching information was not available in two studies. The discontinuation rates were 8%, 14%, and 21% at 6, 12, and 24 months, respectively. The main reasons for drug discontinuation and their respective risks were: disease worsening (2%), remission (4%), loss of adherence (4%), adverse events (5%), and loss of response (7%). The quality of the evidence ranged from low to very low depending on the outcome analyzed. Subjective symptoms leading to drug discontinuation were infrequently reported, and the nocebo effect was clearly assessed in just one of the included papers. CONCLUSION: Discontinuation rates following a switch to a biosimilar in patients with IBD increase over time. However, it was not possible to confirm the nocebo effect as a reason for discontinuation. Therefore, long-term studies evaluating the use of biosimilars to monitor adverse events and potential nocebo effects in post-marketing surveillance are still needed.

ABSTRACT BACKGROUND: Acute kidney injury (AKI) is a common and severe complication of cirrhosis. OBJECTIVE: To evaluate the impact of AKI staging on 30-day mortality of patients with cirrhosis. METHODS: We performed a retrospective cohort study of hospitalized patients with cirrhosis. Acute kidney injury (AKI) was diagnosed according to the International Club of Ascites recommendations and staged according to the European Association for the Study of the Liver guidelines. Comparisons between groups were made by one-way analysis of variance and Tukey test. Chi-square was calculated for dichotomous variables. Comparisons of renal impairment status among patients were performed using Kaplan-Meier statistics and differences between groups were analyzed using the log-rank test. A P-value <0.05 was considered to be statistically significant. RESULTS: Two hundred and thirty-two patients were included in the study. The diagnosis of AKI was performed in 98 (42.2%) of them. The overall 30-day mortality was 19.8% (46/232). Mortality increased as the degree of AKI progressed. Among patients who did not have AKI, mortality was 5.2% (7/134). When compared to patients without AKI, patients diagnosed with AKI stage 1a had mortality of 12.1% (4/33, P=0.152); patients with AKI stage 1b had mortality of 45% (18/40, P<0.001); and patients with AKI stages 2 or 3 had mortality of 68% (17/25, P<0.001). Moreover, it is noteworthy that full response to treatment was associated to a decreased mortality when compared to patients who did not show complete recovery of renal function (14.3% vs 57.9%, P<0.001). CONCLUSION: AKI stages 1b or greater, but not AKI stage 1a, are associated to higher 30-day mortality of patients with cirrhosis.

ABSTRACT BACKGROUND: Copper deficiency has been linked to alterations in lipid metabolism and hepatic steatosis. Oxidative stress plays a role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). One of the enzymes that neutralize oxidative stress is Cu/Zn superoxide dismutase, which depends on the availability of adequate amounts of copper. OBJECTIVE: Correlate the levels of ceruloplasmin and of non-ceruloplasmin-bound copper (NCBC) with clinical, biochemical and histological parameters of non-alcoholic fatty liver disease (NAFLD) patients. METHODS: Data from 95 consecutively admitted NAFLD patients who underwent liver biopsy composed the groups based on ceruloplasmin levels lower than 25 mg/dL and on negative NCBC. The risk factors for NAFLD in each group were compared. RESULTS: Body mass index was lower in patients with ceruloplasmin <25 mg/dL (29.1±3.47 vs 32.8±6.24 kg/m2; P=0.005) as were the levels of LDL, HDL and total cholesterol, when compared with their counterparts with ceruloplasmin >25 mg/dL (101±38 vs 116±35 mg/dL, P=0.05; 43±9 vs 51±16 mg/dL, P=0.01; 174±43 vs 197±39 mg/dL, P=0.01, respectively). Mean serum ferritin levels were higher in the ceruloplasmin <25 mg/dL group (343±327 vs 197±190 ng/mL; P=0.02). Otherwise, patients with negative NCBC had higher HOMA-IR (8.2±14.7 vs 4.6±3.7; P=0.03). Age, gender, hypertension and diabetes showed no statistical difference. CONCLUSION: Patients with NAFLD had different clinical and biochemical markers according to the levels of NCBC and ceruloplasmin.

ABSTRACT BACKGROUND: Current policy for listing to liver transplant (LT) may place cirrhotic patients without MELD exception points (CIR) in a disadvantageous position if compared to patients enlisted with appealed MELD scores - patients with hepatocellular carcinoma (HCC) or special conditions other than hepatocellular carcinoma (SPE). Transplant rates, delisting, and waitlist mortality of CIR, HCC, and SPE candidates were compared. OBJECTIVE: The aim of this study is to counterweight the listing rate and speed of listing of HCC, SPE, and CIR patients. To the best of our knowledge, this is the first study comparing the outcomes of patients enlisted for SPE to those of HCC and CIR. In several countries worldwide, SPE patients also receive appealed MELD scores in a similar way of HCC patients. METHODS: Two cohorts of patients listed for LT in a single institution were evaluated. The first cohort (C1, n=180) included all patients enlisted on August 1st, 2008, and all additional patients listed from this date until July 31st, 2009. The second cohort (C2, n=109) included all patients present on the LT list on October 1st, 2012, and all additional patients listed from this date until May 2014. RESULTS: In both cohorts, HCC patients had a higher chance of receiving a LT than CIR patients (C1HR =2.05, 95%CI=1.54-2.72, P<0.0001; C2HR =3.17, 95%CI =1.83-5.52, P<0.0001). For C1, 1-year waiting list mortality was 21.6% (30.0% for CIR vs 9.5% for HCC vs 7.1% for SPE) (P<0.001). For C2, 1-year waiting list mortality was 13.3% (25.7% for CIR, 8.3% for HCC, and 4.0% for SPE) (P<0.001). Post-transplant survival was similar among the three groups. CONCLUSION: Compared to CIR, SPE and HCC patients had lower wait list mortality. CIR patients had the highest waitlist mortality and the lowest odd of LT. Current LT allocation system does not allow equitable organ allocation.

ABSTRACT BACKGROUND: Hepatopulmonary syndrome (HPS) is a complication associated with cirrhosis that may contribute to worsening exercise capacity and reduced survival after liver transplantation (LT). OBJECTIVE: To evaluate exercise capacity, complications and survival after LT in patients with cirrhosis and HPS and to compare these results with the results of patients with cirrhosis without HPS. METHODS: A prospective cohort study, consisting initially of 178 patients, of whom 90 underwent LT (42 with HPS and 48 without HPS). A previous evaluation consisted of the six-minute walk test (6MWT), an exercise test and manovacuometry. Those who underwent LT were evaluated for the mechanical ventilation time (MV), noninvasive ventilation (NIV) use, and survival two years after the procedure. In the statistical analysis, we used the Kolmogorov-Smirnov test, Student’s t-test, the linear association square test, and the Kaplan-Meier survival curve. The data were analyzed with the SPSS 16.00 program and considered significant at P<0.05. RESULTS: The HPS group demonstrated a lower peak of oxygen consumption (VO2peak) (14.2±2.3 vs 17.6±2.6) P<0.001 and a shorter distance walked on the 6MWT (340.8±50.9 vs 416.5±91.4) P<0.001 before LT compared with the non-HPS group. The transplanted patients with HPS remained longer hours in MV (19.5±4.3 vs 12.5±3.3) P=0.02, required more NIV (12 vs 2) P=0.01, and had lower survival two years after the procedure (P=0.01) compared with the transplanted patients without HPS. CONCLUSION: Patients with HPS had worse exercise capacity before LT, more complications and shorter survival after this procedure than patients without HPS.

ABSTRACT BACKGROUND: Endoscopic papillectomy has been conceived as a less invasive therapeutic option for treatment of early neoplastic lesions located at the major duodenal papilla. OBJECTIVE: Evaluating patients with early ampullary lesions who underwent curative intent endoscopic papillectomy related to technical success (histopathological tumor margin assessment) and safety (adverse event rate). METHODS: A retrospective study including consecutive patients who underwent curative intent endoscopic papillectomy for demographic, histopathological and pre-/post-procedural clinical assessment. Endpoints were technical success (histopathological residual tumor assessment) and adverse events rates. RESULTS: A total of 21 medical records patients with a female predominance (13 cases, 61.9%) were included. The tumor was incidental in 8 (38%) cases. Negative residual tumor resection margin rate was 72% (15 cases); three of these cases confirmed high-grade dysplasia in the resected specimen, and six cases were invasive neoplasia. Tumoral recurrence was seen in two cases, and median follow-up time was 12 months, with a 23% loss rate (five patients). Six (28.5%) patients had adverse events, all of them early (bleeding and pancreatitis); none of them required surgical intervention and there was no mortality. CONCLUSION: Endoscopic papillectomy allowed for technical successful procedure with complete removal of ampullary neoplastic lesions in the majority of cases with acceptable adverse event rates. Recurrence rate should be carefully assessed in further studies. There was a recent increase in the number of procedures. There was also a low correlation between pre- and post-histopathological assessment regarding the presence of invasive carcinoma and adenoma with high grade dysplasia, with a predominance of superficial neoplastic adenomatous lesions.

ABSTRACT BACKGROUND: Rectal bleeding is the most important symptom of intestinal neoplasia; thus, tests of occult blood detection in stools are widely used for pre neoplastic lesions and colorectal cancer (CRC) screening. OBJECTIVE: Evaluate the accuracy of OC-Sensor quantitative test (Eiken Chemical, Tokyo, Japan) at cut-off 10 µg Hb/g feces (50 ng/mL) in a cohort of subjects that had to undergo diagnostic colonoscopy, and if more than one sample collected in consecutive days would improve the diagnostic accuracy of the test. METHODS: Patients (mean age 56.3±9.7 years) that underwent colonoscopy prospectively randomly received one (1-sample FIT, FIT 1) or two (2-sample FIT, FIT 2) collection tubes. They collected the stool sample before starting colonoscopy preparation. Samples were analyzed by the OC-Auto Micro 80 (Eiken Chemical, Tokyo, Japan). The performance of FIT 1 and FIT 2 were compared to the colonoscopy findings. RESULTS: Among 289 patients, CRC was diagnosed in 14 (4.8%), advanced adenoma in 37 (12.8%), early adenoma in 71 (24.6%) and no abnormalities in 141 (48.8%). For FIT 1, the sensitivity for CRC was 83.3% (95%CI 36.5-99.1%), for advanced adenoma was 24% (95%CI 10.1-45.5%), with specificity of 86.9% (95%CI 77.3-92.9%). For FIT 2, the sensitivity for CRC was 75% (95%CI 35.6-95.5%), for advanced adenoma was 50% (95%CI 22.3-77.7%), with specificity of 92.9% (95%CI 82.2-97.7%). The positive likelihood ratios were 1.8 (95%CI 0.7-4.4 for FIT 1) and 7.1 (95%CI 2.4-21.4 for FIT 2) for advanced adenoma, and 6.4 (95%CI 3.3-12.3, for FIT 1) and 10.7 (95%CI 3.8-29.8, for FIT 2) for CRC. The negative likelihood ratio were 0.9 (95%CI 0.7-1, for FIT 1) and 0.5 (95%CI 0.3-0.9, for FIT 2) for advanced adenoma, and 0.2 (0.03-1.1, for FIT 1) and 0.3 (0.08-0.9, for FIT 2) for CRC. The differences between FIT 1 and FIT 2 performances were not significant. However, the comparison of the levels of hemoglobin in feces of patients of FIT 1 and FIT 2 showed that the differences between no polyp group and advanced adenoma and CRC were significant. CONCLUSION: The accuracy of OCR Sensor with 10 µg Hb/g feces cut-off was comparable to other reports and two-sample collection improved the detection rate of advanced adenoma, a pre neoplastic condition to prevent CRC incidence.

ABSTRACT BACKGROUND: Chronic hepatitis C still figures as an important cause of morbidity among the Brazilian population, and is closely associated with metabolic disturbances, including insulin resistance (IR), which can be evaluated by the Homeostatic Model Assessment (HOMA-IR). IR may entail lower sustained virologic response (SVR) on certain therapeutic regimens and faster progression to advanced hepatic fibrosis. With the arrival of the direct acting agents (DAA) in hepatitis C treatment, there is an increased need in observing the impact in patients’ IR profile while using such therapies. OBJECTIVE: - 1) To compare the results of HOMA-IR in patients affected by chronic hepatitis C before treatment with DAA and 12 months after finishing it with SVR. 2) To evaluate the evolution of weight after curing chronic hepatitis C. METHODS: We included patients older than 18 from two tertiary care in Curitiba - PR, of both sexes, with chronic hepatitis C, treated with DAA, from July 2015 to September 2017. We also evaluated the patients’ levels of fasting insulin, fasting glucose and glycated hemoglobin before starting treatment and 12 months after finishing it. We also used epidemiologic data, such as age, sex, hepatic fibrosis degree, body mass index, abdominal circumference, viral genotype and the presence of diabetes mellitus before and after treatment. IR was assessed before and after treatment and calculated by the HOMA-IR score. Insulin resistance was defined by a HOMA-IR greater than 2.5. We excluded patients who lost follow-up, those who did not achieve SRV and those who did not have a laboratory profile. The results of quantitative variables were described by means, medians, and standard deviations. P values <0.05 indicated statistical significance. RESULTS: We included 75 patients in this study, with a mean age of 55.2 years and 60% of males. Forty-three patients had advanced fibrosis. Twenty one (28%) had a previous diabetes mellitus diagnosis. We identified 31 (41.3%) patients with IR before antiviral treatment, and this number increased to 39 (52%) after 12 months of finishing treatment, according to HOMA-IR. There was no statistic difference between insulin, glucose and HOMA-IR measurements before and after curing hepatitis C. We observed a weight gain in patients shortly after curing hepatitis C, but this did not persist at the end of the study. We also had no significant difference in IR prevalence when viral genotype was concerned. CONCLUSION: In this study, there was no statistically significant difference between HOMA-IR results in patients before and 12 months after treatment for hepatitis C. Even though patients gained weight after the cure, this was not statistically significant after a year (P=0.131).