Câncer e meio ambiente. Tabaco - agrotóxicos - radiações – dieta. Um documento para a Conferência Mundial de Ecologia

Trabalho elaborado como parte de um documento global sobre Saúde e Meio Ambiente da Fundação Oswaldo Cruz

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000–2014 (CONCORD-3)

Background: Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. Methods: We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000–2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. Results: The study included 556,237 adults. In 2010–2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%–38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000–2004 and 2005–2009. These improvements were more noticeable among adults diagnosed aged 40–70 years than among younger adults. Conclusions: To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3) : analysis of individual data from 258 cancer registries in 61 countries

Background Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings 164563 young people were included in this analysis: 121328 (73·7%) children, 22963 (14·0%) adolescents, and 20272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group.peer-reviewe

The complete genome sequence of Chromobacterium violaceum reveals remarkable and exploitable bacterial adaptability

Chromobacterium violaceum is one of millions of species of free-living microorganisms that populate the soil and water in the extant areas of tropical biodiversity around the world. Its complete genome sequence reveals (i) extensive alternative pathways for energy generation, (ii) ≈500 ORFs for transport-related proteins, (iii) complex and extensive systems for stress adaptation and motility, and (iv) wide-spread utilization of quorum sensing for control of inducible systems, all of which underpin the versatility and adaptability of the organism. The genome also contains extensive but incomplete arrays of ORFs coding for proteins associated with mammalian pathogenicity, possibly involved in the occasional but often fatal cases of human C. violaceum infection. There is, in addition, a series of previously unknown but important enzymes and secondary metabolites including paraquat-inducible proteins, drug and heavy-metal-resistance proteins, multiple chitinases, and proteins for the detoxification of xenobiotics that may have biotechnological applications

Alterações genéticas no cancro do pulmão: Avaliação das limitações ao seu uso na rotina clínica Genetic alterations in lung cancer: Assessing limitations in routine clinical use

O cancro do pulmão é a causa mais frequente de mortalidade por cancro no mundo, sendo responsável por cerca de 1,1 milhões de mortes por ano. A sobrevivência média dos doentes é geralmente curta, por a doença se encontrar em estádios avançados na altura do diagnóstico, mas também devido à falta de eficácia dos tratamentos disponíveis. O advento da genética molecular dos tumores trouxe consigo a possibilidade de modificar esta situação, quer através do refinamento do diagnóstico, quer da identificação de alvos terapêuticos específicos, quer sobretudo por - pelo menos em teoria - permitir o diagnóstico precoce da doença. No entanto, e apesar de numerosos trabalhos terem já demonstrado a utilidade das técnicas da genética molecular no estudo do cancro do pulmão, o seu uso na rotina clínica em Portugal tem sido limitado. No presente estudo, utilizou-se a pesquisa de mutações no anti-oncogene p53 em amostras clínicas de doentes com diagnóstico de cancro do pulmão como método para identificar as dificuldades práticas à integração da genética molecular na rotina clínica. Os resultados obtidos sugerem que o principal factor limitante a essa integração é a obtenção de amostras de ADN de qualidade, um problema que pode ser superado pela alteração das práticas correntes de recolha de amostras.Lung cancer is the most frequent cause of cancer mortality worldwide, responsible for approximately 1.1 million deaths per year. Median survival is short, both as most tumours are diagnosed at an advanced stage and because of the limited efficacy of available treatments. The development of tumour molecular genetics carries the promise of altering this state of affairs, as it should lead to a more precise classification of tumours, identify specific molecular targets for therapy and, above all, allow the development of new methods for early diagnosis. Despite numerous studies demonstrating the usefulness of molecular genetic techniques in the study of lung cancer, its routine clinical use in Portugal has, however, been limited. In this study, we used a p53 mutation screen in multiple clinical samples from a series of lung cancer patients to attempt to identify the main practical limitations to the integration of molecular genetics in routine clinical practice. Our results suggest that the main limiting factor is the availability of samples with good quality DNA; a problem that could be overcome by alterations in common sample collection and storage procedures

Colônia agrícola amazônica sob inquérito médico-social I – Sintomatologia digestiva ligada ao enteroparasitismo e à carência (Publicado originalmente em 1967)

Ministério da Saúde. Fundação Serviço Especial de Saúde Pública. Instituto Evandro Chagas. Belém, PA, Brasil / Universidade Federal do Pará. Faculdade de Medicina. Belém, PA. Brasil.Universidade Federal do Pará. Faculdade de Medicina. Belém, PA. Brasil.Universidade Federal do Pará. Faculdade de Medicina. Belém, PA. Brasil.Instituto de Desenvolvimento Econômico e Social do Pará. Belém, PA, Brasil.Universidade Federal do Pará. Faculdade de Medicina. Belém, PA. Brasil.Universidade Federal do Pará. Faculdade de Medicina. Belém, PA. Brasil.Universidade Federal do Pará. Faculdade de Medicina. Belém, PA. Brasil.Equipe das cátedras de Clínica Médica e de Parasitologia, da Faculdade de Medicina da Universidade Federal do Pará, que, em janeiro de 1965, se dirigiu ao interior do município de Nova Timboteua, na zona bragantina, em estudos de natureza médico-social, achou interessante estender suas observações à colônia agrícola de Sumaúma, que pode ser tomada como típica dessa zona fisiográfica paraense. É que a dispersão das moradias, sem casas geminadas e, até, sem arruamento, com casas desocupadas por períodos de safras, quando os moradores se deslocam em busca de terras de melhor rendimento para determinados cultivos, oferece oportunidade de comparação de dados com os de aglomerado de povoação situada à distância de alguns quilômetros. A repercussão do enteroparasitismo e da carência na sintomatologia digestiva foi detectada em entrevistas individuais com 35 moradores, de idades que garantissem maior fidelidade às informações, consoante o quadro a seguir, dentre as 120 pessoas em que ficou estimada a população global da colônia: Pessoas De 13 anos de idade 1 De 15 e 16 anos 3 De 20 a 40 anos 21 De mais de 40 anos 10 Total 35 Os dados, coligidos em percentuais, falam a favor de condições nutricionais não satisfatórias, presentes distúrbios digestivos na vigência de parasitismo intestinal