Differences in breast cancer risk after benign breast disease by type of screening diagnosis

Neoplàsies de mama; Detecció precoç del càncer; Factors de riscNeoplasias de mama; Detección precoz del cáncer; Factores de riesgoBreast neoplasms; Early cancer detection; Risk factorsIntroduction: We aimed to assess differences in breast cancer risk across benign breast disease diagnosed at prevalent or incident screens. Materials and methods: We conducted a retrospective cohort study with data from 629,087 women participating in a long-standing population-based breast cancer screening program in Spain. Each benign breast disease was classified as non-proliferative, proliferative without atypia, or roliferative with atypia, and whether it was diagnosed in a prevalent or incident screen. We used partly conditional Cox hazard regression to estimate the adjusted hazard ratios of the risk of breast cancer. Results: Compared with women without benign breast disease, the risk of breast cancer was significantly higher (p-value ¼ 0.005) in women with benign breast disease diagnosed in an incident screen (aHR, 2.67; 95%CI: 2.24e3.19) than in those with benign breast disease diagnosed in a prevalent screen (aHR, 1.87; 95%CI: 1.57e2.24). The highest risk was found in women with a proliferative benign breast disease with atypia (aHR, 4.35; 95%CI: 2.09e9.08, and 3.35; 95%CI: 1.51e7.40 for those diagnosed at incident and prevalent screens, respectively), while the lowest was found in women with non-proliferative benign breast disease (aHR, 2.39; 95%CI: 1.95e2.93, and 1.63; 95%CI: 1.32e2.02 for those diagnosed at incident and prevalent screens, respectively). Conclusion: Our study showed that the risk of breast cancer conferred by a benign breast disease differed according to type of screen (prevalent or incident). To our knowledge, this is the first study to analyse the impact of the screening type on benign breast disease prognosisThis study was supported by grants from Instituto de Salud Carlos III FEDER (grant numbers: PI15/00098 and PI17/00047), and by the Research Network on Health Services in Chronic Diseases (RD12/0001/0015

Telessaúde Covid: caracterização sociodemográfica, clínico-epidemiológica e indicadores do telemonitoramento em Viçosa-MG

Em 2020, a Universidade Federal de Viçosa e a Gestão Municipal implementaram o projeto de extensão Telessaúde Covid para o enfrentamento da pandemia. O objetivo é fazer uma análise descritiva dos quatorze meses de atuação do projeto. Realizou-se análise descritiva da caracterização sociodemográfica, clínico-epidemiológica e indicadores do serviço. Foram atendidos 6.898 pacientes, predominando o gênero feminino e adultos jovens. Os sinais e sintomas mais frequentes foram cefaleia, tosse, coriza, dor de garganta, dor muscular e febre. O RT-PCR foi o teste realizado pela maioria e 31,6% dos pacientes foram positivos. O serviço concluiu o encerramento de 91,5% dos atendimentos. O Telessaúde Covid foi relevante para o contingenciamento da Covid-19, com número expressivo de atendimentos, e contemplou a missão social da universidade pública, transformando o modelo assistencial e reorientando o processo de formação e ação profissional de estudantes e profissionais de saúde

Impactos na Saúde Associados ao Uso de Psicoestimulantes: Uma Revisão Sistemática

This article conducts a systematic review of health impacts associated with the use of psychostimulants, encompassing clinical and recreational contexts. The introduction emphasizes the relevance of the topic given the prevalence of these substances and the need to understand their comprehensive effects. The methodology employed involved an extensive literature search on platforms such as PubMed and Scopus, establishing clear inclusion/exclusion criteria, and applying rigorous assessment of the quality of selected studies. In the discussion, we explore the therapeutic benefits of these psychostimulants, highlighting their efficacy in treating conditions such as Attention-Deficit/Hyperactivity Disorder (ADHD). However, the analysis also covers physical and mental risks, especially when these substances are used outside the medical context, demonstrating associations with cardiovascular complications and psychiatric disorders. The crucial differentiation between therapeutic and recreational use is emphasized, underscoring the importance of an individualized assessment to understand the risks and benefits associated with each usage context. The conclusion emphasizes the need for clarity in communication about the use of psychostimulants, a careful evaluation of long-term impacts, and the implementation of public health strategies sensitive to social and cultural influences. This work contributes to a comprehensive understanding of health impacts related to psychostimulants, providing valuable insights for healthcare professionals, researchers, and policymakers in managing these substances in different contexts.Este artigo realiza uma revisão sistemática dos impactos na saúde associados ao uso de psicoestimulantes, abrangendo contextos clínicos e recreativos. A introdução destaca a relevância do tema diante da prevalência dessas substâncias e da necessidade de compreender seus efeitos abrangentes. A metodologia adotada envolveu uma busca bibliográfica extensiva em bases como PubMed e Scopus, estabelecendo critérios claros de inclusão/exclusão e aplicando uma avaliação rigorosa da qualidade dos estudos selecionados. Na discussão, exploramos os benefícios terapêuticos desses psicoestimulantes, evidenciando sua eficácia no tratamento de condições como o Transtorno de Déficit de Atenção e Hiperatividade (TDAH). Contudo, a análise abrange também os riscos físicos e mentais, especialmente quando essas substâncias são utilizadas fora do contexto médico, evidenciando a associação com complicações cardiovasculares e transtornos psiquiátricos. A diferenciação crucial entre o uso terapêutico e o recreativo é destacada, enfatizando a importância de uma avaliação individualizada para compreender os riscos e benefícios associados a cada contexto de uso. A conclusão ressalta a necessidade de clareza na comunicação sobre o uso de psicoestimulantes, uma avaliação cuidadosa dos impactos a longo prazo e a implementação de estratégias de saúde pública sensíveis às influências sociais e culturais. Este trabalho contribui para a compreensão abrangente dos impactos na saúde relacionados a psicoestimulantes, fornecendo insights valiosos para profissionais de saúde, pesquisadores e formuladores de políticas no manejo dessas substâncias em diferentes contextos

Genomic Surveillance of Yellow Fever Virus Epizootic in São Paulo, Brazil, 2016 – 2018

São Paulo, a densely inhabited state in southeast Brazil that contains the fourth most populated city in the world, recently experienced its largest yellow fever virus (YFV) outbreak in decades. YFV does not normally circulate extensively in São Paulo, so most people were unvaccinated when the outbreak began. Surveillance in non-human primates (NHPs) is important for determining the magnitude and geographic extent of an epizootic, thereby helping to evaluate the risk of YFV spillover to humans. Data from infected NHPs can give more accurate insights into YFV spread than when using data from human cases alone. To contextualise human cases, identify epizootic foci and uncover the rate and direction of YFV spread in São Paulo, we generated and analysed virus genomic data and epizootic case data from NHPs in São Paulo. We report the occurrence of three spatiotemporally distinct phases of the outbreak in São Paulo prior to February 2018. We generated 51 new virus genomes from YFV positive cases identified in 23 different municipalities in São Paulo, mostly sampled from NHPs between October 2016 and January 2018. Although we observe substantial heterogeneity in lineage dispersal velocities between phylogenetic branches, continuous phylogeographic analyses of generated YFV genomes suggest that YFV lineages spread in São Paulo at a mean rate of approximately 1km per day during all phases of the outbreak. Viral lineages from the first epizootic phase in northern São Paulo subsequently dispersed towards the south of the state to cause the second and third epizootic phases there. This alters our understanding of how YFV was introduced into the densely populated south of São Paulo state. Our results shed light on the sylvatic transmission of YFV in highly fragmented forested regions in São Paulo state and highlight the importance of continued surveillance of zoonotic pathogens in sentinel species

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

DOR E PRAZER NA PRÁTICA MUSICAL

Apesar de ser um tema pouco divulgado tanto publicamente quanto dentro da própria classe musical, é grande o número de músicos que sofre com dores, desconfortos e até mesmo lesões e outros problemas de saúde decorrentes da atividade musical. A respeito disso se têm observado, nas últimas décadas, um crescente interesse de pesquisadores, principalmente da área da saúde, o que faz com que já existe uma considerável bibliografia sobre o assunto. Entretanto, ainda existem muitas lacunas de conhecimento que precisam ser preenchidas a fim de tornar a prática musical (profissional ou não) menos prejudicial à saúde de seus praticantes. Esta pesquisa, de caráter exploratório, investiga o tema numa amostra de 39 músicos instrumentistas da cidade de Manaus, dando ênfase às questões emocionais envolvidas na prática e sobre como elas podem interferir na percepção desses constrangimentos por parte dos indivíduos. Um dos pontos centrais abordados é a questão de que a prática musical seria uma situação favorável à ocorrência do estado de flow (CSIKSZENTMIHALYI, 1997), o que justificaria o fato de muitos músicos nem perceberem as dores e desconfortos durante a execução das atividades. Foi aplicado junto a esses respondentes um instrumento de coleta de dados composto de quatro partes: um questionário com informações gerais sobre a prática musical e os constrangimentos; um processo de ordenação de cartões com emoções/sentimentos presentes na prática; uma série de escalas de avaliação tratando do estado de flow e da cultura da dedicação presente no meio musical; e uma entrevista final visando ter opiniões mais aprofundadas dos músicos a respeito do tema tratado. Os dados coletados foram cruzados e analisados e os resultados apontam, entre outras coisas, que a prática musical, dentro dessa amostra, apresenta características similares às encontradas nas ocorrências do estado de flow e ainda contam da importância das questões emocionais na prática, de acordo com a opinião dos músicos participantes.Despite being a little divulged issue both publicly and within the musical class, is high the number of musicians who suffer from pains, discomforts and even injuries and other health problems associated with the musical activity. About this, have been observed in recent decades, a growing interest from researchers, especially in the health area, which means there is already a considerable literature on the subject. However, there are still many knowledge gaps that need to be filled in order to make the musical practice (professional or not) less harmful.This study, which has an exploratory character, investigates this issue with a sample of 39 instrumentalists from Manaus, emphasizing the emotional aspects involved in the practice and how they can interfere in the perception of the constraints of these individuals. One of the main points discussed is that musical practice would be a favorable situation to occurrence of flow state (CSIKSZENTMIHALYI, 1997) what could justify the fact that many musicians don’t even realize the pain and injuries during the execution of the activity. It was applied at these respondents an instrument of data collection consisted on four parts: a questionnaire with general information about musical practice and constraints; a process of ordination of cards containing emotions/feelings involved in the practiced; a series of assessments scales about the flow state and about the dedication culture that exists in the musical environment; and a final interview seeking for more deeper opinions from musicians about the issue. The collected data were crossed and analyzed and the results indicate, among other conclusions, that musical practice from this sample, has similar characteristics from other where flow state is found, and still contain the importance of emotional matters in the practice, according to the participants musicians

Modelagem da incidência do dengue na Paraíba, Brasil, por modelos de defasagem distribuída Modeling of dengue incidence in Paraíba State, Brazil, using distributed lag models

Existem vários modelos estatísticos na literatura para explicar a incidência do dengue. Porém, há divergências a respeito da real validade de modelos baseados em fatores climáticos e de modelos baseados em variáveis relativas ao combate ao vetor, pois a variabilidade apresentada por estas variáveis não são suficientes para explicar satisfatoriamente o comportamento estatístico da incidência do dengue. Os modelos de defasagem distribuída (MDD) supõem que a variável resposta Y será explicada pela presença de uma variável X no mesmo instante de tempo t e também pelos instantes anteriores (t-1, ...). Este estudo apresenta uma proposta de utilização do MDD na modelagem do dengue. Dentre os vários modelos testados, dois apresentaram resultados aparentemente interessantes. Um modelo MDD usando-se pluviometria não foi validado sob o ponto de vista estatístico. Um outro usando-se o número de municípios com dengue apresentou resultados estatísticos válidos e satisfatórios. Além disso, sob o ponto de vista das Secretarias Estaduais de Saúde, é um modelo viável que permite com uma única fonte de informação estabelecer um modelo com resultados estatísticos interessantes e de boa acurácia.The literature provides several statistical models to explain dengue incidence. However, there is disagreement as to the real contribution of models based on climate factors or models based on relative variables to combat the vector, because their variability fails to provide a satisfactory statistical explanation for the behavior of dengue incidence. Distributed lag models (DLM) posit that a variable response Y will be explained by the presence of a variable X at the same moment in time t and in the previous moments (t-1, ...). The current study presents the use of DLM in dengue modeling. Among the several models tested, two displayed apparently interesting results. A DLM using rainfall was not validated statistically. Another model using the number of counties (municipalities) with dengue presented valid and satisfactory results. This DLM was also feasible from the perspective of State Health Departments, allowing the development of a model with interesting statistical results and good accuracy, using a single data source

Renal angiomyolipoma rupture: Case report

Generally benign, renal angiomyolipomas are neoplasms composedof mature adipose tissue, smooth muscle, and thick-walled bloodvessels. Although asymptomatic, massive retroperitoneal hemorrhagefrom angiomyolipomas accompanied by hypovolemic shock has beenfound in up to 10% of patients, usually those with large tumors. Wereport the case of a 33-year-old woman with spontaneous rupture ofan angiomyolipoma, who was initially treated with embolization ofthe lesion in order to stabilize her clinical condition, and later submittedto a partial nephrectomy

Leucismo en Callithrix jacchus (Primates: Callitrichidae) y Sciurus aestuans (Rodentia: Sciuridae) en el noreste de Brasil

Phenotypic variation is common in vertebrates, especially if we consider geographic variations, however, mutations such as leucism, melanism, and albinism are not so common. Here, we report two cases of leucism, in common marmoset (Callithrix jacchus) and Brazilian squirrel (Guerlinguetus aestuans), recorded in Atlantic Forest fragments in northeastern Brazil. These reports allow us to better understand this phenomenon, as well as ecological and physiological implications for animals, which have a significant influence on their survival.La variación fenotípica es común en los vertebrados, especialmente si consideramos las variaciones geográficas, sin embargo, mutaciones como el leucismo, el melanismo y el albinismo no son tan comunes. Aquí, reportamos dos casos de leucismo, en tití común (Callithrix jacchus) y ardilla brasileña (Guerlinguetus aestuans), registrados en fragmentos de Mata Atlántica en el noreste de Brasil. Estos registros nos permiten comprender mejor este fenómeno, así como las implicaciones ecológicas y fisiológicas para los animales, que tienen una influencia significativa en su supervivencia