The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Evaluation Of The Neonatal Outcomes Of The Kangaroo Mother Method In Brazil [avaliação Dos Resultados Neonatais Do Método Canguru No Brasil]

Objective: To evaluate the results of the kangaroo mother method in Brazil. Methods: A prospective cohort study comparing 16 units that have or do not have the second phase of the kangaroo mother method: eight were national centers of excellence for the kangaroo mother method (study group) and eight were part of the Brazilian Neonatal Research Network (control group). A total of 985 newborn infants with birth weights of 500 to 1,749 g were enrolled. Multivariate analyses employedmultiple linear regression and Poisson regression with robust adjustment. Results: The adjusted analysis (controlled for birth weight, gestational age, Score for Neonatal Acute Physiology Perinatal Extension II, Neonatal Therapeutic Intervention Scoring System, and maternal age and educational level) demonstrated that mean length of hospital stay (p = 0.14) and intercurrent clinical conditions in the intermediate or kangaroo unit were equal for both groups. Weight (p = 0.012), length (p = 0.039) and head circumference (p = 0.006) at 36 weeks' corrected gestational age were all lower at the kangaroo units. The kangaroo units exhibited superior performance in relation to exclusive breastfeeding at discharge (69.2 vs. 23.8%, p=0.022). Conclusions: The evidence suggests that the humanization strategy adopted by the Brazilian Ministry of Health is a safe alternative to conventional treatment and a good strategy for promoting breastfeeding. Copyright © 2008 by Sociedade Brasileira de Pediatria.845428435Mathelin, C., (1999) Osorriso da Gioconda: Clínica psicanalí ticacombebês prematuros, , Rio de Janeiro: Companhia de Freud;Lamy, Z.C., (2000) Unidade neonatal: Um espaço de conflitos e negociações [Tese], , Rio de Janeiro, RJ: Fundação Oswaldo Cruz;Walsh-Sukys M, Reitenbach A, Hudson-Barr D, DePompei P. Reducing light and sound in the neonatal intensive care unit: an evaluation of patient safety, staff satisfaction, and costs. J Perinatol. 2001;21:230-5. Erratum in: J Perinatol. 2001;21:572Martín Ancel, A., Iriondo Sanz, M., Fina Martí, A., Roqués Serradilla, V., García Del Río, M., López Sastre, J.B., On recommendations, protocols, and clinical guidelines (2001) An Esp Pediatr, 55, pp. 99-100Brasil. Ministério da Saúde. Norma da atenção humanizada ao recém-nascido de baixo peso - Método Canguru. Brasília, DF: MS1999Brasil. Ministério da Saúde. Norma da atenção humanizada ao recém-nascido de baixo peso - Método Canguru. Brasília, DF: MS2000Rey, E., Martínez, H., Manejo racional del niño prematuro (1983) Bogotá, (Colombia): Universidad NacionalCurso de Medicina FetalAnderson GC, Marks EA, Wahlberg V. Kangaroo care for premature infants. AmJ Nurs. 1986;86:807-9. Erratum in: Am J Nurs. 1986;86:1000Anderson, G.C., Current knowledge about skin-to-skin (kangaroo) care for preterm infants (1991) J Perinatol, 11, pp. 216-226Conde-Agudelo A, Diaz-Rossello JL, Belizan JM. Mãe canguru para reduzir morbidade e mortalidade em recém-nascidos com baixo peso ao nascer (Cochrane Review). In: Resumos de Revisões Sistemáticas em Português, Issue 2, 2007. Oxford: Update SoftwareFeldman, R., Weller, A., Sirota, L., Eidelman, A.I., Skin-to-Skin contact (Kangaroo care) promotes self-regulation in premature infants: Sleep-wake cyclicity, arousal modulation, and sustained exploration (2002) Dev Psychol, 38, pp. 194-207Kirsten, G.F., Bergman, N.J., Hann, K.M., Kangaroo mother care in the nursery (2001) Pediatr Clin North Am, 48, pp. 443-452Ramanathan, K., Paul, V.K., Deorari, A., Taneja, U., George, G., Kangaroo Mother Care in very low birth weight infants (2001) Indian J Pediatr, 68, pp. 1019-1023Ludington-Hoe, S.M., Johnson, M.W., Morgan, K., Lewis, T., Gutman, J., Wilson, P.D., Neurophysiologic assessment of neonatal sleep organization: Preliminary results of a randomized, controlled trial of skin contact with preterm infants (2006) Pediatrics, 117, pp. e909-e923Gray, L., Watt, L., Blass, E.M., Skin-to-skin contact is analgesic in healthy newborns (2000) Pediatrics, 105, pp. e14Charpak, N., Ruiz-Pelaez, J.G., Figueroa de, C.Z., Charpak, Y., A randomized, controlled trial of kangaroo mother care: Results of follow-up at 1 year of corrected age (2001) Pediatrics, 108, pp. 1072-1079Penalva, O., Schwartzman, J.S., Descriptive study of the clinical and nutritional profile and follow-up of premature babies in a Kangaroo Mother Care Program (2006) J Pediatr (Rio J), 82, pp. 33-39Charpak, N., Ruiz-Pelaez, J.G., Figueroa de, C.Z., Charpak, Y., Kangaroo mother versus traditional care for newborn infants >/= 2,000 grams: A randomized, controlled trial (1997) Pediatrics, 100, pp. 682-688Ruiz-Peláez, J.G., Charpak, N., Cuervo, L.G., Kangaroo Mother Care, an example to follow from developing countries (2004) BMJ, 329, pp. 1179-1181Venancio, S.I., Almeida, H., Método Mãe Canguru: Aplicação no Brasil, evidências científicas e impacto sobre o aleitamento materno. (2004) J Pediatr (Rio J), 80, pp. S173-S180Richardson, D.K., Corcoran, J.D., Escobar, G.J., Lee, S.K., SNAP-II and SNAPPE-II: Simplified newborn illness severity and mortality risk scores (2001) J Pediatr, 138, pp. 92-100Gray, J.E., Richardson, D.K., McCormick, M.C., Workman-Daniels, K., Goldmann, D.A., Neonatal therapeutic intervention scoring system: A therapy-based severity-of-illness index (1992) Pediatrics, 90, pp. 561-567Barros, A.J., Hirakata, V.N., Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio (2003) BMC Med Res Methodol, 3, p. 21Roberts, K.L., Paynter, C., McEwan, B., A comparison of kangaroo mother care and conventional cuddling care (2000) Neonatal Netw, 19, pp. 31-35Cattaneo, A., Davanzo, R., Worku, B., Surjono, A., Echeverria, M., Bedri, A., Kangaroo mother care for low birth weight infants: A randomised controlled trial in different settings (1998) Acta Paediatr, 87, pp. 976-985Kadam, S., Binoy, S., Kanbur, W., Mondkar, J.A., Fernandez, A., Feasibility of kangaroo mother care in Mumbai (2005) Indian J Pediatr, 72, pp. 35-38Sloan, N.L., LeonCamacho, L.W., PintoRojas, E., Stern, C., Maternidad IsidroAyora Study Team. Kangaroo mother method: Randomised controlled trial of an alternative method of care for stabilised low-birthweight infants. Maternidad Isidro Ayora Study Team (1994) Lancet, 344, pp. 782-78

Microbicidal effect of medicinal plant extracts (Psidium guajava Linn. and Carica papaya Linn.) upon bacteria isolated from fish muscle and known to induce diarrhea in children Uso de extrato de plantas medicinais (Psidium guajava Linn. e Carica papaya Linn.) frente a bactérias isoladas de pescado, causadoras de diarréias infantis

Out of the twenty-four samples of shrimp and fish muscle used for this study, twelve were collected near a large marine sewer for waste disposal, 3 km off the coast of Fortaleza (Brazil) and used for the isolation of E. coli. Other twelve were collected at the Mucuripe fresh fish market (Fortaleza, Brazil) and used for the isolation of Staphylococcus aureus. Ethanol, water and acetone-diluted extracts of guava and papaya leaf sprouts were tested on the bacteria in order to verify their microbicidal potential. The E. coli strains used in the trials were rated LT positive. The papaya leaf extracts (Carica papaya Linn) showed no microbicidal activity while the guava sprout extracts (Psidium guajava Linn) displayed halos exceeding 13 mm for both species, an effect considered to be inhibitory by the method employed. Guava sprout extracts by 50% diluted ethanol most effectively inhibited E. coli (EPEC), while those in 50% acetone were less effective. It may be concluded that guava sprout extracts constitute a feasible treatment option for diarrhea caused by E. coli or by S. aureus-produced toxins, due to their quick curative action, easy availability in tropical countries and low cost to the consumer.<br>Foram coletadas doze amostras de camarão e peixes nas imediações do interceptor oceânico, em Fortaleza e igual número na Feira de pescado do Mucuripe, Fortaleza, para isolamento de E. coli e Staphylococcus aureus, respectivamente. Extratos aquosos, alcoólicos e cetônicos de broto de goiabeira e de folha de mamão foram testados frente às bactérias para se verificar suas ações antibióticas. As cepas de E. coli utilizadas nos ensaios foram as classificadas como LT positivas. Os extratos de folhas de mamão (Carica papaya Linn) não revelaram quaisquer atividades antibióticas enquanto que os preparados com broto de goiabeira (Psidium guajava Linn) apresentaram halos sempre >13 mm para as duas espécies, considerados como de inibição pelo método empregado. Os extratos de broto de goiabeira que apresentaram melhores resultados frente às cepas de E. coli ETEC foram os alcoólicos a 50% seguido do cetônico também a 50%. Concluímos que nos tratamentos de diarréias causadas por E. coli ou por toxinas elaboradas por S. aureus o extrato de brotos de goiabeira é uma opção devido a sua pronta ação curativa, seu fácil cultivo nos países tropicais e ao seu baixo valor aquisitivo

Genótipos de sorgo para produção de barra de cereais

O objetivo deste trabalho foi desenvolver uma barra de cereais com pipoca de sorgo e avaliá-la quanto à aceitação do produto por consumidores, assim como identificar genótipos de sorgo e distintos modos de processamento para a produção de pipoca visando maior rendimento. Foram avaliados os processamentos sem (STH) e com tratamento hidrotérmico (CTH) dos grãos antes do pipoqueamento. O tratamento CTH reduziu o percentual de piruás em cerca de 36% e aumentou o rendimento da produção de pipoca em cerca de 80%. No STH, os genótipos BRS 310, BR 501, BR 506 e CMSXS 283 produziram menor percentual de piruás e maior capacidade de expansão. No CTH, 'BRS 310' e 'CMSXS 283' apresentaram melhor desempenho. Uma pesquisa sobre a aceitação e a intenção de compra das barras de cereais foi realizada em Londrina, PR e no Rio de Janeiro, RJ. Verificou-se que o produto foi aceito por 98, 4 e 76, 5% dos consumidores, e a média de aceitação, em uma escala de 1 a 9, foi de 7, 7 em Londrina e de 7, 1 no Rio de Janeiro. Quanto à intenção de compra, verificou-se que 88, 8% dos londrinenses e 80, 6% dos cariocas atribuíram notas acima de 4 ("talvez não comprasse, talvez comprasse") na escala de 7 pontos utilizada