Incidência de câncer em Mato Grosso: análise dos registros de base populacional (2007 a 2011)

Objective: To analyze five types of cancer health region in the state of Mato Grosso disaggregated by sex. Methods: A descriptive ecological study of the health regions of the state of Mato Grosso using two population-based data sets the incidence of cancer from the Mato Grosso interior and Cuiabá population-based cancer registries. Age-adjusted annual incidence rates were calculated for the 1960 world population, disaggregated by sex, for the period 2007 to 2011. Results: The most frequent cancer types were prostate, female breast, cervix, lung, colorectal and stomach cancers in the state of Mato Grosso the period 2007 and 2011, however, we are still facing some problems completeness and data quality. The highest incidence rates of cancer per 100,000 inhabitants per health region Tangará da Serra and Sinop and Rondonópolis and Porto Alegre do Norte. Conclusions: The importance of identifying the main cancers is an important factor in the strategy of cancer prevention and control actions, as well as to understand this magnitude and impact on society. For this, it is necessary to continue to improve the quality of information available in the population-based cancer registries in the state of Mato Grosso, Brazil.Objetivo: Descrever os cinco principais tipos de câncer por região de saúde no Estado de Mato Grosso, por sexo. Métodos: Estudo ecológico descritivo das regiões de saúde do Estado de Mato Grosso, com as informações da incidência de câncer dos Registros de Câncer de Base Populacional do Mato Grosso, interior e Cuiabá. Foram calculadas taxas médias anuais de incidência ajustadas por idade pela população mundial de 1960, desagregada por sexo, para o período de 2007 a 2011. Resultados: Apesar de problemas de completude e qualidade dos dados, os principais cânceres do Estado de Mato Grosso (capital e interior) entre 2007 e 2011 foram próstata, mama feminina, colo do útero, pulmão, cólon e reto e estômago. Os cânceres mais frequentes para os homens foram o câncer de próstata e pulmão. Entre as mulheres, foram os cânceres de mama e colo do útero. As maiores taxas de incidência de neoplasia por 100 mil habitantes por região de saúde foram: Tangará da Serra, Sinop, Rondonópolis e Porto Alegre do Norte. Conclusão: A identificação dos cânceres mais incidentes constitui fator fundamental para o aprimoramento das ações de prevenção e controle do câncer, assim como para compreensão desta magnitude e o impacto na sociedade. Para isso, é necessário a continuidade na melhoria da qualidade das informações disponíveis nos Registros de Câncer de Base Populacional no Estado de Mato Grosso

Sobrevida específica do câncer do colo do útero na Grande Cuiabá, Mato Grosso, Brasil

Objective: to estimate specific five-year survival in women diagnosed with cervical cancer living in the municipalities of Cuiabá and Várzea Grande, Mato Grosso, Brazil. Methods: Retrospective cohort study with information from the Cuiabá Population-Based Cancer Registry and the Mortality Information System. To estimate the probability of specific survival in five years, the Kaplan-Meier estimator and the log-rank test were used with the purpose of verifying if there are statistical differences in the lifetime by groups. To verify the proportionality of the failure rates, the Schoenfeld residual test was used according to the statistical significance level of 0.05. Results: Specific five-year survival and median time were 90.0% and 50.3 months, respectively for cervical cancer. When analyzing by age, the highest specific survival was among women aged 20 to 49 years (91.7%) and median time was 53.3 months. For the histological type, the highest specific survival was among women with adenocarcinoma (92.3%) and the mean survival time was 53.5 months. Conclusions: This study showed that specific survival after 5 years of diagnosis remained around 90% in patients with cervical cancer. Patients aged 20 to 49 years had higher specific survival and was statistically significant difference only between age groups.Objetivo: estimar a sobrevida específica em cinco anos de mulheres diagnosticadas com câncer do colo do útero que residem nos municípios de Cuiabá e Várzea Grande, Mato Grosso. Métodos: Estudo de coorte retrospectiva com informações provenientes do Registro de Câncer de Base Populacional de Cuiabá e do Sistema de Informações sobre Mortalidade. Para estimar a probabilidade de sobrevivência específica em cinco anos foi utilizado o estimador de Kaplan-Meier e o teste de log-rank. Para verificar a proporcionalidade das taxas de falhas utilizou-se o teste de resíduos de Schoenfeld, conforme o nível de significância estatística de 0,05. Resultados: A sobrevida específica em cinco anos e o tempo mediano de sobrevida foi de 90,0% e 50,3 meses, respectivamente para o câncer do colo do útero. Quando se analisa por idade a maior sobrevida específica foi entre as mulheres com 20 a 49 anos (91,7%) e tempo mediano de sobrevida foi de 53,3 meses. Para o tipo histológico a maior sobrevida específica foi entre as mulheres com adenocarcinoma (92,3%) e tempo mediano de sobrevida foi de 53,5 meses. Conclusões: Este estudo mostrou que a sobrevida específica após 5 anos do diagnóstico se manteve em torno de 90% em pacientes com câncer de colo do útero. As pacientes entre 20 a 49 anos tiveram maiores sobrevidas específicas e houve diferença estatisticamente significativa somente entre as faixas etárias

Análise de tendência da incidência e mortalidade por câncer de pulmão na Grande Cuiabá, Mato Grosso, Brasil, 2000 a 2016

Objective: To analyses lung cancer incidence and mortality trends to gender and age group in Grande Cuiabá between 2000 to 2016. Methods: Study of times series applying incidence data from the Population-Based Cancer Registry of Cuiabá, and mortality data from Mortality Information System. Annual Percentage Change and the Average Annual Percentage Change were calculated in the incidence and mortality rate through the Joinpoint regression. Results: It was observed between men a decrease of -2,2% in the overall incidence of lung cancer during the term of 2000-2016 and by age range: 40 to 49 years (-4,2%), 60 to 69 years (-2,0%) and 70 to 79 years (-9,4%), in this last age group it was between 2000-2009. The general mortality was stable on historical series, nonetheless, a decline between men of 50 to 59 years (-3,5%) among 2006 to 2016 and of 70 to 79 years among 2002-20011 (-6,3%) were observed. The incidence trends among female individuals maintained stable whereas the overall mortality trends had an increase of 7,2% between 2000-2012 and decrease of -34,1% between 2012-2016. Amid women from 50 to 79 years, there was a raise, ranging from 3,5% to 3,9% between 2000-2016. Conclusions: There is an evident disparity between the trends analysis of incidence and mortality of lung cancer among men and women, that can be explained by changes in smoking over time, for example, the adherence or not of the smoking withdraw program besideObjetivo: Analisar as tendências de incidência e mortalidade por câncer de pulmão, por sexo e faixa etária, na Grande Cuiabá, entre 2000 a 2016. Método: Estudo de séries temporais, utilizando informações de incidência do Registro de Câncer de Base Populacional Cuiabá e de mortalidade do Sistema de Informação de Mortalidade. Foram calculadas a Variação Percentual Anual e a Variação Percentual Média Anual das taxas de incidência e mortalidade, através da regressão por Joinpoint. Resultados: Observou-se entre homens um decréscimo de -2,2% na incidência geral de câncer de pulmão entre 2000-2016 e por faixa etária: 40 a 49 anos (-4,2%), 60 a 69 anos (-2,0%) e 70 a 79 anos (-9,4%), sendo que esta última faixa entre 2000-2009. Para mortalidade geral foi estável na série histórica, porém foi observado decréscimo entre os homens de 50 a 59 anos (-3,5%) entre 2006-2016 e de 70 a 79 anos entre 2002-2011 (-6,3%). Para as mulheres as tendências de incidência se mantiveram estáveis, enquanto nas tendências de mortalidade geral houve aumento de 7,2% entre 2000-2012 e decréscimo de -34,1% entre 2012-2016. Entre mulheres de 50 a 79 anos houve um aumento, variando de 3,5% a 3,9% entre 2000-2016. Conclusão: Existe uma evidente disparidade nas análises de tendências de incidência e mortalidade de câncer de pulmão entre homens e mulheres, que podem ser explicados por mudanças do tabagismo ao longo do tempo, por exemplo, adesão ou não ao programa de abandono do tabagismo, além de diferenças sociais, culturais, econômicas e até mesmo biológicas

Manejo conservador e técnicas cirúrgicas para reparação de lesões do manguito rotador: uma revisão integrativa / Conservative management and surgical techniques for repair of rotator cuff tears: an integrative review

INTRODUÇÃO: Por ser um conjunto músculo-tendíneo de intenso atrito e impacto, o manguito rotador é comumente lesionado, de maneira que a movimentação do ombro causa algia, prejudicando a força no ato do movimento. As lesões do manguito rotador são uma das razões mais comuns para dor no ombro. Entretanto, há diversos tipos de tratamentos que visam diminuir a intensidade dos sintomas. Uma série de técnicas cirúrgicas e não cirúrgicas são abordadas principalmente quando não há efetividade no tratamento clínico, a depender da causa da lesão. OBJETIVOS: Elencar e explanar acerca das condutas conservadoras e técnicas cirúrgicas mais estabelecidas na literatura para lesões do manguito rotador. METODOLOGIA: Trata-se de uma revisão integrativa de literatura, realizada por meio de uma pesquisa com os Descritores em Ciências da Saúde (DeCS/MeSH) “Management”, “Rotator Cuff”, “Surgery” e “Treatment”, associados por meio do operador booleano “AND”, nas bases de dados PubMed e SciELO. Foram incluídos trabalhos publicados entre 2020 e 2021 que apresentavam a conduta terapêutica para lesões do manguito rotador. Foram excluídas revisões, cartas, teses, dissertações e estudos que não atenderam aos critérios de inclusão. Dentre os 53 estudos encontrados, 26 foram considerados elegíveis. RESULTADOS: As técnicas cirúrgicas apresentadas nos estudos foram: liberação capsular artroscópica; reconstrução capsular superior artroscópica; âncora artroscópica ou fixação por parafuso; e fixação com fio K. Em contrapartida, as intervenções não cirúrgicas são classificadas como tratamentos ortorregenerativos, sendo pautados em infiltrações locais de plasma rico em plaquetas e pobre em leucócitos (PRP-PL), células estromais mesenquimais (MSCs),  fatores de crescimento e/ou com fármacos corticoesteroides. O emprego de tais técnicas varia de acordo com o tipo de lesão do manguito rotador e o grau de perda da função articular. Em vista disso, a tomada de decisão acerca da conduta é tracejada nas particularidades de cada caso. CONCLUSÕES: Revelou-se preferência por intervenções menos invasivas, com destaque para as técnicas cirúrgicas artroscópicas, como a reconstrução e a liberação capsular. Embora a artroscopia exija maior nível tecnológico dos equipamentos, minimiza os danos ao paciente, tornando essa abordagem ideal para que os pacientes tenham uma recuperação mais rápida, de forma que seja possível retornar de maneira mais precoce para suas atividades cotidianas. Além disso, em casos de degeneração cartilaginosa completa refratária, o implante de endopróteses ou artroplastia contribuem para a melhora do paciente. Contudo, observa-se que é uma técnica invasiva e não apresenta melhora total da dor e dos movimentos. Dessa maneira, evidencia-se a necessidade da discussão acerca da associação de técnicas cirúrgicas e técnicas conservadoras para lesões do manguito rotador, sendo que a conduta terapêutica deve ser individualizada, preconizando o menor tempo de recuperação possível

Geographic patterns of tree dispersal modes in Amazonia and their ecological correlates

Aim: To investigate the geographic patterns and ecological correlates in the geographic distribution of the most common tree dispersal modes in Amazonia (endozoochory, synzoochory, anemochory and hydrochory). We examined if the proportional abundance of these dispersal modes could be explained by the availability of dispersal agents (disperser-availability hypothesis) and/or the availability of resources for constructing zoochorous fruits (resource-availability hypothesis). Time period: Tree-inventory plots established between 1934 and 2019. Major taxa studied: Trees with a diameter at breast height (DBH) ≥ 9.55 cm. Location: Amazonia, here defined as the lowland rain forests of the Amazon River basin and the Guiana Shield. Methods: We assigned dispersal modes to a total of 5433 species and morphospecies within 1877 tree-inventory plots across terra-firme, seasonally flooded, and permanently flooded forests. We investigated geographic patterns in the proportional abundance of dispersal modes. We performed an abundance-weighted mean pairwise distance (MPD) test and fit generalized linear models (GLMs) to explain the geographic distribution of dispersal modes. Results: Anemochory was significantly, positively associated with mean annual wind speed, and hydrochory was significantly higher in flooded forests. Dispersal modes did not consistently show significant associations with the availability of resources for constructing zoochorous fruits. A lower dissimilarity in dispersal modes, resulting from a higher dominance of endozoochory, occurred in terra-firme forests (excluding podzols) compared to flooded forests. Main conclusions: The disperser-availability hypothesis was well supported for abiotic dispersal modes (anemochory and hydrochory). The availability of resources for constructing zoochorous fruits seems an unlikely explanation for the distribution of dispersal modes in Amazonia. The association between frugivores and the proportional abundance of zoochory requires further research, as tree recruitment not only depends on dispersal vectors but also on conditions that favour or limit seedling recruitment across forest types

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

AimAmazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types.LocationAmazonia.TaxonAngiosperms (Magnoliids; Monocots; Eudicots).MethodsData for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran's eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny.ResultsIn the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R2 = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R2 = 28%). A greater number of lineages were significant indicators of geographic regions than forest types.Main ConclusionNumerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

Aim: Amazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types. Location: Amazonia. Taxon: Angiosperms (Magnoliids; Monocots; Eudicots). Methods: Data for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran\u27s eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny. Results: In the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R$^{2}$ = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R$^{2}$ = 28%). A greater number of lineages were significant indicators of geographic regions than forest types. Main Conclusion: Numerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Mapping density, diversity and species-richness of the Amazon tree flora

Using 2.046 botanically-inventoried tree plots across the largest tropical forest on Earth, we mapped tree species-diversity and tree species-richness at 0.1-degree resolution, and investigated drivers for diversity and richness. Using only location, stratified by forest type, as predictor, our spatial model, to the best of our knowledge, provides the most accurate map of tree diversity in Amazonia to date, explaining approximately 70% of the tree diversity and species-richness. Large soil-forest combinations determine a significant percentage of the variation in tree species-richness and tree alpha-diversity in Amazonian forest-plots. We suggest that the size and fragmentation of these systems drive their large-scale diversity patterns and hence local diversity. A model not using location but cumulative water deficit, tree density, and temperature seasonality explains 47% of the tree species-richness in the terra-firme forest in Amazonia. Over large areas across Amazonia, residuals of this relationship are small and poorly spatially structured, suggesting that much of the residual variation may be local. The Guyana Shield area has consistently negative residuals, showing that this area has lower tree species-richness than expected by our models. We provide extensive plot meta-data, including tree density, tree alpha-diversity and tree species-richness results and gridded maps at 0.1-degree resolution

Consistent patterns of common species across tropical tree communities

Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees.Publisher PDFPeer reviewe