Desigualdades sociais em saúde e o câncer de colo do útero no Brasil: uma análise da realidade brasileira

A detecção precoce do câncer de colo do útero, além de outros fatores, está intimamente relacionada com a prevenção e tratamento da infecção pelo papiloma vírus humano (HPV). Todavia, vários elementos contribuem para a detecção tardia e dificuldade de acesso aos tratamentos adequados. Por isso, objetivamos realizar um debate sobre os principais fatores condicionantes para a detecção tardia do câncer de colo do útero na Política Pública de Saúde do Brasil. Como método de construção deste trabalho realizamos uma abordagem qualitativa através de pesquisa de bibliografias relacionadas à temática. Percebemos com base nas bibliografias que, na população brasileira, os fatores de risco para o desenvolvimento de câncer de colo do útero estão intrinsecamente relacionados com o baixo nível socioeconômico e as grandes dificuldades de acesso à rede de atenção básica.Facultad de Trabajo Socia

Desigualdades sociais em saúde e o câncer de colo do útero no Brasil: uma análise da realidade brasileira

A detecção precoce do câncer de colo do útero, além de outros fatores, está intimamente relacionada com a prevenção e tratamento da infecção pelo papiloma vírus humano (HPV). Todavia, vários elementos contribuem para a detecção tardia e dificuldade de acesso aos tratamentos adequados. Por isso, objetivamos realizar um debate sobre os principais fatores condicionantes para a detecção tardia do câncer de colo do útero na Política Pública de Saúde do Brasil. Como método de construção deste trabalho realizamos uma abordagem qualitativa através de pesquisa de bibliografias relacionadas à temática. Percebemos com base nas bibliografias que, na população brasileira, os fatores de risco para o desenvolvimento de câncer de colo do útero estão intrinsecamente relacionados com o baixo nível socioeconômico e as grandes dificuldades de acesso à rede de atenção básica.Facultad de Trabajo Socia

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status