Análise do padrão de localização anatômica do câncer colorretal no Brasil desde o ano 2000

Objective: Before of the epidemiological importance of colorectal cancer and in the clinical implications of the tumor anatomical localization, the objective of this study is analyze, since 2000, the pattern of anatomical localization of colorectal cancer in Brazil, considering the year of notification, sex, age group, topography and ethnicity. Methods: This is a descriptive, retrospective, observational and quantitative epidemiological study, which the data were obtained by the consultation of the database of the Population-Based Cancer Registry provided by the National Cancer Institute, considering the records as of 2000. The following cities were considered the regionals representatives: Belo Horizonte, Vitória, São Paulo, Goiânia, Campo Grande, Curitiba, Porto Alegre, Aracaju, Sergipe, João Pessoa and Belém. Results: It were selected 37.209 cases between 2000 and 2011 which 14% right-sided colon cancer, 41% left-sided colon cancer and 45% rectal cancer and the sudeste was the region with larger incidence with 72% of those data. Concerning to sex, it was observed that there was an increase in all topographies. In relation to age group, it was noted that the most of the data were localized between 65 to 74 years (n=8.674) and the rectal cancer was the most incident with 3.736 cases. Conclusions: Left-sided colon cancer and rectal cancer presented higher incidence and percentage growth, however, the right-sided colon cancer indexes also stood out, mainly in the Center-West, South and Northeast. It's considered that despite the improvement in the capture of cases and the quality of data over decades, there are limitations due to under-registration.Objetivo: Diante da importância epidemiológica do câncer colorretal e das implicações clínicas da localização anatômica do tumor, tem-se como objetivo analisar o padrão de localização anatômica do câncer colorretal no Brasil, a partir dos anos 2000, considerando ano de notificação, sexo, faixa etária, topografia e etnia. Métodos: Trata-se de um estudo epidemiológico descritivo, retrospectivo, observacional e quantitativo, em que os dados foram obtidos por meio de consulta à base de dados do Registro de Câncer de Base Populacional disponibilizada pelo Instituto Nacional do Câncer, considerando os registros a partir do ano 2000. As cidades representantes foram: Belo Horizonte, Vitória, São Paulo, Goiânia, Campo Grande, Curitiba, Porto Alegre, Aracaju, Recife, João Pessoa e Belém. Resultados: Foram levantados 37.209 casos entre os anos de 2000 e 2011, sendo 14% câncer colorretal direito, 41% câncer colorretal esquerdo e 45% câncer retal, sendo o Sudeste a região de maior incidência com 72% dos dados. Em relação ao sexo, observou-se que houve um aumento em todas as topografias. Quanto à faixa etária, verificou-se que a maior parte dos casos se encontram entre 65 a 74 anos (n=8.674), sendo o câncer retal mais incidente, com 3.736 casos. Conclusões: O câncer de cólon esquerdo e o câncer retal, apresentaram maior incidência e crescimento percentual, entretanto, os índices de câncer de cólon direito também se destacaram, principalmente nas regiões Centro-Oeste, Sul e Nordeste. Pondera-se que apesar da melhoria na captação de casos e na qualidade dos dados ao longo das décadas, ainda há limitações devido ao sub-registro

Seven years of external control of fluoride levels in the public water supply in Bauru, São Paulo, Brazil

Fluoridation of the public water supplies is recognized as among the top ten public health achievements of the twentieth century. However, the positive aspects of this measure depend on the maintenance of fluoride concentrations within adequate levels. To report the results of seven years of external control of the fluoride (F) concentrations in the public water supply in Bauru, SP, Brazil in an attempt to verify, on the basis of risk/benefit balance, whether the levels are appropriate. From March 2004 to February 2011, 60 samples were collected every month from the 19 supply sectors of the city, totaling 4,641 samples. F concentrations in water samples were determined in duplicate, using an ion-specific electrode (Orion 9609) coupled to a potentiometer after buffering with TISAB II. After the analysis, the samples were classified according to the best risk-benefit adjustment. Means (±standard deviation) of F concentrations ranged between 0.73±0.06 and 0.81±0.10 mg/L for the different sectors during the seven years. The individual values ranged between 0.03 and 2.63 mg/L. The percentages of the samples considered “low risk” for dental fluorosis development and of “maximum benefit” for dental caries prevention (0.55-0.84 mg F/L) in the first, second, third, fourth, fifth, sixth, and seventh years of the study were 82.0, 58.5, 37.4, 61.0, 89.9, 77.3, and 72.4%, respectively, and 69.0% for the entire period. Fluctuations of F levels were found in the public water supply in Bauru during the seven years of evaluation. These results suggest that external monitoring of water fluoridation by an independent assessor should be implemented in cities where there is adjusted fluoridation. This measure should be continued in order to verify that fluoride levels are suitable and, if not, to provide support for the appropriate adjustmentsCNPq 403427/2004-5CNPq 403427/2004

Manifestações Neurológicas em Pacientes que Contraíram Covid-19: uma revisão integrativa da literatura / Neurological Manifestations in Patients Who Contracted Covid-19: an integrative literature review

INTRODUÇÃO: O espectro da infecção do SARS-CoV-2 é amplo e predomina o acometimento respiratório. Estudos recentes, no entanto, têm demonstrado cada vez mais o acometimento extra respiratório, incluindo alterações neurológicas diversas. A presente revisão discorre sobre as principais manifestações neurológicas decorrentes da infecção por SARS-CoV-2 e suas consequências para os infectados. METODOLOGIA: Trata-se de uma revisão integrativa da literatura. As bases de dados utilizadas foram MEDLINE/PubMed, Scielo e LILACS. Os seguintes descritores foram utilizados: “Neurological manifestations”, “COVID-19” e “Neurological symptoms”. RESULTADOS: No mundo foram reportadas diversas manifestações neurológicas como as centrais (cefaleia, tontura, convulsões, meningite/encefalite, déficit cognitivo, AVC), periféricas  (analgesia, anosmia) e musculoesqueléticas. As mais frequentemente observadas foram tontura e cefaléia. DISCUSSÃO: O mecanismo de neuro invasão ainda não está totalmente esclarecido, mas as evidências mostram que se deve haver lesão direta, imunomediada ou decorrente de hipóxia, além de eventos secundários relacionados a distúrbios sistêmicos, como sepse, hiperpirexia  hipercoagulabilidade etc. A agressividade dos sintomas pode variar desde as mais leves até predispor manifestações graves como doenças cerebrovasculares agudas. CONCLUSÃO: As  manifestações neurológicas apresentaram-se sob diferentes formas e ainda são necessários mais  ensaios clínicos para analisar a fisiopatologia do SARS-CoV-2 no sistema nervoso, assim como suas consequências tardias

Desafios e avanços na antibioticoterapia para exacerbações pulmonares na fibrose cística

A fibrose cística é uma doença genética complexa que afeta a produção de muco e a função pulmonar. Exacerbações pulmonares, muitas vezes provocadas por Pseudomonas aeruginosa, são comuns. O diagnóstico requer testes de suor e genéticos para guiar a terapia antibiótica. Avanços com moduladores CFTR melhoram a função pulmonar, mas desafios como resistência bacteriana persistem. Este estudo busca analisar a antibioticoterapia para exacerbações pulmonares na fibrose cística, com foco em abordagens inovadoras e personalizadas. O estudo, baseado em uma revisão sistemática da literatura científica, abrange o período de 2016 a 2024, utilizando as bases de dados PubMed (Medline), Cochrane Library e Scientific Electronic Library Online (SciELO). No primeiro estudo, sobre adjuvantes antibióticos no tratamento de infecções pulmonares em pacientes com fibrose cística, não houve impacto significativo nas exacerbações pulmonares ou na função respiratória. O KB001-A não alterou o tempo para a próxima administração de antibióticos em comparação ao placebo. Evidências apontam uma possível redução na densidade de Pseudomonas aeruginosa com o KB001-A e reduções em Staphylococcus aureus e quase-Pseudomonas aeruginosa com o óxido nítrico, sem diferenças na qualidade de vida. O segundo estudo, em um modelo suíno de pneumonia por Pseudomonas aeruginosa multirresistente, a terapia inalatória de amicacina combinada com meropenem mostrou maior eficácia bactericida nas secreções traqueais em comparação à monoterapia intravenosa. A administração inalatória não preveniu a disseminação da infecção, mas a amicacina evitou o aumento da concentração inibitória mínima de meropenem, com alta concentração nas amostras sem diferenças entre pulmões infectados e não infectados. No terceiro estudo, O estudo das nanopartículas poliméricas na eliminação de biofilmes bacterianos em cepas resistentes e suscetíveis associadas à fibrose cística mostrou potencial promissor contra bactérias multirresistentes. Os nanoportadores de lipídios demonstraram eficácia terapêutica significativa, ressaltando a necessidade de mais pesquisas para confirmar seu benefício clínico. Em resumo, os adjuvantes antibióticos não impactaram significantemente o tratamento de infecções pulmonares na fibrose cística. A combinação de amicacina e meropenem foi eficaz contra pneumonia por Pseudomonas aeruginosa multirresistente. As nanopartículas poliméricas e nanoportadores de lipídios mostraram potenciais terapêuticos promissores, demandando mais pesquisas para validar seus benefícios clínicos

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

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Author correction: One sixth of Amazonian tree diversity is dependent on river floodplains

In the version of the article initially published, the affiliation of Edgardo Manuel Latrubesse was incorrect and has now been amended to Environmental Sciences Graduate Program-CIAMB, Federal University of Goiás, Goiânia, Brazil in the HTML and PDF versions of the article

Unraveling Amazon tree community assembly using Maximum Information Entropy: a quantitative analysis of tropical forest ecology

In a time of rapid global change, the question of what determines patterns in species abundance distribution remains a priority for understanding the complex dynamics of ecosystems. The constrained maximization of information entropy provides a framework for the understanding of such complex systems dynamics by a quantitative analysis of important constraints via predictions using least biased probability distributions. We apply it to over two thousand hectares of Amazonian tree inventories across seven forest types and thirteen functional traits, representing major global axes of plant strategies. Results show that constraints formed by regional relative abundances of genera explain eight times more of local relative abundances than constraints based on directional selection for specific functional traits, although the latter does show clear signals of environmental dependency. These results provide a quantitative insight by inference from large-scale data using cross-disciplinary methods, furthering our understanding of ecological dynamics

Unraveling Amazon tree community assembly using Maximum Information Entropy: a quantitative analysis of tropical forest ecology

In a time of rapid global change, the question of what determines patterns in species abundance distribution remains a priority for understanding the complex dynamics of ecosystems. The constrained maximization of information entropy provides a framework for the understanding of such complex systems dynamics by a quantitative analysis of important constraints via predictions using least biased probability distributions. We apply it to over two thousand hectares of Amazonian tree inventories across seven forest types and thirteen functional traits, representing major global axes of plant strategies. Results show that constraints formed by regional relative abundances of genera explain eight times more of local relative abundances than constraints based on directional selection for specific functional traits, although the latter does show clear signals of environmental dependency. These results provide a quantitative insight by inference from large-scale data using cross-disciplinary methods, furthering our understanding of ecological dynamics