Achados não-proliferativos e expressões do marcador Ki-67 e dos receptores de estrogeno em mama contralateral de mulheres tratadas de cancer de mama, em uso tamoxifeno

Orientadores: Cesar Cabello dos Santos, Marcelo AlvarengaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: O objetivo deste estudo foi avaliar a freqüência de achados não-proliferativos, a expressão do marcador Ki-67 e dos receptores de estrógeno avaliados pelo método de imunoistoquímica em mama contralateral de pacientes em tratamento de câncer de mama, usuárias de 20mg/dia de tamoxifeno por um ano ou mais. As mulheres foram recrutadas no Ambulatório de Patologia Mamária do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas e no Ambulatório de Oncologia Ginecológica da Prefeitura de São João da Boa Vista. Para isso, foi realizado um estudo descritivo que avaliou pacientes de abril a junho de 2003. Foram excluídas as pacientes com câncer de mama bilateral, as que estavam em uso de qualquer medicação que tenha ação como hormônio sexual, as pacientes com dificuldade de comunicação que interferisse na coleta de dados, as que haviam parado de usar o tamoxifeno há mais de 24 horas, as que estivessem em uso de medicações anticoagulantes, se o material para análise histológica fosse insuficiente ou se fosse encontrada alguma lesão maligna (nenhuma lesão atípica foi encontrada). Para o cálculo do tamanho amostral foi realizado um estudo-piloto com 13 pacientes. Foram então recrutadas 44 pacientes, submetidas à biópsia em mama contralateral com agulha grossa (dispositivo "biopsy-cut" com agulha gauge 14). A análise dos dados, quando necessária, foi feita pelo teste exato de Fisher com nível de significância estabelecido de 5%. Observamos que globalmente 82% das pacientes apresentaram achados não-proliferativos e 100% das pacientes apresentaram expressão leve do marcador Ki-67. Cerca de 70% das pacientes foram receptor de estrógeno negativo na mama contralateral. O tempo de uso do tamoxifeno não se associou aos achados não-proliferativos, nem à expressão do marcador Ki-67 e do receptor de estrógeno. O índice de massa corpórea não se associou aos achados não-proliferativos, à expressão do marcador Ki-67 e nem do receptor de estrógeno. A presença de achados não-proliferativos não esteve associada ao padrão de densidade mamográfica pelo método de Wolfe. Concluímos que o uso de tamoxifeno por mais de um ano associou-se a uma taxa de cerca de 80% de achados não-proliferativos e a uma baixa taxa de proliferação celular avaliada pelo marcador Ki-67. Com relação ao receptor de estrógeno, apenas 30% das pacientes apresentaram expressão positiva na mama contralateral de pacientes tratadas por câncer de mamaAbstract: The issue of this study was evaluate the frequency of no-proliferate findings, the immunoreactions of the monoclonal Ki-67 antibody and estrogen receptor in contra lateral breast of patients treated of breast cancer and in use of 20mg tamoxifen daily for one year or more They were selected in Breast Pathology Unit in State University of Campinas and in Gynecology-Oncology Unit of Prefeitura Municipal de São João da Boa Vista. A descriptive study had been done, evaluating patients from April to June 2003. Patients with bilateral cancer, in use of any sexual hormones at least one year, difficult of communication to collect information, if tamoxifen had been interrupted up to 24 hours, in use of any anticoagulant agents, if the tissue hadn't been proper to histological evaluation and if we had found any malignant lesion, in any of this cases, the patients were excluded. A pilot trial with 13 patients was carried out. Biopsy-cut with gauge 14 needle has done in contra lateral breast of 44 patients. Some data were analyzed with the help of Fisher's exact test, and others variables were merely descriptive. The significance level was defined at 5%. We observed that around 82% of the patients have had no-proliferate findings and 100% of the patients have had mild immunoreaction of monoclonal Ki-67 antibody. Around 70% of the patients have had a negative expression of estrogen receptor. The length of time of use of tamoxifen did not associate to no-proliferate findings, immunoreactions of monoclonal Ki-67 antibody or estrogen receptor. The body mass index (BMI) didn't associate to no-proliferate findings, immunoreactions of monoclonal Ki-67 antibody or estrogen receptor. The no-proliferate findings did not associate to Wolfe's parenchyma pattern in mammograms. We have concluded that the use of tamoxifen at least 1 year has shown around of 80% no-proliferate findings in opposite breast of breast cancer patients. In concern of expression of estrogen receptor, just 30% of patients have had positive expressionMestradoTocoginecologiaMestre em Tocoginecologi

Reconstructing Three Decades of Land Use and Land Cover Changes in Brazilian Biomes with Landsat Archive and Earth Engine

Brazil has a monitoring system to track annual forest conversion in the Amazon and most recently to monitor the Cerrado biome. However, there is still a gap of annual land use and land cover (LULC) information in all Brazilian biomes in the country. Existing countrywide efforts to map land use and land cover lack regularly updates and high spatial resolution time-series data to better understand historical land use and land cover dynamics, and the subsequent impacts in the country biomes. In this study, we described a novel approach and the results achieved by a multi-disciplinary network called MapBiomas to reconstruct annual land use and land cover information between 1985 and 2017 for Brazil, based on random forest applied to Landsat archive using Google Earth Engine. We mapped five major classes: forest, non-forest natural formation, farming, non-vegetated areas, and water. These classes were broken into two sub-classification levels leading to the most comprehensive and detailed mapping for the country at a 30 m pixel resolution. The average overall accuracy of the land use and land cover time-series, based on a stratified random sample of 75,000 pixel locations, was 89% ranging from 73 to 95% in the biomes. The 33 years of LULC change data series revealed that Brazil lost 71 Mha of natural vegetation, mostly to cattle ranching and agriculture activities. Pasture expanded by 46% from 1985 to 2017, and agriculture by 172%, mostly replacing old pasture fields. We also identified that 86 Mha of the converted native vegetation was undergoing some level of regrowth. Several applications of the MapBiomas dataset are underway, suggesting that reconstructing historical land use and land cover change maps is useful for advancing the science and to guide social, economic and environmental policy decision-making processes in Brazil

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

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