A cidade-floresta na pintura da memória: teias visuais e orais em Maria Necy Balieiro

A cidade de Breves, localizada no ocidente marajoara, banhada pelo rio Amazonas, no Pará, tornou-se ao longo de sua história, importante zona de interstícios culturais. Nesse circuito, diferentes artistas têm construído visualidades, sonoridades e oralidades sobre a vida urbana, pautadas em cosmologias, linguagens e estéticas locais em interações com outros códigos sociais como campo de possibilidades para se repensar e problematizar concepções clássicas, homogêneas e unilaterais de cidade na Amazônia. A pintora Maria Necy Pereira Balieiro, nascida nesse território, é uma das artistas que vem se nutrindo de convivências familiares e percepções pessoais para produzir pinturas que apreendem a interconexão cidade-floresta, cotidiano e memória em textos visuais e orais. Com base no método etnobiográfico, para tecer escrita compartilhada, e fundamentado no conceito de interculturalidade, para apreender o entrelaçamento de enunciados urbanos e rurais, o artigo procura reconstituir aspectos da trajetória de vida pessoal e profissional de Maria Necy, analisando escritas e pinturas de si, do outro e do nós, alinhavadas pelo fazer etnográfico que, pela arte das lembranças em telas, (re)constrói complexas dimensões e experiências interculturais sobre a cidade, seus moradores, suas práticas e a vida da própria artista que transforma as pinturas em textos visuais (auto)biográficos e produz outras narrativas do urbano na Amazônia Marajoara. PALAVRAS-CHAVE: Cidade-Floresta. Arte. Memória. Etnobiografia. Interculturalidade

“Na outra ponta” do Brasil: experiências com escritos de Stuart Hall na Amazônia

Focused on the Stuart Hall's border thinking, this article problematizes the importance of culture studies about the communication forms as socio-cultural practices at the Amazon region. It analyzes seven Master's dissertation that reassert the present situation of the Ja­maican intellectual in Brazilian North region, showing thus: a) dynamic and multifaceted processes of the construction of identities; b) communication forms and technologies that diversify and disclose. The thought established in these analyzed works based the contribu­tion of Hall's thought and socio-cultural practices at the other end of Brazil.Centrado no pensamento fronteiriço de Stuart Hall, este artigo problematiza a importância dos estudos culturais acerca das formas comunicacionais enquanto práticas socioculturais na Amazônia. Analisa sete dissertações de mestrado, que reafirmam a atualidade do intelectual jamaicano no norte do Brasil, deixando ver: a) os processos dinâmicos e multifacetados de construção de identidades; b) as formas de comunicação e os suportes tecnológicos que as diversificam e as disseminam. As reflexões estabelecidas nos trabalhos analisados evidenciam a contribuição do pensamento de Hall para o entendimento das práticas socioculturais na outra ponta do Brasil

Acute Exercise and Appetite-Regulating Hormones in Overweight and Obese Individuals: A Meta-Analysis

In lean individuals, acute aerobic exercise is reported to transiently suppress sensations of appetite, suppress blood concentrations of acylated ghrelin (AG), and increase glucagon-like peptide-1 (GLP-1) and peptide-YY (PYY). Findings in overweight/obese individuals have yet to be synthesised. In this systematic review and meta-analysis, we quantified the effects that acute exercise has on AG and total PYY and GLP-1 in overweight/obese individuals. The potential for body mass index (BMI) to act as a moderator for AG was also explored. Six published studies (73 participants, 78% male, mean BMI: 30.6 kg⋅m −2 ) met the inclusion criteria. Standardised mean differences (SMDs) and standard errors were extracted for AG and total PYY and GLP-1 concentrations in control and exercise trials and synthesised using a random effects meta-analysis model. BMI was the predictor in metaregression for AG. Exercise moderately suppressed AG area-under-the-curve concentrations (pooled SMD: −0.34, 95% CI: −0.53 to −0.15). The magnitude of this reduction was greater for higher mean BMIs (pooled metaregression slope: −0.04 SMD/kg⋅m −2 (95% CI: −0.07 to 0.00)). Trivial SMDs were obtained for total PYY (0.10, 95% CI: −0.13 to 0.31) and GLP-1 (−0.03, 95% CI: −0.18 to 0.13). This indicates that exercise in overweight/obese individuals moderately alters AG in a direction that could be associated with decreased hunger and energy intake. This trial is registered with PROSPERO: CRD42014006265

Peroxisome proliferator-activated receptor gamma and spermidine/spermine N(1)-acetyltransferase gene expressions are significantly correlated in human colorectal cancer

BACKGROUND: The peroxisome proliferator-activated receptor γ (PPARγ) is a transcription factor that regulates adipogenic differentiation and glucose homeostasis. Spermidine/spermine N(1)-acetyltransferase (SSAT) and ornithine decarboxylase (ODC) are key enzymes involved in the metabolism of polyamines, compounds that play an important role in cell proliferation. While the PPARγ role in tumour growth has not been clearly defined, the involvement of the altered polyamine metabolism in colorectal carcinogenesis has been established. In this direction, we have evaluated the PPARγ expression and its relationship with polyamine metabolism in tissue samples from 40 patients operated because of colorectal carcinoma. Since it is known that the functional role of K-ras mutation in colorectal tumorigenesis is associated with cell growth and differentiation, polyamine metabolism and the PPARγ expression were also investigated in terms of K-ras mutation. METHODS: PPARγ, ODC and SSAT mRNA levels were evaluated by reverse transcriptase and real-time PCR. Polyamines were quantified by high performance liquid chromatography (HPLC). ODC and SSAT activity were measured by a radiometric technique. RESULTS: PPARγ expression, as well as SSAT and ODC mRNA levels were significantly higher in cancer as compared to normal mucosa. Tumour samples also showed significantly higher polyamine levels and ODC and SSAT activities in comparison to normal samples. A significant and positive correlation between PPARγ and the SSAT gene expression was observed in both normal and neoplastic tissue (r = 0.73, p < 0.0001; r = 0.65, p < 0.0001, respectively). Moreover, gene expression, polyamine levels and enzymatic activities were increased in colorectal carcinoma samples expressing K-ras mutation as compared to non mutated K-ras samples. CONCLUSION: In conclusion, our data demonstrated a close relationship between PPARγ and SSAT in human colorectal cancer and this could represent an attempt to decrease polyamine levels and to reduce cell growth and tumour development. Therefore, pharmacological activation of PPARγ and/or induction of SSAT may represent a therapeutic or preventive strategy for treating colorectal cancer

Treatment strategies for oesophageal cancer - time-trends and long term outcome data from a large tertiary referral centre

<p>Abstract</p> <p>Background and objectives</p> <p>Treatment options for oesophageal cancer have changed considerably over the last decades with the introduction of multimodal treatment concepts dominating the progress in the field. However, it remains unclear in how far the documented scientific progress influenced and changed the daily routine practice. Since most patients with oesophageal cancer generally suffer from reduced overall health conditions it is uncertain how high the proportion of aggressive treatments is and whether outcomes are improved substantially. In order to gain insight into this we performed a retrospective analysis of patients treated at a larger tertiary referral centre over time course of 25 years.</p> <p>Patients and methods</p> <p>Data of all patients diagnosed with squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the oesophagus, treated between 1983 and 2007 in the department of radiation oncology of the LMU, were obtained. The primary endpoint of the data collection was overall survival (calculated from the date of diagnosis until death or last follow up). Changes in basic clinical characteristics, treatment approach and the effect on survival were analysed after dividing the cohort into five subsequent time periods (I-V) with 5 years each. In a second analysis any pattern of change regarding the use of radio(chemo)therapy (R(C)T) with and without surgery was determined.</p> <p>Results</p> <p>In total, 503 patients with SCC (78.5%) and AC (18.9%) of the oesophagus were identified. The average age was 60 years (range 35-91 years). 56.5% of the patients were diagnose with advanced UICC stages III-IV. R(C)T was applied to 353 (70.2%) patients; R(C)T+ surgery was performed in 134 (26.6%) patients, 63.8% of all received chemotherapy (platinum-based 5.8%, 5-fluorouracil (5-FU)12.1%, 42.3% 5-FU and mitomycin C (MMC)). The median follow-up period was 4.3 years. The median overall survival was 21.4 months. Over the time, patients were older, the formal tumour stage was more advanced, the incidence of AC was higher and the intensified treatment had a higher prevalence. However there was only a trend for an improved OS over the years with no difference between RCT with or without surgery (p = 0.09). The use of radiation doses over 54 Gy and the addition of chemotherapy (p = 0.002) were associated with improved OS.</p> <p>Conclusion</p> <p>Although more complex treatment protocols were introduced into clinical routine, only a minor progress in OS rates was detectable. Main predictors of outcome in this cohort was the addition of chemotherapy. The addition of surgery to radio-chemotherapy may only be of value for very limited patient groups.</p

Association of nutritional status and serum albumin levels with development of toxicity in patients with advanced non-small cell lung cancer treated with paclitaxel-cisplatin chemotherapy: a prospective study

<p>Abstract</p> <p>Background</p> <p>A frequent manifestation of advanced NSCLC is malnutrition, even though there are many studies which relate it with a poor survival, its relation with toxicity has not yet been consistently reported. The aim of this study was to associate malnutrition and albumin serum levels with the occurrence of chemotherapy-induced toxicity in cisplatin plus paclitaxel chemotherapy-treated NSCLC.</p> <p>Methods</p> <p>We prospectively evaluated 100 stage IV NSCLC patients treated with paclitaxel (175 mg/m²) and cisplatin (80 mg/m²). Malnutrition was assessed using SGA prior treatment. Neutrophil Lymphocyte Ratio (NLR) and the Platelet Lymphocyte Ratio (PLR) were used to determine the presence of systemic inflammatory response (SIR) and were related to the development of toxicity. Toxicity was graded according to NCI CTCAE version 3.0 after two chemotherapy cycles.</p> <p>Results</p> <p>Median age was 58 ± 10 years, 51% of patients were malnourished, 50% had albumin ≤3.0 mg/mL. NLR ≥ 5 was associated with basal hypoalbuminemia (mean ranks, 55.7 vs. 39 p = 0.006), ECOG = 2 (47.2 vs. 55.4 p = 0.026) and PLR ≥ 150 were significantly related with a basal body mass index ≤20 (56.6 vs. 43.5; p = 0.02) and hypoalbuminemia (58.9 vs. 41.3; p = 0.02). Main toxicities observed after 2 cycles of chemotherapy were alopecia (84%), nausea (49%), neuropathy (46%), anemia (33%), lymphopenia (31%), and leukopenia (30%). Patients malnourished and with hypoalbuminemia developed more chemotherapy-induced toxicity overall when compared with those without malnutrition (31 vs 22; <it>p </it>= 0.02) and normal albumin (mean ranks, 62 vs 43; <it>p </it>= 0.002), respectively. Hypoalbuminemia was associated with anemia (56 vs 47; <it>p </it>= 0.05), fatigue (58 vs 46; <it>p </it>= 0.01), and appetite loss (57.1 vs 46.7; <it>p </it>= 0.004) compared with normal albumin. PLR ≥ 150 was related with the development of toxicity grade III/IV (59.27 vs. 47.03 p = 0.008) and anemia (37.9 vs 53.8 p = 0.004).</p> <p>Conclusion</p> <p>SIR parameters were associated with malnutrition, weight loss and hypoalbuminemia. Chemotherapy-induced toxicity in NSCLC patients treated with paclitaxel and cisplatin was associated with malnutrition and hypoalbuminemia. Early nutritional assessment and support might confer beneficial effects.</p

Internações hospitalares por neoplasia maligna da próstata na região norte do Brasil: Tendências e impactos na saúde masculina

The study of prostate malignancy is extremely important due to its prevalence and the significant impacts that this condition has on men's health around the world. As one of the most common forms of cancer among males, prostate malignancy represents a substantial public health concern. Furthermore, its incidence increases with age, becoming even more relevant in aging populations. Understanding the risk factors, mechanisms of development, early detection methods, and treatment options is crucial for effective prevention, diagnosis, and management of this disease. Therefore, the objective of this work was to analyse the prevalence of hospital admissions caused by malignant neoplasia of the prostate in the northern region of Brazil, between 2019 and 2023. The information used in the creation of this study was acquired from the SUS Hospital Information System, available on the DATASUS system. We describe a subtle growing trend in hospitalizations for malignant prostate neoplasia in the northern region of Brazil, with the state of Pará being responsible for the majority of hospitalizations. Furthermore, it was possible to identify that black men aged between 70 and 79 years were those most affected by the disease. It is imperative that efforts are directed toward education, awareness, access to healthcare services, and continued research in the field of men's health to effectively address the rise in prostate cancer hospitalizations and promote a holistic approach to wellness masculine.O estudo da neoplasia maligna de próstata é de extrema importância devido à sua prevalência e aos impactos significativos que essa condição tem na saúde dos homens em todo o mundo. Como uma das formas mais comuns de câncer entre o sexo masculino, a neoplasia maligna de próstata representa uma preocupação substancial para a saúde pública. Além disso, a sua incidência aumenta com a idade, tornando-se ainda mais relevante em populações envelhecidas. Compreender os fatores de risco, os mecanismos de desenvolvimento, os métodos de detecção precoce e as opções de tratamento é crucial para a prevenção, diagnóstico e manejo eficazes dessa doença. Dessa forma, o objetivo deste trabalho foi analisar a prevalência das internações hospitalares causadas por neoplasia maligna da próstata na região norte do Brasil, entre 2019 a 2023. As informações utilizadas na criação deste estudo foram adquiridas do Sistema de Informações Hospitalares do SUS, disponível no sistema do DATASUS. Descrevemos uma sutil tendência crescente das internações por neoplasia maligna de próstata na região norte do Brasil, com o estado do Pará sendo responsável pela maioria das internações. Além disso, foi possível identificar que homens pretos com idade entre 70 a 79 anos foram os mais acometidos pela doença. É imperativo que os esforços sejam direcionados para a educação, conscientização, acesso a serviços de saúde e pesquisa contínua no campo da saúde masculina, a fim de enfrentar efetivamente o aumento de internações por câncer de próstata e promover uma abordagem holística para o bem-estar masculino

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life