Pedunculated Morphology of T1 Colorectal Tumors Associates With Reduced Risk of Adverse Outcome

Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

Social Psychology and the Stimulation of Recycling Behaviors: The Block Leader Approach

Recycling has been touted as an important part of the solution to solid waste problems, yet most citizens still do not recycle, even when recycling is made easy by curbside pickups. This field experiment was designed to increase participation in a city-sponsored curbside recycling program. Citizens who consistently recycled with the city program were approached and asked to be recycling block leaders. Those who agreed were instructed to give approximately 10 nonrecycling neighbors a persuasive communication advocating recycling and special recycling bags. A second treatment group (of nonrecycling households) had bags and the communication left at their door. Results indicated that the curbside recycling of the two experimental groups differed significantly from one another (with the block leader group recycling more), and both differed significantly from a control group receiving no treatment. A discussion of past recycling intervention research and its feasibility for community application is included

Modulation of parasitemia and antibody responce to Trypanosoma cruzy by cyclophosphamide in Calomys callosus (Rodentia, Cricetidae) Modulação da parasitemia e da resposta de anticorpos ao Trypanosoma cruzi pela ciclofosfamida em Calomys callosus (Rodentia, Cricetidae)

Calomys callosus a wild rodent, previously described as harboring Trypanosoma cruzi, has a low susceptibility to infection by this protozoan. Experiments were designed to evaluate the contribution of the immune response to the resistance to T. cruzi infection exhibited by C. calossus. Animals were submitted to injections of high (200 mg/kg body weight) and low (20 mg/kg body weight) doses of cyclophosphamide on days -1 or -1 and +5, and inoculated with 4 x 10³ T. cruzi on day O. Parasitemia, mortality and antibody response as measured by direct agglutination of trypomastigotes were observed. Two hundred mg doses of cyclophosphamide resulted in higher parasitemia and mortality as well as in suppression of the antibody response. A single dose of 20 mg enhanced antibody levels on the 20th day after infection, while an additional dose did not further increase antibody production. Parasitemia levels were not depressed, but rather increased in both these groups as compared to untreated controls. Passive transfer of hyperimmune C. callosus anti-T. cruzi serum to cyclophosphamide immunosuppressed animals resulted in lower parasitemia and mortality rates. These results indicate that the immune response plays an important role in the resistance of C. callossus to T. cruzi.<br>Calomys-callosus, roedor silvestre, que já foi encontrado naturalmente infectado pelo Trypanosoma cruzi, tem baixa suscetibilidade à infecção experimental por este protozoário. Foram feitos experimentos para avaliar a contribuição da resposta imune a essa baixa suscetibilidade. Animais foram submetidos a injeção de doses altas (200 mg/kg peso corporal) ou doses baixas (20 mg/kg peso corporal) de ciclofosfamida nos dias -1 ou -1 e +5, e inoculados com 4 x 10³ T. cruzi no dia O. Observou-se a curva de parasitemia, mortalidade e resposta de anticorpos medida por aglutinação direta de tripomastigotas. Doses de 200 mg resultaram em parasitemia e mortalidade mais elevada e supressão da resposta de anticorpos. Uma dose de 20 mg aumentou os níveis de anticorpos no 20º dia após a infecção, enquanto a administração de uma segunda dose não alterou significativamente a produção de anticorpos. Os níveis de parasitemia não diminuíram, mas pelo contrário, elevaram-se em relação aos animais testemunhos, em ambos os grupos. A transferência passiva de soro anti-T. cruzi de C. callosus resultou em parasitemia e mortalidade mais baixa nos animais imunossuprimidos. Estes resultados indicam que a resposta imune é um importante fator na resistência de C. callosus à infecção por T. cruzi