ABSTRACT
Prostate cancer differently affects different regions of the world, displaying higher rates in more developed areas. After the implementation of prostate-specific antigen (PSA) testing, several studies described rising rates globally, but it is possible that indolent lesions are being detected given the lack of changes in mortality data. The Brazilian government recommends against PSA screening in the male population regardless of age, but the Urology Society issued a report recommending that screening should start at 50 years old for certain men and for those aged ≥75 years with a life expectancy exceeding 10 years. In this study, we examined the incidence and mortality rates of invasive prostate cancer over time in the Sergipe state of Brazil. The databases of the Aracaju Cancer Registry and Mortality Information System were used to calculate age-standardized rates for all prostate tumors (International Classification of Diseases 10th edition: C61 and D07.5) in the following age ranges: 20-44, 45-54, and ≥65 years. We identified 3595 cases of cancer, 30 glandular intraepithelial high-grade lesions, and 3269 deaths. Using the Joinpoint Regression Program, we found that the incidence of prostate cancer dramatically increased over time until the mid-2000s for all age groups, after which the rates declined. Prostate cancer mortality rates increased until 2005, followed by a non-significant annual percent change of 22.0 in 2001-2005 and a stable rate thereafter. We noticed that the increases and decreases of the incidence rates of prostate cancer were associated with the screening recommendations. Meanwhile, the increased mortality rates did not appear to be associated with decreased PSA testing; instead, they were linked to the effects of age and improvements in identification of the cause of death. Thus, we do not believe a PSA screening program would benefit the population of this study.
Subject(s)
Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/mortality , Adult , Aged , Brazil/epidemiology , Humans , Incidence , Male , Middle Aged , RegistriesABSTRACT
Cervical cancer is a health issue that disproportionately affects developing countries, where the Papanicolaou test (Pap smear) remains an important screening tool. Brazilian government recommendations have focused screening on the female population aged from 25 to 64 years old. In this study, we examined the incidence and mortality rates of invasive cervical cancer lesions and the incidence rates of in situ precancerous cervical lesions, aiming to calculate their respective statistics over time in a mid-sized Brazilian city, Aracaju. The 1996-2015 database from the Aracaju Cancer Registry and Mortality Information System was used to calculate age standardized rates for all invasive cervical tumors (International code of diseases, ICD-10: C53) and preinvasive cervical lesions (ICD-10: D06) in the following patient age ranges; ≤ 24, 25-34, 35-44, 45-54, 55-64 and ≥ 65 years old. We identified 1,030 cancer cases, 1,871 in situ lesions and 334 deaths. Using the Joinpoint Regression Program, we calculated the annual percentage incidence changes and our analyses show that cervical cancer incidence decreased up to 2008, increased up to 2012 and decreased again thereafter, a significant trend in all age groups from 25 years. The incidence of precursor lesions increased from 1996 to 2005 and has since decreased, a result significant in all age groups until 64 years. Cervical cancer mortality has decreased by 3.8% annually and trend analysis indicates that Pap smears have been effective in decreasing cancer incidence and mortality. However, recent trends shown here show a decreasing incidence of in situ lesions and may indicate either a real decrease or incomplete catchment. Thus, we suggest health policies should be re-considered and include sufficient screening and HPV vaccination strategies to avoid cervical cancer resurgence in the population.
Subject(s)
Early Detection of Cancer/methods , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Adult , Brazil/epidemiology , Databases, Factual , Female , Humans , Incidence , Mass Screening/statistics & numerical data , Middle Aged , Papanicolaou Test/statistics & numerical data , Registries , Time Factors , Vaginal Smears/statistics & numerical dataABSTRACT
OBJECTIVE: To determine frequency, etiology, site and clinical and laboratory findings of ventriculoperitoneal shunt (VPS) infections in children and adolescents with hydrocephalus managed in Hospital Governador João Alves Filho, Aracaju SE, Brazil. METHOD: A non-controlled prospective observational study comprising 50 patients that underwent VPS (58 procedures) from January/2003 to October/2004. RESULTS: Infection rate per procedure was 27.6%; surgical risk index (NNISS-CDC) 0 and 1-2 were 25.7% and 30.4% respectively; surgical site infection was the main complication with 50% of the cases. CONCLUSION: Infection rates per procedure, per patient, and per surgical risk index were high. No statistical differences were found related to the following: age, etiology of hydrocephalus, type of procedure, pre-operative length of stay, duration of procedure, antibiotic prophylaxis, previous central nervous system catheter, and surgical risk index.
Subject(s)
Bacterial Infections , Hydrocephalus/surgery , Surgical Wound Infection , Ventriculoperitoneal Shunt/adverse effects , Adolescent , Bacterial Infections/microbiology , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Risk Factors , Surgical Wound Infection/microbiologyABSTRACT
OBJETIVO: Determinar a freqüência, as causas, o sítio específico e as manifestações clínicas e laboratoriais das infecções em crianças e adolescentes após a implantação de dispositivos neurológicos (DVP) no Hospital Governador João Alves Filho (Aracaju SE). MÉTODO: Estudo prospectivo, observacional, não controlado de 50 pacientes, submetidos a DVP (58 procedimentos), no período de janeiro de 2003 a outubro de 2004. RESULTADOS: Observaram-se taxas de infecção por procedimento de 27,6 por cento, taxas de infecção de índice cirúrgico zero, 1 e 2 de 25,7 por cento e 30,4 por cento, respectivamente (NNIS-CDC). A infecção de sítio cirúrgico foi a principal complicação com 50 por cento das infecções. CONCLUSÃO: Taxa de infecção por procedimento, paciente e índice de risco cirúrgico mostraram-se elevadas. Não houve significância estatística com relação à idade, etiologia da hidrocefalia, ao tipo de procedimento (derivação primária e reinserção), tempo de internação pré-operatória, duração da cirurgia, antibioticoprofilaxia, cateter SNC prévio e índice de risco cirúrgico.
OBJECTIVE: To determine frequency, etiology, site and clinical and laboratory findings of ventriculoperitoneal shunt (VPS) infections in children and adolescents with hydrocephalus managed in Hospital Governador João Alves Filho, Aracaju SE, Brazil. METHOD: A non-controlled prospective observational study comprising 50 patients that underwent VPS (58 procedures) from January/2003 to October/2004. RESULTS: Infection rate per procedure was 27.6 percent; surgical risk index (NNISS-CDC) 0 and 1-2 were 25.7 percent and 30.4 percent respectively; surgical site infection was the main complication with 50 percent of the cases. CONCLUSION: Infection rates per procedure, per patient, and per surgical risk index were high. No statistical differences were found related to the following: age, etiology of hydrocephalus, type of procedure, pre-operative length of stay, duration of procedure, antibiotic prophylaxis, previous central nervous system catheter, and surgical risk index.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Bacterial Infections , Hydrocephalus/surgery , Surgical Wound Infection , Ventriculoperitoneal Shunt/adverse effects , Bacterial Infections/microbiology , Prospective Studies , Risk Factors , Surgical Wound Infection/microbiologyABSTRACT
A case of a pseudoneoplastic lesion of the breast clinically and sonographically suggestive of a fibroadenoma is reported. Excisional biopsy revealed the nodule was an inflammatory process consequent to infection by Schistosoma mansoni.
Subject(s)
Breast Diseases/parasitology , Schistosoma mansoni , Schistosomiasis mansoni/pathology , Adult , Animals , Breast Diseases/drug therapy , Breast Diseases/pathology , Diagnosis, Differential , Female , Humans , Oxamniquine/therapeutic use , Schistosomiasis mansoni/drug therapy , Schistosomicides/therapeutic useABSTRACT
Relata-se um caso de uma lesäo pseudoneoplásica da mama clinicamente e ultrasonograficamente sugestiva de um fibroadenoma. A biópsia excisional revelou que o nódulo tratava-se de um processo inflamatório conseqüente à infecçäo pelo Schistosoma mansoni.
Subject(s)
Animals , Humans , Female , Adult , Breast Diseases , Schistosoma mansoni , Schistosomiasis mansoni , Breast Diseases , Breast Neoplasms , Diagnosis, Differential , Fibroadenoma , Oxamniquine , Schistosomiasis mansoni , SchistosomicidesABSTRACT
É apresentado o caso de uma paciente adulta jovem, previamente sadia, que, em 24 horas, desenvolveu febre com mialgias e artralgias, intensa agitaçäo psicomotora e queda do nível de consciência, simultaneamente com o aparecimento de lesöes petioquiais, lesöes de púrpura fulminans e equimoses disseminadas, entrando em estado de choque refratário e falecendo duas horas após internaçäo. O estudo de necrópsia revelou os achados clássicos da síndrome de Waterhouse-Frederichsen, servindo o caso para demonstrar as características clínicas, patogênicas e anatomopatológicas do mais grave espectro clínico da doença meningocócica
