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OBJECTIVE: Despite the benefits of concomitant radiotherapy and cisplatin for locally advanced cervical cancer, recurrence rates remain high. New treatment strategies such as consolidation chemotherapy and different concomitant chemotherapy combinations have been tested in recent years. Identification of the best candidates for each treatment strategy could optimize results. STUDY DESIGN: A retrospective review of data from 127 patients with locally advanced cervical cancer (International Federation of Gynecology and Obstetrics Stages IIB-IVA), treated at a single institution from 2005 to 2014. Risk factors for loco-regional and systemic recurrence, and prognostic factors for overall survival (OS) were analysed using Cox regression. Survival of patients treated with consolidation chemotherapy was compared with survival of patients not treated with consolidation chemotherapy in the role cohort and in a propensity-score-matched cohort. RESULTS: With a median follow-up time of 48.7 months, loco-regional-recurrence-free survival (LRFS), distant-metastasis-free survival (DMFS) and OS at 5 years were 76.6%, 54.0% and 63.0%, respectively. On multivariate analysis, tumour size ≥6 cm was associated with shorter LRFS [hazard ratio (HR) 5.18; 95% confidence interval (CI) 1.45-18.45; p = 0.011], and adenocarcinoma (HR 2.48; 95% CI 1.10-5.57; p = 0.028) and positive lymph nodes (HR 2.21; 95% CI 1.303-4.72; p = 0.041) were associated with shorter DMFS. Tumour size ≥6 cm was associated with shorter OS (HR 2.64; 95% CI 1.09-6.35; p = 0.031). Twenty-two patients were treated with consolidation chemotherapy; on univariate analysis, these patients had longer OS compared with patients who were not treated with consolidation chemotherapy (p = 0.043). In a propensity-score-matched cohort, patients treated with consolidation chemotherapy had longer DMFS and OS compared with patients who were not treated with consolidation chemotherapy, although the difference was not significant. CONCLUSIONS: Different risk factors are associated with loco-regional and distant metastases in patients with locally advanced cervical cancer, and could potentially lead to particular therapeutic strategies. Although the number of patients treated with consolidation chemotherapy in the study cohort was small, they seemed to live longer and to have better control of distant relapse then patients who were not treated with consolidation chemotherapy.
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Recurrencia Local de Neoplasia/etiología , Neoplasias Pélvicas/secundario , Neoplasias del Cuello Uterino/patología , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/uso terapéutico , Quimioradioterapia/mortalidad , Cisplatino/uso terapéutico , Terapia Combinada , Supervivencia sin Enfermedad , Femenino , Humanos , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia/mortalidad , Estadificación de Neoplasias , Neoplasias Pélvicas/mortalidad , Pelvis/patología , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Neoplasias del Cuello Uterino/mortalidad , Adulto JovenRESUMEN
BACKGROUND: Attention to prenatal care and child delivery is important for the health of women and children, but in the Amazon these indicators tend to be historically unfavorable, in part by geographical and political isolation. In 2003 both Brazilian and Peru governments have finished paving an international road connecting remotes areas in the Brazilian Amazon to the Pacific coast in Peru. METHODS: The situation of prenatal care and child delivery with mothers of children under 5 years old living in the urban area of Assis Brasil, Acre was assessed in two cross-sectional studies performed in 2003 and 2011, corresponding to the period before and after the Pacific highway construction. RESULTS: In 2003, most mothers were of black/Afro-American ethnicity, or "pardos" (the offspring of a Caucasian with a African descendant) (77.69 %), had more than 4 years of schooling (73.40 %) and had a mean age of 22.18 years. In 2011, the number of as a migration of indigenous women increased from 0 to 14.40 % of the respondents, because of migration from communities along the rivers to urban areas, with no other significant changes in maternal characteristics. No significant improvement in childbirth assistance was noticed between 1997 and 2011; only the percentage of in-hospital vaginal deliveries performed by doctors increased from 17.89 to 66.26 % (p <0.001) during this period. Access to prenatal care was associated with white ethnicity in 2003, and higher socioeconomic level and white ethnicity in 2011, while the higher number of prenatal visits was associated with higher maternal education and higher socioeconomic levels in 2011. Vaginal child delivery at a hospital facility was associated with maternal age in 2003, and year of birth, being of white ethnicity and higher level of education in 2011. CONCLUSIONS: The indicators of prenatal care and child delivery were below the national average, showing that geographical isolation still affects women's health care in the Amazon, despite the construction of the highway and governmental health protocols adopted during this period.
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Parto Obstétrico/métodos , Accesibilidad a los Servicios de Salud/normas , Atención Prenatal/estadística & datos numéricos , Adulto , Brasil , Industria de la Construcción , Estudios Transversales , Parto Obstétrico/normas , Parto Obstétrico/estadística & datos numéricos , Etnicidad/psicología , Etnicidad/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud/tendencias , Humanos , EmbarazoRESUMEN
Despite the process of nutritional transition in Brazil, in some places, such as the Amazon region, stunting is still an important public health problem. We identified the prevalence and factors associated with stunting in children under five years old residing in the urban area of Assis Brasil. A survey was conducted in which a questionnaire on socioeconomic, maternal and children's conditions was applied, and height or length was measured. The children with height for age index below -2 Z-scores were considered stunted, according to the criteria by the World Health Organization. Four hundred and twenty-eight children were evaluated. Of these, 62 were stunted. Factors associated with stunting, according to adjusted models, were: the presence of open sewer, the wealth index for households, the receipt of governmental financial aid and the mother's height, age and education. Therefore, it was observed that family and the mother's characteristics as well as environmental and socioeconomic factors were closely related to the occurrence of stunting in the population studied, and such nutritional disturbance is still a health problem in the Brazilian Amazon.
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Trastornos del Crecimiento/epidemiología , Brasil/epidemiología , Preescolar , Estudios Transversales , Estudios Epidemiológicos , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Recién Nacido , Masculino , Prevalencia , Factores SocioeconómicosRESUMEN
Abstract Despite the process of nutritional transition in Brazil, in some places, such as the Amazon region, stunting is still an important public health problem. We identified the prevalence and factors associated with stunting in children under five years old residing in the urban area of Assis Brasil. A survey was conducted in which a questionnaire on socioeconomic, maternal and children’s conditions was applied, and height or length was measured. The children with height for age index below -2 Z-scores were considered stunted, according to the criteria by the World Health Organization. Four hundred and twenty-eight children were evaluated. Of these, 62 were stunted. Factors associated with stunting, according to adjusted models, were: the presence of open sewer, the wealth index for households, the receipt of governmental financial aid and the mother’s height, age and education. Therefore, it was observed that family and the mother’s characteristics as well as environmental and socioeconomic factors were closely related to the occurrence of stunting in the population studied, and such nutritional disturbance is still a health problem in the Brazilian Amazon.
Resumo Apesar do processo de transição nutricional no Brasil, em alguns lugares, como a região amazônica, o nanismo ainda é um importante problema de saúde pública. Identificou-se a prevalência e fatores associados ao déficit de crescimento em crianças menores de cinco anos de idade residentes na área urbana de Assis Brasil. Um inquérito foi realizado utilizando instrumento semiestruturado sobre características socioeconômicas, maternas e das crianças, e foram aferidas medidas antropométricas. As crianças com índice de estatura para idade inferior a -2 escores-Z foram consideradas com déficit de crescimento, de acordo com os critérios da Organização Mundial da Saúde. Quatrocentos e vinte e oito crianças foram avaliadas. Destas, 62 apresentaram déficit de crescimento. Os fatores associados à baixa estatura, de acordo com modelos ajustados, foram: presença de esgoto a céu aberto, índice de riqueza para as famílias, recebimento de ajuda financeira governamental, altura materna, idade e escolaridade maternas. Portanto, observou-se que as características familiares e da mãe, bem como fatores ambientais e socioeconômicos estavam intimamente relacionados com a ocorrência de déficit de crescimento na população estudada, e que a desnutrição ainda é um problema de saúde na Amazônia brasileira.
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Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Trastornos del Crecimiento/epidemiología , Factores Socioeconómicos , Brasil/epidemiología , Estudios Epidemiológicos , Prevalencia , Estudios Transversales , Encuestas EpidemiológicasRESUMEN
OBJECTIVES: Secondary cytoreductive surgery (SCS) is an option for treating patients with recurrent ovarian cancer. Three ongoing randomized trials are comparing SCS plus chemotherapy with chemotherapy alone, and few comparative studies have been published. MATERIALS AND METHODS: We performed a retrospective review of data on 209 patients with recurrent ovarian carcinoma who were treated at a single institution from 2000 to 2013. We analyzed prognostic factors in the recurrence setting to determine the value of SCS in a multivariate model, including propensity score, by prognostic group. RESULTS: In the univariate analysis, younger than 65 years, personal or family history of breast or ovarian cancer, stage I-II at diagnosis, residual disease 10 mm or less after primary debulking surgery, performance status 1 or less, CA125 less than 100, only 1 metastatic site of recurrence, platinum-free interval of more than 12 months, and SCS correlated with better overall survival. In the multivariate model, including propensity score, SCS remained associated with a 66% decrease in the risk of death (hazard ratio, 0.34; 95% CI, 0.15-0.76, P = 0.008). Secondary cytoreductive surgery was also linked to longer progression-free survival (hazard ratio, 0.50; 95% CI, 0.30-0.84, P = 0.008). There was no evidence of a benefit of SCS in patients with unfavorable prognosis (P for interaction = 0.654). CONCLUSIONS: Our results confirm the benefit of SCS in progression-free survival and overall survival in the recurrent setting and suggest that it exists not only for patients with a good prognosis.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Cistadenocarcinoma Seroso/cirugía , Procedimientos Quirúrgicos de Citorreducción , Recurrencia Local de Neoplasia/cirugía , Neoplasia Residual/cirugía , Neoplasias Ováricas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Cistadenocarcinoma Seroso/tratamiento farmacológico , Cistadenocarcinoma Seroso/patología , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Invasividad Neoplásica , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Neoplasia Residual/tratamiento farmacológico , Neoplasia Residual/patología , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/patología , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
Introduction. Children under 5 years of age are more susceptible to developing morbidities such as diarrhea, respiratory infections, anemia, and malnutrition. The objective of the study is to evaluate the prevalence of reported morbidities in this age group in the city of Iñapari (Peru) and the access to health services in this municipality. Methods. Data collection using interviews that assessed socioeconomic and demographic conditions, child morbidity, and access to health services was performed in 2011. Statistical analysis was performed using SPSS 13.0. Results. Regarding morbidities that occurred during lifetime, 39.8% reported previous anemia and intestinal parasite infection. About 53.7% of the children reported any type of morbidities in the last 15 days before interview, being most frequent respiratory symptoms (38.9%), diarrhea (23,4%), and fever (23,1%). Only 63.1% of those reporting recent morbidities sought health care. These morbidities were associated with precarious sanitation and lack of infrastructure, the presence of other comorbidities, and poor access to health services. Conclusion. The main referred morbidities in Amazonian Peruvian children were diarrhea, respiratory symptoms, anemia, and vomiting. Incentives and improvements in the health and sanitation conditions would be important measures to improve the quality of life of the Amazonian child population.
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BACKGROUND: Hepatitis A is still a neglected health problem in the world. The most affected areas are the ones with disadvantaged socioeconomic conditions. In Brazil, seroprevalence studies showed that 64.7 % of the general population has antibodies against HAV (hepatitis A virus), and the Amazon region has the highest seroprevalence in the country. METHODS: In the present study the seroprevalence of total HAV antibodies in children between 1 and 5 years old residing in the urban area of Assis Brasil, Acre was measured and spatial distribution of several socioeconomic inequities was evaluated. RESULTS: In the year of 2011, seroprevalence rate was 16.66 %. Factors associated with having a positive serology identified by multivariate analysis were being of indigenous ethnicity [adjusted Odds Ratio (aOR) = 3.27, CI 1.45-7.28], usage of water from the public system (aOR = 8.18, CI 1.07-62.53), living in a house not located in a street (aOR = 3.48, CI 1.54-7.87), and child age over 4 years old (aOR = 2.43, CI 1.23-4.79). The distribution of seropositive children was clustered in the eastern part of the city, where several socioeconomic inequities (lack of flushed toilets, lack of piped water inside the household and susceptibility of the household to flooding during rain, low maternal education, having wood or ground floor at home, and not owning a house, lack of piped water at home, and type of drinking water) also clustered. CONCLUSIONS: The findings highlight that sanitation and water treatment still need improvement in the Brazilian Amazon, and that socioeconomic development is warranted in order to decrease this and other infectious diseases.
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Hepatitis A/diagnóstico , Factores Socioeconómicos , Brasil/epidemiología , Preescolar , Estudios Transversales , Demografía , Femenino , Hepatitis A/epidemiología , Hepatitis A/virología , Anticuerpos de Hepatitis A/sangre , Virus de la Hepatitis A/aislamiento & purificación , Humanos , Lactante , Masculino , Análisis Multivariante , Oportunidad Relativa , Prevalencia , Factores de RiesgoRESUMEN
BACKGROUND: Interval debulking surgery (IDS) is an option for treating patients with advanced ovarian carcinoma. Two randomized trials have shown similar survival rates for primary debulking surgery (PDS) and IDS. One of the concerns with IDS is the potentially higher risk of inducing platinum resistance when treating patients with greater disease volume. METHODS: A retrospective review of data on 237 patients with stage IIIC and IV ovarian carcinoma who were treated at a single institution from 2000 to 2013. We analyzed the association of IDS with time to first platinum resistant relapse (TTPR); platinum-resistant disease at first relapse, defined as a platinum-free interval (PFI) after first-line chemotherapy of <6 months; and overall response rate (ORR) to chemotherapy at first platinum-sensitive relapse. RESULTS: The TTPR was 60 months, and the median TTPR was longer for the PDS (80.8 months) versus IDS group (39.3 months; p = 0.012) and for patients with residual disease (RD) ≤10 mm (80.8 months) compared with those with RD >10 mm (26.1 months; p < 0.001). In the multivariate analysis, IDS [hazard ratio (HR) 1.92; p = 0.009] and RD >10 mm (HR 1.65; p < 0.001) retained an increased risk of developing platinum-resistant disease. IDS was not associated with a greater risk of PFI <6 months at first relapse, and the ORR to platinum-based chemotherapy at first platinum-sensitive relapse was 87.2 % for patients who were treated with PDS compared with 68.0 % for those who underwent IDS (p = 0.051). CONCLUSIONS: IDS correlates with a higher risk of the development of platinum resistance.
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Procedimientos Quirúrgicos de Citorreducción , Resistencia a Antineoplásicos , Recurrencia Local de Neoplasia/patología , Neoplasia Residual/patología , Neoplasias Ováricas/patología , Platino (Metal)/uso terapéutico , Adenocarcinoma de Células Claras/patología , Adenocarcinoma de Células Claras/terapia , Adenocarcinoma Mucinoso/patología , Adenocarcinoma Mucinoso/terapia , Quimioterapia Adyuvante , Terapia Combinada , Cistadenocarcinoma Seroso/patología , Cistadenocarcinoma Seroso/terapia , Neoplasias Endometriales/patología , Neoplasias Endometriales/terapia , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Terapia Neoadyuvante , Clasificación del Tumor , Invasividad Neoplásica , Recurrencia Local de Neoplasia/terapia , Estadificación de Neoplasias , Neoplasia Residual/terapia , Neoplasias Ováricas/terapia , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de SupervivenciaRESUMEN
This study aimed to evaluate the prevalence of serum IgG dengue in children in an Amazonian population, to assess the seroconversion rate in 12 months, and to estimate how many seropositive children had a prior clinical diagnosis of dengue. We conducted a population-based study between 2010 and 2011, with children aged 6 months to 12 years that were living in the urban area of a small town in the Brazilian Amazon. The prevalence of IgG antibodies against dengue antigens was determined by indirect ELISA technique, and seronegative children were reexamined after 12 months to determine seroconversion rates. Results showed seroprevalence of IgG antibodies against dengue type of 2.9%, with no significant association between age, race, and sex. In seropositive children, only 8.4% had received a clinical diagnosis of dengue, and the ratio of clinically diagnosed cases and subclinical cases was 1 : 11. The seroconversion rate between 2010 and 2011 was 1.4% (CI 3.8% to 35.1%). The seroprevalence of dengue in this pediatric population was low, and the vast majority of cases were not clinically detected, suggesting a difficulty in making the clinical diagnosis in children and a high frequency of asymptomatic infections.
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BACKGROUND: The aim of this study was to analyse the prevalence of undernutrition, overweight and associated factors, before and after the implementation of the Interoceanic Highway. METHODS: A population-based cross-sectional study on children under 5 years of age was conducted in the municipality of Assis Brasil, AC, Brazil, in 2003 and 2010. Prevalence of undernutrition was observed by using height-for-age Z-scores (HAZ) and adopting a cut-off point equal to or lower than a -2 Z-score. Overweight prevalence was defined by a cut-off point equal to or greater than a +2 Z-score of the WHZ index. Z-scores were calculated relative to WHO 2006 reference data. Semi-structured questionnaires were applied to the children's guardians, investigating family socio-economic and demographic characteristics, morbidities, access to services and child care. Associated factors were identified by hierarchical multiple logistic regression analysis. RESULTS: The prevalence of low HAZ (undernutrition) was 7.0% in 2003 and 12.2% in 2010. The prevalence of high WHZ (overweight) was 1.0% and 6.6% for 2003 and 2010, respectively. It was not possible to adjust the multiple model for the year 2003. The factors associated with low HAZ in 2010 were: wealth index, the situation of living with biological parents, maternal height and presence of open sewage, whereas the factors associated with a high WHZ in the same year were: child's age, mother's time of residence in the location, mother's body mass index. CONCLUSIONS: Overweight increase within this undernutrition scenario reveals that the process of nutritional transition began in this Amazonian city only in the last decade, and therefore, it is delayed when compared to overweight in other parts of Brazil. Such nutritional transition in Assis Brasil may have been facilitated by the construction of the Interoceanic Highway.
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Fenómenos Fisiológicos Nutricionales Infantiles , Planificación Ambiental/estadística & datos numéricos , Desnutrición/epidemiología , Estado Nutricional , Sobrepeso/epidemiología , Brasil/epidemiología , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante , Masculino , Prevalencia , Factores de RiesgoRESUMEN
PURPOSE: This paper is the first, to our knowledge, to propose the use of a bovine pericardium graft in corporoplasty for penile prosthesis implantation. The advantages of bovine pericardium graft have been demonstrated by its use in cardiac surgery, including low cost, biocompatibility, impermeability, resistance to dilatation, flexibility, low likelihood of retraction, absence of antigenic reaction and natural absorption of the tissue. In this paper, we propose the use of this heterologous material graft in corporoplasty for penile prosthesis implantation. MATERIALS AND METHODS: Five patients with a history of erosion, infection and fibrosis, mean time of follow-up 32 months (range 9-48 months). Bovine pericardium was used to cover large areas of implanted penile prostheses when use of the tunica albuginea was unfeasible. RESULTS: The surgical procedure resulted in no complications in all patients. CONCLUSIONS: Bovine pericardium may substitute synthetic and autologous material with the additional advantages of lower cost and greater availability.
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Implantación de Pene/métodos , Pene/cirugía , Pericardio/trasplante , Colgajos Quirúrgicos , Adulto , Animales , Materiales Biocompatibles , Bovinos , Fibrosis/patología , Fibrosis/cirugía , Humanos , Masculino , Pene/patología , Neoplasias de la Próstata/cirugía , Trasplante Heterólogo/métodos , Resultado del TratamientoRESUMEN
Purpose: This paper is the first, to our knowledge, to propose the use of a bovine pericardium graft in corporoplasty for penile prosthesis implantation. The advantages of bovine pericardium graft have been demonstrated by its use in cardiac surgery, including low cost, biocompatibility, impermeability, resistance to dilatation, flexibility, low likelihood of retraction, absence of antigenic reaction and natural absorption of the tissue. In this paper, we propose the use of this heterologous material graft in corporoplasty for penile prosthesis implantation. Materials and Methods: Five patients with a history of erosion, infection and fibrosis, mean time of follow-up 32 months (range 9-48 months). Bovine pericardium was used to cover large areas of implanted penile prostheses when use of the tunica albuginea was unfeasible. Results: The surgical procedure resulted in no complications in all patients. Conclusions: Bovine pericardium may substitute synthetic and autologous material with the additional advantages of lower cost and greater availability.
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Adulto , Animales , Bovinos , Humanos , Masculino , Implantación de Pene/métodos , Pene/cirugía , Pericardio/trasplante , Colgajos Quirúrgicos , Materiales Biocompatibles , Fibrosis/patología , Fibrosis/cirugía , Pene/patología , Neoplasias de la Próstata/cirugía , Resultado del Tratamiento , Trasplante Heterólogo/métodosRESUMEN
CONTEXTO: Estudos indicam que estudantes de Medicina, apesar do seu dedutível conhecimento sobre os efeitos das substâncias psicoativas, consomem-nas em proporção semelhante à dos jovens de mesma idade na população geral. OBJETIVO: Analisar o padrão local do consumo dessas substâncias entre graduandos de Medicina e contribuir na formulação de atividades preventivas. MÉTODOS: Aplicação de questionário semi-estruturado no qual foi avaliada a freqüência de uso das substâncias psicoativas entre os estudantes, assim como as principais razões apontadas para o consumo. Foram analisados 404 questionários obtidos entre alunos dos seis anos de curso das duas maiores escolas médicas de Salvador. RESULTADOS: As drogas mais utilizadas no critério uso na vida foram álcool (92,8 por cento) e lança-perfume (46,2 por cento). O uso de álcool apresentou-se constante nos seis anos de curso. Entretanto, o uso de tabaco, lança-perfume e tranqüilizantes aumentou significativamente para os alunos dos últimos anos (p < 0,05). Há um maior consumo de drogas pelo gênero masculino. Diversão foi apontada como razão mais importante para o uso dessas substâncias (58,7 por cento das respostas válidas). CONCLUSÃO: O consumo de substâncias psicoativas entre estudantes de Medicina de Salvador é considerado alto, em concordância com o que se constatou em outros trabalhos científicos.
BACKGROUND: Studies have shown that medical students consume psychoactive substances at the same rates as the same age youth on general population, despite their predictable knowledge about drugs effects. OBJECTIVE: To analyze the local pattern of psychoactive substances use among medical students and contribute for the formulation of preventive activities. METHODS: The frequency of psychoactive substances use was evaluated by a self-administered anonymous questionnaire that also asked the main reasons for that use. Four hundred and four students in the first to sixth year from the two biggest medical schools in Salvador answered the questionnaire. RESULTS: The lifetime use was bigger for alcohol (92.8 percent) and inhalant (46.2 percent). Alcohol use was constant for the students from first to sixth year of course, but it was not statistically significant (p > 0.05). However, tobacco, inhalants and tranquilizers use had a significant increase at the last two years of course students (p < 0.05). It was verified a bigger drugs use by the male gender. "Fun" was shown as the first main reason for psychoactive substances (58.7 percent of the valid answers). CONCLUSION: Psychoactive substances consume rates by medical students from Salvador are as high as the ones shown on other scientific researches about this subject.
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Humanos , Masculino , Femenino , Facultades de Medicina , Estudiantes de Medicina , Trastornos Relacionados con Sustancias/epidemiología , Factores de RiesgoRESUMEN
INTRODUÇÃO: Alguns estudos sugerem que o uso de antidepressivos poderia aumentar o risco de câncer. Este estudo visa realizar uma revisão sobre o tema. MÉTODO: Foi feita uma busca nas bases de dados MEDLINE e LILACS, utilizando como palavras de busca antidepressant, cancer e nomes das diferentes drogas antidepressivas. RESULTADOS: Onze artigos foram selecionados. Foram encontrados seis artigos sugerindo uma associação positiva fraca entre o uso de antidepressivos e o crescimento tumoral e cinco artigos que não sugeriam a associação. Discussão: Os resultados dos estudos com relação ao risco de câncer associado ao uso de antidepressivos são ainda conflitantes. Na maioria dos estudos, a análise multivariada não mostra associação positiva em uso de antidepressivos e câncer, a não ser em casos específicos, como linfoma de Hodgkin.
INTRODUCTION: Some studies suggest that the use of antidepressants could increase the risk of cancer. This study aims at performing a review on this subject. METHOD: A search was performed in the MEDLINE and LILACS databases using the keywords antidepressant, cancer and names of varied antidepressant drugs. RESULTS: Eleven articles were selected. Six articles were found suggesting a positive weak association between use of antidepressants and tumoral growth. In five articles this association was not found. DISCUSSION: The results of studies on increased risk of cancer associated with antidepressants are still conflicting. In most studies the multivariate analysis did not show positive association between use of antidepressants and cancer, unless in specific cases, such as Hodgkin's lymphoma.
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Humanos , Masculino , Femenino , Antidepresivos , Antidepresivos/efectos adversos , Neoplasias , Riesgo , Depresión/complicaciones , Depresión/diagnóstico , Depresión/patología , Depresión/terapiaRESUMEN
Ethnoecological knowledge may be understood as spontaneous knowledge, culturally referenced of any society's members, learned and transmitted through social interactions and that are targeted at resolution of daily routine situations. The traditional knowledge in small scale economy societies as well as the non-academic knowledge in urban-industrial societies might be included in this concept. An ethnoecological approach study was performed here on people living at the communities of Alvinho, Almeida, Chã do Marinho, Floriano, and Chã de Oiti, all located in the municipality of Lagoa Seca, Paraíba state, Northeast Brazil. The general objective pursued here was to study the knowledge that peasant farmers have on management of plant species utilized for pest control. For this, the methodological instruments employed here to investigate the ethnoecological knowledge were: direct observation, structured and semi-structured interviews, and tours conducted by local peasant farmers. We analyzed the data obtained under an emic/etic view and also by comparing the local knowledge with those obtained from the literature. The results showed that people in those communities utilize management alternatives for controlling pests, which are mainly: (i) fallowing; (ii) crop rotation; (iii) destruction of crop remains and fruits attacked by pests; (iv) alternations of crops with repellent plants; and/or (v) mixed cropping; (vi) insect's larvae covered with soil; (vii) crops irrigated abundantly; and (viii) soil preparation. The recovery and comprehension we get about this knowledge as well as the farmers' savoir faire, are extremely important to the revival of ancient agricultural practices, which have been forgotten due to advances in modern agriculture. The data obtained here showed that a huge body of knowledge the farmers have on many forms or strategies of management are generally compatible with scientific knowledge.