Last Updated on Sunday, 3 November 2024, 14:25 by Writer
A Guyana Defence Force (GDF) Lieutenant and two government department Natural Resources officers were among five Guyanese and four Brazilians who were abducted and robbed of gold and guns
The items stolen were an undisclosed quantity of raw gold
two Glock pistols and one Movado watch valued GY$140,000
Investigators were told that at about 10:15 a.m
believed to be Brazilian nationals judging by their Portuguese accent
ambushed the victims from strategic points at the Guyana Geology and Mines Commission (GGMC) checkpoint
located at the Bush Mouth Sub-station in Marudi in Deep South Rupununi
The victims were heading to Marudi Backdam but stopped at the GGMC gate to check in
The abducted Natural Resources officers were 34-year-old Victor Adams of Lot 676 Section 7 Field ‘B’ Pattensen Drive
Georgetown and 39-year-old Romain Simon of Block 1,481 Zeelugt
The other abductees were 17-year-old Christopher Charles of Lethem Central
Rupununi; GDF Lieutenant 35-year-old Curtis Charles of Block ‘X’ Diamond Housing Scheme; Community Mines Ranger
30-year-old Karl Antoine of Aishalton Village
a 28-year-old caretaker of Karaudanau Village
South Rupununi; 29-year-old Dionei Farias De Brito
22-year-old Eduardo Moreira Freitas of Boa Vista
The GPF said members of the Joint Services are on the ground combing the area for the suspects as investigations continue
police said the abductors fled and left the abductees in a vehicle
Tagged with: abduction ambush Deep South Rupununi gold guns robbery
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There have been arguments about the role of breast cancer screening at the population level
and some points of controversy have arisen
such the establishment of organized screening policies and the age at which to begin screening
The real benefit of screening has been questioned because the results of this practice may increase the diagnosis of indolent lesions without decreasing mortality due to breast cancer
The authors have proposed a study of incidence and mortality trends for breast cancer in a developing setting in Brazil to monitor the effectiveness of the official recommendations that prioritize the age group from 50 to 69 years
The database of the Cancer Registry and the Mortality Information System was used to calculate age-standardized and age-specific rates
which were then used to calculate incidence and mortality trends using the Joinpoint Regression Program
The results showed stability in trends across all ages and age-specific groups in both incidence and mortality
we found that incidence and mortality rates are compatible with those in regions with similar human development indexes
and trends have demonstrated stabilization
we do not endorse changes in the official recommendations to conduct screening for ages other than 50 to 69 years
nor should policy makers implement organized screening strategies
Breast cancer is the type of cancer with the highest mortality rate among women
we have decided to carry out a study of trends in the incidence and mortality of female breast cancer
as opposed to an analysis of the trend in carcinoma in situ
to monitor the effectiveness of the official recommendations for the breast cancer screening in a controlled population of a capital in northeastern Brazil with a high-quality cancer registry
Incidence data were obtained from the database of the Aracaju Cancer Registry from 1998 to 2014; mortality data were collected from the Mortality Information System (SIM) for the same period
We analyzed all cases of invasive breast cancer and pure carcinoma in situ and all deaths associated with breast cancer occurring within the defined period using codes C50 and D05 of the International Classification of Diseases (ICD)
We included all cases with the following morphological codes
and their respective confidence intervals for each year
We also calculated the age-specific rates with five-year intervals according to the standard for the Cancer Registry and for the study; for the best evaluation of the screening recommendations
we reorganized the age groups as follows: 20 to 39
we divided the patients into age groups of <50 and 50+ years
We also calculated the mortality-to-incidence rate with confidence intervals and its complement 1-(M/I) to infer annual survival
This project was approved by the Ethics and Research Committee of the Federal University of Sergipe under CAAE number: 57995416.9.0000.5546
We reiterate that all methods were performed in accordance with the relevant guidelines and regulations
for which it would have been impracticable to obtain informed consent
according to Resolution 466 of December 2012 of the Ministry of Health
we asked the Ethics Committee for exemption of the informed consent
Incidence trends for breast carcinoma in situ considering age-standardized rates (ASR) and age groups <50 years and 50+ years
Breast cancer incidence trends remained stable throughout the time series for all ages and defined age groups. The age group 50–69 years showed an upward but nonsignificant trend (APC 1.1), and the age group 70+ years showed a downward and nonsignificant trend (APC −1.3). (Fig. 2).
Incidence trends for invasive breast carcinoma
considering age-standardized rates (ASR) and age groups 20–39
Regarding mortality, none of the age groups demonstrated statistically significant trends. Figure 3 depicts trend showing that the 40- to 49-year age group presented a downward trend (APC −1.15), and the age groups 50–69 and 70+ years exhibited upward trends (APC 0.89 and 1.63, respectively).
Mortality trends for breast cancer considering age-standardized rates (ASR) and age groups 20–39
In Table 2
we also present the mortality-to-incidence ratios (M/I) and their confidence intervals for each year of the series that
As a proxy of the 5-year survival rate by the complement [1 − (M/I)] (Refs)
these values presents an average survival of 70% for the studied population
We analyzed the databases of the Aracaju Cancer Registry and SIM
and after calculating the age-standardized and age-specific rates of breast cancer incidence and mortality
we noticed that trends remained stable throughout the time series
Because there has been no systematic screening
we have noticed that a very small number of cases of carcinoma in situ was diagnosed
Some medical organizations in those developed countries have started to revise their guidelines accordingly because the increased incidence of breast cancer due to early diagnosis has not had a significant impact on the reduction of mortality
do not allow us to infer whether women from any of the analyzed age groups were more likely to participate in therapies after screening programs
with incidence rates much higher than those found in our study
in the Regional Health District of Barretos
This turns out to reflect the policy of mass screening
conducted in the region by a cancer-fighting institution
The increasing trends in the incidence rates of both carcinoma in situ and invasive carcinoma have not led to decreased mortality rates
including screening for women under 50 years
has benefitted the population at an average risk
it is known that such screening practices have inflated cancer statistics
and harms consequent to overtreatment may ensue
we used mean incidence and mortality rates of 58.1 per 100,000 and 16.7 per 100,000
to calculate the mortality-to-incidence ratio
Using this ratio as a proxy for five-year survival
we obtained an estimate of survival of 71%
measures to improve health services need to be implemented to provide equity in cancer control
The improvement of the quality of mortality information in Brazil as well as the incidence data
has allowed a more reliable evaluation of cancer control policies in the study area
the increase in the diagnosis of early lesions has been less pronounced since the implementation of the Mass Screening Program in 2006
incidence trends have remained stable since the initiation of the program
would have been more precise if the authors had included mortality trends for the same time period
as well as including age groups other than 50 to 69 years of age
We do not mean that screening is not necessary; instead
health policies should focus on the specific age groups that could benefit the most
High-resolution mammography has been overused so far
with the consequent overdiagnosis of precursor and indolent lesions that do not necessarily need to be treated
women have become apprehensive and have seemed to have a reduced quality of life because of concern about disease progression and treatment
Breast cancer awareness campaigns should be encouraged
Information on risk factors should be spread to identify women who need special orientation for their screening
Access to diagnostic and treatment services should be facilitated to avoid delays in the management of cases
As a personalized approach is considered to be the key factor in decreasing mortality and increasing survival
government policies should better target their financial resources to more effectively combat breast cancer
We did not assess differences in the incidence of breast cancer among races
Race is not a good parameter in Brazil because of the high level of miscegenation
and because there is no national consensus on identification by race
The classification is based on the race the individual claims to be and usually reflects some social prejudices
any attempted classification by race is unreliable
The incidence and mortality rates of female breast cancer in this developing area of northeastern Brazil display incidence and mortality rates that are similar to those of median risk areas
they are compatible with other regions with similar levels of human development
We recommend that screening policies be reserved for the age group of 50–69 years because the increased incidence of breast cancer due to early diagnosis has not caused a significant impact on the reduction of mortality
Some publications corroborate this recommendation
signaling that this age group should probably benefit the most and that a further decrease in mortality might follow personalized breast cancer treatment
we do not endorse changes in the Ministry of Health’s recommendations that prioritize the age group from 50 to 69 years to mammographic screening
nor should organized screening practices be adopted
breast cancer awareness measures should be implemented
and the female population should have optimal access to diagnostic and treatment services
Global Cancer Incidence and Mortality Rates and Trends–An Update
Breast cancer in Brazil: present status and future goals
Temporal trends in female breast cancer mortality in Brazil and correlations with social inequalities: ecological time-series study
INCA - Instituto Nacional de Câncer - Estimativa 2018. Available at: http://www.inca.gov.br/estimativa/2018/
Effect of three decades of screening mammography on breast-cancer incidence
Effectiveness of and overdiagnosis from mammography screening in the Netherlands: population based study
Gøtzsche, P. C. & Jørgensen, K. J. Screening for breast cancer with mammography. Cochrane Database Syst. Rev., https://doi.org/10.1002/14651858.CD001877.pub5 (2013)
Breast Cancer Screening for Women at Average Risk
ACR Appropriateness Criteria Breast Cancer Screening
Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancer
Diretrizes para a detecção precoce do câncer de mama no Brasil/ Instituto Nacional de Câncer José Alencar Gomes da Silva – Rio de Janeiro: INCA (2015)
IBGE|Brasil em Síntese|Sergipe|Aracaju|Pesquisa|Índice de Desenvolvimento Humano|IDH. Available at: https://cidades.ibge.gov.br/brasil/se/aracaju/pesquisa/37/30255
Available at: https://www.ibge.gov.br/en/np-statistics/social/population/18448-population-estimates.html?=&t=downloads
Evaluation of data quality in the cancer registry: Principles and methods
Evaluation of data quality in the cancer registry: Principles and methods Part II
Steliarova-Foucher, E. et al. International incidence of childhood cancer, 2001–10: a population-based registry study. Lancet Oncol., https://doi.org/10.1016/S1470-2045(17)30186-9 (2017)
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Cancer mortality for selected sites in 24 countries
Joinpoint Regression Program; Statistical Methodology and Applications Branch
Permutation tests for joinpoint regression with applications to cancer rates
Breast-Cancer Screening — Viewpoint of the IARC Working Group
Overall survival and time trends in breast and cervical cancer incidence and mortality in the Regional Health District (RHD) of Barretos
Increasing trends in in situ breast cancer incidence in a region with no population-based mammographic screening program: results from Zurich
Overdiagnosis and overtreatment of breast cancer: Rates of ductal carcinoma in situ: a US perspective
Trends in Breast Cancer Incidence and Stage Distribution Before and During the Introduction of the Mammography Screening Program in Lithuania
and breast cancer incidence and mortality in Canadian women
The mapping of cancer incidence and mortality trends in the UK from 1980–2013 reveals a potential for overdiagnosis
Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
Schottenfeld and fraumeni Cancer epidemiology and prevention
Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018
International Variation in Female Breast Cancer Incidence and Mortality Rates
Disparities in breast cancer survival in the United States (2001–2009): Findings from the CONCORD-2 study
Cancer survival in Brazil: Estimate through the mortality to incidence ratio
The global decrease in cancer mortality: trends and disparities
The Mortality-to-Incidence Ratio Is Not a Valid Proxy for Cancer Survival
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The authors wish to thank the personnel of the Cancer Registry for their great work in collecting data and preparing the database for this research work: José Erinaldo Lobo de Oliveira
Sueli Pina Vieira; Suzana Maria de Carvalho
We thank Nature Research Editing Service for editing a draft of this manuscript
Hugo Leite de Farias Brito & Rosana Cipolotti
University Hospital/EBSERH/Federal University of Sergipe
CONPREV/Brazilian National Cancer Institute
Marceli de Oliveira Santos & Mirian Carvalho de Souza
CHAMADA MS/CNPq/FAPITEC/SE/SES – No 06/2018
and M.O.S.; analysis and interpretation of data: E.A.C.B.
and M.C.S.; drafting of the article: E.A.C.B.
and A.D.M.; critical revision of the article: C.A.L.
and R.C.; final approval of the article: C.A.L.
This research was conducted with the partial support of a Research Development Grant from the Fundação de Apoio à Pesquisa e à Inovação Tecnológica do Estado de Sergipe - FAPITEC/SE to C.A.L
The authors declare no other competing interests
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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Volume 12 - 2021 | https://doi.org/10.3389/fimmu.2021.779534
This is a case series study to evaluate immunological markers associated with schistosomiasis advanced fibrosis
including 69 patients from an endemic area from the State of Sergipe and from the Hepatology Service of the University Hospital in Sergipe
Hepatic fibrosis was classified based on Niamey protocol for ultrasonography (US)
Immune response to Schistosoma mansoni antigens was evaluated by stimulating peripheral blood mononuclear cells (PBMCs) from these patients with either adult worm (SWAP—10 μg/ml) or egg (SEA—10 μg/ml) antigens or purified protein derivative of turberculin (PPD—10 μg/ml) or phytohemagglutinin (PHA—1 μg/ml) for 72 h
and IL-17 were measured in these supernatants by ELISA and IL-9 by Luminex
and CD209 genes were genotyped using TaqMan probe by qPCR
and IL-17 were found in PBMC supernatants of patients with advanced hepatic fibrosis
Direct correlations were detected between IL-9 and IL-17 levels with US spleen sizes
The CD209 rs2287886 AG polymorphism patients produce higher IL-17 levels
these data suggest a role of these cytokines in the immunopathogenesis of advanced fibrosis in human schistosomiasis
he present study evaluates the cytokine profiles of Th1 (IFN-γ
and Th17 (IL-17) in peripheral blood mononuclear cell (PBMC) supernatants stimulated with soluble egg (SEA) and adult worm (SWAP) antigens from patients with schistosomiasis with different stages of hepatic fibrosis and investigates whether SNPs in IL17A
and CD209 receptor [dendritic cell-specific ICAM3-grabbing non-integrin (DC-SIGN)] are associated with this pathogenesis and influence the expression of IL-10 and IL-17 in this population
This study was carried out in accordance with the recommendations of the Declaration of Helsinki
All donors or their legal guardians from whom information and biologic samples were obtained or clinical procedures were performed gave written informed consent for their participation in the study
The study was approved by the Ethics and Research Committee from the University Hospital of the Federal University of Sergipe
patients treated at the Hepatology Service of the University Hospital (UH) at the Federal University of Sergipe were recruited
These patients were from other endemic areas of the state or even from neighboring states
and presented severe hepatosplenic schistosomiasis
but did not have any other associated diseases
it was possible to analyze the immune response associated to more advanced stages of the disease
The inclusion criteria for the study were as follows: positive parasitological diagnosis based on the Kato-Katz method for S
classified using abdominal ultrasonography with different degrees of fibrosis compatible with S
Exclusion criteria were age <5 and >70 years old
pregnant or people with diseases which affect the immune response (HIV
people with other liver diseases associated with portal hypertension (such as hepatitis A
or C; cirrhosis; Budd–Chiari; portal vein thrombosis) and acute viral or bacterial infections in the moment of blood collection
and patients who have not completed the immunological evaluation
the selected patients were divided into two groups: no fibrosis (n = 53)
all of them from the endemic area of Ilha das Flores
all of them from the Hepatology Service of the University Hospital (UH)
The small sample size in the advanced fibrosis group is due to the rigidus selection criteria
which include only patients with confirmed hepatic fibrosis and portal hypertension
also confirmed by esophageal varices in the endoscopy
and exclude patients with comorbidities and coinfections that are very frequent in these group of patients
The small sample might reduce the power and interfere in the negative results
a genetic polymorphism study was performed in both groups
due to problems of DNA recovery from the blood samples and low quantification of DNA
only a total of 37 of these individuals were enrolled in the SNP analysis: 28 patients from the no fibrosis group and 9 patients from the fibrosis group
3 × 106 cells in 1 ml of RPMI 1640 (Gibco™
Brazil) supplemented with 10% AB Rh-positive serum were either not stimulated or stimulated with specific S
The antigen concentration of 10 μg/ml for both SEA and SWAP was chosen because it was able to induce a response in PBMC from patients with schistosomiasis
but not from healthy controls from the same endemic area
The mitogen phytohemagglutinin (PHA) at 1 μg/ml and the purified protein derivative of turberculin (PPD) at 10 μg/ml were used as positive controls
After a 72-h incubation at 37°C in 5% CO2
the plates were centrifuged and the supernatants collected
and stored at −80°C for later cytokine dosage
It was not possible to measure all cytokines in all patients because we run out of some of the PBMC supernatants
The demographic and clinical data of patients recruited from the endemic area and from the UH, classified according to their clinical forms, are shown in Table 1
and ultrasound data of individuals from the endemic area and hepatosplenic ones from the University Hospital (UH) classified according to their clinical forms
It is observed that hepatosplenic patients (HE) from the UH are significantly older than the ones with intestinal (I) and hepatointestinal (HI) forms from the endemic area
All patients from the Hepatology Service of UH (n = 16) had advanced fibrosis on ultrasound
associated with portal hypertension (Niamey 7)
mainly verified by the measurements of the spleen size
and the periportal space and showed portal hypertension signs
confirmed by detection of esophageal varices in upper digestive endoscopy
Patients from the endemic area (n = 53) did not have advanced fibrosis
All patients presented a response to PPD and PHA stimulations
Figure 1 Peripheral blood mononuclear cell (PBMC)-specific cytokines response to Schistosoma mansoni antigens in patients with different degrees of fibrosis
Comparisons between the levels of IL-9 (A)
K) in supernatants from PBMC cultures stimulated with adult worm (SWAP) and egg (SEA) antigens in individuals with different degrees of fibrosis by the Niamey criteria (no fibrosis and advanced fibrosis)
IL-9 was only analyzed in SEA-stimulated supernatants because of the limitation of the number of samples in the kit available
The data represent individual values and the averages are shown
Comparisons were analyzed using the Mann–Whitney U test
Figure 2 Correlations between the response of peripheral blood mononuclear cell (PBMC)-specific cytokines to S
mansoni antigens and the ultrasound data associated with fibrosis and portal hypertension
Correlations between the levels of IL-9 (A–C)
I) in the supernatants from PBMC cultures stimulated with soluble egg antigen (SEA) and the periportal thickening
and the spleen size measured on ultrasound
Correlations were analyzed using Spearman’s correlation test
There were no other differences between the genotype of other SNPs assessed and the cytokine measurement found in the PBMC supernatants in this population when all patients included in the genetic analysis were evaluated together
The present study detects a predominance of IL-17 (Th17) and IL-9 (Th9) production in hepatosplenic patients with advanced fibrosis in PBMC cultures stimulated with S
there is a direct correlation between these cytokine levels and data related to the severity of fibrosis
which suggests an important association of the Th17 and Th9 response with the severe form of human schistosomiasis
the study demonstrates a predominance of IL-10 production in hepatosplenic patients with advanced fibrosis in cultures stimulated with SEA and a correlation between this response and the average measurements of periportal space
indicating a possible Th2/Treg response remaining from the initial periportal fibrosis or an attempt to downmodulate the fibrosis
but they have failed to identify the immune response profile associated with advanced fibrosis
because the studied patients did not present advanced fibrosis
this is the first study that demonstrates the association of these cytokines with advanced fibrosis in human schistosomiasis
The only study carried out in humans by Barreto et al. (39)
evaluating the association of IL-17 and IL-9 in sera from patients with several clinical forms of schistosomiasis
did not show significant differences in the levels of these cytokines in patients with different degrees of fibrosis
the cytokines were measured in serum samples of these patients
and they did not evaluate the specific immune response to S
it is noteworthy that the study only included two patients with advanced fibrosis
Considering previous reports of functional SNPs in these cytokine genes
Although no statistical differences were in the allelic and genotype frequencies comparisons
differences in the genotype frequency distributions of IL-10 (rs1800871 and rs1800872) and CD209 (rs2287886 and rs4804803) SNPs were observed between schistosomiasis patients with fibrosis and without fibrosis
we found an association between the presence of genotype AG for the CD209 rs2287886 with higher levels of IL-17 in non-stimulated PBMC supernatant when compared with the GG genotype in schistosomiasis patients
The lack of associations between the IL17A rs2275913
and CD209 rs4804803 alleles or genotype frequencies with the schistosomiasis clinical manifestations in this population could be due to small sample size
and further studies are necessary to rule out the influence of these SNPs in schistosomiasis pathogenesis
we could observe significant differences between cytokine dosages when advanced fibrosis and no fibrosis patients with the same genotype for the SNPs were compared
suggesting that this modulation may occur as a consequence of disease severity variations and not due to genetic background of the SNPs assessed
the severity of fibrosis observed by ultrasonography in human schistosomiasis is associated with a Th9 and Th17 response specific to S
The direct correlation between the levels of IL-9 and IL-17 cytokines and the spleen size
and thickening of the periportal space reinforces the association of these cytokines with the immunopathogenesis of human schistosomiasis
The observation that IL-10 is also increased in patients with advanced fibrosis and the correlation found between IL-10 levels only with thickening of the periportal space suggest the hypothesis of an attempt of fibrosis modulation by this cytokine
The raw data supporting the conclusions of this article will be made available by the authors
The studies involving human participants were reviewed and approved by the Ethics and Research Committee from the University Hospital of the Federal University of Sergipe
Written informed consent to participate in this study was provided by the legal guardian/next of kin of the participants
and FA recruited and clinically characterized the schistosomiasis patients from the endemic area of Ilha das Flores
and FL recruited and clinically characterized the patients from the University Hospital of Federal University of Sergipe
KF and DF performed the ultrasound exams and analyzed and interpreted the data related to the classification of hepatic fibrosis
and LM performed the immunological evaluation experiments
CS and RC performed the SNP genotyping experiments and analyzed and interpreted the data
AJ and RA conceived and designed the study
and VC supervised the research and interpreted the data
All the authors discussed the results and commented on the manuscript
All authors contributed to the article and approved the submitted version
This work was supported by Edital MS/CNPq/FAPITEC/SE/SES N° 06/2007 – PPSUS (Grant number 19.203-00775/2007-3)
and EDITAL CAPES/FAPITEC N° 11/2016 – PROEF (Grant number 88881.157436/2017-01)
AJ is a scientist supported by the Brazilian Research and Technology Council (CNPq)
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article
or claim that may be made by its manufacturer
is not guaranteed or endorsed by the publisher
The authors thank the population of Ilha das Flores and the patients from University Hospital
This study would not have been possible without the participation of the healthcare agents Jorge Feitosa and Edmilson Nicolaus dos Santos and the medical students Cybele Santos
and Karina Pessoa who helped the research team in the clinical
The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fimmu.2021.779534/full#supplementary-material
Supplementary Figure 1 | CD209 rs2287886 SNP is associated with differences IL-17 in schistosomiasis patients
Levels of IL-17 in 37 schistosomiasis patients stratified by CD209 rs2287886 genotype
Supplementary Figure 2 | Cytokine levels in no fibrosis and advanced fibrosis schistosomiasis patients by different genotypes to IL17A rs2275913
Comparisons between the levels of IL-17 and IL-10 cytokines in supernatants from PBMC cultures not stimulated (Medium) or stimulated with adult worm (SWAP) and egg (SEA) S
mansoni antigens from schistosomiasis patient stratified by groups of advanced fibrosis (n=9) and no fibrosis (n=28) and by genotypes to CD209 rs2287886 (A)
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Received: 19 September 2021; Accepted: 15 November 2021;Published: 14 December 2021
Copyright © 2021 Franco, de Amorim, Santos, Rollemberg, de Oliveira, França, Santos, Magalhães, Cazzaniga, de Lima, Benevides, Carregaro, Silva, Brito, Fernandes, da Silva, de Almeida, Bezerra-Santos and de Jesus. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
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Emerging economy countries in epidemiological transition have been especially challenged in the fight against cancer
This was an ecological study that aimed to describe the temporal trend of cancer mortality in a Brazilian northeastern state with a medium Human Development Index using official Brazilian mortality data from 1980 to 2018
We calculated the mortality crude rate (CR) and age-standardized rate (ASR) based on official population counts and estimates
was used to calculate time trends of cancer mortality
The overall cancer mortality ASR was 70.1 and 57.9 per 100,000 men and women
the leading causes of cancer deaths were prostate (21.3)
oral cavity (5.4) and liver and intrahepatic bile ducts (5.1) in males and breast (13.8)
colon/rectum (5.8) and central nervous system (3.6) in females
there was a significant reduction in deaths from ill-defined causes in the series
Our results show that although there has been an increase in cancer mortality rates associated with Western lifestyles
high rates of cancer related to poverty and infections
This study aimed to describe the temporal trends of cancer mortality in Sergipe in a comprehensive way to compare the results with regions with similar HDI and signal priorities for actions against cancer
We also intended to assess the quality of official mortality data in our state
This was an exploratory ecological study of time trends
Data from 1980 to 2018 were obtained from the Mortality Information System (SIM database)
for all ages and age groups by stage of life (0–19
45–64 and 65+) for both sexes and by the main sites of cancer
based on official population counts and estimates from the Brazilian Institute of Geography and Statistics (IBGE)
the cases were classified and sometimes grouped based on the International Classification of Diseases
as follows: oral cavity—C00 to C10; esophagus—C15; stomach—C16; colon and rectum—C18 to C21; liver and intrahepatic bile ducts—C22; larynx—C32; trachea
bronchus and lung—C33 and C34; melanoma skin cancer—C43; nonmelanoma skin cancer—C44; female breast—C50; cervix uteri—C53; corpus uteri—C54; ovary—C56; prostate—C61; bladder—C67; central nervous system—C70 to C72; thyroid gland—C73; Hodgkin’s lymphoma—C81; non-Hodgkin’s lymphoma—C82 to C85 and C96; leukemias—C91 to C95
The other sites were grouped as ‘other’ and added to cancers of unspecified topography
For the temporal analysis of ill-defined causes of death
The Joinpoint Regression Program, version 4.7.0.0, from the National Cancer Institute, USA21
was used to calculate time trends for age-standardized rates of cancer mortality using a model based on the assumption of a minimal number of join points where statistically significant changes in the curves occur
the annual percent change (APC) and the average annual percent change (AAPC)
which are the summary measures of the trends over the analyzed period
with their respective 95% confidence intervals (CI 95%) and p values
A significant change in a trend was defined as p < 0.05
The present project was submitted to the Research and Ethics Committee of Federal University of Sergipe (Universidade Federal de Sergipe—UFS)
and it was approved and registered under CAAE number 57995416.9.0000.5546
We declare that all methods were in agreement with the relevant guidelines and regulations
it was not possible to obtain informed consent
The Research and Ethics Committee of the Federal University of Sergipe exempted informed consent
in agreement with Resolution 466 of December 2012 of the Ministry of Health
with the respective mortality CRs and ASRs
Time trends of cancer mortality for age-standardized rates (ASR) for all ages and sites in both sexes (A)
for specific age groups in males (B) and in females (C) and for ill-defined causes of death (D)
Table 4 shows the joinpoint analysis of cancer mortality by the main sites for both sexes. The curves modeled by Joinpoint are shown in Fig. 2.
Time trends of cancer mortality for age-standardized rates (ASR) for the main sites in males (A) and females (B)
the 65+ age group showed the greatest increase in the mortality trend
the male age group 20–44 years old presented a slight increasing trend during the entire series (APC/AAPC of 1.31)
which likely reflects improved information on death certificates and decreased deaths from ill-defined causes
The curves for the other age groups remained stable for the past decade in both sexes
such as fecal occult blood tests or even colonoscopy
should be implemented for specific age groups to decrease mortality
We emphasize that some of our cases correspond to metastatic carcinomas of undetermined primary sites
This limited our analysis on the role of hepatitis B and C virus infections in the onset of primary liver cancer
the CNS was the fifth main site of cancer mortality among women and showed a stationary trend in the past decade
As we did not have access to histopathological data on patients
our analysis of primary CNS cancer mortality was limited
we highlight that it presents cancer mortality over a long time period
there has been a progressive improvement in quality data of death certificates and in SIM coverage in our state
which can be verified by the progressive decrease in the mortality rates from ill-defined/undetermined causes since the beginning of the series in Sergipe
We did not include race in the analysis because we think this information is not reliable in our population
There is a high degree of miscegenation in Brazil
the race classification is based on how the individual self-reports
We also did not have access to patients’ medical records
Further studies may go deeper into those topics
Our results show that although there has been a statistically significant increase in cancer mortality rates associated with Western lifestyles
breast and colon/rectum (especially in women)
This profile is similar to that observed in regions that have low and medium HDI and that are usually facing epidemiological transition
we expect cancer mortality to rise in our state
the government should implement or emphasize some measures and control strategies for the prevention of the most common types of cancer
which are evidence-based and well-established in developed countries
screening programs such as Papanicolau tests for cervical cancer and mammography and encouraging a healthier lifestyle
We hope that this brief review of the epidemiology of mortality for the main sites of cancer in a low/medium HDI region will contribute to global findings
We also emphasize the importance of having high quality national databases with wide coverage so that they reflect real-world situations in the best possible way
Cancer patterns and trends in Central and South America
The global decrease in cancer mortality: Trends and disparities
Cancer mortality predictions for 2017 in Latin America
Estimativa 2020: Incidência de câncer no Brasil
Rio de Janeiro: Instituto Nacional de Câncer José Alencar Gomes da Silva (2019)
Atlas On-line de Mortalidade. https://www.inca.gov.br/MortalidadeWeb/pages/Modelo03/consultar.xhtml#panelResultado
TabNet Win32 3.0: Mortalidade-Brasil. http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10uf.def
Spatial analysis and trends of mortality due to penile cancer in sergipe
Trends in prostate cancer incidence and mortality in a mid-sized Northeastern Brazilian city
Do cancer registries play a role in determining the incidence of non-melanoma skin cancers?
Assessing trends of breast cancer and carcinoma in situ to monitor screening policies in developing settings
Trend and spatial analysis of prostate cancer mortality in the state of Sergipe
Time trends in breast cancer incidence and mortality in a mid-sized northeastern Brazilian city
Análise das estimativas de incidência de câncer de boca no Brasil e em Sergipe (2000–2010) Estimates’ evaluation of mouth cancer incidence in Brazil and Sergipe (2000–2010)
Instituto Brasileiro de Geografia e Estatística - IBGE. Cidades/Sergipe/Panorama. Available at: https://cidades.ibge.gov.br/brasil/se/panorama
Instituto Brasileiro de Geografia e Estatística - IBGE. Cidades/Sergipe/Aracaju/Panorama. Available at: https://cidades.ibge.gov.br/brasil/se/aracaju/panorama
Instituto Brasileiro de Geografia e Estatística - IBGE. Projeção da população. Available at: https://www.ibge.gov.br/apps/populacao/projecao/
International Agency for Research on Cancer (1966)
Cancer Mortality for Selected Sites in 24 Countries (1950–1957)
Version 4.7.0.0 - February 2019; Statistical Methodology and Applications Branch
Sistema de Informações sobre Mortalidade: estudo de caso em municípios com precariedade dos dados
A global assessment of civil registration and vital statistics systems: monitoring data quality and progress
The international epidemiology of lung cancer: Latest trends
Exploring disparities in incidence and mortality rates of breast and gynecologic cancers according to the Human Development Index in the Pan-American region
Instituto Nacional do Câncer - INCA. Prevenção do câncer do colo do útero. Available at: https://www.inca.gov.br/controle-do-cancer-do-colo-do-utero/acoes-de-controle/prevencao
Global trends in colorectal cancer mortality: Projections to the year 2035
The role of Helicobacter pylori infection in the web of gastric cancer causation
Global patterns and trends in cancers of the lip
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Health Sciences Graduate Program/Federal University of Sergipe
Rosana Cipolotti & Carlos Anselmo Lima
Alex Rodrigues Moura & Carlos Anselmo Lima
College of Medicine/Federal University of Vale do São Francisco
Department of Medicine/Federal University of Sergipe
Érika de Abreu Costa Brito & Rosana Cipolotti
Fundação de Apoio à Pesquisa e à Inovação Tecnológica do Estado de Sergipe - FAPITEC/SE
and C.A.L.; analysis and interpretation of data: M.S.L
and C.A.L.; drafting of the article: M.S.L.
and E.A.C.B.; critical revision of the article: C.A.L.
H.L.F.B.; R.C.; final approval of the article: all authors approved the manuscript
This research was partially supported by the Research Development Grant from the Fundação de Apoio à Pesquisa e à Inovação Tecnológica do Estado de Sergipe—FAPITEC/SE (CALL MS/CNPq/FAPITEC/SE/SES-No 06/2018) to C.A.L
The other authors declare no competing interests
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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DOI: https://doi.org/10.1038/s41598-020-78381-4
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Antibiotic resistance genes (ARGs) are widespread in the environment due to the overuse of antibiotics and other pollutants
posing a threat to human and animal health
bacterial diversity and ARGs in two important watersheds
that supply drinking water to Rio de Janeiro city
tap water samples were collected from three different cities in Rio de Janeiro State
including the metropolitan area of Rio de Janeiro city
sulfamethoxazole and azithromycin were found in untreated water and drinking water in all samples
A greater abundance of Proteobacteria was observed in Guandu and São João watersheds
with most of the sequences belonging to the Gammaproteobacteria class
A plasmidome-focused metagenomics approach revealed 4881 (Guandu)
3705 (São João) and 3385 (drinking water) ARGs mainly associated with efflux systems
The genes encoding metallo-β-lactamase enzymes (blaAIM
and blaVIM) were detected in the two watersheds and in drinking water samples
we demonstrated the presence of the colistin resistance genes mcr-3 and mcr-4 (both watersheds) and mcr-9 (drinking water and Guandu) for the first time in Brazil
Our data emphasize the importance of introducing measures to reduce the disposal of antibiotics and other pollutants capable of promoting the occurrence and spread of the microbial resistome on aquatic environments and predicting possible negative impacts on human health
and abundance of antimicrobial residues and ARGs in two important watersheds for drinking water supply to South Central regions of Rio de Janeiro state
including the metropolitan region of Rio de Janeiro city
using high-performance liquid chromatography coupled to tandem mass spectrometry and a culture-independent approach
Our study may provide relevant information about the structure
and content of the plasmidome of these waters
which can pose serious threats to human health
Detection frequency and concentration levels of antimicrobials in grouped samples of São João watershed
Relative abundance of bacterial composition at the class level in grouped samples of São João watershed, Guandu watershed, and Drinking water.
(A) Comparison of the alpha diversity of the Operational taxonomic unit (OTUs) between the collection of untreated and treated water samples
Shannon coverage analysis; (B) Comparison of alpha diversity of bacterial OTUs among the analyzed water samples
Chao1 coverage analysis; (C) Principal coordinate analysis (PCoA) between bacterial communities present in the Guandu watershed (green)
revealing that bacterial community richness (Chao1)
and evenness (Shannon even) varied widely among the samples
A total of 3,490,453 paired-end reads were generated for São João watershed
2,719,506 for Guandu and 3,302,359 drinking water samples
6197 contigs from the São João watershed (mean sequence length 2.043 bp)
4866 from Guandu watershed (mean sequence length 4776 bp)
and 5185 contigs from drinking water (mean sequence length 3255 bp) were analyzed
containing genes attributed to resistance and adaptation to antimicrobials
according to analyzes at the MG-RAST database
While the Guandu watershed showed the greatest diversity of subsystems (n = 16)
São João exhibited the least diversity (n = 4) while samples of drinking water revealed 12 subsystems
(A) Relative abundance of sequences related to antimicrobial resistance subsystems and toxic compounds in grouped samples of São João watershed
and Drinking water; (B) Relative abundance of ARGs concerning antimicrobial classes
ARGs found in the samples encode many types of proteins and enzymes capable of conferring resistance to antimicrobials
The genes capable of conferring resistance to 4 or more classes of antimicrobials were grouped as Multidrug
while the less abundant antimicrobial classes (< 1%) were grouped as Others
Resistance genes to macrolides were prevalent in all three sampling sites (15.2% São João
The most abundant genes in both watersheds and drinking water samples were macB and tetA(58)
It is worth noting the presence of the genes blaAIM (Guandu and São João watersheds)
and São João watersheds) encoding metallo-β-lactamase enzymes
and mcr-9 (Drinking water and Guandu watershed) genes that can provide resistance to colistin and are currently considered a serious public health issue
We also show the presence of several genes encoding MBLs (metallo-β-lactamases)
and the mcr (mobile colistin resistance) genes
Current regulations do not establish the monitoring and control of ARBs
Our data emphasize the importance of introducing measures to reduce the disposal of antibiotics and other pollutants capable of promoting the enrichment and maintenance of the microbial resistome
our data indicate that mitigation strategies should be put in place to reduce the risk of AMR and to prolong the efficacy of the currently available antimicrobial agents for use in animals and humans
tetracycline hydrochloride (TC) and sulfamethoxazole (SMZ) were chemical reference substances from the Brazilian Pharmacopeial Convention (Santa Maria
and cefquinome sulphate salt (CFQN) were obtained from Dr
hydrochloride salts of chlortetracycline (CTC) and demeclocycline (DMC)
moxifloxacin (MXF) and ofloxacin (OFX) were supplied from US Pharmacopeial Convention (Rockville
Phenoxymethylpenicillin potassium salt (PENV)
dicloxacillin sodium salt hydrate (DCLOX) and nafcillin sodium salt (NAFC) were supplied from WHO Collaborating Centre for Chemical Reference Substances (Stockholm
4-epitetracycline (4-ETC) and 4-epichlortetracycline hydrochloride (4-ECTC) were acquired from Acros (Pittsburgh
Ampicillin-d5 (AMPID5) was purchased from Purity Grade Standards (San Francisco
Desacetylcephapirin (DESAC) was supplied from Bristol-Myers Squibb (New York
Methanol (MeOH) and acetonitrile (ACN) HPLC grade
hydrochloric acid (HCl) and formic acid (FOA) analytical grade were purchased from Merck (Darmstadt
acetone (ACE) and ascorbic acid (ASA) were purchased from Merck (Darmstadt
Ethylenediaminetetracetic acid disodium dihydrate (EDTA) was acquired from Calbiochem (Gibbstown
Ultrapure water was obtained from a Milli-Q purification system (Millipore
Solid-phase extraction (SPE) was performed with 60 mg Oasis® HLB cartridges from Waters Corp
Membrane filters of polyvinylidene fluoride (PVDF) with pore size 0.22 µm were purchased from Millipore (Billerica
The stock standard solutions were prepared to obtain a concentration of approximately 1000 μg mL−1
Stock solutions of β-lactams (BL) were prepared in water while those of fluoroquinolones (FQ) in a 0.03 mol L−1 NaOH
sulfonamides (SF) and tetracyclines (TC) solutions were prepared in MeOH
The amount weighed for each standard was calculated considering purity
water content and free acid/basic corrections
The solutions were transferred to microtubes and stored in a freezer at − 70 °C or below
DMC and AMPID5 were used as internal standards
Intermediate and working standard solutions were freshly prepared at several concentrations by appropriate dilution of stock standard solutions
Samples were previously filtered through filter paper and 0.22 µm PVDF membrane filter
A 50 mL aliquot of each sample was spiked with 100 ng L−1 of the internal standards
and 2 mL of 25 mg L−1 EDTA stock solution was added
2 mL of 625 mg L−1 ASA was added to reduce any residual chlorine
This solution was applied to an Oasis® HLB cartridge that had been previously conditioned in sequence with 3 mL of MeOH
3 mL of ultrapure water and 3 mL of ultrapure water acidified to pH 2.5 with HCl
After being washed twice with 2 mL of water
SPE cartridges were vacuum-dried (− 35 kPa) for 2 min
Antimicrobials were eluted with three portions of 2 mL MeOH and one portion of 2 mL ACE
4 mL aliquots of the eluate were transferred to two centrifuge tubes and evaporated to dryness with N2 in a temperature up to 47 °C
The residues were reconstituted with 1 mL of 0.1% FOA:MeOH (80:20
v/v) for TC and SF analysis and 1 mL of MeOH:H2O (65:35
vortexed for 30 s and filtered through a 0.22 µm polyvinylidene fluoride (PVDF) syringe filter into amber auto-sampler vials
The chromatographic analysis was performed on a Shimadzu Prominence HPLC (Kyoto
Japan) equipped with a quaternary pump (LC-20AD)
a column oven (CTO-20AC) and a system controller (CBM-20A) interfaced to a triple quadrupole mass spectrometer (API5000
Analyst® V1.4.2 LC/MS control software was used
The analytical column was a Pursuit™ C18 RS (100 mm × 2 mm i.d.
A gradient elution program for TC and SF method was used with a flow rate of 0.15 mL min−1 at 25 °C and for BL
MC and FQ another gradient elution was used with a flow rate of 0.30 mL min−1 at 35 °C
The injection volume was 25 µL for both methods
Positive electrospray ionization technique (ESI +) in Multiple Reaction Monitoring (MRM) acquisition mode was used to monitor two ions for each substance
A six-point calibration set was freshly prepared by spiking varying levels of working standard solutions in ultrapure water
The analytical curves for all analytes in the concentration range from 25 to 1000 ng L−1 were constructed in order to quantify the analytes in samples
Samples were considered contaminated when analytes were detected according to identification criteria by liquid chromatography tandem mass spectrometry and the concentration values exceeded the limits of detection (LOD)
PCR products were purified using the ChargeSwitch™ PCR Clean-Up Kit (ThermoFisher Scientific
Each individual sample library was diluted to 4 nM and then pooled and paired-end sequenced on a MiSeq system (Illumina Inc
The diversity of the bacterial communities was assessed using the Chao1 index and Simpson's index calculated for OTUs with the evolutionary distance of 0.01 (or 99% 16S rRNA gene sequence similarity)
Principal coordinate analysis (PCoA) between bacterial communities present in the Guandu
São João watersheds and in drinking water was built using the Jaccard method with PERMANOVA and using the bacterial OTUs
The pDNA was quantified using a Qubit 2.0 Fluorometer (ThermoFisher ScientificTM
USA) according to the manufacturer's manual
This article does not contain any studies with human or animals performed by any of the authors
All data employed in this report are available in GenBank under BioProject PRJNA812588 (https://www.ncbi.nlm.nih.gov/bioproject/PRJNA812588)
metagenome sequence data are available on MG-RAST under accession numbers mgm4919709.3
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This work was funded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Instituto Nacional de Controle de Qualidade Em Saúde INCQS/FIOCRUZ
Rosana Gomes Ferreira & Maysa Mandetta Clementino
Rodolpho Mattos Albano & Alexander Machado Cardoso
performed experimental works and data analysis
performed experimental works and data analysis; A.S.G.B
performed experimental works and data analysis; A.P.A.N
and the writing of the paper (review and editing); M.M
performed experimental works and data analysis; K.M
contributed to the data analysis and the writing of the paper; C.F
performed experimental works and data analysis; S.O
performed experimental works and data analysis; M.A.M
contributed to the experimental work; B.F.S
and the writing of the paper (review and editing); R.M.A.
and the writing of the paper (review and editing); A.M.C
contributed to the data analysis and the writing of the paper (review and editing); M.M.C
and contributed to the writing of the paper (review and editing)
All authors read and approved the manuscript
The authors declare no competing interests
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DOI: https://doi.org/10.1038/s41598-022-21040-7
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The official Government and Legal notices for today [Jan 29] include notice of intended marriage
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The official notices above have been republished from the relevant section on the official Government website
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A girls-only competition seeks to create a more welcoming environment for female talent in the subject
Márcio Alves / O Globo Agency Luize D’Urso
mentors the girls’ Olympiad team and has created a project at PUC-Rio to train girls from public schools on SaturdaysMárcio Alves / O Globo Agency
Often even teachers cannot treat boys and girls equally, says mathematician Luize D’Urso
INPA OBMEP Medal Award Ceremony in July: Girls took home only 22% of the gold medalsINPA
The unprecedented gold medal at EGMO in Kiev was an achievement by Rio Grande do Sul’s Mariana Bigolin Groff
she left the small town of Frederico Westphalen
to live in three capitals in as many years—Porto Alegre
and Fortaleza—to attend schools that offered her scholarships
which provides housing and food for her and other scholarship beneficiaries
Groff feels fine about living far from her family
when she left Porto Alegre to live in São Paulo
she missed them so much that she returned to Frederico Westphalen
but it requires maturity,” says Groff
she won bronze and silver medals in 2017 and 2018
Her gold medal in Kiev marked the end of her Olympiad participation in high school
Groff shares that she felt intimidated when participating in mixed Olympiad training
“I was the only girl in a 35-student preparatory class for OBM
Sometimes the boys would meet in a hotel room to play and I didn’t want to go
I didn’t feel welcome and I wondered if I really should be there.” Joining the all-female group that competed at EGMO made her feel more comfortable
“We saw that we were not alone and became more confident that we belonged there too,” she explains
she intends to go to university in the United States
undergraduate students first take a common core of generic subjects
You don’t have to go already knowing what you are going to study,” she says
Ceará native Ana Beatriz de Castro Studart
brought home a bronze medal from the Kiev EGMO
While attending the 6th grade at Colégio Militar de Fortaleza
she represented Brazil at the Rioplatense Mathematical Olympiad
which brings together students from various Latin American countries in Argentina
she was offered a scholarship at Colégio Farias Brito
is known for investing in the preparation for exact science olympiads
Some of Studart’s friends would tell her that it was better to not try at all than to make mistakes
When the opportunity arose to compete at EGMO
“I wasn’t sure if I wanted to participate in a gender-divided Olympiad because at the time I still didn’t understand how important that is.” She plans to study abroad: “I have a specific interest in mathematics applied to biological research
so I’d like to get deeper into that.”
while the effort to include more women in international competitions does seek to diversify the area of mathematics and encourage talents that could help the country’s development
“We do not want to prioritize mathematics over human or biological sciences
and other such sciences are essential for the country’s growth and for the education of our citizens,” says Viana
“But we cannot accept that an archaic
sexist culture continue to segregate women from the exact sciences and mathematics
It is very difficult to erase the sociocultural factors that foster this phenomenon
but it is our obligation to fight against this disparity,” he adds
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