Lung cancer in Brazil.

Lung cancer is the second leading cause of death in Brazil, after exclusion of external causes. Registries in the country are not reliable because of under-registration and limited coverage. Incidence rates for Brazil are less then half those for selected areas with good registries. Crude and adjusted incidence and mortality rates for lung cancer are rising, particularly among women. The main reason is the acceleration in tobacco consumption and the spread of smoking among women. At present, approximately 40% of men and 25% of women, 15 years of age or older, are current smokers. In the state of Rio Grande do Sul, where registries are reliable, incidence and mortality for males are similar to US data and the figures for women are rapidly approaching those for men. Occupations associated with risks of exposure to respiratory carcinogens show a rise in the incidence of lung cancer in the industrialized area of São Paulo. The main occupational risk in Brazil is exposure to mineral dusts, silica, or asbestos. Although about 15 million Brazilians are exposed to pesticides, agricultural workers were not a risk group for lung cancer in a case-control study. Pesticides containing arsenic and dichlorodiphenyltrichloroethane (DDT) are banned. In recent years, a trend towards a decrease in male smoking has been noted, but there is still a high tobacco exposure burden in both males and females, with a forecast of a further increase in rates of lung cancer incidence and deaths. Control of respiratory carcinogens at work continues to be a problem, particularly in the present scenario of economic and political pressures on Brazil and other developing nations. Semin Oncol 28:143-152.

Diastolic pressure as an index of salt sensitivity.

This paper analyses the association between blood pressure and sodium excretion in 3975 individuals aged 20-74 years, selected in a probability sample survey of private households carried out in Rio Grande do Sul, Brazil. Sodium and creatinine titrations were performed in casual urine samples collected at the time of BP measurements. A subsample of 611 subjects provided 24 h urine collections. The regression slopes of systolic pressure on sodium excretion increased when diastolic level was higher. At the lowest levels of diastolic pressure the slope did not differ significantly from zero. The adjusted correlation coefficient then rose progressively to a maximum of +0.41 at diastolic pressures of 95-99 mmHg. Strikingly, at diastolic pressures of > or = 100 mmHg, there was no longer any significant association between systolic pressure and sodium excretion. These results could explain some earlier contradictory findings concerning the role of salt intake in hypertension and provide estimates of expected reduction on the prevalence of hypertension in each diastolic pressure group following a reduction on salt intake of a population.

Mortalidade por câncer de colo uterino no Rio Grande do Sul / Mortality from uterine cervix neoplasm in Rio Grande do Sul

O objetivo deste estudo refere-se a mortalidade por câncer do colo uterino (Cid 180), através da verificaçäo dos coeficientes de mortalidade no Rio Grande os Sul e nas 24 microrregiöes que compöem o referido Estado, com estudo das tendências (regressäo linear simples), período de 1970 a 1989. Como objetivos secundários foram abordados a feqüência relativa desta neoplasia em relaçäo ao total de óbitos por neoplasias malignas, estudo comparativo com outras localidades e correlaçäo com fatores de risco. Os dados que permitiram este estudo foram obtidos na Secretaria de Saúde e Meio Ambiente do Rio Grande do Sul, Instituto Brasileiro de Geografia e Estatística IBGE), Ministério de Saúde e Organizaçäo Mundial de Saúde. A média dos coeficientes de mortalidade/100.000 mulheres no Rio Grande do Sul (1970-1989) foi de 3,8, com tendência ascendente. Observaram-se diferenças importantes na distribuiçäo dos coeficientes de mortalidade nas 24 microrregiöes do Estado, com médias oscilando entre 2,5 e 6,7. O câncer de colo uterino ocupou o 4§ lugar na mortalidade por neoplasias entre as mulheres do Rio Grande do Sul, em 1989. Vírus de papiloma humano e tabagismo säo importantes fatores de risco nesta neoplasia

[Mortality from uterine cervix cancer in Rio Grande do Sul]. / Mortalidade por câncer de colo uterino no Rio Grande do Sul.

The mortality from cervical cancer was studied by checking the death rates in Rio Grande do Sul (RS) and in its 24 microregions. Each tendency (linear regression), in the period from 1970 to 1989, was also investigated. We have also studied the relative rates of this kind of cancer, the comparison with the rate in other places and the risk factors. The data were obtained at the Office of Health in Rio Grande do Sul as well as in the Statistics and Geography Brazilian Institute and World Health Organization. The average mortality rates/100,000 women in RS (1970-1989) was 3.8, with ascending tendency. Important differences in the death rates in the 24 microregions in RS were observed and they ranged from 2.5 to 6.7. The cervical cancer was the fourth cause of death in women from RS (mortality by cancer), in 1989. Papillomaviruses and smoking were important factors in the development of cervical cancer.

[Risk factors for non-communicable diseases in a metropolitan area in the south of Brazil. Prevalence and simultaneity]. / Fatores de risco para doenças não-transmissíveis em área metropolitana na região sul do Brasil. Prevalência e simultaneidade.

Three-quarters of deaths in Rio Grande do Sul State, Brazil, are due to non-communicable diseases-cardiovascular diseases, alone, being responsible for 35% of them. To evaluate the prevalence of risk factors for these diseases, a household survey of 1,157 randomly sampled individuals between 15 and 64 years of age was undertaken in 1986 and 1987 in census tracts of 4 areas of the city of Porto Alegre. The age- and sex-adjusted prevalence of smoking was 40%, hypertension 14%, obesity 18%, overall sedentary life-style 47%, and excessive alcohol consumption 7%. Thirty-nine percent of the sample presented two or more of these five risk factors, and only 22% of men and 21% of women had none of them. The high frequencies and simultaneous presence of these risk factors indicate their importance for programs aimed at the prevention of non-communicable diseases and the promotion of adult health.

Socioeconomic distribution of noncommunicable disease risk factors in urban Brazil: the case of Pôrto Alegre.

The study reported here sought to assess the degree to which the prevalences of five risk factors for noncommunicable diseases--hypertension, smoking, obesity, sedentary lifestyle, and excessive alcohol consumption--varied individually and in combination for urban Brazilians with differing socioeconomic status in terms of educational achievement, income, and social class. For this purpose, 1986-1987 data from a cross-sectional household survey of 1,157 randomly selected adults 15-64 years of age residing in the major Brazilian city of Pôrto Alegre were analyzed. In general, it was found that less privileged socioeconomic situations tended to be associated with higher risk factor prevalences. However, this was not the case for obesity and sedentary lifestyle among men, and may not have been the case with respect to hypertension among women. When the effects of education, income, and social class were considered simultaneously, higher risk factor prevalences were most strongly associated with low educational attainment. Important exceptions to this rule were found for smoking among women and excessive alcohol consumption among men, where higher risk factor prevalences were most associated with social class. Once the effects of education and social class were accounted for, low income generally tended to be associated with lower prevalences of the risk factors studied.

Genetic and nongenetic determinants of blood pressure in a southern Brazilian sample.

A probabilistic sample representative of the adult population of Rio Grande do Sul, Brazil, was studied to estimate the genetic and nongenetic determinants of blood pressure. Four thousand five hundred and sixty-five individuals, 20 to 74 years old, from 2050 households, were examined. The genetic determination of the SBP (systolic blood pressure) and DBP (diastolic blood pressure) was evaluated in 557 families extracted from this sample. The analysis was performed first with no adjustments for other influencing factors, and then adjusting for the effects of the two significant covariates, age and Quetelet's index, identified through a multiple stepwise regression analysis with nine independent variables. Higher heritability estimates were obtained for DBP (raw data: 0.40; residuals: 0.45) than for SBP (raw data: 0.22; residuals: 0.26). The significant correlation coefficients varied from 0.13 (for father-offspring raw data, total sample), to 0.36 (for siblings, adjusted data, untreated sample). Slight differences were observed between the total and pharmacologically untreated samples in relation to correlation and heritability estimates.

Salt and blood pressure in Rio Grande do Sul, Brazil.

A 1978 survey of 4,565 people in Rio Grande do Sul obtained interview and blood pressure data as well as casual urine specimens for subsequent sodium and creatinine titrations. Data derived from this survey have demonstrated a variety of complex relationships between blood pressure and sodium, a number of which are examined here. The main conclusion is that observed blood pressure differentials could reflect the kidney's ability to handle sodium, an ability subject to the influences of age, heredity, and the environment. As a consequence, it is suggested that the adoption of salt restriction by populations could bring them large health benefits.

Blood groups, salivary secretion and other immunologic variables in rheumatic fever and rheumatic heart disease.

A total of 100 patients and carefully matched controls were studied in relation to six genetic systems (ABO, MN, Rh, haptoglobin, ABH secretion and amylase types), as well as for serum and saliva antibody and ABH antigen levels. The differences observed between patients and controls were generally small and statistically non-significant, the previously reported association between haptoglobin types and reactions to streptococcus infections being not confirmed here. The A/O, B/O and secretor/non-secretor relative incidences, however, occurred in the expected direction considering previous investigations.

Hipertensao arterial sistemica essencial. Aspects da deteccao e manejo. / Systemic essential arterial hypertension. Aspects of the detection and management

Os autores fazem breves comentarios sobre alguns aspectos praticos de deteccao e do manejo da hipertensao arterial sistemica essencial