Spatial-temporal pattern of colorectal cancer mortality in a Northeastern Brazilian State.

Colorectal cancer (CRC) is one of the most common cancer types worldwide. Its increasing mortality trends, especially in emerging countries, are a concern. The aim of this study was to analyse mortality trends and spatial patterns of CRC in the state of Sergipe, Brazil, from 1990 to 2019. Trends were calculated using data from the Online Mortality Atlas and Joinpoint Regression Program 4.8.0.1. Spatial analyses were performed using the empirical Bayesian model and Moran indices calculated by TerraView 4.2.2 between 1990 to 1999, 2000 to 2009 and 2010 to 2019. A total of 1585 deaths were recorded during the study period, with 58.42% among females. Trends were increasing and constant for both sexes and all age groups studied. The highest mean annual percent change was 6.2 {95% Confidence interval (CI) 3.4;9.0} for males aged +65 years and 4.5 (95% CI 3.2;5.8) for females aged 50-64 years. There was positive spatial autocorrelation for both sexes in all periods studied when using the Moran index for Bayesian rates. In summary, a consistent trend of increasing colorectal cancer (CRC) mortality has been observed overall. Nevertheless, an altered spatial distribution among males has emerged over the studied period.

Risk factors for recurrent urinary tract infections in a cohort of patients with primary vesicoureteral reflux.

BACKGROUND: Knowledge of risk of urinary tract infection (UTI) recurrence in vesicoureteral reflux (VUR) can help clinicians make therapeutic decisions. The aim of this retrospective cohort study was to identify risk factors associated with recurrent urinary tract infection in children with VUR. In addition, a risk score that might predict the chance of UTI recurrence was also proposed. METHODS: Between 1970 and 2007, 740 patients were diagnosed with VUR and were systematically followed up at a single tertiary Renal Unit. Recurrent UTI was defined as more than 1 episode during follow-up. A binary logistic regression model was applied to identify variables independently associated with recurrent UTIs. RESULTS: During follow-up, information was obtained on 58,856 person-months. Recurrent UTIs occurred in 120 (16.2%) patients. The overall incidence rate of UTI was 8.4 episodes per 1000 person-months (95% CI, 7.7, 9.2). After adjustment by multivariable analysis, 5 variables were independent predictors of recurrent UTI: UTI as clinical presentation, age < 6 months, female gender, dysfunctional elimination syndrome, and severe grade of reflux. The risk for recurrent UTI was classified as low in 24% of children, medium in 42%, and high in 34%. UTI incidence rates per 1000 person-months were 4.3 (95% CI, 3.2, 5.6), 7.9 (95% CI, 6.7, 9.1), and 11.3 (95% CI, 9.9, 12.8) for low-, medium-, and high-risk groups, respectively. CONCLUSION: The prediction model of recurrent UTI allows an early recognition of patients at risk for long-term morbidity and might contribute to the formulation of therapeutic strategies.