Introdução: O envelhecimento populacional é um fenômeno que ocorre mundialmente, caracterizado por aumento do número de idosos nas últimas décadas. Quando os indivíduos de um país passam a ter maior expectativa de vida, surgem novos problemas relacionados com o envelhecimento da população, entre os quais destaca-se o número de pessoas com demência. Informações sobre epidemiologia da demência são fundamentais para o planejamento de ações em saúde. Objetivo: Estimar a taxa de incidência de demência em idosos residentes em Ribeirão Preto-SP. Casuística e métodos: Trata-se de estudo de coorte prospectivo em que foram abordados 1076 sujeitos considerados cognitivamente normais no estudo de prevalência de demência. Um total de 469 idosos foram submetidos aos testes de triagem (1a fase). Todos os sujeitos screening positivo possíveis e alguns screening negativo foram reavaliados na 2a fase diagnóstica. O seguimento médio foi de 9,85 anos. Resultados: Foram identificados 45 casos incidentes de demência. As demências mais encontradas foram doença de Alzheimer (51,11%), vascular (20,0%) e mista (17,18%). As taxas de incidência de demência por 1000 pessoas-ano foram 15,0 (IC 95%=11,13-19,77) para demência em geral, 16,48 (IC 95%=10,44-24,70) para demência devido a doença de Alzheimer e 5,74 (IC 95%=2,47-11,28) para demência vascular e mista. A baixa escolaridade foi associada com maiores taxas de incidência. Pelo modelo de regressão de Cox, o risco de demência é maior com o envelhecimento (>= 80 anos: HR 4,25-6,99) e maior entre as mulheres (HR 1,9, IC 95% 1,01-3,57). Não foi encontrado associação de hipertensão arterial, diabetes mellitus e dislipidemia com o desenvolvimento de demência. Conclusão: A taxa de incidência de demência da população estudada foi semelhante ao estudo brasileiro prévio. Em ambos os gêneros houve aumento da taxa de incidência com a idade. O gênero feminino é fator de risco e alta escolaridade é fator de proteção para o desenvolvimento de demência. A demência por Doença de Alzheimer foi a mais encontrada entre os idosos, seguida pela demência mista e vascular. / Background: Population aging is a phenomenon that occurs worldwide, which is characterized by increasing the number of elderly in recent decades. When individuals in a country have longer life expectancy, it emerges new problems related to the population aging, including the number of people with dementia. Informations about dementia epidemiology are essential for planning health actions. Objective: To estimate the incidence rate of dementia in elderly living in Ribeirão Preto-SP. Methods: This is a prospective cohort study in which 1076 subjects cognitively normal in the dementia prevalence study were addressed. A total of 469 elderly were submitted to screening tests (first phase). All possible positive screening subjects and some negative screening were reassessed in the 2nd diagnostic phase. The mean follow-up was 9.85 years. Results: Forty five incident cases of dementia were identified. The most frequent types of dementia were Alzheimer disease (51.11%), vascular (20.0%) and mixed (17.18%). The incidence rates of dementia per 1000 person-years were 15.0 (95% CI = 11,13 to 19,77) for overall dementia, 16.48 (95% CI = 10.44 to 24.70) for Alzheimer disease dementia and 5.74 (95% CI = 2.47 to 11.28) for vascular and mixed dementia. The low level of education was associated with higher incidence rates. As the Cox regression model, the risk of dementia is higher with age (>= 80 anos = HR 4,25-6,99) and higher among women (HR 1.9, 95% CI 1.01 -3.57). It was not found association of hypertension, diabetes mellitus and dyslipidemia with the development of dementia. Conclusion: The incidence rate of dementia was similar to previous brazilian study. In both genders there was an increase incidence rate with age. The female sex is a risk factor and high education is a protective factor against the development of dementia. Alzheimer disease was the most frequent type of dementia among the elderly, followed by mixed dementia and vascular.

Orientadores: Marcio de Moraes, Luciana Asprino / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-09-11T21:11:20Z (GMT). No. of bitstreams: 1 Stang_Bento_M.pdf: 1339091 bytes, checksum: e0465aaac7a4efde689e4fdfd75635e9 (MD5) Previous issue date: 2007 / Resumo: O objetivo deste estudo foi avaliar retrospectivamente os casos de cisto ósseo traumático (COT) tratados pela Área de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba da Universidade Estadual de Campinas, no período de janeiro de 1999 a dezembro de 2006, sendo avaliados 8.383 prontuários, dos quais 11 pacientes apresentaram COT. Não houve prevalência por gênero e os pacientes da cor branca foram envolvidos com maior freqüência (64%). Todos os casos acometeram indivíduos na segunda década de vida, com idade média de 15,2 anos. A mandíbula esteve envolvida em 100% dos casos, acometendo com maior freqüência a região de sínfise mandibular (55%), seguida pela região de corpo (36%) e ramo mandibular (9%). Cinco pacientes relataram história de trauma, ocorrido entre dois a nove anos anteriores ao diagnóstico da lesão. Todos os pacientes foram submetidos à biópsia incisional, associada à exploração cirúrgica da cavidade cística, que já representou a forma de tratamento. O tempo médio de proservação foi de 35,7 meses, o menor e o maior período de acompanhamento foram de 7 e 85 meses respectivamente, período no qual não foi observada recidiva. O tratamento através da cirurgia exploratória, realizado no momento da biópsia, foi efetivo em todos os casos deste estudo. Os resultados deste estudo contribuíram com a caracterização do COT e nos permitiram concluir que: Podemos sugerir que a etiologia do COT deve ter como suspeita o trauma, não havendo relação causal com gênero ou raça; O COT é uma lesão rara, que acomete preferencialmente a mandíbula de pacientes na segunda década de vida; A descoberta do COT ocorre em exames de rotina, sem que a lesão seja a queixa do paciente; O tratamento do COT através da exploração cirúrgica mostrou-se efetivo e seguro / Abstract: The aim of this study was retrospectively evaluate the cases of traumatic bone cyst (TBC) treated by the Oral and Maxillofacial Surgery Area of Piracicaba Dental School - Campinas State University, between January of 1999 to December of 2006, being evaluated 8,383 clinical handbooks, of which 11 patients had presented TBC. There was no prevalence of the gender and Caucasian patients were involved with more frequency (64%). All the cases occurred in patients that were in the second decade of life with a mean age of 15.2 years. Mandible was involved in 100% of the cases, with a prevalence on the symphisis (55%), followed by mandibular body (36%) and mandibular ramus (9%). Five patients reported trauma history, occurred between two to nine previous to the diagnosis of the lesion. All the patients were submitted to an incisional biopsy associate to the surgical exploration of the cystic socket. All patients were submitted to an incisional biopsy that represented the definitive treatment. The average time of preservation was of 35,7 months, the minor and the biggest period of accompaniment had been of 7 and 85 months respectively, period in which was not observed recurrence. The treatment through exploratory surgery, carried through at the moment of the biopsy, was effective in all the cases of this study. The results of this study had contributed with the characterization of the TBC and they had allowed us to conclude that: The etiology of the TBC must have trauma as suspected, with no causal relationship gender or race; The TBC is a rare injury, that have preferential incidence the inferior jaw of patients in the second decade of life; The discovery of TBC occurs in routine examinations, the injury is not the complaint of the patient; The treatment of the COT through the surgical exploration revealed effective and safe / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

Introdução - Estudos sobre o câncer de cólon mostram que a sua incidência, no mundo, tem aumentado de maneira significativa no último século. Acredita-se que este resultado esteja relacionado, entre outros aspectos, com a industrialização, a urbanização ocorridas neste período e mudanças no estilo de vida. A morbimortalidade associada ao câncer de cólon observada em países desenvolvidos é maior do que em países em desenvolvimento e o que se tem observado é que, embora a tendência da incidência seja crescente para ambos os sexos, a mortalidade permanece estável. Objetivo - Analisar as tendências da incidência e da mortalidade de pacientes com câncer de cólon, registrados no Registro de Câncer de Base Populacional (RCBP) do Município de São Paulo. Métodos - Foram analisadas as tendências temporais da incidência no período de 1997 a 2005 e da mortalidade no período de 1980 a 2007. As análises foram feitas separadamente por sexo e faixa etária e os efeitos da idade, do período e da coorte foram estimados através do modelo de regressão de Poisson. Resultados - Houve aumento na incidência por câncer de cólon no município de São Paulo, em quase todas as faixas etárias estudadas. O aumento da mortalidade foi menor do que o aumento da incidência e parece coincidir com um efeito de coorte presente durante todo o período do estudo. Tanto na incidência quanto na mortalidade, os aumentos foram mais pronunciados entre os homens. O modelo idade-período apresentou o melhor ajuste para os coeficientes de incidência para ambos os sexos, e o modelo completo (idade-período-coorte) se mostrou com melhor ajuste para os coeficientes de mortalidade para ambos os sexos. Não foi identificada interação estatisticamente significativa do sexo para os coeficientes de incidência e de mortalidade. Conclusão: Os resultados encontrados no presente estudo mostraram um aumento da incidência e da mortalidade, em ambos os sexos, em quase todas as faixas etárias. Observamos uma tendência da estabilização nas coortes de nascimento do câncer de cólon para ambos os sexos, sugerindo que as mudanças de estilo de vida podem contribuir para a redução da mortalidade por câncer de cólon, principalmente nas coortes mais jovens. / Introduction Studies on colon cancer show that its incidence worldwide has been increasing in the last century. There is evidence suggesting that this can be partially related to the industrialisation and urbanisation which occurred in the period and life style changes. Morbi-mortality associated with colon cancer observed in industrialised countries is greater than in developing countries. Colon cancer incidence presents an increasing trend for both sexes, probably due to a wider access to available diagnostic methods, while mortality rates remain stable. Objective: To assess incidence and mortality trends in patients with colon cancer, registered in São Paulo Cancer Registry. Methods: Temporal trends between 1997 and 2005 for incidence and between 1980 and 2007 for mortality were assessed. Analyses were performed separately by sex and age group, and effects of age, period and cohort were estimated by using Poisson´s regression model. Results: For all age groups assessed, there was an increase in colon cancer incidence in the city of São Paulo. The increase in mortality rates was lower than the increase in incidence which seems to coincide with a cohort effect present during the period studied. Increases in both incidence and mortality rates, were more pronounced among men. The age-period model presented the best adjustment to incidence coefficients for both sexes and the complete age-periodcohort model showed the best adjustment to mortality coefficients for both sexes. No significant statistical interaction for sex and incidence coefficient or sex and mortality coefficient was found. Conclusion: Results found in the present study revealed an increase in incidence and mortality rates, for both sexes and all age groups. A stabilisation in birth cohorts of colon cancer for both sexes was observed, suggesting that life style changes may contribute to the reduction in colon cancer mortality, especially in younger cohorts.

Este estudo epidemiológico do Câncer da Boca refere-se aos municípios da Grande São Paulo, excluído o município de São Paulo, no período de 1969-1971. Fundamenta-se em informações colhidas no Registro de Câncer da Faculdade de Saúde Pública da Universidade de São Paulo, onde dentre 44.140 fichas de notificação de câncer, 238 referem-se a câncer bucal em residentes nesses municípios. Sendo 194 casos no sexo masculino com 43 óbitos e 44 casos no sexo feminino com 9 óbitos. Os coeficientes de incidência de câncer bucal nos sexos masculino e feminino foram respectivamente, 5.71 por 100.000 homens e 2.19 por 100.000 mulheres. Os coeficientes de mortalidade foram de 1,27 para o sexo masculino e de 0.28 para o sexo feminino. A localização anatômica mais frequente no sexo masculino foi o lábio e no sexo feminino a lingua. O tipo histológico mais frequente foi o Carcinoma Espinocelular. / This epidemiological study of cancer of the mouth was conducted in the counties of the Greater São Paulo, excluded the Capital, from 1969 to 1971. It is based on information taken from the cancer files of the São Paulo University School of Public Health, where from 44,140 index cards reporting mouth cancer, 238 refer to mouth cancer in residents of those counties. Of these, 194 ocurred in the male population resulting in 43 deaths and 44 in the female population of which 9 ended in death. The incidence rates of cancer of the mouth in the male and the female populations were respectively 5.71 per 100,000 and 2.19 per 100,000. The death rates were also respectively 1.27 and 0.28. The region most frequently affected in the male population was the lip and in the female population the tongue. The most frequent histological type was the Spinocellu1ar Carcinoma.

Introdução: Estatísticas sobre a ocorrência de casos novos de câncer são fundamentais para o planejamento e monitoramento das ações de controle da doença. No estado de São Paulo, a incidência de câncer é obtida indiretamente por meio de estimativas oficiais (para o estado como um todo e sua capital) e, de forma direta, em municípios cobertos por Registro de Câncer de Base Populacional (RCBP). Existem, atualmente, três RCBP ativos (São Paulo, Jaú e Santos), um inativo (Barretos) e um em reimplantação (Campinas). Dado o desconhecimento do panorama da incidência de câncer em áreas não cobertas por RCBP, este estudo teve como objetivo estimar a incidência de câncer, calcular taxas brutas e padronizadas por idade, específicas por sexo e localização primária do tumor para as 17 Redes Regionais de Atenção à Saúde (RRAS) de São Paulo e municípios, em 2010. Método: Utilizou-se como estimador da incidência de câncer a razão Incidência/Mortalidade (I/M), por sexo, grupo etário quinquenal dos 0 aos 80 anos e localização primária do tumor. O numerador da razão foi formado pelo número agregado de casos novos entre 2006-2010, em dois RCBP ativos (Jaú e São Paulo, respectivamente, com cobertura correspondente a 0,3 por cento e 27,3 por cento da população estadual). No denominador, o número de óbitos oficial nas respectivas áreas e período. O número estimado de casos novos resultou da multiplicação das I/M pelo número de óbitos por câncer registrados em 2010 para o conjunto de municípios formadores de cada uma das RRAS ou para cada município. O método de referência foi aquele utilizado no Globocan series, da Agência Internacional de Pesquisa contra o Câncer. O ajuste por idade das taxas de incidência ocorreu pelo método direto, tendo como padrão a população mundial. Resultados: Estimaram-se 53.476 casos novos de câncer para o sexo masculino e 55.073 casos para o feminino (excluindo-se os casos de câncer de pele não melanoma), com taxas padronizadas de 261/100.000 e 217/100.000, respectivamente. No sexo masculino, a RRAS 6 apresentou para todos os cânceres a maior taxa de incidência padronizada (285/100.000), e a RRAS 10, a menor (207/100.000). Os cânceres mais incidentes em homens foram próstata (77/100.000), cólon/reto/anus (27/100.000) e traqueia/brônquio/pulmão (16/100.000). Entre as mulheres, as taxas de incidência padronizadas por idade foram de 170/100.000 (RRAS 11) a 252/100.000 (RRAS 07); o câncer de mama foi o mais incidente (58/100.000), seguido pelos tumores de cólon/reto/anus (23/100.000) e de colo uterino (9/100.000). Conclusões: Os resultados apontaram diferentes padrões de incidência com taxas que ultrapassaram a magnitude estadual. Dados provenientes de RCBP locais podem ser usados na obtenção indireta de estimativas regionais e locais. Neste estudo, as taxas de incidência apresentadas podem estar sub ou superestimadas refletindo a qualidade, completitude e padrões observados no RCBP de maior representatividade considerado na análise. / Introduction: Statistics on the occurrence of new cases of cancer are fundamental to the planning and monitoring of control measures. In Sao Paulo state, Brazil, cancer incidence can be obtained by the official estimates for the state as a whole and the capital and in municipalities covered by Population Based Cancer Registries (PBCR). The currently panorama of PBCR in Sao Paulo includes three active registries, one retired and one in re-deployment. Given the unknown cancer incidence in areas not covered by PBCR, this study aimed to estimate cancer incidence (standardized incidence rates = SIR) according to gender, age group and tumor type for 17 Regional Networks of Health Care (RNHC) and municipalities in São Paulo state, Brazil, in 2010. Methods: We used as estimator the Incidence:Mortality ratio (I:M) adjusted for sex, five-year age group (0-80 years) and primary tumor site. The ratio numerator was composed by the aggregated number of new cases diagnosed in 2006-2010 in two active PBCR, Jau and Sao Paulo, covering 0.3 per cent and 27.3 per cent of the state population, respectively, while the denominator was the official number of cancer deaths in the same areas and period. The estimated number of incident cases resulted from the multiplication of I:M by the number of deaths registered in 2010 for the set of municipalities that compose the region or for each local area. The reference method was the one used in Globocan series of the International Agency for Research on Cancer. Results: We had estimated a total of 53,476 new cases of cancer for males and 55,073 cases for females (excluding non melanoma skin cancers) in the state of São Paulo, corresponding to standardized rates (world population) of 261/100,000 and 217/100,000, respectively. Among males, RNHC-6 presented the highest standardized incidence rate of all cancers (285/100,000) and the RNHC-10, the lowest (207/100,000). Most frequent tumor sites in men were: prostate (SIR=77/100,000), colorectum/anus (SIR=27/100,000) and trachea/bronchus/lung (SIR=16/100,000). Among women, rates for all cancers excluding non-melanoma skin varied from 170/100,000 (RNHC-11) to 252/100,000 (RNHC-7); breast cancer was the most incident cancer site (SIR=58/100,000), followed by colorectum/anus (SIR=23/100,000) and cervix (SIR=9/100,000). Conclusions: Our results showed different patterns of regional incidence with rates that often exceeded the values presented for the state. Data from local PBCR can be used to obtain regional and local estimates. However, the estimated rates may be under- or overestimated reflecting the quality, completeness and the patterns observed in the most representative registry used in the analysis.

Giant Cell arteritis (GCA) is a systemic inflammatory disease that affects arteries of medium- and large size. Symptoms of GCA such as headache and fever usually promptly improve with treatment of glucocorticoids. Apart from advanced age, female sex and Northern-European descent, risk factors for GCA are unknown. Most studies have found that life expectancy for patients with GCA is not reduced compared with the general population and studies on cardiovascular disease in GCA have provided conflicting results. Data for the studies of this thesis are drawn from the Reykjavik Study (RS) that is a general population-based cohort study with continuous surveillance for coronary heart disease and vital status. Subjects born in 1907–1934 and living in Reykjavik, Iceland or adjacent communities in 1966 were invited for study visit from 1967-1994. Information on cardiovascular risk factors were collected at study visit. Diagnosis of GCA for this study was based on re-examination of all temporal arteries biopsies (TAB) from members of the RS cohort; however, information was also obtained from the original pathology report. Of 19,360 subjects included in the RS, 194 developed GCA during the follow-up period. Body mass index was inversely associated with the occurrence of GCA. Among men, but not women, hypertension was associated and smoking inversely associated with the occurrence of GCA. Among women, but not men, GCA was associated with coronary heart disease. Subjects with GCA had approximately 50% increase in mortality risk compared with the general population. Increase mortality was mainly observed among GCA patients based on the diagnosis of re-examination of TAB; however, no such an association was found if diagnosis of GCA was made based on the original pathology report. Those subjects were likely not clinically diagnosed with GCA, signaling that treatment for GCA might be beneficial with respect to mortality risk.

BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and previous studies have focused on the epidemiology, mechanisms and risk factors for this global disease (Ryder and Benjamin 1999). Various studies have examined the mechanism, epidemiology, and risk factors for AF. One of the most common triggers for AF is believed to be premature atrial contractions (PACs) usually arising from the pulmonary veins of the left atrium, but the relationship between AF and premature ventricular complexes (PVCs) is not well understood. Studies investigating the triggers of premature beats in both the atria and ventricles are similar, so it is possible that treatment for one arrhythmia may affect the incidence of another. It is hypothesized that due to commonly shared mechanisms of triggered activity or automaticity between PACs and PVCs, and shared risk factors, that patients with AF undergoing treatment with catheter ablation may be prone to develop PVCs. OBJECTIVE: To investigate the incidence of clinically detected PVCs among patients undergoing catheter ablation for AF, and clinical predictors of PVC development in this cohort of patients. We also aim to evaluate if incident PVC detection is associated with recurrent AF following AF ablation in a cohort of 317 patients receiving treatment at a single academic medical center. METHODS: A total of 375 patients undergoing AF ablation from 2009-2012 were reviewed, and patients that underwent repeat ablations were excluded, yielding 317 patients for analysis. T-tests and Chi-squared analyses were used in univariate analyses to test for significance between characteristics of AF patients who did and did not develop PVCs. Kaplan-Meier analyses and Cox proportional hazards models were used for univariate and multivariate survival analyses, respectively, to assess the risks of incident PVC development. RESULTS: Of 317 patients with AF undergoing pulmonary vein isolation (PVI) ablation, 36.3% developed clinically detectable PVCs following ablation. A history of clinically evident PVC prior to catheter ablation for AF was associated with an 80% increase in risk of incident PVC development (HR=1.83, 95% CI 1.02-3.26, p=0.041). Additionally, a history of prior angioplasty, stent, or percutaneous coronary intervention (PCI) was associated with a 73% decreased risk of incident PVCs (HR=0.27, 95% CI 0.08-0.88, p=0.03). In patients with a history of PVC prior to ablation, or who developed PVCs after ablation, there was no significant difference in the risk of AF recurrence (HR=1.01, 95% CI 0.70-1.46, p=0.96; and HR=1.09, 95% CI 0.78-1.53, p=0.60, respectively). CONCLUSIONS: Over 1 in 3 patients develop clinically detected PVCs following catheter ablation. Predictors of incident PVC development include a history of PVC, whereas a history of angioplasty, stent, or PCI was associated with less incident PVC development. Furthermore, there was no significant association between both a history of PVC or incident PVC and risk of recurrent AF following ablation.

Introdução. O câncer de boca em 1998 foi a décima-primeira localização mais comum das neoplasias malignas, exceto pele, no sexo masculino, em São Paulo, com 1,6% dos casos. Dados do Registro de Câncer de São Paulo mostram que a incidência não diminuiu em anos recentes. A região é de alta incidência para esse tipo de câncer, em comparação às demais regiões brasileiras e mesmo em termos mundiais. Julgou-se de interesse de Saúde Pública verificar a incidência do câncer de boca no Município de São Paulo, segundo sexo e idade, em anos selecionados. Objetivos. Descrever os coeficientes de incidência de câncer de boca no Município de São Paulo em 1969, 1973, 1978 e 1998, segundo sexo, idade e localização topográfica do tumor, comparando-os; calcular a probabilidade de incidência de câncer de boca em intervalos selecionados de idade segundo sexo e localização topográfica do tumor. Métodos. Partindo-se de dados secundários (Registro de Câncer de SP), obtiveram-se as taxas de incidência e calcularam-se as taxas de incidência acumulada segundo sexo e localização topográfica em intervalos de 5 anos. Os riscos acumulados para até as idades de 20,30,...,70 anos, em porcentagem, foram calculados e apresentados em gráficos seguindo o modelo de Zdeb modificado por Souza; para análise estatística foram construídos intervalos de confiança para os riscos, segundo sexo e localização topográfica, comparando-se as suas magnitudes. Resultados e comentários. Observou-se redução de riscos de câncer de lábio, entre 1969 e 1998, em ambos os sexos. Aumentos de riscos em orofaringe e cavidade bucal, no sexo feminino, poderiam estar relacionados a incremento do tabagismo entre mulheres no período. / Introduction. In 1998, oral cancer was the eleventh most frequent site of all malignant neoplasms in São Paulo, in males, comprising 1.6% of the global incidence (except for the cancer of skin). According to the São Paulo Cancer Registry this incidence has not decreased in recent years. Furthermore, this type of cancer is highly frequent in this city in comparison with other Brazilian regions as well as in the world. The incidence of oral cancer according to sex and age regarding selected years was considered to be of interest to Public Health. Objectives. To describe and to compare incidence rates of oral cancer in São Paulo City in 1969, 1973, 1978 and 1998, according to sex, age and site of the tumor; to calculate the probability of the incidence of oral cancer over selected age-intervals, according to sex and localization of tumour. Methods. Population based incidence data was obtained from São Paulo Cancer Registry, allowing calculation of cumulative incidence rates according to sex and topographic site along 5-year intervals. Cumulative risks until ages of 20,30,...,70 years, in percent, were then calculated and presented graphically following Zdeb model, modified by Souza. Confidence intervals were build up for statistical analysis of risks according to sex and site of the tumor, allowing comparisons of their magnitudes. Results and comments. Lip cancer risks have decreased, in both sexes, between 1969 and 1998. Increase of risks was observed in oropharynx and oral cavity, in females. This result could be related to an increasing prevalence of tobacco use in females, in São Paulo, as have been reported by several surveys carried out in this city.

A retrospective mortality and cancer incidence study of former nuclear weapons assemblers from the Iowa Army Ammunitions Plant was conducted. This study examined whether or not workers at the plant exhibited higher rates of mortality or cancer as a result of their work-related activities. Potential exposures included radiation, beryllium, asbestos, and solvents. Cancer incidence was determined by calculating standardized incidence ratios (SIR) and using the Iowa population as reference. SIRs were calculated on 3,889 workers from1969-2005. Overall and cause-specific mortality was determined by calculating standardized mortality ratios (SMR) and using the U.S. and Iowa populations as reference. SMRs were calculated on 5,743 workers from 1947-2005. The SIR results showed that overall cancer incidence was lower than the Iowa population. Using the Iowa population as reference, the SMR analyses for men demonstrated excesses for all cancers (SMR 1.09, 95% CI 1.02-1.17), lung cancer (SMR 1.38, 95% CI 1.24-1.54), diseases of the respiratory system (SMR 1.15, 95% CI 1.03-1.46), mesothelioma (SMR 6.20, 95 % 1.28-18.1), asbestosis (SMR 9.28, 95% CI 1.12-33.5) and COPD (SMR 1.27, 95% CI 1.10-1.46). Significantly lower SMRs were observed stomach cancer and ischemic heart disease. For women excesses were observed for all cancers (SMR 1.41, 95% CI 1.17-1.69), lung cancer (SMR 2.47, 95% CI 1.72-3.44), ischemic heart disease (SMR 1.32, 95% CI 1.09-1.58), respiratory diseases (SMR 1.59, 95% CI 1.14-2.16), and COPD (SMR 2.47, 95% CI 1.60-3.65). Using the U.S. population, men experienced lower overall mortality while women had significantly higher overall mortality. In conclusion, the SIR portion of the study showed overall lower cancer incidence for both men and women. This may be due to the Healthy Worker Effect and the limited dates of study. There are no cancer registry data before 1969 thus missing cancers with short induction periods. Workers may have also moved out of the Iowa and had a cancer diagnosis in another state. Compared to Iowa population, there was an excess of respiratory disease deaths and deaths from lung cancer in both men and women. Considering the significant respiratory exposures workers may have experienced, further study with a nested case-control design is suggested.

<div><b>Background:</b> Bradycardia and hypotension are complications commonly occurring during general anesthesia in small animals. Intraoperative hypotension has been found to be associated with adverse postoperative consequences. </div><div><br></div><div><b>Objectives: </b>The objectives of his study were first, to determine the incidence of bradycardia, hypotension, and bradycardia with hypotension in dogs undergoing general anesthesia, and second, to identify the risk factors associated with these three complications. The third objective was to evaluate the relationship between these three intraoperative complications and the recovery quality in these dogs.</div><div><br></div><div><b>Methods and Materials:</b> A retrospective cohort study was performed using anesthetic records from 250 dogs undergoing general anesthesia between May 23, 2018 and October 1, 2018 at the Purdue University Veterinary Teaching Hospital. Intraoperative bradycardia was defined as heart rate < 60 beats/min for at least two consecutive readings at 5 minutes apart. Hypotension was defined as mean arterial pressure (MAP) < 60 mmHg or a systolic arterial pressure (SAP) < 80 mmHg for at least two consecutive readings. A univariate analysis followed by multiple logistic regression was performed to build the model for bradycardia, hypotension, and bradycardia with hypotension. The relationships between the three complications and the recovery quality were analyzed using the Pearson’s chi-square test.</div><div><br></div><div><b>Results:</b> The study found that out of the 250 dogs, 114 (45.6%) developed bradycardia, 113 (45.2%) developed hypotension, and 32 (12.8%) dogs developed bradycardia with hypotension. The use of dexmedetomidine-based tranquilizers/sedatives, longer duration of anesthesia, and subjection to orthopedic and neurologic surgical procedures were all identified as risk factors for the dogs to develop bradycardia. The use of acepromazine-based tranquilizers/sedatives, young and old age dogs, and dogs subjected to neurologic surgery were associated with the development of intraoperative hypotension. When the length of the anesthesia increased, the chance for developing bradycardia with hypotension increased. There was no significant association between these intraoperative complications and the recovery quality.</div><div><b><br></b></div><div><b>Conclusions:</b> We found a high incidence of bradycardia or hypotension while a much lower incidence of bradycardia with hypotension in the anesthetized dogs. The risk factors for bradycardia were the use of dexmedetomidine-based tranquilizers/sedatives, the longer duration of anesthesia, and the performance of orthopedic surgery and neurosurgery. The risk factors for hypotension included the use of acepromazine-based tranquilizers/sedatives, the older or younger age of dogs, and the performance of neurosurgery. The risk factor for bradycardia with hypotension was the longer duration of anesthesia. While these adverse events developed intraoperatively, we could not identify a direct influence of these complications on the recovery quality. </div><div><br></div>