Oral cancer mortality trends in Brazilian geographical regions from 1996-2001

The purpose of this study was to analyse the oral cancer mortality trends in Brazil by geographic region, age and sex, from 1996 to 2001. The Brazilian Ministry of Health database DATASUS and the Brazilian Institute of Geography and Statistics were used as the source of data. Oral cancer mortality rates per 100,000 population were estimated. Statistical analyses comprised estimates of oral cancer mortality rates, grouped according to the study variables, in 1996, 1997, 1998, 1999, 2000 and 2001; also, the three-year periods 1996-1998 and 1999-2001 were analysed, allowing the oral cancer mortality trends between these two periods to be calculated. For comparison, in each geographical region, the ratio between two death rates (related to period or sex) was calculated. In the period 1996-2001, a total of 25,972 deaths due to oral cancer were reported, giving a mortality rate of 2.67. The rates for the periods 1996-1998 and 1999-2001 were 2.53 and 2.73, respectively, showing a slight increase in the rate. There was a predominance of oral cancer in males with a male/female ratio of approximately 4. All regions exhibited an increase in mortality rates, with the exception of the Southeast region. From 1996 to 2001, the average mortality rates were 3.55 and 3.58 for the Southeast and South regions, and 1.94, 1.41, and 0.86 for the Mid-West, Northeast, and North regions, respectively. Over the age of 40, oral cancer mortality rates were seen to increase rapidly with age. Oral cancer mortality increased in all regions, except in the Southeast, and was considerably higher among males and older individuals.

CHARACTERIZATION OF THE BRAZPD II COHORT AND DESCRIPTION OF TRENDS IN PERITONEAL DIALYSIS OUTCOME ACROSS TIME PERIODS

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Peritoneal dialysis in acute kidney injury: trends in the outcome across time periods

Peritoneal dialysis (PD) should be considered a suitable method of renal replacement therapy in acute kidney injury (AKI) patients. This study is the largest cohort providing patient characteristics, clinical practice, patterns and their relationship to outcomes in a developing country. Its objective was to describe the main determinants of patient and technique survival, including trends over time of PD treatment in AKI patients. This was a Brazilian prospective cohort study in which all adult AKI patients on PD were studied from January/2004 to January/2014. For comparison purposes, patients were divided into 2 groups according to the year of treatment: 2004-2008 and 2009-2014. Patient survival and technique failure (TF) were analyzed using the competing risk model of Fine and Gray. A total of 301 patients were included, 51 were transferred to hemodialysis (16.9%) during the study period. The main cause of TF was mechanical complication (47%) followed by peritonitis (41.2%). There was change in TF during the study period: compared to 2004-2008, patients treated at 2009-2014 had relative risk (RR) reduction of 0.86 (95% CI 0.77-0.96) and three independent risk factors were identified: period of treatment at 2009 and 2014, sepsis and age>65 years. There were 180 deaths (59.8%) during the study. Death was the leading cause of dropout (77.9% of all cases) mainly by sepsis (58.3%), followed cardiovascular disease (36.1%). The overall patient survival was 41% at 30 days. Patient survival improved along study periods: compared to 2004-2008, patients treated at 2009-2014 had a RR reduction of 0.87 (95% CI 0.79-0.98). The independent risk factors for mortality were sepsis, age>70 years, ATN-ISS > 0.65 and positive fluid balance. As conclusion, we observed an improvement in patient survival and TF along the years even after correction for several confounders and using a competing risk approach.