Dengue is one of the most prominent tropical epidemic diseases present in the Rio de Janeiro city and Southeast part of Brazil, due to the widespread conditions of occurrence of the dengue vector, the mosquito Aedesae...Dengue is one of the most prominent tropical epidemic diseases present in the Rio de Janeiro city and Southeast part of Brazil, due to the widespread conditions of occurrence of the dengue vector, the mosquito Aedesaegypti, such as high-temperature days interlaced with afternoon or nocturnal rainstorms in summer. This work has the objective of investigating the relationships between variabilities of the El Ni?o-South Oscillation (ENSO) and greater epidemics of dengue in Rio de Janeiro city. To accomplish this goal, the analysis and signal decomposition by cross-wavelet transform (WT) was applied to obtain the cross variability associated with variations of power and phase of both signals by characteristic periods and along with the time series. Data considered in the analysis are (the decimal logarithm of normalized value) of the monthly available notifications of dengue worsening, provided by the public health system of Brazil, and the Southern Oscillation Index (SOI) Ni?o 3.4 data, provided by the National Oceanic and Atmospheric Administration (NOAA), in the period 2000-2017. A maximum cross-wavelet power close to 0.45 was obtained for the representative period of 1 year and also to periods between 3 and 4 years, associated with the positive phase of the SOI index (i.e. , La Ni?a) or with a transition to the positive phase. The evolution of the combined variability of SOI and dengue can be expressed by progressive differences in phase along the time, eventually resulting in yielding phases (i.e., La Niña-Dengue epidemic).展开更多
Background: Hepatocellular adenoma is a rare liver tumor that may require surgical treatment in cases of hemorrhage or suspicion of malignant lesions. Aim: To analyze data from patients who underwent hepatectomy for h...Background: Hepatocellular adenoma is a rare liver tumor that may require surgical treatment in cases of hemorrhage or suspicion of malignant lesions. Aim: To analyze data from patients who underwent hepatectomy for hepatocellular adenoma (HCA) in Rio de Janeiro, Brazil. Methods: From January 2005 to March 2019, sixty-nine patients with HCA underwent hepatectomy at centers in Rio de Janeiro. They were included in the analysis patients undergoing hepatectomy with pathological diagnosis of hepatocellular adenoma and excluded patients with hepatectomy with anatomopathological diagnosis other than hepatocellular adenoma, mainly nodular focal hyperplasia. Data related to patients, tumor and surgery were analyzed retrospectively. Results: Sixty patients (87%) were female and nine were male. Among women, 83% had a history of contraceptive use;among men, only one had an androgen intake history. Overall mean age was 36.4 years (15 - 49), with men older than women (33.9 ± 8.14 years vs. 40.4 ± 6.27 years;P = 0.02). Forty one patients reported abdominal pain, associated or not to other symptoms;32% had an episode of hemorrhage;28 were asymptomatic with an incidental radiological finding. In total, 45 patients presented only one lesion and overall mean size was 8.1 cm (2 - 31);tumors were larger among men (mean size 12.9 ± 9.86 cm vs. 7.7 ± 4.58 cm;P = 0.009). Twenty one surgeries were laparoscopic. Hepatocellular carcinoma (HCC) was identified in three specimens and the incidence was higher among men (22.2% vs. 1.6%;P = 0.042) and in tumors larger than 20 cm (66.6% vs. 0.02%). There was no perioperative mortality. Two of the three patients with HCC died with extrahepatic recurrence;the remaining patient is well after 36 months. Overall mean follow-up time was 14.2 months (2 - 76). Conclusion: Male patients with HCA were older and had larger tumors when compared to females. Incidence of HCC was higher among men and in lesions larger than 20 cm. Male patients with HCA should be treated more aggressively than females.展开更多
文摘Dengue is one of the most prominent tropical epidemic diseases present in the Rio de Janeiro city and Southeast part of Brazil, due to the widespread conditions of occurrence of the dengue vector, the mosquito Aedesaegypti, such as high-temperature days interlaced with afternoon or nocturnal rainstorms in summer. This work has the objective of investigating the relationships between variabilities of the El Ni?o-South Oscillation (ENSO) and greater epidemics of dengue in Rio de Janeiro city. To accomplish this goal, the analysis and signal decomposition by cross-wavelet transform (WT) was applied to obtain the cross variability associated with variations of power and phase of both signals by characteristic periods and along with the time series. Data considered in the analysis are (the decimal logarithm of normalized value) of the monthly available notifications of dengue worsening, provided by the public health system of Brazil, and the Southern Oscillation Index (SOI) Ni?o 3.4 data, provided by the National Oceanic and Atmospheric Administration (NOAA), in the period 2000-2017. A maximum cross-wavelet power close to 0.45 was obtained for the representative period of 1 year and also to periods between 3 and 4 years, associated with the positive phase of the SOI index (i.e. , La Ni?a) or with a transition to the positive phase. The evolution of the combined variability of SOI and dengue can be expressed by progressive differences in phase along the time, eventually resulting in yielding phases (i.e., La Niña-Dengue epidemic).
文摘Background: Hepatocellular adenoma is a rare liver tumor that may require surgical treatment in cases of hemorrhage or suspicion of malignant lesions. Aim: To analyze data from patients who underwent hepatectomy for hepatocellular adenoma (HCA) in Rio de Janeiro, Brazil. Methods: From January 2005 to March 2019, sixty-nine patients with HCA underwent hepatectomy at centers in Rio de Janeiro. They were included in the analysis patients undergoing hepatectomy with pathological diagnosis of hepatocellular adenoma and excluded patients with hepatectomy with anatomopathological diagnosis other than hepatocellular adenoma, mainly nodular focal hyperplasia. Data related to patients, tumor and surgery were analyzed retrospectively. Results: Sixty patients (87%) were female and nine were male. Among women, 83% had a history of contraceptive use;among men, only one had an androgen intake history. Overall mean age was 36.4 years (15 - 49), with men older than women (33.9 ± 8.14 years vs. 40.4 ± 6.27 years;P = 0.02). Forty one patients reported abdominal pain, associated or not to other symptoms;32% had an episode of hemorrhage;28 were asymptomatic with an incidental radiological finding. In total, 45 patients presented only one lesion and overall mean size was 8.1 cm (2 - 31);tumors were larger among men (mean size 12.9 ± 9.86 cm vs. 7.7 ± 4.58 cm;P = 0.009). Twenty one surgeries were laparoscopic. Hepatocellular carcinoma (HCC) was identified in three specimens and the incidence was higher among men (22.2% vs. 1.6%;P = 0.042) and in tumors larger than 20 cm (66.6% vs. 0.02%). There was no perioperative mortality. Two of the three patients with HCC died with extrahepatic recurrence;the remaining patient is well after 36 months. Overall mean follow-up time was 14.2 months (2 - 76). Conclusion: Male patients with HCA were older and had larger tumors when compared to females. Incidence of HCC was higher among men and in lesions larger than 20 cm. Male patients with HCA should be treated more aggressively than females.
