Resumo O objetivo deste artigo é analisar a tendência temporal da mortalidade por câncer de colo de útero no Brasil e calcular uma projeção até o ano de 2030. Foram analisados os óbitos ocorridos no Brasil de 1996 a 2010 (Sistema de Informações sobre Mortalidade). Foram realizadas análises das tendências da mortalidade por meio da regressão Joinpoint, e para o cálculo das projeções foi utilizado o Nordpred. Para o Brasil, a tendência é de redução (APC = 1,7% IC95%-2,2; −1,1 p < 0,05), sendo significativa nas regiões centro oeste (APC = −1,3% ao ano), sudeste (APC =−3,3%) e sul (APC = −3,9%). As regiões norte e nordeste apresntam tendência de estabilidade. Os estados do Acre (APC = −6,5%) e Rio Grande do Sul (APC = −4,1%) apresentaram as maiores tendências de redução. Na análise das projeções de mortalidade, haverá uma redução das taxas no Brasil a partir do primeiro período projetado, sendo mais marcante para a região sul. As taxas de mortalidade até o ano 2030 serão explicadas, em maior medida, pela redução dos risco para a doença. A mortalidade por câncer de colo de útero apresenta tendência de redução, todavia está desigualmente distribuída no Brasil, com as regiões norte e nordeste apresentando as maiores taxas.

Cancer is currently in the spotlight due to their heavy responsibility as main cause of death in both developed and developing countries. Analysis of the epidemiological situation is required as a support tool for the planning of public health measures for the most vulnerable groups. We analyzed cancer mortality trends in Brazil and geographic regions in the period 1996 to 2010 and calculate mortality predictions for the period 2011 to 2030.This is an epidemiological, demographic-based study that utilized information from the Mortality Information System on all deaths due to cancer in Brazil. Mortality trends were analyzed by the Joinpoint regression, and Nordpred was utilized for the calculation of predictions.Stability was verified for the female (annual percentage change [APC] = 0.4%) and male (APC = 0.5%) sexes. The North and Northeast regions present significant increasing trends for mortality in both sexes. Until 2030, female mortality trends will not present considerable variations, but there will be a decrease in mortality trends for the male sex. There will be increases in mortality rates until 2030 for the North and Northeast regions, whereas reductions will be verified for the remaining geographic regions. This variation will be explained by the demographic structure of regions until 2030.There are pronounced regional and sex differences in cancer mortality in Brazil, and these discrepancies will continue to increase until the year 2030, when the Northeast region will present the highest cancer mortality rates in Brazil.

Estimation of the size of a cancer group, either through number of cases or extrapolation of past observed trends, is indispensable to the planning of effective assistance measures. The aim of this study was to analyze the mortality trends of human papillomavirus-related cancers in Brazil by sex, in the period 1996-2010, and make predictions until the year 2025. All deaths registered as being a result of cervical cancer (ICD-10 code: C53), as well as those caused by vulvar and vaginal (C51 and C52), anal (C21), penile (C60), and oropharyngeal (C02, C09, C10) cancers, were registered. Adjusted rate calculations for each year were used to study the trends through the regression program 'Joinpoint'. Predictions were made using the Nordpred program, utilizing the age-period-cohort model. When analyzing separately by location, it was observed that penile and anal cancers in men presented an increasing trend for the entire period with a statistically significant annual percentage change of 4% for anal cancer and 1.4% for penile cancer. Predictions indicate a reduction in the risk of death due to oropharyngeal cancer in men and cervical, vulvar, and vaginal cancers in women. It was observed that the increase in the number of deaths occurs mainly because of population changes (size and age structure). In terms of risk, an increase is predicted for anal and penile cancers in men and consequently an increase in mortality rates is observed for these types of cancers, unlike what is expected for human papillomavirus-related cancers in women.

Two Cases of Somnambulism Induced by QuetiapineSir: Somnambulism reflects an impairment in the normal mechanisms of arousal from sleep in which motor behaviors initiated during deep, non-rapid eye movement or slow-wave sleep are activated without full consciousness. Somnambulism, a previously unreported side effect of quetiapine, is described in 2 cases. Both cases described here involved individuals with attention-deficit/hyperactivity disorder (ADHD). The possible significance of this will be discussed.Case 1. Mr. A, a 52-year-old white man with no history of somnambulism, was undergoing treatment for DSM-IV panic disorder and schizoaffective disorder. He reported attention problems and hyperactivity since childhood and restless legs syndrome for 35 years. He was admitted to the medical unit in February 2006 to rule out myocardial infarction after falling off his porch while sleepwalking.The patient reported that somnambulism had begun 18 months previously, after his quetiapine dose was increased to 200 mg at bedtime. This dose was later titrated to a maximum of 1000 mg during the month prior to admission. At that time, mirtazapine 30 mg at bedtime was added. This combination further aggravated the patient's somnambulism, which occurred almost nightly. The patient was witnessed by his roommate to wander in a confused state, manipulate various belongings, open the refrigerator and eat, and visit the bathroom. He was easily redirected back to bed, but did not appear to awaken.A polysomnogram done when Mr. A was taking 800 mg of quetiapine showed no significant respiratory obstruction. Electroencephalogram (EEG) showed no epileptiform activity. Leg electromyogram findings were significant for frequent leg jerks. Quetiapine treatment was discontinued, and methylphenidate and clonazepam were started. Quetiapine 25 mg nightly was reinitiated later. No recurrence of somnambulism was reported at 8-month follow-up.Case 2. Mr. B, an 18-year-old white man with DSM-IV diagnoses of ADHD and pervasive developmental disorder, sought consultation for episodes of somnambulism and nocturnal combativeness. At the time of presentation in June 2003, he was receiving quetiapine 400 mg nightly and dextroamphetamine sulfate 35 mg daily in divided doses.The patient gave a history of starting quetiapine 8 months previously for onset of command auditory hallucinations. Shortly thereafter, he began to have nightmares associated with shouting, jumping from bed, property destruction, and assaults on family members. Mr. B awakened in the mornings with a headache but had no recollection of the events of the night before.Neurologic examination findings were unremarkable, and results of a 24-hour EEG study were normal. The patient's quetiapine dose was reduced to 350 mg nightly, resulting in the return of auditory hallucinations. Dextroamphetamine sulfate was then tapered over a period of 4 months and discontinued with good result and resolution of hallucinations. The patient continued to have nocturnal outbursts, though these were less frequen...

The data suggest there were no significant changes in laryngeal cancer survival in the province of Zaragoza in the period 1978-2002 and that the tumours located in the glottis presented a better prognosis.