BACKGROUND:The global burden of cancer continues to rise, disproportionately affecting low-income and middle-income countries, where cancer workforce shortages are especially acute and contribute to poor outcomes. In this analysis, we estimate the effect on cancer mortality of scaling up specific workforce personnel types in order to provide global, regional, and country-specific guidance to inform cancer workforce policy. METHODS:Using the Global Cancer Workforce microsimulation model, which accounts for demographic, epidemiological, and health system factors related to cancer incidence and survival, we modelled the projected effect of scaling up 18 specific workforce personnel types on total cancer mortality (diagnosed and undiagnosed) from 17 cancers (oral, nasopharynx, oesophagus, stomach, colon, rectum, anus, liver, pancreas, lung, skin melanoma, breast, cervix uteri, ovary, prostate, bladder, and brain and CNS) in 200 countries and territories from 2030 to 2050. Workforce density (per 100 000 population) of each workforce personnel type was modelled based on estimates from various sources (including WHO Global Health Workforce Statistics, the IMAGINE database, and previous Lancet Commissions). Expert opinion surveys, with responses from 86 experts in 16 countries, informed the involvement of workforce personnel in specific model events. We also modelled scale-up of workforce by cadre (ie, teams of personnel that work together in a particular specialty) and level of training (ie, years of education). FINDINGS:Substantial disparities in cancer workforce were projected to persist in 2050, with especially large workforce shortages in Africa. Among single personnel types, scaling up surgeons was projected to yield the largest reduction in global cancer mortality (3·64% [95% uncertainty interval 2·68-4·66]), especially in Africa, Asia, and Oceania, but with considerable heterogeneity by country. Among workforce cadres, scaling up diagnostic and imaging personnel was projected to yield the greatest benefit (global cancer mortality reduction of 7·61% [5·23-9·88]), with some heterogeneity by country. Comprehensive scale-up of all workforce levels was projected to reduce cancer mortality by over 50% in 55 countries, most notably in Africa, central America, and southern Asia. INTERPRETATION:Investments to strengthen the cancer workforce will be essential to reduce global cancer mortality and improve timely diagnosis and survival. Strategic scale-up of personnel, particularly in diagnostics, alongside innovative strategies such as digital health solutions and role delegation, could result in substantial improvements in cancer outcomes. Policy makers should prioritise data-driven workforce planning as a crucial component of comprehensive cancer control strategies. FUNDING:American Cancer Society and Breast Cancer Research Foundation.
Background: Platelet-rich plasma (PRP) is frequently used in sports medicine to treat muscle injuries; however, the clinical evidence remains inconsistent and fragmented. Purpose: To assess whether PRP therapy improves clinical outcomes, particularly return to sport (RTS) and reinjury rate, compared with conventional treatments for acute muscle injuries. Study Design: Systematic review and meta-analysis; Level of evidence, 2. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic search of PubMed, Embase, BVS, and Scopus was conducted through April 2025 for systematic reviews, with or without meta-analysis, to evaluate PRP for acute muscle injuries in athletes. A total of 1464 manuscripts were identified through the initial search. Main outcomes included RTS, reinjury rate, pain, and complications. Methodological quality was assessed using the Risk of Bias in Systematic Reviews (ROBIS) tool, and the certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Meta-analyses were performed using random-effects models with Hartung-Knapp-Sidik-Jonkman adjustments. Results: Eight systematic reviews were included. PRP significantly reduced reinjury risk compared with controls (risk ratio, 0.84 [95% CI, 0.76 to 0.92]; I 2 = 0%), with high-certainty evidence. A reduction in RTS time favored PRP (mean difference, –4.43 days [95% CI, –9.28 to 0.42); however, it did not reach statistical significance (low-certainty evidence). Narrative synthesis suggested inconsistent short-term pain relief and low complication rates, but evidence certainty was rated very low to low due to methodological and reporting limitations. Conclusion: Our review study demonstrated that PRP may reduce muscular reinjury rates and potentially accelerate RTS, although benefits on pain and safety remain uncertain. Current evidence supports the selective use of PRP in sports settings; however, standardization in protocols and outcomes is needed. These findings may assist clinicians in individualizing treatment strategies involving PRP for acute muscle injuries, particularly in high-performance athletes at risk of recurrence. Registration: CRD42021279300.
This study analyzed temporal trends and sociodemographic and territorial inequalities in police records of rape and rape of vulnerable persons in Brazil from 2021 to 2025. An ecological, descriptive, longitudinal study was conducted using data from the Brazilian Public Security Yearbooks published between 2022 and 2026. Absolute numbers, rates per 100,000 inhabitants, annual changes, sex, macroregion, federative unit, race/skin color, age group, relationship to the perpetrator, and place of occurrence were examined. Data from 2020 were used exclusively as the baseline for the 2021 variation. Records increased from 68,885 in 2021 to 84,388 in 2025, a 22.5% rise, after peaking at 88,843 in 2024. Female victims predominated, and more than three quarters of the records involved people aged 0–17 years. Black victims were the majority among cases with valid race/skin color information. The home remained the main setting, and family members or other acquaintances accounted for most reported perpetrators. The North, South, and Central-West showed higher rates, although with different trajectories. The findings demonstrate persistence, concentration among children and adolescents, and sex, racial, and territorial inequalities, requiring intersectoral prevention, improved records, protection within close relationships, and stronger care and accountability networks.
O câncer colorretal (CCR) encontra-se em crescimento e já é o segundo em incidência, tanto em homens quanto em mulheres. Cerca de 50% dos pacientes com CCR desenvolvem metástases hepáticas (MH), e em cerca de 35% desses as lesões permanecem restritas ao fígado. Infelizmente, apenas 20 a 40% dos pacientes com MHCCR apresentam doença ressecável, ficando os demais com prognóstico sombrio, com sobrevida em 5 anos de cerca de 10%, apesar de tratamentos avançados multimodais, sistêmicos e locorregionais. Desde a década de 1980, transplantes de fígado (TF) foram realizados para tratamento de pacientes com MHCCR irressecáveis. Sobrevidas pobres pouco superiores à quimioterapia sistêmica foram observadas na época. Com as publicações do grupo de Oslo a partir de 2013 e o estabelecimento de critérios de seleção e estratégias de imunossupressão, alcançaram-se sobrevidas satisfatórias que impulsionaram estudos multicêntricos que estão confirmando os achados noruegueses e consolidando o TF como alternativa de tratamento para pacientes selecionados com MHCCR irressecáveis. Este estudo faz uma revisão sistemática dos artigos publicados envolvendo o tema TF em MHCCR, incluindo relatos de caso, séries de casos, estudos multicêntricos e revisões sobre o tema, com o objetivo de mostrar o desenvolvimento, os casos iniciais em diversos centros e o estado atual dessa importante alternativa de tratamento.
Objetivo: Realizar uma análise documental sobre a trajetória profissional de Wanda Horta à luz do arcabouço teórico de Claude Dubar, fundamentalmente, em relação à sua profissionalidade, alinhando a história da enfermagem à perspectiva epistemológica feminista, colaborando com estudos de mulheres que atuaram na enfermagem brasileira nos anos pós-1930. Métodos: pesquisa documental estruturada na categoria de análise profissionalidade aplicada em quatro artigos publicados em Número Especial da “Revista da Escola de Enfermagem da USP”, dedicado ao evento científico intitulado “I Semana Wanda de Aguiar Horta”, em 1987. Resultados: a teorista redimensionou a formação e a orientação profissional da enfermagem, instituindo o processo de humanização da assistência, legitimando trajetórias femininas no campo da saúde e das práticas médicas em um contexto singular da história política e social brasileira. Considerações finais: a biografia de Wanda Horta permitiu considerar que sua profissionalidade colaborou decisivamente com a institucionalização da cultura feminina na arte e ciência do cuidado, na gestão da educação e do trabalho em saúde no Brasil, ambas as dimensões materializadas na publicação do livro “Processo de Enfermagem”.
