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Letter from the editor | 101

In favor of women

In July 2002, an article in the Journal of the American Medical Association (Jama) had its conclusions reproduced by the press from all over the world and left women perplexed – in particular those who were around 50 years old. The magazine brought the results of clinical tests carried out on 16,608 healthy volunteers, in their middle age, which imposed serious restrictions on hormone replacement therapy. To such a point that the tests were brought to an end before the planned conclusion. The perplexity came about because the treatment for replacing hormones that the ovaries of mature women cease to produce had turned into an important point of reference for women’s health. Until the publication of the American research, it used to be believed that replacement was a good way, not only lessening the discomfort caused by the arrival of the menopause, but also of preventing cardiovascular and mental diseases. The study published in the Jama indicated the contrary: women who were being given hormones ran a greater risk of developing breast cancer and of having vascular problems affecting the brain, heart, and lungs. A horror, in short.

Two years and several studies afterwards, it is clearer that there are no reasons for excessive concerns. The American team itself that did the research did not rule out hormone replacement in specific cases. What actually happened was a reaction that was disproportionate to the seriousness of the results. It is known today that the therapy is important and that it works, provided that it is used exclusively to alleviate the symptoms of the menopause, with constant monitoring and for a short time – and not to protect against chronic diseases. The story by the assistant editor for science, Ricardo Zorzetto shows that Brazil is accompanying the question closely (there are 14 million women in the country who are candidates for the therapy). In the next few months, the Brazilian Federation of Gynecology and Obstetrics Associations will be making public a document to guide the action of gynecologists in relation to this therapy. Research, naturally, continues to be carried out, here and abroad.

Also in healthcare, there are two other important articles. The editor for science, Carlos Fioravanti, discovered that researchers from the Adolfo Lutz Institute, in São Paulo, have succeeded in identifying the wild rodents that are spreading hantavirus and causing the epidemic that recently reached the Federal District, after having established itself in ten states. The disease that is scaring the inhabitants of Brasilia’s satellite towns is not, therefore, an isolated phenomenon. The other article is by reporter Samuel Antenor: this deals with showing the new tests that are coming onto the market, which are helping to prevent and treat hereditary diseases and in controlling opportunistic infections. Even a while ago, the methodology of the tests was restricted to research in the laboratory. The technology is now beginning to be transferred to laboratories specialized in clinical examinations by two of the Research, Innovation and Diffusion Centers (Cepids), funded by FAPESP.

Finally, this magazine could not fail to accompany the movement that Brazilian researchers are making to change the bill that restricts research with stem cells and the power of the National Technical Biosafety Commission (CTNBio) to decide on the marketing of genetically modified organisms. The decision is in the hands of 81 senators, who are to ratify or otherwise the project approved in the Chamber of Deputies. The scientists’ efforts are not being made for a mere whim. The editor for policy Claudia Izique explains that the studies with stem cells can save lives and help to cure chronic diseases. There is not yet any treatment, for example, for reconstituting the spinal cord of a paraplegic. But if researches are paralyzed by force of law, it will not be possible to gather together enough knowledge to advance in this line of research in Brazil.