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      A introdução na medicina de técnicas oriundas da genética ocasionou uma ruptura antropológica? Translated title: Has the introduction of genetic techniques in medicine occasioned an anthropological rupture?

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          Abstract

          No presente artigo é exposto e discutido um conjunto de posições teóricas acerca da aplicação da genética na medicina com vistas a examinar uma possível ruptura antropológica. Trata-se de uma tese acerca da desumanização da medicina decorrente da implementação de biotecnologias que visam a prevenção e o tratamento de doenças associadas a fenômenos genéticos e à reprodução humana. Segundo essa visão, a "geneticização" da medicina vem acompanhada de uma ideologia que deve ser denunciada por comprometer a dignidade e a liberdade humanas. Após um balanço crítico acerca do impacto real da genética na medicina, são analisados casos concretos de aplicações médicas da genômica nos quais são comparadas as posições contrárias e favoráveis à tese do caráter desumanizante da geneticização.

          Translated abstract

          In this article, a set of theoretical positions concerning the application of genetics in medicine is expounded and discussed, with the aim of examining a possible anthropological rupture. A thesis is defended about the dehumanization of medicine which arises as a consequence of the implementation of biotechnological procedures that aim at preventing and treating diseases associated to genetic phenomena and to human reproduction. According to this view, the "genetization" of medicine comes together with an ideology which should be denounced for challenging human dignity and liberty. After a critical examination of the actual impact of genetics in medicine, concrete cases of medical applications of genomics are analised in which contrary and favourable positions to the thesis of the dehumanizing character of genetization are compared.

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          A Gene-Expression Signature as a Predictor of Survival in Breast Cancer

          A more accurate means of prognostication in breast cancer will improve the selection of patients for adjuvant systemic therapy. Using microarray analysis to evaluate our previously established 70-gene prognosis profile, we classified a series of 295 consecutive patients with primary breast carcinomas as having a gene-expression signature associated with either a poor prognosis or a good prognosis. All patients had stage I or II breast cancer and were younger than 53 years old; 151 had lymph-node-negative disease, and 144 had lymph-node-positive disease. We evaluated the predictive power of the prognosis profile using univariable and multivariable statistical analyses. Among the 295 patients, 180 had a poor-prognosis signature and 115 had a good-prognosis signature, and the mean (+/-SE) overall 10-year survival rates were 54.6+/-4.4 percent and 94.5+/-2.6 percent, respectively. At 10 years, the probability of remaining free of distant metastases was 50.6+/-4.5 percent in the group with a poor-prognosis signature and 85.2+/-4.3 percent in the group with a good-prognosis signature. The estimated hazard ratio for distant metastases in the group with a poor-prognosis signature, as compared with the group with the good-prognosis signature, was 5.1 (95 percent confidence interval, 2.9 to 9.0; P<0.001). This ratio remained significant when the groups were analyzed according to lymph-node status. Multivariable Cox regression analysis showed that the prognosis profile was a strong independent factor in predicting disease outcome. The gene-expression profile we studied is a more powerful predictor of the outcome of disease in young patients with breast cancer than standard systems based on clinical and histologic criteria. Copyright 2002 Massachusetts Medical Society
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            Sickle Cell Anemia, a Molecular Disease

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              Smoking and carcinoma of the lung; preliminary report.

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                Author and article information

                Journal
                ss
                Scientiae Studia
                Sci. stud.
                Universidade de São Paulo, Departamento de Filosofia (São Paulo, SP, Brazil )
                1678-3166
                2316-8994
                June 2004
                : 2
                : 2
                : 161-177
                Affiliations
                [01] Paris orgnameCollège de France orgdiv1Cátedra de filosofia das ciências biológicas e médicas anne.fagot-largeault@ 123456college-de-france.fr
                Article
                S1678-31662004000200002 S1678-3166(04)00200202
                cfbb0dc0-d41e-4cab-abdd-962f4883d30f

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 17
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                SciELO Brazil

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                Artigos

                Genética médica,Anthropological rupture,Genetization,Bioethics,Ruptura antropológica,Geneticização,Biotechnology,Medical genetics,Ética médica,Biotecnologia,Medical ethics,Bioética

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