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Postgraduate education among family and community physicians in Brazil:the Trajetórias MFC project

Family Medicine and Community Health 2020年第3期8卷 1-10页

作者： Leonardo Ferreira Fontenelle Stephani Vogt Rossi Miguel Henrique Moraes de Oliveira Diego JoséBrandão thiago dias sarti Medical School Universidade Vila VelhaVila VelhaBrazil Commission of Medical Residency Universidade Vila VelhaVila VelhaBrazil Department of Social Medicine Universidade Federal do Espirito SantoVitoriaBrazil

Objective Our objective was to describe the postgraduate education trajectories of family and community physicians in Brazil,where neither primary healthcare nor family and community medicine is recognised as a knowledge area for the purpose of research and postgraduate education(master’s and PhD degrees).Design An observational,exploratory study,using administrative data.A nationwide list of family and community physicians as of late November 2018 was compiled from multiple *** on the mode of specialisation was obtained from the same sources and were correlated with data on master’s and PhD degrees,obtained from the curricula vitae on the Lattes *** This study was set in *** 6238 family and community physicians(58.3%female),of whom 2795 had earned a specialist certificate(identified from the list of physicians certified by Sociedade Brasileira de Medicina de Família e Comunidade)and 3957 had completed medical residency(identified from SisCNRM,the national information system for medical residency).Results A master’s degree was held by 747(12.0%)family and community physicians,and a PhD by 170(2.7%);most degrees were in collective health(47.0%and 42%,respectively).Men were more likely than women to hold a master’s degree(adjusted odds ratio(aOR)1.24,95%uncertainty interval(UI)1.07-1.45)and even more likely to a hold PhD(aOR 1.86,95%UI 1.35-2.59).Family and community physicians were also less likely to hold a PhD degree if their master’s degree was professional(oriented towards jobs outside academia)instead of academic(aOR 0.15,95%UI 0.05-0.39)or in some area other than collective health or medicine(aOR 0.41,95%UI 0.21-0.78,compared with a master’s degree in collective health).The postgraduate degree was more likely to precede specialisation for family and community physicians specialising through certification(master’s degree 39.9%,PhD 33%)than through medical residency(master’s degree 9.1%,PhD 6%).Conclusion Family and community

关键词： MFC collective education

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Tertiary peritonitis: A disease that should not be ignored

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World Journal of Clinical Cases 2021年第10期9卷 2160-2169页

作者： Hanna Santos Marques Glauber Rocha Lima Araújo Filipe Antônio França da Silva Breno Bittencourt de Brito Paulo Victor dias Versiani Jaqueline Silva Caires thiago de Carvalho Milet Fabrício Freire de Melo Campus Vitória da Conquista Universidade Estadual do Sudoeste da BahiaVitória da Conquista 45083-900BahiaBrazil Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil Department of Surgery Hospital Geral de Vitória da ConquistaVitória da Conquista 45029-094BahiaBrazil

Intra-abdominal infections can be classified into uncomplicated or complicated(peritonitis). Peritonitis is divided into primary, secondary, and tertiary. Tertiaryperitonitis is the less common but the most severe among peritonitisstratifications, being defined as a recurrent intra-abdominal infection that occurs48 h after a well-succeeded control of a secondary peritonitis. This disease has acomplex pathogenesis that is closely related to the capacity of the peritonealcavity to activate immunological processes. Patients who progress to persistentperitonitis are at an increased risk of developing several infectious complicationssuch as sepsis and multiple organ failure syndrome. Moreover, tertiary peritonitisremains an important cause of hospital death mainly among patients withassociated risk factors. The microbiological profile of organisms causing tertiaryperitonitis is often different from that observed in other types of peritonitis. Inaddition, there is a high prevalence of multidrug-resistant pathogens causing thiscondition, and an appropriate and successful clinical management depends on anearly diagnosis, which can be made easier with the use of clinical scorespresenting a good prediction value during the intensive care unit ***, immediate therapy should be performed to control theinfectious focus and to prevent new recurrences. In this sense, the treatment isbased on initial antimicrobial therapy and well-performed peritoneal drainage.

关键词： Tertiary peritonitis Pathogenesis Clinical manifestation Diagnosis Treatment Prognosis

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Fourier and Wavelet Spectral Analysis of EMG Signals in 1-km Cycling Time-Trial

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Applied Mathematics 2014年第13期5卷 1878-1886页

作者： Marcelo Bigliassi Paulo Rogério Scalassara thiago Ferreira dias Kanthack Taufik Abrao Antonio Carlos de Moraes Leandro Ricardo Altimari Group of Study and Research in Neuromuscular System and Exercise CEFE-State University of LondrinaLondrinaBrazil Department of Electrical Engineering Federal Technological University of ParanaCornélio ProcopioBrazil Department of Electrical Engineering CTU-State University of LondrinaLondrinaBrazil Laboratory of Electromyography Studies FEF-State University of CampinasCampinasBrazil

Frequency domain analyses in electromyographic (EMG) signals are frequently applied to assess muscle fatigue and similar variables. Moreover, Fourier-based approaches are typically used for investigating these procedures. Nonetheless, Fourier analysis assumes the signal as stationary which is unlikely during dynamic contractions. As an alternative method, wavelet-based treatments do not assume this pattern and may be considered as more appropriate for joint time-frequency domain analysis. Based on the previous statements, the purpose of the present study was to compare the application of Short-Time Fourier Transform (STFT) and Continuous Wavelet Transform (CWT) to assess muscle fatigue in dynamic exercise of a 1-km of cycling (time-trial condition). The results of this study indicated that CWT and STFT analyses have provided similar fatigue estimates (slope) (p> 0.05). However, CWT application represents lesser dispersion (p 0.05) according to different methods, it is important to note that these responses seem to show greater values for CWT compared to STFT for 2 superficial muscles. Thereby, we are capable of considering CWT as a reliable and useful method to take into consideration when non-stationary or oscillating exercise models are evaluated.

关键词： Exercise Dynamic Exercise Wavelet Analysis Fourier Analysis

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Actinic Cheilitis: Clinical Characteristics Observed in 75 Patients and a Summary of the Literature of This Often Neglected Premalignant Disorder

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International Journal of Clinical Medicine 2014年第21期5卷 1337-1344页

作者： Ana Maria de Oliveira Miranda thiago de Miranda Ferrari Taiana Campos Leite Karin Soares Goncalves Cunha Eliane Pedra dias Post-Graduate Program in Pathology Medical SchoolFluminense Federal UniversityNiteroiBrazil

Actinic cheilitis can progress to squamous cell carcinoma in 20% of cases. The purpose of this study was to identify the clinical characteristics of 75 patients with actinic cheilitis and to summarise the current literature concerning actinic cheilitis. A total of 75 patients were evaluated over a 3-year period. The medical history, physical examination results and images were collected from each patient. Demographic data were collected and analysed. To review the literature, the relevant data were collected from scientific journals in the last 30 years. The mean age of the patients was 56 years old;42 patients (56%) were female, and 66 patients (88%) were white. Nineteen (25.3%) patients reported at least one symptom, including pain, burning and itching. Sixty-five (86.7%) patients presented actinic cheilitis only in the lower lip. All of the patients reported sun exposure, and 44 (58.6%) patients were exposed for more than 10 years. The main clinical aspects investigated and analysed included dryness (100%), flaking (72%) and white lesions (57.3%). Lip assessment is extremely important in medical and dental care. From the 15 lesions assessed in the presence of actinic cheilitis, the most common clinical characteristics observed were dryness, flaking and white lesions. It is imperative to know the clinical aspects that may be encountered in actinic cheilitis in order to achieve early diagnosis, thus avoiding lip squamous cell carcinoma transformation.

关键词： Actinic Cheilitis Lip Cancer Sun Exposure Premalignant Disorder

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Study on enzymes of industrial interest in digestive viscera: Greater amberjack (Seriola dumerili)

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Journal of Coastal Life Medicine 2017年第6期5卷 233-238页

作者： Vagne Melo Oliveira thiago PajeúNascimento Caio Rodrigo dias Assis Ranilson de Souza Bezerra Ana Lúcia Figueiredo Porto Laboratory of Bioactive Product Technology–LABTECBIO Department of Morphology and Animal PhysiologyFederal Rural University of PernambucoRecife-PEBrazil Laboratory of Enzymology–LABENZ Department of BiochemistryFederal University of PernambucoRecife-PEBrazil Laboratory of Immunopathology Keizo Asami Federal University of PernambucoRecife-PEBrazil

Objective:To investigate the presence of industrial enzymes (trypsin and chymotrypsin) as well as collagenolytic and fibrinolytic activities of the neglected processing waste of greater amberjackSeriola dumerili(S. dumerili). Methods: The investigations on trypsin, chymotrypsin, collagenolytic and fibrinolytic activities in residues in digestive viscera were performed. The enzymes trypsin and chymotrypsin were physicochemically characterized (including pH- and thermo-stabilities and sensitivity to metal ions and inhibitors). The kinetic parameters were also determined. Collagenolytic and fibrinolytic activities of the crude extract were also investigated. Results:The crude extract ofS. dumerili showed enzymatic activity of (1.4600 ± 0.0011 and (0.7100 ± 0.0079) IU/mg protein for trypsin and chymotrypsin, respectively. The optimal temperature and pH was 60°C and 9 for trypsin and 40°C and 8 for chymotrypsin. The main inhibitory ions were in the following order: Fe3+> Cu2+> Zn2+> Cd2+> Hg2+ (trypsin) and Hg2+> Fe3+> Zn2+> Cd2+> Mn2+(chymotrypsin). TLCK and benzamidine were the strongest inhibitors for both enzymes. The crude extract also presented collagenolytic activity [(42.44 ± 0.01) IU/mg] and fibrinolytic activity ((26.70 ± 0.05) IU/mL)Conclusions:The crude extract ofS. dumerili showed potential for reuse of its residues and to provide biomolecules of industrial interest like trypsin and to be a source of fibrinolytic enzymes.

关键词： Biomolecules Enzymes Residues Digestive viscera

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Basosquamous Cell Carcinoma of the Lower Lip Arising from Actinic Cheilitis: Case Report and up Date

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International Journal of Clinical Medicine 2013年第12期4卷 21-24页

作者： Ana Maria de Oliveria Miranda thiago de Miranda Ferrari Daniel Cohen Goldemberg Luciana Pantaleao Andrea Pires Eliane Pedra dias Department of Pathology Medicine schoolFederal Fluminense UniversityRio de JaneiroBrazil.

Background: Basosquamous carcinoma (BSC) is a rare non-melanoma skin cancer, considered to be a subtype of basal cell carcinoma (BCC). BSC often produces distant metastases with a higher risk of recurrence than that of BCC which is not commonly found in the lip. Case Report: A 57-year-old white female patient presented an ulcer on her lower lip that had an ongoing development for over six months. Physical examination, photo documentation, videoroscopy, scraped cytology, toluidine blue test, and biopsy of the ulcer were carried out. Results: Upon physical examination we observed an actinic cheilitis associated with the ulcer. Videoroscopy revealed the presence of fissures and erosion that had not been seen by oroscopy. Toluidine blue test was only positive for the region of the ulcer. Cytological analysis revealed rare nests compatible with carcinoma. Histopathology of the biopsy revealed a carcinoma with nests lined by basal cells associated with areas of squamous differentiation. The patient was then referred to surgery for the removal of the BCC. Analysis of the specimen showed free surgical margins and the immunohistochemical panel did not confirm the initial diagnosis of BCC, indicating a subtype of BSC. After surgery, the patient has been followed by periodic consultations. She is well and without further complications. Coments: BSC is considered to be an aggressive and rare tumor affecting mainly upper face and primarily affects men over 60 years of age. Since our patient is a woman presenting the lesion in the lower lip, this highlights the unusual and interesting presentation of this case report.

关键词： Basosquamous Carcinoma Lip Actinic Cheilitis Basal Cell Carcinoma

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Evaluation of Cytotoxicity of <i>Gossypium barbadense</i>L. Extract in Bone Cord Cells through the Micronucleus Test

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Journal of Biosciences and Medicines 2017年第7期5卷 84-91页

作者： thiago Dornelas de Oliveira Joice Meire Rodrigues thiago Sande Miguel Nayrton Kalys Cruz dos Anjos Juscélio Clemente de Abreu Lamara Laguardia Valente Rocha Raquel Xavier Ligeiro dias Daniel Almeida da Costa Academic of the Graduate Course in Medicine of the University Center of Caratinga Caratinga Brazil Religious Sciences from the Pontifical Catholic University of Sao Paulo Sao Paulo Brazil The Medical School at the Center of Higher Education of Valenca Valenca Brazil The Institute of Health Sciences of the University Center of Caratinga Caratinga Brazil Federal University of Lavras Lavras Brazil Federal University of Vicosa Vicosa Brazil Department of Biochemistry and Molecular Biology at the Federal University of Vicosa Vicosa Brazil Faculty of Medicine of Valenca Valenca Brazil

The cotton plant is a plant belonging to the family Malvaceae and its leaves are often used in folk medicine. The present study aimed to evaluate the mutagenic or antimutagenic activity of the ethanolic extract of Gossypium barbadense L. (EEG) and to analyze its capacity to prevent or repair mutagenic lesions caused by cyclophosphamide (CP). For the Micronucleus test, Swiss mice were divided into 5 groups: negative control;Positive control: treated with 50 mg/kg cyclophosphamide (CP), group receiving EEG 500 mg/kg for 7 days;Group receiving EEG 500 mg/kg for 7 days associated with CP24h before euthanasia;Group who received CP and EEG 500 mg/kg for 7 days. After the treatment period, the animals were euthanized, the bone marrow removed and the blood smear prepared. From this analysis, it was observed that the EEG caused a significant increase in the number of micronucleated erythrocytes, indicating mutagenic activity of the extract. In addition, it was verified that the extract did not present the capacity to prevent, but it presented the capacity of repair of the chromosomal damages caused by CP.

关键词： Gossypium Mutagenesis Phytotherapy

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Conocarpus erectus L., a plant with a high content of structural sugars, ions and phenolic compounds, shows antioxidant and antimicrobial properties promoted by different organic fractions

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Asian Pacific Journal of Tropical Biomedicine 2018年第9期8卷 463-470页

作者： Dayane Kelly dias do Nascimento Santos Weslley Henrique de Oliveira Melo Anastassia Mariáh Nunes de Oliveira Lima Iranildo Joseda Cruz Filho Glaucia Manoella de Souza Lima Tulio Diego da Silva Maiara Celine de Moura Marcia Silva do Nascimento Ana Maria Souto Maior thiago Henrique Napoleao Cristiane Moutinho Lagos de Melo Department of Biochemistry Biosciences Centre Federal University of Pernambuco Department of Antibiotics Biosciences Centre Federal University of Pernambuco Center of Strategic Technologies of the Northeast

Objective: To evaluate the structural and chemical composition of plant and the antioxidant and antimicrobial activities promoted by hexanic, ethanolic and ethyl acetate fractions obtained from leaves of Conocarpus ***: Organic fractions were characterized through UPLC-MS and *** potential was performed through DPPH and molybdenum phosphate *** and antifungal assays were performed in accordance with Clinical and Laboratory Standards Institute ***: The obtained biomass of Conocarpus erectus leaves showed the high presence of glucose(0.45 g/L), cellulose(28.69%), Na(55.126 μg/L) and K(31.163 μg/L).We identified seven compounds in the hexanic and ethyl acetate fractions, and eight compounds in ethanolic ***, phenolic compounds are prevalent in all organic fractions with values of(10.04 ± 0.24),(221.26 ± 1.84),(340.53 ± 0.84) mg/g GAE to hexanic, ethyl acetate and ethanolic fraction, *** results showed a high potential in ethyl acetate fraction(71.82 ± 6.87)% and(10.89 ± 0.05)% in DPPH and molybdenum phosphate techniques, *** ethanolic fraction showed moderate bacteriostatic and bactericidal activity against Staphylococcus aureus and presented a high fungistatic potential for all Candida species ***: Organic fractions obtained from leaves of Conocarpus erectus present antimicrobial and antioxidant properties, and these findings contribute to scientific information for the effectiveness on use of this plant in the development of a phytotherapic compound.

关键词： Combretaceae Phenolic compounds Antimicrobial activity Antioxidant

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Actinic prurigo of the lip: Two case reports

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World Journal of Clinical Cases 2014年第8期2卷 385-390页

作者： Ana MO Miranda thiago M Ferrari Juliana T Werneck Arley Silva Junior Karin S Cunha Eliane P dias Department of Pathology Federal Fluminense UniversityNiteroiRio de Janeiro 24220-008Brazil

Actinic prurigo is a photodermatosis that can affect the skin, conjunctiva and lips. It is caused by an abnormal reaction to sunlight and is more common in high-altitude living people, mainly in indigenous descendants. The diagnosis of actinic prurigo can be challenging, mainly when lip lesions are the only manifestation, which is not a common clinical presentation. The aim of this article is to report two cases of actinic prurigo showing only lip lesions. The patients were Afro-American and were unaware of possible Indian ancestry. Clinical exam, photographs, videoroscopy examination and biopsy were performed, and the diagnosis of actinic prurigo was established. Topical corticosteroid and lip balm with ultraviolet protection were prescribed with excellent results. The relevance of this report is to show that although some patients may not demonstrate the classical clinical presentation of actinic prurigo, the associated clinical and histological exams are determinants for the correct diagnosis and successful treatment of this disease.

关键词： Actinic prurigo Follicular cheilitis Photodermatosis High-altitude Lip diseases

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Interface Recombination &Emission Applied to Explain Photosynthetic Mechanisms for (e–, h+) Charges’ Separation

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World Journal of Nano Science and Engineering 2012年第2期2卷 58-87页

作者： Marco Sacilotti Denis Chaumont Claudia Brainer Mota thiago Vasconcelos Frederico dias Nunes Marcelo Francisco Pompelli Sergio Luiz Morelhao Anderson S. L. Gomes Departament of Eletronics and Systems Federal University of Pernambuco Recife Brazil Department of Physics Federal University of Pernambuco Recife Brazil Institute of Physics University of Sao Paulo Sao Paulo Brazil Nanoform Group ICB & UFR Science and Technology University of Burgundy Dijon France Plant Physiology Laboratory Department of Botany Federal University of Pernambuco Recife Brazil

To copy natural photosynthesis process we need to understand and explain the physics underneath its first step mechanism, which is “how to separate electrical charges under attraction”. But this Nature’s nanotechnological creation is not yet available to the scientific community. We present a new interpretation for the artificial and natural photosynthetic mechanism, concerning the electrical charges separation and the spent energy to promote the process. Interface (e–, h+) recombination and emission is applied to explain the photosynthetic mechanisms. This interpretation is based on energy bands relative position, the staggered one, which under illumination promotes (e–, h+) charges separation through the action of an interface electric field and energy consumption at the interface of both A/B generic materials. Energy band bending is responsible by the interface electric field (and the driving force) for the charges separation. This electric field can be as high or above that for p-n semiconductor junctions (104 - 105 V/cm). This physical effect is not considered by most of the researches. Without an electric field and without spending energy to separate electrical charges, any other existing model violates physical laws. The staggered energy band type is the only energetic configuration that permits charges separation under illumination and energy loss to perform the process. Application to natural photosynthesis and artificial photovoltaic material and their energetic configurations are discussed. Examples for A/B being III-V/III-V, TiO2/materials and II-VI/II-VI staggered energy band gap pairs are presented. In the proposed quantum mechanism, plants are able to eliminate most of the 79% of the absorbed visible light, according to the published reflection and transmission data. Moreover, the proposed mechanism can be applied to explain green fluorescent protein - GFP, charge transfer states - CTS and Fluorescent Resonance Energy Transfer - FRET. As recent litera

关键词： Solar Energy Renewable Energy Photovoltaic Photosynthesis Type II Interfaces Staggered Interface Interface Emission Interface Recombination Quantum Photosynthesis Solar Cell FRET GFP

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