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1.
Med Oral Patol Oral Cir Bucal ; 29(4): e498-e508, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38288851

RESUMO

BACKGROUND: The aim was to evaluate the frequency, clinicopathological features, and HPV status of oropharyngeal squamous cell carcinoma (OP-SCC) and benign HPV-related epithelial lesions of the oropharynx over the last 25 years. Moreover, a literature review was performed to investigate HPV frequency in OP-SCC samples diagnosed in Brazilian Centers. MATERIAL AND METHODS: A cross-sectional study analyzed OP-SCC, squamous papilloma, verruca vulgaris, and condyloma accuminatum, diagnosed from 1997 to 2021. HPV status of OP-SCC was determined by immunohistochemistry and "in situ" hybridization. Bivariate statistics were performed (p≤0.05). For the literature review, MEDLINE/PubMed, Web of Science, EMBASE, and Scopus were searched. Two independent reviewers assessed the studies for eligibility. RESULTS: Cross-sectional: 211 OP-SCC (63.0%) and 124 benign lesions (37.0%) were included. OP-SCC frequency increased gradually over time, whereas benign lesions had steady trends. OP-SCC affected more males (n= 171; 81.0%), though the relative frequency in females rose over time. Smoking (n= 127; 60.2%) was common in OP-SCC. Nineteen OP-SCC (13.0%) were positive for HPV. HPV-positive and HPV-negative tumors had similar clinicopathological features (p>0.05). Benign lesions predominated in middle-aged (n= 32; 26.7%) women (n= 71; 57.3%), in the soft palate (n=101; 81.5%). LITERATURE REVIEW: 32 studies were included, and in 60% of them, HPV frequency in OP-SCC was less than 25%. CONCLUSIONS: OP-SCC prevalence has been increasing, and it was mostly associated with smoking and alcohol rather than with HPV infection in Brazil. Benign lesions had a stationary frequency over the evaluated period.


Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Humanos , Estudos Transversais , Brasil/epidemiologia , Neoplasias Orofaríngeas/virologia , Neoplasias Orofaríngeas/epidemiologia , Neoplasias Orofaríngeas/patologia , Infecções por Papillomavirus/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/virologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Adulto , Idoso , Fatores de Tempo , Carcinoma de Células Escamosas de Cabeça e Pescoço/virologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia
3.
Med Oral Patol Oral Cir Bucal ; 28(6): e512-e518, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37823302

RESUMO

BACKGROUND: Oral Lichen Planus is a potential malignant disorder and shares clinical and histopathological features with other similar lesions. ALDH1 is a specific biomarker for stem cells identification, however its role in stromal cells of immune inflammatory infiltrate has not been explored. The aim of this study was to investigate the ALDH1 immunoexpression in epithelial and stromal cells of Oral Lichen Planus and other lesions with lichenoid inflammatory infiltrate. MATERIAL AND METHODS: 64 samples of Oral Lichen Planus, Oral Lichenoid Lesions, Oral Leukoplakia and Unspecific Chronic Inflammation were included. ALDH1 was evaluated in both epithelium and stromal cells. ALDH1+ cells ≥ 5% were considered positive in epithelium. Stromal cells were evaluated semi quantitatively. Fields were ranked in scores, according to criteria: 1 (0 to 10%); 2 (11 to 50%) and 3 (>50%). The mean value of the sum of the fields was the final score. Statistical differences among groups were investigated, considering p < 0.05. RESULTS: ALDH1 expression in epithelium was low in all groups without difference among them. ALDH1+ cells in the lamina propria were higher for Lichen Planus [2.0], followed by Leukoplakia [1.3], Lichenoid lesions [1.2] and control [1.1] (p<0.05). CONCLUSIONS: ALDH1 immunoexpression in epithelium of lichenoid potential malignant disorders did not show a contributory tool, however ALDH1 in stromal cells of lichen planus might be involved in the complex process of immune regulation associated with the pathogenesis of this disease.


Assuntos
Líquen Plano Bucal , Erupções Liquenoides , Humanos , Líquen Plano Bucal/patologia , Erupções Liquenoides/patologia , Epitélio/patologia , Células Estromais/patologia
4.
Med Oral Patol Oral Cir Bucal ; 28(6): e588-e595, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37471299

RESUMO

BACKGROUND: With the COVID-19 pandemic, there was a need to adopt online teaching methods in a generalized and sudden way, a situation that led to unprecedented changes in the routine of post-graduate students and research development. This study aimed to analyze the evaluation of remote teaching by graduates of master's degrees and advisors in master's programs in the Oral Pathology and Oral Medicine who needed to adapt to a remote teaching methodology in the pandemic. MATERIAL AND METHODS: This quantitative study evaluated the remote teaching in the perception of master's graduates and advisors from postgraduate programs in Oral Pathology and Oral Medicine. Data were collected through an online Google forms® questionnaire. RESULTS: Participated in the study 14 master graduates and 14 master's advisors. Master graduates evaluated that the professors had a good performance (p=0.001), that the duration of the classes was adequate (p=0.015), that the interaction with professors was satisfactory (p=0.007), that they had good interaction with the advisor (p=0.001), that they were satisfied with the remote guidance process (p=0.038) and that face-to-face practical activities were missed (p=0.002). Master's advisors reported satisfaction with remote teaching, good adaptation (p=0.018) and motivation for remote teaching (p=0.016), they evaluated that students were cooperative in activities (p=0.019) and that face-to-face practical activities were missed (p=0.002). CONCLUSIONS: Despite the difficulties, remote teaching proved to be an effective alternative to face-to-face teaching.


Assuntos
COVID-19 , Pandemias , Humanos , Brasil , Patologia Bucal , Inquéritos e Questionários
5.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 33(supl. 2B): 170-170, abr. 2023. tab
Artigo em Português | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1438058

RESUMO

INTRODUÇÃO: Em 5% a 6% dos IAM não são observadas lesões obstrutivas maiores que 50%, sendo estes classificados como MINOCA (Infarto do Miocárdio com Artérias Coronárias não Obstrutivas). Estudos maiores de longo prazo demonstraram que o prognóstico desses pacientes não é benigno com risco aumentado de morte e novos eventos cardiovasculares. MÉTODOS: Nesta coorte de centro único, todos os pacientes que preencheram os critérios diagnósticos para MINOCA com (1) IAM (2) ausência de estenose coronária ≥ 50% na artéria relacionada ao infarto e (3) nenhuma outra causa específica clinicamente evidente entre março de 2000 e junho de 2022 foram incluídos com um acompanhamento médio de 30 (9,5-67,3) meses. As características da amostra foram descritas em frequências e valores medianos (p25%-p75%). A incidência de um novo evento cardiovascular (CV) em 36 meses após a MINOCA foi estimada pelo método de Kaplan-Meier e o teste de log-rank aplicado para comparar os grupos, acompanhado de intervalos de confiança de 95% e alfa de 5% (R 3,6,1 para MacOS). RESULTADOS: Dos 126 pacientes, 57,1% eram mulheres com cerca de 50 anos de idade (42,0-57,8). 20,6% tinham diabetes, 47,6% dislipidemia, 60,3% hipertensão e 20% IAM prévio. A apresentação clínica predominante foi IAMSSST (55,6%) e 7 pacientes tiveram um episódio de morte súbita abortada durante a internação. 38,1% dos pacientes não tiveram uma etiologia identificada. O mecanismo fisiopatológico mais prevalente foi ruptura da placa < 50% (16,7%), seguido de tromboembolismo (13,5%) e dissecção espontânea de coronária (13,5%). Apenas 3,2% realizaram tomografia de coerência óptica (OCT) ou ultrassom intravascular (IVUS). Nenhum teste provocativo foi realizado. 44,4% realizaram ressonância magnética cardíaca (RMC), com mediana de tempo para realização de 180,0 (60,0-707,5) dias após o evento. Em relação à medicação prescrita na alta hospitalar, 79,4% tiveram betabloqueador e IECA/BRA prescritos, 14,3% iniciaram anticoagulação e apenas 34,1% receberam dupla antiagregação plaquetária (DAP). A incidência do desfecho composto (morte CV, novo IAM, AVC e internação CV) em 36 meses foi de 15% (IC95% 8,9%-24,6%). A incidência de novo IAM foi de 6,3% (N=8), de AVC 2,4% (N=3), de hospitalização CV 17,5% (N=22) e apenas um óbito. CONCLUSÃO: Chama a atenção o risco do desfecho primário em 36 meses. Notavelmente, a maior parte da incidência foi atribuída à hospitalização CV. Um número importante de pacientes recebeu alta sem etiologia conhecida para sua apresentação clínica e, consequentemente, sem tratamento individualizado.

6.
Appl Nanosci ; 12(10): 2829-2839, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35996557

RESUMO

Antimicrobial air filtration techniques have recently been widely studied to enhance indoor air quality and mitigate hazardous airborne microorganisms. Here, CuNPs were incorporated into a commercial polyester fiber surface and Scanning Mobility Particle Sizer was used to measure the adherence between fibers and nanoparticles. An acid pretreatment previous CuNP incorporation was effective against the particle release and enhanced the adhesion between particle and fiber. CuNP was a mixture of Cu0 and Cu2O with a diameter size of 90 nm (SEM micrographs). The permeability of the filter was low, in order of 10-9 m2. The activity against pathogens was tested in loco in a real environment using a filtration prototype apparatus. It was observed that the presence of CuNP mitigated the fungi and bacteria growth not only on the surface but also reduced microbe concentrations after passing through the filter. These results show that CuNP can be used as an inhibitor of various microorganisms, making them a good alternative for indoor environments to control indoor air quality.

7.
J Forensic Odontostomatol ; 40(2): 31-37, 2022 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-36027896

RESUMO

Reports of deaths caused by alligators or crocodiles are rare in the literature. These deaths may be related to sharp force trauma caused by the teeth of these animals, with or without mutilation, or even drowning after seizure and submersion of the victim. It is difficult to forensically identify bodies in cases of mutilation of the upper limbs during the attack or when the corpse is in an advanced stage of skeletonization. Smile photographs are an important source of ante-mortem references for comparison. We report a human identification based on a photograph of a victim, with the absence of limbs caused by an alligator attack and the advanced skeletonization stage due to scavenger fish action in the Amazon within only 36 hours after his disappearance. The description of alligator attacks and the marks observed on the victim's body are essential to help medical and forensic professionals diagnose the injuries found and, consequently, define the cause of death.


Assuntos
Jacarés e Crocodilos , Antropologia Forense , Odontologia Legal , Fotografação , Animais , Brasil , Antropologia Forense/métodos , Odontologia Legal/métodos , Humanos , Floresta Úmida , Sorriso
8.
Medwave ; 22(3): e8718, 2022 Apr 13.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-35435889

RESUMO

Introduction: Bogotá has a Medical Emergency System of public and private ambulances that respond to health incidents. However, its sufficiency in quantity, type and location of the resources demanded is not known. Objective: Based on the data from the Medical Emergency System of Bogotá, Colombia, we first sought to characterize the prehospital re- sponse in cardiac arrest and determine with the model which is the least number of resources necessary to respond within eight minutes, taking into account their location, number, and type. Methods: A database of incidents reported in administrative records of the district health authority of Bogotá (2014 to 2017) was obtained. Based on this information, a hybrid model based on discrete event simulation and genetic algorithms was designed to establish the amount, type and geographic location of resources according to the frequencies and typology of the events. Results: From the database, Bogotá presented 938 671 ambulances dispatches in the period. 47.4% high priority, 18.9% medium and 33.74% low. 92% of these corresponded to 15 of 43 medical emergency codes. The response times recorded were longer than expected, especially in out-of-hospital cardiac arrest (median 19 minutes). In the proposed model, the best scenario required at least 281 ambulances, medicalized and basic in a 3:1 ratio, respectively, to respond in adequate time. Conclusions: Results suggest the need for an increase in the resources that respond to these incidents to bring these response times to the needs of our population.


Introducción: Bogotá cuenta con un sistema de emergencias médicas de ambulancias públicas y privadas que responden a incidentes de salud. No se conoce, sin embargo, su suficiencia en cantidad, tipo y ubicación de recursos demandados. Objetivos: A partir de los datos del sistema de emergencias médicas de Bogotá, Colombia, se buscó primero caracterizar la respuesta pre hospitalaria en paro cardiaco. Luego, con el modelo se buscó determinar cuál sería el menor número de recursos necesarios para responder antes de ocho minutos, teniendo en cuenta su ubicación, número y tipo. Métodos: Se obtuvo una base de datos de incidentes reportados en registros administrativos de la autoridad sanitaria distrital de Bogotá (de 2014 a 2017). A partir de esa información, se diseñó un modelo híbrido basado en la simulación de eventos discretos y algoritmos genéticos para establecer la cantidad, tipo y ubicación geográfica de recursos, conforme a frecuencias y tipología de los eventos. Resultados: De la base de datos, Bogotá presentó 938 671 envíos de ambulancias en el período. El 47,4% de prioridad alta, 18,9% media y 33,74% baja. El 92% de estos correspondieron a 15 de 43 códigos de emergencias médicas. Los tiempos de respuesta registrados fueron mayores a lo esperado, especialmente en paro cardiaco extra hospitalario (mediana de 19 minutos). En el modelo planteado, el mejor escenario requirió al menos 281 ambulancias, medicalizadas y básicas en proporción de 3:1 respectivamente para responder en tiempos adecuados. Conclusiones: Los resultados sugieren la necesidad de incrementar los recursos que responden a estos incidentes para acercar estos tiempos de respuesta a las necesidades de nuestra población.


Assuntos
Serviços Médicos de Emergência , Algoritmos , Ambulâncias , Colômbia , Humanos , Fatores de Tempo
9.
Medwave ; 22(3): e002100, 29-04-2022.
Artigo em Inglês, Espanhol | LILACS | ID: biblio-1368124

RESUMO

INTRODUCCIÓN: Bogotá cuenta con un sistema de emergencias médicas de ambulancias públicas y privadas que responden a incidentes de salud. No se conoce, sin embargo, su suficiencia en cantidad, tipo y ubicación de recursos demandados. OBJETIVOS: A partir de los datos del sistema de emergencias médicas de Bogotá, Colombia, se buscó primero caracterizar la respuesta pre hospitalaria en paro cardiaco. Luego, con el modelo se buscó determinar cuál sería el menor número de recursos necesarios para responder antes de ocho minutos, teniendo en cuenta su ubicación, número y tipo. MÉTODOS: Se obtuvo una base de datos de incidentes reportados en registros administrativos de la autoridad sanitaria distrital de Bogotá (de 2014 a 2017). A partir de esa información, se diseñó un modelo híbrido basado en la simulación de eventos discretos y algoritmos genéticos para establecer la cantidad, tipo y ubicación geográfica de recursos, conforme a frecuencias y tipología de los eventos. RESULTADOS: De la base de datos, Bogotá presentó 938 671 envíos de ambulancias en el período. El 47,4% de prioridad alta, 18,9% media y 33,74% baja. El 92% de estos correspondieron a 15 de 43 códigos de emergencias médicas. Los tiempos de respuesta registrados fueron mayores a lo esperado, especialmente en paro cardiaco extra hospitalario (mediana de 19 minutos). En el modelo planteado, el mejor escenario requirió al menos 281 ambulancias, medicalizadas y básicas en proporción de 3:1 respectivamente para responder en tiempos adecuados. CONCLUSIONES: Los resultados sugieren la necesidad de incrementar los recursos que responden a estos incidentes para acercar estos tiempos de respuesta a las necesidades de nuestra población.


INTRODUCTION: Bogotá has a Medical Emergency System of public and private ambulances that respond to health incidents. However, its sufficiency in quantity, type and location of the resources demanded is not known. OBJECTIVE: Based on the data from the Medical Emergency System of Bogotá, Colombia, we first sought to characterize the prehospital response in cardiac arrest and determine with the model which is the least number of resources necessary to respond within eight minutes, taking into account their location, number, and type. METHODS: A database of incidents reported in administrative records of the district health authority of Bogotá (2014 to 2017) was obtained. Based on this information, a hybrid model based on discrete event simulation and genetic algorithms was designed to establish the amount, type and geographic location of resources according to the frequencies and typology of the events. RESULTS: From the database, Bogotá presented 938 671 ambulances dispatches in the period. 47.4% high priority, 18.9% medium and 33.74% low. 92% of these corresponded to 15 of 43 medical emergency codes. The response times recorded were longer than expected, especially in out-of-hospital cardiac arrest (median 19 minutes). In the proposed model, the best scenario required at least 281 ambulances, medicalized and basic in a 3:1 ratio, respectively, to respond in adequate time. CONCLUSIONS: Results suggest the need for an increase in the resources that respond to these incidents to bring these response times to the needs of our population.


Assuntos
Humanos , Serviços Médicos de Emergência , Fatores de Tempo , Algoritmos , Ambulâncias , Colômbia
10.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 32(supl.2B): 137-137, abr.-jun. 2022. tab., graf.
Artigo em Português | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1377792

RESUMO

INTRODUÇÃO: Estima-se que quatro milhões de pacientes sejam atendidos anualmente em serviços de emergência do Brasil com a queixa de dor torácica, dos quais apenas 10% serão diagnosticados com síndrome coronariana aguda. Nesse contexto, escores de risco cardiovascular, como TIMI, HEART e GRACE, são utilizados como ferramenta para avaliar a possibilidade de doença arterial coronária (DAC). Inicialmente validados para estimar risco de eventos cardíacos intra-hospitalares, a sua associação com a presença de placa obstrutiva é pouco conhecida. OBJETIVO: Correlacionar os achados na Angiotomografia de Coronárias (Angio-TC) e os escores de risco cardiovascular, nos pacientes atendidos com dor torácica no pronto-socorro de hospital terciário. METODOLOGIA: Estudo observacional retrospectivo, baseado na análise de prontuários, no período de janeiro de 2019 a dezembro de 2021. Foram incluídos pacientes atendidos em pronto-atendimento de hospital terciário com a queixa principal de dor torácica aguda com valores de troponina negativos e ECG sem achados isquêmicos, submetidos a Angio-TC. Lesões coronárias ateroscleróticas foram quantificadas quanto à proporção de estenose luminal, sendo consideradas significativas aquelas com estenose ≥ 50% da luz do vaso em ≥ 1 artéria epicárdica relevante. RESULTADOS: Foram avaliados 350 pacientes com idade média de 52,6±11,9 anos, sendo 50% mulheres (Tabela 1). Desses pacientes, 72 (20,6%) apresentaram lesão aterosclerótica significativa em Angio-TC. Sexo masculino (OR: 1,87; IC 95%: 1,08 ­ 3,26), idade > 52 anos (OR: 2,85; CI 95%: 1,6 ­ 5,07), diagnóstico de Diabetes Mellitus (OR 2,17; IC 95%: 1,12 ­ 4,2) e relato de angina típica (OR 2,17; IC 95%: 1,12 ­ 4,2) estiveram associados de forma independente à presença de placa obstrutiva. Mais de 90% dos pacientes com lesão significativa na Angio-TC, apresentavam escore GRACE e TIMI de baixo risco. O escore HEART < 4 foi calculado em 23,6% dos pacientes com placa obstrutiva (Figura 1). CONCLUSÕES: A avaliação baseada em características clínicas e nos escores de risco cardiovascular de forma isolada não se mostrou suficiente para excluir de forma segura o diagnóstico de doença arterial coronária. Dessa forma, a Angio-TC é ferramenta complementar importante para o diagnóstico de coronariopatia nos pacientes com dor torácica aguda, possibilitando o início precoce de terapêutica adequada para a prevenção de novos eventos cardiovasculares.


Assuntos
Dor no Peito , Doença das Coronárias , Serviços Médicos de Emergência , Síndrome Coronariana Aguda , Terapêutica , Troponina , Eletrocardiografia , Fatores de Risco de Doenças Cardíacas
11.
J Phys Condens Matter ; 32(17): 175403, 2020 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31935711

RESUMO

This work is devoted to the investigation of nontrivial transport properties in many-body quantum systems. Precisely, we study transport in the steady state of spin-1/2 Heisenberg XXZ chains, driven out of equilibrium by two magnetic baths at their end points. We take graded versions of the model, i.e. asymmetric chains in which some structure gradually changes in space. We investigate how we can manipulate and control the energy and spin currents of such chains by tuning external and/or inner parameters. In particular, we describe the occurrence of energy current rectification and its reversal due to the application of external magnetic fields. We show that, after carefully chosen inner parameters for the system, by turning on an external magnetic field we can find spin and energy currents propagating in different directions. More interestingly, we may find cases in which rectifications of energy and spin currents occur in opposite directions, i.e. if the energy current is larger when flowing from left to right side, then the spin current is larger if it flows from right to left side. We still describe situations with inversion of the energy current direction as we increase the system asymmetry. We stress that our work aims the development of theoretical knowledge as well as the stimulation of future experimental applications.

12.
Allergol Immunopathol (Madr) ; 47(5): 417-424, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31235184

RESUMO

INTRODUCTION: The association regarding the atopic sensitization to mite aeroallergens and the socio-environmental features is still inconsistent. OBJECTIVES: We analyzed the role played by socioeconomic and environmental factors in the prevalence of sensitization to house dust mite (HDM) allergens, and associated with the risk of developing asthma symptoms. PATIENTS AND METHODS: This is a case-control study conducted with 108 patients, aged 1-17. We inquired about family habits, socioeconomic and environmental features. We applied the International Study of Asthma and Allergies in Childhood questionnaire. RESULTS: We observed patients sensitized to all HDM tested, Derp (42%), Derf (37%) and Blot (33%). Middle family income (OR: 2.74; CI95%: 1.127-6.684), exposure to dog (OR: 3.758, CI95%: 1.127-6.684) and artificial climatization (OR: 4.319, CI95%: 1.398-13.348) were associated with sensitization to Derp. We also observed protective factors, such as sharing of dormitories, washing cycle for bedspreads and the presence of basic sanitation. An increased risk of sensitization to Derf was associated with Blot sensitization (OR: 3.172, CI95%: 1.083-9.292) and presence of mold on the walls (OR: 3.095, CI95%: 1.063-9.008). A protective factor was dormitory sharing. For sensitization to Blot, we observed an increase in the risk associated with Derp sensitization (OR: 3.462, CI95%: 1.191-10.061) and exposure to dog (OR: 3.255, CI95%: 0.987-10.736). In addition, sensitization to Blot increases the risk of developing asthma symptoms (OR: 2.732, CI95%: 0.981-7.606). CONCLUSION: Our data show distinct sociodemographic and environmental relations that lead to HDM sensitization and increased probability of development of allergic diseases.


Assuntos
Asma/epidemiologia , Exposição Ambiental/efeitos adversos , Hipersensibilidade/epidemiologia , Fatores Socioeconômicos , Adolescente , Animais , Antígenos de Dermatophagoides/imunologia , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Poeira , Feminino , Humanos , Lactente , Masculino , Prevalência , Pyroglyphidae/imunologia
13.
Public Health ; 171: 31-40, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31082758

RESUMO

OBJECTIVES: The aims of this study were (1) to identify attributes for patient safety at a primary healthcare level and (2) to analyze conceptions of patients, professionals, and managers about how these attributes are being addressed. STUDY DESIGN: This was a qualitative study. METHODS: Participants were recruited from three primary care settings in Brazil. A total of 37 subjects (four physicians, three nurses, three dentists, three managers, five community assistants, and 19 patients) participated on interviews about their perceptions of safety attributes at the primary care settings involved in the study. Some of these participants attended a focus group meeting. A thematic categorical analysis was carried out to interpret the interviews. RESULTS: The main attributes for patient safety were valued by the participants. However, barriers such as discontinuity of care, interruptions during consultations, breakdowns in the communication, and ineffective teamwork were reported as frequent sources of patient safety issues. Reports of patients left unattended for excessive time because of the lack of accurate information and disruptions that took up to 35 min show that there is still a long way to go for primary care to be safe and effective in the study settings. CONCLUSIONS: It is necessary that the strategies meet the patient safety needs more effectively and efficiently. Further research is needed to understand the complex nature of the problems that affect patient safety in these settings so that appropriate decisions can be made.


Assuntos
Avaliação das Necessidades , Segurança do Paciente , Atenção Primária à Saúde/organização & administração , Pessoal Administrativo/psicologia , Pessoal Administrativo/estatística & dados numéricos , Adulto , Brasil , Comunicação , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
14.
Phys Rev Lett ; 120(6): 067002, 2018 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-29481286

RESUMO

We study the relationship between the pseudogap and Fermi-surface topology in the two-dimensional Hubbard model by means of the cellular dynamical mean-field theory. We find two possible mean-field metallic solutions on a broad range of interactions, doping, and frustration: a conventional renormalized metal and an unconventional pseudogap metal. At half filling, the conventional metal is more stable and displays an interaction-driven Mott metal-insulator transition. However, for large interactions and small doping, a region that is relevant for cuprates, the pseudogap phase becomes the ground state. By increasing doping, we show that a first-order transition from the pseudogap to the conventional metal is tied to a change of the Fermi surface from hole- to electronlike, unveiling a correlation-driven mechanism for a Lifshitz transition. This explains the puzzling link between the pseudogap phase and Fermi surface topology that has been pointed out in recent experiments.

15.
Virchows Arch ; 471(6): 793-798, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28849259

RESUMO

Polymorphous adenocarcinoma (PAC) is a malignant epithelial neoplasm that affects almost exclusively the minor salivary glands, generally described as having a relatively good prognosis. Aberrant nuclear factor erythroid 2 (NF-E2)-related factor (Nrf2) activation in tumor cells has been associated with induction of antioxidant enzymes, such as peroxiredoxin I (Prx I) and increased matrix metalloproteinase (MMP) expression. In this context, the aim of the present study was to evaluate the expression of Nrf2 and correlate it with Prx I and MMP-2 secretion in PAC. Thirty-one cases of PAC from oral biopsies were selected and immunohistochemically analyzed for Nrf2 and Prx I. MMP-2 quantification was performed on primary cell cultures derived from PAC. Oral squamous cell carcinoma (OSCC) cell cultures were used as control. A high immunoexpression of Nrf2 was observed in both the cytoplasm and the nucleus of neoplastic cells from PAC. Nuclear staining for Nrf2 suggested its activation in the majority of the PAC cells, which was confirmed by the high expression of its target gene, Prx I. Quantification of MMP-2 secretion showed lower levels in PAC cell cultures when compared to OSCC cell cultures (p < 0.05). In conclusion, although Nrf2 overexpression has been frequently associated with high-grade malignancies, such relationship is not infallible and, in fact, the opposite may occur in low-grade tumors, such as PAC of minor salivary glands.


Assuntos
Adenocarcinoma/metabolismo , Metaloproteinase 2 da Matriz/biossíntese , Fator 2 Relacionado a NF-E2/biossíntese , Peroxirredoxinas/biossíntese , Neoplasias das Glândulas Salivares/metabolismo , Glândulas Salivares Menores/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Feminino , Humanos , Masculino , Metaloproteinase 2 da Matriz/análise , Pessoa de Meia-Idade , Fator 2 Relacionado a NF-E2/análise , Peroxirredoxinas/análise
16.
Phys Rev Lett ; 117(5): 056402, 2016 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-27517782

RESUMO

We present a theoretical investigation of the electronic structure of rutile (metallic) and M_{1} and M_{2} monoclinic (insulating) phases of VO_{2} employing a fully self-consistent combination of density functional theory and embedded dynamical mean field theory calculations. We describe the electronic structure of the metallic and both insulating phases of VO_{2}, and propose a distinct mechanism for the gap opening. We show that Mott physics plays an essential role in all phases of VO_{2}: undimerized vanadium atoms undergo classical Mott transition through local moment formation (in the M_{2} phase), while strong superexchange within V dimers adds significant dynamic intersite correlations, which remove the singularity of self-energy for dimerized V atoms. The resulting transition from rutile to dimerized M_{1} phase is adiabatically connected to the Peierls-like transition, but is better characterized as the Mott transition in the presence of strong intersite exchange. As a consequence of Mott physics, the gap in the dimerized M_{1} phase is temperature dependent. The sole increase of electronic temperature collapses the gap, reminiscent of recent experiments.

17.
Eye (Lond) ; 29(4): 465-8, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25592129

RESUMO

PURPOSE: To evaluate macular and retinal nerve fibre layer (RNFL) measurements in patients with cyanotic congenital heart disease (cCHD) using spectral domain optical coherence tomography (OCT). PATIENTS AND METHODS: Thirty patients with cCHD (18 females and 12 males, mean age 10.9 years) and 60 healthy controls (35 females and 25 males, mean age 11.2 years) underwent complete ophthalmologic examination and OCT measurements of macular and peripapillary RNFL thickness. RESULTS: Patients with cCHD had significantly thinner measurements in all macular subfields compared with healthy controls (P<0.001). There was no significant difference in peripapillary RNFL thickness between the two groups, with the exception of the upper quadrant, for which thickness measurements were higher in patients with cCHD (P=0.021). CONCLUSIONS: Patients with cCHD showed a significant decrease in macular thickness and a thickened superior quadrant RNFL thickness when compared with healthy controls. This may represent the damage caused by the effect of hypoxia.


Assuntos
Cardiopatias Congênitas/patologia , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Cardiopatias Congênitas/complicações , Humanos , Hipóxia/complicações , Hipóxia/etiologia , Masculino , Tomografia de Coerência Óptica , Acuidade Visual
18.
Dentomaxillofac Radiol ; 44(5): 20140360, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25629721

RESUMO

OBJECTIVES: This study aimed to assess how details on dental restorative composites with different radio-opacities are perceived under the influence of ambient light. METHODS: Resin composite step wedges (six steps, each 1-mm thick) were custom manufactured from three materials, respectively: (M1) Filtek™ Z350 (3M/ESPE, Saint Paul, MN); (M2) Prisma AP.H™ (Dentsply International Inc., Brazil) and (M3) Glacier(®) (SDI Limited, Victoria, Australia). Each step of the manufactured wedge received three standardized drillings of different diameters and depths. An aluminium (Al) step wedge with 12 steps (1-mm thick) was used as an internal standard to calculate the radio-opacity as pixel intensity values. Standardized digital images of the set were obtained, and 11 observers independently recorded the images, noting the number of noticeable details (drillings) under 2 dissimilar conditions: in a light environment (light was turned on in the room) and in low-light conditions (light in the room was turned off). The differences between images in terms of the number of details that were observed were statistically compared using ANOVA, Cronbach's alpha coefficient and Wilcoxon and Kruskal-Wallis tests, with a significance level setting of 5% (α = 0.05). RESULTS: The M2 showed higher radio-opacity, the M1 displayed intermediate radio-opacity and the M3 showed lower radio-opacity, respectively; however, all three were without significance (p > 0.05) compared with each other. The differences in radio-opacity resulted in a significant variation (p < 0.05) in the number of noticeable details in the image, which were influenced by characteristics of details, in addition to the ambient-light level. CONCLUSIONS: The radio-opacity of materials and ambient light can affect the perception of details in digital radiographic images.


Assuntos
Resinas Compostas , Luz , Radiografia Dentária Digital , Alumínio , Desenho de Equipamento , Imagens de Fantasmas , Cimentos de Resina
19.
Phys Rev Lett ; 110(6): 066401, 2013 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-23432281

RESUMO

We present a large N solution of a microscopic model describing the Mott-Anderson transition on a finite-coordination Bethe lattice. Our results demonstrate that strong spatial fluctuations, due to Anderson localization effects, dramatically modify the quantum critical behavior near disordered Mott transitions. The leading critical behavior of quasiparticle wave functions is shown to assume a universal form in the full range from weak to strong disorder, in contrast to disorder-driven non-Fermi liquid ("electronic Griffiths phase") behavior, which is found only in the strongly correlated regime.

20.
Phys Rev E Stat Nonlin Soft Matter Phys ; 86(5 Pt 2): 056203, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23214853

RESUMO

Reaction-diffusion systems may lead to the formation of steady-state heterogeneous spatial patterns, known as Turing patterns. Their mathematical formulation is important for the study of pattern formation in general and plays central roles in many fields of biology, such as ecology and morphogenesis. Here we show that Turing patterns may have a decisive role in shaping the abundance distribution of predators and prey living in patchy landscapes. We extend the original model proposed by Nakao and Mikhailov [Nat. Phys. 6, 544 (2010)] by considering food chains with several interacting pairs of prey and predators distributed on a scale-free network of patches. We identify patterns of species distribution displaying high degrees of apparent competition driven by Turing instabilities. Our results provide further indication that differences in abundance distribution among patches can be generated dynamically by self organized Turing patterns and not only by intrinsic environmental heterogeneity.


Assuntos
Comportamento Competitivo/fisiologia , Cadeia Alimentar , Teoria dos Jogos , Modelos Biológicos , Dinâmica Populacional , Comportamento Predatório/fisiologia , Animais
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