O lugar da medicina tropical nas dissertações da escola médica portuense (1875-1923)

Desde 1827 a Escola Médico-Cirúrgica do Porto publicou centenas de teses inaugurais dedicadas a uma grande variedade de temas de natureza médica. Tendo em atenção a predominância da escola de Lisboa na elaboração de um conhecimento científico próprio na área da medicina tropical, o contributo do estabelecimento portuense pode ser considerado residual em termos comparativos. No entanto, entre 1875 e 1923, existem fontes documentais que versam a temática das doenças tropicais, em particular do paludismo/sezonismo. Com este trabalho, pretende-se mostrar os contributos aportados pela Escola Médico-Cirúrgica do Porto a um tema que à partida não despertou um particular interesse dos médicos nortenhos, analisando e enquadrando a produção científica em redor da medicina tropical

O trabalho académico como fonte histórica : as teses inaugurais da escola médico-cirúrgica do porto (1827-1910)

Este estudo pretende realizar uma análise de conteúdo das teses inaugurais da Escola Médico- -Cirúrgica do Porto, publicadas entre 1827 e 1910, com recurso à bibliometria e à categorização temática do corpus documental, bem como ressalvar as potencialidades desses documentos para a historiografia da saúde e das ciências biomédicas em Portugal

Structural characterization of μc-Si:H films produced by R.F. magnetron sputtering

Microcrystalline silicon thin films were produced by R.F. magnetron sputtering. The microstructure of these films has been studied by X-ray diffraction, transmission electron microscopy (TEM) and Raman spectroscopy. Average values of crystalline size and strain obtained by the different tecnhiques used are critically compared and the reasons for the differences are discussed

O trabalho académico como fonte histórica : as teses inaugurais da escola médico-cirúrgica do Porto (1827-1910)

This study intends to carry through a content analysis of the «Teses inaugurais da Escola Médico- Cirúrgica do Porto», published between 1827 and 1910, appealing to bibliometrics and thematic categorization of the corpus, as well as pointing out the potential of these documents for the history of health and biomedical sciences in Portugal

Reflexões sobre os Rankings do Secundário

A publicação de rankings das escolas secundárias, iniciada em 2001, teve um impacto apreciável a vários níveis, suscitando uma série de comentários e especulações nos diversos meios de comunicação social e influindo realmente nas decisões (ou pelo menos aspirações) de muitas pessoas. Beneficiando da disponibilidade de cinco anos de dados, e da possibilidade de comparar os rankings respectivos, o nosso exercício de análise de dados procurou verificar a posteriori até que ponto a hipótese implícita na utilização entusiástica dos rankings é razoável. Ou seja, serão os rankings um indicador fiável da qualidade, ou da eficácia, das escolas? A conclusão geral do exercício aponta para a necessidade de não sobrevalorizar os rankings baseados em exames, sem deixar de os considerar uma peça de informação útil, para as escolas se situarem e para se compararem coisas comparáveis. Por outro lado, sendo evidente o interesse social por este tipo de ordenações, valerá a pena investir na identificação dos factores de caracterização da qualidade que poderão ser utilizados para complementar a informação dos exames, com o cuidado de privilegiar aspectos compreensíveis, objectivos e acessíveis

Dynamic security assessment by fuzzy inference

This paper reports an experience on the application of fuzzy reasoning to the fast assessment of the dynamicsecurity of an isolated power system with high wind power penetration. The inference method is a TakagiSugenotype system with a small number of rules, optimized for each specific learning set by a standard methodincluded in the MATLAB Fuzzy Logic Toolbox. The methodology is demonstrated in a contingency study in thenetwork of Crete that showed good results in the test set. The paper discusses some implementation issues andpossible future developments of the approach

What is the real role of the equilibrium phase in abdominal computed tomography?

OBJECTIVE: To evaluate the role of the equilibrium phase in abdominal computed tomography. MATERIALS AND METHODS: A retrospective, cross-sectional, observational study reviewed 219 consecutive contrast-enhanced abdominal computed tomography images acquired in a three-month period, for different clinical indications. For each study, two reports were issued - one based on the initial analysis of non-contrast-enhanced, arterial and portal phases only (first analysis), and a second reading of these phases added to the equilibrium phase (second analysis). At the end of both readings, differences between primary and secondary diagnoses were pointed out and recorded, in order to measure the impact of suppressing the equilibrium phase on the clinical outcome for each of the patients. The extension of the exact Fisher's test was utilized to evaluate the changes in the primary diagnosis (p 0.999). As regards secondary diagnoses, changes after the second analysis were observed in five cases (2.3%). CONCLUSION: For clinical scenarios such as cancer staging, acute abdomen and investigation for abdominal collections, the equilibrium phase is dispensable and does not offer any significant diagnostic contribution.OBJETIVO: Avaliar a necessidade de realização da fase de equilíbrio nos exames de tomografia computadorizada de abdome. MATERIAIS E MÉTODOS: Realizou-se estudo retrospectivo, transversal e observacional, avaliando 219 exames consecutivos de tomografia computadorizada de abdome com contraste intravenoso, realizados num período de três meses, com diversas indicações clínicas. Para cada exame foram emitidos dois pareceres, um avaliando o exame sem a fase de equilíbrio (primeira análise) e o outro avaliando todas as fases em conjunto (segunda análise). Ao final de cada avaliação, foi estabelecido se houve mudança nos diagnósticos principais e secundários, entre a primeira e a segunda análise. Foi utilizada a extensão do teste exato de Fisher para avaliar a modificação dos diagnósticos principais (p 0,999). Com relação aos diagnósticos secundários, cinco exames (2,3%) foram modificados. CONCLUSÃO: Para indicações clínicas como estadiamento tumoral, abdome agudo e pesquisa de coleção abdominal, a fase de equilíbrio não acrescenta contribuição diagnóstica expressiva, podendo ser suprimida dos protocolos de exame.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Diagnóstico por ImagemHospital São LuizUNIFESP, EPM, Depto. de Diagnóstico por ImagemSciEL

Depression in medical students: insights from a longitudinal study

Background: Factors associated with depression of medical students are poorly understood. The purpose of this study is to determine the prevalence of depression in medical students, its change during the course, if depression persists for affected students, what are the factors associated with depression and how these factors change over time. Methods: A prospective, longitudinal observational study was conducted at the Medical School of the University of Minho, Portugal, between academic years 2009-2010 to 2012-2013. We included students who maintained their participation by annually completing a questionnaire including Beck Depression Inventory (BDI). Anxiety and burnout were assessed using the State Trait Anxiety Inventory and Maslach Burnout Inventory. Surveys on socio-demographic variables were applied to evaluate potential predictors, personal and academic characteristics and perceived difficulties. ANOVA with multiple comparisons were used to compare means of BDI score. The medical students were organized into subgroups by K-means cluster analyses. ANOVA mixed-design repeated measurement was performed to assess a possible interaction between variables associated with depression. Results: The response rate was 84, 92, 88 and 81% for academic years 2009-2010, 2010-2011,2011-2012 and 2012/2013, respectively. Two hundred thirty-eight medical students were evaluated longitudinally. For depression the prevalence ranged from 21.5 to 12.7% (academic years 2009/2010 and 2012/2013). BDI scores decreased during medical school. 19.7% of students recorded sustained high BDI over time. These students had high levels of trait-anxiety and choose medicine for anticipated income and prestige, reported more relationship issues, cynicism, and decreased satisfaction with social activities. Students with high BDI scores at initial evaluation with low levels of trait-anxiety and a primary interest in medicine as a career tended to improve their mood and reported reduced burnout, low perceived learning problems and increased satisfaction with social activities at last evaluation. No difference was detected between men and women in the median BDI score over time. Conclusions: Our findings suggest that personal factors (anxiety traits, medicine choice factors, relationship patterns and academic burnout) are relevant for persistence of high levels of BDI during medical training. Medical schools need to identity students who experience depression and support then, as early as possible, particularly when depression has been present over time.info:eu-repo/semantics/publishedVersio

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception