42 research outputs found
Estudio de la mortalidad de los médicos en el estado de São Paulo, Brasil, durante el período de 2000 a 2009
This study presents the distribution of causes of death among physicians in the State of São Paulo, Brazil, from 2000 to 2009. The study used the database of the Mortality Information System, Secretariat of Health Surveillance, Brazilian Ministry of Health, limited to death certificates in which the item on occupation was reported as physician. Underlying causes of death were classified according to ICD-10 chapters. The study showed that cardiovascular diseases were the leading cause of death among physicians, followed by cancer and respiratory diseases. Under age 40, doctors of both genders died mainly from external causes. Among cancer deaths, breast cancer was the leading cause in women and lung cancer the first cause in men. The results show the need to promote adequate health habits and disease prevention among physicians, seeking to raise awareness in this group of professionals.El estudio presenta la distribución de las causas de muerte de los médicos en el estado de São Paulo, Brasil, entre los años 2000 y 2009. Se utilizó la base de datos del Sistema de Información sobre Mortalidad del Ministerio de Salud, limitándose a los certificados de defunción, cuya ocupación del finado figuraba como médico. Las principales causas de muerte fueron clasificadas de acuerdo con los capítulos del CIE-10. El estudio muestra que las enfermedades cardiovasculares son la principal causa de muerte entre los médicos durante la última década, seguido del cáncer y las enfermedades respiratorias. Las causas externas fueron las principales causas de muerte en menores de 40 años. El cáncer de mama es responsable de la mayoría de las muertes por cáncer entre las mujeres, mientras que entre los hombres el cáncer de pulmón ocupa el primer lugar. Se sugiere la necesidad de estimular los hábitos adecuados de salud y prevención de enfermedades entre los médicos, buscando informar y sensibilizar a este colectivo de profesionales.O presente estudo apresenta a distribuição das causas de morte de médicos do Estado de São Paulo, Brasil, cujos óbitos ocorreram entre os anos de 2000 e 2009. Utilizou-se o banco de dados do Sistema de Informações sobre Mortalidade, do Ministério da Saúde, limitando-se às declarações de óbito cujo campo de ocupação estava preenchido como médico. As causas básicas de morte foram classificadas de acordo com os capítulos da CID-10. O estudo revela que doenças do aparelho circulatório foram a principal causa de morte entre os médicos na última década, seguidas das neoplasias e doenças do aparelho respiratório. As causas externas constituíram as principais causas de morte abaixo de 40 anos. Câncer da mama foi responsável pela maior parte dos óbitos por neoplasias entre mulheres, enquanto entre os homens a neoplasia de pulmão ocupou a primeira posição. Sugere-se a necessidade de se estimular hábitos adequados de saúde e prevenção de doenças entre os médicos, buscando informar e sensibilizar este grupo de profissionais.Universidade Federal de São Paulo (UNIFESP) Departamento de Medicina PreventivaUniversidade Federal de São Paulo (UNIFESP) Departamento de PsiquiatriaUNIFESP, Depto. de Medicina PreventivaUNIFESP, Depto. de PsiquiatriaSciEL
Influência geológica em assinaturas químicas das águas e solos do Parque Estadual do Itacolomi, Minas Gerais
Measurement of the cosmic ray spectrum above eV using inclined events detected with the Pierre Auger Observatory
A measurement of the cosmic-ray spectrum for energies exceeding
eV is presented, which is based on the analysis of showers
with zenith angles greater than detected with the Pierre Auger
Observatory between 1 January 2004 and 31 December 2013. The measured spectrum
confirms a flux suppression at the highest energies. Above
eV, the "ankle", the flux can be described by a power law with
index followed by
a smooth suppression region. For the energy () at which the
spectral flux has fallen to one-half of its extrapolated value in the absence
of suppression, we find
eV.Comment: Replaced with published version. Added journal reference and DO
Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory
The Auger Engineering Radio Array (AERA) is part of the Pierre Auger
Observatory and is used to detect the radio emission of cosmic-ray air showers.
These observations are compared to the data of the surface detector stations of
the Observatory, which provide well-calibrated information on the cosmic-ray
energies and arrival directions. The response of the radio stations in the 30
to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of
the incoming electric field. For the latter, the energy deposit per area is
determined from the radio pulses at each observer position and is interpolated
using a two-dimensional function that takes into account signal asymmetries due
to interference between the geomagnetic and charge-excess emission components.
The spatial integral over the signal distribution gives a direct measurement of
the energy transferred from the primary cosmic ray into radio emission in the
AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air
shower arriving perpendicularly to the geomagnetic field. This radiation energy
-- corrected for geometrical effects -- is used as a cosmic-ray energy
estimator. Performing an absolute energy calibration against the
surface-detector information, we observe that this radio-energy estimator
scales quadratically with the cosmic-ray energy as expected for coherent
emission. We find an energy resolution of the radio reconstruction of 22% for
the data set and 17% for a high-quality subset containing only events with at
least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO
Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy
We measure the energy emitted by extensive air showers in the form of radio
emission in the frequency range from 30 to 80 MHz. Exploiting the accurate
energy scale of the Pierre Auger Observatory, we obtain a radiation energy of
15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV
arriving perpendicularly to a geomagnetic field of 0.24 G, scaling
quadratically with the cosmic-ray energy. A comparison with predictions from
state-of-the-art first-principle calculations shows agreement with our
measurement. The radiation energy provides direct access to the calorimetric
energy in the electromagnetic cascade of extensive air showers. Comparison with
our result thus allows the direct calibration of any cosmic-ray radio detector
against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI.
Supplemental material in the ancillary file
Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial
Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt
Estudo da mortalidade dos médicos no Estado de São Paulo, Brasil, no período 2000-2009
O presente estudo apresenta a distribuição das causas de morte de médicos do Estado de São Paulo, Brasil, cujos óbitos ocorreram entre os anos de 2000 e 2009. Utilizou-se o banco de dados do Sistema de Informações sobre Mortalidade, do Ministério da Saúde, limitando-se às declarações de óbito cujo campo de ocupação estava preenchido como "médico". As causas básicas de morte foram classificadas de acordo com os capítulos da CID-10. O estudo revela que doenças do aparelho circulatório foram a principal causa de morte entre os médicos na última década, seguidas das neoplasias e doenças do aparelho respiratório. As causas externas constituíram as principais causas de morte abaixo de 40 anos. Câncer da mama foi responsável pela maior parte dos óbitos por neoplasias entre mulheres, enquanto entre os homens a neoplasia de pulmão ocupou a primeira posição. Sugere-se a necessidade de se estimular hábitos adequados de saúde e prevenção de doenças entre os médicos, buscando informar e sensibilizar este grupo de profissionais