O Ginecologista obstetra e a internet

OBJETIVOS: identificar a influência do uso da internet na prática e ambiente de trabalho médico e verificar como estas mudanças vêm acorrendo entre médicos ginecologistas e obstetras. MÉTODO: foram enviados 1.120 questionários para médicos ginecologistas e obstetras da cidade de São Paulo, dos quais retornaram 152, o correspondente a 13,6 por cento da amostra ou 6,1 por cento do total dos médicos cadastrados na SOGESP. A análise quantitativa do comportamento do médico quanto ao uso da internet foi realizada por meio de proporções, médias, cálculos de desvios-padrão e do teste de associação de qui-quadrado. Através da técnica de Cluster Analysis, foram determinados 4 grupos segundo o perfil dos profissionais relacionado ao uso desta ferramenta. RESULTADOS: não se observou relação de idade, sexo, locais de trabalho e desenvolvimento de apenas uma das especialidades Ginecologia ou Obstetrícia quanto à utilização da internet na prática médica. Observou-se uma tendência de uso mais freqüente entre médicos com doutorado. Quanto aos serviços médicos prestados por e-mail, receber e devolver exames foram as atividades mais realizadas pelos sujeitos da pesquisa. CONCLUSÃO: os ginecologistas obstetras pesquisados utilizam a internet na prática médica para própria atualização, para comunicação com pacientes ou para oferecer serviços às mesmas com diferentes assiduidades. Entretanto, este uso é ainda parcial, talvez relacionado ao receio de interferências negativas na relação com o paciente, além de preocupações quanto à implicações legais, éticas e principalmente econômicas relacionadas à prática profissional

Microstructural Evidence of beta Co(2)Si- phase Stability in the Co-Si System

The aim of this work was to verify the stability of the beta Co(2)Si phase in the Co-Si system. The samples were produced via arc-melting and characterized through Scanning Electron Microscopy (SEM) and Differential Thermal Analysis (DTA). The results have confirmed the stability of the beta Co(2)Si phase, however, a modification of the shape of beta CoSi phase field is proposed in order to fully explain the results.

Indications of Conical Emission of Charged Hadrons at the BNL Relativistic Heavy Ion Collider

Three-particle azimuthal correlation measurements with a high transverse momentum trigger particle are reported for pp, d + Au, and Au + Au collisions at root(S)NN = 200 GeV by the STAR experiment. Dijet structures are observed in pp, d + Au and peripheral Au + Au collisions. An additional structure is observed in central Au + Au data, signaling conical emission of correlated charged hadrons. The conical emission angle is found to be theta = 1.37 +/- 0.02(stat)(-0.07)(+0.06)(syst), independent of p perpendicular to.

Beam-energy and system-size dependence of dynamical net charge fluctuations

We present measurements of net charge fluctuations in Au+Au collisions at s(NN)=19.6, 62.4, 130, and 200 GeV, Cu+Cu collisions at s(NN)=62.4 and 200 GeV, and p+p collisions at s=200 GeV using the dynamical net charge fluctuations measure nu(+-,dyn). We observe that the dynamical fluctuations are nonzero at all energies and exhibit a modest dependence on beam energy. A weak system size dependence is also observed. We examine the collision centrality dependence of the net charge fluctuations and find that dynamical net charge fluctuations violate 1/N(ch) scaling but display approximate 1/N(part) scaling. We also study the azimuthal and rapidity dependence of the net charge correlation strength and observe strong dependence on the azimuthal angular range and pseudorapidity widths integrated to measure the correlation.

System-Size Independence of Directed Flow Measured at the BNL Relativistic Heavy-Ion Collider

We measure directed flow (v(1)) for charged particles in Au + Au and Cu + Cu collisions at root s(NN) = 200 and 62.4 GeV, as a function of pseudorapidity (eta), transverse momentum (p(t)), and collision centrality, based on data from the STAR experiment. We find that the directed flow depends on the incident energy but, contrary to all available model implementations, not on the size of the colliding system at a given centrality. We extend the validity of the limiting fragmentation concept to v(1) in different collision systems, and investigate possible explanations for the observed sign change in v(1)(p(t)).

Forward Neutral-Pion Transverse Single-Spin Asymmetries in p plus p Collisions at s=200 GeV

We report precision measurements of the Feynman x (x(F)) dependence, and first measurements of the transverse momentum (p(T)) dependence, of transverse single-spin asymmetries for the production of pi(0) mesons from polarized proton collisions at s=200 GeV. The x(F) dependence of the results is in fair agreement with perturbative QCD model calculations that identify orbital motion of quarks and gluons within the proton as the origin of the spin effects. Results for the p(T) dependence at fixed x(F) are not consistent with these same perturbative QCD-based calculations.

Longitudinal double-spin asymmetry for inclusive jet production in (p)over-right-arrow + (p)over-right-arrow collisions at root s=200 GeV

We report a new STAR measurement of the longitudinal double-spin asymmetry A(LL) for inclusive jet production at midrapidity in polarized p+p collisions at a center-of-mass energy of root s = 200 GeV. The data, which cover jet transverse momenta 5 < p(T) < 30 GeV/c, are substantially more precise than previous measurements. They provide significant new constraints on the gluon spin contribution to the nucleon spin through the comparison to predictions derived from one global fit to polarized deep-inelastic scattering measurements. They provide significant new constraints on the gluon spin contribution to the nucleon spin through the comparison to predictions derived from one global fit to polarized deep-inelastic scattering measurements.

Spin alignment measurements of the K*(0)(892) and phi(1020) vector mesons in heavy ion collisions at root S(NN)=200 GeV

We present the first spin alignment measurements for the K*(0)(892) and phi(1020) vector mesons produced at midrapidity with transverse momenta up to 5 GeV/c at root s(NN) = 200 GeV at RHIC. The diagonal spin-density matrix elements with respect to the reaction plane in Au+Au collisions are rho(00) = 0.32 +/- 0.04 (stat) +/- 0.09 (syst) for the K*(0) (0.8 < p(T) < 5.0 GeV/c) and rho(00) = 0.34 +/- 0.02 (stat) +/- 0.03 (syst) for the phi (0.4 < p(T) < 5.0 GeV/c) and are constant with transverse momentum and collision centrality. The data are consistent with the unpolarized expectation of 1/3 and thus no evidence is found for the transfer of the orbital angular momentum of the colliding system to the vector-meson spins. Spin alignments for K(*0) and phi in Au+Au collisions were also measured with respect to the particle's production plane. The phi result, rho(00) = 0.41 +/- 0.02 (stat) +/- 0.04 (syst), is consistent with that in p+p collisions, rho(00) = 0.39 +/- 0.03 (stat) +/- 0.06 (syst), also measured in this work. The measurements thus constrain the possible size of polarization phenomena in the production dynamics of vector mesons.

Centrality dependence of charged hadron and strange hadron elliptic flow from root s(NN)=200 GeVAu+Au collisions

We present STAR results on the elliptic flow upsilon(2) Of charged hadrons, strange and multistrange particles from,root s(NN) = 200 GeV Au+Au collisions at the BNL Relativistic Heavy Ion Collider (RHIC). The detailed study of the centrality dependence of upsilon(2) over a broad transverse momentum range is presented. Comparisons of different analysis methods are made in order to estimate systematic uncertainties. To discuss the nonflow effect, we have performed the first analysis Of upsilon(2) with the Lee-Yang zero method for K(S)(0) and A. In the relatively low PT region, P(T) <= 2 GeV/c, a scaling with m(T) - m is observed for identified hadrons in each centrality bin studied. However, we do not observe nu 2(p(T))) scaled by the participant eccentricity to be independent of centrality. At higher PT, 2 1 <= PT <= 6 GeV/c, V2 scales with quark number for all hadrons studied. For the multistrange hadron Omega, which does not suffer appreciable hadronic interactions, the values of upsilon(2) are consistent with both m(T) - m scaling at low p(T) and number-of-quark scaling at intermediate p(T). As a function ofcollision centrality, an increase of p(T)-integrated upsilon(2) scaled by the participant eccentricity has been observed, indicating a stronger collective flow in more central Au+Au collisions.

Enhanced strange baryon production in Au+Au collisions compared to p+p at root s(NN)=200 GeV

We report on the observed differences in production rates of strange and multistrange baryons in Au+Au collisions at s(NN)=200 GeV compared to p+p interactions at the same energy. The strange baryon yields in Au+Au collisions, when scaled down by the number of participating nucleons, are enhanced relative to those measured in p+p reactions. The enhancement observed increases with the strangeness content of the baryon, and it increases for all strange baryons with collision centrality. The enhancement is qualitatively similar to that observed at the lower collision energy s(NN)=17.3 GeV. The previous observations are for the bulk production, while at intermediate p(T),1 < p(T)< 4 GeV/c, the strange baryons even exceed binary scaling from p+p yields.

rho(0) photoproduction in ultraperipheral relativistic heavy ion collisions at root s(NN)=200 GeV

Photoproduction reactions occur when the electromagnetic field of a relativistic heavy ion interacts with another heavy ion. The STAR Collaboration presents a measurement of rho(0) and direct pi(+)pi(-) photoproduction in ultraperipheral relativistic heavy ion collisions at root s(NN) = 200 GeV. We observe both exclusive photoproduction and photoproduction accompanied by mutual Coulomb excitation. We find a coherent cross section of sigma(AuAu -> Au*Au*rho(0)) = 530 +/- 19(stat.) +/- 57(syst.) mb, in accord with theoretical calculations based on a Glauber approach, but considerably below the predictions of a color dipole model. The rho 0 transverse momentum spectrum (p(T)(2)) is fit by a double exponential curve including both coherent and incoherent coupling to the target nucleus; we find sigma(inc)/sigma(coh) = 0.29 +/- 0.03 (stat.) +/- 0.08 (syst.). The ratio of direct pi(+)pi(-) to rho(0) production is comparable to that observed in gamma(p) collisions at HERA and appears to be independent of photon energy. Finally, the measured rho(0) spin helicity matrix elements agree within errors with the expected s-channel helicity conservation.

The characteristics of depressive symptoms in medical students during medical education and training: a cross-sectional study

Background: Medical education and training can contribute to the development of depressive symptoms that might lead to possible academic and professional consequences. We aimed to investigate the characteristics of depressive symptoms among 481 medical students (79.8% of the total who matriculated). Methods: The Beck Depression Inventory (BDI) and cluster analyses were used in order to better describe the characteristics of depressive symptoms. Medical education and training in Brazil is divided into basic (1(st) and 2(nd) years), intermediate (3(rd) and 4(th) years), and internship (5(th) and 6(th) years) periods. The study organized each item from the BDI into the following three clusters: affective, cognitive, and somatic. Statistical analyses were performed using analysis of variance (ANOVA) with post-hoc Tukey corrected for multiple comparisons. Results: There were 184 (38.2%) students with depressive symptoms (BDI > 9). The internship period resulted in the highest BDI scores in comparison to both the basic (p < .001) and intermediate (p < .001) periods. Affective, cognitive, and somatic clusters were significantly higher in the internship period. An exploratory analysis of possible risk factors showed that females (p = .020) not having a parent who practiced medicine (p = .016), and the internship period (p = .001) were factors for the development of depressive symptoms. Conclusion: There is a high prevalence towards depressive symptoms among medical students, particularly females, in the internship level, mainly involving the somatic and affective clusters, and not having a parent who practiced medicine. The active assessment of these students in evaluating their depressive symptoms is important in order to prevent the development of co-morbidities and suicide risk.

Vascular Endothelial Growth Factor Haplotypes Associated with Childhood Obesity

Expansion of adipose tissue in obesity is associated with angiogenesis and adipose tissue mass depends on neovascularization. Vascular endothelial growth factor (VEGF) is the main angiogenic factor in the adipose tissue, and VEGF expression is tightly regulated at both transcriptional and translational levels. However, no previous study has tested the hypothesis that genetic polymorphisms in the VEGF gene could affect susceptibility to obesity. To test this hypothesis, we compared the distribution of genotypes and haplotypes including three VEGF genetic polymorphisms in obese children and adolescents with those found in healthy controls. We studied 172 healthy children and adolescents and 113 obese children and adolescents. Genotypes of three clinically relevant VEGF polymorphisms in the promoter region (C-2578A, G-1154A, and G-634C) of the VEGF gene were determined by TaqMan allele discrimination assay and real-time polymerase chain reaction. VEGF haplotypes were inferred using Haplo. stats and PHASE 2.1 programs. We found no differences in the distributions of VEGF genotypes and alleles (p > 0.05). However, the CAG haplotype was more frequent in the obese group than in the control group (4% versus 0%, respectively, in white subjects; p = 0.008; odds ratio 10.148 (95% confidence interval: 1.098-93.788). Our findings suggest that VEGF haplotypes affect susceptibility to obesity in children and adolescents.

Endothelial Nitric Oxide Genotypes and Haplotypes Are Not Associated with End-Stage Renal Disease

The identification of genetic markers associated with chronic kidney disease (CKD) may help to predict its development. Because reduced nitric oxide (NO) bioavailability and endothelial dysfunction are involved in CKD, genetic polymorphisms in the gene encoding the enzyme involved in NO synthesis (endothelial NO synthase [eNos]) may affect the susceptibility to CKD and the development of end-stage renal disease (ESRD). We compared genotype and haplotype distributions of three relevant eNOS polymorphisms (T(-786) C in the promoter region, Glu298Asp in exon 7, and 4b/4a in intron 4) in 110 healthy control subjects and 127 ESRD patients. Genotypes for the T(-786) C and Glu298Asp polymorphisms were determined by TaqMan (R) Allele Discrimination assay and real-time polymerase chain reaction. Genotypes for the intron 4 polymorphism were determined by polymerase chain reaction and fragment separation by electrophoresis. The software program PHASE 2.1 was used to estimate the haplotypes frequencies. We considered significant a probability value of p < 0.05/number of haplotypes (p < 0.05/8 = 0.0063). We found no significant differences between groups with respect to age, ethnicity, and gender. CKD patients had higher blood pressure, total cholesterol, and creatinine levels than healthy control subjects (all p < 0.05). Genotype and allele distributions for the three eNOS polymorphisms were similar in both groups (p > 0.05). We found no significant differences in haplotype distribution between groups (p > 0.05). The lack of significant associations between eNOS polymorphisms and ESRD suggests that eNOS polymorphisms may not be relevant to the genetic component of CKD that leads to ESRD.

Interethnic Differences in the Distribution of Clinically Relevant Vascular Endothelial Growth Factor Genetic Polymorphisms

Vascular endothelial growth factor (VEGF) is a homodimeric glycoprotein produced mostly in endothelial cells and its transcription is regulated by a variety of growth factors and cytokines. VEGF plays many relevant roles, and three functional polymorphisms in the promoter region of the VEGF gene (C-2578A, G-1154A, and G-634C) have been associated with disease conditions. Although some studies suggest that interethnic differences exist in the distribution of these variants, no previous study has examined this hypothesis in admixed populations. We examined the distribution of these three clinically relevant VEGF single-nucleotide polymorphisms in 175 white and 185 black subjects. We have also estimated the haplotype distribution and assessed associations between these variants. Although the A-2578 and A-1154 variants were more common in whites (39% and 29%, respectively) than in blacks (29% and 16%, respectively; both p < 0.05), no significant interethnic differences were found with regards to the G-634C polymorphism. While the haplotype including the C-2578, G-1154, and G-634 variants was the most common in both ethnic groups, it was more common in blacks than in whites (p < 0.05). The haplotype including the C-2578, A-1154, and G-634 alleles and the haplotype including the C-2578, A-1154, and C-634 alleles were more common in whites than in blacks (both p < 0.05). These results show marked interethnic differences in the distribution of genetic variants of VEGF that may explain, at least in part, interethnic disparities in the susceptibility to cardiovascular diseases.