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Our previous research found seven specific factors that cause system delays in ST-elevation Myocardial infarction management in developing countries. These delays, in conjunction with a lack of organized STEMI systems of care, result in inefficient processes to treat AMI in developing countries. In our present opinion paper, we have specifically explored the three most pertinent causes that afflict the seven specific factors responsible for system delays. In doing so, we incorporated a unique strategy of global STEMI expertise. With this methodology, the recommendations were provided by expert Indian cardiologist and final guidelines were drafted after comprehensive discussions by the entire group of submitting authors. We expect these recommendations to be utilitarian in improving STEMI care in developing countries.

ABSTRACT A 2‐year‐old female entire Golden Retriever with a history of being subdued was seen. Her physical and neurological examinations were initially unremarkable, but she acutely progressed to non‐ambulatory paraparesis, with absent cervical or thoracolumbar hyperaesthesia. Magnetic resonance imaging of the vertebral column was performed, showing a well‐defined, intradural–extramedullary mass at the level of the caudal aspect of L2 causing right‐sided ventrolateral marked cord compression. The lesion was T2W hyperintense and mildly hyperintense on T1W images. The signal intensity pattern of this lesion suggested the presence of an early stage hyperacute hemorrhagic process. Cerebrospinal fluid (CSF) was collected from the cisterna magna. CSF analysis exhibited a marked mixed pleocytosis with a slight neutrophilic predominance and elevated protein content. Due to the dog going from being ambulatory to non‐ambulatory paraparetic with absent postural reactions in her pelvic limbs, surgery was performed to allow decompression of the spinal cord. A hemilaminectomy with durotomy was performed. Over the course of the dog's hospitalisation, she had two episodes of left‐sided epistaxis which resolved with local application of adrenaline. Seven days post‐operatively, the dog was discharged being non‐ambulatory paraparetic with voluntary movement in both pelvic limbs. Three months after discharge, the dog was ambulatory with no ataxia noted in the pelvic limbs. As there is no current definitive diagnostic test for steroid responsive meningitis‐arteritis (SRMA) available, the diagnosis of it in this case is supported by the dog's signalment, bloodwork, CSF analysis and response to corticosteroid therapy. This report details a rare clinical presentation, including epistaxis, intradural–extramedullary haemorrhage and absence of cervical or thoracolumbar hyperaesthesia, in a dog diagnosed with suspected SRMA.

Abstract Background Power training (PT) has been shown to be an effective method for improving muscle function, including maximal strength, measured by one-repetition maximum (1RM), and power output in older adults. However, it is not clear how PT intensity, expressed as a percentage of 1RM, affects the magnitude of these changes. The aim of this systematic review (International prospective register of systematic reviews—PROSPERO—registration: CRD42022369874) was to summarize the evidence from randomized clinical trials (RCT) assessing the effects of low-intensity (≤ 49% of 1RM) and moderate-intensity (50–69% of 1RM) versus high-intensity (≥ 70% of 1RM) PT on maximal power output and maximal strength in older adults. Methods We included RCTs that examined the effects of different intensities of power training on maximum strength and power output in older people. The search was performed using PubMed, LILACS, Embase, and Scopus. Methodological quality was assessed using the preferred reporting items for systematic reviews and meta-analyses (PRISMA 2020 statement checklist), and the quality of evidence was determined using the PEDro scale. Data were analyzed using standardized mean differences (SMD) with a 95% confidence interval (CI), and random effects models were used for calculations. A significance level of p ≤ 0.05 was accepted. Results Three RCTs assessing 179 participants, all of high methodological quality, were included. There were no significant differences between different PT intensities in terms of power output gains for leg press [SMD = 0.130 (95% CI − 0.19, 0.45), p = 0.425] and knee extension exercises [SMD: 0.016 (95% CI − 0.362, 0.395), p = 0.932], as well as leg press 1RM increases [SMD: 0.296 (95% CI − 0.03, 0.62); p = 0.072]. However, high-intensity PT (70–80% of 1RM) was significantly more effective than low-intensity PT in increasing 1RM for knee extension exercise [SMD: 0.523 (95% CI 0.14, 1.91), p = 0.008]. Conclusions PT performed at low-to-moderate intensities induces similar power gains compared to high-intensity PT (70–80% of 1RM) in older adults. Nonetheless, the influence of PT intensity on lower-limb strength gains seems to be dependent on the assessed exercise. Cautious interpretation is warranted considering the inclusion of only three studies.

A prevalência de pessoas assumidamente trans e não binárias tem vindo a aumentar, sendo que no mundo hodierno estima-se representarem 0,39% e 1,19% da população mundial, respetivamente. Deste modo, torna-se cada vez mais imperativo que os cuidados de saúde primários estejam preparados para receber e orientar esta população nas suas necessidades de saúde gerais e específicas. Neste sentido, este trabalho pretende estudar o conhecimento dos profissionais de saúde e a sua abordagem aos utentes trans e não binários nas Unidades de Saúde Familiar adstritas ao Centro Hospitalar Universitário do Porto, tendo sido enviado um questionário online à população em estudo. Constatou-se que, embora exista um significativo contacto entre médicos internos e especialistas de medicina geral e familiar com pessoas trans e não binárias na prática clínica, o grau percecionado de conhecimentos e de formação acerca das necessidades específicas desta população parece ser extremamente diminuto. É, assim, fulcral o investimento na formação pré-graduada, bem como na formação pós-graduada.

Cancer cells evade the immune system by downregulating antigen presentation. Although immune checkpoint inhibitors (ICI) and adoptive T-cell therapies revolutionized cancer treatment, their efficacy relies on the intrinsic immunogenicity of tumor cells and antigen presentation by dendritic cells. Here, we describe a protocol to directly reprogram murine and human cancer cells into tumor-antigen-presenting cells (tumor-APCs), using the type 1 conventional dendritic cell (cDC1) transcription factors PU.1, IRF8, and BATF3 delivered by a lentiviral vector. Tumor-APCs acquire a cDC1 cell-like phenotype, transcriptional and epigenetic programs, and function within nine days (Zimmermannova et al., 2023). Tumor-APCs express the hematopoietic marker CD45 and acquire the antigen presentation complexes MHC class I and II as well as co-stimulatory molecules required for antigen presentation to T cells, but do not express high levels of negative immune checkpoint regulators. Enriched tumor-APCs present antigens to Naïve CD8+ and CD4+ T cells, are targeted by activated cytotoxic T lymphocytes, and elicit anti-tumor responses in vivo. The tumor-APC reprogramming protocol described here provides a simple and robust method to revert tumor evasion mechanisms by increasing antigen presentation in cancer cells. This platform has the potential to prime antigen-specific T-cell expansion, which can be leveraged for developing new cancer vaccines, neoantigen discovery, and expansion of tumor-infiltrating lymphocytes.Key features• This protocol describes the generation of antigen-presenting cells from cancer cells by direct reprogramming using lineage-instructive transcription factors of conventional dendritic cells type I.• Verification of reprogramming efficiency by flow cytometry and functional assessment of tumor-APCs by antigen presentation assays.

O estudo teve por objetivo investigar como ocorreu o ingresso das mulheres nas instituições de Ensino Superior, no Brasil, no período compreendido entre 1940 e 1980. O período estudado coincide com a maior inserção das mulheres no mercado de trabalho e, em decorrência disso, da necessidade de preparo profissional. O recorte histórico estipulado abrange um período de quarenta anos e considera os dados disponibilizados pelos Recenseamentos Gerais dos anos de 1940 a 1980, no intuito de identificar a composição do quadro de discentes e docentes e os cursos mais frequentados por mulheres. A pesquisa tem caráter bibliográfico e documental. Os resultados evidenciaram que o ingresso de mulheres, como discentes ou docentes, no Ensino Superior, ocorreu de forma gradativa, sendo pouco observado nos censos de 1940 e 1950, vindo a crescer em 1960 e 1970 e, por fim, a quase igualar-se ao número de homens em 1980.

Devido à pandemia de Covid-19, todos os setores da sociedade necessitaram atender novas demandas. O contexto escolar precisou se adaptar a um ambiente não presencial, com uma gama de variáveis implicantes. Este estudo objetivou averiguar a percepção de professores da Educação Básica sobre possíveis alterações no processo de ensino-aprendizagem devido à pandemia de Covid-19. A amostra foi composta por 34 professores da Educação Básica de escolas públicas e particulares do estado de São Paulo. Este estudo possui caráter qualitativo e os instrumentos utilizados foram um questionário sociodemográfico e outro específico com questões abertas. Os dados foram analisados por meio do software Iramuteq. Os resultados demonstraram que os docentes perceberam implicações no processo de ensinoaprendizagem de seus alunos da Educação Básica durante a pandemia de Covid-19. Foi possível concluir que, entre as dificuldades percebidas pelos professores, a desigualdade relacionada ao acesso instrumental e ao conhecimento sobre o uso das ferramentas tecnológicas foi implicante no processo de aprendizagem de seus alunos e, também, na forma de ensino dos próprios professores. Foram percebidas ainda implicações derivadas do distanciamento social devido ao contexto pandêmico no processo de aprendizagem de alunos da Educação Infantil.

For centuries, cannabis has been used with many different purposes, including medicinal use, usually bypassing any formal approval process. However, during the last decade, interest in cannabis in medicine has been increasing, and several countries, including the United States and Canada, have produced their own legislation about marihuana and cannabis-based medicines. Because of this, interest in research has been increasing and evidence about its medical effects is becoming necessary. We conducted a review examining the evidence of cannabis in pain. Cannabis had been shown to be useful in acute and chronic pain, however recently, these results have been controverted. Within the different types of chronic pain, it has a weak evidence for neuropathic, rheumatic pain, and headache, modest evidence for multiple sclerosis related pain, and as adjuvant therapy in cancer pain. There is no strong evidence to recommend cannabis in order to decrease opioids in patients with chronic use. Even though cannabis-based medications appear to be mostly safe, mild adverse effects are common; somnolence, sedation, amnesia, euphoric mood, hyperhidrosis, paranoia, and confusion may limit the use of cannabis in clinical practice. Risks have not been systematically analyzed. Special concern arises on how adverse effect might affect vulnerable population such as elderly patients. More research is needed in order to evaluate benefits and risks, as well as the ideal administration route and dosages. As cannabis use increases in several countries, answers to these questions might be coming soon.

Abstract Nucleotidases contribute to the regulation of inflammation, coagulation, and cardiovascular activity. Exercise promotes biological adaptations, but its effects on nucleotidase activities and expression are unclear. The objective of this study was to review systematically the effects of exercise on nucleotidase functionality in healthy and unhealthy subjects. The MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were searched to identify, randomized clinical trials, non‐randomized clinical trials, uncontrolled clinical trials, quasi‐experimental, pre‐, and post‐interventional studies that evaluated the effects of exercise on nucleotidases in humans, and was not limited by language and date. Two independent reviewers performed the study selection, data extraction, and assessment of risk of bias. Of the 203 articles identified, 12 were included in this review. Eight studies reported that acute exercise, in healthy and unhealthy subjects, elevated the activities or expression of nucleotidases. Four studies evaluated the effects of chronic training on nucleotidase activities in the platelets and lymphocytes of patients with metabolic syndrome, chronic kidney disease, and hypertension and found a decrease in nucleotidase activities in these conditions. Acute and chronic exercise was able to modify the blood plasma and serum levels of nucleotides and nucleosides. Our results suggest that short‐ and long‐term exercise modulate nucleotidase functionality. As such, purinergic signaling may represent a novel molecular adaptation in inflammatory, thrombotic, and vascular responses to exercise.

Abstract Background Radiological features of the novel 2019 coronavirus disease (COVID-19) have been mainly described in adults. Available literature states that imaging findings in children are similar but less pronounced. The aim of this study is to describe and illustrate the chest computer tomography (CT) features of pediatric COVID-19. Results This retrospective study was based on the review of all the chest CTs performed in pediatric patients with confirmed COVID-19 disease between March 8th and May 26th 2020 (n = 24). The presence of comorbidities and coinfection was assessed, as well as timing of CT examination in relation to the onset of symptoms. CT findings were categorized as typical, indeterminate, atypical, and negative for COVID-19 according to International Expert Consensus Statement on Chest Imaging in Pediatric COVID-19 Patient Management. This study found that CT findings were abnormal in 17 (71%) patients, with 5 (21%), 9 (38%), and 3 (13%) patients considered to have typical, indeterminate, and atypical findings, respectively. The most common CT patterns were multiple ground-glass opacities (58%), followed by consolidations (50%). Six patients showed predominantly peripheral distribution of parenchymal abnormalities. A halo sign was identified in 3 patients and a perilobular pattern was identified in one of the cases with typical findings. Conclusions Chest CT findings in children infected with SARS-CoV-2 can be subtle or absent. Besides recognizing typical findings, radiologists should be able to identify features that favor different or concomitant diagnosis.

Entre as preocupações com a sustentabilidade do planeta destaca-se a produção de alimentos para suprir uma população crescente com o mínimo de impactos ambientais. O uso de indicadores de sustentabilidade tem auxiliado na busca de soluções para melhorar a sustentabilidade. A pegada ecológica mostra a quantidade de espaço do planeta que o indivíduo utiliza para manter seu estilo de vida e tem sido usado em diversas áreas do conhecimento. O objetivo deste trabalho foi avaliar a relação da pegada ecológica com o consumo da carne de frango. Para tanto foi realizado um questionário por meio digital obtendo 501 respostas. com as quais obteve-se a pegada ecológica individual e respectivo consumo da carne de frango. Os dados foram processados no programa computacional WEKA® (3.5), utilizando o algoritmo J48, considerando validação cruzada com amostras de 10 % (10-fold Cross-Validation), para a obtenção de uma árvore de decisão. Dos entrevistados 55% assumem que a carne de frango é a mais consumida em sua casa. Para identificar a relação entre consumo da carne de frango e a pegada ecológica foi gerada uma classificação do consumo da carne de frango a partir do algoritmo J48 com 61% de acurácia. De forma geral o consumo da carne de frango esta associado a pegada ecológica boa.

Este estudo trata da atuação dos Irmãos Maristas, a partir de sua chegada ao Brasil e de sua vinda ao Paraná, no início do século XX. Como objetivo, procurou-se destacar os documentos guardados no Memorial Marista, que contribuem para apontamentos históricos sobre a atuação da Instituição Marista na educação, em Curitiba. Para tanto, abordou-se o processo histórico de constituição e desenvolvimento das primeiras escolas implantadas em Curitiba – o Instituto Santa Maria e o Instituto Paranaense –, bem como de que forma é constituída a Educação Marista nos documentos da instituição no Paraná. A pesquisa teve abordagem histórica, sendo de caráter bibliográfico e documental. O apoio teórico e metodológico foi buscado em Le Goff (2013).

Background Pain is a universal experience and the most common reason for seeking healthcare. Inadequate pain management negatively impacts numerous aspects of patient health. Multidisciplinary treatment programmes, including psychosocial interventions, are more useful for pain management than purely biomedical treatment alone. Recently, researchers showed increasing interest in understanding the role of spirituality/religiosity and spiritual/religious practices on pain experience, with engagement in religious practices, such as prayer, showing to positively impact pain experience in religious individuals. This systematic review will seek to summarise and integrate the existing findings from randomised controlled trials assessing the effects of prayer and prayer-based interventions on pain experience.Methods The systematic review procedures and its report will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Electronic searches in nine databases (Web of Science Core Collection, MEDLINE, SCIELO Citation Index, PubMed, Cochrane Central Register of Controlled Clinical Trial, PsycINFO, Scopus, LILACS and Open-SIGLE) will be performed to identify randomised controlled trials of prayer-based interventions. Two independent researchers will assess studies for inclusion and extract data from each paper. Risk of bias assessment will be assessed independently by two reviewers based on the Consolidated Standards of Reporting Trials statement. Qualitative synthesis of the body of research will be conducted using a narrative summary synthesis method. Meta-analysis will be limited to studies reporting on the same primary outcome. Formal searches are planned to start in June 2021. The final report is anticipated to be completed by September 2021.Discussion Findings will be useful to (1) understand the condition of our knowledge in this field and (2) provide evidence for prayer effectiveness in reducing pain intensity and pain-related stress and increasing pain tolerance in adults experiencing acute or chronic pain.PROSPERO registration number CRD42020221733.

La toxoplasmosis es una de las infecciones más comunes en humanos. Debido a la prevalência de la coinfección con VIH, conlleva un alto impacto en los sistemas de salud. Los seres humanos pueden infectarse de toxoplasma al consumir carne mal cocinada de cordero o cerdo que contenga los quistes tisulares, o al consumir agua o alimentos contaminados con heces de gatos. Una vez presente en el humano, el T. gondii se multiplica en los enterocitos y se disemina por el torrente sanguíneo o linfático, parasitando las células musculares, de la retina y frecuentemente el sistema nervioso central. La técnica más usada para la detección de IgG o IgM contra toxoplasma es la técnica de Elisa. Los anticuerpos IgG pueden estar elevados sin tener una infección activa, por lo que el diagnóstico con IgM y posteriormente con test de avidez es fundamental. El líquido cefalorraquídeo muestra pleocitosis leve e hiperproteinorraquia. Las neuroimágenes son de alta utilidad, ya que usualmente la punción lumbar puede estar contraindicada por lesiones que producen efecto de masa. Idealmente, los pacientes deben ser valorados con resonancia magnética en la que típicamente se observan lesiones eccéntricas en ganglios basales con realce en anillo, posteriormente a la aplicación de contraste. Se debe considerar el linfoma del sistema nervioso central como diagnóstico diferencial. El tratamiento suele iniciarse de manera empírica con pirimetamina, sulfadiazina y ácido folínico, con evaluación de la mejoría imagenológica a los 10-14 días. Si no se encuentra disponible, es posible el tratamiento con trimetoprin-sulfametoxazol. El inicio temprano del tratamiento antibiótico es fundamental para el buen pronóstico; en cuatro meses se observa recuperación neurológica completa en menos del 20 % de los casos y a los tres años de seguimiento en aproximadamente el 30 % de los pacientes.

. O presente artigo objetivou analisar os trabalhos aprovados para comunicação, que compuseram o eixo temático denominado História da Educação, que integrou o Educere, entre os anos de 2008 e 2017. Para tanto, procurou-se selecionar, dentre os artigos aprovados para comunicação, aqueles que compuseram o eixo História da Educação; sistematizar os artigos selecionados e examinar os enfoques priorizados nos artigos. Por meio da metodologia ‘estado do conhecimento’, pode-se chegar a resultados que demonstraram que os 367 artigos que compuseram o eixo de História da Educação publicados no Educere discutiram, dentre outras, acerca das temáticas de instituições e práticas educativas; fontes, arquivos e patrimônios; os intelectuais e o ideário pedagógico; políticas; formação de professores.

Background There has been an increasing interest in studying the potential benefits of so-called complementary and alternative approaches for pain management, such as hypnosis and mindfulness-based interventions. More recently, researchers have been interested in studying the effects of spiritual practices on pain experience as well. These practices may increase pain tolerance, result in a positive re-appraisal of pain and influence other psychological variables that are known to be associated with pain experience. The purpose of this study is to evaluate and compare the immediate effects of self-hypnosis, mindfulness meditation, and a spiritual intervention relative to a control condition for increasing pain tolerance and reducing pain intensity and pain-related stress, in response to experimental painful stimulation.Methods and analysis Recruitment is anticipated to start in November 2020. This is a randomised quantitative experimental mixed-design repeated-measures study with three assessment points: baseline (T0), pre-test (T1) and post-test (T2). Eligible healthy adults will be randomised to one of the four study conditions. Interventions will be a 20-minute audio-guided practice of either self-hypnosis, mindfulness meditation, or Christian prayer. Participants in the control group will not be instructed to use any specific strategy during the painful stimulation. Participants will be submitted to a first cycle of Cold Pressor Arm Wrap. They will then listen to a 20-minute audio recording inducing one of the three interventions, or, in the case of the control group, to a 20-minute audio recording of text from a natural history textbook. Primary outcomes are pain intensity and pain tolerance. Pain-related stress as measured by salivary cortisol level and heart rate variability are secondary outcomes.Ethics and dissemination This study was approved by ISPA—University Institute’s internal Ethics Committee for Research on 3rd December 2018 (reference I/010/12/2018). Findings will be published in peer-reviewed indexed journals and presented at conferences.Trial registration number ClinicalTrials.gov registry (NCT04491630). Stage: pre-results.

Introduction: Although cannabinoids have been used for several years, only recently have their mechanisms of action and therapeutic targets been described. Alterations in the endocannabinoid system have been observed in various diseases and conditions such as pain, inflammation, autoimmune diseases and various specific disorders. Inflammatory bowel disease groups two chronic idiopathic conditions with uncertain pathogeneses in which deregulation of the immune system plays an important role. Alternative treatments need to be developed for these patients since only a minority of patients achieve disease remission. Our goal is to review recent evidence related to the use of cannabis to treat ulcerative colitis and Crohn’s disease. Methods: This is a focused narrative review based on searches of Pubmed and Embase. Relevant articles have been reviewed and summarized in narrative form. Results: The two main components of cannabis, CBD and THC, have been extensively studied, and their anti-inflammatory and antinociceptive effects have been tested. The effects of these components for control of the symptoms of ulcerative colitis and Crohn’s disease have been widely described. However, high quality studies are needed to continue evaluating the efficacy and safety of cannabis use in patients with inflammatory bowel disease.

Este artigo faz um estudo da trajetória de Hernan Cortez, de 1519 até a conquista de Tenochtitlán, em 1521, e procura responder: de acordo com as representações contidas cartas de Cortez, quais razões levaram a civilização asteca a ser conquistada pelo contingente militar liderado pelo espanhol? O artigo buscou analisar algumas razões representadas nas cartas enviadas por Cortez que levaram à conquista de Tenochtitlán e relacioná-las com a historiografia acerca do tema. A metodologia utilizada foi análise das fontes buscando as representações das razões que foram narradas por Cortez, confrontando-as com os estudos de Levy (2010) e Léon-Portilha (2012), dentre outros. Os resultados demonstraram que superioridade bélica, comunicação, influência da religião, ambição, epidemias e o comando de Cortez foram algumas das possíveis razões da conquista.

Background: Aerobic training has been widely indicated to patients with type 2 diabetes. However, there are still few studies comparing acute glycemic and blood pressure effects of different methods of aerobic training. The aim is to compare glycemic and pressure acute responses of continuous aerobic exercise to interval aerobic exercise in patients with type 2 diabetes. Materials and Methods: This study is a randomized, crossover clinical trial. Fourteen patients with type 2 diabetes performed two sessions of aerobic training with different methods (continuous and interval). Continuous session had duration of 35 minutes with intensity of 85–90% of heart rate corresponding to anaerobic threshold (HRAT), while interval session had 45 minutes, with stimulus in intensity of 85–90% of HRAT with recovery in intensity under 85% of HRAT. Capillary glycemia, systolic and diastolic blood pressure were analyzed before and after the sessions. Results: Patients were 63.5 ± 9.8 years old. Glycemia was reduced in both sessions (p

Background: Reduced glutathione (GSH) is one of the main thiols involved in antioxidant defense. Changes in circulatory levels of GSH during exercise are associated with hyperthermia and dehydration. The mechanisms by which these alterations occur are not entirely known. We hypothesize that erythrocytes could be an important source of circulatory GSH during heat stress conditions. We performed two separate experiments to address this hypothesis. Methods: In the first experiment, we sought to investigate the impact of exercise in the heat and dehydration on erythrocyte levels of GSH. A total of 10 men performed 60 min of cycling at 60% VO2peak in the heat (38.0 ± 0.9 °C) or in a control temperate environment (23.0 ± 1.0 °C), both with and without dehydration. Relative humidity ranged from 50 to 70%. Blood samples were taken before and after exercise to measure GSH and oxidized (GSSG) glutathione. In the second experiment, erythrocytes were isolated from blood samples taken at rest and heated in vitro to determine the impact of heat on erythrocyte glutathione content. Tubes with erythrocytes were exposed to water baths at different temperatures; one tube was exposed to a water bath at 35 °C and the other tube to a water bath at 41 °C for a period of 30 min. After exposure to heat, plasma and erythrocytes were extracted for GSH and GSSG analyses. Results: Dehydration decreased circulatory GSH, regardless of ambient temperature (temperate and heat decreased 15.35% and 30.31%, respectively), resulting in an altered redox balance. Heat increased GSH levels in vitro. Conclusion: Our data suggest that dehydration decreases circulatory GSH levels regardless of environmental temperature. In addition, in vitro data suggests that erythrocytes may contribute to the release of GSH during exposure to heat stress.

A professora Pórcia Guimarães Alves (1917-2005) teve formação educacional diferenciada e, concluindo o ensino superior, continuou sua formação com cursos e encontros científicos no Brasil e em outros países. Durante as viagens, trocava missivas com seus familiares, que foram mantidas em arquivo pessoal em plástico denominado “Cartas enviadas ao meu pai”. Procurou-se analisar: qual a escrita de si de Pórcia contida nas cartas trocadas com seus familiares entre 1946 e 1958? Listaram-se os objetivos específicos: mapear os familiares mencionados nas cartas; analisar a materialidade do suporte epistolar procurando aspectos subjetivos em seus registros autobiográficos; e identificar temas narrados nessa escrita.

Objective: to investigate how the interlocution between the Committee for the Prevention of Maternal, Infant and Fetal Death and Primary Health Care takes place in the municipality of Florianópolis, Santa Catarina.Method: a single case study, with a qualitative approach, which had the Committee mentioned as the context, justified by the decisive case of the Northern Health District. ,Four sources of evidence were used in the data collection and the explanatory construction technique in the analysis,.Results: the implantation and organization of the Mother and Infant Mortality Study Technical Group was highlighted, this being the interlocutor agent between the Committee and primary care, which reviews behaviors and work processes and proposes improvements in prenatal care.Conclusion: the management strategies implemented by the Northern District can be taken as an example for other scenarios, especially for the promotion of an effective interlocution with primary care

Objetivo: analizar la aplicación del estudio de caso como método de investigación por la enfermería en las publicaciones científicas nacionales e internacionales. Método: revisión integrativa de literatura realizada en las bases bibliográficas electrónicas PubMed, CINAHL, LILACS y SciELO, utilizando los descriptores estudio de caso, investigación y enfermería. Se incluyeron artículos originales disponibles en su totalidad en formato online, en los idiomas portugués, inglés o español, en el recorte temporal de 2010 a 2015. Resultados: se encontraron 624 estudios, de los cuales 50 atendieron al objetivo. Los autores Yin y Stake fueron los investigadores cuyos referenciales metodológicos de estudio de caso se destacaron en el contexto de la investigación en el área de la enfermería. La aplicación del método abarcó los diferentes campos de actuación de la profesión: educación, asistencia/cuidado y gestión/administración. Conclusión: el estudio de caso como método de investigación se mostró una importante metodología que puede ser ampliamente utilizada por la enfermería en sus diversos campos de actuación al buscar comprender fenómenos relacionados a individuos, grupos u organizaciones.

Resumo Introdução: Receptores de rim de doadores vivos HLA-idêntico apresentam menor risco para rejeição aguda e maior sobrevida do enxerto, quando comparado a outros tipos de transplante. Um regime imunossupressor sem inibidor de calcineurina (ICN) pode melhorar ainda mais esses resultados, através da redução de eventos cardiovasculares, metabólicos e tóxicos secundários a esse fármaco. Objetivo: Avaliar eficácia e segurança do novo tratamento imunossupressor com suspensão planejada do ICN. Métodos: Estudo prospectivo, aberto, braço único de tratamento em único centro para avaliar resultados do transplante renal HLA-idêntico em pacientes que recebem everolimo (EVR), tacrolimo (TAC) e corticoide, seguido da descontinuação do TAC 30 dias pós-transplante. Após análise interina de eficácia, a descontinuação do TAC foi postergada para o terceiro mês pós-transplante, através de emenda ao protocolo. Resultados: Trinta e nove pacientes foram incluídos. Apesar de as médias das concentrações de TAC e EVR terem respeitado os intervalos propostos, cinco pacientes tiveram rejeição aguda comprovada por biópsia e um paciente apresentou um episódio de glomerulite com depósitos de C4D. Esse resultado demandou o fim das inclusões. A proporção de pacientes com proteinúria > 0.5g/L não atingiu mais que 22% dos pacientes em nenhuma visita. Os eventos adversos mais frequentes foram relacionados ao uso de EVR: úlceras orais, dislipidemia e edema periférico. Conclusão: O regime proposto não foi eficaz para essa população, principalmente pela alta incidência de rejeição aguda. O perfil de segurança mostrou que a exposição prolongada a altas concentrações sanguíneas de EVR aumenta a incidência dos eventos adversos relacionados ao fármaco.

A prática cultural de compor um arquivo pessoal pode ser demarcada a partir do século XVIII, oriunda da relação que o indivíduo moderno estabeleceu com seus documentos e a produção de uma memória de si. Essas ações estenderam-se durante o século XIX e século XX, porém foram impactadas pelas mudanças ocorridas na produção de suportes para tal atividade, nas modificações no setor da comunicação e na expansão da prática da leitura e da escrita. Nascida no início do século XX, a professora Pórcia Guimarães Alves constituiu um vasto arquivo – o qual contém documentos forjados nos espaços públicos em que frequentou e outros produzidos em seu ambiente privado – cuja composição serviu de suporte material para uma escrita de si da docente. Dessa forma, o artigo procurou responder: Qual a escrita de si, dada a ler, que o ordenamento e o conteúdo do arquivo pessoal da professora Pórcia Guimarães Alves (1917-2005) proporcionam? O artigo objetivou analisar a escrita de si expressa no arquivo pessoal de Pórcia Guimarães Alves (1917-2005) e delimitou os objetivos específicos em: descrever alguns aspectos e conteúdo do arquivo da professora; procurar possíveis lógicas oriundas da docente para o ordenamento do material guardado em seu arquivo; e sistematizar seu arquivo pessoal, a fim de buscar a escrita de si nele contido. A pesquisa documental contou com o arcabouço teórico-metodológico de Gomes (2004); e Artières (1998). Os resultados levam a crer que no processo de constituição do arquivo pessoal, a professora elaborava uma representação de si ao mesmo tempo em que constituía sua identidade.