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O artigo discute as políticas referentes ao atendimento público e institucional à Educação Infantil, tomando como foco específico de análise a realidade do município de Florianópolis. Para tanto, são examinados os documentos orientadores dessas políticas em nível nacional, bem como os documentos locais, orientadores do atendimento educacional realizado às crianças e direcionados ao planejamento das ações docentes em suas instituições. Os resultados evidenciam a sintonia das orientações da Rede Municipal de Ensino de Florianópolis com aquelas divulgadas em nível nacional e indicam a intenção, tão marcada nos documentos, de valorização e trabalho com as múltiplas linguagens, em geral, e com a literatura infantil, de modo específico.

En muchas áreas marinas protegidas de Brasil, el turismo ocurre sin planificación, como en la Reserva de Fauna Costera de Tibau do Sul (REFAUTS). En REFAUTS, los turistas utilizan el área de dos pequeñas bahías para realizar diferentes actividades y compartir espacio con delfines. Por lo tanto, el objetivo de este estudio fue caracterizar el flujo turístico en REFAUTS e identificar cuáles áreas son las más frecuentadas por los turistas. Se midió el flujo turístico en REFAUTS por medio de una encuesta realizada entre las 9:00 a. m. y las 4:00 p. m., y se identificaron las zonas más utilizadas por los turistas. REFAUTS recibe a más de 1.400 visitantes por día, la mayoría entre las 11:00 a. m. y las 3:00 p. m., lo que corresponde al tiempo activo del delfín en las bahías. En una misma zona se practican diferentes actividades, como surf, kayak, stand-up paddle, baño y avistamiento de delfines; esta superposición puede generar conflictos socioambientales y efectos negativos sobre los delfines. Se recomienda un plan de zonificación para determinar cuáles áreas deben ser utilizadas por los turistas y establecer áreas exclusivas para delfines.

O objetivo do estudo foi avaliar a eficácia de um programa de reabilitação dos Músculos do Pavimento Pélvico (MPP) para superar a Incontinência Fecal (IF). Metodologia: estudo de caso com uma participante de 64 anos, professora, autónoma, com diagnóstico de IF devido a sequela de cirurgia a prolapso retal. Realizou-se um programa de Treino dos Músculos do Pavimento Pélvico (TMPP), de uma sessão/semana, durante 16 semanas, supervisionado por Biofeedback anorretal. Cada sessão demorou 45 minutos, dos quais 20 minutos para TMPP e o restante para o exame físico, terapia manual, massagem e ensinos/registos da doente: diário de sintomas, supervisão da gestão da alimentação, treino intestinal, técnicas/posturas de defecação e suporte emocional. Na primeira sessão (T0) e na última (T1), foi ainda efetuado a anamnese, Índice de Wexner, Bristol Stool Form Scale (BSFS) e Fecal Incontinence Quality of Life (FIQL). Os resultados evidenciaram ganhos na força dos MPP, que evoluíram de grau 2 para 4 na escala de Oxford modificada; na qualidade de vida (QdV), ausência de perdas fecais, as fezes passaram de consistência tipo 2 para 4 na BSFS. Conclusão: o programa de reabilitação uropélvica, mostrou-se eficaz na reeducação dos MPP e melhorou significativamente a QdV da participante.

Hidradenitis suppurativa is a chronic inflammatory disease associated with multiple comorbidities, and its association with lymphoma has recently been a topic of debate. However, it is still controversial whether this risk can be attributed to the disease itself or whether it has any relationship with immunosuppressive treatment. Here, we describe the case of a patient with severe perianal hidradenitis suppurativa treated with methotrexate and infliximab, whose exacerbation with persistence of severe symptoms refractory to adequate treatment led to the diagnosis of diffuse large non-Hodgkin B-cell lymphoma. It was decided to perform a colostomy to improve perianal sepsis, and immunochemotherapy was proposed.

Apresenta os artigos da seção de Demanda contínua do número 3 do Volume 40, 2022, da revista Perspectiva

Apresentação dos artigos da seção de Demanda contínua do Volume 40, número 4, 2022, da revista Perspectiva.

Apresenta os artigos da seção de Demanda contínua do número 2 do Volume 40, 2022, da revista Perspectiva

Apresenta os artigos da seção de Demanda contínua do número 1 do Volume 40, 2022, da revista Perspectiva

Background: This systematic review and meta-analysis aims to assess composite and aggregate outcomes of observational studies in Crohn’s disease and to evaluate whether the number and type of variables included affect the frequency of the outcome. Methods: MEDLINE [via PubMed], Scopus and Web of Science were searched to identify observational studies that enrolled patients with Crohn’s disease and evaluated a composite or aggregate outcome. The proportion of patients achieving the outcome was determined and a random-effects meta-analysis was performed to evaluate how the frequency of each outcome varies according to the reporting of predefined variables. Results: From 10,257 identified records, 46 were included in the qualitative analysis and 38 in the meta-analysis. The frequency for composite and aggregate outcomes was 0.445 [95% confidence interval (CI): 0.389–0.501] and 0.140 (95% CI: 0.000–0.211), respectively. When comparing composite outcomes by number of included variables, the frequency was 0.271 (95% CI: 0.000–0.405) and 0.698 (95% CI: 0.651–0.746), for one and six variables, respectively. The frequency of the composite outcome varied according to the identity of the variables being reported. Specific pairs of predefined variables had a significant effect in the frequency of composite outcomes. Conclusion: Composite outcomes with increasing number of predefined variables show an increase in frequency. Outcomes including variables such as ‘Surgery’ and ‘Steroids’ had higher frequencies when compared with the ones that did not include these variables. These results show that the frequency of composite outcomes is dependent on the number and type of variables being reported.

O texto apresenta as representações dos jardins de infância no século XIX por meio da circulação das notícias na imprensa periódica do Rio de Janeiro, nos jornais: Gazeta de Notícias, O Cruzeiro e Jornal do Commercio. A escolha dos periódicos foi orientada pela obra de Bastos (2011) que divulga um dos primeiros manuais pedagógicos destinados à educação nos jardins de infância, o Manual para os jardins da infância, publicado pelo Dr. Menezes Vieira em 1882. A pesquisa foi realizada no acervo da Biblioteca Nacional do Brasil, Hemeroteca Digital, pautada pela análise de conteúdo, de acordo com as técnicas de Vala (1986) e Bardin (1977). As notícias apontaram para: polêmicas a respeito da criação das primeiras instituições educacionais desta origem no Brasil; função dos jardins de infância sustentada nos princípios froebelianos; e tripartida com ênfase nos aspectos físico, intelectual e moral.

Editorial do Volume 39, número 4, 2021

BackgroundAnkle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. ObjectiveWe aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. MethodsWe performed a prospective longitudinal cohort study of individuals eligible for workers’ compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure–activities of daily living (FAAM–ADL) and FAAM–Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. ResultsIn total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P

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The authors present a case of purulent pericarditis probably secondary to respiratory infection, a rare entity in the antibiotic era. Pericardial fluid analysis identified streptococci and oral anaerobes as the causative agents. A prolonged and complicated diagnostic and therapeutic course, which included a long stay in the intensive care unit, is described, and a review of purulent pericarditis provided. Pericardial effusion, particularly in the setting of concomitant respiratory infection and immunocompromise or other risk factors, should raise the suspicion of bacterial pericarditis and prompt its timely diagnosis and treatment. Purulent pericarditis can be lethal and has potentially severe complications, so adequate antimicrobial therapy and source control are key.

Este artigo discute a construção histórica e a disseminação de discursos que mantém o outro como estrangeiro, tanto na constituição da subjetividade contemporânea quanto do conhecimento, estabelecendo uma interlocução com as questões atualizadas pela pandemia causada pela Covid-19. Para trabalhar com essas questões, será analisado o predomínio, nas diversas áreas do conhecimento, das concepções sobre o conhecer e o subjetivar restritas à consciência e à razão, bem como as concepções que encampam o inconsciente e o afeto. Diante disso, questiona-se como essas diferentes concepções sobre o conhecer e o subjetivar se relacionam com o discurso do outro como estranho, sustentando-o como responsável pela condição de desamparo e infelicidade e, no caso específico, suas consequências frente à emergência e proliferação da Covid- 19.

Hemorrhagic cystitis is the main adverse effect associated with the clinical use of oxazaphosphorine, resulting in increased oxidative stress and proinflammatory cytokines, which culminate in injury of the bladder tissue. The aim of this study was to evaluate the protective effect of isopropyl gallate (IPG) against ifosfamide (IFOS)-induced hemorrhagic cystitis in mice. The induction of the hemorrhagic cystitis model was carried out using a single dose of IFOS (400 mg/kg, i.p.) four hours after oral pretreatment with IPG (6.25, 12.5, 25, and 50 mg/kg) or saline (vehicle). Mesna (positive control; 80 mg/kg, i.p.) was administered four hours before and eight hours after induction of cystitis. In the present study, IPG 25 mg/kg significantly decreased edema and hemorrhage, with a reduction of the bladder wet weight (36.86%), hemoglobin content (54.55%), and peritoneal vascular permeability (42.94%) in urinary bladders of mice. Interestingly, IPG increased SOD activity (89.27%) and reduced MDA levels (35.53%), as well as displayed anti-inflammatory activity by decreasing TNF-α (88.77%), IL-1β (62.87%), and C-reactive protein (56.41%) levels. Our findings demonstrate that IPG has a substantial protective role against IFOS-induced hemorrhagic cystitis in mice by enhancing antioxidant activity and proinflammatory mechanisms. Thus, IPG represents a promising co-adjuvant agent in oxazaphosphorine-based chemotherapy treatments.

As teorias formuladas por Piaget e Vygotsky exerceram grande influência na formação de professores e debates sobre alfabetização, no Brasil, ao longo do século XX. Os contrapontos entre esses autores sobre a relação entre linguagem e construção do real pela criança é o foco do presente artigo, especialmente, no que diz respeito às diferenças entre desenvolvimento e aprendizagem e pensamento e linguagem. Compreende-se que a linguagem possibilita a comunicação com o outro e consigo mesmo, na medida em que viabiliza a materialização da nossa sensibilidade e a codificação e sistematização da realidade; a sua codificação passa, não só pelo domínio, mas, sobretudo, pela apreensão e recriação desse código linguístico.

O artigo em tela analisa os programas de ensino de Psicologia, Pedagogia e História da Educação propostos para a Escola Normal Superior Vocacional em Santa Catarina, por meio do Decreto n. 217, de 9 de março de 1937. O objetivo será problematizar a coexistência de conteúdos referentes ao método intuitivo e de conhecimentos escolanovistas em diferentes disciplinas. A utilização e o ensino do método intuitivo/lição das coisas fundamentou a reforma de ensino catarinense de 1911, sendo adotado como princípio orientador da educação no estado e assim permaneceu adentrando os anos 1930, momento que em que eram difundidos e estudados os conhecimentos da Escola Nova, indicando que estas duas orientações assumiram centralidade na formação teórico-prática do futuro docente. A perspectiva empirista parece ter sido um dos fundamentos que orientou as discussões educacionais do contexto da época, desde os pareceres de Rui Barbosa sobre o ensino até as ideias de Lourenço Filho na obra Introdução ao estudo da Escola Nova. Nos programas de 1937, as questões que envolviam a aprendizagem, a motivação e as diferenças individuais dos estudantes pautavam-se nessa perspectiva teórica, sendo a aposta na formação da mentalidade científica do professor.

Although infliximab (IFX) is an efficient therapy for ulcerative colitis (UC) patients, a considerably high rate of therapeutic failures still occurs. This study aimed at a better understanding of IFX pharmacokinetics and pharmacodynamics among clinically-asymptomatic UC patients. This was a multicentric and prospective study involving 65 UC patients in the maintenance phase of IFX therapy. There were no significant differences between patients with positive and negative clinical, endoscopic and histological outcomes concerning their IFX trough levels (TLs), area under the IFX concentration vs. time curve (AUC), clearance and antibodies to infliximab (ATI) levels. However, the need to undergo therapeutic escalation later in disease development was significantly associated with higher ATI levels (2.62 μg/mL vs. 1.15 μg/mL, p = 0.028). Moreover, and after adjusting for disease severity, the HR (hazard ratio) for therapeutic escalation was significantly decreased for patients with an ATI concentration below 3 μg/mL (HR = 0.119, p = 0.010), and increased for patients with fecal calprotectin (FC) level above 250 μg/g (HR = 9.309, p = 0.018). In clinically-stable UC patients, IFX pharmacokinetic features cannot predict therapeutic response on a short-term basis. However, high levels of ATIs or FC may be indicative of a future therapeutic escalation.

O turismo de observação de cetáceos (TOC) pode contribuir para a conservação de cetáceos e desenvolvimento econômico local. Este estudo teve como objetivo caracterizar o turismo de observação de botos-cinza, de forma a subsidiar o plano de manejo da Reserva Faunística Costeira de Tibau do Sul (REFAUTS). Durante quatro expedições à área de estudo, foram realizadas entrevistas com mestres de embarcação, censos e vistorias nas embarcações licenciadas e registro do fluxo do TOC. Nós registramos 11 embarcações licenciadas operando na REFAUTS, 368 passeios durante 16 dias de amostragem e um total de 4.717 turistas. Na REFAUTS, os mestres de embarcação não cumpriram a determinação prevista em lei quanto a limitação do número de barcos nas enseadas em 30% dos registros. O TOC na REFAUTS vem desempenhando um papel importante na economia local, contudo é preciso que um plano de ação seja implantado, para assegurar a conservação do boto-cinza na REFAUTS.

Resumo: O ensaio trata da relação entre o contexto social, econômico e político e a organização escolar no Brasil de 1549 a 1889. Destacamos mecanismos ideológicos que operaram no período analisado e suas relações com a construção da escolarização brasileira, buscando apontar o caminho histórico percorrido pelas diretrizes governamentais e as transformações no cenário educacional. Nos primórdios da implantação do sistema escolar circulavam ideologias vinculadas às elites, o que não exigia interferência do Estado para sua legitimação. A partir de meados do século XIX, momento em que essas ideologias não convergiam com seus interesses, observou-se a mudança de postura do Estado, no sentido de aumentar o controle sobre a circulação de ideologias no interior das escolas. Resumen: El ensayo trata acerca de la relación entre el contexto social, económico y político, y la organización escolar en Brasil durante los años comprendidos entre 1549 y 1889. Destacamos mecanismos ideológicos que operaron en el período analizado y sus relaciones con la construcción de la escolarización brasileira. Se busca señalar el camino histórico recorrido por las directrices gubernamentales y las transfromaciones en el escenario educacional. En los inicios de la implantación del sistema escolar circulaban ideologías vinculadas a las élites, lo que no exigía interferencia del Estado para su legitimación. A partir de mediados del siglo XIX, momento que esas ideologías no convergían con sus intereses, se observó el cambio de postura del Estado, en el sentido de aumentar el control sobre la circulación de ideologías en el interior de las escuelas.

Pancreatic cystic lymphangiomas are rare benign lesions that arise from lymphatic vessels, accounting for less than 0.2% of all pancreatic cysts. Typically it is asymptomatic and discovery occurs during imaging exams for non-pancreatic disease. In the past, a definite diagnosis was made through surgery, with complete resection of all tumoral tissue to prevent recurrence. Nowadays, the development of endoscopic ultrasound (EUS) made it possible to identify these cysts combining morphologic ultrasound features, macroscopic aspirated fluid appearance, biochemical and cytological evaluation of the sample. We report two cases of cystic pancreatic lymphangioma diagnosed through EUS, allowing conservative management without surgery. These cases show that cystic pancreatic lymphangioma should be considered in the differential diagnosis of cystic pancreatic lesions and that EUS is an important tool for their recognition.

This paper critically explores the narratives associated with transitions to adulthood and focuses on the earliest occurrences of the private sphere transitions in Portugal. Using data from the European Social Survey (2006), the conclusion is that life course competing perspectives coexist. Survival analysis allows testing the significant effect of generations, although a steady trend towards greater postponement is not observed. Regressions reveal that girls are associated with earlier family transitions and educational background is only significant for the younger generation.

The entry of a multinational into a cluster, a geographic agglomeration in a given place or region of predominantly small and medium enterprises specialized in a given industry or related industries, impacts the incumbent in the cluster. Aiming to identify the main effects of a multinational entry on the firms’ strategy in a cluster, it was analyzed the entry of IKEA, a Swedish multinational, into the cluster of furniture production in Paços de Ferreira and Paredes, in Portugal. In this study, the data collection technique to access primary data was a survey. The sample has small enterprises, which is similar to the structure of firms in the studied cluster. Results show that more than half the sample thinks that the entry of the multinational had not affected them. However, the firms that acknowledge a significant impact, assess that impact as negative. The competitiveness factors that have improved more significantly after IKEA’s entry were new product development and exporting strategies. The main responses of incumbent firms to the multinational entry were internationalization and the development of generic strategies of differentiation and focus based on differentiation.

Background and Aims: Brush cytology during endoscopic retrograde cholangiopancreatography (ERCP) is the most frequently used strategy for obtaining a tissue sample from an indeterminate biliary stricture. A recent study reported that age is a factor associated with positive yields, but further analysis of how age influences the results was lacking. We aimed to evaluate clinical effectiveness of biliary cytology and prognostic factors for a positive outcome, especially age. Methods: This study was a single-center, retrospective, clinical study of 77 consecutive patients who underwent brush cytology during ERCP to obtain a diagnosis of an indeterminate biliary stricture. We compared 2 routine cytology techniques: A (smear); B (centrifugation of the cytological material collected and the cut-off brush + cell block when sufficient amount of material was available). The data were collected aiming to compare the accuracy of the different techniques used and the prognostic factors affecting the outcome, with a particular focus on age. The yield for brush cytology was compared with the gold standard defined as either definitive histology or the long-term clinical course. Results: The overall accuracy of the 2 used methods was 75.3%. Sensitivity was 52.5%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 66.1%. Although not statistically significant, there was a trend toward accuracy for method B compared with method A (80.4 vs. 65.4%; p = 0.153). Multiple logistic regression analysis showed that younger age was the only independent prognostic factor associated with a positive diagnosis (OR 0.95; 95% CI 0.90–0.99; p = 0.039). Receiver operating characteristic curves for age yielded an area under the curve value of 68.2%. On the basis of the Youden index, 69 years was found to be the optimal cutoff for age. Conclusions: In this series, the accuracy of routine biliary brush cytology was not equal for all methods and ages; in particular, younger patients (below 69 years) tended to have a higher probability of a correct diagnosis.

Introduction: Systemic inflammatory diseases are related to an increased risk of lymphoproliferative disorders. Although inflammatory bowel disease (IBD) was also associated with these conditions, population-based studies failed to demonstrate this relationship, and most studies only identified a very small number of cases. In the last few years, concerns arose regarding the role of thiopurines and tumour necrosis factor-alpha (TNF-α)-blocking agents in the development of lymphoma, influencing therapeutic decisions in IBD patients. The aim of this study was to describe a case series of IBD patients who developed a lymphoproliferative disorder in our tertiary referral centre. Material and Methods: The clinical records of all IBD patients who were observed in our unit between January 2007 and December 2016 were retrospectively reviewed, and IBD subjects who were diagnosed with a lymphoproliferative disorder were selected. Clinical and demographic data regarding both conditions were collected. Results: Six IBD patients were diagnosed with a lymphoma - 4 Hodgkin lymphomas and 2 B-cell non-Hodgkin lymphomas - of which 3 corresponded to primary colonic lymphomas. Immunohistochemical analysis detected the presence of Epstein-Barr virus in the tumour cells of 2 patients, both of them with Hodgkin lymphomas. Only 2 patients were previously treated with thiopurines or anti-TNF-α drugs; none of the remaining had any history of immunosuppressive treatment. Discussion and Conclusions: Despite major attention being currently focused on the effect of treatment, which may play the main role in the increased susceptibility to lymphoma in IBD patients, and although it may be difficult to demonstrate, IBD itself may contribute to the development of lymphoproliferative disorders, particularly primary intestinal lymphomas.

Introduction: Lymphoproliferative disorders, particularly non-Hodgkin's and Hodgkin's lymphomas, are rare in patients with inflammatory bowel diseases. The use of thiopurines and infection by Epstein-Barr virus are well-known cofactors that can raise its prevalence. Other risk factors such as disease activity and biological treatment are the subject of discussion, without enough data in the literature to confirm a potential association. Methods: We report a case of Hodgkin's lymphoma in a patient who had been treated with azathioprine and was on long-term monotherapy with infliximab. Conclusions: We stress the importance of recognizing the possible occurrence of a lymphoproliferative disorder in association with anti-tumor necrosis factor-α therapy

Background: Therapeutic drug monitoring (TDM)-based algorithms can be used to guide infliximab (IFX) adjustments in inflammatory bowel disease (IBD) patients. This study aimed to explore a rapid IFX-quantification test from a clinical perspective. Methods: This manuscript describes a prospective cohort study involving 110 ulcerative colitis (UC) patients on the maintenance phase of IFX. IFX trough levels were quantified using a rapid quantification assay and a commonly-used reference kit. Results: Irrespective of the assay used to measure IFX, its through levels were statistically different between patients with and without endoscopic remission (Mayo endoscopic score = 0), as well as between patients stratified by their faecal calprotectin (FC) levels. Despite the fact that the two methods correlated well with each other [Spearman’s rank correlation coefficient = 0.843, p < 0.001; intraclass correlation coefficients = 0.857, 95% confidence interval (CI): 0.791–0.903], there was a discernible systematic variation; values obtained with the reference kit were on average 2.62 units higher than those obtained with the rapid assay. Notwithstanding, 3 µg/ml was shown to be an acceptable cut-off to assess endoscopic status and inflammatory burden levels using both assays. The percentage of patients that had a positive outcome when the IFX concentration measured by the rapid assay ranked above 3 µg/ml was 88% both for a Mayo endoscopic score ⩽ 1 and for an FC concentration

The continuous delivery of a levodopa/carbidopa gel suspension (Duodopa®) into the small bowel through a jejunal tube inserted via percutaneous endoscopic gastrostomy represents a new treatment method in advanced Parkinson disease. Some severe device-related complications have been described in the last few years. Some of them are associated with phytobezoar formation at the pigtail of the catheter. We present the case of a Parkinson disease patient treated with the Duodopa infusion system complicated by jejunal tube fistulization into the colon. We suggest a possible treatment strategy for this complication, which has not been described in the literature to date.

Background: There is scant information on the accuracy of different assays used to measure anti-infliximab antibodies (ADAs), especially in the presence of detectable infliximab (IFX). We thus aimed to evaluate and compare three different assays for the detection of IFX and ADAs and to clarify the impact of the presence of circulating IFX on the accuracy of the ADA assays. Methods: Blood samples from 79 ulcerative colitis (UC) patients treated with infliximab were assessed for IFX levels and ADAs using three different assays: an in-house assay and two commercial kits, Immundiagnostik and Theradiag. Sera samples with ADAs and undetectable levels of IFX were spiked with exogenous IFX and analyzed for ADAs. Results: The three assays showed 81–96% agreement for the measured IFX level. However, the in-house assay and Immundiagnostik assays detected ADAs in 34 out of 79 samples, whereas Theradiag only detected ADAs in 24 samples. Samples negative for ADAs with Theradiag, but ADA-positive in both the in-house and Immundiagnostik assays, were positive for IFX or IgG4 ADAs. In spiking experiments, a low concentration of exogenous IFX (5 µg/ml) hampered ADA detection with Theradiag in sera samples with ADA levels of between 3 and 10 µg/ml. In the Immundiagnostik assay detection interference was only observed at concentrations of exogenous IFX higher than 30 µg/ml. However, in samples with high levels of ADAs (>25 µg/ml) interference was only observed at IFX concentrations higher than 100 µg/ml in all three assays. Binary (IFX/ADA) stratification of the results showed that IFX+/ADA- and IFX-/ADAs+ were less influenced by the assay results than the double-positive (IFX+/ADAs+) and double-negative (IFX-/ADAs-) combination. Conclusions: All three methodologies are equally suitable for measuring IFX levels. However, erroneous therapeutic decisions may occur when patients show double-negative (IFX-/ADAs-) or double-positive (IFX+/ADAs+) status, since agreement between assays is significantly lower in these circumstances.

This article discusses how prejudice and differences are approached in children’s literature aimed at the K-12 education by the National Program of Schoolbook (Programa Nacional do Livro Didático – PNLD, 2013 edition). It is based on the Historical Cultural Theory. Fourteen literary works which deal with prejudice and/or differences were analyzed. In these books, daily life is the usual scenery and the main scope where prejudice originates. Children’s literature should contribute to allow the readers to create other meanings to the prejudicial situations, using their own life experiences as reference. However, it is fundamental to discuss the differences by their historical dimension, considering that they are produced by unequal processes of production of life.