Resumo A isquemia aguda de extremidades é um evento raro na população pediátrica, com incidência estimada em 26 a cada 100.000 internações, sendo a maioria associada a trauma ou iatrogenia. O tratamento ideal para esses quadros não está bem estabelecido pela literatura, havendo a tendência ao tratamento não invasivo. Relatamos o caso de uma lactente que apresentou isquemia dos quatro membros secundária a complicações hemodinâmicas após realização de cirurgia cardíaca complexa, apresentando preservação tecidual expressiva com o tratamento conservador.

Abstract Acute limb ischemia is a rare event in the pediatric population, with an estimated incidence of 26 per 100,000 admissions, the majority of which are associated with trauma or iatrogeny. The ideal treatment for these cases is not well-established in the literature, although there is a tendency to choose noninvasive treatment. We report the case of an infant who suffered ischemia to all four limbs secondary to hemodynamic complications after complex heart surgery and in whom significant tissue preservation was achieved with conservative treatment.

RESUMO Objetivo: determinar as alterações do padrão do fluxo sanguíneo após tratamento endovascular do aneurisma sacular de aorta abdominal com triplo stent. Métodos: estudo hemodinâmico de sete suínos das raças Landrace e Large White portadores de aneurismas saculares de aorta abdominal infrarrenal artificialmente produzidos segundo técnica descrita. Os animais foram submetidos a implante de triplo stent para correção endovascular do aneurisma e reavaliados por duplex scan quanto ao padrão do fluxo sanguíneo antes e após o implante dos stents. A análise estatística foi realizada com o teste Mann-Whitney não pareado. Resultados: verificou-se uma queda significativa da velocidade sistólica média de 127,4cm/s na fase pré-stent para 69,81cm/s na fase pós-stent. Houve ainda mudança no padrão do fluxo de turbilhonar no saco aneurismático para laminar intrastent. Conclusão: o estudo demonstrou alterações do padrão do fluxo sanguíneo do aneurisma sacular de aorta abdominal após tratamento endovascular com triplo stent.

ABSTRACT Objective: to determine the blood flow pattern changes after endovascular treatment of saccular abdominal aortic aneurysm with triple stent. Methods: we conducted a hemodynamic study of seven Landrace and Large White pigs with saccular aneurysms of the infrarenal abdominal aorta artificially produced according to the technique described. The animals were subjected to triple stenting for endovascular aneurysm. We evaluated the pattern of blood flow by duplex scan before and after stent implantation. We used the non-paired Mann-Whitney test for statistical analysis. Results: there was a significant decrease in the average systolic velocity, from 127.4cm/s in the pre-stent period to 69.81cm/s in the post-stent phase. There was also change in the flow pattern from turbulent in the aneurysmal sac to laminate intra-stent. Conclusion: there were changes in the blood flow pattern of saccular abdominal aortic aneurysm after endovascular treatment with triple stent.

Abstract Objective: To consider modifications in an experimental model of saccular aortic aneurysm, aiming at better reproducibility, to be used in the development of vascular prostheses. Methods: Experimental study in two phases, developed in the Center of Experimental Surgery and Bioterium (CCEB) of the University of Health Sciences of Alagoas (UNCISAL), with 11 hybrid swine, female, mean weight of 20 ± 5 kg, according to modifications in the Perini technique was performed. In the first phase, the aneurysm was confectioned with bovine pericardial patch. In the second phase, fifteen days later, the patency of the aneurysms was confirmed by Doppler ultrasonography. The described variables were aortic and aneurysm sac patency, incidence of rupture, morbidity and mortality. The statistical analysis program used was STATA v.8. Results: All animals survived to the procedures. Surgical mean time was 73 minutes. Aneurysm rupture, proximal or distal aortic thrombosis, visceral or legs ischemia weren't observed. Parietal thrombus formation was observed in all of the aneurysms, two of which (18%; IC 95% = 3.98 - 48.84) were occluded and nine (82%; IC 95% = 51.15 - 96.01) were patent. Conclusion: In this series, the modifications carried out in the technique related to the surgical approach, race, anesthesia, and imaging exams reproduced the experimental model, reducing its costs, without hindering the analysis of the variables. The satisfactory patency ratio allows the method to be used in experimental models for the development of vascular prostheses.

Neste artigo pretende-se reconstruir historicamente o processo de diáspora de três congregações religiosas femininas portuguesas em decorrência da política religiosa estabelecida pela República de Portugal em 1910. Serão privilegiadas as Irmãs Franciscanas Hospitaleiras, as Irmãs Dominicanas de Santa Catarina de Sena e as Irmãs de Jesus, Maria e José, sobretudo, estas duas últimas que se estabeleceram no estado de São Paulo em 1912. Nesse período, São Paulo já havia despontado como o principal estado do Brasil e, em seus limites, as expansões cafeeira, urbana e ferroviária, envolvidas pela imigração europeia e pela industrialização, abriam novas possibilidades de atuação às mulheres, ainda que a modernização tecnológica não fosse acompanhada no campo das relações de gênero. As mulheres freiras de Portugal se juntaram às outras que aqui estavam e assumiram a gestão de asilos, escolas, faculdades e hospitais, chefiando homens e atraindo mulheres que almejavam outras perspectivas de vida para além daquelas oferecidas pela sociedade civil da época.

This article attempts to reconstruct historically the process of diaspora of three Portuguese Women's Religious congregations as a result of the new religious policy established by the Republic of Portugal in 1910: will be favored Franciscan Hospitaller Sisters of the Dominican Sisters of St. Catherine and the Sisters of Jesus, Mary and Joseph, especially the latter two who have settled in São Paulo in 1910. During this period, St. Paul had already emerged as the leading state in Brazil and its boundaries, the coffee expansion, urbanization, railway, surrounded by European immigration and industrialization, opened new possibilities for working women, although the technological modernization was not accompanied in the field of gender relations. Women sisters from Portugal joined the others who were here and took over the management of nursing homes, schools, colleges and hospitals, leading men and women who longed for attracting other perspectives of life beyond those offered by civil society of the time.

Partindo da análise de documentação consultada em arquivos do Brasil e do Vaticano, o artigo discute as relações entre Estado e Igreja Católica Apostólica Romana (ICAR) no período da Primeira República brasileira. Considera-se que a Proclamação da República em 15 de novembro de 1889 foi associada, por algumas parcelas das elites brasileiras da época, ao ideário do progresso e da civilização, sendo uma de suas primeiras tarefas a extinção do padroado em 7 de janeiro de 1890. O laicismo determinado nessa ocasião pelo Decreto 119-A revelou-se, entretanto, ambíguo e pragmático. Livre das amarras constitucionais do padroado, o Estado criou um novo campo de relações com as diferentes confissões religiosas, segundo os seus próprios interesses institucionais. Nesse contexto, a ICAR, por sua vez, empreendeu um processo de reforma e reorganização eclesiástica cujo fulcro consistiu na criação de dioceses e jurisdições similares - um amplo e complexo processo territorial, político e discursivo ao qual se pode denominar diocesanização.

Based on documentation found in archives in Brazil and the Vatican, this article discusses the relationship between the state and the Roman Catholic Church in Brazil in the period 1889-1930. The Proclamation of the Republic on 15 November 1889 was associated by some members of Brazilian elites at the time with the ideas of progress and civilization, and one of its first tasks was the extinction of padroado on 7 January 1890. However, the laicism determined at that time under Decree 119-A has proved ambiguous and pragmatic. Freed from the constitutional constraints of the padroado, the state built a new field of relations with different religions according to its institutional interests. In this context, the Roman Catholic Church also initiated a process of ecclesiastical reform and reorganization whose core consisted of the creation of dioceses and similar jurisdictions - a broad and complex territorial, political and discursive process which can be called diocesanization.