The tomato (Solanum lycopersicon L.) crop has great economic relevance, being one of the most processed agricultural products worldwide. Some pesticides are chemically stable and can remain in food even after processing. In this context, the objective of this work was to analyze food products derived from tomatoes (extract, sauce and ketchup), regarding the levels of pesticide residues. Fifteen samples were acquired from Vale do Jaguaribe, Ceará, Brazil. Six pesticides (bifenthrin, chlorothalonil, chlorpyrifos, cyfluthrin, pyriproxyfen, trifluralin) authorized by Agência Nacional de Vigilância Sanitária (Anvisa) for tomato cultivation were selected for the study. QuEChERS (quick, easy, cheap, effective, rugged, safe) extraction and gas chromatography coupled to mass spectrometry (GC-MS) were used in method validation, according to the recommendations of SANTE 11312/2021 guidelines. Statistical analyses of linearity showed that the six pesticides studied were classified as heterocesdastic. Limits of detection (LOD) and quantification (LOQ) values (0.01-0.03 and 0.03-0.10 mg kg-1, respectively) were below the established maximum residue limits (MRLs) for tomatoes. Accuracy and precision (78-121 and 2.3-16.7%, respectively) were satisfactory. The results indicated that among the 15 analyzed samples, one active ingredient was detected (0.05 mg kg-1) in a tomato sauce sample, lower than MRLs (Anvisa 0.15 mg kg-1 and FAO 0.3 mg kg-1). The results show the relevance of monitoring pesticide residues in tomato-derived products and the validation of new methodologies for food control.

Resumo Introdução: Os efeitos na saúde a médio e longo prazo da infeção por SARS-CoV-2 têm sido cada vez mais reconhecidos. O nosso objetivo foi avaliar a qualidade de vida associada à saúde em doentes críticos tratados em enfermaria avançada e determinar fatores associados a maus resultados. Métodos: A qualidade de vida associada à saúde em doentes SARS-CoV-2 foi avaliada 3 e 6 meses após a alta, através do Questionário Respiratório de Saint George e o EuroQoL 5-dimensões 3-níveis. A prevalência de ansiedade, depressão e stress pós-traumático foi avaliado nas duas visitas. Doentes com questionário Respiratório de Saint George normal ou com melhoria significativa (grupo 1) foram comparados com os que não melhoraram (grupo 2) aos 6 meses. Resultados: Cento e dezassete doentes foram avaliados. A mediana de idades foi 64 anos e 61,5% eram homens. Entre T3 e T6 foi observada redução no score total e domínios específicos do Questionário Respiratório de Saint George (p <0,001). Melhoria longitudinal foi observada no domínio da mobilidade (p = 0,029) e na Escala Visual Analógica (p=0,006) do EuroQoL 5-dimensões 3-níveis. A prevalência de ansiedade, depressão e stress pós-traumático reduziram ao longo do tempo (p <0,05). Após 6 meses, 4,3% dos doentes não tinham retomado ao trabalho e 23% estavam no grupo 2. O grupo 2 teve piores resultados no Questionário Respiratório de Saint George (<0,001); e nos domínios da mobilidade (p = 0,002), auto-cuidado (p <0,001) e atividades habituais (p = 0,014) do EuroQoL 5-dimensões 3-níveis. A regressão logística efetuada para comparar os grupos 1 e 2 não identificou associação entre os resultados e a idade, género, comorbilidades, demora média, ordem de não intubação, pior PaO2/FiO2 durante a hospitalização e técnica de suporte respiratório. Conclusão: Vários domínios na qualidade de vida associada à saúde parecem ser afetados após uma infeção grave por SARS-CoV-2 mas a melhoria parece ser a norma para a maioria dos doentes.

Abstract Introduction: Mid- and long-term health effects of SARS-CoV-2 infection have been increasingly recognised. Our goal was to evaluate health-related quality of life in critically ill patients, treated in a non-ICU setting, and associated factors with poor outcomes. Methods: Health-related quality of life in SARS-CoV-2 survivors was evaluated 3 and 6 months after discharge, using St. George's Respiratory Questionnaire and EuroQoL 5-Dimension 3-Level. Anxiety, depression, and post-traumatic stress disorder prevalence was accessed at both visits. Patients with normal or significant improvement on St. George's Respiratory Questionnaire (group 1) were compared to those who did not improve (group 2) at 6 months. Results: 117 patients were analysed. Median age was 64 years and 61.5% were male. Between T3 and T6 was observed a reduction in total and specific domain scores of St. George's Respiratory Questionnaire (p <0.001). Longitudinal improvement was observed in mobility domain (p = 0.029) and Visual Analogic Scale (p = 0.006) of EuroQoL 5-Dimension 3-Level. Rates of anxiety, depression, and post-traumatic stress disorder decline over time (p <0.05). After 6 months, 4.3% of participants have not return to work and 23% were in group 2. Group 2 had worst results in St. George's Respiratory Questionnaire (p<0.001); and in mobility (p = 0.002), self-care (p <0.001), and usual activities (p = 0.014) of EuroQoL 5-Dimension 3-Level domains. Logistic regression comparing groups 1 and 2 did not find association between outcomes and age, gender, comorbidities, length of stay, do not intubate order, worst PaO2/FiO2 during hospitalization and respiratory support technique. Conclusion: Several domains of health-related quality of life seem to be impaired after SARS-CoV-2 severe infection but improvement seems to be the rule for most patients.

ABSTRACT Introduction: Diabetes is the leading cause of chronic kidney disease and end-stage kidney disease worldwide. A kidney biopsy in a diabetic patient must be considered when non-diabetic renal disease is suspected, such as in the presence of a rapid decline in renal function or severe unexplained proteinuria. However, the timing and criteria of a biopsy remain controversial in these patients. We aimed to identify clinical and histological markers that could help differentiate diabetic and non-diabetic renal disease and decide if this invasive approach is needed or not. Subjects and Methods: We reviewed 30 years of biopsies from diabetic patients performed at a tertiary hospital. We collected patient demographic data, biopsy indications, histological findings, and clinical and analytical data both at the moment of the biopsy and extensive followup. Based on kidney biopsy findings, patients were categorized as isolated diabetic nephropathy, non-diabetic kidney disease, or non-diabetic kidney disease superimposed on diabetic nephropathy (diabetic kidney disease). Results and Discussion: We enrolled 92 patients, mostly with type 2 diabetes, with a mean age of 62.9 ± 13.2 years. Nearly half of them had isolated diabetic nephropathy (53.3%), and 15.2% had diabetic nephropathy superimposed on non-diabetic kidney disease, comprising a total of 63 patients (68.5%) with diabetic kidney disease. Twenty-nine patients (31.5%) were considered to have non-diabetic kidney disease. These last patients were significantly less likely to need insulin therapy (p=0.002), had more frequently an acute deterioration of renal function (p=0.01), lower albumin levels (p=0.03), and a higher prevalence of microhematuria (p=0.001). We found the latter to be an independent predictor of non-diabetic kidney disease. Further, patients with the primary diagnosis of diabetic nephropathy had higher survival than those who had nondiabetic kidney disease, contradicting published data. Conclusions: The criteria for performing a biopsy in diabetic patients still lack consensus, although the priority to identify non-diabetic kidney disease prevails. We believe the non-diabetic kidney disease predictors we describe may prove helpful for determining the need for a histological assessment in diabetic patients.

Introduction: Membranoproliferative glomerulonephritis is a pattern of glomerular injury on renal biopsy with characteristic light microscopic changes, namely mesangial hypercellularity, endocapillary proliferation and double contour formation along the glomerular capillary walls. This pattern does not represent a disease per se but can occur as a result of different pathologic processes. Case Presentation: We present a case of a 37-year-old caucasian female patient with thrombotic microangiopathy (TMA), severe hypertension and immune-complex-mediated glomerulonephritis, secondary to hepatitis C virus (HCV) infection. Steroid therapy and fresh-frozen plasma infusions were started, with progressive improvement of lab results. Treatment of HCV infection was started with direct-acting antiviral therapy. The results of the genetic study of the complement alternative pathway regulatory proteins were positive for a homozygote variant of the gene CFHR5 (p.Val110Ala) and a homozygote deletion on CFHR3/CFHR1 proteins. Discussion: Hypertension is commonly associated with TMA and could explain the features of this case. Nevertheless, the differential diagnosis is often difficult because TMA caused by hypertension is indistinguishable from all other entities. The finding of a homozygote variant of the gene CFHR5, and a homozygote deletion on CFHR3/CFHR1 proteins, raised the possibility that this case might have been an Atypical Hemolytic Uremic Syndrome (aHUS) triggered by the endothelial damage caused by the HCV-related cryoglobulinemic glomerulonephritis

Introduction: Improved technique and materials have allowed us to prolong the life of hemodialysis vascular access using percutaneous transluminal balloon angioplasty (PTA). Central vein stenosis (CVS) can lead to arteriovenous access dysfunction or thrombosis. Our goal was to revise the outcomes of our institution, evaluating the immediate and long-term results in the endovascular treatment of CVS. Methods: We reviewed the data of all procedures performed in our center, Centro Hospitalar e Universitário de Coimbra, during a five-year period July 2009 and June 2014, selecting the cases that had a CVS diagnosis. We evaluated the immediate result and the existence of complications during the procedure. Long-term evaluation of PTA results of the 26 patients with a successful PTA was made through contact with the referring hospital or hemodialysis clinic. Primary and assisted access patencies were verified retrospectively at 3, 6, 12 and 24 months post-intervention. Results: Of the 31 patients in whom there were an intention to treat, in 5 the stenosis was in fact an occlusion and the guide wire could not be passed. The remaining 26 patients underwent PTA with improvement/resolution of the lesion. Consequently, we had an initial intervention success rate of 83.9%. Minor complications occurred in 2 patients. The long-term follow-up results were primary patency at 3, 6, 12 or 24 months of 88%, 63%, 31% and 6%, respectively, and assisted primary patency at 3, 6, 12 or 24 months of 88%, 76%, 70% and 46%, respectively. Conclusion: CVS is a common problem in hemodialysis patients. Our center results are consistent with current literature and demonstrate the benefit of PTA with excellent immediate success. However, the high recurrence rate of these stenoses requires in many cases multiple PTA, with low long-term primary patency.

Introdução: A patologia dermatológica é muitas vezes motivo de consulta em medicina geral e familiar. O caso clínico descrito corresponde ao diagnóstico de líquen plano, que é um problema de saúde pouco frequente. O líquen plano é uma doença inflamatória crónica, imuno-mediada e de etiologia desconhecida que afeta entre 0,22 a 5% da população mundial. Descrição do caso: Sexo masculino, 60 anos de idade, sem antecedentes patológicos de relevo. Em outubro de 2014 recorre à consulta de cuidados de saúde primários por apresentar quadro com cerca de um mês de evolução, caracterizado por pápulas pruriginosas nas mãos, tronco, dorso e pés. Apresentava ainda estriação das unhas das mãos com dor à palpação do leito ungueal. Ao exame objetivo apresentava pápulas poligonais, achatadas e bem definidas, de coloração violácea, agrupadas e confluentes, na face anterior dos punhos, na região anterior do tórax, no dorso e na face anterior dos tornozelos. Como lesões associadas apresentava hipocratismo digital, eritema palmar, eritema periungueal, com atingimento da matriz, adelgaçamento da lâmina ungueal, sulcos longitudinais em toda a superfície ungueal e dor à palpação da raiz das unhas. Foi pedida colaboração de dermatologia via ALERT®, tendo sido sugerido o diagnóstico de líquen plano. Iniciou terapêutica com corticoterapia tópica que não foi eficaz, tendo posteriormente iniciado griseofulvina 500mg/dia, com melhoria do quadro. Comentário: Este caso clínico enfatiza a importância da comunicação entre especialidades para a abordagem dos problemas do doente, de forma a agilizar o tratamento e a melhorar a qualidade de vida.

Introduction: Skin complaints are a common cause for visits to the primary care physician. This case report describes a patient diagnosed with lichen planus, which is an uncommon health problem. It is a chronic, inflammatory, immune-mediated disease of unknown etiology that affects from 0.2 to 5% of the population. Case report: A 60 year-old male patient, previously in good health, saw his family physician in October 2014 complaining of pruritic papules on the hands, trunk, back and feet, which appeared one month before. He also had pain on pressure over his fingernails. Physical examination showed polygonal, flat, well-defined purple papules, grouped and confluent, on the anterior surface of the wrists, chest, back, and the ventral region of the ankle. The patient also presented nail clubbing, erythema on the anterior surface of the hands, periungueal erythema affecting the matrix, thinning, and longitudinal grooves of the nail surface and pain on palpation of the root of the nails. The primary care physician requested dermatology consultation via the on-line referral service (ALERT®). The dermatologist suggested the diagnosis of lichen planus. The patient began therapy with a topical corticosteroid, which was not helpful. He subsequently started treatment with griseofulvin, 500mg per day, which was effective. Comment: This case report emphasizes the importance of communication between specialists to address the patient's problems, in order to expedite treatment and improve quality of life.

Introdução: O envolvimento renal no lupus eritematoso sistémico é um fator determinante de morbimortalidade e um importante marcador de prognóstico. Apesar das elevadas taxas de remissão alcançadas com as terapias imunossupressoras atuais, a abordagem da nefrite lúpica refratária permanece um desafio. A imunoglobulina intravenosa pode ser uma alternativa nestes casos, embora a experiência com a sua administração prolongada seja limitada. Caso clínico: Apresentamos o caso de uma doente de 35 anos de idade com lupus eritematoso sistémico diagnosticado em 1999, aos 23 anos. Em 2002, por síndrome nefrótica, realizou biópsia renal que revelou nefrite lúpica classe IV OMS. Iniciou imunossupressão com prednisolona e ciclofosfamida, com conversão posterior a azatioprina. A proteinúria diminuiu para níveis subnefróticos. Em 2005, por recidiva da síndrome nefrótica repetiu biópsia renal, que foi sobreponível à anterior. Fez conversão de azatioprina para micofenolato de mofetil e a proteinúria reduziu para valores subnefróticos. Em finais de 2006, nova recidiva de síndrome nefrótica associada a artralgia, azotemia, leucopenia e anemia condicionou uma terceira biópsia. O diagnóstico foi o mesmo, sem lesões de esclerose. Iniciou imunoglobulina intravenosa num protocolo de ciclos mensais de 400mg/Kg/dia durante 5 dias consecutivos, mantendo prednisolona e micofenolato de mofetil. Alcançou remissão parcial e completa após o terceiro e décimo ciclos, respetivamente. O esquema de imunoglobulina passou a trimestral após o primeiro ano. Em 2010 engravidou, tendo-se convertido o micofenolato de mofetil para azatioprina. No último trimestre da gravidez agravou a proteinúria e o parto foi induzido à 32ª semana. Atualmente a doente apresenta remissão completa da nefrite, ausência de manifestações extra-renais de lúpus ou de efeitos adversos da imunoglobulina intravenosa. Conclusão: A imunoglobulina intravenosa tem eficácia documentada num amplo espectro de manifestações de lúpus. Pode ser uma opção nos casos de nefrite lúpica resistente aos imunossupressores convencionais. A sua administração prolongada parece ser segura.

Background: Renal involvement in systemic lupus erythematosus is a major factor of morbidity/mortality and a significant prognostic determinant. Despite the high rates of remission with current immunosuppressive therapies, management of refractory lupus nephritis is still cumbersome. In these cases, intravenous immunoglobulin may be a suitable option, regardless of the scarcity of experience with long-term use. Case report: We present the case of a 35-year-old female with a diagnosis of systemic lupus erythematosus since 1999, at the age of 23. In 2002, due to a nephrotic syndrome, a kidney biopsy was performed, which revealed WHO class IV lupus nephritis. She underwent immunosuppression with prednisolone and cyclophosphamide, with subsequent conversion to azathioprine. Proteinuria decreased to subnephrotic levels. In 2005, a nephrotic syndrome relapse occurred and kidney biopsy was repeated, with a similar result. After conversion from azathioprine to mycophenolate mofetil, proteinuria decreased to subnephrotic levels. At the end of 2006, a nephrotic syndrome relapse accompanied by arthralgia, azotaemia, leukopaenia and anaemia led to a third biopsy. The diagnosis was again the same, with no sclerotic lesions. Intravenous immunoglobulin was initiated in a protocol of monthly courses of 400mg/Kg/day during 5 consecutive days, maintaining prednisolone and mycophenolate mofetil. She achieved partial and complete remission after the third and tenth courses, respectively. The treatment scheme of immunoglobulin became quarterly from the second year until today. In 2010, she became pregnant and mycophenolic acid was replaced by azathioprine.In the last trimester of pregnancy proteinuria worsened, thus delivery was induced at the 32nd week. Nowadays the patient is in complete remission of nephritis, without extrarenal manifestations of lupus and no adverse effects of intravenous immunoglobulin. Conclusion: Intravenous immunoglobulin has been effectively used in a broad spectrum of lupus manifestations. As this case illustrates, it may be an option in the treatment of lupus nephritis resistant to conventional immunosuppressive therapy. Its long-term use appears to be safe.

Este trabalho teve como objetivo investigar a síntese de fruto-oligossacarídeos (FOS) a partir de inulinase imobilizada de Kluyveromyces marxianus NRRL Y-7571, em meio aquoso e orgânico usando sacarose como substrato. A estratégia sequencial de planejamento experimental foi utilizada para otimizar a produção de FOS em ambos os sistemas. Para o meio orgânico, um planejamento fatorial fracionário 2(6-2) foi utilizado, visando avaliar os efeitos principais da temperatura, concentração de sacarose, pH, razão molar água/solvente orgânico, atividade da enzima e concentração de polietilenoglicol. Para o sistema aquoso, um planejamento composto central, tendo como variáveis independentes a atividade da enzima e a concentração de sacarose, foi utilizado. A maior produção de FOS foi obtida no sistema orgânico (18,2 ± 0,9% (m/v), a 40 ºC, pH 5.0, concentração de sacarose de 60% (m/m), atividade enzimática de 4 U.mL-1 e razão molar água/solvente orgânico de 25/75% (m/m). Em meio aquoso, a maior produção de FOS foi de 14,6 ± 0,9% (m/m) a 40 ºC, pH 5,0, concentração de sacarose de 60% (m/m) e atividade enzimática de 4,0 U.mL-1.

This work investigated the fructooligosaccharides (FOS) synthesis by immobilized inulinase obtained from Kluyveromyces marxianus NRRL Y-7571 in aqueous and aqueous-organic systems using sucrose as substrate. The sequential strategy of experimental design was used to optimize the FOS conversion in both systems. For the aqueous-organic system, a 2(6-2) fractional design was carried out to evaluate the effects of temperature, sucrose concentration, pH, aqueous/organic ratio, enzyme activity, and polyethylene glycol concentration. For the aqueous system, a central composite design for the enzyme activity and the sucrose concentration was carried out. The highest fructooligosaccharides yield (Y FOS) for the aqueous-organic system was 18.2 ± S0.9 wt%, at 40 ºC, pH 5.0, sucrose concentration of 60% (w/w), enzyme activity of 4 U.mL-1, and aqueous/organic ratio of 25/75 wt%. The highest Y FOS for the aqueous system was 14.6 ± 0.9 wt% at 40 ºC, pH 5.0, sucrose concentration of 60 wt%, and enzyme activity of 4.0 U.mL-1.

O objetivo deste trabalho foi estudar a influência de parâmetros reacionais na obtenção via enzimática de galacto-oligossacarídeos (GOS), utilizando-se a enzima comercial β-galactosidase de Kluyveromyces lactis (Lactozym® 3000 L), tendo como substrato a lactose. Foi proposto um planejamento experimental 2³, verificando a influência da temperatura (30 a 40 °C), da concentração de lactose (200 a 400 mg.mL-1) e da concentração de enzima (5 a 10 U.mL-1) no desempenho da reação enzimática. Os ensaios foram conduzidos a 180 rpm e pH 7,0 (tampão fosfato de sódio 0,1 M). A enzima Lactozym® 3000 L apresentou atividade de transgalactosilação, tendo sido atingido rendimento do processo igual a 41,9% e concentração de GOS de 167,5 mg.mL-1 no sistema reacional composto por 400 mg.mL-1 de lactose e 5 U.mL-1 de enzima a 30 °C em 14 h de reação. Nessa condição, a conversão de lactose foi de 65,0%. Maior concentração de lactose foi favorável ao mecanismo de transgalactosilação, enquanto que, em menores concentrações, o mecanismo hidrolítico predominou.

The main goal of this work was to study the influence of the reaction parameters on the enzymatic production of galactooligosaccharides (GOS) using the commercial β-galactosidase from Kluyveromyces lactis (Lactozym® 3000 L) and lactose as the substrate. A 2³ experimental design was proposed, verifying the influence of the temperature (30 to 40 °C), lactose concentration (200 to 400 mg.mL-1) and enzyme concentration (5 to 10 U.mL-1) on the performance of the enzymatic reaction. The assays were carried out at 180 rpm and pH 7.0 (0.1 M sodium phosphate buffer). The enzyme Lactozym® 3000 L presented transgalactosylation activity, reaching a yield of 41.9% and GOS concentration of 167.5 mg.mL-1 in a reaction system composed of 400 mg.mL-1 of lactose and 5 U.mL-1 of enzyme at 30 °C and 14 h of reaction. Under these conditions the lactose conversion was 65.0%. Higher lactose concentrations favored the transgalactosylation mechanism, whereas the hydrolytic mechanism dominated with lower concentrations.

Esta pesquisa observacional do tipo estudo de caso descritivo teve o objetivo de avaliar a resiliência de cuidadores de idosos demenciados com Alzheimer. Como instrumento, utilizou-se questionário para traçar o perfil do cuidador; protocolo bipolar para avaliar o estado subjetivo de fadiga; o SRQ - Self Report Questionnaire para avaliação do estresse; o inventário de Zarit para a sobrecarga e protocolo para a resiliência dos seis cuidadores que participaram do estudo. As variáveis quantitativas foram descritas em função de sua média e variância. Para as associações, utilizaram-se Correlação de Pearson e o Teste do Chi-Quadrado. O nível de significância adotado foi de p < 0,05. Os resultados indicaram que 83,3% dos cuidadores são femininos e 16,7%, masculinos; sendo quatro (66,7%) filhos e dois (33,3%) cônjuges. Observou-se que o estado de saúde de quatro cuidadores piorou, passando de um estado regular para ruim, em um período de cinco anos. Um (16,7%) cuidador dedica 20 horas do seu tempo ao cuidado e, para os demais (83,3%), a exigência é de 24 horas. Dos seis cuidadores, quatro demonstram probabilidade de desenvolver transtornos psiquiátricos e dois, não. E ainda, 66,7% dos cuidadores não apresentam sobrecarga, enquanto 33,3% acham-se com sobrecarga intensa. Embora alguns se mostrem fatigados e sobrecarregados, a maioria (83,3%) demonstra alta disposição à resiliência. Houve associação significativa entre resiliência e idade (p< 0,050), a qual expressa quanto maior a idade do cuidador maior a resiliência.

This observational study of the descriptive case study type aimed to evaluate the resilience of caregivers of demented elderly people with Alzheimer. A questionnaire was used to trace the profile of the caregivers; bipolar protocol to evaluate the fatigue subjective state; the SRQ - Self Report Questionnaire to evaluate the stress; the Zarit inventory to evaluate overload and protocol to evaluate resilience of the six caregivers who participated in this study. Quantitative variables were described as a function of their average and variance. For associations, the Pearson Correlation and the Chi-Square test were used. The significance level adopted was p < 0.05. Results indicated that 83.3% of caregivers were females and 16.7% males, four of which (66.7%) sons and two (33.3%), consorts. It was observed that the health status of four caregivers got worse, going from a regular to a bad state in a five-year period. One (16.7%) caregiver dedicated 20 hours of his time for caring, and for the others (83.3%) the requirement was of 24 hours. Two did not show any possibility of developing disturbances, while four showed possibilities of developing mental disturbances. 66.7% of the caregivers did not show overload, while 33.3% were under intense overload. Even though some demonstrated fatigue and overload, the majority (83.3%) presented a high disposition for resilience. There was significant association between resilience and age (p< 0.05), and this expressed that the older the caregiver the greater the resilience.

Este estudo teve como objectivos caracterizar e analisar a evolução, medir os níveis de eficiência técnica e relacionar esta com alguns atributos dos agricultores e das explorações, de uma amostra de explorações vitícolas pertencentes à região Alentejo. Os atributos considerados foram a dimensão física e económica, idade do produtor, natureza jurídica do produtor, tipo de posse da terra, irrigação, tipo de comercialização e especialização cultural e produtiva. A amostra analisada é composta por um painel de explorações, produtoras de uva para vinho para o período 2000-2005, pertencentes à Rede de Informação de Contabilidades Agrícolas, do Ministério da Agricultura, Desenvolvimento Rural e Pescas (MADRP). A caracterização e a análise da evolução das explorações vitícolas foram feitas com base num conjunto de indicadores técnicos e económicos. Para medir a eficiência, a metodologia utilizada foi paramétrica, utilizando uma fronteira de produção estocástica, em que foram testadas as características da distribuição utilizada para medir a eficiência, assim como a variabilidade desta ao longo do tempo. Para testar a relação entre a eficiência e os atributos dos produtores e das explorações utilizou-se o teste de análise de variância e o de Kruskall-Wallis. Os resultados mostraram que para estas explorações existe espaço para um aumento dos níveis de eficiência na utilização dos factores de produção e que a eficiência é variante em ordem ao tempo. Verificou-se um aumento da eficiência técnica com a dimensão económica e com o rendimento líquido das explorações, assim como com a empresarialização das mesmas.

This study aims to characterize and to analyse the evolution of wine production, to measure the levels of technical efficiency, and to relate these with farmers and farms attributes. The attributes considered were the physical and economic size, the producer age, the farmer legal status, type of land ownership, land irrigation, type of commercialization and productive specialization. The sample used is composed of a panel of wine farms, producers of grapes for wine, for the period 2000-2005, enrolled in the European Farm Accounting System, belonging to the Alentejo region of Portugal. The characterization and the evolution analysis of the wine farms were done based on a set of technical and economic indicators. In order to measure the efficiency, the methodology utilized was the parametric one, making use of a stochastic production frontier. The characteristics of the utilized distribution to compute the efficiency were tested, as well as the efficiency variability with time. The relationship between the efficiency and the farms and farmers attributes was tested making use of analyses of variance and Kruskall-Wallis tests. The results showed that there are room to improve the levels of technical efficiency in input use and that efficiency is variant with time. The increase on technical efficiency with economic size and with farm net income was observed, as well as with farm entrepreneurship.

O trabalho sintetiza a Proposta Curricular para o Ensino de Ciências e Programas de Saúde, elaborada pela Coordenadoria de Estudos e Normas Pedagógicas (CENP) da Secretaria de Educação do Estado de São Paulo. Evidencia-se sua sustentação teórica marcadamente sócio-histórica. São levantadas as dificuldades em se trabalhar esse enfoque pelo professor com formação tradicional. Discute-se a contribuição do profissional enfermeiro-educador, nesse quadro, relacionando-a à adequação dos elementos do plano de ensino da Proposta de Ciências da CENP (1992), particularmente dos temas relativos a saúde, para o Ciclo Básico.

The paper begins with a shintesis of the Science and Health Programs Curriculum Proposal, worked up by the Pedagogic Studies ans Norms Coordination (CENP), from the bureau of Education in São Paulo State, Brazil. The Proposal's theoretical foudation on social-historic premises is also showed, toghether with the difficulties for the traditionally prepared teacher to work with it. Finally, the paper discusses the possible contribution of the educator-nurse professional, on the improvement of helth themes of the Proposal (1992), especially for the school. (Basic Cicle)

Descreve-se a assistência de enfermagem prestada por uma estudante, salientando a importância da aplicação do relacionamento terapêutico, como função independente da enfermeira.

This article is about nursing care given by a student nurse who emphasizes the impontance of Therapeutic Relationship process as a private action of the nurse.

This article is about nursing care given by a student nurse who emphasizes the impontance of Therapeutic Relationship process as a private action of the nurse.

Descreve-se a assistência de enfermagem prestada por uma estudante, salientando a importância da aplicação do relacionamento terapêutico, como função independente da enfermeira.