RESUMO A gastrostomia endoscópica percutânea é utilizada para oferecer suporte nutricional enteral para pacientes com neoplasias obstrutivas de orofaringe ou esôfago. A colocação da sonda é considerada segura, com poucas complicações. Apesar disso, uma complicação em particular, considerada rara, está sendo cada vez mais descrita na literatura: a metástase de neoplasia de cabeça e pescoço para o estoma da gastrostomia. Neste relato, descrevemos um caso de metástase de carcinoma espinocelular de laringe para o sítio da gastrostomia, e discutimos as possíveis etiologias e alternativas, buscando diminuir a incidência desta complicação.

ABSTRACT Percutaneous endoscopic gastrostomy is used to provide enteral nutritional support for patients with obstructive oropharyngeal or esophageal neoplasms. The placement of the catheter is considered safe, with few complications. Despite this, a specific complication that is considered rare, has been increasingly described in the literature, i.e., metastasis of head and neck cancer in the gastrostomy stoma. In this report, we described a case of metastasis of squamous cell carcinoma of the larynx in the gastrostomy site, and discussed the possible etiologies and alternatives, seeking to reduce the incidence of this complication.

Abstract Objective: To test the capacity of the Logistic CASUS Score on the second postoperative day, the total serum bilirubin dosage on the second postoperative day and the extracorporeal circulation time, as possible predictive factors of long-term stay in Intensive Care Unit after cardiac surgery. Methods: Eight-two patients submitted to cardiac surgery with extracorporeal circulation were selected. The Logistic CASUS Score on the second postoperative day was calculated and bilirubin dosage on the second postoperative day was measured. The extracorporeal circulation time was also registered. Patients were divided into two groups: Group A, those who were discharged up to the second day of postoperative care; Group B, those who were discharged after the second day of postoperative care. Results: In this study, 40 cases were listed in Group A and 42 cases in Group B. The mean extracorporeal circulation time was 83.9±29.4 min in Group A and 95.8±29.31 min in Group B. Extracorporeal circulation time was not significant in this study (P=0.0735). The level of P significance of bilirubin dosage on the second postoperative day was 0.0003 and an area under the ROC curve of 0.708 with a cut-off point at 0.51 mg/dl was registered. The level of P significance of Logistic CASUS Score on the second postoperative day was 0.0001 and an area under the ROC curve of 0.723 with a cut-off point at 0.40% was registered. Conclusion: The Logistic CASUS Score on the second postoperative day has shown to be better than the bilirubin dosage on the second postoperative day as a predictive tool for calculating the length of stay in intensive care unit during the postoperative care period of patients. Notwithstanding, extracorporeal circulation time has failed to prove itself as an efficient tool to predict an extended length of stay in intensive care unit.

Resumo O estudo investiga a potencialidade da Estratégia de Ensino Estudo de Caso (EEEC) para o ensino de Química, no Ensino Médio. Para isso, a EEEC foi aplicada por três professores de Química de uma escola pública da cidade de Juiz de Fora, Minas Gerais. Como instrumentos de pesquisa foram utilizados: observação das aulas, aplicação de questionário aos estudantes e realização de entrevista semiestruturada com os professores. Os dados construídos foram interpretados mediante Análise de Conteúdo. Na percepção dos professores e estudantes investigados, a EEEC é uma proposta de ensino favorável e significativa para o Ensino Médio. Esses sujeitos destacaram: participação ativa e crítica do estudante, trabalho em grupo, aquisição de conhecimentos científicos, aproximação do conteúdo com a realidade do estudante, estímulo ao desenvolvimento de habilidades importantes como leitura, argumentação, comunicação oral, entre outros. Apontaram dificuldades para aplicação da EEEC, como o tempo e a falta de recursos para a pesquisa.

Abstract The focal point of this research was the potentiality of the Case Study Teaching Strategy (CSTS) for teaching High School Chemistry. To do this, CSTS was applied by three Chemistry teachers in a public school in Brazil. As research instruments, we used classroom observation, application of a questionnaire to the students and a semi-structured interview with the teachers. The results indicated that, according to teachers and students, CSTS is a favourable and significant teaching tool for High School. These subjects pointed out the emphasis in the active and analytical participation of students, group work, acquiring of different scientific knowledge, approaching the content from the student's experience, stimulation of the development of important abilities by the students, such as reading, argumentation, oral communication, among others. They also pointed out difficulties involved in the application of CSTS, such as time and the lack of resources for the research.