ABSTRACT Aim: this study aimed to describe the efficacy and safety of fecal microbiota transplantation (FMT) for the treatment of refractory and recurrent Clostridium difficile infection (CDI). Methods: this was an observational study of patients with refractory or recurrent CDI treated with FMT between June 2014 and January 2017. Primary and secondary outcomes were the resolution of diarrhea without CDI recurrence within two months after one or more FMT. A descriptive analysis was performed. Results: thirty-four FMT were performed in 28 patients, 88.2% (n = 30) using an upper route with a gastroscopy and 11.8% (n = 4) with colonoscopy; 50% (n = 17) of FMT were due to recurrent CDI and 50% (n = 17) were due to refractory CDI. The overall cure rate of upper FMT was 87.5% (21/24) and 100% (4/4) when colonoscopy was performed. A cure was achieved after one FMT in 88% (22/25) of cases and after two or more FMT in 8% (2/25) of cases, resulting in an overall cure rate of 96% (24/25). No severe adverse events were reported. Conclusion: FMT constitutes an effective and safe approach for the management of refractory and recurrent CDI, with an overall cure rate of 96% and no reported severe adverse events.

Resumo: As concepções de tempo e a relação que o Homem com ele estabelece têm evoluído no sentido de afirmá-lo como um elemento-chave da civilização. A evolução dos mecanismos horários e dos sincronismos contribuiu para que a escola seja regulada pelo relógio. Mesmo os ritmos circadianos tendem a ser regulados por entidades externas, como os tempos escolares. Está inscrito no currículo oculto da escola o respeito por determinadas regras e valores temporais, ou seja, a escola tem a tarefa de ensinar os alunos a viverem em função de ritmos (temporais) impostos pelas instituições. O tempo tem assumido uma crescente importância na sociedade, onde a escola desempenha um papel importante na transmissão de regras e valores, constituindo-se um elemento da sua gramática. É um elemento estrutural na escola e estruturante na sociedade. No presente, o tempo regula a atividade humana de forma doutrinal, sem ser questionado.

Abstract: Time conceptions and the relationship that humankind establishes with it became a key element of civilization. The evolution of time mechanisms and synchronization methods has contributed to the school regulation being dictated by the clock. Even circadian rhythms tend to be regulated by outside agencies such as the school times. The respect for certain rules and time values is included in the school's hidden curriculum, that is, the school has to teach students to live according to (temporal) rhythms imposed by the institutions. Time has assumed an increasing importance in society, where school has played an important role in the transmission of rules and values, becoming an element of the grammar of schooling. It is a structural element in schools and structuring in society. Presently, time regulates the human activity in a doctrinal way, without being questioned.

Background and aims: Clostridium difficile infection (CDI) constitutes an important cause of antibiotic-associated diarrhea. Recurrence after first-line treatment with antibiotics is high and fecal microbiota transplantation (FMT) may be effective for refractory and recurrent CDI. This series aims to describe the efficacy of FMT in the treatment of refractory and recurrent CDI. Methods: A prospectively recorded single-centre case series of patients with persistent or recurrent CDI treated with FMT between June 2014 and March 2015 was analyzed. Primary and secondary outcomes were defined as resolution of diarrhea without recurrence of CDI within 2 months after one or more FMT, respectively. A descriptive analysis was performed. Results: 8 FMT were performed in 6 patients, 3 with refractory CDI and 3 with recurrent CDI. The median age of recipients was 71 years and 66.7% were women. One FMT was delivered through colonoscopy and the remaining 87.5% through esophagogastroduodenoscopy. One upper FMT was excluded due to recurrence of CDI after antibiotic exposure for a respiratory infection. The overall cure rate of FMT was total with lower route and 83.3% with upper route. Primary cure rate was achieved in 83.3% of patients and secondary cure rate was achieved in all patients. Median time to resolution of diarrhea after FMT was 1 day and no complications were reported during follow-up. Conclusion: FMT appears to constitute a safe and effective approach in the management of refractory and recurrent CDI. Difference between primary and secondary cure rates may result of insufficient restoration of intestinal microbiota with a single FMT.

Este artigo apresenta uma perspectiva histórica do ensino de ciência, desde os finais do Século XIX até à actualidade. Consideramos que os anos de 1950 e 1983 representam alterações marcantes neste domínio. Em 1950, deixou de se ensinar ciência para formar cidadãos com uma postura crítica face à relação entre ciência e sociedade, passando a privilegiar-se os conteúdos, a dar-se ênfase ao rigor e ao método científico. 1983 foi o ano em que se voltou a relevar a relação entre ciência e sociedade, incluindo a tecnologia. Actualmente, pretende-se formar cidadãos informados, capazes de participar em debates científicos, atentos às causas e às consequências inerentes ao conhecimento, bem como à sua aplicação no quotidiano. Na segunda parte deste artigo equacionam-se as finalidades para o futuro do ensino de ciência. Deve-se minimizar a importância de testes e classificações internacionais. Estes acabam por conduzir a uma deterioração do sistema de ensino. Tomam-se decisões políticas para melhorar a classificação, destroem-se os pilares essenciais para a construção de uma sociedade cientificamente literata, e descura-se a especificidade de cada comunidade, não se dando atenção aos interesses dos alunos e dos professores, o que poderá conduzir a uma inibição da criatividade e inovação nas actividades escolares.

This article presents an historical perspective of sciences teaching, from the ends of the 19th century till nowadays. We consider that the years of 1950 and 1983 represent important changes in this domain. In 1950, teaching sciences didn’t intend to form citizens with a critical position related to science and citizenry but started to privilege the scientific contents and to give emphasis to the scientific method. 1983 was the year that the relation between science and society raised again, including the technology. Currently, it is intended to create informed citizens, capable of participating in scientific debates, considering them noteworthy to their everyday life. In the second part of this article we propose goals for the future of the sciences teaching. The importance of international tests and classifications must be minimized. These lead to a deterioration of the education system. Political decisions are made to improve the classification, the essential pillars for the construction of a scientific literate society are destroyed, and each local singularity isn’t considered. Therefore, the goals of pupils or teachers are not regarded and the innovation and the school activities creativity are inhibited.