Abstract Introduction: Latin America is a large and diverse region, comprising more than 600 million inhabitants and one million physicians in over 20 countries. Resistance to antibacterial drugs is particularly important in the region. This paper describes the design, implementation and results of an international bi-lingual (Spanish and Portuguese) online continuing interprofessional interactive educational program on hospital-acquired infections and antimicrobial resistance for Latin America, supported by the American Society for Microbiology. Methods: Participation, satisfaction and knowledge gain (through pre and post tests) were used. Moreover, commitment to change statements were requested from participants at the end of the course and three months later. Results: There were 1169 participants from 19 Latin American countries who registered: 57% were physicians and 43% were other health care professionals. Of those, 1126 participated in the course, 46% received a certificate of completion and 54% a certificate of participation. There was a significant increase in knowledge between before and after the course. Of 535 participants who took both tests, the grade increased from 59 to 81%. Commitments to change were aligned with course objectives. Discussion: Implementation of this educational program showed the feasibility of a continent-wide interprofessional massive course on hospital acquired-infections in Latin America, in the two main languages spoken in the region. Next steps included a new edition of this course and a "New Challenges" course on hospital-acquired infections, which were successfully implemented in the second semester of 2015 by the same institutions.

RESUMOO objetivo deste artigo é discutir as articulações retórica/discurso, tendo como centro das reflexões o livro Figuras de retórica do semioticista José Luiz Fiorin. A obra examina a contribuição da retórica clássica aos estudos do discurso e resgata, para ressignificá-la, a noção de ornamento, que relegou a retórica a um simples estudo de figuras. Apresenta estas últimas como operações enunciativas que intensificam o sentido de algum elemento do discurso, o que acaba por lhes restituir sua dimensão argumentativa. O artigo incorpora, à sua própria argumentação, figuras de linguagem e recursos retóricos explicados pelo autor no livro.

ABSTRACTThis article aims to discuss the articulation between rhetoric and discourse, basing its reflections on José Luiz Fiorin's Figuras de retórica [Figures of Rhetoric] (2014). This work examines the contribution of Classical Rhetoric to Discourse Studies. It retrieves and brings a new meaning to the idea of ornament, which relegated Rhetoric to a mere study of images/figures. It presents figures as enunciative operations that intensify the meaning of some elements of discourse, restituting them with their argumentative dimension. The article incorporates, into its own argumentation, the figures of speech and rhetorical resources that are explained by the author of the book.

O artigo analisa a utilização da noção de gênero na escola fundamental, detendo-se sobre o ensino dos gêneros orais. Apresenta postulados teóricos de Bakhtin e incorpora a contribuição da semiótica discursiva e as sugestões metodológicas da pedagogia de ensino de línguas desenvolvida na Universidade de Genebra. Em seguida, propõe exemplo prático de aplicação do conceito ao desenvolvimento da expressão oral em sala de aula.

The article analyzes the use of the concept of genre in elementary school, focusing on oral genres teaching. It presents the basic Bakhtin's postulates and incorporates the contribution of Semiotics and the suggestions of the pedagogy of language teaching developed at the University of Geneva. It also offers an example of oral genre to be worked in the classroom.

O artigo analisa auto-retratos de Iberê Camargo, fixando-se especialmente nos auto-retratos de 1943 e de 1984, em que a questão do tempo se manifesta tanto na cronologia que diferencia as duas concepções de pintura quanto na gestualidade que marca o ritmo e o andamento como categorias enunciativas da pintura. Se no auto-retrato de 1943 o ritmo é suave, quase etéreo, criando efeitos de harmonia e integração, no quadro de 1984 a gestualidade brusca acelera e confunde o tempo da pintura, conferindo-lhe um andamento veloz e um efeito de inacabamento e imperfeição. É a inscrição do tempo na matéria pictórica que transforma a representação, alterando assim a relação intersubjetiva entre observador e pintor.

The paper analyses Iberê Camargo's self-portraits, in particular his 1943 and 1984 paintings, in which the issue of time manifests itself both in the chronology which distinguishes the two conceptions of painting and in action which marks the rhythm and pace as enunciative categories of painting. In the self-portrait of 1943 the rhythm is soft, almost ethereal; in the 1984 painting, the abrupt action accelerates and disarrays the time of the painting, resulting in a fast pace and an effect of unfinishness and imperfection. It is the inscription of time in the pictorial matter which transforms representation, altering, in this way, the intersubjective relationship between the painter and the observer.

Este artículo analiza autorretratos de Iberê Camargo, en particular los autorretratos de 1943 y de 1984. El tema del tiempo se manifiesta tanto en la cronología que diferencia dos concepciones de pintura como en la gestualidad que marca el ritmo y el desarrollo como categorías enunciativas de la pintura. Mientras que en el autorretrato de 1943 el ritmo es suave, casi etéreo, creando efectos de armonía e integración, en el cuadro de 1984 la gestualidad brusca acelera y confunde el tiempo de la pintura, resultando en un desarrollo veloz y en un efecto inacabado de imperfección. La inscripción del tiempo en la matéria prictórica transforma la representación y altera de esta forma la relación intersubjetiva entre observador y pintor.

Este trabalho, resultado parcial de pesquisa mais ampla sobre sistemas municipais de ensino, apresenta um estudo sobre os conselhos municipais de educação constituídos nos nove municípios mineiros que instalaram seus sistemas de ensino até 2000. Toma-se como pressuposto a idéia de que os conselhos, na função de intermediação entre o Estado e a sociedade, traduzem ideais e concepções mais amplos de educação e de sociedade que, em cada momento histórico, influenciam a dinâmica das políticas educacionais em pauta. Buscando elementos concretos para refletir sobre essas questões, discute como se apresentam esses conselhos, sua composição, suas atribuições e as possibilidades de constituírem espaços democráticos de participação, contribuindo para a autonomia municipal na área do ensino e para o avanço das políticas públicas na área. Com o objetivo de auxiliar a compreensão dessa realidade, o texto traça, inicialmente, o percurso histórico da idéia de Conselho de Educação no país, considerando o período anterior à constituição dos sistemas federal e estaduais de educação pela Lei de Diretrizes e Bases da Educação de 1961, o período que se seguiu a essa lei e a situação atual.

This paper - the partial result of a larger study on municipal education systems - presents an analysis of the boards of education of nine towns in the State of Minas Gerais, which implemented their education systems by 2000. The assumption is that the boards, being an intermediary between the government and the society, express ample ideals and conceptions of education and society, which, in every historical moment, influence the dynamics of the educational policy agenda. In search of concrete elements on which to reflect, there is a focus on these boards' modus operandi, composition and jurisdiction, as well as on the possibility that they become democratic arenas of participation, contributing to county autonomy in education and to the enhancement of public policies in the area. With the purpose of helping to understand this reality, the text initially draws the history of the concept of education board in the country, taking into account the period before the constitution of the federal and state education systems by the LDB (the Brazilian Curricular Law) of 1961, the period after its enforcement and the current scenario.

O presente trabalho descreve a emergência de cepas mucoides do complexo B. cepacia em um paciente com Fibrose Cística dentro de um acompanhamento bacteriológico prospectivo de nove anos. Os dados clínicos sugerem a associação entre o isolamento do morfotipo mucoide e a deterioração clínica do paciente. Apesar da variação fenotípica, os testes moleculares mostraram que o paciente manteve-se cronicamente infectado por cepas de mesma origem clonal.

Mucoid Burkholderia cepacia morphotype emerged within a nine year follow-up of a cystic fibrosis patient. Clinical data suggested a linkage between the mucoid phenotype isolation and the deterioration of the patient's condition. Despite of the phenotypic variation, molecular typing showed that the patient was chronically infected with B. cepacia complex isolates belonging to a same genetic clone.

Foram avaliados os efeitos de dietas aniônicas (DA) e catiônicas (DC), associadas ou não ao uso de estradiol em dois períodos secos: período seco curto (30 dias) (PSC) e período seco regular (60 dias) (PSR) sobre o consumo de matéria seca (MS) de 40 vacas Holandesas, nos períodos pré-parto (PREP) e pós-parto (PP), distribuídas aleatoriamente em esquema fatorial 2x2+2. As dietas foram fornecidas por 21 dias no período pré-parto, após o qual, as vacas passaram a receber uma dieta de lactação. As DA não tiveram efeito sobre o consumo de MS no PREP; entretanto, resultaram em maior consumo quando comparadas à DC no pós-parto. Os contrastes entre tratamentos mostraram que DA fornecidas no PREP produziram aumento no consumo PP, PSR e no PSC associadas ao estradiol (P<0,01), sugerindo o efeito das DA sobre a mais rápida recuperação do consumo no PP; entretanto, essas no PSC sem estradiol resultaram em consumos semelhantes (P>0,05). Quando se comparam dietas com estradiol associado ao PSC com as demais, as primeiras apresentaram menores consumos, o que significa que a utilização de estrógenos exógenos pode reduzir o consumo no pós-parto. Não foram observadas diferenças entre consumo no PSC sem estradiol quando comparado ao PSR. O número de dias que antecederam o parto produziram efeito cúbico sobre o consumo (P<0,01), com aumento desse consumo logo na primeira semana pós-parto. Tanto o consumo no PRE, quanto no PP, foram menores na estação 2 (temperaturas acima de 260 C), quando comparados com a estação 1 (temperaturas abaixo de 260C) (P<0,01). Embora não tenha sido detectada diferença entre tratamentos no consumo no PREP, o uso de estradiol no PREP pode causar redução no consumo PP, e as vacas secas por 60 dias, que consumiram dietas aniônicas, apresentaram maiores consumos no PP, sugerindo sua efetividade sobre o controle da hipocalcemia.

The effects of anionic and cationic diets, associated or not with estradiol injection, and two dry periods (30 days and 60 days), were evaluated in dry matter intake in prepartum and postpartum. The trial was undertaken at Dairy Research Unit of Florida University, in Gainesville, USA. Forty Holstein cows were randomly assigned to the treatments in a factorial design: 1. anionic diet, 30 days dry period (AD30) 2. cationic diet, 30 days dry period (CD30), 3. anionic diet, 30 days dry period plus estradiol (AD30E) 4. cationic diet, 30 days dry period plus estradiol (CD30E); 5.anionic diet, 60 days dry period (AD60); 6. cationic diet, 60 days dry period (CD60). After calving, a standard early lactation diet was fed to all cows for 21 days. The cows were under two different range of temperatures: up to 260C, that calved in Autumn (season 1) and over 260C, (extreme temperatures) and calved in summer (season 2). AD did not affect prepartum feed intake, however it increases intake when compared to CA in postpartum. The contrasts between treatments showed AD increased postpartum intake in 60 days period (P<0.01) and in 30 days period only when associated with estradiol (P<0.01), suggesting that AD comes the cows faster to feeding, however, AD30 did not affect feed intake, and contrast was not significant (P>0,05).When diets associated with estradiol (AD30E and CD30E) were contrasted with the others, they showed lower intakes, what means that exogenous estrogen reduces postpartum intake. No differences were observed when 30 days period without estradiol injection were compared to sixty days dry period. The days in relation to peripartum showed cubic effects on intake (P<0,01), increasing the intake in the first week postpartum. Both feed intake in prepartum and postpartum decreased in season 2, when contrasted to season 1 (P<0,01). In conclusion, however differences between treatments were not detected in prepartum, estradiol injection in prepartum can decrease feed intake.

The in vitro antimicrobial susceptibility of the respiratory pathogens Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis to commonly tested and prescribed agents was investigated during 1999-2000 and compared with results obtained during a previous 1997-1998 study. Of 448 isolates of S. pneumoniae collected and tested in 1999-2000, 77.2% were susceptible, 19.9% were intermediate, and 2.9% were resistant to penicillin, demonstrating that there were no major changes in susceptibility to penicillin from 1997-1998 (77.1% susceptible, 18.7% intermediate, 4.2% resistant). All S. pneumoniae isolates from 1999-2000 were susceptible to levofloxacin and vancomycin, and >90% were susceptible to the beta-lactams (amoxicillin-clavulanate, ceftriaxone, and cefuroxime) and macrolides (azithromycin and clarithromycin), showing that susceptibility to these agents also remained unchanged since 1997-1998. The most notable increase in resistance between the two studies was demonstrated by trimethoprim-sulfamethoxazole, which increased from 23.4% to 38.6%. Penicillin resistance correlated with resistance to beta-lactams, macrolides, and trimethoprim-sulfamethoxazole in both studies. In H. influenzae, the prevalence of beta-lactamase-producing isolates remained unchanged (10.6% in 1999-2000; 11.0% in 1997-1998). All H. influenzae isolates were susceptible to levofloxacin, ceftriaxone, cefuroxime, and azithromycin, and showed no change between the two studies. Trimethoprim-sulfamethoxazole resistance was present in 40.1% of isolates in 1999-2000, and in 45.2% in 1997-1998. In M. catarrhalis, the prevalence of beta-lactamase-producing isolates was unchanged (97.9% in 1999-2000; 98.0% in 1997-1998). The most active agents against M. catarrhalis were azithromycin (MIC90, <0.03 mug/ml) and levofloxacin (MIC90, 0.03 mug/ml). Overall, these results suggest that, in Brazil, between 1999-2000 and 1997-1998, there have been no significant changes in the susceptibility of respiratory pathogens to any of the commonly tested and prescribed agents with the exception of trimethoprim-sulfamethoxazole for S. pneumoniae.

Com a finalidade de estudar resistência a antimicrobianos, sorotipos e quadro clínico de Streptococcus pneumoniae em São Paulo, Brasil, foram avaliados 50 pacientes com culturas positivas: 7 foram considerados portadores e 43 infectados. Pneumonia e meningite foram as infecções mais freqüentes. A letalidade foi de 34% e doenças de base estiveram presentes em 70%. Resistência relativa a penicilina ocorreu em 24% e a resistência completa não foi detectada. Resistência a tetraciclina ocorreu em 32% e a sulfametoxazol/trimetoprim em 32% e houve uma cepa com sensibilidade intermediária a eritromicina. Não houve resistência a cloranfenicol, rifampicina ou vancomicina. Em 62% dos casos houve resistência a pelo menos uma das drogas testadas. Resultados de sensibilidade utilizando o E-teste resultaram semelhantes aos pelo método de diluição em ágar. Houve 24 sorotipos diferentes e 74% das cepas pertenciam a sorotipos vacinais incluindo todas as cepas resistentes a penicilina. Neste estudo Streptococcus pneumoniae causou infecções graves e houve uma alta incidência de resistência a drogas comumente utilizadas. Os autores recomendam a vigilância rotineira para resistência e o uso adequado de vacinação, além da restrição do uso inadequado de antimicrobianos.

To study resistance to antimicrobials, serotypes and clinical features of S. pneumoniae in S. Paulo, Brazil, 50 patients with a positive culture were evaluated: 7 were considered carriers and 43 had pneumococcal infections. Pneumonia and meningitis were the most commom infections. Mortality was 34% and underlying diseases were present in 70%. Relative resistance to penicillin occurred in 24% and complete resistance was not detected. Resistance to tetracycline was 32% and to sulfamethoxazole/trimethoprim 32%; one strain had intermediate susceptibility to erythromycin; no resistance was present for chloramphenicol, rifampin or vancomycin. Resistance to at least one of the drugs tested occurred in 62%. Results by the E-test for penicillin were similar to those by the agar dilution method. There were 24 different serotypes and 74% of the strains belonged to the 23-valent vaccine including all the penicillin-resistant strains. In this study S. pneumoniae caused severe infections and presented a high resistance rate to commonly used antimicrobials. Routine surveillance of resistance and the use of vaccination, as well as the restriction of inappropriate use of antimicrobials, are recommended in São Paulo, Brazil.