Abstract A cesarean scar pregnancy (CSP) is a scary and life-threatening complication of cesarean section (CS). Nevertheless, the incidence of CS is constantly growing. The CSP incidence is 0,15% of pregnancies after CS which represents 6,1% of all ectopic pregnancies in women with condition after CS. Therefore, it should be more present in the clinical daily routine. From mild nonspecific symptoms to hypovolemic shock, diagnosis and therapy must be performed quickly. With the progressive growth of the scar pregnancy, a uterine rupture involves the risk of severe bleeding, and an emergency hysterectomy could be necessary. Prolongation of pregnancy has been successful only in a few cases.We report 11 cases from our hospital in the past 10 years. In the discussion, treatment options of this complication with an increasing incidence, which is associated with serious morbidity and mortality, are presented based on the current literature. Treatment options include drug therapy, but also surgical or combined procedures with radiological intervention.

Este trabalho avalia o efeito democratizante da governança participativa na gestão das águas, a partir de uma pesquisa junto a 626 membros de 14 comitês e 4 consórcios de bacias hidrográficas. A noção de democracia é examinada segundo três noções: a) as arenas participativas devem promover a inclusão e combater a dominação das elites; b) a participação deve promover um processo dinâmico capaz de modificar a compreensão dos participantes; e c) as arenas participativas devem garantir maior controle social do Estado. Sugere-se que comitês e consórcios são mais bem sucedidos como espaços deliberativos. Desigualdades sociais afetam, mas não impedem um processo deliberativo.

Based on a survey of 626 committee and consortium members in 18 river basins, this study evaluates the democratizing effect of stakeholder governance in water resources management in Brazil. The term democracy is examined according to three ideas: a) participatory arenas should promote political inclusion and combat elite domination; b) participation must involve a dynamic process of interaction that transforms the understandings of those who participate; c) participatory arenas should guarantee a greater control over the state by the society. The paper suggests that the committees and consortia work better as deliberative spaces. Social inequalities among members affect but do not hinder the deliberative process.

O presente estudo constitui uma análise de Projeto Itajaí I, com ênfase no aspecto gerencial. Não se propõe discutir o arcabouço teórico-metodológico do planejamento ambiental, nem o quadro de referência que serve de guia à interação interdisciplinar. Tais aspectos são amplamente abordados em outro estudo (Caubet e Frank, 1991). O enfoque a ser dado aqui é mais específico. Uma proposta interdisciplinar a ser realizada em colaboração com diversas instituições, e com crescente participação comunitária, exige que seu gerenciamento tenha características peculiares. Sendo assim, pretende-se contribuir para a discussão de um modelo de gestão para o Projeto Itajaí I. Não é intuito da autoras esgotar o assunto, mas sim oferecer uma primeira aproximação à solução da questão em pauta.

This paper presents an analysis of the itajaí I Project, concerning its managerial aspects. It does not discuss the theoretical and methodological framework of the Environment Planning. These aspects are discussed on another paper (Caubet and Frank, 1991). The emphasis in this paper is more specific. A multi disciplinary proposal to be realized through different institutions, and with increasing community participation, needs some particularly management characteristics. On this way, this paper intends to make a contribution towards a Management Model for the Itajaí I Project. The authors do not want to solve the whole issue but to offer a first approach to it.