Abstract Introduction Chagas’ Disease is responsible for a high rate of morbimortality in Brazil however its real relevance on the maternal mortality is unknown. Objective The aim of this study is to review the literature on the impact of Chagas’ Disease on the Brazilian maternal mortality during the pregnancy-puerperal cycle. Method A review of literature was conducted to identify publications about maternal mortality and Chagas’ Disease. Documents were also searched in the websites of the Brazilian Ministry of Health, World Health Organization (WHO), System of Information about Mortality (SIM) and Brazilian Society of Cardiology (SBC). Manuscripts, master’s degree and PhD thesis, consensus, epidemiologic bulletins and manuals were analyzed. Results Initially were found 1326 paper, however just 14 answered the objective. Five epidemiologic bulletins, 4 manuals of Ministry of Health, 3 consensuses of SBC, 1 book and 3 master’s degree thesis were also used. There is no description of the number of deaths of pregnant women per year caused by complications of Chagas’ Disease in the data of the Ministry of Health and in the SIM. According to the data found, one third of pregnant women with Chagas' Disease are cardiac patients and the mortality among them is 3.5%, therefore is expected a mortality of about 1% in the pregnant-puerperal cycle. There is evidence of underreporting of maternal mortality among chagasic pregnant women. Conclusion The maternal mortality caused by Chagas’ Disease is not known, therefore more studies about it are necessary, in all clinical forms of the disease. Chagas unknown pregnancypuerperal pregnancy puerperal cycle WHO, WHO , (WHO) SIM (SIM SBC. SBC . (SBC) Manuscripts masters master s consensus analyzed 132 paper objective used 35 5 3.5% pregnantpuerperal known necessary disease (WHO (SBC 13 3.5 3.

RESUMO A doença de Crohn (DC) é uma doença inflamatória intestinal (DII) recidivante recorrente que pode afetar qualquer parte do sistema digestivo. É doença heterogênea e possui múltiplos fatores que contribuem para uma resposta imune anormal aos microrganismos intestinais. O tratamento baseia-se no uso de anti-inflamatórios, corticosteroides e imunossupressores e imunobiológicos que são utilizados isoladamente ou em combinação. O tratamento cirúrgico é frequente e 10 anos após o diagnóstico, mais de 50% dos pacientes relatam terem sido submetidos a procedimentos cirúrgicos relacionados à doença. Infelizmente, nenhum dos tratamentos descritos oferece cura, e inúmeros casos tornam-se refratários ou sem opções terapêuticas. Nesse cenário, o transplante de células-tronco hematopoéticas (TCTH) em decorrência da remissão clínica de pacientes que apresentavam DC associada a doenças hematológicas malignas, passou a ser alternativa desde os primeiros resultados em 2010. Neste relato, a Comissão de Transplantes do Grupo Brasileiro de Estudo das Doenças Inflamatórias Intestinais revisa a história e os resultados do procedimento em pacientes com DC, detalhando e discutindo os diversos pontos relevantes que permeiam o TCTH e a terapia celular no tratamento da moléstia. (DC DII (DII digestivo intestinais baseiase baseia se antiinflamatórios, antiinflamatórios anti inflamatórios, inflamatórios anti-inflamatórios combinação 1 diagnóstico 50 Infelizmente cura tornamse tornam terapêuticas cenário célulastronco células tronco (TCTH malignas 2010 relato moléstia 5 201 20 2

ABSTRACT Crohn’s disease (CD) is a relapse-remitting inflammatory bowel disease that can affect any part of the digestive system. This heterogeneous disease has multiple factors that contribute to an abnormal immune response to intestinal microorganisms. Treatment is based on the use of anti-inflammatories, corticosteroids, immunosuppressants and biologic biologic agents either alone or in combination. Surgical treatment is usual and, ten years after diagnosis, more than 80% of patients report having undergone surgical procedures related to the disease. Unfortunately, none of the treatments described offer a cure, and many cases become refractory or without therapeutic options. In this scenario, hematopoietic stem cell transplantation has been suggested because clinical remission was obtained in patients who had CD associated with malignant hematological diseases and an alternative since the first reports in 2010. In this report, the Transplantation Committee of the Brazilian Group for the Study of Inflammatory Bowel Diseases reviews the history and results of the procedure in patients with CD, detailing and discussing the various relevant points that permeate hematopoietic stem cell transplantation and cell therapy in this disease. Crohns Crohn s (CD relapseremitting relapse remitting system microorganisms antiinflammatories, antiinflammatories anti inflammatories, inflammatories anti-inflammatories corticosteroids combination diagnosis 80 Unfortunately cure options scenario 2010 8 201 20 2

RESUMO Contexto: Apesar da terapia medicamentosa otimizada, o risco contemporâneo de cirurgia nas doenças inflamatórias intestinais (DII) após 10 anos do diagnóstico é de 9,2% em pacientes com retocolite ulcerativa (RCU) e de 26,2% na doença de Crohn (DC) na era biológica. Objetivo: Este consenso visa detalhar as orientações para os procedimentos cirúrgicos mais adequados em diferentes cenários da DII. Além disso, detalha as indicações cirúrgicas e o manejo perioperatório de pacientes adultos com DC e RCU. Métodos: Nosso consenso foi desenvolvido por cirurgiões colorretais e gastroenterologistas representantes da Organização Brasileira de Doença de Crohn e Colite (GEDIIB), com a metodologia de revisão rápida sendo conduzida para respaldar as recomendações. As recomendações cirúrgicas foram estruturadas e mapeadas de acordo com os fenótipos da doença, indicações cirúrgicas e técnicas. Após a estruturação das recomendações, a metodologia modificada do Painel Delphi foi utilizada para conduzir a votação por especialistas em cirurgia de DII e gastroenterologia. Esta consistiu em três rondas: duas com recurso a uma plataforma de votação online personalizada e anônima e uma reunião presencial. Sempre que os participantes não concordavam com afirmações ou recomendações específicas, era oferecida uma opção de delinear possíveis razões para permitir respostas em texto livre e dar a oportunidade para os especialistas elaborarem ou explicarem a discordância. O consenso de recomendações/declarações em cada rodada foi considerado alcançado se houve concordância ≥80%. Resultados e conclusão Este consenso abordou as informações mais relevantes para orientar o processo de tomada de decisão para o manejo cirúrgico adequado de DC e RCU. Ele sintetiza recomendações desenvolvidas a partir de evidências e conhecimento de alto nível. As recomendações cirúrgicas foram estruturadas e mapeadas de acordo com os diferentes fenótipos da doença, indicações para cirurgia e manejo perioperatório. O foco específico do nosso consenso foi dado aos procedimentos cirúrgicos eletivos e de emergência, determinando quando indicar a cirurgia e quais procedimentos podem ser os mais adequados. O consenso é direcionado a gastroenterologistas e cirurgiões interessados no tratamento e manejo de pacientes adultos com DC ou RCU e apoia a tomada de decisões de pagadores de saúde, líderes institucionais e/ou administradores. Contexto otimizada (DII 1 92 9 2 9,2 (RCU 262 26 26,2 (DC biológica Objetivo disso Métodos GEDIIB, GEDIIB , (GEDIIB) técnicas gastroenterologia rondas presencial específicas discordância recomendaçõesdeclarações declarações 80 ≥80% nível emergência saúde eou administradores 9, 26, (GEDIIB 8 ≥80 ≥8 ≥

ABSTRACT Background: Despite optimized medical therapy, contemporary risk of surgery in inflammatory bowel diseases (IBD) after 10 years of diagnosis is 9.2% in patients with ulcerative colitis (UC) and 26.2% in Crohn’s disease, (CD) in the biological era. Objective: This consensus aims to detail guidance to the most appropriate surgical procedures in different IBD scenarios. In addition, it details surgical indications and perioperative management of adult patients with CD and UC. Methods: Our consensus was developed by colorectal surgeons and gastroenterologists representing the Brazilian Study Group of Inflammatory Bowel Diseases (GEDIIB), with the Rapid Review methodology being conducted to support the recommendations/statements. Surgical recommendations were structured and mapped according to the disease phenotypes, surgical indications, and techniques. After structuring the recommendations/statements, the modified Delphi Panel methodology was used to conduct the voting by experts in IBD surgery and gastroenterology. This consisted of three rounds: two using a personalized and anonymous online voting platform and one face-to-face presential meeting. Whenever participants did not agree with specific statements or recommendations, an option to outline possible reasons was offered to enable free-text responses and provide the opportunity for the experts to elaborate or explain disagreement. The consensus of recommendations/statements in each round was considered to have been reached if there was ≥80% agreement. Results and conclusion: This consensus addressed the most relevant information to guide the decision-making process for adequate surgical management of CD and UC. It synthesizes recommendations developed from evidence-based statements and state-of-art knowledge. Surgical recommendations were structured and mapped according to the different disease phenotypes, indications for surgery and perioperative management. Specific focus of our consensus was given to elective and emergency surgical procedures, determining when to indicate surgery and which procedures may be the more appropriate. The consensus is targeted to gastroenterologists and surgeons interested in the treatment and management of adult patients with CD or UC and supports decision-making of healthcare payors, institutional leaders, and/or administrators. Background therapy (IBD 1 92 9 2 9.2 (UC 262 26 26.2 Crohns Crohn s (CD era Objective scenarios addition Methods GEDIIB, GEDIIB , (GEDIIB) recommendationsstatements phenotypes techniques gastroenterology rounds facetoface face meeting freetext free text disagreement 80 ≥80 agreement conclusion decisionmaking decision making evidencebased evidence based stateofart state art knowledge payors leaders andor administrators 9. 26. (GEDIIB 8 ≥8 ≥

This paper presents a teaching-learning methodology for the course "Hydropower and Ocean Power" in the Master of Renewable Energy at the Polytechnic University of Cartagena (Spain). From the experience gained in two courses, a teaching approach according to the Bologna Declaration, to ensure that students acquire skills related to the ability of analyzing and designing hydraulic machines is proposed. In particular, The numerical simulation of the flow through a Kaplan turbine was chosen for study. The method includes the problem-based learning and the project-based learning approaches, as well as the concept of facilitator-tutor as a key element of the method. The commercial software Matlab is employed as a tool to translate the geometry to the meshing software Gambit; from where the mesh and the boundary conditions are translated to the Ansys-Fluent CFD code. The aim is to provide the students with relevant knowledge on hydraulic turbines through different numerical simulation projects.

Se presenta una propuesta de metodología docente para la asignatura "Energía Hidráulica y Energía del Mar" en el Máster de Energías Renovables de la Universidad Politécnica de Cartagena (España). A partir de la experiencia docente adquirida en dos cursos, se propone un enfoque didáctico acorde con el Plan Bolonia, para conseguir que el alumno adquiera competencias relacionadas con la capacidad de analizar y proyectar maquinaria hidráulica. Se ha elegido la simulación numérica del flujo a través de una turbina Kaplan. Se incluyen los enfoques de aprendizaje basado en problemas y basado en proyectos, y se incorpora además la figura del tutor facilitador como elemento clave. Se utiliza el software comercial Matlab como herramienta de traducción de geometría al programa mallador Gambit, desde donde se exporta la geometría, la malla y las condiciones de contorno al código CFD Ansys-Fluent. Se facilitará al alumno la adquisición de conocimientos sobre turbinas hidráulicas a través de distintos proyectos de simulación numérica.

The experience gained in a course on Selected Topics of Fluid Mechanics course for the Industrial Engineer degree, Polytechnic University of Cartagena-Spain employing numerical techniques as a motivating element for students. The mean objectives of the course are to provide an understanding of the analytical methods employed for selected topics in Fluid Mechanics and to bring a familiarity with some experimental and numerical techniques. To improve teaching-learning a pedagogical method based on Problem-Solving Based Learning is applied, using Computational Fluid Dynamics. As a result, the motivation and the theoretical and technical abilities of the students have been improved. It can be concluded that now the method is efficient and has increase the satisfaction degree of the students.

Se presenta la experiencia obtenida en la docencia de la asignatura “Ampliación de Mecánica de Fluidos” en la carrera de Ingeniería Industrial, Universidad Politécnica de Cartagena-España, usando métodos numéricos como elemento motivador para los alumnos. El principal objetivo del plan de estudios es que el alumno adquiera distintos conocimientos teóricos, numéricos y experimentales en algunos temas avanzados de Mecánica de Fluidos. Con el objeto de obtener una mejora general en la calidad de la docencia, se emplea un método pedagógico mixto basado en la utilización de herramientas de simulación numérica, así como en el sistema de aprendizaje de resolución de problemas. Como resultado, se consigue aumentar el interés, la motivación y el nivel de adquisición de los conocimientos por parte del alumno. Puede concluirse que el método es eficiente, consiguiendo aumentar el grado de satisfacción del alumnado.