Resumo No Brasil, há mais de três décadas, o ensino superior em Enfermagem está subordinado a um intensivo processo de privatização. Esse artigo caracteriza essa expansão no estado de Pernambuco e analisa as consequências desse processo para a integração ensino-serviço. O estudo é descritivo e exploratório, tipo estudo de caso, com utilização de técnicas combinando abordagens de pesquisa quantitativa e qualitativa. Os resultados demonstram que o estado segue a tendência nacional ao priorizar a expansão do setor privado que em 2018 já detinha 94% do total das vagas. Apontam, ainda, para uma incipiente regulação pública sobre a autorização da abertura dos cursos de Enfermagem, a qual deveria estar adequada à capacidade da rede de Atenção Primária à Saúde, do que vem resultando intensa disputa entre Instituições de Ensino Superior públicas e privadas pela ocupação dos campos de prática. A ausência de diálogo e de planejamento integrado entre os setores da saúde e da educação e a falta de decisão política para a implementação de Contratos Organizativos de Ação Pública Ensino-Saúde, se associam em um efeito que corrói por dentro a necessária interinstitucionalidade proclamada pelas diretrizes da integração ensino-serviço. Brasil décadas privatização ensinoserviço. ensinoserviço serviço. serviço ensino-serviço exploratório caso qualitativa 201 94 vagas Apontam ainda Saúde prática EnsinoSaúde, EnsinoSaúde Ensino-Saúde 20 9 2

Abstract In Brazil, for more than three decades, higher education in Nursing has been subject to an intensive privatization process. This article analyzes the expansion of undergraduate nursing courses in the state of Pernambuco and the consequences of privatization for the teaching-service integration. It is a descriptive-exploratory case study that uses techniques which combine quantitative and qualitative research approaches. The findings show that the state follows the national trend by prioritizing the expansion of the private sector which in 2018 already held 94% of all vacancies. They also point to an incipient public regulation regarding authorization for the opening of nursing courses that should be adjusted to the capacity of the Primary Health Care network. This has resulted in an intense dispute between public and private Higher Education Institutions for training opportunities. The absence of dialogue and integrated planning between the health and education sectors, and the lack of political resolve to implement Organizational Contracts for Public Action in the Teaching-Health context, together produce an effect that corrodes from within the necessary interinstitutional cooperation proclaimed by the teaching-services integration guidelines. Brazil decades process teachingservice teaching service descriptiveexploratory descriptive exploratory approaches 201 94 vacancies network opportunities sectors TeachingHealth Teaching context teachingservices services guidelines 20 9 2

ABSTRACT The project ‘One Health in the Pantanal: society’s participation in the emergency surveillance of zoonoses emergency as a post-fire effect in the territory and the formation of integrated strategies’ aimed to integrate institutional representations and local society; expand the use of Wildlife Health Information System (SISS-Geo) for fauna monitoring; identify priority areas for zoonosis surveillance and build paths involving One Health (OH). A webinar was held, highlighting the need for broader events with the participation of leaders in each of the chosen territories. Seminars and workshops were held in the states of Mato Grosso do Sul (MS), with the participation of health service managers from the Province of Santa Cruz, Bolivia, and Mato Grosso. The representation of different segments at the events enabled the articulation of citizens and local managers. In traditional communities, it was possible to address the impacts of the fires and provide the opportunity for these people to express their health priorities and demands, before and after the fires. The Synthesis Workshop held in Corumbá, MS allowed the feedback of results and integration with representatives from different institutions in Brazil and Bolivia, and prospecting and prioritization of illnesses to be incorporated into the OH model for the Pantanal and western border of Brazil. societys society s postfire post fire strategies SISSGeo SISS Geo (SISS-Geo monitoring OH. . (OH) territories MS, , (MS) Cruz Bolivia communities demands Corumbá (OH (MS

RESUMO O projeto ‘Saúde Única no Pantanal: participação da sociedade na vigilância de emergência de zoonoses como efeito pós-incêndios no território e formação de estratégias integradas’ objetivou integrar representações institucionais e da sociedade local; ampliar o uso do Sistema de Informação em Saúde Silvestre (SISS-Geo) para o monitoramento da fauna; identificar áreas prioritárias para vigilância de zoonoses e construir caminhos envolvendo a Saúde Única (SU). Realizou webinário, apontando a necessidade de eventos mais amplos com a participação de lideranças em cada um dos territórios escolhidos. Foram executados seminários e oficinas nos estados de Mato Grosso do Sul (MS), com a participação de gestores do serviço de saúde da Província de Santa Cruz, Bolívia, e de Mato Grosso. A representatividade dos diferentes segmentos nos eventos possibilitou a articulação de cidadãos e gestores locais. Nas comunidades tradicionais, foi possível abordar os impactos dos incêndios e dar oportunidade para que essas pessoas manifestassem suas prioridades e demandas de saúde, antes e depois dos incêndios. A Oficina Síntese realizada em Corumbá, MS possibilitou a devolutiva dos resultados e a integração com representantes de diferentes instituições do Brasil e da Bolívia, além da prospecção e priorização de enfermidades a serem incorporadas em modelo de SU para o Pantanal e fronteira oeste do Brasil. pósincêndios pós integradas local SISSGeo SISS Geo (SISS-Geo fauna SU. . (SU) webinário escolhidos MS, , (MS) Cruz Bolívia locais tradicionais Corumbá (SU (MS

ABSTRACT: In the last decade, there has been a significant increase in the demand for small rodents such as hamsters, guinea pigs, rats, and mice to be kept as pets. Consequently, the veterinary care provided to these animals has also increased. The aim of this study was to describe gross, histopathological and immunohistochemical findings of 26 spontaneous neoplasms diagnosed in 25 pet rodents in Northeastern Brazil. A retrospective study was carried out from 2014 to 2022 in two veterinary diagnostic laboratories to identify cases of tumoriform lesions in these species. Hamsters represented the most frequent species in this study (60%, 15/25), followed by rats (28%, 7/25), guinea pigs (8%, 2/25), and mice (4%, 1/25), with a mean age of 17.63 months. The anatomical regions of the face/head and thoracic region were the most affected. The most affected tissues were the skin/subcutaneous/mucosal (65%, 15/26) and mammary gland (23%, 6/26). Eighteen different types of neoplasms were diagnosed, and T-cell lymphomas and mammary adenocarcinomas were the most diagnosed tumors, each corresponding to 12% (3/26) of the cases. Leiomyosarcoma, myxosarcoma and mammary adenocarcinoma metastases were also noted. Immunohistochemistry was essential for the diagnosis of certain malignant mesenchymal and round-cell neoplasms. Pet rodent neoplasms in Northeastern Brazil are common, especially in hamsters, and immunohistochemistry can be a useful tool for the definitive diagnosis of these tumors. ABSTRACT decade hamsters pets Consequently increased gross 2 201 202 60%, 60 (60% 15/25, 1525 15/25 , 15 15/25) 28%, 28 (28% 7/25, 725 7/25 7 7/25) 8%, 8 (8% 2/25, 225 2/25 2/25) 4%, 4 (4% 1/25, 125 1/25 1 1/25) 1763 17 63 17.6 months facehead face head skinsubcutaneousmucosal skin subcutaneous mucosal 65%, 65 (65% 15/26 1526 23%, 23 (23% 6/26. 626 6/26 . 6 6/26) Tcell T cell tumors 12 3/26 326 3 (3/26 Leiomyosarcoma noted roundcell round common 20 60% (60 152 15/2 28% (28 72 7/2 8% (8 22 2/2 4% (4 1/2 176 17. 65% (65 23% (23 62 6/2 3/2 32 (3/2 (6 15/ (2 7/ ( 2/ 1/ 6/ 3/ (3/ (3

Abstract In Brazil, for more than three decades, higher education in Nursing has been subject to an intensive privatization process. This article analyzes the expansion of undergraduate nursing courses in the state of Pernambuco and the consequences of privatization for the teaching-service integration. It is a descriptive-exploratory case study that uses techniques which combine quantitative and qualitative research approaches. The findings show that the state follows the national trend by prioritizing the expansion of the private sector which in 2018 already held 94% of all vacancies. They also point to an incipient public regulation regarding authorization for the opening of nursing courses that should be adjusted to the capacity of the Primary Health Care network. This has resulted in an intense dispute between public and private Higher Education Institutions for training opportunities. The absence of dialogue and integrated planning between the health and education sectors, and the lack of political resolve to implement Organizational Contracts for Public Action in the Teaching-Health context, together produce an effect that corrodes from within the necessary interinstitutional cooperation proclaimed by the teaching-services integration guidelines. Brazil decades process teachingservice teaching service descriptiveexploratory descriptive exploratory approaches 201 94 vacancies network opportunities sectors TeachingHealth Teaching context teachingservices services guidelines 20 9 2

Resumo No Brasil, há mais de três décadas, o ensino superior em Enfermagem está subordinado a um intensivo processo de privatização. Esse artigo caracteriza essa expansão no estado de Pernambuco e analisa as consequências desse processo para a integração ensino-serviço. O estudo é descritivo e exploratório, tipo estudo de caso, com utilização de técnicas combinando abordagens de pesquisa quantitativa e qualitativa. Os resultados demonstram que o estado segue a tendência nacional ao priorizar a expansão do setor privado que em 2018 já detinha 94% do total das vagas. Apontam, ainda, para uma incipiente regulação pública sobre a autorização da abertura dos cursos de Enfermagem, a qual deveria estar adequada à capacidade da rede de Atenção Primária à Saúde, do que vem resultando intensa disputa entre Instituições de Ensino Superior públicas e privadas pela ocupação dos campos de prática. A ausência de diálogo e de planejamento integrado entre os setores da saúde e da educação e a falta de decisão política para a implementação de Contratos Organizativos de Ação Pública Ensino-Saúde, se associam em um efeito que corrói por dentro a necessária interinstitucionalidade proclamada pelas diretrizes da integração ensino-serviço. Brasil décadas privatização ensinoserviço. ensinoserviço serviço. serviço ensino-serviço exploratório caso qualitativa 201 94 vagas Apontam ainda Saúde prática EnsinoSaúde, EnsinoSaúde Ensino-Saúde 20 9 2

Resumo No Brasil, há mais de três décadas, o ensino superior em Enfermagem está subordinado a um intensivo processo de privatização. Esse artigo caracteriza essa expansão no estado de Pernambuco e analisa as consequências desse processo para a integração ensino-serviço. O estudo é descritivo e exploratório, tipo estudo de caso, com utilização de técnicas combinando abordagens de pesquisa quantitativa e qualitativa. Os resultados demonstram que o estado segue a tendência nacional ao priorizar a expansão do setor privado que em 2018 já detinha 94% do total das vagas. Apontam, ainda, para uma incipiente regulação pública sobre a autorização da abertura dos cursos de Enfermagem, a qual deveria estar adequada à capacidade da rede de Atenção Primária à Saúde, do que vem resultando intensa disputa entre Instituições de Ensino Superior públicas e privadas pela ocupação dos campos de prática. A ausência de diálogo e de planejamento integrado entre os setores da saúde e da educação e a falta de decisão política para a implementação de Contratos Organizativos de Ação Pública Ensino-Saúde, se associam em um efeito que corrói por dentro a necessária interinstitucionalidade proclamada pelas diretrizes da integração ensino-serviço.

Abstract In Brazil, for more than three decades, higher education in Nursing has been subject to an intensive privatization process. This article analyzes the expansion of undergraduate nursing courses in the state of Pernambuco and the consequences of privatization for the teaching-service integration. It is a descriptive-exploratory case study that uses techniques which combine quantitative and qualitative research approaches. The findings show that the state follows the national trend by prioritizing the expansion of the private sector which in 2018 already held 94% of all vacancies. They also point to an incipient public regulation regarding authorization for the opening of nursing courses that should be adjusted to the capacity of the Primary Health Care network. This has resulted in an intense dispute between public and private Higher Education Institutions for training opportunities. The absence of dialogue and integrated planning between the health and education sectors, and the lack of political resolve to implement Organizational Contracts for Public Action in the Teaching-Health context, together produce an effect that corrodes from within the necessary interinstitutional cooperation proclaimed by the teaching-services integration guidelines.

ABSTRACT The project ‘One Health in the Pantanal: society’s participation in the emergency surveillance of zoonoses emergency as a post-fire effect in the territory and the formation of integrated strategies’ aimed to integrate institutional representations and local society; expand the use of Wildlife Health Information System (SISS-Geo) for fauna monitoring; identify priority areas for zoonosis surveillance and build paths involving One Health (OH). A webinar was held, highlighting the need for broader events with the participation of leaders in each of the chosen territories. Seminars and workshops were held in the states of Mato Grosso do Sul (MS), with the participation of health service managers from the Province of Santa Cruz, Bolivia, and Mato Grosso. The representation of different segments at the events enabled the articulation of citizens and local managers. In traditional communities, it was possible to address the impacts of the fires and provide the opportunity for these people to express their health priorities and demands, before and after the fires. The Synthesis Workshop held in Corumbá, MS allowed the feedback of results and integration with representatives from different institutions in Brazil and Bolivia, and prospecting and prioritization of illnesses to be incorporated into the OH model for the Pantanal and western border of Brazil.

RESUMO O projeto ‘Saúde Única no Pantanal: participação da sociedade na vigilância de emergência de zoonoses como efeito pós-incêndios no território e formação de estratégias integradas’ objetivou integrar representações institucionais e da sociedade local; ampliar o uso do Sistema de Informação em Saúde Silvestre (SISS-Geo) para o monitoramento da fauna; identificar áreas prioritárias para vigilância de zoonoses e construir caminhos envolvendo a Saúde Única (SU). Realizou webinário, apontando a necessidade de eventos mais amplos com a participação de lideranças em cada um dos territórios escolhidos. Foram executados seminários e oficinas nos estados de Mato Grosso do Sul (MS), com a participação de gestores do serviço de saúde da Província de Santa Cruz, Bolívia, e de Mato Grosso. A representatividade dos diferentes segmentos nos eventos possibilitou a articulação de cidadãos e gestores locais. Nas comunidades tradicionais, foi possível abordar os impactos dos incêndios e dar oportunidade para que essas pessoas manifestassem suas prioridades e demandas de saúde, antes e depois dos incêndios. A Oficina Síntese realizada em Corumbá, MS possibilitou a devolutiva dos resultados e a integração com representantes de diferentes instituições do Brasil e da Bolívia, além da prospecção e priorização de enfermidades a serem incorporadas em modelo de SU para o Pantanal e fronteira oeste do Brasil.

RESUMO A investigação problematizou os desafios decorrentes da expansão dos cursos de medicina públicos e privados no estado de Pernambuco, considerando os pressupostos da integração ensino-serviço no âmbito da rede especializada de saúde. O estudo é descritivo e exploratório, tipo estudo de caso, com utilização de técnicas combinando abordagens de pesquisa quantitativa e qualitativa. O processo de privatização no estado ocorreu mais lentamente do que no País. No ano 2000, existiam tão somente 290 vagas em duas instituições públicas. Em apenas duas décadas, atinge-se o total de 1.350 vagas, estando 1.130 delas localizadas no setor privado. A investigação destacou políticas e ações concernentes à centralidade programática da integração ensino-serviço, do que se sobressaíram a preocupação com o caráter descomedido da expansão dos cursos com repercussão imediata na alocação dos alunos nos campos de estágio e a falta de planejamento integrado entre o aparelho formador, os serviços de saúde e a gestão do Sistema Único de Saúde (SUS). Assim, à intencionalidade do setor público de ordenar a presença crescente do setor privado no ensino médico não tem correspondido a disponibilidade de decisões políticas respeitantes à integração ensino-serviço, constituindo-se a não implementação do Contrato Organizativo de Ação Pública Ensino-Saúde (Coapes) um caso paradigmático.

ABSTRACT The research explored the challenges arising from the expansion of public and private medical courses in the state of Pernambuco, based on the premise of teaching-service integration within the specialized health network. The study is a descriptive-exploratory case study that uses techniques which combine quantitative and qualitative research approaches. The privatization process in the state took place at a slower pace than nationwide in the Country. In the year 2000, there were only 290 vacancies in two public institutions. In only two decades, a total of 1.350 have been reached, with 1.130 of them located in the private sector. The research highlighted policies and actions related to the programmatic centrality of teaching-service integration, from which the concern with the immoderate nature of the expansion of courses with immediate repercussion on the allocation of students to training vacancies and the lack of integrated planning between the educational apparatus, health services, and SUS (Unified Health System) management stood out. Thus, the intention of the public sector to bring order into the growing presence of the private sector in medical education has not been matched by political decision-making regarding teaching-service integration, turning the nonimplementation of the Public Health Action Organizational Contract (COAPES) into a paradigmatic case.

ABSTRACT COVID-19 is commonly associated with high serum levels of pro-inflammatory cytokines, and the post-infection status can disturb self-tolerance and trigger autoimmune responses. We are reporting a 45-year-old male who was admitted with fatigue, jaundice, elevated liver enzymes (with cholestatic pattern), and acute kidney injury two weeks after recovering from a mild SARS-CoV-2 infection. Serologies for viral hepatitis and anti-mitochondrial antibody were negative, while anti-nuclear and anti-smooth muscle antibodies were positive. There were no signs of chronic liver disease, and a magnetic resonance cholangiography showed no dilatation of biliary ducts. Histologic evaluation of the liver evidenced numerous foci of lobular necrosis without ductopenia or portal biliary reaction. Considering the autoantibody profile and histologic changes, the medical team started oral prednisone, but there was a suboptimal biochemical response in the outpatient follow-up. Two months later, a second liver biopsy was performed and revealed non-suppurative destructive chronic cholangitis, extensive areas of confluent necrosis with hepatocytes regenerating into pseudorosettes, and numerous plasma cells. According to the Paris Criteria, the patient was then diagnosed with an autoimmune hepatitis-primary biliary cholangitis overlap syndrome (AIH-PBC-OS). After adding azathioprine and ursodeoxycholic acid to the treatment, there was a satisfactory response. This is the second worldwide report of an AIH-PBC-OS triggered by COVID-19, but the first case with a negative anti-mitochondrial antibody. In this setting, histologic evaluation of the liver by an experienced pathologist is a hallmark of achieving the diagnosis and correctly treat the patient. COVID19 COVID 19 COVID-1 proinflammatory pro inflammatory cytokines postinfection post infection selftolerance self tolerance responses 45yearold yearold 45 year old fatigue jaundice pattern, pattern , pattern) SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- antimitochondrial anti mitochondrial antinuclear nuclear antismooth smooth positive disease ducts reaction changes prednisone followup. followup follow up. up follow-up later nonsuppurative non suppurative pseudorosettes cells Criteria hepatitisprimary primary AIHPBCOS. AIHPBCOS AIH PBC OS . (AIH-PBC-OS) treatment COVID19, 19, setting COVID1 1 COVID- 4 SARS-CoV (AIH-PBC-OS

Abstract Aim Amazonian rivers outgas high amounts of carbon dioxide (CO2). However, the outgassing estimate remains uncertain due to the limited spatial distribution of data on water-atmosphere CO2 fluxes. So far, the vast extent of the basin and the difficult access to some regions have hampered complete mapping. We hypothesize that 1) CO2 supersaturation prevails in most Amazonian rivers and 2) undersaturation occurs only at a few locations, particularly during the low-water period. Methods To obtain insight on the spatial distribution of partial pressure of CO2 (pCO2), an essential determinant of CO2 fluxes, we analysed water sampled by a specially equipped hydroplane at an unprecedented sizeable spatial scale in the Amazon basin at 419 locations. Results Confirming our hypothesis, most rivers were supersaturated with CO2 concerning the atmosphere. In contrast to our expectations, however, we also found below equilibrium CO2 concentrations in several tributaries, particularly during low-water periods, when light availability in the water column is highest likely coinciding with the highest aquatic primary production rates. Correlation analyses further indicated that pCO2 values are positively related to the organic carbon density in the soils, net primary production, and the proportion of flood-able land in the sub-basins. Conclusions We conclude that supersaturation with CO2 occurs in most rivers, but several tributaries are undersaturated. Our findings highlight the different roles that Amazonian rivers can play in the regional carbon cycle. We argue that up-scaling should explicitly incorporate areas with riverine CO2 uptake, particularly at the sub-basin scale. CO2. CO . (CO2) However wateratmosphere atmosphere fluxes far mapping 1 2 locations lowwater low period pCO2, pCO , (pCO2) 41 hypothesis expectations however periods rates soils floodable flood able subbasins. subbasins sub basins. basins sub-basins undersaturated cycle upscaling up scaling uptake subbasin (CO2 (pCO2 4 (CO (pCO

Resumo: Objetivo Rios amazônicos liberam quantidades expressivas de dióxido de carbono (CO2). Entretanto, essas estimativas permanecem incertas devido à limitada distribuição espacial de dados sobre fluxos água-atmosfera. A vasta extensão da bacia hidrográfica e a dificuldade de acesso a algumas regiões têm impedido um mapeamento completo até o momento. As hipóteses deste estudo são que: 1) a supersaturação de CO2 prevalece na maioria dos rios amazônicos; e 2) a subsaturação ocorre somente em poucos locais, particularmente durante períodos de águas baixas. Métodos Para melhor compreender a distribuição da pressão parcial de CO2 (pCO2), um determinante essencial de fluxos de CO2, nós analisamos amostras de água coletadas por um hidroavião especialmente equipado em uma escala espacial sem precedente em 419 locais na bacia Amazônica. Resultados Confirmando nossa primeira hipótese, a maioria dos rios esteve supersaturada em relação ao CO2 da atmosfera. No entanto, ao contrário de nossas expectativas, nós também encontramos concentrações de CO2 abaixo do equilíbrio em vários tributários, particularmente durante períodos de águas baixas, quando a disponibilidade de luz na coluna de água é maior provavelmente coincidindo com maiores taxas de produção primária. Análises de correlação indicaram que valores de pCO2 estão positivamente relacionados com a densidade de carbono nos solos, com a produção primária líquida e com a proporção de área alagável nas sub-bacias. Conclusões Nós concluímos que a supersaturação em CO2 ocorre na maioria dos rios, mas vários tributários são subsaturados. Nossos achados trazem luz aos diferentes papéis que os rios amazônicos podem desempenhar no ciclo do carbono regional. Também argumentamos que extrapolações espaciais deveriam explicitamente incorporar áreas com absorção de CO2 fluvial, particularmente na escala de sub-bacias. Resumo CO2. CO . (CO2) Entretanto águaatmosfera. águaatmosfera atmosfera água-atmosfera momento 1 2 baixas pCO2, pCO , (pCO2) 41 Amazônica hipótese entanto expectativas solos subbacias. subbacias sub bacias. bacias sub-bacias subsaturados regional fluvial (CO2 (pCO2 4 (CO (pCO

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region. prevalence clinicopathological (AciCC region 1 countries demographic clinical pathologic followup follow up information 7 included 65.33% 6533 65 33 (65.33% 4551 45 51 45.5 affected 64.28% 6428 64 28 (64.28% 95.66% 9566 95 66 (95.66% 70.68%. 7068 70.68% . 70 68 (70.68%) 48.93% 4893 48 93 (48.93% 86.11%. 8611 86.11% 86 (86.11%) 59.19%. 5919 59.19% 59 19 (59.19%) 20 3043 30 43 30.43% 1250 12 50 12.50% p=0.01, p001 p p=0.01 , 0 01 (p=0.01) highgrade grade p=0.008, p0008 p=0.008 008 (p=0.008) p=0.007, p0007 p=0.007 007 (p=0.007) p=0.03 p003 03 (p=0.03 survival conclusion 65.33 653 6 3 (65.33 455 4 5 45. 64.28 642 2 (64.28 95.66 956 9 (95.66 706 70.68 (70.68% 48.93 489 (48.93 861 86.11 8 (86.11% 591 59.19 (59.19% 304 30.43 125 12.50 p00 p=0.0 (p=0.01 p000 p=0.00 00 (p=0.008 (p=0.007 (p=0.0 65.3 (65.3 64.2 (64.2 95.6 (95.6 70.6 (70.68 48.9 (48.9 86.1 (86.11 59.1 (59.19 30.4 12.5 p0 p=0. (p=0.00 (p=0. 65. (65. 64. (64. 95. (95. 70. (70.6 48. (48. 86. (86.1 59. (59.1 30. 12. p=0 (p=0 (65 (64 (95 (70. (48 (86. (59. p= (p= (6 (9 (70 (4 (86 (59 (p ( (7 (8 (5

ABSTRACT The research explored the challenges arising from the expansion of public and private medical courses in the state of Pernambuco, based on the premise of teaching-service integration within the specialized health network. The study is a descriptive-exploratory case study that uses techniques which combine quantitative and qualitative research approaches. The privatization process in the state took place at a slower pace than nationwide in the Country. In the year 2000, there were only 290 vacancies in two public institutions. In only two decades, a total of 1.350 have been reached, with 1.130 of them located in the private sector. The research highlighted policies and actions related to the programmatic centrality of teaching-service integration, from which the concern with the immoderate nature of the expansion of courses with immediate repercussion on the allocation of students to training vacancies and the lack of integrated planning between the educational apparatus, health services, and SUS (Unified Health System) management stood out. Thus, the intention of the public sector to bring order into the growing presence of the private sector in medical education has not been matched by political decision-making regarding teaching-service integration, turning the nonimplementation of the Public Health Action Organizational Contract (COAPES) into a paradigmatic case. Pernambuco teachingservice teaching service network descriptiveexploratory descriptive exploratory approaches Country 2000 29 institutions decades 1350 1 350 1.35 reached 1130 130 1.13 apparatus services Unified System out Thus decisionmaking decision making COAPES (COAPES 200 2 135 35 1.3 113 13 1.1 20 3 1. 11

RESUMO A investigação problematizou os desafios decorrentes da expansão dos cursos de medicina públicos e privados no estado de Pernambuco, considerando os pressupostos da integração ensino-serviço no âmbito da rede especializada de saúde. O estudo é descritivo e exploratório, tipo estudo de caso, com utilização de técnicas combinando abordagens de pesquisa quantitativa e qualitativa. O processo de privatização no estado ocorreu mais lentamente do que no País. No ano 2000, existiam tão somente 290 vagas em duas instituições públicas. Em apenas duas décadas, atinge-se o total de 1.350 vagas, estando 1.130 delas localizadas no setor privado. A investigação destacou políticas e ações concernentes à centralidade programática da integração ensino-serviço, do que se sobressaíram a preocupação com o caráter descomedido da expansão dos cursos com repercussão imediata na alocação dos alunos nos campos de estágio e a falta de planejamento integrado entre o aparelho formador, os serviços de saúde e a gestão do Sistema Único de Saúde (SUS). Assim, à intencionalidade do setor público de ordenar a presença crescente do setor privado no ensino médico não tem correspondido a disponibilidade de decisões políticas respeitantes à integração ensino-serviço, constituindo-se a não implementação do Contrato Organizativo de Ação Pública Ensino-Saúde (Coapes) um caso paradigmático. Pernambuco ensinoserviço serviço exploratório qualitativa País 2000 29 públicas décadas atingese atinge 1350 1 350 1.35 1130 130 1.13 ensinoserviço, serviço, formador SUS. SUS . (SUS) Assim constituindose constituindo EnsinoSaúde Ensino Coapes (Coapes paradigmático 200 2 135 35 1.3 113 13 1.1 (SUS 20 3 1. 11

Abstract Focal Adhesion Kinase (FAK) protein participates in proliferation, migration, cell survival, and apoptosis process. It has been described as overexpressed in several neoplasms being a promising target for therapy. BCR-ABL negative chronic Myeloproliferative Neoplasms (MPN) are clonal disorders characterized by the excess of proliferation and apoptosis resistance. The identification of the acquired JAK2 V617F mutation in MPN patients allowed a better understanding of pathogenesis. However, there is still no pharmacological treatment that leads all patients to molecular remission, justifying new studies. The present study aimed to evaluate FAK involvement in the viability and apoptosis of HEL and SET-2 cells, both JAK2 V617F positive cell lines. The FAK inhibitor PF 562,271 was used. Cell viability was determined using MTT assay and apoptosis verified by cleaved PARP, cleaved Caspase 3 and Annexin-V/PI staining detection. FAK inhibition significantly reduced HEL and SET-2 cells viability and induced apoptosis. Considering the role of JAK/STAT pathway in MPN, further investigation of FAK participation in the MPN cells proliferation and apoptosis resistance, as well as possible crosstalk between JAK and FAK and downstream pathways may contribute to the knowledge of MPN pathophysiology, the discovery of new molecular targets, and JAK inhibitors resistance mechanisms. (FAK migration survival process therapy BCRABL BCR ABL (MPN VF V F pathogenesis However remission studies SET2 SET 2 SET- lines 562271 562 271 562,27 used PARP AnnexinV/PI AnnexinVPI Annexin V/PI PI detection JAKSTAT STAT pathophysiology targets mechanisms 56227 56 27 562,2 AnnexinV VPI 5622 5 562,

Resumo Enquadramento: Identificação de eventos clínicos indesejáveis relacionados com a administração de aminas é fundamental com vista à segurança dos doentes, particularmente em contexto de cuidados intensivos. Objetivo: O estudo tem como objetivo geral investigar as práticas relacionadas com a administração de aminas vasoativas e como objetivos específicos descrever a administração de aminas e analisar os eventos clínicos indesejáveis relacionados com a administração destes fármacos em doentes críticos. Metodologia: Estudo quantitativo observacional, transversal, amostra de 97 doentes. Investigaram-se as variáveis relacionadas com a administração das aminas e com os registos de eventos clínicos indesejáveis. Realizada análise estatística descritiva e inferencial. Resultados: A noradrenalina obteve uma frequência de uso de (70,1%), seguida da dobutamina (29,9%). Cerca de 47,4% das doses foram administradas no lúmen proximal do cateter venoso central, enquanto que 12,4% foram duplamente confirmadas na prescrição. Evidenciou-se que os eventos clínicos indesejáveis foram três vezes maiores em doentes monitorizados a cada 2 horas. Conclusão: Verifica-se uma falha na monitorização dos doentes com aminas prescritas, bem como na dupla confirmação destes fármacos.

Abstract Background: Identifying undesirable clinical events related to the administration of vasoactive amines is essential for patient safety, particularly in intensive care settings. Objective: The general objective is to analyze the practices related to the administration of vasoactive amines. The specific objectives are to describe the administration of vasoactive amines and analyze the undesirable clinical events related to the administration of these drugs in critically ill patients. Methodology: Quantitative, observational, cross-sectional study with a sample of 97 patients. The variables related to the administration of vasoactive amines and the records of undesirable clinical events were analyzed. Descriptive and inferential statistical analysis was performed. Results: The frequency of use of norepinephrine was 70.1%, followed by dobutamine (29.9%). About 47.4% of amines were administered through the proximal lumen of the central venous catheter, while 12.4% were double-checked in the prescription. The undesirable clinical events were three-fold higher in patients monitored every 2 hours. Conclusion: There is a failure in the monitoring of patients with prescribed amines and in the double checking of these drugs.

Resumen Marco contextual: La identificación de eventos clínicos indeseables relacionados con la administración de aminas es fundamental para la seguridad de los pacientes, especialmente en los entornos de cuidados intensivos. Objetivo: El estudio pretende investigar las prácticas relacionadas con la administración de aminas vasoactivas y tiene como objetivos específicos describir la administración de aminas y analizar los eventos clínicos indeseables relacionados con la administración de estos fármacos en pacientes críticos. Metodología: Estudio observacional cuantitativo, transversal, muestra de 97 pacientes. Se investigaron las variables relacionadas con la administración de aminas y con el registro de eventos clínicos indeseables. Se realizó un análisis estadístico descriptivo e inferencial. Resultados: La frecuencia de uso de la noradrenalina fue del 70,1%, seguida de la dobutamina (29,9%). Alrededor del 47,4% de las dosis se administraron en el lumen proximal del catéter venoso central, mientras que el 12,4% se confirmaron doblemente en la prescripción. Se comprobó que los eventos clínicos indeseables eran tres veces mayores en los pacientes monitorizados cada 2 horas. Conclusión: Se observa una falta en la monitorización de los pacientes con aminas prescritas, así como en el doble control de estos fármacos.

SUMMARY OBJECTIVE: Children with cow’s milk allergy may be at nutritional risk due to the lower intake of nutrients, such as protein, calcium, and vitamin A, which are present in cow’s milk. The objective was to evaluate children’s diets with Children with cow’s milk allergy compared with healthy controls as well as to compare the intake of proteins and amino acids from the diet followed by Children with cow’s milk allergy who consume special infant formula or plant-based dairy alternatives with Children with cow’s milk allergy who do not consume special infant formula or plant-based dairy alternatives. METHODS: Through a cross-sectional controlled study, the dietary intake of 57 children (27 with immunoglobulin E-mediated Children with cow’s milk allergy and 30 healthy controls) was evaluated. Using 24-h nutritional recalls, the total energy intake value, macronutrients, and amino acids were calculated. RESULTS: No statistically significant difference was found between the Children with cow’s milk allergy group and healthy controls for the intake of proteins and amino acids. However, the Children with cow’s milk allergy do not consume special infant formula or plant-based dairy alternatives group had a lower protein (g/kg) and branched-chain amino acid (mg/kg) intake than the Children with cow’s milk allergy consume special infant formula or plant-based dairy alternatives group. CONCLUSIONS: The Children with cow’s milk allergy group achieved the recommendations for the intake of proteins and amino acids compared to the healthy control group. However, the Children with cow’s milk allergy do not consume special infant formula or plant-based dairy alternatives group had a lower intake of protein (g/kg) and branched-chain amino acid (mg/kg) than the Children with cow’s milk allergy consume special infant formula or plant-based dairy alternatives group.

Abstract We have examined the mutagenic effects of the fungicide Elatus® on tadpoles of Rana catesbeiana and Leptodactylus latrans. Sixty-four tadpoles of each species have been exposed to three concentrations of Elatus® (10, 20, and 50 µg/L-1) during 96 hours. We’ve carried out the micronucleus test (MN) and erythrocyte nuclear abnormalities (ENAs) in 32 tadpoles of each species, the others 32 tadpoles of each species remained in a solution free of Elatus® during 96 hours, in order to assess the ability to recover from the damage caused by the fungicide. There was significant difference in MNs frequency between the treatment exposed to 50µg/L-1 and the control groups for R. catesbeiana, while for L. latrans, we’ve found difference between the treatment of 20 µg/L-1, followed by a period without exposure to the contaminant and the control group when all ENAs were analyzed. When we compared the two species, R. catesbeiana presented a higher frequency of MNs than L. latrans in the treatment exposed to 50 µg/L-1of the fungicide. Our findings highlight the need to monitor amphibians in places where this product is widely used.