Resumo O artigo analisa as manchetes da revista Semana, a fim de desvendar a ideologia por ela promovida a respeito do processo de paz nos primeiros quatro meses do mandato de Iván Duque. Para isso, identificou-se a forma como os diferentes atores do pós-conflito foram apresentados e nomeados, foram analisadas as estratégias discursivas utilizadas na revista, além da linguagem retórica e suas implicações discursivas. O paradigma que norteia o estudo é o sociocrítico com abordagem qualitativa. O tipo de pesquisa é a análise crítica do discurso. O método de análise e interpretação considera três etapas: exploratória de corpus, exploratória descritiva e exploratória analítica. Um subcorpus de 23 manchetes foi feito. Conclui-se que em seu discurso jornalístico a revista cria uma estrutura ideológica sobre as crenças, atitudes e valores de diferentes atores, estabelecendo grupos de opinião a favor do processo de paz e contra as posições e decisões do presidente que prejudicam o processo.

Resumen El artículo analiza los titulares de prensa de la revista Semana, con el fin de desentrañar la ideología promovida por esta con respecto al proceso de paz en los primeros cuatro meses del mandato de Iván Duque. Para ello, se identificó la forma como se presentaron y nombraron los diferentes actores del posconflicto, se analizaron las estrategias discursivas usadas en la revista, además del lenguaje retórico y sus implicaciones discursivas. El paradigma que guía el estudio es el sociocrítico con enfoque cualitativo. El tipo de investigación es el análisis crítico del discurso. El método de análisis e interpretación considera tres etapas: exploratoria del corpus, exploratoria descriptiva y exploratoria analítica. Se tomó un subcorpus de 23 titulares. Se concluye que en su discurso periodístico la revista crea una estructura ideológica sobre las creencias, las actitudes y los valores de diferentes actores, instaurando grupos de opinión a favor del proceso de paz y en contra de las posturas y decisiones del presidente que perjudican el proceso.

Abstract The article analyzes the press headlines of the magazine Semana in order to unravel the ideology promoted by it regarding the peace process in the first fourth months of Iván Duque's government. For this, the way in which the different post-conflict actors were presented and named is identified, the discursive strategies used in the magazine were analyzed, in addition to the rhetorical language and its discursive implications. The paradigm that guides the study is the socio-critical one with a qualitative approach. The type of research is the critical analysis of the discourse. The analysis and interpretation method considers three stages: corpus exploratory, descriptive exploratory and analytical exploratory. A subcorpus of 23 headlines was taken. It is concluded that in its journalistic discourse the magazine creates and ideological structure about the beliefs, attitudes and values of different actors, establishing opinion groups in favor of the peace process and against the positions and decisions of the president that harm the process.

Résumé Cet article analyse les titres du magazine Semana dans le but de démêler l'idéologie promue par le magazine en ce qui concerne le processus de paix au cours des quatre premiers mois du mandat d'Iván Duque. Pour ce faire, la manière dont les différents acteurs post-conflit ont été présentés et nommés a été identifiée, et les stratégies discursives utilisées dans le magazine ont été analysées, ainsi que le langage rhétorique et ses implications discursives. Le paradigme qui guide l'étude est socio-critique avec une approche qualitative. Le type de recherche est l'analyse critique du discours. La méthode d'analyse et d'interprétation considere trois étapes : exploratoire du corpus, exploratoire descriptive et exploratoire analytique. Un sous-corpus de 23 titres a été constitué. Il est conclu que dans son discours journalistique, le magazine crée une structure idéologique sur les croyances, les attitudes et les valeurs des différents acteurs, établissant des groupes d'opinion en faveur du processus de paix et contre les positions et les décisions du président qui sont préjudiciables au processus.

Sergey Fedoroff (1925-2012) is considered the father of tissue culture because of his important findings and contributions. He was president of several societies, such as the Pan American Association of Anatomy.

Sergey Fedoroff (19252012) es considerado el padre del cultivo del tejido nervioso por sus importantes descubrimientos y contribuciones. Presidió numerosas sociedades, entre ellas la Asociación Panamericana de Anatomía.

É imperativa a formação de um Residente de Medicina de Família e Comunidade (RMFC) que responda às demandas da saúde pública, porém consideramos que ainda não existe uma concordância no programa para sua formação. Realizou-se uma pesquisa teórica para delinear a proposta de programa para a formação do RMFC embasada na revisão da literatura, nas recomendações da Comissão Nacional de Residência Médica e Sociedade de Medicina de Família e Comunidade do Brasil e na opinião dos RMFC da Pontifícia Universidade Católica do Paraná (PUC-PR), copilada pelo autor principal durante cinco anos como preceptor dos RMFC da PUC-PR. O programa inclui atividades práticas, teórico-práticas, investigativas e avaliativas desenvolvidas durante dois anos na Unidade de Saúde e no Hospital Regional, integrando o processo docente ao assistencial mediante a formação em serviço e no trabalho conjunto da faculdade com a Secretaria Municipal de Saúde e população, com uma visão preventivo-curativa e biopsicossocial do processo saúde-enfermidade, em função da problemática do indivíduo, da família e comunidade. Acreditamos que a proposta possa contribuir para o debate deste tema complexo e polêmico, e que, entre os acertos e desacertos dos programas, encontremos um consenso para a formação do médico de família e comunidade que o Brasil necessita.

The training of family practitioners is essential for meeting the extensive health care demand of the Brazilian population, however there is still no consensus about a Family Medicine Residency Program in this field. With the purpose of delineating a proposal for such a program a theoretical study was conducted taking as a basis a review of the literature, recommendations of the Comissão Nacional de Residência Médica, Sociedade Brasileira de Medicina de Família e Comunidade and the opinion of family medicine residents of the Pontifícia Universidade Católica of Paraná. The data were gathered over five years by the main author of this article and preceptor of the family health residents at the mentioned university. The program includes medical knowledge, practice-based learning, systems-based practice, research and evaluation, to be developed for two years in primary and secondary care facilities. Community assistance is combined with teaching through in-service training and cooperation of the medical school, the local health authorities and the population, building a preventive-curative biopsychosocial paradigm of the health-disease process focused on the individual, the family and the community. We believe that this proposal can contribute to the discussion about this complex and polemic subject and that it will be possible to reach a consensus with regard to the training of the family practitioners needed in Brazil.

A especialização tem gerado uma separação entre e educação e saúde, binômio que, na atualidade, se retoma como uma articulação necessária. Daí o objetivo de abordar estas categorias. Realizou-se uma pesquisa teórica para caracterizar a função da educação para o médico e para a saúde. A educação aperfeiçoa no médico sua comunicação, linguagem e autonomia, além de facilitar seu relacionamento humano e contribuir no processo de conscientização das pessoas, resgatando, assim, sua função de educador. Para que as campanhas de promoção e prevenção em saúde tenham êxito, é necessário que a população tenha uma instrução que lhe permita compreender e participar das mesmas. As escolas precisam incorporar temas como meio ambiente, hábitos tóxicos, sexualidade, planejamento familiar, higiene, exercícios físicos, alimentação, primeiros socorros e trânsito. As faculdades médicas devem oferecer temas de educação que complementem a formação do egresso, e as escolas devem incorporar temas referentes à saúde em busca do bem-estar pleno do cidadão. A educação e a saúde são necessidades sociais que devem ser garantidas pelas instituições governamentais, e o povo, junto ao seu direito de desfrutá-las, tem o dever de contribuir para sua concretização.

Specialization has brought about a rupture between health and education, a binomial today being rescued as a necessary combination. The aim of this article is to show the importance of rearticulating these two areas. To this purpose, a bibliographic research was carried out for defining the role education plays for the physician and for health. Education allows the physician to improve his communication skills, language and autonomy. Education turns it easier for him to establish good doctor-patient relationships and increases his ability to provide professional guidance to people. thus returning to him his function as an educator. Education of the population, on the other hand, is a condition for the success of health prevention and promotion campaigns because they depend on the understanding and active participation of the public. Schools need to include health-related subjects such as environment, toxic habits, sex, birth control, hygiene, physical exercise, nutrition, first aid and traffic in their curriculum. Medical schools should offer their students subjects that complement their professional education and the schools should incorporate subjects related to the health and well-being of the population. Education and health are social demands that must be assured by the State. The people are entitled to enjoy these rights but have the duty to contribute to their concretization.

Thyroid microcarcinoma is a tumor of 10 mm or less, that should have a low risk of mortality. However, a subgroup of these carcinomas is as aggressive as bigger tumors. Aim: To describe the pathological presentation of these tumors, and compare them with larger tumors. Material and methods: All pathological samples of thyroid carcinoma that were obtained between 1992 and 2003, were studied. In all biopsies, the pathological type, tumor size, the focal or multifocal character, the presence of lymph node involvement and the presence of lymphocytic thyroiditis or thyroid hyperplasia, were recorded. Results: One hundred eighteen microcarcinomas and 284 larger tumors were studied. The mean age of patients with microcarcinoma and larger tumors was 42.7±14 and 49.3±16 years respectively (p <0,001) and 83% were female, without gender differences between tumor types. Mean size of microcarcinomas was 8.6 mm and 116 (98%) were papillary carcinomas. Of these, 109 (94%) were well differentiated and seven (6%) were moderately differentiated. Thirty six (31%) were multifocal and in 10 (8,6%), there was lymph node involvement. The mean size of larger tumors was 23.8 mm and 241 (85%) were papillary carcinomas. Of these, 200 (83%) were well differentiated, and 41 (17%) were moderately differentiated. Eighty five (35%) were multifocal and in 44 (18%) there was lymph node involvement. The prevalence of thyroiditis and hyperplasia was significantly higher among microcarcinomas than in larger tumors (15 and 2.5%, respectively, p <0.001, for the former; 32.4 and 1.7%, respectively, p <0.001, for the latter). Conclusions: In this series, one third of microcarcinomas were multifocal and 10% had lymph node involvement. Therefore, the aggressiveness of these tumors is higher than what is reported in the literature and they should be treated with total thyroidectomy

Homem de 37 anos, branco, tabagista, foi internado com tosse seca e dor no hemitórax esquerdo (HE). Ao exame, macicez e murmúrio vesicular diminuído no terço médio do HE. A tomografia axial computadorizada de tórax revelou lesão expansiva nodular do 7º arco costal, projetando-se para o interior do HE, com densidade de parte mole e discreto realce pelo contraste. A histologia e a imuno-histoquímica foram compatíveis com schwannoma benigno. Consideramos que o diagnóstico de schwannoma benigno intercostal deve ser aventado ante toda massa intratorácica posterior ou lateral que curse com escassa sintomatologia e ausência de manifestações clínicas de malignidade.

A 37 years-old white man, smoker, was interned for having dry cough and pain in the left hemithorax (HE). The exam has show diminished vesicle mumble in the medium third part of the HE. The thorax computer thomography showed expansive nodular lesion of the 7º coster arch projecting within the HE, with density of the bulk part and discreet enhance by the contrast. Imuno-histochemistry was compatible to benign schwannoma. We consider the intercostal benign schwannoma diagnosis must be taken before all the posterior or lateral intrathoracic mass that follows with small syntomathology and absence of clinical manifestation of malignity.

Resumo: O paradigma educacional acompanha a evolução do paradigma científico, daí a importância do estudo dessa trajetória. Procura-se fornecer o fundamento epistemológico da transição do Paradigma Educacional Tradicional (PET) ao Paradigma Educacional Inovador (PEI) e sua repercussão no Ensino Médico Inovador (EMI). Realizou-se uma pesquisa teórica para delinear o processo experimentado pelos paradigmas científicos e educacionais. O PET, reflexo do paradigma cartesiano, caracteriza-se pelo ensino memorístico e disciplinar; que impede o saber global. No ensino médico, traduz-se na concepção do homem como uma máquina isolada da sociedade e na visão biologista do ensino hospitalar. As mudanças da ciência a partir do século 19 facilitaram o surgimento do pensamento complexo dos processos, da abordagem holística, progressista e embasada em problemas. A visão holística supera o saber especializado e insere os saberes éticos nos curriculares. A abordagem progressista tem como essência o diálogo professor-aluno-coletivo como fonte do aprendizado colegiado, crítico e reflexivo. O ensino baseado em problemas reduz o espaço das aulas teóricas em função da produção do conhecimento. Essas mudanças no EMI se expressam na formação reflexiva, generalista e preventiva, que resgata os valores éticos, humanos e sociais do indivíduo.

Abstract: The educational paradigm follows the evolution of the scientific paradigm, thus, the importance of studying such evolution. This study seeks to portray the epistemological basis in the transition from the Traditional Educational Paradigm (TEP) to the lnnovative Educational Paradigm (IEP) and its impact on lnnovative Medical Training (IMT). A theoretical study was conducted on the process undergone by the scientific and educational paradigms. The TEP, resulting from the cartesian paradigm, is characterized by rote and subject-based learning, which hinders more global knowledge. ln medical education, this paradigm is expressed in the concept of man as a machine isolated from society and the biologic vision of hospital-based teaching. Changes in science beginning in the 19th century facilitated the emergence of complex conceptualization of processes and the holistic, progressive, and problem-based approaches. The holistic view transcends specialized knowledge and includes ethical knowledge in the curriculum. The essence of the progressive approach is dialogue between faculty, students, and the overall academic community as a source of collective, critical and reflexive learning. Problem-based learning reduces the proportion of theoretical classes as a function of knowledge output. These changes in IMT are expressed in reflexive, generalist, and preventive training reclaiming the individual’s ethical human, and social values.

Background: Anti thyroglobulin antibodies are present in 25% of patients treated for a differentiated thyroid cancer, invalidating thyroglobulin determination. Those patients subjected to total thyroidectomy and free of disease, should reduce the production of these antibodies, due to the lack of antigenic stimulus. Therefore, anti thyroglobulin antibodies could be useful to detect early relapses. Aim: To assess the relationship between anti thyroglobulin antibodies and the evolution of the disease in patients treated for thyroid cancer. Material and methods: Retrospective analysis of 26 patients treated for thyroid cancer with positive anti thyroglobulin antibodies, followed for three years. These were divided in those with or without lymphocytic thyroiditis (19 and 7 respectively). Results: At the first year of follow up, anti thyroglobulin antibody concentration was 401±94.9 UI/ml (x±sem) in patients with thyroiditis and 38.9±8.9 UI/ml in those without thyroiditis (p < 0.005). During the three years of follow up, no differences in anti thyroglobulin antibodies were observed between patients with or without tumor relapse. Conclusions: Concentration of anti thyroglobulin antibodies was higher in patients with thyroiditis and did not differentiate patients with tumor relapse (Rev Méd Chile 2002; 130: 167-72)

100 snorers and their relatives were selected at random and surveyed in the municipality of Marianao from October, 1991, to June, 1992, in order to establish the characteristics of snoring and its possible association with arterial hypertension, ischemic heart disease, cerebrovascular disease and diabetes mellitus. Most of the surveyed persons were males (64 %) and white individuals (70 %). The daily snorers (70 %), the subjects with arrhythmic snoring (62,8 %) and those with more than 30 years of evolution (81,8 %) prevailed. A significant predominance of arterial hypertension was observed in men with arrhythmic snoring and sleep disorders (p=0,01). The relationship of these diseases with the drinking and smoking habits was not remarkable. To conclude, snoring is a sign to be considered in the prevention and/or early attention of arterial hypertension and we should know its frequency, time of evolution, rhythm and sleep disorders

A través del interrogatorio directo, se encuestó a 100 roncadores y a sus familiares escogidos al azar en una población del municipio Marianao, entre octubre de 1991 y junio de 1992, con el objetivo de establecer las características del ronquido y su posible asociación con la hipertensión arterial (HTA), cardiopatía isquémica, enfermedad cerebrovascular y diabetes mellitus. La mayoría de los encuestados fueron hombres (64 %) de la raza blanca (70 %). Predominaron los roncadores diarios (70 %) con ronquido arrítmico (62,8 %) y más de 30 años de evolución (81,8 %). La HTA prevaleció significativamente en los hombres con ronquido arrítmico e interrupción del sueño (p = 0,01). No resultó significativa la relación de estas enfermedades con el hábito de beber alcohol y de fumar. Finalmente, el ronquido es un signo a considerar en la prevención y/o atención temprana de la HTA; de él debemos conocer: frecuencia, tiempo de evolución, ritmicidad e interrupción del sueño