Função autonômica em pacientes portadores de lipodistrofia generalizada congênita - sindrome de berardinelli - SEIP

A Síndrome de Berardinelli-Seip ou Lipodistrofia Generalizada Congênita (LGC) é uma doença rara, com transmissão autossômica recessiva, caracterizada principalmente pela ausência quase total de tecido adiposo. Os pacientes afetados apresentam resistência a insulina, dislipidemia e hipertensão arterial. Estudos têm evidenciado que estas alterações metabólicas interferem na modulação autonômica para o nó sinusal. O principal objetivo deste estudo foi investigar a modulação autonômica em pacientes portadores de LGC, através da variabilidade de freqüência cardíaca (VFC), pelo método linear de domínio de tempo na Eletrocardiografia Dinâmica de 24 horas e estabelecer um critério relativamente simples, não invasivo, para diagnóstico de disfunção autonômica nestes pacientes. Participou voluntariamente deste estudo transversal, um grupo de pacientes portadores de LGC (n=18) na faixa etária de 9,3 a 39,8 anos (21,3 ± 8,3) cuja variabilidade de freqüência cardíaca foi comparada com um grupo de pacientes controles (n=19) com idade de 9,3 a 39,1 anos (21,4 ± 7,8). Todos os voluntários foram submetidos à avaliação clínica, laboratorial, antropométrica e análise de VFC no domínio de tempo através de eletrocardiografia dinâmica de 24 horas. Para análise dos dados relativos aos índices temporais de VFC foram utilizados o MeanRR, SSDN e rMSSD. Pacientes com LGC apresentavam aumento da pressão arterial comparados com indivíduos do grupo controle (sistólica, 131,1 vs 106,3 mmHg, p<0,05); diastólica, 85,0 vs 68,2 mmHg, p<0,05) e 10 tinham critérios para diagnóstico de Hipertensão Arterial e Hipertrofia do Ventrículo Esquerdo. Os níveis de glicose, triglicerídeos, colesterol e HOMA-R eram elevados e 12 pacientes tinham critérios para diabetes mellitus tipo 2. Comparado com os controles, pacientes com LGC tinham diminuição dos índices MeanRR (639,8 vs 780,5 ms, p<0,001), SDNN (79,2 vs 168,5 ms, p<0,001), e rMSSD (15,8 vs 59,6 ms, p<0,001). Em pacientes com LGC, a redução da VFC foi independente de distúrbios metabólicos e hemodinâmicos. Os resultados de nosso experimento indicam que pacientes com LGC apresentavam modulação autonômica anormal caracterizada pelo aumento da freqüência cardíaca e pronunciada redução da VFC, independente de distúrbios metabólicos e hemodinâmicos observados nesta síndrome. O caráter multidisciplinar desse estudo fica contemplado pela interação de profissionais de diversas áreas como: cardiologia, endocrinologia, metabolismo, neurologia, nutrição, etc

Determinação da idade dental de crianças brasileiras nordestinas: novos valores de conversão de maturidade dental para população específica

Since Demirjian's system of estimating dental maturity was first described, many researchers from different countries have tested its accuracy among diverse populations. Some of these studies have pointed out a need to determine population-specific standards. In Brazil, the Northeast region is the one that most suffers the negative impact of exodus, specially related to the increase of abandoned children in the cities. The aim of this study was to test the accuracy of Demirjian's system for assessing the dental maturity of northeastern Brazilian children, so as to present a scale for maturity score conversion into dental age developed specifically for this population. This could be used for forensic, anthropological and legal matters, and also as a model for other countries attempting to formulate their own conversion scales. Panoramic radiographs of 1,491 children (821 females and 670 males), aged 7 to 13 years, from Ceará state, northeast Brazil, were assessed by a single observer to determine dental age (DA) according to Demirjian's system. The mean percentage of intra-observer agreement was 86.6%, with a mean Cohen's Kappa coefficient of 0.67 (substantial agreement). The DA was compared by paired t-test to subjects' chronological age (CA). The differences between CA and DA in all age groups were statistically significant (p<0.0001), demonstrating a great advancement in DA among Brazilians. Scatter plots were drawn for both genders, and the data were fitted to a growth curve, y = 100/ (1 + e-a(x b)). Graphs corresponding to the 50th percentile curves were produced. A table with new values for the conversion of maturity score into dental age for northeastern Brazilian children is presented. The great advancement in DA, as obtained by Demirjian's system in this population, justified the determination of specific scores for dental maturity assessment

Fatores litogênicos em pacientes com litíase urinária de Fortaleza, Ceará

Lithiasis is considered a public health issue due to its high prevalence and rates of recurrence. Objective: To identify risk factors for lithiasis in kidney stone patients from Fortaleza, Brazil. In the first stage of the study, the medical records of 197 patients with urinary lithiasis covering the period 1996 2006 were analyzed with regard to clinical and metabolic data. In the second stage, 340 kidney stones were submitted to morphological examination under 10x magnification. According to the external morphology and the cut surface, the stones were classified as pure or mixed, and major and minor components were identified. In addition, the stone fragments of 25 patients treated with lithotripsy were submitted to morphological analysis. In the third stage, a subsample of 50 stones was used in a double-blind comparison of morphological and chemical findings. Results were expressed as concordant, partly concordant (discordant for minor components) or discordant (discordant for major components). The average age of first symptoms was 35.8±13.3 years, with no significant difference between the genders. The male/female ratio was 1:1.7. Recurrence was reported in 53.3% of cases. The main metabolic changes observed were hypernatriuria (80.7%), hypercalciuria (48.7%), low urine volume (43.7%), hyperoxaluria (30.5%) and hyperuricosuria (17.3%). Pure stones represented 34.7% of the total sample of 340 stones. The most common route of elimination was spontaneous for pure stones (49.1%) and surgical for mixed stones (50.5%). Pure stones consisted most frequently of calcium oxalate (OxCa) (59.3%) and uric acid (UA) (23.7%), the former prevalent in women, the latter prevalent in men. The most frequently observed component in mixed stones was OxCa (67.1%), followed by carbapatite (11.2%) and struvite (7.9%). The main components were OxCa and UA for men, and carbapatite and struvite for women. Nearly half (48%) the 25 analyzed fragments were pure, consisting of calcium oxalate dihydrate (COD) (56%), calcium oxalate monohydrate (COM) (48%), phosphate (32%) and UA (20%). Four patients (16%) had infectious stones. In the chemical analysis of the subsample of 50 stones, the most 64 frequently observed major components were calcium (70%), oxalate (66%), ammonium (56%), urate (28%) and carbonate (24%). In the morphological analysis, the main components were calcium and magnesium phosphate (32%), COM (24%), UA (20%), COD (18%) and cystine (6%). Morphological and chemical findings were totally concordant for 38% of the stones, partly concordant in 52% and discordant in 10%. Conclusion: The risk factors for lithiasis in kidney stone patients from Fortaleza (Brazil) were hyperoxaluria, hypercalciuria with or without hypernatriuria, hyperuricosuria and low urine volume

Marcadores nutricionais e inflamatórios e sua associação com a morbimortalidade em hemodiálise

Background: Malnutrition, inflammation and comorbidities are frequent in patients with chronic renal failure in hemodialysis (HD), contributing for morbidity and mortality. Aims: To evaluate the correlation between anthropometric, laboratory parameters, bioelectrical impedance (BIA) and inflammatory markers with the morbidity and mortality of patients in HD, as well as the impact of its alterations throughout 12 months. Methods: 143 patients of a dialysis facility in Northeast Brazil were evaluated throughout 18 months. Patients with more than 3 months on dialysis, older than 18 years, without amputation of hands and feet, were included in the study. We performed a clinical (subjective global assessment - SGA), anthropometric (BMI, percent of ideal weight, MAC, MAMC, MAMA, percent of fat mass and TSF), laboratory (albumin, creatinine, lymphocyte count as nutritional markers and CRP, IL-6 and TNF- as inflammatory markers) evaluation and BIA (reactance, phase angle and percent of body cell mass) at the beginning of study and after 3, 6 and 12 months of follow-up. The association between study variables and deaths and hospitalizations in 6 and 12 months was investigated. The variable with significance < 10% in the univariate analysis had been enclosed in a multivariate logistic regression analysis. We also investigated the risk of mortality and hospitalization associated with differences in measurements of the variables at baseline and six months later. Results: Patients were aged 52.2 ± 16.6 years on the average, 58% were male, and mean dialysis vintage was 5.27 ± 5.12 years. The prevalence of malnutrition varied from 7.7-63.6%, according to the nutritional marker. The variables associated with morbidity and mortality in 6 and 12 months had been creatinine ≤ 9.45 mg/dl, phase angle ≤ 4.57 degrees, BMI ≤ 23 kg/m2, age ≤ 64.9 years, reactance ≤ 51.7 ohms; Charlson´s index ≥ 4 and socioeconomic status ≤ 7. During six months of follow up, decrease in albumin was associated with significantly higher mortality risk. Conclusions: This study detected that the best predictors of morbidity and mortality between nutritional and inflammatory markers are phase angle, reactance, creatinine and BMI and that changes in albumin values over six 107 months provide additional prognostic information. The authors believe that parameters of BIA may detect early changes in nutritional status and emphasize that longitudinal studies with larger number of patients are necessary to confirm these data and to recommend BIA as a routine nutritional evaluation in HD patients

Impacto da variabilidade de peso no controle matebólico de pacientes transplantados cardíacos

Heart transplantation (HT) represents one of the greatest advances in medicine over the last decades. It is indicated for patients with severe heart disease unresponsive to clinical treatment and conventional surgery, poor short-term prognosis and a 1- year mortality rate over 40%. HT has improved survival worldwide (80% in the first year, 70% in five years and 60% in ten years). However, the procedure has been associated with weight change and increased risk of secondary conditions such as diabetes, hypertension, dyslipidemia and obesity due to immunosuppressive therapy following transplantation. The objective of this study was to determine the impact of weight change on the metabolic stability of HT patients. The study was retrospective with data collected from the records of 82 adult patients (83% male; average age 45.06±12.04 years) submitted to HT between October 1997 and December 2005 at a transplantation service in Ceará (Brazil). The selected outcome variables (biopathological profile, weight and body mass index―BMI) were related to biochemical and metabolic change. The results were expressed in terms of frequency, measures of central tendency, Student s t test and Pearson s correlation coefficients. The analysis showed that following HT the average global BMI increased from 23.77±3.68kg/m2 to 25.48±3.92kg/m2 in the first year and to 28.38±4.97kg/m2 in the fifth. Overweight/obese patients (BMI ≥ 25 kg/m2) had higher average levels of glucose, total cholesterol, low-density lipoprotein and triglycerides than patients with eutrophy/malnutrition (BMI < 25 kg/m2). In conclusion, overweight/obese patients were likely to present higher average levels of glucose, triglycerides, total cholesterol and fractions than patients with eutrophy/malnutrition, indicating a direct and significant relation between nutritional status and weight change in the metabolic profile of HT patients

Estudo genético-clínico de mucopolissariodoses no estado do Ceará

As mucopolissacaridoses (MPS) são doenças genéticas raras decorrente da deficiência de enzimas lisossomais envolvidas no catabolismo de glicosaminoglicanos, resultando em um amplo espectro de manifestações clínicas, progressivas e multissistêmicas, exigindo tratamento por uma equipe multidisciplinar. Embora o Nordeste brasileiro seja uma região com grande taxa de consangüinidade e um efeito fundador envolvendo MPS, não há estudos caracterizando os pacientes dessa região. Nosso objetivo foi determinar o perfil epidemiológico, clínico e genético de casos não publicados com MPS provenientes do Ceará, identificando as diferenças entre outros estudos com MPS e possíveis problemas a serem enfrentados para a realização do diagnóstico precoce. O estudo foi seccional, descritivo, com amostra de pacientes com MPS em acompanhamento no Hospital Infantil Albert Sabin e Hospital Geral Cesar Cals no período de 2006-2013. Os dados foram obtidos a partir da avaliação clínica, revisão de prontuários médicos e entrevista com os pacientes e/ou familiares realizadas pelo investigador principal. Cinquenta e três pacientes foram incluídos no estudo (36 do sexo masculino), sendo 6 MPS I, 17 MPS II, 7 MPS III (3 MPSIII-A, 3 MPS III-B, 1 MPS III-C), 7 MPS IV-A, 16 de MPS VI. O óbito ocorreu em 16 casos (3 MPS I, MPS II 6, 1 MPS IIIA , IIIB 1MPS , 1 MPS IV , 4 MPS VI). A amostra foi composta principalmente por crianças. Houve elevada taxa de consangüinidade e recorrência familiar. Os tipos mais comuns foram MPS II e MPS VI. Exceto para macrossomia em MPS II, os dados de nascimento indicam que não houve risco para desenvolvimento de viii complicações perinatais. Os sintomas iniciaram em crianças com menos de 2 anos. As manifestações clínicas foram heterogêneas exceto para atraso no desenvolvimento neurológico em MPS III e manifestações esqueléticas em MPS IV. As principais características clínicas foram macrocefalia, baixa estatura, alterações odontológicas, respiratórias, cardíacas, hepatoesplenomegalia, hérnia umbilical, rigidez articular e anormalidades esqueléticas. A terapia de reposição enzimática foi instituída em 26 casos (4 MPS I, 10 MPS II, 12 MPS VI). Os problemas sócio-econômicos das famílias, o amplo espectro de sintomas e a gravidade da doença foram causas das dificuldades em realizar a avaliação periódica pela equipe multidisciplinar, além de exames complementares de maior custo para determinar as complicações da doença. Este foi o maior estudo transversal sobre MPS no Nordeste do Brasil. Em contraste com a maior incidência de MPS I na maioria das populações ocidentais, houve maior incidência de MPS II e VI. As alterações respiratórias foram um dos principais contribuintes para a mortalidade precoce, exceto nos casos de MPS I, em que a cardiomiopatia foi prevalente. A menor expectativa de vida ocorreu em MPS I. O envolvimento cognitivo foi comum em casos graves e o maior número de órgãos envolvidos representou maior risco de morrer. Para o diagnóstico precoce, deve-se buscar indivíduos afetados em famílias em que há parentes com MPS, além do maior reconhecimento de sinais e sintomas de MPS por profissionais de saúde

Perfil periodontal de pacientes portadores de alterações endócrino-metabólicas

Objective- Convinced that periodontium, many times, can show alterations in human health, the aim of these studies was to investigate the periodontal situation in patients with endocrine-metabolic disorders such as, Berardinelli-Seip Syndrome, hyperthyroidism, hypothyroidism and acromegaly. Methods- Eight patients with Berardinelli-Seip Syndrome, 16 acromegalics, 30 hypothyroids, 30 hyperthyroids, and a control group with 35 patients were evaluated. Clinical attachment loss, probing depth, gingival bleeding index, gingival overgrowth and Index of Decayed, Missing and Filled Teeth were measured in each patient. All ethical aspects were rigidly observed, being the study conducted after its approval by the University of Fortaleza Research Ethics Committee. Results- The presence of periodontitis was marked in hyperthyroids and in patients with Berardinelli-Seip Syndrome. Hypothyroids showed not much presence of periodontitis, while all acromegalics presented absence of periodontitis. Conclusions- The protective effect of periodontitis in acromegalic patients is a new finding, whose mechanisms are not yet clear, but may be related to the anabolic effects of growth hormone. The presence of periodontitis in Berardinelli-Seip Syndrome may occur due the early onset of diabetes. In hyperthyroids, the high prevalence of periodontitis could be linked to thyroid hormones effects on bone, explaining also the minor prevalence in hypothyroids

Retratos do cotidiano: as mulheres do assentamento rural Santa Vitória

The present work shows trajectories of life of seated women agricultural, with the objective to apprehend on aspects to the experience of its sexuality. The daily one of the seated woman is constructed in a new space, called agricultural nesting whose formation if presents with proper singularity to a social and economic context and politician of the Great River of the North. Its passages of life are permeaty by different violences suffered in its daily one and its sexuality is weaveeed by a set of rules that the naturalization of the subordination of the woman in relation to the man keeps. The societies use the systems of the relations between men and women and transform the biological characteristic into activities human beings

A boa-fé objetiva na concessão dos incentivos fiscais / Humberto Antônio Barbosa Lima

This essay analyzes tax incentives concepts and existing discussions on national and foreing doctrine, especially in countries that influence our legal culture, such as Germany, United States of America, Spain, Italy and England, providing a detailed study about the requirements that must be observed to ensure that there be a legitimate concession of the same. All this using as argument the Constitutional Charter and the development of the Law, mainly through the principle of objective good faith, which acts as the limiting principle of administrative discretion in granting such tax incentives, as well as creative element of the new duties for the public managers in order to be more effective, efficient and transparent compliance with the pact between the government and society and the objectives pursued by the last. Always chasing a strong argument through a broad historical and philosophical analysis of the institutes discussed. Thus, through studies that reveal the necessary incidence of objective good faith in granting tax incentives to achieve the constitutional purposes, this work does not merely disclose what is wrong, but provides solutions to modify reality hitherto existing, ie, introduces ways to reduce the encumbrance of the odious and ineffective tax incentives in society and to redirect these values unjustly destinated for obscure interests to achieve the real reasons for the existence of tax incentives, especially economic development through the reduction of regional and social inaqualities and poverty eradication

O púlpito como cátedra: retórica e educação nos sermões do Pe. Antônio Vieira (1608-1697)

This work aims to analyze the relationship among culture, education and rhetoric on the sermons of the Priest Antonio Vieira (1608-1697). It discusses the presence of oratory on the Western teaching since its Greek origins until the formation of the Ratio Studiorum in 17th-century. Brazilian society is defined as baroque and the rhetoric arises as element essential in the elaboration of the social imaginary speeches and, occupying as an essencial element in the elaboration of discursese and social imaginaries, occupying the centre of controversies, about questions like reason and the faith, ethics and the politics, the nature of the Indian and African peoples, even over the own construction of the modern subject. In this context the vieira´s preaching discharges the functions of kerigma (preaching), didachê (education) and politics (action). The research consisted in a finicky reading over five of these sermons that were returned in the presence of different audiences. The pulpit was the cathedra where Vieira used his sermons as a manner of social mobilization that aimed not only teaching a determined knowledge of reality, but altering cruel situations like Indian and poor people slavery in his epoch. Education by Vieira consist in a tension between utopian hopes and urgencies of practice. The rhetorical tradition affirms the interdependence of technical ethics and politics aspects. To know is not enough is necessary to convince and to move, realizating passage from theorical to practical liverly. It presupposes still the preoccupation with the solidity of argumentation and of reasoning, a wide cultural formation, the requirement of a civic ethics and, mainly, the adequacy between content and the specifics of audience

Educação ambiental: mediações sociais e políticas e a indolência do Poder Público à sua inclusão no ensino formal

As a result of the prediction of irreversible changes on necessary conditions to maintain life, including human, on the planet, environmental education got the spotlight in the political scenario, due to social pressure for the development of individual and collective values, knowledge, skills, attitudes and competences towards environmental preservation. In Brazil, only in 1999 the right for environmental education was officially granted to people, having the status of essential and permanent component in the country s education. Since then, it has been Government s duty, in each federal branch, to plan actions to make it happen, in an articulate way in all levels and modalities of the education process, both formally and informally. This work of research has environmental education in the school as subject matter, and aims on analyzing social and political mediations established between this National Environmental Education policy and the contexts associated to the legislative production process, the political nature of the conceptions about environmental education that underlie Law 9.795/99 (Brazil, 2009c) and also Rio Grande do Norte Government s actions and omissions related to the imperative nature of the insertion of environmental education in the schools ran by the state, during the ten years this law has been in force. The investigation of the subject matter was led by a social and historical understanding of the social and environmental phenomena, as well as of the education system as a whole, considering that only through a dialectical view we can see the real world, by destroying the pseudo-concreteness that surrounds the topic. While analyzing, we assumed that in face of the dominance of a social organization in which market regulations rule on environmental ones, by developing individual and collective critical conscience, environmental education can become a threat to dominant economical interests in exploiting natural resources. The results of this research suggest that as an educational practice to be developed in an integrated, continuous and permanent fashion in all levels and modalities of formal education, environmental education has not yet come to pass in the state of Rio Grande do Norte, due to the neglect and disrespect of the government when facing the need of promoting the necessary and legally appointed measures to make it present in the basic education provided by the state. The legislators silence when it comes to approving a regulation on environmental education essential to define policies, rules and criteria to teaching the subject in the state and the omission from the public administration regarding critical actions in order to integrate in public schools the activities related to the National Environmental Education Policy, represent a political decision for not doing anything, despite the legal demand for an active position. This neglecting attitude for the actualizing of strategically concrete actions, urgent and properly planned for the implementation of environmental education in schools in a multidisciplinary way, exposes the lack of interest the predominant classes have in such kind of education being made available, as it could be developed based on a critic political view, becoming a political and educational action against dominance. When analyzing the basic principles and fundamental goals in Law 9.795/99 (Brazil, 2009c) the development of a critic environmental education is really possible and concurs with the National Environmental Education Policy, reflecting the social and political mediations established between this public policy and the contexts associated to its legislative production process, which are responsible for approving a regulation which also represents the mind of the people about environmental protection above anything else

A Construção social do conhecimento :a reorientação curricular via tema gerador na Escola Cabana em Belém/PA

Cette étude analyse l'expérience de réorientation curriculaire atravers le sujet générateur, vécue dans les écoles qui composent le système municipal d'éducation de Belém du Pará - École Cabana, en ayant comme locus de recherche l'École Municipale João Carlos Batista. Ce mouvement de réorientation curriculaire, qui rompt avec le modèle traditionnel d'un curriculum linéaire, hiérarchique et fragmenté a comme préssuposées théoriquesméthodologiques les principes et les catégories freireanas la pédagogie critique qui estime un curriculum interdisciplinaire, dialogique, démocratique et contextuel, à partir de la systématisation d'une proposition theorico-méthodologique de réorientation curriculaire par le thème générateur, c'est-à-dire, en partant de situations-problème de la communauté scolaire, en faisant des relations négociées par les connaissances scolaires pour la compréhension et possible intervention dans la réalité. Cette proposition est mise en oeuvre non seulement à Belém, mais aussi par d autres municipalités du Brésil. Étant donné que l'École Cabana est une expérience inovatrice dans la tentative de viabiliser une Éducation vraiment démocratique, elle dialogue encore avec autres expériences d'écoles de même nature au Brésil, (comme l'École Plural-MG, l'École Citoyen - RS et l'École Candanga DF). Á partir des idées de Paulo Freire, J. Sacristán, M. Apple, C. Linhares, A. Coulon et autres j apporte des réflexions epistemologiques concernant le problème de la recherche qui consiste sur le registre et l'analyse de la tentative de construction sociale de la connaissance par le thème générateur qui a eu lieu à l'École Cabana dans la période de 2001 à 2004. Comme procédure méthodologique, j'ai développé une Recherche qualitative, de caractère collaboratif, en utilisant comme techniques de rassemble de données l observation participative dans le quotidien écolier, des interviews semi-structurées, et l'analyse des documents et des productions de l'École. Les résultats indiquent l'importance du registre de ce type d expérience, en soulignant leurs avances et reculs qui pourront servir de référentiel pour de futures politiques de réorientation curriculaire dans la direction de la construction sociale de la connaissance et, par conséquent, d'une Éducation plus démocratique et tournée vers une citoyenneté active

Aprendendo a pertencer: uma leitura da trezena de Santo Antônio em Pradoso enquanto territorialidade humana

The Novena of St. Anthony in Pradoso, is an annual celebration that takes place between June 1 and June 13. Since its preparation to the conclusion of the celebration are employed traditional knowledges and techniques, which are shared by the community. Such knowledges, built over generations, associated with popular religion, form it into the educational processes that build, through orality, practices and experiences of everyday life, the sense of belonging. An analysis of scenes, knowledges and subjects involved in the celebration, shows the form and content of practices capable of building symbolic territories of belonging. Thus, the Novena of St. Anthony in Pradoso, while an human territoriality, is designed as a locus of learning of belonging, reaffirming community values such as solidarity, service, brotherhood, integration, among others. While empirical reference for an analysis of the importance of belonging, the Novena of St. Anthony in Pradoso, offers subsidies for the production of knowledge, focused on understanding the need for a reconnection of technical and humanistic knowledges

Aí eu era Antônio Brasil: contribuições de situações didáticas com conhecimentos históricos para a construção da identidade pessoal da criança na educação infantil

L'objectif de cette étude est de comprendre la relation entre les situations didactiques faisant appel aux connaissances historiques et la construction de l'identité personnelle pour les enfants dans l'éducation de la petite enfance. Sa question centrale se demande si les connaissances sont offrent des contributions à la construction de l'identité personnelle par les enfants de la petite enfance. Se distingue, lui aussi, entend contribuer à élargir le débat sur l'enseignement et l'apprentissage des thèmes historiques dans l'éducation des enfants, et permettre un dialogue avec d'autres enseignants dans cette étape de l'éducation. Ont été analysés par des principes théoriques et méthodologiques de qualité et a assumé les orientations méthodologiques de la recherche collaborative. Il a été constaté que la systématisation des situations didactiques impliquant la connaissance historique dans l'éducation de la petite enfance contribue à la construction de l'identité personnelle de l'enfant. Ceci, pour prendre possession de ces connaissances, ils recueillent des renseignements qui permet le plus large éventail de relations, afin de comparer les pratiques culturelles de son temps avec des pratiques à d'autres moments. Ainsi orientée, l'enfant cherche à raconter son histoire avec le thème historique à laquelle elle a eu accès, d'organiser et de construire des réponses des explications sur leur environnement et de lui-même. Tout cela montre à la réalisation que le processus d'internalisation des connaissances historiques de l'enfant est construit comme un sujet et, par conséquent, cette connaissance peut être conçu comme un médiateur dans la formation de l'identité personnelle