O Supremo Tribunal Federal como agente tecnocrático no exercício da jurisdição constitucional na solução de casos complexos : análise das ações diretas de inconstitucionalidade nº 3937/SP e nº 3357/RS

Many changes have taken place in contemporary society causing impacts in its different sectors, making it much more complex and insecure than in past times. The alteration on the decision-making system of the Brazilian society is among the main changes today. The post-modern context contributed to the occurrence of the transfer of state power of the Legislative and Executive Powers to the Judiciary Power, specifically to the Federal Court of Justice, leading to an expansion on the actuation range of this institution mainly through the exercise of the constitutional jurisdiction. This has caused a crisis of legitimacy in society once the Court will now decide the political and social fundamental issues. In this scenario, the Direct Action of Unconstitutionality n° 3937/SP and n° 3357/RS are highlighted and both are being tried by the Supreme Court. Such emphasis is given, since it is a matter of high complexity and social repercussion that will be decided by a legal institution and not a political one. Thus, this work aims to analyze the role of the Supreme Court in the context of contemporary society on the trial of complex and controversial cases, particularly on the trial of Direct Action of Unconstitutionality n° 3937/SP and n° 3357/RS. This study has noticed that due to the post-modern context the majority of the Supreme Court Ministers tend to base their votes in constitutional principles and no longer limit themselves to a formal review of the constitutionality of laws, which indicates a substantialist approach. Moreover, it can be noticed the deliberative potential of the Court as well as the influence of the post-modern features, such as risk, uncertainty and insecurity on the elaboration of the Minister‟s votes. Therefore, sometimes, such as the case in study, the Supreme Court has acted as a technocratic agent in Brazilian society once fundamental political and social decisions for society especially when it comes to complex and controversial cases are being taken by the Supreme Court, which is composed by “Law technicians” and such decisions are mainly based in technical data and scientific studies. For the accomplishment of this work, it has been adopted the inductive approach and monographic procedure method and the bibliographical and documentary research technique.

Análise da expressão dos receptores HER-2 e sua correlação clínica em pacientes com neoplasia gástrica do setor de Oncologia do Hospital de Clínicas da Universidade Federal de Uberlândia-UFU

Introduction: Gastric cancer is currently the fourth higher cancer mortality rate among men in the world and the fifth among women, despite the progressive advances in oncology. The identification of tumor receptors and the development of target-drugs to block them has contributed to increased survival and quality of life of patients, but it becomes important to know the tumor profile of the population being treated, avoiding burdening treatment with examinations and treatments that are not cost-effective. Objective: To evaluate the profile of the population with gastric cancer treated in five years at the Clinical Hospital of the Federal University of Uberlândia and verify the correlation between overexpression of HER-2 receptor with an unfavorable prognosis. Methods: 203 records with gastric cancer were selected through the system database, attending a five-year period, of which 117 paraffin blocks were available for immunohistochemical assessment of HER2 receptor. Results: 2.6% of tumors showed overexpression of HER2, considering for this study two crosses as positive. There was no statistically significant difference in correlation between expression of the HER2 receptor with age, gender, tumor grade, local involvement, Lauren classification, Borrmann classification or staging. Conclusion: For this studied population, we can conclude that there is no need to employ HER2 blockers with high cost as a target-therapy in patients with gastric cancer, since no clinical benefit probably will be obtained due to a low percentage of these patients that demonstrated superexpression of this receptor or even there is no patients with gastric cancer with superexpression of HER2 with more than three crosses of positivity in immunochemistry

Associação entre comprometimento motor, mobilidade e qualidade de vida em crianças com paralisia cerebral espástica, nível I, II e III do Gross Motor Function Classification System

The objective of this study was to verify the association between some mobility items of the International Classification Functionality (ICF), with the evaluations Gross Motor Function Measure (GMFM-88), 1-minute walk test (1MWT) and if the motor impairment influences the quality of life in children with Cerebral Palsy (PC), by using the Paediatric Quality of Life Inventory (PedsQL 4.0 versions for children and parents). The study included 22 children with cerebral palsy spastic, classified in levels I, II, and III on the Gross Motor Function Classification System (GMFCS), with age group of 9.9 years old. Among those who have participated, seven of them were level I, eight of them were level II and seven of them were level III. All of the children and teenagers were rated by using check list ICF (mobility item), GMFM-88, 1-minute walk test and PedsQL 4.0 questionnaires for children and parents. It was observed a strong correlation between GMFM-88 with check list ICF (mobility item), but moderate correlation between GMFM-88 and 1-minute walk test (1MWT). It was also moderate the correlation between the walking test and the check list ICF (mobility item). The correlation between PedsQl 4.0 questionnaires for children and parents was weak, as well as the correlation of both with GMFM, ICF (mobility item) and the walking test. The lack of interrelation between physical function tests and quality of life, indicates that, regardless of the severity of the motor impairment and the difficulty with mobility, children and teenagers suffering of PC spastic, functional level I, II and III GMFCS and their parents have a varied opinion regarding the perception of well being and life satisfaction.

Tradução e adaptação transcultural do domínio função física do Patient-Reported Outcomes Measurement Information System – PROMIS® - versão para a língua portuguesa

In 2004, the National Institutes of Health made available the Patient-Reported Outcomes Measurement Information System – PROMIS®, which is constituted of innovative item banks for health assessment. It is based on classical, reliable Patient-Reported Outcomes (PROs) and includes advanced statistical methods, such as Item Response Theory and Computerized Adaptive Test. One of PROMIS® Domain Frameworks is the Physical Function, whose item bank need to be translated and culturally adapted so it can be used in Portuguese speaking countries. This work aimed to translate and culturally adapt the PROMIS® Physical Function item bank into Portuguese. FACIT (Functional Assessment of Chronic Illness Therapy) translation methodology, which is constituted of eight stages for translation and cultural adaptation, was used. Fifty subjects above the age of 18 years participated in the pre-test (seventh stage). The questionnaire was answered by the participants (self-reported questionnaires) by using think aloud protocol, and cognitive and retrospective interviews. In FACIT methodology, adaptations can be done since the beginning of the translation and cultural adaption process, ensuring semantic, conceptual, cultural, and operational equivalences of the Physical Function Domain. During the pre-test, 24% of the subjects had difficulties understanding the items, 22% of the subjects suggested changes to improve understanding. The terms and concepts of the items were totally understood (100%) in 87% of the items. Only four items had less than 80% of understanding; for this reason, it was necessary to chance them so they could have correspondence with the original item and be understood by the subjects, after retesting. The process of translation and cultural adaptation of the PROMIS® Physical Function item bank into Portuguese was successful. This version of the assessment tool must have its psychometric properties validated before being made available for clinical use.