A cultura de índio, seu menino, vem de longe aqui : formação histórica e territorialização dos Tremembé/CE

This dissertation is based on the ethnography of a strategic selection of three Tremembé ethnic situations, which are situated in the backlands of Acaraú and Itarema, municipalities located in Ceará State (Northeast Brazil). My main aims are the following. Firstly, I reconstitute the historical and social formation of three localities, called Lagoa dos Negros, Telhas, and Queimadas, related to a particular origin myth which refers to Almofala, an extinct colonial Aldeamento in the seashore, where the Tremembé indians and other native populations were converted and gathered under missionary administration. According to the origin myth, these three localities were set up after a strong drought which happened in 1888 (the so called three eights) when a group of Tremembé families moved to the countryside and established close to the Lagoa dos Negros and, later on, they were segmented into smaller groups which started to live in other areas and places not far from the former location. Notably, I develop an anthropological approach to understand the historical formation of these three localities. Secondly, I analyze some processes of territorialization, which were emerged from the 1980s and had important consequences to these indigenous families throughout the next two decades. This historical dimension is re-appropriated and ressignified in ethnic terms. A third point of my work is the analysis of the construction of territorialities and also the cultural and symbolic dimensions which are formulated by the Tremembé Indians who live in these localities. Therefore, I investigate some cultural traditions and rituals, such as the Torém dance, but I also examine their multiple semantics, which constitute a transversal direction throughout the history understood by the Tremembé of the different social situations I researched. To sum up, there is a process of cultural actualization, which is still going on and presents itself through the ludic sphere as well as their political and religions dimensions, which are usually associated to the ritual presentation of the Torém

Vai morrer o meu menino - Paralisado, doente, isolado, exclusivo, desejado e amado: Estudo de um processo de comunicação num universo simbiótico

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

As vicissitudes do espaço urbano moderno ou o menino e a água do banho

Tese de Doutoramento em Arquitetura, com a especialização em Teoria e Prática do Projecto, apresentada na Faculdade de Arquitetura da Universidade de Lisboa, para obtenção do grau de Doutor.

Life quality and the wellness in elderly. study case of the Casa do Menino Jesus

This research aims to present an analysis on the absence of innovative social responses to elderly, taking into account the need for stimulation of this population segment. Our main goal is not only a theoretical approach about the issue of elderly, but also present a study on the potentialities of the Casa do Menino Jesus, our case study, can apply for funding of a multisensorial stimulation response for elderly. This paper is divided into three parts: theoretical framework and characterization of our social organization, according to an exploratory research, structuring a strategic plan of the organization, through field research, and as final result, to present a proposal for funding and implementation of an innovative social response, according to the underlying legislation to Portugal 2020. The sample is focused on the population of Mirandela municipality. To conclude, it is important to make this local approach, because of the increasing number elder people with dementia problems and specific needs of treatment and stimulation.

A QUESTÃO DA EDUCAÇÃO ESCOLAR NO ASSENTAMENTO MENINO JESUS EM ÁGUA FRIA E SUAS IMPLICAÇÕES NA PRODUÇÃO DO ESPAÇO

O presente artigo é resultado de uma pesquisa preliminar desenvolvida no Assentamento Menino Jesus localizado no município de Água Fria (BA). A análise empírica teve como objetivo compreender o conflito político e, por sua vez territorial, estabelecido entre os assentados e o poder público municipal latente no interior do mencionado Assentamento. O centro deste conflito é estabelecido na luta pela supremacia e controle da escola, dos processos educativos formais e do currículo escolar. A perspectiva teórica aqui defendida se fundamenta em Althusser (1985) que afirma existir uma ligação umbilical entre Estado e aparelhos ideológicos. Através do Estado, a classe dominante monta um aparelho de coerção e de repressão social, que lhe permite exercer o poder sobre toda a sociedade, fazendo submeter-se às regras políticas. Neste sentido, compreende-se que os movimentos sociais lançam uma outra proposta de educação que supera a alienação para uma autonomia política. È nesta lógica desigual que o conflito se estabelece no assentamento Menino Jesus, entre a educação que possibilita a formação do sujeito crítico-reflexivo oriundo da Pedagogia do Movimento do Sem Terra e tradicional.

A QUESTÃO DA EDUCAÇÃO ESCOLAR NO ASSENTAMENTO MENINO JESUS EM ÁGUA FRIA E SUAS IMPLICAÇÕES NA PRODUÇÃO DO ESPAÇO

O presente artigo é resultado de uma pesquisa preliminar desenvolvida no Assentamento Menino Jesus localizado no município de Água Fria (BA). A análise empírica teve como objetivo compreender o conflito político e, por sua vez territorial, estabelecido entre os assentados e o poder público municipal latente no interior do mencionado Assentamento. O centro deste conflito é estabelecido na luta pela supremacia e controle da escola, dos processos educativos formais e do currículo escolar. A perspectiva teórica aqui defendida se fundamenta em Althusser (1985) que afirma existir uma ligação umbilical entre Estado e aparelhos ideológicos. Através do Estado, a classe dominante monta um aparelho de coerção e de repressão social, que lhe permite exercer o poder sobre toda a sociedade, fazendo submeter-se às regras políticas. Neste sentido, compreende-se que os movimentos sociais lançam uma outra proposta de educação que supera a alienação para uma autonomia política. È nesta lógica desigual que o conflito se estabelece no assentamento Menino Jesus, entre a educação que possibilita a formação do sujeito crítico-reflexivo oriundo da Pedagogia do Movimento do Sem Terra e tradicional.

Plano de intervenção para melhora da adesão ao tratamento da hipertensão arterial na Unidade Básica de Saúde Menino Marcos no município de São Sebastião

A hipertensão arterial é uma doença crônica de elevada prevalência na população brasileira. É considerada um grave problema na saúde pública devido a sua morbimortalidade, seus custos econômicos e dificuldade no controle. O controle adequado dos pacientes com Hipertensão Arterial deve ser uma das prioridades da Atenção Básica. Este estudo tem como objetivo propor um projeto de intervenção para melhorar a adesão ao tratamento das pessoas com hipertensão arterial da área de abrangência da Equipe de Saúde da Família Cruzeiro I do município de São Sebastião - AL. Foi realizada uma revisão literária acerca do tema proposto e elaborado o projeto de intervenção. Este inclui três projetos: "Pressão em dia", "Promovendo Saúde", e "Medicamento no Posto", com a finalidade de realizar uma busca-ativa para aumentar o número de hipertensos acompanhados na unidade; aumentar a disponibilidade de medicamentos na farmácia da unidade; priorizar e promover atividades coletivas através da criação de grupos operacionais, visando melhor controle dos níveis pressóricos, melhoria do bem estar e mudança nos hábitos de vida. Concluiu-se que a elaboração do plano de intervenção foi de extrema importância para traçar as ações que serão executadas pela equipe multiprofissional almejando os objetivos propostos.

Hearing Preservation And Cochlear Implants According To Inner Ear Approach: Multicentric Evaluation.

Electroacoustic stimulation is an excellent option for people with residual hearing in the low frequencies, who obtain insufficient benefit with hearing aids. To be effective, the subject's residual hearing should be preserved during cochlear implant surgery. To evaluate the hearing preservation in patients that underwent implant placement and to compare the results in accordance with the approach to the inner ear. 19 subjects underwent a soft surgical technique, and the electrode MED-EL FLEX™ EAS, designed to be atraumatic, was used. We evaluated pre- and postoperative tonal audiometric tests with an average of 18.4 months after implantation, to measure the rate of hearing preservation. 17 patients had total or partial preservation of residual hearing; 5 had total hearing preservation and two individuals had no preservation of hearing. The insertion of the electrode occurred through a cochleostomy in 3 patients, and in 2 of these there was no hearing preservation; the other 16 patients experienced electrode insertion through a round window approach. All patients benefited from the cochlear implant, even those who are only using electrical stimulation. The hearing preservation occurred in 89.4% of cases. There was no significant difference between the forms of inner ear approach.

Tumor de células granulares acometendo a órbita em uma criança

The authors report a rare case of granular cell tumor in the left medial rectus muscle of a seven-year-old boy. Clinical, pathologic and radiologic findings of the present case are described and a brief literature review is undertaken.

46,XX Male - Testicular Disorder of Sexual Differentiation (DSD): hormonal, molecular and cytogenetic studies

The XX male syndrome - Testicular Disorder of Sexual Differentiation (DSD) is a rare condition characterized by a spectrum of clinical presentations, ranging from ambiguous to normal male genitalia. We report hormonal, molecular and cytogenetic evaluations of a boy presenting with this syndrome. Examination of the genitalia at age of 16 months, showed: penis of 3.5 cm, proximal hypospadia and scrotal testes. Pelvic ultrasound did not demonstrate Mullerian duct structures. Karyotype was 46,XX. Gonadotrophin stimulation test yielded insufficient testosterone production. Gonadal biopsy showed seminiferous tubules without evidence of Leydig cells. Molecular studies revealed that SRY and TSPY genes and also DYZ3 sequences were absent. In addition, the lack of deletions or duplications of SOX9, NR5A1, WNT4 and NROB1 regions was verified. The infant was heterozygous for all microsatellites at the 9p region, including DMRT1 gene, investigated. Only 10% of the patients are SRY-negative and usually they have ambiguous genitalia, as the aforementioned patient. The incomplete masculinization suggests gain of function mutation in one or more genes downstream to SRY gene.

Long-term follow-up of an 8-year-old boy with insulinoma as the first manifestation of a familial form of multiple endocrine neoplasia type 1

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant hereditary cancer syndrome characterized mostly by parathyroid, enteropancreatic, and anterior pituitary tumors. We present a case of an 8-year-old boy referred because of hypoglycemic attacks. His diagnosis was pancreatic insulinoma. Paternal grandmother died due to repeated gastroduodenal ulcerations and a paternal aunt presented similar manifestations. At a first evaluation, the father presented only gastric ulceration but subsequently developed hyperparathyroidism and lung carcinoid tumor. During almost 15 years of follow-up, three brothers and the index case presented hyperparathyroidism and hyperprolactinemia. Molecular study showed a G to A substitution in intron 4, at nine nucleotides upstream of the splicing acceptor site, causing a splicing mutation. All affected members of the family have the same mutation. Paternal grandmother and aunt were not studied and the mother does not carry any mutation. MEN1 is a rare condition that requires permanent medical assistance. Early clinical and genetic identification of affected individuals is essential for their own surveillance and also for genetic counseling.

46,XX DSD and Antley-Bixler syndrome due to novel mutations in the cytochrome P450 oxidoreductase gene

Deficiency of the enzyme P450 oxidoreductase is a rare form of congenital adrenal hyperplasia with characteristics of combined and partial impairments in steroidogenic enzyme activities, as P450 oxidoreductase transfers electrons to CYP21A2, CYP17A1, and CYP19A1. It results in disorders of sex development and skeletal malformations similar to Antley-Bixley syndrome. We report the case of a 9-year-old girl who was born with virilized genitalia (Prader stage V), absence of palpable gonads, 46,XX karyotype, and hypergonadotropic hypogonadism. During the first year of life, ovarian cyst, partial adrenal insufficiency, and osteoarticular changes, such as mild craniosynostosis, carpal and tarsal synostosis, and limited forearm pronosupination were observed. Her mother presented severe virilization during pregnancy. The molecular analysis of P450 oxidoreductase gene revealed compound heterozygosis for the nonsense p.Arg223*, and the novel missense p.Met408Lys, inherited from the father and the mother, respectively. Arq Bras Endocrinol Metab. 2012;56(8):578-85

Neuronal Ceroid-lipofuscinosis with prominent chorea and without visual manifestations: a case report

A case of neuronal ceroid-lipofuscinosis (NCL) is reported in a 11-year-old girl, whose main symptoms were progressive dementia since the age of 4 years and choreic movements since age 10. Seizures, myoclonus and visual deterioration were absent and optic fundi were normal. A cerebral biopsy disclosed two basic types of stored substance in the cytoplasm of neurons: a) severely balloned nerve cells in cortical layers HI and V contained a non-autofluorescent material, which stained with PAS and Sudan Black B in frozen, but not in paraffin sections; ultrastructurally, these neurons showed abundant corpuscles similar to the membranous cytoplasmic bodies of Tay-Sachs disease and, in smaller amounts, also zebra bodies; b) slightly distended or non-distended neurons in all layers contained lipopigment granules, which were autofluorescent, PAS-positive and sudanophil in both frozen and paraffin sections; their ultrastructure was closely comparable to that of lipofuscin. Similar bodies were found in the swollen segments of axons and in a few astrocytes and endothelial cells. The histochemical and ultrastructural demonstration of large amounts of lipopigments allows a presumptive classification of the case as NCL. However, the presence of involuntary movements, the absence of visual disturbances and the unusual ultrastructural features place the patient into a small heterogeneous group within the NCL. A better classification of such unique instances of the disease must await elucidation of the basic enzymatic defects.

Neurinoma maligno infratentorial: relato de um caso

A solitary malignant schwannoma of the foramen jugular, unassociated with von Recklinghausen's disease in a two years and nine months old girl is presented. A partial removal of the tumor was carried out. The low incidence in this age group is emphasized in report to the literature reviewed.

Familial glioblastoma

The authors describe a family with three members affected by glioblastoma. The proband patient, a 7 year-old girl, developed a rare complication, a pulmonary metastasis. Chromosomal analysis of her peripheral blood lymphocytes showed a normal karyotype (46, XX), without structural abnormalities. Cytogenetic study of the tumor cells disclosed several abnormalities: 46, XX, 7q - / 46, XX, -2, 4p-, 7p-, +15/ 46, XX. Some aspects about genetics of glial neoplasms are discussed.