La conservation autologue de sang de cordon ombilical : une ouverture sur une forme émergente de «citoyenneté biologique»

La transformation du sang de cordon ombilical en une précieuse source de cellules souches a, dès le début des années 1990, donné naissance à une industrie commerciale globale de conservation faisant désormais concurrence à un large réseau de conservation public. Ce mémoire cherche à comprendre et à expliquer les soubassements socio-culturels liés à l’émergence de cette industrie, ainsi qu’à mieux cerner les enjeux éthiques et politiques qu’elle pose. En exposant en premier lieu la manière dont les institutions publiques de conservation de sang de cordon se définissent, et sont généralement définies par les comités bioéthiques, comme étant porteuses des valeurs d’altruisme et de solidarité nationale traditionnellement liées au modèle « redistributif » d’échange de sang et d’organes né au lendemain de la Seconde Guerre mondiale, nous problématisons la manière innovatrice par laquelle les banques privées structurent le rapport entre les mères et leurs propres produits biologiques comme l’expression d’une reconfiguration du lien social et politique caractérisée par l’émergence de nouvelles socialisés. L’hypothèse au coeur de ce mémoire est que celles-ci peuvent être comprises comme l’aboutissant de l‘espoir collectivement partagé par les consommatrices d’améliorer leur propre condition biologique familiale, étant lui-même le fruit d’une financiarisation croissante des sciences du vivant. En analysant le discours « promissif » que représente le matériel promotionnel des banques autologues, notre objectif est alors d’identifier la manière par laquelle les multiples potentialités attribuées au sang de cordon définissent des subjectivités maternelles caractérisées par des obligations morales spécifiques.

Anomalies immunitaires chez les enfants exposés au VIH mais non infectés

La thérapie antirétrovirale prévient la transmission mère-enfant du VIH dans plus de 98% des cas lorsqu’administrée pendant la grossesse, le travail et au nouveau-né. L’accessibilité à la thérapie antirétrovirale dans près de 70% des 1,5 millions cas de grossesses VIH+ dans le monde mène à la naissance de plus d’un million d’enfants exposés non infectés chaque année. Le nombre d’enfants exposés non infectés est à la hausse ainsi que les préoccupations concernant leur santé. En effet, plusieurs groupes ont signalé une augmentation de la morbidité et de la mortalité chez les enfants exposés non infectés. L’analyse des données rétrospectives de 705 enfants exposés non infectés de la cohorte mère-enfant du CMIS a révélé qu’à 2 mois d’âge, les enfants nés de mères ayant une charge virale supérieure à 1,000 copies d’ARN / ml avaient une fréquence de lymphocytes B significativement plus élevés par rapport aux enfants exposés non infectés nés de mères ayant une charge virale indétectable. L’objectif de cette étude est de caractériser ces anomalies. Les lymphocytes, provenant du sang de cordon ombilical et de sang veineux obtenu à 6 et 12 mois d’âge, ont été phénotypés par cytométrie en flux à l’aide des marqueurs CD3 / CD10 / CD14 / CD16 / CD19 / CD20 / CD21 / CD27 / IgM pour les lymphocytes B et CD4 / CD8 / CD3 / CCR7 / CD45RA pour les lymphocytes T. De plus, afin d’étudier les capacités fonctionnelles des lymphocytes B CD19+, la réponse antigène-spécifique au vaccin antitétanique a été mesurée par marquage avec des tétramères fluorescents de fragment C du toxoïde tétanique. Nos travaux ont mis en évidence des différences statistiquement significatives entre les enfants exposés non-infectés (ENI) nés de mères avec une charge virale détectable comparativement à ceux nés de mères avec une charge virale indétectable. À la naissance, les enfants ENI nés de mères avec une charge virale détectable avaient significativement moins de lymphocytes B totaux, plus de lymphocytes B mémoires classiques, activés, plasmablastes et lymphocytes T CD8+ mémoires centrales. À 6 mois, ils avaient significativement plus de lymphocytes B naïfs et significativement moins de lymphocytes T CD8+ effecteurs mémoires. À 12 mois d’âge, ils avaient significativement plus de lymphocytes B et T CD8+ totaux; significativement moins de lymphocytes T CD4+ totaux et leurs lymphocytes T affichaient un profil significativement plus activé (plus de cellules mémoires). L’analyse de la réponse antigène-spécifique a révélé une fréquence plus élevé de lymphocytes B mémoires IgM+ suggérant que les enfants nés de mères avec une virémie détectable ont plus de mal à établir une mémoire immunitaire efficace face au vaccin antitétanique. Nos données suggèrent qu’il y a exposition durant le premier trimestre de grossesse à la virémie maternelle et que cette exposition impacte le système immunitaire en développement du fœtus. Les mécanismes sous-jacents causant ces anomalies doivent encore être élucidés et l’épuisement du compartiment T à la naissance et à 6 mois reste à être investigué. Dans un pays industrialisé où l’accès aux soins est facilité, ces anomalies ont des conséquences modérées mais dans des pays à faible et moyen revenu, les conséquences peuvent être beaucoup plus tragiques voir fatales.

Characterization of the immune response induced by a commercially available inactivated bluetongue virus serotype 1 vaccine in sheep

The protective immune response generated by a commercial monovalent inactivated vaccine against bluetongue virus serotype 1 (BTV1) was studied. Five sheep were vaccinated, boost-vaccinated, and then challenged against BTV1 ALG/2006. RT-PCR did not detect viremia at any time during the experiment. Except a temperature increase observed after the initial and boost vaccinations, no clinical signs or lesions were observed. A specific and protective antibody response checked by ELISA was induced after vaccination and boost vaccination. This specific antibody response was associated with a significant increase in B lymphocytes confirmed by flow cytometry, while significant increases were not observed in T lymphocyte subpopulations (CD4(+), CD8(+), and WC1(+)), CD25(+) regulatory cells, or CD14(+) monocytes. After challenge with BTV1, the antibody response was much higher than during the boost vaccination period, and it was associated with a significant increase in B lymphocytes, CD14(+) monocytes, CD25(+) regulatory cells, and CD8(+) cytotoxic T lymphocytes.

Transthyretin Proteins Regulate Angiogenesis by Conferring Different Molecular Identities to Endothelial Cells

Familial amyloidotic polyneuropathy (FAP) has a high prevalence in Portugal, and the most common form of hereditary amyloidosis is caused by an amyloidogenic variant of transthyretin (TTR) with a substitution of methionine for valine at position 30 (V30M). Until now, the available efficient therapy is liver transplantation, when performed in an early phase of the onset of the disease symptoms. However, transplanted FAP patients have a significantly higher incidence of early hepatic artery thrombosis compared with non-FAP transplanted patients. Because FAP was described as an independent risk factor for early hepatic artery thrombosis, more studies to understand the underlying mechanisms involved in this outcome are of the utmost importance. Knowing that the liver is the major site for TTR production, we investigated the biological effects of TTR proteins in the vasculature and on angiogenesis. In this study, we identified genes differentially expressed in endothelial cells exposed to the WT or V30M tetramer. We found that endothelial cells may acquire different molecular identities when exposed to these proteins, and consequently TTR could regulate angiogenesis. Moreover, we show that V30M decreases endothelial survival by inducing apoptosis, and it inhibits migration. These findings provide new knowledge that may have critical implications in the prevention of early hepatic artery thrombosis in FAP patients after liver transplantation.

Proposal to minimize the difficulty of recording abortion data in sheep

Background: The most frequent viral diseases which can cause abortion in sheep are Blue tongue, Border disease virus, Cache Valley fever and Schmallenberg virus. The diagnosis of abortion, namely virus-induced represents a challenge to field clinicians, since clinical signs presented by the dam are discrete, non-specific and variable (Agerhom et al., 2015). On the other hand, while some foetuses reveal characteristic and visible malformations, others do not reveal any lesions. In face of it, definitive diagnosis requires an appropriate history collection, as well as sending fresh samples, namely abortion material, foetus, placenta and umbilical cord, to a specialty laboratory, to obtain a precise diagnosis. Objectives: The authors suggest a registration method of all mandatory data, in order to further assist the diagnosis of viral diseases at the laboratories, including the most frequent congenital malformations reported in sheep abortions. Methods: Abortion samples of suspected viral origin were collected and all data were registered, in worktables optimized for this purpose. Results: The authors document, using macroscopic figures lesions of malformations in abortions, emphasizing the frequency and the importance of documenting each case, proposing practical and effective worktables to assist the fieldwork. Conclusions: Field clinician’s awareness of the importance of early detection of viral diseases causing abortion outbreaks stimulates a proper data collection for each case of abortion, in order to contribute to a precise diagnosis and posterior consistent epidemiological studies, which may allow diminishing of economic losses.

Rôle du gène de fusion MLL-ENL dans le développement et le maintien du phénotype leucémique

Les translocations chromosomiques du gène MLL sont connues pour mener au développement de leucémies aiguës. La translocation avec un de ses partenaires de fusion les plus communs, ENL, peut engendrer des leucémies aiguës de plusieurs types différents pour cette même translocation. Une fois la leucémogenèse initiée par la fusion MLL-ENL, son rôle quant au maintien du phénotype leucémique n’est pas encore bien connu à ce jour. Pour mieux comprendre l’importance de MLL-ENL après la leucémogenèse, des cellules souches/progénitrices de sang de cordon ombilical humain purifiées ont ainsi été transduites par un virus exprimant le gène de fusion MLL-ENL bordé par des sites LoxP ainsi que le marqueur eGFP. Ces cellules infectées ont ensuite été injectées dans notre modèle de souris immunodéficientes irradiées et placées sous observation pendant 24 semaines pour voir le développement de leucémies aiguës. Elles ont alors été sacrifiées et les cellules la moelle osseuse et de la rate ont ensuite été analysées par cytométrie en flux pour déterminer si la xénogreffe a engendré une leucémie dans notre modèle ainsi que le phénotype de celle-ci. Les souris injectées par les cellules infectées par le MLL-ENL ont généré uniquement des leucémies lymphoïdes aiguës de type B. Les cellules de ces leucémies primaires isolées ont été par la suite infectées par un lentivirus exprimant la cre-recombinase et le marqueur BFP afin d’exciser le gène MLL-ENL des cellules leucémiques grâce aux sites LoxP. Les cellules ont ensuite été triées pour le marqueur BFP et injectées dans des souris secondaires pour de voir si les cellules leucémiques souches pouvaient toujours régénérer la leucémie. Les conséquences de l’absence de MLL-ENL dans le maintien du phénotype leucémique n’ont cependant pas pu être vérifiées à cause d’une erreur dans la séquence de la cre-recombinase, mais nous avons observé la régénération des leucémies secondaires.

Conducta médica versus escala modificada Wood en bronquiolitis aguda

El diagnóstico y clasificación de la severidad de la bronquiolitis se basan en la historia clínica y el examen físico. Actualmente existe una variabilidad en el ámbito clínico en el uso de los predictores de hospitalización de estos pacientes. En Colombia debido al número limitado de camas hospitalarias, es importante diferenciar y clasificar adecuadamente el lugar de manejo para cada paciente, según sus características clínicas, antecedentes y rasgos sociodemográficos. De esta manera se evitará la morbilidad y mortalidad de los pacientes por esta causa, se dará un manejo oportuno y se optimizará un recurso limitado. La escala de severidad clínica de asma modificada de Wood (M-WCAS), combina síntomas y signos encontrados al examen físico para clasificar la severidad de la bronquiolitis aguda. Esta escala fue validada en Colombia en el año 2013 y podría ser un instrumento que apoye la toma de decisiones clínicas de estos pacientes en cuanto al lugar de manejo.

Asfixia perinatal y proteína S100B

La asfixia perinatal es la principal causa de muerte en la primera semana de vida la nivel mundial, los niños que sufren esta complicación y sobreviven pueden presentar trastornos neurológicos de diferente nivel de compromiso que inciden en su desarrollo personal y social. Las cifras de muerte por este problema de salud han disminuido de manera importante, sin embargo en el reporte de la Organización Mundial de Salud (OPS) del 2010, la asfixia perinatal es causa del 29% de muertes infantiles en los países de América Latina y el Caribe 2. Es necesario conocer además la extensión del daño neurológico que sufren estos niños, con este fin se desarrolló un estudio piloto en el Hospital Universitario Mayor Mederi de Bogotá, en el cual se determinó la concentración de un marcador metabólico de daño cerebral, la proteína S100B en suero de 60 recién nacidos sanos, con el objetivo de analizar la asociación del mismo con el peso al nacer, la edad gestacional y el diagnóstico. Los resultados no mostraron diferencias significativas entre este marcador y las variables analizadas que puede asociarse al pequeño número de pacientes, sin embargo han sentado las bases para el desarrollo de un estudio que incluya varios hospitales de Bogotá y sobre todo la determinación del mismo en recién nacidos con diagnóstico de hipoxia en el período perinatal, lo cual aportará información del grado de la alteración que puedan tener a nivel cerebral y contribuya al mejor manejo evolutivo con la aplicación de medidas de intervención en estadios tempranos de la vida.

Isolation and characterization of mesenchymal stem cells derived from bovine Wharton's jelly and their potential for use in cloning by nuclear transfer.

RESUMO: A geleia de Wharton é uma fonte de células tronco mesenquimais (CTMs) que ainda não havia sido testada para a produção de embriões bovinos por transferência nuclear (TN). O objetivo deste estudo foi isolar, caracterizar e testar as CTMs derivadas da geleia de Wharton para produção de embriões e gestações por transferência nuclear em bovinos. O cordão umbilical foi coletado durante o nascimento e as células derivadas da geleia de Wharton (CGWs) foram isoladas por explante e cultivadas em Dulbecco?s Modified Eagle Medium. Fibroblastos (FB) da pele foram isolados após 6 meses de vida. As análises morfológicas foram realizadas pelas microscopias de campo claro e eletrônica de varredura durante o cultivo celular. Caracterização fenotípica e genotípica por citometria de fluxo, imunocitoquímica, RT-PCR e indução da diferenciação em linhagens celulares foi realizada com as CGWs. No procedimento de TN, ovócitos no estágio de metáfase II foram enucleados usando micromanipuladores, fusionados com CGWs ou FB e então ativados artificialmente. Micrografias de microscopia de varredura revelaram que CGWs tiveram forma variada sob cultivo. Os marcadores mesenquimais de CTMs (CD29+, CD73+, CD90+ and CD105+) foram expressos em cultura de CGWs bovina, como evidenciado por citometria de fluxo, imunocitoquímica e RT-PCR. Quando induzidas, estas células diferenciaram-se em osteócitos, condrócitos e adipócitos. Após classificação, as CGWs foram utilizadas na TN. A taxa de formação de blastocistos por TN com CGWs no sétimo dia de cultivo foi de 25,80±0,03%, similar a produção de blastócitos por TN com fibroblastos de pele (19,00±0,07). Gestações foram obtidas e mostraram que CGWs constituem um novo tipo celular para ser usado na clonagem animal. ABSTRACT: Wharton?s jelly is a source of mesenchymal stem cells (MSCs) that had not yet been tested for bovine embryo production by nuclear transfer (NT). Thus, the objective of this study was to isolate, characterize and test MSCs derived from Wharton?s jelly for embryo and pregnancy production by NT in cattle. The umbilical cord was collected during calving and cells derived from Wharton?s jelly (WJCs) were isolated by explant and cultured in Dulbecco?s Modified Eagle Medium. Skin Fibroblasts (FB) were isolated after 6 months of life. Morphological analysis was performed by bright field and scanning electron microscopy (SEM) during cell culture. Phenotypic and genotypic characterization by flow cytometry, immunocytochemistry, RT-PCR and differentiation induction in cell lineages were performed for WJC. In the NT procedure, oocytes at the arrested metaphase II stage were enucleated using micromanipulators, fused with WJCs or FB and later activated artificially. SEM micrographs revealed that WJCs have variable shape under culture. Mesenchymal markers of MSCs (CD29+, CD73+, CD90+ and CD105+) were expressed in bovine-derived WJC cultures, as evidenced by flow cytometry, immunocytochemistry and RT-PCR. When induced, these cells differentiated into osteocytes, chondrocytes and adipocytes. After classification, the WJCs were used in NT. Blastocyst formation rate by NT with WJCs at day 7 was 25.80±0.03%, similar to blatocyst rate with NT using skin fibroblasts (19.00±0.07%). Pregnancies were obtained and showed that WJCs constitute a new cell type for use in animal cloning.

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.

Ions and Small Molecules as Modulators of F1FO-ATPase, Mitochondrial Bioenergetics and Cell Metabolism

The properties of the mitochondrial F1FO-ATPase activated by the natural cofactor Mg2+ or by Ca2+, were studied, mainly on heart mitochondria from swine, widely used in translational medicine. The Ca2+ driven conformational changes in the F1FO-ATPase form the mitochondrial permeability transition pore (mPTP), which triggers regulated cell death and is involved in severe pathologies. The Ca2+-activated F1FO-ATPase hydrolyzes ATP with kinetics slightly different from those of the Mg2+-ATPase. Known F1-ATPase inhibitors inhibit both the Ca2+-activated F1FO-ATPase and the mPTP formation strengthening the molecular link between them. The different Gd3+ effects on the Ca2+- and Mg2+-activated F1FO-ATPases confirm their difference as also phenylglyoxal which preferentially inhibits the Ca2+-activated F1FO-ATPase. The effects of phenylarsine and dibromobimane, which interact with differently distant Cys thiols, show that mPTP opening is ruled by nearby or distant dithiols. Bergamot polyphenols and melatonin inhibit the mPTP and ROS formation. H2S, a known cardiovascular protector, unaffects the F1FO-ATPase, but inhibits Ca2+ absorption and indirectly the mPTP, both in swine heart and mussel midgut gland mitochondria. New generation triazoles inhibit the Ca2+-activated F1FO-ATPase and the mPTP, but unaffect the Mg2+-activated F1FOATPase. In parallel, the energy metabolism was investigated in mammalian cells. In boar sperm ATP is mainly produced by mitochondrial oxidative phosphorylation (OXPHOS), even if it decreases over time because of less active mitochondria. Insufficient ATP may induce sperm dysfunction. Also, canine mesenchymal stem cells rely on OXPHOS; those from umbilical cord which produce more ATP than those from adipose tissue, seem preferable for transplant studies. The intestinal porcine enterocyte cell line IPEC-J2, used for human gut research, responds to different fetal bovine serum concentrations by remodeling OXPHOS without altering the bioenergetic parameters. The IPEC-J2 bioenergetics is modulated by Vitamin K vitamers. These data shoulder cell bioenergetics as precious tool for medical research.

Study on NGF and VEGF during the equine perinatal period

Part 1 of the study aims to: evaluate NGF and VEGF levels obtained at parturition from mare, foal and umbilical cord vein plasma, as well as in amniotic fluid; evaluate NGF and VEGF content in plasma of healthy foals during the first 72 h of life; evaluate NGF and VEGF levels at parturition in relation to selected mares’ and foals’ clinical parameters; evaluate the relationship between the two trophic factors and thyroid hormone levels in the first 72 h of life; assess mRNA expression of NGF, VEGF and BDNF and their cell surface receptors in the placenta. Part 2 aims to clinically characterize a population of foals spontaneously affected by Neonatal Encephalopathy (NE), and then to: evaluate NGF and VEGF levels in plasma samples obtained in the affected population at parturition from mare’s jugular vein, umbilical cord vein and foal’s jugular vein, as well as in amniotic fluid; evaluate NGF and VEGF content in plasma of foals affected by NE during the first 72 h of life/hospitalization; evaluate NGF and VEGF levels at birth/admission in relation to selected mares’ and foals’ clinical parameters; evaluate the relationship between the two trophic factors and thyroid hormone levels in the first 72 h of life/hospitalization; assess the mRNA expression of NGF, VEGF and BDNF, and their cell surface receptors, in the placenta of mares that delivered affected foals. The close relationship between the two trophic factors in foal plasma over time and their fine expression in placental tissues under physiological conditions appear to be key regulators of fetal development and adaptation. Their less pronounced decrease in compromised foals compared to healthy ones, their relationship with thyroid hormones over time, and the reduced expression of NGF and BDNF in placental tissues, could be key regulators in the mechanisms of NE.

Different dietary fibres included in the gestation and lactation diet shape sow's microbiota, modify colostrum and milk composition and affect piglet growth and health

This thesis reports three experimental studies that may contribute to understand how the sources or types of dietary fibres (DFs) included in sow diet with similar level of total DFs influence the composition of colostrum and milk and their related effects on offspring performance and gut microbiota. The first study showed that decreasing the level of hemicelluloses (HCs) in sow’s lactation diet increased the proportion of butyrate and the concentration of volatile fatty acids (VFAs), copper and threonine in milk. Simultaneously, the post-weaning growth of low birthweight piglets was improved, and the diarrhoea occurrence was reduced during the second week post-weaning. The second study showed that the level of HCs in the diet of lactating sows affected their faecal microbiota, modified the VFA profile in sow’s faeces during lactation and barely impacted the faecal microbiota of slow and fast growing piglets. The third study showed that replacing a source soluble DFs by one of insoluble DFs in sow’s diet during late gestation and lactation reduced farrowing duration, increased total VFAs and lactoferrin concentrations in colostrum, improved growth performance from birth to 1 day of lactation, during the post-weaning period and throughout the study, and reduced diarrhoea occurrence during the first week post-weaning. Finally, a fourth study proposed a workflow to analyse low biomass samples from the umbilical cord blood aiming at investigating the existence of a pre-birth microbiota with no substantial findings to confirm this hypothesis. Overall, the results of these studies confirmed that, besides the level of DFs, the sources, and the types of DFs included in the sow's diet shape the sow's microbiota, influence the composition of colostrum and milk, and improve offspring performance, but with limited impacts on the microbiota of piglets.

Problemas mais comuns no recém-nascido e lactantes

O objeto alerta aos profissionais de saúde sobre os dez problemas agudos mais comuns encontrados nos recém-nascidos e lactentes, e que precisam ser conhecidos. Mostra um quadro com explicações de cada um deles, a saber: obstrução nasal, conjuntivite química neonatal, refluxo gastroesofágico, cólicas do recém-nascido, granuloma umbilical, hérnia umbilical, hérnia ingnal, onfalite, impetigo e moniliase oral e perineal. Unidade 6 do módulo 5 que compõe o Curso de Especialização em Saúde da Família.