As Memórias de Lacroix: a instrução pública na França revolucionária, em geral, e o ensino de Matemática, em particular

O artigo - um exame hermenêutico do livro Essais sur l'enseignement en général, et sur celui des mathématiques en particulier, de 1805, de Sylvestre-François Lacroix, enfatizando sua segunda parte, na qual o autor discute seu Curso de Matemática Elementar, uma série de manuais escolares elaborados para a Escola Central das Quatro Nações - tem sua fundamentação ligada à Hermenêutica de Profundidade de Thompson conjugada a procedimentos de investigação textual sugeridos por Genette quanto aos paratextos editoriais. Defende que o livro de Lacroix é uma obra auto-referencial, de cunho claramente autobiográfico, que responde mais aos ideais iluministas da França do Setecentos que às perspectivas do século XIX, quando a obra circulou, tendo sido reeditada por quatro vezes, sob Napoleão, na primeira metade do Oitocentos. Raramente focalizado em trabalhos de pesquisa, o livro - cujas edições estão disponíveis eletronicamente - tem uma única tradução, ainda inédita, para o português.

A instrução pública na França revolucionária: considerações a partir do Essais Sur L'enseignement En General Et Sur Celui Des Mathématiques En Particulier, de Sylvestre-François Lacroix

L'article présente le livre Essais sur l'enseignement en général, et sur celui des mathématiques en particulier de Sylvestre-François Lacroix, à l'origine publié en France en 1805, mettant l'accent sur sa première partie, dans lequel l'auteur traite de l'instruction publique, et en particulier des écoles centrales crées pendant la Revolution Française pour remplacer des colléges et des facultés des arts des anciennes universités.

Intercostal nerve mononeuropathy: study of 14 cases

Este trabalho apresenta estudo retrospectivo de 14 pacientes com mononeuropatia de nervo intercostal (MNI), obtidos dentre 5.560 exames eletromiográficos, realizados de janeiro de 1991 até junho de 2004, em nosso Hospital Universitário. MNI foi encontrada em 14 pacientes, tendo como causas prováveis intervenções cirúrgicas torácicas em 6 (43%), neuropatia por herpes-zoster em 4 (28%), provável neurite de nervo intercostal em 2 (14%), neoplasia pulmonar em 1 (7%) e radiculopatia em 1 (7%). As principais causas de MNI de nosso Serviço são similares às da literatura. Os antidepressivos tricíclicos e anticonvulsivantes foram os fármacos mais utilizados no controle da dor.

Ambulatory surgery in proctology: retrospective analysis of 1 031 cases

Introduction: The number of ambulatory surgeries accomplished in hospitals, as in private clinics, grows each day, with this increase having been observed principally in the last two decades. In many countries, such as France, ambulatory surgeries have predominated in relation to those in hospitals. Objective: To evaluate retrospectively 1 031 cases of patients operated on in the Ambulatory Surgery Service of CH. in the School of Medicine at Botucatu. Material and method: Retrospectively, 1 031 clinical cases of orificial pathologies operated on in the service were studied, analyzing the distribution by age group, sex, pathologies and postoperative complications. Result: We note predominance of patients aged less than 45 years (56.6%), discrete prevalence of males (51.2%), with hemorrhoidal disease (60%) being the principal affliction, with pain and bleeding being the most frequent complications (3.2%). Conclusions: The results obtained demonstrate that ambulatory procedures in proctology can be accomplished in a safe and systematic manner at low cost with advantages and fewer complications in relation to procedures completed in a hospitalization regime.

Prevalence of deep vein thrombosis and pulmonary embolism in superficial thrombophlebitis of the lower limbs: prospective study of 60 cases

Aim. Superficial thrombophlebitis (ST) ascending the lower limbs is a common disease, which may be associated with deep vein thrombosis (DVT) and pulmonary embolism (PE). The aim of this study was to investigate the prevalence of DVT and PE as complications of ascending ST of the lower limbs in the great saphenous vein (GSV) or SSV (SSV) and probable risk factors.Methods. For this study 60 consecutive patients were enrolled with ascending ST of the GSV or SSV, seen between 2000 and 2003 at a public hospital in Botucatu, SP, Brazil. All patients were assessed clinically, by venous Duplex scanning of the lower limbs to confirm ST and test for DVT, and by means of pulmonary scintigraphy to test for PE.Results. In 13 ST cases (21.67%) there was concomitant DVT and 17 ST patients (28.33%) also had PE. Eleven patients had a clinical status suggestive of DVT, but only in eight of these (61.5%), this clinical diagnosis was confirmed. Fourteen patients had a clinical status suggestive of PE, and this diagnosis was confirmed in six cases (35.30%). ST patients who also had DVT and/or PE were given anticoagulant treatment with heparin and warfarin. None of the variables studied was predictive of DVT or PE (P>0.05). However, the presence of varicose veins reduced the risk of patients having DVT (relative risk=9.09; 95%CI:1.75 - 50.00 and P=0.023).Conclusion. The prevalence rates of PE (28.3%) and DVT (21.6%) were elevated in this sample of ascending ST cases, indicating a need for detailed assessment of patients for signs of these complications, including for therapeutic management decision making. [Int Angiol 2009;28:400-8]

Cirurgia ambulatorial em proctologia: análise retrospectiva de 437 casos

RACIONAL: O número de cirurgias ambulatoriais realizadas em hospitais, como em clínicas particulares, cresce a cada dia. Hoje, em alguns países, como a França, há predomínio das cirurgias ambulatoriais em relação às hospitalares. OBJETIVO: Avaliar retrospectivamente os pacientes operados no Serviço de Cirurgia Ambulatorial do Hospital das Clínicas da Faculdade de Medicina de Botucatu, SP. CASUÍSTICA E MÉTODO: Foram estudados retrospectivamente 437 casos clínicos de patologias orificiais, analisando a distribuição por faixa etária, por sexo, por patologias e as complicações pós-operatórias. RESULTADOS: Notou-se predomínio de pacientes com idade inferior a 45 anos (62,8%), prevalência do sexo feminino (56%), sendo a doença hemorroidária (45,1%) a principal patologia e a dor e sangramento as complicações mais freqüentes (9,8% e 7,3%). CONCLUSÕES: Os resultados satisfatórios observados demonstram a possibilidade de realização, em ambulatório, de diversos procedimentos simples em patologias anorretais freqüentes, a baixo custo e poucas complicações, sendo estas não superiores às observadas em cirurgia hospitalar.

Cytogenetic studies of Brazilian pediatric myelodysplastic syndrome cases: challenges and difficulties in a large and emerging country

Myelodysplastic syndromes (MDS) and juvenile myelomonocytic leukemia (JMML) are rare hematopoietic stem cell diseases affecting children. Cytogenetics plays an important role in the diagnosis of these diseases. We report here the experience of the Cytogenetic Subcommittee of the Brazilian Cooperative Group on Pediatric Myelodysplastic Syndromes (BCG-MDS-PED). We analyzed 168 cytogenetic studies performed in 23 different cytogenetic centers; 84 of these studies were performed in patients with confirmed MDS (primary MDS, secondary MDS, JMML, and acute myeloid leukemia/MDS+Down syndrome). Clonal abnormalities were found in 36.9% of the MDS cases and cytogenetic studies were important for the detection of constitutional diseases and for differential diagnosis with other myeloid neoplasms. These data show the importance of the Cooperative Group for continuing education in order to avoid a late or wrong diagnosis.

Conservative management of pituitary tumor apoplexy

A apoplexia pituitária é uma rara síndrome neuroendócrina causada, na maioria dos casos, pela hemorragia ou enfarte de um adenoma pituitário preexistente. O tratamento recomendado é variável; alguns autores defendem a descompressão cirúrgica do tumor em regime de urgência, enquanto outros sugerem que o tratamento conservador pode levar à recuperação da função neuroftalmológica. Descrevemos os casos de dois pacientes com apoplexia pituitária que apresentaram macroadenomas clinicamente não secretores e hipopituitarismo, incluindo hipogonadismo. Ambos foram submetidos ao tratamento conservador, sem cirurgia, e houve a remissão do tumor.

Hipotireoidismo congênito: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

O hipotireoidismo congênito (HC) é o distúrbio endócrino congênito mais frequente, com incidência variando de 1:2.000 a 1:4.000 crianças nascidas vivas e uma das principais causas de retardo mental que pode ser prevenida. Os Programas de Triagem Neonatal para a doença permitem a identificação precoce dos afetados e seu tratamento de modo a evitar as complicações da falta do hormônio. A maioria dos casos de hipotireoidismo congênito é decorrente de disgenesias tireoidianas (85%), entre elas a ectopia, hipoplasia ou agenesia tireoidianas, e os demais resultam de defeitos de síntese hormonal. As crianças afetadas (> 95%) geralmente não apresentam sintomas sugestivos da doença ao nascimento. Os sintomas e sinais mais comuns são: icterícia neonatal prolongada, choro rouco, letargia, movimentos lentos, constipação, macroglossia, hérnia umbilical, fontanelas amplas, hipotonia e pele seca. Várias estratégias são utilizadas para a triagem do HC. No Brasil, esta é obrigatória por lei e geralmente é feita com a dosagem de TSH em sangue seco coletado do calcanhar. A idade recomendada para sua realização é após as 48 horas de vida até o quarto dia. A confirmação diagnóstica é obrigatória com as dosagens de TSH e T4 livre ou T4 total.

A report of 49 cases of cnidarian envenoming from southeastern Brazilian coastal waters

Forty-nine accidents caused by jellyfish (Cnidaria) were observed during a period of 5 years on the southeastern coast of Brazil. Most of them involved male patients (65.3%), the injured areas being mainly the legs (71.3%) and the trunk (65.3%). Twenty accidents with Chiropsalmus quadrumanus, four with Physalia physalis and 20 with unidentified jellyfish presented intense pain, linear plaques and systemic symptoms. The five cases with Olindias sambaquiensis caused mild pain, round plaques and no systemic symptoms. There are a few reports on accidents caused by jellyfish, in this country, and scarce clinical or epidemiological data are available up to the present moment. (C) 2002 Elsevier B.V. Ltd. All rights reserved.

Primary cutaneous cryptococcosis in Brazil: report of 11 cases in immunocompetent and immunosuppressed patients

Background Primary cutaneous cryptococcosis is an uncommon infectious disease caused by Cryptococcus neoformans or Cryptococcus gattii affecting immunosuppressed as well as immunocompetent patients. It is often misdiagnosed as it may mimic other cutaneous diseases. Materials and methods We report a series of cases diagnosed from 2005 to 2010 in two general hospitals. The diagnosis in all patients was made on the basis of histopathology and culture. Phenoloxidase and canavanine-glycine-bromothymol blue tests were used in order to identify the Cryptococcus species. Systematic investigation ruled out the systemic involvement in every case. Results Eleven patients, 81.8% male, were diagnosed during this study. The immunosuppression status was identified in 54.5% of patients, and all of them were under corticosteroid therapy due to a variable set of diseases. All patients presented with circumscribed lesions on their upper limbs. Most lesions showed an infiltrative or tumoral aspect with up to 40 cm diameter. Fluconazole, up to 400 mg/daily, was the main therapeutic regimen and proved to be efficient. Conclusions Primary cutaneous cryptococcosis has been diagnosed in both immunosuppressed and immunocompetent patients. Its peculiar clinical aspect could facilitate early diagnosis. Culture and biochemical tests should be performed in order to define the species involved.

Oro-genital lichen planus: Report of two cases

Lichen planus is a common mucocutaneous disease. However, lichen planus with concomitant oral and genital involvement is a rare condition that requires multidisciplinary intervention for appropriate diagnosis. In this study, we reported two cases of oro-genital lichen planus in a man and a woman. Analyses of oral and genital lesions were clinically and histopathologically compatible with lichen planus. This description highlights the importance of patients presenting oral lichen planus be routinely required to undergo further medical examination in order to investigate putative genital mucosal involvement. These lesions have the potential to progress to neoplasia. Therefore, medical and dentistry professionals should be aware of this condition. (c) 2007 Elsevier B.V. All fights reserved.

Paracoccidioidomycosis of external genitalia: report of six new cases and review of the literature

BACKGROUND: Paracoccidioidomycosis is a systemic mycosis of dermatological interest due to the frequency of cutaneous and mucosal lesions. The involvement of the external genitalia is extremely rare and few cases have been reported.OBJECTIVE: To study the prevalence of external genitalia lesions in paracoccidioidomycosis patients, identify clinical characteristics and compare with what is observed in the specific literature.METHODS: This is a cross-sectional, descriptive study, with focus on paracoccidioiodomycosis patients with external genitalia lesions. The demographic and clinical aspects of cases were compared with what has been reported so far on LILACS, SciELO e MEDLINE data bases.RESULTS: Data of 483 cases of paracoccidioidomycosis were studied in a 42-year period. Six (1.2%) patients showed specific lesions on external genitalia. Five patients were male with mean age of 47.2 years and all of them presented with the chronic multifocal clinical form. Only one, a 15-year-old female patient was observed who showed a subacute clinical form, juvenile type.CONCLUSIONS: Compromise of the genitourinary tract among paracoccidioidomycosis patients is rare and even rarer when only the external genitalia are considered. As observed in the classical picture of paracoccidioidomycosis patients, the male gender and the chronic multifocal clinical form prevailed in the present study.

SEABATHER'S ERUPTION: A CLINICAL and EPIDEMIOLOGICAL STUDY of 38 CASES IN SANTA CATARINA STATE, BRAZIL

Seabather's eruption (SBE) is an intensely itchy, papule-erythematous dermatitis that occurs predominantly in regions of the body covered by bathing costumes, after exposure to marine water. The planulae larvae of Linuche unguiculata scyphomedusae (thimble jellyfish) are the etiologic agent of the dermatitis, which is frequent in waters of Caribbean, Gulf of Mexico and Florida. The authors report 38 cases of SBE in the State of Santa Catarina (Southern region of Brazil), with emphasis on their clinical and epidemiological aspects, such as profile of victim, topography of the papules and conditions predisposing to the accident.

First Description of a Cluster of Acute/Subacute Paracoccidioidomycosis Cases and Its Association with a Climatic Anomaly

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)