Avaliação da adesão ao acompanhamento ambulatorial dos pacientes em profilaxia secundária da febre reumática no Hospital de Clínicas de Porto Alegre

A Febre Reumática (FR) é uma doença com significativa prevalência na população de pacientes em idade escolar. Constitui-se na principal causa de cardiopatia crônica em adultos jovens em países em desenvolvimento. A prevenção é de fácil manejo terapêutico, embora com reduzido índice de adesão. Até o momento, a melhor forma de evitarmos as seqüelas cardíacas é através da identificação e tratamento precoces e a manutenção de uma adequada profilaxia secundária. São raras as publicações referentes ao acompanhamento da profilaxia secundária após a alta hospitalar. O objetivo deste trabalho é avaliar a adesão ao acompanhamento dos pacientes com FR internados no Hospital de Clínicas de Porto Alegre, no período de janeiro de 1977 a junho de 1999. A coorte foi constituída de 112 indivíduos com FR que tinham indicação de retorno ao ambulatório após a alta. Quarenta pacientes (35,7%) foram atendidos no primeiro episódio de FR. A maioria apresentou seqüelas cardíacas (52,7%), ocorrendo registro de casos a partir de 8 anos de idade. As manifestações clínicas nos 40 pacientes atendidos no primeiro episódio de FR foram: 21 (52,5%) com cardite, 30 (75%) com artrite e 14 (35%) com coréia. Apenas 77 (68,7%) retornaram ao ambulatório após a alta e somente 13 (21% pelo método de Kaplan-Meier) mantiveram acompanhamento por no mínimo 5 anos. A idade menor ou igual a 16 anos foi fator preditivo de maior tempo de acompanhamento. Local de procedência, presença de seqüelas e renda familiar não mostraram associação significante. A interrupção do acompanhamento pela maioria dos pacientes e a verificação do pior prognóstico cardíaco nos pacientes com recidivas sugere a necessidade da adoção de um programa de orientação e busca para garantir a efetividade da profilaxia secundária.

Fatores genéticos e não genéticos em formas avançadas de Retinopatia Diabética em pacientes com Diabete Melito tipo 2

Introdução: A retinopatia diabética (RD) é a principal causa de novos casos de cegueira entre norte-americanos em idade produtiva. Existe uma associação entre RD e as outras complicações microvasculares do diabete melito. A associação da RD com a fase inicial da nefropatia, a microalbuminúria, não está esclarecida em pacientes com diabete melito (DM) tipo 2. Polimorfismos de genes (ENNP1; FABP2) relacionados à resistência insulínica, entre outros, poderiam estar associados à RD. Objetivo: O objetivo deste estudo foi avaliar fatores genéticos e não genéticos associados à RD avançada em pacientes com DM tipo 2. Métodos: Neste estudo caso-controle foram incluídos pacientes DM tipo 2 submetidos à avaliação clínica, laboratorial e oftalmológica. Foi realizada oftalmoscopia binocular indireta sob midríase e obtidas retinografias coloridas em 7 campos padronizados. Foram classificados como casos os pacientes portadores de RD avançada (formas graves de RD não proliferativa e RD proliferativa) e como controles os pacientes sem RD avançada (fundoscopia normal, e outras formas de RD). Foram estudados os polimorfismos K121Q do gene ENNP1 e A54T do gene FABP2. Na análise estatística foram utilizados testes paramétricos e não paramétricos conforme indicado. Foi realizada análise de regressão logística múltipla para avaliar fatores associados à RD avançada. O nível de significância adotado foi de 0,05%. Resultados: Foram avaliados 240 pacientes com DM tipo 2 com 60,6 ± 8,4 anos de idade e duração conhecida de DM de 14,4 ± 8,4 anos. Destes, 67 pacientes (27,9%) apresentavam RD avançada. Os pacientes com RD avançada apresentaram maior duração conhecida de DM (18,1 ± 8,1 vs. 12,9 ± 8,2 anos; P< 0,001), menor índice de massa corporal (IMC) (27,5 ± 4,2 vs. 29,0 ± 9,6 kg/m2; P= 0,019), além de uso de insulina mais freqüente (70,8% vs 35,3%; P< 0,001) e presença de nefropatia diabética (81,1% vs 34,8%; P< 0,001) quando comparados com os pacientes sem RD avançada. Na avaliação laboratorial os pacientes com RD avançada apresentaram valores mais elevados de creatinina sérica [1,4 (0,6 -13,6) vs 0,8 (0,5-17,9) mg/dl; P<0,001] e de albuminúria [135,0 (3,6-1816,0) vs 11,3 (1,5-5105,0) μg/min; P<0,001] quando comparados com pacientes sem RD avançada. A distribuição dos genótipos dos polimorfismos do ENNP1 e FABP2 não foi diferente entre os grupos. A análise de regressão logística múltipla demonstrou que a presença de nefropatia (OR=6,59; IC95%: 3,01-14,41; P<0,001) e o uso de insulina (OR=3,47; IC95%: 1,60- 7,50; P=0,002) foram os fatores associados à RD avançada, ajustados para a duração de DM, presença de hipertensão arterial, glicohemoglobina e IMC. Quando na análise foram incluídos apenas pacientes normoalbuminúricos e microalbuminúricos, a microalbuminúria (OR=3,8; IC95%: 1,38-10,47; P=0,010), o uso de insulina (OR=5,04; IC95%: 1,67-15,21; P=0,004), a duração do DM (OR=1,06 IC95%: 1,00-1,13; P=0,048) e a glicohemoglobina (OR=1,35; IC95%: 1,02-1,79; P=0,034) foram os fatores associados à RD avançada, ajustados para a presença de hipertensão arterial e IMC. Conclusão: Pacientes com DM tipo 2 portadores de formas avançadas de RD apresentam mais freqüentemente envolvimento renal pelo DM, incluindo o estágio de microalbuminúria. Uma avaliação renal com medida de albuminúria dever ser incorporada como avaliação de rotina nestes pacientes.

Escola pública em Macapa: como, ate quando e porque

A Escola Pública de Macapá possui uma qualidade que justifica sua prevalência sobre a Particular. Além disso, ela tem sido o tipo de instituição predominante no atendimento da população em idade escolar. O presente estudo analisa a concepção dos educadores macapaenses sobre a importância da preservação da Escola Pública. Procurou-se verificar, também, o grau de consciência destes profissionais sobre o privilégio de usufruir do ensino público. Trata-se de uma pesquisa que visa chamar a atenção dos educadores para a importância de sua participação no resgate da credibilidade da Escola Pública em Macapá.

O perfil de bem-estar dos beneficiários em idade economicamente ativa (BIEAs) do Programa Bolsa Família (PBF) : uma proposta de avaliação

O presente trabalho propõe uma avaliação do bem-estar social dos beneficiários em idade economicamente ativa do Programa Bolsa Família (BIEAs PBF) no município de Porto Alegre. Tal avaliação é norteada pela identificação de situações de restrições ou armadilhas (SACHS, 2005) da capacidade dos indivíduos escolherem diferentes estilos de vida, através dos papéis instrumentais da liberdade (SEN, 2010). Assim, são testadas hipóteses que envolvem as relações dos indivíduos com a escolarização, o mercado de trabalho e a renda. Os resultados da avaliação sugerem a existência de um nível de renda com restrições; incentivos para a interrupção do processo de escolarização, antes de um nível desejável; uma relação entre escolaridade e renda, pouco convergente; e um baixo acesso ao mercado de trabalho formal, prevalecendo relações de trabalho mais precárias. Finalmente, o presente trabalho propõe o posicionamento das questões relevantes atinentes aos BIEAs PBF em uma perspectiva mais ampla do desenvolvimento humano.

Emprego formal na região nordeste brasileira: seus efeitos na inclusão social

This work aims to study the problem of the formal job in the Brazilian Northeast region and its effect in the social inclusion, taking for base the analysis of variables defined in the Atlas of Social Exclusion, which is based on the 2000 Brazilian Census, choosing the county as unit of analysis. As methodological options, an exploratory data analysis was performed, followed by multivariate statistical techniques, such as weighted multiple regression analysis, cluster analysis and exploratory analysis of spatial data. The results pointed out to low rates of formal job for the active age population as well as low indexes of social inclusion in the Northeast region of Brazil. A strong association of the formal job with the indicators of social inclusion under investigation, was evidenced (schooling, inequality, poverty, youth and income form government transfers), as well as a strong association of the formal job with the new index of social inclusion (IIS), modified from the IES. At the Federative Units, in which better levels of formal job had been found, good indexes of social inclusion are also observed. Highlights for the state of the Rio Grande do Norte, with the best conditions of life, and for the states of the Maranhão and Piauí, with the worst conditions. The situation of the Northeast region, facing the indicators under study, is very precarious, claiming for the necessity of emphasizing programs and governmental actions, specially directed to the raise of formal job levels of the region, reflecting, thus, in improvements on the income inequality, as well as in the social inclusion of the population of Northeastern natives.

Social Panorama of Latin America 2002-2003

Includes bibliography

Innovations in health care services: The CAALYX system

Purpose: This paper describes proposed health care services innovations, provided by a system called CAALYX (Complete Ambient Assisted Living eXperiment). CAALYX aimed to provide healthcare innovation by extending the state-of-the-art in tele-healthcare, by focusing on increasing the confidence of elderly people living autonomously, by building on the knowledge base of the most common disorders and respective characteristic vital sign changes for this age group. Methods: A review of the state-of-the-art on health care services was carried out. Then, extensive research was conducted on the particular needs of the elderly in relation to home health services that, if offered to them, could improve their day life by giving them greater confidence and autonomy. To achieve this, we addressed issues associated with the gathering of clinical data and interpretation of these data, as well as possibilities of automatically triggering appropriate clinical measures. Considering this initial work we started the identification of initiatives, ongoing works and technologies that could be used for the development of the system. After that, the implementation of CAALYX was done. Findings: The innovation in CAALYX system considers three main areas of contribution: (i) The Roaming Monitoring System that is used to collect information on the well-being of the elderly users; (ii) The Home Monitoring System that is aimed at helping the elders independently living at home being implemented by a device (a personal computer or a set top box) that supports the connection of sensors and video cameras that may be used for monitoring and for interaction with the elder; (iii) The Central Care Service and Monitoring System that is implemented by a Caretaker System where attention and care services are provided to elders, where actors as Caretakers, Doctors and Relatives are logically linked to elders. Innovations in each of these areas are presented here. Conclusions: The ageing European society is placing an added burden on future generations, as the 'elderly-to-working-age-people' ratio is set to steadily increase in the future. Nowadays, quality of life and fitness allows for most older persons to have an active life well into their eighties. Furthermore, many older persons prefer to live in their own house and choose their own lifestyle. The CAALYX system can have a clear impact in increasing older persons' autonomy, by ensuring that they do not need to leave their preferred environment in order to be properly monitored and taken care of. © 2011 Elsevier B.V. All rights reserved.

Avaliação da qualidade do reparo ósseo em ratas ovariectomizadas, lesionadas e tratadas com Arnica montana fitoterápica e homeopática

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Information technology as a technical resource for the memories: memories of UNATI-Marília in the virtual environment

UNATI (Open University of the Third Age), UNESP, Marília campus, has offered subsidies for the development of this work aimed at researching the existing relationships between information mediation processes and technological devices, especially computers, assuming that reading practices and textual construction in online environments could help the “third age” population to have access to these devices, thus promoting digital inclusion in this group. Mediation was presented as an interventionist action that, by introducing an intermediate element in the learning process, causes a rupture in the ways of living and personal digital inclusion processes hitherto experienced. In the context of a workshop, we found out that there is a physical relationship between subjects and technological supports and such a contact proved to be necessary, considering that handling a computer required knowledge of procedures, thus furthering a logic of use. It turned out to be necessary to develop actions that would enable the handling of a computer so as to bring about acceptance of these supports. Accordingly, activities were developed so as to articulate reminiscent processes, memories of older adults, the writing down of such memories and the creation of a blog to bring enhanced visibility to the content produced by older people. Such actions have shown that remembering, writing down and posting can reshape not only social relations but somehow significantly promote digital inclusion among older adults.

Entre livres e oficiais: a expansão do ensino normal em São Paulo (1927-1933)

Pós-graduação em Educação - FFC

Provenance signature of a forearc basin modified by spreading ridge subduction: Detrital zircon geochronology and detrital modes from the Paleogene Arkose Ridge Formation, southern Alaska

Upper Paleocene–Eocene boulder conglomerate, cross-stratified sandstone, and laminated carbonaceous mudstone of the Arkose Ridge Formation exposed in the southern Talkeetna Mountains record fluvial-lacustrine deposition proximal to the volcanic arc in a forearc basin modified by Paleogene spreading ridge subduction beneath southern Alaska. U-Pb ages of detrital zircon grains and modal analyses were obtained from stratigraphic sections spanning the 2,000 m thick Arkose Ridge Formation in order to constrain the lithology, age, and location of sediment sources that provided detritus. Detrital modes from 24 conglomerate beds and 54 sandstone thin sections aredominated by plutonic and volcanic clasts and plagioclase feldspar with minor quartz, schist, hornblende, argillite, and metabasalt. Westernmost sandstone and conglomerate strata contain <5% volcanic clasts whereas easternmost sandstone and conglomerate strata contain 40 to >80% volcanic clasts. Temporally, eastern sandstones andconglomerates exhibit an upsection increase in volcanic detritus from <40 to >80% volcanic clasts. U-Pb ages from >1400 detrital zircons in 15 sandstone samples reveal three main populations: late Paleocene–Eocene (60-48 Ma; 16% of all grains), Late Cretaceous–early Paleocene (85–60 Ma; 62%) and Jurassic–Early Cretaceous (200–100 Ma; 12%). A plot of U/Th vs U-Pb ages shows that >97% of zircons are <200 Ma and>99% of zircons have <10 U/Th ratios, consistent with mainly igneous source terranes. Strata show increased enrichment in late Paleocene–Eocene detrital zircons from <2% in the west to >25% in the east. In eastern sections, this younger age population increases temporally from 0% in the lower 50 m of the section to >40% in samples collected >740 m above the base. Integration of the compositional and detrital geochronologic data suggests: (1) Detritus was eroded mainly from igneous sources exposed directly north of the Arkose Ridge Formation strata, mainly Jurassic–Paleocene plutons and Paleocene–Eocenevolcanic centers. Subordinate metamorphic detritus was eroded from western Mesozoic low-grade metamorphic sources. Subordinate sedimentary detritus was eroded from eastern Mesozoic sedimentary sources. (2) Eastern deposystems received higher proportions of juvenile volcanic detritus through time, consistent with construction of adjacent slab-window volcanic centers during Arkose Ridge Formation deposition. (3)Western deposystems transported detritus from Jurassic–Paleocene arc plutons that flank the northwestern basin margin. (4) Metasedimentary strata of the Chugach accretionaryprism, exposed 20-50 km south of the Arkose Ridge Formation, did not contribute abundant detritus. Conventional provenance models predict reduced input of volcanic detritus to forearc basins during exhumation of the volcanic edifice and increasing exposure ofsubvolcanic plutons (Dickinson, 1995; Ingersoll and Eastmond, 2007). In the forearc strata of these conventional models, sandstone modal analyses record progressive increases upsection in quartz and feldspar concomitant with decreases in lithic grains, mainly volcanic lithics. Additionally, as the arc massif denudes through time, theyoungest detrital U-Pb zircon age populations become significantly older than the age of forearc deposition as the arc migrates inboard or ceases magmatism. Westernmost strata of the Arkose Ridge Formation are consistent with this conventional model. However, easternmost strata of the Arkose Ridge Formation contain sandstone modes that record an upsection increase in lithic grains accompanied by a decrease in quartz and feldspar, and detrital zircon age populations that closely match the age of deposition. This deviation from the conventional model is due to the proximity of the easternmost strata to adjacent juvenile volcanic rocks emplaced by slab-window volcanic processes. Provenance data from the Arkose Ridge Formation show that forearc basins modified by spreading ridge subduction may record upsection increases in non-arc, syndepositional volcanic detritusdue to contemporaneous accumulation of thick volcanic sequences at slab-window volcanic centers. This change may occur locally at the same time that other regions of the forearc continue to receive increasing amounts of plutonic detritus as the remnant arc denudes, resulting in complex lateral variations in forearc basin petrofacies and chronofacies.

Mesoproterozoic Deposition, Regional Metamorphism and Deformation in North-Central New Mexico: Evidence from Metamorphic Monazite and Detrital Zircon Geochronology in the Picuris Mountains

Detrital zircon and metamorphic monazite ages from the Picuris Mountains, north central New Mexico, were used to confirm the depositional age of the Marquenas Formation, to document the depositional age of the Vadito Group, and to constrain the timing of metamorphism and deformation in the region. Detrital zircon 207Pb/206Pb ages were obtained with the LA-MC-ICPMS from quartzites collected from the type locality of the Marquenas Formation exposed at Cerro de las Marquenas, and from the lower Vadito Group in the southern and eastern Picuris Mountains. The Marquenas Formation sample yields 113 concordant ages including a Mesoproterozoic age population with four grains ca. 1470 Ga, a broad Paleoproterozoic age peak at 1695 Ma, and minor Archean age populations. Data confirm recent findings of Mesoproterozoic detrital zircons reported by Jones et al. (2011), and show that the Marquenas Formation is the youngest lithostratigraphic unit in the Picuris Mountains. Paleoproterozoic and Archean detrital grains in the Marquenas Formation are likely derived from local recycled Vadito Group rocks and ca. 1.75 Ga plutonic complexes, and ca. 1.46 detrital zircons were most likely derived from exposed Mesoproterozoic plutons south of the Picuris. Ninety-five concordant grains from each of two Vadito Group quartzites yield relatively identical unimodal Paleoproterozoic age distributions, with peaks at 1713-1707 Ma. Eastern exposures of quartzite mapped as Marquenas Formation yield detrital zircon age patterns and metamorphic mineral assemblages that are nearly identical to the Vadito Group. On this basis, I tentatively assigned the easternmost quartzite to the Vadito Group. Zircon grains in all samples show low U/Th ratios, welldeveloped concentric zoning, and no evidence of metamorphic overgrowth events, consistent with an igneous origin. North-directed paleocurrent indicators, such as tangential crossbeds (Soegaard & Eriksson, 1986) and other primary sedimentary structures, are preserved in the Marquenas Formation quartzite. Together with pebble-toboulder metaconglomerates in the Marquenas, these observations suggest that this formation was deposited in a braided alluvial plain environment in response to syntectonic uplift to the south of the Picuris Mountains. Metamorphic monazite from two Vadito Group quartzite samples were analyzed with an electron microprobe (EMP). Elemental compositional variation with respect to Th and Y define core and rim domains in monazite grains, and show lower concentrations of Th (1.46-1.52 wt%) and Y (0.67 wt%) in the cores, and higher concentrations of Th (1.98 wt%) and Y (1.06 wt%) in the rims. Results show that Mesoproterozoic core and rim ages from five grains overlap within uncertainty, ranging from 1395-1469 Ma with an average age of 1444 Ma. This 1.44 Ga average age is the dominant timing of metamorphic monazite growth in the region, and represents the timing of metamorphism experienced by the region. An older 1630 Ma core observed in sample CD10-12 may be interpreted as a result of low temperature metamorphism in lower Vadito Group rocks due to heat from ca. 1.65 Ga granitic intrusions. Core ages ca. 1.5 Ga are likely due to a mixing age of two different age domains during analyses. Confirmed sedimentation at 1.48-1.45 Ga and documented mid-crustal regional metamorphism in northern New Mexico ca. 1.44-1.40 are likely associated with a Mesoproterozoic orogenic event.

The association between beliefs about low back pain and work presenteeism

OBJECTIVE: To examine the influence of beliefs about low back pain (LBP) on reduced productivity at work ("presenteeism") caused by LBP. METHODS: Two thousand five hundred seven individuals completed the Back Beliefs Questionnaire, the Fear Avoidance Beliefs questionnaire (FABQ), and questions about LBP-related work-absence, reduced work-productivity, pain, comorbidity, and demographics. RESULTS: Six hundred seventy (25%) individuals were of working age, employed and reported current LBP. Univariate models showed beliefs were more "negative" in individuals with work-absence and reduced productivity (P = 0.0001). In multivariable analysis, controlling for confounders, "FABQwork" was a unique predictor of both absenteeism and presenteeism (each, P = 0.0001), though with small effect sizes. CONCLUSIONS: Negative beliefs about LBP are associated with both work absence and reduced work-productivity. Further investigations should examine their potential as a target for educational interventions when considering initiatives to reduce the socioeconomic costs of LBP.

Effect of Health Risk Assessment and Counselling on Health Behaviour and Survival in Older People: A Pragmatic Randomised Trial.

BACKGROUND Potentially avoidable risk factors continue to cause unnecessary disability and premature death in older people. Health risk assessment (HRA), a method successfully used in working-age populations, is a promising method for cost-effective health promotion and preventive care in older individuals, but the long-term effects of this approach are unknown. The objective of this study was to evaluate the effects of an innovative approach to HRA and counselling in older individuals for health behaviours, preventive care, and long-term survival. METHODS AND FINDINGS This study was a pragmatic, single-centre randomised controlled clinical trial in community-dwelling individuals aged 65 y or older registered with one of 19 primary care physician (PCP) practices in a mixed rural and urban area in Switzerland. From November 2000 to January 2002, 874 participants were randomly allocated to the intervention and 1,410 to usual care. The intervention consisted of HRA based on self-administered questionnaires and individualised computer-generated feedback reports, combined with nurse and PCP counselling over a 2-y period. Primary outcomes were health behaviours and preventive care use at 2 y and all-cause mortality at 8 y. At baseline, participants in the intervention group had a mean ± standard deviation of 6.9 ± 3.7 risk factors (including unfavourable health behaviours, health and functional impairments, and social risk factors) and 4.3 ± 1.8 deficits in recommended preventive care. At 2 y, favourable health behaviours and use of preventive care were more frequent in the intervention than in the control group (based on z-statistics from generalised estimating equation models). For example, 70% compared to 62% were physically active (odds ratio 1.43, 95% CI 1.16-1.77, p = 0.001), and 66% compared to 59% had influenza vaccinations in the past year (odds ratio 1.35, 95% CI 1.09-1.66, p = 0.005). At 8 y, based on an intention-to-treat analysis, the estimated proportion alive was 77.9% in the intervention and 72.8% in the control group, for an absolute mortality difference of 4.9% (95% CI 1.3%-8.5%, p = 0.009; based on z-test for risk difference). The hazard ratio of death comparing intervention with control was 0.79 (95% CI 0.66-0.94, p = 0.009; based on Wald test from Cox regression model), and the number needed to receive the intervention to prevent one death was 21 (95% CI 12-79). The main limitations of the study include the single-site study design, the use of a brief self-administered questionnaire for 2-y outcome data collection, the unavailability of other long-term outcome data (e.g., functional status, nursing home admissions), and the availability of long-term follow-up data on mortality for analysis only in 2014. CONCLUSIONS This is the first trial to our knowledge demonstrating that a collaborative care model of HRA in community-dwelling older people not only results in better health behaviours and increased use of recommended preventive care interventions, but also improves survival. The intervention tested in our study may serve as a model of how to implement a relatively low-cost but effective programme of disease prevention and health promotion in older individuals. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number: ISRCTN 28458424.

Constraints on the thermal evolution of the Adriatic margin during Jurassic continental break-up: U–Pb dating of rutile from the Ivrea–Verbano Zone, Italy

The Ivrea–Verbano Zone (IVZ), northern Italy, exposes an attenuated section through the Permian lower crust that records high-temperature metamorphism under lower crustal conditions and a protracted history of extension and exhumation associated partly with the Jurassic opening of the Alpine Tethys ocean. This study presents SHRIMP U–Pb geochronology of rutile from seven granulite facies metapelites from the base of the IVZ, collected from locations spanning ~35 km along the strike of Paleozoic fabrics. Rutile crystallised during Permian high-temperature metamorphism and anatexis, yet all samples give Jurassic rutile U–Pb ages that record cooling through 650–550 °C. Rutile age distributions are dominated by a peak at ~160 Ma, with a subordinate peak at ~175 Ma. Both ~160 and ~175 Ma age populations show excellent agreement between samples, indicating that the two distinctive cooling stages they record were synchronous on a regional scale. The ~175 Ma population is interpreted to record cooling in the footwall of rift-related faults and shear zones, for which widespread activity in the Lower Jurassic has been documented along the western margin of the Adriatic plate. The ~160 Ma age population postdates the activity of all known rift-related structures within the Adriatic margin, but coincides with extensive gabbroic magmatism and exhumation of sub-continental mantle to the floor of the Alpine Tethys, west of the Ivrea Zone. We propose that this ~160 Ma early post-rift age population records regional cooling following episodic heating of the distal Adriatic margin, likely related to extreme lithospheric thinning and associated advection of the asthenosphere to shallow levels. The partial preservation of the ~175 Ma age cluster suggests that the post-rift (~160 Ma) heating pulse was of short duration. The regional consistency of the data presented here, which is in contrast to many other thermochronometers in the IVZ, demonstrates the value of the rutile U–Pb technique for probing the thermal evolution of high-grade metamorphic terrains. In the IVZ, a significant decoupling between Zr-in-rutile temperatures and U–Pb ages of rutile is observed, with the two systems recording events ~120 Ma apart.