Os princípios cooperativistas e a identidade do movimento cooperativista em xeque

This paper contributes to the discussion on the current dilemma of cooperatives: maintain the identity of the movement or seek for more competitive forms to their development. The proposed approach is part of cross case study about the practice of cooperative principles in four credit unions in the state of Tocantins, in Brazil, in order to subsidize the debate. At the end, we present some points to advance the debate.Este texto contribui na discussão sobre o atual dilema das cooperativas: manter a identidade do movimento ou buscar formas mais competitivas para se desenvolver. A abordagem proposta parte de um estudo “cross case” sobre a prática de princípios cooperativistas em quatro cooperativas de crédito do estado do Tocantins no Brasil de modo a subsidiar o debate. Ao final são apresentados alguns pontos para o avanço do debate

Technology Perspectives and Innovative Scenarios Applied in the Amazon Region

This paper aims to summarize the technology perspectives and innovative scenarios applied in the Amazon region. A call for papers for the Special Issue yielded four accepted articles that serve as the source for the summary. All these articles focus on specific cases in the Legal Amazon region and provide empirical evidence supported by theories and relevant literature. All the articles emphasized the need for investment in the form of networks for development and innovation. A descriptive, qualitative approach using the bibliometric software WordStat 8® identified the words most frequently used in the four papers included this special issue. The most relevant terms identified were: network, innovation, firms, production, research and development. In total, these articles point to varied partners and institutions necessary for building networks to further development and innovation. This Special Issue is a first step to building a knowledge base focused on the Amazon region that is missing in the academic literature. Future contributions must build and expand the discussion of empirical cases and reflect different disciplines that contribute to industries, policies, society and networks. This is necessary to improve innovation and economic development of this important region

Clinical outcome of renal transplant patients after coronary stenting

OBJECTIVE: To assess the clinical outcome of renal transplant patients who developed coronary artery disease and were treated with coronary stenting (TCA-ST). METHODS: A total of 3,334 renal transplants were performed in our service - Hospital do Rim e Hipertensão - HRH (Kidney and Hypertension Hospital) from July, 1998 to November, 2004. During this period, 33 of the renal transplant patients underwent TCA-ST to treat 62 severe stenoses in 54 coronary arteries. A retrospective analysis was performed with renal transplant patients undergoing TCA-ST at HRH. The clinical events were registered using medical charts, medical visits and phone calls. RESULTS: During the 30-month clinical follow-up after TCA-ST, 67% of the patients remained asymptomatic, 18% presented stable angina, 6% presented acute coronary syndrome without ST-segment elevation (ACSWSTE), and 3% presented acute coronary syndrome with ST-segment elevation (ACSSTE). No strokes, CHF or cardiac deaths were observed. Three non-cardiac deaths occurred. A restenosis rate of 9% was observed, which is comparable to those found in studies on drug-eluting stents. CONCLUSION: In conclusion, renal transplant patients who developed CAD and were treated with coronary stenting had a low rate of in-stent restenosis, probably related to the immunosuppressive regimen given to prevent kidney rejection.OBJETIVO: Avaliar a evolução clínica de pacientes submetidos a transplante de rim, portadores de doença arterial coronariana, que foram tratados com implante de stent coronariano (ATC-ST). MÉTODOS: Entre julho de 1998 e novembro de 2004, foram realizados, no total, 3.334 transplantes de rim em nossa Instituição (Hospital do Rim e Hipertensão). Desse total, 33 pacientes previamente submetidos a transplante de rim fizeram ATC-ST para o tratamento de 62 estenoses graves em 54 artérias coronárias, nos quais foi realizada análise retrospectiva. O registro dos eventos clínicos foi feito por meio de análise do prontuário médico, consulta médica e ligações telefônicas. RESULTADOS: No seguimento clínico de 30 meses, após a ATC-ST, observou-se que 67% dos pacientes permaneceram assintomáticos, 18% dos pacientes apresentaram quadro de angina estável, 6% apresentaram síndrome coronariana aguda sem supra de ST e 3% apresentaram síndrome coronariana aguda com supra de ST. Não houve pacientes com acidente vascular cerebral, insuficiência cardíaca congestiva ou morte cardíaca. Houve três mortes não-cardíacas. Foi observado índice de reestenose de 9%, que é comparável ao dos estudos de stent farmacológico. CONCLUSÃO: Concluímos que pacientes submetidos a transplante de rim que desenvolveram doença arterial coronariana e que foram tratados com stent coronariano tiveram baixo porcentual de reestenose clínica, provavelmente relacionado ao regime de imunossupressão administrado para evitar rejeição renal.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Hospital do Rim e HipertensãoUNIFESP, EPM, Hospital do Rim e HipertensãoSciEL

POLAR registry (Promus eluting stent registry in Latin America ):1 year follow-up results

BACKGROUND: Drug-eluting stents have been used since 2002 in different patient populations aiming to achieve high success rates with low clinical and angiographic restenosis rates. With the late thrombosis adverse events associated to the first generation sirolimus and paclitaxel-eluting stents, second-generation everolimus and zotarolimus-eluting stents has been recently developed. METHODS: The POLAR registry is a prospective, non-randomized, multicenter study, which included 988 patients, totaling 1,362 lesions treated with the everolimus-eluting stent Promus®. In order to represent the clinical practice, almost all subtypes of patients and lesions were included in this registry. Clinical follow-up was planned to be performed 1, 6, 12 and 24 months after the procedure. RESULTS: Most patients were male (69.8%), with mean age of 64.9 ± 9.4 years, 35.2% were diabetics and 55% had been treated for acute coronary syndrome. Vessel diameter was 2.95 ± 0.43 mm and lesion extension was 20.5 ± 5.6 mm. A total of 1.14 ± 0.38 stent/patient were implanted and the procedural success rate was 96.6%. Major adverse cardiac events occurred in 4.5% of patients, and stent thrombosis was observed in 5 patients (0.5%) after a clinical follow-up of 12 months. CONCLUSIONS: The present registry suggests that everolimus-eluting stents are safe and effective in daily clinical practice patients, with a low rate of major adverse cardiac events at the end of the first year of follow-up.INTRODUÇÃO: Desde 2002, os stents farmacológicos são utilizados em diversas populações de pacientes objetivando alcançar elevados índices de sucesso, com baixas taxas de reestenose angiográfica e clínica. Com os resultados adversos em relação à trombose tardia associados aos stents farmacológicos de primeira geração eluidores de sirolimus e paclitaxel, surgiram recentemente os stents farmacológicos de segunda geração eluidores de zotarolimus e everolimus. MÉTODOS: O registro POLAR é um registro prospectivo, não-randomizado, multicêntrico, que incluiu 988 pacientes totalizando 1.362 lesões tratadas com o stent Promus®. Objetivando representar a prática clínica, praticamente todos os subtipos de pacientes e lesões foram incluídos neste registro. O seguimento clínico foi planejado para ser realizado 1 mês, 6 meses, 12 meses e 24 meses após o procedimento. RESULTADOS: A maioria dos pacientes era do sexo masculino (69,8%), com média de idade de 64,9 ± 9,4 anos, 35,2% eram diabéticos e 55% tinham sido tratados na vigência de síndrome coronária aguda. O diâmetro do vaso foi de 2,95 ± 0,43 mm e a extensão da lesão, de 20,5 ± 5,6 mm. Foi implantado 1,14 ± 0,38 stent/paciente e o sucesso do procedimento foi alcançado em 96,6% dos casos. Eventos cardíacos adversos maiores ocorreram em 4,1% dos pacientes, e trombose de stent esteve presente em 5 pacientes (0,5%) após o seguimento clínico de 12 meses. CONCLUSÕES: O presente registro sugere que os stents farmacológicos eluidores de everolimus são seguros e eficazes em pacientes da prática clínica diária, com baixas taxas de eventos cardíacos adversos maiores ao término do primeiro ano de seguimento.Universidade Federal de São Paulo (UNIFESP)Instituto Dante Pazzanese de CardiologiaStatus CorHospital Israelita Albert EinsteinENCORE Hospital Lúcio RebeloReal e Benemérita Associação Portuguesa de BeneficênciaHospital Cardiológico CostantiniHemodinâmica Meridional Intercath MeridionalInstituto de Cardiologia do Espírito SantoFundação Universitária de Cardiologia Instituto de Cardiologia do Rio Grande do SulUNIFESPSciEL

O território paulista na iconografia oitocentista: mapas, desenhos e fotografias. análise de uma herança cotidiana

This paper presents a study about the cartography elaborated to represent São Paulos territory during the 19th century. The author seeks to show the permanence of cultural values related to the colonial period by analyzing some cartographical models, which are not necessarily linked to a cartographic school. In this context, the author seeks to identify the formative values of the regional territorial space, the cultural identity of the common Man and the specific needs of his or her daily life