O desempenho de alunos do 6º ano em questões que envolvem a obtenção dos fatores de um número e sua decomposição em fatores

O presente artigo objetiva analisar o desempenho de alunos de 6º ano do ensino fundamental de uma escola particular da zona norte do Rio de Janeiro, Brasil, em situações-problema que envolvem a obtenção dos fatores e decomposição de um número. Para tanto, aplicamos um diagnóstico (pré e pós-testes) antes e após uma intervenção de ensino baseada em atividades lúdicas e jogos. Neste artigo, analisaremos três situações do teste, o qual enfocou conceitos associados ao Teorema Fundamental da Aritmética. Os resultados apontam que houve crescimento significativo nos rendimentos dos alunos nas três situações. Com base nas ideias de Vergnaud (1996), Campbell (2002), Barbosa (2002), Piaget (1994) e Macedo, Petty e Passos (2000) analisamos as representações, estratégias e equívocos encontrados nas soluções e em que medidas eles foram superados. Concluímos que, para o grupo pesquisado, as atividades lúdicas e os jogos contribuíram fortemente para o avanço na compreensão dos conceitos em questão

Position Paper Português Sobre o Uso de Biossimilares na Psoríase

info:eu-repo/semantics/publishedVersio

Toxic epidermal necrolysis and Stevens-Johnson syndrome

Toxic epidermal necrolysis (TEN) and Stevens Johnson Syndrome (SJS) are severe adverse cutaneous drug reactions that predominantly involve the skin and mucous membranes. Both are rare, with TEN and SJS affecting approximately 1or 2/1,000,000 annually, and are considered medical emergencies as they are potentially fatal. They are characterized by mucocutaneous tenderness and typically hemorrhagic erosions, erythema and more or less severe epidermal detachment presenting as blisters and areas of denuded skin. Currently, TEN and SJS are considered to be two ends of a spectrum of severe epidermolytic adverse cutaneous drug reactions, differing only by their extent of skin detachment. Drugs are assumed or identified as the main cause of SJS/TEN in most cases, but Mycoplasma pneumoniae and Herpes simplex virus infections are well documented causes alongside rare cases in which the aetiology remains unknown. Several drugs are at "high" risk of inducing TEN/SJS including: Allopurinol, Trimethoprim-sulfamethoxazole and other sulfonamide-antibiotics, aminopenicillins, cephalosporins, quinolones, carbamazepine, phenytoin, phenobarbital and NSAID's of the oxicam-type. Genetic susceptibility to SJS and TEN is likely as exemplified by the strong association observed in Han Chinese between a genetic marker, the human leukocyte antigen HLA-B*1502, and SJS induced by carbamazepine. Diagnosis relies mainly on clinical signs together with the histological analysis of a skin biopsy showing typical full-thickness epidermal necrolysis due to extensive keratinocyte apoptosis. Differential diagnosis includes linear IgA dermatosis and paraneoplastic pemphigus, pemphigus vulgaris and bullous pemphigoid, acute generalized exanthematous pustulosis (AGEP), disseminated fixed bullous drug eruption and staphyloccocal scalded skin syndrome (SSSS). Due to the high risk of mortality, management of patients with SJS/TEN requires rapid diagnosis, evaluation of the prognosis using SCORTEN, identification and interruption of the culprit drug, specialized supportive care ideally in an intensive care unit, and consideration of immunomodulating agents such as high-dose intravenous immunoglobulin therapy. SJS and TEN are severe and life-threatening. The average reported mortality rate of SJS is 1-5%, and of TEN is 25-35%; it can be even higher in elderly patients and those with a large surface area of epidermal detachment. More than 50% of patients surviving TEN suffer from long-term sequelae of the disease

Infliximab in psoriasis and psoriatic arthritis.

Psoriasis is a chronic inflammatory disorder of the skin and joints. Although rarely life threatening, psoriasis can significantly impair quality of life (QOL) and cause considerable physical and psychological distress. Between 6 and 42\% of patients with psoriasis develop psoriatic arthritis, which is characterized by stiffness, pain, swelling and tenderness of the joints. Nail psoriasis is highly prevalent in both plaque-type psoriasis and psoriatic arthritis and is found in approximately 50\% of patients with psoriasis and in 80\% of patients with psoriatic arthritis. Infliximab, a chimeric human-murine monoclonal antibody directed against tumour necrosis factor α, is approved in the USA and EU for the treatment of plaque psoriasis and psoriatic arthritis at a recommended dosage of 5 mg/kg administered by intravenous infusion at 0,2 and 6 weeks, then every 8 weeks thereafter. The EXPRESS and EXPRESS II trials demonstrated that infliximab is efficacious as induction and maintenance therapy in the treatment of moderate to severe plaque psoriasis and also improved health-related QOL. Infliximab is also efficacious in the treatment of psoriatic arthritis, as shown in the IMPACT and IMPACT II studies. Infliximab is generally well tolerated, with a similar adverse event profile in both psoriasis and psoriatic arthritis. The use of infliximab in three case reports is presented. The patients are similar to those normally seen by clinicians, and include a male patient with plaque psoriasis and a history of severe psoriatic arthritis who was corticosteroid dependent and in whom other systemic treatments were not effective or were not able to be used. This patient showed a rapid response to infliximab with no skin lesions or arthritis after 7 weeks' treatment. Infliximab was also safe and effective in the treatment of a female patient with plaque and nail psoriasis and a history of psoriatic arthritis. Importantly, this case report supports the efficacy of infliximab in psoriatic nail disease in the context of severe skin and joint involvement. Case 3 describes a young male patient with moderate plaque-type psoriasis associated with severe nail involvement and early signs of psoriatic arthritis. Treatment with infliximab improved nail psoriasis and appears to be an effective biological treatment for nail psoriasis. Importantly, ultrasound was able to diagnose joint involvement, as seen from the proliferative synovitis in the distal interphalangeal joint and mild enthesitis, despite there being no clinical evidence of psoriatic arthritis. This case report highlights the importance of early screening. If such abnormalities are detected early on in the course of psoriasis, clinicians may be able to predict which patients are more likely to develop psoriatic arthritis, and therefore offer effective and long-term treatment that may reduce the disability and impairment of daily activities that can be associated with psoriatic arthritis

As Estratégias de Resolução de Problemas das Estruturas Aditivas nas Quatro Primeiras Séries do Ensino FundamentalPrimary school children’s strategies concerning problem solving in additive structuresp.(15-50)

Este artigo analisa as estratégias de 1021 estudantes das séries iniciais do Ensino Fundamental, de 26 escolas públicas do Sul da Bahia, na resolução de problemas das estruturas aditivas. A Teoria dos Campos Conceituais foi utilizada como referencial teórico. Os estudantes responderam, coletivamente, um teste contendo 12 problemas de adição e subtração, doravante chamados como problemas de estruturas aditivas. Os resultados apontam uma queda significativa no percentual de acerto em problemas que envolviam extensões mais complexas dessa estrutura; também naqueles que apresentavam incongruência semântica entre as palavras-chave e a operação a ser realizada. Observou-se um crescente sucesso na resolução dos problemas considerados protótipos, segundo o nível de instrução. Já nos problemas mais complexos não observou-se ganhos significativos com a instrução. Considerando a intrínseca relação entre o saber do professor e de seus alunos, o estudo enfatiza a necessidade de se repensar a formação matemática, inicial e continuada, do professor das séries inicias e o papel da pesquisa em sua formação. Palavras-chave: Campos conceituais, estruturas aditivas, ensino fundamental, resolução de problemas, estudo diagnóstico Abstract: This paper analyzes strategies used by 1021 primary school children from 26 public schools located in the south of Bahia, when they were solving additive structure problems. The conceptual field theory was adopted as a theoretical framework. The students were asked to collectively solve 12 problems involving addition and subtraction, treated from now on as additive structure problems. The results revealed significant decrease in the percentage of correct answers in problems that involved more complex extensions of this structure, as well as in those which presented semantic incongruence between key words and the operation that should be used. Although there was some improvement in the children’s performance in prototype problems, according the level of instruction, no significant improvement was observed with more complex problems. Considering the intrinsic relationship between the teacher’s and the students’ knowledge, the study emphasizes the need to review initial and in-service mathematics teacher formation, as well as the role of research in teacher formation. Key words: Conceptual field; addictive structures; basic school; problem solving; diagnostic stud