A PROBLEMÁTICA DA VIOLÊNCIA NO AMBIENTE DA ESCOLA: POSSIBILIDADES DE DISCUSSÃO A PARTIR DO PROJETO POLÍTICO PEDAGÓGICO.

This paper analyzes the possibilities of building a political pedagogical project that dialogue with society to tackle violence in school. Thus , our problem is to try to investigate how the political pedagogical project can become a powerful articulator in the development of prevention of school violence policies , on the assumption that it is necessary to give visibility on PPP issues of school violence and its forms coping . For construction of the text , we use in the literature . As preliminary results we can point out that the issues surrounding the PPP should always be thought of as fundamental in strengthening the role of education , which must be built through democratic movements and joints with the participation of all who are part of the school community.Este texto analisa as possibilidades da construção de um projeto político pedagógico que dialogue com a sociedade para enfrentar a violência na escola. Dessa forma, a nossa problemática é tentar investigar como o projeto político pedagógico pode se tornar um potente articulador no desenvolvimento de políticas de prevenção à violência escolar, partindo do pressuposto de que é necessário dar visibilidade no PPP às questões da violência escolar e suas formas de enfrentamento. Para construção do texto, utilizamo-nos da pesquisa bibliográfica. Como resultados preliminares podemos apontar que as questões que envolvem o PPP devem ser sempre pensadas como fundamentais no fortalecimento do papel da educação, devendo este ser construído através de movimentos e articulações democráticas com a participação de todos que fazem parte da comunidade escolar

PERFIL SOCIODEMOGRÁFICO E QUALIDADE DE VIDA DE IDOSOS DE UM CENTRO DE REFERÊNCIA DO IDOSO DO OESTE PAULISTA

The study that was describing the profile of the socioeducation, quality of life, level of physical activities of the center of Elderly (CRI) and comparatives of the Brazilian plan by the governmental. A comparative and cross-sectional study involving 100 elderly women of both sexes, aged 73.2 ± 6 years. To assess quality of life, use the WHOQOL-OLD questionnaire, the level of physical activity through the questionnaire, and the cognitive level of the Mental State Mini Exam. The chi-square test was used to analyze the intergroups. The analysis of the level of physical activity was used as Kruskal-Wallis test (p <0.05). Data on the socio-demographic aspects are related to schooling, marital status, income and child penetration, when compared to data from the Brazilian population, of Systemic Arterial Hypertension, similar to data such as morbidity and data from the elderly population on the level of physical activity made it difficult to compare. Essay is a population study found to be equal and superior in most profiles of the Brazilian population.O objetivo deste estudo foi descrever o perfil sóciodemográfico, qualidade de vida e nível de atividade física de idosos do Centro de Referência do Idoso (CRI) comparados aos idosos do Brasil por plataforma governamental. Estudo comparativo e transversal, incluindo 100 idosos de ambos os gêneros com idade de 73,2±6 anos. A qualidade de vida foi avaliada pelo questionário WHOQOL-OLD, o nível de atividade física pelo questionário Baecke e o nível cognitivo através do Mini Exame do Estado Mental. A análise intergrupos foi realizada pelo teste Qui-quadrado. Para análise do nível de atividade física utilizou-se o teste Kruskal-Wallis (p<0,05). Os resultados sociodemográficos mostraram que escolaridade, estado civil, renda e profissão foram superiores quando comparados aos dados nacionais e a ausência de dados da população idosa brasileira sobre nível de atividade física dificultou realizar comparações. Concluiu-se que a amostra encontra-se em nível igual ou superior na maioria dos perfis da população brasileira

Thalidomide plus dexamethasone as a maintenance therapy after autologous hematopoietic stem cell transplantation improves progression-free survival in multiple myeloma

Despite the good response of stem cell transplant (SCT) in the treatment of multiple myeloma (MM), most patients relapse or do not achieve complete remission, suggesting that additional treatment is needed. We assessed the impact of thalidomide in maintenance after SCT in untreated patients with MM. A hundred and eight patients (<70 years old) were randomized to receive maintenance with dexamethasone (arm A; n = 52) or dexamethasone with thalidomide (arm B; n = 56; 200 mg daily) for 12 months or until disease progression. After a median follow-up of 27 months, an intention to treat analysis showed a 2-year progression-free survival (PFS) of 30% in arm A (95% CI 2238) and 64% in arm B (95% CI 5771; P = 0.002), with median PFS of 19 months and 36 months, respectively. In patients who did not achieve at least a very good partial response, the PFS at 2 years was significantly higher when in use of thalidomide (19 vs. 59%; P = 0.002). Overall survival at 2 years was not significantly improved (70 vs. 85% in arm A and arm B, respectively; P = 0.27). The addition of thalidomide to dexamethasone as maintenance improved the PFS mainly in patients who did not respond to treatment after SCT. Am. J. Hematol. (c) 2012 Wiley Periodicals, Inc.FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)CNPq (Conselho Nacional do Desenvolvimento Cientifico e Tecnologico)Conselho Nacional do Desenvolvimento Cientifico e Tecnologico (CNPq)FAPERJ (Fundacao de Apoio a Pesquisa do Estado do Rio de Janeiro)FAPERJ (Fundacao de Apoio a Pesquisa do Estado do Rio de Janeiro

Conhecimentos sobre prevenção da SIDA entre profissionais e acadêmicos da área de saúde

Este estudo exploratório foi realizado pelas alunas e alunos da Disciplina de Enfermagem nas Doenças Transmissíveis. Foram analisadas as respostas de 52 questionários distribuídos entre acadêmicos de enfermagem, de medicina, médicos, dentistas, enfermeiros e auxiliares de enfermagem que assistem pacientes com SIDA e enfermeiros que não assistem pacientes com SIDA. Estes questionários versaram sobre medidas de prevenção da transmissão sexual, normal de biossegurança, testes diagnósticos, direitos do paciente e do trabalhador e alterações no atendimento aos portadores desta patologia.This work is a exploratory research based on the analysis of the answers to the questionaires of 52 students and health care professionals knowledge about AIDS sexual prevention, biossecurity, diagnosis tests, patients and workers rights and the modifications of nursing and medica/ care to this kind of diseaseTrata se de un estudio exploratório acerca del conocimiento de la prevención de la SIDA, normas de seguridad biológica, pruebas diagnósticas, derechos de /os enfermos y trabajadores con SIDA y de esa mfermedad. Fueron analizados las respuestas de 52 cuestionários de estudientes de enfermería, nédicos, odontólogos, enfermeras y ajudantes de enfermería

Management of chronic myeloid leukemia during pregnancy: a retrospective analysis at a single center

We analyzed the management and outcomes of pregnancies of patients with chronic myeloid leukemia at a single center over fifteen years. Among the 203 CML female patients, there were ten pregnancies in seven women, all of them not planned. In three cases, the chronic myeloid leukemia diagnosis was made during pregnancy. Five patients received tyrosine kinase inhibitors in the first weeks of pregnancy and the drug was interrupted until delivery. One patient lost complete cytogenetic response, and two patients lost the hematological response. A patient with a stable major molecular response had two successful pregnancies without loss of response. There were four premature births. There were no maternal adverse events, fetal malformation or death. All patients received Interferon-alpha during gestation, and two received hydroxyurea for a short period. Leukapheresis was performed in two patients for hyperleukocytosis control. One patient with sickle cell disease died from disease progression six months after delivery. Conclusions: The tyrosine kinase inhibitors ministration should be interrupted during pregnancy. Patients should be advised to achieve a stable and deep molecular response if they plan to conceive, to avoid the risk of disease progression. Keywords: Chronic myeloid leukemia, Pregnancy, Imatinib, Interferon-alpha, Hydroxyurea, Dasatini

Treatment with dasatinib or nilotinib in chronic myeloid leukemia patients who failed to respond to two previously administered tyrosine kinase inhibitors - a single center experience

OBJECTIVE:To evaluate hematological, cytogenetic and molecular responses as well as the overall, progression-free and event-free survivals of chronic myeloid leukemia patients treated with a third tyrosine kinase inhibitor after failing to respond to imatinib and nilotinib/dasatinib.METHODS:Bone marrow karyotyping and real-time quantitative polymerase chain reaction were performed at baseline and at 3, 6, 12 and 18 months after the initiation of treatment with a third tyrosine kinase inhibitor. Hematologic, cytogenetic and molecular responses were defined according to the European LeukemiaNet recommendations. BCR-ABL1 mutations were analyzed by Sanger sequencing.RESULTS:We evaluated 25 chronic myeloid leukemia patients who had been previously treated with imatinib and a second tyrosine kinase inhibitor. Nine patients were switched to dasatinib, and 16 patients were switched to nilotinib as a third-line therapy. Of the chronic phase patients (n=18), 89% achieved a complete hematologic response, 13% achieved a complete cytogenetic response and 24% achieved a major molecular response. The following BCR-ABL1 mutations were detected in 6/14 (43%) chronic phase patients: E255V, Y253H, M244V, F317L (2) and F359V. M351T mutation was found in one patient in the accelerated phase of the disease. The five-year overall, progression-free and event-free survivals were 86, 54 and 22% (p<0.0001), respectively, for chronic phase patients and 66%, 66% and 0% (p<0.0001), respectively, for accelerated phase patients. All blast crisis patients died within 6 months of treatment. Fifty-six percent of the chronic phase patients lost their hematologic response within a median of 23 months.CONCLUSIONS:Although the responses achieved by the third tyrosine kinase inhibitor were not sustainable, a third tyrosine kinase inhibitor may be an option for improving patient status until a donor becomes available for transplant. Because the long-term outcome for these patients is poor, the development of new therapies for resistant chronic myeloid leukemia patients is necessary

Cardiovascular risk and cardiovascular events in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors

We evaluated the incidence of cardiovascular events in 233 consecutive patients with chronic myeloid leukemia, treated with imatinib (116), dasatinib (75), and nilotinib (42). Three events occurred with dasatinib and 6 with nilotinib. Arterial occlusive events occurred more frequently in patients treated with nilotinib (14.2%) rather than dasatinib (2.6%) in patients with high and very high cardiovascular risk factors. This finding may help to guide therapy. Background: Cardiovascular events (CVEs) have been observed in patients with chronic myeloid leukemia treated with second-generation tyrosine kinase inhibitors. Patients and Methods: We retrospectively evaluated the incidence of CVEs on 233 consecutive patients with chronic myeloid leukemia, of which 116 were treated with imatinib, 75 with dasatinib, and 42 with nilotinib. The median follow-up was 2047, 1712, and 1773 days, respectively. Results: The cumulative incidence of CVEs was 4.29%. Three events occurred during dasatinib treatment, 6 during nilotinib treatment, and none during imatinib treatment (P <=.001). Arterial occlusive events occurred in 2 (2.6%) of 75 patients treated with dasatinib and in 6 (14.2%) of 42 patients treated with nilotinib (P <=.001). Furthermore, all of them occurred in patients with high-risk (n = 2) and very high-risk (n = 6) cardiovascular risk, contributing to 4.3% of mortality. Conclusion: CVEs were more frequent in patients treated with second-generation tyrosine kinase inhibitors. Arterial occlusive events were more frequent in patients treated with nilotinib, with high and very high cardiovascular risk.193162166COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESSem informaçã

Apresentação

Apresentação e editorial para a Quarta Edição do EPHIS.Conselho Editorial da Temporalidades - 201

Brazilian experience using high dose sequential chemotherapy followed by autologous hematopoietic stem cell transplantation for malignant lymphomas

OBJECTIVE: To evaluate the use of high-dose sequential chemotherapy in a Brazilian population. METHODS: High-dose cyclophosphamide followed by autologous hematopoietic stem cell transplantation is an effective and feasible therapy for refractory/relapsed lymphomas; this regimen has never before been evaluated in a Brazilian population. All patients (106 with high-grade non-Hodgkin lymphoma and 77 with Hodgkin's lymphoma) submitted to this treatment between 1998 and 2006 were analyzed. Chemotherapy consisted of the sequential administration of high-dose cyclophosphamide (4 or 7 g/m²) and granulocyte-colony stimulating factor (300 µg/day), followed by peripheral blood progenitor cell harvesting, administration of etoposide (2g/m²) and methotrexate (8 g/m² only for Hodgkin's lymphoma) and autologous hematopoietic stem cell transplantation. RESULTS: At diagnosis, non-Hodgkin lymphoma patients had a median age of 45 (range: 8-65) years old, 78% had diffuse large B-cell lymphoma and 83% had stage III/IV disease. The Hodgkin's lymphoma patients had a median age of 23 (range: 7-68) years old, 64.9% had the nodular sclerosis subtype and 65% had stage III/IV disease. Nine Hodgkin's lymphoma patients (13%) and 10 (9%) non-Hodgkin lymphoma patients had some kind of cardiac toxicity. The overall survival, disease-free survival and progression-free survival in Hodgkin's lymphoma were 29%, 59% and 26%, respectively. In non-Hodgkin lymphoma, these values were 40%, 49% and 31%, respectively. High-dose cyclophosphamide-related mortality was 10% for Hodgkin's lymphoma and 5% for non-Hodgkin lymphoma patients. High-dose cyclophosphamide dosing had no impact on toxicity or survival for both groups. CONCLUSIONS: Despite a greater prevalence of poor prognostic factors, our results are comparable to the literature. The incidence of secondary neoplasias is noteworthy. Our study suggests that this approach is efficient and feasible, regardless of toxicity-related mortality