ResUMO Para entender a carência de pediatras em certas regiões do País, objetivamos identificar fatores associados à escolha da Pediatria e a intenção de retorno

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Riziform bodies are structures formed by fibrin and cells that can be found in the synovial fluid or attached to the synovium, and have this denomination due to its rice grain-like appearance. They have already been described in several diseases such as tuberculous arthritis, rheumatoid arthritis, and rarely in juvenile idiopathic arthritis (JIA). This is the case of a boy with a 4-month course of chronic monoarthritis of the left knee, with family history of sarcoidosis in which diagnostic investigation showed the presence of these riziform bodies in the synovial biopsy. Diagnostic investigation ruled out sarcoidosis, tuberculosis and malignancies, establishing the diagnosis of JIA. Our objective was to describe what we believe is the 9th case reported on the presence of riziform bodies in JIA, which are probably underdiagnosed, and should be considered mainly in cases of severe arthritis of difficult medical treatment.

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O presente trabalho se propõe a apresentar as viagens em Mário de Andrade, indicando caminhos e possibilidades para uma nova leitura dos relatos de viagem do autor modernista. Uma à região Norte e outra ao Nordeste. À primeira registrada com o título O turista aprendiz: viagens pelo Amazonas até o Peru pelo Madeira até a Bolívia e por Marajó até dizer chega! Já a segunda O turista aprendiz. Em 1976, os relatos das duas viagens foram reunidos e publicados no livro O Turista Aprendiz. Apesar de publicadas em conjunto, as duas viagens são bastante distintas e específicas (apenas unificadas em livro por uma edição póstuma), e embora o escritor só tivesse nomeado a segunda viagem como uma “viagem etnográfica”, não é raro ver estudos que atribuam a ambas as viagens a mesma característica. No entanto, Botelho (2013), sugere que essa noção de “etnografia” em Mário de Andrade precisa ser qualificada cuidadosamente, para que não se caia tão facilmente em um discurso que atrela, de antemão, a experiência etnográfica do escritor paulista à prática da antropologia. Como nosso objetivo principal é analisar a “viagem etnográfica”, nos interessa sobremaneira compreender quais são as especificidades dessa viagem, e das experiências que nela tiveram lugar, que levaram Mário de Andrade a qualificá-la de “etnográfica” e qual é o(s) sentido(s) atribuído a essa categoria pelo autor quando mobilizada nesse contexto específico.

Introduction Hospital-acquired venous thromboembolism (HA-VTE) in children comprises multiple risk factors that should not be evaluated separately due to collinearity and multiple cause and effect relationships. This is one of the first case-control study of pediatric HA-VTE risk factors using a Directed Acyclic Graph (DAG) analysis. Material and methods Retrospective, case-control study with 22 cases of objectively confirmed HA-VTE and 76 controls matched by age, sex, unit of admission, and period of hospitalization. Descriptive statistics were used to define distributions of continuous variables, frequencies, and proportions of categorical variables, comparing cases and controls. Due to many potential risk factors of HA-VTE, a directed acyclic graph (DAG) model was created to identify confounding, reduce bias, and increase precision on the analysis. The final model consisted of a DAG-informed conditional logistic regression. Results In the initial conventional univariable model, the following variables were selected as potential risk factors for HA-VTE: length of stay (LOS, days), immobility, ICU admission in the last 30 days, LOS in ICU, infection, central venous catheter (CVC), number of CVCs placed, L-asparaginase, heart failure, liver failure, and nephrotic syndrome. The final model using the set of variables selected by DAG analysis revealed LOS (OR = 1.106, 95%CI = 1.021–1.198, p = 0.013), L-asparaginase (OR = 26.463, 95%CI = 1.609–435.342, p = 0.022), and nephrotic syndrome (OR = 29.127, 95%CI = 1.044–812.508, p = 0.004) as independent risk factors for HA-VTE. Conclusion The DAG-based approach was useful to clarify the influence of confounders and multiple causalities of HA-VTE. Interestingly, CVC placement—a known thrombotic risk factor highlighted in several studies—was considered a confounder, while LOS, L-asparaginase use and nephrotic syndrome were confirmed as risk factors to HA-VTE. Large confidence intervals are related to the sample size; however, the results were significant.

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