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Neste artigo, as autoras partem de uma retomada histórica sobre o papel da Associação dos Membros Filiados (AMF) em suas cinco décadas de existência e apresentam resultados de pesquisa realizada a propósito do impacto da pandemia da covid-19 nas formações, nas clínicas e nas vidas dos filiados. Descrevem como neste momento de pandemia a Associação aproximou-se de modo mais significativo de seus membros e se tornou ainda mais um espaço de escuta, de trocas e um porta-voz dos filiados diante da diretoria do Instituto Durval Marcondes e da SBPSP. Com base nessas reflexões, conclui-se que a AMF precisa, para conservar seu vigor e caráter, manter-se como um lugar reflexivo e independente, em que seus membros possam ser ouvidos, respeitados e a formação, debatida.

In this article, the authors begin with a historical review of the role of the Affiliated Members Association (AMF) in its five decades of existence and report the results of research conducted on the impact of the covid-19 pandemic on the training, clinics, and lives of affiliates. They describe how, in this moment of pandemic, the Association came closer in a more significant way to its members and became even more a space for listening, exchanges and a spokesperson for the affiliates before the board of the Instituto Durval Marcondes and the SBPSP. From the reflections of the article we conclude that the AMF needs, in order to maintain its vigor and character, to remain a reflective and independent place where its members can be heard, respected and their training debated.

En este artículo, las autoras parten de una reanudación histórica del papel de la Asociación de Miembros Afiliados (AMF) en sus cinco décadas de existencia y presentan los resultados de la investigación realizada sobre el impacto de la pandemia covid-19 en la formación, clínicas y vidas de los afiliados. Describen cómo, en este momento pandémico, la Asociación se volvió más significativa para sus miembros y se convirtió aún más en un espacio de escucha, intercambio y en portavoz de los afiliados junto el directorio del Instituto Durval Marcondes y de SBPSP. De estas reflexiones, se puede concluir que la AMF necesita, para mantener su vigor y carácter, permanecer como un lugar reflexivo e independiente, donde sus miembros puedan ser escuchados, respetados y discutida la formación.

Dans cet article, les auteurs partent d'une reprise historique du rôle de l'Association des membres affiliés (AMF) au cours de ses cinq décennies d'existence et présentent les résultats d'une recherche sur l'impact de la pandémie de covid-19 sur la formation, les cliniques et la vie des affiliés. Elles décrivent comment, en ce moment de pandémie, l'Association est devenue plus significative pour ses membres et est devenue encore plus un espace d'écoute, d'échanges et de porte-parole des affiliés à l'Instituto Durval Marcondes et au SBPSP. Des réflexions de l'article, on peut conclure que l'AMF a besoin, pour conserver sa vigueur et son caractère, de rester comme un lieu de réflexion et d'indépendance, où ses membres peuvent être entendus, respectés et la formation peut être discutée.

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OBJECTIVE: The present study aimed to verify the existence of a rebound inflammatory effect after statin withdrawal in the acute phase of myocardial infarction (MI). METHODS: In a prospective observational cohort, changes in C-reactive protein (CRP) between the first and the fifth day after MI were evaluated in 249 consecutive patients who were using statins prior to and during MI (SS), statins prior to but not during MI (SN), no statin prior to but during MI (NS), and no statin prior to nor during MI (NN). Data are presented as median (interquartile range). RESULTS: At baseline, statin users presented a trend to lower CRP values as compared with those without this treatment before the MI (NN: 1.0(0.4-1.5)mg/dL vs. NS: 1.0(0.3-2.8)mg/dL vs. SS: 0.5(0.3-1.0)mg/dL vs. SN: 0.6(0.4-1.0)mg/dL; p=0.08). By the fifth day, median CRP was significantly higher in the SN (18.1(16.1-23.2)mg/dL) group as compared with other groups (NN: 10.5(9.3-13.2)mg/dL vs. NS: 2.9(1.5-4.5)mg/dL vs. SS: 1.1(0.8-2.4)mg/dL; p<0.0001). At the fifth day, the median CRP in the NN group was lower than in the SN group (p<0.0001), but higher than the NS and SS groups (p<0.0001). There was no significant correlation between CRP change and the change of LDL-cholesterol, HDL-cholesterol or triglycerides. CONCLUSION: The present study has, for the first time, provided evidence for the existence of a rebound inflammatory effect after statin cessation. This rebound reaction may contribute for the adverse outcome of patients who stop statin treatment during MI.

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