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Neste artigo propomo-nos a construir uma reflexão teórico-prática sobre os modos de vulnerabilidade produzidos ou desencadeados nas dimensões territorial, econômica, histórica, social, cultural e psicopolítica da experiência humana, cujos efeitos se entrelaçam nas histórias dos sujeitos no interior da escola. Para tal discussão, apresentaremos alguns autores que abordam o conceito de vulnerabilidade. Em seguida, proporemos um conceito de vulnerabilidade que a diferencia do fenômeno do desamparo, mas que com ele se relaciona. A partir disso, apresentaremos algumas vinhetas oriundas de uma pesquisa científica1 que nos permitiu indagar como tais fenômenos se apresentam dinamicamente no contexto escolar. Concluímos que a vulnerabilidade se apresenta na escola como atualizações do desamparo, matizadas pelas condições ambientais e pelo desejo do sujeito, o qual busca modos de enfrentamento do paradoxo entre alienação e desalienação.

Resumos In this article we propose to make a theoretical-practical reflection on the modes of vulnerability that can be produced or triggered in the territorial, economical, historical, social, cultural, and psychopolitical dimensions of human experience, whose effects are intertwined with the stories of the subjects inside the school. For such a discussion, we will present some authors who approach the concept of vulnerability. Then, we will propose a concept of vulnerability that differentiates it from the helplessness phenomenon, but is related to it. From this, we will present some vignettes from a scientific investigation that allow us to investigate how such phenomena dynamically present themselves in the school environment. We have concluded that the vulnerability presents itself at school as new forms of helplessness, nuanced by environmental conditions by the subject's desire, whom seeks to find ways to face the paradox between alienation and disalienation.

Dans cet article, nous nous proposons de construire une réflexion théorico-pratique sur les modes de vulnérabilité produits ou déclenchés dans les dimensions territoriale, économique, historique, sociale, culturelle et psychopolitique de l'expérience humaine, dont les effets sont imbriqués dans les histoires des sujets à l'école. Pour cette discussion, nous présenterons quelques auteurs qui ont abordé le concept de vulnérabilité. Nous proposerons ensuite un concept de vulnérabilité qui se différencie du phénomène d'impuissance, mais qui lui est apparenté. Sur cette base, nous présenterons quelques vignettes issues de la recherche scientifique qui nous ont permis d'étudier la façon dont ces phénomènes se présentent de manière dynamique dans le contexte scolaire. Nous concluons que la vulnérabilité se présente à l'école comme des actualisations de l'impuissance, nuancées par les conditions environnementales et le désir du sujet, qui cherche des moyens de faire face au paradoxe entre l'aliénation et la désaliénation.

En este artículo nos proponemos construir una reflexion teórico-práctica sobre los modos de vulnerabilidad que pueden ser producidos o desencadenados en las dimensiones territorial, económica, histórica, social, cultural y psicopolítica de la experiencia humana, cuyos efectos se entrelazan en las historias de los sujetos dentro de la escuela. Para esta discusión, presentaremos algunos autores que abordan el concepto de vulnerabilidad. Luego, propondremos un concepto de vulnerabilidad que la diferencia del fenómeno de la indefensión, pero que se relaciona con él. A partir de ello, presentaremos algunas vinetas oriundas de una investigación científica que nos permitan indagar cómo tales fenómenos se presentan dinamicamente en el contexto escolar. Concluímos que la vulnerabilidad se presenta en la escuela como actualizaciones de la indefensión, matizadas por las condiciones ambientales y por el deseo del sujeto, el cual busca modos de enfrentamiento a la paradoja entre alienación y desalienación.

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Este trabalho tem como objetivo discutir como os professores e os alunos podem construir estratégias de intervenção diante dos impasses contemporâneos presentes em uma experiência de uma Escola Municipal de Campinas-SP, Brasil. A metodologia utilizada se baseia na psicanálise freudiana, e o enfoque conceitual abrange a relação de transferência, a escuta, os afetos e a realidade psíquica, como instrumentos estratégicos para acolher a ação de professores e alunos na construção de intervenções ético-políticas. Os resultados são apresentados nas situações escolares como um desafio cotidiano para os envolvidos no processo de ensino-aprendizagem.(AU)

This paper aims to discuss how teachers and students can build intervention strategies in face of contemporary impasses based in an experience of a Municipal School in Campinas-SP, Brazil. The methodology used is based on Freudian psychoanalysis, and the conceptual approach covers the transference relationship, the listening, the affections and psychic reality, as strategic instruments to welcome the action of teachers and students in the building of ethical-political interventions. The results are presented in educational situations as a daily challenge for those involved in the teaching-learning process.(AU)

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INTRODUCTION: Triage by on-demand telemedicine is a strategy for healthcare surge control in the COVID-19 pandemic. We aimed to assess the impact of a large-scale COVID-19 telemedicine system on emergency department (ED) visits and all-cause and cardiovascular hospital admissions in Brazil. METHODS: From March 18, 2020-May 18, 2020 we evaluated the database of a cooperative private health insurance, with 1.28 million clients. The COVID-19 telemedicine system consisted of: a) mobile app, which redirects to teleconsultations if indicated; b) telemonitoring system, with regular phone calls to suspected/confirmed COVID-19 cases to monitor progression; c) emergency ambulance system (EAS), with internet phone triage and counselling. ED visits and hospital admissions were recorded, with diagnoses assessed by the Diagnosis Related Groups method. COVID-19 diagnosis and deaths were identified from the patients' registries, and outcomes assessed until June 1st. RESULTS: In 60 days, 24,354 patients accessed one of the telemedicine systems. The most frequently utilized was telemonitoring (16,717, 69%), followed by teleconsultation (13,357, 55%) and EAS (687, 3%). The rates of ED and hospital admissions were: telemonitoring 19.7% (3,296) and 4.7% (782); teleconsultation 17.3% (2,313) and 2.4% (318) and EAS: 55.9% (384) and 56.5% (388) patients. At total 4.1% (1,010) had hospital admissions, 36% (363) with respiratory diseases (44 requiring mechanical ventilation) and 4.4% (44) with cardiovascular diagnoses. Overall, 277 (1.1%) patients had confirmed COVID-19 diagnosis, and 160 (0.7%) died, 9 with COVID-19. CONCLUSION: Telemedicine resulted in low rates of ED visits and hospital admissions, suggesting positive impacts on healthcare utilization. Cardiovascular admissions were remarkably rare.

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RESUMO: O presente artigo conceitua uma estratégia psicanalítica para o diagnóstico de acontecimentos sociais, que vão desde um evento-limite até uma cena traumática ou catastrófica. Tal estratégia comporta os tempos de ver, de compreender e de concluir, e abarca as dimensões singulares e coletivas que atravessam os sujeitos. O texto apresenta o excerto de um encontro com professores de uma escola pública, que se reuniram para abordar os aspectos traumáticos da experiência escolar durante a pandemia. Tal excerto serve de modelo para a análise das possibilidades de reconstrução que oferece o Diagnóstico Ético-Político.

Abstract: This article conceptualizes a psychoanalytical strategy for diagnosing social events, ranging from a limit event to a traumatic or catastrophic scene. Such a strategy includes the times of seeing, understanding, and concluding, in addition to covering the singular and collective dimensions that impinge on subjects. The text presents excerpts from an encounter with teachers in a public school, who met to discuss the traumatic aspects of school experience during the pandemic. These excerpts serve as a model for the analysis of reconstruction possibilities that offers the Ethical-Political Diagnosis.

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Research background: Cocoa honey and cocoa pulp are both highly appreciated fruit pulp, but until now, cocoa honey has been less processed than cocoa pulp. In this work, we investigate the applicability of Saccharomyces cerevisiae strains to ferment cocoa honey complemented with cocoa pulp to obtain fruit wines and improve cocoa honey commercialization. Experimental approach: The strain, previously isolated from cachaçaria distilleries in Brazil, was selected based on its fermentation performance. The following conditions for fermentation with S. cerevisiae L63 were then studied: volume fraction of cocoa honey (φ CH) complemented with cocoa pulp, sucrose addition (γ suc), temperature (t) and inoculum size (N o). The best conditions were applied in order to obtain fermentation profiles. Results and conclusions: S. cerevisiae L63 (N o=107-108 cell/mL) is capable of fermenting φ CH=90 and 80% for 24 or 48 h with γ suc=50 and 100 g/L at t=28-30 °C resulting in wines with ethanol volume fractions from 8 to 14%. Additionally, the wine produced from φ CH=90% had lower residual sugar concentration (<35 g/L) than the wine produced from φ CH=80% (~79 g/L) which could be classified as a sweet wine. In general, S. cerevisiae L63 resulted in a similar fermentation performance as a commercial strain tested, indicating its potential for fruit pulp fermentation. Novelty and scientific contribution: Saccharomyces cerevisiae L63 can ferment cocoa honey complemented with cocoa pulp to produce fruit wines with good commercial potential, which may also benefit small cocoa producers by presenting a product with greater added value.

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INTRODUCTION: We aimed to evaluate the impact of the new coronavirus disease 2019 on coronary hospitalizations in the Brazilian private health system. METHODS: Data on coronary admissions in 2020 and a 2-year historical series were collected from the UNIMED-BH insurance system. RESULTS: Admission rates in 2020 reduced by 26% (95%CI, 22-30) in comparison with 2018/2019, markedly from March to May (37%) compared to the peak of the pandemic (June-September, 19%). Mortality was higher in 2020 (5.4%, 95%CI 4.5-6.4) than in 2018/2019 (3.6%, 95%CI 3.2-4.1). CONCLUSIONS: There was a significant decrease in coronary admissions, with higher mortality during the COVID-19 pandemic.

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Abstract INTRODUCTION: We aimed to evaluate the impact of the new coronavirus disease 2019 on coronary hospitalizations in the Brazilian private health system. METHODS: Data on coronary admissions in 2020 and a 2-year historical series were collected from the UNIMED-BH insurance system. RESULTS: Admission rates in 2020 reduced by 26% (95%CI, 22-30) in comparison with 2018/2019, markedly from March to May (37%) compared to the peak of the pandemic (June-September, 19%). Mortality was higher in 2020 (5.4%, 95%CI 4.5-6.4) than in 2018/2019 (3.6%, 95%CI 3.2-4.1). CONCLUSIONS: There was a significant decrease in coronary admissions, with higher mortality during the COVID-19 pandemic.

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O presente trabalho traz uma formulação do conceito de confluência de línguas a partir da Confusão de Línguas de Sándor Ferenczi, na qual a linguagem da ternura de caráter autoplástico, e a linguagem da paixão, que trabalha através de forma aloplástica, ou seja, da modificação do que é externo para o sujeito, se confundem. Na confusão de línguas, pela metapsicologia ferencziana, o sujeito pode construir em busca de uma reorganização psíquica, pela perlaboração, a confluência de línguas. Diante do exposto, a investigação propõe a oportunização à capacidade aloplástica do testemunho em consonância com a evocação de um estado autoplástico no sujeito, dando origem não mais a uma “confusão de línguas”, mas a uma “confluência de línguas”.(AU)

The present work brings a formulation of the concept of confluence of languages based on the Confusion of languages of Sándor Ferenczi, in which the language of tenderness of an auto plastic character, and the language of passion, which works through alloplastic form, that is, the modification of what is external to the subject, get confused. In the confusion of languages, by Ferenczian metapsychology, the subject can build in search of a psychic reorganization, through perlaboration, the confluence of languages. In view of the above, the investigation proposes the opportunity for the alloplastic capacity of the testimony in line with the evocation of an autoplastic state in the subject, giving rise no longer to a “confusion of languages”, but to a “confluence of languages”.(AU)

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INTRODUÇÃO: Durante décadas, os laboratórios foram considerados pouco impactantes ao meio ambiente. Tiveram essa comodidade abalada devido à mobilização da sociedade civil que vem exigindo mudanças. A Agência Nacional de Vigilância Sanitária (ANVISA) implementou a Resolução da Diretoria Colegiada (RDC) nº 306, de 7 de dezembro de 2004, criando o Plano de Gerenciamento de Resíduos de Serviços de Saúde (PGRSS), devido ao fato de o gerenciamento de resíduos sólidos não urbanos ser de responsabilidade do gerador desde sua geração até sua disposição final. OBJETIVOS: A expectativa desta pesquisa foi avaliar as concentrações de fenol no momento de descarte na pia, investigar processos que minimizem os riscos ao ambiente e à saúde pública e validar a técnica para extração do fenol a partir dos resíduos gerados pelo setor da bioquímica; substância sólida, tóxica, corrosiva, constituinte dos reativos utilizados nas análises de colesterol. A legislação brasileira permite que um efluente de descarte seja de 0,5 µg ml-Õ. MATERIAL E MÉTODOS: Para tanto, utilizou-se a técnica de cromatografia gasosa. RESULTADOS E CONCLUSÃO: Essa técnica foi capaz de qualificar e quantificar o fenol tanto nas amostras do laboratório semiautomatizado quanto automatizado, havendo decréscimo e, em seguida, constância nas concentrações de fenol como resultado.

INTRODUCTION: During decades, laboratories were deemed to produce low environmental impact. This has changed dramatically due to current social environmental demands. ANVISA implemented RDC nº 306 from December 7, 2004, creating the Health Care Waste Management Plan (PGRSS), which states that producers of non-urban solid waste are accountable for its generation and ultimate disposal. OBJECTIVES: To evaluate phenol concentrations at wastewater discharge. To investigate processes that minimize environmental and public health risks. To validate procedure for phenol extraction from waste generated by the biochemist area, once it is a toxic solid, corrosive chemical substance, commonly found in reagents used in cholesterol analyses. According to our Brazilian Legislation, the discharge effluent emission standard is 0.5 µg ml-1. MATERIAL AND METHODS: It was used gas chromatography. RESULTS AND CONCLUSION: It was possible to qualify and quantify phenol concentrations in both semi-automated and automated laboratory samples and the results revealed a decrease and subsequent stability in phenol concentrations.

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Este trabalho é o relato de uma experiência de estágio em Grupos e Instituições, realizado numa Construtora Civil em São José dos Campos. O objetivo deste trabalho foi construir identidades através do projeto de alfabetização de adultos. A metodologia utilizada foi análise institucional do discurso e o procedimento utilizado: oficina de escrita apoiado no método de Paulo Freire. Os resultados obtidos foram: o reconhecimento das pessoas que participaram como sujeitos no processo de alfabetização, a escrita como mediadora da inscrição subjetiva na construção da identidade e do laço social. Os participantes durante esta experiência se alfabetizaram a partir das palavras que faziam sentido à eles. Pode-se observar que aprender a ler e escrever tornou-se um marco identificatório em suas vidas. Na oficina de escrita produziram cartas aos familiares, aos amigos e relataram sobre suas histórias de vida. Revelaram que antes de aprender a ler e escrever, tinham inveja das pessoas que possuíam muito dinheiro, agora o sentimento de inveja era daqueles que sabiam ler e escrever mais do que eles. Este desejo de saber constitui-se como mola propulsora desta aprendizagem e modifica o modo de viver desta clientela.

This work is the report of an apprenticeship experience in Groups and Institutions, accomplished in a Civil Construction Company in São José dos Campos. The objective of this work was build identities through the project of adults' literacy. The used methodology was institutional analysis of the speech and the used procedure: writing shop supported in Paulo Freire's method. The obtained results were: the people's recognition that participated as subjects in the literacy process, the writing as mediator of the subjective registration in the construction of the identity and of the social liaison. The participants during this experience were alphabetized starting from the words that made sense to them. It can be observed that learning to read and to write became a onenness mark in its lives. In the writing shop they produced letters to their relatives and friends and told on its life histories. They revealed that before learning to read and to write, they were envy of rich people, now this feeling is of those that knew how to read and to write more than they. This desire to know is a propelling spring of this learning and it modifies the way of living of this clientele.

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OBJETIVO: Comparar a resistência cicatricial de anastomoses jejunais em ratos, submetidos à administração de vitamina C e de hidrocortisona, em distintos períodos pós-operatórios. MÉTODOS: Foram estudados 40 ratos Wistar, submetidos à secção e subsequente anastomose término-terminal de segmento jejunal, a 10 cm da flexura duodenojejunal. Os animais foram distribuídos em quatro grupos (n=10): Grupo I - controle; Grupo II - administração de vitamina C oral 100 mg/kg; Grupo III - administração de hidrocortisona intraperitoneal 10 mg/kg; Grupo IV - administração de vitamina C mais hidrocortisona nas doses e vias de administração acima. Avaliaram-se as pressões de ruptura anastomótica no 5º e 21º dias do pós-operatório. RESULTADOS: Os ratos que receberam vitamina C isolada ou associada a hidrocortisona tenderam a ter pressão de ruptura maior do que os demais grupos, tanto no 5º quanto no 21º dia pós-operatório. CONCLUSÃO: A vitamina C contribui para aumentar a resistência das anastomoses jejunais dos ratos durante os primeiros cinco dias do pós-operatório. A resistência das anastomoses jejunais murinas foi pouco influenciada pela administração de corticóide intraperitoneal.

OBJECTIVE: The effects of vitamin C and hidrocortisone on anastomotic healing process are controversial. The objective of the present paper was to compare the jejunal anastomotic tension in different postoperative periods. METHODS: 40 male rats weighing 200 to 400 grams were submitted to laparotomy. The jejunum was transversally cut 10 cm from the duodenojejunal flexure, and subsequently anastomosed. The rats were divided into four groups (n=10). Group I - control, Group II - oral administration of vitamin C (100 mg/kg), Group III - intraperitoneal administration of hidrocortisone (10 mg/kg), and Group IV - administration of vitamin C and hidrocortisone at the above mentioned doses. The anastomotic resistance was determined by using bursting pressure test on the 5th and 21st postoperative days. RESULTS: The resistances of the groups with vitamin C, isolated or associated to hidrocortisone trend to be higher in both postoperative periods. However, the administration of intraperitoneal steroid did not change the resistance of murine jejunal anastomosis. CONCLUSION: The results of the present study suggest that vitamin C enhances the resistance of jejunal anastomosis in the rat.

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OBJECTIVE: The effects of vitamin C and hidrocortisone on anastomotic healing process are controversial. The objective of the present paper was to compare the jejunal anastomotic tension in different postoperative periods. METHODS: 40 male rats weighing 200 to 400 grams were submitted to laparotomy. The jejunum was transversally cut 10 cm from the duodenojejunal flexure, and subsequently anastomosed. The rats were divided into four groups (n=10). Group I - control, Group II - oral administration of vitamin C (100 mg/kg), Group III - intraperitoneal administration of hidrocortisone (10 mg/kg), and Group IV - administration of vitamin C and hidrocortisone at the above mentioned doses. The anastomotic resistance was determined by using bursting pressure test on the 5th and 21st postoperative days. RESULTS: The resistances of the groups with vitamin C, isolated or associated to hidrocortisone trend to be higher in both postoperative periods. However, the administration of intraperitoneal steroid did not change the resistance of murine jejunal anastomosis. CONCLUSION: The results of the present study suggest that vitamin C enhances the resistance of jejunal anastomosis in the rat.

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BACKGROUND: The effects of vitamin C on anastomotic healing process are controversial. OBJECTIVE: To compare the jejunal anastomotic tension and in the upright segment in different postoperative periods. METHOD: Fifty male rats weighing 250 to 400 grams were submitted to laparotomy. The jejunum was transversally cut 10 cm from the duodenojejunal flexure, and subsequently anastomosed. The rats were divided into two groups (n = 25). Group I--control, Group II--oral administration of vitamin C (100 mg/kg). The anastomotic and the upright segment resistance was determined by using bursting pressure test on the 3rd, 5th, 7th, 21st and 28th postoperative days. RESULTS: The rats submitted to oral administration of ascorbic acid show higher bursting pressure on the 5th, 7th and 28th postoperative days. The bursting resistances of the upright segment was higher on the rats submitted to vitamin C ingestion. CONCLUSIONS: Vitamin C enhances the anastomotic and jejunal resistances. Moreover, the final resistance on the upright jejunal segment was significant higher than in the control group.

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O efeito da vitamina C e da hidrocortisona sobre os processos cicatriciais anastomóticos apresenta resultados conflitantes na literatura. Dessa forma, o presente trabalho teve o objetivo de comparar a resistência cicatricial de anastomoses jejunais em ratos, submetidos à administração de vitamina C e de hidrocortisona, em distintos períodos pós-operatórios. Foram estudados 40 ratos Wistar, submetidos a secção e subseqüente anastomose término-terminal de segmento jejunal, a 10 cm da flexura duodenojejunal. Os animais foram divididos em quatro grupos (n=10): Grupo I - controle; Grupo II - administração de vitamina C oral 100 mg/kg; Grupo III - administração de hidrocortisona intraperitoneal 10 mg/kg; Grupo IV - administração de vitamina C mais hidrocortisona nas doses e vias de administração acima. Avaliaram-se as pressões de ruptura anastomótica nos 5 º e 21º dias pós-operatórios. Os ratos que receberam vitamina C isolada ou associada a hidrocortisona tenderam a uma pressão de ruptura maior do que os demais grupos, tanto no 5º quanto no 21º dias pós-operatórios. Os resultados deste trabalho sugerem que a vitamina C contribui para aumentar a resistência das anastomoses jejunais dos ratos durante os primeiros 5 dias pós-operatórios. A resistência das anastomoses jejunais murinas foi pouco influenciada pela administração de corticóide intraperitoneal.

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The effects of vitamin C and hidrocortisone on anastomotic healing process are controversial. In order to compare the jejunal anastomotic tension in different postoperative periods, 40 male rats weighing 200 to 400 grams were submitted to laparotomy. The jejunum was transversally cut 10 cm from the duodenojejunal flexure, and subsequently anastomosed. The rats were divided into four groups (n=10). Group I - control, Group II - oral administration of vitamin C (100 mg/kg), Group III - intraperitoneal administration of hidrocortisone (10 mg/kg), and Group IV - administration of vitamin C and hidrocortisone at the above mentioned doses. The anastomotic resistance was determined by using bursting pressure test on the 5th and 21st postoperative days. The resistances of the groups with vitamin C, isolated or associated to hidrocortisone trend to be higher in both postoperative periods. However, the administration of intraperitoneal steroid did not change the resistance of murine jejunal anastomosis. The results of the present study suggest thart vitamin C enhances the resistance of jejunal anastomosis in the rat.

O efeito da vitamina C e da hidrocortisona sobre os processos cicatriciais anastomóticos apresenta resultados conflitantes na literatura. Dessa forma, o presente trabalho teve o objetivo de comparar a resistência cicatricial de anastomoses jejunais em ratos, submetidos à administração de vitamina C e de hidrocortisona, em distintos períodos pós-operatórios. Foram estudados 40 ratos Wistar, submetidos a secção e subseqüente anastomose término-terminal de segmento jejunal, a 10 cm da flexura duodenojejunal. Os animais foram divididos em quatro grupos (n=10): Grupo I - controle; Grupo II - administração de vitamina C oral 100 mg/kg; Grupo III - administração de hidrocortisona intraperitoneal 10 mg/kg; Grupo IV - administração de vitamina C mais hidrocortisona nas doses e vias de administração acima. Avaliaram-se as pressões de ruptura anastomótica nos 5 º e 21º dias pós-operatórios. Os ratos que receberam vitamina C isolada ou associada a hidrocortisona tenderam a uma pressão de ruptura maior do que os demais grupos, tanto no 5º quanto no 21º dias pós-operatórios. Os resultados deste trabalho sugerem que a vitamina C contribui para aumentar a resistência das anastomoses jejunais dos ratos durante os primeiros 5 dias pós-operatórios. A resistência das anastomoses jejunais murinas foi pouco influenciada pela administração de corticóide intraperitoneal.

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