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No presente artigo, realizamos uma breve apresentação de Agustina Bessa-Luís, introduzindo as contribuições da autora para a literatura, com o objetivo de refletir sobre a ressignificação da aura mística feminina por meio das protagonistas Quina de A Sibila (1954) e Eugénia Viseu e Silvina do romance Eugénia e Silvina (1989). São apresentadas, em vista disso, algumas posições teóricas sobre o projeto estético agustiniano, estabelecendo relações entre a representação feminina feita por Bessa-Luís e a condição da mulher na sociedade patriarcal. Para tanto, embasamo-nos em Beauvoir (2016), Bloch (1995), Coelho (1999), Fonseca (2017), Machado (1979), Moisés (2001, 2013), entre outros. Ao tratar das representações do feminino nos seus romances, Agustina Bessa-Luís proporciona uma discussão demasiado importante acerca de estereótipos misóginos, favorecendo sua desconstrução. Nesse sentido, o projeto estético e literário de Agustina Bessa-Luís, a nosso ver, transforma o panorama da ficção portuguesa novecentista, e abre espaço para os escritos que vieram depois.

Background. Infection in acute pancreatitis will worsen the disease prognosis. The aim of our study was to analyze the role of procalcitonin as a prognostic biomarker for infections and clinical severity. Method. A prospective single-cohort observational study of patients diagnosed of acute pancreatitis (n = 152) was designed. PCT determination was tested on admission (first 72 hours). Infections (biliary, extrapancreatic and infected pancreatic necrosis), need for antibiotics, need for urgent ERCP and severity scores for acute pancreatitis was assessed. ROC curves were designed and the area under the curve was calculated. Logistic regression for multivariate analysis was performed to evaluate the association between procalcitonin optimal cut-off level and major complications. Results. PCT > 0.68mg/dL had higher incidence of global infection, acute cholangitis, bacteraemia, infected pancreatic necrosis, use of antibiotics in general, and need for urgent ERCP. In the multivariate regressions analysis, PCT > 0.68mg/dL at admission demonstrated to be a strong risk factor for complications in acute pancreatitis. Discussion. PCT levels can be used as a reliable laboratory test to predict infections and the clinical severity of acute pancreatitis. High levels of PCT predict antibiotics prescription as well as the need for urgent ERCP in patients with concomitant clinically severe cholangitis.

Acute pancreatitis; Comorbidity; Hospital mortality Pancreatitis aguda; Comorbilidad; Mortalidad hospitalaria Pancreatitis aguda; Comorbilitat; Mortalitat hospitalària Background The impact of pre-existing comorbidities on acute pancreatitis (AP) mortality is not clearly defined. Our study aims to determine the trend in AP hospital mortality and the role of comorbidities as a predictor of hospital mortality. Methods We analyzed patients aged ≥ 18 years hospitalized with AP diagnosis between 2016 and 2019. The data have been extracted from the Spanish National Hospital Discharge Database of the Spanish Ministry of Health. We performed a univariate and multivariable analysis of the association of age, sex, and comorbidities with hospital mortality in patients with AP. The role of the Charlson and Elixhauser comorbidity indices as predictors of mortality was evaluated. Results A total of 110,021 patients diagnosed with AP were hospitalized during the analyzed period. Hospital mortality was 3.8%, with a progressive decrease observed in the years evaluated. In multivariable analysis, age ≥ 65 years (OR: 4.11, p 1.5 (OR: 2.03, p 1.5 (OR: 2.71, p

Purpose The purpose of this paper is to present a practical instrument for self-evaluation of maturity in the processes of procurement and supply management, applicable to small and medium-size companies, as well as to show how the use of this evaluation tool may help companies to decide what to improve in these processes. Design/methodology/approach Based on an empirical and theoretical framework, the instrument developed measures the maturity of procurement and supply management activities in four macro-processes: materials management, purchase process, supplier evaluation process and process of procurement planning. For testing the self-evaluation instrument, the authors evaluated the maturity of 48 hospitals and 37 metal-mechanic manufacturing companies located in the southern region of Brazil. To show how to use this tool to decide what to improve in procurement and supply processes, the authors conducted a comparative analysis of a hospital and a metal-mechanic company, in relation to the sample of the same segment. Findings The results show that the instrument is reliable for practical application. Metal-mechanic industries have a greater maturity in the purchase process than in the other three macro-processes. The management of materials is the most mature macro-process in hospitals. Comparing hospitals to metal-mechanic companies, the present research shows that, between 20 and 99 employees, hospitals tend to have a higher level of maturity in the purchase process than metal-mechanic companies. With 100 employees or more, metal-mechanic companies are more mature than hospitals in procurement planning and in selection/evaluation of suppliers. Originality/value Presenting a useful self-evaluation instrument, this work demonstrates that the measurement of the maturity level, and benchmarking it with other companies, may help a firm to decide what to improve in its processes of procurement and materials management, showing how an economic sector can understand itself better. Few scientific studies have practical application to the assessment of the degree of maturity of procurement and supply management processes. Besides that the authors did not find other papers presenting a comparison of different segments.