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Background The advantage of using the macroscopic on-site evaluation (MOSE) technique during endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) performed with 22G Franseen needles has not been investigated. We aimed to compare EUS-FNB with MOSE vs. EUS-FNB performed with three needle passes. Methods This randomized trial involved 10 Italian referral centers. Consecutive patients referred for EUS-FNB of pancreatic or nonpancreatic solid lesions were included in the study and randomized to the two groups. MOSE was performed by gross visualization of the collected material by the endoscopists and considered adequate when a white/yellowish aggregate core longer than 10 mm was retrieved. The primary outcome was diagnostic accuracy. Secondary outcomes were specimen adequacy, number of needle passes, and safety. Results 370 patients with 234 pancreatic lesions (63.2 %) and 136 nonpancreatic lesions (36.8 %) were randomized (190 EUS-FNB with MOSE and 180 with standard EUS-FNB). No statistically significant differences were found between EUS-FNB with MOSE and conventional EUS-FNB in terms of diagnostic accuracy (90.0 % [95 %CI 84.8 %–93.9 %] vs. 87.8 % [95 %CI 82.1 %–92.2 %]; P = 0.49), sample adequacy (93.1 % [95 %CI 88.6 %–96.3 %] vs. 95.5 % [95 %CI 91.4 %–98 %]; P = 0.31), and rate of adverse events (2.6 % vs. 1.1 %; P = 0.28). The median number of passes was significantly lower in the EUS-FNB with MOSE group (1 vs. 3; P Conclusions The accuracy of EUS-FNB with MOSE is noninferior to that of EUS-FNB with three needle passes. MOSE reliably assesses sample adequacy and reduces the number of needle passes required to obtain the diagnosis with a 22G Franseen needle.

Background and study aims Endoscopic ultrasound-guided through-the-needle biopsy (TTNB) of pancreatic cystic lesions (PCLs) is associated with a non-negligible risk for adverse events (AEs). We aimed to identify the hierarchic interaction among independent predictors for TTNB-related AEs and to generate a prognostic model using recursive partitioning analysis (RPA). Patients and methods Multicenter retrospective analysis of 506 patients with PCLs who underwent TTNB. RPA of predictors for AEs was performed and the model was validated by means of bootstrap resampling. Results Mean cysts size was 36.7 mm. Most common diagnoses were intraductal papillary mucinous neoplasm (IPMN, 45 %), serous cystadenoma (18.8 %), and mucinous cystadenoma (12.8 %). Fifty-eight (11.5 %) AEs were observed. At multivariate analysis, age (odds ratio [OR] 1.32, 1.09–2.14; p = 0.05), number of TTNB passes (OR from 2.17, 1.32–4.34 to OR 3.16, 2.03–6.34 with the increase of the number of passes), complete aspiration of the cyst (OR 0.56, 0.31–0.95; p = 0.02), and diagnosis of IPMN (OR 4.16, 2.27–7.69; p Conclusion TTNB should be selectively used in the evaluation of patients with IPMN. The present model could be applied during patient selection as to optimize the benefit/risk of TTNB.

To develop and validate a risk score for predicting clinical success after duodenal stenting using self-expanding metallic stents (SEMS) for malignant gastric outlet obstruction (GOO).Consecutive patients who underwent duodenal stenting for malignant GOO were evaluated. Potential predictors of clinical success were determined by uni/multivariate logistic regression analysis.Multiplication of the regression coefficients of the logistic regression model by a factor of two and rounding to obtain easy-to-use point numbers enabling the calculation of the score. Using 10-fold cross-validation, the model was internally validated.One hundred twelve patients were included. Clinical success was achieved in 93 (83.0%) patients. On multivariate logistic regression, selected age ≤65 years (p = 0.05, 1.5 points), stenosis type I (p = 0.04, 3 points), and pancreatic cancer (p = 0.01, 3.5 points) were significant predictors of clinical success. On the Receiver Operating Characteristic (ROC) analysis, a score of 5 had higher specificity and sensitivity.Our score could be useful at identifying, among poor surgical candidates, patients more likely to benefit from SEMS.

Many tumors may secondarily involve the pancreas; however, only retrospective autopic and surgical series are available. We retrospectively collected data from all consecutive patients with histologically confirmed secondary tumors of the pancreas referred to five Italian centers between 2010 and 2021. We described clinical and pathological features, therapeutic approach and treatment outcomes. EUS characteristics of the lesions and the tissue acquisition procedures (needle, passages, histology) were recorded. A total of 116 patients (males/females 69/47; mean age 66.7) with 236 histologically confirmed pancreatic metastases were included; kidney was the most common primary site. EUS was performed to confirm the diagnosis in 205 lesions which presented as predominantly solitary (59), hypoechoic (95) and hypervascular (60), with a heterogeneous (n = 54) pattern and well-defined borders (n = 52). EUS-guided tissue acquisition was performed in 94 patients with an overall accuracy of 97.9%. Histological evaluation was possible in 88.3% of patients, obtaining final diagnosis in all cases. When cytology alone was performed, the final diagnosis was obtained in 83.3% of cases. A total of 67 patients underwent chemo/radiation therapy, and surgery was attempted in 45 (38.8%) patients. Pancreatic metastases are a possible event in the natural history of solid tumors, even long after the diagnosis of the primary site. EUS-guided fine needle biopsy may be suggested to implement the differential diagnosis.

There is a paucity of evidence regarding whether biliary stents influence endoscopic ultrasound-guided tissue acquisition using either fine-needle biopsy (EUS-FNB) or fine-needle aspiration (EUS-FNA), among patients with head of pancreas (HOP) lesions. We aimed at assessing the diagnostic accuracy of endoscopic ultrasound-guided tissue sampling in patients with or without bile duct stents. A total of seven studies with 2458 patients were included. The main aim was to assess overall pooled diagnostic accuracy. A pairwise meta-analysis was performed using a random effects model. Outcomes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). We found that pooled accuracy was 85.4% (CI 78.8–91.9) and 88.1% (CI 83.3–92.9) in patients with and without stents, respectively. There was no statistically significant difference between the two (OR 0.74; p = 0.07). Furthermore, patients with metal stents demonstrated a significant difference (OR 0.54, 0.17–0.97; p = 0.05), which was not seen with plastic stents. EUS-FNB showed poorer diagnostic accuracy with concurrent biliary stenting (OR 0.64, 0.43–0.95; p = 0.03); however, the same was not observed with EUS-FNA. Compared to plastic stents, metal biliary stenting further impacted the diagnostic accuracy of EUS-guided tissue acquisition for pancreatic head lesions. There was no difference in the rate of procedure-related adverse events between the stent and no-stent groups.

Background and Aims Electrocautery-tip lumen-apposing metal stents (EC-LAMSs) have extended the indications of therapeutic EUS. We aimed to retrospectively evaluate safety and technical and clinical success of a newly developed EC-LAMS, the Hot-Spaxus (Taewoong Medical Co, Gimpo, Korea), for various EUS-guided procedures. Methods We included and retrospectively analyzed consecutive patients at 8 tertiary care referral centers who had undergone EUS interventional procedures using the Hot-Spaxus between October 2018 and February 2021. Results Of 58 included patients (male-to-female, 36:22; mean age, 63.5 ± 14.9 years), 29 had undergone pancreatic fluid collection drainage (50%), 22 (37.9%) biliary drainage for malignant distal obstruction, 3 (5.1%) gallbladder drainage for acute cholecystitis, 3 gastroenteroanastomoses, and 1 (1.7%) pelvic collection drainage. Technical success was achieved in 54 of 58 patients (93.1%) and clinical success in all 58. Adverse events occurred in 6 patients (11.1%): 2 early (3.7%), 1 late (1.8%), and 3 long term (5.6%). The outcomes were similar to those observed in a control group of patients treated with the Hot-Axios (Boston Scientific, Marlborough, Mass, USA), the other available EC-LAMS. Conclusions Our study showed that the novel EC-LAMS has high technical and clinical success rates for various interventional EUS indications. Future multicenter prospective studies will better clarify the role of this new EC-LAMS for different indications.

Background It is unknown whether there is an advantage to using the wet-suction or slow-pull technique during endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) with new-generation needles. We aimed to compare the performance of each technique in EUS-FNB. Methods This was a multicenter, randomized, single-blind, crossover trial including patients with solid lesions of ≥ 1 cm. Four needle passes with 22 G fork-tip or Franseen-type needles were performed, alternating the wet-suction and slow-pull techniques in a randomized order. The primary outcome was the histological yield (samples containing an intact piece of tissue of at least 550 μm). Secondary end points were sample quality (tissue integrity and blood contamination), diagnostic accuracy, and adequate tumor fraction. Results Overall, 210 patients with 146 pancreatic and 64 nonpancreatic lesions were analyzed. A tissue core was retrieved in 150 (71.4 %) and 129 (61.4 %) cases using the wet-suction and the slow-pull techniques, respectively (P = 0.03). The mean tissue integrity score was higher using wet suction (P = 0.02), as was the blood contamination of samples (P Conclusion Overall, the wet-suction technique in EUS-FNB resulted in a higher tissue core procurement rate compared with the slow-pull method. Diagnostic accuracy and the rate of samples with adequate tumor fraction were similar between the two techniques.

Introdução: Os diversos eventos que circundam a internação de neonatos sob cuidados intensivos são estressores que, por si só, configuram em notícias difíceis para os familiares. Nesses momentos delicados, a carência de conhecimento de instrumentos para apoio aos profissionais ou de recomendações específicas para a comunicação de notícias difíceis no contexto retratado, pode gerar um quadro de ansiedade nos profissionais de saúde, além de ser prejudicial à criação de vínculo entre equipe e familiares. Objetivo: Compreender como ocorre o processo de comunicação de notícias difíceis na perspectiva dos receptores, os pais de neonatos internados em Unidade de Terapia Intensiva Neonatal (UTIN). Método: Estudo descritivo, com abordagem qualitativa, realizado através de entrevistas semiestruturadas a pais de recém-nascidos internados em UTIN, com posterior análise temática dos dados obtidos. Foi realizada também, anteriormente às entrevistas, a aplicação da escala PSS:NICU, objetivando aproximar os participantes do objeto de pesquisa, além de observar a relação entre o estresse proveniente de fatores intrínsecos à UTIN e a concepção de notícias difíceis. Resultados: Das 21 entrevistas, emergiram sete temas, sendo: a. O que são notícias difíceis; b. Quando ocorre a comunicação de notícias difíceis; c. Como os familiares percebem a comunicação de notícias difíceis; d. O que são boas notícias para os pais e o que gostariam de ouvir; e. Qual a maneira ideal de comunicar uma notícia difícil; f. Sentimentos despertados pela comunicação de notícias difíceis; g. O papel da equipe multiprofissional na comunicação de notícias difíceis. Foi evidenciado que a sensibilidade quanto a COMO, QUANTO e QUANDO comunicar, são aspectos que humanizam e qualificam a comunicação. A definição, pelos familiares, do que são notícias difíceis e a compreensão pelo profissional do fluxo de informações tolerável para cada caso, são fatores que tornam o momento menos traumático. Também foi evidenciado que, a maioria dos aspectos negativos percebidos, advêm do escasso preparo/ treinamento dos profissionais acerca do tema. Quanto ao instrumento, as análises estatísticas evidenciaram que diversos elementos presentes na UTIN podem representar uma provável gravidade/piora do quadro de saúde do recém-nascido e, assim, podem ser considerados potenciais notícias difíceis devido ao impacto causado nos acompanhantes. Considerações Finais: Pelo relato dos pais, foi possível observar que ainda há uma carência no preparo da equipe para a comunicação, sendo esse despreparo notado, principalmente, no tocante ao acolhimento dos sentimentos derivados da interação. Além disso, a grande carga de estresse vivenciada pode ser prejudicada por uma equipe despreparada para realizar a comunicação das notícias difíceis e o acolhimento aos familiares. Independentemente do contexto em que a notícia é dada, é necessário que o profissional responsável pela comunicação seja capaz de utilizar-se de habilidades comunicacionais e interpessoais para que a mensagem seja recebida de maneira menos traumática, além de ser compreendida em sua totalidade. Introduction: The various events surrounding the hospitalization of newborns under intensive care are stressors that, by themselves, constitute difficult news for family members. In these delicate moments, the lack of knowledge of instruments to support professionals or specific recommendations for communicating difficult news in the context portrayed, can generate an anxiety in health professionals, in addition to being harmful to the creation of a bond between the team and relatives. Objective: To understand how the process of communicating difficult news takes place from the perspective of recipients, the parents of newborns admitted to the Neonatal Intensive Care Unit (NICU). Method: Descriptive study, with a qualitative approach, conducted through semi-structured interviews with parents of newborns admitted to the NICU, with subsequent thematic analysis of the data obtained. The application of the PSS:NICU scale was also carried out, aiming to observe the relationship between the stress arising from factors intrinsic to the NICU and the conception of difficult news. Results: From the 21 interviews, seven themes emerged, namely: a. What is difficult news; b. When difficult news communication occurs; c. How family members perceive difficult news communication; d. What is good news for parents and what they would like to hear; d. What is the ideal way to communicate difficult news; f. Feelings aroused by the communication of difficult news; g. The role of the multidisciplinary team in communicating difficult news. It was evidenced that sensitivity regarding HOW, HOW MUCH and WHEN to communicate are aspects that humanize and qualify communication. The definition, by family members, of what is difficult news and the professional\'s understanding of the tolerable flow of information for each case, are factors that make the moment less traumatic. It was also evidenced that most of the negative aspects perceived come from the lack of preparation/training of professionals on the subject. As for the instrument, the statistical analyzes showed that different aspects of the NICU may highlight the severity/worsening of the newborn\'s health condition, and could be considered as potential difficult news due to the impact caused on the caregivers. Final Considerations: From the parents\' report, it was possible to observe that there is still a lack in the team\'s preparation for communication, and this lack of preparation was noticed, mainly, regarding the acceptance of the feelings derived from the interaction. In addition, the great load of stress experienced can be impaired by a team that is unprepared to communicate difficult news and welcome family members. Regardless of the context in which the news is given, the professional responsible for communication must be able to use communication and interpersonal skills so that the message is received in a less traumatic way, in addition to being understood in its entirety.

Este artigo é uma ampliação do texto apresentado no Seminário Internacional de pesquisa em Educação Matemática (SIPEM), em 2021 e apresenta a experiência vivida em uma Atividade Curricular de Ensino Pesquisa e Extensão (ACIEPE). A atividade, coordenada pelas autoras, ocorreu entre 2020 e 2021, de forma remota. Nela pretendeu-se dar protagonismo aos professores que ensinam matemática, com o destaque para o ensino e a aprendizagem da Estatística na Educação Infantil e nos Anos Iniciais do Ensino Fundamental. A pesquisa possui uma abordagem qualitativa; os dados foram construídos por meio das narrativas orais e/ou escritas de 20 participantes. Refletir a respeito da própria narrativa e compartilhá-la com outros professores tem se mostrado potencialmente favorável à formação e ao desenvolvimento profissional dos envolvidos. Seu desenvolvimento possibilitou a ampliação da competência teórica e metodológica dos envolvidos relacionada à Estatística no início na escolarização.

The relationship between chronic intestinal disease, including inflammatory bowel disease (IBD) and celiac disease (CelD), and pancreatic disorders has been little investigated. Although an increased risk of acute pancreatitis (AP), exocrine pancreatic insufficiency with or without chronic pancreatitis, and chronic asymptomatic pancreatic hyperenzymemia have been described in these patients, the pathogenetic link remains unclear. It may potentially involve drugs, altered microcirculation, gut permeability/motility with disruption of enteric-mediated hormone secretion, bacterial translocation, and activation of the gut-associated lymphoid tissue related to chronic inflammation. In addition, the risk of pancreatic cancer seems to be increased in both IBD and CelD patients with unknown pathogenesis. Finally, other systemic conditions (e.g., IgG4-related disease, sarcoidosis, vasculitides) might affect pancreatic gland and the intestinal tract with various clinical manifestations. This review includes the current understandings of this enigmatic association, reporting a clinical and pathophysiological overview about this topic.

Studies comparing EUS-guided fine-needle aspiration (EUS-FNA) with EUS-guided fine-needle biopsy (EUS-FNB) for the evaluation of pancreatic neuroendocrine tumors (pNETs) are lacking. We aimed at comparing EUS-FNA with EUS-FNB in terms of Ki-67 proliferative index (PI) estimation capability, cellularity of the samples, and reliability of Ki-67 PI/tumor grading compared with surgical specimens.Patients diagnosed with pNETs on EUS and/or surgical specimens were retrospectively identified. Specimens were re-evaluated to assess Ki-67 PI feasibility, sample cellularity by manual counting, and determination of Ki-67 PI value. Outcomes in the EUS-FNA and EUS-FNB groups were compared. Kendall rank test was used for Ki-67 PI correlation between EUS and surgical specimens. Subgroup analysis including small (≤20 mm), non-functioning pNETs was performed.Three-hundred samples from 292 lesions were evaluated: 69 EUS-FNA cytology and 231 EUS-FNB histology. Ki-67 PI feasibility was similar for EUS-FNA and EUS-FNB (91.3% vs. 95.7%, p = 0.15), while EUS-FNB performed significantly better in the subgroup of 179 small pNETs (88.2% vs. 96.1%, p = 0.04). Rate of poor cellulated (500 cells) specimens was equal between EUS-FNA and EUS-FNB. A significant correlation for Ki-67 PI values between EUS and 92 correspondent surgical specimens was found in both groups, but it was stronger with EUS-FNB (tau = 0.626, p 0.0001 vs. tau = 0.452, p = 0.031). Correct grading estimation was comparable between the two groups (p = 0.482).Our study showed stronger correlation for Ki-67 values between EUS-FNB and surgical specimens, and that EUS-FNB outperformed EUS-FNA in the evaluation of small pNETs. EUS-FNB should become standard of care for grading assessment of suspected pNETs.

Este trabalho traz excertos de uma dissertação que discute o uso do Laboratório de Ensino de Matemática (LEM) no ensino superior, junto à formação de licenciandos em Matemática e foi defendida no âmbito de um mestrado profissional. A pesquisa teve como objetivo analisar os alcances e limitações do uso do LEM FaE como suporte no planejamento de aulas a serem desenvolvidas no âmbito do estágio supervisionado dos licenciandos em Matemática. Temos como objetivo, neste artigo, apresentar algumas percepções dos licenciandos que participaram da pesquisa a respeito do usodo LEM na formação de professores. A pesquisa foi desenvolvida por meio de uma abordagem qualitativa e para o artigo utilizamos as entrevistas como principal meio de coleta de informações. Aofinal foi possível notar, pelas percepções dos licenciandos, que o LEM FaE pode ser um espaço de trocas de conhecimento, novas aprendizagens, experimentações, planejamentos, desenvolvimentos, avaliações de atividades. Dessa maneira, ponderamos que o uso do LEM pode distanciar o ensino domodo mais tradicional, que utiliza apenas giz e lousa, desconsiderando o protagonismo do estudante.

Este artigo tem a finalidade de trazer as percepções a respeito do uso da calculadora nos Anos Iniciais do Ensino Fundamental pelos estudantes do curso de Pedagogia de uma Universidade Federal Mineira. Para isso, realizamos uma oficina de calculadoras no Laboratório de Ensino da Matemática que consistia em quatro momentos: preenchimento do questionário inicial, discussão teórica a respeito do uso desta ferramenta, oficina e preenchimento do questionário final. Ao final, realizaram-se análises quantitativa e qualitativa a respeito das respostas obtidas nos questionários, de modo a analisar crenças e percepções sobre o uso desta ferramenta, além de ter um parâmetro sobre a importância de uma oficina com foco no ensino que envolva os recursos da calculadora. Ao fim deste trabalho, concluímos que houve uma maior quantidade de estudantes interessados em implementar a calculadora na sala de aula, além de todos terem afirmado sentir maior segurança quanto ao uso desta ferramenta.

This article aims to bring the perceptions regarding the use of the calculator in the Early Years of Elementary Education by students of the Pedagogy course of a Federal University of Minas Gerais. For this, we carried out a calculator workshop at the Mathematics Teaching Laboratory which consisted of four moments: filling in the initial questionnaire, theoretical discussion about the use of this tool, workshop and filling in the final questionnaire. At the end, quantitative and qualitative analyzes were performed regarding the responses obtained in the questionnaires, in order to analyze beliefs and perceptions about the use of this tool, in addition to having a parameter on the importance of a workshop focused on teaching that involves resources the calculator. At the end of this work, we concluded that there was a greater number of students interested in implementing the calculator in the classroom, in addition to all saying that they felt more secure about the use of this tool.

Gastrointestinal Stromal Tumors (GISTs) are subepithelial lesions (SELs) that commonly develop in the gastrointestinal tract. GISTs, unlike other SELs, can exhibit malignant behavior, so differential diagnosis is critical to the decision-making process. Endoscopic ultrasound (EUS) is considered the most accurate imaging method for diagnosing and differentiating SELs in the gastrointestinal tract by assessing the lesions precisely and evaluating their malignant risk. Due to their overlapping imaging characteristics, endosonographers may have difficulty distinguishing GISTs from other SELs using conventional EUS alone, and the collection of tissue samples from these lesions may be technically challenging. Even though it appears to be less effective in the case of smaller lesions, histology is now the gold standard for achieving a final diagnosis and avoiding unnecessary and invasive treatment for benign SELs. The use of enhanced EUS modalities and elastography has improved the diagnostic ability of EUS. Furthermore, recent advancements in artificial intelligence systems that use EUS images have allowed them to distinguish GISTs from other SELs, thereby improving their diagnostic accuracy.

OBJECTIVES Type 1 autoimmune pancreatitis (AIP) is a manifestation of immunoglobulin G4-related diseases (IgG4-RD). To evaluate the activity of the disease, the IgG4-RD responder index (RI) has been created. This study evaluated the IgG4-RD RI as prognostic factor of 1-year disease relapse. METHODS Patients diagnosed with type 1 AIP between January 2012 and December 2016, with available magnetic resonance imaging and IgG4 dosage, were enrolled. Immunoglobulin G4-RD RI was calculated at baseline (time 0), and at 3 to 6 and 12 to 18 months after the end of steroid therapy (time 1 and time 2, respectively). RESULTS Thirty-three patients were included in the study. Immunoglobulin G4-RD RI was 8.9 (standard deviation [SD], 3.8) at time 0, 2.4 (SD, 3.1) at time 1 (P < 0.0001 vs time 0), and 4.2 (SD, 3.9) at time 2 (P = 0.02 vs time 1). Fourteen patients who relapsed within 1 year showed a higher mean value of IgG4-RD RI at time 0 (10.9; SD, 4.3) versus 19 who did not (7.4; SD, 2.6; P = 0.012). This difference was observed also at time 2 (6.8 vs 2.1; P = 0.002). CONCLUSIONS Immunoglobulin G4-RD RI correlates with type 1 AIP disease activity, and it predicts disease relapse within 1 year.

Background: Despite weak evidence, antibiotic prophylaxis prior to endoscopic ultrasound-guided through-the-needle biopsy (EUS-TTNB) of pancreatic cystic lesions (PCLs) is routinely used in clinical practice. We aim to compare a group of patients treated with antibiotics before EUS-TTNB of PCLs and a group who did not undergo antimicrobial prophylaxis. Methods: Out of 236 patients with pancreatic cystic lesions referred to two high-volume centers between 2016 and 2021, after propensity score matching, two groups were compared: 98 subjects who underwent EUS-TTNB under antibiotic prophylaxis and 49 subjects without prophylaxis. Results: There was no difference in terms of baseline parameters between groups. Final diagnosis was serous cystadenoma in 36.7% of patients in the group not treated with prophylaxis and in 37.7% of patients in the control group, whereas IPMN and mucinous cystadenoma were diagnosed in 3 (6.1%) and 16 (32.6%) versus 6 (6.1%) and 32 (32.6%) patients in the two groups, respectively (p = 0.23). Overall, the adverse event rate was 6.1% in the group not treated with antibiotic prophylaxis and 5.1% in the control group (p = 0.49). Only a single infectious adverse event occurred in each group (p = 0.48). The diagnostic yields were 89.7% and 90.8% in the two groups (p = 0.7), and the diagnostic accuracy rate was 81.6% in both groups (p = 1.0). Conclusions: Prophylactic antibiotics do not seem to influence the risk of infection, and their routine use should be discouraged.

Os conteúdos de Probabilidade e Estatística, intitulados “Tratamento da Informação”, aparecem pela primeira vez no Brasil em 1997 com a publicação dos Parâmetros Curriculares Nacionais. Em 2017, foram reafirmados como Unidade Temática “Probabilidade e Estatística” na edição da Base Nacional Comum Curricular – BNCC. Esses documentos apontam que todos os cidadãos precisam desenvolver habilidades para coletar, organizar, representar, interpretar e analisar dados, bem como entender que nem todos os fenômenos são determinísticos e que pode haver eventos certos, impossíveis, improváveis ​​e prováveis, ​​a fim de usar esses conceitos em diferentes contextos diários, na tomada de decisões e em situações de incerteza. Assim, o objetivo desta contribuição é apresentar, por meio de documentos, a trajetória histórica que situa a questão curricular em relação ao ensino de Estatística e Probabilidade no Brasil, da BNCC no que diz respeito aos Anos Iniciais do Ensino Fundamental (1º ao 5º ano - crianças entre 6 e 10 anos) e depois, seguindo o documento referente a esses conteúdos, trilhando caminhos ("por quê", "o quê" e "como"), podemos dinamizar o currículo prescrito.

Este artigo e resultado de um projeto de Iniciacao Cientifica e contempla uma pesquisa bibliografica na qual foram levantadas informacoes de artigos e documentos sobre o “calculo mental”. Esta publicacao tem como objetivo entrelacar diferentes aspectos teoricos sobre essa tematica. Foram exploradas a definicao de calculo mental, bem como estrategias para desenvolve-lo. Alem disso, sao apresentadas vantagens que essa pratica pode oferecer aos estudantes. A partir do estudo, pudemos refletir sobre a importância de se trabalhar o calculo mental em todos os anos da escola basica. Em conclusao, salientamos a relevância dessa tematica ser trabalhada nao so com estudantes, mas tambem na formacao de professores, para que esses possam refletir sobre essa modalidade de calculo e, consequentemente, incentivar sua pratica em sala de aula. Palavras-chave: Educacao Matematica. Calculo Mental. Ensino de Matematica. Escola Basica. Mental calculation in question: theoretical basis and reflections This article is the result of a Junior Researcher Program that collected bibliographical research data surveying information in articles and documents related to "mental calculation". The objective of this article is to interweave different aspects of this subject, according to the perspective of several authors. It explored the definition of mental calculation as well as strategies to develop it. In addition, different advantages that this practice can offer students have been presented. From this study, we could reflect on the importance of using mental calculation in all years of school. In conclusion, we emphasize the relevance of this theme for students and future teachers, so that they can reflect on this modality of calculation and consequently encourage their practice in the classroom. Keywords: Mathematics Education. Mental Calculation. Mathematics Teaching. Basic school. Calculo mental en cuestion: fundamentacion teorica y reflexiones El presente articulo es el resultado de un primer proyecto de iniciacion cientifica, en el que se contempla una investigacion bibliografica de articulos y documentos informaciones sobre el "calculo mental". Esta publicacion tiene como objetivo analizar y entrelazar diferentes aspectos de la tematica susodicha, de acuerdo con diferentes autores. Se exploraron la definicion de calculo mental, asi como estrategias para desarrollarlo. Ademas, se presentaron diferentes ventajas que esta practica puede ofrecer a los estudiantes. A partir del estudio, pudimos reflexionar sobre la importancia de trabajar el calculo mental durante el transcurso de la primaria o escuela basica. Y a modo de conclusion, subrayo la relevancia de esta tematica ser trabajada no solo con estudiantes, sino tambien en la formacion de docentes, para que puedan reflexionar sobre esa modalidad de calculo y consecuentemente incentivar su practica en el aula. Palavras chave: Educacion Matematica. Calculo Mental. Ensenanza de Matematicas. Escuela Basica.

Background The SARS-CoV-2 pandemic has had a huge impact on healthcare systems, resulting in many routine diagnostic procedures either being halted or postponed. Aims To evaluate whether the diagnoses of colorectal, gastric and pancreatic cancers have been impacted by the SARS-CoV-2 pandemic in Italy. Methods A survey designed to collect the number of histologically-proven diagnoses of the three cancers in gastroenterology services across Italy from January 1 to October 31 in 2017–2020. Non-parametric ANOVA for repeated measurements was applied to compare distributions by years and macro-areas. Results Compared to 2019, in 2020 gastric cancer diagnoses decreased by 15.9%, CRC by 11.9% and pancreatic by 9.9%. CRC distributions showed significant differences between all years, stomach cancer between 2018 and 2020 and 2019–2020, and pancreatic cancer only between 2017 and 2019. The 2019–2020 comparison showed fewer CRC diagnoses in the North (-13.7%), Center (-16.5%) and South (-4.1%), fewer stomach cancers in the North (-19.0%) and South (-9.4%), and fewer pancreatic cancers in the North (-14.1%) and Center (-4.7%), with an increase in the South (+12.3%). Distributions of CRC and gastric cancer were significantly different between all years in the North. Conclusions This survey highlights the concerning effects of the COVID-19 pandemic on the diagnostic yield of gastroenterology services for stomach, colorectal and pancreatic cancers in Italy.

The interest for pancreatic neoplasm ablation under endoscopic ultrasound (EUS) guidance has increased during the last decade because of technology advancement and availability of dedicated devices for thermal ablation. The most commonly used technique is radiofrequency ablation (RFA). Currently, three needle-electrodes and one "through-the-needle" probe are available. Published studies mainly demonstrated the feasibility and safety of the procedure. However, the role of EUS-RFA for the treatment of pancreatic ductal adenocarcinoma is not yet well defined. Randomized studies are needed to assess any advantage in terms of survival and quality of life when RFA is included in a multimodal treatment strategy compared with chemo(radio)therapy alone. In the setting of pancreatic neuroendocrine tumors (pNETs), published studies are consistent in demonstrating the efficacy of EUS-RFA in relieving symptoms related to hormone secretion by functioning pNETs. Moreover, EUS-RFA could find a role even in selected patients with small non-functioning pNETs when treatment is indicated but surgical resection would like to be avoided. Finally, EUS-RFA can be applied also for the treatment of pancreatic cystic neoplasm. However, patients should be carefully selected taking into account the low incidence of progression of cystic neoplasms towards malignancy and factors related to the patient, such as age, symptoms, comorbidity, and life expectancy.