IntroductionWhen solving multi-objective combinatorial optimization problems using a search algorithm without a priori information, the result is a Pareto front. Selecting a solution from it is a laborious task if the number of solutions to be analyzed is large. This task would benefit from a systematic approach that facilitates the analysis, comparison and selection of a solution or a group of solutions based on the preferences of the decision makers. In the last decade, the research and development of algorithms for solving multi-objective combinatorial optimization problems has been growing steadily. In contrast, efforts in the a posteriori exploration of non-dominated solutions are still scarce.MethodsThis paper proposes an abstract framework based on hierarchical clustering in order to facilitate decision makers to explore such a Pareto front in search of a solution or a group of solutions according to their preferences. An extension of that abstract framework aimed at addressing the bi-objective Next Release Problem is presented, together with a Dashboard that implements that extension. Based on this implementation, two studies are conducted. The first is a usability study performed with a small group of experts. The second is a performance analysis based on computation time consumed by the clustering algorithm.ResultsThe results of the initial empirical usability study are promising and indicate directions for future improvements. The experts were able to correctly use the dashboard and properly interpret the visualizations in a very short time. In the same direction, the results of the performance comparison highlight the advantage of the hierarchical clustering-based approach in terms of response time.DiscussionBased on these excellent results, the extension of the framework to new problems is planned, as well as the implementation of new validity tests with expert decision makers using real-world data.

Condrocalcinose Articular Familiar 305RELATO DE CASO CASE REPORT RESUMO Condrocalcinose articular familiar é uma condição clínica caracterizada pela deposição de cristais de pirofosfato de cálcio no líquido sinovial e cartilagens articulares levando à artrite. Descrevemos três membros de uma família com condrocalcinose cujo quadro clínico era caracterizado por artrite intermitente em dois e artrite crônica lembrando artrite reumatóide em um. A avaliação radiológica mostrou calcificações em cartilagens de diversas articulações, particularmente de joelhos. A utilização de colchicina foi suficiente para prevenir as crises de artrite em dois pacientes e o paciente com a forma crônica necessitou uso contínuo de antiinflamatórios não-hormonais. Embora aparentemente rara no Brasil, não afastamos a possibilidade desse dado estar subestimado e sugerimos que seja realizada uma avaliação radiológica articular dos familiares de todo paciente com diagnóstico de condrocalcinose esporádica.Palavras-chave: condrocalcinose familiar, artrite, pseudo-gota, doença de deposição de pirofosfato de cálcio. ABSTRACTFamilial articular chondrocalcinosis is a disorder characterized by deposition of calcium pyrophosphate dihydrate crystal in synovial fluid and articular cartilage that can cause joint pain and arthritis. We have identified three members of the same family with chondrocalcinosis. The clinical features of the disease were intermittent episodes of arthritis in two patients and polyarthritis resembling rheumatoid arthritis in one member. The radiological evaluation showed calcification in several joints, particularly in cartilages of the knees. Therapy with colchicine was enough to prevent arthritic crisis in two patients and continous NSAID use was necessary to control symptoms in the last one. Familial chondrocalcinosis seems to be rare in Brazil, but we do not exclude the possibility that this figure is underestimated and suggest that in cases of sporadic chondrocalcinosis other members of the family should be fully investigated.

Fortbildung W eltweit wird das Blasenkarzinom als die fünfthäufigste bösartige Tumorerkrankung des Menschen klassifiziert. Männer erkranken dreimal häufiger als Frauen. In der Bundesrepublik Deutschland wird pro Jahr von rund 16.000 neuen Fällen berichtet [2]. In den Industrieländern ist die Prävalenz von Harnblasenkrebs fast sechsmal so hoch wie in Entwicklungsländern [2]. Bei der Erstdiagnose wird mit rund 75 %iger Wahrscheinlichkeit ein oberflächliches Karzinom gefunden. In circa 20 % der Fälle ist das Karzinom bereits invasiv und bei circa 5 % sind bereits Metastasen aufgetreten [1]. Aufgrund neuer genetischer Daten und neuer klinischer Beobachtungen wurde die lange gültige Klassifikation (WHO 1973) mit dreistufigem Grading-System 2004 durch ein zweistufiges Sy-stem ersetzt. Heute wird nur noch zwischen "low grade" und "high grade" unterschieden (Tabelle 1). Schon 1998 wurde mit der WHO/ISUP-Klassifikation eine Untergruppe der pTa-Tumoren als papilläre urotheliale Neoplasie "low malignant potential" (PUNLMP) abgegrenzt. PUNLMP gilt heute als gutartig und zählt nicht mehr zu den Karzinomen. Die Nutzung der WHO-Klassifikation von 2004 wird bis heute empfohlen, da hierdurch eine einheitlichen Diagno-

O Método do Diálogo Aberto surgiu no oeste da Lapônia, no início dos aos 80 como uma forma de atenção imediata à crise psicótica. Este artigo tem como objetivo apresentar uma análise do Método do Diálogo Aberto para o enfrentamento de crises psicóticas em seus fundamentos teóricos, aplicação prática e resultados. Neste artigo é apresentada uma análise do Método do Diálogo Aberto sendo discutido: O diálogo aberto – histórico e princípios (ajuda imediata, perspectiva de rede social, flexibilidade e mobilidade, responsabilidade, continuidade psicológica, tolerância a incerteza, dialogismo).