Objective To determine the enzymatic activity and cellular localization of matrix metalloproteinases (MMPs) 2, 3, and 9 in labial salivary glands from patients with different degrees of severity of primary Sjögren's syndrome (primary SS). Methods Gelatinase activity was determined by zymography and quantified by densitometry. The specificity of MMPs was determined using protease inhibitors and chelators, as well as activators of the latent forms of these enzymes. The cellular localization of MMPs was carried out using monoclonal antibodies that recognize their latent and active forms. Results Labial glands from control subjects and patients showed gelatinase activity for MMP‐2 and MMP‐9. Activation studies revealed that both enzymes were predominantly present in their latent forms. The highest levels of MMP‐9 activity were detected in patients with severe, active, primary SS (except for patients with severe clinical symptoms for extended periods) and correlated with structural and functional glandular changes. MMP‐2 activity was almost the same in patients and controls. MMPs were detected by immunolocalization only in acinar and ductal cells and were homogeneously distributed throughout patients' glands. MMP‐2 and MMP‐9 expression paralleled their gelatinase activity. MMP‐3, detectable only with immunologic methods, was absent in control subjects but abundantly expressed in patients. Importantly, MMP protein levels in acinar and ductal cells were independent of either the presence or the proximity of mononuclear infiltrate cells. Conclusion MMP‐3 and MMP‐9 expression, as well as MMP‐9 catalytic activity, were increased in tissue samples from SS patients in a manner that correlated with the severity of the disease. Most important, increased MMP activity stemmed from exocrine epithelial cells and was not due to infiltrating lymphocytes. Thus, changes in salivary glands as a consequence of proteolysis may lead to severe glandular destruction.

Metaevaluation: a decade of Institutional Evaluation Process of SINAESAbstract: This research presents the metaevaluation of Brazilian Superior Education Institutes' Institutional Evaluation Process, from 2004 to 2014, regarding keeping the system up as well as its revision. It has been chosen to study the 66 Universities -public and private -that had their reaccreditation publicized in the Federal Official Press in 2014. The results indicated that private universities haven't had any grade above the satisfactory level of quality at all the Dimensions. On the other hand, the public ones got grades under satisfying level of quality on the First Dimension -Mission and "PDI" -and also on the Eighth Dimension -Planning and Evaluation. The metaevaluation is opportune and necessary as from an appreciative view.

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A superlotação das emergências hospitalares de grande parte dos hospitais públicos brasileiros foi umas das justificativas do Ministério da Saúde para a criação das Unidades de Pronto Atendimento (UPA) no país. A UPA tem como objetivo prestar apoio intermediário aos hospitais e às Unidades Básicas de Saúde, evitando que casos de menor complexidade sejam encaminhados para as emergências hospitalares, tendo como uns dos efeitos a diminuição da superlotação dos prontos-socorros. Assim, este artigo objetiva verificar o desempenho, incluindo a forma de organização da primeira unidade de UPA habilitada no município de Pelotas, no período de julho de 2016 e julho de 2017. Busca-se identificar os possíveis impactos da UPA no Pronto Socorro do município e à comunidade local. Trata-se de um estudo de caráter exploratório, quali-quantitativo. Com isso, verificou-se que a UPA em estudo no período especificado efetuou 73.333 atendimentos no acolhimento, sendo que 68.255 pacientes passaram pelo atendimento médico evidenciando que a Unidade tem apresentado resultados positivos, relacionados à redução, em média, a 80 atendimentos diários, dos acolhimentos do Pronto Socorro local, além de proporcionar aos usuários serviços específicos, por possuir uma estrutura simplificada com raio-X, eletrocardiografia, pediatria, laboratório de exames e leitos de observação, atendimentos muitas vezes difíceis de obter em outras unidades hospitalares. Contudo, a continuação do estudo é necessária, em vista da abertura de outra unidade no município para o ano de 2018, o que apresentará novos resultados aos estudos vinculados às Unidades e ao Pronto Socorro.