Catatonia is a rare manifestation in patients with systemic lupus erythematosus (SLE). As catatonia can be associated with both psychiatric and organic conditions, this could create a diagnostic dilemma once this occurs in SLE patients. The report describes a 15-year-old female with SLE who developed catatonia three days after the diagnosis of SLE was made. Her catatonia was refractory to the treatment with immunosuppressive therapy, which included pulse methylprednisolone, intravenous cyclophosphamide, rituximab, intravenous immunoglobulin (IVIG) and plasmapheresis. Given her persistent catatonia, electroconvulsive therapy (ECT) was initiated three months after the onset of her symptoms. After the third ECT treatment, her mental status dramatically improved and returned nearly to baseline while she was continued on the immunosuppression. This is the first report of a successful ECT therapy in catatonic lupus in children.

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In view of the growing supply of reference models in various domains and in different formats, and the potential benefits to organizations using them, this article proposes to (1) present the theoretical background to the subject, and (2) situate and discuss issues associated with integrating such references. Adopting multiple reference models poses practical problems for organizations as regards where to look for the models, which to adopt, and once selected, how to ensure the references are consistent with each other and suited to the organization's particular features. As a possible avenue to solutions, this text describes the conception of an organization-specific reference model. The model proposed can be constructed by way of an articulated solution based on one or more reference models, which were selected thematically, subjected to adjustments for coherence and interrelationship, matched against the organizational culture, and explicitly formulated.

O desbalanceamento entre os recursos financeiros aplicados à saúde e o aumento da população colocam um grande desafio na perspectiva de gestão: encontrar novas medidas gerenciais para coordenar os recursos escassos de forma a otimizar sua eficiência. Neste contexto, este artigo aborda a gestão de materiais que, de forma geral, refere-se ao planejamento e controle do fluxo de materiais de forma eficiente com objetivo de assegurar disponibilidade de materiais, no momento e no local adequado, para prestação de serviço. Ponderar custos e disponibilidade, entretanto, não é simples no ambiente hospitalar, uma vez que muitas vezes não é possível prever a demanda de pacientes com exatidão ou suas necessidades. Assim, para garantir o atendimento aos pacientes, os estoques desempenham um papel muito importante e, neste artigo, as propostas são apresentadas com base na melhoria de processos voltados para o aumento da eficiência operacional e alinhamento ao planejamento estratégico de um hospital.

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