7 research outputs found
A Ă©tica do silĂȘncio racial no contexto urbano: polĂticas pĂșblicas e desigualdade social no Recife, 1900-1940
Mais de meio sĂ©culo apĂłs o preconceito racial ter se tornado o principal alvo dos movimentos urbanos pelos direitos civis nos Estados Unidos e na Ăfrica do Sul, e dĂ©cadas depois do surgimento dos movimentos negros contemporĂąneos no Brasil, o conjunto de ferramentas legislativas criado no Brasil para promover o direito Ă cidade ainda adere Ă longa tradição brasileira de silĂȘncio acerca da questĂŁo racial. Este artigo propĂ”e iniciar uma exploração das raĂzes histĂłricas desse fenĂŽmeno, remontando ao surgimento do silĂȘncio sobre a questĂŁo racial na polĂtica urbana do Recife, Brasil, durante a primeira metade do sĂ©culo XX. O Recife foi eĂ© um exemplo paradigmĂĄtico do processo pelo qual uma cidade amplamente marcada por traços negros e africanos chegou a ser definida polĂtica e legalmente como um espaço pobre, subdesenvolvido e racialmente neutro, onde as desigualdades sociais originaram na exclusĂŁo capitalista, e nĂŁo na escravidĂŁo e nas ideologias do racismo cientĂfico. Neste sentido, Recife lança luzes sobre a polĂtica urbana que se gerou sob a sombra do silĂȘncio racial.More than half a century after racial prejudice became central to urban civil rights movements in the United States and South Africa, and decades after the emergence of Brazilâs contemporary Black movements, Brazil's internationally recognized body of rights-to-the-city legislation still adheres to the country's long historical tradition of racial silence. This article explores the historical roots of this phenomenon by focusing on the emergence of racial silence in Recife, Brazil during the first half of the 20th Century. Recife was and remains a paradigmatic example of the process through which a city marked by its Black and African roots came to be legally and politically defined as a poor, underdeveloped and racially neutral space, where social inequalities derived from capitalist exclusion rather than from slavery and scientific racism. As such, Recife'sexperience sheds light on the urban policies that were generated in the shadow of racial silence
Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial
Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt
Virulence associated factors in bacteria from water bodies in Belem, Para, Brazil: bacteriological composition and threat to public health
MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. LaboratĂłrio de Microbiologia Ambiental. Ananindeua, PA, Brasil.Federal University of ParĂĄ. BelĂ©m, PA, Brazil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. LaboratĂłrio de Microbiologia Ambiental. Ananindeua, PA, Brasil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. LaboratĂłrio de Microbiologia Ambiental. Ananindeua, PA, Brasil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. LaboratĂłrio de Microbiologia Ambiental. Ananindeua, PA, Brasil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. LaboratĂłrio de Biologia Molecular. Ananindeua, PA, Brasil.MinistĂ©rio da SaĂșde. Secretaria de VigilĂąncia em SaĂșde. Instituto Evandro Chagas. LaboratĂłrio de Microbiologia Ambiental. Ananindeua, PA, Brasil.A lack of sewage treatment contaminates water bodies threatening human health by spreading
waterborne gastroenteritis. This is a particular problem for developing countries, where the risks
associated with surface water contamination remain largely unknown. To understand the risk
associated with sewage contamination of water bodies, we evaluated the microbiological indicators
of water quality and isolated bacterial strains from water bodies from the city of Belém, Parå, Brazil.
The strains were identified by biochemical and serological tests and polymerase chain reactions
(PCRs). The thermotolerant coliforms and Escherichia coli presented values above 1,000 (NMP/
100 mL) biweekly from August 2012 to November 2015, without a significant statistical difference
between sampling periods (KruskalâWallis p > 0.05). The water of the Tucunduba river presented
contamination levels similar to those in a sewage pumping station (Dunn test p > 0.05). From 240
bacterial isolates, we identified 163 Vibrio cholerae, 8 Vibrio mimicus, 24 E. coli, and 5 Salmonella
spp. The isolates of V. cholerae demonstrated N-acetylglucosamine (NAG) profile (Non-O1 and NonO139) and 18 expressed the stn/sto gene. No E. coli was shown to be potentially pathogenic.
The results revealed that water bodies in Belém were constantly contaminated by sewage and fecal
microorganisms, including the potential circulation of pathogens in viable and cultivable form
Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial
Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt
International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module
We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health careâassociated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396Â days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central lineâassociated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN