Água de beber: a filtração doméstica e a difusão do filtro de água em São Paulo

This work studies the advent and diffusion of water filter usage in São Paulo State, during the 20th Century. The water filter, a set of two terracotta vessels equipped with a filtering device, was a product of the ceramics industry, one of the first to be developed in São Paulo. This research shows that in São Paulo at the end of 19th and beginning of 20th Centuries, with the growth of cities and rapid urbanisation, a concern about the quality of water increased due to serious public health hazards, mainly epidemics caused by the consumption of unhealthy drinking water. Despite the existence of an incipient market of domestic equipment for water filtration, these were imported and of limited usage. From the 1910's, ceramics companies, owned by Portuguese and Italian immigrants, started installing filtering devices in terracotta vessels, launching the water filter set. It caught on and became the main domestic filtering equipment after the 1930's, when several companies specialized in this kind of product and started catering for the national market, such as Filtros Salus (from São Paulo city), Pozzani (Jundiaí) and Stéfani (Jaboticabal). Studying the advent and diffusion of the water filter entails knowledge about one of the first consumer goods of the Brazilian industry and, at the same time, knowledge about the history of the ways in which the Brazilian population obtained water to drink.Este artigo trata do processo de surgimento e difusão do uso do filtro de água no Estado de São Paulo, ao longo do século XX. O filtro de água, conjunto de dois recipientes de argila equipado com vela filtrante, é um produto da indústria cerâmica, uma das primeiras a se desenvolver em São Paulo. A pesquisa mostra que, em São Paulo, no final do século XIX e início do XX, com o aumento da urbanização e o crescimento das cidades, a preocupação com a qualidade da água que se consumia ganhou importância em virtude de graves problemas de saúde pública principalmente epidemias causadas por águas impróprias para beber. Embora já existisse um incipiente mercado de equipamentos domésticos de filtração da água, eles eram ainda importados e de uso restrito. A partir da década de 1910, empresas cerâmicas, de imigrantes portugueses e italianos, passaram a acoplar velas filtrantes a recipientes de argila, dando origem ao filtro de água. Depois dos anos de 1930, o filtro difundiu-se e tornou-se o principal equipamento de filtração doméstica, quando diversas empresas, como Filtros Salus (São Paulo-SP), Pozzani (Jundiaí-SP) e Stéfani (Jaboticabal-SP), especializaram-se nesse produto e passaram a atender ao mercado nacional. Estudar o surgimento e a difusão do filtro de água significa conhecer um dos primeiros bens de consumo da indústria brasileira e, ao mesmo tempo, a história de como a população obtém água para beber

Dilatação dos confins: caminhos, vilas e cidades na formação da Capitania de São Paulo (1532-1822)

Este ensaio analisa a formação da rede urbana das capitanias de São Vicente e Santo Amaro, depois unidas na Capitania de São Paulo. Discute o processo de apropriação do sertão, a pulsação e dilatação dos confins ao sabor dos deslocamentos humanos e de interesses políticos. Interpreta o papel de capelas, freguesias, vilas e cidades no controle e produção de territórios metropolitanos em solos ultramarinos.This essay analyzes the development of urban networks in the Captaincies of São Vicente and Santo Amaro, later merged into the Captaincy of São Paulo. It discusses the process of appropriation of the sertão (backcountry), the commotion and expansion beyond the confines to the tune of population movements and political interests. The paper also interprets the role of chapels, parishes, villages and towns in initiatives to create and control metropolitan areas on overseas soil

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 cmH2O 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 6430 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 metho