Edición del género epistolar. Hacia un lugar en el campo literario. Caso: el archivo Alfredo Veiravé

 Este proyecto de investigación situado en un campo transdisciplinario en el que convergen los estudios semióticos, la teoría literaria en general, la crítica genética y los saberes de una edición anotada, en particular, se propone relevar el epistolario del Fondo Documental personal del poeta, escritor y docente universitario Alfredo Veiravé con vistas a una edición crítica. La investigación se articula con el proyecto “Del texto manuscrito al texto editado. Edición crítico-genética de la obra de Alfredo Veiravé”. (PID 3151) y se propone como caso testigo de una manera de establecer una relación entre los estudios literarios y la archivística. En la concurrencia entre la archivística y la crítica genética se examinará la relación entre la memoria que genera el archivo específicamente vinculadas a las relaciones entre escritores y los procesos sociales de conformación del canon. Este proyecto habilita que los materiales editables discutan entre sí con los textos en el sistema literario en que se incorporarán. La figura de Veiravé ha sido elegida para inscribirse en el debate abierto respecto de la producción literaria de provincias y su tensión y articulación con las producciones literarias que adquieren carácter nacional. En este sentido afrontar el armado de la correspondencia de y hacia Alfredo Veiravé como espacio semiótico viene a aportar en su conjunto -obras del autor y análisis críticos- a una tendencia literaria animada por la voluntad de posicionar las obras de carácter regional o federal y, especialmente, la producción literaria de provincias en el canon, al tiempo que busca ser una intervención en el campo de la literatura argentin

PRÁTICAS ADOTADAS POR PROFISSIONAIS DE ENFERMAGEM PARA MEDIDA INDIRETA E REGISTRO DA PRESSÃO ARTERIAL

RESUMO Objetivou-se identificar como é realizado o procedimento de medida indireta e registro da pressão arterial por profissionais de enfermagem e as condições técnicas dos dispositivos utilizados. Trata-se de estudo quantitativo, observacional, de delineamento transversal. A amostra compôsse de 80 servidores observados no período de agosto de 2013 a janeiro de 2014, em cinco unidades de saúde de Londrina, Paraná. Na coleta de dados utilizou-se instrumento fundamentado nas VI Diretrizes Brasileiras de Hipertensão e, para o registro do procedimento, instrumento construído conforme recomendações do COREn-SP.Na análise dos dados usou-se o Programa Statistical Package for the Social Science versão 1.6. Os resultados mostraram altos índices de "não realização" (93,8 a 100%) das etapas de preparo do paciente para a medida da pressão. A calibração dos equipamentos não era aferida e não havia manguitos disponíveis de tamanhos variados. Concluiu-se que há importantes lacunas nos procedimentos adotados pela enfermagem para a medida da pressão arterial, indicando a necessidade de medidas educativas

ALTERNATIVAS SUSTENTÁVEIS NA EDUCAÇÃO INFANTIL: AGROECOLOGIA ALIADA À SEGURANÇA ALIMENTAR

http://dx.doi.org/10.5902/223611708806The subproject Architects of Saber, Federal University of Santa Maria, was developed from a proposal magna CAPES - New Talents Project, reaching target audience is students of the State School of Elementary Education Dr. Honorato de Souza Santos, located in town Step d 'Sand, peri-urban area of the municipality of Cachoeira do Sul / RS, Brazil. At school worked three axes are calling themselves Agroecology, Environmental Education and Citizenship, and the actual experience lived and assisted on Axis Agroecology. This axis aims to establish a harmonious relationship between children and nature, making them reflect and learn in practice it is possible to obtain food through natural resources without degradation thereof. The activities conducted at the school involve workshops, explanations to students on topics such as natural soil cover and its importance consortium of plants in a particular place and its purpose, deployment garden and Agroforestry Systems (AFS) in the school environment and its contribution for sustainability and food security. The results are relevant because there is the interaction of students with the proposed activities, and have the experience, for example, they are reaping the vegetable garden itself (suspended - vertical and horizontal) vegetables and legumes to your diet.http://dx.doi.org/10.5902/223611708806O subprojeto Arquitetos do Saber, da Universidade Federal de Santa Maria, foi desenvolvido a partir de uma proposta magna da CAPES - Projeto Novos Talentos, atingindo como público alvo alunos da Escola Estadual de Ensino Fundamental Dr. Honorato de Souza Santos, localizada na localidade Passo d’ Areia, área peri-urbana do município de Cachoeira do Sul/RS, Brasil. Na escola são trabalhados três eixos que se intitulam Agroecologia, Educação Ambiental e Cidadania, sendo a atual experiência assistida e vivenciada no Eixo Agroecologia. Este eixo tem por objetivo estabelecer uma relação harmônica entre as crianças e a natureza, fazendo-as refletir e aprender na prática que é possível obter alimentos através dos recursos naturais sem a degradação dos mesmos. As atividades conduzidas na escola envolvem oficinas, explanações aos alunos sobre assuntos tais como cobertura natural do solo e sua importância, consórcio de plantas dentro de um determinado local e sua finalidade, implantação de horta e Sistemas Agroflorestais (SAFs) no ambiente escolar e sua contribuição para a sustentabilidade e segurança alimentar. Os resultados são relevantes, pois há a interação destes alunos com as atividades propostas, além de terem a experiência, por exemplo, de colherem da própria horta (suspensa – vertical e horizontal) hortaliças e legumes para sua alimentação

Factores pronósticos de mortalidad por sepsis severa en unidades de cuidado crítico del área metropolitana de Bucaramanga

Resumen Introducción La sepsis es la principal causa de mortalidad en unidades de cuidado crítico, factores de riesgo de mortalidad como la edad, el género y las escalas de severidad han sido estudiados. En nuestra población de estudio las otras complicaciones durante la hospitalización fueron las más relacionadas con el descenlace. Materiales y métodos Estudio de cohorte de 150 pacientes admitidos a unidad de cuidado critico de cuatro unidades del área metropolitana de Bucaramanga, con diagnostico de sepsis severa o choque séptico fueron estudiados mediante un cuestionario sobre variables socio-económicas, clínicas y microbiológicas. Se realizó análisis bivariado con pruebas t de student y chi cuadrado. El análisis multivariado mediante regresión de cox con el tiempo al evento como variable de descenlace.Resultados Los pacientes sobrevivientes tuvieron un promedio de edad de 64 años y los no sobrevivientes de 67 años, sin que se demostraran diferencias estadísticas entre los dos grupos de pacientes. No se encontraron diferencias en cuanto al género. El factor de riesgo más importante asociado a mortalidad por sepsis fueron las complicaciones durante la hospitalización, incluso luego de ajustar por el puntaje sofá inicial, el sitio de infección y los indicadores de respuesta inflamatoria como la hiperlactatemia e hiperbilirrubinemia. Conclusiones Se encontraron tres modelos de riesgo para mortalidad por sepsis con otras complicaciones durante la hospitalización como el factor de riesgo más relevante y el control glicemico como el factor de protección más importante. Palabras clave: Epidemiologia, Sepsis, Cuidados intensivos, Mortalidad, Factores pronóstico

Association between prognosis factorsand mortality in Bucaramanga

El objetivo del presente artículo fue evaluar los factores de riesgo para mortalidad por sepsis severa en cuatro instituciones de cuidado crítico de la ciudad, estudiando variables socio-demográficas, clínicas y microbiológicas. Materiales y métodos: Estudio de cohorte de 150 pacientes admitidos a unidad de cuidado crítico de cuatro unidades del área metropolitana de Bucaramanga, con diagnóstico de sepsis severa o choque séptico. Fueron estudiados mediante un cuestionario sobre variables socio-económicas, clínicas y microbiológicas. Se realizó análisis bivariado con pruebas t de student y chi cuadrado. El análisis multivariado mediante regresión de Cox con el tiempo al evento como variable de desenlace. Resultados: Los pacientes sobrevivientes tuvieron un promedio de edad de 64 años y los no sobrevivientes de 67 años, sin que se demostraran diferencias estadísticas entre los dos grupos de pacientes. No se encontraron diferencias en cuanto al género. El factor de riesgo más importante asociado a mortalidad por sepsis fueron las complicaciones durante la hospitalización, incluso luego de ajustar por el puntaje SOFAinicial, el sitio de infección y los indicadores de respuesta inflamatoria como la hiperlactatemia e hiperbilirrubinemia. Conclusiones:Se encontraron tres modelos de riesgo para mortalidad por sepsis con otras complicaciones durante la hospitalización como el factor de riesgo más relevante y el control glicémico como el factor de protección más importante. [Niño ME, Torres D, Cárdenas ME, Godoy AP, Moreno N, Sanabria V, et al. Factores pronósticos de mortalidad por sepsis severa en unidades de cuidado critico del área metropolitana de Bucaramanga.The objective of this article was to evaluate the risk factors for mortality due to severe sepsis in four critical care institutions in the city, studying socio-demographic, clinical and microbiological variables. Materials and methods: Cohort study of 150 patients admitted to a critical care unit of four units in the metropolitan area of ​​Bucaramanga, diagnosed with severe sepsis or septic shock. They were studied by means of a questionnaire on socio-economic, clinical and microbiological variables. Bivariate analysis was performed with Student's t and chi square tests. Multivariate analysis using Cox regression with time to event as an outcome variable. Results: The surviving patients had an average age of 64 years and the non-survivors of 67 years, without statistical differences between the two groups of patients. No differences were found regarding gender. The most important risk factor associated with mortality from sepsis was complications during hospitalization, even after adjusting for the initial SOFA score, the site of infection, and indicators of inflammatory response such as hyperlactatemia and hyperbilirubinemia. Conclusions: Three risk models were found for mortality from sepsis with other complications during hospitalization as the most relevant risk factor and glycemic control as the most important protective factor. [Niño ME, Torres D, Cárdenas ME, Godoy AP, Moreno N, Sanabria V, et al. Prognostic factors for mortality due to severe sepsis in critical care units in the metropolitan area of ​​Bucaramanga

Differences in clinical features and mortality in very old unvaccinated patients (≥ 80 years) hospitalized with COVID-19 during the first and successive waves from the multicenter SEMI-COVID-19 Registry (Spain)

Background: Old age is one of the most important risk factors for severe COVID-19. Few studies have analyzed changes in the clinical characteristics and prognosis of COVID-19 among older adults before the availability of vaccines. This work analyzes differences in clinical features and mortality in unvaccinated very old adults during the first and successive COVID-19 waves in Spain. Methods This nationwide, multicenter, retrospective cohort study analyzes unvaccinated patients >= 80 years hospitalized for COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry). Patients were classified according to whether they were admitted in the first wave (March 1-June 30, 2020) or successive waves (July 1-December 31, 2020). The endpoint was all-cause in-hospital mortality, expressed as the case fatality rate (CFR). Results Of the 21,461 patients hospitalized with COVID-19, 5,953 (27.7%) were >= 80 years (mean age [IQR]: 85.6 [82.3-89.2] years). Of them, 4,545 (76.3%) were admitted during the first wave and 1,408 (23.7%) during successive waves. Patients hospitalized in successive waves were older, had a greater Charlson Comorbidity Index and dependency, less cough and fever, and met fewer severity criteria at admission (qSOFA index, PO2/FiO2 ratio, inflammatory parameters). Significant differences were observed in treatments used in the first (greater use of antimalarials, lopinavir, and macrolides) and successive waves (greater use of corticosteroids, tocilizumab and remdesivir). In-hospital complications, especially acute respiratory distress syndrome and pneumonia, were less frequent in patients hospitalized in successive waves, except for heart failure. The CFR was significantly higher in the first wave (44.1% vs. 33.3%; -10.8%; p = 95 years (54.4% vs. 38.5%; -15.9%; p < 0.001). After adjustments to the model, the probability of death was 33% lower in successive waves (OR: 0.67; 95% CI: 0.57-0.79). Conclusions Mortality declined significantly between the first and successive waves in very old unvaccinated patients hospitalized with COVID-19 in Spain. This decline could be explained by a greater availability of hospital resources and more effective treatments as the pandemic progressed, although other factors such as changes in SARS-CoV-2 virulence cannot be ruled out

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie