Transformações do espaço habitacional ocorridas na arquitetura brasileira do século XIX

Depois de referências à arquitetura colonial (inclusive no exame de modelos vernaculares portugueses, da contribuição indígena e da adaptação a condições climáticas, ao isolamento geográfico e a padrões segregacionistas de comportamento), o autor descreve os principais traços do padrão difuso de residência rural, assim como de seus equivalentes urbanos. O Ecletismo - com suas raízes externas - é apontado como o principal vetor de transformações, da segunda metade do século XIX até a 1.0 Guerra Mundial

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Imigração, patrimônio cultural e turismo no Brasil

The heritage of immigration, like all cultural expression, has multiple forms and understanding permeates the approach to several issues, among them: the various manifestations of cultural heritage, the intentions of conservation actions and appreciation of the cultural heritage of immigrant groups and practices for the resonance of this heritage, such as tourism. The objective of this paper is to analyze the heritage of immigration as a phenomenon that was constituted in a particular environment, not only by the above issues, but also as a particular form of instituting the past in the present and its consequences for the construction of collective identitiesO patrimônio da imigração, como toda expressão cultural, possui múltiplas formas e sua compreensão perpassa pela abordagem de várias questões, dentre elas: as várias manifestações do patrimônio cultural; as intencionalidades das ações de preservação e valorização da herança cultural de grupos de imigrantes; e as práticas para a ressonância deste patrimônio, como é o caso do turismo. O objetivo deste artigo é analisar o patrimônio da imigração como fenômeno que se constituiu num ambiente determinado, não só pelas questões acima, mas também como uma forma particular de instituir o passado no presente e seus desdobramentos para a construção de identidades coletivas

Coronary plaque rupture in patients with myocardial infarction after noncardiac surgery: Frequent and dangerous

textabstractPurpose: The pathophysiology of acute coronary syndromes (ACS) after noncardiac surgery is not established yet. Thrombosis over a vulnerable plaque or decreased oxygen supply secondary to anemia or hypotension may be involved. The purpose of this study was to investigate the pathophysiology of ACS complicating noncardiac surgery. Methods: Clinical and angiographic data were prospectively recorded into a database for 120 consecutive patients that had an ACS after noncardiac surgery (PACS), for 120 patients with spontaneous ACS (SACS), and 240 patients with stable coronary artery disease (CAD). Coronary lesions with obstructions greater than 50% were classified based on two criteria: Ambrose's classification and complex morphology. The presence of Ambrose's type II or complex lesions were compared between the three groups. Results: We analyzed 1470 lesions in 480 patients. In PACS group, 45% of patients had Ambrose's type II lesions vs. 56.7% in SACS group and 16.4% in stable CAD group (P< 0.001). Both PACS and SACS patients had more complex lesions than patients in stable CAD group (56.7% vs. 79.2% vs. 31.8%, respectively; P< 0.001). Overall, the independent predictors of plaque rupture were being in the group PACS (P< 0.001, OR 2.86; CI, 1.82-4.52 for complex lesions and P< 0.001, OR 3.43; CI, 2.1-5.6 for Ambrose's type II lesions) or SACS (P< 0.001, OR 8.71; CI, 5.15-14.73 for complex lesions and P< 0.001, OR 5.99; CI, 3.66-9.81 for Ambrose's type II lesions). Conclusions: Nearly 50% of patients with perioperative ACS have evidence of coronary plaque rupture, characterizing a type 1 myocardial infarction

Mediastinal histoplasmosis: report of the first two Brazilian cases of mediastinal granuloma Histoplasmose mediastinal: relato dos dois primeiros casos brasileiros de granuloma mediastinal

This report documents the first two Brazilian cases of mediastinal granuloma due to histoplasmosis, presenting selected aspects on the diagnosis. Tissue samples revealing histoplasmosis were obtained from each of the patients by mediastinoscopy and thoracotomy. In the second patient, a subcarinal calcified mass eroded into the bronchial tree, leading to secondary bilateral aspiration pneumonitis one week after thoracotomy. Although rare, histoplasmosis should be included in the differential diagnosis of mediastinal granuloma, specially if there are calcifications greater than 10 mm in dimension.<br>São relatados os dois primeiros casos de granuloma mediastinal por histoplasmose no Brasil, apresentando aspectos selecionados sobre dignóstico. O diagnóstico tecidual de histoplasmose foi obtido por mediastinoscopia e toracotomia, respectivamente. Em um paciente a massa calcificada subcarinal erodiu na árvore brônquica com pneumonite de aspiração bilateral uma semana após a toracotomia. Embora rara, histoplasmose deve ser incluída no diagnóstico diferencial de granuloma mediastinal especialmente com calcificação maior do que 10 mm de diâmetro