[2,6-Bis(dimethyl­amino­meth­yl)phen­yl]selenium bromide monohydrate

In the title hydrated molecular salt, C12H19N2Se+·Br−·H2O, the two independent bromide anions lie on a twofold rotation axis. Strong intra­molecular N→Se inter­actions [2.185 (3) and 2.181 (3) Å] are established by both N atoms of the organic group in the cation, in trans positions to each other, with an N—Se—N angle of 161.6 (1)°, resulting in a T-shaped (C,N,N′)Se core. In the crystal, dimeric associations are formed by Br⋯Se [3.662 (2) Å] and Br⋯H inter­actions [2.56 (6) and 2.63 (7) Å] involving two bromide anions, two cations and two water mol­ecules

Juridical perspectives of interruption of pregnancy with zika virus infection regarding medical, emotional and social consequences

 Uganda and isolated in humans in 1952 in the same country. Up to 2007 there were few cases of human infection in African and Asian countries. The first outbreak of the Zika virus occurred in Brazil in 2015, becoming a serious public health problem due to the increase in the number of cases of microcephaly in infected pregnant women. Objective: To describe the legal abortion at Zika virus infection during pregnancy regarding medical, emotional and social consequences. perspectives of abortion for the pregnant woman with Zika virus regarding the medical, emotional and social consequences. Methods: This is a documentary study based on documents about abortion and its outcomes in Brazil. Technical norms, textbooks, indexed articles of Scopus and PubMed, documents extracted from international human rights treaties and conventions, and legal documents on the subject were used. It was decided to direct the text based on the experiences of each theme on abortion and its outcomes in Brazil, with a synthesis of the current scenario. Results: Recognizing the exceptional nature of this situation, it is sought to confer an interpretation according to the Constitution and Article 128 of the Criminal Code, based on an analogical application, which seeks to protect the physical and mental health of women infected by the Zika virus. It is possible to qualify the practice of abortion in these circumstances as atypical conduct by the state of necessity, excluding the unlawfulness by comparing with articles 23, I and 24 of the Penal Code. Conclusion: Authorizing the termination of pregnancy after diagnosis of the virus Zika guarantees women the free exercise of their reproductive rights, which is not confused with state imposition of abortion or eugenic practice.  Introduction: The Zika virus was identified in 1947 in Rhesus monkeys in the Republic of Uganda and isolated in humans in 1952 in the same country. Up to 2007 there were few cases of human infection in African and Asian countries. The first outbreak of the Zika virus occurred in Brazil in 2015, becoming a serious public health problem due to the increase in the number of cases of microcephaly in infected pregnant women. Objective: To describe the legal abortion at Zika virus infection during pregnancy regarding medical, emotional and social consequences. perspectives of abortion for the pregnant woman with Zika virus regarding the medical, emotional and social consequences. Methods: This is a documentary study based on documents about abortion and its outcomes in Brazil. Technical norms, textbooks, indexed articles of Scopus and PubMed, documents extracted from international human rights treaties and conventions, and legal documents on the subject were used. It was decided to direct the text based on the experiences of each theme on abortion and its outcomes in Brazil, with a synthesis of the current scenario.  Results: Recognizing the exceptional nature of this situation, it is sought to confer an interpretation according to the Constitution and Article 128 of the Criminal Code, based on an analogical application, which seeks to protect the physical and mental health of women infected by the Zika virus. It is possible to qualify the practice of abortion in these circumstances as atypical conduct by the state of necessity, excluding the unlawfulness by comparing with articles 23, I and 24 of the Penal Code.  Conclusion: Authorizing the termination of pregnancy after diagnosis of the virus Zika guarantees women the free exercise of their reproductive rights, which is not confused with state imposition of abortion or eugenic practice.

Comida de Rua na Cidade de São Paulo, SP: Uma Breve Descrição

<p class="MsoNormal" style="text-align: justify; text-justify: inter-ideograph;"><span style="font-size: 11.0pt; line-height: 150%; font-family: &quot;Calibri&quot;,&quot;sans-serif&quot;; mso-fareast-font-family: Calibri; mso-bidi-font-family: Arial; color: #4f6228; mso-ansi-language: PT-BR; mso-fareast-language: AR-SA; mso-bidi-language: AR-SA;">O presente trabalho discute a comida de rua sob diferentes aspectos, entre eles, suas possibilidades econ&ocirc;micas e culturais, uma vez que est&aacute; associada est&aacute; associada a alimentos popularmente aceitos e com pre&ccedil;os acess&iacute;veis. Para tanto, foram pesquisados locais na cidade de S&atilde;o Paulo, SP, com grande movimenta&ccedil;&atilde;o de pessoas, tais como esta&ccedil;&otilde;es de metro, terminais de &ocirc;nibus, pra&ccedil;as, parques e redondezas de hospitais e que apresentassem esse tipo de com&eacute;rcio. Neles foram entrevistados vendedores de comida de rua buscando compreender as raz&otilde;es para o exerc&iacute;cio da atividade, quais as suas condi&ccedil;&otilde;es de trabalho, quais desafios enfrentados. Foram pesquisadas, tamb&eacute;m, solu&ccedil;&otilde;es aplicadas em outras cidades, onde a legaliza&ccedil;&atilde;o da atividade significou incremento da atividade econ&ocirc;mica.</span></p

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates