11 research outputs found

    A Santa Casa da Misericórdia do Rio de Janeiro nos séculos XVI a XIX Rio de Janeiro's Holy House of Mercy from the 16th to the 19th centuries

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    Este artigo tem como objetivo apontar as principais transformações ocorridas no espaço e nos prédios da irmandade da Santa Casa da Misericórdia do Rio de Janeiro da sua fundação até o século XIX, relacionando-as a alguns dos possíveis significados sociais dessas mudanças.<br>The present article aims at showing the main changes taken place in the buildings and the surrounding areas of Rio de Janeiro's Holy House of Mercy from its foundation to the 19th century, relating them to some of the possible social meanings of such changes

    Religiosidade e suas manifestações no espaço urbano de Salvador

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    O Brasil foi descoberto e ocupado sob a égide do cristianismo, reforçado pelo movimento da Contrarreforma Católica. Promovida pela Igreja Católica Apostólica Romana, opunha-se à Reforma Protestante, reafirmava o uso das imagens e ditava uma série de normas a serem seguidas pelos fiéis, expressas nas Constituições Primeiras do Arcebispado da Bahia, de 1707. A Contrarreforma enfatizou a importância das manifestações públicas de fé, a maior participação da população nas coisas da Igreja. As procissões foram o exemplo típico dessas manifestações, promovidas, especialmente, pelas Irmandades e/ou ordens terceiras leigas. Nas procissões, ou cenários públicos de fé, as imagens das figuras santas e festas barrocas tiveram um papel primordial. Dentre elas, se resgatou um uso medieval das marionetes - acrescido da dramaticidade tirada do teatro de ópera -, transformadas em imagens de roca e de vestir. Estas constituíram, sobretudo no século XVIII, instrumentos eficientes para despertar a fé de leigos e religiosos. As ruas e praças - do antigo centro histórico da cidade do Salvador - serviram de grande cenário, no qual evoluía a maior parte das procissões. Destacavam-se as procissões dos Mistérios da Paixão, de Corpus Christi ou cenas correlatas, em datas fixas ou móveis, ao lado da multiplicação das representações da Santíssima Trindade, especialmente a cruz ou o Cristo Crucificado

    ALMA PIEDOSA, CORPO SÃO: O PAPEL DA DEVOÇÃO NA CURA DAS DOENÇAS NO BRASIL COLONIAL

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    Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial

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    IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022
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