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Univ Fed Sao Paulo, Disciplina Pneumol, Sao Paulo, SP, BrazilDisciplina de Pneumologia, Universidade Federal de São Paulo, São Paulo (SP) BrasilWeb of Scienc

Who needs to be allocated in icu after thoracic surgery? An observational study

Background. The effective use of ICU care after lung resections has not been completely studied. The aims of this study were to identify predictive factors for effective use of ICU admission after lung resection and to develop a risk composite measure to predict its effective use. Methods. 120 adult patients undergoing elective lung resection were enrolled in an observational prospective cohort study. Preoperative evaluation and intraoperative assessment were recorded. In the postoperative period, patients were stratified into two groups according to the effective and ineffective use of ICU. The use of ICU care was considered effective if a patient experienced one or more of the following: maintenance of controlled ventilation or reintubationacute respiratory failurehemodynamic instability or shockand presence of intraoperative or postanesthesia complications. Results. Thirty patients met the criteria for effective use of ICU care. Logistic regression analysis identified three independent predictors of effective use of ICU care: surgery for bronchiectasis, pneumonectomy, and age >= 57 years. In the absence of any predictors the risk of effective need of ICU care was 6%. Risk increased to 25-30%, 66-71%, and 93% with the presence of one, two, or three predictors, respectively. Conclusion. ICU care is not routinely necessary for all patients undergoing lung resection.Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Capes)Respiratory Division, Universidade Federal de São Paulo (UNIFESP), 04023-062 São Paulo, SP, BrazilRespiratory Division, Universidade Federal de São Paulo (UNIFESP), 04023-062 São Paulo, SP, BrazilWeb of Scienc

Comparative study of prognostic factors among longer and shorter survival patients with bronchogenic carcinoma

Despite the improvements seen in the treatment of lung cancer, little has improved in the survival of these patients, and a great importance is attributed to the factors that have a role to play in such survival. Purpose: To check for possible prognostic factor differences in two populations of lung cancer patients, one of them with short survival (less than six months), and the other with longer survival (more than 24 months). Methods: From 1997 to 1999, 52 patients with histopathologic diagnosis of homogenous carcinoma were studied, and demographics, clinical parameters, smoking pattern, Karnofsky's index, disease staging, and laboratory dosing of lactic dehydrogenase, alkaline phosphatase, carcinoembryonic antigen, and calcium data were surveyed. Results: 29 patients had less than six month survival, and 23 had more than 24 month survival. The three most important factors for short survival were the low initial Karnofsky's index, loss of appetite, and high serum LDH levels. Conclusion: The three prognosis components are: current physical status, prior physical status, and current status of the disease.Apesar dos avanços no tratamento, há pouca melhora na sobrevida dos pacientes com câncer do pulmão. Atualmente, é importante o conhecimento dos fatores que intervêm na sobrevida. Objetivos: Verificar possíveis diferenças de fatores prognósticos em duas populações de pacientes com câncer de pulmão, uma com pequena sobrevida (menos de seis meses) e outra com maior sobrevida (acima de 24 meses). Métodos: De 1997 a 1999 foram estudados 52 pacientes com diagnóstico histopatológico de carcinoma homogênico, sendo colhidos dados demográficos, clínicos, paramétricos, hábitos tabágicos, índice de Karnofsky, estadiamento da doença e dosagem laboratorial de desidrogenase lática, fosfatase alcalina, antígeno carcinoembrionário e cálcio. Resultados: 29 pacientes tiveram sobrevida menor do que seis meses e 23, superior a 24 meses. Os três fatores mais importantes que influenciaram o tempo curto de sobrevida foram baixo índice de Karnofsky inicial, redução do apetite e alto nível sérico de DHL. Conclusão: Os três componentes do prognóstico são o estado físico atual, o estado físico prévio e o estado atual da doença.Universidade Federal de São Paulo (UNIFESP) Disciplina de PneumologiaUNIFESP, Disciplina de PneumologiaSciEL

A ANATOMIA HISTÓRICA DE GRAY: A REPRESENTAÇÃO DA ERA VITORIANA EM POOR THINGS, DE ALASDAIR GRAY

Poor Things (1992), de Alasdair Gray, apresenta uma releitura de Frankenstein, de Mary Shelley. Gray retoma a história de uma criatura trazida à vida por meio de um experimento científico em uma paródia que se passa na cidade escocesa de Glasgow, durante a Era Vitoriana. O objetivo deste trabalho é analisar a representação da Era Vitoriana no romance, enfocando principalmente questões sociais, políticas e econômicas. Além disso, pretende-se explorar a visão sobre a ciência na sociedade vitoriana, assim como o papel das mulheres nesse campo. Finalmente, será investigada a forma como a representação do século XIX contribui para a apresentação de críticas por parte de Gray sobre a época contemporânea.PALAVRAS-CHAVE: ficção escocesa; história; Alasdair Gray; Era Vitoriana

DEVERES E QUERERES: CONFLITOS TRÁGICOS EM 'FILOCTETES' E 'O ZOOLÓGICO DE VIDRO' | DUTIES AND DESIRES: TRAGIC CONFLICTS IN 'PHILOCTETES' AND 'THE GLASS MENAGERIE'

O objetivo deste trabalho é explorar a permanência de elementos trágicos no teatro contemporâneo, tendo como base as obras Filoctetes, de Sófocles, e O zoológico de vidro, de Tennessee Williams. Embora a produção da tragédia grega tenha se limitado a um curto período da Antiguidade clássica, elementos dessa forma artística ainda perduram e têm influenciado obras teatrais de diversos lugares até os dias de hoje. As duas peças analisadas compartilham a temática de um dilema ético, retratando um conflito entre a vontade e o dever que se reflete nos embates entre os personagens. Abstract: This article explores the permanence of tragic elements in contemporary drama by focussing on Sophocles's Philoctetes and Tennessee Williams's The Glass Menagerie. Although the production of Greek tragedies was limited to a short period of classical antiquity, some elements of this artistic form endure and have influenced drama in various places up until the current day. Both plays thematize an ethical dilemma by portraying a conflict between one's will and one’s sense of duty, which is reflected in the verbal disputes between characters

“THE PRIME O’ OUR LAND LIE CAULD IN THE CLAY”: WORLD WAR ONE IN LEWIS GRASSIC GIBBON’S SUNSET SONG

This paper aims at analyzing how Lewis Grassic Gibbon portrays World War One in his novel Sunset Song (1932). In the narrative, Gibbon depicts the influence of the war on the fictional village of Kinraddie, which functions as a representation of the Northeast of Scotland. Although the conflict seems distant from the characters at first, its impact reaches the rural community, mainly in the form of propaganda and loss. The war brings drastic changes to the village, with economic transformations and the end of the peasants’ traditional way of life

Reproducibility of the Brazilian Portuguese version of the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire used in conjunction with its lung cancer-specific module

OBJECTIVE: The assessment of the quality of life in patients with lung cancer has become one of the main goals in current clinical trials. To assess the quality of life of these patients, the most widely used instrument is the 30-item European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) in conjunction with its supplemental 13-item lung cancer-specific module (QLQ-LC13). The objective of this study was to assess the reproducibility of the Brazilian Portuguese version of these questionnaires. METHODS: A prospective study involving 30 stable outpatients with lung cancer who completed the instruments on the first day of the study and two weeks later. RESULTS: The test-retest reproducibility using the intraclass correlation coefficient for the EORTC QLQ-C30 and the QLQ-LC13 ranged from 0.64 to 1.00 and from 0.64 to 0.95, respectively. No correlations were found between the domains of the instruments and clinical parameters. CONCLUSIONS: Our findings show that these instruments were reproducible in this sample of patients with lung cancer in Brazil.OBJETIVO: A avaliação da qualidade de vida em pacientes com câncer de pulmão tem se tornado um dos principais objetivos em ensaios clínicos atuais. Para avaliar a qualidade de vida desses pacientes, o instrumento mais utilizado é o 36-item European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) em conjunto com seu módulo específico para câncer de pulmão com 13 itens (QLQ-LC13). O objetivo deste estudo foi avaliar a reprodutibilidade da versão em português do Brasil desses questionários. MÉTODOS: Estudo prospectivo com 30 pacientes ambulatoriais estáveis com câncer de pulmão, os quais completaram os instrumentos no primeiro dia do estudo e duas semanas depois. RESULTADOS: A reprodutibilidade teste-reteste através do coeficiente de correlação intraclasse para o EORTC QLQ-C30 e o QLQ-LC13 variou de 0,64 a 1,00 e de 0,64 a 0,95, respectivamente. Não houve correlações entre os domínios dos instrumentos e os parâmetros clínicos. CONCLUSÕES: Estes achados demonstram a reprodutibilidade dos instrumentos utilizados nesta amostra de pacientes com câncer de pulmão no Brasil.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Ambulatório de OncopneumologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de MedicinaUNIFESP, EPM, Ambulatório de OncopneumologiaUNIFESP, EPM, Depto. de MedicinaSciEL