O Programa de Cidades Históricas, o turismo e a "viabilidade econômica" do patrimônio (1973-1979)

Created by the President's Office of Planning (Seplan) in 1973, the Program for the Revitalization of historical cities (PCH) had as its main goal the preservation and the economical development of some of Brazil's heritage urban complexes. The actions carried out by this program will be analyzed here as part of a broader phenomenon in the history of Brazilian cultural heritage preservation, namely an encouragement to transform preserved sites into tourist attractions. In order to do so, I analyze documents, lectures, and speeches delivered by some of the essential players in the activities of heritage preservation and the promotion tourism, in addition to periodicals and legislation from the time period.Criado pela Secretaria de Planejamento da Presidência da República (Seplan), no ano de 1973, o Programa de Revitalização das Cidades Históricas (PCH) tinha como meta principal a preservação e o desenvolvimento econômico de alguns dos conjuntos urbanos brasileiros patrimonializados. As ações desenvolvidas por esse programa serão aqui analisadas como parte de um fenômeno mais amplo da história da preservação do patrimônio cultural brasileiro, o estímulo à transformação dos sítios preservados em atrações turísticas. Para tanto, foram analisados documentos, palestras e discursos de personagens fundamentais para as atividades de salvaguarda do patrimônio e de promoção do turismo, além de periódicos e legislação do período

ANÁLISE DAS TÉCNICAS CIRÚRGICAS PARA REPARAÇÃO E RECONSTRUÇÃO DE PACIENTES COM SÍNDROME DE FOURNIER

Fournier syndrome, also known as Fournier gangrene, is a rare and potentially fatal disease that affects the soft tissues of the genital and perineal region. It is usually caused by a serious bacterial infection, often from a nearby source such as the urinary tract, intestines or skin. This bacterial infection spreads rapidly through the subcutaneous tissue, resulting in inflammation, necrosis (tissue death), and possible sepsis (generalized infection). The objective of this article was to understand the surgical procedures performed on patients with this syndrome and to understand how the process of reconstruction and repair of these conditions occurs. After surgery to treat Fournier syndrome, patients can experience a number of post-operative benefits. This includes removing the infection, relieving symptoms such as pain and swelling, preventing serious complications such as sepsis, promoting proper tissue healing, and improving overall quality of life. Successful recovery from surgery is critical to ensuring these benefits and allowing patients to resume their daily activities.A síndrome de Fournier, também conhecida como gangrena de Fournier, é uma doença rara e potencialmente fatal que afeta os tecidos moles da região genital e perineal. Geralmente é causada por uma infecção bacteriana grave, muitas vezes proveniente de uma fonte próxima, como o trato urinário, intestinos ou pele. Esta infecção bacteriana se espalha rapidamente pelo tecido subcutâneo, resultando em inflamação, necrose (morte do tecido) e possível sepse (infecção generalizada). O objetivo deste artigo foi compreender os procedimentos cirúrgicos realizados em pacientes com essa síndrome e entender como ocorre o processo de reconstrução e reparação dessas condições. Após a cirurgia para tratar a síndrome de Fournier, os pacientes podem experimentar uma série de benefícios pós-operatórios. Isso inclui a remoção da infecção, alívio dos sintomas como dor e inchaço, prevenção de complicações graves como sepse, promoção da cicatrização adequada dos tecidos e melhoria geral da qualidade de vida. A recuperação bem-sucedida da cirurgia é fundamental para garantir esses benefícios e permitir que os pacientes retomem suas atividades diárias

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Arte e Arquitetura - A Obra de Talha em Minas Gerais

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Fome Zero: uma política social em questão

Este texto apresenta algumas reflexões sobre o Programa do Governo Fedreral brasileiro: Fome Zero - Uma Proposta de Política de Segurança Alimentar para o Brasil, buscando apresentá-lo ao leitor, assim como problematizá-lo do ponto de vista político face a questão social no país, no contexto do ideário neoliberal com suas políticas sociais focalizadas e seletivas.This text present some reflections on Brazilian Central Government Program Zero Hunger - One Proposal of Food Security Policy for Brazil, in both introduces the program and discusses it from a political point of view given country's social issue in the country, within the neo-liberal context with then focused selective social politicies

Monumento e sombra na Brasília de Marcel Gautherot

Em Brasília, a objetividade e a clareza das fotografias de Marcel Gautherot, quando combinadas à presença marcante de sombras densas e perspectivas agudas, as tornam semelhantes, do ponto de vista formal, às obras iniciais do pintor italiano Giorgio de Chirico. Partindo dessa comparação, o artigo coteja a perspectiva do fotógrafo com os propósitos de Lucio Costa e Oscar Niemeyer, e com interpretações literárias e críticas que descrevem Brasília como uma paisagem "metafísica" e "surrealista".<br>The objectivity and clarity of Marcel Gautherot's photographs of Brasília, combined to the remarkable presence of thick shadows and sharp perspectives, bring them close, from a formal point of view, to the early works of the Italian painter Giorgio de Chirico. The article measures up Gautherot's artistic perspective against the intentions of architects Lucio Costa and Oscar Niemeyer and the literary and critical interpretations that describe the city as a "methaphysical" and "surrealist" landscape