A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Expression of functional recombinant human factor IX in milk of mice

Human factor IX is synthesized in the liver and secreted in the blood, where it participates in a group of reactions involving coagulation factors and proteins that permit sanguinary coagulation. in this work two lines of transgenic mice were developed to express the FIX gene in the mammalian glands under control of milk beta-casein promoter. the founding females secreted the FIX in their milk (3% total soluble protein). the stable integration of transgene was confirmed by southern blot analysis. the presence of the FIX recombinant protein in the milk of transgenic females was confirmed by western blot and the clotting activity was revealed in blood-clotting assays. the coagulation activity in human blood treated with recombinant FIX increased while the time of coagulation decreased. Our results confirm the production of a large amount of recombinant biologically active FIX in the mammary gland of transgenic mice.Empresa Brasileira de Pesquisa Agropecuaria (Embrapa)Hospital de Apoio de BrasiliaUniversidade Federal de São PauloConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)International Hemophilia Training Center-World Federation of HemophiliaEmbrapa Recursos Genet & Biotecnol, BR-70770900 Brasilia, DF, BrazilUniv Brasilia, Dept Biol Celular, BR-70910900 Brasilia, DF, BrazilSGAIN, Hosp Apoio Brasilia, BR-70620000 Brasilia, DF, BrazilUniversidade Federal de São Paulo, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, BR-04023062 São Paulo, BrazilWeb of Scienc

Os relatos do Caminho-Morte: etnografia e tradução de poéticas ameríndias Tales of the Way of Death: ethnography and the translation of Amerindian poetry

O artigo trata de aspectos da etnografia e da tradução de poéticas ameríndias das terras baixas sul-americanas, em especial do povo Marubo (Vale do Javari, Amazonas). A partir de uma breve revisão de perspectivas teóricas centrais para a compreensão do assunto, busco argumentar que o trabalho de recriação tradutória de cantos e narrativas provenientes de performances orais deve ser realizado em conexão com o trabalho de tradução conceitual. Por fim, apresento a tradução bilíngue de um longo depoimento narrativo sobre o destino póstumo e a formação do Caminho dos Mortos ("Os relatos do Caminho-Morte"), oferecido pelo xamã marubo Armando Cherõpapa.<br>The article addresses aspects of the ethnography and the translation of the poetry of Amerindian peoples from the South American lowlands, particularly the Marubo (Javari valley, Amazon). I begin with a brief review of theoretical perspectives that are central to understanding the subject and go on to argue that the work of translational re-creation of songs and narratives derived from oral performances should be carried out in tandem with the work of conceptual translation. Finally, I provide a bilingual rendering of a long narrative testimony on posthumous fate and the formation of the Way of the Dead ("The Reports of the Death-Path"), as given by Marubo shaman Armando Cherõpapa