Outcomes of cancer patients admitted to Brazilian intensive care units with severe acute kidney injury Ddesfecho de pacientes com câncer internados em unidades de terapia intensiva brasileiras com lesão renal aguda ABSTRACT Objectives: Critically ill cancer patients are at increased risk for acute kidney injury, but studies on these patients are scarce and were all single centered conducted in specialized intensive care units. The objective was to evaluate the characteristics and outcomes in a prospective cohort of cancer patients admitted to several intensive care units with acute kidney injury. Methods: Prospective multicenter cohort study conducted in intensive care units from 28 hospitals in Brazil over a two-month period. Univariate and multivariate logistic regression were used to identify factors associated with hospital mortality. Results: Out of all 717 intensive care unit admissions, 87 (12%) had acute kidney injury and 36% of them received renal replacement therapy. Kidney injury developed more frequently in patients with hematological malignancies than in patients with solid tumors (26% vs. 11%, P=0.003). Ischemia/shock (76%) and sepsis (67%) were the main contributing factor for and kidney injury was multifactorial in 79% of the patients. Hospital mortality was 71%. General and renal-specific severity-of-illness scores were inaccurate in predicting outcomes for these patients. In a multivariate analysis, length of hospital stay prior to intensive care unit, acute organ dysfunctions, need for mechanical ventilation and a poor performance status were associated with increased mortality. Moreover, cancer-related characteristics were not associated with outcomes. Conclusions: The present study demonstrates that intensive care units admission and advanced life-support should be considered in selected critically ill cancer patients with kidney injury.
Resumo O artigo se propõe a apresentar dois eixos comuns a dois autores paradigmáticos da interpretação da formação social brasileira: Oliveira Vianna e Gilberto Freyre. De um lado, evidencia-se os caminhos que buscaram para velar e diluir o antagonismo entre dominados e dominadores, o que passou pela modernização do discurso conservador que acompanhou a amplitude e a intensidade das tensões sociais. De outro lado, destaca-se as saídas que estes autores sugeriram para acomodar as crescentes tensões entre as oligarquias regionais. Para tanto, mostramos que ambos idealizaram o passado colonial com o intuito de forjar uma narrativa sobre a cultura nacional que legitimasse um equilíbrio mais estável das estruturas de poder no Brasil, coincidindo com suas defesas da segregação social.
Roberto de Oliveira Campos foi personagem de destaque no Brasil durante a segunda metade do século XX. Ocupou cargos importantes em instituições públicas como BNDE e Itamaraty, foi ministro do planejamento e senador. O intuito deste artigo é apresentar a dimensão conservadora do liberal-desenvolvimentismo de Roberto Campos. Nossa hipótese é a de que sua visão de planejamento e de intervenção do Estado era coerente com o uso que o autor fazia da ortodoxia econômica. Para tanto, apresentaremos uma interpretação das opiniões do autor utilizando textos produzidos por ele (ênfase ao período de 1955 a 1964) e textos de outros autores que procuraram analisar o pensamento de Roberto Campos.
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