ABSTRACT
OBJECTIVE: This article characterize the contributions of Peter Safar and Vladimir Negovsky to the field of resuscitation and critical medicine during the 20th century and the dawn of the 21st century with the purpouse to correlate the discoveries and developments of each one, with their life stories and with the historical moments throughout the 20th century. MATERIALS AND METHODS: A review of literature on the subject was conducted, in which primary and secondary sources on the life and scientific and academic production of Vladimir Negovsky and Peter Safar were searched in online databases, in English as well as Spanish. RESULTS: Peter Safar and Vladimir Negovsky, although they had two very different life histories and developed their academic contributions in opposite political contexts, this did not prevent each of them from laying the foundations of cardiopulmonary resuscitation, both in the concepts and the physiopathological understanding of the damage processes, as well as the procedures to act in a timely manner, minimizing them. They also contributed to critical medicine, and to the formation of intensive care units. This work aims to show how a field of knowledge is based on collective work, as the discovery does not depend on a single character, but on a social, historical process, which is also based on the knowledge and elements developed by others.
OBJETIVO: Con este artículo se caracterizan los aportes de Peter Safar y Vladimir Negovsky en el campo de la reanimatología y de la medicina crítica durante el siglo XX y albores del siglo XXI, y se correlacionan sus investigaciones y descubrimientos con sus historias de vida y momentos compartidos. MATERIALES Y MÉTODOS: Se realizó una revisión de literatura sobre el tema, mediante la búsqueda de fuentes primarias y secundarias sobre la vida y producción científica y académica de Vladimir Negovsky y Peter Safar, en bases de datos en línea, en inglés y en español. RESULTADOS: Peter Safar y Vladimir Negovsky, pese a tener dos historias de vida muy distintas y desarrollar sus aportes académicos en contextos políticos diferentes, coincidieron en un campo de la ciencia que no les impidió que cada uno sentara las bases de la reanimación cardio cerebro pulmonar, tanto en los conceptos y en la comprensión fisiopatológica de los procesos de lesión, como en los procedimientos para prevenir la muerte y minimizar los efectos del proceso isquemia/reperfusión. Así mismo, concibieron y desarrollaron las unidades de medicina crítica y cuidado intensivo, el sistema integral para el transporte de los pacientes y el campo vasto en la formación de posgrados como anestesiología y medicina crítica. CONCLUSIÓN: Definitivamente la ciencia no tiene fronteras políticas y se fundamenta en el trabajo colectivo. Estos dos personajes vivieron tiempos políticos y sociales adversos, unieron lazos de amistad y compartieron experiencias para producir cambios históricos en la ciencia de la reanimación conocida como Reanimatología.
Subject(s)
History, 20th Century , Resuscitation/history , Anesthesiology , Austria , UkraineABSTRACT
Klebsiella pneumoniae produtoras de ESBL estão frequentementeenvolvidas em infecções relacionadas à assistência à saúde (IRAS). ESBLsão capazes de hidrolisar todas as penicilinas, cefalosporinas de amploespectro e aztreonam, sendo os carbapenêmicos o fármaco de escolha parainfecções por microrganismos produtores de ESBL. Porém, Klebsiella spp.produtoras de carbapenemases tem se tornado cada vez mais frequentes.Além disso, já foi descrita, no Brasil, K. pneumoniae produtoras da 16SRMTase, RmtD, uma enzima que confere resistência em nível elevado paratodos os aminoglicosídeos, tornando as opções terapêuticas bastantelimitadas. O objetivo desse trabalho foi caracterizar genes de resistênciaresponsáveis pela produção de ESBL, carbapenemases e 16S RMTases eseu contexto genético em Klebsiella spp. produtoras de KPC isoladas deamostras clínicas provenientes de hospitais do Estado de São Paulo. Cemcepas de Klebsiella spp., isoladas de 2009 a 2011, previamente confirmadascomo produtoras de KPC, foram submetidas a PCR para detecção de blaSHV,blaTEM, blaCTX-M, blaCTX-M-15, blaCTX-M-2, blaCTX-M-8, blaGES-1, blaVIM, blaIMP,blaSPM, blaNDM, blaOXA- 48, armA, rmtA, rmtB rmtC e rmtD e sequenciamentode DNA. Para as cepas negativas para os genes blaSHV foram realizadas aidentificação de Klebsiella spp.a partir de provas bioquímicas, PCR Multiplexpara detecção dos genes blaSHV, blaLEN e blaOKP e sequenciamento dosgenes 16S rRNA e rpoB. Experimentos de transformação e clonagem foramutilizados para a identificação de um novo gene de resistência aosaminoglicosídeos e plasmídeos carreadores de genes de 16S RMTasesforam sequenciados. As cepas apresentaram resistência em nível elevadopara a maioria dos antibióticos testados...
Klebsiella pneumoniae producing ESBLs are frequently involved in hospitalinfections in intensive care unit (ICU). ESBLs are capable of hydrolyzing allpenicillins, cephalosporins and aztreonam. Carbapenems are considered theagents of choice for treatment of infections caused by ESBL-producingmicroorganisms. However, Klebsiella spp. producing carbapenemases hasbecome more frequent. Moreover, K. pneumoniae producing 16S RMTase,RmtD, which confers high level resistance to aminoglycosides, have beendescribed in Brazil, limiting the therapeutical options. The aim of this studywas to characterize resistance genes responsible to the production of ESBL,carbapenemases and 16S RMTases and their genetic context in Klebsiellaspp. producing KPC from hospitals at Sao Paulo State. A hundred K.pneumoniae strains isolated in the period of 2009 and 2011 and previouslyconfirmed as KPC producers were subjected to PCR for the detection ofblaSHV, blaTEM, blaCTX-M, blaCTX-M-15, blaCTX-M-2, blaCTX-M-8, blaGES-1, blaVIM,blaIMP, blaSPM, blaNDM, blaOXA-48, armA, rmtA, rmtB rmtC e rmtD and DNAsequencing. Identification of Klebsiella spp. by biochemical tests, detection ofblaSHV, blaLEN e blaOKP genes by Multiplex PCR and 16S rRNA gene and rpoBsequencing was performed on blaSHV negative isolates. Transformation andgenomic cloning were performed for the identification of a newaminoglycosides resistance gene. Sequencing of plasmids carrying 16SRMTases genes was performed. All strains showed high resistance levels formost antibiotics tested...