O Sistema CEP/Conep e as pesquisas em ciências humanas e sociais: outras éticas, outras semânticas / The CEP/Conep System and research in human and social sciences: other ethics, other semantics / El Sistema CEP/Conep y las investigaciones en ciencias humanas y sociales: otras éticas, otras semánticas

Esta nota de conjuntura tem o objetivo de evidenciar algumas questões importantes sobre como se configura o Sistema CEP/Conep e as implicações dessa regulação no campo das ciências humanas e sociais. Primeiro, explicito o que consiste esse sistema para, em seguida, esboçar as controvérsias provenientes desse controle, que tem como aspecto central, ser regido pelo que a análise do Estado e sua organização burocrática chamam de lógica cartorial

This note aims to highlight some important questions about the configuration of the CEP/CONEP System and the implications of this regulation in the field of human and social sciences. First, I will explain what is this system, and then I will outline the controversies resulting from this control, which has as central aspect, to be governed by the so-called notarial logic, according to the analysis of the State and its bureaucratic organization

Esta nota de coyuntura tiene como objetivo poner en evidencia algunas cuestiones importantes sobre como es configurado el Sistema CEP/CONEP y las implicaciones de esta normativa para el campo de las ciencias humanas y sociales. Primero explicaré en que consiste ese sistema y, en seguida, esbozaré las controversias que surgen de ese control, que tiene como aspecto central ser regido por lo que el análisis del Estado y su organización burocrática denominan lógica notarial

Clinical controversy and research thoughts on lymphadenectomy of gastric cancer / 中华胃肠外科杂志

Lymphadenectomy, as one of the controversial foci in clinic, is an extremely important part of radical surgery for gastric cancer. So far, the preliminary consensus has been reached on the scope and number of lymph node dissection, based on the etiological mechanism, disease progression, diagnosis and treatment prognosis of gastric cancer. At present, some clinical issues of lymphadenectomy in curative gastrectomy are still need to be addressed. Firstly, standardized procedure in lymph node dissection for gastric cancer is a prerequisite to decrease the incidence of postoperative complications and to improve the prognosis of gastric cancer patients. Furthermore, the plausible treatment strategy in perioperative phase is also deemed as the other key method to offer a benefit of survival rate for advanced stage patients after lymphadenectomy. Last but not least, the technologies for enhancement the prediction accuracy of lymph node metastasis preoperatively or intraoperatively should be worthy in-depth study.

Pluralismo e dissensão: o magnetismo animal em debate no Portugal de meados de Oitocentos / Pluralism and dissent: animal magnetism in debate in Portugal in the mid-nineteenth century

Resumo Em meados do século XIX, em Portugal, discutiu-se, com relativa intensidade, medicina e sistemas médicos alternativos e complementares, quer na imprensa periódica especializada, quer em alguns jornais de cunho generalista. Desses sistemas médicos, que emergiram com vigor no Portugal do Romantismo, um parece ter gerado especial debate: o magnetismo animal. O presente artigo, em perspectiva comparada, visa resgatar o alcance histórico desse sistema clínico, analisando a curiosidade popular e especializada em torno dessa terapia. Finalmente, contextualizar-se-ão as querelas literárias e institucionais que o magnetismo animal desencadeou no período.

Abstract In mid-nineteenth century Portugal, alternative and complementary medical systems and medicine were discussed with relative intensity in the specialized press and in some mainstream newspapers. One of these medical systems, which gained ground during Portugal's romantic era, seems to have sparked particular debate: animal magnetism. A comparative approach is taken to review the historical scope of this healing system, analyzing popular and specialized curiosity regarding this therapy. Finally, the literary and institutional disagreements that animal magnetism unleashed during the period are contextualized.

Current consensus and controversy in neoadjuvant therapy for pancreatic cancer / 中华外科杂志

Pancreatic cancer is malignant and has a poor prognosis.At present, the treatment mode has changed from "Surgery First" to systemic therapy under multi-disciplinary team, but surgical resection is still the only way to cure pancreatic cancer. In systemic treatment of pancreatic cancer, the effect of postoperative adjuvant therapy is significant, and preoperative neoadjuvant therapy has gradually attracted widespread attention. Neoadjuvant therapy can improve the rate of R0 resection in patients with pancreatic cancer.There is a consensus on neoadjuvant therapy for patients who with borderline resectable and locally advanced, but for the patients who with resectable remains controversial.

Current consensus and controversy in neoadjuvant therapy for pancreatic cancer / 中华外科杂志

Pancreatic cancer is malignant and has a poor prognosis.At present, the treatment mode has changed from "Surgery First" to systemic therapy under multi-disciplinary team, but surgical resection is still the only way to cure pancreatic cancer. In systemic treatment of pancreatic cancer, the effect of postoperative adjuvant therapy is significant, and preoperative neoadjuvant therapy has gradually attracted widespread attention. Neoadjuvant therapy can improve the rate of R0 resection in patients with pancreatic cancer.There is a consensus on neoadjuvant therapy for patients who with borderline resectable and locally advanced, but for the patients who with resectable remains controversial.

Clasificación de las miocardiopatías. Un objetivo, muchas propuestas / Classification of cardiomyopathies. One goal, many proposals / Classificação das cardiomiopatias. Um objetivo, muitas propostas

Resumen: Resulta innegable la importancia de la patología del miocardio como causa de enfermedad y muerte de origen cardíaco. Actualmente, cerca de la mitad de los pacientes que fallecen súbitamente en la niñez y la adolescencia o que reciben un trasplante cardíaco están afectados por una miocardiopatía. No obstante, las enfermedades del miocardio han constituido históricamente un grupo desconcertante, tanto en relación con su origen como en su sistematización nosológica. Identificadas inicialmente con patología inflamatoria y concebidas luego como desórdenes de causa desconocida o manifestación de múltiples enfermedades sistémicas, las miocardiopatías fueron más tarde categorizadas en ciertos patrones de presentación morfológico-funcional y objeto en los últimos 30 años de intensa investigación en el ámbito de las ciencias básicas, que permitió reconocer el origen genético de muchas de estas entidades. Esa nueva información sustentó, ya en este siglo, iniciativas de clasificación por parte de la American Heart Association (AHA) y la European Society of Cardiology (ESC), que a pesar de representar un valioso avance con respecto a intentos previos, muestran áreas de incertidumbre y discrepancias sustantivas que son objeto de debate. Una propuesta más reciente, la clasificación MOGE(S), pone énfasis en la creciente información aportada por la genética molecular y en la implementación de una nosología descriptiva fenotipo-genotipo que posibilite la máxima precisión en la nomenclatura y el diagnóstico clínico. En este capítulo se revisa la evolución de los conceptos que sustentaron las sucesivas clasificaciones publicadas y se analizan las diferencias entre las propuestas de la AHA y la ESC, concluyendo en la necesidad de un abordaje conjunto del problema en pos de una nomenclatura y un ordenamiento taxonómico coherentes y universalmente compartidos.

Summary: The importance of myocardial pathology as a cause of illness and death from cardiac origin is undeniable. Currently, almost half of the patients who die suddenly in childhood and adolescence or receive a heart transplant are affected by cardiomyopathy. However, myocardial diseases have historically constituted a perplexing group, both in relation to their origin and in their nosological systematization. Initially identified with inflammatory pathology, and then conceived as disorders of unknown cause or as a manifestation of multiple systemic diseases, cardiomyopathies were later categorized in certain patterns of morphological and functional presentation, and were object in the last 30 years of intense research in the field of basic sciences, which allowed to recognize the genetic origin of many of these entities. Already in this century, that new information sustained classification initiatives by the American Heart Association (AHA) and the European Society of Cardiology (ESC), which despite being a valuable improvement over previous attempts, exhibit areas of uncertainty and substantive differences that are subject of debate. A more recent proposal, the MOGE (S) classification, stresses on the growing information provided by molecular genetics and on the implementation of a phenotype-genotype descriptive nosology that enables maximum accuracy in nomenclature and clinical diagnosis. This chapter reviews the evolution of the concepts that sustained the successive classifications published, and analyzes the discrepancies between the proposals of the AHA and the ESC, concluding on the need for a joint approach to the problem in order to generate a coherent and universally shared taxonomic arrangement and nomenclature.

Resumo: A importância da patologia miocárdica como causa de doença e morte de origem cardíaca é inegável. Atualmente, cerca de metade dos pacientes que morrem subitamente na infância e adolescência ou que recebem um transplante cardíaco são afetados pela cardiomiopatia. No entanto, historicamente, as doenças do miocárdio têm sido um grupo desconcertante, tanto em relação à sua origem quanto em sua sistematização nosológica. Inicialmente identificadas com patologia inflamatória e, em seguida concebidas como doenças de causa desconhecida ou manifestação de muitas doenças sistêmicas, as cardiomiopatias foram posteriormente categorizadas em certos padrões de apresentação morfofuncional e objeto nos últimos 30 anos de intensa investigação no campo das ciências básicas, o que permitiu reconhecer a origem genética de muitas dessas entidades. Essa nova informação sustentou, já neste século, iniciativas de classificação da American Heart Association (AHA) e da European Society of Cardiology (ESC), que apesar de representar um valioso avanço sobre as tentativas anteriores mostram áreas de incerteza e discrepâncias substanciais que são objeto de debate. Uma proposta mais recente, a classificação MOGE (S), enfatiza a crescente informação fornecida pela genética molecular e a aplicação de uma nosología descritiva fenótipo-genótipo, permitindo a maior precisão no diagnóstico clínico e nomenclatura. Neste capítulo é revista a evolução dos conceitos que sustentaram as classificações sucessivas publicadas, e as diferenças entre as propostas da AHA e da ESC são analisadas, concluindo na necessidade de um abordagem conjunto do problema em busca de uma nomenclatura e ordem taxonômica coerente e universalmente compartilhada.

Controversy and agreement of lymph node dissection in radical resection for esophageal cancer / 中华消化外科杂志

Currently esophagectomy is still the main procedure for the treatment of esophageal cancer.Optimal lymph node dissection in esophagectomy is the most important link.However,the issues about lymphadenectomy have always been controversial,including two-field or three-field dissection,numbers of harvest lymph nodes and sentinel lymph node,while some consensuses on lymph node dissection are formed in clinical practice under controversy.

Current status and controversy of neoadjuvant therapy for esophageal squamous cell carcinoma / 中国肿瘤临床

Surgery is the first choice of treatment for resectable esophageal squamous cell carcinoma. However, for locally advanced patients, the treatment of esophageal cancer requires a more multidisciplinary, comprehensive approach. Nevertheless, there is no unified standard that defines the best comprehensive treatment strategy for esophageal cancer. In recent years, neoadjuvant therapy has been widely considered as the best treatment by practitioners, but there are still many controversies, including those related to the selection of a neoadjuvant therapy scheme, timing of surgery after neoadjuvant therapy, choice of postoperative adjuvant therapy after neoadjuvant therapy, choice of neoadjuvant and adjuvant therapy, and sensitivity testing of neoadjuvant therapy. In this paper, the present situation and controversies regarding the application of neoadjuvant therapy for esophageal squamous cell carcinoma are reviewed systematically.

Controversies and surgical techniques in the laparoscopic radical resection for right colon cancer / 中华消化外科杂志

Right colon cancer is a kind of clinically common colorectal cancer.Surgical resection is the main treatment and the only curative method for patients.Improvement of surgical methods in recent years is one of the hotspots in the surgical treatment of colorectal cancer.There are controversies in laparoscopic surgery or traditional open surgery,intestine resection extent,D3 radical surgery or complete mesocolic excision,selective arterial guidance or venous guidance,pyloric lymph nodes (No.6 group lymph nodes) dissection,and most of the issues are currently lacking of prospectively randomized controlled trials.Therefore,this article discusses the above problems.At the same time,in view of the complicated operation of right hemicolectomy,and the greater risk of surgery,the author consulted the relevant literature and combined his clinical experience to introduce the key techniques of the operation.

Review and forecast of critical care medicine in 2018 / 中华危重病急救医学

In 2018,a bunch of considerable positive progresses have been presented,including a revised "hour-1 bundle" introduced by international guideline for management of sepsis and septic shock,trans-pulmonary pressure monitoring via esophageal manometry in acute respiratory distress syndrome (ARDS) models,successful trials for new antibiotics,angiotensin Ⅱ in patients with vasodilatory shock and renal replacement therapy,advanced airway management in out-of-hospital cardiac arrest (OHCA) patients as well cellular immunotherapy for septic shock.But some of investigational trials did not yield expected results.For example,extracorporeal membrane oxygenation (ECMO) therapy for ARDS patients,the strategy of sequencing weaning with early extubation to noninvasive ventilation,prevention of delirium with haloperidol,surrogate decision supported by interprofessional intensive care unit (ICU)team and prophylaxis for gastrointestinal stress ulceration with pantoprazole in ICU.And more importantly,it has been obvious that the voices and evidences gathered by the opponents against guidelines development,compulsory polices of implementing bundled strategy,market position of hydroxyethyl-starch solutions (HES) and the usage of steroid in septic shock have been largely strengthen,highlighting a more divided and controversial situation.

Prowess and controversies in the resection extent of hilar cholangiocarcinoma / 中华肝胆外科杂志

There have been different views over the resection extent of hilar cholangiocarcinoma worldwide.In this review,we will describe expert-views on the resection extent of hepatic tissue,as well as the hilar vascular resection and reconstruction.We hope this article will be helpful to the optimal operation of hilar cholangiocarcinoma.

La controversia científico-técnica sobre las benzodiacepinas en profesionales de la salud pública de Uruguay / A controvérsia científico-técnica sobre as benzodiazepinas entre profissionais de saúde pública do Uruguai / The scientific-technical controversy over benzodiazepines among public health professionals in Uruguay

Resumen La controversia científico-técnica internacional sobre las benzodiacepinas, intensa durante los años ochenta y noventa, cuestionó su lugar en la práctica clínica, por su potencialidad adictiva, y por el abuso que médicos y pacientes parecerían realizar. Este artículo presenta resultados de una investigación que tuvo como objetivo analizar el papel de dicha controversia en las prácticas médica, psiquiátrica y psicológica en los servicios de salud pública uruguayos. Se utilizó metodología cualitativa y se combinó relevamiento de artículos académicos nacionales (1960-2012), entrevistas en profundidad a 45 profesionales y dos grupos de discusión. Se efectuó análisis de contenido desde cuatro ejes: ansiedad en la clínica, prescripción, relación tratamientos farmacológicos con no farmacológicos y valoración de benzodiacepinas. Se obtuvo un panorama diacrónico de la controversia académica y se identificó una valoración condicional de estos medicamentos realizada por los profesionales que supone: reconocimiento de atributos positivos y negativos de las benzodiacepinas, uso mesurado, médicos y pacientes vigilantes de sus propios comportamientos. Se concluye que la controversia se plantea en términos individuales, lo que obstaculiza una discusión global de las dimensiones políticas y colectivas implicadas.

Resumo A controvérsia científico-técnica internacional sobre as benzodiazepinas, intensa durante os anos 1980 e 1990, questionou seu lugar na prática clínica devido a sua potencialidade aditiva e pelo abuso que médicos e pacientes pareciam realizar. Este artigo apresenta resultados de uma pesquisa que teve como objetivo analisar o papel dessa controvérsia nas práticas médica, psiquiátrica e psicológica nos serviços de saúde pública do Uruguai. Utilizou-se metodologia qualitativa e combinou-se um levantamento de artigos acadêmicos nacionais (1960-2012), entrevistas em profundidade com 45 profissionais e dois grupos de discussão. Realizou-se análise de conteúdo a partir de quatro eixos: ansiedade na clínica, prescripção, relação entre tratamentos farmacológicos e não farmacológicos e avaliação das benzodiacepinas. Obteve-se um panorama diacrônico da controvérsia acadêmica e identificou-se uma avaliação condicional desses medicamentos realizada pelos profissionais, que supõe: reconhecimento de atributos positivos e negativos das benzodiazepinas, uso controlado, médicos e pacientes vigilantes de seus próprios comportamentos. Conclui-se que a controvérsia é levantada em termos individuais, o que obstaculiza uma discussão global das dimensões políticas e coletivas implicadas.

Abstract The international technoscientific controversy on benzodiazepines, especially intense during the 1980s and 1990s, questioned the place of benzodiazepines in clinical practice because of its addictive potentiality and the abuse of physicians and patients. This article presents some results from a research that aimed to analyze the role of benzodiazepine controversy in medical, psychiatric and psychological practices in Uruguayan public health services. This research methodology was qualitative, combining a review of national academic articles (1960-2012), in-depth interviews with 45 professionals and two discussion groups. Content analysis was carried out using four axes: anxiety in clinic practice, prescription, relationship between pharmacologic and non-pharmacologic treatment, and benzodiazepines valoration. We obtained a diachronic pictures of the academic controversy and we identified a conditional assessment of these medicines made by the professionals. This assessment implies: the recognition of positive and negative attributes of benzodiazepines, a controlled use of benzodazepines, and professionals and patients that must watch their own behaviors. We conclude that the controversy is presented mainly in individual terms, and this prevents a global discussion on the political and collective dimensions involved.

The view of the clinical obstetrician in the caesarian vs. normal childbirth controversy / A visão do obstetra clínico na polêmica cesariana X parto normal

Obstetrics has not been indifferent to the profound socioeconomic and cultural changes, nor to the scientific technological achievements of the last decades. Obviously, it also had to adjust, adapt and evolve in relation to this new vision. Changes in the obstetric population have also occurred. Women have stopped getting pregnant in their nubility. They first seek professional and economic achievement and then think about childbearing. The number of elderly and late primigravidae has grown; often, from assisted reproduction. Pregnant women have conquered the right of being better assisted and the respect regarding their convictions. We have seen and read concerning the emphasis with which women, who desire a normal birth, receive support and encouragement. Whereas other women, convicted in their decision to receive their child through cesarean, do not receive the same consideration

A Obstetrícia não ficou indiferente às profundas mudanças socioeconômicas e culturais, nem às conquistas científicas tecnológicas das últimas décadas. Obviamente, que também teve de se ajustar, adaptar e evoluir em relação a esta nova visão. Ocorreram, outrossim, mudanças na população obstétrica. A mulher deixou de engravidar na nubilidade. Procura primeiro a realização profissional e econômica e depois pensa na prole. O número de primigestas idosas e tardias cresceu, muitas vezes, oriundo da reprodução assistida. A grávida conquistou o direto de ser melhor assistida e o respeito às suas convicções. Assistimos e lemos a ênfase com que se apoia e se estimula a resolução da mulher que deseja um parto normal. A outra, também convicta em sua decisão de receber o seu filho através da cesariana, não recebe a mesma consideração

Surgical strategy and controversy about upper limit of splenic size for laparoscopic splenectomy / 中华消化外科杂志

Laparoscopic splenectomy (LS) is considered as the standard approach for patients with normal-sized or moderately enlarged spleens because of advantages of minimal invasion.With the improvement of laparoscopic techniques,the previous concept that massive splenomegaly (MS) is a contraindication to LS is being challenged.Nevertheless,there is still a tremendous controversy over this issue.(1) Splenomegaly and MS are not clearly defined.(2) The feasibility,safety and postoperative outcomes of LS for MS are fiercely debated despite much improvement of LS for MS.(3) Whether supporting or opposing LS for MS,the core problem that the upper limit of splenic size can be in accord with a requirement of LS is controversial.Taking these issues into account,authors recommended that the splenomegaly shotdd be divided into four degrees rather than three degrees for the sake of guiding the choice of surgery.

"Ethical Consideration about the Technology of ""Three-parent Test Tube Baby""" / 中国医学伦理学

Three-parent test tube baby technology is important to solve the mitochondrial genetic disease.Once available,it raises greatly ethical controversy such as breaking traditional family values,hitting the religious belief,existing unknown risks,correctly handling the failed embryo,as well as the influence on the social status of the babies.Regarding these controversy,we can discuss it from several aspects.Because the development of ethics is behind the progress of science and technology,we should affirm the value of three-parent test tube baby technology and balance the development of science and technology with respecting the religious beliefs.Strict supervision system and standard application system reflect our respect for life.Incomprehension to the unknown things should become the motivation of our inquiry.We should face up to our fear of three-parent test tube baby technology,and thus to strengthen research and deepen understanding.Based on the above argument,this paper puts forward the ethical principles that should be followed in the development of three-parent test tube baby technology,namely respect,benefit,no harm and justice.

Uma cura controversa: a promessa biomédica para a hanseníase em Portugal e no Brasil / A controversial cure: the biomedical promise for hanseniasis in Portugal and Brazil

Este artigo procura responder à pergunta, nascida na empiria do trabalho de campo: por que algumas pessoas portadoras de hanseníase e tratadas com a poliquimioterapia (PQT) se sentem curadas e outras não? Com base numa etnografia multissituada nas escalas transnacional (programa global para a hanseníase da Organização Mundial da Saúde), nacional (paisagens morais e paradigmas biopolíticos para a hanseníase em Portugal e Brasil) e local (prática clínica em contexto hospitalar e experiência incorporada das pessoas portadoras nos dois países), analisa como a incerteza documentada na clínica da hanseníase e a clivagem experienciada por algumas pessoas, entre a cura bacteriológica e o sentimento de se sentir sanado, abre uma controvérsia em torno dos principais postulados que sustentam o emprego da PQT como uma entidade autônoma do contexto e difratam a fronteira entre o normal e o patológico em que se baseia o enquadramento contemporâneo da hanseníase e as respostas institucionais à mesma. Finalmente, conclui pela necessidade de incluir uma escolha incorporada na atual política ontológica para a hanseníase que amplie a própria nosologia e refunde um novo paradigma de cuidado, de tipo participativo.

This paper aims to answer the following question that arouse during fieldwork: why some people with hanseniasis and treated with multidrug therapy (MDT) feel healed and others don't? From a multi-sited ethnography in the transnational (global program for hanseniasis from the World Health Organization), national (Portuguese and Brazilian moral landscapes and biopolitical paradigms), local (clinical practice and incorporated experience of people with hanseniasis in both countries) scales, it examines how the uncertainty documented in the clinic and the gap experienced by some people between the bacteriological cure and the feeling of being healed, opens for a controversy on the main postulates that sustain the use of MDT as an autonomous entity and diffract the contemporaneous framing of hanseniasis and the institutional responses to it. Finally, it concludes on the need for including an incorporated choice that might widen hanseniasis' ontological politics and rebuild a new participatory paradigm of care.

The controversy over the restructuring of perinatal emergency services in Portugal and the importance of citizen participation in health care decision-making processes / A controvérsia sobre a restruturação dos serviços de urgência perinatal em Portugal e a importância da participação cidadã em processos de decisão sobre saúde

This article explores the controversial decision made by the Ministry of Health to restructure the perinatal emergency services in Portugal in 2006. Particular emphasis is given to the protests held across the country against, the actors involved, and the arguments put forward for and against the measure, in an attempt to understand the forms of knowledge and experiences brought to the discussion about the issues raised by the decision, and how different forms of knowledge are reconciled under a democratic process. In addition, this article explores the importance of citizen participation, including that which emerges from conflicting relations, in the formulation of health policies.

O artigo examina o processo de restruturação dos serviços de emergência perinatal implementado pelo Ministério da Saúde em Portugal em 2006 e tem como objetivo analisar essa decisão controversa. Especial ênfase é dada aos protestos desencadeados no país contra essa medida, os atores envolvidos e os argumentos contra e a favor, de forma a compreender os conhecimentos e as experiências trazidos para discussão dos problemas suscitados pela decisão tomada e como diferentes formas de conhecimento podem ser conciliadas no âmbito de procedimentos democráticos. Além disso, explora a relevância da participação cidadã na formulação de políticas de saúde, incluindo aquela que emerge de relações conflitantes.

Pulsões, vocês têm uma vida? / Drives, do you have a life?

Cada avanço de Freud em sua teoria das pulsões resultou em resistências, às vezes em polêmicas e, no melhor dos casos, em debates e controvérsias. As grandes controvérsias que atravessaram a história do pensamento humano não estariam ligadas às mesmas características que definem as pulsões, a satisfação alucinatória da sexualidade infantil transgressiva, a origem sexual do narcisismo com suas vexações resultantes, a qualidade regressiva até alcançar o inorgânico que exige um trabalho psíquico das vivências de perda? Essa regressividade extintiva coloca o traumático no âmago de toda pulsão e nos obriga a conceber um ato fundador, posto sob a égide de um imperativo de inscrição, apto a dar vida às pulsões, a lhes dar corpo, matéria e palavra(AU)

Each step forward Freud took in his theory of the drives, resulted in resistances, sometimes in polemics, leading, at best, to debates and controversies. Wouldn't the great controversies that crossed the history of human thinking be bound to the same characteristics which define drives, the hallucinatory satisfaction of transgressive child sexuality, the sexual origin of narcissism, with its resulting shames, regressivity to the extreme of reaching the inorganic, which require a psychic work to deal with feelings of loss? This extinctive regressivity puts trauma at the core of every drive and forces us to conceive a founding act, placed under the aegis of an imperative inscription, capable of giving life, body, matter and voice to the drives(AU)

Cada progreso de Freud en su teoría de las pulsiones resultó en resistencias, a veces en polémicas y, en lo mejor de los casos, en debates y controversias. ¿Las grandes controversias que atravesaron la historia del pensamiento humano no estarían relacionadas a las mismas características que definen las pulsiones, la satisfacción alucinatoria de la sexualidad infantil transgresiva, el origen sexual del narcisismo con sus vejaciones consiguientes, la calidad regresiva hasta alcanzar lo inorgánico exigiendo un trabajo psíquico de las vivencias de pérdida? Esta regresividad extintiva emplaza a lo traumático en el centro de toda pulsión, y nos obliga a concebir un acto fundador, bajo la égida de un imperativo de inscripción, apto a dar vida a las pulsiones, a darles cuerpo, materia y palabra(AU)

International controversy in partial hepatectomy for patients in stage B or C of Barcelona Clinic Liver Cancer / 中华消化外科杂志

Barcelona Clinic Liver Cancer (BCLC) has been recommended as the best staging system and treatment guideline for hepatocellular carcinoma by European Association for the Study of the Liver (EASL) and the American Association for the Study of the Liver Disease (AASLD),assuming that hepatectomy is only for patients in stage 0 or A of BCLC rather than for patients in stage B or C.Recent retrospective studies show that the long-term survival rate of patients in stage B or C receiving partial hepatectomy is higher than Transhepatic Arterial Chemotherapy and Embolization (TACE) and systemic treatment,leading to controversies among international scholars.Therefore,whether or not partial hepatectomy as the treatment method for patients in stage 0 or A of BCLC need further researches to determine.

"Não é meu intuito estabelecer polêmica": a chegada da peste ao Brasil, análise de uma controvérsia, 1899 / "I do not wish to be controversial": the arrival of the plague in Brazil; analysis of a controversy, 1899

Analisa um debate trazido a público pelo Jornal do Commercio , entre agosto e setembro de 1899, envolvendo duas autoridades sanitárias, Nuno de Andrade, diretor-geral de Saúde Pública, e Jorge Pinto, diretor de Higiene e Assistência Pública do Estado do Rio de Janeiro. No cerne da questão as medidas tomadas pelo governo federal para evitar a chegada da peste bubônica ao Brasil, a partir de uma epidemia existente na cidade do Porto, Portugal. O referencial teórico para a análise foi a noção de campo de Pierre Bourdieu e os estudos sobre controvérsia científica de Bruno Latour.

This article analyzes a debate brought to the public arena by Jornal do Commercio newspaper in August and September 1899 involving two sanitation officials: Nuno de Andrade, Director-General of Public Health, and Jorge Pinto, Director of Hygiene and Public Welfare of the State of Rio de Janeiro. The issue in question was the measures taken by the federal government to prevent bubonic plague reaching Brazil from Porto, Portugal, where there was an epidemic. The theoretical framework for the analysis is Pierre Bourdieu’s notion of field, and Bruno Latour’s studies into scientific controversy.