Transperiferismo, necropolítica y sufrimiento social. Etnografía experimental sobre las condiciones de vida de inmigrantes venezolanos en el Caribe colombiano / Transperiferism, Necropolitics and social suffering. Experimental ethnography on the living conditions of Venezuelan immigrants in the Colombian Caribbean

RESUMEN Objetivos En este trabajo exploramos la crueldad y el sufrimiento que experimentan inmigrantes venezolanos que habitan en un asentamiento irregular llamado Villa Caracas, en la periferia de Barranquilla. Nuestro objetivo principal se centró en analizar desde una perspectiva antropológica y filosófica la condición de lo humano, el dolor que toma forma a raíz de la extrema precariedad material manifiesta en el flujo transnacional migratorio entre Venezuela y Colombia. Método A través de una etnografía extendida por cerca de 6 meses, hecha mediante observación participante, entrevistas semiestructuradas y relatos de vida, describimos el sufrimiento social del inmigrante en su tránsito, asentamiento y supervivencia cotidiana. Resultados Los resultados preliminares de esta investigación nos llevaron a formular el concepto de transperiferismo como una categoría que engloba transversalmente el fenómeno migratorio con una perspectiva urbana.

ABSTRACT Objective In this research we explore the cruelty and suffering experienced by a high percentage of Venezuelan immigrants who live in an irregular settlement called Villa Caracas on the outskirts of Barranquilla. Our main objective focused on analyzing from an anthropological and philosophical perspective the condition of the human, the pain that takes shape because of the extreme material precariousness manifested in the transnational migratory flow between Venezuela and Colombia. Method Through an ethnography extended for about 6 months applying participant observation, semi-structured interviews and life stories, we describe the social suffering that the immigrant experiences in their transit, settlement and daily survival. Result Based on the research, we formulate the concept of trans-periphery as a cate-gory that transversally encompasses the migratory phenomenon in cities.

Estudio etnográfico sobre la dramatización de la alegría por clases sociales y del estigma en los adultos de la tercera edad del Asilo San Antonio (Colombia) / Ethnographic study on dramatization of joy for social classes and stigma in the elderly of San Antonio Asylum (Colombia) / Estudo etnográfico sobre dramatização da alegria por classes sociais e do estigma dos idosos do Albergue Santo Antônio (Colômbia)

OBJETIVO: Analizar las interacciones sociales de los internos del asilo San Antonio (Barranquilla) desde la perspectiva dramática, con el fin de entender los mecanismos por medio de los cuales asumen sus estigmas para acomodarse al sistema. METODOLOGÍA: Etnografía interaccionista de corte analítico. Se recogió la información por medio de observación participante, notas de campo, registro fotográfico y entrevistas en profundidad a informantes clave. La información, previamente organizada en unidades de registro, contexto y categorías, se sometió a un análisis crítico del discurso para hallar patrones de relevancia que sirvieron para desarrollar, analíticamente, los resultados en cinco ejes. RESULTADOS: se identificaron cinco estrategias dramáticas por medio de las cuales los internos del asilo incorporan los estigmas en aras de complacer tácticamente al sistema: la presencia de los propios investigadores como agentes estigmatizadores, la obediencia atribuida, la excesiva trasparencia identitaria como enfermo, la autoimposición del estigma y el edadismo estratégico. CONCLUSIONES: Los internos del Asilo San Antonio terminan por participar de su propio sometimiento, incorporando los estigmas que le son atribuidos por el sistema. Abogamos por desarrollar una visión cultural humanista de los cuidados que restituya, al espacio de atención a personas sensibles, su valor antropológico, para que prevalezca sobre los procedimientos institucionales

OBJECTIVE: Analyze the social interactions of the San Antonio asylum inmates (Barranquilla) from the dramatic perspective, in order to understand the mechanisms by which they assume their stigmas to accommodate the system. METHOD: Interactionist ethnography of an analytical nature. The information was collected through participant observation, field notes, photographic record and 22 in-depth interviews with key informants. The information, previously organized in units of registration, context and categories, underwent a critical discourse analysis to find patterns of relevance that served to develop, analytically, the results in five axes. RESULTS: Five dramatic strategies were identified through which the inmates of the asylum incorporate the stigmas in order to tactfully please the system: the presence of the researchers themselves as stigmatizing agents, the attributed obedience, the excessive identity transparency as a patient the self-imposed stigma and strategic ageism. CONCLUSIONS: The San Antonio asylum inmates end up participating in their own subjection, incorporating the stigmas attributed to them by the system. We advocate to develop a humanistic cultural vision of the care that restores, to the space of attention to sensitive people, its anthropological value, so that it prevails over institutional procedures

OBJETIVO: Analisar as interações sociais dos internos do Asilo Santo Antônio (Barranquilla) desde a perspectiva dramática, com a finalidade de entender os mecanismos através dos quais assumem seus estigmas para adequar-se ao sistema. METODOLOGIA: Etnografía Interacionista de corte analítico. Apanhou-se a informação mediante o uso da observação participante, anotações de campo, registro fotográfico e 22 entrevistas em profundidade em informantes clave. A informação previamente organizada em unidades de registro, contexto e categorias, foi submetida a uma análise crítica do discurso para encontrar padrões de relevância que serviram para desenvolver, analiticamente, os resultados em cinco eixos. RESULTADOS: foram identificadas cinco estrategias dramáticas através das quais os interno do asilo incorporam os estigmas em áreas de complacer taticamente ao sistema:a presença dos mesmos pesquisadores como agentes estigmatizadores, a obediência atribuída, a excesiva transparência identitária como doente, a auto-imposição do estigma e o edadismo estratégico. CONCLUSÕES: os internos do Asilo Santo Antônio findam participando de seu próprio submetimento, incorporando os estigmas que lhes são atribuídos pelo sistema. Advogamos pelo desenvolvimento de uma visão humanista dos cidadãos que restitua, ao espaço de atenção a pessoas sensíveis, seu valor antropológico, para que prevaleça sobre os procedimentos institucionais

[Urology before illustration. From the Urology of the Royal College of Cadiz to that of the "veneranda" gathering]. / La urología preilustrada. De la Urología del Real Colegio de Cádiz a la de la Veneranda Tertulia.

The study of the urological activity in the Andalusian occident is contained in the printed and handwritten "Observations" of the records of the Royal Society of Medicine of Seville and the Royal College of Surgery of Cadiz. They encompass the period from 1693 to the first third of the 18th century. By the first of October 1701, the "Veneranda" gathering consolidates and Philip V gives the "royal warrant". The "Royal Society of Medicine and Other Sciences of Seville" starts its medical-surgical path. It should be reminded that all the Andalusian surgery and specially the one from Cadiz (through the Royal College of Surgeons) was present in the Royal Society. Ordoñez de la Barrera, Sánchez Bernal, Fray Ambrosio de Guibeville, Juan Lacombe, Pedro Virgili and many others were founders of this extraordinary event. Surgical training and, by extension, urological training had their root and basement in the anatomical amphitheaters (Seville 1731 and Cadiz 1728), which were considered ungodly by the Church. José Celestino Mutis (1750-53) and Pedro Fernandez Castilla (1741) excluded the university from this new movement. There was and intense relationship between Navy surgeons and the Royal Society, being members since its foundation: Guibeville (1719); Sánchez Bernal (1719); Gregorio Arias (1729); Gaspar de Pellicer (1729); Lacombe (1730); Fernández Castilla (1741); Calero (1789). The main protagonist was Luis Montero, real paradigm with projection to the next century, having a neat French influence altogether with Ramos, both of them being Beaumond's alumni (an anatomist of recognized prestige).

La urología preilustrada. De la urología del Real Colegio de Cádiz a la de la Veneranda Tertulia / Urology before illustration. From the Urology of the Royal College of Cadiz to that of the «veneranda» gathering

El estudio de la actividad urológica del occidente andaluz se encuentra contenido en las «Observaciones» impresas y manuscritas de las Memorias de la Regia Sociedad de Medicina Sevillana y en aquellas pertenecientes al Real Colegio de Cirugía de Cádiz. Comprende un período que abarca desde 1693 hasta el primer tercio del siglo XVIII. Se consolida la Veneranda Tertulia, Felipe V concede «Cédula Real»; es el 1º de Octubre de 1701. Inicia su andadura Médico-Quirúrgica la «Regia Sociedad de Medicina y demás Ciencias de Sevilla». Hay que recordar que toda la cirugía andaluza y especialmente la de Cádiz (a través del Real Colegio de Cirugía) estuvo presente en la Regia Sociedad. Ordoñez de la Barrera, Sánchez Bernal, Fray Ambrosio de Guibeville, Juan Lacombe, Pedro Virgili y otros muchos fueron fundacionales de este extraordinario acontecimiento. La formación quirúrgica y, por ende, la urológica tenía su raíz y fundamento en los anfiteatros anatómicos, (Sevilla 1731) y (Cádiz 1728) definidos «impíos» por la Iglesia. José Celestino Mutis (1750-53) y Pedro Fernández Castilla (1741) aíslan a la Universidad de este nuevo movimiento. Hubo una intensa relación entre Cirujanos de la Armada y la Regia Sociedad, siendo socios desde su fundación: Guibeville (1719); Sánchez Bernal (1719); Gregorio Arias (1729); Gaspar de Pellicer (1729); Lacombe (1730); Fernández Castilla (1741); Calero (1789). Siendo el principal protagonista Luis Montero, verdadero paradigma con proyección hacia la centuria siguiente, de influencia netamente francesa junto con Ramos, ambos alumnos de Beaumond, anatómico de reconocido prestigio (AU)

The study of the urological activity in the Andalusian occident is contained in the printed and handwritten «Observations» of the records of the Royal Society of Medicine of Seville and the Royal College of Surgery of Cadiz. They encompass the period from 1693 to the first third of the 18th century. By the first of October 1701, the «Veneranda» gathering consolidates and Philip V gives the «royal warrant». The «Royal Society of Medicine and Other Sciences of Seville» starts its medical-surgical path. It should be reminded that all the Andalusian surgery and specially the one from Cadiz (through the Royal College of Surgeons) was present in the Royal Society. Ordoñez de la Barrera, Sánchez Bernal, Fray Ambrosio de Guibeville, Juan Lacombe, Pedro Virgili and many others were founders of this extraordinary event. Surgical training and, by extension, urological training had their root and basement in the anatomical amphitheaters (Seville 1731 and Cadiz 1728), which were considered ungodly by the Church. José Celestino Mutis (1750-53) and Pedro Fernandez Castilla (1741) excluded the university from this new movement. There was and intense relationship between Navy surgeons and the Royal Society, being members since its foundation: Guibeville (1719); Sánchez Bernal (1719); Gregorio Arias (1729); Gaspar de Pellicer (1729); Lacombe (1730); Fernández Castilla (1741); Calero (1789). The main protagonist was Luis Montero, real paradigm with projection to the next century, having a neat French influence altogether with Ramos, both of them being Beaumond's alumni (an anatomist of recognized prestige) (AU)

[Prostate cyst at the midline in a patient with a renal transplantation]. / Quiste prostático de línea media en paciente trasplantado renal.

Cystic lesions at the midline of the prostate are uncommon and they are considered as congenital disorders. Is generally accepted that active treatment should be instituted only in symptomatic patients and watchful waiting in asymptomatic ones. The most common active treatment is minimally invasive surgery by puncture-aspiration or endoscopic unroofing. We are attaching an inmunosupressed patient because of a renal transplantation in which we provided an active treatment by puncture-aspiration of the cystic lesion in spite of being asymptomatic.

Quiste prostático de línea media en paciente trasplantado renal / Prostate cyst at the midline in a patient with a renal transplantation

Las lesiones quísticas localizadas en la línea media de la próstata son poco frecuentes y se consideran alteraciones congénitas. Se acepta generalmente que el tratamiento activo se realiza sólo a los pacientes sintomáticos, haciendo observación a los asintomáticos. El tratamiento activo más común es la cirugía mínimamente invasiva por medio de punción-aspiración o la decorticación endoscópica. Aportamos un caso de un paciente inmunosuprimido por un trasplante renal, circunstancia que nos hizo optar por el tratamiento activo con punción aspiración del mismo, a pesar de ser asintomático

Cystic lesions at the midline of the prostate are uncommon and they are considered as congenital disorders. Is generally accepted that active treatment should be instituted only in symptomatic patients and watchful waiting in asymptomatic ones. The most common active treatment is minimally invasive surgery by puncture-aspiration or endoscopic unroofing. We are attaching an inmunosupressed patient because of a renal transplantation in which we provided an active treatment by puncture-aspiration of the cystic lesion in spite of being asymptomatic

[Endoscopic anterior commissurotomy (EAC) versus TUR as the treatment for the neck obstruction syndrome. Our experience. The results]. / La comisurotomía anterior endoscópica (CAE) versus RTU como tratamiento del síndrome obstructivo cervical. Experiencia. Resultados.

OBJECTIVE: 30 patients were included over a 5-year period in a protocol divided into two uniform cohorts (age, surgical risk, prostatic volume, etc.). Both groups are compared based on morphological effectiveness, functionality, quality of life parameters, etc. Also a comparison on the efficacy of anterior commissurotomy vs. conventional TUR is carried out. METHOD: After 12 hours, a cohort of 15 patients had a Collins' loop section of the vesical neck anterior aspect, a technique described by Keitzer (1969). RESULTS: Results were optimal and superior to those obtained with TUR. We conclude this technique is effective, and emphasize the validity of the concepts described by Gil Vernet in 1956.

[Usefulness of posterior capsulectomy in the treatment of bladder neck disease]. / Utilidad de la capsulectomía posterior como tratamiento de la enfermedad de cuello vesical.

RATIONALE: Presentation of 12-year experience accrued in the surgical treatment of the acquired bladder neck disease. Based on Riches' experience (1961), posterior capsulotomy, although exceptional in terms of indication, was effective in the treatment of 26 patients with early failure of standard endoscopic techniques. MATERIALS AND METHOD: Over a 12-year period, 945 prostatectomies were entered in a protocol, 305 (32.2%) open surgery and 640 (67.8%) transurethral resections. Incidence of sclerosis was 5.03% (48 patients). Treatment of second group with TUR and/or cervicotomy failed in 26 (45-58%) patients. Posterior capsulotomy was effective in 100% patients. RESULTS: Mean follow-up has been productive, and exceeds 4 years based on clinical, radiologic, endoscopic and urodynamic parameters.

[Eosinophilic cystitis in children. Study of 4 cases]. / Cistitis eosinofílica en el niño. Estudio de 4 casos.

OBJECTIVE: To present our experience in the diagnosis and treatment of 4 children with eosinophilic cystitis. METHODS: 4 children (3 boys and 1 girl) with eosinophilic cystitis are described. The mean follow-up since diagnosis was 30 months, the mean age was 7 years and the main symptom was hematuria. The clinical features, etiology, course of the disease, pathological findings and diagnostic methods are reviewed. The definitive diagnosis was established by the pathological findings. None of the patients had a recurrence. CONCLUSIONS: The diagnosis of eosinophilic cystitis is exclusively based on the histological findings. There are no clinical or complementary pathognomonic signs. Like most authors, we believe that the immune system plays a decisive role in the appearance of this disease.

[A retrospective study of surgery for tumors of the renal parenchyma in adults]. / Estudio retrospectivo sobre la cirugía de los tumores del parénquima renal en el adulto.

OBJECTIVES: To determine the incidence of renal parenchymal tumors in adult patients over the last 30 years, analyze the therapeutic approach and compare radical vs conservative surgery, the surgical principles involved and the survival rates achieved. METHODS/RESULTS: We have reviewed 260 cases of renal parenchymal tumors in adults and the utilization of conservative vs radical surgery over the last 30 years. This tumor type has been significantly influenced by the availability of US for routine evaluation, which has led to changes in the clinical features of this condition and the surgical expectations. CONCLUSIONS: Although the techniques of conservative surgery of the kidney have remained unchanged over the last 50 years, the indications have changed. The incidence of nononcological conditions has decreased while the number of incidentally discovered tumors has increased. The tumor is diagnosed earlier, of smaller size and lower histological grade and stage.

[Vestibular approach in urinary incontinence in women. Original technic. Experience. Results]. / La vía de abordaje vestibular en la incontinencia de orina en la mujer. Técnica original. Experiencia. Resultados.

Presentation of an original technique to treat S.U.I. in women. This technique contains in itself many others, both in terms of the conceptual anatomical base on which it is inspired, and in the possibilities of its surgical application. Lisfranc's approach, supra-meatic and infra-clitoridean, allows to section both the pubo-urethral ligament and Colles fascia thus reaching into the Retzius. It makes possible the use of solid anatomical elements (pelvian fascia, elevator, urethro-vaginal septum, etc...) thus allowing to suspend the pelvian base from fascia ligaments or from the abdominal wall muscles. Sixty patient who had simple S.U.I. received treatment, with a 95% efficacy index based on the evaluation of the urodynamic, bacteriological and clinical studies. We conclude with an evaluation on the validity of the results obtained by emphasizing the high efficacy index, simplicity, low morbidity and short hospital stay.

[Ureteral stenosis. Complication of the urinary tract in renal transplantation. Experience. Comments]. / La estenosis ureteral. Complicación de la vía urinaria en el trasplante renal. Experiencia. Comentarios.

Our experience in stenosis of the urinary tract after renal transplantation is described. We reviewed the records of 160 consecutive cases of renal transplantation. The data gleaned over a period of 10 years (1982-1992) show a stenosis rate of 4.37%. All the cases were successfully treated by surgery.

[Bivalve transinusal anatrophic nephrolithotomy. Anatomic considerations. New technique]. / Nefrolitotomía anatrófica transinusal bivalva. Consideraciones anatómicas. Nueva tecnica.

The paper describes the experience accumulated over a 9- year period on surgical treatment of coralliform lithiasis. The treatment implied the use of an original technique inspired in the surgical concepts divulged by Gil-Vernet, Kelly and Dufour. Ninety-four patients have been effectively treated with this technique, known as the Bivalve Transinusal Anathropic Nephrothomy. The surgical technique applied is described and analyzed.

[Surgical complications after 160 renal transplantations. Experience. Comments]. / Complicaciones quirúrgicas tras 160 transplantes renales. Experiencia. Comentarios.

The present study reviewed the complications observed in 160 renal transplants that had been performed from 1982 to 1992. Complications were observed in 27 cases (16.87%), which falls within reasonable limits and is similar to the complication rate reported elsewhere. The treatment utilized in these cases was highly effective and only 3 grafts (1.87%) were lost. The following complications were observed: obstructive uropathy (7 cases, 4.37%), fistula (18 cases, 11.25%), vascular complications (1 case, 0.62%) and other complications (1 case, 0.62%).

[Anatomical and technical foundations of the non-hemorrhagic treatment of simple hydrocele. Technical contributions]. / Fundamentos anatómicos y técnicos del tratamiento no hemorrágico del hidrocele simple. Aportaciones técnicas.

The efficacy of the conventional surgical techniques in the treatment of simple hydrocele has been well-established. However, further insights into the embryological anatomy of the testis and its layers have led to the development of new surgical concepts. We have conducted a retrospective study after using an "avascular" technique (extravaginalization-marsupialization) with optimum results. 120 patients treated by the Wilkinson vaginal reversal were assessed for efficacy and complications. The working hypothesis and the principles based on embryological anatomy are discussed. The results and relevant data of the treated group of patients are presented.

[Gonadal stromal tumor in childhood. Report of a case. Comments]. / Tumor de estroma gonadal en la infancia. Aportación de un caso. Comentarios.

A case of testicular gonadal stromal tumor in an 8-month-old boy is described. Patient evaluation revealed no hormonal alterations. The patient underwent orchidectomy and has remained tumor-free at two years follow-up, which meets the well-established criteria for benign tumors. A detailed anatomopathological description is presented.

[The endourological treatment of distal ureteral fistulae in the kidney transplant. The exclusion or "dry" technic]. / Tratamiento endourológico de las fístulas de uréter distal en el trasplante renal. Técnica de exclusión o "seca".

The present study reports our experience in the endourological treatment of fistulas of the distal ureter in renal transplant patients. The temporary urinary exclusion or dry technique was effective in 8 of the 10 patients. We advocate the use of this simple and safe technique which achieves excellent results.

[The surgical treatment of anterior hypospadias. Apropos 590 cases (1966-1988). The indications and results. The current trends in surgical treatment]. / Consideraciones sobre el tratamiento quirúrgico del hipospadias anterior. A propósito de 590 casos (1966-1988). Indicaciones y resultados. Tendencias actuales del tratamiento quirúrgico.

The surgical treatment of hypospadias is very complex. The objective is to obtain a satisfactory urinary and genital function with an equal morphological, anatomical and aesthetic result. Our contribution covers twenty-two years of surgical multicentre experience (590 cases). We evaluate the surgical indication, results, complications, associated malformations and study protocols. We have objectively evaluated the evolution of the indications, as well as the application of different techniques depending on the extent of urethral malformation.

[Surgical treatment of hypospadias. Apropos of 700 hypospadias surgically treated (1966-1988). Indications and results. Current trends of the surgical treatment]. / Consideraciones sobre el tratamiento quirúrgico del hipospadias. A propósito de 700 hipospadias intervenidas (1966-1988). Indicaciones y resultados. Tendencias actuales del tratamiento quirúrgico.

The surgical treatment of hypospadias is very complex. The objective is to obtain a satisfactory urinary and genital function with an equal morphological, anatomical and aesthetic result. Our contribution covers 22 years of surgical multicentre experience (700 cases). We evaluate the surgical indication, results, complications, associated malformations and study protocols. The anterior forms 590 (82%) were treated using the Duckett Magpi, Mathieu, Duplay and Leveuf techniques. Posterior forms 110 (18%) with a wide variety of techniques. Results have been encouraging in both. We have objectively evaluated the evolution of the indications, as well as the application of different techniques depending on the extent of urethral malformation.

[Liposarcoma in childhood. Report of an exceptional case. Review of the literature]. / Liposarcoma en la infancia. Aportación de un caso excepcional. Revisión de la literatura.

This paper describes a case of liposarcoma of exceptional paratesticular location (first in the literature described in infancy). The case corresponds to a 5-year-old boy. The influence of the histology, location of the tumour and possibility of complete surgical exeresis is fundamental with regard to prognosis and evolution. Pediatric experience is extremely limited and we may superimpose the treatment in children of that carried out in adults (more case histories), in whom multimodal therapy (surgery, radiotherapy, chemotherapy) concludes with encouraging results. The updating of previously published cases reveals the predominance of myxoid histology, a lower index of relapses in infancy and a high peak of incidence in early infancy.