Abstract Objective Testing an experimental model for ischemic necrosis of the femoral head in Legg-Calvé-Perthes disease by evaluating gait, imaging and morphohistology. Methods The operation was done in 11 piglets. Necrosis by cerclage in the right femoral neck was induced. Piglets were divided into group A, with 8 animals, euthanizing two in the 2nd, 4th, 6th, and 8th weeks, respectively; and group B, with 2 animals (sham), submitted to the surgical procedure without cerclage of the right femoral neck. The gait classification used was that of Etterlin. The frozen femurs were submitted to digital radiography and computed tomography. The height and width of the epiphysis and epiphysary coefficient were measured at study times. Light microscopy and immunohistochemistry with TGF-β1 were performed. Results One animal died of sepsis in Group A. In this group, claudication was observed in all animals. On digital radiography and computed tomography, bone sclerosis, enlargement of the right femoral neck, flattening, collapse, and fragmentation of the right femoral head were observed. All epiphysis height and epiphysary coefficient values of the right femoral head were lower than the contralateral ones, in which were observed chondrocytes disordered and separated by gaps. A reduction in TGF-β1 expression was observed at 2 and 6 weeks in the right femoral head and at eight in the left. In group B, there were no signs of necrosis and gait was normal. Conclusions The model presented reproduced macroscopic necrosis on digital radiography, computed tomography, and microscopy. Gait evaluation showed a good correlation with other ischemia findings. Level of EvidenceV. Diagnostic studies.

Resumo Objetivo Testar um modelo experimental para necrose isquêmica da cabeça femoral na doença de Legg-Calvé-Perthes avaliando a marcha, exames de imagens e morfohistologia. Métodos Operaram-se 11 leitões. Induziu-se a necrose por cerclagem no colo femoral direito. Dividiram-se os leitões em grupo A com 8 animais, sacrificando-se dois na 2ª, 4ª, 6ª e 8ª semanas, respectivamente; e grupo B, com 2 animais (sham), submetidos ao procedimento cirúrgico sem a cerclagem do colo femoral direito. A classificação da marcha utilizada foi a de Etterlin. Os fêmures congelados foram submetidos à radiografia digital e tomografia computadorizada. Mediram-se a altura e largura da epífise e o coeficiente epifisário nos tempos de estudo. Realizou-se, microscopia de luz e imunohistoquímica com TGF-β1. Resultados Um animal morreu por sepse no grupo A. Neste grupo, observou-se claudicação em todos os animais. Na radiografia digital e tomografia computadorizada observaram-se: esclerose óssea, alargamento do colo femoral direito, achatamento, colapso e fragmentação da cabeça femoral direita. Todos os valores da altura da epífise e coeficiente epifisário da cabeça femoral direita foram menores que os contralaterais, nos quais observaram-se condrócitos desordenados e separados por lacunas. Observou-se redução da expressão do TGF-β1 com 2 e 6 semanas nas cabeças femorais direitas e nas esquerdas com oito. No grupo B, não ocorreram sinais de necrose e a marcha foi normal. Conclusões O modelo apresentado reproduziu a necrose macroscopicamente, na radiografia digital, tomografia computadorizada e microscopia. A avaliação da marcha demonstrou boa correlação com os demais achados de isquemia. Nível de EvidênciaV. Estudos diagnósticos.

ABSTRACT Purpose This study examined and compared efficacy, safety, satisfaction, and complications of the retropubic Safyre™ sling and a retropubic hand-made synthetic sling (HMS) in a short-, mid- and long-term follow-up. Methods We retrospectively reviewed a prospectively maintained database of women who underwent Safyre™ or HMS between March 7ths 2005 and December 27ths, 2017. Patients had first assessment (7-10 days), second (40-45 days), and third (sixth month) postoperatively. Between September and December 2018, patients who completed at least one year of surgery, received a telephone call. Follow-up compared quartiles of follow-up time to determine complications (Clavien-Dindo), success rates (International Consultation on Incontinence Modular Questionnaire for Urinary Incontinence Short Form – ICIQ-UI SF), and patient satisfaction. Results Three hundred fifty-one patients underwent surgery and 221 (63%) were evaluated after a median of 78.47 (± 38.69) months, 125 (55%) in the HMS, and 96 (45%) in the Safyre™ group. Higher intraoperative bladder injury was observed with Safyre™ (0% vs. 4.2%, p=0.034), and a tendency for urinary retention, requiring indwelling urinary catheter over 24 hours (2.4% vs. 8.3%, p=0.061). Both HMS (p<0.001) and Safyre™ (p<0.001) presented improvements on ICIQ-UI SF. There were no differences in satisfaction, subjective cure rates, ICIQ-UI SF, or complications between groups. Conclusions Both HMS and Safyre™ have similar satisfaction and subjective cure rates, with marked ICIQ-UI SF score improvement. Higher rates of intraoperative bladder injury were seen in patients who received Safyre™ retropubic sling.

O artigo define neoliberalismo como a construção política da sociedade de mercado, constituindo o modo de regulação ou o regime de governamentalidade predominante na fase atual do capitalismo. Historicamente, o neoliberalismo sempre esteve associado ao esvaziamento da democracia e a estratégias autoritárias. Após a crise de 2008, o neoliberalismo radicalizou suas medidas ao mesmo tempo em que aprofundou o recurso ao autoritarismo, estabelecendo uma diferença de grau que permite afirmar, seguindo a análise de Nancy Fraser (2017), a passagem de uma fase progressista que mantinha práticas autoritárias para uma fase propriamente autoritária do neoliberalismo. Por fim, o artigo busca compreender tal deslocamento de fase na crise da Nova República, admitindo a singularidade do processo de neoliberalização brasileiro. Esta singularidade se deve ao fato de que o neoliberalismo não substituiu completamente outras racionalidades políticas e projetos de regulação previamente existentes, mas se hibridizou com eles, reconfigurando a nossa constelação histórica específica.

This paper defines neoliberalism as the form of regulation or the regime of governmentality predominant in the current phase of capitalism and shows how it has been historically associated with the emptying of democracy and with authoritarian strategies. Then, based on the most recent literature, we show how, after the 2008 crisis, neoliberalism radicalized its measures while it deepened its recourse to authoritarianism, constituting a difference of degree that allows us to affirm, following the analysis of Nancy Fraser (2017), the passage from a progressive phase that maintained authoritarian practices to a properly authoritarian phase of neoliberalism. Finally, we seek to understand this phase shift in the crisis of the Nova República (New Republic), admitting the singularity of the Brazilian neoliberalization process. This singularity is due to neoliberalism not completely replacing other previously existing political rationalities and regulatory projects but hybridizing with them and reconfiguring our specific historical constellation.

L’article définit le néolibéralisme comme le mode de régulation ou le régime de gouvernementalité prédominant dans la phase actuelle du capitalisme et montre comment il a été historiquement associé à la limitation de la démocratie et aux stratégies autoritaires. Dans la séquence, en s’appuyant sur la littérature la plus récente, on montre comment, après la crise de 2008, le néolibéralisme a radicalisé ses mesures en même temps qu’il a approfondi son recours à l’autoritarisme, constituant une différence de degré qui permet d’affirmer, en suivant l’analyse de Nancy Fraser (2017), le passage d’une phase progressive qui maintenait des pratiques autoritaires à une phase proprement autoritaire du néolibéralisme. Enfin, nous cherchons à comprendre ce changement de phase dans la crise de la Nova República (République Nouvelle), en admettant la singularité du processus de néolibéralisation brésilien. Cette singularité est due au fait que le néolibéralisme n’a pas complètement remplacé les autres rationalités politiques et projets de régulation existants, mais s’est hybridé avec eux et a reconfiguré notre constellation historique spécifique.

O conceito de necropolítica introduzido no debate público por Achille Mbembe tem sido frequentemente mobilizado para a reflexão acerca das formas de violência perpetradas pelo Estado, especialmente contra as populações mais pobres e as minorias raciais. Entretanto a leitura do ensaio de Mbembe demonstra que, mais do que um desdobramento da biopolítica de Foucault – conceito que procura explicar as especificidades da dominação sob a égide do Estado moderno –, o conceito de necropolítica pretende dar conta do modo como a governamentalidade e suas tecnologias se impõem diante das mudanças na forma de reprodução social do capitalismo, no caso, as mudanças provocadas pelo neoliberalismo. Portanto pretende-se analisar como Mbembe, a partir da leitura crítica de Foucault, concebe a especificidade das formas de dominação no que considera ser a etapa neoliberal da economia capitalista.

The concept of necropolitics introduced into public debate by Achille Mbembe has been increasingly mobilized to reflect on the forms of violence perpetrated by the State, especially against the poor population and the racial minorities. However, reading Mbembe’s essay demonstrates that more than an unfolding of Foucault’s biopolitics concept – which seeks to explain the specifics of the domination carried out under the aegis of the Modern State –, the idea of necropolitics intends to account for the form with which governmentality and its technologies impose themselves in the face of changes in the way of social reproduction of capitalism, in this case, the changes caused by neoliberalism. Therefore, this text intended to analyze how Mbembe, based on Foucault’s critical reading, conceives the specificity of forms of domination in what he considers to be the neoliberal stage of the capitalist economy.

Le concept de nécropolitique introduit par Achille Mbembe dans le débat public est souvent utilisé pour réfléchir à propos des formes de violence fait par l’État, spécialement à la population plus pauvre et les minorités raciales. Pourtant, la lecture de l’essai de Mbembe montre que, en plus qu’un déroulement de la biopolitique de Foucault – un concept qui cherche à expliquer les spécificités de la domination sous la égide de l’État moderne –, le concept de nécropolitique a l’intention de rendre compte de la façon dont la gouvernmentalité et ses technologies s’imposent face à les changements dans la façon de reproduction sociale du capitalisme, dans ce cas, les changements causés par le néolibéralisme. Ainsi, ce texte a l’intention d’analiser comment Mbembe, basé sur une lecture critique de Foucault, conçoit les spécificités des formes de domination dans celle qu’il considère la phase néolibéraliste du capitalisme.

Resumo O principal objetivo do presente estudo é analisar as consequências da tortura e de outras atrocidades ocorridas no Brasil na ditadura militar. Por meio do emprego dos métodos hipotético-dedutivo e indutivo, procura-se expor a decisão do Supremo Tribunal Federal no tocante à extensão interpretativa da Lei de Anistia, a condenação internacional do Brasil no caso Araguaia, diante das mortes e do desaparecimento forçado de corpos, incluindo a falta de transparência, sendo essas as preocupações da Justiça de Transição. Trata-se de assunto que diz respeito não apenas ao passado, mas que tem efeitos prospectivos, pois trazer da invisibilidade o tema da opressão estatal é uma medida que contribui para a consolidação da democracia.

Abstract The main purpose of this study is to focus on the consequences of torture and other atrocities occurred during the Brazilian military coup. Through hypothetical-deductive and inductive methods, it aims to expose the decision of the Supreme Court concerning the Amnesty Law, international condemnation of Brazil in Araguaia case and the responsibility of the State for the death and disappearance of the bodies, including lack of transparency, which are significant worries about transitional law rules. It concerns not only the past, but also has prospective effects, as taking the state oppression out of invisibility contributes to the consolidation of democracy.

Resumo O artigo sustenta que durante a escravidão brasileira houve um grande pacto contra os escravos, do qual participavam amplos setores da população brasileira. Isso se deu pelas características concretas da formação econômico social do Brasil escravista, na qual a propriedade de cativos se espraiou pelas distintas regiões, classes sociais e setores econômicos. Essa “democratização” da propriedade de escravos gerou uma unidade de interesses muito ampla e heterogênea socialmente, que isolou os escravos e suas lutas. As características bastante liberais para os padrões da época da primeira Constituição do Brasil e dos seus primeiros códigos são a consubstanciação na superestrutura jurídico-política desta grande associação de pequenos, médios e grandes proprietários de escravos. O método utilizado foi a pesquisa bibliográfica.

Abstract This article defends the idea that Brazilian slavery was underpinned by a great pact of Brazilian society against slaves, with the participation of several sectors of the population, not only the major slave owners. In Brazil, slave ownership spread throughout all regions, social classes and economic sectors, creating a unity of interest that isolated the slaves and their struggles. This social alliance against the slaves explains, among other things, why the first Constitution and the first Brazilian penal codes were so liberal for the time.

RESUMO Sobre o autoritarismo brasileiro se propõe a apresentar de forma acessível e didática as raízes históricas do autoritarismo brasileiro. Trata-se de livro que surge ligado a um contexto político de crise e que se propõe a tarefa de disputar os sentidos da história diante dos perigos do revisionismo, da falsificação e da naturalização da violência política.

ABSTRACT “About Brazilian authoritarianism” proposes to present in an accessible and didactic way the historical roots of Brazilian authoritarianism. This book is linked to a political context of crisis and proposes the task of disputing the meanings of history in the face of the dangers of revisionism, falsification and naturalization of political violence.

ABSTRACT Purpose The polypropylene mesh (PPM) is used in many surgical interventions because of its good incorporation and accessibility. However, potential mesh-related complications are common. Platelet-rich plasma (PRP) improves the healing of wounds and is inexpensive. Thus, the purpose of this study was to analyze the effect of the PRP-gel coating of a PPM on inflammation, production of collagen, and smooth muscle in the rabbit vagina. Materials and Methods The intervention consisted of a 1.5cm incision and divulsion of the vaginal mucosa for the implantation of a PRP-coated PPM. The PRP-coated mesh was implanted in 15 rabbits, and in the second group, the same implant was used without the PRP coating. In the sham group, the intervention consisted of the incision, divulsion, and suture. The rabbits were euthanized at 7, 30 and 90 days, and full-thickness sagittal sections of the posterior vaginal wall and rectum were scored. The inflammatory infiltrate was evaluated using hematoxylin and eosin staining. The Sirius Red stain was used to examine deposition of collagen I and III, and Masson’s trichrome staining was used to visualize the smooth muscle. Results The group with PRP-coated meshes had a lower inflammatory infiltrate count at 30 days. Deposition of collagen III increased with the use of PRP-coating at 90 days. Conclusions The area of inflammatory infiltrate was significantly increased in the group without the PRP-coated mesh at 30 days but not in the group with the PRP-coated mesh, indicating a less intense inflammatory response. In addition, a significant increase in collagen III occurred at 90 days.

Resumo O presente artigo procura destacar as novas perspectivas para compreensão do Estado e do direito abertas pela Revolução Russa. A Revolução Russa, ao constituir um “lúcido intervalo” na ascensão do capitalismo, expôs o problema das formas sociais – político-jurídicas – inerentes a este modo de produção e os dilemas do processo de transição socialista. Ao mesmo tempo, a Revolução Russa apresentou a relação entre as formas sociais e a especificidade das formações econômico-sociais, sintetizadas na questão do nacionalismo.

Abstract This article aims to highlight that the Russian Revolution opened new perspectives for understanding the State and the law with consequences that unfold until the present time. The Russian Revolution, when constituting a "lucid interval" in the rise of capitalism, exposed the problem of the social forms – political-juridical – inherent in this mode of production and the dilemmas of the socialist transition process. At the same time, the Russian Revolution put us before the relationship between social forms and the specificity of socio-economic formations, synthesized in the question of nationalism.

ABSTRACT Introduction: The platelet-rich plasma (PRP) is part of a set of biotechnologies, providing some growth factors that promote repair of different tissues. The polypropylene meshes (PPM) are applied in the correction of abdominal defects, pelvic floor and urinary incontinence, however, they induce many significant complications, as a result of an inappropriate inflammatory response. Purpose: To investigate the changes caused by PRP associated with the implantation of PPM in the abdomen of female rabbits, in the production of collagen I and III and the inflammatory infiltrate (ININ). Materials and Methods: We performed implant meshes with and without PRP in adult rabbits (n=30) and euthanasia at 7, 30 and 90 days. Two plates were prepared from each animal and analyzed in five different fields. The ININ was evaluated by quantification of inflammatory cells using hematoxylin-eosin and the collagen by Sirius red method. The results were analyzed applying the Wilcoxon, Kruskal-Wallis, Junckheere and Friedmann tests. Results: There was a significant difference in the number of inflammatory cells between the groups with and without PRP (p=0.01) at 90 days. There was increased production of collagen I, III and total with the use of PRP, at seven days. Conclusion: The PPM coating with PRP was associated with increased ININ at the implant area, and an increasing trend during the process of tissue repair. The PPM coated with PRP was related to increased concentration of collagen I, collagen III and the concentration of total collagen increased after seven days of implantation.

ABSTRACT Objective: The purpose of this video is to present the laparoscopic repair of a VUF in a 42-year-old woman, with gross hematuria, in the immediate postoperative phase following a cesarean delivery. The obstetric team implemented conservative management, including Foley catheter insertion, for 2 weeks. She subsequently developed intermittent hematuria and cystitis. The urology team was consulted 15 days after cesarean delivery. Cystoscopy indicated an ulcerated lesion in the bladder dome of approximately 1.0cm in size. Hysterosalpingography and a pelvic computed tomography scan indicated a fistula. Materials and Methods: Laparoscopic repair was performed 30 days after the cesarean delivery. The patient was placed in the lithotomy position while also in an extreme Trendelenburg position. Pneumoperitoneum was established using a Veress needle in the midline infra-umbilical region, and a primary 11-mm port was inserted. Another 11-mm port was inserted exactly between the left superior iliac spine and the umbilicus. Two other 5-mm ports were established under laparoscopic guidance in the iliac fossa on both sides. The omental adhesions in the pelvis were carefully released and the peritoneum between the bladder and uterus was incised via cautery. Limited cystotomy was performed, and the specific sites of the fistula and the ureteral meatus were identified; thereafter, the posterior bladder wall was adequately mobilized away from the uterus. The uterine rent was then closed using single 3/0Vicryl sutures and two-layer watertight closure of the urinary bladder was achieved by using 3/0Vicryl sutures. An omental flap was mobilized and inserted between the uterus and the urinary bladder, and was fixed using two 3/0Vicryl sutures, followed by tube drain insertion. Results: The operative time was 140 min, whereas the blood loss was 100ml. The patient was discharged 3 days after surgery, and the catheter was removed 12 days after surgery. Discussion: Laparoscopy has advantages over open surgery in that it is associated with less pain, shorter length of hospital stay, better cosmesis, quicker recovery, and equal efficacy. Although cases of VUF are rarely noted, the laparoscopic skill obtained through other urological procedures suggest, that laparoscopic repair may be the procedure of choice for such cases (2). The reported operative time for the laparoscopic repair of VUF in the literature varies between 140 and 220 min (3). However, laparoscopic techniques should be considered as a mode of abdominal access and should not influence the method of surgical repair. Surgical success should depend on the adherence to good technique rather than the approach. Hence, this method appears to be a viable alternative for surgeons experienced with laparoscopic suturing techniques. Conclusion: Laparoscopic repair appears to be a viable alternative for surgeons experienced with laparoscopic suturing techniques.

Purpose The aim of this video is to demonstrate an endoscopic and minimally invasive repair of an urethrocutaneous fistula with cyanoacrylate glue. Materials and Methods: A 56 year-old-man with post-infectious urethral stricture and recurrent perineal abscess formation due to urethral fistulas. Results The operative time was 60 minutes, no major complications were observed perioperatively and postoperatively. At a follow-up time of 6 months the patient had no evidence of recurrent fistula and abscess formation. CONCLUSIONS The endoscopic use of cyanoacrylate glue represents a safe and minimally invasive approach that might be offered as a first line option for the treatment of urinary fistulas in selected patients, especially those with narrow and long tracts.