Anxiety and depression symptoms in recurrent painful renal lithiasis colic

Several studies have reported that symptoms of anxiety and depression are significantly associated with diseases characterized by painful crises. However, there is little information about the psychological aspects of recurrent painful episodes of renal stone disease. Our objective was to evaluate the association of symptoms of anxiety, depression and recurrent painful renal colic in a case-control study involving 64 subjects (32 cases/32 controls) matched for age and sex. Cases were outpatients with a confirmed diagnosis of nephrolithiasis as per their case history, physical examination, image examination and other laboratory exams. Patients had a history of at least two episodes within a 3-year period, and were currently in an intercrisis interval. The control group consisted of subjects seen at the Ophthalmology Outpatient Clinic of this University Hospital with only eye refraction symptoms, and no other associated disease. Symptoms of anxiety were evaluated by the State-Trait Anxiety Inventory and symptoms of depression by the Beck Depression Inventory. Statistically significant differences were observed between patients with nephrolithiasis and controls for anxiety state (P = 0.001), anxiety trait (P = 0.005) and symptoms of depression (odds ratio = 3.74; 95%CI = 1.31-10.62). The Beck Depression Inventory showed 34.5% of respondents with moderate and 6% with severe levels of depression. There was a significant linear correlation between symptoms of anxiety (P = 0.002) and depression (P < 0.001) and the number of recurrent colic episodes (anxiety-state: P = 0.016 and anxiety-trait: P < 0.001). These data suggest an association between recurrent renal colic and symptoms of both anxiety and depression.

Síndrome de Gitelman: do diagnóstico ao acompanhamento na gestação

ResumoA síndrome de Gitelman (SG) é uma forma rara de nefropatia autossômica recessiva perdedora de sal, caracterizada classicamente por hipocalemia, hipomagnesemia, hipocalciúria, alcalose metabólica e pressão arterial baixa. Fadiga, fraqueza muscular e paralisia muscular estão entre seus sintomas mais comuns. Além dos distúrbios eletrolíticos típicos, outros achados laboratoriais incluem a hiperreninemia e o hiperaldosterismo secundário. Nefrocalcinose bilateral pode ocorrer. O tratamento consiste basicamente na reposição de potássio e uso de antagonistas da aldosterona. A melhor abordagem para gestantes portadoras de SG ainda está por ser definida. Entretanto, enfatiza-se a necessidade de suplementação dos íons, o controle do peso como ferramenta clínica de avaliação do balanço hídrico e a monitorização frequente do feto e dos níveis de líquido amniótico. O risco cirúrgico associado à cesariana em paciente com SG não está definido. Apesar dos riscos associados às crises sintomáticas de hipocalemia/hipomagnesemia, a SG apresenta bom prognóstico quando adequadamente tratada. A gravidez impõe a necessidade de controle mais intenso da doença, mas apresenta bom prognóstico para o binômio materno-fetal.

Resuming growth in Latin America: short and long term policies

The authors of this paper assert that the paralysis of the state generated by the crises of the 1970s and 1980s deprived the economies of the region of an important lever to resume and sustain growth. They thus maintain that to overcome stagnation it will be necessary to reconstruct the state's capacity to implement pro-growth policies. Following Keynes and Kalecki's ideas, but also classical development economists, the authors argue, first, that short-term macroeconomic policies, to reduce unemployment and to increase the degree of capacity utilization, should be used to promote the generation of profits to firms and to wake up entrepreneurs' animal spirits. Short-term expansionary policies should be coupled with measures to improve competitiveness and avoid balance of payments problems. They also claim that alternatives to the liberal programme will fail unless a pro-growth strategy is adopted which includes both short- and long-term policies. They thus propose that long-term policies must complete the package, signaling: a) sustained increases of effective demand in the future; and b) investment priorities to ensure that capacities will be created in strategic sectors and branches of the economy.

Inovações financeiras e institucionais do sistema de financiamento residencial americano

This article has the gold of summarize the institutional modifications of the US housing finance system between the 60's and the end of the 90's. Those changes narrowed the bonds between this segment of the credit market and the securitized financial markets, encouraging the foundation and diffusion of financial innovations that are in the core of the current financial crises.

Ajuste fiscal no Brasil: algumas considerações de caráter pós-keynesian

Fiscal adjustment in Brazil: Some considerations under a post Keynesian approach. The article analyses the main issues concerned to fiscal policy in Brazil. For doing so, it assumes a Post Keynesian approach on this issue. First, it observes the origins of the Brazilian fiscal crises, showing that the Brazilian external debt had a fundamental role to play in its configuration. After, it analyses the present conduction of the fiscal policy in Brazil, emphasizing the orthodox framework that support it. Finally, the Post Keynesian approach on fiscal policy and the role of the State, as an element essential to reach a greater economic stability is discussed, showing that there are several experiences that seems to have a Keynesian bias, but that has little relation to Keynes approach, as is the case of Brazil.

Democracia e eficiência: a difícil relação entre política e economia no debate contemporâneo

Democracy and efficiency: hard relations between politics and economy. Many economists see politics as an irrational activity. They also think state action usually generates market inefficiencies and democratic institutions, such as elections, often work as obstacles to sound economic measures. Showing that vision has been embedded into the main currents of economic thought since the last century, we also argue those ideas are exported to great part of contemporary political science, including the area of public policies. Examining the literature, we show that rational choice political scientists, as the economists, claim governability and effective decisions will be guaranteed mainly through concentrated arenas or through insulated arrangements able to protect policy makers from political interference. In other words, governability depends on the reduction of the political arenas. On the contrary, we reject this technocratic solution of splitting politics from economy. With the support of classical pluralist thinkers, we stand another conception, arguing politics is the privileged social space for building interests and values in an institutionalized way. The difficulties to surpass current international crises since 2008 reveal this is a crucial problem: reducing politics would prevent societies from improving institutional solutions which are the only ones able to give space to emerging conflicts and, then, reach eventual consensus around them.

The grab of the world's land and water resources

In this paper, I review recent developments in global political economy and political economy of development that have captured inter alia the attention of agrarian political economists. I do so through the periscope of two recent publications by Fred pearce, Great Britain's leading eco journalist and an edited volume by Tony Allann, Martin Keulertz, Suvi Sojamo and Jeroen Warner, scholars trained in different disciplines and based at various universities in the UK, the netherlands, and Finland. The account of the pace, places, and perpetrators, procedures, and problems of this particular agrarian model provides fodder for the further development of a locus classicus on what is happening to the land question in this current moment under the capitalist order, a shorthand for which is 'water and land grab'.

A regional arrangement proposal for the UNASUR

The article analyses the current process of economic integration in South America. Thus, concentrating our attention on the UNASUR regional integration process, two questions arise: First, is UNASUR the most viable institution to achieve a consistent economic integration process in South America? Second, what model of economic integration should be adopted in the case of UNASUR, which would ensure macroeconomic stability and avoid financial and exchange rate crises in the South America? To answer these questions, the article proposes, based on the Keynes (1944/1980)'s revolutionary analysis presented in his International Clearing Union, during the Bretton Woods Conference in 1944, a regional arrangement to UNASUR.

A plausibilidade da pós-história no sentido estético

A ideia do "fim da história", subentendida no capítulo final da Fenomenologia do espírito, serviu de base para o início de uma discussão, feita a partir das posições assumidas por Alexandre Kojève nos seus cursos sobre Hegel em Paris, na década de 1930, e em sua publicação no final dos anos 1940 (com reedição em 1968), voltou à baila com o artigo de Francis Fukuyama, de 1989, sobre o "fim da história", no qual ele comemorava o fim do "socialismo real" e a hegemonia mundial completa dos Estados Unidos da América. Passada a euforia sobre a "nova ordem mundial", inclusive em virtude de sucessivas crises econômicas, é interessante recolocar a questão sobre as condições sob as quais são aceitáveis conceitos associados a esse tema, especialmente o substantivo "pós-história" e o adjetivo "pós-histórico". A tese a ser defendida nesse artigo é a de que o campo da estética é um âmbito em que esses conceitos são defensáveis. Como exemplos de reflexões estéticas frutíferas que deles se valem, são consideradas a noção de "arte pós-histórica", de Arthur Danto, e os desdobramentos estéticos do conceito de "pós-história", tal como sustentado por Vilém Flusser.

Heidegger and Blumenberg on modernity

The debate surrounding the way in which Heidegger and Blumenberg understand the modern age is an opportunity to discuss two different approaches to history. On one hand, from Heidegger's perspective, history should be understood as starting from how Western thought related to Being, which, in metaphysical thinking, took the form of the forgetfulness of Being. Thus, the modern age represents the last stage in the process of forgetfulness of Being, which announces the moment of the rethinking of the relationship with Being by appealing to the authentic disclosure of Being. On the other hand, Blumenberg understands history as the result of the reoccupation process, which means replacing old theories with other new ones. Thus, to the historical approach it is not important to identify epochs as periods of time between two events, but to think about the discontinuities occurring throughout history. Starting from here, the modern age will be thought of not as an expression of the radicalization of the forgetfulness of Being, but as a response to the crises of medieval conceptions. For the same reason, the interpretation of history as a history of the forgetfulness of Being is considered by Blumenberg to subordinate history to an absolute principle, without taking into account its protagonists' needs and necessities.