DESENVOLVIMENTO DO TEATRO MUSICAL BRASILEIRO À LUZ DA NOTORIEDADE MIDIÁTICA DAS ADAPTAÇÕES E DOS ARTISTAS

O trabalho tem a proposta de analisar os desdobramentos do teatro musical brasileiro desde a primeira encenação em território nacional de adaptações de espetáculos do Teatro de Revista, gênero originário da França, até as superproduções musicais realizadas nos últimos 16 anos de adaptações de espetáculos americanos. O panorama histórico e analítico será estudado, com ênfase no teatro musical que se utiliza de elementos midiatizados para estar inserido em uma sociedade em que a produção cultural é vista como internacionalizada e mercantilizada. Como forma de marketing, os produtores utilizam-se da notoriedade midiática presente em formatos estrangeiros já consagrados, adaptações renomadas e bem aceitas pelo público, além da fama de celebridades que são escaladas para os musicais. Tudo para a conquista de um patrocinador que, por sua vez, acaba fazendo exigências que interferem de maneira decisiva na montagem dos espetáculos. Em meio a um processo onde são tantos os direcionamentos pré-estabelecidos por patrocinadores, onde se encontra o genuíno teatro musical brasileiro? A pesquisa abrange o ineditismo da presença de temáticas nacionais em formatos estrangeiros e agrega o conjunto de fatores que possibilitam que um roteiro de musical saia do papel e adentre os palcos, tais como as políticas públicas de incentivos fiscais; a ligação de empresas patrocinadoras e suas marcas a musicais; o fato de que, mesmo as produções sendo pagas por dinheiro público, possuírem ingressos que não são a preços populares. Para auxiliar nas conjecturas a serem formadas, será utilizada uma metodologia histórico-descritiva com foco na relação do tema com elementos notórios na mídia, como os artistas e obras a serem adaptadas no palco.

Cost Analysis of Long-Term Treatment of Patients with Symptomatic Gastroesophageal Reflux Disease (GERD) with Esomeprazole On-Demand Treatment or Esomeprazole Continuous Treatment: An Open, Randomized, Multicenter Study in Switzerland.

Objectives: To assess the difference in direct medical costs between on-demand (OD) treatment with esomeprazole (E) 20 mg and continuous (C) treatment with E 20 mg q.d. from a clinical practice view in patients with gastroesophageal reflux disease (GERD) symptoms. Methods: This open, randomized study (ONE: on-demand Nexium evaluation) compared two long-term management options with E 20 mg in endoscopically uninvestigated patients seeking primary care for GERD symptoms who demonstrated complete relief of symptoms after an initial treatment of 4 weeks with E 40 mg. Data on consumed quantities of all cost items were collected in the study, while data on prices during the time of study were collected separately. The analysis was done from a societal perspective. Results: Forty-nine percent (484 of 991) of patients randomized to the OD regimen and 46% (420 of 913) of the patients in the C group had at least one contact with the investigator that would have occurred nonprotocol-driven. The difference of the adjusted mean direct medical costs between the treatment groups was CHF 88.72 (95% confidence interval: CHF 41.34-153.95) in favor of the OD treatment strategy (Wilcoxon rank-sum test: P < 0.0001). Adjusted direct nonmedical costs and productivity loss were similar in both groups. Conclusions: The adjusted direct medical costs of a 6-month OD treatment with esomeprazole 20 mg in uninvestigated patients with symptoms of GERD were significantly lower compared with a continuous treatment with E 20 mg once a day. The OD therapy represents a cost-saving alternative to the continuous treatment strategy with E.

A contribuição histórica da sofistica a educação: a relação entre poder, saber e discurso

Esta pesquisa tem como objetivo básico resgatar a contribuição da sofística grega à teoria geral da educação analisando-a como paradigma da gênese teórica e histórica da relação entre poder, saber e discurso na educação ocidental. Em primeiro lugar, mostra-se que, contrariamente à crítica da filosofia que considerou-a falsa sabedoria, a sofística representou um autêntico movimento pedagógico, o primeiro do Ocidente que sustentou uma concepção orgânica entre educação, política e discurso. Em segundo lugar, afirma-se que a sofística foi um movimento pedagógico autêntico, mas diverso e contraditório internamente e muito ligado às condiçoes políticas da Grécia. A questão da sofística ganha neste estudo toda sua relevância em função de uma diferenciação fundamental: a primeira ou antiga sofística e a nova ou segunda sofística. Sublinha-se a contribuião positiva, principalmente, da primeira sofística e explica-se por que mudou sua conotação original de sabedoria, muito popular na democracia, para sua contr'ria de falso saber, amplamente rejeitada durante a demagogia e a queda da cidade. Considera-se que o resgate da sofística uma importante contribuição para repensar a educação atual segundo sua tradição histórica.

Respiratory physiotherapy can increase lower esophageal sphincter pressure in GERD patients

Background: Inspiratory muscle training (IMT) has been shown to increase diaphragm thickness. We evaluated the effect of IMT on mid-respiratory pressure (MRP) in patients with gastroesophageal reflux disease (GERD) and hypotensive lower esophageal sphincter (LES), and compared the results with a sham group. Methods: Twenty consecutive patients (progressive loading group) and 9 controls (sham group) were included. All patients had end expiratory pressure (EEP) between 5 and 10 mmHg, underwent esophageal manometry and pulmonary function tests before and after 8 weeks of training, and used a threshold IMT twice daily. The threshold IMT was set at 30% of the maximal inspiratory pressure for the progressive loading group; while, the threshold for sham-treated patients was set at 7 cmH(2)O for the whole period. Results: There was an increase in MRP in 15 (75%) patients in the progressive loading group, with an average gain of 46.6% (p<0.01), and in six (66%) patients in the sham group with a mean increase of 26.2% (p<0.01). However, there was no significant difference between the groups (p = 0.507). The EEP also increased compared with measurements before training (p<0.01), but it did not differ between groups (p = 0.727). Conclusion: IMT increased LES pressure in patients with GERD, in both the treatment and sham groups, after an eight-week program. Although there was no statistically significant difference between groups, suggesting the pressure increase in LES occurs regardless of the resistance load of the threshold IMT. These findings need to be confirmed in further studies with a larger sample. Registration number: 0922/09. (C) 2012 Elsevier Ltd. All rights reserved.

Erosioni dentali nei bambini affetti da GERD

L’erosione dentale è definita come una perdita progressiva e irreversibile dei tessuti duri del dente, a causa di un processo chimico che non coinvolge i batteri. La sua prevalenza è accresciuta negli ultimi anni nella popolazione generale, particolarmente nei bambini e negli adolescenti e rappresenta attualmente un’enorme sfida per la cura della salute orale. L'eziologia delle erosioni è difficile da diagnosticare perché può essere il risultato di una varietà di fattori e si può manifestare in maniera differente in base alla causa che l’ha determinata. L’eziologia può essere intrinseca, cioè derivante dal contenuto acido dello stomaco associato a disordini alimentari come l’anoressia, la bulimia nervosa, il reflusso gastro-esofageo e il regurgito, o estrinseca, derivante dal contenuto acido proveniente dall’ambiente esterno (cibi dietetici, bevande analcoliche, succhi di frutta, ecc). L’erosione è particolarmente frequente nei bambini e poiché i soggetti che presentano erosioni in dentizione decidua hanno un rischio aumentato di manifestare erosioni in dentizione permanente, una diagnosi precoce e una prevenzione attuata in tenera età, aiuterà a prevenire il danno a carico dei denti permanenti. Inoltre se l’erosione dentale non è controllata e stabilizzata, il bambino potrebbe soffrire di severe perdite di superfici dentali, sensibilità dentale, malocclusione, inestetismi o anche ascessi dentali dei denti affetti. Lo studio caso-controllo è stato condotto dalla Sezione di Odontostomatologia del Dipartimento Testa - Collo, in collaborazione con l’Unità Operativa Complessa di Gastroenterologia Pediatrica dell’Azienda Ospedaliera-Univesitaria di Parma. Il gruppo di studio comprende 60 pazienti di età compresa tra i 4 e i 13 anni. Dei 60 bambini arruolati, 30 presentano sintomi e storia clinica di GERD, mentre gli altri 30 sono bambini sani senza alcun sintomo di GERD o di altri disturbi gastrointestinali. Il gruppo campione A include anche soggetti affetti, oltre che dal reflusso gastro-esofageo, da varie forme di disabilità, in alcune delle quali il GERD sembra essere parte del quadro sindromico. I risultati ottenuti dallo studio hanno dimostrato una prevalenza maggiore di erosioni dentali nel gruppo di bambini affetti da GERD, rispetto ai bambini sani, in accordo con quanto riportato dalla letteratura.

Obesity and GERD: pathophysiology and effect of bariatric surgery

Epidemiologic, endoscopic, and pathophysiologic studies document the relationship between obesity and gastroesophageal reflux disease (GERD). Increased body mass index and accumulation of visceral fat are associated with a two- to threefold increased risk of developing reflux symptoms and esophageal lesions. Given this association, many studies were designed to evaluate the outcome of reflux symptoms following conventional and surgical treatment of obesity. Among bariatric procedures, gastric sleeve and banded gastroplasty were shown to have no effect or even worsen reflux symptoms in the postoperative setting. Gastric banding improves reflux symptoms and findings (endoscopic and pH-measured distal esophageal acid exposure) in many patients, but is associated with de novo reflux symptoms or lesions in a considerable proportion of patients. To date, Roux-en-Y gastric bypass is the most effective bariatric procedure that consistently leads to weight reduction and improvement of GERD symptoms in patients undergoing direct gastric bypass and among those converted from restrictive bariatric procedures to gastric bypass.

Quantification of dental erosions in patients with GERD using optical coherence tomography before and after double-blind, randomized treatment with esomeprazole or placebo

OBJECTIVES: Dental erosion, the chemical dissolution of enamel without bacterial involvement, is a rarely reported manifestation of gastroesophageal reflux disease (GERD), as well as of recurrent vomiting and dietary habits. It leads to loss of tooth substance, hypersensitivity, functional impairment, and even tooth fracture. To date, dental erosions have been assessed using only very basic visual methods, and no evidence-based guidelines or studies exist regarding the prevention or treatment of GERD-related dental erosions. METHODS: In this randomized, double-blind study, we used optical coherence tomography (OCT) to quantify dental tissue demineralization and enamel loss before and after 3 weeks of acid-suppressive treatment with esomeprazole 20 mg b.i.d. or placebo in 30 patients presenting to the Berne University Dental Clinic with advanced dental erosions and abnormal acid exposure by 24-h esophageal pH manometry (defined as >4% of the 24-h period with pH<4). Enamel thickness, reflectivity, and absorbance as measures of demineralization were quantified by OCT before and after therapy at identical localizations on teeth with most severe visible erosions as well as several other predefined changes in teeth. RESULTS: The mean+/-s.e.m. decrease of enamel thickness of all teeth before and after treatment at the site of maximum exposure was 7.2+/-0.16 black trianglem with esomeprazole and 15.25+/-0.17black trianglem with placebo (P=0.013), representing a loss of 0.3% and 0.8% of the total enamel thickness, respectively. The change in optical reflectivity to a depth of 25 black trianglem after treatment was-1.122 +/-0.769 dB with esomeprazole and +2.059+/-0.534 dB with placebo (P 0.012), with increased reflectivity signifying demineralization. CONCLUSIONS: OCT non-invasively detected and quantified significantly diminished progression of dental tissue demineralization and enamel loss after only 3 weeks of treatment with esomeprazole 20 mg b.i.d. vs. placebo. This suggests that esomeprazole may be useful in counteracting progression of GERD-related dental erosions. Further validation of preventative treatment regimens using this sensitive detection method is required, including longer follow-up and correlation with quantitative reflux measures.

Gerd Schwerhoff and Alex Kästner, eds., Göttlicher Zorn und menschliches Maß: Religiöse Abweichung in frühneuzeitlichen Stadtgemeinschaften (Constance: UVK, 2013)

This book presents six essays by researchers associated with the Technological University of Dresden’s collaborative research centre, Transzendenz und Gemeinsinn, on the interesting theme of religious deviance in early modern cities. As Gerd Schwerhoff and Alexander Kästner make clear in the introduction, early modern religious deviance is a broad concept, and one difficult to delimit, particularly because most early modern secular crimes—theft, adultery, witchcraft and magic, blasphemy—were also sins. Should such offences fall under the rubric of secular or religious deviance? Historians have traditionally approached these offences as secular (and indeed, they were commonly prosecuted in ‘secular’ courts), but one cannot help but see their religious roots. Moreover, religious deviance also encompassed divergence over confessional practices and doctrinal beliefs among Catholics, Protestants, Anabaptists, Calvinists, and so on. To try and demarcate this broad field, Schwerhoff and Kästner advocate using the ‘labelling approach’, drawn from sociology and previously used in Schwerhoff’s work: that is, behaviour only becomes deviant when contemporaries classified (or labelled) it as such (p. 27).