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Introduction: The tumour infiltrating lymphocytes (TIL) have a complimentary role alongside TNM assessment in determining the future management in colorectal carcinoma. The present study aimed at evaluating tumour infiltrating lymphocytes at the invasive front of the tumour and to correlate with other known prognostic variables. Methods: A total of 76 cases of colorectal adenocarcinoma were selected and TILs were assessed on hematoxylin and eosin (H-E) stained tumour sections based on Klintrup-Makinen (K-M) score; classified cases into high TIL and low TIL groups and correlated with clinicopathological parameters. Results: Of the 76 cases, 46 cases (60%) belonged to low TIL group and 30 cases (40%) to high TIL group. Statistical analysis showed that density of TILs at the invasive front of the tumour negatively correlated with grade of differentiation (p=0.02), lymphovascular invasion (p=0.03), nodal involvement (p=0.01) and pathological staging (p=0.02). Conclusion: Tumour infiltrating lymphocytes showed significant association with grade of tumour differentiation, lymphovascular invasion, nodal involvement and stage of tumour.

Introduction Gastrointestinal (GI) tract is the most common site of extranodal lymphoma accounting for 30–40% of the cases. In Western countries, stomach is the most common site of GI lymphoma, whereas in the Middle East and Mediterranean countries, small intestine is commonly involved. Studies about primary intestinal lymphoma (PIL) are heterogeneous in anatomical distribution, presentation, and histological subtypes. The present study was aimed at studying the anatomical distribution, histological subtypes, and clinical characteristics at tertiary care centers. Materials and methods The present study was retrospective, conducted between 2006 and 2020. Patient's data were collected from institutional medical records. PIL was diagnosed by Lewin's criteria. After histological diagnosis, PIL was classified as per the World Health Organization (WHO) criteria and staging was done according to the Ann Arbor classification as modified by Musshoff. Results A total of 941 lymphoma cases were diagnosed during the study period between 2006 and 2020 consisting of 238 Hodgkin's lymphoma and 703 non-Hodgkin's lymphoma (NHL) cases. PIL constituted 5.8% of all lymphoma cases (55 out of 941) and 50.9% (55 of 108) of all primary GI lymphoma. Median age at diagnosis was 44 years and comprised predominantly males (85.45%). Diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma were the most common histological subtype (78%) seen. Two patients with primary Hodgkin's lymphoma involving the intestine were seen. T-cell lymphoma was seen in three (5.4%) patients. Ileocecal region was the most common site involved (27%). The common presenting complaints were intestinal obstruction (40%) requiring surgical resection and abdominal pain (32%). Majority of the patients presented in the early stages (I and II). Conclusion Our study demonstrates the pattern of distribution and various histological subtypes of PIL including the rare variants like primary intestinal Hodgkin's lymphoma. Relatively more number of patients presented with intestinal obstruction requiring surgery in comparison with other studies. How to cite this article Malipatel R, Patil M, Rout P, et al. Primary Intestinal Lymphoma: Clinicopathological Characteristics of 55 Patients. Euroasian J Hepato-Gastroenterol 2021;11(2):71–75.

Colorectal cancer (CRC) is a complex disease as shown by consensus classification. The present study attempted to identify subtypes with known prognostic markers for better clinical management. A total of 72 CRC tumors were examined for the expression of mismatch repair (MMR) proteins, along with caudal-type homeobox protein 2 (CDX2) and BRCA1, by immunohistochemistry. Tumors were assigned based on the presence or loss of MMR proteins as proficient or deficient. Correlations were examined with CDX2 and BRCA1 along with clinico-pathological features. Expressional pattern of microRNAs (miRs/miRNAs), such as miR-183-96-182, known to be associated with defective DNA damage repair were evaluated by reverse transcription-quantitative PCR. A total of 22% of the CRC tumors were assigned as deficient in mismatch repair. 71% of the tumors expressed CDX2 while only 21% had nuclear expression of BRCA1. Loss of CDX2 protein was higher in the deficient subtype compared with the proficient subtype. A total of 14% of the tumors had dual loss of MMR and BRCA1 proteins and showed aggressive clinical features in addition to elevated expression of DNA damage repair microRNAs. The present study shows the presence of a small proportion of colorectal tumors with dual loss of key proteins involved in DNA damage repair which may be amenable to specific therapy. The implication of the present observations warrants investigation in a larger patient cohort with prognostic information.

Introduction Gastrointestinal tract (GIT) is the most common site of involvement of extranodal non-Hodgkin's lymphoma (NHL). There is regional variation in anatomical distribution of extranodal NHL, stomach being the most common site followed by small intestine. Primary gastric lymphoma (PGL) predominantly involves the antrum and corpus of the stomach. It arises from mucosa-associated lymphoid tissue (MALT) and is of B-cell lineage and often associated with Helicobacter pylori infection. Primary gastric lymphoma often presents with nonspecific symptoms. The present study was undertaken to ascertain the clinicopathological characteristics of PGL at a tertiary care center in South India. Materials and methods It is a retrospective study from 2006 to 2016. Patient's data were obtained from institutional medical records. The histopathology slides were reviewed. The relevant immunohistochemistry (IHC) markers done were leukocyte common antigen (LCA), CD3, CD20, CD79a, CD10, Bcl-2, Bcl-6, CD5, Cyclin D1, CD138, and Ki-67. Correlating with the immunoprofile, further subtyping was done. Results A total of 405 patients of NHL were seen during the study period, out of which 43 patients were PGL. There were 32 males and 11 females, with M:F of 2.9:1. The mean age at diagnosis was 58 years. Abdominal pain and new-onset dyspepsia were the commonly observed presenting symptoms. The common site of involvement was antrum (20). Diffuse large B-cell lymphoma (DLBCL) was the most common histological subtype. Helicobacter pylori infection was seen in 18 (41%) patients. Majority of the patients were in stages II and III. Conclusion In our study, the initial presentation of PGL was with nonspecific symptoms like abdominal pain and new-onset dyspepsia. High degree of suspicion of such symptoms and biopsy of all suspicious lesions is essential for early detection. Diffuse large B-cell lymphoma was the most common histological subtype seen in our study.How to cite this article: Malipatel R, Patil M, Rout P, Correa M, Devarbhavi H. Primary Gastric Lymphoma: Clinicopathological Profile. Euroasian J Hepato-Gastroenterol 2018;8(1):6-10.

Aim Recent studies have shown an increase in the incidence of gastric neuroendocrine tumors (NETs) (carcinoids). This may be attributable to the frequent employment of endoscopy in clinical practice and the increasing use of proton pump inhibitors. From the literature that is available, it is interesting to note that the profile of patients with gastric carcinoids is different in the Asian population when compared to the western societies. As limited data is available from India, we evaluated retrospectively the clinical profile and pathology of gastric carcinoids presenting to our hospital. Materials and methods A total of 31 patients with gastric carcinoids who presented to our institution from 2006 till 2013 were included in this study. The clinical data were obtained from the case files and the histopathology slides were reviewed. Results Gastric carcinoids constituted about 32% of all gastrointestinal (GI) NETs and were second only to duodenal carcinoids in frequency. Men were more commonly affected (74%) and the majority were of type 1 (90%). Multifocal gastric atrophy with intestinal metaplasia was additional features seen in the majority of cases with type 1 carcinoids. Conclusion This study, one of the largest series reported from India, shows that the frequency and profile of gastric carcinoids is different in this population when compared to the west. It also raises the possibility that Helicobacter pylori induced multifocal gastric atrophy might be a triggering factor for the most common type 1 gastric carcinoid rather than autoimmune gastritis. Clinical significance Eradication of H. pylori may be a potential preventive strategy for the occurrence of gastric carcinoids. How to cite this article Ananthamurthy A, Correa M, Patil M. Type 1 Gastric Carcinoid in the Indian Population and Its Association with Multifocal Gastric Atrophy. Euroasian J Hepato-Gastroenterol 2016;6(2):106-110.

Background: Chylothorax is a rare complication of gastric adenocarcinoma and data on its identification, prevalence and outcomes are scant. Objectives: To enable identification of gastric carcinoma as a cause of chylothorax. Methods: A case report and a systematic review were conducted of all reported cases of gastric adenocarcinoma with chylothorax as the presenting complaint in the English literature. Results: Chylothorax is a rare presenting complaint of gastric adenocarcinoma. There are only 18 case reports in the world literature, of which six are in English. Chylothorax occurred variably in gastric adenocarcinoma, either as a presenting feature or as a complication of therapy. Here, we analyze the index case and six patients in whom gastric carcinoma presented with chylothorax as the initial symptom. Respiratory features of cough and dyspnea preempted any abdominal complaint. Bilateral chylothorax (66%) with associated chylous ascites (50%) was common. Four of the six patients had skin lymphedema also as a prominent feature. The chylothoraces have been treated by therapeutic pleurocentesis, intercoastal tube drainage and restriction of oral intake. Gastric adenocarcinoma was associated with high mortality (50%) and morbidity. Conclusions: Chylothorax can be the presenting feature of gastric adenocarcinoma. A thorough search for this life-threatening disease should be done before labeling the chylothorax as idiopathic.

ER negative and Triple negative breast cancers carry a poorer prognosis and are not amenable to hormone therapy. It has been previously observed that Indian patients with breast cancer have a higher tendency to have these tumours. Whether this is due to inherent biological differences in the tumours of our patients is a matter of much debate. We have analysed 250 patients of breast cancer for hormone receptor status, compared them with western series, and attempted to support the hypothesis that the higher ER negativity and triple negativity is indeed due to different tumour biology.

Summary Objective Thyroglossal duct (TD) anomalies are generally considered to be a distinct clinical entity. However occasional cases do not conform to the standard picture and are complex. This study aimed to scrutinise consecutive cases of TD anomaly managed surgically over 7 years at a tertiary teaching hospital and analyse those with atypical features. Methods This is a retrospective study of 62 children managed for a clinical diagnosis of TD anomaly from 1998 to 2005. Their medical records were reviewed for clinical presentation, investigations, operative findings, histopathology, management and outcome. After a clinical diagnosis, they had individualized investigations (USG, MRI, radioiodine scan, FNA) prior to the Sistrunk operation. Results 5/62 cases had atypical features. 2/5 were adolescents with a short history while 3 were below 5 years of age with onset since infancy. 4/5 were females. 1/5 had a Sistrunk operation earlier, 2/5 had a redo surgery prior to cure. 3/5 had a grossly identifiable tract at surgery, one with a midline course and two deviating laterally to open at the left pharyngeal wall. The final histological diagnosis was a mixed thyroglossal-dermoid cyst (case 1), TD anomalies with aberrant pharyngeal communication (cases 2 and 3), isthmic thyroglossal ‘cold’ cyst (case 4), and a tuberculous cyst (case 5). Postoperatively, Cases 2 and 3 had wound infections that were managed conservatively while case 5 developed an incisional sinus that healed after a month of anti-tuberculous chemotherapy. Cases 1 and 4 had an uneventful recovery. At an average f/u of 2 years, all are asymptomatic and well. Conclusions 5–10% of apparent TD anomalies may present with atypical clinicopathologic characteristics. Atypical cases and late presentations may warrant additional investigations to establish the diagnosis and tailor management.

Neonatal gastrointestinal (GI) mucormycosis is a rare, usually fatal, opportunistic fungal infection, which is difficult to diagnose early or preoperatively. We report three babies, only one of whom survived, with a review of the literature. All three had similar findings of necrosis of colon with multiple perforations. While the first baby was diagnosed as long segment Hirschsprung's, the second was treated as small left colon but went on to show signs of peritonitis. The third presented with pneumonia, which progressed to sepsis and peritonitis. All three were diagnosed by histology postoperatively and two of them succumbed, one in spite of amphotericin and the other as he was too sick to start antifungals and had a rapid downhill course. The one who survived did so even though she did not receive amphotericin, but had clear margins of resection. The only chance of survival in this fatal disease is early diagnosis and rapid institution of aggressive therapy inclusive of adequate surgical debridement and appropriate antifungal medications.

Papillary thyroid carcinoma (PTC) is the most frequently occurring malignant neoplasm of the thyroid gland and is known to have several morphologic variants. PTC with nodular fasciitis-like stroma (PTC-NFS) is one of the unusual variants of PTC, with only a few cases being reported in the literature. This neoplasm is characterized by extensive reactive stromal proliferation, which may occupy 60 to 80% of the tumor along with areas of a typical papillary carcinoma. We report a case of PTC-NFS and address the diagnostic difficulties posed by the conditions extensive reactive stromal proliferation. We also emphasize that when one encounters a fibroproliferative lesion of the thyroid, a diligent search should also be made for PTC to avoid diagnostic errors.

Hemangiomas are a benign vascular tumor and are of two types: capillary and cavernous. Isolated cavernous hemangiomas of paranasal sinuses are rare. We report a case of hemangioma involving the left maxillary and ethmoid sinus managed endoscopically.

Gastrinomas are rare neuroendocrine tumours. A 9-year-old boy who initially presented with recurrent upper abdominal pain and was managed as hyperacidity syndrome was later diagnosed to have a primary, retroperitoneal, extra pancreatic gastrinoma after an asymptomatic period of 6 years is presented. At the second presentation, the contrast-enhanced CT revealed an epigastric mass and serum gastrin was grossly elevated. A complete excision of the mass was done; histopathological evaluation showed a well-differentiated neuroendocrine tumour. At a year follow up, the child is asymptomatic and the review imaging and serum gastrin levels are normal.

A study was conducted on the value of Ultrasound (US) in the detection of cervical lymph node metastases in cases of Head and Neck malignancy; and its usefulness in planning surgical management. The clinical, ullrasonographic and histopathological examination (HPE) findings were compared in 20 patients as a preliminary assessment of this ongoing study. Clinically and ultrasonogiaphically, patients were assessed for presence of nodes, their size, shape, mobility and overall positivity for malignancy. All patients then underwent neck dissection, and individual nodes from the specimens were assessed by HPE.It was found that US, when compared with clinical examination had a sensitivity of 47.62% versus 43.75%, specificity of 77.78% versus 25.0% and an accuracy of 61.54% as opposed to 38.9%. US proved valuable in detecting sub-clinical nodes, central necrosis, extra-capsular spread, pressure on large vessels - all indicators of metastatic spread. Hence, US was found to be efficient and cost-effective pre-operatively, in planning surgical management.

Objectives Lingual thyroglossal duct cysts (TGDC) are rare and liable to be missed in a cursory clinical examination. This study aimed to report the details of lingual TGDC from the authors’ series and review existing literature on the entity. Methods A 12 year retrospective survey of all cases of thyroglossal duct anomalies managed at a tertiary teaching hospital was conducted to identify those with lingual TGDC. Their clinical presentation, investigations, diagnosis and management were analysed. Case series from anecdotal published English literature were critically reviewed with particular regard to diagnosis and management. Results Of 78 cases of thyroglossal duct anomalies, 3 were lingual TGDC. All were females. One neonate presented with feeding difficulty and was clinically misdiagnosed as a ranula. The two older children presented with a cyst at the foramen caecum. The varied imaging and diagnostic dilemma are presented. The older children had cysts abutting the hyoid and were managed with transoral excision and a Sistrunk procedure; the neonate was managed with transoral excision only. This report also reviews the sparse literature and discusses specific issues in their treatment. The differential diagnoses encompass a wide array of developmental and neoplastic entities. Specific anatomic imaging with USG/CT/MRI and functional evaluation with radionuclide thyroid scan are essential investigative modalities. Besides a classical Sistrunk procedure and simple transoral excision, newer less invasive treatment options including marsupialisation and alcohol ablation have been reported. Conclusions In conclusion, the diagnosis and management of lingual TGDC needs to be individualised depending on their presentation and anatomic location. The Sistrunk's procedure is ideal for those in close proximity to the hyoid; however complete cyst excision would suffice in the rest.

Synovial sarcomas commonly occur in the extremities of young adults. A primary occurrence in the mediastinum is very rare with only a few reported cases in the world literature. This paper is about a 42-year-old male who presented with chest pain and dyspnoea on exertion. Imaging showed an anterior mediastinal mass with adhesions to the lung. Pathological examination of the resected mass showed a biphasic neoplasm with a spindle cell component admixed with gland-like elements. The tumour showed positive staining with cytokeratin, epithelial membrane antigen, and Bcl-2 confirming the diagnosis of a biphasic synovial sarcoma. A wide range of neoplasms, both primary and metastatic, occur in the mediastinum, which pose considerable diagnostic difficulties. A synovial sarcoma should always be considered in the differential diagnosis, and immunohistochemistry is an important adjuvant tool in this situation. This paper highlights the importance of recognizing an unusual presentation of this aggressive neoplasm to aid appropriate clinical management.

Background: Pilomatricoma is a benign tumor of hair matrix differentiation and has been classically described as comprising of basaloid and shadow cells admixed with multinucleated giant cells and areas of calcification. However, there are a diverse range of histologic features this tumor displays that are often unrecognized. Aims: This study was undertaken to record the histopathologic features of pilomatricoma with an emphasis on the occurrence of other forms of differentiation. Methods: The study included all skin biopsy specimens over a 13-year period from 1995 to 2007 that had a histologic diagnosis of pilomatricoma. Hematoxylin and eosin-stained slides were reviewed. Results: This study included 21 cases of pilomatricoma. Supramatrical differentiation was seen in all cases and three-quarters of the cases showed matrical differentiation. Also observed in some of the cases were clear cell differentiation toward the outer root sheath, infundibular differentiation, calcification, ossification and secondary inflammation with a foreign body giant cell reaction. Epidermal induction in the form of a downward plate-like growth of the epidermis was seen in a few cases. Conclusion: Pilomatricoma, although considered a tumor of hair matrix differentiation, can show cellular evolution toward the other parts of the hair follicle, such as the outer and inner root sheaths, sebaceous and infundibular components and, therefore, can be considered a panfollicular neoplasm.

Oncocytomas are rare tumors with characteristic histological features of large eosinophilic cells with prominent nucleoli and small round nuclei. They commonly occur in the kidney and salivary glands. Their occurrence in the lungs is very rare; fewer than 6 cases being reported so far in the available world literature. We encountered one such case and present the details of the management and its outcome.

There are only four reports of glycogen storage disease (GSD), totalling six cases, from India.To determine the clinical phenotypes of children diagnosed with GSD in southern India.Liver biopsy reports from 1994 to 2005 were reviewed and GSD was confirmed in 17 patients. All 17 patients were tested for the three commonest GSD 1a mutations by restriction fragment length polymorphism: R83C, Q347X and G727T.They presented at mean age of 15 months (range, birth to 46 months) with hypoglycemia, hepatomegaly and delayed milestones. None of the patients showed R83C, Q347X or G727T mutation.Glycogen storage disease may not be rare in India. The commonest 1a mutations are probably rare here.

Background: Cervical cytology screening for carcinoma of the cervix in India is mainly opportunistic in nature and is practiced mainly in urban centres. The effectiveness of cervical cytology screening depends on various factors. The quality of cervicovaginal cytology service is assessed by various quality indices and by cyto-histology correlation, which is the most important quality assurance measure. Aims: To describe the cervical cytology diagnoses, estimate the quality indices, and evaluate the discrepant cases on cytohistological correlation. Settings and Design: Retrospective observational study from a tertiary care centre in South India. Materials and Methods: Using a database search, all the cervicovaginal cytology reported during the period of 2002-2006 was retrieved and various diagnoses were described. The data was analysed to assess the quality indices. The cytohistologically discrepant cases were reviewed. Results: A total of 10,787 cases were retrieved, of which 98.14% were labeled negative and 1.36% were unsatisfactory for evaluation. A few (0.81%) of the cases were labeled as squamous intraepithelial lesions and 0.38% as atypical squamous cells. The ASCUS: SIL ratio was 0.5. Cytohistological correlation revealed a total of ten cases with significant discrepancy. The majority of these were carcinomas that were misdiagnosed as atypical glandular cells. These cytology smears and the subsequent biopsies were reviewed to elucidate the reasons for the discrepancies. Conclusions: The cervical cytology service at our centre is well within the accepted standards. An increased awareness of cytological features, especially of glandular lesions, a good clinician-laboratory communication and a regular cytohistological review would further improve the diagnostic standards.

Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma with limited literature available on its cytological features. We report here one such case where a diagnosis of EMC was made based on fine needle aspiration cytology (FNAC). A 51 year-old male presented to our FNAC clinic with a slowly growing mass in the left thigh, which was subjected to fine needle aspiration biopsy. Radiological images showed no involvement of the underlying bone. Magnetic resonance imaging was suggestive of a malignant neoplasm. The FNA smears showed cell fragments and cords of monotonous cells embedded in abundant myxoid stroma. A diagnosis of a myxoid sarcoma favoring an EMC was made in this patient. Subsequent excision of the mass for histopathological examination confirmed this diagnosis. EMC has distinctive cytological features that are helpful in confidently making a diagnosis in the appropriate clinical setting.

Background: Nevus sebaceus (NS), otherwise designated as ′organoid nevus′, involves proliferative changes of the sebaceous glands, sweat glands, and the hair follicles. It displays a range of appearances, depending on the lesion′s age. Aims: To study the histopathological features of NS and correlate these with clinical findings. Methods: All skin biopsy specimens over a 12-year period from 1995 to 2007 which had a diagnosis of NS were included. Clinical data with follow-up notes and histopathology were reviewed. Results: Half of the cases had a verrucous clinical appearance, while the rest presented as papules, plaques, or patches. All the cases showed immature hair follicles, and 24% of cases showed immature sebaceous glands. Normal terminal hair follicles were characteristically absent in the lesion. Nineteen percent of the cases showed dilated apocrine glands, and 14% showed hyperplasia of eccrine glands. Epidermal changes in the form of acanthosis, papillomatosis, and hyperkeratosis were seen in 86% of cases. Dilated keratin-filled infundibula were observed in 24% of cases. One case was associated with a squamous cell carcinoma. Conclusions: Nevus sebaceus is a cutaneous hamartoma, consisting of various elements indigenous to the organ. Normal terminal hair follicles are characteristically absent in the lesion although the same may be seen in rest of the epidermis, a feature of diagnostic importance, not usually highlighted in literature. The divergent differentiation observed in NS is consistent with the common embryologic origin of the folliculosebaceous-apocrine unit and should not mislead the pathologist.

O Parlamento Infantil de Moçambique é uma instituição participativa voltada para o grupo geracional da infância, e tem como objetivo colocar os infantes moçambicanos no processo de deliberação pública nacional em Moçambique. É uma instituição de participação infantil formulada pelo Estado moçambicano, através do pelouro do Gênero, Criança e Ação Social, do poder executivo. Com esta instituição, se visa a inclusão democrática do grupo geracional da infância em Moçambique, e foi concebida para servir ou funcionar como um elo democrático entre o grupo geracional da infância e o Estado moçambicano. Devido aos fatores negativos sucessivos que afetaram o Estado moçambicano no período entre 2016 e 2021 que resultaram em miséria em Moçambique e dificultaram o funcionamento normal do Estado moçambicano, dentre os quais a crise financeira devido à suspensão de ajuda externa por descoberta de dívidas moçambicanas consideradas ilegais, além dos ciclones e inundações de alta magnitude Idai e Keneth, e a pandemia da COVID-19, se empreendeu este estudo. Nesta dissertação, que é um estudo de caso, sob as lentes da teoria da democracia deliberativa conectada à teoria da democracia participativa, se analisa se o Parlamento Infantil de Moçambique serviu ou funcionou como elo democrático entre o grupo geracional da infância e o Estado moçambicano no período entre 2016 e 2021. A dissertação possui três capítulos, dos quais, os dois iniciais são ensaios teóricos e o último é resultado de pesquisa empírica. O primeiro capítulo aborda a participação infantil e a deliberação pública. O segundo capítulo é uma exposição detalhada e contextualizada sobre o Parlamento Infantil de Moçambique. O terceiro e último capítulo é o retrato dos resultados do trabalho empírico sobre o Parlamento Infantil de Moçambique no período entre 2016 e 2021, acompanhados de suas respectivas análises e discussões. Este estudo adota a abordagem qualitativa e se vale de entrevistas em profundidade e análise documental como métodos de coleta de dados no âmbito do trabalho empírico. Da análise e discussão dos resultados do trabalho empírico, o estudo concluiu que o Parlamento Infantil de Moçambique não serviu ou funcionou como elo democrático entre o grupo geracional da infância e o Estado moçambicano no período entre 2016 e 2021, sendo como consequência da não efetividade da conexão entre o Parlamento Infantil de Moçambique e as instituições moçambicanas de representação eleitoral e deliberativas de tomada de decisões no período entre 2016 e 2021, causada pelos impactos diretos dos fatores negativos e sucessivos, dentre os quais a crise financeira pela suspensão da ajuda externa pela descoberta das dívidas moçambicanas consideradas ilegais, os C«ciclones de alta magnitude Idai e Keneth, e a pandemia da COVID-19, acrescidos do compromisso insuficiente do Estado moçambicano para com esta instituição de participação infantil, que se evidencia e é denunciado pela falta de apoio político e falta de apoio administrativo a esta instituição participativa moçambicana.

A partir de trabalho realizado por organizações ligadas à igreja católica junto a pessoas em situação de rua, deu-se início ao processo organizativo de catadoras e catadores de materiais recicláveis em associações e cooperativas no Brasil. Nesse processo, ao discutirem questões relativas à cidadania, direito a ter direitos, trabalhadores perceberam o valor e a importância do trabalho que realizam, uma vez que, além de prover o sustento dos mesmos e de suas famílias, a separação dos materiais recicláveis e seu retorno para o ciclo produtivo trazem benefícios ambientais, sociais e econômicos para a coletividade. A construção da autopercepção dessas catadoras e catadores como cidadãos e como trabalhadores permitiu igualmente a construção da percepção de que é injusto o fato de não serem reconhecidos, por parte da sociedade e pelo poder público, pelo trabalho que realizam, inclusive não sendo remunerados por ele. Construiu-se, a partir daí, a ideia do direito dos catadores à contratação para a realização do serviço de coleta seletiva municipal. Para analisar o processo de luta dos catadores pela contratação de suas organizações, foram realizados estudos de caso em quatro municípios, com objetivo de compreender como as diferentes dimensões da Moldura Interpretativa de Ação Coletiva mobilizada nas bases, incluindo percepções sobre oportunidades políticas, se relacionam com as escolhas atinentes ao repertório de ação coletiva utilizado. A análise realizada teve suporte nas TMS, principalmente de conceitos importantes na TPP, como repertório de ação coletiva, oportunidades políticas e enquadramento. Também foi relevante a contribuição dos estudos de mobilização do direito. Com o estudo, foi possível perceber uma tendência das lideranças dos catadores a evitar estratégias de confronto, privilegiando, sempre que possível, as formas de interação das chamadas política de proximidade e participação institucional (ABERS, SERAFIM E TATAGIBA). Se a gestão pública é lida como impermeável às demandas dos catadores, as lideranças lançam mão de outras possibilidades: a implementação de espaço de interlocução no âmbito da sociedade civil, o FMLC e o encaminhamento de demandas a instituições do sistema de justiça, como o MP e a DP. Ações coletivas com caráter de confronto são menos comuns, em geral ocorrem quando há a percepção de alguma ameaça considerada muito relevante pelas lideranças. Embora seja possível constatar grande influência das percepções das lideranças sobre oportunidades e ameaças políticas nas tomadas de decisões relativas ao repertório, é importante frisar que a capacidade de agência dos catadores também é perceptível, haja vista a formação de amplas redes de apoio e o êxito na aprovação de legislação – 12.305/2010 –, que hoje se apresenta como oportunidade jurídica às organizações de catadores em todo o Brasil, sendo possível perceber que os catadores não apenas aproveitam, mas também criam oportunidades políticas. Works of organizations related to the catholic church directed to homeless people started the organizational process of waste pickers in associations and cooperatives in Brazil. In this process, while discussing issues about citizenship, the right to have rights, these workers realized the value and importance of their labor, which, in addition to providing their family’s livelihood, brings environmental, social, and economic benefits to the collectivity, by separating recyclable materials and putting them back into the productive cycle. The construction of their self-perception as citizens and workers allowed the construction of the perception that it is unfair the fact that they are not recognized for their work by the society and the government, including not being remunerated for it. Thereafter, it has been constructed the idea that waste pickers have the right to be hired to do the municipal waste selective collection services. In order to analyse the struggling process of the waste pickers for their organizations to be hired, case studies were developed in four municipalities with the purpose of comprehend how the different dimensions of the Interpretive Frame of Collective Action mobilized on the bases, including perceptions of political opportunities, relate to the choices concerning to the repertory of collective action used. The analysis had support on SMT, mainly of relevant concepts on PPT, as repertory of collective action, political opportunities and framing. The contribution of studies of legal mobilization were important too. With this study, it was possible to understand a tendency of the waste pickers leaderships to avoid confrontational strategies, privileging forms of interaction called by Abers, Serafim, and Tatagiba of: policy of proximity and institutional participation; whenever possible. If the public management is read as impermeable to the demands of the waste pickers, the leaderships adopt other possibilities: the implementation of space of interlocution in the ambit of civil society, the FMLC, and the forwarding of demands to justice system institutions, such as the Ministério Público and the Defensoria Pública. Collective actions with confrontational disposition are less common, in general, they occur when there is the perception of some threat consider highly relevant by the leaderships. Although it is possible to note a strong influence of the leaderships’ perceptions upon opportunities and political threats on the decision-makings related to the repertory, it is important to highlight that the capacity of the waste pickers agency is also perceptible, given the formation of wide nets of support and the success on the approval of legislation - 12.305/2010 - which nowadays is presented as a juridical opportunity to the waste pickers organizations in Brazil. Therefore, it is possible to realize that waste pickers not only take advantage, but they create political opportunities as well.

Programa de Pós-Graduação em Direito. Departamento de Direito, Escola de Direito, Turismo e Museologia, Universidade Federal de Ouro Preto. A busca judicial pela efetivação do direito à saúde devido à incompletude das políticas públicas e até mesmo por uma ineficiente gestão ganhou maior destaque com a instituição de um Sistema Único de Saúde (SUS), ancorado nos princípios da assistência universal, integral e gratuita, consagrados pela Constituição de 1988. A viabilização do acesso aos bens e serviços de saúde através da esfera judicial culminou no fenômeno denominado judicialização da saúde. Neste trabalho, abordase tal fenômeno a partir do recorte do Estado de Minas Gerais e das ações pleiteando a dispensação judicial de medicamentos. Diante do aumento acentuado das demandas judiciais, que muitas vezes acaba desorganizando o planejamento administrativo e comprometendo o orçamento público, cabe perquirir se a judicialização da saúde está dificultando a efetivação do princípio da justiça social, que dentro da perspectiva constitucional consiste na justa distribuição de bens e recursos de modo a propiciar iguais oportunidades e liberdades a todos, visando a redução das desigualdades sociais. Para tal, intentou-se descrever o perfil socioeconômico de quem pede em juízo e o modo como pede, e se as demandas partem de municípios do Estado com maior Índice de Desenvolvimento Humano Municipal (IDHM), já que este reflete a desigualdade social. Assim, buscou-se investigar, através de um estudo descritivo retrospectivo das ações, do período de 1999 a 2009, se a judicialização favorece aqueles que não são os mais vulneráveis na estrutura social e que podem arcar com os custos do acesso à justiça, aumentando as desigualdades no que se refere a bens e serviços de saúde e distorcendo o princípio da justiça social. Ainda, se o Judiciário está servindo como meio para os setores mais vulneráveis da sociedade buscarem demandas igualitárias e contestarem as políticas de saúde. A partir das análises realizadas constatou-se que a maioria das ações foram ajuizadas de forma individualizada, por advogados privados, tiveram como origem da prescrição médica receituários da rede privada de saúde e quase 1/3 dos beneficiários eram profissionais das ciências e das artes, que possuem alto nível de competência, conhecimento e experiência no ramo das ciências físicas, biológicas, sociais e humanas. Ainda, que os municípios que mais judicializaram possuem IDHM alto ou muito alto, o que indica uma distorção do princípio da justiça social e da equidade na distribuição dos bens em saúde. Due to deficiency of public policy and inefficient management, the legal pursue for fulfillment of the right to health has gained more prominence with the establishment of SUS (Unified System of Health), anchored in the principles of universal, unabridged, and free assistance, consecrated by the 1988 Brazilian Constitution. The feasibility of access to goods and services of health through the judicial sphere has culminated in the phenomenon called “judicialization of health”. This work approaches this phenomenon using data from the Brazilian state of Minas Gerais about legal actions for dispensation of medicines. In the face of a sharp increase of legal demands, which many times end up messing with the administrative planning and compromising public budget, it is fit to investigate if the judicialization of health is getting in the way of the principle of social justice, that in the constitutional perspective consists on a fair distribution of goods and services as to assure equal opportunity and freedom to all, with the purpose of reducing social inequalities. To this end, this work details the social-economic profile of those who move legal action, the way it happens, and if the demands come from cities with higher or lower IDHM (Municipal Human Development Index), seeing as it reflects social inequality. Thus, this works intends on investigating, through a descriptive, retrospective study of legal actions from 1999 to 2009, if the judicialization of health favors those who aren’t the most vulnerable in the social structure and who are able to handle the cost of accessing justice, which would increase inequality in what concerns good and services of health and would distort the principle of social justice. Additionally, if the judiciary system has been serving as means for the most vulnerable to seek more egalitarian demands and to contest health policies. The analysis has verified that most legal actions have been filed in an individualized manner by private lawyers, and have as their origins drug prescriptions by doctors from the private healthcare system, and that nearly a third of the beneficiaries were professionals of the arts and sciences, with high level of knowledge and experience in the field of physical, biological, social and human sciences. Moreover, the cities that filed the higher number of actions in the state have a high or very high IDHM, which indicates a distortion in the principle of social justice and equity in the distribution of goods in health.

Submitted by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2015-03-23T15:21:38Z No. of bitstreams: 1 dissertação homero chiaraba.pdf: 796748 bytes, checksum: 0f4d454ae4117583dd31c84e8ac92543 (MD5) Approved for entry into archive by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2015-03-23T15:22:00Z (GMT) No. of bitstreams: 1 dissertação homero chiaraba.pdf: 796748 bytes, checksum: 0f4d454ae4117583dd31c84e8ac92543 (MD5) Made available in DSpace on 2015-03-23T15:22:00Z (GMT). No. of bitstreams: 1 dissertação homero chiaraba.pdf: 796748 bytes, checksum: 0f4d454ae4117583dd31c84e8ac92543 (MD5) A pesquisa, de carater teórica exploratória, visa interpretar criticamente o conceito de cidadania, a partir da cidadania coletiva. Para tanto parte-se a política da diferença, que consiste em uma mudança de paradigma filosófico de fundamentação dos Direitos da política da igual dignidade, cujo fundamento é uma igualdade hipotética e transcendental entre os indivíduos, para a política da diferença que se baseia na ideia de que os humanos são igualmente dignos de respeito quanto suas diferenças identitárias. Propondo uma interpretação crítica de um princípio participativo na Constituição Federal brasileira, explora-se conceito de Constituição cultural, que seria a Constituição interpretada pelos diversos atores sociais e seria o bem coletivo mais privilegiado da sociedade, pois a partir dele todos os bens jurídicos são produzidos. Os grupos hegemônicos se ocupam de restringir os acessos às instituições dotadas de competência para produzir a interpretação válida do Direito, a fim de garantir assim o monopólio sobre a Constituição; o resultado disso é uma Constituição jurídica produzida a partir da identidade de um ou limitado número de grupos sociais que, detentores do capital cultural, do saber reconhecido como válido pelas instituições oficiais de nomeação, provocando uma identificação entre os bens jurídicos assim reconhecidos pelo Estado e os bens assim considerados pelos grupos hegemônicos, que assim se definiu como patrimonialismo cultural. Em contrapartida, os diversos grupos da sociedade buscam participar de diversas formas desta produção dos bens juridicamente válidos. Esta busca, empreendida por sujeitos coletivos, em sua maioria não reconhecidos oficialmente como sujeitos de Direito, chama-se de cidadania coletiva. Buscou-se densificar juridicamente esta cidadania coletiva, sugerindo uma relação entre cidadania, identidade e participação, que resultou em um encontro com a proposta de democracia não-hegemônica participativa. Tal interpretação sugere o fortalecimento de instituições híbridas, onde a representação e a participação social se misturam a fim de garantir um maior reconhecimento das diferentes identidades da sociedade. Por fim, sugere-se que uma dimensão essencial desta tentativa de se institucionalizar a participação, para evitar o desvirtuamento de tais instâncias, precisa compreender uma institucionalização da educação para a democracia participativa no currículo escolar, sendo esta interpretação sustentada pelo princípio da qualidade de ensino postulado no artigo 206 da Constituição Federal.