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Em 2005, foi fundado o curso de Gestão de Políticas Públicas da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP). Em 2019, a disciplina “Direito e Políticas Públicas” foi incluída entre as optativas possíveis da grade e sua ementa publicada. No segundo semestre de 2022, por sua vez, a disciplina foi oferecida pela primeira vez para os estudantes da EACH. Este artigo tem por objetivo apresentar os temas e questões didáticas envolvidas na elaboração da proposta da disciplina, bem como relatar e discutir os resultados das primeiras experiências em sala de aula. O artigo está organizado em cinco seções. Na primeira, relata-se brevemente a história do campo de públicas, do curso de Gestão de Políticas Públicas na Escola de Artes, Ciências e Humanidades da USP e o contexto de criação da disciplina “ACH3857 - Direito e Políticas Públicas” como disciplina optativa. A segunda seção apresenta e discute as razões das diferenças entre o programa previsto na ementa de 2019 e o programa efetivamente oferecido no segundo semestre de 2022. A terceira parte tem como título “Comentários sobre as bibliografias escolhidas”, e apresenta as razões das escolhas e o que poderia ser diferente em um eventual segundo oferecimento da disciplina. Na quarta seção apresenta-se algumas das discussões que foram interessantes ao longo do curso. Essas discussões se organizaram em torno da noção de que o direito exerce funções junto às políticas públicas. Nas considerações finais, uma reflexão sobre o papel dessa disciplina optativa e das disciplinas jurídicas para a formação do Bacharelado em Gestão de Políticas Públicas.

É o Parlamento que está em destaque na obra de Otto Kirchheimer sobre a República de Weimar. Quer para criticar a escolha pelo parlamentarismo nas decisões da Assembleia Nacional Constituinte, quer para defendê-lo do Poder Executivo que promovia o saque de suas competências, referendado pelo Poder Judiciário, é essa a instituição que tem centralidade na análise do autor entre 1928 e 1933. Em dois livros e quinze artigos de intervenção política, o significado e a forma de funcionamento do Poder Legislativo para o Estado Alemão eram permanentemente debatidos. Em um primeiro momento, em função da mudança de significado gerada pela possibilidade de representação da classe trabalhadora, só possível após a implementação do fim do voto censitário e da implementação de sua universalidade. Ainda assim, a legalidade e a democracia possíveis no âmbito do Estado de Direito instituído pela Constituição de Weimar eram vistas com desconfiança por Kirchheimer. Só quando a supressão da legalidade – inclusive de sua aparência – corroeu os fundamentos da República de Weimar, Kirchheimer passou a reconhecer inequivocamente um valor emancipatório na forma direito.

Para entender o atual cenário de crise internacional do ideário neoliberal – dos quais o Brexit, bem como a eleição de Trump e de Bolsonaro, seriam sintomas –, Nancy Fraser propõe uma ampla análise da estrutura do capitalismo, a qual engloba, mas ultrapassa, a caracterização marxista usual. De sua análise surge uma importante chave de leitura histórica: a hegemonia das últimas décadas não seria apenas do neoliberalismo, mas do que ela chama de “neoliberalismo progressista”; e a crise não é apenas do neoliberalismo, mas do progressismo que o acompanhou. Trata-se de uma análise política, que supera as análises frequentemente moralistas que têm sido feitas da ascensão de líderes populistas de direita. A reflexão acerca do caso brasileiro a partir desse instrumental pode ajudar a estabelecer, assim esperamos, cursos de ação para o futuro.

O esporte é um direito no cenário internacional e, no caso brasileiro, constitucional, fruto de processos históricos de construção e disputa de narrativas. Ainda assim, há grandes desafios a serem superados para sua realização. Entre eles, estão as ambiguidades e tensões entre práticas discursivas distintas que o apresentam como uma atividade humana que é própria à realização do desenvolvimento ou como ferramenta de desenvolvimento. Neste ensaio, questionamos a retórica instrumental do esporte - o esporte-meio - que, a nosso ver, marginaliza e empobrece a experiência esportiva e, consequentemente, enfraquece-o como direito social. No lugar, argumentamos em favor do direito ao esporte como esporte-fim em que assegurá-lo pressupõe tornar as pessoas capazes de praticá-lo com liberdade e autodeterminação como experiência humana fundante de uma vida digna e boa.

O pressuposto que orienta a montagem dos cursos de graduação no campo das políticas públicas é claro: para se formar um bom profissional ou um bom pesquisador da área é necessário fazê-lo transitar por diversos campos de conhecimento que, historicamente, se constituíram afastados uns dos outros. O desafio é como compreender e praticar a interdisciplinaridade intrínseca a essa proposta. Mais especificamente, como fazer com que a transição constante e necessária entre diversos campos de saber não resulte, ao final, em uma formação deficiente, quando considerada do ponto de vista de cada disciplina particular, e fragmentada, quando considerada em seu conjunto? Para indicar o núcleo do desafio da formação interdisciplinar, utilizamos o conceito de “comunidade epistêmica”, que se caracteriza pelo fato de que seus membros compartilham, em maior ou menor medida: a) uma linguagem comum, dotada de certos conceitos que se supõem aptos a descrever os objetos de estudo do campo, mas que, bem considerados, estão também construindo esses objetos de estudo; b) uma avaliação comum acerca de quais são os problemas relevantes a serem resolvidos com relação a esses objetos; c) tendência a uniformizar certas crenças básicas, pré-teóricas, que permitem estruturar o campo de estudos; d) uma visão compartilhada a respeito de quais são os métodos válidos, aceitáveis, para a abordagem e resolução dos problemas da disciplina (ZITO, 2001; HAAS, 1992). O desafio aos professores do campo de públicas reside no dilema entre se afastarem de suas comunidades de origem para forjar uma comunidade epistêmica própria, interdisciplinar, ou manter o vínculo com sua comunidade epistêmica de origem.

Unlabelled: Abdominal blunt trauma is the main cause of death in people younger than 40 years old. The liver injury still represents a challenging problem. Isolated hepatic injury is rare and it occurs more frequentely in polytraumatizated patients and causes massive haemoperitoneum. The Authors report a case of a 83 years-old woman admitted to Emergency Department for syncope due to an active bleeding arising from a rupture of a right hepatic lobe unsuspected tumor. The computer tomography (CT) scans showed a clear pattern of liver laceration of the VI segment with contrast enhancement spreading in the surrounding tissues, and detected a multifocal hepatocarcinoma located in the VI, VII and VIII segments. Patient's haemodinamically unstable conditions suggested an urgent laparotomy. An accurate perihepatic packing with sterile-drape were successfully employed to control liver hemorrage. Temporary abdominal closure, followed by hepatic arteriography and the right hepatic artery embolization, completed the damage control. Re-exploration laparotomy after 72 hours confirmed the definitive haemostasis and the pack removal was performed without complications., Conclusions: CT plays a leading role in the diagnosis of liver damage. The patient's haemodynamic status is the principal criterion determining conservative or operative therapy in blunt liver injury. The early perihepatic packing followed by artheriographic embolization to stop liver hemorrhage showed efficacy and safety for the patient. The packing performed with sterile-drape is able to avoid removal complications and 72 hours timing for the pack removal is effective to avoid re-bleeding.

Background and Study Aims: This study was undertaken to compare the efficacy, side effects and patient acceptance of standard 4-liters polyethylene glycol (PEG) and 2 doses of sodium phosphate (NaP) solution for precolonoscopy colon cleansing., Patients and Methods: A total of 182 patients were randomized to receive either standard 4-L PEG (88 patients) or 80 mL of NaP (94 patients) in a split regimen of two 40 mL doses separated by 24 h, prior to colonoscopic evaluation. The primary endpoint was the segmental assessment of colonic wall visualization. Secondary outcomes included percent of assumed preparation, and the patient tolerance and acceptability., Results: A significantly higher completion rate was found in the NaP group compared to the PEG group (84.3% vs 62.9%; difference, 21.40%; 95% confidence interval [CI], 8.29% to 34.51%; p = 0.001). PEG solution caused more nausea than NaP solution (p = 0.024). Patient acceptance for bowel preparation with NaP was greater (p = 0.019). Adequate colon wall visualization was achieved in similar proportion of patients in both groups with exception of the descending colon, where NaP regimen was superior (72.0% vs 52.9%; difference, 19.10%; 95% CI, 5.20% to 33.00% ; p = 0.012)., Conclusions: Two doses of NaP solution, taken 24 h and 12 h before colonoscopy, tend to guarantee superior results in colonic cleansing with respect to standard 4-liters PEG solution. Taking the second dose of NaP 24 h after the first dose reduces side effects and allows achieving a more satisfactory compliance of the patient.

Diverticular disease is very frequent in Western countries; in 5% of the cases it is the cause of serious bleeding, haemodynamic instability and death. The authors report a case of 74 years old patient with severe lower gastrointestinal bleeding. She was in antiplatelet treatment with acetylsalicylic acid (100 mg/die) and clopidogrel (75 mg/die) for preventing the restenosis of medicated stents positioned to treat an acute coronary syndrome. At the same time the patient was under treatment for primary hypercholesterolemia with rosuvastatin (20 mg/die). The severe haemorrhage demanded haemodynamic stabilization, achieved by colloid infusion and blood transfusions. The bleeding continued; selective arteriography showed it's origin from the areas of the sigmoid and superior hemorrhoidal arteries. During the procedure, embolization of the inferior mesenteric artery using spiral type BALT was performed, with consequent bleeding interruption. Fifteen days after the embolization, a rectosigmoid colonoscopy showed a sigmoid diverticular disease. The treatment with acetylsalicylic acid and clopidogrel has surely contributed to the severity of the hemorrhage. Recent experimental and clinical evidence suggests a possible antiplatelet effect of the statins.

The management of traumatic retroperitoneal haematomas is still a much debated question. Although the diagnosis has become easier using CT with contrast medium, the therapeutic decisions are still difficult because of the great variability of the lesions, which may be simple but very often complicated. Our study is based on 1086 treated patients, 29.5% of the 3682 critical abdominal polytrauma seen in 35 years. Mortality has been 12.9% with a medium ISS (Injury Severity Score) of 23.4. 71.4% of the cases were closed traumas, 28,6% were open traumas. The most common single lesions have been pelvic (43%), followed by the renal traumas (39%). Regarding the associated lesions, the thoracic traumas cause an increment of the ISS score up to 26.2% and of mortality up to 14.6%. The maxillofacial traumas associated with traumatic retroperitoneal haematomas represent 11%, mainly associated with motorcycle accidents, which have increased in the last years from 2,4% in the 70s to 32% these days. Our approach to these patients has been basically conservative. Following the indications obtained by the CT, we widely used interventional angiography, especially for renal lesions and, after pelvic stabilization, for pelvic haematomas. We have chosen surgery considering the kind of traumas (open or closed), the location of the haematoma and especially, the clinical course of the patient's hemodynamic condition.

There have been millions of people found to have AIDS. Death rates from AIDS have declined 15% to 20% in the past 5 years. However, nearly 75000 people will die with AIDS in this year. Patients with AIDS are also at risk for developing both Aids-defining cancers, such as Kaposi's sarcoma and non-Hodgkin lymphoma, and non-Aids-defining cancers and opportunistic infections. In patients with advanced Aids, the Cytomegalovirus is a frequent cause of chorioretinitis, pneumonitis, chronic perineal ulcerations and oesophagitis. It has been involved in endocrine, bone marrow, central nervous system and kidney abnormalities. CMV infection of the small bowel accounts for only 4.3% of all cytomegalovirus infection of the GI tract (large bowel 47%, duodenum 21,7%, stomach 17,4%); isolated cases of small bowel perforation due to CMV have been reported in AIDS patients, and all but one patient died. The Authors report a rare case of an HIV-positive young man with gastroenteric Cytomegalovirus infection responsible for generalized peritonitis from multiple perforations.

The abdominal compartment syndrome (ACS) is defined a situation of high degrade abdominal hypertension (IAH) with clinicals signs of multiorganic dysfunction. It's observed like in the intensive care, in particular surgycals and postraumatics, there is ever a bigger frequence of complications presented by criticals patients. The various trials remark a changeable incidence, but the common factor is characterized by a particular severity of scores. All the possibles mechanicals, haemorragicals, infiammatories, and postraumatics causes act, but don't enable the stability among abdominal content, abdominal compliance and parietal tension. The initial triad of effects is constitued by the elevation of diaphragm and the visceral and vascular compression; after this triad provoke a pathophysiologic system that, through various levels, bring to a respiratory, renal and cardiocirculatory dysfunction and to a parietal, hepatic and intestinal ischemia with consequent bacterical translation: sepsis and MOF. The Burch's classification (1996) report four levels of gravity by the slight (< 15 mmHg) to the heavyest (> 35 mmHg): the firsts two levels are of intensivistic competence and for the detention are used conservatives metodics and pharmacological approach; instead in the lasts two levels it's necessary to foresee a surgycal treatment of laparotomy, washing and drainage with following temporary paret's closure. The mortality is now very elevated (29-62%) especially when it's already established a multiorganical dysfunction; therefore it's necessary forward its appearance through the monitorization of abdominal pression (IAP) with the measurement of vescical pression in alls criticals patients at the aim to treat immediately the firsts signs of IAH.

We present a case of sigmoid colon injury after blunt abdominal trauma. The patient was submitted to sigmoid resection with primary end-to-end colo-colic anastomosis. He died 22 days after operation with septic shock and acute respiratory failure. Post-mortem examination showed left lung generalized pneumonia with no signs of intra-abdominal pathology; colo-colic anastomosis was intact. We reviewed the literature about the management of this rare trauma.

The femoral hernia can be defined as infrequent, and predominantly found in females, with the highest incidence between 30 and 40 years of age. It shows a high tendency to strangulation, also up to 40% of cases, due to the presence of the Gimbernat ligament, which with its tense fibrous margins, aids strangling known as "raised crest". The diagnosis may not be easy, overall in the clinical presence of acute abdomen in elderly patients, disabled people or people who are uncooperative during physical examination. Therefore, it should be sought with an adequate bilateral exploration of the region in all occlused patients and especially with the use of radiological images of the small intestine. The solution currently practiced is prosthetic, proposed by Lichtenstein, and variously modified by Gilbert, Rutkow, Bendavid, and other which uses a prolene plug in the shape of a cigar, umbrella, or basket, according to the size and characteristics of the parietal defect. In emergency conditions, the technique doesn?t change; but if there is stercorary contamination, it is advisable to use direct repair according to the old method of Bassini. In the last 10 years, we have treated 37 femoral hernias in emergency, using direct repair in only 2 cases. In 3 cases we used PTFE; in the other 32 cases prolene was always used; 20 patients were operated under local anesthetic, 12 under general anesthetic and 5 under peridural anesthetic. Satisfactory results were achieved, with average hospital recovery time of 1.4 days, with an early recovery between 3 and 5 days, with only 2 relapses.

The emergency treatment for neoplastic occlusions of rectum still needs debugging. While we finds perfect accord in to directly treat with a right hemicolectomy (more or less widened) the tumours from cecum to the first portion of the right colon, not the indications are likewise shared in presence of neoplastic stenosis of sigma-rectum. The treatment of urgency of these tumours is lent to so many variable and the tendencies too are constantly in evolution in relationship to the improvement of the technologies and the surgical devices. We have to chose from the two-three times intervention (now with less succession), or the total or subtotal colectomy otherwise the most used left hemicolectomy and anterior resection for sigmoid colon. Presenting our historical cases of 31 years of activity (Institute of Surgical Emergency Department--University La Sapienza of Rome), 564 neoplastic occlusions of the colon (75.7% sigma-rectum), the Authors describe their attitude both of approach and of surgical therapy in urgency that has brought them to practise in the 65.6% of the cases the anterior resection without protection colostomy, with extraperitoneal anastomosis and reconstitution of the pelvic peritoneum, in all the stenosis under descendant--sigma. In the last period it is frequent more and more the tendency to the positioning of a stent on the neoplastic stenosis: this treatment allows us to overcome the emergency to operate then under fitter conditions.

Colon lesions resulting from blunt trauma in the abdomen can be defined as infrequent. Actually, they represent 3-5% of all hollow organ trauma. They present, however, serious social burden because of its prevalence in males with medium age ranging from 40 to 70 years. Study was conducted from 1971 to present at the University of Rome "La Sapienza" Institute of Clinical Emergency Surgery. 42 cases were observed in which 72% had motor vehicle accidents (with less than 1/4 of these resulting from seat belt). Numerous lesions were associated, especially in the abdomen (31), and the skull (20), both with Medium OIS 4.2. Most part of the cases was within the OIS-Class III category. The clinical parameters recorded upon admission revealed particular serious situations with average values of SAP-92 mm Hg, HR-114, RR-28, GCS-12, RTS-10.8. 17% had shock upon arrival with unsuccessful resuscitation. Ultrasound results at emergency indicated 62% with effusion/major parenchymal lesion, and 22% with severe peritonitis. 41% were treated with direct suture, 26% with resection-anastomosis, 19% with primary Hartman resection, and 14% with simple colostomy. 24% had abdominal complications including 14% sepsis, 5% hemorrhage, and 2 cases of post-surgical caval thrombus. The overall mortality was 26%. In general these lesions were frightening because of their uncertain manifestations. In most instances clinical signs related to associate lesions are overlooked, and these often present late symptoms from 24 to 48 hours. Delayed treatment for untimely diagnosis is one of the yet prevailing complications. The methods of surgical repair depend on the timing, the nature of associated lesions and, above all, eventual peritoneal contamination. The primary treatment involves surgical option actually recommended according to the EAST guideline with specific preference of reconstruction using the primary principle, and resorting to earlier interventions only in the presence of associated critical factors.