O auto do [consenso] de Viena: Estratégias de legitimação no Sistema Internacional de Controle de Drogas / The Tale of the Vienna [Concensus]: legitimation Strategies in the International Drug Control System

As drogas foram construídas como um problema mundial por organismos internacionais, responsáveis pela elaboração de normativas com a finalidade de combater seu consumo, cultivo e comércio, enquanto interpreto esse fenômeno como um problema público, criado a partir da universalização de algo tão específico quanto a compreensão segundo a qual elas devem ser usadas para fins médicos e científicos. Esta visão de mundo mobiliza grandes estruturas burocráticas e moralizantes onde agentes engendram esforços para disputar a hegemonia no Sistema Internacional de Controle de Drogas que, por sua vez, é organizado pela Organização das Nações Unidas. Seus Estados-Membros disputam a hegemonia de um campo que viu seu balizador se quebrar recentemente, qual seja, o Consenso de Viena, o entendimento de que a demanda por drogas deve ser extinta. Mas, na Década da Gestão do Dissenso (2009-2019), o principal argumento, tanto dos agentes hegemônicos, quanto daqueles contra-hegemônicos, persistiu: deve-se proteger a saúde. Com o objetivo de identificar e compreender as estratégias de legitimação adotadas durante a 62ª Sessão da Comissão de Drogas Narcóticas (2019), empregamos uma metodologia que conjugou etnografia de eventos e de documentos, observação participante e realização de entrevistas semiestruturadas. Foram delineadas 15 estratégias, acionadas num contexto de árdua batalha entre delegações de todos os continentes por categorias referentes à Redução de Danos e aos Direitos Humanos, como "atitudes não estigmatizantes" e "mulheres que usam drogas". Esperamos colaborar para debates institucionais em escala global e local mais permeáveis às contribuições das Ciências Sociais e Humanas em Saúde, fortalecendo uma ciência capaz de reformular radicalmente a política de drogas

Drugs were constructed as a global problem by international bodies, responsible for drafting regulations in order to combat their consumption, cultivation and trade, while I interpret this phenomenon as a public problem, created from the universalization of something as specific as understanding that they should be used for medical and scientific purposes. This worldview mobilizes large bureaucratic and moralizing structures where agents engender efforts to dispute hegemony in the International Drug Control System, which, in turn, is organized by the United Nations. Its Member States are vying for the hegemony of a field that has recently seen its beacon broken, namely the Vienna Consensus, the understanding that the demand for drugs should be extinguished. But, in the Decade of Dissent Management (2009-2019), the main argument, from both hegemonic agents and those against hegemonic ones, persisted: health must be protected. In order to identify and understand the legitimation strategies adopted during the 62nd Session of the Commission on Narcotic Drugs (2019), we used a methodology that combined ethnography of events and documents, participant observation and semi-structured interviews. Fifteen strategies were outlined, triggered in a context of an uphill battle between delegations from all continents for categories related to Harm Reduction and Human Rights, such as "non-stigmatizing attitudes" and "women who use drugs". We hope to contribute to institutional debates on a global and local scale that are more permeable to the contributions of the Social and Human Sciences in Health, strengthening a science capable of radically reshaping drug policy.

O que o crack tem a ver com a rua? Uma revisão narrativa com implicações políticas (2011-2017) / What does crack have to do with the street? A narrative review with political implications (2011-2017)

Resumo Objeto: Produção científica sobre o crack e a rua publicada em periódicos brasileiros indexados no SciELO e portal CAPES. Objetivo: Revisar tal produção, trabalhando os resultados a fim de investigar a recente associação entre pessoas que fazem uso de crack e que se encontram em situação de rua. Metodologia: Busca na base online de artigos do SciELO e portal CAPES, utilizando-se 3 out. 2017 como corte temporal, "crack AND rua", "crack AND moradores de rua" e "crack AND população em situação de rua" como "termo pesquisado" a partir de 2011 a outubro de 2017. Identificaram-se 63 referências, cujos resumos foram analisados, chegando-se aos 20 artigos que, efetivamente, dizem respeito à questão da associação entre crack e rua. Análise: critérios institucionais (título, periódico e data de publicação). Categorias: "crack e população em situação de rua"; "crack e o espaço da rua" e "indexadores históricos das ruas". Resultados: Dentre os 20 artigos consultados, 18 vinculam diretamente o consumo de crack à população em situação de rua e/ou ao espaço da rua. A associação entre crack e rua é notável não só na produção científica nacional sobre o consumo da "droga", mas também na produção normativa e governamental.

Abstract Object: Scientific production on crack and street published in Brazilian journals indexed in SciELO and CAPES portal. Objective: To review such production, working on the results in order to investigate the recent association between people who use crack and who are on the street. Methodology: Search the SciELO articles online database and CAPES portal, using 3 out. 2017 as a temporal cut, "crack AND street", "crack AND homeless people" and "crack AND homeless people" as "search term" from 2011 to October 2017. We identified 63 references, whose abstracts were analyzed, arriving at the 20 articles that, effectively, concern the issue of the association between crack and street. Analysis: institutional criteria (title, periodical and date of publication). Categories: "crack and homeless people"; "Crack and street space" and "historical street indexes". Results: Among the 20 articles assessed, 18 directly linked the consumption of crack to the population living on the street and / or to the street space. The association between crack and street is notable not only in national scientific production on the consumption of "drugs", but also in normative and governmental production.

Recurrent giant cell tumour of the maxillary sinus and pterygoid process treated with denosumab.

We report the case of a 74-year-old man with a giant cell tumour (GCT) of the right maxilla and pterygoid process. The patient presented to the maxillofacial and head and neck surgery clinic with an ulcerated lesion of the hard palate. Initial workup with CT revealed a mass within the right maxillary sinus and pterygoid process with associated bone expansion and erosion. Biopsy showed a GCT with mucosal ulceration. Two years after surgical resection, a follow-up CT revealed tumour recurrence involving the right pterygoid process and lateral pterygoid muscle. The patient was then proposed for therapy with denosumab. Under denosumab treatment, the lesion maintained stable dimensions and became sclerotic and heavily ossified.

Atypical mandibular metastasis as the first presentation of a colorectal cancer.

We describe a case of a 70-year-old man presenting with a mandibular metastasis as the first sign of a mucinous adenocarcinoma of the rectum. After 6 months of a protracted toothache, the patient presented with a palpable mandibular mass and trismus, precluding adequate clinical evaluation. A CT scan was performed, and imaging findings suggested an aggressive primary jawbone tumour, most likely an osteosarcoma. However, biopsy and further patient's management proved to be a metastasis. Metastasis to the oral cavity account for only 1%-3% of all malignant oral tumours, and the mandible is the most frequent site. Clinical presentation can be quite variable, and most often a primary malignancy is already known. Jawbone metastases are a sign of disseminated malignant neoplasms, with poor prognosis and usually an indication for palliative therapy.

Ganglioneuroma of the retropharyngeal space in a patient with glottic cancer.

We describe the case of a 71-year-old man with a ganglioneuroma of the retropharyngeal space. The patient presented with a submucosal bulge of the left oropharyngeal wall during follow-up examination of a treated vocal cord carcinoma. CT and MRI revealed a non-specific, well-defined retropharyngeal soft tissue lesion. Positron emission tomography-CT did not show relevant metabolic activity, excluding the hypothesis of metastatic nodal disease. Surgical biopsy of the lesion was compatible with ganglioneuroma. Ganglioneuromas are well-differentiated tumours composed of mature sympathetic ganglion cells that account for approximately 1% of spinal and paraspinal tumours. Peripherally, ganglioneuromas are predominantly found in the posterior mediastinum and retroperitoneal space. Only nine ganglioneuromas of the retropharyngeal space have been reported in the English literature since the early 1980s.