Cryoablation for the treatment of breast cancer: immunological implications and future perspectives. Utopia or reality?

Cryoablation is a minimally invasive technique currently employed in breast cancer care, that uses freeze and thaw cycles to treat benign breast lesions, small breast cancers or focal sites of metastatic disease in patients not eligible for surgery. The final goal of this procedure is to destroy breast cancer cells using extreme cold. In addition, several studies have shown that this technique seems to have an enhancing effect on the immune response, especially by increasing the expression of tumor neoantigens specific to tumor cells, which are then attacked and destroyed. Exploiting this effect, cryoablation in combination with immunotherapy could be the key to treating early-stage breast cancers or patients who are unsuitable for surgery. According to some recent studies, there are other potential tools that could be used to enhance the therapeutic effect of cryoablation, such as FE3O4 nanoparticles or the manipulation of aquaporin expression. The aim of this narrative review is to summarize the current evidence regarding the use, indications, advantages and disadvantages of cryoablation in the treatment of breast cancer.

Phenotyping the obesities: reality or utopia?

In this thematic issue on phenotyping the obesities, prominent international experts offer an insightful and comprehensive collection of articles covering the current knowledge in the field. In order to actually capture all the polyhedral determinants of the diverse types of obesity, the granularity of the phenotypic information acquired must be expanded in the context of a personalized approach. Whilst the use of precision medicine has been successfully implemented in areas like cancer and other diseases, health care providers are more reluctant to embrace detailed phenotyping to guide diagnosis, treatment and prevention in obesity. Given its multiple complex layers, phenotyping necessarily needs to go beyond the multi-omics approach and incorporate all the diverse spheres that conform the reality of people living with obesity. Potential barriers, difficulties, roadblocks and opportunities together with their interaction in a syndemic context are analyzed. Plausible lacunae are also highlighted in addition to pointing to the need of redefining new conceptual frameworks. Therefore, this extraordinary collection of state-ofthe-art reviews provides useful information to both experienced clinicians and trainees as well as academics to steer clinical practice and research in the management of people living with obesity irrespective of practice setting or career stage.

From Retrograde Menstruation to Endometrial Determinism and a Brave New World of "Root Treatment" of Endometriosis: Destiny or a Fanciful Utopia?

Practically unknown outside of China, the "endometrial determinism" theory was proposed to account for the apparent gap between the relatively low prevalence of endometriosis and nearly universal retrograde menstruation. Attracting uncritical advocacy, the theory culminates in a recent consensus by elite Chinese gynecologists in favor of "root treatment", intended to nip endometriosis in the bud. Correcting endometrial "defects" can gain further momentum by the presence of cancer-driver mutations such as KRAS mutations in the endometrium of women with endometriosis and the recent introduction of therapeutics aiming to rectify the effect of these mutations for cancer treatment. We provide a critical appraisal of evidence for endometrial aberrations in endometriosis and relevant experimental evidence. All available evidence of endometrial "defect" is invariably post hoc and may well be secondary to induced endometriosis. We propose that the theory of "endometrial determinism" needs to demonstrate a clear causal and a phylogenetic relationship between endometrial aberrations and endometriosis. We argue that while it is highly likely that endometriosis is a consequence of retrograde menstruation, the case that molecular aberrations as a sole or a necessary determinant remains to be proven. "Root treatment" is a worthy ambition but as of now it is close to a fanciful Utopia.

Is precision medicine for colorectal liver metastases still a utopia? New perspectives by modern biomarkers, radiomics, and artificial intelligence.

The management of patients with liver metastases from colorectal cancer is still debated. Several therapeutic options and treatment strategies are available for an extremely heterogeneous clinical scenario. Adequate prediction of patients' outcomes and of the effectiveness of chemotherapy and loco-regional treatments are crucial to reach a precision medicine approach. This has been an unmet need for a long time, but recent studies have opened new perspectives. New morphological biomarkers have been identified. The dynamic evaluation of the metastases across a time interval, with or without chemotherapy, provided a reliable assessment of the tumor biology. Genetics have been explored and, thanks to their strong association with prognosis, have the potential to drive treatment planning. The liver-tumor interface has been identified as one of the main determinants of tumor progression, and its components, in particular the immune infiltrate, are the focus of major research. Image mining and analyses provided new insights on tumor biology and are expected to have a relevant impact on clinical practice. Artificial intelligence is a further step forward. The present paper depicts the evolution of clinical decision-making for patients affected by colorectal liver metastases, facing modern biomarkers and innovative opportunities that will characterize the evolution of clinical research and practice in the next few years.

No limite da cidade: diálogos entre a cidade e o quarto de despejo / On the edge of the city: dialogues between the city and the dumping room

O presente texto se compõe de reflexões realizadas a respeito do lugar dos pobres no direito à cidade capitalista, incitadas através da leitura do livro Quarto de despejo: o diário de uma favelada, de Carolina Maria de Jesus e de sua correlação com alguns autores que trazem a questão da cidade em suas obras. Ao longo de três seções, foram abordados temas como a criminalização da pobreza e a retirada dos pobres das cidades tradicionais, quando do estabelecimento da cidade enquanto mercadoria de luxo; a cidade e a para-cidade, a ilha que a cerca, onde procuramos compreender então quem tem direito a essa cidade-negócio e quem não tem; e, por fim, procuramos trazer à tona o sonho, a esperança que nos direciona ao campo de possibilidades, ao campo da vida e da restituição do urbano, onde tratamos um pouco a respeito da utopia desenhada por Lefebvre e da arte e do sensível enquanto meios de restaurar a vida nas cidades

This present is composed of reflections about the place of the poor in the right to the capitalistic city, incited by reading the book: Quarto de despejo: o diário de uma favelada, written by Carolina Maria de Jesus and its correlation to some authors who bring the issue of the city into their works. Throughout trhee sections, we approached subjects such as the criminalization of poverty and the removal of the poor from traditional cities, when the city was established as a luxury commodity; the city and the para-city, the island that surrounds it, where we tried to comprehend then who is entitled to this business-city and who is not; and, by the end, we tried to bring the dream, the hope that drives us to the possibilities field, to life field and to restitution of the urban, where we dealed a little with the utopia drawed by Lefebvre and with art and sensitive as paths to restore life in the cities

As ocupações das escolas e suas formas inéditas de revolta / School occupations and their original forms of revolt / Les occupations juvéniles et leurs formes originales de révolte / Las ocupaciones de escuelas y sus nuevas formas de revuelta

Resumo Este trabalho apresenta uma reflexão acerca da emergência de novas discursividades no campo político com o movimento de ocupações de escolas no Brasil, entre 2015 e 2016, considerando a dimensão utópica presente nessas experiências estudantis que se conjugaram a partir da posição de um não-saber. Articula-se com registros bibliográficos, fotográficos e audiovisuais, convocando o pensamento para uma conversa entre política e utopia.

Abstract This paper reflects on the emergence of new political discourses regarding students' lived experience of school occupations in Brazil, between 2015 and 2016, considering their utopic content built upon a not-knowing position. The text articulates bibliographic research, photographic and audio-visual records, inviting a debate about politics and utopia.

Résumé Cet article réfléchit à l'émergence de nouveaux discours politiques concernant les occupation juvéniles dans les écoles au Brésil, entre 2015 et 2016, en considérant leur contenu utopique construit sur une position de non-savoir. Le texte articule des recherches bibliographiques, des enregistrements photographiques et audiovisuels, invitant à un débat sur la politique et l'utopie.

Resumen Este trabajo presenta una reflexión sobre las urgencias de las nuevas discursividades en el campo político a partir del movimiento de ocupaciones de escuelas en Brasil, entre 2015 y 2016, considerando la dimensión utópica presente en estas experiencias de los estudiantes que están intercaladas a partir de la posición de un no-saber. Para ello, se utilizan bibliografía, registros fotográficos y audiovisuales, que estimulan la discusión entre política y utopía.

De uma utopia estética a uma estética utópica: a linguagem que pulsa / From aesthetic utopia to utopian aesthetics: the pulsating language / De una utopía estética a una estética utópica: el lenguaje que pulsa

Este artigo busca tensionar o significante utopia, a partir de uma articulação com a estética. Com esse intuito, dialogamos, especificamente, com a linguagem cinematográfica, assumindo a premissa de que não aplicamos a Psicanálise ao cinema, mas o cinema à Psicanálise, de modo a construir um percurso mediante o qual podemos escutar os significantes em sua equivocidade. Com a emergência de uma utopia estética, a qual ilustramos com o realismo socialista, entendemos que uma política de linguagem estrita foi colocada em cena, restringindo os jogos com os significantes e, portanto, as possibilidades discursivas. No entanto, nos emaranhados da cultura, entre fechamentos e (re)aberturas, uma estética utópica pode ganhar forma, a qual colocamos para discussão a partir do cinema de Tarkovsky, que aposta em uma linguagem cinematográfica fora dos ditames estéticos vigentes. Nesse sentido, o que está em jogo é a dimensão inventiva da linguagem, o pulsar dos significantes que convocam os sujeitos a posturas distintas.

This article seeks to underscore the 'utopia significant, based on an articulation with aesthetics. The premise is not to apply Psychoanalysis to cinema: cinema is applied to Psychoanalysis building a path through which we can listen to the signifiers in their equivocality. With the emergence of an aesthetic utopia, which we illustrate with socialist realism, we understand that a strict language policy was established, restricting games with language and, therefore, discursive possibilities. However, in the entanglements of culture, between closings and (re)openings, a utopian aesthetics can take shape, and also shape the discussion based on Tarkovsky's cinema, with his outsider cinematographic language. In this sense, what is at stake is the inventive dimension of language, the pulse of the signifiers that call the subjects to position themselves differently.

Este artículo busca tensionar el significante utopía, a partir de una articulación con la estética. Para eso, dialogamos específicamente con el lenguaje cinematográfico, asumiendo la premisa de que no aplicamos el Psicoanálisis al cine, sino el cine al Psicoanálisis, para construir un camino a través del cual podamos escuchar los significantes en su equívoco. Con el surgimiento de una utopía estética, la cual ilustramos con el realismo socialista, entendemos que una politica de lenguaje estricta fue colocada en escena, restringiendo los juegos con los significantes y, por lo tanto, las posibilidades discursivas. Sin embargo, en los enredosn de la cultura, entre cierres y (re)aperturas, puede tomar forma una estética utópica, la cual ponemos en discusión a partir del cine de Tarkovsky, que apuesta por un lenguaje cinematográfico fuera de los dictámenes estéticos actuales. En este sentido, lo que está en juego es la dimensión inventiva del lenguaje, el pulso de los significantes que convocan a los sujetos a diferentes posturas.

Teamwork in Cranial Base Surgery: A Feasible Task or a Utopian Dream.

In the past decade or perhaps a little earlier than that the concept of teamwork evolved among the circles of surgeons especially among those involved in complicated and time consuming surgeries. Skull base surgeries were one of those surgeries where the role of teamwork was acutely felt owing to innumerable specialties involved in the consummation of such surgeries. Although teamwork in this specialty is the need of the hour but, achieving the spirit of teamwork is not that easy and perhaps a challenging task. This manuscript tackles the much needed demand of teamwork in this arena of surgery and unveils whether such a teamwork is achievable or is just an utopian dream.

Paraguay, ¿el renacer de una utopía contagiosa? / Paraguay, the rebirth of a contagious utopia?

El artículo analiza las movilizaciones políticas en Paraguay, a partir de la década de 2000, con mayor atención a la relación entre los movimientos sociales y el gobierno de Fernando Lugo (2008 - 2012). Entre los aspectos que destaca el texto está que los movimientos sociales en Paraguay tuvieron un rol significativo desde la década del 2000. Desde la llegada de Lugo al gobierno nacional, sin embargo, se observó que las acciones de los líderes de las Centrales Sindicales comenzaron a priorizar las posiciones gubernamentales. Es decir, los partidos y agrupaciones de izquierda apuestan por el fortalecimiento de organizaciones populares, sindicatos, movimientos sociales partiendo del supuesto de que la vía administrativa podría fortalecer las organizaciones y garantizar mayores ganancias de derechos. Lo que sucedió, sin embargo, fue que los líderes fueron rápidamente cooptados por la lógica del poder estatal y la ocupación de cargos se convirtió en el objetivo principal.(AU)

The article analyzes the political mobilizations in Paraguay, starting in the 2000s, with greater attention to the relationship between social movements and the government of Fernando Lugo (2008 - 2012). Among the aspects highlighted in the text is that social movements in Paraguay had a significant role since the 2000s. Since Lugo's arrival in the national government, however, it was observed that the actions of the leaders of the Trade Union Centrals began to prioritize government positions. In other words, the parties and groups of the left are committed to strengthening popular organizations, unions, and social movements based on the assumption that the administrative route could strengthen organizations and guarantee greater gains in rights. What happened, however, was that the leaders were quickly co-opted by the logic of state power and the occupation of positions became the main objective.(AU)

#UTOPia: Urogynecology Tag Ontology Project.

OBJECTIVE: The objective of this study was to review and analyze the current social media status of urogynecology/female pelvic medicine and reconstructive surgery on Twitter and create a tag ontology. METHODS: A "tag ontology" is a standardized list of hashtags used to organize specific subject matter within a social media platform. We used an online social media analytics tool, Symplur to identify tweets and hashtags related to #urogynecology between January 2018 and July 2020. Hashtags identified using Symplur were verified manually via Twitter inquiries and reviewed by urogynecology social medial influencers for external validation. The hashtags were selected based on frequency of use, social media influencer opinion, and clinical relevance. RESULTS: We identified 6,847 tweets and 2,946 users. Our ontology includes 67 terms categorized into 5 groups (urinary, prolapse, anus/rectum, vulva, and other). Using "Symplur Rank," the 2 top influencers included @FPMRS and @FPMRSJournal. CONCLUSIONS: Adaptation of a standardized hashtag ontology facilitates communication between providers and patients about pertinent health care issues. Our study has created a urogynecology-specific ontology based on 2018-2020 Twitter usage.

Is Intraoperative Opioids Avoidance A Utopia? A Matched Study in Laparoscopic Hysterectomy.

BACKGROUND: Opioid-sparing strategies are recommended, and Opioid-Free Anaesthesia (OFA) is proposed in the literature. But few data exist about the feasibility of OFA in the routine practice. From a larger series of 21,463 patients receiving OFA, this work investigates the postoperative pain and related outcomes in patients undergoing laparoscopic hysterectomy. MATERIALS AND METHODS: This matched retrospective study concerned 521 patients scheduled for a laparoscopic hysterectomy between 2010 and 2015 (118 receiving OFA and 403 receiving anaesthesia with opioids, AO). Primary outcome was pain in the Post-Anaesthetic Care Unit (PACU). RESULTS: Among the 521 included patients, 403 received sufentanil (mean±SD: 0.1±0.05 mcg/kg), the only synthetic opioid used to balance anaesthesia. Concerning the 118 patients receiving OFA, most of them received an association of clonidine (97%) and ketamine (95%). Most of the patients in both groups received non-steroidal anti-inflammatory drugs. No difference in pain scores was observed between AO and OFA (median [IQR], respectively: 4 [0-5] vs. 4.5 [0-6], P=0.74). A difference in the perioperative morphine equivalent use was observed (mean±SD: 0.18±0.06 mg/kg vs. 0.09±0.06 mg/kg, P<0.001). No difference was observed regarding the nausea/vomiting incidences, use of anti-emetics, sedation scores, or time spent at the PACU. CONCLUSION: Coming from an extensive daily practice, these data show that OFA is feasible and not associated with higher pain scores or longer PACU stay, suggesting the absence of specific immediate complications.

A proposal of a "ready to use" COVID-19 control strategy in an Oncology ward: Utopia or reality?

The Coronavirus Disease-2019 (COVID-19) pandemic is spreading in Italy and Lombardy is one of the most affected region. Cancer patients are higher risk of complication from COVID-19 complications; therefore they should be protected from contagion while still ensuring access to cancer care. The aim of this article is to suggest a strategy to reorganize hospital spaces and Healthcare Professionals (HCPs) staff in order to avoid COVID-19 nosocomial infection in an Oncology ward. SARS-CoV-2 is primarily transmitted through respiratory droplets and by contact. We speculated that precautions against droplet and contact transmission should be the proper way to preserve ward from COVID-19. The essence of our protocol involves: triage outside of the ward, identification of risk zones, traffic control, surveillance of all the involved subjects. Whoever attends the ward must follow the general risk prevention and mitigation measures. The application of this practical strategy can contribute to breaking the cycle of community-hospital-community transmission.

Em defesa das utopias: enlaçamentos entre educação, política e psicanálise / En defensa de las utopías: enlaces entre la educación, la política y el psicoanálisis / In defense of utopias: the links between education, politics and psychoanalysis / En défense des utopies: les liens entre l'éducation, la politique et la psychanalyse

Ter esperança é condição para ensinar. Trata-se de esperar sem expectativa, mas supondo que uma criança possa sempre aprender algo. Por parte do professor, é necessário, portanto, fazer uma aposta e sustentar esse lugar desejante que dá origem à transferência. Quando adultos podem sonhar um futuro para a criança, há efeitos e, por isso, ter, para elas, uma utopia, nos parece fundamental. Esta é a tese que buscamos defender ao longo do trabalho. Nossas reflexões nasceram a partir de experiências vivenciadas em escolas angolanas e moçambicanas. O objeto sobre o qual nos debruçamos nesta investigação foram as maneiras pelas quais a posição do sujeito pode se relacionar com o lugar desse sujeito no desejo do Outro e incidir, como efeito, na relação da criança com o conhecimento.

La esperanza es una condición para la enseñanza. Es cuestión de esperar sin expectativas, pero asumiendo que un niño siempre puede aprender algo. Por lo tanto, por parte del maestro, es necesario hacer una apuesta y sostener este lugar deseable que da lugar a la transferencia. Cuando los adultos pueden soñar un futuro para el niño, hay efectos y, por lo tanto, tener una utopía para ellos, nos parece fundamental. Esta es la tesis que buscamos defender. Nuestras reflexiones nacieron de las experiencias vividas en las escuelas de Angola y Mozambique. En esta investigación nos interesamos a las formas en que la posición del sujeto puede relacionarse con el lugar que ocupa en el deseo del Otro y afectar, como efecto, la relación del niño con el conocimiento.

Hope is a condition for teaching. It is a matter of waiting without expectation, but assuming that a child can always learn something. On the part of the teacher, therefore, it is necessary to make a bet and sustain this desiring place that gives rise to the transfer. When adults can dream of a future for the child, there are effects and, therefore, have a utopia for them, it seems fundamental to us. This is the thesis that we seek to defend throughout this work. Our reflections were born from experiences lived in Angolan and Mozambican schools. The object on which we focused in this investigation were the ways in which the position of the subject can relate to the place of that subject in the desire of the Other and affect, as an effect, the relationship of the child with knowledge.

L'espoir est une condition pour enseigner. Il s'agit d'espérer sans expectation, mais tout en supposant qu'un enfant puisse toujours apprendre quelque chose. Du côté du professeur, il est donc nécessaire de faire un pari et de soutenir ce lieu désirant qui donne origine au transfert. Lorsque des adultes peuvent songer à un avenir pour l'enfant, cela produit des effets. Avoir, pour eux, une utopie, nous semble fondamental. C'est cette thèse que nous nous emploierons à défendre tout au long de cette étude. Notre réflexion est née à partir d'expériences vécues dans des écoles angolaises et mozambicaines. Notre analyse a privilégié l'examen de traits qui semblent pointer vers une position inconsciente du sujet face au désir de l'Autre et qui, souvent, émergeaient comme des impasses dans cette position du sujet et, en conséquence, face à la connaissance.

[Genomic profiling and personalized approach, utopia or future reality? A clinical case.] / Profilazione genomica e approccio personalizzato, utopia o realtà futuribile? Un caso clinico.

The management of advanced lung cancer has changed in recent years, young and long-surviving patients with chronic diseases and good clinical conditions are frequently observed. These patients need complex, integrated and personalized treatments. The possibility of obtaining more information about the genomic profile would allow the identification of patients who could benefit from chemotherapy rather than immunotherapy or molecular target therapies. Below is the case of a 44-year-old man, ECOG PS 0, with stage IV lung cancer. This clinical history confirms the importance of a personalized approach. The patient, with non-oncogene addicted lung adenocarcinoma, achieves a good clinical-instrumental response after a first line of treatment, followed by a long maintenance phase for a total of 52 weeks. Upon progression, the patient maintains excellent clinical conditions over time, and three additional lines of therapy are carried out. At the end of this sequence, we have proposed a genomic profiling test on a tissue sample of the disease (next generation sequencing - NGS). The study, which also included the state of microsatellites and tumour mutational burden, identified the genetic alteration ATM - Q2762fs*6 (ataxia telangiectasia mutated, ATM) and for this reason we have administered niraparib for off-label use. Although this is not a standard clinical practice context, the case presented can be considered an example of a future strategy in which the ab initio identification of the rare genetic alteration, driver for tumour disease, could represent the first step in the diagnostic-therapeutic process. By improving knowledge on genetic alterations and identifying the most influential alterations for each single solid tumour, it will be possible to identify the most effective therapy, probably with even lower costs in terms of overall patient management.

Bacurau, "bacurando-me", "bacurando-se" / Bacurau, "bacurando-me", "bacurando-se" / Bacurau, "bacurando-me", "bacurando-se" / Bacurau, "bacurando-me", "bacurando-se"

Você já viu Bacurau? Não? Você já reviu Bacurau? Essas perguntas continuarão sendo repetidas entre quem viu, nunca viu, reviu ou não reviu o filme de Kleber Mendonça Filho e Juliano Dornelles. Alegoria, utopia, distopia, drama, suspense, ficção? Bacurau provoca perguntas, respostas, dúvidas e certezas. É o Brasil que dará certo um dia; é apenas um "western-rapadura" onde oprimidos se vingam de opressores; é um libelo de resistência, de reconstrução de uma comunidade e seus moradores; de um país e seus habitantes. Bacurau produz ecos e respostas presentes em fatos históricos e, também, no futuro, a luta contra a escravidão; é a guerra de Canudos com o Conselheiro e seus seguidores. É o Estado Novo de Vargas e a ditadura dos generais pós-1964. É a luta contra uma elite corrupta e secular. Bacurau é utopia, uma utopia diferente, pois o protagonismo é da comunidade: comunidade individuada-e-individuante.

Did you see Bacurau? No? Did you see Bacurau again? These questions will continue to be repeated among those who saw, never saw, saw again or did not see the movie by Kléber Mendonça Filho and Juliano Dornelles. Allegory, utopia, dystopia, drama, suspense, fiction? Bacurau elicits questions, answers, doubts and certainties. It is the Brazil that one day will succeed; is just a "western rapadura" where the oppressed take revenge of the oppressors; it is a lampoon of resistance, of reconstruction of a community and its residents, of a country and its inhabitants. Bacurau produces echoes and answers present in historical facts and also in the future; the struggle against slavery; it is the War of Canudos with Conselheiro and his followers. It is Vargas's Estado Novo and the Generals' dictatorship post 1964. It is the struggle with the corrupt and secular elite. Bacurau is utopia, a different utopia, because the antagonism is of the community: individuated community that individuates.

¿Has visto Bacurau? ¿No? ¿Has analizado Bacurau? Estas preguntas continuarán repitiéndose entre aquellos que vieron, nunca vieron, analizaron o no la película de Kléber Mendonça Filho y Juliano Dornelles. ¿Alegoría, utopía, distopía, drama, suspenso, ficción? Bacurau causa preguntas, respuestas, dudas y certezas. Es el Brasil que funcionará algún día; es solo un "western-rapadura" donde las personas oprimidas se vengan de los opresores; es un libelo de resistencia, de reconstrucción de una comunidad y sus residentes; de un país y sus habitantes. Bacurau produce ecos y respuestas presentes en hechos históricos y también en el futuro; la lucha contra la esclavitud; Es la guerra de Canudos con el Consejero y sus seguidores. Es el Estado Nuevo de Vargas y la dictadura de los generales posteriores a 1964. Es la lucha contra una élite corrupta y secular. Bacurau es una utopía, una utopía diferente, porque el protagonismo es el de la comunidad: comunidad individuada e individuante.

Avez-vous déjà vu Bacurau ? Non ? Avez-vous déjà revu Bacurau ? Ces questions continueront à être répétées parmi ceux qui l'ont vu, ceux qui ne l'ont jamais vu, qui ont revu ou pas le film de Kléber Mendonça Filho et Juliano Dornelles. Allégorie, utopie, dystopie, drame, suspense, fiction ? Bacurau engendre des questions, des réponses, des doutes et des certitudes. C'est le Brésil qui réussira un jour ; c'est juste un « western-rapadura ¼ où les opprimés se vengent des oppresseurs ; c'est un libéllé de résistance, de reconstruction d'une communauté et ses habitants ; d'un pays et ses citoyens. Bacurau produit des échos et des réponses présents aussi bien dans les faits historiques que dans le futur ; la lutte contre l'esclavage ; c'est la guerre de Canudos avec Conselheiro et ses partisans. C'est le «Estado Novo¼ de Vargas et la dictature des généraux post-1964. C'est la lutte contre une élite corrompue et séculaire. Bacurau est utopie, une utopie différente, puisque le protagonisme est celui de la communauté: communauté individuée-et-individuante.

Targeting Vitamin D Deficiency to Limit Exacerbations in Respiratory Diseases: Utopia or Strategy With Potential?

Patients with respiratory diseases such as cystic fibrosis, chronic obstructive pulmonary disease, or asthma often experience an acute worsening of respiratory symptoms, termed exacerbations. Although the course of exacerbations is disease specific, they are mostly triggered by a respiratory infection. Exacerbations often require hospitalization and are an important cause of mortality. Treatments of exacerbations aim to minimize the negative impact and to prevent subsequent events. Despite many existing therapy options, many patients do not benefit from therapy and suffer from recurrent events. Vitamin D deficiency is a worldwide problem and is extremely prevalent in these patients. Vitamin D, known for its calcemic effects, also has immunomodulatory and anti-infectious actions and can therefore be a possible agent to treat or prevent exacerbations. This review will focus on vitamin D as a potential candidate to treat or prevent exacerbations in CF, COPD, and asthma.