Circulação e produção de saberes e práticas científicas na América meridional no século XVIII: uma análise do manuscrito Materia medica misionera de Pedro Montenegro (1710) Circulation and production of knowledge and scientific practices in southern America in the eighteenth century: an analysis of Materia medica misionera, a manuscript by Pedro Montenegro (1710)

Analisa uma versão manuscrita de 1790, do livro escrito originalmente em 1710 pelo jesuíta Pedro Montenegro, Materia medica misionera. Além da persistência de saberes mágico-religiosos e dos exóticos ingredientes para as receitas, encontram-se na obra a inconfundível presença das concepções hipocráticas e galênicas e o crescente empirismo que marca as transformações científicas do século XVIII. Sua análise permite, ainda, a reflexão sobre difusão, circulação e produção de conhecimentos farmacológicos e médicos na primeira metade do século XVIII, no âmbito das reduções e dos colégios instalados na região Província Jesuítica do Paraguai, na América meridional.<br>The article analyzes a 1790 manuscript copy of Materia medica misionera, a book written in 1710 by a Jesuit, Pedro Montenegro. Alongside knowledge of a magical or religious nature, and exotic ingredients for the recipes, this work also contains the unmistakable presence of Hippocratic and Galenic conceptions and a growing empiricism, characteristic of the scientific transformations seen in the eighteenth century. The analysis of this work also prompts reflections about the diffusion, circulation and production of pharmacological and medical knowledge in the first half of the eighteenth century within the missions and colleges installed in the area that was the Jesuit Province of Paraguay, southern America

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially