A sombra dos submersos

A divisão entre submersos e salvos revela-se a divisão-chave da visão de mundo de Primo Levi. O “submerso interno” (Di Castro) presente em todo sobrevivente se desdobra no submerso como Doppelgänger, uma voz interna que impulsiona o testemunho e que no escritor encontra sua representação narrativa, oscilante entre a metáfora da ameaça de uma sombra persecutória (presente na produção poética) e a personagem do amigo-duplo Alberto, companheiro desaparecido.A urgência do testemunho se desdobra na questão de como representar os submersos, os únicos que desceram até o fundo e poderiam devolver um testemunho realmente integral. Contudo, o escritor encontra uma “palavra sobrevivente” (Derrida) para aprofundar as facetas da vergonha, interrogar os fantasmas da culpa e delinear a “zona cinzenta”. Diante desta ferida insanável, Levi recusa a ideia de um privilégio merecido, nem precisa do conforto de uma providência divina: vários fatores contribuíram à sua salvação, mas as forças que operam são o acaso e a sorte. Já que a Fortuna, como salienta Robert Gordon, é uma força mítica que nossa cultura sempre utilizou para lidar com a realidade incompreensível e incontrolável, no caso do sobrevivente ela preenche a ausência angustiante de explicações; em Levi torna-se ponto de apoio para compor a representação literária dos eventos.A sobrevivência é, portanto, da ordem do “estranho”. Origem, evolução, adaptação, seleção natural, embate entre ordem e caos confluem no conto “Carbono” e demonstram que afinal o polo de maior atração de toda sua produção é o quesito: quem sobrevive e por quê?The division between the drowned and the saved is the key division of Primo Levi's worldview. The “internal submerged” (Di Castro) present in every survivor unfolds in the submerged as Doppelgänger, an internal voice oscillating between the metaphor of a persecutory shadow (present in his poetry) and the representation of his brotherly friend Alberto.The urgency of the testimony is faced with the question of how to represent the drowned, the only ones who  could return a truly comprehensive testimony. However, the writer finds a “surviving word” (Derrida) to probe the facets of shame, interrogate the ghosts of guilt and outline the “grey zone”.Despite this insurmountable wound, Levi refuses the idea of ​​a deserved privilege, nor does he need the comfort of divine providence: several factors contributed to his salvation, but the forces at work are chance and luck. Since Fortuna, as Robert Gordon points out, is a mythical force that our culture has always used to deal with the incomprehensible and uncontrollable reality, in the case of the survivor it fills the distressing absence of explanations; in Levi it ​​becomes a support point to combat the feeling of guilt and to compose the literary representation of events.Survival is, therefore, something "strange". Origin, evolution, adaptation, natural selection, clash between order and chaos converge in the short story “Carbono” and demonstrate that, after all, the pole of greatest attraction of all his production is the question: who survives and why

Bárbaro, inimigo, amigo: o estrangeiro entre construção política e narrativa de testemunho

Na leitura de Primo Levi, a temática do estrangeiro traz à luz a polarização, entre hostilidade e troca. O entrelaçamento entre barbárie, totalitarismo e antissemitismo se sobressai em diversos textos, permitindo um diálogo com pensadores como Arendt, Todorov e Bauman. O escritor parte da premissa iluminista de uma barbárie originária que só a razão poderia conter numa evolução humana linear. Contudo, em muitas narrativas, Levi representa o encontro com os estrangeiros, ou sua própria condição de estrangeiro em Auschwitz, sob o signo oposto a qualquer conflito. A percepção do estrangeiro, portanto, oscila entre dois polos que Paul Ricoeur identifica como simpatia e luta, mas afinal o embate com estranhos, mesmo quando problemático, desenvolve-se em episódios onde prevalece a ideia de hospitalidade (Derrida) como motor dos relacionamentos humanos. Contradizendo uma visão positivista, a percepção do inimigo e as divisões étnico-religiosas configuram-se sobretudo como uma construção política arbitrária da nossa “civilização”

Short-term and long-term effects of tibolone in postmenopausal women

Background: Tibolone is a synthetic steroid used for the treatment of menopausal symptoms, on the basis of short-term data suggesting its efficacy. We considered the balance between the benefits and risks of tibolone. Objectives: To evaluate the effectiveness and safety of tibolone for treatment of postmenopausal and perimenopausal women. Search methods: In October 2015, we searched the Gynaecology and Fertility Group (CGF) Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PsycINFO (from inception), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and clinicaltrials.gov. We checked the reference lists in articles retrieved. Selection criteria: We included randomised controlled trials (RCTs) comparing tibolone versus placebo, oestrogens and/or combined hormone therapy (HT) in postmenopausal and perimenopausal women. Data collection and analysis: We used standard methodological procedures of The Cochrane Collaboration. Primary outcomes were vasomotor symptoms, unscheduled vaginal bleeding and long-term adverse events. We evaluated safety outcomes and bleeding in studies including women either with or without menopausal symptoms. Main results: We included 46 RCTs (19,976 women). Most RCTs evaluated tibolone for treating menopausal vasomotor symptoms. Some had other objectives, such as assessment of bleeding patterns, endometrial safety, bone health, sexuality and safety in women with a history of breast cancer. Two included women with uterine leiomyoma or lupus erythematosus. Tibolone versus placebo Vasomotor symptoms Tibolone was more effective than placebo (standard mean difference (SMD) -0.99, 95% confidence interval (CI) -1.10 to -0.89; seven RCTs; 1657 women; moderate-quality evidence), but removing trials at high risk of attrition bias attenuated this effect (SMD -0.61, 95% CI -0.73 to -0.49; odds ratio (OR) 0.33, 85% CI 0.27 to 0.41). This suggests that if 67% of women taking placebo experience vasomotor symptoms, between 35% and 45% of women taking tibolone will do so. Unscheduled bleeding Tibolone was associated with greater likelihood of bleeding (OR 2.79, 95% CI 2.10 to 3.70; nine RCTs; 7814 women; I2 = 43%; moderate-quality evidence). This suggests that if 18% of women taking placebo experience unscheduled bleeding, between 31% and 44% of women taking tibolone will do so. Long-term adverse events Most of the studies reporting these outcomes provided follow-up of two to three years (range three months to three years). Breast cancer We found no evidence of differences between groups among women with no history of breast cancer (OR 0.52, 95% CI 0.21 to 1.25; four RCTs; 5500 women; I2= 17%; very low-quality evidence). Among women with a history of breast cancer, tibolone was associated with increased risk (OR 1.5, 95% CI 1.21 to 1.85; two RCTs; 3165 women; moderate-quality evidence). Cerebrovascular events We found no conclusive evidence of differences between groups in cerebrovascular events (OR 1.74, 95% CI 0.99 to 3.04; four RCTs; 7930 women; I2 = 0%; very low-quality evidence). We obtained most data from a single RCT (n = 4506) of osteoporotic women aged 60 to 85 years, which was stopped prematurely for increased risk of stroke. Other outcomes Evidence on other outcomes was of low or very low quality, with no clear evidence of any differences between the groups. Effect estimates were as follows: \u2022 Endometrial cancer: OR 2.04, 95% CI 0.79 to 5.24; nine RCTs; 8504 women; I2 = 0%. \u2022 Cardiovascular events: OR 1.38, 95% CI 0.84 to 2.27; four RCTs; 8401 women; I2 = 0%. \u2022 Venous thromboembolic events: OR 0.85, 95% CI 0.37 to 1.97; 9176 women; I2 = 0%. \u2022 Mortality from any cause: OR 1.06, 95% CI 0.79 to 1.41; four RCTs; 8242 women; I2 = 0%. Tibolone versus combined HT Vasomotor symptoms Combined HT was more effective than tibolone (SMD 0.17, 95% CI 0.06 to 0.28; OR 1.36, 95% CI 1.11 to 1.66; nine studies; 1336 women; moderate-quality evidence). This result was robust to a sensitivity analysis that excluded trials with high risk of attrition bias, suggesting a slightly greater disadvantage of tibolone (SMD 0.25, 95% CI 0.09 to 0.41; OR 1.57, 95% CI 1.18 to 2.10). This suggests that if 7% of women taking combined HT experience vasomotor symptoms, between 8% and 14% of women taking tibolone will do so. Unscheduled bleeding Tibolone was associated with a lower rate of bleeding (OR 0.32, 95% CI 0.24 to 0.41; 16 RCTs; 6438 women; I2 = 72%; moderate-quality evidence). This suggests that if 47% of women taking combined HT experience unscheduled bleeding, between 18% and 27% of women taking tibolone will do so. Long-term adverse events Most studies reporting these outcomes provided follow-up of two to three years (range three months to three years). Evidence was of very low quality, with no clear evidence of any differences between the groups. Effect estimates were as follows: \u2022 Endometrial cancer: OR 1.47, 95% CI 0.23 to 9.33; five RCTs; 3689 women; I2 = 0%. \u2022 Breast cancer: OR 1.69, 95% CI 0.78 to 3.67; five RCTs; 4835 women; I2 = 0%. \u2022 Venous thromboembolic events: OR 0.44, 95% CI 0.09 to 2.14; four RCTs; 4529 women; I2 = 0%. \u2022 Cardiovascular events: OR 0.63, 95% CI 0.24 to 1.66; two RCTs; 3794 women; I2 = 0%. \u2022 Cerebrovascular events: OR 0.76, 95% CI 0.16 to 3.66; four RCTs; 4562 women; I2 = 0%. \u2022 Mortality from any cause: only one event reported (two RCTs; 970 women). Authors' conclusions: Moderate-quality evidence suggests that tibolone is more effective than placebo but less effective than HT in reducing menopausal vasomotor symptoms, and that tibolone is associated with a higher rate of unscheduled bleeding than placebo but with a lower rate than HT. Compared with placebo, tibolone increases recurrent breast cancer rates in women with a history of breast cancer, and may increase stroke rates in women over 60 years of age. No evidence indicates that tibolone increases the risk of other long-term adverse events, or that it differs from HT with respect to long-term safety. Much of the evidence was of low or very low quality. Limitations included high risk of bias and imprecision. Most studies were financed by drug manufacturers or failed to disclose their funding source

O tradutor como testemunha

The testimony literature involves the reader in a peculiar way, because his responsibility of listening (Jeanne Marie Gagnebin) forces him to position himself, through a deep reading, within a witness-community (Lina Insana) that guarantees the transmission of the narration. As the reader, the translator too. Taking into account narrative and stylistic aspects of the testimonial literature, it is possible to draw up a proposal that enriches the ethics and practice of its translation by identifying the listener/reader/translator as a witness. At the same time, useful interrogatives are sent to the translation in general, considered here, following HenriMeschonnic, as a relation between two texts. The reflection is conducted from the analysis of translation problems and representation in Se questo è un uomo, the first book of Primo Levi, an Auschwitz survivor and great writer of the twentieth century.A narrativa testemunhal convoca o leitor de maneira peculiar, pois sua responsabilidade de escuta (Jeanne Marie Gagnebin) o obriga a se posicionar, através de uma leitura profunda, dentro de uma witness-community (Lina Insana) que garante a transmissão da narração. E como o leitor, o tradutor. Levando em conta aspectos narrativos e estilísticos da literatura testemunhal, é possível traçar uma proposta que visa enriquecer a ética e a prática de sua tradução identificando no ouvinte/leitor/tradutor uma testemunha. Ao mesmo tempo, são lançados interrogativos úteis à tradução em geral, aqui considerada, seguindo Henri Meschonnic, como relação entre dois textos. A reflexão é conduzida a partir da análise de problemáticas e cenas de tradução na obra Se questo è un uomo de Primo Levi, sobrevivente de Auschwitz e hoje considerado um grande escritor do século XX.

The witness indiscreet window: Primo Levi and surrealism after Auschwitz

Primo Levi, renowned for his testimony of Nazi camp (If This Is a Man, 1947), published a collection of short stories entitled “Natural Tales”. He uses the surrealistic elements and plots to imagine the paradoxical consequences of human rationality. “Angelic Butterfly” relates to the theme of genetic experiments during Nazism and stands out for horror elements and drama. This tale’s re­lation to the post-Auschwitz reflection lies firstly in its structure which raises the question of the wit­ness; secondly, in the uncertain effect of the “imaginable” as it questions the fragile boundary be­tween real, possible and fantastic; thirdly in the narrative organization based on the connection of the ideas of trace, fragment and testimony. In my analysis I will expose how this text is marked by one of the most traumatic events of the twentieth century

A janela indiscreta da testemunha: Primo Levi e o fantástico pós-Auschwitz

Primo Levi, mundialmente conhecido por seu testemunho do campo de extermínio (Se questo è un uomo, 1947) publicou uma coletânea de contos intitulados Histórias naturais onde utiliza os recursos do fantástico para imaginar as consequências paradoxais da racionalidade humana. A narrativa “Borboleta angélica” destaca-se pelos elementos do horror e do drama, relacionados ao tema das experiências genéticas durante o nazismo. O interesse deste conto e a sua especificidade pós-Auschwitz reside em alguns aspectos: em primeiro lugar em sua estrutura que reflete a problemática sobre o testemunho; no efeito de incerteza que se produz entorno ao que seria “imaginável” questionando a frágil fronteira entre real, possível e fantástico; a organização narrativa a partir do eixo rastro-fragmento-testemunho. Veremos, desta forma, como o texto é marcado por um dos eventos mais traumáticos do século XX

Plasma Myoglobin in the Early Diagnosis of Acute Myocardial Infarction

Peer Reviewe