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BACKGROUND: Hormonal therapy is an integral component for breast cancer treatment in women with oestrogen receptor positive tumours in early-stage and advanced cases of the disease. Little is known about what factors influence oncologists' prescribing practices, especially non-biological factors, although this information may have important implications for understanding inequalities in health care quality and outcomes. This paper presents findings from research on factors influencing oncologists' prescribing hormonal therapy for women with early and advanced cases of breast cancer in the city of Córdoba, Argentina. METHODS: A qualitative study using in-depth, semi-structured interviews with 16 oncologists was conducted. A stratified purposive sampling was used to recruit female and male participants and working at 3 health subsystems (private, social security, public). Data was analysed using the Framework approach. RESULTS: According to the respondents, factors influencing prescribing practices of hormonal therapy are varied. Women's socio-economic status (poverty and wealth) and their level of health literacy can affect oncologists' prescribing practices. Overall, in comparison to male, female oncologists reported more awareness of patients' needs, more involvement in communicating drug side-effects, and in offering treatment options in private health settings. The 3 health subsystems provided a differential access to drugs and lines of hormonal treatment, which ranged from a limited availability in the public sector, to administrative restrictions imposed by the social security system, and to a lesser extent, the private sector. This happened in the backdrop of national legislation covering oncological treatments and drugs free of charge. CONCLUSIONS: Addressing prescribing practices for hormonal therapy as a distinct type of breast cancer treatment (chronic care) is fundamental in the understanding of breast cancer care and can shed light on inequalities in treatments. Identifying the underlying care gaps in the prescription of hormonal therapy can help in the design of tailored interventions.

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This chapter proposes to analyse tge continuities and discontinuities, the significations and re-significations of work therapy for mentally ill patients in a time of fluid academic exchange between German and Angentinean doctors during the first decades of the twentieth century.

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This article analyses the organisation of cancer control in Argentina, with a special focus on the initiatives, institutions, and models that targeted female or gynaecological cancers. It identifies and examines the main factors in the process of elaborating a national policy to control the disease drawing on a series of actors and instruments such as the state, medical professionals, institutions and services, and the use of technology (notably diagnostic tools) for the detection of the disease. It traces the developments in the organisation highlighting its transformations from a centralising to a decentralised model of service provision. Using the concept of "path-dependence" the article examines the continuities and changes observed in the organisation of female cancer critically signalling the particular time at which a path was taken where "fragmentation" became consolidated within the health system. It also argues that it was within the field of cancer diagnosis that Argentinian doctors first sought to create the foundational structures of cancer organisation. The article contends that the path-dependence analytical approach helps us acknowledge the importance of historical analysis in the identification of factors that led to the lack of service coordination, including the persistent strain between national/provincial states that hampered the development of comprehensive programmes, aspects that have continued to mark efforts in the elaboration of cancer policies to the present day.

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Esse tema emergiu no campo da "história de doenças 'graças ao trabalho de um grupo heterogêneo de historiadores médicos e sociais, sociólogos, antropólogos e profissionais de saúde baseada principalmente em países da Europa e anglo-saxões. Tal abordagem multidisciplinar parte de perspectivas onde o câncer e sua história parecem abrigar alguns insights significativos para muitos sem resposta. Tais pesquisas estão contribuindo para expandir a análise do histórico de doenças pelo desenho da atenção às doenças crônicas e não transmissíveis, cuja relevância ter sido um pouco negligenciada em comparação com a atenção dada às doenças contagiosas e infecciosas. Uma boa parte dos estudos tem se concentrado particularmente na história dos cânceres femininos, mais especificamente, ginecológicos (mama, colo do útero, ovário e útero) começando a delinear a trajetória contemporânea sobre o câncer na saúde da mulher e o impacto do câncer nas sociedades. Há, no entanto, alguma razão crescente para a literatura examinar os cânceres femininos: no início no século XX, o câncer ginecológico é mencionado muitas vezes quando a doença é abordada. Nas décadas seguintes cresceram em grande extensão as observações acerca da identificação, diagnóstico, tratamento e prognóstico sustentado e noções gerais sobre o câncer como uma doença, de forma mais ampla. Exames históricos sobre câncer têm sido cautelosos em retratar os componentes de gênero da doença, permeando toda as iniciativas em "luta contra o câncer."Recentemente, os historiadores de câncer na América Latina estão contribuindo bastante para os relatos históricos da doença, documentando algumas de suas características distintas em uma região. Neste sentido, a América Latina oferece um lócus fecundo para explorar questões de espacialidade em conhecimentos médicos que vão além de uma mera recontagem da comunalidade e as diferenças observadas ao controle da doença em relação a Europa e à América.

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This article analyses the organisation of cancer control in Argentina, with a special focus on the initiatives, institutions, and models that targeted female or gynaecological cancers. It identifies and examines the main factors in the process of elaborating a national policy to control the disease drawing on a series of actors and instruments such as the state, medical professionals, institutions and services, and the use of technology (notably diagnostic tools) for the detection of the disease. It traces the developments in the organisation high lightingits transformations from a centralising to a decentralised model of service provision. Using the concept of «path-dependence» the article examines the continuities and changes observed in the organisation of female cancer critically signalling the particular time at which a path was taken where «fragmentation» became consolidated within the health system. It also argues that it was within the field of cancer diagnosis that Argentinian doctors first sought to create the foundational structures of cancer organisation. The article contends that thepath-dependence analytical approach helps us acknowledge the importance of historical analysis in the identification of factors that led to the lack of service coordination, including the persistent strain between national/provincial states that hampered the development of comprehensive programmes, aspects that have continued to mark efforts in the elaboration of cancer policies to the present day. (AU)

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Motherhood holds a special place in Argentinian culture. This book examines the historical intersections of medicine and culture that have underpinned the representations of matherhood during the first half of twentieth century.

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This article on the early detection of cervical cancer focuses on the development of two leading diagnostic techniques - colposcopy and the Pap smear test - and their histories in Argentina and Brazil. It explores how diagnostic tools were transferred between Europe and the Americas, while examining the intersection of cultural and medical aspects and the processes of adaptation and resignification in the receiving countries. Colposcopy received little attention in the main Western medical centers until South American countries reasserted its significance in the 1950s. 'Peripheral' centers played a central role in early detection policies and the combined uses of these methods gave rise to a new stage of 'cumulative confidence' in cervical cancer diagnosis and screening.(AU)

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This article on the early detection of cervical cancer focuses on the development of two leading diagnostic techniques - colposcopy and the Pap smear test - and their histories in Argentina and Brazil. It explores how diagnostic tools were transferred between Europe and the Americas, while examining the intersection of cultural and medical aspects and the processes of adaptation and resignification in the receiving countries. Colposcopy received little attention in the main Western medical centers until South American countries reasserted its significance in the 1950s. 'Peripheral' centers played a central role in early detection policies and the combined uses of these methods gave rise to a new stage of 'cumulative confidence' in cervical cancer diagnosis and screening.

Este artigo trata da detecção precoce do câncer cervical. Coloca em evidência as duas principais técnicas diagnósticas, a colposcopia e o teste de Papanicolau, e mostra suas trajetórias no Brasil e na Argentina. Analisa o modo como se deu a transferência de métodos diagnósticos entre a Europa e as Américas, procurando perceber a interseção de aspectos médicos e culturais e ainda os processos de adaptação e ressignificação nos países que acolheram as novas técnicas. A colposcopia recebeu pouca atenção nos principais centros médicos ocidentais até os países sul-americanos validarem sua importância nos anos 1950. Centros 'periféricos' desempenharam papel crucial nas políticas de detecção precoce, e o uso combinado desses métodos deu lugar a novo estádio de 'confiança cumulativa' no exame e diagnóstico do câncer cervical.

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This article looks at medical approaches to women's fertility in Argentina in the 1930s and explores the ways in which eugenics encouraged the reproduction of the fit and attempted to avoid the reproduction of the unfit. The analysis concentrates on three main aspects: biotypology (the scientific classification of bodies), endocrine therapy, and sterilization. The article concludes by suggesting that a eugenically oriented obstetrical and gynecological practice encouraged both endocrine treatments (to achieve the ideal fertile woman) and sterilization, which, in spite of being legally banned, found a subtle application.

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Looks at medical approaches to women's fertility in Argentina in the 1930s and explores the ways in which eugenics encouraged the reproduction of the fit and attempted to avoid the reproduction of the unfit. The analysis concentrates on three main aspects: biotypology (the scientific classification of bodies), endocrine therapy, and sterilization. The article concludes by suggesting that a eugenically oriented obstetrical and gynecological practice encouraged both endocrine treatments (to achieve the ideal fertile woman) and sterilization, which, in spite of being legally banned, found a subtle application. (AU)

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Desde el convencimiento de que el trabajo como terapéutica en los enfermos mentales no conformaba un discurso propiamente psiquiátrico, el propósito ha sido atender a cierta circulación de discursos que conectaban el trabajo con ciencias afines como la Higiene y la Criminología. A través de ellos es posible ubicar el trabajo dentro de un campo más amplio de discursividades que remiten a los problemas sociales emergentes en la Argentina de entre los siglos XIX y XX. Al mismo tiempo, dentro de las propuestas de implementación del Asilo Colonia (como un nuevo modelo asistencial), es posible articular una concepción del trabajo como categoría esencial del Hombre; una mirada médica-estatal que hará de la salud corporal y psíquica un valor fundamental; y una particular relación del Estado con la asistencia de los indigentes.(AU)

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Interesa reparar que el enfermo mental, especialmente el crónico incurable, percibido como un verdadero problema desde esta perspectiva, se convertirá en líneas generales, en el destinatario dilecto del discurso psiquiátrico sobre el trabajo. Y desde esta centralidad, posteriormente indagar cómo el discurso médico deslizará también otros argumentos, que se abren a dimensiones más amplias, y que a modo de reforzamiento de sus postulados, sugieren el camino a otras interpretaciones. En ese movimiento pueden detectarse, hacia la década del 30`, una lectura social del enfermo mental crónico que devela un esfuerzo por conceptuar su posición no ya desde la concepción estrictamente psiquiátrica sino desde la social-asistencial. (AU)

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Procura analizar la emergencia y el proceso de consolidación de una especialidad médica, la Obstetricia; como así también, alguna de sus consecuencias para el "acto" de ser madre. Tomando por caso la ciudad de Córdoba, se parte de la premisa de que las especialidades médicas no han sido fruto de la evolución consustancial al desarrolo del conocimiento, sino del resultado de un proceso de legitimación frente a la sociedad y frente a los otros profesionales médicos. Este proceso supuso, para el caso de la Obstetricia, entre otros: la competencia por la apropiación de un monopolio (frente a las parteras y médicos generales); la creación de nuevas instituciones (maternidades); la emergencia y participación en foros especializados (órganos de expresión, sociedades, congresos); el desarrollo de técnicas y recursos que llevaron a la medicalización del embarazo y del parto. (AU)

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Referencia la concepción médica epocal que asocia la idea de "país civilizado" con la transformación y modernización de los manicomios urbanos para el asiento de la enseñanza psiquiátrica y el tratamiento de los casos agudos, y con la distribución en el espacio rural de un nuevo modelo hospitalar basado en procedimientos más liberales y humanitarios de asistencia: los "asilos colonia de puertas abiertas" destinados a la atención de procesos agudos y a dar albergue a la mayor cantidad posible de crónicos e incurables. Trata sobre los sueños de una sociedad sin conflictos, sobre los medios de encauzamiento de las conductas y sobre las resistencias o adaptaciones de esta base social compuesta por los internados y por el personal de vigilancia encargado de su custodia.(AU)

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