Reflexões psicanalíticas winnicottianas sobre o sentido do silêncio no setting

We tried to analyze in this paper the meaning of silence into the analytical setting, based in Winnicott’s proposal of psychoanalysis and from clinical experience fragments of one the authors. Therefore, we surveyed the meaning of silence in the setting for some psychoanalysts and, afterwards, we made reference mainly to the concepts related to Winnicott’s Theory of the Emotional Maturity, such as holding, handling, the presentation of objects, and those concerning hesitation and transitionality. We further availed ourselves of the concepts of transference and count transference to ponder on the therapeutic dyad into the analytical setting. Our final considerations point to the need to consider silence as an important communication in certain circumstances of the therapeutic work, as well as suggesting that the setting, in this case study, requested hopeful non-invasive approach of the therapist, to allow the appearance of transitional space through which the emotional maturity can be resumed in this patient.

Enquadres clínicos, enquadramentos estéticos: arte e psicanálise

This paper aims at establishing a link between the psychoanalytic idea of a clinical setting and the notion of framing in the artistic image. To this end, the reading is based on issues related to clinical care, in the specific sense of a setting, casting itself in artistic creations that challenge the rigid status – when it’s the case – of this setting, and reflecting on the notion of transference, a basic phenomenon in this context. The conclusions refer to a direct approach between the aesthetic experience and psychoanalytic experience.

Ética e clínica na atenção psicossocial: contribuições da psicanálise de Freud e Lacan

O objetivo central é discutir a possibilidade de uma ética pertinente ao conjunto de ações atualmente realizadas sob o enfoque da Atenção Psicossocial no campo da Saúde Mental Coletiva. Utilizando o método do ensaio, partirei da análise de algumas proposições importantes sobre a ética na Saúde Mental, presentes na literatura recente, e da experiência de vários anos no campo da Atenção Psicossocial como trabalhador, como assessor clínico-institucional do Ministério da Saúde e como formador de psicoterapeutas. Duas vertentes de análise são consideradas: éticas disciplinares, chamadas éticas da psiquiatria, incluindo uma tentativa importante de complementá-las criticamente sob o enfoque da ética do cuidado, e éticas fundadas em concepções psicanalíticas do sujeito e seu sofrimento, que destacam as dimensões do sujeito como entre social e como entre subjetivo ou entre sentido. Com base nas diretrizes do Sistema Único de Saúde e na psicanálise do campo freudiano, procura-se fundamentar a ética da Clínica na Atenção Psicossocial como ética do cuidar-se - base necessária para a construção do protagonismo dos sujeitos do sofrimento na produção do sentido necessário à superação do sofrimento e demais impasses que motivaram a procura de ajuda, e para a possibilidade de seu reposicionamento no entre social e no entre sentido; componentes da saúde em sintonia com a subjetividade singularizada referenciada nos Ideais socioculturais e no devir desejante. Demonstra-se que essa ética exige dos trabalhadores do campo a superação dialética dos modos de produção de saúde e subjetividade em sintonia com o Modo Capitalista de Produção e seus derivados autoritários.

As origens da psicanálise de crianças no Brasil: entre a educação e a medicina

O presente artigo tem por objetivo investigar a forma como as primeiras informações relativas à psicanálise de crianças foram introduzidas no Brasil, bem como delinear como estas idéias foram apropriadas pelos teóricos nacionais e incorporadas nas práticas de assistência à criança desenvolvidas no País nas primeiras décadas do século XX. Para isto foi desenvolvida uma pesquisa histórica de natureza qualitativa, mediante a realização de um levantamento bibliográfico que buscou identificar a produção de autores nacionais sobre psicanálise de crianças entre as décadas de 1920 a 1950. Os resultados indicam que a inserção da psicanálise de crianças no país ocorreu por duas vias: primeiramente através da educação, mediante a utilização deste referencial teórico com o intuito de melhor gerir a educação das crianças e solucionar seus problemas escolares; e, posteriormente, por intermédio da medicina, mediante o desenvolvimento de uma prática psicoterápica destinada ao tratamento de crianças com transtornos emocionais.

As influências da psicanálise na educação brasileira no início do século XX

O presente artigo tem por objetivo discutir, a partir de um vértice histórico, a relação entre educação e psicanálise no Brasil. Partindo de um estudo qualitativo, fundamentado na análise bibliográfica relativa à produção psicanalítica dedicada à educação produzida no país nas primeiras décadas do século XX, são discutidas as contribuições da psicanálise na transformação das práticas educacionais. Os resultados indicam que a psicanálise esteve presente na educação de duas formas: inicialmente, pela divulgação de informações teóricas relativas aos conceitos psicanalíticos e às características do desenvolvimento emocional da criança, por intermédio de livros e cursos destinados a educadores, e, posteriormente, através da criação de uma prática de assistência ao escolar com problemas de aprendizagem ou comportamento, desenvolvida em clínicas de orientação infantil, que consistia na avaliação da criança e na orientação de pais e professores. Conclui-se que a psicanálise, enquanto fundamento teórico e prático, forneceu elementos que contribuíram para a sustentação dos pressupostos filosóficos da Escola Nova, que surgiu, a partir da década de 1920, como alternativa ao ensino tradicional.

Genotyping of Mycobacterium tuberculosis isolates from alow-endemic setting in northwestern state of Paraná in Southern Brazil

The purpose of this study was to provide information about the genetic diversity and prevalent genotype of Mycobacterium tuberculosis in a low-endemic setting in northwestern state of Paraná in Southern Brazil. We employed spoligotyping and mycobacterial interspersed repetitive units-variable number tandem repeat (MIRU-VNTR) techniques to genotype M. tuberculosisisolates from patients with pulmonary tuberculosis (TB). The 93 isolates analyzed by spoligotyping were divided into 36 different patterns, 30 of which were described in the SITVIT database. Latin American and Mediterranean, Haarlem and T families were responsible for 26.9%, 17.2% and 11.8% of TB cases, respectively. From the 84 isolates analyzed by MIRU-VNTR, 58 shared a unique pattern and the remaining 26 belonged to nine clusters. The MIRU loci 40, 23, 10 and 16 were the most discriminatory. A combination of MIRU-VNTR and spoligotyping resulted in 85.7% discriminatory power (Hunter-Gaston index = 0.995). Thus, combining spoligotyping and MIRU-VNTR typing proved to be most useful for epidemiological study in this low-endemic setting in Southern Brazil. The current study demonstrated that there is significant diversity in circulating strains in the city of Maringá and the surrounding regions, with no single genotype of M. tuberculosispredominating.

Setting the preheating and steady-state operation of electronic ballasts, considering electrodes of hot-cathode fluorescent lamps

This paper presents a new methodology for the adjustment of the preheating process and steady-state operation of electronic ballasts intended for hot-cathode fluorescent lamps. The classical series-resonant parallel-loaded half-bridge inverter is the power stage analyzed in this paper. In addition, the preheating process is based on the imposition of a constant rms current through the electrodes, in order to provide a proper value of the R-h/R-c ratio before the lamp start. According to the proposed methodology, it is possible to set suitable operating points for, the electronic ballast, considering optimal conditions for the lamps electrodes. Therefore, the proposed methodology for setting the preheating and steady-state operation is a complete platform to the design of electronic ballasts for hot-cathode fluorescent lamps.

Setting time and thermal expansion of two endodontic cements

The purpose of this study was to evaluate the setting time and the thermal expansion coefficient of 2 endodontic cements, MTA-Angelus and a novel cement called CER. The setting time was determined in accordance to ANSI/ADA specifications no. 57. Three samples of 10 mm diameter and 2 mm thickness were prepared for each cement. The thermal expansion measurements were performed by strain gauge technique. Four samples of each cement were prepared using silicone rings of 5 mm diameter and 2 mm thickness. The data were analyzed statistically using the Student t test. The setting time obtained for the MTA-Angelus and CER cements was 15 (SD 1) min and 7 (SD 1) min, respectively. The linear coefficient of thermal expansion was 8.86 (SD 0.28) mu strain/degrees C for MTA-Angelus and 11.76 (SD 1.20) mu strain/degrees C for CER. The statistical analysis showed significant difference (P < .05) in the setting time and linear coefficient of thermal expansion between the 2 cements. The CER cement has a coefficient of expansion similar to dentin, which could contribute to a decrease of microleakage degree.

Influence of Hydatidiform Mole Follow-Up Setting on Postmolar Gestational Trophoblastic Neoplasia Outcomes A Cohort Study

OBJECTIVE: To assess the influence of hydatidiform mole (HM) management setting (reference center versus other institutions) on gestational trophoblastic neoplasia (GTN) outcomes. METHODS: This cohort study included 270 HM patients attending Botucatu Trophoblastic Diseases Center (BTDC, São Paulo State University, Brazil) between January 1.990 and December 2009 (204 undergoing evacuation and entire postmolar follow-up at BTDC and 66 from other institutions [OIs]). GTN characteristics and outcomes were analyzed and compared according to HM management setting. The confounding variables assessed included age, gravidity, parity, number of abortions and HM type (complete or partial). Postmolar GTN outcomes were compared using Mann-Whitney's test, chi(2) test or Fisher's exact test.RESULTS: Postmolar GTN occurred in 34 (34/204= 16.7%) BTDC patients and in 27 (27/66=40.9%) of those initially treated in other institutions. BTDC patients showed lower metastasis rate (5.8% vs. 48%, p = 0.003) and lower median FIGO (2002) score (2.00 0.00, 3.001 vs. 4.00 [2.00, 7.00], p = 0.003]. Multiagent chemotherapy to treat postmolar GTN was required in 2 BTDC cases (5.9%) and in 8 OI cases (29.6%) (p = 0.017). Median time interval between molar evacuation and chemotherapy onset was shorter among BTDC patients (7.0 [6.0, 10.0] vs. 10.0[7.0, 16.0], p = 0.040). CONCLUSION: BTDC patients showed GTN characteristics indicative of better prognosis. This underscores the importance of GTD specialist centers. (J Reprod Med 2012;57:305-309)

Effect of Incorporation of Disinfectant Solutions on Setting Time, Linear Dimensional Stability, and Detail Reproduction in Dental Stone Casts

Purpose: The aim of this paper was to analyze the influence of incorporation of disinfectants during the cast die stone-setting time. Setting time, linear dimensional stability, and reproduction details on casts were measured.Materials and Methods: Die stone type IV specimens with disinfection solutions (sodium hypochlorite 1%, glutaraldehyde 2%, chlorhexidine 2%) were incorporated in two concentrations (50%, 100%). The detail reproduction, dimensional stability, and setting time were tested in accordance with ADA recommendations.Results: Disinfecting solutions promoted an increase in setting time compared to control; sodium hypochlorite was responsible for the highest setting time. The addition of undiluted sodium hypochlorite 1.0% led to contraction during setting, but the groups with 50% diluted sodium hypochlorite 1.0% and undiluted chlorhexidine 2.0% resulted in intermediate values compared to the other groups, thus matching the control. The others did not demonstrate any effect on expansion. For detail reproduction, it was observed that the control group presented results similar to the others, except those where sodium hypochlorite was added.Conclusions The addition of sodium hypochlorite in both dilutions significantly altered, negatively, all the evaluated properties. But the addition of glutaraldehyde and chlorhexidine did not promote any significant alterations in the evaluated properties.

pH, Calcium Ion Release, and Setting Time of an Experimental Mineral Trioxide Aggregate-based Root Canal Sealer

Introduction: An experimental mineral trioxide aggregate sealer (MTAS) has been developed for use as a root canal sealer. The aim of this study was to evaluate the setting time, pH, and calcium ion release of MTAS compared with white Portland cement (CPB-40; Votorantin Cimentos, Camargo Correa SA, Pedro Leopoldo, MG, Brazil), white MTA Angelus (MTA; Angelus, Londrina, PR, Brazil), and AH Plus (Dentsply DeTrey, Konstanz, Germany). Methods: For the evaluation of setting time, each material was analyzed using Gilmore-type needles. Polyethylene tubes with the materials were immersed in distilled water for the measurement of pH (digital pH meter) and calcium release (atomic absorption spectrophotometry). The evaluations were performed at 3, 6, 12, 24, and 48 hours and 7, 14, and 28 days. Data were analyzed by analysis of variance and the Tukey test at 5% significance level. Results: MTAS showed higher calcium release at all experimental periods, a greater increase in pH up to 48 hours and the longest setting time. Conclusions: MTAS presented favorable properties for its indication as a root canal sealer. (J Endod 2011;37:844-846)

The Influence of Calcium Chloride on the Setting Time, Solubility, Disintegration, and pH of Mineral Trioxide Aggregate and White Portland Cement with a Radiopacifier

This study evaluated the influence of addition of 10% calcium chloride (CaCl(2)) on the setting time, solubility, disintegration, and pH of white MTA (WMTA) and white Portland cement (WPC). A test of the setting time was performed following the #57 ADA specifications and a test of the final setting time according to the ASTM. For the solubility tests disintegration and pH, Teflon rings were filled with the cements and weighed after setting. After 24 h in a desiccator, they were once again weighed. Thereafter, they were immersed in MiliQ water for 24 and 72 h and 7, 14, and 28 days, with maintenance in the desiccator and weighing between periods. The pH of water in which the rings were immersed was measured immediately after contact with them and in the other periods. The addition of CaCl(2) provided a significant reduction (50%) in the initial setting time of cements. The final setting time of WMTA was reduced in 35.5% and the final setting time of WPC in 68.5%. The WMTA with CaCl(2) absorbed water and gained weight with time, except for in the 24-h period. The addition of CaCl(2) to the WPC reduced its solubility. The addition of CaCl(2) increased the pH of WMTA in the immediate period and at 24 and 72 h and for WPC in the immediate period and at 24 h. The addition of CaCl(2) to WMTA and WPC reduced the setting times and solubility of both and increased the pH of cements in the initial periods. (J Endod 2009;35:550-554)

High-pressure granulites from Carire, Borborema Province, NE Brazil: Tectonic setting, metamorphic conditions and U-Pb, Lu-Hf and Sm-Nd geochronology

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O corpo na psicanálise contemporânea: sobre as concepções psicossomáticas de Pierre Marty e Joyce McDougall

Este estudo tem como objetivo apresentar algumas considerações a respeito das concepções teóricas de Pierre Marty e Joyce McDougall. Tal propósito justifica-se tendo em vista que os referidos autores se afiguram como dois dos mais importantes expoentes da psicossomática psicanalítica e, assim, oferecem contribuições de grande valor para a compreensão dos determinantes psicológicos das enfermidades orgânicas. Além disso, vale destacar que Marty e McDougall acrescentam à psicanálise conceitos que ainda não foram devidamente incorporados à literatura científica especializada. Conseqüentemente, considerou-se relevante focalizar no presente estudo a discussão de dois desses conceitos, a saber: pensamento operatório e desafetação.

Persuasão antes que convencimento: apontamentos sobre Wittgenstein e a psicanálise

As relações que Wittgenstein mantém com o pensamento de Freud, como atestaram vários estudiosos, são marcadamente ambíguas: existe, por um lado, uma crítica acerba do caráter pseudocientífico com que a psicanálise apresenta supostas “descobertas empíricas”, e do fascínio exercido por este modo de proceder; mas há, por outro lado, evidências da sua admiração pelo efeito dissolvente do uso de metáforas e interpretações, chegando mesmo Wittgenstein a incorporar essa estratégia ao seu próprio método de investigação lógica dos conceitos filosóficos. Neste trabalho pretendo retirar de uma reflexão acerca do método incorporado às Investigações Filosóficas, comparável em muitos aspectos à clínica de uma psicanálise lingüística dessubstancializada, alguns pontos positivos que se poderiam acrescentar à crítica da concepção de linguagem de Lacan.