Optimising bloodless cardiovascular surgery for Jehovah's Witnesses and beyond.

Emerging evidence suggests surgical outcomes of patients undergoing cardiovascular surgery that refuse autologous transfusion is comparable to those who accept whole blood product transfusions. There are several methods that can be used to minimize blood loss during cardiovascular surgery. These methods can be categorised into pharmacological measures, including the use of erythropoietin, iron and tranexamic acid, surgical techniques, like the use of polysaccharide haemostat, and devices such as those used in acute normovolaemic haemodilution. More prospective studies with stricter protocols are required to assess surgical outcomes in bloodless cardiac surgery as well as further research into the long-term outcomes of bloodless cardiovascular surgery patients. This review summarizes current evidence on the use of pre-, intra-, and post-operative strategies aimed at the subset of patients who refuse blood transfusion, for example Jehovah's Witnesses.

Cardiac Surgery in Patients With Blood Disorders.

Blood disorders that can contribute to abnormal bleeding can have a detrimental effect during cardiac surgery. Patients who are known to have such pathologies should be investigated thoroughly and cautious measures would need to be taken when cardiac surgery is needed in this cohort. The majority of current literature for cardiac surgery in patients with von Willebrand Disease and haemophilia are case reports. Nevertheless, evidence shows that optimising factor levels pre, intra and postoperatively offers outcomes similar to that of patients without these disorders. Preoperative screening followed by appropriate iron therapy reduces mortality for patients with anaemia. In this group, haemoglobin levels can be improved postoperatively through iron supplementation. The management strategy of cardiac surgery for people with blood disorders requires a multidisciplinary approach that is highly individualised for each patient. It is essential to adequately adjust preoperative, perioperative and postoperative care to the patient's blood disorder in order to achieve outcomes similar to that of patients without blood disorders.

Transcatheter versus surgical closure of atrial septal defects: a systematic review and meta-analysis of clinical outcomes.

BACKGROUND: Atrial septal defects are a common form of CHD and dependent on the size and nature of atrial septal defects, closure may be warranted. The paper aims to compare outcomes of transcatheter versus surgical repair of atrial septal defects. METHODS: A comprehensive electronic literature search was conducted. Primary studies were included if they compared both closure techniques. Primary outcomes included procedural success, mortality, and reintervention rate. Secondary outcomes included residual defect and mean hospital stay. RESULTS: A total of 33 studies were included in meta-analysis. Mean total hospital stay was significantly shorter in the transcatheter cohort across both the adult (95% confidence interval, mean difference -4.05 (-4.78, -3.32) p < 0.00001) and paediatric populations (95% confidence interval, mean difference -4.78 (-5.97, -3.60) p < 0.00001). There were significantly fewer complications in the transcatheter group across both the adult (odds ratio 0.45, 95% confidence interval, [0.28, 0.72], p < 0.00001) and paediatric cohorts (odds ratio 0.26, 95% confidence interval, [0.14, 0.49], p < 0.00001). No significant difference in overall mortality was found between transcatheter versus surgical closure across the two groups, adult (odds ratio 0.76, 95% confidence interval, [0.40, 1.45], p = 0.41), paediatrics (odds ratio 0.62, 95% confidence interval, [0.21, 1.83], p = 0.39). CONCLUSION: Both transcatheter and surgical approaches are safe and effective techniques for atrial septal defect closure. Our study has demonstrated the benefits of transcatheter closure in terms of lower complication rates and mean hospital stay. However, surgery still has a place for more complex closure and, as we have demonstrated, shows no difference in mortality.

Pedicled or skeletonized bilateral internal mammary artery harvesting - a meta- analysis and trial sequential analysis.

OBJECTIVE: There is varying evidence on the role of skeletonization of internal mammary artery in reducing the risk of sternal wound infections and ischemia following bilateral internal mammary artery grafting. Post-operative clinical outcomes of skeletonized bilateral internal mammary artery versus pedicled bilateral internal mammary artery harvesting in patients undergoing coronary artery bypass surgery were compared. METHODS: A comprehensive electronic search was conducted using MEDLINE, Scopus, EMBASE, Cochrane database and Google Scholar from inception until 15 June 2020. All studies directly comparing skeletonized and pedicled bilateral internal mammary artery harvesting were included. Meta-analysis and trial sequential analysis were conducted. RESULTS: Nine studies (one randomized controlled trial and eight observational studies) consisting of 3649 patients (2050 patients with skeletonized bilateral internal mammary artery grafting and 1599 patients with pedicled bilateral internal mammary artery grafting) were included. Pooled effects analysis and trial sequential analysis reported significantly lower risk of sternal wound infection with skeletonized bilateral internal mammary artery harvesting (OR 0.27, 95% CI 0.20-0.51, p < 0.00001). CONCLUSIONS: Skeletonization reduces the risk of sternal wound infections by preserving vasculature as much as possible. This facilitates its use in patients at high risk of sternal wound infection.

Pernicious pregnancy: Type B aortic dissection in pregnant women.

BACKGROUND: Type B aortic dissection (TBAD) occurs seldomly, particularly in pregnancy, but has disastrous consequences for both mother and fetus. The focus of immediate surgical repair of type A aortic dissection due to higher mortality of patients is less clear in its counterpart, TBAD, in which management is controversial and debated. This article collates knowledge so far on this rare event during pregnancy. METHODS: A comprehensive literature search was performed in PubMed, Scopus, Google Scholar, Embase, and Medline. Key search terms included "type B aortic dissection," "pregnancy," and corresponding synonyms. Non-English papers were excluded. RESULTS: Risk factors for TBAD include aortic wall stress due to hypertension, previous cardiac surgery, structural abnormalities (bicuspid aortic valve, aortic coarctation), and connective tissue disorders. In pregnancy, pre-eclampsia is a cause of increased aortic wall stress. Management of this condition is often conservative, but this is dependent on a number of factors, including gestation, cardiovascular stability of the patient, and symptomology. In most cases, a cesarean section before intervention is carried out unless certain indications are present. CONCLUSIONS: Due to a scarce number of cases across the decades, it is difficult to determine which management is optimal. The gold-standard management of TBAD has traditionally been the medical treatment for uncomplicated cases and open surgery for those needing urgent intervention, but with the advent of techniques, such as thoracic endovascular aortic repair, the management of these group of patients continues to develop.

Cardiac output monitoring in paediatric cardiac surgery: a review.

The aim of this review is to present the current options for cardiac output (CO) monitoring in children undergoing cardiac surgery. Current technologies for monitoring identified were a range of invasive, minimally invasive, and non-invasive technologies. These include pulmonary artery catheter, transoesophageal echocardiography, pulse contour analysis, electrical cardiography, and thoracic bioreactance. A literature search was conducted using evidence databases which identified two current guidelines; the NHS Greater Glasgow and Clyde guideline and Royal College of Anaesthetics Guideline. These were appraised using the AGREE II tool and the evidence identified was used to create an overview summary of each technological option for CO monitoring. There is limited evidence regarding the accuracy of modalities available for CO monitoring in paediatric patients during cardiac surgery. Each technology has advantages and disadvantages; however, none could be championed as the most beneficial. Furthermore, a gold standard for CO monitoring has not yet been identified for paediatric populations, nor is it apparent whether one modality is preferable based on the available evidence. Additional evidence using a standardised method for comparing CO measurements should be conducted in order to determine the best option for CO monitoring in paediatrics. Furthermore, cost-effectiveness assessment of each modality should be conducted. Only then will it be possible for clear, evidence-based guidance to be written.

Outcomes of cardiac surgery in Jehovah's Witness patients: A review.

OBJECTIVE: To review current literature evidence on outcomes of cardiac surgery in Jehovah's Witness patients. METHODS: A comprehensive electronic literature search was done from 2010 to 20th August 2020 identifying articles that discussed optimisation/outcomes of cardiac surgery in Jehovah's Witness either as a solo cohort or as comparative to non-Jehovah's Witnesses. No limit was placed on place of publication and the evidence has been summarised in a narrative manner within the manuscript. RESULTS: The outcomes of cardiac surgery in Jehovah's Witness patients has been described, and also compared, to non-Witness patients within a number of case reports, case series and comparative cohort studies. Many of these studies note no significant differences between outcomes of the two groups for a number of variables, including mortality. Pre-, intra and post-operative optimisation of the patients by a multidisciplinary team is important to achieve good outcomes. CONCLUSION: The use of a bloodless protocol for Jehovah's Witnesses does not appear to significantly impact upon clinical outcomes when compared to non-Witness patients, and it has even been suggested that a bloodless approach could provide advantages to all patients undergoing cardiac surgery. Larger cohorts and research across multiple centres into the long term outcomes of these patients is required.

Outcomes in minimally invasive double valve surgery.

OBJECTIVE: To review current literature evidence on outcomes of minimally invasive double valve surgeries (MIS). METHODS: A comprehensive electronic literature search was done from inception to 20th June 2020 identifying articles that discussed outcomes of minimally invasive approach in double valve surgeries either as a solo cohort or as comparative to conventional sternotomies. No limit was placed on time and place of publication and the evidence has been summarized in narrative manner within the manuscript. RESULTS: Majority of current literature reported similar perioperative and clinical outcomes between MIS and conventional median sternotomy; except that MIS has better cosmetic effects and pain control. Nevertheless, minimal invasive techniques are associated with longer cardiopulmonary bypass and aortic cross-clamp times which may have impact on the reported outcomes and overall morbidity and mortality rates. CONCLUSION: Minimally invasive double valve surgery continues to develop, but scarcity in the literature suggests uptake is slow, possibly due to the learning curve associated with MIS. Many outcomes appear to be comparable to conventional sternotomy. There is need for larger, multi-center, and randomized trial to fully evaluate and establish the early, mid- and long-term morbidity and mortality rates associated with both techniques.

O medo e o tédio no confinamento / Fear and boredom in confinement

Este artigo analisa como a realidade do confinamento devido à pandemia de COVID 19 veio, com o medo do contágio, a se justapor a um protesto insidioso contra a vida parecido com a depressão e cuja origem no sujeito é a impossibilidade de sair do círculo mágico, invisível e inabitável que o encerra e o afasta da vida que teria sonhado.(AU)

This article analyzes how the reality of confinement due to the pandemic of COVID 19 came, with the fear of contagion, to juxtapose itself with an insidious protest against life similar to that of depression and whose origin for the subject is the impossibility to leave the invisible and uninhabitable magic circle that encloses and distances him/her from the life he/she would have dreamed of.(AU)

O engajamento político dos “intelectuais” / The political engagement of “intellectuals”

Quando e como se ultrapassa o limite que vai transformar uma reflexão em atos irreparáveis? O pensamento que, para existir, só pode ser livre, deve ser por isso considerado responsável diante do que pode engendrar? É, então, uma abordagem psicanalítica, e também uma interrogação ética, sobre a passagem da construção das ideias à fábrica de ideologias o objeto desta apresentação(AU)

When and how are limits surpassed that change a simple reflection into irreparable acts? Could thought that, to exist necessarily has to be free, be responsible towards what it might result in? Thus, the object of this article is a psychoanalytical approach, and also an ethical interrogation, about the transition between the constructions of ideas to the fabrication of ideologies(AU)

A maternidade é uma forma de sublimação? / The maternity is a kind of sublimation?

O presente artigo parte de uma contraposição das definições do conceito de sublimação com as construções sobre a feminilidade, presentes na obra de Sigmund Freud. Busca situar o “enigma” freudiano da feminilidade em sua época, remetendo seus ensinamentos àquilo que se pode validar na atualidade. Para além de uma leitura canônica, a autora, especialista na conceituação sobre a sublimação, põe em questão algumas proposições facilmente tomadas por uma leitura superficial da obra, conduzindo o leitor a uma reflexão dialética e inovadora da relação entre esse conceito e a parentalidade, sobretudo no que concerne a sexualidade materna. Ampliando o escopo das saídas sublimatórias na mulher, discorda de um destino exclusivamente masculino no que concerne a sublimação, dado o complexo de masculinidade como única saída sublimatória para o homossexualismo recalcado na mulher. A autora leva, pois, em conta a economia pulsional e uma análise metapsicológica, não se restringindo apenas a uma crítica feminista da posição freudiana. Com essa exegese, formula, então, uma nova forma de conceber a relação entre feminilidade e sublimação que ilumina o entendimento teórico das funções da maternidade, situando a sublimação ao lado da ternura e do respeito à alteridade.(AU)

The present paper illustrates a confrontation between the definitions of sublimation, with some constructions about femininity presented by Sigmund Freud. It intends to situate the “enigma of femininity” in the Freudian’s epoch, in order to validate some parts of his knowledge in present time. Far beyond a traditional reading, the author - an expert in the concept of sublimation’s – puts in check some propositions easily taken for granted by a superficial reading of Freud’s texts. She drives the reader throw a dialectical and pioneering reflection within sublimation and parentality, in particular as concerning the maternal sexuality. Opening the spectrum of sublimatory issues for the woman, the author disagree that only a masculine destiny for sublimation would be possible, given the masculine complex as the only sublimatory issue for repressed homosexuality in the woman. The author takes into account the “economical” point of view and a metapsychological analysis, but she doesn’t remain fixed in critical feminist statement about Freud’s position. Through this exegesis, she formulates a new manner for understanding the relation among femininity and sublimation that enlightens the theoretical comprehension of the maternal function, putting sublimation besides tenderness and the respect to otherness.(AU)

Sublimação e prazer do pensamento / Sublimation and pleasure of thought / La sublimación y el placer del pensamiento

Na psicanálise, a noção de sublimação ocupa uma posição paradoxal: do ponto de vista meta-psicológico ela nunca foi totalmente definida por Freud, no entanto ela é indispensável ao edifício teórico tanto do ponto de vista individual como coletivo pois supostamente ela demonstra o investimento libidinal de metas e objetos que não são originários das pulsões. Seu lugar é tão importante quanto o do recalque dado que ela constitui tanto na idade adulta a saída positiva em oposição à neurose, como na infância a alternativa precoce e criativa. Muito discutida do tempo de Freud até hoje, essa noção não conheceu modificações profundas apesar das contribuições sucessivas que puseram em questão certos aspectos ou acrescentaram outros. Mais do que uma noção, é de um conceito organizador que se trata, do mesmo nível que o conceito de Pulsão, em torno do qual gravitam os questionamentos sobre os sentimentos de ternura e de amizade, os laços sociais, a atividade profissional, as realizações artísticas, literárias, científicas, esportivas etc., e o prazer que adultos e crianças sentem ao encarar os enigmas e tentar resolvê-los, o prazer do pensamento. A autora se esforçou para resumir neste texto suas contribuições para pensar essa noção.

The notion of sublimation in psychoanalysis occupies a paradoxical position: never having been completely defined by Freud from a metapsychological point of view, it is nonetheless indispensable to the theoretical premise, from an individual point of view as well as a collective one, as it supposedly explains the libidinal investment in goals and objectives which are not original to the drives. It holds the same importance as repression, because it constitutes either the positive outlet in adult life in opposition to neurosis, or the precocious and creative alternative in childhood. Much discussed from Freud's days to ours, the idea of sublimation has not undergone great modifications, in spite of successive contributions which dealt with certain aspects of it, and added others. More than a notion, it is of an organizational concept which is at the same level as the concept of drive, around which gravitate the ponderings about feelings of fondness and friendship, social ties, professional activity, as well as artistic, literary, scientific, and sports-related achievements, not to mention the pleasure felt by adults and children alike when they face conundrums and try to solve them, and also the pleasure of thought. The author strives to summarize the contributions proposed to brainstorm this notion.

La noción de sublimación en el psicoanálisis ocupa una posición paradójico: nunca totalmente definida por Freud del punto de vista meta-psicológico, y mientras tanto indispensable para el edificio teórico tanto desde el punto de vista individual como colectivo porque supuestamente da cuenta de la inversión libidinal y objetos que no son originarios de las pulsiones. Su lugar es tan importante como aquel del recalque pues ella constituye la salida positiva la edad adulta en oposición a la neurosis, siendo en la infancia la alternativa precoz y creativa. Muy discutida desde los tiempos de Freud hasta hoy, esta noción no ha tenido modificaciones profundas a pesar de las sucesivas contribuciones que cuestionaron ciertos aspectos y acrecentaron otros. Más que una noción, se trata de un concepto organizador, del mismo nivel que el concepto de Unidad, en torno al cual gravitan los cuestionamientos sobre los sentimientos de ternura y amistad, los lazos sociales, la actividad profesional, las realizaciones artísticas, literarias, científicas, deportivas, etc., y el placer que adultos y niños sienten al encarar los enigmas e intentar resolverlos, el placer del pensamiento. La autora se esfuerza para resumir las contribuciones que propone para pensar en esa noción.

Os ideais e a sublimação / The ideals and the sublimation / Les idéaux et la sublimation / Los ideales y lal sublimación

Pretende-se, nesse artigo, relacionar o trabalho da sublimação com a constituição dos ideais que caracterizam a economia narcísica do sujeito freudiano. Partindo da diferenciação, sublinhada por Freud, entre sublimação e idealização, demonstra-se de que modo o processo sublimatório se aproxima do trabalho de desidealização promovido pelo humor. Na sublimação, assim como no humor, assiste-se a uma ôereção do eu no euõ, ao mesmo tempo em que se elabora o luto pelos objetos idealizado da infância. O papel da pulsão de morte para a emergência de processos criativos é também analisado(AU)

The intention of this article is to relate the work of the sublimation with that of the constitution of the ideas that characterise the narcissistic economy of the Freudian subject. Based on the differentiation, highlighted by Freud, between sublimation and idealization, the article aims to demonstrate in what manner the sublimate process approaches the work of breaking down the defence mechanism through humour. In sublimation, as with humour, are we witnessing the erecting of I in the Self? While we elaborate the mourning for the idealized objects of childhood. The role of the death drive in the emergence of the creative process is also analysed(AU)

Le but de cet article est celui d'articuler le travail de sublimation avec la constitution des idéaux qui caractérisent l'économie narcissique du sujet freudien. En partant de la différenciation, soulignée para Freud, entre la sublimation et l'idéalisation, la manière par laquelle le procès sublimatoire s'approche du travail de desidéalisation promu par l'humour est démontrée. Dans la sublimation, ainsi que dans l'humour, on assiste à une érection du moi dans le moi, en même temps que s'élabore le deuil des objets idéalisés de l'enfance. Le rôle de la pulsion de mort dans le surgissement du procès créatif est aussi analysé(AU)

En este artículo, se pretende relacionar el trabajo de la sublimación con la constitución de los ideales que caracterizan la economía narcisista del sujeto freudiano. Partiendo de la diferenciación, anotada por Freud, entre sublimación e idealización, se demuestra de qué forma el proceso sublimatorio se aproxima del trabajo de desidealización promovido por el humor. En la sublimación, así como en el humor asistimos a ¿una erección del yo en el yo?, al mismo tiempo que elaboramos el luto por los objetos idealizado de la infancia. El papel de la pulsión de la muerte para la emergencia de procesos creativos también es analizado(AU)

Os ideais e a sublimação / The ideals and the sublimation / Les idéaux et la sublimation / Los ideales y lal sublimación

Pretende-se, nesse artigo, relacionar o trabalho da sublimação com a constituição dos ideais que caracterizam a economia narcísica do sujeito freudiano. Partindo da diferenciação, sublinhada por Freud, entre sublimação e idealização, demonstra-se de que modo o processo sublimatório se aproxima do trabalho de desidealização promovido pelo humor. Na sublimação, assim como no humor, assiste-se a uma ôereção do eu no euõ, ao mesmo tempo em que se elabora o luto pelos objetos idealizado da infância. O papel da pulsão de morte para a emergência de processos criativos é também analisado

The intention of this article is to relate the work of the sublimation with that of the constitution of the ideas that characterise the narcissistic economy of the Freudian subject. Based on the differentiation, highlighted by Freud, between sublimation and idealization, the article aims to demonstrate in what manner the sublimate process approaches the work of breaking down the defence mechanism through humour. In sublimation, as with humour, are we witnessing the erecting of I in the Self? While we elaborate the mourning for the idealized objects of childhood. The role of the death drive in the emergence of the creative process is also analysed

Le but de cet article est celui d'articuler le travail de sublimation avec la constitution des idéaux qui caractérisent l'économie narcissique du sujet freudien. En partant de la différenciation, soulignée para Freud, entre la sublimation et l'idéalisation, la manière par laquelle le procès sublimatoire s'approche du travail de desidéalisation promu par l'humour est démontrée. Dans la sublimation, ainsi que dans l'humour, on assiste à une érection du moi dans le moi, en même temps que s'élabore le deuil des objets idéalisés de l'enfance. Le rôle de la pulsion de mort dans le surgissement du procès créatif est aussi analysé

En este artículo, se pretende relacionar el trabajo de la sublimación con la constitución de los ideales que caracterizan la economía narcisista del sujeto freudiano. Partiendo de la diferenciación, anotada por Freud, entre sublimación e idealización, se demuestra de qué forma el proceso sublimatorio se aproxima del trabajo de desidealización promovido por el humor. En la sublimación, así como en el humor asistimos a ¿una erección del yo en el yo?, al mismo tiempo que elaboramos el luto por los objetos idealizado de la infancia. El papel de la pulsión de la muerte para la emergencia de procesos creativos también es analizado

O ressurgimento do mito mágico-sexual na inquietante estranheza / The resurgence of the magical-sexual myth in the disquieting strangeness

Este artigo tem por objetivo apontar a forma pela qual as crianças se deparam com a diferença sexual e os recursos aos quais recorrem para poderem lidar com tal enigma. O autor pretende demonstrar que a forma infantil de significar o enigma da sexualidade, ou o enigma da origem, diverge da lógica do adulto, marcada pela racionalidade e raciocínio objetivo. Nos relatos infantis, os mitos mostram ter uma função operacional que consiste na convivência de pensamentos opostos, que se excluiriam pela lógica ou/ou, mas que são experimentados numa adição que só enriquece e amplia esta questão. Assim, enquanto o sujeito do conhecimento busca a compreensão a partir da dedução e da síntese, a criança lida com a contradição de sentidos, entre o mágico e o racional, ampliando seus espaços e buscando uma resposta própria frente ao enigma da sexualidade. (AU)

This article strives to point out the way in which children deal with sexual difference and the resources they use in order to solve this enigma. The author intends to show that the infantile way of signifying the sexual enigma, or the origin enigma, diverges from the adult’s logic, which is marked by rationality and objective reasoning. In children’s accounts, the myths have an operational function that consists in joining opposite thoughts, which would exclude themselves by the logic of or/or, but that are experienced in an addition that enriches and amplifies this issue. Therefore, while the subject of knowledge searches for comprehension through deduction and synthesis, the child deals with the contradiction of meanings, between what is magical and what is rational, by amplifying its spaces and searching for its own answer to the enigma of sexuality. (AU)

O ressurgimento do mito mágico-sexual na inquietante estranheza / The resurgence of the magical-sexual myth in the disquieting strangeness

Este artigo tem por objetivo apontar a forma pela qual as crianças se deparam com a diferença sexual e os recursos aos quais recorrem para poderem lidar com tal enigma. O autor pretende demonstrar que a forma infantil de significar o enigma da sexualidade, ou o enigma da origem, diverge da lógica do adulto, marcada pela racionalidade e raciocínio objetivo. Nos relatos infantis, os mitos mostram ter uma função operacional que consiste na convivência de pensamentos opostos, que se excluiriam pela lógica ou/ou, mas que são experimentados numa adição que só enriquece e amplia esta questão. Assim, enquanto o sujeito do conhecimento busca a compreensão a partir da dedução e da síntese, a criança lida com a contradição de sentidos, entre o mágico e o racional, ampliando seus espaços e buscando uma resposta própria frente ao enigma da sexualidade.

This article strives to point out the way in which children deal with sexual difference and the resources they use in order to solve this enigma. The author intends to show that the infantile way of signifying the sexual enigma, or the origin enigma, diverges from the adult’s logic, which is marked by rationality and objective reasoning. In children’s accounts, the myths have an operational function that consists in joining opposite thoughts, which would exclude themselves by the logic of or/or, but that are experienced in an addition that enriches and amplifies this issue. Therefore, while the subject of knowledge searches for comprehension through deduction and synthesis, the child deals with the contradiction of meanings, between what is magical and what is rational, by amplifying its spaces and searching for its own answer to the enigma of sexuality.

A imagem do corpo adolescente em Botticelli / The body image in Botticeli's work

Baseado nas noções de “imagem do corpo” (P. Schilder) e de“pathosformel” (A. Warburg), este estudo se propõe a revisitar a obra pictóricade Botticelli do ponto de vista da adolescência percebida como ficçãoidealizada e que repousa em um sofrimento triplo: a busca inacessívelda pureza, a dimensão do excesso maníaco em relação ao tempo futuro e adesaparição nostálgica do tempo irremediavelmente perdido da infância.O método seguido é o das “interações da psicanálise”, isto é, não se aplicao método psicanalítico à decodificação da obra de arte, opta-se por relacionara escuta sensível da obra de arte com a clínica psicanalítica da adolescência.(AU)

Based on the notions of “body image” (P. Schilder) and“pathosformel” (A. Warburg) this study revisits Botticelli’s pictorial work fromthe point of view of adolescence, perceived as an idealized fiction that restsupon a triple suffering: an inaccessible search for purity, a maniacal excessregarding the future, and the nostalgic disappearance of infancy. We follow a“psychoanalytic interactions” method, that is, the traditional psychoanalyticmethod is not applied to a decoding of the work of art, but we choose to relatea sensitive listening to art with the psychoanalytic clinic of adolescence.(AU)

A imagem do corpo adolescente em Botticelli / The body image in Botticeli's work

Baseado nas noções de “imagem do corpo” (P. Schilder) e de“pathosformel” (A. Warburg), este estudo se propõe a revisitar a obra pictóricade Botticelli do ponto de vista da adolescência percebida como ficçãoidealizada e que repousa em um sofrimento triplo: a busca inacessívelda pureza, a dimensão do excesso maníaco em relação ao tempo futuro e adesaparição nostálgica do tempo irremediavelmente perdido da infância.O método seguido é o das “interações da psicanálise”, isto é, não se aplicao método psicanalítico à decodificação da obra de arte, opta-se por relacionara escuta sensível da obra de arte com a clínica psicanalítica da adolescência.

Based on the notions of “body image” (P. Schilder) and“pathosformel” (A. Warburg) this study revisits Botticelli’s pictorial work fromthe point of view of adolescence, perceived as an idealized fiction that restsupon a triple suffering: an inaccessible search for purity, a maniacal excessregarding the future, and the nostalgic disappearance of infancy. We follow a“psychoanalytic interactions” method, that is, the traditional psychoanalyticmethod is not applied to a decoding of the work of art, but we choose to relatea sensitive listening to art with the psychoanalytic clinic of adolescence.

Sobre a necessidade de crer / On the necessity to believe

Neste trabalho, espécie de introdução ao livro A necessidade de crer, publicado recentemente no Brasil pela editora Unimarco, a autora expõe os eixos principais de sua obra, mostrando a complexidade da crença na obra freudiana e no trabalho psicanalítico, assim como sua atualidade no mundo contemporâneo(AU)

Terrorismo, barbárie e desordem. Parte I / Terrorism and Barbarism. Part I

A partir de uma interrogação sobre as representações dos atos terroristas na imprensa e na televisão, examinam-se as noções de barbárie, de crueldade e de sadismo, tanto na esfera individual quanto coletiva, de um ponto de vista psicanalítico. As novas formas do conflito e da destrutividade que marcam quotidianamente a atualidade incitam a uma reflexão ampla sobre a natureza, as relações e até os paradoxos da oposição entre ordem e desordem. A ordem responde a uma necessidade de domínio sobre o mundo e constitui uma parte inerente da busca do sentido da vida. Entretanto, longe de se desenvolver numa harmonia, ela produz contestações, revoltas e necessita ser “mantida”, confundindo-se com uma violência “legítima”.(AU)