Supervisão no Núcleo de Estudos Psicanalíticos da Infância e Adolescência – NEPsI: ofício e transmissão da Psicanálise / Supervision at the Center for Psychoanalytic Studies of Childhood and Adolescence – NEPsI: the craft and transmission of Psychoanalysis

Este trabalho aborda o lugar da supervisão de atendimentos psicanalíticos de crianças e adolescentes na formação do analista, realizando uma articulação entre a constituição do analista e a constituição do sujeito. Também apresenta questões sobre a especificidade da supervisão de atendimentos psicanalíticos com crianças e adolescentes e seus efeitos no analista em formação, que está encontrando o seu estilo. Para essa reflexão, fazemos uma costura com a vivência como supervisora da clínica do Núcleo de Estudos Psicanalíticos da Infância e Adolescência (NEPsI), que pertence a Clínica Social do Círculo Brasileiro de Psicanálise – seção Rio de Janeiro (CBP-RJ)(AU)

This work addresses the place of supervision of psychoanalytic care for children and adolescents in the training of the analyst, creating a link between the constitution of the analyst and the constitution of the subject. It also presents questions about the specificity of supervising psychoanalytic care with children and adolescents and its effects on the analyst in training, who is finding his style. For this reflection, we draw on my experience as supervisor of the clinic at the Center for Psychoanalytic Studies of Childhood and Adolescence - NEPsI, which belongs to the Social Clinic of the Brazilian Psychoanalysis Circle - Rio de Janeiro - Section CBP-RJ(AU)

Análise de crianças em tempos de pandemia: ecos no analista / Analysis of children in times of pandemic: echoes in the analyst Analysis of children in times of pandemic: echoes in the analyst

O trabalho propõe pensar o lugar do analista na clínica on-line com crianças durante a pandemia da covid-19. Como o analista, nessa clínica, lida com suas vivências tão arcaicas, infantis, ou seja, os ecos no analista da clínica psicanalítica com crianças em tempos de pandemia. Para contribuir com a reflexão, são apresentados fragmentos clínicos articulados com contribuições de Dolto, Gutfreind, Lacan e Quinet(AU)

The work proposes to think about the analyst's place in the online clinic with children during the covid-19 Pandemic. How the analyst, in this clinic, deals with his experiences so archaic, childish, that is, the echoes in the analyst of the psychoanalytic clinic with children in times of pandemic. To contribute to the reflection, clinical fragments articulated with contributions from Dolto, Gutfreind, Lacan and Quinet will be presented(AU)

Clínica psicanalítica on-line: articulações com a ficção / On-line psychoanalytic clinic: articulations with fiction

A história contada no seriado O gambito da rainha, imersa no desamparo, no luto e na dor psíquica é o tema deste texto que aponta para algumas reflexões baseadas na literatura psicanalítica de Freud, Green, Ogden, Bowlby, Klein e Winnicott. O trabalho se propõe a abordar questões sobre morte, adoção, narcisismo e superação das dificuldades vivenciadas pela protagonista do seriado para uma reflexão e associação com os momentos da realidade atual, vivenciados pela condição humana, especialmente nestes tempos de pandemia(AU)

The story told in the TV series "The Queen's Gambit", immersed in helplessness, mourning and psychic pain is the theme of this text, which points to some reflections based on the psychoanalytic literature of Freud, Green, Ogden, Bowlby, Klein and Winnicott. The work proposes to address issues about death, adoption, narcissism and overcoming difficulties experienced by the protagonist of the TV series, to reflect on and associate them with moments of current reality, experienced by the human condition, especially in these pandemic times(AU)

Reflexões sobre o bebê em tempos de pandemia: contribuições de Ester Bick e Emmi Pikler / Reflections on the baby in times of pandemic: contributions by Ester Bick and Emmi Pikler

Buscando pensar a constituição psíquica do bebê em tempos de pandemia, este artigo propõe o diálogo interdisciplinar entre psicanálise e psicomotricidade, usando como fio condutor as contribuições do método de observação psicanalítica da relação mãe-bebê (OPRMB), da psicanalista Esther Bick, e da abordagem proposta pela pediatra Emmi Pikler nos cuidados aos bebês em situação de acolhimento institucional(AU)

Seeking to think about the baby’s psychic constitution in times of pandemic, this article proposes an interdisciplinary dialogue between psychoanalysis and psychomotricity, using, as guiding lines, the contributions of the Psychoanalytical Observation of the Mother-infant Relationship, method by psychoanalyst Esther Bick, and the approach proposed by pediatrician Emmi Pikler in the care of infants in institutional care(AU)

Use of second generation supraglottic airway device for endovascular treatment of unruptured intracranial aneurysms: a retrospective cohort.

BACKGROUND: We aimed to assess the feasibility of using supraglottic devices as an alternative to orotracheal intubation for airway management during anesthesia for endovascular treatment of unruptured intracranial aneurisms in our department over a nine-year period. METHODS: Retrospective single center analysis of cases (2010-2018). Primary outcomes: airway management (supraglottic device repositioning, need for switch to orotracheal intubation, airway complications). SECONDARY OUTCOMES: aneurysm complexity, history of subarachnoid hemorrhage, hemodynamic monitoring, and perioperative complications. RESULTS: We included 187 patients in two groups: supraglottic device 130 (69.5%) and orotracheal intubation 57 (30.5%). No adverse incidents were recorded in 97% of the cases. Three supraglottic device patients required supraglottic device repositioning and 1 supraglottic device patient required orotracheal intubation due to inadequate ventilation. Three orotracheal intubation patients had a bronchospasm or laryngospasm during awakening. Forty-five patients (24.1%) had complex aneurysms or a history of subarachnoid hemorrhage. Thirty-three of them (73.3%) required orotracheal intubation compared to 24 of the 142 (16.9%) with non-complex aneurysms. Two patients in each group died during early postoperative recovery. Two in each group also had intraoperative bleeding. A post-hoc analysis showed that orotracheal intubation was used in 55 patients (44%) in 2010 through 2014 and 2 (3.2%) in 2015 through 2018, parallel to a trend toward less invasive blood pressure monitoring from the earlier to the later period from 34 (27.2%) cases to 5 (8.2%). CONCLUSION: Supraglottic device, like other less invasiveness protocols, can be considered a feasible alternative airway management approach in selected patients proposed for endovascular treatment of unruptured intracranial aneurisms.

Os efeitos da pandemia na instituição e na clínica psicanalítica: trabalhando on-line / Pandemic effects on the institution and the psychoanalytic clinic - working on-line

Este trabalho apresenta uma reflexão sobre os efeitos da pandemia na clínica e na instituição psicanalítica, bem como a vivência do analista durante o trabalho on-line. Para sustentar as reflexões ora apresentadas, recorro a textos de Freud (1914-1920), destacando: Considerações contemporâneas sobre a guerra e a morte (1915); Introdução à psicanálise das neuroses de guerra (1919); Além do princípio de prazer (1920). A partir dos textos investigados, foi possível, de forma inicial, estabelecer as seguintes articulações: neuroses de guerra (neuroses traumáticas) e as neuroses como efeito da pandemia; a morte em tempos de Freud e em tempos de pandemia, bem como a vivência de Freud durante a I Guerra Mundial, a gripe espanhola e a vivência do analista durante a pandemia(AU)

This writing in the form of conversation is the narrative of a journey of reflections and psychoanalytic actions during the period in our history marked by the Covid-19 crisis, in the year 2020. The author, inspired by the paths of the Grande Sertão, book written by Guimarães Rosa, punctuates their crossing, highlighting fragments of aspects that have been configured, on the one hand, as coping reinsurers and, on the other, promoting openness to a new psychoanalytic clinic outlined in the online molds(AU)

As diversidades da clínica psicanalítica / The diversities of the psychoanalytic clinic

Este trabalho pretende refletir sobre o lugar do analista diante das diversidades da clínica psicanalítica. Como os analistas lidam com a diversidade? Como os analistas lidam com as diversidades dos analisandos? Essas questões serão sustentadas teoricamente em Freud e Lacan. A autora traz uma contribuição, em processo de construção, a partir da sua prática clínica e acadêmica, que denomina, nesse momento, de “código de barra do sujeito(AU)

This paper aims to reflect on the analyst's place in the face of the diversity of psychoanalytic clinic. How do analysts deal with diversity? How do analysts deal with the analysands' diversity? Issues that will be theoretically supported in Freud and Lacan. The author brings a contribution, in the process of being built based on her clinical and academic practice, which she calls, at this moment, the subject's barcode(AU)

Procalcitonin is a predictor for high-grade vesicoureteral reflux in children: meta-analysis of individual patient data.

OBJECTIVE: To assess the predictive value of procalcitonin, a serum inflammatory marker, in the identification of children with first urinary tract infection (UTI) who might have high-grade (≥3) vesicoureteral reflux (VUR). STUDY DESIGN: We conducted a meta-analysis of individual data, including all series of children aged 1 month to 4 years with a first UTI, a procalcitonin (PCT) level measurement, cystograms, and an early dimercaptosuccinic acid scan. RESULTS: Of the 152 relevant identified articles, 12 studies representing 526 patients (10% with VUR ≥3) were included. PCT level was associated with VUR ≥3 as a continuous (P = .001), and as a binary variable, with a 0.5 ng/mL preferred threshold (adjusted OR, 2.5; 95% CI, 1.1 to 5.4). The sensitivity of PCT ≥0.5 ng/mL was 83% (95% CI, 71 to 91) with 43% specificity rate (95% CI, 38 to 47). In the subgroup of children with a positive results on dimercaptosuccinic acid scan, PCT ≥0.5 ng/mL was also associated with high-grade VUR (adjusted OR, 4.8; 95% CI, 1.3 to 17.6). CONCLUSIONS: We confirmed that PCT is a sensitive and validated predictor strongly associated with VUR ≥3, regardless of the presence of early renal parenchymal involvement in children with a first UTI.

A escuta psicanalítica de uma criança autista / Psychoanalytic listening to autistic child

Este artigo apresenta o caso de uma criança autista que possibilitou à autora investigar sobre a importância do desejo do analista na clínica psicanalítica com autistas. A utilização da linguagemsonoro-musicalcomorecursopodeserfavorávelparapossibilitarocomparecimento do sujeito. É necessário que o analista aposte que o autista, mesmo não estando no discurso, está no campo da linguagem e seus atos podem assumir um estatuto equivalente à fala.(AU)

This paper presents the case of an autistic child that has given the author occasion of investigation of the importance of analyst’s desire at psychoanalytical clinic. The use of musical sounds as a resource may be useful for making the subject appear. The analyst must bet that the autistic child, even being out of the discourse, is into the field of language and that his/her actions may assume an statute similar to speech.(AU)

Reflexões sobre a contribuição da psicanálise no entendimento do autismo infantil

A autora relata a evolução histórica do conceito de angústia para a Psiquiatria e para a Psicanálise, observando os pontos de aproximação e de distanciamento entre os referenciais teóricos e a apresentação clínica dos casos na atualidade