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Background: Overweight and obesity are global health issues, impacting a significant portion of young adults. Obesity is a complex condition influenced by genetics and environmental factors, leading to increased susceptibility to cardiovascular diseases (CVDs), hypertension, dyslipidemia, and insulin resistance. Irisin, a protein derived from the cleavage of fibronectin type III domain-containing protein 5, may have relationship with these cardiometabolic diseases. Objective: This systematic review aims to examine the relationship between serum irisin levels and obesity, particularly in individuals predisposed to cardiovascular risk factors. Methods: A thorough literature search was conducted in multiple databases, including "Science Direct," "Scopus," "PubMed," and "Lilacs," from July 2020. Inclusion criteria encompassed subjects with metabolic disorders (with or without obesity, BMI ≥30 kg/m2), clinical trials, and observational studies published between 2010 and June 2020. Exclusion criteria were animal studies, meta-analyses, systematic reviews, studies evaluating only healthy subjects, and those investigating disorders beyond cardiometabolic diseases. Results: Out of 151 identified articles, 30 met the inclusion criteria. These studies, published between 2013 and 2020, assessed adults (≥21 years) and included 26 observational studies and 4 clinical trials (n = 7585 subjects). All studies examined irisin's role in obesity and CVDs, often including associated diseases such as type 2 diabetes and hypertension. Despite varying sample sizes, the samples within the articles were homogeneous. Observational studies exhibited a low risk of bias in at least 60% of the evaluated domains. Clinical trials demonstrated a low risk of bias in at least 50% of the domains. Limitations. Although the systematic review provides valuable insights, it is limited by the available literature and the varying methodologies used across studies. Conclusion: The review suggests that irisin plays a significant role as both a preventive measure and a biomarker for comorbidities linked to obesity and cardiometabolic disorders. Future research should focus on standardized irisin measurement methods and diverse populations to further elucidate its mechanisms of action.
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BACKGROUND: Point of care ultrasound (PoCUS) is a useful tool for the early diagnosis of thrombosis related to the central venous catheter for dialysis (TR-CVCd). However, the application of PoCUS is still not common as a bedside imaging examination and TR-CVCd remains often underdiagnosed in the routine practice. The aim of this study was to investigate if a compression technique for the diagnosis of TR-CVCd blindly performed by PoCUS experts and medical students is accurate when compared to a Doppler study. METHODS: Two medical students without prior knowledge in PoCUS received a short theoretical-practical training to evaluate TR-CVCd of the internal jugular vein by means of the ultrasound compression technique. After the training phase, patients with central venous catheter for dialysis (CVCd) were evaluated by the students in a private hemodialysis clinic. The results were compared to those obtained on the same population by doctors with solid experience in PoCUS, using both the compression technique and the color Doppler. RESULTS: Eighty-one patients were eligible for the study and the prevalence of TR-CVCd diagnosed by Doppler was 28.4%. The compression technique performed by the students and by experts presented, respectively, a sensitivity of 59.2% (CI 51.6-66.8) vs 100% and a specificity of 89.6% (CI 84.9-94.3) vs 94.8% (CI 91.4-98.2). CONCLUSION: The compression technique in the hands of PoCUS experts demonstrated high accuracy in the diagnosis of TR-CVCd and should represent a standard in the routine examination of dialytic patients. The training of PoCUS inexperienced students for the diagnosis of TR-CVCd is feasible but did not lead to a sufficient level of sensitivity.
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Objective: To assess the influence of vitamin D on body weight loss in women who had previously undergone Roux-en-Y gastric bypass (RYGB). Methodology: This is an analytical, longitudinal and retrospective study comprising 40 women of reproductive age who had previously undergone RYGB. To investigate the influence of the serum concentrations of vitamin D on body weight reduction, the variables were analyzed in the pre-operative period (T0), in the first (T1) and in the second postoperative year (T2) and were stratified according to the BMI measured in T1 and T2. In addition, in the pre-operative period, participants were subdivided into groups based on adequacy (G1), deficiency (G2) and insufficiency (G3), according to their serum concentrations of vitamin D. Results: Although weight loss occurred in a substantial way in T1, it continued to decrease in T2 (p = 0.017). The women who reached normal weight within two years of surgery showed the lowest vitamin D concentrations preoperatively when compared to those who were overweight (p = 0.011). Women with preoperative vitamin D deficiency showed increased concentrations in the assessed times (p < 0.001), while the opposite (p = 0.001) occurred in women with adequacy. Conclusion: The study showed that inadequacy of vitamin D does not interfere with weight loss in the two-year-follow-up after RYGB and highlights that vitamin D can present a differentiated response postoperatively, to the detriment of the pre-operative period.
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PURPOSE: The purpose of this study is to evaluate the relationship between body composition, basal metabolic rate (BMR), and serum concentrations of leptin with long-term weight regain after Roux-en-Y gastric bypass (RYGB) and compare it with obesity before surgery. MATERIALS AND METHODS: Prospective longitudinal analytical study. Three groups were formed: individuals 60 months post RYGB, with weight regain (G1) and without it (G2), and individuals with obesity who had not undergone bariatric surgery (G3). Body fat (BF), body fat mass (BFM), visceral fat (VF), fat-free mass (FFM), skeletal muscle mass (SMM), and BMR were assessed by octapolar and multi-frequency electrical bioimpedance. Fasting serum concentrations of leptin were measured. RESULTS: Seventy-two individuals were included, 24 in each group. Higher means of BF, BFM, VF, and leptin levels were observed in G1, when compared to G2 (BF: 47.5 ± 5.6 vs. 32.0 ± 8.0, p < 0.05; FBM: 47.8 ± 11.6 vs. 23.9 ± 7.0, p < 0.05; VF: 156.8 ± 30.2 vs. 96.1 ± 23.8, p < 0.05; leptin: 45,251.2 pg/mL ± 20,071.8 vs. 11,525.7 pg/mL ± 9177.5, p < 0.000). G1 and G2 did not differ in FFM, SMM, and BMR. G1 and G3 were similar according to BF, FFM, BMR, and leptin levels. Body composition, but not leptin, was correlated with %weight regain in G1 (FBM: r = 0.666, p < 0.000; BF: r = 0.428, p = 0.037; VF: r = 0.544, p = 0.006). CONCLUSION: Long-term weight regain after RYGB is similar to pre-surgical obesity in body composition, BMR, and leptin concentrations, indicating relapse of metabolic and hormonal impairments associated with excessive body fat.
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Derivação Gástrica , Obesidade Mórbida , Metabolismo Basal , Composição Corporal/fisiologia , Humanos , Leptina , Obesidade/metabolismo , Obesidade/cirurgia , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Aumento de Peso/fisiologiaRESUMO
OBJECTIVE: To compare the nutritional status of vitamin D, calcium, and serum concentrations of parathyroid hormone (PTH) between women undergoing Roux-en-Y gastric bypass (RYGB) who became pregnant and women who did not become pregnant during the same postoperative period, as well as the impact of these changes on maternal and child health. METHODS: This is a longitudinal and retrospective study of women who previously underwent RYGB, paired by age and preoperative body mass index (BMI), divided into two groups: group 1 (G1), comprising 79 women who did not become pregnant, and group 2 (G2), comprising 40 pregnant women assessed in the overall trimesters. Both groups were analyzed before surgery (T0) and in the same interval after surgery: less than or equal to 1 year (T1) or greater than 1 year (T2), with a 2-year period at the most. Serum concentrations of vitamin D, calcium, parathyroid hormone (PTH), and gestational and neonatal complications were investigated. Statistical analysis was performed by the Statistical Package for the Social Sciences 21.0 (p < 0.05). RESULTS: Despite the additional nutritional demands at pregnancy, women evaluated after 1 year of RYGB had the highest demands of vitamin D when compared with pregnant women in the second trimester(p = 0.04). Women who became pregnant within 1 year of bariatric surgery were more likely to develop a urinary tract infection which, in turn, was associated with vitamin D inadequacy (p = 0.02).In the same period, the concentrations of calcium in the second and third trimesters showed a strong correlation with the number of pregnancies (R = 0.8, p = 0.008, R = 0.8, p = 0.003) and deliveries (R = 0.7, p = 0.013, R = 0.8, p = 0.006) and its nutritional status in the first trimester also showed a strong correlation with the occurrence of small newborns for gestational age/large for gestational age (SGA/LGA) (R = 0.8, p = 0.007). CONCLUSION: Since the highest vitamin D depletions occurred in G1 when compared with G2, the study suggests that a period of time for supplementation and its adjustments in post-bariatric pregnancy may be beneficial. It also encourages further investigation on the number of pregnancies/deliveries during prenatal care, due to vitamin D influence on the nutritional status of calcium, and it points out that changes in concentrations of this vitamin in pregnant women may lead to SGA/LGA newborns' births.
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Derivação Gástrica , Obesidade Mórbida , Complicações na Gravidez , Criança , Feminino , Humanos , Recém-Nascido , Obesidade Mórbida/cirurgia , Hormônio Paratireóideo , Gravidez , Gestantes , Estudos Retrospectivos , Vitamina DRESUMO
OBJECTIVE: To assess the influence of pre-pregnancy body mass index (BMI), total gestational weight gain (TGWG), and pre-pregnancy surgical success on the nutritional status of vitamin D, calcium, and parathyroid hormone (PTH) in the trimesters of pregnancy of women who previously underwent Roux-en-Y gastric bypass (RYGB). METHODOLOGY: This is an analytical, longitudinal, and retrospective study comprising 42 pregnant women who previously underwent RYGB. Concentrations of vitamin D3, calcium, and PTH were assessed in all trimesters. Anthropometric variables necessary for calculating TGWG, surgical success, and BMI were collected preoperatively and over the trimesters of pregnancy. RESULTS: A total of 97.1% had vitamin D3 inadequacy at some point in pregnancy. Pre-pregnancy BMI, even when classified as overweight, may have exacerbated the serum concentrations of this vitamin in the third trimester (p = 0.011), and it was significantly lower in women with normal weight and/or obesity (p = 0.039). It was evidenced that both pre-pregnancy BMI and TGWG above the recommended optimal weight can be associated with calcium homeostasis, especially early in pregnancy. It was also shown that surgical success in the pre-pregnancy period may have influenced the serum concentrations of vitamin D in the second trimester of pregnancy (p = 0.013). CONCLUSION: This study draws attention to the importance of monitoring the nutritional status of vitamin D3 and calcium in the prenatal period due to its relationship with pre-pregnancy BMI, TGWG, and surgical success.
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Cálcio/sangue , Obesidade Mórbida/cirurgia , Hormônio Paratireóideo/sangue , Complicações na Gravidez , Vitamina D/sangue , Feminino , Derivação Gástrica , Humanos , Estado Nutricional/fisiologia , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologiaRESUMO
OBJECTIVE: The objectives of this study are to compare the nutritional status of vitamin A in women who previously underwent Roux-en-Y gastric bypass (RYGB) who became pregnant or did not, in the same period after surgery, and to assess its effects on mother and child health. METHODOLOGY: A retrospective longitudinal study conducted with women who previously underwent RYGB, paired by age and BMI measured before surgery, divided into group 1 (G1) comprising 77 women who did not become pregnant and group 2 (G2) with 39 women in their third gestational trimester. Both groups were assessed before surgery (T0) and in the same interval after surgery: less than or equal to 1 year (T1) or over 1 year (T2), during a maximum of 2 years. Serum concentrations of retinol and ß-carotene, night blindness (NB), and gestational and neonatal complications were investigated [urinary tract infection, iron deficiency anemia, hypertensive syndrome of pregnancy, dumping syndrome, birth weight, gestational age at birth (GAB), and correlation between weight and GAB]. Data were analyzed by the Statistical Package for Social Sciences 21.0 (p < 0.05). RESULTS: RYGB reduced the serum levels of retinol and ß-carotene, especially before the first postsurgical year. When associated with pregnancy, inadequacy rate was 55% higher in T1 and T2. Comparing G1 to G2, we noted that pregnancy in women undergoing RYGB can contribute to increased inadequacy of retinol and ß-carotene, reaching a higher percentage of women with NB after 1 postsurgical year. High prevalence of pregnancy/neonatal complications was found in T1 and T2. NB was correlated with inadequacy of ß-carotene. CONCLUSION: Pregnancy after RYGB aggravates vitamin A deficiency, increases the percentage of NB cases, and can contribute to pregnancy and neonatal complications even in 1 postsurgical year.
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Derivação Gástrica/efeitos adversos , Obesidade Mórbida/cirurgia , Deficiência de Vitamina A/etiologia , Deficiência de Vitamina A/patologia , Vitamina A/sangue , Adulto , Peso ao Nascer , Criança , Progressão da Doença , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Relações Mãe-Filho , Mães , Estado Nutricional , Obesidade Mórbida/sangue , Obesidade Mórbida/complicações , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etiologia , Complicações na Gravidez/cirurgia , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos , Deficiência de Vitamina A/sangue , Adulto Jovem , beta Caroteno/sangueRESUMO
The aim of this study was to compare the nutritional status of vitamin A per trimester of pregnancy, as well as to assess its influence on pre-pregnancy BMI, total gestational weight gain (TGWG) and presence of anemia in women who had previously undergone Roux-en-Y gastric bypass (RYGB). An analytical, longitudinal and retrospective study comprising 30 pregnant women who had previously undergone RYGB was undertaken. In all trimesters of pregnancy, the serum concentrations of retinol, ß-carotene, stages of vitamin A deficiency (VAD), night blindness (NB), anemia and anthropometric variables were assessed. VAD in pregnancy affected 90% of women, 86.7% developed NB and 82.8% had mild VAD. TGWG above/below the recommended range was related to the low serum concentrations of ß-carotene (p = 0.045) in the second trimester and women with TGWG above the recommended range showed 100% of inadequacy of this nutrient in the third trimester. Among the pregnant women with anemia, 90.9% had VAD and 86.4% had NB. This study highlights the importance of monitoring the nutritional status of vitamin A in prenatal care, due to its relationship with TGWG and the high percentage of VAD and NB found since the beginning of pregnancy. It also reaffirms the use of the cut-off <1.05 µmol/L for determining VAD.
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Anemia , Derivação Gástrica/efeitos adversos , Estado Nutricional , Complicações na Gravidez/sangue , Deficiência de Vitamina A , Vitamina A/sangue , Adulto , Antropometria , Feminino , Humanos , Cegueira Noturna , Obesidade Mórbida/cirurgia , Gravidez , Trimestres da Gravidez , Adulto JovemRESUMO
PURPOSE: The objective of this study was to evaluate vitamin D nutritional status and its relation with ionic calcium, parathyroid hormone (PTH), maternal anthropometry and perinatal outcomes in pregnant women who previously underwent Roux-en-Y gastric bypass (RYGB) surgery. METHODS: In a clinic specialized in obesity control located in the city of Rio de Janeiro (Brazil), the following information were collected for adult women who underwent RYGB before pregnancy: serum concentrations of vitamin D [25(OH)D], calcium and PTH per gestational trimester and data on maternal anthropometry, gestational intercurrences and perinatal outcomes. RESULTS: The present study included 46 post-RYGB pregnant women. The prevalence of pregnant women with deficiency (≤20 ng/mL) or insufficiency (≥21 and 29 ng/mL) of vitamin D was above 70% in all trimesters. The prevalence of calcium deficiency was 15.2% in the first and in the second trimesters and 20% in the third trimester, while the prevalence of excess PTH was 19.6, 30.4 and 32.6% in the first, the second and the third trimesters, respectively. In the second and the third trimesters, a significant difference was observed between concentrations of 25(OH)D, and a negative correlation was observed between concentrations of calcium and PTH. Association of 25(OH)D with urinary tract infection (UTI) was found, but there was no association with calcium, PTH, maternal anthropometry, type of delivery and weight and gestational age at birth CONCLUSIONS: The post-RYGB pregnant women showed an elevated serum inadequacy (deficiency or insufficiency) of 25(OH)D during pregnancy. Maternal vitamin D status showed no association with maternal variables, except UTI, and the neonatal variables analyzed.
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Cálcio/metabolismo , Derivação Gástrica/métodos , Obesidade/cirurgia , Hormônio Paratireóideo/sangue , Vitamina D/metabolismo , Adulto , Brasil , Cálcio/sangue , Feminino , Derivação Gástrica/efeitos adversos , Humanos , Estado Nutricional , Obesidade/complicações , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Trimestres da Gravidez , Prevalência , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/metabolismo , Redução de Peso , Adulto JovemRESUMO
PURPOSE: To evaluate vitamin A concentration in mature breast milk of nursing mothers aiming to meet the daily needs and the formation of liver reserve in pre-term (PT) and term infants (T) in comparison with the recommended intake for this nutrient in this group. METHODS: We analyzed the retinol concentration in the milk of 120 nursing mothers (40 of PT infants and 80 of T infants) by collecting 10 mL of mature breast milk, held by a hand spray of one of the breasts 2 h after the last feeding in the morning. The cutoff points adopted for identification of vitamin A deficiency (VAD) and the liver reserve were <1.05 and >2.3 µmol/L, respectively. RESULTS: The concentrations of retinol in the human milk of T infants were superior to concentrations in the milk of PT infants (1.87 + 0.81 > 1.38 + 0.67 µmol/L, p < 0.0001). They were higher in T compared to PT (352.64 + 152.72 > 217.65 + 105.65 µg, p < 0.0001), but both were below the recommendation. VAD was 20.0 % (T) and 27.5 % (PT). Only 40.0 % (T) and 22.5 % (PT) of the mothers had retinol concentrations in milk above 2.3 mmol/L. CONCLUSION: The milk of the nursing mothers studied did not have enough retinol to meet the daily needs and to form liver reserve in both groups, especially in PT newborns. This finding reinforces the idea that supplementation with massive doses of vitamin A in the immediate postpartum period can be used as a protective device of the infant against VAD.
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Aleitamento Materno , Leite Humano/química , Deficiência de Vitamina A/epidemiologia , Vitamina A/análise , Adulto , Suplementos Nutricionais , Feminino , Humanos , Lactente , Recém-Nascido , Fígado/química , Masculino , Mães , Período Pós-Parto , Recomendações Nutricionais , Nascimento a Termo , Adulto JovemRESUMO
Estudos demonstraram efeito positivo principalmente no ganho ponderalem pacientes com esclerose lateral amiotrófica (ELA), suplementadoscom aminoácidos de cadeia ramificada (AACR). Achados recentes têm mostrado que o consumo excessivo e crônico de AACR pode contribuir para a progressão da doença, provavelmente devido a estes serem precursores do glutamato. O objetivo deste estudo foi avaliar a evidência acerca da utilização dos AACR por pacientes com ELA, a fim de elucidar questões pertinentes a sua ingestão. Foi feita busca em base de dados de artigos científicos relacionados ao consumo de AACR na ELA, no período de 1988 a 2013. Foram encontrados seis artigos relacionados ao consumo de AACR por pacientes com ELA. Desses, um referiu melhora da força, enquanto os outros relataram ganho ponderal ou não mostraram resultados significativosem relação aos desfechos. Além disso, foi possível observar uma estreita relação entre o consumo excessivo e crônico dos AACR com o agravamento da doença. À luz dos conhecimentos ora disponíveis, a suplementação com AACR não é recomendada devido aos possíveis efeitos nocivos. O consumo adequado de alimentos proteicos, fontes desses aminoácidos, deve ser utilizado pelos pacientes, respeitando as recomendações estabelecidas. No entanto, estudos adicionais devem ser desenvolvidos em virtude do escasso número de publicações disponíveis.
Studies have shown positive effect mainly in weight gain inpatients with amyotrophic lateral sclerosis (ALS) supplemented with branched chain amino acids (BCAA). However, recent studies have shown that excessive and chronic intake has contributed to the worsening of the disease progression, probably because the amino acids are glutamate precursors. The objective of this study was to assess the evidence about the use of BCAA by patients with ALS, with the aim to clarify pertinent issues for its intake. A search was conducted in data bases for scientific papers related to the intake of BCAA in ALS, between 1988 and 2013. For these review six articles related to the use of BCAA in ALS were found. Of these, one described strength improvement, while the remaining reported weight gain or no significant effects in relation to the outcome. Additionally, it waspossible to observe a close relationship between the excessive and chronic BCAA intake with the worsening of the disease. Considering the presente day available knowledge BCAA supplementation should not be indicated due to the possible harmful effect. The intake of appropriated protein foods should be consumed by these patients, respecting the suggested recommendation. However, more studies are necessary due to the scarce papers in this area.
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Humanos , Doenças Neurodegenerativas/tratamento farmacológico , Aminoácidos de Cadeia Ramificada/administração & dosagem , Aminoácidos de Cadeia Ramificada/efeitos adversos , Aminoácidos de Cadeia Ramificada/uso terapêutico , Esclerose Lateral Amiotrófica/tratamento farmacológico , Literatura de Revisão como Assunto , Resultado do Tratamento , Ácido Glutâmico/toxicidade , NeurotoxinasRESUMO
OBJECTIVE: to evaluate retinol and ß-carotene serum levels and their relationship with risk factors for cardiovascular disease in individuals with morbid obesity, resident in Rio de Janeiro. METHODOLOGY: blood serum concentrations of retinol and ß-carotene of 189 morbidly obese individuals were assessed. The metabolic syndrome was identified according to the criteria of the National Cholesterol Education Program (NCEP) and World Health Organization (WHO). Lipid profile, insulin resistance, basal insulin, glycemia, blood pressure, and anthropometry and their correlation with retinol and ß-carotene serum levels were evaluated. RESULTS: metabolic syndrome diagnosis was observed in 49.0% of the sample. Within this percentage the levels of ß-carotene were significantly lower when body mass index increased. Serum retinol didn't show this behavior. Serum retinol inadequacy in patients with metabolic syndrome (61.3%), according to WHO criterion, was higher (15.8%) than when the whole sample was considered (12.7%). When metabolic syndrome was diagnosed by NCEP criterion, ß-carotene inadequacy was higher (42.8%) when compared to the total sample (37.5%). There was a significant difference between average ß-carotene values of patients with and without metabolic syndrome (p=0.048) according to the classification of the NCEP. Lower values were found in patients with metabolic syndrome. CONCLUSION: considering the vitamin A contribution in antioxidant protection, especially when risk factors for cardiovascular disease are present, it is suggested that great attention be given to morbidly obese. This could aid in prevention and treatment of cardiovascular disease, which affects a significant part of the population.
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Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/epidemiologia , Obesidade Mórbida/sangue , Vitamina A/sangue , beta Caroteno/sangue , Adulto , Idoso , Envelhecimento , Índice de Massa Corporal , Brasil/epidemiologia , LDL-Colesterol/sangue , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Obesidade Mórbida/fisiopatologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Saúde da População Urbana , Deficiência de Vitamina A/epidemiologia , Adulto Jovem , beta Caroteno/deficiênciaRESUMO
Trata-se, neste texto, de articular, na neurose, os conceitos de desejo do psicanalista, o lugar da causa e a ética da psicanálise. Trata-se, também, de pensar a possibilidade de um tratamento da psicose pelo discurso do analista(AU)
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A infecção pelo HTLV-I (human T-cell lymphotropic virus-I) tem sido associada ao desenvolvimento de síndromes clínicas como o linfoma/leucemia de células T do adulto e a paraparesia espástica tropical/mielopatia crônica progressiva. Felizmente, apenas a minoria dos pacientes infectados por este vírus desenvolve tais complicações e, mesmo assim, após um longo período de latência. Outras manifestações clínicas vinculadas a este vírus, tais como artrite, uveíte e síndrome de Sjõgren têm sido recentemente descritas. O estudo das patologias ligadas à infecção pelo HTLV-I torna-se bastante relevante devido à alta prevalência desse vírus em nosso meio, particularmente no Nordeste do Brasil. Esta revisão busca abordar os aspectos reumatológicos da infecção pelo HTLV-I, a prevalência dessas manifestações, os possíveis mecanismos patogênicos e os tratamentos propostos para estas complicações.
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Humanos , Infecções por HTLV-I , Leucemia de Células T , Linfoma , Doenças Reumáticas , Síndrome de SjogrenRESUMO
A autora busca justificar a presença do psicanalista no hospital. Trata sobre a possibilidade de interlocução entre Medicina e Psicanálise utilizando os conceitos de angústia e urgência(AU)
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A autora articula, sob uma perspectiva da clínica, a questão da angústia e do desejo(AU)
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As autoras formulam um trilhamento sobre a questão da angústia, a partir da ocorrência, atualmente tão frequente, na clínica psicanalítica, da chamada Síndrome do Pânico(AU)
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As autoras traçam um panorama histórico da histeria desde a sua origem até a sua captura no campo psíquico. Consideram a necessária sensibilidade da Psicanálise aos giros do contemporâneo no que concerne aos modos de manifestação do sintoma histérico. Consideram, ainda, a universalidade dos conceitos psicanalíticos e sua operatividade, justamente no ponto que relaciona as questões demandadas pela subjetividade e a escuta psicanalítica
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As autoras, ao compreenderem o movimento criador de Freud na construção da Psicanálise, apostam na clínica como lugar, por excelência, da criação e recriação da psicanálise. Ao articularem a psicanálise com alguns fenômenos do contemporâneo, as autoras se deparam, novamente, com a clínica, trazendo questões sobre o inconsciente, a transferência, a posição do analista na experiência psicanalítica, questões estas que relacionam o mal-estar da civilização e o mal-estar que advém do desejo(AU)
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As autoras pretendem cotejar o discurso da psicanálise sobre o amor. Ao abordarem amor e transferência na experiência analítica, apontam a problemática da vertente narcísica e identificatória do amor, assinalando que a questão do amor e da transferência deve ser pensada mais além da sua dimensão imaginária, considerando a dimensão significante e real