The Eternalized Alienation: a Structural Approach of a Clinical Case.

This work is an application of a clinic strategy based on the alienation concept - as defined by Jacques Lacan - to handle a supposed psychotic child and her mother. This strategy, proposed by Jussara Falek Brauer, prescribes individual assistance through weekly sessions with daughter and mother. It considers the family structure and intends to deal with the structural determinations on the Subject constitution. Two moments are especially focused when the work begins and a later one that exemplify the changing in the positioning of the child as a result from the therapeutic process in course. The theoretical concepts that support this approach Alienation, The Lacanian Topology about the Subject Constitution, Significant, Unconscious, Castration, Fetish, Perversion, Separation - are presented and related to the clinical material. Some hypotheses are presented about the mother’s psychic structure, withdrawn from the changing of positions and the evolution observed in both mother and daughter. These lead to the establishment of a diagnostic hypothesis for the daughter.Este trabalho é uma aplicação de uma estratégia clínica baseada no conceito de alienação, tal como definido por Jacques Lacan, para o atendimento de uma criança considerada psicótica e sua mãe. Tal estratégia, proposta por Jussara Falek Brauer, prescreve um atendimento individual, com uma sessão semanal, para a criança e para a mãe. Considera a estrutura familiar e pretende lidar com as determinações estruturais sobre a constituição do Sujeito. Dois momentos são especialmente focados quando o trabalho é iniciado e outro posterior que exemplificam a mudança de posicionamento dessa criança, em função do processo terapêutico em curso. Os conceitos teóricos que embasam esta abordagem a Alienação, a Topologia Lacaniana da Constituição do Sujeito, o Significante, o Inconsciente, a Castração, o Fetiche, a Perversão, a Separação são apresentados e relacionados ao material clínico. Algumas hipóteses são apresentadas a respeito da estrutura psíquica da mãe, considerando a evolução observada e as mudanças de posicionamento dessas pessoas, que levam ao estabelecimento de uma hipótese diagnostica para afilha

Evaluation of S-RBD and high specificity ACE-2-binding antibodies on SARS-CoV-2 patients after six months from infection

The antibody response to SARS-CoV-2 has not yet fully defined, but the availability of sensitive and specific serological assays is crucial to observe the presence of specific antibodies against the human receptor binding domain (S-RBD) and high specificity ACE-2-binding antibodies or neutralizing antibodies (NT) in response to vaccines. Indeed, these peculiar antibodies should prevent viral interaction between RBD and AngiotensinConverting Enzyme 2 (ACE2) receptor, located on surface of host cells. In this study, 72 samples from 37 hospitalized COVID-19 patients and 35 not-hospitalized patients were analyzed longitudinally. The detection of SRBD and NT antibodies was carried out using CLIA tests. Hospitalized patients showed elevated serum levels of S-RBD (97.22%) and NT (77.78%) antibodies, differently, not-hospitalized, who were paucisymptomatic or asymptomatic patients, showed lower serum levels of SRBD (65.71%) and NT (38.14%) antibodies. The results suggest that the NT serum level is strongly related to disease severity (p < 0.001) and to the serum level of S-RBD antibodies (p < 0.0001)

Cabozantinib After a Previous Immune Checkpoint Inhibitor in Metastatic Renal Cell Carcinoma: A Retrospective Multi-Institutional Analysis

Background: Angiogenesis has been recognized as the most important factor for tumor invasion, proliferation, and progression in metastatic renal cell carcinoma (mRCC). However, few clinical data are available regarding the efficacy of cabozantinib following immunotherapy. Objective: To describe the outcome of cabozantinib in patients previously treated with immunotherapy. Patients and methods: Patients with mRCC who received cabozantinib immediately after nivolumab were included. The primary endpoint was to assess the outcome in terms of efficacy and activity. Results: Eighty-four mRCC patients met the criteria to be included in the final analysis. After a median follow-up of 9.4 months, median overall survival was 17.3 months. According to the IMDC criteria, the rates of patients alive at 12 months in the good, intermediate, and poor prognostic groups were 100%, 74%, and 33%, respectively (p < 0.001). The median progression-free survival (PFS) was 11.5 months (95% CI 8.3-14.7); no difference was found based on duration of previous first-line therapy or nivolumab PFS. The overall response rate was 52%, stable disease was found as the best response in 25.3% and progressive disease in 22.7% of patients. Among the 35 patients with progressive disease on nivolumab, 26 (74.3%) patients showed complete/partial response or stable disease with cabozantinib as best response after nivolumab. The major limitations of this study are the retrospective nature and the short follow-up. Conclusions: Cabozantinib was shown to be effective and active in patients previously receiving immune checkpoint inhibitors. Therefore, cabozantinib can be considered a valid therapeutic option for previously treated mRCC patients, irrespective of the type and duration of prior therapies

A alienação eternizada: uma abordagem estrutural de um caso clínico

Este trabalho é uma aplicação de uma estratégia clínica baseada no conceito de alienação, tal como definido por Jacques Lacan, para o atendimento de uma criança considerada psicótica e sua mãe. Tal estratégia, proposta por Jussara Falek Brauer, prescreve um atendimento individual, com uma sessão semanal, para a criança e para a mãe. Considera a estrutura familiar e pretende lidar com as determinações estruturais sobre a constituição do Sujeito. Dois momentos são especialmente focados - quando o trabalho é iniciado e outro posterior - que exemplificam a mudança de posicionamento dessa criança, em função do processo terapêutico em curso. Os conceitos teóricos que embasam esta abordagem - a Alienação, a Topologia Lacaniana da Constituição do Sujeito, o Significante, o Inconsciente, a Castração, o Fetiche, a Perversão, a Separação - são apresentados e relacionados ao material clínico. Algumas hipóteses são apresentadas a respeito da estrutura psíquica da mãe, considerando a evolução observada e as mudanças de posicionamento dessas pessoas, que levam ao estabelecimento de uma hipótese diagnóstica para a filha

O ingresso de pessoa com deficiência na administração pública municipal: um estudo exploratório

O objetivo desta pesquisa é abordar o Ingresso de Pessoas com Deficiência na Administração Pública Municipal, a partir de um estudo exploratório dos depoimentos de dois funcionários com deficiência da Secretaria da Pessoa com Deficiência e Mobilidade Reduzida (Seped) da Prefeitura Municipal de São Paulo (PMSP). A análise de conteúdo resultou em 11 Núcleos Temáticos, que posteriormente foram reagrupados pela semelhança e correlação direta dos temas, oferecendo-nos três grandes categorias principais e norteadoras da pesquisa, sendo elas: Ingresso, Inclusão e Assistencialismo. Dentre as contribuições deste estudo, destacamos duas: a visão crítica dos entrevistados, contrários à prática assistencialista por parte de instituições e pessoas, por entenderem que essa é uma forma de manter a exlusão, o estigma e o preconceito; e a constatação do significado e valor do trabalho na vida destas pessoas, ao proporcionar autonomia, auto-estima, identidade e participação social.The purpose of this research is to tackle the entry of Handicap people on the Public Administration, studying the testimony of two Handicap employees from Sao Paulo City Hall that work on a department specially assigned for Handicaps (Seped).The analysis of contents resulted in 11 different subjects that later were regrouped by similarity and correlation between them, leaving us with three major categories which are: Entry on the Job Market, Inclusion on Society and People who Discriminate, keeping that taboo alive. Among the contributions of this study are the critic vision of the interviewed, who are against a discrimination by society where exclusion and prejudice exist, and the meaning and importance of work on their lives, leading to independence, self esteem, identity and social participation.Fundo Mackenzie de Pesquis

Space and time: dimensions of captive apes well-being

SPACE AND TIME: DIMENSIONS OF CAPTIVE APES WELL-BEING Monica Carosi1, Barbara Simeoni1, Cristina Sagnotti2, Pietro Ciaccia2, Maria Ricotta5, Ilaria Orlando6 1 Roma Tre University, 2 Safari Ravenna, 3 University of Florence, 4 Zoosafari di Fasano In captivity space and time represent two main axes around which the quality of life and variability of social interactions may find the proper amount of degrees of freedom to express. Environmental enrichment, arising from a proper space/time interplay, should aim at allowing an animal behavioral choice, therefore increasing sense of control, which in turn may lower stress and grant well-being. These are the stories of four chimpanzees (Pan troglodytes verus) who have been rescued from an inhibited and human-like life, and the last gorilla (Gorilla gorilla) left in Italy. In collaboration with the hosting safaris (Safari Ravenna and Zoosafari di Fasano, Italy) we provided them enriched space and time. We carried out a strictly planned environmental enrichment program and studied ape behavioral response over a control and an enrichment period. Enrichment included varied substrates for locomotion; an assorted diet; diversified food provisioning and unpredictable schedule; chances to freely express agonistic behaviors (chimps), and interaction-with-operator sessions (gorilla). Behavioral categories analyzed were displacement activities, abnormal behaviors (including stereotypies), prosocial behavior, agonism and activity budget (AB), with air temperature, amounts of public and noise as covariates. Although high chimpanzee inter-individual variability and differences in housing and social conditions between species, two main common outcomes of enrichment were: changes in AB (mainly locomotion), and the decrease of stress as measured by both displacement activities and abnormal behaviors. Further success for the gorilla was the healing of a long lasting self-induced wound

Low-dose angiotensin receptor blockers as an alternative to ACE-inhibitors increase the risk of appropriate ICD interventions in heart failure

Low-dose angiotensin receptor blockers as an alternative to ACE-inhibitors increase the risk of appropriate ICD interventions in heart failur