Susane Vasconcelos Zanotti

Aux limites de l'hystérie, la douleur chronique

This paper presents a reflection on the etiology and treatment of chronic pain from a psychoanalytic perspective. We discuss the reduction of chronic pain to a contemporary manifestation of hysteria. Considering a symptom as a specific form of jouissance and a way of inscribing the individual in a social bond, the text emphasizes the function of pain based on the specific aspects of each case.

Prevalence of genital abnormalities in neonates

OBJECTIVES To assess the prevalence of genital abnormalities among neonates in two public maternity-schools. METHODS Case-control, cross-sectional descriptive study. Genital morphology of 2,916 neonates was assessed using a clinical protocol between 04/19/2010 and 04/18/2011. Control group included neonates without birth defects, born at the same maternity unit and in the same day in which a case was identified. Fisher and Kruskal-Wallis tests were used for statistics. RESULTS The study identified 29 (1:100) neonates with genital abnormalities. Most of them were examined within 3 days of life and presented only one genital defect. Morphological abnormalities comprised: genital ambiguity (1/29), fusion of labia majora (1/29), micropenis (2/29), enlarged clitoris (6/29), hypospadia (9/29), and combined defects (4/29). Only one case reported the genital abnormality in the statement of live birth correctly. Prematurity occurred in 13/29 cases and was the only variable statistically associated with genital defects. Eight cases agreed on the complementary investigation of the genital defect, among which three were diagnosed with disorder of sex development. CONCLUSIONS There is a high prevalence of genital abnormalities in the maternity units included in the present study and most cases are under-diagnosed and under-reported. Our results reinforce the importance of a careful examination of genital morphology in neonatal period towards the recognition of minor defects that can be clinical features of a disorder of sex development.

Prevalência de anormalidades genitais em recém-nascidos

OBJECTIVES: To assess the prevalence of genital abnormalities among neonates in two public maternity-schools. METHODS: Case-control, cross-sectional descriptive study. Genital morphology of 2,916 neonates was assessed using a clinical protocol between 04/19/2010 and 04/18/2011. Control group included neonates without birth defects, born at the same maternity unit and in the same day in which a case was identified. Fisher and Kruskal-Wallis tests were used for statistics. RESULTS: The study identified 29 (1:100) neonates with genital abnormalities. Most of them were examined within 3 days of life and presented only one genital defect. Morphological abnormalities comprised: genital ambiguity (1/29), fusion of labia majora (1/29), micropenis (2/29), enlarged clitoris (6/29), hypospadia (9/29), and combined defects (4/29). Only one case reported the genital abnormality in the statement of live birth correctly. Prematurity occurred in 13/29 cases and was the only variable statistically associated with genital defects. Eight cases agreed on the complementary investigation of the genital defect, among which three were diagnosed with disorder of sex development. CONCLUSIONS: There is a high prevalence of genital abnormalities in the maternity units included in the present study and most cases are under-diagnosed and under-reported. Our results reinforce the importance of a careful examination of genital morphology in neonatal period towards the recognition of minor defects that can be clinical features of a disorder of sex development.

CONCEPÇÕES ATRIBUÍDAS POR MULHERES AO PROCESSO DE ADOECIMENTO POR LÚPUS

This study aims to understand the concepts attributed by women to the disease process of Systemic Lupus Erythematosus (SLE). We have interviewed nine women who were undergoing treatment at the outpatient rheumatology clinic of a university hospital in the Northeast of Brazil. The collected data was organized, based on content analysis, in five axis: disease onset; body and Lupus; the treatment; Lupus and its causes; medical discourse and Lupus disease. As for interpreting the data, psychoanalytic theory was used with that aim, especially its conceptions of body and illness. Results indicated that the Lupus disease process leads to estrangement, affecting the body and its image and causing anguish. Nevertheless, with the course of treatment, these women began to recognize themselves in a condition of chronic patient. This condition is understood by them from the symbolic references provided by medical discourse which aids in the assemblage of a new body image and provokes changes in their lifestyles.

O sem sentido no testemunho do nome próprio

Este artigo aborda o nome proprio em sua relacao com a literatura de teor testemunhal ou literatura do trauma. Valemo-nos dessa literatura para desenvolver algumas reflexoes sobre a nomeacao em Lacan, mais especificamente do testemunho de descendentes de nazistas notorios. Porquanto os nomes legados por seus pais os ligam as barbaries da Shoah, varias narrativas circundam esse tema tao caro a psicanalise. O prestimo do testemunho, entretanto, nao se encerrou nesse ponto, pois observamos que o nome proprio e o testemunho se conectam a partir de certa relacao com a linguagem que nao deixa de incluir o sem sentido.

Profile of patients with genitourinary anomalies treated in a clinical genetics service in the Brazilian unified health system

Abstract Objective: To describe the profile of patients with genitourinary abnormalities treated at a tertiary hospital genetics service. Methods: Cross-sectional study of 1068 medical records of patients treated between April/2008 and August/2014. A total of 115 cases suggestive of genitourinary anomalies were selected, regardless of age. A standardized clinical protocol was used, as well as karyotype, hormone levels and genitourinary ultrasound for basic evaluation. Laparoscopy, gonadal biopsy and molecular studies were performed in specific cases. Patients with genitourinary malformations were classified as genitourinary anomalies (GUA), whereas the others, as Disorders of Sex Differentiation (DSD). Chi-square, Fisher and Kruskal–Wallis tests were used for statistical analysis and comparison between groups. Results: 80 subjects met the inclusion criteria, 91% with DSD and 9% with isolated/syndromic GUA. The age was younger in the GUA group (p<0.02), but these groups did not differ regarding external and internal genitalia, as well as karyotype. Karyotype 46,XY was verified in 55% and chromosomal aberrations in 17.5% of cases. Ambiguous genitalia occurred in 45%, predominantly in 46,XX patients (p<0.006). Disorders of Gonadal Differentiation accounted for 25% and congenital adrenal hyperplasia, for 17.5% of the sample. Consanguinity occurred in 16%, recurrence in 12%, lack of birth certificate in 20% and interrupted follow-up in 31% of cases. Conclusions: Patients with DSD predominated. Ambiguous genitalia and abnormal sexual differentiation were more frequent among infants and prepubertal individuals. Congenital adrenal hyperplasia was the most prevalent nosology. Younger patients were more common in the GUA group. Abandonment and lower frequency of birth certificate occurred in patients with ambiguous or malformed genitalia. These characteristics corroborate the literature and show the biopsychosocial impact of genitourinary anomalies.

At the limits of hysteria, chronic pain

This paper presents a reflection on the etiology and treatment of chronic pain from a psychoanalytic perspective. We discuss the reduction of chronic pain to a contemporary manifestation of hysteria. Considering a symptom as a specific form of jouissance and a way of inscribing the individual in a social bond, the text emphasizes the function of pain based on the specific aspects of each case.

En los límites de la histeria, el dolor crónico

This paper presents a reflection on the etiology and treatment of chronic pain from a psychoanalytic perspective. We discuss the reduction of chronic pain to a contemporary manifestation of hysteria. Considering a symptom as a specific form of jouissance and a way of inscribing the individual in a social bond, the text emphasizes the function of pain based on the specific aspects of each case.

Nos limites da histeria, a dor crônica

This paper presents a reflection on the etiology and treatment of chronic pain from a psychoanalytic perspective. We discuss the reduction of chronic pain to a contemporary manifestation of hysteria. Considering a symptom as a specific form of jouissance and a way of inscribing the individual in a social bond, the text emphasizes the function of pain based on the specific aspects of each case.

Conceptions attributed by the women to the disease process for Lupus

This study aims to understand the concepts attributed by women to the disease process of Systemic Lupus Erythematosus (SLE). We have interviewed nine women who were undergoing treatment at the outpatient rheumatology clinic of a university hospital in the Northeast of Brazil. The collected data was organized, based on content analysis, in five axis: disease onset; body and Lupus; the treatment; Lupus and its causes; medical discourse and Lupus disease. As for interpreting the data, psychoanalytic theory was used with that aim, especially its conceptions of body and illness. Results indicated that the Lupus disease process leads to estrangement, affecting the body and its image and causing anguish. Nevertheless, with the course of treatment, these women began to recognize themselves in a condition of chronic patient. This condition is understood by them from the symbolic references provided by medical discourse which aids in the assemblage of a new body image and provokes changes in their lifestyles.