Psychotherapy in Hospitals in Brazil and Some Contributions from Psychoanalysis: A Historical Study

Psychotherapeutic practice in hospitals in Brazil started in the 1950s even before the profession of psychologist in the country was formalized, and has been building a fairly rich history because it is differentiated according to the development of the practice over the decades as a function of the various clinical methods associated with it, as a consequence of the policies and/or different theoretical orientations that have underpinned it. Twenty years after this practice began, during the 1970s, the field of mental health was configured as a major center of absorption of psychologists in an attempt to change the prevailing medical model. It is at that time that we can first see the formation of multidisciplinary teams linked to psychotherapy treatments. When we examine the relationship between the advancement of the practice and its theoretical foundations, in a field where political orientations toward the practice carried no less weight, we realize that this entire movement has led to important developments in the history of psychology in general. In order to specify what clinical practice in hospitals has contributed to psychology in general, it is necessary to follow its guidelines over the decades, where we can confirm that a certain prevalence of psychoanalysis has been and is being established. To the extent that it is characterized as a discourse directed at the subject, it is fundamental that it allows for situating the work in the hospital in an exchange with the medical field in such a way that each field may sustain its own particularities, respect their differences, and contribute, each in their own way, toward the advancement of clinical work. From the 1950s through today, clinical practice highlights a concern with asserting subjectivity in hospitals where the contributions of some psychoanalytical developments to different forms of psychotherapy have not been lacking.

Renal failure in cirrhosis: Emerging concepts

Acute renal failure, now termed acute kidney injury(AKI), is frequently found in patients with cirrhosis. The occurrence of AKI, irrespective of the underlying cause, is associated with reduced in-hospital, 3-mo and 1-year survival. Hepatorenal syndrome is associated with the worst outcome among AKI patients with cirrhosis. Several definitions for AKI that have been proposed are outlined and evaluated in this paper. Among these, the International Club for Ascites-AKI criteria substantially strengthen the quality of early diagnosis and intervention according to underlying cause of AKI.

Heart failure in the elderly

The aging of the population is, currently, a major phenomenon, drawing the attention of a number of investigators. The significant increase of life expectancies over the past few decades, in addition to social and economic consequences, has lead to a major change in the morbidity and mortality profile of elders. Heart failure （HF） is a condition in which the heart can not pump enough blood to meet the body＇s needs. HF is predominantly a disorder of the elderly with rates increasing exponentially. The prevalence of HF approximately doubles with each decade of life. As people live longer, the occurrence of HF rises, as well as other conditions that complicate its treatment. Impaired heart function implies a reduced duration of survival. Fortunately, many factors that can prevent HF and improve outcome are known and can be applied at any stage. This review emphasizes the importance of factors inherent in aging itself, focusing on heart disease, particularly as a disease of aging, can help critically refine management of this acute and chronic disease, as well as foster preventive strategies to reduce the incidence of this common malady.

Randomized controlled trial comparing open anterograde anatomic radical retropubic prostatectomy with retrograde technique

Objective:Radical prostatectomy is the recommended treatment for localized prostate cancer;however,it is an invasive procedure that can leave serious morbidity.Robot-assisted radical prostatectomy was introduced with the aim of reducing postoperative morbidity and facilitating rapid recovery compared to the traditional Walsh’s open radical retropubic prostatectomy.Therefore,a protocol was developed to perform an open prostatectomy comparable to that performed by robotics,but without involving novel instrumentation.Methods:A total of 220 patients diagnosed with localized prostate cancer underwent radical prostatectomy.They were divided into two groups:anterograde technique(115 patients)and the retrograde method(105 patients).The study outcomes were observed 3 months after surgery.Results:No differences were found in terms of surgical time,hospital stay,and suction drainage.However,reduced bleeding was observed in the anterograde technique(p=0.0003),with rapid anastomosis duration(p=0.005).Among the patients,60.9% undergoing the anterograde technique were continent 3 months after surgery compared to 42.9%treated by the retrograde method(p=0.007).Additionally,fewer complications in terms of the number(p=0.007)and severity(p=0.0006)were observed in the anterograde technique.Conclusion:The anterograde method displayed increased efficiency in reducing complications,compared to the retrograde technique.

Surgical treatment of bilateral temporalis and masseteric hypertrophy: Report of a case

Hypertrophy of the masticatory muscles is characterized by generalized enlargement of the muscular tissue that affects the facial esthetic and may or not be accompanied by pain [1-3]. This condition can be congenital, but more often it is acquired. The origin has been attributed to muscle hyperactivity and parafunctionsoriginated from stressful lifestyle that causes bruxing or clenching [2,3]. Masseteric muscle hypertrophy is a relative common clinical entity that can affect one or both sides and is also thought to causesecondary enlargement of the mandibular angle as a result of functional remodeling. Temporalis muscle hypertrophy is a rare clinical entity and only a few cases are reported. More often, it presents a bilateral involvement and is usually associated with masseteric hypertrophy [3]. The aim of this report is to present a case of bilateral temporalis and masseteric muscles hypertrophy treated

Association between Ebstein Anomaly and Coronary Artery Disease： A Report Case

The intention of this article is to report a case of a 26 years old man presenting a rare combination of congenital heart disease （Ebstein anomaly） and coronary artery disease. EA （Ebstein anomaly） has a prevalence of 1% of all congenital heart diseases, as CAD （coronary artery disease） has a little evidence in literature＇s registries when occurred in individuals with 40 years old or less. Therefore, this case report rises attention to the rarity of those patologies, which individually are already considerably rare and, in this case, it comes associated what turns this diagnosis excepcional, highlighting the complexity of the treatment.