Child Psychotherapy in a cultural-historical perspective: The movement of subjectivity in Art Therapy / Psicoterapia infantil na perspectiva cultural histórica: o movimento da subjetividade em Arteterapia

This paper presents an approach on psychotherapy for children using the theoretical foundations of subjectivity under a cultural and historical perspective. The purpose of this study is to understand the movement of subjective formations and processes in the psychotherapy context, through actions and relations developed in an Art Therapy atelier. This is the theoretical and methodological discussion of records elaborated by the therapist when caring for a 4-year-old girl. The principles of qualitative Epistemology proposed by González Rey inspired the analysis and construction of information along the study, which discusses the emphasis of the singularity, the dialogical relationship and constructive-interpretative character that recognizes interpretive psychotherapy, and the artistic practice as a driver of new processes of an individual subjectivities. It was found that the new subjective senses, which were produced from the induced tensions, allowed the recognition of the artistic practice as a driver of new processes of subjectivation, and provided conditions for the production of other, new subjective settings.

Este trabalho apresenta a psicoterapia infantil na perspectiva cultural e histórica. Tem por objetivo compreender o movimento dos processos e formações subjetivas, em contexto psicoterápico, por meio de ações e relações desenvolvidas em um ateliê de arteterapia. Trata-se da discussão teórico-metodológica de registros elaborados pela autora/terapeuta em atendimentos a uma menina de quatro anos. A análise e construção das informações inspiraram-se nos princípios da Epistemologia qualitativa propostos por González Rey, que discute a ênfase do singular, a relação dialógica e o caráter construtivo-interpretativo, reconhecendo, na psicoterapia, o fazer artístico como condutor de novos processos de subjetivação do indivíduo. A presente pesquisa evidencia que os novos sentidos subjetivos, produzidos a partir dos tensionamentos provocados, proporcionaram condições para a produção de outras e novas configurações subjetivas.

role of SPECT/CT in detection and localization of sentinel lymph node in breast cancer

Objectives: The purpose of this study was to compare SPECT/CT and planar lymphoscintigraphy in detecting hot nodes

Methods: In this retrospective study, planar and SPECT/CT lymphoscintigraphy were performed in 119 consecutive women with invasive breast cancer. Both images were assessed for the number of lymph nodes and their anatomical site. Hot nodes were categorized based on the classification used by surgeons as level I, II, III nodes. In addition, pathology reports were retrieved which provided additional information concerning the characteristics of the lesions missed or detected by either or both imaging modalities

Results: SPECT/CT detected hot nodes in 81 [68%] patients, while planar lymphoscintigraphy detected hot nodes in 70 [58.8%] patients. SPECT/ CT and planar imaging had 38 [32%] patients in common where they did not detect any hot nodes. According to histopathology, 15 [12.6%] out of 36 patients with negative lymphoscintigraphic sentinel node identification on both modalities had nodal metastasis. The higher lymph node detection rate by SPECT/CT was significant [p = 0.019]

Conclusion: When compared to planar lymphoscintigraphy, SPECT/CT refines preoperative lymph node detection and thus [N] staging. As such, we recommend that SPECT/CT ought to be performed in a particular set of patients, for it improves localization of the draining nodes, detects nodes missed on planar, and excludes false positives in cases of lymphatic/blood vessel radiotracer accumulation