A permanência dos símbolos teriomórficos na arte e na psique / The permanence of sybols in artand in the psyque / La permanencia de los simlolos del teriomorfismo en elarte yen la psique

O artigo trata de símbolos teriomórficos­referidos a animais. A importância que exercem pode ser atestada pela permanência na arte (pinturas parietais até os grafites contemporâneos) e na psique. A perpetuação de símbolos e temas é tratada por estudos como os de Aby Warburg em história da arte, com as noções de Kulturgeschichte, Pathosformele Mnemosyne: a recorrência de temas, emoções e comportamentos revela a perpetuação de símbolos interligados à cultura. Essa recorrência simbólica, em termos psíquicos é entendida por C.G. Jung mediante as noções de arquétipo e inconsciente coletivo. Autores contemporâneos a Warburg e a Jung e seus respectivos conceitos, bem como a apresentação de algumas obras de arte, ilustram a importância dos símbolos teriomórficos .Aventa-se a hipótese de que seja uma necessidade psíquica de reunir a natureza biológica, sua força desejante instintiva com a esfera da mente e do sentido de ser constantemente renovada (AU).

Teriomorphicsymbols refer to animals. The importance they exercise can be demonstrated by the permanence of these symbols both in art (parietal paintings to contemporary graffiti) and in the psyche. The perpetuation of symbols and themes is dealt with by studies suchas those by Aby Warburg in art history: Kulturgeschichte, Pathosformel and Mnemosyne. The recurrence of themes, emotions and behaviors reveals the perpetuation of symbols intertwined with culture. This symbolic recurrence, in psychic terms, is understood by C.G. Jung through the notions of archetype and collective unconscious. Contemporary authors of Warburg and Jungand their respective concepts, as well as the presentation of some works of artillustratethe importance of teriomorphic symbols. It is hypothesized that it is a psychic need to unite the biological nature, its instinctive desiring force with the sphere of the mind and the sense of being constantly renewed (AU).

Los símbolos teriomorfosse refieren a los animales. La importancia que ejercen puede ser atestiguada por su permanencia en el arte (pinturas parietales hasta grafitis contemporáneos) y en la psiquis. La perpetuación de símbolos y temas es abordada por estudios como los de Aby Warburg en historia del arte: Kulturgeschichte, Pathosformel y Mnemosyne: la recurrencia de temas, emociones y comportamientos revela la perpetuación de símbolos entrelazados con la cultura. Esta recurrencia simbólica, en términos psíquicos, es comprendida por C.G. por Jung a través de las nociones de arquetipo e inconsciente colectivo. Autores contemporáneos de Warburg y Jungy sus respectivos conceptos,así como la presentación de algunas obras de arte, ilustran la importancia de los símbolos teriomorfos. Se plantea la hipótesis de que se trata de una necesidad psíquica de unir la naturaleza biológica, su fuerza instintiva deseante con la esfera de la mente y el sentido de renovarse constantemente (AU).

Amylase as a Diagnostic Tool for Plunging Ranula: Clinical Series and Description of the Technique.

OBJECTIVES: This study describes a technique of measurement for neck cyst amylase content and reviews the experience of a tertiary referral center for cases of suspected plunging ranula. METHODS: A retrospective study was performed at the Manukau Surgical Center in Auckland, New Zealand. Patients with a possible diagnosis of plunging ranula based on clinical presentation and diagnostic aspiration of the cyst contents were included. Demographic data, imaging and laboratory findings were collected, along with findings from surgery and histology. The technique for measuring the amylase of the aspirated cyst contents was also carefully recorded. RESULTS: The 37 cases of confirmed plunging ranula included in this study had a submandibular cystic swelling that was aspirated. Imaging features consistent with a plunging ranula were seen in 89% of the study group. All cases had detectable levels of amylase of ≥3 U/L in the ranula contents. There was large variability (range: 5-560 U/L) in the concentration of amylase, with 70% of the cases demonstrating an amylase concentration below 200 U/L. Aspirates were typically described as viscous (87.5%) and yellow or straw-colored. CONCLUSION: The combination of clinical presentation, imaging and the presence of amylase in the cyst contents is diagnostic for plunging ranula. LEVEL OF EVIDENCE: 4 Laryngoscope, 133:535-538, 2023.

Arte-testemunho em nazareth pacheco / Testimonio de arte sobre nazareth pacheco / Testimony art in nazareth pacheco

Resumo A presente pesquisa aborda a obra de arte enquanto testemunho, à luz de falas e escritos da artista Nazareth Pacheco. O testemunho trata da questão biográfica e dá voz àquele que tem algo a dizer a partir de sua experiência de vida. Abrirmo-nos para os sentidos, que se expressam para além da comunicação verbal em criação artística, imprimem relevância ao presente escrito no âmbito da psicologia, ao buscar evidenciar que a expressão através das artes visuais, além de assumir contornos terapêuticos, permite reconstruir o conteúdo da experiência com o potencial de desafiar crenças e valores. O material coletado foi composto por entrevistas e a dissertação de mestrado da artista, submetidos a análise temática. Foram identificados quatro temas: enfrentamento, ideal de beleza, literalidade e transcendência. Conclui-se que, se dar voz ao sofrimento implica em elaborar a experiência vivida, a expressão artística pode se afigurar como importante estratégia terapêutica no campo da psicologia.

Resumen Esta investigación aborda la obra de arte como un testimonio, a la luz de los discursos y escritos de la artista Nazareth Pacheco. El testimonio aborda el tema biográfico y da voz a quienes tienen algo que decir a partir de su experiencia de vida. Abrirnos a los sentidos, que se expresan más allá de la comunicación verbal en la creación artística; imprimen relevancia a la escritura actual en el campo de la psicología, al buscar mostrar que la expresión a través de las artes visuales, además de asumir contornos terapéuticos, nos permite reconstruir el contenido de la experiencia con el potencial de desafiar creencias y valores. El material recolectado consistió en entrevistas y en la disertación de maestría de la artista, sometidas a análisis temático. Se identificaron cuatro temas: confrontación, ideal de belleza, literalidad y transcendencia. Se concluye que, si dar voz al sufrimiento implica elaborar la experiencia vivida, la expresión artística puede representar una importante estrategia terapéutica en el campo de la psicología.

Abstract This research addresses the work of art as a testimony, in the light of speeches and writings of the artist Nazareth Pacheco. The testimony deals with the biographical issue and gives voice to those who have something to say based on their life experience. Opening ourselves to the senses, which are expressed beyond verbal communication in artistic creation, imprint relevance to the present writing in the field of psychology, by seeking to show that expression through the visual arts, in addition to assume therapeutic contours, it allows us to reconstruct the content experience with the potential to challenge beliefs and values. The collected material consisted interviews and the master's thesis of the artist, all submitted to thematic analysis. Four themes were identified: confrontation, ideal of beauty, literality, and transcendence. It is concluded that, if giving voice to suffering implies elaborating the lived experience, artistic expression may represent an important therapeutic strategy in the field of psychology.

A permanência dos símbolos teriomórficos na arte e na psique / The permanence of teriomorphic symbols in art and in the psyche / La permanencia de los simbolos del teriomorfismo en el arte y en la psique

O artigo trata de símbolos teriomórficos referidos a animais. A importância que exercem pode ser atestada pela permanência na arte (pinturas parietais até os grafites contemporâneos) e na psique. A perpetuação de símbolos e temas é tratada por estudos como os de Aby Warburg em história da arte, com as noções de Kulturgeschichte, Pathosformele Mnemosyne: a recorrência de temas, emoções e comportamentos revela a perpetuação de símbolos interligados à cultura. Essa recorrência simbólica, em termos psíquicos é entendida por C.G. Jung mediante as noções de arquétipo e inconsciente coletivo. Autores contemporâneos a Warburg e a Jung e seus respectivos conceitos, bem como a apresentação de algumas obras de arte, ilustram a importância dos símbolos teriomórficos.Aventa-se a hipótese de que seja uma necessidade psíquica de reunir a natureza biológica, sua força desejante instintiva com a esfera da mente e do sentido de ser constantemente renovada (AU).

Teriomorphicsymbols refer to animals. The importance they exercise can be demonstrated by the permanence of these symbols both in art (parietal paintings to contemporary graffiti) and in the psyche. The perpetuation of symbols and themes is dealt with by studies suchas those by Aby Warburg in art history: Kulturgeschichte, Pathosformel and Mnemosyne. The recurrence of themes, emotions and behaviors reveals the perpetuation of symbols intertwined with culture. This symbolic recurrence, in psychic terms, is understood by C.G. Jung through the notions of archetype and collective unconscious. Contemporary authors of Warburg and Jungand their respective concepts, as well as the presentation of some works of artillustratethe importance of teriomorphic symbols. It is hypothesized that it is a psychic need to unite the biological nature, its instinctive desiring force with the sphere of the mind and the sense of being constantly renewed (AU).

Los símbolos teriomorfosse refieren a los animales. La importancia que ejercen puede ser atestiguada por su permanencia en el arte (pinturas parietales hasta grafitis contemporáneos) y en la psiquis. La perpetuación de símbolos y temas es abordada por estudios como los de Aby Warburg en historia del arte: Kulturgeschichte, Pathosformel y Mnemosyne: la recurrencia de temas, emociones y comportamientos revela la perpetuación de símbolos entrelazados con la cultura. Esta recurrencia simbólica, en términos psíquicos, es comprendida por C.G. por Jung a través de las nociones de arquetipo e inconsciente colectivo. Autores contemporáneos de Warburg y Jungy sus respectivos conceptos,así como la presentación de algunas obras de arte, ilustran la importancia de los símbolos teriomorfos. Se plantea la hipótesis de que se trata de una necesidad psíquica de unir la naturaleza biológica, su fuerza instintiva deseante con la esfera de la mente y el sentido de renovarse constantemente (AU).

Impact on quality of life in obstructive sialadenitis predicting outcomes after sialendoscopy.

PURPOSE: Sialendoscopy is a minimally invasive procedure considered a paradigm shift in the treatment of obstructive sialadenitis. However, it shows an average need for revision procedure in up to 24% of operated cases. This study analyzed whether patient-related variables could predict the need for a revision during postoperative follow-up. METHODS: From 2012 to 2020, this prospective comparative study analyzed demographic data as well as preoperative responses to the "Manukau Salivary Symptoms Score" (MSSS) questionnaire as predictors of the need for a revision procedure due to symptoms recurrence. RESULTS: 188 sialendoscopies (39.4% for stones/60.6% for stenoses) in 112 parotid (59.6%) and 76 submandibular glands (40.4%) were included in this study. Forty patients (21.3%) required a revision procedure. The variable "Impact on quality of life" in the preoperative period of patients with sialoliths showed that the likelihood of a revision procedure increases by 33.6% with each increase in the 10-point Likert scale presented in the MSSS (p = 0.010, OR = 1336, CI = 1.071 to 1.667). This finding was not influenced by the location of the sialolith in the duct (p = 0.415), size (p = 0.058) or number of stones (P = 0.476). Other demographic variables related to the patient showed no association with the need of a revision procedure. CONCLUSION: Further studies should be performed to exclude the influence of other variables on the results; however, special attention should be given to patients who report a greater pre-operative impact on quality of life due to sialolithiasis. LEVEL OF EVIDENCE: II.

The Need for Studies on Oral Corticosteroids After Sialendoscopy for Obstructive Salivary Gland Disease: Systematic Review.

OBJECTIVES: This qualitative systematic review evaluates the evidence in support of the use of oral corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis. DESIGN: Qualitative systematic review. METHODS: A literature search was conducted from January 1985 and September 2020. Inclusion criteria embraced peer-reviewed articles in which adult patients undergoing interventional sialendoscopy for obstructive salivary gland disease received oral corticosteroids. The results were initially screened based on title and abstract, and the remaining articles were reviewed for eligibility. RESULTS: About 218 papers were selected by title and abstract, 96 were selected for full-text review, and 9 met the inclusion criteria. Eight published reports were retrospective observational studies and 1 was a prospective comparative study. Overall, the heterogeneity of clinical data stood out in this systematic review. The pooled success rate in the studies was 873/979 (89%). Only 5 studies described a rationale for oral corticosteroid use as part of the post-operative management. In 4 studies, a prednisone total daily dose of 40 to 50 mg was used. One study clearly showed a lower recurrence rate in patients who received oral steroids for more than 7 days in addition to sialendoscopy for management of ductal stenoses. CONCLUSION: This systematic review showed that most centers that prescribe oral corticosteroids after sialendoscopy are unaware of the specific results with this treatment. For ductal stenoses, only 1 paper clearly showed the benefits of oral corticosteroids after sialendoscopy but more high-quality evidence is required in the form of a comparative study or randomized controlled trial, with appropriate long-term follow up.

The Manukau Salivary Symptoms Score for Assessing the Impact of Sialendoscopy in Recurrent Obstructive Sialadenitis.

OBJECTIVE: To examine the Manukau Salivary Symptom Score (MSSS) questionnaire as a validated tool to assess obstructive sialadenitis-specific symptoms to both indicate disease severity and assess the outcome after sialendoscopic procedures. STUDY DESIGN: A prospective observational study was performed from 2010 to 2019 comprising 164 patients undergoing sialendoscopy for nonneoplastic chronic obstructive salivary gland disease (COSGD). SETTING: Department of Otolaryngology-Head and Neck Surgery at the Manukau Surgical Centre, Auckland, New Zealand, between June 2010 and September 2019. METHODS: A prospective observational study was performed from 2010 to 2019 comprising 164 patients undergoing sialendoscopy for nonneoplastic COSGD. Patients completed the MSSS preoperatively and at postoperative follow-up. Statistical tests were used to compare pre- and postoperative answers. Cronbach's α was used to measure internal consistency. Finally, construct validity was determined by comparing the 5-question MSSS questionnaire to the preexisting 20-question Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire. RESULTS: Postoperatively, patients had significant improvements in pain, eating, talking, swelling, and quality of life (P < .001). The MSSS questionnaire was found to have high internal consistency (α = 0.938). Questions in the MSSS had a very strong positive correlation with 3 COSS questions, a strong positive correlation with 8, a moderate positive correlation with 4, and a weak positive correlation with 1. Four COSS questions were not considered relevant and were not included in the MSSS questionnaire. CONCLUSION: The MSSS questionnaire is a simple, validated questionnaire that is useful for assessing the impact of sialendoscopy in patients with COSGD.

Patient Outcomes After Unsuccessful Endoscopic Sialolith Extraction.

OBJECTIVE/HYPOTHESIS: To evaluate clinical outcomes following failed endoscopic extraction of salivary calculi and to assess any relation between clinical outcome and calculi location, number, size, and mobility. If sialendoscopy fails to extract the calculus, subsequent spontaneous passage of the calculus out of the ductoglandular system or secondary effects of sialendoscopy could mitigate the clinical impact of a residual sialolithiasis. STUDY DESIGN: Prospective observational study. METHODS: Prospective comparative study of endoscopic procedures for sialolithiasis performed in the Manukau Surgery Center, in Auckland, New Zealand, from 2010 to 2020. The recurrent symptoms and the variables related to the need for additional surgical intervention for salivary calculi were analyzed. RESULTS: Among the 465 sialendoscopy procedures, 154 (33.1%) were for obstructive sialolithiasis. Among these, there were 30 (19.4%) with unsuccessful stone extraction with re-operation for these failures performed in 14 of the 27 failed submandibular cases (52%) and 2 of the 3 parotids (66.7%). Location of calculi was a significant factor in predicting the need of further surgery. Patients with perihilar stones were 5 times more likely to have a failed procedure (P = .001). If the stone was intraglandular, the likelihood increased to 8.5 times (P = .005). The likelihood for a revision procedure increased almost 11 times if the stone was intraglandular (P = .004). Calculi size, mobility, multiple calculi, and presence of concurrent stenosis did not correlate with need for further surgery. CONCLUSIONS: A significant proportion of "failed" sialendoscopy did not require further intervention. Stone location was a significant factor in predicting a failed procedure and the need for re-intervention. Laryngoscope, 132:1029-1033, 2022.

Do Postoperative Oral Corticosteroids Improve Results After Sialendoscopy for Ductal Stenosis?

OBJECTIVES: This study aims to review the effects of short- and long-term oral administration of postoperative corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis due to ductal stenosis. STUDY DESIGN: Prospective comparative study. METHODS: A prospective observational study was conducted at Manukau Surgical Center in Auckland, New Zealand, where patients undergoing sialendoscopic surgery for recurrent obstructive sialadenitis due to ductal stenoses were reviewed. Univariable and multivariable analysis, and also logistic regression were performed to identify variables correlated with the likelihood of the need for revision surgery for persistent or recurrent symptoms. RESULTS: In this study, sialendoscopy was performed in 142 patients: 162 parotid glands (86.6%) and 25 submandibular glands (13.4%). Postoperative oral steroids were prescribed for 48 patients (34%); 19 (13%) were prescribed for less than 7 days and 29 (20%) for more than 7 days. In total, 33 patients (23.2%) required a revision sialendoscopy during follow-up due to recurrence of symptoms. Oral steroids prescribed for more than 7 days after a sialendoscopy reduced the likelihood of a revision procedure by 93% when compared with patients who did not receive this medication, and by 96% when compared with patients who received steroids for less than 7 days. CONCLUSION: The results showed that in our population oral administration of corticosteroids for more than 7 days after sialendoscopy for the treatment of recurrent obstructive sialadenitis due to ductal stenosis markedly reduced the need for later revision surgery. Routine use of corticosteroids for more than 7 days is recommended after sialendoscopy in patients with ductal stenosis. LEVEL OF EVIDENCE: II Laryngoscope, 131:E1503-E1509, 2021.

How does sinus surgery affect topical irrigation distribution?

PURPOSE OF REVIEW: The current article reviews the literature on the distribution of nasal irrigation in the treatment of chronic sinusitis, especially in how sinus surgery and irrigation techniques affect its delivery to the nasal cavity and paranasal sinuses. RECENT FINDINGS: Nasal irrigation has become a useful tool in the treatment of chronic sinusitis. Used after endoscopic surgery of the paranasal sinuses, irrigation has shown to be effective in improving edema and removing crusts and secretions in that place. However, some relevant points have been considered in the surgical technique and in the postoperative period to improve irrigation access to the paranasal sinuses such as the amplitude of the sinus ostial opening, irrigation volume and device used, as well as head position during irrigation. SUMMARY: Postoperative lavage of the paranasal sinus is a recognized adjuvant in the treatment of chronic rhinosinusitis, reducing morbidity and improving local healing, besides allowing the association of topical medications that can be carried to the paranasal sinuses along with the saline increasing the reach of these drugs. Detailed attention to the techniques described in this review improves the distribution of irrigation in the paranasal sinuses after sinus surgery and considerably increases the efficacy of this therapy.

Pancreatectomia distal preservando o baço / Spleen preserving distal pancreatectomy

É relatado aqui o caso de paciente com diagnóstico de neoplasia cística do corpo e cauda do pâncreas. Discute-se a técnica cirúrgica utilizada nesse caso e suas vantagens, com a preservação do baço durante a ressecção distal do pâncreas.

The authors report a case of a patient with diagnosis of body and tail cystic neoplasm of the pancreas, discuss the surgical technique used in this case and its advantages, succesfully preserving the spleen, during the ressection of distal pancreas.