[PROPOSAL OF INITIAL PSYCHOTERAPEUTIC AND PSYCHOPHARMACOLOGICAL APPROACH IN PATIENTS WITH DIAGNOSE OF 5 DIFFERENT SUBTYPES OF BORDERLINE PERSONALITY DISORDER]. / Propuesta de enfoque psicofarmacológico y psicoterapéutico inicial en pacientes con diagnóstico de cinco subtipos diferentes de Trastorno Límite de la Personalidad.

The evidence shows that borderline personality disorder (BPD) is the most frequently diagnosed personality disorder. However, the diagnostic criteria are very heterogeneous, suggesting that very different patients may be included within a single construct. Despite its severity, there are no standardized treatments for this group of patients. We find the same problem in the Acute Mental Health Services. The numerous proposals that have been put forward are unclear and have not reached a final consensus. According to Oldham's classification, BPD can be divided into the following subtypes: Affective, Impulsive, Aggressive, Empty and Dependent. In this paper, we propose a psychotherapeutic initial approach from the Dialectical Behavioral Therapy (DBT) perspective and an initial psychopharmacological approach for each subtype of BPD.

Clinical and Pathological Evidence of Anti-GD2 Immunotherapy Induced Differentiation in Relapsed/Refractory High-Risk Neuroblastoma.

BACKGROUND: Neuroblastic tumors (NBTs) originate from a block in the process of differentiation. Histologically, NBTs are classified in neuroblastoma (NB), ganglioneuroblastoma (GNB), and ganglioneuroma (GN). Current therapy for high-risk (HR) NB includes chemotherapy, surgery, radiotherapy, and anti-GD2 monoclonal antibodies (mAbs). Anti-GD2 mAbs induce immunological cytoxicity but also direct cell death. METHODS: We report on patients treated with naxitamab for chemorefractory NB showing lesions with long periods of stable disease. Target lesions with persisting 123I-Metaiodobenzylguanidine (MIBG) uptake after 4 cycles of immunotherapy were further evaluated by functional Magnetic Resonance Imaging (MRI) and/or Fluorodeoxyglucose (FDG)-positron emission tomography (PET). MIBG avid lesions that became non-restrictive on MRI (apparent diffusion coefficient (ADC) > 1) and/or FDG-PET negative (SUV < 2) were biopsied. RESULTS: Twenty-seven relapse/refractory (R/R) HR-NB patients were enrolled on protocol Ymabs 201. Two (7.5%) of the 27 showed persistent bone lesions on MIBG, ADC high, and/or FDG-PET negative. Forty-four R/R HR-NB patients received chemo-immunotherapy. Twelve (27%) of the 44 developed persistent MIBG+ but FDG-PET- and/or high ADC lesions. Twelve (86%) of the 14 cases identified were successfully biopsied producing 16 evaluable samples. Histology showed ganglioneuroma maturing subtype in 6 (37.5%); ganglioneuroma mature subtype with no neuroblastic component in 4 (25%); differentiating NB with no Schwannian stroma in 5 (31%); and undifferentiated NB without Schwannian stroma in one (6%). Overall, 10 (62.5%) of the 16 specimens were histopathologically fully mature NBTs. CONCLUSIONS: Our results disclose an undescribed mechanism of action for naxitamab and highlight the limitations of conventional imaging in the evaluation of anti-GD2 immunotherapy clinical efficacy for HR-NB.

La preocupación como estrategia de afrontamiento en pacientes con trastornos de ansiedad generalizada / Worry as coping strategy in patients with generalized anxiety disorder

El siguiente trabajo se enmarca dentro de un proyecto UBACyT sobre conductas de afrontamiento en trastornos de ansiedad. En el presente artículo se muestran los resultados de una revisión bibliográica sobre la utilización de la preocupación como estrategia de afrontamiento en pacientes con trastorno de ansiedad generalizada. El método utilizado consistió en una búsqueda de los trabajos disponibles en las bases de datos PubMed, Scielo, Lilacs y Ebsco utilizando como palabras clave afrontamiento, ansiedad generalizada y preocupación. En primer lugar se describen brevemente las características del cuadro y se define el concepto de afrontamiento y sus diversos tipos. Seguidamente, en base a los resultados obtenidos en la búsqueda se analiza el concepto de preocupación así como las consecuencias de su uso como estrategia de afrontamiento en pacientes con trastorno de ansiedad generalizada. Finalmente se discuten las implicancias de los resultados para el tratamiento del cuadro.

The following work is part of a research project about coping behaviors in anxiety disorders. In this paper we show the results of a literature review focused on the use of worry as a coping strategy in patients with generalized anxiety disorder. The method used consisted of a bibliographic search of the available studies in the PubMed, Scielo, Lilacs and Ebsco databases using the terms coping strategies, generalized anxiety and concern as keywords. First, we briely describe the characteristics of the disorder and deine the concept of coping and its diverse forms. Then, following the results found in the search we explore the concept of worry and the consequences of its use as a coping strategy in patients with generalized anxiety disorder. Finally, we discuss the implications of the results for the treatment of the disorder.