Case-Case Comparison of Candida auris Versus Other Candida Species Bloodstream Infections: Results of an Outbreak Investigation in Colombia.

BACKGROUND: Candida auris is an emerging multidrug-resistant yeast that causes outbreaks in healthcare settings around the world. In 2016, clinicians and public health officials identified patients with C. auris bloodstream infections (BSI) in Colombian healthcare facilities. To evaluate potential risk factors and outcomes for these infections, we investigated epidemiologic and clinical features of patients with C. auris and other Candida species BSI. METHODS: We performed a retrospective case-case investigation in four Colombian acute care hospitals, defining a case as Candida spp. isolated from blood culture during January 2015-September 2016. C. auris BSI cases were compared to other Candida species BSI cases. Odds ratio (OR), estimated using logistic regression, was used to assess the association between risk factors and outcomes. RESULTS: We analyzed 90 patients with BSI, including 40 with C. auris and 50 with other Candida species. All had been admitted to the intensive care unit (ICU). No significant demographic differences existed between the two groups. The following variables were independently associated with C. auris BSI: ≥ 15 days of pre-infection ICU stay (OR: 5.62, CI: 2.04-15.5), evidence of severe sepsis (OR: 3.70, CI 1.19-11.48), and diabetes mellitus (OR 5.69, CI 1.01-31.9). CONCLUSION: Patients with C. auris BSI had longer lengths of ICU stay than those with other candidemias, suggesting that infections are acquired during hospitalization. This is different from other Candida infections, which are usually thought to result from autoinfection with host flora.

A psicanálise nas políticas sociais públicas / The psychoanalysis in social public policies

Resumo: Aborda a inserção da psicanálise nas políticas sociais públicas, ressaltando as primeiras considerações freudianas sobre o assunto. Discute sua pretensão como direito no contexto de sua não regulamentação profissional e concepção de formação. Trabalha o tema por meio dos desdobramentos da segunda tópica freudiana e da crítica lacaniana aos desvirtuamentos da análise em termos de educação, adaptação à realidade e conscientização. Por fim, chama atenção para uma direção na qual se mantém o rigor e o caráter não tendencioso da psicanálise no âmbito dessas políticas.

Abstract: This paper approaches the insertion of psychoanalysis in social public policies, highlighting Freudian first considerations on the subject. It discusses the claim of analysis as a right in the context of its non-professional regulation and specific training. It intends the theme through the outspread from the Freudian second topic and the Lacanian critique of psychoanalysis distortions in terms of education, reality adaptation and consciousness. Finally, it aims on a direction in which it maintains the accuracy and non-tendencious character of psychoanalysis within these policies.

O herói na psicanálise de Freud e Lacan: revolução e subversão / Le héros dans la psychanalyse de Freud et Lacan: révolution et subversion / El héroe en la psicoanálisis de Freud y Lacan: revolución y subversión / The hero in Freudian and Lacanian psychoanalysis: revolution and subversion

Resumo Embora o herói não receba um estatuto propriamente conceitual, o termo é recorrente no pensamento de Freud e Lacan no cerne da elaboração teórico-clínica da psicanálise. Este texto trabalha os desdobramentos das significações do herói de acordo com as transformações da metapsicologia analítica. A partir disso, traz duas dimensões do herói no âmbito dos destinos do sujeito no mal-estar na civilização: a revolução, que se lança a uma transformação nos laços sociais, mas promove a manutenção do lugar do Pai, e a subversão, que avança em um ato que produz mudanças em relação às coordenadas simbólico-imaginárias que determinam o sujeito.

Résumé Bien que le héros ne reçoive pas un statut proprement conceptuel, ce terme est récurrent dans les pensées de Freud et Lacan dans les développements théorico-cliniques de la psychanalyse. Cet article traite des significations du héros selon les transformations de la métapsychologie. De là, il apporte deux dimensions du héros à propos des destins du sujet dans le malaise de la civilisation: la révolution, qui se lance vers une transformation des liens sociaux, mais qui favorise la manutention de la place du Père ; et la subversion, qui avance dans un acte qui produit des changements par rapport aux coordonnées symboliques-imaginaires qui déterminent le sujet.

Resumen Aunque el héroe no reciba un estatuto propiamente conceptual, este término es recurrente en el pensamiento de Freud y Lacan en el centro de la elaboración teórico-clínica del psicoanálisis. Este texto trabaja los desdoblamientos de las significaciones del héroe de acuerdo con las transformaciones de la metapsicología analítica. A partir de eso, trae dos dimensiones del héroe en el ámbito de los destinos del sujeto en el malestar de la civilización: la revolución, que se lanza a una transformación en los lazos sociales, pero promueve el mantenimiento del lugar del Padre; y la subversión, que avanza en un acto que produce cambios con relación a las coordenadas simbólico-imaginarias que determinan al sujeto.

Abstract Although the hero does not receive a properly conceptual statute, the term is recurrent in Freudian and Lacanian thoughts inside the theoretical-clinical elaborations of Psychoanalysis. This study unfolds the meanings of hero according to the transformations of analytical metapsychology. From this, it brings two dimensions of the hero regarding the destinies of the subject inside civilization and its discontents: revolution, which is launched to a transformation in social bonds, but promotes the maintenance of the Father's place; and subversion, which advances in an act that produces changes regarding the symbolic and imaginary coordinates that determines the subject.