Analytical and clinical evaluation of DiaSorin Liaison® Calprotectin fecal assay adapted for serum samples.

BACKGROUND: Calprotectin is a calcium-binding protein that can be measured in serum, plasma, and feces. Increased serum and plasma calprotectin concentrations have been found in chronic inflammatory rheumatic disorders. An analytical and clinical evaluation of the DiaSorin Liaison® fecal Calprotectin assay using LIAISON® XL was performed. METHODS: The protocol included an analytical and clinical evaluation in which imprecision, the linearity of dilution, differences between serum and plasma samples and method comparison with CalproLab™ ELISA kit were assessed. Serum calprotectin concentrations in active (n = 26) and remission (n = 23) rheumatoid arthritis (RA) patients were compared. RESULTS: The intra-day and inter-day analytical imprecision CVs ranged from 2.9% to 4.0% and 2.7% to 10.4%, respectively. Correlation between measured and expected values was high (R > 0.99), indicating good linearity. The Wilcoxon signed-rank test showed that serum and plasma matched samples presented statistically significant differences (p < 0.001) being the highest concentrations of calprotectin observed in serum samples. Deming regression equation was as follows: Diasorin calprotectin (µg/ml) = -0.32 (95% CI: -0.65 - -0.05) +1.58 (95% CI: 1.42-1.79).* Calprolab calprotectin (µg/ml). Significantly higher serum calprotectin levels were found in RA patients with active disease when compared to patients with low disease activity or in clinical remission (mean ± SD) [(3.35 µg/ml ± 1.55) vs. (1.63 µg/ml ± 0.52), p < 0.001] and these levels correlated well with all disease activity indices. CONCLUSIONS: The DiaSorin Liaison® fecal Calprotectin assay adapted for serum samples showed adequate technical performances and the clinical performances were similar to other assays.

Validation of a Microwave-Assisted Derivatization Gas Chromatography-Mass Spectrometry Method for the Quantification of 2-Hydroxybutyrate in Human Serum as an Early Marker of Diabetes Mellitus.

Circulating levels of 2-hydroxybutyrate (2HB) are highly related to glycemic status in different metabolomic studies. According to recent evidence, 2HB is an early biomarker of the future development of dysglycemia and type 2 diabetes mellitus and may be causally related to the progression of normal subjects to impaired fasting glucose or insulin resistance. In the present study, we developed and validated a simple, specific and sensitive gas chromatography-mass spectrometry (GC-MS) method specifically intended to quantify serum levels of 2HB. Liquid-liquid extraction with ethyl acetate was followed by 2 min of microwave-assisted derivatization. The method presented acceptable accuracy, precision and recovery, and the limit of quantification was 5 µM. Levels of 2HB were found to be stable in serum after three freeze-thaw cycles, and at ambient temperature and at a temperature of 4 °C for up to 24 h. Extracts derivatized under microwave irradiation were stable for up to 96 h. No differences were found in 2HB concentrations measured in serum or plasma EDTA samples. In summary, the method is useful for a rapid, precise and accurate quantification of 2HB in serum samples assessed for the evaluation of dysglycemia and diabetes mellitus.

Validation of a Gas Chromatography-Mass Spectrometry Method for the Measurement of the Redox State Metabolic Ratios Lactate/Pyruvate and ß-Hydroxybutyrate/Acetoacetate in Biological Samples.

The metabolic ratios lactate/pyruvate and ß-hydroxybutyrate/acetoacetate are considered valuable tools to evaluate the in vivo redox cellular state by estimating the free NAD+/NADH in cytoplasm and mitochondria, respectively. The aim of the current study was to validate a gas-chromatography mass spectrometry method for simultaneous determination of the four metabolites in plasma and liver tissue. The procedure included an o-phenylenediamine microwave-assisted derivatization, followed by liquid-liquid extraction with ethyl acetate and silylation with bis(trimethylsilyl)trifluoroacetamide:trimethylchlorosilane 99:1. The calibration curves presented acceptable linearity, with a limit of quantification of 0.001 mM for pyruvate, ß-hydroxybutyrate and acetoacetate and of 0.01 mM for lactate. The intra-day and inter-day accuracy and precision were within the European Medicines Agency's Guideline specifications. No significant differences were observed in the slope coefficient of three-point standard metabolite-spiked curves in plasma or liver and water, and acceptable recoveries were obtained in the metabolite-spiked samples. Applicability of the method was tested in precision-cut liver rat slices and also in HepG2 cells incubated under different experimental conditions challenging the redox state. In conclusion, the validated method presented good sensitivity, specificity and reproducibility in the quantification of lactate/pyruvate and ß-hydroxybutyrate/acetate metabolites and may be useful in the evaluation of in vivo redox states.

Prevalence and trends of markers of hepatitis B virus, hepatitis C virus and human Immunodeficiency virus in Argentine blood donors.

BACKGROUND: Transfusion-transmitted infections are a major problem associated with blood transfusion. The aim of this study was to determine prevalence and trends of HBV, HCV and HIV in blood donors in Argentina. METHODS: A retrospective study was carried out in blood donors of 27 transfusion centers covering the whole country over a period of eight years (2004-2011). Serologic screening assays for HBsAg, anti-HBc, anti-HCV, and anti-HIV were performed in all centers and nucleic acid amplification testing (NAT) was performed in 2 out of the 27 centers. RESULTS: The 2,595,852 samples tested nationwide from 2004 to 2011 showed that the prevalence of HBsAg decreased from 0.336% to 0.198% (p < 0.0001), that of anti-HBc from 2.391% to 2.007% (p < 0.0001), that of anti-HCV from 0.721% to 0.460%, (p < 0.0001) and that of anti-HIV from 0.208% to 0.200 (p = 0.075). The prevalence of HBV, HCV and HIV was unevenly distributed among the different regions of the country. Two out of 74,838 screening- negative samples were positive in NAT assays (1 HIV-RNA and 1 HCV-RNA); moreover, HBV-DNA, HCV-RNA and HIV-RNA were detected in 60.29, 24.54 and 66.67% of screening-positive samples of the corresponding assays. As regards donors age, positive HBV-DNA and HCV-RNA donors were significantly older than healthy donors (46.6, 50.5 and 39.5 y respectively, p < 0.001). CONCLUSIONS: Argentina has a low prevalence of HBsAg, anti-HCV and anti-HIV in blood donors, with a decreasing trend for HBsAg, anti-HBc and anti-HCV but not for anti-HIV over the last 8 years. The uneven distribution of transfusion-transmitted infections prevalence among the different regions of the country highlights the need to implement regional awareness campaigns and prevention. The discrepancy between samples testing positive for screening assays and negative for NAT assays highlights the problem of blood donors who test repeatedly reactive in screening assays but are not confirmed as positive upon further testing. The uneven distribution of age between healthy donors and NAT-positive donors could be related to changes in risks of these pathogens in the general population and might be attributed to a longer exposure to transmission risk factors in elderly people.

Pharmacokinetic study of dual therapy with raltegravir 400 mg twice daily and Darunavir/Ritonavir 800/100 mg once daily in HIV-1-infected patients.

BACKGROUND: Combinations of new classes of antiretroviral drugs are attractive options to avoid toxicity associated with nucleoside reverse transcriptase inhibitors (NRTIs) and to provide a full active regimen in patients with some degree of resistance to NRTIs. However, data on the pharmacokinetic (PK) profiles of these regimens are limited. We explore the plasma PK profile of raltegravir (RAL) at a dose of 400 mg twice a day plus darunavir/ritonavir (DRV/RTV) at a dose of 800/100 mg once a day in HIV-1-infected patients. METHODS: This was a pilot, open-label, fixed-sequence, prospective, single-center single-arm PK study. The treating physician chose an NRTI-sparing regimen because of toxicity or resistance mutations to NRTIs, which included DRV/RTV 800/100 mg once daily plus RAL 400 mg twice daily. All patients were RAL and DRV naive and had no evidence of protease inhibitor mutations. After at least 15 days on therapy, patients were admitted for a 24-hour PK study. Laboratory tests to assess efficacy and safety were performed at all study visits. RESULTS: Fifteen patients were included. The geometric mean values for DRV were AUC0-24 68,730 ng·h·mL [95% confidence interval (CI): 58,970-86,480], Ctrough 1330 ng/mL (95% CI: 1110-1760; IC-50 for wild-type and resistant HIV-1 strains was 55 and 550 ng/mL, respectively), Cmax 7630 ng/mL (95% CI: 6740-9000), and t1/2 10.9 hours (95% CI: 9.20-13.99). Geometric mean values for RAL were AUC0-12 3050 ng·h·mL (95% CI: 2530-5180); Ctrough 40 ng/mL (95% CI: 30-80), Cmax 970 ng/mL (95% CI: 840-2270), t1/2 2.68 hours (95% CI: 1.97-4.40). No adverse effects including rash or laboratory test abnormalities were noted. At week 24, the HIV-1 viral load was below 37 copies/mL in all patients. CONCLUSIONS: Our data suggest that dual therapy with RAL 400 mg twice daily plus DRV/RTV 800/100 mg once daily had a favorable PK profile for both drugs and that short-term efficacy and tolerability of this combination were adequate.

Association between serum 25-hydroxyvitamin D and prostate-specific antigen: a retrospective study in men without prostate pathology.

Objectives: Recently, vitamin D status has been associated with prostate cancer risk. However, some studies argue that there is no association of vitamin D with prostate cancer risk and serum prostate-specific antigen (PSA) concentrations. No clear conclusions can be drawn from the studies found in the literature. Our aim was to assess the relationship between PSA and 25-hydroxyvitamin D [25(OH)D]. Methods: We selected 415 individuals without prostate pathologies and subgroups were generated according to age and 25(OH)D. Statistical analyses were performed using Shapiro-Wilk test, Student's t and ANOVA tests, and Pearson's correlation. Besides, the minimum sample size needed to obtain statistically significant results between groups according to 25(OH)D concentration was calculated and a Student's t-test for paired samples was performed to study individuals with two PSA measurements over time, where 25(OH)D concentration increased or decreased more than 25 %. Results: We observed a slight correlation between age and PSA concentration (r=0.379, p<0.001). However, we found no significant differences when we compared PSA concentrations between groups according to 25(OH)D concentrations (p=0.891): 1.25 ± 1.32 µg/L (group with 25(OH)D<50 nmol/L) and 1.17 ± 0.90 (group with 25(OH)D≥50 nmol/L). Pearson's correlation coefficient was close to 0. The minimum samples size to obtain statistically significant results was 815,346 men, and we observed no differences in PSA concentrations in individuals with two measurements. Conclusions: Our findings show no association in men without prostate pathologies, based on 25(OH)D levels.

Validation of a routine gas chromatography mass spectrometry method for 2-hydroxyglutarate quantification in human serum as a screening tool for detection of idh mutations.

High circulating levels of 2-hydroxyglutarate (2HG) have been reported in patients with determinate isocitrate dehydrogenase (IDH) mutated tumors. Recent studies indicate that in malignancies such as acute myeloid leukemia (AML), measurements of 2HG in serum provide useful diagnostic and prognostic information and improve patient selection and monitoring of IDH-targeted treatments. In the current study, we validated a sensitive and specific gas chromatography mass spectrometry (GC-MS) method specifically intended to quantify serum levels of 2HG in routine clinical laboratories. Extraction was liquid-liquid with ethyl acetate, and derivatization was reduced to 3 min of microwave irradiation. The analytical method was linear over a wide dynamic range, presenting acceptable intraday and day-to-day precision and accuracy. The limit of quantification was 10 ng/mL, process efficiency ranged between 38% and 49%, and recovery of added 2HG was 99-105%. 2HG was found to be stable in serum for up to 48 h at both 4 °C and at ambient temperature, and after three freeze-thaw cycles. Microwave derivatizated extracts in the autosampler were found to be stable for up to 120 h. In summary, the present method is useful for quantification of 2HG serum levels in patients with IDH mutated malignancies in clinical laboratories.

El desarrollo de la noción de "mitad" en niños de dos comunidades shipibo-konibo de Ucayali / The development of the notion of "half" in children from two Ucayali's Shipibo-Konibo communities

Resumen La presente investigación tuvo como objetivo identificar y describir los niveles de desarrollo de la noción de "mitad" en un grupo de niños de dos comunidades indígenas pertenecientes al pueblo shipibo-konibo de la región Ucayali, en la Amazonía del Perú. Se trabajó con 14 estudiantes de edades entre 7 y 13 años, seis de ellos pertenecientes a la comunidad de Bethel y ocho a la comunidad de Bena Jema. Todos fueron evaluados utilizando el método clínico-crítico de Jean Piaget. Los estudiantes de la comunidad de Bethel fueron evaluados con una tarea centrada en cantidades discretas y los de la comunidad de Bena Jema, con la misma tarea y con otra centrada en cantidades continuas. Los desempeños de los participantes evidenciaron cuatro niveles de desarrollo en cada una de las tareas. Sus respuestas fueron consistentes con otras investigaciones que evaluaron la misma noción en contextos occidentales. Los resultados apoyan la universalidad en la construcción de la noción de "mitad", pero evidencian un retraso en la adquisición de los niveles por parte de los niños evaluados, si se toma como referencia los currículos nacionales. Se discuten los hallazgos resaltando la universalidad de las estructuras lógico-matemáticas y la necesidad de repensar el momento y la forma en que la noción de "mitad" aparece en el currículo.

Abstract This research aims to identify and describe developmental levels of the notion of "half" in a group of children from two Shipibo-Konibo native communities of the Ucayali region, in the Peruvian Amazon rainforest. Fourteen students aged between 7 and 16 participated, six from Bethel community and eight from Bena Jema community. The community of Bethel is located approximately 6 hours by river from the city of Pucallpa, while Bena Jema is located within Pucallpa's boundaries, in the Yarinacocha district. All participants were assessed using Jean Piaget's clinical-critical method, with two tasks. In the first task, focusing on discrete quantities: different sets of cards with the picture of a fish were presented sequentially, some with an even number of units and some with an odd number. Participants were asked to choose and present back half of each set. In the second task, focusing on continuous quantities: participants were asked to choose and present half of a single raw spaghetti, which they needed to break with their hands. If the resulting pieces were unequal, they were asked to break them again and redistribute the results. Students from Bena Jema community were assessed with both tasks, while students from Bethel community were assessed only with the discrete quantities task. The results showed four developmental levels in the discrete quantities task. In the first level, participants took any one of two parts of the set to be "half", without checking if they were equal or whether putting them back together reconstituted the original whole. In the second level, participants took any one of two equal parts to be "half", but were inconsistent and accepted the possibility of the parts being unequal. In the third level, participants only took any one of two equal parts to be "half" but had difficulties splitting odd-numbered sets, including sets with fewer elements than the even-numbered ones they had previously split correctly. In the fourth level, the task was solved successfully with both even-numbered and odd-numbered sets. For the continuous quantities task, three levels were found. In the first level, any one of two raw spaghetti pieces was taken to be "half", without checking their evenness. In the second level, participants took any two equal pieces of the raw spaghetti to be "half", but without checking whether putting them back together reconstituted the original whole, with no extra parts remaining. In the third level, participants took any one of two equal pieces to be "half", checking whether putting them back together reconstituted the original whole. These results are consistent with reports from previous research assessing the notion of "half" in Western contexts. Results support universality in the development of the notion of "half", but show a delay in the participants' level of acquisition, taking Peru's national curriculum as reference. This study is a contribution to the understanding of the development of the notion of "half" in indigenous children living in Amazonian native communities, and shows the relevance of the Piagetian clinical-critical interview in these sociocultural contexts. The implications of these findings are discussed in relation to the universality of logical-mathematical knowledge, as well as the need to rethink the timing and manner in which the notion of "half" appears in the curriculum.

Development and validation of a UHPLC diode array detector method for meropenem quantification in human plasma.

OBJECTIVES: Meropenem is a ß-lactam antibiotic frequently used to treat serious infections in intensive care unit patients. The main objective was to develop and validate a sensitive and specific ultra high performance liquid chromatography method with photodiode array detection for the quantitation of meropenem in human plasma. The applicability of the method for meropenem monitoring was also examined. DESIGN AND METHODS: The validation of the method was performed following the FDA's guidelines for bioanalytical methods. In parallel, the method was applied for monitoring meropenem in forty plasma samples from ten critically ill patients treated intravenously at a total dose of 1 g. Drug levels were measured in each patient at 0 h, 2 h, 4 h and 8 h after meropenem infusion. RESULTS: With this method, intraday and day-to-day variation was below 10%; intraday and day-to-day accuracy was between 94% and 114%; the limit of quantification was 0.5 µg/mL and recovery was above 70%. The method was successfully applied to quantitate meropenem concentrations and the results showed significant pharmacokinetic interindividual variability. Of special interest is that 50% of treated patients had meropenem plasma levels below the minimum inhibitory concentration at 8h after the start of infusion, which was strongly related to creatinine clearance >60 mL/min. CONCLUSIONS: The method meets the requirements to be applied for meropenem concentration measurements in pharmacokinetics studies and clinical routine. The results suggest the need for therapeutic drug monitoring of meropenem in treated critically-ill patients.

Evaluación de operaciones lógico-matemáticas mediante dos métodos distintos en niños del pueblo indígena Shipibo-Konibo / Assessment of mathematical operations by two different methods in Shipibo-Konibo indigenous children

Se presentan los resultados de una evaluación de las operaciones matemáticas de adición y sustracción, en un grupo de niños de enseñanza primaria (5 niñas y 2 niños) de 7, 9 y 11 años, de una comunidad nativa Shipibo-Konibo de la región Ucayali, en la Amazonía del Perú. Se realizó con dos métodos distintos, la Entrevista Clínico-crítica de Piaget, que incluyó problemas culturalmente contextualizados y material representativo y manipulable como figuras de animales y bolitas para armar collares, y una prueba tradicional de lápiz y papel. Ambas pruebas evaluaron el mismo tipo de operaciones, extraídas de lo que propone el diseño curricular nacional para esos grados. Los resultados muestran que los niños tienen dificultades tanto en la adición como en la sustracción y no logran resolver con éxito todas las tareas. Sin embargo, se pueden observar mejores resultados con la evaluación cualitativa por medio de la entrevista clínico-crítica, en contraste con la evaluación tradicional de lápiz y papel que evidencia resultados mucho más pobres. La primera otorga además mayor información sobre el proceso operativo de los niños y muestra que los niveles de desarrollo de sus competencias matemáticas van de la mano con lo que plantea la teoría piagetiana. Los resultados se discuten señalando la universalidad del conocimiento lógico-matemático y su pertinencia para comprender los procesos de aprendizaje en contextos de diversidad cultural y analizando críticamente el modo en que la evaluación constructivista ofrece mayor información y recursos para los docentes de educación intercultural bilingüe de comunidades amazónicas del Perú.

Elementary-school children from a Shipibo-Konibo indigenous community in the Ucayali region, in the Amazonian rainforest of Perú, were evaluated regarding their abilities to solve addition and subtraction problems. These operations were assessed by two means: through Jean Piaget's clinical-critical method (using culturally contextualized problems and concrete materials such as pictures of Amazonian fish, pictures of arrows, or beads and thread to make necklaces), and by a traditional pencil-and-paper test. Both the clinical interview and the pencil-and-paper test evaluated the same type of operations, which were taken from the national curricular program for these school grades. The Shipibo-Konibo people are an Amazonian indigenous group that speaks a native language in the Panoan family; since most members of this group are fluent in Spanish, however, no translator was needed and the assessments were conducted in Spanish. The Shipibo-Konibo people are principally settled along the Ucayali River in the Amazon rainforest in Perú, although currently many of them have relocated to other areas of the country, including Lima the capital city, in search of better work or education opportunities. After the Asháninka and the Awajún, the Shipibo-Konibo is the third largest Amazonian indigenous group in Perú. Informed consent was obtained following the guidelines of Frisancho, Delgado, and Lam (2015), which are based on previous experience working with Amazonian indigenous communities in the Ucayali region of Peru. As research has shown that individuals from cultural diverse backgrounds may have different expectations for the research process, and may perceive it in a different way than people from industrialized nations (Lakes, Vaughan, Jones, Burke, Baker, & Swanson 2012), informed consent included both individual consent and a communitarian meeting. It also included the donation of gifts (tools, groceries, and other useful items) for the community, and a debriefing meeting with the community's school teachers. The assessment was conducted by two researchers in a school classroom. It took around 30 minutes with the older children and 45 with the younger ones. In all cases the clinical-critical interview was applied first (addition and then subtraction), and finally the pencil-and-paper test. Although a native speaker of shipibo was present during the evaluation, his services were not needed as children were fluent in Spanish. Results show that children have difficulties in the development of both addition and subtraction. They make counting mistakes and have trouble understanding the logic of subtraction (taking a number from another, larger one). Some do not conceptualize subtraction as the opposite of addition and, in consequence, cannot foresee that joining two numbers that were previously separated will result in the same original quantity. Children aged seven were unable to solve any of the operations in the pencil-and-paper test. However, better results were obtained through qualitative, Piagetian assessments, in contrast to the quantitative, pencil-and-paper assessments. During the interviews, children were able to show their cognitive processes and ways of thinking while solving the problems, and with scaffolding, the use of concrete materials such as pictures or beads, and strategic help from the evaluators (Parrat, 2016a, 2016b), many of them were also able to develop a better comprehension of the problem and self-correct their initial answers. Developmental levels for addition and subtraction consistent with Piagetian theory were identified. These levels show a progression from the impossibility of grasping logical addition or subtraction, to the capabilities of psychological reversibility and logical composition of inverse and direct operations. The results are discussed using Piaget's theory and the problem of particulars and universals in cognitive development, and analyzing critically how this kind of assessment can help elementary school teachers respond to the needs of intercultural bilingual education in Peru's Amazonian indigenous communities.

Is the intracellular ATP concentration of CD4+ T-Cells a predictive biomarker of immune status in stable transplant recipients?

BACKGROUND: Intracellular ATP (iATP) production in CD4(+)-T cells has been proposed as a biomarker for routine personalized monitoring in transplant recipients. The aim of our study was to measure this biomarker in adult renal and liver transplant recipients receiving moderate immunosuppressive treatment (IST) during the maintenance period and to evaluate whether this biomarker can effectively predict clinical status (stability, rejection, or infection) and drug effect. METHODS: iATP concentration and trough blood levels of IST were evaluated in 84 adult transplant recipients (50 renal and 34 liver) during the maintenance period. One hundred and fifty healthy donors were also recruited as a control group. In addition, 22 of 34 liver transplant recipients were included in a clinical study in which IST was withdrawn gradually until total elimination. RESULTS: Most of the patients evaluated had iATP levels in the moderate immune response zone during a posttransplantation maintenance period with no relevant clinical events. iATP levels were significantly lower in transplant patients with infection (n=3) than in those free of infection. In the IST withdrawal study, 10 of 22 liver transplant recipients have achieved complete withdrawal and 12 receive 50% of IST. So far, there have been eight rejections once IST began to be withdrawn. None of these patients had iATP in the strong immune response zone (risk of rejection). CONCLUSIONS: iATP seems to be more effective in identifying overimmunosuppressed patients with a high risk of adverse events (IST-safety) than in identifying those with a high risk of rejection (IST-efficacy) and should be used in combination with other biomarkers of immunosuppressive effect to improve the efficacy of IST.

Adicciones y fetichismo / Addiction and fetichism

El trabajo establece una serie de relaciones entre conflicto pulsional, neurosis actuales y psiconeurosis, para comparar la adicción con el fetichismo. En ambas patologías se trata con objetos –fetiche o droga- que no son verdaderos símbolos, sino más bien equiparaciones simbólicas, objetos que no se gastan, no pierden su significado y obstruyen la deriva simbólica, promoviendo rituales que no se resuelven en síntomas sino se realizan como actos. Aun cuando un observador juzgaría que el fetichismo elude la sexualidad y la adicción tóxica conduce a la muerte, tanto el fetiche como la droga aparecen para el fetichista y para el adicto como la condición absoluta de potencia y satisfacción sexual en el primer caso y de vida y saciedad en el otro. Pueden señalarse otras afinidades, así como el fetiche da consistencia al pene sustancial que la ilusión supuso a la madre, la droga parece dar consistencia a una experiencia satisfactoria mítica, ambos objetos parecen ser los emblemas de triunfo uno frente a la angustia de castración, otro frente a la angustia de separación, de vacío o de desánimo, alojando en su estructura tanto la repudiación como la afirmación de lo que angustia.

Experiencia analítica: entre lo imprevisto y lo sabido / Analitic experience: betwen the unexpected and the know

Proponemos una lectura que tenga en cuenta la historia del movimiento analítico, considere sus desvíos, reconozca el rechazo y retorno de ciertas ideas, advierta sus mutaciones, explore la genealogía de los conceptos que sirvieron de fundamento a distintas corrientes y procure conmover la fijeza en la que a veces cristaliza su sistematización en escuelas. Desplegado el conjunto heterógeneo de elaboraciones, instrumentos clínicos y metapsicológicos producidos por el psicoanálisis priorizamos, más allá del destino que lo coyuntural haya decidido para tal o cual noción, su potencialidad de verdad y de sorpresa para perfilar la trayectoria de las ideas freudianas confluyentes en el psicoanálisis actual que al igual que el psicoanálisis de los inicios tiene su suelo en una experiencia de interlocución basada en la convicción de la determinación inconsciente.

La abstinencia en la clínica de la deprivación / Abstinence in the clinic of the deprivation

El estudio de la deprivación y de la tendencia antisocial nos permitió advertir que una serie de fenómenos clínicos abordados clasicamente como resistenciales eran susceptibles de ser engarzados con ciertas acciones específicas sugeridas como instrumentos clínicos, constituyendo en su conjunción configuraciones transferenciales específicas. Postulamos que la clínica de la deprivación evidencia de manera ejemplar el valor instrumental y el alcance de la noción de abstinencia. En términos freudianos, se trata del dominio de la contratransferencia, de la respuesta en lugar de la reacción, confiriendo a la abstinencia el mérito de aunar efectivamente ética y técnica...