El malestar a través de la voz y la forma subjetiva del saber hacer con el conflicto. Un estudio de caso / Discomfort through the voice and the subjective form of knowing do with the conflicto. A case study

La voz es un elemento particular de los primeros años de vida en el sujeto debido a que es una de las formas de manifestar su necesidad, un deseo, u otro, por lo cual se adopta como una herramienta que se vincula a los procesos anímicos; puede ser una forma de ver síntomas o malestares que el paciente no quiere ni confesarse, ni confesar en una consulta. Objetivo: Comprender la manifestación del malestar a través de la voz del sujeto y la forma subjetiva del saber hacer con el conflicto, que apertura la importancia de la voz en el proceso psicoterapéutico. Materiales y métodos: Se enmarcó en un paradigma fenomenológico, es una investigación de campo con enfoque cualitativo mediante un estudio de caso. Resultados: A partir de este estudio se pudo determinar que el malestar incide en la voz del sujeto cuando no puede ser expresado con anterioridad, por tanto, la voz es una forma de expresión inconsciente que en ocasiones no es percibida por el sujeto que manifiesta un malestar. Conclusiones: El fenómeno de la voz está presente en los sujetos que formaron parte de esta investigación, pero cada uno de ellos lo formula de manera distinta, haciendo del malestar un saber hacer individual; por medio de la voz se manifiestan los silencios, el grito, el llanto y variadas formas orales que indican que hay asuntos pendientes, reflejando el conflicto que tiene el individuo con lo que está refiriendo, así deja huellas fonéticas en todo lo que nos relata(AU)

The voice is a particular element of the first years of life in the subject due to which is one of the ways to express their need, a desire, or another, for which it is adopted as a tool that is linked to psychic processes; it may be a way of seeing symptoms or discomforts that the patient does not want to confess or confess in a consultation. Objective:Understand the manifestation of discomfort through the voice of the subject and the subjective form of knowing how to deal with conflict, which opens up the importance of the voice in the psychotherapeutic process. Materials and methods:It was framed in a phenomenological paradigm, it is an investigation of field with a qualitative approach through a case study. Results:From this study it was possible to determine that discomfort affects the voice of the subject when it cannot be expressed with previously, therefore, the voice is a form of unconscious expression that sometimes is not perceived by the subject who manifests discomfort. Conclusions:The phenomenon of the voice is present in the subjects who were part of this investigation, but each one of them formulates it in a different way, making discomfort an individual know-how; through the voice silences, screaming, crying and various oral forms that indicate thatthere are issues pending, reflecting the conflict that the individual has with what he is referring to, thus leaving traces phonetics in everything he tells us(AU)

A falha básica: alguns aspectos sobre a teoria da técnica em Michael Balint / La falla básica: algunos aspectos de la teoría de la técnica en Michael Balint

O artigo aborda alguns pontos teóricos sobre a técnica, pontos estes relacionados aos pacientes que funcionam de forma ao nível da falha básica, como descreve o psicanalista Michael Balint. O objetivo é trazer reflexões para o atendimento dos pacientes que apresentam quadros regressivos, no sentido de permitir a vivência do novo começo. O texto discute algumas ideias da teoria balintiana sobre a questão da regressão em psicanálise (Au)

The article addresses some theoretical points about the technique related to patients who function more at the level of basic failure, as described by psychoanalyst Michael Balint. The objective is to bring reflections for the care of patients who present regressive conditions in order to allow the experience of the new beginning. The text discusses some ideas of the Balintian theory on the issue of regression in psychoanalysis.

El artículo aborda algunos puntos teóricos sobre la técnica, puntos que se relacionan con pacientes que funcionan en el nivel de falla básica, como lo describe el psicoanalista Michael Balint. El objetivo es traer reflexiones para el cuidado de los pacientes que presentan condiciones regresivas, a fin de permitir la experiencia de un nuevo comienzo. El texto analiza algunas ideas de la teoría balintiana sobre el tema de la regresión en psicoanálisis

Regressões em análise: contribuições de Ferenczi e Balint para a técnica psicanalítica / Regressions in psychoanalysis: Ferenczi's and Balint's contributions to the psychoanalytic technique / Regresiones en análisis: contribuciones de Ferenczi y Balint a la técnica psicoanalítica

Na clínica psicanalítica contemporânea temos nos defrontado, cada vez mais, com impasses técnicos que nos exigem repensar a teoria sobre a técnica psicanalítica. Essa revisão teórica se justifica a partir de uma maior incidência de quadros clínicos cujo dinamismo psíquico não se encontra balizado hegemonicamente pela lógica do recalque, mas pela predominância de outros mecanismos defensivos, como a clivagem/splitting do eu, e formas de expressão não verbais como passagens ao ato e acting outs. Diante da necessidade de reconfigurar alguns parâmetros da técnica psicanalítica, delimitamos como objetivo deste artigo a investigação do tema do manejo clínico das regressões em análise a partir das contribuições teórico-clínicas de Sándor Ferenczi e de seus desdobramentos e avanços propostos Michael Balint. Assim, pretendemos extrair das modificações no dispositivo analítico propostas por esses autores, elementos que nos ajudem a pensar o manejo clínico com pacientes cujo sofrimento remete às falhas traumáticas dos primórdios da constituição subjetiva.

In contemporary psychoanalytic clinic we have faced increasingly technical deadlocks that require to rethink the psychoanalytic technique theory. This situation requires a revision of psychoanalysis technical theory. This theoretical revision is justified by a higher incidence of clinical conditions whose psychic dynamic is not hegemonic marked by the logic of repression, but the predominance of other defensive mechanisms, e.g. splitting, and non-verbal forms of expression such as acting out. Given the need to reconfigure some parameters of the psychoanalytic technique, we set as the objective of this article the investigation of clinical management of regressions under analysis from the theoretical and clinical contributions of Sándor Ferenczi and from developments and advances by Michael Balint. Therefore, from the changes proposed by these authors, we will attempt to extract elements that will help us think different clinical management of patients whose suffering refers to traumatic failures in the early stages of development, in an analytical setting.

En la clínica psicoanalítica contemporánea nos hemos enfrentado, cada vez más, con impases técnicos que nos obligan a repensar la teoría sobre la técnica psicoanalítica. Esta revisión teórica se justifica por una mayor incidencia de cuadros clínicos cuyo dinamismo psíquico no responde a la lógica de la represión, sino por el predominio de otros mecanismos defensivos, como el clivaje / escisión del yo, y formas de expresión no verbal como pasajes al acto y "acting outs". Ante la necesidad de reconfigurar algunos parámetros de la técnica psicoanalítica, el objetivo de este artículo es delinear la investigación del tema del manejo clínico de las regresiones en análisis, a partir de las contribuciones teórico-clínicas de Sándor Ferenczi y sus desdoblamientos y avances en la teoría de Michael Balint. Así, pretendemos extraer, de las modificaciones en el dispositivo analítico propuestas por esos autores, elementos que nos ayuden a pensar sobre el manejo clínico con pacientes cuyo sufrimiento remite a los fracasos traumáticas de los primordios de la constitución subjetiva.

El Leonardo de Freud: notas cruzadas sobre la interpretación en la cura y fuera de la cura / Freud's Leonardo. Cross notes on interpretation in the cure and outside the cure

La posteridad de Un recuerdo infantil de Leonardo da Vinci de Sigmund Freud (1910) se ha centrado en el error de traducción del psicoanalista, del italiano al alemán, de un recuerdo del artista (buitre en lugar de milano). Al releer este texto y volver a ciertas etapas de su posteridad, el artículo ofrece una reflexión sobre los desafíos de la interpretación, tanto en la cura como fuera de ella. El carácter abierto y fundamentalmente inscrito en un entresujetos de la interpretación resulta fructífera para los teóricos del arte

The posterity of Sigmund Freud's Leonardo da Vinci.A Memory of His Childhood (1910) emphasized the translation error by the psychoanalyst from Italian to German of a memory of the artist (vulture instead milan). By rereading this text and returning to certain steps of its posterity, the article offers a reflection on the challenges of interpretation, both in psychoanalytical treatment and outside. The open and fundamentally intersubjective nature of psychoanalytical interpretation proves fruitful for art theorists

Psychiatric illness and regression in individuals with Phelan-McDermid syndrome.

BACKGROUND: Phelan-McDermid syndrome (PMS) is a genetic condition characterized by intellectual disability, speech and language deficits, hypotonia, autism spectrum disorder, and epilepsy. PMS is caused by 22q13.33 deletions or mutations affecting SHANK3, which codes for a critical scaffolding protein in excitatory synapses. SHANK3 variants are also known to be associated with an increased risk for regression, as well as for psychiatric disorders, including bipolar disorder and catatonia. This study aimed to further describe these phenomena in PMS and to explore any relationship between psychiatric illness and regression after early childhood. METHODS: Thirty-eight people with PMS were recruited to this study through the Phelan-McDermid Syndrome Foundation based on caregiver report of distinct development of psychiatric symptoms. Caregivers completed a clinician-administered semi-structured interview focused on eliciting psychiatric symptomatology. Data from the PMS International Registry were used to confirm genetic diagnoses of participants and to provide a larger sample for comparison. RESULTS: The mean age of the 38 participants was 24.7 years (range = 13 to 50; SD = 10.06). Females (31 of 38 cases; 82%) and sequence variants (15 of 38 cases; 39%) were over-represented in this sample, compared to base rates in the PMS International Registry. Onset of psychiatric symptoms occurred at a mean age of 15.4 years (range = 7 to 32), with presentations marked by prominent disturbances of mood. Enduring substantial loss of functional skills after onset of psychiatric changes was seen in 25 cases (66%). Symptomst indicative of catatonia occurred in 20 cases (53%). Triggers included infections, changes in hormonal status, and stressful life events. CONCLUSIONS: This study confirms that individuals with PMS are at risk of developing severe neuropsychiatric illness in adolescence or early adulthood, including bipolar disorder, catatonia, and lasting regression of skills. These findings should increase the awareness of these phenotypes and lead to earlier diagnosis and the implementation of appropriate interventions. Our findings also highlight the importance of genetic testing in the work-up of individuals with intellectual disability and acute psychiatric illness or regression. Future research is needed to clarify the prevalence and nature of psychiatric disorders and regression among larger unbiased samples of individuals with PMS.

A pulsão de morte no primeiro Ferenczi: quietude, regressão e os primórdios da vida psíquica / La pulsión de muerte en el primer Ferenczi: quietud, regresión y los primordios de la vida psíquica / Death drive in the first Ferenczi: a quiet state, regression, and the beginnings of psychic life

Este artigo procura expor e discutir o uso que Ferenczi faz da ideia de pulsão de morte, ainda na década de 1910. Apresentamos a história e o contexto da utilização da ideia entre os primeiros psicanalistas e, em seguida, argumentamos que a primeira hipótese do analista húngaro sobre a pulsão de morte procurava relacionar um estágio de onipotência incondicional, característico, a seu ver, da vida intrauterina, com um estado de quietude originário, uma tendência à regressão e uma concepção do narcisismo primitivo. Cada um desses aspectos é problematizado junto à teoria freudiana. Ao final, fazemos uma análise crítica da hipótese à luz das postulações de outros autores.

Este artículo busca exponer y discutir el uso que Ferenczi hace de la idea de pulsión de muerte, aún en la década de 1910. Presentamos la historia y el contexto de la utilización de la idea entre los primeros psicoanalistas y, a continuación, argumentamos que la primera hipótesis del analista húngaro sobre la pulsión de muerte buscaba relacionar una etapa de omnipotencia incondicional, característico, a su ver, de la vida intrauterina, con un estado de quietud originario, una tendencia a la regresión y una concepción del narcisismo primitivo. Cada uno de estos aspectos es problematizado junto a la teoría freudiana. Al final, hacemos un análisis crítico de la hipótesis a la luz de las postulaciones de otros autores

This article seeks to present and discuss Ferenczi's use of the idea of a death drive in the 1910s. We present the history and context of the use of the idea among the first psychoanalysts, and then argue that Ferenczi's first hypothesis on the death instinct sought to relate a stage of unconditional omnipotence, characteristic, in his view, of intrauterine life, with an original state of quietness, a tendency to regression and a conception of primitive narcissism. We then compare each one of these aspects with the Freudian theory. In conclusion, we make a critical analysis of the hypothesis using the ideas of other authors.

Psicoterapia de grupos e Psicologia Analítica / Group Psychotherapy and Analytical Psychology

Jung e a Psicologia Analítica não contemplaram em profundidade o estudo da psicoterapia de grupos, tendo privilegiado o trabalho clínico individual. O presente artigo tem como objetivo principal fornecer um panorama descritivo das pesquisas sobre como a participação em pequenos grupos psicoterapêuticos pode influenciar no processo de individuação de seus membros, no referencial da Psicologia Analítica, e também, como um objetivo secundário, recapitular e confrontar com o que a literatura da área expõe sobre o tema. Para isso, foi feito num primeiro momento uma revisão estruturada, em bases de dados. Os critérios de seleção do material é que fossem artigos, em português e inglês, que tratassem do desenvolvimento da personalidade no interior de pequenos grupos de desenvolvimento pessoal, na área da psicologia analítica. Na sequência foi feita uma pesquisa não estruturada, levantando artigos frequentemente citados e também através da literatura da área e posteriormente uma revisão integrativa que aponta a dificuldade do tema no campo da psicologia analítica, especialmente pelo receio dos processos de identificação e regressão entre os membros do grupo - que para Jung operariam invariavelmente contra a individuação. Os artigos levantados questionam essa afirmação e apresentam possibilidades de desenvolvimento psíquico no interior desses grupos e correlacionam individuação com vida em sociedade. Eles também propõem métodos de psicoterapia grupal no referencial da psicologia analítica. Considera-se que pequenos grupos fazem parte do contexto de vida de qualquer indivíduo, e seu potencial para favorecer a individuação ainda precisa ser melhor compreendido.(AU)

Jung and Analytical Psychology did not contemplate in depth the study of the psychotherapy of groups, having privileged the individual psychotherapy. The main objective of this article is to provide a descriptive overview of the researches on how the participation in small psychotherapeutic groups can influence the individuation process of its members in the framework of Analytical Psychology and - as a secondary objective - to recapitulate and confront it with what the literature of the area exposes about this subject. In order to do that, a structured review was firstly carried out in the databases. The criteria for selecting the material were them to be articles, in both Portuguese and English, dealing with the development of personality, within small groups of personal development, in analytical psychology field. Secondly, an unstructured research was executed, with the examination of the most cited articles, and also a thorough search through the literature of the matter. Lastly an integrative revision was made and that signalized the difficulty of the subject in the field of analytical psychology, especially because of the fear of the processes of identification and regression between the members of the group - which for Jung would invariably work against individuation. The examined articles question this statement and present possibilities of psychic development within these groups and correlate individuation with life in society. They also propose methods of group psychotherapy in the framework of analytical psychology. Small groups are considered part of the life context of any individual, and their potential for individuation still needs to be better understood.(AU)

Jung y la Psicología Analítica no contemplaron en profundidad el estudio de la psicoterapia de los grupos, habiendo privilegiado trabajo clínico del individuo. El presente artículo tiene como objetivo principal proporcionar un panorama descriptivo de las investigaciones sobre cómo la participación en pequeños grupos psicoterapéuticos puede influir en el proceso de individuación de sus miembros, en el enfoque de la Psicología Analítica, y también, como un objetivo secundario, recapitular y confrontar con lo que la literatura del área expone sobre el tema. Para ello, se hizo en un primer momento una revisión estructurada, en bases de datos. Los criterios de selección de materiales es que fuesen artículos en portugués y inglés, que tratasen del desarrollo de la personalidad dentro de pequeños grupos de desarrollo personal en el campo de la psicología analítica. En la secuencia se realizó una investigación no estructurada, buscando artículos frecuentemente citados y también a través de la literatura del área y posteriormente una revisión integrativa que apunta la dificultad del tema en el campo de la psicología analítica, especialmente por el temor de los procesos de identificación y regresión entre los miembros del grupo - que para Jung operaría invariablemente contra la individuación. Los artículos encontrados cuestionan esa afirmación y presentan posibilidades de desarrollo psíquico en el interior de esos grupos y correlacionan individuación con vida en sociedad. También proponen métodos de psicoterapia grupal en el referencial de la psicología analítica. Se considera que pequeños grupos forman parte del contexto de vida de cualquier individuo, y su potencial para favorecer la individuación aún necesita ser mejor comprendido.(AU)

Pulsões de destruição e doenças somáticas / Destructive drives and somatic illnesses / Pulsiones de destrucción y enfermedades somáticas

O autor examina primeiramente a ambiguidade dos conceitos de P. Marty (regressão, desorganização). Considera a necessidade da revisão do conceito de pulsão, que, tal qual concebido, explica insuficientemente as desorganizações da psicossomática. Propõe a hipótese de uma dissociação precoce entre a pulsão e o objeto nas estruturas psicossomáticas. Conclui com o exemplo de Goya, que sofreu crises somáticas que quase o levaram à morte, e sua produção das Pinturas negras, posterior a esse período

The author first examines the ambiguity in the concepts of Pierre Marty (regression, disorganisation). He considers the need to revise the concept of the drive which as it now stands, does not account well enough for disorganisations in psychosomatics. He proposes the hypothesis of an early dissociation between the drive and the object in psychosomatic structures. He concludes using the example of Goya who suffered from somatic crises which almost killed him, afterwards leading him to produce the Black paintings

El autor destaca en primer lugar la ambigüedad de los conceptos de Pierre Marty (regresión, desorganización) y contempla la necesidad de revisar el concepto de pulsión que, tal cual, no refleja las desorganizaciones de la psicosomática. Propone la hipótesis de una disociación precoz entre la pulsión y el objeto en las estructuras psicosomáticas. Concluye con el ejemplo de Goya y las crisis de somatización que le llevaron al borde de la muerte y desembocaron en la producción de las Pinturas negras

Genomic analysis of small nucleolar RNAs identifies distinct molecular and prognostic signature in hepatocellular carcinoma.

As one of the most lethal malignancies worldwide, hepatocellular carcinoma (HCC) has a high mortality rate, which is mainly due to the complex and multi­step aberrations in gene expression associated with it. Small nucleolar RNAs (snoRNAs), non­coding RNAs that are 60­300 nucleotides in length, have been proposed to be closely associated with numerous human diseases, including HCC. However, the current knowledge regarding their clinical significance and mechanistic roles in HCC is limited. The present study comprehensively analyzed the snoRNA expression profiles in HCC and identified several ones that were dysregulated. The potential regulatory mechanisms of these snoRNAs were assessed via gene functional enrichment analyses. Univariate and multivariate Cox regression analyses were performed to identify snoRNAs that are independently associated with the risk of mortality. Subsequently, a prognostic index (PI) for survival prediction was established, which may serve as a prognostic biomarker for patients with HCC (hazard ratio, 3.023; 95% confidence interval: 1.785­5.119; P<0.001). In addition, a series of bioinformatics analyses were performed to identify potential differences in the perturbation of pathways between high­ and low­risk groups. The PI developed in the present study was determined to have a moderate predictive value regarding the clinical outcome for HCC patients.

Predicting microRNA-disease associations using bipartite local models and hubness-aware regression.

The development and progression of numerous complex human diseases have been confirmed to be associated with microRNAs (miRNAs) by various experimental and clinical studies. Predicting potential miRNA-disease associations can help us understand the underlying molecular and cellular mechanisms of diseases and promote the development of disease treatment and diagnosis. Due to the high cost of conventional experimental verification, proposing a new computational method for miRNA-disease association prediction is an efficient and economical way. Since previous computational models ignored the hubness phenomenon, we presented a novel computational model of Bipartite Local models and Hubness-Aware Regression for MiRNA-Disease Association prediction (BLHARMDA). In this method, we first used known miRNA-disease associations to calculate the Jaccard similarity between miRNAs and between diseases, then utilized a modified kNNs model in the bipartite local model method. As a result, we effectively alleviated the detriments from 'bad' hubs. BLHARMDA obtained AUCs of 0.9141 and 0.8390 in the global and local leave-one-out cross validation, respectively, which outperformed most of the previous models and proved high prediction performance of BLHARMDA. Besides, the standard deviation of 0.0006 in 5-fold cross validation confirmed our model's prediction stability and the averaged prediction accuracy of 0.9120 showed the high precision of our model. In addition, to further evaluate our model's accuracy, we implemented BLHARMDA on three typical human diseases in three different types of case studies. As a result, 49 (Esophageal Neoplasms), 50 (Lung Neoplasms) and 50 (Carcinoma Hepatocellular) out of the top 50 related miRNAs were validated by recent experimental discoveries.

Pulsões de destruição e doenças somáticas / Destructive drives and somatic diseases

O autor examina primeiramente a ambiguidade dos conceitos de Pierre Marty (regressão, desorganização). Considera a necessidade da revisão do conceito de pulsão, que, tal qual concebido, explica insuficientemente as desorganizações da psicossomática. Propõe a hipótese de uma dissociação precoce entre a pulsão e o objeto nas estruturas psicossomáticas. Conclui com o exemplo de Goya, que sofreu crises de somatização que quase o levaram à morte, e sua produção das Pinturas Negras posterior a esse período

Crowdsourced Health Data: Comparability to a US National Survey, 2013-2015.

OBJECTIVES: To determine the generalizability of crowdsourced, electronic health data from self-selected individuals using a national survey as a reference. METHODS: Using the world's largest crowdsourcing platform in 2015, we collected data on characteristics known to influence cardiovascular disease risk and identified comparable data from the 2013 Behavioral Risk Factor Surveillance System. We used age-stratified logistic regression models to identify differences among groups. RESULTS: Crowdsourced respondents were younger, more likely to be non-Hispanic and White, and had higher educational attainment. Those aged 40 to 59 years were similar to US adults in the rates of smoking, diabetes, hypertension, and hyperlipidemia. Those aged 18 to 39 years were less similar, whereas those aged 60 to 75 years were underrepresented among crowdsourced respondents. CONCLUSIONS: Crowdsourced health data might be most generalizable to adults aged 40 to 59 years, but studies of younger or older populations, racial and ethnic minorities, or those with lower educational attainment should approach crowdsourced data with caution. Public Health Implications. Policymakers, the national Precision Medicine Initiative, and others planning to use crowdsourced data should take explicit steps to define and address anticipated underrepresentation by important population subgroups.

The Impact of Impulsivity on Weight Loss Four Years after Bariatric Surgery.

Bariatric surgery has serious implications on metabolic health. The reasons for a failure of bariatric surgery, i.e., limited weight loss, are multifactorial and include psychological factors. We established a theoretical model of how impulsivity is related to weight loss outcome. We propose that depressive symptoms act as a mediator between impulsivity and pathological eating behavior, and that pathological eating behavior has a direct impact on weight loss outcome. We calculated excessive weight loss (%EWL) and assessed self-reported impulsivity (using the Baratt Impulsiveness Scale (BIS-15) total score), depressive symptoms (the Patient Health Questionnaire (PHQ-9) score), and pathological eating behavior (the Eating Disorder Inventory 2 (EDI-2) total score) in 65 patients four years after laparoscopic sleeve gastrectomy. Regression and mediation analyses were computed to validate the theoretical model. The BIS-15, PHQ-9, and EDI-2 have medium to high correlations between each other, and EDI-2 correlated with %EWL. The mediation analysis yielded that the PHQ-9 represents a significant mediator between BIS-15 and EDI-2. The regression model between EDI-2 and %EWL was also significant. These results support our theoretical model, i.e., suggest that impulsivity has an indirect impact on weight loss outcome after bariatric surgery, mediated by depression and transferred through pathological eating behavior. Thus, the underlying psychological factors should be addressed in post-operative care to optimize weight loss outcome.

Intra-articular Diagnostic Injection Exhibits Poor Predictive Value for Outcome After Hip Arthroscopy.

PURPOSE: To determine whether the amount of pain relief after preoperative intra-articular (IA) anesthetic injection predicts clinical and functional outcomes after hip arthroscopy, especially when controlling for the presence of chondral degeneration. METHODS: We identified patients who underwent IA injection and subsequent hip arthroscopy for labral pathology between 2007 and 2013 performed by a single surgeon. Inclusion criteria were ultrasound- or fluoroscopic-guided IA anesthetic injection performed at our institution, prospectively documented pre- and postinjection numerical rating scale pain scores, and minimum 1-year follow-up postoperatively. Patients were divided into 2 groups, those who received >50% pain relief from preoperative IA anesthetic injection and those who received ≤50% relief. Preoperative radiographs were reviewed, and degree of osteoarthritis was determined using the Tonnis classification system. Outcomes were assessed with Modified Harris Hip Score and Hip Outcome Score (HOS). Univariate and multivariate models were performed to assess whether percent pain relief correlated with outcome. RESULTS: Of the 319 arthroscopic hip surgeries performed between 2007 and 2013, 115 (37%) patients were lost to follow-up, 16 (5%) patients did not receive an IA injection, 16 (5%) patients had an injection containing gadolinium, and 40 (13%) patients completed injections at an outside institution. Five (2%) patients were excluded for a history of ipsilateral hip surgery, and 3 (1%) for a history of contralateral hip surgery, leaving 96 hips in 96 patients. There were 71 females (74%) and 25 males (26%) with a mean age of 37.6 ± 14.0 years. Tonnis was grade 0, 1, and 2 for 26 (27%), 55 (56%), and 16 (17%) patients, respectively. Fifty-one (53%) of the injections contained a corticosteroid. The mean pain relief after IA injection was 73% ± 36% (range, 0% to 100%). Twenty-six hips (26%) had ≤50% pain relief, whereas 70 (73%) had >50% pain relief, and the median time interval from injection to surgery was 3 (range, <1 to 20) months. Outcome scores were obtained at a mean 14.8 (range, 11 to 30) months after arthroscopic surgery. Postoperative mean Modified Harris Hip Score, HOS activities of daily living, and HOS-Sport scores were 79.2 ± 17.3, 82.6 ± 17.3, and 67.4 ± 28.2, respectively. There was no statistical correlation between percent pain relief and outcome. There was no significant difference in outcome scores between those with ≤50% and >50% pain relief. Multivariate regression analysis showed no significant predictors of outcome, including age, gender, Tonnis grade, percent relief with IA injection, or type of surgery. CONCLUSIONS: In this study of patients undergoing hip arthroscopy for labral pathology, our data indicate that the amount of pain relief from IA injection may be a poor predictor of short-term outcome, even when adjusting for chondral degeneration. Although anesthetic injections can be an important diagnostic tool in select patients, a combination of the clinical history, physical examination, and imaging findings is fundamental. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Lithium as a rescue therapy for regression and catatonia features in two SHANK3 patients with autism spectrum disorder: case reports.

BACKGROUND: Phelan-Mc Dermid syndrome is a contiguous disorder resulting from 22q13.3 deletion implicating the SHANK3 gene. The typical phenotype includes neonatal hypotonia, moderate to severe intellectual disability, absent or delayed speech, minor dysmorphic features and autism or autistic-like behaviour. Recently, point mutations or micro-deletions of the SHANK3 gene have been identified, accompanied by a phenotype different from the initial clinically description in Phelan McDermid syndrome. CASE PRESENTATION: Here we present two case studies with similar psychiatric and genetic diagnosis as well as similar clinical history and evolution. The two patients were diagnosed with autism spectrum disorders in childhood and presented regression with catatonia features and behavioural disorders after a stressful event during adolescence. Interestingly, both patients presented mutation/microdeletion of the SHANK3 gene, inducing a premature stop codon in exon 21. Different pharmacological treatments (antipsychotics, benzodiazepines, mood stabilizer drugs, antidepressants, and methylphenidate) failed to improve clinical symptoms and lead to multiple adverse events. In contrast, lithium therapy reversed clinical regression, stabilized behavioural symptoms and allowed patients to recover their pre-catatonia level of functioning, without significant side effects. CONCLUSION: These cases support the hypothesis of a specific SHANK3 phenotype. This phenotype might be linked to catatonia-like deterioration for which lithium use could be an efficient treatment. Therefore, these cases provide an important contribution to the field of autism research, clinical genetics and possible pharmacological answers.

Psicologia socill de adorno: resistência à violência do mundo adminsttrado / Psicoogía sociall de adorno: resistencia a la violencia del mundo administrado / Adorno' social ppsychology: resistance to the violence in the administered world

O objetivo deste ensaio é analisar o potencial político da psicologia social de Theodor W. Adorno; refletir sobre sua capacidade de opor resistência à violência típica do mundo administrado, cuja dimensão psíquica regressiva, semelhante à que serviu de sustentação para a instauração do horror nazifascista, nos impulsiona a investigar os atuais mecanismos psicossociais de dominação responsáveis pela integração dos indivíduos regredidos a condições de existência manifestamente contrárias à preservação racional da vida. O método adotado para esta análise consiste na ênfase no objeto desta psicologia social - desindividualizados átomos sociais pós-psicológicos - e na atualização de seu modelo de crítica. Conclui-se que a continuidade dos mecanismos de integração psicossocial responsáveis pela interceptação do processo de individuação repete a violência totalitária: a aniquilação do indivíduo autônomo. Diante dessa tendência histórica funesta, a psicologia social de Adorno impõe-se como práxis: convertendo-se em resistência à barbárie...

El propósito de este ensayo es analizar el potencial político de la psicología social de Theodor W. Adorno; reflexionar sobre su capacidad de oponer resistencia a la violencia típica del mundo administrado, cuya dimensión psíquica regresiva, similar a la que sirvió de apoyo a la creación del horror nazifascista, nos impulsa a investigar los actuales mecanismos psicosociales de dominación responsables por la integración de los individuos regredidos a condiciones de existencia manifiestamente contrarias a la preservación racional de la vida. El método adoptado para este análisis consiste en el énfasis en el objeto de esta psicología social - desindividualizados átomos sociales pospsicológicos - y en la actualización de su modelo de crítica. Se concluyó que la continuidad de los mecanismos de integración psicosocial responsables por la interceptación del proceso de individuación repite la violencia totalitaria: la aniquilación del individuo autónomo. Delante de esa tendencia histórica lúgubre, la psicología social de Adorno se impone como praxis: convirtiéndose en resistencia a la barbarie...

The objective of this paper is to analyze the political potential of Theodor W. Adorno's social psychology, i.e., its capacity to resist in the face of the typical violence of the administered world. The current psychosocial mechanisms of domination, responsible for the integration of the regressed individuals to conditions of existence clearly contrary to the rational preservation of life, are to be understood in this paper. The adopted method for this analysis consists of the emphasis on the subject of this social psychology - post-psychological de-individualized social atoms - and on the update of its critique model. It is concluded that the continuity of the mechanisms of psychosocial integration responsible for the interception of the process of individuation replicates the totalitarian violence: the annihilation of the autonomous individual. Before this tragic historical tendency, Adorno's social psychology imposes itself as a praxis: it converts itself into resistance to the barbarousness...

Application of Logistic Regression on the Analysis of Chilean Children's Fears / Aplicación de la regresión logística al análisis de los miedos de los niños chilenos

The research aimed at finding some deciding factors in Chilean children's fears. For carrying out this study, a survey was administered to children be' tween 6 and 11 years old through personal interviews, under their teachers' supervision and parents' permission. The measuring instrument was based on the questionnaire adaptation "Fear Survey for Children; revised, FSSC-R". The sample consisted of 729 children of both genders and from different socioeconomic strata and areas (urban and rural). For its examination, a Factorial Analysis of Main Components was applied, resulting that fears can be grouped into five factors: Daily life, Supernatural facts, Health, Natural disasters and Self-esteem. Thanks to this, a weighted index of fears was built. Through a Logistic Regression Model, some possible deciding factors in children's fears were analysed. For example, it was found that living in the city or in the country is not a significant factor when determining children's fears. On the other hand, the factors that turned out to be significant are: the gender, finding terrifying images on the internet, the socioeconomic level that each child belongs to and, being able to manage on his or her own when the child confronts a frightening event.

La investigación tuvo como objetivo encontrar algunos factores determinantes del miedo en los niños chilenos. Para realizar el estudio, se administró una encuesta a 729 niños entre los 6 y 11 años de edad. El instrumento de medición se basó en una adaptación del cuestionario "Fear Survey Schedule for Children - Revised, FSSC - R". Luego, para el examen de los datos se realizó un análisis factorial exploratorio que agrupó los miedos en cinco factores los que posteriormente permitieron construir un índice ponderado de miedos. Finalmente, a través de un modelo de regresión logística y usando una categorización del índice ponderado de miedos como variable dependiente, se encontraron algunos factores determinantes de los miedos infantiles. Entre estos están: el género, encontrar imágenes atemorizantes en internet, el nivel socioeconómico y la auto'suficiencia para enfrentar situaciones de miedo.

Increasing incidence of thyroid cancer in Shanghai, China, 1983-2007.

Increasing incidence of thyroid cancer has been observed in some countries such as the United States, United Kingdom, France, and so on. Joinpoint regression was used to analyze the incidence of thyroid cancer in Shanghai, China, from 1983 to 2007. The results showed that there were 2 distinct slopes: in men, representing a significant annual percentage change (APC) of 2.6% from 1983 to 2000 (P < .001) followed by a sharp APC of 14.4% (P < .001), and in women, representing a significant APC of 4.9% from 1983 to 2003 (P < .001) followed by a sharp APC of 19.9% (P = .001). The sharp increase in thyroid cancer occurred 5 and 8 years after the iodine supplementation by salt, for men and women, respectively, suggesting that either the developed screening techniques or iodine supplementation might have contributed to the rapid increase in the incidence of thyroid cancer. The burden of thyroid cancer cases is expected to be substantial, based on predictions through 2020.

Simulation studies as designed experiments: the comparison of penalized regression models in the "large p, small n" setting.

New algorithms are continuously proposed in computational biology. Performance evaluation of novel methods is important in practice. Nonetheless, the field experiences a lack of rigorous methodology aimed to systematically and objectively evaluate competing approaches. Simulation studies are frequently used to show that a particular method outperforms another. Often times, however, simulation studies are not well designed, and it is hard to characterize the particular conditions under which different methods perform better. In this paper we propose the adoption of well established techniques in the design of computer and physical experiments for developing effective simulation studies. By following best practices in planning of experiments we are better able to understand the strengths and weaknesses of competing algorithms leading to more informed decisions about which method to use for a particular task. We illustrate the application of our proposed simulation framework with a detailed comparison of the ridge-regression, lasso and elastic-net algorithms in a large scale study investigating the effects on predictive performance of sample size, number of features, true model sparsity, signal-to-noise ratio, and feature correlation, in situations where the number of covariates is usually much larger than sample size. Analysis of data sets containing tens of thousands of features but only a few hundred samples is nowadays routine in computational biology, where "omics" features such as gene expression, copy number variation and sequence data are frequently used in the predictive modeling of complex phenotypes such as anticancer drug response. The penalized regression approaches investigated in this study are popular choices in this setting and our simulations corroborate well established results concerning the conditions under which each one of these methods is expected to perform best while providing several novel insights.