ABSTRACT
En "La dirección de la cura y los principios de su poder" Lacan cuestiona, dentro de lo que denomina "parcialidades" en el abordaje del problema de la transferencia (Apartado 3, parágrafo 2, p. 583), una tercera vía de abordaje del problema que postularía, como modo de resolución de la transferencia y culminación del análisis, una suerte de identificación del paciente con el analista ("introyección en Ferenczi, identificación con el superyó del analista en Strachey, trance narcisístico terminal en Balint", parágrafo 6, p. 587). Culmina y sintetiza de esta forma sus propios desarrollos sobre el tema llevados a cabo en los Seminarios 1 y 4. Sin embargo, y a nuestro entender, la problemática de la identificación y del objeto en la culminación del tratamiento analítico no queda resuelta, sino tan solo planteada. Serán necesarias nuevas reelaboraciones de la noción de "identificación" (Seminario 9) y de la de "objeto" (Seminario 10), para retomar esos desarrollos en un nuevo análisis del concepto de "transferencia" (Seminario 11), que busca delimitarlo en un esquema que propone una maniobra clínica para su resolución. El presente trabajo ofrece una síntesis del recorrido argumental de Lacan
In "The direction of cure" Lacan questions, within what he called "bias" in the approach to the problem of transfer (section 3, paragraph 2, p. 583), the problem of run, as a way of resolution of transfer and completion of the analysis, a third way of approach a sort of identification of the patient with the analyst ("introjection in Ferenczi, identification with the superego of the analyst in Strachey, trance terminal fusionary in Balint", paragraph 6, p. 587). It culminates and synthesized in this way their own development on the subject carried out in Seminars 1 and 4. However, and in our opinion, the problem identification and the object at the culmination of the analytic treatment is not resolved, but only raised. Necessary new reworkings of the notion of "identification" (Seminar 9) and the of "object" (Seminar 10), will be to return to these developments in a new analysis of the concept of "transfer..." which seeks to define it in a scheme that proposes a clinical move to its resolution. This paper provides a synthesis of the story journey of Lacan
Subject(s)
Humans , Professional-Patient Relations , PsychoanalysisABSTRACT
ABSTRACT Radioiodine (RAI)-refractory thyroid cancer is an uncommon entity, occurring with an estimated incidence of 4-5 cases/year/million people. RAI refractoriness is more frequent in older patients, in those with large metastases, in poorly differentiated thyroid cancer, and in those tumors with high 18-fluordeoxyglucose uptake on PET/CT. These patients have a 10-year survival rate of less than 10%. In recent years, new therapeutic agents with molecular targets have become available, with multikinase inhibitors (MKIs) being the most investigated drugs. Two of these compounds, sorafenib and lenvatinib, have shown significant objective response rates and have significantly improved the progression-free survival in the two largest published prospective trials on MKI use. However, no overall survival benefit has been achieved yet. This is probably related to the crossover that occurs in most patients who progress on placebo treatment to the open treatment of these studies. In consequence, the challenge is to correctly identify which patients will benefit from these treatments. It is also crucial to understand the appropriate timing to initiate MKI treatment and when to stop it. The purpose of this article is to define RAI refractoriness, to summarize which therapies are available for this condition, and to review how to select patients who are suitable for them.
Subject(s)
Humans , Thyroid Neoplasms/drug therapy , Protein Kinase Inhibitors/therapeutic use , Iodine Radioisotopes/therapeutic use , Antineoplastic Agents/therapeutic use , Radiation Tolerance , Thyroid Neoplasms/mortality , Thyroid Neoplasms/radiotherapy , Treatment Failure , Retreatment , Disease ManagementABSTRACT
El presente texto es un resumen de los resultados obtenidos en nuestro proyecto de investigación 2008-9, en el que nos propusimos como objetivo general delimitar y formalizar modelos de dirección de la cura en la obra de Freud y Lacan.