Psiquiatría transcultural y depresión en China: un relato clínico / Cross-cultural psychiatry and depression in the eastern population

El siguiente trabajo presenta la historia de una paciente de 19 años oriunda de China, que cursó una internación en una sala de psiquiatría de un hospital general por un cuadro de características depresivas. El caso es notable por el polimorfismo en la sintomatología clínica que presentó. El objetivo es analizar, a partir de él, la necesidad de un enfoque interdisciplinario que trate a la cultura como una variable significativa en la construcción de una enfermedad, entendiendo que los modelos fisiopatológicos resultan necesarios pero no suficientes para comprender de qué modo se constituye. Para dicho fin se hará un breve recorrido por los estudios efectuados en la década del 80 en China por el psiquiatra y antropólogo Arthur Kleiman y se desarrollará la perspectiva de la psicoanalista Helena Lunazzi, quien en su libro Alexitimia desarrolla cómo la cultura influye en la expresión verbal de las emociones. (AU)

The following work presents the history of a 19-year-old patient from China who was hospitalized in a psychiatric ward of a general hospital due to a depressive illness, being the case remarkable for the polymorphism in the clinical symptoms that she presented. The objective is to analyze the need for an interdisciplinary approach that treats culture as a significant variable in the construction of a disease, understanding that pathophysiological models are necessary but not sufficient to comprehend how they are constituted. For this purpose, a brief review will be made of the studies carried out in the 1980s in China by the psychiatrist and anthropologist Arthur Kleiman and the perspective of the psychoanalyst Lunazzi Helena, who in her book "Alexithymia" develops how culture influences the verbal expression of emotions. (AU)

Marcel Proust y en busca del tiempo perdido: ética de la existencia humana y el mundo de la medicina recuperado / Marcel Proust and in search of lost time: ethics of human existence and the world of medicine recovered / Marcel Proust e em busca do tempo perdido: ética da existência humana e o mundo da medicina recuperado

Resumen: 1. En busca del tiempo perdido de Marcel Proust narra el proyecto-de-existencia del "autor" de la ficción de llegar a ser artista. 2. El mundo de la medicina es el ámbito en que se exterioriza la fragilidad del hombre como ser-referido-a-la-muerte. 3. El sentimiento engañoso de poder de la buena salud embriaga a la medicina, médicos, pacientes, parientes, tratamientos -depreciación irreverente hacia lo perecedero. 4. El tratamiento médico de la agonía de la abuela del "autor" muestra los elementos centrales de la relación médico-paciente de la medicina de comienzos del siglo XX: cognoscitivo, afectivo, operativo, ético y social. 5. El "autor" de la novela no es Marcel Proust y, aunque se trata de una ficción, estimula al mundo médico actual a reflexionar sobre sus fundamentos bioéticos últimos.

Abstract: 1. Marcel Proust´s In Search of Lost Time recounts the fiction of the "author's" project-of-existence to become an artist. 2. The world of medicine is the area in which the fragility of man is expressed as being-referred-to-death. 3. The deceptive feeling of the power of good health intoxicates medicine, physicians, patients, relatives, treatments - irreverent depreciation toward the perishable. 4. The medical treatment of the agony of the "author's" grandmother shows the central elements of the doctor-patient relationship in medicine at the beginning of the 20th century: cognitive, affective, operational, ethical, and social. 5. The "author" of the novel is not Marcel Proust and, although it is a fiction, it encourages today´s medical world to reflect on its fundamental bioethical foundations.

Resumo: 1. Em busca do tempo perdido de Marcel Proust narra o projeto-de-existência do "autor" da ficção de chegar a ser artista. 2. O mundo da medicina é o âmbito em que se exterioriza a fragilidade do homem como ser-referido-à-morte. 3. O sentimento enganoso de poder da boa saúde embriaga a medicina, médicos, pacientes, parentes, tratamentos -depreciação irreverente ao perecível. 4. O tratamento médico da agonia da avó do "autor" mostra os elementos centrais da relação médicopaciente da medicina do princípio do século XX: cognitivo, afetivo, operativo, ético e social. 5. O "autor" do romance não é Marcel Proust e, ainda que se trate de uma ficção, estimula o mundo médico atual a refletir sobre seus fundamentos bioéticos últimos.

Relationship between preoperative frailty and postoperative cognitive dysfunction in elderly patients undergoing non-cardiac surgery / 中华麻醉学杂志

Objective:To evaluate the relationship between preoperative frailty and postoperative cognitive dysfunction (POCD) in elderly patients undergoing non-cardiac surgery.Methods:A total of 336 elderly patients of both sexes, aged≥65 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with body mass index of 18.6-25.1 kg/m 2, undergoing elective non-cardiac surgery under general anesthesia, were enrolled in the study.Faltering status was assessed with the Clinical Faltering Scale at 1 day before surgery.Mini-Mental State Examination score, Digital Span Test, Digit Symbol Substitution Test, Stroop Color and Word Test, Visual Word Learning Test and Trail Making Test were performed at 1 day before surgery and at 1, 7 and 30 days after surgery.The Z score was used to identify POCD.The patients was divided into non-POCD group and POCD group according to the occurrence of POCD within 30 days after surgery.Logistic regression analysis was used to identify the risk factors for POCD in elderly patients undergoing non-cardiac surgery. Results:The results of logistic regression analysis showed that preoperative frailty and diabetes mellitus were independent risk factors for POCD in elderly patients undergoing non-cardiac surgery ( P<0.05). Conclusion:Preoperative frailty is an independent risk factor for POCD in elderly patients undergoing non-cardiac surgery.

La metáfora energética del ser humano y su incidencia en el auge de la neurastenia, la neurosis y la depresión / The energy metaphor for the human body and its effect on the rise of neurasthenia, neurosis and depression

Resumen El artículo tiene por objetivo realizar una historia crítica del auge de tres categorías diagnósticas: la neurastenia (fin del siglo XIX), la neurosis (primera mitad del siglo XX) y la depresión (segunda mitad del siglo XX hasta nuestros días). La hipótesis es que su amplia difusión se explicaría debido al vínculo que ellas han tenido con la metáfora energética del ser humano. Desde mediados del siglo XIX, la concepción energética se difundió por la cultura occidental, habilitando ciertas ficciones acerca de lo que somos - dimensión ontológica - y lo que podríamos llegar a ser - dimensión ética. El artículo muestra que estas patologías han codificado y tornado inteligible determinadas trayectorias vitales que no cumplían con los imperativos de tales ficciones onto-éticas.

Abstract This article aims to provide a historical critique of the rise of three diagnostic categories: neurasthenia (late nineteenth century), neurosis (first half of the twentieth century) and depression (mid-twentieth century to the present). The hypothesis is that their broad dissemination can be explained through their link to the energy metaphor for the human body. From the mid-nineteenth century on, the concept of energy spread through western culture, encouraging certain fictions about what we are - the ontological dimension - and what we could be - the ethical dimension. The article shows that these pathologies have codified and made intelligible a set of life trajectories that did not obey the imperatives of those onto-ethical fictions.

Strategies and Methods of Diagnosis and Treatment for Chronic Prostatitis with Sexual Neurasthenia as Main Clinical Manifestation / 中国中医药信息杂志

In clinical work, many chronic prostatitis whose main clinical manifestations of sexual neurasthenia are misdiagnosed due to lack of typical lower urinary tract symptoms and pelvic floor pain. Therefore, attention is paid to prostate digital rectal examination and routine examination of prostatic fluid, and neuromodulators or psychotropic medicine should not be applied in the performance of sexual neurasthenia alone. Instead, integrated traditional Chinese and Western medicine treatment measures should be actively adopted to achieve satisfactory clinical results.

Research progress in heavy metal toxic damage of nervous system / 中国药理学与毒理学杂志

With the development of modern industry,heavy metal pollution in China is becoming increasingly serious.Large-scale water sources and farmland have been severely contaminated.Frequent contact with heavy metal in life or at work has caused a marked increase in heavy metal poisoning in recent years.Nervous system damage caused by heavy metal poisoning is extremely common in clinic,and poses a threat to a patient's life,bringing heavy burden to society and families.Therefore,early prevention and treatment are crucial.This article takes commonpoisoning several common heavy metals as an example and combine the domestic and foreign research to review the damage to the nervous system caused by heavy metal poisoning.We aim to make patients and medical staff more alert to such poisoning and provide the basis for clinical prevention,diagnosis,treatment and research.

Test study on changes of serum cortisol and hypersensitivity C-reactive protein in elderly patients with neurasthenia / 国际检验医学杂志

Objective To investigate the significance of serum cortisol and high‐sensitivity C‐reactive protein (hs‐CRP) test in elderly patients with neurasthenia .Methods A total of 160 elderly patients with neurasthenia in our hospital from January 2012 to June 2015 were selected as the research subjects (observation group) and 160 individuals undergoing the physical examination as the control group .The differences of serum BDNF ,CORT and hs‐CRP levels were compared between the two groups .The patients were divided into the obvious anxiety group and anxiety group according to the Hamilton Anxiety Scale (HAMD) .The differences of serum BDNF ,CORT and hs‐CRP levels were compared between these two groups ;meanwhile serum BDNF ,CORT and hs‐CRP levels after treatment in the patients with ideal curative effect were detected and the detection results were statistically compared with those before treatment .Results The BDNF and CORT levels in the observation group were significantly lower than those in the control group ,while the hs‐CRP level was significantly higher than that in the control group ;the BDNF and CORT levels in the obvious anxiety group were significantly lower than those in the anxiety group ,while the hs‐CRP level was significantly higher than that in the anxiety group ;the treatment outcome also showed that the BDNF and CORT levels after treatment in the patients obtai‐ning the ideal effect were significantly increased compared with the pre‐treatment levels ;while the hs‐CRP level was significantly decreased .Conclusion BDNF ,CORT and hs‐CRP are significantly correlated with neurasthenia occurrence and its severity ,which deserves to pay attention to in clinical practice .

Prevalence of neurasthenia and its related multivariate analysis among population attending postgraduate exam in medical class / 重庆医学

Objective To explore the neurasthenia situation of the population attending the postgraduate exam in medical class and its influencing factors .Methods The random cluster sampling method was adopted .The influencing factors were per‐formed the χ2 test and Logistic regression analysis .Results According to the inclusion criteria and exclusion criteria ,36 positive ca‐ses were screened out ,accounting for 8 .89% of participants ,which was higher than the value of the general population ;the statisti‐cally significant differences were noted in the factors of the confidence of attending the postgraduate exam ,stress ,adjusting ability , interpersonal situation ,reading duration ,sleep ,nutrition and dietary (P<0 .05) .Conclusion Attending the postgraduate exam such highly intensitive mental activity is the important reason causing neurasthenia among the population attending the postgraduate ex‐am ,which mainly display in the aspects of stress size ,bearing ability facing stress and regulation .

The relationship between Marcel Proust and Joseph Babinski: the encounter of two geniuses / A relação entre Marcel Proust e Joseph Babinski: o encontro de dois gênios

Marcel Proust was one of the greatest French writers of all times. Since early in his life, Proust was interested in arts and particularly literature. He also demonstrated a great knowledge of medicine, particularly neurology. His father was a doctor, and contributed to neurology through studies on aphasia, stroke, hysteria, and neurasthenia. During his childhood, Proust had the first asthma attack, initially considered a manifestation of neurasthenia. Regarding his illness, Proust was in touch with several renowned neurologists, such as Brissaud, Babinski and Sollier, and other disciples of Charcot. Proust spent the last three years of his life mostly confined to his bedroom since his health had badly deteriorated. In one moment, Babinski was called, examined Proust and after leaving his bedroom, announced to his brother that Proust was practically dead. Few hours later, Proust developed vomica and died.

Marcel Proust foi um dos maiores escritores franceses de todos os tempos. Desde jovem, Proust era interessado em artes e especialmente literatura. Ele também demonstrava um grande conhecimento sobre medicina, especialmente neurologia. Seu pai era um médico, e contribuiu para a neurologia através de estudos sobre a afasia, acidente vascular cerebral, histeria, neurastenia. Durante sua infância, Proust teve o primeiro ataque de asma, inicialmente considerado uma manifestação da neurastenia. Devido à sua doença, Proust estava frequentemente em contato com vários neurologistas renomados, tais como Brissaud, Babinski e Sollier, entre outros discípulos de Charcot. Proust passou a maior parte do tempo nos últimos três anos da sua vida confinado em seu quarto, após deterioração da sua saúde. Em um determinado momento, Babinski foi chamado, examinou Proust e depois de sair de seu quarto, anunciou a seu irmão que Proust estava praticamente morto. Poucas horas depois, Proust desenvolveu vômica e faleceu.

Os paulistanos, “ianques do sul”, e a “doença moderna”, a neurastenia, nas primeiras décadas do século XX / São Paulo residents known as ?Southern Yankees? and the ?modern disease,? namely neurasthenia, in the early decades of the twentieth century

Em pouco tempo o boom do café, a imigração europeia e a atlantização de diversos setores de vida transformaram São Paulo de um pequeno povoado em uma próspera metrópole atlântica. Nas primeiras décadas do século XX, observadores descreviam a cidade, por seu progresso e atividade, como Yankee City. De que forma a neurastenia, “a mais moderna e americana das doenças”, combina com essa imagem? Após a análise de anúncios, livros científicos e de divulgação da ciência, bem como de artigos em revistas, pode-se afirmar que a neurastenia era amplamente difundida e bastante comercializável. O presente trabalho enfatiza a relação sociocultural dos paulistanos com o fenômeno da neurastenia.

In a brief period of time the coffee boom, European immigration and the “atlanticization” of various sectors of life saw São Paulo transform from a small village into a thriving Atlantic metropolis. In the early decades of the twentieth century, observers described the city as Yankee City, due to its progress and activity. To what extent does neurasthenia, namely “the most modern and American of disorders”, tally with that image? After analysis of advertisements, scientific books and texts for the dissemination of science, as well as articles in journals, it can be stated that neurasthenia was prevalent and widespread. This work emphasizes the socio-cultural familiarity of São Paulo with the phenomenon of neurasthenia.

Intervenciones freudianas sobre el problema de la nerviosidad: la neurosis de angustia como crítica al paradigma neurasténico de la modernidad de George M. Beard / Intervenções freudianas sobre o problema da nervosidade: a neurose de angústia como crítica ao paradigma neurastênico da modernidade de George M. Beard / Freud's interventions into the question of nervousness: the anxiety neurosis as George Beard's critique of the neurasthenic paradigm of modernity / Les interventions freudiennes sur le problème de la nerviosité: la névrose d'angoisse comme critique du paradigme neurasthénique de la modernité de George M. Beard

El presente artículo analiza la crítica freudiana a la categoría de neurastenia, propuesta por George Beard. Primeramente, se exponen las hipótesis de Beard que asocian nerviosidad, civilización moderna y neurastenia; luego, se identifica la concepción freudiana de nerviosidad implicada en la categoría de neurosis de angustia. Al refutar los postulados de Beard, Freud no sólo hará un aporte a la psicopatología de su época, sino que otorgará un nuevo fundamento a la nerviosidad moderna.

O presente artigo analisa a crítica freudiana à categoria de neurastenia, proposta por George Beard. Primeiramente, se expõe as hipóteses de Beard que associam nervosidade, civilização moderna e neurastenia; em seguida, se identifica a concepção freudiana de nervosidade implicada na categoria da neurose de angústia. Ao refutar os postulados de Beard, Freud não só contribuirá à psicopatologia da sua época, mas também outorgará um novo fundamento à nervosidade moderna.

This article examines Freud's critique of the category of neurasthenia as proposed by George Beard. First, it presents Beard's hypotheses that associate nervousness, modern civilization and neurasthenia. It then identifies Freud's concept of nervousness as applied to the category of anxiety neurosis. In refuting Beard's postulates, Freud not only made a contribution to psychopathology of his time, but also presented a new basis for modern nervousness.

Cet article examine la critique de Freud portant sur la catégorie de la neurasthénie proposée par George Beard. Nous présentons en premier lieu les hypothèses de Beard qui associent la nervosité, la civilisation moderne et la neurasthénie. Ensuite, nous identifions la conception freudienne de la nervosité impliquée dans la catégorie de névrose d'angoisse. En réfutant les principes de Beard, Freud ne contribue non seulement à la psychopathologie de son époque, mais fournit également un nouveau fondement à la nervosité moderne.

Neurastenia / Neurasthenia

Apresenta a categoria médica da neurastenia, criada em solo estadunidense no fim do século XIX pelo neurologista George Beard. São apresentadas as características gerais do quadro clínico, bem como as principais hipóteses explicativas para os sintomas, e as proposições terapêuticas sugeridas nas obras do referido autor. Além disso, é discutida a recepção do diagnóstico fora dos EUA, tanto no que se refere ao seu uso na Europa quanto ao caso específico do Brasil.

The article addresses the medical category of neurasthenia, developed in the United States by neurologist George Beard at the close of the nineteenth century. Points of discussion include the principle features of the category's clinical presentation, the main hypotheses advanced to account for symptoms, and the treatment alternatives suggested in Beard's works. The article also looks at how the diagnosis was received outside the United States, both in Europe and, more specifically, in Brazil.

A fadiga e seus transtornos: condições de possibilidade, ascensão e queda da neurastenia novecentista / Fatigue and its disturbances: conditions of possibility and the rise and fall of twentieth-century neurasthenia

Analisa alguns dos elementos sociohistóricos que configuraram condições de possibilidade para a emergência da neurastenia como categoria nosológica, na segunda metade do século XIX, bem como os aspectos que influenciaram seu declínio em meios médicos e leigos. Propõe breve apresentação dessa categoria médica e discussão mais detalhada sobre alguns debates em que ela encontra sustentação, tais como a ideia do desgaste do suprimento nervoso, os estudos e as preocupações novecentistas sobre a fadiga e a pressuposição da somatogênese da doença. Analisa, por fim, o processo de declínio da categoria ressaltando alguns elementos que alteraram seu estatuto e sua utilidade como diagnóstico.

The article first analyzes some of the social and historical components underlying the conditions of possibility that allowed neurasthenia to emerge as a nosological category in the latter half of the nineteenth century and then explores the elements that influenced its demise in medical and lay circles. It offers a brief introduction to this medical category and a more detailed discussion of some supporting debates, including the idea of nervous exhaustion, twentieth-century studies and concerns on fatigue, and the malady's presumed somatogenesis. The concluding analysis of how the category met its demise highlights elements that altered its status and its diagnostic usefulness.

Hipóteses etiológicas sobre a neurastenia na obra de George Beard e seus contemporâneos europeus / Etiological hypotheses on neurasthenia in the work of George Beard and his European contemporaries

Este artigo apresenta a neurastenia como categoria médica a partir de suas fontes primárias, partindo dos escritos do neurologista norte-americano George Beard, bem como de seus contemporâneos europeus. Abordam-se características e sintomas atribuídos a essa condição e as três principais hipóteses etiológicas a que se atribuía a doença nas fontes consultadas: a civilização americana do fim do século XIX, a diátese neuropática e a lesão funcional do sistema nervoso.

Este artículo presenta la neurastenia como una categoría médica a partir de fuentes primarias, partiendo del neurólogo norte-americano George Beard y de sus contemporáneos europeos. En el artículo se analizan características y síntomas atribuidos a esa condición y las tres hipótesis etiológicas principales a las que se atribuía la enfermedad en las fuentes consultadas: la civilización americana de finales del siglo XIX, la diátesis neuropática y la lesión funcional del sistema nervioso.

Cet article présente la neurasthénie comme catégorie médicale à partir de ses sources primaires, soit l'oeuvre du neurologiste américain George Beard et celles de ses contemporaines européens. Nous décrivons les caractéristiques et les symptômes de cette maladie, ainsi que les trois principales hypothèses attribuées à la neurasthénie dans les sources citées: la civilisation américaine à la fin du XIX siècle; la diathèse nerveuse et le concept de lésion fonctionnelle du system nerveux.

This article presents the medical category of neurasthenia and its etiological hypotheses in the medical writings of George Beard and other European writers who were his contemporaries. We present the main features and symptoms of neurasthenia and an overview of the etiological hypothesis attributed to the disease at that time, that is: the American civilization in the late 19th century, nervous diathesis and the concept of functional lesions of the nervous system.

Clinical Study of Yinao Capsules for Neurasthenia / 中药新药与临床药理

Objective To evaluate the clinical effect and safety of Yinao Capsul es for neurasthenia with the syndrome of liver-kidney deficiency and Qi-yin de ficiency. Methods A multi-center,randomized,single-blind and positive drug p arallel controlled trial was adopted. Three hundred and forty-two cases in the treatment group were treated with Yinao Capsules,and 111 cases in the control g roup were treated with Naolinsu Capsules. Results Yinao Capsules had a total eff ective rate of 93.6 %and the markedly effective rate of 52.1 %. Compared with Naolinsu Capsules,Yinao Capsules showed a better clinical effect (P