Haploidentical Hematopoietic Stem Cell Transplantation with Post-Transplantation Cyclophosphamide in Children with High-Risk Leukemia Using a Reduced-Intensity Conditioning Regimen and Peripheral Blood as the Stem Cell Source.

The use of haploidentical donor hematopoietic stem cell transplantation with post-transplantation cyclophosphamide (Haplo-PTCy) in children is increasing; however, it is still not clear which preparative regimen is best in this setting. We present the long-term results of 42 patients age <18 years with high-risk leukemia who underwent this procedure using a reduced-intensity conditioning regimen (RIC) and peripheral blood as the stem cell source. Twenty-six patients had acute lymphoblastic leukemia, 13 had acute myelogenous leukemia, 2 had juvenile myelomonocytic leukemia, and 1 had blast crisis of chronic myelogenous leukemia. One-third of the patients were in first remission, 50% were in second remission, 14% were in third remission, and 3% had refractory disease. Neutrophil recovery occurred in 100% of the 40 patients alive at day +30, and transplantation-related mortality at 1 year was 14%. The incidence of acute graft-versus-disease (GVHD) grade III-IV was 17%, and the cumulative incidence of moderate to severe chronic GVHD at 1 year was 29%. The median duration of follow-up for surviving patients was 45 months; overall survival and event-free survival at 36 months were 56% and 46%, respectively. Long-term results of this series show that the use of an RIC regimen with peripheral blood stem cells as the cell source, in children with high-risk leukemia who underwent haplo-PTCy has tolerable toxicity, universal engraftment, and good survival rates.

Remifentanilo vs. analgesia epidural para el manejo del dolor agudo relacionado con el trabajo de parto. Revisión sistemática y meta-análisis / Remifentanil vs. epidural analgesia for the management of acute pain associated with labour. Systematic review and meta-analysis

Introducción: El remifentanilo presenta un perfil farmacológico atractivo para definirse como analgesia obstétrica, dada la necesidad de una técnica de empleo masivo, con similares beneficios y satisfacción que la analgesia epidural. Objetivo: Evaluar la eficacia, la equivalencia y la seguridad del remifentanilo vs. analgesia epidural en analgesia obstétrica. Métodos: Revisión sistemática y meta-análisis de experimentos clínicos siguiendo la metodología Cochrane. Resultados: No hallamos equivalencia con respecto a analgesia epidural, pero sí eficacia en el grupo de remifentanilo a diferentes horas de evaluación. La incidencia de efectos adversos fue similar en ambos grupos, salvo para las náuseas. Conclusiones: El remifentanilo puede no ser equivalente a la analgesia epidural, pero podría disminuir la intensidad del dolor consonante con los niveles de satisfacción de cada artículo.

Introduction: Remifentanil has an attractive pharmacological profile for use in obstetric analgesia as a technique for mass application, with similar benefits and satisfaction as epidural analgesia. Objective: To assess the efficacy, equivalence and safety of remifentanil vs. epidural analgesia in obstetrics. Methods: Systematic review and meta-analysis of clinical trials using the Cochrane methodology. Results: No equivalence was found in relation to epidural analgesia; however, efficacy was found in the remifentanil group at different time points during the evaluation. The incidence of adverse effects was similar in the two groups, except for nausea. Conclusions: Remifentanil is not equivalent to epidural analgesia but could certainly decrease the intensity of pain.

Aporías de lo femenino / Aporiae of femininity

El presente artículo es un resultado de la investigación Aporías de lo femenino: un acercamiento al tema del goce femenino realizada en el marco del Master de Investigación en Psicoanálisis de la Universidad Paris VIII. Nos proponemos seguir el rastro al concepto lacaniano de goce femenino, tal como ha sido presentado en Aún, el Seminario 20 de Lacan de 1972-1973. Dicho concepto, según Lacan, sólo es abordable por las vías de la contradicción. Partiendo de esta premisa develaremos algunas aporías inherentes al estudio psicoanalítico de cuatro categorías puntuales que proponemos analizar: el cuerpo, el saber, el amor y la verdad.

This article results from my thesis Aporiae of femininity: an approach to the issue of feminine jouissance carried out as part of the Master in Psychoanalysis at the University Paris VIII. We propose to follow the Lacanian concept of feminine jouissance as it was elaborated in his Seminar 20, Encore, from the years 1972-1973. This concept, according to Lacan, is approachable only by means of contradiction. Starting from this premise, we will attempt to unveil the aporiae inherent to a psychoanalytic study of four specific categories that we intend to analyze: body, knowledge, love, and truth.

Cet article est l’une des conclusions de la recherche Apories du féminin : une approche au sujet de la jouissance féminine réalisée dans le cadre du Master Recherche de Psychanalyse de l’Université Paris VIII. Nous nous proposons d’examiner le concept lacanien de la jouissance féminine, tel qu’il a été présenté dans Encore, le séminaire 20 de 1972-1973. Selon Lacan, ce concept n’est abordable que par le biais de la contradiction. Basés sur cette prémisse, nous tenterons de dévoiler quelques apories inhérentes à l’étude psychanalytique de quatre catégories ponctuelles que nous proposons d’analyser : le corps, le savoir, l’amour et la vérité.

Health and working conditions in carpenter's workshops in Armenia (Colombia).

We conducted a study of the health and working conditions in 10 carpenter's workshops in the municipality of Armenia (Colombia). In these workshops, all the most exposed workers to wood dust were surveyed at the areas of sanding, brushing, immunization and painting (workers with the highest risk to get chronic respiratory disease). They were 177 workers. The use of hard and soft woods for furniture was detected. Besides, some pesticides, volatile organic solvents, synthetic epoxy resins glues and paintings, were used for finishes, which increases the risk of acquiring some neurological diseases and damage to the nervous system. Occurrence of cancer in nostrils mainly due to the use of hardwoods is an additional risk. With regard to the basic lighting conditions, it was found that half of workshops had deficiencies in special carving areas, because they were below the minimum allowable lighting limit level (500 lux). With relation to noise, all the workshops exceeded the permissible maximum limit value (85 dBA). With respect to the occurrence of occupational events, no data were found in the companies, or analysis of employee absenteeism due to the exposure to particulate matter.