Percutaneous Tibial Nerve Stimulation in Chronic Post-Surgical Anorectal Pain: A Case Report.

Introduction: Anorectal pain is a symptom with a negative impact on quality of life and it can sometimes develop into a chronic pain syndrome. Structural anorectal pain is treated according to the underlying pathology. In situations of chronic post-surgical pain that is refractory to conventional therapeutic approaches, percutaneous tibial nerve stimulation (PTNS) is an option. PTNS is a neurostimulation technique used in the treatment of lower urinary tract dysfunction. There has been increasing evidence of its benefits for improving other conditions, such as chronic pelvic pain (CPP) and faecal incontinence (FI). Case Presentation: We report a case of a 45-year-old woman with chronic post-surgical anorectal pain (CPAP) treated with PTNS. The patient reported a consistent and dramatic decrease in both the frequency and intensity of pain, assessed by the Brief Pain Inventory (BPI). A decrease in the pain interference with mood, normal work, and walking/mobility was also noted, as evaluated by BPI and EQ-5D-3L questionnaires. Discussion: Neuromodulation treatments have been reported as effective for anorectal pain, but reports on the use of PTNS are rare. The tibial nerve is easily accessible and provides an optimal site for neurostimulation without the need of an operating room or anaesthesia. The overall improvement observed in this case of chronic anorectal pain suggests a potential new area of research for PTNS.

Introdução: A dor anorectal é um sintoma com um impacto negativo na qualidade de vida, podendo, por vezes, desenvolver-se numa síndrome de dor crónica. A dor ano rectal de etiologia estrutural trata-se de acordo com a patologia subjacente. No entanto, em situações de dor crónica pós-cirúrgica refratária a abordagens terapêuticas convencionais, a estimulação percutânea do nervo tibial (percutaneous tibial nerve stimulation − PTNS) é uma opção de tratamento. A PTNS é uma técnica de neuroestimulação, estando descritos benefícios da sua aplicação no tratamento da urgência, frequência, incontinência e retenção urinária. Evidência crescente mostra, ainda, resultados promissores noutras condições, como a dor crónica pélvica e a incontinência fecal. Caso Clínico: Descrevemos um caso de uma mulher de 45 anos, com dor crónica anorectal pós-cirúrgica tratada com PTNS. Ao longo do período de seguimento, a doente reportou uma diminuição consistente e significativa na frequência e na intensidade da dor, tal como avaliado pelo Brief Pain Inventory (BPI). Adicionalmente, foi notória uma melhoria significativa de parâmetros relacionados com a qualidade de vida, avaliados pelos questionários BPI e EQ-5D-3L. Discussão: A evidência atual mostra que técnicas baseadas em neuromodulação têm sido eficazes no tratamento da dor anorectal, apesar dos estudos com PTNS ainda serem escassos. O nervo tibial é uma estrutura facilmente acessível e constitui um local óptimo para aplicação de neuroestimulação. A PTNS é uma opção terapêutica pouco invasiva, que não necessita de idas ao bloco operatório, nem de apoio de anestesia. O benefício observado do uso da PTNS neste caso sugere uma nova área de estudo e de potencial aplicabilidade para a técnica.

Micellar Polymer Magnetic Microrobots as Efficient Nerve Agent Microcleaners.

Micro-/nanorobot technology has developed rapidly in recent years due to their great potential to perform multiple tasks. Here, we develop magnetic microrobots prepared as polycaprolactone/Fe3O4 microspheres covered by micellar polyethyleneimine and use them to efficiently remove a nerve agent from contaminated water. The magnetic polymeric microrobots presented in this work removed around 60% of the nerve agent from water samples in a short time. The attractive performance of these magnetic microrobots offers a very promising approach to large-scale water treatment for environmental remediation.

Transition metal dichalcogenide-based Janus micromotors for on-the-fly Salmonella detection.

Janus micromotors encapsulating transition metal dichalcogenides (TMDs) and modified with a rhodamine (RhO)-labeled affinity peptide (RhO-NFMESLPRLGMH) are used here for Salmonella enterica endotoxin detection. The OFF-ON strategy relies on the specific binding of the peptide with the TMDs to induce fluorescence quenching (OFF state); which is next recovered due to selectively binding to the endotoxin (ON state). The increase in the fluorescence of the micromotors can be quantified as a function of the concentration of endotoxin in the sample. The developed strategy was applied to the determination of Salmonella enterica serovar Typhimurium endotoxin with high sensitivity (limits of detection (LODs) of 2.0 µg/mL using MoS2, and 1.2 µg/mL using WS2), with quantitative recoveries (ranging from 93.7 ± 4.6 % to 94.3 ± 6.6%) in bacteria cultures in just 5 min. No fluorescence recovery is observed in the presence of endotoxins with a similar structure, illustrating the high selectivity of the protocol, even against endotoxins of Salmonella enterica serovar Enteritidis with great similarity in its structure, demonstrating the high bacterial specificity of the developed method. These results revealed the analytical potential of the reported strategy in multiplexed assays using different receptors or in the design of portable detection devices.

Functional coatings enable navigation of light-propelled micromotors in blood for effective biodetoxification.

Herein we report the coating of visible light-driven polycaprolactone (PCL) based micromotors with an anti-biofouling poly lactic-co-glycolic acid (PLGA) layer for effective navigation and detoxification in blood samples. The micromotors encapsulate CdSe@ZnS quantum dots as photoresponsive materials and a Fe3O4 nanoparticle patch to promote electron transfer and reaction with glucose present in the media for diffusiophoretic propulsion in diluted blood. The coating of the micromotor with the PLGA layer prevents red blood cell adhesion and protein adsorption due to the creation of a highly efficient hydration layer. This results in an enhanced speed and efficient operation for enhanced toxin removal as compared with the bare PCL micromotors. Hemolysis and MTT assays along with no platelets aggregation revealed the high biocompatibility of the micromotors with living cells. Effective adsorptive removal of two relevant toxins, sepsis associated Escherichia coli O111:B4 toxin and snake venom α-bungarotoxin from blood is achieved with the PLGA micromotors. The new developments illustrated here represent one step forward in the use of light-driven micromotors for biomedical applications.

Engineering Janus micromotors with WS2 and affinity peptides for turn-on fluorescent sensing of bacterial lipopolysaccharides.

Herein we describe an "OFF-ON" Janus micromotor approach for the fast (5 min) and sensitive determination (limit of detection, 120 pM) of Escherichia coli O111:B4 lipopolysaccharide (LPS) associated with sepsis shock in microliter samples. The OFF-ON strategy relies on the loading of a specifically designed rhodamine-labeled affinity peptide into WS2-Pt-Fe2O3 polycaprolactone Janus micromotors. Specific attachment of the peptide with the WS2 via electrostatic and hydrophobic interactions results in fluorescent quenching, which is subsequently recovered by the detachment of the probe in the presence of the target LPS. Peptide loading into the micromotor structure increases the overall stability for over 2 months without any change in its properties and excellent analytical performance. No fluorescence recovery is observed in the presence of LPS with a similar structure, illustrating the high selectivity of the protocol, along with quantitative recoveries in human serum and bacteria cultures. The method was validated against the gold standard Limulus Amoebocyte lysate assay in real bacteria culture containing naturally occurring LPS, with similar recoveries in both cases. The micromotors hold great potential to carry out analytical measurements in real-time with small amounts of sample and reagents, allowing for fast detection of deadly toxins with high clinical relevance.

Chalcogenides-based Tubular Micromotors in Fluorescent Assays.

WS2/Pt and MoS2/Pt bubble propelled micromotors are used as "on-the-fly" sensing platforms in bioassays, using a highly selective affinity peptide probe for "OFF-ON" detection of Escherichia coli as a model endotoxin. The different outer micromotor surface characteristics play an important role in the sensing performance. The relatively high outer surface of WS2/Pt micromotors results in a 3.5-fold increase in sensitivity compared to MoS2/Pt micromotors due to enhanced peptide probe loading and release. The peptide-modified WS2 micromotors are used as a low-cost and high-throughput approach for the determination of E. coli endotoxin after only 60 s, with a limit of detection of 1.9 ng mL-1 and high selectivity. The method has been validated using spiked samples (tap water, blood serum, and saliva) and bacteria media (blank broth, Staphylococcus aureus, and E. coli). The concept can be extended to the analysis of other (bio)-analytes and easily incorporated into portable instrumentation, holding great promise in a myriad of clinical, environmental, or food-safety applications.

Visible-Light-Driven Janus Microvehicles in Biological Media.

A light-driven multifunctional Janus micromotor for the removal of bacterial endotoxins and heavy metals is described. The micromotor was assembled by using the biocompatible polymer polycaprolactone for the encapsulation of CdTe or CdSe@ZnS quantum dots (QDs) as photoactive materials and an asymmetric Fe3 O4 patch for propulsion. The micromotors can be activated with visible light (470-490 nm) to propel in peroxide or glucose media by a diffusiophoretic mechanism. Efficient propulsion was observed for the first time in complex samples such as human blood serum. These properties were exploited for efficient endotoxin removal using lipopolysaccharides from Escherichia coli O111:B4 as a model toxin. The micromotors were also used for mercury removal by cationic exchange with the CdSe@ZnS core-shell QDs. Cytotoxicity assays in HeLa cell lines demonstrated the high biocompatibility of the micromotors for future detoxification applications.

Self-propelled micromachines for analytical sensing: a critical review.

Self-propelled micromotors are micro- and nanoscale devices that move autonomously in solution by converting a specific stimulus into mechanical work. The broad scope of operations and applications along with the ultra-small dimensions have opened new possibilities to solve complex analytical challenges. Herein we give a critical overview of early developments and future prospects of such tiny moving objects for different analytical sensing and biosensing strategies. From early electrophoretic propelled nanomotors, which were limited to low viscous media, to bubble-propelled micromotors, the field has evolved into sophisticated all-in-one analytical systems with built-in sensing capabilities. Current progress for in vivo biosensing and integration into analytical instrumentation towards fully functional devices will be also covered. We hope that this review provides the reader with some general knowledge and future prospects of self-propelled micromachines as a new paradigm in analytical chemistry. Graphical abstract.

Improving the non-sterile food waste bioconversion to hydrogen by microwave pretreatment and bioaugmentation with Clostridium butyricum.

This work targeted the energy recovery from food waste (FW), aiming at the implementation of a potentially participative process of FW conditioning before the non-sterile biological conversion to hydrogen (H2). Food waste conversion was initially performed under sterile conditions, achieving a maximum H2 productivity of 249.5 ±â€¯24.6 mL H2 (L h)-1 and a total H2 production to 4.1 ±â€¯0.2 L L-1. The non-sterile operation was implemented as a way of process simplification, but the total H2 production decreased by 59% due to the FW native microorganisms. To counteract this effect, FW was submitted to acid, microwave (MW), and combined acid and MW pretreatment. The application of 4 min MW, 550 W, efficiently controlled the FW microbial counts. The Clostridium butyricum bioaugmented conversion of MW-pretreated FW accelerated the H2 production to 406.2 ±â€¯8.1 mL (L h)-1 and peaked the total H2 production and conversion yield to 4.6 ±â€¯0.5 L L-1 and 234.6 ±â€¯55.6 mL (g sugar)-1, respectively. These results exceeded in 63, 12 and 4%, respectively, the H2 productivity, total production and sugar conversion yield obtained under sterile conditions, and are encouraging for the future implementation of increasingly responsible waste valorisation practices.

On the road to cost-effective fossil fuel desulfurization by Gordonia alkanivorans strain 1B.

Biodesulfurization (BDS) is an ecofriendly process that uses microorganisms to efficiently remove sulfur from fossil fuels. To make the BDS process economically competitive with the deep hydrodesulfurization process, which is currently used in the oil industry, it is necessary to improve several factors. One crucial limitation to be overcome, common within many other biotechnological processes, is the cost of the culture medium. Therefore, an important line of work to make BDS scale-up less costly is the optimization of the culture medium composition aiming to reduce operating expenses and maximize biocatalyst production. In this context, the main goal of this study was on the minimization of inorganic key components of sulfur-free mineral (SFM) medium in order to get the maximal production of efficient desulfurizing biocatalysts. Hence, a set of assays was carried out to develop an optimal culture medium containing minimal amounts of nitrogen (N) and magnesium (Mg) sources and trace elements solution (TES). These assays allowed the design of a SFMM (SFM minimum) medium containing 85% N-source, 25% Mg-source and 25% TES. Further validation consisted of testing this minimized medium using two carbon sources: the commercial C-source (glucose + fructose) versus Jerusalem artichoke juice (JAJ) as a cheaper alternative. SFMM medium allowed microbial cells to almost duplicate their specific desulfurization rate (q 2-HBP) for both tested C-sources, namely from 2.15 to 3.39 µmoL g-1 (DCW) h-1 for Fru + Glu and from 1.91 to 3.58 µmoL g-1 (DCW) h-1 for JAJ, achieving a similar net 2-hydroxybiphenyl produced per g of consumed sugar (∼17 µmoL g-1). These results point out the great advantage of using cheaper culture medium that in addition enhances the bioprocess effectiveness, paving the way to a sustainable scale-up for fossil fuel BDS.

Lab-on-a-micromotor: catalytic Janus particles as mobile microreactors for tailored synthesis of nanoparticles.

Catalytic Janus micromotors encapsulating Cd2+ or citrate are used here as mobile microreactors for "on the fly" CdS quantum dot and gold nanoparticle synthesis. Micromotor navigation in microliter "reagent solutions" results in the generation of the corresponding nanoparticles inside the micromotor body with high yield and negligible waste generation. Nanoparticle generation can be attributed to convective diffusion of reagents into the moving reactor body. "On-demand" modulation of nanoparticle size and catalytic activities can be achieved by judicious control of the motion behavior of the microreactor. The use of confined reagents in connection with such enhanced movement allows for efficient operation in very low (less than 800 µL) volumes. The new microreactors developed here hold considerable promise for reactions in aqueous environments for novel synthetic schemes in different sites along with multiplexed capabilities for a myriad of catalytic reactions.

Magnetocatalytic Graphene Quantum Dots Janus Micromotors for Bacterial Endotoxin Detection.

Magnetocatalytic hybrid Janus micromotors encapsulating phenylboronic acid (PABA) modified graphene quantum dots (GQDs) are described herein as ultrafast sensors for the detection of deadly bacteria endotoxins. A bottom-up approach was adopted to synthesize an oil-in-water emulsion containing the GQDs along with a high loading of platinum and iron oxide nanoparticles on one side of the Janus micromotor body. The two different "active regions" enable highly efficient propulsion in the presence of hydrogen peroxide or magnetic actuation without the addition of a chemical fuel. Fluorescence quenching was observed upon the interaction of GQDs with the target endotoxin (LPS), whereby the PABA tags acted as highly specific recognition receptors of the LPS core polysaccharide region. Such adaptive hybrid operation and highly specific detection hold considerable promise for diverse clinical, agrofood, and biological applications and integration in future lab-on-chip technology.

Indignação: entre o fim da ingenuidade e o prenúncio da tragédia / Indignation: between the end of naivety and the beginning of tragedy

O presente trabalho consiste num exercício psicanalítico inspirado na leitura do livro Indignação de Phillip Roth (2008). Seu principal objetivo é discutir, à luz da teoria do campo psicanalítico, a organização de um campo geracional crivado de conflitos que conduzem o herói do romance a um desfecho trágico. Inspirados na teoria do campo (Baranger & Baranger, 1961-62), os autores introduzem o tema proposto a partir de duas falas dos protagonistas da trama construída por Roth, como se estivessem se apresentando em uma sessão psicanalítica. No seguimento, apresentam algumas considerações sobre a obra e seu autor e sobre o campo criado entre o leitor e o processo de leitura. Por fim, buscam explorar, estimulados pela riqueza dramática da leitura do romance, alguns aspectos psicanalíticos sobre a trajetória do herói, cujo afastamento deliberado do convívio familiar é um disfarce inconsciente para a dificuldade de enfrentar o confronto geracional. As hipóteses psicanalíticas de filicídio e simbiose pai-filho são consideradas(AU)

This paper is a psychoanalytic exercise encouraged by the reading of the book Indignation by Philip Roth (2008). In light of the psychoanalytic field theory, the authors discuss the organization of a conflictual generational field that eventually leads the novel's hero to a tragic outcome. Inspired by field theory (Baranger & Baranger, 1961-62), they start by imagining how the two main characters of the book would talk about themselves to an analyst in a psychoanalytic session. Next, some thoughts about Phillip Roth and his work are presented, as well as the field that was created between the reader and the reading process. Finally, moved by the dramatic richness of the novel, the authors investigate some of the psychoanalytical aspects about the hero´s trajectory, whose deliberate departure from his family was an unconscious disguise for the difficulty in facing the generational confrontation. The hypotheses of filicide and father-son symbiosis are considered.(AU)

El presente trabajo consiste en un ejercicio psicoanalítico inspirado en la lectura del libro Indignación, de Phillip Roth (2008). Su principal objetivo es discutir, a la luz de la teoría del campo psicoanalítico, la organización de un campo generacional minado de conflictos que conducen al héroe de la novela a un desenlace trágico. Inspirados en la teoría del campo (Baranger & Baranger, 1961- 62), los autores introducen el tema propuesto a partir de dos intervenciones de los protagonistas del argumento construido por Roth como si estuvieran presentándose en una sesión psicoanalítica. Acto seguido, plantean algunas consideraciones sobre la obra y su autor y sobre el campo creado entre el lector y el proceso de lectura. Por último, buscan explorar, estimulados por la riqueza dramática de la lectura de la novela, algunos aspectos psicoanalíticos sobre la trayectoria del héroe, cuyo alejamiento deliberado de la convivencia familiar es un disfraz inconsciente de la dificultad de enfrentar el conflicto generacional. Las hipótesis de filicidio y simbiosis padre-hijo son manejadas

Synthesis and biological evaluation of α-hydroxyalkylphosphonates as new antimicrobial agents.

A set of α-quaternary 3-chloro-1-hydroxyalkylphosphonates, analogues of fosfomycin and fosfonochlorin, some of which are new compounds, was synthesized. The compounds were screened for bioactivity against several clinical and standard microbial isolates. Some were found to have moderate activity. The activity was higher with phenyl protection of the phosphoryl ester groups and α-phenyl substitution. Compound 11 was as effective or more potent than fosfomycin or chloramphenicol against several Gram-negative bacteria as well as against some Gram-positive ones.

Baluarte, surpresa e comunicação no campo analítico / Bastion, surprise and communication in the analytic filed / Baluarte, sorpresa y comunicación en el campo analítico

Os autores refletem acerca do conceito de campo analítico e do exame do valor comunicativo de um de seus elementos, a surpresa, a partir de uma vinheta clínica.

The authors reflect on the concept of the analytic field and exam the communicative value of one of its elements - surprise - based on a clinical vignette.

Los autores reflexionan sobre el concepto de campo analítico y el examen del valor comunicativo de uno de sus elementos, la sorpresa, a partir de una viñeta clínica.

Iodine intakes of 100-300 µg/d do not modify thyroid function and have modest anti-inflammatory effects.

Little information is available as to whether doses of iodide similar to those recommended in clinical practice for the prevention of iodine deficiency in pregnant women affect thyroid function. The aim of the present study was to analyse whether doses of iodide can affect thyroid function in adults, and evaluate its effect on plasma markers of oxidative stress, inflammation and acute-phase proteins. A total of thirty healthy volunteers (ten men and twenty women) with normal thyroid function were randomly assigned to three groups (n 10). Each group received a daily dose of 100, 200 or 300 µg of iodide in the form of KI for 6 months. Free tetraiodothyronine (FT4) levels at day 60 of the study were higher in the groups treated with 200 and 300 µg (P = 0·01), and correlated with the increase in urinary iodine (r 0·50, P = 0·007). This correlation lost its significance after adjustment for the baseline FT4. The baseline urinary iodine and FT4 correlated positively with the baseline glutathione peroxidase. On day 60, urinary iodine correlated with C-reactive protein (r 0·461, P = 0·018), and free triiodothyronine correlated with IL-6 (r - 0·429, P = 0·025). On day 60, the changes produced in urinary iodine correlated significantly with the changes produced in α1-antitrypsin (r 0·475, P = 0·014) and ceruloplasmin (r 0·599, P = 0·001). The changes in thyroid-stimulating hormone correlated significantly with the changes in α1-antitrypsin (r - 0·521, P = 0·005) and ceruloplasmin (r - 0·459, P = 0·016). In conclusion, the administration of an iodide supplement between 100 and 300 µg/d did not modify thyroid function in a population with adequate iodine intake. The results also showed a slight anti-inflammatory and antioxidative action of iodide.

Tipos polínicos encontrados em colônias de abelhas africanizadas sujeitas à doença cria ensacada brasileira / Pollen types found in africanized honeybees colonies submitted to brazilian sac brood disease

O pólen de algumas espécies de Stryphnodendron (Mimosoidea), conhecidas popularmente por barbatimão, tem sido apontado como agente causador da mortandade de larvas pré-pupas observada na cria ensacada brasileira (CEB). Neste estudo, objetivou-se identificar os tipos polínicos encontrados em amostras de pólen coletadas em colméias de Apis mellifera L., no Estado do Rio de Janeiro, a fim de elucidar as fontes florais utilizadas por essa espécie de abelhas em períodos sujeitos a CEB, com especial atenção para a presença do pólen de Stryphnodendron spp. Foram coletadas amostras de pólen apícola e pão de abelhas em sete apiários, em três municípios do Estado do Rio de Janeiro. A amostragem foi tomada um mês antes e durante a ocorrência da CEB. As famílias botânicas mais representativas foram: Leguminosae, Euphorbiaceae, Asteraceae, Poaceae e Myrtaceae. O pólen de Stryphnodendron não esteve presente nas amostras analisadas. A ausência de Stryphnodendron no menu floral das colônias africanizadas acometidas pela CEB em condições naturais sugere outro fator causal para a CEB no Estado do Rio de Janeiro.

The pollen of some Stryphnodendron species (Mimosoidea), commonly known as barbatimão, has been identified as a causative agent of pre-pulps larvae mortality, observed in Brazilian sac brood disease (BSB). The goal of this study is to identify the pollen types found in samples of pollen collected by Apis mellifera L. to elucidate the floral diet used by this honeybee specie in Rio de Janeiro state during the periods where BSB usually occurs. Particular attention was given to the pollen of Stryphnodendron spp presence. Samples of pollen and bee bread were collected from seven apiaries located in Rio de Janeiro state, Brazil. Sampling procedures were done a month before BSB usual occurrence and also during its occurrence. Leguminosae, Euphorbiaceae, Asteraceae, Poaceae and Myrtaceae were most representative botanical families on pollen sampling. Pollen from Stryphnodendron was not presented at the analyzed samples. In order to Stryphnodendron absent at the floral diet of Africanized hives affected by BSB in natural conditions, it is proposed another causal factor for BSB in the state of Rio de Janeiro.

Síndrome neurotóxico irreversible secundario a litio. A propósito de un caso / Syndrome of irreversible lithium-effectuated neurotoxicity. A propos of a case

El síndrome de neurotoxicidad irreversible causada por litio (SILENT) agrupa un conjunto de complicaciones neurológicas que persisten más allá de 2 meses después de haber cesado el tratamiento con litio. Desconocemos la base etiopatogénica de dicho cuadro y, por tanto, el tratamiento utilizado en la actualidad es meramente sintomático. Describimos un caso a propósito de este síndrome y recordamos las medidas preventivas que aconsejan un grupo de expertos

The acronym SILENT (syndrome of irreversible lithium-effectuated neurotoxicity) has been coined to denote the neurologic sequelae of lithium intoxication persisting for at least 2 months after lithium withdrawal. The etiopathogenic mechanism of SILENT is far from clear and treatment is purely symptomatic. We describe a case of this syndrome and describe the preventive measures recommended by a group of experts

[Iodine deficiency and thyroid function in healthy pregnant women]. / Déficit de yodo y función tiroidea en una población de mujeres embarazadas sanas.

BACKGROUND AND OBJECTIVE: Studies from Spain suggest that the intake of iodine in pregnant women is below nutritional requirements. This study was designed to determine iodine intake and its relation with thyroid volume during pregnancy in women from southeast Spain. PATIENTS AND METHOD: A total of 520 healthy pregnant women were studied during the full three trimesters of their pregnancy. A control group was composed of 373 non-pregnant women. The following variables were measured: TSH, FT3, FT4, thyroglobulin, antiperoxidase antibodies, urinary iodine levels, and thyroid volume. RESULTS: Median urinary iodine levels were below 100 g/l in the controls and the pregnant women during their first trimester. These levels rose progressively and significantly over the second and third trimesters. Thyroid volume increased during the second and third trimesters compared with the first. TSH levels were lower during the first trimester compared to controls, and increased significantly during the third trimester. FT4 levels fell significantly during the third trimester. There was a significant negative correlation between TSH levels and thyroid volume (r = 0.22; p = 0.005). CONCLUSIONS: Iodine intake in pregnant women in Malaga is low. The results suggest a deficit in thyroid function secondary to iodine deficiency, which is worsened as pregnancy advances. The data support the convenience of systematic administration of an iodine supplement in healthy pregnant women.

Transferencia negativa e interpretacao em psicoterapia psicanalitica: algumas consideracoes tecnicas

Os autores utilizam material clinico para situar o entendimento da transferencia negativa no contexto do processo psicoterapico e da sua interferencia na relacao terapeutica, especialmente no tocante a atividade interpretativa do terapeuta. Constatam que, habitualmente, existe uma tendencia a interpretar a transferencia negativa - os sentimentos agressivos dirigidos ao terapeuta - como um ataque a relacao, sugerindo que essa situacao possa ser lidada de outra maneira, quando o terapeuta percebe a transferencia negativa como uma defesa intensa contra o temor a dependencia. Concluem que o terapeuta, ao utilizar a funcao materna atraves de uma atitude benevolente, tem melhores condicoes de preservar a relacao, evitando confrontos desnecessarios, situacoes de impasse, ou mesmo abandono de tratamento.