Tiempos posibles de la transferencia en una adolescente: efectos en la subjetividad / Possible times of an adolescent transference: effects on subjectivity

El presente desarrollo se inscribe en la investigación "Modalidades de las transferencias de pacientes adolescentes que han sido abusados sexualmente en la infancia" 2013-2016.A partir de un caso de la práctica clínica se intenta dar cuenta de la apertura y devenir de la transferencia que, sostenida en el lazo analizante-analista, devela la continuidad-discontinuidad de los tiempos necesarios y propicios para que poco a poco lo disociado-silenciado que conlleva lo traumático: el abuso sexual vivido alrededor de los 8 años de edad, tenga lugar. Eso traumático se presenta como reviviscencia, no como recuerdo. Lo escindido (no reprimido) retorna y algo nuevo se produce: el abrazo y la mirada de la analista marca -como intervención en transferencia, el procesamiento de eso que era y sigue siendo tan excesivo.

This development is a part of the investigation "Transference Modalities of adolescent patients who have been sexually abused in childhood". From a clinical practice case, it is attemped to account of the opening and future of the transference. This phenomenon, when sustainedin the analysand-analyst link, reveals the continuity-discontinuity of the necessary and adequate times for the disassociated-silenced connected to the traumatic to take place little by little; that is, the sexual abuse experience around the age of eight. That traumatic episode is presented as a lashback, not as a memory. What is divided (not repressed) returns and something new takes place: the hug and look of the analyst marks - as intervention in transference- the processing of what was and remains so excessive.

El aporte del término ôdeprivaciónö acuñado por D. W. Winnicott, en la época que transitamos / The contribution of the term deprivation acuñado by D. W. Winnicott, in the age we are going through

El presente desarrollo se basa en el novedoso aporte que hiciera Winnicott en 1945 con el término "deprivación", constituyendo el eje central desde donde se aborda la importancia de la implicancia y provisión del ambiente, desde los inicios de la vida de un infante hasta la adultez. Determinadas condiciones ambientales son necesarias para que el desarrollo emocional de cada individuo tenga lugar, a partir de la función de la "madre suficientemente buena" y por extensión, la familia, la escuela y la sociedad. Si acordamos con lo propuesto por Winnicott que la salud individual es condición para concebir una salud social, la revisión de esta noción permite volver a pensar la tendencia antisocial en la época actual caracterizada por una sociedad donde la tendencia homogeneizante desdibuja el tiempo y el espacio necesario para el despliegue subjetivo de cada uno de sus individuos.(AU)

El aporte del término “deprivación” acuñado por D. W. Winnicott, en la época que transitamos / The contribution of the term deprivation acuñado by D. W. Winnicott, in the age we are going through

El presente desarrollo se basa en el novedoso aporte que hiciera Winnicott en 1945 con el término "deprivación", constituyendo el eje central desde donde se aborda la importancia de la implicancia y provisión del ambiente, desde los inicios de la vida de un infante hasta la adultez. Determinadas condiciones ambientales son necesarias para que el desarrollo emocional de cada individuo tenga lugar, a partir de la función de la "madre suficientemente buena" y por extensión, la familia, la escuela y la sociedad. Si acordamos con lo propuesto por Winnicott que la salud individual es condición para concebir una salud social, la revisión de esta noción permite volver a pensar la tendencia antisocial en la época actual caracterizada por una sociedad donde la tendencia homogeneizante desdibuja el tiempo y el espacio necesario para el despliegue subjetivo de cada uno de sus individuos.

Biocontrol potential and polyphasic characterization of novel native Trichoderma strains against Macrophomina phaseolina isolated from sorghum and common bean.

Native strains of Trichoderma isolated from sorghum and common bean crop soils were investigated to assess their biocontrol potential over the phytopathogenic fungus Macrophomina phaseolina, isolated from diseased plants. The Trichoderma strains were characterized with a polyphasic approach, which combined the analysis of their morphological characteristics, enzymatic activity, macro- and microculture test results, rDNA restriction patterns (AFLP), ITS1-5.8S-ITS2 rDNA sequences, and protein profiles. The integration of these data sets can be used to select new isolates as biological control agents against native fungal phytopathogens. In general, we observed a positive correlation between the secretion of beta-1,3-glucanase and N-acetylhexosaminidase, and the biocontrol capacities of all the Trichoderma isolates. Strains with the best hyperparasitic behavior against M. phaseolina isolated from diseased bean and sorghum were Trichoderma sp. (TCBG-2) and Trichoderma koningiopsis (TCBG-8), respectively.

¿Qué, como y cuánto de la psicoeducación del paciente bipolar en Chile / ¿What, how and how many of the psychoeducation in the bipolar patient in Chile?

Today it is accepted that psycho education is essential for the adequate treatment of bipolar disorder. The combination of modern pharmacology with psycho education has been demonstrated to be determinants in the evolution of these patients. This article includes a brief look into the most important studies dealing with psycho education in bipolar patients and its goal is to show a wide angle view on “what, how and how much” is done in psycho education in the most prominent psychiatric centers in the country. Finally, there are some suggestions for the improvement of such activities.

Hoy se acepta que la psicoeducación es una herramienta esencial para el manejo adecuado del trastorno bipolar. La combinación de farmacología moderna con técnicas de psicoeducación, han demostrado ser determinantes en la evolución de estos pacientes. Este artículo incluye una breve reseña de los trabajos más importantes sobre psicoeducación en el paciente bipolar y pretende mostrar una panorámica acerca del “qué, cómo y cuánto” se hace en psicoeducación en los centros psiquiátricos más importantes del país. Finalmente, se proponen algunas sugerencias para mejorar esta actividad.

Aplicación del examen clínico, objetivo estructurado, OSCE, en la evaluación final del internado de pediatría en dos escuelas de medicina / Objetive structured clinical examination for a pediatric internship assessment in 2 medical schools

Background: The Objective Structured Clinical Examination (OSCE) has become a respected and widely used tool for the assessment of clinical competence in medical education. Aim: To describe the first experience of an OSCE as a summative assessment in undergraduate Pediatric Internship, in two universities. Material and Methods: The OSCE was structured by a committee of faculty members of the 5 campi of University of Chile and I campus of the Catholic University. A 21 station OSCE was administered simultaneously to 124 Pediatric Interns (University of Chile =104, Catholic University=20), in 3 centers. A total of 50 faculty members participated in the examination. The OSCE consisted of 20 clinical problems, including videotape recordings, photographs, x-rays and laboratory exams, phantoms and 7 simulated standardized parents. Results: The average total OSCE score was 67.3 percent (range: 84.5 percent-43.5 percent). The maximum theoretic score was achieved in 19 stations. A significant correlation between station and total score, was found for 18 of the 20 clinical problems. Conclusions: The experience of using OSCE has been a success. The OSCE was an adequate procedure to assess a large number of interns simultaneously and it allowed us to measure the main objectives in all domains and a wide range of clinical competence of Pediatric Internship Programs

Water quality improvement of treated wastewater by intermittent soil percolation.

Our research aimed to evaluate intermittent soil infiltration of treated sewage for reuse in the north of Chile. Aerated lagoon effluent was infiltrated in columns packed with native soils (sandy-lime, lime-gravel and limey-sand). Columns were operated for more than a year under different cycles of filling and drying, depths and load pressures depending on soil characteristics. The efficiency of the system was determined through influent-effluent microbiological indicators level (faecal coliforms, E. coli, Salmonella spp, MS2 phage, and protozoan cysts), physicochemical characterisation (TOC, COD, BOD, nitrogen), and hydraulic flow measurement. Results showed: (a) high reduction of enteric bacteria (5-7 log10), some inactivation of phage (2-4 log10) and complete removal of intestinal cyst; (b) stable removal of organic matter (80-90% reduction of TOC, COD, BOD); and (c) partial ammonia reduction through adsorption and nitrification with denitrification mainly occurring in sandy soil. Preliminary data from pilot plant working in the field showed better results that those obtained in the laboratory especially removal of microbiological indicators. Microbiological quality of effluent met Class A regulations for agricultural reuse (WHO, 1989) and the system looks like an attractive alternative to cope with water shortage in the region.

[Implementation of an indirect method for the measurement of memory in the elderly]. / Implementación de un método indirecto para medir la memoria en la tercera edad.

INTRODUCTION: There is interference between emotional factors and intellectual output in the elderly, in whom there is a high prevalence of depression. Low output in conventional psychological tests may lead to false positive diagnoses of dementia. PATIENTS AND METHODS: We evaluated 48 patients aged between 50 and 84 years with regard to their emotional and intellectual state by means of the SCAN system. We also used a test designed by ourselves to implicitly examine memory. This consisted of a task involving naming objects. Six stimuli were repeated three times, seeking an effect of perceptual representation of 'priming' which facilitated later recall. RESULTS: The results showed that patients with dementia recalled 0 to 2 of the repeated stimuli, as a result of weakened priming. Meanwhile the non-demented persons, in spite of having other neurological disorders answered between 4 and 6 times. Multivariate analysis of the variance showed that measurement of memory, both implicit and explicit, allowed discrimination between patients with and without dementia. However, the explicit results were not independent of the effects of depression. CONCLUSIONS: Implicit measurements of memory were superior to direct or explicit measurements in the diagnosis of dementia. Patients with other degenerative conditions, such as Parkinsonism and multisystemic atrophy, had above average results. This corroborates the view that the neurological basis of this type of memory is not at subcortical level.

Construction of Heterometallic Cubanes

Incorporation of M(CO)(3) fragments by trinuclear Ti complexes [{Ti(3)Cp(µ(3)-CR)}(µ-O)(3)] and [{Ti(3)Cp(µ(3)-N)}(µ-NH)(3)] (Cp*=eta(5)-C(5)Me(5)) leads to the formation of an unprecedented class of heterometallic clusters with cubane structure [e.g., Eq. (a)]. Density functional calculations on these complexes indicate the existence of electron delocalization in the Ti(3)M cores (M=Cr, Mo, W).

[Fetal drug addiction as a consequence of maternal cocaine free base abuse during pregnancy]. / Drogadicción embriofetal por abuso de pasta base de cocaína durante el embarazo.

BACKGROUND: Fetal drug addiction is a serious public health problem. In the United States 10 to 15% of children have been exposed "in utero" to cocaine. In a Chilean public health service, more than 200 offspring of cocaine free base abuser have been detected. AIM: To analyze the clinical and social features of 100 children exposed to cocaine free base during fetal development. PATIENTS AND METHODS: Clinical features of children born from cocaine free base consume mothers were described at birth. During subsequent follow up, growth and development, disease episodes, developmental alterations and social situation were recorded. Data was compared with other newborns from the same health service. RESULTS: Compared to their normal counterparts, exposed children has a lower birth weight, the frequency of premature babies was thrice higher, and small-for-gestational age children were four times more common. There was also a higher prevalence of cardiac malformations, seizures and apnea. Hospital admissions were more frequent, prolonged and required more complex facilities. During follow up, undernutrition and stunting were more prevalent. Psychomotor retardation was present in 67% of children and behavioral disturbances in 93%. Most of these children are governmental protection. CONCLUSIONS: Strategies to prevent drug abuse during pregnancy and its devastating medical and social consequences should be urgently developed (Rev Méd Chile 2000; 128: 1093-1100).

Hidatidosis en la provincia de Ñuble: estudio descriptivo sobre egresos hospitalarios entre los años 1993 y 1997 / Hidatidosis at the Ñuble province: descriptive study of hospital discharges from 1993 to 1997

La hidatidosis es un importante problema de salud pública que se encuentra subestimado por la dificultad de su vigilancia epidemiológica. Para estimar la magnitud de la subnotificación de esta patología, se analizaron los egresos hospitalarios en comparación con las notificaciones realizadas en el formulario RMC 14 (Registro Mensual Consolidado de Enfermedades de Notificación Obligatoria), entre los años 1993 y 1997 en la provincia de Ñuble. Se observó que el porcentaje de subnotificación alcanzó un 73 por ciento. Las tasas de morbilidad y mortalidad por esta enfermedad son mayores en la provincia de Ñuble, con relación al país, con una tendencia estable en el tiempo. Esta patología presenta su sintomatología preferentemente en edades productivas, con largas estadías hospitalarias, con intervenciones quirúrgicas importantes y licencias laborales prolongadas; además de la repercusión sobre la producción animal, lo cual hace necesario realizar programas preventivos focalizados en los lugares de mayor riesgo

Differential kinetic patterns for Shiga toxin production by Escherichia coli

El objetivo de este trabajo fue estudiar la cinetica de produccion de los distintos tipos de toxinas Shiga (Stx1; Stx2c) asociadas a Escherichia coli, en cepas de referencia y aisladas de pacientes con Sindrome Uremico Hemolitico (SUH). Las cepas fueron cultivadas en caldo Penassay e incubadas a 37§ con agitacion (200 rpm), tomandose muestras a distintos tiempos (1,5; 3; 9 y 24 horas) para determinar el crecimiento bacteriano y la citotoxicidad libre y asociada a celulas. Para Stx1, a las 3 horas de incubacion, la relacion entre la concentracion intracelular y la extracelular (ic/ec), estuvo comprendida entre 32 y 200 veces. A las 24 horas, ambas concentraciones se igualaron o (ec) resulto 2 veces mayor, dependiendo de la cepa estudiada. Sin embargo, tanto la actividad citotoxica libre como la asociada a celulas presentaron titulos muy bajos. Esto indico una perdida de actividad durante la fase estacionaria que podria deberse al cese de la sintesis de Stx1 o la accion de enzimas proteoliticas. Para Stx2, a las 3 horas (ic) fue igual o 2 veces superior a (ec), a las 34 horas (ec) fue 16 a 32 veces superior a (ic). Para Stx2c, (ec) aumento logaritmicamente con un rendimiento maximo a las 5 horas, permaneciendo luego constante hasta las 24 horas. En ese tiempo (ic) fue dos veces superior a (ec). El estudio de la cinetica de produccion de Stx por cepas de E. coli aisladas de pacientes con SUH demostro que correspondian al tipo Stx2. Estos resultados fueron confirmados por ensayos de citotoxicidad especifica en celulas Vero y por hibridacion con sondas geneticas. El tipo de Stx es considerado uno de los mayores factores de riesgo en la evolucion a SUH en pacientes infectados con E. coli enterohemorragicos. Por lo tanto, la disminucion de la citotoxicidad de Stx1, durante la fase estacionaria de crecimiento, podria explicar la mayor frecuencia de accion entre SUH y cepas de E. coli productoras de Stx2 en distintos paises, incluyendo Argentina

Differential kinetic patterns for Shiga toxin production by Escherichia coli

El objetivo de este trabajo fue estudiar la cinetica de produccion de los distintos tipos de toxinas Shiga (Stx1; Stx2c) asociadas a Escherichia coli, en cepas de referencia y aisladas de pacientes con Sindrome Uremico Hemolitico (SUH). Las cepas fueron cultivadas en caldo Penassay e incubadas a 37º con agitacion (200 rpm), tomandose muestras a distintos tiempos (1,5; 3; 9 y 24 horas) para determinar el crecimiento bacteriano y la citotoxicidad libre y asociada a celulas. Para Stx1, a las 3 horas de incubacion, la relacion entre la concentracion int

Differential kinetic patterns for Shiga toxin production by Escherichia coli.

We studied the differential kinetic patterns for Shiga toxin (Stx) production (i.e. Stx1, Stx2 and Stx2c) in different reference Escherichia coli strains and in those isolated from hemolytic uremic syndrome (HUS) patients. These results were correlated with those obtained by specific cytotoxic activity assays on Vero cells and hybridization tests with DNA probes for Stx1 and Stx2. Strains cultured in Penassay broth were sampled at 1.5; 3; 5; 9 and 24 hours to determine bacterial growth and its association with cell-bound and free cytotoxicity. Stx1 showed an intracellular/extracellular concentration ratio (ic/ec) between 32 and 200 times after 3 h-growth. At 24 h both Stx1 concentrations were equal or, in some strains, the ec resulted 2-fold higher that the ic. The ic-Stx1 was equal or just 2-fold higher that ec after 3 h-growth. However, at 24 h the released toxin level was 16 to 32 times higher that cell-bound toxin. The ec-Stx2c increased logarithmically, with maximal yields at 5 h, remaining constant up to 24 h. At that time ic-toxin was 2-fold higher than the released one. When the same experiments were performed on strains isolated from HUS patients they showed that the kinetic patterns obtained corresponded to Stx2. These results were confirmed by hybridization assays. In this study we have shown that Stx1 production decreases dramatically during stationary phase while Stx2 is detected at high level at that time. This could explain the higher frequency of association of Stx2-producing E. coli strains and HUS in some countries, including Argentina.

[Alcohol consumption and family: a descriptive study in adolescents]. / Consumo de alcohol y familia: un estudio descriptivo en adolescentes.

AIM: To study abnormal alcohol ingestion among parents and family dysfunction of pregnant and non pregnant teenagers. SUBJECTS AND METHODS: Pregnant and non pregnant girls from 12 to 18 years old consulting in the Teenager Health Unit of a public hospital outpatient clinic were studied. Their degree of instruction attained, marital status, social behavior, alcohol, drug intake and history of child abuse was recorded. The level of instruction, marital status, alcohol ingestion and work stability of their fathers was also studied. RESULTS: One hundred sixteen pregnant and 60 non pregnant teenagers were studied. The fathers of pregnant girls had a higher level of alcohol consumption, more civil irregularities and a higher level of family dysfunction. Among these girls, a higher frequency of neurological abnormalities and fetal alcohol syndrome was observed. They had also a lower educational level and a higher degree of alcohol and drug use. CONCLUSIONS: Alcohol consumption among parents leads to family dysfunction and has adverse physical, intellectual and social consequences in the offspring.

Nutritional status of institutionalised elderly in Ecuador.

The nutritional status of 111 elderly men and women aged 60 to 99 years in two institutions in the Ecuadorian Andes was evaluated using dietary, anthropometric and biochemical measurements. Mean daily energy intakes of men and women were 1720 and 1650 kcal, respectively (7.2 and 6.9 MJ), corresponding to 1.5 times the calculated basal metabolic rate (BMR). 6% of subjects had intakes less than 1.2 x BMR and 40% less than 1.5 x BMR. Body mass index (BMI) was below 20 kg/m2 in 21% of subjects; 45% were between 20 and 24. Only one subject had a BMI over 29. Intakes of protein, calcium, iron, riboflavin and vitamin C were satisfactory, in contrast to those of zinc, vitamin A, niacin and thiamin. Using sex- and altitude-specific cutoffs for hemoglobin, anemia was observed in 11% of subjects. Nutritional status, evaluated using biochemical indicators, was satisfactory with respect to riboflavin, vitamin A, vitamin E and copper. 14% of subjects had low serum zinc levels and 17% had serum albumin values below 35 g/L. Low physical activity was associated with low energy intake and low serum albumin levels.