Parallel process in psychodynamic supervision: The supervisor's perspective.

Nine postdoctoral-level experienced psychodynamic supervisors were interviewed about working with a supervisee on a case involving parallel process (PP) that started in therapy and was enacted in supervision. Consensual qualitative research was used to analyze transcripts of the interviews. The general pattern that emerged from the analysis of the supervisors' reports was that clients behaved unusually in session, therapists "got hooked" by this change, therapists enacted the client's behavior in supervision, supervisors "got hooked," supervisors reflected on their reactions and intervened in a different way; reported outcomes were mostly positive (e.g., enhanced growth or understanding for the therapist). Results of this qualitative investigation provide evidence of PP and clues as to how experienced supervisors observe, describe, and respond to PP in ways that promote growth, insight, and understanding for their supervisees. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

[The bilateral renal lymphoma: an incurable disease? Case report]. / Il linfoma renale bilaterale: è ancora una malattia incurabile? Case Report.

The bilateral primary renal lymphoma (PRL) is a rare disease with a high mortality rate (75% within the first year). We report the case of a fifty-three years old women observed in January 2011 for renal colic. Ultrasonography showed hypoechoic lobular formations in the kidney. Blood tests showed: creatinine 1.8 mg/dl, urea 75 mg/dl , Creatinine Clerance 35 ml/m, hemoglobinemia 11 g/dl, with blood cells 8.500/mcL, Albumin 2.8 g/dl, Beta -2 micro - 27.3/mL. Proteinuria was 0.3 g/24 hours. The CT scan showed kidneys with larger dimensions and multiple hypodense areas infiltrating the renal parenchyma with contrast-enhanced low in which kidneys had lesions similar to "leopard skin". The CT scan showed no enlarged lymph nodes. Renal biopsy showed: renal parenchyma largely occupied by infiltration of lymphoid elements, small and medium-sized, densely packed with compression of the tubular structures . Immunofluorescence for immunoglobulin (Ig) G, IgA, IgM, C3, C4, C1q, fibrinogen, kappa and lambda were negative. The bone marrow biopsy excluded lymphomatous infiltration. The histological diagnosis was "non-Hodgkin's B-cell lymphoma"; the clinical diagnosis was LRBP. The patient was treated by 6 cycles of R-CHOP-21 protocol (rituximab - endoxan, adriblastina , vincristine, prendnisone), the latter of which practiced in August 2011. The pt is currently in follow-up hematology and nephrology . The first TAC control , in October 2011, showed a complete regression of the lesions infiltrating . This finding was confirmed by two other CT scan performed in February and October 2012. The last blood tests of February 2013 showed : creatinine 1.1 mg / dl , Urea 40 mg/dl, proteinuria absent. Currently, the pt is asymptomatic and is being treated by low dose of ACE inhibitor. The bilateral PRL is considered a severe disease with one-year mortality of 75% . The successful outcome of the case described can be attributed to haematological therapy and to the early diagnosis.

Effects of captopril and of other antihypertensive drugs on cell membrane ion transport--a preliminary report.

We measured red blood cell Na+-K+ pump, Na+-Li+ countertransport and Na+-K+ cotransport activities, together with intraerythrocyte sodium content before and after 3 months therapy with captopril and two other antihypertensive drugs (atenolol and canrenoate potassium) in subjects suffering from essential hypertension. All patients discontinued any previous treatment at least 3 months before the basal evaluation of cell membrane activities. All three drugs significantly lowered blood pressure but only captopril and canrenoate potassium induced significant modifications in red blood cell parameters. After three months of captopril therapy intraerythrocyte Na+ content was significantly decreased (P less than 0.01) without any detectable change in cation transport system activity. After 3 months of canrenoate potassium therapy we also observed a significant decrease in internal Na content (P less than 0.01), together with a significant increase in Na+-K+ pump (P less than 0.02) and Na+-Li+ countertransport (P less than 0.05) activities.

Sodium balance and peripheral resistance in arterial hypertension.

In this brief review, some aspects of the relation between sodium balance and peripheral resistance in four types of arterial hypertension are discussed. Renal hypertension, hypertension caused by reduced kidney mass and sodium load, mineralocorticoid hypertension, and spontaneous or "genetic" hypertension in rats are considered. In all these forms of hypertension, the increase in peripheral resistance is preceded by changes in body sodium and fluids. However, the precise role of these changes in the development of the subsequent rise of peripheral resistance is not yet clear. Changes in ion transport across the cell membranes have been demonstrated even before the development of hypertension, especially the forms caused by mineralocorticoids or genetic factors. Even though we do not know the underlying mechanisms, it is very likely that these cell-membrane changes are involved in the rise of peripheral resistance and blood pressure.

Genetic hypertension and the kidney.

The relationship between the kidney and genetic hypertension has been assessed in light of the changes seen in some kidney and cell functions during the phases preceding and accompanying the development of "genetic" types of hypertension in rats and humans. Comparison of the kidney function of normotensive subjects likely to develop hypertension with that of matched controls resistant to hypertension showed, in the former, a higher glomerular filtration rate (GFR), greater tubular reabsorption, larger 24-h urinary output, larger fraction of cardiac output to the kidney, and lower plasma renin activity. After the transplantation of a kidney from a subject in the hypertension-prone group, recipients had higher blood pressure and required more antihypertensive therapy than recipients of kidneys from the hypertension-resistant group. In humans this finding is not as clear as in rats. During the development of hypertension most of these differences in kidney function in the two groups of subjects tend to disappear. The changes in cell function, measured particularly in rats, were consistent with the organ function changes. Cell volume and sodium content were lower, while the transport rate across the cell membrane was faster in proximal tubular cells of rats with genetic hypertension than in the appropriate controls. This is in keeping with the concept of a primary increase in proximal tubular reabsorption leading, on the one hand, to an increase in GFR and renal blood flow and a decrease in renin and, on the other, to an increase in blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)