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The increase in prices of fertilizers, energy and other materials necessary for the industry triggered a global economic crisis. Reason that was investigated on the biological and chemical characteristics in relation to the yield of radish nourished with humus from plant residue. The objective was to determine the appropriate dose of humus to obtain greater yield and its relationship with the chemical and biological characteristics of the radish. It is based on applied methodology with an experimental approach; Therefore, the Completely Random Block Design model was used, which consisted of 3 blocks and 5 treatments that were T1 with 0, T2 with 4, T3 with 6, T4 with 8 and T5 with 10 t/ha of humus and They applied 15 days after sowing. The physical characteristics of the radish were evaluated and processed using analysis of variance and Duncan. Concentration of elements in leaves and stomatal density were also analyzed. It was determined that T5 stood out in total plant length with 28.95 cm, plant weight with 76.87 g, equatorial diameter with 4,404 cm and commercial yield with 20,296 t/ha. Nitrogen consumption in relation to yield with 247.44 kg/ha. Stomatal density 459 stomata/mm2 and profitability with 150% and nutrient concentration in leaves highlighted T4 with N, K, Ca, Mg, Mo and Zn. It concludes that T5 stood out with 20,296 t/ha, which differed by 26.04% in relation to the control (T1) with 15,011 t/ha. Therefore, this dose added nutrients to the soil that improved the availability for plant absorption and this influenced the concentration of nutrients in leaves such as N, P and Fe and stomatal density with 459 stomata/mm2, which had a response in good development, strengthening against environmental stress and therefore greater performance.
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Fertilizantes , Raphanus , Raphanus/química , Raphanus/crescimento & desenvolvimento , Fertilizantes/análise , Substâncias Húmicas/análise , Folhas de Planta/química , Nitrogênio/análise , Nitrogênio/metabolismo , BiomassaRESUMO
The laundering of synthetic fabrics has been identified as an important and diffuse source of microplastic (<5 mm) fibre contamination to wastewater systems. Home laundering can release up to 13 million fibres per kg of fabric, which end up in wastewater treatment plants. During treatment, 72-99% of microplastics are retained in the residual sewage sludge, which can contain upwards of 56 000 microplastics per kg. Sewage sludge is commonly disposed of by application to agricultural land as a soil amendment. In some European countries, application rates are up to 91%, representing an important pathway for microplastics to enter the terrestrial environment, which urgently requires quantification. Sewage sludge also often contains elevated concentrations of metals and metalloids, and some studies have quantified metal(loid) sorption onto various microplastics. The sorption of metals and metalloids is strongly influenced by the chemical properties of the sorbate, the solution chemistry, and the physicochemical properties of the microplastics themselves. Plastic-water partition coefficients for the sorption of cadmium, mercury and lead onto microplastics are up to 8, 32, and 217 mL g-1 respectively. Sorptive capacities of microplastics may increase over time, due to environmental degradation processes increasing the specific surface area and surface density of oxygen-containing functional groups. A range of metal(loid)s, including cadmium, chromium, and zinc, have been shown to readily desorb from microplastics under acidic conditions. Sorbed metal(loid)s may therefore become more bioavailable to soil organisms when the microplastics are ingested, due to the acidic gut conditions facilitating desorption. Polyester (polyethylene terephthalate) should be of particular focus for future research, as few quantitative sorption studies currently exist, it is potentially overlooked from density separation studies due to its high density, and it is by far the most widely used fibre in apparel textiles production.
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Metaloides , Poluentes Químicos da Água , Cádmio , Metais , Microplásticos , Plásticos , Esgotos/química , Solo , Poluentes Químicos da Água/análiseRESUMO
Background The studies IMvigor 210 cohort 2 and IMvigor211 evaluated the efficacy of atezolizumab in patients with locally advanced or metastatic urothelial cancer (mUC) upon progression to platinum-based chemotherapy worldwide. Yet, the real impact of this drug in specific geographical regions is unknown. Materials and methods We combined individual-level data from the 131 patients recruited in Spain from IMvigor210 cohort 2 and IMvigor211 in a pooled analysis. Efficacy and safety outcomes were assessed in the overall study population and according to PD-L1 expression on tumour-infiltrating immune cells. Results Full data were available for 127 patients; 74 (58%) received atezolizumab and 53 (42%) chemotherapy. Atezolizumab patients had a numerically superior median overall survival although not reaching statistical significance (9.2 months vs 7.7 months). No statistically significant differences between arms were observed in overall response rates (20.3% vs 37.0%) or progression-free survival (2.1 months vs 5.3 months). Nonetheless, median duration of response was superior for the immunotherapy arm (non-reached vs 6.4 months; p = 0.005). Additionally, among the responders, the 12-month survival rates seemed to favour atezolizumab (66.7% vs 19.9%). When efficacy was analyzed based on PD-L1 expression status, no significant differences were found. Treatment-related adverse events of any grade occurred more frequently in the chemotherapy arm [46/57 (81%) vs 44/74 (59%)]. Conclusion Patients who achieved an objective response on atezolizumab presented a longer median duration of response and numerically superior 12 month survival rates when compared with chemotherapy responders along with a more favorable safety profile. PD-L1 expression did not discriminate patients who might benefit from atezolizumab (AU)
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Carcinoma de Células de Transição/tratamento farmacológico , Carcinoma de Células de Transição/secundário , Neoplasias Ureterais/tratamento farmacológico , Estudos de Coortes , Intervalo Livre de Doença , Resultado do Tratamento , Neoplasias Ureterais/patologia , EspanhaRESUMO
BACKGROUND: The studies IMvigor 210 cohort 2 and IMvigor211 evaluated the efficacy of atezolizumab in patients with locally advanced or metastatic urothelial cancer (mUC) upon progression to platinum-based chemotherapy worldwide. Yet, the real impact of this drug in specific geographical regions is unknown. MATERIALS AND METHODS: We combined individual-level data from the 131 patients recruited in Spain from IMvigor210 cohort 2 and IMvigor211 in a pooled analysis. Efficacy and safety outcomes were assessed in the overall study population and according to PD-L1 expression on tumour-infiltrating immune cells. RESULTS: Full data were available for 127 patients; 74 (58%) received atezolizumab and 53 (42%) chemotherapy. Atezolizumab patients had a numerically superior median overall survival although not reaching statistical significance (9.2 months vs 7.7 months). No statistically significant differences between arms were observed in overall response rates (20.3% vs 37.0%) or progression-free survival (2.1 months vs 5.3 months). Nonetheless, median duration of response was superior for the immunotherapy arm (non-reached vs 6.4 months; p = 0.005). Additionally, among the responders, the 12-month survival rates seemed to favour atezolizumab (66.7% vs 19.9%). When efficacy was analyzed based on PD-L1 expression status, no significant differences were found. Treatment-related adverse events of any grade occurred more frequently in the chemotherapy arm [46/57 (81%) vs 44/74 (59%)]. CONCLUSION: Patients who achieved an objective response on atezolizumab presented a longer median duration of response and numerically superior 12 month survival rates when compared with chemotherapy responders along with a more favorable safety profile. PD-L1 expression did not discriminate patients who might benefit from atezolizumab.
Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Carcinoma de Células de Transição/tratamento farmacológico , Neoplasias Ureterais/tratamento farmacológico , Neoplasias Uretrais/tratamento farmacológico , Neoplasias da Bexiga Urinária/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos/efeitos adversos , Antígeno B7-H1/metabolismo , Carcinoma de Células de Transição/metabolismo , Carcinoma de Células de Transição/mortalidade , Carcinoma de Células de Transição/secundário , Estudos de Coortes , Feminino , Humanos , Linfócitos do Interstício Tumoral/metabolismo , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Espanha , Taxa de Sobrevida , Resultado do Tratamento , Neoplasias Ureterais/metabolismo , Neoplasias Ureterais/mortalidade , Neoplasias Ureterais/patologia , Neoplasias Uretrais/metabolismo , Neoplasias Uretrais/mortalidade , Neoplasias Uretrais/patologia , Neoplasias da Bexiga Urinária/metabolismo , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/patologiaRESUMO
BACKGROUND: Patients on peritoneal dialysis treatment represent 15% of the global dialysis population. The major complication of peritoneal dialysis is catheter and peritoneal infection. Peritoneal dialysis patients who receive kidney transplants are at increased risk of infection because of immunosuppressive therapy. AIM: The purpose of this study is to show our ideal timing to remove peritoneal catheter after kidney transplant, which gives adequate security on renal function recovery and reduction of septic risk. METHOD OF STUDY: We analyzed the outcomes of 65 patients on peritoneal dialysis who underwent kidney transplant between 2000 and 2016. RESULTS: In 61 cases there was an immediate graft functional recovery. In 4 cases there was a delayed graft function (DGF), and we performed a hemodialysis with temporary placement of a venous catheter. In all patients we removed peritoneal dialysis catheter 30 to 45 days after transplant. There has been 1 case of catheter infection, which was treated with antibiotic therapy. DISCUSSION: Our average time to remove the peritoneal dialysis catheter was shorter than times in previous studies, between the 30th and 45th postoperative day. In the 4 cases in which there has been a DGF, we performed hemodialysis treatment to avoid, in the immediate postoperative period, direct insults to the peritoneum by local dialysis procedures. CONCLUSION: Our experience show that the 30th to 45th postoperative day is a good time frame, better yet a good watershed between the safe removal of peritoneal catheter when patients have a stabilized renal function and the possibility of leaving it in situ, to resume peritoneal dialysis in case of persistent DGF.
Assuntos
Transplante de Rim , Diálise Peritoneal , Adulto , Cateteres de Demora , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Peritoneal/métodos , Estudos Retrospectivos , Fatores de TempoRESUMO
En este artículo se aborda el problema planteado en el plan de beca de Doctorado: "Intervenciones desde la clínica de la urgencia en situaciones de violencia. Consideraciones y abordaje de la problemática de la violencia familiar: perspectiva psicoanalítica". Este plan se enmarca en la investigación "La Urgencia en Salud Mental en el Hospital Público en la Ciudad de Buenos Aires", cuyo objetivo general es analizar los modos en que se presenta la demanda en Servicios de Urgencias en Salud Mental. Con tal fin, se tomó una muestra de 233 casos de pacientes que consultaron en un periodo de tres meses corridos en 8 Hospitales Públicos. Los datos, recabados mediante un protocolo, se analizaron desde dos perspectivas: epidemiológica y psicoanalítica. En esta oportunidad, nos centraremos en el estudio de los resultados epidemiológicos obtenidos respecto de la posición inicial de quienes consultan en urgencias relacionadas con la problemática de la violencia familiar y en la lectura del texto de un caso en el que la intervención psicoanalítica, a la que situaremos en relación con la concepción lacaniana del tiempo lógico, posibilita la apertura de la dimensión simbólica y da lugar a la subjetivación de la urgencia
This article addresses the problem raised in the Doctorate scholarship plan: "Interventions from the urgency clinic in situations of violence. Considerations and approach to the problem of family violence: psychoanalytic perspective". This plan is part of the research The Urgency in Mental Health in the Public Hospital in the City of Buenos Aires", whose general objective is to analyze the ways in which demand is presented in Urgency Services in Mental Health. To this end, a sample of 253 cases of patients who consulted in a period of three consecutive months in 8 Public Hospitals was taken. The data, collected through a protocol, were analysed from two perspectives: epidemiological and psychoanalytic. In this opportunity, we will focus on the study of the epidemiological results obtained regarding the initial position of those who consult in urgencies related to the problem of family violence and in the reading of the text of a case in which the psychoanalytic intervention, that will be situated in relation to the Lacanian conception of logical time, allows the opening of the symbolic dimension and gives rise to the subjectification of urgency
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Humanos , Violência Doméstica , Serviços de Saúde Mental , Relações Profissional-Paciente , Hospitais PúblicosRESUMO
A sentence under 'Results' heading in the Abstract section was published incorrectly. The correct sentence should read as follows.
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INTRODUCTION: This study aimed to describe the efficacy of fulvestrant 500 mg in postmenopausal women with estrogen receptor (ER)-positive advanced/metastatic breast cancer who had disease progression after receiving anti-estrogen therapy in clinical practice, getting real-world data. MATERIALS AND METHODS: Multicenter, retrospective, observational study conducted in Spain. Postmenopausal women with locally advanced/metastatic ER-positive breast cancer who received treatment with fulvestrant 500 mg after progression with a previous anti-estrogen therapy were eligible. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), clinical benefit rate (CBR), duration of clinical benefit (DoCB), and safety profile. RESULTS: A total of 263 women were evaluated (median age, 65.8 years). At a median follow-up of 21.5 months, median PFS and OS were 10.6 and 43.2 months, respectively. PFS according to 1st, 2nd, 3rd, and ≥ 4th lines were 11.5, 10.6, 9.9, and 8.5 months, respectively (p = 0.0245). PFS in patients with visceral involvement was 10 months vs 10.6 months in patients without visceral involvement (p = 0.6604), 9.6 months in patients with high Ki67 vs 10 months in patients with low Ki67 (p = 0.7224), and 10.2 months in HER2+ patients vs 10.3 months in HER2- patients (p = 0.6809). The CBR was 56.5% and the DoCB was 18.4 months. The most frequently adverse events were injection site pain (10.3%) and musculoskeletal disorders (7.6%). CONCLUSIONS: Fulvestrant 500 mg administered in clinical practice was shown to be effective (PFS, 10.6 months; CBR, 56.5%) and well tolerated, in accordance with previous trials.
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Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Lobular/tratamento farmacológico , Resistencia a Medicamentos Antineoplásicos , Estradiol/análogos & derivados , Pós-Menopausa , Idoso , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/secundário , Carcinoma Lobular/metabolismo , Carcinoma Lobular/secundário , Estradiol/uso terapêutico , Feminino , Seguimentos , Fulvestranto , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Prognóstico , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Estudos RetrospectivosRESUMO
The solubility of uranium and thorium has been measured under the conditions anticipated in a cementitious, geological disposal facility for low and intermediate level radioactive waste. Similar solubilities were obtained for thorium in all media, comprising NaOH, Ca(OH)2 and water equilibrated with a cement designed as repository backfill (NRVB, Nirex Reference Vault Backfill). In contrast, the solubility of U(VI) was one order of magnitude higher in NaOH than in the remaining solutions. The presence of cellulose degradation products (CDP) results in a comparable solubility increase for both elements. Extended X-ray Absorption Fine Structure (EXAFS) data suggest that the solubility-limiting phase for uranium corresponds to a becquerelite-type solid whereas thermodynamic modelling predicts a poorly crystalline, hydrated calcium uranate phase. The solubility-limiting phase for thorium was ThO2 of intermediate crystallinity. No breakthrough of either uranium or thorium was observed in diffusion experiments involving NRVB after three years. Nevertheless, backscattering electron microscopy and microfocus X-ray fluorescence confirmed that uranium had penetrated about 40 µm into the cement, implying active diffusion governed by slow dissolution-precipitation kinetics. Precise identification of the uranium solid proved difficult, displaying characteristics of both calcium uranate and becquerelite.
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Recuperação e Remediação Ambiental/métodos , Resíduos Radioativos/análise , Eliminação de Resíduos/métodos , Tório/análise , Urânio/análise , Poluentes Radioativos da Água/isolamento & purificação , Cinética , Solubilidade , Soluções/química , TermodinâmicaRESUMO
This work describes the solubility of nickel under the alkaline conditions anticipated in the near field of a cementitious repository for intermediate level nuclear waste. The measured solubility of Ni in 95%-saturated Ca(OH)2 solution is similar to values obtained in water equilibrated with a bespoke cementitious backfill material, on the order of 5×10(-7)M. Solubility in 0.02M NaOH is one order of magnitude lower. For all solutions, the solubility limiting phase is Ni(OH)2; powder X-ray diffraction and scanning transmission electron microscopy indicate that differences in crystallinity are the likely cause of the lower solubility observed in NaOH. The presence of cellulose degradation products causes an increase in the solubility of Ni by approximately one order of magnitude. The organic compounds significantly increase the rate of Ni transport under advective conditions and show measurable diffusive transport through intact monoliths of the cementitious backfill material.
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This work presents the study of the solubility of selenium under cementitious conditions and its diffusion, as SeO3(2-), through monolithic cement samples. The solubility studies were carried out under alkaline conditions similar to those anticipated in the near-field of a cement-based repository for low- and intermediate-level radioactive waste. Experiments were conducted in NaOH solution, 95%-saturated Ca(OH)2, water equilibrated with a potential backfill material (Nirex reference vault backfill, NRVB) and in solutions containing cellulose degradation products, with and without reducing agents. The highest selenium concentrations were found in NaOH solution. In the calcium-containing solutions, analysis of the precipitates suggests that the solubility controlling phase is Ca2SeO3(OH)2·2H2O, which appears as euhedral rhombic crystals. The presence of cellulose degradation products caused an increase in selenium concentration, possibly due to competitive complexation, thereby, limiting the amount of calcium available for precipitation. Iron coupons had a minor effect on selenium solubility in contrast to Na2S2O4, suggesting that effective reduction of Se(IV) occurs only at Eh values below -300mV. Radial through-diffusion experiments on NRVB and in a fly ash cement showed no evidence of selenium breakthrough after one year. However, autoradiography of the exposed surfaces indicated that some migration had occurred and that selenium was more mobile in the higher porosity backfill than in the fly ash cement.
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The influence of anthropogenic organic complexants (citrate, EDTA and DTPA from 0.005 to 0.1M) on the solubility of nickel(II), thorium(IV) and uranium (U(IV) and U(VI)) has been studied. Experiments were carried out in 95%-saturated Ca(OH)2 solutions, representing the high pH conditions anticipated in the near field of a cementitious intermediate level radioactive waste repository. Results showed that Ni(II) solubility increased by 2-4 orders of magnitude in the presence of EDTA and DTPA and from 3 to 4 orders of magnitude in the case of citrate. Citrate had the greatest effect on the solubility of Th(IV) and U(IV)/(VI). XRD and SEM analyses indicate that the precipitates are largely amorphous; only in the case of Ni(II), is there some evidence of incipient crystallinity, in the form of Ni(OH)2 (theophrastite). A study of the effect of calcium suggests that U(VI) and Ni(II) may form metal-citrate-OH complexes stabilised by Ca(2+). Thermodynamic modelling underestimates the concentrations in solution in the presence of the ligands for all the elements considered here. Further investigation of the behaviour of organic ligands under hyperalkaline conditions is important because of the use of the thermodynamic constants in preparing the safety case for the geological disposal of radioactive wastes.
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BACKGROUND: The prognostic role of circulating tumor cells (CTC) in early colorectal cancer (CRC) has not been determined yet. We evaluated the potential prognostic value of CTC in stage III CRC patients. PATIENTS AND METHODS: Prospective multicenter study of 519 patients with stage III CRC recruited between January 2009 and June 2010. CTC were enumerated with the CellSearch System after primary tumor resection and before the start of adjuvant therapy. A total of 472 patients were included in the analysis. RESULTS: CTC ≥1, ≥2, ≥3 and ≥5 were detected in 166 (35%), 93 (20%), 57 (12%) and 34 (7%) patients, respectively. Median follow-up was 40 months. In the overall population, CTC ≥1 (disease-free survival (DFS): HR 0.97, P = 0.85; overall survival (OS): HR 1.03, P = 0.89), ≥2 (DFS: HR 1.07, P = 0.76; OS: HR 1.02, P = 0.95), ≥3 (DFS: HR 0.96, P = 0.87; OS: HR 0.74, P = 0.41) and ≥5 (DFS: HR 0.72, P = 0.39; OS: HR 0.48, P = 0.21) were not associated with worse DFS and OS. No clinicopathological characteristics were significantly associated with the presence of CTC. In patients with disease relapse, the proportion with CTC ≥1 was not significantly different between those with single versus multiple metastatic locations (37.9% versus 31.4%, P = 0.761). In the multivariate analysis, CTC ≥1 was not an independent prognostic factor for DFS (HR 0.97, P = 0.87) and OS (HR 0.96, P = 0.89). CONCLUSION: CTC detection was not associated with worse DFS and OS in patients with stage III CRC. Given the scarcity of CTC in these patients, it is likely that CTC determined by CellSearch system does not have a prognostic role in this setting. However, a longer follow-up is needed.
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Biomarcadores Tumorais/sangue , Neoplasias Colorretais/sangue , Neoplasias Colorretais/cirurgia , Células Neoplásicas Circulantes/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos ProspectivosRESUMO
El presente trabajo se desprende de la investigación UBACyT 2012-2015: Los dispositivos para alojar la urgencia en Salud Mental, desde la mirada de los profesionales, psiquiatras y psicólogos, que intervienen en ellos, dirigida por la Prof. Dra. María Inés Sotelo. En el presente artículo nos proponemos, a partir del análisis de los datos obtenidos, situar aquellas consultas que incluyen episodios de violencia, así como el abordaje que cada dispositivo propone para alojarlos. Nos interesa profundizar en el estudio de esta problemática, que se despliega en un abanico que va desde la violencia contra sí mismo hasta la violencia colectiva. A partir de estos desarrollos, y desde una lectura de orientación psicoanalítica, procuraremos aportar herramientas de intervención para los profesionales que atienden este tipo de problemática en los Servicios de urgencias en Salud Mental...
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Humanos , Serviços de Emergência Psiquiátrica , Serviços de Saúde Mental , Violência/psicologia , PsicanáliseRESUMO
El presente escrito se desprende del Proyecto de Investigación UBACyT: Los dispositivos para alojar la urgencia en Salud Mental, desde la mirada de los profesionales, psiquiatras y psicólogos, que intervienen en ellos. Directora: Prof. Dra. Inés Sotelo, Co-director: Dr. Guillermo Belaga.Tomando como eje dicha investigación, el objetivo de este artículo es analizar, desde el marco teórico del psicoanálisis de orientación lacaniana, la mirada que tienen psiquiatras y psicólogos que trabajan en urgencias acerca del consumo problemático de sustancias.Tomaremos para ello 50 protocolos correspondientes a las entrevistas realizadas a dichos profesionales, destacando que se trata de psiquiatras y psicólogos que trabajan en los dispositivos de guardia en los hospitales públicos, monovalentes y polivalentes, de CABA y del conurbano bonaerense.Los resultados obtenidos permitirán un primer acercamiento en el conocimiento de la realidad de la atención de esta problemática en la urgencia, así como la posibilidad de interrogar la necesidad de rediseñar los dispositivos para el tratamiento de los pacientes con consumo problemático de sustancias.
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Humanos , Serviços de Emergência Psiquiátrica , Equipe de Assistência ao Paciente , Transtornos Relacionados ao Uso de Substâncias/psicologia , PsicanáliseRESUMO
El presente trabajo se enmarca en la investigación UBACyT 2012-2015 Los dispositivos para alojar la urgencia, desde la mirada de los profesionales, psiquiatras y psicólogos, que intervienen en ellos, dirigida por Inés Sotelo. El propósito es trazar estrategias para la atención a la demanda en urgencia en Salud Mental y su prevención. En esta oportunidad, nos proponemos poner en consideración la interpretación analítica como orientadora de la atención a la demanda en urgencias en casos de neurosis. Para ilustrar la lógica de la intervención del analista, recurriremos a un término tomado de la música: la cadencia. Pensamos que este término puede ser representativo de cómo la labor interpretativa del analista puede convocar la producción de un significante en el cual el sujeto se represente, aún en los momentos de crisis. Asimismo, se harán referencias respecto de la cuestión del tiempo y su relación con la clínica de la urgencia. La intervención del analista, en la clínica de la urgencia de la neurosis, posibilitará que aquello que se presenta como ajeno al sujeto, la crisis, pueda subjetivarse e inaugurar un nuevo tiempo. Tiempo de resolución de la urgencia y de apertura de una eventual demanda de análisis.
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Humanos , Serviços de Emergência Psiquiátrica , Interpretação Psicanalítica , Transtornos Neuróticos/psicologia , PsicanáliseRESUMO
El presente escrito se desprende del Proyecto de Investigación UBACyT: ôLos dispositivos para alojar la urgencia en Salud Mental, desde la mirada de los profesionales, psiquiatras y psicólogos, que intervienen en ellosö. Directora: Prof. Dra. Inés Sotelo, Co-director: Dr. Guillermo Belaga.Tomando como eje dicha investigación, el objetivo de este artículo es analizar, desde el marco teórico del psicoanálisis de orientación lacaniana, la mirada que tienen psiquiatras y psicólogos que trabajan en urgencias acerca del consumo problemático de sustancias.Tomaremos para ello 50 protocolos correspondientes a las entrevistas realizadas a dichos profesionales, destacando que se trata de psiquiatras y psicólogos que trabajan en los dispositivos de guardia en los hospitales públicos, monovalentes y polivalentes, de CABA y del conurbano bonaerense.Los resultados obtenidos permitirán un primer acercamiento en el conocimiento de la realidad de la atención de esta problemática en la urgencia, así como la posibilidad de interrogar la necesidad de rediseñar los dispositivos para el tratamiento de los pacientes con consumo problemático de sustancias.(AU)
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Humanos , Serviços de Emergência Psiquiátrica , Transtornos Relacionados ao Uso de Substâncias/psicologia , Equipe de Assistência ao Paciente , PsicanáliseRESUMO
El presente trabajo se enmarca en la investigación UBACyT 2012-2015 ôLos dispositivos para alojar la urgencia, desde la mirada de los profesionales, psiquiatras y psicólogos, que intervienen en ellosö, dirigida por Inés Sotelo. El propósito es trazar estrategias para la atención a la demanda en urgencia en Salud Mental y su prevención. En esta oportunidad, nos proponemos poner en consideración la interpretación analítica como orientadora de la atención a la demanda en urgencias en casos de neurosis. Para ilustrar la lógica de la intervención del analista, recurriremos a un término tomado de la música: la cadencia. Pensamos que este término puede ser representativo de cómo la labor interpretativa del analista puede convocar la producción de un significante en el cual el sujeto se represente, aún en los momentos de crisis. Asimismo, se harán referencias respecto de la cuestión del tiempo y su relación con la clínica de la urgencia. La intervención del analista, en la clínica de la urgencia de la neurosis, posibilitará que aquello que se presenta como ajeno al sujeto, la crisis, pueda subjetivarse e inaugurar un nuevo tiempo. Tiempo de resolución de la urgencia y de apertura de una eventual demanda de análisis.(AU)
Assuntos
Humanos , Serviços de Emergência Psiquiátrica , Interpretação Psicanalítica , Transtornos Neuróticos/psicologia , PsicanáliseRESUMO
BACKGROUND/AIM: Erlotinib and chemotherapy have shown similar efficacy for pretreated non-small cell lung cancer (NSCLC) patients, but none of the large studies have selected patients based on histology. We present a retrospective single-center series of advanced non-squamous NSCLC patients treated with erlotinib or pemetrexed as second-line therapy. Our aim was to compare the efficacy and safety data under clinical practice conditions and to identify subgroups of patients who could benefit more from these therapies. METHODS: A total of 88 patients were included. Squamous histology was our main exclusion criterion. EGFR mutation status was known for 54.5% of the patients; 6 patients treated with erlotinib and 2 with pemetrexed had EGFR-mutated tumors. Smoking history was analyzed as possible predictive factor of efficacy. RESULTS: No significant differences in progression-free survival (PFS; 3 vs. 2.5 months, p = 0.06) or overall survival (OS; 4.9 vs. 7.4 months, p = 0.733) between the erlotinib and pemetrexed groups were found in the overall population. EGFR wild-type patients had a similar median PFS with erlotinib compared to pemetrexed (2.7 vs. 2.3 months, p = 0.42), with no statistical differences in OS. Statistically significant differences in OS in favor of pemetrexed for current smokers (3 vs. 7.1 months, p = 0.017) were found, while erlotinib achieved significantly better PFS in never-smokers compared to former smokers (3.5 vs. 2.7 months, p = 0.005). Serious adverse events were uncommon but more frequent with pemetrexed, and were mainly related to hematologic toxicity. CONCLUSIONS: Erlotinib should be considered as another equal option in second-line treatment for EGFR wild-type patients as well as for subpopulations with unknown mutational status. Smoking history could be a useful clinical marker to choose a second-line treatment.
Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Glutamatos/uso terapêutico , Guanina/análogos & derivados , Neoplasias Pulmonares/tratamento farmacológico , Quinazolinas/uso terapêutico , Idoso , Algoritmos , Carcinoma Pulmonar de Células não Pequenas/patologia , Análise Mutacional de DNA , Intervalo Livre de Doença , Receptores ErbB/genética , Cloridrato de Erlotinib , Feminino , Guanina/uso terapêutico , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Mutação , Pemetrexede , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fumar , Resultado do TratamentoRESUMO
El siguiente artículo se enmarca en el Proyecto de Investigación UBACyT: "Proyectos terapéuticos bajo la clínica psicoanalítica en el hospital público" cuyo objetivo principal es establecer la eficacia de los tratamientos psicoterapéuticos, conducidos desde la perspectiva del psicoanálisis, en un período de 16 entrevistas realizadas en el Servicio de Salud Mental del Hospital Central de San Isidro (Provincia de Buenos Aires, Argentina). En este trabajo nos centraremos en la variable "tiempo" con el propósito de circunscribir la función del tiempo lógico en psicoanálisis, subrayar su valor clínico e interrogar su posible articulación con el tiempo de tratamiento institucional. Para ello hemos tomado como referencia el escrito de J. Lacan "El tiempo lógico y el aserto de certidumbre anticipada. Un nuevo soisma", único escrito dedicado específicamente a desarrollar la noción de tiempo lógico.
The following article is part of the Research Project UBACyT: 'Therapeutic projects under the psychoanalytic clinic in public hospital" whose main objective is to establish the eficiency of psychotherapeutic treatments conducted from the perspective of psychoanalysis in a period of 16 interviews carried out at the Department of Mental Health at the Central Hospital of San Isidro (Buenos Aires Province, Argentina). In this paper we focus on the "time" variable in order to circumscribe the role of logical time in analysis, underline its clinical value and examine its possible joint with institutional treatment time. So we've taken as a reference the article "The logical time and the assertion of anticipated certainty, a new sophism ", written by J. Lacan, the only specifically dedicated to develop the notion of logical time.