Towards a "transitioning": Biographical clues on gender transition, malaise, and health services in Chile.

We analyze how the interactions between the trans population and the Chilean healthcare system shape specific processes of malaise associated with gender transition ("tránsito de género"). Adopting psychoanalytic and transfeminist conceptual approaches, as well as a biographical methodology, we examine autobiographical narratives of three trans subjects. We discuss three topics: childhood as a critical period for gender transition and malaise; the role of institutions; and the ways through which subjects manage malaise. We argue that trans subjects face specific sociocultural conditions that lead to unique processes of malaise associated with gender transition. We show how politicization and the construction of an institutional framework, bodily aesthetical modifications, and the self-administration of medical knowledge emerge as some of the paths to navigate the gender transition process. Besides, we foreground the notion of "transitioning" ("transicionar") by considering the criticism voiced by the participants. By using this notion, they interrogate the rigidity and psychopathologization of identity that is implicitly present in the notion of gender transition, as well as they enrich the transfeminist discourse in favor of their agency/autonomy.

Towards a "transitioning": Biographical clues on gender transition, malaise, and health services in Chile / Rumo a "transição": pistas biográficas sobre trânsito de gênero, mal-estar e serviços de saúde no Chile

Abstract We analyze how the interactions between the trans population and the Chilean healthcare system shape specific processes of malaise associated with gender transition ("tránsito de género"). Adopting psychoanalytic and transfeminist conceptual approaches, as well as a biographical methodology, we examine autobiographical narratives of three trans subjects. We discuss three topics: childhood as a critical period for gender transition and malaise; the role of institutions; and the ways through which subjects manage malaise. We argue that trans subjects face specific sociocultural conditions that lead to unique processes of malaise associated with gender transition. We show how politicization and the construction of an institutional framework, bodily aesthetical modifications, and the self-administration of medical knowledge emerge as some of the paths to navigate the gender transition process. Besides, we foreground the notion of "transitioning" ("transicionar") by considering the criticism voiced by the participants. By using this notion, they interrogate the rigidity and psychopathologization of identity that is implicitly present in the notion of gender transition, as well as they enrich the transfeminist discourse in favor of their agency/autonomy.

Resumo Analisamos como as interações entre a população trans e o sistema de saúde chileno conformam processos específicos de mal-estar associados à transição de gênero ("tránsito de género"). Adotando abordagens conceituais psicanalíticas e transfeministas, bem como uma metodologia biográfica, examinamos narrativas autobiográficas de três sujeitos trans. Discutimos três tópicos: a infância como um período crítico para a transição e mal-estar de gênero; o papel das instituições; e as maneiras pelas quais os sujeitos lidam com o mal-estar. Argumentamos que sujeitos trans enfrentam condições socioculturais específicas que levam a processos únicos de mal-estar associados à transição de gênero. Mostramos como a politização e a construção de um arcabouço institucional, as modificações estéticas corporais e a autogestão do saber médico surgem como alguns dos caminhos para navegar o processo de transição de gênero. Além disso, colocamos em primeiro plano a noção de "transição" ("transicionar") considerando as críticas expressas pelos participantes. Ao utilizar essa noção, interrogam a rigidez e a psicopatologização da identidade que está implicitamente presente na noção de transição de gênero, bem como enriquecem o discurso transfeminista em favor de sua agência/autonomia.

Methotrexate-induced pulmonary toxicity in psoriatic arthritis (PsA): case presentation and literature review.

A 45-year-old female with a 4-week history of psoriatic arthritis developed cough, fever, and progressive shortness of breath 2 weeks following initiation of methotrexate therapy. High resolution CT of chest revealed bilateral basal interstitial involvement and diffuse ground glass opacities. Patient, though, died despite immediate discontinuation of methotrexate and initiation of treatment with IV methylprednisolone and cyclophosphamide. Post-mortem examination showed diffuse interstitial pulmonary fibrosis. Methotrexate-induced pulmonary toxicity is a serious event, unpredictable, and unusual, especially in patients with psoriatic arthritis, and although reversible, it may be fatal.

Análisis epidemiológico de las consultas oftalmológicas en el servicio de urgencia del Hospital 21 de Mayo de Taltal año 2009 / Epidemiological analysis of the ophthalmologist consults in the emergency department of Hospital de Taltal

Objetivo: Realizar un análisis epidemiológico de las consultas oftalmológicas atendidas en el Servicio de Urgencia (SU) del Hospital de Taltal. Método: Estudio retrospectivo de los pacientes atendidos en el SU el 2009, clasificados según edad, sexo y diagnóstico. Resultados: 533 atenciones de causa oftalmológica se realizaron el 2009, 330 hombres (62 por ciento) y 203 mujeres (38 por ciento). Consultaron desde los 15 días de edad hasta los 82 años, la mayor concentración de atenciones en el rango etario de 25-44 años con un 30,1 por ciento, 67 por ciento fueron por causa no traumática y 33 por ciento de causa traumática. El diagnóstico más frecuente fue Conjuntivitis (36 por ciento). Los pacientes derivados correspondieron al 9,1 por ciento del total. Conclusiones: La morbilidad oftalmológica es una importante causa de consultas en los SU del país, en su mayoría atendidas por médicos generales, por lo que es importante insistir en su perfeccionamiento continuo para evitar una sobredemanda de interconsultas a los hospitales de referencia.

Objective: To conduct an epidemiological analysis of the ophthalmologist consults in the Emergency Department (ED) Hospital de Taltal. Method: Retrospective study of patients in the ED during 2009, classified by age, sex and diagnosis. Results: 533 eye attentions causes were conducted during 2009, 330 were men (62 percent) and 203 women (38 percent). Patients who consulted were from 15 days to 82 years old, with the greatest concentration of attention in the age range of 25-44 years with 30.1 percent of consultations, 67 percent were for no traumatic causes and 33 percent were traumatic causes. The most frequent diagnosis was conjunctivitis with 36 percent. Patients who require derivations correspond to 9.1 percent of the total. Conclusions: The morbidity of ophthalmologic origin are a major cause of consultations in the country's emergency services, which are mostly attended by general doctors, so it is important to insist on their improvement in order to prevent oversubscription to the ophthalmology services.