[Teleconsultation: finding its place in primary care]. / Teleconsulta: encontrando su lugar en Atención Primaria.

Teleconsultation is a remote health consultation using information and communication technologies. There are different modalities and specific practical and communication skills are required. Notwithstanding its prominence in Spain, there is little evidence on teleconsultation. This article explores the applicability, barriers, facilitators and future challenges of teleconsultation. While it has the potential to improve access to healthcare, as well as save time and costs for both patients and healthcare professionals, it faces a number of challenges such as the digital divide and resistance to change. To address new challenges and overcome obstacles, it is crucial to gain the trust of patients and professionals. Improving training in the skills required to optimize their use is also essential. Future research should aim to provide robust evidence regarding safety and cost-effectiveness to ensure successful implementation.

Rspo2-LGR4 exacerbates hepatocellular carcinoma progression via activation of Wnt/b-catenin signaling pathway / Rspo2-LGR4 agrava la progresión del carcinoma hepatocelular al activar la vía de señalización Wnt/beta-catenina

Background: The leucine-rich repeat-containing G-protein-coupled receptor 4 (LGR4) plays an important role in stem cell differentiation, organ development and cancer. Whether LGR4 affects the progression of hepatocellular carcinoma (HCC) remains unknown. This study aimed to reveal the role of LGR4 in HCC. Methods: Clinical samples of HCC were collected to assess the expression of LGR4 and its correlation with patients’ clinical characteristics. The expression level of LGR4 in HCC cells was altered by pharmacological and genetic methods, and the role of LGR4 in HCC progression was analyzed by in vivo and in vitro assays. HCC was induced by diethylnitrosamine (DEN) and carbon tetrachloride (CCl4) in wild-type and LGR4 deficient mice, the effect of LGR4 on HCC was examined by histopathological evaluation and biochemical assays. Results: LGR4 expression was up-regulated in HCC samples, and its expression level was positively correlated with tumor size, microvascular invasion (MVI), TNM stage and pathological differentiation grade of HCC patients. In the mouse HCC model induced by DEN+CCl4, knockdown of LGR4 effectively inhibited the progression of HCC. Silencing of LGR4 inhibited the proliferation, migration, invasion, stem cell-like properties and Warburg effect of HCC cells. These phenotypes were promoted by R-spondin2 (Rspo2), an endogenous ligand for LGR4. Rspo2 markedly increased the nuclear translocation of β-catenin, whereas IWR-1, an inhibitor of Wnt/β-catenin signaling, reversed its effect. Deficiency of LGR4 significantly reduced the nuclear translocation of β-catenin and the expression of its downstream target genes cyclinD1 and c-Myc. Conclusions: LGR4 promotes HCC progression via Wnt/β-catenin signaling pathway. (AU)

Antecedentes: El receptor de acoplamiento de proteínas G de secuencia repetida 4 (LGR4), rico en leucina, juega un papel importante en la diferenciación de células madre, el desarrollo de órganos y el cáncer. Se desconoce si LGR4 afecta la progresión del carcinoma hepatocelular (HCC). El objetivo de este estudio es revelar el papel de LGR4 en el HCC. Métodos: Se recolectaron muestras clínicas de HCC para evaluar la expresión de LGR4 y su correlación con los resultados clínicos de HCC. Alterar los niveles de expresión de LGR4 en las células de HCC mediante métodos farmacológicos y genéticos y analizar el papel de LGR4 en la progresión del cáncer de hígado mediante mediciones in vivo e in vitro. El HCC fue inducido en ratones de tipo salvaje y con defectos de LGR4 con Nitrosamina de dietilo (DEN) y cloruro de carbono (CCl4), y los efectos de LGR4 sobre el HCC fueron detectados por evaluación histopatológica y determinación bioquímica. Resultados: La expresión de LGR4 está regulada en HCC, y su nivel de expresión está positivamente relacionado con el tamaño tumoral, la infiltración microvascular (MVI), la etapa de TNM y el grado de diferenciación patológica en pacientes con HCC. En el modelo de HCC de ratón inducido por DEN+CCl4, golpear bajo LGR4 inhibió efectivamente la progresión del HCC. El silencio de LGR4 inhibe la proliferación, migración, invasión, propiedades similares a las células madre y el efecto Warburg de las células HCC. Estos fenotipos son promovidos por el ligando endógeno roof slab-specific sponge 2 (Rspo2)de LGR4. El Rspo2 aumentó significativamente la translocación nuclear de la proteína beta-catenina, mientras que el inhibidor de la señalización Wnt/beta-cateninaIWR-1 revirtió su acción... (AU)

O desamparo em Freud e a política como ruptura dos possíveis / Helplessness in Freud and politics as a rupture of the possible / Le délaissé chez Freud et la politique comme rupture du possible / Lo desamparo en Freud y la política como ruptura de lo posible

Este trabalho visa delinear o conceito de desamparo por meio da metapsicologia freudiana e como isso implica outra forma de pensar a política. Desse modo, o desamparo não é concebido unicamente como a vulnerabilidade do bebê ao nascer, mas, também, como a falta de respostas às excitações internas. Tal estado de desamparo é radicalizado a partir da concepção de pulsão de morte construída por Freud. A pulsão de morte gera processos de desabamentos, rupturas, desligamentos e despossessão, essenciais para a própria vida se complexificar. Nesse sentido, propomos o desamparo como afeto político central quando pensamos em transformação. A partir do desabamento de si e da abertura radical ao contato do outro, podemos experimentar outras formas de experiências, outras formas de afetação e, consequentemente, a construção de corpos políticos rumo à transformação política radical

This paper outlines the concept of helplessness through Freudian metapsychology and by doing so imply a new way of thinking about politics. Helplessness is not conceived simply as the newborn's vulnerability, but also as the lack of response to internal excitements. Such an estate is radicalized by Freud's concept of death drive, which generates processes of collapsing, ruptures, unplugging and dispossession that are essential for turning life complex. In this sense, we propose helplessness as a main political affection when referring to transformation. By the collapse of oneself and the radical opening to contact with others, one may experience other ways of experiencing and of being affected and, consequently, the construction of political bodies leading to the radical transformation of politics

Cet article présente le concept de délaissé à travers la métapsychologie freudienne et, ce faisant, lui imprime une nouvelle façon de penser la politique. Le délaissé n'est pas simplement conçu comme la vulnérabilité du nouveau-né, mais aussi comme une absence de réponse aux excitations internes. Tel état est radicalisé par le concept de pulsion de mort de Freud, qui produit des processus de glissement, de rupture, d'arrêt et de dépossession essentielles à la complexification de la vie. En ce sens, nous proposons le délaissé comme principale affection politique lorsqu'il est question de transformation. Par le glissement de soi-même et l'ouverture radicale au contact avec les autres, nous pouvons expérimenter d'autres façons de vivre et d'être affecté et, par conséquent, la construction de corps politiques vers à la transformation politique radicale

Este artículo pretende esbozar el concepto de desamparo a través de la metapsicología freudiana y cómo esto implica otra forma de pensar sobre política. De esa manera, la impotencia no solo se concibe como la vulnerabilidad del bebé al nacer, sino también debido a la falta de respuestas a las excitaciones internas. Tal estado de desamparo se radicaliza desde la concepción del impulso de muerte construido por Freud. El impulso de la muerte genera procesos de colapsos, rupturas, desconexiones y desposesión esenciales para que la vida misma se vuelva más compleja. En este sentido, proponemos lo desamparo como un afecto político central cuando pensemos en la transformación. Desde el colapso de uno mismo y la apertura radical al contacto con el otro, podemos experimentar otras formas de experiencias y otras formas de afectación y,en consecuencia, la construcción de cuerpos políticos hacia una transformación política radical

Survival Analysis and Prognostic Factors in a Case Series of 148 Cutaneous T-Cell Lymphomas. / Análisis de supervivencia y factores pronósticos en una serie de 148 casos de linfomas cutáneos de células T.

BACKGROUND AND OBJECTIVE: Cutaneous T-cell lymphomas (CTCL) such as mycosis fungoides (MF) and Sézary syndrome (SS) are rare lymphomas with varying prognoses. The aim of the study was to describe the survival of a cohort of patients with MF/SS and evaluate the prognostic factors impacting disease survival. MATERIALS AND METHODS: All cases of MF/SS diagnosed from 2008 through 2022 were retrospectively analyzed. The demographic variables, histological parameters, and analytical data were analyzed too. Progression-free survival (PFS) and disease-specific survival (DSS) were calculated. RESULTS: A total of 148 cases were included. A total of 121 (82%) and 27 cases were diagnosed with MF, and SS, respectively. A total of 37 patients (25%) experienced progression at some point disease progression. The median PFS and median DSS were 127 and 135 months, respectively. Age >60 years, diagnosis of SS, the presence of large cell transformation (LCT) at diagnosis, folliculotropism in early stages, high Ki-67 expression, the presence of the clonal T-cell receptor (TCR) in blood, elevated LDH and B2M levels, and advanced stages (IIB, IVA, T3, T4, N3/Nx) were associated with worse prognosis across the entire cohort. CONCLUSIONS: Stage IVA and the presence of LCT at diagnosis stood out as independent factors of unfavorable prognosis. LCT was the variable that most significantly impacted the patients' survival and was closely associated with tumor skin involvement and stage IIB.

Abordaje de la transformación digital en salud para reducir la brecha digital / Approach to digital transformation in healthcare to reduce the digital divide

La transformación digital implica la integración de tecnología en todas las áreas de una organización y un cambio en la forma de operar y de proporcionar valor. En el sector de la salud, la transformación digital debe centrarse en mejorar la salud para todos, acelerando el desarrollo y la adopción de soluciones digitales. La OMS considera la salud digital como un factor clave para garantizar la cobertura sanitaria universal, la protección frente a emergencias sanitarias y un mejor bienestar para mil millones de personas en todo el mundo. La transformación digital en salud debe incluir los determinantes digitales en salud como nuevos factores de desigualdad junto a los determinantes sociales clásicos. Abordar los determinantes digitales de la salud y la brecha digital es esencial para garantizar que todas las personas tengan acceso a los beneficios de la tecnología digital para su salud y su bienestar.(AU)

Digital transformation involves the integration of technology into all areas of an organization and a change in the way of operating and providing value. In the healthcare sector, digital transformation should focus on improving health for all by accelerating the development and adoption of digital solutions. The WHO considers digital health as a key factor in ensuring universal health coverage, protection against health emergencies, and better well-being for one billion people worldwide. Digital transformation in healthcare should include digital determinants of health as new factors of inequality alongside classic social determinants. Addressing digital determinants of health and the digital divide is essential to ensure that all people have access to the benefits of digital technology for their health and well-being.(AU)

Rspo2-LGR4 exacerbates hepatocellular carcinoma progression via activation of Wnt/ß-catenin signaling pathway.

BACKGROUND: The leucine-rich repeat-containing G-protein-coupled receptor 4 (LGR4) plays an important role in stem cell differentiation, organ development and cancer. Whether LGR4 affects the progression of hepatocellular carcinoma (HCC) remains unknown. This study aimed to reveal the role of LGR4 in HCC. METHODS: Clinical samples of HCC were collected to assess the expression of LGR4 and its correlation with patients' clinical characteristics. The expression level of LGR4 in HCC cells was altered by pharmacological and genetic methods, and the role of LGR4 in HCC progression was analyzed by in vivo and in vitro assays. HCC was induced by diethylnitrosamine (DEN) and carbon tetrachloride (CCl4) in wild-type and LGR4 deficient mice, the effect of LGR4 on HCC was examined by histopathological evaluation and biochemical assays. RESULTS: LGR4 expression was up-regulated in HCC samples, and its expression level was positively correlated with tumor size, microvascular invasion (MVI), TNM stage and pathological differentiation grade of HCC patients. In the mouse HCC model induced by DEN+CCl4, knockdown of LGR4 effectively inhibited the progression of HCC. Silencing of LGR4 inhibited the proliferation, migration, invasion, stem cell-like properties and Warburg effect of HCC cells. These phenotypes were promoted by R-spondin2 (Rspo2), an endogenous ligand for LGR4. Rspo2 markedly increased the nuclear translocation of ß-catenin, whereas IWR-1, an inhibitor of Wnt/ß-catenin signaling, reversed its effect. Deficiency of LGR4 significantly reduced the nuclear translocation of ß-catenin and the expression of its downstream target genes cyclinD1 and c-Myc. CONCLUSIONS: LGR4 promotes HCC progression via Wnt/ß-catenin signaling pathway.

[Approach to digital transformation in healthcare to reduce the digital divide]. / Abordaje de la transformación digital en salud para reducir la brecha digital.

Digital transformation involves the integration of technology into all areas of an organization and a change in the way of operating and providing value. In the healthcare sector, digital transformation should focus on improving health for all by accelerating the development and adoption of digital solutions. The WHO considers digital health as a key factor in ensuring universal health coverage, protection against health emergencies, and better well-being for one billion people worldwide. Digital transformation in healthcare should include digital determinants of health as new factors of inequality alongside classic social determinants. Addressing digital determinants of health and the digital divide is essential to ensure that all people have access to the benefits of digital technology for their health and well-being.

Pancreatic intraductal papillary mucinous neoplasm with sarcomatous transformation. A case report / Transformación sarcomatosa de neoplasia papilar mucinosa intraductal pancreática. Reporte de un caso

Mixed pancreatic epithelial and mesenchymal tumors are rare, usually invasive, entities. Intraductal papillary mucinous neoplasm (IPMN) is a precursor of invasive ductal carcinoma and shares mutations with its invasive counterparts. We report the case of a 72-year-old female with a previously undescribed sarcomatous transformation of a residual IPMN with no evidence of an invasive component. The mesenchymal component showed no heterologous differentiation. Both the epithelial and the mesenchymal populations showed aberrant expression of p53 protein and the same point mutation in KRAS gene. After a 6 month follow up, there were no signs of local or distant relapse. The present case suggests that sarcomatous transformation is possible in non-invasive, intraductal pancreatic lesions.(AU)

Las neoplasias pancreáticas mixtas son entidades raras que usualmente asocian comportamientos invasivos. La neoplasia papilar mucinosa intraductal (NPMI) es una lesión precursora del carcinoma invasivo que comparte con este último mutaciones clave. En el presente estudio se reporta por primera vez una transformación sarcomatosa sobre NPMI residual sin evidencia de componente infiltrante en una paciente de 72años. El componente mesenquimal no mostró diferenciación heteróloga. Tanto la población mesenquimal como la epitelial mostraron tinción aberrante para p53 y albergaban la misma mutación en el gen KRAS. Tras 6meses de seguimiento, la paciente no mostró signos de recaída local ni a distancia. El presente estudio demuestra que es posible una transformación sarcomatosa sobre NPMI.(AU)

Upregulation of miR-200a improves ureteral obstruction-induced renal fibrosis via GAB1/Wnt/ß-catenin signaling.

BACKGROUND: Renal fibrosis is a basic pathological change of almost all chronic kidney disorders. Epithelial-mesenchymal transition (EMT) and excessive extracellular matrix (ECM) accumulation play a crucial role in the process of fibrosis. METHODS: Western blot and qRT-PCR were accomplished to analyze the expression levels of target proteins and genes, respectively. The fibrotic levels in the renal tissues of rats were confirmed utilizing Masson staining. Expression of ECM-related α-SMA in the renal tissues was determined by immunohistochemistry assay. The combination of GRB2 associated binding protein 1 (GAB1) and miR-200a was ensured by starBase database and luciferase reporter assay. RESULTS: Our data uncovered that miR-200a was downregulated, but GAB1 was upregulated in the renal tissues of the rat experienced unilateral ureteral obstruction (UUO). Overexpression of miR-200a improved tissues fibrosis, suppressed GAB1 expression and ECM deposition, and inactivated Wnt/ß-catenin in UUO rats. Moreover, miR-200a expression was inhibited, while GAB1 expression was facilitated in the TGF-ß1-induced HK-2 cells. In TGF-ß1-induced HK-2 cells, miR-200a overexpression inhibited GAB1 expression, also declined ECM-related proteins and mesenchymal markers expression. Oppositely, miR-200a overexpression facilitated epithelial marker expression in the TGF-ß1-induced HK-2 cells. Next, the data revealed that miR-200a inhibited GAB1 expression through binding to the mRNA 3'-UTR of GAB1. Increasing of GAB1 reversed the regulation of miR-200a to GAB1 expression, Wnt/ß-catenin signaling activation, EMT and ECM accumulation. CONCLUSION: Overall, miR-200a increasing improved renal fibrosis through attenuating EMT and ECM accumulation by limiting Wnt/ß-catenin signaling via sponging GAB1, indicating miR-200a may be a promising objective for renal disease therapy.

Pancreatic intraductal papillary mucinous neoplasm with sarcomatous transformation. A case report.

Mixed pancreatic epithelial and mesenchymal tumors are rare, usually invasive, entities. Intraductal papillary mucinous neoplasm (IPMN) is a precursor of invasive ductal carcinoma and shares mutations with its invasive counterparts. We report the case of a 72-year-old female with a previously undescribed sarcomatous transformation of a residual IPMN with no evidence of an invasive component. The mesenchymal component showed no heterologous differentiation. Both the epithelial and the mesenchymal populations showed aberrant expression of p53 protein and the same point mutation in KRAS gene. After a 6 month follow up, there were no signs of local or distant relapse. The present case suggests that sarcomatous transformation is possible in non-invasive, intraductal pancreatic lesions.

La Transformación Organizacional en los Servicios de Atención Temprana en Castilla la Mancha Hacia un Enfoque Centrado en la Familia / Organizational Transformation in Early Intervention Services in “Castilla-La Mancha”: Towards an Approach Centered in the Family

Se está produciendo un cambio en España, y a escala internacional, con respecto a la atención temprana y a la concepción de los/as niños/as y la discapacidad (Tamarit, 2015). Se está pasando de un enfoque clínico, basado en la rehabilitación y centrado en las/los niñas/os, a un enfoque más global, sistémico, ecológico, centrado en la familia y en los entornos naturales. Sin embargo, su alcance y generalización siguen siendo desiguales. En Castilla-La Mancha (una comunidad autónoma española) se está realizando un esfuerzo de transformación en este sentido. El presente estudio, a través de entrevistas en profundidad a agentes relevantes (familiares, personal de la Administración y profesionales que ocupaban los roles de coordinación y de gerencia en entidades de Plena inclusión Castilla-La Mancha) y el análisis de su contenido, ha indagado en los avances logrados en el proceso de transformación; los factores involucrados, tanto en la vida interna de los servicios y entidades como en el entorno externo; y los principales obstáculos y los retos pendientes. A partir de la información recabada, se propone un modelo que describe la transformación y que puede facilitar la transferencia de conocimiento a centros y comunidades que estén desarrollando (o se lo estén planteando) un proceso de transformación similar hacia un enfoque centrado en la familia. (AU)

A change is taking place in Spain, and internationally, regarding early intervention and the conception of children and disability (Tamarit, 2015). It is moving from a clinical approach, based on the rehabilitation and focused on children, to a more global, systemic and ecological approach centered on the family and natural contexts. However, its scope and generalization remain irregular. In Castilla-La Mancha (a Spanish autonomous region), a transformation effort is being made in this regard. The present study, through in-depth interviews with relevant agents (family members, public administration staff, and professionals who perform coordination and management roles in organizations pertaining to “Plena inclusión Castilla-La Mancha”) and the analysis of its content, has examined the following aspects: progress made in the transformation process; the factors involved, both in the internal life of the services and organizations and in the external environment; and the main obstacles and pending challenges. Based on the information collected, a model is proposed that describes the transformation, facilitating the transfer of knowledge to centers and communities that are developing (or considering it) a similar transformation process towards an approach centered on the family. (AU)

Facilitating biodiversity conservation through partnerships to achieve transformative outcomes.

Conservation biology is a mission-driven discipline that must navigate a new relationship between conservation and science. Because conservation is a social and political as well as an ecological project, conservation biologists must practice interdisciplinarity and collaboration. In a comparative study of 7 cases (Jaguars in the Chaco, Grevy's zebra in Kenya, Beekeeping in Tanzania, Andean cats in Argentina, Jaguars in Mexico, Lobster fishing, and Black bears in Mexico), we examined motivations for collaboration in conservation, who can collaborate in conservation, and how conservation professionals can work well together. In 5 case studies, successful conservation outcomes were prioritized over livelihood benefits. In the other 2 cases, livelihoods were prioritized. All case studies employed participatory approaches. There were multiple external actors, including local and Indigenous communities, nongovernmental organizations, agencies, regional and national governments, and international organizations, which enhanced conservation and wider sustainability outcomes. Key collaboration aspects considered across the case studies were time (mismatch between relationship building and project schedules), trust required for meaningful partnerships, tools employed, and transformative potential for people, nature, and the discipline of conservation biology. We developed guidelines for successful collaboration, including long-term commitment, knowledge integration, multiscalar and plural approaches, cultivation of trust, appropriate engagement, evaluation, supporting students, and efforts for transformation.

Facilitación de la conservación de la biodiversidad a través de colaboraciones para lograr resultados transformadores Resumen La biología de la conservación es una disciplina impulsada por sus objetivos que debe navegar una nueva relación entre la conservación y la ciencia. Dado que la conservación es un proyecto social y político así como ecológico, los biólogos de la conservación deben practicar la interdisciplinariedad y la colaboración. En un estudio comparativo de siete casos (jaguares en el Chaco, cebras de Grevy en Kenia, apicultura en Tanzania, gatos andinos en Argentina, jaguares en México, pesca de langosta, osos negros en México), analizamos las motivaciones para colaborar en la conservación, quién puede colaborar en la conservación y cómo los profesionales de la conservación pueden trabajar bien juntos. En cinco estudios de caso, se priorizaron los resultados satisfactorios de la conservación sobre los beneficios para los medios de subsistencia. En los otros 2 casos, se dio prioridad a los medios de sustento. Todos los estudios de caso emplearon enfoques participativos. Hubo múltiples actores externos, como comunidades locales e indígenas, organizaciones no gubernamentales, agencias, gobiernos regionales y nacionales y organizaciones internacionales, que mejoraron los resultados de conservación y sostenibilidad en general. Los aspectos clave de la colaboración considerados en los estudios de caso fueron el tiempo (desajuste entre el establecimiento de relaciones y los calendarios de los proyectos), la confianza necesaria para establecer colaboraciones significativas, las herramientas empleadas y el potencial transformador para las personas, la naturaleza y la disciplina de la biología de la conservación. Se elaboraron directrices para el éxito de la colaboración, como el compromiso a largo plazo, la integración de conocimientos, los enfoques multiescalares y plurales, el fomento de la confianza, la participación adecuada, la evaluación, el apoyo a los estudiantes y los esfuerzos de transformación. Facilitación de la conservación de la biodiversidad a través de colaboraciones para lograr resultados transformadores.

Le devenir d'Eva: les transformations entre puberté et adolescence / The becoming of Eva: Transformations between puberty and adolescence / O tornar-se de Eva: as transformações entre a puberdade e a adolescência / El convertirse de Eva: las transformationes entre la pubertad y la adolescencia

L'adolescence est une période de développement qui se caractérise par la présence de forts contrastes, étant donné la nécessité de concilier le nouveau et l'inconnu, favorisant une avance dans la croissance. Le contexte scolaire est par excellence l'espace où se tissent et s'entretissent un ensemble de dynamiques basées sur la construction de processus identitaires et d'identification, favorisant la connaissance. Les autrices proposent de réfléchir aux transformations psychiques d'Eva, une adolescente de 15 ans, en suivi psychothérapeutique dans le cadre scolaire. Le Rorschach a été l'instrument d'évaluation à deux moments différents, à 12 et à 14 ans, permettant d'accéder et de décrire, les transformations psychiques de son adolescence. Cette nouvelle lecture est très bénéfique pour une meilleure planification et exécution du travail psychothérapeutique.

A adolescência é um período do desenvolvimento caracterizado pela presença de fortes contrastes, dada a necessidade de conciliar o novo e o desconhecido, favorecendo um avanço no crescimento. O contexto escolar é por excelência o espaço onde se vão tecendo um conjunto de dinâmicas e tramas baseadas na construção de processos identitários e de identificação, promovendo o autoconhecimento. As autoras propõem se pensar as transformações psíquicas de Eva, uma adolescente de 15 anos, em acompanhamento psicoterapêutico no contexto escolar. O Rorschach foi o instrumento de avaliação em dois momentos distintos, aos 12 e aos 14 anos, permitindo aceder e descrever as transformações psíquicas durante o processo de adolescer. Essa nova leitura é altamente benéfica para um melhor planeamento e execução do processo psicoterapêutico.

Adolescence is a period of development characterized by the presence of strong contrasts, given the need to reconcile the new and the unknown, favoring an advance in growth. The school context is par excellence the space where a set of dynamics are woven and woven based on the construction of identity and identification processes, promoting self-knowledge. The authors propose to think about the psychic transformations of Eva, a 15-year-old adolescent, undergoing psychotherapeutic follow-up in the school context. The Rorschach was the assessment instrument at two different times, at 12 and 14 years old, allowing access and describing the psychic transformations during the process of becoming an adolescent. This new reading is highly beneficial for better planning and execution of the psychotherapeutic process.

La adolescencia es un período de desarrollo caracterizado por la presencia de fuertes contrastes, dada la necesidad de conciliar lo nuevo y lo desconocido, favoreciendo un avance en el crecimiento. El contexto escolar és por excelencia el espacio donde se tejen y tejen un conjunto de dinámicas a partir de procesos de construcción de identidad e identificación, fomentando el autoconocimiento. Los autores proponen pensar las transformaciones psíquicas de Eva, una adolescente de 15 años, en seguimiento psicoterapéutico en el contexto escolar. El Rorschach fue el instrumento de evaluación en dos momentos diferentes, a los 12 y 14 años, permitiendo acceder y describir las transformaciones psíquicas durante el proceso de convertirse en una adolescente. Esta nueva lectura es altamente beneficiosa para una mejor planificación y pratica del proceso psicoterapéutico.

Terapia de infidelidad: puente para transitar de la devastación a la re-creación de sí y de la relación / Infidelity therapy: a bridge to transition from the devastation to the renovation of oneself and of the relationship

Objetivo: reconocer las vivencias que tuvieron los consultantes en el proceso terapéutico y que favorecieron mantener la relación de pareja luego de una infidelidad. Metodología: estudio cualitativo, fenomenológico-hermenéutico. Se realizaron dos entrevistas semiestructuradas, a tres parejas y una participante; triangulación de la información con un grupo de discusión con terapeutas. Resultados: las reflexiones suscitadas en el espacio terapéutico llevan a una mirada de sí y de la pareja en términos más compasivos, lo que permite que emerjan transformaciones individuales y relacionales que se denominaron: la renovación de la langosta y la transformación del cristal en oro, respectivamente. Los cambios en el pensamiento, acciones y maneras de relacionarse se constituyeron como prácticas de cuidado de sí y de la pareja. Conclusión: la terapia actúa como un "puente" para la recuperación de las parejas, facilita dejar atrás los efectos devastadores de la infidelidad y florecer en un panorama más estético y esperanzador.

Objective: to recognize the experiences that the consultants had in the therapeutic process that favored maintaining the couple's relationship after an infidelity. Methodology: qualitative study, hermeneutical phenomenological. Two semi-structured interviews were conducted with three couples and one participant; triangulation of information with a discussion group with therapists. Results: the reflections raised in the therapeutic space, lead to a look at oneself and the couple in more compassionate terms, which allows individual and relational transformations to emerge that were called: the renewal of the lobster and the transformation from crystal to gold, respectively. The changes in thinking, actions and ways of relating to each other were constituted as self-care and partner-care practices. Conclusion: therapy acts as a "bridge" for the recovery of couples, it makes it easier to leave behind the devastating effects of infidelity and flourish in a more aesthetic and hopeful outlook.

Violencia por prejuicio de género y prácticas de autocuidado en mujeres transgénero residentes en Bogotá / Violence due to gender bias and self-care practices in transgender women living in Bogotá

Resumen Objetivos. Conocer las prácticas de autocuidado de mujeres transgénero de la ciudad de Bogotá, en respuesta a la violencia por prejuicio de género desprendida del proceso de transformación. Metodología. Aproximación cualitativa a 5 mujeres transgénero y a 5 personas acompañantes del proceso, mediante entrevistas semiestructuradas, grabadas, transcritas y analizadas. Resultados y Conclusiones. En el discurso de las mujeres transgénero es reiterativa la vivencia de violencias por prejuicio de género, experimentada durante el proceso de transformación. A partir de ello, se encontraron diversas prácticas de autocuidado, creadas y adaptadas para proteger su salud. Se considera necesaria la implementación de políticas públicas en salud que permitan la visibilización de identidades diversas, propiciando la protección y la garantía de los derechos de las mujeres transgénero.

Abstract Goals. To know the self-care practices of transgender women in the city of Bogotá, in response to violence due to gender bias arising from the transformation process. Methodology. . Qualitative approach to 5 transgender women and 5 people accompanying the process, through semi-structured, recorded, transcribed and analyzed interviews. Results and conclusions. In the discourse of transgender women, experiences associated with violence due to gender bias, experienced during the transformation process, are repeated. From this, various self-care practices were found, created and adapted to protect their health. It is considered necessary to implement public health policies that allow the visibility of diverse identities, promoting the protection and guarantee of the rights of transgender women.