Identification and characterization of colorectal-cancer-associated SNPs on the SMAD7 locus.

PURPOSE: Genome-wide association studies have identified SMAD7 as a colorectal cancer (CRC) susceptibility gene. However, its underlying mechanism has not yet been characterized. This study screened functional SNPs (fSNPs) related to colorectal cancer through Reel-seq and obtained regulatory proteins on functional SNPs. METHODS: The candidate fSNPs on the SMAD7 locus were screened by Reel-seq method. Eight SNPs such as rs8085824 were identified as functional SNPs by luciferase reporter assay and EMSA, SDCP-MS and AIDP-WB revealed that HNRNPK can specifically bind to the rs8085824-C allele. The knockdown of HNRNPK by RNAi proved that HNRNPK could affect cell function by regulating SMAD7. RESULTS: Eight functional SNPs was found on the SMAD7 locus in linkage disequilibrium (LD) with R2 > 0.8, i.e., rs12953717, rs7227023, rs34007497, rs58920878, rs8085824, rs4991143, rs4939826, and rs7227023. We also identified allele-imbalanced binding of HNRNPK to rs8085824, H1-3 to rs12953717, THOC6 to rs7227023, and DDX21 to rs58920878. Further functional analysis revealed that these proteins are the regulatory proteins that modulate the expression of SMAD7 in the human colorectal cancer cell line DLD1. In particular, we discovered that siRNA knockdown of HNRNPK inhibits cell proliferation and cell clonal formation by downregulating SMAD7, as the decreased cell proliferation and cell clonal formation in the siRNA HNRNPK knockdown cells was restored by SMAD7 overexpression. CONCLUSION: Our findings reveal a mechanism which underlies the contribution of the fSNP rs8085824 on the SMD7 locus to CRC susceptibility.

Involuntary arm movements post-pacemaker insertion - real or Reel syndrome?

BACKGROUND: Twiddler syndrome, and the variant Reel syndrome, are rare but important complications of pacemaker implantation. CASE SUMMARY: We describe a rare complication of conventional permanent pacemaker implantation of rhythmic arm twitching secondary to brachial plexus stimulation from a displaced pacing lead caused by Reel syndrome. DISCUSSION: Twiddler syndrome and its variants are rare but important complications of pacemaker insertion. Holistic planning of cardiac procedures in elderly patients should identify those at risk to allow for targeted education and post-procedural care.

A cross-sectional study on Saudi pharmacists working as medical representatives: What attracted them and what is keeping them in this sector-Misconceptions and reality.

Background: The government in Saudi Arabia issued a labor reform initiative to renationalize the pharmacy profession in pharmaceutical companies to generate more employment for Saudi pharmacists. Considering the nationalization of the pharmacy workforce employed in this sector, as well as the pharmacists' preferences toward working in this setting, the current study was conducted determine the reasons to choose this career pathway, to clarify the common misconceptions about this sector and to assess job satisfaction, work commitment, and intentions to leave. Methods: An online self-administered questionnaire was used to collect data from pharmacists working as medical representatives across Saudi Arabia. A total of 133 medical representatives participated in the study. Results: The main factors that motivated study participants to join this sector included performing a socially important job, receiving a high salary, and further career development. The common misconceptions about the sector, such as lacking honor and value and considering commercial values to be accepted, were found to be incorrect by the medical representatives. A high job satisfaction level, high work commitment, and low intentions to leave the sector were reported by participants. Conclusion: Working as a medical representative in a pharmaceutical company is an appealing career choice that fulfills pharmacists' career ambitions and may help in creating more jobs for the increasing numbers of pharmacy graduates.

A fantasia e "a condição humana": a psicanálise em contato com a obra de René Magritte / Fantasy and "the human condition": psychoanalysis in contact with the work of René Magritte / Le fantame et "la condition humaine": la psychanalyse au contact de l'oeuvre de René Magritte / La fantasia y "la condición humana': el psicoanálisis en contacto con la obra de René Magritte

O artigo se propõe a incitar reflexões sobre a função da fantasia na psicanálise a partir do contato de Lacan com a obra do artista René Magritte, e especificamente, com o quadro La condition humaine (1933). Analisam-se algumas vertentes do funcionamento fantasístico como realidade do sujeito e, acima de tudo, como "condição humana" ligada a uma evitação do contato com "a janela para o real", em relação à falta de objeto último para a satisfação pulsional, à inconsistência do Outro e ao desamparo fundamental. Para tanto, examinam-se os dilemas da relação subjetiva com o objeto a e com das Ding, investigando o funcionamento ambíguo da fantasia e o seu possível entendimento como obra de arte para uso interno do sujeito. Propõe-se, finalmente, uma ressonância entre a compreensão da arte na obra de Magritte e a direção do tratamento conforme proposta por Lacan.

Resumos The article aims to incite reflections on the function of fantasy in psychoanalysis based on Lacan's contact with the work of the artist René Magritte, and specifically with the painting "La condition humaine" (1933). It analyzes some aspects of the functioning of fantasy as the subject's reality and, above all, as the "human condition" related to an avoidance of contact with "the window to the real," in relation to the lack of ultimate object for drive satisfaction, to the inconsistency of the Other and to fundamental helplessness. To this end, the dilemmas of the subjective relation with the object a and with das Ding are examined, investigating the ambiguous functioning of fantasy and its possible understanding as a work of art for the subject's internal use. Finally, a resonance is proposed between the understanding of art in Magritte's work and the direction of treatment as proposed by Lacan.

L'article réfléchit sur la fonction du fantasme dans la psychanalyse à partir du contact de Lacan avec l'œuvre de l'artiste René Magritte, et plus particulièrement avec le tableau « La condition humaine ¼ (1933). Il analyse certains aspects du fonctionnement fantasmatique comme réalité du sujet et, surtout, comme « condition humaine ¼ liée à l'évitement du contact avec « la fenêtre du réel ¼, en relation avec le manque d'objet ultime pour la satisfaction des pulsions, avec l'inconsistance de l'Autre et avec l'impuissance fondamentale. À cette fin, on examine les dilemmes de la relation subjective avec l'objet a et das Ding, en étudiant le fonctionnement ambigu du fantasme et sa compréhension possible en tant qu'œuvre d'art destinée à l'usage interne du sujet. Enfin, on propose une résonance entre la compréhension de l'art dans l'œuvre de Magritte et l'orientation de la cure telle que proposée par Lacan.

Este artículo pretende incitar a la reflexion sobre la función de la fantasía en el psicoanálisis desde el contacto de Lacan con la obra del artista René Magritte, más específicamente el cuadro "La condition humaine" (1933). Analiza algunos aspectos del funcionamiento de la fantasía como realidad del sujeto, sobre todo, como "condición humana" ligada a una evitación del contacto con "la ventana a lo real", con relación a la falta de objeto último para la satisfacción pulsional, con la inconsistencia del Otro y con el desamparo fundamental. Para ello, se examinan los dilemas de la relación subjetiva con el objeto a y das Ding, investigando el funcionamiento ambiguo de la fantasía y su posible comprensión como obra de arte para uso interno del sujeto. Por último, se propone una resonancia entre la comprensión del arte en la obra de Magritte y la dirección del tratamiento que propone Lacan.

An unusual cause of pacemaker malfunction: A case report of an association of twiddler and reel syndrome.

Introduction and importance: Lead dislodgement syndromes (Twiddler, Ratchet or Reel syndromes) are rare causes of cardiac stimulation device malfunction that can occur most commonly early after device implantation. Each one of them associated with a unique pattern of lead coiling and dysfunction. Our clinical case reports an unusual association and shed the light on the available diagnostic modalities. Case presentation: A 62-year-old woman who was referred to our hospital for a symptomatic high degree AV block, she underwent dual chamber pacemaker implantation. She experienced 3 weeks following implantation a rhythmic twitching of the right arm without syncope. The device interrogation revealed an increase in both leads pacing impedance and chest X-ray showed leads had pulled out of the heart and were tangling and wrapped repeatedly around the pulse generator. Revision procedure was performed to reposition the leads. Clinical discussion: Recognizing this complication early can prevent life threatening complication and is then of the utmost importance. Twiddler's syndrome is due to rotation of the device along its long axis. Reel syndrome is produced by device rotation along the transverse axis. In most cases, lead replacement or reposition is needed. Preventive measures such as patient education and use of a smaller pocket will reduce the risk of developing the syndrome. Conclusion: Our case highlights the available diagnostic modalities for early detection of twiddler's syndrome. The unique nature of this case increases the importance of considering device lead dislodgement as the cause for patients presenting with extra-cardiac symptoms.

Reel syndrome: a rare presentation of a rare cause of cardiac resynchronization malfunction.

Abstract: Reel syndrome is a rare cause of pacemaker lead displacement. This case report shows a rare presentation of Reel syndrome highlighting the importance of an early diagnosis and discussing the underlying mechanism, management and prevention.

Delayed presentation of pacemaker Reel Syndrome and lead damage: Coincidence or consequence?

Reel syndrome is a pacemaker lead early dislodgment, characterized by reeling-in of the lead(s) without being damaged. We herein present a case of an 86-year-old woman, with medical history of single chamber pacemaker implantation two years ago, admitted in cardiology department with complete AV block. Chest-Xray revealed ventricular lead coiling around and behind the pacemaker device. Urgent extraction of the previous pacemaker was performed; however, the lead damage made its repositioning unfeasible. Successful implantation of single-chamber pacemaker has been made. This clinical case highlights the importance of adequate follow-up to timely identify lead dislodgement, avoid lethal complications and lead fracture.

[All about the Pancreas]. / Alles über das Pankreas.

All about the Pancreas Abstract. Ultrasound has made tremendous progress with the use of contrast media and elastography, particularly in patients with small, solid pancreatic lesions (SPL) <20mm and cystic tumors (CPL) of any size. In the case of solid and cystic pancreatic lesions, the differential diagnosis must first be evaluated after detection in order to define the indications for radical surgery, strategies for preserving the pancreatic parenchyma or simply for control examinations. Contrast-enhanced transcutaneous (TUS, CEUS) and endoscopic (EUS, CE-EUS) ultrasound and elastography facilitate further characterization of SPL and ZPL. Pancreatic ductal adenocarcinomas (PDAC) show hypoenhancement in contrast-enhanced ultrasound. The majority of the important differential diagnoses, on the other hand, are multi-enhancing. PDAC are almost always harder than healthy pancreatic parenchyma. In contrast, elastographically soft SPL are - with very few exceptions - benign. This review provides an overview of the use of modern ultrasound techniques to detect and characterize solid and cystic pancreatic lesions.

Síndrome del carrete: una causa poco común de asistencia en laurgencia hospitalaria / Reel's syndrome: a rare cause of emergency hospital care

Poor positioning of the electrodes implantable cardiac electronic device(IEHD) is a very rare event, but can occasionally lead to serious clinical complications, such as syncope, heart failure or death due to asystole in patientsdependent on stimulation1.Recently, a new terminology management for ICED lead macro-dislodgementhas been proposed2. This new classification may be useful for clinicians. Wereport a clinical case of Reel´s Syndrome. (AU)

El mal posicionamiento de electrodos de dispositivos cardiacos electrónicosimplantables (DCEI) es un hecho infrecuente pero asociado a complicacionesclínicas graves como síncopes, insuficiencia cardiaca e incluso muerte porasistolia en pacientes dependientes de estimulación1.Recientemente se ha propuesto una actualización de la ordenación terminológica sobre macrodislocación de electrodos de DCEI que resulta de granutilidad para la práctica clínica habitual2. Siguiendo esta terminología presentamos el caso clínico de un síndrome del carrete. (AU)

The Magnetic Urtext: Restoration as Music Interpretation.

This paper discusses historical-critical thought to address the problems of restoration and preservation of tape music, proposing viable solutions to the matter of digitizing the historically valuable data that exists on and is represented by magnetic tapes. A detailed program of research and restoration and some software for helping in creation of critical editions of the musical works are proposed. We also present some of the issues and controversies that must be considered and approaches we have applied in the preservation of tape music, highlighting how these interpretations can impact later performances (playback) of these tape documents. Fundamentally, we argue that the act of tape music restoration has a parallel with the interpretation of the "Urtext score" in the performance of music from the Common Practice Era.

Clinical Utility of Switching to Insulin Degludec From Other Basal Insulins in Adult Patients With Type 1 or Type 2 Diabetes.

OBJECTIVES: The effects of switching Canadians from other basal insulins to degludec (IDeg) in an outpatient setting are unknown. Our aim in this study was to evaluate the clinical effectiveness and safety of switching insulin-treated adults with either type 1 (T1DM) or type 2 (T2DM) diabetes mellitus to IDeg. METHODS: This was a retrospective observational cohort study of Albertans who were switched to IDeg between December 1, 2018, and December 1, 2019, and followed until March 1, 2020. We used administrative databases (provincial cohort) and electronic medical records (clinic cohort) to gather data and interrupted time series for the primary outcome analysis. RESULTS: We analyzed a provincial cohort of 5,294 patients, 287 of whom were also included in the clinic cohort (T1DM, n=80; T2DM, n=207). After switching to IDeg, glycated hemoglobin (A1C) decreased by -0.3 (95% confidence interval [CI], -0.4% to -0.2%) and the reduction in A1C was maintained throughout the follow-up period. Rates of all-cause hospitalizations/emergency department visits per patient were not affected (hospitalizations pre-switch 0.07 [95% CI, 0.07 to 0.08], post-switch 0.08 [95% CI, 0.06 to 0.09], p=0.45; ED visits pre-switch 0.25 [95% CI, 0.23 to 0.27], post-switch 0.26 [95% CI, 0.23 to 0.29], p=0.27). In the clinic cohort, at switch, there was an average basal insulin dose reduction of 11.2% (T1DM), 12.3% (T2DM) and 16.3% (patients with insulin resistance). CONCLUSIONS: Patients with inadequate glycemic control or who find their basal insulin dosing inconvenient may benefit from switching to Ideg, with the potential for small improvementa in A1C at lower basal insulin doses.

Abdominal twitches due to ICD lead dislodgement; A case report.

Malfunctions of implantable cardiac devices have the potential to be catastrophic. A 63-year-old patient was admitted to our emergency department with new-onset abdominal pain and sensation of twitching on his abdominal wall. One month ago, an implantable cardioverter-defibrillator (ICD) was implanted in him to prevent malignant ventricular arrhythmias. An electrocardiogram was obtained that showed pace spikes unrelated to QRS complexes. The patient was diagnosed with ICD lead dislodgement and the lead was repositioned in another procedure. In conclusion, emergency physicians should be familiar with the problems of implantable cardiac devices.

Real-World Incidence and Risk Factors for Daytime and Nocturnal Non-Severe Hypoglycemia in Adults With Type 2 Diabetes Mellitus on Insulin and/or Secretagogues (InHypo-DM Study, Canada).

BACKGROUND: The aim of this study was to estimate the real-world incidence of self-reported non-severe hypoglycemia (NSH) and its related sociodemographic and clinical risk factors in a general population of Canadian adults with type 2 diabetes mellitus (T2DM) taking insulin and/or secretagogues. METHODS: Data for this study were obtained from the InHypo-DM Study. Self-reported data on the frequency of NSH (past 30 days) as well as sociodemographic and clinical characteristics were collected through an online questionnaire. Risk factors for any, daytime and nocturnal NSH were identified using multivariable negative binomial regression with backward selection. RESULTS: Among 432 adults with T2DM (43.8% female, mean age of 53.1 years), 53.9% (95% confidence interval [CI], 49.2% to 58.6%) reported ≥1 event of any (i.e. daytime or nocturnal) NSH in the past 30 days. The 30-day incidence rate of any NSH was 2.3 events per 30 person-days (95% CI, 2.1 to 2.4). Risk factors associated with the increased rate of any NSH were younger age, lower annual household income, being employed, longer duration of diabetes, higher glycated hemoglobin and presence of comorbidity. Risk factors were generally similar for daytime NSH (except for the exclusion of diabetes duration and addition of diabetes medication type) and nocturnal NSH (except for the exclusion of being employed). CONCLUSIONS: This is the largest Canadian investigation to estimate the real-world frequency and distribution of self-reported NSH in T2DM. Events were alarmingly frequent and recurrent. Numerous sociodemographic and clinical risk factors were elucidated. These results highlight the importance of identifying high-risk individuals to minimize future occurrences of hypoglycemia.

A duplex real-time NASBA assay targeting a serotype-specific gene for rapid detection of viable Salmonella Paratyphi C in retail foods of animal origin.

Salmonella enterica serovar Paratyphi C is highly adapted to humans and can cause a typhoid-like disease with high mortality rates. In this study, three serovar-specific genes were identified by comparative genomics for Salmonella Paratyphi C, SPC_0871, SPC_0872, and SPC_0908. Based on the SPC_0908 and xcd genes for testing Salmonella spp., we developed a duplex real-time nucleic acid sequence-based amplification (real-time NASBA) with a molecular beacon approach for the simultaneous detection of viable cells of Salmonella spp. and serotype Paratyphi C. The test selectively and consistently detected 53 Salmonella spp. (representing 31 serotypes) and 18 non-Salmonella strains. Additionally, the method showed high resistance to interference from natural background flora in pork and chicken samples. The sensitivity of the established approach was determined to be 4.89 cfu/25 g in artificially contaminated pork and chicken samples after pre-enrichment. We propose this NASBA-based protocol as a potential detection method for Salmonella spp. and serotype Paratyphi C in foods of animal origin.

Síndrome de reel como causa del mal funcionamiento del marcapasos: A propósito de un caso / Reel syndrome as cause of pacemaker malfunction: Apropos of a case

Implantation of cardiac electronic devices is an increasingly common technique and the possibility of device dysfunction caused by electrode displacement should be taken into account. We describe the case of an 88-year-old patient with syncopes several months after pacemaker implantation in which a pacemaker dysfunction was found. Chest X-ray confirmed lead displacement reeled around the generator. Reel syndrome is an entity that should be ruled out as a possible cause of pacemaker malfunction mainly in patients with risk factors for developing this syndrome.

La implantación de dispositivos cardíacos electrónicos es una técnica cada vez más habitual y debe tenerse en cuenta la posibilidad de disfunción del dispositivo debido al desplazamiento de los electrodos. Describimos el caso de una paciente de 88 años que comenzó con clínica de cuadros sincopales varios meses después de la implantación de un marcapasos, y en la que se demostró una disfunción del dispositivo. Mediante radiografía de tórax se confirmó el desplazamiento de los electrodos debido a un enrollamiento alrededor del generador. El síndrome de reel es una entidad que debe ser descartada como una de las posibles causas de mal funcionamiento de un marcapasos, principalmente en pacientes con factores de riesgo para presentar dicho síndrome.

A psicanálise, o pensamento científico e o real: uma nota propedêutica ao debate sobre a experiência educativa / El psicoanálisis, el pensamiento científico y lo real: una nota propedéutica al debate sobre la experiencia educativa / Psychoanalysis, scientific thought and the real: apropaedeutic note to the debate on the educational experience / La psychanalyse, la pensée scientifique et le réel: une note propédeutique au débat sur l'expérience éducative

O desdobramento dos estudos psicanalíticos em educação e formação é parasitado de tempos em tempos por consignas supostamente psicanalíticas. Nos dias de hoje constata-se a proliferação de referências ao termo real bastantes imprecisas com relação ao uso que Lacan fez do mesmo. O artigo visa esclarecer de forma propedêutica o uso do termo real no pensamento lacaniano no contexto preciso de uma operação singular de subversão do pensamento metafísico. O autor sustenta que o real lacaniano se inscreve no "retorno a Freud" de forma tal que ele constitui tanto a precipitação de uma diferença quanto o estabelecimento de uma continuidade com o pensamento freudiano. O texto objetiva assim o desafio de fazer avançar os estudos no campo, em particular a pergunta do que se transmite na experiência educativa, sobre outras bases que não sejam a repetição ecolálica de certas ideias pouco claras e precisas dos clássicos do pensamento psicanalítico

El desarrollo de los estudios psicoanalíticos en educación y formación es parasitado de vez en cuando por consignas supuestamente psicoanalíticas. En la actualidad proliferan las referencias al término real, bastante imprecisas en relación con el uso que hace Lacan del mismo. El artículo pretende propedéuticamente esclarecer el uso del término real en el pensamiento lacaniano en el contexto preciso de una singular operación de subversión del pensamiento metafísico. El autor sostiene que el real lacaniano se inscribe en el "retorno a Freud" de tal manera que constituye tanto la precipitación de una diferencia como el establecimiento de una continuidad con el pensamiento freudiano. El texto apunta así al desafío de hacer avanzar los estudios en el campo, en particular la cuestión de lo que se transmite en la experiencia educativa, sobre bases distintas a la repetición ecolálica de ciertas ideas poco claras y precisas de los clásicos del pensamiento psicoanalítico

Psychoanalytic studies in education and training are taken from time to time by supposedly psychoanalytic statements. Nowadays, there is a proliferation of references to the term real, which are quite imprecise in relation to Lacan's use of it. The article aims to clarify in a propaedeutic way the use of the term real in Lacanian thought in the precise context of a singular operation of subversion of metaphysical thought. The author argues that the Lacanian real is inscribed in the "return to Freud" in such a way that it constitutes both the precipitation of a difference and the affirmation of a continuity with Freudian thought. The text thus aims to contribute to the advancement of studies in the field, in particular the question about what is transmitted in the educational experience, from other bases than the echolalia repetition of certain imprecise ideas of the classics of psychoanalytic thought

Le développement des études psychanalytiques en éducation et formation est parasité de temps à autre par des slogans supposément psychanalytiques. On assiste aujourd'hui à une prolifération de références au terme «réel¼, assez imprécises par rapport à l'usage qu'en fait Lacan. Cet article vise à éclairer de manière propédeutique l'usage du terme «réel¼ dans la pensée lacanienne dans le contexte précis d'une opération singulière de subversion de la pensée métaphysique. L'auteur soutient que le réel lacanien s'inscrit dans le «retour à Freud¼ de telle manière qu'il constitue à la fois la précipitation d'une différence et l'établissement d'une continuité avec la pensée freudienne. Le texte se donne ainsi pour objectif le défi de faire avancer les études, en particulier la question de ce qui se transmet dans l'expérience éducative, sur d'autres bases que la répétition écholalique de certaines idées floues et imprécises des classiques de la pensée psychanalytique

Lacan, esteta? Anotações sobre a clínica do real / Lacan, aesthete? Notes about the clinic of the real / Lacan, ¿esteta? Notas sobre la clínica de lo real / Lacan, esthète ? Notes concernant la clinique du réel

O objetivo deste ensaio é desenvolver a hipótese segundo a qual é possível ouvir uma estética na proposta ética da psicanálise lacaniana. Para tanto, será discutida a clínica do simbólico tal como delineada, sobretudo, no seminário A ética da psicanálise, para em seguida apresentar a clínica do real desde o seminário O sinthoma, na qual a problemática da escrita do gozo se radicaliza. No desenrolar do debate, pretende-se destacar como, progressivamente, Lacan aprofunda a experiência analítica enquanto poiesis, ato de criação, um gesto de abandono de uma "vontade de poder", no sentido foucaultiano, para a afirmação de uma "vontade de criação", para dizê-lo nietzschianamente, própria às artes, e portanto como o avesso da biopolítica, de uma ordem de controle dos corpos e da subjetividade.

The aim of this essay is to develop the hypothesis according to which it is possible to hear an aesthetic in the ethical proposal of Lacanian psychoanalysis. In order to do so, the symbolic clinic will be discussed as outlined in the seminar The ethics of psychoanalysis to then present the clinic of the real since the seminar The sinthome in which the problem of writing of jouissance is radicalized. In the course of the debate, it is intended to highlight how, progressively, Lacan deepens the analytical experience as an act of poiesis, creation, a gesture of abandonment of a "will of power", in the Foucauldian sense, for an affirmation of a "willingness to create", to put it in a Nietzschean way, as the reverse of biopolitics, of an order of control over bodies and subjectivity.

El objetivo de este ensayo es desarrollar la hipótesis de que es posible escuchar una estética en la propuesta ética del psicoanálisis lacaniano. Con este fin, se discutirá la clínica de lo simbólico, sobre todo, como se describe en el seminario La ética del psicoanálisis, y luego presentaremos la clínica de lo real desde el seminario Le sinthome en el que se radicaliza el problema de la escritura del goce. En el transcurso del debate, se pretende destacar cómo, progresivamente, Lacan profundiza en la experiencia analítica como poiesis, acto de creación, un gesto de abandono de una "voluntad de poder", en el sentido de Foucault, para una afirmación de una "voluntad de crear", en el sentido de Nietzsche, propio de las artes y, por lo tanto, como el reverso de la biopolítica, de un orden para controlar los cuerpos y la subjetividad.

L'objectif de cet essai est de développer l'hypothèse selon laquelle il est possible de s'entendre une proposition éthique de la psychanalyse lacanienne. Pour cela, on discutera de la clinique du symbolique telle qu'elle a été délinéée surtout pendant le séminaire L'éthique de la psychanalyse pour ensuite présenter la clinique du réel depuis le séminaire Le sinthome, dans laquelle la problématique de l'écriture de la jouissance se radicalise. Pendant le déroulement du débat, on a l'intention de souligner comment Lacan approfondit progressivement l'expérience analytique en tant que poïétique, ou poiesis, un acte de création, un geste d'abandon d'une « volonté de pouvoir ¼ dans le sens foucaldien, vers une affirmation d'une « volonté de création ¼ pour le dire à la façon nietzschéenne, propre aux arts et, donc telle que l'inverse de la biopolitique, d'un ordre de contrôle des corps et de la subjectivité.

A substancialização dos conceitos psicanalíticos: efeitos e impasses / The substantialization of psychoanalytical concepts: effects and impasses / La substantialisation des concepts psychanalitiques: effets et impasses / La sustancialización de los conceptos psicoanalíticos: efectos e impases

Este artigo se insere em um debate atual acerca das políticas conceituais do campo lacaniano. Ele procura explorar um dos traços distintivos desse debate: a crítica à progressiva tematização da insuficiência da linguagem e à substancialização dos conceitos psicanalíticos no movimento lacaniano, identificada no trabalho de alguns psicanalistas. Este trabalho, por sua vez, apontaria para outra leitura do texto lacaniano, vetorizada por um horizonte ético-epistemológico distinto, marcadamente antisubstancialista. Destacaremos nisso o lugar de uma política dos usos de três conceitos fundamentais a esse campo: real, gozo e corpo. A partir das articulações propostas, procuraremos apresentar o substancialismo como um obstáculo em potencial para a psicanálise lacaniana, além de explorar algumas de suas possíveis implicações éticas, clínicas e epistemológicas.

This article is set in a current debate on the conceptual politics of the Lacanian field. It seeks to explore one of the distinctive features of this debate: the critique of the progressive thematization of language insufficiency and the substantialization of psychoanalytical concepts in the Lacanian movement, identified by the work of some psychoanalysts. This work, in turn, points to a different reading of the Lacanian text, vectorized by a distinct ethico-epistemological horizon, markedly anti-substantialist. We highlight the place of a politics of the use of three fundamental concepts in this field: real, jouissance and body. Based on the proposed reflections, we try to present substantialism as a potential obstacle for Lacanian psychoanalysis and explore some of its possible ethical, clinical and epistemological implications.

Cet article s'inscrit dans un débat actuel sur les politiques conceptuelles du champ lacanien. Il cherche à explorer l'un des traits distinctifs de ce débat : la critique de la thématisation progressive de l'insuffisance du langage et la substantialisation des concepts psychanalytiques dans le mouvement lacanien, identifié dans le travail de certains psychanalystes. Ce travail, à son tour, pointerait vers une autre lecture du texte lacanien, vectorisée par un horizon éthico-épistémologique distinct, nettement anti-substantialiste. En cela, nous mettrons en évidence la place d'une politique d'usage de trois concepts fondamentaux dans ce champ : réel, jouissance et corps. Dans ces articulations, nous présenterons le substantialisme comme un obstacle potentiel à la psychanalyse lacanienne, en plus d'explorer certaines de ses possibles implications éthiques, cliniques et épistémologiques.

Este artículo es parte de un debate actual sobre las políticas conceptuales del campo lacaniano. Busca explorar uno de los rasgos distintivos de este debate: la crítica a la tematización progresiva de la insuficiencia del lenguaje y a la sustancialización de los conceptos psicoanalíticos en el movimiento lacaniano, crítica identificada en el trabajo de algunos psicoanalistas. Este trabajo, por su parte, señalaría otra lectura del texto lacaniano, una lectura vectorizada por un horizonte ético-epistemológico diferente, marcadamente antisustancialista. Destacaremos el lugar de una política de uso de tres conceptos fundamentales en este campo: real, goce y cuerpo. A partir de las articulaciones propuestas, intentaremos presentar el sustancialismo como un potencial obstáculo para el psicoanálisis lacaniano, además de analizar algunas de sus posibles implicaciones éticas, clínicas y epistemológicas.

Reel syndrome, a diagnostic conundrum: a case report.

BACKGROUND: Pacemaker lead dislodgement and failure, related to device manipulation, is a rare complication of permanent pacemaker (PPM) insertion. Reel's, Twiddler's, and Ratchet syndrome are rare causes of pacemaker failure with varying mechanisms, defined by their classical lead and generator findings on chest X-ray imaging. Misleading patient presentations may be attributed to lead stimulation of surrounding structures. CASE SUMMARY: A 77-year-old female was admitted with abdominal wall pulsations, abdominal pain, and lower limb jerking 3 months following PPM insertion. Following exclusion of a ruptured abdominal aortic aneurysm, the presence of Reel syndrome was noted on the patient's chest X-ray and the electrocardiogram showed inappropriate pacing. Deactivation of the pacemaker resulted in immediate symptom cessation and urgent repositioning of pacemaker leads was undertaken. DISCUSSION: This case highlights the importance of considering pacemaker complications causing non-cardiac symptomatology. Pacemaker lead stimulation of surrounding structures can present in an unconventional fashion, veiling the diagnosis. However, a structured approach to undifferentiated neuromuscular presentations in patients with PPMs should consider lead dislodgement as a differential diagnosis. Rapid recognition of lead dislodgement, device deactivation, and re-implantation or repositioning of the leads are critical in preventing potentially life-threatening complications.

Reliability of a two-dimensional sock-clad footprint linear measurement method.

A two-dimensional linear measurement approach for footprints, herein referred to as the "Reel Method," has been shown to be valid and reliable when used on bare footprints, however, few measurement approaches have been examined on sock-clad footprints. The present investigation examines the validity and reliability of the Reel Method as a two-dimensional linear measurement approach for use on sock-clad footprints. A walking, mid-gait footprint was collected from 30 volunteer participants using the Identicator Inkless Shoe Print Model LE 25P system. The width of the ball of the foot, calcaneal width, and distance from the most posterior aspect of the heel to the most distal aspect of the first toe were each measured and compared between and within three raters. The statistical analysis demonstrated high reliability of the Reel Method among these three raters. The data were found to be normally distributed, and measurements were consistent between and within raters. 95% Intraclass Correlation coefficients, 95% Bland-Altman Limits of Agreement and 95% Standard Error of Measurement determined high statistical agreement between and within raters, demonstrating that the Reel Method is reliable and thus valid for the linear measurement of sock-clad footprints.