Association of FCGR2A with the response to infliximab treatment of patients with rheumatoid arthritis.

OBJECTIVES: We aimed to assess a functional polymorphism in FCGR2A H131R, for association with the treatment response to Fc-containing inhibitors of tumor necrosis factor (TNF). METHODS: A total of 429 biologic-naive patients with rheumatoid arthritis collected in two sets (299 and 130) were treated during standard care with infliximab (INX), etanercept, or adalimumab. Response to the treatment was evaluated at 3, 6, and 12 months of follow-up as the change in the Disease Activity Score (DAS) 28 from baseline and as the response by the European League Against Rheumatism (EULAR) criteria. These variables were analyzed for association with linear and logistic regression models that included sex, inhibitors of TNF, and baseline DAS28 as covariates. RESULTS: Significant association was found between the FCGR2A H131R polymorphism and the response to treatment with INX, but not with the other two TNF inhibitors. The 131R allele was associated with a lower change in DAS28 (P=0.04-0.008 at different times) in the first set of patients and confirmed in the second group of patients (P=0.026 at 3 months of follow-up). Association was also found in the comparison between nonresponders and responders to INX by the EULAR criteria. CONCLUSION: We found an association of the FCGR2A 131R allele with poor response to INX. This finding could be of utility to understand the mechanisms behind treatment failure and contribute to biomarker panels for INX response prediction.

Virtual Clinical Listening Groups for Psychological Intervention With University Students in the COVID-19 Pandemic.

The pandemic has affected people's mental health and university students are considered one of the most vulnerable groups, encouraging the development of psychological interventions that can minimize the suffering and illness of this public. Among the possibilities of intervention, virtual clinical listening groups were created which, during the period of social isolation, had the purpose of opening up a listening space for university students suffering from emotional distress. The focus of the group meetings was how university students were experiencing the pandemic, as well as the consequences of this experience. In this article, we discuss virtual clinical listening groups as a form of psychological intervention in the mental health care of university students during the COVID-19 pandemic at a university in northeastern Brazil. This is a qualitative study that began with 274 university students and 5 psychologists who facilitated the listening groups. We used as instruments the registration forms, the participation records of the virtual clinical listening groups and the field diaries written by the facilitators after each meeting. We described in the results the collected data and, from the field diaries, the themes that emerged in the various meetings were listed and analyzed in dialogue with the literature. At the end of the psychological screening process, 117 students participated in the 17 organized groups, with an average of 8 university students per group. Among the main motivations for participating in virtual clinical listening groups, we highlight: the desire to share experiences, a search for control of anxiety, depression and stress, care for mental health, a willingness to promote listening to psychological support for themselves and for others, and self-knowledge. We discuss the nuances in the process of forming the listening groups and the characteristics of the participants, as well as a central element of the group process, which is the establishment of bonds and mutual help among the participants. Feeling vulnerable and the fear of contamination is an element of suffering and, above all, of stress experienced by university students. The group presented itself as an alternative of mutual care in the pandemic context.

The potential of anthocyanins in smart, active, and bioactive eco-friendly polymer-based films: A review.

Among the bioactive compounds that are considered important for the food industry, anthocyanins, which are flavonoid compounds presenting antioxidant activity and are responsible for beneficial health effects, have received researchers' attention in the last decades. In addition, anthocyanins are highly reactive and can be used as indicators of foodstuff quality conditions, particularly as a packaging ingredient. Considering this line of work, the eco-friendly film is a novel packaging technology that arose from the concern to reduce non-renewable resources and their impact on the environment. These films can be vehicles for loading bioactive compounds such as anthocyanins. Among the contribution of films in the food industry, we can highlight several potential applications: i) smart film: assess food quality and safety, transmitting food information to consumers and increasing the reliability of their consumption without breaking the packaging; ii) active film: use to preserve food quality through the release of active agents; and iii) bioactive film: carry substances in desired concentrations until their controlled or rapid diffusion within the gastrointestinal tract so that they can promote its benefit to human health. Thus, this review presents anthocyanin extract's potential as a powerful tool to improve the development of eco-friendly films, directing its purpose to the application as smart, active, and bioactive films.

Evaluation of 12 GWAS-drawn SNPs as biomarkers of rheumatoid arthritis response to TNF inhibitors. A potential SNP association with response to etanercept.

Research in rheumatoid arthritis (RA) is increasingly focused on the discovery of biomarkers that could enable personalized treatments. The genetic biomarkers associated with the response to TNF inhibitors (TNFi) are among the most studied. They include 12 SNPs exhibiting promising results in the three largest genome-wide association studies (GWAS). However, they still require further validation. With this aim, we assessed their association with response to TNFi in a replication study, and a meta-analysis summarizing all non-redundant data. The replication involved 755 patients with RA that were treated for the first time with a biologic drug, which was either infliximab (n = 397), etanercept (n = 155) or adalimumab (n = 203). Their DNA samples were successfully genotyped with a single-base extension multiplex method. Lamentably, none of the 12 SNPs was associated with response to the TNFi in the replication study (p > 0.05). However, a drug-stratified exploratory analysis revealed a significant association of the NUBPL rs2378945 SNP with a poor response to etanercept (B = -0.50, 95% CI = -0.82, -0.17, p = 0.003). In addition, the meta-analysis reinforced the previous association of three SNPs: rs2378945, rs12142623, and rs4651370. In contrast, five of the remaining SNPs were less associated than before, and the other four SNPs were no longer associated with the response to treatment. In summary, our results highlight the complexity of the pharmacogenetics of TNFi in RA showing that it could involve a drug-specific component and clarifying the status of the 12 GWAS-drawn SNPs.

Saúde mental na universidade: atendimento psicológico online na pandemia da covid-19 / Mental health at the university: online psychological care during the covid-19 pandemic / Salud mental en la universidad: atención psicológica en línea en la pandemia de covid-19

Com a pandemia da covid-19, o contexto universitário, que já vinha sendo palco de discussões em relação à saúde mental, tem vivenciado crises mais severas pelos estudantes. Diante deste cenário, foi desenvolvido o projeto Escuta Solidária, voltado à saúde mental dos discentes de graduação e de pós-graduação. Neste artigo, temos como objetivo discutir o atendimento psicológico online com estudantes do curso de psicologia durante o período de isolamento social rígido (maio a junho de 2020). Fizemos, com os psicólogos voluntários, um grupo focal direcionado para a experiência de atendimento psicológico online de curta duração no contexto pandêmico. Trata-se de um estudo qualitativo, realizado com os 11 psicólogos clínicos participantes do referido projeto. A partir de uma análise fenomenológica crítica, os resultados foram divididos em cinco categorias: a) limitações e contribuições do projeto; b) a importância da capacitação e supervisão clínica para a qualidade do projeto; c) atendimento psicológico online; d) ser psicólogo clínico durante a crise da covid-19; e e) demandas emergentes nos atendimentos psicológicos na quarentena. Por fim, discutimos a importância da desmistificação do atendimento psicológico em situações de crise, especialmente na modalidade online, fomentando questionamentos à formação e atuação dos profissionais, no sentido de estarmos atentos às demandas psicológicas que o contexto de crise acarreta na sociedade.(AU)

With the COVID-19 pandemic, the university context, which had already been the stage for discussions regarding mental health, has experienced more severe crises by students. In view of this scenario, the Solidarity Listening project was developed, aimed at the mental health of undergraduate and graduate students. In this article, we aim to discuss online psychological care with psychology students during the period of strict social isolation (May to June 2020). We carried out, with volunteer psychologists, a focus group aimed at the experience of short-termonline psychological care in the pandemic context. This is a qualitative study, carried out with 11 clinical psychologists participating in the aforementioned project. From a critical phenomenological analysis, the results were divided into five categories: a) limitations and contributions of the project; b) the importance of training and clinical supervision for the quality of the project; c) online psychological care; d) being a clinical psychologist during the COVID-19 crisis; and e) emerging demands in psychological care in quarantine. Finally, we discuss the importance of demystifying psychological care in crisis situations, especially in the online modality, promoting questions regarding the training and performance of professionals, to be aware of the psychological demands that the context of crisis entails in society.(AU)

La pandemia del covid-19 provocó que las universidades, que ya habían sido escenario de discusiones sobre la salud mental, experimentaran crisis más severas entre los estudiantes. Ante este escenario, se desarrolló el proyecto Escucha Solidaria, dirigido a la salud mental de estudiantes de grado y posgrado. Este artículo pretende discutir la atención psicológica en línea con estudiantes de Psicología durante el período de aislamiento social más estricto (mayo/junio de 2020). Se conformó un grupo focal con los psicólogos voluntarios orientado a la práctica de la atención psicológica en línea, a corto plazo, en el contexto de una pandemia. Se trata de un estudio cualitativo, realizado con 11 psicólogos clínicos que participaron en el mencionado proyecto. A partir del análisis fenomenológico crítico, los resultados se dividieron en cinco categorías: a) limitaciones y aportes del proyecto; b) importancia de la capacitación y la supervisión clínica para la calidad del proyecto; c) atención psicológica en línea; d) ser psicólogo clínico durante la crisis del covid-19; y e) demandas emergentes en atención psicológica en la cuarentena. Se concluye que es importante desmitificar la atención psicológica en situaciones de crisis, especialmente en la modalidad en línea, al promover principalmente preguntas sobre la formación y el desempeño de los profesionales con el fin de ser conscientes de las demandas psicológicas que el contexto de crisis conlleva la sociedad.(AU)

Validation study of genetic biomarkers of response to TNF inhibitors in rheumatoid arthritis.

Genetic biomarkers are sought to personalize treatment of patients with rheumatoid arthritis (RA), given their variable response to TNF inhibitors (TNFi). However, no genetic biomaker is yet sufficiently validated. Here, we report a validation study of 18 previously reported genetic biomarkers, including 11 from GWAS of response to TNFi. The validation was attempted in 581 patients with RA that had not been treated with biologic antirheumatic drugs previously. Their response to TNFi was evaluated at 3, 6 and 12 months in two ways: change in the DAS28 measure of disease activity, and according to the EULAR criteria for response to antirheumatic drugs. Association of these parameters with the genotypes, obtained by PCR amplification followed by single-base extension, was tested with regression analysis. These analyses were adjusted for baseline DAS28, sex, and the specific TNFi. However, none of the proposed biomarkers was validated, as none showed association with response to TNFi in our study, even at the time of assessment and with the outcome that showed the most significant result in previous studies. These negative results are notable because this was the first independent validation study for 12 of the biomarkers, and because they indicate that prudence is needed in the interpretation of the proposed biomarkers of response to TNFi even when they are supported by very low p values. The results also emphasize the requirement of independent replication for validation, and the need to search protocols that could increase reproducibility of the biomarkers of response to TNFi.

"My life only happened on the Internet": Pedro's case in the perspective of Merleau-Ponty's phenomenology / "Minha vida só acontecia na Internet": o caso Pedro na perspectiva da fenomenologia de Merleau-Ponty / "Mi vida sólo sucedía en Internet": el caso Pedro en la fenomenología de Merleau-Ponty

The Internet has changed our relationship with time and also transformed experiences, developing new forms of subjectivation. In contemporary society, individuals are increasingly connected, which can lead to addictions such as Internet gaming disorder. This is related to one of the dimensions that underlies human existence: time. This work aims to understand, from the view of Merleau-Ponty's philosophical phenomenology, the experience of the lived time of Pedro, a young man dependent on Internet gaming. We use the single case study as a method, and we understand Pedro's addiction to Internet gaming as a phenomenon linked to the relationships established between him and the contemporary world, whether in the individual or collective sphere. These relationships are inseparable from the elements that make up Pedro's Lebenswelt (lifeworld), such as temporality. The time of the clock influenced the internal time and vice versa, denoting the indivisibility of the phenomenon inwhich there is only a sense of time because man is time itself.

A Internet mudou a nossa relação com o tempo e também transformou nossas experiências, fomentando novas formas de subjetivação. Na sociedade contemporânea, os indivíduos estão cada vez mais conectados, o que pode ocasionar em adoecimentos, tais como o transtorno do jogo pela Internet. Este se relaciona com uma das dimensões que fundamenta a existência humana, a saber: o tempo. Este trabalho tem o objetivo de compreender, sob o olhar da fenomenologia filosófica de Merleau-Ponty, a experiência do tempo vivido de Pedro, jovem dependente do jogo pela Internet. Utilizamos como método o estudo de caso único, e compreendemos a dependência do jogo pela Internet de Pedro como um fenômeno ligado às relações estabelecidas entre ele e o mundo contemporâneo, seja em âmbito individual ou coletivo. Relações que são inseparáveis dos elementos que constituem o Lebenswelt (mundo vivido) de Pedro, como a temporalidade. O tempo do relógio influenciou o tempo interior e vice-versa, denotando a indivisibilidade do fenômeno para o qual só há sentido do tempo porque o homem é o próprio tempo.

La internet há cambiado nuestra relación con el tiempo y también ha transformado nuestras experiencias, fomentando nuevas formas de subjetivación. En la sociedad contemporánea, los individuos están cada vez más conectados, lo que puede ocasionar en enfermedades, tales como el trastorno del juego por Internet. Este se relaciona con una de las dimensiones que fundamenta la existencia humana, a saber: el tiempo. Este trabajo tiene el objetivo de comprender, bajo la mirada de la fenomenología filosófica de Merleau-Ponty, la experiencia del tiempo vivido de Pedro, joven dependiente del juego por Internet. Utilizamos como método el estudio de caso único, y comprendemos la dependencia del juego por Internet de Pedro como un fenómeno ligado a las relaciones establecidas entre él y el mundo contemporáneo, sea en ámbito individual o colectivo. Relaciones que son inseparables de los elementos que constituyen el Lebenswelt (mundo vivido) de Pedro, como la temporalidad. El tiempo del reloj influyó en el tiempo interior y viceversa, denotando la indivisibilidad del fenómeno para el cual sólo existe un sentido del tiempo porque el hombre es el tiempo mismo.

Contribuições da Noção de Crise do Senso Comum na Esquizofrenia em Stanghellini / Contributions of Stanghellini's notion of the Crisis of Common Sense in Schizophrenia

Resumo A noção de crise do senso comum na esquizofrenia é introduza por Wolfgang Blankenburg através do conceito de perda da evidência natural. Na contemporaneidade, Giovanni Stanghellini revista e amplia essa noção, propondo uma perspectiva panorâmica dessa crise. Este artigo apresenta as contribuições trazidas pela perspectiva de Stanghellini, introduzindo seu entendimento sobre o conceito de senso comum e a relevância deste para a compreensão da esquizofrenia. Para o autor, o senso comum é compreendido de três modos: como saber socialmente compartilhado, sintonização intuitiva e cenestesia. Através das noções de intercorporeidade e koinè aisthesis, Stanghellini entende a esquizofrenia como experiência de rompimento da relação habitual com o mundo. Sua proposta contribui para a prática clínica ao sugerir direções à psicoterapia com esquizofrênicos.

Abstract The notion of crisis of common sense on schizophrenia is introduced by Wolfgang Blankenburg through his concept of loss of natural evidence. In contemporaneity, Giovanni Stanghellini revisits and amplifies this notion by proposing a panoramic perspective on this crisis. This paper presents the contributions brought by Stanghellini's perspective, introducing his understanding of common sense and its relevance for the comprehension of schizophrenia. For the author, common sense is understood in three ways: as a knowledge socially shared, intuitive attunement, and cenesthesia. Through the notions of intercorporeality and koinè aisthesis, Stanghellini conceives schizophrenia as an experience of disruption of the habitual relation with the world. His proposal contributes to clinical practice by suggesting directions for the psychotherapy with schizophrenics.

The hyperphagic experience in obesity: a phenomenological study of French and Brazilian contexts / A experiência hiperfágica na obesidade: um estudo fenomenológico nos contextos francês e brasileiro

This article aims to understand the hyperphagic experience in the obesity of patients in the French and Brazilian contexts. Using the critical phenomenological method, twenty subjects were interviewed in health services in Paris and in Fortaleza. We note an objectification and expropriation of the body often experienced in the hyperphagic experience in obesity. We highlight the emphasis on health in the French context and on form and aesthetics in the Brazilian context. In Fortaleza, there seems to be a more evidenced discrimination in relation to obesity and a pathological discourse, whereas in Paris this pathologization is viewed from a critical position regarding the treatments. We conclude that the hyperphagic experience in obesity reveals a subject who is often lost in his/her way of being and having a body, and that clinical work must involve the re-appropriation of this body and the recovery of the condition of the autonomous subject.

Este artigo tem como objetivo compreender a experiência hiperfágica na obesidade de pacientes nos contextos francês e brasileiro. Utilizando o método fenomenológico crítico, 20 sujeitos foram entrevistados em serviços de saúde de Paris e de Fortaleza. São evidenciadas a objetificação e a desapropriação do corpo frequentemente vividas na experiência hiperfágica na obesidade. No contexto francês, destaca-se a ênfase na saúde e, no contexto brasileiro, a forma corporal e a estética. Em Fortaleza parece haver uma discriminação em relação à obesidade mais evidenciada e um discurso em direção à patologização dessa experiência, enquanto que em Paris essa patologização é revestida por uma posição crítica em relação aos tratamentos. Conclui-se que a experiência hiperfágica na obesidade revela um sujeito, muitas vezes, perdido em seu modo de ser e de ter um corpo e que o trabalho clínico deve envolver a reapropriação desse corpo e a recuperação de sua condição de sujeito autônomo.

Linguagem e relação com os outros: contribuições da fenomenologia de Merleau-Ponty para a psicoterapia infantil / Lenguaje y relación con otros: contribuciones de la fenomenología de Merleau-Ponty a la psicoterapia infantil / Langage et relation avec l'autre: contributions de la phénoménologie Merleau-Ponty à la psychothérapie pour enfants / Language and relationship with the others: contributions from Merleau-Ponty's phenomenology to child psychotherapy

Resumo O objetivo deste ensaio teórico é discutir a noção de linguagem e a relação com os outros na fenomenologia de Merleau-Ponty como possível fundamento para a psicoterapia humanista-fenomenológica com crianças. Para Merleau-Ponty, a linguagem se apresenta como experiência viva e intersubjetiva, e o reconhecimento de si e de outrem pela criança não se daria na intelecção, mas pela dimensão experiencial. O psicoterapeuta escuta a criança naquilo que ela tem a dizer e sua participação se dá como reconhecimento e afetação diante da linguagem infantil. A relação se constitui numa dupla reversibilidade: reconhecimento do outro pela criança em sua própria experiência de corpo e dos sentimentos manifestos acerca de outrem; e afetação do encontro vivenciado tanto pelo psicoterapeuta como pela criança. Concluímos que esta proposta representa uma fecunda contribuição para a psicoterapia humanista-fenomenológica com crianças ao privilegiar a compreensão da criança para além dos estereótipos e noções cristalizadas de infância.

Resumen Este ensayo teórico tiene como objetivo discutir la noción del lenguaje y la relación con otros en la fenomenología de Merleau-Ponty como una posible base para la psicoterapia humanista-fenomenológica con niños. Para Merleau-Ponty, el lenguaje se presenta como una experiencia viva e intersubjetiva y el reconocimiento de uno mismo y del otro por parte del niño no ocurre en la intelección, sino en la dimensión experiencial. El psicoterapeuta escucha al niño en lo que tiene que decir y su participación se lleva a cabo como reconocimiento y afectación frente al lenguaje infantil. La relación constituye una doble reversibilidad: el reconocimiento del otro por parte del niño en su propia experiencia del cuerpo y de los sentimientos manifiestos sobre los demás; y la afectación del encuentro, experimentado tanto por el psicoterapeuta como por el niño. Se concluye que esta propuesta representa una contribución fructífera a la psicoterapia humanista-fenomenológica con niños al privilegiar la comprensión del niño más allá de los estereotipos y las nociones cristalizadas de la infancia.

Résumé Cet essai théorique vise à discuter la notion de langage et la relation avec les autres dans la phénoménologie de Merleau-Ponty, en tant que fondement possible d'une psychothérapie humaniste-phénoménologique pour les enfants. Pour Merleau-Ponty, le langage est une expérience vivante et intersubjective, et la reconnaissance de soi et de l'autre par l'enfant ne se ferait pas par l'intellection, mais par la dimension expérientielle. Le psychothérapeute écoute l'enfant dans ce qu'il a à dire et sa participation se produit comme une reconnaissance et une affectation face au langage des enfants. La relation constitue une double réversibilité : la reconnaissance de l'autre par l'enfant dans sa propre expérience corporelle et les sentiments qu'il manifeste à l'égard de l'autre ; et l'affectation de la rencontre, vécue à la fois par le psychothérapeute et par l'enfant. Nous concluons que cette proposition représente une contribution fructueuse à la psychothérapie humaniste-phénoménologique pour enfants en privilégiant la compréhension de l'enfant au-delà des stéréotypes et des notions cristallisées de l'enfance.

Abstract Our article aims at discussing the notion of language and the relationship with others in Merleau-Ponty's phenomenology as a possible foundation for humanistic-phenomenological psychotherapy with children. For Merleau-Ponty, language presents itself as a living and intersubjective experience and the recognition of oneself and others by the child would not occur in intellection, but through the experiential dimension. The psychotherapists listen to the child and their participation occurs as recognition and affectation in the face of children's language. The relationship constitutes a double reversibility: recognition of the other by the child in his own experience of the body and of the manifest feelings about others; affectation of the encounter, experienced by both the psychotherapist and the child. We conclude that this proposal represents a fruitful contribution to humanistic-phenomenological psychotherapy with children by privileging the child's understanding beyond stereotypes and crystallized notions of childhood.

Contribuições de Kraepelin, Bleuler e Bergson para a fenomenologia clínica da esquizofrenia de Minkowski / The contributions of Kraepelin, Bleuler and Bergson to Minkowskis clinical phenomenology of schizophrenia / Les contributions de Kraepelin, Bleuler et Bergson à la phénoménologie clinique de la schizophrénie de Minkowski / Contribuciones de Kraepelin, Bleuler y Bergson a la fenomenología clínica de la esquizofrenia de Minkowski

Resumo Este artigo se propõe a apresentar a fenomenologia clínica da esquizofrenia construída pelo psiquiatra Eugène Minkowski por meio de influências teóricas sofridas a partir das ideias de Kraepelin, Bleuler e Bergson. O interesse de Minkowski ao discutir a esquizofrenia é alcançar uma delimitação dessa patologia. Por mais que se remeta constantemente a Bleuler por ter sido seu aluno, é na filosofia de Bergson que encontra uma fonte sólida para aprofundar sua discussão sobre o aspecto estrutural da esquizofrenia. Com essa influência filosófica, é possível compreender a esquizofrenia como perda de contato vital com a realidade, e não como um relaxamento de associações, conforme Bleuler destacava. Concluímos que utilizar a fenomenologia clínica da perda do contato vital com a realidade e a compreensão da esquizofrenia como perda desse contato com o mundo permite apontar um novo direcionamento para estudar esta patologia como uma patologia da intersubjetividade.

Abstract This article presents the clinical phenomenology of schizophrenia constructed by the psychiatrist Eugène Minkowski through theoretical influences from the ideas of Kraepelin, Bleuler and Bergson. Minkowski's interest in discussing schizophrenia is to be able to determine this pathology. Although references are constantly made by him to Bleuler for having been his student, it is in Bergson's philosophy that he finds a solid source to further his discussion of the structural aspect of schizophrenia. With this philosophical influence, it is possible to understand schizophrenia as a loss of vital contact with reality and not as a relaxation of associations, as Bleuler pointed out. We conclude that using the clinical phenomenology of the loss of vital contact with reality and the understanding of schizophrenia as a loss of this contact with the world allows for a new direction to study this pathology as a pathology of intersubjectivity.

Résumé Le présent article se propose à discuter la phénoménologie clinique de la schizophrénie construite par le psychiatre Eugène Minkowski à travers les influences théoriques issues des idées de Kraepelin, Bleuler et Bergson. L'intérêt de Minkowski lorsqu'il élabore une discussion sur la schizophrénie est de parvenir à avoir une délimitation de cette pathologie. Même si on reconnaît qu'il mentionne constamment Bleuler, vu qu'il était son élève, c'est dans la philosophie de Bergson qu'il trouve une source solide pour approfondir sa discussion sur l'aspect structurel de la schizophrénie. Avec cette influence philosophique, il est possible de comprendre la schizophrénie comme une perte de contact vital avec la réalité et non comme une relaxation d'associations, comme l'a soulignée Bleuler. Nous concluons que l'usage de la phénoménologie clinique de la perte de contact vital avec la réalité et la compréhension de la schizophrénie comme une perte de ce contact avec le monde nous permet de souligner une nouvelle direction d'études de cette pathologie comme une pathologie de l'intersubjectivité.

Resumen El presente artículo se propone presentar la fenomenología clínica de la esquizofrenia construida por el psiquiatra Eugène Minkowski por medio de influencias teóricas sufridas a partir de las ideas de Kraepelin, Bleuler y Bergson. El interés de Minkowski al elaborar una discusión de la esquizofrenia es alcanzar una delimitación de esta patología. El autor alude constantemente a Bleuler por haber sido su alumno, pero en la filosofía de Bergson encuentra una fuente sólida para profundizar en su discusión sobre el aspecto estructural de la esquizofrenia. Con esta influencia filosófica, es posible comprender la esquizofrenia como la pérdida de contacto vital con la realidad y no como una relajación de asociaciones, tal como Bleuler destacaba. Concluimos que utilizar la fenomenología clínica de la pérdida del contacto vital con la realidad y la comprensión de la esquizofrenia como pérdida de este contacto con el mundo permite apuntar un nuevo direccionamiento para estudiarla como una patología de la intersubjetividad.

A clínica de Ludwig Binswanger inspirada no Dasein de Heidegger e na fenomenologia genética de Husserl / Ludwig Binswanger's clinic inspired by Heidegger's Dasein and Husserl's genetic phenomenology / La clinique de Ludwig Binswanger inspirée par le Dasein de Heidegger et par la phénoménologie génétique de Husserl / La clínica de Ludwig Binswanger inspirada en el Dasein de Heidegger y en la fenomenología genética de Husserl

A clínica fenomenológica de Ludwig Binswanger propõe uma nova compreensão sobre a psicopatologia ao realçar a importância na história de vida do paciente. Encontra-se dividida em três fases mostrando a fertilidade de seus estudos psicopatológicos após a leitura de Ser e tempo e através da influência husserliana, com o intuito de esclarecer a constituição da experiência delirante. Este artigo tem como objetivo apresentar dois casos clínicos, Lola Voss e Suzanne Urban, para ilustrar a contribuição oferecida por Ludwig Binswanger à psicopatologia fenomenológica em sua segunda e última fase.

Ludwig Binswanger's phenomenological clinic provides a new understanding of psychopathologies by highlighting the importance of patients' life stories. It is divided into three phenomenological stages and shows how fertile his psychopathological studies became after he had read Being and Time and due to Husserl's influence, which he undertook to investigate the formation of delusional experience. This article presents two clinical cases, Lola Voss and Suzanne Urban, to illustrate Ludwig Binswanger's contribution to phenomenological psychopathology in its second and final stage.

La clinique phénoménologique de Ludwig Binswanger propose une nouvelle compréhension de la psychopathologie soulignant l'importance de l'histoire de vie du patient. Les trois phases de sa pensée phénoménologique montrent la fécondité de ses études psychopathologiques, influencées par la lecture de l'Être et Temps et par Husserl, qu'il menait pour élucider la formation de l'expérience délirante. Cet article présente deux cas cliniques, Lola Voss et Suzanne Urban, qui illustrent la contribution apportée par Ludwig Binswanger à la psychopathologie phénoménologique dans sa deuxième et dernière phase.

La clínica fenomenológica de Ludwig Binswanger propone una nueva comprensión de la psicopatología al destacar su importancia en la historia de vida del paciente. Está divida en tres fases, mostrando la fertilidad de sus estudios psicopatológicos tras la lectura de Ser y tiempo, y a través de la influencia de Husserl, a fin de aclarar la constitución de la experiencia delirante. Este artículo tiene como objetivo presentar dos casos clínicos, Lola Voss y Suzanne Urban, para ilustrar la contribución de Ludwig Binswanger a la psicopatología fenomenológica en su segunda y última fase.

O Tempo vivido em Mrs. Dalloway à Luz da fenomenologia de Merleau-Ponty / Experienced Time in Mrs. Dalloway in Light of Merleau-Ponty's phenomenology / El Tiempo Vivido en La Señora Dalloway a la Luz de la fenomenología de Merleau-Ponty

O romance Mrs. Dalloway, escrito pela inglesa Virginia Woolf (1882-1941), é um marco na literatura universal por apresentar um novo formato na arte da escrita intitulado fluxo de consciência. Esta forma estilística visa descrever as falas e os pensamentos dos personagens por meio do discurso indireto livre, integrado à preleção do narrador. O enredo se passa em um único dia da vida da protagonista Clarissa Dalloway, no qual são captados os ínfimos detalhes do que ela experiencia. Dentre os fenômenos vivenciados encontramos a noção de tempo, por meio da qual o narrador mistura homogeneamente o fluxo passado, presente e futuro. O objetivo deste artigo é discutir a vivência do tempo na referida obra literária pautada numa discussão fenomenológica. Para isto, utilizamos como método a revisão narrativa da literatura de autores que contribuíram para o desenvolvimento da noção de tempo vivido na fenomenologia. É no fluxo do tempo que se dão os significados das experiências na história dos personagens no seu contato ambíguo com o mundo. Concluímos que as descrições elaboradas por Virginia Woolf possibilitam uma aproximação à vivência do tempo, que atravessa a totalidade da dimensão do ser...(AU)

The novel Mrs. Dalloway, written by English writer Virginia Woolf (1882-1941), is a landmark in universal literature for presenting a new format in the art of writing named Stream of Consciousness. This stylistic form aims to describe the speeches and thoughts of the characters through free indirect speech, integrated to the narrator's lecture. The novel takes place in a single day of the life of the protagonist Clarissa Dalloway, capturing the minute details of what she experiences. Among the phenomena experienced we find the notion of time, whereby the narrator mixes the past, present, and future flux into one envelope. This article thus discusses the experience of time in this literary work based on a phenomenological discussion. We conducted a review of the literature including authors that contributed to the development of the notion of experienced time in phenomenology. In the flow of time lie meanings of the experiences of characters in their ambiguous contact with the world. We conclude that the descriptions elaborated by Virginia Woolf allow for an approximation to the experience of time that crosses the totality of the dimension of being...(AU)

La novela La Señora Dalloway, de la escritora inglesa Virginia Woolf (1882-1941), es un hito en la literatura universal por presentar un nuevo formato en el arte de la escritura titulado "flujo de conciencia". Esta forma estilística pretende describir las palabras y los pensamientos de los personajes por medio del discurso indirecto libre, integrado a la prelección del narrador. La historia de la novela se pasa en un único día de la vida de la protagonista Clarissa Dalloway, en el que se captan los ínfimos detalles de lo que ella experimenta. Entre los fenómenos vivenciados encontramos la noción de tiempo, por medio de la cual el narrador mezcla el flujo pasado, presente y futuro en un envoltorio único. El objetivo de este artículo es discutir la vivencia del tiempo en la referida obra literaria pautada en una discusión fenomenológica. Para ello, utilizamos como método la revisión de la literatura de autores que contribuyeron al desarrollo de la noción de tiempo vivido en la fenomenología. Es en el flujo del tiempo que se dan los significados de las experiencias en la historia de los personajes en su contacto ambiguo con el mundo. Concluimos que las descripciones elaboradas por Virginia Woolf posibilitan una aproximación a la vivencia del tiempo, que atraviesa la totalidad de la dimensión del ser...(AU)

Corpo, Tempo, Espaço e Outro como Condições de Possibilidade do Vivido (Psico)patológico / Body, Time, Space and Other as Possibility of (Psycho)pathological Lived / Cuerpo, Tiempo, Espacio y Otro como Posibilidad del Vivido (Psico)patológico

Corpo, tempo, espaço e Outro são as bases que constituem nossa experiência intersubjetiva. Nomeadas aqui como categorias fenomenológicas, elas são uma ferramenta para a compreensão do mundo vivido (psico)patológico, pois em suas alterações se desvelam a estrutura da experiência de adoecer. Este artigo tem como objetivo desenvolver um estudo teórico a respeito das condições que possibilitam o aparecimento dos mundos vividos (psico)patológicos na perspectiva de uma fenomenologia clínica da ambiguidade. A perda de comunicação vital com o mundo característica das alterações corporais, a dessincronização da experiência temporal, o espaço vazio e sem significações atrelado a um prejuízo na relação dialética Eu-Outrem forma o eixo nuclear de sustentação dos mundos vividos (psico)patológicos, ilustrados aqui por meio dos modos de funcionamento na depressão melancólica e na esquizofrenia. Concluímos que estas categorias se atravessam mutuamente e sua divisão é apenas de ordem didática. Elas precisam ser compreendidas globalmente para alcançarmos as experiências de adoecer. (AU)

Body, time, space and Other are the bases that constitute our intersubjective experience. Named here as phenomenological categories, they are a tool for understanding the lived (psycho)pathological world, as these changes can result in an adornment experience structure, as the changes can result in a structure of experience of illness. This article aims to develop a theoretical study about the conditions that enable the emergence of the (psycho)pathological lived world from the perspective of a clinical phenomenology of ambiguity. The loss of vital communication with the world that is characteristic of bodily changes, the desynchronization of temporal experience, the empty and meaningless space linked to a loss in the I-Other dialectical relationship forms the nuclear axis of support of the (psycho)pathological worlds, illustrated here through the modes of functioning in melancholic depression and schizophrenia. We conclude that these categories cross each other and their division is only didactic. They need to be understood globally to reach the experiences of falling ill. (AU)

El cuerpo, el tiempo, el espacio y el Otro son las bases que constituyen nuestra experiencia intersubjetiva. Nombradss aquí como categorías fenomenológicas, son una herramienta para comprender el mundo vivido (psico)patológico ya que en sus cambios se revela la estructura de la experiencia de enfermarse. Este artículo tiene como objetivo desarrollar un estudio teórico sobre las condiciones que permiten la aparición de mundos vividos (psico)patológicos en la perspectiva de una fenomenología clínica de la ambigüedad. La pérdida de la comunicación vital con el mundo característico de las alteraciones corporales, la desincronización de la experiencia temporal, el espacio vacío y sin sentido vinculado a una pérdida en la relación dialéctica Yo-Otro forma el eje nuclear de soporte de los mundos vividos (psico)patológicos, ilustrado aquí a través de los modos de funcionamiento en la depresión melancólica y la esquizofrenia. Encontramos que estas categorías se cruzan entre sí y su división es solo didáctica. Deben entenderse globalmente para alcanzar las experiencias de enfermarse. (AU)

Lifetime reproductive efficiency of BALB/c mouse pairs after an environmental modification at 3 mating ages.

The aim of this study was to evaluate the effects of an environment change and the age at which mating pairs were formed on the lifetime reproductive performance of BALB/c mice. We assigned 60 monogamous pairs to a randomized design in a 2 × 3 factorial arrangement (with or without an environmental modification and with 3 mating ages: 28, 45, or 60 d). Autoclaved cardboard tubes (length, 10 cm; diameter, 4 cm) were used as the environmental modification. Data were collected from a total of 456 litters over a period of 10 mo. The mice tore the cardboard tube and used its parts both as shelters and as nesting material. The presence of a cardboard tube decreased the preweaning litter mortality rate in the first 6 reproductive cycles. Mating at 28 or 45 d of age also decreased the preweaning mortality rate in the first 6 reproductive cycles, compared with monogamous pairs formed at 60 d of age. Treatments did not affect age at first parturition, number of litters, time between litters, or litter size and weight at birth and weaning. In addition to contributing to animal wellbeing, providing a cardboard tube improved productivity by decreasing the preweaning mortality rate. BALB/c siblings should be paired for mating when no older than 28 d, to reduce preweaning mortality of the offspring.

Parental behavior and anxiety in isogenic and outbred mice given access to two types of nesting materials

The objective was to investigate if providing two types of nesting materials could modulate parental behavior and anxiety in laboratory mice. For that, 54 full-sib BALB/cJ and 50 randomly mated Swiss Webster mouse pairs were employed in a completely randomized designwith a 2×2 factorial arrangement (two genetic groups and with/ without access to nesting materials). Eight pieces of disposable polypropylene caps/ hairnets and 3g of cotton were provided as nesting materials to half the cages from each genetic group. Maternal and paternal behaviors were recorded on the third reproductive cycle, twice a week, for three weeks, using scan sampling. The behaviors were recorded every 10s for a period of 10min (totaling 60 records) each day. Dams (N=40) were tested in the elevated plus maze (EPM) on the fifth reproductive cycle, 7–10 days postpartum. Their 21-days-old weanlings (N=208) were tested in the same apparatus. Total number of closed arm entries was used as measurement of motor activity, the percentage of time spent on open arms as measurement of anxiety and head dipping time as measurement of exploratory behavior. The provision of nesting materials increased the frequency of dams licking pups (1.72±0.20 vs. 1.10±0.21, P=0.0342) and of sires resting in contact with pups (25.0±1.5 vs. 18.9±1.5, P=0.0050), while simultaneously decreased the frequency of sires in non-contact rest with pups (6.4±1.1 vs. 10.8±1.2, P=0.0074). Swiss Webster dams were recorded nursing their pups in the arched-back posture more frequently than BALB/cJ dams (9.63±0.89 vs. 7.13±0.86, P=0.0187) and Swiss Webster sires showed a higher frequency of nest building than BALB/cJ sires (0.80±0.16 vs. 0.31±0.15, P=0.0281). Motor activity was higher (8.00±0.43 vs. 2.83±0.41, P<0.0001) and anxiety was lower (3.2±28.4 vs. 2.4±3.1%, P<0.0001) in Swiss Webster than in BALB/cJ dams. Anxiety (26.6±3.2 vs. 37.9±3.5%, P=0.0168) was also lower in Swiss Webster than in BALB/cJ weanlings. The availability of nesting materials increased the time dams spent in head dipping (10.9±2.0 vs. 4.6±1.9, P=0.0087), but weanling behaviors in the EPM were unaffected. Slight differences in parental behavior and contrasting patterns of anxiety and motor activity were found between genetic groups. The provision of nesting materials promoted an intensification of favorable parent-offspring interactions and enhanced exploratory behavior of dams.

FCGR polymorphisms in the treatment of rheumatoid arthritis with Fc-containing TNF inhibitors.

OBJECTIVES: Reproducible association of a functional polymorphism in FCGR2A with response to a TNF inhibitor (TNFi) in patients with rheumatoid arthritis (RA) led us to explore other FcγR functional polymorphisms. METHODS: Functional polymorphisms FCGR3A F158V, FCGR2B I223T and promoter VNTR in FCGRT were analyzed in up to 429 patients with RA. Response to TNFi was recorded during standard care at 3, 6 and 12 months of follow-up. Fixed effects meta-analysis of studies addressing FCGR3A F158V polymorphism, which is the most studied of these polymorphisms, was conducted with inverse variance weighting. RESULTS: None of the functional polymorphisms were associated with change in DAS28. Meta-analysis of the seven studies (899 patients) with available data addressing association of FCGR3A F158V with response to TNFi in RA showed no association (OR: 1.11, 95% CI: 0.8-1.5; p = 0.5). CONCLUSION: None of the three functional polymorphisms in FcγR genes showed association with response to TNFi in patients with RA. These negative results were obtained in spite of the larger size of this study relative to previous studies addressing the same polymorphisms. In addition, meta-analysis of FCGR3A F158V was also negative against the results provided by previous studies. Original submitted 17 September 2014; Revision submitted 9 December 2014.

Rheumatoid arthritis response to treatment across IgG1 allotype - anti-TNF incompatibility: a case-only study.

INTRODUCTION: We have hypothesized that incompatibility between the G1m genotype of the patient and the G1m1 and G1m17 allotypes carried by infliximab (INX) and adalimumab (ADM) could decrease the efficacy of these anti-tumor necrosis factor (anti-TNF) antibodies in the treatment of rheumatoid arthritis (RA). METHODS: The G1m genotypes were analyzed in three collections of patients with RA totaling 1037 subjects. The first, used for discovery, comprised 215 Spanish patients. The second and third were successively used for replication. They included 429 British and Greek patients and 393 Spanish and British patients, respectively. Two outcomes were considered: change in the Disease Activity Score in 28 joint (ΔDAS28) and the European League Against Rheumatism (EULAR) response criteria. RESULTS: An association between less response to INX and incompatibility of the G1m1,17 allotype was found in the discovery collection at 6 months of treatment (P = 0.03). This association was confirmed in the replications (P = 0.02 and 0.08, respectively) leading to a global association (P = 0.001) that involved a mean difference in ΔDAS28 of 0.4 units between compatible and incompatible patients (2.3 ± 1.5 in compatible patients vs. 1.9 ± 1.5 in incompatible patients) and an increase in responders and decrease in non-responders according to the EULAR criteria (P = 0.03). A similar association was suggested for patients treated with ADM in the discovery collection, but it was not supported by replication. CONCLUSIONS: Our results suggest that G1m1,17 allotypes are associated with response to INX and could aid improved therapeutic targeting in RA.

A fenomenologia como base epistemológica e ética do movimento desalienista na frança e no Brasil / Phenomenology as an ethical and epistemological basis of the desalienist movement in france and in Brazil / La fenomenología como base epistemológica y ética del movimiento desalienista en francia y en Brasil

Este artigo tem como objetivo apresentar a fenomenologia como base epistemológica e ética do movimento desalienista da psicoterapia institucional na França e da Reforma Psiquiátrica no Brasil. Descrevemos estes dois movimentos e os principais nomes que fizeram parte de suas histórias em interlocução com a fenomenologia, refletindo sobre como esta pode ser considerada uma base para a prática de profissionais da saúde mental inseridos neste contexto que está em plena transformação. (Re)discutir tais bases nos parece de fundamental importância para reafirmar o sentido epistemológico e ético necessário que fundamenta ambos os processos. Concluímos que a fenomenologia se apresentou e ainda se apresenta como uma via de questionamento das práticas em saúde mental e oferece o fundamento para se pensar uma prática que busca o encontro com os sujeitos, e não somente com a doença mental, e para o processo de desinstitucionalização dos doentes mentais.

This article aims to present the phenomenology as the epistemological and ethical basis of the desalienist movement of institutional psychotherapy in France and the Psychiatric Reform in Brazil. We describe these two movements and the main names that were part of their stories in interlocution with phenomenology, reflecting on how this can be considered a basis for the practice of mental health professionals inserted in this context that is in full transformation. To discuss such bases seems to us to have a fundamental importance in order to reaffirm the necessary epistemological and ethical sense that underlies both processes. We conclude that phenomenology has been presented and still presents itself as a way of questioning mental health practices and offers the basis to think of a practice that seeks the encounter with the subjects and not only with the mental illness, as well as the process of deinstitutionalization of the mentally ill.

Este artículo tiene como objetivo presentar la fenomenología como base epistemológica y ética del movimiento desalienista de la psicoterapia institucional en Francia y de la Reforma Psiquiátrica en Brasil. Describimos estos dos movimientos y los principales nombres que formaron parte de sus historias en interlocución con la fenomenología, reflexionando sobre cómo ésta puede ser considerada una base para la práctica de profesionales de la salud mental insertados en este contexto que está en plena transformación. (Re)discutir tales bases nos parece de fundamental importancia para reafirmar el sentido epistemológico y ético necesario que fundamenta ambos procesos. Concluimos que la fenomenología se presentó y aún se presenta como una vía de cuestionamiento de las prácticas en salud mental y ofrece el fundamento para pensar una práctica que busca el encuentro con los sujetos y no sólo con la enfermedad mental y para el proceso de desinstitucionalización de los enfermos mentales.

Transtorno de compulsão alimentar: revisão sistemática da literatura / Binge eating disorder: a systematic literature review / Trastorno de compulsión alimentaria: revisión sistemática de la literatura

Através de uma Revisão Sistemática da Literatura retomamos a literatura sobre o Transtorno de Compulsão Alimentar (TCA) entre 2006 a 2016, para caracterizar e discutir as produções sobre o tema. Foi realizada uma busca nas bases de dados SciELO, Science Direct, Redalyc e Lilacs, utilizando os descritores "compulsão alimentar" e "transtorno da compulsão alimentar" e traduções para os idiomas espanhol, francês e inglês. Foram incluídos artigos disponíveis para download em periódicos com Qualis CAPES A1, A2, B1 e B2. Os achados apontam uma tendência da valorização do caráter biológico e voltado para o diagnóstico a partir do Manual Diagnóstico e Estatístico de Transtornos Mentais, com foco nos sintomas e nos tratamentos. O panorama das pesquisas demonstra a necessidade de pesquisas que se proponham a compreender o TCA de forma ampla e avaliar os possíveis impactos da efetivação como transtorno nos indivíduos envolvidos e nas práticas de saúde que os circundam.

Through a Systematic Review of Literature we return to the literature on Binge Eating Disorder (BED) between 2006 and 2016, to characterize and discuss the productions on the subject. A search was made in the databases SciELO, Science Direct, Redalyc and Lilacs, using the descriptors «compulsão alimentar¼ and «transtorno de compulsão alimentar¼ and translations into the Spanish, French and English languages. Articles available for download in journals with Qualis CAPES A1, A2, B1 and B2 were included. The findings point to a trend towards the valorization of the biological character and aimed at the diagnosis from the Diagnostic and Statistical Manual of Mental Disorders, focusing on symptoms and treatments. The research landscape demonstrates the need for research that intends to comprehend the BED in a broad way and to evaluate the possible impacts of effectiveness as a disorder in the individuals involved and in the health practices that surround them.

A través de una Revisión Sistemática de la Literatura retomamos la literatura sobre el Trastorno de Compulsión Alimentaria (TCA) entre 2006 y 2016, para caracterizar y discutir las producciones sobre el tema. Se realizó una búsqueda en las bases de datos SciELO, Science Direct, Redalyc y Lilacs, utilizando los descriptores «compulsão alimentar¼ y «transtorno da compulsão alimentar¼ y traducciones a los idiomas español, francés e inglés. Se incluyeron artículos disponibles para descargar en periódicos con Qualis CAPES A1, A2, B1 y B2. Los hallazgos apuntan una tendencia de valorización del carácter biológico y orientado hacia el diagnóstico a partir del Manual Diagnóstico y Estadístico de los Trastornos Mentales, con foco en los síntomas y en los tratamientos. El panorama de las investigaciones demuestra la necesidad de investigaciones que se propongan a comprender el TCA de forma amplia y evaluar los posibles impactos de la efectividad como trastorno en los individuos involucrados y en las prácticas de salud que los circundan