ABSTRACT
O descobrimento de manuscritos inéditos de Jean-Martin Charcot no Hospital da Pitié-Salpêtrière, em Paris, é apresentado a partir da pulsão episte-mofílica da pesquisadora e dos bibliotecários da Biblioteca Charcot, caraterística da sexualidade infantil, fundamental para a pesquisa. A transcrição, tradução e escrita do caso é analisada com base nos conceitos freudianos de transferência e sexualidade e na relação transferencial da pesquisadora com Freud e Charcot. O caminho investigativo feito por Charcot envolve a histeria e acontecimentos traumáticos como hipótese etiológica da esclerose múltipla. O caminho feito pela paciente acompanhada por Charcot, marcado pela escrita, também é atravessado pela transferência e pela sexualidade. Os sintomas no corpo de Joséphine Leruth, diagnosticada com esclerose múltipla, apresentam melhora em razão da relação transferencial que foi estabelecendo com Charcot.
Unpublished manuscripts by Jean-Martin Charcot have been discovered at the Hôpital Pitié-Salpêtrière in Paris. This was due to the epistemophilic drive of the researcher and librarians at the Bibliothèque Charcot, which is a characteristic of childhood sexuality and is essential in scientific research. The transcription, translation, and writing of the case study is analyzed, in this paper, based on the Freudian concepts of transference and sexuality, as well as on the transference relationship between the researcher who found the manuscripts and the father of psychoanalysis and, in turn, Freud's relationship to his master, Charcot, the father of neurology. The investigative trail that Charcot pursued proposes that hysteria, as well as traumatic events, makes up the etiological basis for multiple sclerosis. Charcot's patient's trajectory, which is marked by her writings, is also effected by the transference relations she established and by her sexuality. The symptoms on Joséphhine Leruth's body - she who was diagnosed with MS - present with signs of amelioration, as a function of the transference relationship she had established with Charcot.
El descubrimiento de manuscritos inéditos de Jean-Martin Charcot en el Hospital Pitié-Salpêtrière en París, que se presenta, tiene como base la pulsión epistemofílica de la investigadora y de los bibliotecarios de la Bibliothèque Charcot, característica de la sexualidad infantil, fundamental para la investigación. La transcripción, traducción y escritura del caso es analizada con base en los conceptos freudianos de transferencia y sexualidad y por la relación transferencial de la investigadora con el padre del psicoanálisis y con su maestro, Charcot, padre de la neurología. El camino investigativo seguido por Charcot involucra la histeria y acontecimientos traumáticos como hipótesis etiológicas de la esclerosis múltiple. El camino seguido por la paciente acompañada por Charcot, marcado por la escritura, también es atravesado por la transferencia y la sexualidad. Los síntomas en el cuerpo de Joséphhine Leruth, diagnosticada con EM presentan mejoras en función de la relación transferencial que se estableció con Charcot.
La découverte de manuscrits inédits de Jean-Martin Charcot dans l'Hôpital Pitié-Salpêtrière à Paris, présentée ici, s'est basée sur la pulsion épistémophilique, caractéristique de la sexualité infantile de la chercheuse et des bibliothécaires de la Bibliothèque Charcot, fondamentale pour la recherche. La transcription, la traduction et l'écriture du cas sont analysées à partir des concepts freudiens de transfert et de sexualité et de la relation transférentielle de la chercheuse avec le père de la psychanalyse et son maître, Charcot, père de la neurologie. La voie d'investigation de Charcot concerne l'hystérie et les événements traumatiques en tant qu'hypothèse étiologique de la sclérose en plaques. Le chemin emprunté par la patiente accompagnée par Charcot, marqué par l'écriture, est également traversé par le transfert et la sexualité. Les symptômes dans le corps de Joséphhine Leruth, diagnostiquée de la SP, montrent des améliorations en fonction de la relation de transfert qu'elle a peu à peu établie avec Charcot.
ABSTRACT
Para avaliar a correlação entre a resposta inflamatória (RI) pós-implante de "stent" coronário (SC) e a composição de placa, 30 pacientes com angina estável (PAE) realizaram ultrassom intracoronário (UIC) antes do SC. As placas foram classificadas em calcificadas, fibrocalcificadas (FC), fibrolipídicas (FL) ou lipídicas. As lesões angiográficas também foram analisadas. Sangue do seio coronário foi coletado antes e 15 minutos depois do SC para a dosagem dos marcadores inflamatórios (MI): interleucina-6 (IL-6), fator de necrose tumoral-a, interferon-g (IFN) e neopterina. Todos os MI se modificaram significativamente apenas para as placas FC e FL. Apenas IL-6 e IFN aumentaram para as lesões B1 e B2. Assim, UIC foi capaz de identificar placas propensas a uma RI aguda de maior grau após SC em PAE.In order to access the correlation between the inflammatory response (IR) post-coronary stenting (CS) and plaque composition, 30 stable angina patients (SAP) underwent intravascular ultrasound (IVUS) before CS. Plaques were classified as calcified, fibrocalcified (FC), fibrolipidic (FL) or lipid. Angiographic lesion types were also analyzed. Coronary sinus blood was collected before and 15 minutes after CS for the measurement of inflammatory markers (IM): interleukin-6 (IL-6), tumoral necrosis factor-a, interferon-g (IFN) and neopterin. All IM changed markedly only for FC and FL plaques. Only lesions B1 and B2 resulted changes for IL-6 and IFN. Thus, IVUS is able to identify plaques prone to a greater acute IR following CS in SAP...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Coronary Disease/diagnosis , Inflammation Mediators , Stents , Interferon-gamma/analysis , /analysis , Neopterin/analysis , Tumor Necrosis Factor-alpha , Ultrasonography, InterventionalABSTRACT
OBJECTIVE: To assess whether coronary stenting in diabetic patients provides in-hospital results and clinical evolution similar to those in nondiabetic patients. METHODS: From July `97 to April '99 we performed coronary stent implantation in 386 patients with coronary heart disease, who were divided into two groups: diabetic patients and nondiabetic patients. The in-hospital results and the clinical evolution of each group were retrospectively analyzed. RESULTS: The nondiabetic group comprised 305 (79 percent) patients and the diabetic group 81 (21 percent) patients. Basic clinical and angiographic characteristics were similar. Angiographic success was in diabetics = 96.6 percent vs in nondiabetics = 97.9 percent (p=ns). Among the major complications in the in-hospital phase, the rate of myocardial infarction was higher in the diabetic group (7.4 percent vs 1.9 percent) (p=0.022). In the follow-up, a favorable and homogeneous evolution occurred in regard to asymptomatic patients, myocardial infarction, and death in the groups. A greater need for revascularization, however, existed in the diabetic patients (15 percent vs 2.4 percent, p<0.001). CONCLUSION: Coronary stenting in diabetic patients is an efficient procedure, with a high angiographic and clinical success rate similar to that in nondiabetic patients. Diabetic patients, however, had a higher incidence of in-hospital myocardial infarction and a greater need for additional myocardial revascularization