ABSTRACT
Background: Papular urticaria caused by flea bite presents clinical symptoms of a hypersensitivity reaction accompanied by skin lesions. However, the pattern of recognition by different antibody isotypes during the progression of the disease is unknown. This study evaluated variations in immunoglobulin E and immunoglobulin G subclass antibody responses to flea antigens during the progression of papular urticaria caused by flea bite. Methods: Twenty-five patients clinically diagnosed with papular urticaria due to flea bite were included. Ten healthy children were included as controls. Recognition of antigens from complete flea body extract by patients and healthy controls was determined using immunoblot assays. Results: The results revealed that patients with 25 years of papular urticaria evidenced more IgE bands than those with shorter or longer durations of symptoms. In contrast, healthy children showed a predominance of immunoglobulin G1 and immunoglobulin G3. The majority of the recognised antigens were low molecular weight proteins (<90kDa). Proteins with molecular weights between 16-20, 21-25, and 31-35kDa showed different patterns of recognition between patients and healthy children. Conclusion: The predominant specific antibody isotypes vary according to the time elapsed since the onset of symptoms in papular urticaria caused by flea bite
No disponible
Subject(s)
Humans , Male , Female , Child , Siphonaptera/pathogenicity , Immunoglobulin G/analysis , Hypersensitivity, Immediate/complications , Hypersensitivity, Immediate/diagnosis , Immunoglobulin E/analysis , Urticaria/diagnosis , Antigens/administration & dosage , Antigens/analysis , Hypersensitivity/complications , Hypersensitivity/diagnosis , Antigens , Antigens/therapeutic use , 28599ABSTRACT
BACKGROUND: Papular urticaria caused by flea bite presents clinical symptoms of a hypersensitivity reaction accompanied by skin lesions. However, the pattern of recognition by different antibody isotypes during the progression of the disease is unknown. This study evaluated variations in immunoglobulin E and immunoglobulin G subclass antibody responses to flea antigens during the progression of papular urticaria caused by flea bite METHODS: Twenty-five patients clinically diagnosed with papular urticaria due to flea bite were included. Ten healthy children were included as controls. Recognition of antigens from complete flea body extract by patients and healthy controls was determined using immunoblot assays. RESULTS: The results revealed that patients with 2-5 years of papular urticaria evidenced more IgE bands than those with shorter or longer durations of symptoms. In contrast, healthy children showed a predominance of immunoglobulin G1 and immunoglobulin G3. The majority of the recognised antigens were low molecular weight proteins (<90 kDa). Proteins with molecular weights between 16-20, 21-25, and 31-35 kDa showed different patterns of recognition between patients and healthy children. CONCLUSION: The predominant specific antibody isotypes vary according to the time elapsed since the onset of symptoms in papular urticaria caused by flea bite.
Subject(s)
Bites and Stings/immunology , Epitopes/immunology , Immunoglobulin E/immunology , Immunoglobulin G/immunology , Adolescent , Animals , Bites and Stings/complications , Bites and Stings/diagnosis , Bites and Stings/physiopathology , Child , Child, Preschool , Disease Progression , Epitopes/metabolism , Female , Humans , Infant , Male , Siphonaptera , Skin Diseases, Vesiculobullous/diagnosis , Skin Diseases, Vesiculobullous/etiology , Skin Diseases, Vesiculobullous/immunology , Skin Diseases, Vesiculobullous/physiopathology , Urticaria/diagnosis , Urticaria/etiology , Urticaria/immunology , Urticaria/physiopathologyABSTRACT
BACKGROUND: The Th1/Th2 balance has not been characterized in patients suffering from flea bite-induced papular urticaria (FBPU). Our aim was to improve understanding of the immunopathogenesis of CD4+ and CD8+ T-cells in humans suffering from flea bite-induced papular urticaria. METHODS: Peripheral blood mononuclear cells were obtained from 18 pediatric patients and 10 age-matched healthy controls. Cellular phenotypes, intracellular production of interferon gamma (IFNgamma) and interleukin-4 (IL-4) in T-cells stimulated with polyclonal stimuli was determined by flow cytometry following short-term in vitro stimulation. RESULTS: The results revealed lower frequencies of IFNgamma-secreting (p = 0.02) and higher frequencies of IL-4-secreting (p = 0.03) CD4+ T-cells in patient lymphocyte cultures compared to healthy control cultures in the presence of polyclonal stimuli. This is the first description of differential cytokine patterns in papular urticaria patients. CONCLUSION: Patients suffering from papular urticaria have an atopic status compared to healthy children.
Subject(s)
Insect Bites and Stings/immunology , Siphonaptera/immunology , Th1 Cells/immunology , Th2 Cells/immunology , Urticaria/immunology , Adolescent , Animals , Antigens, CD/metabolism , Antigens, Differentiation, T-Lymphocyte/metabolism , CD4 Lymphocyte Count , CD8-Positive T-Lymphocytes/cytology , CD8-Positive T-Lymphocytes/metabolism , Child , Child, Preschool , Enterotoxins/immunology , Female , Humans , Infant , Interferon-gamma/blood , Interferon-gamma/metabolism , Interleukin-4/blood , Interleukin-4/metabolism , Lectins, C-Type , Lymphocyte Activation/immunology , Lymphocyte Count , Male , Th1 Cells/cytology , Th1 Cells/metabolism , Th2 Cells/cytology , Th2 Cells/metabolism , Urticaria/bloodABSTRACT
Background: The Th1/Th2 balance has not been characterized in patients suffering from flea bite-induced papular urticaria (FBPU). Our aim was to improve understanding of the immunopathogenesis of CD4+ and CD8+ T-cells in humans suffering from fl ea bite-induced papular urticaria. Methods: Peripheral blood mononuclear cells were obtained from 18 pediatric patients and 10 age-matched healthy controls. Cellular phenotypes, intracellular production of interferon gamma (IFN ) and interleukin-4 (IL-4) in T-cells stimulated with polyclonal stimuli was determined by flow cytometry following short-term in vitro stimulation. Results: The results revealed lower frequencies of IFN -secreting (p = 0.02) and higher frequencies of IL-4-secreting (p = 0.03) CD4+ T-cells in patient lymphocyte cultures compared to healthy control cultures in the presence of polyclonal stimuli. This is the first description of differential cytokine patterns in papular urticaria patients. Conclusion: Patients suffering from papular urticaria have an atopic status compared to healthy children (AU)
No disponible
Subject(s)
Humans , Male , Female , Child , Acrodermatitis , Urticaria , Interferon-gamma , Ectoparasitic Infestations , Th1-Th2 Balance , Cytokine-Induced Killer Cells , HypersensitivityABSTRACT
For most of its history, the psychoanalytic literature on lying dealt exclusively with the dynamic, genetic meanings of lying: the problems for treatment presented by a patient who lies, and the technique used in dealing analytically with lies. In recent decades, issues relating to the moral and general development of children in relation to lying have been considered. In this paper, a lie told by a 21-month-old child is used to raise and explore questions about lying and its relation to intrapsychic structure and development. It is suggested that cognitive abilities and the psychic apparatus have to develop to the point that self can be distinguished from object, and a superego prototype must be present, before the means and motivations for lying are in place. This would date the beginning of the capacity to lie to sixteen to twenty-four months of age.
Subject(s)
Anxiety, Castration , Child Development , Deception , Psychology, Child , Age Factors , Female , Humans , Infant , Mother-Child Relations , Motivation , Psychoanalytic Interpretation , Toilet TrainingABSTRACT
Transference to physicians contains a fantasy of the physician as omnipotent healer who can control life and death. While there may be many variations of the fantasy that reflect differences in individual psychological makeup and experience, the fantasy of a multipotentialed, bisexual figure who can magically control the forces of nature is probably an element in all transference wishes that occur in a therapeutic setting. Material from the myth of Asclepius, from a patient of Freud's, and from two of the author's patients will be examined to elucidate this transference fantasy.
Subject(s)
Magic , Mythology , Physician-Patient Relations , Psychoanalytic Interpretation , Transference, Psychology , Adult , Fantasy , Female , Freudian Theory , Humans , Male , Mental Healing , Middle Aged , Psychoanalytic TherapyABSTRACT
The MAP of the University of Miami/Jackson Memorial Medical Center/Highland Park Pavilion is a comprehensive inpatient and outpatient chemical dependency rehabilitation program that serves mostly lower socioeconomic, African-American perinatal substance-abusing women. The multidisciplinary treatment team incorporates a broad spectrum of group and individual therapeutic modalities, including 12-step, psychoeducational, and RP components. Within MAP programs, significant attention is given to issues and experiences that are unique to this population and that must be addressed if rehabilitation is to be successful. These topics include, but are not limited to, physical, emotional and sexual abuse, empowerment, family and parenting concerns, and HIV prevention and coping skills for HIV-seropositive women.
Subject(s)
Black or African American/psychology , Illicit Drugs , Pregnancy Complications/rehabilitation , Prenatal Care , Psychotropic Drugs , Substance-Related Disorders/rehabilitation , Urban Population , Academic Medical Centers , Adolescent , Adult , Combined Modality Therapy , Crack Cocaine , Female , Florida , Humans , Infant, Newborn , Patient Care Team , Poverty/psychology , Pregnancy , Pregnancy Complications/psychology , Substance Abuse Treatment Centers , Substance-Related Disorders/psychologySubject(s)
Cyclosporins/adverse effects , Kidney Transplantation , Skin Diseases/chemically induced , Adolescent , Child , Child, Preschool , Female , Humans , Infant , MaleABSTRACT
A middle-aged person's involvement in making a decision about whether or not to institutionalize an aged parent whose physical and/or mental capacities have failed inevitably arouses intense feelings, memories, fantasies, and conflicts. Fantasies that equate putting the parent in a nursing home with abandonment and murder, as well as the narcissistic threat posed by seeing one's own future in a parent's deterioration, are common. The conflicts aroused may upset long-standing psychological balances. This paper explores ego, superego, id, and reality issues that are aroused as they were seen in the psychoanalysis and psychotherapy of several patients involved in making this decision. The importance of looking for the unique aspects of the conflicts set off in each individual facing this dilemma is stressed, as is the potential for countertransference responses.
Subject(s)
Frail Elderly/psychology , Home Nursing/psychology , Homes for the Aged , Nursing Homes , Parent-Child Relations , Psychoanalytic Theory , Psychoanalytic Therapy , Aged , Conflict, Psychological , Decision Making , Dreams , Female , Humans , Male , Middle Aged , Psychoanalytic InterpretationABSTRACT
The origins and development of mental representations of internal bodily organs are, in general, difficult to discern. This is so even in the case of an internal bodily organ such as the heart, which is more readily perceived than most other body organs since its beating can be felt and heard. It is even true in the case of individuals in whose psyche the heart comes to play an inordinately prominent role. It was so in the case presented in this paper, the case of a man who was preoccupied with the idea that he was going to die of a heart attack, as his father had. It required a great deal of analytic work to uncover some of the underlying conflict-laden factors which lay behind his cardiac preoccupations. Those conflicts and fantasies that were uncovered derived from many developmental layers, but seemed to be organized around a central bisexual conflict resulting from the threat of castration for both positive and negative oedipal wishes. The two main unconscious mental representations of the heart in his case were as an erect, pulsating penis and as a blood-filled vagina, although other representations such as a bloody anus also existed. A relatively accurate, realistic mental representation of the heart probably evolves slowly during the development of any individual and is probably always distorted somewhat by infantile unconscious concepts along the way. In a situation where a parent has had a cardiac illness, and particularly when this illness occurred during the individual's childhood, the mental representation of the heart can be even more distorted than usual by the developmental conflicts that are intensified by the parental illness.
Subject(s)
Neurocirculatory Asthenia/psychology , Psychoanalytic Theory , Psychoanalytic Therapy/methods , Adult , Attitude to Death , Dreams , Humans , Male , Myocardial Infarction/psychology , Psychoanalytic Interpretation , Sick RoleABSTRACT
This is a study of the effects on the patient, the analyst, and the analytic process of chronic life-threatening illness in the analyst. The vicissitudes of the aggressive drive and its derivatives within the patient are studied in most detail. The analyst's use of denial and isolation, as well as his narcissistic withdrawal in such circumstances, is also illustrated. In addition, some of the practical technical issues which arise are discussed.
Subject(s)
Attitude to Death , Chronic Disease/psychology , Professional-Patient Relations , Psychoanalytic Therapy , Adult , Denial, Psychological , Fantasy , Female , Freudian Theory , Humans , Male , Referral and Consultation , Sick RoleABSTRACT
The technique of referral has been given scant attention in the analytic literature. Yet the method of referral, particularly to analytic candidates, can have a significant impact on the subsequent treatment. Listening to detailed case presentations by candidates over a four-year period in a course on selection of patients, it became apparent to me that when analysts referred patients to candidates they almost always avoided telling the patient that the analyst was in training. The reasons for the evasion and the consequences of it are explored in all three parties: the referring analyst, the patient, and the candidate. Clinical material from typical situations is presented to illustrate how evasions and distortions by the referring analyst can have a negative impact on the patient, the candidate, and the analysis. The suggestion is made that the referring analyst be open about the candidate's status, particularly when the patient is being seen at a reduced fee. As with any other situation, candor enhances the chances of success of the referral and subsequent analysis.
