Protocol-driven therapy for lower extremity ulcers: a case series supporting the use of porcine intestine extracellular matrix.

INTRODUCTION: Chronic ulcers pose a public health challenge. Thus, it is imperative to be aware of and assess new management strategies that contribute to patient quality of life and optimize health resources. This study evaluated the efficacy of a new protocol for chronic wound management that includes porcine intestine ECM. MATERIALS AND METHODS: Twenty-one patients with chronic wounds of different etiologies were included in this study. A new healing protocol that incorporates the use of porcine ECM was initiated for a maximum period of 12 weeks. Follow-up included a weekly visit to photograph the ulcers and record their size. RESULTS: Wounds ranged in size from 0.5 cm2 to 10 cm2 at the outset of the study. Two of the 21 patients who started the protocol withdrew, 1 for nonadherence to the protocol and 1 for health complications unrelated to the study. Most lesions occurred in the lower limbs. All patients who completed the treatment protocol achieved wound regeneration and total wound closure within an average of 4.5 weeks. The average percentage closure rate was 100% at 8 weeks, with no AEs. CONCLUSIONS: The findings of this study demonstrate the efficacy of an evidence-based wound management protocol in achieving safe, complete tissue regeneration in a short period of time.

Fragmentos de amor de transferência / Fragments of transference love

Objetivo. Mostrar las formas que el concepto de amor de transferencia enunciado por Freud toma en un par de casos clínicos, y la manera en como el analista trabaja con este elemento en un proceso psicoanalítico. Desarrollo. A través de viñetas que ilustran momentos de un proceso psicoanalítico el autor da cuenta de las configuraciones que el amor de transferencia va dibujando a lo largo de las sesiones. Resultados y Conclusiones: El amor de transferencia es la reedición de relaciones que tenemos con objetos tempranos, determina la forma en como establecemos nuevas relaciones y particularmente la relación con el terapeuta. Lo importante en este último es que no desconozca el doble carácter del amor transferencial, un amor real en el que el terapeuta opera como señuelo. Si no se percata de ser señuelo sino objeto real, el amor se convertiría en acto. Si lo considera como irreal esta evadiendo el principal aspecto de comprensión de la dinámica psicoanalítica. El fin del terapeuta no es desmentir el amor que el paciente siente, sino mostrar como la forma estereotipada de amar hace que todo nuevo objeto encarne una especie de guión preestablecido por el inconsciente(AU)

The aim of the present paper is to show some of the forms taken by the concept of transference love, enunciated by Freud, in some clinical cases, and how the analyst works with this element in the psychoanalytical process. Using some vignettes to illustrate moments of the psychoanalytical process, the author discusses the settings that transference love goes through along the sessions. The transference love would be a revival of relations that people had with their initial objects, and determines how they establish new relationships, particularly the relationship with the therapist. The most important in the last mentioned relationship, considering the therapist, is to recognize the double character of transference love; a real love, in which the therapist acts as bait. If the therapist doesn’t realize that it is a kind of bait and not the real object, love would turn into action. On the other hand, if it is considered unreal, the main aspect of the dynamics understanding of psychoanalysis would be avoided. The purpose of the therapist is not to deny the love felt by the patient, but show how the stereotypical way of loving makes every single new object embodies a whole new kind of screenplay, previously established by the unconscious(AU)

Psicoterapia de una adolescente puntualizaciones en el caso de A / Psychotherapy of an adolescent. remarks on ‘a’ case

Introducción: El presente caso clínico tiene como objetivo analizar las transformaciones en las relaciones objetales y en el narcisismo de una adolescente que inició su tratamiento psicoterapéutico por conflictos en la constitución de su identidad sexual. Método: Tratamiento de soporte y expresión, con un encuadre de tiempo abierto y una frecuencia de una sesión semanal. Desarrollo: El análisis del proceso permitió ver cómo tanto las representaciones objetales como de sí misma se fueron integrando e incidieron positivamente en el enfrentamiento de los conflictos propios de su adolescencia, especialmente de su identidad sexual. Finalmente, se plantea la hipótesis de que los resultados positivos del tratamiento podrían estar en relación con la actitud de “sí memoria y sí deseo” de la terapeuta, lo cual sería de interés en la reflexión sobre la técnica psicoterapéutica con adolescentes...

Introduction: The aim of this clinical case is to analyze the transformations in object relations and narcissism of a teenager who began psychotherapeutic treatment because of conflicts in the constitution of her sexual identity. Method: The treatment was one of support and expression with an open time frame and a weekly session. Development: The analysis of the process allowed us to see how object representations and those of the self were gradually integrated, and contributed positively in her dealing with her adolescent conflicts and especially the one related to her sexual identity. Finally, we suggest the hypothesis that the treatment’s positive results could be in connection with the therapeutic attitude of “yesmemory and yes-wish”, which would be an interesting matter for discussion in relation to the use of psychotherapeutic techniques with adolescents...