ABSTRACT
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:⢠Assess differences between adult patients with the diagnosis of borderline personality disorder (BPD) and healthy control subjects in terms of empathy and related processes⢠Evaluate the effects of empathy or related processes as factors contributing to abnormal social functioning in BPD ABSTRACT: We reviewed 45 original research studies, published between 2000 and 2019, to assess differences between adult patients with the diagnosis of borderline personality disorder (BPD) and healthy control subjects in terms of empathy and related processes (i.e., theory of mind, mentalizing, social cognition, and emotional intelligence). Thirty-six studies reported deficits of empathy or related processes in patients with BPD. Enhanced emotional empathy in BPD was also reported in eight studies, all of which revealed that patients had increased scores of personal distress on the Interpersonal Reactivity Index self-report questionnaire. Six studies did not find significant differences between patients with BPD and healthy control subjects in terms of empathy or related processes. No study reported enhanced cognitive empathy, social cognition, or emotional intelligence in patients with BPD. We postulate that deficits of empathy or related processes contribute to preempting the formation of stable interpersonal relationships, whereas enhanced emotional empathy might lead to personal (and interpersonal) distress, further contributing to abnormal social functioning in BPD.
Subject(s)
Borderline Personality Disorder/psychology , Empathy , Interpersonal Relations , Adult , Borderline Personality Disorder/diagnosis , Cognition , Emotions , HumansABSTRACT
Ultrasound has been applied for varied purposes as it provides additional mechanical energy to a system, and is still profitable and straightforward, which are advantages for industrial applications. In this work, ultrasonic treatments were applied to purified collagenase fractions from a fermented extract by Aspergillus terreus UCP 1276 aiming to evaluate the potential effect on collagen hydrolysis. The physical agent was evaluated as an inductor of collagen degradation and consequently as a producer of peptides with anticoagulant activity. The sodium dodecyl sulphate-polyacrylamide gel electrophoresis analyses were also carried out to compare the hydrolysis techniques. The ultrasound (40 kHz, 47.4 W/L) processing was conducted under the same conditions of pH and temperature at different times. The ultrasound-assisted reaction was accelerated in relation to conventional processing. Collagenolytic activity was enhanced and tested in the presence of phenylmethanesulfonyl fluoride inhibitor. Underexposure, the activity was enhanced, reaching more than 72.0% of improvement in relation to the non-exposed enzyme. A period of 30 min of incubation under ultrasound exposure was enough to efficiently produce peptides with biological activity, including anticoagulation and effect on prothrombin time at about 60%. The results indicate that low-frequency ultrasound is an enzymatic inducer with likely commercial applicability accelerating the enzymatic reaction. Bioelectromagnetics. 2020;41:113-120. © 2019 Bioelectromagnetics Society.
Subject(s)
Anticoagulants/pharmacology , Aspergillus/enzymology , Collagen/chemistry , Collagenases/metabolism , Peptides/chemistry , Anticoagulants/chemistry , Catalysis , Collagen/metabolism , Collagenases/chemistry , Collagenases/isolation & purification , Electrophoresis, Polyacrylamide Gel , Fermentation , Humans , Hydrolysis , Peptides/pharmacology , Phenylmethylsulfonyl Fluoride/chemistry , Phenylmethylsulfonyl Fluoride/pharmacology , Protease Inhibitors/chemistry , Protease Inhibitors/pharmacology , Protein Hydrolysates/chemistry , Ultrasonics/methodsABSTRACT
Este artigo tem como objetivo analisar os desdobramentos da perspectiva biomédica em atendimentos psicológicos em um serviço interdisciplinar de transtornos alimentares. A metodologia consistiu em uma pesquisa documental de prontuários dos pacientes atendidos no programa diagnosticados com transtorno alimentar e que estavam em atendimento no período de agosto de 2012 a janeiro de 2013. As categorias clínicas privilegiadas nesta análise foram transferência, sintomas e diagnóstico. Ao todo foram 17 prontuários, todos de pacientes do sexo feminino, com idades entre 14 e 61 anos. Identificamos além da prevalência do discurso biomédico nos relatos de sessões, questões subjetivas presentes no discurso do paciente, mas pouco elaboradas nos prontuários, como as relações familiares, questões da oralidade, puberdade e da feminilidade. A partir da teoria psicanalítica de Freud e Lacan, discutimos tais questões, ressaltando a importância para a compreensão e acompanhamento de pacientes com transtornos alimentares...
This article aims to analyze the ramifications of the biomedical perspective in psychological services on an interdisciplinary service of nutritious disorders. The methodology consists of a documental research of medical registers of patients attended on the program who were diagnosed with nutritious disorder and that were being attended on the period between August 2012 and January 2013. The clinical categories privileged on this analysis were transference, symptoms and diagnosis. There was a total of 17 medical registers, all of female gender, aging between 14 and 61 years. Besides the prevalence of the biomedical discourse on the sessions report we identified subjective questions present on the patients discourse, but they were not extensively elaborated, such as familiar relationships, orality questions, puberty and femininity. From the psychoanalytical theory of Freud and Lacan, we discuss the mentioned questions, pointing out the importance to the comprehension and following of patients with nutritious disorders...
Cet article a pour but analyser le développement de la perspective biomédicale dans l'assistance psychologique sur un service interdisciplinaire de troubles alimentaires. La méthodologie repose sur une enquête documentaire de dossiers des patients traités dans le programme et diagnostiqués avec trouble alimentaire, ils ont été traités pendant la période d'Août 2012 à Janvier 2013. Les catégories cliniques envisagées dans cette analyse sont transfert, symptômes et diagnostic. En tout, ce sont 17 dossiers de patients, tous du sexe féminin, de 14 à 61 ans. Nous avons identifié au-delà de la prévalence du discours biomédical dans les comptes rendus des sessions, questions subjectives présentes dans le discours du patient, mais peu élaborées dans les dossiers, telles que les relations familiales, les questions de l'oralité, puberté et de la féminité. À partir de la théorie de Freud et Lacan, nous avons discuté ces questions, en soulignant l'importance pour la compréhension et le suivi des patients avec troubles alimentaires...
Este artículo tiene como objetivo analizar los desdoblamientos de la perspectiva biomédica en atendimientos psicológicos en un servicio interdisciplinar de transtornos orales. La metodología consistió in una investigación documental de prontuarios de los pacientes atendidos en el programa diagnosticados con transtorno alimentar y que estaban en atendimiento en el período de Agosto de 2012 a Enero de 2013. Las categorías clínicas privilegiadas en este análisis fueran transferencia, síntomas y diagnostico. Al todo fueran 17 prontuarios, todos de pacientes del sexo femenino, con edades entre 14 y 61 años. Identificamos allá de la prevalencia del discurso biomédico en los relatos de sesiones, cuestiones subjetivas presentes en el discurso del paciente, más poco elaboradas en los prontuatrios, como las relaciones familiares, cuestiones de la oralidad, pubertad y da feminidad. Partiendo de la teoría psicoanalítica de Freud y Lacan, discutimos tales cuestiones, resaltando la importancia para la comprensión y acompañamiento de pacientes con transtornos alimentares...
Subject(s)
Humans , Behavioral Medicine , Feeding and Eating Disorders , Psychology, AppliedABSTRACT
Este artigo tem como objetivo analisar os desdobramentos da perspectiva biomédica em atendimentos psicológicos em um serviço interdisciplinar de transtornos alimentares. A metodologia consistiu em uma pesquisa documental de prontuários dos pacientes atendidos no programa diagnosticados com transtorno alimentar e que estavam em atendimento no período de agosto de 2012 a janeiro de 2013. As categorias clínicas privilegiadas nesta análise foram transferência, sintomas e diagnóstico. Ao todo foram 17 prontuários, todos de pacientes do sexo feminino, com idades entre 14 e 61 anos. Identificamos além da prevalência do discurso biomédico nos relatos de sessões, questões subjetivas presentes no discurso do paciente, mas pouco elaboradas nos prontuários, como as relações familiares, questões da oralidade, puberdade e da feminilidade. A partir da teoria psicanalítica de Freud e Lacan, discutimos tais questões, ressaltando a importância para a compreensão e acompanhamento de pacientes com transtornos alimentares.(AU)
This article aims to analyze the ramifications of the biomedical perspective in psychological services on an interdisciplinary service of nutritious disorders. The methodology consists of a documental research of medical registers of patients attended on the program who were diagnosed with nutritious disorder and that were being attended on the period between August 2012 and January 2013. The clinical categories privileged on this analysis were transference, symptoms and diagnosis. There was a total of 17 medical registers, all of female gender, aging between 14 and 61 years. Besides the prevalence of the biomedical discourse on the sessions report we identified subjective questions present on the patients discourse, but they were not extensively elaborated, such as familiar relationships, orality questions, puberty and femininity. From the psychoanalytical theory of Freud and Lacan, we discuss the mentioned questions, pointing out the importance to the comprehension and following of patients with nutritious disorders.(AU)
Cet article a pour but analyser le développement de la perspective biomédicale dans l'assistance psychologique sur un service interdisciplinaire de troubles alimentaires. La méthodologie repose sur une enquête documentaire de dossiers des patients traités dans le programme et diagnostiqués avec trouble alimentaire, ils ont été traités pendant la période d'Août 2012 à Janvier 2013. Les catégories cliniques envisagées dans cette analyse sont transfert, symptômes et diagnostic. En tout, ce sont 17 dossiers de patients, tous du sexe féminin, de 14 à 61 ans. Nous avons identifié au-delà de la prévalence du discours biomédical dans les comptes rendus des sessions, questions subjectives présentes dans le discours du patient, mais peu élaborées dans les dossiers, telles que les relations familiales, les questions de l'oralité, puberté et de la féminité. À partir de la théorie de Freud et Lacan, nous avons discuté ces questions, en soulignant l'importance pour la compréhension et le suivi des patients avec troubles alimentaires.(AU)
Este artículo tiene como objetivo analizar los desdoblamientos de la perspectiva biomédica en atendimientos psicológicos en un servicio interdisciplinar de transtornos orales. La metodología consistió in una investigación documental de prontuarios de los pacientes atendidos en el programa diagnosticados con transtorno alimentar y que estaban en atendimiento en el período de Agosto de 2012 a Enero de 2013. Las categorías clínicas privilegiadas en este análisis fueran transferencia, síntomas y diagnostico. Al todo fueran 17 prontuarios, todos de pacientes del sexo femenino, con edades entre 14 y 61 años. Identificamos allá de la prevalencia del discurso biomédico en los relatos de sesiones, cuestiones subjetivas presentes en el discurso del paciente, más poco elaboradas en los prontuatrios, como las relaciones familiares, cuestiones de la oralidad, pubertad y da feminidad. Partiendo de la teoría psicoanalítica de Freud y Lacan, discutimos tales cuestiones, resaltando la importancia para la comprensión y acompañamiento de pacientes con transtornos alimentares.(AU)
Subject(s)
Feeding and Eating Disorders , Psychology, Applied , Behavioral MedicineABSTRACT
Este artigo tem como objetivo discutir a construção do caso como um dispositivo clínico psicanalítico capaz de responder aos desafios do campo da saúde mental. A metodologia consistiu em um levantamento bibliográfico a partir de comentadores da psicanálise, tais como Vorcaro, Viganò e Figueiredo. A pesquisa teve como referência os descritores saúde mental, psicanálise e construção do caso clínico. De acordo com a discussão desses autores, a construção do caso clínico se caracteriza como uma proposta de trabalho e de investigação de orientação psicanalítica que norteia a conduta em equipe a partir da reflexão sobre as particularidades vivenciadas no contexto da saúde pública, da instituição e dos sintomas dos sujeitos, possibilitando a realização do trabalho em um solo comum a todos os profissionais da área da saúde mental. Tais características são consideradas fundamentais frente aos desafios do cenário da saúde mental que se caracteriza cada vez mais amplo e heterogêneo devido às mudanças advindas com a criação do SUS e da reforma psiquiátrica. Dessa forma, defendemos a construção do caso clínico como um dispositivo capaz de abranger a amplitude, as singularidades e as divergências, problematizando os pilares organizadores da clínica e os entraves institucionais, mobilizando o sujeito em seu diagnóstico permitindo que surja um espaço para que a subjetividade possa advir.
This article has as an objective to discuss the case construction as a psychoanalytical clinical device capable of providing an answer to the challenges of the mental health field. The methodology consists in a bibliographic mapping from psychoanalysis commentators that discuss clinical-institutional interventions in mental health, such as Vorcaro, Viganó and Figueiredo. The research had as reference the descriptors mental health, psychoanalysis and construction of clinical case. According to the discussion of said authors, the construction of the clinical case is characterized as a work and investigation proposal of psychoanalytical orientation that guides the team conduct from the reflection about the particularities experienced in the public health context, the institution and the subject's symptoms, enabling the accomplishment of the work in a soil common to all professionals of mental health area. The said characteristics are considered to be fundamental in facing the challenges of the mental health scenery which is characterized to be wider and heterogeneous by the time due to the changes resulted from the creation of the SUS and the psychiatric reform. This way, we defend the construction of the clinical case as a device able to cover the amplitude, the singularities and the divergences, raising problems about the organizer pillars of the clinic and the institutional hindrances, rallying the subject in his diagnostics allowing the emergence of a space for subjectivity to occur.
Este artículo tiene como un objetivo discutir la construcción del caso clínico como un dispositivo clínico psicoanalítico capaz de responder a los desafíos del campo de la salud mental. La metodología consiste en un levantamiento bibliográfico a partir de comentaristas de la psicoanálisis que discuten intervenciones clínico-institucionales en salud mental, tales como Vorcaro, Viganó y Figueiredo. La investigación tuvo como referencia los descriptores salud mental, psicoanálisis y construcción del caso clínico. In acuerdo con la discusión de los autores, la construcción del caso clínico. De acuerdo con la discusión de los autores, la construcción del caso clínico se caracteriza como una propuesta de trabajo e investigación de orientación psicoanalítica que orienta la conducta in equipe a partir de la reflexión sobre las particularidades experimentadas en lo contexto de la salud pública, de la institución e los síntomas de los sujetos, posibilitando la realización del trabajo in suelo común a todos los profesionales de la área de la salud mental. Tales características san consideradas fundamentales frente a los desafíos del escenario de la salud mental que se caracteriza cada vez más amplio y heterogéneo debido a las mudanzas advenidas con la creación del SUS y de la reforma psiquiátrica. Así, defendemos la construcción del caso clínico como un dispositivo capaz de alcanzar la amplitud, las singularidades y las divergencias, problematizando los pilares organizadores de la clínica y los obstáculos institucionales, movilizando el sujeto in suyo diagnostico permitiendo la insurgencia de un espacio para que la subjetividad posa advenir.
Ce travail a pour but discuter la construction du cas en tant que dispositif clinique psychanalytique capable de répondre aux défis du domaine de la santé mentale. La méthodologie repose sur une enquête bibliographique à partir de commentateurs de la psychalyse, tels que Vorcaro, Viganò et Figueiredo. La recherche a pour point de repère les descripteurs santé mentale, psychanalyse et construction du cas clinique. Selon la discussion de ces auteurs, la construction du cas clinique se caractérise par une proposition de travail et de recherche d'orientation psychanalytique qui guide la conduite en équipe à partir de la réflexion sur les particularités vécues dans le contexte de la santé publique, de l'institution et des symptômes des sujets possibilitant aussi la réalisation du travail sur un terrain commun à tous les professionnels du domaine de la santé mentale. Ces caractéristiques sont considérées fondamentales pour surmonter les défis du scénario de la santé mentale qui se trouve de plus en plus large et hétérogène, en raison des changements venus avec la mise en place du SUS et de la réforme psychiatrique. Ainsi, nous défendons la construction du cas clinique en tant que dispositif capable de toucher l'ampleur, les particularités et divergences, en problématisant les piliers organisateurs de la clinique et des entraves institutionnels et, qui, au même temps, mobilisera le sujet vers son diagnostic, permettant élever un espace pour que la subjectivité puisse se produire.
Subject(s)
Humans , Psychoanalysis , Mental HealthABSTRACT
BACKGROUND: Communication is important for the quality of clinical practice, and programs have been implemented to improve healthcare providers' communication skills. However, the consistency of programs teaching communication skills has received little attention, and debate exists about the application of acquired skills to real patients. This study inspects whether (1) results from a communication program are replicated with different samples, and (2) results with standardized patients apply to interviews with real patients. METHODS: A structured, nine-month communication program was applied in two consecutive years to two different samples of healthcare professionals (25 in the first year, 20 in the second year). Results were assessed at four different points in time, each year, regarding participants' confidence levels (self-rated), basic communication skills in interviews with standardized patients, and basic communication skills in interviews with real patients. Data were analyzed using GLM Repeated-Measures procedures. RESULTS: Improvements were statistically significant in both years in all measures except in simulated patients' assessment of the 2008 group. Differences between the two samples were non-significant. Differences between interviews with standardized and with real patients were also non-significant. CONCLUSIONS: The program's positive outcomes were replicated in different samples, and acquired skills were successfully applied to real-patient interviews. This reinforces this type of program structure as a valuable training tool, with results translating into real situations. It also adds to the reliability of the assessment instruments employed, though these may need adaptation in the case of real patients.
Subject(s)
Clinical Competence , Communication , Education, Medical/methods , Teaching/methods , Curriculum , Humans , Patient Simulation , Physician-Patient RelationsABSTRACT
The diagnosis of Alzheimer disease (AD) at an early age of onset may be a challenging task. The diagnosis of such a type of dementia may be even more difficult when concomitant depressive symptoms occur. We report the case of a 51-year-old woman who was admitted at a Psychiatric Day Hospital presenting with depressive symptoms, visuospatial deficits, apraxia, and minor memory loss. The patient underwent long-term antidepressant therapy, but despite the improvement of depressive symptoms, there was progressive cognitive deterioration. Otherwise, the prior clinical history was unremarkable, and there was no family history of dementia. The clinical examination revealed cognitive deficits in several domains. The patient scored 12 in the Mini-Mental State Examination. Routine laboratory tests were normal. Magnetic resonance (MR) imaging showed global brain volume loss more pronounced than would be expected for someone of the patient's age, especially in the precuneus-a pattern of posterior cortical atrophy consistent with the diagnosis of early-onset AD. Images obtained with 99mTc-HMPAO single-photon emission computed tomography (SPECT) also revealed marked brain hypoperfusion involving the left parietal lobe, far beyond the regions of brain volume loss. This clinical case report illustrates the relative contribution of both MR imaging and SPECT for the diagnosis of dementia in a patient with concomitant depressive symptoms. Apart from contributing to the diagnosis of dementia beyond the traditional exclusionary approach, neuroimaging is increasingly being used to classify its particular subtypes. The role of neuroimaging role in AD is also supported by a recent proposal of revised diagnostic criteria, which take into account abnormal biomarkers of disease.
Subject(s)
Alzheimer Disease/diagnostic imaging , Alzheimer Disease/diagnosis , Tomography, Emission-Computed, Single-Photon/methods , Alzheimer Disease/complications , Brain/diagnostic imaging , Cognition Disorders/etiology , Female , Humans , Magnetic Resonance Imaging/methods , Mental Status Schedule , Middle Aged , Technetium Tc 99m ExametazimeABSTRACT
Among eigtheen yeast isolates studied as potential agents for biocontrol of stem-end rot on mango fruits caused by Lasiodiplodia theobromae, five were selected for testing in relation to three pathogen concentrations (1x10ü, 1x10 elevada à quarta and 1x10 elevada à quinta conidia/ml). The isolate LM-5 (Candida maritima) showed high control level at all pathogen concentrations. When tested against five pathogen isolates, LM-5 again demonstrated high control efficiency, and at in vitro test, highlyinhibited L.theobromae spore germination. The isolate LM-5 demonstrated great potential as agent for postharvest biocontrol of mango rot
