Synthesis and PI3 Kinase Inhibition Activity of a Wortmannin-Leucine Derivative.

Wortmannin is a potent covalent inhibitor of PI3K that shows substantial in vivo toxicity and thus is unsuitable for systemic therapeutic applications. One possible approach to minimize systemic toxicity is to generate a latent wortmannin pro-drug that will be selectively activated in target tissues. To test this approach, a wortmannin derivative with a leucine linker attached to C20 has been synthesized and tested for inhibition of PI3K activity in prostate cancer cells. Analysis of PI3K pathway inhibition by Wormannin-Leu (Wn-L) and intact Wortmannin (Wn) showed that attachment of Leu at C-20 decreased potency of PI3K pathway inhibition 10-fold compared to intact wortmannin, yet exceeded the potency of a competitive PI3K inhibitor LY294002.

Las dificultades que ofrecen los pacientes con difusión de identidad al tratamiento psiquiátrico / Difficulties that patients with identity diffusion offer to psychiatric treatment

En este artículo describiremos brevemente ciertos pacientes que consultan por cuadros psiquiátricos agudos y que además sufren de difusión de identidad. Estos pacientes ofrecen dificultades importantes a su propio tratamiento porque tienden a no persistir en una tarea, no cuidar de sí mismos, no confiar en las personas y a no recuperarse de las fallas de mentalización que puedan tener en sus relaciones interpersonales, produciendo graves complicaciones en el proceso terapéutico. Describiremos el Programa de Intervención Psicoeducativa y Control Farmacológico en Grupo que hemos implementado en el Instituto Psiquiátrico José Horwitz Barak para manejar de mejor forma las dificultades terapéuticas que estos pacientes ofrecen.

In this article we will briefly describe certain patients who consult for acute psychiatric symptoms and who also suffer from identity diffusion. These patients offer significant difficulties to their own treatment because they tend not to persist in a task, do not take care of themselves, do not trust people and do not recover from the mentalization failures they may have in their interpersonal relationships, producing serious complications in the therapeutic process. We will describe the Program of Psychoeducative Intervention and Pharmacological Control in Group that we have implemented in the José Horwitz Barak Psychiatric Institute to better manage the therapeutic difficulties that these patients offer.

Adaptación y validación de un cuestionario para evaluar contratransferencia en una sesión / Adaptation and validation of a questionnaire to asses countertransference in a session

Despite the clinical importance of the concept of countertransference there are few instruments to evaluate it; one of them is the Countertransference Questionnaire (CQ), which measures countertransference during a therapeutic process. The CQ is a self-report questionnaire, composed of a set of items that refer to a wide range of ideas, feelings and behaviors that therapists develop towards their patients. It is written in common language, without the use of technical terms, allowing the instrument to be used and compared by clinicians of any theoretical orientation. The following paper shows the translation to Spanish, an adapted version for its application in one interview or session, and its validation in a population of Chilean psychiatrists and psychologists in a sample of 333 completed questionnaires. Three versions of the questionnaire were created: Interviewer, Observer and Observer of the Interviewer. We conducted an exploratory factor analysis wich grouped the items on a total of seven factors with good or very good internal consistency (Cronbach’s alpha between 0.66 and 0.89) Results showed that the instrument is valid for its application in Chilean psychiatrists and psychologists.

A pesar de la importancia clínica del concepto de la contratransferencia hay pocos instrumentos para evaluarla, uno de ellos es el Countertransference Questionnaire que mide la contratransferencia durante un proceso terapéutico. Este cuestionario es de autoreporte, sus ítems se refieren a un amplio rango de ideas, sentimientos y conductas hacia sus pacientes expresados por los terapeutas. Está redactado en lenguaje cotidiano, sin términos técnicos, lo que permite que el instrumento pueda ser usado y comparado por clínicos de cualquier orientación teórica. En este artículo presentamos su traducción, adaptación para ser aplicado en una entrevista o sesión y la validación en una población de psiquiatras y psicólogos chilenos que realizamos con una muestra de 333 cuestionarios. Hicimos tres versiones del cuestionario: Entrevistador, Observador y Observador del entrevistador. Realizamos un análisis factorial exploratorio que agrupó los ítems en siete factores con consistencia interna buena o muy buena (alfa de Cronbach entre 0,66y 0,89). Los resultados arrojaron que este instrumento es válido para ser aplicado en psiquiatras y psicólogos chilenos.

Intermittent-continuous eclectic therapy: a group approach for borderline personality disorder.

Psychotherapies recommended for borderline personality disorder (BPD) can be difficult to implement in public hospitals. For example, in Chile, patients with BPD generally receive only pharmacotherapy, which is far from sufficient. This report describes a group psychotherapy approach called Intermittent-Continuous Eclectic Therapy (ICE) developed to treat patients with BPD. Results are presented from a small pilot study in which 15 outpatients with BPD between 15 and 40 years of age treated with ICE were followed for 1 year. In this small group of patients, improvements were seen in self-aggression and general symptoms. These preliminary findings suggests that ICE may be a useful option for treating BPD in real-world clinical settings and that more research in this area is warranted. A case report illustrating the implementation of ICE is also presented.

ICE: una nueva aproximación terapéutica para trastornos limítrofes de la personalidad / ICE: a new therapeutic approach for borderline personality disorders

Se describe una nueva terapia para pacientes con trastorno de personalidad limítrofe. Este enfoque es ecléctico, lo que alude al uso de técnicas extraídas de diferentes terapias que han probado ser útiles para el tratamiento de estos pacientes. Se describen los principios básicos de la terapia tales como el concepto intermitente-continuo y su naturaleza ecléctica. Estos tres conceptos le dan el nombre ICE a esta psicoterapia.