Change in psychoanalysis: epistemological aspects.

The paper addresses the objectives of therapeutic work, emphasising processes of change which move an 'inadequate' state towards another, more 'adequate' one. Different types of change are considered, and the factors necessary for detecting them. Following the mathematical model, we distinguish between continuous and discontinuous change. In social processes also there are continuous changes, where a transition occurs cumulatively and slowly. In another type of change a drastic modification is produced, implying discontinuity and a sudden jump. On this point it is necessary to distinguish between removable discontinuities having little significance, and essential ones which have significant effects. 'Levels of change' imply categorical or structural differences. We consider different forms of obstacle which get in the way of the adequate management of change: non-perception of change on the part of the therapist, epistemological inertia and therapeutic zeal. We address the location of change in the psychoanalytic process in relation to the patient-analyst couple.

Postcircumcision urinary tract infection.

The possible association of urinary tract infection (UTI) with ritual circumcision on the eighth day of life was studied by analyzing the epidemiology of urinary tract infections during the first year of life in 169 children with UTI (56 males and 113 females) born in Israel from 1979 to 1984. Forty-eight percent of the episodes of UTI occurring in males appeared during the 12 days following circumcision, and the increased incidence during that period was highly significant. The median age of the males at the time of the UTI was 16 days, compared with seven months in females. Ritual Jewish circumcision as practiced in Israel may be a predisposing factor for UTI during the 12-day period following that procedure.