Mudanças das características de personalidade e dos sintomas no processo terapêutico

Dissertação de Mestrado apresentada ao ISPA - Instituto UniversitárioA Personalidade é um dos objetos de estudo de maior relevância no campo das ciências sociais, que tem sido alvo de inúmeros estudos de investigação, dando origem a diferentes teorias sobre a sua estrutura, formação e funcionamento. O presente estudo pretende abordar de que forma a mudança na estrutura da personalidade versus mudança dos sintomas evoluem ao longo de um processo terapêutico. Neste sentido, a revisão de literatura incide sobre o conceito de personalidade e sua mudança, apresentando diferentes abordagens teóricas propostas por alguns autores, passando pela questão fundamental do próprio conceito de mudança em psicoterapia. Ao longo da exposição teórica, serão abordados alguns estudos que permitem entender de que forma a mudança da personalidade e dos sintomas ocorrem ao longo de um processo psicoterapêutico. A partir da literatura revista, conclui-se que essas mudanças são efetivamente mais notórias ao nível dos sintomas logo no início da terapia, comparativamente aos traços de personalidade que revelaram necessitar de um maior tempo de psicoterapia para que essa mudança ocorra.ABSTRACT: Personality is one of the objects of study most relevant in the social sciences, which has been the subject of numerous research studies, giving rise to different theories about its structure, formation, function. The present study aims to address how the changing structure of personality versus change of symptoms evolve over a therapeutic process. In this sense, the literature review focuses on the concept of personality and its change, presenting different theoretical approaches proposed by some authors, through the fundamental question of the concept of change in psychotherapy. Along the theoretical exposition, some studies that allow us to understand how the change of personality and symptoms occur along a psychotherapeutic process will be addressed. From the literature reviewed, it is concluded that these changes are actually more noticeable at the level of symptoms early in therapy, compared to personality traits revealed that require a longer psychotherapy for this change to occur.RESUMO: Problema: A perceção ao nível da mudança em psicoterapia de que os sintomas são os primeiros indicadores de mudança em relação aos traços de personalidade, tem vindo a ser apoiada pela literatura pesquisada. Contudo, não são muitos os estudos que relacionam estes dois conceitos. Objetivo: perceber, em contexto de psicoterapia analítica, a relação entre as mudanças na personalidade e o grau de sintomatologia apresentada em duas pacientes seguidas em psicoterapia, por diferentes terapeutas, por um período de 2 anos. Método: A personalidade foi avaliada através das gravações áudio de 4 sessões por cada período de avaliação: início, 6, 12, 18 e 24 meses com o Shedler-Westen Assessment Procedure (SWAP-200; Shedler & Westen, 1998). Os sintomas foram medidos através do Symptom Checklist-90- Revised (SCL-90-R; Derogatis & Savitz, 2000), em cinco e três momentos distintos na paciente 1 e paciente 2 respetivamente, ao longo do processo psicoterapêutico. Resultados: Concluiu-se que, tanto para a paciente 1 como para a paciente 2, a mudança sintomática deu-se mais rapidamente do que a mudança ao nível da personalidade.ABSTRACT: Problem: The perception at the level of changing in psychotherapy whose symptoms are the first indicators of changing in relation to personality traits, has been supported by literature. However, not many studies link these two concepts. Objective: To understand, in the context of analytic psychotherapy, the relationship between changes in personality and the degree of symptoms reported in two patients in psychotherapy followed by different therapists, for a period of 2 years. Method: Personality was assessed using the audio recordings of 4 sessions per each period: starting with 6, 12, 18 and 24 months with the Shedler-Westen Assessment Procedure (SWAP-200; Shedler & Westen, 1998). Symptoms were measured by the Symptom Checklist-90-Revised (SCL-90-R, Derogatis & Savitz, 2000), in five and three distinct moments in patient 1 and patient 2 respectively, during the psychotherapeutic process. Results: It was found that for both patient 1 and patient 2 the symptomatic change was faster than the change at the level of personality

Computer-Generated Ovaries to Assist Follicle Counting Experiments

Precise estimation of the number of follicles in ovaries is of key importance in the field of reproductive biology, both from a developmental point of view, where follicle numbers are determined at specific time points, as well as from a therapeutic perspective, determining the adverse effects of environmental toxins and cancer chemotherapeutics on the reproductive system. The two main factors affecting follicle number estimates are the sampling method and the variation in follicle numbers within animals of the same strain, due to biological variability. This study aims at assessing the effect of these two factors, when estimating ovarian follicle numbers of neonatal mice. We developed computer algorithms, which generate models of neonatal mouse ovaries (simulated ovaries), with characteristics derived from experimental measurements already available in the published literature. The simulated ovaries are used to reproduce in-silico counting experiments based on unbiased stereological techniques; the proposed approach provides the necessary number of ovaries and sampling frequency to be used in the experiments given a specific biological variability and a desirable degree of accuracy. The simulated ovary is a novel, versatile tool which can be used in the planning phase of experiments to estimate the expected number of animals and workload, ensuring appropriate statistical power of the resulting measurements. Moreover, the idea of the simulated ovary can be applied to other organs made up of large numbers of individual functional units

Molecular Characterization and Expression Analysis of Pathogenesis related Protein 6 from Panax ginseng

Panax ginseng Meyer is one of the important medicinal plants in the world, particularly in Asian countries. Ginseng encounters many stress exposure during its long cultivation period. However, the molecular mechanism of stress resistance is still poorly understood in spite of its importance. In this study, pathogenesis- related protein 6 (PR6), also called proteinase inhibitor (PI), was isolated from ginseng embryogenic callus, named PgPR6. The small size of PR6, containing an open reading frame of 219 bp encoding 72 amino acids, the typical characteristic of PR6 protein, shares the highest sequence similarity to PR6 of Theobroma cacao (69% identity). Sequence and structural analysis indicated that PgPR6 belongs to class Kunitz-type PI family. This is the first report pertaining to the identification of PR6 gene from the P. ginseng genome. The high-level expression of PgPR6 was observed in root as revealed by quantitative real-time PCR. The temporal expression analysis demonstrated that PgPR6 expression was highly up-regulated by signaling molecules, heavy metals, mechanical wounding, chilling, salt, sucrose, and mannitol stress, indicating that PgPR6 may play an important role in the molecular defense response of ginseng to a various range of environmental stresses

Assessment of Allergic Rhinitis Websites in Korea

Objectives. The internet has become an important source of medical information and a great amount of information related to allergic rhinitis (AR) is available on the internet. However, the quality of this information is still a matter of debate. Therefore, this study was conducted to assess the AR-related information on Korean websites. Methods. The key word "allergic rhinitis" was entered into 4 popular search engines, and this led to identifying 40 websites. After being categorized according to authorship, the informational value of these websites was evaluated using 4 different assessment tools such as the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire, the Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update and the Health On the Net (HON) code. Results. The 40 websites containing AR-related information were categorized according to their authorship as Western physician: 20, Oriental physician: 14, commercial: 1, and others: 5. The mean citation frequencies of the JAMA benchmarks and the ARIA 2008 Update concepts was 1.23 out of 4 and 4.33 out of 8, respectively, while the mean DISCERN score was 1.92 out of 5. When the websites were evaluated based on the type of authorship, the mean citation frequencies of the AMA 2008 Update concepts were Western physician: 5.35, Oriental physician: 2.64. Additionally, three websites authored by Western physicians and 13 authored by Oriental physicians contained unreliable information. Among these 16 websites, only 3 websites met the requirements for the HON code "Justification". Conclusion. AR-related information available on Korean websites is of variable quality and not all of the information provided is justifiable. Thus, performing surveillance of the medical information on these websites is necessary. Furthermore, common criteria that can be used to evaluate the websites created by both Western and Oriental physicians are also needed.Bousquet J, 2008, ALLERGY, V63, P8*HLTH NET FDN, 2006, HLTH NET COD COND VESILVA LVE, 2005, BRAZILIAN J OTHORHIN, V71, P590Park HW, 2004, J KOREAN MED SCI, V19, P364Winker MA, 2000, JAMA-J AM MED ASSOC, V283, P1600Charnock D, 1999, J EPIDEMIOL COMMUN H, V53, P105Silberg WM, 1997, JAMA-J AM MED ASSOC, V277, P1244

A biophysical model of cell adhesion mediated by immunoadhesin drugs and antibodies

A promising direction in drug development is to exploit the ability of natural killer cells to kill antibody-labeled target cells. Monoclonal antibodies and drugs designed to elicit this effect typically bind cell-surface epitopes that are overexpressed on target cells but also present on other cells. Thus it is important to understand adhesion of cells by antibodies and similar molecules. We present an equilibrium model of such adhesion, incorporating heterogeneity in target cell epitope density and epitope immobility. We compare with experiments on the adhesion of Jurkat T cells to bilayers containing the relevant natural killer cell receptor, with adhesion mediated by the drug alefacept. We show that a model in which all target cell epitopes are mobile and available is inconsistent with the data, suggesting that more complex mechanisms are at work. We hypothesize that the immobile epitope fraction may change with cell adhesion, and we find that such a model is more consistent with the data. We also quantitatively describe the parameter space in which binding occurs. Our results point toward mechanisms relating epitope immobility to cell adhesion and offer insight into the activity of an important class of drugs.Comment: 13 pages, 5 figure

Role of Intranasal Topical Steroid in Pediatric Sleep Disordered Breathing and Influence of Allergy, Sinusitis, and Obesity on Treatment Outcome

ObjectivesTo evaluate efficacy of short term intranasal corticosteroid (mometasone furoate) treatment in pediatric sleep-disordered breathing (SDB) patients.MethodsA prospective, observational study was done. A total of 41 children (2-11 years old) were enrolled into this study. All patients received 4-weeks course of mometasone furoate 100 µg/day treatment. They were evaluated at pretreatment and immediately after treatment with obstructive sleep apnea (OSA)-18 quality of life survey and lateral neck X-ray. Also, the assessment of each patients included history, skin prick test or CAP test, and sinus radiography. We compared the OSA-18 survey score and adenoidal-nasopharyngeal (AN) ratio between before and after treatment.ResultsTotal OSA-18 score and AN ratio decreased significantly after treatment regardless of allergy, sinusitis, and obesity (P=0.003, P=0.006). There was no complication after treatment of mometasone furoate.ConclusionPediatric SDB patients with adenoid hypertrophy could be effectively treated with 4-weeks course of mometasone furoate. Allergy, obesity, and sinusitis did not affect on the result of treatment

Brunner's Gland Hyperplasia: Treatment of Severe Diffuse Nodular Hyperplasia Mimicking a Malignancy on Pancreatic-Duodenal Area

Brunner's gland hyperplasia is a benign tumor of the duodenum and it is rarely associated with clinical symptoms. We report on a 64-yr-old man with Brunner's gland hyperplasia who had undergone a duodenocephalo-pancreatectomy. The reason is that he presented upper gastrointestinal obstructive symptoms and the esophagogastroduodenoscopic finding revealed the lesion to be an infiltrating type mass on the second portion of the duodenum with luminal narrowing. An abdominal computed tomography showed a 2.5 cm-sized mass in the duodenal second portion with a suspicious pancreatic invasion and 7 mm-sized lymph node around the duodenum. Duodenocephalopancreatectomy was successfully performed. Histological examination revealed a Brunner's gland hyperplasia. The final diagnosis was the coexistence of Brunner's gland hyperplasia and pancreatic heterotopia with a pancreatic head invasion. The literature on Brunner's gland hyperplasia is reviewed

Human and preclinical studies of the host-gut microbiome co-metabolite hippurate as a marker and mediator of metabolic health.

OBJECTIVE: Gut microbial products are involved in regulation of host metabolism. In human and experimental studies, we explored the potential role of hippurate, a hepatic phase 2 conjugation product of microbial benzoate, as a marker and mediator of metabolic health. DESIGN: In 271 middle-aged non-diabetic Danish individuals, who were stratified on habitual dietary intake, we applied 1H-nuclear magnetic resonance (NMR) spectroscopy of urine samples and shotgun-sequencing-based metagenomics of the gut microbiome to explore links between the urine level of hippurate, measures of the gut microbiome, dietary fat and markers of metabolic health. In mechanistic experiments with chronic subcutaneous infusion of hippurate to high-fat-diet-fed obese mice, we tested for causality between hippurate and metabolic phenotypes. RESULTS: In the human study, we showed that urine hippurate positively associates with microbial gene richness and functional modules for microbial benzoate biosynthetic pathways, one of which is less prevalent in the Bacteroides 2 enterotype compared with Ruminococcaceae or Prevotella enterotypes. Through dietary stratification, we identify a subset of study participants consuming a diet rich in saturated fat in which urine hippurate concentration, independently of gene richness, accounts for links with metabolic health. In the high-fat-fed mice experiments, we demonstrate causality through chronic infusion of hippurate (20 nmol/day) resulting in improved glucose tolerance and enhanced insulin secretion. CONCLUSION: Our human and experimental studies show that a high urine hippurate concentration is a general marker of metabolic health, and in the context of obesity induced by high-fat diets, hippurate contributes to metabolic improvements, highlighting its potential as a mediator of metabolic health

Observation of a J^PC = 1-+ exotic resonance in diffractive dissociation of 190 GeV/c pi- into pi- pi- pi+

The COMPASS experiment at the CERN SPS has studied the diffractive dissociation of negative pions into the pi- pi- pi+ final state using a 190 GeV/c pion beam hitting a lead target. A partial wave analysis has been performed on a sample of 420000 events taken at values of the squared 4-momentum transfer t' between 0.1 and 1 GeV^2/c^2. The well-known resonances a1(1260), a2(1320), and pi2(1670) are clearly observed. In addition, the data show a significant natural parity exchange production of a resonance with spin-exotic quantum numbers J^PC = 1-+ at 1.66 GeV/c^2 decaying to rho pi. The resonant nature of this wave is evident from the mass-dependent phase differences to the J^PC = 2-+ and 1++ waves. From a mass-dependent fit a resonance mass of 1660 +- 10+0-64 MeV/c^2 and a width of 269+-21+42-64 MeV/c^2 is deduced.Comment: 7 page, 3 figures; version 2 gives some more details, data unchanged; version 3 updated authors, text shortened, data unchange