As implicações da reprodução assistida na constituição subjetiva infantil

Os papéis ocupados pelas mulheres no âmbito pessoal e profissional sofreram significativas mudanças sócio-culturais nas ultimas décadas, ocasionando o adiamento da maternidade e um declínio das taxas de fecundidade. Consequentemente, há um aumento na procura por técnicas de reprodução artificial, que, de descoberta recente, não permitem um distanciamento histórico para avaliar as implicações na subjetivação das crianças concebidas através delas. Esse estudo busca, então, refletir sobre a procura por essas tecnologias e analisar seus prováveis efeitos na subjetividade infantil. Para isso, foi realizado um ensaio teórico sobre o tema, utilizando-se o referencial da psicanálise. Assim, pode-se pensar que essas técnicas vêm ao encontro do discurso do imediatismo contemporâneo, podendo constituir sujeitos sem limites, que nascem como esperança do gozo de seus pais

La produzione di Ennione e degli altri vitrarii sidonii:alcune riflessioni

Nel volume vengono proposte alcune riflessioni sulla produzione di Ennione vitrario siriaco e degli altri vitrarii sidonei

Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial

BackgroundTocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients.MethodsA multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival.ResultsIn the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6-24.0, P=0.52) and 22.4% (97.5% CI: 17.2-28.3, P<0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline.ConclusionsTocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline.Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092)