We are presenting the conclusions of a clinical research project developed by the General Directorate for Health and Social Assistance, UBA, which assessed the therapeutic eficacy in the treatment of a panic attack. The results were based on the comparison of two therapeutic modalities: Focal Psychoanalytically Oriented Psychotherapy (POP) and Combined Treatment (TC) - POP and Psychopharmacological Treatment. The sample group was comprised of 55 subjects with panic disorder (based on DSM-IV TR panic disorder diagnosis) who randomly received one or another weekly treatment during a period of 12 weeks (one session per week). The results showed that POP and the TC are effective intermission methods for the treatment of panic disorder, the ability to reduce the symptoms, improve the quality of life of the patient, and maintain long term results. POP favors adherence to pharmacological treatment. The TC showed no significant differences with regard to POP with relation to its eficacy.

Se presentan los resultados de un proyecto de investigación clínica desarrollado en la Dirección General de Salud y Asistencia Social, UBA, que evaluó la eficacia terapéutica en el tratamiento del ataque de pánico. Para ello se compararon dos modalidades terapéuticas: Psicoterapia Focal de Orientación Psicoanalítica (POP) y Tratamiento Combinado (TC) -POP y Tratamiento Psicofarmacológico-. La muestra fue constituida por 55 sujetos con trastorno de pánico, según los criterios del DSM-IV TR, que recibieron aleatoriamente uno u otro tratamiento durante 12 sesiones a razón de una sesión semanal. Los resultados obtenidos demostraron que POP y el TC constituyen modalidades de intervención eicaces en el tratamiento del trastorno de pánico permitiendo reducir la sintomatología del mismo, mejorar la calidad de vida del paciente y mantener los resultados en el largo plazo. POP favorece la adherencia al tratamiento farmacológico. El TC no mostró diferencias significativas respecto de POP con relación a su eficacia.

OBJETIVO: Avaliar a segurança e efetividade de um programa de treinamento para cateterização da veia jugular interna guiada por ultrassom em pacientes críticos. MÉTODOS: Estudo de coorte prospectivo, avaliando pacientes adultos internados em uma unidade de terapia intensiva com programa de ensino. Os médicos residentes do serviço realizaram as punções de veia jugular interna guiadas por ultrassom. Foram avaliadas as características de base dos pacientes, sintopia dos vasos e experiência dos operadores. Os desfechos primários foram a taxa de sucesso da cateterização e a incidência de complicações graves. RESULTADOS: No período entre maio de 2008 e novembro de 2009 foram avaliados 118 pacientes. A taxa de sucesso da punção guiada por ultrassom foi 90% (106/118), 77% dessas na primeira tentativa. Complicações graves ocorreram em 4% dos casos (n = 5) e não foram associadas às variáveis analisadas. Incapacidade de progredir o fio-guia foi a razão de 58% (7/12) das falhas. Operadores com mais de 15 punções guiadas por ultrassom obtiveram uma maior taxa de sucesso (95% vs. 79%, p = 0,01) e pacientes com cateterização prévia apresentaram um maior número de falhas (26% vs. 7%, p = 0,02). CONCLUSÃO: O aprendizado da técnica de punção de veia jugular interna guiada por ultrasssom é seguro e efetivo em pacientes críticos. Este processo não esteve associado a um aumento da taxa de complicações e melhores resultados são obtidos à medida que aumenta a experiência do operador

OBJECTIVES: Evaluate the safety and effectiveness of a training program for performing ultrasound-guided internal jugular vein cannulation in critically ill patients. METHODS: Cohort prospective study, evaluating adult patients admitted in a teaching intensive care unit (ICU). Catheter placement was performed by an ICU medical resident. The patient's baseline characteristics, vessel's position and operator experience were the evaluated variables. The main outcomes were cannulation success rate and incidence of major complications. RESULTS: A total of 118 consecutive patients were enrolled between May 2008 and November 2009. The success rate of ultrasound guided catheter placement was 90% (106/118), 77% in the first attempt. Major complications occurred in 4% of the cases (n = 5) and were not associated with the analyzed variables. Inability to place the guide wire was the reason for 58% (7/12) of the failures. Operators with more than 15 previous ultrasound guided cannulations had an increased success rate (95% vs. 79%, p = 0.01) and increased failure was related to previous catheterization (26% vs. 7%, p = 0.02). CONCLUSION: Learning ultrasound guidance for IJV vein cannulation was safe and feasible in ICU patients. This process was not associated to complications and better results were achieved across the spectrum of operator experience

Os inibidores da fosfodiesterase têm sido introduzidos, nos últimos anos, como novos agentes farmacológicos no tratamento dos pacientes com fenômeno de Raynaud e isquemia digital. Será descrito o caso de uma paciente com lúpus eritematoso sistêmico e esclerose sistêmica limitada apresentando fenômeno de Raynaud grave e necrose digital refratária à terapia. A paciente obteve excelente resposta à associação de imunossupressão e sildenafil.

The phosphodiesterase inhibitors have been used recently for the treatment of Raynaud's phenomenon and digital ischaemia. We report the case of a patient affected by systemic lupus erythematosus and limited systemic sclerosis who presented severe Raynaud's phenomenon with digital necrosis despite treatment. The patient presented an excellent response to the association of immunosuppressant therapy and sildenafil.

Data gathered administering the SCL-90-R and a scale to assess tendency to forgive (self, others, situation, believes) to a sample of 419 college students (age Mean 23 years old) are presented. We found that mean values in SCL are that those found in the local normative data. Statistical significant differences between sexes were found in depression, somatizations and paranoid ideations. Younger students show higher mean values in psychopathological symptoms than older ones. Negative correlations between symptoms and three dimensions of forgiveness (self, others, situation) were found as well as positive correlations with believes. 97% of the students participating in the research considered that it is important to be able to forgive. A tendency to relate forgiveness with religious affiliation was verified.

Se presentan datos obtenidos en una muestra de 419 estudiantes universitarios (edad promedio 23 años) a quienes se les administró el cuestionario de síntomas SCL-90-R y una escala para evaluar la Capacidad de Perdonar en cuatro dimensiones (self, otros, situación, creencias) que incluye una pregunta sobre afiliación religiosa. Se verifica que los valores promedios en las dimensiones del SCL-90 corresponden a puntuaciones T 50 del baremo local. Se encontraron diferencias según géneros en las dimensiones depresión, somatizaciones e ideaciones paranoides. Las dimensiones psicopatológicas correlacionan de manera negativa con tres dimensiones del perdonar (self, otros, situación) y positiva con creencias sobre el tema. Los estudiantes más jóvenes revelan síntomas con valores promedios más altos que los mayores de 22 años. El 97% de los estudiantes considera que es importante ser capaces de perdonar. Se ha encontrado una tendencia entre la predisposición a perdonar y el grado de afiliación religiosa.