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Fifty Years of Change: A Shared Journey
No full textThe author shares a personal account of 50 years of experience practicing psychodynamic psychiatry and psychoanalysis after migrating from Argentina to the United States. Her career developed in parallel as a clinician and as an academic psychiatrist, with leadership roles in the American Psychiatric Association, the Association of Women Psychiatrists, and the American Academy of Psychodynamic Psychiatry and Psychoanalysis. After describing what constitutes the essence, substance, and form of psychoanalysis, she reviews the historic shift within psychoanalysis in the United States from intrapsychic dyadic practice with selected patients to the application of psychodynamic concepts to everyday psychiatric care of patients with complex morbidities in multiple clinical settings
Clinical Characteristics, Laboratory Findings, and Tolerance Acquisition in Infants With Cow\u27s Milk Protein Allergy in a Private Center in Lima, Peru for the Period 2021-2022
No full textBACKGROUND: Cow\u27s milk protein allergy (CMPA) remains relatively understudied in Latin America.
METHODS: In this observational study, we enrolled 64 patients with a median age of 3 months, of whom 60% were male. Patients included had a history of IgE-mediated reactions with IgE sensitization or non-IgE-mediated reactions or symptoms following exposure to cow\u27s milk. They underwent skin prick test, ImmunoCAP, fecal calprotectin (FC), and fecal eosinophil-derived neurotoxin (EDN), in addition to double-blinded placebo-controlled oral food challenges (DBPCFC), with clinical evolution and tolerance acquisition observed over 1 year.
RESULTS: Malnutrition was present in 78.1% of patients, and 87.5% had a family history of atopy, with 51.6% receiving exclusive breastfeeding. Gastrointestinal manifestations were prevalent in 90.6% of patients, followed by dermatological manifestations (10.9%), with only 2 experiencing anaphylaxis. IgE-mediated CMPA was observed in only six patients. In those with non-IgE-mediated CMPA, FC had a median of 284 mg/dL (IQR: 138.5-415.5), while EDN had a median of 508.5 mg/dL (IQR: 160.25-868). One year after diagnosis, median FC significantly decreased (p \u3c 0.0001), and malnutrition prevalence reduced to 17.1%. Moreover, 81% of patients acquired tolerance following DBPCFC, with 52% utilizing nutritional replacement formulas at diagnosis. Notably, 94% of those extensively hydrolyzed casein-based formulas achieved tolerance (p = 0.08).
CONCLUSION: Our findings provide a foundational framework for future investigations into CMPA diagnosis, tolerance acquisition, and the utilization of hypoallergenic formulas tailored to the unique characteristics of our region
Working Environment for Historically Marginalized Faculty, Administrators, and Librarians in Pharmacy Education
No full textBarriers and Motivational Factors for Engaging in Novel Opioid and Medication Disposal-Related Services in Community Pharmacies
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