Discovery and validation of serologic biomarkers for the diagnosis and prognosis of invasive candidiasis by computational immunomics

Invasive candidiasis (IC) is an opportunistic systemic mycosis caused by Candida species (commonly Candida albicans) that continues to pose a significant public health problem worldwide. Despite great advances in antifungal therapy and changes in clinical practices, IC remains a major infectious cause of morbidity and mortality in severely immunocompromised or critically ill patients, and further accounts for substantial healthcare costs. Its impact on patient clinical outcome and economic burden could be ameliorated by timely initiation of appropriate antifungal therapy. However, early detection of IC is extremely difficult because of its unspecific clinical signs and symptoms, and the inadequate accuracy and time delay of the currently available diagnostic or risk stratification methods. In consequence, the diagnosis of IC is often attained in advanced stages of infection (leading to delayed therapeutic interventions and ensuing poor clinical outcomes) or, unfortunately, at autopsy. In addition to the difficulties encountered in diagnosing IC at an early stage, the initial therapeutic decision-making process is also hindered by the insufficient accuracy of the currently available tools for predicting clinical outcomes in individual IC patients at presentation. Therefore, it is not surprising that clinicians are generally unable to early detect IC, and identify those IC patients who are most likely to suffer fatal clinical outcomes and may benefit from more personalized therapeutic strategies at presentation. Better diagnostic and prognostic biomarkers for IC are thus needed to improve the clinical management of this life-threatening and costly opportunistic fungal infection...

Del síndrome al sinthome

Currently, the concept of symptom is based on the notion of singularity (from a base perspective, underlined by Freud, regarding the persistence of symptomatic residue). This indicates that the demise of the symptom will never be complete, since the demand drive will always persist and will not cease to search for satisfaction.Let us then, insist on this matter, on the existence of an incurable residue in the symptom (which entails a particular relationship between the subject and its own pleasure), resisting sense and interpretation. The following paper has been elaborated following a diachronic trajectory of psychoanalytic theory, which allows establishing pauses, outlining the most important shifts produced in Freudian and Lacanian elaborations, respectively. Starting from Freud‘s productions, as main fulcrum, the Lacanian approach of the symptom will be introduced to link to the proposal of the sinthome proposed by Lacan. Freud will explain symptoms through the theory of trauma; those will find themselves hinged on mnemic traces, which will make the analysis of the patient‘s produced associations a crucial activity, to comprehend the etiology of the symptoms and the development of the cure. The clinical practice of this period may be summarized as ―the unconscious is susceptible to become conscious‖, aiming to the discovery and/or decoding of the symptoms, as long as they carry meaning. All of this at the same time, will be the base of future elaborations...