RESUMO
Abstract The present article investigates an essential question raised by the experience of the psychoanalytic clinic of autism: otherness. The goal of this research is to establish the specificity and the variety of forms of otherness in autism. From the Freudian premise of the complex of the 'fellow human being' (Nebenmensch) to the distinction between this and the Other as a place of language, this research examines the forms of otherness that can arise in autism, such as identified by J.-C. Maleval. They are as follow: the autistic object, the double, and the synthetic Other. For this purpose, this paper finds support on life events narrated by autistics as well as clinical fragments from the specialized literature.
Resumo O presente artigo investiga uma problemática suscitada pela experiência clínica e essencial à psicanálise com autistas: a alteridade. O objetivo da pesquisa consistiu em estabelecer a especificidade e a variedade das formas de alteridade nesses casos. Partindo da premissa freudiana do complexo do próximo (Nebenmensch) e passando pela distinção entre o próximo e o Outro enquanto lugar da linguagem, a pesquisa percorre as formas de alteridade suscetíveis de se delinearem no autismo, tais como identificadas por J.-C. Maleval: o objeto autístico, o duplo e o Outro de síntese. Para tal, recorre a relatos de vida narrados pelos autistas e a fragmentos clínicos da literatura especializada.
RESUMO
OBJECTIVE: to determine the immunogenicity of the monovalent vaccine against 2009 pandemic influenza A/H1N1 in HIV-1-infected individuals. DESIGN: a total of 192 participants, including 44 HIV-1-positive individuals and 148 HIV-1-negative healthy controls were enrolled to receive a single dose of MF59-adjuvanted 2009 A/H1N1v vaccine formulated to contain 7.5 microg of haemagglutin antigen. METHODS: standard haemagglutination inhibition (HAI) assay was performed to evaluate seroconversion and seroprotecsion rates against the pandemic virus in serum samples collected at baseline (T0) and 3-5-week postvaccination (T28). Seroconversion to vaccination was defined by either prevaccination HAI titer less than 1: 10 with a postvaccination titer higher than 1: 40, or a prevaccination titer higher than 1: 10 and increase of at least four-fold or more after vaccination. Seroprotection was defined by HAI titers higher than 1: 40. RESULTS: the vaccine induced specific antibody titers in HIV-1-positive individuals similar to those of HIV-1-negative controls [215.3, 95% confidence interval (CI) 150.4-308.1 vs. 275.9, 95% CI 232.6-327.3] with postvaccination seroprotection rates higher than 97%. In contrast, the seroconversion rate was lower in the HIV-1-positive individuals as compared with the HIV-1-negative controls (36.4 vs. 79.0%, P < 0.0001), likely as a consequence of their high HAI baseline titers. Multivariable logistic regression analysis showed that seroconversion was less likely in HIV-1-positive individuals [odds ratio (OR) = 0.237, 95% CI 0.104-0.539, P = 0.0006) and with increasing age (OR = 0.805, 95% CI 0.684-0.947, P = 0.009). CONCLUSIONS: a single dose of MF59-adjuvanted 2009 influenza H1N1 vaccine induced an immune response against pandemic H1N1 virus in HIV-1-positive individuals reaching titers similar to those of HIV-1-negative individuals. The seroconversion rate was negatively associated with HIV infection and increasing age.