El buceo recreativo y la otorrinolaringología: ¿qué sabemos y deberíamos saber? / Recreational diving and otolaryngology: what do we know and should we know?

El buceo recreativo es una práctica cada vez más popular en la población mundial, sin embargo, no está exenta de riesgos. A medida que transcurre una inmersión, el buzo es susceptible a una serie de cambios de presión que afectan las distintas cavidades que contienen aire dentro del cuerpo humano, tales como el oído, cavidades paranasales y los pulmones. Existe un gran espectro de patologías asociadas al buceo, explicándose la mayoría de ellas por el barotrauma asociado, cuya gravedad depende de la magnitud del daño asociado, pudiendo presentar desde manifestaciones a nivel local, así como también a nivel sistémico. Las patologías otológicas suelen ser las más frecuentes y el principal motivo de consulta en este tipo de pacientes. Sin embargo, las afecciones otoneurológicas, rinosinusales, de vía aérea y sistémicas pueden ser comunes dependiendo de cada perfil de buceo. Actualmente no existen recomendaciones locales sobre esta práctica, por lo que el conocimiento de la fisiología, fisiopatología y el tratamiento de las patologías otorrinolaringológicas asociadas deben ser conocidas a medida que este deporte se vuelve cada vez más popular. Se realizó una revisión de la literatura sobre las distintas afecciones otorrinolaringológicas con el fin de sistematizarlas y elaborar recomendaciones para establecer una práctica segura.

Recreational diving is an increasingly popular practice in the world; however, it is not without risks. As a dive progresses, the diver is susceptible to a series of pressure changes that affect the air-containing cavities, such as the ear, paranasal cavities, and lungs. There is a large spectrum of pathologies associated with diving, most of them being explained by associated barotrauma, the severity of which depends on the magnitude of the associated damage, could present local manifestations, as well as at systemic level. Otological pathologies are usually the most frequent and the main reason for consultation in this type of patients, however, otoneurological, rhinosinusal, airway and systemic conditions can be common depending on each diving profile. Currently there are no local recommendations on this practice, therefore, knowledge of the physiology, pathophysiology and treatment of associated otorhinolaryngological pathologies should be known as this sport becomes increasingly popular. A review of the literature on the different ear, nose and throat conditions was carried out in order to systematize them and develop recommendations to establish a safe practice.

Acerca del acto sublimatorio / About sublimatory act

El presente trabajo aborda la noción de sublimación a partir de los conceptos de acto, angustia, deseo y pulsión. Para ello plantea un contrapunto entre el modo neurótico del deseo, es decir el deseo inhibido sostenido en el fantasma, y el trabajo de creación que supone un deseo actuado en la pulsión. Por otro lado, en su segunda parte, ensaya una articulación posible entre la sublimación como modo de ser en acto, y la destitución subjetiva que da cuenta de una renuncia a la indeterminación del sujeto a la que tanto se aferra el neurótico. En este sentido desarrolla la idea de la sublimación como un caso de destitución subjetiva. Para demostrarlo toma a la creación artística como paradigma, pero advirtiendo que los alcances de esta noción no se agoten en dicha referencia al arte.

The present work approach the notion of sublimation from the concepts of act, anguish, desire and drive. This poses a counterpoint between the neurotic mode of desire, desire inhibited sustained in the phantom, and the work of creation, which is a desire acted on drive. On the other hand, in the second part, rehearse possible linkages between sublimation as a way of being in act, and subjective destitution that accounts for a waiver of the indeterminacy of the subject to which both the neurotic clings. Thus develops the idea of sublimation as a case of subjective destitution. To demonstrate takes artistic creation as a paradigm, but warning that the scope of this notion are not depleted in this reference to art.

Wilderness medicine / 世界急诊医学杂志（英文）

@#BACKGROUND:Human activity in wilderness areas has increased globally in recent decades, leading to increased risk of injury and illness. Wilderness medicine has developed in response to both need and interest. METHODS:The field of wilderness medicine encompasses many areas of interest. Some focus on special circumstances (such as avalanches) while others have a broader scope (such as trauma care). Several core areas of key interest within wilderness medicine are discussed in this study. RESULTS:Wilderness medicine is characterized by remote and improvised care of patients with routine or exotic illnesses or trauma, limited resources and manpower, and delayed evacuation to definitive care. Wilderness medicine is developing rapidly and draws from the breadth of medical and surgical subspecialties as well as the technical fields of mountaineering, climbing, and diving. Research, epidemiology, and evidence-based guidelines are evolving. A hallmark of this field is injury prevention and risk mitigation. The range of topics encompasses high-altitude cerebral edema, decompression sickness, snake envenomation, lightning injury, extremity trauma, and gastroenteritis. Several professional societies, academic fellowships, and training organizations offer education and resources for laypeople and health care professionals. CONCLUSIONS:The future of wilderness medicine is unfolding on multiple fronts:education, research, training, technology, communications, and environment. Although wilderness medicine research is technically difficult to perform, it is essential to deepening our understanding of the contribution of specific techniques in achieving improvements in clinical outcomes.

Differences in submergence time and alarm reaction rate in Anopheles stephensi, Aedes egypti and Culex pipiens fourth instar larvae in response to vibration stimulus

Studying mosquito larvae behavior can provide insights into developing new ways in controlling vector borne diseases. Feeding is an aspect of larval behavior that has been studied extensively. Surface and underwater feeding behaviors are linked by diving. The larvae use dive behavior to feed underwater or to escape predators. We elicited dive responses in fourth instar larvae of three different mosquito species using vibration stimulus and compared their response rate and submergence time. Marked differences in the response rate and submergence time were recorded for the three species of mosquitoes. These differences can be exploited to develop new larvae control methods to reduce mosquito borne diseases.

The Brachyura and Anomura fauna (Decapoda; Crustacea) in the Arvoredo Marine Biological Reserve on the southern brazilian coast

Eight species of Brachyura and two species of Anomura were registered for the first time on the Santa Catarina coast, in the waters around the Arvoredo Marine Biological Reserve. The animals were collected by scuba divers, between 3 and 22 meters depth, from September 2001 to February 2003. A total of 31 decapod species were collected, and most of the new occurrences had already been registered in the adjacent northern waters.

Oito espécies de Brachyura e duas espécies de Anomura foram registradas pela primeira vez na costa de Santa Catarina, em águas no entorno da Reserva Biológica Marinha do Arvoredo. Os animais foram coletados por meio de mergulho autônomo, entre 3 e 22 metros de profundidade, de setembro 2001 a fevereiro de 2003. Um total de 31 espécies de Decapoda foram coletadas e a maioria das novas ocorrências já haviam sido registradas em águas adjacentes ao norte da Reserva.

NUTRITION STUDIES OF HUMANS DURING A HELIUM-OXYGEN DIVE TO A SIMULATED DEPTH OF 200M / 营养学报

Nutrition studies were made on four divers performing a helium-oxygen saturation dive to a simulated depth of 200m in a hyperbaric chamber for about seven days. Daily intake of food was surveyed by regular weighing method and its calories and nutrients were calculated from Chinese food composition table. Fasting blood and 24h urine samples were collected on several occasions before, during and after the dive for estimation of free amino acid, nitrogen and minerals. Vitamin load test was conducted for evaluation of vitamin status. The results showed that during the dive intakes of cereal, meat and oil of divers were decreased, but vegetable, fruit and beverage intakes increased. An average body weight loss of 1.75 kg was found after a 7-day period, but little changes in the body fat. Free amino acid levels of serum and urinary output were reduced, especially the essential amino acids. The urinary excretion of minerals was in an acceptable range, but thiamin decreased markedly and not returned to an acceptable range until 10 days after leaving the hyperbaric chamber.