Fuentes de energía en apendicectomía laparoscópica en un programa académico de Cirugía general en Colombia / Energy sources in laparoscopic appendectomy in an academic program of General Surgery in Colombia

Introducción. La apendicectomía por laparoscopia se considera el patrón de oro en el tratamiento de la apendicitis aguda. Sin embargo, su disponibilidad es limitada en nuestro sistema de salud, principalmente por los costos asociados. El objetivo de este estudio fue evaluar la relación entre el uso de los diferentes tipos de energía y los métodos de ligadura de la base apendicular, con las complicaciones postoperatorias, al igual que describir los costos asociados. Métodos. Estudio observacional analítico de una cohorte retrospectiva de pacientes mayores de 15 años a quienes se les realizó apendicectomía por laparoscopia, en un hospital universitario entre los años 2014 y 2018. Se utilizaron modelos de regresión logística y lineal para evaluar la relación entre métodos de ligadura del meso y base apendicular, desenlaces operatorios y costos. Resultados. Se realizaron 2074 apendicectomías por laparoscopia, 58,2 % (n=1207) en mujeres, la edad mediana fue de 32 años. En el 71,5 % (n=1483) la apendicitis aguda no fue complicada. La energía monopolar para la liga-dura del meso apendicular fue la utilizada más frecuentemente en 57,2 % (n=1187) y el Hemolok® el más utilizado para la ligadura de la base apendicular en el 84,8 % (n=1759) de los pacientes. No se observaron diferencias estadísticamente significativas en la tasa de infección del sitio operatorio, reintervención o íleo. El uso de energía simple redujo los costos del procedimiento de manera significativa durante el período evaluado. Discusión. El uso de energía monopolar demostró ser una técnica segura, reproducible y de menor costo en comparación con el uso de energía bipolar, independientemente de la fase de la apendicitis aguda. Lo anterior ha permitido que se realicen más apendicectomías por laparoscopia y que los médicos residentes de cirugía general puedan realizar procedimientos laparoscópicos de forma más temprana

Introduction. Laparoscopic appendectomy is considered the gold standard in the treatment of acute appendicitis. However, its availability is limited in our health system mainly due to the associated costs. The objective of this study is to evaluate the relationship between the use of different types of energy and the methods of ligation of the appendicular base with postoperative complications, as well as to describe the associated costs. Methods. Retrospective observational study of a cohort of patients older than 15 years old who underwent laparoscopic appendectomy in a university hospital between 2014 and 2018. Logistic and linear regression models were used to evaluate the relationship between methods of ligation of the meso and appendicular base, operative outcomes and costs. Results: 2074 laparoscopic appendectomies were performed. Of those, 58.2% (n=1207) were women, median age was 32 years. In 71.5% (n=1483), acute appendicitis was uncomplicated. Monopolar energy for ligation was the most frequently used for ligation of the appendicular meso in 57.2% (n=1187) and Hem-o-lok® the most used for ligation of the appendicular base in 84.8% (n=1759) of the patients. There were no statistically significant differences in the rate of surgical site infection, reoperation, or ileus. The use of simple energy reduced the costs of the procedure significantly during the study period. Discussion. The use of monopolar energy proved to be a safe, reproducible and a lower cost technique compared to the use of bipolar energy, regardless of the phase of acute appendicitis. This has allowed more laparoscopic appendectomies to be performed and the general surgery residents to perform laparoscopic procedures earlier

Potential of Alternative Sources for Electric Power Generation in the State of Paraná

Abstract The State of Paraná stands out in Brazil for its hydraulic potential for electricity generation. Furthermore, the State also shows potential for the use of other sources of energy, such as solar energy, biogas and biomass. The study traces the profile of electric energy consumption and compiles analysis of the alternative energy potentials of Paraná on the use of solar energy, the biomass of forest residues and agricultural crops, the generation of biogas through the residues of farmed animals and the urban solids residues. The work took account for the estimates, the logistical limitations for the biomass or biogas collection and the real availability of the wastes in terms of viability of exploration through distributed generation plants. The use of the business analytics software Tableau Desktop 2020.3.2® made possible the open data analysis at the municipal level. The paper provides realistic estimates about the feasibility of the use of alternative energy sources in the State of Paraná.

Diferentes fontes energéticas durante o período de transição de vacas primíparas e os seus efeitos sobre metabólitos sanguíneos e hormônios / Different energy sources during the primiparous dairy cow transition period and its effects on blood metabolites and hormones

Objetivou-se com este estudo comparar os efeitos do fornecimento de dietas glicogênicas ou lipogênicas sobre metabolitos sanguíneos e hormônios em vacas primíparas (n=40) durante o período de transição. Os animais foram aleatoriamente distribuídos em quatro tratamentos: controle, sais de cálcio de ácidos graxos poli-insaturados (Megalac-E, 100g pré-parto e 250g pós-parto), soja tostada (400g pré-parto e 800g pós-parto) e propilenoglicol (300ml pré e pós-parto). Os suplementos foram fornecidos individualmente. Foram realizadas coletas de sangue para determinação das concentrações plasmáticas de insulina, glicose, ácidos graxos não esterificados (AGNE) e IGF-I. As concentrações de insulina e de glicose foram maiores nos animais do tratamento com sais de cálcio de ácidos graxos poli-insaturados. A maior concentração de AGNE foi observada no grupo controle. A concentração plasmática de IGF-I foi mais elevada para os animais do tratamento que receberam suplementos lipogênicos. A adição de sais de cálcio de ácidos graxos poli-insaturados a dieta foi capaz de amenizar as mudanças hormonais e metabólicas características do período de transição.(AU)

The aim of this study was to compare the effects of glycogenic supply or lipogenic diets on blood metabolites and hormones in primiparous dairy cows (n=40) during the transition period. The animals were randomly assigned to four treatments: control, calcium salts of polyunsaturated fatty acids (Megalac-E, 100g prepartum and 250g postpartum), roasted soybeans (400g prepartum and 800g postpartum) and propylene glycol (300ml pre- and postpartum). The supplements were provided individually. Blood samples were taken to determine plasma concentrations of insulin, glucose, non-esterified fatty acids (NEFA) and IGF-I. The glucose and insulin concentrations were higher in calcium salts of polyunsaturated fatty acids treatment. The highest concentration of NEFA was observed in the control group. The plasma concentrations of IGF-I were higher for the treatments with lipogenic supplements. Adding calcium salts of polyunsaturated fatty acids diet was able to ease the hormonal and metabolic changes of the transition period features.(AU)

Evaluation of biogas and syngas as energy vectors for heat and power generation using lignocellulosic biomass as raw material

The use of nonrenewable energy sources to provide the worldwide energy needs has caused different problems such as global warming, water pollution, and smog production. In this sense, lignocellulosic biomass has been postulated as a renewable energy source able to produce energy carriers that can cover this energy demand. Biogas and syngas are two energy vectors that have been suggested to generate heat and power through their use in cogeneration systems. Therefore, the aim of this review is to develop a comparison between these energy vectors considering their main features based on literature reports. In addition, a techno-economic and energy assessment of the heat and power generation using these vectors as energy sources is performed. If lignocellulosic biomass is used as raw material, biogas is more commonly used for cogeneration purposes than syngas. However, syngas from biomass gasification has a great potential to be employed as a chemical platform in the production of value-added products. Moreover, the investment costs to generate heat and power from lignocellulosic materials using the anaerobic digestion technology are higher than those using the gasification technology. As a conclusion, it was evidenced that upgraded biogas has a higher potential to produce heat and power than syngas. Nevertheless, the implementation of both energy vectors into the energy market is important to cover the increasing worldwide energy demand.

Physicochemical Characteristics of Oil Obtained from the Treatment of Poultry Abattoir Effluents and its Potential for Biodiesel Production

ABSTRACT Sludge oil derived from the effluent generated in poultry abattoirs offers a promising biomass for the production of biodiesel. In this work, determination was made of its physicochemical characteristics, including acidity, density at 20ºC, peroxide index, moisture content, and saponification index, together with evaluation of a route for its conversion to biodiesel.

Uso do metanol e risco de exposição dos trabalhadores de uma usina de biodiesel / Use of methanol and workers' risk of exposure at a biodiesel plant

Contexto: O metanol é usado como matéria-prima na fabricação de biodiesel e pode causar, em especial, danos oftalmológicos e neurológicos. A exposição ocupacional acontece principalmente pela inalação de vapores. No entanto, os dados relacionados aos efeitos da exposição crônica ao metanol em humanos são limitados. Objetivos: Mostrar situações e atividades com risco de exposição ao metanol em uma planta de biodiesel e a presença de possíveis sintomas de contaminação nos trabalhadores. Métodos: Questionário, entrevistas, observação direta e análise documental possibilitaram a coleta dos dados. Resultados: O processo produtivo apresentou oito situações de exposição ao metanol. Entre os 42 sujeitos da pesquisa, 27 trabalhavam diretamente expostos e rela-taram ter dor de cabeça (71,42%), formigamento (42,00%), entre outros sintomas. As mais importantes queixas relacionadas com os efeitos neurotóxicos foram irritação (40,50%), ansiedade (35,70%) e dor de cabeça (64,30%). Funcionários das áreas administrativas também apresentavam sintomatologia idêntica à de contaminação pelo químico. Conclusões: Trabalhadores em diferentes atividades estavam expostos ao metanol, e a análise dos sintomas associados à exposição a esse solvente revelou que a maioria apresentava alguma sintomatologia compatível com a contaminação por ele.

Background: Methanol is used as raw material for biodiesel production and might cause especially visual and neurological disorders. Occupational exposure mainly occurs through vapor inhalation. However, the available data on the effects of human chronic exposure to methanol are limited. Aims: To describe situations and activities involving risk of exposure to methanol in a biodiesel plant and the possible presence of symptoms of contamination in workers. Methods: Data collection was performed by means of direct observation, interviews, document analysis and application of a questionnaire. Results: The production process included eight different situation os methanol exposure. Among the 42 participants in the study, 27 worked under conditions of direct methanol exposure and reported headache (71.42%) and tingling (42.00%) among other symptoms. The most important complaints related to the neurotoxic effects of methanol were irritation (40.50%), anxiety (35.70%) and headache (64.30%). Similarly, workers in administrative areas exhibited the same symptoms of contamination by the chemical. Conclusions: Workers performing various different activities were exposed to methanol; analysis of the symptoms associated with exposure to the solvent showed that most of them exhibited symptoms compatible with methanol contamination.

Sows' parity and coconut oil postnatal supplement on piglets performance / Número de partos y la suplementación de aceite de coco para lechones recién nacidos

Objective. The study aimed to evaluate the effect of sows' of different parities and the supplement of coconut oil for piglets, on the development of litter. Materials and methods. A total of 51 sows of different parities and their 642 piglets were used in the trial. Each piglet was weighed and identified at birth in a sequential order. They were randomly distributed in two treatments (CG=control group and TG=test group). TG piglets had the first access to a dosage of 3.0 ml of coconut oil 12 hours after birth, and the second at 36 h after the first. Piglets were weighed at 21 days. In order to analyze the effect of the coconut oil supplement as a function of the weight at birth, piglets were grouped according to their weight (0.600 to 0.900 kg; 1.000 to 1.499kg; 1.500 to 1.999 kg; and 2.000 to 2.499 kg). Results. Sows parity affected the number and weight of born piglets. Sows in 4th, 5th and 7th parity had a larger litter than those from the 2nd parity. Sows from 2nd and 3rd parity had a lower number of piglets but heavier litter. No effect of the coconut oil supplement on neonatal piglets' performance was found. Conclusions. The coconut meal was neither beneficial to neonatal piglets nor to those with low weight at birth, which usually present low body energy.

El objetivo del estudio fue evaluar el efecto del número de partos y el suplemento de aceite de coco en lechones recien nacidos. Materiales y métodos. Se utilizaron 51 cerdas de diferentes partos y sus 642 lechones. Cada lechón se pesó y se identificó al nacer en orden secuencial. Fueron distribuidos aleatoriamente en dos grupos (CG = control y TG=tratamiento). Lechones TG tenían el primer acceso a una dosis de 3.0 ml de aceite de coco 12 horas después del nacimiento, y el segunda a las 36 h después de la primera. Los lechones fueron pesados a los 21 días. Con el fin de analizar el efecto de los suplementos de aceite de coco con relación al peso al nacer. Los lechones fueron agrupados de acuerdo con su peso (0.600 a 0.900 kg; 1.000 a 1.499 kg; 1.500 a 1.999 kg y 2.000 a 2.499 kg). Resultados. El número de partos afectó el peso y el número de lechones nacidos. Cerdas en cuarto, quinto y séptimo parto, tuvieron una camada mayor que las de segundo parto. Las cerdas de segundo y tercer parto tuvieron menor número de lechones y con peso mayor. No se encontró efecto del suplemento de aceite de coco en el desarrollo de los lechones recién nacidos. Conclusiones. Lo aceite de coco no es favorable para los lechones recién nacidos, tampoco para aquellos con el bajo peso al nacer, que normalmente presentan la energía corporal baja.

Tendencias del uso de fuentes de energía favorables y adversas al clima y la salud en Chile, 2009-2010 / Sources of energy with favourable an adverse effects on climate and health: trends of their utilization in Chile, 2009-2010

Se presenta la información más reciente acerca del cambio climático y su relación con la salud humana. La evolución del tema ha sido investigada en detalle mediante el seguimiento de la prensa del período diciembre 2009 a mayo 2010, en continuación de una serie de estudios anteriores. Comprobamos que todavía no se da, ni en el mundo ni en nuestro país, un quiebre favorable de la tendencia que lleva hacia una catástrofe ambiental y sanitaria. Persiste el riesgo de la eventual construcción de centrales nucleares y de grandes represas. Sin embargo, el progreso en el conocimiento y conciencia del problema, por un lado, y el desarrollo de las tecnologías limpias y seguras de generación energética, por otro, ofrecen todavía una posibilidad de control social de los factores negativos en juego, posibilidad que reside en el campo de las políticas estatales, en las cuales es urgente que intervenga el sector de la salud. Pero la situación es muy urgente. La opinión pública chilena debe influir sobre el gobierno para que éste perfeccione y aplique los instrumentos legales y financieros de que dispone y el país desempeñe el rol que le corresponde en el concierto internacional.

This paper is based on the most up to date information on climate change and its relationship with human health. Events in this field have been followed through the news in the press, during the period December 2009 till May 2010, in continuation of a series of previous publications. We do not find a significant change, either in the world or in Chile, of the trends leading to an environmental and sanitary catastrophe. The risk of the eventual installation of nuclear power and of large dams is ever present. Nevertheless, progress regarding the awareness of the issue, on one hand, and the development of clean and safe energy generation technologies, still offer a possibility for social and political control of the negative influences at work. This possibility lies in the political system, and it is urgent that the health sector commits itself to a definite role therein. The need for action is urgent. National public opinion must act on the government so that its legal and financial instruments are applied in practice and so that the country may perform its pertinent duties in the international arena.

Salud, cambio climático y contaminación: actualización acercade las fuentes alternativas de energía en Chile / Health, climate change and environmental pollution: present status

Son indiscutibles los daños y los peligros inminentes que resultan del uso de los hidrocarburos fósiles como fuentes de electricidad y de energía para el trasporte y la industria. Sin embargo, en muchos países se proyecta una dependencia sostenida o aún creciente respecto a esas fuentes, que no sonrenovables. Los proyectos son cuantiosos en Chile. El argumento para seguir usándolas se basa en una necesidad pretendidamente insoslayable por parte de la economía. Esa no esuna verdad absoluta y su validez depende de lo que la sociedad decida.Desde siempre se han usado otras fuentes, además de la fuerza humana y animal: el calor del sol, el viento, la leña, las corrientes fl uviales y marinas, las termas. Hoy se sabe cómo adaptarlas para su empleo como alternativas suficientes para las fuentesnocivas. Los argumentos a favor de estas fuentes alternativas “de primer tipo “son: limpieza, seguridad, y que están disponibles sin costo y sin límites al interior de los países. También esta demostrada, para varias de ellas, la factibilidad tecnológica y económica, a corto plazo, de las instalaciones necesarias. Hay que tener presente que se ofrecen alternativas “de segundo tipo”, las cuales presentan serios problemas. Algunas son insegurasy generan contaminación radioactiva: las centrales nucleares. Otras destruyen permanentemente el entorno, generan gases de invernadero y presentan el peligro de catástrofes: son los grandes embalses. Y otras aún compiten por suelos necesarios para la alimentación y para la regulación ecológica, además de producir gases de invernadero, como los biocombustibles. No son alternativas convenientes, y las de gran envergadura llegarán tarde para aportar significativamente a las necesidades de la economía, en la competencia con las alternativas de “primer tipo”, particularmente si éstas son apoyadas por los gobiernos y si se cuida la efi ciencia energética...

The risks and damages that arise from the utilization of fossil fuels as sources of electricity and of energy for transport and industrial activities are now undisputable. In spite of this, many countries still have or tolerate plans for the continuing dependence on those non-renewable sources. In Chile there are many such projects. In support of this, it is argued that national economic growth absolutely requires the increased use of coal, petroleum and gas. This is not true; the validity of the argument depends on what society decides. Since time immemorial, man has utilized natural energy sources, besides his own and animal strength: the sun, wind, fi rewood, the movement of river and of sea water, termal spas. Today, we know how to harness them as suffi cient alternatives in respect to the sources that through climate change and pollution are a menace to the health of mankind and to life in general. The arguments in favour of these alternative sources “of a first type” are that they are clean, safe, inexhaustible within the frontiers of all countries. For several of them, their short term technological and economic feasibility is already a fact.At the same time we should bear in mind the availability of “second type alternatives” which present serious problems. Some of them are unsafe and generate radioactive contamination: the atomic plants; in the case of Chile they would perpetuate dependence onforeign sources of fuel. Others bring about permanent environmental destruction, generate greenhouse gases and present a real danger of catastrophic accidents: these are the great barrages for hydroelectric power. Still others compete for the soil requiredto produce food and ecological regulation, besides also producing greenhouse gases: these are the biofuels. The largest of thesefacilities take a long time to plan, fi nance and build and therefore will arrive too late make a signifi cant contribution to the economy, in competition...

Escenario de desarrollo eléctrico en Cuba considerando la opción nuclear / Scenario of electricity development in Cuba including nuclear power

El uso de electricidad en el país ha mantenido un crecimiento sostenido en los últimos años. Con los programas de la revolución energética que se realizan con vistas a elevar el nivel de vida de la población, se espera un crecimiento más acelerado en el uso de la electricidad, aun cuando se introduzca equipamiento más eficiente que el explotado actualmente. En este trabajo se analizó el incremento que tendrá el uso de la electricidad teniendo en cuenta estos programas de desarrollo y la introducción de la energía nuclear como una opción para el suministro de la misma. A partir de las opciones de desarrollo previstas en el tema energía, se estudiaron dos posibles escenarios de cubrimiento de la demanda de electricidad. El primero basa el suministro de electricidad en tecnologías fósiles y el segundo estudia la posibilidad de utilizar en el futuro reactores nucleares modulares de lecho de bolas de nueva generación. Además se incluyeron en el segundo escenario tecnologías renovables y ciclos combinados de gas. Se realizó el análisis de los resultados y se emitieron conclusiones.

The electricity use in the country has maintained a sustained growth in the last years. Due to the programs to enhance the population life being, within the energy revolution program carrying out in the country, a faster growth in the electricity use is expected; even with the introduction of more efficiency equipment. In this paper the increment in the electricity usage taking into account theses programs and the introduction of nuclear power, as an option to meet the electricity demand, were analyzed. Two supply scenarios to meet the electricity demand, which include the energy development options foreseen, were studied. In the first one the electricity supply is based on fossil fuel technologies and the second one the introduction of the new generation of Pebble Bed Modular Reactor is analized. Moreover, in the second scenario, renewable technologies and combined cycles of gas were considered. The results are analyzed, and conclusions were drawn.

Energía, clima y salud: las soluciones / Energy, climate and health

El artículo forma parte de una serie (1-5) y resume la situación general de la generación de energía en el mundo y en Chile en agosto de 2007, destacando los efectos sobre la salud y la economía. Se postula que la solución para las manifestaciones negativas, tales como el cambio climático y la contaminación, es la adopción de las fuentes limpias y desprovistas de riesgos. Los principales argumentos en contra de éstas son: alto costo y baja capacidad. Se analizan estos aspectos para la energía eólica, la geotermia, las centrales hidroeléctricas de pasada, la energía solar, la marítima y el hidrógeno. En cada caso se mencionan los costos, que hoy son abordables para las tres primeras fuentes mencionadas; y se ejemplifica su grado de expansión actual a nivel internacional y nacional. Se concluye que las objeciones no son válidas, en el futuro inmediato, para las tres fuentes aludidas. Chile es un país privilegiado por la naturaleza respecto a todas las energías limpias. Se documenta a continuación el alto grado de utilización actual y proyectada de los combustibles fósiles, de las centrales hidroeléctricas de represa y de los biocombustibles, fuente ésta cuyos aspectos negativos tienden a pasar desapercibidos. Frente al lobby a favor de la energía atómica como fuente de electricidad, se enumeran sus numerosos inconvenientes. Un paso importante dado por el gobierno de la Presidenta, Dra. M. Bachelet, ha sido la creación en Chile de un Ministerio de Energía y de un Ministerio del Medio Ambiente; otro es la presentación de un proyecto que obliga a las generadoras a producir al menos un 8 por ciento de incremento de energía a partir de medios renovables no convencionales. Se propone la formulación una política nacional de la energía que fortalezca su acción planificadora y reguladora del desarrollo futuro, creando, entre otras cosas, un Instituto de la Energía y un Fondo Nacional para las Energías Limpias y Seguras.

This paper is a part of a series (1-5) and summarizes the overall status of energy sources in the world and in Chile, as of August 2007, emphasizing their effects upon human and environmental health and upon the economy. We propose as a solution for the negative aspects, such as global warming and pollution, the adoption of those sources that are clean and free from major risks. Against them it is argued that they are expensive and that their potential for supporting economic growth is low. These aspects are analyzed in regard to eolic, geothermal, solar, and sea energy, and in respect of small hydroelectric power plants and of hydrogen. We show that the objections are not valid for the immediate and short term in regard to the first two clean sources mentioned and to small hydroelectric plants. In addition, Chile is a privileged country as far as the abundance of natural energy sources is concerned. We then document the high degree of current and projected use of fossil fuels, of large hydroelectric plants and of biofuels; the negative aspects of the latter, undetected by many, are exposed. Given the current promotion, from many quarters, of atomic energy as a source of electricity, its numerous setbacks and dangers are presented. The recent creation of the Ministries of Energy and of the Environment by Dr. Bachelet´s government are important positive steps. Another initiative is the introduction in Parliament of a bill mandating that 8 percent of the energy additional produced be derived from non traditional renewable sources. We have proposed ideas for a National Energy Policy that may strengthen the planning and regulatory roles of the Ministry, by creating, for example, a National Energy Institute and a National Fund for Clean and Safe Energy.

Energy sources for laparoscopic partial nephrectomy: critical appraisal

Laparoscopic partial nephrectomy (LPN) has emerged as a viable alternative for the conventional open nephron-sparing surgery (NSS). So far, an adequate renal parenchymal cutting and hemostasis, as well as caliceal repair remains technically challenging. Numerous investigators have developed techniques using different energy sources to simplify the technically demanding LPN. Herein we review these energy sources, discussing perceived advantages and disadvantages of each technique.

Diagnóstico y propuesta conjunta de Colegio Médico de Chile y del Colegio de Ingenieros de Chile para desarrollar una política nacional de energía que favorezca la salud, el medio ambiente y la economía nacional / Joint diagnosis and proposal of the Colegio Médico de Chile and of the Colegio de Ingenieros de Chile for a National Energy Policy in favour of human and environmental health and of economic development

Los Colegios Profesionales de Ingenieros y de Médicos de Chile convinieron en presentar este documento con información y propuestas relativas a la prevención y control de las graves consecuencias – para la salud, el ambiente, la economía y la seguridad del país – del uso continuado de fuentes energéticas contaminantes en la industria, el transporte y la generación de electricidad. Desde el punto de vista de la salud, el Colegio Médico detalla cuales son los contaminantes atmosféricos procedentes de los combustibles fósiles y la leña; y revisa sus efectos agudos y crónicos en la mortalidad ymorbilidad respiratoria, cardiovascular y por cáncer, y señala el volumen del gasto consiguiente. Se refiere alcalentamiento de la tierra y a su impacto directo sobre las personas y sobre la salud a través de la alteraciónobservada en los vectores, en la agricultura y en los desastres “naturales”. Advierte acerca del riesgo que implicaría la introducción de la energía nuclear. Desde los puntos de vista tecnológico y económico, el Colegio de Ingenieros se refiere a los costos crecientes de los combustibles, al control del mercado por privados, a la falta de previsión de estos y a los costos sumergidos de atenciones médicas, del daño a las infraestructuras, de la reducción de la competitividad, de la dependencia de suministros externos y de la vulnerabilidad de los productores nacionales. Ambos Colegios exponen los requisitos que deberían cumplir las opciones energéticas –el primero, que no sean contaminantes– y la existencia de alternativas tecnológicas viables, ya presentes en el mundo: eólica, mareomotriz, de las corrientes marinas, solar, e hidrógeno. Se describe la situación actual de ellas. Se refieren también a otras fuentes no contaminantes con menor impacto y a medidas complementarias como el ahorro de energía y la forestación. Los Colegios dirigen al gobierno, con sentido de urgencia, una propuesta basada en las energías renovables no convencionales (ERNC) y en el d...

The Chilean Engineers’ Association and the Chilean Medical Association agreed to present this paper, containing information and proposals regarding prevention and control of the serious consequences – for health, the environment, the economy and national security – of the continued utilization of polluting energy sources in industry, transport and electricity generation. From the health standpoint, the Medical Association describes the atmospheric pollutants derived from fossil fuels and firewood; and it goes over their acute and chronic effects on respiratory, circulatory and cancer mortality and morbidity; the high resulting expenditure is indicated. The “greenhouse” effect is also referred to, with the direct impact of heat on persons and the indirect health damage through changes concerning vectors, agriculture and “natural” disasters. Attention is also drawn to the risks implied by the eventual introduction of nuclear energy. From the technological and economic viewpoint, the Engineers’ Association deals with the increasing price of fossil fuels, the control of the market by private agents, the lack of foresight of these agents in the case of natural gas imports and the submerged costs such as those of medical care requirements, infrastructure damage, reduction of competitive capabilities, dependence on foreign sources and the vulnerability of national enterprises. Both Associations indicate which are the required characteristics of energy sources – above all, that they should be non-polluting – and describe the viable technological alternatives: wind power, tides, marine currents, sunlight power, and hydrogen. Their present status is analyzed. A reference is made to other clean sources of lesser potential and to complementary measures such as energy saving and forestation. The Associations, with a sense of urgency, address their proposal to the government. This is based on the development of the non-conventional renewable sources of energy (ERNC)...

Recent Advances in Surgery for Atrial Fibrillation / 영남의대학술지

Atrial fibrillation (AF) is the most common cardiac rhythm disturbance, which carries significant cardiovascular morbidity and mortality. The medical treatment for AF is cumbersome and unsatisfactory, which has highlighted the need to develop alternative treatments for AF. The recent discovery that AF is often initiated by atrial ectopic beats has resulted in treatments designed to target the ectopic sources, particularly those within the pulmonary veins. Building on the pioneering work of Cox et al., a recent reported series demonstrated the feasibility of treating patients undergoing cardiac surgery for other structural heart diseases with limited, left-atrial ablation lesion sets using alternative energy sources. As less complex modifications of the Maze procedure have been developed, a number of energy sources have been introduced to create of electrically isolating lesions within the atria. These sources have been used both endocardially in arrest heart procedures as well as epicardially in a beating heart setting. This review summarizes the recent advances in surgery for AF that will aid in the development of an effective, minimally invasive surgical procedure to cure patients with AF.