Reducción, reutilización y reciclaje: Una revisión crítica del conocimiento científico sobre las pérdidas y desperdicios de alimentos en Chile

Reducir, reutilizar y reciclar, "regla de las tres R", son estrategias que promueven una actitud responsable hacia el medioambiente y contribuyen al desarrollo sostenible. El objetivo de esta revisión fue analizar las publicaciones científicas generadas en Chile en el área de las pérdidas y desperdicios de alimentos (PDA), con enfoque en su cuantificación y basadas en "la regla de las tres R". Se realizó una búsqueda de literatura en tres bases de datos: Web of Science, Pubmed y Scopus. Los artículos originales seleccionados se clasificaron según tipo de acción, etapa de la cadena de suministro de alimentos, grupo de alimentos, cuantificación de PDA y tipo de estrategia (reducción, reutilización o reciclaje). Se encontraron 5 artículos de revisión y 31 artículos originales. La revalorización de subproductos agroindustriales fue la principal acción involucrada en los estudios de PDA (n= 22). El tipo de subproducto también fue analizado, y se encontró que los compuestos fenólicos provenientes de frutales son los más estudiados. Solo el 32% (12/31) de los artículos reportaron información sobre cuantificación de PDA. La revalorización de subproductos sumada a la recuperación de alimentos para producción de energía (n= 4) y de compostaje (n= 2) hacen que el reciclaje sea la estrategia más investigada. Estos antecedentes evidencian la necesidad de complementar la investigación nacional a nivel de acciones que apunten más hacia la reducción y reutilización de PDA y su cuantificación. Este conocimiento permitirá establecer líneas base y planes de monitoreo que contribuyan al cumplimiento de los Objetivos de Desarrollo Sostenible en Chile.

Reduce, reuse, and recycle "the 3Rs rule" are strategies that promote a responsible attitude towards the environment and contribute to sustainable development. The objective of this review was to analyze the scientific publications generated in Chile in the area of food loss and waste (FLW), with a focus on its quantification and based on "the 3Rs rule". A literature search was carried out in three databases: Web of Science, Pubmed, and Scopus. The selected original articles were classified according to the type of action, stage of the food supply chain, food group, FLW quantification, and type of strategy (reduction, reuse, or recycling). Five review articles and 31 original articles were found. The revalorization of agro-industrial by-products was the main initiative involved in the FLW studies (n= 22). The type of by-product was also analyzed, and it was found that the phenolic compounds from fruits are the most studied. Only 32% (12/31) of the articles reported information on FLW quantification. The revalorization of by-products added to food recovery for energy production (n= 4) and composting (n= 2) make recycling the most researched strategy. These antecedents show the need to complement the national research at the level of actions that point more towards reducing and reusing of FLW and its quantification. This knowledge will allow the establishment of baselines and monitoring plans that contribute to the fulfillment of the Sustainable Development Goals in Chile.

Financiamiento del sistema de salud colombiano: Tendencias y desafíos / Financing of the Colombian health system: Trends and challenges

RESUMEN El financiamiento es una función fundamental que contribuye al propósito que tienen los sistemas de salud de mejorar el estado de salud de la población. Esta función se concreta en la recaudación de fondos, su mancomunación y asignación, y en ella se diferencian las fuentes y los usos de los recursos, especialmente en cuanto al carácter público o privado y a la forma como se cubren los costos de los servicios de salud. En este artículo se presenta una mirada de largo plazo sobre el financiamiento de la salud en Colombia, identificando los antecedentes y la evolución a partir de la reforma de 1993. Se identifican cuatro momentos en esta evolución: I. incremento significativo de recursos, al momento de expedir las Leyes 60 y 100 de 1993; II. contención fiscal, en el marco de la crisis de 1998 y 1999; III. mayor esfuerzo fiscal, especialmente a partir de 2010, y IV. sustitución de fuentes, de cotizaciones a impuestos generales, que se inició en 2012. Se evidencia un desarrollo importante de la función de financiamiento, con un fortalecimiento a partir de la Administradora de los Recursos del Sistema (ADRES), la reducción en la dependencia de las cotizaciones, el proceso de igualación per cápita entre regímenes de aseguramiento, y un mayor aporte de impuestos generales para buscar el equilibrio del sistema. Todo ello implica mantener el predominio público y garantizar la protección financiera en salud.

ABSTRACT Financing is a fundamental function that contributes to the purpose of health systems to improve the health status of the population. This function takes the form of fundraising, pooling and allocation, and it differentiates the sources and uses of resources, especially in terms of their public or private nature and the way in which health costs are covered. This article presents a long-term view of health financing in Colombia, identifying the background and evolution since the 1993 reform. Four moments in this evolution are identified: I. significant increase in resources, at the time of issuing Laws 60 and 100 of 1993; II. fiscal containment, in the context of the 1998 and 1999 crisis; IV. greater fiscal effort, especially since 2010, and V. substitution of sources, from contributions to general taxes, which began in 2012. An important development of the financing function is evident, with a strengthening of the System's Resources Administrator (ADRES), a reduction in the dependence on contributions, the process of equalization of the capita among insurance regimes, and a greater contribution of general taxes to seek the balance of the system, all of which implies maintaining public predominance and guaranteeing financial protection in health.

Postmortem Distribution and Postmortem Redistribution of Carbofuran-7-Phenyl Glucuronic Acid in Rabbits / 法医学杂志

OBJECTIVES@#To establish a carbofuran intragastric administration death model in rabbits, and to observe the postmortem distribution and postmortem redistribution of carbofuran-7-phenyl glucuronic acid (Glu-7PH) in rabbits.@*METHODS@#The postmortem distribution: Rabbits were given an administration of 1/2LD50, LD50, 2LD50 carbofuran. Dead rabbits were dissected immediately. Rabbits that had remained alive 2 hours were sacrificed by carbon dioxide (CO2) inhalation and dissected immediately. The myocardium, cardiac blood, liver, spleen, lung, kidney, brain and right hindlimb muscle were collected. The postmortem redistribution: After giving an administration of 4LD50 carbofuran, the myocardium, cardiac blood, liver, spleen, lung, kidney, brain, and right hindlimb muscle were collected at 0, 12, 24, 48, and 72 h postmortem in supine position at 15 ℃ room temperature. The quantity of Glu-7PH was determined by LC-MS/MS.@*RESULTS@#The postmortem distribution: Among the three dose groups, there were significant differences in the quantities of Glu-7PH in different tissues. The postmortem redistribution: There was no significant difference in the Glu-7PH quantities in cardiac blood, mycardium, spleen, kidney, brain and right hindlimb muscle, but there was a significant difference in the Glu-7PH quantities in the liver and lung.@*CONCLUSIONS@#The mycardium, cardiac blood, liver, lung, kidney, brain and hindlimb muscle of rabbits can be used as appropriate samples for Glu-7PH detection. However, it should be noted that Glu-7PH was redistributed postmortem in rabbit liver and lung.

Exo70 intracellular redistribution after repeated mild traumatic brain injury

BACKGROUND: Exo70 is a subunit of the greater exocyst complex, a collection of proteins that oversees cellular membrane addition and polarized exocytosis by acting as a tethering intermediate between the plasma membrane and newly synthesized secretory vesicles. Although Exo70 function has been implicated in several developmental events including cytokinesis and the establishment of cell polarity, its role in neuropathologies is poorly understood. On the other hand, traumatic brain injury is the result of mechanical external force including contusion, fast acceleration, and expansive waves that produce temporal or permanent cognitive damage and triggers physical and psychosocial alterations including headache, memory problems, attention deficits, difficulty thinking, mood swings, and frustration. Traumatic brain injury is a critical health problem on a global scale, constituting a major cause of deaths and disability among young adults. Trauma-related cellular damage includes redistribution of N-methyl-D-aspartate receptors outside of the synaptic compartment triggering detrimental effects to neurons. The exocyst has been related to glutamate receptor constitutive trafficking/delivery towards synapse as well. This work examines whether the exocyst complex subunit Exo70 participates in traumatic brain injury and if it is redistributed among subcellular compartments RESULTS: Our analysis shows that Exo70 expression is not altered upon injury induction. By using subcellular fractionation, we determined that Exo70 is redistributed from microsomes fraction into the synaptic compartment after brain trauma. In the synaptic compartment, we also show that the exocyst complex assembly and its interaction with GluN2B are increased. Finally, we show that the Exo70 pool that is redistributed comes from the plasma membrane. CONCLUSIONS: The present findings position Exo70 in the group of proteins that could modulate GluN2B synaptic availability in acute neuropathology like a traumatic brain injury. By acting as a nucleator factor, Exo70 is capable of redirecting the ensembled complex into the synapse. We suggest that this redistribution is part of a compensatory mechanism by which Exo70 is able to maintain GluN2B partially on synapses. Hence, reducing the detrimental effects associated with TBI pathophysiology.

The 4Rs in radiation therapy / 中华放射医学与防护杂志

It has been realized that the 4Rs (repair,repopulation,redistribution,and reoxygenation) would affect the result of cell irradiation,and thus radiation treatment.The 4Rs each occurs at different dose rates,usually very low dose rates.Depending on the dose rate used for treatment,the corresponding R should be included in the linear-quadratic equation (LQ) and biological effective dose (BED) calculation.For low dose rate brachytherapy(LDR) especially permanent implant,all the 4Rs should be included in LQ for BED calculation.The 4Rs,especially repair and repopulation,play a critical role in dose fractionation.Various dose fractionation schemes such as hyperfractionation and hypofractionation are determined in consideration of the 4Rs.Stereotactic radiation therapy uses hypofractionation with high fractional doses and combine with high accuracy target localization techniques to achieve high local control rates compared to conventional dose fractionation schemes.The 4Rs have been taken into account for LDR and permanent implant.Recently,LQ for permanent implant brachytherapy has been modified to include all the 4Rs for gynecological malignancy 131Cs permanent implants.Including the 4Rs in radiation therapy has significantly improved the effectiveness and efficiency of radiation therapy for cancer treatment.

Postmortem Redistribution of Avermectin in Acute Poisoning death of Rabitts / 中国法医学杂志

Objective To investigate the postmortem redistribution of Avermectin in acute poisoning death of rabitts. Methods According to the minimum lethal dose intragastric of 250mg/kg avermectin, the avermectin contents in the heart blood and major organs and tissues of the rabitts after death of 0h~72h were assayed by HPLC method. Results Determination of clinical death time was 120.6±9.2min(x±s, n=10)by intragastric 250mg/kg avermectin to the rabitts; Lethal blood concentrations and lethal tissue concentrations of Avermectin were determined; Presence of postmortem redistribution of avermectin contents in the heart blood and major organs and tissues of the rabitts after death of 0h~72h were proved; Determination of the liver, kidney and lung were the best tissue samples for toxicological anaysis. Conclusion The data of Avermectin postmortem redistribution in the rabbits have important reference value for the forensic management of such cases.

The Effect of RGP Lens and Reverse Geometry Lens on Redistribution of Corneal Epithelial Cell in Rabbit

PURPOSE: To investigate the migration and redistribution of rabbit corneal epithelial cells when wearing reverse geometry lens (RGL) or rigid gas permeable lens (RGP). METHODS: In 30 rabbits, the right eyes were fitted with either RGL or RGP and the left eyes were untreated to serve as controls. The rabbits were sacrificed at 1, 3, 7, 10 and 14 days after lens fitting. The central and peripheral corneal thicknesses were measured by microscope and the ratio of right to left corneal thickness was calculated to evaluate the characteristics of change over time. By using the molecular probe 7-nitrobenz-2-ox-1,3-diazolylphallacidin (NBD phallacidin), the samples were examined with light microscope to determine the migration and redistribution of epithelial cells in the rabbit cornea. RESULTS: No consistent changes in the thickness of both central and peripheral corneal epithelium were found. The corneal epithelial cells of both eyes with RGL and RGP reacted positively to NBD phallacidin. The fluorescence was most increased at day 3 of sacrifice in RGL cases and at day 7 in RGP cases, and then decreased in both cases. The corneal epithelium of eyes with RGL exhibited marked increase in the intensity of fluorescence compared to the eyes with RGP. CONCLUSIONS: The corneal epithelium with RGL showed the strongest intensity of NBD phallacidin fluorescence. This result suggests that wearing RGL may induce the migration and redistribution of corneal epithelial cells.

Autogenous orbital septum fat redistrbution in correction of sunken upper eyelid / 中华医学美学美容杂志

Objective To study the effect and methods of orbital septum fat redistribution or autogenous orbital septum granular fat transplantation methods on upper eyelid depression.Methods Blepharoplasty incision was used to cut open musculus orbicularis oculi and septum orbitale horizontally,exposuring orbital fat,the conjunction was relieved between orbit fat envelope and septum orbitale,displaced orbital fat was extended and replaced to the depression region of upper eyelid,and the wound was routinely sutured.For orbital septum fat volume depletion,appropriate amount of granular fat was injected into depression region and put fat backward upto supraorbital margin.Then,resetting orbital septum and closing incision were conducted with suture technique of blepharoplasty.Results Of 48 cases (96 eyes),32 cases was followed-up for 6 to 42 months with mean of 11 months.All cases got ideal outcomes,with smooth and symmetry lid folds,depression of upper eyelid were fixed and no complication occurred.Conclusions Orbital septum fat redistribution or autogenous orbital septum granular fat transplantation can anatomically reduce the fat distribution of upper eyelid.This method is easy and effective to improve the appearance of eyelid.

Redistribuição postmortem de barbitúricos em tecidos biológicos humanos / Postmortem redistribution of barbiturates in human biological tissues

Os barbitúricos são fármacos com atividade depressora do sistema nervoso central e estão relacionados com elevados números de casos de intoxicações e uso não-médico em vários países. No Brasil, a droga antiepiléptica mais encontrada em casos de intoxicação é o fenobarbital, pois os pacientes relatam que "essa é uma substância com ação forte no cérebro". De fato, os barbitúricos estão altamente relacionados com tentativa de suicídio e homicídio. Nesses casos existe a necessidade da quantificação dessas substâncias para correlacionar com a causa mortis. No entanto, as análises toxicológicas postmortem são de difícil execução e interpretação, pois a concentração de agentes tóxicos encontrados é bastante complexa e afetada não só pela condição de deterioração do corpo, mas também por um processo conhecido como redistribuição postmortem. Em geral, concentrações mais elevadas são encontradas no sangue situado nos sítios centrais (como o sangue coletado da cavidade cardíaca) em comparação aos níveis verificados nos vasos periféricos (como a veia femoral). Em outros casos, o tempo entre a morte e o exame postmortem é suficiente para que algumas substâncias que normalmente estariam presentes no sangue não estejam mais disponíveis neste fluido biológico. Há ainda um agravante, pois não existem valores de referências para a maioria das amostras biológicas não-convencionais, dificultando assim a interpretação dos resultados. Os exames toxicológicos devem ser realizados em amostras biológicas e tem como objetivo a avaliação da intoxicação como circunstância qualificadora do delito, como causa de periculosidade ou imputabilidade. O objetivo deste trabalho foi o desenvolvimento e aplicação de métodos de identificação de barbitúricos (butalbital, secobarbital, pentobarbital e fenobarbital) em amostras postmortem (sangue cardíaco, sangue femoral e fígado). Os analitos foram extraídos das amostras utilizando a micro extração em fase líquida (LPME), identificados...

Barbiturates are a class of drugs that act as central nervous system depressant and are associated with high numbers of poisoning cases and non-medical use in several countries. In Brazil, phenobarbital is the most related antiepileptic drug involved in intoxication cases. Patients report that "this drug is a substance with strong action in the brain." In fact, barbiturates are highly related to attempted suicide and homicide cases, in which quantification of these substances to correlate with the possible cause of death is necessary. However, postmortem toxicological analyses are difficult to perform and interpret, because the concentration of toxic agents found is quite complex and affected not only by deterioration condition of the body but also by a process known as postmortem redistribution. In general, higher concentrations are found in the blood located in central sites (e.g. heart cavity) compared with the levels found in peripheral vessels (such as the femoral vein). In other cases, the time between death and postmortem examination is enough for some substances that would normally be present in the blood are no longer available in this biological fluid. Besides, there are few reference values for most non-conventional biological samples, making it difficult to interpret the results. The objective of this work was the development and application of methods for identification of barbiturates (butalbital, secobarbital, pentobarbital and phenobarbital) in postmortem samples (heart blood, femoral blood and liver). The analytes were extracted by using liquid-phase micro extraction (LPME) and quantified by gas chromatography-mass spectrometry (GC-MS). After the development and validation, analytical methods were applied in real cases of eleven corpses autopsied by Death Verification Service of São Paulo City (USP-SVO), with suspected of barbiturates involvement. Nine cases were positive for phenobarbital. The mean ratio of blood femoral / cardiac blood was...

Rapid Spontaneous Reduction of a Huge Intracerebral Hematoma

Rapid reduction of a large acute subdural hematoma has been frequently reported. In my knowledge, however, it was rarely reported that rapid spontaneous reduction occurred in large volume of spontaneous intracerebral hematoma (sICH). We describe a patient with a rapid spontaneous decrease in the volume of a large hematoma. A 73-year-old man presented semi-comatose mentality. Initial brain computed tomography (CT) revealed the huge sICH. An emergency operation was planned, but was not performed due to the refusal of patient's family. Therefore, we decided to treat with conservative therapy. However, follow-up brain CT 16 hours after initial scan showed a remarkable reduction of previous sICH. The mechanism involving the spontaneous rapid decrease of the hematoma is presumed to occur through redistribution in brain atrophy, compression effect from the increased intracranial pressure and dilution through a wash out by the cerebrospinal fluid.

Welfare state e desenvolvimento / Welfare state and development / Welfare state et développement

The relations between the welfare state and development are frequently portrayed as problematic and even dilemmatic. For example, it is claimed that the welfare state is only possible in developed countries, or that typical welfare state redistribution is necessarily accompanied by weaker economic growth. The main purpose of this article is to systematize the arguments and evidence against these assumptions, featuring the functionality of the welfare state for development in both economic and non-economic terms.

Souvent, les rapports entre l'État du État-providence et le développement sont décrits comme source de problèmes et même de dilemmes. On présume, par exemple, que l'État du État-providence n'est possible que dans des pays développés, ou alors que la redistribution propre à l'Etat-providence a pour contrepartie une croissance économique moindre. Dans cet article, on cherche à réunir des arguments et justifications contraires à ces suppositions. Comme, par exemple, une démonstration sur la fonctionnalité de l'État-providence en faveur du développement, dans le sens économique et non-économique du terme.

Redistribuição da cocaína e sua influência na neuroquímica post mortem / Cocaine redistribution and their implication in post mortem neurochemistry

A interpretação dos achados laboratoriais no estabelecimento da causa mortis consiste na integração dos conhecimentos sobre a toxicocinética e toxicodinâmica do agente, conhecimentos de sua redistribuição post mortem (RPM) e achados necroscópicos que possibilitem o nexo causal entre o toxicante e o efeito letal. Neste sentido, é importante considerar que somente as concentrações de cocaína (COC) e seus metabólitos podem não ser determinantes na interpretação da causa de morte, podendo ser útil o cotejamento com outros parâmetros, como os níveis de neurotrasmissores que representem o mecanismo de ação do fármaco. Assim, este trabalho teve por objetivo investigar a RPM da COC e seu metabólito benzoilecgonina (BE) em três segmentos do tecido encefálico (TE), no humor vítreo (HV) e sangue (SG), bem como determinar as concentrações de catecolaminas e indolaminas no encéfalo para avaliar a aplicação da neuroquímica post mortem (NPM) na toxicologia forense. No estudo de RPM foram quantificados os níveis de COC e BE em três segmentos do TE (córtex frontal, núcleos da base e cerebelo), no HV e no SG através de método por cromatografia líquida de alta eficiência (HPLC) acoplada ao detector de arranjo de diodos. Os estudos de neuroquímica foram realizados empregando-se HPLC acoplada ao detector eletroquímico. Os resultados indicaram que as concentrações médias de COC foram maiores no TE, seguido por SG e HV (3,09, 2,92 e 1,71 µg/mL, respectivamente), enquanto para BE foram maiores em SG, seguido por HV e TE (6,12, 1,39 e 0,87 µg/mL, respectivamente). As concentrações de COC se apresentaram distribuídas uniformemente nos três segmentos de TE e apresentaram alta correlação com o HV. Adicionalmente, a média de concentrações de dopamina total foi maior no grupo de indivíduos com amostras positivas para COC, sendo verificado diferença significativa entre este grupo e o de indivíduos com amostras negativas para o fármaco de interesse. Os resultados demostraram que o estudo...

In case of intoxication, the interpretation of analytical results to assess the cause and process of death requires knowledge about toxicokinetics, toxicodynamic, postmortem redistribution, and autopsy elements. Cocaine-related deaths occur mainly after prolonged drugs use and the presence of cocaine (COC) in fluids or tissues does not prove that death was due to COC consumption, and the interpretation of postmortem concentrations is even more complicated than attempts at making such correlations in the living. The objectives of this study were to investigate the post mortem redistribution (PMR) of COC and its metabolite benzoylecgonine (BE) in three segments of brain (frontal cortex, base nucleous, and cerebellum), vitreous humor, and blood. In additional, catecholamines and indolamines were quantified in brain in order to evaluate the usefulness of post mortem neurochemistry (PMN) in forensic toxicology. In PMR studies were quantified the COC and BE levels in three brain (BR) segments, in vitreous humor (VH), and blood (BL) by High Performance Liquid Chromatography (HPLC) with diode array detection, and for neurochemistry studies the neurotransmitters were quantified by HPLC with electrochemical detection. A homogenous distribution of COC and BE within frontal cortex, base nucleous, and cerebellum was found. The COC media concentrations were 3.09, 2.92 e 1.71µg/mL in BR, BL and VH, respectively, and the BE media concentrations were 6.12, 1.39 e 0.87 µg/mL in BL, VH, and BR, respectively. The COC concentrations in VH show high correlation with brain. The media total dopamine concentration was significant higher in COC positive group. These findings suggest that the studies of PMR and PMN by neurotransmitters levels may be useful to assess the cause and process of death.

Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction / 핵의학분자영상

PURPOSE: This study was performed to investigate the clinical significance of reverse redistribution (RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography (SPECT) in patients with acute myocardial infarction after revascularization. MATERIALS AND METHODS: A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography (CAG) were performed 9 months later. RESULTS: On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments (31%) and in 43 patients (64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR (p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR (p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. CONCLUSIONS: In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium.

Rapid Spontaneous Redistribution of Acute Epidural Hematoma : Case Report and Literature Review

Acute epidural hematoma (AEDH) occurring as a result of traumatic head injury constitutes one of the most critical emergencies in neurosurgery. However, there are only several reports that show the rapid disappearance of AEDH without surgical intervention. We suggest redistribution of hematoma through the overlying skull fractures as the mechanism of rapid disappearance of AEDH. A 13-year-old female fell from a height of about 2 m and presented with mild headache. A computed tomography (CT) scan performed 4 hours after the injury revealed an AEDH with an overlying fracture in the right temporal region and acute small hemorrhagic contusion in the left frontal region. A repeat CT scan 16 hours after injury revealed that the AEDH had almost completely disappeared and showed an increase in the epicranial hematoma. The patient was discharged 10 days after injury with no neurological deficits. This case is characterized by the rapid disappearance of an AEDH associated with an overlying skull fracture. We believe that the rapid disappearance of the AEDH is due to the redistribution of the hematoma, rather than its resolution or absorption, and fracture plays a key role in this process.

ONGs, vulnerabilidade juvenil e reconhecimento cultural: eficácia simbólica e dilemas / ONGS, vulnerabilidad juvenil y reconcimiento cultural: eficacia simbólica y delemas / NGOs, juvenile vulnerability and cultural recognition: symbolic efficacy and dilemmas

A busca pelo reconhecimento cultural como estratégia no enfrentamento da vulnerabilidade entre jovens tornou-se predominante entre as ONGs (organizações não governamentais) brasileiras. Após dez anos de crescimento desta forma de ação, analisamos sua eficácia simbólica e seus dilemas. O artigo debate, inicialmente, conceitos e práticas envolvidas nesse cenário. Em seguida, volta-se para o campo das ONGs brasileiras que atuam com jovens em situação de vulnerabilidade, por meio de atividades artísticas e culturais, com o intuito de reconhecer os elementos simbólicos presentes neste contexto. Apresenta-se, ainda, um estudo de caso sobre a experiência de uma delas e destaca-se um dilema comum às ações das ONGs no enfrentamento da vulnerabilidade juvenil: o de conciliar as ações de caráter cultural que valorizam o repertório particular dos jovens de classes populares com a viabilização do acesso a estruturas e recursos básicos dos quais estão afastados.

The search for cultural recognition, as a strategy for confronting vulnerability among adolescents, has become predominant among Brazilian NGOs (non-governmental organizations). After ten years of growth of this form of action, we seek to analyze its symbolic efficacy and its dilemmas. This article starts by discussing the concepts and practices involved in this scenario. It then turns to the field of Brazilian NGOs operating among adolescents in vulnerable situations through artistic and cultural activities, aiming to recognize the symbolic elements within this context. Furthermore, it presents a case study that observes the experience of an NGO. This article highlights a dilemma common to NGO actions dealing with juvenile vulnerability: how to reconcile actions of a cultural nature aimed at strengthening the private repertoire among working-class adolescents with enablement of access to the structures and basic resources from which they are distanced.

La búsqueda por el reconocimento cultural como estrategia en la confrontación de la vulnerabilidad entre jóvenes se hizo predominante las ONGS (organizaciones no gubernamentales) brasileñas. Después de die anõs de crecimiento de esta maneira de acción buscamos analizar su eficacia simbólica y sus dilemas. El artículo debate, inicialmente, conceptos y prácticas comprendidas en este escenario. En seguida, se vuelve para el campo de las ONGS brasileñas que actúan con jóvenes en situación de vulnerabilidad a través de actividades artísticas y culturales, con la intención de reconocer los elementos simbólicos presientes artísticas y culturares, con la intención de reconocer los elementos simbólicos presientes en el contexto estudiado. Se presenta tambíen un estudio de caso que observa la experiencia de una organización no gubernamental. El artículo destaca un dilema común a las acciones de las ONGS en el enfrentamiento de la vulnerabilidad juvenil, cual sea, conciliar las acciones de carácter cultural que tienen por objeto la valorización del repertorio particular de los jóvenes de clases populares con la viabilidad del acceso a estructuras y recursos básicos de los cuales están alejados.

Defect of 18F-FDG Uptake Observed in Infarcted Myocardium Showing Reverse Redistribution on Rest / 24-Hour Delayed 201Tl Myocardial SPECT after Acute Myocardial Infarction / 핵의학분자영상

Reverse redistribution is frequently observed after revascularization in acute myocardial infarction, and usually regarded as a predictor of viable myocardium on stress/rest and 2- to 4-hour redistribution 201Tl SPECT. However, there is not enough report of reverse redistribution in case of 24-hour delayed SPECT, which is commonly used for viability assessment. In this report, a case of reverse redistribution on rest and 24-hour delayed 201Tl SPECT is reported with use of automatic segmental quantitative analysis. The myocardium of reverse redistribution was dysfunctional on gated SPECT, and diagnosed as non-viable on 18F-FDG PET.

Effects of Whole Body Warm Water Immersion on Indocyanine Green (ICG) Excretion Test in Healthy Human / 日本温泉気候物理医学会雑誌

Objective: Warm water immeresion (WWI) has been customary in Japan as useful thermal therapy. However, a comprehensive investigation of the effects of WWI on internal organs has never been undertaken. The purpose of this study was to examine the effects of single WWI on indocyanine green (ICG) excretion in healthy humans. Subjects: 23 healthy males. (32.6±1.9 [mean±SEM] years) Methods: 1CG was administered intravenously (0.5mg/kg) to calculate excretion rate (ER). ICG injection was given before and after WWI (10min at 41°C). Sublingual temperature (ST), blood pressure (BP), heart rate (HR), and cardiac output (CO) were simultaneously measured by noninvasive methods. Results: Significant changes were observed after WWI. These included an increase in ST, HR, and CO and a decrease in systolic BP (p<0.01). ER significantly decreased from 0.210±0.015 to 0.168±0.009 (p<0.01). Front-back ratio of ICG-ER which was calculated in order to evaluate the effect of aging increased significantly with age (R=0.582, p<0.0001). Conclusion: These results indicate that although CO increased due to the vasodilating effects of WWI, hepatic blood flow decreased after WWI and its response reduced with age even in before middle age.

Effects of Ventilation/Perfusion of BLVR in an Experimental Canine Model of COPD / 医学研究杂志

Objective We generated an experimental canine model of heterogeneous emphysema.The dogs subsequently underwent unilateral bronchoscopic lung volume reduction(BLVR).Observing the postoperative condition of ventilation/perfusion,blood gas analysis,respiratory dynamics,hemodynamic measurement,HRCT and radiologic outcomes,compared with the preoperative level,the correlative mechanism and the effects of BLVR were analyzed.Methods There were 15 healthy dogs that were treated samely with localized papain instillations under bronchoscopic guidance to generate heterogeneous emphysema.The right dorsal lobe was selected as the target area.All dogs were divided into 3 groups randomly.Group A was control group;Group B and Group C received BLVR 6 weeks later while group A was raised as the same way.Group B underwent endobronchial valve insertion(EVI);Group C underwent bronchial blocking with albumin gel.Measurements were made in each animal at 3 time points:prior to papain exposure(base-line),after establishment of emphysema(6 weeks later),6 weeks after BLVR.Data included blood gas analysis(PaO2,PaCO2),respiratory dynamics(respiratory peak pressure,lung compliance),hemodynamic measurement(pulmonary artery pressure,pulmonary capillary vessel wedge pressure),nuclear ventilation/perfusion scan(CTS,CTS/PIX).Dogs were euthanized at 6-week time point followed by autopsy.The data was statistically managed and compared.Results After development of emphysema,all dogs exhibitted aggravation in PaO2,PaCO2,PAP and lung compliance(P0.05).Through ventilation/perfusion scan,CTS/PIX of the target areas reduced(P

Comparison of the Effects of Etomidate and Propofol on Redistribution Hypothermia during General Anesthesia / 대한마취과학회지

BACKGROUND: Redistribution hypothermia can be modified by the effects of induction anesthesia on the systemic vascular resistance. This study compared the effects of etomidate and propofol on redistribution hypothermia during general anesthesia. METHODS: Forty patients were randomly allocated into one of two groups, based on the induction agent used: Group E (n = 20) received 0.2 mg/kg of etomidate and group P (n = 20) received 2.5 mg/kg propofol. After intubation, anesthesia was maintained with sevoflurane and 50% nitrous oxide in oxygen in both groups. The core and peripheral temperatures were measured, and the peripheral temperature gradients (forearm minus fingertip) were used as an index of an arteriovenous shunt. RESULTS: The patients in both groups demonstrated intense vasoconstriction prior to the induction of anesthesia with similar skin-temperature gradients. After induction, group P showed more rapid and significant vasodilation than group E (P = 0.02). The difference in vasodilation between the two groups disappeared from 5 minutes after intubation. The pre-induction core temperatures were similar in both groups. After induction, the core temperatures in group P were consistently lower than those in group E (P < 0.01). The core temperatures during the first hour of anesthesia decreased by 1.5 +/- 0.4 degrees C in group P but only by 0.9 +/- 0.4 degrees C in group E. Conclusions: Propofol caused more rapid and aggravated redistribution hypothermia during surgery than etomidate due to the earlier arteriovenous shunt vasodilation.

Effects of Low Dose Propofol on Core and Peripheral Temperatures during Spinal Anesthesia / 대한마취과학회지

BACKGROUND: Core hypothermia during the first hour after induction of anesthesia results primarily from a redistribution of body heat. Propofol in low doses provides reliable sedation and is associated with fast recovery. However, propofol-induced peripheral vasodilation is likely to facilitate core-to-peripheral heat redistribution. This study was designed to evaluate the effects of low dose propofol on core and peripheral temperatures during spinal anesthesia. METHODS: Fifty patients of ASA status I or II, aged 20 to 60, undergoing lower extremity surgery under spinal anesthesia were studied. Spinal anesthesia was administered to all patients, who were assigned sedation as follows: 1) control (n = 25), 2) propofol (n = 25); propofol infusion rates were, 8 mg/kg/h for the first 3 min, 4 mg/kg/h for the next 10 min, and 2 mg/kg/h for the next 15 min. Temperatures were recorded after beginning surgery at 5-min intervals for 30 min. RESULTS: Core temperature was significantly decreased after 15, 20, 30 min of surgery in the propofol group, and this result was statistically different between the two groups. Forearm skin temperature decreased in the control group and increased in the propofol group, without significance. Fingertip skin temperature did not changed significantly in the control group, but increased significantly after 15 min in the propofol group and continued to increasing to 30 min. Forearm minus finger skin temperature gradients were not changed significantly in control group, but decreased between 5 and 30 min in the propofol group, which was statistically significant. CONCLUSIONS: Low dose propofol may induce a degree of hypothermia during spinal anesthesia. Close monitoring is needed to prevent core hypothermia, if sedation is induced using propofol during spinal anesthesia.