Payment for ecosystem services (PES): a holistic tool for sustainable forest management-a case study from Pakistan / Pagamento por serviços ecossistêmicos (PES): uma ferramenta holística para o manejo florestal sustentável: um estudo de caso do Paquistão

Economic valuation of ecosystem services is a new concept in forest management. Economic valuation provides basis for payment for ecosystem services (PES). Therefore, objective of this study was to evaluate eco-tourism and carbon stock services of the Maindam valley, District Swat, Pakistan. For the carbon stock calculation, a sample size of 155 plots of 0.1 hectare (Ha) was taken using preliminary survey at 95% confidence interval and 10% allowable error. The data for tourism services was collected from owners of all the hotels, 100 tourists and key informants of the area at 10% sampling intensity on pretested questionnaire for twenty years period (1997-2017). Results showed that Miandam valley has carbon stock worth US$ 16,306,000 while the value of eco-tourism was US$ 1,578,458 on annual basis. The results also showed that trend of tourism has drastically declined after the 9/11 incident for foreigners and locals and the situation was further deteriorated during the era of Talibanization or militancy from 2008-2011. This study recommends implementation of PES strategy at the rate of 5%, thus a total of US$ 78,922 can be earned from eco-tourism and carbon crediting in the study area annually, which could play important role in sustainable forest management.

A valoração econômica dos serviços ecossistêmicos é um novo conceito no manejo florestal. A avaliação econômica fornece base para o pagamento por serviços ecossistêmicos (PES). Portanto, o objetivo deste estudo foi avaliar o ecoturismo e os serviços de estoque de carbono do vale de Miandam, distrito Swat, Paquistão. Para o cálculo do estoque de carbono, um tamanho de amostra de 155 parcelas de 0,1 hectare (ha) foi tirado, usando pesquisa preliminar com intervalo de confiança de 95% e erro admissível de 10%. Os dados para serviços de turismo foram coletados de proprietários de todos os hotéis, 100 turistas e informantes-chave da área em 10% de intensidade de amostragem em questionário pré-testado para um período de 20 anos (1997-2017). Os resultados mostraram que o vale de Miandam tem estoque de carbono no valor de US$ 16.306.000, enquanto o valor do ecoturismo foi de US$ 1.578.458 anualmente. Os resultados também mostraram que a tendência do turismo diminuiu drasticamente para estrangeiros e locais após o incidente de 11 de Setembro, e a situação se agravou ainda mais durante a era da talibanização ou militância de 2008-2011. Este estudo recomenda a implementação da estratégia de PES na taxa de 5%, portanto um total de US$ 78.922 pode ser ganho com ecoturismo e crédito de carbono na área de estudo anualmente, o que pode desempenhar um papel importante no manejo florestal sustentável.

Payment for ecosystem services (PES): a holistic tool for sustainable forest management-a case study from Pakistan

Abstract Economic valuation of ecosystem services is a new concept in forest management. Economic valuation provides basis for payment for ecosystem services (PES). Therefore, objective of this study was to evaluate eco-tourism and carbon stock services of the Maindam valley, District Swat, Pakistan. For the carbon stock calculation, a sample size of 155 plots of 0.1 hectare (Ha) was taken using preliminary survey at 95% confidence interval and 10% allowable error. The data for tourism services was collected from owners of all the hotels, 100 tourists and key informants of the area at 10% sampling intensity on pretested questionnaire for twenty years period (1997-2017). Results showed that Miandam valley has carbon stock worth US$ 16,306,000 while the value of eco-tourism was US$ 1,578,458 on annual basis. The results also showed that trend of tourism has drastically declined after the 9/11 incident for foreigners and locals and the situation was further deteriorated during the era of Talibanization or militancy from 2008-2011. This study recommends implementation of PES strategy at the rate of 5%, thus a total of US$ 78,922 can be earned from eco-tourism and carbon crediting in the study area annually, which could play important role in sustainable forest management.

Resumo A valoração econômica dos serviços ecossistêmicos é um novo conceito no manejo florestal. A avaliação econômica fornece base para o pagamento por serviços ecossistêmicos (PES). Portanto, o objetivo deste estudo foi avaliar o ecoturismo e os serviços de estoque de carbono do vale de Miandam, distrito Swat, Paquistão. Para o cálculo do estoque de carbono, um tamanho de amostra de 155 parcelas de 0,1 hectare (ha) foi tirado, usando pesquisa preliminar com intervalo de confiança de 95% e erro admissível de 10%. Os dados para serviços de turismo foram coletados de proprietários de todos os hotéis, 100 turistas e informantes-chave da área em 10% de intensidade de amostragem em questionário pré-testado para um período de 20 anos (1997-2017). Os resultados mostraram que o vale de Miandam tem estoque de carbono no valor de US$ 16.306.000, enquanto o valor do ecoturismo foi de US$ 1.578.458 anualmente. Os resultados também mostraram que a tendência do turismo diminuiu drasticamente para estrangeiros e locais após o incidente de 11 de Setembro, e a situação se agravou ainda mais durante a era da talibanização ou militância de 2008-2011. Este estudo recomenda a implementação da estratégia de PES na taxa de 5%, portanto um total de US$ 78.922 pode ser ganho com ecoturismo e crédito de carbono na área de estudo anualmente, o que pode desempenhar um papel importante no manejo florestal sustentável.

Payment for ecosystem services (PES): a holistic tool for sustainable forest management-a case study from Pakistan / Pagamento por serviços ecossistêmicos (PES): uma ferramenta holística para o manejo florestal sustentável: um estudo de caso do Paquistão

Abstract Economic valuation of ecosystem services is a new concept in forest management. Economic valuation provides basis for payment for ecosystem services (PES). Therefore, objective of this study was to evaluate eco-tourism and carbon stock services of the Maindam valley, District Swat, Pakistan. For the carbon stock calculation, a sample size of 155 plots of 0.1 hectare (Ha) was taken using preliminary survey at 95% confidence interval and 10% allowable error. The data for tourism services was collected from owners of all the hotels, 100 tourists and key informants of the area at 10% sampling intensity on pretested questionnaire for twenty years period (1997-2017). Results showed that Miandam valley has carbon stock worth US$ 16,306,000 while the value of eco-tourism was US$ 1,578,458 on annual basis. The results also showed that trend of tourism has drastically declined after the 9/11 incident for foreigners and locals and the situation was further deteriorated during the era of Talibanization or militancy from 2008-2011. This study recommends implementation of PES strategy at the rate of 5%, thus a total of US$ 78,922 can be earned from eco-tourism and carbon crediting in the study area annually, which could play important role in sustainable forest management.

Resumo A valoração econômica dos serviços ecossistêmicos é um novo conceito no manejo florestal. A avaliação econômica fornece base para o pagamento por serviços ecossistêmicos (PES). Portanto, o objetivo deste estudo foi avaliar o ecoturismo e os serviços de estoque de carbono do vale de Miandam, distrito Swat, Paquistão. Para o cálculo do estoque de carbono, um tamanho de amostra de 155 parcelas de 0,1 hectare (ha) foi tirado, usando pesquisa preliminar com intervalo de confiança de 95% e erro admissível de 10%. Os dados para serviços de turismo foram coletados de proprietários de todos os hotéis, 100 turistas e informantes-chave da área em 10% de intensidade de amostragem em questionário pré-testado para um período de 20 anos (1997-2017). Os resultados mostraram que o vale de Miandam tem estoque de carbono no valor de US$ 16.306.000, enquanto o valor do ecoturismo foi de US$ 1.578.458 anualmente. Os resultados também mostraram que a tendência do turismo diminuiu drasticamente para estrangeiros e locais após o incidente de 11 de Setembro, e a situação se agravou ainda mais durante a era da talibanização ou militância de 2008-2011. Este estudo recomenda a implementação da estratégia de PES na taxa de 5%, portanto um total de US$ 78.922 pode ser ganho com ecoturismo e crédito de carbono na área de estudo anualmente, o que pode desempenhar um papel importante no manejo florestal sustentável.

Caso clínico. Golpe de calor ¿Futura pandemia? / Heat stroke, future pandemic? Case report

The clinical case of a patient admitted to the intensive care unit (ICU) of a tertiary university hospital with a diagnosis of heat stroke is presen- ted. Meets the definitions of this pathology with hyperthermia (41°), altered level of consciousness with ambient temperatura of more than 40°. For its management, the patient requires mechanical ventilation connection, vasoactive drugs, and an intravascular hypothermic device. During the month of July 2022, temperaturas held extraordinarily high. It is foreseeable that these phenomena will increase in intensity or frequency. A critical medical pathology directly related to this phenomenon is the heat stroke. The objective of this case is to make a description of a pathology not very frequent in intensive care units at present, but with real possibilities of increase.

Se presenta el caso clínico de un paciente ingresado en la Unidad de Cuidados Intensivos (UCI), de un hospital terciario universitario con el diagnóstico de golpe de calor. Cumple con las definiciones de este cuadro con hipertermia (41°), alteración de nivel de consciencia con temperatura ambiente de más de 40°. El paciente precisa para su manejo conexión a ventilación mecánica, fármacos vasoactivos y dispositivo intravascular de hipotermia. Durante el mes de julio de 2022, se registraron en gran parte de Europa temperaturas mantenidas extraordinariamente altas. Es previsible, que estos fenómenos aumenten en intensidad o frecuencia. Una patología médica crítica relacionada directamente con este fenómeno es el golpe calor. El objetivo del presente caso es realizar una descripción de una patología no muy frecuente en las unidades de cuidados intensivos en la actualidad, pero con posibilidades reales de aumento.

Manifestaciones clínicas, diagnóstico y tratamiento del golpe de calor / Clinical Manifestations, Diagnosis and Management of Heat Stroke

Introducción: El golpe de calor es una enfermedad que fue descrita hace más de 2000 años, sin embargo, los cambios climáticos que se han presentado en las últimas décadas han permitido que su prevalencia esté en aumento. Se considera una entidad compleja en la cual existe un compromiso importante de la termorregulación corporal y, en consecuencia, del resto de sistemas. Objetivos: Orientar al abordaje adecuado y óptimo de conceptos clínicos, epidemiológicos, factores el riesgo, presentación clínica y repercusión sobre los diferentes sistemas. Métodos: Se realizó una revisión de la literatura científica de personas con golpe de calor, en quienes se evaluaron sus factores asociados, métodos diagnósticos y manejos terapéuticos. Se realizó una búsqueda de la literatura en las siguientes bases de datos: Pubmed/Medline, Science Direct, Scopus, DOAJ, Embase, Cochrane, Direme, Redalyc y SciELO. Conclusiones: El golpe de calor es una urgencia médica que implica un manejo rápido y óptimo dado su morbilidad y mortalidad, lo cual puede minimizarse si se cumplen los objetivos de tratamiento. El enfriamiento por inmersión en agua helada, por convección o evaporación son las medias más usadas. Evitar la falla multiorgánica es el segundo objetivo terapéutico(AU)

Introduction: Heat stroke is a disease described more than 2000 years ago; however, the climatic changes that have occurred in recent decades have allowed an increase in its prevalence. It is considered a complex entity in which there is an important compromise of body thermoregulation and, consequently, of the rest of the systems. Objectives: To define important concepts concerning heat stroke, risk factors, clinical presentation and repercussions on the different systems, as well as to guide an appropriate and optimal management. Methods: A review of the scientific literature about people with heat stroke was carried out to assess its associated factors, diagnostic methods and therapeutic management. A literature search was performed in the following databases: Pubmed/Medline, Science Direct, Scopus, DOAJ, Embase, Cochrane, Bireme, Redalyc, and SciELO. Conclusions: Heat stroke is a medical emergency that requires rapid and optimal management given its morbidity and mortality, which can be minimized if management goals are met. Cooling by immersion into ice water, convection or evaporation are the most commonly used measures. Avoidance of multiorgan failure is the second therapeutic objective(AU)

Características clínicas e funcionais de mulheres após AVC, caidoras e não caidoras: um estudo longitudinal / Clinical and functional characteristics of women after stroke, fallers and non-fallers: a longitudinal study

INTRODUÇÃO: A ocorrência de quedas está entre as complicações mais frequentes apresentadas por idosos e portadores de doenças neurológicas. Sabe-se que em idosos há maior frequência de quedas em mulheres. Em indivíduos após AVC, essa relação não é estabelecida. OBJETIVO: Diferenciar as características clínicas e funcionais de mulheres caidoras e não caidoras após AVC e verificar a associação entre mobilidade funcional e capacidade funcional nessas mulheres. DESENHO DE ESTUDO E LOCAL: Trata-se de um estudo prospectivo longitudinal realizado em Salvador (BA). MÉTODOS: Foram incluídas mulheres com marcha independente atendidas em ambulatório de referência. Foram coletados dados sociodemográficos e clínicos e aplicados a Escala do National Institutes of Health Stroke, o Índice de Barthel modificado, o Timed Up and Go (TUG) e a qualidade de vida europeia. O nível de significância adotado foi de 5%. RESULTADOS: Foram selecionadas 68 mulheres com média de idade de 56 (± 13,7) anos, 51% das mulheres caíram no seguimento, esta última tinha menos de 55 anos (± 13,4), com maior gravidade do AVC. O comprometimento do território vascular posterior foi mais evidente entre as mulheres que caíram (P = 0,009), mas todas, as que caíram e as que não caíram, apresentaram mobilidade funcional prejudicada (TUG = 15 segundos). No entanto, a amostra total foi classificada como totalmente independente ou com leve dependência das atividades de vida diária (AVDs) (MBI = 49). A correlação entre o tempo de TUG e MBI foi negativa e significativa (R = -0,702, P ≤ 0,001). CONCLUSÕES: O envolvimento da circulação posterior é um importante preditor de quedas, sendo um importante indicador no acompanhamento de mulheres após AVC. Também enfatiza que a menor mobilidade funcional impactou a capacidade funcional da mulher.

BACKGROUND: Occurrence of falls is among the most frequent complications presented by the elderly and individuals with neurological diseases. It is known that in the elderly, there is a greater frequency of falls in women. However, in individuals after stroke, this relationship is not established. The purpose of this study was to differentiate the clinical and functional characteristics of fallers and non-fallers women after stroke and to verify the association between functional mobility and functional capacity in these women. DESIGN AND SETTING: This is a longitudinal prospective study conducted in Salvador, Bahia, Brazil. METHODS: Women with independent gait assisted in a reference outpatient clinic were included. Sociodemographic and clinical data were collected, and the National Institutes of Health Stroke Scale, Modified Barthel Index, Timed Up and Go (TUG), and European quality of life were applied. The level of significance was set at 5%. RESULTS: A total of 68 women with a mean age of 56 (± 13.7) years were selected; 51% of the women fell in the follow-up, the latter was younger than 55 years (± 13.4), with greater severity of the stroke. Impairment in the posterior vascular territory was more evident among falling women (P = 0.009), but all falling and non-falling women presented impaired functional mobility (TUG = 15seconds). However, the total sample was classified as totally independent or with slight dependence on the activities of daily living (ADLs) (MBI = 49). The correlation between TUG time and MBI was negative and significant (R = -0.702, P ≤ 0.001). CONCLUSIONS: The involvement of posterior circulation is an important predictor of falls, an important indicator in the monitoring of women after stroke. It also emphasizes that the lower functional mobility impacted women's functional capacity.

Mejora del rendimiento post-activación con banco plano o landmine en la fuerza del golpe recto / Melhoria do desempenho de pós-ativação com banco plano ou landmine na força do golpe reto / Post-activation performance enhancement with bench press or landmine on straight punch strength

RESUMEN La presente investigación centró sus esfuerzos en descubrir alternativas metodológicas que beneficien la posibilidad de aplicar altos niveles de fuerza en el golpe recto, favoreciendo con ello la probabilidad de una victoria por la vía del knock out. La hipótesis de trabajo planteó que, si se emplean ejercicios con un efecto de mejora del rendimiento postactivación, se puede incrementar la fuerza aplicada al golpe recto. Este cuasi-experimento tuvo como objetivo determinar los efectos agudos de la mejora del rendimiento postactivación en la fuerza aplicada en el golpe recto, utilizando el banco plano o el Landmine como actividad condicionante. Se trabajó con 20 boxeadores (ocho profesionales y 12 amateur), y dividió la población en dos grupos, emparejados según el peso corporal. Se evaluó la fuerza máxima de impactocon una celda de carga modelo WLCC01, luego se determinó la fuerza máxima dinámica para cada ejercicio, y a partir de estos datos, se colocó una carga a movilizar del 60 % de la fuerza máxima dinámica, ejecutando repeticiones hasta que la velocidad del movimiento disminuyó más del 10 %. Seguidamente, se volvió a evaluar la fuerza máxima de impacto. Se tomaron registros inmediatamente después, al minuto uno, dos, tres, cuatro y cinco. Los resultados expresaron un aumento del 9.3 % en el grupo de banco plano y del 12,46 % en el grupo de Landmine. Se concluyó que ambos ejercicios, al ser utilizados como actividad condicionante, generan un incremento significativo (p 0.05) de la fuerza máxima de impacto en el golpe recto.

RESUMO A presente investigação centrou os seus esforços na descoberta de alternativas metodológicas que beneficiem a possibilidade de aplicar níveis elevados de força no golpe reto, favorecendo assim a probabilidade de uma vitória por knock-out. A hipótese de trabalho propôs que, se forem utilizados exercícios com um efeito de melhoria do desempenho pós-ativação, a força aplicada ao golpe reto pode ser aumentada. Esta quase-experimentação visava determinar os efeitos agudos do melhoramento do desempenho pós-ativação sobre a força aplicada ao golpe reto, utilizando como atividade condicionadora a bancada plana ou Landmine. Trabalhámos com 20 pugilistas (oito profissionais e 12 amadores). A força máxima de impacto foi avaliada com uma célula de carga modelo WLCC01, depois a força dinâmica máxima foi determinada para cada exercício, e a partir destes dados, foi colocada uma carga para mobilizar 60 % da força dinâmica máxima, executando repetições até a velocidade do movimento diminuir mais de 10 %. Depois, a força máxima de impacto foi reavaliada. Os registos foram tirados imediatamente após, aos um, dois, três, quatro e cinco minutos. Os resultados mostraram um aumento de 9,3 % no grupo dos bancos planos e de 12,46 % no grupo das minas terrestres. Concluiu-se que ambos os exercícios, quando utilizados como atividade condicionante, geram um aumento significativo (p 0,05) da força máxima de impacto no soco reto.

ABSTRACT The present research focused its efforts on discovering methodological alternatives that benefit the possibility of applying high levels of strength in the straight punch, thus favoring the probability of a victory by knockout. The working hypothesis proposed that, if exercises with a post-activation performance enhancement effect are used, the strength applied to the straight punch can be increased. This quasi-experiment aimed to determine the acute effects of post activation performance enhancement on the strength applied to the straight punch, using the bench press or the Landmine as the conditioning activity. It was worked with 20 boxers (eight professional and 12 amateur), and the population was divided into two groups, matched according to body weight. The maximum impact strength was evaluated with a load cell model WLCC01, then the maximum dynamic strength was determined for each exercise, and from this data, a load was placed to mobilize 60 % of the maximum dynamic strength, performing repetitions until the speed of the movement decreased by more than 10 %. Then, the maximum impact strength was re-evaluated. Records were taken immediately after, at one, two, three, four and five minutes. The results showed an increase of 9.3 % in the bench press group and 12.46 % in the Landmine group. It was concluded that both exercises, when used as conditioning activity, generate a significant increase (p 0.05) of the maximum impact strength in the straight punch.

Morfeas con manifestaciones cefálicas / Morpheas with cephalic manifestations

Introducción: La hemiatrofia facial progresiva (HFP) o síndrome de Parry-Romberg y la morfea en golpe de sable (MGS) forman parte de las morfeas lineales cefálicas. Son enfermedades inflamatorias crónicas de la piel y tejidos subyacentes, que se caracterizan por esclerosis y atrofia cutánea. Objetivos: Describir las características clínicas, manifestaciones asociadas, histología, laboratorio, estudios complementarios y tratamientos instaurados. Diseño: Estudio retrospectivo descriptivo. Materiales y métodos: Se revisaron las historias clínicas de pacientes con morfea evaluados en el Sector Colagenopatías desde julio de 2010 hasta diciembre de 2016. Resultados: De 56 pacientes, 11 cumplieron con los criterios de inclusión, 7 con diagnóstico de HFP, 2 con MGS y 2 con ambas patologías. El 64% fueron mujeres. Las manifestaciones extracutáneas se presentaron en el 64% de los casos. El tratamiento utilizado en todos los pacientes fue el metotrexato, asociado o no, al uso de corticosteroides sistémicos. Conclusiones: La mayoría de nuestros resultados concuerdan con la bibliografía consultada, excepto las manifestaciones asociadas. Destacamos el tratamiento asociado de metotrexato y pulsos de corticosteroides intravenosos con resultados satisfactorios y bien tolerado. (AU)

Introduction: Progressive facial hemiatrophy (PFH) or Parry-Romberg Syndrome and morphea en coup de sabre are cephalic linear morpheas. They are chronics inflammatories diseases of the skin and underlying tissues, characterized by cutaneous atrophy and sclerosis. Objectives: To describe clinical features, associated extracutaneous manifestations, histological and laboratory findings, imaging and diagnostic modalities and treatments established in patients with diagnosis of HFP, MGS, or both, evaluated in our Department. Design: Retrospective descriptive study. Materials and methods: We included medical histories of patients diagnosed with morphea evaluated in Collagenopathy Sector from July 2010 up to December 2016. Results: Of 56 patients, 11 met the inclusion criteria, 7 with diagnosis of PFH, 2 with morphea en coup de sabre and 2 with both pathologies. 64% were women. 64% showed extracutaneous manifestations. The treatment used in all of the patients was methotrexate, associated or not, with the use of systemic corticosteroids. Conclusions: Most of our results agree with the bibliography consulted, with the exception of the associated manifestations. We emphasize the associated treatment of methotrexate and intravenous corticosteroid pulses with satisfactory results and well tolerated. (AU)

O uso político do discurso do ódio: um estudo de caso no facebook (2016) / The political use of hate speech: a case study on facebook (2016) / El uso político del discurso del odio: um estudio de caso en facebook (2016) / L'utilisation politique du discours de haine: une étude de cassur facebook (2016)

No período de instauração do processo de investigação das "pedaladas fiscais" realizadas pela presidenta Dilma Rousseff, as redes sociais on-line, dentre elas o Facebook, eram usadas pelos seus navegadores para expressar seus posicionamentos a favor e contra o pedido de investigação, bem como para divulgar as mobilizações e atos públicos de apoio e oposição a esse processo. Dentre as postagens publicadas nesse período, o discurso de ódio se sobressaiu e parecia unir alguns sujeitos que compartilhavam das mesmas posições ideológicas e políticas. Com o objetivo de compreender por que este discurso se fazia tão presente neste momento e quais seriam seus possíveis efeitos, que realizamos um estudo de caso e analisamos a partir do referencial psicanalítico, alguns desses discursos de ódio. Percebemos como o Facebook, as bolhas online reforçaram esse discurso e como este foi usado politicamente para legitimar o pedido de investigação e o resultado desse processo.

In the period of the process of the investigation of the "taxpedaling" carried out by President Dilma Rousseff, the online social networks, including Facebook, were used by their browsers to express their positions for and against the investigation request, as well as to publicize the mobilizations andpublic acts of support and opposition to this process. Among the posts published during this period, hate speech stood out and seemed to unite some subjects who shared the same ideological andpoliticalpositions. In order to better understand why this discourse was so present at this moment and what would be its possible effects, which we analyzed through case study, supported by the psychoanalytic framework, some of these hate discourses. We realizedfrom this study that Facebook, the online bubbles reinforced this discourse and how it was usedpolitically to legitimize the investigation request and the outcome of this process.

En el período de instauración del proceso de investigación de las "pedaleadas fiscales" realizadas por la presidenta Dilma Rousseff, las redes sociales online, entre ellas Facebook era utilizado por sus navegadores para expresar sus posicionamientos a favor y contra la solicitud de investigación, así como para divulgar las movilizaciones y actos públicos de apoyo y oposición a ese proceso. Entre las posturas publicadas en este período el discurso de odio se sobresalía y parece haber unido a algunos sujetos que compartían las mismas posiciones ideológicas y políticas. Para comprender mejorpor qué este discurso estaba tan presente en este momento y cuáles serían sus posibles efectos, que analizamos a través del estudio de caso, apoyados por el referencial psicoanalítico, algunos de estos discursos de odio. Nos damos cuenta a través de este estudio, cómo el Facebook, las burbujas en línea, reforzó ese discurso y cómo éste fue utilizado políticamente para legitimar la petición de investigación y el resultado de esse proceso.

Au cours de la période de investigacion sur les «pédalier fiscales¼ effectué par la présidente Dilma Rousseff, les réseaux sociaux en ligne, dont Facebook, ont été utilisés par leurs navigateurs Web pour exprimer leurs positions pour et contre la demande d'enquête, ainsi que de faire connaitre les mobilisations et les actespublics de soutien et d'opposition à ceprocessus. Parmi les articlespubliés au cours de cette période, les discours de haine se distinguent et semblent unir certains sujetspartageant les mêmes positions idéologiques et politiques. Afin de mieux comprendre pourquoi ce discours était si présent en ce moment et quels en seraient les effets possibles, que nous avons analysés à travers des études de cas, étayées par le cadre psychanalytique, certains de ces discours de haine. Nous avons réalisé à partir de cette étude que Facebook, les bulles en ligne ont renforcé ce discours et son utilisation politiquement pour légitimer la investigation et les résultats de ce processus.

Rol de los estreptococos del grupo Streptococcus anginosus en infecciones de piel y partes blandas: reporte de 3 casos / Role of streptococci of the Streptococcus anginosus group in skin and soft tissue infections: report of 3 cases

Los estreptococos del grupo Streptococcus anginosus (GSA) comprenden uno de los grupos que conforman el grupo viridans de estreptococos y son parte de la microbiota humana habitual de la cavidad oral, del tracto respiratorio superior y del tracto gastrointestinal. Pueden producir colecciones purulentas de órganos sólidos, abscesos cutáneos y celulitis, entre otras infecciones. Este grupo posee numerosos factores de virulencia como hialuronidasa, adhesinas, enzimas extracelulares y hemolisinas. El objetivo de este trabajo fue presentar tres casos clínicos de infecciones asociadas a traumatismos vinculados con la cavidad oral como golpes de puño o mordeduras humanas. En todos ellos, los GSA desarrollaron como germen único, lo que pone de manifiesto su importante rol en este tipo de infecciones.

The Streptococcus anginosus group (SAG) is part of the viridans group streptococci and they belong to the normal human microbiota of the oral cavity, the upper respiratory tract and the gastrointestinal tract. It can produce purulent collections of solid organs, cutaneous abscesses and cellulitis, among other infections. This group has numerous virulence factors such as hyaluronidase, adhesins, extracellular enzymes and hemolysins. The objective of this work is to present three clinical cases of infections associated with trauma related to the oral cavity such as fist bumps or human bites. In all of them, the SAG developed as a single organism, which highlights its important role in this type of infection.

Os estreptococos do grupo do Streptococcus anginosus (GSA) são parte de um dos grupos que constituem o grupo viridans e fazem parte da microbiota normal da cavidade oral, do trato respiratório superior e do trato gastrointestinal dos seres humanos. Podem produzir coleções purulentas de órgãos sólidos, abscessos cutâneos e celulite, entre outras infecções. Este grupo possui numerosos fatores de virulência, como hialuronidases, adesinas, enzimas extracelulares e hemolisinas. O objetivo desse trabalho foi apresentar três casos clínicos de infecções associadas a traumatismos associados à cavidade oral, decorrentes de socos ou mordidas humanas. Em todos eles os GSA se desenvolveram como germe único, o que põe de manifesto seu papel importante nesse tipo de infecções.

Golpe de calor: Síndrome del niño olvidado / Heat Stroke: Forgotten baby syndrome

El golpe de calor es la forma más severa de las enfermedades por calor. Es una emergencia médica que puede comprometer la vida del paciente. Se caracteriza por hipertermia central extrema asociada a daños neurológicos. Los lactantes y niños pequeños son más propensos a sufrirla, sobretodo, en el marco del llamado "Síndrome del Niño Olvidado". Reportamos un caso que ilustra los severos daños de dejar atrapado a un niño en un vehículo, su evolución y manejo.

Heat stroke is the most severe form of heat related illeness. It is a pediatric emergecy and a life-threatening condition in children. Is defined by extreme core hyperthermia accompanied by central nervous system disfunction. Infants and children are at higher risk of heat stroke due to the so called "Forgotten Baby Syndrome". We present an illustrative case of a child who died left unattended in a closed vehicle, his evolution and management.

Los temas de la memoria colectiva del golpe de estado de 1976 en Argentina en función de la ideología y las generaciones / Themes of the collective memory of the coup d'etat of 1976 in Argentina as a function of ideology and generations

El recuerdo del Golpe de Estado de 1976 en Argentina ofrece una oportunidad para estudiar los procesos de formación y composición de la memoria colectiva. En el trabajo que se informa se estudió cómo los contenidos del recuerdo del golpe son afectados por dos factores: las generaciones que lo recuerdan y la ideología política de los participantes. Con este objetivo, se solicitó a 52 participantes argentinos y de ambos sexos que completaran una tarea de Recuerdo Libre entorno a los hechos del Golpe de Estado de 1976. Se dividió la muestra en dos grupos de 26 sujetos, uno estuvo compuesto por personas que vivieron durante esos años (mayores de 48 años) y el otro, por personas de una generación que no vivió aquella época (menores de 30). Se consideró también la ideología política de los participantes (Izquierda o Derecha). Se utilizó un enfoque de análisis descriptivo, centrado en analizar el contenido del recuerdo, considerando qué temas / ideas principales lo conformaban. Los resultados muestran una mayoría de temas comunes al recuerdo de los distintos grupos. Estos elementos comunes conformarían una memoria nacional del golpe. También muestran que la generación y la ideología política promueven temas / ideas principales propios de cada grupo. Aquellos de la generación mayor recordaron más temas / ideas principales de tipo contextual y emocional / afectivo. Los de la generación menor recordaron en mayor medida los hechos acontecidos durante la dictadura. Los sujetos del grupo de Izquierda recordaron temas / ideas principales vinculados a la violencia de Derecha y más aspectos contextuales que los del grupo de Derecha. Se propone que hay un sistema de memoria nacional que operaría en los sujetos y que es afectado por las metas y objetivos de cada grupo.

Argentina, as well as others Latin American countries, lived through a military dictatorship from 1976 to 1983. Because of the magnitude of its consequences, it is a period of the Argentinean history that is still discussed by its citizens and that has a place in the educational curricula of the country now. Moreover, its current importance is evident, for example, as shown in the ongoing trials for the responsibilities of the crimes committed by the militaries so many years ago, and the frequent news of people recovering their stolen identity after being born in captivity during those years and being raised by families that appropriated them. A collective memory of the events taking place over those years is in the process of constitution and development. As people talk about it, as new information is spread on the news, as justice works over those committing the terrible crimes during that period in Argentina, a collective memory of the 1976 coup d’état takes shape. One aim of the present work was to contribute to the study of the collective memory of the coup d´état of 1976 in Argentina. Even though this issue has received attention in previous studies, an empirical approach towards it that focuses on the discourse of the memories of the participants, conforms a new contribution. Another aim of this study was to contribute to the study of collective memory from a psychological perspective. Recalls of the coup d´état of 1976 in Argentina offer one of those opportunities to study the processes of formation and constitution of collective memory. In the present study, we are interested in studying how the contents of the recall of the coup d´état are affected by two specific factors: generations and ideology. Our interest is to study how similar and different are the memories for those events for different generations of citizens. We are basically considering those who lived through those years and those who learned about those same events indirectly, through books, documentary, news, etc. We are also interested in studying how much political ideology can affect the recall of those events. In that, we considered the basic ideological distinction between left and right. The dependent variable was a concrete aspect of the content of the recall: the -mes / main ideas. A total of 52 subjects participated in the study. The sample was divided in two groups, one of which was constituted by subjects who lived-through those years. This was the older generation group. The other group conformed the younger generation and was integrated by subjects that didn’t live through those years because they were not yet born. At the same time, people from the left and right ideologies composed each of these two groups. Participants completed a Free Recall Test, where we asked them to recall all of what they could remember about the events around March 24, 1976. We focused on analyzing the content of there call, considering the themes / main ideas that configured it. There are common elements of the recall that seem to configure a national memory of the coup d´état. However, generations and political ideology promoted themes / main ideas typical of each group. Those of the older generation remembered more contextual and emotional / affective themes / main ideas. Those of the younger generation remembered more facts that took place during the military dictatorship. People with a left wing ideology remembered more themes / main ideas related to the ‘Right wing violence’ and more contextual aspects than those with a right wing ideology. A national memory system that would operate in the citizens and that is affected by the goals of each group is proposed.

Golpe de calor / Heatstroke

El golpe de calor es una situación en la que una persona sometida a altas temperaturas ambientales experimenta un fracaso, potencialmente letal, del sistema de termorregulación corporal. Se trata de una patología infradiagnosticada, de baja prevalencia, pero con elevada morbimortalidad, cuya incidencia ha aumentado en los últimos años y seguramente seguirá aumentando, debido a la frecuencia cada vez mayor de las olas de calor vinculadas al cambio climático, producto del calentamiento global. Su presentación clínica se caracteriza por temperaturas corporales por encima de los 40º C y disfunción orgánica múltiple que, si no se tratan de manera rápida y adecuada, conducen a la muerte. Los pilares de su tratamiento son el sostén de las funciones en falla y la disminución inmediata de la temperatura central.(AU)

Heat stroke is a situation where a person subject to high temperatures experiences the failure of the body thermoregulation system, a potentially lethal condition. This is an underdiagnosed disease, with low prevalence, but a high mortality, whose incidence has increased in recent years and will surely continue to rise due to the increasing frequency of heat waves linked to climate change, as a result of global warming. Its clinical presentation is characterized by body temperature >40º C and multiple organ dysfunction leading to death, if the patient does not receive prompt and appropriate treatment. The mainstays of treatment are function support and the immediate drop in core temperature.(AU)

Golpe de calor: a propósito de un caso clínico / Heat stroke. a case report

El golpe de calor es una entidad poco frecuente y subdiagnosticada. La elevación de la temperatura corporal es la que desencadena las disfunciones metabólicas que pueden incluso llevar a la muerte. Se presenta el caso de un militar que se encontraba realizando ejercicios de infantería, durante el mes de septiembre, en días donde se produjeron condiciones climáticas extremas y desarrolla un cuadro de Disfunción Orgánica Múltiple (DOM) primaria; fue llevado al Servicio de Emergencia del Hospital de Fray Bentos, Río Negro. La evolución inicial se caracterizó por deterioro de la función neurológica, respiratoria, necesidad de ventilación mecánica, falla renal aguda y disfunción hematológica; se establecieron los diagnósticos de golpe de calor, injuria renal, rabomiólisis, insuficiencia respiratoria aguda y coagulación intravascular diseminada (CID). A pesar del tratamiento y manejo de sostén tiene una mala evolución, falleciendo a las 48 horas del ingreso. El caso nos recuerda que la exposición a condiciones de calor por arriba de la temperatura corporal, deteriora los mecanismos de control de calor corporal y metabólico. Es necesario un diagnóstico rápido y un manejo de sostén para conseguir una evolución satisfactoria.

A heat stroke is a very rare and under diagnosed entity. The rise in the body’s temperature is the element that triggers the metabolic dysfunctions that can even lead to death. A case of a soldier is presented; this soldier was training, doing his infantry exercises routine, during September, in days were extreme climate situations were happening, installing a case of primary Multiple Organ Dysfunction (MOD) syndrome. The soldier was taken to the Emergency Service in Fray Bentos’ Hospital, in Rio Negro. The initial evolution was clumsy and slowly, and the neurologic and breathing functions were worsening, with acute renal failure, and also hematological dysfunction. In addition to this, the patient was in need of mechanic ventilation. The diagnosis of temperature shock, acute renal injury, Rhabdomyolysis, acute respiratory failure and disseminated intravascular coagulation (DIC) were established. Supportive care was given to the patient, with an un satisfactory development, leading to death 48 hours after the hospital admission. This case reminds us that, the exposure to weather conditions that are over the body temperature interferes in the metabolism and the body’s mechanisms for controlling heat. A quick diagnosis and supportive care are needed in order to achieve a satisfactory evolution.

Falla multiorgánica asociada a hipertermia en una lactante con síndrome de Prader-Willi. caso clínico / Multiorgan failure associated with hyperthermia in an infant with Prader-Willi syndrome. Case report

El golpe de calor es una emergencia médica y se debe entender como una forma de hipertermia asociada a una respuesta inflamatoria sistémica, que ocasiona falla multiorgánica y en la cual la disfunción del sistema nervioso central es predominante. Si no es tratada precozmente, puede ocasionar una alta mortalidad. El síndrome de Prader-Willi es un trastorno genético multisistémico secundario a una anormalidad en el brazo largo del cromosoma 15 (15q11-q13), caracterizado por hipotonía central neonatal, retraso del desarrollo psicomotor, hipogonadismo, hiperfagia y obesidad. Estos pacientes son proclives a presentar problemas de termorregulación. Se comunica el caso de una lactante de 5 meses en quien se estableció el diagnóstico de síndrome de Prader-Willi en el curso de un episodio febril sin foco conocido, que evolucionó con falla multiorgánica y rabdomiólisis secundaria a la hipertermia.

Heat stroke is a medical emergency characterized primarily by an elevated core temperature associated with a systemic inflammatory response, which causes multiple organ dysfunction in which encephalopathy predominates. If it is not early treated has high mortality. The Prader-Willi syndrome is a multisystem genetic disorder secondary to an abnormality in long arm chromosome 15 (15q11-q13), characterized by neonatal central hypotonia, developmental delay, hypogonadism, hyperphagia and obesity. These patients are susceptible to developing thermoregulatory problems. We report the case of a 5-month-old infant, in whom a diagnosis of Prader-Willi syndrome was established in the course of a febrile episode without known focus, who developed multiorganic failure and rhabdomyolysis secondary to hyperthermia.

Golpe de judô o soto gari: validação de lista de checagem / Throwing technique o soto gari: validation checklist

O objetivo deste trabalho foi elaborar e validar duas listas de checagem para avaliação qualitativa do golpe de judô o soto gari, uma referente à configuração global e outra relativa à fase de desequilíbrio (kuzushi). Em ambas as listas, (a) ao menos 90% dos peritos em judô avaliaram os itens como claros, adequados tecnicamente e viáveis para aplicação em contextos de pesquisa e (b) os índices de correlação intra e interavaliadores atingiram, no mínimo, 0,80 na configuração global e 0,70 no desequilíbrio. Assim, pode-se concluir que as listas propostas apresentaram teor representativo do golpe e mostraram-se fidedignas.

This study aimed at creating and validating two checklists for the qualitative assessment of the judo throwing technique o soto gari, one concerning to the global movement and other to the unbalance phase (kuzushi). On both checklists, (a) at least 90% of the judo experts evaluated the items as clear, technically adequate and viable for research purposes and (b) within- and between-judges correlation indexes were higher than 0.80 for the global movement and than 0.70 for the unbalance phase. It can be concluded therefore that the proposed checklists showed solid content of the technique and were reliable.

Insuficiencia hepática fulminante debida a golpe de calor

Presentamos un caso de "golpe de calor" (GC) grave complicado de insuficiencia hepática fulminante, admitido a la UCI del Instituto Médico la Floresta (IMLF). Se trataba de una paciente de 14 años de edad que se encontraba realizando ejercicios de montañismo en San Juan de los Morros (Venezuela), en un día de mucho calor y humedad. La paciente presentó en forma brusca un cuadro de convulsiones tónico-clónicas generalizadas e hipertermia, seguido de coma profundo. Durante los días siguientes fue desarrollando falla multiorgánica progresiva caracterizada por insuficiencia renal aguda, coagulación intravascular diseminada (CID) e insuficiencia hepática fulminante (IHF). El tratamiento consistió en asistencia ventilatoria mecánica, corticoesteroides y nutrición enteral. La paciente sobrevivió y recuperó las funciónes hepática, renal, y neurológica después de 3 semanas. Hasta ahora solo han sido reportados 3 casos de IHF secundaria a GC. Este caso ilustra que a pesar de la gravedad de la IHF con falla multiorgánica, la paciente sobrevivió con solo las medidas de soporte vital actualmente disponibles en las UCI.

We present a case of a young female patient, admitted to our ICU with a heat stroke (HS) while she was practicing trekking in San Juan de Los Morros (Venezuela) during a hot day with high humidity. The patient had generalized convulsions and hyperthermia followed by coma. During the following days she presented multiple organ failure, including renal failure, disseminated intravascular coagulation (DIC), and fulminant hepatic failure (FHF). The treatment consisted of mechanical ventilatory assistance, corticosteroids, enteral nutrition and other vital supporting measures in the ICU. Up to now there have been published only three cases of FHF following exertional HS. The patient survived and recovered normal hepatic, renal and neurological function after 3 weeks of conservative treatment. This case of FHF demonstrates that in spite of the severity of the FHF and multiple organ failure, the patient survived only with the supporting measures currently available in the ICU.

Hemorragia pulmonar y síndrome de insuficiencia respiratoria aguda secundaria a golpe de calor / Pulmonary hemorrhage and acute respiratory distress syndrome secondary to heat stroke

El golpe de calor es una entidad poco frecuente y subdiagnosticada. Se presenta relativamente más en los estados del norte del país, al exponerse los migrantes a condiciones climáticas extremas. La elevacion de la temperatura corporal es la que dispara las disfunciones metabólicas que pueden incluso llevar a la muerte. Se presenta el caso de un migrante chiapaneco que fue encontrado en el desierto de Altar, Sonora en malas condiciones generales; fue traído al Servicio de urgencias del Hospital General del Estado en Hermosillo, Sonora. La evolución inicial fue tórpida, con deterioro de la función respiratoria, infiltrados pulmonares, necesidad de ventilación mecánica, datos de falla renal y cifras muy elevadas de creatinincinasa; se establecieron los diagnósticos de golpe de calor, insuficiencia renal, rabdomiólisis, hemorragia pulmonar y SIRA. Se le dio manejo de sostén con buena evolución, egresó al 21° día de estancia hospitalaria por resolución del problema. El caso nos recuerda que la exposición a condiciones de calor por arriba de la temperatura corporal, lo cual es muy frecuente en las áreas desérticas del norte del país, deteriora los mecanismos de control de calor corporal y metabólico. Es necesario un diagnóstico rápido y un manejo de sostén para conseguir una evolución satisfactoria.

Heat stroke is a rare and underdiagnosed entity, it is more frequently seen in the northern states of Mexico after exposure to high environmental temperatures that induce elevation of the body temperature, triggering metabolic derangements that can result in death. We present the case of a 24 year old immigrant from the southeast state of Chiapas found in the Desert of Altar, in the northern state of Sonora; he was semiconscious, dehydrated and in poor general condition after attempting to cross the desert in his way to the border with the USA. He was brought to our hospital with labored breathing, hemoptysis, lung infiltrates and progressive deterioration of his blood gases. He was intubated and mechanically ventilated; the initial course was characterized by increased CPK levels suggestive of rabdomyolisis, acute renal failure, disseminated intravascular coagulation, lung hemorrhage and acute respiratory distress syndrome secondary to the heat stroke. He spent 14 days in the ICU receiving 4 courses of hemodyalisis, ventilatory support, iv fluids, antibiotics and monitoring of his respiratory, renal, cardiovascular, neurologic and metabolic parameters. He was discharged 21 days after admission. Heat stroke prevention is mandatory by public education; early diagnosis should avoid the full-blown systemic derangements; adequate support can reverse an otherwise potentially fatal course.