La educación, la sociedad y los trasplantes: una solución a demostrar

Resumen: La grave consecuencia del comportamiento renuente de la sociedad respecto de la donación es la “muerte injusta de pacientes” en listas de espera. La escasez de órganos y el incremento de estas listas han alentado la búsqueda de soluciones. El público necesita educación e información sin ambigüedades. Además, la parcial formación universitaria sobre este tema es también responsable de una inadecuada acción médica. Para lograr esto, sería necesaria la incorporación de programas de educación en trasplantes en los planes de estudios escolares, el apoyo de las comunidades trasplantológicas nacionales e internacionales y el activo sostén del Estado y de los distintos credos religiosos. Es nuestro deber generar una solución para evitar que políticas racionalistas dirigidas a modificar la escasez de órganos no resulten ineficaces y aun contraproducentes debido a una atención inadecuada a los complejos rasgos antropológicos, psicológicos y ético-sociales del ser humano

Trasplantes : un servicio a la libertad y a la caridad

La posibilidad que la ciencia y la técnica nos brinda respecto de la ablación y trasplantes, es también una oportunidad para que cada persona pueda ejercer una de las características más nobles de su humanidad: actuar con una libertad madura y responsable, que nos hace crecer como personas; además nos permite ejercer un acto de caridad con el prójimo que reciba sus órganos y con sus propios familiares, porque hemos dejado intención explícita de ser o no donantes antes de morir.

Los derechos y deberes de médicos y pacientes desde la vigencia de la Ley 26.529

Resumen: El artículo considera los derechos y deberes de médicos y pacientes, especialmente luego de la sanción de la ley 26.529, destacando sus temas relevantes, aquellos que habían dado lugar a distintas interpretaciones tanto en la jurisprudencia, como en la doctrina. Se tratan, así, la historia clínica y el consentimiento informado, precisándose sus conceptos, formas, funciones e interpretaciones. Similar atención merecen las directivas anticipadas de salud, el “testamento vital”, las posibilidades del médico y sus posibles objeciones de conciencia. De igual modo la autonomía de la voluntad del paciente, su libertad y responsabilidad. Se considera la eutanasia, precisándose que no es un derecho del paciente. Se estudia el secreto profesional del médico, a la luz de las contradictorias normas legales vigentes y jurisprudencia consecuente, para detenerse en la más reciente decisión de la Corte Suprema de Justicia de la Nación en su actual composición. Finalmente se precisan los conceptos de las responsabilidades de médicos y órganos sanitarios, con la posibilidad de su aseguramiento y el conflicto de algunas de las coberturas que se otorgan en plaza, como la conocida claims made.

Materials selection in mechanical design for microsensors and microactuators

Microsensors and microactuators are vital organs of microelectromechanical systems (MEMS), forming the interfaces between controller and environment. They are usually used for devices ranging in size at sub-millimeter or micrometer level, transforming energy between two or more domains. Presently, most of the materials used in MEMS devices belong to the silicon material system, which is the basis of the integrated circuit industry. However, new techniques are being explored and developed, and the opportunities for MEMS materials selection are getting broader. The present paper tries to apply 'performance index' to select the material best suited to a given application, in the early stage of MEMS design. The selection is based on matching performance characteristics to the requirements. A series of performance indices are given to allow a wide range comparison of materials for several typical sensing and actuating structures, and a rapid identification of candidates for a given task. (C) 2002 Elsevier Science Ltd. All rights reserved.

El federalismo en el origen, consolidación, desarrollo y superación del constitucionalismo

Resumen: Los poderes territoriales predominaron en el nacimiento de los Estados en Europa occidental, en los que se advierten contrapesos entre órganos, de sustento consuetudinario y reconocimiento escrito de derechos. En la aparición y el afianzamiento del constitucionalismo escrito tienen singular importancia la transformación de confederaciones en Estados federales, en Estados Unidos, Suiza y Alemania; así como los procesos de Venezuela, Colombia, México, Brasil y Argentina. Su consolidación resulta de los sistemas de control de constitucionalidad: el difuso, que nace en Estados Unidos; y el concentrado, que comienza en Austria; ambos países federales. En la actualidad los Estados semicontinentales y las regiones de similares dimensiones pueden entenderse como superación del constitucionalismo, pues se ha modificado sustancialmente su ámbito geográfico, el cual resulta esencial para que la representación posea una inmediación suficiente y puedan funcionar los frenos y contrapesos que aseguran la moderación del poder. Una gran autonomía y fortaleza de las instituciones locales, es decir un auténtico federalismo, puede configurar un reaseguro suficiente para los objetivos iniciales del constitucionalismo: que el reconocimiento de los derechos y los equilibrios entre los titulares de poderes locales y centrales tengan la oportunidad de lograrse.

Role of Monoubiquitylation on the Control of IκBα Degradation and NF-κB Activity

9 p.

Food habits as an ecological partitioning mechanism in the nearshore rockfishes (Sebastes) of Carmel Bay, California

In the kelp forests of Carmel Bay there are six common rockfishes (Sebastes). Three are pelagic (S. serranoides, S. mystinus, and S. melanops) and two are demersal (S. chrysomelas and S. carnatus). The sixth (S. atrovirens) is generally found a few meters above the sea floor. The pelagic rockfishes which are spatially overlapping have different feeding habits. All rockfishes except S. mystinus utilize juvenile rockfishes as their primary food source during the upwelling season. Throughout the non-upwelling season, most species consume invertebrate prey. The pelagic rockfishes have shorter maxillary bones and longer gill rakers than their demersal congeners, both specializations for taking smaller prey. They also have longer intestines, enabling them to utilize less digestable foods. S. mystinus, which has the longest intestine, may be able to use algae as a food source. Fat reserves are accumulated from July through October, when prey is most abundant. Fat is depleted throughout the rest of the year as food becomes scarce and development of sexual organs takes place. Gonad development occurs from November through February for all species except S. atrovirens.

Os atores-chave no processo decisório no âmbito das comissões permanentes

Descreve os atores-chave no processo decisório no âmbito das comissões permanentes da Câmara dos Deputados, a partir de uma análise de como influenciam na tomada de decisões naqueles órgãos. Essa análise parte de três variáveis: poder de agenda, poder de veto (veto player) e capacidade de influenciar na decisão final do colegiado. Para tanto, o método utilizado foi de levantar as atribuições regimentais de cada um dos atores definidos em comparação com os poderes dos demais parlamentares. Concluiu-se que a concentração de poderes em determinados atores pode influenciar na tomada de decisões

Histological atlas of Florida Surgeonfish (Acanthuridae)

This histological atlas focuses on A. coeruleus and includes major organs and tissues. Particularly note the stomach tissues of both species, which illustrate the difference in digestive strategies of the Carribbean Acanthurids. Acanthurus chirurgus was intentionally left out of this atlas, as its tissues are identical to those of ?A. bahianus(PDF has 22 pages)

Uso de células iPS en terapia regenerativa renal: obtención de células iPS mediante vector no integrativo y diferenciación hacia podocitos.

[ES]En las sociedades modernas existe una creciente preocupación por el aumento de la incidencia de la enfermedad renal crónica. Debido a la deficiencia de donantes de órganos y al elevado coste del tratamiento de diálisis, existe la necesidad de desarrollar nuevos tratamientos para estos pacientes. La medicina regenerativa basada en la aplicación de células iPS es una opción prometedora para el tratamiento de esta enfermedad. Sin embargo, la falta de conocimientos sobre el estado pluripotencial de las células y sobre su proceso de diferenciación, así como las limitaciones derivadas del propio procedimiento de reprogramación, impiden su aplicación clínica en un futuro inmediato. Para que se convierta en realidad, numerosas investigaciones se están llevando a cabo con el objetivo de mejorar el procedimiento y hacerlo adecuado para su aplicación clínica. En este trabajo se propone un método que permitiría obtener células iPS a partir de células mesangiales mediante la transfección con un vector no integrativo, el virus Sendai, portador de los genes Oct3/4, Sox2, Klf4 y c-Myc. Al tratarse de un vector no integrativo, se minimizaría el efecto del proceso de reprogramación sobre la estabilidad del genoma celular. Además, en este proyecto se estudiará la capacidad de las células iPS obtenidas para diferenciarse en células progenitoras de podocitos que puedan ser aplicadas específicamente en terapias regenerativas para enfermos renales crónicos.

Resveratrol prevents inflammation-dependent hepatic melanoma metastasis by inhibiting the secretion and effects of interleukin-18

Background: Implantation and growth of metastatic cancer cells at distant organs is promoted by inflammation-dependent mechanisms. A hepatic melanoma metastasis model where a majority of metastases are generated via interleukin-18-dependent mechanisms was used to test whether anti-inflammatory properties of resveratrol can interfere with mechanisms of metastasis. Methods: Two experimental treatment schedules were used: 1) Mice received one daily oral dose of 1 mg/kg resveratrol after cancer cell injection and the metastasis number and volume were determined on day 12. 2) Mice received one daily oral dose of 1 mg/kg resveratrol along the 5 days prior to the injection of cancer cells and both interleukin-18 (IL-18) concentration in the hepatic blood and microvascular retention of luciferase-transfected B16M cells were determined on the 18(th) hour. In vitro, primary cultured hepatic sinusoidal endothelial cells were treated with B16M-conditioned medium to mimic their in vivo activation by tumor-derived factors and the effect of resveratrol on IL-18 secretion, on vascular cell adhesion molecule-1 (VCAM-1) expression and on tumor cell adhesion were studied. The effect of resveratrol on melanoma cell activation by IL-18 was also studied. Results: Resveratrol remarkably inhibited hepatic retention and metastatic growth of melanoma cells by 50% and 75%, respectively. The mechanism involved IL-18 blockade at three levels: First, resveratrol prevented IL-18 augmentation in the blood of melanoma cell-infiltrated livers. Second, resveratrol inhibited IL-18-dependent expression of VCAM-1 by tumor-activated hepatic sinusoidal endothelium, preventing melanoma cell adhesion to the microvasculature. Third, resveratrol inhibited adhesion-and proliferation-stimulating effects of IL-18 on metastatic melanoma cells through hydrogen peroxide-dependent nuclear factor-kappaB translocation blockade on these cells. Conclusions: These results demonstrate multiple sites for therapeutic intervention using resveratrol within the prometastatic microenvironment generated by tumor-induced hepatic IL-18, and suggest a remarkable effect of resveratrol in the prevention of inflammation-dependent melanoma metastasis in the liver.

Design and synthesis of biofunctional magnetic/fluorescent glyco-nanoparticles and quantum dots and their application as specific molecular imaging probes

206 p.

Descripción de la morfología externa e interna del langostino con algunas aplicaciones de indole taxonómica y biológica

In the present paper the external and internal morphology of the shrimp Pleoticus muelleri (Bate), is described in detail. Special attention is given to those features which are of diagnostic value or which are significant for a fuller understanding of the biology of this species. The major portion of the paper deals with the description of the cephalopereion, pleon and telson and its appendages, as well as the nervous, respiratory, circulatory, digestive, excretory and reproductive systems. Special attention is given to the digestive system, the stomodaeal apparatus and sexual dimorphism. The relations between form and function of several organs and systems are pointed out. A study is made of the development of the gonads, the sexual cycle in males and females; the variations found in relative weight and size are described. The phylogenetical jposition of the Penaeidae, the genera of the subfamily Solenoceridae and of P. muelleri are discussed. (PDF contains 72 pages)

Enfrentando mudanças e valorizando a vida - uma referência para a enfermeira no cuidado à mulher submetida à cirurgia ginecológica

Diversos estudos que abordam as repercussões das cirurgias ginecológicas na vida da mulher apontam para uma relação existente com aspectos subjetivos, em virtude da construção social da identidade feminina, indicando que a perda de órgãos ginecológicos pode interferir na maneira da mulher se perceber e se relacionar com o mundo. O presente estudo tem como objeto o processo de interação da mulher no contexto das cirurgias ginecológicas. Para isso foram formulados os objetivos: Descrever os significados da cirurgia ginecológica para a mulher submetida a este procedimento e Analisar o processo de interação da mulher com ela mesma e com o seu núcleo social a partir dos significados por ela atribuídos à cirurgia ginecológica, considerando o fenômeno da mutilação. O estudo de natureza qualitativa, do tipo descritivo-exploratório, teve como referencial teórico-metodológico o Interacionismo Simbólico e a Grounded Theory, que subsidiaram uma interpretação da ação e das relações das mulheres no contexto da cirurgia ginecológica e da mutilação, baseados na definição e interpretação de significados por elas atribuídos. Dos resultados emergiram quatro categorias: Investigando a doença e decidindo aceitar a cirurgia, A passagem pela cirurgia: vivendo o processo de resolução do problema, Enfrentando as mudanças impostas pela cirurgia e Valorizando a vida. Evidenciou-se que ao receber o diagnóstico da doença, a mulher interage com dúvidas, medos, a busca por informação e pelos benefícios da cirurgia, e por fim decide aceitá-la. Ao passar pela cirurgia, vivencia incômodos, complicações, compreende que perdeu uma parte do corpo e procura conformar-se, tentando crer que foi o único caminho. As diversas mudanças que ocorrem fazem-na construir novos significados e mudar a percepção de si e do seu meio social, a partir da interação consigo mesma e com este meio, fazendo-a refletir sobre a sexualidade, seus relacionamentos, sua saúde, a diferença no corpo e em si mesma, nas funções que desempenha e sobre a mutilação provocada pela cirurgia. O desenvolvimento de mecanismos de enfrentamento, como comparar sua cirurgia e histórias com outras, identificar aprendizados com a experiência, buscar formas de superação e resignar-se resultaram na valorização da vida e na vontade de viver melhor. Percebe-se a importância da enfermeira estabelecer um cuidado multidimensional, que identifique as necessidades que vão além do corpo biológico, respeitando as particularidades e a individualidade no momento do cuidado e contribuindo para o bem-estar físico, psíquico, social e espiritual das mulheres.

Neural and computational representations of decision variables

These studies explore how, where, and when representations of variables critical to decision-making are represented in the brain. In order to produce a decision, humans must first determine the relevant stimuli, actions, and possible outcomes before applying an algorithm that will select an action from those available. When choosing amongst alternative stimuli, the framework of value-based decision-making proposes that values are assigned to the stimuli and that these values are then compared in an abstract “value space” in order to produce a decision. Despite much progress, in particular regarding the pinpointing of ventromedial prefrontal cortex (vmPFC) as a region that encodes the value, many basic questions remain. In Chapter 2, I show that distributed BOLD signaling in vmPFC represents the value of stimuli under consideration in a manner that is independent of the type of stimulus it is. Thus the open question of whether value is represented in abstraction, a key tenet of value-based decision-making, is confirmed. However, I also show that stimulus-dependent value representations are also present in the brain during decision-making and suggest a potential neural pathway for stimulus-to-value transformations that integrates these two results.

More broadly speaking, there is both neural and behavioral evidence that two distinct control systems are at work during action selection. These two systems compose the “goal-directed system”, which selects actions based on an internal model of the environment, and the “habitual” system, which generates responses based on antecedent stimuli only. Computational characterizations of these two systems imply that they have different informational requirements in terms of input stimuli, actions, and possible outcomes. Associative learning theory predicts that the habitual system should utilize stimulus and action information only, while goal-directed behavior requires that outcomes as well as stimuli and actions be processed. In Chapter 3, I test whether areas of the brain hypothesized to be involved in habitual versus goal-directed control represent the corresponding theorized variables.

The question of whether one or both of these neural systems drives Pavlovian conditioning is less well-studied. Chapter 4 describes an experiment in which subjects were scanned while engaged in a Pavlovian task with a simple non-trivial structure. After comparing a variety of model-based and model-free learning algorithms (thought to underpin goal-directed and habitual decision-making, respectively), it was found that subjects’ reaction times were better explained by a model-based system. In addition, neural signaling of precision, a variable based on a representation of a world model, was found in the amygdala. These data indicate that the influence of model-based representations of the environment can extend even to the most basic learning processes.

Knowledge of the state of hidden variables in an environment is required for optimal inference regarding the abstract decision structure of a given environment and therefore can be crucial to decision-making in a wide range of situations. Inferring the state of an abstract variable requires the generation and manipulation of an internal representation of beliefs over the values of the hidden variable. In Chapter 5, I describe behavioral and neural results regarding the learning strategies employed by human subjects in a hierarchical state-estimation task. In particular, a comprehensive model fit and comparison process pointed to the use of "belief thresholding". This implies that subjects tended to eliminate low-probability hypotheses regarding the state of the environment from their internal model and ceased to update the corresponding variables. Thus, in concert with incremental Bayesian learning, humans explicitly manipulate their internal model of the generative process during hierarchical inference consistent with a serial hypothesis testing strategy.