[An analysis of the "slippery slope" of assisted death]. / Pendiente resbaladiza de la muerte asistida en los Países Bajos, Bélgica y Colombia.

The study analyzes the phenomenon of the "slippery slope" of assisted death in The Netherlands, Belgium, and Colombia after the depenalization or legalization of this practice. Data analysis was performed reviewing the evidence published in scientific journals and in the governments' official reports. We verified a progressive broadening of the limits initially established by the law for the practice of assisted death in these three countries. This confirms the occurrence of the "slippery slope". Also, the exponential increase in the number of assisted deaths in these three countries after the legalization indirectly suggests the presence of the "slippery slope". An analysis of the anthropological and ethical implications of assisted death highlights that its moral assessment should not be exclusively based on consequentialist arguments. Also, a prudential interpretation of the slippery slope argument in the legal debate about assisted death should be incorporated. We conclude that the moral evaluation of assisted death cannot be exclusively grounded on its negative social consequences, but rather on the lack of respect for basic human values such as life and the intrinsic dignity of a person. The verification of the "slippery slope" in these three countries should be regarded as an alarm for an eventual legalization of euthanasia in Chile.

Delayed allergic dermatitis presenting as a keloid-like reaction caused by sting from an Indo-Pacific Portuguese man-o'-war (Physalia utriculus).

Cnidarian envenomations are common occurrences in the tropics that can affect holidaymakers. The cutaneous reactions are classified as immediate or delayed types. Delayed allergic reactions are persistently recurring dermatitis, which can occur within 1-4 weeks from the initial sting, and may last for several months. Hypertrophic scar-like or keloid-like reactions are rare, and are believed to be a type IV hypersensitivity reaction to sequestered antigens from stinging filaments. We report an unusual case of delayed allergic dermatitis with keloid-like presentation caused by Physalia utriculus.

Pendiente resbaladiza de la muerte asistida en los Países Bajos, Bélgica y Colombia / An analysis of the "slippery slope" of assisted death

The study analyzes the phenomenon of the "slippery slope" of assisted death in The Netherlands, Belgium, and Colombia after the depenalization or legalization of this practice. Data analysis was performed reviewing the evidence published in scientific journals and in the governments' official reports. We verified a progressive broadening of the limits initially established by the law for the practice of assisted death in these three countries. This confirms the occurrence of the "slippery slope". Also, the exponential increase in the number of assisted deaths in these three countries after the legalization indirectly suggests the presence of the "slippery slope". An analysis of the anthropological and ethical implications of assisted death highlights that its moral assessment should not be exclusively based on consequentialist arguments. Also, a prudential interpretation of the slippery slope argument in the legal debate about assisted death should be incorporated. We conclude that the moral evaluation of assisted death cannot be exclusively grounded on its negative social consequences, but rather on the lack of respect for basic human values such as life and the intrinsic dignity of a person. The verification of the "slippery slope" in these three countries should be regarded as an alarm for an eventual legalization of euthanasia in Chile.

Calidad higiénico-sanitaria de dos sistemas de ordeño en fincas bovinas ubicadas en el sector Vuelta Larga, municipio Maturín, estado Monagas (Venezuela) / Hygienic-sanitary quality of two milking systems in bovine farms located in sector Vuelta Larga, Maturín municipal state, Monagas state (Venezuela)

RESUMEN El objetivo de la presente investigación fue evaluar la calidad higiénico-sanitaria de dos sistemas de ordeño en fincas bovinas del municipio Maturín estado Monagas (Venezuela). El ensayo tuvo una duración de seis semanas, se calculó la eficiencia higiénica (%EH) de las instalaciones, el personal, la rutina de ordeño, la limpieza-desinfección y el almacenamiento-transporte de dos unidades de producción. Adicionalmente, se determinó la población de bacterias aerobias mesófilas (BAM) que se cuantificaron en un experimento en bloques al azar, con arreglo factorial de los tratamientos (2x2) donde el factor A, correspondió al sistema de ordeño manual y mecánico y el factor B, a la aplicación y omisión de secado de los pezones de cada animal previo al ordeño. La variable se examinó por análisis de varianza y sus valores promedios comparados por Tukey al 5% de probabilidad. El %EH de las fincas evaluadas fue de 66,66% para la finca 2 y de 54,84% para la finca 1, considerados no satisfactorios. Los resultados obtenidos para la variable BAM indican que el factor sistema de ordeño mostró diferencia altamente significativa (p ≤ 0,01); el sistema manual presentó el menor conteo con 5,24 Log10 UFC/ mL; mientras que para el factor condición de secado se constató diferencia significativa (p ≤ 0,05), ya que la aplicación de secado presentó la menor población de bacterias aerobias mesófilas con 5,25 Log10 UFC/mL. Las medidas higiénicas y sanitarias implementadas en la rutina de ordeño influyeron directamente en la calidad de la leche cruda.

ABSTRACT The objective of the present investigation, was to evaluate the 'Hygienic-Sanitary Quality of two Milking Systems in Bovine Farms' in Vuelta Larga Sector, Maturín City, Monagas State (Venezuela). The trial lasted six weeks, in which the Hygienic Efficiency (% EH) of the facilities, the workers, the milking routine, the cleaning and disinfection measures and the storage and transport of both milking systems, were calculated. Furthermore, the population of Mesophilic Aerobic Bacteria (BAM) was determined ; The data were processed following a distribution in random blocks with factorial arrangement (2x2) whose factor A represented the milking system: manual and mechanical, and the factor B was the application and omission of manual drying of teats for each animal prior to milking. The percentage of Hygienic Efficiency (% EH) of the farms evaluated was not satisfactory, corresponding to 66.66% in the farm 2 and 54.84% in the farm 1. The variable was examined by analysis of variance and its mean values compared by Tukey test at 5% of probability. Factor A achieved a highly significant difference (p ≤0.01), with the manual system obtaining the lowest count with 5.24 Log10 CFU / mL. In factor B significant difference was found (p≤0.05), the drying application decreased the BAM population with 5.25 Log10 CFU / mL. The Hygienic and Sanitary measures implemented in the milking routine directly influence the quality of raw milk.

Ventral and dorsal striatal cholinergic neurons have different sensitivities to kainic acid.

The present study was conducted to investigate the sensitivity of the cholinergic elements of ventral and dorsal striatal regions of the rat brain to the neurotoxin kainic acid (KA). Cholinergic activity was assessed by determining choline-acetyltransferase activity (CAT) and by measurements of acetylcholine (Ach) release from slices prelabeled with [3H]-choline. Direct stereotaxic injections of high-dose KA (4 micrograms/2 microliters) into specific brain regions, reduced CAT in caudate putamen (CP) by 91 +/- 1%, in nucleus accumbens (Nac) by 71 +/- 6%, but CAT in the olfactory tubercle (OT) was not affected by KA. The effects of KA on CP CAT were dose- and volume-dependent. In the OT, KA failed to affect CAT at low, moderate or high doses. Slices obtained from CP injected with KA (3 days prior) showed a 90% reduction in the electrically evoked release of [3H]-transmitter release; however, KA had no effect on transmitter release from OT. These results indicate that KA spares the cholinergic elements of the OT, and reveal the existence of marked differences in excitotoxic action of KA between ventral and dorsal striatal regions and among regions of the ventral striatum. Kainic acid preferentially damages neuronal cell bodies, dendrites and terminals intrinsic within the structures injected, with little or no effect on afferent axons and terminal boutons. Therefore, we propose that most of the Ach present in the OT may be within afferent axons and axon terminals. In the CP and NAc, KA lesions reflect loss of intrinsic cholinergic neurons. In addition, variable levels of excitatory inputs and of excitatory receptors, of the mechanisms available to reduce elevated intracellular calcium concentrations and of the levels of free-radical scavenging resources, also could account for the differences in KA neurotoxicity between OT and CP.

Differential effects of kainic acid on dopamine and serotonin metabolism in ventral and dorsal striatal regions.

The comparative effects of kainic acid (KA) on dopamine (DA) and serotonin (5-HT) metabolism in ventral and dorsal striatum were investigated. Local injection of KA into the caudate-putamen (CP) increased by 155% DOPAC (2,3-dihydrophenylacetic acid), by 114% HVA (homovanillic acid) and by 79% 5-HIAA (5-hydroxyindoleacetic acid) concentrations; with little or no effect on monoamine levels. The (DOPAC + HVA)/DA ratio increased from 0.33 +/- 0.2 in vehicle-treated to 0.77 +/- 0.1 in KA-treated CP. 5-HIAA/5-HT ratio increased from 2.7 +/- 0.2 to 5.9 +/- 0.1 after KA treatment. However, direct KA injections into the olfactory tubercle (OT), the most ventral part of the ventral striatum, did not alter significantly the levels of DA, 5-HT, DOPAC, HVA or 5-HIAA. Since KA is a neurotoxin which preferentially destroys perykaria and dendrites, leaving unchanged terminal boutons and axons of passage, the lack of effects on DA and 5-HT metabolism in OT suggests, that contrary to the CP, interneurons and projecting neurons in the OT play no role in inhibitory feedback mechanisms to control DA and 5-HT activities.

Comparative dopamine-acetylcholine interactions in the ventral and dorsal striatum of rabbit and rat brain.

The dopamine (DA)-acetylcholine (ACh) interactions were investigated in dorsal (nucleus caudate, NC) and ventral (olfactory tubercle, OT) striatal regions, of rats and rabbits. Both regions receive a dense dopaminergic innervation and have high ACh concentrations. Brain slices of NC and OT from both animal species were prelabeled with [3H]choline and superfused. In rat and rabbit OT and NC, higher ACh release per pulse was elicited by lower than higher stimulation frequencies; in addition, rabbit tissues released a greater fraction of tissue [3H]transmitter than rat tissues. Blockade of D2 DA-receptors with sulpiride (1 microM), did not modify ACh release in OT and NC of rats and rabbits; suggesting that the lower ACh release observed in rat tissues is not due to an inhibitory dopaminergic tone on cholinergic neurons. Apomorphine (APO), a D2 DA-receptor agonist, inhibited in a concentration-dependent manner the evoked release of ACh from rat and rabbit NC (maximal inhibition = 90%). In rabbit OT, maximal inhibition induced by APO was 49 +/- 2% and in the rat OT, it was 23 +/- 1%. Sulpiride antagonized APO-induced inhibition of ACh release from rat and rabbit NC; however, it failed to prevent APO-induced inhibition in rat OT, and in the rabbit OT reduced it from 47% to 20 +/- 5%. These results indicate differences in the wiring of DA and cholinergic neurons and terminals in dorsal and ventral striatal structures, as well as between rat and rabbit tissues. Cholinergic ventral striatal structures may not receive a direct DA input, and afferent cholinergic nerve terminals (rather than interneurons) predominate in the ventral striatum.

El cuidado de enfermería: una visión integradora en tiempos de crisis / Nursing care: an integrating vision in times of crisis

Existen diversas organizaciones y movimientos humanitarios a nivel mundial que tratan de luchar contra las expresiones de deshumanización, sin embargo, continúa la presencia de situaciones que son causas de dolor en el mundo, por lo que debemos constituir una sociedad para que el mundo sea civilizado, vivir por la calidad de vida y no por acumular cifras estadísticas. El cuidado es una característica común de todos los seres vivos. Por consiguiente, el cuidado humano se reconoce como un concepto universal, inherente a la humanidad. Heidegger, el filósofo por excelencia del cuidado, reconoce que éste es "una constitución ontológica, siempre subyacente a todo lo que el ser humano emprende, proyecta y hace". Enfermería como profesión de naturaleza social intenta que su personal, bajo una óptica humanista, ayude a la persona solicitante del cuidado a reforzar potencialidades y/o minimizar desequilibrios en su estado de salud, por ello reconoce al ser humano como un ser complejo, misterioso, estructurado por diversas dimensiones que van de lo orgánico a lo espiritual, de lo tangible a lo intangible; con inclusión del aspecto social e histórico, que lo define como un ser de interrelaciones permanentes consigo mismo y el mundo. Bajo esta perspectiva, en enfermería, se procura reconocer que la persona cuidada es una entidad única, poseedora de atributos: conciencia, intelecto, dignidad, emociones, sentimientos y saberes, por lo tanto, el cuidado en enfermería asume una dimensión humanista y comprensiva del ser, cuya subjetividad está estructurada por sus vivencias y significados, sentimientos, emociones, intuiciones, razonamientos (AU)

Nowadays, there exist several organizations of humanitarian movements all over the world which try to fight against the dehumanization expressions; however there still exists the presence of situations which are the reasons of pain in the world. That is why we must construct a better and civilized world in which people worries about the quality of life instead of accumulating statistical numbers .Care is a common feature of all human beings. Therefore, human care is recognized as a universal concept, inherent in humanity. Heidegger, the philosopher for excellence of care, recognizes that this is "an ontological constitution that is always underlying to all what the human beings begin, project and make." Nursing as a profession of social nature tries that its staff , under an humanistic perspective , helps the person interested in care to reinforce his /her abilities and /or to minimize imbalances in her /his state of health .That is why it recognizes the human beings as a complex , mysterious and structured in several dimensions being that range from the organic to the spiritual, from the tangible to the intangible , including the social and historical aspect , which defines it as a being of permanent relationships with himself and the world. Under this point of view, nursing tries to recognize that the cared person is a unique entity which has attributes such as: awareness, intellect, dignity, emotions, feelings and knowledge. Therefore, the nursing care assumes a comprehensive and humanistic dimension of the human being whose subjectivity is structured by his experiences ,meanings , feelings , emotions , intuitions ,and reasoning (AU)

Chemical factors involved in cholesterol gallstone formation: possible prevention and medical management.

PIP: Cholesterol supersaturated bile with the concomittant dimunition of bile acids and lecithin usually leads to precipitation and formation of gallstones. Since cholesterol is insoluble in water but soluble in bile, it is important that the proportion of bile to the cholesterol content be such that the latter is always at a lower level. Individuals with gallstones have higher molar percentage of cholesterol than those without; hence the rationale for the low cholesterol diet in people prone to gallstones. Of the 3 bile acids, cholic acid, chenodeoxycholic acid (CDCA), and deoxycholic acid, it is CDCA that is diminished in bile that has become lithogenic; a genetic factor is postulated because of ethnic group tendencies to lithogenecity. Tendency to produce lithogenic bile is not diminished by lessening the exogenous cholesterol and increasing the intake of essential unsaturated fatty acids. Instead, CDCA intake should be increased. Healthy women planning to take oral contraceptives (OCs) are cautioned that ingestion is accompanied by significant rise in the cholesterol saturation of gall baldder bile. 1 report showed that the mean level of cholesterol saturation was 92% in women off the OCs and 125% in women on OCs. Of the women off OCs, only 6/20 had supersaturated bile, whereas 16/20 women on OCs had supersaturated bile. Supersaturation is explained by 2 mechanisms: 1) secretion of cholesterol into bile by the liver; and 2) secretion of solubilizing lipids. Prevention of gallstone formation may be accomplished by administering CDCA from .75-4 gms daily or maintaining sufficient intake of vitamin C.^ieng

Effects of heating procedures on deoxynivalenol, nivalenol and zearalenone levels in naturally contaminated barley and wheat.

The influence of heating temperature and time on deoxynivalenol (DON), nivalenol (NIV) and zearalenone (ZEA) contents in naturally co-contaminated barley and wheat was investigated intending to establish the basis for a decontamination model of Fusarium mycotoxins in cereals. The standard toxins and whole barley powder samples were heated in a convection oven at 140, 160, 180, 200, or 220 degrees C, and kernel subsamples (200 g each) were roasted in an experimental rotary gas-fired roaster at 150, 180 or 220 degrees C. All treatments resulted in a time-temperature-dependent decomposition of the toxins; the logarithm of the toxin remaining % presented a linear relationship with heating time. The lines equations were used to estimate the half (H) and decimal (D) decomposition times (time required to destroy 50 or 90% of the toxin, respectively). DON and NIV H and D decomposition times were similar and 50% shorter for heated standards than for whole barley powder. ZEA standard values were considerably longer, while whole barley powder values were comparable with those of DON and NIV. At 220 degrees C, D decomposition times of DON, NIV and ZEA heated standards were 11, 10 and 85 min, respectively, while the values obtained in whole barley powder were the same for the three toxins (25 min). The determination of H and D decomposition values constitutes a basis to understand the heating stability nature of each toxin.

Ictericias. Nuevos procedimientos diagnosticos. / Jaundices. New diagnostic procedures

Se mencionan los nuevos procedimientos diagnosticos auxiliares de la clinica en el esclarecimiento de los casos dificiles de ictericia. Se destaca el valor de la ultrasonografia hepatica (colangiografia ultrasonica) en el diagnostico de la ictericia obstructiva mecanica extrahepatica, presentando 3 casos demostrativos, dos de los cuales fueron confirmados por la cirugia y el tercero por la autopsia

Análisis de la placenta en el retardo del crecimiento intrauterino / Analysis of the placenta in the intrauterine growth retardation

Se estudian los cambios morfológicos e histológicos de 47 placentas de niños con retardo de crecimiento intrauterino, encontrándose una relación directa entre el peso placentario y el peso del recién nacido, así como también un predominio de la inserción marginal y paracentral extrema del cordón umbilical. Histológicamente la presencia de congestión y corioangiosis fue notable al igual que el depósito de fibrina intervellosa, predominando este último hallazgo entre las madres fumadoras

Investigación sobre una técnica proyectiva mediante el uso de dibujos colectivos / A projective technical investigation by means of collective drawings

Describimos el uso de dibujos colectivos como la posibilidad de utilizar un recurso plástico, una técnica de acción y un medio proyectivo para esclarecer, fortalecer y dilucidar hipótesis formuladas con respecto al proceso grupal, en cuanto a su desarrollo, avances, desviaciones, generación de síntomas y conciencia de sí mismo. Es la posibilidad de "ver" con más claridad tanto para los coordinadores del grupo como para los participantes del mismo. En estos últimos, el dibujo llega a representar la evidencia de fenómenos grupales que no habían sido hecho explicitos aún, o bien, que no se había expuesto con palabras por alguna razón; sirven como la representación-cosa que por medio de asociaciones generarán sentidos