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Water evacuations in remote tourist regions: evaluating case studies from natural hazards in North Patagonian lakes, Argentina

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Journal of Mountain Science 2022年第6期19卷 1782-1807页

作者： salgado pablo agustin VILLAROSA Gustavo BEIGT Debora OUTES Valeria IPATEC(Instituto Andino-Patagonico de Tecnologias Biologicas y Geoambientales) CONICET-UNCOAv.de los Pioneros 23508400 S.C.de BarilocheArgentina Centro Regional Uniuersitario Bariloche Universidad Nacional del ComahueQuintral 12508400 S.C.de BarilocheArgentina

The remote North Patagonian region is a sparsely populated territory and a world famous tourist destination located on the leeward side of the Andes Mountains. Recent disasters triggered by various types of geoenvironmental hazards(including volcanic eruptions, mass-wasting processes and extreme weather events) heavily disrupted ground transport networks in a region with already limited territorial accessibilities. All these catastrophes prompted the need to evacuate or assist a number of secluded visitors, locals and livestock extemporaneously on board of coastguards and tourist passenger-ships from the shores of the many glacial lakes that make up part of the regional attraction. Despite the recurrence of these types of events, water evacuations in the region continue to be spontaneous, improvised and hazardous procedures. This contribution reconstructs and assesses a number of recent local-scale cases of lake evacuations and assistances from a number of Patagonian urban centers, rural areas and tourist sites. For each case study, we systematically elaborated on the prime components of an evacuation process, which enabled us to recognize key achievements, failures and conditioning factors for managing emergencies via water transport, most of them inherent to the studied region. Some of the complexities to emerge from case studies referred to: complex hazard-related scenarios;limited ground-based accessibilities and risk of isolation;various inter-and intra-organizational issues, incidental to natural reserves and tourist regions;a wide range of particular demographic features;and the availability and vulnerability of water transport resources. We suggested fundamental and replicable recommendations for developing water evacuation plans, also identifying forthcoming problems to solve in order to improve the management of emergencies through this alternative means of transport.

关键词： Water transport Emergency management Accessibility problems Tourism activities Volcanic crises Mountain area

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Addition of statins to the standard treatment in patients with cirrhosis:Safety and efficacy

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World Journal of Gastroenterology 2021年第28期27卷 4639-4652页

作者： Alberto E Muñoz Florencia D Pollarsky Mónica Marino Mariano Cartier Horacio Vázquez pablo salgado Gustavo Romero Sección Hepatología Hospital de Gastroenterología Dr.Carlos Bonorino UdaondoFacultad de MedicinaUniversidad de Buenos AiresCiudad Autónoma de Buenos Aires 1264Argentina Instituto de Investigaciones en Salud Pública Facultad de OdontologíaUniversidad de Buenos AiresCiudad Autónoma de Buenos Aires 1122Argentina Unidad Clínica Hospital de Gastroenterología Dr.Carlos Bonorino UdaondoInvestigador Asociado del Gobierno de la Ciudad Autónoma de Buenos AiresCiudad Autónoma de Buenos Aires 1264Argentina

This review summarizes the safety and efficacy of statins in patients with *** to concerns about the safety of statins in patients with impaired liver function,they have recently been investigated as a potential treatment option in *** most clinically significant adverse event is statin-related myopathy,and this may be related to the high serum statin concentrations in the setting of severely impaired liver *** is the most serious and potentially life-threatening *** has recently been demonstrated that the recommended dose of simvastatin in patients with decompensated cirrhosis would be 20 mg/d because higher values,such as 40 mg/d,are associated with many adverse events,especially muscle ***,simvastatin should not be administered to patients with Model for End-stage Liver Disease score>12 and/or Child-Pugh class C because of the high risk of severe muscle *** to the pleiotropic effects,the focus on statins has shifted from being considered harmful to something *** these effects,statins could prevent liver-related morbidity and mortality in cirrhotic *** studies in large populations of patients with cirrhosis have shown that treatment with statins to decrease high cholesterol levels was associated with a reduced risk of hepatic decompensation,hepatocellular carcinoma development and *** few randomized controlled trials in patients with cirrhosis and portal hypertension showed that statins lower portal pressure,quite likely through a reduction in hepatic *** large randomized controlled trial in patients with variceal bleeding showed that simvastatin in addition to standard of care did not prevent rebleeding but improved survival *** these encouraging outcomes,the quality of the evidence regarding the use of statins is low or very low due to the observational characteristics of most of the studies ***,it is advisable to per

关键词： Cirrhosis Liver disease Statins Safety Efficiency

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