Les indications géographiques (IG) sont un instrument de plus en plus utilisé dans le monde entier. Sujet fréquent des négociations de commerce international, la régulation des IG est un des thèmes les plus importants dans les discussions concernant l'organisation du système agroalimentaire mondial, dans la mesure où il concerne un ensemble de questions autour des droits de propriété intellectuelle et de l'accès aux marchés. Opposé à un processus de standardisation de la production et de la consommation alimentaire, les IG cherchent à valoriser la diversité et l'originalité de produits ancrés dans des territoires spécifiques, mettant l'accent sur les biens immatériels (savoir-faire, tradition, habitudes, façon de produire etc.). Pourtant, il s'agit d'un concept générique qui peut être utilisé dans différents contextes et par des acteurs sociaux les plus divers, y compris pour ceux qui sont dehors du territoire. Chaque projet d'indication géographique est composé par un réseau sociotechnique hétérogène, au sein duquel sont négociées différentes conceptions de qualité et où des valeurs sont en conflit permanent. L'institutionnalisation des règles et des modes de production qui permettent aux acteurs d'échanger est le résultat de ce processus de négociation où des compromis entre des valeurs différentes sont constitués. Dans le monde des vins, les indications géographiques ont été pendant longtemps un concept qui était presque exclusivement lié à un modèle de production lié à la valorisation de terroirs distincts, à l'institutionnalisation de la rareté et à des méthodes traditionnelles de viticulture et de vinification. Cependant, les changements en cours sur le marché mondial, associés à l'entrée en scène de nouveaux acteurs et de nouvelles conventions qualitatives, ont commencé à transfigurer la vie des terroirs et la notion même d'indication géographique. Son adaptation aux nouveaux enjeux économiques a révélé la façon dont ce mécanisme peut être adapaté à différents objectifs. Dans cette thèse, nous révèlons que le développement récent de cet instrument de qualification dans le secteur vitivinicole exprime un double processus d'institutionnalisation. D'un côté, les IG ont incité la valorisation des territoires et de leur identité, avec, dans certains cas, la création d'obstacles aux innovations qui pourraient mettre en péril la typicité des produits. De l'autre, les IG ont été ajustées, dans le cadre d'un processus d'appropriation sectorielle, pour permettre des innovations techniques et organisationnelles jugées nécessaires pour que les producteurs puissent réagir à la perte de compétitivité sur les marchés nationaux et internationaux. Ainsi, dans un contexte d'hybridation des stratégies compétitives sur le marché du vin, les projets concilient des modèles conceptuels autrefois antagonistes. Pour cela, plus que concilier tradition et innovation, les IG créent des nouveaux compromis entre des principes de valorisation (définitions de qualité), qui se matérialisent dans un ensemble de changements des pratiques productives impliquant notamment le choix des cépages ou la définition des méthodes de vinification parmi d'autres composants. Nous avons étudié sept IG distinctes au Brésil (Vale dos Vinhedos, Pinto Bandeira, Monte Belo Sul, Farroupilha, Garribaldi) et en France (Beaujolais, Languedoc) sur la base d'entretiens semi-directifs, d'observation et d'analyse documentaire.

This thesis presents an ethnography of the processes and practices through which Australian grape and wine producers attempt to produce, and to assess, quality and value in the materials with which they work. Drawing on participant observation research conducted within two wine companies in South Australia – one owned by a multinational beverage conglomerate, one a family-owned boutique winery – this thesis engages with three overarching questions, which engage with the concerns of agro-food studies and of social studies of markets. First, how – and with what economic effects – are the sensory qualities of materials made to matter within the Australian wine industry? Second, how do grape and wine producers pursue wine quality in a more-than-human world, and in what ways might their endeavours problematise extant theorisations of economic agency? Finally, what might be the consequences of Australian wine producers’ recent engagements with principles of grape and wine quality centred upon geographical origin? In response to these questions, this thesis explores time-reckoning and value production in viticultural practice, the pricing of winegrapes during a fungal disease epidemic, the commercial relationships convened through the production of large-volume mass-market wine blends, and Australian wine producers’ recent attempts to produce ‘wines from somewhere.’ These empirical engagements lead it to argue that the qualification and valuation practices deployed within the Australian wine industry do not simply affect the qualities and prices of grapes and wines. They also shape economic agencies and vulnerabilities, organise and value commercial relationships among grape growers and wine producers, and reassemble the economic geographies of Australian grape production. This thesis concludes that because different ways of pursuing quality enact these phenomena in different ways, much may depend not only upon how successfully, but also upon how – through what techniques, practices, and associations – quality is pursued.

Submitted by Maicon Juliano Schmidt (maicons) on 2015-06-03T13:37:45Z No. of bitstreams: 1 Alexandre Rubenich Silva.pdf: 4758080 bytes, checksum: 83c6bf0e9ccaab76925ae6559ba1fcce (MD5) / Made available in DSpace on 2015-06-03T13:37:45Z (GMT). No. of bitstreams: 1 Alexandre Rubenich Silva.pdf: 4758080 bytes, checksum: 83c6bf0e9ccaab76925ae6559ba1fcce (MD5) Previous issue date: 2015-03-24 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / PROSUP - Programa de Suporte à Pós-Gradução de Instituições de Ensino Particulares / Com a publicação da Gesamtausgabe temos a possibilidade única de acompanharmos a gênese do pensamento de Martin Heidegger. Os diferentes caminhos percorridos por sua filosofia hermenêutica, as interrupções, as voltas, os giros que suas noções sofreram no maturar do seu pensamento não se deixam apreender compreensivamente sem que se atente, entretanto, para aquilo que despontou já desde muito cedo, a saber, a utilização do método fenomenológico da ‘indicação formal’ [formale Anzeige]. Com efeito, a presente tese defende a ideia de que foi por intermédio de tal método que Heidegger pôde chegar a perguntar pelo sentido do ser, e não mais pelo sentido do ente, como até então propunha a tradição metafísica. Nesses termos, o nosso trabalho procura descer ao tempo das primeiras preleções do filósofo alemão, especialmente aquelas que vão de 1919 a 1923, quando a noção da indicação formal vai ser trabalhada extensivamente. É nosso interesse, pois, contribuir para o esclarecimento do seu significado, bem como entender a importância de sua formulação, na medida em que tal noção funcionará como uma defesa para a filosofia contra a queda no âmbito da referência, cuja pretensão, esquecida de sua origem, era alcançar adequadamente o objeto e, assim, enquadrar-se como uma ciência dos entes, ainda que em sua totalidade. Acontece que as preocupações de Heidegger estão inicialmente voltadas para o “conceito” de ‘vida’ [Leben], que lida em chave fenomenológica receberá a singular interpretação de ‘ser-aí’ [Dasein], ‘existência’ [Existenz], o que vai lhe exigir a elaboração de uma hermenêutica específica, nomeada, a partir de 1923, de ‘hermenêutica da facticidade’ [Hermeneutik der Faktizität]. Ora, é justamente esta hermenêutica, enquanto interpretação fenomenológica da vida, que Heidegger quer conquistar, com o intuito de liberar a vida da sua trama teórico-conceitual. Pois, de acordo com o filósofo alemão, somente se acede ao pensamento do ser passando pela pergunta pelo seu sentido, o qual diz respeito ao como do estar desperto do existir para consigo mesmo. / With the publication of Gesamtausgabe we have the unique opportunity to accompany the genesis of the thought of Martin Heidegger. The different paths taken by his hermeneutic philosophy, the interruptions, the changes, the turns that his notions suffered in the mature of his thought don´t let itself apprehend comprehensively without paying attention, however, to what has already emerged very early, namely, the use of the phenomenological method of 'formal indication' [formale Anzeige]. Indeed, the present thesis supports the idea that it was through this method that Heidegger was able to ask the meaning of the being, and not by the sense of the being anymore, as the metaphysical tradition proposed so far. In these terms, our work tries to go down to the time of the first lectures of the German philosopher, especially those from 1919 to 1923, when the notion of the formal indication is worked extensively. It is of our interest, thus, to contribute to the clarification of its meaning, as well as to understand the importance of the formulation, to the point that such a concept will work as a defense for the philosophy against a fall in the context of the reference, in which the intention, with its origin forgotten, was to adequately achieve the object and thus framed as a science of the beings, still in its totality. It turns out that the concerns of Heidegger are initially focused on the "concept" of "life" [Leben], which deals in phenomenological key will receive the unique interpretation of the 'being-there' [Dasein] 'existence’ [Existenz], which will require the preparation of a specific hermeneutics, named, from 1923, the 'hermeneutics of facticity' [Hermeneutik der Faktizität]. Now, it is exactly this hermeneutic, while phenomenological interpretation of life, which Heidegger wants to conquest, in order to free life from its theoretical and conceptual frame. Since, according to the German philosopher, only reaches the thought of the being going through the question through its meaning, which relates to how to be awake from the exist for oneself.

O Exame de Medula Óssea (EMO) permite avaliação citológica da medula, sendo útil no diagnóstico e monitoramento de desordens hematológicas, quando exames mais simples não são suficientes para esclarecer o quadro clínico. Investigação clínica e laboratorial completa deve ser realizada para garantir que a indicação apropriada exista. São requeridas pelo menos duas colorações (Romanowsky e Azul da Prússia), onde devem ser avaliadas a qualidade da amostra, celularidade global da mesma, contagem diferencial de células nucleadas, relação Mielóide/Eritróide bem como cuidadosa avaliação quantitativa e qualitativa das três linhagens hematopoéticas (Granulocítica, Eritróide e Megacariocítica). O EMO fornece informações relevantes no diagnóstico e monitoramento de Leucemias/Linfomas, Mieloma Múltiplo (MM), Síndrome Mielodisplásica (SMD), Aplasia medular, doença metastática na Medula Óssea (MO), infecções em HIV positivos, febre de origem desconhecida e investigação de citopenias. Tendo em vista a classificação da OMS de 2008 para neoplasias mielóides e leucemias agudas cabe ressaltar a importância de unir achados citogenéticos, dentre os quais se destacam atualmente as mutações gênicas FLT3, KIT, NPM1 e CEBPA, aos achados morfológicos, imunofenotípicos, citoquímicos e clínicos, alcançando desta forma marcadores diagnósticos e prognósticos precisos que servem como guia para um tratamento eficaz. Este estudo tem por objetivo identificar as principais indicações para o EMO no HCPA bem como verificar a acurácia das mesmas. Foram analisados 400 pacientes submetidos ao EMO na Unidade de Hematologia do HCPA no período de Janeiro a Dezembro de 2009, tendo sido resgatados todos os resultados do Aspirado de Medula Óssea bem como dados clínicos e laboratoriais relevantes obtidos do prontuário médico. Verificou-se que cerca de metade dos pacientes submetidos ao EMO em nosso centro são para controle de tratamento, o que está de acordo com as características do mesmo, o qual é referência regional para tratamento de doenças malignas. Nos pacientes que realizam o exame com propósito diagnóstico as indicações principais são suspeita de Leucemia e MM. Nos 260 pacientes com suspeita de doença hematológica primária observou-se confirmação da mesma em 61% dos casos, nos 39% restantes foram encontradas alterações qualitativas e/ou quantitativas (29%), MO normal (7%) e amostra insuficiente/diluída (3%). Dos pacientes que fizeram o exame com propósito diagnóstico 20.5% não fizeram biópsia. Com relação à acurácia da indicação, encontrou-se que 7 pacientes (2%) provavelmente não deveriam ter sido submetidos a este procedimento. Ressaltamos a importância de realizar em todos os casos Aspirado e Biópsia de MO simultaneamente uma vez que seus achados devem ser correlacionados e se a Biópsia for omitida o patologista pode não obter a informação máxima requerida. / The Bone Marrow Examination (BME) permits cytological assessment of Marrow, being useful in the diagnosis and monitoring of hematological disorders, when simpler tests are not sufficient to clarify the clinical picture. Are required at least two colors (Romanowsky and Prussian blue), it should be evaluated the quality of the sample, the same overall cellularity, differential count of nucleated cells, myeloid:erythroid (M:E) ratio and carefull evaluation quantitative / qualitative from the three lineages of hematopoietic (granulocytic, erythrocytic and megakaryocytic). The BME provides information relevant to diagnosis and follow-up of leukemia/lymphoma, multiple myeloma (MM), myelodysplastic syndrome (MDS), marrow aplasia, bone marrow (BM) metastatic disease , infections in HIV positive, pyrexia of unknown origin and investigation of cytopenias. The 2008 classification of the World Health Organization (WHO) to the myeloid neoplasms and acute leukemia highlight the importance of join cytogenetic findings - bring out currently FLT3, KIT, NPM1 and CEBPA gene mutations - to the morphologic, immunophenotypic, cytochemical and clinical findings reaching this way accurate diagnostic and prognostic markers that serve as a guide to effective treatment. This study aims to identify the main indications for the BME at HCPA and to verify their accuracy. It were analyzed 400 patients submitted to BME in the Hematology Unit of HCPA in the period January to December 2009, having been rescued the bone marrow aspirate results as well as all relevant clinical and laboratory data obtained from the medical records. It was found that about half of patients submit BME in our center are to control treatment, which agrees with the characteristics of it, it is a regional referral center for treatment of malignancies. In patients who perform the test with diagnostic purpose the main indications were suspected leukemia and MM. In 260 patients with suspected primary hematological disease 61.2% turned out to be the case, the remaining 38.8% had quantitative and/or qualitative BM alterations (29.6%), normal MO (6.5%) and insufficient sample or diluted (2.7%). Of the patients who took the exam with diagnostic purpose 20.5% had no biopsy. With respect to accuracy of indication, it was found that 7 patients (2%) probably should not have undergone this procedure. We emphasize the importance of performing in all cases aspirate and biopsy since their findings must be correlated and furthermore if the biopsy is omitted the pathologist can not get the maximum information required.

<p>Background: Pain can be a constant problem in many older people's daily life, associated with particular physical and social disability, depression and poor quality of life. Dementia diseases are often associated with old age. Communication difficulties are one of the consequences of the disease, which clarifies the role of nursing staff in detecting and assessing pain. Objective: The aim was to compile knowledge about how nursing staff can identify pain in people with dementia. Method: A systematic literature review, where data were collected through manual and database searches. Databases Cinahl, Pubmed and electronic journal Health in the Nordic countries were used. Results: The results showed that pain-identification can be improved by knowing how the pain is reflected in different forms through physical and psychological reactions. Nursing staff knowledge and beliefs were essential for reliable pain assessment. It was also important to be able to see the relationship between cognitive function and pain perception, and to have access to pain assessment tools adapted to individual conditions. Conclusion: Living with constant pain can lead to unnecessary suffering and reduced quality of life. It’s important to be alert to changes in behaviours and habits of daily life. To provide good care, requires knowledge and engagement in caring for people with dementia.</p> / <p>Bakgrund: Smärta som kan vara ett ständigt problem i många äldres dagliga liv, förenad medbland annat fysiska och sociala handikapp, depression samt dålig livskvalitet.Demenssjukdom innefattar skador i hjärnan som ofta är förknippade med hög ålder.Kommunikationssvårighet är en av sjukdomens konsekvenser, vilket tydliggörvårdpersonalens roll i att upptäcka och bedöma smärta. Syfte: Syftet var att sammanställakunskap om hur vårdpersonalen kan identifiera smärta hos personer med demenssjukdom.Metod: En systematisk litteraturstudie, där datainsamling genomfördes via manuella ochdatabassökningar. Databaser Cinahl, Pubmed och elektronisk tidskriften Vård i Nordenanvändes. Resultat: Resultatet visade att smärtidentifiering kan förbättras genom att kännatill hur smärta speglar sig i olika uttryck genom fysiska och psykosociala reaktioner.Vårdpersonalens kunskap och förståelse var grundläggande förutsättningar för att uppnåadekvat bedömning och behandling av smärta. Viktigt var det också att kunna se sambandmellan kognitiv funktion och smärtupplevelse samt att ha tillgång tillsmärtskattningsinstrument som är anpassade efter individers behov och möjligheter.Slutsats: Att leva med ständig smärta kan leda till onödigt lidande och försämrad livskvalitet.Det är viktigt att vara uppmärksam på förändringar i beteende, vanor och mönster i detdagliga livet. För att kunna ge en god omvårdnad, krävs det kunskap samt engagemang ivårdande av personer med demenssjukdom.</p>

Background: Pain can be a constant problem in many older people's daily life, associated with particular physical and social disability, depression and poor quality of life. Dementia diseases are often associated with old age. Communication difficulties are one of the consequences of the disease, which clarifies the role of nursing staff in detecting and assessing pain. Objective: The aim was to compile knowledge about how nursing staff can identify pain in people with dementia. Method: A systematic literature review, where data were collected through manual and database searches. Databases Cinahl, Pubmed and electronic journal Health in the Nordic countries were used. Results: The results showed that pain-identification can be improved by knowing how the pain is reflected in different forms through physical and psychological reactions. Nursing staff knowledge and beliefs were essential for reliable pain assessment. It was also important to be able to see the relationship between cognitive function and pain perception, and to have access to pain assessment tools adapted to individual conditions. Conclusion: Living with constant pain can lead to unnecessary suffering and reduced quality of life. It’s important to be alert to changes in behaviours and habits of daily life. To provide good care, requires knowledge and engagement in caring for people with dementia. / Bakgrund: Smärta som kan vara ett ständigt problem i många äldres dagliga liv, förenad medbland annat fysiska och sociala handikapp, depression samt dålig livskvalitet.Demenssjukdom innefattar skador i hjärnan som ofta är förknippade med hög ålder.Kommunikationssvårighet är en av sjukdomens konsekvenser, vilket tydliggörvårdpersonalens roll i att upptäcka och bedöma smärta. Syfte: Syftet var att sammanställakunskap om hur vårdpersonalen kan identifiera smärta hos personer med demenssjukdom.Metod: En systematisk litteraturstudie, där datainsamling genomfördes via manuella ochdatabassökningar. Databaser Cinahl, Pubmed och elektronisk tidskriften Vård i Nordenanvändes. Resultat: Resultatet visade att smärtidentifiering kan förbättras genom att kännatill hur smärta speglar sig i olika uttryck genom fysiska och psykosociala reaktioner.Vårdpersonalens kunskap och förståelse var grundläggande förutsättningar för att uppnåadekvat bedömning och behandling av smärta. Viktigt var det också att kunna se sambandmellan kognitiv funktion och smärtupplevelse samt att ha tillgång tillsmärtskattningsinstrument som är anpassade efter individers behov och möjligheter.Slutsats: Att leva med ständig smärta kan leda till onödigt lidande och försämrad livskvalitet.Det är viktigt att vara uppmärksam på förändringar i beteende, vanor och mönster i detdagliga livet. För att kunna ge en god omvårdnad, krävs det kunskap samt engagemang ivårdande av personer med demenssjukdom.

No description available.

O Exame de Medula Óssea (EMO) permite avaliação citológica da medula, sendo útil no diagnóstico e monitoramento de desordens hematológicas, quando exames mais simples não são suficientes para esclarecer o quadro clínico. Investigação clínica e laboratorial completa deve ser realizada para garantir que a indicação apropriada exista. São requeridas pelo menos duas colorações (Romanowsky e Azul da Prússia), onde devem ser avaliadas a qualidade da amostra, celularidade global da mesma, contagem diferencial de células nucleadas, relação Mielóide/Eritróide bem como cuidadosa avaliação quantitativa e qualitativa das três linhagens hematopoéticas (Granulocítica, Eritróide e Megacariocítica). O EMO fornece informações relevantes no diagnóstico e monitoramento de Leucemias/Linfomas, Mieloma Múltiplo (MM), Síndrome Mielodisplásica (SMD), Aplasia medular, doença metastática na Medula Óssea (MO), infecções em HIV positivos, febre de origem desconhecida e investigação de citopenias. Tendo em vista a classificação da OMS de 2008 para neoplasias mielóides e leucemias agudas cabe ressaltar a importância de unir achados citogenéticos, dentre os quais se destacam atualmente as mutações gênicas FLT3, KIT, NPM1 e CEBPA, aos achados morfológicos, imunofenotípicos, citoquímicos e clínicos, alcançando desta forma marcadores diagnósticos e prognósticos precisos que servem como guia para um tratamento eficaz. Este estudo tem por objetivo identificar as principais indicações para o EMO no HCPA bem como verificar a acurácia das mesmas. Foram analisados 400 pacientes submetidos ao EMO na Unidade de Hematologia do HCPA no período de Janeiro a Dezembro de 2009, tendo sido resgatados todos os resultados do Aspirado de Medula Óssea bem como dados clínicos e laboratoriais relevantes obtidos do prontuário médico. Verificou-se que cerca de metade dos pacientes submetidos ao EMO em nosso centro são para controle de tratamento, o que está de acordo com as características do mesmo, o qual é referência regional para tratamento de doenças malignas. Nos pacientes que realizam o exame com propósito diagnóstico as indicações principais são suspeita de Leucemia e MM. Nos 260 pacientes com suspeita de doença hematológica primária observou-se confirmação da mesma em 61% dos casos, nos 39% restantes foram encontradas alterações qualitativas e/ou quantitativas (29%), MO normal (7%) e amostra insuficiente/diluída (3%). Dos pacientes que fizeram o exame com propósito diagnóstico 20.5% não fizeram biópsia. Com relação à acurácia da indicação, encontrou-se que 7 pacientes (2%) provavelmente não deveriam ter sido submetidos a este procedimento. Ressaltamos a importância de realizar em todos os casos Aspirado e Biópsia de MO simultaneamente uma vez que seus achados devem ser correlacionados e se a Biópsia for omitida o patologista pode não obter a informação máxima requerida. / The Bone Marrow Examination (BME) permits cytological assessment of Marrow, being useful in the diagnosis and monitoring of hematological disorders, when simpler tests are not sufficient to clarify the clinical picture. Are required at least two colors (Romanowsky and Prussian blue), it should be evaluated the quality of the sample, the same overall cellularity, differential count of nucleated cells, myeloid:erythroid (M:E) ratio and carefull evaluation quantitative / qualitative from the three lineages of hematopoietic (granulocytic, erythrocytic and megakaryocytic). The BME provides information relevant to diagnosis and follow-up of leukemia/lymphoma, multiple myeloma (MM), myelodysplastic syndrome (MDS), marrow aplasia, bone marrow (BM) metastatic disease , infections in HIV positive, pyrexia of unknown origin and investigation of cytopenias. The 2008 classification of the World Health Organization (WHO) to the myeloid neoplasms and acute leukemia highlight the importance of join cytogenetic findings - bring out currently FLT3, KIT, NPM1 and CEBPA gene mutations - to the morphologic, immunophenotypic, cytochemical and clinical findings reaching this way accurate diagnostic and prognostic markers that serve as a guide to effective treatment. This study aims to identify the main indications for the BME at HCPA and to verify their accuracy. It were analyzed 400 patients submitted to BME in the Hematology Unit of HCPA in the period January to December 2009, having been rescued the bone marrow aspirate results as well as all relevant clinical and laboratory data obtained from the medical records. It was found that about half of patients submit BME in our center are to control treatment, which agrees with the characteristics of it, it is a regional referral center for treatment of malignancies. In patients who perform the test with diagnostic purpose the main indications were suspected leukemia and MM. In 260 patients with suspected primary hematological disease 61.2% turned out to be the case, the remaining 38.8% had quantitative and/or qualitative BM alterations (29.6%), normal MO (6.5%) and insufficient sample or diluted (2.7%). Of the patients who took the exam with diagnostic purpose 20.5% had no biopsy. With respect to accuracy of indication, it was found that 7 patients (2%) probably should not have undergone this procedure. We emphasize the importance of performing in all cases aspirate and biopsy since their findings must be correlated and furthermore if the biopsy is omitted the pathologist can not get the maximum information required.

O Exame de Medula Óssea (EMO) permite avaliação citológica da medula, sendo útil no diagnóstico e monitoramento de desordens hematológicas, quando exames mais simples não são suficientes para esclarecer o quadro clínico. Investigação clínica e laboratorial completa deve ser realizada para garantir que a indicação apropriada exista. São requeridas pelo menos duas colorações (Romanowsky e Azul da Prússia), onde devem ser avaliadas a qualidade da amostra, celularidade global da mesma, contagem diferencial de células nucleadas, relação Mielóide/Eritróide bem como cuidadosa avaliação quantitativa e qualitativa das três linhagens hematopoéticas (Granulocítica, Eritróide e Megacariocítica). O EMO fornece informações relevantes no diagnóstico e monitoramento de Leucemias/Linfomas, Mieloma Múltiplo (MM), Síndrome Mielodisplásica (SMD), Aplasia medular, doença metastática na Medula Óssea (MO), infecções em HIV positivos, febre de origem desconhecida e investigação de citopenias. Tendo em vista a classificação da OMS de 2008 para neoplasias mielóides e leucemias agudas cabe ressaltar a importância de unir achados citogenéticos, dentre os quais se destacam atualmente as mutações gênicas FLT3, KIT, NPM1 e CEBPA, aos achados morfológicos, imunofenotípicos, citoquímicos e clínicos, alcançando desta forma marcadores diagnósticos e prognósticos precisos que servem como guia para um tratamento eficaz. Este estudo tem por objetivo identificar as principais indicações para o EMO no HCPA bem como verificar a acurácia das mesmas. Foram analisados 400 pacientes submetidos ao EMO na Unidade de Hematologia do HCPA no período de Janeiro a Dezembro de 2009, tendo sido resgatados todos os resultados do Aspirado de Medula Óssea bem como dados clínicos e laboratoriais relevantes obtidos do prontuário médico. Verificou-se que cerca de metade dos pacientes submetidos ao EMO em nosso centro são para controle de tratamento, o que está de acordo com as características do mesmo, o qual é referência regional para tratamento de doenças malignas. Nos pacientes que realizam o exame com propósito diagnóstico as indicações principais são suspeita de Leucemia e MM. Nos 260 pacientes com suspeita de doença hematológica primária observou-se confirmação da mesma em 61% dos casos, nos 39% restantes foram encontradas alterações qualitativas e/ou quantitativas (29%), MO normal (7%) e amostra insuficiente/diluída (3%). Dos pacientes que fizeram o exame com propósito diagnóstico 20.5% não fizeram biópsia. Com relação à acurácia da indicação, encontrou-se que 7 pacientes (2%) provavelmente não deveriam ter sido submetidos a este procedimento. Ressaltamos a importância de realizar em todos os casos Aspirado e Biópsia de MO simultaneamente uma vez que seus achados devem ser correlacionados e se a Biópsia for omitida o patologista pode não obter a informação máxima requerida. / The Bone Marrow Examination (BME) permits cytological assessment of Marrow, being useful in the diagnosis and monitoring of hematological disorders, when simpler tests are not sufficient to clarify the clinical picture. Are required at least two colors (Romanowsky and Prussian blue), it should be evaluated the quality of the sample, the same overall cellularity, differential count of nucleated cells, myeloid:erythroid (M:E) ratio and carefull evaluation quantitative / qualitative from the three lineages of hematopoietic (granulocytic, erythrocytic and megakaryocytic). The BME provides information relevant to diagnosis and follow-up of leukemia/lymphoma, multiple myeloma (MM), myelodysplastic syndrome (MDS), marrow aplasia, bone marrow (BM) metastatic disease , infections in HIV positive, pyrexia of unknown origin and investigation of cytopenias. The 2008 classification of the World Health Organization (WHO) to the myeloid neoplasms and acute leukemia highlight the importance of join cytogenetic findings - bring out currently FLT3, KIT, NPM1 and CEBPA gene mutations - to the morphologic, immunophenotypic, cytochemical and clinical findings reaching this way accurate diagnostic and prognostic markers that serve as a guide to effective treatment. This study aims to identify the main indications for the BME at HCPA and to verify their accuracy. It were analyzed 400 patients submitted to BME in the Hematology Unit of HCPA in the period January to December 2009, having been rescued the bone marrow aspirate results as well as all relevant clinical and laboratory data obtained from the medical records. It was found that about half of patients submit BME in our center are to control treatment, which agrees with the characteristics of it, it is a regional referral center for treatment of malignancies. In patients who perform the test with diagnostic purpose the main indications were suspected leukemia and MM. In 260 patients with suspected primary hematological disease 61.2% turned out to be the case, the remaining 38.8% had quantitative and/or qualitative BM alterations (29.6%), normal MO (6.5%) and insufficient sample or diluted (2.7%). Of the patients who took the exam with diagnostic purpose 20.5% had no biopsy. With respect to accuracy of indication, it was found that 7 patients (2%) probably should not have undergone this procedure. We emphasize the importance of performing in all cases aspirate and biopsy since their findings must be correlated and furthermore if the biopsy is omitted the pathologist can not get the maximum information required.

At the beginning of the 1990s, the Argentine wine industry experienced a shift from quantity to quality production which occurred while economic policies in Argentina opened economic opportunities for investment in the country. With these new opportunities, the industry began to focus on producing quality wine because of the desire to export and compete in the international market. As foreign investment entered Mendoza, the heart of Argentine wine country, new ideas and knowledge about wine production began to disseminate into the region and everyday practices. The shift from quantity to quality production was a paradigm shift in that it ushered in a new way of understanding quality in relation to the land, resulted in the younger generation of winemakers excelling in the region, and ultimately led to a new way of viewing production practices and techniques entirely separate from the previous century of production. This project asks: to what extent did this shift impact the implementation and regulation of geographic indications in Mendoza? It seeks to understand the impact that terroir-driven wine production imparted on Argentine winemakers to illuminate the resilience and perseverance of a growing wine center in the Global South.