RESUMEN
The care of combatants with lesions caused by frostbite during the battle of Teruel, which was fought in extreme weather conditions and in temperatures as low as twenty degrees below zero, was the period of greatest medical activity and the highest rates of occupation in the military hospitals of Navarre during the civil war of 1936-1939. From November 1937 to March 1938, 375 cases of frostbite were registered in the provincial establishments, amongst which there was a predominance of cases of dry gangrene partially affecting the lower extremity, which was popularly known as "Teruel feet". Some of the medical staff, conscious of the exceptional nature of the casuistry, registered statistics, clinical cases and personal impressions of the evolution of the lesions and the effectiveness of the treatments. In treating this affectation they employed medicines, surgical techniques and novel therapeutic procedures that were not widely used in the medical milieu of the time. However, the limited duration of the problem, the inconclusive results of the treatments and the differing opinions on their effectiveness -questions that are considered in this article- restricted the subsequent medical repercussion of the experiences of frostbite developed during the wartime period in Teruel.
Asunto(s)
Congelación de Extremidades/historia , Congelación de Extremidades/terapia , Pie de Inmersión/historia , Pie de Inmersión/terapia , Medicina Militar/historia , Guerra , Pie/irrigación sanguínea , Pie/patología , Congelación de Extremidades/complicaciones , Congelación de Extremidades/tratamiento farmacológico , Congelación de Extremidades/cirugía , Gangrena/etiología , Historia del Siglo XX , Hospitales Militares/historia , Humanos , Pie de Inmersión/complicaciones , Pie de Inmersión/tratamiento farmacológico , Pie de Inmersión/cirugía , Masculino , EspañaRESUMEN
La atención a combatientes con lesiones por congelación sufridas durante la batalla de Teruel, desarrollada en condiciones meteorológicas extremas y temperaturas de hasta veinte grados bajo cero, supuso la etapa de mayor actividad asistencial y tasas de ocupación más altas en los hospitales militares navarros durante toda la contienda civil de 1936-1939. De noviembre de 1937 a marzo de 1938 se registraron en los establecimientos de la provincia más de 375 casos de congelación, entre los que predominaban las gangrenas secas con afectación parcial de la extremidad inferior, lo que popularmente se denominó 'pies de Teruel'. Algunos facultativos, conscientes de la excepcionalidad de la casuística, registraron estadísticas, casos clínicos e impresiones personales sobre la evolución de las lesiones y la efectividad de sus tratamientos. En ellos, emplearon fármacos, técnicas quirúrgicas y procedimientos terapéuticos novedosos en el tratamiento de esta afección y poco difundidos en el entorno médico del momento. Sin embargo, la limitación temporal del problema, los resultados poco concluyentes de los tratamientos y las opiniones controvertidas sobre su efectividad, cuestiones que se analizan en este artículo, limitaron la repercusión médica posterior de las experiencias sobre congelaciones desarrolladas durante la etapa bélica turolense
The care of combatants with lesions caused by frostbite during the battle of Teruel, which was fought in extreme weather conditions and in temperatures as low as twenty degrees below zero, was the period of greatest medical activity and the highest rates of occupation in the military hospitals of Navarre during the civil war of 1936-1939. From November 1937 to March 1938, 375 cases of frostbite were registered in the provincial establishments, amongst which there was a predominance of cases of dry gangrene partially affecting the lower extremity, which was popularly known as 'Teruel feet'. Some of the medical staff, conscious of the exceptional nature of the casuistry, registered statistics, clinical cases and personal impressions of the evolution of the lesions and the effectiveness of the treatments. In treating this affectation they employed medicines, surgical techniques and novel therapeutic procedures that were not widely used in the medical milieu of the time. However, the limited duration of the problem, the inconclusive results of the treatments and the differing opinions on their effectiveness questions that are considered in this article restricted the subsequent medical repercussion of the experiences of frostbite developed during the wartime period in Teruel
Asunto(s)
Masculino , Humanos , Historia del Siglo XX , Congelación de Extremidades/historia , Congelación de Extremidades/cirugía , Congelación de Extremidades/terapia , Pie de Inmersión/historia , Pie de Inmersión/cirugía , Pie de Inmersión/terapia , Medicina Militar/historia , Guerra , Pie/irrigación sanguínea , Pie/patología , Congelación de Extremidades/complicaciones , Congelación de Extremidades/tratamiento farmacológico , Gangrena/etiología , Hospitales Militares/historia , Pie de Inmersión/complicaciones , Pie de Inmersión/tratamiento farmacológico , EspañaRESUMEN
BACKGROUND: A relevant increase in the spanish biomedical production has occurred in the last few years. The magnitude, evolution and characteristics of the Spanish scientific production in Rheumatology is here analyzed through the published papers in foreign specialty journals. METHODS: Location in spanish documents published from 1990 to 1996 in nine foreign rheumatology journals of great visibility in MEDLINE. Classification of documents according to type of publication, specialty of authors and type of design. Estimation of bibliometric and collaboration indicators. Analysis of their evolution and comparison with data published for 1987. RESULTS: The number of Spanish documents from 1990 to 1996 doubled and from 1987 to 1996 tripled, with a 54% increase for the four journals with more visibility. In 1996, the spanish documents reached 5% of the total of published documents in several journals. From 1990 to 1996 original papers increased almost four times more than letters, the analytical studies increased almost eight times more than descriptive studies, and the mean expected impact factor of the originals multiplied by 1.6. The published documents by spanish rheumatologists had a more favorable profile--higher ratios for originals: letters, analytical studies: descriptive studies--than publications performed by other specialists in this area. The number of authors by document (median) increased from 5 to 6 during the analyzed period. Seventy-two percent of documents was signed by more than one department and 75% by only one institution. CONCLUSIONS: A relevant increase has occurred in the number and quality spanish documents published in the rheumatology area during the last ten years. To note a lack of collaboration between different institutions and few analytical studies of great complexity: cohort studies and controlled clinical trials.