RESUMEN

The article examines two seemingly unconnected occurrences at the nineteenth-century north east frontier of British India. The first is the production of a pathological space via moral, social, and cultural codes enacted by medical topographies on the region since the first Anglo-Burmese war (1824-1826) and the subsequent rise of disease thinking. The second is the ambivalence in disease thinking that is brought to fore through the mysterious malady called kala azar (visceral leishmaniasis), which was geographically designated as Assam fever. This article contends that the geographical designation of kala azar as Assam fever is not just coincidental or a nosological confusion of the late nineteenth century but rather has its origin in the preceding pathological carving of space at the frontier. Further, it explores the troubled ontology between research on malaria and kala azar investigations to show that the old codes enacted by medical topographies hinged upon the era of laboratory medicine.

RESUMEN

This article details how the French army employed medical topography as a tool of military occupation throughout the Mediterranean world from the mid-eighteenth to mid-nineteenth century. It departs from other works by focusing exclusively on medical topography's military applications. Medical topographies charted the connections between health and the environment by observing a location's features, such as soil, air, and water quality, as well as elevation, prevailing winds, common local diseases, sources of potential contagion, and the cleanliness of urban environments. Because a medical-topographic study took time to write and implement, its findings provided little utility during active conflict. Only after the fighting ceased during a campaign could the army make use of a medical topography's findings by taking measures such as draining swamps, relocating hospitals in unhealthy environments, and issuing climate-appropriate gear.

Cet article examine la façon dont l'armée française utilisait la topographie médicale en tant qu'outil d'occupation militaire pendant les dix-huitième et dix-neuvième siècles dans le monde Méditerranéen. Il se détache des autres travaux en se concentrant exclusivement sur les applications militaires de l'étude. Les études topographiques-médicales analysaient des liens entre l'environnement et la santé. Ces études permettaient l'observation minutieuse et l'enregistrement des caractéristiques d'un lieu, comme par exemple : son élévation, les vents dominants, la qualité de terre, d'eaux, et d'air, la propreté des centres urbaines, et des maladies locales ainsi que leurs origines. Parce que ces études exigeaient du temps d'écrire et d'implémenter, elles n'ont pas eu une grande utilité pratique pendant une campagne. Cependant, après la cessation des hostilités, l'armée a mis en pratique les résultats de ces études. Elle a vidé des marais, déménagé des hôpitaux malsains, et distribué du matériel adapté à l'environnement.

Asunto(s)

RESUMEN

Las Topografías Médicas (TM) o Geografías Médicas, son un género de la literatura médica, cuyos orígenes pueden encontrarse en el tratado de Hipócrates, Sobre los aires, aguas y lugares. El objetivo básico de las TM fue simplemente describir la salud de la población de un lugar determinado, aunque pronto ampliaron su campo de acción, para investigar la influencia del entorno físico y social en las enfermedades que padece la población en zonas geográficas o localidades. El inicio de su desarrollo tiene lugar en el contexto de la Medicina de la Ilustración, y adquirirán su mayoría de edad durante el siglo xix y las primeras décadas del siglo xx, para finalizar su producción en los años setenta del pasado siglo. Las Reales Academias de Medicina tuvieron una importancia decisiva en el desarrollo de las TM, proponiendo una metodología y un contenido homogéneo para la redacción de las mismas y estableciendo premios anuales para las obras galardonadas, lo que permitió mejorar su calidad y homogeneidad. El texto de las TM incluía generalmente un esbozo histórico de la población, la geografía de la zona, la descripción de la flora y de la fauna, con frecuencia de forma muy detalladas, el estudio del clima, de las vías públicas y las viviendas, la descripción de las enfermedades más frecuentes y epidemias, así como la demografía y situación socioeconómica de la población, entre otros. ... En el presente artículo se describe la evolución histórica de las TM, sus contenidos principales, su distribución por autonomías y años, y algunos personajes ilustres relacionados con ellas; aportándose alguna iconografía y copias de los documentos más interesantes por su valor médico o artístico. (AU)

Medical Topographies (TM) or Medical Geographies, are a genre of medical literature, whose origins can be found in Hippocrates’ treatise, On Airs, Waters and Places. The initial objective of TM was simply to describe the health of the population of given place, although they soon expanded their field of action to investigate the influence of the physical and social environment on the diseases suffered by the population in geographical areas or localities. The beginning of their development took place in the context of Enlightenment Medicine, and they came of age during the 19th century and the first decades of the 20th century, ending their production in the seventies of the last century. The Royal Academies of Medicine had a decisive importance in the development of TM, proposing a methodology and homogeneous content for their writing and establishing annual prizes for the award-winning works, which allowed them to improve their quality and homogeneity. The text of the TM generally included a historical outline of the population, the geography of the area, the description of the flora and fauna, often in very detailed form, the study of the climate, public roads and homes, the description of the most frequent diseases and epidemics, as well as the demographics and socio-economic situation of the population, among others. ... This article describes the historical evolution of the TM, its main contents, its distribution by autonomies and years, and some illustrious people related to them, providing some iconography and copies of the most interesting documents due to their medical or artistic value. (AU)

Asunto(s)

RESUMEN

OBJECTIVES: Research on the role of environment and place in various aspects of dental public health using geographic information systems (GIS) is escalating rapidly. Yet, the understanding of GIS and the analytical tools that it offers are still vaguely understood. This narrative review therefore draws from the utilization of GIS in the dental public health research. MATERIALS AND METHODS: Electronic databases such as Google Scholar, PUBMED, and Scopus were searched using terms "spatial epidemiology," "GIS," "geographic information systems," "health geography," "environment public health tracking," "spatial distribution," "disease mapping," "geographic correlation studies," "cartography," "big data," and "disease clustering" through December 2019. RESULTS: This review builds upon the prospects of GIS application in various aspects of dental public health. Studies were classified as: (1) GIS for mapping of disease, population at risk, and risk factors; (2) GIS in geographic correlation studies; (3) GIS for gauging healthcare accessibility and spatial distribution of healthcare providers. We also identified the commonly used GIS analytical techniques in oral epidemiology. CONCLUSIONS: We anticipate that this review will spur advancement in the utilization of spatial analytical techniques and GIS in the dental public health research.

RESUMEN

BACKGROUND: During the surgery for intrinsic brain lesions, it is important to plan the proper site of the craniotomy and to identify the relations with the gyri and superficial veins. This might be a challenge, especially in small subcortical lesions and when there is a distortion of the cortical anatomy. MATERIALS AND METHODS: Using the free computer software Osirix, we have created a 3-dimensional reconstruction of the head and cerebral showing the gyri and superficial veins. With the aid of some tools, it is possible to create a colored image of the lesion and also to calculate the distance between the areas of interest and some easily identifiable structure, making it easier to plan the site of the craniotomy identify the topography of the lesion. RESULTS: The reconstructions were compared to the intraoperative view. We found this technique to be useful to help identify the gyri and cortical veins and use them to find the lesions. The use of a region of interest to show better the lesion under the cortical surface and in the three-dimensional reconstruction of the head was also helpful. CONCLUSIONS: This is a low-cost and easy technique that can be quickly learned and performed before every surgery. It helps the surgeon to plan a safe craniotomy and lesionectomy.

RESUMEN

In recent years, the role of medical subspecialty textbooks as sources of information for students, trainees, and practicing clinicians has been challenged. Although the structure of textbooks continues to evolve from standard, printed versions to digital formats, including e-books and online texts, we maintain that the authoritative compilation of clinical and scientific material by experts in the field (i.e., a modern-day textbook) remains central to the education, training, and practice of subspecialists. Regardless of format, an effective medical subspecialty textbook is authoritative, comprehensive, and integrated in its coverage of the subject. Textbook content represents a unique synthesis of clinical and scientific material of real educational and clinical value. Incorporation of illustrations, including figures, tables, videos, and audios, bolsters the presentation and further solidifies the reader's understanding of the subject. The textbook, both printed and digital, reinforces the many widely available online resources and serves as a platform from which to evaluate other sources of information and to launch additional scientific and clinical inquiry.

Asunto(s)

RESUMEN

OBJETIVO: Comparar discos ópticos de pacientes normais com história familiar de glaucoma primário de ângulo aberto (GPAA) com um grupo controle sem histórico familiar de glaucoma através da oftalmoscopia confocal a laser (HRTII). MÉTODOS: Análise retrospectiva da morfometria dos discos ópticos de pacientes com e sem história familiar de GPAA. Cada paciente foi submetido a exame oftalmológico completo, perimetria computadorizada, paquimetria e HRTII. Os pacientes foram classificados em três grupos de acordo com o grau de parentesco: primeiro grau (grupo 1), segundo grau (grupo 2) e grupo controle sem história familiar de glaucoma (grupo 3). Foram analisados: área total do disco óptico (Área Total), área de faixa neural (FxN), área da escavação (Esc.), relação escavação/disco (E/D) e relação E/D linear (L). Para a análise estatística, utilizou-se o programa SPSS 12.0. considerando-se apenas um dos olhos de cada paciente selecionado aleatoriamente. RESULTADOS: Foram incluídos setenta e quatro pacientes com idade média de 42,58 anos. Comparando-se os grupos 1 e 2, encontrou-se diferença estatisticamente significativa na variável Área Total, observando-se discos ópticos maiores no grupo 1. Comparando-se os grupos 1 e 3, as diferenças entre as variáveis Área Total, Esc, E/D e L foram estatisticamente significativas com predominância de valores mais elevados no grupo 1. Comparando-se os dados estereométricos entre os grupos 2 e 3 não foram encontradas diferenças de valores estatisticamente significantes. CONCLUSÃO: Pacientes normais parentes de primeiro grau de glaucomatosos apresentam maiores valores das variáveis topográficas do disco óptico quando comparados aos dos pacientes sem histórico familiar de glaucoma.

PURPOSE: To investigate whether there is a difference in topographic characteristics of optic nerve head analyzed by Heidelberg retina tomography (HRTII) in relatives of normal patients with or without history of open angle glaucoma. METHODS: Retrospective study analyzing the optic disc morphometry of normal patients with or without family history of glaucoma. Each participant underwent a routine examination, visual field testing, pachimetry and optic nerve head topography. Patients were classified according their family history of glaucoma in groups as first-degree (group 1), far second-degree (group 2) and no siblings with glaucoma (control group). Optic disc analyzed parameters were: disc area, rim area, cup area, cup/disc ratio (E/D) and linear cup/disc ratio. Statistical analysis was made through the SPSS 12.0 program considering only one randomized eye. A P value of less than 0.05 was considered statistically significant. RESULTS: Seventy-four patients (74 eyes) were included. The average age was 42.58 years. In the stereometric analysis, the comparison between the disc area from the group 1 and group 2 was statistically significant (P < 0.005), with marked overlap in group 1, fact that was repeated for the variables disc area, cup area, cup/disc ratio linear cup/disc ratio comparing first -degree and control group. There was no statistical difference comparing group 2 and 3 in the stereometric analysis. CONCLUSION: First-degree siblings of glaucoma patients present stereometric differences in optic disc when compared with patients without history of glaucoma. These differences were found in patients with no signs of the disease.

Asunto(s)

RESUMEN

Introducción: Ninguna neoplasia ha generado tanta confusión en sus sistemas de clasificación como los linfomas no Hodgkin (LNH). Una correcta tipificación es necesaria para el diagnóstico, pronóstico y tratamiento. El propósito de este estudio fue clasificar los LNH del registro poblacional de cáncer del área metropolitana de Bucaramanga. Pacientes y métodos: Se realizó un estudio observacional de corte transversal, utilizando como población los pacientes con LNH del área metropolitana de Bucaramanga de enero de 2000 a diciembre de 2006. La información se obtuvo de las historias clínicas y de inmunohistoquímica en bloques de parafina. Se utilizo la clasificación de linfomas de la OMS. Resultados: Se estudiaron 320 pacientes y se encontró predominio de la enfermedad en la 6ª y 7ª década. La distribución por género fue mayor en hombres con 61,26% y mujeres 45,6%. El sitio anatómico de compromiso más frecuente fue ganglios cervicales con 25,6%. La mayoría expresaron antígenos B, 86,8%, y T, 1,8%. El subtipo más frecuente fue difuso de célula grande en el 29,6%. Conclusiones: La mayoría los LNH del área metropolitana de Bucaramanga son de linajes B, nodales y de célula grande difuso. Fue evidente el uso limitado de otras técnicas para la clasificación de estas neoplasias en nuestra región.

Introduction: There is not a neoplasm that has generated such confusion on its classification system such as the Non- Hodgkin’s lymphoma. An adequate classification is necessary for diagnosis, prognostic and treatment. The purpose of this study was to classify the NHL from the Bucaramanga metropolitan area poblational cancer registry. Patients and methods: An observational cross-sectional study was made, using as population the patients with NHL from the Bucaramanga metropolitan area from January 2000 until December 2006. The information was obtained from the clinical records and inmunohistochemistry in paraffin blocks. The WHO lymphoma classification was used. Results: 320 patients were studied and a predominance of the disease was found on the 6th and 7th decade of life. Gender distribution was higher in men with 61.26% and women 45.6%. The anatomical site more frequently affected were the cervical lymph nodes with 25.6%. Most of them expressed B antigens, 86.8%, and T, 1.8%. The most frequent subtype was diffuse large B cell in 29.6%. Conclusions: Most of the NHL from the Bucaramanga metropolitan area are nodal, of B lineage, and diffuse large cell subtype. The limited use of other techniques for the classification of these neoplasms in our region was evident.

Asunto(s)

RESUMEN

Antecedentes: Los linfomas extranodales (LEN) se localizan en cualquier sitio diferente a los ganglios linfáticos, como el tracto gastrointestinal (TGI) y la piel; la mayoría son de tipo linfoma no Hodgkin (LNH). Representan entre el 25-45% de todos los LNH, y el subtipo histopatológico más frecuente corresponde a linfoma difuso de células B grandes (LDCBG). El objetivo de este estudio es identificar algunas características socio-demográficas de los pacientes con linfomas extranodales residentes en el Área Metropolitana de Bucaramanga (AMB), así como otras características propias de los LEN. Metodología: Usando los datos recolectados en el RPC - AMB se calcularon frecuencias de algunas variables (sexo, edad, localización anatómica, tipo histopatológico) de los LEN. Resultados: entre los años 2000-2004 se detectaron 247 casos de linfomas; 72 (29%) correspondieron a LEN. El 58% de los casos ocurrieron en hombres y el 42% en mujeres. Se encontró predominio de la enfermedad en la 6a y 7a década de la vida. Los sitios de mayor presentación fueron TGI (29%), piel (14%), y tejidos blandos (14%). Las clasificaciones más frecuentes para los LEN fueron LNH - NOS (No especificado) (27,7%) y linfoma difuso de células B grandes (19,4%). Conclusiones: Se encontraron semejanzas en las características de los LEN - NH comparado con los datos registrados a nivel mundial. Es necesario promover la implementación de métodos diagnósticos avanzados para este tipo de neoplasias. [Uribe CJ, García CA, Meza EE, Camacho RM, Acevedo DJ. Linfomas extranodales en el Área Metropolitana de Bucaramanga: 2000-2004. MedUNAB 2009; 12:19-21].

Background: Extranodal Lymphomas (ENL) are localized in any site different to the lymph nodes, as the Gastrointestinal Tract and the skin, and in the majority of the cases are Non Hodgkin Lymphoma (NHL). They represent between 25-45% of all the cases of NHL, and the most frequent histopathologycal subtype is the diffuse large-B-cell lymphoma (DLBCL). The purpose of this study is to identify some socio-demographic characteristics and other that are inherent to the ENL in this geographical region between 2000-2004. Methodology: Using data collected by RPC - AMB, were calculated frequencies of some variables (sex, age, anatomic localization, and histopathologycal type). Results: 247 cases of lymphomas were detected between 2000-2004, 72 (29%) were EN-NHL. Men were most frequently affected than women, with 59% and 41% respectively. The disease was most frequent in the 6th and 7th decade of the life. The most involved anatomical sites were the GIT (29%), the skin (14%), and soft tissues (14%). The most frequent histopathologycal types were NHL - NOS (Not Otherwise Specified) (30,4%), DLBCL (15,1%), and Malignant Lymphoma - NOS (13,5%). Conclusions: compared with worldwide data, our study presents similar characteristics of the ENL. It is necessary to promote the improvement in advance diagnosis methods for this kind of neoplasm. [Uribe CJ, García CA, Meza EE, Camacho RM, Acevedo DJ. Extranodal lymphomas in Bucaramanga Metropolitan Area: 2000-2004. MedUNAB 2009; 12:19-21].

Asunto(s)