Julio Escámez Contreras y su original mural Historia de la Medicina y de la Farmacia en Chile / Julio Escámez Contreras and his masterful mural History of the Medicine and Pharmacy in Chile

Julio Escámez Contreras was a highly creative, skilled and versatile Chilean painter who painted in Chile from 1940 to 1974 when he went into exile to Costa Rica and died there in 2015. In 1953-54, Escámez painted a large mural in a private pharmacy in the city of Concepcion, Chile, The History of Medicine and Pharmacy in Chile. This mural describes the origins and development of medicine and pharmacy in Chile, placing that origin in the medicinal activities of the mapuche indigenous population. The mural consists of three sections, each painted on the upper segment of three adjacent walls in the pharmacy, with each section focused on one period in the evolution of medicine and pharmacy in Chile. The first section is devoted to indigenous medical practices including its pharmacopeia and religious practices, the second describes medical approaches during colonial times, still with strong indigenous components but also with indigenous and Catholic hybrid religious elements, while the third depicts modern medicine, including chemistry, anatomical, physical and pharmacological activities complemented with public health components such as nursing, vaccination and health education. Read from left to right, the mural provides a highly lively, accurate and valid depiction of the evolution of medicine and pharmacy in Chile. Escámez' artistry and skill in the use of perspective, color, landscape, architecture and Chilean subjects, including real life individuals, produces a typical Chilean mural. However, his originality and consummate use of a non-verbal visual language delivers a more universal message, one that helps to explain the repeated efforts, of the government responsible for his exile, to destroy some of the works produced by him.

Mascotas felinas, medicina y arte / Pet cats, medicine and art

The author in this short text remembers the passing of a beloved pet cat. Cats are beautiful animals and wonderful companions. They evolved together with humans in Africa, subsequently spread over the five continents with them, and became the subject of many human cultural activities, including art, poetry and religion. Abandoned and roaming free, cats readily return to the wild, potentially acquiring many zoonotic infections. Surprisingly, feline company is increasingly used for therapy of mental and other illnesses such as cardiovascular disorders. Responsible ownership and good veterinary care of these marvelous animals under the One Health paradigm are essential to their well-being as well as to that of humans. They are an ethical and small price to pay for the affectively rewarding relationships humans have with these endearing and evocative animals.

Realismo pictórico y medicina: las dos clínicas quirúrgicas de Thomas Eakins / Painting realism and medicine: the two surgical clinics of Thomas Eakins

Realism is a painting style that began with Millet and Courbet in politically convulsed France in the middle of the nineteenth century. In the second half of that century, the pragmatic and democratic tradition of the United States fostered the careers of many realist painters, including that of Thomas Eakins. Eakins, trained in France, developed his career completely associated with Philadelphia at a time when this city was in the vanguard of American emerging industry, culture and medicine. Eakins The clinic of Dr. Gross and the The clinic of Dr. Agnew are icons of these developments and symbolize a perfect union of art and medicine. Both paintings permit the viewer to appreciate the artist s mastery, originality and Americanism while simultaneously tracking the progress of surgery as evidenced by the introduction of asepsis, anesthesia and nursing. Eakins mastery is revealed by its use of some European Old Masters approaches to portray medical professionals undertaking their daily duties in their work environments with critical and unadorned vision. This combination of vision and skills led Eakins to create a highly original yet analytical art. Unfortunately, his representations were far ahead of his time and resulted in under appreciation of his paintings and a censorious reaction to their content. His contemporaries rejection of Eakins work negatively affected his career as a painter, as a teacher and even his private life. This judgment was overturned in subsequent years and by the twentieth century Eakins was recognized as an American master without parallel.

Diego Rivera: gran maestro y un didáctico y lúcido historiador de la medicina / Diego Rivera: a great master and a didactic and discerning medical historian

Diego Rivera is one of the artistic giants of the 20th century. His many original creations included landscapes, portraits and large murals created in both Mexico and the United States. Rivera ventured into many styles-cubism, naturalism and narrative realism-with great success. Rivera’s murals build on those of the Renaissance, pre-historic and colonial civilizations of Mexico. Biological and medical topics and their history form an important concern in Rivera’s work, present in many of his murals in a highly informative and creative manner. His two History of Cardiology murals present an original and comprehensive account of the developments of this medical specialty from pre-historic to modern times. His History of Medicine in Mexico (The people demands health) mural is a creatively and vigorously fashioned and highly dynamic and synthetic vision of the relationships between pre-historic and modern medicine in Mexico and its social foundations. Medical topics such as vaccines and vaccination, embryology and surgery are inventively and accurately presented in the large mural, Detroit Industry. The trigger and impetus for the concern of Rivera for these topics of life and death, and the exceedingly ground-breaking way he presents them, appear to stem from his rational materialism, his concern for collective wellbeing, his belief in progress through scientific developments and political action and his commitment to understand Mexican and American history.

El gran europeo Georg Friedrich Nicolai: médico y pacifista. Berlín, Alemania, 1874 - Santiago, Chile, 1964 / The Great European Georg Friedrich Nicolai: physician and pacifist. Berlin, Germany, 1874 - Santiago, Chile, 1964

Georg Friedrich Nicolai (1874-1964) was a German physician and physiologist whose pacifism during the First World War led him in 1914 to cosign with W. J. Foerster, A. Einstein and O. Bueck a "Manifesto to the Europeans" against the entry of Germany into the war and the invasion of Belgium. As a result of this appeal and his strong pacifism, Nicolai lost his positions as cardiologist to the German royal family, professor at the University of Berlin and chief of laboratory at the Charite hospital also in Berlin, and was sent as a garrison physician in Graundenz, in today's Poland. There he began to write his book, The Biology of War. It managed to avoid censorship and was published in Leipzig in 1916. He was court-martialed in Danzig in 1916 but escaped to Denmark. Nicolai was reinstated to his faculty positions by the Weimar Republic after the war but was subsequently forced to emigrate from Germany to South America by the pressure of right wing student groups who accused him of being a deserter and a traitor. From 1922 to 1932 Nicolai lived in Argentina, and from 1932 until his death in 1964, in Chile. In this later country Nicolai was professor in the University of Chile and interacted with members of the Chilean intelligentsia, including the poets Vicente Huidobro, Gonzalo Rojas and Pablo Neruda. Through his friendship with Chilean psychiatrist Agustin Tellez, Nicolai influenced the development of phenomenological psychiatric school in Chile. The Chilean novelist Fernando Alegria compared him favorably with Robert J. Oppenheimer and Linus Pauling.

175 años de la National Library of Medicine, de los EE.UU. de NA: un tesoro científico y cultural digno de admiración / 175 years of the National Library of Medicine, of the Unites States of America: a scientific and cultural treasure worthy of admiration

The National Library of Medicine (NLM) of the United States of America, celebrates in 2011 its 175th anniversary. This Library, the largest biomedical library in the world, has a proud and rich history serving the health community and the public, especially since its transfer to the National Institutes of Health in Bethesda, Maryland, in 1968. It holds 17 million publications in 150 languages, and has an important collection of ancient and modern historical books as well as original publications of Vesalius and other founders of biomedicine. Its modern document collections illustrate the progress of medical sciences. These collections include laboratory notes from many scientists whose work forms the foundations of contemporary life sciences. The Library also provides several services for health research and for the public, including databases and services such as MedLine and BLAST. The NLM constantly strives to fulfill the information needs of its customers, whether scientists or the public at large. For example, as the Hispanic population of the Unites States has increased in recent years, the NLM has made larger and larger amounts of data available in Spanish to fulfill the health information needs of this population. NLM programs train professionals in library science and biomedical informatics and link biomedical libraries of 18 academic centers throughout the United States. The NLM funds competitive grants for training at the Library, organizing short instruction courses about library science and informatics, and writing books on health related matters including the history of medicine and public health. The NLM is managed and maintained by an outstanding and farsighted group of professionals and dedicated support staff. Their focus on serving and reaching both the biomedical community and the public at large has been crucial to its development into a world icon of biomedical sciences, information technology and the humanities.

Tuberculosis: una dinámica continua entre el pasado y el presente, para imaginar el futuro / Tuberculosis: steady dynamics between past and present to imagine the future

Progress in understanding the biological processes that allow Mycobacterium tuberculosis to be a successful parasite have accelerated in the last twenty years. This progress has been stimulated by the return of tuberculosis (TB) as an important disease in industrialized countries, by its increase in emergent nations in the tail of population increases and poverty and by the spread of multiple drug resistant (MDR) and extensively drug resistant (XDR) M. tuberculosis as a result of treatment failures. Progress on M. tuberculosis biology has also been fueled by advances in microbiology and molecular biology, including molecular genetics, genomics, proteomics and in vitro and in vivo models of infection. The study of latency or dormancy, a phenomenon central to understanding the persistence of M. tuberculosis and the development of TB in individuals, its spread in human populations and the emergence of antibiotic-resistant/tolerant organisms, has been preferred targets for investigators in this area. In this manner, factors that trigger M. tuberculosis latency (e. g, hypoxia, nutrient starvation, NO exposure) have been characterized and the metabolic shifts to host lipid utilization, tolerance to antimicrobials and resistance to host immune mechanisms involved in latency have been determined. Similarly, genetic changes and the resulting antimicrobial mechanisms mediating the MDR and XDR states have been characterized and potential new vaccines that avoid reactivation from latency and infection are being developed. Despite this progress, and given the fact that effective anti tuberculosis therapy was developed and first introduced clinically at the end of the 1940s, there are now more cases of latent and active TB worldwide than ever before. This reinforces the concept of TB as a bacterial disease with strong social and economical! determinants which are presently stimulating increased transmission in many human groups, undermining diagnostics, treatment and prevention. It suggests that in a scenario of global economical crisis the struggle against TB will be weakened, unless efforts are included to alleviate poverty, decrease economic inequality, improve public health and allow democracy and political organization.

Zoonosis con reservorios silvestres: Amenazas a la salud pública y a la economía: [revisión] / Zoonoses with wildlife reservoirs: A threat to public health and the economy: [review]

The world is experiencing an increase in emergent infections as a result of anthropogenic changes of the biosphere and globalization. Global warming unrestricted exploitation of natural resources such as forests and fisheries, urbanization, human migration, and industrialization of animal husbandry cause environmental destruction and fragmentation. These changes of the biosphere favor local emergence of zoonoses from their natural biotopes and their interaction with domestic animals and human populations. Subsequently, international commerce, human and animal migration and travel, favor the dissemination of these zoonotic pathogens worldwide. Chile is undergoing an important degradation of many wild-life biotopes, affecting their diversity and contributing to the dissemination of zoonoses such as Chagas disease, Hantavirus, rabies, fish tapeworms, and marine vibriosis. Moreover, agents of many other zoonoses such as ¡eptospirosis, hydatidosis, salmonellosis, rabies, brucellosis and anthrax have been detected in different wild-life environments in the country. The intensification and accelerations of the anthropogenic deterioration of the biosphere in Chile, as results of the unrestricted utilization of natural resources and global climate change, suggests that emergence of new zoonoses in the near future will lead to important public health and economic problems. Forestalling of these problems will require active epidemiológica! surveillance of wild and domestic animals with a wide range of modern molecular and ancillary epidemiológica! tools. This also demands government and private sector (i.e., animal husbandry) intervention, funding and the collaboration of professionals in human and veterinary medicine with those in the environmental sciences including ecology, climatology and oceanography.

Detección de algunos agentes zoonóticos en la paloma doméstica (Columba livia) en la ciudad de Chillán, Chile / Detection of some zoonotic agents in the domestic pigeon (Columba livia) in the city of Chillán, Chile

Introducción: En las últimas décadas, se ha detectado un aumento de las poblaciones de palomas (Columba livia) y un mayor contacto con personas sanas e inmunocomprometidas. Objetivos: detectar algunos agentes zoonóticos en la paloma doméstica (Columba livia) en la ciudad de Chillán. Materiales y Métodos: Desde octubre de 2002 hasta septiembre de 2003 fueron capturadas 100 palomas. Se tomaron muestras de sangre, órganos y contenido intestinal de cada una de ellas, para ser cultivadas en diferentes tipos de agar, de acuerdo al microorganismo buscado. La identificación de hongos se efectuó mediante estudio de morfología con azul de metileno al 2%. Para la detección de Chlamydophila psittaci se realizó un examen serológico utilizando un kit comercial de ELISA (IDEXX). Resultados: se registraron palomas positivas frente a: clamidiosis (11%), estafilococcosis (8%), salmonelosis (4%) y aspergilosis (1%). No se detectaron palomas con evidencias de criptococcosis y listeriosis. Conclusiones: La paloma doméstica de la ciudad de Chillán actúa como portador de agentes zoonóticos de importancia en salud pública.

Introduction: There is an increase in the population of doves (Columba livia) as well as their contact with healthy and immunocompromised hosts. Objectives: detection of some zoonotic agents of the domestic pigeon (Columba livia) in Chillán city, Chile. Materials and Methods: From October 2002 to September 2003, 100 domestic pigeons were captured. Blood, organs and intestine contents were sampled from each pigeon. The samples were cultivated in different kinds of agar according to the searched microorganism. Fungi were typified by morphological studies after staining with 2% methilene blue. For the detection of Chlamydophila psittaci a commercial Elisa kit (IDEXX) was used. Results: Pigeons were registered positive for: clamidiosis (11%), staphylococosis (8%), salmonellosis (4%) and aspergillosis (1%). No pigeon had evidence of cryptococosis and listeriosis. Conclusions: these results confirm that domestic pigeon could act as vector of zoonotic agents of public health importance.

Residuos de tetraciclina y quinolonas en peces silvestres en una zona costera donde se desarrolla la acuicultura del salmón en Chile / Residues of tetracycline and quinolones in wild fish living around a salmon aquaculture center in Chile

La presencia de antibacterianos y antiparasitarios residuales fue investigada en muestras de carne de peces silvestres de consumo humano pescados alrededor de un recinto de acuicultura en Cochamó (41° 29' S; 72° 19'W), X Región, Chile. Esta investigación demostró que peces silvestres, incluyendo róbalo (Elginops maclovinus), cabrilla (Sebastes capensis) y truchas de vida libre (Oncorhynchus mykiss), ingieren alimento artificial para salmón y que la carne de algunos ejemplares de estos peces contienen tetracicilina y quinolona en cantidades detectables. Estos resultados sugieren que el uso de antibacterianos en la acuicultura del salmón, como ha sido demostrado en otros países, tiene efectos ambientales que se proyectan más allá de los recintos de acuicultura. Se indica que dada la relevancia de estos hallazgos para la salud humana y animal, el ambiente requerirá de estudios más amplios y detallados para implementar futuras regulaciones del uso de antibacterianos en acuicultura.

The presence of residues of tetracycline, quinolones and antiparasitic drugs was investigated in wild fish captured around salmon aquaculture pens in Cochamó, Region X, Chile. Residues of both antibiotics were found in the meta of two species of wild fish that are consumed by humans, robalo (Elginops maclovinus) and cabrilla (Sebastes capensis) . These findings suggest that the antibiotic usage in salmon aquaculture in Chile has environmental implications that may affect human and animal health. More studies are needed in Chile to determine the relevance of these findings for human and animal health and the environment to regulate this use of antibiotics.

Frequency of viruses associated with acute respiratory infections in children younger than five years of age at a locality of Mexico City

A locality in the district of Tlalpan, Mexico City, was selected in order to identify the viral agents in children younger than 5 years of age with acute respiratory infection (ARI). A total of 300 children were randomly selected and were included in this study for a period of 13 months. During this period nasopharyngeal exudates were collected for the isolation of viral agents. Monoclonal fluorescent antibodies were used for viral identification after cell culture. Viral infection was detected in 65 percent of the specimens. The respiratory syncytial virus (RSV) was the most common virus agent detected. Children required an average of two consultations during the study period. Two high incidence peaks were observed, one during the summer and the other during winter; the most frequent viruses during these seasons were influenza A and RSV, respectively. The largest number of viruses was isolated in the group of children between 1 and 2 years of age and in the group between 4 and 5 years of age. This study demonstrated the presence of ARI and of different viruses in a period of 13 months, as well as the most frequent viruses in children younger than 5 years of age from a community of Mexico City.

Infecciones por Vibrio parahaemolyticus e intoxicaciones por algas: problemas emergentes de salud pública en Chile / Vibrio parahaemolyticus infections and algal intoxications as emergent public health problems in Chile

There is interest in the paradigm that relates environmental sea changes to the emergence of diseases that affect both aquatic organisms in the sea and human beings. The emergence of Vibrio parahaemolyticus as an important cause of epidemic summer diarrhea in 2004 and 2005, confined mainly to the tenth region in Chile, could be a manifestation of this trend. This and other areas of the country have also experienced several outbreaks of paralytic shellfish poisoning (PSP), diarrheal shellfish poisoning (DSP) and amnesic shellfish poisoning (ASP) caused by harmful algal blooms (HAB) of Alexandrium catenella, Dinophysis acuta and Pseudonitzchia species, respectively. The short historical record of these pathological phenomena in Chile suggests that they are increasing in frequency and expanding their geographical range. The V parahaemolyticus isolates responsible for the Chilean outbreaks correspond mainly to the pandemic strain O3:K6. HAB found in Chile and the intoxications caused by them have similar biological characteristics to those described in other areas of the world. The tenth region, the area where these problems are emerging, produces approximately 80-90% of the shellfish consumed in Chile and a large proportion of the shellfish that is exported. Prevention of these public health problems can be attained by developing policies that increase environmental surveillance for Vibrios and toxic algae, improve the epidemiological surveillance of acute diarrhea and algal intoxications after the ingestion of raw bivalves, and educate the population on the mode of transmission of these diseases. Scientific capacity and laboratories need to be developed to widen the limited knowledge of the biology of Vibrio and toxic algae and the environmental factors that favor their emergence as public health and economic problems in Chile.

Lupus eritematoso sistémico en pediatría / Sistemic lupus erythematous in children

Revisaremos el lupus en su forma sistémica, que si bien puede presentarse a cualquier edad, es más frecuente en adultos.El LES en pediatría se ha descrito clásicamente de presentación más severa que en adultos, y se ha relacionado con la edad de diagnóstico. Su forma de presentación habitualmente es similar a los adultos, es decir, fiebre, compromiso articular y renal, compromiso del estado general y baja de peso de curso crónico, aunque en algunos casos se puede presentar en forma aguda como convulsiones, psicosis, falla reanl aguda, hemorragia pulmonar, serositis o alteraciones hematológicas.

Encuesta telefónica sobre posición al dormir en lactantes menores de un año que asisten a una muestra de salas cuna privadas en Santiago de Chile / Telephonic survey on infant sleeping position in private day care centers at Santiago de Chile

El síndrome de muerte súbita infantil es causa significativa de mortalidad infantil en Chile y otros países. Un factor de riesgo conocido es colocar lactantes en prono para dormir. Un estudio reciente en Estados Unidos demostró fallas al respecto ya que en 49 por ciento de salas cuna encuestadas lactantes dormían en prono. Objetivo: conocer las conductas que dice adoptar el personal de una muestra de salas cuna de Santiago, respecto de la posición en que son colocados a dormir lactantes menores. Pacientes y Métodos: realizamos una encuesta telefónica a 126 salas cuna de Santiago para determinar la posición al dormir de los lactantes. No se visitó las salas cuna para validar las respuestas. Resultados: Obtuvimos respuesta de 91 en que dijieron atender el lactante menores. Sesenta y tres declararon tener normas sobre el tema, pero solamente 20 eran escritas (22 por ciento). Entre las salas cuna que dijieron tener norma, 38 por ciento incluía la posición prona como única alternativa. Cicuenta y siete salas cuna (63 por ciento) declararon tener lactantes menores durmiendo en prono y en 17 (19 por ciento) exclusivamente en prono. Conclusión: Un alto porcentaje de salas cuna mantienen el factor de riesgo para muerte súbita "posición prona al dormir" presente en la práctica diaria. Se debe mejorar la información sobre el tema para disminuir este factor de riesgo de muerte súbita