"A little monster inside me that comes out now and again": endometriosis and pain in Austria / "Um pequeno monstro dentro de mim que sai de vez em quando": endometriose e dor na Áustria / "Un pequeño monstruo dentro de mí que sale una y otra vez": endometriosis y dolor en Austria

Abstract: The topics of endometriosis and pain imply far-reaching problems for women's health. Using a qualitative research approach, this paper addresses the subjective experience and effects of pain, the methods for dealing with these issues, and the needs of affected women in Austria. Data were collected by problem-focused interviews conducted with ten women suffering from endometriosis, which were later transcribed and subjected to qualitative content analysis. Findings are therefore described using content-related categories. Results show that negative thoughts and feelings like fear, despair, and anger are associated with endometriosis and pain. Moreover, predominantly negative impacts and changes are found in various areas of life, such as the well-being and psyche of those affected, their attitude towards life in general, partnerships, social life, leisure time and work-life balance. In dealing with endometriosis and pain, both Western biomedicine and complementary medicine treatments are used. Support from one's inner circle of friends and exchange and interaction with others affected by the disease are seen to be invaluable. Attending physicians as well as patients themselves and their private, social, and working environment should encourage open communication about endometriosis and the related pain.

Resumo: O tema da endometriose e dor tem implicações relevantes para a saúde das mulheres. O artigo procura contextualizar a experiência subjetiva e os efeitos da dor, os métodos para lidar com essas questões e as necessidades das mulheres afetadas por essa condição na Áustria. Foi escolhida uma abordagem qualitativa para examinar esses temas. Foram realizadas entrevistas focadas em problemas com dez mulheres com história de endometriose. Após a transcrição do material, foi realizada a análise qualitativa do conteúdo. Assim, os achados são retratados com o uso de categorias relacionadas ao conteúdo. Os resultados mostram que pensamentos e sentimentos negativos como medo, desesperança e raiva estão associados com a endometriose e dor. Além disso, são encontrados impactos e mudanças predominantemente negativos em vários domínios da vida, tais como o bem-estar e o estado psicológicos das mulheres afetadas, a atitude geral em relação à vida, parcerias, vida social, tempo de lazer e equilíbrio entre trabalho e vida pessoal. Tanto a medicina ocidental quanto os tratamentos da medicina complementar são utilizados no manejo da endometriose e da dor. O apoio do círculo próximo de amigas e as trocas e interação com outras pessoas afetadas pela doença são vistos como extremamente úteis. Os médicos atendentes e as próprias pacientes e seus ambientes privados, sociais e laborais devem incentivar a comunicação aberta sobre a endometriose e a dor associada.

Resumen: La endometriosis y su dolor asociado implican problemas profundos para la salud de las mujeres. El objetivo de este trabajo es identificar la experiencia subjetiva y los efectos del dolor, los métodos para tratarlos, así como las necesidades de las mujeres afectadas en Austria. Para el examen de los temas mencionados anteriormente, se eligió un enfoque de investigación cualitativo. Las entrevistas enfocadas en los problemas se realizaron con diez mujeres que sufrían endometriosis. Tras la transcripción material de los datos, el análisis se realizó usando un análisis cualitativo de contenido. Por lo tanto, los resultados se describen usando categorías relacionadas con el contenido. Los resultados muestran que los pensamientos negativos y los sentimientos como miedo, desesperación, y enfado están conectados con la endometriosis y el dolor. Además, predominantemente se encontraron impactos negativos y cambios en varias áreas de la vida, tales como: bienestar, psique de quienes se veían afectadas, su actitud ante la vida en general, relaciones, vida social, equilibrio entre tiempo de ocio y trabajo. Para enfrentarse a la endometriosis y el dolor, se utilizan tratamientos biomédicos occidentales, así como medicina complementaria. El apoyo del círculo íntimo de los afectados, como son los amigos, así como el intercambio e interacción con otras personas afectadas por la enfermedad parecen ser muy útiles. Ir al médico, el entorno privado, social y laboral de las pacientes, así como ellas mismas, deben estar y ser animadas para una comunicación abierta sobre la endometriosis y el dolor relacionado con la misma.

Carl von Rokitansky, el Linneo de la anatomía patológica / Carl von Rokitansky, the Linné of pathological anatomy

Resumen Carl von Rokitansky fue una de las figuras más importantes en la anatomía patológica y el responsable, en parte, del renacimiento de Viena como centro de la medicina a mediados del siglo XIX. Nació en la actual Hradec Králové, estudió medicina en Praga y Viena y se graduó en 1828. Tuvo gran influencia de los estudios de anatomía, embriología y patología de Andral, Lobstein y Meckel. En la escuela de Viena fue asistente de anatomía patológica de Johann Wagner y se convirtió en profesor de anatomía patológica, donde permaneció hasta cuatro años antes de su muerte. Rokitansky hizo énfasis en correlacionar la sintomatología del enfermo con los cambios post mortem. Es posible que haya tenido acceso a entre 1500 y 1800 cadáveres al año para que pudiera realizar 30 000 necropsias; además, revisó varios miles más de autopsias. En Handbuch der Pathologischen Anatomie, publicado entre 1842 y 1846, realizó numerosas descripciones: de la neumonía lobular y lobular, endocarditis, enfermedades de las arterias, quistes en varias vísceras, diversas neoplasias y de la atrofia aguda amarilla del hígado. Con su brillante labor de patología macroscópica, Rokitansky estableció la clasificación nosológica de las enfermedades, por lo cual Virchow lo llamó “el Linneo de la anatomía patológica”.

Abstract Carl von Rokitansky was one of the most important figures in pathological anatomy, and was largely responsible for the resurgence of Vienna as the great medical center of the world in the mid-19th century. He was born in current Hradec Králové, studied medicine in Prague and Vienna and was graduated in 1828. He was greatly influenced by the anatomy, embryology and pathology studies of Andral, Lobstein and Meckel. At the Vienna School, he was Johann Wagner pathological anatomy assistant and became a pathology professor, where he remained until four years before his death. Rokitansky emphasized the importance of correlating patient symptoms with postmortem changes. It is possible that he had access to between 1,500 and 1,800 cadavers annually to be able to perform 30,000 necropsies; in addition, he reviewed several thousand more autopsies. In Handbuch der pathologischen Anatomie, published between 1842 and 1846, he made numerous descriptions: lobar and lobular pneumonia, endocarditis, diseases of the arteries, cysts in several viscera, various neoplasms and acute yellow atrophy of the liver. With his brilliant work on gross pathology, Rokitansky established the nosological classification of diseases, for which Virchow named him “the Linné of pathological anatomy”.

The Population Census in Austria / Os censos de população na Áustria / Los censos de población en Austria

Based on the Constitution, the Population Census in Austria is a matter of the central state, serving many political-administrative, planning, research, and other purposes. After its start as a systematic operation in the middle of the 18th century, it developed further by a modern legal basis in 1857 and advances in statistical technology in 1890 (punch cards) and 1971 (machine-readable questionnaires). In the second half of the 20th century, the Population Census became a comprehensive operation, including dwellings, buildings, and workplaces. The communes organized the classical method of on the spot household data collection on behalf of the state. The register-based Census replaced the household collection in 2011. Following a government decision of 2000, which aimed at the sole use of available micro-data, the first steps for creating the necessary administrative and statistical registers took place in conjunction with the last traditional census of 2001. With new provisions for linking the records, the Register Census Act of 2006, and a full test census in the same year, the new methodology was established and evaluated in a short period. The first regular Register Census "took place" with reference date 31 October 2011. It is described in the central part of this communication, featuring the advantages, strengths, and weaknesses, the backbone registers, the "comparison registers," and the redundancy principle, which help to ensure high data quality and the fit of the census into the international framework. Current developments include the annual update of results, changes and improvements in the data sources, and a short outlook on the next census of 2021.

Baseado na Constituição, o Censo Populacional na Áustria é uma questão do governo central e serve a muitos propósitos político-administrativos, de planejamento e pesquisa, entre outros. Após seu início, como uma operação sistemática, em meados do século XVIII, ele foi aperfeiçoado devido a uma nova base legal, em 1857, e aos avanços na tecnologia estatística, em 1890 (cartões perfurados) e 1971 (questionários lidos por máquinas). Na segunda metade do século XX, o censo populacional tornou-se uma operação abrangente, incluindo habitações, domicílios e locais de trabalho. O método clássico de coleta de dados no próprio domicílio, organizado pelos municípios em nome do Estado, foi substituído pelo censo baseado em registros, em 2011. Seguindo uma decisão governamental de 2000, cujo objetivo era o uso exclusivo dos microdados disponíveis, os primeiros passos para a criação dos registros administrativos e estatísticos necessários ocorreu conjuntamente com o último censo tradicional, de 2001. Com novas disposições para parear os registros, a Lei do Censo de Registros de 2006 e um censo- -teste completo no mesmo ano, a nova metodologia foi definida e avaliada em um curto período. O primeiro censo de registro teve como referência 31 de outubro de 2011. Sua descrição, na parte principal deste texto, apresenta as vantagens, os pontos fortes e fracos, os registros mais relevantes ("espinha dorsal"), os registros de comparação e o princípio da redundância, que ajudam a manter a qualidade dos dados e adequação do censo ao arcabouço internacional. Desenvolvimentos atuais incluem atualizações anuais dos resultados, mudanças e melhorias nas fontes de dados. É apresentado, também, um breve panorama do próximo censo, em 2021.

Sobre la base de la Constitución el censo de población es un asunto estatal central en Austria, con arreglo a diversos fines politicoadministrativos, de planificación e investigación, entre otros. Luego de haber comenzado como operación sistemática a mediados del siglo XVIII, se desarrolló luego como sobre bases legales modernas en 1857 y avanzó en tecnología estadística en 1890 (tarjetas perforadas) y en 1971 (cuestionarios legibles por máquinas). En la segunda mitad del siglo XX el censo de población se convirtió en una operación integral que incluyó vivienda, edificios y lugares de trabajo. El método clásico de recolección de datos en el punto en los hogares, organizado por las comunas a expensas del Estado, fue reemplazado por el censo basado en registro de 2011. A consecuencia de una decisión de gobierno del año 2000, que tenía como objetivo el uso exclusivo de los microdatos disponibles, el primer paso para la creación de los registros administrativos y estadísticos necesarios se llevó a cabo junto con el último censo de tipo tradicional de 2001. Con nuevas provisiones para vincular los registros, el Acto de Registro del Censo de 3006 y una prueba completa de censo en el mismo año, la nueva metodología se estableció y evaluó en un período muy corto. El primer censo de registro regular «tuvo lugar¼ con datos de referencia el 31 de octubre de 2011. Es descripto en la parte principal de su comunicación, donde se presentan sus ventajas, fortalezas y debilidades, así como sus registros principales, los registros «de comparación¼ y el principio de redundancia, que ayudan a asegurar datos de alta calidad y el ajuste del censo al marco de referencia internacional. Hoy, los desarrollos incluyen la actualización anual de los resultados, los cambios y mejoras en las fuentes de datos y una breve mirada hacia el nuevo censo de 2021.

Osteosarcoma of the jaw - experience at the Medical University Vienna and comparative study with international tumor registries

OBJECTIVES: Osteosarcoma of the jaw (OSAJ) is fundamentally different in clinical practice from its peripheral counterparts. Studies are difficult to conduct due to low incidence rates. The primary aim of this study was to provide for the first time a comprehensive retrospective analysis of the treatment concepts and outcome data of OSAJ patients treated at the University Hospital Vienna and to compare these with two recently published studies on OSAJ. The clinical study was accompanied by a biomarker study investigating the prognostic relevance of melanoma-associated antigen-A (MAGE-A) in OSAJ specimens. METHOD: Eighteen patients were included, and their outcomes were compared to published data. Immunohistochemistry was performed with mouse monoclonal antibodies against MAGE-A. Survival rates were estimated by the Kaplan-Meyer method. The log-rank test was used to analyze potential prognostic parameters. Fisher's exact test was performed to define the significant differences between the survival rates of the current study and the DOESAK registry. RESULTS: Disease-specific survival was 93.8% after five and 56.3% after ten years. The development of metastases (p=0.033) or relapse (p=0.037) was associated with worsened outcomes in our group as well as in the comparative group. Despite the different treatment concepts of the study groups, survival rates were comparable. MAGE-A failed to show prognostic relevance for OSAJ patients. CONCLUSIONS: Uncertainties about the optimal treatment strategies of OSAJ patients will currently remain. Thus, prospective studies of OSAJ are needed but are only feasible in a multicenter study setting, conducted over a prolonged time period.

Negovsky y Safar unidos por la ciencia de la reanimación / Negovsky and Safar together for science of resuscitation

OBJECTIVE: This article characterize the contributions of Peter Safar and Vladimir Negovsky to the field of resuscitation and critical medicine during the 20th century and the dawn of the 21st century with the purpouse to correlate the discoveries and developments of each one, with their life stories and with the historical moments throughout the 20th century. MATERIALS AND METHODS: A review of literature on the subject was conducted, in which primary and secondary sources on the life and scientific and academic production of Vladimir Negovsky and Peter Safar were searched in online databases, in English as well as Spanish. RESULTS: Peter Safar and Vladimir Negovsky, although they had two very different life histories and developed their academic contributions in opposite political contexts, this did not prevent each of them from laying the foundations of cardiopulmonary resuscitation, both in the concepts and the physiopathological understanding of the damage processes, as well as the procedures to act in a timely manner, minimizing them. They also contributed to critical medicine, and to the formation of intensive care units. This work aims to show how a field of knowledge is based on collective work, as the discovery does not depend on a single character, but on a social, historical process, which is also based on the knowledge and elements developed by others.

OBJETIVO: Con este artículo se caracterizan los aportes de Peter Safar y Vladimir Negovsky en el campo de la reanimatología y de la medicina crítica durante el siglo XX y albores del siglo XXI, y se correlacionan sus investigaciones y descubrimientos con sus historias de vida y momentos compartidos. MATERIALES Y MÉTODOS: Se realizó una revisión de literatura sobre el tema, mediante la búsqueda de fuentes primarias y secundarias sobre la vida y producción científica y académica de Vladimir Negovsky y Peter Safar, en bases de datos en línea, en inglés y en español. RESULTADOS: Peter Safar y Vladimir Negovsky, pese a tener dos historias de vida muy distintas y desarrollar sus aportes académicos en contextos políticos diferentes, coincidieron en un campo de la ciencia que no les impidió que cada uno sentara las bases de la reanimación cardio cerebro pulmonar, tanto en los conceptos y en la comprensión fisiopatológica de los procesos de lesión, como en los procedimientos para prevenir la muerte y minimizar los efectos del proceso isquemia/reperfusión. Así mismo, concibieron y desarrollaron las unidades de medicina crítica y cuidado intensivo, el sistema integral para el transporte de los pacientes y el campo vasto en la formación de posgrados como anestesiología y medicina crítica. CONCLUSIÓN: Definitivamente la ciencia no tiene fronteras políticas y se fundamenta en el trabajo colectivo. Estos dos personajes vivieron tiempos políticos y sociales adversos, unieron lazos de amistad y compartieron experiencias para producir cambios históricos en la ciencia de la reanimación conocida como Reanimatología.

High-Tech Acupuncture for Prevention of Lifestyle Diseases-A Sino-Austrian Cooperation Research Protocol on Heart Rate Variability / 中国结合医学杂志

<p><b>BACKGROUND</b>Acupuncture can not only be used for well-known diseases, but also for so-called modern lifestyle-related diseases. Using innovative methods like e.g. new analyses of heart rate variability (HRV), it is also possible to investigate diseases like burnout syndrome, ie., qi deficiency in Chinese medicine (CM).</p><p><b>OBJECTIVE</b>The main object of this research protocol is to perform research on the relationship of burnout syndrome and heart rate (HR) and HRV.</p><p><b>METHODS</b>A total of 175 patients with burnout syndrome (qi deficiency syndrome) in five groups and 35 healthy volunteers will be investigated. Based on random numbers generated by computer and concealed in opaque envelops, the patients will be assigned to four acupuncture groups using Zusanli (ST 36) acupuncture stimulation, Guanyuan (CV4) acupuncture stimulation, both points, and both points with Streitberger device respectively, and a moxibustion group using both points mentioned above, with 35 cases in each group. Altogether four different experiments are planned. Experiment 1 includes 70 subjects and is a comparison between a burnout group and a control group (healthy volunteers). The evaluation parameters are different scores and indices of HR and HRV. Experiment 2 includes 140 subjects and compares the efficacy of different acupuncture points. In experiment 3 (105 subjects), acupuncture and moxibustion should be compared to healthy volunteers. Experiment 4 (70 subjects) investigates the long-term therapeutic effects of acupuncture and moxibustion on the scores of qi deficiency and HR/HRV in qi deficiency patients. In both the acupuncture and moxibustion groups, a total of 10 treatments will be performed.</p><p><b>CONCLUSIONS</b>The joint research aims at the scientific evaluation of CM, mainly in the field of HRV. This parameter could be a very good indicator of the state of health and can be inflfluenced by different acupuncture methods, as shown in the past.</p>

Projected Numbers of Ischemic Strokes Recorded in the Austrian Stroke-Unit Registry from 2012 to 2075

BACKGROUND AND PURPOSE: This study analyzed the number of patients with ischemic strokes recorded in the Austrian Stroke-Unit Registry with the aim of projecting this number from 2012 to 2075 and to highlight that the Austrian health system will face a dramatic increase in older patients within the next few decades. METHODS: Current demographic information was obtained from EUROSTAT, and information on age- and sex-stratified 1-year incidence rates of ischemic stroke were obtained from the Austrian Stroke-Unit Registry. Sensitivity analysis was performed by analyzing the projections based on predicted ageing, main, and growth population scenarios, and with stratification by age and gender. RESULTS: The total number of ischemic strokes recorded in the Austrian Stroke-Unit Registry was 8,690 in 2012 and is expected to increase to 15,826, 15,626, or 18,134 in 2075 according to the ageing, main, and growth scenarios, respectively. The corresponding numbers of patients are projected to increase or decrease within different age strata as follows (100%=number of registered ischemic strokes in 2012): 0–40 years, 100%/99% (males/females); 40–50 years, 83%/83%; 50–60 years, 98%/97%; 60–70 years, 126%/119%; 70–80 years, 159%/139%; 80–90 years, 307%/199%; and 90+ years, 894%/413%. CONCLUSIONS: The ageing population in Austria will result in the number of patients increasing considerably from 2012 to 2075, to 182%, 180%, or 208% (relative to 100% in 2012) according to the ageing, main, and growth scenarios, respectively; the corresponding value among those aged 80+ years is 315%, 290%, or 347%. These figures demonstrated the importance of improving primary preventive measures. The results of this study should provide a basis for discussions among health-care professionals and economists to face the future large financial burden of ischemic stroke on the Austrian health system.

No Concentration Decrease of House Dust Mite Allergens With Rising Altitude in Alpine Regions

PURPOSE: Several studies over the past 4 decades have indicated a significant reduction in house dust mite (HDM) and HDM allergen concentration in areas higher than 1,500 m above sea level. These have served as basis of allergen avoidance therapies for HDM allergy and asthma. However, modern construction techniques used in the insulation, heating, and glazing of buildings as well as global warming have changed the environmental parameters for HDM living conditions. The present study revisits the paradigm of decreasing HDM allergen concentrations with increasing altitude in the alpine region of Germany and Austria. METHODS: A total of 122 dust samples from different abodes (hotels, privates and mountain huts) at different altitudes (400-2,600 m) were taken, and concentrations of HDM allergens were analyzed. Humidity and temperature conditions, and numerous indoor environmental parameters such as fine dust, type of flooring, age of building, and frequency of cleaning were determined. RESULTS: HDM allergen concentrations did not significantly change with increasing altitude or relative humidity. At the level of indoor parameters, correlations could be found for different flooring types and the concentration of HDM allergens. CONCLUSIONS: In contrast to the widespread view of the relationship between altitude and HDM allergen concentrations, clinically relevant concentrations of HDM allergens could be detected in high-lying alpine regions in Austria and Germany. These results indicate that improvement in conditions of asthmatic patients sensitized against HDMs during a stay at high altitude can no longer be ascribed to decreased levels of HDM allergens, instead, other mechanisms may trigger the beneficial effect.

Auricular acupuncture and biomedical research--A promising Sino-Austrian research cooperation / 中国结合医学杂志

Treatment by auricular acupuncture has a long history. Ear-acupoint research has been advancing step by step in China and also in Europe. Auricles are rich in nerves, therefore a close relationship with different functions of the human body has been proved by the research teams of the two main authors of this article from China and Austria. In recent years, great progress has been made in the research of regulating human body functions through electroacupuncture at the auricular branch of the vagus nerve, which is part of auricular acupuncture therapy. It is well known that the auricular branch of the vagus nerve is the only peripheral pathway to the cerebral cortex. Studies of the Chinese team on hypertension, diabetes, epilepsy and depression have shown that the mechanism of auricular vagus nerve stimulation (VNS) may be comparable with cervical VNS in terms of pathways. Auricular VNS has a broad clinical application prospect.

Gustav Klimt (1862-1918) y su cuadro sobre la medicina / The portrait of medicine and Gustav Klimt (1862-1918)

Gustav Klimt was an Austrian Symbolist painter and one of the most important representatives of the modernist movement of the Viennese Secession. The most notable works carried out at his golden age were the "Portrait of Adele Bloch-Bauer I" and "The kiss". In 1901 he paints "Medicine" where he returns to the entanglement of floating bodies -the lifetime- among which appears the skeleton of death; a female figure stands out from the column to represent freedom from pain. The figure of Hygeia or Hygieia, daughter of Aesculapius, who personifies medicine, is shown in the foreground. In 1911, thanks to "The life and death", a picture related to medicine, he was awarded the first prize at the Universal Exhibition of Rome. A number of his artworks were confiscated by the Nazi dictatorship. During the advance of enemy troops, and fearing that these works would become spoils of war, it was decided to burn the castle where they remained confiscated. Therefore, countless artworks were lost. The progressive development of symbolic or abstract motifs already emphasized the freedom of spirit that permeated all the avant-garde of early twentieth century.

Blood Safety Management System in Foreign Countries / 대한수혈학회지

In an effort to improve the blood safety management system, Korea Centers for Disease Control and Prevention visited the national agencies and blood centers of foreign countries. In Japan, the management system for Human T-lymphotropic virus positive donors is operated. In Germany, Red Cross Blood Centers provide 75~80% of national blood consumption, and hospital blood centers provided 15~20%. In addition, the Paul Ehrlich Institut is engaged in blood center management and blood product safety, and the Robert Koch Institut manages transfusion-transmitted infection. The standard temperature of RBC transport is 1~10degrees C. In Austria, haemovigilance is operated by the National Blood Authority and adverse reactions following transfusion are investigated by Blood Centers. In Britain, blood is provided by National Health Service Blood and Transplant, and the Serious Hazards of Transfusion, haemovigilance system is operated. Universal leukoreduction has been performed since 1999 in order to prevent transmission of variant Creutzfeldt-Jakob disease.

Medicina, música, amistad y prejuicios: Billroth I y Billroth II, los cuartetos para cuerdas Opus 51, N° 1 y N° 2 de Johannes Brahms / Medicine, music, friendship and prejudices: Billroth I and Billroth II, the string quartets Opus 51, N° 1 and N° 2 by Johannes Brahms

Background: The great German surgeon Theodor Billroth and the imaginative and creative composer Johannes Brahms had a very close friendship centered on musical activities, that lasted for more than thirty years while they lived and worked in Zurich and Vienna, during the second half of the Nineteenth Century. Billroth, besides his all-consuming medical activities, had time to be a musical enthusiast who directed orchestras, played the violin in chamber music groups, and wrote musical criticism for newspapers. The common affection between these two creative giants is documented by their abundant and effusive correspondence, by the constant requests by Brahms of Billroth's opinions regarding his compositions, and by the positive and stimulating answers that Billroth gave to these requests. Billroth opened his house for musical evenings to play Brahms chamber compositions for the first time, and Brahms dedicated his two Opus 51 string quartets Nos. 1 and 2, known in the musical milieu as Billroth I and II, to his physician friend. Unfortunately, the close bonds between these two geniuses weakened towards the end of their lives as a result of Billroth's becoming intolerant to the lack of social refinements and gruff behavior of the composer. This baffling intolerance of Billroth to his friend Brahms can be better understood after reading Billroth's writings in his book The Medical Sciences in the German Universities. A Study in the History of Civilization. There Billroth expresses strong prejudices against potential medical students of humble social origins, such as those of Brahms, coupled to a primitive anti-Semitism.

Sigmund Freud (1856-1939) e Karl Köller (1857-1944) e a descoberta da anestesia local: [revisão] / Sigmund Freud (1856-1939) and Karl Köller (1857-1944) and the Discovery of local anesthesia: [revision] / Sigmund Freud (1856-1939) y Karl Köller (1857-1944) y el Descubrimiento de la anestesia local: [revisión]

JUSTIFICATVA E OBJETIVOS: O entendimento por vezes admitido de que Sigmund Freud teve a intuição de utilizar a cocaína como anestésico local para intervenções cirúrgicas, ou mesmo de que ele tenha tido algum papel na descoberta da anestesia local não é verídico. Os objetivos das pesquisas de Freud eram outros e o verdadeiro realizador da descoberta foi Karl Kõller, sobre o que há argumentos irrefutáveis. Diante desses fatos, tem importância histórica o conhecimento correto da questão. CONTEÚDO: O texto refere-se às propriedades há muito conhecidas da cocaína. Recorda dados pessoais, atividades profissionais e científicas de Sigmund Freud e de Karl Kõller. Apresenta as pesquisas de Freud sobre efeitos fisiopatológicos observados com a cocaína. Expõe as razões das duras críticas recebidas por Freud diante de conceitos por ele emitidos. Descreve a súbita, porém consciente e justificada idéia de Karl Kõller de estudar cientificamente a cocaína como anestésico local em animais e seres humanos. Indica como foram realizadas as pesquisas pioneiras que culminaram com a descoberta da anestesia local por Kõller e as duas exposições sobre esta, feitas em Viena. Relata a primeira intervenção cirúrgica oftalmológica sob anestesia local. Comprova a imediata difusão pelo mundo da descoberta que marcou o início da anestesia locorregional. Comenta numerosos documentos comprobatórios da prioridade de Kõller na descoberta. Finalmente, menciona as numerosas homenagens recebidas por Kõller em várias partes do mundo. CONCLUSÕES: A anestesia locorregional foi iniciada por Karl Kõller em 1884, quando ele provou a possibilidade de praticar intervenções cirúrgicas oftalmológicas sem dor utilizando a cocaína como anestésico local. Sigmund Freud realizou muitas pesquisas sobre a cocaína, mas não participou diretamente do importantíssimo feito.

BACKGROUND AND OBJECTIVE: The understanding, occasionally recognized, that Sigmund Freud had the intuition to use cocaine as local anesthetic for surgical procedures, or even that he played any role in the discovery of local anesthesia is not true. The objective of Freud's studies were different, and based in irrefutable evidence, Karl Kõller was the real inventor of local anesthesia. In face of those facts, proper knowledge of this historically important subject is due. CONTENTS: This report refers to the long-known properties of cocaine. It also remembers personal data, and the professional and scientific activities of Sigmund Freud and Karl Kõller. It presents Freud's researches on the pathophysiological effects of cocaine. It exposes the reasons for the harsh criticism of Freud's concepts. It describes the sudden, but conscious and justified, idea of Karl Kõller to study scientifically the use of cocaine as a local anesthetic in animals and humans. It indicates how those pioneering studies, that culminated with the discovery of local anesthesia by Kõller and two presentations in Vienna on the subject, were done. It also reports the first ophthalmologic surgery under local anesthesia. It shows the immediate dissemination throughout the world of the discovery that marked the beginning of regional blocks. It comments several documents corroborating the role of Kõller in this discovery. And, finally, it mentions the numerous homages received by Kõller in different areas of the world. COCLUSIONS: Regional block was introduced by Karl Kõller in 1884, when he demonstrated the feasibility of performing painless ophthalmologic surgeries by using cocaine as a local anesthetic. Sigmund Freud studied cocaine extensively, but he did not have direct participation in this important discovery.

JUSTIFICATIVA Y OBJETIVOS: Los que a veces se cree de que Sigmund Freud tuvo la intuición de utilizar la cocaína como anestésico local para las intervenciones quirúrgicas o incluso de que él haya tenido algún rol en el descubrimiento de la anestesia local, no es verídico. Los objetivos de las investigaciones de Freud eran otros y el verdadero realizador del descubrimiento fue Karl Kõller, sobre lo que ofrece argumentos irrefutables. Frente a esos hechos, el correcto conocimiento de esa cuestión, tiene uma importancia histórica. CONTENIDO: El texto se refiere a propiedades que hace mucho tiempo se conocían sobre la cocaína. Nos habla sobre datos personales, actividades profesionales y científicas de Sigmund Freud y de Karl Kõller. Presenta las investigaciones de Freud sobre los efectos fisiopatológicos observados con la cocaína. Expone las razones de las duras críticas recibidas por Freud sobre conceptos que él había explicado. Describe la súbita, pero conciente y justificada idea de Karl Kõller de estudiar científicamente la cocaína como um anestésico local en animales y seres humanos. Indica cómo fueron realizadas las investigaciones pioneras que redundaron con el descubimiento de la anestesia local por Kõller y las de los exposiciones sobre esta, hechas en Viena. Relata la primeira intervención quirúrgica oftalmológica bajo anestesia local. Comprueba la inmediata difusión por el mundo del descubrimiento que marcó el inicio de la anestesia locorregional. Comenta innumerables documentos que comprueban la prioridad de Kõller en ese descubrimiento. Y finalmente, menciona los numerosos homenajes recibidas por Kõller en varias partes del mundo. CONCLUSIONES: La anestesia locorregional fue iniciada por Karl Kõller en 1884, cuando él probó la posibilidad de practicar intervenciones quirúrgicas oftalmológicas sin dolor utilizando la cocaína como anestésico local. Sigmund Freud realizó muchas investigaciones sobre la cocaína, pero no participó...

¿Que causó la temprana muerte de Mozart? / What caused the early death of Mozart?

Mozart junto con Bach, Handel y Beethoven, es uno de los mayores músicos de nuestra historia. Sin embargo existe mucho de leyenda y misterio alrededor de 105 eventos y factores que rodearon su muerte. La siguiente revisión analiza la hipótesis más aceptada sobre la etiología de la enfermedad de Mozart, la cual está basada en evidencia actualizada extraída de literatura biográfica científica. Considerando los datos epidemiológicos de Viena en esos tiempos, y los registros médicos de las atenciones dadas a Mozart, es planteable que sufría de complicaciones derivadas de la Fiebre Reumática, afectando la función renal con glomerulonefritis crónica y finalmente un accidente vascular hemorrágico.

Mozart remains among Bach, Handel and Beethoven, as one of the greatest musicians of the whole history. However, still there is a lot of legend and mystery regarding the faro surrounding his death. In this review, based on current evidence by scientific literature and authoritative biographies, the most accepted hypothesis respecting the etiology of Mozarts disease is analyzed. Considering the epidemiologic data of Viena at that time and the reports of the physicians who gave the musician last medical support suggests that Mozart suffered from complications from a rheumatic fever affecting his kidneys with chronic glomerulonephritis and a final hemorrhagic stroke.

Una breve historia de la invención del espejillo laríngeo y del espejo frontal / A brief history of the invention of the laryngeal and head mirrors

Se presenta una breve historia sobre el espejillo laríngeo y el espejo frontal y los personajes que participaron en su invención. El mérito principal de haber ideado un sistema para efectuar una laringoscopía recae en Manuel V. García, profesor de música español, quien usando un espejillo dental, un espejo manual y la luz del sol, logró por primera vez observar el movimiento de las cuerdas vocales el año 1854. Posteriormente el mismo método fue difundido entre los médicos europeos por un neurofisiólogo austríaco, Ludwig Türck en 1856, técnica que no tuvo mucha aceptación por lo engorroso que resultaba el procedimiento al depender de la luz del sol. Esta idea de Türck, fue ampliamente superada por Johann Czermak, fisiólogo checo, quien modificó el espejo cóncavo manual, con un agujero central usado por los otólogos para examinar el tímpano, agregándole un cintillo para sujetarlo a la cabeza, con lo que pudo observar las cuerdas vocales con la luz de una lámpara sin ninguna dificultad, trabajo que publicó el año 1858.

A brief history of the laryngeal and head mirrors and of the people that participated in their invention is presented. The main credit for having thought of a system to perform a laryngoscopy is on Manuel V. Garcia, a Spanish music professor. In 1854, he used a dental speculum, a hand mirror and sunlight to observe vocal chords movements for the first time. A couple of years later, in 1856, the method spread among European doctors thanks to an Austrian neurologist: Ludwig Türck. His technique was not very widely accepted because of its dependence on sunlight. Türck s idea was perfected by Johann Czermack, a Czech physiologist. He modified the concave hand mirror with a central hole, which at the time was used by otologists to examine the tympanum, adding a headband in order to attach it to the forehead. In this way he managed to easily observe the vocal chords using light from a lamp, and reported his technique in a 1858 paper.

A Survey on the Mode of Working of Estheticians in OECD Member Nations andSome Asian Countries in Relation to Medical Service / 대한피부과학회지

In 2008, Korea has enacted new ordinances about the role of estheticians, but this law can be interpreted ambiguously, restricting hiring of estheticians in medical clinics. The purpose of the study is to obtain information about medical-esthetic systems in other countries. We have taken a survey of this object from 30 OECD & Asian countries, and the questionnaires returned from a total of 22 countries (Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Japan, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Spain, Switzerland, Turkey, United Kingdom, United States, Singapore, Israel, and Thailand), were used for the final analysis. The results are summarized as follows. In most countries, estheticians working independently deal with only healthy, normal skin. In most countries, estheticians working independently have no right to operate any medical instruments. In all 17 countries that returned the questionnaires medical clinics can employ estheticians, and only theses estheticians who belong to the medical clinics can handle the non-invasive medical instruments under the supervision of doctors. In 17 countries that have related legal regulations, nurses, under the control of doctors, can perform wider range of duties in various settings than estheticians. The survey concludes that the duties of estheticians are closely related with medical skin care services and estheticians can perform various non-invasive medical procedures only under the control of doctors. From consulting a variety of medical-esthetic systems in other countries, we propose that the estheticians be allowed to work in medical clinics to provide better medical services for the patients and to make more chances of employment for themselves.

La distrofia adiposo genital o síndrome de Frohlich: su contribución al establecimiento de la neuroendocrinología / The adiposogenital distrophy or Frohlich syndrome and the beginning of the concept of neuroendocrinology

Hace casi un siglo Harvey Cushing llamó la atención médica mundial con motivo de un informe clínico consistente en el caso de obesidad e infantilismo sexual ocasionado por un tumor en la base del cráneo al cual se le dio el nombre de distrofia adiposo-genital o síndrome de Frohlich por haber sido quien lo describió por primera vez. El estudio de este síndrome permitió establecer la conexión entre la hipófisis y el hipotálamo que eran estructuras con funciones poco conocidas hasta ese momento. Así se fue gestando la neuroendocrinología clínica.

A century has passed since Harvey Cushing presented a syndrome characterized by obesity and sexual infantilism, caused by a tumour located in the base of the brain, and named it as Adiposogenital dystrophy or Frohlich's syndrome, on the name of its discoverer. Further study of this syndrome contributed to establish the hormonal connection between the brain and the anterior pituitary, and then the concept of neuroendocrinology.