Historical High Complexity Neurosurgery Development of One of the Poorest Brazilian Regions

Human development rates in the Vale do Jequitinhonha, state of Minas Gerais, Brazil, called "Misery Valley," are among the lowest in the country, not to mention the often precarious psychosocial realities that daily contact with these families reveals. The history of neurosurgery at the Neurosurgical Reference Center at the Vale do Jequitinhonha e Mucuri dates from 2004, when the first neurosurgical procedures were performed in the recently organized Section of Neurosurgery. The historical surgical series shows the positive impact of the service. In 2007, the average was 3 neurosurgeries/month. In the last year, 2018, service growth boosted the record to 34.83 neurosurgeries/month. In addition to performing elective surgery, the neurosurgery team supports the emergency team by performing some neurosurgical procedures. The service number of patients operated since the development of the service is nearly 3,000. Neurosurgery at the Santa Casa de Caridade from Diamantina has been made comparable to the best national neurosurgery services.

The controversy over the restructuring of perinatal emergency services in Portugal and the importance of citizen participation in health care decision-making processes / A controvérsia sobre a restruturação dos serviços de urgência perinatal em Portugal e a importância da participação cidadã em processos de decisão sobre saúde

This article explores the controversial decision made by the Ministry of Health to restructure the perinatal emergency services in Portugal in 2006. Particular emphasis is given to the protests held across the country against, the actors involved, and the arguments put forward for and against the measure, in an attempt to understand the forms of knowledge and experiences brought to the discussion about the issues raised by the decision, and how different forms of knowledge are reconciled under a democratic process. In addition, this article explores the importance of citizen participation, including that which emerges from conflicting relations, in the formulation of health policies.

O artigo examina o processo de restruturação dos serviços de emergência perinatal implementado pelo Ministério da Saúde em Portugal em 2006 e tem como objetivo analisar essa decisão controversa. Especial ênfase é dada aos protestos desencadeados no país contra essa medida, os atores envolvidos e os argumentos contra e a favor, de forma a compreender os conhecimentos e as experiências trazidos para discussão dos problemas suscitados pela decisão tomada e como diferentes formas de conhecimento podem ser conciliadas no âmbito de procedimentos democráticos. Além disso, explora a relevância da participação cidadã na formulação de políticas de saúde, incluindo aquela que emerge de relações conflitantes.

Semmelweis: de médicos: estetoscopios: corbatas y otros atuendos / Semmelweis: about physicians: athetoscopes: neckties and other garments

Por la heroica historia de Ignaz Semmelweis (1818-1865), los médicos hemos sido aconsejados a lavarnos las manos cada vez que examinamos un paciente. Deberíamos hacerlo antes y después, y estar seguros de que él nos viera… Una manifiesta y justificada cruzada a favor de la limpieza de los estetoscopios y contra del uso de batas blancas. Corbatas y otras prendas de vestir, ha venido expresándose en ambientes médicos, primero en forma tímida y ahora con mayor fuerza, al aportarse pruebas convenientes acerca de la inconveniencia de llevarlas. La consigna es la eliminación de las corbatas durante la visita o revistas médicas al considerárselas como diseminadoras de infecciones adquiridas en el hospital. Las corbatas más que un probable reservorío de gérmenes son prendas innecesarias por lo que el médico debe reconocer su eventual riesgo. Las nuevas guías de la Brithish Medical Association incluyen un mayor énfasis en el lavado de las manos y de acuerdo a ella, “es la intervención más importante en el control de las infecciones”. Igualmente, se aboga por un mejor diseño de las salas de hospitalización, mejor provisión de lavamanos o geles antisépticos, políticas más inteligentes en la prescripción de antibióticos y eliminar el uso de ítems tales como corbatas, a veces usadas continuamente y por semanas y solo por raridad enviadas a la lavandería

Since the heroic history of Ignaz Semmelweis (1818´1865), we doctors have been advised to wash our hands every time we examine a patient. We should have to do it before and sfter, and be sure that the patients is seeing us… An overt and warranted crusade in favor of cleaning stethoscopes and against the use of medical gowns, neckties and other clothing items has begun expressing itselfin medical spheres, first in timed form and now with greater force, thanks to convincing test regarding the inconvenience of their use. The main message is the alimination of neckties during examinations or medical rounds, considering that these are vehicles of infection acquired in the hospital. Neckties, more than probable reservoirs of germs, are unnecessary clothing items, reason why doctors must recognize their possible risk. The new guidelines of the Medical Brithish Association include a greater emphasis on the washing of hands and according to it, “(it) is the most important intervention in the control of infections”. Also, it pleads for a better design of hospital rooms, better provision of sink and/or antiseptic gels, more intelligent policies for antibiotic prescriptions and the elimination of the use of items such as neckties, sometimes used continuously and for weeks and only rarely washed

How medical functions shaped architecture in anatolian seljuk darussifas [hospitals] and especially in the divrigi turan malik darussifa

The dominant cultural effectiveness of the Seljuks, which affected different nations and regional races within the borders of their empire that stretched from Central Asia to Cairo, has left behind famous civilizations which are today within the borders of various countries [India, Iraq, Iran, Syria, Egypt, Turkey, etc.]. As for structural characteristics, in an atmosphere whose origin is rooted in pagan culture and architecture formed by its symbols is continued, the form does not change when planning big buildings or where the "house" is concerned. The root lies back in the Central Asian house or multifunctional Turcoman tent. Hospitals were so improved that various establishments developed in a way that suited the needs of the period's social life, ruling administration and military life. To group these: Mobile hospitals were to be found in caravans behind the soldiers who were fighting. In the Malik Shah Era, in the Seljuk army there were military hospitals carried by 40 camels. Seljuk hospitals were caravanserai hospitals, palace hospitals, and serving public, usually within the structure of a medical madrasah, darussifas. It was inconceivable for a culture whose scope is as deep and wide as this to not affect the West that was drowning in the conservative religion suppression of the Middle Ages. Like the architectural structures of the sifahanes, the education systems of great medical scholars also occurred in Europe. Extending back to the symbols of the knights of Malta and the baroque style, the lily motif seen in sifahanes and Divrigi ornamentations; on the other side and again from Anatolian culture, the snake motif that originated in healing temples are renowned symbols and a form of expression