Marcel Proust y en busca del tiempo perdido: ética de la existencia humana y el mundo de la medicina recuperado / Marcel Proust and in search of lost time: ethics of human existence and the world of medicine recovered / Marcel Proust e em busca do tempo perdido: ética da existência humana e o mundo da medicina recuperado

Resumen: 1. En busca del tiempo perdido de Marcel Proust narra el proyecto-de-existencia del "autor" de la ficción de llegar a ser artista. 2. El mundo de la medicina es el ámbito en que se exterioriza la fragilidad del hombre como ser-referido-a-la-muerte. 3. El sentimiento engañoso de poder de la buena salud embriaga a la medicina, médicos, pacientes, parientes, tratamientos -depreciación irreverente hacia lo perecedero. 4. El tratamiento médico de la agonía de la abuela del "autor" muestra los elementos centrales de la relación médico-paciente de la medicina de comienzos del siglo XX: cognoscitivo, afectivo, operativo, ético y social. 5. El "autor" de la novela no es Marcel Proust y, aunque se trata de una ficción, estimula al mundo médico actual a reflexionar sobre sus fundamentos bioéticos últimos.

Abstract: 1. Marcel Proust´s In Search of Lost Time recounts the fiction of the "author's" project-of-existence to become an artist. 2. The world of medicine is the area in which the fragility of man is expressed as being-referred-to-death. 3. The deceptive feeling of the power of good health intoxicates medicine, physicians, patients, relatives, treatments - irreverent depreciation toward the perishable. 4. The medical treatment of the agony of the "author's" grandmother shows the central elements of the doctor-patient relationship in medicine at the beginning of the 20th century: cognitive, affective, operational, ethical, and social. 5. The "author" of the novel is not Marcel Proust and, although it is a fiction, it encourages today´s medical world to reflect on its fundamental bioethical foundations.

Resumo: 1. Em busca do tempo perdido de Marcel Proust narra o projeto-de-existência do "autor" da ficção de chegar a ser artista. 2. O mundo da medicina é o âmbito em que se exterioriza a fragilidade do homem como ser-referido-à-morte. 3. O sentimento enganoso de poder da boa saúde embriaga a medicina, médicos, pacientes, parentes, tratamentos -depreciação irreverente ao perecível. 4. O tratamento médico da agonia da avó do "autor" mostra os elementos centrais da relação médicopaciente da medicina do princípio do século XX: cognitivo, afetivo, operativo, ético e social. 5. O "autor" do romance não é Marcel Proust e, ainda que se trate de uma ficção, estimula o mundo médico atual a refletir sobre seus fundamentos bioéticos últimos.

Students' experience with literature in medical education / Experiência de estudantes com a literatura na formação médica

Abstract: Introduction: The National Curricular Guidelines (NCG) for medical school bring the teaching of Humanities, among them Literature, as a way to overcome the biomedical model. Literature can strengthen compassion directed to the 'other'. It starts with a curriculum organized by active teaching-learning methodologies. Objective: This study aims to understand the experiences of students from a Medical School in the interior of São Paulo who had contact with literary texts in the beginning of medical school, creating a representative model based on the experience. Method: This is a qualitative research guided by the Grounded Theory. The data collection was carried out through semi-structured interviews with undergraduate students who were randomly chosen from all years of the Medical School. The only inclusion criteria was the participation in groups coordinated by a teacher who had used literature as a teaching strategy. Twelve interviews were carried out, transcribed and codified. The sampling was performed by theoretical saturation. Results: The created categories were: 1. "Identifying the importance of the literature and Arts in Medical School, seeking a rupture from the biomedical model, while improving empathy and the humanization of care"; 2. "Reflecting on the use of artistic tools to learn practical contents in Medicine and to provide psychosocial knowledge"; 3. "Proposing a possible curricular systematization, considering active methodologies and other artistic forms"; 4. "Recalling the tales that are more often associated to the student's personal interest, which can promote the integration with all the acquired knowledge". Based on these categories, it was possible to create the representative model of the experience that relays the students' satisfaction with literature in medical education, enhancing the humanization of care; however, there is a need for curriculum homogenization, aiming at organizing the activity and the learning opportunity for others students. Conclusion: The model comprises the idea that literature enhances the humanization of care and is able to establish a rupture from the biomedical model. The study potential lies in proposing strategies to the community and academic management, aiming to strengthen humanization in curricular perspective of medical training.

Resumo: Introdução: As Diretrizes Curriculares Nacionais (DCN) de 2014 para o curso de Medicina trazem o ensino das humanidades, entre elas a literatura, como forma de superar o modelo biomédico. A literatura pode fortalecer a compaixão, com o olhar para a alteridade. Parte-se de um currículo organizado por metodologias ativas de ensino-aprendizagem. Objetivo: Este estudo teve como objetivo compreender as experiências dos estudantes de uma faculdade do interior paulista que tiveram contato com textos literários no início da graduação, elaborando um modelo representativo da experiência. Método: Trata-se de pesquisa qualitativa, orientada pela Teoria Fundamentada nos Dados (TFD). A coleta de dados foi realizada por meio de entrevistas semi-estruturadas, com estudantes, sorteados, de todas as séries do curso de Medicina, tendo como critério para inclusão a participação em grupos conduzidos por professora que fez uso de literatura como estratégia educacional. Houve realização de 12 entrevistas, transcritas e codificadas. A amostragem se deu por saturação teórica. Resultados: Foram geradas as seguintes categorias: 1. "Importância da literatura e das artes em geral na formação médica, visando ao rompimento do modelo biomédico e à potencialização tanto da empatia quanto da humanização do cuidado na relação médico-paciente"; 2. "Refletindo sobre o uso de ferramentas artísticas para o aprendizado de conteúdos técnicos/práticos da medicina, assim como para proporcionar a mudança de habilidades e conhecimentos psicossociais"; 3. "Refletindo acerca de uma possível sistematização curricular considerando as metodologias ativas e outras formas artísticas, e comparando grupos/séries da graduação que tiveram ou não contato com essas ferramentas"; 4. "Possibilitando a lembrança dos contos ou das discussões fomentados nos primeiros anos da graduação, associando ao interesse pessoal do estudante pela atividade e promovendo a integração dos conhecimentos adquiridos na prática médica". A partir das categorias, foi possível elaborar o modelo representativo da experiência que remete à satisfação dos estudantes com a literatura na formação médica, potencializando a humanização do cuidado, porém sinaliza-se a necessidade de homogeneização curricular para organização da atividade e oportunidade da aprendizagem para outros estudantes. Conclusões: O modelo compreende a noção de que a literatura potencializa a humanização da atenção e é capaz de romper com o modelo biomédico. A potencialidade do estudo tem seu alcance na proposição de estratégias à comunidade e gestão acadêmica, para fortalecimento da humanização na perspectiva curricular da formação médica.

Cartas a um jovem mentor - aprendendo mentoria com os clássicos / Letters to a young mentor - learning mentoring through classics

Resumo: Introdução: Como ser mentor para alguém? Como fazer acontecer a mentoria? Qual é o caminho a seguir? Podemos aprender sobre mentoria no cotidiano, em programas estruturados e, desde a sua origem, nos clássicos literários. Neste ensaio, a partir de releitura pessoal do livro Cartas a um jovem poeta, de Rainer Maria Rilke, busco identificar e apresentar elementos que possam aprofundar a compreensão do ser mentor e do fazer mentoria. Desenvolvimento: A troca de correspondências entre o poeta experiente e o iniciante mostra a importância da generosidade e da humildade como atributos de um mentor. Mesmo a distância e mediada por cartas, a relação é sustentada pelos três vértices da mentoria que promovem desenvolvimento: o acolhimento, a reflexão e a visão. Conclusão: Mentores modernos podem encontrar, nessa e em outras narrativas clássicas, novas inspirações para o seu fazer. Rilke e o jovem Kappus, tal como Mentor e Telêmaco, na Odisseia, caminham juntos e nos contam uma história que vale a pena ler e reler.

Abstract: Introduction: How should one be a mentor to someone else? How should one make mentoring happen? Which is the correct path to take? We can learn about mentoring in everyday life, in structured programs, and, since its origins, in literary classics. In this essay, taking as a starting point Letters to a Young Poet, by Rainer Maria Rilke, I sought to identify and present elements that can further our understanding of what it means to be a mentor and to make mentoring happen. Development: The letters exchanged between the experienced poet and the beginner show the importance of generosity and humility as a mentor's attributes. Even if through letters, the relationship is established on three vertices of mentoring that promote development: support, reflection, and vision. Conclusion: In the classic narratives, modern mentors can find new inspiration for their practice. Rilke and the young Kappus, as Mentor and Telemachus, walk together and tell us a story that is worth reading and rereading.

Grandes personajes de la medicina, grandes lecciones / Great personalities of medicine. Great lessons

Resumen El análisis de tres personajes correspondientes a espacios y tiempos diferentes muestra el estrecho vínculo entre la literatura y la historia de la medicina. Por un lado, don Quijote de la Mancha, quien refleja el pensamiento de los últimos años del Renacimiento y ha sido asimilado en el México contemporáneo. Por otro lado, los doctores Miguel Francisco Jiménez y Rita Levi Montalcini, quienes vivieron en los siglos XIX y XX, respectivamente. A pesar de los años que separan a los tres personaje, se advierten numerosos elementos en común que no pierden vigencia: el valor que se otorga a la salud, la ética, la tenacidad y la experiencia para obtener resultados exitosos, entre otros. Los tres personajes aluden a la medicina de su tiempo, los logros alcanzados y la promoción del humanismo, siempre inherente a la medicina.

Abstract The analysis of three characters corresponding to different spaces and times shows the close link between literature and the history of medicine. On one hand, Don Quixote of La Mancha, who reflects the thought of the last years of the Renaissance and that has been assimilated in contemporary Mexico. On the other hand, Doctors Miguel Francisco Jiménez and Rita Levi Montalcini who lived in the 19th and 20th centuries, respectively. Despite the years that separate these three personalities, many elements in common are observed that do not lose their validity: the value that is given to health, ethics, tenacity and experience to attain successful results. All three characters refer to the medicine of their time, their achievements and the promotion of humanism, always inherent to medicine.

Eutanásia sob a perspectiva da bioética e clínica ampliada / Euthanasia from the perspective of extended bioethics and clinics / La eutanasia desde la perspectiva de la bioética y la clínica ampliada

Resumo "Eutanásia" significa causar óbito rápido e indolor ou não o evitar, visando aliviar o sofrimento do paciente quando a morte é entendida como melhor bem ou menor mal. "Clínica ampliada" diz respeito à expansão do objeto de interesse clínico, ocupando-se não apenas da doença, mas também e sobretudo do sujeito singular. O objetivo deste trabalho é analisar a eutanásia a partir da bioética ampliada. Para isso, utilizou-se trecho do romance Anne Prédaille , do escritor francês Henri Troyat, no qual a personagem principal provoca a morte da mãe aplicando dose elevada de morfina. O fragmento mostra a eutanásia como questão de sujeitos com histórias de vida singulares que se inter-relacionam, e não como a passagem asséptica da vida para a morte. Concluiu-se que a bioética deve considerar a história das pessoas envolvidas no processo da eutanásia.

Abstract Euthanasia is the act of intentionally ending a life quickly and painlessly, or omitting to prevent it, to alleviate suffering when death is understood as the greater good or the lesser evil. An extended clinical approach refers to the expansion of the object of clinical interest, which is concerned not only with the disease, but also and above all with the individual. This study analyzes euthanasia from the perspective of extended bioethics. To this end, we used an excerpt from the novel Anne Prédaille by French writer Henri Troyat, in which the main character causes the death of her mother, who suffers from a terminal illness, by applying a high dose of morphine. The literary fragment was intended to show euthanasia as a matter of subjects with unique interrelated life stories, and not as the aseptic passage from life to death. We concluded that bioethics must consider the life history of people involved in the process of euthanasia.

Resumen "Eutanasia" es hacer que una persona muera rápidamente y sin dolor, o no evitarlo, con el fin de aliviar el sufrimiento, cuando la muerte se entiende como el mejor bien o el menor mal. "Clínica ampliada" se refiere a la expansión del objeto de interés de la clínica, que se ocupa no solo de la enfermedad, sino también y sobre todo del individuo. El objetivo de este trabajo es analizar la eutanasia desde una bioética ampliada. Para ello, se utilizó un extracto de la novela Anne Prédaille del escritor francés Henri Troyat, en la que el personaje principal provoca la muerte de la madre por la aplicación de una alta dosis de morfina. El fragmento muestra la eutanasia como una cuestión de sujetos con historias de vida únicas que se interrelacionan, y no como la transición aséptica de la vida a la muerte. Se llegó a la conclusión de que la bioética debe considerar la historia de la vida de las personas que participan en el proceso de eutanasia.

William Shakespeare y la medicina / William Shakespeare and medicine

Si repensamos a escritores que se ocuparon de la medicina, el presente trabajo pretende destacar a William Shakespeare, como un escritor que prácticamente en toda su obra describe en sus personajes problemas de salud de todo tipo. Se harán ciertas referencias de los aspectos médicos desarrollados en la obra del escritor, advirtiendo que son sólo una parte de su extensa producción. (AU)

If we rethink writers who dealt with medicine, this paper intends to highlight William Shakespeare, as a writer who practically describes all kinds of health problems in his characters. Certain references will be made of the medical aspects developed in the writer's work, warning that they are only part of his extensive production. (AU)

The world is waiting, use sequential analysis and get us the evidence-based treatment we need for COVID-19

In spite of the relatively high morbidity and mortality, there is no approved medication yet for COVID-19. There are more than 200 ongoing trials on different drugs or vaccines, but new medications may take until 2021 to develop. Defining the optimal number of patients to be included in a study is a considerable challenge in these interventional researches. Ethical considerations prompt researchers to minimize the number of patients included in a trial. This gains particular importance when the disease is rare or lethal which is particularly so in the case of COVID-19. It is of paramount importance to explore some of the available tools that could help accelerate the adoption of any or some of the many proposed modalities for the treatment of diseases. These tools should be effective, yet efficient, for rapid testing of such treatments. Sequential analysis has not been frequently used in many clinical trials where it should have been used. None of the authors in published literature, as far as we know, used sequential analysis techniques to test potential drugs for COVID-19. In addition to its usefulness when the results of new forms of treatment are quickly needed, other important benefit of sequential analysis includes the ability to reach a similar conclusion about the utility of a new drug without unduly exposing more patients to the side effect of the old drug, in particularly, for the treatment of a rare disease

The poor insane Ophelia: reconsidering Ophelia syndrome / La pobre e insensata Ofelia: reconsiderando el síndrome de Ofelia

ABSTRACT The association between memory loss and Hodgkin's lymphoma has been given the eponym of Ophelia syndrome, in memory of Shakespeare's character in The Tragedy of Hamlet, Prince of Denmark. Nevertheless, there are differences between the disease and the character. Objective: To review the origins and uses of the eponym through an original article by pathologist Ian Carr, its relation to the character Ophelia, and the related autoantibodies. Methods: Historical narrative review. Results: Besides an eloquent description in the original article, Carr presaged the presence of autoantibodies, before they had been thoroughly researched. Since then, five different autoantibodies (mGluR5, Hu, NMDAR, SOX, PCA2) have been associated with Hodgkin's disease. It is interesting to note the divergent outcomes of Shakespeare's character and the patient in the original description by Carr, the latter recovering to lead a normal life, and the former deceased. Conclusions: Although there is little relationship between the fictional character and the syndrome, both imply the unintentional trigger of self-harm (suicide in one case, autoimmunity in the other), thus remaining associated.

RESUMO El síndrome de Ofelia describe la asociación entre pérdida de memoria y enfermedad de Hodgkin, en memoria del personaje de La Tragedia de Hamlet, Príncipe de Dinamarca, de William Shakespeare. Sin embargo, existen diferencias entre ambos. Objetivo: Revisar los orígenes y usos del epónimo a través del artículo original, su relación con el personaje y los autoanticuerpos relacionados. Métodos: Revisión narrativa histórica. Resultados: Además de una descripción elocuente, el artículo original prefigura los autoanticuerpos, cuando no se buscaban de rutina. Desde entonces, cinco distintos (mGluR5, Hu, NMDAR, SOX, PCA2) han sido asociados. Cabe destacar, que el desenlace del personaje y del paciente fueron diametralmente opuestos, el primero falleció y el segundo se recuperó, llevando una vida normal. Conclusiones: A pesar de la poca relación entre el personaje y el síndrome, ambos implican el desencadenamiento no intencional de daño auto-inflingido (suicidio en un caso, autoinmunidad en el otro), manteniendo así la adecuacía.

Emilio Zola y la influencia de la Medicina en su obra La Fortuna de los Rougon-Macquart / The influence of medicine in Emile Zola's "Fortune of the Rougon-Macquart"

Emile Zola is one of the greatest writers in universal literature. In his important series of novels called "The Fortune of the Rougon-Macquart", Zola shows a surprising medical knowledge even though he did not have a formal medical education. We highlight not only his outstanding literary talent, but also the scientific relevance of the tremendous contribution to the medical field that can be extracted from his work. In this series, which describe the history of five generations within a large family suffering from neuropsychiatric and general pathologies, Zola emphasizes the hereditary component of several diseases. These observations probably place him as the first novelist who made an explicit emphasis on the power of inheritance in human behavior. He also mentions for the first time several medical aspects that were seldom addressed in the scientific literature of the time, demonstrating the genius of the writer, his outstanding power of observation and the rigorous preparation with which he wrote his work.

Los síntomas melancólicos del filósofo en las Intercenales (1424-1439) de Leon Battista Alberti / The melancholy of the philosopher in the Intercenales (1424-1439)

This essay analyzes the presence of the modern concept of melancholy in the Intercenales (1424-1439) by the humanist Leon Battista Alberti. The Intercenales is a collection of satirical, allegorical and moralizing writings composed with the purpose of entertaining an audience of close friends. In spite of the fact that the term "melancholia" does not appear in the text, this paper argues that Alberti's character of "the philosopher" is melancholic, since he is "ill in the soul" (suffering from morbus animi), and his illness is evidenced by a series of physical and psychological symptoms associated with melancholy in the classical and medieval medical traditions. These symptoms are stomach pain, pallor, insomnia, a rich memory, a propensity to study at night, and an ability to have premonitory dreams. With this characterization Alberti promotes a connection between melancholy and being a genius, which is distinctive to the Renaissance and the basis for the modern concept of melancholy. The essay concludes that the ultimate purpose of the Intercenales is to cure, from a literary and philosophical point of view, the illness of the melancholic philosopher.

Thomas Mann y las enfermedades infecciosas en la primera mitad del siglo XX. Parte II: Tuberculosis, cólera, trasplantes / Thomas Mann and the infectious diseases in the first half of 20th. century: second part: tuberculosis, cholera and transplants

Resumen Con seguridad Thomas Mann es hoy en día un escritor olvidado, para los infectólogos y para todo el mundo, con apenas un selecto grupo de poquísimos lectores entre nuestros jóvenes colegas. No les hará mal, a éstos y a aquéllos, sin embargo, adquirir algún conocimiento de las ideas sobre las enfermedades infecciosas en la primera mitad del siglo XX, período en que Mann escribió las obras aquí comentadas: por el contrario puede resultarles particularmente útil si este conocimiento les llega a través de la visión muy personal del germano, quien pone el foco más en el espíritu -la voluntad, el alma en suma- que en el componente físico de la enfermedad, en la miseria corporal, ignorando de paso, desdeñosamente, a las bacterias causantes.

Surely Thomas Mann is today a forgotten writer, with only a little and selected group of readers between our young colleagues. However, perhaps could be useful for the others some knowledge about his vision of the infectious diseases in the first half of the twentieth century, when he wrote the novels here reviewed. Typhoid fever, meningitis, syphilis, tuberculosis and cholera are present in Mann's thematic from Buddenbrooks till Doktor Faustus, always with a personal focus, more on spirit -the will to live- rather than flesh and bones... or bacteria. One of his lasts and minor works let us throw an ironical glance over transplant, no so named, indeed, by Mann, who speaks of "exchange". In this second part we present tuberculosis, cholera and…transplant.

Origen de epónimos médicos derivados de la mitología / Origin of medical eponyms derived from mythology

Resumen: Muchos mitos y leyendas han tenido una profunda influencia sobre el lenguaje médico moderno y están extendidos a todas las especialidades, formando parte de su cultura y de la historia de la Me dicina. Este artículo revisa en forma breve la historia de algunos epónimos los cuales son empleados habitualmente en medicina. Es conocimiento de pocos el origen mitológico en su denominación.

Abstract: Many myths and legends have had a profound influence on modern medical language and are exten ded to all specialties as part of their culture and the history of medicine. This article briefly reviews the history of some eponyms which are usually used in medical practice. It is the knowledge of a few the mythological origin in its denomination.

Identification of Chinese character "in and " in / 中国针灸

In order to identify the differences between " in () and " in (), the edition of Ninna-ji, Japan, the author analyzed all " and "of the extant , its annotation books, its handed-down books and its collated books during the past dynasties. " and " are similar in Chinese character pattern. The authors had also analyzed the evolution factors of Chinese character patterns in detail, which induced the misunderstanding of " as ". Hence, the phonology and Chinese exegetics were adopted in analysis. " and "()" were completely same in ancient pronunciation. In compliance with the theory as seeking for the connotation from the pronunciation, " was explained as "()", meaning cleft needling or point needling. Additionally, the academic significance of " was explored. It was believed that it was the specific recognition stage from the vessel to the point regarding the sites of acupuncture and moxibustion in terms of the differences in needling techniques, i.e. vessel needling, muscle needling or tendon needling. It is concluded that " resulted from the misunderstanding of " in the books of different dynasties, hence, the mistakes in the explanation and annotation of " since the Northern Song Dynasty have been clarified.

Analysis of "sinking requires moxibustion" in / 中国针灸

"Sinking requires moxibustion", a sentence coming from : ), is one of the basic principles of moxibustion treatment. Sinking of vessel and sinking of are the two primary recognitions for the word "sinking" in ancient and modern. This paper organizes all related references comprehensively and illustrates the meaning of "sinking" in context with the expectancy of helping readers understand the classic original accurately.

A (in)formação científica e humanizada dos profissionais da área de saúde: a literatura nas humanidades médicas / The scientific and humanized information for training of health professionals: literature in the medical humanities / La (in)formación científica y humanizada de los profesionales de la salud: la literatura en las humanidades médicas

Literatura e medicina convivem harmoniosamente, sendo trivial afirmar que ler faz bem à saúde. Todavia, o diálogo entre literatura e ciência nem sempre é assumido em benefício mútuo. A literatura faz bem à medicina e mostra-se útil à (in)formação dos profissionais de saúde? Com o objetivo de refletir sobre este assunto, efetuou-se uma auscultação da literatura científica recente sobre essa temática. Como resultado, enumeraram-se os trabalhos considerados mais relevantes, com contributos concretos da literatura para a medicina e das humanidades para a educação em ciências médicas. Conclui-se que os profissionais de saúde valorizam a literatura na prática clínica e que a neurologia e a psiquiatria são as áreas que mais reconhecem o potencial literário. Reconhece-se uma tendência à inclusão das humanidades médicas nos currículos dos cursos das ciências da saúde. Assim, será benéfica a inclusão da literatura nas humanidades médicas e na formação dos profissionais de saúde.(AU)

Literature and medicine coexist harmoniously, being trivial to say that reading is good for health. However, the dialogue between literature and science is not always assumed for their mutual benefit. Is literature good for medicine and useful for training of health professionals? Aiming to reflect on this subject, a study of recent scientific literature on this subject was carried out. As a result, we have listed the works considered most relevant, with concrete contributions from the literature for the medicine and from the humanities for the education in medical sciences. We concluded that the health professionals value the literature in clinical practice and that the neurology and the psychiatry are the areas that most recognize the literary potential. A trend towards the inclusion of medical humanities in the curricula of health science courses is acknowledged. Thus, it will be beneficial to include literature in the medical humanities and in the training of health professionals.

La literatura y la medicina conviven armoniosamente, siendo trivial afirmar que leer hace bien a la salud. Sin embargo, el diálogo entre literatura y ciencia no siempre es asumido en beneficio mutuo. ¿La literatura hace bien a la medicina y se muestra útil a la (in)formación de los profesionales de salud? Con el objetivo de reflexionar sobre este asunto, ha se efectuado una auscultación de la literatura científica reciente sobre esta temática. Como resultado, se han enumerado los trabajos considerados más relevantes, con contribuciones concretas de la literatura para la medicina y de las humanidades para la educación en ciencias médicas. Se concluye que los profesionales de salud valoran la literatura en la práctica clínica y que la neurología y la psiquiatría son las áreas que más reconocen el potencial literario. Se reconoce una tendencia a la inclusión de las humanidades médicas en los currículos de los cursos de las ciencias de la salud. Así, será benéfica la inclusión de la literatura en las humanidades médicas y en la formación de los profesionales de la salud.

Estudio bibliométrico sobre la realidad virtual aplicada a la neurorrehabilitación y su influencia en la literatura científica / Bibliometric study about virtual reality applied to neurorehabilitation and its presence in scientific literature

Desde los años 90 la realidad virtual se ha aplicado en el ámbito de la salud para tratar fobias y trastornos mentales. Actualmente se utiliza para la neurorrehabilitación, ya que es capaz de engañar al cerebro y extrapolar al usuario a un mundo virtual. Dado el interés creciente por la temática, este trabajo tiene como objetivo analizar la producción científica en la Web of Science y Scopus sobre la realidad virtual aplicada a la neurorrehabilitación durante los últimos 10 años. Para esto, se ha empleado una metodología propia de los estudios bibliométricos a partir del establecimiento de una serie de palabras clave comprobadas en bases de datos y utilizadas por distintos autores en sus publicaciones. Se analizaron 8 variables siguiendo la línea de estudios previos: número total de documentos, producción por años, tipología de los archivos, títulos de las fuentes, instituciones, países, autores y artículos más citados. Entre los resultados se destaca el creciente interés de la temática a partir del año 2013 y el auge de la producción en el año 2016, así como la implicación de las principales potencias mundiales en la investigación y publicación sobre la realidad virtual para la rehabilitación. El análisis de los metadatos muestra un panorama incipiente en las publicaciones sobre la realidad virtual en el ámbito de la salud, donde Estados Unidos se destaca como el país con mayor producción científica(AU)

Ever since the 1990s virtual reality has been applied in healthcare to treat phobias and mental disorders, and is currently used for neurorehabilitation, as it is able to deceive the brain and extrapolate the user to a virtual world. Given the growing interest in the topic, this study aims to analyze the high-impact scientific production about virtual reality applied to neurorehabilitation included in the Web of Science and Scopus in the last 10 years. To achieve this end, a bibliometric methodology was used based on a number of keywords checked in databases and used by different authors in their publications. Eight variables were analyzed, in line with previous studies: total number of documents, production per year, document type, source title, affiliation, countries, authors and most cited articles. Among the results is the growing interest in the topic as of the year 2013 and the boom in production in 2016, as well as the involvement of the main world powers in research and publication about the use of virtual reality for rehabilitation. Finally, analysis of the metadata shows an incipient panorama in publications about virtual reality in healthcare, with the United States as the country with the greatest scientific production(AU)

A importância da perspectiva histórica para o pensamento social em saúde: a contribuição de Madel Luz e Emerson Merhy / The importance of the historical perspective for social thinking in health: the contributions of Madel Luz and Emerson Merhy

Resumo O artigo examina a obra de dois autores representativos da produção acadêmica de saúde coletiva nos anos 1970-1980: Madel Luz e Emerson Merhy. Sua produção teórica se apoiou em estudos marxistas e em Michel Foucault, dando centralidade à história. Procurou-se analisar esse aspecto, que nesses trabalhos se tornou importante para o campo da saúde coletiva, pois os autores romperam com o pensamento anterior, positivista e evolucionista, sobre saúde. Concluiu-se que, embora os autores reiterem ideias e abordagens metodológicas dos seus antecessores, eles são parte do grupo que inaugurou uma historiografia crítica no campo da saúde. O estudo de obras como essas contribui para a compreensão da relevância da historicidade na relação entre saúde coletiva, política, saber e prática.

Abstract This article examines the work of two authors who represent academic production on collective health from 1970 to 1980: Madel Luz and Emerson Merhy. Their theoretical production was based on Marxist studies and Michel Foucault, and centered on history. The object of this analysis was this particular aspect, which became important to the field of collective health, since the authors broke with previous positivist and evolutionist thinking on health. Although Luz and Merhy reiterated the ideas and methodological approaches of their predecessors, they were part of the group that launched a critical historiography in the field of health. Studying works like these builds understanding on the relevance of historicity in the relationship between collective health, politics, learning, and practice.

The history of basilar artery occlusion: when art aids science / História da oclusão da artéria basilar: quando a arte auxilia a ciência

ABSTRACT Basilar artery occlusion (BAO) ischemic stroke is a relatively rare condition with high morbidity and mortality rates. To date, the best acute reperfusion therapy for BAO has still not been established, mainly due to the lack of randomized controlled trials in this field. In this article, we review the history of BAO diagnosis and treatment, and the impact of modern technological resources on the clinical evolution and prognosis of BAO over time. Furthermore, we describe historical events and nonmedical literature descriptions related to BAO. We conclude that BAO is a singular example of how art may help medical sciences with accurate descriptions of medical conditions.

RESUMO O acidente vascular cerebral isquêmico secundário à oclusão aguda da basilar (OAB) é uma condição relativamente rara, que cursa com elevada morbimortalidade. Até o momento atual, a melhor estratégia de recanalização arterial na fase aguda da OAB não está definida, principalmente pela carência de ensaios clínicos randomizados e controlados neste contexto. Neste artigo, revisamos aspectos históricos do diagnóstico e do tratamento desta condição, assim como o impacto do avanço tecnológico na evolução clínica e prognóstico desta condição. Ademais, descrevemos fatos históricos e a literatura fictícia relacionados à OAB. Concluímos que a OAB é um exemplo peculiar de como a arte pode auxiliar a medicina na descrição acurada de condições médicas.