Experimental Sciences in Surgery : Harvey Cushing's Work at the Turn of the Twentieth Century / 의사학

No Abstract Available.

Un enfoque epistemológico en la esfigmomanometría / Epistemological focus on sphygmomanometry

In the XVIII century, the English naturalist Stephen Hales started to apply blood sphygmomanometry in animals. Direct recording of the blood pressure was first applied, in the XIX century, by AE Chauveau and JLM Poiseuille. However, it was not until 1856 that it was possible to perform a direct determination of blood pressure in humans by means of a device designed by Faivre. The first sphygmomanometer appeared at the end of the XIX century. The physician Samuel K. von Basch, native of Prague and who lived a few years in Mexico, fabricated successively three models of sphygmomanometers. The first (1881), with a mercury column, proved to be the most practical and useful. This instrument inspired the sphygmomanometer of the Italian physician Scipione Riva-Rocci who presented it in 1896. His sphygmomanometer, supported on the Vierordt principle, could measure manometrically the force needed to stop the pulse wave. Thanks to the research of Russian physician N. Korotkoff, the auscultatory method was added to sphygmomanometry. During the XX century other instruments to measure blood pressure were fabricated: the Pachon's and Plesch's oscillometers, as well as the aneroid manometer. On the other side, the use of direct tensional recordings has subsisted which has allowed to document the wide oscillations of arterial pressure levels during the day. Anyway, the sphygmomanometer with a mercury column has persisted until the present and will still be used for a long time. A new evolving methodology is the continuous ambulatory sphygmomanometry.

O impacto das descobertas de Riva-Rocci e Korotkoff / The impact of Riva-Rocci's and Korokoff's findings

A medida da pressäo arterial é o recurso mais utilizado para o diagnóstico e o tratamento da hipertensäo arterial. Scipione Riva-Rocci é o responsável pelo marco, na era moderna, da medida da pressäo arterial. Em 1896, Riva-Rocci idealizou o esfigmomanômetro de coluna de mercúrio, que difere do utilizado em nossos dias apenas pelo manguito, que possuía 4,4 cm de largura. Em 1905, Nicolai Sergievic Korotkoff sugeriu a possibilidade de auscultar os sons com a utilizaçäo do estetoscópio, identificando as pressões sistólica e diastólica e determinando o método indireto com técnica auscultatória usado nos dias atuais. Em 1970, surgiram os primeiros aparelhos, automáticos ou semi-automáticos, de medida da pressäo arterial. Entretanto, eles só podem ser utilizados se forem precisos e devidamente aprovados de acordo com a legislaçäo internacional. A medida indireta da pressäo arterial com técnica auscultatória pode apresentar erros ligados ao observador, ao paciente, ao equipamento e à técnica, apesar de ser um procedimento simples e fácil de ser realizado. Portanto, os profissionais da área da saúde que medem a pressäo arterial devem ter conhecimento adequado para evitar possíveis erros