The Declaration of Sydney on human death.

On 5 August 1968, publication of the Harvard Committee's report on the subject of "irreversible coma" established a standard for diagnosing death on neurological grounds. On the same day, the 22nd World Medical Assembly met in Sydney, Australia, and announced the Declaration of Sydney, a pronouncement on death, which is less often quoted because it was overshadowed by the impact of the Harvard Report. To put those events into present-day perspective, the authors reviewed all papers published on this subject and the World Medical Association web page and documents, and corresponded with Dr A G Romualdez, the son of Dr A Z Romualdez. There was vast neurological expertise among some of the Harvard Committee members, leading to a comprehensible and practical clinical description of the brain death syndrome and the way to diagnose it. This landmark account had a global medical and social impact on the issue of human death, which simultaneously lessened reception of the Declaration of Sydney. Nonetheless, the Declaration of Sydney faced the main conceptual and philosophical issues on human death in a bold and forthright manner. This statement differentiated the meaning of death at the cellular and tissue levels from the death of the person. This was a pioneering view on the discussion of human death, published as early as in 1968, that should be recognised by current and future generations.

[Juxtapapillary diverticuli and biliary lithiasis]. / Divertículo paravateriano y litiasis biliar.

Duodenal diverticuli has been associated with biliary stones, specially in the common bile duct. Its presence alters the anatomy of the region of the papilla difficulting its identification and cannulation. ERCP was performed in 800 patients with suspicion of bilio-pancreatic disease, 60 (7.5%) of these patients (39 male and 21 female) had juxtapapillary diverticuli (single diverticuli in 52, 2 in 7 and 3 in 1 patient). In these patient cannulation of the common bile duct was possible in 43 (72%), only the pancreatic duct in 5 (8%) and no cannulation in 12 (20%). Common bile duct stones were found in 22 patients, papillotomy was indicated in 14 patients and was performed in 12, in 2 patients it was not possible to position the papillotomy.

[Variations in pulse rate and arterial pressure during hyperbaric oxygenation]. / Variaciones medias de la frecuencia del pulso y la tension arterial durante la sesion de oxigenacion hiperbarica (OHB).

Forty-five patients receiving at least 5 sessions of hyperbaric oxygenation treatment were studied. Mean values of pulse rate were calculated during the different regimes of the session, as well as mean values of blood pressure before and after each treatment in order to assess the influence of hyperbaric oxygenation upon these parameters. With the hyperbaric oxygenation dosages employed in the group of patients studied, the variations of these parameters are not statistically significant. However, the behavior observed corresponds directly with the pressures used.

[Work of nurses in hyperbaric oxygenation]. / Labor de enfermeria en el tratamiento con oxigenacion hiperbarica (OHB).

The work of nursing personnel with patients receiving treatment with hyperbaric oxygenation is intended mainly to prepare the patients and provide care and psychological support. Hyperbaric oxygenation as a therapeutic method was included in Cuba's Health System in 1986. Hyperbaric oxygenation is applied in different diseases, both alone and as supportive treatment for clinical or surgical therapy and it is based on the significant increased oxygen dissolved in the plasma when gas pressure is increased to a proper dosage using hyperbaric chambers. Nursing personnel plays a very important role in providing care to patients and the team is in charge of the security measures and techniques. Hyperbaric oxygenation has proved to be effective for the treatment of anaerobic sepsis, intoxication due to carbon monoxide, peritonitis, gastroduodenal ulcers, liver diseases, osteomyelitis, as a support for grafting and transplants and other diseases.