ABSTRACT
Memory and its care were significant sociocultural and scientific topics in early modern Spain. While a major interest in memory was related to its rhetorical implications, medical treatises discussing memory, cognitive impairment, and its treatment began to appear in the 16th- and 17th-century. Among these treatises, Disputationes phylosophicæ ac medicæ super libros Aristotelis de memoria, et reminiscentia (Philosophical and medical arguments on Aristotle's "De memoria et reminiscentia"), published in 1629 by the physician Juan Gutiérrez de Godoy, is unique in that it is entirely devoted to the medical aspects of memory. While many of its concepts are now superseded, the treatise is valuable to understand the views on memory and cognitive impairment in 17th-century Spain and their sources, as Gutiérrez quoted many classical, medieval, and contemporary scholars and physicians. The book, written in Latin, is exclusively devoted to memory from a physiological and medical point of view, with chapters on the classification of memory loss, a description of its causes (including old age, something not widely recognized before), and several chapters on its prevention and treatment, with a fascinating emphasis on confectio anacardina, or anacardium, an intranasal concoction made with the "marking nut", the fruit of the Semecarpus anacardium tree (also known as Malacca bean), with alleged memory-enhancing properties. We review Gutiérrez's Disputationes phylosophicæ, putting it into the wider intellectual and social context in the Europe of its time, and discuss the relevance and purported neuropharmacological effects of anacardina.
Subject(s)
Breast Feeding , Religion , Breast Feeding/ethnology , Breast Feeding/psychology , Family , Female , History, 16th Century , History, 17th Century , History, 18th Century , HumansABSTRACT
INTRODUCCIÓN: La neoplasia intraepitelial anal de alto grado (NIAAG) está en aumento en determinados grupos de riesgo y en su etiopatogenia están implicados algunos genotipos del virus del papiloma humano (VPH). El cribado de la NIAAG contempla el uso sistemático de la citología anal y más recientemente el genotipado de VPH. Nuestro objetivo fue determinar la sensibilidad y especificidad de ambas herramientas diagnósticas en la identificación de NIAAG. MATERIAL Y MÉTODO: Estudio de correlación entre los hallazgos citológicos y microbiológicos con respecto a la biopsia anal de una cohorte de pacientes con conductas de riesgo de desarrollar neoplasia intraepitelial anal atendidos en la consulta de infecciones de transmisión sexual del área de Dermatología del Hospital Costa del Sol desde enero de 2008 a diciembre de 2014. RESULTADOS: De los 151 pacientes sometidos al cribado, se seleccionaron aquellos pacientes con las tres pruebas de cribado realizadas (citología anal, genotipado y biopsia guiada por anoscopia), 92 en total, de los que el 62% presentaban infección por VIH. La sensibilidad y especificidad para identificar NIAAG fue 52,8 y 85,7% para la citología anal (k: 0,328), y 78 y 62,8% de la presencia de dos o más genotipos oncogénicos VPH (k: 0,417). La detección de VPH oncogénicos permitió clasificar correctamente 23 casos de NIAAG confirmados por biopsia guiada por anoscopia e infradiagnosticados con la citología anal, 14 de ellos con al menos 3 genotipos de riesgo. CONCLUSIÓN: La citología anal ha mostrado una sensibilidad insuficiente para la detección de NIAAG. El genotipado del VPH, aunque como única herramienta de cribado daría lugar a un sobrediagnóstico, es una herramienta que puede complementar el procedimiento de cribado, especialmente con el objetivo de identificar los casos de NIAAG
INTRODUCTION: The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. MATERIALS AND METHODS: This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. RESULTS: Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. CONCLUSION: Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure
Subject(s)
Humans , Anus Neoplasms/diagnosis , Papillomaviridae/pathogenicity , Genotyping Techniques/methods , Cytological Techniques/methods , Carcinoma in Situ/diagnosis , Sensitivity and Specificity , Biopsy/methods , Risk Factors , Mass Screening/methodsABSTRACT
INTRODUCTION: The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN. MATERIALS AND METHODS: This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014. RESULTS: Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes. CONCLUSION: Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure.
Subject(s)
Anus Neoplasms/diagnosis , Anus Neoplasms/virology , Carcinoma in Situ/diagnosis , Carcinoma in Situ/virology , Papillomaviridae/genetics , Papillomavirus Infections/diagnosis , Adult , Anus Neoplasms/pathology , Carcinoma in Situ/pathology , Cross-Sectional Studies , Female , Genotype , Genotyping Techniques , Humans , Male , Sensitivity and Specificity , SpainABSTRACT
Don Quixote de la Mancha, which is considered one of the most important and influential works of Western modern prose, contains many references of interest for almost all of the medical specialties. In this regard, numerous references to neurology can be found in Cervantes' immortal work. In this study, we aimed to read Don Quixote from a neurologist's point of view, describing the neurological phenomena scattered throughout the novel, including tremors, sleep disturbances, neuropsychiatric symptoms, dementia, epilepsy, paralysis, stroke, syncope, traumatic head injury, and headache; we relate these symptoms with depictions of those conditions in the medical literature of the time. We also review Cervantes' sources of neurological information, including the works by renowned Spanish authors such as Juan Huarte de San Juan, Dionisio Daza Chacón and Juan Valverde de Amusco, and we hypothesize that Don Quixote's disorder was actually a neurological condition. Although Cervantes wrote it four centuries ago, Don Quixote contains plenty of references to neurology, and many of the ideas and concepts reflected in it are still of interest.
