ABSTRACT
Este trabajo tiene como principal objetivo rescatar del olvido la historia de las transfusiones de sangre cadavérica y la figura de su principal artífice, Sergei Yudin. Para ello, se lleva a cabo una revisión sistemática de fuentes bibliográficas en diferentes idiomas para describir su trayectoria vital y su obra científica. La idea partió de las experiencias transfusionales en perros de Vladimir Shamov y fue desarrollada clínicamente a partir de 1930 por Yudin en el Instituto Sklifosovsky de Medicina de Emergencia de Moscú, donde se realizaron transfusiones de sangre cadavérica humana de manera regular durante cuatro décadas. La conservación de esta sangre durante varias semanas permitió la creación del primer banco de sangre en el mundo y fue el punto de partida de los trasplantes clínicos, considerando que la sangre es un tejido especial. A finales de los años veinte y principios de los treinta, Yudin viajó a Alemania, Francia, España e Inglaterra y gozó de gran prestigio entre los círculos médicos internacionales, incluidos los catalanes y españoles. El curso de su vida fue azaroso, pasando de ser el cirujano más prestigioso de la Unión Soviética al ostracismo tras ser encarcelado en 1948 y posteriormente desterrado a Siberia.
This work aims to rescue from oblivion the history of cadaveric blood transfusions and the figure of its main protagonist, Sergei Yudin. For this reason, an extensive review of bibliographic sources in Russian and other languages is carried out to describe Yudins life trajectory and his scientific work. The idea originated from Vladimir Shamovs transfusion experiences in dogs and started clinically in 1930 by Yudin at the Sklifosovsky Institute of Emergency Medicine in Moscow, where human cadaveric blood transfusions were performed on a regular basis for four decades. The conservation of this blood for several weeks allowed the creation of the first blood bank in the world and was the starting point of clinical transplants, considering that blood is a special tissue. In the late 1920s and early 1930s, Yudin traveled to Germany, France, Spain and England and enjoyed great prestige in international medical circles, including Catalan and Spanish. The course of his life was arduous, going from being the most prestigious surgeon in the Soviet Union to ostracism after being imprisoned in 1948 and later exiled to Siberia.
Subject(s)
History, 20th Century , Health Sciences , Blood Transfusion , Transfusion Medicine , Cadaver , History, 20th CenturyABSTRACT
OBJECTIVE: To determine the causative agents of infections and their antimicrobial susceptibility at a tertiary care hospital in Moshi, Tanzania, to guide optimal treatment. METHODS: A total of 590 specimens (stool (56), sputum (122), blood (126) and wound swabs (286)) were collected from 575 patients admitted in the medical and surgical departments. The bacterial species were determined by conventional methods, and disc diffusion was used to determine the antimicrobial susceptibility pattern of the bacterial isolates. RESULTS: A total of 249 (42.2%) specimens were culture-positive yielding a total of 377 isolates. A wide range of bacteria was isolated, the most predominant being Gram-negative bacteria: Proteus spp. (n = 48, 12.7%), Escherichia coli (n = 44, 11.7%), Pseudomonas spp. (n = 40, 10.6%) and Klebsiella spp (n = 38, 10.1%). Wound infections were characterised by multiple isolates (n = 293, 77.7%), with the most frequent being Proteus spp. (n = 44, 15%), Pseudomonas (n = 37, 12.6%), Staphylococcus (n = 29, 9.9%) and Klebsiella spp. (n = 28, 9.6%). All Staphylococcus aureus tested were resistant to penicillin (n = 22, 100%) and susceptible to vancomycin. Significant resistance to cephalosporins such as cefazolin (n = 62, 72.9%), ceftriaxone (n = 44, 51.8%) and ceftazidime (n = 40, 37.4%) was observed in Gram-negative bacteria, as well as resistance to cefoxitin (n = 6, 27.3%) in S. aureus. CONCLUSION: The study has revealed a wide range of causative agents, with an alarming rate of resistance to the commonly used antimicrobial agents. Furthermore, the bacterial spectrum differs from those often observed in high-income countries. This highlights the imperative of regular generation of data on aetiological agents and their antimicrobial susceptibility patterns especially in infectious disease endemic settings. The key steps would be to ensure the diagnostic capacity at a sufficient number of sites and implement structures to routinely exchange, compare, analyse and report data. Sentinel sites (hospitals) across the country (and region) should report on a representative subset of bacterial species and their susceptibility to drugs at least annually. A central organising body should collate the data and report to relevant national and international stakeholders.
