Prospective external validation of IOTA methods for classifying adnexal masses and retrospective assessment of two-step strategy using benign descriptors and ADNEX: a Portuguese multicenter study.

OBJECTIVE: This study aimed to externally and prospectively validate the International Ovarian Tumor Analysis (IOTA) Simple Rules (SRs), Logistic Regression model 2 (LR2) and Assessment of Different NEoplasias in the adneXa (ADNEX) in a Portuguese population, comparing them with operator subjective assessment (SA), Risk-of-Malignancy Index (RMI), as well as with each other. This study also aimed to retrospectively validate IOTA two-step strategy, using modified benign descriptors (MBDs) followed by the application of ADNEX in cases where MBDs were not applicable (MBDs + ADNEX). METHODS: In this multicenter diagnostic accuracy study, conducted between January 2016 and December 2021, three tertiary referral centers prospectively included consecutive patients with ultrasound diagnosis of at least one adnexal tumor who underwent surgery. All ultrasound assessments were performed by level II or III sonologists with IOTA certification. Patient clinical data and serum cancer antigen (CA125) levels were collected from the hospital databases. Each adnexal mass was classified as benign or malignant using SA, RMI, IOTA SRs, LR2 and ADNEX (with and without CA125). The reference standard was histopathological diagnosis. In the second phase, all adnexal tumors were retrospectively classified using the two-step strategy (MBDs + ADNEX). The sensitivity, specificity, positive (PPV) and negative predictive value (NPV), positive (LR+) and negative likelihood ratio (LR-) as well as overall accuracy were determined for SA, RMI, IOTA SRs, LR2, ADNEX and two-step strategy (MBDs + ADNEX). Receiver-operator characteristic curves were constructed and corresponding areas under the curve (AUC) determined for RMI, LR2 and ADNEX and two-step strategy (MBDs + ADNEX). The ADNEX calibration plots were constructed and estimated by LOESS smoother. RESULTS: Of the 571 included patients, 428 had benign disease, 42 borderline ovarian tumors, 93 primary invasive adnexal cancers and 8 metastatic tumors in adnexa (malignancy prevalence: 25.0%). The operator SA had an overall sensitivity of 97.9% and a specificity of 83.6% for distinguishing between benign and malignant lesions. RMI showed high specificity (95.6%) but very low sensitivity (58.7%), with an AUC of 0.913. The IOTA SRs were applicable in 80.0% of patients, with a sensitivity of 94.8% and a specificity of 98.6%. LR2 revealed a sensitivity of 84.6%, a specificity of 86.9% and an AUC of 0.939, at the malignancy risk cut-off of 10%. At the same cut-off, ADNEX with and without CA125 had a sensitivity of 95.8% and 98.6%, respectively, and a specificity of 82.5% and 79.7%, respectively. The AUC of ADNEX with vs. without CA125 was 0.962 vs. 0.960. The ADNEX model provided heterogeneous results in distinguishing between benign and different subtypes of malignancy, with the highest AUC (0.991) for discriminating benign masses from primary adnexal cancer stage II-IV, and the lowest AUC (0.696) for distinguishing primary adnexal cancer stage I and metastatic lesion in adnexa. The ADNEX calibration plots suggested an underestimation of the predicted risk in relation with the observed proportion of malignancies. The MBDs were applicable in 26.3% of cases (150/571 tumors, none of which were malignant). Similar to the ADNEX model applied in all patients, the two-step strategy using ADNEX in the second step only, with and without CA125, had an AUC of 0.964 and 0.961, respectively. CONCLUSIONS: Our results showed a good to excellent performance of the IOTA methods in the studied Portuguese population, outperforming RMI. ADNEX was superior in accuracy, but interpretation of its ability to distinguish malignant subtypes was fundamentally limited not only by sample size but also by large differences in the prevalence of tumor subtypes. The IOTA MBDs have been shown to be reliable in identifying benign disease. The two-step strategy based on the application of MBDs, followed by the ADNEX model if MBDs are not applicable, has proven to be suitable for daily practice circumventing the need to use electronic support in all patients. This article is protected by copyright. All rights reserved.

Validation of NoSAS (Neck, Obesity, Snoring, Age, Sex) score as a screening tool for obstructive sleep apnea: Analysis in a sleep clinic.

INTRODUCTION: Screening methods have become increasingly important due to the growing number of patients suspected of having obstructive sleep apnea (OSA) being referred to sleep clinics. The Lausanne NoSAS (Neck circumference, Obesity, Snoring, Age, Sex) score test is a simple, efficient, and easily employed tool enabling identification of individuals at risk for the disease. The score ranges from 0 to 17 and the patient has a high probability of OSA if they have a NoSAS score of 8 or higher. OBJECTIVES: To evaluate the performance of the NoSAS score as a screening tool for the diagnosis of OSA in a sleep clinic. METHODS: Prospectively, for 12 months, we included all the patients referred by primary care physicians to our sleep unit for clinical evaluation who had undergone in-lab polysomnography (PSG) and completed the NoSAS score. This test assigns 4 points for a neck circumference of more than 40cm, 3 points for a body-mass index of 25kg/m2 to less than 30kg/m2 or 5 points for having a body-mass index of 30kg/m2 or more, 2 points for snoring, 4 points for being older than 55 years of age and 2 points for being male. RESULTS: Of the 294 patients, 70.7% were male, aged 53.5±12.1 years, with a neck circumference of 41.0±3.6cm and a BMI of 30.8±5.1kg/m2. OSA was present in 84.0% of the patients, 34.8% with moderate OSA and 36.4% severe OSA. Using the NoSAS model for the prediction of all OSA, moderate/severe OSA and severe OSA, the area under the ROC (Receiver Operating Characteristic) was 0.770 (IC95%: (0.703; 0.837), p<0.001), 0.746 (IC95%: (0.691; 0.802), p<0.001) and 0.686 (IC95%: (0.622; 0.749), p<0.001), respectively, thus confirming the diagnostic ability of the NoSAS model. With a NoSAS score ≥7, the sensitivity and positive predictive value (PPV) were 94.3% and 87.6% for all OSA, 94.9% and 62.8% for moderate/severe OSA and 100% and 33.8% for severe OSA, respectively. With the same cut-off, the negative predictive value (NPV) for moderate/severe and severe OSA were 67.9% and 100%, respectively. Each increase in the NoSAS score was associated with an increase in the probability of OSA, reaching a 97% OSA probability for a score of 17. CONCLUSIONS: The NoSAS score showed high sensitivity and PPV for OSA with specificity and diagnostic accuracy steadily increasing with higher scores. Furthermore, a low score showed high predictive value for the exclusion of moderate/severe OSA. Overall, our results suggest that, in primary care, this score can be a powerful tool for stratifying and prioritizing patients in the diagnosis of OSA. Nevertheless, more studies are needed to evaluate the efficacy of this score in hospital health care, in younger populations, with a predominance of female and non-obese individuals or in cardiovascular disease.

Prevalence of asthma, allergic rhinitis and eczema in 6-7-year-old schoolchildren from Luanda, Angola.

BACKGROUND: Epidemiological data have shown that the prevalence of asthma, rhinoconjunctivitis and eczema in children is still increasing, namely in Africa. However, there are no epidemiological studies on asthma or allergic diseases in Angolan children. OBJECTIVE: To study the prevalence of asthma and other allergic diseases in Angolan children. METHODS: Descriptive, observational, cross-sectional study, using the ISAAC study methodology, in the province of Luanda, Angola in 6-7-year-old children. Forty-six (8.3%) public schools were randomly selected. Data were analysed using the SPSS Statistics version 24.0 software. RESULTS: A total of 3080 children were studied. Results showed that the prevalence of asthma (wheezing in the previous 12 months) was 15.8%, that of rhinitis (sneezing, runny or blocked nose in the previous 12 months) was 19%, and that of eczema (itchy skin lesions in the previous 12 months) was 22%, without differences between sexes. Rhinitis was associated with a higher number of episodes of wheezing episodes, disturbed sleep and night cough, in children with asthma. Rhinitis, eczema, Split-type air conditioning system, antibiotic intake in the child's first year of life, frequent intake (more than once per month) of paracetamol and active maternal smoking were associated with a higher risk of having asthma, whereas electrical cooking was associated with a protective effect. CONCLUSION: Asthma and allergic diseases are highly prevalent in children from Luanda. A strategy for preventive and control measures should be implemented.

The Bronchiectasis Severity Index and FACED score for assessment of the severity of bronchiectasis.

INTRODUCTION: Bronchiectasis (BC) is a multidimensional and etiologically diverse disease and, therefore, no single parameter can be used to determine its overall severity and prognosis. In this regard, two different validated scores are currently used to assess the severity of non-cystic fibrosis bronchiectasis (NCFB): the FACED score and the Bronchiectasis Severity Index (BSI). OBJECTIVE: To describe the etiology of NCFB and compare the results of the assessment of NCFB severity obtained via FACED and BSI scores. METHODS: Retrospective study of demographic and clinical data of a convenience sample of NCFB patients attending the Functional Breathing Re-adaptation appointment at the Pneumology B Unit, University Hospital Center of Coimbra. All patients underwent evaluation of the variables incorporated in the FACED score (FEV1% predicted, age, chronic colonization by Pseudomonas aeruginosa, radiological extent of the disease, and dyspnea) and in the BSI (age, body mass index, FEV1% predicted, hospitalization and exacerbations before study, dyspnea, chronic colonization by P. aeruginosa and other microrganisms, and radiological extent of the disease). Statistical analysis of the data was performed using Microsoft Excel® and IBM SPSS® v23. RESULTS: The sample included 40 patients, 22 females and 18 males, aged 39-87 years. Regarding the etiology of NCFB, we found: idiopathic (60%), post-infectious (20%), sequelae of pulmonary tuberculosis (12.5%) and primary immunodeficiency related (7.5%). According to the FACED score we found 20 patients (50%) with mild BC, 15 patients (37.5%) with moderate and 5 patients (12.5%) with severe BC. The frequency of patients with low, intermediate and high BSI was 13 (32.5%), 13 (32.5%) and 14 (35%), respectively in relation to derived BSI, Moreover, we observed a weak but statistically significant association between FACED and BSI scores: Fisher's exact test (p=0.004), tau-b de Kendall (0.469; p=0.001). The Kappa test (0.330; p=0.002) also shows us that there is 55% agreement between the two scales. CONCLUSION: There is a small but significant correlation between the two scales: a tendency is observed for patients to be classified with a higher BSI compared to the FACED score. This can be explained by the fact that BSI (and not FACED) evaluates parameters including BMI, hospitalization and exacerbations before study, chronic colonization by other microorganisms and development of cystic bronchiectasis. Further studies should address how these scores may impact clinical practice.

Recommendations for the prevention and diagnosis of asthma in children: Evidence from international guidelines adapted for Mexico.

BACKGROUND: With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS: The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. RESULTS: The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6-11 years and ≥12 years. CONCLUSIONS: For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.

Social behaviour involving drug resistance: the role of initial density, initial frequency and population structure in shaping the effect of antibiotic resistance as a public good.

Bacteria sometimes cooperate with co-inhabiting cells. Pathogenic bacteria, for example, often produce and excrete virulence factors, eventually benefitting both producer and non-producer cells. The role of social interactions involving antibiotic resistance, however, has been more elusive. Enzymes that inactivate ß-lactam antibiotics such as ampicillin or penicillin (ß-lactamases) are good candidates as public goods. Nonetheless, it has been claimed that bacteria harbouring plasmids of natural origin coding for ß-lactamase almost do not protect sensitive bacteria. This does not fit with the fact that ampicillin-sensitive bacteria can be isolated from subjects undergoing ampicillin treatment. We hypothesised that there are two non-exclusive explanations for the discrepancy between previous works: (1) the range of values of demographic conditions (such as initial strain frequency, initial total cell density or habitat structure) has not been broad enough to include most scenarios, or (2) there are interactions between some of these factors. We performed experiments with Escherichia coli bacterial cells to measure the degree of protection of sensitive cells when co-cultured with cells harbouring RP4, R16a or the R1 plasmids, all of natural origin and coding for ß-lactamases, and in presence of ampicillin. In these co-cultures, performed in structured and non-structured environments, both the initial total cell density and the initial frequency of sensitive cells spanned four orders of magnitude. We found protection of sensitive cells in 63% of tested conditions. All factors (plasmid, structure, frequency and density) significantly affect levels of protection. Moreover, all factors interact, with interactions revealing large or very large effect sizes.

Prevalence of asthma and allergies in 13-14-year-old adolescents from Luanda, Angola.

SETTING: The few epidemiological studies on asthma and allergic diseases performed in Africa have shown that the prevalence of these diseases is high or increasing. No such studies have been performed in Angola. OBJECTIVE: To determine the prevalence of asthma and other allergic diseases in Angolan adolescents. DESIGN: This was a descriptive, observational, cross-sectional study in the province of Luanda, Angola, using the International Study of Asthma and Allergies in Childhood study methodology in adolescents aged 13 and 14 years. Twenty-three (12%) public schools were randomly selected. Data were analysed using the Statistical Package for the Social Sciences version 22.0 software. RESULTS: A total of 3128 adolescents were included. The prevalence of asthma (wheezing in the previous 12 months) was 13.4%. The prevalence of rhinitis (sneezing, runny or blocked nose in the previous 12 months) was 27% and that of eczema (itchy skin lesions in the previous 12 months) was 20%; both were more prevalent in girls. Rhinitis was associated with a greater number of episodes of night cough in adolescents with asthma. Rhinitis and eczema, a split-type air conditioning system, and frequent intake (more than once per month) of paracetamol were associated with a higher risk of having asthma. CONCLUSION: Asthma and related allergic diseases are a public health problem in adolescents from Luanda. Preventive and control measures should be implemented.

Tomographic follow-up of bone regeneration after bone block harvesting from the mandibular ramus.

Autogenous bone is still considered the gold standard, and the applicability of autogenous bone grafts is well established. However, the possibility of second harvesting from the same donor region remains unclear. The aim of this study was to perform a prospective evaluation of hard tissue deposition in the mandibular ramus after bone block harvesting using cone beam computed tomography (CBCT). Twenty-two patients with indications for augmentation procedures using autogenous bone from the mandibular ramus were selected. Three CBCT scans were performed with a tomographic guide before bone harvesting (T1) and at 14 days (T2) and 6 months (T3) after the surgical procedures. Measurements were obtained in 2D (area, mm(2)) and 3D (volume, mm(3)), and were subsequently compared. In the 2D analysis, the mean bone formation rate was 56%, while for the 3D analysis the mean rate was 9.7%. Despite this difference, there was a significant correlation between area and volume measurements. Our findings demonstrated the presence of hard tissue in the mandibular ramus at 6 months after bone harvesting, which suggests that it would be possible to reuse the same region for a second block harvesting. However, the second bone harvesting would involve less bone for transplantation when compared to the first bone harvesting.

Memória da água / Memory of water

O autor discute um tema polêmico, a memória da água, trazendo novas interpretações ao tema.

Memória da água / Memory of water

O autor discute um tema polêmico, a memória da água, trazendo novas interpretações ao tema.(AU)

Qualidade fisiológica e sanitária de sementes de erva-doce (Foeniculum vulgare Mill. ) armazenadas / Physiological and sanitary quality of fennel seeds stored

A incidência de fungos em sementes interfere negativamente o seu potencial fisiológico, podendo ter início no campo, durante o armazenamento ou na pós-colheita. Desta forma o objetivo deste trabalho foi avaliar a qualidade fisiológica e sanitária de sementes de erva-doce armazenadas em diferentes embalagens. O trabalho foi realizado no Laboratório de análise de sementes da UFPB, em Areia-PB. As sementes foram colhidas em plantas tratadas e não tratadas com inseticida Actara, beneficiadas e acondicionadas nas embalagens papel alumínio, saco plástico e vidro. Em seguida, armazenadas em câmara fria durante 315 dias. Inicialmente e a cada 45 dias foram realizados as seguintes determinações e testes: teor de água, emergência de plântulas, primeira contagem de emergência, índice de velocidade de emergência, comprimento e massa seca das plântulas e sanidade das sementes pelo método "blotter-test". Utilizou-se o delineamento inteiramente casualizado, com quatro repetições, os tratamentos foram distribuídos em fatorial 2 x 3 x 8 (com e sem inseticida, 3 embalagens e 8 períodos de avaliação). Os resultados indicam que a qualidade fisiológica das sementes de erva-doce foi principalmente afetada pelo fungo Alternaria sp., ocorrendo a manutenção da viabilidade das sementes por aproximadamente 95 dias na embalagem de saco plástico; a aplicação do inseticida Actara mantém a qualidade fisiológica das sementes de Foeniculum vulgare no armazenamento.

The fungi incidence in seeds affect negatively their physiological potential may begin in the field, during storage or in post-harvest. The objective was to evaluate the sanitary quality of fennel seeds stored in packagings differents. The study was conducted in laboratory analysis of seeds of UFPB, in Areia-PB. Seeds were harvested in experimental field with plants treated and untreated with insecticide Actara, processed and packed in aluminum foil, plastic bag and glass and stored in cold chamber during 315 days. Initially and every 45 days were performed the following tests and determinations: water content, seedling emergence, first count of emergency, emergency speed index, length and seedling dry mass and seed health by the "blotter-test." We used a completely randomized design with four replications, the treatments were distributed in a factorial 2 x 3 x 8. The results indicated that the physiological quality of fennel seeds was negatively affected by the fungus Alternaria sp., occurring at maintaining the viability of seeds for about 95 days in the plastic bag packaging; the application of the insecticide Actara keeps the physiological quality of seeds of Foeniculum vulgare in storage.

Memória da água / Water of memory

O tema Memória da Água sempre merece considerações para debate. O autor levanta a problemática sobre ciência e sua relação com outros setores como jornalismo, magia etc.

Analysis of colored teeth from Precolumbian Tlatelolco: postmortem transformation or intravitam processes?

The etiological basis of the abnormal coloration of archaeological teeth has been an unsolved question for a long time. Differences in the appearance of some archaeological teeth from Precolumbian adult and infant skeletons, detected by external optical inspection, led us to study this problem. A blue stain is visible in a few of the deciduous erupted teeth, and a brown color in various unerupted teeth in the collection, while brown spots appear on some permanent teeth. Several processes or factors that may occur during one's life, others around the time of death, and still others resulting from postmortem alterations have been reported as potential causes of abnormal tooth coloration.A sample of 35 colored teeth and two soil layers taken from Tlatelolco were analyzed by particle-induced X-ray emission (PIXE) as well as selective dissolution techniques. Concentrations of total and extractable elements in enamel and soil layers (Cg1-Cg2) were obtained. This paper describes the occurrence and implications of a substantial secondary concentration of Zinc (Zn), manganese (Mn), strontium (Sr), and iron (Fe) in the deciduous erupted and nonerupted teeth as compared to that in the adult teeth. Our interpretation is that, in this archaeological context, the brown spots and blue stains on the teeth are due to differences in tooth enamel porosity and to a postmortem biogeochemical process. The alterations involve cumulization and diagenesis of iron, manganese, and organic matter solutions that were eluviated from the soil and are not the result of antemortem or perimortem conditions such as trauma or disease.

[Electronic forum of Revista de neurología: 'Internet, Medicine and Neuroglia']. / Foro electrónico de revista de neurología: 'Internet, Medicina y Neurología'.

INTRODUCTION: In recent years Internet has drastically transformed the world of telecommunications. Questions about whether Internet and the global communication accessibility may be considered as a fundamental aspect in the medicine of today and tomorrow have been brought up. OBJECTIVE: Discuss current and future applications of Internet to the field of Medicine and Neurology. METHODS: Bibliographical review based on Medline and standard Web search engines. Forum sessions performed through Internet by means of Web-Chat. Forum coordination entirely performed by electronic mail. RESULTS: There are several opinions regarding the influence of Internet on Medicine and Neurology. Currently, the communication and collaboration between teams is improving. It allows scientific publications on-line, improves continuous remote training and facilitates information to patients. New applications like telemedicine need more development. CONCLUSIONS: Currently, Internet represents an efficient tool for collaboration, training and distribution of information in the field of Medicine and Neurology.

[Prevalence of asthma: survey of a school population in Coatzacoalcos, Veracruz, Mexico]. / Prevalencia del asma: encuesta en una población escolar de Coatzacoalcos, Veracruz, México.

In some areas of the Mexican Republic there had been done a few similar studies, this is going to complete the ones done before and it will help to know the prevalence of the asthma in Coatzacoalcos city. Because of confiability reasons, we used questionnaires in a directly form and taking like a patron the one used by Baeza and collaborators with some modifications. The investigation has been done in 583 students from 6 to 12 years old (309 of masculine sex and 274 feminine sex). The investigation ranges the 5.8% of the students poblation in the locality. The 34% reports asthma in some time of their life, the 44% reports asthmatic bronchitis and the 20% chronic coughs because of exercise.

Sodium 2,3-dimercaptopropane-1-sulfonate challenge test for mercury in humans: II. Urinary mercury, porphyrins and neurobehavioral changes of dental workers in Monterrey, Mexico.

The sodium salt of 2,3-dimercaptopropane-1-sulfonic acid (DMPS) challenge test (300 mg p.o. after an 11-hr fast) was given in Monterrey, Mexico to dental and nondental personnel. Urine samples were collected and analyzed for total mercury. The mean mercury urinary excretion (+/- S.E.) for 6 hr before and 6 hr after DMPS administration for 10 dental technicians, who formulate amalgam, was 4.84 micrograms +/- 0.742 and 424.0 micrograms +/- 84.9; for 5 dentists, who use amalgam in their practice, 3.28 micrograms +/- 1.11 and 162.0 micrograms +/- 51.2; and for 13 nondental personnel, 0.783 microgram +/- 0.189 and 27.3 micrograms +/- 3.19. The urinary coproporphyrin levels before DMPS administration, which are indicative of renal mercury content, were quantitatively associated with the urinary mercury levels among the three study groups after DMPS administration. This was not so if the urinary mercury level before DMPS administration was compared with the urinary coproporphyrin concentration. The urinary mercury level after DMPS administration is a better indicator of exposure and renal mercury burden than is the mercury level measured in the urine before DMPS is given. Regression analysis showed that the coefficient of urinary mercury was statistically and adversely associated with complex attention (switching task), the perceptual motor task (symbol-digit substitution), symptoms and mood. The easily performed DMPS-mercury challenge test is useful for monitoring dental personnel for mercury vapor exposure.

Tratamento da Paracoccidioidomicose experimental no camundongo com Isoterápico dinamizado / Experimental \"paracoccidioidomicose\"teatment in mice with dinamized isotherapic

Moscardi & Franco (1985) utilizando a via venosa estabeleceram um modelo experimental dessa infecçäo em camundongo, acompanhando a evoluçäo da moléstia e proporcionando ampla linha de pesquisa, que tem produzido vários trabalhos e na qual passamos a participar com este estudo. Com base neste modelo experimental pretendemos observar se a terapêutica com Isoterápico Dinamizado (ISO-D30) tem efeito curativo e profilático na Paracoccidioidomicose Experimental do Camundongo

Miasmas: uma visao historica e dentro da patologia geral / Miasma: a historical view, and within general pathology

A palavra miasma e os conceitos emitidos para mante-la em uso tem gerado mais discordia e confusao do que propriamente polemica e estudos. Em face desta observacao apresentamos este trabalho com o objetivo de iniciar um processo com vistas a solucionar este entrave, e buscar uma linguagem comumpara melhor comunicacao com a comunidade cientifica, colocando a palavra Miasma na Historia da Medicina. Avaliamos nao so a distorcao do conceito de Miasma, como tambem de Patologia Geral, Imunidade e Alergia. Para tanto, tentamos rapidamente a busca de alguns aspectos da Historia da Medicina para argumentar em favor dessa distorcao de significados

Miasmas: uma visäo histórica e dentro da patologia geral / Miasma: a historical view, and within general pathology

A palavra MIASMA e os conceitos emitidos para mantê-la em uso tem gerado mais discórdia e confusäo do que propriamente polêmica e estudos. Em face desta observaçäo apresentamos este trabalho com o objetivo de iniciar um processo com vistas a solucionar este entrave, e buscar uma linguagem comum para melhor comunicaçäo com a comunidade cientifica, colocando A palavra MIASMA na História da Medicina. Avaliamos näo só a distorçäo do conceito de Miasma, como também de Patologia Geral, Imunidade e alergia. Para tanto, tentamos rapidamente a busca de alguns aspectos da História da Medicina para argumentar em favor dessa distorçäo de significados