Causas médicas de exención para el servicio militar obligatorio durante el siglo XIX en Jerez de los Caballeros, Badajoz, España / Medical causes of exemption for compulsory military service during the 19th century in Jerez de los Caballeros, Badajoz, Spain / Razões médicas para isenção do serviço militar obrigatório durante o século XIX em Jerez de los Caballeros, Badajoz, Espanha

Introducción: el objeto del estudio es la población de Jerez de los Caballeros (Badajoz). Debido a la implantación del Servicio Militar obligatorio en España, el reclutamiento se efectuaba basándose en los censos de los Ayuntamientos, eligiendo a una quinta parte de los mozos sorteables. Objetivo: exponer las causas de exención por parte de los quintos para no realizar el Servicio Militar, durante el siglo XIX. Material y métodos: la investigación en el Archivo Histórico Municipal de Jerez de los Caballeros, así como en publicaciones actuales y de la época, refiriendo las patologías médicas esgrimidas según la Clasificación Internacional de Enfermedades de Jacques Bertillon. Resultados: los mozos utilizaban toda clase de argumentos, entre ellos patologías médicas, reales o no, para eludir el Servicio Militar, el cual era muy cuestionado en la época, y que suponía muchas veces una sentencia de muerte para el quinto, debido a los frecuentes conflictos militares en los que estuvo envuelta España durante el siglo XIX. Discusión: el sorteo se efectuaba mediante unos bombos de manera pública, pero se podía evitar la realización del Servicio Militar, mediante el pago de una cantidad, o sustituciones, lo que suponía una gran discriminación. Conclusiones: a consecuencia del descontento popular que suponía el Servicio Militar obligatorio, los mozos seleccionados esgrimían toda clase de excusas para eludir su realización, circunstancia que fue aumentado con el correr de los años, y por consecuencia también la cantidad de quintos que lo lograban.

Introduction: the object of the study is the population of Jerez de los Caballeros (Badajoz). Due to the implementation of the obligatory Military Service in Spain, the recruitment was carried out based on the census of the City Councils, choosing a fifth part of the drawable young men. Objective: to expose the causes of exemption on the part of the fifth for not performing the Military Service, during the 19th century. Material and methods: research in the Municipal Historical Archive of Jerez de los Caballeros, as well as in current and period publications, referring to the medical pathologies used according to Jacques Bertillon's International Classification of Diseases. Results: the young men used all kinds of arguments, among them medical pathologies, real or not, to avoid the Military Service, which was very questioned at the time, and which was often a death sentence for the fifth, due to the frequent military conflicts in which Spain was involved during the 19th century. Discussion: the lottery was carried out by means of a public drawing of lots, but the Military Service could be avoided by paying an amount, or substitutions, which meant a great discrimination. Conclusions: as a consequence of the popular dissatisfaction with the compulsory military service, the selected young men used all kinds of excuses to avoid performing it, a circumstance that increased over the years, and as a consequence, so did the number of young men who did so.

Introdução: o objeto de estudo é a população de Jerez de los Caballeros (Badajoz). Devido à introdução do serviço militar obrigatório na Espanha, o recrutamento foi realizado com base nos censos dos conselhos municipais, sendo selecionado um quinto dos jovens elegíveis. Objetivo: expor as causas da isenção por parte dos quintos por não prestarem o serviço militar durante o século XIX. Material e métodos: pesquisa no Arquivo Histórico Municipal de Jerez de los Caballeros, bem como em publicações atuais e da época, referentes às patologias médicas utilizadas de acordo com a Classificação Internacional de Doenças de Jacques Bertillon. Resultados: os jovens usaram todos os tipos de argumentos, incluindo patologias médicas, reais ou não, para evitar o serviço militar, que era altamente questionado na época e que muitas vezes significava uma sentença de morte para o quinto, devido aos frequentes conflitos militares nos quais a Espanha estava envolvida durante o século XIX. Discussão: o sorteio era realizado por meio de um sorteio público, mas o serviço militar podia ser evitado mediante o pagamento de uma taxa ou substituições, o que significava uma grande discriminação. Conclusões: como resultado do descontentamento popular com o serviço militar obrigatório, os jovens selecionados usaram todos os tipos de desculpas para não cumpri-lo, uma circunstância que aumentou com o passar dos anos e, consequentemente, também o número de recrutas que o cumpriram.

[Correlation between consultation time and patient´s satisfaction in primary care]. / Correlación entre tiempo consulta y satisfacción del paciente en primer nivel de atención.

Background: It is important to understand how consultation time relates to patient satisfaction, as these two variables have not been extensively studied together. Objective: To determine the correlation between consultation time and patient satisfaction in primary care settings in Mexico. Materials and methods: Cross-sectional, observational, and analytical study that included patients over 18 years old. Time was measured using a stopwatch, and satisfaction was assessed using the Patient Doctor Relationship Questionnaire (PDRQ-9). The correlation between both variables was analyzed using the Spearman test, and multiple linear regression was employed to associate satisfaction with the consultation. Results: A total of 115 participants were included. The average consultation duration was 12.1 minutes, and 74% of patients reported that the consultation time was adequate. A weak positive correlation (p < 0.001, r = 0.38) was found between actual consultation time and satisfaction. Multiple linear regression demonstrated that for every minute increase in consultation time, level of satisfaction increased in 0.04 units (p = 0.001, CI95%: 0.016-0.063). Conclusion: Most patients reported satisfaction with the duration of their medical consultation, and longer consultation times were associated with higher satisfaction levels.

Introducción: es importante conocer cómo el tiempo de la consulta se relaciona con la satisfacción del paciente, ya que son dos variables que no se han estudiado a profundidad de forma conjunta. Objetivo: determinar la correlación que existe entre el tiempo de consulta y la satisfacción del paciente en un primer nivel de atención en México. Material y métodos: estudio transversal, observacional y analítico que incluyó a pacientes mayores de 18 años. Se midió el tiempo con cronómetro, así como la satisfacción mediante el cuestionario Patient Doctor Relationship Questionnaire (PDRQ-9). Se analizó la correlación entre ambas variables con la prueba de Spearman y para asociar la satisfacción con la consulta se empleó regresión lineal múltiple. Resultados: se incluyeron 115 participantes. La duración media de la consulta fue de 12.1 minutos y el 74% de los pacientes indicó que el tiempo de consulta les pareció adecuado. Se encontró una correlación positiva leve (p < 0.001, r = 0.38) entre el tiempo real de la consulta y la satisfacción. Mediante la regresión lineal múltiple se demostró que, por cada minuto de aumento en la consulta, el índice de satisfacción aumentaba en un 0.04 (p = 0.001, IC95%: 0.016-0.063). Conclusión: la mayoría de los pacientes refieren estar satisfechos con la duración de la consulta médica; sin embargo, a mayor duración de la consulta los pacientes muestran mayor satisfacción.

Prevalence and associated factors of bullying in medical residents: A systematic review and meta-analysis.

OBJECTIVE: To assess the prevalence of bullying in medical residents and its associated factors. METHODS: In this systematic review and meta-analysis, articles from MEDLINE, EMBASE, Scopus, PsycInfo, Cochrane databases, and Web of Science were searched. Published and unpublished cross-sectional studies were included. Cochrane's Q test and I2 statistics were used to assess the existence of heterogeneity. Subgroup analysis and sensitivity analysis were performed on evidence of heterogeneity. Egger's test and funnel plots were performed to investigate publication bias. RESULTS: A total of 13 cross-sectional studies with a total of 44 566 study participants from different medical residencies were analyzed. The overall prevalence of bullying was 51% (95% CI 36-66). Furthermore, female residents and residents that belong to a minority group had higher odds of experiencing bullying compared to their peers. CONCLUSION: A high prevalence of bullying in medical residents exists around the world. There is a need for education, dissemination, and more effective interventions among the residents and authorities about bullying to build and promote adequate behaviors and diminish bullying prevalence.

Rol de trampas extracelulares de neutrófilos en el pronóstico de las infecciones del sistema respiratorio / Role of neutrophil extracellular traps in the prognosis of respiratory tract infections

Las trampas extracelulares de neutrófilos (NET, por sus siglas en inglés) han surgido recientemente como un vínculo potencial entre la inmunidad y la inflamación, que podría cumplir un papel clave en la patogénesis de las infecciones de vías respiratorias. El objetivo de esta revisión es determinar su rol como marcador pronóstico en enfermedades infecciosas de vías respiratorias. Para la elaboración de este artículo de revisión narrativa se consultaron las publicaciones disponibles a través de una búsqueda automatizada en las bases de datos de PubMed, Scopus y Embase. Las concentraciones elevadas de trampas extracelulares de neutrófilos (cfADN, complejos de mieloperoxidasas-ADN) en pacientes con cuadro clínico grave por infecciones de vías respiratorias, se relacionan con una estancia hospitalaria más larga, periodo prolongado de administración de antibióticos, aumento del riesgo de ingreso a la UCI, necesidad de ventilación mecánica, disfunción orgánica e incluso la muerte (p ≤ 0,05). A pesar de no contar con un parámetro de medición estandarizado, el exceso de trampas extracelulares de neutrófilos se corresponde con la gravedad del daño tisular observado en pacientes con infecciones de vías respiratorias, esto revela el importante rol pronóstico de la respuesta de los neutrófilos y del proceso de la NETosis en las enfermedades infecciosas pulmonares

Neutrophil extracellular traps (NET) have recently emerged as a potential link between immunity and inflammation, which could play a key role in the pathogenesis of respiratory tract infections. This review aims to determine the role of neutrophil extracellular traps as prognostic markers in respiratoria tract infectious diseases. For this article a literature review was undertaken, consulting available publications through an automated search in PubMed, Scopus, and Embase databases. High concentrations of neutrophil extracellular traps (cfDNA, Myeloperoxidase-DNA complexes) in patients with severe clinical presentation due to respiratory tract infections are related to a longer length of hospital stay, prolonged period of antibiotic administration and increased risk of admission to the ICU, need for mechanical ventilation, organ dysfunction and even death (p ≤ 0.05). Despite not having a standardized measurement parameter, the excess of neutrophil extracellular traps corresponds to the severity of tissue damage observed in patients with respiratory tract infections, revealing the important prognostic role of the neutrophil response and NETosis process in pulmonary infectious diseases

Muertes por cáncer en "Jerez de los Caballeros"(Badajoz, España) en el s. XIX: Un estudio histórico observacional de centro único / Deaths from cancer in "Jerez de losCaballeros" (Badajoz, Spain) in the 19th century. XIX. A single-center, historical observational study

Introducción:El cáncer representa un extraordinario problema para la Salud Pública mundial, suponiendo la primera causa de mortalidad global. El cáncer de pulmón es el más frecuente. El número de defunciones se ha ordenado de acuerdo a la Clasificación de Bertillon. El objetivo del estudio fue analizar las causas de mortalidad por cáncer; determinar que grupos de edad presentan más muertes y que estaciones; calcular las tasas de mortalidad.Materiales y métodos:mediante la lectura de los Libros de Defunción del Archivo Parroquial de la ciudad (APJC), se han obtenido 26.203 difuntos, 18.538 de los cuales tienen anotado el motivo de su muerte, los cuales son utilizados para su análisis posterior.Resultados:Se registraron 182 defuncionespor cáncer(1% del total), la gran mayoría adultos, 165 (90.7%), siendo las mujeres casi el doble, 121 (66.5%). La mayor mortalidad se da entre los 45 y los 74 años, 122 difuntos (67.0%). El cáncer más frecuente es el del apartado de otros órganos, con 50 defunciones (40.6%). El mes con más muertos es marzo.las papeletas de defunción solían presentar errores ortográficos o de transcripción. Estudios similares en otras poblaciones arrojan cifras dispares según el periodo analizado y la cifra de muertos. Existe una estrecha relación entre cáncer y edad.Conclusión:El cáncer de otros órganos es el más numeroso. La mortalidad difiere entre las distintas poblaciones comparadas. El número de difuntos es muy inferior al actual, debido a la falta de medios diagnósticos y conocimientos de la época y la posible existencia de un subregistro

Introduction: Cancer represents an extraordinary problem for Global Public Health and is the leading cause of global mortality. Lung cancer is the most common cancer. The number of deaths was ordered according to the Bertillon Classification. The objective of the study was to analyze the causes of mortality due to cancer, determine which age groups have the most deaths and which seasons, and calculate mortality rates.Materials and methods: By reading the Death Books of the city's Parish Archive (APJC), 26,203 deceased persons were obtained, 18,538 of whom were diagnosed with COVID-19, and these individuals were used for subsequent analysis.Results: A total of 182deaths due to cancer were recorded (1% of the total);the vast majority wereadults (165,90.7%), with nearlytwice as manywomen (121, 66.5%). The highest mortal-ity occurredbetween 45 and 74 years of age, with 122 deaths (67.0%). The most common cancer wasthat of other organs, accounting for50 deaths (40.6%). The month with the most deaths wasMarch. Death certificates often had spelling or transcription errors. Similar studies in other populations show different figures depending on the period analyzed and the number of deaths. There is a close relationship between cancer incidence and age.Conclusion: Cancer of other organs is the most common cancer. Mortality differs between the different populations compared. The number of deaths is much lower than the current numberdue to the lack of diagnostic methods, knowledge of the time,and the possibility of underrecording

First wave of SARS-CoV-2 in Santiago Chile: Seroprevalence, asymptomatic infection and infection fatality rate.

BACKGROUND: The first wave of SARS-CoV-2 infection in Chile occurred during the cold season reaching a peak by the end of June 2020, with 80 % of the cases concentrated in its capital, Santiago. The main objective of this study was to estimate the attack rate during this first wave of SARS-CoV-2 in a large, densely populated city with more than seven million inhabitants. Since the number of confirmed cases provides biased information due to individuals' potential self-selection, mostly related to asymptomatic patients and testing access, we measured antibodies against SARS-CoV-2 to assess infection prevalence during the first wave in the city, as well as estimate asymptomatic cases, and infection fatality ratio. To our knowledge this is one of the few population-based cross-sectional serosurvey during the first wave in a highly affected emerging country. The challenges of pandemic response in urban settings in a capital city like Santiago, with heterogeneous subpopulations and high mobility through public transportation, highlight the necessity of more accurate information regarding the first waves of new emerging diseases. METHODS: From April 24 to June 21, 2020, 1326 individuals were sampled from a long-standing panel of household representatives of Santiago. Immunochromatographic assays were used to detect IgM and IgG antibody isotypes. RESULTS: Seroprevalence reached 6.79 % (95 %CI 5.58 %-8.26 %) in the first 107 days of the pandemic, without significant differences among sex and age groups; this figure indicates an attack rate 2.8 times higher than the one calculated with registered cases. It also changes the fatality rate estimates, from a 2.33 % case fatality rate reported by MOH to an estimated crude 1.00 % (CI95 % 0.97-1.03) infection fatality rate (adjusted for test performance 1.66 % [CI95 % 1.61-1.71]). Most seropositive were symptomatic (81,1 %). CONCLUSIONS: Despite the high number of cases registered, mortality rates, and the stress produced over the health system, the vast majority of the people remained susceptible to potential new epidemic waves. We contribute to the understanding of the initial spread of emerging epidemic threats. Consequently, our results provide better information to design early strategies that counterattack new health challenges in urban contexts.

[The estimated economic impact of cardiovascular and diabetes mellitus complications 2019-2028]. / Estimación del impacto económico por complicaciones cardiovasculares y de diabetes mellitus 2019-2028.

Background: In Mexico, diabetes mellitus (DM) and diseases cardiovascular, register an upward trend. Objective: To estimate the number of complications due to cardiovascular events (CVD) and complications derived from DM (CDM) accumulated in beneficiaries of the Mexican Institute of Social Security (IMSS) from 2019 to 2028, as well as the expense for medical and economic benefits in a scenario baseline and one of change in metabolic profile due to lack of medical follow-up during the COVID-19 pandemic. Material and methods: The number of CVD and CDM was estimated from 2019, with a 10-year risk projection using the ESC CVD Risk Calculator and United Kingdom Prospective Diabetes Study, considering risk factors registered in the institutional databases. Results: From 2019 to 2028, cumulative CVD cases were estimated at 2 million and those of CDM in 960 thousand, with an impact on medical spending of 439,523 million pesos and on the economic benefits of 174,085 millions. When considering the COVID-19 pandemic, CVD events and CDM increased by 589 thousand, with an increase in spending of 93,787 million pesos for medical care and 41,159 million for economic benefits. Conclusions: Without a comprehensive intervention in the management of CVD and CDM, the cost by both diseases will continue to increase, with financial pressures getting older.

Introducción: en México la diabetes mellitus (DM) y las enfermedades cardiovasculares, registran una tendencia ascendente. Objetivo: estimar el número de complicaciones por eventos cardiovasculares (ECV) y complicaciones derivadas de la DM (CDM) acumuladas en derechohabientes del Instituto Mexicano del Seguro Social (IMSS) de 2019 a 2028, así como el gasto por prestaciones médicas y económicas en un escenario de referencia y uno de cambio en el perfil metabólico debido a la falta de seguimiento médico durante la pandemia por COVID-19. Material y métodos: se estimó el número de ECV y CDM a partir de 2019, con una proyección de riesgo a 10 años con los modelos ESC CVD Risk Calculator y United Kingdom Prospective Diabetes Study, considerando los factores de riesgo registrados en las bases de datos institucionales. Resultados: de 2019 a 2028, los casos acumulados de ECV se estimaron en 2 millones y los de CDM en 960 mil, con un impacto sobre el gasto médico de 439,523 millones de pesos y sobre las prestaciones económicas de 174,085 millones. Al considerar la pandemia por COVID-19, los eventos de ECV y de las CDM aumentaron en 589 mil, con un incremento del gasto en 93,787 millones de pesos por atención médica y en 41,159 millones por prestaciones económicas. Conclusiones: sin una intervención integral al manejo de ECV y de CDM, el gasto por ambas enfermedades seguirá incrementándose, con presiones financieras cada vez mayores.

Causas de mortalidad por enfermedades puerperales en Jerez de los Caballeros (Badajoz, España) durante el siglo XIX / Mortality caused by postpartum diseases in Jerez de los Caballeros (Badajoz, Spain) during the 19th century

Resumen Introducción. Las causas de mortalidad por enfermedades puerperales halladas en Jerez de los Caballeros durante el siglo XIX han sido agrupadas según la clasificación de Bertillon. Objetivo. Estudiar las causas de mortalidad por enfermedades del estado puerperal en Jerez de los Caballeros (Badajoz, España) en el siglo XIX. Materiales y métodos. Se consultaron los libros de defunción y se reunieron 26 203 muertes; para el análisis se utilizaron los 18 538 registros en los que constaba la causa de fallecimiento y se excluyeron los 7 665 restantes. Resultados. Se encontraron 168 de casos de muerte en estado puerperal, en las cuales el sobreparto y la fiebre fueron las causas de fallecimiento más frecuentes. El año con más muertes fue 1875 con 7 muertes, la franja de edad de 25-34 años arrojó mayor mortalidad con 77 defunciones (45.9%) y los meses de mayor mortalidad fueron agosto y noviembre con 22 difuntas (13.1%) cada uno. Conclusiones. El sobreparto fue la causa más frecuente de defunción en estado puerperal con un 35.1% de las muertes. La fiebre en esta etapa alcanzó las cifras más elevadas en la última década del siglo XIX, lo cual quizá se debe a errores de diagnóstico o de interpretación.

Abstract Introduction: The causes of death related to puerperal diseases in Jerez de los Caballeros during the 19th century have been categorized according to the Bertillon classification. Objective: To study the causes of death by puerperal diseases in Jerez de los Caballeros (Badajoz, Spain) in the 19th century. Materials and methods: Death books were consulted and 26 203 deaths were recorded. In total, 18 538 records reporting the cause of death were used for the analysis, while the remaining 7 665 were excluded. Results: Death in the puerperal period was confirmed in 168 cases, and the most common causes of death were postpartum complications and puerperal fever. The year with the highest number of deaths was 1875 with 7 deaths. The highest mortality rate was found in the 25-34 years age group with 77 deaths (45.9%). The months with the highest mortality rates are August and November with 22 deaths (13.1%). Conclusions: Postpartum complications was the most common cause of death with 35.1%. In Jerez, puerperal fever reached its highest levels in the last decade of the 19th century, probably due to misdiagnosis or misinterpretation.

Causas de mortalidad por enfermedades psiquiátricas en Jerez de los Caballeros (Badajoz, España) en el siglo XIX / Causes of mortality due to psychiatric diseases in Jerez de los Caballeros (Badajoz, España) in the nineteenth century

Introducción: Se propone agrupar de acuerdo a la clasificación de Bertillon, basada en modelos etiológicos y anatómicos, las causas de mortalidad por enfermedades psiquiátricas, halladas en Jerez de los Caballeros (Badajoz, España) durante el siglo XIX. Objetivos: Examinar detalles estadísticos y clínicos de las causas de mortalidad por enfermedades psiquiátricas detectadas en el estudio. Material y métodos: Se utilizó la información obtenida de los Libros de Defunción del Archivo Parroquial de la ciudad. Resultados: Se encontró documentación de 26 203 defunciones, en 7665 de las cuales no constaba la causa del fallecimiento; en las restantes 18538, que sí la incluyeron, las patologías psiquiátricas constituyeron la decimoquinta causa de defunción, con 57 casos y un 0,3% del total de la mortalidad en la población estudiada, siendo el cólico histérico la enfermedad más frecuente. Discusión: El estudio refleja las dificultades para la obtención de datos fidedignos en áreas como ésta, debidas a posibles errores de transcripción, interpretación y diagnóstico en la documentación de dos siglos atrás.

Introduction: The causes of mortality from psychiatric diseases found in Jerez de los Caballeros (Badajoz, Spain) during the 19th. Century, are classified in different groups following the Bertillon Classification based on etiologic and anatomical models. Objectives: To examine statistical and clinical details about the causes of mortality from psychiatric disease found in the documentation studied. Material and Methods: Pertinent information was obtained from the Death Register of the local Parish Archives. Results: 26203 deaths had been recorded. In 7665 of them, no cause of death was recorded; from the remaining 18538, psychiatric pathologies account for the fifteenth cause of death, with 57 cases recorded or 0.3% of the total mortality rate, and hysteric colic being the most frequent diagnosis. Discussion: The study reflects the difficulties in gathering reliable data for areas like this due to possible errors in transcription, interpretation and diagnosis of documentation of two centuries back.

The impact of the use of intraoperative radiotherapy on costs, travel time and distance for women with breast cancer in the Mexico City Metropolitan Area.

BACKGROUND AND OBJECTIVES: The low availability and poor access to external beam radiotherapy (EBRT) in developing countries makes it hard for women with breast cancer to receive breast conservation. We studied the effect of providing intraoperative radiotherapy (IORT) on the travel time, distance, and costs of in the Mexico City Metropolitan Area (MCMA). METHODS: Sixty-nine patients treated between January 2013 and September 2014 were analyzed. Travel distance and transit time was calculated using Google Maps. The time and distance patients living in the MCMA treated with IORT would have spent if they had received EBRT was calculated. Cost analysis for each modality was performed. RESULTS: 71% (n = 49) lived in the MCMA. Sixteen (33%) received additional EBRT and 33 (66%) received IORT only. Mean driving distance and transit time of those 33 women was 132.6 km (SD 25.7) and 66 min (SD 32.9). Patients from the MCMA receiving IORT alone avoided 990 visits, 43 700 km and 65 400 min in transit. IORT led to a 12% reduction in costs per patient. CONCLUSIONS: By reducing costs and time needed for patients to receive radiotherapy, IORT could potentially enhance access to breast conservation in resource-limited developing countries.

Carcinoma basocelular en nariz de paciente interno en un centro penitenciario / Basal cell carcinoma in nose in a patient residing in a penitentiary center

Introducción. El carcinoma basocelular es el tumor cutáneo maligno más común, dependiendo de su agresividad puede llegar a metastatizar. Caso clínico. Paciente masculino ingresado en centro penitenciario con lesión en región nasal izquierda de años de evolución que se ulcera y al que se le diagnostica carcinoma basocelular sin metastatizar. Se trata con radioterapia radical lográndose la remisión completa. Discusión. Existen varias alternativas terapéuticas, siendo la cirugía la más efectiva. El interés para el médico de atención primaria reside en saber hacer el diagnóstico diferencial de otras lesiones benignas, realizar el seguimiento y estar al día de las alternativas terapéuticas.

Introduction. Basal cell carcinoma is the most common malignant skin tumor, depending on its aggressiveness it can metastasize. Clinical case. Male patient sent to prison with an injury of years of evolution in left nasal region ulcerated and diagnosed as basal cell carcinoma without metastasizing. It was treated with radical radiotherapy achieving complete remission. Discussion. There are several treatment options, surgery being the most effective one. What it is important for the primary care physician is to know the differential diagnosis of other benign lesions, to monitor and to keep updated on therapeutic alternatives.

Los veterinarios titulares de Jerez de los Caballeros (Badajoz, España) durante el siglo XIX / Professional veterinarians in Jerez de los Caballeros (Badajoz, Spain) during the 19th century / Os veterinários titulares de Jerez de los Caballeros (Badajoz, Espanha) durante o século XIX

Los veterinarios recibieron diferentes denominaciones a lo largo del siglo XIX en España: albéitares, herradores, castradores, mariscales, etc., y no fueron reconocidos laboral y socialmente hasta el siglo XX. En 1850 se les ceden responsabilidades sanitario-zootécnicas, aunque muchos siguieron practicando el herrado. Con la creación de las escuelas de veterinaria, se plantan las bases de la veterinaria moderna en España, lo cual le da trascendencia en la salud pública, sobre todo en figuras como el subdelegado veterinario y el inspector de carnes, al entender las repercusiones que las enfermedades que sufren los animales tienen en la población que consume sus carnes. Mediante el estudio del Archivo Histórico de Jerez de los Caballeros (Badajoz, España) se ha podido analizar cómo vivieron y trabajaron los profesionales de la veterinaria en la población durante el siglo XIX. Se observa cómo se asentaban o marchaban de la ciudad, cómo atendían las epidemias que sufrían los animales para el consumo humano y cómo sufrían las dificultades económicas de la época y del Ayuntamiento. La destrucción y pérdida de parte del Archivo dificulta la obtención de más datos.

Veterinarians had different names throughout the 19th century in Spain: veterinary surgeons, farriers, castrators, marshals, etc., and they were not professionally and socially recognized until the 20th century. In 1850 they were given sanitary and zootechnical responsibilities, although many of them continued practicing horse shodding. With the creation of veterinary schools, the foundations of modern veterinary medicine were established in Spain; this has a special importance for public health issues, especially regarding figures like deputy veterinary and meat inspector, as they tried to understand the impact of animal diseases on the population who consumed animal meat. Studies in the Historical Archives of Jerez de los Caballeros (Badajoz, Spain) made it possible to analyze how veterinary professionals lived and worked there during the 19th century, how they settled in or left the city, how they treated epidemics in animals for human consumption, and how they suffered the economic difficulties of the period and the City. The destruction and loss of part of the Archives makes it difficult to obtain more data.

Os veterinários receberam diferentes denominações ao longo do século XIX na Espanha: veterinários, ferradores, castradores, mariscais, etc., e não foram reconhecidos laboral e socialmente até o século XX. Em 1850 foram-lhes cedidas responsabilidades sanitário-zootécnicas, ainda que muitos tenham continuado praticando o ferrageamento. Com a criação das escolas de veterinária, se planta as bases da veterinária moderna na Espanha, o que dá transcendência na saúde pública, principalmente em figuras como o subdelegado veterinário e o inspetor de carnes, ao entender as repercussões que as doenças sofridas pelos animais têm na população que consume suas carnes. Através do estudo do Arquivo Histórico de Jerez de los Caballeros (Badajoz, Espanha) foi possível analisar como viveram e trabalharam os profissionais da veterinária na população durante o século XIX. Observa-se como se assentavam ou deixavam a cidade, como atendiam as epidemias que os animais para o consumo humano sofriam e como sofriam as dificuldades econômicas da época e da Prefeitura. A destruição e perda de parte do Arquivo dificulta a obtenção de mais dados.

Las nuevas categorías sexuales y la psicología del sujeto como 'empresario de sí': un análisis sobre los dilemas de la disidencia sexogenérica en el contexto neoliberal / New sexual categories and the psychology of the entrepreneurial self: Dilemmas of sex/gender dissidence in the neoliberal context

El presente artículo indaga por las formas en que distintas identidades sexo-genéricas no normativas -especialmente en el contexto mediático- entran en relación con una racionalidad neoliberal de gobierno de la subjetividad y la conducta. De manera particular, propone mostrar la consonancia entre determinadas formas de construcción mediática de estas identidades y la noción del sujeto como 'empresario de sí', presente en los discursos psicológicos contemporáneos. Para mostrar esta relación, se analiza el caso de un reportaje de prensa titulado "Las nuevas categorías sexuales", utilizando herramientas del análisis del discurso desde una perspectiva pragmática y foucaultiana. Finalmente, se advierten algunas tensiones y dilemas que existen en los proyectos políticos de resistencia y disidencia sexogenérica en el contexto neoliberal contemporáneo.

In this paper I discuss the way in which specific non-normative sex/gender identities -especially in media context- can be connected to a form of neoliberal governmentality acting upon the subjectivity and behavior of individuals. The particular aim is to examine the relationship between specific media constructions of sex/gender identities and the notion of the subject as a "entrepreneur of the self" present in contemporary psychological discourse. To show this relation, a case consisting on a report published in a pop magazine titled "The new sexual categories" is analyzed. Analysis is conducted using discourse analysis from a pragmatic and foucauldian perspectives. Finally, I show some tensions and dilemmas faced by sex/ gender political projects of resistance in contemporary neoliberal context.

Los farmacéuticos en Jerez de los Caballeros (Badajoz, España) durante el siglo XIX / Pharmacists from Jerez de los Caballeros (Badajoz, Spain) in 19th century

La Farmacia durante el siglo XIX era una profesión separada de la Medicina, dedicada fundamentalmente a la preparación, conservación y dispensación de medicamentos. Mediante el análisis delos documentos existentes en el Archivo Histórico de la ciudad de Jerez de los Caballeros, se siguió el devenir de los boticarios y farmacéuticos de ese siglo, así como las vicisitudes y problemas que enfrentaron para su asentamiento en la localidad, mediante la presentación de sus títulos ante el Ayuntamiento, y para la apertura de sus respectivas oficinas de farmacia. Se pudo conocer que entre sus obligaciones estuvo el suministro de medicamentos a los enfermos pobres, al hospital, a los presos ya los pacientes militares. El Subdelegado de Farmacia fue el encargado de realizar inspecciones y evitar el intrusismo. Las viudas e hijos menores de los farmacéuticos fallecidos tuvieron el derecho de continuar con la farmacia abierta, siempre que la regentase un boticario autorizado(AU)

Pharmacy was a profession separated from medicine, mainly devoted to preparation, storage and sale of drugs. By analyzing the Historical Files of the city of Jerez de los Caballeros, we studied the evolution of the druggists and pharmacists throughout the 19th century, their misfortunes and problems that faced to settle down in the town when presenting their titles to the Town Hall, and to open their retail pharmacies. Among their duties were the supply of medicines to poor patients, the Hospital, prisoners and military patients. The figure of subdelegate of Pharmacy was given the task of supervision and of avoiding intrusism. The widows and children of deceased pharmacists could continue with the pharmacy, provided that an authorized apothecary agreed to manage it(AU)

Causas de mortalidad a consecuencia de la vejez en Jerez de los Caballeros (Badajoz, España) en el siglo XIX / Causes of mortality as a result of old age in Jerez de los Caballeros (Badajoz, Spain) in the 19th century

Antecedentes. Según la Clasificación Internacional de Enfermedades de Bertillon de 1899, se han reunido las causas de defunción ocasionadas por la vejez en Jerez de los Caballeros (Badajoz, España) durante el siglo XIX. Objetivo. Estudiar las causas de mortalidad a consecuencia de la vejez en Jerez de los Caballeros (Badajoz, España) durante el siglo XIX. Materiales y métodos. Se han recopilado un total de 26.203 defunciones, de las cuales 7.665 no tienen constancia de la causa del fallecimiento. Para ello, se han estudiado los Libros de Defunciones del Archivo Parroquial y legajos del Archivo Histórico. Resultados. El primer difunto registrado aparece el 28 de junio de 1808. Las tasas brutas de mortalidad específica promedian un 0.3%. El término vejez fue cambiado a lo largo de los años, sobre todo al aumentar la esperanza de vida, pero la condición de marginado social del anciano continuó. Conclusión. Las enfermedades relacionadas con el envejecimiento causaron 204 defunciones, el 1.1% del total de la mortalidad de la población durante el siglo XIX, correspondiendo a la decimosegunda causa de mortalidad en la población. La mayor mortalidad se da entre los 75 y 84 años con 85 defunciones (41.7%). Las mujeres presentan las cifras más elevadas: 128 fallecimientos (62.7%). Enero es el mes con más óbitos.

Background. We have compiled the causes of age-related decease in Jerez de los Caballeros (Badajoz, Spain) during the 19th century, following Bertillon's International Classification of Diseases of 1899. Objective. To study the causes of mortality due to old age in Jerez de los Caballeros (Badajoz, Spain) during the 19th century. Materials and methods. A total of 26.203 deceases has been found. For 7.665 of these no cause of death is recorded. We have consulted the Books of the Death, located in the Parish Archives, and files of the Historical Archives. Results. The first decease appears on 28th June, 1808. Gross specific mortality rates are 0.3% on average. The application of the term old age changed with the passing of time, especially with the increase of life expectancy, but the elderly remain an object of social marginalization. Conclusion. Age-related diseases caused 204 deceases-1.1% of the total for the period under research-being the twelfth most frequent cause of death in the population. The highest mortality rate occurs between the ages of 75 and 84 with 85 deceases (41.7%). Females have a higher mortality rate than males (128 deceases, 62.7%). January is the month with most deceases.

Dipstick urinalysis for diabetes screening in TB patients.

INTRODUCTION: Diabetes knowledge among TB patients can contribute to improved TB treatment outcomes, but lack of diabetes diagnosis awareness is a limitation in developing countries. Given its low cost, the sensitivity of urine glucose dipsticks for diabetes screening in TB patients was assessed. METHODS: Glycosuria was assessed in 90 newly diagnosed TB patients (38 with diabetes) in south Texas, USA (n = 20) and northeast Mexico (n = 70) during January 2009-December 2010. RESULTS: Glycosuria was detected in 65% of the diabetic patients with chronic hyperglycemia (positive predictive value 91%, negative predictive value 84%). CONCLUSION: We propose that TB clinics with limited budgets where portable glucometers may not be available conduct universal screening for diabetes with urine dipsticks. This could be followed by blood glucose or HbA1c testing in the subset of patients requiring confirmation or higher sensitivity assessment, to improve the comanagement of TB and diabetes.

Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed tuberculosis cases.

OBJECTIVE: To estimate the contribution of clinically-confirmed diabetes mellitus to tuberculosis (TB) rates in communities where both diseases are prevalent as a way to identify opportunities for TB prevention among diabetic patients. METHODS: This is a prospective study in which TB patients ≥ 20 years old at TB clinics in the Texas-Mexico border were tested for diabetes. The risk of tuberculosis attributable to diabetes was estimated from statistics for the corresponding adult population. FINDINGS: The prevalence of diabetes among TB patients was 39% in Texas and 36% in Mexico. Diabetes contributed 25% of the TB cases studied, whereas human immunodeficiency virus (HIV) infection contributed 5% or fewer. Among TB patients, fewer Mexicans than Texans were aware that they had diabetes before this study (4% and 19%, respectively). Men were also less frequently aware than women that they had diabetes (P = 0.03). Patients who knew that they had diabetes before the study had an 8-year history of the disease, on average, before being diagnosed with TB. CONCLUSION: Patients with diabetes are at higher risk of contracting TB than non-diabetic patients. Integrating TB and diabetes control programmes worldwide would facilitate TB prevention among diabetes patients and increase the number of diabetics who learn of their condition, particularly among males. Such a strategy would lead to earlier case detection and improve the management of both TB and diabetes.

Association between family structure, parental smoking, friends who smoke, and smoking behavior in adolescents with asthma.

Recent investigations show that the smoking prevalence among asthmatic adolescents is higher than among healthy adolescents, and the causes that lead these asthmatic adolescents to smoke are unclear. We investigated the association between family structure, parental smoking, smoking friends, and smoking in asthmatic adolescents (n = 6,487). After adjusting for sex and age, logistic regression analyses showed that nonintact family structure, parental smoking, and smoking friends are associated with smoking in adolescents with and without asthma. Asthmatic adolescents who reside in the household of a nonintact family have a 1.90 times greater risk of smoking compared with those who live with both biological parents. It is important that parents who have children with asthma be made aware that the presence of smokers in the home and adolescent fraternization with smoking friends not only favor the worsening of asthma, but also induce the habit of smoking.

Incidencia de linfoma gastrointestinal en el hospital militar Dr. Carlos Arvelo en el lapso 2003-2008 un período de 5 años

Los Linfomas No Hodgkin del tracto gastrointestinal son los linfomas extranodales más comunes, representando entre el 30 y 70% de esta última patología constituyendo un grupo heterogéneo de tumores con diferentes características clínicas y patológicas. El estómago está lesionado de manera predominante siendo los linfomas tipo MALT los tumores de bajo grado más frecuentes en el sistema gastrointestinal, contando con 40% de todos los linfomas gástricos primarios, manteniéndose localizados por períodos prolongados sin tratamiento. Objetivos: evaluar la epidemiología de los linfomas gastrointestinales en nuestro centro. Pacientes y métodos: Análisis retrospectivo de las historias de pacientes con diagnóstico de Linfoma Gastrointestinal. Resultados: Se presentan datos clínicos e histopatológicos de 20 pacientes con diagnóstico de Linfoma Gastrointestinal tratados en el Hospital Militar "Dr. Carlos Arvelo", Caracas, Venezuela, desde 2003 a 2008. 15 hombres, 5 mujeres, con edades comprendidas entre 23 y 64 años. De ellos, 14 (70 %) se presentaron con enfermedad limitada (estadio I-II) mientras que 6 (30%) tuvieron lesión de varios órganos (hígado, páncreas, bazo, duodeno) o más de un órgano gastrointestinal, siendo clasificado como estadio IV. 11 pacientes tuvieron linfoma gástrico, 2 de páncreas, 1 hepático esplénico y de columna lumbar, 1 intestino delgado, 1 en bazo, 4 de colon, y en 5 pacientes se observaron multiples localizaciones en el sistema gastrointestinal. Dolor abdominal, hemorragia digestiva, pérdida de peso fueron los síntomas más frecuentes de presentación. El estómago fue el órgano mas frecuentemente lesionado.

Non-Hodgkin´s lymphomas (NHL) of the gastrointestinal (GI) tract are the most common extra nodal lymphomas. They represent between 30% to 70% of all extra nodal lymphomas and constitute a heterogeneous group of tumors with different clinical and pathological features. The stomach is predominantly involved. MALT type lymphomas are the most frequent low grade non-Hodgkin´s lymphomas encountered in the GI tract. They account for 40% of all primary gastric lymphomas and remain, in the majority of cases, localized for a prolonged period of time without therapy. Aim: To evaluate the epidemiology of gastrointestinal lymphomas in our Hospital. Patients and Methods: Retrospective analysis of patientÊs recorders performed at the Hospital Militar "Dr. Carlos Arvelo", Caracas, that had the diagnosis of gastrointestinal lymphoma. Results Clinical and histopathologjcal data from 20 patients presenting with GI-NHL treated from 2003 until 2008, were reviewed. 15 men, 5 women with an age range between 23 and 64 years old. Of these, 14 (70%) presented with limited disease (stage I and II), while 6 patients were found to have disease involvement of other abdominal organs (i.e., liver, pancreas, spleen, duodenum) or more than one gastrointestinal site and were therefore classified as stage IV. 11 patients presented with lymphoma in the stomach, 2 pancreatic, 1 in liver, spleen and lumbar vertebrae, 1 in the small intestine and 4 in the large bowel, while in 5 cases multiple localizations of the gastrointestinal tract were documented. Abdominal pain, gastrointestinal bleeding, weighs loose were the main presenting symptom.

Prevalencia de tumor del estroma gastrointestinal en el hospital militar Dr. Carlos Arvelo durante los años 2000-2008

Objetivo: Determinar la prevalencia de pacientes con diagnostico de tumores del estroma gastrointestinal hospitalizados desde el año 2000-2008 en el Hospital Militar Dr. Carlos Arvelo. Materiales y métodos: Se realizó un estudio retrospectivo cuyos datos fueron obtenido de la revisión de historias clínicas del hospital, en pacientes con diagnostico de GIST, cuyas biopsias confirmaron el diagnóstico. Se revisaron 7 casos, de los cuales 4 (57%) fueron masculinos, y 3 (43%) femeninos, con edades comprendidas entre 49 y 76 años, de los cuales fallecieron 2, durante su hospitalización. Se clasificaron según edad, sexo, motivo de consulta, complicaciones, y tratamiento. Resultados: De un total de 7 pacientes registrados con diagnostico de tumor del estroma gastrointestinal, fueron estudiados, 4 masculinos y 3 femeninos, con una media de edad de 64 años. Los motivos de consulta de estos pacientes de los cuales fueron: dolor abdominal, masa palpable, pérdida de peso. Conclusiones: Los tumores del Estroma Gastrointestinal son un reto diagnóstico para el clínico, por lo que ante la presencia de tumoración Gastrointestinal con signos y síntomas inespecíficos, el apoyo anatomopatológico sustentado en el estudio inmunohistoquímico es determinante.

Objective: Determine the number of patients with diagnosis of gastrointestinal stromal tumor hospitalized from the year 2000-2008 in the Military Hospital Dr. Carlos Arvelo. Patients and Methods: retrospective study which information was obtained of the review of clinical histories from the file of the hospital,in patients with GISTÊs diagnosis, to which endoscopic studies were realized and which biopsies confirmed the diagnosis. There were checked 7 cases, of which 4 (57 %) were masculine, and 3 (43 %) were feminine, with ages included between 49 and 76 years, of which 2 died, during their hospitalization. They qualified according to age, sex, motive of consultation, complications, and treatment. Results: Of a whole of 7 patients registered in the file of the hospital, with diagnosis of gastrointestinal stromal tumor were studied, 4 masculine and 3 feminine, by an average of age of 64 years. The motives of consultation of these patients were: abdominal pain, palpable mass, loss of weight. Conclusions: Gastrointestinal stromal tumors are a diagnostic challenge for the clinician, thatÊs why when the diagnosis is made; the support in a pathological study based on immunohistochemistry is determinant.