Los saberes en torno a la tuberculosis en Valencia a través de la prensa médica (1882-1914)

Para la realización de este trabajo se ha partido del interés que tiene estudiar la literatura científica que a finales del siglo XIX y principios del XX dedicó una sociedad como la valenciana al tema de la tuberculosis, de primera importancia no solo en la realidad epidemiológica de la época, sino también para la constitución de la ciencia y las prácticas médicas contemporáneas. Se ha abordado el estudio de los saberes en torno a la tuberculosis en Valencia a través de las revistas médicas publicadas en ella entre 1882 y 1914, periodo en el que se descubrió el origen microbiano de la enfermedad y se desarrollaron nuevas técnicas diagnósticas, preventivas y curativas de la infección tuberculosa. En las ocho revistas consultadas se han encontrado 602 artículos, el 37,04% de los mismos en la Revista de Higiene y Tuberculosis, cuyo director, el tisiólogo José Chabás, fue también el autor más prolífico, con 31 artículos. Los temas que se trataron con mayor frecuencia fueron el descubrimiento del bacilo de Koch, el descubrimiento y aplicaciones de la tuberculina y la organización de la lucha antituberculosa.//Per a la realització d'aquest treball s'ha partit de l'interés que té estudiar la literatura científica que a la fi del segle XIX i principis del XX va dedicar una societat com la valenciana al tema de la tuberculosi, de primera importància no sols en la realitat epidemiològica de l'època, sinó també per a la constitució de la ciència i les pràctiques mèdiques contemporànies. S'ha abordat l'estudi dels sabers entorn de la tuberculosi a València a través de les revistes mèdiques publicades en ella entre 1882 i 1914, període en el qual es va descobrir l'origen microbià de la malaltia i es van desenvolupar noves tècniques diagnòstiques, preventives i curatives de la infecció tuberculosa. En les huit revistes consultades s'han trobat 602 articles, el 37,04% dels mateixos en la Revista d'Higiene i Tuberculosi, el director de la qual, el tisiòleg José Chabás, va anar també l'autor més prolífic, amb 31 articles. Els temes que es van tractar amb major freqüència van ser el descobriment del bacil de Koch, el descobriment i aplicacions de la tuberculina i l'organització de la lluita antituberculosa.//Pour la réalisation de ce travail, nous sommes parti de l’intérêt qu’offre l’étude de la littérature scientifique sur la tuberculose à la fin du XIXe siècle et au début du XXe siècle à Valence. Ce sujet est d’une importance capitale non seulement quant à la réalité épidémiologique de l’époque, mais aussi pour la constitution de la science et la pratique médicale contemporaines. L’étude a été abordée à travers les revues médicales qui y sont publiées entre 1882 et 1914, période pendant laquelle l’origine microbienne de la maladie a été découverte et se sont développées de nouvelles techniques de diagnostic, de prévention et de traitement de la tuberculose. Dans les huit revues consultées ont été recensés 602 articles sur cette question ; 37,04 % d’entre eux sont parus dans la Revista de Higiene y Tuberculosis, dont le directeur, José Chabás, a aussi été l’auteur le plus prolifique, avec 31 articles. Les sujets les plus fréquemment abordés sont ceux qui portent sur la découverte du bacille de Koch, la découverte et les applications de la tuberculine ainsi que sur l’organisation de la lutte contre la tuberculose.To carry out this work we have started the interest of studying the scientific literature about tuberculosis in the late nineteenth and early twentieth centuries. This topic is important not only in epidemiological reality time, but also for the establishment of science and contemporary medical practice. It deals with the study of knowledge about tuberculosis in Valencia through medical journals published there between 1882 and 1914, a period in which it was discovered the microbial origin of the disease and developed new diagnostic, preventive and curative technologies of the tubercular infection. In the eight journals consulted 602 articles were found, 37,04% of them in the Revista de Higiene y Tuberculosis, whose director, Jose Chabás, was also the most prolific author, with 31 articles. The topics discussed most frequently were the discovery of Koch’s bacillus, the discovery and application of tuberculin and the organization of tuberculosis control

A propòsit dels nusos mòbils en la construcció dels sermons vicentins

Fra Vicent es refereix a la seva predicació a través del símil de la xarxa. La predicació es conforma -segons ell- com una mena de filat o xarxa, teixida a partir d’autoritats, exempla, similitudines, etc. Seguint aquesta metàfora, en aquest article estudiem alguns dels nusos d’aquesta xarxa: els grups consolidats de símils que podem trobar, repetidament, tot al llarg dels seus sermons. Pensem que aquestes agrupacions faciliten el desenvolupament d’aquestes peces oratòries i ens mostren una tècnica de construcció que havia quedat eclipsada per l’atenció concedida a altres aspectes de la predicació vicentina

Aviso a la poblácion para no morrir de vejiguillas

[Excerto] Introdução: Num momento em que os meios de comunicação são invadidos por especialistas que comentam a espuma dos dias, os investigadores na área da demografia e dos estudos de população devem procurar afirmar de forma credível e responsável o seu campo de investigação. Acima de tudo, consideramos que é nossa responsabilidade apresentar o que tem sido a evolução da população, os desafios que tem enfrentado no passado, bem como aqueles que hoje nos preocupam. É nesse sentido, que consideramos oportuno recordar algumas obras pioneiras que, confrontadas com o presente, têm a virtualidade de demonstrar que algumas dos acesos debates da atualidade já preocupavam os nossos antepassados e que a análise das suas respostas nos pode ainda hoje iluminar. É o caso da multiplicidade de publicações que, desde inícios do século XIX, procuravam esclarecer a população dos benefícios da vacinação contra a varíola. Ao trazer a público estes textos, destacamos a credibilidade de uma abordagem consolidada ao longo de mais de dois séculos, com um enorme impacto na redução da mortalidade por doenças infeciosas. Neste âmbito, é particularmente interessante a publicação do farmacêutico Manuel José de Passos Lima, que face à grave epidemia de «bexigas» que grassava na cidade de Guimarães em 1873, decidiu oferecer aos seus concidadãos um «Aviso ao povo para não morrer de bexigas…».[Extracto] En un momento en que los medios de comunicación son invadidos por especialistas que comentan la espuma de la actualidad, los investigadores en el área de la demografía y de los estudios de población deben tratar de afirmar, de manera creíble y responsable, su campo de investigación. Por encima de todo, consideramos que es nuestra responsabilidad presentar cuál ha sido la evolución de la población, los desafíos que ha enfrentado en el pasado, así como los que hoy nos preocupan. En ese sentido, consideramos oportuno recordar algunas obras pioneras que, confrontadas con el presente, tienen el potencial de demostrar que algunos de los acalorados debates de la actualidad ya preocuparon a nuestros antepasados y que el análisis de sus respuestas aún puede iluminarnos hoy. Es el caso de multitud de publicaciones que, desde comienzos del siglo XIX, buscaban informar a la población sobre los beneficios de la vacunación contra la viruela. Al hacer públicos estos textos, destacamos la credibilidad de un abordaje consolidado a lo largo de más de dos siglos, con un enorme impacto en la reducción de la mortalidad por enfermedades infecciosas. En este ámbito, resulta particularmente interesante la publicación del farmacéutico Manuel José de Passos Lima que, ante la grave epidemia de «vejiguillas» que se propagaba en la ciudad de Guimarães en 1873, decidió ofrecer a sus conciudadanos un «Aviso a la población para no morir de vejiguillas…»

Tuberculosis in Spain: past and future challenges

Los objetivos de este trabajo son conocer la historia y la situación epidemiológica de la Tuberculosis en España a través de su historia, la situación actual y los retos a futuro de una de las enfermedades infecciosas y mortíferas más antiguas hasta la pandemia de coronavirus. La lucha contra la tuberculosis durante los siglos XIX y XX fue compleja y su evolución tuvo una importante inflexión, sobre todo en lo relacionado con las medidas preventivas, con el descubrimiento del bacilo de Koch. A partir de ese momento, se desarrollaron nuevas políticas en materia de higiene, tanto a nivel colectivo como individual. Otro punto de inflexión fue la llegada de la II República, en la que la Sanidad pasó a manos del Estado. La Guerra Civil Española supuso un estancamiento en las políticas sanitarias y un nuevo rumbo. Por último, con la llegada de nuevos medicamentos en los años 50 y 60 se logró el control de la enfermedad, aunque no se alcanzó la total erradicación de la enfermedad debido a la asociación con el VIH, las resistencias antibióticas y el acceso precario a la sanidad, entre otras causas. Los últimos informes indican que la tasa de incidencia de tuberculosis en España ha caído una media de 5,4% al año del 2005 al 2020, lejos aún de los objetivos de la Organización Mundial de la Salud por lo que en la actualidad se están revisando las estrategias planteadas en el Plan Nacional para la Prevención y el Control de la Tuberculosis.The goals of this work are to understand the history and epidemiological situation of Tuberculosis in Spain through the history, chronology, current situation, and future challenges of one of the oldest and deadly infectious disease in Spain until the coronavirus pandemic. The fight against tuberculosis during the 19th and 20th centuries was complex and its evolution had an important turning point, especially in relation to preventive measures, with the discovery of Koch's bacillus. From that time onwards, new hygiene policies were developed, both at the collective and individual level. Another turning point was the arrival of the Second Republic, when health care was controlled by the State. The Spanish Civil War led to a stagnation in health policies and a new direction. Finally, with the arrival of new drugs in the 1950s and 1960s, the disease was brought under control, although it was not completely eradicated due to the association with HIV, antibiotic resistance, and poor access to healthcare, among other causes. The latest reports indicate that the incidence rate of tuberculosis in Spain has fallen by an average of 5.4% per year from 2005 to 2020, still far from the World Health Organization’s targets, which is why the strategies set out in the National Plan for the Prevention and Control of Tuberculosis are currently being reviewed.Máster Universitario en Acción Humanitaria Sanitaria (M161

Prognostic value of degree and types of anaemia on clinical outcomes for hospitalised older patients

Study objective This study investigated in a large sample of in-patients the impact of mild-moderate-severe anaemia on clinical outcomes such as in-hospital mortality, re-admission, and death within three months after discharge. Methods A prospective multicentre observational study, involving older people admitted to 87 internal medicine and geriatric wards, was done in Italy between 2010 and 2012. The main clinical/laboratory data were obtained on admission and discharge. Based on haemoglobin (Hb), subjects were classified in three groups: group 1 with normal Hb, (reference group), group 2 with mildly reduced Hb (10.0–11.9 g/dL in women; 10.0–12.9 g/dL in men) and group 3 with moderately-severely reduced Hb (<10 g/dL in women and men). Results Patients (2678; mean age 79.2 ± 7.4 y) with anaemia (54.7%) were older, with greater functional impairment and more comorbidity. Multivariable analysis showed that mild but not moderate-severe anaemia was associated with a higher risk of hospital re-admission within three months (group 2: OR = 1.62; 95%CI 1.21–2.17). Anaemia failed to predict in-hospital mortality, while a higher risk of dying within three months was associated with the degree of Hb reduction on admission (group 2: OR = 1.82;95%CI 1.25–2.67; group 3: OR = 2.78;95%CI 1.82–4.26) and discharge (group 2: OR = 2.37;95%CI 1.48–3.93; group 3: OR = 3.70;95%CI 2.14–6.52). Normocytic and macrocytic, but not microcytic anaemia, were associated with adverse clinical outcomes. Conclusions Mild anaemia predicted hospital re-admission of older in-patients, while three-month mortality risk increased proportionally with anaemia severity. Type and severity of anaemia affected hospital re-admission and mortality, the worst prognosis being associated with normocytic and macrocytic anaemia

Risk factors for three-month mortality after discharge in a cohort of non-oncologic hospitalized elderly patients: Results from the REPOSI study

Background: Short-term prognosis, e.g. mortality at three months, has many important implications in planning the overall management of patients, particularly non-oncologic patients in order to avoid futile practices. The aims of this study were: i) to investigate the risk of three-month mortality after discharge from internal medicine and geriatric wards of non-oncologic patients with at least one of the following conditions: permanent bedridden status during the hospital stay; severely reduced kidney function; hypoalbuminemia; hospital admissions in the previous six months; severe dementia; ii) to establish the absolute risk difference of three-month mortality of bedridden compared to non-bedridden patients. Methods: This prospective cohort study was run in 102 Italian internal medicine and geriatric hospital wards. The sample included all patients with three-months follow-up data. Bedridden condition was defined as the inability to walk or stand upright during the whole hospital stay. The following parameters were also recorded: estimated GFR <= 29 mL/min/1.73 m(2); severe dementia; albuminemia << 2.5 g/dL; hospital admissions in the six months before the index admission. Results: Of 3915 patients eligible for the analysis, three-month follow-up were available for 2058, who were included in the study. Bedridden patients were 112 and the absolute risk difference of mortality at three months was 0.13 (CI 95% 0.08-0.19, p << 0.0001). Logistic regression analysis also adjusted for age, sex, number of drugs and comorbidity index found that bedridden condition (OR 2.10, CI 95% 1.12-3.94), severely reduced kidney function (OR 2.27, CI 95% 1.22-4.21), hospital admission in the previous six months (OR 1.96, CI 95% 1.22-3.14), severe dementia (with total or severe physical dependence) (OR 4.16, CI 95% 2.39-7.25) and hypoalbuminemia (OR 2.47, CI 95% 1.12-5.44) were significantly associated with higher risk of three-month mortality. Conclusions: Bedridden status, severely reduced kidney function, recent hospital admissions, severe dementia and hypoalbuminemia were associated with higher risk of three-month mortality in non-oncologic patients after discharge from internal medicine and geriatric hospital wards

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2