Lowered serum cesium levels in schizophrenia: association with immune-inflammatory biomarkers and cognitive impairments

Objectives: A previous study has shown that schizophrenia (SCZ) is accompanied by lowered levels of trace/metal elements, including cesium. However, it is not clear whether changes in cesium, rubidium, and rhenium are associated with activated immune-inflammatory pathways, cognitive impairments, and the symptomatology of SCZ. Methods: This study measured cesium, rubidium, and rhenium, cognitive impairments (using the Brief Assessment of Cognition in Schizophrenia [BACS]), and the levels of cytokines/chemokines interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and eotaxin (CCL11) in 120 patients with SCZ and 54 healthy controls. Severity of illness was assessed using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), the Fibromyalgia and Chronic Fatigue Syndrome Rating (FF) Scale, and the Hamilton Depression Rating Scale (HAM-D). Results: Serum cesium was significantly lower in patients with SCZ as compared with controls. Further, serum cesium was significantly and inversely associated with CCL11 and TNF-α, but not IL-1β, in patients with SCZ; significant inverse associations were also noted between serum cesium levels and BPRS, FF, HAM-D, and SANS scores. Finally, cesium was positively correlated with neurocognitive probe results including the Tower of London, Symbol Coding, Controlled Word Association, Category Instances, Digit Sequencing Task, and List Learning tests. Conclusion: The results suggest that lowered serum cesium levels may play a role in the pathophysiology of SCZ, contributing to specific symptom domains including negative, depressive and fatigue symptoms, neurocognitive impairments (spatial working, episodic, and semantic memory and executive functions), and neuroimmune pathways.

Florence Nightingale e a arte de enfermagem: texto e contexto da Inglaterra Vitoriana / Florence Nightingale y el arte de la enfermería: texto y contexto de la Inglaterra Victoriana / Florence Nightingale and the art of nursing: text and context of Victorian England

Resumo Objetivo refletir sobre a figura pública de Florence Nightingale, suas realizações, Reforma Sanitária e a criação da Escola de Enfermeiras, e compreender o nascimento da enfermagem como profissão. Método partiu-se da literatura de um quadro das pressões sociais que agiam sobre o comportamento individual de Florence Nightingale e dos marcos divisórios aparentes, que entendemos como a densidade das relações sócio-históricas, e o seu tempo social. Análise sócio-histórica da história de vida de Florence Nightingale e da literatura social de Charles Dickens. O marco temporal compreendeu da promulgação da New Poor Law (1.834) à revogação (1.601). Resultados Florence Nightingale foi uma mulher adiante do seu tempo que, contrariando as teorias do Darwinismo social de sua época, criou a profissão da enfermeira, e produziu uma clivagem na profissão definindo-a como ciência e arte. Conclusão e implicações para a enfermagem ao criar a figura emblemática da Dama da Lâmpada, Florence Nightingale gravou no cuidado de enfermagem, o zelo, o desvelo e a compaixão, aqui entendida como empatia e piedade com o sofrimento do outro acompanhada do desejo de minorá-lo, uma participação espiritual na dor do outro.

Resumen Objetivo reflexionar sobre la figura pública de Florence Nightingale, sus logros, Reforma Sanitaria y la creación de la Escuela de Enfermeras, y comprender el nacimiento de la enfermería como profesión. Método se partió de la literatura de un cuadro de las presiones sociales sobre el comportamiento individual de Florence Nightingale y de los marcos divisorios aparentes que se entiende como la densidad de las relaciones socio histórico y su tiempo social. Análisis socio histórico de la historia de vida de Florence Nightingale y de la literatura social de Charles Dickens. El marco temporal se comprendió entre la promulgación del New Poor Law en 1834 y su revocación promulgada en 1601. Resultados Florence Nightingale fue una mujer adelante a su tiempo que, contrariando las teorías del Darwinismo social de su época, creó la profesión de enfermera, y produjo una mirada embrionaria en la profesión definiéndola como ciencia y arte. Conclusión e implicaciones para la enfermería al crear la figura emblemática de la Dama de la Lámpara, Florence Nightingale registró en el cuidado de enfermería, el celo, el cuidado y la compasión, entendido aquí como empatía y piedad con el sufrimiento del otro acompañado del deseo de una disminución, una participación espiritual en el dolor del otro.

Abstract Objective to reflect on Florence Nightingale's public figure, her achievements, Health Care Reform and the creation of the School for Nurses, and understand the birth of nursing as a profession. Method a framework of the social pressures acting on Florence Nightingale's individual behavior and the apparent dividing marks, which we understand as the density of socio-historical relations, and her social time, was drawn from the literature. This is a socio-historical analysis of Florence Nightingale's life story and Charles Dickens' social literature. The time frame spanned from the enactment of the New Poor Law (1834) to the repeal (1601). Results Florence Nightingale was a woman ahead of her time who, going against the theories of social Darwinism of her time, created the nurse profession, and produced a divide in the profession by defining it as science and art. Conclusion and implications for nursing by creating the emblematic figure of the Lady of the Lamp, Florence Nightingale engraved in nursing care, zeal, devotion, and compassion, here understood as empathy and pity for the suffering of others accompanied by the desire to alleviate it, a spiritual participation in the pain of others.

Tribute to Professor Andrew J. Lees / Tributo ao Professor Andrew J. Lees

Abstract Professor Andrew John Lees, from the National Hospital for Neurology and Neurosurgery, a neurological hospital in Queen Square, London, UK, has contributed in a stupendous way to the development of the field of movement disorders in Brazil, with a constant and intense participation in numerous congresses and scientific meetings of this specialty since 1983.

Resumo O professor Andrew Lees, do National Hospital for Neurology and Neurosurgery, Queen Square, Londres, Reino Unido, tem contribuído de maneira estupenda para o desenvolvimento da área dos distúrbios do movimento no Brasil, com uma participação constante e intensa em inúmeros congressos e encontros científicos desta especialidade, desde o ano de 1983.

Margaret Dix, Charles Hallpike and the 'Lagerungs' Manoeuvre / Margaret Dix, Charles Hallpike e a Manobra 'Lagerungs'

ABSTRACT The main objective of this manuscript is to describe some personal and professional aspects of two outstanding researchers and pioneers in neuro-otology. Among other achievements, Margaret Ruth Dix, and Charles Skinner Hallpike, designed the most-used provocative test for positional nystagmus for the diagnosis of lithiasis in the vestibular posterior semicircular canal.

RESUMO O principal objetivo desse manuscrito diz respeito a alguns aspectos pessoais e profissionais de dois excelentes pesquisadores e pioneiros da neuro-otologia. Entre outras descrições, Margaret Ruth Dix e Charles Skinner Hallpike descreveram o teste provocativo mais utilizado de nistagmo posicional para o diagnóstico de litíase no canal semicircular posterior do sistema vestibular.

Dimensions of youth psychopathy differentially predict concurrent pro- and antisocial behavior

Objective: To investigate the unique contribution of narcissism and impulsivity, in addition to callous-unemotional (CU) traits, in explaining concurrent prosocial and antisocial behavior. Method: Two hundred and forty-nine schoolchildren (53% female; age 9-12 years) completed the self-report Strengths and Difficulties Questionnaire (SDQ) and the Antisocial Process Screening Device (APSD). Two statistical models were tested, predicting conduct problems (CP) and prosocial behavior (PB). In the first one, CU traits and gender were entered into the equation. The second model added narcissism and impulsivity. Results: Gender, narcissism and impulsivity, but not CU, were statistically significant predictors of CP in the second model (F3,226 = 45.07, p < 0.001, R2 = 43.7%; betas: gender = -0.20, narcissism = 0.29, impulsivity = 0.36, CU = 0.06). PB was significantly predicted by all domains except gender (F3,226 = 42.57, p < 0.001, R2 = 42.4%; betas: gender = 0.08, narcissism = -0.16, impulsivity = -0.23, CU = -0.41). Conclusion: Our results confirmed that CU traits refer to a distinct manifestation of psychopathy in youth, but we also found that narcissism and impulsivity are equally important when predicting CP. Previous reports of sex differences on APSD and SDQ domains were also corroborated.

Parkinson's disease - 200 years: the outstanding contribution of "Old Hubert" / Doença de Parkinson's 200 anos: a notável contribuição do "Velho Humberto"

ABSTRACT Two hundred years after the publication, of “An Essay on the Shaking Palsy”, this indisputable landmark in our understanding of the nature of Parkinson’s disease still remains. What is frequently overlooked, however, is the originality of James Parkinson’s ideas about how clinical observations could be segregated into diagnostic entities. Parkinson was a surgeon apothecary with wide ranging interests outside medicine including geology and paleontology. He was also a strong campaigner for social change and a political pamphleteer, writing under the nom de plume of “Old Hubert”.

RESUMO A publicação de James Parkinson intitulada “An Essay on the Shaking Palsy”, 200 anos atrás, é considerada uma obra prima de fundamental importância científica. James Parkinson foi um cirurgião apotecário com uma ampla faixa de interesses, além da medicina, incluindo geologia e paleontologia. Ele foi também um grande reformador social e panfletário político, que escreveu sob o pseudônimo de “Velho Humberto”.

The opportunity to remember William Richard Gowers (1845-1915) and his concept of abiotrophy, now best understood and called apoptosis or programmed cell death / A oportunidade de rememorar William Richard Gowers (1845-1915) e seu conceito de abiotrofia, agora melhor compreendido e denominado apoptose ou morte celular programada

William Richard Gowers (1845-1915) was one of the most prolific and insightful neurologists of all times. He gave major contributions to the development of the medicine through the presentation of signs, syndromes, new concepts and many publications, mainly based on his thorough examination of his patients at the National Hospital, London. In this paper, they were enrolled several Gowers' contribu-tions, besides, it is discussed his concept of abiotrophy. Gowers at his time already recognized what is now most deeply understood  and called programmed cell death or apoptosis that occurs normally du-ring the development or aging, but also under a range of stimuli and conditions, physiological or pathological, on the dependence of a cell selective vulnerability.

William Richard Gowers (1845-1915) foi um dos mais prolíficos e perspicazes neurologistas de todos os tempos. Ele deu grandes contribuições para o desenvolvimento da medicina, por meio da apresentação de sinais, síndromes, novos conceitos e muitas publicações, principalmente com base em sua análise aprofundada de seus pacientes no National Hospital, em Londres. Neste trabalho, foram registradas várias contribuições, além disso, discute-se o seu conceito de abiotrofia. Gowers, na sua época, já reconheceu o que agora é mais profundamente compreendido e denominado de morte celular programada ou apoptose, que ocorre normalmente durante o desenvolvimento ou envelhecimento, mas também sob uma gama de estímulos e condições, fisiológicas ou patológicas, na dependência de uma vulnerabilidade seletiva de células.

Indução de endividamento hospitalar na compra de medicamento em situação de monopólio: o caso do mesilato de imatinibe / Induction of hospital indebtedness due to medicine purchases under monopoly conditions: the case of imatinib mesylate / Inducción de la deuda hospitalaria en la compra de medicamentos en monopolio: el caso de mesilato de imatinib

Os gastos com medicamentos correspondem a uma grande parcela do orçamento em saúde. Sendo assim, a produção de conhecimento sobre o uso desses recursos é essencial na tomada de decisão em saúde pública e melhoria da assistência farmacêutica. Este estudo teve como objetivo analisar o processo de endividamento em um hospital universitário de alta complexidade devido ao gasto crescente com a aquisição de mesilato de imatinibe. Por meio de análise documental e registros no Sistema de Informações Hospitalares (SIH) entre 2002 e 2010, realizou-se um estudo descritivo. A partir do caminho da incorporação do medicamento, foram mapeadas as estratégias da indústria farmacêutica e do governo, assim como as respostas governamentais de redução do preço. A sistematização e publicação de informações guardadas em arquivos e na memória podem contribuir para o acompanhamento dos resultados dos programas mantidos pelo Ministério da Saúde.

Medicine expenditures consume a large share of the health budget, so knowledge on the use of these funds is essential for decision-making in public health and improvement of pharmaceutical care. This study analyzed the indebtedness of a high-complexity university hospital due to increased spending on imatinib mesylate. The descriptive study was based on analysis of documents and records in the Hospital Information System (SIH) from 2002 to 2010. Starting with inclusion of the medicine in the budget, the study mapped strategies by the pharmaceutical industry and government, as well as government responses to reduce the product's price. The systematization and publication of information stored in files and electronic databases can help monitor the results of programs funded by the Brazilian Ministry of Health.

Los gastos en medicamentos representan una gran proporción del presupuesto de salud, por lo que la producción de conocimiento sobre el uso de estos recursos es esencial en la toma de decisiones en salud pública y la mejora de la atención farmacéutica. Este estudio tuvo como objetivo analizar el proceso de endeudamiento en un hospital universitario de alta complejidad, debido al aumento de los gastos en la adquisición de mesilato de imatinib. A través del análisis de los documentos y registros en el Sistema de Información Hospitalaria (SIH) entre 2002 y 2010, se realizó un estudio descriptivo. A partir de la incorporación del medicamento, se mapearon las estrategias de la industria farmacéutica y del gobierno, así como las respuestas del gobierno para reducir el precio. La sistematización y publicación de la información almacenada en los archivos y su memoria puede contribuir para el seguimiento de los resultados de los programas mantenidos por el Ministerio de Salud.

A estrutura latente da depressão em idosos: uma análise taxométrica / Latent structure of depression in the elderly: a taxometric analysis / Estructura latente de la depresión en los adultos mayores: un análisis taxométrico

O objetivo deste estudo foi investigar a estrutura latente da depressão em uma amostra não clínica de idosos, utilizando a análise taxométrica. Essa análise é uma família de procedimentos estatísticos concebidos para testar se um determinado construto é mais bem representado por categorias ou por dimensões nas quais os sujeitos variam. A amostra foi composta por 570 idosos, com média de idades de 71,90 anos (DP = 7,45), que responderam à Escala de Depressão Geriátrica, a um teste de rastreio cognitivo e a questões demográficas. Foram utilizados três procedimentos taxométricos: o Mean Above Minus Below a Cut (MAMBAC), o Maximum Eigenvalue (MAXEIG) e o Latent Model (L-Mode). Foram analisados conjuntos de dados categóricos e dimensionais simulados, assim como os índices de ajuste CCFI. Os resultados encontrados nas três técnicas apontaram para um melhor ajuste ao formato dimensional em detrimento do taxônico, ou seja, a depressão parece ser mais bem representada como uma síndrome, na qual os sujeitos estão distribuídos em um contínuo e não em uma entidade discreta de diagnóstico.

This study aimed to investigate the latent structure of depression with a non-clinical sample of elderly, using taxometric analysis. The latter consists of a family of statistical procedures conceived for testing whether a given psychological construct is best represented by categories or dimensions in which individuals vary. The sample consisted of 570 elderly with a mean age of 71.9 years (SD = 7.45), who answered the Brazilian version of the Geriatric Depression Scale, a cognitive test, and demographic questions. Three taxometric procedures were used: Mean Above Minus Below A Cut (MAMBAC), Maximum Eigenvalue (MAXEIG), and Latent Mode (L-mode). Sets of simulated categorical and dimensional data, along with the comparison curve fit indices (CCFI), oriented the study data's interpretation. The results with the three techniques pointed to a better fit with the dimensional format as opposed to the taxonic one, that is, depression represented better as a syndrome in which subjects are distributed along a continuum rather than as a discrete diagnostic entity.

Este estudio ha investigado la estructura latente de la depresión en una muestra de una clínica geriátrica, mediante un análisis taxométrico, que es una familia de procedimientos estadísticos diseñados para probar si un constructo es representado mejor por categorías o dimensiones en el que los sujetos varían. La muestra estuvo conformada por 570 ancianos, con una edad media de 71,90 años (DS = 7,45) que respondieron a la Escala de Depresión Geriátrica, una prueba de screening cognitivo y a cuestiones demográficas. Se utilizaron tres procedimientos taxométricos: Mean Above Minus Below a Cut (MAMBAC), Maximum Eigenvalue (MAXEIG) y Latent Mode (L-Mode). Se usaron conjuntos de datos simulados categóricos y dimensionales, así como los índices de ajuste CCFI (Comparison Curve Fit Index). Los resultados mostraron en las tres técnicas un mejor ajuste para el modelo dimensional, en detrimento de la solución taxónica. O sea, depresión parece estar mejor representada como un síndrome, donde los sujetos se distribuyen en un continuum, en lugar de como una entidad discreta de diagnóstico.

Studies on Phlebotominae (Diptera: Psychodidae) in the Campus FIOCRUZ Mata Atlântica, Jacarepaguá, in the City of Rio de Janeiro, Brazil

INTRODUCTION: The presence of American cutaneous leishmaniasis (ACL) in the communities of the Campus FIOCRUZ Mata Atlântica (CFMA) in the City of Rio de Janeiro initiated the investigation of the Phlebotominae fauna in the Atlantic Forest to determine the occurrence of putative ACL vectors associated with the enzootic cycle. METHODS: For 24 consecutive months, sand flies were captured inside the forest and in the border area near the communities. RESULTS: The following sand fly species were identified: Brumptomyia brumpti, Brumptomyia cunhai, Brumptomyia nitzulescui, Lutzomyia edwardsi, Lutzomyia pelloni, and Lutzomyia quinquefer. Other identified sand fly vectors, such as Lutzomyia intermedia (the predominant species), Lutzomyia migonei, Lutzomyia whitmani, Lutzomyia fischeri, and Lutzomyia hirsuta hirsuta, are associated with ACL transmission, and the vector for American visceral leishmaniases (AVL), Lutzomyia longipalpis, was also found. CONCLUSIONS: All sand fly vectors were found in both studied environments except for Lutzomyia whitmani, which was only identified in the forest. This study represents the first identification of Lutzomyia longipalpis in the CFMA, and the epidemiological implications are discussed. .

Caracterización clínica de la incontinencia urinaria y factores asociados en usuarias de la Unidad de la Mujer del Centro de Salud Familiar “Ultraestación” en la ciudad de Chillán, Chile / Prevalence and risk factors for urinary incontinence among women consulting in primary care

Background: It is important to determine the relative importance of urinary incontinence in terms of its prevalence and how it affects the quality of life of women. Aim: To characterize urinary incontinence and factors associated with it in women aged over 30 years. Material and Methods: A survey about urinary incontinence and associated factors was answered by 289 women aged 30 to 81 years, attending a public primary care clinic. Results: The prevalence of urinary incontinence was 62.2%, and it was significantly associated with obesity, diabetes and a history of episiotomy. Conclusions: The high prevalence of urinary incontinence should prompt the implementation of public health measures to prevent and treat it effectively.

Examen de detección de virus papiloma humano en el tamizaje de cáncer cervicouterino en un Servicio de Salud de Santiago, Chile / Human papillomavirus testing in cervical cancer screening at a public health service of Santiago, Chile

Background: Molecular techniques for human papillomavirus (HPV) detection have a good performance as screening tests and could be included in cervical cancer early detection programs. We conducted a population-based trial comparing HPV detection and Papanicolaou as primary screening tests, in a public health service in Santiago, Chile. Aim: To describe the experience of implementing this new molecular test and present the main results of the study. Material and Methods: Women aged 25 to 64 enrolled in three public health centers were invited to participate. In all women, samples were collected for Papanicolaou and HPV DNA testing, and naked-eye visual inspection of the cervix with acetic acid was performed. Women with any positive screening test were referred to the local area hospital for diagnostic confirmation with colposcopy and biopsy of suspicious lesions. Results: Screening results were obtained for 8265 women, of whom 931 (11.3%) were positive to any test. The prevalence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was 1.1%; nine women had invasive cervical cancer. Sensitivities for the detection of CIN2+ were 22.1% (95% confidence interval (CI) 16.4-29.2) for Papanicolaou and 92.7% (95% CI 84.4-96.8) for HPV testing; specificities were 98.9% (95% CI 98.7-99.0) and 92.0% (95% CI 91.4-92.6) respectively. Conclusion: This experience showed that the implementation of a molecular test for cervical cancer screening is not a major challenge in Chile: it was well accepted by both the health team and the participants, and it may improve the effectiveness of the screening program.

Influence of surgical technique in the peritoneal carcinomatosis surgical wound implant: experimental model in mice / Influência da técnica cirúrgica na implantação da carcinomatose peritoneal em ferida operatória: modelo experimental em camundongos

BACKGROUND: The number of malignancies increased alarmingly. Surgery constitutes one of the most efficient therapeutic modalities for the treatment of solid tumors. The neoplastic implant in surgical wound is a complication whose percentage of occurrence reported in the literature is variable, but sets with high morbidity and therapeutic difficulties. Protecting the wound is one of the recommended principles of oncologic surgery. AIM: To evaluate the influence of wound protection in the development of tumor implantation. METHODS: Sarcoma 180 tumor cells were used, with intraperitoneal inoculation in Swiss mice. After the establishment of neoplastic ascites, animals were randomized into two groups of 10, each group consisting of five males and five females. In both groups, laparotomy and manipulation of intra-abdominal organs was performed. In a group laparotomy was performed using the protection of the abdominal wound and the other group without it. On the 9th postoperative day macroscopic evaluation of the operative scar was performed, which was later removed for microscopic evaluation. RESULTS: There was microscopic infiltration of tumor cells in the wound of all animals. However, the group that held the protection, infiltration was less intense when compared to the group without it. The infiltration was also more severe in females than in males of the same group. CONCLUSION: Tumor infiltration into the wound was more intense in the group in which the protection of the surgical site was not performed, and in females when compared to males of the same group. .

RACIONAL: O número de neoplasias vem aumentando de maneira preocupante. O tratamento cirúrgico constitui-se em uma das modalidades terapêuticas mais eficientes para os tumores sólidos. O implante neoplásico em ferida operatória é complicação cujo percentual de ocorrência relatado na literatura é variável, porém configura alta morbidade e grande dificuldade terapêutica. A proteção da ferida operatória é um dos princípios de cirurgia oncológica recomendados, entretanto pouco estudado. OBJETIVO: Avaliar a influência da proteção de ferida operatória no desenvolvimento de implante tumoral na ferida operatória. MÉTODOS: Foram utilizadas linhagens de células tumorais do Sarcoma 180, com inoculação intraperitoneal em camundongos Swiss. Após o estabelecimento da ascite neoplásica, os animais foram randomizados em dois grupos de 10, cada grupo composto por cinco machos e cinco fêmeas. Nos dois grupos foi realizada laparotomia e manipulação de órgãos intra-abdominais. Em um grupo a laparotomia foi realizada utilizando a proteção da ferida abdominal e no outro grupo sem proteção. No 9º dia pós-operatório foi realizada avaliação macroscópica da cicatriz operatória, sendo esta removida posteriormente para avaliação microscópica. RESULTADOS: Houve infiltração microscópica de células tumorais na ferida operatória em todos animais. Porém, no grupo em que se realizou a proteção da ferida a infiltração foi menos intensa quando comparado ao grupo sem proteção. A infiltração também foi mais intensa nas fêmeas do que nos machos do mesmo grupo. CONCLUSÃO: A infiltração tumoral na ferida operatória foi mais intensa no grupo em que não foi realizada a proteção da ferida operatória e nas fêmeas quando comparadas aos machos do mesmo grupo. .

A biosketch of William Richard Gowers with a new review of his inpatient case history notes / Resumo biográfico de William Richard Gowers com uma nova revisão das notas de pacientes hospitalizados

William Richard Gowers (1845–1915) spent his career working at the National Hospital for the Relief and Cure for the Paralyzed and Epileptic at Queen Square, in London, United Kingdom, and at the nearby University College Hospital. His “Manual of the Diseases of the Nervous System” and many published lectures were based almost entirely on his own clinical observations meticulously recorded in shorthand. In this paper, we have focused on an analysis of his inpatient case records from 1878 to 1911 preserved in the archives at the National Hospital for Neurology and Neurosurgery, Queen Square. We reviewed all 42 volumes and analyzed 2,478 patients. Between 1897 and 1909, a mean of 129.7 cases per year were admitted to the hospital under Gowers' care. We grouped the diagnoses in 12 different categories. Epilepsy (16.5%), followed by spinal cord diseases (10.3%), cerebrovascular diseases (9.5%), and functional disorders (7.9%) were the most common diagnoses.

William Richard Gowers (1845–1915) passou sua vida profissional trabalhando no National Hospital for the Relief and Cure for the Paralyzed and Epileptic e no University College Hospital na Queen Square, em Londres, Reino Unido. Seu livro Manual of the Diseases of the Nervous System, assim como suas várias aulas publicadas foram baseadas quase inteiramente em suas próprias observações clínicas, anotadas meticulosamente em estenografia. Neste artigo, o objetivo foi a análise das notas de casos clínicos de pacientes hospitalizados entre 1878 e 1911 armazenadas nos arquivos do National Hospital for Neurology and Neurosurgery, na Queen Square. Foram revisados 42 volumes e analisados 2.478 pacientes. Entre 1897 e 1909, uma média de 129,7 casos foram admitidos ao ano no hospital sob supervisão de Gowers. Os diagnósticos foram agrupados em 12 categorias diferentes. Epilepsia (16,5%), seguida de doenças da medula espinhal (12,7%), doenças cerebrovasculares (9,5%) e transtornos funcionais (7,9%) foram os diagnósticos mais encontrados nas notas dos casos clínicos.

Henry Mayhew: jornalista, investigador social e precursor da pesquisa qualitativa / Henry Mayhew: journalist, social investigator, and foreshadower of qualitative research

Henry Mayhew serviu-se de sua profissão, o jornalismo, para registrar o dia a dia da Londres da segunda metade do século XIX de uma forma que até hoje interessa historiadores e cientistas sociais, como obra precursora da pesquisa qualitativa. Este artigo destaca aspectos metodológicos das investigações de Mayhew e analisa dois de seus relatos: sobre o surto de cólera e sobre uma vendedora de rua. Aborda também trabalhos críticos que tomam sua obra como referência.

As a journalist, Henry Mayhew recorded daily life in London in the latter half of the nineteenth century. His approach remains of interest to historians and social scientists today in that it foreshadowed qualitative research. The article highlights methodological aspects of Mayhew's investigations and analyzes two of his reports, one on a cholera outbreak and the other on a female street vendor. It also addresses some analyses that have critiqued his work.

John Snow, la epidemia de cólera y el nacimiento de la epidemiología moderna / John Snow, the cholera epidemic and the foundation of modern epidemiology

John Snow (1813-1858) fue un brillante médico inglés. Desde temprana edad destacó por su agudo sentido de observación, razonamiento lógico y perseverancia, primero en el ámbito de la anestesia y posteriormente en epidemiología. Los sucesivos brotes de cólera que afectaron a la ciudad de Londres, lo motivaron a estudiar esta enfermedad desde un punto de vista poblacional, relacionando la incidencia de casos al consumo de aguas contaminadas por una "materia mórbida", responsable de la diarrea aguda con deshidratación que la caracteriza. En forma valerosa, Snow se opuso a las teorías vigentes de su época, sacrificando su prestigio. Fue pionero en el uso de metodologías de investigación epidemiológica moderna, por ejemplo, la implementación de encuestas y la epidemiología espacial. Con justa razón, hoy en día es considerado por la comunidad científica como el padre de la epidemiología moderna.

John Snow (1813-1858) was a brilliant British physician. Since young he stood out for his acute observation capacity, logical thinking and perseverance, first in anesthetics and later in epidemiology. The successive outbreaks of cholera that affected London, motivated him to study this disease from a populational point of view. He related the appearance of cases to the consumption of "morbid matter", responsible for the acute diarrhea with dehydration that characterizes this disease. Bravely, Snow opposed to certain theories present at his time, sacrificing his own prestige. He was a pioneer in the use of modern epidemiological investigation methodologies such as conducting surveys and spatial epidemiology. Fairly, he is considered nowadays as father of modern epidemiology by the scientific community.