Origen y evolución del control de salud / Origin and evolution of periodic health check-ups

Los controles periódicos de salud son aquellos cuidados médicos realizados a intervalos regulares, motivados por la necesidad de evaluar la salud en general y prevenir enfermedades a futuro. Se presume que comenzaron a ponerse en práctica durante el siglo XIX para la detección precoz de la tuberculosis y otras enfermedades contagiosas. A principios del siglo XX fueron difundidos los programas de examinación médica en el contexto de la estimación del riesgo de enfermedad y/o muerte previo a la contratación de seguros de vida. El desarrollo tecnológico posterior a la Segunda Guerra mundial fomentó el interés en estas examinaciones periódicas con la implementación de pruebas masivas de rastreo, lo que aumentó de manera considerable de la mano de los servicios de medicina prepaga. En los últimos años se han realizado múltiples esfuerzos por cuantificar los beneficios de estos controles. Si bien existen diversas opiniones respecto a su utilidad, pareciera ser que el enfoque actual del control periódico de salud implica tener en cuenta las necesidades de las personas, el riesgo individual y la relación médico-paciente como eje de la discusión. (AU)

Periodic health check-ups are medical care performed at regular intervals, motivated by the need to assess general health and prevent future diseases. It is presumed that they began to be implemented in the 19thcentury for the early detection of tuberculosis and other contagious diseases, and later spread in the early 20thcentury in the context of estimating the risk of illness and/or death prior to taking out life insurance. The technological development after the World War II encouraged interest in these periodic examinations with the implementation of mass screening tests, which increased considerably with the introductionof prepaid medical services. In recent years, multiple efforts have been made to quantify the benefits of such controls. While there are varying opinionsas to their usefulness, it appears that the current approach to periodic health check-ups is to take into account the needs of individuals, their individual risk, and the doctor-patient relationship at the core of the discussion. (AU)

GLOBAL ENDOCRINOLOGY: Global perspectives in endocrinology: coverage of iodized salt programs and iodine status in 2020.

Iodine deficiency has multiple adverse effects on growth and development. Diets in many countries cannot provide adequate iodine without iodine fortification of salt. In 2020, 124 countries have legislation for mandatory salt iodization and 21 have legislation allowing voluntary iodization. As a result, 88% of the global population uses iodized salt. For population surveys, the urinary iodine concentration (UIC) should be measured and expressed as the median, in µg/L. The quality of available survey data is high: UIC surveys have been done in 152 out of 194 countries in the past 15 years; in 132 countries, the studies were nationally representative. The number of countries with adequate iodine intake has nearly doubled from 67 in 2003 to 118 in 2020. However, 21 countries remain deficient, while 13 countries have excessive intakes, either due to excess groundwater iodine, or over-iodized salt. Iodine programs are reaching the poorest of the poor: of the 15 poorest countries in the world, 10 are iodine sufficient and only 3 (Burundi, Mozambique and Madagascar) remain mild-to-moderately deficient. Nigeria and India have unstable food systems and millions of malnourished children, but both are iodine-sufficient and population coverage with iodized salt is a remarkable 93% in both. Once entrenched, iodine programs are often surprisingly durable even during national crises, for example, war-torn Afghanistan and Yemen are iodine-sufficient. However, the equity of iodized salt programs within countries remains an important issue. In summary, continued support of iodine programs is needed to sustain these remarkable global achievements, and to reach the remaining iodine-deficient countries.

La poliomielitis en la prensa española (1960-1975) / Poliomyelitis in the Spanish press (1960-1975)

OBJETIVO: La vacunación ha sido una de las medidas preventivas más eficaces para disminuir el número de enfermedades que afectan a los seres humanos. El objetivo primordial de este estudio fue describir el tratamiento informativo de la poliomielitis en la prensa escrita de una época donde tuvo gran importancia. MÉTODOS: A partir de la hemeroteca digital de los periódicos ABC y La Vanguardia se seleccionaron todas las informaciones en las que apareciera el concepto "poliomielitis", publicadas durante el periodo de tiempo comprendido entre 1960 y 1975. RESULTADOS: En total hubo 961 unidades de análisis, 557 para el periódico ABC y 404 para La Vanguardia. El año con más publicaciones fue 1963, coincidiendo con la autorización para la utilización de la vacuna Sabin. Se destaca la necesidad de intensificar las campañas de vacunación, ya que el número de casos anuales seguía aumentando. CONCLUSIONES: No existen diferencias significativas en las coberturas del periódico ABC y la de La Vanguardia, siguiendo un patrón de publicación muy parecido entre ellos, en donde la vacuna Sabin aparece como uno de los avances científicos más importantes. Gracias a ella se pudo proteger a los niños y niñas frente a esta temida enfermedad, evitando así una epidemia mayor

OBJECTIVE: Vaccination has been one of the most effective preventive measures to reduce the number of diseases that affect humans. The primary objective of this study is to describe the informative treatment of polio in the written press at a time when it was of great importance. METHODS: From the digital newspaper archive of the ABC and La Vanguardia newspapers, all the information in which the concept "polio", published during the period between 1960 and 1975 was selected. RESULTS: In total there have been 961 units of analysis, 557 for the ABC newspaper and 404, for La Vanguardia. The year of greatest publication was the year 1963, coinciding with the authorization for the use of the Sabin vaccine. The need to intensify vaccination campaigns is highlighted as the number of annual cases continued to increase. CONCLUSIONS: There are no significant differences in the coverage of the newspaper ABC and La Vanguardia, following a pattern of publication very similar between them, where the Sabin vaccine appears as one of the most important scientific advances, thanks to which they allowed to protect children against to this dreaded disease, thus avoiding a major epidemic

Firm-Led Malaria Prevention in the United States, 1910-1920.

In the absence of capable government services, a railroad company in Texas and multiple cotton mills in North Carolina successfully prevented malaria in the early twentieth century. This Article looks through the lens of economics to understand how and why people had the incentive to privately coordinate malaria prevention during this time, but not after. These firms, motivated by increases in productivity and profit, implemented extensive anti-malaria programs and used their hierarchical organizational structures to monitor performance. The factors underlying the decline of private prevention include a fall in the overall rate of malaria, the increasing presence of the federal government, and technological innovations that lowered exposure to mosquitoes. Understanding how, why, and when firms can prevent diseases has important implications for current disease policy, especially where governments, international organizations, and technologies are not enough.

The Historical Perspective of Athletic Sudden Death.

Since antiquity, the athlete has been elevated to a heroic status both within small communities and at the international level. Although numerous population studies have estimated athletic sudden death to be a rare event, the consequences resonate far beyond those directly affected. Sports cardiology has evolved as a result of these tragedies, which highlighted a need for safer play and more programmatic protection of the athlete in play. In this article, athletic sudden death is analyzed from a historical and literary perspective and the development of modern initiatives to protect athletes from sudden death is reviewed.

The implantable cardioverter-defibrillator: An update.

The implantable cardioverter-defibrillator (ICD) provides life-saving therapy to prevent sudden cardiac death. ICDs have been implanted in millions of patients worldwide since the first human implant in 1980. Clinical trials have helped establish guidelines for ICD implantation in primary and secondary prevention of sudden cardiac death. Recent trials have also tested and compared various programing strategies to avoid unnecessary shocks and improve survival among ICD recipients. ICDs may also assist with monitoring for heart failure management. In this review, we discuss the clinical science to date that has helped define the role of ICDs in current practice.

A new medical research model: ethically and responsibly advancing health for humans and animals.

With the increasing use of genomics, computational analytics, emerging technologies, and personalized medicine, the possibility of a new research model is emerging. Using the clues from thousands of species living on our planet, scientists from many disciplines (medicine, veterinary medicine, wildlife) must collaborate, prioritize, and strategize on how to address causes of health and disease. Such clues should guide disease prevention, as well as the development of innovative, efficacious, and gentler therapies. Geographic and language barriers must be broken down, and scientists--even within a single academic, corporate, or government research site--must be vigilant in seeking the help of nonmedical disciplines of colleagues from whence answers might come. The public will become more interested in and demanding of such a model, desiring that all family members (humans and animals) have an opportunity for a long and healthy life. Above all, such activities will be humanely conducted with outcomes having the greatest chance for success.

"When pirates feast who pays?" condoms, advertising, and the visibility paradox, 1920s and 1930s.

For most of the 20th century, the condom in the United States was a cheap, useful, but largely unmentionable product. Federal and state statutes prohibited the advertising and open display of condoms, their distribution by mail and across state lines, and their sale for the purpose of birth control; in some states, even owning or using condoms was illegal. By the end of World War I, condoms were increasingly acceptable for the prevention of sexually transmitted disease, but their unique dual function--for disease prevention and contraception--created ongoing ambiguities for sellers, consumers, and distributors as well as for legal, political, health, and moral leaders. Not until the 1970s did condoms emerge from the shadows and join other personal hygiene products on open drugstore and supermarket shelves and in national advertisements. Then came the 1980s and AIDS when, despite the rise of Ronald Reagan, the radical right's demonization of condoms, and the initial reluctance of condom merchants to market to gay constituencies, the HIV/AIDS epidemic slowly but inexorably propelled the condom to the top of the prevention agenda. The condom's journey from lewd device to global superstar was fitful, but colorful. The Comstock Act of 1873, prohibiting birth control information and devices, created a vast underground operation--periodically illuminated, however, by arrests, protests, legal proceedings, and media coverage. This essay chronicles one such moment of illumination: the legal battle in the 1920s and 1930s over the legitimacy and legality of the Trojan Brand condom trademark and the unusual series of advertisements produced by the Youngs Rubber Corporation, makers of Trojans, to dramatize the ethical and economic issues of the trademark battle. Culminating in Youngs Rubber Corporation v. C.I. Lee & Co., Inc. (45 F, U.S. Court of Appeals for the Second Circuit 103 [1930]), this landmark case in trademark law established the right of the Trojan Brand condom, despite its ambiguous dual function, to the protection of a federal trademark. I seek to show how the Youngs antipiracy ad series illuminates the paradox of visibility by illuminating the paradox of any binary division: to establish the one depends inevitably on invoking or making visible--even if to suppress--the other. This essay is a case study in the negotiation of such a dialectic.

Clinical use of aspirin in ischemic heart disease: past, present and future.

Aspirin is an antiplatelet drug, inhibiting the cyclooxygenase activity of platelet prostaglandin H synthase-1 and almost complete suppressing platelet capacity to generate the prothrombotic and proatherogenic thromboxane A2. Antiplatelet therapy with aspirin reduces the risk of serious vascular events by about a quarter in patients who are at high risk because they already have occlusive vascular disease. However, the inhibition of thromboxane-dependent platelet function by aspirin is effective for the prevention of thrombosis, but is also associated with excess bleeding, although the absolute increase in major gastrointestinal or other major extracranial bleeds is an order of magnitude smaller. For secondary prevention of vascular events, the benefits of aspirin therapy substantially exceed the risks. Therefore, aspirin is a cornerstone of antithrombotic therapy in acute coronary syndromes, in chronic ischemic heart disease and in percutaneous coronary intervention. On the other hand, the role of aspirin in primary prevention remains uncertain and it is still debated, because the absolute risk of vascular complications is the major determinant of the absolute benefit of antiplatelet prophylaxis and the reduction in vascular events needs to be weighed against any increase in major bleeds. Future data from ongoing studies will help us to identify people at high vascular risk who take advantage from aspirin therapy for primary prevention or will indicate if specific category of high risk patients, like patients with diabetes, could be better protected from an increase in the frequency of aspirin administration.

Environmental justice and primary prevention of cancer: the odyssey and legacy of lorenzo tomatis.

Lorenzo Tomatis [1929-2007] devoted his private and professional life to the betterment of mankind. As a physician, scientist, and humanitarian he championed against the plight of social injustice and promoted the obvious benefits of primary prevention of diseases compared to treatments that prevent or delay disease progression, especially occupational cancers. An avowed student and scholar of literature, the arts, the history of medicine and science, and chemical carcinogenesis, he believed in and wrote about these issues throughout his storied life. Some of his achievements, with excerpts from his writings, especially on primary prevention and on social injustice, are highlighted herein.