Marcelino Weiss y Gramatges, su legado en la formación de los estomatólogos de Sancti Spíritus / Marcelino Weiss y Gramatges, his legacy in the training of stomatologists in Sancti Spíritus

RESUMEN Fundamento: Marcelino Weiss fue un reconocido estomatólogo que luchó para que el dentista fuera un médico especializado. Objetivo: Describir la vida personal y profesional de Marcelino Weiss y Gramatges y su legado a la estomatología de Sancti Spíritus. Metodología: Se realizó un estudio relacionado con la historia en ciencias de la salud, sobre la vida de Marcelino Weiss y Gramatges desde su nacimiento en Sancti Spíritus 1877 hasta su fallecimiento en La Habana en 1927, para lo cual se confeccionó una estrategia de búsqueda de la información, se consultaron bases de datos disponibles en el portal de Infomed. Se emplearon métodos del nivel teórico y métodos empíricos. Conclusiones: La vida y obra del Dr. Marcelino Weiss y Gramatges constituye un paradigma a seguir para las actuales y futuras generaciones de profesionales de la estomatología espirituana. Por sus valores, destacada labor patriótica, notable trayectoria asistencial, docente e investigativa, logró el reconocimiento y la admiración de todos.

ABSTRACT Background: Marcelino Weiss was a renowned stomatologist who fought for the dentist to be a specialized physician. Objective: To describe the personal and professional life of Marcelino Weiss y Gramatges and his legacy to stomatology in Sancti Spíritus. Methodology: A study related to the history of health sciences was conducted on Marcelino´s Weiss y Gramatges life from his birth in Sancti Spíritus in 1877 to his death in Havana in 1927, for that, an information search strategy was prepared, some databases available on the Infomed site were consulted. Theoretical and empirical methods were used. Conclusions: The life and work of Dr. Marcelino Weiss y Gramatges is a paradigm to be followed by current and future generations from Sancti Spíritus dental professionals. For his values, outstanding patriotic work, and remarkable care, teaching and research career, he achieved total recognition and admiration.

Homenaje al profesor José María Segovia de Arana. Un referente en la historia de la educación médica / Tribute to Professor José María Segovia de Arana. A point of reference in the history of medical education

El profesor José María Segovia de Arana falleció en Madrid el día 4 de enero de 2016 a la edad de 96 años. Su figura es fundamental para poder entender el nivel alcanzado por la sanidad pública de nuestro país. Todas sus decisiones sirvieron para dar un salto exponencial en la calidad asistencial e investigadora de nuestros hospitales y centros de salud, así como de la educación médica en particular

Professor José María Segovia de Arana died in Madrid on 4th January 2016 at the age of 96 years. His professional career was fundamental in allowing the public health system to reach its current level in Spain. All his decisions served to provide an exponential leap in the quality of patient care and research in our hospitals and health care centers and especially with respect to medical education

Management by missions in the healthcare sector / La dirección por misiones en el sector sanitario

This article discusses the importance of the mission statement in the healthcare sector. It's also argued that only formal declaration of the mission it's insufficient to the appropriate professional coordination of doctors, nurses and managers. It's proposed a systematic approach to facilitate the introduction of the mission within the systems of the organization, what is called «Management by missions.» It promotes horizontal and vertical integration between doctors, nurses and managers. Criteria that ensure this integration are specified (AU)

En este artículo se aborda la importancia de la declaración de la misión en instituciones del sector sanitario; también se constata la insuficiencia de esta declaración formal para la adecuada coordinación profesional de médicos, enfermeros y gestores. Se propone un abordaje sistemático que facilite la introducción de la misión en los sistemas de la organización, lo que se denomina «Dirección por misiones». Se explicita como esto promueve la integración horizontal y vertical entre médicos, enfermeros y gestores. Se especifican los criterios que garantizan esa integración (AU)

La «desinversión en lo inefectivo» suena bien; ¿alguien se animará a bailar? / Disinvestment in ineffective care sounds fine; does anyone eventually dance?

No disponible

Diego Alcorta y la difusión de saberes médicos en Buenos Aires, 1821-1842 / Diego Alcorta and diffusion of medical knowledge in Buenos Aires, 1821-1842

Este artículo tiene como objetivo analizar los saberes médicos que impulsa el doctor Diego Alcorta derivados de la tradición francesa, en particular los provenientes de la corriente denominada Ideólogie, en el contexto de la Universidad de Buenos Aires entre 1821-1842. Se analiza el proceso de circulación de dichas enseñanzas sumadas a las de la Escuela de Montpellier adaptadas y situadas en el plano local y su paulatino impacto en el ámbito académico, constituyendo un fenómeno relevante en la incipiente conformación de la profesión médica porteña. Alcorta retoma, en especial, la importancia de la observación como método de diagnóstico y curación en el tratamiento de las enfermedades y, la inauguración, en la enseñanza e investigación médicas, de una orientación empírica que introdujo una actividad práctica específica: la clínica hospitalaria. Asimismo, se examina la transmisión de un lenguaje fisiológico y su alcance en las generaciones posteriores preguntándonos qué ocurrió con estos procedimientos prácticos y la difusión de los nuevos saberes fisiológicos. Para responder a esta pregunta compleja se analizan las tesis presentadas y defendidas en el Departamento de Medicina de la Universidad de Buenos Aires durante la época, las que permiten tanto confirmar la presencia del lenguaje sensualista y fisiológico de las enseñanzasde Alcorta como su impacto dentro del mismo ejercicio de la medicina (AU)

The aim of this article is to analyse the medical knowledge that Dr Diego Alcorta derived from the French tradition, especially from the Idéologie movement, in the context of the University of Buenos Aires between 1821 and 1842. It analyses the circulation of these teachings alongside those of the Montpellier School, which were adapted and located at the local level, and their gradual impact on academia as an important phenomenon in the incipient formation of the medical profession in Buenos Aires. Alcorta emphasised the importance of observation as a diagnostic and therapeutic method and called for an empirical approach to medical teaching and research, which introduced a specific practical activity, i.e., hospital clinical work. This article also examines the transmission of a physiological «language» and its relevance to subsequent generations, asking what happened to these practical procedures and the dissemination of new physiological knowledge. This complex question is addressed by discussing the PhD theses developed in the Department of Medicine of the University of Buenos Aires during this period, which provide confirmation of the presence of the sensualist and physiological language derived from the teachings of Alcorta and its impact on the practice of medicine

Registro de actividad de la Sociedad Española de Angiología y Cirugía Vascular, año 2006 / Activity registry of the Spanish Society of Angiology and Vascular Surgery, year 2006

Objetivo. Se trata de describir la actividad asistencial, correspondiente al año 2006, de los servicios/unidades deangiología y cirugía vascular en España. Pacientes y métodos. Es un estudio transversal. Se registraron los procedimientosquirúrgicos y endovasculares que se realizaron en el año 2006 en 70 servicios/unidades de Angiología y Cirugía Vascularque aceptaron voluntariamente la participación en el registro. El instrumento de recogida de información fue un cuestionarioespecífico, Registro Vascular (RV), utilizado por la Sociedad Española de Angiología y Cirugía Vascular en los últimos años(2000-2006). Se realizó un análisis descriptivo y se comparó el volumen de la actividad de los centros acreditados para ladocencia con el de los centros no docentes. Resultados. El RV fue cumplimentado por 70 servicios/unidades, 34 de los cualesposeen acreditación para la docencia. Se produjeron un total de 49.075 ingresos hospitalarios, 18.377 (37,5%) urgentes y30.698 (62,5%) programados, con una estancia media global de 8,2 días. En la lista de espera, a fecha 31 de diciembre de2006 existía un predominio de pacientes con patología venosa (n = 7.629), frente a un menor número de casos con patologíaarterial (1.612). El detalle de la actividad quirúrgica en cirugía arterial directa comprende 2.248 procesos practicados en lostroncos supraaórticos, 969 en miembros superiores (MMSS), 135 en la aorta torácica, 3.423 en el sector aortoilíaco anatómico(de los que 1.225 fueron por aneurismo aórtico abdominal electivo y 462 por aneurismo aórtico abdominal urgente), 1.296vía extraanatómica, 128 en los troncos viscerales digestivos, 77 en arterias renales, 2.805 en sector femoropoplíteo y 1.362en sector femorodistal de los miembros inferiores (MMII). La cirugía venosa tuvo un alto predominio de varices, con 18.272procedimientos realizados. De los procedimientos endovasculares, 687 correspondieron a troncos supraaórticos, 282 aMMSS, 946 a aneurismas de la aorta (torácica 158 y abdominal 788) y 3.749 a arterias de MMII. Los procedimientosendovasculares venosos incluyendo embolizaciones de las venas pelvianas y 320 fueron fibrinólisis venosas. El número totalde exploraciones del laboratorio vascular ascendió a 19.081. El volumen de actuaciones, tanto quirúrgicas como endovasculareso del laboratorio vascular de exploraciones no invasivas, es significativamente más elevado en los centros docentesque en los no docentes. La lista de espera arterial se ha incrementado en los centros no docentes y la lista de espera venosaha descendido en ambos tipos de centros. Conclusión. La participación de los centros sigue siendo insuficiente. Según los datosobtenidos, la actividad quirúrgica media se ha incrementado en relación a 2005 (especialmente la endovascular), y laactividad de los centros docentes es superior a la de los no docentes. La lista de espera venosa ha disminuido en 2006 enrelación con 2005, no así la arterial, que ha aumentado en los centros no docentes

Aim. To describe the health care activities carried out by Angiology and Vascular Surgery Services/Units inSpain during 2006. Patients and methods. Cross-sectional study. The surgical and endovascular procedures carried outin 2006 were recorded in the 70 Angiology and Vascular Surgery Services/Units that voluntarily agreed to participate inthe registry. The data collection instrument was a specific questionnaire, the Vascular Register (RV), used by the SpanishSociety of Angiology and Vascular Surgery in recent years (2000-2006). A descriptive analysis was made, and centers withteaching accreditation were compared with non-teaching centers with regard to volume of activity. Results. The RV wascompleted by 70 Services/Units, 34 of which have teaching accreditation. There were a total of 49,075 hospital admissions,of which 18,377 (37.5%) were for emergencies and 30,698 (62.5%) were for programmed admissions, with an overall meanstay of 8.2 days. As of 31.12.2006, most of the patients on the waiting list had venous pathologies (n = 7,629) while a smallernumber had arterial pathologies (1,612). Direct arterial surgical activity consisted of 2,248 interventions in the supraaortictrunk, 969 in upper limbs, 135 in the thoracic aorta, 3,423 in the anatomic aorto-iliac segment (of which 1,225 werefor elective abdominal aortic aneurysms and 462 for emergency abdominal aortic aneurysms), and 1,296 interventionsinvolving an extra-anatomic route, 128 in digestive tract arteries, 77 in renal arteries, 2,805 in the femoral-poplitealsegment and 1,362 in the femoral-distal segment of the lower limbs. The most frequently performed intervention in venoussurgery was for varicose veins, with 18,272 procedures. Of the endovascular procedures, 687 involved the supra-aortictrunk, 282 the upper limbs, 946 were for aortic aneurysms (158 thoracic and 788 abdominal), and 3,749 for lower limbarteries. A total of 320 venous endovascular procedures were performed, including pelvic vein embolization and venousfibrinolysis. In all, 19,081 examinations were carried out in the vascular laboratory. The volume of activity, including bothsurgical and endovascular interventions and non invasive vascular laboratory examinations, was significantly higher inteaching centers than in non-teaching centers. The waiting list for arterial surgery has increased in non-teaching centers,and the waiting list for venous surgery has been reduced in both types of centers. Conclusion. The number of participatingcenters is still not sufficient. According to the data obtained, mean surgical activity has increased compared to 2005(especially endovascular surgery), with teaching centers performing more interventions than non-teaching ones. Thewaiting list for venous surgery was shorter in 2006 than in 2005, in contrast to the waiting list for arterial surgery, whichhas increased in non-teaching centers

Ações do processo de integração docente-assistencial entre um curso de graduação em enfermagem e um hospital de ensino / Actions of the process of integration academic knowledge and clinical skillsbetween an undergraduate nursing program and a university hospital

O objetivo deste estudo foi indicar as ações do processo de integração docente-assistencial (IDA) desenvol-vidas entre um Curso de Graduação em Enfermagem e um Hospital de Ensino. Como método, utilizou-se aanálise documental. Assim, para entender, por intermédio de documentos o processo de IDA ocorrido, foinecessário analisar retrospectivamente, registros escritos em documentos legais, atas de reuniões, ofícios,portarias e outros dispositivos legais existentes nas duas instituições, que diziam respeito ao assunto. Paraindicar as ações do processo de IDA entre um Curso de Graduação em Enfermagem e um Hospital de Ensinofoi importante, além de considerar as características organizacionais das duas instituições, conhecer as expe-riências de IDA que ocorreram, numa retrospectiva histórica, no período de 1992 a 2001. Deste modo, com afinalidade de favorecer uma visão mais objetiva dessa relação de articulação/integração/parceria, na busca datransformação da prática de ambas as instituições, optou-se por apresentar o histórico/cronológico daspropostas e ações de IDA até então desenvolvidas. De forma geral, os enfermeiros docentes que atuavam nocurso foram divididos para que assumissem e desenvolvessem, além das atividades didático-pedagógicas dagraduação, também atividades paralelas como: ministrar aulas no curso de auxiliar de enfermagem, implantar oNúcleo de Educação Continuada, atuar junto a comissões de qualidade, grupo de curativo, vigilância epide-miológica, em parceria com enfermeiros e outros profissionais, além de assumir a chefia do serviço de enferma-gem do hospital. A análise dos documentos legais das duas instituições e os dados históricos de integraçãodocente assistencial permitiu várias reflexões e questionamentos, nas quais foram demonstradas que asatividades desenvolvidas, no contexto da IDA, revelam aspectos da inserção e participação dos docentes emdiversos programas hospitalares na busca de melhoria da qualidade da assistência de enfermagem deste...

Organització social i atenció médica a la cocentaina baixmedieval: el procés a Abraham Abengahell (1318) / No disponible

En las cortes judiciales fronterizas del sur del reino de Valencia se hizo tangible una peculiar 'convivencia' entre prácticos sanitarios cristianos y judíos, atendiendo pacientes, hombres y mujeres, de ambas religiones, dentro de un mismo espacio de ejercicio profesional donde se desarrolla rápidamente el nuevo sistema basado en la medicina universitaria

In the bordering judicial courts of the valencian Kingdom could be seen a characteristic fellowship between christian and jewish sanitary practitioners, who attended patients, men and women, that belonged to both religions, in the same professional practice where a new system based on the academic medicine was being developed

Relaçäo ensino/serviços: dez anos de integraçäo docente assistencial (IDA) no Brasil / Teaching/services relationship: ten years of teaching care integration in Brazil

Tem por objetivos: 1. resgatar a história das experiências de Integraçäo Docente Assistencial no Brasil, ressaltando os princípios centrais que nortearam seu desenvolvimento e as particularidades que foram assumindo os projetos; 2. Analisar a legislaçäo que incentivou as experiências e deu-lhes suporte, no que diz respeito tanto à formaçäo de profissionais quanto à política de saúde e, em especial, às normas referentes à integraçäo entre ensino e assistência; 3. Analisar as possibilidades e condiçöes de institucionalizaçäo das experiências de IDA tanto nas escolas quanto nos serviços de saúde; 4. Analisar o papel e a influência da criaçäo da Rede IDA e das Sub-Redes no desenvolvimento das experiências, bem como as expectativas dos responsáveis pelas experiências em curso com respeito à Rede

New concepts of hospitalization of hanseniasis patients and their proctical application in Sao Paulo, Brazil

Five large specialized "asilo-colônias" were founded in the early thirties in São Paulo with two main objectives - asylum for the physically and/or socially handicapped "lepers", and compulsory isolation for infectious patients. The former degenerated by abuse and institutionalism; the second failed in its purpose of control, and kept the social atmosphere tense. With their resources jammed, these establishments were not able to offer a resonable degree of confort and medico-social assistance to their increasting number of inmates. About 1/3 of the 5000 hanseniasis patients have benn transferred to dispensaries in 1967, and one of the "colonias" was converted into a psychiatric institution. Applications for asylum care are now carefully scrutinized by social workers, and prophylatic isolation is infrequent. Physical rehabilitation, intercurrent illness and scientific research are now the chief reasons for hospitalization, and facilities for such purposes are increasing. the establishments were renamed "Hospitais de Dermatologia Sanitária", after having been dissociated from the extinct "Leprosy Department" and integrated with other public health hospitals. they are frequented by medical students in their curricular activities, and are often the site of dermatological metings and extra-curricular courses. In one of the hospitals, an infirmary is receiving various dermatological cases. The image of the old dreadfull "asilo-colônias" is fading slowly but steadily.