Extracorporeal Photopheresis for Treatment of Acute and Chronic Graft Versus Host Disease: An Italian Multicentric Retrospective Analysis on 94 Patients on Behalf of the Gruppo Italiano Trapianto di Midollo Osseo.

BACKGROUND: Extracorporeal photopheresis (ECP) is considered a valid second-line treatment for acute and chronic graft versus host disease (GVHD). METHODS: Ninety-four patients with acute GVHD (aGVHD) (n = 45) and chronic GVHD (cGVHD) (n = 49), retrospectively recruited in 6 Italian centers, were submitted to ECP for second-line treatment. At the time of ECP, 22 (49%) and 23 (51%) of 45 patients with aGHVD were nonresponsive and in partial remission (PR) after steroids, respectively, and all the 49 patients with cGVHD were steroid refractory. RESULTS: Forty-one (91%) of 45 patients with aGVHD achieved complete remission (CR) after ECP. Fifteen (33%) of 45 patients developed cGVHD. The CR rate in patients who started ECP being nonresponsive and in PR after steroid was 86% and 96%, respectively. After a median follow-up of 20 months (range, 2-72), 15 (33%) of 45 patients developed cGHVD and 16 (35%) of 45 patients died, in 3 cases for aGVHD. A trend for a better survival was seen among patients who started ECP in PR after steroid (80% vs 50% at 2 years; P = 0.07). Overall, 22 (45%) of 49 patients and 17 (35%) of 49 patients with steroid refractory cGHVD achieved CR and PR after ECP, respectively. After a median follow-up of 27 months, 44 (90%) of 49 patients are alive, 21 of whom (48%) are on steroid. CONCLUSIONS: Extracorporeal photopheresis is confirmed as an effective second-line treatment in both aGVHD and cGVHD, because it can induce a response in more than 80% of the patients and a long-term survival in at least 50% of the cases.

Validación y verificación analítica de los métodos microbiológicos / Validation and verfication of microbiology methods

Los microbiólogos clínicos deben asegurar, al máximo nivel permitido por el desarrollo científico y técnico, la fiabilidad de los resultados. Esto implica que, además de reunir los criterios técnicos que aseguren su validez, deben ser realizados con una serie de garantías, que permitan obtener resultados comparables, con independencia del laboratorio que los ejecute. En este sentido, el empleo de métodos de referencia, reconocidos y aceptados, es la herramienta más eficaz para obtener estas garantías. Las actividades relacionadas con la verificación y validación de métodos analíticos ha cobrado gran importancia, debido por un lado al continuo desarrollo y actualización de técnicas y equipos analíticos cada vez más complejos, y por otro lado, al interés de los profesionales en garantizar la calidad de sus procesos y resultados. Se describen las definiciones de validación y verificación, las diferentes modalidades de validación/verificación, así como los tipos de métodos y el nivel de validación necesario según sea el grado de normalización. Se comentan las situaciones en las que es obligatoria y/o recomendable la validación/verificación, así como las particularidades que la validación tiene en microbiología. Se incide en la importancia de potenciar el uso de las cepas de referencia como control en microbiología y del uso de controles normalizados, así como en la importancia de la participación en programas de evaluación externa de la calidad para poder demostrar competencia técnica. Se hace hincapié en la forma de calcular algunos de los parámetros imprescindibles para la validación/verificación, como son la exactitud y la precisión. El desarrollo completo de estos conceptos se puede consultar en el procedimiento microbiológico SEIMC número 48: «Validación y verificación de métodos microbiológicos» disponible en: www.seimc.org/protocolos/microbiologia

Clinical microbiologists should ensure, to the maximum level allowed by the scientific and technical development, the reliability of the results. This implies that, in addition to meeting the technical criteria to ensure their validity, they must be performed with a number of conditions that allows comparable results to be obtained, regardless of the laboratory that performs the test. In this sense, the use of recognized and accepted reference methodsis the most effective tool for these guarantees. The activities related to verification and validation of analytical methods has become very important, as there is continuous development, as well as updating techniques and increasingly complex analytical equipment, and an interest of professionals to ensure quality processes and results. The definitions of validation and verification are described, along with the different types of validation/verification, and the types of methods, and the level of validation necessary depending on the degree of standardization. The situations in which validation/verification is mandatory and/or recommended is discussed, including those particularly related to validation in Microbiology. It stresses the importance of promoting the use of reference strains as controls in Microbiology and the use of standard controls, as well as the importance of participation in External Quality Assessment programs to demonstrate technical competence. The emphasis is on how to calculate some of the parameters required for validation/verification, such as the accuracy and precision. The development of these concepts can be found in the microbiological process SEIMC number 48: «Validation and verification of microbiological methods» www.seimc.org/protocols/microbiology

[Validation and verfication of microbiology methods]. / Validación y verificación analítica de los métodos microbiológicos.

Clinical microbiologists should ensure, to the maximum level allowed by the scientific and technical development, the reliability of the results. This implies that, in addition to meeting the technical criteria to ensure their validity, they must be performed with a number of conditions that allows comparable results to be obtained, regardless of the laboratory that performs the test. In this sense, the use of recognized and accepted reference methodsis the most effective tool for these guarantees. The activities related to verification and validation of analytical methods has become very important, as there is continuous development, as well as updating techniques and increasingly complex analytical equipment, and an interest of professionals to ensure quality processes and results. The definitions of validation and verification are described, along with the different types of validation/verification, and the types of methods, and the level of validation necessary depending on the degree of standardization. The situations in which validation/verification is mandatory and/or recommended is discussed, including those particularly related to validation in Microbiology. It stresses the importance of promoting the use of reference strains as controls in Microbiology and the use of standard controls, as well as the importance of participation in External Quality Assessment programs to demonstrate technical competence. The emphasis is on how to calculate some of the parameters required for validation/verification, such as the accuracy and precision. The development of these concepts can be found in the microbiological process SEIMC number 48: «Validation and verification of microbiological methods¼ www.seimc.org/protocols/microbiology.

[Topographical-medical study on the Virgin of Guadalupe's ayate. Unpublished paper from a New Spanish sage]. / Estudio topográfico-médico sobre el ayate de la virgen de Guadalupe. Escrito inédito de un sabio novohispano.

In the context of medical studies, the topographic aspect (a study about the special circumstances that contributes to the beginning, develop, and ending of diseases belonging to a country) acquired particular significance in New Spain through the work of Diego Cisneros (1618). Juan de Melgarejo, professor, protophysician, priest, and author of two medical writings, continued with the work of Cisneros. The one that concerns us in this paper is called Parecer que ejecutó el Dr. D. Juan de Melgarejo por mandato de su Santidad y orden del Proto Medicato sobre la incorrupción del Ayate de María Santísima de Guadalupe, por los años de 1666. This text remained unpublished and it is closely related to the line of Melgarejo's works on the Virgin of Guadalupe. In this work he analyzes the ayate (cloak) of Juan Diego from a topographic perspective inserted in theoretical and experimental aspects of the hippocratical-galenic slope that prevailed in the medicine perspective of the Baroque New Spain. This research includes aspects on the university education of the author and regarding his tasks as protophysician, one of which was, precisely, the development of the Guadalupean manuscript. All the sources we have used are original. They come from México's General Archive of the Nation, and they all were interpreted by the author. They show the training given by doctors at the Royal and Pontifical University of Mexico and the link between this and the tasks of the Royal Protomedicato Tribunal.

En el marco de los estudios médicos, la vertiente topográfica (estudio detenido de las circunstancias especiales que contribuyen al desarrollo, curso y desenlace de las enfermedades propias de un país) adquirió especial relevancia en la Nueva España a partir de la obra de Diego Cisneros (1618). Un continuador de ella fue el doctor Juan de Melgarejo, catedrático, protomédico, sacerdote y autor de dos escritos médicos. El texto al que se hace referencia en este artículo, denominado Parecer que ejecutó el Dr. D. Juan de Melgarejo por mandato de su Santidad y orden del Proto Medicato sobre la incorrupción del Ayate de María Santísima de Guadalupe, por los años de 1666, había permanecido inédito y está estrechamente relacionado con la línea de trabajos guadalupanos de Juan de Melgarejo. En él analiza el ayate de la imagen guadalupana desde una perspectiva médico-topográfica inserta en aspectos teóricos y experimentales, en la vertiente hipocrática-galénica que prevalecía en la medicina novohispana del barroco. La presente investigación incluye los aspectos de la formación universitaria del autor y de sus tareas como protomédico, una de las cuales fue la elaboración del escrito guadalupano. Las fuentes a las que se recurrió son todas originales, proceden de los fondos del Archivo General de la Nación de México, y fueron interpretadas por la autora. En esas fuentes se describe cómo se llevaba a cabo la formación de los médicos en la Real y Pontificia Universidad de México y la vinculación entre ella y las tareas del Real Tribunal del Protomedicato.

[A New Spain medication: magisterial oil and salutiferous liquor]. / Un medicamento novohispano: aceite magistral y licor salutífero.

During the 16th century, physicians who lived and cured New Spain's population, attended their profession privately and institutionally; few of them were authors of medical works, and it is not easy to discover one who invented and used successfully medicament of his own development. We have found one, Joan Martel, a Spaniard, who came to New Spain and here cured and served. He invented and used a salutiferous oil and liquor widely accepted by other physicians, but mainly by the neighbors of Mexico City. In reward for his successfully medicament, he received the appointment of physician at the Royal Court Prison. This article is dedicated to him, and his until now unknown life, his work and the relation between his oil with a similar product in Spain. This study forms part of larger social-historical research that deals with "Physicians in New Spain, their social and professional roles (16 to 19 centuries)."

Un cirujano en las Cárceles del Santo Oficio, Juan Antonio Xarillo, representante de asceno socio-económico en la sociedad novohispana del siglo XVIII / A surgeon in the prisons of the Inquisition, Juan Antonio Xarillo, representing the socioeconomic progress in the colonial society of the XVIII century

En el siglo XVIII, las cárceles del Tribunal del Santo Oficio de la Inquisición disponían de cirujanos para atender a sus reos. Juan Antonio Xarillo destacó en ese grupo por su alto nivel socio-económico. Dicha posición fue producto de actividades distintas a la cirugía. Gracias a los inventarios de la época sabemos que poseyó casas, terrenos, numerosos libros, instrumentos quirúrgicos y utensilios de uso cotidiano. (AU)

Convento real de Nuestra Señora de la Concepción, la atención médico-quirúrgica de su población femenin / Convent of Nuestra Señora de la Concepción: Medical-surgical care for the female population

The monasteries in New Spain dedicated to women were the result of the ideals of conquerors and religious people, but also of the rest of the population of the large cities, mainly, Mexico City. Here the first institution of nuns was founded as the Monastery of [quot ]Nuestra Señora de la Concepción,[quot ] thanks to the archbishop Juan de Zumárraga. From it, the expansion of new and different foundations was constant and, to give support and refuge to the female population in need of housing due to poverty or abandonment, were their main tasks. Inside the monasteries and behind their tall walls, all persons received spiritual and medical attention. The latter was in the hands of physicians, apothecaries and surgeon who cured all [quot ]external[quot ] disorders and, during the first years of existence of all the monasteries, they were mainly barbers. The purpose of this article is to discover who the surgeons were who served the first female monastery and this study constitutes part of a larger research study that not only studied all monasteries both for men and women, but also the large number of surgeons who lived and worked in New Spain. The number of surgeons serving in this monastery were all those that we were able to find.

[Convent of "Nuestra Señora de la Concepción": Medical-surgical care for the female population]. / Convento real de Nuestra Señora de la Concepción, la atención médico-quirúrgica de su población femenin.

The monasteries in New Spain dedicated to women were the result of the ideals of conquerors and religious people, but also of the rest of the population of the large cities, mainly, Mexico City. Here the first institution of nuns was founded as the Monastery of "Nuestra Señora de la Concepción," thanks to the archbishop Juan de Zumárraga. From it, the expansion of new and different foundations was constant and, to give support and refuge to the female population in need of housing due to poverty or abandonment, were their main tasks. Inside the monasteries and behind their tall walls, all persons received spiritual and medical attention. The latter was in the hands of physicians, apothecaries and surgeon who cured all "external" disorders and, during the first years of existence of all the monasteries, they were mainly barbers. The purpose of this article is to discover who the surgeons were who served the first female monastery and this study constitutes part of a larger research study that not only studied all monasteries both for men and women, but also the large number of surgeons who lived and worked in New Spain. The number of surgeons serving in this monastery were all those that we were able to find.

[The venerable Varón Gregorio López, impact of his life and work throughout 400 years, 1562-2000]. / El venerable Varón Gregorio López, repercusiones de su vida y obra a lo largo de cuatrocientos años, 1562-2000.

During the second half of the 16th century in New Spain, there was a peculiar but versatile man named Gregorio López whose ascetic lifestyle, remarkable erudition and talent granted him an important place in history to date. The aim of this work was to focus attention on two aspects that have been ignored by contemporary historians. On the one hand, we will refer to Lopez's medical works, known as Tesoro de Medicinas (A Treasure of Medicines), a piece that although it is still immersed within the hypocraticgalenic tradition, continues to be highly valued. On the other hand, we found a vast amount of historiographic works that support the case for his beautification that began just 24 years after his death in 1596. The contribution we now make is divided into two parts for better understanding of the subject. We must emphasize, however, that both the exciting life this "Venerable Man" (Venerable Varón) led and the repercussions his deeds had, demonstrate an extraordinary coherence between the learned and the mystical man that he was. Gregorio López always maintained a remarkable social and religious presence, not only throughout the three centuries of colonial rule in Mexico, but also during the subsequent two hundred years that followed the struggle for Independence.

Diego de Cisneros y la medicina astrológica y geográfica novohispana / Diego de Cisneros and the astrologic and geographic medicine

La acumulación de información geográfica sobre el Nuevo Mundo que tuvo lugar durante el XVI empezó a sistematizarse y a tratar de ser explicada en el plano de la medicina hacia finales del siglo y durante las primeras décadas del siguiente. Los autores médicos de esa época se caracterizan por su interés, simultáneo o alternado, en los temas patogeográficos y astrológico. Destaca entre ellos por su valiosa y única obra conocida, Diego Cisneros, médico madrileño formado en Alcalá de henares y llegado a la Nueva España en 1612. Su obra representa al incipiente barroco del momento y, además de su valor médico-geográfico también lo es por el artístico. Contiene uno de los primeros planos de la ciudad de México y sus alrededores, en típico estilo barroco. La importancia científica radica en que en su trabajo se localiza ya la tendencia a separar ciencia que le lleva a afirmar la libertad del ser humano que permitirá acabar con aquellos aspectos de la astrología medieval que encadenaban al individuo. En su filiación alcalaína sostiene la utilidad de la ciencia y de la experiencia y unidad a ésta la observación clínica objetiva. Cisneros contribuye, a través de su obra, al inicio de dos procesos significativos en la historia de la cultura nacional; el de identidad y el de comunidad científica. A lo largo de nuestro trabajo los analizamos y conformamos.

Enrico Martínez, primer científico y técnico multidisciplinario en la Nueva España del siglo XVII / Enrico Martinez, first scientist and multidiscipline technical of the XVIIth century in New Spain

Enrico Martínez, nacido Heinrich Martin en Hamburgo, Alemania entre 1550 y 1560 fue, en la historia de la ciencia mexicana, el primer científico representativo de la multidisciplina. Detentó el cargo de cosmógrafo real y, además fue ingeniero hidraúlico, cartógrafo e impresor. Autor de una de las primeras obras impresas en la Ciudad de México a principios del XVII, 1606, en la que se combinan la astrología y la medicina, el Repertorio de los Tiempos e Historia Natural de Nueva España. La principal obra de Martínez trata de diferentes temas que incluyen interesantes descripciones geográficas y antropológicas de la naturaleza y pobladores de la Nueva España. El aspecto fundamental del libro es la consideración del aspecto astrológico, contiene numerosos lunarios, arreglador al meridiano de México para los años 1586 a 1604. Estos lunarios estaban enfocados a la agricultura, navegación y aspectos metereológicos, constituyeron en su época la novedad científica de carácter divulgatorio y sus autores lograban con su elaboración, buenas ganancias pecuniarias. Además de su obra científica, Martínez se desempeño como uno de los primeros técnicos de la Nueva España, muy especialmente por su importante participación en las obras del desagüe de la Ciudad de México. Fue director técnico y científico de dicha obra durante varios años, su actuación se inició en 1607 y concluyó hasta poco antes de su muerte en 1635. El desempeño de su trabajo técnico se vió continuamente sometido a numerosas dificultades y sobresaltos, intrigas y envidias, aspectos que le llevaron a su muerte. A la obra cartográfica de Enrico Martínez se debe el conocimiento de 32 mapas de la costa occidental del Pacífico mexicano, desde Acapulco hasta el Cabo Mendocino en la Alta California. Los mapas proceden de las observaciones de la expedición de Sebastián Vizcaíno. Se le atribuye también, pero sin absoluta seguridad, un mapa de la expedición de Juan Oñate al Nuevo México

Médicos y cirurjanos del siglo XVI en la nueva España, su participación en el proceso de formación de la mexicanidad / Physicians and surgeons of the XVIth century in New Spain, their participation in the process of constituting the Mexican culture

Proporciona una primera visión de conjunto de las actividades científicas, técnicas y académicas que, en la Nueva España del siglo XVI, desarrollaron algunos de sus personajes médicos más destacados. Inclue versiones abreviadas de las semblanzas socio-históricas de algunos de los principales médicos y cirujanos que trabajaron en la Nueva España durante el siglo XVI: Agustín Farfán, Alonso López de Hinojosos, Juan de la Fuente, Francisco Bravo y Juan de Cárdenas.(AU)