To Sir, With Love.

In this biography, the life of William Hugh Isbister is traced through three continents, where he planted the seeds of academic surgery into a generation of leaders in colorectal surgery. This ultimately improved the care for thousands of patients. His last station in Saudi Arabia made a huge impact on the country. I hope this article inspires others to write about their mentors who were important in their development as surgeons and physicians. Short biographies of these important figures will serve as a valuable historical record for generations to come.

Evidence-based medicine: a brief historical analysis of conceptual landmarks and practical goals for care. / Medicina baseada em evidências: breve aporte histórico sobre marcos conceituais e objetivos práticos do cuidado.

Evidence-based medicine (EBM) is intended to improve the efficiency and quality of health services provided to the population and reduce the operational costs of prevention, treatment, and rehabilitation; the objective of EBM is to identify relevant issues and promote the social applicability of conclusions. This article underscores the importance of EBM in modern clinical teaching and social practices from the contributions of Archibald Cochrane and David Sackett to the development and dissemination of this paradigm in care and education during the twentieth century. EBM has helped broaden discussions on the relationships between teaching and medical practice, and has taken on an important role in curriculum reforms and training models and practices in health care.

A medicina baseada em evidências (MBE) pretende aumentar a eficiência e qualidade dos serviços de saúde prestados à população e diminuir os custos operacionais dos processos de prevenção, tratamento e reabilitação. Busca identificar problemas relevantes do paciente e promover a aplicabilidade social das conclusões. O artigo ressalta a importância da MBE para o ensino e para as práticas clínicas sociais da atualidade a partir da contribuição de Archibald Cochrane e David Sackett no desenvolvimento e na difusão desse paradigma assistencial e pedagógico durante o século XX. A MBE tem contribuído para ampliar a discussão sobre as relações entre ensino e prática da medicina, assumindo papel de destaque em reformas curriculares e modelos de formação no cuidado e práticas em saúde.

Medicina baseada em evidências: breve aporte histórico sobre marcos conceituais e objetivos práticos do cuidado / Evidence-based medicine: a brief historical analysis of conceptual landmarks and practical goals for care

Resumo A medicina baseada em evidências (MBE) pretende aumentar a eficiência e qualidade dos serviços de saúde prestados à população e diminuir os custos operacionais dos processos de prevenção, tratamento e reabilitação. Busca identificar problemas relevantes do paciente e promover a aplicabilidade social das conclusões. O artigo ressalta a importância da MBE para o ensino e para as práticas clínicas sociais da atualidade a partir da contribuição de Archibald Cochrane e David Sackett no desenvolvimento e na difusão desse paradigma assistencial e pedagógico durante o século XX. A MBE tem contribuído para ampliar a discussão sobre as relações entre ensino e prática da medicina, assumindo papel de destaque em reformas curriculares e modelos de formação no cuidado e práticas em saúde.

Abstract Evidence-based medicine (EBM) is intended to improve the efficiency and quality of health services provided to the population and reduce the operational costs of prevention, treatment, and rehabilitation; the objective of EBM is to identify relevant issues and promote the social applicability of conclusions. This article underscores the importance of EBM in modern clinical teaching and social practices from the contributions of Archibald Cochrane and David Sackett to the development and dissemination of this paradigm in care and education during the twentieth century. EBM has helped broaden discussions on the relationships between teaching and medical practice, and has taken on an important role in curriculum reforms and training models and practices in health care.

Amphiaraos, the Healer and Protector of Attika.

Amphiaraos was an important and popular healing hero/god in Athens from the end of the fifth century BC, however, not much has been studied. This paper investigates the figure in various ways by examining different sources. In the sixth century BC and in to the fifth, Amphiaraos was an Argive warrior hero that came into war against Thebes. He then seems to have acquired a sanctuary in the Theban territory being a mantic hero. In the end of the fifth century BC, however, he is said to have swallowed up by the earth and sprang up again in a spring at Oropos. Between 420-414 BC, his sanctuary was set up by the Athenians at Oropos. But this time, he was venerated as a healing hero. In 420 BC, Asklepios was introduced to Athens in order to cure plague that went around from 430s BC. It seems that the Athenians benchmarked Asklepios to promote one more healing hero/god at their north eastern border. When Oropos was taken by their enemies, a substitute Amphiareion was established in Rhamnous, a deme close to Oropos. The Athenians also promoted a patriotic hero through the words of Euripides. Illustrated as having gone through the same process of sacrifice - death - commemoration, Amphiaraos was put in parallel with the Athenian mythical king Erechtheus. Through this parallel, Amphiaraos became a political figure that protected Athens from outside threats. Healing was, by the ancient Athenians, understood in a wide spectrum and was considered as a way to protect the polis.

Paralelismo en los cuidados enfermeros entre Isabel Zendal y Florence Nightingale / Parallelism in nursing care between Isabel Zendal and Florence Nightingale

OBJETIVO PRINCIPAL: documentar el paralelismo en los cuidados enfermeros administrados por Isabel Zendal y Florence Nightingale durante su estancia en el Hospital de la Caridad y en Escutari. METODOLOGÍA: se realizó una revisión bibliográfica narrativa a través de fuentes secundarias y una investigación histórica mediante la observación documental y hermenéutica de las fuentes primarias. Para la localización y selección de las fuentes primarias se consultó el Arquivo da Deputación da Coruña y el Arquivo Histórico Municipal da Coruña. Para localizar las fuentes secundarias se utilizó el buscador Google académico y se consultaron las siguientes bases de datos: Cuiden, Scielo, y Dialnet. RESULTADOS-CONCLUSIONES: a pesar de la distancia en espacio y tiempo, el análisis de la bibliografía y de los documentos utilizados muestra muchas similitudes en cuanto a los cuidados ofrecidos por ambas enfermeras. Llama la atención el diferente reconocimiento que se le otorgó a cada una de ellas. Creemos que lo que determina esta diferencia son los distintos factores sociales, educativos y económicos de ambas

OBJECTIVE: our objective in this study has been to document the parallelism in the nursing care administered by Isabel Zendal and Florence Nightingale during their stay at the Hospital de la Caridad and in Escutari. METHODS: a narrative bibliographic review was carried out through secondary sources and a historical investigation through documentary and hermeneutic observation of the primary sources. To locate and choose the primary sources both the Provincial Council Archive and the Historical Municipal Archive of A Coruña were consulted. Both Academic Google and data basis such as Cuiden, Scielo and Dialnet were used to locate the secondary sources. RESULTS- CONCLUSIONS: in spite of the space and time distance, the bibliography and document analysis show many similarities regarding the attentions given by both nurses. However, the credit given to each one attracts the attention. We believe that they are the different social, educational and economic factors which determine that difference

Secundum Regulam: cuidados y asistencia a enfermos y ancianos en las reglas monásticas hispano-visigodas / Secundum Regulam: care for the sick and elderly in Hispanic-Visigoth monastic rules

Las reglas elaboradas para organizar la vida cotidiana en las comunidades monásticas que proliferaron en torno al Mediterráneo durante la Antigüedad Tardía son una privilegiada fuente de información para conocer cuáles eran las circunstancias en las que vivían los enfermos y los ancianos durante ese periodo. El objetivo de este trabajo es utilizarlas para conocer mejor cuál era la situación de estos dos colectivos a finales de la Hispania tardoantigua. Las cuatro reglas monásticas conservadas se elaboraron en un arco cronológico que abarca desde la segunda mitad del siglo VI hasta un periodo similar del siglo VII, coincidiendo en gran medida con la duración del reino hispano-visigodo de Toledo. Con su lectura se puede constatar la importancia de la asistencia social entre los cometidos habituales de los distintos monasterios que las tomaron por norma, ocupando un lugar fundamental los cuidados y las atenciones brindados a enfermos y ancianos. En todas ellas se muestra cómo se organizaban para cumplir tales cometidos y cómo se alteraban las normas de convivencia vigentes con la intención de ofrecerles los cuidados oportunos. Se observa igualmente qué tipo de alimentación se consideraba útil como medicina, cómo se debía tratar a los enfermos en lugares físicamente separados del recinto monástico y quiénes eran los más aptos para ocuparse de ellos. Asimismo, se aprecia cómo tales cuidados no se dispensaban únicamente a los miembros de las comunidades, sino que se hacían extensivos a personas del exterior. Se documenta, además, cómo en la zona noroccidental se había extendido la práctica de que los ancianos ingresaran en los monasterios llevados sobre todo por las emergencias propias de una edad avanzada

Rules for the organization of daily life in the monastic communities that proliferated around the Mediterranean during Late Antiquity are a privileged source of information on the life circumstances of sick and elderly people during this period. The objective of this study was to use this information to determine the situation of these two populations at the end of Late Antique Hispania. The four monastic rules preserved were formulated during a chronological period extending from the second half of the 6th century to the second half of the 7th century, largely coinciding with the duration of the Hispanic-Visigoth Kingdom of Toledo. They reveal the importance of social welfare among the habitual duties of the different monasteries, which adopted them as rules. In this way, these monasteries became vital places for the care of the sick and elderly. The rules show how they were organized to carry out these duties and how restrictions on cohabitation could be modified to enable the delivery of appropriate care. They also reveal the type of food considered medicinally useful, the requirement to treat the sick in places physically separated from the monastic area, and the most appropriate people to provide care. The rules also establish that this care was offered not only to members of their community but also to outsiders. The practice of admitting elderly people into monasteries became extensive in the North-West area, largely for the health emergencies that characterize old age

Sharing the Airway: The Importance of Good Communication Between Anesthesiologist and Surgeon.

One of the most challenging tasks during airway surgery is ensuring adequate ventilation throughout the procedure. Because the airway is shared between surgeon and anesthesiologist, successful oxygenation and ventilation of the patient can only be accomplished through close collaboration during the various stages of the procedure. This includes periods in which surgical airway manipulation compromises adequate ventilation and periods in which ventilation interferes with the surgical environment. With continuous communication between surgeon and anesthesiologist, optimal outcomes can be achieved.

UniversitätsSpital Zürich: 80 years of neurosurgical patient care in Switzerland.

BACKGROUND: The predecessor of today's Department of Neurosurgery, UniversitätsSpital Zürich (USZ), was founded 80 years ago as the first independent Swiss clinic dedicated to neurosurgical patient care. On the occasion of this anniversary, we aimed to highlight the history of neurosurgery as a specialty at the USZ, and to put it into the historical context of Swiss and European Neurosurgery. METHOD: A literature review was conducted and we searched the archives of the USZ and the city of Zurich, as well as those of Swiss journals to extract relevant published articles, books, historical reports and pictures. The USZ Department of Medical History, the Museum of Medical History and the Swiss National Library were contacted to provide source material. To further verify the content, (emeritus) faculty from the USZ and external experts on the history of Swiss neurosurgery reviewed the manuscript. RESULTS: Surgeries of the head and spine had occasionally been conducted in Zurich by the general surgeons, Rudolf Ulrich Krönlein and Paul Clairmont, before an independent neurosurgical clinic was founded by Hugo Krayenbühl on 6 July 1937. This was the first Swiss department dedicated to neurosurgical patient care. Besides providing high-quality medicine for both the local and wider population, the department was chaired by eminent leaders of neurosurgery, who influenced the scientific and clinical neurosurgery of their time. As such, it has long been regarded as one of the top teaching and research hospitals in Switzerland and in Europe. CONCLUSIONS: On the occasion of its 80th anniversary, we have performed an in-depth review of its development, successes and challenges, with a special focus on the early decades. Reflecting on the past, we have identified common denominators of success in neurosurgery that remain valid today.

From Georgia to Jerusalem: some Medical Aspects of "The Knight in the Panther's Skin" by Shota Rustaveli.

The Georgian poet Rustaveli wrote his epic poem The Knight in the Panther's Skin around 1200. He knew the works of Hippocrates and Galen, and believed in the unity of body and soul.Thereare many references to health and medicine in the poem, and we shall highlight some of them. In 1185 Rustaveli left Georgia and settled in Jerusalem. There he lived and died at the Monastery of the Cross, where he was buried.

Cómo pasa la vida, que de pronto son años / How life passes by, and how years fly

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Sentinel node biopsy and improved patient care.

Sentinel lymph node biopsy (SLNB) is based on the hypothesis that the sentinel lymph node (SLN) reflects the lymph-node status and a negative SLN might allow complete axillary lymph node dissection (ALND) to be avoided. Past and current sentinel lymph node clinical trials for breast carcinoma have addressed the prognostic and therapeutic benefits of this technique and as such, SLNB has become a standard of care for select breast cancer patients. This article reviews the history of SLNB as well as current guidelines and recent controversies.

O Tratamento dos doentes insanos de Vila Viçosa no hospital de Rilhafoles (segunda metade do século XIX) / The treatment of the insane patients at the hospital in Vila Viçosa rilhafoles (second half of the nineteenth century)

Neste trabalho analisamos os trâmites processuais respeitantes ao envio de doentes insanos de Vila Viçosa para o hospital de Rilhafoles, na segunda metade do século XIX, e as relações estabelecidas com o hospital desta vila alentejana relativamente ao pagamento do tratamento. A braços com uma grave crise financeira, o hospital de Vila Viçosa recusava sistematicamente a responsabilidade de enviar os alienados para Rilhafoles, numa tentativa de passar esse ónus para a administração do concelho, mostrando-se muito renitente no pagamento das faturas que lhe chegavam do hospital de São José. O conflito entre as duas instituições chegou ao monarca e sem outra alternativa que a do pagamento, o hospital da vila alentejana procedeu ao envio de parcelas de dinheiro, ainda que de forma muito atrasada. Para a realização deste trabalho servimo-nos dos livros de atas da Misericórdia e do fundo do Governo Civil de Évora, custodiadas pelo Arquivo Distrital da mesma cidade. Estas fontes resultam essencialmente da correspondência estabelecida entre a Misericórdia de Vila Viçosa, o administrador do concelho e o governador civil de Évora (AU)

In this work we examined the procedural requirements related to the sending of insane patients of Vila Viçosa to the hospital of Rilhafoles, in the second half of the 19th century, and the relationships established with the hospital of this Alentejo town relating to the payment of treatment. Faced with a severe financial crisis, the hospital of Vila Viçosa systematically refused the responsibility to send the insane patients to the Rilhafoles hospital in an attempt to pass this burden on the administration of the county, being very reluctant to pay the bills that came to him from the hospital of São José. The conflict between the two institutions came to the monarch with no other alternative than the payment, the hospital of village of the Alentejo region proceeded to sending parcels of money, albeit way too late. For the realization of this work we use the books of the Misericórdia and the documents of the Civil Governor found of the city of Évora under the custody of the Distrital Archive of the same city. This documents results, basically, from the correspondence between the Misericórdia of Vila Viçosa, the council administrator and the civil governor of Évora (AU)

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Anarcosindicalismo y sanidad en la retaguardia y en el frente. Los casos de Valencia y de la columna de hierro en la Guerra Civil Española (1936-1937) / Anarcho-syndicalism and healthcare in the retaguard and int he warr front. The cases of Valencia and the columna de hierro in the Spanish Civil War (1936-1937)

El principal nexo de unión entre el anarquismo y la Guerra Civil española es la revolución que surgió del fracaso de la insurrección militar. Como es conocido, el aspecto socioeconómico de esta revolución ha sido ampliamente abordado; sin embargo, el impacto de la revolución anarquista en el terreno sanitario ha sido estudiado parcialmente. El objetivo general de este artículo es analizar la relación que se estableció entre el anarquismo y la política sanitaria en el contexto de la revolución social que se vivió en algunas zonas de la España republicana durante, aproximadamente, el primer año de conflicto. En concreto, el trabajo se centra en Valencia, una ciudad imprescindible en este tipo de estudios por su enorme importancia geopolítica y geoestratégica durante el período de análisis. Además, se aborda el análisis de la organización sanitaria de la Columna de Hierro, la milicia anarquista por excelencia que operó en el frente de Teruel. En Valencia, el anarquismo aplicó prácticas revolucionarias al ámbito de la salud con el objetivo final de conseguir la colectivización de la asistencia sanitaria. Posteriormente, el transcurso de los acontecimientos políticos en la España leal apartó progresivamente al anarquismo de la política sanitaria de la ciudad (AU)

Revolution that emerged from the failure of the military insurrection is the main link between anarchism and the Spanish Civil War. As known, the socio-economic aspect of this revolution has been widely discussed, but the impact of the anarchist revolution in healthcare has been studied partially. The overall aim of this article is to analyze the relationship established between anarchism and health policy in the context of the social revolution that took place in some parts of Republican Spain for about the first year of conflict. Healthcare organization of the Columna de Hierro, the most famous anarchist militia that operated in the Teruel front, is also approached. In Valencia, anarchism implemented revolutionary practices in the healthcare field in order to get the collectivization of medical care. Subsequently, the course of political events in loyal Spain progressively keep anarchism away from health policy (AU)

Obligations of an academic and clinical oncologist: historical reflections.

Obligations are derived from one's core values-those fundamental, enduring, deeply held beliefs that guide one's everyday actions. Gandhi stated it more eloquently than I ever could: "Your beliefs become your thoughts, your thoughts become your words, your words become your actions, your actions become your habits, your habits become your values, your values become your destiny." So what are the obligations of the academic oncologist and clinician? I believe there are a few indubitable and fundamental obligations: professionalism, patient care, stewardship, maintenance of knowledge, productivity, and mentorship). I might add that I do not see these obligations as unique to the academician but rather applicable to all physicians.