Jean Dominique Larrey and his recognition in Mexico.

The figure of Jean Dominique Larrey, military surgeon who participated in the Napoleonic wars, is analyzed. The objectives of the study are to highlight their contributions, including the creation of ambulances that allowed the injured to be given prompt assistance. Also note the post-mortem recognition that Larrey had in Mexico through an academic group founded by the surgeon Francisco Montes de Oca y Saucedo. The facts cited show the progress of military surgery, its institutionalization and professionalization as well as the communication and updating of knowledge in one and another continent.

Se analiza la figura de Jean Dominique Larrey, cirujano militar que participó en las guerras napoleónicas. Los objetivos de estudio consisten en destacar sus aportaciones, entre ellas la creación de las ambulancias que permitieron dar una pronta asistencia al herido. Asimismo, señalar el reconocimiento post mortem que Larrey tuvo en México a través de una agrupación académica fundada por el cirujano Francisco Montes de Oca y Saucedo. Los hechos citados muestran el progreso de la cirugía militar, su institucionalización y profesionalización, así como la comunicación y la actualización de saberes en uno y otro continente.

Primer simulacro de amputación traumática de miembro superior de necesidad y rescate en un escenario inhóspito. Base Marambio, Antártida Argentina. 9 de diciembre de 2011 / First simulacrum of traumatic upper limb amputation of necessity and rescue a bleak scenario. Bse Marambio, Antarctica Argentina. December 9, 2011

Se efectuó un simulacro de amputación de necesidad y rescate en dependencias de la Base Marambio (Antártida Argentina). La amputación de una extremidad constituye un dilema al cual está sujeto un médico en determinadas situaciones críticas. Además, los intentos infructuosos para salvar una extremidad irrecuperable están asociados a una alta morbilidad y muchas veces son letales para el paciente. Existen innumerables discusiones en relación con los criterios de predicción para conservar un miembro lesionado, por lo que se han propuesto varios índices de valoración para determinar qué extremidad puede ser conservada o cuál amputada. Por ello en el presente trabajo se efectúa una revisión bibliográfica sobre el uso de tablas y/o criterios para la toma de tal decisión. Se efectuó un ejercicio simulado en el cual se consideró la escena (situación de aislamiento geográfico, características inhóspitas y recursos limitados en la Antártida) y el estado de atrapamiento de la víctima, más la irrecuperabilidad de la porción distal del miembro superior, en donde debía priorizarse la vida del paciente, respecto a la pérdida de la extremidad que ya se encontraba mutilada en forma irreversible, con el fin de ser estabilizado y extricado del lugar para ser trasladado a otro espacio para completar con mejores medios su tratamiento definitivo. Dicho ejercicio se realizó como parte de la capacitación continua del personal que se desempeña en las Bases Antárticas, que dadas las características del escenario antártico, hacen necesaria tal preparación para afrontar situaciones de extrema gravedad en un lugar inhóspito y alejado del continente. (AU)

We conducted a mock amputation and rescue agencies need the Marambio Base (Antarctica Argentina). The amputation of a limb is a dilemma which is subject to a doctor in certain critical situations. In addition, unsuccessful attempts to save a limb unrecoverable are associated with high morbidity and are often lethal to the patient. There are countIess discussions regarding prediction criteria to retain an injured limb, so that several indices have been proposed assessment to determine what can be preserved limb amputated or what, why in the present study the authors reviewed the literature on use of tables and/or criteria for making such a decision. We conducted a simulation exercise, which was considered the scene (geographical isolation, limited resources and inhospitable features in Antarctica) and the state of entrapment of the victim, plus the irrecoverable from the distal upper limb, where needed to prioritize the patients life, about the loss of the limb that was already irreversibly mutilated, in order to be stabilized and extricated the place to be moved to a place with better ways to complete definitive treatment. This exercise was conducted as part of the continuous training of personnel working in the Antarctic Bases, that given the characteristics of the Antarctic scenario necessitates such a preparation to deal with situations of extreme gravity in an inhospitable place and away from the continent. (AU)

Primer simulacro de amputación traumática de miembro superior de necesidad y rescate en un escenario inhóspito. Base Marambio, Antártida Argentina. 9 de diciembre de 2011 / First simulacrum of traumatic upper limb amputation of necessity and rescue a bleak scenario. Bse Marambio, Antarctica Argentina. December 9, 2011

Se efectuó un simulacro de amputación de necesidad y rescate en dependencias de la Base Marambio (Antártida Argentina). La amputación de una extremidad constituye un dilema al cual está sujeto un médico en determinadas situaciones críticas. Además, los intentos infructuosos para salvar una extremidad irrecuperable están asociados a una alta morbilidad y muchas veces son letales para el paciente. Existen innumerables discusiones en relación con los criterios de predicción para conservar un miembro lesionado, por lo que se han propuesto varios índices de valoración para determinar qué extremidad puede ser conservada o cuál amputada. Por ello en el presente trabajo se efectúa una revisión bibliográfica sobre el uso de tablas y/o criterios para la toma de tal decisión. Se efectuó un ejercicio simulado en el cual se consideró la escena (situación de aislamiento geográfico, características inhóspitas y recursos limitados en la Antártida) y el estado de atrapamiento de la víctima, más la irrecuperabilidad de la porción distal del miembro superior, en donde debía priorizarse la vida del paciente, respecto a la pérdida de la extremidad que ya se encontraba mutilada en forma irreversible, con el fin de ser estabilizado y extricado del lugar para ser trasladado a otro espacio para completar con mejores medios su tratamiento definitivo. Dicho ejercicio se realizó como parte de la capacitación continua del personal que se desempeña en las Bases Antárticas, que dadas las características del escenario antártico, hacen necesaria tal preparación para afrontar situaciones de extrema gravedad en un lugar inhóspito y alejado del continente.

We conducted a mock amputation and rescue agencies need the Marambio Base (Antarctica Argentina). The amputation of a limb is a dilemma which is subject to a doctor in certain critical situations. In addition, unsuccessful attempts to save a limb unrecoverable are associated with high morbidity and are often lethal to the patient. There are countIess discussions regarding prediction criteria to retain an injured limb, so that several indices have been proposed assessment to determine what can be preserved limb amputated or what, why in the present study the authors reviewed the literature on use of tables and/or criteria for making such a decision. We conducted a simulation exercise, which was considered the scene (geographical isolation, limited resources and inhospitable features in Antarctica) and the state of entrapment of the victim, plus the irrecoverable from the distal upper limb, where needed to prioritize the patient's life, about the loss of the limb that was already irreversibly mutilated, in order to be stabilized and extricated the place to be moved to a place with better ways to complete definitive treatment. This exercise was conducted as part of the continuous training of personnel working in the Antarctic Bases, that given the characteristics of the Antarctic scenario necessitates such a preparation to deal with situations of extreme gravity in an inhospitable place and away from the continent.

[Neurological paleopathology in the pre-Columbian cultures of the coast and the Andean plateau (I). Artificial cranial deformation]. / Paleopatologia neurologica en las culturas precolombinas de la costa y altiplano andino (I). Deformaciones craneales intencionales.

AIMS: The aim of this work was to study the cranial trepanations and deformations carried out by the ancient Paraca, Huari, Tiahuanaco and Inca cultures. To do so, we conducted a field study involving visits to archaeological remains and anthropological museums on the Andean plateau and the Peruvian coast. DEVELOPMENT: Cranial deformation was more common in the Andean regions and was performed by putting little pieces of wood or compressive bandages on newborn infants' heads in order to modify the growth axis of the cranial cavity. Cranial deformations were performed for aesthetic and magic religious reasons, but were also used as a means of ethnic or social identification, as a symbol of nobility or to distinguish the ruling classes. The immediate consequence of such deformation was the modification of the normal process by which the cranial sutures close. There is a significant correlation between the presence of posterior and lateral wormian bones, according to the degree of artificial deformation. The persistence of metopic suture and exostosis of the outer ear canal have been found in 5% of the skulls belonging to pre Columbine mummies. Other paleopathological findings include cranial fractures (7%), porotic hyperostosis (25% of children's skulls), spina bifida occulta, signs of spinal disk arthrosis and Pott's disease. CONCLUSIONS: Artificial cranial deformation was a very widespread practice in the Andean regions in pre Columbine times.

Acquired amputation and prostheses before the sixteenth century.

Amputation has been practiced at least since 43,000 B.C.E. for ritualistic, punitive, curative, or vocational reasons. Fitting with prostheses has been done since at least 1,500 B.C.E. Anesthetics were used, but which ones is not known. Analgesics such as salicylates in plants, narcotics such as cocaine and opium, and soporifics such as alcohol and peyote were common. Amputation was done with knives, axes, and saws. Control of bleeding was by ligature, cautery, bandaging pressure, and plant and animal products. Suture was with cotton or human hair, acacia and other thorns, ant jaws, and sinew, with or without a drain. Prostheses were made of fiber, wood, bone, and metals, often lined with rags.