Scientia Potentia Est: How the Italian World of Oncology Changes in the COVID-19 Pandemic.

PURPOSE: After coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO, a response from the Italian Health System to react to an unprecedented condition became necessary and sudden. The COVID-19 pandemic has required oncologists to redefine clinical organization and patient management. The purpose of our study was to document the difficulties emerging during the SARS-CoV-2 pandemic in Italian oncology. METHODS: We broadcasted an electronic survey to oncologic health care professionals. It consisted of 45 questions ranging from individual perception of pandemic management by hospital centers to physicians' and nurses' psychological distress and patient care. RESULTS: A total of 383 oncology health workers participated in the survey. The majority were female (71.8%) and from central Italy (46.2%). Impressively, a total of 357 (93%) participants declared the oncologic department reorganized routine clinical activity, but only 40.5% were adequately trained about the required procedures; 20% of the survey respondents think they have not received adequate and timely protective devices. CONCLUSION: Our survey demonstrated the flexibility of oncologic teams. However, the emergency response quality has been heterogeneous, and several drawbacks have emerged from the first analyses investigating how the world of oncology changes in the COVID-19 pandemic. Information, protection, testing, and training of health care professionals are key words that should be kept in mind to encourage recovery after this tragedy and to be ready to face a similar emergency in the future.

Voluntariado e suas razões / Volunteerism and its rationale

Reflexões sobre o voluntariado como atividade de estudantes de medicina, apresentadas por Sapiro e Mattiello nesta edição da Scientia Medica, trazem à tona o pensamento de que quem beneficia tem que entender porque beneficia, que é o que ocorre com adultos. E para o entendimento do que seja o altruísmo, tema familiar à medicina através dos tempos, não basta a leitura do que já foi produzido sobre o assunto, mas é inevitável a exposição à prática do benefício. Evidências observacionais sugerem que o voluntariado pode beneficiar a saúde mental e a sobrevida dos indivíduos expostos, embora os mecanismos causais permaneçam desconhecidos. Consequentemente, estudos futuros são necessários e devem esclarecer mais sobre o assunto e enquanto isto não acontece pode-se pensar sobre uma citação: "If you would like to be selfish, you should do it in a very intelligent way. The stupid way to be selfish is … seeking happiness for ourselves alone. … the intelligent way to be selfish is to work for the welfare of others." The Dalai Lama.

The contemplation of volunteerism as activity in medical school, put forward by Sapiro and Mattiello in the present issue of Scientia Medica, brings to light the idea that those who provide benefits have to understand why they do so, as occurs among adults. And to understand selflessness, a topic that has been recurrent in medicine over time, reading about what has already been produced is not enough, since exposure to the practice of concern for the welfare of others is essential. Observational evidence suggests that volunteerism may be beneficial to the mental health and survival of exposed individuals, even though the causal mechanisms remain unknown. Consequently, further studies are needed to shed more light upon the topic, but while that does not occur, the following quotation gives us some food for thought: "If you would like to be selfish, you should do it in a very intelligent way. The stupid way to be selfish is … seeking happiness for ourselves alone. … the intelligent way to be selfish is to work for the welfare of others." The Dalai Lama.

O que compromete o ineditismo de um artigo?: [Editorial] / What compromises the ineditism of an article?: [Editorial]

A equipe editorial da Scientia Medica decidiu que continuará considerando para publicação artigos originais resultantes de teses, dissertações e trabalhos de conclusão de curso de nível superior (seja no seu todo ou em parte), assim como trabalhos apresentados em eventos e ainda não publicados sob a forma de artigo. Se ocorrer redundância por outras situações que não estas, o artigo será considerado como não inédito e impróprio para publicação neste periódico. A informação sobre a origem do trabalho deverá ser fornecida pelos autores e será repassada aos revisores quando iniciar o processo de revisão por pares. Se o artigo for aceito para publicação, a informação será disponibilizada aos leitores...

The editorial team of Scientia Medica decided that this journal will continue to consider, for publication, original articles based on theses and dissertations, as well as works presented at events and not yet published in the article form. If redundancy occur in other situations, the item will be considered as not inedit and therefore inappropriate for publication in this journal. Information on the origin of the work must be provided by the authors and will be passed to the reviewers when starting the process of peer review. If the article is accepted for publication, the information will be made available to readers...

Scientia Medica ? Novas diretrizes para autores [Editorial] / Scientia Medica ? New guidelines for authors [Editorial]

Atualmente o volume de informação científica é enorme. Os periódicos científicos são numerosos e o número de pesquisas publicadas é crescente. Assim, torna-se importante que os artigos de revisão da literatura observem uma metodologia que evite vieses na seleção dos trabalhos e permita que os leitores tenham a informação exata sobre as fontes consultadas e os critérios de seleção do conteúdo.

Currently the volume of scientific information is enormous. Scientific journals are numerous and the number of published research is growing. Thus, it becomes important that the literature review articles observe a methodology that avoids bias in the selection of works and allow readers to have accurate information about the sources consulted, and the selection criteria of the content.

Um dos delineamentos mais empregados em epidemiologia: estudo transversal [Erratum para: volume 17, número 4] / One of the most used epidemiological designs: cross-sectional study [Erratum to: volume 17, issue 4]

Na edição impressa da Scientia Medica de 2007, volume 17, número 4, páginas 229-232, o artigo ?Um dos delineamentos mais empregados em epidemiologia: estudo transversal? tem grafadas erradamente duas fórmulas na página 231. Na versão eletrônica da revista, volume 17, número 4, de 2007, o original com erro foi substituído pelo arquivo corrigido.Apresentamos nesta página o parágrafo correto.

In the print edition of Scientia Medica 2007, volume 17, issue 4, pages 229-232, the article ?One of the most used epidemiological designs: cross-sectional study? has two misspelled formulas on page 231. In the online version of the journal, volume 17, issue 4, 2007, the original file was replaced by the corrected file.We present the correct paragraph in this page.

Mais um passo importante da Scientia Medica: [editorial] / One further important step for Scientia Medica: [editorial]

É com satisfação que comunicamos aos usuários da Scientia Medica, especialmente aos autores que a prestigiam com a publicação de seus trabalhos, que a revista foi indexada na Scopus. Essa base de dados, oficialmente denominada SciVerse Scopus e pertencente ao grupo editorial Elsevier, é a maior base indexadora de resumos e citações da literatura científica revisada por pares.

[The contradictive tendencies in medical treatment of the Hellenistic age--diversity versus simplification, chronic extension (physical therapy) versus rapidity, humane medicine versus worldly success].

It is a one-sided view to find the greatness of Hippocrates just in seeking after scientific medicine (medicina scientia) and sublating superstitious treatment. The scientific medicine did not begin with him, and the succeeding generations of him were not one and the same in opinions. For example, there were the confrontations between the school of Kos and that of Knidos in the very age of Hippocrates, as well as the opposition of rationalism and empiricism. The school of Kos was alleged to succeed the tradition of Hippocrates, taking into consideration individual physical conditions and being based on the principle of various clinical methods of physical therapy assuming chronical extension. On the contrary, the school of Knidos tended to define the diseases in simple aspects, paying no much attention to the difference of physical conditions and developmental stages of illness. Futhermore, the latter grasped the diseases rather in the point of individual organs than the disorder of physical state of the body. It can be said that the anatomical knowledge was more useful for the school of Knidos. The difference between the two schools can also be found in what purpose the medicine sought after. While Hippocrates attached much importance to physical therapy and made the people including the poor as object of medical treatment, there were doctors in no small number, we can suppose, in pursuit of money, power, worldly glory. As time passed, however, the two schools gradually got similar to each other, the difference of them reduced as well as the tradition of Hippocrates faded. The opposition between rationalism and empiricism in the Hellenistic Age shared, in some aspect, the difference of Kos and Knidos. According to Celsus, the conflict between rationalism and empiricism did not refer to pharmacy or anatomy, but just to diet. The rationalism materialized various methods of therapy considering environmental elements as well as individual physical conditions, but the empiricism in reality tended to expedite simplification of treatment. This tendency of simplification of the latter corresponded to the contemporary need of society, that is, speedy and effective treatment for the wounded in war or for epidemic in the army, farms of collective labour or much crowded cities. The bigger the groups were, the more the methods of treatment got simplified, individual conditions not much accounted. Then, the empiricism came to be united with anatomy, as the anatomy, being much developed in the process of curing the wounded in war, goes with simplification of medical treatment in the hospital of large scale. It can be said that the origin of simplified definition of diseases goes back far to the school of Knidos. On the other hand, in Hippocrates the drugs were in contrast to the diet. While the diet was to help health and rehabilitate physical conditions, the drugs were to result in strong effects of change. The drugs like as poison, eye-salve, ointment were to be made use of for rapid, effective change of physical state or for the treatment of a concrete, limited part of the body, These drugs were also much developed in the Hellenistic Age of the state of chronic war. In initial stages, the toxical drugs as well as the anatomy and surgical operations must have been developed on peaceful purpose, such like as 'theriaca' detoxicating (antidoting) animal's poison, or for easing childbirth. With the increasement of social inequality and unexhausted human desire, however, the toxical drugs or anatomical knowledges got to be used for undesirable purposes. Thus, we can not estimate Hippocrates simply in the point whether he developed scientific medicine or not. The great fame of Hippocrates could be found rather in his method of medical treatment as well as the principle of medicine, as he believed that the medicine should not be exploited for worldly power or wealth but for the convenience of all the people. He pursued healthy life matching to natural state(physis) and took much account of different physical states of individual to embody various methods of treatment, which presupposed chronic delay. The opposite to the Hippocratic medicine is called for the wounded by war, or the collective labourer of large farm with intensive labour exploitation. The medical treatment for them assumed anatomical surgery and drugs of rapid, strong effect.

The Contradictive Tendencies in Medical Treatment of the Hellenistic Age: Diversity versus Simplification, Chronic Extension(Physical Therapy) versus Rapidity, Humane Medicine versus Worldly Success / 의사학

It is a one-sided view to find the greatness of Hippocrates just in seeking after scientific medicine(medicina scientia) and sublating superstitious treatment. The scientific medicine did not begin with him, and the succeeding generations of him were not one and the same in opinions. For example, there were the confrontations between the school of Kos and that of Knidos in the very age of Hippocrates, as well as the opposition of rationalism and empiricism. The school of Kos was alleged to succeed the tradition of Hippocrates, taking into consideration individual physical conditions and being based on the principle of various clinical methods of physical therapy assuming chronical extension. On the contrary, the school of Knidos tended to define the diseases in simple aspects, paying no much attention to the difference of physical conditions and developmental stages of illness. Futhermore, the latter grasped the diseases rather in the point of individual organs than the disorder of physical state of the body. It can be said that the anatomical knowledge was more useful for the school of Knidos. The difference between the two schools can also be found in what purpose the medicine sought after. While Hippocrates attached much importance to physical therapy and made the people including the poor as object of medical treatment. there were doctors in no small number, we can suppose, in pursuit of money, power, worldly glory. As time passed, however, the two schools gradually got similar to each other, the difference of them reduced as well as the tradition of Hippocrates faded. The opposition between rationalism and empiricism in the Hellenistic Age shared, in some aspect, the difference of Kos and Knidos. According to Celsus, the conflict between rationalism and empiricism did not refer to pharmacy or anatomy, but just to diet. The rationalism materialized various methods of therapy considering environmental elements as well as individual physical conditions, but the empiricism in reality tended to expedite simplification of treatment. This tendency of simplification of the latter corresponded to the contemporary need of society, that is, speedy and effective treatment for the wounded in war or for epidemic in the army, farms of collective labour or much crowded cities. The bigger the groups were, the more the methods of treatment got simplified, individual conditions not much accounted. Then, the empiricism came to be united with anatomy, as the anatomy, being much developed in the process of curing the wounded in war, goes with simplification of medical treatment in the hospital of large scale. It can be said that the origin of simplified definition of diseases goes back far to the school of Knidos. On the other hand, in Hippocrates the drugs were in contrast to the diet. While the diet was to help health and rehabilitate physical conditions, the drugs were to result in strong effects of change. The drugs like as poison, eye-salve, ointment were to be made use f for rapid, effective change of physical state or for the treatment of a concrete, limited part of the body, These drugs were also much developed in the Hellenistic Age of the state of chronic war. In initial stages, the toxical drugs as well as the anatomy and surgical operations must have been developed on peaceful purpose, such like as 'theriaca' detoxicating(antidoting) animal's poison, or for easing childbirth. With the increasement of social inequality and unexhausted human desire, however, the toxical drugs or anatomical knowledges got to be used for undesirable purposes. Thus, we can not estimate Hippocrates simply in the point whether he developed scientific medicine or not. The great fame of Hippocrates could be found rather in his method of medical treatment as well as the principle of medicine, as he believed that the medicine should not be exploited for worldly power or wealth but for the convenience of all the people. He pursued healthy life matching to natural state(physis) and took much account of different physical states of individual to embody various methods of treatment, which presupposed chronic delay. The opposite to the Hippocratic medicine is called for the wounded by war, or the collective labourer of large farm with intensive labour exploitation. The medical treatment for them assumed anatomical surgery and drugs of rapid, strong effect.

From Ars to Scientia: the revolution of anatomic illustration.

Art and anatomy have been closely related since the Renaissance, when artists studied the human body to gain more perfect perspectives, and anatomists began illustrating their texts. As the two fields became increasingly intertwined, the distinctions between artistic drawings and scientific illustrations of the human body's form and function became increasingly blurred. Early Renaissance anatomists were more artistic than scientific with their images, but Hieronymus Fabricius ab Acquapendente (1533-1619) provided a crucial turning point in the evolution of anatomic illustration. His new and strict focus upon scientific illustration developed in the context of previous anatomists' work and theories, but his is a critical and previously untold story in the history of medicine.

[The Epistolarum medicinalium libri XX by Giovanni Mainardi]. / Per lo studio degli Epistolarum medicinalium libri XX di Giovanni Mainardi.

The paper aims at highlighting some aspects of the Epistolarum medicinalium libri XX by Giovanni Mainardi. This work, that enjoyed an European repute and was reprinted many times, has to be set against the background of the early 16th century attempts at reforming medical education. Mainardi, a skilled humanist and the pupil of Nicolb Leoniceno and Pico della Mirandola, advocated a return to the original sources of Greek and Latin medical thought. The choice of Epistolae as a literary genre was in itself meaningful, in that it allowed Mainardi an unusual freedom of expression on the whole range of medical problems. Mainardi advocated the notion of medicine as ars - not scientia - and he believed in disengaging it from natural philosophy in the Aristotelian sense. At the same time, he believed in the possibility of introducing novelties in medicine, and of correcting ancient but incorrect textual traditions.

Clinical practice: between Aristotle and Cochrane.

Health and disease consist of amino acids and self image, cell membranes and human ideals, muscles and politics. Only to a limited extent can clinical practice be based on science. It can never be carried on in isolation from political, and cultural forces that influence patients' health behaviour. Evidence-based medicine is essential but not sufficient. A continuous relationship with patients is a conditio sine qua non for general practice. The general practitioner must be a master of pragmatic medicine. Rationality, the dominant modern trend, may be dangerous for patients and doctors: (1) advances in technology can give patients and doctors the illusion of mastering the universe; (2) patients complain of being treated like biomachines, without human touch. Another symptom of modernity is the decline of religion. But patients and doctors are by no means rational beings. God, destiny and hope are replaced by modern medico-scientific megalomania. Modern medicine is also strongly influenced by commercialization and invasion by bureaucrats. Instead of becoming a biomedical robot, the general practitioner must learn to value the Aristotelian concept of phronesis. It means practical wisdom and can only be gained by personal experience; a form of learning by doing. Good clinical practice cannot come from science alone, or from personal experience alone. It is an amalgam of scientia and phronesis.