Inadvertent perioperative hypothermia prevention strategies for urology surgical patients who received a blood transfusion: A retrospective analysis.

OBJECTIVES: This study aimed to establish whether hypothermia was present in patients who required a blood transfusion and underwent a urology procedure, as well as identify staff knowledge and understanding. PATIENTS AND METHODS: A staff survey was conducted with respondents from a range of clinical settings, with some staff working across more than one area. A retrospective review of 46 medical records was conducted between January 2021 and July 2022. All data were exported into an Excel spreadsheet and analysed. RESULTS: Staff (70%) were unaware of guidelines informing thermoregulation practices; however, 90% understood the importance of normothermia in the perioperative environment. Medical record review demonstrated temperature monitoring and intervention implementation varied across the perioperative journey, with 20% of patients hypothermic on admission and 89% of the cohort having two or more risk factors. CONCLUSION: There is no formal process for the management of inadvertent perioperative hypothermia throughout the patient journey at the hospital. A variety of intrinsic factors (age, patient comorbidities, American Society of Anaesthesiologists score) and external factors (patient waiting times, anaesthetic modality, type of procedure, environmental influences), impact each patient's risk of inadvertent perioperative hypothermia.

[Cardiorenal syndromes: historical aspects and current challenges].

The article describes major milestones in acknowledgment of pathophysiological relationship between heart and kidneys since Ancient Egypt till our time and history of term "cardiorenal syndrome" (CRS). First references about kidney and heart functions could be dated to 13 BC when Hippocrates mentioned them. In the XIV century Gentile da Foligno proposed a hypothesis about functional interconnection between heart and kidneys. In the XVIII century Richard Bright described the link between myocardial hypertrophy and kidneys diseases. Frederic Justin Collet was the first one who used the term "cardiorenal" in his article in 1903. In Russia, I.I. Stolnikov conducted his experiments about myocardial hypertrophy and kidneys ischemia in 1880. Famous Russian internist, E.M. Tareev, devoted several paragraphs to cardiorenal interactions in his fundamental manuals "Anemia in Bright's disease" (1929) and "Hypertension" (1948). The research on this topic was continued by Tareev's followers: N.A. Mukhin, V.S. Moiseev, more recent successors - Zh.D. Kobalava, S.V. Moiseev, V.V. Fomin, S.V. Villevalde and others. Their contribution resulted in development of first Russian clinical guidelines on cardio and nephroprotection in CRS in 2014. In 2008 consensus of Acute Disease Quality Initiative summarized current experience on CRS. Today, research on controversial classification questions, biomarkers and other aspects of CRS continues.

History of endoscopic treatment of vesicoureteral reflux.

Since its first clinical application in 1984, the endoscopic subureteral injection of bulking agents has become an alternative to long-term antibiotic prophylaxis and open surgical intervention in the treatment of VUR in children. The 15 min day care endoscopic procedure has gained worldwide popularity in the management of VUR in children. Over the years, multiple studies have demonstrated safety and long-term efficacy of this minimally invasive outpatient procedure. Nowadays almost 90% of the surgical treatment of VUR in Sweden is done by endoscopic procedure. In the current article, our aim was to review how the endoscopic treatment of VUR developed.

Pericardial tamponade, a diagnostic chameleon: from the historical perspectives to contemporary management.

BACKGROUND: Pericardial tamponade (PT) early after cardiac surgery is a challenging clinical entity, not infrequently misrecognized and often only detected late in its course. Because the clinical signs of pericardial tamponade can be very unspecific, a high degree of initial suspicion is required to establish the diagnosis. In addition to clinical examination the deployment of imaging techniques is almost always mandatory in order to avoid delays in diagnosis and to initiate any necessary interventions, such as pericardiocentesis or direct cardiac surgical interventions. After a brief overview of how knowledge of PT has developed throughout history, we report on an atypical life-threatening cardiac tamponade after cardiac surgery. A 74-year-old woman was admitted for elective biological aortic valve replacement and aorto-coronary-bypass grafting (left internal mammary artery to left anterior descending artery, single vein graft to right coronary artery). On the 10th postoperative day, the patient unexpectedly deteriorated. She rapidly developed epigastric pain radiating to the left upper abdomen, and features of low peripheral perfusion and shock. There were no clear signs of pericardial tamponade either clinically or echocardiographically. Therefore, for further differential diagnosis, a contrast-enhanced computed tomography scan was performed under clinical suspicion of acute abdomen. Unexpectedly, active bleeding distally from the right coronary anastomosis was revealed. While the patient was prepared for operative revision, she needed cardiopulmonary resuscitation, which was successful. Intraoperatively, the source of bleeding was located and surgically relieved. The subsequent postoperative course was uneventful. CONCLUSIONS: In the first days after cardiac surgery, the occurrence of life-threatening situations, such as cardiac tamponade, must be expected. Especially if the symptoms are atypical, the entire diagnostic armamentarium must be applied to identify the origin of the complaints, which may be cardiac, but also non-cardiac. CENTRAL MESSAGE: A high level of suspicion, immediate diagnostic confirmation, and rapid treatment are required to recognize and successfully treat such an emergency (Fig. 5). PERSPECTIVE: Pericardial tamponade should always be considered as a complication of cardiac surgery, even when symptoms are atypical. The full range of diagnostic tools must be used to identify the origin of the complaints, which may be cardiac, but also non-cardiac (Fig. 5).

Temporal Medical Knowledge Representation Using Ontologies.

Representing temporal information is a recurrent problem for biomedical ontologies. We propose a foundational ontology that combines the so-called three-dimensional and four-dimensional approaches in order to be able to track changes in an individual and to trace his or her medical history. This requires, on the one hand, associating with any representation of an individual the representation of his or her life course and, on the other hand, distinguishing the properties that characterize this individual from those that characterize his or her life course.

Intensive care medicine and the intensivist: from 1850 to 2021 / A medicina intensiva e o intensivista: de 1850 a 2021

Intensive Care Medicine gained prominence in 2020 and 2021 due to the COVID-19 pandemic. It is a recent medical specialty, which many physicians and the public know little about. This article makes a historical perspective, from the emergence of the first areas for observation of critically ill patients in the nineteenth century to the present, to the impact of the pandemic and its consequences (AU)

A Medicina Intensiva ganhou destaque no anos de 2020 e 2021 devido à pandemia por COVID-19. Trata-se de uma especialidade recente, e ainda pouco conhecida por muitos médicos e pelo público. Este artigo faz uma perspectiva histórica, desde o surgimento das primeiras áreas para observação de pacientes graves no século XIX, até o pre-sente, com o impacto da pandemia, e as perspectivas futuras (AU)

The current state of the surgical care team in the United Kingdom: Shall we 'do a time out'?

The reduction of junior doctors' working hours over the last two decades paved the way to non-medical practitioners providing care traditionally discharged by surgeons and other medics. These registered practitioners play a vital role in the care of patients in surgery and work within multi-disciplinary teams comprising surgical care practitioners, advanced clinical practitioners in surgery, and physician associates, with significant experience in nursing or allied health care professional practice. Health Education England and the Royal Colleges of Surgeons have invested considerably in developing the relevant educational frameworks to support and quality assure the training of non-medical practitioners. Notwithstanding, to ascertain whether advanced and extended practice have been developed appropriately, a wide critical stance is needed. This article aims to begin to analyse the status quo of the extended surgical team and of the associated pitfalls and challenges, making conservative comparisons between the roles with the international scene. The objective is to help students, trainees and all involved in surgical care to adopt an informed and critical viewpoint about the extended surgical team in the United Kingdom, in the hope that this can lead to improvement and forward planning in workforce design for the benefit of patients and their communities.

[Development of surgery of the heart and great vessels in Rassia during the first half of the 20th century]. / Razvitie otechestvennoi khirurgii serdtsa i krupnykh sosudov v pervoi polovine XX stoletiia.

Analysed in the article are scientific priorities of Russian cardiovascular surgeons in the first half of the 20th century, showing rapid and successful development of surgery of the lungs, heart, and great vessels over a comparatively short time period, also underlining the fundamental works of Yu.Yu. Dzhanelidze, S.S. Bryukhonenko, N.N. Terebinsky and their contribution to the development of Soviet cardiovascular surgery, highlighting the pioneering developments of A.A. Vishnevsky, N.K. Galankin, D.A. Donetsky in surgery of the heart and large vessels. Mention is made that during those years, Russian scientists carried out a series of interesting experimental global-level studies on cardiovascular surgery. It was demonstrated that in the middle of the 20th century vascular surgery strengthened its position as an independent branch of clinical medicine. In connection with the increased range and scope of operative interventions on vessels, it was essential to develop the previously existing and to establish new vascular surgical approaches. They should be maximally simple, possibly less aggressive, taking into account the location of nerves and vascular collaterals, as well as sufficient for exposing a neurovascular bundle and creating the possibilities for drainage of the wound, if necessary. Determination of rational operative approaches to blood vessels turned out to be significant for solving the problem of surgical management of acute arterial obstruction. The subsequent rapid development of medical science confirmed groundlessness of a sceptical attitude towards vascular surgery.

Tribute to Theodor Kocher: Far Beyond an Anatomical Reference

We know Kocher's name as an anatomical reference in neurosurgery. In fact, Theodor Kocher was a Swiss general surgeon, and his contributions were such that Kocher was honored in 1909 with the Nobel Prize in Medicine and Physiology, and he was the first surgeon to receive this honor. Kocher participated in the initial scientific phase of medicine, livingwith names that are in history, as well as him; Langenbeck and Virchow, Lucke, Billroth, Horsley, Lister, Halstedt, Pasteur, Osler, Lawson Tait, Verneuil, and a long list and other icons of the time. The present account rescues the many important facets and contributions of the Swiss surgeonTheodor Kocher, and his relationship with several of them. Kocher's memory, surgical instruments and literary production are preserved in a small wing of the University of Bern. The present article highlights how intense Kocher's dedication to the medical field was.

A Historical Review of Headaches: Who First Described Them and When did This Occur?

BACKGROUND: Headache is as old as human history and has been able to report, and the first descriptions were found in Greece and Mesopotamia. OBJECTIVE: Our objective was to know the date of the first description of ICHD-3 headaches, with their respective author. METHODS: We searched for articles that addressed the historical aspects of primary and secondary headaches and painful cranial neuropathies. RESULTS: Twenty-seven different headaches were analyzed according to the occurrence of their first description, with the respective author and country of origin. CONCLUSIONS: The knowledge of the first description of ICHD-3 headaches, with their respective author, showed us how and when the different headaches appeared over the years.

A historical review of the techniques of recovery of parasites for their detection in human stools

Abstract Since the early 20th century, the detection of intestinal parasites has improved with the development of several techniques for parasitic structures recovery and identification, which differ in sensitivity, specificity, practicality, cost, and infrastructure demand. This study aims to review, in chronological order, the stool examination techniques and discuss their advantages, limitations, and perspectives, and to provide professionals and specialists in this field with data that lays a foundation for critical analysis on the use of such procedures. The concentration procedures that constitute the main techniques applied in routine research and in parasitological kits are a) spontaneous sedimentation; b) centrifugation-sedimentation with formalin-ethyl acetate; and c) flotation with zinc sulfate solution. While selecting a technique, one should consider the purpose of its application and the technical-operational, biological, and physicochemical factors inherent in the procedures used in stool processing, which may restrict its use. These intrinsic limitations may have undergone procedural changes driven by scientific and technological development and by development of alternative methods, which now contribute to the improvement of diagnostic accuracy.

Las técnicas nucleares en un enfoque no invasivo para el estudio arqueométrico de bienes culturales cubanos / Nuclear techniques in a non-invasive approach to the archeometric study of Cuban cultural heritage

RESUMEN A propósito del 500 Aniversario de la Habana, presentamos una experiencia singular desarrollada en la Oficina del Historiador de la Ciudad, donde físicos nucleares y radio-químicos en un ambiente multidisciplinario en el Centro Histórico de la Habana, estudian sistemáticamente bienes culturales desde el Laboratorio de Arqueometría del Gabinete de Conservación y Restauración. Se presenta una revisión sobre nuestros estudios en el campo de la Arqueometría, en las que prevalece un enfoque no invasivo desde los inicios de esta experiencia, que incluye las técnicas nucleares como protagonistas principales, y se caracteriza por la diversidad de bienes culturales examinados. Las investigaciones realizadas comprenden desarrollo de tecnologías, de metodologías específicas para la caracterización o identificación de diferentes materiales y tipos de bienes culturales y metodologías generales dedicadas a responder interrogantes de interés para la Historia del Arte y la Arqueología o relacionadas con la conservación y restauración, para finalmente realizar los estudios arqueométricos o tratamientos de conservación no invasivos de bienes culturales cubanos. Una mayor parte de estas investigaciones se han realizado in situ en los museos o lugares donde estos objetos se conservan. En la discusión se enfatizan los análisis cualitativos y los cuantitativos y las validaciones realizadas, según los requerimientos del caso de estudio. En este artículo se abordan también otras experiencias validas sobre el tema en el ámbito de colaboraciones nacionales e internacionales.

ABSTRACT On the occasion of the 500th Anniversary of Havana, we present a singular experience in the Havana City Historian's Office, where nuclear physicists and radiochemists in a multidisciplinary environment in the historic center of Havana, systematically study cultural heritage, from the Archaeometry Laboratory of the Cabinet of Conservation and Restoration. A review of our studies in the field of Archaeometry is presented, in which a non-invasive approach prevails from the beginning of this experience, which includes nuclear techniques, as main protagonists and is characterized by the diversity of cultural heritage examined. The research carried out includes the development of technologies, specific methodologies for the characterization or identification of different materials and types of cultural heritage, and general methodologies dedicated to answer questions of interest for the History of Art and Archeology or related to conservation and restoration, for eventually perform the Archaeometry studies and non-invasive conservation treatments of Cuban cultural assets. Most of these investigations have been carried out in situ, in the museums or places where these objects are conserved. In the discussion, the qualitative and quantitative analysis, and the validations are emphasized, according to the requirements of the case study. This article also addresses other valid experiences on the subject in the field of national and international collaborations.

Memória do judô na cidade do Recife: uma análise a partir de sua relação com a educação e o processo civilizatório / Judo memory in the city of Recife: an analysis based on its relationship with education and the civilizational process / Memoria del judo en la ciudad de Recife: un análisis a partir de su relación con la educación y el proceso civilizatorio

Objetiva-se analisar a história do judô recifense e suas dimensões educacionais e civilizatórias por meio da técnica de análise de conteúdo das falas de antigos senseis de judô em Recife. Constatou-se que o judô possibilita a aprendizagem, formação para a vida constituída por regras e a formação ética/moral diante da sociedade, através de fatores como disciplina e hierarquia. As entrevistas indicam os ganhos do judô como modalidade esportiva e reconhece-se que o judô esportivizado atual teve perdas. Conclui-se que, dentre as modalidades esportivas, o judô ainda se diferencia por conta de suas características e especificidades filosóficas preconizadas por Jigoro Kano e sua incidência sobre a educação

This article aims to analyze the history of judo in Recife and its educational and civilizational dimensions by conducting content analysis about the speeches of old judo 'senseis' in that city. Judo was found to enable learning and education for life under ethical/moral rules and education of society through factors such as discipline and hierarchy. Interviews point to judo's gains as a sport and recognize that the current sport-oriented judo has suffered osses. Among sports, judo is still distinguished by its characteristics and philosophical peculiarities advocated by Jigoro Kano and its influence on education

El objetivo es analizar la historia del Judo de Recife y sus dimensiones educativas y civilizatorias a través de la técnica de análisis de contenido de los discursos de antiguos senseis de Judo en Recife. Se constató que el Judo posibilita el aprendizaje, la formación para la vida constituida por reglas y la formación ética/moral frente a la sociedad, a través de factores como disciplina y jerarquía. Las entrevistas mostraron los méritos del Judo como modalidad deportiva y reconocieron que el Judo deportivo actual tuvo pérdidas. Se concluye que, entre las modalidades deportivas, el Judo todavía se destaca, debido a sus características y especificidades filosóficas, preconizadas por Jigoro Kano, y por su incidencia sobre la educación.

Revealing the Genetic Impact of the Ottoman Occupation on Ethnic Groups of East-Central Europe and on the Roma Population of the Area.

History of East-Central Europe has been intertwined with the history of Turks in the past. A significant part of this region of Europe has been fallen under Ottoman control during the 150 years of Ottoman occupation in the 16-17th centuries. The presence of the Ottoman Empire affected this area not only culturally but also demographically. The Romani people, the largest ethnic minority of the East-Central European area, share an even more eventful past with Turkish people from the time of their migration throughout Eurasia and they were a notable ethnic group in East-Central Europe in the Ottoman era already. The relationship of Turks with East-Central European ethnic groups and with regional Roma ethnicity was investigated based on genome-wide autosomal single nucleotide polymorphism data. Population structure analysis, ancestry estimation, various formal tests of admixture and DNA segment analyses were carried out in order to shed light to the conclusion of these events on a genome-wide basis. Analyses show that the Ottoman occupation of Europe left detectable impact in the affected East-Central European area and shaped the ancestry of the Romani people as well. We estimate that the investigated European populations have an average identity-by-descent share of 0.61 with Turks, which is notable, compared to other European populations living in West and North Europe far from the affected area, and compared to the share of Sardinians, living isolated from these events. Admixture of Roma and Turks during the Ottoman rule show also high extent.

Fluoride Mode of Action: Once There Was an Observant Dentist . . .

The discovery and implementation of fluoride in the prevention of dental caries is often praised as one of the most important achievements in health care. In the early 20th century, it took 30 y to identify fluoride as the cause of enamel mottling but also of reduced caries prevalence in a population drinking water containing fluoride. Similarly, from 1960 to 1990, it took major efforts to unravel the working mode of fluoride in such detail that a rational scheme of caries prevention could be formulated. This article describes the scientific struggle leading to a consensus on the topic. For a historic purpose, the field, the actors, and their main research achievements are described. Ultimately it was generally agreed that the effect of fluoride is primarily topical by fluorides in the oral fluids rather than systemic by incorporation of fluoride in the enamel mineral crystals. Fluoride concentrations, even <1 mg/L, enhance the deposition of calcium phosphates during remineralization of enamel (and dentin). Similarly, such low levels of fluoride are effective in reducing the dissolution of the calcified tissues. This understanding has led to the development of fluoride-containing caries-preventive products that had an undisputed beneficial effect on the levels of dental caries.

Apuntes históricos y fisiopatológicos sobre apendicitis aguda / Historical and Physiopathological Annotations about Acute Appendicitis

RESUMEN Se realizó un estudio de revisión de corte histórico sobre apendicitis aguda, en el que se profundizó en los aspectos históricos conocidos en mayor o menor grado desde la era Bizantina hasta nuestros días. El objetivo fue actualizar los resultados hallados desde el punto de vista histórico y fisiopatológico y mostrarlos al lector. Para este estudio se realizó una búsqueda a través de las bases de datos Scielo, Medline y PubMed y complementada mediante los buscadores Google, Yahoo y Wikipedia. Se realizó un análisis crítico de los artículos encontrados; se estudiaron también otros artículos de cualquier país, idioma, institución, autor (es) y fecha; de preferencia los nacionales. Se exponen las cuatro teorías relacionadas al origen de esta enfermedad, que son: obstrucción de la luz, ulceraciones mucosas superficiales, la higiene y el rol de la infección, por último, la hipótesis de las fibras dietéticas. Se identificaron aspectos históricos en apendicitis aguda en el tiempo; se aludió a un reporte reciente sobre rasgos gastrointestinales en las distintas especies y las cuatro teorías fisiopatológicas y todas resultaron atractivas(AU)

ABSTRACT A historical review about acute appendicitis was carried out, for which the historical aspects known to a greater or lesser degree were studied in depth. This article covers from the Byzantine era to the present day. The objective is to update the results found from the historical and physiopathological viewpoints. For this study, a search was made through the databases Scielo, Medline and PubMed and complemented by the search engines Google, Yahoo and Wikipedia. A critical analysis of the findings was made and other articles from various countries and institutions, written in other languages, by several author(s) and on different dates were also studied; preferably the nationals. The four theories related to the origin of this disease were exposed: obstruction of light, superficial mucosal ulcerations, hygiene and the role of infection, and finally, the hypothesis of dietary fibers. We identified historical aspects in acute appendicitis over time, as well as referred to a recent report on gastrointestinal traits in the different species and the four physiopathological theories, all of which were attractive(AU)

[From volunteer work to critical care paramedic : The history of an ongoing process of professionalisation]. / Vom Ehrenamt zum Notfallsanitäter : Die Geschichte eines anhaltenden Professionalisierungsprozesses.

BACKGROUND: For 4 years, the profession of critical care paramedic has been established in Germany. As a result, nonmedical rescue service personnel receive a 3-year apprenticeship for the first time. This also led to a revaluation of functions and responsibilities within this occupational field. OBJECTIVES: Which medical and social processes contributed to the establishment of the occupational profile of a critical care paramedic? How did training methods change over the last 50 years and which debates helped to shape the development of the occupational field? MATERIALS AND METHODS: The article at hand is based on an interpretation of archival primary sources of the parties observed. Moreover, it is also predicated on a qualitative content analyses of the secondary literature focusing on the subject area of nonmedical rescue service personnel. RESULTS: In the 1960s, a professionalisation process for paramedics was initiated after realising that rapid medical treatment on location can have a positive impact on the healing process. The debate on the training for paramedics has been influenced by longstanding negotiations between different parties about the question of which tasks could be ascribed to nonmedical rescue service personnel. CONCLUSIONS: In the larger context, the discussions about the tasks of critical care paramedics are centered around the question of delegation and, respectively, the substitution of medical tasks usually assigned to physicians. The academization of the profession that is currently emerging will continue to lead to conflicts with the medical profession.

Usher Parsons (1788-1868) and His 19th-Century Understanding and Surgical Treatment of Spinal Curvatures.

Usher Parsons was a prominent surgeon in the 19th century. However, his contributions to the understanding and treatment of spinal curvatures have been largely forgotten. Herein, we review Parsons' theories, understanding, and treatment strategies for treating abnormal spinal curvatures. This glimpse into history offers insight into the thought processes and surgical strategies that were available in the early 19th century. It is pioneers in this field, such as Usher Parsons, on which our current understanding of spinal curvatures and its treatment is built.

[Anatomy and biomechanics of the scaphoid]. / Anatomie und Biomechanik des Kahnbeins.

The scaphoid is biomechanically and clinically of great importance for function of the wrist. In the literature, its anatomy and biomechanics are clearly underrepresented as well as underestimated. In the following review the scaphoid will be presented in more detail, according to recent information and findings. Not only will the origin of the name and the history of previous names, such as cotyloid or navicular, be introduced, but also for the first time in medical literature the significant phylogeny and ontogeny of the scaphoid will be shown. Moreover, the clinically very important blood supply, the ligaments of the scaphoid and relevant biomechanical details will be described.