Royal Centre for Defence Medicine: el Role 4 británico / Royal Centre for Defence Medicine: UK Role 4

La misión principal del Royal Centre for Defence Medicine es proporcionar apoyo sanitario a las operaciones militares, actuando como último escalón sanitario con capacidad de Role 4 en Reino Unido. Además, proporciona atención secundaria y especializada para miembros de las Fuerzas Armadas Británicas. Es un centro de formación para el personal sanitario militar y un núcleo de investigación médica militar

The mission of the Royal Centre for Defence Medicine is to provide medical support to all military operations, acting as the last echelon of treatment; in its capacity as the Role 4 hospital in the United Kingdom (UK). In addition, it provides secondary care and specialist opinions for members of the UK Armed Forces. It is a training centre for defence medical personnel, and a focus for military medical research

Modifications of Callender's Classification of Uveal Melanoma at the Armed Forces Institute of Pathology.

One hundred well-documented cases of uveal melanoma accessioned at the Armed Forces Institute of Pathology before 1970 were reviewed and reclassified to identify changes made in the Callender classification. We compared the new classification with the original classification to determine the effect of the changes on the prediction of outcome for the patient after enucleation. Staff pathologists had originally classified 52 of the 100 cases as spindle-cell type melanoma. Only 31 of the 100 cases were reclassified as spindle-cell types (two spindle-cell nevi and 29 spindle-cell melanomas). Tumors classified as mixed-cell type were further subdivided into groups based on the percentage and size of the epithelioid cells. Tumors formerly classified as spindle-cell type that contained small or rare epithelioid cells were reclassified as mixed-cell type. This improved the prediction of outcome for the patient. We found that nucleolar size and pleomorphism are important variables that should be considered in the classification of uveal melanomas.

Ptolemaic military operations were a dominant factor in the spread of Egyptian cults across the early Hellenistic Aegean Sea.

Early in the Ptolemaic era, Egyptian cults, particularly those of Isis and Sarapis, spread successfully to ports across the ancient Aegean Sea. Leading researchers in the field claim that the spread of these cults was influenced by multiple factors, ones that were mainly economic or political in character. However, the question of which factors had more weight or impact than others in the process of the early spread of Egyptian cults has not yet been answered in academic discussion. This could be related to the fact that the issue of the spread of religious innovations in the ancient Mediterranean has been addressed mainly by established historiographical methods such as the collection and critical analysis of archaeological and literary sources. Hypotheses and conclusions derived from these methods are, however, often unable to reflect the complexity of historical processes. A possible solution can be found in supplementing this established methodological apparatus by formalized methods, e.g. the coding of relevant datasets, statistics, geospatial modeling, and network analysis. To be able to compare the possible impacts of different factors on the spread of Egyptian cults in the Aegean Sea region, we 1) constructed a model of the ancient maritime transportation network as a platform for quantitative analysis, 2) transformed selected factors of possible influence into georeferenced parameters of the network, and 3) defined a mathematical model that allowed us to determine which parameters of the network explain the spatial dissemination of archaeological evidence connected to Egyptian cults. The results suggest that the most significant correlation is between the placement of Ptolemaic garrisons and the distribution of Egyptian temples and artefacts in the early Hellenistic Aegean Sea region. The interpretation would be that Egyptian military forces potentially played a significant role in the spread of Egyptian cults.

Yesterday and Today: The Impact of Research Conducted at Camp Detrick on Botulinum Toxin.

Introduction: This review summarizes the research conducted on botulinum toxin (BoTx) from 1943 to 1956 by a small group of Camp Detrick investigators and their staff. A systematic, cross-disciplinary approach was used to develop effective vaccines against this biological warfare threat agent. In response to the potential need for medical countermeasures against BoTx during World War II, the refinement of isolation and purification techniques for BoTx successfully led to the large-scale production of botulinum toxoid vaccines. In addition, the work at Camp Detrick provided the foundation for the subsequent use of BoTx as a tool for studying the trophic regulation of skeletal muscle within motor neuron terminals and, more recently, for elucidation of the intricate details of neurotransmitter release at the molecular level. Indirectly, Camp Detrick investigators also played a significant role in studies that culminated in the use of BoTx as a pharmaceutical product that has been approved by the U.S. Food and Drug Administration for treating movement disorders, autonomic dysfunctions, and other conditions. Methods: Online literature searches were performed with Google, Google Scholar, PubMed, the bibliography from the Camp Detrick technical library, and at the Defense Technical Information Center. Reference lists in some of the primary research publications and reviews also provided source material. Search terms included botulinum, botulinus, and Camp Detrick. References related to the subsequent impacts of the Camp Detrick results were selected and cited from reviews and primary references in the more recent literature. Notes on toxin nomenclature and potential sources of error in this study are presented. Results: The literature searches returned 27 citations of Camp Detrick authors, 24 of which were articles in peer-reviewed journals. The publications by these investigators included several disciplines such as biochemistry, immunology, pharmacology, physiology, and toxicology. A fundamental finding was the identification of critical nutritional components for improved growth of Clostridium botulinum and the increased production of BoTx serotype A. The purification processes that were developed at Camp Detrick allowed for the production of crystalline material to be scaled up for the manufacture of toxoid vaccine. Based on the research by Camp Detrick scientists, a toxoid supply of over 1 million units was available to vaccinate ~300,000 troops before the large-scale operations of D-Day. Conclusions: BoTx research during the period 1943 to 1956 resulted in refinements in the techniques for isolating and purifying the crystalline BoTx type A. These results led to the development and manufacture of a toxoid vaccine that was available in a sufficient quantity to protect ~300,000 warfighters in a large-scale military operation. One of the most important long-term consequences derived from the knowledge gained by the efforts at Camp Detrick was the development in the 1980s of safe and effective therapeutic uses for BoTx type A, the most lethal biological substance known.

La provisión de los destinos militares del Cuerpo de Sanidad Militar en Marruecos durante el bienio Azaña (1931-1933) / The provision of military destinations of the Military Health Division in Morocco during President Azaña’ s two-year period (1931-1933)

El Cuerpo de Sanidad Militar realizó una gran aportación en la obra colonizadora y de pacificación de la Zona del Protectorado de España en Marruecos. Centrándose este trabajo especialmente en la época en que Azaña ocupó el Ministerio de la Guerra. En este trabajo se ha pretendido estudiar las circunstancias que se tenían en cuenta a la hora de regular la provisión de estos destinos y el modo en que aquéllas llegaron a poner de manifiesto la necesidad de articular una legislación especial. Y ello porque las vigentes con carácter general, imponían a este personal una movilidad excesiva. Esta legislación propia, en el caso concreto de la Sección de Medicina, se tradujo en la clasificación de las vacantes en dos series: Melilla, Rif, Larache, Arcila, Alcazarquivir, Tetuán y Ceuta por un lado, y todas las demás por otro. Esta distinción sentaba un criterio diferente y discriminatorio en cuanto a la asignación de los destinos

The Military Health Division had an influential role in the colonising and peace keeping works in the area of the Spanish Protectorate in Morocco, particularly during the period in which Manuel Azaña was in charge of the Ministry of War in Spain. This work intends to study the circumstances that, at the time, regulated the provision of the destinations and the way in which they stressed the need to articulate a special legislation, given the fact that the sanitary staff was subjected to an excessive mobilization. This special legislation, specifically the one apllied to the Medicine section, led to the classification of the vacancies in two series: the first one formed by Melilla, Rif, Larache, Arcila, Alcazarquivir, Tetuán and Ceuta, and the second one including the rest. This distinction established a different and discriminatory criterium regarding the destination allotment

1925: Cuando volvimos a ser grandes ... el apoyo sanitario en el desembarco de Alhucemas / 1925: when we became great again ... medical support in the Alhucemas landing

El desembarco de Alhucemas fue una operación militar llevada a cabo en la zona del Rif entre el 8 de septiembre y el 13 de octubre de 1925, por efectivos españoles y franceses que combatieron frente a fuerzas rifeñas. Finalizó con la derrota de estos últimos y la consiguiente ocupación y pacificación total de la zona española del protectorado. Está considerado el primer desembarco conjunto-combinado de la historia militar y sirvió como base para proyectar el desembarco de Normandía durante la segunda guerra mundial. En el presente estudio se describe el apoyo sanitario prestado a nivel terrestre, naval y aéreo, la preparación sanitaria del despliegue y del desembarco, la logística, la evacuación y las bajas sufridas por el contingente español durante esta operación (AU)

The Alhucemas landing was a military operation carried out in the Rif area between the 8th September and the 13th October of 1925, by Spanish and French military units against Riffian forces. It ended with the Riffians’ defeat and the occupation and total pacification of the Spanish Protectorate. It is considered the first combined-joint landing in military history and served as the basis to plan the Normandy landings during the Second World War. This article describes the land, naval and air medical support, the medical preparation of the deployment and landing, the logistics, evacuation and casualties suffered by the Spanish contingent during this operation (AU)

La enfermería británica y postbritánica en el hospital de Riotinto (1873-1983) / O britânicas enfermeiras e postbritánica no hospital de Riotinto (1873-1983) / The british nurses and postbritánica in the hospital de Riotinto (1873-1983)

Desde que la Rio Tinto Company Limited adquirió las minas de Riotinto en 1873, esta región se convirtió factualmente en una colonia inglesa hasta 1954. La creación de un hospital para atender a la población inglesa fue un ejemplo de su organización, si bien pasando el tiempo su plantilla pasaría a ser española. Algunos de los principales objetivos de este estudio son identificar a las enfermeras inglesas y a las españolas que trabajaron en el hospital, así como conocer el tipo de enfermería practicada y su influencia en los profesionales españoles que trabajaban allí. Hasta ahora hemos identificado a 36 enfermeras inglesas (1873-1954), 13 practicantes y 11 enfermeras españolas (1954-1983). Aparentemente, la enfermería española no tuvo contacto con la inglesa que la precedió en el hospital, mucho más avanzada en cuanto a organización y competencia, pero no por ello su prestigio profesional fue menor (AU)

Since the purchase of the Riotinto mines by the Rio Tinto Rio Company Limited in 1873, the region actually became a British colony until 1954. The creation of a hospital to attend the English people was an example of its organization, although as time went by its staff would be Spanish. Some of the main targets of this study are to identify the British and the Spanish nurses who worked at the hospital, as well as to find out the kind of nursery craft and its influence on the Spanish professionals who worked there. By the moment we have identified not less than 36 British nurses (1873-1954), 13 male nurses and 11 Spanish female nurses (1954-1983). It seems that the Spanish nursery was not really in contact with its British precedent in the hospital, mucho more advanced as for organization and competence, but not for that its professional prestige was lower (AU)

Após a compra das minas de Riotinto pela Rio Tinto Rio Limited Companhia em 1873, a região torna-se de facto uma colônia britânica até 1954. A criação de um hospital para atender o povo da Inglaterra foi um exemplo da sua organização, mas depois o pessoal desta institui-ção passou ser espanhol. Alguns dos principais objetivos deste estudo são identificar as enfermeiras britânicas e as espanholas que trabalharon no hospital, assim como determinar o tipo de enfermeria praticada e a sua influença nos professionais espanhóis que trabalharon li. Até agora temos identificado não menos de 36 enfermeiras britânicas (1873-1954), 13 enfermeiros e 11 enfermeiras espanholas (1954-1983). Parece que a enfermeria espanhola não teve contacto com a precedente britânica no hospital, muito mais avançada a respeito de organização e capacidade, mais não por isto o seu prestígio professional foi menor (AU)

Aerospace medicine at Brooks AFB, TX: hail and farewell.

With the impending termination of USAF operations at Brooks Air Force Base (AFB) in San Antonio, TX, it is time to consider its historic role in Aerospace Medicine. The base was established in 1917 as a flight training center for the U.S. Army Air Service and in 1926 became home to its School of Aviation Medicine. The school moved to San Antonio's Randolph Field in 1931, but in 1959 it returned to Brooks where it occupied new facilities to support its role as a national center for U.S. Air Force aerospace medicine, including teaching, clinical medicine, and research. The mission was then expanded to encompass support of U.S. military and civilian space programs. With the abrupt termination of the military space program in 1969, research at Brooks focused on clinical aviation medicine and support of advanced military aircraft while continuing close cooperation with NASA in support of orbital spaceflight and the journey to the Moon. Reorganization in the 1990s assigned all research functions at Brooks to the Human Systems Division and its successors, leaving to USAFSAM the missions related to clinical work and teaching. In 2002 the USAF and the city of San Antonio implemented shared operation of Brooks as a "City-Base" in the hope of deflecting threatened closure. Nevertheless, under continuing pressure to consolidate military facilities in the United States, the 2005 Base Closure and Realignment Commission ordered Brooks closed by 2011, with its aerospace medicine functions relocated to new facilities at Wright-Patterson AFB in Dayton, OH.

[The 75th anniversary of the Center of state sanitarium-epidemiological control of PUrMD].

At the first of October 2010 Federal state institute "The 1026th center of state sanitarium-epidemiological control of the Ministry of Defense of RF", situated in Ekaterinburg celebrates it's 75th anniversary. Now days the Center is a large multiprofile institute of medical service of the military region, equipped by moern laboratory and instrumental environment for examination of electro-magnetic and electro-magnetic, microclimate, environment, indication of biological agents, effectuating of immune-enzymatic analyze and PCR-diagnostics.

La Sanidad Militar durante la Guerra de la Independencia / Medical Service in the Independence War

El conflicto bélico que asoló la Península Ibérica, desde 1808 a 1814, se desarrolló con los mismos medios que en el siglo XVIII, aunque la táctica experimentó la influencia decisiva de la aparición generalizada de guerrillas. Las guerras napoleónicas sirvieron para consolidar, en todos los países beligerantes, unos servicios sanitarios castrenses de ámbito nacional. La Medicina y la Cirugía eran profesiones separadas y con frecuencia enfrentadas. Los cirujanos tenían una preparación superior a los médicos que, en España, se había logrado con la creación, en la segunda mitad del siglo XVIII, de los Reales Colegios de Cirugía. Participaron en la contienda las máximas figuras de la Cirugía Militar del momento, como Guthrie o Larrey, que aportó el revolucionario concepto asistencial de las ambulancias volantes. Aunque las técnicas quirúrgicas estaban bien descritas, la deficiente hemostasia, el dolor y, sobre todo, las infecciones imponían limitaciones. La mortalidad de los heridos era del 33% y la tasa de infección del 90%. La escuela quirúrgica española aportó la llamada «cura española», o método conservador de tratar las heridas, que fue adoptado por los cirujanos de los otros ejércitos. Las bajas por enfermedad eran diez veces superiores al número de heridos. No se conocía la etiopatogenia de la mayoría de los procesos morbosos y no se disponía de medios diagnósticos o terapéuticos mínimamente eficaces (AU)

The armed conflict that ravage the Iberian Peninsula from 1808 to 1814 was fought using the same technical means available in the XVIII century. However, a major change took place in the field of tactics, where the extensive use of guerrilla warfare had a decisive influence on the outcome of the fight. In all contending countries, the Napoleonic Wars served to consolidate Army Medical Services on a national scale. At the time, medicine and surgery were two separate and often opposed disciplines and surgeons were commonly better prepared tham medical practitioners. In the case of Spain this was due to the success of the Royal Schools or Surgery, created in the second half of the XVIII century. All major eminent surgeons of the moment such as Guthrie or Larrey took part in the fight. Larrey made the revolutionary contribution of developing the «flying ambulances», a completely new concept at the time. Although surgical techniques were alreadt well describe at the time, the deficient hemostasis, the unchecked pain, and above all the numerous infections imposed severe limitations. Mortality among the injured reached 33% and the rate of infection was 90%. The Spanish surgical school contributd to military surgery with the practice known as «te Spanish Cure» which was a conservative approach to the treatment of wounds. This approach was later adopted by the army surgeons of the other countries. Deaths by illness were ten times higher than the number of injured. The etiology of most morbid processes was unknown and no efficient diagnostics and therapeutics means were available (AU)

Heridas de guerra y su tratamiento en la campaña de Filipinas (1896-1898). Segunda Parte / War wounds and their treatment in the Philippines Campaign (1896.1898)

En este artículo se exponen y comentan los tipos de heridas de guerra en la última campaña de Filipinas (1896-1898) así como los métodos de curación de los heridos, recogidos en la obra: La Campaña de Filipinas. Recuerdos de un Médico Militar, del médico mayor D. Lorenzo Ayean López, que participó activamente como cirujano heridos, durante toda la campaña (AU)

In chisarticle, che types of war wound in tite last Philippines campaign (18961898) are presented and commented on, along with methods for creating che wounds. gathered in che work: The Philippines Campaign. Memoirs of a Militar)’ Doctor, by the doctor Major D. Lorenzo Aycart López, who was active as a milicaiy surgeon and in tite sanitary logistic organisation and treacment of wounded soldiers during the whole campaign (AU)