Military Dictatorship and the Faculty of Medicine-USP: the Experimental Medicine Course, 1967-1982. / Ditadura Militar e a Faculdade de Medicina-USP: o Curso Experimental de Medicina, 1967-1982.

This article aimed to historically assess the impact undergone by the Faculty of Medicine-USP when it formally supported the military regime established in Brazil from 1964 onwards and the consequences of this support in its daily life. Another objective was unearthing how this context, lived between persecution, prisons, and torture, also intervened in didactic-pedagogical actions, such as the creation of a new model of medical education in 1967, known as the Experimental Course. This course would be immediately attacked by groups that saw it as a communist stronghold and a threat to the tradition of the so-called "Casa de Arnaldo", resulting in the closure of its activities in 1974.

O objetivo deste artigo é estudar historicamente o impacto sofrido pela Faculdade de Medicina-USP quando ela apoiou formalmente o regime militar que se estabelecia no Brasil a partir de 1964 e os reflexos desse apoio em seu cotidiano. Outro objetivo é apresentar como esse contexto, vivido entre perseguições, prisões e torturas, interveio também em ações de ordem didático-pedagógica, como na criação de um novo modelo de ensino médico no ano de 1967, conhecido como Curso Experimental. Esse curso seria imediatamente atacado por grupos que o viam como um reduto comunista e uma ameaça à tradição da chamada "Casa de Arnaldo", logrando o encerramento de suas atividades no ano de 1974.

Eduardo Odio Pérez, un médico cubano que combatió al fascismo en España / Eduardo Odio Pérez, a Cuban doctor who fought fascism in Spain

En la Guerra Civil Española participaron médicos cubanos que integraron la sanidad militar de las fuerzas republicanas; un tema que ha suscitado diversos estudios, pero del que quedan aún aspectos por investigar. El presente trabajo se enfoca en un médico cubano que participó en la gesta internacionalista en España, el doctor Eduardo Odio Pérez. Nació en Santiago de Cuba y se graduó de médico en los EE. UU. El objetivo es contribuir al conocimiento de los médicos cubanos que participaron en la lucha contra el fascismo en España. Los resultados hacen referencia a su participación como integrante de la sanidad militar de la XV Brigada Internacional Abraham Lincoln. Prestó servicios en hospitales militares, donde se atendieron las bajas sanitarias de importantes acciones combativas del conflicto armado, como la batalla del Jarama. Alcanzó el grado de capitán y solicitó el ingreso al Partido Comunista Español. Su contribución a la lucha contra el fascismo en España es una muestra de internacionalismo y un modelo referencial para el trabajo educativo en la formación médica.

Cuban doctors participated in the Spanish Civil War as part of the military health service of the Republican forces; a topic that has been the subject of several studies, but aspects of which still remain to be investigated. The present work focuses on a Cuban physician who participated in the internationalist heroic deed in Spain, Dr. Eduardo Odio Perez. He was born in Santiago de Cuba, and graduated as a doctor in the U.S.A. The objective is to contribute to the knowledge of Cuban doctors who participated in the fight against fascism in Spain. The results refer to his participation as a member of the military health service of the XV International Abraham Lincoln Brigade. He served in military hospitals, where he attended the medical casualties of important combat actions of the armed conflict, such as the battle of Jarama. He reached the rank of captain and applied to join the Spanish Communist Party. His contribution to the fight against fascism in Spain is an example of internationalism and a reference model for educational work in medical training.

Evaluation of Gender Disparity in Tactical Combat Casualty Care.

INTRODUCTION: Women comprise nearly 19% of the U.S. military and now serve in almost all operational roles, increasing their risk of combat trauma and injuries.3 Data from the Joint Trauma Registry during Operation Enduring Freedom shows that battle-injured females had a higher case fatality rate at 36% compared to their male counterparts at 17%.1 The Tactical Combat Casualty Care curriculum is used to prepare battlefield medics to provide immediate care to wounded service members, but fails to address differences in the care of female versus male casualties. The students, who are presented with life-threatening injuries in simulated trauma scenarios, may be slower to assess, identify, and treat injuries in female patients as compared with male patients. MATERIALS AND METHODS: This observational program analysis was reviewed by the Uniformed Services University Human Research Protections Program and approved for execution as an exempt protocol under the provision of 32 CFR 219.104(d)(1). The study assessed the performance of male and female Mexican military personnel during a Tactical Combat Casualty Care course, using standardized trauma scenarios. Anatomically, correct male and female manikins were used to compare response time for different gender patients presenting with the same injuries. RESULTS: There was a statistically significant increase in time required to complete an initial blood sweep, identify a gunshot wound to the chest, and call for medical evacuation when treating a female patient compared to a male patient. CONCLUSIONS: A lack of female representation in trauma training may have contributed to the higher case fatality rate of female soldiers compared to male soldiers during Operation Enduring Freedom. Female live actors and Gender Retrofit Kits can augment trauma casualty assessment and treatment training scenarios and better prepare our forces to respond to life-threatening emergencies.

La Defensa Pasiva y su división médica de emergencia / Passive Defense and its emergency medical division / Passive Defence e sua divisão médica de emergência

Durante la Segunda Guerra Mundial el gobierno de Uruguay intentó prepararse para una eventual defensa militar del territorio y la defensa de la población civil en caso de sufrir ataques aéreos. La Defensa Pasiva, fue la estructura gubernamental que junto a la voluntad en todas las clases sociales, funcionó en todo el territorio nacional con la finalidad de proteger a la población civil de los ataques aéreos y guerra química, generando un espíritu de solidaridad a través de su División Médica de Emergencia.

During the Second World War, the government of Uruguay tried to prepare for an eventual military defense of the territory and the defense of the civilian population in case of air raids. The Passive Defense was the governmental structure that, together with the will of every social class, operated throughout the national territory with the purpose of protecting the civilian population from air raids and chemical weapons, generating a spirit of solidarity through its Emergency Medical Division.

Durante a Segunda Guerra Mundial, o governo uruguaio tentou se preparar para uma eventual defesa militar do território e para a defesa da população civil em caso de ataques aéreos. A Defesa Passiva era a estrutura governamental que, juntamente com a vontade de todas as classes sociais, operava em todo o território nacional com o objetivo de proteger a população civil de ataques aéreos e da guerra química, gerando um espírito de solidariedade por meio de sua Divisão Médica de Emergência.

The last days: The medical response of United States and allied military teams during the Afghanistan Exodus.

OBJECTIVES: The objective of this study is to describe the United States and allied military medical response during the withdrawal from Afghanistan. BACKGROUND: The military withdrawal from Afghanistan concluded with severe hostilities resulting in numerous civilian and military casualties. The clinical care provided by coalition forces capitalized on decades of lessons learned and enabled unprecedented accomplishments. METHODS: In this retrospective, observational analysis, casualty numbers, and operative information was collected and reported from military medical assets in Kabul, Afghanistan. The continuum of medical care and the trauma system, from the point of injury back to the United States was captured and described. RESULTS: Prior to a large suicide bombing resulting in a mass casualty event, the international medical teams managed distinct 45 trauma incidents involving nearly 200 combat and non-combat civilian and military patients over the preceding 3 months. Military medical personnel treated 63 casualties from the Kabul airport suicide attack and performed 15 trauma operations. US air transport teams evacuated 37 patients within 15 hours of the attack. CONCLUSION: Lessons learned from the last 20 years of combat casualty care were successfully implemented during the culmination of the Afghanistan conflict. Ultimately, the effort, teamwork, and system adaptability exemplify not only the attitudes and character of service members who provide modern combat casualty care but also the paramount importance of the battlefield learning health care system. A continued posture to maintain military surgical preparedness in unique environments remain crucial as the US military prepares for the future.Retrospective observational analysis. LEVEL OF EVIDENCE: Therapeutic/Care Management; Level V.

Lessons from the Fallen: An After-Action Review of Prehospital Casualty Data during the Global War on Terror.

BACKGROUND: The US military's recent involvement in long standing conflict has caused the pioneering of many lifesaving medical advances, often made possible by data-driven research. However, future advances in battlefield medicine will likely require greater data fidelity than is currently attainable. Continuing to improve survival rates will require data which establishes the relative contributions to preventable mortality and guides future interventions. Prehospital data, particularly that from Tactical Combat Casualty Care (TCCC) Cards and TCCC After Action Reports (TCCC AARs), are notoriously inconsistent in reaching searchable databases for formal evaluation. While the military has begun incorporating more modern technology in advanced data capture over the past few years like the Air Force's Battlefield Assisted Trauma Distributed Observation Kit (BATDOK) and the Army's Medical Hands-free Unified Broadcast system (MEDHUB), more analysis weighing the advantages and disadvantages of substituting analog solutions is needed. DISCUSSION: We propose 3 changes which may aid prehospital data capture and facilitate analysis: reexamine the current format of TCCC Cards and consider reducing the number of available datapoints to streamline completion, implement a military-wide mandate for all Role 1 providers to complete a TCCC AAR within 24 hours of a casualty event, and formalize the process of requesting de-identified data from the Armed Forces Medical Examiner System (AFMES) database. CONCLUSION: Reflecting on the state of US military medicine after 20 years of war, an important focus is improving the way prehospital data is gathered and analyzed by the military. There are steps we can take now to enhance our capabilities.

George W. Crile (1864-1943); excepcional cirurgião americano / George W. Crile (1864-1943); excepcional cirujano estadounidense / George W. Crile (1864-1943); exceptional American surgeon

George W. Crile (1864-1943); excepcional cirurgião americano, que serviu no Corpo Médico do Exército durante a Guerra Hispano-Americana. Durante a Primeira Guerra Mundial, foi diretor cirúrgico do American Ambulance Hospital em Neuilly, na França. Ajudou fundar o American College of Surgeons em 1913, foi membro e diretor não apenas dessa organização, mas também da American Medical Association, da American Surgical Association, da Royal Academy of Surgeons e da Royal Academy of Medicine (Reino Unido). Em 1921, foi cofundador da Cleveland Clinic em Cleveland, Ohio, EUA. Foi um importante médico cujas pesquisas e escritos incluíam choque cirúrgico, função glandular, pressão arterial e transfusões, neurose de guerra e os efeitos da cirurgia em tempos de guerra. Ele também foi um cirurgião extraordinário e prolífico que introduziu inovações no tratamento cirúrgico de muitas patologias. Embora sua pesquisa tenha sido publicada há muito tempo, suas contribuições para a medicina continuam sendo fundamentais para a prática clínica nas salas de cirurgia e unidades de terapia intensiva atuais.

George W. Crile (1864-1943) fue un excepcional cirujano estadounidense que sirvió en el Cuerpo Médico del Ejército durante la Guerra Hispanoamericana. Durante la Primera Guerra Mundial fue director quirúrgico del American Ambulance Hospital de Neuilly (Francia). Ayudó a fundar el Colegio Americano de Cirujanos en 1913 y fue miembro y director no sólo de esta organización, sino también de la Asociación Médica Americana, la Asociación Quirúrgica Americana, la Real Academia de Cirujanos y la Real Academia de Medicina (Reino Unido). En 1921 fue cofundador de la Cleveland Clinic de Cleveland (Ohio, EE.UU.). Fue un importante médico cuyas investigaciones y escritos abarcaron el shock quirúrgico, la función glandular, la presión arterial y las transfusiones, la neurosis de guerra y los efectos de la cirugía en tiempos de guerra. También fue un cirujano extraordinario y prolífico que introdujo innovaciones en el tratamiento quirúrgico de muchas patologías. Aunque sus investigaciones se publicaron hace mucho tiempo, sus aportaciones a la medicina siguen siendo fundamentales para la práctica clínica en los quirófanos y unidades de cuidados intensivos actuales.

George W. Crile (1864-1943) was an exceptional American surgeon who served in the Army Medical Corps during the Spanish-American War. During the First World War, he was surgical director of the American Ambulance Hospital in Neuilly, France. He helped found the American College of Surgeons in 1913 and was a member and director not only of this organization, but also of the American Medical Association, the American Surgical Association, the Royal Academy of Surgeons and the Royal Academy of Medicine (UK). In 1921, he co-founded the Cleveland Clinic in Cleveland, Ohio, USA. He was an important physician whose research and writings included surgical shock, glandular function, blood pressure and transfusions, war neurosis and the effects of wartime surgery. He was also an extraordinary and prolific surgeon who introduced innovations in the surgical treatment of many pathologies. Although his research was published long ago, his contributions to medicine remain fundamental to clinical practice in today's operating rooms and intensive care units.

An Innovative Civilian Research Model to Inform Combat-Relevant Prolonged Casualty Care.

Prolonged Casualty Care (PCC) is a major US military research focus area. PCC is defined as the need to provide patient care for extended periods when evacuation or mission requirements surpass capabilities and/or capacity. US military experts have called for more data relevant to PCC. In response, we aimed to develop an innovative research model using a tiered system of trauma care in the Western Cape of South Africa as a framework for studying relevant US military trauma care and outcomes in a natural prolonged care environment. The objective of this report is to describe the research model and to illustrate how various components of the model may be helpful to provide data relevant to US military PCC. To develop the model, we used a combination of published data, open access reports, and expert opinion to identify, define, and compare relevant components of the Western Cape trauma system suitable for researching aspects of US military PCC. Several key features of the research model are as follows: In the Western Cape, patients are referred from primary and secondary to tertiary facilities (analogous to escalating capabilities by advancing roles of care in the US military). Western Cape civilian trauma providers' capabilities range from prehospital basic life support to definitive trauma surgical and critical care (comparable to US military Tactical Combat Casualty Care to advanced definitive surgical care). Patterns of injuries (e.g., high rates of penetrating trauma and hemorrhagic shock) and prolonged times from injury to definitive surgical care in the Western Cape system have relevance to the US military. This civilian research model for studying PCC is promising and can inform US military research. Importantly, this model also fills gaps in the South African civilian system and is useful for other prolonged trauma care communities worldwide.

Evaluación del efecto antibacteriano sinérgico de rifamicina en propóleo sobre bacterias grampositivas / Evaluation of the synergistic antibacterial effect of rifamycin in propolis on gram-positive bacteria

Introducción: En la medicina militar, la aplicación de las sustancias antibacterianas en las infecciones tópicas, es importante en el tratamiento de las tropas. Objetivos: Evaluar el efecto antibacteriano sinérgico de rifamicina en propóleo sobre bacterias grampositivas. Métodos: Estudio experimental in vitro y comparativo. Se efectuó el análisis fitoquímico preliminar del propóleo de Apis mellífera. Se utilizaron 96 placas de agar Muller Hinton (Britania®) (48 placas para cada especie bacteriana) repartidas en 6 grupos (n = 8). grupo I (agua destilada), grupo II (alcohol etílico al 96 por ciento), grupo III (rifamicina al 0,5 por ciento), grupo IV (rifamicina al 1 por ciento), grupo V (propóleo al 20 por ciento) y grupo VI (rifamicina al 1 por ciento en propóleo al 40 por ciento); se empleó la metodología de Kirby - Bauer; las cepas usadas fueron Staphylococcus aureus ATCC 25923, Streptococcus pyogenes ATCC 19615 y las mediciones de las zonas de inhibición se efectuaron a las 24 horas. Resultados: Se detectaron compuestos fenólicos, taninos, flavonoides, alcaloides y triterpenoides en propóleo. Se comprobó el efecto antibacteriano del grupo V con 18,627 ± 0,1008 mm (92,59 por ciento) y 19,247 ± 0,0762 mm (96,74 por ciento), y el efecto antibacteriano sinérgico del grupo VI con 19,316 ± 0,1202 mm (96,02 por ciento) y 19,613 ± 0,0820 mm (98,58 por ciento), comparados con rifamicina al 1 por ciento (100 por ciento) sobre S. aureus ATCC 25923 y S. pyogenes ATCC 19615. Conclusiones: La combinación de rifamicina al 1 por ciento unida al propóleo al 40 por ciento presenta una mayor actividad antibacteriana in vitro sobre bacterias grampositivas debido a su efecto sinérgico(AU)

Introduction: In military medicine, the application of antibacterial substances in topical infections are important in the treatment of troops. Objectives: To evaluate the synergistic antibacterial effect of rifamycin in propolis on gram-positive bacteria. Methods: In vitro and comparative experimental study. Preliminary phytochemical analysis of Apis mellifera propolis was carried out. 96 Muller Hinton agar plates (Britania®) (48 plates for each bacterial species) divided into 6 groups (n = 8) were used group I (distilled water), group II (96 percent ethyl alcohol), group III (rifamycin 0,5 percent), group IV (rifamycin 1 percent), group V (propolis 20 percent) and group VI (rifamycin 1 percent in 40 percent propolis); Kirby-Bauer methodology was used; the strains used were Staphylococcus aureus ATCC 25923, Streptococcus pyogenes ATCC 19615 and the measurements of the zones of inhibition were carried out at 24 hours. Results: Phenolic compounds, tannins, flavonoids, alkaloids and triterpenoids were detected in propolis. The antibacterial effect of group V was verified with 18,627 ± 0,1008 mm (92,59 percent) and 19,247 ± 0,0762 mm (96,74 percent), and the synergistic antibacterial effect of group VI with 19,316 ± 0,1202 mm (96,02 percent) and 19,613 ± 0,0820 mm (98,58 percent), compared with rifamycin 1 percent (100 percent) on S. aureus ATCC 25923 y S. pyogenes ATCC 19615. Conclusions: The combination of rifamycin 1 percent together with propolis 40 percent has a greater antibacterial activity in vitro on gram-positive bacteria due to its synergistic effect(AU)

A Descriptive Analysis of Battlefield First Responder and Combat Lifesaver Interventions during the Role 1 Phase of Care.

BACKGROUND: Battlefield first responders (BFR) are the first non-medical personnel to render critical lifesaving interventions for combat casualties, especially for massive hemorrhage where rapid control will improve survival. Soldiers receive medical instruction during initial entry training (IET) and unit-dependent medical training, and by attending the Combat Lifesaver (CLS) course. We seek to describe the interventions performed by BFRs on casualties with only BFRs listed in their chain of care within the Prehospital Trauma Registry (PHTR). METHODS: This is a secondary analysis of a dataset from the PHTR from 2003-2019. We excluded encounters with a documented medical officer, medic, or unknown prehospital provider at any time in their chain of care during the Role 1 phase to isolate only casualties with BFR medical care. RESULTS: Of the 1,357 encounters in our initial dataset, we identified 29 casualties that met inclusion criteria. Pressure dressing was the most common intervention (n=12), followed by limb tourniquets (n=4), IV fluids (n=3), hemostatic gauze (n=2), and wound packing (n=2). Bag-valve-masks, chest seals, extremity splints, and nasopharyngeal airways (NPA) were also used (n=1 each). Notably absent were backboards, blizzard blankets, cervical collars, eye shields, pelvic splints, hypothermia kits, chest tubes, supraglottic airways (SGA), intraosseous (I/O) lines, and needle decompression (NDC). CONCLUSIONS: Despite limited training, BFRs employ vital medical skills in the prehospital setting. Our data show that BFRs largely perform medical interventions within the scope of their medical knowledge and training. Better datasets with efficacy and complication data are needed.

The 1942 Massive Contamination of Yellow Fever Vaccine: A Public Health Consequence of Scientific Arrogance.

In the late 1930s, the 17D vaccine against yellow fever was produced in record time. 17D was and is an excellent vaccine. Its rapid diffusion led, however, to several problems, the most important among them being the 1942 massive contamination of the vaccine distributed to the US Army by the hepatitis B virus. The US part of this story is relatively well-known, but its Brazilian part much less so. In 1940, scientists who were producing the 17D vaccine in Rio de Janeiro found that it was contaminated by an "icterus virus" that originated in normal human serum. They solved this problem through the exclusion of human serum from vaccine production, but failed to persuade their US colleagues to do the same. The Rio experts, aware of the potential pitfalls of a new technology, carefully supervised the consequences of their vaccination campaigns. They were thus able to rapidly spot problems and eliminate them. By contrast, US scientists, persuaded of their technical superiority and distrustful of warnings that originated from a "less developed" country, neglected to implement basic public health rules. A major disaster followed. (Am J Public Health. 2021;111(9): 1654-1660. https://doi.org/10.2105/AJPH.2021.306313).

A Descriptive Analysis of Notional Casualties Sustained at the Joint Readiness Training Center: Implications for Health Service Support during Large-Scale Combat Operations.

INTRODUCTION: The Joint Readiness Training Center (JRTC) offers a laboratory for study of combat casualty care delivery during brigade-sized collective training exercises. We describe the casualty outcomes during largescale combat operations as part of a JRTC rotation. METHODS: During JRTC rotation 20-02, 2/4 Infantry Brigade Combat Team (IBCT) participated in force on force operations as part of a joint and multinational task force. Medical assets available included a Role II associated with the Brigade Support Medical Company and Role I facilities associated with six subordinate battalion elements. Observers, coaches, and trainers (OCTs) categorized all casualties as killed in action (KIA) or wounded in action (WIA). OCTs categorized WIA casualties as died of wounds (DOW) based upon time elapsed from time of injury to transportation to successive roles of care within time standards, dependent upon the severity of injuries. We portrayed our DOW rates using descriptive statistics. RESULTS: Force on force operations spanned 14 days. The task organization comprised 3,820 persons. Casualties included 642 KIA and 1061 WIA. Of the WIA, 502 (47.3%) dies from their wounds. The primary reason for DOW was evacuation delay from point of injury (POI) to military treatment facility (MTF) (443 casualties, 88.2%). An additional 40 casualties DOW at the Role 1 (8.0%) and 10 died at Role II (2.0%). Nine casualties (1.8%) DOW due to improper care rendered. DISCUSSION: Casualty DOW during simulated large-scale combat operations are overwhelmingly due to evacuation delays from POI. Medical readiness for near-peer force on force operations depends upon shared understanding across medical and non-medical personnel of casualty movement through echelons of care on the battlefield.

Triunfo de Finlay, una obra para el proceso formativo de profesionales de la salud / Triumph of Finlay, one picture useful for preparation the professionals of the health

Un acontecimiento en la vida del doctor Carlos Juan Finlay Barrés motivó al Maestro Esteban Valderrama Peña a realizar la composición pictórica Triunfo de Finlay. La pintura representa al médico cubano exponiendo ante una comisión médica militar estadounidense, su teoría sobre el modo de contagio de la fiebre amarilla y el ente transmisor, el mosquito Aedes aegypti. Finlay había estudiado durante años la enfermedad sin que las autoridades coloniales reconocieran los resultados de sus investigaciones, a pesar de que la enfermedad causaba estragos en los militares españoles y la población. En 1898 la intervención norteamericana en la guerra de los cubanos contra el colonialismo español, generó la necesidad de sanear la Isla y crear condiciones higiénicas favorables para la estancia de las tropas norteñas. El general y médico Leonard Wood fijó su atención en la teoría de Finlay y solicitó al gobierno de su país especialistas para verificarla. Fue enviada una comisión dirigida por el mayor Walter Reed, cirujano del ejército y catedrático de bacteriología de la Facultad de Medicina Militar en Washington, para confirmarla. En la pintura, el artista representó la reunión de Finlay con la comisión norteña. El presente trabajo destaca la trascendencia de la obra, su valor estético y la integración del arte, la historia, la medicina y la ciencia. Se propone incluir su estudio como parte del trabajo educativo dirigido a fomentar la cultura general en la formación de los profesionales de la salud(AU)

One event for Doctor Carlos J. Finlay Barrés was the motive for the oil painting composition named "Triumph of Finlay" by Master of Art Esteban Valderrama Peña. The picture shows Finlay presenting his theory about the transmission of yellow fever by mosquitoes to the US Army Yellow Fever Commission. He had conceived a new infection way able to explain the propagation of the illness, and added the possibility of their scientific confirmation by experimental method. In 1898 the US army took place in the Cuban`s fighting against the Spanish colonialism. This circumstance beginning the need to improve the sanitary condition in the Island to create favorable hygienic conditions to the stay of the troops. The Military Governor of the Island, general and physician Leonard Wood took Finlay´s theory as center of his attention. He requested the government of his country experts to verify it. One commission heading for Major Walter Reed was sent. Reed was a surgeon of the army and professor of bacteriology in Military Medicine Faculty in Washington. After experimentally investigation, the commission could confirm Finlay´s theory. Valderrama´s picture shows the meeting of Finlay with the experts. This article has like objective to give emphasis about this pictorial by its importance for the Cuba´s medicine and the science history in Cuba. By the esthetic value that contains it must be included in the educational labor towards the preparation the professionals of the health. It is useful for contributing with the general culture integrating art, history, medicine and science(AU)

Reciprocal Learning Between Military and Civilian Surgeons: Past and Future Paths for Medical Innovation.

Numerous surgical advances have resulted from exchanges between military and civilian surgeons. As part of the U.S. National Library of Medicine Michael E. DeBakey Fellowship in the History of Medicine, we conducted archival research to shed light on the lessons that civilian surgery has learned from the military system and vice-versa. Several historical case studies highlight the need for immersive programs where surgeons from the military and civilian sectors can gain exposure to the techniques, expertise, and institutional knowledge the other domain provides. Our findings demonstrate the benefits and promise of structured programs to promote reciprocal learning between military and civilian surgery.

Dr. René Cirilo Vallejo Ortiz, paradigma de la medicina en Granma / Dr. René Cirilo Vallejo Ortiz, paradigm of Medicine in Granma

En este artículo se reseñan los aspectos más relevantes de la vida y obra del Dr. René CiriloVallejo Ortiz, paradigma de la medicina granmense que por su consagración como médico guerrillero y revolucionario deja a lo largo de la historia la imagen de un manzanillero abnegado, comprometido con su pueblo y la Revolución, no vaciló en dejar bienes ycomodidades para incorporarse a la lucha, salvó incontables vidas y se convirtió en un ejemplo de profesional para las nuevas generaciones.(AU)

In this article the most relevant aspects of the life and work of Dr. René Cirilo Vallejo Ortiz,paradigm of Medicine in Granma were described and because of his devotion as a physician, a fighter and a revolutionary, leaves along history the image of a sacrificed man from Manzanillo, engaged with his people and the Revolution, who did not vacillate in leavinggoods and commodities to incorporate himself to fight, saving uncountable lives, so, hebecame an example of professional for the new generations.(AU)

Universidad de Ciencias Médicas de las Fuerzas Armadas Revolucionarias, 39 años formando médicos militares / University of Medical Sciences of the Revolutionary Armed Forces, 39 years training military doctors

El 7 de octubre de 1981, por el acuerdo No. 1074 del Comité Ejecutivo del Consejo de Ministros, se creó el Instituto Superior de Medicina Militar, hoy Universidad de Ciencias Médicas de las Fuerzas Armadas Revolucionarias, como centro de educación superior, adscrito al Ministerio de las Fuerzas Armadas Revolucionarias. Constituye la única institución docente de nivel superior de su tipo en el Cuba, para la formación de médicos militares, estomatólogos, enfermeros y tecnólogos de la salud. Las vías de ingreso a la universidad, son los alumnos egresados de las escuelas militares Camilo Cienfuegos y del servicio militar. La universidad arriba a su 39 aniversario, con satisfacción y logros en las ciencias médicas, pedagógicas y de la educación médica. Tiene un claustro de profesores, que responde a las exigencias y necesidades de la educación superior cubana, la salud pública y el Ministerio de las Fuerzas Armadas Revolucionarias. Dentro de los profesores, es un honor contar varios que ostentan la Orden Carlos J. Finlay, por sus aportes a la ciencia; con miembros del contingente Henry Reeve, que han trabajado y trabajan en varias partes del mundo; así como poseedores de la Distinción por la Educación Cubana...(AU)