History of medicine

医学史
  • 文章类型: Journal Article
    感染控制仍然是医疗保健系统的重大负担。抗生素在对抗微生物疾病中的不合理使用导致了抗生素耐药性的快速发展。考虑到后者如何对现代治疗的有效性和医学的实践方式产生不利影响,我们应该修改导致建立防腐一般原则的事件,并特别向为其形成做出贡献的人们致敬,记住,直到今天,它们在很大程度上都没有被修改过。如果没有Semmelweis对脓毒症直接传播的概念的概念化,巴斯德的象征性人物,帮助进一步促进了这个想法,和李斯特的方法论结构,科学界将大大推迟赢得与细菌的斗争。
    Infection control remains a significant burden for healthcare systems. The irrational use of antibiotics in the fight against microbial diseases has led to the fast development of antimicrobial resistance. Considering how the latter can adversely influence the effectiveness of modern treatments and the way medicine is practiced, we should revise the events that led to the establishment of the general principles of antisepsis and pay special tribute to the people who contributed to their formation, bearing in mind that they remain unmodified to a great extent until today. Without Semmelweis\' conceptualization of the idea of direct transmission of sepsis, Pasteur\'s emblematic figure that helped promote the idea even further, and Lister\'s methodology structuring, the scientific community would have significantly delayed winning the battle against germs.
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  • 文章类型: Journal Article
    我们文章的目的是强调疼痛管理的历史。面对疼痛的多学科团队(MDT)概念首先由希波克拉底概念化,并随着时间的推移而发展,并在最近几十年成为医学的趋势。进行了纪录片研究,以揭示MDT演变的故事。从1950年代初开始,医学中偶尔引入了MDT方法来处理各种类型的疼痛。研究鼓励卫生机构通过向卫生专业人员提供培训来支持这一概念,以及必要的设施和资源。专业护理计划始于CicelyMaryStrodeSaunders夫人作为先驱之一。结论:团队合作和持续的疼痛跨学科治疗使MDTs对卫生系统至关重要。灵活性的障碍,信息流和个人问题导致需要更好的组织和培训。疼痛和晚期疾病缓解需要MDT,和受过教育的领导人来管理他们。当前和未来的健康MDT被认为在所有医学领域都是必要的。
    The aim of our article is to highlight the history of pain management. The multidisciplinary team (MDT) concept in confronting pain was first conceptualized by the Hippocratics, and has evolved through time and become a trend in medicine over recent decades. Documentary research was conducted to unveil the story of the evolution of MDTs. From the early 1950\'s the idea of an MDT approach to deal with various types of pain was sporadically introduced in medicine. Studies encouraged health institutions to support this concept by providing health professionals with training, alongside the necessary facilities and resources. Specialized care programs started with Dame Cicely Mary Strode Saunders as one of the pioneers. CONCLUSIONS: Team work and continuous interdisciplinary treatment of pain have rendered MDTs essential for health systems. Barriers in flexibility, information flow and personal issues give rise to the need for better organization and training. Pain and terminal disease palliation call for MDTs, and educated leaders to run them. Present and future health MDTs are considered necessary in all medical fields.
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  • 文章类型: Journal Article
    丙氨酸氨基转移酶(ALT)血清水平由于肝细胞损伤而升高。代谢功能障碍相关脂肪性肝病(MAFLD),确定与≥2代谢异常相关的脂肪变性肝病(SLD),有明显的性别差异。代谢综合征定义了一个包括腹部肥胖的集群,改变葡萄糖代谢,血脂异常,和高血压。男性,身体质量指数,葡萄糖,脂质,铁蛋白,高血压,和年龄独立预测献血者的ALT水平。在过去的几十年里,由于试图更新特定性别的参考范围,人们对ALT水平的参考范围进行了激烈的争论.有了这个倒退,Chen等人最近发表了一项研究,其中有两个主要发现。首先,>80%的MAFLD患者ALT水平正常。第二,ALT累积过量高正常值水平与MAFLD发生率之间呈线性增加趋势.这项研究有生物学上可信的发现。然而,它不准确地考虑了MAFLD领域的性别差异。因此,未来关于代谢功能障碍导致的SLD的研究应采用局部确定和前瞻性验证的ALT参考范围,并仔细考虑肝酶和MAFLD病理学的性别差异.
    Alanine aminotransferase (ALT) serum levels increase because of hepatocellular damage. Metabolic dysfunction-associated fatty liver disease (MAFLD), which identifies steatotic liver disease (SLD) associated with ≥ 2 metabolic abnormalities, has prominent sexual differences. The Metabolic Syndrome defines a cluster comprising abdominal obesity, altered glucose metabolism, dyslipidemia, and hypertension. Male sex, body mass index, glucose, lipids, ferritin, hypertension, and age independently predict ALT levels among blood donors. Over the last few decades, the reference range of ALT levels has been animatedly debated owing to attempts to update sex-specific reference ranges. With this backset, Chen et al have recently published a study which has two main findings. First, > 80% of individuals with MAFLD had normal ALT levels. Second, there was a linear increasing trend in the association between cumulative excess high-normal ALT levels and the rate of incident MAFLD. This study has biologically credible findings. However, it inaccurately considered sex differences in the MAFLD arena. Therefore, future studies on SLD owing to metabolic dysfunction should adopt locally determined and prospectively validated reference ranges of ALT and carefully consider sex differences in liver enzymes and MAFLD pathobiology.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    在对两个医疗电子数据库进行了全面的文献检索后,PubMed和Embase,以及两个引文数据库,WebofScience核心收藏(WoS)和Scopus,我们旨在对医学研究中的医学史文献进行Altmetric和Scientometric分析。
    以下软件工具用于分析从PubMed和Embase数据库中检索到的记录,并进行合作分析,以确定涉及科学医学论文的国家,以及聚类关键词,以揭示未来医学史研究的趋势。这些软件工具(VOSviewer1.6.18和Spss16)允许研究人员可视化文献计量网络,进行统计分析,并识别数据中的模式和趋势。
    我们的分析揭示了来自PubMed的53,771条记录和来自EMBASE数据库的54,405条记录,这些记录在医学史领域由105,286位WoS的撰稿人检索。我们确定了157个在科学医学论文上合作的国家。通过对59,995个关键字进行聚类,我们能够揭示未来医学史研究的趋势。我们的研究结果表明,传统文献计量学和社交媒体指标(如医学史文献中的Altmetric注意力评分)之间存在正相关(p<0.05)。
    在社会科学网络中分享文章的研究成果将增加医学史研究中科学著作的知名度,这是影响文章引用的最重要因素之一。此外,我们对医学领域文献的概述使我们能够识别和检查医学史研究中的空白。
    UNASSIGNED: After conducting a comprehensive literature search of two medical electronic databases, PubMed and Embase, as well as two citation databases, Web of Science Core Collections (WoS) and Scopus, we aimed to conduct an Altmetric and Scientometric analysis of the History of Medicine literature in medical research.
    UNASSIGNED: The following software tools were used for analyzing the retrieved records from PubMed and Embase databases and conducting a collaboration analysis to identify the countries involved in scientific medical papers, as well as clustering keywords to reveal the trend of History of Medicine research for the future. These software tools (VOSviewer 1.6.18 and Spss 16) allowed the researchers to visualize bibliometric networks, perform statistical analysis, and identify patterns and trends in the data.
    UNASSIGNED: Our analysis revealed 53,771 records from PubMed and 54,405 records from EMBASE databases retrieved in the field of History of Medicine by 105,286 contributed authors in WoS. We identified 157 countries that collaborated on scientific medical papers. By clustering 59,995 keywords, we were able to reveal the trend of History of Medicine research for the future. Our findings showed a positive association between traditional bibliometrics and social media metrics such as the Altmetric Attention Score in the History of Medicine literature (p < 0.05).
    UNASSIGNED: Sharing research findings of articles in social scientific networks will increase the visibility of scientific works in History of Medicine research, which is one of the most important factors influencing the citation of articles. Additionally, our overview of the literature in the medical field allowed us to identify and examine gaps in the History of Medicine research.
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  • 文章类型: Case Reports
    本案例研究报告了在DuckworthCollection(剑桥大学)举行的两个古埃及头骨上观察到的恶性肿瘤和创伤性病变。该分析旨在表征病变并使用基于micro-CT扫描和微观骨表面分析的方法进行诊断。结果指出了两种情况下的肿瘤性病变,其中一种治愈了严重的颅骨创伤,表明成功的创伤治疗。有趣的是,我们的分析发现,其中一个头骨中存在与转移性溶解性病变相关的死前切口,表明潜在的手术治疗尝试或死后医学探索。我们认为这两种情况,虽然不是当代的,允许对过去的肿瘤和创伤学理解和管理进行古病理学讨论。由两种不同类型的病变所代表的两种潜在管理的对抗代表了古埃及医疗保健的清晰边界,也是医学史上的里程碑。
    The present case studies report malignant neoplastic and traumatic lesions observed on two ancient Egyptian skulls held at the Duckworth Collection (Cambridge University). The analysis aims to characterise the lesions and provide a diagnosis using a methodology based on micro-CT scanning and microscopic bone surface analysis. Results pointed towards neoplastic lesions in both cases and healed severe skull trauma in one of them suggesting successful traumatological therapy. Interestingly, our analysis has identified the presence of perimortem cutmarks associated with metastatic lytic lesions in one of the skulls, indicating a potential surgical treatment attempt or postmortem medical exploration. We argue that the two cases, although not contemporary, allow a palaeopathological discussion on oncological and traumatological understanding and management of such conditions in the past. The confrontation of two potential managements represented by two different types of lesions represent a clear boundary in ancient Egyptian medical care and a milestone in the history of medicine.
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  • 文章类型: Journal Article
    背景:许多学术健康中心(AHC)试图修改健康专业教育以包括种族主义作为健康的社会和结构决定因素(SSDoH)的影响所面临的挑战是缺乏广泛的教师专业知识来加强和避免破坏解决此主题的学习模块。鼓励一种符合新的反种族主义指示的机构文化,我们开发了一个由六部分组成的教育系列,内容涉及美国种族主义的历史及其对当代健康不平等的影响,用于向卫生专业院士教授结构能力。
    方法:我们为教职员工开发了六小时的选修继续教育(CE)系列,目标如下:(1)描述和讨论种族作为一种社会建构;(2)描述和讨论健康科学和医疗保健的非殖民化;(3)从社会生态学的角度描述和讨论系统性种族主义和结构性暴力的历史;(4)描述和讨论生物医学中的和解与修复。该系列课程为期六个月,每个月的讲座在一周后进行公开讨论汇报会。在每个系列片段之前和之后,评估与会者对每个目标的理解。
    结果:我们发现随着系列的进展,对每个目标的知识和理解都有了显著的提高。与会者报告说,该系列节目帮助他们以建设性的方式克服了不适。自我选择的参与者绝大多数是女性(81.8%),表明比男人更愿意使用这种材料。
    结论:该系列为希望在其教职员工中促进反种族主义和结构能力的AHC提供了一个模型。
    BACKGROUND: A challenge facing many Academic Health Centers (AHCs) attempting to revise health professions education to include the impact of racism as a social and structural determinant of health (SSDoH) is a lack of broad faculty expertise to reinforce and avoid undermining learning modules addressing this topic. To encourage an institutional culture that is in line with new anti-racism instruction, we developed a six-part educational series on the history of racism in America and its impact on contemporary health inequities for teaching structural competency to health professions academicians.
    METHODS: We developed a six-hour elective continuing education (CE) series for faculty and staff with the following objectives: (1) describe and discuss race as a social construct; (2) describe and discuss the decolonization of the health sciences and health care; (3) describe and discuss the history of systemic racism and structural violence from a socio-ecological perspective; and (4) describe and discuss reconciliation and repair in biomedicine. The series was spread over a six-month period and each monthly lecture was followed one week later by an open discussion debriefing session. Attendees were assessed on their understanding of each objective before and after each series segment.
    RESULTS: We found significant increases in knowledge and understanding of each objective as the series progressed. Attendees reported that the series helped them grapple with their discomfort in a constructive manner. Self-selected attendees were overwhelmingly women (81.8%), indicating a greater willingness to engage with this material than men.
    CONCLUSIONS: The series provides a model for AHCs looking to promote anti-racism and structural competency among their faculty and staff.
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  • 文章类型: Journal Article
    人类疟疾-Aotus猴模型自1966年在巴拿马的Gorgas纪念实验室(GML)成立以来,一直为疟疾研究界服务。跨越五十年,该模型有助于评估多种候选抗疟药的体内功效和药代动力学,无论是单独使用还是组合使用。该动物模型可以感染耐药和易感的恶性疟原虫和间日疟原虫菌株,这些菌株遵循特征性和可重复的感染过程,非常像人类未经治疗和治疗的感染。多年来,该模型实现了对几种合成和半合成内过氧化物的评估,例如,Artelinicacid,青蒿琥酯,蒿甲醚,arteether,还有青蒿素.这些化合物已经单独和与长效伴侣药物组合进行了评估,通常被称为青蒿素为基础的联合疗法,被推荐作为一线治疗简单的疟疾。Further,该模型还支持伯氨喹类似物他非诺喹对间日疟原虫血液分期的评价,有助于其进展为临床试验和最终批准。此外,GML的恶性疟原虫/Aotus模型在探索生物学方面也发挥了关键作用,免疫学,和疟疾的发病机理以及耐药恶性疟原虫和间日疟原虫菌株的表征。这篇简短的评论提供了巴拿马猫头鹰猴(Aotuslemurinuslemuriinus)对疟疾化疗研究的最重要贡献的历史概述。
    The human malaria-Aotus monkey model has served the malaria research community since its inception in 1966 at the Gorgas Memorial Laboratory (GML) in Panama. Spanning over five decades, this model has been instrumental in evaluating the in vivo efficacy and pharmacokinetics of a wide array of candidate antimalarial drugs, whether used singly or in combination. The animal model could be infected with drug-resistant and susceptible Plasmodium falciparum and Plasmodium vivax strains that follow a characteristic and reproducible course of infection, remarkably like human untreated and treated infections. Over the years, the model has enabled the evaluation of several synthetic and semisynthetic endoperoxides, for instance, artelinic acid, artesunate, artemether, arteether, and artemisone. These compounds have been evaluated alone and in combination with long-acting partner drugs, commonly referred to as artemisinin-based combination therapies, which are recommended as first-line treatment against uncomplicated malaria. Further, the model has also supported the evaluation of the primaquine analog tafenoquine against blood stages of P. vivax, contributing to its progression to clinical trials and eventual approval. Besides, the P. falciparum/Aotus model at GML has also played a pivotal role in exploring the biology, immunology, and pathogenesis of malaria and in the characterization of drug-resistant P. falciparum and P. vivax strains. This minireview offers a historical overview of the most significant contributions made by the Panamanian owl monkey (Aotus lemurinus lemurinus) to malaria chemotherapy research.
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  • 文章类型: English Abstract
    近年来,人类遗传咨询的历史越来越成为医学和科学史上的研究主题。在这篇文章中,我根据当时的档案材料和医学文献,研究了从1960年代到1989年柏林墙倒塌的GDR中人类基因咨询的建立和设计。在GDR建立遗传咨询服务的倡议起源于1960年代,可以追溯到具有不同政治背景的科学家,他们关心人类的遗传问题。在1970年代和80年代,建立了全国性的人类基因咨询中心网络。他们位于大学机构或地区医院。尽管集中控制,各个地区之间存在很大差异。生物学家和医生都在GDR进行遗传咨询。他们专注于单身个人或家庭,拒绝任何形式的胁迫,人类遗传学家将自己与纳粹时代的优生实践区分开来。然而,他们并没有完全忽视人口遗传目标,就像FRG的情况一样。GDR中的人类遗传咨询与其他没有区别,即使是非社会主义者,在其目标中,即防止残疾儿童的出生和促进健康儿童的出生。这个意图不是国家规定的,但它反映了一种将残疾等同于痛苦的社会态度。
    In recent years, the history of human genetic counseling has increasingly become the subject of research in the history of medicine and science. In this article, I examine the establishment and design of human genetic counselling in the GDR from the 1960s until the fall of the Berlin Wall in 1989, based on archive material and medical literature of the time. The initiative for the establishment of a genetic counselling service in the GDR originated in the 1960s and can be traced back to scientists with different political backgrounds who were concerned with human genetic problems. In the 1970s and 80s, a nationwide network of human genetic counseling centers was established. They were located at either university institutions or district hospitals. Despite the centralized control, there was a considerable difference between the individual districts. Both biologists and doctors practiced genetic counselling in the GDR. With their focus on single individuals or families and their rejection of any kind of coercion, human geneticists set themselves apart from the eugenic practices of the Nazi era. Nevertheless, they did not completely ignore population-genetic objectives, as was the case in the FRG. Human genetic counseling in the GDR did not differ from other, even non-socialist, states in its objectives, namely to prevent the birth of handicapped children and to promote the birth of healthy children. This intent was not prescribed by the state, but it reflected a social attitude that equated disability with suffering.
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  • 文章类型: English Abstract
    在2016年至2018年之间,对德国1970年至2000年之间的人类遗传学历史进行了33人的采访。29位受访者同意将访谈用于历史研究。目前正在用定性内容分析和扎根理论的方法对这些访谈进行分析。本文的重点在于对口述历史方法及其在人类遗传学中的应用进行严格审查。口述历史项目侧重于关于(1)传记数据和受访者的职业生涯的问题,(2)诊断和治疗技术的发展和应用,(3)人类遗传学机构的建立和发展;(4)有关该学科的社会辩论。
    Between 2016 and 2018, interviews with 33 persons were conducted about the history of human genetics in Germany between 1970 and the 2000s. 29 interviewees gave consent to have the interviews used for historical research. These interviews are currently being analysed with the methods of qualitative content analysis and grounded theory. The focus of this article lies on the critical examination of the method of oral history and its application to human genetics. The oral history project focuses on questions regarding (1) biographical data and careers of interviewees, (2) development and application of diagnostic and therapeutic techniques, (3) establishment and growth of institutions of human genetics and (4) social debates regarding the discipline.
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