927 resultados para Medicine, Medieval
Resumo:
In the history of food shortages and subsistence crises which affected the Catalan counties during the eleventh and twelfth centuries, the famine of 1129-1131 deserves special mention. Originating in the war of 1128 involving the Empordà and neighboring counties, this famine affected the city of Barcelona and other points of Catalonia (Winter, 1131) and created conditions for the spread of a deadly epidemic (July 1130 -January 1132).
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A menudo se acusa a los libros de texto escolares de transmitir una imagen falsa, peyorativa, de la Edad Media. Aunque semejantes reproches puedan parecer nuevos, las protestas contra la hostilidad a la Edad Media, que rechazan el tópico del oscurantismo medieval, han estado a la orden del día durante los dos últimos siglos. Sin embargo, es muy difícil encontrar en los modernos libros de historia nada que justifique la acusación de haber exagerado las tinieblas medievales. En general, los historiadores modernos, tanto liberales como socialistas, han mantenido una opinión favorable de las instituciones y la cultura medievales, llegando incluso a encomiar la obra de la Iglesia como resguardo de la civilización, pero sin ocultar sus aspectos irracionales y reaccionarios. Las acusaciones que Jacques Heers y Jeffrey Burton Russell dirigen contra una presunta falsificación de la historia medieval apuntan explícitamente contra la influencia del darwinismo y el anticlericalismo, lo cual nos pone sobre la pista de sus verdaderas motivaciones ideológicas.
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A variety of technologies have been developed to assist decision-making during the management of patients with acute brain injury who require intensive care. A large body of research has been generated describing these various technologies. The Neurocritical Care Society (NCS) in collaboration with the European Society of Intensive Care Medicine (ESICM), the Society for Critical Care Medicine (SCCM), and the Latin America Brain Injury Consortium (LABIC) organized an international, multidisciplinary consensus conference to perform a systematic review of the published literature to help develop evidence-based practice recommendations on bedside physiologic monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews on physiologic processes important in the care of acute brain injury. In this article we provide the evidentiary tables for select topics including systemic hemodynamics, intracranial pressure, brain and systemic oxygenation, EEG, brain metabolism, biomarkers, processes of care and monitoring in emerging economies to provide the clinician ready access to evidence that supports recommendations about neuromonitoring.
Resumo:
Careful patient monitoring using a variety of techniques including clinical and laboratory evaluation, bedside physiological monitoring with continuous or non-continuous techniques and imaging is fundamental to the care of patients who require neurocritical care. How best to perform and use bedside monitoring is still being elucidated. To create a basic platform for care and a foundation for further research the Neurocritical Care Society in collaboration with the European Society of Intensive Care Medicine, the Society for Critical Care Medicine and the Latin America Brain Injury Consortium organized an international, multidisciplinary consensus conference to develop recommendations about physiologic bedside monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews as a background to the recommendations. In this article, we highlight the recommendations and provide additional conclusions as an aid to the reader and to facilitate bedside care.
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El objetivo del presente trabajo es trazar una panorámica sobre algunas de las plasmaciones literarias más relevantes de la magia y de la brujería en las letras castellanas medievales y sobre sus significaciones históricas. Con tal propósito se comentan textos de Don Juan Manuel, Juan Ruiz, Juan de Mena o Garci Rodríguez de Montalvo, entre otros autores de los siglos XIII al XV, y se apuntan algunas coordenadas culturales que reformulan la especificidad del contexto hispánico en su marco europeo.
Resumo:
BACKGROUND/RATIONALE: Patient safety is a major concern in healthcare systems worldwide. Although most safety research has been conducted in the inpatient setting, evidence indicates that medical errors and adverse events are a threat to patients in the primary care setting as well. Since information about the frequency and outcomes of safety incidents in primary care is required, the goals of this study are to describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents. Label="METHODS AND ANALYSIS" ="METHODS"/> <AbstractText STUDY DESIGN AND SETTING: We will conduct a prospective surveillance study to identify cases of medication incidents among primary care patients in Switzerland over the course of the year 2015. PARTICIPANTS: Patients undergoing drug treatment by 167 general practitioners or paediatricians reporting to the Swiss Federal Sentinel Reporting System. INCLUSION CRITERIA: Any erroneous event, as defined by the physician, related to the medication process and interfering with normal treatment course. EXCLUSION CRITERIA: Lack of treatment effect, adverse drug reactions or drug-drug or drug-disease interactions without detectable treatment error. PRIMARY OUTCOME: Medication incidents. RISK FACTORS: Age, gender, polymedication, morbidity, care dependency, hospitalisation. STATISTICAL ANALYSIS: Descriptive statistics to assess type, frequency, seasonal and regional distribution of medication incidents and logistic regression to assess their association with potential risk factors. Estimated sample size: 500 medication incidents. LIMITATIONS: We will take into account under-reporting and selective reporting among others as potential sources of bias or imprecision when interpreting the results. ETHICS AND DISSEMINATION: No formal request was necessary because of fully anonymised data. The results will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT0229537.
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Las relaciones entre actos festivos y espacios arquitectónicos, y las modalidades con que las ceremonias cortesanas llegaban a modificar los centros urbanos y las residen- cias palaciegas, han sido los temas principales del congreso internacional Making Space for Festival, 14001700. Interactions of Architecture and Performance in Late Medieval and Early Modern Festivals, que tuvo lugar del 21 al 24 de marzo de 2013 en el Palacio Pesaro-Papafava de Venecia, residencia de la Universidad de Warwick en la Laguna. La Society for European Festivals Research (SEFR), entidad vinculada a esta universidad, ha promovido el encuentro junto con la Red PALATIUM financia- da por el Research Networking Programme de la European Science Fundation (ESF) (2010-2015), dedicada al estudio de las residencias palaciegas de la Edad Moderna como espacios de intercambios políticos y culturales. El tema de las jornadas nacía de la unión de los intereses científicos de los grupos organizadores, dejando lugar a temáticas diferentes como: la articulación de un mensaje festivo a lo largo del recorri- do de procesiones y entradas públicas, la financiación y los aspectos más prácticos de la puesta en escena de un evento festivo, la tipificación de ceremonias y decoraciones en determinados contextos, el intercambio cultural a través de la fiesta, o la recepción de las modificaciones de los espacios por parte de los espectadores
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Sudden cardiac death (SCD) is by definition unexpected and cardiac in nature. The investigation is almost invariably performed by a forensic pathologist. Under these circumstances the role of the forensic pathologist is twofold: (1.) to determine rapidly and efficiently the cause and manner of death and (2.) to initiate a multidisciplinary process in order to prevent further deaths in existing family members. If the death is determined to be due to "natural" causes the district attorney in charge often refuses further examinations. However, additional examinations, i.e. extensive histopathological investigations and/or molecular genetic analyses, are necessary in many cases to clarify the cause of death. The Swiss Society of Legal Medicine created a multidisciplinary working group together with clinical and molecular geneticists and cardiologists in the hope of harmonising the approach to investigate SCD. The aim of this paper is to close the gap between the Swiss recommendations for routine forensic post-mortem cardiac examination and clinical recommendations for genetic testing of inherited cardiac diseases; this is in order to optimise the diagnostic procedures and preventive measures for living family members. The key points of the recommendations are (1.) the forensic autopsy procedure for all SCD victims under 40 years of age, (2.) the collection and storage of adequate samples for genetic testing, (3.) communication with the families, and (4.) a multidisciplinary approach including cardiogenetic counselling.
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Several studies contributed to improving the diagnostic and prognostic assessment of delirium in hospitalized older patients. Direct patient education proved efficient in benzodiazepines withdrawal. A position statement of the American Geriatrics Society does not recommend tube feeding when eating difficulties arise in older persons suffering from advanced dementia. Several studies emphasized once again the potential importance of preventative interventions (in particular physical activity) to prevent or delay dementia occurrence. Two randomized controlled trials of monoclonal antibodies that bind amyloid did not show benefit in patients with mild-to-moderate Alzheimer's dementia (AD). In contrast, vitamin E reduced functional decline in these patients, and citalopram reduced agitation among AD patients as well as their caregiver's stress.
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New evidences published this year are susceptible to change the management of several medical emergencies. Combined antiplatelet therapy might be beneficial for the management of TIA or minor stroke and rapid blood pressure lowering might improve the outcome in patients with intracerebral hemorrhage. A restrictive red cell transfusion strategy is indicated in case of upper digestive bleeding and coagulation factors concentrates are superior to fresh frozen plasma for urgent warfarin reversal. Prolonged systemic steroid therapy is not warranted in case of acute exacerbation of BPCO, and iterative physiotherapy is not beneficial after acute whiplash. Finally, family presence during cardiopulmonary resuscitation may reduce post-traumatic stress disorder among relatives.
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Les recommandations en termes de prévention contre la malaria pour les pays à risques modéré à faible diffèrent entre les pays, malgré le fait que les personnes soient exposées à un risque identique dans les pays qu'ils visitent. Pour inclure les voyageurs dans la réflexion, des outils de partage de la décision ont été développés et testés dans cette population. Leur utilisation a montré que la majorité des personnes choisissent de ne pas prendre de chimioprophylaxie en avançant des raisons valides. Le développement d'aides décisionnelles répondant à des critères reconnus est prévu et permettra d'améliorer la pertinence des recommandations. Les aides décisionnelles permettront aussi aux voyageurs de faire un choix de prévention avec les soignants au plus près de leurs valeurs et préférences, tout en respectant les règles de l'éthique médicale. Recommendations for malaria prevention for travelers planning a trip in medium to low risk countries differ between countries, despite the fact that people are exposed to the same risk in the travelled country. Decision aids have been developed and tested in a population of travelers planning a trip in such countries n order to present travelers the various prevention options and involve them in the decision. The use of the decision aid showed that he majority of people choose not to take chemoprophylaxis and that they could motivate their choice with valid reasons. The development of decision aids based on recognized quality criteria is foreseen; these will allow to improving the relevance of the recommendations and enable travelers to choose a prevention option that will be the closest to their values and preferences while following to the principles of medical ethics.
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[cat]Els treballs arqueològics duts a terme al solar localitzat entre la plaça de Pau Vila i els carrers del Dr. Aiguader i de la Marquesa, al peu del baluard del Migdia, han permès descriure l'evolució geoarqueològica d'un tram del front marítim de Barcelona i generar dades fiables de la configuració de la façana litoral. Sota una potent capa de sorres, s'identificà un paquet de llims i argiles orgàniques característiques d'un medi de baixa energia; és a dir, protegit de l'onatge marí probablement per barres sorrenques. Aquesta seqüència presenta una cronologia entre finals del segle IX i ca. 1440, moment en què es realitzaren els primers intents de construcció d'estructures portuàries. En aquest nivell llimoargilós s'han dut a terme analítiques paleoambientals consistents en l'estudi pol·línic, sedimentològic i geoquímic dels sediments que han posat en evidència els canvis ambientals del front marítim barceloní, del paisatge vegetal del pla, com també de les activitats agrícoles i productives urbanes en època medieval i inicis de l'edat moderna. La informació així obtinguda ha estat contrastada amb la informació històrica. [eng]The archaeological work conducted at the site located at the foot of the Baluard del Migdia bastion between Plaça Pau Vila and Carrer Dr. Aiguader and Carrer Marquesa has provided the opportunity to describe the geoarchaeological evolution of a stretch of the seafront of Barcelona and to generate reliable data on the configuration of the coastline. A layer of silt and organic clays typical of a low-energy environment was found below a thick layer of sands. In other words, this packet was protected from the swell of the sea, probably by sandbars. This sequence presents a chronology spanning from the late 9th century BC to around 1440, the time when the first attempts were made to build port structures. This layer of silt and clay has been subjected to palaeoenvironmental analyses consisting of the study of the pollen, sediment and the geochemistry of the sediments. The results of this analysis provide evidence of the environmental changes in the seafront of Barcelona and the landscape in the plain, as well as the urban agricultural and production activities in medieval times and the early modern age. The information obtained has been compared with historical information.
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The purpose of this PhD thesis is to investigate a semantic relation present in the connection of sentences (more specifically: propositional units). This relation, which we refer to as contrast, includes the traditional categories of adversatives - predominantly represented by the connector but in English and pero in Modern Spanish - and concessives, prototypically verbalised through although / aunque. The aim is to describe, analyse and - as far as possible - to explain the emergence and evolution of different syntactic schemes marking contrast during the first three centuries of Spanish (also referred to as Castilian) as a literary language, i.e., from the 13th to the 15th century. The starting point of this question is a commonplace in syntax, whereby the semantic and syntactic complexity of clause linkage correlates with the degree of textual elaboration. In historical linguistics, i.e., applied to the phylogeny of a language, it is commonly referred to as the parataxis hypothesis A crucial part of the thesis is dedicated by the definition of contrast as a semantic relation. Although the label contrast has been used in this sense, mainly in functional grammar and text linguistics, mainstream grammaticography and linguistics remain attached to the traditional categories adversatives and concessives. In opposition to this traditional view, we present our own model of contrast, based on a pragma-semantic description proposed for the analysis of adversatives by Oswald Ducrot and subsequently adopted by Ekkehard König for the analysis of concessives. We refine and further develop this model in order for it to accommodate all, not just the prototypical instances of contrast in Spanish, arguing that the relationship between adversatives and concessives is a marked opposition, i.e., that the higher degree of semantic and syntactic integration of concessives restricts some possible readings that the adversatives may have, but that this difference is almost systematically neutralised by contextual factors, thus justifying the assumption of contrast as a comprehensive onomasiological category. This theoretical focus is completed by a state-of-the-question overview attempting to account for all relevant forms in which contrast is expressed in Medieval Spanish, with the aid of lexicographic and grammaticographical sources, and an empirical study investigating the expression of corpus in a corpus study on the textual functions of contrast in nine Medieval Spanish texts: Cantar de Mio Cid, Libro de Alexandre, Milagros de Nuestra Sehora, Estoria de Espana, Primera Partida, Lapidario, Libro de buen amor, Conde Lucanor, and Corbacho. This corpus is analysed using quantitative and qualitative tools, and the study is accompanied by a series of methodological remarks on how to investigate a pragma-semantic category in historical linguistics. The corpus study shows that the parataxis hypothesis fails to prove from a statistical viewpoint, although a qualitative analysis shows that the use of subordination does increase over time in some particular contexts.