The charity and the care: the origin and the evolution of hospitals

BackgroundThe hospital is considered as one of the founding elements of modern medicine. Such an institution, originally born to be a center for housing the sick and the poor, has provided with a place to improve the medical knowledge and to educate new generations of nurses and physicians. This paper wants to remind the meaning and the development of the hospital institution in the western world.MethodsThe first part of this work analyzed the evolution of hospital, using a classical historiographical approach. In the second part, the history of the “Ospedale Maggiore” in Milan was used as a paradigm to describe the evolution of hospital from the Renaissance to nowadays through a “microhistorical approach”.ResultsThe origins of the public hospital are evidenced in early Christian age, when the Christian message led people to assist the sick and the poor and to establish centers for such interventions, initially in the house of the bishop, then in monasteries and, finally, in autonomous buildings (the hospitals). These institutions were economically supported by the donations of wealthy philanthropists. Since the nineteenth century the hospitals have changed their organization and functions, but have continued to associate the charity and the care.ConclusionChristian charity and the lay culture originated from it may be rightly credited not only as the founding element of ancient hospitals, but also as the virtue which has made possible for the development of medicine, as we know it.     

Structure and physiology of the pleura and the pleural space

The pleural space, derived from the intraembryonic coelom, is limited by a serous membrane including the mesothelium formed by cells possessing not only the characteristic features of epithelial cells but also the potential of secretory cells (cytokines and growth factor). Blood supply to visceral pleurae differs depending on the species while the lymphatic circulation is directly connected to the pleural space via pores in the parietal pleura. Pleural physiology and movement of pleural fluid are directly related to the particular structures of the pleura.     

Ceramide and the regulation of apoptosis and the stress response

The process of apoptosis or programmed cell death has been the subject of intense study due to the realization of its importance in a wide variety of biological and pathological conditions, including development, ischemia, cancer, and neurodegenerative disorders. Although a vast number of inducers of this process and several critical components have been identified, the signal transduction pathways regulating apoptosis are poorly understood. Recently, a pathway involving sphingolipid turnover and the production of the lipid mediator, ceramide, has emerged as a candidate regulator of apoptosis. This review provides a summary of the evidence implicating ceramide as a mediator of apoptosis and the stress response. (Trends Cardiovasc Med 1996;6:158-162).     

Ligaments of the larynx and the adjacent pharynx and esophagus

Two ligament systems of the larynx are demonstrated by dissection. The suspensory ligament of the esophagus is attached to the posterior aspect of the cricoid cartilage and is also a part of the fascial sheath which is common to the hyoid, thyroid, and cricoid. The ligaments at the inner margins of the vocal, ventricular, and aryepiglottic folds are distinctive in site and, inferentially, in function. The aryepiglottic ligaments join at the incisura between the arytenoid cartilages and are continued as the corniculopharyngeal ligament which splays into the flexible tissues in the anterior wall of the hypopharynx, posterior to the suspensory ligament of the esophagus. These ligament systems are involved in two different actions in swallow. The gross superior and anterior motions of the larynx are transmitted to the esophagus by the suspensory ligament, so that the esophagus is elevated in relation to the bolus and is also opened. These esophageal displacements resemble, in effect, the swallow displacements of the pharyngoesophageal segment and of the constrictor wall of the hypopharynx. The marginal ligaments of the laryngeal folds help to implement the constriction and closure of the larynx during swallow. By anatomical inference, the corniculopharyngeal ligament effects vertical traction within the flexible tissues of the anterior wall of the hypopharynx.     

单纯收缩期高血压与波反射及治疗

收缩压≥ 14 0ｍｍＨｇ(1ｍｍＨｇ =0 133ｋＰａ)而舒张压 <90ｍｍＨｇ时 ,我们称之为单纯收缩期高血压。 60岁以上老年高血压患者中有一半都属于此类 ,故又称之为老年单纯收缩期高血压。以前单纯收缩期高血压被认为是随着年龄增长 ,血管弹性降低不可避免的一种生物学现象 ,并且还是原发的良性高血压。然而 ,近年来的纵向、交叉、随机对照实验却得到确凿的证据表明 ,它是心血管疾病的一个很重要的危险因素[1～ 3] 。1　收缩压升高的机制导致收缩压升高的主要原因是动脉硬化 ,它和进行性动脉扩张相关联并由动脉壁的退化情况决定。动脉硬化通…     

Condoms and seat belts: the parallels and the lessons

This paper investigates the relation between behavior adaptation and safety benefits of seat belts and whether condom promotion can be undermined by unintended changes in sexual risk perception and behavior. The comparison between 13 countries that passed seat belt laws and 4 countries without such laws shows a significant number of deaths among countries with seat belt laws. It has been suggested that drivers who wear seat belts feel safer and drive faster and more carelessly compared to those without seat belts. A model of individual risk management, postulating that every individual is comfortable with a certain level of risk and aims to balance the rewards of risk-taking against perceived hazards was developed to describe the behavior. This increase in seat belt use was then paralleled with condom use since the rise of HIV, with 3 ways in which a large increase in condom use could fail to affect transmission: 1) it appeals to risk-averse individuals who contribute little to epidemic transmission; 2) increased use of condom increases the number of transmission caused by condom failure; and 3) the increased use of condoms reflect the change in the decision of individuals from one partner to maintaining higher rates of partners and reliance on condoms. This paper, in conclusion, emphasizes the need for program development and implementation in response to this sexual behavior, particularly among developing countries.