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[Myths, challenges, and fallacies in nursing research].

Upon the completion of 25 years of the integration of Nursing in the Spanish University system, this author presents a reflection on the role of research in nursing professional development and the consolidation of nursing as a university field. After tearing down the negative mythology which surrounds research in nursing, the author develops what he considers are the three main challenges at the start of this new millennium: to make visible the potential researchers in the field of Nursing, construct Nursing by manes of research, and utilize research as a method to emancipate Nursing. At the end of his article, the author proposes using the critical spirit which develops during a research exercise in order to think critically about the system, with a goal to adopt an intellectual compromise to provide scientifically valid response to the contradictions in the hegemonic medical system, favoring the democratization of health care.

Nursing Research↗

Migraine triggers: practice and theory.

The basis of our belief in migraine triggering factors is questioned. To avoid creating migraine-mythology, it is proposed that a trigger for migraine must also cause headache in non-migrainous subjects. This headache-migraine parallelism is examined and if correct, casts doubt on migraine precipitation by cheese, chocolate or allergy. A further weakness of "dietary migraine" is pointed out because the quantity of the trigger consumed, or the time interval between ingestion and the onset of attacks, are rarely mentioned, let alone studied. A difficulty in assessing migraine precipitants is that two factors may act in unison, e.g. stress and not eating. Further an external factor may provoke an attack only if the migraine "milieu intériur" is set appropriately, for example the hormonal state in a woman's menstrual cycle. The value of studying migraine precipitants is two-fold: (1) it provides a means of counselling patients to avoid or reduce these factors, thereby diminishing frequency and severity of attacks; (2) a comprehensive migraine pathogenetic theory must incorporate how and where precipitants act. It is concluded that analysis of triggering mechanisms lends support to the concept that migraine is a primary neurological disturbance with secondary vascular manifestations.

Contraceptives, Oral↗

[Hatred of foreigners and purity--current aspects of an illusion. Social psychological and psychoanalytic considerations].

This study draws upon both Carlo Ginzburg's procedures for establishing and preserving (historical) evidence and Claude Lévi-Strauss' structuralist approach with its analysis of "primitive" mythologies to demonstrate that binary coding of the social domain is an all-pervasive structural principle. Heim's intention in this is to show that (present-day) xenophobia and racism are the products of a phantasm centering around the division of the world into pure and impure. The author brings into alignment collective fantasies about the homogeneity of the "body politic" with a form of primary narcissism which, if it is to preserve the illusion of original purity, is forced to externalize instinctual urges experienced as heterogeneous and unpleasurable and project them onto "foreigners" and things foreign.

Culture↗

Metropolis redux: the unique importance of library skills in informatics.

OBJECTIVES: The objective is to highlight the important role that librarians have in teaching within a successful medical informatics program. Librarians regularly utilize skills that, although not technology dependent, are essential to conducting computer-based research. The Metropolis analogy is used to introduce the part librarians play as informatics partners. Science fiction is a modern mythology that, beyond a technical exterior, has lasting value in its ability to reflect the human condition. The teaching of medical informatics, an intersection of technology and knowledge, is also most relevant when it transcends the operation of databases and systems. Librarians can teach students to understand, research, and utilize information beyond specific technologies. METHODS: A survey of twenty-six informatics programs was conducted during 2002, with specific emphasis on the role of the library service. RESULTS: The survey demonstrated that librarians currently do have a central role in informatics instruction, and that library-focused skills form a significant part of the curriculum in many of those programs. In addition, librarians have creative opportunities to enhance their involvement in informatics training. As a sample program in the study, the development of the informatics course at the Massachusetts College of Pharmacy and Health Sciences is included. CONCLUSIONS: Medical informatics training is a wonderful opportunity for librarians to collaborate with professionals from the sciences and other information disciplines. Librarians' unique combination of human research and technology skills provides a valuable contribution to any program.

Education, Continuing↗

Myths of isotretinoin therapy in patients with acne: a personal opinion.

Isotretinoin therapy for the treatment of severe nodulocystic acne has been used for the last twenty-three years. Its use has been associated with many restrictions to the patient, with some of these based on mythology rather than on scientific evidence. The purpose of the article is to discuss the myths associated with acne treatment with isotretinoin. This article expresses the sole opinion of the author and does not give any guidelines as to the use of isotretinoin.

Acne Vulgaris↗

[Unraveling the myths about nausea and vomiting during pregnancy].

Nausea and vomiting are the most uncomfortable symptoms of early pregnancy. They also affect many pregnant women. Recent research has shown that nausea and vomiting are not simply pathological issues; they also reflect psychosocial and cultural factors. These are complex and diverse phenomena, but their influences on pregnant women are often underestimated. The long-term disregard of these phenomena has not only affected our actual understanding of them, but also given rise to many misconceptions. With some of these misconceptions there is no proof. With others, there has not even been any scientific research, and yet they have become prevalent, fusing together with the passage of time to become a sort of mythology. This has profoundly affected care provision, the pregnant women themselves and also their families. It also explains why so many pregnant women with the symptoms cannot receive proper care. On that basis, this article categorizes these common myths, having established their numbers by means of research, and uses a theoretical basis as the foundation from which to further discuss and clarify them, in order to promote an accurate understanding of the problems of nausea and vomiting as they affect pregnant women, to assist nurses caring for such women and their families.

Female↗

[The frightening body].

Following a quotation of Marcel Proust about his own body experience, the paper begins with some of the reasons for the--more frequency unconscious than conscious--fears of ones own body and the reasons for its alienation. As a result of unfavourable conditions during development, in particular during the early developmental stages, undifferentiated and more physically dependent emotions are experienced as threatening, since they endanger personal integration. An additional factor is the identification of certain regions of the body with malignant object representations. There follow examples of the application of physical metaphorics in politics and mythology. The present-day role of body-orientated psychotherapy forms and their unconcluded problems are discussed at the end of the paper.

Body Image↗

[On the pathology of the human voice. Reflections on castrato singing from the point of view of the history of medicine].

The origins of castration can be traced back to the times of Classical Mythology. THe reasons for this kind of operation were extremely varied.Up into the 20th century it was performed as punishment and revenge upon conquered enemies, on religious grounds and for acquiring slaves and harem guards. THere are very few diseases to date giving rise to a medical indication for castration. According to the excessively strict interpretation of the words of St. Paul that "women should remain silent in Church", women were not permitted to participate in signing for several voices in the church. The high-pitched voices of young boys were therefore adopted, whose skill no longer met the continuously rising demands placed upon singers. The vocal performance of men signing in the falsetto registers ("falsettos") progressively failed to suffice in church singing and even more so in the opera, which started to become established as a new art form towards the end of the 16th century. Young boys' voices and flasettos were therefore gradually replaced by singing castratos. The "heyday" of this type of singing was in the 18th century and one of its best known representatives was Carlo Broschi, known as Farinelli. THe high pitches and aria di bravura corresponded to the taste of the audiences. In the 19th century the demand for castratos declined. One of the last was Alessandro Moreschi (1858-1922), who sang for over 30 years in the Sistine Chapel, in later years mainly conducting. According to present-day knowledge, he is the only castrato of whom several recordings were made between 1902 and 1904. They were published on a record, now available as a CD.

Christianity↗

[The moon and delivery].

In different cultures and mythologies, the moon is related with fertility, pregnancy and delivery. Professional obstetricians also notice an increase in care demands on the days when the moon is full. Many studies have been made which try to correlate delivery processes to the phases of the moon with contradictory results. The authors plan to try to find any basis in fact which support these popular beliefs and to discover if lunar phases bear an influence on the distribution of deliveries. They carried out a descriptive transversal study on a total of 1715 unassisted deliveries over the course of ten complete lunar cycles. The authors have carried out a descriptive and inferential analysis, a one way ANOVA and a Kruskal Wallis test on their three data bases which are general, primipara and multipara in which they contemplated the total number of deliveries per phase, the mean of each phase, as well as the central day in each phase of the lunar cycle. The differences found in the distribution of deliveries over the four lunar phases, along with the comparison of the means and the comparison of the number of deliveries on the central day in each phase are not statistically significant. The different phases in the lunar cycle and especially the full moon do not appear to have any influence over the distribution of deliveries in this study.

Cross-Sectional Studies↗

Possible human sacrifice at the origins of Rome: novel skeletal evidences.

Recent archaeological excavations at the Carcer/Tullianum, in the Roman Forum, allowed the unexpected recovery of human burials associated with the very early foundations of the monument, at the beginning of the iron age. The study of these burials resulted in interesting paleopathological discoveries, concerning the skeleton of a strongly-built male, radiocarbon-dated between 830 and 780 BC. The telltale posture of the skeleton and the presence of a massive perimortal blunt force trauma of the skull shed light on the mode and circumstances of the death of this subject, and are suggestive of ritual sacrifice. The archaeological, mythological and historical backgrounds, combined with the paleopathological evidence, help us to get a glimpse of life and death at the origins of Rome.

Bone and Bones↗

Transplantation activities in Iran.

Iran is a tropical country with a land area of 1,648,000 square kilometers and a population of 68,100,000. Iran has a recorded history that dates back 2553 years. Its earliest medical school was Pasargad. Jondi Chapour University was founded 1753 years ago during the Sassanid dynasty as a center for higher education in medicine, philosophy, and pharmacology. Indeed, the idea of xenotransplantation dates back to days of Achaemenidae (Achaemenian dynasty), as evidenced by engravings of many mythologic chimeras still present in Persepolis. Avicenna (980-1037 AD), the great Iranian physician, performed the first nerve repair. Transplantation progress in Iran follows roughly the same pattern as that of the rest of the world, with some 10-20 years' delay. Modern organ transplantation dates back to 1935, when the first cornea transplant was performed at Farabi Hospital in Tehran, Iran. The first living-related kidney transplantation performed at Shiraz University Hospital dates back to 1968. The first bone marrow transplant was performed at Dr. Shariaati's Hospital in Tehran. The first heart transplant was performed 1993 in Tabriz, Iran. The first liver transplant was performed in 1993 in Shiraz. The first lung transplant was performed in 2001, and the first heart and lung transplants were performed in 2002, both at Tehran. In late 1985, the renal transplantation program was officially started in a major university hospital in Tehran and was poised to carry out 2 to 4 transplantations each week. Soon, another large center initiated a similar program. Both of these centers accepted surgical, medical, and nursing teams from other academic medical centers for training in kidney transplantation. Since 2002, Iran has grown to include 23 active renal, 68 cornea, 2 liver, 4 heart, 2 lung, and 2 bone marrow transplantation centers in different cities. In June 2000, the Organ Transplantation Brain Death Act was approved by the Parliament, followed by the establishment of the Iranian Network for Transplantation Organ Procurement. This act helped to expand heart, lung, and liver transplantation programs. By 2003, Iran had performed 131 liver, 77 heart, 7 lung, 211 bone marrow, 20,581 cornea, and 16,859 liver tranplantations. Sources of these donations were living-unrelated donor, 82%; cadaver, 10%; and living-related donor, 8%. The 3-year renal transplant patient survival rate was 92.9%, and the 40-month graft survival rate was 85.9%. Another large step in expanding the transplantation program is the construction of the Avi- Cenna (Abou Ali Sina) Transplant Hospital in Shiraz. This hospital hopefully will begin operation in 2 years. It will offer the opportunity for the exchange and sharing of organs and increased cooperation between transplant teams in the Middle East. The hospital offers great promise for transplant medicine in Iran and other Persian Gulf countries.

History, 20th Century↗

[Olaus Rudbeck as scientist and professor of medicine].

Olaus Rudbeck (1630-1702) was one of the pioneers in the study of lymphatic vessels. As a young student at Uppsala University he began dissecting small animals with great diligence and found the lymphatic connection between the intestines and the circulating blood, leading the prepared nutrients via the thoracic duct to the veins. By applying ligatures to the lymphatic vessels he could observe the direction of the flow. His observations confirmed William Harvey's newly advanced theory about the circulation of the blood and were in agreement with the then modern mechanistic view of body functions. Rudbeck demonstrated his findings for Queen Christina in the spring of 1652 and received from her money for a visit to the University of Leiden, Holland in the autumn of 1653. He had just before his departure published his own discoveries, but the Danish anatomist Thomas Bartholin had reported very similar results slightly before. During his stay in Holland (autumn 1653-summer 1654) where he was admired for his anatomical skillfullness, a priority dispute began between him and one of Bartholin's students, lasting for years. Back in Uppsala Rudbeck began and extensive activity, including the foundations of the botanical garden, the anatomical theatre and other university buildings. He became a professor of medicine in 1660 but soon left his anatomical studies for work in several disciplines and trades. He was a prominent master-builder and garden architect as well as an astronomer, botanist, musician and archaeologist. In the last mentioned capacity he published his ill-famed Atlantica, a gigantic reconstruction of the history of old Sweden from the times of the Flood, through the era of vast conquests including Russia and the Mediterranean region, supposed to have take place in the third and second millenium B.C. Rudbeck mingled philogical methods and mythological explanations with excavations and natural history to reach his phantastic conclusions. At the same time the Atlantica (in three volumes plus one unfinished) is a very personal document, demonstrating i.a. that he had a medical practices, including advanced anatomical surgery, as when helping at the birth of one of his children. The boy was christened "Johannes Caesar" in commemoration of the event, but apparently it was not a regular Caeserian section.

Anatomy↗

[Wittgenstein and Freud].

In this paper I present the most important limits in the reading that Ludwig Wittgenstein made of Sigmund Freud. In particular, starting from certain thematic axes (distinction causes / reasons, conception of the meaning, interpretation concept, the problem of the truth in the therapeutic treatment, the paper of the patient's conviction), I try to show that the position of Wittgenstein in front of the Freudian psychoanalysis was ambiguous: on one hand he conceives it as an example more than "philosophical mythology", but on the other hand, he is identified with the psychoanalyst and he is conceived itself as making something related with that an analyst makes.

Austria↗

[Clinical features of messianic delusions in schizophrenic spectrum disorders].

Clinical features of messianic delusions in endogenous psychoses have been retrospectively studied in 75 patients (33 male, 42 female, aged 16-62 years, illness duration from 0.5 to 39 years) with diagnosis paranoid schizophrenia, continuous type (F20.00)--18 patients, attack like progressive type (F20.02)--17 patients, schizoaffective disorder (F25)--27 and acute polymorphic psychotic disorder (F23.03)--13. Being a kind of delusion of grandeur, messianic delusion is characterized by destruction of "self" as break with the past experience, transformation to mythological characters (total depersonalization) and assignment of supernatural power. Its content is similar to apocalyptical, mystical, antagonistic (Manicheam) delusions. Formation of the delusion plot occurred in the framework of hallucinate-paranoid syndrome received its greatest expression in the structure of paraphrenic and oneiroid syndromes. The volume of its content, duration and mechanisms of delusion formation (hallucinative, sensual and delusion of imagination) were defined by a form of schizophrenic psychosis. Sometimes such patients confer social danger and demand more attention from psychiatrists.

Adolescent↗

Overcoming the force and power of immunity: a history of immunosuppression in kidney transplantation.

Immunosuppression for organ transplantation is a modern concept. The earliest reports of organ replacement have their roots in mythology and human fantasy. The primacy of overcoming the immunologic barrier for successful transplantation of organs has been influenced by geopolitical conflict, unorthodox ideas, application of knowledge across medical disciplines, and serendipity. The earliest form of chemical immunosuppression had its origin in chemical gas in warfare. Further developments in immunology, cancer therapy and biochemistry helped shape the intellectual basis for the introduction of chemical immunosuppression.

Cyclosporine↗

[Sacred psychoactive seeds and ritual sacrifices in the Moche culture].

INTRODUCTION: Archaeological findings have confirmed the existence of representations of ritual human sacrifices on pottery belonging to the Moche culture (100-750 AD) in northern Peru; until recently these images were thought to be mythological narrations. We review the archaeological and ethno-historical data concerning Moche sacrifices and we attempt to identify the psychoactive seeds and plants used during such rites. DEVELOPMENT: Ethno-historical data from different chronicles of the New World written in the 16th century state that hamala seeds (belonging to the species Nectandra) were used for their analgesic, sedative, narcotic and anticoagulating properties, and that chamico, or stramonium, had an intoxicating effect on those who took it. There were two kinds of Moche rituals, that is, sacrifices as offerings to divinities and as exemplary punishments. Methods of sacrifice included slitting victims' throats, dismembering them and throwing them off mountains. The sacrifices of the Moche were part of a complex and elaborate ritual which consisted in capturing prisoners, parading them with nooses around their necks, making offerings, preparing the officiants and the community, consummation of the sacrifice and presenting the blood to the priest in a chalice. Human sacrifices were part of the propitiatory ceremonies held in honour of the gods in order to favour human fertility, obtain good harvests and preserve a plentiful supply of water for irrigating the valleys. CONCLUSIONS: The therapeutic properties of the seeds of the Nectandra species favoured their utilisation in the ritual sacrifices of the Moche culture. Their use was probably associated with stramonium and San Pedro cactus, which contain extracts rich in hallucinogenic alkaloids.

Ceremonial Behavior↗

[Observations of a case of sirenomelia in a 37-year-old adult].

The authors study a case of sirenomelia at a 37 years old adult woman, nosographic table presented for the first time by Charles Duhamel in 1959, having the denomination of "caudal regression syndrome", similar to Goldenhar syndrome cephalic expression of this regression. The malformation is known and well presented by Greek mythology in Homer (Odissey), Ovide (The Metamorphosis) etc. One presents little enough information, its classification and a few etiopathology data.

Adult↗

[Knight Yvain's melancholia].

The first, or maybe, occurrence of the word "melancholia" is found in a French mediaeval book "Knight Yvain" (12th century). A clinical and mythological analysis is propounded.

Depressive Disorder↗