International archives of medicine最新文献

{"title":"Medical Ethics Code: an Analysis from Ethical-Disciplinary Cases Against Medical Professionals within the Specialty of Psychiatry","authors":"G. Gracindo, Leda Virgínia Moreno","doi":"10.3823/2552","DOIUrl":"https://doi.org/10.3823/2552","url":null,"abstract":"Objective: To identify the nature of infractions committed by doctors working within the field of psychiatry, between 2010 and 2016, from the scope of appeals within ethical-disciplinary cases judged at the Plenary Tribunal of the Federal Medical Council, based on the medical ethics code, and to list some elements that make it possible to outline the professional profile of those involved. \u0000Method: This was a document-based investigation in the form of a retrospective and descriptive study. Data were gathered using the Federal Medical Council (CFM) database and from consultation of judgments issued by the Plenary Body of the Medical Ethics Tribunal (TSEM), of the CFM. The investigation used a sample consisting of 206 appeals and 19 referrals, totaling 224 appeals by doctors who underwent trials. We took into account cases judged between April 13, 2010 and August 3, 2016. Three databases were used in the investigation: cases (224); doctors facing charges (191) and cases/penalties (146). Based on the records of the 191 doctors charged, the ethical-disciplinary cases of seven doctors working in psychiatry were analyzed specifically for the present study, whether or not they had a specialist title. Characterization of infractions committed encompassed references to the articles of the medical ethics code most frequently infringed in the field of psychiatry, along with a survey of the motives for these infractions and some characteristics relating to these professionals’ profile. \u0000Results: Among the findings from this investigation, infractions of the articles of the medical ethics code can be highlighted, such as article 30 “[...] Use of the profession to corrupt customs and to commit or favor crime [...]” and article 40 “[...] Taking advantage of situations arising from the doctor-patient relationship to obtain physical, emotional, financial or any other advantage [...]”. The professional profile of those involved in these cases was also shown: the average age was 49.8 years, and all of these professionals were male. The mean length of time since graduation among the psychiatrists with appeals to the plenary body of the TSEM was 31.28 years at the time of judgment. The punishment handed down most frequently was to strike these professionals off the register, reaching the percentage of 42.9%. Among the five professionals with specialist titles, four complemented their studies with specializations, after the episode that originated the ethics charges.  \u0000Conclusion: The data gathered showed that the professionals were punished for irregularities in the sphere of ethics, including issues going beyond technical and/or scientific competence. This makes it possible to highlight that punishments proportional to the seriousness of the infraction act were applied, along with the importance of bioethics in medical training and the need for specialization, from the results of the judgments on ethical-professional cases before the plenary body of the TSEM.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45382240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential distribution patterns in cerebellar irrigation. A study with autopsy material","authors":"H. Y. Estupiñán, F. A. Gómez, L. Ballesteros","doi":"10.3823/2554","DOIUrl":"https://doi.org/10.3823/2554","url":null,"abstract":"Aim: The aim of this investigation was characterize morphologically the cerebellar artery and its branches in a specimen of autopsy material. \u0000Methods: This descriptive cross-sectional study evaluated the anatomical characteristics of the cerebellar arteries and their branches in 93 brain stem and cerebellum blocks obtained from fresh cadavers. The specimens were perfused bilaterally channeling the proximal segments of the internal carotid and vertebral arteries with a semi-synthetic resin (Palatal GP40L 85%; styrene 15%) impregnated with mineral red dye. We evaluated the distribution patterns of the cerebellar artery and its branches. \u0000Results: The calibers of the superior cerebellar artery (SCA), anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) were 1.46 ± 0.2 mm, 1.02 ± 0.35 mm and 1.45 ± 0.37 mm, respectively. Agenesis of the SCA was observed in six specimens (3.2%), AICA in 30 (16.1%), and PICA in 14 (7.5%) specimens. Usual irrigation was observed in 44 (47.3%) cerebellar blocks, whereas 49 (52.7%) specimens showed irrigation variants, 23 (46.9%) of which appeared bilaterally. The dominant distribution of the cerebellar arteries corresponded to SCA in 9 (12.5%) cases, AICA in 46 (63.9%) and PICA in 7 (9.7%) specimens; shared dominance was found in 10 (13.9%) specimens. \u0000Conclusion: The high variability of the cerebellar arteries observed in the present study is consistent with previous reports. The diverse anatomic expressions of the cerebellar arteries were typified in relation to their dominance and territories irrigated, useful for the diagnosis and clinical-surgical management of the cerebellum blood supply.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42069310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Control Actions on Leprosy in Primary Health Care in a Brazilian Capital: Profile of Professionals and Users","authors":"A. A. Lustosa, N. A. Barboza, Y. G. D. S. Barbosa, Caique Veloso, F. D. C. R. M. Neto","doi":"10.3823/2553","DOIUrl":"https://doi.org/10.3823/2553","url":null,"abstract":"Objective: analyze  profile of users of primary health care services affected by leprosy, as well as the medical professionals and nurses responsible for the follow - up of these patients.   \u0000Methods: This is a field study that surveyed the socioeconomic and clinical profile of 26 patients affected by leprosy, attended at the municipal health units of the urban area of ​​Teresina-PI, as well as the professional profile and clinical practices of 15 physicians and 19 nurses responsible for the follow-up of these patients. \u0000Results: It was observed a profile of people affected by leprosy, characterized by: individuals aged 50 years or more; predominantly male; with low schooling and income. The clinical characteristics reveal a high prevalence of multibacillary cases of leprosy and with a significant diagnosis of some degree of physical disability. Regarding the profile of the professionals and their clinical behaviors, it was verified that the majority had post-graduation and a long time of experience in primary health care and leprosy control actions, however, it has been shown that they do not always put into practice all actions necessary for the diagnosis and treatment of the disease. \u0000Conclusions: The profile of patients with leprosy treated at the municipal health units in the urban area of Teresina was similar to that found in other Brazilian territories, thus evidencing the need to implement public social support policies and more effective diagnostic and therapeutic follow-up practices by reduce the high rates of endemicity of the disease.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41657773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptomatic Bochdalek Hernia in Adult: a Case Report","authors":"Luis Eduardo Almeida de Souza, Karlla Lorenna dos Santos Anjos, Danielle Oliveira de Sousa, Gabriel de Jesus da Fonseca Loureiro, D. Centeno, Y. C. D. Lima, Rodrigo Cordeiro, Felipe Teixeira Lisboa, J. Machado, Karen Giovana Leal Matos, Mauro Carvalho Vieira","doi":"10.3823/2550","DOIUrl":"https://doi.org/10.3823/2550","url":null,"abstract":"Background: The congenital malformation of the posterolateral portion of the diaphragm is called the Bochdalek hernia, and was first described in 1948 by anatomy professor Bochdalek. The diagnosis in adults is extremely rare, being in the majority, an occasional finding in a chest x-ray. \u0000Case: The authors report a Bochdalek Hernia case in an adult pacient, with complaints of dyspnea and epigastralgia refractory to pharmacological treatment. The diagnosis was confirmed after a chest CT scan. \u0000Conclusion: Bochdalek hernias are extremely rare in adults, commonly diagnosed in childhood. The importance of recognition of its diagnosis is crucial, so it should be always among differential diagnoses in radiology, due to the range of complications that may affect the patients.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44898782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atelectasis as a Complication of Tuberculosis: a Case Report","authors":"Luis Eduardo Almeida de Souza, Karlla Lorenna dos Santos Anjos, Danielle Oliveira de Sousa, Gabriel de Jesus da Fonseca Loureiro, Y. C. D. Lima, J. C. Souza, Rodrigo Cordeiro, Felipe Teixeira Lisboa, Karen Giovana Leal Matos, H. Mcphee, José Antonio Cordero da Silva","doi":"10.3823/2551","DOIUrl":"https://doi.org/10.3823/2551","url":null,"abstract":"Background: Tuberculosis is an infectious disease caused by a bacillus called Mycobacterium tuberculosis or Koch's Bacillus (BK). It is associated with various long-term lung complications, including: lung scarring (fibrosis), bronchiectasis, Chronic Pulmonary Aspergillosis, and more rarely, atelectasis. There is however very limited data in literature on the full spectrum of these complications, and relies mostly on case reports and small case series. \u0000Case: The authors report a case of atelectasis in a patient with previous diagnosis of Tuberculosis. Normal laboratory tests and imaging test presenting right lung atelectasis. Went under respiratory therapy, presented improve and is under clinical control. \u0000Conclusion: There is a huge importance of knowing the various methods to diagnose this disease and treat it well. Thus, it enables an improvement in the patient and a reduction in the spread of bacteria.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46898144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Free Survival of Well Differentiated Thyroid Cancer: 20 years Experience at a tertiary care center in Lebanon","authors":"Rita Hajj Boutros, A. Arabi, Mahmoud Shoucair, J. Abbas, I. Salti","doi":"10.3823/2545","DOIUrl":"https://doi.org/10.3823/2545","url":null,"abstract":"Background: Thyroid cancer is the most common endocrine malignancy. Although relatively common, to date, there is no study about its prognosis in Lebanon. The objectives of this study were to determine the disease free survival, the recurrence rate and possible predictors of recurrence, as well as the rate of post thyroidectomy complications among patients with differentiated thyroid cancer who received treatment at the American University of Beirut Medical Center. \u0000Methods and Findings: retrospective observational study of 480 cases of differentiated thyroid cancer who underwent thyroidectomy between January 1995 and June 2014. The mean age was 42±14 years. 74.4% were females. The mean tumor size was 1.9 cm±1.4. Papillary type was predominant (91%). Males had more extra-glandular extension than females (24.8% versus 10.9% respectively, p=0.001), more lymph node involvement (69.7% versus 52.9% respectively, p=0.017) and more vascular invasion (28.1% versus 14.9%, p=0.007). Around 70% of patients had at least one follow up visit after the surgery; among those, the median follow up duration was 4 years (1month-19years). At last follow-up visit, 78.7% were disease free, 14.9% had residual disease and only 6.3% had recurrent disease. By multivariate analysis, age greater than 45 years was the only independent predictor of persistence or recurrence (p=0.03) whereas both age below 45 years and lack of vascular invasion were significant predictors of disease free survival (p=0.001 and p=0.019 respectively). \u0000Conclusion: Differentiated thyroid cancer has an overall good prognosis in this cohort of Lebanese patients. Young age and lack of vascular invasion are the most important predictors of disease free survival. \u0000  \u0000Key words: Differentiated thyroid cancer: disease free survival, prognostic factors, recurrence","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44621995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atopic Eczema Simulating Mammary Paget’s Disease in an Adult: Case Report","authors":"Débora Bacellar Cruz Nunes, Adriana Kamilly Leitão Pitman Machado, Michelle Fonseca Goiabeira, Samira Oliveira Silveira, Yandra Sherring Einecke, A. Mendes, Maria Amélia Lopes dos Santos, Miguel Saraty de Oliveira, W. Loureiro, Leônidas Braga Dias Júnior, Juliana Bacellar Cruz Nunes, M. Nunes, F. Carneiro","doi":"10.3823/2546","DOIUrl":"https://doi.org/10.3823/2546","url":null,"abstract":"An atopic breast eczema is usually bilateral, with intense pruritus and good response to corticosteroids. The differential diagnosis with mammary Paget’s disease is fundamental, mainly in unilateral clinical manifestations, since it is frequently associated to adjacent breast tumors. The aim of the present report was to present a clinical condition of an atopic breast eczema through an exuberant and unilateral clinical presentation, emphasizing the need of the differential diagnosis for malignant diseases at this location.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45782358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Combination Of Vascular Variations In The Retroperitoneal Region. A Morphological Study","authors":"Humberto Ferreira Arquez","doi":"10.3823/2548","DOIUrl":"https://doi.org/10.3823/2548","url":null,"abstract":"Background: Blood supply of kidney and gonads is characterized by the presence of variations, which are usually silent and unnoticed until they are found by retroperitoneal surgery, radiologic examination or necropsy. Multiple renal vessels are no longer relative contraindication for laparoscopic donor nephrectomy, however of their presence may help avoid possible complication on a patient with these variations. The purpose of this morphological study was to analyze the frequency of supernumerary renal and testicular vessels and describe an unusual combination of vascular variations in the retroperitoneal region. \u0000Methods and Findings: A total of 18 cadavers with different age group and 10 visceral blocks were used for the study in the Morphology Laboratory of the University of Pamplona. Multiple anatomical variations bilateral of testicular vessels and renal were found during routine dissection in a 65-year-old male cadaver. The variations found were: bilateral presence of three renal arteries and three renal veins. The three left renal arteries are divided and gave rise to seven branches: the left main renal artery originates two branches; the upper branch originates four branches and the lower branch originates one branch. Retro-aortic left renal vein. Three left testicular artery and double right testicular artery all originating from accessory renal arteries. \u0000Conclusions:  Awareness of renal and testicular vessels anomalies is essential for decreasing the rate of accidental injuries in surgical procedures in the retroperitoneal region as well as aid in diagnosis of diseases associated with vascular variation in the posterior abdomen. An understanding of the morphology of renal and testicular vessels is necessary in uroradiology, Doppler imaging and computed tomography studies.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43492655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteochondroma. An Osteological Study","authors":"Humberto Ferreira Arquez","doi":"10.3823/2549","DOIUrl":"https://doi.org/10.3823/2549","url":null,"abstract":"Background: Osteochondroma is the most common tumor of bone, accounting for approximately one third of benign lesions in the skeleton is a broad (sessile) or narrow (pedunculated) skeletal protrusion comprised of marrow and cortical bone. Although it is benign, its biological behavior still has a malignant potential. Chondrosarcoma arising in osteochondroma has been recognized for many years. Osteochondromas might occur on any bone preformed in cartilage, they were especially seen on the long bones of the extremities, predominantly around the knee. In fact, the lower limb seemed to be at a higher risk of the tumor than the upper limb on the top two locations: distal part of the femur and proximal part of the tibia, however, the proximal humerus ranked the third place for solitary osteochondroma while the proximal fibula for multiples osteochondromas. \u0000Methods and Findings: A total of 20 skeletons and 18 cadavers of both sex, 16 males and 2 females, with different age groups were used, this study was carried out by routine dissection classes for undergraduate medical student´s in the Morphology Laboratory of the University of Pamplona during the years 2013-2016. In only one sample was found the presence of osteochondroma. The measurement of the osseous mass was of 7 x 3.5 x 1.5 cm, attached to the posterolateral aspect of the middle third of the femur. \u0000Conclusions: Osteochondroma is generally asymptomatic or discovered accidentally, but it can cause different symptoms depending on site of occurrence local swelling, bony deformities, fracture, bursa formation, arthritis and impingement on adjacent tendons, vascular or neurologic compromise, and dislocation The importance of correct treatment and follow-up of large osteochondromas to avoid complications such as further damage to neighboring neurovascular structures, and potential malignant degeneration. The present study describe a rare location from an osteochondroma in the femur diaphysis.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44529557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial Vein Variation: A Cadaveric Study","authors":"Humberto Ferreira Arquez","doi":"10.3823/2547","DOIUrl":"https://doi.org/10.3823/2547","url":null,"abstract":"Background: The veins of the head and neck have a complex developmental pattern which predisposes them to variations in formation and drainage. Superficial veins of the head and neck are utilized for central venous cannulation, oral reconstruction and parenteral nutrition in debilitated patients. Clinical and sonological examinations of these veins may provide clues toward underlying cardiac pathology. \u0000Aims: The aim of the present study was to describe anatomical variation and determined the position of the facial vein in relation to neighboring structures. \u0000Methods and Findings: Head and neck region were carefully dissected as per standard dissection procedure, studied serially during the years 2013-2017 in 16 males and 2 females, i.e. 36 sides, embalmed adults cadavers with different age group, in the laboratory of Morphology of the University of Pamplona. In 34 sides (94.5 %) of the cases the facial vein (FV) terminated into the internal jugular vein via the common facial vein (CFV) as per standard anatomic description. The facial vein on two sides (5.5 %) was found to drain into the external jugular vein with different degree of angulations and variable distance from the angle of the mandible. On the right side, the facial vein was draining into external jugular vein (EJV), 63.6 mm below the angle of the mandible. On the left side, the facial vein was draining into EJV, 42.4 mm below the angle of the mandible. The length of the neck was 137.8 mm.  The mean distance of the superior and inferior labial veins, deep facial vein, and angular vein from the inferior orbital margin was 41.89 ± 3.01, 52.31 ± 3.72, 26.85 ± 3.55 and 6.25 ± 0.65 mm, respectively. \u0000Conclusion: A sound knowledge on variation of the course and termination of facial vein is very useful for oral and maxillofacial surgeons, plastic surgeons, otorrhinologists and radiologists, is essentially important in the clinical examination and surgical procedures of the head and neck region.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48938180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}