Acta médica portuguesa
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The authors report a clinical case of clonidine poisoning in a 20-month-old child. Although a paradigmatic case, due to extensive symptomatology, it presented a diagnostic and therapeutic challenge.
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Acta médica portuguesa · Nov 1993
[Burns. A retrospective study of the Burn Unit of the Hospital de Santa Maria].
A retrospective analysis was made concerning 291 admissions to the Burn Care Unit from June 1987 to March 1992, due to acute burns. Within that considered period of time there was a progressive increase in the number of admissions. Of the patients admitted, patients 177 men were and 144 women. ⋯ The average time of admission was 24.3 days. The mortality rate was 18%. The observer complications were mainly cutaneous and were seen on patients who were lately debrided.
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Acta médica portuguesa · Nov 1993
[The treatment of burn patients. What are the prospects for the northern area of Portugal?].
The AA studied the distribution of age, sex, aetiology, and destiny of the 173 in-patients at the S. João Hospital (Central hospital that has no Burn Unit). In what concerns age, 38.1% are children less than 10 years old; the male/female ratio was 1.7:1. ⋯ These findings were compared to a Burn Unit of a Spanish Hospital (Alicante) which has 18 beds for adults and children, normally interning 132 patients per year. As the WHO suggest one special bed per 30,000 persons, we should be expected to have at least 110 beds for burn patients (we only have 9 beds at Prelada Hospital), the AA suggest the establishment of a Burn Unit at S. João Hospital, also due to the fact that is the only hospital that has a permanent emergency care for Plastic Surgery.
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Acta médica portuguesa · Oct 1993
[The directional axes in the reform of medical teaching. A strategic proposal].
The circumstances preceding the future revision of the medical curriculum are analysed, main internal and external stimuli are described, and sources of resistance to changes in medical training require new educational philosophy, privileging oriented training during undergraduation, as a preliminary phase of medical education. The definition and accompaniment of the general and specific objectives, the strategy and programme used, the design and adequacy of the available support, and the related engagement of all political, academic and socially responsible persons and institutions, are fundamental factors for successful change. The education and training of polyvalent medical doctors requires methodological modifications, namely the definition of a core curriculum, made dynamic through the teaching of interdependent subjects and earlier contact with common clinical problems. ⋯ The education resulting from a renewal in undergraduate medical education will be mostly determined by organizational and institutional frameworks, teaching methods and the evaluation process used, as well as by teacher commitment, pedagogic and scientific capacities. Professional competence should be the end product of efficient training. Otherwise, undergraduate medical education would not prepare the professional development of the young doctors, thus diminishing the quality of medical training in the future.
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Diagnostic and therapeutic management options in cases of subarachnoid hemorrhage secondary to aneurysm rupture are discussed. Particular emphasis is given to the diagnosis, medical treatment and timing of surgery. The problems raised by the presence of an intracerebral hematoma, acute hydrocephalus and multiple aneurysms are reviewed. The author also discusses the management of incidental aneurysms, partially treated lesions, familial and genetic aneurysms, lesions which ruptured during pregnancy or associated with arterio-venous malformations, and the question of a negative angiogram in cases of subarachnoid hemorrhage.