Acta Medica Port
-
Meningococcal disease has a wide spectrum of clinical presentation. Occult bacteremia is not easily diagnosed and may have good prognostic. ⋯ Meningococcal disease may present with fever without toxic appearance--unsuspected meningococcal disease--causing difficulty in the diagnosis and delaying the treatment. Spontaneous resolution is rare and severe complications may occur.
-
This review is focused on doctors' occupational stress. A synthesis of the broad negative impact of distress is presented, as well as its spreading importance and magnitude according to recent research. Contemporary definitions of stress and burnout models are underlined with a remembering of their historical evolution. ⋯ The core risk factors of occupational medical stress are detailed and discussed, with more emphasis in those related to doctors vulnerabilities. Great need actually unmeeted regards the public recognition of the professional medical risks, the acceptance by the doctors of their normal fragility as humans, and their insight about their own vulnerabilities as a group with specifics professional representation. The conclusion is that there is a major and urgent need for the doctors to develop and practice competences of stress management.
-
Comparative Study Historical Article
[The myth of Apollo and Marsyas. Artistic representations and anatomical studies].
The authors analyze an interesting sculpture found in the gardens of a 17th Century palace in Lisbon, representing the myth of Apollo and Marsyas, which led them to compare the details of the sculpture of the flayed satyr with the previous anatomic studies by Leonardo da Vinci (cc.1510-1530) or Vesalius (cc.1543). The photographic material obtained from the 17th century Italian sculpture presents amazing similitude with these, earlier, 16th century anatomical studies. ⋯ Some of the artistic representations of surface anatomy depict other motives, as is the case of the self-portrait of Michelangelo, painted in the Sistine Chapel, in honour of St. Bartholomew.
-
Thyrotoxic periodic paralysis (TPP) is characterized by recurrent episodes of muscle weakness and hypokalemia associated with thyroid hyperactivity. Reported predominantly among individuals of Asian descent, TPP is a rare manifestation of hyperthyroidism in western populations. We describe a typical case of TPP in a 33-year-old portuguese male, who presented with acute tetraparesis associated with hypokalemia (K+ 2.6 mEq/L). ⋯ The correction of the hyperthyroid function with metimazol and propranolol prevented further episodes of muscle weakness. Thyrotoxic periodic paralysis should be considered in the differential diagnosis of acute episodes of motor paralysis in young patients. The maintenance of a euthyroid status is an essential part of management as this prevents the paralytic episodes.
-
In the last years has been observed an increased incidence of invasive group A beta-hemolytic streptococcal infections, including the toxic shock syndrome. The most common portal of entry is the skin and mucous membranes. The toxic shock syndrome can occurred as a rare complication of pharyngitis. ⋯ The authors reported the clinical case of a 12 year old adolescent, that 15 days after the diagnosis of mononucleosis infectious confirmed by serology and treated with ibuprofen, was internment by streptococcal toxic shock syndrome with rhabdomyolysis, hepatitis, cellulitis of the leg, arthritis of the knee and pleural effusion. Therapeutics was made with penicillin G and clindamycin. We present this case for the severity of the clinical situation and for the questions that rise.