RESUMO
In 2007, several international studies brought useful information for the daily work of internists in hospital settings. This summary is of course subjective but reflects the interests and questions of the chief residents of the Department of internal medicine who wrote this article like an original trip in medical literature. This trip will allow you to review some aspects of important fields such as heart failure, diabetes, endocarditis, COPD, and quality of care. Besides the growing diversity of the fields covered by internal medicine, these various topics underline also the uncertainty internists have to face in a practice directed towards evidence.
Assuntos
Medicina Interna , Corpo Clínico Hospitalar , Acidentes por Quedas/prevenção & controle , Idoso , Albuterol/análogos & derivados , Albuterol/uso terapêutico , Anemia/tratamento farmacológico , Anticoagulantes/uso terapêutico , Antagonistas dos Receptores de Hormônios Antidiuréticos , Fibrilação Atrial/etiologia , Atitude do Pessoal de Saúde , Benzazepinas/uso terapêutico , Bronquite Crônica/tratamento farmacológico , Broncodilatadores/uso terapêutico , Estimulação Cardíaca Artificial/métodos , Diabetes Mellitus/etiologia , Endocardite Bacteriana/prevenção & controle , Eritropoetina/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Heparina/uso terapêutico , Humanos , Relações Interprofissionais , Infarto do Miocárdio/complicações , Infarto do Miocárdio/tratamento farmacológico , Proteínas Recombinantes , Gestão de Riscos , Rosiglitazona , Xinafoato de Salmeterol , Tiazolidinedionas/uso terapêutico , Tromboembolia/prevenção & controle , Tolvaptan , Vasodilatadores/uso terapêutico , Disfunção Ventricular Esquerda/terapia , Carga de TrabalhoRESUMO
Clinical practice in internal medicine has fundamentely changed over the last decade. Our knowledge has dramatically improved and we are facing new types of patients. Their number is increasing, they are older and suffer from increasingly complex medical conditions. The society has evolved as well therefore transforming our daily practice. This implies important modifications of our role and new challenges. We must also develop new aspects of our practice such as recognizing our errors, quality of care, quality of education, ethics, new strategies for taking care of the patient all this in parallel with continuous education. Our role as (general practitioner) is of utmost importance since it enables us to keep the "big pictures" in a more and more specialized environment.
Assuntos
Medicina Interna/educação , Medicina Interna/normas , Internato e ResidênciaRESUMO
Systemic amyloidosis with cardiac involvement may clinically be suspected in the presence of heart failure or arrhythmia of unknown origin. Herein two cases of cardiac amyloidosis are described with a clinical presentation of heart failure refractory to usual treatment. The key role of echocardiography in the diagnosis and prognosis evaluation of cardiac amyloidosis is discussed. A treatment targeted against the generation of amyloid fibril should ideally be initiated before apparition of heart failure.