RESUMO
The number of medical autopsies has declined in recent decades due to the development of imaging techniques and some risks linked to autopsies. However, the contribution of autopsy is diagnostically significant, even better than new technologies currently available. It is thus a good indicator of quality, but also a training tool, and has a significant impact in the grieving process. At the CHUV, under the leadership of Pathology Department, institutional projects have been implemented in order to increase the number of autopsies, including a pre- and post-graduate training and systematic request for autopsy, with significant gain for clinicians and pathologists, but also for families who get systematic and customized return results.
Le nombre des autopsies médicales a régressé ces dernières décennies en raison du développement des techniques d'imagerie et de certains risques autour de l'autopsie. Cependant, l'apport de l'autopsie est considérable sur le plan diagnostique, meilleur même que celui des nouvelles technologies actuellement à disposition. Elle représente un bon indicateur de qualité, mais aussi un outil de formation, avec un impact non négligeable dans le processus de deuil des proches. Au CHUV, des projets ont été mis en place en vue d'augmenter le nombre des autopsies : enseignement pré et postgrade et demande systématique lors de chaque décès avec un gain significatif pour les médecins, mais également pour les familles qui bénéficient d'un retour personnalisé des résultats.
Assuntos
Autopsia , Educação Médica/métodos , Medicina Interna/métodos , Controle de Qualidade , Humanos , Medicina Interna/educaçãoRESUMO
Conventional skin cancer prevention programs appeal to limited populations, and the middle aged male population responds less frequently. Our objective was to establish a complementary health promotion campaign tool for skin cancer prevention. Internet-based education, instruction for self assessment and teledermatological evaluation of skin lesions by an expert commission of dermatologists was used. Compliance and clinical diagnosis was assessed in a subgroup. 12,000 users visited the educational website. There was strong interest among the middle aged male population (53% (N = 262): male; mean age: 42). 28.5% of examined lesions (N = 494) were considered suspicious. Email requests, sent to the group whose lesions where considered suspicious, were answered by 46.0% of females (N = 29) and 59.7% of males (N = 46) with a female distribution predominantly in younger ages (52.6% of females with known age: < 30 years). Males were predominantly represented over 30 years (86.2% of all males). According to user's declarations, at least 8 (8.5%) malignant lesions (1 melanoma in situ, 1 squamous cell carcinoma, 4 basal cell carcinomas, 2 malignant lesions without declared diagnosis) were finally diagnosed by physicians. We conclude that internet-based, interactive, educational programs, in addition to existing health promotion campaigns, can enhance public participation in the middle aged male population in skin cancer prevention.