Correlação entre os achados radiográficos e ecocardiográficos sugestivos de aumento cardíaco em cães: 104 casos / Correlation between radiographic and ecocardiographic findings suggestive of cardiomegaly in 104 dogs

Radiografias torácicas e ecocardiogramas de 104 caninos foram avaliados e correlacionados quanto ao aumento das câmaras cardíacas. Os achados radiográficos foram correlacionados estatisticamente a fim de se estabelecer a acurácia do exame radiográfico na detecção do aumento cardíaco em comparação ao ecocardiográfico - padrão-ouro não invasivo. A correlação entre os achados radiográficos indicativos de aumento cardíaco e os índices ecocardiográficos mostrou-se fraca, significativa somente para VHS versus relação átrio esquerdo/aorta (r=0,3136), eixo curto versus relação átrio esquerdo/aorta (r=0,3813) e eixo curto versus velocidade da onda E (r=0,2021). A acurácia da radiografia na determinação subjetiva de aumento das câmaras cardíacas foi razoável, variando entre 72,1% e 80,8%. Em contrapartida, o VHS apresentou baixa acurácia (50,9%) na detecção de cardiomegalia.(AU)

Thoracic radiographs and echocardiograms of 104 canines were evaluated and correlated regarding cardiac chambers enlargement. The radiographic findings were statistically correlated in order to establish the accuracy of the radiographic examination in the detection of cardiac enlargement in comparison with the echocardiogram - non-invasive gold standard. The correlation between the radiographic findings indicative of cardiac enlargement and echocardiographic indexes was weak, significant only for VHS versus left atrium to aorta ratio (r= 0.3136), short axis versus left atrium to aorta ratio (r= 0, 3813) and short axis versus E wave velocity (r= 0.2021). The radiographic accuracy in the subjective determination of cardiac chamber enlargement was reasonable, ranging from 72.1% to 80.8%. On the other hand, VHS presented low accuracy (50.9%) in the detection of cardiomegaly.(AU)

A study on the ethics of microallocation of scarce resources in health care.

OBJECTIVES: This study attempts to analyse the ethical dilemmas arising from the microallocation of scarce health care resources, in terms of deontology and utilitarianism. METHODS: A group of 395 people were interviewed in the region of Diadema, greater San Paulo, Brazil, while visiting patients in the only state hospital in town. Each interviewee was given a list of eight simulated emergencies (see appendix). In each of the eight cases the interviewee had to choose which of the two patients described, both of whom suffered from exactly the same problem, should receive the only hospital bed currently available. The differences between the hypothetical patients were as follows: age, gender, family dependency, and lifestyle. Each interviewee was asked to justify one of their responses. These responses were then analysed. RESULTS: The results pointed to the co-existence of deontological and utilitarian orientations among the people interviewed. A tendency to give priority to the destitute was revealed throughout the research, contradicting the idea that society, valuing only productive people, wishes only such people to receive the most resources, thus maximising the benefits to be gained from resources. The results showed that people's disapproval of the alcoholic was stronger than that of the nicotine abuser.

[Social criteria for selecting patients in emergency services]. / Critérios sociais na seleção de pacientes em serviços de emergência.

OBJECTIVE: To identify the social first-year and senior undergraduate students of a healthcare management course used for selecting patients who need emergency medical care. METHODS: A random sample of 64 first-year and 25 senior year students of a healthcare management course in São Paulo, Brazil, were studied. To collect data, a survey instrument was developed with nine hypothetical simulated case scenarios, including the social criteria involved in the patient selection process, such as age, sex, economical status, life-style, and social duty. RESULTS: There were significant differences in the two groups concerning criteria such as the patient's life-style and economic status. CONCLUSIONS: The results suggest that the respondents accept the inclusion of social criteria in the decision-making process in a situation of scarce resources.