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1.
BMJ Case Rep ; 14(9)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497056

RESUMO

Our patient was a 57-year-old woman with a history of bilateral retropectoral silicone breast augmentation and axillary hyperhidrosis who underwent a bilateral thoracic sympathectomy via video-assisted thoracoscopic surgery by a surgeon at an outside hospital approximately 20 years ago. The left side required an open thoracotomy. Shortly after the surgery, she developed a left-sided Baker 4 capsular contracture and the left implant was noted to be ruptured. Both implants were exchanged. Several years later the patient began to experience progressive fatigue. Work-up revealed a left lung nodule and she underwent a biopsy that confirmed silicone granulomas. It was hypothesised that at the time of her initial thoracotomy the implant was violated resulting in silicone spillage into the thoracic cavity. The patient was referred to our institution for advanced management of her intrathoracic silicosis. The patient underwent bilateral removal of her silicone implants, total capsulectomy and needle-localised removal of her left thoracic silicone masses. She had an uneventful postoperative course with resolution of her fatigue.


Assuntos
Implante Mamário , Implantes de Mama , Mamoplastia , Implantes de Mama/efeitos adversos , Feminino , Humanos , Doença Iatrogênica , Pessoa de Meia-Idade , Géis de Silicone/efeitos adversos
2.
J Coll Physicians Surg Pak ; 31(9): 1111-1113, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34500533

RESUMO

Motor innervation of trapezius and sternocleidomastoid (SCM) muscles is provided solely by the spinal accessory nerve (SAN). SAN palsy most often occurs as a result of iatrogenic injury to the nerve. A patient, who had undergone neck dissection for thyroid cancer, presented with pain and reduced range of motion of the shoulders. Electroneuromyography revealed denervation of the trapezii and SCM muscles secondary to SAN injury. The patient was treated with a course of physical therapy (PT). This case reminds us that a SAN lesion should be considered in the differential diagnosis of a patient presenting with shoulder pain following surgery of the neck. Even though unilateral SAN injury can eventually lead to atrophy of the trapezius, muscle asymmetry may not be obvious, especially in bilateral iatrogenic SAN injuries. In our experience, these patients benefit from PT. However, evidence to support the use of PT in the treatment of shoulder dysfunction secondary to SAN injury is insufficient; the optimum type and timing of PT requires further investigation. Development of best-practice guidelines in terms of management is necessary. Key Words: Spinal accessory nerve, Electroneuromyography, Scapular winging.


Assuntos
Traumatismos do Nervo Acessório , Nervo Acessório , Nervo Acessório/cirurgia , Humanos , Doença Iatrogênica , Esvaziamento Cervical/efeitos adversos , Ombro/cirurgia
3.
Anthropol Med ; 28(2): 255-275, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34355977

RESUMO

This paper seizes Ivan Illich's recurring notion of corruption to reflect on medicine's immanent spiral of maleficence. For Illich, the institutionalization of any 'good' necessarily corrupts it, and the institutionalization of health and care under the tutoring hand of medicine has produced counterproductive consequences on every plane. The paper explores the nemetic character of contemporary biomedicine - whose growth in technique has meant a corresponding growth in its capacity for corruption and harm - in an autoethnographic project that apprises and names the escalation from iatrogenic harm to iatrogenic violence that the author discovered at two UK hospitals in 2014. In January, she went to the hospital for a colonoscopy; in November, she finally left, disabled and unmade. In the interim, she suffered infection, sepsis, pneumonia, cardiac arrest, and - worst of all - a factitious psychiatrizing diagnosis embedded in spiralling loops of iatrogenic harm. By reflecting critically on this experience, interlocuting personal memory and writings with doctors' inscribed notes and insights from medical anthropology, the paper elucidates an iatrogenic spiral, showing how unknowable bodies pose an insurmountable epistemic and existential challenge to medicine's technic mandate, how medicine locates and uses an 'epistemic escape valve' in the face of such challenges, and how snowballing nosocomial harm escalates into brutality and vice. The argument, in short, is that iatrogenic violence (destructive, subjective or agentic, and intentional) is the natural endpoint of iatrogenic harm (destructive but objective or systemic, and unintentional).


Assuntos
Antropologia Médica , Atitude do Pessoal de Saúde/etnologia , Atenção à Saúde/etnologia , Ética Médica , Doença Iatrogênica , Colonoscopia , Infecção Hospitalar , Feminino , Humanos , Institucionalização , Violência
4.
Anthropol Med ; 28(2): 141-155, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34355978

RESUMO

Drawing on the work of Ivan Illich, our special issue reanimates iatrogenesis as a vital concept for the social sciences of medicine. It calls for medicine to expand its engagement of the injustices that unfold from clinical processes, practices, and protocols into patient lifeworlds and subjectivities beyond the clinic. The capacious view of iatrogenesis revealed by this special issue collection affords fuller and more heterogeneous insights on iatrogenesis that does not limit it to medical explanations alone, nor locate harm in singular points in time. These papers attend to iatrogenesis' immediate and lingering presences in socialities and structures within and beyond medicine, and the ways it reflects or reproduces the racism, sexism, and ableism built into medical logics.


Assuntos
Disparidades em Assistência à Saúde , Doença Iatrogênica , Racismo , Antropologia Médica , COVID-19/etnologia , Humanos
5.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(7): 753-758, 2021 Jul 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34382593

RESUMO

Recturethral fistula (RUF) is a kind of serious complication that mainly happened during the treatment of prostate cancer. It has become one of the most difficult diseases to treat in urology because of its special anatomical location, complicated condition, and the varied prognosis. At present, the main treatment methods for RUF are conservative treatment such as application of antibiotics and indwelling catheters, etc. and surgical treatment such as transperineal approach, transsphincter approach, transanal approach, transabdominal approach, etc. However, there is no explicit treatment protocol for RUF. What's more, the etiology of RUF has changed greatly in recent years. Summarizing the advantages and disadvantages of different RUF's treatment methods and their prognosis will be helpful for the decision of clinical treatment.


Assuntos
Fístula Retal , Doenças Uretrais , Fístula Urinária , Humanos , Doença Iatrogênica , Masculino , Prognóstico , Fístula Retal/etiologia , Fístula Retal/cirurgia , Doenças Uretrais/etiologia , Doenças Uretrais/cirurgia , Fístula Urinária/etiologia , Fístula Urinária/cirurgia
6.
Arthroscopy ; 37(8): 2485-2487, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34353557

RESUMO

Successful outcomes after psoas tenotomies have been reported and proposed in the setting of recalcitrant internal snapping and psoas impingement. However, case reports citing hip flexion weakness and iatrogenic instability created concern regarding the role for psoas tenotomies. Despite these concerns, some recent studies reporting improved outcomes after endoscopic psoas tenotomies breathe further life into this controversial topic. Psoas tenotomy in the setting of a borderline dysplastic hip likely carries an even greater risk for iatrogenic instability. It might be critical to evaluate for clinical signs and symptoms of instability in addition to radiographic parameters to avoid this potentially devastating complication. In addition, the traditional definition of borderline dysplasia is based on lateral acetabular coverage that might be less important than anterior acetabular coverage and femoral version when contemplating psoas tenotomies on the basis of the dynamic anterior stabilizing effect of the iliopsoas myotendinous unit. Surgeons should also be extremely cautious when considering psoas tenotomy in an athletic population with the potential for persistent weakness and limited data hinting at inferior sports specific outcomes. In the end, it is not clear whether the psoas tenotomy "drives" the improvements seen in some studies, or whether many of these patients ultimately battle their way into a minimally clinically important difference "despite" the psoas tenotomy.


Assuntos
Articulação do Quadril , Tenotomia , Artroscopia , Atletas , Humanos , Doença Iatrogênica
7.
Ned Tijdschr Geneeskd ; 1652021 07 16.
Artigo em Holandês | MEDLINE | ID: mdl-34346602

RESUMO

BACKGROUND: Despite the availability of different medical tools to simplify blood withdrawal, an old-fashioned method is still frequently being used in neonatal infants: the use of warm elements such as a warm washcloth or a glove filled with warm water, wrapped around an extremity. Use of these warm elements may easily cause contact burns in neonates. Unfortunately, not seldom we see and treat neonates with these burn injuries. CASE DESCRIPTION: We present the case of a neonate, who was referred to our outpatient clinic with an iatrogenic contact burn. The patient received topical treatment and wound dressings for over a month time. Scars remained. CONCLUSION: We would like to raise awareness among care givers on this type of injuries. To prevent these iatrogenic burns injuries, we advise to use alternative methods to simplify blood withdrawal.


Assuntos
Queimaduras , Administração Tópica , Bandagens , Queimaduras/etiologia , Cicatriz , Humanos , Doença Iatrogênica , Lactente , Recém-Nascido
8.
Soins Gerontol ; 26(151): 14-18, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34462106

RESUMO

The links between the emergency department (ED) and drug-related harm are close. In practice, it is necessary to ask systematically if an iatrogenic accident is possible and to evaluate a new prescription carefully so as not to create iatrogenia during the visit to the emergency department. Any situation in which a nurse takes charge of an emergency room must be subject to precautions. Simple measures should be put in place during any hospitalisation of an elderly person.


Assuntos
Serviço Hospitalar de Emergência , Hospitalização , Idoso , Humanos , Doença Iatrogênica/epidemiologia
9.
Rev Med Liege ; 76(7-8): 620-624, 2021 Jul.
Artigo em Francês | MEDLINE | ID: mdl-34357715

RESUMO

The occurrence of metabolic acidosis with increased anion gap in the context of chronic paracetamol intoxication is an easily treatable clinical situation. Its rapid recognition is essential given its complete reversibility in the event of adequate management by eviction of the toxic agent, in this case paracetamol. It has an unknown cause and therefore potentially under-diagnosed, to be considered in the same way as the other more frequent etiologies. Because of this lack of knowledge, its frequency is probably underestimated considering the widespread consumption of paracetamol in the population.


Assuntos
Acetaminofen , Acidose , Equilíbrio Ácido-Base , Acidose/induzido quimicamente , Humanos , Doença Iatrogênica , Ácido Pirrolidonocarboxílico/metabolismo
10.
Stomatologiia (Mosk) ; 100(4): 123-126, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34357740

RESUMO

OBJECTIVE: The aim of the study was to study the structure of odontogenic sinusitis and identify iatrogenic etiological factors. MATERIAL AND METHODS: A retrospective analysis of the case histories of patients operated from 2015 to 2019 with a diagnosis of «Sinusitis¼ in the Clinical City Emergency Hospital in Tashkent, Republic of Uzbekistan in the department of emergency maxillofacial surgery was carried out. The total number of patients was 333 people: 105 (31.5%) men and 228 (68.5%), the average age of patients was 39.4 years. RESULTS: When analyzing the reasons for the development of sinusitis, in 73% of the total number of operated patients, there was an associated lesion of the teeth. When detailing the sources of odontogenic infection, it was determined that periapical foci of inflammation (granulomatous, granulating periodontitis, cystogranulomas) accounted for 26%, foreign bodies (teeth, roots of teeth, filling materials removed into the maxillary sinus during endodontic treatment) 31%, fistulous passages after removal teeth and attempts to eliminate perforation by surgery 43%. Other etiological factors were found: chronic polypous rhinosinusitis 14%, benign tumors 8%, allergic fungal sinusitis 5%. CONCLUSION: Clinical analysis showed that the development of most cases of odontogenic sinusitis is associated with the mistakes of dentists and is of iatrogenic origin. To prevent the development of odontogenic iatrogenic sinusitis, prior to dental interventions on the teeth of the upper jaw, it is necessary to carry out a topical diagnosis of their ratio with the maxillary sinus.


Assuntos
Sinusite Maxilar , Sinusite , Adulto , Humanos , Doença Iatrogênica/epidemiologia , Masculino , Seio Maxilar , Sinusite Maxilar/epidemiologia , Sinusite Maxilar/etiologia , Estudos Retrospectivos
11.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 52-55, maio-ago. 2021. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1283891

RESUMO

Pacientes com históricos de defeitos ósseos provocados por infecções, malformação congênita, neoplasias, deformação por iatrogenia, radioterapia e trauma buscam contornos faciais mais harmônicos através da reabilitação cirúrgica. Para facilitar a reconstrução maxilofacial dois grupos de materiais podem ser utilizados, os enxertos ósseos e os materiais aloplásticos. O objetivo é relatar um caso incomum de infecção e exposição de material utilizado para enxertia a base de polimetilmetacrilato, bem como a sua posterior reabordagem cirúrgica. Embora o Polimetilmetacrilato aparente ser seguro, ele exibe complicações diversas em função da imunologia do hospedeiro, que poderá reagir de diferentes formas. Desse modo, faz-se necessário ressaltar a importância da prevenção e proservação de cada caso de forma individualizada(AU)


Patients with a history of bone defects caused by infections, congenital malformation, neoplasms, iatrogenic deformation, radiotherapy and trauma seek more harmonious facial contours through surgical rehabilitation. To facilitate maxillofacial reconstruction, two groups of materials can be used, bone grafts and alloplastic materials. The objective is to report an unusual case of infection and exposure of material used for grafting with polymethylmethacrylate, as well as its subsequent surgical approach. Although Polymethylmethacrylate appears to be safe, it exhibits different complications depending on the host's immunology, which may react in different ways. Thus, it is necessary to emphasize the importance of preventing and preserving each case individually(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Transplante Ósseo , Polimetil Metacrilato , Traumatismos Maxilofaciais , Órbita , Cirurgia Bucal , Zigoma , Materiais Biocompatíveis , Doença Iatrogênica , Maxila
12.
J Forensic Leg Med ; 82: 102209, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34229151

RESUMO

The occurrence of air embolism is highly related to medical operations, and air embolism can cause sudden death. Such situations require attention in forensic work. This article reports two cases of iatrogenic air embolism confirmed by autopsy. In case 1, air embolism occurred after hydrogen peroxide was used to irrigate and disinfect a wound on the patient's left forearm. Approximately 90 ml of 3% hydrogen peroxide solution was used in case 1, and this volume can produce approximately 890 ml of oxygen by complete decomposition, which is far more than the average lethal air embolism volume. Attention should be given to the risk of air embolism when using hydrogen peroxide for irrigation and disinfection. In case 2, air embolism occurred during left ureteroscopy and stent placement. Due to inappropriate processing, the normal saline pump infused air into the patient at a high pressure of 120 mmHg. Based on our autopsy findings, we discuss the pathways of arterial air embolism and cerebral air embolism. In addition to the air entrainment volume and accumulation rate, the location of air accumulation also significantly impacts the risk of air embolism. After an arterial air embolus develops into a coronary and/or cerebral air embolus, the lethal air volume drops to only a few milliliters.


Assuntos
Morte Súbita/etiologia , Embolia Aérea/etiologia , Peróxido de Hidrogênio/efeitos adversos , Irrigação Terapêutica/efeitos adversos , Ureteroscopia/efeitos adversos , Adolescente , Autopsia , Evolução Fatal , Feminino , Humanos , Doença Iatrogênica , Masculino , Pessoa de Meia-Idade
13.
Pol Merkur Lekarski ; 49(291): 231-234, 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34218246

RESUMO

Vascular injury during lumbar disc surgery was first reported as a complication in 1945 by Linton and White [32]. Injuries of the major blood vessels located anteriorly to the spine in the retroperitoneal space are rare but occur suddenly and are life-threatening. The authors present anatomo-topographical background of this complication, standards of diagnostic process and treatment on the base of literature as well the surgical and endovascular management of this complication. The authors performed a literature search for reported iatrogenic vascular injuries due to lumbar disc surgery. We were able to find 10 case series and 17 single case reports describing this rare but serious lumbar disc surgeryrelated complication. Overall, there were 159 patients who developed vascular injury due to lumbar disc surgery. The surgical exploration and repair has been done in 116 patients. In last decades due to rapid development of endovascular techniques this complication was repaired endovascular techniques in 21 patients. The most common lumbar level which resulted in iatrogenic vascular injury was L4-L5. There were reported 66 deaths and in 83 patients the postoperative period was uneventful. CONCLUSIONS: We would like to highlight the occurrence of this complication and introduction of rapid management to prevent the fatal outcome. Lumbar disc surgery is one of the most often performed procedures in neurosurgical wards. The awareness of this life-threatening complication should be known to all members of an operative team. The knowledge of proper management of this serious adverse event may save a patient's life.


Assuntos
Deslocamento do Disco Intervertebral , Lesões do Sistema Vascular , Humanos , Doença Iatrogênica , Artéria Ilíaca , Vértebras Lombares
14.
Anthropol Med ; 28(2): 188-204, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34196238

RESUMO

'Medical iatrogenesis' was first defined by Illich as injuries 'done to patients by ineffective, unsafe, and erroneous treatments'. Following Lokumage's original usage of the term, this paper explores 'obstetric iatrogenesis' along a spectrum ranging from unintentional harm (UH) to overt disrespect, violence, and abuse (DVA), employing the acronym 'UHDVA' for this spectrum. This paper draws attention to the systemic maltreatment rooted in the technocratic model of birth, which includes UH normalized forms of mistreatment that childbearers and providers may not recognize as abusive. Equally, this paper assesses how obstetric iatrogenesis disproportionately impacts Black, Indigenous, and People of Color (BIPOC), contributing to worse perinatal outcomes for BIPOC childbearers. Much of the work on 'obstetric violence' that documents the most detrimental end of the UHDVA spectrum has focused on low-to-middle income countries in Latin America and the Caribbean. Based on a dataset of 62 interviews and on our personal observations, this paper shows that significant UHDVA also occurs in the high-income U.S., provide concrete examples, and suggest humanistic solutions.


Assuntos
Parto Obstétrico , Disparidades em Assistência à Saúde/etnologia , Doença Iatrogênica/etnologia , Serviços de Saúde Materna , Antropologia Médica , Feminino , Humanos , Gravidez , Relações Profissional-Paciente , Estados Unidos , Violência/etnologia
15.
Antimicrob Resist Infect Control ; 10(1): 106, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34281623

RESUMO

Globally, tuberculosis (TB) is a leading cause of death from a single infectious agent. Healthcare workers (HCWs) are at increased risk of hospital-acquired TB infection due to persistent exposure to Mycobacterium tuberculosis (Mtb) in healthcare settings. The World Health Organization (WHO) has developed an international system of infection prevention and control (IPC) interventions to interrupt the cycle of nosocomial TB transmission. The guidelines on TB IPC have proposed a comprehensive hierarchy of three core practices, comprising: administrative controls, environmental controls, and personal respiratory protection. However, the implementation of most recommendations goes beyond minimal physical and organisational requirements and thus cannot be appropriately introduced in resource-constrained settings and areas of high TB incidence. In many low- and middle-income countries (LMICs) the lack of knowledge, expertise and practice on TB IPC is a major barrier to the implementation of essential interventions. HCWs often underestimate the risk of airborne Mtb dissemination during tidal breathing. The lack of required expertise and funding to design, install and maintain the environmental control systems can lead to inadequate dilution of infectious particles in the air, and in turn, increase the risk of TB dissemination. Insufficient supply of particulate respirators and lack of direction on the re-use of respiratory protection is associated with unsafe working practices and increased risk of TB transmission between patients and HCWs. Delayed diagnosis and initiation of treatment are commonly influenced by the effectiveness of healthcare systems to identify TB patients, and the availability of rapid molecular diagnostic tools. Failure to recognise resistance to first-line drugs contributes to the emergence of drug-resistant Mtb strains, including multidrug-resistant and extensively drug-resistant Mtb. Future guideline development must consider the social, economic, cultural and climatic conditions to ensure that recommended control measures can be implemented in not only high-income countries, but more importantly low-income, high TB burden settings. Urgent action and more ambitious investments are needed at both regional and national levels to get back on track to reach the global TB targets, especially in the context of the COVID-19 pandemic.


Assuntos
COVID-19/complicações , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Tuberculose/prevenção & controle , Tuberculose/transmissão , COVID-19/prevenção & controle , Humanos , Doença Iatrogênica/prevenção & controle , Incidência , Fatores de Risco
16.
BMJ Case Rep ; 14(7)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34266829

RESUMO

A 72-year-old woman with a history of removal of a right hemimandibular keratocyst 10 years ago was referred to our attention for a large swelling of the right cheek. The orthopantomography and the CT scan showed a huge osteolytic area of the right mandibular ramus and angle. The patient's refusal to resection and reconstruction with a free flap pushed us towards a conservative treatment. The high probability of a iatrogenic mandibular fracture during and after surgery required the design of a customised titanium plate to be preliminary placed through cervical incision along the posterior border of the mandible. The patient successfully underwent the surgical positioning of the customised plate and subsequent removal of the keratocyst. She was discharged fit and well 5 days after surgery. She did not experience any infections, pathological fractures or relapse in the 6-month follow-up.


Assuntos
Fraturas Mandibulares , Cistos Odontogênicos , Idoso , Feminino , Humanos , Doença Iatrogênica/prevenção & controle , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Fraturas Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/cirurgia , Recidiva Local de Neoplasia , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/cirurgia , Titânio , Suporte de Carga
17.
Anthropol Med ; 28(2): 223-238, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34058932

RESUMO

Opioids, a set of potent pain medications, have numerous known deleterious side effects, ranging from constipation to respiratory depression and death, and yet they are routinely prescribed and administered in biomedical settings. Situated against the backdrop of the US opioid epidemic, this paper examines how the iatrogenic and inadvertent harms and complications caused by opioid administration in clinical settings are experienced by clinicians as forms of moral injury. 'Moral injury' describes a moral agent's experience of perpetrating or being unable to prevent events that are at odds with their moral beliefs and social expectations. This concept powerfully extends Illich's notion of clinical iatrogenesis, which refers to harms experienced by patients; instead, 'moral injury' indexes forms of harm that extend beyond patients to those providing them care. Using an analytic auto-ethnographic approach based on more than a decade of clinical practice in urban hospitals in the Midwestern and Northeastern United States, the authors describe interactions with patients on opioids whose treatment trajectories are fraught with iatrogenic complications, and explore how biomedical institutions and systems further harm vulnerable patients who receive and are addicted to opioids. Though anxious to avoid harming their patients, clinicians are disempowered by hierarchical systems of medical decision-making, which hinder their ability to always act in what they feel are the patient's best interests. This paper highlights the emotional/affective distress and ambivalence experienced by physicians when making decisions about whether to administer or prescribe opioids. Ultimately, the paper demonstrates how iatrogenesis and moral injury are concomitantly produced through cascades of decision-making and local health systems, rather than individual clinical decisions alone.


Assuntos
Analgésicos Opioides , Doença Iatrogênica/etnologia , Epidemia de Opioides , Transtornos Relacionados ao Uso de Opioides/etnologia , Idoso , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/uso terapêutico , Antropologia Médica , Tomada de Decisão Clínica , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Estados Unidos/etnologia
18.
Anthropol Med ; 28(2): 205-222, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34075822

RESUMO

Biomedicine controls seizures for many children with epilepsy - but not all. In such cases, parents struggle in the wake of various structural, cultural, and corporeal ruptures. Continued use of ineffective medications can lead, iatrogenically, to frightening and serious symptoms and debilitations whose effects, along with those of uncontrolled seizures, ripple outward in challenging ways. Using data from 25 Californian (US) parents who favored providing cannabis to their ill children to meet the iatrogenic burdens of biomedical epilepsy treatments in 2015, well before cannabis's present destigmatization, this paper explores parental refiguration of the effects of clinical iatrogenesis as inevitable - and as productive of evidence necessary to finding better options. In attending to the generative dimensions of iatrogenesis, this paper strives to help clarify the dilemma for parents who critique biomedicine's isolating, materialist, and sometimes apparently haphazard approach to their children, but depend on biomedical and associated systems for their family's well-being nonetheless. Along the way, this paper underscores raced and gendered dimensions of their experiences. Rather than rejecting biomedicine, most hung on tightly, blaming the uncontrolled seizures and their aftermath on a lag in 'the science' and pointing to the cultural idea that every child is unique in explaining their own children's non-responsiveness to treatment thus far. Likewise, they worked to determine effective cannabis regimens with scientised rigour. However, in the end - and in keeping with a culture of (male) Whiteness - stigmatisation, fatigue from chronic care provision, faith in science, and a need for a biomedically-mediated form of social belonging underwrote a majority desire for cannabis's incorporation into the official biomedical pharmacopeia.


Assuntos
Epilepsia , Maconha Medicinal/uso terapêutico , Adolescente , Adulto , Antropologia Médica , Criança , Pré-Escolar , Terapias Complementares , Epilepsia/etnologia , Epilepsia/terapia , Feminino , Humanos , Doença Iatrogênica , Masculino , Pessoa de Meia-Idade , Pais
19.
Injury ; 52(8): 2038-2048, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34074487

RESUMO

Facial nerve iatrogenic injuries are serious and can negatively affect the quality of life of the patients. Due to the properties of the nerve, the complications are devastating involving the aesthetic appearance and the function of the face. Moreover, the multiple branches of the nerve increase the risk of an iatrogenic injury making the detailed knowledge of the anatomical correlations around them critical. In this review, a meticulous analysis was performed including the surgical procedures posing the greater risk of an iatrogenic injury as well as the full description of all the reported anatomical landmarks involving the extracranial course of the facial nerve.


Assuntos
Traumatismos do Nervo Facial , Nervo Facial , Traumatismos do Nervo Facial/etiologia , Humanos , Doença Iatrogênica , Qualidade de Vida
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