RESUMO
BACKGROUND: Kawasaki disease (EK) is frequently identified in pediatric patients. It affects principally the coronary arteries, causing aneurysms, ischemic heart disease and sudden death. The opportune diagnosis and its early treatment avoid these complications. Our objective was to describe 17 cases with EK. CLINICAL CASES: seventeen patients' files with EK were reviewed, obtaining information about age, sex, date of admission, clinical manifestations, laboratory results, complications and treatment. RESULTS: four patients presented coronary aneurysm. The average age was 37 months, with a range from 15 months to 11 years. There was a predominance of males, with relation 2.4 to 1. CONCLUSIONS: the EK was not considerated initially; on post-mortem studies, affected coronary arteries were demonstrated. The EK treatment is intravenous gamma-globulin and aspirin and it must be established before the tenth day after the fever begins in order to avoid cardiac complications. Four cases developed AC remitted after 16 months. The EK diagnosis is predominantly clinical.
Assuntos
Síndrome de Linfonodos Mucocutâneos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológicoRESUMO
In relation to the letter to the editor on the article "Professionalism in physicians in a second-level hospital" this reply is issued.
En relación a la carta al editor sobre el artículo "Profesionalismo en médicos de segundo nivel" se emite esta réplica.
RESUMO
BACKGROUND: It takes many years to acquire abilities and technical skills necessary to do a good work as a doctor and even more years, for being "good professionals". Much of this training is based on old teaching schemes, but medicine has changed. So far no studies in our medium addressing the problem are known. The aim of this paper was to determine the level of professionalism in physicians that work in a second-level hospital. METHODS: Descriptive cross-sectional study. We apply a survey to physicians, residents and medical interns in a second-level hospital. We developed and implemented a questionnaire on professionalism, which contained 18 items, 3 demographic questions and 15 questions with a Likert scale, which identified four dimensions: specialized knowledge, autonomy in decision-making, self-regulation and social commitment. Descriptive and inferential statistics were used, considering significant a p-value <0.05. RESULTS: We surveyed 228 physicians, 57.5% demonstrated competence in professionalism. 93.3% of the participants were competent in specialized knowledge and 60.5% in social commitment. The physicians and residents got the higher scores, and these differences were significant between autonomy in decision-making and specialized knowledge (p < 0.001). The medical interns obtained lower scores in all dimensions compared with residents and physicians. CONCLUSIONS: More than a half of physicians surveyed had a competent level of professionalism but only in some dimensions. We observed higher scores with a higher academic grade.
Introducción: se requieren años para adquirir las habilidades y destrezas necesarias para un buen desempeño médico y varios más para ser "buen profesionista". Gran parte de este entrenamiento se fundamenta en esquemas de enseñanza antiguos, siendo que la práctica de la medicina ha cambiado notablemente. No se conocen estudios en nuestro medio que aborden el profesionalismo en médicos. El objetivo de este trabajo fue determinar el nivel de profesionalismo en médicos de un hospital de segundo nivel de atención. Métodos: estudio descriptivo-transversal. Se encuestaron médicos adscritos, residentes e internos en un hospital de segundo nivel. Se elaboró y aplicó un cuestionario sobre profesionalismo, con 18 ítems (3 preguntas demográficas y 15 tipo Likert), que incluyó 4 dimensiones: conocimiento especializado, autonomía en la toma de decisiones, autorregulación y servicio de compromiso social. Se utilizó estadística descriptiva e inferencial. Resultados: se incluyeron 228 médicos, el 57.5% fueron competentes en profesionalismo de manera global. El 93.3% en conocimiento especializado y 60.5% en compromiso social. Los médicos adscritos y residentes obtuvieron las calificaciones más altas, siendo significativas estas diferencias en conocimiento especializado y autonomía (p < 0.001). Los internos obtuvieron puntajes más bajos en todas las categorías. Conclusiones: poco más de la mitad de los médicos presentó un nivel de profesionalismo competente en algunas dimensiones. Se obtuvieron puntajes más altos a mayor grado académico.