Introduction: After the residency in Internal Medicine, most graduates choose to undergo a new selection process to obtain a second specialty. The phenomenon of early specialization is encouraged as early as in the undergraduate course. Despite this, the demand for general practitioners is growing. Objective: To investigate the factors that lead the newly graduated clinician to undertake a new residency. Method: This is a cross-sectional study that analyzes the responses of Internal Medicine residency graduates from the state of Pernambuco in 2020, through a questionnaire available online by Google Forms, containing questions about social aspects, undergraduate medical course, Medical Residency and intentions for the future career. Results: There were 81 responses of the 104 possible participants (77.88%). Most of these were female (66.67%), graduated from public universities (69.14%) and had already started the Internal Medicine residency shortly after graduation (50.62%). Regarding the specialty choice, 51.85% answered they had decided in the second year of residency, and 80.25% stated that they had undergone the selection process for the second specialty shortly after completing the Internal Medicine residency. The most often chosen career was Cardiology (20%). The factors most often associated with the choice of specialty were, according to the means on the Likert scale, “work in an outpatient setting”, “long-term patient follow-up”, and “more contact with patients”. Conclusion: As far as it could be investigated in the literature, this was the first Brazilian study on specialty choices after the Internal Medicine residency. It was possible to identify the most important reasons for choosing a second specialty among the graduates of this Medical Residency program in Pernambuco in 2020. More studies are needed to establish correlations between the factors of choice with the chosen specialty.
Autoimmune hemolytic anemia (AIHA) is a rare hematologic disease in children with an incidence of 0.2/100,000 under 20 years of age. This article reports the case of an infant with AIHA in which blood transfusions were not necessary, and performs a brief literature review of this rare disease in children. A 5-month-old infant was with a 9-day fever, progressive and intense pallor, severe hepatosplenomegaly, anicteric, and a history of blood incompatibility in cross-tests. Complementary exams showed hemoglobin 3.3 g/dL with reticulocytosis and erythroblastosis, leukocytosis with left upper shift, elevated lactic dehydrogenase, Coombs direct reactive with predominance of IgG. The child evolved with important improvement after pulse methylprednisolone therapy and treatment with folic acid and ceftriaxone, without performing any blood transfusion. The clinical features of AIHA include anemic and hemolytic signs. Mainly, diagnosis is done by laboratory tests showing anemia, hemolysis and positive direct antibody test. In children, it tends to an acute course and to an excellent response to corticosteroids, but erythrocytes transfusions are often used in critical hemoglobin levels.
Introduction: After the residency in Internal Medicine, most graduates choose to undergo a new selection process to obtain a second specialty. The phenomenon of early specialization is encouraged as early as in the undergraduate course. Despite this, the demand for general practitioners is growing. Objective: To investigate the factors that lead the newly graduated clinician to undertake a new residency. Method: This is a cross-sectional study that analyzes the responses of Internal Medicine residency graduates from the state of Pernambuco in 2020, through a questionnaire available online by Google Forms, containing questions about social aspects, undergraduate medical course, Medical Residency and intentions for the future career. Results: There were 81 responses of the 104 possible participants (77.88%). Most of these were female (66.67%), graduated from public universities (69.14%) and had already started the Internal Medicine residency shortly after graduation (50.62%). Regarding the specialty choice, 51.85% answered they had decided in the second year of residency, and 80.25% stated that they had undergone the selection process for the second specialty shortly after completing the Internal Medicine residency. The most often chosen career was Cardiology (20%). The factors most often associated with the choice of specialty were, according to the means on the Likert scale, “work in an outpatient setting”, “long-term patient follow-up”, and “more contact with patients”. Conclusion: As far as it could be investigated in the literature, this was the first Brazilian study on specialty choices after the Internal Medicine residency. It was possible to identify the most important reasons for choosing a second specialty among the graduates of this Medical Residency program in Pernambuco in 2020. More studies are needed to establish correlations between the factors of choice with the chosen specialty.
BACKGROUND Pseudotumor cerebri (PTC) is an uncommon cause of vision loss in systemic lupus erythematosus (SLE). Disbalance between cerebral spinocellular fluid (CSF) absorption/production or cerebral veins microthrombosis/stenosis are proposed physiopathological mechanisms for PTC. Headache is the most common symptom, also, patients can present with peripheral bilateral vision loss, bilateral papilloedema, elevated intracranial pressure, normal CSF composition and normal brain imaging exams. Differential diagnosis include optic neuropathy and visual field defects. PTC must be recognized and treated quickly to preserve optic nerve. Most authors report a good response to corticosteroids in SLE patients with PTC. Still, in corticosteroid refractory cases, treatment can be done with acetazolamide, serial lumbar punctures, optic nerve sheath decompression and/or ventricular shunts. We report a PTC case on a patient in her first SLE flare, that did not occur with headache, and did not respond to corticosteroids.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.