The very high rates of poorly completed medical certificates of death highlights a significant failure in the medical schools' curriculum, as well as a lack of continuing medical education programs addressing such topic of paramount importance. The results demonstrated neglect or lack of knowledge on the pathophysiology of diseases by physicians.
ResumoUm total de 59 amostras de soros de suínos, procedentes de vários locais de abate clandestino, apresentaram ao "card test" e à soroaglutinação rápida anticorpos antiBrucella e títulos de anticorpos sugestivos de infecção brucélica. Ações e medidas de vigilância sanitária são recomendadas para prevenir o risco potencial de infecção brucélica zoonótica. Desde a descoberta da Brucella melitensis por Bruce, em 1887, e sua associação com a doença zoonótica transmitida por alimento, a brucelose continuou sendo uma doença cosmopolita que tem como fatores de risco, além da ingestão de alimentos contaminados, o contato com animais e o exercício de atividades que envolvem o contato com eles. Abstract 1De acordo com Sánchez et al 5 (1998), o abate de animais, uma das atividades de risco, tem importante significado na transmissão das espécies de Brucella sp. para o homem, principalmente nas operações que envolvem contato direto com a fonte de infecção, representada por carcaças e vísceras de animais abatidos e pela formação de aerossóis conseqüentes às condições ambientais reinantes nos estabelecimentos de abate, situações muito comuns nos matadouros.Apesar de contínuas demonstrações e divulgações a respeito do risco decorrente do consumo de alimentos crus ou não adequadamente tratados pelo calor, do contato com animais sem a observação de medidas de precaução, do manuseio e da manipulação de órgãos, produtos, subprodutos e excreções de animais, sem o uso de equipamentos de proteção, a brucelose continua sendo um importante problema de saúde pública no mundo. 1,2,5 O abate clandestino de suínos, uma prática condenável que ocorre no País, representa um dos mais graves fatores de risco, pela exposição coletiva a agentes infecciosos, como aqueles que são transmitidos ao homem pelo contato com animais, pela ingestão de alimentos de qualidade sanitária suspeita e pela contaminação do meio ambiente. Contudo, apesar das
ResumoConsiderando-se que o segredo médico é característica moral obrigatória da medicina e pilar da relação mé-dico-paciente, e o pensamento ético do médico o reflexo de sua formação acadêmica, viu-se a necessidade de pesquisar o conhecimento ético do estudante de Resumen El secreto y la confidencialidad de la relación médico-paciente: el conocimiento y la opinión ética del estudiante de medicina Considerando que el secreto médico es una característica moral obligatoria de la medicina y el pilar de la relación médico-paciente y el pensamiento ético del médico, el reflejo de su formación académica, se vio la necesidad de investigar el conocimiento ético de los estudiantes de medicina de la Universidad del Estado de Pará. El estudio se caracteriza por un cuestionario con situaciones en las que el alumno debe juzgar en cuales la confidencialidad puede ser rota. También se preguntó si estos hubieran leído el Código de Ética Médica y el juramento de Hipócrates. Fueron entrevistados 207 estudiantes de medicina, del 1 er a 4 o año de la Universidad del Estado de Pará, Brasil. Se observó que 25 estudiantes mostraron el dominio de la confidencialidad médica, 135 poseían pobre conocimiento y 27 mostraron desconocimiento del tema. Es de fundamental importancia la formación y la orientación ética de los estudiantes de medicina, para formar graduados capaces de rendir culto, practicar y respetar el sigilo del paciente. Palabras-clave: Sigilo. Ética médica. Confidencialidad. Educación médica. Abstract Secrecy and cconfidentiality in the doctor-patient relationship: ethical knowledge and opinion of medical students Given that the medical secrecy is a moral characteristic of medicine and basis of the doctor-patient relationship, and the physician's ethical thought reflect their academic background, it was necessary to research the ethical knowledge of medical students at the University of Para State. The study is characterized by a questionnaire with situations where the student should judge situations in which confidentiality could be broken. It was also asked whether they had read the Code of Medical Ethics and the Hippocratic Oath. 207 medical students were interviewed, from 1 st to 4 th year of University of the State of Para. It was observed that 25 students showed high-knowledge about medical confidentiality, with 135 as regular-knowledge and 27 showed low-knowledge about the issue. The ethical orientation to medical students becomes extremely important seeking to have graduates capable of practicing and respecting the patient confidentiality.
Animal movement is inherent in the marketing between the rural productive units, establishing space-time connections between them. The relational nature of such information is kept in the Animal Transit Guides (GTA), a mandatory issuance in Brazil. When evaluating such set of information, this work aimed at characterizing the bovine movement network in the state of Pará through the application of concepts from Social Network and Network Theory analysis. Where the nodes and edges that structure the network are respectively the rural properties and the number of cattle moved between them. The results obtained characterize the bovine movement in the state, which show distinct patterns such as the movement of a great number of animals rambling and a clear seasonality due to commercialization purposes. The evaluation of the network components' modularity also shows the subdivision of the state in four commercial clusters, where the central measures of its components define municipalities of economic and epidemiological interest. The results described herein help in the support of health surveillance and control measures, as well as the adoption of economic strategies and policies.
This case report describes a patient with manic and psychotic symptoms who had a history of neurocysticercosis and presented with an episode of hypertensive hydrocephalus in 2003. Despite her history, she was initially treated for primary psychiatric disease.
Toxoplasma gondii is an obligate intracellular protozoan that parasitizes several hosts worldwide, of which cats are definitive hosts. The objective of this study is to evaluate the risk factors associated with the epidemiology of T. gondii in cattle and buffaloes in the state of Pará, Brazil. A total of 2,070 bovine samples (1,749 cattle and 321 buffaloes) were evaluated in 100 rural properties distributed in 51 municipalities from all mesoregions of the state. The evaluated risk factors were animal gender, type of farm, and number of cats in the properties. The serological prevalence of T. gondii was evaluated using the indirect enzyme immunoadsorption assay (iELISA). The samples with a sample/positive (S/P) ratio ? 0.5 were considered positive and analyzed using the indirect immunofluorescence assay (IFA). The samples diluted at 1:64 were considered positive. The chi-square test with a level of significance of 5% and the odds ratio (OR) with a confidence interval of 95% was applied.The data were analyzed using BioEstat software version 5.0.The prevalence of T. gondii in bovines was 35.79% and 45.12% in ELISA and IFAT, respectively. The prevalence was 34.48% and 44.14% in cattle and 42.99% and 50.47% in buffaloes using ELISA and IFA, respectively. The mesoregion with the highest prevalence of infection was Marajó Island, corresponding to 42.86% (129) and 50.5% (152) in ELISA and IFA, respectively. In buffaloes, the prevalence of T. gondiiusing ELISA was higher in males (p < 0.05) in the two age groups. In contrast, the prevalence of T. gondii using IFA was higher in males in the age group 13 to 24 months (p < 0.05). The type of farm did not affect the prevalence of T. gondii in cattle (p > 0.05). However, the presence of cats strongly affected the occurrence of infection in cattle. These results demonstrate the high levels of anti-T. gondii antibodies in cattle and buffaloes in Pará and this may be a public health problem. Furthermore, the presence of cats is a risk factor for infection with T. gondii in these species in Pará.
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