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quarta-feira, 26 de março de 2014

Diagnóstico de “WhatsAppitis” : The Lancet




As facilidades advindas da incorporação de novas tecnologias no dia-a-dia, como o uso de smartphones e tablets,  facilitaram muito algumas tarefas, mas não vieram desprovidas de ônus. São cada vez mais comuns lesões osteomusculares decorrentes de postura inadequada e pouco exercício que esses gadgets acabam trazendo. Além disso podem induzir até lesão por esforço repetitivo.

Nesse contexto um dos artigos da revista Lancet desse mês foi um diagnóstico de... WhatAppitis...  uma variante nova da Nintendinitis... Veja abaixo:

The Lancet, Volume 383, Issue 9922, Page 1040, 22 March 2014

"WhatsAppitis"

Copyright © 2014 Elsevier Ltd All rights reserved.
Fonte: http://imgs.rafaelbelomo.com
A 34-year-old emergency medicine physician, 27 weeks pregnant, presented with bilateral wrist pain with sudden onset upon waking up one morning. She had no history of trauma and had not engaged in any excessive physical activity in the previous days. Hands examination revealed discomfort upon bilateral palpation of the radial styloid and mobilisation of the thumb. Physical examination was negative for Phalen's sign and Tinel's sign but positive for Finkelstein's sign. Because of the patient's pregnancy, x-rays were not taken to rule out rhizarthrosis. The diagnosis was bilateral extensor pollicis longus tendinitis of the thumb. The patient was on duty on Dec 24 (Christmas Eve), and the following day, she responded to messages that had been sent to her on her smartphone via WhatsApp instant messaging service. She held her mobile phone, that weighed 130 g, for at least 6 h. During this time she made continuous movements with both thumbs to send messages.


Fonte: http://laclinfisioterapia.blogspot.com.br
Tenossinovite de De Quervain
The diagnosis for the bilateral wrist pain was WhatsAppitis. The treatment consisted of non-steroidal anti-inflammatory drugs and complete abstinence from using the phone to send messages. Because of her pregnancy, the patient only took acetaminophen (1 g every 8 h for 3 days) with partial improvement, and did not completely abstain from using her phone, with exchange of new messages on Dec 31 (New Year's Eve).
A so-called Nintendinitis was first described in 1990,1 and since then several injuries associated with video games and new technologies have been reported. Initially reported in children, such cases are now seen in adults. Tenosynovitis caused by texting with mobile phones could well be an emerging disease. Physicians need to be mindful of these new disorders.
I declare that I have no competing interests.

Veja um vídeo com o teste de Finkelstein:



segunda-feira, 6 de maio de 2013

Profissionalismo Online: Guidelines / Position Papper American College of Physicians

Caros,

Recentemente abordamos o tema de mídias sociais e profissionalismo online no treinamento introdutório da ResMed e no New England. 

Coincidentemente, nesse contexto, uma nova publicação, um Position Papper, saiu em 16 de abril no Annals of Internal Medicine. (Ann Intern Med. 2013;158(8):620-627).

Esse Position Papper foi publicado pela ACP (American College of Physicians) e a Federation of State Medical Boards para trazer recomendações sobre:
  • A Influência de mídias sociais na relação médico-paciente
  • O Papel dessas mídias na percepção pública do comportamentos dos médicos
  • Estratégias para comunicação médico-a-médico que preserve ao máximo a confidencialidade do paciente enquanto se potencializa o uso dessas tecnologias.

Seguem os cinco Statements e uma tabela com algumas orientações e pitfalls

STATEMENTS

  1. “Use of online media can bring significant educational benefits to patients and physicians, but may also pose ethical challenges. Maintaining trust in the profession and in patient–physician relationships requires that physicians consistently apply ethical principles for preserving the relationship, confidentiality, privacy, and respect for persons to online settings and communications.”
  2. “The boundaries between professional and social spheres can blur online. Physicians should keep the 2 spheres separate and comport themselves professionally in both.”
  3. “E-mail or other electronic communications should only be used by physicians in an established patient–physician relationship and with patient consent. Documentation about patient care communications should be included in the patient’s medical record.”
  4. “Physicians should consider periodically “self-auditing” to assess the accuracy of information available about them on physician-ranking Web sites and other sources online.”
  5. The reach of the Internet and online communications is far and often permanent. Physicians, trainees, and medical students should be aware that online postings may have future implications for their professional lives.”

Tabela

Pra quem tiver mais interesse, o link é free e basta clicar na imagem abaixo. Quem quiser baixar o PDF, clique aqui.

Abraços,


terça-feira, 10 de julho de 2012

HU sem fio!

Caros,


Alguns já devem ter percebido em seus smartphones ou laptops a rede "HU_SEM_FIO". Pois bem, o CPD já está cadastrando as senhas e os residentes devem preencher e assinar um formulário que pode ser encontrado aqui ou no próprio CPD, haja vista a rede não sofrer restrições de firewall.
A rede será aberta e após a conexão são solicitados login e senha (de forma semelhante a conexões em hotéis).

Formulário para cadastro na rede "HU_SEM_FIO" para download ou imprima abaixo.




PS: Hoje pode haver dificuldade na conexão por que compraram nova antena para aumentar a cobertura do sinal.
As coisas continuam melhorando! :-)
Abraços,