Video-consultations

Recomendado pela AMICOR Maria Inês Reinert Azambuja Video consultations in primary and specialist care during the covid-19 pandemic and beyond BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3945 (Published 20 October 2020) Cite this as: BMJ 2020;371:m3945 Practice Practice Pointer Video consultations in primary and specialist care during the covid-19 pandemic and beyond BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3945 (Published 20 October 2020) Cite this as: BMJ 2020;371:m3945 Read our latest coverage of the coronavirus outbreak Article Related content Metrics Responses Josip Car, director1 2, Gerald Choon-Huat Koh, professor3, Pin Sym Foong, postdoctoral fellow3, C Jason Wang, director4 5 Author affiliations Correspondence to J Car josip.car@ntu.edu.sg What you need to know Video consultations in healthcare present an approximation of face-to-face interaction and are a “visual upgrade” of widely used telephone consultations Evidence for the effectiveness of video consultations is scarce, but points towards effectiveness, safety, and high satisfaction in patients and healthcare providers Be prepared to switch from a video to a telephone or in-person consultation, depending on technical, patient, or clinical factors

Doktors

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Les barbiers, des chirurgiens...

Les barbiers, des chirurgiens au poil

RETOUR VERS LA SUTURE

Bien avant que ne soient réunies médecine et chirurgie, les opérations étaient pratiquées dans les échoppes des barbiers. Point d’anesthésie, mais des acolytes solides 
et des sangles serrées pour maintenir les patients en place. Et ça fonctionnait plutôt bien

Avant le XIXe siècle, la médecine telle qu’on la connaît aujourd’hui était pratiquée par un aréopage d’herboristes, rebouteux et autres guérisseurs, dont les barbiers faisaient également partie. — © Hector De La Vallée pour Le Temps

 

Fabien Goubet 

Publié lundi 23 juillet 2018 à 20:34
Modifié mardi 7 août 2018 à 11:13

Les barbiers, des chirurgiens au poil Ajouter l'article à vos favorisRetirer l'article de vos favorisRETOUR VERS LA SUTURE Bien avant que ne soient réunies médecine et chirurgie, les opérations étaient pratiquées dans les échoppes des barbiers. Point d’anesthésie, mais des acolytes solides 
et des sangles serrées pour maintenir les patients en place. Et ça fonctionnait plutôt bien Avant le XIXe siècle, la médecine telle qu’on la connaît aujourd’hui était pratiquée par un aréopage d’herboristes, rebouteux et autres guérisseurs, dont les barbiers faisaient également partie. — © Hector De La Vallée pour Le Temps Fabien Goubet Fabien Goubet Publié lundi 23 juillet 2018 à 20:34 Modifié mardi 7 août 2018 à 11:13

Frances Oldham Kelsey (1914-2015)

A médica que salvou uma geração de bebês da tragédia da talidomida nos EUA

Margarita RodríguezBBC News Mundo

• 15 julho 2020

Direito de imagemGETTY IMAGES

Image captionMédica canadense Frances Oldham Kelsey morreu em 2015 aos 101 anos de idade

O "não" que a médica Frances Oldham Kelsey disse a uma empresa em 1960 foi um dos mais poderosos da história da indústria farmacêutica.

Com sua negativa, ajudou a "salvar talvez milhares de pessoas da morte ou da invalidez durante a vida”, afirmou a Agência Americana de Drogas e Alimentos (FDA, na sigla em inglês)./.../

Remote Care

GET USED TO IT: REMOTE CARE IS THE NEW NORM The novel coronavirus made healthcare professionals retrace their way of thinking. It did disrupt the systems, and forced health networks to rehash their telemedicine concepts. Not only that: in order to protect medical professionals from the virus, the need for remote technologies skyrocketed. What’s for sure is that telemedicine is faster, cheaper and can also be better streamlined. And it’s definitely a better solution for both the patient and the doctor. I just wish moving on to digital health solutions would be as easy as this. READ MORE

Polio History

What the History of Polio Can Teach Us About COVID-19

A Piece of My Mind

IN THIS ISSUE OF JAMA

Audio Highlights

Audio Summary: Narrative Medicine and JAMA's "A Piece of My Mind" Anniversary Theme Issue

A PIECE OF MY MIND

The Changing of the Seasons

Terry J. Ratner, RN, MFA

May 5, 2020: JAMA

Forty Years of A Piece of My Mind

Preeti N. Malani, MD, MSJ^1,2; Jody W. Zylke, MD³

Author Affiliations Article Information

JAMA. 2020;323(17):1651-1652. doi:10.1001/jama.2020.3760

Forty years ago, in 1980, Jimmy Carter was president. Pac-Man debuted. In medicine, smallpox was declared to be eradicated. Additionally, on May 9, 1980, A Piece of My Mind was inaugurated in JAMA. The first essay, “Tuna on Rye, 1984,” was written by then–senior editor Samuel Vaisrub under the pen name Sam Vee.¹ He introduced the column with an editorial entitled “For the Peace of Your Mind.”²

Although much has changed in the world and in medicine since then, A Piece of My Mind has endured and changed very little during the subsequent 4 decades. The essays are longer, for a time they were peer reviewed, and the specific topics and issues have kept pace with medical advances, but the column still serves as a forum for physicians to discuss the human side of medicine. Physicians are trained in science and evidence. Indeed, most articles published in medical journals are research studies full of technical methods and statistics, but devoid of emotion by design. But physicians treat patients, not just their diseases, and confront complicated issues and circumstances daily, with the complexity of medicine only increasing over the past 40 years.

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For the Peace of Your Mind

Article Information

JAMA. 2020;323(17):1642. doi:10.1001/jama.2019.13422

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Originally Published May 9, 1980 | JAMA. 1980;243(18):1845.

We hasten to assure our readers that a piece of my mind...is not intended as a sounding board for peevish gripes, nit-picking beefs, or sundry assortments of righteous indignation, which are usually prefaced by an angry “let me give you a piece of my mind.” Nor is this section of The Journal meant to be a podium for pompous preachments and ex cathedra pronouncements. Nor again is it designed to be a forum for half-baked speculations and warmed-over hypotheses. Least of all is a piece of my mind envisaged as a jamboree of jokes and a shivaree of limericks.

What we have in mind for the newly inaugurated feature is not a formal court of opinion but an informal courtyard of creativity, in which physicians display vignettes of their nonscientific and not strictly clinical observations, experiences, reflections, and fantasies tinged with philosophy or humor.

The appearance of a piece of my mind will, of necessity, be determined by available contributions. These will not be assessed by peer review. They will be accepted or rejected without explanation. Based on the principle of “De gustibus non est disputandum,” this arbitrariness needs no apology. Do take a chance and mail us your masterpieces.

Samuel Vaisrub, MD

Section Editor: Jennifer Reiling, Assistant Editor.

Editor’s Note: JAMA Revisited is transcribed verbatim from articles published previously, unless otherwise noted.

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Editorial

May 5, 2020

Forty Years of A Piece of My Mind

Preeti N. Malani, MD, MSJ^1,2; Jody W. Zylke, MD³

Author Affiliations Article Information

JAMA. 2020;323(17):1651-1652. doi:10.1001/jama.2020.3760

•  FF

Forty years ago, in 1980, Jimmy Carter was president. Pac-Man debuted. In medicine, smallpox was declared to be eradicated. Additionally, on May 9, 1980, A Piece of My Mind was inaugurated in JAMA. The first essay, “Tuna on Rye, 1984,” was written by then–senior editor Samuel Vaisrub under the pen name Sam Vee.¹ He introduced the column with an editorial entitled “For the Peace of Your Mind.”²

Although much has changed in the world and in medicine since then, A Piece of My Mind has endured and changed very little during the subsequent 4 decades. The essays are longer, for a time they were peer reviewed, and the specific topics and issues have kept pace with medical advances, but the column still serves as a forum for physicians to discuss the human side of medicine. Physicians are trained in science and evidence. Indeed, most articles published in medical journals are research studies full of technical methods and statistics, but devoid of emotion by design. But physicians treat patients, not just their diseases, and confront complicated issues and circumstances daily, with the complexity of medicine only increasing over the past 40 years.

A journal limited to research would fail to convey the entire experience of a physician or meet all the needs of readers. In one essay, “Story as Evidence, Evidence as Story,” Dr Aronson writes “a single, well-told story of human suffering trumps the most eloquent explanation of a large-scale trial.”³ In JAMA, A Piece of My Mind allows authors to share their perspectives and recount the patients who have touched them or redefined their careers; their experiences trying to balance medicine and all the other parts of their lives; their struggles learning to be physicians, whether in medical school or adjusting to changes in practice; their own medical and emotional challenges or those of family members; and the aspects of medicine that confound or delight them./.../

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Editorial

May 5, 2020

Writing Medicine

Abraham Verghese, MD¹

Author Affiliations Article Information

JAMA. 2020;323(17):1649-1650. doi:10.1001/jama.2020.1488

My first glimpse into the craft of physician-writers did not come through Anton Chekhov, Walker Percy, or William Carlos Williams, whose works I only came to after medical school. As a schoolboy, I loved W. Somerset Maugham, although he never practiced medicine, and his craft had little to do with his medical degree. My introduction to physicians as writers came through my textbooks. Boyd’s Pathology made me aware of literary voice, the ability of authors to place themselves in the text, let their personality come through, and subtly become a character in the reading experience.¹ On the topic of defining the moment of death, Boyd in his single-author text wrote, “It was the author of the book of Ecclesiastes who said, ‘There is a time to be born, and a time to die.’ Fortunately it is the clinician, not the pathologist, who has to make this difficult decision. Sometimes, however, the kindly doctor may find himself murmuring those moving lines from the last act of King Lear: O let him pass! He hates him/That would upon the rack of this tough world/Stretch him out longer.”

Diseases with slave trade

16th century skeletons suggest the slave trade brought some diseases to Mexico Slaves buried in a 16th century grave in Mexico had hepatitis B and yaws, suggesting the slave trade helped spread some versions of those diseases.

Brain Death

Understanding Brain Death

Robert D. Truog, MD, MA^1,2; Erin Talati Paquette, MD, JD, MBe^3,4; Robert C. Tasker, MA, MD, MBBS, DCH^2,5

Author Affiliations Article Information

JAMA. Published online May 1, 2020. doi:10.1001/jama.2020.3593

The concept of brain death, or the determination of death by neurological criteria, was first proposed by a Harvard committee in the United States in 1968,¹ and then adopted into the Uniform Determination of Death Act (UDDA) in 1981.² Although the UDDA was widely accepted and endorsed by medical professional organizations, in recent years the concept has come under greater scrutiny and is increasingly the focus of legal challenges. Most urgent is that the current diagnostic standards do not satisfy the wording of the law. The UDDA defines brain death as the “irreversible cessation of all functions of the entire brain.” Yet, it is now widely acknowledged that some patients who meet the current diagnostic standards may retain brain functions that are not included in the required tests, including hypothalamic functioning.³ Until the UDDA is revised to be more specific about which functions must be lost to satisfy the definition (such as, for example, consciousness and the capacity to breathe), current medical practice will not be in alignment with the legal standard.

Medicalo response to Crisis

From NEJM: History of Medicine: A National Medical Response to Crisis — The Legacy of World War II J. Barr and S.H. Podolsky DOI: 10.1056/NEJMp2008512 | April 29, 2020 History in a Crisis — Lessons for Covid-19 D.S. Jones N Engl J Med 2020;382:1681-1683 | Published Online March 12, 2020

Snorkeling Mask

April 28, 2020

Dear Reader, This week, we have another article about innovation in the face of the COVID-19 pandemic. As the need for ventilators increases, some hospitals are instead trying out a less invasive breathing aid made from a snorkeling mask. For another story of how this swim gear can be repurposed, check out the archive tale of how a teenage chemist snatched up a similar mask to protect himself from an experiment gone wrong. In other coronavirus-related news, the gene editing technique called CRISPR could accelerate our ability to test for infections. And for something completely different, read about some centimeter-scale shapeshifting robots or a new method for close examination of tumors.

Sophie Bushwick, Associate Editor, Technology @sophiebushwick

Medical & Biotech Snorkeling Mask Apparatus Might Help COVID-19 Patients Avoid Intubation The jury-rigged breathing aid, invented to deal with ventilator shortages, is now being tested as a kinder, gentler alternative to a tube in the trachea By Emily Willingham

Dr. Li Wenliang

Requiem for a whistle-blower

Agence France-Presse — Getty Images

Dr. Li Wenliang tried to warn China about the coronavirus but was silenced by the government authorities. He became a hero in the country when his warnings proved true, then a martyr when he died from the virus in February.

Today, people gather, virtually, at his last post on Weibo, the Chinese social media platform, to grieve and seek solace in the comments section.

Our columnist Li Yuan writes: “In a largely atheist yet spiritual nation with little tradition of praying, the digital Wailing Wall allows the Chinese people to share their sadness, frustration and aspirations with someone they trusted and loved.”