Modelo de gestión por competencias en el Sistema Sanitario Público de Andalucía

Publicado en la página Web de la Consejería de Igualdad, Salud y Políticas Sociales (Consejería de Igualdad, Salud y Políticas sociales / Profesionales / Investigación, Desarrollo e Innovación / Modelo de Gestión por Competencias / Modelo de gestión por competencias del Sistema Sanitario Público de Andalucía)

Nephrocalcinosis in a patient with complete distal renal tubular acidosis.

A 35-year-old patient, diagnosed with distal renal tubular acidosis (dRTA), presented with metabolic acidosis (pH =7.1) together with hypokalaemia (2.8 meq/l), hyperlipidaemia and renal insuffi ciency (creatinine clearance = 60.8 ml/min). A 24 h urine examination showed an alkaline pH (7.5), hypercalciuria, hyperkaliuria hypocitraturia (1, 2 ,3). The patient was treated with potassium, citrate supplements and simvastatin . A typical renal colic occurred and an image study revealed considerable bilateral nephrocalcinosis, radio-opaque lithiasis in the left distal lumbar ureter and the right mid lumbar ureter with severe left ureter-hydronephrosis. Ureteroscopy and laser lithotripsy of left lumbar fragments were performed, continuing with the medical treatment (4).

Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations

Summary Points Brucellosis remains the commonest anthropozoonosis worldwide, and its treatment remains complex, requiring protracted administration of more than one antibiotic. In November 2006, a consensus meeting aimed at reaching a common specialist statement on the treatment of brucellosis was held in Ioannina, Greece under the auspices of the International Society of Chemotherapy and the Institute of Continuing Medical Education of Ioannina. The author panel suggests that the optimal treatment of uncomplicated brucellosis should be based on a six-week regimen of doxycycline combined either with streptomycin for 2–3 weeks, or rifampicin for six weeks. Gentamicin may be considered an acceptable alternative to streptomycin, while all other regimens/combinations should be considered second-line. The development of a common global therapeutic language for human brucellosis, and future, properly conducted clinical trials would definitely solve controversies regarding the disease.

Diferencias de género en la percepción del logro profesional en especialistas de medicina familiar y comunitaria

BACKGROUND The concept of achievement is important to study the professional development. In medicine there are gender inequalities in career. The purpose was to know and compare the professional achievement's perceptions and attributions of female and male primary care physicians in Andalusia. METHOD Qualitative study with 12 focus groups (October 2009 to November 2010). POPULATION primary care physicians. SAMPLE intentionally segmented by age, sex and health care management. Were conducted by sex: two groups with young physicians, two groups with middle aged and two with health care management. TOTAL: 32 female physician and 33 male physicians. Qualitative content analysis with Nuddist Vivo. RESULTS Female and male physicians agree to perceive internal achievements and to consider aspects inherent to the profession as external achievements. The most important difference is that female physician related professional achievement with affective bond and male physician with institutional merit. Internal attributions are more important for female physician who also highlight the importance of family, the organization of working time and work-family balance. Patients, continuing education, institutional resources and computer system are the most important attributions for male physician. CONCLUSIONS There are similarities and differences between female and male physicians both in the understanding and the attributions of achievement. The differences are explained by the gender system. The perception of achievement of the female physicians questions the dominant professional culture and incorporates new values in defining achievement. The attributions reflect the unequal impact of family and organizational variables and suggest that the female physicians would be changing gender socialization.

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