Hernia discal traumática. Implicaciones médico-legales.

Traumatic origin of disc herniation, remains as a relevant Medico-Legal problem. The present paper makes a disc protrusion/ herniation revision, mainly about mechanic and traumatic factors involved in their origin. A multifactorial (genetic, bio-antropometric, environnement, metabolic, etc.) causation is concluded to explain etiology of disc herniation. Pure disc herniation (occurring in a healthy non degenerated disc) is considered an exceptional phenomenon. Clinical and radiological spine degeneration sings are revised, along with others that can point to a traumatic origin. Dealing with a disc herniation after an accident, Medical Expert has always to consider the possibility of a precedent disc damage status, assessing the role of a worsening of such antecedent condition in each case. A classification of degree of causation accident-herniation, and antecedent disc damage decompensation are proposed.

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.