A ONU estima que 10% da populacao brasileira sao portadores de algum tipo de deficiencia, e se sabe que desses individuos apenas 3% estao de alguma forma atendidos em programas precariamente subvencionados pelo governo. Neste artigo apresenta-se uma defesa dos direitos de cidadania do portador de deficiencia, que ainda sofre variadas formas de discriminacao. A autora enumera dez pontos basicos para o enfrentamento dos problemas que afetam o cotidiano do grupo mencionado e sugere formas de atuacao do poder publico que levem a incorporacao de acoes rotineiras em cada uma das areas da administracao municipal. (ram/DÜI)
A inibição do desejo sexual (IDS) implica na diminuição ou extinção do interesse e capacidade de engajamento em atividades sexuais, inclusive com o afastamento de comportamentos sexuais e não aceitação de propostas sexuais. A IDS pode ocorrer junto à disfunção erétil (DE). Objetivando estudar a ocorrência e implicações da IDS do desempenho sexual, analisaram-se retrospectivamente 495 pacientes com queixas de DE. Encontraram-se 21% dos pacientes com IDS. A IDS secundária à DE equi- vale a 90% dos pacientes estudados e era concomitante à ejaculação prematura em 41%. Uma única parceira sexual existia em 95% dos pacientes. A masturbação estava presente em 58%, com freqüência "rara" para 38%; a atividade sexual era nula para 19%, chegando à média de 1,2 relacionamentos sexuais semanais. Estes pacientes tiveram diagnóstico exclusivo psicológico para a DE em 44%, de orgânico em 32% e misto em 24%. A indicação de psicoterapia ocorreu em 70%, com aceitação de 51%, e de prótese peniana (para a DE) em 24%, com aceitação de 14% se não houvesse outra indicação de tratamento concomitante. Aparentemente a IDS encontra-se relacionada com a baixa aceitação da prótese peniana. A IDS deve ser considerada para a melhor prescrição do tratamento da DE, com indicação de psicoterapia breve intensiva para o retomo e desenvolvimento do desejo sexual.
Aktinische Keratosen (AK) sind häufige Hautveränderungen bei hellhäutigen Menschen mit dem Potenzial, in ein kutanes Plattenepithelkarzinom (PEK) überzugehen. Beide Erkrankungen können mit erheblicher Morbidität verbunden sein und stellen eine große Krankheitslast insbesondere in der älteren Bevölkerung dar. Um eine evidenzbasierte, klinische Entscheidungsfindung zu unterstützen, wurde die Leitlinie "Aktinische Keratose und Plattenepithelkarzinom der Haut" auf der Methodikebene S3 nach dem Regelwerk der AWMF entwickelt. Die Leitlinie richtet sich dabei an Dermatologen, Allgemeinmediziner, HNO‐Ärzte, Chirurgen, Onkologen, Radiologen und Strahlentherapeuten in Klinik und Praxis sowie an andere medizinische Fachgebiete, die sich mit der Diagnose und Behandlung von Patienten mit AK und PEK befassen. Die Leitlinie richtet sich auch an betroffene Patienten, deren Angehörige, politische Entscheidungsträger und Versicherungsgesellschaften. In diesem Teil behandeln wir die Themen Diagnostik, Interventionen bei AK, Versorgungsstrukturen und Qualitätsindikatoren. ; Peer Reviewed
Introduction Surgical oncology is a defined specialty within the European Board of Surgery within the European Union of Medical Specialists (UEMS). Variation in training and specialization still occurs across Europe. There is a need to align the core knowledge needed to fulfil the criteria across subspecialities in surgical oncology. Material and methods The core curriculum, established in 2013, was developed with contributions from expert advisors from within the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy and Oncology (ESTRO) and European Society of Medical Oncology (ESMO) and related subspeciality experts. Results The current version reiterates and updates the core curriculum structure needed for current and future candidates who plans to train for and eventually sit the European fellowship exam for the European Board of Surgery in Surgical Oncology. The content included is not intended to be exhaustive but, rather to give the candidate an idea of expectations and areas for in depth study, in addition to the practical requirements. The five elements included are: Basic principles of oncology; Disease site specific oncology; Generic clinical skills; Training recommendations, and, lastly; Eligibility for the EBSQ exam in Surgical Oncology. Conclusions As evidence-based care for cancer patients evolves through research into basic science, translational research and clinical trials, the core curriculum will evolve, mature and adapt to deliver continual improvements in cancer outcomes for patients.
In: ESSO core curriculum contributors , van der Hage , J , Sandrucci , S , Audisio , R , Wyld , L , Søreide , K , Amaral , T , Audisio , R , Bahadoer , V , Beets , G , Benstead , K , Berge Nilsen , E , Bol , K , Brandl , A , Braun , J , Cufer , T , Dopazo , C , Edhemovic , I , Eriksen , J G , Fiore , M , van Ginhoven , T , Gonzalez-Moreno , S , van der Hage , J , Hutteman , M , Masannat , Y , Onesti , E C , Rau , B , De Reijke , T , Rubio , I , Ruurda , J , Sandrucci , S , Soreide , K , Stattner , S , Trapani , D , D'Ugo , D , Vriens , M , Wyld , L & Zahl Eriksson , A G 2021 , ' The ESSO core curriculum committee update on surgical oncology ' , European Journal of Surgical Oncology , vol. 47 , no. 11 , pp. e1-e30 . https://doi.org/10.1016/j.ejso.2021.10.003
INTRODUCTION: Surgical oncology is a defined specialty within the European Board of Surgery within the European Union of Medical Specialists (UEMS). Variation in training and specialization still occurs across Europe. There is a need to align the core knowledge needed to fulfil the criteria across subspecialities in surgical oncology. MATERIAL AND METHODS: The core curriculum, established in 2013, was developed with contributions from expert advisors from within the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy and Oncology (ESTRO) and European Society of Medical Oncology (ESMO) and related subspeciality experts. RESULTS: The current version reiterates and updates the core curriculum structure needed for current and future candidates who plans to train for and eventually sit the European fellowship exam for the European Board of Surgery in Surgical Oncology. The content included is not intended to be exhaustive but, rather to give the candidate an idea of expectations and areas for in depth study, in addition to the practical requirements. The five elements included are: Basic principles of oncology; Disease site specific oncology; Generic clinical skills; Training recommendations, and, lastly; Eligibility for the EBSQ exam in Surgical Oncology. CONCLUSIONS: As evidence-based care for cancer patients evolves through research into basic science, translational research and clinical trials, the core curriculum will evolve, mature and adapt to deliver continual improvements in cancer outcomes for patients.