Purpose Physicians worldwide need to be able to identify and assess suicide risk or behavior in their consults. The proper training of medical staff is an important form of suicide prevention, especially because 80% of the patients who died by suicide were in contact with a health-care service in the year of their death. The purpose of this study is to verify if some of the most important Brazilian medical schools includes discussions regarding suicide in their curricula, and describe them. Design/methodology/approach The study performed a documentary analysis of all Brazilian federal higher education institutions. The analysis involved selecting the institutions that approached the topic of suicide in their curricula, and sorting it by keywords. The curricula that contained such keywords were then entirely read, analyzed and all components found were described regarding course period, workload and approach. Findings Within the 68 analyzed institutions, 19 (28%) included suicide in their curricula with a total of 31 components approaching suicide among them. Those components belonged to different stages of the course and had different workloads and approaches. A total of seven different approaches were identified: Clinical (54.8%); Emergency (16.1%); Medical Psychology (9.7%); Ethics (6.5%); Social (6.5%); Occupational (3.2%) and Forensic (3.2%). Originality/value To the best of the authors’ knowledge, the study is the first to address medical education regarding suicide in a large number of Brazilian institutions. It is also one of the few studies worldwide to quantify suicide discussion on a large number of institutions using documentary analysis.
A úlcera péptica (UP) é definida como lesão no trato gastrointestinal, devido ao excesso de acidez ou de infecção por Helicobacter pylori (H. pylori). Quanto à epidemiologia, a UP possui maior prevalência em idosos de 65 anos ou mais e em pessoas com comorbidades que causam um maior consumo de medicações como anti-inflamatórios não esteroides (AINES), aspirina e anticoagulantes. Quanto às manifestações clínicas, a doença apresenta epigastralgia como principal sintoma, mas também pode estar associada à plenitude pós-prandial ou saciedade precoce, náuseas e vômitos, perda ponderal e dor abdominal logo em período pós-prandial, podendo alguns serem assintomáticos. Sua identificação depende de uma anamnese minuciosa, um exame físico bem detalhado e exames complementares. No que tange ao diagnóstico clínico, dor abdominal, melena, taquicardia e sinais de perda sanguínea, são essenciais para identificação da patologia. Para diagnóstico definitivo, lança-se mão da endoscopia digestiva alta, biópsia com exame histopatológico, imuno-histoquímica, teste de urease, ensaio de cultura e reação em cadeia da polimerase (PCR), fornecendo mais detalhes com melhor acurácia para, juntamente com os dados clínicos, obter o diagnóstico. Já a abordagem terapêutica, apresenta-se através do manejo farmacológico e cirúrgico. Na abordagem farmacológica, lança-se mão de inibidor de bomba de prótons (IBP), claritromicina e amoxicilina. A abordagem cirúrgica utiliza a vagotomia troncular, antrectomia e técnicas cirúrgicas como Bilroth I, Bilroth II e Y de Roux para a reconstrução do trânsito intestinal. Em relação a prevenção, medicamentos gastroprotetores podem ajudar a reduzir a carga global da úlcera péptica e suas complicações.
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