Responsabilidad por pérdida de oportunidad asistencial en patología oncológica maligna en la medicina pública española

ObjectiveThe loss of chance in healthcare has been forcibly introduced in the adjudications pronounced in recent years. Our objective was to analyse the verdicts of guilt resulting from the loss of chance ordered by the Contentious-Administrative Court (i.e., in the public healthcare system), in which both the origin of the disease to be treated and the sequelae were oncological processes.MethodWe analysed 137 cancer-related court judgments from the Contentious-Administrative Court, which referred to the concept of loss of chance, issued in Spain up to May 2014.ResultsOf the 137 sentences, 119 (86.9%), were pronounced due to diagnostic error and 14 (10.2%) due to inadequate treatment. Since 2010, 100 sentences have been passed (73.0%), representing an increase of more than 170% with respect to the 37 (27.0%) ordered in the first six years of the study (from 2004 to 2009). Most of the patients (68.6%) died, predominantly from breast cancer and gynaecological cancer (24.1%), and gastrointestinal cancers (21.1%). These malignancies were the ones most often involved in the sentences.ConclusionsThe litigant activity due to loss of chance in oncological processes in the public health care has significantly increased in the last years. The judgments were mainly given because of diagnostic error or inadequate treatment.     

Claves diagnósticas en displasias pilosas I

Hair shaft disorders, involving dysplastic abnormalities in the shaft, may be either congenital or acquired. Two large categories have been defined according to the presence or not of hair fragility. A diagnosis can usually be made after taking a thorough medical history and performing a physical examination. Trichoscopy has become a useful, cost-effective tool in recent years, particularly for examining the hair of children, because it facilitates inspection without removal of hairs. Structural abnormalities in the hair shaft are sometimes clues to the diagnosis of more complex diseases in which early treatment can improve prognosis. This review describes key features that enable the diagnosis of the most common hair shaft disorders and discusses the various treatments currently available.     

90岁以上长寿老人听力与发中微量元素的观察

作者对30名90岁以上老人作纯音测听、高频测听和发中微量元素检测,与<60岁组人进行比较。结果:老年组纯音全频率听阈与对照组相比差异非常显著(P<0.01),高频测听,90岁组随着频率提高,听到耳数越来越少。并观察到90岁组发中锌、镁微量元素均低于<60岁组,两组间有显著差异(P<0.01)。对90岁组老人听力的特点,发中锌、镁微量元素含量减少对老年性耳聋的影响进行探讨。     

早年父亲去世的心理创伤研究——1例男大学生的深入访谈分析

目的 探讨男孩8岁时父亲去世对其带来的创伤影响。方法 运用质的研究方法，对一名在8岁时经历父亲去世的男大学生进行深入访谈，采用主要概念或主题突出分类的方法进行编码分析。结果 父亲去世使个体产生了强烈的不安全感，严重的自卑感和神经症性的防御机制。结论 父亲去世后，家庭氛围是影响孩子心理健康的重要因素。     

异丙酚对豚鼠耳蜗外毛细胞钙离子移动的影响

目的观察不同浓度异丙酚对氯化钾诱发的豚鼠耳蜗外毛细胞内钙离子移动的影响，探讨其对听觉外周感受器（耳蜗）作用的可能机制。方法用Fluo-3AM荧光指示剂染色急性分离的豚鼠耳蜗外毛细胞，在激光共聚焦显微镜下动态观察使用异丙酚前及异丙酚（50、250μmol／L）预处理后，氯化钾诱发的细胞内钙离子浓度的变化。结果异丙酚可使氯化钾诱发的外毛细胞内钙荧光染色强度的峰值下降，较对照组有明显差异，并与浓度呈正相关。结论异丙酚浓度依赖性地降低耳蜗外毛细胞内钙离子浓度，部分与抑止细胞外钙内流有关。     

松花江汞污染治理后沿江渔民发汞调查

调查结果表明，沿江渔民发汞均值为２．２５μｇ／ｇ，与对照点相比差异显著（Ｐ＜０．０１），其中扶余一松江段渔民发汞均值２．５４μｇ／ｇ，高于其他各江段；３０～４０岁年龄组渔民发汞值超过正常值者占４５％，比其他各年龄组多；在调查的１１９５人中有２５名发汞值超过１０μｇ／ｇ，其中１８人发甲基汞含量超过５μｇ／ｇ。