ABSTRACT
Leishmaniasis is a disease caused by the intracellular protozoan parasite Leishmania and are known more than 20 species(1) harmful for men. A 74-year-old man, with sarcoidosis treated with methotrexate and corticoid, was assessed, in 2021, by an ENT specialist due to dysphagia, dysphonia, and odynophagia with a 5-year evolution and progressive worsening. A biopsy of the right vocal cord and epiglottis was performed, and the histology demonstrated the presence of amastigotes in the tissues coloured by Giemsa making the diagnosis of Leishmaniasis. The patient was referred to the Infectious Diseases Department, with the diagnosis of mucosal leishmaniasis, and hospitalized for treatment with Liposomal Amphotericin B. The dysphagia and odynophagia improved and was discharged to Infectious Diseases Day hospital to continue treatment. He completed a total of 10 days of treatment and continued follow up in Infectious Diseases, Pneumology and ENT departments. During this time the patient stopped treatment with methotrexate but maintained deflazacort 6 mg per day. In 2023, the patient presented with worsening dysphonia and dysphagia. A new biopsy of the epiglottis was performed in the ENT department. Leishmania DNA was detected, and histology was compatible with Leishmaniasis of the left larynx. He was hospitalized in Infectious Diseases department and started treatment with Liposomal Amphotericin B. The patient completed a total of 10 days of treatment, and, by this time, the medical team decided to maintain suppressive therapy once a month with Liposomal Amphotericin B, until the patient present with a CD4 leucocyte count superior to 350/mm³ . By the time of this article, the patient maintained follow up in the Infectious Disease department with monthly sessions of therapy.
ABSTRACT
INTRODUCTION: The aim of this study is to characterize and assess work-family balance within the medical profession in Portugal. MATERIAL AND METHODS: This cross-sectional and exploratory study analyzed a sample of 181 doctors who are members of the Portuguese Catholic Doctors' Association. A qualitative survey with multiple-choice questions was applied in order to assess socioeconomic and working conditions as well as work-family balance. Descriptive and linear regression analyses were carried out. RESULTS: Nearly 40% of the surveyed doctors negatively assessed the work-family balance within the private sector. As for the Portuguese National Health System, 73% negatively assessed the work-family balance within the public sector. More than half of those surveyed (56%) worked more hours than what they considered as harmful for their work-family balance and the vast majority was working at the limit or overtime. Data collected enabled us to associate a heavier workload with working in the emergency room, age and men. Moreover, it was observed that working more hours was not linked to having children or being married. DISCUSSION: In our study, the three measures of work-family balance that the participants considered to be the most important were the possibility of flexible scheduling, part-time work and temporarily reducing working hours (e.g. for family assistance). These aspects may explain the differences found in the assessment of work-family balance between the public and private sector. CONCLUSION: Due to the demanding nature of the medical profession, doctors are placed into a particularly risky situation in order to achieve a suitable work-family balance. The results of our study indicate a general dissatisfaction regarding this balance - special in the public sector - which is mainly associated with excessive weekly working hours.
Introdução: Este estudo propôs-se caraterizar e avaliar a conciliação trabalho-família na profissão médica em Portugal.Material e Métodos: Este é um estudo observacional, transversal e exploratório de uma amostra de 181 médicos sócios da Associação dos Médicos Católicos Portugueses. Foi aplicado um questionário de resposta múltipla e valoração qualitativa, por forma a avaliar caraterísticas socioeconómicas, laborais e a conciliação trabalho-família. Foram realizadas análises descritiva e de regressão linear.Resultados: Cerca de 40% dos médicos inquiridos avaliam negativamente a conciliação trabalho-família no sector privado. Já para o Serviço Nacional de Saúde, são 73% os médicos inquiridos que avaliam negativamente a conciliação trabalho-família no sector público. Verificou-se que mais de metade dos inquiridos (56%) tinha uma carga horária superior à que considera danosa à sua conciliação trabalho-família, sendo que a grande maioria trabalhava no limite ou em excesso de carga horária. Os dados obtidos permitiram associar maior carga horária com fazer urgências, com a idade e ser do sexo masculino. Foi ainda observado que maior carga horária não está associada a ter filhos ou ser casado.Discussão: No nosso estudo, as três medidas de conciliação trabalho-família que os participantes consideraram ser as mais importantes foram a possibilidade de flexibilizar o horário, trabalhar a tempo parcial e reduzir temporariamente o horário de trabalho (por exemplo, devido a assistência à família). Estes aspetos poderão explicar as diferenças encontradas na avaliação da conciliação trabalho-família entre o sector público e o sector privado.Conclusão: A profissão médica pelas suas características de exigência coloca os médicos numa situação particular de risco para alcançarem uma adequada conciliação trabalho-família. Os resultados do nosso estudo apontam para uma insatisfação dessa conciliação, sendo que essa insatisfação é mais marcada no sector público, tendencialmente associada ao excesso de carga horária semanal.
