ABSTRACT
A case is reported of a male patient with rheumatic mitral valve disease and open mitral valve commissurotomy, performed 13 years before, who had fever and multiple septic embolic events. Serial blood cultures were positive for Pseudomonas aeruginosa. Transthoracic and transesophageal echocardiography demonstrated the presence of an irregular, round, very mobile mass inserted in the fossa ovalis region of the interatrial septum. After resolution of the infectious process, surgery was performed. The structure previously described corresponded to a elongated suture material covered by fibrin. It had been secondarily infected and it was the cause of the entire process.
Subject(s)
Endocarditis, Bacterial/etiology , Mitral Valve/surgery , Postoperative Complications , Pseudomonas Infections/etiology , Echocardiography, Transesophageal , Endocarditis, Bacterial/diagnostic imaging , Humans , Male , Middle Aged , Pseudomonas Infections/diagnostic imaging , Rheumatic Heart Disease/surgery , Sutures/adverse effects , Time FactorsABSTRACT
In order to obtain specialist training in Portugal, doctors must pass a multiple-choice examination. The aim of this article is to present a structural and mathematical analysis of the examinations in the last three years. We based our work on the calculation of reliability coefficient of the examinations, and the difficulty and discrimination index of the questions and the examinations as a whole. A detailed analysis of the examinations, including that of each of the three hundred questions, will be published by the Department of Health Manpower in January, 1997.
