Digital transformation shaping structural pillars for academic entrepreneurship: A framework proposal and research agenda.

Digital technology always accelerates change, altering organisations culturally, socially and technically. These modifications are known as "digital transformation" (DT). On a much greater scale than DT, the world was changed in 2020 by the COVID-19 pandemic, which re-organised society in the way of thinking, acting, producing, consuming and creating new business. Higher Education Institutions (HEIs) were no different, since these institutions had to make changes to the student-lecturer interaction; teaching-learning, where DT had a relevant role, above all in academic entrepreneurship. Therefore, this study aims to propose a framework showing the structural pillars of the link between digital transformation (DT) and academic entrepreneurship (AC) (DT-AC Framework). This framework identifies the new patterns, methods, skills and other discoveries in aspects such as management, information systems and culture sciences. The intention is not to analyse how the COVID-19 pandemic imposed global structural changes, but because of it, lecturers and students found their DT accelerated and intensified, and so it is necessary to investigate the pillars supporting academic entrepreneurship. The results show that DT was already emerging as a basic element of academic entrepreneurship before the pandemic, but the process has speeded up. This bibliometric study indicates the structural pillars that support entrepreneurship following the Covid19 pandemic, as created from DT in universities, providing an extensive systematic review that indicates the cause and effect of the academic entrepreneurship process.

Meningite asséptica e doença autoimune / Aseptic meningitis and autoimmune disease

A meningite asséptica (MA) é uma entidade anatomoclínica aguda, benigna, de ocorrência rara na população geral, com manifestações clínicas variáveis e ausência de patógenos identificáveis no líquido cefalorraquidiano. Sua prevalência é maior associada a administração ou presença de algum medicamento e/ou doença autoimune, respectivamente. Seu diagnóstico é dificultado devido à inespecificidade das manifestações clínicas e laboratoriais, o que resulta em hospitalizações, propedêutica invasiva e antibioticoterapia desnecessárias.

Aseptic meningitis (AM) is an acute and benign condition, rare in the general population, characterized by nonspecific clinical manifestations associated with changes on cerebrospinal fluid (CSF) sample analysis, including negative cultures. The subject of analysis is the relationship between medication intake and autoimmune diseases with the occurrence of AM. It has been concluded that this condition occurs more often in case both causes are associated. The diagnosis of AM is difficult because of the nonspecifity of the signs and symptoms and findings on CSF analysis, which results in unnecessary hospitalizations, invasive exams and antibiotic therapy.

Sintomas inespecíficos no diagnóstico de leucemia na infância / Vague symptoms in leukemia diagnosis in childhood

As manifestações clínicas de extenso número de doenças, sejam benignas, de cursoauto-limitado, ou malignas, podem ser caracterizadas por sintomatologia inespecífica,como: febre, cefaleia e fadiga. Essas manifestações requerem atenção acurada paraserem surpreendidas e valorizadas para que o diagnóstico da doença que expressamseja feito precocemente. A leucemia mieloblástica aguda (LMA) também pode se apresentarcom sintomatologia inespecífica, exigindo diagnóstico com base na anamnesee exame físico minuciosos. Os principais exames complementares são o hemogramae o mielograma. Este caso descrito ilustra a maneira como o paciente com LMA seapresentou ao Pronto Atendimento e como sua condução foi realizada pela equipe desaúde que o atendeu.

Vague signs and symptoms as fever, headache and fatigue compose the clinical presenta-tion of an extensive number of diseases, from the benign ones, with a self-limited course, to the severe ones. Thus, a proper medical attention is indispensable for early diagnosis of the affections that begins with vague signs and symptoms. The inespecific clinical manifestations also permeates the diagnosis of acute myeloblastic leukemia - AML, whose diagnosis is based on history taking and physical examination. The hemogram and the myelogram are the major exams complementaires. The clinical case described in this article illustrates how the patient with AML has presented himself to the emergency care and the conduction to the case proportionated by the health team that attended him.

Violência contra a mulher e a criança: condutas médicas à paciente agredida sexualmente / Violence against the woman and the child: medical management of the sexually assaulted patient

A assistência a pacientes vítimas de abuso sexual deve ser intersetorial e interdisciplinar, incluindo interface com questões policiais e judiciais. Nesse contexto, o médico tem dever ético e legal de prestar atendimento prioritário a essas pacientes. É necessário que o serviço de saúde realize exame físico, exame ginecológico, coleta de amostras para diagnóstico de infecções genitais e coleta de material para identificação do agressor. As evidências mostram que a violência contra a mulher tem impacto sobre a saúde física e mental desta. A equipe médica, portanto, deve estar preparada para oferecer apoio psicossocial. Outra preocupação médica é diminuir ao máximo as consequências do ato de violência, seja protegendo a mulher de doenças sexualmente transmissíveis ou de gravidez traumática. A paciente vítima de violência sexual, ocasional e sem uso de preservativo, deve receber no serviço de urgência profilaxia contra HIV, hepatite B, sífilis, gonorreia, clamidiose, cancro mole, tricomoníase e tétano. Além de ter direito a receber anticoncepção de emergência, o aborto nessas pacientes pode ser feito legalmente. Para isso, basta a autorização da paciente e/ou do responsável, dependendo da idade da paciente, sendo incorreta e ilegal a exigência de Boletim de Ocorrência Policial ou laudo do Instituto Médico Legal.

The assistance to patients who are victims of sexual abuse should be intersectoral and interdisciplinary, including interface with police and justice affairs. In this context the physician has an ethical and legal obligation to give priority attention to these patients. It is necessary for the health service to perform physical examination, gynecological examination, collection of samples for diagnosis of genital infections and collection of material for the aggressor’s identification. Evidences shows that violence against women has an impact on both their mental and physical health. The medical team, therefore, must be prepared to offer psychosocial support. Another medical concern is to minimize as much as possible the consequences of the act of violence, either by protecting the woman from Sexually transmitted Diseases or from traumatic pregnancy. The patient who was suffered occasional sexual violence without the use of a condom must receive in the emergency service prophylaxis against HIV, type B hepatitis, syphilis, gonorrhea, chlamydia, chancroid, trichomoniasis and tetanus. Besides having the right to receive emergency contraception, abortion in these patients can be legally done. It is only required the written consent of the patient and/or the person legally responsible for her, depending on the patient’s age, and the requirement of the Police or Forensic Medicine reports is considered both incorrect and illegal.

Abuso sexual em serviços de emergência: relato de caso / Sexual abuse in emergency centers: case report

Este artigo trata de paciente com 54 anos, atendida no Hospital Júlia Kubitschek, com relato de ter sido vítima de violência sexual. O agressor armado invadiu sua casa e a obrigou, mediante ameaça de morte, a manter com ele sexo vaginal, anal e oral, sem uso de preservativo. Apresentava-se ansiosa e chorosa. Havia lesão contusa em região escapular esquerda e leve hiperemia de grande lábio direito. O exame especular e a inspeção da região anal não apresentavam alterações. Foram realizadas avaliação laboratorial e profilaxia para doenças sexualmente transmissíveis (DSTs), incluindo administração de antirretrovirais. Foi encaminhada ao ambulatório de vítimas de violência sexual.

This article is about a 54-year-old female patient, assisted at Júlia Kubitschek Hospital, who reported having been victim of sexual violence. According to her, the armed aggressor broke into her house and forced her by threat of death to have vaginal, anal and oral sex with him without using condom. The patient was anxious and tearful. There were blunt injury in the left scapular region (shoulder blade area) and mild hyperemia of the right labium. Speculum examination and inspection of the anal region showed no alterations. The treatment included laboratory tests and prophylaxis for Sexually Transmitted Diseases (STDs), including administration of antiretroviral medication. The patient was referred to an outpatient center for victims of sexual violence.