M Mikolajcikova, V Ferencikova, K Fiolkova, V Sokolikova, Z Matuskova and O Osina
Introduction: Voice disorders primarily affect workers in professions with increased voice demands, such as teaching personnel in educational system, singers, lecturers, actors or managers. Severe voice disorders often require a permanent change of work position.
Methods: Retrospective analysis of a set of patients with occupational voice disorders who were hospitalized at the Clinic of Occupational Medicine and Toxicology, Martin University Hospital (COMaT, MUH) in the years of 2000–2017. Comparison of the data obtained with the National Centre of Medical Information (NCMI) data on the occurrence of occupational voice disorders throughout the Slovak Republic (SR). Comparison with the retrospective analysis of reported occupational voice disorders in the years of 1967-1996. Case report of a patient with an occupational voice disorder.
Results: We point to a long-term low incidence of occupational voice disorders. In the years of 2000-2017, 24 cases of occupational voice disorders were reported in Slovakia, of which 20 cases were reported under item 42-1 and 4 cases under item 42-2 in the List of Occupational Diseases. Through the COMaT, MUH 11 cases of occupational voice disorders were reported during these years, of which 9 cases were listed under item 42-1 and 2 cases under item 42-2. From 1967 to 1996 there were 52 occupational voice disorders reported in Slovakia, of which 45 were under item 42-1 and 7 under item 42-2.
Conclusions: As there is a tendency to underestimate the voice difficulties among teaching staff, it is necessary to provide better information about the possible consequences, prevention, and treatment of these diseases. All of this should be in the competency of occupational health services.
Kazeem Kanmodi Kehinde, Adebayo Oladimeji, Ayomikun Adesina Miracle, Francis Fagbule Omotayo and Emerenini Franklin
should represent the medical profession? Lancet 364(9432):416.
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Gabriel Ungureanu, Ioana-Dana Alexa and Maria-Christina Ungureanu
The authors discuss an important chapter of iatrogenic pathology – unneccessary medicine, by reviewing epidemiological aspects and financial impact and identifying such elements in no less than 10 areas: surgery, interventional medicine, diagnostic investigation, substitute procedures, preventive medicine, drug therapy, aesthetic shared medical appointments, surgery, unconventional medicine, medicine on political demand. We shall review the causes, motives and mechanisms of unnecessary medicine such as one’s hyperprudence to cover oneself with diagnosis arguments or to prevent potential complications through preventive therapies (defensive medicine), weak functionality of the institutionalized inspection bodies, onerous motivation. The respect for the fundamental principles of medical ethics (the primum non-nocere principle doubled by the principle of doing good), the use of practice guidelines, the proper functioning self-control mechanisms in exercising the medical profession, a different management of error and the existence of a consistent protective legislation for both the patient and doctor would be key-elements to avoiding unnecessary medicine.
Medical doctors are granted a license to practice following years of study and diligent assessment. Licensure is granted on the understanding that doctors will use their knowledge and skills to meet and advance the needs of their patients and, in so doing, place those needs ahead of other considerations, most notably self-interest. The compact thus formed engenders trust between the medical profession, patients, and society. The smooth functioning of a modern healthcare system cannot occur in the absence of trust. The adverse experience of healthcare systems in