Ulyssess syndrome

(A saga de Ulisses)

Manuel Salgado
15.10.2015 Hospital Peditrico, Centro Hospitalar Universitrio de Coimbra, CHUC
Sindroma de Ulisses

-Mdico

-Social
Ulisses, heri grego, rei de taca, foi um dos elementos
mais decisivos no cerco a Tria O retorno de Ulisses
sua terra, o tema da Odisseia O azar ou a m sorte
- a inimizade de Neptuno , as ciladas vrias, o Inferno,
um emaranhado tenebroso obrigaram o heri e seus
companheiros a errarem pelos mares durante dez longos anos,
perdidos por maus caminhos e sujeitos a amargos e demorados
sacrifcios.
 Tambm as sereias sujeitaram Ulisses a
provaes.
Com as suas melodias maviosas e
enganadoras
Para resistir s tentaes o heri tapou com cera
os ouvidos dos seus companheiros e pediu-lhes que
o amarrassem bem ao mastro do navio.
A analogia da Odisseia de Ulisses com os maus
caminhos, enganos, e sacrifcios passados por
estes pacientes, levou a denominar de Sindroma
de Ulisses esta forma de iatrogenia, caracterizada
por:

- extensivas e desnecessrias investigaes,

- resultantes da tentativa de esclarecimento de

achado insignificante:
clnico,
laboratorial ou
imagiologia.

Salgado M., Fonseca N. A Sndrome de Ulisses. Sade Infantil 1993;15:83-4

Int J Environ Res Public Health. 2009 May;6(5):1649-64. doi:
10.3390/ijerph6051649. Epub 2009 May 14.
The risks of inappropriateness in cardiac imaging.
Picano E.
Author information
Institute of Clinical Physiology, CNR, Pisa, Italy. picano@ifc.cnr.it
Abstract
The immense clinical and scientific benefits of cardiovascular imaging are well-
established, but are also true that 30 to 50% of all examinations are partially or
totally inappropriate. Marketing messages, high patient demand and defensive
medicine, lead to the vicious circle of the so-called Ulysses syndrome. Mr.
Ulysses, a typical middle-aged "worried-well" asymptomatic subject with an A-
type coronary personality, a heavy (opium) smoker, leading a stressful life,
would be advised to have a cardiological check-up after 10 years of war. After a
long journey across imaging laboratories, he will have stress echo, myocardial
perfusion scintigraphy, PET-CT, 64-slice CT, and adenosine-MRI performed, with
a cumulative cost of >100 times a simple exercise-electrocardiography test and
a cumulative radiation dose of >4,000 chest x-rays, with a cancer risk of 1 in
100. Ulysses is tired of useless examinations, exorbitant costs, unaffordable
even by the richest society, and unacceptable risks.
Picano E. The risks of inappropriateness in cardiac imaging
Int J Environ Res Public Health. 2009 May;6(5):1649-64. doi:
10.3390/ijerph6051649. Epub 2009 May 14.
 Em Hematologia
J Lab Clin Med. 2004 Jul;144(1):7-10.
Did Ulysses have porphyria?
Pierach CA.

An errant patient with a conundrum of symptoms but without an explanation for

them might have to take iatrogenic detours only to learn after what are at times
ulyssean vagaries that the initial diagnosis of porphyria is in the end untenable.

. the occurrence of the Ulysses syndrome can be curtailed through the careful
ordering of tests and cogent interpretation of their results.
 Eugenio Picano, Gaetano Mottola. Ulysses Syndrome. Stress Echocardiography
2003;469-75.
Reich JM. Dysutility of screening chest roentgenograms for lung cancer: the
Ulysses syndrome. Arch Intern Med. 1993 23;153(16):1933
Flecknoe-Brown S. The "Ulysses syndrome" in pathology. Med J Aust. 1992;
4;156(9):671
Mutile S, Stpn J, Dolezalov P, Kesslerov Z. Transient hyperphosphatasemia in
childhood - the Ulysses syndrome. Cas Lek Cesk. 1989 Mar 17;128(12):375-7
[Article in Czech]
Mercado Rodrguez U. Ulysses syndrome. Rev Clin Esp. 1982 Jan 31;164(2):127-8.
(Article in Spanish)
Laerum OD. The Ulysses syndrome - health problems in patients with "non-
disease". Nord Med. 1976;91(8-9):205-7 (Article in Norwegian)
Nicol WG. The Ulysses syndrome. Can Med Assoc J. 1975;22;113(10):928
Campos FJ, Mercado-Rodriguez U. The Ulysses syndrome. Can Med Assoc J.
1975;113(6):493 (Letter)
Babineau M. The Ulysses syndrome. Can Med Assoc J. 1972;106(9):964.
Watson WC. The Ulysses syndrome. Can Med Assoc J. 1972;106(9):964.
Dunn EV. The Ulysses syndrome. Can Med Assoc J. 1972;106(9):963-4
1 Rang M. The Ulysses syndrome. Can Med Assoc J. 1972;106(2):122-3
Stress Echocardiography 2003;469-475
Ulysses Syndrome
Eugenio Picano, Gaetano Mottola
Abstract
Detecting myocardial ischemia can now be done using a wide ranging somewhat
confusing series of tests: a plethora of diagnostic approaches with a variety of
stresses (physical, electrical, and pharmacological) in combination with all the
available technologies, from the well-established tools (e.g., electrocardiography),
to the more recent imaging techniques (nuclear cardiology, echocardiography), up
to the latest, most sophisticated, and expensive ones (magnetic resonance, ultrafast
computed tomography, positron emission tomography). These imaging techniques
provide noninvasive insight into myocardial function and metabolism in a
polychrome, three-dimensional, almost overwhelming fashion [1]. Not infrequently,
the patients complexity is reduced to a transient perfusion defect or a reversible
hypokinesia, and technological output replaces integrated clinical reasoning [2,3].
 Diluies

O inverso das diluies = Ttulos

Anlises com resultados
em Ttulos

Um dos mltiplos exemplos de

potencial criao de
sndroma de Ulisses mdico
Obrigado pela vossa ateno

Contacto: reumatologia@chc.min-saude.pt
Neologismo = palavra ou expresso nova,
formada no interior da lngua ou importada
Sndroma de Ulisses Social

What is the " Ulysses Syndrome "?

Ulysses syndrome is characterized by the following hot spots:

- Loneliness: Once a person comes to a country that is not yours is just a bleak
outlook . They can not bring the family because they first have to have
economic stability. Furthermore, the fact that their closest relatives , as their
children, especially in the case of women , have been left in the home country
produces a nostalgia hard to beat.
- The feeling of failure. They think that so much effort has served not because
they can not progress in the market and can not get jobs .
They live very tough situations in the struggle for survival. Their main concern
is where to eat and where to sleep .
- Spend scary situations. For example , it is common is arriving in boats feel
dread, soon after, the water.

http://www.bubblews.com/news/1459210-what-is-the-quot-ulysses-syndrome-quot
Exemplos de Exames na origem de Sndroma de Ulisses
- Ttulo TASO
- Ttulo ANAs
- Ttulo AcDsDNA
- RA teste e /ou Waaler- Rose positivos
- Reao Widal
- ...
- Alteraes do ECG (electrocardiograma)
- RX do trax
- mltiplos outros