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Resenha de CABANAS, E.; ILLOUZ, E. Happycracia: fabricando cidadãos felizes. Tradução Humberto do Amaral. São Paulo: Ubu Editora, 2022. 288p. (Coleção Exit)

Background Interscalene brachial plexus block is associated with phrenic nerve paralysis. The objective of this study was to evaluate an alternative approach to interscalene brachial plexus blocks in terms of efficacy, grade of motor and sensory blockade, and phrenic nerve blockade. Methods The study was prospective and interventional. The ten living patients studied were 18 to 65 years old, ASA physical status I or II, and submitted to correction of rotator cuff injury. A superior trunk blockade was performed at the superior trunk below the omohyoid muscle, without blocking the phrenic nerve. The needle was advanced below the prevertebral layer until contacting the superior trunk. In order to guarantee the correct positioning of the needle tip, an intracluster pattern of the spread was visualized. The block was performed with 5 mL of 0.5% bupivacaine in ten patients. In the six cadavers, 5 mL of methylene blue was injected. Diaphragmatic excursion was assessed by ultrasonography of the ipsilateral hemidiaphragm. In three patients, pulmonary ventilation was evaluated with impedance tomography. Pain scores and analgesic consumption were assessed in the recovery room for 6 hours after the blockade. Results In the six cadavers, methylene blue didn’t reach the phrenic nerve. Ten patients underwent arthroscopic surgery, and no clinically phrenic nerve paralysis was observed. No patient reported pain during the first 6 hours. Conclusions This study suggests that this new superior trunk approach to block the superior trunk may be an alternative technique to promote analgesia for shoulder surgery in patients with impaired respiratory function.

Objetivo: Analisar os motivos de consulta classificados segundo capítulos da International Classification for Primary Care – 2 (ICPC-2) pelos médicos de família na região Centro de Portugal, entre 2010 e 2018. Métodos: Estudo transversal observacional dos motivos de consulta classificados pelos médicos de família de três Agrupamentos de Centros de Saúde da área da Administração Regional de Saúde do Centro, selecionados aleatoriamente, para os anos de 2010, 2012, 2014, 2016 e 2018. Obtiveram-se dados anonimizados organizados por sexo, ano, número total de consultas, número de consultas com classificação ICPC-2 do motivo de consulta e capítulos ICPC-2 registados, calculando-se as dinâmicas e crescimento. Resultados: Em 12.569.898 consultas realizadas verificou-se proporção de 5,3% de consultas com motivo de consulta classificado. Os capítulos mais classificados em todos os anos estudados foram, decrescentemente, A (15,4%), L (11,3%), D (10,3%), R (8,4%), S (9,7%) e K (7,9%). Os capítulos menos classificados foram, crescentemente, Z (1,6%), Y (1,7%), B (1,9%), W (2,1%), H (2,9%) e N (3,7%). O capítulo Z teve a maior dinâmica de crescimento de 2010 para 2018 (∆=+1,15). Discussão: Numa década de problemas socioeconómicos, os motivos de consulta registados pela ICPC-2 mantiveram-se constantes. A atividade de classificação de motivos de procura de consulta, mesmo com problemas de qualidade e volume de realização, pode ajudar na qualidade e resultado da consulta, sendo semelhantes aos já conhecidos na literatura. Conclusão: Verificou-se classificação ICPC-2 de motivos de consulta pelos médicos de família em 5,3% das consultas, sendo os capítulos invariáveis ao longo do tempo. O capítulo Z registou a maior dinâmica de crescimento no volume de classificação.

RESUMO: O Sāṁkhya clássico parte da constatação da existência do sofrimento. Ele é provocado por fatores relacionados à constituição corpórea ou mental, por fatores oriundos do habitat natural e por fatores provenientes das forças da natureza ou dos deuses, permeando toda a existência, até mesmo o relacionamento com os deuses. O objetivo do Sāṁkhya é fornecer meios de libertação ou erradicação do sofrimento. Só existe um meio de atingir tal erradicação: através da discriminação intuitiva entre o(s) conhecedor(es) (Puruṣa(s)), o mundo manifesto (vyakta) e o não manifesto (avyakta). A doutrina da pluralidade de Puruṣas resulta em uma doutrina da pluralidade da salvação, que prescinde da existência de uma divindade maior, unificadora e monística. Se entendemos o ecumenismo como um diálogo positivo entre diferentes religiões, o Sāṁkhya dá um passo além: ele viabiliza o ecumenismo não apenas entre religiões, mas também com filosofias laicas e ateias. Não há salvação no pós-morte: a salvação ocorre durante a vida, na percepção de que somos drasticamente idênticos entre si, enquanto Puruṣas, merecedores de idênticos cuidados e afetos. PALAVRAS-CHAVE: Sāṁkhya; Soteriologia; Prakṛti; Puruṣa. ABSTRACT: The classical Sāṁkhya starts from the verification of the existence of suffering. It is caused by factors related to bodily or mental constitution, factors arising from the natural habitat and factors arising from the forces of nature or the gods, permeating all existence, even the relationship with the gods. The purpose of Sāṁkhya is to provide means of liberation or eradication of suffering. There is only one way to achieve such eradication: through intuitive discrimination between the knower(s) (Puruṣa(s)), the manifest (vyakta) and the unmanifest (avyakta) world. The doctrine of the plurality of Puruṣas results in a doctrine of the plurality of salvation, which dispenses with the existence of a greater, unifying, and monistic deity. If we understand ecumenism as a positive dialogue between different religions, Sāṁkhya goes a step further: it makes ecumenism possible not only between religions, but also with secular and atheistic philosophies. There is no salvation in the afterlife: salvation occurs during life, in the realization that we are drastically identical to each other, as Puruṣas, deserving identical care and affection. KEYWORDS: Sāṁkhya; Soteriology; Prakṛti; Puruṣa.

Objetivos: Perceber se a avaliação familiar está preenchida e atualizada, conhecer o risco familiar e a associação deste e da classificação socioeconómica da família e multimorbilidade com os tipos de famílias estudados no ficheiro de um médico de medicina geral e familiar. Materiais e Métodos: Estudo observacional transversal numa amostra aleatória representativa dos processos familiares de um médico de família no Centro de Portugal. Recolheram-se dados sobre a escala de risco familiar de Garcia Gonzalez, o Índice de GRAFFAR, o tipo de agregado familiar, o número de patologias crónicas classificadas pela Classificação Internacional de Problemas em Cuidados de Saúde Primários-2, o nível académico mais elevado dos membros da família, a existência ou não de isenção de taxas moderadoras por insuficiência económica e o número de elementos na família. Resultados: Foram estudados 145 agregados familiares com uma média de 2,94 elementos por agregado. As variáveis que apresentaram diferenças estatisticamente significativas entre os diferentes tipos de famílias foram: o nível socioeconómico, a escolaridade, a distribuição SOCFAM, a escala de risco familiar de Garcia Gonzalez, o número de elementos por agregado familiar e o número de patologias presentes. Discussão: Não possuindo dados de outros estudos com os quais comparar os presentes, as famílias que apresentaram maior risco foram as alargadas, unitárias e monoparentais, já as famílias reconstruídas e nucleares apresentaram melhores indicadores para risco mais baixo. Torna-se importante alargar este estudo para conhecer melhor a epidemiologia das famílias num contexto geográfico mais alargado. Conclusão: O elevado risco familiar esteve associado ao tipo de família, ao nível socioeconómico e à maior multimorbilidade familiar.

This article aims to verify the impacts brought by the covid-19 pandemic in cases of domestic violence against women. For this, we used the bibliographic search, having this article essentially theoretical character. The search is divided: violence definition; definition of domestic violence and its legal modalities; factors that increase that violence and, finally, the analysis of the relationship between social isolation and the increasing rates of that violence and how to fight it. Arrived the conclusion that the social isolation during the pandemic began to directly impact such form of violence and that the fight can occurs through: repression of aggressors through public security investments; cooperation through private individuals themselves; promotion of reporting campaigns; enhancement of support places for victims in times of pandemic; as well as in making occasional additions to already consolidated combat instruments, such as the Maria da Penha law. Este artigo objetiva verificar os impactos trazidos pela pandemia da Covid-19 nos casos de violência doméstica contra as mulheres. Para isto, foi utilizada pesquisa bibliográfica, possuindo este artigo caráter essencialmente teórico. Divide-se a pesquisa em: definição de violência; definição institucional da violência doméstica e suas modalidades legais; fatores que a impulsionam e, por fim, a análise da relação entre o isolamento social e o aumento dos índices de tal violência, bem como meios de combatê-la. Concluiu-se que o isolamento social durante a pandemia passou a impactar diretamente em tal forma de violência, e que o combate pode se dar através de: repressão aos agressores mediante investimento em segurança pública; cooperação entre os particulares; fomento a campanhas de denúncia; aprimoramento de locais de apoio às vítimas na pandemia; bem como na realização de acréscimos pontuais a instrumentos de combate já consolidados, como a Lei Maria da Penha.

“Linguagem, corpo e estética na educação” é uma coletânea de textos que surgiu da iniciativa de docentes da linha de pesquisa Linguagem, Corpo e Estética na Educação (LICORES), do Programa de Pós-Graduação em Educação da Universidade Federal do Paraná (PPGE/UFPR). A proposta da obra é discutir diferentes olhares para o discurso e a formação estéticos.

Background Empathy is the capacity to understand and resonate with the experiences of other people. Patient enablement is the degree to which a patient feels strengthened in terms of being able to deal with, understand and manage their disease. Methods Secondary cross-sectional analysis of existing data from 2 independent datasets (456 primary health care patients), with the application of two validated questionnaires, Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and Patient Enablement Instrument (PEI). Objective Evaluate medical empathy and patients’ enablement after consultation with their family doctors and to verify if there was an association between these two concepts. Results The median value of JSPPPE-VP score was 6.60 (interquartile range 1.00) and of PEI/ICC score was of 1.83 (interquartile range 0.67). Regarding empathy (JSPPPE-VP), patients taking chronic medication had a slight but significantly higher median score than patients not taking them (6.70 versus 6.60, P = 0.049), although regression modelling did not confirm any relevant predictor of JSPPPE-VP score. Regarding enablement (PEI/ICC), we found significantly higher scores on younger patients, as well as, on more educated and professionally active ones (P < 0.001). Multivariable linear regression and Poisson regression modelling confirmed such variables as statistically significant potential predictors. Conclusions A significant positive association was found between empathy score (JSPPPE-VP) and enablement score (PEI/ICC), when adjusted to sociodemographic cofactors. On this linear regression model, age category and educational level were also significantly associated with empathy score, with the same pattern found on bivariate analysis.

IntroductionDeprescribing is the process of tapering or stopping medications aiming at improving patient outcomes and optimising current therapy. Some studies have tried to identify which patients will have inappropriate medication deprescribed, but none have found any association with sociodemographic and clinical characteristics, number of prescribed medications or duration of medication. Our aim was to determine Portuguese elderly patients’ attitudes and beliefs regarding medication use and their willingness to have regular medications deprescribed.Material and methodsWe conducted a cross-sectional study in triangulation in primary care centres from mainland Portugal and its autonomous regions. We used a random sample of 386 polymedicated older adult patients who answered the questionnaire between October 2018 and February 2019. For the quantitative analysis, we used sociodemographic characteristics, clinical profile and medication. For the qualitative analysis, we studied an included open question by coding participants’ answers; common codes were grouped together. A convergent mixed methods design was used.Results74.0% expressed the belief that medicines were generally beneficial. 19.9% reported a strong belief that medicines were harmful and 33.4% that they were overused. 61.8% were against the idea of deprescribing and 24.6% were in favour of deprescription. Those against the idea had a lower education level (p = 0.006) and a higher number of self-perceived morbidities (p = 0.001) than those not against it.ConclusionsMedication benefits were accepted by the majority of patients who also were against the idea of deprescribing. It is important that doctors are aware of this reality, namely in the primary care setting, addressing the patients’ fears and beliefs and making the deprescribing process possible.

Healthcare-associated infections (HAI) are one of the major concerns worldwide, posing significant challenges to healthcare professionals’ education and training. This study intended to measure nursing students’ perceptions regarding their learning experiences on HAI prevention and control. In the first phase of the study, a cross-sectional and descriptive study with a convenience sample composed of undergraduate nursing students from Portugal, Spain, Poland, and Finland was conducted to develop the InovSafeCare questionnaire. In the second phase, we applied the InovSafeCare scale in a sample of nursing students from two Portuguese higher education institutions to explore which factors impact nursing students’ adherence to HAI prevention and control measures in clinical settings. In phase one, the InovSafeCare questionnaire was applied to 1326 students internationally, with the instrument presenting adequate psychometric qualities with reliability results in 14 dimensions. During phase two, the findings supported that Portuguese nursing students’ adherence to HAI prevention and control measures is influenced not only by the curricular offerings and resources available in academic settings, but also by the standards conveyed by nursing tutors during clinical placements. Our findings support the need for a dedicated curricular focus on HAI prevention and control learning, not only through specific classroom modules, innovative resources, and pedagogical approaches, but also through a complementary and coordinated liaison between teachers and tutors in academic and clinical settings.

Abstract Background Compassion, one of the items of empathy, is crucial in health care professions. So, the evaluation of the levels of compassion of Medicine, Dentistry and Pharmaceutical Sciences Master Degrees’ (M.D.) students of the public Colleges in Portugal according to the type of Master Degree and the participation in extracurricular activities (E.A.) was a task to be performed. Methods Cross-sectional study in 2020, applying an on-line questionnaire including the “Compassion” items of the Jefferson Medical Empathy Scale – Students’ version and questions about the participation in E.A. Results A sample of 901 students was studied. Its distribution by participation in E.A. did not differ significantly between M.D. (p = 0,854), most of the students participating in E.A. Using quartile distribution of compassion, the distribution of compassion levels was different among the three I.M. (p p p p = 0.036). For 56.4%, 74,6% and 69,5% of the respondents there was “medium-low” and “low” compassion for I.M. in Medicine, Pharmaceutical Sciences and Dentistry. These levels were also more prevalent among students in the 1st and 5th years. Levels of compassion were not different with the participation (p = 0,865), type (p = 0,177) and frequency of E.A. (p = 0,109). Conclusions For their importance in future health care professionals, compassion and their differences found among the M.Ds. of this area deserve future studies. Levels of compassion showed differences between the M.D. studied and academic years of frequency. There was no relationship between the participation, type, and frequency of E.A. and the students’ levels of compassion. The distribution of the level of compassion did not vary significantly with participation in E.A. (p = 0.865), with the type of E.A. (p = 0.177), with the frequency of E.A. (p = 0.109) or with the answer to the question “The practice of E.A. can make a person more compassionate?” (p = 0.503).

The high prevalence of polypharmacy and potentially inappropriate medications in the elderly makes them a vulnerable group to adverse drug events. Deprescribing is the medication review plus cessation of potentially inappropriate medications with a health professional’s help. Several barriers and enablers influence it, and its knowledge can help health professionals. The objective of the study is to understand the Portuguese elderly’s attitudes and ideas about polypharmacy and deprescription. We made a qualitative approach through a focus group with elderly patients from an adult daycare center with transcription and codification into themes and subthemes based on previous frameworks. Eleven elderly patients participated in the focus group. The identified elderly’s ideas and attitudes could be clustered into five main barriers: appropriateness, process, influences, fear, and habit, and five main enablers: appropriateness, process, influences, dislike, and cost. Although the elderly’s strong beliefs regarding medication benefits and necessity prevail, contrary opinions regarding lack of benefit/necessity, drug interaction/side effects, and medication complexity/number may influence their willingness to deprescribe positively. The health professional’s influence and the patient’s trust in their doctors were perceived essential for decision-making as either a barrier or an enabler. The medication benefit was a big barrier, and side effects/drug interaction experiences are an important enabler.

Internal structures of the liquid cargo tanks, such as horizontal girders and small longitudinal stiffeners may affect sloshing behaviors in lower filling conditions. Since the assessment of sloshing load in shallow liquid conditions is required by the classification societies for the structural dimensioning, the present study investigates the impact of the tiny bottom stiffeners on the resonance behaviors of the sloshing. For this purpose, sloshing resonant period and damping in rectangular tanks were obtained from sloshing free oscillation tests using a clean tank and a tank with small bottom stiffeners. Both experimental study and numerical simulations based on Moving Particle Semi-implicit (MPS) method were carried out. Initially, the numerical results are validated. After that, a series of simulations were performed considering different combinations of stiffeners sizes and a range of filling ratio that included very shallow liquid condition. The results show that in clean tanks, the resonant period obtained numerically agreed well with analytical ones. The stiffeners on the bottom increase resonant period, but its value is slightly lower than the analytically obtained considering the filling height as the difference between the real filling height and stiffener height. Finally, two distinct behaviors regarding the damping were identified.

Patient Centred Medicine is a method and a model of practicing allowing gains for both the doctor and the patient. Its practice must be evaluated for purposes of continuous professional development and continuous medical education. The aim of this study was to create an instrument focused in measuring the practice based on person centered medicine in general and family medicine, as well as in determining its reliability and validity.A first version of a questionnaire according to the four dimensions of the patient- centred clinical method was revised in a focus group providing the content validity. The final questionnaire includes 22 items, using a Likert scale with four response options. Factorial analysis made it possible to confirm the dimensions defined by Moira Stewart, and internal consistency, test-retest reproducibility and item-total correlations were determined. The online implementation of the questionnaire to a sample of 905 family doctors guaranteed the construct and criterion validities.The measurement instrument includes four dimensions: (i) exploring health, disease and the illness experience; (ii) investing in the doctor-patient relationship; (iii) seeking understanding; and (iv) understanding the whole person. The internal consistency was demonstrated with a global Cronbach's alpha of 0.892, varying between 0.783 and 0.844 for all dimensions. The test-retest reproducibility obtained an intraclass correlation value between 0.678 and 1.000. The item-total correlations varied between 0.457 and 0.870. Women doctors are more aware than their colleagues about seeking understanding with the person, and young doctors are more susceptible to approach the disease through history and to seek understanding with the patient. Specialist physicians have shown to be more careful with the history and with viewing the patient as a whole and the professionals who work in a Family Health Unit are those who seek a better understanding with the person. Finally, specific training about person centered medicine and about consultation in person centered medicine demonstrated a positive impact in all dimensions of the person-centred medicine and this is acknowledged by professionals.The assessment of self-perception of person-centred medicine is now possible.The questionnaire presents good reliability and validity, thus allowing doctors to assess their main weaknesses, as well as enabling the development of specific training.Introdução: A Medicina Centrada na Pessoa é um método e modelo de prática permitindo ganhos para o médico e o paciente, devendo a sua prática ser avaliada para fins de desenvolvimento profissional contínuo e educação médica continuada. O objectivo deste estudo foi construir, determinar a fiabilidade e a validade de um instrumento capaz de aferir a auto perceção genérica da prática médica segundo a medicina centrada na pessoa no ambiente de medicina geral e familiar.Material e Métodos: Uma primeira versão de um questionário segundo as quatro dimensões do método clínico centrado na pessoa foi revista por um grupo focal garantindo a validade de conteúdo. O questionário final engloba 22 itens, utilizando para resposta uma escala de Likert com quatro opções. A análise fatorial permitiu confirmar as dimensões definidas por Moira Stewart, tendo também sido determinada a consistência interna, a reprodutibilidade por teste-reteste e a correlação item-total. A aplicação online a uma amostra de 905 médicos de medicina geral e familiar permitiu testar as validades de constructo e de critério.Resultados: O instrumento de medição inclui quatro dimensões: (i) explorar a saúde, a doença e a experiência de doença, (ii) investir na relação médico-doente; (iii) procurar entendimento; e (iv) compreender a pessoa como um todo. A consistência interna foi demonstrada com um alfa de Cronbach global de 0,892, variando entre 0,783 a 0,844 para todas as dimensões. A reprodutibilidade teste-reteste obteve um valor de correlação intraclasse entre 0,678 e 1,000. As correlações item-total variaram entre 0,457 e 0,870. As mulheres médicas estão mais sensibilizadas do que os seus colegas no que respeita à procura de entendimento com o doente e os médicos mais novos são os mais sensíveis à abordagem da doença através da anamnese e à procura de entendimento com o doente. Os especialistas demonstraram ter mais cuidado com a anamnese e com o facto de encarar o doente como um todo, e os profissionais que trabalham numa unidade de Saúde Familiar são os que procuram um melhor entendimento com a pessoa. Por fim, a formação específica sobre medicina centrada na pessoa e sobre consulta em medicina centrada na pessoa demonstraram ter um impacto positivoem todas as dimensões da medicina centrada na pessoa e isso é reconhecido pelos próprios profissionais.Discussão: A avaliação da auto perceção de desempenhar medicina centrada na pessoa é agora possível.Conclusão: O presente questionário apresenta boa fiabilidade e validade permitindo ao médico verificar quais as principais insuficiências bem como desenvolver formação específica.

This research aims at investigating TED Talks as a genre. The analysis focuses on its rhetorical structure, characterized by moves and steps and the communicative purposes of the genre. The corpus comprises 10 talks selected from the website TED Talks. The data are discussed in the light of Bhatia’s (1996/2004) and Swales’ (1990/2004) theories of genre. Results demonstrate that, in terms of the analysis of the rhetorical structure, it reveals a constant pattern of moves and steps along the corpus, since every talk contained the five moves identified by the analysis. These cyclical and more frequent moves are: topic introduction, speaker presentation, topic development, concluding messages, and acknowledgments/gratitude. In terms of its communicative purpose, TED aims to celebrate ideas to a diverse audience worldwide, due to the variety of topics encompassed. This study also allowed us to develop a deeper view of this spoken genre, its features, and the way individuals may benefit from it in their lives.

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Introduction: Lugol is helpful in identifying early second primary tumors (SPTs) during oroscopy and pharyngoscopy, but this technique has not been assessed during follow-up visits with these patients. Aim: The aim of this study is to describe the use of Lugol (a low-cost method) to diagnose SPTs in the oral cavity and oropharynx. Methods: Patients treated for squamous cell carcinoma of the head and neck were randomly assigned to two groups. Group A was examined with routine oroscopy and pharyngoscopy without Lugol, and Group B was examined with routine oroscopy and pharyngoscopy without stain and with Lugol. A total of 211 patients were included during 4 years. Results: Six oral and oropharynx carcinomas were detected in Group A. Eighteen oral and oropharynx carcinomas were detected in Group B, twelve of which were not seen without chromoscopy but were detected with Lugol. Conclusion: Lugol increases the detection of malignant lesions compared to routine examination alone.

O presente artigo tem como objetivo, analisar o acontecimento da recuperação judicial e as fases enfrentadas pelo empresário falido, fazendo um apanhado histórico de como surgiu o direito falimentar, desse modo, analisando os fatos marcantes de como se instituiu este direito tão importante para nossa legislação. Diante disso, entende-se que o tema ora trazido em tela, tem uma relevância significativa, pois, com o advento da Lei 11.101/05, a qual regula o direito de falência e do pedido de recuperação judicial da pequena e média empresa.[...]

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Riedel’s thyroiditis (RT) represents one type of IgG4-related thyroid disease (IgG4RTD) and the diagnosis involves quantitative immunohistochemistry showing dense lymphoplasmacellular inflammatory infiltrate consisting of IgG4-positive plasma cells with storiform fibrosis and obliterative phlebitis. We report a case of RT with progressive enlargement of the anterior neck, severe dysphagia, odynophagia, and dyspnea. The patient underwent surgical decompression of the airway, protection tracheotomy, and gastrostomy for nutritional intake 6 months after first symptoms. Complete resolution occurred after surgical treatment combined with prednisolone. Immunostaining revealed IgG4-positive plasma cells 12/HPF (high-power field) and the IgG4/IgG ratio 25%, values that were disproportionate to the intensity of the patient’s symptoms. As to this case and the few cases described and analyzed in the literature, our impression is that there is no relation between the intensity of symptoms in RT with the total number of IgG4-positive plasma cells and the IgG4/IgG ratio, but more studies are needed.

To determine the point of entrance of the thoracic duct in the venous system, as well as to evaluate some biometric measurements concerning its terminal portion, we conducted an anatomic study on 25 non-preserved cadavers. The termination of the thoracic duct occurred on the confluence between the left internal jugular vein and the left subclavian vein in 60 % of the individuals. The average results for the biometric measurements were: distance between the end of left internal jugular vein and omohyoid muscle 31.2 ± 2.7 mm; distance between the end of thoracic duct and the left internal jugular vein 0.0 ± 0.0 mm; distance between the end of thoracic duct and the left subclavian vein 3.6 ± 1.0 mm; distance between the end of thoracic duct and the left brachiocephalic vein 10.7 ± 3.1 mm. Moreover, it was identified that the left internal jugular vein length in level IV, measured between its entrance in the left subclavian vein and the omohyoid muscle, was able to predict the termination of the thoracic duct on the junction between the left internal jugular vein and the left subclavian vein (OR = 2.99) with high accuracy (79.3 %). In addition, the left internal jugular vein length at level IV was able to predict the localization of thoracic duct termination. Thus, this finding has practical value in minimizing the risk for a potential chyle leak during or after a left-sided neck dissection.