General medicine is the study of the science that allows physicians to deal with the prevention, diagnosis and treatment of adult diseases in human beings. Since medicine is the science or practice of the diagnosis, treatment, and prevention of disease, those who are physicians are normally called general practitioners (GPs). The American College of Physicians confirms that internal medicine (IM) is a discipline focused on adult care underscoring the use of the best medical science available in caring for patients with a thoughtful, meaningful doctor-patient relationship.

Practical work requires deepening in the theory. In this way, the intention of this article is to systematize the concept of "minimal interventions", as well as draw attention to the impact that this type of interventions of the general practitioner can have on the patient, however small and insignificant, their action may seem. The doctor-patient relationship creates contexts that act, in one way or another, on the patient. There is no absence of medical intervention, even when there is no conscious intervention of the doctor on the patient. Non-intervention is a type of intervention. Non-intervention is a bio-fiction. The different types of doctor-patient relationship give rise, naturally, perhaps imperceptibly, to different models of educational intervention. In this scenario, a conceptualization and systematization of the "micro-interventions" in general medicine is presented: minimal, imperceptible, briefs, low cost, zen, human size, opportunistic, small and mild, but continuous interventions. These micro-interventions are cost-effective no matter how small and insignificant their action seems. These minimal interventions of the general practitioner are of great importance and constitute an updated form of the "less is more" rationalist, they express the power of the minimum gesture in general / family medicine, and can transform health / disease on a large scale. In this way we can hypothesize a plausible relationship between the minimal but concentrated and powerful means, that is to say "contextualized", and the intensity of the effect in general medicine. The clarity of the reading of a message depends on the appreciation of the context; what counts is not what, but how. The context highlights or "pulls" the message. Many small people, in small places, doing small things, can change the world.

Cervico-facial cellulitis can cause serious complications including neuro-meningeal infections. Among these neuro-meningeal infections are intracranial empyemas, which are rarer than brain abscesses. We report the case of a young patient of 25 years, immunocompetent, having presented a cerebral empyema secondary to diffuse cervicofacial cellulitis of dental origin. The diagnosis was suspected in the presence of cervicofacial cellulitis, febrile meningeal syndrome and consciousness disorder, confirmation was reported by brain MRI. The evolution was favorable after the recourse to the surgical treatment.

Objectives - Analyze the prevalence of biochemical recurrence (BCR) in patients submitted to radical prostatectomy with lymphadenectomy (RP-LD) the most prevalent clinical and pathological staging in the BCR and to correlate the sum of the Gleason score (GS) in the surgical specimen in patients who presented BCR. Method - Analysis of 100 patients diagnosed with prostate adenocarcinoma who performed RP-LD between 2013 to 2017. All subjects underwent transrectal prostate biopsy due to PSA or rectal examination and RP-LD. The lymphadenectomy considered in the study was the iliac-obturator, and the surgical pieces were analyzed to determine the pathological staging and its descriptors. All patients who had two or more PSA measurements >0.2 ng/ml and who had undergone RP-LD were considered postoperative. Results -About 22% of the patients submitted to RP-LD presented BCR. Patients with BCR had a 59-76 age range, mean age of 66.27 years, and median age of 63.50 years. The most prevalent preoperative PSA in patients with BCR was between 10-20 ng/ml (40.90%) and the most prevalent clinical stage was cT2 (59.10%). Regarding the Gleason score, the BCR patients had the most prevalent 6 (36.37%) score in the biopsy and score 7 (4 + 3) (36.37%) in the surgical specimen. All patients (100%) with BCR presented perineural invasion, with pT3 staging (81.81%) and pN0 (77.28%) being the most prevalent in patients with BCR. Patients with BCR presented a correlation (p<0.05) between the increase in the sum of pathological GS and the increase in pTN staging. Conclusion - All these variables were important in the determination of BCR in patients submitted to RP-LD, thus demonstrating the importance of this information in the analysis of the prognosis and in the follow-up of these patients.

Introduction: Pyomyositis is a rare condition in temperate climates with approximately 15 cases reported annually in the United States. Predisposing factors include immunodeficiency, trauma, intravenous drug use, and bacteremia. We report a case not yet seen in the literature due to in- volvement of the lateral leg compartment, no history of predisposing factors, and clinical presen- tation with elevated compartment pressures. Case Report: We present a case of a 45 year old male who presented with worsening lower left leg pain for one week. The area felt firm and was exquisitely tender to palpation. Initial laborato- ry studies showed normal white blood cell counts and a slightly elevated erythrocyte sedimenta- tion rate. Compartment pressures were elevated and imaging revealed evidence of pyomyositis in the lateral compartment. Fasciotomy was avoided with prompt broad-spectrum antibiotics. At follow-up, the patient’s symptoms were resolved and no further treatment was needed. Conclusion: While pyomyositis is rare in nontropical countries, patients presenting with elevat- ed compartment pressures and no history of trauma or surgery should warrant further investiga- tion of the etiology with pyomyositis being included in the differential diagnosis.