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Governance Report 2 - Virtual Patient System

Governance Report 2

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Comparison of Teleconsultations for Sigmund Freud’s Palatal Ulcerous Lesion

The following table presents a detailed comparison of the teleconsultations provided by Prof. R. E. and Prof. Dr. Hans Pichler regarding Sigmund Freud’s palatal ulcerous lesion and its potential connection to cocaine use.

AspectProf. R. E. (AI-generated)Prof. Dr. Hans Pichler
Institution AffiliationUniversity of ViennaFirst Surgical University Clinic
Examination and ImagingAdvises thorough clinical examination and possibly radiographic imaging.Suggests surgical excision of the lesion with histopathological examination.
BiopsyRecommends a biopsy to rule out other etiologies.Emphasizes surgical excision with immediate histopathological examination for diagnosis and guidance on further treatment.
Cocaine CessationUrges immediate cessation of cocaine use.Stresses the importance of stopping cocaine use to prevent further damage and progression of the lesion.
Antibiotic TherapySuggests initiation based on culture and sensitivity results if secondary infection is evident.Considers it as part of the tertiary recommendation if biopsy results indicate an infectious process.
Local Wound CareIncludes debridement, saline lavages, and topical agents.Not explicitly mentioned.
Nutritional SupportHighlights the importance of a diet rich in proteins, vitamins, and minerals.Not explicitly mentioned.
Pain ManagementMay prescribe analgesics.Suggests pain management as part of postoperative care.
Follow-UpRecommends regular appointments to monitor healing.Recommends follow-up and additional treatment based on biopsy results.
Reconstructive SurgeryConsiders reconstructive surgery for significant tissue loss.Not explicitly mentioned.
Treatment Approach SummaryFocuses on local wound care, cessation of cocaine use, and conservative management with a biopsy for diagnosis.Prioritizes surgical intervention with a biopsy for a definitive diagnosis followed by tailored treatment based on results.
Connection Between Cocaine Use and Palatal LesionCautions about well-documented correlation in medical literature, emphasizing intervention on local and underlying causes.Acknowledges well-documented connection, advising immediate cocaine cessation and surgical intervention.
Rehabilitation and Supportive CareNot explicitly mentioned.Includes supportive care such as speech therapy as part of rehabilitation.
Further RecommendationsNot specified beyond treatment plan.Open to answering further questions or concerns.
Signature and CredentialsProf. R. E., University of Vienna (AI-generated)Hans Pichler, Head of the Maxillofacial Surgery Department, First Surgical University Clinic

Analysis and Conclusions

Both consultations emphasize the need for immediate cessation of cocaine use and acknowledge the correlation between cocaine use and palatal ulceration. Prof. Dr. Hans Pichler advocates for a surgically oriented approach, with excisional biopsy for a definitive diagnosis and subsequent treatment, particularly in cases where malignancy due to tobacco use is a concern. In contrast, Prof. R. E. recommends a more conservative initial approach, focusing on local management and biopsy, but also suggests more invasive steps if necessary. Prof. Dr. Hans Pichler’s proactive stance on potential malignancy reflects a cautious and thorough surgical perspective, providing a specific direction for immediate and future care.


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