Síndrome de burnout / Burnout syndorme

Noviembre 21, 2017. No. 2909

Síndrome de burnout en medicina de urgencias Burnout syndrome in emergency medicine Dubravka Ivanic1, Visnja Nesek Adam1,2,3,  Ivana Srzic1, Anika Stepic1 and Hrvoje Pintaric4,5 Hong Kong Journal of Emergency Medicine 2017:24(6) Abstract Background: Occupational burnout syndrome generally develops in individuals of helping professions and is considered to result from long-standing stress. Burnout syndrome is characterized by loss of interest, fatigue, or frustration, the negative consequences of which affect the individual's performance, thus being a major factor that influences the quality of work. Objectives: The aim of the study was to assess the existence of burnout syndrome in medical staff working at hospital emergency department. Methods: The study included 120 subjects working at emergency departments. The following two questionnaires were used: Copenhagen Burnout Inventory and Copenhagen Psychosocial Questionnaire. Likert scale was employed on scoring the answers offered in the questionnaires. Statistical analysis was performed using the exploratory factor analysis, analysis of variance, Bonferroni test, and Pearson correlation coefficient. The level of statistical significance was set at p < 0.05. Results: Study results revealed that the subjects suffer mostly from the symptoms of fatigue due to occupational burnout and exhaustion at the end of the day. The prevalence of burnout syndrome was highest among subjects with 11-15 years work in emergency department, while lower risk was recorded in those nurses and physicians who reported a higher level of social support, sense of community, and feedback information. Conclusion: Results of the study confirmed the existence of burnout syndrome in medical staff working at hospital emergency department, with the highest prevalence recorded in those working at this department for more than 11 years. The main burnout symptoms reported by study subjects were fatigue, exhaustion at the end of the day, and feeling that they were giving more than they were receiving in return. Burnout syndrome was found to be less common among those nurses and physicians who reported a higher level of social support, sense of community, and feedback information. Keywords Burnout syndrome, medical staff, emergency department PDF Síndrome de burn out durante la residencia Burnout Syndrome During Residency. Turgut N1, Karacalar S1, Polat C1, Kıran Ö1, Gültop F1, Kalyon ST1, Sinoğlu B1, Zincirci M1, Kaya E2. Author information Turk J Anaesthesiol Reanim. 2016 Oct;44(5):258-264. Epub 2016 Oct 1. Abstract OBJECTIVE: The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. METHODS: After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. RESULTS: Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. CONCLUSION: BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects. KEYWORDS: Burnout syndrome; Maslach Burnout Inventory; resident PDF Anestesistas y síndrome de burnout: ¿qué estrategias pueden prevenir esta peligrosa combinación? Anesthetists and burnout syndrome: what strategies can prevent this dangerous combination? Caruselli M1, Michel F2,3. Minerva Anestesiol. 2017 Feb;83(2):136-137. doi: 10.23736/S0375-9393.16.11771-7. Epub 2016 Nov 8. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo LI Congreso Mexicano de Anestesiología Mérida Yucatán, Noviembre 21-25, 2017 Información / Information International Anesthesia Research Society Annuals Meetings USA Informes / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Dolor crónico postamputación / Chronic post-amputation pain

Noviembre 17, 2017. No. 2905 Estimad@ Dr@ Víctor Valdés:

Dolor crónico post-aputación. Manejo perioperataorio. Revisión Chronic post-amputation pain: peri-operative management - Review. Srivastava D1. Author information Br J Pain. 2017 Nov;11(4):192-202. doi: 10.1177/2049463717736492. Epub 2017 Oct 9. Abstract STUDY DESIGN: Narrative review. METHOD: Eight bibliographic databases were searched for studies published in the (last five years up until Feb 2017). For the two database searches (Cochrane and DARE), the time frame was unlimited. The review involved keyword searches of the term 'Amputation' AND 'chronic pain'. Studies selected were interrogated for any association between peri-operative factors and the occurrence of chronic post amputation pain (CPAP). RESULTS: Heterogeneity of study populations and outcome measures prevented a systematic review and hence a narrative synthesis of results was undertaken. The presence of variation in two gene alleles (GCH1 and KCNS1) may be relevant for development of CPAP. There was little evidence to draw conclusions on the association between age, gender and CPAP. Pre-operative anxiety and depression influenced pain intensity post operatively and long-term post amputation pain (CPAP). The presence of pre-amputation pain is correlated to the development of acute and chronic post amputation pain while evidence for the association of post-operative pain with CPAP is modest. Regional anaesthesia and peri-neural catheters improve acute postoperative pain relief but evidence on their efficacy to prevent CPAP is limited. A suggested whole system pathway based on current evidence to optimize peri-operative amputation pain is described. CONCLUSION: The current evidence suggests that optimized peri-operative analgesia reduces the incidence of acute peri-operative pain but no firm conclusion can be drawn on reducing risk for CPAP. KEYWORDS: Amputation; chronic pain; persistent post-surgical pain; phantom limb pain; stump pain PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo LI Congreso Mexicano de Anestesiología Mérida Yucatán, Noviembre 21-25, 2017 Información / Information International Anesthesia Research Society Annuals Meetings USA Informes / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Medwave edición Noviembre-Diciembre 2017

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Estimado(a) Victor Manuel Valdes:

-----  Contenidos recientemente publicados:  ----- EDITORIAL ¿Qué son los preprints? Dra. Vivienne C. Bachelet, MSc Medwave 2017 Nov-Dic;17(9):e7091 EPISTEMONIKOS Corrección temprana versus tardía en hernia diafragmática congénita Alexandra Yunes, Matías Luco, Juan Carlos Pattillo (Chile) Medwave 2017 Nov-Dic;17(8):e7081 REVISIÓN CLÍNICA Preservación de la fertilidad en la paciente oncológica Anibal Scarella Chamy, César Díaz-García, Sonia Herraiz, Jhenifer Kliemchen Rodrigues (Internacional) Medwave 2017 Nov-Dic;17(9):e7090 Enfermedad coronaria aguda, pronóstico y prevalencia de los factores de riesgo en adultos jóvenes Alvaro Gudiño Gomezjurado, Bianca Pujol Freitas, Flavia Contreira Longatto, Juliana Negrisoli, Gustavo Aguiar Sousa (Brasil) Medwave 2017 Nov-Dic;17(9):e7088 Medwave está actualmente indizada en: MEDLINE/PubMed, Scopus (MEDLINE-sourced), LILACS, DOAJ, Emerging Sources Citation Index (WoS) de Clarivate Analytics. Envío de manuscritos originales http://ojs.medwave.cl/index.php/medwave/login ------------------------------------------------ Instrucciones a los autores http://www.medwave.cl/link.cgi/instrucciones.act ----------------------------------------------------------------- Si quiere participar como par revisor de Medwave http://www.medwave.cl/link.cgi/revisor.act ------------------------------------------------------------------ Contacto con la revista: Rodrigo Núñez publishing@medwave.cl

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Cambio de la utilización de imágenes de extremidades musculoesqueléticas desde 1994 hasta 2013

http://www.cirugiarticular.com.mx/academia/cambio-de-la-utilizacion-de-imagenes-de-extremidades-musculoesqueleticas-desde-1994-hasta-2013/

Changing Musculoskeletal Extremity Imaging Utilization From 1994 Through 2013: A Medicare Beneficiary Perspective

Fuente:

Este artículo es publicado originalmente en:

https://www.ncbi.nlm.nih.gov/pubmed/28777654

http://www.ajronline.org/doi/10.2214/AJR.17.18346



De:

Gyftopoulos S1, Harkey P2, Hemingway J3, Hughes DR3, Rosenkrantz AB1, Duszak R Jr2.

AJR Am J Roentgenol. 2017 Nov;209(5):1103-1109. doi: 10.2214/AJR.17.18346. Epub 2017 Aug 4.



Todos los derechos reservados para:

Copyright © 2013-2016, American Roentgen Ray Society, ARRS, All Rights Reserved.



Abstract

OBJECTIVE:

The objective of our study was to assess temporal changes in the utilization of musculoskeletal extremity imaging in Medicare beneficiaries over a recent 20-year period (1994-2013).



CONCLUSION:

In the Medicare population, the most common musculoskeletal extremity imaging modalities increased substantially in utilization over the 2-decade period from 1994 through 2013. Throughout that time, radiology remained the most common billing specialty, and the physician office and hospital outpatient settings remained the most common sites of service. These insights may have implications for radiology practice leaders in making decisions regarding capital infrastructure, workforce, and training investments to ensure the provision of optimal imaging services for extremity musculoskeletal care.

KEYWORDS:

MRI; extremity imaging; imaging trends; imaging utilization; musculoskeletal imaging





Resumen

OBJETIVO:

El objetivo de nuestro estudio fue evaluar los cambios temporales en la utilización de imágenes de las extremidades musculoesqueléticas en los beneficiarios de Medicare durante un período reciente de 20 años (1994-2013).

CONCLUSIÓN:

En la población de Medicare, las modalidades de imágenes de las extremidades musculoesqueléticas más comunes aumentaron sustancialmente en la utilización durante el período de 2 décadas desde 1994 hasta 2013. A lo largo de ese tiempo, la radiología siguió siendo la especialidad de facturación más común, y el consultorio médico y el entorno hospitalario sitios comunes de servicio. Estas ideas pueden tener implicaciones para los líderes de práctica de radiología en la toma de decisiones con respecto a la infraestructura de capital, la fuerza de trabajo y las inversiones de capacitación para garantizar la prestación de servicios óptimos de imágenes para la atención musculoesquelética de las extremidades.



PALABRAS CLAVE:

Resonancia magnética; imágenes de extremidades; tendencias de imagen; utilización de imágenes; imágenes musculoesqueléticas



PMID: 28777654 DOI: 10.2214/AJR.17.18346

Manejo de las lesiones del ligamento cruzado posterior: una revisión basada en la evidencia

http://www.reemplazoprotesico.com.mx/academia/manejo-de-las-lesiones-del-ligamento-cruzado-posterior-una-revision-basada-en-la-evidencia/

Management of Posterior Cruciate Ligament Injuries: An Evidence-Based Review

Fuente

Este artículo es publicado originalmente en:

https://www.ncbi.nlm.nih.gov/pubmed/27097125
https://insights.ovid.com/crossref?an=00124635-201605000-00001


De:

Bedi A1, Musahl V, Cowan JB.
J Am Acad Orthop Surg. 2016 May;24(5):277-89. doi: 10.5435/JAAOS-D-14-00326.

Todos los derechos reservados para:

Copyright © 2017 Ovid Technologies, Inc., and its partners and affiliates. All Rights Reserved.

Some content from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

Abstract

Isolated injuries of the posterior cruciate ligament are uncommon, are often caused by a posteriorly directed force to the proximal tibia, and result in abnormal knee kinematics and function. A thorough clinical evaluation, including history, physical examination, and imaging, is required to rule out a concomitant structural knee injury. No clear prognostic factors predict outcomes, and ideal management remains uncertain. Nonsurgical management is advocated for isolated grade I or II posterior cruciate ligament injuries or for grade III injuries in patients with mild symptoms or low activity demands. Surgical management is reserved for high-demand athletes or patients in whom nonsurgical management has been unsuccessful. Although biomechanical studies have identified differences between single-bundle, double-bundle, transtibial, and tibial inlay reconstruction techniques, the optimal surgical technique has not been established. No high-quality evidence is available regarding immobilization, weight-bearing, bracing, or rehabilitation protocols for patients treated either nonsurgically or surgically. Additional long-term clinical studies with homogeneous patient populations are needed to identify the ideal management of these injuries.

Resumen

Las lesiones aisladas del ligamento cruzado posterior son poco frecuentes, a menudo son causadas por una fuerza dirigida hacia la parte posterior de la tibia proximal y dan como resultado una cinemática y función anormales de la rodilla. Se requiere una evaluación clínica exhaustiva, que incluya la historia, el examen físico y las imágenes, para descartar una lesión de rodilla estructural concomitante. Ningún factor pronóstico claro predice los resultados, y la gestión ideal sigue siendo incierta. El tratamiento no quirúrgico se recomienda para lesiones aisladas de ligamentos cruzados posteriores de grado I o II o para lesiones de grado III en pacientes con síntomas leves o demandas de baja actividad. La administración quirúrgica está reservada para atletas de alta demanda o pacientes en quienes la administración no quirúrgica ha sido infructuosa. Aunque los estudios biomecánicos han identificado diferencias entre las técnicas de reconstrucción con incrustaciones de un solo paquete, doble haz, transtibiales y tibiales, no se ha establecido la técnica quirúrgica óptima. No hay evidencia disponible de alta calidad con respecto a los protocolos de inmovilización, soporte de peso, arriostramiento o rehabilitación para los pacientes tratados de forma no quirúrgica o quirúrgica. Se necesitan estudios clínicos adicionales a largo plazo con poblaciones homogéneas de pacientes para identificar el tratamiento ideal de estas lesiones.
PMID: 27097125 DOI: 10.5435/JAAOS-D-14-00326
[Indexed for MEDLINE]