Workplace aggressions on hospital workers: A current and prevalent problem with a high demand for training.

BACKGROUND: Workplace aggressions on hospital workers is a very frequent and under-reported problem. OBJECTIVE: The novel objective of our study was to analyze the number of workplace aggressions per hospital worker. Other objectives of the study were to analyze the management knowledge and interest in receiving training on aggressions by hospital workers. METHODS: An anonymous survey was handed out among all professionals in a university hospital. RESULTS: A total of 1118 anonymous surveys were collected. The responders declared that throughout their working life they had suffered some sort of verbal aggression in the hospital in 766 cases (68.5%) and physical aggression in 393 cases (35.2%). Multiple logistic regression analyses found higher risk of receiving physical and verbal aggression in the nursing category and in the Emergency, Critical Care or Psychiatry Units, and a higher risk of receiving physical aggression in women. The score on the level of personal knowledge regarding the legal, physical, and psychological management of aggressions (score 0-10 for each of the 3 aspects) was 2.91±2.68 in legal management, 2.97±2.77 in psychological management and 2.91±2.76 in physical management. The opinion about the interest of receiving training (score from 0 to 10) on the legal management of hospital aggressions was 8.90±1.72, on psychological management was 8.85±1.78 and on physical management was 8.88±1.78. CONCLUSIONS: Workplace aggression on hospital workers mainly affects women, the nursing category and the Emergency, Critical Care or Psychiatry Units. Hospital workers showed little knowledge on the topic but a great interest in receiving training.

[Prevalence of the expression of the MLH1 and MSH2 genes in colorectal serrated polyps and its correlation with morphological and cytoarchitectural characteristics]. / Prevalencia de expresión de genes MLH1 y MSH2 en pólipos serrados colorrectales y su correlación morfológica y citoarquitectural.

INTRODUCTION: Serrated polyps of the large intestine comprise a diverse group of lesions of the colonic mucosa that includes hyperplastic polyps, sessile serrated adenomas and traditional serrated adenomas. These lesions have been considered precursors of colorectal carcinogenesis associated with microsatellite instability. OBJECTIVE: To determine the prevalence of the MLH1 y MSH2 mutations in serrated polyps and to correlate with morphological and cytoarchitectural characteristics. METHODS: A descriptive study of 164 serrated colorectal polyps was performed. Tissue microarray technique was used to analyze their morphological and cytoarchitectural features and immunohistochemical expression of the MLH1 and MSH2 mutated genes in different regions of the colonic crypts. RESULTS: One-hundred and fifty-nine hyperplastic polyps, 2 sessile serrated adenomas and 3 traditional serrated adenomas were included. There was no significant difference in the immunohistochemical expression between hyperplastic polyps and serrated adenomas for MLH1 and MSH2. Moreover, the degree of expression decreased from the base toward the surface of the crypt where it was negative. This finding was not a sufficient to qualify for microsatellite instability. CONCLUSIONS: The prevalence of the MLH1 and MSH2 mutated genes were similar between hyperplastic polyps and serrated adenomas. No correlation was found with morphological and cytoarchitectural characteristics.

Technical modifications for laparoscopic appendetomy and other pelvic procedures using microinstruments.

Reusable microinstruments are used in a modification of the three-port technique for laparoscopic appendectomy and other pelvic procedures; the method is described herein. Fifty-seven consecutive patients were operated upon using this technique. There was no mortality; there were two minor complications and no conversions to laparotomy. Pain medication needs were minimal in all patients, and the cosmetic results were excellent. The use of microinstruments for pelvic laparoscopic procedures is safe and cost-effective using the technical modifications described.