ABSTRACT
Introducción. Las lesiones musculoesqueléticas traen consecuencias en los profesionales quirúrgicos, y más aún en cirujanos de cabeza y cuello, que conllevan gran carga de discapacidad y ausentismo laboral, ocasionando retiro temprano, restricciones o modificaciones en la práctica quirúrgica. Métodos. Se seleccionaron publicaciones de las bases de datos Pubmed, Embase y LILACS. Se incluyeron todos los estudios que midieron la prevalencia de lesiones musculoesqueléticas y la presencia de riesgo ergonómico, síntomas asociados, uso de escalas de medición y estrategias de prevención. Los efectos estimados de los estudios se mostraron con intervalo de confianza del 95 %. Resultados. Se encontraron 438 estudios. Después de la revisión, se incluyeron 7 estudios, con un total de 868 pacientes. Se estimó mediante un metaanálisis de efectos aleatorios una prevalencia del 81 %. Conclusiones. Los problemas posturales en cirujanos de cabeza y cuello tienen una prevalencia de 81 %. Esto genera un gran impacto en su salud física y mental, aumentando las incapacidades y pérdida de años laborales. Las herramientas utilizadas para la evaluación son heterogéneas y algunos estudios no incluyen datos como los años de práctica y el nivel de entrenamiento.
Introduction. Musculoskeletal injuries have consequences for surgical professionals, and even more so for head and neck surgeons, which entail a large burden of disability and absenteeism from work, causing early retirement, restrictions or modifications in surgical practice. Methods. Publications were selected from the Pubmed, Embase and LILACS databases. All studies that measured the prevalence of musculoskeletal injuries and the presence of ergonomic risk, associated symptoms, use of measurement scales and prevention strategies were included. The estimated effects of the studies were shown with a 95% confidence interval. Results. 438 studies were found. After the review, seven studies were included, with a total of 868 patients. A prevalence of 81% was estimated through a random effects meta-analysis. Conclusions. Postural problems in head and neck surgeons have a prevalence of 81%. This generates a great impact on their physical and mental health, increasing disabilities and loss of working years. The tools used for evaluation are heterogeneous and some studies do not include data such as years of practice and level of training.
Subject(s)
Humans , Meta-Analysis , Musculoskeletal Pain , Systematic Review , Risk , Surgeons , Head , NeckSubject(s)
Humans , Health , Mental Health , Surgeons , Research , Suicide , Psychological Well-Being , ErgonomicsABSTRACT
Objective: To describe the pro file of surgeons who treat patients with inflammatory bowel disease as well as the characteristics of inflammatory bowel disease care, unmet demands, and difficulties. Methods: The research participants answered a Google Forms questionnaire. Results: Of the 99 surgeons who participated in the survey, 84.5% were coloproctologists, 40% were from the southeastern region of Brazil, and 77.7% were male and had been working for more than 19 years. Regarding the healthcare sector, 63.6% of surgeons worked in both public and private clinics, and most clinically cared for up to 50 patients with inflammatory bowel disease and operated on up to 5 cases per year. Conclusion: This is the first national study that aimed to identify the profile of surgeons working with inflammatory bowel disease in Brazil. The vast majority are experienced male coloproctologists, located in the southern and southeastern regions, who perform clinical and surgical treatment of these pathologies, with major surgeries being performed in large centers by a small number of surgeons. (AU)
Subject(s)
Inflammatory Bowel Diseases , Surgeons/statistics & numerical data , Colitis, Ulcerative/surgery , Crohn Disease/surgery , Surveys and QuestionnairesABSTRACT
Background Morbidity and mortality following emergency surgeries can be reduced with timely access to emergency surgery and five billion people globally, lack access to essential surgery. Data on the determinants of these are still lacking. Objectives We studied resident doctors' perspectives of the patient-, healthcare-giver-, and health-institution-related determinants of access to emergency surgery at the University College Hospital, Ibadan, Nigeria. Methodology This self-administered, questionnaire-based, cross-sectional survey involved eighty-five resident doctors; recruited using systematic random sampling. Ethical approval (UI/EC/20/0318) and prospective registration (NCT04487496) were obtained. Results Major patient-related sources of delays included financial constraints (97.7%), patient's consent (78.8%), guardian's consent (74.1%) and diagnosis denial (70.6%). Anaesthetists (65.9%) caused and surgeons (61.2%) reduced delays. The healthcare-giver factors were provision of blood (84.7%), optimization of patient (83.5%), unavailable theatre space (82.4%), anaesthetic personnel fatigue (67.1%), surgical personnel fatigue (43.5%) and time-to-diagnosis (58.8%). Diagnostic delays were mostly from investigations (97.6%) and missed diagnosis (47.1%). Unavailable bedspace (82.4%), delays in arrival (82.4%) and entry (74.1%) into the theatre were major health institution challenges. Establishing diagnosis was delayed by payment for (96.5%) and doing (88.2%) diagnostic investigations, and time-to-review by specialist team (80.0%). Arrival in theatre was affected by theatre trolley conveying patient (70.6%), pre-anaesthesia review (70.6%) and pre-operative nursing logistics (64.7%). Entry into the suite depended on payment/payment deferment (87.06%) and suites being unavailable (75.3%). Conclusion patient, and the surgical procedure. The patient factors were poor finances, diagnosis denial and giving of consent for surgery. We encourage (recommend) physician-run point-of-care diagnostics in emergency rooms (ER), with improved health insurance coverage, ER bedspace, and personnel (surgical and anaesthesiological).
Subject(s)
General Surgery , Surgical Procedures, Operative , Cross-Sectional Studies , Delivery of Health Care , Emergencies , Emergency Service, Hospital , Point-of-Care Testing , Missed Diagnosis , SurgeonsABSTRACT
Francisco Javier Muñiz nació en Monte Grande en 1795 y se graduó de médico en la Facultad de Medicina de la Universidad de Buenos Aires en 1822. Además de la medicina y la paleontología, Muñiz se desempeñó como cirujano de guerra en la guerra con el Brasil y en la guerra de la Triple Alianza. En 1871, encontrándose jubilado, se ofrece como voluntario en la lucha contra la epidemia de fiebre amarilla que asoló a la ciudad de Buenos Aires provocando 14.467 muertos. Muñiz falleció el 8 de abril de 1871 en cumplimiento del deber, contagiado de fiebre amarilla. Médico, periodista, paleontólogo, descubridor de la vacuna nativa contra la viruela y realizador de apuntes de lingüística, Francisco Javier Muñiz, representa uno de los grandes ejemplos para la sociedad argentina. (AU)
Francisco Javier Muñiz was born in Monte Grande in 1795 and graduated as a physician from the Faculty of Medicine of the University of Buenos Aires in 1822. In addition to medicine and paleontology, Muñiz served as a military surgeon in the War with Brazil and in the War of the Triple Alliance. In 1871, when he was retired, he volunteered to fight the yellow fever epidemic that devastated the city of Buenos Aires, causing 14,467 deaths. Muñiz died in the line of duty on April 8, 1871, infected with yellow fever. Doctor, journalist, paleontologist, discoverer of the native vaccine against smallpox and linguistic note-taker, Francisco Javier Muñiz is one of the great examples for Argentinian society. (AU)
Subject(s)
History, 19th Century , Yellow Fever/history , Armed Conflicts/history , Surgeons/history , Paleontology/history , Argentina , Physicians/history , Brazil , History of MedicineABSTRACT
Introducción: La fractura de radio distal resulta común en la extremidad superior y representa un reto terapéutico. Objetivo: Determinar la concordancia entre radiografía simple y tomografía computarizada con respecto a las clasificaciones AO Foundation y de Fernández, y la elección del tratamiento. Métodos: Se realizó un estudio de concordancia diagnóstica entre radiografía simple y tomografía computarizada. Ortopedistas y cirujanos de mano analizaron 19 imágenes de fracturas de radio distal de acuerdo con las clasificaciones AO Foundation y de Fernández, y las distintas opciones de tratamiento. Para el grado de concordancia se usó el coeficiente Kappa de Fleiss. La prueba de t-Student y Chi cuadrado diferenciaron los grupos para variables cuantitativas y cualitativas, respectivamente. Hubo una significancia estadística de p= 0,05. Resultados: La clasificación de Fernández coincidió mejor que la clasificación AO Foundation entre radiografía y tomografía computarizada. En la elección del tratamiento y la técnica de osteosíntesis la concordancia fue mayor al 90 por ciento, mientras que el abordaje quirúrgico solo alcanzó el 50 por ciento. La clasificación AO Foundation radiográfica se correspondió con fracturas complejas, mientras la de Fernández con las menos complicadas. Las fracturas se subestimaron cuando se clasificaron con radiografía. Conclusiones: La relación de las clasificaciones entre radiografía y tomografía computarizada para fracturas de radio distal no resulta satisfactoria. La tomografía computarizada ofrece información que modifica las decisiones en el tratamiento(AU)
Introduction: Distal radius fracture is common in the upper extremity and represents a therapeutic challenge. Objective: To determine the agreement between simple radiography and computed tomography with respect to AO Foundation and Fernández classifications, and the choice of treatment. Methods: A diagnostic agreement study was carried out between simple radiography and computed tomography. Orthopedists and hand surgeons analyzed 19 images of distal radius fractures according to AO Foundation and Fernández classifications, and the different treatment options. Fleiss Kappa coefficient was used for the degree of agreement. The Student's t-test and chi-square differentiated the groups for quantitative and qualitative variables, respectively. There was a statistical significance of p = 0.05. Results: Fernández classification coincided better than AO Foundation between radiography and computed tomography. In the choice of treatment and osteosynthesis technique, agreement was greater than 90 percent, while the surgical approach only reached 50 percent. The radiographic AO Foundation classification corresponded to complex fractures while Fernández classification corresponded to less complicated ones. Fractures were underestimated when classified with radiography. Conclusions: The relationship of classifications between radiography and computed tomography for distal radius fractures is not satisfactory. Computed tomography provides information that modifies treatment decisions(AU)
Subject(s)
Humans , Radiography/classification , Tomography, X-Ray Computed/classification , Reproducibility of Results , Fracture Fixation, Internal/methods , Wrist Fractures/therapy , Surgeons , Orthopedic SurgeonsABSTRACT
En este artículo el autor primero relata su ingreso y su formación como cirujano en la Escuela Finochietto; comparte sus sentires íntimos, las anécdotas y las experiencias vividas junto a discípulos directos de Ricardo Finochietto, en particular con su maestro, Delfín Luis Vilanova. Más adelante, el relato cuenta sobre su especialización como cirujano plástico junto al Dr. José Alberto Cerisola, también discípulo directo de Finochietto. Y por último, el autor habla sobre su proceso de «mutación¼ de cirujano a terapeuta y sobre cómo influyó la formación como cirujano en la Escuela en el desarrollo de la técnica terapéutica que emplea. (AU)
In this article, the author first relates his admission and training as a surgeon at the Finochietto School. He shares his intimate feelings, anecdotes and experiences with direct disciples of Ricardo Finochietto, particularly with his teacher, Delfín Luis Vilanova. Later on, he talks about his specialization as a plastic surgeon together with Dr. José Alberto Cerisola, also a direct disciple of Finochietto. Finally, he refers to the process of "mutation" from surgeon to therapist and how his training as a surgeon at the School influenced the development of the therapeutic technique that he uses. (AU)
Subject(s)
History, 20th Century , Schools, Medical/history , General Surgery/history , Surgeons , Argentina , History of Medicine , Hospitals , Internship and ResidencyABSTRACT
La Asociación Médica Argentina (AMA) reconoce el valor de la Escuela Quirúrgica de los hermanos Finochietto y por tal motivo efectúa un homenaje anual desde el año 2002. En este artículo se hace una breve reseña histórica del Hospital Rawson, donde se inició y desarrolló dicha escuela. Se resaltan dos hechos: por un lado, el término "diáspora finochiettista", porque la dispersión de los cirujanos fue obligada y tuvieron que abandonar su lugar de procedencia original, el Hospital Rawson y, por el otro, que dicho nosocomio nació y murió como consecuencia de movimientos políticos cívico-militares. (AU)
The Argentine Medical Association (AMA) recognizes the value of the Surgical School of the Finochietto brothers, and for this reason has paid an annual tribute since 2002. Tthis article provides a brief historical review of the Rawson Hospital, where the school was initiated and developed. Two facts are highlighted: on the one hand, the term "Finochiettista diaspora" because the dispersal of the surgeons was forced and they had to leave their original place of origin, the Rawson Hospital; and on the other hand, the fact that this hospital was born and died as a consequence of civil-military political movements. (AU)
Subject(s)
History, 19th Century , History, 20th Century , Schools, Medical/history , Surgeons/history , Hospitals/history , Argentina , Societies, Medical , History of MedicineABSTRACT
Introducción: La inteligencia emocional es una habilidad blanda, definida como la capacidad de reconocer las emociones propias y ajenas para gestionarlas frente a otros de manera adecuada. Este tipo de inteligencia se relaciona con competencias y aptitudes humanas en diferentes áreas sociales, académicas y de trabajo. Objetivo: Describir el papel de la inteligencia emocional en la práctica clínica de los residentes médicos, como marco de referencia para su aplicación en la educación teórico-práctica y la realización de futuras investigaciones. Métodos: Se realizó una revisión de la literatura en las bases de datos PubMed, LILACS y Google Scholar. Se emplearon operadores lógicos mediante distintas combinaciones: MeSH: Emotional Intelligence, Medical Residencies, Education, Medical, Education, Medical, Graduate; y DeCS: Inteligencia Emocional, Residencia Médica, Educación Médica, Educación de Postgrado en Medicina. La búsqueda se limitó por año, idioma y acceso libre, teniendo en cuenta criterios de inclusión y exclusión. Se obtuvieron 279 resultados, de los cuales fueron seleccionados 26 para ser incluidos en la revisión y síntesis de los resultados. Resultados: Los resultados se organizaron según su relación con la inteligencia emocional en: medición en residentes médico-quirúrgicos, niveles de estrés y burnout, empatía en la relación médico-paciente, desempeño académico, bienestar y satisfacción laboral. Conclusiones: La inteligencia emocional en los residentes médico-quirúrgicos se ha relacionado con menores niveles de estrés y burnout, comunicación asertiva, mayor empatía con los pacientes y calidad en la atención médica; además, con elevado rendimiento académico, mejores habilidades de enseñanza, liderazgo y motivación; y, finalmente, con mejor bienestar psicológico, satisfacción laboral y rendimiento clínico(AU)
Introduction: Emotional intelligence is a soft skill, defined as the ability to recognize one's own and others' emotions in view of managing them in front of others adequately. This type of intelligence is related to human competences and skills in different social, academic and occupational areas. Objective: To describe the role of emotional intelligence in the clinical practice of medical residents, as a frame of reference for its application in theoretical-practical education and the development of future research. Methods: A literature review was carried out in the PubMed, LILACS and Google Scholar databases. Logical operators were used by means of different combinations from the Medical Subject Headings: Emotional Intelligence, Medical Residencies, Education, Medical, Education, Medical, Graduate. The following combinations from the Health Sciences Descriptors were also used: "Inteligencia Emocional [emotional Intelligence], Residencia Médica [medical residence], Educación Médica [medical education], Educación de Postgrado en Medicina [postgraduate education in Medicine]. The search was limited by year, language and free access, taking into account inclusion and exclusion criteria. A total of 279 results were obtained, of which 26 were selected to be included in the review and synthesis. Results: The results were organized, according to their relationship with emotional intelligence, in measurement in medical-surgical residents, levels of stress and burnout, empathy in the doctor-patient relationship, academic performance, well-being, and job satisfaction. Conclusions: Emotional intelligence in medical-surgical residents has been related to lower levels of stress and burnout, assertive communication, greater empathy with patients, and quality in medical care; furthermore, with high academic performance, better skills for teaching, leadership and motivation; and, finally, with better psychological well-being, job satisfaction and clinical performance(AU)
Subject(s)
Humans , Preceptorship/methods , Professional Competence , Emotional Intelligence , Physician-Patient Relations , Empathy , Surgeons/education , Medical Staff, Hospital/educationABSTRACT
BACKGROUND@#Total knee arthroplasty (TKA) can reduce severe joint pain and improve functional disability in hemophilia. However, the long-term outcomes have rarely been reported in China. Therefore, this study aimed to evaluate the long-term outcomes and complications of TKA in Chinese patients with hemophilic arthropathy.@*METHODS@#We retrospectively reviewed patients with hemophilia who underwent TKA between 2003 and 2020, with at least 10 years of follow-up. The clinical results, patellar scores, patients' overall satisfaction ratings, and radiological findings were evaluated. Revision surgery for implants during the follow-up period was recorded.@*RESULTS@#Twenty-six patients with 36 TKAs were successfully followed up for an average of 12.4 years. Their Hospital for Special Surgery Knee Score improved from an average of 45.8 to 85.9. The average flexion contracture statistically significantly decreased from 18.1° to 4.2°. The range of motion (ROM) improved from 60.6° to 84.8°. All the patients accepted patelloplasty, and the patients' patellar score improved from 7.8 preoperatively to 24.9 at the last follow-up. There was no statistically significant difference in clinical outcomes between the unilateral and bilateral procedures, except for a better ROM at follow-up in the unilateral group. Mild and enduring anterior knee pain was reported in seven knees (19%). The annual bleeding event was 2.7 times/year at the last follow-up. A total of 25 patients with 35 TKAs were satisfied with the procedure (97%). Revision surgery was performed in seven knees, with 10- and 15-year prosthesis survival rates of 85.8% and 75.7%, respectively.@*CONCLUSIONS@#TKA is an effective procedure for patients with end-stage hemophilic arthropathy, which relieves pain, improves knee functions, decreases flexion contracture, and provides a high rate of satisfaction after more than ten years of follow-up.