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BACKGROUND AND OBJECTIVE: Burnout syndrome is a mental health disorder due to chronic occupational stress. Both burnout and associated comorbidities are prevalent among health care professionals, being medical residents a vulnerable group. Despite this, the scientific medical literature currently available on this issue in dermatology residents is scarce. The aim of this study was to analyze the prevalence of the burnout syndrome, anxiety, and depression in dermatology residents, and the associated risk factors. MATERIAL AND METHOD: This was a cross-sectional trial designed to include dermatology residents from Spain (from December 2022 through June 2023). A self-administered form was sent via online messaging applications, including validated scales to study professional quality of life, burnout syndrome, anxiety, and depression. RESULTS: A total of 48 dermatology residents were included in the study, 50% of whom (24/48) were women, with a mean age of 27 years (1.25). A total of 58.33% (28/48) of the residents had some degree of anxiety, 22.9% (11/48) some degree of depression, and 23.4% a moderate risk of burnout (11/48). Workload was the main risk factor associated with the 3 disorders studied, while managerial support or intrinsic motivation seem to play a protective role. CONCLUSIONS: Burnout syndrome and its comorbidities are both prevalent in dermatology residents in Spain and closely related to each other.
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BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had typical scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of the cases of scabies studied, the patient had already received treatment. In those cases, we observed several remediable shortcomings that could explain why some of these treatments had failed. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.
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Escabiosis , Humanos , Femenino , Escabiosis/tratamiento farmacológico , Escabiosis/epidemiología , España/epidemiología , Estudios Transversales , Insuficiencia del Tratamiento , Academias e InstitutosRESUMEN
BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had clinical features of classic scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of scabies cases, the patient has already received treatment. In those cases, we observe several remediable shortcomings that could explain why some of these treatments fail. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.
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Escabiosis , Humanos , Femenino , Escabiosis/diagnóstico , Escabiosis/tratamiento farmacológico , Escabiosis/epidemiología , España/epidemiología , Estudios Transversales , Insuficiencia del Tratamiento , Academias e InstitutosRESUMEN
Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact. The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections. This document analyzes the epidemiological, clinical, therapeutic, and control characteristics of 2 sexually transmitted parasitosis: scabies due to Sarcoptes scabiei var. hominis, and pubic pediculosis due to Phthirus pubis. Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired. This specific feature creates particularities in the management and control of the infestation.
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COVID-19 , Niño , Humanos , Hospitales Pediátricos , Hospitalización , SARS-CoV-2 , Pruebas Diagnósticas de Rutina , Prueba de COVID-19RESUMEN
No disponible
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Humanos , Niño , Atención Perioperativa/métodos , Atención a la Salud/organización & administración , Infecciones por Coronavirus/epidemiología , Hospitales Pediátricos/estadística & datos numéricos , Estrategias de Salud Locales , Precauciones Universales/métodos , Pandemias , Infecciones por Coronavirus/prevención & controlAsunto(s)
Betacoronavirus , Servicios de Salud del Niño/organización & administración , Infecciones por Coronavirus/epidemiología , Servicios Médicos de Urgencia/organización & administración , Hospitales Pediátricos/organización & administración , Atención Perioperativa , Neumonía Viral/epidemiología , COVID-19 , Niño , Cuidados Críticos/organización & administración , Humanos , Pandemias , Asignación de Recursos/organización & administración , SARS-CoV-2 , España/epidemiologíaRESUMEN
INTRODUCCIÓN: La versión digital de las escalas de valoración recomendadas para el paciente pediátrico podría contribuir a su mejora y a implementar los indicadores de calidad descritos para el manejo del dolor agudo. MATERIAL Y MÉTODOS: Desarrollo de una aplicación electrónica (PainAPPle) que incorpora versiones de las escalas de valoración del dolor y efectos secundarios validados para cada edad, así como las estrategias terapéuticas aceptadas para el manejo del dolor agudo en pacientes pediátricos. Validación psicométrica (validez y fiabilidad) de las escalas incorporadas en 44 pacientes de 4 a 18 años de la unidad de dolor agudo, aplicándoles ambos formatos (papel y electrónico) de todas las escalas en dos mediciones con 30 min de diferencia. Evaluación de los datos recogidos por PainAPPle en pacientes pediátricos a cargo de dicha unidad. RESULTADOS: La fiabilidad se estudió analizando la correlación (Spearman mayor de 0,5, p < 0,001) que obtuvimos para las distintas escalas en dos momentos con 30 min de diferencia, en los mismos pacientes. Para la validez se analizó la correlación (Spearman mayor de 0,5, p < 0,001) entre los valores de las escalas en papel (regla de oro) y en PainAPPle tanto en el minuto 0 como en el minuto 30. Los niveles de concordancia obtenidos teniendo en cuenta el punto de corte de las escalas que obligaría a un tratamiento fueron también estadísticamente significativos (p < 0,005). CONCLUSIONES: PainAPPle es un instrumento validado para el manejo del dolor agudo en pacientes pediátricos. Los datos recogidos permiten aplicar los indicadores de calidad descritos para el manejo del dolor agudo postoperatorio
INTRODUCTION: The digital version of the assessment scales recommended for the pediatric patient could contribute to its improvement and to implement the quality indicators described for the management of acute pain. MATERIAL AND METHODS: Psychometric validation (validity and reliability) of pain assessment and treatment side effects scales incorporated in the electronic application PainAPPle. For this, both formats (paper and electronic) of all the scales were applied in two measurements with 30 minutes of difference in 44 patients from 4 to 18 years of the Acute Pain Unit in the immediate postoperative period. In addition, the data collected by PainAPPle was evaluated by retrospectively applying the quality indicators described for the management of acute postoperative pain. RESULTS: Reliability was studied analyzing the high correlation (Spearman greater than 0.5, P<.001) that we obtained for the values of each scale in two moments with 30minutes of difference, in the same patients. For validity, the high correlation (Spearman greater than 0.5, P<.001) between the values of the paper scales (gold rule) and PainAPPle at both minute 0 and 30 was analyzed. Concordance obtained taking into account the cut-off point of the scales that would force a treatment were also statistically significant (P<.005). CONCLUSIONS: PainAPPle is a validated instrument for the management of acute pain in pediatric patients. The collected data allow to apply the quality indicators described for the management of acute postoperative pain
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Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Aplicaciones Móviles , Dimensión del Dolor/instrumentación , Dimensión del Dolor/métodos , Dolor Postoperatorio/diagnóstico , Dolor Agudo/diagnóstico , Reproducibilidad de los ResultadosRESUMEN
Las complicaciones inducidas por anestesia general (AG) y relajación neuromuscular (RNM) en cirugía de masa mediastínica anterior pueden ser graves, sobre todo si existe clínica de compresión de la vía aérea o grandes vasos, como disnea u ortopnean entre otros. Es preferible realizar el procedimiento en ventilación espontánea para evitar el colapso respiratorio o cardiovascular por decúbito supino o por pérdida de la presión negativa intratorácica con la AG y RNM. En caso de precisar decúbito supino y RNM se realizarán paso a paso con técnicas de rescate preparadas (posición de rescate, broncoscopio, esternotomía). Una correcta evaluación preoperatoria, adecuada planificación y abordaje multidisciplinar permiten realizar una anestesia y cirugía seguras. Presentamos el caso de un niño con antecedentes de ortopnea severa con diagnóstico de masa mediastínica anterior, linfoma linfoblástico (parada respiratoria y colapso cardiovascular en sedación para punción lumbar y biopsia de médula ósea) que no responde al tratamiento médico y precisa cirugía de resección bajo AG con RNM
Complications induced by general anesthesia (GA) and neuromuscular relaxation (NMR) in anterior mediastinal mass (AMM) resection can be serious, especially when there are signs of compression of the airway or large vessels (dyspnea, orthopnea, etc.) (1). It is preferable to perform the procedure in spontaneous ventilation to avoid respiratory or cardiovascular collapse due to the supine position or to loss of negative intrathoracic pressure with GA and NMR. If the supine position and NMR are unavoidable, procedures should be performed in a step-wise manner, and rescue strategies should be prepared (rescue position, bronchoscope, sternotomy). Correct preoperative evaluation, adequate planning, and a multidisciplinary approach will ensure patient safety. We present the case of a child with a history of severe orthopnea and a diagnosis of AMM and lymphoblastic lymphoma (respiratory arrest and cardiovascular collapse during sedation for lumbar puncture and bone marrow biopsy) that did not respond to medical treatment and required resection surgery under GA with NMR
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Humanos , Masculino , Niño , Enfermedades del Mediastino/cirugía , Leucemia-Linfoma Linfoblástico de Células Precursoras/cirugía , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Enfermedades del Mediastino/etiología , Anestesia General/métodos , Anestesia General/efectos adversos , Enfermedades del Mediastino/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Punción Espinal , Broncoscopios , ToracostomíaRESUMEN
INTRODUCTION: The digital version of the assessment scales recommended for the pediatric patient could contribute to its improvement and to implement the quality indicators described for the management of acute pain. MATERIAL AND METHODS: Psychometric validation (validity and reliability) of pain assessment and treatment side effects scales incorporated in the electronic application PainAPPle. For this, both formats (paper and electronic) of all the scales were applied in two measurements with 30minutes of difference in 44 patients from 4 to 18years of the Acute Pain Unit in the immediate postoperative period. In addition, the data collected by PainAPPle was evaluated by retrospectively applying the quality indicators described for the management of acute postoperative pain. RESULTS: Reliability was studied analyzing the high correlation (Spearman greater than 0.5, P<.001) that we obtained for the values of each scale in two moments with 30minutes of difference, in the same patients. For validity, the high correlation (Spearman greater than 0.5, P<.001) between the values of the paper scales (gold rule) and PainAPPle at both minute 0 and 30 was analyzed. Concordance obtained taking into account the cut-off point of the scales that would force a treatment were also statistically significant (P<.005). CONCLUSIONS: PainAPPle is a validated instrument for the management of acute pain in pediatric patients. The collected data allow to apply the quality indicators described for the management of acute postoperative pain.
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Dolor Agudo/diagnóstico , Manejo del Dolor/métodos , Dimensión del Dolor/métodos , Dolor Postoperatorio/diagnóstico , Programas Informáticos , Dolor Agudo/terapia , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Masculino , Dolor Postoperatorio/terapia , Psicometría , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
Complications induced by general anesthesia (GA) and neuromuscular relaxation (NMR) in anterior mediastinal mass (AMM) resection can be serious, especially when there are signs of compression of the airway or large vessels (dyspnea, orthopnea, etc.) (1). It is preferable to perform the procedure in spontaneous ventilation to avoid respiratory or cardiovascular collapse due to the supine position or to loss of negative intrathoracic pressure with GA and NMR. If the supine position and NMR are unavoidable, procedures should be performed in a step-wise manner, and rescue strategies should be prepared (rescue position, bronchoscope, sternotomy). Correct preoperative evaluation, adequate planning, and a multidisciplinary approach will ensure patient safety. We present the case of a child with a history of severe orthopnea and a diagnosis of AMM and lymphoblastic lymphoma (respiratory arrest and cardiovascular collapse during sedation for lumbar puncture and bone marrow biopsy) that did not respond to medical treatment and required resection surgery under GA with NMR.
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Anestesia/métodos , Linfoma de Células T/cirugía , Neoplasias del Mediastino/cirugía , Posicionamiento del Paciente/métodos , Biopsia/métodos , Niño , Humanos , Linfoma de Células T/diagnóstico por imagen , Masculino , Neoplasias del Mediastino/diagnóstico por imagen , Sedestación , Tomografía Computarizada por Rayos XRESUMEN
No disponible
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Humanos , Estudios de Validación como Asunto , Encuestas y Cuestionarios , Alopecia/epidemiología , Calidad de Vida , Autoimagen , Alopecia/psicologíaRESUMEN
No disponible
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Humanos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Enfermedades de la Piel/epidemiología , Calidad de Vida , Perfil de Impacto de EnfermedadRESUMEN
Osteoporosis (OP) is highly prevalent in rheumatoid arthritis (RA) and is influenced by genetic factors. Single-nucleotide polymorphism (SNP) rs2073618 in the TNFRSF11B osteoprotegerin (OPG) gene has been related to postmenopausal OP although, to date, no information has been described concerning whether this polymorphism is implied in abnormalities of bone mineral density (BMD) in RA. We evaluated, in a case-control study performed in Mexican-Mestizo women with RA, whether SNP rs2073618 in the TNFRSF11B gene is associated with a decrease in BMD. RA patients were classified as follows: (1) low BMD and (2) normal BMD. All patients were genotyped for the rs2073618 polymorphism by PCR-RFLP. The frequency of low BMD was 74.4%. Higher age was observed in RA with low BMD versus normal BMD (62 and 54 years, resp.; p < 0.001). Worse functioning and lower BMI were observed in RA with low BMD (p = 0.003 and p = 0.002, resp.). We found similar genotype frequencies in RA with low BMD versus RA with normal BMD (GG genotype 71% versus 64.4%, GC 26% versus 33%, and CC 3% versus 2.2%, resp.; p = 0.6). We concluded that in Mexican-Mestizo female patients with RA, the rs2073618 polymorphism of the TNRFS11B gene is not associated with low BMD.