Burn-out of urologists in the county of Schleswig-Holstein, Germany: a comparison of hospital and private practice urologists.

PURPOSE: Mental and physical burden of physicians, especially surgeons, is high. The degree of burn-out was estimated among urologists in the German federal county of Schleswig-Holstein, with special emphasis on differences related to age, qualification and hospital versus private practice. MATERIALS AND METHODS: The Maslach Burnout Inventory was mailed to all urologists and urologists in training registered in the county of Schleswig-Holstein to determine the frequency and intensity of the 3 burn-out subscales of emotional exhaustion, depersonalization and low personal accomplishment, together with a questionnaire covering demographic data. RESULTS: Of 128 urologists 75 (58.6%) replied. Levels of burn-out in the subscales of emotional exhaustion and depersonalization were increased among hospital urologists, urologists in training and urologists younger than 45 years. Urologists in private practices, fully trained urological specialists and urologists older than 45 years showed a low degree of burn-out, corresponding to normal values, whereas young urologists in training and working in hospitals had the highest risk of burn-out. The personal accomplishment level was generally high in all groups. CONCLUSIONS: The constellation of being a urologist in private practice and older than 45 years appears to provide some protection against burn-out that might be due to a more personal relationship to the patients, lesser hierarchical situation and workload related income. In times of increasing pressure on the health care system, the personal situation of physicians in training should not be overlooked.

Thiamine repression and pyruvate decarboxylase autoregulation independently control the expression of the Saccharomyces cerevisiae PDC5 gene.

The Saccharomyces cerevisiae gene PDC5 encodes the minor isoform of pyruvate decarboxylase (Pdc). In this work we show that expression of PDC5 but not that of PDC1, which encodes the major isoform, is repressed by thiamine. Hence, under thiamine limitation both PDC1 and PDC5 are expressed. PDC5 also becomes strongly expressed in a pdc1delta mutant. Two-dimensional gel electrophoresis of whole protein extracts shows that thiamine limitation stimulates the production of THI gene products and of Pdc5p. Deletion of PDC1 only stimulates production of Pdc5p. We conclude that the stimulation of PDC5 expression in a pdc1delta mutant is not due to a response to thiamine limitation.

[Habitual patella dislocation and Goldthwait's surgery]. / Habituelle Patellaluxation und Operation nach Goldthwait.

In this study 17 patients with recurrent dislocation of the patella were followed up 10 years after Goldthwait-operation. The subjective and clinical findings were excellent rsp. good in 70%, whereas the x-ray findings showed osteoarthritis of the femoropatellar joint in 60%. Concerning the aetiopathological factors we found an increased external torsion of the afflicted extremity measured by computed tomography.