Prevalence of the burnout syndrome among Brazilian medical oncologists.

INTRODUCTION: Burnout syndrome which is prevalent among oncologists is characterized by three aspects: emotional exhaustion, depersonalization and low personal accomplishment. The purpose was to evaluate prevalence of the burnout syndrome among Brazilian medical oncologists and the variables that correlate with its presence. METHODS: A survey was conducted with members of the Brazilian Society of Medical Oncology (SBOC) who received three questionnaires (general, Maslach burnout questionnaire and an opinion survey) mailed to all 458 members. RESULTS: Response rate was of 22.3%. According to the criteria proposed by Grunfeld, which consider burnout present when at least one of the aspects is severely abnormal, prevalence of this syndrome was 68.6% (95% confidence interval, CI: 58.68% to 77.45%). By multivariate analysis having a hobby/physical activity, a religious affiliation, older age, living with a companion and rating vacation time as sufficient were correlated significantly and independently with burnout syndrome. CONCLUSIONS: The burnout syndrome is prevalent among Brazilian oncologists. Oncologists having sufficient personal and social resources to engage in a hobby, physical activity, have enough vacation time and religious activities are at lower risk of developing burnout.

Surgical biatrial ablation of atrial fibrillation: initial results.

OBJECTIVE: To evaluate the results of intraoperative radiofrequency ablation with biatrial procedure in the treatment of chronic atrial fibrillation in patients with associated cardiac disease. METHODS: Between February 2008 and May 2009, 15 consecutive patients were underwent mitral valve procedure plus modified radiofrequency biatrial ablation of chronic atrial fibrillation. The mean age was 47.73 +/- 9.85 years and 60% were male. The mean left atrial diameter was 55.06 +/- 7.56 mm. RESULTS: There were no hospital mortality or complications related to radiofrequency ablation. The mean follow-up period was 7 +/- 4 months. At the time of hospital discharge nine (60%) patients were in sinus rhythm. After a mean follow-up period 11 (73.3%) were in sinus rhythm. CONCLUSION: Intraoperative biatrial radiofrequency ablation is a safe and effective technique for the treatment of chronic atrial fibrillation, with satisfactory midterms outcomes in terms of conversion to sinus rhythm.

Right coronary bypass grafting with coronary-coronary venous bypass graft.

OBJECTIVE: The following report describes the experience of the Cardiovascular Surgery Team of the ABC Medical School with coronary-coronary bypass grafting. METHODS: Four patients undergone off-pump coronary artery bypass grafting, with coronary-coronary bypass of the right coronary artery, by using great saphenous vein graft. RESULTS: The follow-up period was 3 to 5 years without any intra- or postoperative recurrence. One patient presented anginal symptoms four years after the surgery and underwent cinecoronariography that revealed patent anastomosis. CONCLUSION: The coronary-coronary bypass is a good option for patients undergone coronary artery bypass grafting.

Avaliação inicial da ablação operatória biatrial por radiofrequência de fibrilação atrial / Surgical biatrial ablation of atrial fibrillation: initial results

OBJETIVO: Apresentar o resultado inicial da ablação operatória de fibrilação atrial (FA) por radiofrequência irrigada, aplicada em ambos os átrios, para reversão e manutenção do ritmo sinusal, a curto e médio prazo, nos pacientes submetidos à operação cardíaca concomitante da valva mitral. MÉTODOS: Entre fevereiro de 2008 e maio de 2009, 15 pacientes consecutivos portadores de FA permanente foram submetidos à ablação intraoperatória da taquiarritmia por radiofrequência irrigada, aplicada de forma biatrial, com operação cardíaca concomitante (plastia ou troca valvar mitral). O grupo era constituído de nove (60 por cento) pacientes do sexo masculino, com idades variando de 25 a 59 anos (média de 47,73 ± 9,85 anos). O diâmetro do átrio esquerdo variou de 44 a 70 mm (média de 55,06 ± 7,56 mm). RESULTADOS: Não houve mortalidade hospitalar ou complicações relacionadas à radiofrequência. Na alta hospitalar, 9 (60 por cento) pacientes estavam em ritmo sinusal. No tempo médio de seguimento de 7 ± 4 meses, 11 (73,3 por cento) pacientes estavam em ritmo sinusal. CONCLUSÕES: A ablação operatória por radiofrequência irrigada da fibrilação atrial crônica, aplicada em ambos os átrios, é efetiva na reversão e manutenção do ritmo sinusal, no seguimento a curto e médio prazo. A inclusão de maior número de pacientes e a continuidade do seguimento pós-operatório são necessárias para confirmar a efetividade da técnica empregada.

OBJECTIVE: To evaluate the results of intraoperative radiofrequency ablation with biatrial procedure in the treatment of chronic atrial fibrillation in patients with associated cardiac disease. METHODS: Between February 2008 and May 2009, 15 consecutive patients were underwent mitral valve procedure plus modified radiofrequency biatrial ablation of chronic atrial fibrillation. The mean age was 47.73 ± 9.85 years and 60 percent were male. The mean left atrial diameter was 55.06 ± 7.56 mm. RESULTS: There were no hospital mortality or complications related to radiofrequency ablation. The mean follow-up period was 7 ± 4 months. At the time of hospital discharge nine (60 percent) patients were in sinus rhythm. After a mean follow-up period 11 (73.3 percent) were in sinus rhythm. CONCLUSION: Intraoperative biatrial radiofrequency ablation is a safe and effective technique for the treatment of chronic atrial fibrillation, with satisfactory midterms outcomes in terms of conversion to sinus rhythm.

Revascularização da artéria coronária direita com enxerto venoso coronária-coronária / Right coronary bypass grafting with coronary-coronary venous bypass graft

OBJETIVO: Descrever a experiência do Serviço de Cirurgia Cardiovascular da Faculdade de Medicina da Fundação do ABC com a revascularização do miocárdio com ponte coronária-coronária. MÉTODOS: Foram analisados quatro pacientes submetidos a operação com ponte coronária-coronária, todos sem circulação extracorpórea. Em todos os casos, foi realizada ponte coronária-coronária na artéria coronária direita exclusivamente, utilizando segmento da veia safena magna. RESULTADOS: Não houve nenhuma intercorrência intra ou pós-operatória. O tempo de seguimento variou de 3 a 5 anos. Apenas um dos pacientes apresentou angina após quatro anos da operação, sendo submetido a cinecoronariografia, que demonstrou ponte coronária-coronária livre de lesões. CONCLUSÃO: A ponte coronária-coronária constitui opção viável e satisfatória para pacientes submetidos à revascularização do miocárdio

OBJECTIVE: The following report describes the experience of the Cardiovascular Surgery Team of the ABC Medical School with coronary-coronary bypass grafting. METHODS: Four patients undergone off-pump coronary artery bypass grafting, with coronary-coronary bypass of the right coronary artery, by using great saphenous vein graft. RESULTS: The follow-up period was 3 to 5 years without any intra- or postoperative recurrence. One patient presented anginal symptoms four years after the surgery and underwent cinecoronariography that revealed patent anastomosis. CONCLUSION: The coronary-coronary bypass is a good option for patients undergone coronary artery bypass grafting

Prevalence of the burnout syndrome among Brazilian medical oncologists

INTRODUCTION: Burnout syndrome which is prevalent among oncologists is characterized by three aspects: emotional exhaustion, depersonalization and low personal accomplishment. The purpose was to evaluate prevalence of the burnout syndrome among Brazilian medical oncologists and the variables that correlate with its presence. METHODS: A survey was conducted with members of the Brazilian Society of Medical Oncology (SBOC) who received three questionnaires (general, Maslach burnout questionnaire and an opinion survey) mailed to all 458 members. RESULTS: Response rate was of 22.3 percent. According to the criteria proposed by Grunfeld, which consider burnout present when at least one of the aspects is severely abnormal, prevalence of this syndrome was 68.6 percent (95 percent confidence interval, CI: 58.68 percent to 77.45 percent). By multivariate analysis having a hobby/physical activity, a religious affiliation, older age, living with a companion and rating vacation time as sufficient were correlated significantly and independently with burnout syndrome. CONCLUSIONS: The burnout syndrome is prevalent among Brazilian oncologists. Oncologists having sufficient personal and social resources to engage in a hobby, physical activity, have enough vacation time and religious activities are at lower risk of developing burnout.

INTRODUÇÃO: A Síndrome da Estafa Profissional (SEP) é considerada uma doença caracterizada por três componentes básicos: exaustão emocional (EE), despersonalização (DP) e reduzida realização pessoal (RP), sendo identificada em oncologistas. OBJETIVO: Analisar a prevalência da SEP entre oncologistas clínicos e possíveis fatores relacionados. MÉTODOS: Foram enviados três questionários (Questionário Geral, Questionário Maslach de Burnout e Questionário de Opinião) para 458 cancerologistas cadastrados na Sociedade Brasileira de Oncologia Clínica (SBOC). RESULTADOS: A taxa de resposta foi de 20 por cento. 43,3 por cento dos entrevistados demonstraram nível baixo de EE, 57,8 por cento apresentaram nível alto de DP e 55,5 por cento alta RP. Para avaliarmos a presença da SEP, utilizamos o critério de Ramirez, que considera as três dimensões em nível grave (8,9 por cento) e o de Grunfeld que considera pelo menos um dos três domínios em nível grave (68,9 por cento). Pelos critérios de Ramirez, houve correlação negativa com praticar exercícios/hobby (p=0,0007) e crer em uma religião (p=0,0445) com SEP. Já por Grunfeld, se correlacionou positivamente com morar com o companheiro (p=0,0054) e considerar o tempo de férias insuficiente (p=0,0037). Por ambos os critérios, foi constatada uma correlação positiva entre ter a síndrome e não optar por oncologia novamente se tivesse essa oportunidade. CONCLUSÃO: A SEP é muito prevalente entre os oncologistas clínicos. Porém, a maioria destes profissionais optaria novamente por essa especialidade. Prática de exercícios/hobby, tempo de férias suficiente e crer em uma religião surgiram como possíveis fatores para prevenir esta síndrome.