Ataque al personal de la salud durante la pandemia de COVID-19 en Latinoamérica / Attacks on healthcare workers during the COVID-19 pandemic in Latin America

Resumen En la actualidad los profesionales de la salud son el recurso más valioso con el que cuenta cada país para combatir la enfermedad COVID-19. Las tasas de contagio intrahospitalario son altas y ligadas al acto de atención sanitaria. Las medidas de protección por parte de los empleadores son fundamentales para el cuidado de los que cuidan. La situación de pánico generada por el temor a contraer o transmitir la enfermedad, siendo primeros respondedores en la línea de combate ante la pandemia, ha sido amplificada por varios factores. Cuestiones como presión psicológica, carga laboral, mediatización, aspectos judiciales, desprotección, falta de descanso, nuevos roles, discriminación y agresiones son algunas de las situaciones a las que se los profesionales se deben enfrentar.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1975).

Abstract Today, healthcare professionals are a country's most valuable resource for combating COVID-19. Hospital contagion rates are high and linked to the practice of health care. Employers' protective measures are essential in caring for the caregivers. The panic resulting from a fear of contracting or transmitting the disease, with first responders being at the front line of the battle against the pandemic, has been amplified by various factors. Issues such as psychological pressure, workload, media coverage, legal aspects, lack of protection, lack of rest, new roles, discrimination and assaults are some of the situations faced by these professionals.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1975).

Emerging roles of long non-coding RNAs in cancer

Cancer is a physiological condition that has both the endogenous and exogenous influences on its progression. It originatesfrom unusual cell growth, where the cells undergo massive genetic alterations, bypass the signaling machinery andcompromise its genetic cohesion. Literature has well narrated the DNA damage studies including driver mutations thatinterfere with the treatment strategies. However, with evolving medical excellence, recent day studies are trying to unveilthe contribution of RNAs in the progression of tumor malignancies. A number of non-coding RNAs have been identified asan active component in cancer genomics. This article aims to review the role of long non-coding RNAs in the spectra ofcancers and its prognostic value as the biomarkers in molecular targeting with clinical utility and therapeutic beneficence.

Intervenção psicológica em vítimas de estupro na cidade de São Paulo / Psychological intervention in rape victim in the city of São Paulo / Intervención psicológica con mujeres que sufrieron estupro en la ciudad de São Paulo

A intervenção psicológica com vítimas de estupro é essencial para a reorganização psíquica da mulher. Este estudo objetivou analisar, por meio da experiência profissional de psicólogas, as especificidades do processo de intervenção terapêutica em mulheres vítimas de estupro. Foram realizadas entrevistas semidirigidas com cinco psicólogas que atuam em serviços públicos de saúde - hospitais e em Centros de Referência a vítimas de violência sexual - na cidade de São Paulo. Os resultados foram analisados por meio de análise de conteúdo. As vítimas ingressam no atendimento com vivências intensas de angústia, sentimentos de tristeza, vergonha, medo e culpa. Algumas profissionais fazem uso de procedimentos específicos como hipnose, inventários e técnicas projetivas. De modo geral, o trabalho psicoterápico, focal ou não, visa criar condições para que as vítimas superem o evento traumático e retomem sua rotina

Psychological intervention in rape victim is essential to woman's health and reorganization. This study aimed to analyze the specificity of the therapeutic intervention process in female rape victims through psychologists' professional experience. Semi-structured interviews have been carried out by five psychologists who work in the health service - hospitals and centers for attention to women victims of sexual violence - in the city of São Paulo. Results were analyzed through content analysis. Victims come to the health service with anguish, sadness, shame, fear, and guilt. Some professionals use specific procedures as hypnosis, inventories, and projective techniques. Altogether, the therapeutic work, being focal or not, aims to create conditions so that the victims can overcome the traumatic event and resume their lives routine

La intervención psicológica con víctimas de estupro es fundamental para la reorganización psíquica de la mujer. Este estudio tuvo como objetivo analizar, por medio de la experiencia profesional de psicólogas, las especificidades del proceso de intervención terapéutica en mujeres víctimas de estupro. Se realizaron entrevistas semi-dirigidas con cinco psicólogas que actúan en servicios públicos de salud - hospitales y en Centros Especializados para víctimas de violencia sexual - de la ciudad de São Paulo. Los resultados se analizaron mediante el análisis de contenido. Las víctimas empiezan el atendimiento con vivencias fuertes de angustia, sentimientos de tristeza, vergüenza, miedo y culpa. Algunas profesionales hacen uso de procedimientos específicos como hipnosis, inventarios y técnicas proyectivas. De manera general, el trabajo psicoterápico, focal o no, visa crear condiciones para que las víctimas superen el evento traumático y retomen sus rutinas de vida

Workplace Violence Toward Mental Healthcare Workers Employed in Psychiatric Wards

BACKGROUND: Workplace violence (WPV) against healthcare workers (HCWs) employed in psychiatric inpatient wards is a serious occupational issue that involves both staff and patients; the consequences of WPV may include increased service costs and lower standards of care. The purpose of this review was to evaluate which topics have been focused on in the literature and which are new in approaching the concern of patient violence against HCWs employed in psychiatric inpatient wards, in the past 20 years. METHODS: We searched for publications in PubMed and Web of Science using selected keywords. Each article was reviewed and categorized into one or more of the following four categories based on its subject matter: risk assessment, risk management, occurrence rates, and physical/nonphysical consequences. RESULTS: Our search resulted in a total of 64 publications that matched our inclusion criteria. The topics discussed, in order of frequency (from highest to lowest), were as follows: “risk assessment,”“risk management,”“occurrence rates,” and “physical/nonphysical consequences.” Schizophrenia, young age, alcohol use, drug misuse, a history of violence, and hostile-dominant interpersonal styles were found to be the predictors of patients’ violence. CONCLUSION: Risk assessment of violence by patients appeared the way to effectively minimize the occurrence of WPV and, consequently, to better protect mental HCWs. We found paucity of data regarding psychologic sequelae of WPV. According to these findings, we suggest the need to better investigate the psychologic consequences of WPV, with the aim of checking the effective interventions to assist HCW victims of violence and to prevent psychologic illness.

Agresión y maltrato como problemática laboral del ámbito médico sanitario / Violence and mistreatment as problems in the healthcare workplace

Introducción: no sólo la violencia física provoca grandes impactos en la salud del profesional, sino que también lo hace la violencia infringida a través de un comportamiento que dañe la integridad psicológica del afectado. De esta forma se encuentran también expuestos al desgaste profesional, que puede llevar al agotamiento o burnout y ser causa de trastornos psicológicos, abandono de la profesión o del campo de trabajo, perturbaciones de largo plazo de las relaciones entre las personas, de la organización y de todo el entorno laboral. Objetivos: expresar la problemática laboral de agresión y maltrato en el ámbito médico y sanitario a través de la percepción del profesional. Material y Método: 203 encuestas confidenciales y anónimas realizadas a profesionales médicos, Resultados: 88% respondió que ha recibido agresiones durante su trabajo. 78% de los encuestados refirieron que la misma fue reiterada. 97% conoce compañeros laborales que recibieron maltrato en el trabajo. Conclusiones: al resultar víctimas de agresiones reiteradas y permanentes los profesionales involucrados ven afectado su estado de salud, claramente en detrimento de la calidad médica asistencial, representando de esta forma riesgo ocupacional, biológico y emocional, lo que corresponde al ambiente laboral insalubre.

Introduction: Not only physical violence has considerable impact on the professional’s health but also does the violence inflected by some behavior that harms the psychological integrity of the person involved. In this way, professionals are also subject to burnout, which can lead to psychological disorders, career or work field abandonment, long-term disturbance in people’s relationships, into the organization and in the work environment. Objectives: State the problem of violence and mistreatment in the healthcare workplace through the perception of the professionals.Material and Method: 203 confidential and anonymous surveys which medical professionals responded to. Results: 88% declared having suffered violence while working. 78% of the surveyed professionals stated that the assaults were repeated. 97% of them know colleagues who have been mistreated in the workplace.Conclusions: As a result of suffering repeated and constant assaults, the involved professionals’ health is affected, to the clear detriment of the healthcare medical quality, which in turn is an emotional, biological and occupational hazard. This represents an unhealthy work environment.

Características y consecuencias de las agresiones sexuales en adolescentes consultantes en un centro de salud sexual y reproductiva / Characteristics of sexual assault and its consequences in adolescents at a sexual and reproductive health center

Antecedentes: La agresión sexual es un evento traumático y doloroso que afecta de manera transversal, a las víctimas de ambos sexos, de todos los niveles socioeconómicos con graves consecuencias para la salud física, psicológica y social para quienes la sufren. Objetivo: Determinar las características de las agresiones sexuales y sus consecuencias en adolescentes consultantes en un centro de atención en Salud Sexual y Reproductiva. Método: Estudio analítico de corte transversal de 573 adolescentes atendidas en un centro de medicina reproductiva (CEMERA) en el período 2003-2010 y que reportaron antecedente de abuso sexual. Se estudiaron tanto las características como las consecuencias del abuso, datos que se obtuvieron desde las fichas clínicas. Resultados: En el 86,5 por ciento de los casos se reportó abuso sexual y en un 13,5 por ciento violación. El 48,5 por ciento de los agresores son familiares. La edad más vulnerable fue entre 5-9 años con un 41,2 porciento. En el 39,2 por ciento el abuso sexual fue reiterado. En un 43,4 por ciento el lugar fue el propio hogar de la víctima. Un 70 por ciento reveló y de estos el 45,9 por ciento lo hizo en forma tardía. Sólo en un 19 por ciento se hizo la denuncia legal. De las adolescentes que iniciaron actividad sexual voluntaria (83,3 por ciento), un 35,4 por ciento tenía menos de 15 años. Un 11,8 por ciento reportó 3 y más parejas sexuales. Conclusión: El antecedente de abuso sexual debe ser considerado en la atención de adolescentes que consultan por salud sexual y reproductiva. El equipo de salud debe estar preparado para atender sus múltiples necesidades.

Background: Sexual assault is a traumatic and painful event, which affects victims of both genders, across all socioeconomic levels, with serious consequences for physical, psychological, and social health. Objective: Determine the characteristics of sexual assault and its consequences in adolescents at a sexual and reproductive health center. Method: Analytic and cross-sectional study of 573 adolescents seen at a reproductive medicine center (CEMERA) in the period 2003-2010 and who reported history of sexual abuse. Patient's clinical records were reviewed to study the characteristics as well as the consequences of sexual abuse. Results: The abuse was reported as sexual abuse in 86.5 percent of the cases and as rape in 13.5 percent. In 48.5 percent of the cases, the aggressors were relatives of the victims. The most vulnerable group is between 5-9 of age, representing 41.2 percent of the cases. For 39.2 percent of the cases, the sexual abuse was reiterative, and in 43.4 percent, the abuse took place on the victim's home. 70 percent of the victims told someone about the abuse; 45.9 percent of those revealed their abuse in a delay manner. Only 19 percent of victims filed a legal complaint. Of the adolescents who started voluntary sexual activity (83.3 percent) a 35.4 percent was under de age of 15, and 11,8 percent reported having 3 or more sexual partners. Conclusion: A history of sexual abuse must be considered in the attention of adolescents who consult for reproductive and sexual health. The health team must be prepared to address their multiple needs.

Original research paper a descriptive one year study on the alleged male and female victims and accused of sex crimes.

This study was based on the cases of alleged male and female victims and accused of sex crimes reporting to Gauhati Medical College mainly from the Kamrup districts and other nearby areas. The city of Guwahati is facing rise in crime incidences and the sex crime cases. The cases reported varied: abduction and kidnapping, rape, immoral trafficking, prostitution, unnatural sexual offences, child molestation, outraging the modesty of a woman, allegation of a man masturbating on a victim girl etc. The burden of such crimes on the society is huge. Many victims suffer from psychiatric problems as a result of sexual assault. The venereal diseases are another horrible consequence along with unwanted pregnancies. Moreover, many of these crimes are never reported. Sexual assaults on male are also under reported. The need for a new law on sexual assault is felt as the present law does not define and reflect the various kinds of sexual assault that women and children are subjected to in our country. This study tried to analyze the present scenario in relation to the age groups, occupation, relationship of the victims and accused and physical findings

Symptomatic Correlates of Interpersonal Trauma in Outpatients with Anxiety Disorders / 신경정신의학

OBJECTIVES: Psychiatric patients report higher rates of interpersonal trauma, and they present with more symptoms and behavioral problems. However, less is known about other anxiety disorders, except for posttraumatic stress disorder. In this study, we investigated symptomatic correlates of interpersonal trauma (i.e., physical or sexual assaults) in patients with heterogeneous anxiety disorders. METHODS: We surveyed a consecutive sample of 90 outpatients with DSM-IV anxiety disorders (panic disorder, generalized anxiety disorder, obsessive compulsive disorder, social phobia, anxiety disorder not otherwise specified) at the psychiatric department of a university-affiliated hospital. The questionnaire was comprised of the Symptom Checklist-90-Revised (SCL-90-R), Beck Depression Inventory, State and Trait Anxiety Inventory, and Impact of Events Scale-Revised. RESULTS: Patients with interpersonal trauma (n=51) demonstrated a significantly higher level of interpersonal sensitivity, paranoid ideation, and obsessive-compulsive subscale of the SCL-90-R. However, logistic regression analysis suggested that interpersonal sensitivity alone was suggested as the best fitting model. CONCLUSION: Anxiety disorder patients with interpersonal trauma demonstrated difficulty in domains of interpersonal relationship. Clinicians treating this population should consider this finding for better engagement and management.

La historia médico legal en casos de delitos sexuales en niños: un enfoque médico forense / The medical-legal history in cases of sexual assault in children: a forensic medical approach

Se ha considerado al interrogatorio médico forense en casos de delitos sexuales en niños como revictimizante. La historia médico legal en delitos sexuales recoge la información necesaria para orientar el examen físico y para la recolección de evidencias en la víctima y en su contexto. Existen técnicas médico forenses para interrogar al niño con el afán de evitar la revictimización, entendida esta como el sufrimiento que experimentan las víctimas al promoverse una actualización del evento traumático. La historia médico legal persigue objetivos diferentes al resto de los interrogatorios dentro del proceso judicial y sigue las pautas del arte y ciencia de la medicina y bien implementadas no produce la revictimización del paciente.

The Forensic Medical interrogation has been considered as revictimizing in cases about Sexual Assaults on Children. The Medical Legal History in Sexual Assaults meets the necessary information to guide the two main procedures: the physical examination and the gathering of evidence on the victim as well as in its context. There are forensic techniques to avoid revictimization on children during interrogation, understanding the revictimization as the suffering the victim experiences, when remembering a traumatic event during the Medical Legal Examination. The medical-legal history pursues goals that are different from those of other interrogation procedures within the judicial process, and when following the guidelines of the art and science of medicine, it well established, do not produce revictimization of the patient.

A Case of Crush Syndrome after Physical Assaults / 대한법의학회지

The crush syndrome was first defined as a clinical entity in 1941. The term myorenal syndrome is preferred to the term crush injury or crush syndrome. The syndrome occurs in sjambok, deep burns and crush injuries. Crush injury is caused by continuous prolonged pressure on the limb. The main injury is to muscles of the limbs. Crush syndrome, which is the general manifestation of crush injury, has been accompainment of crushing injuries following disaster situations and war. However, we report a case of crush syndrome after physical assaults.