Medición de la calidad de vida en médicos residentes / Measurement of the quality of life in the residents doctors

Introducción. Durante los estudios de especialidad el médico residente afronta niveles de estrés superiores a la población general afectándolo profesional y personalmente, por lo que cuestionamos por qué los estudios de residencia modifican la calidad de vida de los médicos residentes que los cursan. Sujetos y métodos. Se realizó un estudio descriptivo, comparativo, entre febrero de 2006y febrero de 2007. Se aplicó el módulo central del cuestionario PECVEC a dos grupos de residentes: un grupo de residentes que iniciaba su especialidad y un año después, y a otro grupo que ya tenía más de un año realizando estudios de especialidad; se incluyeron residentes tanto de especialidades medicas como quirúrgicas que aceptaron participar. Los datos se capturaron en el programa SPSSv. 15. Se utilizó estadística descriptiva para variables sociodemográficas de Student para comparar la calidad de vida entre residentes y especialidad cursada. La calidad de vida se clasificó como ‘muy buena’ de 3,1 a 4, ‘buena ‘de 2,1 a 3, ‘regular’ de 1,1 a 2 y ‘mala’ entre 0 y 1. Resultados. En el primer grupo se incluyeron 54 residentes, sólo45 residentes completaron las encuestas al ingreso y un año después, y se excluyó a 9 por no completar la segunda evaluación; el segundo grupo incluyó a 62 residentes de segundo y tercer año que tenían más de un año realizando estudios de especialidad. Se encontró que después de un año de especialidad en las seis (..) (AU)

Introduction. During specialty studies, the resident doctor faces higher stress levels than the normal population, affecting him/her professionally and personally, hence we ask the question: do the residency studies modify the quality of life of the resident doctors who are taking the specialty? Subjects and methods. A descriptive, comparative study was carried out in February 2006 and in February 2007. We applied the PECVEC questionnaire central module to two resident’s groups: the first one, initiating their medical specialty and one year later; and the second one, residents with more than one year of specialty studies. We included residents from medical and surgical specialties that agreed to participate in this study. All data was captured on SPSS v. 15 for analysis descriptive statistics were used for socio-demographic variables, the Student’s t for comparing the quality of life among residents and specialty. The quality of life was classified as ‘very good’ between 3.1 and 4,‘good’ between 2.1 and 3, ‘regular’ between 1.1 and 2 and ‘bad ‘between 0 and 1. Results. 54 residents were included in the FirstGroup, from which only 45 completed the questionnaires at the beginning and one year later. We excluded 9 residents because they didn’t complete the second questionnaire. In the second group, we included 62 second and third year residents that had more than a year of specialty studies. We found that after one year of specialty, the 6 evaluation scales showed a decline in the quality of life, falling from a level considered as ‘very good’(3.18) to ‘good’ (2.73) p < 0.001. However, when we compared these results with the second group, this one didn’t have a decline in the quality of life; the most affected parameters were: physical function and negative state of mind, with respect to (..) (AU)

Epilepsy and neurocysticercosis in an Andean community.

BACKGROUND: Taenia solium neurocysticercosis (NCC) has been documented as one of the major causes of epilepsy in developing countries. However, methodological limitations have hindered the evaluation of the epidemiological relationship between cysticercosis and epilepsy at the community level. METHODS: We used the WHO protocol for epidemiological evaluation of neurological disorders to conduct a door-to-door survey among 2723 residents of San Pablo del Lago, an Ecuadorean rural community in which T. solium taeniasis/cysticercosis was known to be endemic. The WHO protocol was complemented by neuroimaging and immunological tests to confirm the diagnosis of this infection. RESULTS: In all 31 people suffering from active epilepsy were detected (prevalence 11.4 per 1000, 95% CI:7.7-15.4); 26 agreed to undergo a computer tomography (CT) examination, and 28 agreed to have blood drawn for serodiagnosis. Fourteen of the 26 (53.8%) had CT changes compatible with NCC and six of the 28 (21.4%) tested positive in the enzyme-linked immunoelectro-transfer blot (EITB) assay. In a seizure-free random sample of this population, 17 of 118 (144 per 1000) subjects examined by CT and 10 out of 96 (104 per 1000) examined by EITB had evidence of this infection. The differences between the epilepsy group and the random sample of the population were statistically significant (OR = 6.93, 95% CI: 2.7-17.5, P < 0.001) for CT diagnosis, but not for EITB results (OR = 2.75, 95% CI: 0.8-7.1, P > 0.12, NS). CONCLUSIONS: These findings confirm that T. solium NCC is a significant cause of epilepsy at the community level in Andean villages of Ecuador. It is important to initiate effective public health interventions to eliminate this infection, which may be responsible for at least half of the cases of reported epilepsy in Ecuador.

MR findings in childhood gangliogliomas.

Gangliogliomas are uncommon primary brain tumors composed of atypical glial and neuronal cells. These tumors usually occur in children and young adults. They are slow-growing tumors that present with seizures. We have reviewed four cases from our institution and have correlated the magnetic resonance (MR) findings with CT and histology. Two distinct patterns were observed with MR. In three of four patients, ranging in age from 7 to 14 years, MR showed a mass with decreased signal on T1-weighted images (WI) and increased signal on T2WI. The most common CT finding was a hypodense enhancing mass with focal calcifications. The histologic features of these tumors comprised microcysts and hypervascularity. In one of four patients, an infant. MR showed increased signal on T1WI and decreased signal on T2WI. Computed tomography showed a hyperdense nonenhancing mass. Histology demonstrated an increase of hypercellularity with both atypical glial and neuronal components.

Craniopharyngioma presenting as a nasopharyngeal mass: CT and MR findings.

Craniopharyngiomas usually arise in the suprasellar or parasellar region. The occurrence of the tumors in other locations is rare and they have to be distinguished from lesions in the suprasellar or sellar region with unusual extension. Thus far, few craniopharyngiomas of infrasellar origin have been described. We report a case in which the tumor presented as a nasopharyngeal mass and CT and magnetic resonance were used for evaluation. Review of the pertinent embryology and literature is also included.