ABSTRACT
Monkeypox (MPX) is an exanthematous disease first identified in the 1950s, associated with animals in Central and Western Africa, and has since been found sporadically worldwide. In May 2022, a returning family from Nigeria tested positive for MPX, which marked the onset of the current outbreak. It has now become a disease of concern in most parts of the world. The current standings are nearing 90,000 cases, with numbers increasing daily. The United States reported 29,711 cases so far. The characteristic exanthem of MPX is known to be present ubiquitously on the human habitus, with recent reports describing anogenital and mucosal lesions. Here, we present a rare case of a 43-year-old male presenting with excruciating perianal pain and purulent discharge, found to have proctitis secondary to MPX, and subsequently treated with Tecovirimat, a targeted antiviral therapy.
ABSTRACT
Diffuse pulmonary ossification (DPO) is a rare pulmonary condition characterized by the diffuse formation of mature bone in the lungs. Pulmonary ossification, in general, can be subdivided into diffuse pulmonary ossification (DPO) and nodular pulmonary ossification (NPO). DPO occurs most commonly in the settings of chronic pulmonary conditions; however, idiopathic cases have been reported. We present a case of DPO in a 36-year-old man with progressive exertional dyspnea, productive cough, and occasional hemoptysis. Imaging studies showed innumerable pulmonary nodules scattered throughout both lungs. Initially, the diagnoses of pulmonary alveolar microlithiasis (PAM) or, less likely miliary tuberculosis (TB) were considered. However, Quantiferon TB test was negative and genetic testing was negative for SLC34A2, lowering the probability of PAM. The patient underwent a segmentectomy. Microscopic examination showed ramifying spicules of mature woven bone and fatty marrow consistent with DPO. There were no significant underlying pathologic findings, such as interstitial fibrosis, granulomas, organizing pneumonia, or significant inflammation in the background lung parenchyma. In conclusion, clinicians and radiologists need to be aware of DPO in the differential diagnosis of miliary tuberculosis and pulmonary alveolar microlithiasis. The absence of an underlying chronic pulmonary condition does not exclude the possibility of DPO.
ABSTRACT
Introducción: la cultura de seguridad del paciente es el resultado de los valores individuales y grupales, así como de actitudes, percepciones, competencias y patrones de comportamiento, que determinan el compromiso, estilo y competencia de una organización hacia la salud y manejo de la seguridad. Diversos organismos internacionales y nacionales reconocen el quirófano como un servicio hospitalario de alto riesgo en materia de seguridad del paciente. Objetivo: describir la cultura de seguridad del paciente por enfermería perioperatoria en un hospital público de Aguas- calientes, México. Metodología: estudio descriptivo y transversal. La muestra se conformó con 59 trabajadores con contratación indefinida que desempeñaban funciones de circulante, instrumentista, en sala de preanestesia y de recuperación posanestésica, durante los turnos matutino, vespertino y nocturno. Se realizó un censo estadístico. La población de estudio incluyó a 52 personas. Se utilizó el cuestionario sobre seguridad de los pacientes, con alfa de Cronbach de 0.96. Resultados: el aprendizaje organizacional mostró 57.7% de respuestas positivas. Las dimensiones restantes tuvieron res- puestas neutras. El grado de seguridad del paciente fue µd = 8.0. El grado de cultura de seguridad del paciente fue µd = 133.0 puntos. Existió buena cultura en el 73% de los casos. Conclusiones: la cultura de seguridad del paciente fue buena. El turno vespertino registró mayor cultura de seguridad del paciente.
Introduction: The Patient Safety Culture is the result of individual and group values, as well as attitudes, perceptions, competencies and behavior patterns, which determine the commitment, style and competence of an organization towards health and management of the security. The opera- ting room is recognized by various international and national organizations as a high-risk hospital service in terms of patient safety. Objective: To describe the Patient Safety Culture for perioperative nursing in a public hospital in Aguascalientes, Mexico. Methods: Descriptive-transversal study. The universe was made up of 59 workers with permanent contracts who per- formed the functions of circulating, instrumentalist, in the pre-anesthesia and post-anesthesia recovery rooms, during the morning, afternoon and night shifts. A statistical census was carried out. The study population was 52 people. The Patient Safety Survey was used, with a Cronbach's alpha of 0.96. Results: Organizational learning presented 57.7% positive responses. The remaining dimensions showed neutral responses. The degree of patient safety was µd = 8.0. The level of Patient Safety Culture was µd = 133.0 points. There was a good culture in 73% of the cases. Conclusions: The Patient Safety Culture was good. The afternoon shift presented a higher Patient Safety Culture.
