Síndrome de quemarse por el trabajo en profesionales de enfermería, Bogotá, Colombia / Burnout syndrome among nursing professionals, Bogotá, Colombia / A síndrome de esgotamento profissional em enfermeiros, Bogotá, Colômbia

Objetivo: describir el Síndrome de Quemarse por el Trabajo (SQT) en profesionales de enfermería de los servicios de Urgencias y de la Unidad de Cuidado Intensivo de tres hospitales de Bogotá 2011-2013. Métodos: estudio de tipo descriptivo transversal, en el que se aplicó el "Cuestionario de Evaluación del Síndrome de Quemarse por el Trabajo" (CESQT), instrumento validado y que se adquirió para este estudio. Se preservaron los aspectos éticos. Los datos se procesaron en programa estadístico SPSS; asimismo, se emplearon procedimientos estadísticos para el análisis de los mismos. Resultados: participaron en el estudio 114 enfermeros. El 4,1% de los profesionales de enfermería de Urgencias, presenta SQT, aunque los profesionales de UCI tienen riesgo de desarrollar el síndrome. El SQT (p=0,009) y las subescalas de desgaste psíquico (p=0,034) e indolencia (p=0,004) difieren significativamente según el servicio en donde laboran estos profesionales. Conclusiones: los profesionales de Urgencias presentan SQT. Se debe profundizar en las consecuencias negativas que este síndrome genera en las instituciones, en los profesionales, en los pacientes, sus familias y en la sociedad en general. De ahí la importancia de generar intervenciones y asegurar ambientes laborales saludables que fortalezcan el cuidado de pacientes y la salud de estos profesionales.

Objective: to describe the burnout syndrome among nurses at the emergency services and intensive care units of three hospitals in Bogotá 2011-2013. Methods: a descriptive, cross sectional study using the "Assessment Questionnaire for the Syndrome of Burning Oneself Out At Work" (CESQT), which has been validated and was acquired for this study. Ethical aspects were preserved, and data were processed in the SPSS statistics software. Similarly, statistical procedures were used for the data analysis. Results: one hundred and fourteen nurses participated in the study, and 4.1% of the nurses in the emergency services had SBW. Similarly, the professionals from the ICU are at risk of developing the syndrome. The SBW (p=0.009) and the psychological exhaustion (p=0.034) and indolence (p=0.004) subscales differ significantly depending on the service for which these professionals work. Conclusions: emergency professionals have "Syndrome of burning oneself out at work" (SBW). The understanding of the negative consequences that this syndrome generates in different contexts such as institutions, professionals, patients, families and society in general should be deepened. Thus, it is important to create interventions and ensure healthy work environments which strengthen patient care as well as the health of these professionals.

Objetivo: Descrever a Síndrome de Esgotamento Profissional em profissionais da enfermagem dos serviços de Urgências da Unidade de Terapia Intensiva de três hospitais de Bogotá entre 2011 e 2013. Metodologia: É um estudo descritivo transversal, para o qual se utilizou o "Questionário de Avaliação da Síndrome de Esgotamento Profissional": um instrumento validado, especialmente adquirido para esta pesquisa. Preservaramse aspectos éticos. Os dados foram processados no programa estatístico de nome SPSS. Também se utilizaram procedimentos estatísticos para analisar esses dados. Resultados : Neste estudo participaram 114 enfermeiros. 4,1% dos enfermeiros profissionais de Urgência tem Síndrome de Esgotamento Profissional, embora os profissionais da UTI têm risco de sofrer a síndrome. A Síndrome de Esgotamento Profissional (p = 0,009) e as subescalas de Esgotamento Psíquico (p = 0,034), e a Indolência (p = 0,004) diferem significativamente dependendo do serviço onde trabalhem os profissionais. Conclusão: Os profissionais de Urgências sofrem da Síndrome de Esgotamento Profissional. É necessário pesquisar mais sobre as consequências negativas que esta síndrome gera nas instituições, nos profissionais, nos pacientes, nas suas famílias e na sociedade completa. Por isso é tão importante gerar intervenções e garantir ambientes de trabalho saudáveis, para fortalecer o atendimento dos pacientes e a saúde dos trabalhadores.

Chronic Treatment with a Clinically Relevant Dose of Methylphenidate Increases Glutamate Levels in Cerebrospinal Fluid and Impairs Glutamatergic Homeostasis in Prefrontal Cortex of Juvenile Rats.

The understanding of the consequences of chronic treatment with methylphenidate is very important since this psychostimulant is extensively prescribed to preschool age children, and little is known about the mechanisms underlying the persistent changes in behavior and neuronal function related with the use of methylphenidate. In this study, we initially investigate the effect of early chronic treatment with methylphenidate on amino acids profile in cerebrospinal fluid and prefrontal cortex of juvenile rats, as well as on glutamatergic homeostasis, Na(+),K(+)-ATPase function, and balance redox in prefrontal cortex of rats. Wistar rats at early age received intraperitoneal injections of methylphenidate (2.0 mg/kg) or an equivalent volume of 0.9% saline solution (controls), once a day, from the 15th to the 45th day of age. Twenty-four hours after the last injection, the animals were decapitated and the cerebrospinal fluid and prefrontal cortex were obtained. Results showed that methylphenidate altered amino acid profile in cerebrospinal fluid, increasing the levels of glutamate. Glutamate uptake was decreased by methylphenidate administration, but GLAST and GLT-1 were not altered by this treatment. In addition, the astrocyte marker GFAP was not altered by MPH. The activity and immunocontent of catalytic subunits (α1, α2, and α3) of Na(+),K(+)-ATPase were decreased in prefrontal cortex of rats subjected to methylphenidate treatment, as well as changes in α1 and α2 gene expression of catalytic α subunits of Na(+),K(+)-ATPase were also observed. CAT activity was increased and SOD/CAT ratio and sulfhydryl content were decreased in rat prefrontal cortex. Taken together, our results suggest that chronic treatment with methylphenidate at early age induces excitotoxicity, at least in part, due to inhibition of glutamate uptake probably caused by disturbances in the Na(+),K(+)-ATPase function and/or in protein damage observed in the prefrontal cortex.

Impairment of the organization of locomotor and exploratory behaviors in bile duct-ligated rats.

Hepatic encephalopathy (HE) arises from acute or chronic liver diseases and leads to several problems, including motor impairment. Animal models of chronic liver disease have extensively investigated the mechanisms of this disease. Impairment of locomotor activity has been described in different rat models. However, these studies are controversial and the majority has primarily analyzed activity parameters. Therefore, the aim of the present study was to evaluate locomotor and exploratory behavior in bile duct-ligated (BDL) rats to explore the spatial and temporal structure of behavior. Adult female Wistar rats underwent common bile duct ligation (BDL rats) or the manipulation of common bile duct without ligation (control rats). Six weeks after surgery, control and BDL rats underwent open-field, plus-maze and foot-fault behavioral tasks. The BDL rats developed chronic liver failure and exhibited a decrease in total distance traveled, increased total immobility time, smaller number of rearings, longer periods in the home base area and decreased percentage of time in the center zone of the arena, when compared to the control rats. Moreover, the performance of the BDL rats was not different from the control rats for the elevated plus-maze and foot-fault tasks. Therefore, the BDL rats demonstrated disturbed spontaneous locomotor and exploratory activities as a consequence of altered spatio-temporal organization of behavior.

Apoplejía en metástasis hipofisiaria de carcinoma de células renales: caso clínico con 7 años de seguimiento / Pituitary apoplexy secondary to a metastatic renal cell carcinoma: report of a case followed for 7 years

We report a man in whom a 15 cm. renal tumor was excised at the age of 49. The pathological examination showed a clear cell carcinoma. Five years later, he presented with headache, vomiting and unilateral palpebral ptosis. Imaging studies showed a sellar tumor with pituitary apoplexy. The tumor was excised and the pathological study disclosed a clear cell tumor, positive for vimentin, cytokeratins AE1 and AE3 and immunohistochemically negative for LH, TSH, ACTH and GH. Considering the similar histopathological features, it was considered as a metastasis of the renal tumor. The patient was supplemented with thyroid, adrenal and gonadal hormones. Seven years later, he presented a new tumor in the remaining kidney, that corresponded to a cystic papillary renal cell carcinoma. Afterwards, he presented a transitional urinary bladder tumor. Mortality associated to renal cell tumors is 90 percent at 5 years, and pituitary metastases are extraordinarily uncommon

Importancia del déficit de inhibidores de la cristalización en la etiopatogenia de la urolitiasis / Importance of crystallization inhibitors deficit in the etiopathogenic of urolithiasis

Background: five percent of consultations at the emergency room of Catholic University Hospital are due to nephrolithiasis. The causes of this high frequency remain unknown. Aim: to know the main metabolic and anatomic factors involved in the genesis of nephrolithiasis. Patients and methods: 41 patients (31 male) were studied presenting with a renal colic were studied as soon as the acute episode subsided and without diet modifications. Fasting blood calcium and creatinine and 24 h urine calcium, uric acid, citrate, magnesium and pH were measured and an intravenous pyelogram was performed. 21 subjects without a history of nephrolithiasis were used as controls. Results: Patients with nephrolithiasis did not differ from controls in urinary calcium (159 ñ 67 and 172 ñ 67 mg/24 h respectively), uricosuria (417 ñ 171 and 431 ñ 121 mg/24 h respectively) or urinary magnesium (55 ñ 19 and 62 ñ 21 mg/24 h respectively, whereas urinary citrate was lower (219 ñ 172 vs 319 ñ 179 mg/24 h in controls p <0.05). All patients had a normal renal functions, urinary acidification and intravenous pyelogram. Seven percent of patients with nephrolithiasis had hypercalciuria, 2.4 percent had hyperuricosuria, 68.3 percent had a low urinary citrate and 44.4 percent had low urinary magnesium. Conclusions: in this sample, there is a strong association of nephrolithiasis with low levels of crystallization inhibitors in special with urinary citrate, a crystallization inhibitor

Tratamiento del seminoma puro de testículo: estados I y II / Therapy of the pure testicular seminoma: stage I and II

Desde octubre 1976 hasta junio 1986, 185 pacientes portadores de seminoma puro de testículo han sido tratados con radioterapia. 101 pacientes etapificados en estado I recibieron irradiación infradiafragmática y 84 pacientes etapificados como estado II recibieron irradiación infra y supra diafragmática. Con seguimiento mínimo de 36 meses, la sobrevida para pacientes en estado I fue del 98%, subiendo a 99% luego de rescate, en estado II la sobrevida sin evidencia de enfermedad fue 93%, subiendo a 96% luego de rescate. Ni desarrollo de segundos tumores testiculares, compromiso escrotal, albugínea, epididímo, cordón, rete testis, carcinoma in situ, multifocalidad, diferenciación, título de beta gonadotrofinas fueron de importancia pronóstica. En pacientes en estado II sólo presencia de masa abdominal palpable fue de influencia adversa

BCG y cáncer vesical superficial: consideraciones clínicas y morfológicas en serie de estudio / Superficial vesical cancer: clinical and morphological consideration in study series

En 36 pacientes con Ca vesical se usó BCG en instalación local. Se evaluó en 18 de ellos aspectos de respuesta clínica y morfológica frente a dosis variable decreciente de BCG (50 mg a 2 mg). Se usó cepa Pasteur con alta viabilidad. La respuesta anátomo-clínica encontrada fue independiente de la dosis empleada. La presencia de inflamación vesical granulomatosa post tratamiento coincidió en mayor frecuencia con la desaparición persistente del tumor, no así la inflamación vesical inespecífica que tuvo más recurrencia