Niveles de ansiedad de médicos residentes / Anxiety levels in medical residents

Introducción: La residencia médica es un período de riesgo para el desarrollo de problemas de salud mental. Los estudios de ansiedad en residentesson contrastantes; sin embargo, se cree que los niveles de ansiedad son altos ya que los programas se desarrollan en hospitales nacionales que carecende recursos fsicos, materiales y humanos. El objetvo del presente estudio es determinar los niveles de ansiedad en médicos residentes en diferentesespecialidades empleando el cuestonario inventario de la ansiedad rasgo-estado (IDARE).Métodos: Se administró una encuesta electrónica para determinar el nivel de ansiedad en médicos residentes en diferentes especialidades del HospitalGeneral San Juan de Dios.Resultados: Se obtuvieron 132 encuestas para el análisis. La mayoría de los médicos encuestados son hombres (59%), solteros (83%) que no tenendependientes (79%), cursan residencia de cirugía o medicina interna (54%), trabajan más de 80 horas por semana (85%) y viajan menos de una horapara llegar al lugar de residencia (67%). El promedio del nivel de ansiedad-estado de los médicos residentes fue 46.94 puntos, mientras que el nivelpromedio de ansiedad-rasgo fue de 42.77 puntos. El 35% de los residentes poseen niveles de ansiedad medio y 59% altos en el momento de responderla encuesta; y el 56% posee niveles de ansiedad medio y 37% alto generalmente. No se encontró diferencia estadístcamente signifcatva en los nivelesde ansiedad en base a género, estado civil, tpo de residencia, dependientes y horas de tráfco. La única variable asociada con ansiedad fue la cantdadde horas de trabajo por semana.Conclusiones: La mayoría de los residentes encuestados poseen niveles de ansiedad medio-altos, la única variable asociada con niveles de ansiedadfue la cantdad de horas de trabajo por semana.

Background: Medical residency is a risky period for the development of mental health problems. Although anxiety studies in medical residents areinconclusive; we hypothesize anxiety levels in residents are high, since residency programs are developed in community hospitals that lack material andhuman resources. The aim of this study is to determine the levels of anxiety in medical residents of diferent specialtes using the State Trait-AnxietyInventary (STAI).Methods: An electronic poll with STAI was administered to medical residents of diferent specialtes of a tertary referral hospital.Results: We received 132 questonnaires for analysis. Most of the respondents are men (59%), single (83%), without dependents (79%), belong tosurgical or internal medicine residency (54%), work more than 80 hours per week (85%) and travel less than an hour to get to the hospital (67%). Theaverage level of state anxiety of the residents was 46.94 points, while the average level of trait anxiety was 42.77 points. Thirty fve percent of theresidents have medium anxiety levels and 59% high anxiety levels at the tme they answered the inventory; and 56% have medium anxiety levels and37% have high anxiety levels as a trait. We did not found a statstcal diference in anxiety levels based on gender, marital status, and type of residency,number of dependents or number of hours spent in trafc. The only variable that was associated with anxiety was the amount of work hours per week.Conclusions: Most of the residents have medium-high levels of anxiety; the only variable associated with anxiety levels was the amount of work hoursper week

Involvement of K-RAS mutations and amino acid substitutions in the survival of metastatic colorectal cancer patients.

The efficacy of epidermal growth factor-targeting therapies has been found to be limited in tumors with the wild-type K-RAS gene, suggesting a predictive value of K-RAS gene analysis in tumoral response. However, the prognostic value of K-RAS is controversial. This study included patients diagnosed with metastatic colorectal cancer. The presence of K-RAS mutations was analyzed, and the tumors positive for a K-RAS mutation were further analyzed to identify the mutation type. Similarly, the following clinical and pathological variables were also collected. The study was composed of 53.3 % of patients with wild-type K-RAS and 46.7 % of patients with mutated K-RAS (mutated codon 12 was the most frequent). With a mean follow-up of 15 months (range, 1-45), the median survival of patients with wild-type K-RAS was 31.6 months. The median survival was 24.8 months for patients with K-RAS mutated in codon 12 and 17.8 months for patients with mutated codon 13 (p = 0.37). In a univariate analysis, K-RAS was associated with stage IV at diagnosis (p < 0.005). When K-RAS was mutated, a lower overall survival was observed in cases of G → A transition compared with G → T transversion (19.5 vs. 24.2 months, respectively; p = 0.47). When the amino acid change resulted in an acidic substitution, survival was lower, but it increased when the substitution resulted in a polar or nonpolar amino acid (19.5 vs. 23.2 vs. 24.4 months, p = 0.79). The type of K-RAS mutation or amino acid changes may have prognostic implications in metastatic colon cancer patients. Further research is needed in patients treated in prospective controlled trials.

Anti-angiogenic treatment (sunitinib) for disseminated malignant haemangiopericytoma: a case study and review of the literature.

INTRODUCTION: A meningeal haemangiopericytoma (HP) is a mesenchymal tumour that makes up less than 1% of all CNS tumours. HPs arise from pericytes and present high rates of recurrence and distant metastasis. The primary treatment option is surgery. When the disease is disseminated, chemotherapy produces a weak and short-lived response; therefore, new drugs are needed. CASE PRESENTATION: We describe the case of a 65-year-old woman with a 13-year history of recurrent HP. After local treatment with radiotherapy, she developed metastases that required systemic treatment, and treatment with sunitinib, an oral inhibitor of the vascular endothelial growth factor receptor and the platelet-derived growth factor receptor, was initiated. As a result, radiological stabilisation of the systemic disease was maintained for over 12 months. CONCLUSIONS: Anti-angiogenic agents can be useful for treating disseminated HP, but further studies are needed to confirm their possible role in controlling metastatic disease.