Systemic relations among the variables involved in occupational accidents of the nursing team in a psychiatric hospital.

BACKGROUND: The occupational activities carried out in hospital environments pose occupational risks to professionals. In psychiatric hospitals, due to the characteristics of the patients treated, professionals are also subjected to other risks, such as physical aggression. OBJECTIVE: This research aimed to identify the systemic context, highlighting the cause-and-effect relationships that culminate in occupational accidents that occurred with the nursing staff in a psychiatric hospital in Brazil. METHODS: The current study is an applied research and was divided into three stages. First, the collection of data related to the case study was made and accidents were analyzed and occupational hazards were identified. In the second stage, from the collected information, occupational safety indicators were defined. Lastly, in the third stage, the qualitative aspect of System Dynamics was applied to perform the systemic analysis and to identify how the different variables were related. RESULTS: The results showed that physical aggression was the main cause of accidents. Regarding safety indicators, while both the level of use of Personal Protective Equipment (PPE) by professionals and the high level of PPE protection were positive aspects, the level of training of professionals to use PPE was a negative aspect. The Causal Link Diagram (CLD) showed that the perception of risk influenced the level of use of PPE and those organizational measures influenced the accident rate. CONCLUSION: In conclusion, the systemic analysis of the system dynamics can optimize the diagnostic process of occupational accidents in psychiatric hospitals, and especially help to identify the cause and effect among the variables involved.

Mixoma de válvula mitral. El ecocardiograma como herramienta de caracterización tisular. Reporte de caso / Mitral valve myxoma. The echocardiogram as a tissue characterization tool. A case report

Resumen: Compartimos el caso de un paciente de 32 años que se presentó con síndrome coronario agudo con elevación del ST en cara inferior y cineangiocoronariografía sin lesiones coronarias, a quien se le diagnosticó mediante ecocardiografía la presencia de un tumor en la válvula mitral. Mediante técnicas de caracterización tisular se arribó al diagnóstico presuntivo de mixoma que fue confirmado por la anatomía patológica.

Summary: We share the case of a 32-year-old patient who presented with inferior infarction and no coronary lesions at coronariography, in whom the presence of a tumor in the mitral valve was diagnosed by echocardiography. Through tissular characterization techniques, we arrived at a presumptive myxoma diagnosis, which was confirmed by pathological anatomy.