RESUMO
Biliary tract complications after orthotopic liver transplantation (OLT) are frequently reported. The diagnosis and management of these complications have become increasingly crucial, with digital single operator cholangioscopy (DSOC) emerging as an essential tool. We describe the approach to biliary complications using DSOC in 5 patients post-OLT. Inflammatory and ischemic stricture, a stricture secondary to post-transplant lymphoproliferative disease, and common bile duct lithiasis were the main findings. The exceptional image quality provided by the DSCO allowed us to precisely characterize strictures, observe epithelial changes, and identify obstructions due to bile casts that remained undetectable through ERCP. DSOC is a viable method for evaluating post-OLT biliary complications, offering alternative therapies beyond ERCP, thus improving care precision and outcomes.
RESUMO
INTRODUCCIÓN: Se ha demostrado que el desarrollo de burnout en los médicos se inicia desde su formación académica y puede repercutir en su vida personal. OBJETIVO: Evaluar la prevalencia de burnout al inicio y tras un mes de rotación clínica. MATERIAL Y MÉTODOS: Se empleó el Maslach Burnout Inventory-Human Services Survey de 22 reactivos. Se evaluaron al inicio de la rotación, después de un período vacacional, y después de un mes de rotación clínica. Se estableció la prevalencia y las diferencias entre las 2 mediciones. RESULTADOS: Veintiún (12,3%) alumnos presentaban síntomas de severidad al inicio del trimestre y 34 (19,8%) después del primer mes (p = 0,059). Tras eliminar la realización personal, 54 (31,6%) y 76 (44,2%) alumnos presentaron severidad en el resto de las dimensiones (p = 0,016), respectivamente. CONCLUSIÓN: Después de un mes de exposición clínica se presentó un incremento significativo en la presencia de cansancio emocional, despersonalización y burnout
INTRODUCTION: It has been demonstrated that the development of burnout in physicians begins during their academic training and it can affect their personal life. OBJECTIVE: To evaluate the prevalence of burnout in medical students at the beginning, and after one month of clinical rotation. MATERIALS AND METHODS: We evaluated students at the beginning of surgical clinical rotation and one month after using the Maslach Burnout Inventory-Human Services Survey. The prevalence and differences between the 2 measurements were calculated. RESULTS: Twenty-one (12.3%) students showed symptoms of severity at the beginning, and 34 (19.8%) after the first month (P = .059). After eliminating the personal accomplishment scale, 54 (31.6%) and 76 (44.2%) students had severity of symptoms in the rest of the dimensions at the beginning and after one month, respectively (P = .016). CONCLUSION: Medical students showed an increase in the presence of severe burnout, as well as emotional exhaustion and depersonalisation after one month of clinical rotation