Second victim phenomenon in a surgical area: Online survey.

BACKGROUND AND AIM OF STUDY: An effective and accessible first source of support for second victims (SV) is usually the colleagues themselves, who should have tools to help emotionally and detect the unusual course of a SV. The aim of this work is to assess health professionals' perception of the phenomenon, as well as their capability to apply psychological first aid. MATERIAL AND METHODS: Observational descriptive study through online surveys answered anonymously. Participants were different health professionals from surgical area, mainly from a third-level hospital. RESULTS: 329 responses, 67 anaesthesiologists, 110 anaesthesiologists in training, 152 nurses. 78.4% had felt SV, more frequent among anaesthesiologists; however, 58% had never heard of the term. Guilt was the most frequent emotion. Residents were more afraid of judgmental colleagues and thought more about drop out their training. From those who sought help, most did it through a colleague, but most did not feel useful in helping a SV. 66% affirmed there is a still punitive, evasive or silent culture about medical incidents. CONCLUSIONS: Despite the frequency of the phenomenon there is still lack of knowledge of the term SV. Impact of the phenomenon is heterogenous and changes based on experience and responsibility. Colleagues are the first source of emotional help but there is a lack of tools to be able to provide it. Institutions are urged to create training programs so that professionals can guarantee «psychological first aid¼.

Second victim phenomenon in a surgical area: online survey. / El fenómeno de segunda víctima en un área quirúrgica: Encuesta online.

BACKGROUND AND AIM OF STUDY: An effective and accessible first source of support for second victims (SV) is usually the colleagues themselves, who should have tools to help emotionally and detect the unusual course of a SV. The aim of this work is to assess health professionals' perception of the phenomenon, as well as their capability to apply psychological first aid. MATERIAL AND METHODS: Observational descriptive study through online surveys answered anonymously. Participants were different health professionals from surgical area, mainly from a third-level hospital. RESULTS: 329 responses, 67 anaesthesiologists, 110 anaesthesiologists in training, 152 nurses. 78.4% had felt SV, more frequent among anaesthesiologists; however, 58% had never heard of the term. Guilt was the most frequent emotion. Residents were more afraid of judgmental colleagues and thought more about drop out their training. From those who sought help, most did it through a colleague, but most did not feel useful in helping a SV. 66% affirmed there is a still punitive, evasive or silent culture about medical incidents. CONCLUSIONS: Despite the frequency of the phenomenon there is still lack of knowledge of the term SV. Impact of the phenomenon is heterogenous and changes based on experience and responsibility. Colleagues are the first source of emotional help but there is a lack of tools to be able to provide it. Institutions are urged to create training programs so that professionals can guarantee «psychological first aid¼.

Usefulness of biomarkers on infection management: with or without them?

Infectious diseases are disorders caused by many different microorganisms that produce clinical conditions with a wide variation in patient-rated symptoms and severity. Therefore, different diagnostic and prognostic tools are needed to help make the most accurate decisions at each moment of patient´s care with suspected infection. This mini review will analyse how some biomarkers reduce the level of uncertainty in the making decision process at some phases of sepsis, including prompt identification of septic patients, early initiation of empiric broad-spectrum antimicrobials, regimen and duration.

Protein digestion and absorption in the rat.

1. A randomly labelled 14C protein was synthesized in order to investigate the site and rate of digestion and absorption of dietary protein in the rat. 2. A liquid test meal consisting of protein and a non-absorbable marker, 51CrCl3, was administered to rats which were then sacrificed at intervals up to 4 hr after ingestion of the meal. Analysis of intestinal contents showed that as gastric emptying proceeded, the meal moved rapidly to the distal two thirds of the small intestine. 3. Protein digestion and absorption occurred predominantly in this area over a period of 1-2 hr. 4. Amounts of endogenous protein present in the small intestine never exceeded amounts of exogenous protein during maximum absorption of exogenous protein (0-1 hr). At later time periods (2-4 hr), however, more endogenous than exogenous protein was detected in the intestinal lumen. 5. It is concluded that the digestion and absorption of dietary protein is a rapid process, taking place in the distal two-thirds of the small intestine. Endogenous protein levels do not exceed exogenous protein levels until after the bulk of exogeneous protein is absorbed.

Alterations of membrane glycopeptides in human colonic adenocarcinoma.

Membrane glycopeptides were examined in human colonic adenocarcinoma and normal colonic mucosa. The carbohydrates of membrane glycopeptides were found to be markedly reduced in tumor tissue and the relative proportions of the various sugars were altered. Although all of the sugars were lower in tumor tissue when compared to the adjacent normal mucosa, galactosamine, fucose, and sialic acid were more significantly reduced. Examination of the blood group activity and lectin-binding properties of membrane glycopeptides revealed that specific carbohydrate structures had changed in the tumor tissue. Most striking of these changes was the disappearance of glycoprotein-associated blood group A activity. Assay of the enzyme responsible for synthesis of the blood group A determinant showed that this glycosyltransferase activity was greatly diminished in tumor tissue. A galactosyltransferase and a fucosyltransferase were also significantly lower in the tumor tissue whereas the levels of another galactosyltransferase and a sialyltransferase were unaltered. Glycosidase activities in the normal and tumor tissues were similar. The results show that an alteration in glycoprotein biosynthesis occurred during tumorigenesis that resulted in a modified membrane glycoprotein composition and that these changes are probably a reflection of reduced levels of the enzymes responsible for glycoprotein synthesis.