Surgical management of penetrating pulmonary injuries

Chest injuries were reported as early as 3000 BC in the Edwin Smith Surgical Papyrus. Ancient Greek chronicles reveal that they had anatomic knowledge of the thoracic structures. Even in the ancient world, most of the therapeutic modalities for chest wounds and traumatic pulmonary injuries were developed during wartime

Mobbing - Moral Harassment: Prospective Study in Public Hospitals of the Province of Buenos Aires, Argentina

Antecedentes: el mobbing se define como acoso, ofensa, exclusión social de alguien e interferencia negativa en sus tareas por uno o más individuos del mismo ambiente laboral. Objetivo: identificar los factores de riesgo, procedencia y análisis de la incidencia del mobbing, así como su relación con los factores de riesgo psicosociales y su afectación en los trabajadores de la salud. Material y métodos: estudio prospectivo, observacional descriptivo, con participante natural y de campo. Se utilizaron encuestas anónimas a personal sanitario incluido en las Leyes No 10.471 y No 10.430 de hospitales públicos de la provincia de Buenos Aires, durante un período de 12 meses consecutivos. Resultados: se incluyeron 147 participantes, de los cuales 101 (68,7%) fueron mujeres, 42 (28,5%) varones, y 4 (2,8%) no contestaron. El grupo más numeroso correspondió a la franja etaria 41-50 años (n = 51; 36%). La antigüedad laboral presentó una distribución bimodal de los grupos 1-5 años (27,25%) y 16-20 años (24%). El número que se consideró acosado fue de 86 agentes (58,5% de la muestra). Hubo mayor preponderancia de los superiores como los principales acosadores con 52,4% (n = 77). Conclusiones: la incidencia hallada es mayor que la informada en la literatura al comparar solo un sector laboral con la totalidad de la población activa (58,5% vs. 11,4%). Las variables sociodemográficas, como sexo, nacionalidad de origen, estado civil, nivel de estudios cursados y alcanzados y el tipo de contratación no se asociaron a una mayor incidencia de mobbing, como sí tuvieron una relación directa tanto la edad como la antigüedad, lo que confirma el acoso moral como un estresor crónico en el trabajo. Los motivos del ausentismo de naturaleza psicológica (depresión y crisis de ansiedad) producidos por el mobbing no solo afectan los síntomas psicosomáticos evaluados, sino también aumentan el ausentismo laboral, afectando la productividad de la empresa hospital.Background: mobbing is defined as harassment, offense, social exclusion of someone and negative interference in their work tasks by one or more individuals from the same work environment. Objective: to identify the risk factors, origin and analysis of the incidence of mobbing, as well as its relationship with psychosocial risk factors and their involvement in health workers. Material and methods: prospective, observational, descriptive study with natural and field participant. Anonymous surveys were used for health personnel included in Laws No. 10471 and No. 10430 from public hospitals in the province of Buenos Aires, during a 12-month period. Results: a total of 147 participants were included, 101 (68.7%) were female, 42 (28.5%) were male, and 4 (2.8%) did not answer. The largest group corresponded to the age group 41-50 years (n= 51; 36%). The age of labor presented a bimodal distribution of groups 1-5 years (27.25%) and 16-20 years (24%). The number that was considered harassed was 86 agents (58.5% of the sample). There was greater preponderance of superiors as the main stalkers with 52.4% (n= 77). Conclusions: the incidence found is greater than that reported in the literature when comparing a single labor sector with the total of the active population (58.5% vs. 11.4%). Sociodemographic variables such as gender, national origin, marital status, level of studies completed and type of recruitment, were not associated with a higher incidence of mobbing, as were age and seniority in a direct proportion, confirming moral harassment as a chronic stressor at work. The reasons for leave of absence of a psychological nature (depression and crisis of anxiety) produced by mobbing, not only affects the psychosomatic symptoms evaluated, but also increase work leaves of absence, affecting the productivity of the hospital.Facultad de Ciencias Económica

Mobbing - Moral Harassment: Prospective Study in Public Hospitals of the Province of Buenos Aires, Argentina

Antecedentes: el mobbing se define como acoso, ofensa, exclusión social de alguien e interferencia negativa en sus tareas por uno o más individuos del mismo ambiente laboral. Objetivo: identificar los factores de riesgo, procedencia y análisis de la incidencia del mobbing, así como su relación con los factores de riesgo psicosociales y su afectación en los trabajadores de la salud. Material y métodos: estudio prospectivo, observacional descriptivo, con participante natural y de campo. Se utilizaron encuestas anónimas a personal sanitario incluido en las Leyes No 10.471 y No 10.430 de hospitales públicos de la provincia de Buenos Aires, durante un período de 12 meses consecutivos. Resultados: se incluyeron 147 participantes, de los cuales 101 (68,7%) fueron mujeres, 42 (28,5%) varones, y 4 (2,8%) no contestaron. El grupo más numeroso correspondió a la franja etaria 41-50 años (n = 51; 36%). La antigüedad laboral presentó una distribución bimodal de los grupos 1-5 años (27,25%) y 16-20 años (24%). El número que se consideró acosado fue de 86 agentes (58,5% de la muestra). Hubo mayor preponderancia de los superiores como los principales acosadores con 52,4% (n = 77). Conclusiones: la incidencia hallada es mayor que la informada en la literatura al comparar solo un sector laboral con la totalidad de la población activa (58,5% vs. 11,4%). Las variables sociodemográficas, como sexo, nacionalidad de origen, estado civil, nivel de estudios cursados y alcanzados y el tipo de contratación no se asociaron a una mayor incidencia de mobbing, como sí tuvieron una relación directa tanto la edad como la antigüedad, lo que confirma el acoso moral como un estresor crónico en el trabajo. Los motivos del ausentismo de naturaleza psicológica (depresión y crisis de ansiedad) producidos por el mobbing no solo afectan los síntomas psicosomáticos evaluados, sino también aumentan el ausentismo laboral, afectando la productividad de la empresa hospital.Background: mobbing is defined as harassment, offense, social exclusion of someone and negative interference in their work tasks by one or more individuals from the same work environment. Objective: to identify the risk factors, origin and analysis of the incidence of mobbing, as well as its relationship with psychosocial risk factors and their involvement in health workers. Material and methods: prospective, observational, descriptive study with natural and field participant. Anonymous surveys were used for health personnel included in Laws No. 10471 and No. 10430 from public hospitals in the province of Buenos Aires, during a 12-month period. Results: a total of 147 participants were included, 101 (68.7%) were female, 42 (28.5%) were male, and 4 (2.8%) did not answer. The largest group corresponded to the age group 41-50 years (n= 51; 36%). The age of labor presented a bimodal distribution of groups 1-5 years (27.25%) and 16-20 years (24%). The number that was considered harassed was 86 agents (58.5% of the sample). There was greater preponderance of superiors as the main stalkers with 52.4% (n= 77). Conclusions: the incidence found is greater than that reported in the literature when comparing a single labor sector with the total of the active population (58.5% vs. 11.4%). Sociodemographic variables such as gender, national origin, marital status, level of studies completed and type of recruitment, were not associated with a higher incidence of mobbing, as were age and seniority in a direct proportion, confirming moral harassment as a chronic stressor at work. The reasons for leave of absence of a psychological nature (depression and crisis of anxiety) produced by mobbing, not only affects the psychosomatic symptoms evaluated, but also increase work leaves of absence, affecting the productivity of the hospital.Facultad de Ciencias Económica

Inteligencia artificial y redes neurales artificiales

Hace tiempo que la inteligencia artificial abandonó el espectro de la ciencia ficción para filtrarse e instalarse en nuestras vidas, y está llamada a protagonizar una revolución equiparable a la que generó internet. Pero ¿qué es realmente la Inteligencia Artificial (IA)? Es la combinación de algoritmos planteados con el propósito de crear sistemas que repliquen las mismas capacidades que el ser humano

Condiciones psicofísicas en el acoso moral en el trabajo : Factores de riesgo y experiencia en hospitales públicos provinciales

El interés por estudiar el fenómeno de acoso laboral se debe a la frecuencia en que se produce, a las graves consecuencias sobre la salud de las víctimas y para las organizaciones, y fundamentalmente a la necesidad de intervención con oportunas medidas de prevención. Es por ello que interesa conocer las situaciones ligadas al mobbing, su entorno y las circunstancias en las cuales se presenta, y sus consecuencias. El presente trabajo se divide en dos apartados principales. La primera parte describe el ámbito en que se desarrolla el estudio, como es el hospital público dependiente del Ministerio de Salud de la provincia de Buenos Aires. Se trata de un sector especialmente significativo para estudiar un fenómeno que está fuertemente influenciado por aspectos contextuales y organizativos. De allí que el objetivo del presente estudio sea analizar las condiciones psicofísicas en el acoso moral en el trabajo así como los factores de riesgo en dichos hospitales. La segunda parte presenta los objetivos y la justificación del presente estudio, el método utilizado, los principales resultados obtenidos y su discusión. Se describirán las posibles explicaciones de este fenómeno, haciendo hincapié en las medidas preventivas, finalizando con las conclusiones.Facultad de Ciencias Económicas (FCE

Pericardiocentesis Followed by Thoracotomy and Repair of Penetrating Cardiac Injury Caused by Nail Gun Injury to the Heart

INTRODUCTION: Work site injuries involving high projectile tools such as nail guns can lead to catastrophic injuries. Generally, penetrating cardiac injuries are associated with a high mortality rate. PRESENTATION OF CASE: A construction worker was brought to the emergency room having sustained a nail gun injury to the chest. The patient was hypotensive, tachycardic with prominent jugular venous distention, and had a profound lactic acidosis. Bedside ultrasound confirmed the presence of pericardial fluid. Pericardiocentesis was performed twice using a central venous catheter inserted into the pericardial space, resulting in improvement in the patient\u27s hemodynamics. Thereafter he underwent left anterolateral thoracotomy and repair of a right atrial laceration. He recovered uneventfully. DISCUSSION: Penetrating cardiac injuries caused by nail guns, although rare, have been previously described. However, pericardiocentesis, while retaining a role in the management of medical causes of cardiac tamponade, has been reported only sporadically in the setting of trauma. We report a rare case of penetrating nail gun injury to the heart where pericardiocentesis was used as a temporizing measure to stabilize the patient in preparation for definitive but timely operative intervention. CONCLUSION: We propose awareness that percardiocentesis can serve as a temporary life saving measure in the setting of trauma, particularly as a bridge to definitive therapy. To our knowledge, this represents the first reported case of catheter pericardiocentesis used to stabilize a patient until definitive repair of a penetrating cardiac injury caused by a nail gun

Bringing Packed Red Blood Cells to the Point of Combat Injury: Are We There Yet?

INTRODUCTION: Hemorrhage is the leading cause of injury related pre-hospital mortality. We investigated worst case scenarios and possible requirements of Turkish Military. As we plan to use blood resources during casualty transport, the impact of transport related mechanical stress on PRBC (packed red blood cell) were analyzed. MATERIAL AND METHODS: The in vitro experiment was performed in the environmental test laboratories of ASELSAN(R). Operational vibrations of potential casualty transport mediums such as Sikorsky Helicopters, Kirpi(R) Armoured Vehicle and NATO vibration standardsoftware MIL-STD-810G were recorded. The most powerful mechanical stress, which was created by the NATO standard, was applied to 15 units of fresh (7 day) PRBC in a blood cooler box. The vibrations were simulated by TDS v895 Medium-Force Shaker Device. On site blood samples were analyzed at 0, 6th and 24th hours for biochemical and biomechanical analyses. RESULTS: The mean age of fresh and old PRBCs was 4.9 (SD +/- 2.2) and 32.8 (SD +/- 11.8) days, respectively. Six-hour mechanical damage of fresh PRBC was demonstrated by increased erythrocyte fragmentation rates (p=0.015), hemolysis rates (p=0.003), supernatant potassium levels (p=0.003) and decreased hematocrit levels (p=0.015). Old PRBC hemolysis rates (p=0.015), supernatant potassium levels (p=0.015), supernatant Hb (p=0.015) were increased and Htc levels were decreased (p=0.015) within 6 hours. Two (%13) units of fresh and none of the old PRBC were eligible for transfusion after 6 hours of mechanical stress. CONCLUSION: When the austere combat environment was simulated for 24 hours, fresh and old PRBC hemolysis rates were above the quality criteria. Currently, a technology to overcome this mechanical damage does not seem to exist. In the light of the above data, a new national project is being performed

SARS-CoV-2 Breakthrough Infections According to the Immune Response Elicited after mRNA Third Dose Vaccination in COVID-19-Naïve Hospital Personnel

Background: Vaccine-induced SARS-CoV-2-anti-spike antibody (anti-S/RBD) titers are often used as a marker of immune protection and to anticipate the risk of breakthrough infections, although no clear cut-off is available. We describe the incidence of SARS-CoV-2 vaccine breakthrough infections in COVID-19-free personnel of our hospital, according to B- and T-cell immune response elicited one month after mRNA third dose vaccination. Methods: The study included 487 individuals for whom data on anti-S/RBD were available. Neutralizing antibody titers (nAbsT) against the ancestral Whuan SARS-CoV-2, and the BA.1 Omicron variant, and SARS-CoV-2 T-cell specific response were measured in subsets of 197 (40.5%), 159 (32.6%), and 127 (26.1%) individuals, respectively. Results: On a total of 92,063 days of observation, 204 participants (42%) had SARS-CoV-2 infection. No significant differences in the probability of SARS-CoV-2 infection for different levels of anti-S/RBD, nAbsT, Omicron nAbsT, or SARS-CoV-2 T cell specific response, and no protective thresholds for infection were found. Conclusions: Routine testing for vaccine-induced humoral immune response to SARS-CoV-2 is not recommended if measured as parameters of ‘protective immunity’ from SARS-CoV-2 after vaccination. Whether these findings apply to new Omicron-specific bivalent vaccines is going to be evaluated

Risk and protective factors for {sars}-{cov}-2 reinfections, surveillance data, Italy, August 2021 to March 2022

We explored the risk factors associated with SARS-CoV-2 reinfections in Italy between August 2021 and March 2022. Regardless of the prevalent virus variant, being unvaccinated was the most relevant risk factor for reinfection. The risk of reinfection increased almost 18-fold following emergence of the Omicron variant compared with Delta. A severe first SARS-CoV-2 infection and age over 60 years were significant risk factors for severe reinfection