Inter-Professional Collaboration and Occupational Well-Being of Physicians Who Work in Adverse Working Conditions

Inter-professional collaboration, empathy and lifelong learning, components of medical professionalism, have been associated with occupational well-being in physicians. However, it is not clear whether this role persists in adverse working conditions. This study was performed to assess whether this is the case. These three abilities, and the self-perception of somatization, exhaustion and work alienation, were measured in a sample of 60 physicians working in a hospital declared to be in an institutional emergency. A multiple regression model explained 40% of the variability of exhaustion, with a large effect size (Cohen’s-f 2 = 0.64), based on a linear relationship with teamwork (p = 0.01), and more dedication to academic (p < 0.001) and management activities (p < 0.003). Neither somatization nor alienation were predicted by empathy or lifelong learning abilities. Somatization, exhaustion, or alienation scores either explained empathy, inter-professional collaboration or lifelong learning scores. These findings indicate that, in adverse working environments, physicians with a greater sense of inter-professional collaboration or performing multi-task activities are more exposed to suffering exhaustion.Fundación Rioja Salu

Scorpion sting, literature review and update

Introducción: las picaduras de escorpión son comunes en diversas partes del mundo y son un verdadero problema de salud pública.Objetivo: describir las especies de alacranes, características del veneno, fisiopatología, manifestaciones clínicas, clasificación de la gravedad, diagnóstico y su manejo en la unidad de cuidados intensivos.Métodos: se realizó una búsqueda de información en el periodo febrero-marzo de 2023 en las bases de datos SciELO, Scopus, PubMed/MedLine, el buscador Google Académico, así como en los servicios ClinicalKeys. De los documentos resultantes se seleccionaron aquellos redactados en los últimos 10 años, en idioma español o inglés.Desarrollo: aproximadamente existen 2584 especies de alacranes. La especie Tityus (Tityus) sorataensis fue descrita para Bolivia. Los venenos de escorpión se han estudiado durante más de un siglo. Las principales manifestaciones clínicas: placas de urticaria, hinchazón, eritema, equimosis y celulitis con edema. Las manifestaciones sistémicas   van de uno a dos días después del envenenamiento y pueden desarrollar signos sistémicos: fiebre, palidez, fatiga, edema generalizado. El diagnóstico se basa en una historia de una picadura de escorpión y signos característicos de envenenamiento. El tratamiento puede ser empírico, aplicar medidas generales, manejo del dolor y si está presente algunas complicaciones como edema pulmonar, choque cardiogénico es necesario su manejo en una sala de cuidados intensivosConclusiones: la intoxicación por picadura de alacrán, es un reto terapéutico. Es recomendable la administración del antídoto (antiveneno) junto al tratamiento de sostén. un mejor conocimiento de los escorpiones, puede alentar el interés en realizar nuevas investigaciones. Introduction: scorpion stings are common in different parts of the world and are a real public health problem.Objective: to describe scorpion species, venom characteristics, pathophysiology, clinical manifestations, severity classification, diagnosis and management in the intensive care unit.Methods: a search for information was carried out in the period February-March 2023 in the SciELO, Scopus, PubMed/MedLine databases, the Google Scholar search engine, as well as in the ClinicalKeys services. The resulting documents were selected from those written in the last 10 years, in Spanish or English.Development: There are approximately 2584 species of scorpions. The species Tityus (Tityus) sorataensis was described for Bolivia. Scorpion venoms have been studied for more than a century. The main clinical manifestations: urticarial plaques, swelling, erythema, ecchymosis and cellulitis with edema. Systemic manifestations range from one to two days after envenomation and may develop systemic signs: fever, pallor, fatigue, generalized edema. Diagnosis is based on a history of a scorpion sting and characteristic signs of envenomation. Treatment can be empirical, applying general measures, pain management and if some complications such as pulmonary edema, cardiogenic shock are present, management in an intensive care unit is necessary.Conclusions: intoxication by scorpion sting is a therapeutic challenge. It is advisable to administer antivenom together with supportive treatment. A better knowledge of scorpions may encourage interest in further research