Search

A cross-sectional study was performed to assess the frequency of burnout in healthcare workers of a university teaching hospital in Rome (Italy), by means of the Maslach Burnout Inventory. In total 142 healthcare workers participated in the study. Average levels of emotional exhaustion and depersonalization were observed in the study population. Working in emergency care services was found to be correlated with lower levels of personal accomplishment with respect to working in other services. Monitoring burnout in social service and healthcare workers is an effective tool for identifying critical situations in the workplace.

The goal of our study was to estimate the presence (or absence) of latero-cervical nodal metastases (pN+), in patients with squamous oropharyngeal cancer, correlating this finding with T stage. We examined 255 patients out of 329 affected by squamous oropharyngeal cancer, from 1976 to 2005. The 255 patients examined were treated surgically (both T and N). As far as clinical latero-cervical nodal metastases were concerned, 215 patients (84%) were cN+, while 40% (16%) were cN-. The result of the histological examination showed that 82% of the neck dissections (both cN+ and cN-) actually had latero-cervical metastases, while the remaining patients had reactive lymph nodes. The false-positive (cN+ -->pN-) patients, were 14% while false-negative patients (cN- -->pN+) amounted to 63%. The correlation between T and pN+ of the patients classified as cN- showed that 24% of patients were T1, 44% T2, 32% T3, and none T4; the pN+ patients, who clinically manifested latero-cervical lymph-node metastases were: T1 8%, T2 15%, T3 37%, T4 40%. Analysis of these data led us to the conclusion that, in view of the high lymphophilia of squamous cancer in the oropharyngeal district, it would be advisable to treat N metastases, both cN+ and cN-, at any T stage of cancer, surgically or with chemo- or radiotherapy, according to the patient's performance status.

The author proposes a modus operandi for organizing first-aid services for motor-racing accidents. After reviewing the literature relating to first-aid systems and the provisions of aw applying in this field, attention is drawn to the need to create efficient first-aid systems, particularly in view of the very high number of such events held during the course of the year. In particular, the author examines the problems relating to the study of the territory in which the event is to be held and suggests special training for technical support personnel and for those actually participating in races. He then goes on to assess in detail the positioning of emergency vehicles, the choice of such vehicles and means of liaison with the base of operations. Particular attention is devoted to the role of the doctor in charge of the first-aid service, who should possess the necessary expertise and practical experience.

The Authors reviewed their experience with palliative intubation for esophageal cancer. They have treated with endoscopic endoprostheses 197 patients with malignant strictures of the esophagus and/or cardias. Results and complications ore reported.