ObjectivesThe objective of this study is to evaluate the impact of the COVID-19 outbreak on mental health and burn-out syndrome in Spanish internists and the factors that could be related to its appearance.DesignWe performed an observational, cross-sectional, descriptive study for which we designed a survey that was distributed in May 2020.SettingWe included internists who worked in Spain during the COVID-19 outbreak.ParticipantsA total of 1015 internists responded to the survey. Of those 62.9% were women.ResultsOf 1015 people, 58.3% presented with high emotional exhaustion, 61.5% had a high level of depersonalisation and 67.6% reported low personal fulfilment. 40.1% presented with the 3 criteria described, and therefore burn-out syndrome.Burn-out syndrome was independently related to the management of patients with SARS-CoV-2 (HR: 2.26; 95% CI 1.15 to 4.45), the lack of availability of personal protective equipment (HR: 1.41; 95% CI 1.05 to 1.91), increased responsibility (HR: 2.13; 95% CI 1.51 to 3.01), not having received financial compensation for overtime work (HR: 0.43; 95% CI 0.31 to 0.62), not having rested after 24-hour shifts (HR: 1.61; 95% CI 1.09 to 2.38), not having had holidays in the previous 6 months (HR: 1.36; 95% CI 1.01 to 1.84), consumption of sleeping pills (HR: 1.83; 95% CI 1.28 to 2.63) and higher alcohol intake (HR: 1.95; 95% CI 1.39 to 2.73).ConclusionsDuring the COVID-19 outbreak, 40.1% of Internal Medicine physicians in Spain presented with burn-out syndrome, which was independently related to the assistance of patients with SARS-CoV-2, overworking without any compensation and the fear of being contagious to their relatives. Therefore, it is imperative to initiate programmes to prevent and treat burn-out in front-line physicians during the COVID-19 outbreak.

Due to its high incidence, low back pain is a major problem from a social, health, and labor perspective. It is considered one of the most common causes of medical consultations in primary care, and one of the main reasons for temporary disability. A correct diagnostic approach and adequate therapeutic management will allow for better control of the clinical condition and its evolution. To do this, there are functional assessment techniques, both objective and subjective, which will provide fundamental information to perform appropriate management of the pathology, as well as to assess the effectiveness of the treatment. Within the subjective techniques, the Oswestry disability index is the most widely questionnaire used in hospitals, while the Roland Morris scale is used mainly in primary care. The results provided by the isokinetic and isoinertial techniques assess the functional capacity of the lumbar spine in an easy and convenient way for the patient. The main objective of this study is to present different subjective questionnaires and objective techniques to make a correct valuation of lumbar pain, improving access to adequate treatment and reducing work time.

El síndrome piramidal forma parte de las neuropatías por atrapamiento, en el que se ve comprimido el nervio ciático a su paso a través de la escotadura isquiática. Mujer de 40 años diagnosticada de síndrome piramidal y radiculopatía L5-S1 como consecuencia de accidente de tráfico. Se trata de una patología infradiagnosticada, probablemente debido a su complejidad diagnóstica y a la superposición de síntomas comunes a otras patologías. El retraso diagnóstico conlleva una cronificación de la sintomatología y una dificultad en el manejo terapéutico. La combinación de una analgesia adecuada, tratamiento rehabilitador y técnicas invasivas suele ser el tratamiento de elección.

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Durante el embarazo, hay cambios fisiológicos que producen alteraciones en la farmacocinética de los diferentes antimicrobianos, además de los efectos tóxicos que los mismos pueden tener sobre el embrión y el feto. La mayor parte de los antibióticos pasan la barrera hematoplacentaria y hay una limitación al realizar ensayos clínicos en el embarazo para valorar la efectividad de unos fármacos u otros. A continuación, se presentan diferentes escenarios clínicos durante el embarazo y las mejores opciones de tratamiento antibiótico

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