Parosteal lipoma is a rare benign soft tissue mesenchymal tumour that may impair limb motor function when located adjacent to neurovascular structures. We report a case of a woman in her 80s with a long-standing lesion in the forearm and consequent sensory and motor function changes. She was admitted for an elective excision of the lipoma. Postoperative evolution was favourable, with marked improvement of limb function. Our aim in sharing this case is to create awareness of these rare deep-seated lipomas that might originate nerve palsy and should therefore be excised as soon as possible to avoid neurological damage.
Cardiac arrest is relatively an uncommon event during cesarean sections. That’s why obstetric teams have low exposure to these critical situations and need frequent training in early identification, differential diagnosis and treatment. We present a case report of a 36-year-old woman, who underwent cesarean section under spinal anesthesia due to delayed labor progress. Once the skin incision was performed the patient underwent asystole. There is a wide range of etiologies for maternal cardiac arrest. We describe and analyze the possible etiologies that could have led to cardiac arrest in this particular case. Citation: Germanova L, Czajkowska K, Gomes J, Infante C, Castro M, Martins I. Cardiac arrest during cesarean section - A case report. Anaesth pain & intensive care 2019;23(4)__ Received: 10 September 2019, Reviewed: 28 September, 23 October 2019, Revised: 24 October 2019, Accepted: 28 October 2019
Background and Goal of Study:Considering anesthesiologists among other medical specialties, it is well known that they have an increased risk of suffering from burnout syndrome. Unfortunately, burnout syndrome is often related to lower work performance, coronary artery disease and deteriorating overall mental health, all of which may seriously affect the patient's treatment. The aim of this paper is to compare possible burnout syndrome among Croatian anesthesiologists. Materials and Methods:This research involved 2568 doctors working in different fields of medicine including 177 anaesthesiologists. The Maslach Burnout Inventory (MBI) was used to measure burnout. MBI defines burnout as a three-dimensional syndrome via 22 questions; 9 question relate to emotional exhaustion (EE), 5 question relate to depersonalization (DP) and 8 question relate to diminished personal accomplishment (PA). Possible answers on the main scale ranged from 0=never to 6=every day. We created 3 subscales for every MBI dimension; EE subscale with severity indeks (SI) ranging from ≥27 for high, 27-16 for moderate and ≤16 for low, DP subscale with SI ≥13 for high, 13-6 for moderate and ≤6 for low and PA subscale with SI ≥39 for high, 39-31 for average and ≤31 for low. Results and discussion:All 2568 doctors had EE of 30% (high), DP of 8,75% (moderate) and PA of 29,9% (low). 63% of anesthesiologist showed high EE, 57% exibited high PA and 46% had low DP. Emotional exhaustion is lowest when their career begins or ends. Depersonalization deteriorates over time whereas diminished personal accomplishment is constant throughout the working years. We also found positive correlation between DP total score and years of experience (r=-0,320, p<0,0001). A total of 55 (33%) were resident, 72 (42%) consultants and 44 (25%) subspecialist and we found statistical significant differences of DP score (p=0,026). Conclusion(s):Anestesiologists are not trained to fail. In relation to sense of increased responsibility and perfectionism, these factors trigger burnout syndrome. It often emerges when there is insufficient workforce so fewer anesthesiologists must compensate, often working overtime, for the lack of their colleagues. Results show that prevention of burnout is highly necessary among Croatian anesthesiologists and it involves a spectrum of measures, ranging from changing the working conditions to taking care of employee's overall mental health.
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