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Abdel MP, Pulido L, Severson EP, Hanssen AD. Stepwise surgical correction of instability in flexion after total knee replacement. Bone Joint J 2015; 96-B:1644-8. [PMID: 25452367 DOI: 10.1302/0301-620x.96b12.34821] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Instability in flexion after total knee replacement (TKR) typically occurs as a result of mismatched flexion and extension gaps. The goals of this study were to identify factors leading to instability in flexion, the degree of correction, determined radiologically, required at revision surgery, and the subsequent clinical outcomes. Between 2000 and 2010, 60 TKRs in 60 patients underwent revision for instability in flexion associated with well-fixed components. There were 33 women (55%) and 27 men (45%); their mean age was 65 years (43 to 82). Radiological measurements and the Knee Society score (KSS) were used to assess outcome after revision surgery. The mean follow-up was 3.6 years (2 to 9.8). Decreased condylar offset (p < 0.001), distalisation of the joint line (p < 0.001) and increased posterior tibial slope (p < 0.001) contributed to instability in flexion and required correction at revision to regain stability. The combined mean correction of posterior condylar offset and joint line resection was 9.5 mm, and a mean of 5° of posterior tibial slope was removed. At the most recent follow-up, there was a significant improvement in the mean KSS for the knee and function (both p < 0.001), no patient reported instability and no patient underwent further surgery for instability. The following step-wise approach is recommended: reduction of tibial slope, correction of malalignment, and improvement of condylar offset. Additional joint line elevation is needed if the above steps do not equalise the flexion and extension gaps.
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Journal Article |
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Kappenschneider T, Maderbacher G, Weber M, Greimel F, Holzapfel D, Parik L, Schwarz T, Leiss F, Knebl M, Reinhard J, Schraag AD, Thieme M, Turn A, Götz J, Zborilova M, Pulido LC, Azar F, Spörrer JF, Oblinger B, Pfalzgraf F, Sundmacher L, Iashchenko I, Franke S, Trabold B, Michalk K, Grifka J, Meyer M. Special orthopaedic geriatrics (SOG) - a new multiprofessional care model for elderly patients in elective orthopaedic surgery: a study protocol for a prospective randomized controlled trial of a multimodal intervention in frail patients with hip and knee replacement. BMC Musculoskelet Disord 2022; 23:1079. [PMID: 36494823 PMCID: PMC9733347 DOI: 10.1186/s12891-022-05955-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/04/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to demographic change, the number of older people in Germany and worldwide will continue to rise in the coming decades. As a result, the number of elderly and frail patients undergoing total hip and knee arthroplasty is projected to increase significantly in the coming years. In order to reduce risk of complications and improve postoperative outcome, it can be beneficial to optimally prepare geriatric patients before orthopaedic surgery and to provide perioperative care by a multiprofessional orthogeriatric team. The aim of this comprehensive interventional study is to assess wether multimorbid patients can benefit from the new care model of special orthopaedic geriatrics (SOG) in elective total hip and knee arthroplasty. METHODS The SOG study is a registered, monocentric, prospective, randomized controlled trial (RCT) funded by the German Federal Joint Committee (GBA). This parallel group RCT with a total of 310 patients is intended to investigate the specially developed multimodal care model for orthogeriatric patients with total hip and knee arthroplasty (intervention group), which already begins preoperatively, in comparison to the usual orthopaedic care without orthogeriatric co-management (control group). Patients ≥70 years of age with multimorbidity or generally patients ≥80 years of age due to increased vulnerability with indication for elective primary total hip and knee arthroplasty can be included in the study. Exclusion criteria are age < 70 years, previous bony surgery or tumor in the area of the joint to be treated, infection and increased need for care (care level ≥ 4). The primary outcome is mobility measured by the Short Physical Performance Battery (SPPB). Secondary outcomes are morbidity, mortality, postoperative complications, delirium, cognition, mood, frailty, (instrumental) activities of daily living, malnutrition, pain, polypharmacy, and patient reported outcome measures. Tertiary outcomes are length of hospital stay, readmission rate, reoperation rate, transfusion rate, and time to rehabilitation. The study data will be collected preoperative, postoperative day 1 to 7, 4 to 6 weeks and 3 months after surgery. DISCUSSION Studies have shown that orthogeriatric co-management models in the treatment of hip fractures lead to significantly reduced morbidity and mortality rates. However, there are hardly any data available on the elective orthopaedic care of geriatric patients, especially in total hip and knee arthroplasty. In contrast to the care of trauma patients, optimal preoperative intervention is usually possible. TRIAL REGISTRATION German Clinical Trials Register DRKS00024102. Registered on 19 January 2021.
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Estrada O, Pulido L, Admella C, Hidalgo LA, Clavé P, Suñol X. Sentinel lymph node biopsy as a prognostic factor in non-metastatic colon cancer: a prospective study. Clin Transl Oncol 2016; 19:432-439. [PMID: 27541595 DOI: 10.1007/s12094-016-1543-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/06/2016] [Indexed: 02/06/2023]
Abstract
PURPOSE Around a third of node-negative patients with colon cancer experience a recurrence after surgery, suggesting poor staging. Sentinel lymph node techniques combined with immunochemistry could improve colon cancer staging. We prospectively assessed the effect of Sentinel node mapping on staging and survival in patients with non-metastatic colon cancer. METHODS An observational and prospective study was designed. 105 patients with colon cancer were selected. Patients were classified according to node involvement as: N1, with node invasion detected by the conventional techniques; up-staged, with node invasion detected only by sentinel node mapping; and N0, with negative lymph node involvement by both techniques. Five-year survival and disease-free survival rates were analysed. Multivariate regression analyses were performed to identify prognostic factors for disease-free and overall survival. RESULTS Sentinel node mapping was successfully applied in 78 patients: 33 % were N1; 24.5 % were up-staged (18 patients with isolated tumour cells and 1 patient with micrometastases); and 42.5 % were N0. N1 patients had the poorest overall 5-year survival (65.4 %) and 5-year disease-free survival (69.2 %) rates compared with the other two groups. No significant 5-year survival differences were observed between N0 patients (87.9 %) and up-staged patients (84.2 %). CONCLUSIONS Patients up-staged after sentinel node mapping do not have a poorer prognosis than patients without node involvement. Detection of isolated cancer cells was not a poor prognosis factor in these patients.
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Dal Cero M, Rodríguez-Santiago J, Miró M, Castro S, Miranda C, Santamaría M, Gobbini Y, Garsot E, Pujadas M, Luna A, Momblán D, Balagué C, Aldeano A, Olona C, Molinas J, Pulido L, Sánchez-Cano JJ, Güell M, Salazar D, Gimeno M, Grande L, Pera M. Evaluation of data quality in the Spanish EURECCA Esophagogastric Cancer Registry. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2021; 47:3081-3087. [PMID: 33933340 DOI: 10.1016/j.ejso.2021.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/27/2021] [Accepted: 04/19/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although the number of nationwide clinical registries in upper gastrointestinal cancer is increasing, few of them perform regular clinical audits. The Spanish EURECCA Esophagogastric Cancer Registry (SEEGCR) was launched in 2013. The aim of this study was to assess the reliability of the data in terms of completeness and accuracy. METHODS Patients who were registered (2014-2017) in the online SEEGCR and underwent esophagectomy or gastrectomy with curative intent were selected for auditing. Independent teams of surgeons visited each center between July 2018 and December 2019 and checked the reliability of data entered into the registry. Completeness was established by comparing the cases reported in the registry with those provided by the Medical Documentation Service of each center. Twenty percent of randomly selected cases per hospital were checked during on-site visits for testing the accuracy of data (27 items per patient file). Correlation between the quality of the data and the hospital volume was also assessed. RESULTS Some 1839 patients from 19 centers were included in the registry. The mean completeness rate in the whole series was 97.8% (range 82.8-100%). For the accuracy, 462 (25.1%) cases were checked. Out of 12,312 items, 10,905 were available for verification, resulting in a perfect agreement of 95% (87.1-98.7%). There were 509 (4.7%) incorrect and 35 (0.3%) missing entries. No correlation between hospital volume and the rate of completeness and accuracy was observed. CONCLUSIONS Our results indicate that the SEEGCR contains reliable data.
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Schuh A, Mada L, Pulido LC, Koehl P. [Mallet finger]. MMW Fortschr Med 2025; 167:9. [PMID: 40180711 DOI: 10.1007/s15006-025-4657-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2025]
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Gabbai F, Aceves A, Pulido L, Mendoza Aviña V, Fernández M, Hernández-Ortíz J, Bordes-Aznar J, Chávez-Peón F, Arriaga-Gracia J, Herrera-Acosta J. [Renovascular hypertension. Studies of 16 cases with long-term follow-up]. ARCHIVOS DEL INSTITUTO DE CARDIOLOGIA DE MEXICO 1984; 54:355-66. [PMID: 6388517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Surgical correction of renovascular hypertension was studied in 16 patients. In all the patients severe high blood pressure and stenosis of at least one renal artery was demonstrated; in 14 patients plasma renin activity (PRA) in renal veins and peripheral blood was measured. All cases were followed for 36 to 48 months after surgical treatment. Blood pressure was normalized after surgical treatment (2 aortorenal bypasses, 2 nephrectomies and 7 autotransplants) in 7 patients, all of them had hyperreninemia, hypersecretion from the stenotic kidney and suppression of the contralateral kidney. In one patient with stenosis of one renal artery, blood pressure was normalized after surgery, even though no alterations in renin secretion was demonstrated. Surgery (1 bypass, 2 nephrectomies, 1 autotransplant and 1 aortorenal anastomosis) induced a decrease in blood pressure in five patients, all had normal PRA in peripheral blood and hypersecretion from the stenotic kidney. Three patients remained hypertensive in spite of nephrectomy of the stenotic kidney all had hyperreninemia without lateralization. In two patients renal failure was evident from the time they entered the study; both had hyperreninemia, lateralization and suppression of the contralateral kidney, one improved with nephrectomy of stenotic kidney and hemi-nephrectomy of the contralateral and the other remained hypertensive after nephrectomy. The initial status of renin secretion has prognostic value for the response to surgical treatment of renovascular hypertension.
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Comparative Study |
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Lennon PA, Lovshe D, Deleon E, Reynolds A, Pulido L, Cheong S, Zhao L, Frimpong L, Harper E, Van Fleet T, Honore L, Hu P. Professional development model for cytogenetic technologists at University of Texas-M.D. Anderson Cancer Center sets high standards. JOURNAL OF THE ASSOCIATION OF GENETIC TECHNOLOGISTS 2010; 36:195-197. [PMID: 21149989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Reinhard J, Pulido LC, Schindler M, Schraag A, Greimel F, Grifka J, Benditz A. No Success without Effort: Follow-Up at Six Years after Implementing a Benchmarking and Feedback Concept for Postoperative Pain after Total Hip Arthroplasty. J Clin Med 2023; 12:4577. [PMID: 37510694 PMCID: PMC10380292 DOI: 10.3390/jcm12144577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/12/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) is still ranked among the operations with the highest postoperative pain scores. Uncontrolled postsurgical pain leads to prolongated hospital stays, causes more frequent adverse reactions and can induce chronical pain syndromes. In 2014, we implemented a standardized, multidisciplinary pain management concept with continuous benchmarking at our tertiary referral center by using the "Quality Improvement in Postoperative Pain Management" (QUIPS) program with excellent results over a period of two years. The initial study ended in 2016 and we aimed to evaluate if it was possible to obtain the excellent short-term results over a period of six years without any extra effort within the daily clinical routine. MATERIALS AND METHODS In a retrospective study design, we compared postoperative pain, side effects and functional outcome after primary THA for 2015 and 2021, using validated questionnaires from the QUIPS project. In contrast to the implementation of the pain management concept in 2014, the weekly meetings of the multidisciplinary health care team and special education for nurses were stopped in 2021. Data assessment was performed by an independent pain nurse who was not involved in pain management. RESULTS Altogether, 491 patients received primary THA in 2015 and 2021 at our tertiary referral center. Collected data revealed significantly worse maximum and activity-related pain (both p < 0.001) in combination with significantly higher opioid consumption in comparison to implementation in 2015. Though the patients reported to be less involved in pain management (p < 0.001), the worse pain scores were not reflected by patient satisfaction which remained high. While the participation rate in this benchmarking program dropped, we still fell behind in terms of maximum and activity-related pain in comparison to 24 clinics. CONCLUSION Significantly worse pain scores in combination with higher opioid usage and a lower hospital participation rate resemble a reduced awareness in postoperative pain management. The significantly lower patient participation in pain management is in line with the worse pain scores and indirectly highlights the need for special education in pain management. The fact patient satisfaction appeared to remain high and did not differ significantly from 2015, as well as the fact we still achieved an acceptable ranking in comparison to other clinics, highlight the value of the implemented multidisciplinary pain management concept.
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Garcia-Zamora S, Pulido L, Antoniolli M, Garcia D, Perez G, Priotti M, Zaidel E, Lopez-Santi R, Vazquez G, Chango-Azanza DX, Nunez-Mendez R, Cabral LT, Sosa-Liprandi A, Miranda-Arboleda AF, Baranchuk A. Aggression, mini-aggression, and abuse against health care workers during the COVID-19 pandemic. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
COVID-19 pandemic brought multiple negative consequences that go beyond the direct damage caused by the disease and that affect health systems as well. Complaints of attacks against health care workers became frequent and concerning. The objective of this survey was to characterize the frequency and type of violent behavior against front-line professionals in Latin America.
Material and methods
A cross-sectional electronic survey was carried out between January 11th to February 28th, 2022. Different health care workers from Latin America who have been delivering care at least from March 2020, regardless of whether they assist or not patients with COVID-19 were included. A non-probabilistic snowball sampling was performed, and the survey was
Results
The survey was responded by 3,544 participants from 19 countries (Figure 1); 58.5% were women, and the mean age was 41.9±11 years. The 70.8% were doctors, 16% nurses, 3.4% physiotherapists, and the remaining 9.8% had other functions within the health team. About 85.1% of physicians were specialists: 33.9% were cardiologists, 14.4% were intensivists or emergency physicians, 10.9% had some surgical specialty, 7.7% were pediatricians or related subspecialties, and the remaining 33.1% had other specialties. The 36.3% and 28.8% worked in public and private practice respectively, the remaining worked in both. Direct and regular care to COVID-19 patients was provided by 74.7% of all contestants.
Among the participants, 54.8% reported acts of violence: 95.6% suffered verbal violence, 11.1% physical violence, and 19.9% other types. 39.5% of respondents experienced it at least once a week. The acts of violence involved patients' relatives (32%), or patients together with their relatives (35.1%). The victims rated the stress level of these events with an average of 8.2±1.8 points (scale from 1 to 10). Approximately half of the health personnel who suffered an assault experienced psychosomatic symptoms after the traumatic event (Figure 2). Among the victims of violence, 56.2% considered changing their care tasks, and 33.6% abandoning their profession. However, only 23% of the health personnel attacked stated that they had made some type of legal action regarding these acts.
In a logistic regression model, doctors (OR 1.95, p<0.01), nurses (OR 1.77, p=0.001), and administrative staff (OR 3.20, p<0.01) suffered more violence than other health workers. Women more frequently suffered violence (OR 1.56, p<0.01), as well as those who worked with patients with COVID-19 (OR 3.59, p<0.01). Conversely, a lower probability of violence was observed at older ages (OR 0.96, p<0.01).
Conclusion
We detected a high prevalence of violence against health personnel in Latin America during the current pandemic. Those caring for COVID-19 patients, younger staff, and women were found to be more vulnerable. It is imperative to develop strategies to mitigate these acts and their repercussions on the health team.
Funding Acknowledgement
Type of funding sources: None.
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Benditz A, Koehl P, Pulido LC, Unterpaintner I, Schuh A. [Cause of pain: the sacroiliac joint]. MMW Fortschr Med 2023; 165:58-65. [PMID: 37828335 DOI: 10.1007/s15006-023-2979-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
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Haeseler F, Snyder D, Gorfein P, Pulido L. A diagnostic pattern of nocturnal solute excretion in pyelonephritis. BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE 1971; 47:1225. [PMID: 5286458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Pulido LC, Koehl P, Sesselmann S, Rueth MJ, Schuh A. [Splayfoot]. MMW Fortschr Med 2023; 165:56-57. [PMID: 37016238 DOI: 10.1007/s15006-023-2465-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
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Pagano S, Strumolo L, Michalk K, Schiegl J, Pulido LC, Reinhard J, Maderbacher G, Renkawitz T, Schuster M. Evaluating ChatGPT, Gemini and other Large Language Models (LLMs) in orthopaedic diagnostics: A prospective clinical study. Comput Struct Biotechnol J 2024; 28:9-15. [PMID: 39850460 PMCID: PMC11754967 DOI: 10.1016/j.csbj.2024.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Revised: 12/14/2024] [Accepted: 12/18/2024] [Indexed: 01/25/2025] Open
Abstract
Background Large Language Models (LLMs) such as ChatGPT are gaining attention for their potential applications in healthcare. This study aimed to evaluate the diagnostic sensitivity of various LLMs in detecting hip or knee osteoarthritis (OA) using only patient-reported data collected via a structured questionnaire, without prior medical consultation. Methods A prospective observational study was conducted at an orthopaedic outpatient clinic specialized in hip and knee OA treatment. A total of 115 patients completed a paper-based questionnaire covering symptoms, medical history, and demographic information. The diagnostic performance of five different LLMs-including four versions of ChatGPT, two of Gemini, Llama, Gemma 2, and Mistral-Nemo-was analysed. Model-generated diagnoses were compared against those provided by experienced orthopaedic clinicians, which served as the reference standard. Results GPT-4o achieved the highest diagnostic sensitivity at 92.3 %, significantly outperforming other LLMs. The completeness of patient responses to symptom-related questions was the strongest predictor of accuracy for GPT-4o (p < 0.001). Inter-model agreement was moderate among GPT-4 versions, whereas models such as Llama-3.1 demonstrated notably lower accuracy and concordance. Conclusions GPT-4o demonstrated high accuracy and consistency in diagnosing OA based solely on patient-reported questionnaires, underscoring its potential as a supplementary diagnostic tool in clinical settings. Nevertheless, the reliance on patient-reported data without direct physician involvement highlights the critical need for medical oversight to ensure diagnostic accuracy. Further research is needed to refine LLM capabilities and expand their utility in broader diagnostic applications.
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Parodi JB, Burgos LM, Garcia-Zamora S, Liblik K, Pulido L, Gupta S, Saldarriaga C, Puente-Barragan AC, Morejón-Barragán P, Alexanderson-Rosas E, Sosa-Liprandi A, Botto F, Sosa-Liprandi MI, Lopez-Santi R, Vazquez G, Gulati M, Baranchuk A. Gender differences in workplace violence against physicians and nurses in Latin America: a survey from the Interamerican Society of Cardiology. Public Health 2023; 225:127-132. [PMID: 37924636 DOI: 10.1016/j.puhe.2023.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/17/2023] [Accepted: 09/28/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES To evaluate gender differences in workplace violence (WPV) against physicians and nurses in Latin America. STUDY DESIGN Cross-sectional study. METHODS A cross-sectional electronic survey was conducted between January 11 and February 28, 2022. A prespecified gender analysis was performed. RESULTS Among the 3056 responses to the electronic survey, 57% were women, 81.6% were physicians, and 18.4% were nurses. At least one act of violence was experienced by 59.2% of respondents, with verbal violence being the most common (97.5%). Women experienced more WPV than men (65.8% vs 50.4%; P < 0.001; odds ratio [OR]: 1.89; 95% confidence interval [CI]: 1.63-2.19). Women were more likely to report at least one episode of WPV per week (19.2% vs 11.9%, P < 0.001), to request for psychological help (14.5% vs 9%, P = 0.001) and to experience more psychosomatic symptoms. In addition, women were more likely to report having considered changing their job after an aggression (57.6% vs 51.3%, P = 0.011) and even leaving their job (33% vs 25.7%, P = 0.001). In a multivariate analysis, being a woman (OR: 1.76), working in emergency departments (OR: 1.99), and with COVID-19 patients (OR: 3.3) were independently associated with more aggressive interactions, while older age (OR: 0.95) and working in a private setting (OR: 0.62) implied lower risk. CONCLUSIONS Women are more likely to experience WPV and to report more psychosomatic symptoms after the event. Preventive measures are urgently needed, with a special focus on high-risk groups such as women.
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Lennon PA, Deleon E, Reynolds A, Pulido L, Lewing C, Mehta P, Biscanin S, Hai S, Bowman C, Galbincea J, Jakacky J, Hu P. A model for rewarding professional growth in the diagnostic molecular oncology laboratory. JOURNAL OF THE ASSOCIATION OF GENETIC TECHNOLOGISTS 2011; 37:80-83. [PMID: 21654071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The University of Texas M.D. Anderson Cancer Center (UTMDACC), Department of Pathology and Laboratory Medicine is committed to the endless pursuit of innovative research, education, training and administration for the prevention, diagnosis and clinical management of cancer and associated diseases. The molecular genetic technology professional development model promotes personal development, recognizes increased competencies, and sets high standards for all skills and services provided. There are four competency levels that comprise our Professional Development Model (PDM): Discovery, Application, Maturation, and Expert. The skill, knowledge, education, and certification requirements for each level are defined based on the business needs of each lab. When a genetic technologist successfully completes all skills, knowledge, proficiency, education and certification requirements within the appropriate time frame for a particular competency level, his/her salary would be adjusted to the entry point for the competency level he/she has completed.
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