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Rojas-Castillo E.,Instituto Nacional Of Cancerologia | Obregon-Hernandez G.,National Autonomous University of Mexico | Gonzalez-Marana M.,Centro Oncologico Integral Diana Laura Riojas Of Colosio | Alvarado-Aguilar S.,Instituto Nacional Of Cancerologia | And 3 more authors.
Gaceta Mexicana de Oncologia | Year: 2012

Objective: The purpose of the present study was to identify potential sources of BO in medical and paramedical staff. Methods: Two questionnaires were applied to medical or paramedical staff at a Comprehensive Cancer Center; the first contained employment data and two questions to identify potential sources of BO or the possible effect on medical care provided, while the second comprised the Maslach burnout inventory. Multinomial logistic regression method was used to define associated factors. Results: One hundred seventy one participants were included. Three hundred eighty five potential sources of burnout were identified from the first questionnaire. These were grouped in eight categories: work overload; difficult work atmosphere; lack of commitment to work; organizational problems; emotional impact; lack of appreciation and stimuli; material resources, and human resources. For participants, those sources of BO affects the quality of care and the physician-patient relationship, generates a suffocating work environment, depresses motivation, causes hostility, apathy and absenteeism, and decreased efficiency. From the second questionnaire, participant age and work hours were associated with emotional exhaustion, age was related with depersonalization, and working morning shift was associated with personal accomplishment (all models p<0.0001). Conclusion: A higher exhaustion score was observed in younger participants, whit less on the job seniority and fewer years of professional activity, and with extensive work activity per week. For depersonalization, a higher score was associated with younger participants. Morning-shift workers appeared to be those with a better sense of personal accomplishment.

Ruiz-Morales J.M.,Residencia Medica de Segundo Ano en la Especialidad de Oncologia Medica | Ruiz-Morales J.M.,Centro Oncologico Integral Diana Laura Riojas Of Colosio | Rodriguez-Cid J.R.,Centro Oncologico Integral Diana Laura Riojas Of Colosio | Alvarado-Luna G.,Centro Oncologico Integral Diana Laura Riojas Of Colosio | And 2 more authors.
Gaceta Mexicana de Oncologia | Year: 2014

Introduction: Ipilimumab, a cytotoxic T-lymphocyte antigen-4 (CTLA-4)-blocking monoclonal antibody, is a new drug in the treatment of patients with metastatic melanoma. It is novel with regard to its mechanism of action and it has a special toxiciological profile as well. In phase III studies, it has been shown to increase overall survival of patients with metastatic melanoma. The approved dose is 3 mg/kg every 3 weeks, for a total of 4 applications. Objective: To describe the clinical features, progression-free survival, overall survival, and adverse events associated with the use of ipilimumab at the Médica Sur Hospital in Mexico City. Materials and method: Medical charts of patients diagnosed with metastatic melanoma and treated with ipilimumab at the Médica Sur Comprehensive Cancer Center were reviewed from January 2012 to March 2013. Results: Ten patients could be identified meeting the above-described criteria. Of them, a complete response (10%) and 4 partial responses (40%) were achieved. Median survival was 40 weeks, and progression-free survival was 31 weeks. Most adverse effects were immunologically mediated, mild and reversible, and included pruritus (30%), rash (20%), diarrhea (60%), and hemorrhagic colitis (10%). Conclusion: Treatment response was adequate and correlates with other series. © 2014 Gaceta Mexicana de Oncología.

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