Introduction: The present study aimed to establish the frequency and clinical characteristics of cutaneous tuberculosis among Mexican adult patients. Methodology: Ninety-five patients with clinically compatible lesions to cutaneous tuberculosis participated in the study. All patients were HIV negative and none of them had previous anti-TB treatment. A skin biopsy was taken from every patient suspected of having tuberculosis, and a histopathologic examination was performed as follows: Ziehl-Neelsen staining; culturing of mycobacteria by Löwenstein-Jensen (L-J) medium; Mycobacteria Growth Indicator Tube detection via BACTEC (MGIT-360); and polymerase chain reaction (PCR) with the sequence of insertion IS6110 for Mycobacterium tuberculosis complex. Results: Tuberculosis was confirmed in 65 out of 95cases (68.4%). Identified lesions were scrofuloderma (42 cases, 64.6%); lupus vulgaris (12 cases, 18.4%); warty tuberculosis (six cases, 9.2%); and papulonecrotic tuberculoid (five cases; 7.7%). The Ziehl-Neelsen staining was positive for acid fast bacilli in nine cases (13.8%) and 48 patients were positive for the PCR amplification (73.8%). All skin biopsies resulted positive for tuberculosis. A positive clinical response to the specific treatment was considered a confirmation for tuberculosis. The noninfectious etiology corresponded to 30 cases (31.6%). Conclusions: Tuberculosis in developing countries is still an important cause of skin lesions which must be studied via histopathological examination and culture due to their low bacillary load. A PCR test is necessary to obtain faster confirmation of the disease and to establish an early, specific and effective treatment.

Objetivo: este estudio evaluó síntomas de Burnout entre médicos y enfermeros antes, durante y después de la atención provista a pacientes con la enfermedad COVID-19. Método: estudio comparativo y transversal realizado en la unidad de Atención Respiratoria de un hospital público de nivel terciario. Se empleó el Inventario de Burnout Maslach. Resultados: se distribuyeron 280 encuestas entre los tres períodos: antes (n=80), durante (n=105) y después (n=95) de la atención a pacientes con COVID-19; se obtuvieron 172 encuestas respondidas. Las tasas de respuesta fueron 57,5%, 64,8% y 61,1%, respectivamente. Los valores de prevalencia de Burnout grave fueron 30,4%, 63,2% y 34,5% antes, durante y después de la atención a pacientes por la enfermedad del coronavirus 2019 (p<0,001). Los síntomas de agotamiento emocional (p<0,001) y despersonalización (p=0,002) fueron más prevalentes entre los enfermeros que entre los médicos. El Síndrome de Burnout grave fue más prevalente en las mujeres, los enfermeros y el personal del turno noche. Conclusión: la elevada prevalencia de Burnout se duplicó en el primer pico de internaciones y regresó a niveles previos a la pandemia un mes después de finalizada la atención a pacientes por la enfermedad del coronavirus 2019. El Síndrome de Burnout varió por sexo, turno de trabajo y ocupación, y los enfermeros representaron los grupos más vulnerables. Es necesario enfocarse en estrategias de evaluación y mitigación tempranas para asistir a los enfermeros, no solo durante la crisis sino permanentemente.

Objective: this study evaluated burnout symptoms among physicians and nurses before, during and after COVID-19 care. Method: a cross-sectional comparative study in the Pulmonary Care unit of a tertiary-level public hospital. The Maslach Burnout Inventory was used. Results: 280 surveys were distributed across three periods: before (n=80), during (n=105) and after (n=95) COVID-19 care; 172 surveys were returned. The response rates were 57.5%, 64.8% and 61.1%, respectively. The prevalence of severe burnout was 30.4%, 63.2% and 34.5% before, during and after COVID-19 care (p<0.001). Emotional exhaustion (p<0.001) and depersonalization (p=0.002) symptoms were more prevalent among nurses than among physicians. Severe burnout was more prevalent in women, nurses and night shift staff. Conclusion: the high prevalence of burnout doubled in the first peak of hospital admissions and returned to pre-pandemic levels one month after COVID-19 care ended. Burnout varied by gender, shift and occupation, with nurses among the most vulnerable groups. Focus on early assessment and mitigation strategies are required to support nurses not only during crisis but permanently.