Praxis
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We report the case of a 56 year-old female patient without previous medical history presenting in the emergency room with acute left-sided thoracic pain and dyspnea. Initial lab exams, ECG and chest X-ray in supine position were normal and excluded most common pathologies, e.g. a large pneumothorax or myocardial infarction. ⋯ A spontaneous esophageal rupture (Boerhaave Syndrome) was diagnosed. An additional fluoroscopic study was performed to evaluate the exact site of rupture.
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Now, more than ever, everyone is talking about burnout syndrome. As was previously the case with neurasthenia, the aim is to characterize a job-related stress and non-stigmatized clinical picture. However, burnout is neither a psychiatric diagnosis nor a clearly delineated scientific concept. ⋯ Some of the causes may be attributable to chronic stress at work, but also to biographically related vulnerability and general meaninglessness in our society. Prevention and treatment focus on improving the individual's stress coping skills, optimizing their job situation, planning more time for rest and recreation and more far-reaching changes in their attitude and lifestyle. The means to achieve this include behavioral therapy-based educational learning processes, analytically oriented psychotherapy regimens, pharmacotherapy and hospital treatments.