Negative Factors Influencing Multiple-Trauma Patients.

BACKGROUND AND OBJECTIVES: This study aimed to assess the impact and predicted outcomes of patients with multiple trauma by identifying the prevalence of trauma sustained and associated complications. MATERIALS AND METHODS: This retrospective cohort study focused on individual characteristics of patients with multiple trauma admitted to our County Emergency Hospital. The final table centralized the characteristics of 352 subjects aged between 3 and 93 years who presented with multiple trauma from 2015 to 2021. Inclusion criteria for this study were the presence of multiple trauma, intervention times, mentioned subjects' ages, and types of multiple trauma. RESULTS: Patients with multiple trauma face an increased risk of mortality due to the underlying pathophysiological response. Factors that can influence the outcomes of multiple-trauma patients include the severity of the initial injury, the number of injuries sustained, and the location of injuries. CONCLUSION: The first 60 min after trauma, known as the "golden hour," is crucial in determining patient outcomes. Injuries to the head, neck, and spine are particularly serious and can result in life-threatening complications.

The Prevalence of ST-Segment Elevation Myocardial Infarction in Patients Presenting in the Emergency Service of Galati Hospital from 2015 to 2019.

BACKGROUND AND OBJECTIVES: The purpose of this study is to determine the prevalence of cardiovascular emergencies and the relationships between these emergencies and the personal medical histories of patients. MATERIALS AND METHODS: This study is retrospective, observational, and longitudinal, spanning five years from 1 January 2015 to 31 December 2019. Descriptive elements were observed and recorded to conduct statistical analysis on the cardiovascular characteristics of 723 patients transported by air and treated at the Emergency County Hospital of Galati, Romania. RESULTS: Cardiovascular disease is a complex condition that often originates in the heart and presents with a variety of symptoms. Deaths related to cardiovascular diseases outnumber cancer-related deaths in both men and women worldwide. The one-year mortality rate for patients admitted to the hospital with acute pulmonary edema can be as high as 40%. Coronary heart disease is the leading cause of death and disability in the Western world and globally. CONCLUSIONS: The highest prevalence of cardiovascular diseases was noted in 2016, particularly among elderly men, who appear to be more affected by these conditions, while liver disease was minimal. In our study, the most prevalent cardiovascular disease was ST-elevation myocardial infarction. Gender plays a role in the risk of cardiovascular emergencies, with men being at a higher risk of developing life-threatening conditions. Additionally, there is a linear increase in risk with age for developing these pathologies.

The Impact of Work-Related Problems on Burnout Syndrome and Job Satisfaction Levels among Emergency Department Staff.

Burnout syndrome is caused by a number of factors, including personal, organizational, and professional problems. The purpose of this study was to investigate burnout and satisfaction levels among emergency department staff in the context of professional activity issues. We studied a sample of 184 participants working in the emergency department. Participants signed an informed consent form, completed a socio-demographic questionnaire and the MBI-HSS (MP) questionnaire to assess burnout, a JSS (Job Satisfaction Survey) to assess their professional satisfaction, and the AWS (AWS of work survey) questionnaire on work aspects. The questionnaires were completed between November 2022 and March 2023. The study group was aged between 24-64 years old, most of the subjects being female. The study found that 30.2% of emergency medical staff are at high risk of burnout. Emotional exhaustion is indirectly proportional to workload, interpersonal relationships, and rewards. Emotional exhaustion is a direct result of work experience. While participants expressed ambivalence and dissatisfaction with the work environment, they were satisfied with the nature of their work. This study found that job-related factors such as social support and feedback are significant predictors of employee well-being and reducing the risk of burnout. Emotional exhaustion was negatively correlated with job satisfaction, while personal accomplishment was positively correlated with job satisfaction. Depersonalization was associated with job dissatisfaction with operating conditions and coworkers. The study also identified differences in burnout and related constructs among healthcare professionals, with resident physicians reporting higher levels of personal accomplishments and paramedics reporting relatively low levels of emotional exhaustion. The findings suggest that tailored interventions addressing job demands and resources are critical in improving employee well-being and reducing burnout.

Emotional Distress in a Patients Following Polytrauma.

Introduction: Emotional affectivity can be described under two general dimensions: positive affectivity and negative affectivity. It is often assessed by means of questionnaires completed retrospectively by the subjects. The most common scales used are PANAS, DES, and PANA-X. All these scales are based on the concept of two dimensions, negative and positive affective emotions, respectively. Both dimensions mentioned, positive and negative affectivity, can be associated with a bipolar dimensional entity called pleasant-unpleasant. Specifically, a high level of positive emotions and a low level of negative emotions are associated with pleasant/positive feelings (happiness, well-being, satisfaction, cheerfulness, etc.), while a low level of positive emotions and a high level of negative emotions are associated with negative feelings (sadness, anger, nervousness, depression, anxiety, etc.). Materials and Methods: This study is an observational and cross-sectional study. The elements that led to the production of the final database were collected by means of a questionnaire, which included 43 items, 39 of which were specific questions found in the affective distress profile. The questionnaire was administered to 145 patients who had suffered polytrauma and were admitted to the Emergency Hospital of Galati in October 2022. The final centralizing tables included the characteristics of 145 patients, aged between 14 and 64 years. Results: The aim of this study is to identify the level of emotional distress in patients who have suffered polytrauma, so the following scores were evaluated, obtained after the application of PDA: STD, ENF, END. The total distress score was obtained by summing all the negative items found in the PDA questionnaire. Conclusion: Men show a high level of emotional distress compared to women. Polytrauma has a negative effect on patients' emotional status, with a worrying prevalence of negative functional and dysfunctional emotions. The level of distress in polytrauma patients is high.

Incidence of Intoxications in the Emergency Department of Galati Hospital with Examples of Cardiovascular Effects of MDMA Intoxication.

MDMA (3,4-methylenedioxymethamphetamine; commonly referred to as "Molly" or "ecstasy") is a synthetic compound, structurally and pharmacologically similar to both amphetamines and mescaline. MDMA differs somewhat from traditional amphetamines in that it is not structurally similar to serotonin. Cocaine is rare and cannabis is consumed less frequently than in Western Europe. Heroin is the drug of choice for the poor in Bucharest, Romania's capital of two million people, and alcoholism is common in villages where more than a third of the population lives in poverty. By far, the most popular drugs are Legal Highs (Romanians call them "ethnobotanics"). All of these drugs have significant effects on cardiovascular function that contribute significantly to adverse events. Most adverse cardiac events occur in young adults and are potentially reversible. Poisoning among patients aged 17 years and over was commonly seen in the Emergency Departments of a large tertiary hospital in the city centre, accounting for 3.2% of all patients. In a third of the poisonings, more than one substance was used. Intoxication with ethnobotanicals was the most frequently observed, followed by use of drugs from the amphetamine group. The majority of patients presenting to the Emergency Department were male. Therefore, this study suggests further research on hazardous alcohol consumption and drug abuse.

The Impact of Burnout Syndrome on Job Satisfaction among Emergency Department Nurses of Emergency Clinical County Hospital "Sfântul Apostol Andrei" of Galati, Romania.

Background and Objectives: Burnout syndrome is caused by a number of factors, including personal, organizational, and professional problems. Data from the literature reported a strong relationship between burnout syndrome and job satisfaction among emergency medical personnel. Materials and Methods: We studied a sample of 80 nurses working in the Emergency Department of Emergency Clinical County Hospital "Sfântul Apostol Andrei" of Galati Romania. Participants signed an informed consent and then completed a socio-demographic questionnaire and the MBI-HSS (Maslach Burnout Inventory-Human Services Survey) questionnaire to assess the level of burnout and JSS (Job Satisfaction Survey) to assess the level of professional satisfaction. The aim of this study was to measure the levels of burnout and satisfaction among nurses in the Emergency Department as well as the relationship between these two variables and a group of selected socio-demographic characteristics. Results: This study found that 36.25% of nurses reported a high level of burnout. Additionally, emotional exhaustion is directly proportional to professional experience and age. Participants also reported a sense of ambivalence and satisfaction with the workplace, but were satisfied with the nature of their work. Conclusions: The results of this study suggest the relationship between variables and this could be used to implement psychoactive intervention strategies at both individual and organizational levels, which could lead to a decrease in burnout levels. Burnout is a predictor of job satisfaction for Emergency Department nurses. Personal achievement was relatively commensurate with the nature of the work. Additionally, the increase in burnout among nurses is directly proportional to the nature of the work.

Did Personality Type Influence Burn Out Syndrome Manifestations During Covid-19 Pandemic?

Introduction: Emergency department (ED) health care providers had one of the highest incidences of burnout just before the pandemic. Personality type influences the way we communicate and relate to others, as well as our reaction to stress. In evaluating the causes of burnout, we take into account several factors, the most important of which being the conditions of the professional environment, interpersonal relationships and personality traits. This study aims to identify and analyze the relationships between personality traits and burnout syndrome in medical staff in the Emergency Department. Material and Methods: A descriptive, multicenter cross-sectional study project was used to collect data from 60 physicians and nurses from the Emergency Department of the County Emergency Clinical Hospital Galati. The tools used, distributed to participants to collect socio-demographic details, included the Eysenck Personality Inventory (EPI), and a pilot questionnaire. The questionnaire consisted of 11 questions, concerning exhaustion level, and focused on stress-generating elements and emotional management in the Emergency Department during the pandemic. Results: A large percentage of doctors in ED (45.8%) (n = 24) indicated a high level of exhaustion, while only 30.6% (n = 36) of nurses indicated a high level of exhaustion. Physicians displayed a higher level of stress than nurses, with 66.6% (n = 24) of physicians indicating an increased level of stress, compared to only 36.1% (n = 36) of nurses. A large percentage of nurses indicated a high level of depression (36.1%), whereas only 25% of Emergency Department physicians indicated a high level of depression. Discussion: The individuals with a melancholic and choleric temperament, as rated by the EPI, appeared more susceptible to developing burnout syndrome. The indication of instability or neuroticism appears to enhance the occurrence of burnout syndrome. There was also a correlation between extraversion and a high level of burnout, with extraverted individuals more easily reaching a high level of burnout. Conclusion: The results indicate a greater occurrence of exhaustion and stress in Emergency Department physicians compared to nurses in the Emergency Department. From the results, we can propose that there is a relationship between the personality traits as measured by the EPI and the occurrence of burnout syndrome. These findings may help to understand the vulnerability of medical staff to burnout, and to pre-emptively support them to deal effectively with stressors in the work environment.

Clinical or Imaging Diagnosis of the Current Medical Practice for Superior Vena Cava Syndrome?

Most cases of superior vena cava syndrome are easily diagnosed bya clinical examination alone, but several diagnostic tests and procedures can be helpful. When a patient presentswith a suspected diagnosis of superior vena cava syndrome, the first step is to obtain an imaging study that confirms the diagnosis and aids treatment decisions. Magnetic resonance imaging, contrast-enhanced CT scanning, radionuclide flow studies and traditional venography are all appropriate techniques. Still, the CT scan is the most readily available technology in most centers. The CT scan and magnetic resonance imaging also provide information on possible etiologies and can therefore direct the approach towards a tissue diagnosis.

An Unusual Case of Meckel Diverticulitis Misdiagnosed as an Infected Urachal Cyst.

Introduction: Meckel's diverticulum (MD), a remnant of the omphaloenteric duct, is among the most frequent intestinal malformations. Another embryonic vestige is the urachus, which obliterates, becoming the median umbilical ligament; the failure of this process can lead to a urachal cyst formation. We present a case of Meckel diverticulitis misdiagnosed as an infected urachal cyst. Presentation of case: A 16-year-old girl presented with hypogastric pain, fever and vomiting. She had undergone an appendectomy 6 years prior and no digestive malformation had been documented. In the last 2 years, she had 3 events of urinary tract infections with Escherichia coli, and anabdominal ultrasound discovered a 28/21 mm hypoechogenic preperitoneal round tumor, anterosuperior to the bladder. We established the diagnosis of an infected urachal cyst, confirmed later by magnetic resonance imaging. Intraoperative, we found MD with necrotic diverticulitis attached to the bladder dome. Discussions: Meckel's diverticulum and urachal cyst (UC) are embryonic remnants. Both conditions are usually asymptomatic, being incidentally discovered during imaging or surgery performed for other abdominal pathology. Imaging diagnosis is accurate for UC, but for MD they are low sensitivity and specificity. For UC treatment, there is a tendency to follow an algorithm related to age and symptoms, but there is no general consensus on whether to perform a routine resection of incidentally discovered MD. Conclusion: Preoperatory diagnosis of MD represents a challenge. We want to emphasize the necessity of a thorough inspection of the small bowel during all abdominal surgical interventions and MD surgical excision regardless of its macroscopic appearance. These two actions seem to be the best prophylaxis measures for MD complications and consequently to avoid emergency surgery, in which case more extensive surgical procedures on an unstable patient may be needed.