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.

Acute Computer Tomography Findings in Pediatric Accidental Head Trauma-Review.

Head trauma in paediatric patients is a worldwide and constant issue. It is the number one cause for childhood mortality and morbidity. Children of all ages are susceptible to sustaining head trauma and the anatomical characteristics of the region put them in a high-risk category for developing severe traumatic brain injuries. Boys are more frequently victims of accidental head traumas, and their injuries are more severe than those encountered in girls. The mechanisms of the trauma are a determining factor for the types of lesions we find. The traumatic injuries fall into two categories, primary and secondary. Primary traumatic injuries can be severe and life threatening, and their presence needs to be documented in order to set the correct therapeutic conduct. Due to their importance, this pictorial review focuses on them and the images used herein are selected from the database of our hospital. It is important to distinguish each of the different injuries that can be encountered. At the same time, radiologists are advised to remember that for children up to five years of age, some non-accidental imaging findings may appear to coincide with those found in accidental head trauma.

Spectrum of Magnetic Resonance Imaging Findings in Acute Pediatric Traumatic Brain Injury - A Pictorial Essay.

Head trauma (HT) in pediatric patients is the number one cause of mortality and morbidity in children. Although computer tomography (CT) imaging provides ample information in assessing acute traumatic brain injuries (TBIs), there are instances when magnetic resonance imaging (MRI) is needed. Due to its high sensitivity in diagnosing small bleeds, MRI offers a well-documented evaluation of primary acute TBIs. Our pictorial essay aims to present some of the latest imaging protocols employed in head trauma and review some practical considerations. Injury mechanisms in accidental HT, lesions' topography, and hematoma signal variability over time are also discussed. Acute primary intra- and extra-axial lesions and their MRI aspect are showcased using images from patients in our hospital. This pictorial essay has an educational purpose. It is intended to guide young emergency and intensive care unit doctors, neurologists, and neurosurgeons in diagnosing acute primary TBIs on MRI while waiting for the official radiologist's report. The presentation focuses on the most frequent traumatic lesions encountered in acute pediatric head trauma.

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 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.

The Patient Hides the Truth, but the Computer Tomography Examination Restores It!

In this article, we present the case of a patient who hid the real reason for which he came to the emergency room. This patient in this case is a 61-year-old man, who presented to the emergency department for symptoms relevant to respiratory disease. However, the initial diagnosis turned out to be only the "tip of the iceberg" in the evolution and treatment of this patient. Fournier gangrene is a fulminant form of infectious necrotizing fasciitis of the perineal, genital, or perianal regions, which frequently affects men, but can also occur in women and children. It is a rare but life-threatening disease. Due to potential complications, it is important to diagnose Fournier gangrene as early as possible. Although antibiotics and aggressive debridement have been widely accepted as standard treatment, the mortality rate remains high. In many cases, the doctor's mission is much more difficult than it first seems. The challenges to which the doctor is subjected, especially in the emergency room, are immense. In establishing a diagnosis and emergency treatment, all parties involved-medical staff, on the one hand, and patients and relatives, on the other hand-must collaborate so that the outcome is a positive one. The overall conclusion of the medical team was that Fournier gangrene in the patient was the consequence of both the presence of an intrarectal foreign body, as well as excessive alcohol consumption. The case of our patient with Fournier gangrene and an intrarectal foreign body had a positive outcome due to quick, aggressive, and adequate medical and surgical management, as well as the fact that the patient had no other associated pathologies beyond alcohol "passion." Our patient's case is an example of the exceptional situations we sometimes encounter in medical practice.

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 leg wound made by a Sea Shell (Scapharca inaequivalis).

INTRODUCTION: Most of beaches tend to have a lot of shells and other sharp objects that might hurt you while you're walking on the beach. Cuts, particularly on the bottom of feet, are common at the beach. In this article we want to present a rare case of a little girl with a knee wound made by a seashell, while playing in the water. CASE PRESENTATION: A 9-year-old female patient was presented to the ER with a left knee injury because of a penetrating Scapharca inaequivalis. Since this type of trauma is considered a surgical emergency, taking a thorough history along with careful examination to find out the mechanism and cause of the trauma is crucial towards correct diagnosis and management of the disease. The patient underwent a local surgical procedure to remove the foreign body. Interestingly, the seashell (Scapharca inaequivalis) pinned her left knee in water. CONCLUSIONS: Through this article we want to draw attention to the puncture wounds and cuts caused by sea shells. The particuliarity lies in the fact that the sea shells injuries can be made both in water and on the sand. One main concern with cuts on the feet is risk of infection, especially with diabetic patients.

Cáncer renal. Descripción poblacional en una institución académica / Kidney cancer. Population description in an academic institution

El conocimiento en cáncer renal ha sido manifiesto en la última década, con adelantos que optimizan el abordaje diagnóstico, quirúrgico y terapéutico con agentes dirigidos contra blancos específicos. El objetivo del trabajo fue la evaluación retrospectiva de pacientes con cáncer de riñón, destacando los datos demográficos, patológicos, quirúrgicos, de recurrencia, así como las modalidades terapéuticas empleadas, y describir la evolución clínica a través de parámetros de eficacia y seguridad. Fueron incluidos 417 pacientes, analizándose los datos de 356. La edad mediana fue de 56 años y 68% eran hombres. El 14% presentó otro tumor primario no renal y 14 desarrollaron otro tumor renal. El diagnóstico fue incidental en el 28% de los casos, la histología más frecuente fue el carcinoma de células claras, el tamaño mediano fue 6.1 cm y en el 20% se observó infiltración capsular. De los 298 pacientes operados, 54% fueron a nefrectomía radical y 26% parcial. El 19% presentaba metástasis al diagnóstico. Recurrencia post-operatoria en 75 de los 298 operados. Los tratamientos más frecuentemente utilizados en primera línea fueron los inhibidores de tirosina-quinasa (55% de los casos) con remisiones del 43-50% y un tiempo a la progresión de 12.1 meses. La revisión retrospectiva de los datos en cáncer renal de una población académica que incorpora la metodología diagnóstica, quirúrgica y terapéutica en enfermedad localizada y avanzada, permite reproducir los datos que surgen de países centrales y de estudios clínicos aleatorizados (AU)

Improving knowledge in renal cancer has been successful in the last decade in terms of diagnosis, surgical and therapeutic approach with targeted agents. The objective of the study was the retrospective evaluation of patients with kidney cancer, emphasizing recurrence as well as therapeutic modalities, pathological and surgical, demographic data and to describe outcome through efficacy and safety parameters. There were included 417 patients. The median age was of 56 years and 68% were men. There was a 14% of patients with another non-renal primary tumor and 14 patients developed another kidney tumor. The diagnosis was incidental in 28% of cases. The most common histology was clear cell carcinoma, medium size was 6.1 cm and capsular infiltration was observed in 20%. Of the 298 patients operated, 54% were to radical nephrectomy and 26% partial. The 19% of the patients had metastases from diagnosis. Post-operative recurrence was developed in 75 of 298 surgical patients. The most frequent systemic first line therapy was tyrosine-kinase inhibitors (55% of cases) with remissions of 43-50% and time to progression was 12.1 months. The retrospective review in renal cancer of an academic population gives the rationale of data of the real world and to compare with those that arise from central countries and randomized clinical trials (AU)