Burnout is a state of physical or mental collapse caused by overwork or stress. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. The new COVID-19 pandemic has raised public health problems around the world and required a reorganization of health services. In this context, burnout syndrome and physical exhaustion have become even more pronounced. Resident doctors, and especially those in certain specialties, seem even more exposed due to the higher workload, prolonged exposure and first contact with patients. This article is a short review of the literature and a presentation of some considerations regarding the activity of the medical residents in a non-Covid emergency hospital in Romania, based on the responses obtained via a questionnaire. Burnout prevalence is not equal in different specialties. We studied its impact and imagine the potential steps that can be taken in order to reduce the increasing rate of burnout syndrome in the pandemics.

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RezumatDiverticulita apendiculară este o cauză rară a durerii din fosa iliacă dreaptă. Chiar dacă este simptomatică sau descoperită întâmplător în timpul apendicectomiei sau irigografiei, trebuie înţeleasă evoluţia clinică pentru a avea o atitudine terapeutică corectă. În acest articol vom prezenta cazul unei bolnave în vârstă de 50 de ani cu diverticulită apendiculară descoperită întâmplător în timpul apendicectomiei.Cuvinte cheie: diveticulită, apendicită, chirurgie de urgenţă, diverticuli AbstractAppendiceal diverticulitis is a very rare cause for pain in the right iliac fossa. Whether it is simptomatic or discovered randomly during an appendectomy or barium enema, understanding its clinical evolution is important for having a good management. In this report we present the case of a 50 year old female who underwent an open appendectomy during which we discovered appendiceal diverticulitis.

Over the past six decades, abdominal compartment syndrome (ACS) remained a very controversial subject, both in surgical and non-surgical specialties. Doctors failed to understand why critically ill patients died in the ICU with distended abdomens without fi nding any cause or why postoperative patients with wound defects such as dehiscence died after suturing the wound again "very tightly". After the concept of intra-abdominal pressure (IAP) was established and methods for measuring it and diagnosing intra-abdominal hypertension (IAH) were available for clinicians to use it, it became clearer that ACS was a very serious and life threating pathology and the need for a correct treatment is essential. In this article we will try to make a literature review of the past decade and see when and how to diagnose correctly a patient with ACS and also how the diagnostic and treatments methods changed over the years. RezumatÎn ultimele șase decenii, sindromul compartimentului abdominal a rămas un subiect foarte controversat, atât în specialităţile chirurgicale, cât și în cele non-chirurgicale. Medicii nu înţelegeau de ce pacienţii în stare critică decedau în ATI cu abdomenul destins, fără a găsi nicio cauză sau de ce pacienţii cu evisceraţii postoperatorii, decedau după resuturarea "foarte strânsă" a plăgii. După ce a fost stabilit conceptul de presiune intraabdominală și au fost disponibile metode pentru măsurarea și diagnosticarea hipertensiunii intra-abdominale pentru clinicieni, a devenit mai clar că sindromul de compartiment reprezintă o patologie foarte gravă, care ameninţă viaţa și că necesitatea unui tratament corect este esenţială. În acest articol vom încerca să facem o revizuire a literaturii ultimului deceniu și să vedem când și cum diagnosticăm corect un pacient cu sindrom de compartiment și, de asemenea, modul în care metodele de diagnosticare și tratament s-au schimbat de-a lungul anilor. Cuvinte cheie: sindrom de compartiment, presiune intra-abdominală crescută REVIEW Bogdan Socea et al.

The increasing proportion of laparoscopic interventions in the surgical centers has, also, determined an increased incidence of specific complications, such as trocar hernia. Nowadays, there is no unanimously agreed concensus regarding the optimal closure technique of the trocar incision, wether it should include the suture of the aponeurosis or not at the 10 mm ports. There is, also, no consensus regarding the proper surgical technique for the trocar hernia repair- alloplastic or tissue repair technique.The purpose of the study is to present our experience on the alloplastic repair of the trocar hernias. It is a retrospective study that analyzes the results obtained by our clinicalteam regarding the alloplastic repair of the trocar hernias, over a five-year period, between January 2011 and December 2015. The recurrence and the occurrence rates of different complications (seroma, neuroma with postoperative pain, parietal infiltration, infections and mesh rejection), depending on the type of mesh used for the surgical repair,are studied.

Prosthetic mesh implants in hernia repair are frequently used based on the fact that lower recurrence rates are detected compared to anatomic repair. In latest years, researchers tried to answer weather there is an ideal mesh material for abdominal hernia repair. The studies tried to compare resistance, bio-tolerance, rates of recurrence and infection of several materials used in alloplasty. The results are far from pointing an unique ideal chemical structure of mesh. In our study, we compared the results of a cohort of 265 patients operated in 2010 and 2011 in our clinic for complicated abdominal incisional hernias. We compared the results of polypropylene mesh vs. polyester. Polypropylene mesh proved significantly better for preventing hernia recurrence and showed a lower shrinkage rate.

Appendicite aigue après coloscopie-série des cas et revue de la littérature La coloscopie est une procédure de diagnostic courante pour le côlon. La perforation du côlon est une complication iatrogène bien connue de la coloscopie diagnostique. Toutefois, les atteintes appendiculaires avec inflammation ou perforation sont extrêmement rares et seuls quelques cas d'appendicite aiguë après coloscopie ont été rapportés jusqu'à présent. Nous décrivons une série de quatre cas opérés dans notre clinique d'appendicite aiguë, qui se sont développés à un jeune âge, peu après la coloscopie d'une autre pathologie (syndrome de l'intestin irritable, maladie diverticulaire du côlon, douleur a la fosse iliaque gauche et au flanc gauche).

The high number of available wound dressing materials as well as the scientific reports about the topic indicate that the problem of an ideal wound dressing is to be solved. For the last half of century many scientific reports about collagen as wound covering have been published, the benefits of collagen application as a wound dressing being proved. The aim of the present study is to demonstrate the efficiency of the collagen sponge on healing full thickness skin wounds. The study population was divided into two groups: control and experimental. In the control group, the wounds were treated conventionally, using gauze swabs, in the experimental group such wounds being covered with collagen sponge, the results being compared. The wounds from the control group healed in 50 days, covering the wounds with collagen sponge in the case-group shortening the healing process to 27 days. Not only the healing time was shortened but also the quality of the wound repair by dressing the wounds with collagen sponge was enhanced.