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.

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.

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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.

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 Covid-19 pandemic changed certain social habits and practices. The pandemic also changed the profile of polytrauma patients who presented in the emergency room. The etiology of polytraumas has undergone changes in the context of social distancing. While road accidents, falls and physical assaults, including gunshot trauma on the streets have decreased, we are confronting with an alarming increase in domestic violence. We analyzed the etiology of polytraumas from a period of 3 months that overlapped with the pandemic and compared it with the similar periods of the previous 3 years. We found an increase of about 4 times the incidence of physical aggression through domestic violence.

Repairing an incisional ventral hernia represents a challenge for the surgeon. The high recurrence rates observed during hernia repair by tissue approximation leads to development of tension-free procedures by using prosthetic materials. Incisional or ventral hernia is a very common multifactorial pathology that requires surgical intervention to prevent complications, such as pain, discomfort, bowel obstruction or strangulation. To perform the wall repair it is of utmost importance to understand the pathogenesis of the hernia, the anatomy and physiology of the abdominal wall, and surgical techniques. Several repair methods are available, including open suture repair, open mesh repair, the component separation technique, and tissue expansion assisted closure. To perform the ventral hernia repair properly, a full understanding and correct selection of mesh and management of probable complications, such as seroma, bowel injury, enteric fi stulae, and recurrence, is essential. There are lots of scientifi c debates about an ideal material for mesh parietal repair. In latest years, the tendency is that the continuous decreasing territory of polyester mesh to be slowly replaced by the increasing territory of polypropylene mesh in open procedures for abdominal incisional hernia repair. The goals of incisional hernia repair are the prevention of visceral eventration, incorporation of the abdominal wall in the repair, provision of dynamic muscular support, and restoration of abdominal wall continuity in a tension-free manner.

Approche non opératoire du volvulus sigmoïde-présentation de cas Le volvulus sigmoïde se produit lorsque le sigmoïde s'enroule autour de lui-même et de son mésentère. Le volvulus sigmoïde représente de 2% à 50% de toutes les obstructions coliques. Cette pathologie affecte généralement les adultes et est plus fréquente chez les hommes. L'étiologie est multifactorielle et controversée; les principaux symptômes sont douleur abdominale diffuse, distension et constipation, tandis que les signes de grossesse sont distension et sensibilité abdominales. Les résultats de laboratoire ne sont pas pathognomoniques: les radiographies abdominales montrent un côlon sigmoïde dilaté et de multiples niveaux de liquide intestinal, le scanner abdominal et l'IRM montrent un mésentère sigmoïde en tournoiement.