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Anaesthesiology trainees and their needs: a Romanian perspective. Results from a European survey

Abstract

Anaesthesiology training is going through continuous transformations worldwide. Recent data from a European Survey on anaesthesiology postgraduate trainees and their concerns have been published for the first time, following an initiative by the European Society of Anaesthesiology. Among the responders of this survey, 10.8% were represented by Romanian trainees. The main needs of the Romanian anaesthesiology trainees who completed the questionnaire were, in descending order educational contents/EDAIC, technical skills, exchange programmes, residency workload, residency costs and autonomy transition. Another observation coming from the analysed data is that Romanian anaesthesiologists in training are highly concerned and interested in the field of intensive care medicine. The results also pinpoint to the high costs associated with continuous medical education, leading to a high incentive for workforce migration.

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International survey of neuromuscular monitoring in two European countries: a questionnaire study among Hungarian and Romanian anaesthesiologists

Abstract

Background: Accumulating evidence indicates that objective neuromuscular monitoring and pharmacological reversal of neuromuscular block reduces the occurrence of residual muscle paralysis in the acute postoperative phase. However, objective neuromuscular monitoring is not a routine habit in anaesthesia. In order to change this situation, we wished to find out, as a first step to improvement, the current use of neuromuscular monitors and the custom of anaesthetists for reversal of neuromuscular block before tracheal extubation.

Methods A ten-point questionnaire was available via the Surveymonkey website and the link was sent to 2202 Hungarian and Romanian anaesthetists by email.

Results: Three hundred and two (13.7%) of the 2202 registered anaesthetists responded. Less than 10% of them regularly use neuromuscular monitors. They underestimated the occurrence of residual block; only 2.2% gave a correct answer. Neuromuscular monitors are available in 74% of hospitals but are scarcely used. One third of anaesthetists rarely or never use reversal; approximately 20% regularly reverse before extubation. The responders typically believe that clinical signs of residual block are reliable. Instead of monitoring, they use the “timing methods” for tracheal extubation such as time elapsed from last dose, the duration of action of relaxant, the number of top-up doses, the cumulative dose, the return of adequate respiratory tidal volume and the ability to sustain a 5 s head lift.

Conclusions: We concluded that neuromuscular monitoring in these two European countries is suboptimal as is the reversal strategy. Given the fact that monitors are available in the hospitals, the mentality should be changed towards evidence based practice.

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Burnout syndrome in the Anaesthesia and Intensive Care Unit

References 1. Freudenberger HJ, Richerson G. Burn-Out: The High Cost of High Achievement. 1 st edition. Garden City, NY: Anchor Press; 1980. 2. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav 1981; 2: 99-113. doi: 10.1002/job.4030020205 3. Poncet MC, Toullic P, Papazian L, Kentish-Barnes N, Timsit JF, Pochard F, et al. Burnout Syndrome in Critical Care Nursing Staff. Am J Respir Crit Care Med 2007; 175: 698-704. doi: 10.1164/rccm.200606-806OC 4. Hagau N, Pop RS. Prevalence of burnout in Romanian anaesthesia

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Perception of Healthy Eating among Romanian Adults

better than cure. Diabetes Metab Syndr Obes . 2016;9:83-89. 15. Badau A, Badau D, Serban C, Tarcea M, Rus V. Wellness integrative profile 10 (WIP10) – an integrative educational tool of nutrition, fitness, and health. J Pak Med Assoc . 2018;68:882-887. 16. Rus VA, Ruta FD, Salcudean M, Tarcea M, Serban C, Avram C, Simion I, Benedek T. Adherence to the DASH-style Diet and the presence of Cardiovascular risk factors in adults from Tirgu Mures, Romania. Journal of Interdisciplinary Medicine . 2018;3:134-140. 17. Manippa V, Padulo C, Laan LN, Brancucci

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Diagnostic Difficulties in a Severely Ill HIV Patient with Multiple Superinfections - A Case Report

large fall in the number of cases of PML and markedly improved survival rates. However, patients with a HIV-associated disease still account for roughly 80 % of all reported cases of PML, and over half of them die within two years of diagnosis [ 2 ]. Case presentation A thirty-year-old male patient with AIDS was admitted to the Infectious Diseases Clinic 1, Târgu-Mureș, Romania in January 2019 because of left temporo-parietal headache, left side face paraesthesia, hearing impairment, vertigo and abnormal gait. The patient belonged to the Romanian HIV cohort of

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Fatal Hypocalcaemia Due to Hungry Bone Syndrome with Secondary Refractory HyperParathyroidism after Parathyroidectomy: A Case Report

. Resuscitation measures were unsuccessful. Case report A 65-year-old man, BMI of 33 kg/m 2 , was admitted to the Nephrology and Endocrinology/Internal Medicine Department of Harghita General Hospital ( Harghita General Hospital, Miercurea Ciuc, Romania), with generalised weakness, severe pruritus and difficulty walking due to severe left leg pain. His medical history included end-stage renal disease (ESRD) due to adult polycystic disease having been on chronic haemodialysis three times weekly for the past eight and a half years. He had ben diagnosed with secondary

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