The purpose of this study was to identify the predictors of burnout in healthcare workers during the COVID-19 pandemic. Data were collected from March to June in 2020, during the COVID-19 pandemic, from employees of two Romanian hospitals. Five hundred and twenty-three healthcare workers completed a series of questionnaires that measured burnout, job demands, job resources, and personal resources. Among the respondents, 14.5% had a clinical level of exhaustion (the central component of burnout). Three job demands (work–family conflict, lack of preparedness/scope of practice, emotional demands), three job resources (training, professional development, and continuing education; supervision, recognition, and feedback; autonomy and control), and one personal resource (self-efficacy) were significant predictors of burnout, explaining together 37% of the variance in healthcare workers’ burnout. Based on our results, psychological interventions during the COVID-19 pandemic for healthcare employees should focus primarily on these demands and resources.

Ovarian masses are one of the most frequently identified entities in gynecological practice. Early differential diagnosis is a key factor in the medical management of each patient. Transvaginal ultrasound along with additional preoperative testing, such as serum cancer antigen 125 (CA-125) levels and the Risk of Ovarian Malignancy Algorithm (ROMA) score, usually provide sufficient information for a presumptive diagnosis. Minimally invasive surgery as a therapeutic approach is the standard procedure for uncomplicated and benign adnexal masses. Histopathological examination alone, or in conjunction with immunohistochemical testing establishes a more certain diagnosis in the final step of the patient management plan. We developed a retrospective descriptive observational study based on the evaluation of 107 patients admitted to the Department of Obstetrics and Gynecology at “Sf Pantelimon” Clinical Emergency Hospital in Bucharest between January 2000 and July 2017. Each patient was diagnosed with an ovarian mass and underwent laparoscopic surgery for treatment. All data underwent descriptive statistical analysis in order to establish correlations between preoperative test results and definitive diagnoses. The typical ultrasound findings of endometriotic cysts were histopathologically confirmed in 52.6% of the examined patients. Using ultrasound, benign teratomas were suspected in 66.6% of all documented dermoid cysts and 90% of the patients with a calculated ROMA score had corresponding values less than 15%. Mean CA-125 value was 26.58 U/mL. Laparoscopic surgery with ovarian cystectomy was performed for 78.5% of the cases. Histopathological examinations established endometriosis was present in 26.16% of cases. According to an independent samples t test (with 2 extreme values eliminated), patients in the premenopausal group had a significantly lower mean ROMA score than postmenopausal patients (6.87% vs 20.98%, respectively; P < .001). The groups had similar homogeneity (P = .131 according to the Levene test). Our results showed that transvaginal ultrasound established a presumptive diagnosis for almost half of our patients. Cystectomy was the main surgical procedure used for the management of benign ovarian masses. Endometriosis was the most common benign ovarian pathology evaluated and treated in our study.

Rationale: Defensive caesarean section (CS) has become one of the most common medical procedure worldwide. Additionally, performing CS in accordance with the patient's choice is an appropriate professional practice.Aims and Objective: This paper reports a prospective, observational, multicenter study to quantify the use of this type of practice that is performed by obstetricians to avoid medico‐legal complaints and decrease the frequency of malpractice litigations.Methods: We interviewed 73 obstetricians from three distinct units of obstetrics and gynaecology, to assess their opinion regarding defensive caesarean delivery and caesarean delivery performed upon maternal request. We conducted an opinion‐based survey using questionnaires based on nine, close‐ended questions.Results: Out of 73 respondents, 51 (69.9%) stated that they perform defensive CS; 63 (86.3%) declared that their choice of birth delivery is influenced by the risk of being accused of malpractice; 60 (82.2%) indicated that it is normal for the patient to be able to decide on the type of delivery; and 63 (86.3%) declared that they consult their patients regarding their delivery preferences. We found statistically significant differences between the respondents who declare that they perform defensive CS (69.9%) and those who said that they are influenced by the risk of malpractice when they choose the method of delivery for their patients (86.3%) (P < .001; McNemar Test).Conclusions: The results of our study indicate that defensive caesarean section is a widespread practice among obstetrics practitioners in Romania.

Introduction: The larvae of Echinococcus, a parasitic tapeworm, cause hydatid disease. The most commonly involved organ after the liver is the lung but there are cases of hydatid cysts in all systems and organs, such as brain, muscle tissue, adrenal glands, mediastinum and pleural cavity. Extra-pulmonary intrathoracic hydatidosis can be a diagnostic challenge and a plain chest x-ray can be misleading. It can also lead to severe complications such as anaphylactic shock or tension pneumothorax. The purpose of this paper is to present a severe case of primary pleural hydatidosis, as well as discussing the difficulties that come with it during diagnosis and treatment. Case Report: We present the case of a 43-year-old male, working as a shepherd, presenting with moderate dyspnea, chest pain and weight loss. Chest x-ray revealed an uncharacteristic massive right pleural effusion and thoracic computed tomography (CT) confirmed it, as well as revealing multiple cystic formations of various sizes and liquid density within the pleural fluid. Blood work confirmed our suspicion of pleural hydatidosis with an elevated eosinophil count, typical in parasite diseases. Surgery was performed by right lateral thoracotomy and consisted of removal of the hydatid fluid and cysts found in the pleura. Patient was discharged 13 days postoperative with Albendazole treatment. Conclusion: Cases of primary pleural hydatidosis are very rare but must be taken into consideration in patients from endemic regions with jobs that may have exposure to this parasite. Proper treatment, both surgical and antiparasitic medication, can lead to a full recovery and a low chance of recurrent disease.

Romania has the highest incidence of cervical cancer morbidity and mortality in Europe. This study identifies the major clusters for genital cancers, observes the features of genital and cervical cancer, and determines the extent to which cancer is a contributor to total Disability-Adjusted Life Year (DALY). Spatial analysis used Besag and Newell’s method for genital cancer distribution, prevalence considered Arad County patients records (2008–2017), and DALY was determined according to WHO methodology and GLOBOCAN 2013 data. Diagnosis was established by histopathological examination of diagnostic biopsies or tissues obtained by surgical procedures, followed by clinical staging. 1695 women were recorded with genital cancer. Of these, 14.9% of lesions were in situ (n = 252) and 74.20% of cases were recorded in stage III or IV (n = 1258) (p < 0.0001). Over 90% of cervical cancers were squamous cell carcinomas (n = 728), 33.76% of endometrial cancers were adenocarcinomas in situ (n = 131), 32.42% of ovarian cancers were serous adenocarcinomas (n = 131), and 70.58% of vulvar cancers were squamous cell carcinomas (n = 48) (p < 0.0001). DALY/1000 was 67.2 for genital cancers and 33 for cervical cancers. From the point of view of Romanian women, cervical cancer remains one of the major problems that need to be dealt with and access to optimal treatment proves to be extremely limited.