The aim of the paper is to observe the effectiveness of prophylactic administration of antibacter... more The aim of the paper is to observe the effectiveness of prophylactic administration of antibacterials against empyema and pneumonia after tube thoracostomy for traumatic collections. Material and methods: Observational retrospective study over a ten years period (2002-2011), at the Oradea County Emergency Hospital on 939 patients with chest tube drainage for traumatic haemo/pneumothoraces. The morbidity by intrathoracic infections was 5,5% in the curative antibiotic group. Results: The median number of risk factors for surgical infections and case severity were not statistically different (p=0.9653 and p=0,6601) between cases with antibioprophylaxis and curative treatment, but the incidence of intrathoracic infection in the prophylaxis group (n=86) was half (2,3%). Antibioprophylaxis was effective in over 95% of the cases and it associated in-hospital length of stay, length of stay in the ICU and costs of care significantly (p<0.0001, p<0.0001, p=0.0046) lesser than of those patients treated with curative regimen. The overall mortality was 8.6% within the curative regimen group with an attributable mortality to infections of 17.39%; but it was only 2.3% and respectively 0 within the prophylaxis group. Conclusions: Antibiotic prophylaxis for intrathoracic infections after tube thoracostomy for traumatic collections was justified by case severity and risk factors and was effective and cost-efficient, but it should be administered selectively.
BackgroundCurrently considered an occupational disease, the burnout syndrome affects 13–27% of th... more BackgroundCurrently considered an occupational disease, the burnout syndrome affects 13–27% of the active population in multiple occupational sectors of the modern world.ObjectivesConsidering the burnout syndrome from the new perspective of the predictive, preventive, personalized medicine concept as a pathological entity with a predictable appearance and evolution which allows a preventive approach and a personalized therapy, the main objective of the study is to highlight the possibility of psychotherapeutic interventions for producing measurable psychological changes in order to decrease the burnout level of hospital nurses.MethodThe research design is experimental, the independent variable being the participation or non-participation of nurses in psychotherapeutic sessions where specific classical psychodrama techniques are originally used. Nurses previously identified with medium or high levels of burnout participated in the clinical study, split into two groups: the experimental one, with 150-min weekly sessions, and the control one, without any intervention. Pre- and post-intervention questionnaires were administered to the members of both groups.ResultsThe statistical analysis of the differences between pre- and post-intervention revealed (a) the decrease of the levels of personal burnout and of burnout generated by the working conditions and (b) the decrease of the depression and of anxiety on four dimensions (self-awareness, ergic tension, veiled and general anxiety).ConclusionsThe classical psychodrama method can be an effective solution in the prophylaxis and treatment of the burnout syndrome. The multidisciplinary approach according to the PPPM concept including changes of the environmental factors within the professional framework associated with stress control programmes can be promising solutions for the management of this syndrome.
The risk of ectropion recurrence due to skin graft contracture is high especially in patients wit... more The risk of ectropion recurrence due to skin graft contracture is high especially in patients with ichthyosis. In order to overcome this problem, fat transfer underneath the skin graft was carried out in three consecutive sessions during the early postoperative period of a 27-year-old male patient with lamellar ichthyosis and bilateral upper and lower eyelid ectropion. Transferred fat reduced graft contraction by improving the hydration and viability of the skin. In addition, the grafted fat acted like a spacer and provided tarsal support. To address the persisting epiphora, a medial spindle technique was used to invert the lower punctum lacrimalis. At 8 months follow-up, all the symptoms associated with the ectropion were completely resolved.Level of evidence: Level V, therapeutic study.
The coronavirus disease 2019 (COVID-19) pandemic is probably the most critical epidemiological si... more The coronavirus disease 2019 (COVID-19) pandemic is probably the most critical epidemiological situation that human civilization has faced in the last few decades. In this context, of all the professional categories involved in the management of patients with COVID-19 are the most likely to develop burnout syndrome. The main objective of this study is to analyze specific predictive factors of the occurrence and development of the burnout syndrome in the healthcare workers involved in the diagnosis and treatment of patients with COVID-19. The study focused on determining factors of the occurrence, development and maintaining the specific burnout syndrome related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic infection. The study was conducted on a sample of 959 participants, medical personnel from all the public medical entities in Romania(including 5 hospitals): 122 male and 755 female (82 participants did not declare their gender), with a mean age of 4...
The surgical meshes selection, according to the structure and porosity of the biomaterial type an... more The surgical meshes selection, according to the structure and porosity of the biomaterial type and meshes design, is directly dependent on the surgical procedure used and interaction between biomaterial type and abdominal viscera. Surgical mesh must provide sufficient biomechanical strength in order to assure the physiological requirements in order to protect the soft tissue defects. The large variety of biomaterials used in abdominal surgery and the multitude of surgical fixation procedures show that we are still far from the ideal prosthesis. The main objective of this paper is to determine the effect of the sterilization procedures of some surgical meshes, with different design and made of different materials, on their structure and properties of interest. Experimental research was conducted on three types of surgical meshes, different from material and design point of view. Fourier Transform Infrared (FTIR) Spectroscopy was used to evaluate the structural characteristics of the ...
Palpebral ptosis is a condition caused by different congenital and acquired pathologies. Seeing d... more Palpebral ptosis is a condition caused by different congenital and acquired pathologies. Seeing difficulty due to the visual field obstruction, prefrontal headaches due to chronic use of the frontalis muscle in an attempt to lift the eyelids and cosmetic deformity are the main complaints of the patients. The surgical correction of the ptosis can be challenging. According to the preoperative evaluation, the most appropriate technique should be used to maximize the postoperator result. We describe a new surgical approach for severe upper eyelids acquired ptosis consisting in reanimation of both eyelids by using the neighboring active muscle. We considered the patient a good candidate for the new surgical approach we introduce as one time operative procedure. The result was a normal palpebral fissure for both eyes. The advantage of this approach consists in performing one time surgery followed by immediate postoperative mobilization of the upper eyelids which determine the recovery of ...
The present research was made by following three directions: dissection and plastination, clinica... more The present research was made by following three directions: dissection and plastination, clinical ankle joint ligament injuries and MRI and CT examination of the cases.191 cases of ankle joint ligament injuries have been studied during two years. They were examined clinically and radiologically, using CT and MRI testing. The classification of ankle sprain was based on the number of injured ligaments. Out of the 191 cases diagnosed with ligament injuries, 92 involved the anterior talofibular ligament, 54 in the calcaneofibular ligament, 40 involved the posterior talofibular ligament and 5 involved the deltoid ligament. First degree sprain involves the injury of the anterior talofibular ligament, the second degree sprain involves the injury of the anterior talofibular ligament and of the calcaneofibular ligament, and the third degree sprain involves the damaging of anterior and posterior talofibular ligaments, as well as the calcaneofibular ligament. In this paper we have diagnosed a...
The risk of ectropion recurrence due to skin graft contracture is high especially in patients wit... more The risk of ectropion recurrence due to skin graft contracture is high especially in patients with ichthyosis. In order to overcome this problem, fat transfer underneath the skin graft was carried out in three consecutive sessions during the early postoperative period of a 27-year-old male patient with lamellar ichthyosis and bilateral upper and lower eyelid ectropion. Transferred fat reduced graft contraction by improving the hydration and viability of the skin. In addition, the grafted fat acted like a spacer and provided tarsal support. To address the persisting epiphora, a medial spindle technique was used to invert the lower punctum lacrimalis. At 8 months follow-up, all the symptoms associated with the ectropion were completely resolved.Level of evidence: Level V, therapeutic study.
The aim of the paper is to observe the effectiveness of prophylactic administration of antibacter... more The aim of the paper is to observe the effectiveness of prophylactic administration of antibacterials against empyema and pneumonia after tube thoracostomy for traumatic collections. Material and methods: Observational retrospective study over a ten years period (2002-2011), at the Oradea County Emergency Hospital on 939 patients with chest tube drainage for traumatic haemo/pneumothoraces. The morbidity by intrathoracic infections was 5,5% in the curative antibiotic group. Results: The median number of risk factors for surgical infections and case severity were not statistically different (p=0.9653 and p=0,6601) between cases with antibioprophylaxis and curative treatment, but the incidence of intrathoracic infection in the prophylaxis group (n=86) was half (2,3%). Antibioprophylaxis was effective in over 95% of the cases and it associated in-hospital length of stay, length of stay in the ICU and costs of care significantly (p<0.0001, p<0.0001, p=0.0046) lesser than of those patients treated with curative regimen. The overall mortality was 8.6% within the curative regimen group with an attributable mortality to infections of 17.39%; but it was only 2.3% and respectively 0 within the prophylaxis group. Conclusions: Antibiotic prophylaxis for intrathoracic infections after tube thoracostomy for traumatic collections was justified by case severity and risk factors and was effective and cost-efficient, but it should be administered selectively.
BackgroundCurrently considered an occupational disease, the burnout syndrome affects 13–27% of th... more BackgroundCurrently considered an occupational disease, the burnout syndrome affects 13–27% of the active population in multiple occupational sectors of the modern world.ObjectivesConsidering the burnout syndrome from the new perspective of the predictive, preventive, personalized medicine concept as a pathological entity with a predictable appearance and evolution which allows a preventive approach and a personalized therapy, the main objective of the study is to highlight the possibility of psychotherapeutic interventions for producing measurable psychological changes in order to decrease the burnout level of hospital nurses.MethodThe research design is experimental, the independent variable being the participation or non-participation of nurses in psychotherapeutic sessions where specific classical psychodrama techniques are originally used. Nurses previously identified with medium or high levels of burnout participated in the clinical study, split into two groups: the experimental one, with 150-min weekly sessions, and the control one, without any intervention. Pre- and post-intervention questionnaires were administered to the members of both groups.ResultsThe statistical analysis of the differences between pre- and post-intervention revealed (a) the decrease of the levels of personal burnout and of burnout generated by the working conditions and (b) the decrease of the depression and of anxiety on four dimensions (self-awareness, ergic tension, veiled and general anxiety).ConclusionsThe classical psychodrama method can be an effective solution in the prophylaxis and treatment of the burnout syndrome. The multidisciplinary approach according to the PPPM concept including changes of the environmental factors within the professional framework associated with stress control programmes can be promising solutions for the management of this syndrome.
The risk of ectropion recurrence due to skin graft contracture is high especially in patients wit... more The risk of ectropion recurrence due to skin graft contracture is high especially in patients with ichthyosis. In order to overcome this problem, fat transfer underneath the skin graft was carried out in three consecutive sessions during the early postoperative period of a 27-year-old male patient with lamellar ichthyosis and bilateral upper and lower eyelid ectropion. Transferred fat reduced graft contraction by improving the hydration and viability of the skin. In addition, the grafted fat acted like a spacer and provided tarsal support. To address the persisting epiphora, a medial spindle technique was used to invert the lower punctum lacrimalis. At 8 months follow-up, all the symptoms associated with the ectropion were completely resolved.Level of evidence: Level V, therapeutic study.
The coronavirus disease 2019 (COVID-19) pandemic is probably the most critical epidemiological si... more The coronavirus disease 2019 (COVID-19) pandemic is probably the most critical epidemiological situation that human civilization has faced in the last few decades. In this context, of all the professional categories involved in the management of patients with COVID-19 are the most likely to develop burnout syndrome. The main objective of this study is to analyze specific predictive factors of the occurrence and development of the burnout syndrome in the healthcare workers involved in the diagnosis and treatment of patients with COVID-19. The study focused on determining factors of the occurrence, development and maintaining the specific burnout syndrome related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic infection. The study was conducted on a sample of 959 participants, medical personnel from all the public medical entities in Romania(including 5 hospitals): 122 male and 755 female (82 participants did not declare their gender), with a mean age of 4...
The surgical meshes selection, according to the structure and porosity of the biomaterial type an... more The surgical meshes selection, according to the structure and porosity of the biomaterial type and meshes design, is directly dependent on the surgical procedure used and interaction between biomaterial type and abdominal viscera. Surgical mesh must provide sufficient biomechanical strength in order to assure the physiological requirements in order to protect the soft tissue defects. The large variety of biomaterials used in abdominal surgery and the multitude of surgical fixation procedures show that we are still far from the ideal prosthesis. The main objective of this paper is to determine the effect of the sterilization procedures of some surgical meshes, with different design and made of different materials, on their structure and properties of interest. Experimental research was conducted on three types of surgical meshes, different from material and design point of view. Fourier Transform Infrared (FTIR) Spectroscopy was used to evaluate the structural characteristics of the ...
Palpebral ptosis is a condition caused by different congenital and acquired pathologies. Seeing d... more Palpebral ptosis is a condition caused by different congenital and acquired pathologies. Seeing difficulty due to the visual field obstruction, prefrontal headaches due to chronic use of the frontalis muscle in an attempt to lift the eyelids and cosmetic deformity are the main complaints of the patients. The surgical correction of the ptosis can be challenging. According to the preoperative evaluation, the most appropriate technique should be used to maximize the postoperator result. We describe a new surgical approach for severe upper eyelids acquired ptosis consisting in reanimation of both eyelids by using the neighboring active muscle. We considered the patient a good candidate for the new surgical approach we introduce as one time operative procedure. The result was a normal palpebral fissure for both eyes. The advantage of this approach consists in performing one time surgery followed by immediate postoperative mobilization of the upper eyelids which determine the recovery of ...
The present research was made by following three directions: dissection and plastination, clinica... more The present research was made by following three directions: dissection and plastination, clinical ankle joint ligament injuries and MRI and CT examination of the cases.191 cases of ankle joint ligament injuries have been studied during two years. They were examined clinically and radiologically, using CT and MRI testing. The classification of ankle sprain was based on the number of injured ligaments. Out of the 191 cases diagnosed with ligament injuries, 92 involved the anterior talofibular ligament, 54 in the calcaneofibular ligament, 40 involved the posterior talofibular ligament and 5 involved the deltoid ligament. First degree sprain involves the injury of the anterior talofibular ligament, the second degree sprain involves the injury of the anterior talofibular ligament and of the calcaneofibular ligament, and the third degree sprain involves the damaging of anterior and posterior talofibular ligaments, as well as the calcaneofibular ligament. In this paper we have diagnosed a...
The risk of ectropion recurrence due to skin graft contracture is high especially in patients wit... more The risk of ectropion recurrence due to skin graft contracture is high especially in patients with ichthyosis. In order to overcome this problem, fat transfer underneath the skin graft was carried out in three consecutive sessions during the early postoperative period of a 27-year-old male patient with lamellar ichthyosis and bilateral upper and lower eyelid ectropion. Transferred fat reduced graft contraction by improving the hydration and viability of the skin. In addition, the grafted fat acted like a spacer and provided tarsal support. To address the persisting epiphora, a medial spindle technique was used to invert the lower punctum lacrimalis. At 8 months follow-up, all the symptoms associated with the ectropion were completely resolved.Level of evidence: Level V, therapeutic study.
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Papers by Dan Grigorescu