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Background: Emergency medicine in Romania has developed fast since inception. The need for faster diagnostic capabilities due to the high workload pre- and in-hospital made point-of-care ultrasound (POCUS) a logical next step. The advantages of POCUS are well known, but implementation presents challenges. Our goal was to study how a straightforward method of implementation would work locally. Methods: Two prospective observational studies were conducted at 6 months (prehospital) and 4 months (in-hospital). The protocol used was extended focused assessment sonography in trauma (eFAST), and the shock index (SI) was used to stratify patients. Voluntary sampling was conducted by emergency physicians. The primary outcomes were patient numbers, type of case use, results, and accuracy. Results: The prehospital study registered 34 patients: 41% traumas, 35% cardiac arrest, 18% shock, and 6% acute respiratory distress. The in-hospital study patients were 78: 36% traumas, 6% cardiac arrests, 41% shock, and 17% acute respiratory distress. A total of 88.5% of the cases were confirmed with definitive imagistic findings. Conclusion: The studies mark an increase in POCUS usage and use in complicated cases. Providing supervision and feedback into clinical practice resulted in a further increase in POCUS usage, the second study having an 88.5% accuracy when compared to the final diagnostic proving the increased efficiency of a longitudinal training approach. [ABSTRACT FROM AUTHOR]

Introduction: Acute otitis media (AOM) is the most frequent diagnosis of the sick children visiting clinicians' offices and the most common reason for administration of antibiotics. Method: The study included 104 patients discharged from Pediatric Clinic III - "Saint Mary's" Children's Clinical Emergency Hospital of Iasi from January 2015 to January 2017, diagnosed with "Acute otitis media". Objective: On this batch we performed a retrospective study based on the data found in the children's medical charts, by observing the risk factors to which they were exposed and that favor the illness, and also the connection between the risk factors and the occurrence of complications. Results: The risk factors for acute otitis media that we identified in this group were the cold season, male gender, premature birth, low birth weight, artificial alimentation in the first year of life, incorrect dietary diversification, child's becoming a community member, higher number of siblings, association of respiratory tract infections, of chronic diseases or immune deficiencies, allergic status, exposure to pollutants. To prevent premature and late complications, it is important to accurately specify the diagnosis and establish individualized therapy according to guidelines. It is also essential to follow up and ensure directly observed therapy for children through the collaboration of a pediatrician with the family doctor and the ENT specialist. [ABSTRACT FROM AUTHOR]

Aim: Suicide is a global health problem with an increasing incidence among young adults and teenagers. The study was aimed at analyzing the profile and identifying the frequency, nature, and contributing factors of suicides., Material and Methods: This retrospective study included all patients who attempted suicide admitted to the Emergency Department (ED) of ‘St Spiridon’ Hospital Iasi - Romania, during 2015. They were analyzed by sex, age, residence, suicide method, associated pathology, potential risk factors and interventions., Results and Discussion: The study included 368 patients (53.81% female and 46.19% male). 63.58% were admitted to ED for drug ingestion, 14.13% for ingestion of organophosphorus compounds, rat poison, herbicide and corrosive substances and 22.28% for traumatic suicide attempts. Drug ingestion (42.11%) was preferred by women while self-inflicted cut injuries (14.94%) and corrosive substance ingestion (8.42%) were more common in males. Benzodiazepines ingestion (20.10%) followed by self-inflicted cut injuries (13.85%) and corrosive substance ingestion (6.52%) were the most frequently used suicide methods. At the time of admission to ED31.52% of patients were on psychiatric treatment and 65.48% were at the first suicide attempt. The admission rate was 57% and mortality rate 0.27%., Conclusions: Suicidal behavior can be prevented by psychotherapeutic, pharmacological or neuromodulatory treatments for mental disorders. Also, regular follow-up of people who attempted suicide by mental health services is key to preventing future suicide attempts.

Aim: The study aimed to identify the risk factors and the particularities of ethnobotanicals and cannabis users who needed medical care in the Emergency Department of the „Sf. Spiridon” County Hospital., Material and Methods: Retrospective study conducted over a period of 18 months (January 1, 2015- June 30, 2016). This study included all patients who presented to the E.D. after drug (cannabis and ethnobotanicals) consumption. The variables studied for creating the consumer profile were sex, age, social background, method of consumption, clinical and laboratory changes., Results and Discussion: The study included 153 patients brought to hospital by ambulance (71.89%) for cannabis or ethnobotanical poisoning. Most patients were males (92.15%) from urban areas (75.97%), aged between 18 and 24 years (52.28%). At the time of admission to ED 96.07% of them needed medical care for consumption of ethnobotanicals through various methods and only 3.92% were brought to hospital for cannabis or marijuana use. For 61.70% of patients, curiosity was the reason behind their addiction. Toxicology testing (qualitative urine analysis) was useful in identifying the presence of tetrahydrocannabinol(THC) or a combination of THC and barbiturates, benzodiazepines, opioids in 26.53% of ethnobotanical and 66.67% of cannabis users., Conclusions: In Romania, the most commonly used drugs are cannabis followed by ethnobotanical products. For a while, ethnobotanical products were falsely considered as risk-free, but they contain dangerous substances with devastating effects, which, unless treatment is initiated immediately, can lead to death.

Aim: To identify the risk factors for the use of ethnobotanicals and the people at risk to becoming users., Material and Methods: This questionnaire basez objective population study included 89 subjects aged 14 to 42 years., Results: 19.10% of the subjects admitted using ethnobotanicals, most of them being 20-25 years old (35.29%), males (82.35%), with an average educational level, and unmarried. It should be noted that 23.52% of the users were underage. 85.15% of the subjects first used ehnobotanicals out of curiosity, 29,41% under the influence of friends (94.11% of them having friends that use these products). 11.76% of the respondents stated that they did not know what they used, the product being offered to them by friends as a cigarette or candy. Favorite places for consumption were: at home (64.70%), parks and public areas (23.52%), coffee shops and night clubs (11.76%). Cigarette was the preferred method of use (70.58%), followed by joint (23.52%) and "salt bath" (5.88%). The described effects were: hallucinogen (35.29%), aphrodisiac (29.41%) and relaxing (23.52%). To strengthen these effects, most users associated alcohol and tabacco (70.58%), or other illegal drugs (7.14%). According to this study all users were familiar with the risks associated with the use of these products, but only 64.70% agree with closing the weed-shops., Conclusions: The obtained data are of help in initiating prevention and rehabilitation programs in school and colleges.

Aims: to assess the profile and the characteristic of oncological patients, establishing management in patients with neoplasia presented in the emergency department (ED), the analysis of short-term movements in patients with neoplasia whilst in the ED., Material and Methods: we performed a retrospective study on nonrandomized consecutive cases. The lot analysis included 1315 oncological patients admitted in the Emergency Department of the Clinical Emergency Hospital "St. Spiridon" Iaşi, in the period June 1st, 2009 - May 31st, 2010. 23.12% of the patients had high suspicion of neoplasia at the first visit to the ED., Results: 67.07% of patients were in metastatic stage disease located as follows: liver metastasis 37.59%, lung metastasis 18.36%, lymph node metastasis 13, 29%. After processing the data there were found statistically significant correlations between the age of patients and the documented/suspected diagnosis of neoplasia (p = 0.01) in the sense that a neoplasia diagnosis in emergency was more frequent in people of young age. It should be mentioned that other studies rarely mention first diagnosis of neoplasia in emergency department with presence of complications., Conclusion: 1315 oncological patients presented in ED, almost a quarter of which presented high suspicion of neoplasia (still without histopathological confirmation) when in ED (23.12%). Most of them were aged male patients (over 65 years old), with tumors of the digestive system. A significant proportion (almost 60%) of these patients ended up in emergency due to complications and the therapy intended life support and pain management. Some of these patients were directed to further exploring and emergency outpatient therapy while 75% of patients were hospitalized after stabilization. Although we expected that the frequency of complications to be higher in patients previously diagnosed with cancer, data analysis showed no statistically significant differences (p = NS) between the rate of complications in patients previously diagnosed with neoplasia and those with high-suspicion neoplasia first diagnosed in the ED.