Ramus to Ramus Mandibular Defect Reconstruction with Osteocutaneous Fibula Free Flap - Case Presentation.

Introduction: Head and neck defects after tumor resection can be difficult to reconstruct using autogenous tissue without utilizing a free flap. Osteocutaneous fibula free flap is now considered the gold standard used for mandibular reconstruction after resections due to malignancy. Case presentation: We present the case of a 49-year old female known with an ectopic mucoepidermoid carcinoma involving the mandibula from one ramus to another. After tumor resection, we have reconstructed the mandible by using the only method available for reconstruction in this case - an osteocutaneous fibula free flap. We were able to reconstruct the mandible using 3D printed custom-made surgical guides. Discussion: Postoperative imaging showed that the height and symmetry of the mandible were satisfactory. There were no microvascular failures and the intraoral healing time was about 10 days. The donor site skin defect from the left leg was grafted with an autograft harvested from the ipsilateral thigh. The donor site healed uneventfully. Conclusion: Osteocutaneous fibula free flap is a highly effective method and sometimes the only one available for reconstruction of mandibular defects after resection of intraoral malignancies. Modern technologies, such as surgical planning using computer-aided design, play a critical part in extensive reconstructions, lowering the total intervention time.

Factors Associated with Acculturative Stress among International Medical Students.

There is an array of reasons why acculturation can be stressful, and acculturative stress can be triggered by a plethora of factors. The aim of the study was to identify factors associated with acculturative stress among international students enrolled in a public medical university from Romania. 265 students were included in the research. Sociodemographic, academic, and family data, comfortability with living in study city, satisfaction with administrative staff, colleagues, and professors and Acculturative Stress Scale for International Students were gathered. Data have been processed using SPSS Statistics v23.0.0 for MAC.OSX. Female students are more prone to experience homesickness and stress due to change compared to male students. International students with Romanian origins had lower scores on perceived hate and stress due to change/culture shock compared to those with no Romanian origins. Students with relatives or friends enrolled in the same university had significantly lower levels of acculturative stress, perceived discrimination, perceived hate/rejection, and general/nonspecific concerns. Age and year of study are associated with homesickness and stress due to change/culture shock. The existence of factors associated with acculturative stress demand institutional, social, and psychological support for international students.

Reasons for and Facilitating Factors of Medical Malpractice Complaints. What Can Be Done to Prevent Them?

Background and objectives. Medical malpractice is an increasing phenomenon all over the world, and Romania is not spared. This matter is of concern as it has a significant impact on the physicians and the patients involved, as well as on the health care system and society in general. The purpose of our study was to perform an insight analysis on the reasons for medical malpractice complaints as well as the factors that facilitate the complaints to identify specific ways to prevent them and, implicitly, to improve the medical practice. Materials and Methods. The authors conducted a retrospective study of the medical malpractice complaints registered in the period 2006-2019 at the Commission for monitoring and professional competence for malpractice cases in the region of Moldova, Romania, collecting data on both the patients and the medical professionals involved. Results. The authors analyzed 153 complaints directed against 205 medical professionals and identified 15 categories of reasons for complaints, the most significant being related to the occurrence of complications, and to the doctor-patient interaction (e.g., communication, behavior, informed consent). The most frequently reported medical specialties were obstetrics and gynecology, emergency medicine, general surgery, and orthopedics and traumatology. Emergency medicine was often involved in complaints suggesting an over utilization of this department in our country and the need for health policies, which could divert the large number of patients accessing emergency medicine towards primary care. Conclusions. Regarding the dysfunctions in the doctor-patient relationship frequently claimed by patients, the authors concluded that doctors need special undergraduate training and periodic updating during their practice for them to be able to adequately address the challenges of interacting with their patients.

Eating Disorders in Relationship with Dietary Habits among Pharmacy Students in Romania.

Changing dietary habits of university students is due to personal, social, educational or religious factors. The relationship between dietary habits and presence of eating disorders among university students is less known in Romania. Material and Methods: Ninety-one pharmacy students (91.21% women) were included in the research. Socio-demographic, anthropometric, medical, and psychological data were collected. Dietary self-declared habits were registered. The analysis of data was done using SPSS, v23. Results: A total of 69.2% of students had normal weight, 64.84% preferred to have lunch, and 23.08% eat during nights. The majority of subjects (95.6%), stated that they eat snacks daily. More than one-third of students keep diets to reduce their weight. Younger students tend to eat more main meals per week, snack more, and eat later after getting up in the morning. Subjects with high body dissatisfaction tended to have fewer main meals (r = -0.265, p = 0.011) and to skip breakfasts (-0.235, p = 0.025) and dinners (r = -0.303, p < 0.001). Pharmacy students that presented higher rate of emotional problems tend to sleep less and skip breakfast. Conclusions: Female pharmacy students had higher mean scores on all subscales than those found among Romanian women. A strong relationship between dietary habits and eating disorders was identified.