After analyzing the psychosocial context in which the professional stress appeared and the professional stress appearance in case of ICU personnel, specialized authors propose an antistress program, whose application points are represented by: 1. decrease the action of the stress initiators, specific to the ICU environment (focusing on improvement the unfavorable working condition, but also on controlled reduction of the negative emotional impact, through psychological counseling and psychotherapy, including a climate of mutual peer support); 2. achieving a rigorous psychological and physical recovery, considering the following personal goals: covering the basic psychological needs (affiliation, long-term security and new experience) (Linton) and obtaining an optimal balance between the level of aspirations and possibilities. In cases where the personal resources and the social support – absolutely necessary – are not enough, especially when the first signs of SBO have already appeared, the psychotherapy becomes very appropriate, especially cognitive-behavioral therapy and, in the future, Well Being Psychoterapy. As the avalanche of psyhical stress occurred in the current activity of ICU personnel can only be reduced – SBO appearance can be prevented only in cases where, starting with the psychological examination at the ICU specialty admission, prophylactic measures (rehabilitation) will be undertaken, including our proposed program.

No abstract

Allergic rhinitis is the result of a permanent/intermitent inflammation of the nasal mucosa, exposed to certain alergens. An immunological reaction is the fundamental cause – a type I hypersensitivity reaction, followed by local inflammatory response and immune cell pooling (eosinophiles, basophiles, Th cells, mast cells) in the nasal mucosa. Matrix metaloproteinases are tissue proteases that degrade extracellular matrix and basilar membrane and modulate immune responses. Our article reviews the part metalloproteinases play in the changes suffered by the nasal mucosa in chronic allergic rhinitis (fibrosis, metaplasia, edema, inflammatory cell infiltration).

Vestibular syndromes are less common seen in pediatric practice than in adult pathology. Vestibular testing is not usual in pediatric hospitals. The most usual causes for vertigo in children are usually less investigated. The authors present a rare case of a child with a brainstem tumor presenting concomitant rhinosinusitis symptoms. Vestibular investigation and a thorough history managed to discover the real nature of the clinical signs. Conclusion: vertigo in children needs careful evaluation for precise determination of its cause.

The authors review the techniques described for the surgical treatment of the tonsils. Each new method has its own advantages and disadvantages. The difference can be evaluated by studying the intraoperative blood loss and safety of the procedure. Also, the postoperative complications and quality of life can be used as an adjunct to objectively appreciate the different surgical techniques. There is no literature consensus about the superiority of one technique over the other. Multiple studies brought multiple significant results. It is also hard to evaluate the entire panel of surgical methods described concomitantly. The experience of one surgeon and his/her mastering of a certain technique is the actual cause of so many surgical options still in use for tonsil treatment in children.