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Dentophobia is a significant problem in oral health management. In the conditions of the COVID-19 pandemic, with the associated sanitary measures (quarantine, social distancing) at national level, the fear and dental anxiety are supposedly increased, especially in children. Pediatric patients are emotionally affected when they faced with the need for emergency dental intervention. The current study seeks to assess the emotional state of children aged 8-12, who needed dental care during quarantine, at the regional level, as well as the degree of anxiety of their parents. Dental anxiety was assessed independently by the dentist, parents and children themselves. If in children, the level of dental anxiety increased insignificantly, compared to the pre-pandemic period, the levels of parental anxiety were higher. The boys in the pandemic group had a higher level of anxiety, especially in the parental assessment. The results suggest that the reorganization of oral care in the pandemic scenario did not have a major effect on children's dental anxiety. However, the results of the assessment in boys show that they may be more vulnerable and need special care to alleviate their anxiety and reduce their risk of dentophobia in the future. These conclusions should be treated with caution, given the small sample size, which requires further confirmation. It is also important to convince parents of the safety of a visit to the dentist during a pandemic, to minimize their anxiety about their children's dental fears. [ABSTRACT FROM AUTHOR]

The need for a medical consultation always generates an unpleasant sensation, which becomes more accentuated, when the doctor is a surgeon. The surgeon is next to the dentist, gynecologist and psychiatrist, the doctor to whom the patient turns with the greatest fear. The operative indication and the discussion of therapeutic perspectives can trigger a psycho-emotional imbalance, leading to tomophobia. In fact, it is a complex psychological reaction, including odynophobia (fear of pain), dysmorphophobia (fear of postoperative bodily sequelae), hypnophobia (fear of anesthetic sleep, from which one could not wake up), trypanophobia (fear of injections, needles, scalpel), pantophobia (fear of everything that happens around, in this case, in the hospital environment) and above all, thanatophobia (fear of death). Therefore, it can be stated that the surgical intervention is a test of the psychoaffective capacity. The paper presents the authors' experience in 20 years (2002-2021), related to the psychological management of surgical patients, subjected to medium or large-scale surgical interventions (75% performed in emergency mode), in 958 patients. Mental stress can have consequences, both on the reactivity of the surgical patient and on his postoperative evolution. In the time crunch and in the absence of a psychologist, available to offer specific advice on medical objectives, the management of perioperative anxiety rests with the surgeon and the nursing staff. The paper discusses and underlines some elements related to the psychology of the surgical patient and insists on the importance and role of the psychologist, in the prophylaxis and treatment of what can be called operative disease. [ABSTRACT FROM AUTHOR]

Introduction: Choosing the optimal treatment for patients with complicated colon cancer operated in an emergency remains a challenge. The study aims to identify the factors that influence the therapeutic decision in these patients. Patients and Methods: We included in this retrospective study 449 patients operated in emergency for complicated colon cancer, in the Clinical Emergency County Hospital "St. Ap. Andrei" Galati between 2008-2017. The patients data were collected from the observation sheets, the surgical, imaging and laboratory protocols. Results: The operations performed were: resections with a stoma in 37.63% of cases, resections with anastomosis in 36.97%, stomas in 16.26% and internal derivations in 9.13% of patients. Elderly age was correlated with stomas with or without tumour resection (p 0.05). Preoperative diagnosis of IDH was associated with resections with anastomosis, those with occlusion were associated with internal derivations and those with digestive perforations with resections with a stoma (p 0.05). The stomas were associated with the presence of intraoperatively detected complications (p 0.05). Conclusions: Complicated colon tumours operated on in an emergency require surgical treatment tailored to each patient. It is important to choose the type of treatment taking into account the patient's condition at admission, clinical-paraclinical data, tumour location, tumour complication and the presence of other complications detected intraoperatively., (Celsius.)

Introduction: In 2018, the colon cancer was the 5th type of neoplasia regarding the cancer mortality and the rectal cancer was the 10th. The survival of patients with colorectal cancer operated in emergency still remains unsatisfactory, the death being due to local recurrences and to metastases. The aim of this study is to evaluate some correlations of overall survival with clinic and paraclinic features, tumor or treatment characteristics in order to identify prognostic factors, for cases with colorectal tumors that underwent emergency surgery. Material and Methods: We performed a retrospective analysis on 431 patients with colorectal cancer operated in emergency between 2008-2017, excluding 40 patients with postoperative deaths, with a follow-up period of at least one year. There were correlations of some clinic and paraclinic features, tumor or treatment characteristics with the overall survival. Results: In the univariate statistical survival analysis, a statistically significant association was obtained with: the age 61 years (p_value = 0.000049), abdominal surgical history (p_value = 0.031725), heart disease (p_value = 0.000007), atrial fibrillation (p_value = 0.007496), preoperative diagnosis (p_value = 0.034352), cachexia (p_value = 0.000000), oliguria (p_value = 0.000000), anemia (p_value = 0.000006) hydro-electrolytic disorders (p_value = 0.000001), tumor localization (p_value = 0.000030), invasion into other organs (p_value = 0.000000), appearance of "frozen pelvis" (p_value = 0.000000), peritoneal carcinomatosis (p_value = 0.000000), liver metastases (p_value = 0.000000), type of surgery (p_value = 0.000000), lymph node dissection (p_value = 0.000001), liver biopsy (p_value = 0.043483), stoma reversal (p_value = 0.000000 ), serial interventions (p_value = 0.000000), pTNM (p_value = 0.000000), tumor grading (p_value = 0.007069). The Cox multivariate regression analysis revealed that: the age 61 years - HR = 1,026, 95% CI (1,012, 1,039) (p value = 0.000139), cachexia - HR = 1,358, 95% CI (1,046, 1,764) (p value = 0.021617), peritoneal carcinomatosis - HR = 2.346, 95% CI (1.163, 4.732) (p_value = 0.017253), disease stage - HR = 36.745, 95% CI (14.778, 91.366) (p_ value = 0.000000), intervention type - HR = 0.187, 95% CI (0.045, 0.779) (p_ value = 0.021281) and serial interventions - HR = 0.282, 95% CI (0.144.0.551) (p_ value = 000213) are independent prognostic factors. Conclusions: The prognostic factors for patients with colorectal cancers operated in emergency are: the age 61, the presence of abdominal surgical history and associated cardiac conditions, especially atrial fibrillation, diagnosis of diastatic perforation imminence, cachexia, oliguria, hydro-electrolytic disorders at admission, rectal tumors, tumor invasion in other organs, the appearance of "frozen pelvis", the presence of liver metastases or peritoneal carcinomatosis, undifferentiated tumors, stage IV, practicing an internal derivation or not performing lymph node dissection. The age over 61, cachexia, as well as peritoneal carcinomatosis, stage III or IV are independent risk factors the Hartmann procedure and the serial interventions are independent protective factors., (Celsius.)