Dental Fear – Prevalence and Ways to Combat It

The fear of the dentist, dental anxiety and dental phobia continue to concern the medical world, seeking to elucidate the causes, calculate the prevalence and its implications on the oral health of the population, as well as identify the most effective methods to combat it. The survey included 208 patients, who were treated and investigated, in the period 2018-2019. The questionnaire consisted of 15 questions, structured in 3 sections: socio-demographic data, oral hygiene habits and past experience, during dental treatment, with analysis of dental anxiety, using modified MDAS.The mean value of MDAS in the study group was 11.7 ± 4. Most of the respondents (80%) had medium or low dental anxiety. High levels of anxiety were observed in 20% of patients, including 12% with dental phobia. A statistically significant correlation was found between the mean values of the MDAS and sex (p = 0.030), age (p &lt;0.0005), place of residence (p = 0.016), socioeconomic status (p = 0.040), subjective assessment of oral health (p &lt;0.0005), frequency of dental appointments (p &lt;0.0005) and negative dental experiences in the past (p &lt;0.0005). No correlation was observed between anxiety, education, or habits related to oral hygiene. As methods of combating dentist fear, it resorted, somehow differentiated and personalized, to progressive muscle relaxation techniques, desensitization and cognitive behavioral therapy, the therapeutic act being carried out in a "tell-show-do" manner. These applied methods have meant the extension of the working time, but without additional costs. We consider our experience in using them as positive, with stable results and with increasing efficiency over time.Our study shows that most of the respondents were without any special fear of dental treatment, one in five patients had a high level of anxiety, and one in ten suffered from dental phobia. Middle-aged women seem to have higher rates of dental anxiety, compared to men.Practitioners need to be aware of the common occurrence of fear, in order to combat it being required knowledge of behavioral psychology and, first of all, establishing a relationship based on trust with the patient, from the beginning.</p

The Influence of the Mental State on the Emergency Colostomized Patients Postoperative Evolution

A colostomy creates a temporary or permanent opening for the colon through the abdominal wall, in order to eliminate fecal matter, which is collected in a closed or open bag, attached to the skin with the help of an adhesive. It is obvious that the patient with colostomy faces psycho-emotional problems, due to the alteration of the body image and the need to change the lifestyle.Under emergency conditions, when the informed consent of the critically ill patient, as well as the psychological preparation for the colostomized future, are difficult, incomplete or impossible to achieve, psychological assistance in the postoperative evolution of patients becomes a problem, on which the whole medical staff (doctors, nurses, psychologists, stomatotherapists) involved in their care must insist. In the immediate postoperative period, combating pain, ensuring biological comfort (hydric, caloric and nutritional), local care and prevention of so-called minor complications, are very important. The patient must also know the alternatives in choosing the type of colostomy bag and the prospects of social reintegration, over time. The measures of emotional support of these patients must be applied intensively, but with tact and professionalism, in parallel with the education and preparation for the new anatomical-physiological changes. In such situations, in addition to the surgical act and the postoperative physical care, the postoperative evolution and the therapeutic success depend, to a large extent, on the modelling of the patient’s mental state.The present paper focuses on the above-mentioned aspect, drawing on the data from the literature and the experience of the authors.</em

The Issue of Dentophobia among Young Adults during the Pandemic

We intend to present the results of an on-going study started in pandemic concerning dentophobia as a health problem. Our aim was to correlate the level of health education with the feeling of fear of dentistry and anxiety in young population during the pandemic. We used an anonymous online questionnaire on a group of 45 subjects aged 18-55. The results of this on-going study up to this stage show that despite the pandemic, there is a concern of young adults about about oral hygiene and dental issues as part of the overall health of the subjects investigated. The need to implement psycho-educational dentistry programs still exists.</em

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Si GAA NW FETs threshold voltage evaluation

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DESCRIPTION AND PRESENTATION OF THE ALLERGIC CONJUNCTIVITIS CASUISTIC

Allergic conjunctivitis is a common eye condition characterized by inflammation of the conjunctiva, which is the thin membrane that covers the inside of the eyelids and the exposed part of the eyeball. Allergies are the main cause of allergic conjunctivitis, and substances called allergens trigger an inflammatory reaction in the conjunctiva. The causes of allergic conjunctivitis are related to the reaction of the immune system to specific allergens. When a person with an allergic sensitivity comes in contact with an allergen, the immune system releases histamines and other chemicals that cause inflammation and irritation of the conjunctiva. Seasonal allergic conjunctivitis occurs in certain seasons of the year, being mainly caused by plant pollen. Symptoms include redness, swelling, itching, excessive tearing, and watery or mucous secretion. Treatment involves avoiding allergens and using antiallergic eye drops. Perennial allergic conjunctivitis is a chronic form that can occur as much as possible and is caused by persistent allergens such as dust mites, mold, or animal hair. Symptoms and treatment are similar to those of seasonal allergic conjunctivitis but often involve a longer and more complex approach

Postoperative pain after total abdominal hysterectomy and bilateral salpingo-oophorectomy depending on the type of anaesthesia administration

Total abdominal hysterectomy and bilateral salpingo-oophorectomy is a surgical procedure frequently associated with severe or moderate postoperative pain. We conducted a retrospective study on 90 patients who underwent this procedure. One part of the patients (58; 64.4%) was administered bupivacaine 5% without intrathecal opioid administration. The other part (32; 35.6%) underwent general anaesthesia with endotracheal intubation. We evaluated the postoperative analgesic requirements based on the type of anaesthesia used and other factors like age, environment and body mass index. The findings indicated that the patients who received general anaesthesia with endotracheal intubation developed severe postoperative pain more frequently than those who underwent spinal anaesthesia (P = 0.018). A higher percentage of patients from rural areas scored lower in postoperative pain intensity on the numerical rating scale (P = 0.033). There was no statistically significant correlation regarding postoperative pain and age or body mass index

Value of post-resuscitation electrocardiogram in the diagnosis of acute myocardial infarction in out-of-hospital cardiac arrest patients

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