Gender Differences in Coping, Depression, and Anxiety in Patients with Non-Metastatic Lung Cancer.

Background: Depression and anxiety are prevalent issues amongst individuals suffering from thoracic cancer. Gender differences in coping with thoracic cancer have a serious impact upon the management of emotional distress. The purpose of our study has been to assess sex variations in handling anxiety and depression, including the use of coping mechanisms and their relationship with respect to anxiety and depression. Methods: This cross-sectional study registered 18 women and 22 men with non-metastatic lung cancer and operated upon. Pre-operatively and at one month post-operatively, the patients were assessed by means of scales (COPE, GAD-7 and PHQ-9). Results: Post-operatively, the intensity of depression and anxiety was substantially greater in males than in females (p = 0.049, p = 0.042). Male individuals tended to use coping mechanisms of humour (p = 0.009) and restraint (p = 0.029) significantly more frequently than women. Moreover, in women, depression correlated significantly with denial and behavioural deactivation (rho = 0.465, p = 0.029, respectively, rho = 0.562, p = 0.006); whilst anxiety, similarly, correlated with positive interpretation, behavioural deactivation, and use of social-emotional support (rho = 0.484, p = 0.022, respectively, rho = 0.590, p = 0.004 and rho = 0.502, p = 0.017). Furthermore, in males, depression correlated significantly with mental deactivation, use of social-instrumental and social-emotional support (rho = 0.702, p = 0.001, respectively, rho = 0.505, p=0.033, and rho = 0.773 with p < 0.001), whilst anxiety correlated significantly with mental deactivation, denial, and use of social-emotional support (rho = 0.597, p = 0.009, respectively, rho = 0.553 with p = 0.017 and rho = 0.755, p < 0.001). Conclusion: There were gender divergences in the use of coping mechanisms and the level of post-surgical anxiety and depression. We found significant positive relationships between some coping mechanisms and depression/anxiety. The patient's gender governs the coping style, which in turn has bearing upon the post-operative evolution.

Coping, Anxiety, and Pain Intensity in Patients Requiring Thoracic Surgery.

Stress, anxiety, and post-surgical chest pain are common problems among patients with thoracic surgical pathology. The way in which psychological distress is managed-the coping style-can influence the postsurgical evolution and quality of life of patients. In our study, we monitored the influence of coping style on patients' anxiety and the intensity of post-operative chest pain. We conducted a cross-sectional study on 90 subjects with thoracic surgical pathology. One month after their surgeries, patients completed the following scales and questionnaires, translated, adapted, and validated for the Romanian population: COPE scale inventory, Generalized Anxiety Disorder-7 Questionnaire, McGill Pain Questionnaire, and Numeric Pain Rating Scale. Anxiety (evaluated using the Generalized Anxiety Disorder-7 Questionnaire) and postoperative thoracic pain intensity (evaluated by means of the Numeric Pain Rating Scale, Number of Words Chosen, and McGill Pain Questionnaire) were significantly higher in patients exhibiting social-focused coping than in patients presenting emotion-focused or problem-focused coping as their main coping style (Kruskal-Wallis, p = 0.028, p = 0.022, p = 0.042, p = 0.007). In our study, there were no differences observed in pain intensity relative to level of anxiety. Coping style is an important concept in the management of anxiety and pain experienced by patients undergoing chest surgery. Therefore, a multidisciplinary approach should be considered in clinical practice.

Cystic echinococcosis in children and adults: a seven-year comparative study in western Romania.

This study aims to compare the epidemiological, clinical, and laboratory aspects of cystic echinococcosis (CE) in children with those of adults from western Romania, and to determine the specifics of this disease in the younger population. The medical records of the patients diagnosed with CE and hospitalized during 2004-2010 in four western Romanian counties were retrospectively investigated. Overall, 82 children (mean age, 10.8 years) and 369 adults (mean age, 48 years) were diagnosed with CE during the study period. The yearly detection rate was 3.1/100,000 children and 3.4/100,000 adults. The incidence rate registered a peak in children aged 5-14 years (4.4/100,000) and adults aged 60-69 years (5/100,000). Female to male ratio was 1.6:1 in pediatric cases and 1.2:1 in adults. CE was almost twice more frequent in rural areas (4.4/100,000 children and 4.9/100,000 adults) as compared to urban regions (2.3/100,000 children and 2.6/100,000 adults). Hepatic cysts were found more frequently than pulmonary cysts, at a ratio of 3.6:1 in children and 12.8:1 in adults. Most of the cases had no complications (91.5% of children and 87% of adults). Children had higher eosinophil count (7%) and erythrocyte sedimentation rate (ESR) (29.7 mm/h) as compared with adults (eosinophil count, 5.3%, p<0.001; ESR, 22.4 mm/h, p=0.001). The active transmission of the parasite in western Romania is demonstrated by the high incidence of CE in children. Long-term prevention of this disease may be reached through joined legislative efforts focused on the registration of dogs, home slaughter of sheep and swine, veterinary control in abattoirs, destruction of infected materials, and restriction of dogs' access to vegetable gardens and children's parks.

New foci of trichinellosis in western Romania, 2011.

Romania reported the highest incidence of trichinellosis in the world in 2004, and the figures continue to be high. This report aims to bring new information regarding 2 foci of trichinellosis that occurred in the winter of 2011 in a western Romanian region. Data were collected from the outbreak reports and hospitalization documents of the patients diagnosed with this condition. Of 22 patients admitted to hospitals, the medical records were available in 20 cases. The mean age of the study group was 37.4±13.6 years (range: 3-56) with most of them (n=7; 35%) aged 30-39 years old. The majority of the patients (n=19; 95%) were adults (≥18 years old), males (n=13; 65%) and rural inhabitants (n=13; 65%). Mylagia represented the most common clinical symptom (n=17; 85%). All but one of the patients had benign and moderately severe courses of the disease. The mean eosinophil counts and leukocyte counts were 17±10.7% and 10,162.4±3798.4 cells/mm(3), respectively. Re-emergence of trichinellosis in this region has deep roots in the population's ancestral customs and education. To limit the occurrence of the disease, new and efficient public health strategies should be designed and implemented in the nearest future.

Giant pulmonary and hepatic hydatid cysts in a child.

This case report focuses on hydatidosis, one of the most important parasitic zoonoses in Romania. We describe an interesting paediatric case of an eight-year old boy from a rural region presenting with a both giant and life-threatening pulmonary cyst (that was successfully managed) and a hepatic cyst. Noteworthy are the negative consequences of this disorder on children's health and development as a result of prolonged hospitalizations, surgical interventions and chemotherapy.

Human cystic echinococcosis in two south-western and central-western Romanian counties: a 7-year epidemiological and clinical overview.

PURPOSE: To analyze the epidemiological and clinical characteristics of human cystic echinococcosis (CE) in two Romanian counties, of which one is known from a previous survey as hyperendemic, whereas in the other no extensive studies have been undertaken so far. METHODS: Retrospective investigation of the medical records of the patients diagnosed with this condition and hospitalized during 2004-2010 in Caras-Severin and Hunedoara counties. RESULTS: A total of 190 patients aged 5-88 years (44.3±21.8 years old) were diagnosed with CE. More than one fifth of cases (21.1%) were younger than 19 years old, indicating active transmission of the disease. The yearly average incidence was 3.3 cases/100,000 inhabitants. The highest incidence was registered in patients aged 60-69 years (6.2 cases/100,000 inhabitants), regardless of their gender. Liver involvement occurred in 84.7% of patients. One fifth of the cases (20%) presented complications. Normal values of the eosinophil counts and leukocyte counts predominated within the study group. The length of the hospital stay varied between 1 and 65 days with a mean of 13.1±9.5 days. CONCLUSIONS: CE has a significant burden in this part of Romania, and continues to be a public health concern. Consequently, better implementation of preventive measures and extensive informative campaigns for the population are mandatory.

Knowledge and interests of Romanian medical students in parasitology, tropical and travel medicine.

As travel has become easier and faster, the rate of tropical infections across the world is expected to increase; more students working abroad are going to encounter these diseases more often. Disorders of parasitic etiology play an important role in travel and tropical medicine. The aim of our study was to assess the preclinical students' knowledge regarding parasitic diseases, tropical and travel medicine in the broad context of their professional background. A total of 346 Romanian medical students completed a 13-item questionnaire on the above-mentioned topics. In order to allow for complex evaluation, the questionnaire also included items related to their extracurricular training as well as their future perspectives. The majority of the students (97.7%) declared they had prior knowledge (before studying parasitology) of malaria. Most of the responders (90.2%) knew that a journey in (sub)tropical regions requires adequate prophylactic measures. About a quarter of those interviewed (26.4%) would agree to practice tropical medicine after graduation. They were mainly interested in helping people from underdeveloped countries regardless of remuneration (52.7%). The majority of students (59.8%) wished to practice clinical medicine. It has been observed that fewer than 5% of the questioned students had ever read a scientific paper or book in the field of tropical medicine. English was the most commonly spoken foreign language (92.8%), and 99.1% of students had at least intermediate computer skills. Finally, 71.6% of students would choose to practice the specialty of travel medicine if it were available in Romania. The implementation of appropriate measures towards the globalization of medical teaching in Romanian universities should represent an important issue in this new millennium, in which borders between various nations are starting to fade; otherwise the next generations of physicians will lose the chance to gain wider experiences and share the international influences on health.