Background: The increased rates of postoperative mortality after emergency surgery for obstructive colon cancer (OCC) require the use of risk-stratification scores. The study purpose is to external validate the surgical risk calculator (SRC) and the AFC/OCC score and to create a score for risk stratification. Patients and methods: Overall, 435 patients with emergency surgery for OCC were included in this retrospective study. We used statistical methods suitable for the aimed purpose. Results: Postoperative mortality was 11.72%. SRC performance: strong discrimination (AUC = 0.864) and excellent calibration (11.80% predicted versus 11.72% observed); AFC/OCC score performance: adequate discrimination (AUC = 0.787) and underestimated mortality (6.93% predicted versus 11.72% observed). We identified nine predictors of postoperative mortality: age > 70 years, CHF, ECOG > 2, sepsis, obesity or cachexia, creatinine (aN) or platelets (aN), and proximal tumors (AUC = 0.947). Based on the score, we obtained four risk groups of mortality rate: low risk (0.7%)—0–2 factors, medium risk (12.5%)—3 factors, high risk (40.0%)—4 factors, very high risk (84.4%)—5–6 factors. Conclusions: The two scores were externally validated. The easy identification of predictors and its performance recommend the mortality score of the Clinic County Emergency Hospital of Galați/OCC for clinical use.

Generalized secondary peritonitis is a life-threatening intra-abdominal infection requiring urgent surgical intervention. Despite advances in surgical and antimicrobial therapy, morbidity and mortality remain high. Identifying key prognostic factors is crucial for improving patient outcomes. This review examines significant prognostic indicators and explores the potential role of scoring systems and artificial intelligence in risk stratification. A review was conducted using PubMed, Web of Science, Scopus, and Medline databases. Studies published from 2000 to 2024 focusing on prognostic factors in secondary peritonitis were included. A total of 145 studies were identified, with 40 selected based on relevance and methodological quality. Data extraction included patient demographics, comorbidities, severity scores, microbiological profiles, and artificial intelligence applications in peritonitis management. Poor prognosis was associated with advanced age, severe sepsis, organ failure, chronic kidney disease, cardiovascular comorbidities, and diabetes mellitus. The Mannheim Peritonitis Index (MPI) remains a widely validated prognostic tool, while APACHE II and SOFA scores also provide valuable risk estimates. Increasing multidrug-resistant infections further complicate management and impact outcomes. Emerging evidence suggests that machine learning algorithms may improve early risk stratification and individualized outcome prediction when integrated with conventional scoring systems. Identifying prognostic factors remains essential for optimizing outcomes in secondary peritonitis, and future research should prioritize the clinical validation and integration of AI-based models into perioperative management protocols.

Breast cancer is the most prevalent form of malignancy among women worldwide. Breast cancer can emerge on the skin in two ways: directly, as skin metastases or a direct extension of the tumor; or indirectly, as a paraneoplastic disease. Breast cancer imaging is an essential part of breast cancer screening, diagnosis, preoperative/treatment assessment, and follow-up. The selection of optimal imaging modalities should be contingent upon the patient’s risk factors and breast density since breast cancer imaging necessitates a personalized approach rather than a universal solution. There are a lot of different skin conditions that point to breast cancer, either as a sign of recurring disease, undiagnosed breast cancer, or a condition that puts you at a higher risk of getting it. Even though reconstruction has been shown to improve quality of life for many women, there are still a lot of complicated factors that affect morbidity and results.

The subject of anxiety related to dental treatments is recognized and long debated in medical literature. There are various motivations, starting with individual, age-related, social, economic or strictly medical reasons. Considering the medical and psychological importance of oral health that impact the whole organism health, there is an increasingly sustained, interdisciplinary concern, with the involvement of dentists, generalists, psychologists or psychiatrists. This situation is quantified at the individual and social level with reference to both the financial costs and the organic and psychological suffering determined by this medico-psycho-social problem. This is why the authors of this article proposed in the current study to determine if there is a difference in terms of anxiety towards dental treatments in subjects trained from a medical point of view versus people without medical instruction. The study used an online questionnaire and was carried out over a period of one month in the year 2023. The data were processed with the help of LibreOffice Calc and Microsoft Excel. The conclusions of the study revealed that poor oral health can serve as a precursor to anxiety and depression, creating a link between oral hygiene and mental well-being. Oral pain, embarrassment and the resulting self-consciousness can contribute to feelings of anxiety and depression, feelings that exist no matter if there were subjects trained in medical field or not, therefore individuals may have difficulty socializing, communicating, and maintaining a positive self-image.

Background: Little is known about the physiopathological factors or mechanisms that underlie tumor invasion of the serosa and lead to perforation in the peritoneal cavity. The aim of the work was to analyze the pathological and immunohistochemical factors of tumor neoangiogenesis which could influence tumor perforation in colorectal cancer. Results and discussions: 451 cases of complicated colorectal carcinomas were statistically analyzed, of which 19 cases were perforated sigmoid tumors. The immunohistochemical detection of mutant p53 proteins was the first molecular parameter examined in the context of the search for markers predicting the natural evolution mode in colorectal carcinomas. Conclusions: Both loss of p53 and overexpression of bcl-2 proteins confer immortalization on cancer cells by inhibiting the processes leading to apoptosis. The paper proposes a review of the specialized literature, but also the presentation of a clinical case.

Background: Minimally invasive surgery has become the standard of care in colorectal cancer management, with laparoscopic techniques widely adopted due to their established short-term benefits and comparable oncological outcomes to open surgery. More recently, robotic-assisted surgery has emerged as an advanced minimally invasive alternative, offering enhanced visualization, improved instrument dexterity, and superior ergonomics. However, the extent to which these technical advantages translate into clinically meaningful improvements remains a subject of ongoing debate. Methods: A systematic review of the literature was conducted using PubMed, Scopus, and Web of Science databases, including studies published between 2005 and 2025. Eligible studies comprised randomized controlled trials, observational studies, cohort studies, and meta-analyses comparing laparoscopic and robotic colectomy for colon cancer. Outcomes of interest included intraoperative parameters (operative time, blood loss, conversion rate), postoperative outcomes (length of hospital stay, complications, mortality), and oncological endpoints (lymph node yield, resection margins, survival). The review was performed in accordance with PRISMA 2020 guidelines. Results: A total of 150 studies met the inclusion criteria. Robotic colectomy was consistently associated with reduced intraoperative blood loss, lower conversion rates to open surgery, and shorter length of hospital stay, albeit at the expense of longer operative times, particularly during the learning phase. Oncological outcomes, including lymph node harvest and margin status, were comparable between approaches, with some studies reporting a modest increase in lymph node yield in robotic procedures. The adoption of intracorporeal anastomosis was significantly higher in robotic surgery, contributing to improved postoperative recovery and reduced wound-related complications. Composite quality metrics, such as textbook outcome (TO), were more frequently achieved in robotic cohorts, largely driven by shorter hospitalization and lower complication rates. However, evidence from randomized controlled trials remains limited, and heterogeneity among studies persists. Conclusions: Robotic colectomy and rectal resection represent a safe and effective alternative to laparoscopic surgery in the treatment of colon cancer, offering potential advantages in perioperative outcomes and surgical precision. Its benefits appear particularly relevant in technically demanding cases, such as deep pelvic dissection and obese patients. Nevertheless, higher costs, longer operative times during the initial learning curve, and limited high-quality randomized evidence warrant cautious adoption. Future large-scale randomized studies are needed to clarify long-term oncological outcomes, cost-effectiveness, and the optimal integration of robotic platforms into standard colorectal surgical practice.