Journal of Mind and Medical Sciences

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Open AccessCase Report

Synchronous Cervical Sympathetic Chain Schwannoma, Parathyroid Adenoma and Hypofunctional Nodular Goiter—A Case Report and Literature Review

by Flaviu Muresan, Alexandrina-Manuela Muresan, Gabriel-Emil Petre, Iacob Domsa, Vasile Ovidiu Fabian and Olga Hilda Orasan

J. Mind Med. Sci. 2024, 11(1), 261-266; https://doi.org/10.22543/2392-7674.1432 - 30 Apr 2024

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Abstract

Simultaneously diagnosing cervical sympathetic chain schwannoma, nodular goiter and parathyroid adenoma is a very rare event during clinical practice. We had the opportunity to find this unusual association on a female patient. While nodular goiter and parathyroid adenoma are more common diseases and [...] Read more.

Simultaneously diagnosing cervical sympathetic chain schwannoma, nodular goiter and parathyroid adenoma is a very rare event during clinical practice. We had the opportunity to find this unusual association on a female patient. While nodular goiter and parathyroid adenoma are more common diseases and easier to diagnose, identifying the etiology of a parapharyngeal space tumor remains a challenge and requires multiple imaging studies such as computed tomography scan, magnetic resonance imaging or angiography. A cervical sympathetic chain schwannoma, a carotid body tumor, a paraganglioma or a vagal schwannoma must be taken into account as possible diagnostic variants. Complaints such as Horner`s syndrome, hoarse voice or dysphagia may suggest a nerve originating tumor, but this is a rare situation. Only the surgical exploration is successful in detecting the tumor origin from the cervical sympathetic chain. Even so, the exact origin of the tumor cannot usually be detected without surgical exploration and removal of the piece or biopsies. Therefore, the pathological report of the specimen (adding or not immunohistochemistry tests) is mandatory to be able to confirm the diagnosis of schwannoma. Full article

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Open AccessCase Report

ERCP Extraction of Stones In Situs Inversus Patients; State-of-the-Art Techniques

by Deniz Gunsahin, Madalina Ilie, Oana Plotogea, Dan Nicolae Paduraru, Alexandra Bolocan, Octavian Andronic, Florentina Musat, Vlad Baleanu, Dragos Davitoiu, Mihai Pahomeanu, Bogdan Dumbrava, Vlad Enciu and Alexandru Constantinescu

J. Mind Med. Sci. 2024, 11(1), 256-260; https://doi.org/10.22543/2392-7674.1446 - 30 Apr 2024

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Abstract

Situs inversus totalis (SIT) is a rare congenital disease that causes mirror transposition of the abdomino-thoracic structures. When such patients develop pathologies related to the bile duct, most commonly choledocholithiasis, the optimal diagnostic process can be hampered by the rarity of such a [...] Read more.

Situs inversus totalis (SIT) is a rare congenital disease that causes mirror transposition of the abdomino-thoracic structures. When such patients develop pathologies related to the bile duct, most commonly choledocholithiasis, the optimal diagnostic process can be hampered by the rarity of such a pathology and the lack of medical information on this topic. Once the diagnosis is established, through endoscopic ultrasound and MRCP, the patient is sent to perform ERCP, which requires tailored approaches for each case. We present the case of a 33-year-old patient who was previously documented with SIT. On admission she presented with abdominal pain and fever that started a week before presentation, so antibiotic therapy was initiated. Imaging investigations revealed intrahepatic gallstones, so she underwent ERCP the next day with the identification of an intrahepatic bile lake containing stones within. Naso-biliary drainage was placed and further 2 ERCP procedures followed, with the insertion of 3 plastic biliary stents. The evolution was favorable, until the complete removal of gallstones and remission of clinical symptoms. The patient was carefully monitored in the following two days and the stents were removed, being later discharged and monitored for a period of 6 months in which no biliary/digestive symptoms were noted. Full article

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Open AccessCase Report

The Role of Radiotherapy in the Complex Treatment of Mycosis Fungoides; A Case Report

by Laura Florentina Rebegea, Claudia Elena Pavel, Nadejda Corobcean, Ana Maria Ilie, Dorel Firescu, Madalin Guliciuc, Elena Niculet, Mihaela Dumitru, Daniela Mihalache, Flavius Bulgaru and Roxana Andreea Rahnea-Nita

J. Mind Med. Sci. 2024, 11(1), 249-255; https://doi.org/10.22543/2392-7674.1506 - 30 Apr 2024

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Abstract

Introduction. Mycosis fungoides (MF) is the most common form of primary cutaneous T-cell lymphoma. Radiotherapy induces excellent response rates in the treatment of localized or extensive lesions of MF, both as monotherapy and as part of a multidisciplinary treatment. Total skin irradiation [...] Read more.

Introduction. Mycosis fungoides (MF) is the most common form of primary cutaneous T-cell lymphoma. Radiotherapy induces excellent response rates in the treatment of localized or extensive lesions of MF, both as monotherapy and as part of a multidisciplinary treatment. Total skin irradiation with electrons or protons is available in a limited number of medical centers and is mainly used in patients with extensive MF. Case presentation. It is presented the case of a 47-year-old patient who developed erythematous papules and plaques on the chest, upper limbs, face and scalp, initially diagnosed as chronic eczema and treated with systemic corticotherapy, antihistamines and dupilumab. Under treatment, the lesions progressed with the appearance of tumorous formations on the scalp and face, some of them ulcerated. Thus, additional (histopathological and immunohistochemical) tests were performed and established the diagnosis of MF. As a result, treatment with methotrexate and narrow-band UVB was initiated, subsequently associated with radiotherapy on the scalp and face lesions (right frontal, right parietal, left oral commissure), 30 Gy to each area. During radiotherapy, the patient developed second grade radiodermatitis associated with radiomucositis, but with a significant reduction in the surface area of the lesions until their disappearance. Conclusions. Radiotherapy can be used in all stages of MF, being useful both for alleviating symptoms and eradicating the disease, meaning that the potential of this form of treatment needs to be further exploited and investigated. Full article

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Open AccessCase Report

Metachronous Mucinous Breast Carcinoma and Mucinous Pancreatic Cystadenoma in a Patient with Metabolic Comorbidities; Case Report and a Literature Review

by Teodora Gabriela Alexescu, Irina Obada, Angela Cozma, Mirela Georgiana Perne, Olga Hilda Orasan, Vasile Negrean, Iacob Domsa, Victoria Ruta and Simina Felicia Țărmure

J. Mind Med. Sci. 2024, 11(1), 242-248; https://doi.org/10.22543/2392-7674.1462 - 30 Apr 2024

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Abstract

Mucinous breast carcinoma is a rare subtype of mammary neoplasm encountered in medical practice. It represents approximately 1–6% of all breast cancers and is more common in postmenopausal women. There are two subtypes of mucinous breast carcinoma: pure and mixed. We report the [...] Read more.

Mucinous breast carcinoma is a rare subtype of mammary neoplasm encountered in medical practice. It represents approximately 1–6% of all breast cancers and is more common in postmenopausal women. There are two subtypes of mucinous breast carcinoma: pure and mixed. We report the case of a 73-year-old Caucasian woman diagnosed with mucinous pancreatic cystadenoma in 2007. She underwent a surgical procedure involving pancreatectomy of the body and tail, along with multiple known cardiovascular and metabolic comorbidities. In November 2019, during a clinical-biological evaluation for associated diseases, a mucinous carcinoma of the right breast was accidentally detected and later confirmed through further investigations. For treatment, a surgical procedure was performed involving lower right quadrantectomy with right axillary lymph node dissection. The postoperative clinical course was favorable. In conclusion, we present the case of a patient diagnosed with mixed mucinous breast carcinoma, without axillary lymph node invasion. Postmenopausal women with diabetes, overweight, and obesity have an increased susceptibility to breast cancer, with our patient having all these risk factors. To date, no study has demonstrated the genetic or radiation implication in the occurrence of mucinous carcinomas, nor the possible development of mucinous carcinomas in series in the same patient. Yet, current data are insufficient to provide recommendations for the screening of malignant mucinous tumors in subjects with significant cardiometabolic risk factors. Full article

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Open AccessCase Report

Single Case Experimental Design Examining Cognitive Behavioural Therapy for Post-Stroke Depression

by Liam Alexander MacKenzie Myles and Emma Jones

J. Mind Med. Sci. 2024, 11(1), 233-241; https://doi.org/10.22543/2392-7674.1470 - 30 Apr 2024

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Abstract

Background. Post-stroke depression (PSD) is common in older-age adults and is typically treated with cognitive-behavioural therapy (CBT). However, research has ascertained mixed findings regarding the efficacy of CBT for PSD in older-age adults, with limited evidence in people from global majority backgrounds. [...] Read more.

Background. Post-stroke depression (PSD) is common in older-age adults and is typically treated with cognitive-behavioural therapy (CBT). However, research has ascertained mixed findings regarding the efficacy of CBT for PSD in older-age adults, with limited evidence in people from global majority backgrounds. Materials and Methods. This case study used single case experimental design methodology to examine the effectiveness of CBT for PSD in a black, older-age man. The effects of health conditions, cohort beliefs, transitions in role investments, socio-cultural context and early experiences on the client’s thoughts, emotions, physical sensations and behaviours were formulated, before behavioural activation was used to increase engagement in meaningful and pleasurable activities. Results. Throughout therapy, the client’s mood, motivation and optimism for the future improved, and their depression and anxiety symptoms reduced. Conclusions. This case study offers tentative evidence that CBT for PSD may be effective in black older-age adults. Full article

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Open AccessArticle

Surgical Management of Retroperitoneal Hydatid Cysts—Results on a Group of Six Patients

by Dragos George Popa, Cosmin Vasile Obleaga, Ana Maria Rukie Ahmet, Cristin Constantin Vere, Vlad Ionuț Ducu, Cecil Sorin Mirea, Dan Nicolae Florescu, Mihai Călin Ciorbagiu, Dragoş Marian Popescu, Costin Teodor Streba, Lucian Florescu, Teodor Sas and Lorena Sas

J. Mind Med. Sci. 2024, 11(1), 225-232; https://doi.org/10.22543/2392-7674.1435 - 30 Apr 2024

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Abstract

Objectives. Hydatid disease is a potentially lethal parasitic condition caused by the larvae of Echinococcus Granulosus; it is found in humans and more commonly in domestic and wild animals in endemic areas. This pathology is frequently encountered in the liver, the hydatid [...] Read more.

Objectives. Hydatid disease is a potentially lethal parasitic condition caused by the larvae of Echinococcus Granulosus; it is found in humans and more commonly in domestic and wild animals in endemic areas. This pathology is frequently encountered in the liver, the hydatid cyst with retroperitoneal location representing a rarely encountered form of evolution. Materials and Methods. In the present paper, we present a study carried out on 6 patients hospitalized in the Surgery Department of the Craiova County Emergency Clinical Hospital. These patients were diagnosed between 2002–2022 with retroperitoneal hydatid cyst or with multiple cysts (including retroperitoneal), being operated and monitored postoperatively at a distance. Results. The diagnosis was generally established by clinical examination, laboratory investigations and CT imaging, while the MRI evaluation was performed only in two of the cases, in order to provide additional data necessary for the surgeon. Conclusions. The difficulty of surgical interventions was determined by the size and local/multilocular extension of the disease; in the case of one patient, a double approach, abdominal and thigh, was necessary. Full article

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Open AccessArticle

Systematic Surgical Approach to Juvenile Angiofibroma

by Raluca Oana Pulpă, Viorel Zainea, Cătălina Voiosu, Ruxandra Oana Aliuș, Andreea Rusescu, Irina-Gabriela Ioniță, Veronica Epure, Dragoș Octavian Palade and Răzvan Hainăroșie

J. Mind Med. Sci. 2024, 11(1), 218-224; https://doi.org/10.22543/2392-7674.1471 - 30 Apr 2024

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Abstract

Introduction. Juvenile nasopharyngeal angiofibroma is a rare type of benign vascular tumour that affects only young males, especially those between the ages of 9 and 19. Therapeutic management depends on the extent of the lesion, being conditioned by the complexity of the [...] Read more.

Introduction. Juvenile nasopharyngeal angiofibroma is a rare type of benign vascular tumour that affects only young males, especially those between the ages of 9 and 19. Therapeutic management depends on the extent of the lesion, being conditioned by the complexity of the anatomy of the skull base and the risk of massive bleeding due to the abundant vascular supply. The purpose of this article is to describe the modern approach to juvenile nasopharyngeal angiofibroma, starting from the general knowledge on this topic and presenting the experience of our clinic. Materials and Methods. A retrospective study was conducted on 10 male patients with juvenile angiofibroma, with clinical and imaging diagnoses, confirmed by post-ablative histopathological examination. From the 10 juvenile angiofibroma case treated in our clinic, 4 of them were less extensive, 2 with invasion to the pterygopalatine fossa, 3 involving the infratemporal fossa and 1 with minimal intracranial extension. Results. Combined approach (endoscopic trans-nasal approach and Caldwell Luc approach) was necessary in the treatment of a IIC case. Follow-up after surgery was done using MRI scans every 6 months. Recurrence was encountered in one case (9 months from the first surgery), and needed reintervention to remove the residual tumour. Conclusions. Even if it is a rare condition, the development of specific materials and techniques (endoscopic, embolization) has been considerable, allowing the reduction of intraoperative bleeding and residual tumour tissue, in conditions of minimal interference with the facial anatomy of such young patients. Full article

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Open AccessArticle

Advantages of Mechanical Anastomosis in Rectal Cancer Surgery

by Paul Șiancu, Adrian Boicean, Denisa Tănăsescu, Dan Bratu and Ciprian Tănăsescu

J. Mind Med. Sci. 2024, 11(1), 210-217; https://doi.org/10.22543/2392-7674.1423 - 30 Apr 2024

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Abstract

Rectal oncological pathology represents an increased degree of difficulty in terms of surgical approach. Along with the development of minimally invasive surgery, technology has also increased the options for performing digestive anastomoses. A significant increase has been observed among mechanical anastomoses. The evolution [...] Read more.

Rectal oncological pathology represents an increased degree of difficulty in terms of surgical approach. Along with the development of minimally invasive surgery, technology has also increased the options for performing digestive anastomoses. A significant increase has been observed among mechanical anastomoses. The evolution of mechanical sutures through the use of the stapler has become a true symbol of technological advancement, as they have led to improvements and effective gains in quality and productivity in suture making. The aim of this paper is to highlight the advantages of the use of staplers in rectal surgery, with their help achieving a lower percentage of postoperative complications, a lower incidence of suppuration, fistula and evisceration, a much faster patient recovery, a lower mortality, an increase in the possibility of performing low anastomosis and a decrease in the performance of colostomies that are difficult to be accepted by patients, most of them requiring a shorter period of hospitalization after major oncological surgery. Full article

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Open AccessArticle

Arterial Vascularization of the Colon; A Guide to Surgical Resection

by Iulian Slavu, Florin Filipoiu, Raluca Tulin, Ileana Dima, Alexandru Dogaru, Bogdan Socea, Luminita Tomescu, Theodor Badea, Anca Oprescu Macovei and Adrian Tulin

J. Mind Med. Sci. 2024, 11(1), 203-209; https://doi.org/10.22543/2392-7674.1498 - 30 Apr 2024

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Abstract

Background. Colorectal cancer is a commonly diagnosed neoplasia in men and women worldwide. This study aims to rigorously map the arterial distribution of the colon in order to assess the implications of vascular patterns in surgical resection. Methods. Cadaveric dissections were [...] Read more.

Background. Colorectal cancer is a commonly diagnosed neoplasia in men and women worldwide. This study aims to rigorously map the arterial distribution of the colon in order to assess the implications of vascular patterns in surgical resection. Methods. Cadaveric dissections were performed to explore the arterial distribution (including collateral blood flow) of the colon. The study used standard dissection tools and photographic documentation to detail the vascular architecture supporting the large intestine. Results. The dissection revealed important arterial branches and anastomoses in the area of the superior and inferior mesenteric arteries, which are able to ensure continuous local blood supply especially in cases of arterial ischemia. An important arterial anastomosis was identified between the right branch of the middle colic artery and the ascending branch of the right colic artery, as well as the specific distribution of the marginal artery of Drummond and Haller-Riolan anastomotic arch. Conclusions. The blood supply of the colon derived from both mesenteric arteries includes redundant arterial anastomoses, but which are critical in specific situations such as the approach and results of surgical resection. Understanding these vascular patterns and collateral pathways, as well as careful intraoperative surgical exploration, are essential for oncologic surgeons to ensure successful colic resections with minimal complications and morbidity. Full article

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Open AccessArticle

Smoking during Pregnancy; An Epidemiologic Study of Knowledge and Behavior in Caucasian Women

by Victoria Maria Ruta, Teodora Gabriela Alexescu, Nicoleta Stefania Motoc, Roxana Constantin, Daisy Vaida-Voevod and Milena Adina Man

J. Mind Med. Sci. 2024, 11(1), 195-202; https://doi.org/10.22543/2392-7674.1466 - 30 Apr 2024

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Abstract

Introduction. Although it is an easily avoidable lifestyle, tobacco use during pregnancy is an important chronic health care problem, potentially leading to severe pregnancy complications for both mother and infant. Objectives. The purpose of this study was to evaluate the level [...] Read more.

Introduction. Although it is an easily avoidable lifestyle, tobacco use during pregnancy is an important chronic health care problem, potentially leading to severe pregnancy complications for both mother and infant. Objectives. The purpose of this study was to evaluate the level of knowledge regarding the effects of tobacco smoking during pregnancy. Methods. An online self-report questionnaire was administered using social networks and websites to women who were pregnant or who had recently given birth. Results. 1357 women were eligible to be included in the study. 919 women smoked during their pregnancy, 105 smoked but stopped before pregnancy (former smoker) and 333 never smoked cigarettes in their life. Comorbidities were found in 11.4% of active smokers group, 10.5 % (p = 0.758) in the former smokers’ group and 8.1% (p = 0.224) in the never smokers’ group. In addition, 33.8% of active smokers, 42.9% among former smokers and 31.5 % of never smokers had a good knowledge about smoking effects. Unfortunately, about 67% of them continued to smoke, even though they knew that nicotine passes into breast milk. The other women reduced the number of cigarettes or even quit smoking, usually with the encouragement and support of close people. Conclusions. Both passive and active smoking during pregnancy is a serious health problem that must be addressed through rigorous health programs, which must include (but not necessarily be limited to) behavioral therapy. Full article

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Open AccessArticle

Efficacy of Tranexamic Acid in Nasopharyngeal Hemorrhage; Single Center Prospective Study and Literature Review

by Septar Haldun, Andra-Iulia Suceveanu, Mihai Lupascu, Laura Mazilu, Alina Nicoara, Viorel Gherghina, Felix Voinea, Razvan Hainarosie, Alexandru Aristide Alexe, Ana Maria Dascalu and Adrian Paul Suceveanu

J. Mind Med. Sci. 2024, 11(1), 189-194; https://doi.org/10.22543/2392-7674.1469 - 30 Apr 2024

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Abstract

Nasopharyngeal hemorrhage is one of the most common ear, nose, and throat (ENT) emergencies that present in a hospital or primary care clinic. While many cases of hemorrhage are self-limiting, in more severe cases medical intervention is necessary, either to cauterize the bleeding [...] Read more.

Nasopharyngeal hemorrhage is one of the most common ear, nose, and throat (ENT) emergencies that present in a hospital or primary care clinic. While many cases of hemorrhage are self-limiting, in more severe cases medical intervention is necessary, either to cauterize the bleeding vessel or to pack the nose with various materials (thus involving specialized medical care and time, which implicitly lead to additional costs). In the case of the packaging, the medical treatment can in some cases be extremely painful and unpleasant. Tranexamic acid is an affordable, inexpensive, easy-to-use antifibrinolytic agent and with no notable side effects, as demonstrated by numerous studies related to most surgical fields. The aim of this paper is to provide an evidence-based approach to the use of tranexamic acid (TXA) in nasopharyngeal hemorrhages in our research center, comparing with the available literature on the subject, but presented in an updated form. As a conclusion, the combined use (intravenous and topical) of TXA may be a reasonable, safe and non-invasive option for hemodynamic stabilization of rhino-pharyngeal bleeding. Full article

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Open AccessArticle

Affective Temperaments and Personality Traits in Couple Well-Being

by Carmela Mento, Chiara La Barbiera, Maria Catena Silvestri, Maria Rosaria Anna Muscatello, Clemente Cedro, Antonio Bruno, Gianluca Pandolfo, Fiammetta Iannuzzo and Clara Lombardo

J. Mind Med. Sci. 2024, 11(1), 183-188; https://doi.org/10.22543/2392-7674.1467 - 30 Apr 2024

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Abstract

Background. The objective of this study is to establish the link between affective temperament traits and maladaptive personality traits, to verify whether the potential presence of elements related to emotional, affective and dysfunctional relational functioning can affect the couple satisfaction, modifying the [...] Read more.

Background. The objective of this study is to establish the link between affective temperament traits and maladaptive personality traits, to verify whether the potential presence of elements related to emotional, affective and dysfunctional relational functioning can affect the couple satisfaction, modifying the well-being or discomfort condition. Materials and Methods. A data collection questionnaire was developed to investigate the factors associated with dysfunctional emotional, affective, and relational modes of functioning. The sample consisted of 473 subjects. Data were collected including the TEMPS-A questionnaire, The Dirty Dozen Italian Assessment and the Relationship Assessment Scale (RAS). Results. The findings of this study showed that the subscales of affective temperament were predictors of dark triad traits. The expressive, irritable and hyperthymic temperamental traits were found to be predictors of trait psychopathy; hyperthymic temperament is also a predictor of narcissistic traits and cyclothymic temperament is a predictor of lower couple satisfaction; men show higher scores than women in Dark triad. Conclusions. This study confirmed that temperamental traits can predict maladaptive personality traits belonging to the dark triad and confirms the importance of evaluating maladaptive personality traits to prevent forms of psychological violence in couple. Full article

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Open AccessArticle

Correlation between Molecular Prognostic Factors and Bevacizumab Therapeutic Resistance in Patients with Metastatic Colorectal Cancer; The AVAMET Study

by Adrian Paul Suceveanu, Dragos Serban, Andreea Daniela Caloian, Georgeta Camelia Cozaru, Anca Chisoi, Anca Antonela Nicolau, Ioan Sergiu Micu and Andra Iulia Suceveanu

J. Mind Med. Sci. 2024, 11(1), 175-182; https://doi.org/10.22543/2392-7674.1477 - 30 Apr 2024

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Abstract

Objectives. Colorectal cancer is responsible for more than two million cases diagnosed annually. Despite early diagnosis through screening programs and adequate treatment, 25% of cases are diagnosed with metastatic disease while up to 50% of patients diagnosed early progress to metastatic disease. [...] Read more.

Objectives. Colorectal cancer is responsible for more than two million cases diagnosed annually. Despite early diagnosis through screening programs and adequate treatment, 25% of cases are diagnosed with metastatic disease while up to 50% of patients diagnosed early progress to metastatic disease. Materials and Methods. The study of 40 patients aims to identify the role of placental growth factor and heparin-binding growth factor as prognostic tools for current treatments involving resistance to bevacizumab in metastatic colorectal cancer. Results. Our results suggested that overall survival was influenced by serum fibroblast growth factor 1 levels. A cut-off value of 260.71 pg/ml was considered predictive of a disease-free survival/DFS of 6 months to 1 year, while a cut-off value of 117.51 pg/ml was considered predictive of a better DFS. Regarding placental growth factor involvement, a serum level of 13.75 pg/ml as a first determination and 11.48 pg/ml after 8 months of chemotherapy and anti-vascular endothelial growth factor therapy were considered cut-off values for 1- to 3-year overall survival/OS, while 6.45 pg/ml and 8.12 pg/ml levels were considered cut-off levels for 3- to 5-year OS. Conclusions. The results of the current study detected cutoff levels that may better predict treatment resistance in advanced-stage colorectal cancer and poor OS and DFS rates. Serum levels of placental growth factor and fibroblast growth factor 1 at diagnosis become important prognostic factors predicting resistance to bevacizumab in metastatic colorectal cancer. Full article

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Open AccessArticle

Medical and Psychological Management of Patients with a History of Surgical Treatment for Pancreatic Diseases

by Magdalena Țone, Daniel Cochior, Oana Denisa Balalau, Tomescu Dana Rodica, Cristian Balalau, Teodora Mocan, Aurelian Udristoiu and Gabriel Petre Gorecki

J. Mind Med. Sci. 2024, 11(1), 163-174; https://doi.org/10.22543/2392-7674.1480 - 30 Apr 2024

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Abstract

Background. Pancreatic cancer, known for its high mortality rate and late diagnosis, remains a significant health concern. Surgery offers a potential therapeutic remedy, but it is only valid in the early stage of detection. Increasing risk factors and an aging population are [...] Read more.

Background. Pancreatic cancer, known for its high mortality rate and late diagnosis, remains a significant health concern. Surgery offers a potential therapeutic remedy, but it is only valid in the early stage of detection. Increasing risk factors and an aging population are expected to raise the incidence of pancreatic cancer, further challenging healthcare systems. Methods. The general objective of this study was to analyze doctors' experiences regarding the health status of patients with benign pancreatic pathology who underwent surgery and were admitted to CF2 Clinical Hospital in Bucharest. The research involved a specialized questionnaire addressing various aspects of patient health, including mobility, pain intensity, psycho-emotional state, and prognosis. The study also included a protocol evaluating patients based on criteria like symptomatology, treatment, and postoperative complications. Results. The findings show significant discrepancies between patients' perceptions and doctors' evaluations in quality-of-life domains, with some positive correlations. The statistical analysis, including reliability, alpha, mean, and standard deviation, underscores these differences. Respondents reported a relatively good perception of their overall health state, and a moderate perception of their level of social functioning. The correlation between patients' perceptions and medical evaluations of mental health was 0.423, indicating a moderate but not necessarily significant relationship. Conclusions. The study reveals that physicians recognize the multifaceted challenges faced by patients with surgically treated pancreatic diseases. It emphasizes the need for a comprehensive approach to patient care, addressing physical, emotional, and social aspects. The study also highlights the importance of early detection and the complexity of doctor-patient interactions in pancreatic cancer treatment. Full article

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Open AccessArticle

Surgery of the Colon; The Impact of Colostomy and Postoperative Complications on Patients' Quality of Life

by Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Daniela Gabriela Bălan, Florin Silviu Groseanu, Denisa Mihaela Nedelcu and Ioana Paunica

J. Mind Med. Sci. 2024, 11(1), 156-162; https://doi.org/10.22543/2392-7674.1493 - 30 Apr 2024

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Abstract

Introduction. This study aims to evaluate the impact of stoma formation on the quality of life of patients undergoing colonic surgery, considering both emergency and elective procedures. Several factors (demographic data, Charlson comorbidity score, type of surgical intervention, duration of hospitalization, postoperative [...] Read more.

Introduction. This study aims to evaluate the impact of stoma formation on the quality of life of patients undergoing colonic surgery, considering both emergency and elective procedures. Several factors (demographic data, Charlson comorbidity score, type of surgical intervention, duration of hospitalization, postoperative outcomes and complications, etc.) were analyzed to understand their influence on patients' well-being. Materials and Methods. A retrospective analysis was performed on patients who underwent colorectal surgery that required stoma formation. A total of 270 patients were included in the study, with 69.25% undergoing emergency surgery and 30.74% undergoing elective procedures. Results. The Charlson comorbidity score was significantly higher in the emergency surgery group compared to the elective group, 8.51 vs. 7.67, respectively (p < 0.05). Patients who underwent emergency surgery experienced more postoperative (including stoma-related) complications, leading to a lower quality of life score compared to those undergoing elective procedures. Conclusions. Especially in emergency cases, colostomy involves difficulties related to patient compliance and quality of life, a fact supported by higher scores regarding comorbidities and postoperative complications. Thus, presenting patients at early stages of disease, customized surgical techniques, and appropriate preoperative counseling can help improve both patient outcomes and overall well-being. Full article

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Open AccessArticle

Preoperative Risk Factors in Hernia Recurrence: A Single-Center Study

by Anca Tigora, Vlad Paic, Dragos Nicolae Garofil, Mircea Nicolae Bratucu, Mihai Zurzu, Daniela Nuta, Florian Popa, Valeriu Surlin, Stefan Patrascu, Victor Strambu and Petru Adrian Radu

J. Mind Med. Sci. 2024, 11(1), 146-155; https://doi.org/10.22543/2392-7674.1487 - 30 Apr 2024

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Abstract

Background and Objectives. Hernia recurrence is still a great challenge for surgeons regarding the optimal surgical technique, the best alloplastic material and the management of risk factors (advanced age, female sex, body mass index, smoking, diabetes, the presence of connective tissue disorders, [...] Read more.

Background and Objectives. Hernia recurrence is still a great challenge for surgeons regarding the optimal surgical technique, the best alloplastic material and the management of risk factors (advanced age, female sex, body mass index, smoking, diabetes, the presence of connective tissue disorders, chronic cough, etc.). The present study attempts to assess the impact of these factors in hernia recurrence, as well as the integration of the prosthetic material at the tissue level, in order to reduce possible postoperative complications. Material and Methods. A retrospective study was performed on 108 patients operated (between January 2012 and December 2022) for recurrence of inguinal, umbilical and incisional hernias. Demographic data and comorbidities were analyzed in relation to hernia recurrence. Fragments of unintegrated and well-fitted mesh were sampled and examined microscopically to assess tissue-level implications. Results. The strongest factors associated with hernia recurrence were obesity (p = 0.001), diabetes mellitus (p = 0.003), high blood pressure (p = 0.003) and atrial fibrillation (p = 0.044). Microscopic analysis of unintegrated mesh fragments revealed the presence of foreign body granulomas and predominance of thin fibrillar type 3 collagen, whereas well-integrated material showed thick type I collagen fibers and low inflammatory infiltrate. Conclusions. Insufficient oxygen supply, an altered inflammatory response, and diminished proliferative capacity during the wound healing stages resulted in abnormalities in the development of mature granulation tissue. Therefore, to reduce the risk of hernia recurrence, it is essential to have a surgical treatment that must manage all these possible factors. Full article

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Open AccessArticle

Low Anterior Rectal Resection; The Impact of Anastomotic Fistula on Incidence and Severity of Low Anterior Resection Syndrome

by Giorgiana Coțofană Graure, Cecil Mirea, Silviu Daniel Preda, Stefan Patrascu, Tiberiu Stefanita Tenea-Cojan, Adina Turcu-Stiolica, Alexandru Munteanu, Vlad Padureanu, Dragos Margaritescu, Sandu Ramboiu, Dan Cartu, Valeriu Surlin and Petre Radu

J. Mind Med. Sci. 2024, 11(1), 139-145; https://doi.org/10.22543/2392-7674.1465 - 30 Apr 2024

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Abstract

Objectives. Low anterior resection is a common surgical procedure for rectal cancer, but it is associated with a distressing complication known as Low Anterior Resection Syndrome (LARS). The incidence of LARS varies, with severe symptoms persisting in some patients even years after [...] Read more.

Objectives. Low anterior resection is a common surgical procedure for rectal cancer, but it is associated with a distressing complication known as Low Anterior Resection Syndrome (LARS). The incidence of LARS varies, with severe symptoms persisting in some patients even years after surgery. This study aimed to investigate the association between anastomotic leak and LARS severity in rectal cancer patients. Methods. A retrospective analysis was conducted on 100 rectal cancer patients who underwent LAR between 2017 and 2021. Patients were categorized based on LARS questionnaire responses into groups with anastomotic leakage and LARS, LARS alone, or no LARS. Various factors, including demographics, comorbidities, tumor characteristics, and surgical details, were analyzed for their association with LARS. Results. In our study, anastomotic leakage was observed in 23 patients, and 17 of them subsequently developed LARS. Male gender, age over 70, and neoadjuvant therapy were identified as risk factors for LARS. Additionally, LARS was more prevalent in patients with medium and low rectal cancers and those with a protective ostomy. Conclusion. Our findings suggest that male sex and neoadjuvant chemoradiotherapy are associated with the development of LARS in rectal cancer patients undergoing low anterior resection. The timing of stoma closure and the extent of neorectal reservoir may also impact LARS severity. Full article

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Open AccessArticle

Assessing Mid to Long Term Amputation-Free Survival Rates in Chronic Limb-Threatening Ischemia; A Study of Hybrid Vascular Techniques

by Cristian Traian Paius, Vlad Denis Constantin, Alexandru Carap, Andrei Tarus and Grigore Tinica

J. Mind Med. Sci. 2024, 11(1), 132-138; https://doi.org/10.22543/2392-7674.1496 - 30 Apr 2024

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Abstract

Introduction. Chronic limb-threatening ischemia (CLTI) is a debilitating condition characterized by inadequate blood supply to the lower extremities, often leading to tissue damage, ulcers, and limb loss. Amputation-free survival (AFS) serves as a crucial measure in evaluating interventions and managing CLTI, emphasizing [...] Read more.

Introduction. Chronic limb-threatening ischemia (CLTI) is a debilitating condition characterized by inadequate blood supply to the lower extremities, often leading to tissue damage, ulcers, and limb loss. Amputation-free survival (AFS) serves as a crucial measure in evaluating interventions and managing CLTI, emphasizing limb preservation, functional restoration, and prevention of recurrent ischemic events. Objectives. This study aimed to assess mid to long term AFS in CLTI patients treated with hybrid vascular techniques. Materials and Methods. Conducted over 24 months at the Emergency Hospital of Saint Pantelimon in Bucharest, Romania, the study enrolled 62 adult CLTI patients, tracking them postoperatively. Kaplan Meyer survival curves were used to assess AFS rates. Results. Findings revealed a high prevalence of cardiovascular risk factors among participants, with most undergoing infrainguinal bypass revascularization in association with proximal and/or distal angioplasty with or without stenting. Prior to intervention, the majority of patients exhibited advanced stages of ischemia, with trophic lesions predominantly confined to the toes. Analysis of AFS revealed a decline over time, with the majority of amputations occurring within three months post-revascularization. Notably, 64.5% of patients achieved amputation free complete wound healing within the first year, with 90% of them achieving this within the first six months. Complex wounds were associated with prolonged healing. Conclusions. The study shows a 75.2% AFS rate at 24 months, highlighting the effectiveness of hybrid revascularization techniques and proper wound care in optimizing outcomes for CLTI patients. Full article

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Open AccessArticle

Prevalence, Persistence and Microscopic Aspects of the Vomeronasal Organ in Normal versus Embryos with Chromosomal Abnormalities

by Carmen Constantina Martinescu, Marius Alexandru Moga, Codrut Ioan Ciurea, Lorena Dima, Liana Ples and Andreea Neculau

J. Mind Med. Sci. 2024, 11(1), 123-131; https://doi.org/10.22543/2392-7674.1479 - 30 Apr 2024

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Abstract

Background. The objective of this study was to describe the histological and immunohistochemical aspects of vomeronasal organ in two groups of (normal and pathological) embryos and fetuses, with chromosomal morphological abnormalities. Methods. The research was based on a retrospective, descriptive analysis, [...] Read more.

Background. The objective of this study was to describe the histological and immunohistochemical aspects of vomeronasal organ in two groups of (normal and pathological) embryos and fetuses, with chromosomal morphological abnormalities. Methods. The research was based on a retrospective, descriptive analysis, carried out over a period of 5 years. The study included 46 biopsy fragments taken from aborted embryos and fetuses aged between 9 and 23 weeks. We compared the microscopic structure of the vomeronasal organ using different histologic and immunohistochemical staining procedures. Results. Our results showed that in both groups of embryos and fetuses there are three major stages of histological development of the vomeronasal organ, depending by intrauterine age. We also observed that in the group of abnormal embryos and fetuses, although the morphological and immunohistochemical characteristics of vomeronasal organ were similar to the control group, the specific structures of the vomeronasal organ persisted beyond 22 weeks. In the control group, the vomeronasal organ was no longer visible at this age. The results of the immunohistochemical study indicated that the positive surface for cytokines in the control group decreased with age, and in the group with morphological anomalies, the number of positive cells was low. On the other hand, in fetuses with chromosomal anomalies, the positivity, although a slight downward trend was recorded, it remained high. Conclusions. This study is still ongoing in order to identify the increased frequency of vomeronasal organ in fetuses. Moreover, we anticipate that our study can be a starting point for other researchers in order to identify a relationship between the behavioral pattern of the fetuses with trisomy 21 and the persistence of the VNO. Full article

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Open AccessArticle

Management of Macrovascular Diabetic Complications: A Single-Center Case Series Analysis of Consecutively Attending Patients in Primary Care

by Sanda Maria Crețoiu, Mihaela Adela Iancu, Laura Maria Condur, Teodor Salmen, Andreea Steriu, Ana Maria Alexandra Stănescu, Irina Anca Eremia, Cristina Mihaela Olariu, Eliza Elena Cinteză and Camelia Cristina Diaconu

J. Mind Med. Sci. 2024, 11(1), 114-122; https://doi.org/10.22543/2392-7674.1451 - 30 Apr 2024

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Abstract

Introduction. The prevalence of diabetes mellitus is increasing, with type 2 diabetes (T2DM) being a major health priority for any public health system. Increased arterial stiffness in patients with diabetes will lead to the appearance of vascular complications. Increased arterial stiffness in [...] Read more.

Introduction. The prevalence of diabetes mellitus is increasing, with type 2 diabetes (T2DM) being a major health priority for any public health system. Increased arterial stiffness in patients with diabetes will lead to the appearance of vascular complications. Increased arterial stiffness in patients with diabetes usually leads to vascular complications. Any earlier diagnosis of impaired macrovascular evidence may lead to improved outcomes in patient care. The objective of our study was to assess and evaluate the finger-toe pulse wave velocity (ftPWV), as a measure of arterial stiffness, in order to assist with early detection of macrovascular diabetic complications. Materials and Methods. The observational case series included 140 patients who are registered in a primary care office, of whom 73 were previously diagnosed with diabetes mellitus (study group). The age-matched non-diabetic group included 67 consecutive registered patients who visited the practice for other reasons. Results. The mean age of all patients was 51.42 ± 11.57 years, with DM patients being with 4.5 years older than the non-DM patients (CI 95% and CI 95%). There was a significantly higher mean value of ftPWV in the DM group (p = 0.0039) although the study presented some limitations. Conclusions. The mean value of ftPWV was statistically significant higher in diabetic patients. The assessment of ftPWV is a non-invasive test, and the data can be used as a useful marker of vascular stiffness in primary care, thus providing an early diagnosis of macrovascular complications during the monitoring and care of the diabetic patient. Full article

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Open AccessArticle

Syndrome or Symptoms? Assessing Cothymia, Neuroticism and Lifetime Comorbidity in a Sample of Psychiatric Patients

by Fiammetta Iannuzzo, Fabiana Fiasca, Antonella Mattei, Carmela Mento, Maria Catena Silvestri, Fabrizio Turiaco, Rocco Antonio Zoccali, Maria Rosaria Anna Muscatello and Antonio Bruno

J. Mind Med. Sci. 2024, 11(1), 106-113; https://doi.org/10.22543/2392-7674.1460 - 30 Apr 2024

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Abstract

Background. Cross-sectional and longitudinal psychiatric comorbidity rates could represent a syndromic process rather than the co-occurrence of different disorders. ‘Cothymia’, the concomitant presence of depression and anxiety symptoms, and the ‘neuroticism’ dimension have been proposed as candidate vulnerability factors for psychiatric disorders [...] Read more.

Background. Cross-sectional and longitudinal psychiatric comorbidity rates could represent a syndromic process rather than the co-occurrence of different disorders. ‘Cothymia’, the concomitant presence of depression and anxiety symptoms, and the ‘neuroticism’ dimension have been proposed as candidate vulnerability factors for psychiatric disorders trajectories. Based on this background, the present research was aimed at assessing the role of cothymia and neuroticism as syndromic processes in lifetime psychiatric disorders, and examining homotypic or heterotypic trends in the diagnostic continuum of comorbid mental disorders. Materials and methods. Data collection was carried out retrospectively through the consultation of medical records at the Psychiatry Unit of the University Hospital of Messina. Cothymia was determined by the lifetime presence of depression and other anxiety disorders, and neuroticism was determined by the presence of borderline personality disorders and other personality disorders. Results. Cothymia and neuroticism were found in 580 patients with higher rates of hospitalization, drug prescription, polypharmacotherapy, and longer duration of illness. Furthermore, diagnostic trajectories in patients with cothymia and neuroticism followed both homotypic and heterotypic progressions. Limitations: This study presented several limitations. The small sample size from a restricted recruitment area, and the retrospective design may have influenced a realistic and accurate estimation of the lifetime prevalence of the disorders. Conclusions. Despite the limitations, the findings of this study confirm the presence of consistent and meaningful homotypic and heterotypic trajectories in psychiatric patients, suggesting that the evolution of lifetime diagnoses should become a focus in theoretical and practical approaches to psychiatric disorders. Full article

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Open AccessReview

Ovarian Cancer Prevention and Screening—Where Do We Stand Today?

by Cristina Bucur, Irina Balescu, Sorin Petrea, Bogdan Gaspar, Lucian Pop, Valentin Varlas, Adrian Hasegan, Marilena Stoian, Gabriel Petre Gorecki and Nicolae Bacalbasa

J. Mind Med. Sci. 2024, 11(1), 99-105; https://doi.org/10.22543/2392-7674.1464 - 30 Apr 2024

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Abstract

Widely recognized as the most deathful gynecologic malignancy affecting women worldwide, ovarian cancer has reported a significant decline in terms of prevalence and incidence in the last decades. This fact has been especially explained by to the use of menopausal hormonal therapy and [...] Read more.

Widely recognized as the most deathful gynecologic malignancy affecting women worldwide, ovarian cancer has reported a significant decline in terms of prevalence and incidence in the last decades. This fact has been especially explained by to the use of menopausal hormonal therapy and of oral contraceptives in association with genetic, oncologic and gynecologic counseling. The aim of the current review is to discuss about actual ovarian cancer prevention and screening tools. For this reason, we reviewed several data related to ovarian cancer, such as: incidence and risk factors, histopathological types (epithelial with high- and low-grade serous carcinomas, clear cell carcinoma, mucinous carcinoma, germ cells ovarian cancer tumors), as well as screening, diagnosis and prevention methods (ovulation disruption, surgical prevention, etc.). Although progress has been reported in the last decades in terms of early diagnosis and treatment of ovarian cancer, this malignancy still represents a significant health problem affecting women worldwide. However, it seems that the golden key for optimizing the long-term outcomes in such patients is represented by a better understanding of the complex pathogenesis of this disease. Full article

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Open AccessReview

A New Approach to Balancing Dental Fear and Anxiety Using BachTM Flower Therapy

by Irina Maria Gheorghiu, Alexandru Andrei Iliescu, Stana Paunica, Marina Giurgiu, Brandusa Mocanu, George Alexandru Popescu and Anca Silvia Dumitriu

J. Mind Med. Sci. 2024, 11(1), 92-98; https://doi.org/10.22543/2392-7674.1475 - 30 Apr 2024

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Abstract

Treatments in dentistry currently consist of an interdisciplinary approach, including (but not necessarily limited to) the holistic perspective. The different fields of allopathic and complementary medicine are used together to ensure not only a high-quality restorative treatment, but also to provide patients with [...] Read more.

Treatments in dentistry currently consist of an interdisciplinary approach, including (but not necessarily limited to) the holistic perspective. The different fields of allopathic and complementary medicine are used together to ensure not only a high-quality restorative treatment, but also to provide patients with psychological and emotional support. This perspective also applies to dental anxiety, which consists of complex (emotional, vegetative and psychomotor) manifestations. One of the most well-known complementary therapies for reducing dental fear and anxiety is BachTM Flower Therapy. Even if the mechanism of action of this therapy is not yet scientifically documented, notable results have been and continue to be reported in the literature in several clinical studies on patients with dental diseases. It is indicated for both adults and children, in the latter when they go through major biological changes, such as primary and permanent dentition. As a conclusion, BachTM flower therapy is effective and complementary to dental treatments applied to patients, by reducing stress, anxiety, as well as creating a climate of peace, trust and confidence, both for the patient and the doctor. In addition, it is a relatively accessible and cheap form of care, with no significant adverse effects noted so far. Full article

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Open AccessReview

Genetic and Serological Markers in Colorectal Cancer Surgery

by Adrian Silaghi, Vlad Denis Constantin, Dragos Serban, Dragos Epistatu, Ioana Paunica, Daniela Gabriela Bălan and Laura Florentina Rebegea

J. Mind Med. Sci. 2024, 11(1), 84-91; https://doi.org/10.22543/2392-7674.1474 - 30 Apr 2024

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Abstract

Colon cancer is relatively asymptomatic in the early stages, the manifestations appearing and intensifying with the evolution of the disease, especially when associated with local and/or systemic complications. In such cases, surgical interventions are often emergency and involve more extensive operations (on metabolically [...] Read more.

Colon cancer is relatively asymptomatic in the early stages, the manifestations appearing and intensifying with the evolution of the disease, especially when associated with local and/or systemic complications. In such cases, surgical interventions are often emergency and involve more extensive operations (on metabolically and immune-stressed organisms), so that an early diagnosis (endoscopy, tumor markers, etc.) remains not only desirable but even a priority, especially in predisposed patients (genetic factors, lifestyle, etc.). As a consequence, the involvement of tumor markers in colon neoplasms has become more and more investigated in recent times. This review investigates the roles of serological and genetic markers in the management of patients with colon cancer, focusing on carcinoembryonic antigen, mismatch repair deficiency (dMMR), as well as KRAS and BRAF mutations. As a preliminary conclusion, tumor biomarkers seem to have a significant contribution to the diagnosis, decisions related to operative management, prognosis and postoperative follow-up of colon cancer, both in the categories of patients from high-risk groups and those without a clear predisposition to this condition. Full article

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Open AccessReview

Effect of Continuous Renal Replacement Therapy on Serum Levels of Inflammatory Cytokines/Interleukin-17 in Severe Acute Pancreatitis

by Diana Iosif, Adrian Paul Suceveanu, Marius Prazaru, Iulia Cindea, Viorel Gherghina, Anca Mihaela Pantea Stoian, Laura Mazilu, Dragos Serban, Alina Nicoara and Andra Iulia Suceveanu

J. Mind Med. Sci. 2024, 11(1), 78-83; https://doi.org/10.22543/2392-7674.1476 - 30 Apr 2024

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Abstract

Despite continuous investigations in the diagnosis and treatment of severe acute pancreatitis (SAP), this disease still remains a critical condition with a mortality rate of up to 35%. The pathophysiology of SAP involves an important inflammatory reaction of the pancreas (mediated by inflammatory [...] Read more.

Despite continuous investigations in the diagnosis and treatment of severe acute pancreatitis (SAP), this disease still remains a critical condition with a mortality rate of up to 35%. The pathophysiology of SAP involves an important inflammatory reaction of the pancreas (mediated by inflammatory cytokines and immune system activation), causing severe local tissue damage as well as important systemic imbalances. IL-17 is an inflammatory mediator that have a pivotal role in SAP evolution, generating multiple interactions between inflammatory cytokines and significantly influencing the immune system response. Consequently, continuous renal replacement therapy/CRRT was added to the conventional therapy, leading to improved treatment results. This review aims to evaluate the involvement of Interleukin 17 in the diagnosis, pathogenesis and evolution of SAP, as well as the role of CRRT in reducing elevated serum levels of IL-17. As a conclusion, CRRT is a promising method to eliminate cytokine mediators from the blood, thus leading to a reduction of both pancreatic/peripancreatic tissue damage and systemic imbalances in severe acute pancreatitis, being strongly correlated with better therapeutic outcomes. Full article

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Open AccessReview

The Effects of SGLT2 Inhibitors in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease; A Narrative Review

by Mihaela Simona Popoviciu, Lorena Paduraru, Md Mominur Rahman, Fatema Akter Supti, Roxana Adriana Stoica, Delia Reurean-Pintilei, Cristina Ioana Bica and Simona Cavalu

J. Mind Med. Sci. 2024, 11(1), 62-77; https://doi.org/10.22543/2392-7674.1439 - 30 Apr 2024

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Abstract

Worldwide, metabolic dysfunction-associated fatty liver disease (MAFLD) is a significant public health concern, especially since more than fifty percent of people with type 2 diabetes are affected by it. This pathological condition includes all states of fatty liver disease, from non-alcoholic fatty liver [...] Read more.

Worldwide, metabolic dysfunction-associated fatty liver disease (MAFLD) is a significant public health concern, especially since more than fifty percent of people with type 2 diabetes are affected by it. This pathological condition includes all states of fatty liver disease, from non-alcoholic fatty liver disease (NAFLD) to steatohepatitis (NASH). Prolonged evolutions can lead to cirrhosis and cancer, so treatment must be started early. Hepatic steatosis may be improved by sodium glucose co-transporter 2 inhibitors (SGLT2 inhibitors), which prevent glucose reabsorption in the proximal renal tubule and increase urinary excretion, thus lowering plasma glucose levels. Experimental studies in animal models have suggested that SGLT2 inhibitors may have beneficial modulatory effects on NAFLD and NASH, while numerous clinical trials have demonstrated their favorable effects on the liver enzymes, body mass index, blood lipids, blood glucose, and insulin resistance in NAFLD patients. This review highlights the state of knowledge regarding the epidemiology, diagnosis and pathogenetic pathways of MAFLD, focusing primarily on the effectiveness of SGLT2 inhibitors as a promising drug class in the treatment of NAFLD. Full article

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Open AccessReview

Updating Data on Cognitive Impairment in Stroke Patients

by Denisa Floriana Vasilica Pîrșcoveanu, Carmen Valeria Albu, Elena Anca Târtea, Iulia Cristina Mărginean, George Alexandru Iacob, Elena Pinoșanu, Anca Maria Țucă, Cristina Maria Mărginean, Raluca Elena Sandu and Mircea Pîrșcoveanu

J. Mind Med. Sci. 2024, 11(1), 49-61; https://doi.org/10.22543/2392-7674.1456 - 30 Apr 2024

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Abstract

Vascular cognitive impairments are the expression of complex interactions between vascular etiology, risk factors (brain diseases, white matter lesions, etc.) and cellular changes at the brain level. Consequently, vascular cognitive impairment is highly dependent on the location, extent (volume of brain tissue affected) [...] Read more.

Vascular cognitive impairments are the expression of complex interactions between vascular etiology, risk factors (brain diseases, white matter lesions, etc.) and cellular changes at the brain level. Consequently, vascular cognitive impairment is highly dependent on the location, extent (volume of brain tissue affected) and number of lesions. Memory impairment is not necessarily characteristic of vascular cognitive decline, usually having an evolution with episodic exacerbations and multiple cerebrovascular attacks (cumulative effect), thus producing a gradual deterioration. In recent years, the concept of mild cognitive impairment has emerged as a potential form of predementia, but which can progress to different types of dementia, including Alzheimer's disease or vascular dementia. This review presents recent data related to the etiological and risk factors of cognitive decline after stroke, the associated neuropsychological and behavioral changes, the clinical forms/diagnosis and general principles of vascular dementia therapy. As preliminary conclusions, the Hachinski score is a very useful tool in differentiating vascular dementia from Alzheimer's dementia. A score greater than 7 points (especially when associated with imaging and anamnestic criteria) suggests a vascular etiology of dementia, whereas a score of 4 points or less excludes such an etiology. Although it is not the only factor involved, vascular etiology is still intensively studied because it is the only one that can be prevented and treated. Full article

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Open AccessReview

Venous Thrombosis Associated with Pancreatic Cancer

by Vlad Buică, Camelia Cristina Diaconu and Octavian Andronic

J. Mind Med. Sci. 2024, 11(1), 42-48; https://doi.org/10.22543/2392-7674.1457 - 30 Apr 2024

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Abstract

Introduction. Cancer-associated thrombosis is a significant prognostic marker in pancreatic neoplasia, with a venous thromboembolism incidence of 17–34%. This study focuses on cancer-associated thrombosis risk factors, screening scores, and treatment options. Materials and Methods. Comprehensive database searches were conducted across Web [...] Read more.

Introduction. Cancer-associated thrombosis is a significant prognostic marker in pancreatic neoplasia, with a venous thromboembolism incidence of 17–34%. This study focuses on cancer-associated thrombosis risk factors, screening scores, and treatment options. Materials and Methods. Comprehensive database searches were conducted across Web of Science, PubMed, Reaxys, ScienceDirect, and Scopus. Results. Of the 37 articles reviewed, findings include splanchnic vein thrombosis correlating with pancreatic complications and survival rates. Gender differences in cancer-associated thrombosis risk were inconclusive, while African Americans showed a higher incidence of pulmonary embolism. Various cancer-associated thrombosis staging scores were evaluated, with ONKOTEV score outperforming Khorana. Direct oral anticoagulants were suggested as viable alternatives to low molecular weight heparins. Non-anticoagulant sulfated low molecular weight heparin emerged as a future option, offering reduced bleeding risks with similar efficacy. Conclusions. Managing cancer-associated thrombosis in pancreatic cancer is challenging, highlighting the need for improved understanding, better screening methods, and more effective treatments. Full article

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Open AccessReview

Diabetic Patients and Postoperative Complications in Colorectal Surgery

by Ioana Paunica, Adrian Silaghi, Daniela Gabriela Bălan, Bogdan Socea, Cristian Balalau, Florin Silviu Groseanu, George Alexandru Popescu, Dragos Epistatu and Vlad Denis Constantin

J. Mind Med. Sci. 2024, 11(1), 33-41; https://doi.org/10.22543/2392-7674.1495 - 30 Apr 2024

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Abstract

Diabetes mellitus is one of the most common comorbidities of patients undergoing surgery. Colorectal surgery is frequently associated with postoperative complications, and diabetic patients represent a population that presents a high risk of developing such complications. Understanding the interrelationships between neoplastic disease and [...] Read more.

Diabetes mellitus is one of the most common comorbidities of patients undergoing surgery. Colorectal surgery is frequently associated with postoperative complications, and diabetic patients represent a population that presents a high risk of developing such complications. Understanding the interrelationships between neoplastic disease and diabetes, as well as the pathophysiological mechanisms underlying postoperative complications, are essential for effective therapeutic management. Genetic predispositions, alterations in the gut microbiota, inflammatory response, ischemic, thrombotic and infectious processes contribute significantly to the development of severe surgical complications, such as anastomotic fistulas. Postoperative ileus, characterized by gastrointestinal dysmotility, is common in diabetic patients due to neuropathic dysfunction and altered intestinal metabolism. In addition, diabetic patients are at increased risk of intestinal ischemia, requiring specific perioperative care. The strategies to avoid these complications assume an adequate surgical technique, a personalized anesthesia management, and last but not least, the best possible glycemic control. This article highlights the importance of a better understanding of the interaction between diabetes and postoperative complications, in order to obtain good results with an important impact on the patient's health and well-being. This article highlights the importance of a better understanding of the interplay between diabetes and postoperative complications informs targeted interventions aimed at reducing morbidity and improving patient well-being. Full article

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Open AccessReview

Correlation between Periodontal Status and Parkinson's Disease; A Literature Review

by Dragos Nicolae Ciongaru, Anca-Silvia Dumitriu, Bogdan Alexandru Dimitriu, Stana Paunica, Marina Cristina Giurgiu, Brandusa Florina Mocanu, George Alexandru Popescu and Silviu Mirel Pituru

J. Mind Med. Sci. 2024, 11(1), 24-32; https://doi.org/10.22543/2392-7674.1492 - 30 Apr 2024

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Abstract

This systematic review aims to explore the relationship between chronic inflammation of periodontal disease and neurodegenerative disorders (especially Parkinson's disease), focusing primarily on pathophysiological, clinical and immunological aspects. An exhaustive search on this topic was performed in several databases (including PubMed, Scopus and [...] Read more.

This systematic review aims to explore the relationship between chronic inflammation of periodontal disease and neurodegenerative disorders (especially Parkinson's disease), focusing primarily on pathophysiological, clinical and immunological aspects. An exhaustive search on this topic was performed in several databases (including PubMed, Scopus and Web of Science) selecting articles published between 2006 and 2023. After reviewing the titles, abstracts and protocols of each study, 13 articles were extracted for detailed assessment. The main indicators in the study included clinical signs of gingival inflammation, bleeding on probing (BoP), bone loss (BL), periodontal probing depth (PPD), and clinical attachment loss (CAL). Additionally, levels of inflammatory markers such as epidermal growth factor (EGF), interleukin-8 (IL-8), interleukin-17 (IL-17), interferon γ-induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1) were monitored. The investigation also explored the presence of one of the main periodontal pathogens (Porphyromonas gingivalis) in the microbiota of Parkinson's disease patients. In conclusion, the data presented further support the intricated relationship between periodontal health and neurodegenerative processes, including aspects related to changes in clinical periodontal indices, immunological indices, as well as oral hygiene and patient medication. Full article

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J. Mind Med. Sci., Volume 11, Issue 1 (April 2024) – 34 articles

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