Journal of Mind and Medical Sciences

878 KiB

Open AccessCase Report

Gastrointestinal Stromal Tumor (GIST) of the Treitz’s Angle—A Very Rare Cause of High Bowel Obstruction

by Mădălina Elena Tobă, Dan Florin Ungureanu, Lota Corina Georgescu and Traian Pătraşcu

J. Mind Med. Sci. 2016, 3(2), 194-202; https://doi.org/10.22543/2392-7674.1049 - 24 Sep 2016

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Gastrointestinal stromal tumors (GIST) are somewhat rare gastrointestinal tumors - approximately 1% to 3% incidence, but they are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs are usually found in the stomach or small intestine but can occur anywhere within the [...] Read more.

Gastrointestinal stromal tumors (GIST) are somewhat rare gastrointestinal tumors - approximately 1% to 3% incidence, but they are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs are usually found in the stomach or small intestine but can occur anywhere within the gastrointestinal tract, even in extremely uncommon locations like duodeno-jejunal flexure. Only 3%–5% of GISTs are located in the duodenum and tumors occurring in the angle of Treitz are even rarer, most published studies being case reports. These tumors have a size ranging from small lesions to large masses and can cause digestive bleeding or high bowel obstruction. This paper is a case presentation illustrating an emergency situation involving a high bowel obstruction caused by a small tumor with an unusual location in the Treitz’s angle. A large percentage of duodenal GISTs are localized in the third and fourth part of the duodenum and may not be found through standard upper endoscopy; only the barium study of the upper gastrointestinal tract highlights the obstruction point. Preoperative diagnosis is difficult but non-invasive imaging techniques like ultrasonography and computed tomography of the abdomen can be helpful. Recently, targeted therapy with inhibitors of tyrosine kinase receptors (IMATINIB) has been introduced for the management of advanced and metastatic tumors. In our opinion the surgical resection with curative intent is the treatment of choice. Full article

990 KiB

Open AccessArticle

A Retrospective Surgical Experience Regarding Open and Laparoscopic Procedures of the Hepatic Hydatid Cyst with an Up-to-Date Review of the Literature and Focus on Original Romanian Techniques

by Diana Moldovan, Cosmin Alec Moldovan, Laurențiu Ungurianu and Dan Florin Ungureanu

J. Mind Med. Sci. 2016, 3(2), 182-193; https://doi.org/10.22543/2392-7674.1045 - 24 Sep 2016

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Abstract

Introduction: Even though the development of the recent anti-parasitic drugs has led to a high degree of efficiency, surgical treatment still remains the gold standard for a number of conditions. Material and method. The authors discuss a series of 90 cases [...] Read more.

Introduction: Even though the development of the recent anti-parasitic drugs has led to a high degree of efficiency, surgical treatment still remains the gold standard for a number of conditions. Material and method. The authors discuss a series of 90 cases in a multicenter and retrospective analysis that stretches over 20 years. Results and discussions. These cases have been diagnosed and treated—through different surgical methods, both classical and laparoscopic—for hepatic hydatid cysts. The paper also presents a short review of the major types of surgical procedures cited in the international literature, with a specific focus on the advantages brought by Romanian innovations in this field. Conclusions. Even though the classical open approach still assumes the first place among surgical procedures, modern laparoscopic techniques have earned a much appreciated place in providing positive results based on long-term assessment, with virtually no or only minor complications. In this regard the Romanian school of surgery has offered a significant contribution to this field. Full article

539 KiB

Open AccessArticle

Metabolic Alterations in Experimental Models of Depression

by Maria-Gabriela Puiu, Mihnea C. Manea, George L. Paraschiv, Traian Purnichi, Ecaterina Ionescu, Simona Tache, Ioana Paunica and Mirela Manea

J. Mind Med. Sci. 2016, 3(2), 172-181; https://doi.org/10.22543/2392-7674.1042 - 24 Sep 2016

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Abstract

Introduction: Major depressive disorder is one of the most prevalent psychiatric disorders and is associated with a severe impact on the personal functioning, thus with incurring significant direct and indirect costs. The presence of depression in patients with medical comorbidities increases the [...] Read more.

Introduction: Major depressive disorder is one of the most prevalent psychiatric disorders and is associated with a severe impact on the personal functioning, thus with incurring significant direct and indirect costs. The presence of depression in patients with medical comorbidities increases the risks of myocardial infarction and decreases diabetes control, and adherence to treatment. The mechanism through which these effects are produced is still uncertain. Objectives of this study were to evaluate the metabolic alterations in female Wistar rats with induced depression, with and without administration of Agomelatine. The methods included two experiments. All data were analyzed by comparison with group I (control), and with each other. In the first experiment we induced depression by: exposure to chronic mild stress-group II; olfactory bulbectomy-group III; and exposure to chronic mild stress and hyperlipidic/ hyper caloric diet-group IV. The second experiment was similar with the first but the rats received Agomelatine (0.16 mg/ animal): group V (depression induced through exposure to chronic mild stress), VI (depression induced through olfactory bulbectomy) and VII (depression induced through exposure to chronic mild stressing hyperlipidic/ hypercaloric diet). Weight, cholesterol, triglycerides and glycaemia were measured at day 0 and 28, and leptin value was measured at day 28. The results in the 1st experiment revealed significant differences (p < 0.01) for weight and cholesterol in Group IV, for triglycerides in groups III and IV (p < 0.001), and for glycaemia in group II. The 2nd experiment revealed significant differences (p < 0.001) in group VII for weight and triglycerides, and in groups V and VI for triglycerides (p < 0.01). In conclusion, significant correlations were found between high level of triglycerides and depression induced by chronic stress and olfactory bulbectomy. Agomelatine groups had a lower increase of triglycerides levels. Full article

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Open AccessArticle

A Proposed Therapeutic Algorithm Based on Multiple Case Analyses Regarding the Repair Options of Iatrogenic Biliary Lesions Following Open and Laparoscopic Surgery

by Cosmin Alec Moldovan, Dan Florin Ungureanu and Vladimir Beliș

J. Mind Med. Sci. 2016, 3(2), 162-171; https://doi.org/10.22543/2392-7674.1044 - 24 Sep 2016

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Abstract

Introduction: the problem of the iatrogenic lesions of the main biliary pathways is far from being completely clarified and still represents a serious surgical situation, during both open and laparoscopic surgeries. The outcome of these situations is closely linked with the actual [...] Read more.

Introduction: the problem of the iatrogenic lesions of the main biliary pathways is far from being completely clarified and still represents a serious surgical situation, during both open and laparoscopic surgeries. The outcome of these situations is closely linked with the actual moment of discovery of the lesion and the surgical methods for repairing such defects and implies a great number of options, such as reconstructive, derivative and substitutive techniques. Objectives: the goal of this paper is to present an algorithm of choices and their consequences for clinical conduit in the case of iatrogenic biliary lesions discovered in the course of open or laparoscopic procedures of the main biliary pathways, based on our experience. Material and method: We present a multicentric retrospective study of 53 cases of lesions following open and laparoscopic procedures, from a larger lot of 10.015 surgeries on extrahepatic biliary ducts recorded during a 40 years period of time, in 2 clinical hospitals. Out of these, 2127 interventions were strictly focused on the common bile duct, for various pathology. Conclusion: The choice of the optimum method is strictly correlated with the morphological nature of the lesion, which is different from one stage to the other, depending upon the moment of detection, and therefore have different surgical implications. Full article

449 KiB

Open AccessReview

Helicobacter pylori: Types of Diseases, Diagnosis, Treatment and Causes of Therapeutic Failure

by Cosmin Vasile Obleaga, Cristin Constantin Vere, Ionica Daniel Valcea, Mihai Calin Ciorbagiu, Emil Moraru and Cecil Sorin Mirea

J. Mind Med. Sci. 2016, 3(2), 150-161; https://doi.org/10.22543/2392-7674.1048 - 24 Sep 2016

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Abstract

Acute upper gastrointestinal lesions have a multifactorial etiology but, regardless of the cause, they are related to mucosal barrier destruction. Since Helicobacter pylori induces a superficial chronic gastritis with the infiltration of neutrophils in the mucosa, it was speculated that Helicobacter pylori infection [...] Read more.

Acute upper gastrointestinal lesions have a multifactorial etiology but, regardless of the cause, they are related to mucosal barrier destruction. Since Helicobacter pylori induces a superficial chronic gastritis with the infiltration of neutrophils in the mucosa, it was speculated that Helicobacter pylori infection could also cause bleeding lesions. The diagnosis, the proper treatment and the revaluation of its effectiveness actually represent the prophylaxis of some diseases such as peptic ulcer, gastric lymphoma or mucosa-associated lymphoid tissue (MALT) and gastric cancer. These diseases and their severe complications are life-threatening for the patient. Periodic renewal of the treatment and knowing the real causes of Helicobacter pylori resistance to various antibiotics must always be understood by the clinician. Although Helicobacter pylori treatment fails in about 20% of cases, moral support of the patient by the clinician, information about possible evolutional complications of Helicobacter pylori infection, and periodic evaluation of the patient during therapy, are important tools on which the therapeutic success depends. Full article

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Open AccessReview

Vulvodynia—An Under-Recognized Disease

by Simona R. Georgescu, Cristina I. Mitran, Mădălina I. Mitran, Maria I. Sârbu and Mircea Tampa

J. Mind Med. Sci. 2016, 3(2), 141-149; https://doi.org/10.22543/2392-7674.1055 - 24 Sep 2016

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Abstract

Vulvodynia is a chronic condition which affects an increasing number of women; it presents currently an incidence that is higher than had previously been estimated. Regarding pathogenesis, several (hormonal, infectious, inflammatory and psychological) factors have been proposed, but vulvodynia etiology remains still unclear. [...] Read more.

Vulvodynia is a chronic condition which affects an increasing number of women; it presents currently an incidence that is higher than had previously been estimated. Regarding pathogenesis, several (hormonal, infectious, inflammatory and psychological) factors have been proposed, but vulvodynia etiology remains still unclear. This disorder is a multifactorial condition with a significant impact on the patient’s quality of life, yet is difficult to diagnose (an under-estimated/under-recognized affection). Certain medical investigations are required in order to exclude other diseases (the diagnosis of vulvodynia being one of exclusion), but anamnesis and physical examination are essential steps in the diagnosis. Although many therapies have been proposed, both pharmacological and non-pharmacological, a standardized therapy has not yet been established/generally accepted. Accordingly, many therapeutic options have been studied with varying results. Vulvodynia remains a challenging disease and a multidisciplinary approach is needed to achieve satisfactory outcomes. Further studies are needed to completely understand its pathogenesis and to develop a standardized treatment. Full article

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Open AccessReview

Structural Dichotomy of the Mind—The Role of Sexual Neuromodulators

by Ion G. Motofei and David L. Rowland

J. Mind Med. Sci. 2016, 3(2), 131-140; https://doi.org/10.22543/2392-7674.1053 - 24 Sep 2016

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Abstract

The mind (mental function) and sexuality represent two distinct environmental functions, but which are supported within the brain by a common (somatic-autonomic) neurobiological substrate. As a consequence, mental function takes on autonomic characteristics from the sexual-autonomic system (like autonomy, duality), while sexual function [...] Read more.

The mind (mental function) and sexuality represent two distinct environmental functions, but which are supported within the brain by a common (somatic-autonomic) neurobiological substrate. As a consequence, mental function takes on autonomic characteristics from the sexual-autonomic system (like autonomy, duality), while sexual function takes on features from mental functioning (such as lateralization). In this paper we discuss the lateralized action of two classes of sexual neuromodulators: hormones and pheromones. This process of lateralization is assimilated with the structural dichotomy of the mind. A relatively similar process but related to informational dichotomy of the mind will be presented in a forthcoming paper. Structural and informational dichotomies of the mind represent essential aspects that need clarification in order to continue the solving of the mind-body process, a work in progress articulated through a succession of papers. Full article

549 KiB

Open AccessReview

The Current Treatment of Erectile Dysfunction

by Maria I. Sârbu, Mircea Tampa, Mădălina I. Mitran, Cristina I. Mitran, Vasile Benea and Simona R. Georgescu

J. Mind Med. Sci. 2016, 3(2), 118-130; https://doi.org/10.22543/2392-7674.1054 - 24 Sep 2016

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Abstract

Erectile dysfunction (ED) is the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. It is the most frequent sexual dysfunction in elderly men and its prevalence increases with age. Ever since ED was recognized as a real health problem, [...] Read more.

Erectile dysfunction (ED) is the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. It is the most frequent sexual dysfunction in elderly men and its prevalence increases with age. Ever since ED was recognized as a real health problem, several treatment options became available and some of them proved to be very efficient. PDE5 inhibitors are the mainstay treatment of ED. However, other treatment options such as intracorporal injections, surgery, vacuum devices and prosthesis are also available for patients who are unresponsive to PDE5 inhibitors. Since none of the treatment options available so far has proven ideal, research in the field of sexual medicine continues. The aim of this paper is to review the most advances in the treatment of ED. Full article

667 KiB

Open AccessReview

The Substrate of the Biopsychosocial Influences in the Carcinogenesis of the Digestive Tract

by Georgică C. Târtea, Cristina Florescu, Daniel Pirici, Daniel Caragea, Elena A. Târtea and Cristin C. Vere

J. Mind Med. Sci. 2016, 3(2), 108-117; https://doi.org/10.22543/2392-7674.1043 - 24 Sep 2016

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Abstract

Digestive cancer represents a severe public health problem, being one of the main causes of death. It is considered a multifactorial disease, with hereditary predisposition, environmental factors, and other factors involved in carcinogenesis. Both the evolution and the pathogenesis of digestive neoplasms remain [...] Read more.

Digestive cancer represents a severe public health problem, being one of the main causes of death. It is considered a multifactorial disease, with hereditary predisposition, environmental factors, and other factors involved in carcinogenesis. Both the evolution and the pathogenesis of digestive neoplasms remain incompletely elucidated. As a multifactorial disease, it can be approached by taking into account the biopsychosocial influences via enteric nervous system. Many peptides and non-peptides having a neurotransmitter role can be found in the enteric nervous system, which can influence the neoplastic process directly or indirectly by affecting some angiogenic, growth, and metastasis factors. However, neurotransmitters can also cause directly, through intercellular signalizing, the angiogenesis, the proliferation, and the digestive neoplasms’ metastasis. This new approach to neoplasms of the digestive tube assumes broader psychosocial factors can play an important role in the understanding the ethiopathogenie, the evolution of the disease, and determination of possible molecular targeted therapies; it also suggests that behavioral strategies may be important for maintaining a healthy state with respect to the digestive tract. Full article

413 KiB

Open AccessReview

The Postfinasteride Syndrome; An Overview

by David L. Rowland, Ion G. Motofei, Florian Popa, Vlad D. Constantin, Adriana Vasilache, Ioana Păunică, Cristian Bălălău, Georgeta P. Păunică, Petrisor Banu and Stana Păunică

J. Mind Med. Sci. 2016, 3(2), 99-107; https://doi.org/10.22543/2392-7674.1051 - 24 Sep 2016

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Abstract

As a 5-α reductase inhibitor, Finasteride has proven effective in ameliorating two conditions documented to be androgen dependent, namely male androgenic alopecia and benign prostatic hyperplasia. Therapeutic results are maintained as long as the drug is administered, with treatment cessation generally leading to [...] Read more.

As a 5-α reductase inhibitor, Finasteride has proven effective in ameliorating two conditions documented to be androgen dependent, namely male androgenic alopecia and benign prostatic hyperplasia. Therapeutic results are maintained as long as the drug is administered, with treatment cessation generally leading to the return of symptomatology for each condition. In addition, during the therapeutic phase, several adverse effects have been reported, some of which persist long or indefinitely after treatment cessation, known as “post-finasteride syndrome.” Herein we present and discuss the most common finasteride side effects, along with a psycho-neuroendocrine rationale that could explain the persistence of many adverse effects after treatment cessation. Moreover, we argue that finasteride adverse effects occurring during finasteride administration should be delineated from postfinasteride side effects (encountered after treatment cessation), suggesting the need to be addressed separately within a therapeutic perspective. Until a tailored therapeutic approach of postfinasteride syndrome becomes available, we have noted that hand preference and sexual orientation seem to be useful as possible predicting factors for finasteride side effects and postfinasteride syndrome. Finally, even though finasteride administration is considered relatively safe, literature data urges prudence. Specifically, recent studies report that some subjects receiving finasteride develop severe depressive episodes including suicidal thoughts, in part due to persistent sexual side effects. Full article

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J. Mind Med. Sci., Volume 3, Issue 2 (September 2016) – 10 articles

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