Journal of Mind and Medical Sciences

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Open AccessCase Report

Hepatocarcinoma with Tumor Thrombus Occupying the Right Atrium and Portal Vein in a Patient with Hereditary Hemochromatosis and Liver Cirrhosis

by Olga Hilda Orasan, Andreea Maria Stefan, Laura Urian, Anca Mihailov, Ovidiu Fabian, Flaviu Muresan, Iulia Breaban, Sorina Cezara Secara, Simina Tarmure Sarlea, Vasile Negrean, Dorel Sampelean and Angela Cozma

J. Mind Med. Sci. 2018, 5(2), 300-304; https://doi.org/10.22543/7674.52.P300304 - 3 Oct 2018

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Abstract

We present the case of a 46-year old patient with Child-Pugh class C cirrhosis with MEDL-Score 16, and hepatocellular carcinoma invading the inferior vena cava and the right atrium. The etiology of cirrhosis is type 1 hereditary hemochromatosis with positive HFE C282Y/C282Y and [...] Read more.

We present the case of a 46-year old patient with Child-Pugh class C cirrhosis with MEDL-Score 16, and hepatocellular carcinoma invading the inferior vena cava and the right atrium. The etiology of cirrhosis is type 1 hereditary hemochromatosis with positive HFE C282Y/C282Y and H63D/H63D mutations. A systematic review of the literature was performed and only 30 cases of hepatocellular carcinoma with tumor thrombosis extending into the right atrium have been described. To our knowledge, this is the first case that evidences the presence in hereditary hemochromatosis of hepatocellular carcinoma with atypical invasion into the right atrium. Screening of patients with a family history of hereditary hemochromatosis allows detection of the disease in the asymptomatic phase, allowing initiation of early therapy and improved prognosis. Full article

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Open AccessArticle

Determination of Pyrrolizidine Alkaloids in Dietary Sources Using a Spectrophotometric Method

by Oana C. Șeremet, Octavian T. Olaru, Mihaela Ilie, Claudia M. Guțu, Mihai G. Nițulescu, Camelia Diaconu, Catalina Motofei, Denisa Margină, Simona Negreș, Cristina E. Zbârcea and Emil Ștefănescu

J. Mind Med. Sci. 2018, 5(2), 294-299; https://doi.org/10.22543/7674.52.P294299 - 3 Oct 2018

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Abstract

Pyrrolizidine alkaloids (PAs) are a class of toxic compounds found in the composition of more than 6000 plants. People can be exposed to PAs by consuming phytotherapeutic products, food from crops contaminated with seeds of some species with high content of PAs, and/or [...] Read more.

Pyrrolizidine alkaloids (PAs) are a class of toxic compounds found in the composition of more than 6000 plants. People can be exposed to PAs by consuming phytotherapeutic products, food from crops contaminated with seeds of some species with high content of PAs, and/or contaminated animal products like bee products. For this reason we developed and validated a method for quantitative determination of PAs, from the most frequently contaminated food sources, honey and flour. Colorimetric Ehrlich reagent method was used with standard addition (1 mg/kg senecionine). The extraction solvent was methanol 50% acidified with citric acid to pH 2–3, as this solvent can be used for alkaloids and N-oxides. We found that, in extracting the alkaloid only once from the dietary sources, the percent of recovery is low (52.5% for honey, and 45.75% for flour). Using successive extractions, three times with the same solvent, the senecionine retrieval percentage increased to 86.0% for honey and 76.0% for flour. The method was validated using the following parameters: selectivity, linearity (0.25–20 mg/mL senecionine), accuracy (average recovery 93.5–107.93%) and precision (RSD 3.26–4.55%.). The calculated limit of quantification (0.174 mg/mL) makes this method applicable for determining Pas occurring at toxic levels for consumers. Full article

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Open AccessArticle

Personality Dimensions and Attributional Styles in Individuals With and Without Gender Dysphoria

by Siamak Khodarahimi, Hassan Ali Veiskarami and Maria Mercedes Ovejero Bruna

J. Mind Med. Sci. 2018, 5(2), 284-293; https://doi.org/10.22543/7674.52.P284293 - 3 Oct 2018

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Abstract

This research investigates personality dimensions and attributional styles among individuals with and without gender dysphoria in relationship to gender, educational level, and ethnicity. Participants were 60 men and women with and without gender dysphoria. A demographic sheet and two inventories were used. Results [...] Read more.

This research investigates personality dimensions and attributional styles among individuals with and without gender dysphoria in relationship to gender, educational level, and ethnicity. Participants were 60 men and women with and without gender dysphoria. A demographic sheet and two inventories were used. Results showed that patients with gender dysphoria had significantly higher neuroticism and lower agreeableness compared with individuals without gender dysphoria. No significance differences in extraversion, openness to experience, and conscientiousness (based on the “big five” personality model) were found between those with and without gender dysphoria. Also, individuals without gender dysphoria had higher positive attributional styles compared to patients with gender dysphoria. Finally, there were significant effects for gender and ethnicity on personality dimensions, but not for gender, ethnicity, or the ethnicity by gender interaction on the attributional styles. Full article

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Open AccessArticle

Functional Radical Cervical Dissection for Differentiated Thyroid Cancer: The Experience of a Single Center

by Adrian Tulin, Lucian Alecu, Catalina Poiana, Luminita Tomescu, Iulian Slavu, Raluca Tulin, Silviu Pituru, Cristina Orlov, Radu Jecan, Cristian Balalau, Anca Pantea Stoian, Razvan Hainarosie and Cornelia Nitipir

J. Mind Med. Sci. 2018, 5(2), 278-283; https://doi.org/10.22543/7674.52.P278283 - 3 Oct 2018

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Abstract

There is ongoing debate regarding the role of neck dissection in differentiated thyroid cancer, about its usefulness in elective settings, and the increased costs regarding morbidity and operative time. This retrospective study aimed to determine the rate of metastases in cervical lymph nodes, [...] Read more.

There is ongoing debate regarding the role of neck dissection in differentiated thyroid cancer, about its usefulness in elective settings, and the increased costs regarding morbidity and operative time. This retrospective study aimed to determine the rate of metastases in cervical lymph nodes, to examine the morbidity of this surgery, and to assess whether a pattern of distribution of tumor cells concerning neck lymphatic compartments exists. The most frequent type of cancer to metastasize was papillary cancer, the majority of patients were young with a median of 30 years, predominantly females. Differentiated thyroid cancer frequently metastasizes to the central and lateral compartments of the neck. The morbidity is minimal in a high-volume center. Radical neck dissection is safe and feasible in selected patients with confirmed invaded or enlarged lymph nodes due to differentiated thyroid cancer, and postoperative complications are minimal if the anatomy is correctly identified and the cases strictly selected. Full article

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Open AccessArticle

Pancreatogenic Type 3C Diabetes

by Anca Pantea-Stoian, Giorgiana Ditu, Mircea Diculescu, Mircea Manuc, Andra Iulia Suceveanu, Dana Manuc, Camelia Diaconu, Adrian Paul Suceveanu, Cornelia Nitipir, Razvan Hainarosie, Catalina Poiana and Cristian Serafinceanu

J. Mind Med. Sci. 2018, 5(2), 270-277; https://doi.org/10.22543/7674.52.P270277 - 3 Oct 2018

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Abstract

Background. The relationship between chronic pancreatitis and diabetes is well established. This form of diabetes is secondary to exocrine pancreatic disorder and is known as diabetes mellitus type 3c (T3cDM). Materials and Methods. In this retrospective study we included 261 patients, 59 patients [...] Read more.

Background. The relationship between chronic pancreatitis and diabetes is well established. This form of diabetes is secondary to exocrine pancreatic disorder and is known as diabetes mellitus type 3c (T3cDM). Materials and Methods. In this retrospective study we included 261 patients, 59 patients being diagnosed with chronic pancreatitis and secondary diabetes mellitus, and admitted in the Fundeni Clinical Institute, 2nd Department of Gastroenterology or N.C. Paulescu Institute/ Carol Davila University of Medicine and Pharmacy. Results and Discussions. Patients were 22.2% women and 77.8% men, with an average age of 56.8 years and 53.4 years respectively. 63% came from urban areas. The mean duration of chronic pancreatitis was six years. Non-diabetic patients were compared with patients who were previously diagnosed with T3cDM and who had been analyzed for body mass index (BMI). Imaging investigations were also performed to confirm pseudotumors or pancreatic tumours. Patients already considered non-diabetic had basal blood glucose values and were mostly overweight and obese. In this context, insulin resistance cannot be excluded for this group of patients. Conclusions. T3cDM is a new pathological entity that needs to be explored more deeply, and that should benefit from both a diagnostic stratification and treatment. Full article

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Open AccessArticle

A Proposed Therapeutic Algorithm for Colorectal Cancer Prevention, Based on Endoscopic Polypectomies in Patients with Multiple Colonic Polyps

by Alexandru Septimiu, Florin Dan Ungureanu, Kutasi Incze Reka and Alec Cosmin Moldovan

J. Mind Med. Sci. 2018, 5(2), 261-269; https://doi.org/10.22543/7674.52.P261269 - 3 Oct 2018

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Abstract

Introduction. Results from single medical centers having large numbers of patients with multiple colonic polyps that have undergone colonoscopy management are rare. Material and method. The present study is based on 2000 cases enrolled during 2009 and 2017, including patients that underwent colonoscopy [...] Read more.

Introduction. Results from single medical centers having large numbers of patients with multiple colonic polyps that have undergone colonoscopy management are rare. Material and method. The present study is based on 2000 cases enrolled during 2009 and 2017, including patients that underwent colonoscopy for various reasons in the Department for Upper and Lower Endoscopy of Witting Clinical Hospital, Bucharest, Romania. Results. Of the 2000 patients examined during 2009–2017, 594 tumor formations were detected; 148 (24.9%) patients had colorectal malignancies, and 446 (75%) polypoid formations in 313 patients who had one or more colon polyps were found. Discussions. After performing statistical analyses on several general parameters (such as age, sex, overall clinical outcome of the patient) and polyp-related characteristics (such as: dimensions, location, histological type), we developed a stepwise algorithm for clinical management (with endoscopic polypectomy) of patients with multiple polyposis, with the goal of reducing unnecessary colorectal surgeries. Conclusions. We believe that this type of stepwise algorithm-based approach in the clinical management of patients with multiple polyposis can lead to a substantial decrease in unnecessary colectomies (no matter the approach, via laparotomy or laparoscopic procedures), with the accompanying benefit of avoiding the complications and negative long-life impact that they impose. Full article

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Open AccessArticle

Can Non-Small Cell Lung Cancer Histologic Subtypes Predict Survival? A Single Institution Experience

by Cornelia Nitipir, Cristina Orlov, Ana-Maria Popa, Mihaela Olaru, Iulian Slavu, Iaciu Cristian, Razvan Hainarosie, Anca Pantea Stoian and Cristian Balalau

J. Mind Med. Sci. 2018, 5(2), 255-260; https://doi.org/10.22543/7674.52.P255260 - 3 Oct 2018

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Abstract

Introduction. The latest histological classification of lung adenocarcinoma includes lepidic, acinar, papillary, micropapillary, and solid as subtypes. Testing these subtypes for their prognostic and predictive value is an ongoing scientific challenge. The present research article aims to describe the influence this classification has [...] Read more.

Introduction. The latest histological classification of lung adenocarcinoma includes lepidic, acinar, papillary, micropapillary, and solid as subtypes. Testing these subtypes for their prognostic and predictive value is an ongoing scientific challenge. The present research article aims to describe the influence this classification has on patient survival. Materials and Methods. Thirty-three patients were included in the trial. The most important enrollment criterion was the clear specification of the adenocarcinoma subtype in the pathology report. Patients were stratified into three groups which included the adenocarcinoma pathological subtypes as follows: lepidic (LEP), acinar and papillary (ACN/PAP), and micropapillary/solid (MIP/SOL). The primary endpoint was progression-free survival. Other endpoints included overall survival. Results. The lepidic subtype of ADC had superior PFS and OS, regardless of stage. Papillary and acinar subtype showed an intermediate prognosis, whereas micropapillary and solid subtypes were the most aggressive. Conclusions. The experience of this single center confirmed data in the literature. Further studies are needed to demonstrate all the possible implications of this pathology classification. Full article

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Open AccessArticle

Reconstruction of Heel Soft Tissue Defects Using Sensate Medial Plantar Flap

by Mihaela Pertea, Natalia Velenciuc, Oxana Grosu, Bogdan Veliceasa, Vladimir Poroch and Sorinel Lunca

J. Mind Med. Sci. 2018, 5(2), 250-254; https://doi.org/10.22543/7674.52.P250254 - 3 Oct 2018

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Abstract

Introduction. Reconstruction of heel soft tissue defects represents a true challenge for any surgeon due to the particularities of this anatomical region. The tissue used to reconstruct the heel area must be resistant, innervated, and adapted to take over the body weight. Innervated [...] Read more.

Introduction. Reconstruction of heel soft tissue defects represents a true challenge for any surgeon due to the particularities of this anatomical region. The tissue used to reconstruct the heel area must be resistant, innervated, and adapted to take over the body weight. Innervated medial plantar fasciocutaneous flap is one of the best solutions to cover defects at the heel level. Materials and Methods. We studied 5 patients, 4 males and one female, aged 42 to 67 years, who presented heel soft tissue defects of various etiologies. In all cases, the used reconstructive method was an insular innervated medial plantar fasciocutaneous flap. Results. Immediate and late outcomes were good. No immediate complications of necrosis type were recorded in any of the cases, and 2 years postoperatively there was no evidence of ulceration or other type of flap injury. The socio-professional reintegration of the patients was relatively rapid and their satisfaction was high. Donor area morbidity was minimal. Conclusions. Sensate medial plantar fasciocutaneous flap represents the first choice for the reconstruction of the heel soft tissue defects when patients’ local and general status allows it. Full article

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Open AccessArticle

HPTLC Assay of Nicotine and Cotinine in Biological Samples

by Ana Maria Vlasceanu, Daniela Luiza Baconi, Anne Marie Ciobanu, Vlad D. Constantin, Liana Pleș, Cristian Balalau and Miriana Stan

J. Mind Med. Sci. 2018, 5(2), 244-249; https://doi.org/10.22543/7674.52.P244249 - 3 Oct 2018

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Abstract

This study presents the development of a simple high-performance thin layer chromatography (HPTLC) method for the determination of nicotine and its metabolite cotinine in human plasma and urine. The following mobile phases: methanol: ammonia (100:1.5, v:v), chloroform: acetone: ammonia (48.75:48.75:2.5, [...] Read more.

This study presents the development of a simple high-performance thin layer chromatography (HPTLC) method for the determination of nicotine and its metabolite cotinine in human plasma and urine. The following mobile phases: methanol: ammonia (100:1.5, v:v), chloroform: acetone: ammonia (48.75:48.75:2.5, v:v:v), methanol: chloroform: ammonia (48.75:48.75:0.5, v:v:v) and glass plates precoated with silicagel 60 F254 (20 × 20) as a stationary phase were used. Densitometric scanning was performed at 263 nm. Two different extraction procedures have been applied: liquid-liquid extraction using dichloromethane at alkaline pH and solid-phase extraction using C18 cartridges. Preliminary tests in order to establish the system of solvents for development, as well as the range of linearity, were conducted. The best separation of nicotine and cotinine was obtained by using methanol: chloroform: ammonia (48.75:48.75:0.5, v:v:v) as the mobile phase. The liquid-liquid extraction technique led to better results than solid phase extraction. The regression curves were linear (with a corresponding correlation coefficient higher than 0.99) in the quantities range of 200 ng–1000 ng/spot for both nicotine and cotinine. The UV spectra confirm the identification of nicotine and cotinine both in the standards and in the extracts after liquid-liquid extraction. The proposed method can be applied for the simultaneous evaluation of nicotine and cotinine in biological samples at toxic/lethal levels. Thus, the method may be applicable in lethal nicotine intoxication cases in forensic toxicological analysis. Full article

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Open AccessArticle

Thrombocytopenia in End-Stage Renal Disease and Chronic Viral Hepatitis B or C

by Olga Hilda Orasan, Laura Urian, George Ciulei, Iulia Breaban, Andreea Maria Stefan, Sorina Cezara Secara, Adela-Sitar Taut, Simina Tarmure Sarlea, Vasile Negrean, Dorel Sampelean, Ioan Mihai Patiu, Remus Aurel Orasan and Angela Cozma

J. Mind Med. Sci. 2018, 5(2), 236-243; https://doi.org/10.22543/7674.52.P236243 - 3 Oct 2018

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Abstract

Objectives. We evaluated platelet counts in end-stage renal disease and chronic viral hepatitis. Materials and Methods. We studied 70 patients with end-stage renal disease and chronic viral hepatitis and compared them to a control group of 45 patients without hepatitis. Results. The presence [...] Read more.

Objectives. We evaluated platelet counts in end-stage renal disease and chronic viral hepatitis. Materials and Methods. We studied 70 patients with end-stage renal disease and chronic viral hepatitis and compared them to a control group of 45 patients without hepatitis. Results. The presence of viral hepatitis was associated with a higher prevalence of thrombocytopenia. Correlations between age, C-reactive protein, liver stiffness measurement, and platelet count were observed. C-reactive protein levels > 10 mg/dL were associated with a lower risk of thrombocytopenia in patients with end-stage renal disease and chronic viral hepatitis, yet age > 60 years, dialysis vintage > 10 years, aspartate and alanine aminotransferase levels > 20 IU/L, albumin levels < 3.5 g/dL, and fibrosis stage ≥ 3 were not related. Conclusions. Chronic viral hepatitis leads to a higher prevalence of thrombocytopenia. Platelet counts in these patients begin to decrease significantly once liver fibrosis reaches stage III. Full article

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Open AccessArticle

The Switch from Patented Medicine to the Generic One: An Option or a Necessity?

by Dan Nicolae Păduraru, Daniel Ion, Adriana Elena Nica, Florentina Coman, Marius Coțofană, Dumitru Cristinel Badiu, Valentin Titus Grigorean, Alexandra Bolocan and Octavian Andronic

J. Mind Med. Sci. 2018, 5(2), 230-235; https://doi.org/10.22543/7674.52.P230235 - 3 Oct 2018

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Abstract

This paper assesses the influence of a number of factors taken into account when a brand name drug is replaced by a generic one. It also evaluates responses of health professionals – physicians and pharmacist—and patients regarding the issue of switching. We compared [...] Read more.

This paper assesses the influence of a number of factors taken into account when a brand name drug is replaced by a generic one. It also evaluates responses of health professionals – physicians and pharmacist—and patients regarding the issue of switching. We compared and contrasted their responses in order to identify new points of cooperation for the intended benefit of the patient. Thus, the sample drew from all three groups, consisting of 50 doctors, 50 pharmacists, and 50 patients. We collected information regarding the age, residence, income level, and education level for the patients, and age and experience for the specialists. Based on responses to the survey, replacing the original medication with a generic one raises many issues, such as lack of information for the patient and specialist, lack of collaboration between physician and pharmacist, ineffective communication between specialist and patient, and the influence of the overall profit motive. Full article

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Open AccessArticle

Unhealthy Lifestyle and the Risk of Metabolic Syndrome—The Romanian Experience

by Angela Cozma, Adela Sitar-Taut, Laura Urian, Adriana Fodor, Ramona Suharoschi, Crina Muresan, Vasile Negrean, Dorel Sampelean, Dumitru Zdrenghea, Dana Pop, Leucuta Daniel and Olga Hilda Orasan

J. Mind Med. Sci. 2018, 5(2), 218-229; https://doi.org/10.22543/7674.52.P218229 - 3 Oct 2018

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Abstract

Background. Metabolic syndrome (MetS) represents a clustering of metabolic risk factors for cardiovascular disease. Many studies have shown the influence of an unhealthy lifestyle on the risk of MetS, yet some aspects remain controversial. Aim of the study: to investigate the relationship between [...] Read more.

Background. Metabolic syndrome (MetS) represents a clustering of metabolic risk factors for cardiovascular disease. Many studies have shown the influence of an unhealthy lifestyle on the risk of MetS, yet some aspects remain controversial. Aim of the study: to investigate the relationship between an unhealthy lifestyle and the risk of MetS. Materials and Methods. The study was conducted using a sample of 181 patients, 54 (29.8%) males and 127 (70.2%) females, aged 59.95 ± 10.8 years. The baseline survey involved the completion of structured questionnaires and clinical examination. Results. Rural environment, lower education level, past smoking, the absence of fruit/vegetables in the diet, carbonated soft drinks, and the consumption of significant amounts of alcohol were risk factors for the MetS. Conclusion. A precise etiology for the MetS remains unclear, but it is known to result from a complex interaction of genetic, metabolic, and socio-economic and environmental factors. Full article

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Open AccessArticle

Self-Reported Nutritional Status, Executive Functions, and Cognitive Flexibility in Adults

by Siamak Khodarahimi

J. Mind Med. Sci. 2018, 5(2), 210-217; https://doi.org/10.22543/7674.52.P210217 - 3 Oct 2018

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Abstract

Objectives. The purpose of this study was to investigate the relationship between nutrition status, executive cognitive functions, and cognitive flexibility; and to analyze the role of gender, age, and nutrition status in the prediction of executive cognitive functions and cognitive flexibility in a [...] Read more.

Objectives. The purpose of this study was to investigate the relationship between nutrition status, executive cognitive functions, and cognitive flexibility; and to analyze the role of gender, age, and nutrition status in the prediction of executive cognitive functions and cognitive flexibility in a sample of Iranian adults. Background. This study is based on the hierarchy of needs, health beliefs, developmental, cognitive and psychophysiological conceptualizations of nutrition and their plausible influences on human cognitive functions and cognitive flexibility. Materials and Methods. The randomly selected sample consisted of 200 adult participants (M = 99 and F = 101) from Eghlid City, the north of Fars province, Iran. A demographic questionnaire, the Nutrition Assessment Inventory (NAI), the Amsterdam Executive Function Inventory (AEFI), and the Cognitive Flexibility Scale (CFS) were used. Results. Findings showed significant positive relationships between healthy nutrition (diet-oriented nutrition and high fat foods subscales of Nutrition Assessment Inventory), the evaluation coping subscale, and the total score of Cognitive Flexibility Inventory. In addition, age and nutritional status had a significant impact with regards to predicting cognitive flexibility and executive cognitive functions. Conclusions. Given the significant positive relationship between nutrition status and cognitive flexibility, and the role of gender and nutrition status on executive cognitive functions and mental flexibility, this study may offer beneficial approaches for nutrition and cognitive health programs by clinicians and health education professionals. Full article

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Open AccessArticle

Quality of Life in Romanian Patients with Schizophrenia Based on Gender, Type of Schizophrenia, Therapeutic Approach, and Family History

by Elena Alina Roșca, Ovidiu Alexinschi, Călin Brîncuș, Valentin Petre Matei and Ana Giurgiuca

J. Mind Med. Sci. 2018, 5(2), 202-209; https://doi.org/10.22543/7674.52.P202209 - 3 Oct 2018

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Abstract

The low quality of life of patients with schizophrenia has been extensively discussed and investigated. Various aspects from gender, socio-demographic profile, and/or type of neuroleptic treatment have been taken into account in describing this condition. The purpose of this study is to assess [...] Read more.

The low quality of life of patients with schizophrenia has been extensively discussed and investigated. Various aspects from gender, socio-demographic profile, and/or type of neuroleptic treatment have been taken into account in describing this condition. The purpose of this study is to assess the perceived quality of life of Romanian patients suffering from schizophrenia and to correlate it with gender differences, type of schizophrenia, family history of psychiatric illness, and type of antipsychotic treatment. 143 patients diagnosed with schizophrenia according to DSM IV-TR and ICD 10 were included in the study. Social demographic data were documented and further assessment was performed using the Subjective Well Being under Neuroleptic Treatment Scale –the short form (SWN-S) and the short version of the WHO- Questionnaire for The Quality of Life (WHO-QoL-BREF). The mental functioning dimension was higher in men than women; the social integration dimension was higher for the residual type of schizophrenia. Emotional regulation and the capacity of social integration did not show significant differences between patients who had a family history of mental illness and those who did not. Levels of self-control and physical functioning were better for patients treated with atypical antipsychotics and who did not report a family history of psychiatric illness. All five dimensions of the SWN-S were higher in patients treated with atypical antipsychotics, compared to those who were treated with typical antipsychotics. The study showed that for people with schizophrenia mental functioning was better preserved in men, in patients who did not have a family history of psychiatric illness, and in patients who were treated with atypical antipsychotics. The level of social integration was better in patients who were treated with atypical antipsychotics but this effect depended on the type of schizophrenia. Full article

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Open AccessReview

New Oral Anticoagulants and Their Reversal Agents

by Crista L. Laslo, Anca Pantea Stoian, Bogdan Socea, Dan N. Păduraru, Oana Bodean, Laura I. Socea, Tiberiu Paul Neagu, Ana Maria Alexandra Stanescu, Dragoș Marcu and Camelia C. Diaconu

J. Mind Med. Sci. 2018, 5(2), 195-201; https://doi.org/10.22543/7674.52.P195201 - 3 Oct 2018

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Abstract

Atrial fibrillation is a commonly encountered pathology in medical practice, and its prevalence has shown a continuous rise over the past years. Atrial fibrillation has a significant impact on patients' quality of life, not only due to the standard anticoagulant treatment with vitamin [...] Read more.

Atrial fibrillation is a commonly encountered pathology in medical practice, and its prevalence has shown a continuous rise over the past years. Atrial fibrillation has a significant impact on patients' quality of life, not only due to the standard anticoagulant treatment with vitamin K antagonists that require close monitoring and dose adjustment, but also due to the fragile equilibrium between hemorrhagic and thrombotic risks. The introduction of new oral anticoagulants (NOACs) in the treatment guidelines for atrial fibrillation has improved the quality of life, as NOACs do not require close monitoring or dose adjustments. However, even if the safety profile of the NOACs regarding the hemorrhagic risk is superior to vitamin K antagonists, the problem raised by an unexpected hemorrhage (e.g., severe hemorrhage after an accident) and the need for efficient hemostasis in a chronic anticoagulated patient has remained unsolved. To find a solution for this problem, reversal agents for NOACs have been developed and tested, and two of them, idarucizumab and andexanet-alpha, have already been approved by the FDA, thus making NOACs increasingly appealing as a choice of anticoagulation treatment. Full article

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Open AccessReview

A Brief Review of the Literature on the Malignant Ureteral Obstruction

by Sorin Lupu, Adrian Brînză, Bogdan Socea, Dragoș Marcu, Ileana Peride, Ana Maria Alexandra Stănescu, Tiberiu Paul Neagu and Laurian Maxim

J. Mind Med. Sci. 2018, 5(2), 189-194; https://doi.org/10.22543/7674.52.P189194 - 3 Oct 2018

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Abstract

Malignant ureteral obstruction (MUO) caused by a primarily urological tumor or secondary to a late-stage malignancy can be difficult for the urologist to manage. Due to a lack of clinical data on the management of MUO, every case is particular and should be [...] Read more.

Malignant ureteral obstruction (MUO) caused by a primarily urological tumor or secondary to a late-stage malignancy can be difficult for the urologist to manage. Due to a lack of clinical data on the management of MUO, every case is particular and should be aborted individually. Lack of specific treatment, either palliative or definitive, can severely damage renal function and lifetime expectancy in patients, causing even more damage that could otherwise be avoided. Prompt management directed at the recovery of renal function is the main goal in such cases. Even after urinary flow is restored, life threatening post-obstructive diuresis needs to be managed. Full article

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Open AccessReview

Sentinel Lymph Node in Early Stage Ovarian Cancer; A Literature Review

by Irina Balescu, Nicolae Bacalbasa, Mihaela Vilcu, Vladislav Brasoveanu and Iulian Brezean

J. Mind Med. Sci. 2018, 5(2), 184-188; https://doi.org/10.22543/7674.52.P184188 - 3 Oct 2018

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Abstract

Although sentinel lymph node mapping has been widely implemented in gynecological malignancies in order to minimize the number of unnecessary lymph node dissections and to diminish postoperative morbidity rate, little is known about ovarian cancer sentinel lymph node mapping. This article presents a [...] Read more.

Although sentinel lymph node mapping has been widely implemented in gynecological malignancies in order to minimize the number of unnecessary lymph node dissections and to diminish postoperative morbidity rate, little is known about ovarian cancer sentinel lymph node mapping. This article presents a literature review regarding the effectiveness, safety and benefits of this method. Sentinel lymph node detection in early stage ovarian cancer seems to be a safe and effective method, able to minimize the rate of patients submitted to unnecessary lymph node dissection. The second goal of the procedure, to minimize the risk of missing involved lymph nodes, seems also to have been achieved, most studies reporting a very small number of cases diagnosed with positive non-sentinel lymph nodes. Considering all these data we can note that this procedure is not yet included as part of the standard therapeutic protocol, so that further studies would be necessary to include it as a common therapeutic approach in the case of patients with early stage ovarian cancer. Full article

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Open AccessReview

The Importance of Early Arthritis in Patients with Rheumatoid Arthritis

by Georgiana Iftimie, Ana Maria Alexandra Stănescu, Mihaela Adela Iancu, Anca Pantea Stoian, Răzvan Hainăroșie, Bogdan Socea, Gheorghița Isvoranu, Dragoș Marcu, Tiberiu Paul Neagu and Camelia C. Diaconu

J. Mind Med. Sci. 2018, 5(2), 176-183; https://doi.org/10.22543/7674.52.P176183 - 3 Oct 2018

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Abstract

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that manifests predominantly in the synovial joint, where it causes a chronic inflammatory process, leading to early osteoarticular destructions. These destructions are progressive and irreversible, generating a significant functional deficiency. During the last years, the [...] Read more.

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that manifests predominantly in the synovial joint, where it causes a chronic inflammatory process, leading to early osteoarticular destructions. These destructions are progressive and irreversible, generating a significant functional deficiency. During the last years, the diagnostic approach of RA has focused on early arthritis. Early arthritis can develop into established RA or another established arthropathy, like systemic lupus erythematosus or psoriatic arthritis. It can have a spontaneous resolution or may remain undifferentiated for indefinite periods of time. The management of early arthritis has changed considerably in the past few years, under the influence of new concepts of diagnosis and new effective therapies. The treatment goal of early arthritis should now be the clinical remission and prevention of joint destruction. Methotrexate is the first line of therapy, used to treat early arthralgia and to reverse or limit impending exacerbation to RA. Biological treatment is used as a second line therapy in patients with severe disease who do not respond or have a contraindication to disease-modifying antirheumatic drugs (DMARDs). Patients with early arthritis should usually be identified and directed to rheumatologists to confirm the presence of arthritis, and to establish the correct diagnosis plus to initiate the proper treatment strategies. Full article

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Open AccessReview

Biological Therapy in the Treatment of Melanoma

by Simona Roxana Georgescu, Mihaela-Roxana Ioghen, Maria-Isabela Sarbu, Alexandra-Florentina Ion, Ela Ghita, Cristina-Iulia Mitran, Madalina-Irina Mitran, Vasile Benea and Mircea Tampa

J. Mind Med. Sci. 2018, 5(2), 169-175; https://doi.org/10.22543/7674.52.P169175 - 3 Oct 2018

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Abstract

Melanoma is one of the most aggressive tumors and its incidence is on the rise. The low rates of survival in metastatic melanoma has led to the development of new drugs for this type of patient, such as biological therapy which has shown [...] Read more.

Melanoma is one of the most aggressive tumors and its incidence is on the rise. The low rates of survival in metastatic melanoma has led to the development of new drugs for this type of patient, such as biological therapy which has shown remarkable results. This therapy is based on stimulation of the immune system to fight tumoral cells through: injection of cytokines with immunomodulatory properties (interleukin-2, alpha-interferon), vaccination with tumor antigens or immune cells that process tumor antigens, adoptive immunotherapy, inhibition of immune checkpoints (PD-1, CTLA-4), inhibition or stimulation of immune modulator molecules (OX-40, LAG-3), inhibition of signaling pathways involved in cell proliferation (Raf/MAPK/ERK signaling pathway), or administration of oncolytic viruses. Biological therapy in melanoma has shown promise in laboratory and clinical studies, with more therapeutic targets to be revealed as new molecular and cellular mechanisms of the disease are discovered. Full article

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Open AccessReview

Postpartum Depression: Prevention and Multimodal Therapy

by Anca Daniela Stanescu, Denisa Oana Balalau, Liana Ples, Stana Paunica and Cristian Balalau

J. Mind Med. Sci. 2018, 5(2), 163-168; https://doi.org/10.22543/7674.52.P163168 - 3 Oct 2018

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Abstract

A woman goes through many biological (hormonal, physical), psychological (emotional), and socio-cultural changes during pregnancy. Furthermore, changes also occur in the mother's familial and interpersonal world after childbirth. While some mothers have positive emotions at birth, such as joy and pleasure, others complain [...] Read more.

A woman goes through many biological (hormonal, physical), psychological (emotional), and socio-cultural changes during pregnancy. Furthermore, changes also occur in the mother's familial and interpersonal world after childbirth. While some mothers have positive emotions at birth, such as joy and pleasure, others complain of negative experiences varying from sadness and depression to psychosis. Thus, the risk of depression is higher for women during the postpartum period, having a tendency to decrease in most cases over the first 2 weeks after delivery. Unfortunately, this favorable evolution does not happen in about 1 in 4–7 women, who develops postpartum depression. Postpartum depression has generally the same features as any common depressive episode encountered at any other time in life. However, assessment of depressive symptoms in the parental period implies not only general tools (such as the Depression Scale of the Center for Epidemiological Studies or the Beck Depression Inventory), but also a specific evaluation using the Edinburgh Postnatal Depression Scale. Taking into account all changes that occur during the peripartum period, a multimodal approach for postpartum depression would be recommended, including an appropriate lifestyle (walks, ambient environments), counseling, cognitive-behavioral therapy, and finally antidepressant medication when required. As a conclusion, postpartum depression may range from a mild and reversible episode to a severe and persistent form. Antepartum and postpartum screening, an early diagnosis, and a tailored approach to depression are essential for better results and prognosis related to both mother and child. Full article

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Open AccessReview

Abdominal-Pelvic Pain in Female Patients with Endometriosis—A Review of the Literature

by Dumitru Cristinel Badiu, Marina Romina Sima, Claudia Mehedintu, Bogdan Mastalier, Mihaela Mandu, Liliana Florina Andronache, Dan Nicolae Paduraru, Anca Pantea Stoian and Valentin Titus Grigorean

J. Mind Med. Sci. 2018, 5(2), 158-162; https://doi.org/10.22543/7674.52.P158162 - 3 Oct 2018

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Abstract

Abdominal-pelvic pain is the dominant symptom in endometriosis, one of the most common pathologies that affect women, being also a multifactorial disorder. Exploratory laparoscopy allows the correct assessment of the location as well as severity and extent of the lesions, thus representing the [...] Read more.

Abdominal-pelvic pain is the dominant symptom in endometriosis, one of the most common pathologies that affect women, being also a multifactorial disorder. Exploratory laparoscopy allows the correct assessment of the location as well as severity and extent of the lesions, thus representing the current gold standard in diagnosis. The correlation of pain intensity with the evolutionary stage of endometriosis is inconstant. Surgical treatment, preferably performed laparoscopically, includes the excision of the ectopic endometrium, having as a primary objective the control of persistent pain and the removal of all endometriotic foci. This procedure helps to improve the life quality of the patient, to reduce relapses, to control postoperative pain, and to eliminate the disease. Pre- and post-operative adjuvant medical treatment is used due to its effects on the symptomatology, prolonging the asymptomatic period of the disease. Despite the use of the above procedures, there are cases in which the abdominal-pelvic pain persists even after surgery, which makes endometriosis a significant challenge for both the specialist and the patient, as well as for the medical system itself, as the study of the pathogenic mechanisms is yet the subject of numerous studies. Nutritional education in these patients is essential, given the recommendation to restrict the range of foods and to increase other foods that have an important role in reducing the risk or even leading to regression of the endometrial pathology. Full article

299 KiB

Open AccessReview

The Evidence for the Benefits from Breast Milk in the Neurodevelopment of Premature Babies—A Review of the Recent Literature

by Dănuța Iulia Păduraru

J. Mind Med. Sci. 2018, 5(2), 151-157; https://doi.org/10.22543/7674.52.P151157 - 3 Oct 2018

Viewed by 51

Abstract

Introduction. The brain in preterm babies is usually not fully developed and therefore early post-term events can have long-lasting neurodevelopment and cognitive outcomes. It is known that cerebral white matter connectivity is important for later intact cognitive functioning amongst children born very preterm [...] Read more.

Introduction. The brain in preterm babies is usually not fully developed and therefore early post-term events can have long-lasting neurodevelopment and cognitive outcomes. It is known that cerebral white matter connectivity is important for later intact cognitive functioning amongst children born very preterm and that breast milk imparts neurotrophic factors. The relationship between breastfeeding and child development is a long and well-studied area, and the evidence in support of breast milk is already substantial. Here we review the recent literature on the topic to establish whether additional evidence is available to strengthen the view that breast milk is superior in maximizing neurological development in premature infants. Materials and Methods. A search was undertaken of PubMed, limited to the last 10 years and humans. No language restrictions were imposed. Results. The search yielded 45 articles, of which 12 included all three elements of breast milk, neurological/cognitive development and preterm babies; 10 were reviewed. The gestation period and birth weight (either or both were reported) ranged from 23 to 36 weeks and from 580 g to to <1500 g. Studies were heterogeneous in methodology. In addition to two systematic reviews and a review of the literature, other studies focused particularly on the effects of certain key components within breast milk on neurological development. They generally found evidence to support the beneficial effects of breast milk on brain, visual, and cognitive development in Preterm infants. Studies focusing on how breast milk intake affects the preterm infant brain are limited. We found only two studies published in the last 2 years in relation to brain volume in breast fed preterm infants. Both used magnetic resonance imaging (MRI) to examine the brains of breast-fed babies born prematurely. These studies found that preterm infants fed more breast milk had larger brain volumes (cortical surface) compared to those fed little/no breast milk. The timing of the nutritional intervention and the dose of the nutrient/supplement have been found to be relevant factors. However, not all studies have been conclusively positive. Conclusions. Although the profile of preterm infants is a wide one, from the limited but recent evidence, it is reasonable to conclude that breast milk contributes positively to neurological development. Full article

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J. Mind Med. Sci., Volume 5, Issue 2 (October 2018) – 22 articles

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