Journal of Mind and Medical Sciences

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Open AccessCase Report

Complex Reconstruction After Extreme Fournier’s Gangrene; A Case Report

by Serban Dumitrache, Leonida A. Goman, Raluca Dutu, Raluca Capatina, Carmen Giuglea and Dan M. Enescu

J. Mind Med. Sci. 2020, 7(2), 261-264; https://doi.org/10.22543/7674.72.P261264 - 29 Sep 2020

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Abstract

In this article we present a severe case of Fournier's gangrene (FG) that affected a 64-year-old male patient, with no other known comorbidities. FG is a type of necrotizing fasciitis of the perineal and genital regions, that affects mostly males in the 5th–7th [...] Read more.

In this article we present a severe case of Fournier's gangrene (FG) that affected a 64-year-old male patient, with no other known comorbidities. FG is a type of necrotizing fasciitis of the perineal and genital regions, that affects mostly males in the 5th–7th decades, with mortality rates that reach 70%. The infection usually advances through the superficial fascial layers of the perineum and abdomen and affects the skin. In our case the infection also affected the spermatic fasciae and advanced in the abdominal and pelvic cavities, abdominal muscles, and surrounding soft tissues. Subsequent debridement left the patient with large soft tissue and muscle defects and an open abdominal cavity that needed reconstruction. We designed two pedicled tensor fascia lata flaps with extra fascia for abdominal support. Healing was marked by a pseudomonas aeruginosa infection that led to skin graft sloughing and marginal wound breakdown, which was treated with antibiotics and local wound care. Eventually the wounds healed, and the patient left the hospital 11 weeks after admittance. The outcome of the case was good considering the initial extent of the infection. The cosmetic shortcomings were not shared by the patient and future scar corrections are planned. Full article

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Open AccessCase Report

Unexpected Hope for a Multiple Myeloma Patient

by Minodora Cezarina Onisâi, Iuliana Iordan, Mihaela Gaman, Horia Bumbea and Ana-Maria Vlădăreanu

J. Mind Med. Sci. 2020, 7(2), 257-260; https://doi.org/10.22543/7674.72.P257260 - 29 Sep 2020

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Abstract

Multiple myeloma (MM) is a plasma cell neoplasm, characterized by periods of remission and relapses. The emergence of novel therapies, with multiple mechanisms of action and fewer adverse reactions, brings more and better options and also a higher survival rate. However, MM is [...] Read more.

Multiple myeloma (MM) is a plasma cell neoplasm, characterized by periods of remission and relapses. The emergence of novel therapies, with multiple mechanisms of action and fewer adverse reactions, brings more and better options and also a higher survival rate. However, MM is still an incurable disease, and patients eventually become refractory to an extensive range of therapies. We present the case of a patient diagnosed with MM standard risk, who was at first refractory to multiple treatment regimens, and then had an unexpected and stable complete response to a newer drug of the same class. Full article

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Open AccessCase Report

Immunohistochemical Pattern—A Prognostic Factor for Synchronous Gastrointestinal Cancer

by Catalin Alius, Catalin Gabriel Cirstoveanu, Cristinel Dumitru Badiu, Valeriu Ardeleanu and Vasile Adrian Dumitru

J. Mind Med. Sci. 2020, 7(2), 250-256; https://doi.org/10.22543/7674.72.P250256 - 29 Sep 2020

Cited by 1 | Viewed by 28

Abstract

Recent advancements in medical genetics and molecular biology are reflected in the modern understanding and approach to colorectal carcinoma (CRC). Understanding the cellular mechanisms and mutational patterns that promote carcinogenesis could enhance the predictive accuracy of the TNM classification. Furthermore, this will allow [...] Read more.

Recent advancements in medical genetics and molecular biology are reflected in the modern understanding and approach to colorectal carcinoma (CRC). Understanding the cellular mechanisms and mutational patterns that promote carcinogenesis could enhance the predictive accuracy of the TNM classification. Furthermore, this will allow for a much more documented stratification and tailored oncological treatment. This paper presents an illustrative case of a relatively young patient (50 years old) with no family history of cancer who was diagnosed with four synchronous gastrointestinal (GI) adenocarcinomas displaying a wild type P53, negative BRAF testing, and mutated MLH1 and PMS2 proteins. This case report contributes to the relevant literature with a concise review of the role of micro-satellite instability (MSI), chromosomal instability (CIN), and CpG island methylator phenotype (CIMP) in carcinogenesis, hereditary and sporadic gastrointestinal cancers, a discussion over the importance of molecular sub-typing in predicting long term outcomes and choosing the most suitable adjuvant treatment regimen. Full article

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Open AccessCase Report

Paroxysmal Nocturnal Hemoglobinuria: Pandora’s Box?

by Mihnea-Alexandru Găman, Iulia Ursuleac and Daniel Coriu

J. Mind Med. Sci. 2020, 7(2), 245-249; https://doi.org/10.22543/7674.72.P245249 - 29 Sep 2020

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Abstract

Introduction. Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired non-malignant hematological disorder which affects the pluripotent hematopoietic stem cell. The cause of PNH development is the occurrence of somatic mutations in the phosphatidylinositol glycan-A gene which encodes a protein necessary for the biosynthesis [...] Read more.

Introduction. Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired non-malignant hematological disorder which affects the pluripotent hematopoietic stem cell. The cause of PNH development is the occurrence of somatic mutations in the phosphatidylinositol glycan-A gene which encodes a protein necessary for the biosynthesis of glycosylphosphatidylinositol anchors. The diagnosis of PNH requires the presence of signs of intravascular hemolysis, thrombosis, and (or) bone marrow failure. Case Report. We report the case of a 42-year-old female, diagnosed with PNH at the age of 27, whose evolution was initially characterized predominantly by hemolytic attacks and whose disease pattern evolved towards thromboembolic episodes with the advancement of age. Conclusions. Establishing the diagnosis of PNH is a difficult task and its management requires teamwork. During the evolution of the disease, a PNH patient can acquire supplementary risk factors for thrombosis, in addition to the pro-coagulant potential of the disease itself. We reported this case to remind physicians that establishing the diagnosis of PNH is troublesome, and thus it is questionable whether PNH is a rare disease or just underdiagnosed. In this context, in the clinical practice of hematologists and other physicians as well, PNH remains a veritable Pandora's box. Full article

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Open AccessCase Report

Carbamazepine-Induced Dress Syndrome: A Case Report

by Andrada Luciana Lazar, Olga Hilda Orășan, Corina Baican, Nicolae Voicu Rednic, Adela Sitar-Tăut, Bogdan Man, Vasile Negrean, Nicolae Rednic and Angela Cozma

J. Mind Med. Sci. 2020, 7(2), 239-244; https://doi.org/10.22543/7674.72.P239244 - 29 Sep 2020

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Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, idiosyncratic, acute adverse drug reaction. Fever, morbilliform cutaneous eruption, and eosinophilia are essential features for the diagnosis of this syndrome, along with significant multisystem involvement, hepatitis being the most common, [...] Read more.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, idiosyncratic, acute adverse drug reaction. Fever, morbilliform cutaneous eruption, and eosinophilia are essential features for the diagnosis of this syndrome, along with significant multisystem involvement, hepatitis being the most common, followed by nephritis. The pathogenesis of DRESS syndrome is not yet fully understood. Several hypotheses have been proposed which support the involvement of an intricate interplay of multiple factors. We report a clinical case of DRESS syndrome with renal injury, induced by carbamazepine, in a patient with alcohol abstinence syndrome. In order to define the case, the RegiSCAR score and the Japanese Group score, used in the diagnosis of drug-induced hypersensitivity, were applied. DRESS syndrome is a potentially fatal disease, with a mortality that can reach up to 40% of cases. This condition endangers the patient's life by affecting the internal organs, mainly the liver, kidneys, heart, and lungs. Our case attempts to increase awareness among physicians about this serious disease and the importance of early diagnosis, especially since carbamazepine is a commonly used anticonvulsant drug. Full article

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Open AccessCase Report

When Myocardial Infarction Is Choosing Young Victims

by Cristina Nedelcu, Mihaela Ionescu, Paris Ionescu, Vitalie Morosanu, Gabriel Smarandache, Dumitru Cristinel Badiu, Florentina Gherghiceanu, Vlad Denis Constantin, Emanuele Maria Merlo and Daniel Niţă

J. Mind Med. Sci. 2020, 7(2), 233-238; https://doi.org/10.22543/7674.72.P233238 - 29 Sep 2020

Viewed by 27

Abstract

We present the case of a 31-year-old patient, without cardiovascular risk factors, without significant pathological or family history of cardiovascular disease, who was diagnosed with severe coronary artery disease, left main bifurcation localization, which required surgical coronary revascularization. The angiographic and intraoperative aspect [...] Read more.

We present the case of a 31-year-old patient, without cardiovascular risk factors, without significant pathological or family history of cardiovascular disease, who was diagnosed with severe coronary artery disease, left main bifurcation localization, which required surgical coronary revascularization. The angiographic and intraoperative aspect excluded the most common causes of non-atherosclerotic causes of coronary lesions. Vasculitis was another possible etiology but was also excluded based on the normal clinical examination, negative inflammation markers, lack of diffuse vascular impairment, TPHA and negative VDRL. Prolonged mental stress can lead to accelerated progression of atherosclerosis by inducing endothelial dysfunction, our patient describing a “burnout syndrome” in the last few months. The particularity of the presented case is the severe coronary artery disease in a young patient without discovering the main etiology of the advanced atherosclerotic process. Full article

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Open AccessArticle

Clinical Features, Pathology, and Surgical Management of Periocular Giant Basal Cell Carcinoma

by Oxana Madalina Grosu, Vladimir Poroch, Natalia Velenciuc and Sorinel Lunca

J. Mind Med. Sci. 2020, 7(2), 227-232; https://doi.org/10.22543/7674.72.P227232 - 29 Sep 2020

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Abstract

Objectives. Basal cell carcinomas (BCCs) are malignant tumors which rarely metastasize, are slow-growing, and extensively locally destructive. BCCs more than 5 cm in diameter are defined as giant. Most often they arise as a result of neglect, as the patient avoids, delays, or [...] Read more.

Objectives. Basal cell carcinomas (BCCs) are malignant tumors which rarely metastasize, are slow-growing, and extensively locally destructive. BCCs more than 5 cm in diameter are defined as giant. Most often they arise as a result of neglect, as the patient avoids, delays, or refuses to see a doctor. The large tumor diameter and consequently of the post-excisional defect make these lesions difficult to treat surgically with respect to selecting the surgical reconstruction technique. Method. We studied a group of 9 patients, aged 60 to 85 years, diagnosed with giant basal cell carcinomas (GBCCs) with periocular location in which surgery was indicated. Results. In all cases, complete excision with histologically clear margins was performed and for the coverage of the remaining defect various, complex, and sometimes two-stage reconstructive techniques were used. Conclusions. Giant cell carcinoma of the periocular region requires extensive and risky surgery, especially when performed on the elderly. Early referral to a doctor avoids all these risks, in all cases the pathological diagnosis was nodular BCCs. The aesthetic and functional outcomes were good to very good, and the patients reported being highly satisfied. Full article

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Open AccessArticle

The Influence of Serum Calcium and Magnesium Levels in the Radiological Evolution of Knee Osteoarthritis

by Nicoleta-Bianca Tudorachi, Iuliana Eva, Cristina Gena Dascalu, Rami AL-Hiary, Bogdan Barbieru, Mihai Paunica, Catalina Motofei and Aurelian-Corneliu Moraru

J. Mind Med. Sci. 2020, 7(2), 217-226; https://doi.org/10.22543/7674.72.P217226 - 29 Sep 2020

Viewed by 38

Abstract

Calcium and magnesium are minerals with important functions throughout the body. The deficiency has been associated with an increased risk of cardiovascular disease, diabetes, and prostate cancer, and affects the skin and teeth. Some studies have associated it with osteoarthritis. Knee osteoarthritis is [...] Read more.

Calcium and magnesium are minerals with important functions throughout the body. The deficiency has been associated with an increased risk of cardiovascular disease, diabetes, and prostate cancer, and affects the skin and teeth. Some studies have associated it with osteoarthritis. Knee osteoarthritis is a degenerative pathology with a high prevalence that affects the knee joint, and prevention is necessary in the context of the lack of understanding of pathophysiology. The role of serum calcium and magnesium levels was considered in this regard. The study included a group of 371 hospitalized patients for unilateral or bilateral knee pain, of whom 326 patients had knee osteoarthritis and were the subject of the research. The risk factors such as age, gender, body mass index, weight status, and certain anatomical changes were analyzed, including the varus and valgus alignment. The results show the inverse relationship of Ca values with the radiological classification of knee osteoarthritis and the importance of risk factors such as age, gender, and obesity for the onset and progression of the pathology. Serum Mg values were not statistically significant in this study group. Full article

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Open AccessArticle

COVID-19 Outbreak Impact on Plastic Surgery Residents from Romania

by Cristina N. Marina, Daniela E. Gheoca-Mutu, Laura Răducu, Adelaida Avino, Lăcrămioara A. Brîndușe, Corina M. Stefan, Razvan V. Scaunasu and Cristian R. Jecan

J. Mind Med. Sci. 2020, 7(2), 212-216; https://doi.org/10.22543/7674.72.P212216 - 29 Sep 2020

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Abstract

The COVID-19 outbreak triggered a global crisis with long-term effects on people’s daily lives. It has altered surgical practice and education and imposed major changes in healthcare systems and resources. In order to analyze the impact the COVID-19 pandemic has had on Romanian [...] Read more.

The COVID-19 outbreak triggered a global crisis with long-term effects on people’s daily lives. It has altered surgical practice and education and imposed major changes in healthcare systems and resources. In order to analyze the impact the COVID-19 pandemic has had on Romanian Plastic Surgery residents, we carried out an anonymous questionnaire through Google forms. Survey items addressed aspects such as how the pandemic has affected their surgical practice, their exposure to the virus, and the protective measures that have been implemented to minimize risk. Among other results, our study found that nearly 1 in 5 respondents had contact with a coronavirus patient, that most of the patients were tested at admission, mostly using RT-PCR, and that various combinations of personal protective equipment had been used. Most participants also felt that their surgical training has been negatively affected, despite attendance at online courses and webinars. Although the pandemic has brought significant changes to the daily lives of residents and to the residency training, the Plastic Surgery community has been brought closer than ever and reminded that, through unified efforts, such obstacles can be overcome. Full article

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Open AccessArticle

The Use of NDYAG Laser Combined with Pulsed Light in the Treatment of Rosacea

by Valeriu Ardeleanu, Lavinia Alexandra Moroianu, Vlad Denis Constantin, Petrisor Banu, Florin Silviu Groseanu, Ioana Paunica, Ana Maria Dascalu and Alin Laurentiu Tatu

J. Mind Med. Sci. 2020, 7(2), 206-211; https://doi.org/10.22543/7674.72.P206211 - 29 Sep 2020

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Abstract

Rosacea is a chronic inflammatory skin disease with a complex pathogenesis that mainly affects the central part of the face, with a global incidence of 5.46%. The present study was performed on a group of 68 patients with rosacea 1 and 2 subtypes, [...] Read more.

Rosacea is a chronic inflammatory skin disease with a complex pathogenesis that mainly affects the central part of the face, with a global incidence of 5.46%. The present study was performed on a group of 68 patients with rosacea 1 and 2 subtypes, patients between 34–63 years old. The treatments were performed using a Cutera Xeo laser, using 2 types of probes: NdYag 1064 nm for telangiectasias and LimeLight 520–1100 nm for diffuse facial erythema, papules, and pustules, having an 10 × 30 mm window. For patients with diffuse facial erythema, etc., the optimal number of sessions was between 3 and 6 with or without anesthetic cream, using energies between 14–19 J/cm. The average recovery time was 5 days. Registered effects included bruises, pustules, burning sensation, transient stinging, and hypopigmentation. For patients with telangiectasia, the optimal number of sessions was two, performed at an average interval of once per month/monthly. Full article

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Open AccessArticle

The Quality of Sexual Life After Vaginal Surgical Interventions

by Maria Pană, Romina-Marina Sima, Oana-Denisa Bălălău, Anca-Daniela Stănescu, Liana Pleş and Mircea-Octavian Poenaru

J. Mind Med. Sci. 2020, 7(2), 201-205; https://doi.org/10.22543/7674.72.P201205 - 29 Sep 2020

Viewed by 18

Abstract

Introduction. The malfunction of the supporting pelvic system generates signs and symptoms that require various procedures. The aim of our study was to evaluate whether vaginal surgical interventions for genital prolapse or urinary incontinence have an impact on patients’ sexual quality of [...] Read more.

Introduction. The malfunction of the supporting pelvic system generates signs and symptoms that require various procedures. The aim of our study was to evaluate whether vaginal surgical interventions for genital prolapse or urinary incontinence have an impact on patients’ sexual quality of life. Materials and methods. We studied 40 eligible women who underwent vaginal surgical procedures in Saint John Hospital, Bucharest. Patients completed a questionnaire 6 months after the intervention. Results. Patients who underwent vaginal surgery for prolapse were 50–64 years of age. The most frequent vaginal surgical intervention was vaginal hysterectomy (32.5%), followed by anterior and posterior colporaphy (17.5%), and direct cystopexy (15.0%). Regarding their sexual life, 42.5% patients described improvement in sexual life, 22.5% described decreased libido after surgery, and 35% indicated no significant improvement. 57.5% of women indicated that they had no sexual discomfort (57.5%), whereas 27.5% had dyspareunia and 15% had dysuria. There was no negative impact on patients’ male partner quality of sexual intercourse after intervention. Conclusions. Vaginal surgical interventions for genital prolapse or urinary incontinence do not appear to lead to significant alteration of quality of sexual life in women. Full article

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Open AccessArticle

Study on the Formulation and Characterization of a Photoprotective Cream Containing a New Synthetized Compound

by Teodora Dalila Balaci, Emma Adriana Ozon, Daniela Luiza Baconi, Georgiana Nițulescu, Bruno Velescu, Cristian Bălălău, Ioana Păunică and Cătălina Ancuța Fița

J. Mind Med. Sci. 2020, 7(2), 193-200; https://doi.org/10.22543/7674.72.P193200 - 29 Sep 2020

Cited by 1 | Viewed by 25

Abstract

Starting from a new organic sunscreen synthesized in our laboratory by the condensation of sodium salt of the p-aminosalicylic acid with 2,6–dichloroacetanilide, efficient cosmetic formulation with broad photoprotective properties was obtained by using the new compound as organic UV filter, metal oxides as [...] Read more.

Starting from a new organic sunscreen synthesized in our laboratory by the condensation of sodium salt of the p-aminosalicylic acid with 2,6–dichloroacetanilide, efficient cosmetic formulation with broad photoprotective properties was obtained by using the new compound as organic UV filter, metal oxides as inorganic filters, and vegetable extracts, oils and other ingredients with emollient, protective, and moisturizing effect. After showing the lack of toxicity of the new compound, in order to reduce the amount of UV filter used, it was encapsulated into nanostructured lipid carriers (NLCs). The final cream has demonstrated good qualities for skin application, possessing suitable physicochemical characteristics (pH, viscosity) and spreadability. The SPF value of the product is 16, a value considered to be satisfactory. Full article

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Open AccessArticle

Work Place Impact on Mental Wellbeing of Frontline Doctors

by Vishnupriya Veeraraghavan and Krishnan Srinivasan

J. Mind Med. Sci. 2020, 7(2), 188-192; https://doi.org/10.22543/7674.72.P188192 - 29 Sep 2020

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Abstract

Background. Coronavirus Disease 2019 (COVID-19, also known as 2019-nCoV), a cluster of acute respiratory illness with unknown causes, has occurred in India since January 2020. Over the past several months, the entire world is struggling to cope with and contain the virus [...] Read more.

Background. Coronavirus Disease 2019 (COVID-19, also known as 2019-nCoV), a cluster of acute respiratory illness with unknown causes, has occurred in India since January 2020. Over the past several months, the entire world is struggling to cope with and contain the virus spread. Several studies showed that mental health problems could occur in both healthcare workers and SARS survivors during the SARS epidemic. Considering the geographical variation, dense population, multi-strata health care structure, and rising COVID cases in South India, we have a reason to speculate that the burden on the frontline doctors is high and their psychological condition may also be affected during COVID-19 outbreak. Aims. The aim of the study is to estimate the anxiety and depression among front line doctors during COVID-19 duty in south India and also the impact of the various strata of health care on the depression and anxiety scores. Methods. An online form was created which included personal details of COVID-19 duty, Beck’s anxiety and depression questionnaire. Results. Severity of anxiety and depression scores was significantly higher among front line doctors working in primary health centers when compared to medical college and private hospital doctors (p < 0.002). Conclusion. Our study verified the results from previous reports that anxiety and depression are high among doctors posted in COVID duties, but also that they remain largely unaddressed. We provide new findings regarding the nature of work place and the mental health issues. Full article

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Open AccessArticle

Indicators of Psychological Distress and Body Image Disorders in Female Patients with Breast Cancer

by Helena van Oers and Lourens Schlebusch

J. Mind Med. Sci. 2020, 7(2), 179-187; https://doi.org/10.22543/7674.72.P179187 - 29 Sep 2020

Cited by 3 | Viewed by 42

Abstract

Breast cancer patients are vulnerable to elevated stress related to receiving the diagnosis, unfamiliar and invasive treatment, and coping with the side-effects of treatment, which may find various forms of expression. Another common feature of this patient population is body image dysphoria. Both [...] Read more.

Breast cancer patients are vulnerable to elevated stress related to receiving the diagnosis, unfamiliar and invasive treatment, and coping with the side-effects of treatment, which may find various forms of expression. Another common feature of this patient population is body image dysphoria. Both the disease and treatment lead to impairments in physical appearance and general bodily functioning. This study aimed to explore the differential manifestations of stress and the nature of body image dysphoria within a sample of female breast cancer patients (n = 80), compared to female patients with other sites of disease (n = 80) in order to examine differences in the experiences of distress in these groups. Patients completed 4 questionnaires relating to psychological distress and body image dysphoria. The results showed the breast patients reported significantly higher levels of body image dysphoria and reflected differential indicators of stress, namely more psychological and behavioral expression, as compared to the other group. Full article

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Open AccessArticle

Assessing Test Anxiety and Resilience Among Greek Adolescents During COVID-19 Pandemic

by Sofia Sakka, Vasiliki Aliki Nikopoulou, Eleni Bonti, Paraskevi Tatsiopoulou, Panayiota Karamouzi, Aikaterini Giazkoulidou, Virginia Tsipropoulou, Eleni Parlapani, Vasiliki Holeva and Ioannis Diakogiannis

J. Mind Med. Sci. 2020, 7(2), 173-178; https://doi.org/10.22543/7674.72.P173178 - 29 Sep 2020

Cited by 16 | Viewed by 29

Abstract

The aim of the present study was to explore the impact of school year’s extension due to the coronavirus pandemic (COVID-19) by addressing test anxiety and by studying the coping strategies adolescents used to overcome it. For the majority of the adolescents the [...] Read more.

The aim of the present study was to explore the impact of school year’s extension due to the coronavirus pandemic (COVID-19) by addressing test anxiety and by studying the coping strategies adolescents used to overcome it. For the majority of the adolescents the final exams can be a powerful source of stress, since the entrance examinations are required for admission into higher education and further reflect the transition to adulthood. The sample consisted of 67 High School students and the data collection was conducted online due to the imposed measures by the Greek government. Results showed normal or average levels of test anxiety with low self-esteem and fear of a family member contracting the virus identified as significant predictors. Students who participated in the research pointed teachers as the main source of pressure in school exams. Gender differences regarding social media engagement and online video gaming were also detected. Resilience was equally as high among genders [t(63) = 858, p = 0.324] and the correlation between test anxiety and resilience did not produce a statistically significant result (r = −0.178, p = 0.155). Full article

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Open AccessReview

Intestinal Microbiota—A Possible Contributor to Cardiovascular Diseases?

by Roua Iorga, Ovidiu Gabriel Bratu, Nicolae Bacalbasa, Mihnea-Alexandru Gaman and Camelia Cristina Diaconu

J. Mind Med. Sci. 2020, 7(2), 168-172; https://doi.org/10.22543/7674.72.P168172 - 29 Sep 2020

Cited by 1 | Viewed by 25

Abstract

The intestinal microbiota represents an interesting and emergent field of research, with already known implications in metabolic and immunological functions. Recently, there is increasing evidence that specific gut microbial populations are associated with cardiovascular diseases. Numerous completed and ongoing studies aim to evaluate [...] Read more.

The intestinal microbiota represents an interesting and emergent field of research, with already known implications in metabolic and immunological functions. Recently, there is increasing evidence that specific gut microbial populations are associated with cardiovascular diseases. Numerous completed and ongoing studies aim to evaluate the potential of intestinal microbiota assessment to improve the prevention, diagnosis, and therapeutic arsenal of cardiovascular diseases, considering dysbiosis as a cardiovascular risk factor. There is strong evidence for a correlation between intestinal flora imbalance and metabolic changes secondary to bacterial metabolites. In this minireview, we discuss recent data about the connections between intestinal microbiota and cardiovascular disease. Full article

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Open AccessReview

Composition and Modification of the Lung Microbiome in Patients with Idiopathic Pulmonary Fibrosis

by Victoria Maria Ruta, Teodora Gabriela Alexescu, Ana Rodica Ungur, Milena Adina Man, Victoria Georgiana Sfirlea, Iulia Olimpia Pfingstgraf, Nicoleta Motoc and Carmen Monica Pop

J. Mind Med. Sci. 2020, 7(2), 162-167; https://doi.org/10.22543/7674.72.P162167 - 29 Sep 2020

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Abstract

Lungs have long been considered sterile, but recent research has shown that a large number of microbiological organisms exist in the lungs of healthy subjects (including bacteria, fungi, and viruses), collectively known as the microbiome. It undergoes changes in patients with respiratory pathology. [...] Read more.

Lungs have long been considered sterile, but recent research has shown that a large number of microbiological organisms exist in the lungs of healthy subjects (including bacteria, fungi, and viruses), collectively known as the microbiome. It undergoes changes in patients with respiratory pathology. Studies in idiopathic pulmonary fibrosis show that a large number of bacteria or the abundant presence of potentially pathogenic bacteria can cause disease progression and exacerbation, and can implicitly increase mortality. There seems to be a quantitative balance, a well-established proportion between the components of this microbiome, which is disturbed during a disease and can reach a “state of pulmonary dysbiosis”. Evidence suggests that the microbiome may be used as a prognostic biomarker and may also explain the pathogenesis of interstitial fibrosis. Full article

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Open AccessReview

Hepatitis C Virus: Host, Environmental and Viral Factors Promoting Spontaneous Clearance

by Sergiu Ioan Micu, Marilena Musat, Andrada Dumitru, Dan Nicolae Paduraru, Anca Rogoveanu, Anca Dumitriu, Stana Paunica, Cristian Balalau and Roxana Emanuela Popoiag

J. Mind Med. Sci. 2020, 7(2), 156-161; https://doi.org/10.22543/7674.72.P156161 - 29 Sep 2020

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Abstract

Hepatitis C virus (HCV) is a pathogenic entity which determines inflammation and liver damage through complex immune mechanisms. Although progress has been made in managing the disease course, chronic infection still remains a significant cause of morbidity and mortality to this day. Because [...] Read more.

Hepatitis C virus (HCV) is a pathogenic entity which determines inflammation and liver damage through complex immune mechanisms. Although progress has been made in managing the disease course, chronic infection still remains a significant cause of morbidity and mortality to this day. Because both acute and chronic infection are often asymptomatic, chronic infection is frequently diagnosed when its complications have developed. In a small proportion of cases, the chronic infection does not develop, the immune system managing to cleanse the body from this silent pathogen in the absence of specific treatment, a process called spontaneous viral clearance, which occurs rarely, in about 20–30% of cases. A competent immune response that manages to eliminate the virus from the organism was associated with IL-28B genetic polymorphism, female gender, young age, which often lead to clinical manifestations of acute hepatitis after initial exposure. Environmental factors such as limited viral exposure also play an important role. These factors and the mechanisms underlying spontaneous clearance are not fully understood but their action is complementary. In this paper, we review the concept of spontaneous clearance of HCV and assess the factors that have been associated with this clinical outcome of the infection. Full article

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Open AccessReview

Diagnosis and Management of Pericardial Effusion

by Maria Manea, Ovidiu Gabriel Bratu, Nicolae Bacalbasa and Camelia Cristina Diaconu

J. Mind Med. Sci. 2020, 7(2), 148-155; https://doi.org/10.22543/7674.72.P148155 - 29 Sep 2020

Cited by 1 | Viewed by 20

Abstract

Pericardial effusion is a common pathology in clinical practice. The etiology of pericardial effusion is diverse, from infectious diseases, malignancies, autoimmune diseases, chronic renal failure, to drug-related or after an invasive cardiac intervention. Clinical presentation of pericardial effusion is variable, depending on the [...] Read more.

Pericardial effusion is a common pathology in clinical practice. The etiology of pericardial effusion is diverse, from infectious diseases, malignancies, autoimmune diseases, chronic renal failure, to drug-related or after an invasive cardiac intervention. Clinical presentation of pericardial effusion is variable, depending on the volume of the fluid and the rate of accumulation. Clinical manifestations are dramatic if the pericardial fluid accumulates rapidly. Classical symptoms in pericardial effusion include pleuritic chest pain associated with dyspnea. In case of cardiac tamponade, orthopnea, jugular venous distension, pulsus paradoxus, hypotension, and shock appear. Transthoracic echocardiography is the gold standard investigation for the diagnosis of pericardial effusions. The echocardiographic signs of cardiac tamponade are represented by the collapse of the right atrium and right ventricle, respiratory alteration of mitral and tricuspid flow, and changes of the inferior vena cava. Management of pericardial effusion is guided by several factors, including hemodynamic impact and etiology. Pericardiocentesis guided by echocardiography is a life-saving procedure in cases of large pericardial effusions and cardiac tamponade. This is a review of the diagnosis and treatment of pericardial effusion. Full article

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Open AccessReview

Oral Pathology Induced by Excess or Deficiency of Glucocorticoids in Adults

by Rucsandra Elena Dănciulescu Miulescu, Loreta Guja, Bogdan Socea, Anca Dumitriu, Stana Paunica and Emil Ștefănescu

J. Mind Med. Sci. 2020, 7(2), 141-147; https://doi.org/10.22543/7674.72.P141147 - 29 Sep 2020

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Abstract

Oral manifestations are present both in Cushing's syndrome and in adrenal insufficiency. Possible oro-dental pathology in patients with Cushing's syndrome include jawbone loss, tooth loss, and periodontal diseases. Professional societies did not include Cushing's syndrome as being part of systemic diseases associated with [...] Read more.

Oral manifestations are present both in Cushing's syndrome and in adrenal insufficiency. Possible oro-dental pathology in patients with Cushing's syndrome include jawbone loss, tooth loss, and periodontal diseases. Professional societies did not include Cushing's syndrome as being part of systemic diseases associated with loss of periodontal supporting tissues. The comorbidities of Cushing's syndrome such as obesity, osteoporosis, and diabetes are conditions that influence periodontal attachment apparatus. In patients with adrenal primary insufficiency, the most specific sign is the melanic pigmentation of the skin and mucosal surfaces due to increments of corticotropin and pro-opiomelanocortin peptide levels that occur as a result of decreased cortisol feedback. The oral mucosa develops black plaques that can also be present on the gums, palate, tongue, and lips. The pallor may occur in patients with adrenocortical insufficiency secondary to corticotropin deficiency. Patients with primary adrenal insufficiency need to increase their glucocorticoid doses during physical activity, intercurrent illnesses, surgery, and medical procedures. Current evidence indicates that routine, nonsurgical, or minor surgical procedures do not need supplemental glucocorticoids in diagnosed patients who are in a stable condition. However, for major oral surgery, glucocorticoid supplementation is necessary for the surgery day and for at least one postoperative day. Full article

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Mental Health & Drugs; A Map of the Mind

by Wylie Jones Jordan

J. Mind Med. Sci. 2020, 7(2), 133-140; https://doi.org/10.22543/7674.72.P133140 - 29 Sep 2020

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Abstract

The practice of physical medicine underwent a sea change at the turn of the 20th century, but the management of mental disorders stayed much the same as it had been since Rome. New names have been coined for disorders, and synthetic drugs are [...] Read more.

The practice of physical medicine underwent a sea change at the turn of the 20th century, but the management of mental disorders stayed much the same as it had been since Rome. New names have been coined for disorders, and synthetic drugs are advertised as a solution to every problem, but the causes are still largely unknown and, although spontaneous remission can occur, there are no cures. This review of psychiatric diagnosis and treatment from Rome to the 21st century offers a rationale to support the classic (and still current) classification of disorders. It offers a method of distinguishing the major kinds of disorders and suggests when the prescription of psychoactive drugs may—or may not—be appropriate. Full article

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J. Mind Med. Sci., Volume 7, Issue 2 (September 2020) – 21 articles

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