Journal of Mind and Medical Sciences

1 pages, 156 KiB

Open AccessEditorial

Publisher’s Note: Welcoming the Journal of Mind and Medical Sciences to the MDPI Family

by Carla Aloè

J. Mind Med. Sci. 2025, 12(1), 1; https://doi.org/10.3390/jmms12010001 - 3 Jan 2025

We are happy to welcome the Journal of Mind and Medical Sciences (JMMS) to our portfolio of publications [...] Full article

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Open AccessArticle

Approaches and Indications in Laparoscopic Choledoscopy

by Iulian Slavu, Raluca Tulin, Ileana Dima, Alexandru Dogaru, Florin Filipoiu, Bogdan Socea, Anca Monica Oprescu-Macovei and Adrian Tulin

J. Mind Med. Sci. 2024, 11(2), 482-487; https://doi.org/10.22543/2392-7674.1563 - 31 Oct 2024

Abstract

Objectives. Up to 20% of patients with biliary lithiasis have bile duct stones, which are asymptomatic in 50% of cases. The aim of the study was to evaluate the role of choledoscopy in extracting stones from the main bile ducts. Materials and [...] Read more.

Objectives. Up to 20% of patients with biliary lithiasis have bile duct stones, which are asymptomatic in 50% of cases. The aim of the study was to evaluate the role of choledoscopy in extracting stones from the main bile ducts. Materials and Methods. This is a retrospective study (January 2014–December 2024) on 2309 patients who underwent a laparoscopic cholecystectomy. Laparoscopic choledoscopy was performed in 32 cases. Of the 32 patients with complete clearance, none had residual common bile duct stones (CBDS) at 1 year postoperatively. Results. The ideal approach in our study was the transcystic approach, with the shortest hospital stays (mean 3 days) transcholedochal approach; it was only feasible in 7 patients. All patients had transcystic drainage that was removed after 10 days (mean operative time 105 min). The transcholedochal approach was demanding from a technical point of view. Primary ductal closure was performed in 5 patients. Ductal closure with transcystic drain was in 9 patients. A total of 14 patients had a T-tube and a longer operative time (on average 170 min). Conversion to open surgery was performed in 4 cases, due to difficult dissection at the level of the hepatic porta. Conclusions. LCBDE for previously documented or discovered CBDS during LC is a safe and feasible procedure. The technique is technically demanding, and requires advanced laparoscopic skills. Patient selection is very important, but the transcystic approach for LCBDE when possible is optimal. Full article

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Open AccessArticle

Effects of the COVID-19 Pandemic on Clinical Manifestations and Therapeutic Outcomes in Acute Endophthalmitis

by Ana Maria Dascalu, Sanda Jurja, Carmen Luminita Mocanu, Cristina Alexandrescu, Daniela Stana, Madalina Totir, Ece Ergin, Corneliu Tudor, Catalin Cicerone Grigorescu, Dragos Serban, Laurentiu Simion, Dan Dumitrescu, Andrei Marin, Catalin Teodor Constantinescu and Bogdan Mihai Cristea

J. Mind Med. Sci. 2024, 11(2), 475-481; https://doi.org/10.22543/2392-7674.1554 - 31 Oct 2024

Abstract

Endophthalmitis incidence and clinical characteristics was reported to change during COVID-19 pandemic, due to multiple influencing factors, such as prolonged lockdown periods, persistent immune suppression following SARS-CoV-2 infection, and mask wearing. We conducted a retrospective eight-year study, during January 2016 and December 2023, [...] Read more.

Endophthalmitis incidence and clinical characteristics was reported to change during COVID-19 pandemic, due to multiple influencing factors, such as prolonged lockdown periods, persistent immune suppression following SARS-CoV-2 infection, and mask wearing. We conducted a retrospective eight-year study, during January 2016 and December 2023, that aims to investigates the differences in terms of etiology, clinical characteristics and outcomes in cases with acute endophthalmitis, admitted before (2016–2019) and during COVID-19 pandemic (2020–2023). The two study subgroups were homogenous in term of age, gender distribution, associated comorbidities, and addressability. During COVID-19 pandemic there were significant delays in presentation (p = 0.02), more cases of endogenous endophthalmitis (p = 0.025), and patients presented a more intense systemic inflammatory reaction (p < 0.01). Moreover, undiagnosed cases of diabetes were more frequent in pandemic group, and were associated with endogenous endophthalmitis (59.3% vs. 16.6%, p < 0.001). The were differences in etiology between the two subgroups, the first cases of hypervirulent Klebsiella pneumoniae endogenous endophthalmitis reported in our center. The outcomes were comparable in terms of hospital stay and rate of evisceration. However, the visual function was worse in the pandemic group, which may be correlated with the specific differences in etiology and delayed presentation. Early diagnosis and prompt initiation of large spectrum antibiotherapy are essential to preserve vision. Full article

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Open AccessArticle

Infertility as a Possible Multifactorial Condition; The Experience of a Single Center

by Cristina Diana Popescu, Bashar Haj Hamoud, Romina Marina Sima, Anca Bobirca, Oana Denisa Balalau, Mihaela Amza, Romeo Micu, Gabriel Petre Gorecki and Liana Ples

J. Mind Med. Sci. 2024, 11(2), 466-474; https://doi.org/10.22543/2392-7674.1535 - 31 Oct 2024

Abstract

Objectives. Infertility is a topic of great interest around the world because it affects many couples at young ages. It can be caused by genetic background, associated with pathologies and/or external factors. The purpose of our study was to identify the causes [...] Read more.

Objectives. Infertility is a topic of great interest around the world because it affects many couples at young ages. It can be caused by genetic background, associated with pathologies and/or external factors. The purpose of our study was to identify the causes of infertility of women presented in our clinic with this pathology. Materials and Methods. This retrospective study was performed on women with primary or secondary infertility. The analyzed data were age, weight, hereditary and personal pathological history, medication, menstrual cycle characteristics, standard blood tests, ultrasound, hysterosalpingography and hysteroscopy. Results. The study included 204 women with average age 35 years. The main diagnosis was primary infertility in 68.63% and secondary infertility in 31.37% cases. One of the most common diagnosed findings in ultrasound were uterine fibroids with an incidence of 6.86%, the incidence being higher among women with primary infertility than in women with secondary infertility. Regarding endometrial polyps, 96.15% of cases were observed ultrasonographical and the incidence of endometrial polyps was higher among women with primary infertility than in women with secondary infertility. Conclusions. This study identified that infertility is a multifactorial pathology, which requires multidisciplinary addressability. Gynecological pathology (such as tubal pathologies, uterine malformations, uterine fibroids, endometriosis, endometrial polyps, etc.) was very common among these patients, finding and treating the condition being the main objective of the study. Full article

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Open AccessArticle

Assessment of the Bioaccumulation of Nicotine and Cotinine by the Crustacean Daphnia magna

by Ana Maria Vlasceanu, Daniela Luiza Baconi, Octavian Tudorel Olaru, Daniela Grădinaru and Viorela Gabriela Nitescu

J. Mind Med. Sci. 2024, 11(2), 459-465; https://doi.org/10.22543/2392-7674.1540 - 31 Oct 2024

Abstract

Objectives. This study aimed to investigate the toxicity of nicotine and its metabolite cotinine on crustacean D. magna, and evaluate the quantity of compounds accumulated by D. magna. Materials and Methods. The bioassays involved the exposure of D. magna to varying [...] Read more.

Objectives. This study aimed to investigate the toxicity of nicotine and its metabolite cotinine on crustacean D. magna, and evaluate the quantity of compounds accumulated by D. magna. Materials and Methods. The bioassays involved the exposure of D. magna to varying doses of nicotine and cotinine, for 24 h and 48 h. The amount of bioaccumulated nicotine and cotinine was determined by an HPLC-DAD method. Results. The study has revealed that nicotine is more toxic than cotinine on D. magna, as the medium lethal concentration (LC50) values were higher for nicotine compared to cotinine. After 24 h of exposure, D. magna accumulated comparable amounts of nicotine and cotinine. However, after 48 h of exposure, the crustacean accumulated significantly lower levels of nicotine, which is consistent with the higher toxicity of nicotine compared to cotinine. Conclusions. These findings demonstrated that nicotine triggers various alterations in aquatic organism, hence jeopardizing the equilibrium of the aquatic ecosystem within a little timeframe. Full article

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Open AccessArticle

Evaluation of Short-Term Complications in Laparoscopic Peritoneal Dialysis Catheter Placement—A Single Tertiary Center Experience

by Cristina Raluca Iorga, Iuliana Andreiana, Simona Hildegrad Stancu, Traian Constantin, Victor Strambu and Cristian Iorga

J. Mind Med. Sci. 2024, 11(2), 452-458; https://doi.org/10.22543/2392-7674.1547 - 31 Oct 2024

Abstract

Background. Peritoneal dialysis is a form of kidney function replacement that is not as widespread as hemodialysis. However, it has recognized advantages, such as preservation of residual renal function, lack of vascular access, and the ability to be performed at home. On [...] Read more.

Background. Peritoneal dialysis is a form of kidney function replacement that is not as widespread as hemodialysis. However, it has recognized advantages, such as preservation of residual renal function, lack of vascular access, and the ability to be performed at home. On the other hand, it requires the correct insertion of a peritoneal dialysis (PD) catheter and maintaining its patency. Methods. We conducted a retrospective study of 126 patients with end-stage renal disease who underwent laparoscopic Tenckhoff catheter placement for peritoneal dialysis between January 2016 and December 2022. The study analyzed the frequency and type of complications registered within three months, in order to validate laparoscopy as a safe method of catheter insertion (with reduced periprocedural complications), as well as the importance of the multidisciplinary team in the care of patients with peritoneal dialysis. Results. In about 14% of patients, we encountered a total of 23 complications: 61% in the first month, 34.7% in the second month, and 4.3% in the third month. The most frequent complication was infection (peritonitis 35%, catheter exit site infection 30.4%), followed by peri-catheter leak (21.7% of total complications). Catheter migration, hernia, and significant bleeding were rare events (4.3% of total complications each). All complications were managed by medical treatment, except two cases which required replacement of the catheter. Conclusions. Laparoscopic catheter insertion is a safe procedure with low post-procedural complications in patients who are dependent on peritoneal dialysis. Full article

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Open AccessArticle

Biological Effect of Modern Bioactive Materials Used in Direct and Indirect Capping; In Vitro Study

by Irina Maria Gheorghiu, Alexandru Andrei Iliescu, George Alexandru Denis Popescu, Stana Paunica and Anca Silvia Dumitriu

J. Mind Med. Sci. 2024, 11(2), 444-451; https://doi.org/10.22543/2392-7674.1544 - 31 Oct 2024

Abstract

Objective. In this study, the biological effect of MTA Repair HP (Mineral Trioxide Aggregate Repair High Plasticity) and Biodentine have been tested on a stabilized fibroblast cell line NCTC clone 929. Materials and Methods. We assessed quantitative and qualitative parameters related [...] Read more.

Objective. In this study, the biological effect of MTA Repair HP (Mineral Trioxide Aggregate Repair High Plasticity) and Biodentine have been tested on a stabilized fibroblast cell line NCTC clone 929. Materials and Methods. We assessed quantitative and qualitative parameters related to cytotoxic effect of the investigated products. The experimental period was 96 hours. Statistical analysis was performed with Kruskal-Wallis and Wilcoxon tests. Results. The detached cells test showed no statistically significant difference on cell culture for Biodentine and MTA Repair HP, while for the cellular density assay we found the same biological effect on the tested fibroblasts in the first 24 and 48 h, but a significant different cellular response for the investigated pulp capping materials for the next 48 h of the experiment. Conclusions. The results demonstrated that the materials presented a very low level of cytotoxicity. Biodentine showed in all parameters better biological effects than MTA Repair HP, expressed by lower and limited cellular damage and a higher cell density. Full article

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Open AccessArticle

Challenges in Diagnosing Nasopharyngeal Tumors

by Alexandru Aristide Alexe, Mihai Victor Lupascu, Haldun Septar, Anca Pantea Stoian, Andra Iulia Suceveanu, Viorel Gherghina, Iuliana Cindea, Alina Doina Nicoara, Laura Mazilu, Razvan Hainarosie, Felix Voinea and Adrian Paul Suceveanu

J. Mind Med. Sci. 2024, 11(2), 437-443; https://doi.org/10.22543/2392-7674.1548 - 31 Oct 2024

Abstract

Malignant nasopharyngeal tumors account for approximately 4% of ENT malignant tumor pathology and 1% of all cancers. The diagnosis of nasopharyngeal tumors is often late, the reason being the location in a silent anatomical region in terms of symptomatology and accessibility. Thus, approximately [...] Read more.

Malignant nasopharyngeal tumors account for approximately 4% of ENT malignant tumor pathology and 1% of all cancers. The diagnosis of nasopharyngeal tumors is often late, the reason being the location in a silent anatomical region in terms of symptomatology and accessibility. Thus, approximately 70% of newly diagnosed patients with nasopharyngeal carcinoma unfortunately present with the condition in an advanced local stage. The early signs and symptoms are varied (nasal obstruction, hearing loss, otalgia, headache) and are usually ignored by the patient and even by the doctor in the initial stage of nasopharyngeal tumor evolution. Approximately 5% of patients have systemic metastases at presentation, the most common location being bone. Latent Epstein-Barr virus infection appears to be involved in the pathogenesis of nasopharyngeal carcinoma. There is no exact evidence of how often a nasopharynx tumor’s first sign is unilateral hearing loss. Thus, further work is required to determine that exactly to help patients get diagnosed faster and therefore improving their therapeutical options. This study aims to explore which symptoms are most common as the first indication of NPC, as well as how these symptoms compare to each other in terms of frequency and likelihood of occurrence. Full article

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Open AccessArticle

Assessment of Psycho-Emotional Symptoms in Cancer Patients in an Oncology-Palliative Care Department from Romania

by Roxana Andreea Rahnea-Nita, Laura Florentina Rebegea, Elena Gabriela Valcu, Mihaela Dumitru, Radu Valeriu Toma, Mihai Georgescu, Georgia Luiza Serbanescu, Maria Alexandra Barbu, Georgiana Bianca Constantin and Gabriela Rahnea-Nita

J. Mind Med. Sci. 2024, 11(2), 428-436; https://doi.org/10.22543/2392-7674.1524 - 31 Oct 2024

Abstract

Introduction. Anxiety and depression have an increased prevalence in cancer patients, especially in those in an advanced stage of the disease. These disorders have a major impact on the social life, existential concerns and quality of life of cancer patients. Materials and [...] Read more.

Introduction. Anxiety and depression have an increased prevalence in cancer patients, especially in those in an advanced stage of the disease. These disorders have a major impact on the social life, existential concerns and quality of life of cancer patients. Materials and Methods. A number of 114 consecutive patients were included in the study (in a period of 2 weeks) who were screened for anxiety, depression and for other common symptoms, using Hospital Anxiety and Depression Scale (HADS) and Edmonton Symptom Assessment System (ESAS). Results. Regarding the age—the abnormal level of anxiety and depression: the percentage of patients over 65 years was higher than the percentage of patients under 64 years, both in terms of anxiety and depression. Regarding the Performance status ECOG—abnormal level of anxiety and depression: the percentage of patients with ECOG = 3–4 is higher than that of patients with ECOG = 0–2. Results. The increased prevalence of anxiety and depression requires psychological counseling and treatment. It is important for these symptoms to be identified as soon as possible, in order to provide a good quality of life. Conclusions. The model we propose is for the HADS to be a screening tool on admission to a palliative care ward, for certain categories of patients. Full article

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Open AccessArticle

Relationship Between Serum Estradiol Level, Ultrasound Follicle Count, Number of Oocytes Retrieved and Their Influence on IVF/ICSI Treatment Outcomes: A Retrospective Cross-Sectional Study

by Bashar Haj Hamoud, Gilda Schmidt, Chiara Hipp, Meletios Pantelis Nigdelis, Romina Marina Sima, Liana Ples, Oana Denisa Balalau, Simona Lucia Baus, Georg Peter Breitbach, Gudrun Wagenpfeil, Erich Franz Solomayer, Tim Schmidt and Sebastian Findeklee

J. Mind Med. Sci. 2024, 11(2), 420-427; https://doi.org/10.22543/2392-7674.1536 - 31 Oct 2024

Abstract

This retrospective cross-sectional study investigates determinants on follicular development, oocyte retrieval and pregnancy outcome. It assessed the clinical practicability of monitoring parameters in relation to predict a successful treatment. Analysis of serum-estradiol (E2), sonographic follicle count, number of oocytes and optimizable parameters have [...] Read more.

This retrospective cross-sectional study investigates determinants on follicular development, oocyte retrieval and pregnancy outcome. It assessed the clinical practicability of monitoring parameters in relation to predict a successful treatment. Analysis of serum-estradiol (E2), sonographic follicle count, number of oocytes and optimizable parameters have therefore been carried out based on patient files from the IVF outpatient clinic at the Department of Gynecology, Obstetrics and Reproductive Medicine, Homburg/Saar, Germany. Equidirectional connection occurred between serum-E2, sonographic follicle count and number of oocytes (p < 0.001). There was no significant difference between sonographic and punctured follicle count (p = 0.428), but between sonographic/punctured follicle count and number of oocytes obtained (p < 0.01). Increasing endometrial thickness was associated with increasing serum-E2 (p = 0.003) and number of oocytes (p < 0.001), but not with the follicle count (p > 0.05). Additionally, age was inversely associated with sonographic follicle count and number of oocytes (p < 0.001) but not with E2 (p > 0.05). BMI, nicotine and stimulation protocol had no association with the observed parameters (p > 0.05). Mean differences in follicle numbers can be used for predicting expectable numbers of oocytes. Due to comparable numbers of follicles visualized on the day of ovulation induction and the number of follicles punctured, more emphasis should be placed in optimizing oocyte retrieval procedures. Full article

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Open AccessArticle

Gastrointestinal Stromal Tumors: A Focus on the Impact of Interstitial Cells of Cajal in Disease Development

by Petru Radu, Mihai Zurzu, Anca Tigora, Vlad Paic, Mircea Bratucu, Dragos Garofil, Valeriu Surlin, Stefan Patrascu, Virgiliu Prunoiu, Ionut Simion Coman, Valentin Georgescu, Razvan Daniel Chivu, Florian Popa, Victor Strambu and Raluca Gabriela Ioan

J. Mind Med. Sci. 2024, 11(2), 412-419; https://doi.org/10.22543/2392-7674.1537 - 31 Oct 2024

Abstract

Introduction. Interstitial Cells of Cajal (ICCs) play a critical role in the regulation of gastrointestinal motility and have been implicated in various functional gastrointestinal disorders. Recent research indicates a possible association between ICCs and the tumor risk of Gastrointestinal Stromal Tumors (GISTs). [...] Read more.

Introduction. Interstitial Cells of Cajal (ICCs) play a critical role in the regulation of gastrointestinal motility and have been implicated in various functional gastrointestinal disorders. Recent research indicates a possible association between ICCs and the tumor risk of Gastrointestinal Stromal Tumors (GISTs). This research aims to examine the clinical, histopathological, and biomolecular characteristics of ICCs and their relevance in assessing GIST risk. Materials and Methods. This study examined fourteen GIST patients who underwent surgical intervention at the Surgery Department of Carol Davila Nephrology Hospital in Bucharest. Parameters including age, gender, tumor location/ dimensions were scrutinized. Immunohistochemistry employing markers CD117, DOG-1, and CD34 was employed to ascertain the presence of ICCs and GISTs. Results. The GIST risk stratification revealed distribution with 35.71% very low-risk, 21.42% low-risk, 14.28% intermediate-risk, and 28.57% high-risk categories. Predominantly, 57.14% of cases fell within the very low-risk and low-risk categories. Positive immunoreactivity for CD117 and DOG-1 was noted in 92.86% of patients, while CD34 exhibited positivity in 85.71% of cases. Gastric GISTs manifested heightened marker expression. Notably, immunohistochemistry unveiled robust positivity for CD117, DOG-1, and CD34, illustrating a positive correlation between elevated ICC levels and high-risk GISTs. Conclusions. The findings propose an association between ICC levels and high-risk GISTs, accentuating the diagnostic utility of CD117, DOG-1, and CD34 markers in GIST assessment. Full article

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Open AccessArticle

Socio-Economic Disparities in Prenatal Prognosis and Intervention Accessibility

by Simona Raluca Iacoban, Madalina Piron-Dumitrascu, Camil Laurentiu Bohiltea, Ioan Dumitru Suciu, Silviu Cristian Voinea and Nicolae Suciu

J. Mind Med. Sci. 2024, 11(2), 402-411; https://doi.org/10.22543/2392-7674.1541 - 31 Oct 2024

Abstract

Objectives. This study aimed to assess the impact of socio-economic factors on prenatal care accessibility and outcomes and to evaluate the effectiveness of specialized integrative prenatal care in mitigating these disparities. Materials and Methods. A prospective cohort study was conducted between [...] Read more.

Objectives. This study aimed to assess the impact of socio-economic factors on prenatal care accessibility and outcomes and to evaluate the effectiveness of specialized integrative prenatal care in mitigating these disparities. Materials and Methods. A prospective cohort study was conducted between 2020 and 2023 in Bucharest, Romania, involving 100 pregnant women. Participants were equally divided into two groups that received standard and specialized prenatal care. Data were collected through structured interviews, medical record reviews, and standardized questionnaires at multiple time points during pregnancy and postpartum. Results. Women receiving integrative care had longer gestation periods (37.8 vs. 37.6 weeks), higher average birth weights (3.3 kg vs. 3.14 kg), and fewer complications during labor (10% vs. 12.5%) compared to the standard care group. Socio-economic status significantly influenced outcomes, with lower income and education levels associated with shorter gestation periods and lower birth weights. Stronger support systems correlated with better mental health and improved pregnancy outcomes. Conclusions. Integrative prenatal care, which addresses both medical and psychosocial needs, significantly improves pregnancy outcomes, particularly for women of lower socio-economic status. Targeted interventions are essential to ensure equitable maternal and neonatal health outcomes. Full article

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Open AccessArticle

Postoperative Pain Management in the Enhanced Recovery After Surgery (ERAS) for Emergency Laparoscopic Cholecystectomy

by Antonio Mihai Istrate, Dragos Serban, Dan Dumitrescu, Corneliu Tudor, Laurentiu Simion, Vlad Denis Constantin, Ciprian Tanasescu, Dan Giorgian Bratu, Bogdan Mihai Cristea, Catalin Cicerone Grigorescu and Ana Maria Dascalu

J. Mind Med. Sci. 2024, 11(2), 396-401; https://doi.org/10.22543/2392-7674.1551 - 31 Oct 2024

Abstract

Introduction. Enhanced recovery after surgery (ERAS) is a new patient-centered concept that aims to deliver high-quality perioperative care to surgical patients. This study was performed to compare the effectiveness of the pain management measures in an ERAS-protocol versus the traditional approach of [...] Read more.

Introduction. Enhanced recovery after surgery (ERAS) is a new patient-centered concept that aims to deliver high-quality perioperative care to surgical patients. This study was performed to compare the effectiveness of the pain management measures in an ERAS-protocol versus the traditional approach of postoperative pain. Materials and Methods. A comparative prospective study was performed on 50 patients admitted in the Fourth General Surgery of University Emergency Hospital of Bucharest between 2022 and 2024, with the diagnosis of acute cholecystitis, undergoing emergency laparoscopic cholecystectomy. The patients were randomly assigned into two study groups, an ERAS-group and a Traditional group, according to the type of perioperative care applied. The evaluated outcomes were length-of-stay; preoperative anxiety level, leukocyte count at admission and 24 hours postoperatively, postoperative pain levels quantified using Visual Analog Scale 24 hours after surgery and postoperative nausea and vomiting events. Results. The two study subgroups were comparable in terms of demographic and clinical preoperative characteristics. Statistical analysis showed significant lower values of preoperative anxiety level in ERAS group (p < 0.001), lower levels of postoperative pain (VAS 2.96 ± 0.75 vs. 4.65 ± 1.69, p < 0.001) and earlier resumption of the intestinal transit. However, there were no differences in the total hospital stay between the traditional and ERAS groups. Conclusions. Implementing ERAS protocol for emergency laparoscopic cholecystectomy improve postoperative functional outcome and the patients’ quality of care. Full article

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Open AccessArticle

Survival Prognostic Factors and Molecular Aspects in Extremity Soft Tissue Sarcoma

by Bogdan Serban, Eugen Radu, Adrian Cursaru, Bogdan Stefan Cretu, Sergiu Andrei Iordache, Madalina Cirnu, Cosmin Florentin Niculae and Cătălin Florin Cîrstoiu

J. Mind Med. Sci. 2024, 11(2), 388-395; https://doi.org/10.22543/2392-7674.1528 - 31 Oct 2024

Abstract

Soft tissue sarcomas are defined as relatively rare, wide-ranging mesenchymal tumors that present several forms of aggressive behavior. In order to improve the therapeutic result and thus the patient's prognosis, reliable diagnostic and evaluation tools are needed, capable of establishing the evolutive pattern [...] Read more.

Soft tissue sarcomas are defined as relatively rare, wide-ranging mesenchymal tumors that present several forms of aggressive behavior. In order to improve the therapeutic result and thus the patient's prognosis, reliable diagnostic and evaluation tools are needed, capable of establishing the evolutive pattern of each patient. Materials and Methods. An analytical observational study was conducted in the period 2016–2023 in the Orthopedics Department of the Bucharest University Emergency Hospital, on patients diagnosed with soft tissue sarcoma. Data such as sex, age, site, size, depth, histotype, grade and margin status, vessel or bone involvement, adenopathies, adjuvant therapy, clinical findings, etc., were analyzed. Diagnosis included immunohistochemistry after macroscopic pathological findings were carefully reviewed by a dedicated pathologist. A molecular study was performed to increase the accuracy of diagnosis, prognosis and clinical management of selected sarcomas. Results. In adult soft tissue sarcomas, histotype has been reported to be a significant predictor of overall survival. In terms of survival rate, vascular invasion appears to be a significant pathological factor for progression in extremity STS. Even though the local control of the disease has improved, the development of systemic metastases seems to be largely influenced by the biological characteristics of the tumor. Conclusions. Significant prognostic factors for the likelihood of a lower survival and death rate are tumor size, tumor depth, histology type, and vascular invasion. The results of the study support and complement the literature data, thus improving the understanding of the prognosis of soft tissue sarcomas. Full article

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Open AccessArticle

Telomeres Are Shorter in Portuguese Obese Adults

by Catarina Duarte, Maria Teresa Braz, Ana Marques-Ramos, José Silva-Nunes, Luisa Veiga and Miguel Brito

J. Mind Med. Sci. 2024, 11(2), 381-387; https://doi.org/10.22543/2392-7674.1483 - 31 Oct 2024

Abstract

Obesity is a clinical condition characterized by an abnormal accumulation of adipose tissue with an increased risk of developing illnesses such as type 2 diabetes, cardiovascular disease, and cancer. In obesity, the secretion of proinflammatory adipokines contributes to oxidative stress that can lead [...] Read more.

Obesity is a clinical condition characterized by an abnormal accumulation of adipose tissue with an increased risk of developing illnesses such as type 2 diabetes, cardiovascular disease, and cancer. In obesity, the secretion of proinflammatory adipokines contributes to oxidative stress that can lead to a decline in the length of telomeres. Telomeres are structures of repetitive sequences delimiting the chromosomes, that plays a crucial role in maintaining their integrity and stability and, thus, its shortening is associated with cellular senescence and possible apoptosis. Although some studies indicate that obesity is associated with shorter telomeres, others contradict this data. Accordingly, the aim of our study was to determine whether obesity is associated with telomere shortening in Portuguese obese adults. For that, we collected buccal epithelial cells from 72 obese (Body Mass Index (BMI) greater than 30 kg/m²) and 74 norm weight individuals (BMI between 18.5 kg/m² and 24.99 kg/m²) and determine telomere length through Real Time PCR. Results revealed that the relative telomere length of obese individuals is statistically significantly shorter than that of control non-obese group. By comparing obese subgroups, it was possible to observe that in the female subgroup the relative length of telomeres was shorter, in opposition to the male obese group, which indicates that the association between high BMI and shorter telomeres is genre-dependent. Furthermore, by studying the telomere length by age it was observed that there was no difference in the relative telomere length in obese under versus over 45 years old, demonstrating an age-independent association between obesity and telomere length. Accordingly, our results suggest that obesity is associated with telomeres shortening, and that this could be used as biomarker in obesity. Full article

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Open AccessReview

Artificial Intelligence and Liver Transplantation; Literature Review

by Maria Serban, Irina Balescu, Sorin Petrea, Bodan Gaspar, Lucian Pop, Valentin Varlas, Marilena Stoian, Camelia Diaconu, Cristian Balalau and Nicolae Bacalbasa

J. Mind Med. Sci. 2024, 11(2), 374-380; https://doi.org/10.22543/2392-7674.1532 - 31 Oct 2024

Abstract

Liver transplantation is the last life-saving solution for patients with end stage liver disease. The discrepancy between waiting list and available organs has led to the appearance of extended donation criteria and the development of several scores (Child-Pugh score, MELD score, DRI score, [...] Read more.

Liver transplantation is the last life-saving solution for patients with end stage liver disease. The discrepancy between waiting list and available organs has led to the appearance of extended donation criteria and the development of several scores (Child-Pugh score, MELD score, DRI score, SOFT score), in order to find the most suitable donor-recipient match. But none of these scores can predict survival after transplantation. Artificial Intelligence (AI) has recently been shown as an excellent tool for the study of the liver and comes in this aid with its various methods (random forest, artificial neural networks, decision tree, Bayesian networks, and support vector machine). Materials and Methods. By reviewing the literature (mostly retrospective multicenter studies), we aimed to establish if the AI is a proper or even a more accurate method of predicting posttransplant survival, in comparison with the existing linear statistical models. Results. Machine learning showed better results than several current scoring systems that use either isolated donor/recipient scores or combined donor/recipient factors. The advantages of this model are its capacity for analyzing both linear and nonlinear relationships between features and outcomes, its robustness of overfitting by design, and built-in insights into feature importance aiding model explainability. Nevertheless, machine learning has its limitations because it requires large amounts of data, which can be difficult to obtain, it also requires high levels of technical skill, can be difficult to engineer and it’s expensive. Conclusion. AI may have significant potential in aiding clinical decision-making during liver transplantation, including donor-recipient matching. Full article

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Open AccessReview

Challenges of Anticoagulant Treatment in Atrial Fibrillation with Liver Disease

by Alina Doina Nicoara, Andra Iulia Suceveanu, Ionut Eduard Iordache, Iulia Tania Andronache, Andreea Nelson Twakor, Andreea Georgiana Sunda, Ioan Cristian Nichita, Anca Pantea Stoian, Felix Voinea and Adrian Paul Suceveanu

J. Mind Med. Sci. 2024, 11(2), 363-373; https://doi.org/10.22543/2392-7674.1550 - 31 Oct 2024

Abstract

Managing anticoagulation therapy in individuals with atrial fibrillation who also have liver disease is highly challenging due to altered blood clotting processes and the risk of bleeding due to liver dysfunction. The literature highlights the complex nature of anticoagulant therapy in these patients, [...] Read more.

Managing anticoagulation therapy in individuals with atrial fibrillation who also have liver disease is highly challenging due to altered blood clotting processes and the risk of bleeding due to liver dysfunction. The literature highlights the complex nature of anticoagulant therapy in these patients, emphasizing the need for personalized treatment methods that take into account both thrombosis and bleeding risks. Research has shown a higher occurrence of atrial fibrillation in people with cirrhosis, highlighting the need to find the best anticoagulation methods based on the severity of liver disease and patient-specific factors. The debate over the safety and effectiveness of direct oral anticoagulants compared to traditional drugs like warfarin in cirrhotic patients with atrial fibrillation is still ongoing. Collaborative initiatives between experts in hepatology and cardiology are needed to address the complicated interplay between liver disease and atrial fibrillation, promoting interdisciplinary care models that enhance patient safety and treatment effectiveness. By prioritizing a patient-centered approach guided by extensive research, future directions in the hemostatic management of cirrhotic patients with atrial fibrillation may improve clinical decision-making and therapeutic outcomes. Full article

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Open AccessReview

Diabetes Mellitus and Associated Complications in the Digestive Tract

by Ioana Paunica, Vlad Denis Constantin, Dragos Serban, Cristian Paius, Bogdan Gaspar, Dragos Epistatu, Valentin Verlas, Roxana Sfetea, Liliana Florina Andronache, Cristian Balalau, Daniela Gabriela Bălan, Alexandru Florin Motofei and Adrian Silaghi

J. Mind Med. Sci. 2024, 11(2), 351-362; https://doi.org/10.22543/2392-7674.1567 - 31 Oct 2024

Abstract

Diabetes mellitus presents an increasing prevalence and severe multisystemic complications, with notable personal, professional and social implications. Diabetes is generally known by hyperglycemia and subsequent metabolic disorders. In addition to hyperglycemia, it appears that other factors (related to anthropometric-pathophysiology and genome-based subphenotyping) are [...] Read more.

Diabetes mellitus presents an increasing prevalence and severe multisystemic complications, with notable personal, professional and social implications. Diabetes is generally known by hyperglycemia and subsequent metabolic disorders. In addition to hyperglycemia, it appears that other factors (related to anthropometric-pathophysiology and genome-based subphenotyping) are involved not only in the clinical course but also in the occurrence of diabetes complications. This review presents several diabetes-induced complications on the digestive tract (periodontal disease, xerostomia, oral infections, dental caries, taste disturbances, gastroesophageal reflux disease, gastroparesis, gastric ulcer and cancer, diabetic enteropathy, inflammatory bowel diseases, colorectal cancer, etc.), many of them with major implications and unfavorable long-term prognosis. Consequently, prompt recognition and treatment of diabetes and its complications, as well as strict follow-up education, still remain essential for the effective management of this complex metabolic disease. Full article

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Open AccessReview

Giant Adrenal Myelolipomas: A Literature Review

by Mircea Hogea, Anda Hogea, Marius Moga, Roxana Dragomir, Simona Grigorescu and Bogdan Socea

J. Mind Med. Sci. 2024, 11(2), 345-350; https://doi.org/10.22543/2392-7674.1522 - 31 Oct 2024

Abstract

Myelolipomas are described as small tumors, with some authors referring to sizes less than 4 cm in diameter. However, when greater than 10 cm, myelolipomas are labeled as giant tumors and thus, have a definite indication for surgical resection. Myelolipomas represent a small [...] Read more.

Myelolipomas are described as small tumors, with some authors referring to sizes less than 4 cm in diameter. However, when greater than 10 cm, myelolipomas are labeled as giant tumors and thus, have a definite indication for surgical resection. Myelolipomas represent a small percentage of adrenal tumors. Giant myelolipomas are usually discovered incidentally during imaging studies performed for other conditions. They are often slow-growing and may reach sizes that significantly distort the anatomy of the affected area. Despite their large size, they are usually benign and do not spread to other parts of the body. Adrenal myelolipoma is a benign tumor with a scarce number of detailed cases reported in literature. It is frequently discovered by chance, covering a variety of differential diagnoses. Imaging techniques and histopathological examinations are of great importance in the differential diagnosis of adrenal gland lesions, including retroperitoneal lipoma and liposarcoma, adrenal myelolipoma, adrenal lymphoma, adrenal adenoma, adrenocortical carcinoma, pheochromocytoma or metastasis. We performed a comprehensive review on PubMed of all cases of giant adrenal myelolipoma reported in literature with more than 10 cm in diameter, in order to estimate the incidence, diagnosis and treatment of giant myelolipoma. So far, only 15 cases of truly giant adrenal myelolipoma have been reported between 1981 and 2023. Full article

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