Journal of Mind and Medical Sciences

5 pages, 465 KiB

Open AccessCase Report

Necrotizing Fasciitis of the Neck: Case Presentation

by Emil Marginean, Ciprian Venter, Maria Domuta, Oana Valenas, Ildiko Sorban, Alina Pantis, Bogdan Popescu and Răzvan V. Scăunașu

J. Mind Med. Sci. 2017, 4(2), 198-202; https://doi.org/10.22543/7674.42.P198202 - 5 Oct 2017

Cited by 1 | Viewed by 101

Abstract

Necrotizing fasciitis represents a severe and rare infectious disease, which is accompanied by extended necrosis of subcutaneous tissues and fascia layers, having as a result gangrene of the teguments. To reduce mortality associated with this disease, a rapid diagnosis is necessary as well [...] Read more.

Necrotizing fasciitis represents a severe and rare infectious disease, which is accompanied by extended necrosis of subcutaneous tissues and fascia layers, having as a result gangrene of the teguments. To reduce mortality associated with this disease, a rapid diagnosis is necessary as well as aggressive surgical treatment, accompanied by adequate, aggressive antibiotic therapy. As a rule, etiology is teeth related, with the condition more common in immunology-depressed patients. This article presents the experience of the authors regarding a case presentation of necrotizing fasciitis with typical clinical expression and management of the disease in an immunological-depressed patient. Further data on diagnosis, microbiology, clinical manifestations, therapy principles, and prognosis are yet needed for atypical cases. Full article

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5 pages, 444 KiB

Open AccessCase Report

Zenker’s Diverticulum and Squamous Esophageal Cancer: A Case Report

by Ion Dina, Octav Ginghina, Corina D. Toderescu, Cristian Bălălău, Bianca Galateanu, Carolina Negrei and Claudia Iacobescu

J. Mind Med. Sci. 2017, 4(2), 193-197; https://doi.org/10.22543/7674.42.P193197 - 5 Oct 2017

Cited by 1 | Viewed by 86

Abstract

Zenker’s diverticulum represents a rare esophageal lesion developed especially in the elderly population due to herniation of esophageal mucosa above the cricopharyngeus muscle. The condition leads to food retention, regurgitation, aspiration, and dysphagia in affected patients. Progressive dysphagia also characterizes malignant diseases of [...] Read more.

Zenker’s diverticulum represents a rare esophageal lesion developed especially in the elderly population due to herniation of esophageal mucosa above the cricopharyngeus muscle. The condition leads to food retention, regurgitation, aspiration, and dysphagia in affected patients. Progressive dysphagia also characterizes malignant diseases of the esophagus like squamous esophageal carcinoma that typically appears in male patients in the seventh decade of life, with a history of cigarette smoking and alcohol abuse. We report a case of a male patient who presented with dysphagia for both solids and liquids along with significant weight loss, and who was diagnosed with medium esophageal cancer associated with Zenker’s diverticulum. Full article

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7 pages, 664 KiB

Open AccessCase Report

Therapeutic Challenges in a Case of Psoriasis with Nail Onset

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

J. Mind Med. Sci. 2017, 4(2), 186-192; https://doi.org/10.22543/7674.42.P186192 - 5 Oct 2017

Cited by 3 | Viewed by 95

Abstract

Nail psoriasis affects a large number of patients with psoriasis and has a major psychosocial impact. Furthermore, it may be regarded as a predictor of more severe forms of psoriasis and early sign of psoriatic arthritis. The clinical presentations vary depending on the [...] Read more.

Nail psoriasis affects a large number of patients with psoriasis and has a major psychosocial impact. Furthermore, it may be regarded as a predictor of more severe forms of psoriasis and early sign of psoriatic arthritis. The clinical presentations vary depending on the structure affected (nail matrix or nail bed), the nail lesions may range from minor to severe, but they are not specific. Treatment is a challenge, in most cases the lesions being resistant to therapy. We present a rare case of psoriasis with nail onset in a 59-year-old woman. The nail involvement confined to the fingernails was severe, with significant impairment of the patient’s quality of life. Conventional therapies failed to improve the nail lesions, but a marked improvement was achieved under etanercept therapy. Full article

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8 pages, 834 KiB

Open AccessArticle

Development and Validation of Triticum Phytobiological Method as an Alternative Procedure for Investigating In Vivo Acute Toxicity on Mice

by Emil Ştefănescu, Aurelia N. Cristea, Cornel Chiriță, Octavian Olaru, Adriana Anghel and Mihaela Dinu

J. Mind Med. Sci. 2017, 4(2), 178-185; https://doi.org/10.22543/7674.42.P178185 - 5 Oct 2017

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Abstract

The goal of this study was to validate an alternative method for determining in vivo acute toxicity using vegetal material instead of laboratory animals, starting from the phytobiological method known also as the Triticum technique. We set out to demonstrate that vegetal cells [...] Read more.

The goal of this study was to validate an alternative method for determining in vivo acute toxicity using vegetal material instead of laboratory animals, starting from the phytobiological method known also as the Triticum technique. We set out to demonstrate that vegetal cells have similar sensitivity to some toxic agents as animal cells, in which case a statistical correlation could be established. A series of new compounds synthesized by the Romanian National Institute for Chemical Pharmaceutical Research and Development as potential β3 adrenergic receptors agonists were tested for their acute toxicity using classic animal exposure models, before investigating possible anti-diabetic and anti-obesity effects. We then determined whether similar conclusions might be reached exposing vegetal material to the same agents. We successfully demonstrated that plants are affected in a very similar way as animals when exposed to some potentially toxic agents, providing new possibilities for ending unethical animal experiments. Full article

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6 pages, 633 KiB

Open AccessArticle

The Psychological Influence of the Diagnosis of Breast Cancer on Therapeutic Options Selection

by Răzvan V. Scăunaşu, Ștefan Voiculescu, Bogdan Popescu, Cristina Cozma, Radu Jecan and Cristian Bălălău

J. Mind Med. Sci. 2017, 4(2), 172-177; https://doi.org/10.22543/7674.42.P172177 - 5 Oct 2017

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Abstract

The therapeutic management decision-making process for breast cancer is complex, and is influenced by multiple factors including patient age, comorbidities, ethnicity, education, and availability of immediate or delayed reconstruction options. Our study analysed 276 patients diagnosed with breast cancer in the “Colțea” Clinical [...] Read more.

The therapeutic management decision-making process for breast cancer is complex, and is influenced by multiple factors including patient age, comorbidities, ethnicity, education, and availability of immediate or delayed reconstruction options. Our study analysed 276 patients diagnosed with breast cancer in the “Colțea” Clinical Hospital between 2014 and 2015. Mean patients age was 61.24, median 62, with a range of 31 to 89 years. Younger age was associated with a less advanced local disease and younger patients were more likely to choose and benefit from conservative surgery. Most patients (61.76%) came from rural areas. Place of origin had a significant influence on the tumor size at the time of diagnosis (3.9 cm vs. 1.8 cm) as well as on the choice of surgical procedure. Personalized treatment management plans that include aesthetic satisfaction coupled with oncological safety should be the objectives of contemporary breast surgery. Patient age is so important to the decision making process that it has been proposed as a determinant of educational and counselling strategies. From our experience, young patients from urban areas were more proactive patients. They were diagnosed earlier and more involved in treatment decisions compared with patients from rural areas, who generally did not question the surgeon’s opinion. Factors that influence the decision-making process likely include age, socioeconomic status, availability of radiotherapy, the necessity of periodic follow-up and the concern about recurrence. Full article

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9 pages, 405 KiB

Open AccessArticle

Protective Role of S-Adenosylmethionine Against Fructose-Induced Oxidative Damage in Obesity

by Kameliya Zh Bratoeva, Mariya A. Radanova, Albena V. Merdzhanova and Ivan S. Donev

J. Mind Med. Sci. 2017, 4(2), 163-171; https://doi.org/10.22543/7674.42.P163171 - 5 Oct 2017

Cited by 6 | Viewed by 124

Abstract

Introduction. It has been shown that S-adenosylmethionine (S-AMe) stimulates glutathione synthesis and increases cell resistance to the cytotoxic action of free radicals and pro-inflammatory cytokines. The aim of this study was to determine the effect of S-adenosylmethionine on the oxidative stress in [...] Read more.

Introduction. It has been shown that S-adenosylmethionine (S-AMe) stimulates glutathione synthesis and increases cell resistance to the cytotoxic action of free radicals and pro-inflammatory cytokines. The aim of this study was to determine the effect of S-adenosylmethionine on the oxidative stress in adipose tissue in a model of fructose-induced obesity. Methods. The study was performed on male Wistar rats divided into 3 groups: control, fructose fed (HFD) (35%, 16 weeks), and HFD + S-AMe (20 mg/kg). We examined the changes in the ratio of retroperitoneal adipose tissue weight / body weight; levels of reduced glutathione (GSH) and malondialdehyde (MDA) in the retroperitoneal adipose tissue, and serum levels of GSH and TNF-α. Results. Significant increases in the retroperitoneal adipose tissue, MDA, and serum TNF-α were identified, as well as decreased tissue and serum levels of GSH in rats fed with a high-fructose diet as compared with the control group. In the group fed with HFD and S-AMe, we found significant reduction in the retroperitoneal adipose tissue and decreased levels of MDA and serum TNF-α, as well as increased tissue and serum levels of GSH as compared with the group only on HFD. In conclusion, our results show that fructose-induced obesity causes oxidative stress in hypertrophic visceral adipose tissue. The administration of S-AMe improves the antioxidative protection of adipocytes, and reduces oxidative damage and excessive accumulation of lipids and inflammation. Full article

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7 pages, 469 KiB

Open AccessArticle

Cesarean Scar Defects and Placental Abnormalities—A 3 Year Survey Study

by Denisa O. Bălălău, Nicolae Bacalbașa and Anca D. Stănescu

J. Mind Med. Sci. 2017, 4(2), 156-162; https://doi.org/10.22543/7674.42.P156162 - 5 Oct 2017

Cited by 2 | Viewed by 88

Abstract

The placenta is an essential organ for embryonic and fetal development, ensuring nutrient uptake, gas exchange (via the mother’s blood supply), waste elimination, thermo-regulation, immunological and hormonal factors, etc. The most common placental abnormalities are represented by placenta previa, and a morbidly adherent [...] Read more.

The placenta is an essential organ for embryonic and fetal development, ensuring nutrient uptake, gas exchange (via the mother’s blood supply), waste elimination, thermo-regulation, immunological and hormonal factors, etc. The most common placental abnormalities are represented by placenta previa, and a morbidly adherent placenta (in the form of accreta, increta, and percreta placenta). This study was performed on a sample of 99 patients diagnosed with abnormalities of placentation who underwent cesarian delivery during a period of 3 years in Bucur Maternity Hospital. Seven patients were diagnosed with morbidly adherent placenta (5 accreta and 2 percreta subtypes), the others having placenta previa (65 with lateral disposition, 18 marginal, and 9 central insertion). All patients had been diagnosed by ultrasound (which was also used for general monitoring), being confirmed during operation and histopathologically. Complications required 4 emergency peripartum hysterectomies, with no maternal mortality but with fetal death in one case. The research literature shows that about half of women with placenta previa have several episodes of bleeding, being the leading cause of antepartum hemorrhage. For some women with placenta previa/accrete, hemorrhaging is severe and requires hysterectomy as a necessary step to control the life-threatening situation. Thus, such patients should be carefully monitored to avoid as much as possible the medical, social, and psychological implications of this critical therapeutic procedure. Full article

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8 pages, 547 KiB

Open AccessArticle

Experimental Pharmacological Research Regarding Some Newly Synthesized Benzamides on Central Nervous System Functions

by Cornel Chiriță, Emil Ștefănescu, Cristina D. Marineci, Simona Negreș and Diana C. Nuță

J. Mind Med. Sci. 2017, 4(2), 148-155; https://doi.org/10.22543/7674.42.P148155 - 5 Oct 2017

Cited by 1 | Viewed by 82

Abstract

Three newly synthesized benzamides by the Department of Pharmaceutical Chemistry of the Faculty of pharmacy from the University of Medicine and Pharmacy “Carol Davila” Bucharest were tested in order to determine whether these new molecules have similar effects on the central nervous system [...] Read more.

Three newly synthesized benzamides by the Department of Pharmaceutical Chemistry of the Faculty of pharmacy from the University of Medicine and Pharmacy “Carol Davila” Bucharest were tested in order to determine whether these new molecules have similar effects on the central nervous system as those already in therapeutic use belonging to the same chemical group, such as tiapride (neuroleptic) or lidocaine (local anaesthetic). Tests were carried out on NMRI mice which were given new compounds, conventionally named I5C, I14C, and II5C in a dose of 1/20 of the lethal dose 50% (LD50), as previously determined. They received this treatment daily for 21 days. The evasive–investigating capacity of mice was determined using the platform test, and the motor activity using an Activity cage device. The results have shown that compounds I5C and II5C decrease the investigation capacity of the mice; and compound I5C inhibits motor activity, while II5C stimulates it. Thus we concluded that only compounds I5C and II5C have a neuroleptic potential that might be investigated further. Full article

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6 pages, 519 KiB

Open AccessArticle

Emergency Surgery and Limitation of Therapeutic Effort in Relation to Neurologic Deterioration in Elderly Patients—A Survey of European Surgeons

by Mihai Păduraru, Luca Ponchietti, Isidro M. Casas, Jorge Pereira, Aitor Landaluce-Olavarria and Diego Mariani

J. Mind Med. Sci. 2017, 4(2), 142-147; https://doi.org/10.22543/7674.42.P142147 - 5 Oct 2017

Cited by 2 | Viewed by 92

Abstract

Background. In emergency surgery, a very heterogeneous approach is required in the decision making process, especially when considering the patient’s postoperative quality of life as well as medical, ethical, and legal factors. In some cases, the presence of an Advance Directive (AD) form [...] Read more.

Background. In emergency surgery, a very heterogeneous approach is required in the decision making process, especially when considering the patient’s postoperative quality of life as well as medical, ethical, and legal factors. In some cases, the presence of an Advance Directive (AD) form may potentially help resolve the surgeon’s dilemma. Objectives. The primary objective of this survey was to investigate the opinions of surgeons across a representative cross-section of European countries regarding the decision making process using a specific case scenario so as to identify similarities and differences in practice. A secondary objective was to identify the possibility of establishing a more uniform approach and best practice. Method. A survey was conducted of surgeons from a range of European countries. Questionnaires were designed to obtain an overview of decision making in relation to the Limitation of Therapeutic Effort (LTE) using a specific case study and the level of awareness and practical use of ADs. Surveys were distributed via email to the members of the ESTES (European Society for Trauma and Emergency Surgery) and AEC (Association of Spanish surgeons), with voluntary, anonymous participation. Conclusions. Clear and additional support in the form of legal and ethical guidance with clinical protocols for surgical practice in such case scenarios is necessary. Wider use of ADs, together with education about their role and support for patients and relatives, would benefit the type of patient described in our scenario. A multidisciplinary team should play a more active role in decision making in order to avoid surgical procedures that are potentially futile. The concepts of LTE and Quality of life need a broader understanding among surgeons as well as more consistent application. Full article

10 pages, 450 KiB

Open AccessReview

Is There a Utility for QRS Dispersion in Clinical Practice?

by Ionuț Donoiu, Georgică C. Târtea and Elibet Chávez-González

J. Mind Med. Sci. 2017, 4(2), 132-141; https://doi.org/10.22543/7674.42.P132141 - 5 Oct 2017

Cited by 6 | Viewed by 84

Abstract

Prognostic markers derived from standard ECG have always been seductive. Increased dispersion of durations of the P wave, of the QRS complex, or of the QT interval has been associated with the risk of atrial fibrillation, ventricular arrhythmias, sudden cardiac death, as well [...] Read more.

Prognostic markers derived from standard ECG have always been seductive. Increased dispersion of durations of the P wave, of the QRS complex, or of the QT interval has been associated with the risk of atrial fibrillation, ventricular arrhythmias, sudden cardiac death, as well as with a general negative prognosis in various settings. However, these markers have intrinsic and methodological issues that question their utility. This paper presents data supporting the utility of QRS dispersion in clinical practice. Our investigation shows that QRS dispersion is a simple electrocardiographic marker with potential value in the assessment of patients in a variety of clinical settings: ischemic heart disease, heart failure, and cardiomyopathies. More studies are needed to validate QRS clinical utility for predicting the risk for ventricular arrhythmias and sudden cardiac death, and for the evaluation of the response to cardiac resynchronization therapy. Full article

7 pages, 430 KiB

Open AccessReview

Finasteride as a Model for Personalized Medicine

by Ion G. Motofei, David L. Rowland, Ioana Păunică, Octavian C. Tănăsescu, Petrişor Banu and Stana Păunică

J. Mind Med. Sci. 2017, 4(2), 125-131; https://doi.org/10.22543/7674.42.P125131 - 5 Oct 2017

Cited by 4 | Viewed by 90

Abstract

The side effects of Finasteride are currently a subject of controversy. Some studies report minor or acceptable adverse effects, which decrease after a variable period of time so that they do not necessitate terminating Finasteride administration. However, several clinical and neuro-endocrine studies show [...] Read more.

The side effects of Finasteride are currently a subject of controversy. Some studies report minor or acceptable adverse effects, which decrease after a variable period of time so that they do not necessitate terminating Finasteride administration. However, several clinical and neuro-endocrine studies show that some adverse effects persist indefinitely in the form of post-Finasteride syndrome, even after the drug cessation. This paper presents a possible explanation for these inconsistent findings. First, the study design of either informing or not informing patients prior therapy about possible adverse effects can influence the incidence and magnitude of reported adverse effects. Second, structural and information dichotomies of the brain generate four distinct neuronal networks, which are activated through specific cerebral neuromodulators and that are able to support four distinct minds within an individual body. As a conclusion, the "mind psychophysiology" and the corresponding mental impairments differ across individuals, such that not only the prediction of adverse effects should be addressed from a more individualized medical perspective, but also the therapeutic strategies could be tailored to the four distinct mental profiles described. It is a personalized approach that would be applicable to several interrelated domains of neuroscience, like psychology, psychiatry and sexuality. Finally, this perspective may represent a starting point for a more individualized understanding of mental events, perhaps even a step forward in the understanding of the mind-body problem. Full article

10 pages, 591 KiB

Open AccessReview

Non-Compaction Cardiomyopathy—Brief Review

by Oana Mirea, Mihaela Berceanu, Anca Constantin, Mirela Mănescu, Georgică C. Târtea, Ionuț Donoiu, Constantin Militaru and Octavian Istrătoaie

J. Mind Med. Sci. 2017, 4(2), 115-124; https://doi.org/10.22543/7674.42.P115124 - 5 Oct 2017

Cited by 4 | Viewed by 88

Abstract

Left ventricular non-compaction cardiomyopathy is a genetic disorder characterized by the presence of two myocardial layers with numerous prominent trabeculations and deep inter-trabecular recesses that communicate with the ventricular cavity. The diagnosis is often challenging because excessive trabeculations may also be a normal [...] Read more.

Left ventricular non-compaction cardiomyopathy is a genetic disorder characterized by the presence of two myocardial layers with numerous prominent trabeculations and deep inter-trabecular recesses that communicate with the ventricular cavity. The diagnosis is often challenging because excessive trabeculations may also be a normal finding in performance athletes and black people. Echocardiography is the gold standard for diagnosis of this condition, but other useful diagnostic techniques may include cardiac magnetic resonance imaging, computed tomography, and contrast ventriculography. Moreover, newer echocardiographic methods such as three-dimensional imaging and speckle tracking analysis promise to improve the diagnosis of left ventricular non-compaction cardiomyopathy. The purpose of this paper is to review the pathogenesis, diagnosis, and management of this disease. Full article

15 pages, 455 KiB

Open AccessReview

Therapeutic Drug Monitoring and Methods of Quantitation for Carbamazepine

by Cristian Tuchila, Daniela L. Baconi, Cristina D. Pirvu, Denisa O. Balalau, Ana M. Vlasceanu, Miriana Stan and Cristian Balalau

J. Mind Med. Sci. 2017, 4(2), 100-114; https://doi.org/10.22543/7674.42.P100114 - 5 Oct 2017

Cited by 11 | Viewed by 194

Abstract

Carbamazepine is an early anticonvulsant still used today in the treatment of several forms of epilepsy. An active metabolite in the human body contributes to its pharmacological effect. Carbamazepine metabolism has high inter-individual variability, such that it is relatively difficult to establish a [...] Read more.

Carbamazepine is an early anticonvulsant still used today in the treatment of several forms of epilepsy. An active metabolite in the human body contributes to its pharmacological effect. Carbamazepine metabolism has high inter-individual variability, such that it is relatively difficult to establish a direct link between dose and concentration, or between concentration and pharmacological effect. Carbamazepine is thus a good candidate for therapeutic drug monitoring (TDM). Good UV specific absorbance and high plasmatic concentrations allow for the use of UV detection, which is often more accessible than other methods of detection. This paper presents several methods used for the detection of carbamazepine in plasma, methods that are capable of detecting drug and metabolites at adequate levels/acceptance criteria. These methods have possible application not only in pharmacokinetic, bioequivalence, and permeability studies, but also in the therapeutic drug monitoring of carbamazepine. Full article

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7 pages, 424 KiB

Open AccessReview

End-Stage Head and Neck Cancer: Coping Mechanism

by Bogdan Popescu, Oana Păun, Răzvan V. Scăunaşu and Șerban V.G. Berteşteanu

J. Mind Med. Sci. 2017, 4(2), 93-99; https://doi.org/10.22543/7674.42.P9399 - 5 Oct 2017

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Abstract

Coping mechanisms are patients’ means of adapting to stressful situations and involve psychological and physical changes in behavior. Patients adapt to head and neck cancer in a variety of ways. Head and neck cancers are extremely debilitating, especially in advanced stages of the [...] Read more.

Coping mechanisms are patients’ means of adapting to stressful situations and involve psychological and physical changes in behavior. Patients adapt to head and neck cancer in a variety of ways. Head and neck cancers are extremely debilitating, especially in advanced stages of the disease or in end-of-life situations. While an oncology team needs to address the needs of all oncology patients, the advanced terminal patients require special attention. Most of these patients do not cope well with their situation and have a tendency to cease social interactions. Pain is the most frequentlyexperienced medical disability in patients having an end-stage illness experience, and thus an important medical endeavor is to afford dignity to the dying patient facingan incurable disease. In such cases, the medical community should never refuse therapy or to assist a dying patient.In some instances, the patient and family may derive benefit from their religious beliefs. Full article

8 pages, 447 KiB

Open AccessReview

Psycho-Physiologic Emergentism—Four Minds in a Body

by David L. Rowland and Ion G. Motofei

J. Mind Med. Sci. 2017, 4(2), 85-92; https://doi.org/10.22543/7674.42.P8592 - 5 Oct 2017

Cited by 1 | Viewed by 69

Abstract

The mind-body problem represents one of the most debated topics in the neurosciences. From a psychological standpoint, abstract/non-material data are an intrinsic part of the mind, intervening to a large extent in reasoning and decision making processes. Imaging studies also show a strong [...] Read more.

The mind-body problem represents one of the most debated topics in the neurosciences. From a psychological standpoint, abstract/non-material data are an intrinsic part of the mind, intervening to a large extent in reasoning and decision making processes. Imaging studies also show a strong correlation between higher cognitive functions (such as working memory) and specific cerebral brain regions (a fronto-parietal network of interacting left and right brain areas). In contrast, the physical/material brain would be unable to interact with abstract-immaterial data, such that the psychological processing of abstract data (processes such as thinking, reasoning, and judgment) is attributed to the mind, with the mind representing a distinct entity interposed between the brain and abstract-immaterial data. Recent data suggest that the mind-body problem may simply be an artifact of human experience/ understanding, as the brain actually represents actually an intrinsic part of the mind. Even if the physical brain is not able to interact with abstract mental data, the brain still could process abstract data through a dynamic association between the abstract data and cerebral stimuli/ impulses. This form of processing without interaction defines the mind as a complex neurobiological structure, with the unconscious part of the mind processing abstract-immaterial data in a conscious/ mental format. In this overview, important concepts of psycho-physiologic emergentism, including internal mental reality, internal mental existence, internal mental interaction, and structural and informational dichotomies of the brain, are iterated. Such concepts/properties represent a neuro-informational support system capable of generating four distinct minds within the single brain. Future studies should further develop the dynamic and immaterial-material nature of the mind, as a possible premise for a scientific definition and understanding of mental events like affectivity, emotions, soul, etc. Full article

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J. Mind Med. Sci., Volume 4, Issue 2 (October 2017) – 15 articles

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