Journal of Mind and Medical Sciences

10 pages, 229 KiB

Open AccessArticle

The Incidence of Oncocytoma and Angiomyolipoma in Patients Undergoing Nephron-Sparing Surgery for Small Renal Masses

by Stelian Ianiotescu, Constantin Gingu, Irina Balescu, Nicolae Bacalbasa, Cristian Balalau and Ioanel Sinescu

J. Mind Med. Sci. 2025, 12(2), 38; https://doi.org/10.3390/jmms12020038 - 16 Jul 2025

Abstract

Background: Oncocytoma and angiomyolipoma (AML) are benign renal tumors that may mimic malignant lesions on imaging. With the increasing use of partial nephrectomy (PN) for renal masses, accurate preoperative characterization of these lesions is essential. This study highlights the role of partial nephrectomy [...] Read more.

Background: Oncocytoma and angiomyolipoma (AML) are benign renal tumors that may mimic malignant lesions on imaging. With the increasing use of partial nephrectomy (PN) for renal masses, accurate preoperative characterization of these lesions is essential. This study highlights the role of partial nephrectomy as a valuable diagnostic tool in situations where imaging is inconclusive or raises concern for malignancy without definitive confirmation. In the absence of a reliable preoperative diagnosis, partial nephrectomy provides direct histologic verification with minimal perioperative morbidity. Moreover, it offers curative potential when malignancy is present. By achieving both diagnostic certainty and renal preservation, this approach is well-suited for clinical scenarios in which imaging ambiguity might otherwise result in overtreatment through radical surgery or undertreatment Material and methods: in this retrospective study, we reviewed our 5-year experience (2019–2024), 188 partial nephrectomies—including bilateral procedures and operations on solitary kidneys—using robotic and open approaches. All of these 30 tumors were solid renal masses with indeterminate imaging features or suspicious characteristics suggestive of malignancy, further underscoring the limitations of current preoperative diagnostic modalities. Results: Histopathological evaluation confirmed benign renal tumors in 30 cases, with oncocytoma diagnosed in 18 cases (16 robotic, 2 open) and AML in 12 cases (9 robotic, 3 open). Conclusions: Even when imaging raises suspicion of malignancy or remains inconclusive, many small renal masses are ultimately confirmed as benign upon histopathological examination. This study underscores the diagnostic uncertainty associated with small renal tumors and highlights the value of partial nephrectomy as a decisive diagnostic intervention. In situations where non-invasive modalities fail to provide definitive answers, partial nephrectomy offers tissue confirmation with minimal morbidity. Furthermore, when malignancy is present, this approach ensures appropriate oncologic management while preserving renal function. Our findings support the integration of this strategy into routine clinical practice, particularly when diagnostic clarity is essential for guiding safe and effective treatment. Full article

17 pages, 1276 KiB

Open AccessReview

Deep Caries Lesions Revisited: A Narrative Review

by Irina Maria Gheorghiu, Sergiu Ciobanu, Ion Roman, Stana Păunică, Anca Silvia Dumitriu and Alexandru Andrei Iliescu

J. Mind Med. Sci. 2025, 12(1), 37; https://doi.org/10.3390/jmms12010037 - 23 May 2025

Abstract

Background/Objectives: Deep caries lesions represent an actual concern in preserving tooth vitality and preventing irreversible pulpitis. As presently the non-selective approach is considered an overtreatment, the concept of selective caries removal is highly recommended. The goal of this narrative review is to [...] Read more.

Background/Objectives: Deep caries lesions represent an actual concern in preserving tooth vitality and preventing irreversible pulpitis. As presently the non-selective approach is considered an overtreatment, the concept of selective caries removal is highly recommended. The goal of this narrative review is to focus on current trends in carious dentine excavation and adjunctive therapies. Methods: A keyword-based selection of scientific publications issued in the last six years, i.e., 2019–2024, was conducted with the search engine of PubMed (MEDLINE) and ScienceDirect databases, using the following keywords: deep carious lesion; caries removal; indirect pulp capping; adjunctive antimicrobial therapy; adjunctive anti-enzymatic therapy; biomimetic restorative dentistry. Discussions: In deep caries management, the current trends of carious dentine excavation recommend preferentially partial caries removal technique as less risky to pulp exposure and more conservative compared to the stepwise technique (SW). Presently, advanced additional procedures such as antimicrobial photodynamic therapy and an anti-enzymatic approach are also considered for caries arrest. Conclusions: Selective caries removal and adjunctive photodynamic antimicrobial therapy are procedures of choice in preserving pulp vitality. Anti-enzymatic therapies impede decoupling with time of adhesive restorations from the smear layer. Biomimetic restorative dentistry and smart materials introduce the principles of artificial intelligence in the therapeutic approach of deep caries. Full article

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7 pages, 211 KiB

Open AccessArticle

Occult Thyroid Carcinoma Incidence in Multinodular Goiter Experience of a Medium-Volume Center in Romania

by Iulian Slavu, Raluca Tulin, Alexandru Dogaru, Ileana Dima, Cristina Orlov-Slavu, Virgiliu Mihai Prunoiu, Marius Popescu, Cornelia Nipir, Bogdan Socea and Adrian Tulin

J. Mind Med. Sci. 2025, 12(1), 36; https://doi.org/10.3390/jmms12010036 - 20 May 2025

Abstract

Background: Multinodular goiter (MNG) is a common thyroid condition characterized by multiple nodules within the thyroid gland. This study aims to evaluate the incidence and clinical features of occult thyroid carcinoma in patients with multinodular goiter, based on the experience from a medium-volume [...] Read more.

Background: Multinodular goiter (MNG) is a common thyroid condition characterized by multiple nodules within the thyroid gland. This study aims to evaluate the incidence and clinical features of occult thyroid carcinoma in patients with multinodular goiter, based on the experience from a medium-volume cancer center. Methods: A retrospective analysis was conducted on patients diagnosed with multinodular goiter who underwent thyroidectomy. Clinical, radiological, and histopathological data were reviewed to identify cases of occult thyroid carcinoma. Factors such as age, sex, and histopathological characteristics were analyzed to determine potential risk factors for malignancy in this cohort. Results: A total of 332 patients with MNG were included in the study, with 61 (17.5%) diagnosed with occult thyroid carcinoma. The incidence of occult carcinoma was more frequent in females, with a notable predilection for papillary carcinoma. Regarding age, occult tumors were more frequently encountered in the 20–40 age group, irrespective of gender. Conclusions: In conclusion, we observed that in our center over a 6-year period, the incidence of thyroid cancer after total thyroidectomy for multinodular goiter sits at 17.5%. Thyroid diseases are more frequent in women, which in turn leads to an increased rate of occult carcinomas. Up to 70% of the cancers were papillary. The clinical risk factors associated with a higher probability of cancer were lower age and female gender. Full article

16 pages, 502 KiB

Open AccessReview

Health Status After Total Hip Arthroplasty: A Literature Review

by Mădălin Bulzan, Florica Voiță-Mekeres, Simona Cavalu, Gheorghe Szilagyi, Gabriel Mihai Mekeres, Lavinia Davidescu and Călin Tudor Hozan

J. Mind Med. Sci. 2025, 12(1), 35; https://doi.org/10.3390/jmms12010035 - 19 May 2025

Cited by 1

Abstract

Total hip arthroplasty (THA) is the definitive treatment for end-stage hip osteoarthritis, reliably relieving pain and restoring joint function. However, patient-reported quality of life (QoL) after THA remains heterogeneous, with recovery trajectories influenced by a range of biological, psychological, and social factors. A [...] Read more.

Total hip arthroplasty (THA) is the definitive treatment for end-stage hip osteoarthritis, reliably relieving pain and restoring joint function. However, patient-reported quality of life (QoL) after THA remains heterogeneous, with recovery trajectories influenced by a range of biological, psychological, and social factors. A comprehensive synthesis of these determinants is lacking, limiting our ability to optimize individualized perioperative care and long-term outcomes. This review examines the various factors impacting quality of life (QoL) before and after hip arthroplasty. An analysis of 67 studies reveals significant postoperative enhancements in physical function, pain alleviation, and overall patient satisfaction. Identified key factors encompass physical activity, mental health status (anxiety and depression), lifestyle choices (diet and weight management), and social support systems, particularly from spouses and family members. The review indicates that, although these elements positively influence recovery, it also recognizes limitations including dependence on subjective, self-reported QoL measures, possible selection biases, and inconsistencies in study design. The results indicate that a com-prehensive, patient-focused strategy—integrating organized rehabilitation, psychological assistance, and family engagement—can markedly improve recovery and long-term QoL for arthroplasty patients. Nonetheless, additional research employing standardized protocols and extended follow-up durations is essential to corroborate these findings and guide clinical practice. The early implementation of tailored, multidisciplinary perioperative pathways—including structured rehabilitation programs, routine psychological screening and intervention, nutritional counseling for weight management, and active family involvement—may optimize functional recovery, reduce complications, and maximize long-term QoL in patients undergoing THA. This review highlights the importance of a multidisciplinary approach to enhance post-surgical quality of life, thereby advancing the understanding of patient-centered recovery strategies in orthopedic care. Full article

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10 pages, 233 KiB

Open AccessArticle

AI-Based Intervention to Enhance Self-Control in Adolescents Studying Drama—A Pilot Study

by Alina Mihaela Munteanu, Teodor Cristian Rădoi, Cristiana Susana Glavce, Monica Petrescu, Suzana Turcu and Adriana Borosanu

J. Mind Med. Sci. 2025, 12(1), 34; https://doi.org/10.3390/jmms12010034 - 12 May 2025

Abstract

(1) Background: Self-control is an essential capacity in educating young generations for the good management of personal resources and a healthy life adapted to the constantly changing demands of technological society. Artificial intelligence is an economical and efficient solution for designing medical education [...] Read more.

(1) Background: Self-control is an essential capacity in educating young generations for the good management of personal resources and a healthy life adapted to the constantly changing demands of technological society. Artificial intelligence is an economical and efficient solution for designing medical education programs aimed at optimizing this capacity, which can be personalized according to each personal needs and characteristics. (2) Methodology: This research is a sequential intervention study that aims to investigate if the level of impulsivity decreases and consequently the self-control in adolescents studying drama can be improved by using an online program designed for this purpose. The program’s effectiveness is evaluated by analyzing its impact on vocational performance and the reduction in unhealthy lifestyle habits. A sample of 90 subjects aged between 14 and 17 years, enrolled in the compulsory vocational education system was included in this study. The study was conducted over a five-month period and was organized in three stages: 1. The preparatory stage in which the Barratt Impulsiveness Scale was initially applied (pre-test scores); 2. Selecting the tasks for the online self-control education program and uploading the artificial intelligence network; the application of the program lasted for three months; 3. Applying Barratt Impulsiveness Scale (post-test scores). (3) Results: The results indicated both a statistically significant decrease in self-reported impulsivity and an improvement in the self-control of the sample of adolescents after three months of training on the online platform, compared to the pretest scores of impulsivity. (4) Conclusion: A comparative analysis between the initial and the final BIS scores showed a statistically significant decrease in teens‘ impulsivity, suggesting that the program was effective for this sample of adolescents. Consequently, the study findings indicate significant improvements in adolescents’ self-control after completing the three-month training program, which included cognitive-behavioral games. Full article

13 pages, 394 KiB

Open AccessArticle

Our Experience and Literature Update Regarding Concomitant Radiotherapy with CDK4/6 Inhibitors and Hormonal Therapy in Metastatic Breast Cancer

by Laura-Florentina Rebegea, Dorel Firescu, Oana-Gabriela Trifanescu, Roxana-Andreea Rahnea-Nita, Liviu Bilteanu, Mihaela Dumitru, Florentina Lacatus and Gabriela Rahnea-Nita

J. Mind Med. Sci. 2025, 12(1), 33; https://doi.org/10.3390/jmms12010033 - 12 May 2025

Abstract

Background and Objectives: Standard treatment in metastatic breast cancer with positive estrogen receptors and negative HER2neu is represented by CDK4 inhibitors combined with aromatase inhibitors or fulvestrant. Palliative radiotherapy is indicated for symptoms or local–regional control. Multiple preclinical data suggest a potential synergistic [...] Read more.

Background and Objectives: Standard treatment in metastatic breast cancer with positive estrogen receptors and negative HER2neu is represented by CDK4 inhibitors combined with aromatase inhibitors or fulvestrant. Palliative radiotherapy is indicated for symptoms or local–regional control. Multiple preclinical data suggest a potential synergistic effect when CDK4/6 inhibitors and radiotherapy are administered concurrently. We are trying to address some questions and/or to establish correlations within a subgroup of patients with unusual toxicities, the safety of combined treatments, the correlation with radiotherapy techniques and fractionation schemas. Also, we are aware that some organs at risk of a rapid turnover are more vulnerable to the occurrence of acute toxicities. Materials and Methods: This retrospective study includes 20 patients with metastatic breast cancer, treated with CDK4 inhibitors and radiotherapy on 29 disease sites; we followed the compliance and toxicities of combined treatments. Results: Regarding the recorded hematological toxicities, grade 1 associated with CDK4 inhibitors, occurring anterior radiotherapy was recorded; grade 2, leucopenia during radiotherapy presented in three cases without radiotherapy interrupting and leucopenia with neutropenia grade 3 presented in one case after pleural secondary lesion’s irradiation. Non-hematological grade 3 toxicities occurred in two cases: one case with grade 3 enteritis, at 2 weeks from bone metastases irradiation—iliac bone (in field toxicity) and one case with radiodermitis during radiotherapy on the breast and lymph node level, in the second week of external radiotherapy (RTE). Conclusions: In all analyzed cases, we obtained control of irradiated lesions. Secondary toxicities occurred only in irradiated areas. A close monitoring of patients during combined treatment must be considered and we are confident that in the future it will be possible to identify the subgroup of patients with a high risk of unusual toxicities occurring; additionally, we hope that using more conforming radiotherapy techniques minimizes the organ being at risk from radiation doses. Full article

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10 pages, 399 KiB

Open AccessArticle

Hyperuricemia as a Systemic Risk Factor for Periodontal Disease: A Review of Clinical and Microbial Evidence

by Anca Silvia Dumitriu, Stana Paunica, Irina Bodnar, Dragos Nicolae Ciongaru, Brindusa Florina Mocanu, Marina Cristina Giurgiu, George Alexandru Denis Popescu and Dana Bodnar

J. Mind Med. Sci. 2025, 12(1), 32; https://doi.org/10.3390/jmms12010032 - 8 May 2025

Abstract

(1) Background: Hyperuricemia and periodontal disease are interconnected through shared inflammatory pathways, oxidative stress, and microbiome alterations. Both conditions involve chronic inflammation with uric acid contributing to systemic inflammation and oxidative stress that can exacerbate gum disease. Studies suggest that hyperuricemia may alter [...] Read more.

(1) Background: Hyperuricemia and periodontal disease are interconnected through shared inflammatory pathways, oxidative stress, and microbiome alterations. Both conditions involve chronic inflammation with uric acid contributing to systemic inflammation and oxidative stress that can exacerbate gum disease. Studies suggest that hyperuricemia may alter the oral microbiome, increasing the risk of periodontal infections. In addition, gout, a condition linked to chronic hyperuricemia, is associated with a higher prevalence of periodontal disease. (2) Objective: This study aims to investigate the association between hyperuricemia and periodontal disease, focusing on their inflammatory and microbial pathways. By integrating the literature data, the research attempts to better understand the potential role of gout as a risk factor for periodontal disease. (3) Methods: A systematic review was conducted following the PICOS framework, including studies that evaluated the association between gout and periodontal disease. (4) Results: The review highlighted a consistent association between gout and increased periodontal inflammation, which was likely driven by shared inflammatory mediators. (5) Conclusions: The effective management of periodontal disease in patients with gout requires supportive oral hygiene practices, lifestyle changes/control of uric acid levels through diet, as well as specific therapy to reduce inflammation and microbial pathogens to reduce disease severity. Full article

11 pages, 566 KiB

Open AccessArticle

Overview of the Surgical Management of Liver Oligometastatic Disease in Colorectal Cancer

by Anca Monica Oprescu Macovei, Dana Paula Venter, Bogdan Dumitriu, Constantin Oprescu, Mircea Dan Venter, Gabriel-Nicolae Andrei, Mures Sebastian Valcea Precup, Bogdan Socea and Mihai Stefan

J. Mind Med. Sci. 2025, 12(1), 31; https://doi.org/10.3390/jmms12010031 - 7 May 2025

Abstract

Oligometastatic colorectal cancer (CRC) refers to a state in which distant metastatic spread is limited to a few sites, offering the potential for curative treatment with aggressive local therapies. The surgical management of oligometastatic CRC has gained increasing attention due to its potential [...] Read more.

Oligometastatic colorectal cancer (CRC) refers to a state in which distant metastatic spread is limited to a few sites, offering the potential for curative treatment with aggressive local therapies. The surgical management of oligometastatic CRC has gained increasing attention due to its potential to improve survival. This review explores the evolving role of surgery in the treatment of oligometastatic disease, focusing on the criteria for selecting patients, surgical techniques, and outcomes. While systemic therapy remains essential, surgery can offer long-term survival benefits for appropriately selected patients with limited metastatic disease, particularly those with metastases confined to the liver. Advances in imaging technologies, minimally invasive surgical techniques, and perioperative care have enhanced the safety and efficacy of these procedures. The integration of multimodal therapies, such as chemotherapy, targeted therapy, and immunotherapy, in conjunction with surgery, is also discussed, with a focus on optimizing outcomes. To conclude, surgical resection of liver metastases improves survival compared to systemic therapy alone; thus, resection should be taken into consideration whenever possible. For initially unresectable diseases, personalized conversion therapy is indicated. This review aims to clarify how and when liver resection can first be chosen; when preoperative systemic treatment is needed; and if this is chosen, what is the best approach. Full article

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10 pages, 1608 KiB

Open AccessCase Report

Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report

by Iuliana Pantelimon, Andra-Maria Stancu, Claudiu Socoliuc, Fikirie Abzait, Irina Balescu, Nicolae Bacalbasa, Cristian Balalau, Laurenţia Nicoleta Galeș and Iulian Brezean

J. Mind Med. Sci. 2025, 12(1), 30; https://doi.org/10.3390/jmms12010030 - 6 May 2025

Abstract

Background/Aim: This case report navigates through the challenges of a complex clinical scenario involving germ cell tumors (GCTs), one of the most frequently encountered malignancies in adolescents and young adults. Case report: We present the case of an 18-year-old patient exhibiting atypical clinical [...] Read more.

Background/Aim: This case report navigates through the challenges of a complex clinical scenario involving germ cell tumors (GCTs), one of the most frequently encountered malignancies in adolescents and young adults. Case report: We present the case of an 18-year-old patient exhibiting atypical clinical manifestations, prompting emergent extensive surgical intervention. Upon admission to the Oncology Department, the adolescent presented with jaundice and dyspnea, being diagnosed with pure non-seminomatous embryonal carcinoma, a poor-risk prognosis group. Based on his prognostic group, the patient should have undergone chemotherapy with a well standardized regimen, but the imminent “liver visceral crisis” did not allow for the standard dose chemotherapy administration, so an adapted regimen of chemotherapy was considered and the full number of cycles was applied after this induction cycle. The treatment journey was protracted, emphasizing the need for early recognition and intervention in such cases. A comprehensive ongoing evaluation, including imagistic examinations and laboratory tests, revealed the presence of extensive refractory disease, which led to urgent treatment. Conclusions: This case provides valuable insights into the management of advanced testicular germ cell tumor in young patients facing imminent organ failure and underlines the importance of interdisciplinary collaboration. Understanding the complexities of this condition can aid in improving patient outcomes and enhancing the quality of care provided. Full article

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17 pages, 4131 KiB

Open AccessArticle

Enhancing Malignant Lymph Node Detection in Ultrasound Imaging: A Comparison Between the Artificial Intelligence Accuracy, Dice Similarity Coefficient and Intersection over Union

by Iulian-Alexandru Taciuc, Mihai Dumitru, Andreea Marinescu, Crenguta Serboiu, Gabriela Musat, Mirela Gherghe, Adrian Costache and Daniela Vrinceanu

J. Mind Med. Sci. 2025, 12(1), 29; https://doi.org/10.3390/jmms12010029 - 4 May 2025

Abstract

Background: The accurate identification of malignant lymph nodes in cervical ultrasound images is crucial for early diagnosis and treatment planning. Traditional evaluation metrics, such as accuracy and the Dice Similarity Coefficient (DSC), often fail to provide a realistic assessment of segmentation performance, as [...] Read more.

Background: The accurate identification of malignant lymph nodes in cervical ultrasound images is crucial for early diagnosis and treatment planning. Traditional evaluation metrics, such as accuracy and the Dice Similarity Coefficient (DSC), often fail to provide a realistic assessment of segmentation performance, as they do not account for partial overlaps between predictions and ground truth. This study addresses this gap by introducing the Intersection over Union (IoU) as an additional metric to offer a more comprehensive evaluation of model performance. Specifically, we aimed to develop a convolutional neural network (CNN) capable of detecting suspicious malignant lymph nodes and assess its effectiveness using both conventional and IoU-based performance metrics. Methods: A dataset consisting of 992 malignant lymph node images was extracted from 166 cervical ultrasound scans and labeled using the ImgLab annotation tool. A CNN was developed using Python, Keras, and TensorFlow and employed within the Jupyter Notebook environment. The network architecture consists of four neural layers trained to distinguish malignant lymph nodes. Results: The CNN achieved a training accuracy of 97% and a validation accuracy of 99%. The DSC score was 0.984, indicating a strong segmentation performance, although it was limited to detecting malignant lymph nodes in positive cases. An IoU evaluation applied to the test images revealed an average overlap of 74% between the ground-truth labels and model predictions, offering a more nuanced measure of the segmentation accuracy. Conclusions: The CNN demonstrated high accuracy and DSC scores, confirming its effectiveness in identifying malignant lymph nodes. However, the IoU values, while lower than conventional accuracy metrics, provided a more realistic evaluation of the model’s performance, highlighting areas for potential improvement in segmentation accuracy. This study underscores the importance of using IoU alongside traditional metrics to obtain a more reliable assessment of deep learning-based medical image analysis models. Full article

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25 pages, 970 KiB

Open AccessReview

Current Insight into the Dynamics of Secondary Endodontic Infections

by Alexandru Andrei Iliescu, Irina Maria Gheorghiu, Sergiu Ciobanu, Ion Roman, Anca Silvia Dumitriu and Stana Păunică

J. Mind Med. Sci. 2025, 12(1), 28; https://doi.org/10.3390/jmms12010028 - 4 May 2025

Abstract

Background/Objectives: The aim of this narrative review is to perform an updated literature review of the root canal microbiome in secondary endodontic infections and the bacterial dynamics that govern the processes leading to the development of these persistent endodontic infections and periapical lesions. [...] Read more.

Background/Objectives: The aim of this narrative review is to perform an updated literature review of the root canal microbiome in secondary endodontic infections and the bacterial dynamics that govern the processes leading to the development of these persistent endodontic infections and periapical lesions. Methods: A literature search of scientific publications issued in the last 8 years, i.e., 2017–2024, was conducted in PubMed (MEDLINE) and ScienceDirect databases, using the following keywords: endodontic microbiome; endodontic pathogens; periapical lesion; primary endodontic infection; secondary/persistent endodontic infection; functional redundancy. Discussions: Secondary endodontic infections (SEIs) are a highly prevalent pathological condition affecting a minimum of one tooth in more than half of adults worldwide. The transition from primary endodontic infection (PEI) to secondary endodontic infection (SEI) is mainly governed by Enterococus faecalis (EF) that invades and dominates the previous endodontic biofilm initiated by Fusobacterium nucleatum (FN). Conclusions: The findings from different studies indicate that secondary endodontic infections are polymicrobial. In SEIs, the microbial species interactions are crucial in influencing the ecology of infected root canals. The issue of the keynote pathogen is still under debate. Both EF and FN pathogens cooperate with neighboring residents. Functional redundancy of the endodontic microbiome explains how the ecological diversity modulates its pathogenicity. Full article

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10 pages, 1421 KiB

Open AccessCase Report

Acrodermatitis Chronica Atrophicans in a Patient with Pulmonary Sarcoidosis: Case Report and Literature Review

by Simona Roxana Georgescu, Alexandra Florentina Dobrescu, Ela Ghiță, Iulia Maria Teodora Leulescu and Mircea Tampa

J. Mind Med. Sci. 2025, 12(1), 27; https://doi.org/10.3390/jmms12010027 - 3 May 2025

Abstract

Introduction: Acrodermatitis chronica atrophicans (ACA) is a late-stage cutaneous manifestation of Lyme borreliosis, primarily caused by Borrelia afzelii. It mainly affects the distal limbs and leads to progressive skin atrophy. Unlike other Lyme disease rashes, ACA does not resolve on its own [...] Read more.

Introduction: Acrodermatitis chronica atrophicans (ACA) is a late-stage cutaneous manifestation of Lyme borreliosis, primarily caused by Borrelia afzelii. It mainly affects the distal limbs and leads to progressive skin atrophy. Unlike other Lyme disease rashes, ACA does not resolve on its own and can worsen into severe atrophy and fibrosis if left untreated. Diagnosing ACA can be difficult due to its delayed onset and subtle symptoms, requiring clinical evaluation, multiple blood tests, and skin biopsy. Case presentation: We present the case of a 48-year-old female with a history of pulmonary sarcoidosis who presented to our clinic with multiple erythemato-violaceous patches over her left lower leg and was initially misdiagnosed with venous insufficiency. Histopathological and serological analyses confirmed ACA in its inflammatory phase. The patient responded well to a 30-day course of doxycycline, achieving complete resolution. This report underscores the importance of considering ACA in differential diagnoses and provides a comprehensive review of its pathogenesis, clinical progression, histopathological features, and epidemiology. Conclusions: This case emphasizes the need to consider acrodermatitis chronica atrophicans (ACA) in the differential diagnosis of chronic skin lesions. Clinicians should maintain a high index of suspicion for ACA, particularly in atypical presentations. When the diagnosis is uncertain but clinical suspicion persists, skin biopsy is recommended for histopathologic confirmation. Early diagnosis and appropriate antibiotic therapy are essential to prevent disease progression and irreversible cutaneous atrophy. Accurate diagnosis and effective management require a multidisciplinary approach, involving close collaboration between dermatologists, pathologists, and infectious disease specialists. Full article

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16 pages, 1266 KiB

Open AccessReview

Diuretic Therapy: Mechanisms, Clinical Applications, and Management

by Nicoleta-Mirela Blebea, Ciprian Pușcașu, Emil Ștefănescu and Alina Mihaela Stăniguț

J. Mind Med. Sci. 2025, 12(1), 26; https://doi.org/10.3390/jmms12010026 - 2 May 2025

Cited by 1

Abstract

Diuretics are a class of pharmacological agents that promote the renal excretion of water and electrolytes, increasing urine output and reducing fluid retention. They play a critical role in the management of edematous syndromes, irrespective of their etiology (cardiac, renal, or hepatic), as [...] Read more.

Diuretics are a class of pharmacological agents that promote the renal excretion of water and electrolytes, increasing urine output and reducing fluid retention. They play a critical role in the management of edematous syndromes, irrespective of their etiology (cardiac, renal, or hepatic), as well as in the treatment of hypertension (HTA). The mechanism of action of diuretics can be classified as either renal, as seen with saluretic diuretics that inhibit sodium and water reabsorption at various segments of the nephron, or extrarenal, involving alterations in the glomerular filtration pressure or osmotic mechanisms. Based on their site of action and mechanism, diuretics are categorized into multiple classes, including loop diuretics, thiazide and thiazide-like diuretics, potassium-sparing diuretics, carbonic anhydrase inhibitors, and osmotic diuretics. These agents are frequently used in combination with other antihypertensive or heart failure medications to optimize therapeutic efficacy. By reducing the blood volume and peripheral vascular resistance, diuretics improve cardiac function, lower blood pressure, and enhance exercise tolerance. Additionally, they are employed in managing chronic kidney disease (CKD), electrolyte imbalances, and specific metabolic disorders. Given the potential for adverse effects such as electrolyte disturbances and renal dysfunction, diuretic therapy should be individualized, with the careful monitoring of the dosage, patient response, and comorbid conditions. Patient education on adherence, lifestyle modifications, and the recognition of side effects is essential for optimizing the therapeutic outcomes and minimizing the risks associated with diuretic therapy. Full article

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12 pages, 1786 KiB

Open AccessReview

Comprehensive Prenatal Genetic Analysis: From Non-Invasive Prenatal Testing to Whole-Exome Sequencing in a High-Risk Pregnancy with Gaucher Disease—A Case Report and Literature Review

by Ileana-Delia Săbău, Laurențiu-Camil Bohîlțea, Mihaela Țurcan, Adelina Silvana Gheorghe, Maria Riza, Mihai Mitroi, Antoanela Curici and Iuliana Ceaușu

J. Mind Med. Sci. 2025, 12(1), 25; https://doi.org/10.3390/jmms12010025 - 29 Apr 2025

Abstract

Gaucher disease (GD) is the most common lysosomal storage disorder, with an increased prevalence among Ashkenazi Jews. It is an autosomal recessive metabolic disorder caused by pathogenic variants in the GBA1 gene. In this study, we present the case of a 35-year-old patient [...] Read more.

Gaucher disease (GD) is the most common lysosomal storage disorder, with an increased prevalence among Ashkenazi Jews. It is an autosomal recessive metabolic disorder caused by pathogenic variants in the GBA1 gene. In this study, we present the case of a 35-year-old patient who initially underwent comprehensive non-invasive prenatal testing (NIPT), which included monogenic disorder screening. The result indicated a very high risk for GD in the fetus. Subsequently, the patient opted for a confirmatory prenatal diagnostic test—prenatal Whole-Exome Sequencing (WES). The results ruled out the diagnosis of GD in the fetus and excluded other genetic disorders included in the panel. This case highlights the importance of confirmatory prenatal testing after a high-risk NIPT and underscores the value of a comprehensive approach, such as WES, in prenatal genetic diagnostics. Full article

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13 pages, 1433 KiB

Open AccessArticle

The Relationship Between Alcohol Consumption and Depression: An Analysis of Secondary Affections and Therapeutic Interventions

by Simona Dana Mitincu-Caramfil, Eduard Drima, Loredana Sabina Pascu, Lavinia-Alexandra Moroianu, Florentina Gherghiceanu, Mihaela-Simona Popoviciu and Anca Pantea Stoian

J. Mind Med. Sci. 2025, 12(1), 24; https://doi.org/10.3390/jmms12010024 - 26 Apr 2025

Abstract

Alcohol use disorders are associated with many negative mental health outcomes such as the aggravation of symptoms of depression and anxiety disorders and, notably, increased suicidality. The nearly reciprocal relationship between the two entities makes treatment much more complex and necessitates care pathways [...] Read more.

Alcohol use disorders are associated with many negative mental health outcomes such as the aggravation of symptoms of depression and anxiety disorders and, notably, increased suicidality. The nearly reciprocal relationship between the two entities makes treatment much more complex and necessitates care pathways that are integrated. The present research addressed linking levels of alcohol use to the common mood disorders depression and anxiety and evaluating the feasibility of psychological interventions in reducing consumption and relieving the associated psychiatric symptoms. The sample comprised 147 patients hospitalized in a psychiatric facility (2021–2023) that were diagnosed according to DSM-5 criteria with alcohol dependence and depressive or anxiety comorbidities. The baseline and follow-up assessments utilized AUDIT (alcohol use), BDI (depression), and GAD-7 (anxiety) questionnaires. The psychological interventions included cognitive-behavioral techniques and motivational interviews. Of the participants, 33.8% presented with comorbid depression, 32.8% with anxiety disorders, and 33.4% with cognitive impairments. The psychological interventions significantly reduced alcohol consumption and the severity of depressive and anxiety symptoms. Superlative clinical outcomes came about with longer intervention time. The results call for the need for co-treating associated alcohol use as well as said mental conditions to optimize therapeutic results and improve quality of life for patients. These major implications lend themselves to the development of public health policies and tailored interventions to combat the concurrent battles between alcohol consumption and depression. Full article

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18 pages, 1385 KiB

Open AccessArticle

Detection of Adulterants in Herbal Weight Loss Supplements

by Oana Ramona Cătălina Gheorghiu, Anne Marie Ciobanu, Claudia Maria Guțu, George-Mădălin Dănilă, Gabriela Viorela Nițescu, Ștefan Rohnean and Daniela Luiza Baconi

J. Mind Med. Sci. 2025, 12(1), 23; https://doi.org/10.3390/jmms12010023 - 25 Apr 2025

Abstract

The growing popularity and consumption of herbal slimming supplements can be attributed to their perception as natural products that lack side effects. However, the composition and ingredient quality listed on their labels often undergo insufficient control. As a result, some manufacturers add undeclared [...] Read more.

The growing popularity and consumption of herbal slimming supplements can be attributed to their perception as natural products that lack side effects. However, the composition and ingredient quality listed on their labels often undergo insufficient control. As a result, some manufacturers add undeclared synthetic pharmaceuticals to enhance weight loss effects. The synthetic adulterants, particularly the anorectic stimulants, have been associated with increased risks of cardiovascular adverse effects, posing significant health risks to consumers. This study aimed to analyze various weight loss supplements marketed as “natural” products to detect possible adulterants. A new high-performance thin-layer chromatography (HPTLC) method was used for initial screening, while gas chromatography coupled with mass spectrometry (GC–MS) served as a confirmation tool. Additionally, high-performance liquid chromatography (HPLC) was employed to analyze phenolphthalein. A total of 34 supplements acquired online or from specialty stores were analyzed. It was found that most of them contain caffeine from herbal ingredients included in the products’ formulation. Some products list the added caffeine, but the measured levels significantly exceeded the labeled values. The most commonly detected adulterants were sibutramine and phenolphthalein. These results highlighted the inadequacies and inconsistencies in labeling, as all herbal supplements were declared “natural” despite containing adulterants. Furthermore, they highlighted the suitability of the HPTLC method as an effective and cost-effective screening tool for detecting adulterants in dietary supplements. Full article

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14 pages, 252 KiB

Open AccessArticle

Evaluation of Key Risk Factors Associated with Postoperative Complications in Colorectal Cancer Surgery

by Silviu Stefan Marginean, Mihai Zurzu, Dragos Garofil, Anca Tigora, Vlad Paic, Mircea Bratucu, Florian Popa, Valeriu Surlin, Dan Cartu, Victor Strambu and Petru Adrian Radu

J. Mind Med. Sci. 2025, 12(1), 22; https://doi.org/10.3390/jmms12010022 - 17 Apr 2025

Abstract

Background: Colorectal surgery remains a cornerstone in the management of colorectal cancer, yet postoperative complications continue to impact surgical outcomes. This study investigates key risk factors influencing morbidity, focusing on patient comorbidities, tumor characteristics, surgical techniques, and anastomotic methods. Methods: A retrospective analysis [...] Read more.

Background: Colorectal surgery remains a cornerstone in the management of colorectal cancer, yet postoperative complications continue to impact surgical outcomes. This study investigates key risk factors influencing morbidity, focusing on patient comorbidities, tumor characteristics, surgical techniques, and anastomotic methods. Methods: A retrospective analysis was conducted on 195 patients who underwent colorectal cancer surgery between January 2021 and December 2024 at the Clinical Hospital of Nephrology “Carol Davila”. Variables analyzed included patient demographics, comorbidities, tumor staging, surgical approach, and postoperative complications. Statistical methods included chi-square tests and multivariate logistic regression (significance threshold: p < 0.05). Results: The overall complication rate was 21%, with anastomotic leakage observed in 8.2% of cases. Significant risk factors for morbidity included cardiovascular disease (p = 0.001), chronic respiratory failure (p = 0.003), and chronic renal failure (p = 0.002). Laparoscopic surgery had a lower complication rate (7.1%) than open surgery (28%) (p = 0.003). Mechanical anastomosis showed lower complication rates than manual suturing (p = 0.009). Left-sided resections were associated with higher morbidity than right-sided procedures (p = 0.013). Conclusions: Optimizing colorectal surgery outcomes requires personalized perioperative strategies. Laparoscopic approaches and mechanical anastomosis significantly reduce complications. Further multicenter studies are needed to confirm these findings and enhance surgical guidelines. Full article

16 pages, 305 KiB

Open AccessReview

A Review of Postoperative Complications in Colon Cancer Surgery: The Need for Patient-Centered Therapy

by Adrian Silaghi, Dragos Serban, Corneliu Tudor, Bogdan Mihai Cristea, Laura Carina Tribus, Irina Shevchenko, Alexandru Florin Motofei, Crenguta Sorina Serboiu and Vlad Denis Constantin

J. Mind Med. Sci. 2025, 12(1), 21; https://doi.org/10.3390/jmms12010021 - 16 Apr 2025

Abstract

Surgery continues to be the primary therapeutic approach for patients diagnosed with colon cancer. Unfortunately, postoperative complications have been shown to negatively impact short-term patient outcomes, long-term oncological prognosis, and overall healthcare costs. The risk factors of postoperative complications are multiple, being linked [...] Read more.

Surgery continues to be the primary therapeutic approach for patients diagnosed with colon cancer. Unfortunately, postoperative complications have been shown to negatively impact short-term patient outcomes, long-term oncological prognosis, and overall healthcare costs. The risk factors of postoperative complications are multiple, being linked to the patient’s general condition (lifestyle, comorbidities, etc.), the state of the neoplastic disease, as well as the drug and surgical treatments applied. If these factors are associated, the incidence of postoperative complications especially increases in the form of anastomotic leakage, bleeding, infections, postoperative ileus, and stoma-related complications. It is not surprising that these conditions are common causes of prolonged hospitalization in colon surgery, being associated with high rates of morbidity and mortality. Literature data show that the management of the oncological patient, especially if treated surgically and even more so when they develop postoperative complications, is difficult. It is a direct consequence of the fact that such cases can be quite different from each other, so that the development of a common therapeutic protocol is not possible. Therefore, the purpose of this review is to update and highlight the main risk factors for unfavorable outcomes in patients diagnosed and treated surgically for colon cancer, determine what are the most common postoperative complications, and how the course towards severe forms of evolution is influenced by various clinical and biological parameters. Data used for this review were collected from literature published between 2013 and 2025, using several parameters presented in the text. Consequently, the management strategy for these postoperative complications must be primarily based on an early, multidisciplinary and personalized approach, which appear to significantly improve the therapeutic results obtained. Full article

6 pages, 1151 KiB

Open AccessCase Report

Synchronous Metastasizing High-Grade Papillary Serous Carcinoma of the Fallopian Tube and Triple-Negative Primary Breast Cancer in a BRCA1 Mutation Carrier

by Mihnea-Andrei Nicodin, Tudor-Petru Nicodin, Anca Popescu, Elena Rusu, Cosmin Alec Moldovan, Alice Elena Munteanu, Mariam Dalaty and Ovidiu Vasile Nicodin

J. Mind Med. Sci. 2025, 12(1), 20; https://doi.org/10.3390/jmms12010020 - 15 Apr 2025

Abstract

Patients with a BRCA1 germline mutation often represent a challenge for medical healthcare, since they develop malignancies that tend to be more aggressive and which need to be addressed in multidisciplinary teams with more individualized therapies. We report a case of a 37-year-old [...] Read more.

Patients with a BRCA1 germline mutation often represent a challenge for medical healthcare, since they develop malignancies that tend to be more aggressive and which need to be addressed in multidisciplinary teams with more individualized therapies. We report a case of a 37-year-old woman with a BRCA1 mutation who was diagnosed and treated for high-grade papillary serous carcinoma of the fallopian tube. Eight years later, her regular check-up imaging revealed a latero-aortic lymphadenopathy and a right breast tumor. She underwent a fine needle breast biopsy which was positive for invasive non-specific type carcinoma with negative estrogen, progesterone and Her2 receptors in immunohistochemistry tests. The patient underwent debulking surgery for metastatic lymphadenopathy, followed by chemotherapy with Carboplatin and Paclitaxel, and a modified right mastectomy with axillary lymphadenectomy. She subsequently initiated therapy with the PARP inhibitor Olaparib. No evidence of tumor recurrence was detected during the six-month postoperative follow-up period. The primary goal of this paper is to emphasize the complexity and challenges of managing patients with BRCA1 mutations who develop synchronous malignancies. This case report aims to highlight the increasing role of precision medicine and the importance of personalized, multidisciplinary therapeutic strategies, which include surgery, chemotherapy, and targeted therapies. Full article

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