Journal of Mind and Medical Sciences doi: 10.3390/jmms13020012

Authors: Caoimhe Hannigan Cassandra Dinius Eve Larkin Michelle E. Kelly

Background: Cognitive Stimulation Therapy (CST) is one of the most highly recommended non-pharmacological interventions for people living with dementia. In Ireland, over 650 practitioners have been trained to deliver CST; however, the intervention is not routinely available as a post-diagnostic support. The objective of this study was to identify barriers and facilitators to implementation of CST within the healthcare system in Ireland, through interviews with healthcare and policy professionals. Methods: Semi-structured interviews were conducted with 10 key stakeholders involved in the provision of dementia services in Ireland, either in a policy role (n = 5) or as a healthcare professional (n = 5). Participants were responsible for the leadership of a dementia service and/or the direct provision of clinical care. Data collection and analysis was guided by the Consolidated Framework for Implementation Research (CFIR). Framework analysis was used to identify themes that illustrated key barriers and facilitators to the implementation of this intervention in an Irish context. Results: Findings were organised into five themes: Familiarity, Understanding, and Evidence; Partnerships and Connections; Policy; Resources; and Attitudes and Culture. These themes illustrated barriers and facilitators to implementation operating at the Innovation, Outer Setting, and Inner Setting CFIR domains. Conclusion: Identifying and addressing key barriers and facilitators to the implementation of CST within the Irish healthcare system may help to support successful implementation and sustained use of the intervention in future. The CFIR provides a useful framework for conceptualising pre-implementation barriers and facilitators. The findings of this study can be used to develop specific implementation strategies and/or models to increase the availability of CST in Ireland.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13020011

Authors: Xolani Lawrence Mhlongo

Background: South African university students face escalating levels of psychological distress driven by academic overload, financial precarity, and social challenges. Health professions students are particularly vulnerable due to the demanding nature of clinical training and repeated exposure to human suffering. Aim: This study aims to propose an Integrated Student Well-being and Resilience Model tailored to the South African health professions education context. Methods: This conceptual paper draws on empirical evidence from South African studies on student mental health, global campus well-being frameworks, and socio-ecological theory. Bronfenbrenner’s Socio-Ecological Systems Theory and a tiered public health approach were synthesized to develop a multi-level model aimed at addressing the academic, financial, and social determinants of student mental health. Conceptual synthesis: The study unequivocally identified a syndemic of interconnected factors predisposing students to depression, which included the interplay of academic rigour and cognitive burnout, financial vulnerability as a determinant of mental health, the crisis of social connection and psychological safety, and institutional failure and the resilience fallacy. Conclusions: The Integrated Student Well-being and Resilience (ISWR) Model is a systemic architecture designed to coordinate institutional governance with the complex psychosocial needs of health professions students. The model provides a holistic, scalable framework for strengthening student well-being within health professions education. By shifting from reactive counselling to proactive, system-level interventions, the model offers a strategic blueprint for creating resilient, supportive learning environments capable of improving student mental health and fostering a healthier future healthcare workforce.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13020010

Authors: Sevgi Koroglu Gokbel Gulgun Durat

Background: Eating disorders are among serious psychiatric conditions and are associated with an increased risk of mortality and significant psychological distress. Mind–body therapies are attracting increasing attention as complementary interventions aimed at improving psychological well-being. The aim of this meta-analysis is to examine the effects of mind–body therapies on psychological outcomes in adults diagnosed with an eating disorder or exhibiting clinically significant symptoms associated with it. Methods: Randomized controlled trials published between 2003 and 2026 were identified through a systematic search of the PubMed, CINAHL, Web of Science, Cochrane, and Scopus databases. Studies were included that involved participants aged 18 years and over who had received a diagnosis of an eating disorder according to standard diagnostic criteria (e.g., DSM-IV, DSM-IV-TR, DSM-5) or who exhibited clinically significant symptoms associated with an eating disorder. Mind–body interventions were compared with control conditions. Methodological quality was assessed using the Joanna Briggs Institute assessment tool. Statistical analyses were performed using Stata 16.0 software. Results: Nine randomized controlled trials involving a total of 688 participants were included in the meta-analysis. It was found that mind–body interventions significantly reduced levels of depression (Hedges’ g = −0.44, 95% CI: −0.67 to −0.20). Similarly, significant reductions were observed in levels of inadequate self (g = −0.51, 95% CI: −0.84 to −0.18) and self-hated (g = −0.56, 95% CI: −0.89 to −0.23). Although an effect in the direction of an increase was observed for self-compassion (g = 0.31, 95% CI: 0.07–0.54), this effect was not found to be statistically significant following the correction applied for multiple comparisons. In contrast, anxiety (g = −0.19, 95% CI: −0.39 to 0.02), stress (g = −0.48, 95% CI: −1.05 to 0.09), and self-esteem (g = 0.29, 95% CI: −0.16 to 0.73). Conclusions: Mind–body therapies are associated with improvements in certain psychological outcomes among adults with a diagnosis of an eating disorder or those exhibiting clinically significant symptoms. However, the current findings should be interpreted with caution, as the included studies largely relied on waiting-list or usual-care control groups.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13020009

Authors: Melissa J. Culligan Angela Tod Mary Regan N. Jennifer Klinedinst Joseph S. Friedberg Kim Mooney-Doyle

Pleural Mesothelioma (PM) is a rare, incurable malignancy of the pleura. Lung-sparing surgery, considered investigational, aims to prolong survival and improve quality of life (QOL). Beyond the standard quantitative measures used to determine successful surgical outcomes, an understanding of an individual’s perception of the impact surgery has had on their symptom burden and QOL has not been reported in the literature. The primary aim of this study was to explore the lived experience of dyspnea and QOL before and after lung-sparing surgery. The philosophical approach to this study was grounded in hermeneutical phenomenology. Participants underwent in-depth semi-structured interviews before and 3–4 months post-surgery, analyzed through Interpretive Phenomenological analysis. The analysis identified Group Experiential Themes (GETs) before and after surgery: Psychological (mind supports body), Physiological (body fighting, enduring, and adapting), Social (others sharing and supporting), and Existential (facing an uncertain future). The emotional impact of PM is multidimensional, involving time, internal psychological struggles, and coping with the diagnosis. The physical impact disrupts normal routines and interactions, while social interactions influence the perception of the illness experience. Facing PM disrupts normal bodily routines and interactions with the world. This study provides qualitative evidence that perceptions of dyspnea and QOL significantly impact the patient experience before and after surgery. The enriched understanding of living with mesothelioma and enduring lung-sparing surgery comes from the patients’ voices, highlighting the continuum of dyspnea and QOL influenced by various factors. Healthcare teams must consider patients’ physical, emotional, social, and existential experiences beyond measurable outcomes.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13020008

Authors: Magdalena Dzięgiel Aleksandra Maciejowska Dawid Juszkiewicz Wiktor Kaleta Marta Zawadzka Maria Mazurkiewicz-Bełdzińska

Worster-Drought syndrome (WDS), also known as congenital suprabulbar paresis, is a rare neurodevelopmental disorder characterized by feeding, swallowing, drooling, and speech disturbances. Currently, it is classified as a subtype of cerebral palsy. However, the limited number of studies and the clinical and radiological overlap with related entities such as congenital bilateral perisylvian syndrome (CBPS) and Foix-Chavany-Marie syndrome (FCMS) have contributed to persistent uncertainty regarding its proper classification. In this review, we summarize the current knowledge on the WDS based on data from published case series. Special emphasis is placed on proposed etiological mechanisms, including recent genetic findings potentially contributing to WDS, as well as on the diagnostic process, ongoing classification dilemmas, and spectrum-based perspective. We point out the need to establish standardized diagnostic criteria and conduct large-scale genetic and neurodevelopmental research. Addressing these gaps may help clarify the underlying pathophysiology, reappraise the classification framework, and ultimately minimize misdiagnosis and time to proper diagnosis to improve outcomes for individuals affected by WDS.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13010007

Authors: Brent Nixon Anne Pleydon Nicholas Deptuch Fiyin Peluola Patrick Emeka Okonji Cameron Bye Kingsley Nwachukwu Winifred Okoko Mansfield Mela

Cognitive impairments are a core feature of psychotic disorders and are strongly associated with long-term functional disability. Although Cognitive Remediation Therapy (CRT) is an evidence-based intervention for improving cognition in psychosis, its feasibility and preliminary effects in acute inpatient settings—particularly using web-based platforms—remain underexplored. This single-arm, pre–post pilot study evaluated the feasibility of delivering a web-based CRT program and examined preliminary cognitive outcomes in a secure psychiatric inpatient facility. Thirteen inpatients with psychotic and non-psychotic diagnoses completed a 15-week intervention comprising twice-weekly sessions that included adaptive computerized CRT exercises (Happy Neuron Pro) and therapist-led bridging discussions focused on metacognitive reflection and functional application. Cognitive performance was assessed pre- and post-intervention using the MATRICS Consensus Cognitive Battery. All participants completed the study with no withdrawals or adverse events, attending a mean of 27.77 of 30 sessions (93.0%). Pre–post improvements were observed in processing speed, verbal learning, and overall composite cognition, with large within-sample effect sizes that remained robust in sensitivity analyses. Exploratory analyses suggested potential associations between sex, history of self-harm, and cognitive change, though these findings require cautious interpretation. Findings support the feasibility of inpatient web-based CRT and provide preliminary cognitive effect-size estimates. Given the single-arm design and absence of systematic medication monitoring, results should be interpreted as exploratory signals warranting controlled validation. Overall, findings support the feasibility of inpatient web-based CRT and provide preliminary signals of cognitive benefit, warranting evaluation in larger controlled studies.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13010006

Authors: Kimberley Estenson Carmel Digman Katharina Reichelt Ian A. James

Background/Objectives: Behaviours that challenge (BtC) are common in people with dementia. International guidelines recommend using non-pharmacological interventions (NPIs) as first-line treatments. A promising training package that provides a framework for delivering NPIs is “Communication and Interaction Training” (CAIT); this programme has received national recognition within the UK. Our study aimed to explore staff’s perceptions of the effect of CAIT on their understanding and responses to the behaviours and emotions of people with dementia. The study also sought to further understand how CAIT worked and the conditions which help implement it. Methods: Reflexive thematic analysis was used to analyse interviews with 11 staff who had been trained in the use of CAIT and then attempted to implement the contents of the training in clinical settings. Results: Six main themes emerged regarding the impact of the training: enhancing understanding, transforming interactions, skills development, accessible and flexible, socio-cultural change enablers, and obstacles in training. CAIT was viewed positively by the participants and was perceived to improve their knowledge, attitudes and skills. Conclusions: The positive findings are consistent with previous studies on CAIT and its current use in guiding training programmes in the UK. Implications for the delivery of CAIT are discussed, as well as suggestions for further trials of the programme.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13010005

Authors: Canahmet Boz Feyza Topçu

A cancer diagnosis has long-term physical and psychological consequences, and patients vary considerably in their mental health outcomes during the disease process. Psychological resilience has been identified as a protective factor, yet the mechanisms through which it influences mental health remain unclear. This study aims to examine the mediating role of psychological flexibility in the relationship between psychological resilience and mental health among individuals diagnosed with cancer. A total of 234 cancer patients participated in this cross-sectional study. Data were collected using the Depression, Anxiety and Stress Scale (DASS-21), the Connor–Davidson Resilience Scale–Short Form, and the Psychological Flexibility Scale. Path analysis was conducted to test the proposed mediation model. The results indicated that psychological resilience was positively associated with psychological flexibility, and psychological flexibility was negatively associated with depression, anxiety, and stress. Psychological flexibility fully mediated the relationship between psychological resilience and mental health. These findings suggest that psychological flexibility plays a key role in explaining how psychological resilience contributes to better mental health outcomes in cancer patients. Interventions aiming to enhance psychological flexibility may therefore be beneficial in psychosocial support programs for individuals coping with cancer.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13010004

Authors: Janet Real-Ramírez Oscar Arias-Carrión

Training the public health workforce is a critical component of health system strengthening. In Mexico, postgraduate education operates under a national accreditation framework intended to ensure academic quality and social relevance, yet comprehensive information about the scope and distribution of training programs is limited. This study characterizes public health and related academic programs available in 2024, examining the institutional sector, delivery modality, geographic distribution, and accreditation status. A systematic institutional mapping was conducted through structured searches of the official websites of public and private higher education institutions. Eligible programs included bachelor’s degrees, specializations, master’s degrees, and PhDs that were active between March and November 2024. Searches used predefined keyword combinations, repeated at multiple timepoints, and were restricted to official institutional domains. Data were extracted on academic level, institutional sector, delivery format, duration, geographic region, and inclusion in the National Postgraduate System. Descriptive statistics and logistic regression were used to analyze accreditation patterns; geospatial analysis assessed regional distribution. A total of 175 programs were identified across 30 of Mexico’s 32 states. Professional master’s degrees represented the largest category, followed by research-oriented master’s and PhD programs. Public institutions offered nearly two-thirds of all programs. Among postgraduate programs, fewer than half were accredited, with accreditation concentrated in master’s degrees in science (84.6%) and PhDs (55.6%). Only 23.0% of professional master’s degree were accredited. Most programs were delivered fully in person; online offerings were limited and more common in private institutions. Research-oriented programs were geographically concentrated in a small number of states, whereas professional programs exhibited broader but uneven national distribution. Public health education in Mexico shows growth in professionally oriented training but also reveals persistent gaps in accreditation, geographic equity, and flexible delivery modalities. The disproportionate expansion of professional programs without corresponding integration into accreditation frameworks raises concerns for workforce planning and educational equity. Strengthening national information systems, improving institutional reporting standards, and aligning accreditation criteria with workforce needs are essential to ensure that public health training supports progress towards universal health coverage and the Sustainable Development Goals.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13010003

Authors: Ettore D’Aleo Marco Leuzzi Maria Carmela Zagari Lorenzo Campedelli Mara Lastretti Emanuela A. Greco Giuseppe Seminara Antonio Aversa

Gender incongruence significantly impacts the family system, yet the subjective experiences of caregivers remain relatively underexplored. This narrative review synthesizes contemporary evidence regarding psychological distress, emotional burden, and quality of life among caregivers of transgender and gender-diverse individuals. A targeted literature search of PubMed, Scopus, PsycInfo, and Google Scholar (2015–2025) was conducted, identifying 16 studies for thematic synthesis. Results indicate that caregivers consistently report elevated emotional distress, characterized by chronic anxiety, hypervigilance, and ambiguous loss. This burden is primarily driven by prolonged exposure to uncertainty, the weight of complex medical decision-making—particularly regarding fertility and hormone therapy—and vicarious minority stress stemming from social stigma and systemic barriers. Notably, distress is often intensified by sociopolitical climates rather than the transition process itself. Conversely, access to peer support networks, healthcare relationships, and engagement in advocacy emerged as vital protective factors facilitating resilience and adaptive meaning-making. We can conclude that caregiver well-being is a multifaceted process deeply embedded in social and institutional contexts. These findings underscore the necessity of integrated, family-centered medical-psychological models that explicitly support caregivers to ensure more equitable and effective gender-affirming care pathways.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13010002

Authors: Lucky Norah Katende-Kyenda

Background: Medication adherence and persistence in treating chronic diseases present as a continuous challenge for healthcare providers in long-term management. The most frequent reasons that several diseases are poorly controlled in the population include suboptimal drug adherence and discontinuation of therapies. One main issue why physicians cannot detect patients with poor adherence is that they have relatively limited time and tools to do so. Aim: To review the critical role of medication adherence in the management of chronic diseases by addressing the following: what medication adherence is; its critical role; factors and strategies influencing it; challenges and consequences of poor adherence; patients at risk; present and future strategies in place to detect and improve adherence; implications for public health and health value creation for patients; key analytical frameworks for understanding it; determinants; how adherence improves health; the role of healthcare professionals and technological innovations; implications of medication adherence; adherence as a key area for exploring the psychological mechanisms underlying patient behavior; and patient adherence as a major social and public health challenge. Finally, this review considers strengths, limitations, recommendations, and future value. Methodology: The following databases were used to carry out the review: PubMed, Scopus, Google Scholar, and ScienceDirect. The following themes were combined in the search: what adherence is, why it is critical, why adherence occurs, and how to improve adherence. The following search terms were used: what adherence is and critical, why and adherence and occurs, and how and to improve adherence. Results: Under the theme of why adherence is critical, five sub-themes were reviewed; four sub-themes were reviewed under the theme of why adherence occurs; and five sub-themes were reviewed under the theme of how to improve adherence. Conclusions: Strategies to enhance medication adherence involve a comprehensive approach that includes patient education, streamlined treatment plans, digital tools, and effective communication from healthcare professionals.

Journal of Mind and Medical Sciences doi: 10.3390/jmms13010001

Authors: Turky J. Arbaein Afnan A. Alandijani Mohammad Shah Khulud K. Alharbi Sahal Alzahrani Soukaina Ennaceur Afrah A. Alfahmi Khawlah O. Alharthi

Objectives: The present study examined the prevalence of depression, anxiety, and other mental disorders among patients visiting primary healthcare centers (PHCs) in Makkah, Saudi Arabia, and explored demographic, lifestyle, and socioeconomic determinants associated with these conditions. Methods: The study analyzed regional-level data from PHC patients diagnosed with mental health illnesses. The prevalence rates of depression, anxiety, and other mental health disorders were calculated and associated risk factors were assessed using binary variables. Results: The study found that 40% of the population was diagnosed with depression, 25% with anxiety, and 35% with other mental disorders. Depression was most prevalent among patients aged 50–64 years, while anxiety was highest among those aged 19–34 years. The lowest rates were observed in patients aged 65 years or older. Females exhibited higher rates of depression and anxiety than males. Saudi nationals accounted for most cases, with unemployment having the highest prevalence. Single individuals reported the highest prevalence of depression and anxiety. Conclusions: The research indicates a significant prevalence of depression, anxiety, and other mental disorders among primary healthcare patients in Makkah, with females, the unemployed, and younger individuals at elevated risk. Low follow-up rates suggest barriers to ongoing mental health care and highlight the need for targeted interventions.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12020044

Authors: Ion G. Motofei

Contemporary clinical medicine relies on the integration of clinical observation with physiological and pathological mechanisms to improve diagnosis, therapeutic decision-making, and patient outcomes. However, most current biomedical research interprets these mechanisms predominantly through the lens of upward emergence, according to which higher-order biological functions arise from the interaction of simpler lower-level components. Although indispensable for understanding visceral diseases, this perspective provides only partial access to biological complexity. Accumulating evidence from neuroscience, developmental biology, endocrinology, psychiatry, and regenerative medicine shows that higher-level systemic functions can also reorganize, modulate, or generate lower-level structures, a phenomenon known as downward emergence. Together, upward and downward emergence form a bidirectional framework that more accurately reflects the complex organizational pattern of biological systems. This editorial argues that clinical practice and biomedical research must explicitly acknowledge this bidirectional dynamic, as many diseases (including malignancy) cannot be fully understood through upward emergence alone. Downward emergent processes explain phenomena such as morphogenesis, regeneration, matrix remodeling, immunological reprogramming, endocrine-neurovegetative integration, and forms of pathological transformation that are difficult to interpret through classical reductionism. Viewing cancer as the pathological expression of a disturbed supracellular program provides a coherent explanation of its complex biology and highlights the possibility that malignant progression could be responsive to higher-order regulatory instructions. In this context, the Journal of Mind and Medical Sciences is undertaking a conceptual and editorial realignment, positioning itself as a journal of bidirectional emergence in health and disease. Rather than diminishing its clinical mission, this shift strengthens it by providing a more comprehensive framework for understanding physiological and pathological organization, one that integrates structure–function and function–structure relationships. As medicine moves toward increasingly integrative and mechanistic models of disease, adopting a bidirectional perspective becomes not only scientifically justified but also necessary for advancing diagnostic accuracy, therapeutic innovation, and the development of novel supracellular strategies for human health.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12020043

Authors: Mugapish Hussain Mushi Ahmad Iqmer Nashriq Mohd Nazan Mohd Ismail Ibrahim Irniza Rasdi Omar Zayyan Alsharqi Majed Awad Albalawi

Background: Medication errors pose significant health risks and economic burdens globally. In Saudi Arabia, the reported error rates range from 1.6% to 84.8%; yet, the contributing factors remain inadequately understood. This systematic review aims to identify the associated factors and predictors of medication errors across Saudi healthcare settings. Methods: Electronic databases (EMBASE, CINAHL, and PubMed) were searched for peer-reviewed articles published from January 2010 to January 2025. Studies reporting statistically significant factors associated with medication errors or error reporting in Saudi Arabia were included. A quality assessment was conducted using the Appraisal tool for Cross-Sectional Studies (AXIS). Results: Thirteen studies met the inclusion criteria. Healthcare-worker-related factors included age (workers < 35 years are more prone to errors), experience level (4–5 years optimal for reporting), negative attitudes toward errors (AOR = 14.08), and a lack of training (AOR = 7.29). Patient-related factors included advanced age (1.0–2.7-times increased risk), males, polypharmacy (1.1–5.3-times increased risk), and high-risk medications (hypoglycemic drugs, warfarin, and antibiotics). System-related factors included day shift timing (AOR = 1.1), oral medication route (AOR = 0.4), ICU setting (3.3-times increased risk), medical unit setting (1.7-times increased risk), confusing packaging, and look-alike/sound-alike medications. Conclusions: Our findings emphasize that medical errors arise from a complex interplay between healthcare-worker-related factors (age, experience, and attitudes) and hospital-administration-related factors (reporting mechanisms, documentation practices, shift timing, and workload).

Journal of Mind and Medical Sciences doi: 10.3390/jmms12020042

Authors: Shan-Ju Lin Yin-Chi Chen Chih-Yin Chang Mei-Jing Huang Chen-Kai Young Ru-Ting Liu Hsin-Po Sun Shuo-Tsung Chen

Unexpected in-hospital cardiac arrest (IHCA) in the emergency department is defined as an unexpected cardiac arrest during the stay in the emergency department with measured vital signs when entering the emergency department, requiring immediate emergency treatment to save a life. Since IHCA is an urgent medical event, especially in the emergency department, this study explored the risk prediction of IHCA events in the emergency department. IHCA not only has a high mortality rate, but is also likely to cause permanent neurological damage. In the emergency environment, due to the complexity and rapid changes in the patient’s condition, traditional assessment tools often fail to identify high-risk cases in a timely manner. In view of this, this study uses both the Power BI visual analysis platform and the binary decision tree model to construct a data-driven risk prediction tool. Power BI analysis successfully presented the dynamic ranking of influencing factors, and the decision tree prediction model showed excellent performance, with an accuracy of 91%, a recall rate of 89%, an F1-score of 89%, and an overall accuracy of 100%; this prediction system is expected to improve the efficiency of emergency medical care, identify high-risk patients in a timely manner, and assist medical staff in intervening in advance and implementing preventive measures. This study provided two different approaches: Power BI and decision tree. Power BI requires no coding and can be used by medical professionals without a programming background, while decision tree is designed for professionals with a programming background. While the structures of Power BI and decision tree differ slightly, they are generally similar and can both serve as intelligent clinical tools.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12020041

Authors: Nayelli Nájera Levy Munguía Miguel Ortiz Francisco Villarreal Yuridia Martínez-Meza Amalia Gómez-Cotero Guillermo Ceballos

Cognitive decline among older people is a growing concern worldwide since it impacts quality of life and independence. Recently, we reported that an epicatechin-enriched product improves cardiometabolic status, physical performance/mobility, and quality of life (QoL) in over-60-year-old subjects. Here, we explored the effects of an (−)-epicatechin-enriched cacao supplement on the cognitive conditions of older and sedentary individuals residing in a community center. Twelve persons with the inclusion criteria were included in this proof-of-concept study. We evaluated reasoning, memory, attention, coordination, and perception using CogniFit software, version 4.6.18. Patients received a mixture of cacao flour and 15 mg of free (−)-epicatechin twice daily for 3 months. The main results from the trial suggested a positive and significant improvement in perception, coordination, reasoning, attention, and memory.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12020040

Authors: Oana Denisa Balalau Fernanda Ecaterina Augustin Cristian Balalau Romina Marina Sima Liana Ples

Vulvar carcinoma is the fourth most common gynecological cancer, with squamous cell carcinoma being the most frequent type. Vulvar intraepithelial neoplasia (VIN) is a precursor lesion and is strongly associated with human papillomavirus (HPV) infection. This paper presents two patients in their sixth decade of life, the first diagnosed with VIN 3 (carcinoma in situ) and the second with stage IA keratinizing squamous cell carcinoma. Both patients had HPV infection; immunohistochemistry confirmed HPV-dependent VIN3 in the first case, while the second patient had a pre-existing HPV high-risk 53 infection. Both patients underwent partial vulvectomy, with the second also having bilateral inguinal–femoral lymph node dissection, which showed no lymph node invasion. The first patient had a histopathological result of VIN 3 with clear margins. The second patient underwent adjuvant radiotherapy following restaging pathology. Both are showing favorable postoperative progress. Conclusions. The early diagnosis of vulvar neoplasms enables less radical but effective surgeries, balancing oncologic control with quality of life. A multidisciplinary approach is essential for adjusting treatments, improving both clinical outcomes and patient well-being.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12020039

Authors: Felicia Suciu Oana Cristina Șeremet Emil Ștefănescu Ciprian Pușcașu Cristina Isabel Viorica Ghiță Cerasela Elena Gîrd Robert Viorel Ancuceanu Simona Negreș

Background: Chronic pain poses a major global health burden, often inadequately managed by conventional analgesics due to limited efficacy and side effects. In this context, plant-based therapies offer a promising alternative. This study aimed to evaluate the antioxidant and analgesic potential of four medicinal plants traditionally used for pain relief: Morus alba, Angelica archangelica, Valeriana officinalis, and Passiflora incarnata. Methods: Phytochemical analyses quantified total phenolic acid, flavonoid, and polyphenolic acid contents in the extracts. Antioxidant activity was assessed using the ABTS radical scavenging assay. Analgesic effects were evaluated in vivo using the hot-plate and tail-flick tests in mice treated for 14 days with plant extracts or paracetamol. Results: Morus alba showed the highest polyphenolic content and strongest antioxidant activity (IC50 = 0.0695 mg/mL). In analgesic tests, Angelica archangelica demonstrated the most significant effect in the hot-plate test (72.2% increase in latency), while Valeriana officinalis had the highest efficacy in the tail-flick test (41.81%), exceeding paracetamol’s performance in that model. Conclusions: While antioxidant activity correlated with polyphenol content, analgesic effects appeared to involve additional mechanisms. These findings support the potential of Angelica archangelica and Valeriana officinalis as effective natural alternatives for pain relief.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12020038

Authors: Stelian Ianiotescu Constantin Gingu Irina Balescu Nicolae Bacalbasa Cristian Balalau Ioanel Sinescu

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010037

Authors: Irina Maria Gheorghiu Sergiu Ciobanu Ion Roman Stana Păunică Anca Silvia Dumitriu Alexandru Andrei Iliescu

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010036

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

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010035

Authors: Mădălin Bulzan Florica Voiță-Mekeres Simona Cavalu Gheorghe Szilagyi Gabriel Mihai Mekeres Lavinia Davidescu Călin Tudor Hozan

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010034

Authors: Alina Mihaela Munteanu Teodor Cristian Rădoi Cristiana Susana Glavce Monica Petrescu Suzana Turcu Adriana Borosanu

(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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010033

Authors: Laura-Florentina Rebegea Dorel Firescu Oana-Gabriela Trifanescu Roxana-Andreea Rahnea-Nita Liviu Bilteanu Mihaela Dumitru Florentina Lacatus Gabriela Rahnea-Nita

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010032

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

(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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010031

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

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010030

Authors: Iuliana Pantelimon Andra-Maria Stancu Claudiu Socoliuc Fikirie Abzait Irina Balescu Nicolae Bacalbasa Cristian Balalau Laurenţia Galeș Iulian Brezean

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010029

Authors: Iulian-Alexandru Taciuc Mihai Dumitru Andreea Marinescu Crenguta Serboiu Gabriela Musat Mirela Gherghe Adrian Costache Daniela Vrinceanu

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010028

Authors: Alexandru Andrei Iliescu Irina Maria Gheorghiu Sergiu Ciobanu Ion Roman Anca Silvia Dumitriu Stana Păunică

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010027

Authors: Simona Roxana Georgescu Alexandra Florentina Dobrescu Ela Ghiță Iulia Maria Teodora Leulescu Mircea Tampa

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010026

Authors: Nicoleta-Mirela Blebea Ciprian Pușcașu Emil Ștefănescu Alina Stăniguț

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010025

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

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010024

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

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010023

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

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010022

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

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010021

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

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010020

Authors: Mihnea-Andrei Nicodin Tudor-Petru Nicodin Anca Popescu Elena Rusu Cosmin Moldovan Alice Munteanu Mariam Dalaty Ovidiu Nicodin

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.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010019

Authors: Hayriye Mihrimah Ozturk Ibrahim Halil Inanc Mehmet Cilingiroglu Yasar Turan Huseyin Kandemir Selcuk Ozturk

Objective: The literature concerning the association between coronary slow flow (CSF) and anxiety and depression is controversial. Furthermore; there is no existing data in the literature on the potential association between CSF and adverse childhood experiences or alexithymia. Methods: The participants underwent coronary angiography through femoral access. Coronary artery blood flow rate was evaluated quantitatively for each coronary artery according to the Thrombolysis in Myocardial Infarction frame count (TFC) method. CSF was diagnosed as a corrected TFC value >27 in at least one coronary artery during the imaging. Symptoms of anxiety and depression were assessed through the Hospital Anxiety and Depression Scale (HADS). Alexithymia and ACE were evaluated by the Twenty-item Toronto Alexithymia Scale (TAS-20) and the Childhood Trauma Questionnaire (CTQ). Results: The study participants were categorized into two groups: normal coronary flow (n = 58) and CSF (n = 18). Total HADS score; HADS anxiety subscale (HADS-A) score; and HADS depression subscale (HADS-D) score were determined as significant factors associated with CSF in univariate logistic regression analysis. However; the TAS-20 and CTQ scores showed no significant association with CSF. Multivariate regression analysis performed in separate models demonstrated that total HADS score (OR: 1.27; 95 CI%: 1.08–1.50; p = 0.003); HADS-A score (OR: 1.25; 95 CI%: 1.03–1.51; p = 0.019); and HADS-D score (OR: 1.36; 95 CI%: 1.06–1.74; p = 0.014) were independently associated with CSF in multivariate logistic regression analysis. Conclusions: Neither alexithymia nor ACE was associated with CSF. On the other hand; measures of both anxiety and depression assessed through HADS were independently associated with CSF. Future studies should address the major limitations of this study; such as the limited sample size; lack of structured diagnostic interview by a psychiatrist; and the lack of establishment of causality

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010018

Authors: Petar Kalaydzhiev Tsvetelina Velikova Gergana Voynova Desislava Somleva Natalia Spasova Radostina Ilieva Elena Kinova Assen Goudev

Background: Managing acute decompensated heart failure (ADHF) is complex, particularly when combined with comorbidities like sleep apnea. Effective treatment requires personalized approaches, focusing on quality of life (QoL) and mental health outcomes. Purpose: This study explored the prevalence and characteristics of sleep apnea in patients with obesity and AHF exacerbations. It assessed how different sleep apnea phenotypes impact QoL and mental health, applying personalized medicine strategies. Methods: A prospective cohort study was conducted on 150 patients admitted for AHF exacerbation. Inclusion criteria included an Apnea–Hypopnea Index (AHI) > 5, an Epworth Sleepiness Scale (ESS) > 8, NT-proBNP > 900 pg/mL and informed consent obtained prior to participation. Optimized medical treatment was provided. QoL and mental health were evaluated using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Beck Depression Inventory (BDI). Results: Among 81 patients with sleep apnea, 73% (n = 59) had obstructive sleep apnea (OSA) and 27% (n = 19) had central sleep apnea (CSA). OSA patients reported a higher QoL (61.12 ± 17.88) compared to CSA patients (37.18 ± 19.98, p < 0.001). CSA patients exhibited more severe depression (BDI: 26.18 ± 5.5 vs. 16.64 ± 4.1, p < 0.001). Significant correlations were noted between KCCQ and BDI scores (r = −0.849, p < 0.001) and central apnea events (r = −0.485, p < 0.001). Conclusions: Sleep apnea is common in ADHF patients, with CSA being linked to poorer QoL and greater depression. Personalized medicine offers promising strategies to enhance care and outcomes.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010017

Authors: Esra Tosun Ali Timucin Atayoglu

Objective: This study aims to explore the integration of Enneagram personality types with homeopathic prescribing by evaluating the relationship between personality traits and the corresponding homeopathic remedies, enhancing individualized care through an analysis of the possible mind rubrics. Method: Personality traits from the dynamic Enneagram model were mapped to corresponding mental–emotional traits. These traits were matched to the relevant possible rubrics in the Synthesis Treasure Edition repertory, using Radar Opus software. A total of 36 analyses were conducted across nine personality types. The frequency distribution (%) of remedies appearing in the top five rankings was analyzed, identifying remedies corresponding to the highest number of rubrics. Results: Forty rubrics were used in the repertorization, with duplicate rubrics counted only once, and nine different remedies were identified with a value of four points. The frequency distribution showed that polychrest remedies appeared most frequently in the top five rankings across all 36 analyses, indicating a relationship between certain remedies and personality traits. Conclusions: Integrating Enneagram personality traits into homeopathic prescribing could enhance individualized care by providing additional insights for remedy selection, alongside the traditional approaches that are commonly used, such as case analysis using the totality of symptoms. Further research is needed to refine and validate this approach.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010016

Authors: Bianca Mihaela Berechet Olga Hilda Orășan Vasile Negrean Ioana Para Irina Camelia Chiș Nicolae Dan Sporiș Angela Cozma Adela Viviana Sitar-Tăuț Simona Valeria Clichici

Research undertaken over the past few years has brought attention to the role of oxidative stress in the development of neoplasms by damaging nucleic acids, lipids, and proteins, thereby altering their normal function. In general, the levels of antioxidant enzymes are low in patients with neoplasms, and the biomarkers used to quantify oxidative stress have increased levels. Elevated levels of 8-hydroxy-deoxyguanosine (8-OHdG) and malondialdehyde (MDA), as well as decreased levels of antioxidant enzymes, have been observed in patients diagnosed with colorectal cancer (CRC) at various stages of evolution, but further research is needed on the correlation between these biomarkers and disease progression. Inflammation enhances the production of reactive oxygen species and plays an important role in CRC development. Studies in the field of metabolomics have suggested that changes in serum metabolites might be indicators of the progression from adenoma to colorectal carcinoma, particularly those resulting from lipid metabolism. The role of lipidomics in the pathogenesis of CRC warrants further investigation, as these combinations of metabolites (metabolic fingerprints) may have the potential to become clinically useful markers. In this article, we review our current understanding of the interplay between oxidative stress, inflammatory markers and lipidomic products in the pathogenesis of CRC.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010015

Authors: Florentina Dumitrescu Livia Dragonu Eugenia-Andreea Marcu Rodica Pădureanu Lucian Giubelan Cristiana-Luiza Rădoi-Troacă Anca Duduveche Ilona-Andreea Georgescu Andreea Gabriela Istrate Mihai Olteanu

Measles remains an important cause of morbidity and mortality worldwide. Most HIV-infected adults are immune against measles, so titres of measles antibodies should be determined prior to vaccination. A measles vaccine can be administered to HIV-positive patients who do not have protective antibody levels and who have a CD4 lymphocyte count ≥ 200 cells/mm3. We describe the case of an HIV-infected patient, diagnosed with complicated measles at our Infectious Diseases Hospital in April 2024.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010014

Authors: Teodora-Gabriela Alexescu Antonia Nechita Paula Alexander Mirela-Georgiana Perné Mircea-Vasile Milaciu George Ciulei Ioana Para Vasile Negrean Ana-Florica Chiș Doina-Adina Todea Dan Vălean Simina-Felicia Țărmure Olga-Hilda Orășan

Background: Diabetes mellitus (DM) is a chronic metabolic disorder significantly associated with cardiovascular complications. Electrocardiographic (ECG) abnormalities are common in patients with type 2 diabetes (T2DM) and can serve as early markers for cardiovascular risk. Objective: This meta-analysis aims to evaluate the impact of T2DM on electrocardiographic changes, focusing on major ECG abnormalities, fragmented QRS (fQRS) complexes, and prolonged corrected QT (QTc) intervals. Materials and Methods: A systematic review of observational studies published between 2017 and 2022 was conducted using databases such as PubMed, Web of Science, Cochrane Library, Embase, and ClinicalTrials.gov. The inclusion criteria required studies to focus on patients with T2DM and report ECG changes. A total of 13 studies comprising 25,530 participants met the criteria and were included in the meta-analysis. The statistical analysis was performed using RevMan 5.4 with a random-effects model. Results: T2DM patients were 1.74 times more likely to develop major ECG abnormalities than non-diabetic individuals (crude OR = 1.74, 95% CI = 1.17–2.57, p = 0.006). The prevalence of fQRS complexes was significantly higher among T2DM patients (crude OR = 2.48, 95% CI = 2.09–2.957, p < 0.00001). Additionally, T2DM patients exhibited a higher likelihood of QTc interval prolongation (crude OR = 1.38, 95% CI = 1.09–1.74, p = 0.008). Conclusions: This meta-analysis demonstrates that T2DM patients have a significantly higher risk of ECG abnormalities, including major changes, fQRS complexes, and prolonged QTc intervals. Regular ECG monitoring is essential for early detection and management of cardiovascular risks in T2DM patients.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010013

Authors: Mirela-Georgiana Perné Teodora-Gabriela Alexescu Călin-Vasile Vlad Mircea-Vasile Milaciu Nicoleta-Valentina Leach Răzvan-Dan Togănel Gabriel-Emil Petre Ioan Șimon Vlad Zolog Vlad Răzniceanu Savin Bianca Lorena Ciumărnean Olga-Hilda Orășan

Desmoid tumors are rare mesenchymal neoplasms arising from locally invasive fibroblasts. While they lack metastatic potential, they exhibit high local recurrence rates and can cause significant tissue destruction. We present the case of a 39-year-old female patient who initially presented with epigastric pain, pyrosis, and a palpable, firm, painless mass in the left upper quadrant, extending to the left hemithorax. The patient’s medical history included treated cervical neoplasia. Clinical evaluation, imaging studies, and histopathological analysis suggested aggressive fibromatosis. The patient opted for a surgical excision, which resulted in tumor recurrence one year later, with infiltration of the ribs near the sternum. Despite oncological recommendations favoring conservative management, the patient opted for a second surgical intervention, involving an en-bloc resection of the tumor and the affected sternum and ribs, followed by thoracic wall reconstruction.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010012

Authors: Rateb Abd Alrazak Daowd Ateeq Mohamad Algarni Majed Abdulhadi Almograbi Sara Majed Saab Naif Mansour Alrashed Maryam Mohammad Harthi Amira Fatmah Paguyo Quilapio Ibrahim Numan Alnajjar Shahzad Ahmad Mumtaz Raed Fahad Albusayyis Dalya Ali Aljumaiah Yazeed Alsalamah Huda Ibrahim Almulhim

Venous thromboembolism (VTE) is a relatively common condition that is the leading cause of preventable deaths in developed nations. VTE encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE) and affects both hospitalized and non-hospitalized patients. When left untreated, VTE is associated with substantial morbidity and mortality; accurate risk assessment and appropriate prophylaxis programs are therefore vital, as overlooked risk factors of these processes can potentially result in misdiagnosis and inappropriate treatment of the condition, with associated complications. In this study, we aimed to assess the impact of active monitoring on VTE management practices among healthcare providers to improve patient outcomes at Imam Abdulrahman Al Faisal Hospital (IAFH) in Riyadh, Saudi Arabia, from April 2018 to July 2023. In this study, a longitudinal retrospective study design was utilized and data from 33,237 admitted patients were analyzed using a Statistical Process Control (SPC) chart to evaluate the relationship between VTE risk assessment, active monitoring, and patient outcomes. In total, 11 cases of hospital-acquired VTE were identified, with patients aged 18–40 years representing most cases (7 out of 11 cases) and a male predominance of 54.5%. The overall VTE incidence rate during the study period was 0.31%, or one case per 11,000 admissions, including four cases of PE and seven cases of DVT. The results of this study indicate that active monitoring through continuous education and regular patient rounds significantly improves adherence to VTE risk assessment and prophylaxis at IAFH. The researchers attributed the increased identification and timely reporting of VTE cases to vigilance by healthcare providers and not to a decline in the quality of care. A comprehensive multidisciplinary strategy for VTE management and continuous quality improvement can aid in reducing VTE-related morbidity and improve patient outcomes. Lastly, we recommend addressing the risk factors associated with the occurrence of hospital-acquired VTE and performing post-discharge follow-ups of patients.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010011

Authors: Sergio Da Silva Maria Fiebig Raul Matsushita

Do individuals with autism overlook opportunity costs? Considering the mediating role of cognitive biases and utilizing an AI-driven experiment, our provisional answer is yes. Cognitive biases can severely distort the accurate calculation of opportunity costs, which is essential for making optimal decisions by clearly understanding the trade-offs involved in pursuing a particular course of action. In turn, biased information processing may contribute to developmental disorders such as autism that are marked by difficulties with social interaction, communication, and restricted or repetitive behaviors. We developed a 20-question scale to assess the neglect of opportunity costs, targeting specific cognitive biases, and compared the results with the RAADS-R autism scale. We find that individuals scoring low on the opportunity cost scale, due to these cognitive biases, are likely to score higher on the RAADS-R, aligning their decision-making biases with traits typical of the autism spectrum.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010010

Authors: Sorina Ispas Andreea Nelson Twakor Nicoleta Mihaela Mindrescu Viorel Ispas Doina Ecaterina Tofolean Emanuela Mercore Hutanu Adina Petcu Sorin Deacu Ionut Eduard Iordache Cristina Ioana Bica Lucian Cristian Petcu Florentina Gherghiceanu Mihaela Simona Popoviciu Anca Pantea Stoian

The global rise in type 2 diabetes mellitus (T2DM) calls for an urgent focus on lifestyle interventions, particularly physical activity, as a critical factor in its management and prevention. This systematic review evaluates the impact of physical activity and sedentary behavior on glycemic control in individuals with T2DM. Studies included in this review were selected based on specific criteria: randomized controlled trials involving adults aged 18 and older, published in English between January 2018 and May 2024, with full-text availability and quantifiable outcome results. Exclusion criteria included non-peer-reviewed research, small sample sizes, and studies limited to abstracts, posters, or editorials. The analysis of the selected studies revealed that regular physical activity, including aerobic exercises and resistance training, significantly improves glycemic control as measured by fasting blood glucose (FBG) and glycated hemoglobin (HbA1C) levels. Reductions in sedentary behavior were also associated with better metabolic outcomes, highlighting the importance of integrating physical activity into daily routines for individuals with T2DM. These findings feature the need for continued research to refine and optimize lifestyle interventions to mitigate the global burden of T2DM.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010009

Authors: Rubing Ma Sizhe Chen Jinjing Xiang

Objectives: Adverse childhood experiences (ACEs) pose a significant public health concern, negatively impacting children’s physical and mental health. This study examines the association between ACEs and the co-occurrence of somatization and post-traumatic stress symptoms (PTSSs) among Chinese college students. Additionally, it explores the roles of both internal (psychological resilience) and external (social support) protective factors in this relationship. Methods: A sample of 701 students were analyzed using the Adverse Childhood Experiences International Questionnaire, the Somatization subscale from the Symptom Checklist-90, the PTSD Checklist from the DSM-5, the Connor–Davidson Resilience Scale, and the Multidimensional Scale of Perceived Social Support. A four-level outcome variable was created based on measures of somatization and PTSSs: no symptoms, somatization-only, post-traumatic stress symptoms-only (PTSSs-only), and co-occurring symptoms. Data analysis was conducted using multiple logistic regression. Results: Among Chinese college students, the prevalence of ACEs was 62.9%, while the prevalence of co-occurring somatization and PTSSs was 13.7%. The results of the multiple logistic regression analysis indicated a positive association between ACEs and the co-occurrence of somatization and PTSSs compared to no symptoms (OR = 2.28, p < 0.001). Furthermore, social support (OR = 0.26, p < 0.001) and psychological resilience (OR = 0.48, p = 0.049) were negatively associated with the co-occurrence. Conclusions: ACEs are risk factors for the co-occurrence of somatization and PTSSs among college students, while social support and psychological resilience serve as effective protective factors against this risk.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010008

Authors: Loo Keat Wei Saras Menon Lyn R. Griffiths

Recent years have seen a rapid expansion in research examining the relationship between homocysteine and stroke. In this study, we conducted a comprehensive bibliometric analysis of 233 articles related to homocysteine and stroke, published over the past 30 years in the Web of Science Core Collection. Our findings reveal a significant global increase in research on homocysteine and stroke, with China emerging as a leader, representing 39.9% of the total publications. Employing advanced methodologies such as co-citation analysis, bibliographic coupling, keyword co-occurrence, and citation burst analysis, we identified key research themes and emerging trends within the field. Notably, the results indicate a shift in focus from viewing homocysteine solely as a biomarker to recognizing its potential role in stroke prevention and management. These insights provide a valuable roadmap for future research directions and clinical strategies aimed at enhancing stroke prevention and improving patient outcomes.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010007

Authors: Ileana-Delia Săbău Laurentiu-Camil Bohîltea Viorica Rădoi Anca Bardan Ovidiu Maioru Mihaela Țurcan Viorel Suciu-Lazar Iuliana Ceausu

One major cause of prenatal mortality and morbidity is congenital abnormalities. Knowing the prevalence and etiology of congenital malformations is essential for analyzing trends and improving neonatal care. Objective: the team aimed to evaluate the utility of whole-exome sequencing (WES) in Romanian prenatal care, highlighting its diagnostic efficacy in comparison to molecular karyotyping, particularly in cases with negative genetic results prior to WES, unfavorable pregnancy outcomes, and consanguinity. Methods: Initially, we identified pregnancies with abnormal ultrasounds unrelated to known syndromes. Subsequently, we performed SNP (single nucleotide polymorphism)-array testing, yielding negative results. We then applied prenatal WES, utilizing Massive Parallel Sequencing on the NovaSeq 6000 platform (average coverage > 100× read length: 2 × 100 bp) with library preparation using the Twist Human Core Exome kit RefSeq & Mitochondrial panel (Twist Bioscience). The bioinformatic analysis involved direct comparison to the human reference sequence (hg38). Results: We achieved a 50% diagnostic rate. After receiving results, two couples chose pregnancy termination, five had uneventful births, and one pregnancy ended in stillbirth. Additionally, we identified three incidental findings that enhanced patient and at-risk member management. This article details ten prenatal cases tested with WES, highlighting its superior diagnostic performance compared to the SNP array. WES detected the genetic diagnostic in 50% of cases that the SNP array did not. We emphasize the advantages of WES in prenatal diagnostics while acknowledging the need for further investigations to comprehensively evaluate its diagnostic utility in the Romanian population.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010006

Authors: Ionut Eduard Iordache Lucian-Flavius Herlo Razvan Popescu Daniel Ovidiu Costea Luana Alexandrescu Adrian Paul Suceveanu Sorin Deacu Gabriela Isabela Baltatescu Alina Doina Nicoara Nicoleta Leopa Andreea Nelson Twakor Andrei Octavian Iordache Liliana Steriu

Over the past two decades, surgical techniques in colorectal cancer (CRC) have improved patient outcomes through precision and reduced invasiveness. Open colectomy, laparoscopic surgery, robotic-assisted procedures, and advanced rectal cancer treatments such as total mesorectal excision (TME) and transanal TME are discussed in this article. Traditional open colectomy offers reliable resection but takes longer to recover. Laparoscopic surgery transformed CRC care by improving oncological outcomes, postoperative pain, and recovery. Automated surgery improves laparoscopy’s dexterity, precision, and 3D visualisation, making it ideal for rectal cancer pelvic dissections. TME is the gold standard treatment for rectal cancer, minimising local recurrence, while TaTME improves access for low-lying tumours, preserving the sphincter. In metastatic CRC, palliative procedures help manage blockage, perforation, and bleeding. Clinical examples and landmark trials show each technique’s efficacy in personalised care. Advanced surgical techniques and multidisciplinary approaches have improved CRC survival and quality of life. Advances in CRC treatment require creativity and customised surgery.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010005

Authors: Flavia Turcu Ileana Vacaroiu Andra Balcangiu-Stroescu Ana Mitrea Daniela Miricescu Daniela Balan Alina Stanigut

Worldwide, urinary tract infections (UTIs) have an increased incidence, especially in women. Recurrent UTIs (rUTIs) appear in less than three months in 80% of the cases, being associated with age, sexual activity, or diabetes mellitus. Antibiotics represent the first line of treatment for rUTIs after the diagnosis based on a positive mid-stream urine (MSU) culture. Alternative therapies including low-dose antibiotic treatment, immunoprophylaxis, cranberry extracts, probiotics, D-mannose, intravesical instillations, methenamine, and estrogens may reduce the recurrence of UTIs in female patients. Multimodal therapy seems to be the future in preventing and treating rUTIs. The main aim of this narrative review is to present the actual therapeutic challenges and the most efficient prophylaxis options in women diagnosed with rUTIs.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010004

Authors: Albena Toneva Antoniya Hachmeriyan Rouzha Pancheva Miglena Marinova-Achkar

Objectives: Early environmental factors have a significant impact on the development of atopic conditions in children. Breastfeeding has been highlighted for its role in enhancing both immune support and cognitive development. Early allergic conditions and maternal behaviors are linked to cognitive and neurodevelopmental challenges. Our study aims to compare children from atopic families focusing on early nutrition and the neuropsychological development of children, especially in the presence of an allergic predisposition. Materials and methods: The study included 120 children with a family history of allergies (55% boys). Children were divided into group A, children breastfed for at least two months, and group B, children breastfed for less than two months or fed with formula. The study measurements and outcomes included demographic and social data, medical data, the smoking status of the parents, breastfeeding and early feeding practices, and anthropometric measurements. The assessment of the neurological development was carried out with a validated Developmental Profile-3 questionnaire. Diagnosis of allergic conditions was carried out with the SCORAD (SCORing Atopic Dermatitis) questionnaire for assessing atopic dermatitis; the CoMiSS (Cow’s Milk-Related Allergy Symptom Score) questionnaire for potential cow’s milk protein allergy and Prick testing and elimination-provocation protocol were used to confirm allergic status in children with atopic conditions. Data were analyzed using Jamovi 2.2.2 software, with statistical significance set at p ≤ 0.05. Results: The age of the examined children was 13 ÷ 31 months, the age of the mothers was 21 ÷ 42 years, and that of the fathers was 22 ÷ 44 years. Educational levels among mothers were 68.35% (n = 54) with higher education in group A and 61.5% (n = 24) in group B, compared to fathers with rates of higher education of, respectively, 54.3% (n = 44) and 38.5% (n = 15). The average gestational age of the children was 38.8 ± 1.08 weeks, and the relative share of cesarean delivery—50.8% (n = 61)—was slightly higher than vaginal delivery. Anthropometric results (HAZ, WAZ, BMIAZ) did not show a statistically significant influence of the type of feeding (breastfeeding, standard formula, or hydrolyzed formula) on growth during the first two months after birth (p > 0.05). During the study period, a significant number of the children developed allergic conditions, which were more common in children from group A—43.2% (n = 35)—compared to group B—38.5% (n = 15). In the families included in the study, mothers smoked more often (53.3%; n = 64) than fathers (43.3%; n = 52), and 13.3% (n = 16) of the women smoked during pregnancy. Children’s neuropsychological development, assessed with the DP-3 questionnaire, according to the duration of breastfeeding, does not show statistically significant differences for the five functional areas (“Physical development”, “Adaptive behavior”, “Social-emotional” Development”, “Cognitive development “, and “Communication”) or the overall development of children from both groups. The neuropsychological development (DP-3) of the group A children showed correlations with the presence of atopic dermatitis, parents’ age, father’s level of education, mother’s smoking during pregnancy, number of cigarettes smoked by the mother per day, and cesarean delivery. Maternal smoking (number of cigarettes per day) had significant negative correlations with all areas of children’s neuropsychological development, which were most pronounced with physical (rho = −0.352; p = 0.001) and overall development (rho = −0.329; p= 0.003). Cesarean delivery moderately correlated with physical development (rho = 0.292; p = 0.008) and adaptive behavior (rho = −0.294; p = 0.008). In group B, neuropsychological development (DP-3) correlates most clearly with allergic conditions (allergy at two years of age and atopic dermatitis), as well as with maternal smoking during pregnancy, with a strong negative correlation with physical development (rho = −0.510; p = 0.001). Conclusions: Our study reinforces the link between early feeding practices, neuropsychological development, and allergic conditions, emphasizing the lasting effects they have on children’s neurological health. However, limitations such as the relatively small sample size and reliance on parental reporting may affect the generalizability of the findings. Future studies with larger cohorts and objective biomarkers for allergic conditions are needed to further validate these results.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010003

Authors: Flaviu Mureşan Ovidiu Vasile Fabian Emilia Maria Pătruţ Olga Hilda Orăşan Ana Valea Radu Bogdan Popescu

Before performing a thyroidectomy, a range of diagnostic studies is typically conducted to evaluate thyroid function and structure. Ultrasound and elastography are employed to assess the gland’s morphology and to identify nodular goiters that may necessitate fine-needle aspiration cytology (FNAC) or surgical intervention. Cervical adenopathies in patients suspected of thyroid malignancy are also evaluated via ultrasound. FNAC is the most effective diagnostic tool for suspicious thyroid nodules. Computed tomography (CT) is invaluable in assessing the relationship between large goiters and surrounding structures or identifying deep lymph node metastases in thyroid carcinomas. This article discusses the essential preoperative investigations required for thyroidectomy and their impact on surgical decision-making.

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010002

Authors: Ion G. Motofei

The Journal of Mind and Medical Sciences was founded in 2014 by Ion G [...]

Journal of Mind and Medical Sciences doi: 10.3390/jmms12010001

Authors: Carla Aloè

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

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1563

Authors: Iulian Slavu Raluca Tulin Ileana Dima Alexandru Dogaru Florin Filipoiu Bogdan Socea Anca Oprescu-Macovei Adrian Tulin

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1554

Authors: Ana 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 Constantinescu Bogdan Mihai Cristea

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1535

Authors: Cristina Diana Popescu Bashar Hamoud Romina Sima Anca Bobirca Oana Balalau Mihaela Amza Romeo Micu Gabriel Gorecki Liana Ples

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1540

Authors: Ana Vlasceanu Daniela Baconi Octavian Olaru Daniela Grădinaru Viorela Nitescu

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1547

Authors: Cristina Raluca Iorga Iuliana Andreiana Simona Hildegrad Stancu Traian Constantin Victor Strambu Cristian Iorga

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1544

Authors: Irina Gheorghiu Alexandru Andrei Iliescu George Alexandru Popescu Stana Paunica Anca Silvia Dumitriu

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1548

Authors: Alexandru Alexe Mihai Lupascu Haldun Septar Anca Pantea Stoian Andra Iulia Suceveanu Viorel Gherghina Iuliana Cindea Alina Doina Nicoara Laura Mazilu Razvan Hainarosie Felix Voinea Adrian Paul Suceveanu

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1524

Authors: 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 Gabriela Rahnea-Nita

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1536

Authors: Bashar Hamoud Gilda Schmidt Chiara Hipp Meletios Nigdelis Romina Sima Liana Ples Oana Balalau Simona Baus Georg Breitbach Gudrun Wagenpfeil Erich Solomayer Tim Schmidt Sebastian Findeklee

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1537

Authors: Petru Radu Mihai Zurzu Anca Tigora Vlad Paic Mircea Bratucu Dragos Garofil Valeriu Surlin Stefan Patrascu Virgiliu Prunoiu Ionut Coman Valentin Georgescu Razvan Chivu Florian Popa Victor Strambu Raluca Ioan

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1541

Authors: Simona Iacoban Madalina Piron-Dumitrascu Camil Bohiltea Ioan Suciu Silviu Voinea Nicolae Suciu

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1551

Authors: Antonio Mihai Istrate Dragos Serban Dan Dumitrescu Corneliu Tudor Laurentiu Simion Vlad Constantin Ciprian Tanasescu Dan Bratu Bogdan Mihai Cristea Catalin Cicerone Grigorescu Ana Dascalu

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1528

Authors: Bogdan Serban Eugen Radu Adrian Cursaru Bogdan Cretu Sergiu Iordache Madalina Cirnu Cosmin Niculae Cătălin Cîrstoiu

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1483

Authors: Catarina Duarte Maria Braz Ana Marques-Ramos José Silva-Nunes Luisa Veiga Miguel Brito

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1532

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

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1550

Authors: Alina Doina Nicoara Andra Suceveanu Ionut Iordache Iulia Tania Andronache Andreea Nelson Twakor Andreea Sunda Ioan Cristian Nichita Anca Pantea Stoian Felix Voinea Adrian Paul Suceveanu

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1567

Authors: Ioana Paunica Vlad Constantin Dragos Serban Cristian Paius Bogdan Gaspar Dragos Epistatu Valentin Verlas Roxana Sfetea Liliana Andronache Cristian Balalau Daniela Bălan Alexandru Motofei Adrian Silaghi

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1522

Authors: Mircea Hogea Anda Hogea Marius Moga Roxana Dragomir Simona Grigorescu Bogdan Socea

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.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1531

Authors: Cristina Bucur Irina Balescu Sorin Petrea Bodan Gaspar Lucian Pop Valentin Varlas Marilena Stoian Cristian Balalau Nicolae Bacalbasa

Ovarian cancer remains the most lethal gynecological malignancy due to challenges in early detection stemming from a lack of reliable biomarkers. Despite this, various laboratory tests are commonly employed in clinical practice, some showing diagnostic and prognostic promise for ovarian cancer. This review aims to synthesize current literature to delineate the role of artificial intelligence (AI) in both the diagnosis—from laboratory tests to imaging—and treatment of ovarian cancers. Thus, the epidemiology, risk factors, pathology, screening methods, as well as the integration of AI in the diagnosis of ovarian cancer (AI based on both blood biomarkers and imaging-based ovarian cancer detection) are presented. AI and biomarkers show considerable potential in improving ovarian cancer management, but ongoing research efforts are necessary to refine these technologies and integrate them effectively into clinical practice. This approach aims to enhance diagnostic accuracy, predict patient outcomes, and ultimately improve treatment strategies for ovarian cancer patients.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1500

Authors: Marina Neri Antonino Reitano Lavinia Rinnone Antonio Bruno Fabrizio Turiaco Felicia Matilde Ferreri Carmela Mento Maria Rosaria Muscatello Fiammetta Iannuzzo

Borderline personality disorder (BPD) is a severe mental disorder characterized by pervasive patterns of relational instability, chronic feelings of emptiness, sense of abandonment, self-injurious and anticonservative attempts. Pharmacological treatment has been found useful only for the management of severe symptoms and management of comorbidities, while psychotherapy is the main treatment for BPD. Although the disorder has long been considered resistant to any treatment, in recent years research has not only shown that BPD can be treated but also provided several manualized and empirically validated psychotherapeutic treatments. This paper set out to examine the most effective current psychotherapies for the treatment of BPD. All articles published in the last five years on the new psychotherapic treatments for BPD were included. Articles not relevant to this topic, as well as case reports and articles on animal models, were excluded. EBs forms of psychotherapy directed at symptom control and comorbidities occurring in BPD and forms termed generalist, were analyzed. Overall, the study found that there is no single form of psychotherapy that can fully treat BPD. The most effective forms of psychotherapy in controlling impulsive and self-injurious symptoms and in managing comorbidities remain Dialectical Behaviour Therapy and Schema Therapy.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1539

Authors: Marina Giurgiu George Popescu Stana Paunica Dragos Ciongaru Brandusa Mocanu Ana Maria Stanescu Anca Dumitriu

This study investigates the relationship between periodontal disease and vitamin D deficiency by correlating clinical periodontal parameters with serum levels of vitamin D; (2) Methods: Data from the literature and the periodontal status of two patients diagnosed with both periodontal disease and vitamin D deficiency were evaluated. Clinical parameters were measured, including plaque index, bleeding on probing, and bone resorption (%). Serum levels of vitamin D were also analyzed. Additionally, the patients underwent initial periodontal treatment to improve the periodontal status; (3) Results: Both patients exhibited advanced periodontal disease with elevated clinical parameters and significant bone resorption. Serum levels of vitamin D were below normal; (4) Conclusions: The findings suggest a significant association between vitamin D deficiency and periodontal disease severity. Low serum levels of vitamin D may exacerbate periodontal tissue destruction and bone resorption. Early detection and management of vitamin D deficiency could play a crucial role in preventing and treating periodontal disease.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1521

Authors: Ancuța Năstac Lucian Negreanu Alexandru Constantinescu Octavian Andronic Andreea Dobromirescu

Paraneoplastic acral vascular syndrome (PAVS) is a captivating enigma in the landscape of oncological pathology, characterized by vascular disturbances of the extremities. PAVS is linked to rapidly progressing trajectory and understanding the intricate interplay between cancer and this vascular dysfunction is imperative for timely diagnosis. We describe the case of a 45-year-old cachectic male who presented at the ICU with bilateral tumefied, cyanotic digits, accompanied by acute pain and numbness in both hands. A Digital Angiography described complete obstruction of the digital arteries. Imaging showed a laterocervical tumor mass with pulmonary metastases. This form of digital ischemia likely stems from endothelial dysfunction and prothrombotic effects induced by the tumor through a paraneoplastic mechanism. This case underscores the importance of recognizing acral vascular syndrome, prompting thorough investigation for an underlying malignancy. Ultimately, collective efforts aimed at enhancing our understanding of PAVS and optimizing its management hold promise for improving outcomes and alleviating the burden of this condition on affected patients.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1557

Authors: Iulia Leulescu Grigore Bălan Claudia Dogaru Maria Moga Emil Popa Irina Popescu Mircea Tampa Simona Georgescu

Introduction. According to the European Cancer Information System, melanoma is the sixth most diagnosed cancer in Europe (following breast, colorectal, prostate, lung, and bladder cancer) and ranks among the top 20 most common causes of cancer-related death. The diagnosis of melanoma can be a clinical challenge due to the variety of signs and symptoms, ranging from small, asymptomatic lesions with slow progression to large, painful tumors with rapid growth. In this paper, we will report an exceptional case of cutaneous melanoma with an atypical presentation in a patient with no personal or family history of skin cancer. Case presentation. We present the case of an 85-year-old patient who presented to our dermatology clinic with multiple nodular lesions on her right calf, extending to her thigh as isolated lesions. These violaceous lesions varied in size and displayed signs of bleeding, fibrin deposits, and purulent, foul-smelling discharge. The patient reported a five-month history of rapid tumor progression. The initial presumptive diagnosis was Kaposi's sarcoma; however, the biopsy ruled out this diagnosis, revealing the presence of malignant melanoma. Given the extensive locoregional spread and invasion of deep structures, the patient was transferred to palliative care. Conclusions. Melanoma is an aggressive form of cancer that can rapidly progress, often presenting with atypical clinical manifestations or mimicking other skin conditions. When the clinical presentation deviates from the classic patterns, a biopsy is considered the gold standard for guiding the clinician's subsequent approach. It provides valuable diagnostic information and aids in determining the prognosis as well as the appropriate therapeutic course.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1508

Authors: Irina Enache Florin Anghelina Mircea-Sorin Ciolofan Carmen Aurelia Mogoantă Alex Emilian Stepan Ioana-Cristina Vîlcea Cosmin Vasile Obleagă Andrei Osman

An inverted papilloma is a medical condition in which epithelial cells placed on the surface grow in depth into the underlying supporting tissue. The case of a 68-year-old man with a 6-month history of right-sided complete nasal obstruction, who was referred to the ENT Department of our hospital, is presented. The associated symptoms were represented by repeated epistaxis, rhinorrhea and anosmia. From a clinical point of view, a polypous reddish-gray irregular mass, with cauliflower-like appearance, has been described. The formation was friable, richly vascularized, and with minor bleeding on light touch. The patient was diagnosed with inverted papilloma which was treated by endoscopic surgery. By analyzing the clinical, histochemical and immunohistochemical aspects of this case, the cause of tumor growth and its potential for malignant transformation were established. Many particularities are presented in this article: increased regional aggressiveness, its ethmoidal sinus origin, specific symptomatology, paraclinical examinations, all of which were useful in choosing a customized therapy and follow-up program.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1561

Authors: Vlad Constantin Ion Motofei Gelu Stefanescu Adrian Silaghi

Aneurysms of the splenic artery are relatively rare, being found in patients with portal hypertension, multiparous, atherosclerosis, or in young people with various genetic diseases. In the uncomplicated forms, splenic artery aneurysms are often difficult to diagnose either because of the asymptomatic evolution, or because of the non-specific symptoms. In cases of trauma or large sizes, aneurysms can be complicated by rupture, which can cause hemoperitoneum with the risk of death if specific treatment is not initiated as soon as possible. Depending on the location of the splenic aneurysm, comorbidities, the patient's general condition or life-threatening complications, laparotomy, laparoscopy, endovascular techniques or combined procedures can be performed. The case of a 33-year-old female patient who presented to the emergency room with abdominal pain, nausea, vomiting and later syncope is presented. The patient was referred to the radiology department, and computed tomography revealed a ruptured splenic artery aneurysm with hemoperitoneum. The splenic artery aneurysm and the spleen were excised by emergency surgery, with a favorable postoperative outcome. The young age of diagnosis and treatment probably implies a genetic component, so that she was referred for additional investigations after discharge.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1549

Authors: Irina Stoian Simona Pârvu Radu Cucuiu Dana Galieta Mincă

Constant exposure to the atmospheric air polluted with particulate matter is considered to have a negative influence on human health, even if it is found at values that may not exceed the maximum allowable concentration. Starting from the correlation between atmospheric air polluted with PM and COVID-19 incidence/mortality, this research had as first objective to assess the exposure to an average concentration of PM10 in Romania and, in particular, in Bucharest for a period of six years and the cumulative incidence of COVID-19 cases per 1000 inhabitants (continuing previous research, from 2020). Subsequently, we studied the cumulative incidence of COVID-19 cases per 1000 inhabitants until January 2022. Another research objective was to identify a possible association between the atmospheric air polluted with particulate matter, viruses (SARS-CoV-2) and aeroallergens (common ragweed). To achieve the first two proposed objectives, the research method used was a univariate statistical analysis, correlation and regression analysis, subsequently analyzing the data and comparing with the results obtained in the research conducted previously (2020). In the selection of data, which formed the basis of the last part of the research, we used the recommendations of the PRISMA-ScR Guidelines, which were useful and guided us in the proper conduct of the research and in obtaining results in line with the proposed purpose. The applied regression model showed that in Bucharest, 86.34% of the variation in the cases incidence is explained by the variation in the PM10 concentration. In the second part of the research, we observed an exponential increase in the number of cases, without demonstrating a direct causal relationship with exposure to particulate matter air polluted. Otherwise, we additionally studied the data on the existence of a causal relationship between the increase of pollen in the atmospheric air over time and the incidence of SARS-CoV-2 infection, as well as the data that considered that there would be no causal relationship between these parameters.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1488

Authors: Vasile Obleagă Dan Gheonea Ioana Gheonea Cecil Mirea Emil Moraru Mihai Ciorbagiu Ionică Vîlcea Tiberiu Cojan-Țenea

Objectives. Esophageal cancer is one of the most aggressive types of cancer, with a 5-year relative survival rate of only 18%-20.5%. Survival is highly dependent on accurate positive diagnosis and staging, in which the imaging modalities available have a primary role. The study is focused on the analysis of the preoperative T and M staging strategy and the reliability of computed tomography and endoscopic esophageal ultrasound in predicting resectability. A second objective was to evaluate the influence of preoperative imaging modalities on decreasing the number of unnecessary thoracotomies and laparotomies. Material and Methods. This study was conducted on a lot of 97 consecutive esophageal cancers, admitted in the Second General Surgery Clinic of Emergency County Hospital No. 1 of Craiova, between January 2007 to December 2019. We recorded patient data, imaging details and staging, as well as intraoperative aspects and tactics. For statistical analysis we have used chi square test. Conclusions. Computed tomography is not a basic investigation in the T-category evaluation of the TNM stage, the accuracy of the method being extremely variable with the T-stage, the type of CT scan. The maximum utility of CT remains in the identification of invasion of neighboring organs and the operability of the case. Despite the differences in the accuracy, sensitivity and specificity of computed tomography and endoscopic ultrasound in esophageal cancer, the use of these imaging methods is essential in staging esophageal cancer and establishing the therapeutic indication.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1525

Authors: Roxana Stoica Florentina Gherghiceanu Denisa Nedelcu Valeria-Anca Pietroșel Cristina Ioana Bica Teodor Salmen Claudiu Teodorescu Mihaela Popoviciu Anca Pantea Stoian

Objectives. As weight modification during the COVID-19 pandemic was reported in several circumstances, we aimed to assess the body composition changes using bio impedance in patients with type 2 diabetes mellitus (T2DM) during this period. Materials and Methods. We conducted an observational, retrospective study, from January 2021–June 2021, in two outpatient clinics, enrolling all patients with T2DM and SARS-CoV2 infection that presented for evaluation after the infection. Blood tests (serum creatinine, urea, blood glucose, lipid profile, transaminases, HbA1c) were available before the onset of infection as well as at an interval of 1–3 months post-infection. Results. From a total of 118 patients, 101 subjects were eligible, 50.5% males. 68.6% had a mild form of SARS-CoV2 infection. There is a significant decrease in mean weight (91.9 ± 26.00 kg before and 90.00 ± 23.00 kg after infection vs. control, p < 0.05), body mass index (31.80 ± 8.89 kg/m2 before and 30.47 ± 8.48 after infection vs. control, p < 0.05), and visceral fat (15.00 ± 8.00% vs. 14.5 ± 7.25%) after infection. Median HbA1c increased in patients that were infected (6.5 ± 1.5 before vs. 7.1 ± 1.5 after infection, non-significant) and significantly decreased in the control group (7.0 ± 2.3 % vs. 6.4 ± 1.00%). We did not find any significant correlation between weight decrease and clinical or biological parameters in the SARS-CoV2 group. Conclusions. Weight, body mass index, and visceral fat decreased at 3-month follow-up in T2DM subjects with SARS-CoV2 infection vs controls.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1468

Authors: Cornel Cheregi Teodora Alexescu Andrei Pascalau Ovidiu Pop Calin Magheru Ioana Muresan Nicoleta Suciu Maur Horgos Mihai Muresan

Sigmoid diverticulitis is a common disease characterized by a well-standardized diagnostic approach and treatment. Colorectal cancer is the third most common malignancy worldwide, irrespective of gender. In 2020, CRC global-related mortality rate was estimated at 935,173 cases, with an incidence of 9.3% in men and 9.5% in women. The diagnosis of acute diverticulitis is always made by performing a contrast-enhanced-computed tomography (CT) of the abdomen. Current diagnosis guidelines do not recommend the use of a magnetic resonance imaging (MRI) for further and more precise assessment of a suspected sigmoid diverticulitis diagnosed by CT. Early lower-gastrointestinal (lower-GI) endoscopy is rarely conducted; thus, the diagnosis delay could have a negative impact over the oncological outcome of the disease. Few and scarce data can be found related to this issue, with only a recent Swedish study paying attention towards early identification of neoplastic disease residing on a background of sigmoid diverticulitis, facilitated by MRI. The purpose of this study is to evaluate the feasibility of systematically performing an abdominal MRI included in the primary assessment of acute diverticulitis already diagnosed by CT, in order to argument in favor of an early lower-GI endoscopy where a positive MRI for neoplasia is found.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1478

Authors: Valeriu Ardeleanu Lavinia-Alexandra Moroianu Cecilia Curis Alin Tatu Iasmina-Raisa Ardeleanu

Chronic varicose veins disease is widespread worldwide (up to 60% in the adult population), with a significant impact on patients' quality of life and a high cost to society, both due to treatment and the limitation of physical activity imposed by the disease. This article presents a retrospective study on a number of 14 patients treated in Arestetic Clinic in Galati, for a period of one year. The patients included in the study presented reticular and varicose veins up to 6 mm in diameter and under 14 mm on the saphenous vein. Patients completed the Aberdeen Varicose Disease Questionnaire (excluding the first part of the questionnaire) and the Venous Clinical Severity Score was used by the physician. Doppler ultrasound was used for preoperative evaluation and postoperative monitoring. Polidocanol was administered in concentrations of 0.5% and 2%, with the patients being monitored one year after treatment. All patients were declared satisfied with the results and 1 year after treatment no recurrences were found. Polidocanol sclerotherapy is a safe, easy-to-administer, low-cost treatment with no healing time and can be administered multiple times if needed, with minimal risks of complications. Aesthetic results are good, with an important symptom remission rate and high patient satisfaction. Complications were rare and minor (represented by local hyperpigmentation and hardening of the injected path), and the recurrence rate is comparable to surgical treatment.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1516

Authors: Flaviu Muresan Olga Orasan Angela Cozma Madalina Bancos Lorena Ciumarnean Mircea Milaciu Tinca Pocol Nicoleta Leach Teodora Alexescu Ovidiu Fabian George Ciulei Mirela Perne

Immune checkpoint inhibitors (ICIs) are an effective immunotherapeutic approach for cancers affecting the lung, skin, kidney, mammary gland, or certain hematologic malignancies. Regarding the prognosis of these oncological conditions, treatments with ICIs open new therapeutic perspectives with benefits for both patients and healthcare providers. A drawback of immune checkpoint inhibition is the occurrence of immune-related adverse events that can involve a wide range of organs, such as the liver. Given widespread usage of immunotherapy, the number of patients who suffer from this unwanted condition has increased. Hepatopathy induced by ICIs can be severe and can even lead to death. Detecting liver toxicity in ICIs regiments requires a close monitorization of patients during and after the treatment. Such hepatopathies often involve discontinuation of immune checkpoint inhibitors and administration of corticosteroids. In conclusion, hepatopathies induced by immune checkpoint inhibitors require a comprehensive understanding for effective management, both to protect the patient's life during therapy and to ensure longer survival after cessation of treatment.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1562

Authors: Alexandru Iliescu Irina Gheorghiu Sergiu Ciobanu Ion Roman Anca Dumitriu George Popescu Stana Păunică

Primary root canal infection is a dynamic process. All species of oral microbiota have comparable abilities to establish in the root canals of necrotic teeth. The essential ecological factors in their biological selection are nutrient availability, anaerobic environment and bacterial interactions. In chronic apical periodontitis, all selected microflora residing in the long-term infected habitat of root canals system are synergistic, and each of them can play the role of an endodontic pathogen. Microorganisms living in the root canal system of pulpless teeth progressively reach through anatomical communications to the periodontal ligament where, sooner or later, they cause the inflammatory and immunological conflict between the infection and the host. The insight into the complexity of the root canal microbiota is improved by the current pyrosequencing and next-generation sequencing diagnostic techniques, which allow the identification of multispecies of the microbiome and their targeted treatment. The insight into the complexity of root canal microbiota is improved by present diagnostic techniques of pyrosequencing and next generation sequencing, which allow the identification of multispecies of the microbiome and their targeted treatment.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1502

Authors: Catalin Savin Luiza Tarca Irina Balescu Sorin Petrea Bogdan Gaspar Lucian Pop Valentin Varlas Adrian Hasegan Gabriel Gorecki Cristina Martac Marilena Stoian Cristian Balalau Nicolae Bacalbasa

Intrahepatic cholangiocarcinoma is one of the most aggressive forms of cancer. It is usually diagnosed in advanced stages of the disease, mainly because it is asymptomatic for a long time after the onset. Consequently, intrahepatic cholangiocarcinoma still represents an important problem of diagnosis and treatment. In the multidisciplinary treatment of these patients, oncological surgery is essential, as the accuracy of resection is one of the most important prognostic factors for the long-term results of these patients. Therefore, there has been a continuing concern to improve surgical techniques, with the aim of maximizing the chances of achieving the best possible long-term survival. The purpose of this paper is to discuss the surgical standard of care in intrahepatic cholangiocarcinoma, with particular attention being paid to resection margins and lymph node dissection. For unresectable cholangiocarcinoma, locoregional therapy can be used such as transarterial chemoembolization, transarterial radioembolization, thermal ablation, radiotherapy and hepatic artery infusion pump chemotherapy.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1543

Authors: Cecilia Curis Valeriu Ardeleanu Lavinia Moroianu Corina Manole Roxana Stoica Florentina Gherghiceanu Anca Pantea Stoian

Although obesity is a frequently formulated diagnosis at all ages, due to the long-term projection of the consequences of this condition in children it is a real public health problem. The etiology of obesity is multiple and its complexity requires a multidisciplinary medical approach from which the psychological component cannot be omitted. Thus, diseases such as diabetes, dyslipidemias, cardiovascular diseases, sleep apnea syndrome, non-alcoholic fatty liver or neoplasia are encountered with a higher incidence in this category of individuals. During the COVID-19 pandemic, the isolation and, consequently, the reduction of access to ways of performing physical exercise increased the balance between caloric intake and caloric consumption resulting in the accumulation of surplus calories in the form of adipose tissue. The purpose of the present work is to emphasize the interest manifested by the medical scientific world regarding obesity in the pediatric population, in the pre-pandemic period, during the pandemic period and one year after its’ end (2018-2023). We performed systematic review of clinical studies on obesity in the pediatric population, including 98 articles published in the PubMed database. The number of studies published during the pandemic period (53) vs the number of studies published ex-pandemic (45), corresponds to a ratio of 1.17:1 in favor of the first. Obesity remains a research topic of major interest in early life, regardless of the coexistence of COVID-19.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1564

Authors: Adrian Silaghi Dragos Serban Bogdan Gaspar Valentin Verlas Dragos Epistatu Cristian Paius Roxana Sfetea Liliana Andronache Ioana Paunica Irina Strambu Daniela Bălan Alexandru Motofei Vlad Constantin

Despite substantial improvements in survival rates for most cancers, pancreatic cancer still remains a leading cause of death from malignancy. The disease has no symptoms in the initial stages, it can early invade the surrounding organs, and treatment methods have poor long-term prognosis. In addition, this neoplasia is starting to be diagnosed more and more frequently in young people. High incidences have been found in developed regions such as Europe, North America, Australia, but recent data show that this condition is increasing in other regions as well. Pancreatic cancer involves multiple factors such as cigarette smoking, obesity, diabetes, alcohol consumption, inherited genetic factors, recent studies also correlating pancreatic cancer with abnormal metabolism of human microorganisms, blood type, as well as glucose and lipid levels. This review aims to update knowledge on the epidemiology, pathophysiology, diagnosis and treatment of pancreatic cancer. The goal is to encourage screening and early diagnosis methods, as well as to stimulate further research on this oncological topic, insufficiently studied to date.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1519

Authors: Andreea Pușcașu Florin Bobîrcă Alexandra Bolocan Ion Daniel Octavian Andronic Dan Păduraru

Type 2 diabetes mellitus is a complex condition with high prevalence in the global population, implying multiple complications for the entire organism. It is essential to understand its implications in the development and evolution of other pathologies in order to manage efficiently their complications thus decreasing overall mortality. A surgical pathology potentially associated with type 2 diabetes is acute mesenteric ischemia. Although it has a decreased prevalence in the global population, mesenteric infarction is related to an extremely high mortality rate due to its elusive clinical presentation and rapid progression. The difficult diagnosis emphasizes the need to make associations between acute mesenteric ischemia and other pathologies involved in its evolution, such as type 2 diabetes mellitus. This metabolic disease raises the risk of macro and microvascular complications, therefore disturbing the vascularization of the bowel. The purpose of this review is to describe how diabetes is particularly involved in all four types of mesenteric infarction by modulating different physiopathological mechanisms based on the process of atherosclerosis and other endothelial molecular processes.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1542

Authors: Luciano Alt Amanda Bortolini Bruna Andreis Caroline Schmidt Giovana Rugeri Maria Clara Pagliarin Maria Eduarda Dupond Kindel Maria Fernanda Costa Nathália Costa Pedro Dariz Vinícius Omizzolo

Objectives. Although COVID-19 mainly affects the respiratory system, it can also cause neurological complications like memory impairment, which may be part of post-COVID-19 Syndrome. Identifying these impairments is challenging due to the lack of approaches and limited follow-up. This systematic review aimed to identify the effects of COVID-19 on memory. Methods. Analyzing articles from PubMed, SciELO, and VHL databases, focusing on the relationship between COVID-19 infection and memory impairment. Results. COVID-19 infection was linked to significant declines in memory function. The severity of infection correlated with the intensity of neurological sequelae, particularly memory impairment, with cognitive and executive functions most affected. Recovery in these functions paralleled symptom improvement. Conclusions. Patients often continued to exhibit executive function impairments and cognitive deficits after recovering, complicating the understanding of the underlying pathophysiology.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1432

Authors: Flaviu Muresan Alexandrina-Manuela Muresan Gabriel-Emil Petre Iacob Domsa Vasile Fabian Olga Orasan

Simultaneously diagnosing cervical sympathetic chain schwannoma, nodular goiter and parathyroid adenoma is a very rare event during clinical practice. We had the opportunity to find this unusual association on a female patient. While nodular goiter and parathyroid adenoma are more common diseases and easier to diagnose, identifying the etiology of a parapharyngeal space tumor remains a challenge and requires multiple imaging studies such as computed tomography scan, magnetic resonance imaging or angiography. A cervical sympathetic chain schwannoma, a carotid body tumor, a paraganglioma or a vagal schwannoma must be taken into account as possible diagnostic variants. Complaints such as Horner`s syndrome, hoarse voice or dysphagia may suggest a nerve originating tumor, but this is a rare situation. Only the surgical exploration is successful in detecting the tumor origin from the cervical sympathetic chain. Even so, the exact origin of the tumor cannot usually be detected without surgical exploration and removal of the piece or biopsies. Therefore, the pathological report of the specimen (adding or not immunohistochemistry tests) is mandatory to be able to confirm the diagnosis of schwannoma.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1446

Authors: Deniz Gunsahin Madalina Ilie Oana Plotogea Dan Nicolae Paduraru Alexandra Bolocan Octavian Andronic Florentina Musat Vlad Baleanu Dragos Davitoiu Mihai Pahomeanu Bogdan Dumbrava Vlad Enciu Alexandru Constantinescu

Situs inversus totalis (SIT) is a rare congenital disease that causes mirror transposition of the abdomino-thoracic structures. When such patients develop pathologies related to the bile duct, most commonly choledocholithiasis, the optimal diagnostic process can be hampered by the rarity of such a pathology and the lack of medical information on this topic. Once the diagnosis is established, through endoscopic ultrasound and MRCP, the patient is sent to perform ERCP, which requires tailored approaches for each case. We present the case of a 33-year-old patient who was previously documented with SIT. On admission she presented with abdominal pain and fever that started a week before presentation, so antibiotic therapy was initiated. Imaging investigations revealed intrahepatic gallstones, so she underwent ERCP the next day with the identification of an intrahepatic bile lake containing stones within. Naso-biliary drainage was placed and further 2 ERCP procedures followed, with the insertion of 3 plastic biliary stents. The evolution was favorable, until the complete removal of gallstones and remission of clinical symptoms. The patient was carefully monitored in the following two days and the stents were removed, being later discharged and monitored for a period of 6 months in which no biliary/digestive symptoms were noted.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1506

Authors: Laura Florentina Rebegea Claudia Elena Pavel Nadejda Corobcean Ana Maria Ilie Dorel Firescu Madalin Guliciuc Elena Niculet Mihaela Dumitru Daniela Mihalache Flavius Bulgaru Roxana Andreea Rahnea-Nita

Introduction. Mycosis fungoides (MF) is the most common form of primary cutaneous T-cell lymphoma. Radiotherapy induces excellent response rates in the treatment of localized or extensive lesions of MF, both as monotherapy and as part of a multidisciplinary treatment. Total skin irradiation with electrons or protons is available in a limited number of medical centers and is mainly used in patients with extensive MF. Case presentation. It is presented the case of a 47-year-old patient who developed erythematous papules and plaques on the chest, upper limbs, face and scalp, initially diagnosed as chronic eczema and treated with systemic corticotherapy, antihistamines and dupilumab. Under treatment, the lesions progressed with the appearance of tumorous formations on the scalp and face, some of them ulcerated. Thus, additional (histopathological and immunohistochemical) tests were performed and established the diagnosis of MF. As a result, treatment with methotrexate and narrow-band UVB was initiated, subsequently associated with radiotherapy on the scalp and face lesions (right frontal, right parietal, left oral commissure), 30 Gy to each area. During radiotherapy, the patient developed second grade radiodermatitis associated with radiomucositis, but with a significant reduction in the surface area of the lesions until their disappearance. Conclusions. Radiotherapy can be used in all stages of MF, being useful both for alleviating symptoms and eradicating the disease, meaning that the potential of this form of treatment needs to be further exploited and investigated.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1462

Authors: Teodora Alexescu Irina Obada Angela Cozma Mirela Perne Olga Orasan Vasile Negrean Iacob Domsa Victoria Ruta Simina Țărmure

Mucinous breast carcinoma is a rare subtype of mammary neoplasm encountered in medical practice. It represents approximately 1–6% of all breast cancers and is more common in postmenopausal women. There are two subtypes of mucinous breast carcinoma: pure and mixed. We report the case of a 73-year-old Caucasian woman diagnosed with mucinous pancreatic cystadenoma in 2007. She underwent a surgical procedure involving pancreatectomy of the body and tail, along with multiple known cardiovascular and metabolic comorbidities. In November 2019, during a clinical-biological evaluation for associated diseases, a mucinous carcinoma of the right breast was accidentally detected and later confirmed through further investigations. For treatment, a surgical procedure was performed involving lower right quadrantectomy with right axillary lymph node dissection. The postoperative clinical course was favorable. In conclusion, we present the case of a patient diagnosed with mixed mucinous breast carcinoma, without axillary lymph node invasion. Postmenopausal women with diabetes, overweight, and obesity have an increased susceptibility to breast cancer, with our patient having all these risk factors. To date, no study has demonstrated the genetic or radiation implication in the occurrence of mucinous carcinomas, nor the possible development of mucinous carcinomas in series in the same patient. Yet, current data are insufficient to provide recommendations for the screening of malignant mucinous tumors in subjects with significant cardiometabolic risk factors.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1470

Authors: Liam MacKenzie Myles Emma Jones

Background. Post-stroke depression (PSD) is common in older-age adults and is typically treated with cognitive-behavioural therapy (CBT). However, research has ascertained mixed findings regarding the efficacy of CBT for PSD in older-age adults, with limited evidence in people from global majority backgrounds. Materials and Methods. This case study used single case experimental design methodology to examine the effectiveness of CBT for PSD in a black, older-age man. The effects of health conditions, cohort beliefs, transitions in role investments, socio-cultural context and early experiences on the client’s thoughts, emotions, physical sensations and behaviours were formulated, before behavioural activation was used to increase engagement in meaningful and pleasurable activities. Results. Throughout therapy, the client’s mood, motivation and optimism for the future improved, and their depression and anxiety symptoms reduced. Conclusions. This case study offers tentative evidence that CBT for PSD may be effective in black older-age adults.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1435

Authors: Dragos Popa Cosmin Obleaga Ana Maria Rukie Ahmet Cristin Vere Vlad Ducu Cecil Mirea Dan Florescu Mihai Ciorbagiu Dragoş Popescu Costin Streba Lucian Florescu Teodor Sas Lorena Sas

Objectives. Hydatid disease is a potentially lethal parasitic condition caused by the larvae of Echinococcus Granulosus; it is found in humans and more commonly in domestic and wild animals in endemic areas. This pathology is frequently encountered in the liver, the hydatid cyst with retroperitoneal location representing a rarely encountered form of evolution. Materials and Methods. In the present paper, we present a study carried out on 6 patients hospitalized in the Surgery Department of the Craiova County Emergency Clinical Hospital. These patients were diagnosed between 2002–2022 with retroperitoneal hydatid cyst or with multiple cysts (including retroperitoneal), being operated and monitored postoperatively at a distance. Results. The diagnosis was generally established by clinical examination, laboratory investigations and CT imaging, while the MRI evaluation was performed only in two of the cases, in order to provide additional data necessary for the surgeon. Conclusions. The difficulty of surgical interventions was determined by the size and local/multilocular extension of the disease; in the case of one patient, a double approach, abdominal and thigh, was necessary.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1471

Authors: Raluca Pulpă Viorel Zainea Cătălina Voiosu Ruxandra Aliuș Andreea Rusescu Irina-Gabriela Ioniță Veronica Epure Dragoș Octavian Palade Răzvan Hainăroșie

Introduction. Juvenile nasopharyngeal angiofibroma is a rare type of benign vascular tumour that affects only young males, especially those between the ages of 9 and 19. Therapeutic management depends on the extent of the lesion, being conditioned by the complexity of the anatomy of the skull base and the risk of massive bleeding due to the abundant vascular supply. The purpose of this article is to describe the modern approach to juvenile nasopharyngeal angiofibroma, starting from the general knowledge on this topic and presenting the experience of our clinic. Materials and Methods. A retrospective study was conducted on 10 male patients with juvenile angiofibroma, with clinical and imaging diagnoses, confirmed by post-ablative histopathological examination. From the 10 juvenile angiofibroma case treated in our clinic, 4 of them were less extensive, 2 with invasion to the pterygopalatine fossa, 3 involving the infratemporal fossa and 1 with minimal intracranial extension. Results. Combined approach (endoscopic trans-nasal approach and Caldwell Luc approach) was necessary in the treatment of a IIC case. Follow-up after surgery was done using MRI scans every 6 months. Recurrence was encountered in one case (9 months from the first surgery), and needed reintervention to remove the residual tumour. Conclusions. Even if it is a rare condition, the development of specific materials and techniques (endoscopic, embolization) has been considerable, allowing the reduction of intraoperative bleeding and residual tumour tissue, in conditions of minimal interference with the facial anatomy of such young patients.