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 Mihaela 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 Alec Moldovan Alice Elena Munteanu Mariam Dalaty Ovidiu Vasile 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 Elena Rădoi Anca Mirela Bardan Ovidiu Virgil Maioru Mihaela Țurcan Viorel Aurel 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 Liliana Turcu Ileana Adela Vacaroiu Andra Elena Balcangiu-Stroescu Ana Raluca Mitrea Daniela Miricescu Daniela Gabriela Balan Alina Mihaela 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: 10.22543/2392-7674.1024

Authors: Mihai Dumitrache Daniel Badescu Stefan Rascu Oana Balalau Bogdan Popescu Răzvan Scaunasu Cristian Balalau

The psychological impact on patients suffering radical cystectomy is twofold—(both that of the underlying neoplastic disease and that measured by the quality of life subsequent to surgery) and increases as the urinary derivation technique is less physiological and affects more the local anatomy. Although there are numerous questionnaires that assess the quality of life of patients with cancer (HRQoL—health related QoL), not many probe bladder cancer morbidity or correlate the different types of urinary diversions’ impact on QoL (quality of life). We analyzed 39 cases in our clinic who underwent radical cystectomy between August 2013 and August 2014. Different diversions were performed, as follows: for 24 patients a cutaneous ureterostomy was performed, in 10 cases a Mainz II pouch, in 3 cases a Bricker derivation and in 2 patients a Studer neobladder was performed. In these patients, QoL—Cancer Version and FACT-BL questionnaires were administered and were followed for an initial period of 2 years. According to our survey, the Bricker derivation is best tolerated, followed by neobladder and the Mainz II pouch.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P1923

Authors: Ion Motofei David Rowland

Many basic physiological mechanisms of sexuality were initially studied on animal subjects and conclusions regarding human subjects extrapolated afterward. These ancestral reflexes are assumed to have ascended during human evolution to the cerebral level, where cognition would intermediate (being an environmental operator) both sexual and mental processes. Accordingly, the study of human sexuality suggests an additional/particular documentation regarding mental existence and its implication, phenomena that are not characteristic of animals. In a previously published paper we presented ideas regarding the structural dichotomy of the mind and its subsequent implications to sexuality. In this paper we present a general perspective regarding the informational dichotomy of the mind and sexuality, which will be followed by a forthcoming paper that addresses the relational dichotomy of the mind and brain. Though these psychological implications may initially seem implausible, they represent in our opinion essential hypothetical perspectives that could further promote a better understanding of both cognition and sexuality.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P1318

Authors: Roxana Duncea Irina Apostol Relu Calota Vladimir Belis

“Shaken baby syndrome” in child abuse cases is a challenge for pediatrician and forensic experts, often a diagnosis of exclusion, with overwhelming moral and legal implications. Diagnosis is based on: subdural bleeding, rupture of retinal vessels, traumatic diffuse axonal injury with diffuse brain encephalopathy in the absence of external traumatic injuries and anamnesis data of an accidentally head injury. Microscopic findings in diffuse axonal injuries were initially considered as a specific traumatic effect due to unrestricted movement and accelerated rotation of the head. Immunohistochemistry of beta amyloid protein precursor is gold standard method for identifying pathological diffuse axonal lesions, which is however non-specific in brain trauma. In the diagnosis of this syndrome pediatricians and forensic examiners must take into account the particularities of each case, avoiding scientific speculation, to intuit controversies and always be familiar with the differential diagnosis.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P0412

Authors: Maria Sârbu Mircea Tampa Mădălina Mitran Cristina Mitran Alexandra Limbău Simona Georgescu

Psoriasis is a chronic, immune-mediated disorder characterized by well demarcated, erythematous plaques covered by thick, silvery-white scales, most often located on the knees, elbows, sacral area and scalp. It has a significant impact on the patient's quality of life. Biological therapies revolutionized the treatment of psoriasis vulgaris but there has been concern regarding the use of those agents due to severe adverse reactions reported in patients receiving TNF-α inhibitors for various inflammatory diseases. The aim of this paper is to review the most important adverse reactions reported in patients receiving biological treatments. The most common and severe side effects associated with biologicals are infections, cardiac adverse reactions, neurologic adverse reactions, lymphomas, non-melanoma skin cancers and hepatobiliary disease.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1045

Authors: Diana Moldovan Cosmin Moldovan Laurențiu Ungurianu Dan Ungureanu

Introduction: Even though the development of the recent anti-parasitic drugs has led to a high degree of efficiency, surgical treatment still remains the gold standard for a number of conditions. Material and method. The authors discuss a series of 90 cases in a multicenter and retrospective analysis that stretches over 20 years. Results and discussions. These cases have been diagnosed and treated—through different surgical methods, both classical and laparoscopic—for hepatic hydatid cysts. The paper also presents a short review of the major types of surgical procedures cited in the international literature, with a specific focus on the advantages brought by Romanian innovations in this field. Conclusions. Even though the classical open approach still assumes the first place among surgical procedures, modern laparoscopic techniques have earned a much appreciated place in providing positive results based on long-term assessment, with virtually no or only minor complications. In this regard the Romanian school of surgery has offered a significant contribution to this field.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1042

Authors: Maria-Gabriela Puiu Mihnea Manea George Paraschiv Traian Purnichi Ecaterina Ionescu Simona Tache Ioana Paunica Mirela Manea

Introduction: Major depressive disorder is one of the most prevalent psychiatric disorders and is associated with a severe impact on the personal functioning, thus with incurring significant direct and indirect costs. The presence of depression in patients with medical comorbidities increases the risks of myocardial infarction and decreases diabetes control, and adherence to treatment. The mechanism through which these effects are produced is still uncertain. Objectives of this study were to evaluate the metabolic alterations in female Wistar rats with induced depression, with and without administration of Agomelatine. The methods included two experiments. All data were analyzed by comparison with group I (control), and with each other. In the first experiment we induced depression by: exposure to chronic mild stress-group II; olfactory bulbectomy-group III; and exposure to chronic mild stress and hyperlipidic/ hyper caloric diet-group IV. The second experiment was similar with the first but the rats received Agomelatine (0.16 mg/ animal): group V (depression induced through exposure to chronic mild stress), VI (depression induced through olfactory bulbectomy) and VII (depression induced through exposure to chronic mild stressing hyperlipidic/ hypercaloric diet). Weight, cholesterol, triglycerides and glycaemia were measured at day 0 and 28, and leptin value was measured at day 28. The results in the 1st experiment revealed significant differences (p < 0.01) for weight and cholesterol in Group IV, for triglycerides in groups III and IV (p < 0.001), and for glycaemia in group II. The 2nd experiment revealed significant differences (p < 0.001) in group VII for weight and triglycerides, and in groups V and VI for triglycerides (p < 0.01). In conclusion, significant correlations were found between high level of triglycerides and depression induced by chronic stress and olfactory bulbectomy. Agomelatine groups had a lower increase of triglycerides levels.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1044

Authors: Cosmin Moldovan Dan Ungureanu Vladimir Beliș

Introduction: the problem of the iatrogenic lesions of the main biliary pathways is far from being completely clarified and still represents a serious surgical situation, during both open and laparoscopic surgeries. The outcome of these situations is closely linked with the actual moment of discovery of the lesion and the surgical methods for repairing such defects and implies a great number of options, such as reconstructive, derivative and substitutive techniques. Objectives: the goal of this paper is to present an algorithm of choices and their consequences for clinical conduit in the case of iatrogenic biliary lesions discovered in the course of open or laparoscopic procedures of the main biliary pathways, based on our experience. Material and method: We present a multicentric retrospective study of 53 cases of lesions following open and laparoscopic procedures, from a larger lot of 10.015 surgeries on extrahepatic biliary ducts recorded during a 40 years period of time, in 2 clinical hospitals. Out of these, 2127 interventions were strictly focused on the common bile duct, for various pathology. Conclusion: The choice of the optimum method is strictly correlated with the morphological nature of the lesion, which is different from one stage to the other, depending upon the moment of detection, and therefore have different surgical implications.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1048

Authors: Cosmin Obleaga Cristin Vere Ionica Valcea Mihai Ciorbagiu Emil Moraru Cecil Mirea

Acute upper gastrointestinal lesions have a multifactorial etiology but, regardless of the cause, they are related to mucosal barrier destruction. Since Helicobacter pylori induces a superficial chronic gastritis with the infiltration of neutrophils in the mucosa, it was speculated that Helicobacter pylori infection could also cause bleeding lesions. The diagnosis, the proper treatment and the revaluation of its effectiveness actually represent the prophylaxis of some diseases such as peptic ulcer, gastric lymphoma or mucosa-associated lymphoid tissue (MALT) and gastric cancer. These diseases and their severe complications are life-threatening for the patient. Periodic renewal of the treatment and knowing the real causes of Helicobacter pylori resistance to various antibiotics must always be understood by the clinician. Although Helicobacter pylori treatment fails in about 20% of cases, moral support of the patient by the clinician, information about possible evolutional complications of Helicobacter pylori infection, and periodic evaluation of the patient during therapy, are important tools on which the therapeutic success depends.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1036

Authors: Tashev Roman Margarita Ivanova Stiliana Belcheva Iren Belcheva

There is conflicting evidence regarding the effect of AT1 receptor antagonists on learning and memory processes. The effects of angiotensin II and losartan administration into CA1 hippocampal area on the avoidance performance in olfactory bulbectomized (OBX) rats using active avoidance (shuttle box) test and passive avoidance (step through) test were investigated. Rats were microinjected unilaterally through implanted guide cannulas into the CA1 area of the dorsal hippocampus and the drugs were administered separately, 5 minutes before each training session. The microinjections of losartan into the left, but not the right CA1 hippocampal area improved the acquisition and retention of active and passive avoidance learning, thus suggesting dependence on the side of injection. The unilateral (left or right) administration of angiotensin II did not significantly affect the performance of OBX rats in the avoidance tasks. A differential distribution of the AT1 receptors in the left and right hemisphere could contribute for the asymmetry in the behavioral effects of the AT receptor antagonist.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1031

Authors: Bogdan Popescu Oana Păun Răzvan Scăunașu Cristian Bălălău Șerban Berteșteanu

Larynx cancer is one of the most susceptible form of cancer susceptible to induce alteration of the patient’s psychological profile due to the social role that the larynx has in communication. Oral communication is severely impaired even after voice rehabilitation of the laryngectomized patients, so that the social rehabilitation is somewhat not only a medical but also a social problem. The psychological profile of these patients is altered in a way that dealing with the disease is sometimes neglected and the interaction with the outside world in terms of oral communication is totally abandoned. The starting point for depression in these cases is the acknowledgement of the disease and is, in some cases, the entire medical environment. Facial scarring, the inability to verbally interact with other human, as well as the presence of the tracheostoma, are all deciding factors in the presence of a low self-esteem for these particular patients. Psychological counseling is a mandatory approach for laryngectomized patients, in order to improve their ability to cope with cancer and providing better recovery chances.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1038

Authors: Mircea Tampa Maria Sârbu Mădălina-Irina Mitran Cristina-Iulia Mitran Adrian Dumitru Vasile Benea Simona-Roxana Georgescu

Photodynamic therapy is a modern treatment with applications in several medical specialties, which has been intensely studied in the last years. The main indications in dermatology are actinic keratosis, superficial basal cell carcinoma and Bowen's disease- common skin disorders in which photodynamic therapy proved its efficacy. At present, the use of photodynamic therapy for the treatment of other skin disorders is profoundly researched. Pain is the most common and redoubtable adverse effect of photodynamic therapy and it is the most important factor affecting the patient's adherence to treatment. The aim of this article is to look over the most recent medical studies regarding pain in PDT, with emphasis on the factors affecting the occurrence of pain and the most recent strategies for controlling photodynamic therapy- related pain.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1030

Authors: Răzvan Scăunașu Traean Burcoș Ștefan Voiculescu Bogdan Popescu Șerban Berteșteanu Oana-Denisa Bălălău Nicolae Bacalbașa Cristian Bălălău

Breast surgery was one of the most dynamic fields of medicine which benefited from significant progress during the last decades. The transition from aggressive and mutilating amputations to conservative, oncoplastic and reconstructive techniques has been constant, offering improved and rewarding results, viewed from both, oncological and aesthetical perspectives. Conservative techniques, especially those which preserve the nipple areola complex, are followed by improved patient’s perception of their body image, confidence and sexuality, with the only drawback of increased anxiety linked to recurrence risk.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1037

Authors: Ion Motofei David Rowland

Physiologically, the somatic nervous system intervenes in external interaction between the body and environment, while autonomic nervous system ensures the functioning of internal organs. We present in this paper a psycho-physiological perspective suggesting that mental function (somatic in nature, because coordinates environmental interaction) is closer to and more aligned with the physiologic functioning of autonomic nervous system (due to autonomy, duality, etc.). At opposite end, sexual function (autonomic in nature, erection for example being a parasympathetic vasodilatory reflex) seems to be compatible and even dependent by a somatic participation (erectile response is rather induced by environmental stimuli than internal visceral stimuli). The perspective presented here is that the mind and sexuality are two distinct relational processes which, being related to the same environmental stimuli/ peripheral afferents, should be supported by a common (somatic-autonomic) neurobiological substrate.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P2430

Authors: Denisa Bălălău Romina Sima Nicolae Bacalbașa Petrișor Banu Cristian Bălălău Liana Pleș Anca Stănescu

Despite being rare, the incidence of pregnancy-related cancer is expected to rise as women continue to delay childbearing and give birth later in their reproductive years. In this broad category, tumors like breast cancer, dermatological neoplasia and cervical cancer are most common and tend to arise in women of childbearing age. All pregnant women with clinical and cytologic suspicion of cervical cancer, except for squamous atypia or low-grade squamous intraepithelial lesions, should undergo colposcopy, with or without biopsy, the latter being avoided if possible due to possible complications which, although rare, may involve preterm labor initiation. Some studies have attempted to assimilate comparable results of USG with MRI during the gestational period by determining the sensitivity, specificity, and accuracy of trans-rectal ultrasound (TRUS) in comparison to magnetic resonance imaging (MRI). In order to identify the proper way to diagnose and treat the disease, because of the complexity due to pregnancy, a multidisciplinary team consisting of a gynecologist, medical and surgical oncologist, and radiologist should be assembled. Both maternal and fetal wellbeing should be taken into consideration when the medical team must choose among termination of pregnancy, delay of maternal treatment, and iatrogenic preterm delivery. Psychological counseling also plays an important role and due to the sensitivity of the issue, should continue through gestation and the postpartum. In order to develop optimal guidelines for diagnosis, treatment, and outcome issues, large scale prospective studies are needed, but feasibility may be limited due to the scarcity of cervical cancer cases associated with pregnancy.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1021

Authors: Paunica Stana Giurgiu Marina Dumitriu Anca

Systemic diseases often present associated oral signs and symptoms, which can occur either from the beginning of the disease or during its evolution. In some cases the oral manifestations reveal an undetected and severe disease, like leukemia. According to the encountered oral signs and symptoms and their response to topical/dental treatment, the dentist and physician should take into account specific additional tests, which could highlight a possible associated systemic disease. The most frequent oral manifestations associated with leukemia are represented by paleness of oral mucosa/local abnormal colour of the gum, gingival petechiae, ecchymosis, bleeding associating painless gingival hyperplasia, hemorrhages, ulcerative necrotic lesions and buccal infections. We presented in this paper the relevant literature data in respect to the oral manifestations encountered in leukemia, exemplified with two suggestive cases. As a conclusion, dentists should be advised not only to recognize and treat the encountered oral lesions but also to refer the patient to specialized professionals for additional investigations, especially in the situation when suspect a severe systemic disease that require a precocious diagnosis or in the case when the establishment of diagnosis exceed the possibilities of the usual tests. Chemotherapy administration in association with topical/oral solutions often leads to total or partial remission of the oral signs and symptoms.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1020

Authors: Emil Ștefănescu Corina Scutari Ioana Păunică Adrian Junghină

Background. Depression is a relatively frequent encountered mental disorder in the general population, affecting both the quality of the individual life and its ability to perform the social tasks; it is generally accepted that new studies related to this pathologic condition are further necessary, in order to identify more adequate, efficient and accessible therapeutic compounds. Materials and methods. This study was performed on a sample of 60 white male mice, NMRI strain, who were divided into 6 groups of 10 animals and treated with 4 new derivatives of dibenzo [a, d] cycloheptene, amitriptyline as a reference substance, or with distilled water for the control group. The animals were tested in respect to the forced swim test, both before and at 2 hours after administration of the mentioned substances. It was determined thus the time of immobilization. Results. The study showed the fact that only two of the four investigated compounds presented a relatively similar antidepressant effect with the reference substance. Conclusions. Minor structural changes, such as modifications of some substitutes from the basic chemical core of the reference substance can decisively influence the conservation or loss of the antidepressant properties.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1019

Authors: Manea Mirela Paunica Ioana Puiu Maria Manea Mihnea

Finasteride is in present a relatively frequent prescribed drug for male androgenic alopecia. The adverse effects reported by some patients seem to be notable, consisting of various (physical, mental/ neurological, sexual, etc.) manifestations which are encountered both during Finasteride administration and after treatment cessation (in the form of ‘post-Finasteride syndrome’). The pharmacological action and the corresponding adverse effects related to Finasteride administration were investigated and published in literature through several and successive studies. In respect to psychiatric disorders, the most notable concern is related to depressive symptoms and suicidal thoughts among former users of finasteride with persistent adverse effects. Regarding genito-urinary symptoms, these are usually represented by gynecomastia, decreased interest in sexual intercourse/ low level of sexual desire and erectile dysfunction. Finally, we viewed Finasteride side effects and post-Finasteride syndrome as distinct physio-pathologic entities, thus requiring possible distinct therapeutic approaches. Additional studies will be necessary, in order to further investigate the cerebral neuromodulation of the two relational (cognitive and sexual) functions, both of which may be interfered by administration of hormones or by the corresponding compounds such as Finasteride.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1016

Authors: Ion Motofei David Rowland

In a previous published paper, we initiated in this journal discussion about new perspectives regarding the organization and functioning of the mind, as a premise for addressing the mind-body problem. In this article, we continue focussing discussion on two distinct but interrelated concepts, internal-mental existence/entity and internal-mental reality. These two psycho-physiological subunits of the mind interact each other in the form of an internal-mental interaction, having no sense if one is isolated/studied separately from the other. In other words, the mind (as a dynamic psycho-physiological construction) has no sense in the absence of this internal mental interaction that which takes places between internal-mental existence and internal-mental reality. In the case of the ‘mind-body problem’, the tendency until now was to assign extremely complex functions of the mind (abstract ideas, consciousness, colors) to simplistic physiological/neuronal structures. We hope that this paper opens a new perspective, in respect to complex/interrelated neuronal structures that construct the mind through their interaction, a process that is both physiologically (transmission of neural impulses) and psychologically (transmission of information), and that requires time (an immaterial component) to occurs.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1013

Authors: C. Gingu A. Dick I. Ianiotescu C. Baston M. Crasneanu A. Andresanu L. Domnisor V. Brasoveanu A. Martiniuc I. Sinescu

Introduction. Fecaluria and pneumaturia are the patognomonic signs of an abnormal communication between the bladder and the intestinal tract. Therefore, when a history of digestive signs, symptoms or digestive diseases is missing, this borderline pathology leads the patients in the care of urologists. From diagnosis to treatment the management of these cases can be difficult and challenging. Materials and Methods. A 48 year old patient, without any significant medical history, presented to the emergency room for fecaluria, pneumaturia and an episode of haematuria. He had no prior digestive symptoms. The contrast enhanced abdominal and pelvic CT scan revealed a pelvic mass involving the sigmoid colon and the dome and the posterior wall of the bladder. The cystoscopy objectifies a tumor mass involving the right postero-lateral bladder wall, with extravasation of faeces. A biopsy was taken and the frozen section found mainly uncertain inflammatory type tissue. A colonoscopy couldn’t be done because of an impassable obstacle at 15 cm from the anus. Together with general surgeons we decided for en bloc resection of the tumor with partial cystectomy, right ureterocystoneostomy and rectosigmoid resection with mechanic end to end anastomosis. Results. The postoperative period was uneventful. The histopathological examination revealed an abscessed sigmoid diverticulum with vesico-sigmoid fistula and perilesional inflammatory tissue. Two years after the surgery the patient is asymptomatic with a normal function of the right kidney and restored bladder capacity. Conclusions. Being a borderline pathology, patients with fecaluria and pneumaturia and lack of digestive symptoms are referred and managed by the urologists. Despite extensive investigations, even when preoperative biopsies reveal inflammatory tissue the patients should be treated as oncologic cases. A close cooperation with general surgeons for en bloc multiorgan resection within oncologic safety margins is mandatory.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1012

Authors: Bogdan Socea Alexandru Carȃp Simona Bobic Vlad Constantin

The retroperitoneal hematoma can have, mainly, a traumatic etiology - blunt abdominal trauma (falls from height, road accidents, aggression of any kind, etc.), or open (incised wounds, puncture, penetration or gunshot wounds). Ruptured arterial aneurysms can cause hemorrhage in the retroperitoneal space. There is also spontaneous retroperitoneal trauma in patients with chronic treatment with anticoagulant or antiaggregant drugs (1). Hemorrhage in the retroperitoneal space can be iatrogenic, after surgical, open or laparoscopic, interventions (2, 3). A particular type of retroperitoneal hematoma is the psoas muscle hematoma in patients with chronic oral anticoagulant treatment (Acenocumarol, Warfarin).

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1011

Authors: Emil Ștefănescu Mihaela Pleșu Corina Scutari Adrian Junghină Horațiu Mireșan

Background. Metoclopramide is a pharmacological agent frequently used in therapy against nausea and vomiting that can occur in indigestion, motion sickness, gastric ulcer, pyloric spasm and after surgery as a side effect of some anesthetics. Knowing the frequency and intensity of metoclopramide neurological side effects is essential for an efficient management of the dysfunctions it addresses. Material and method. Based on a standard questionnaire containing questions regarding metoclopramide therapy, we analyzed the answers given by 1000 patients or patient tutors in 20 open circuit pharmacies situated all over Bucharest. All subjects freely consented to participate in this study that was coordinated only by pharmacists. Results. Our study highlights the fact that in certain situations having to do with the age of patients, with the use of multiple drugs or with the tendency to self medicate, the neurological side effects of metoclopramide can reach dangerous levels. In some cases it might even be necessary to immediately interrupt metoclopramide therapy, despite its positive benefit/ risk ratio. Conclusions. Respecting the physician’s recommendations, avoiding self medication and reporting side effects as quickly as possible, are essential elements for minimizing the consequences of metoclopramide side effects.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1010

Authors: Bălălău Cristian Cobani Denisa Trambitasu Gloria Popescu Bogdan Carolina Negrei Scăunașu Valentin

Psychological dependence involves a desire to use a drug to avoid the unpleasant withdrawal syndrome that results from cessation of exposure to it. Alcohol withdrawal syndrome is one of the most feared complications of alcohol addiction and sometimes can be fatal if not treated properly. Withdrawal syndrome is characterized by neurological hyperexcitability, which can lead to severe psychological and neurological symptoms. A survey was conceived in order to monitor the efficiency of several drug associations (Clonidine, Midazolam, IV ethanol), which were administered at the beginning of intensive therapy admission of achohol addicts. By comparing the postoperative evolution parameters and complications incidences for these patients (such as the hospitalization duration in AIT department, the tracheobronchitis incidence, complications as sepsis, pneumonia and cardiac complications), we managed to determine which treatment is the most beneficial for these cases. Benzodiazepines are frequently used for pharmacological therapy of alcohol addicted patients. In our study Midazolam was very efficient, compared to other therapies. When administered for a maximum of 7 days, the inccidence of side effects remains minimal.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1007

Authors: Mircea Tampa Maria Sarbu Alexandra Limbau Monica Costescu Vasile Benea Simona Georgescu

Body piercing has been practiced for thousands of years all over the world for beautification, religion, initiation rites or status reasons. Genital piercings also have a significant background and have been practiced for enhancing sexual pleasure, chastity, shocking or as a protest against a conservative society. As the popularity of genital piercings increased in the last years, the number of complications is also on the rise. It is therefore important for the medical professionals to have at least basic knowledge regarding this practice, as it might be required in the management of unpredictable complications.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1005

Authors: Vlad Constantin Alexandru Carȃp Bogdan Socea Simona Bobic

Background. Pancreatic encephalopathy is a rare complication of severe acute pancreatitis, with high mortality, being difficult to diagnose and treat, thus requiring continuous research regarding its management. Materials and Methods. Of 20 patients diagnosed with severe acute pancreatitis on admission at Department of Emergency and Admission (DEA), from 1 January 2010 to 31 March 2014, 5 cases complicated by pancreatic encephalopathy were analyzed using a descriptive observational, retrospective, single-centre study. Results. The study shows different types of diagnostic algorithm and therapeutical approaches, in correlation with morbidity and mortality rates. Conclusions. Our study highlighted the fact that speed is critical, early management being the key to outcome.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1004

Authors: Daniela Baconi Robert Vasile Cristian Bălălău

Cannabis is one of the oldest psychotropic drugs known to humanity. The paper assesses the current knowledge on the cannabis, including the mechanisms of action and the therapeutic potential of cannabinoids. Three varieties of Cannabis plant are recognised: Cannabis sativa, Cannabis indica, and Cannabis ruderalis. The variety indica is used predominantly to obtain the drugs. Cannabis herb is usually named marijuana, while the cannabis oleoresin secreted by the glandular hairs found mainly on the flowering or fruiting tops of the plant is known as hashish. More than 400 known chemicals are present in cannabis, at least 70 of which are called cannabinoids. The major psychoactive constituent in cannabis is delta-9-tetrahydrocannabinol (Δ9-THC). It is now recognized that there are three types of cannabinoids: natural (phytocannabinoids), endogenous cannabinoids, and synthetic cannabioids. 2 (CB2) receptors, found predominantly in peripheral tissues with immune functions have been cloned. Therefore, the concept of endogenous cannabinoid system (endocannabinoid system, SEC) has been developed. Based on the current scientific evidence, there are several effects of cannabinoids with potential therapeutic use: antiemetic, analgesic in cancerous pains, and chronic neuropathic pain, in multiple sclerosis or spinal cord injuries. Cannabis consume can result in a state of drug dependency and cannabis withdrawal has been included in DSM-V. Cannabis plant remains controversial in the twenty-first century and the potential therapeutic of specific cannabinoid compounds and medical marijuana remains under active medical research.

Journal of Mind and Medical Sciences doi: 10.22543/7674.42.P125131

Authors: Ion Motofei David Rowland Ioana Păunică Octavian Tănăsescu Petrişor Banu Stana Păunică

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

Journal of Mind and Medical Sciences doi: 10.22543/7674.52.P176183

Authors: Georgiana Iftimie Ana Maria Alexandra Stănescu Mihaela Iancu Anca Pantea Stoian Răzvan Hainăroșie Bogdan Socea Gheorghița Isvoranu Dragoș Marcu Tiberiu Neagu Camelia Diaconu

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that manifests predominantly in the synovial joint, where it causes a chronic inflammatory process, leading to early osteoarticular destructions. These destructions are progressive and irreversible, generating a significant functional deficiency. During the last years, the diagnostic approach of RA has focused on early arthritis. Early arthritis can develop into established RA or another established arthropathy, like systemic lupus erythematosus or psoriatic arthritis. It can have a spontaneous resolution or may remain undifferentiated for indefinite periods of time. The management of early arthritis has changed considerably in the past few years, under the influence of new concepts of diagnosis and new effective therapies. The treatment goal of early arthritis should now be the clinical remission and prevention of joint destruction. Methotrexate is the first line of therapy, used to treat early arthralgia and to reverse or limit impending exacerbation to RA. Biological treatment is used as a second line therapy in patients with severe disease who do not respond or have a contraindication to disease-modifying antirheumatic drugs (DMARDs). Patients with early arthritis should usually be identified and directed to rheumatologists to confirm the presence of arthritis, and to establish the correct diagnosis plus to initiate the proper treatment strategies.

Journal of Mind and Medical Sciences doi: 10.22543/7674.52.P169175

Authors: Simona Georgescu Mihaela-Roxana Ioghen Maria-Isabela Sarbu Alexandra-Florentina Ion Ela Ghita Cristina-Iulia Mitran Madalina-Irina Mitran Vasile Benea Mircea Tampa

Melanoma is one of the most aggressive tumors and its incidence is on the rise. The low rates of survival in metastatic melanoma has led to the development of new drugs for this type of patient, such as biological therapy which has shown remarkable results. This therapy is based on stimulation of the immune system to fight tumoral cells through: injection of cytokines with immunomodulatory properties (interleukin-2, alpha-interferon), vaccination with tumor antigens or immune cells that process tumor antigens, adoptive immunotherapy, inhibition of immune checkpoints (PD-1, CTLA-4), inhibition or stimulation of immune modulator molecules (OX-40, LAG-3), inhibition of signaling pathways involved in cell proliferation (Raf/MAPK/ERK signaling pathway), or administration of oncolytic viruses. Biological therapy in melanoma has shown promise in laboratory and clinical studies, with more therapeutic targets to be revealed as new molecular and cellular mechanisms of the disease are discovered.

Journal of Mind and Medical Sciences doi: 10.22543/7674.52.P163168

Authors: Anca Stanescu Denisa Balalau Liana Ples Stana Paunica Cristian Balalau

A woman goes through many biological (hormonal, physical), psychological (emotional), and socio-cultural changes during pregnancy. Furthermore, changes also occur in the mother's familial and interpersonal world after childbirth. While some mothers have positive emotions at birth, such as joy and pleasure, others complain of negative experiences varying from sadness and depression to psychosis. Thus, the risk of depression is higher for women during the postpartum period, having a tendency to decrease in most cases over the first 2 weeks after delivery. Unfortunately, this favorable evolution does not happen in about 1 in 4–7 women, who develops postpartum depression. Postpartum depression has generally the same features as any common depressive episode encountered at any other time in life. However, assessment of depressive symptoms in the parental period implies not only general tools (such as the Depression Scale of the Center for Epidemiological Studies or the Beck Depression Inventory), but also a specific evaluation using the Edinburgh Postnatal Depression Scale. Taking into account all changes that occur during the peripartum period, a multimodal approach for postpartum depression would be recommended, including an appropriate lifestyle (walks, ambient environments), counseling, cognitive-behavioral therapy, and finally antidepressant medication when required. As a conclusion, postpartum depression may range from a mild and reversible episode to a severe and persistent form. Antepartum and postpartum screening, an early diagnosis, and a tailored approach to depression are essential for better results and prognosis related to both mother and child.

Journal of Mind and Medical Sciences doi: 10.22543/7674.52.P158162

Authors: Dumitru Cristinel Badiu Marina Sima Claudia Mehedintu Bogdan Mastalier Mihaela Mandu Liliana Andronache Dan Paduraru Anca Stoian Valentin Grigorean

Abdominal-pelvic pain is the dominant symptom in endometriosis, one of the most common pathologies that affect women, being also a multifactorial disorder. Exploratory laparoscopy allows the correct assessment of the location as well as severity and extent of the lesions, thus representing the current gold standard in diagnosis. The correlation of pain intensity with the evolutionary stage of endometriosis is inconstant. Surgical treatment, preferably performed laparoscopically, includes the excision of the ectopic endometrium, having as a primary objective the control of persistent pain and the removal of all endometriotic foci. This procedure helps to improve the life quality of the patient, to reduce relapses, to control postoperative pain, and to eliminate the disease. Pre- and post-operative adjuvant medical treatment is used due to its effects on the symptomatology, prolonging the asymptomatic period of the disease. Despite the use of the above procedures, there are cases in which the abdominal-pelvic pain persists even after surgery, which makes endometriosis a significant challenge for both the specialist and the patient, as well as for the medical system itself, as the study of the pathogenic mechanisms is yet the subject of numerous studies. Nutritional education in these patients is essential, given the recommendation to restrict the range of foods and to increase other foods that have an important role in reducing the risk or even leading to regression of the endometrial pathology.

Journal of Mind and Medical Sciences doi: 10.22543/7674.52.P151157

Authors: Dănuța Păduraru

Introduction. The brain in preterm babies is usually not fully developed and therefore early post-term events can have long-lasting neurodevelopment and cognitive outcomes. It is known that cerebral white matter connectivity is important for later intact cognitive functioning amongst children born very preterm and that breast milk imparts neurotrophic factors. The relationship between breastfeeding and child development is a long and well-studied area, and the evidence in support of breast milk is already substantial. Here we review the recent literature on the topic to establish whether additional evidence is available to strengthen the view that breast milk is superior in maximizing neurological development in premature infants. Materials and Methods. A search was undertaken of PubMed, limited to the last 10 years and humans. No language restrictions were imposed. Results. The search yielded 45 articles, of which 12 included all three elements of breast milk, neurological/cognitive development and preterm babies; 10 were reviewed. The gestation period and birth weight (either or both were reported) ranged from 23 to 36 weeks and from 580 g to to <1500 g. Studies were heterogeneous in methodology. In addition to two systematic reviews and a review of the literature, other studies focused particularly on the effects of certain key components within breast milk on neurological development. They generally found evidence to support the beneficial effects of breast milk on brain, visual, and cognitive development in Preterm infants. Studies focusing on how breast milk intake affects the preterm infant brain are limited. We found only two studies published in the last 2 years in relation to brain volume in breast fed preterm infants. Both used magnetic resonance imaging (MRI) to examine the brains of breast-fed babies born prematurely. These studies found that preterm infants fed more breast milk had larger brain volumes (cortical surface) compared to those fed little/no breast milk. The timing of the nutritional intervention and the dose of the nutrient/supplement have been found to be relevant factors. However, not all studies have been conclusively positive. Conclusions. Although the profile of preterm infants is a wide one, from the limited but recent evidence, it is reasonable to conclude that breast milk contributes positively to neurological development.

Journal of Mind and Medical Sciences doi: 10.22543/7674.51.P129134

Authors: Dragoș Popa Cosmin Obleagă Ștefan Paitici Stelian Mogoanta Ionică Vîlcea Pouya Pourgolafshan Cristian Gheorghe Manuela Vasile Raluca Câmpeanu Cecil Mirea

Vulvar cancer is a malignant disease having a low frequency and with well-established surgical and oncological treatments based on the stage of the disease. The most important therapeutic problem encountered is represented by cases of perineal local regional recurrence, which are common in patients with large primary tumors and can occur even if the margins of the resection had no tumoral invasion. We present a case study of a 64-year-old patient diagnosed one year ago with squamous vulvar carcinoma (G3) for which a vulvectomy was performed after neoadjuvant radiotherapy. The patient later developed local recurrence with invasion of the anal sphincter, creating a delicate problem regarding a surgical approach. The size and the extent of the recurrent tumor required a complex surgical intervention using a mixed surgical team of general surgeons and plastic surgeons. Surgical intervention with a large excision of the recurrent cancer along with amputation of the inferior rectum via perineal route, and creation of a left iliac anus was performed. The perineal defect was covered via a musculocutaneous flap using the gracilis muscle. The immediate post-operative evolution was favorable.

Journal of Mind and Medical Sciences doi: 10.22543/7674.51.P123128

Authors: Cornelia Nitipir Lucian Alecu Iulian Slavu Raluca Tulin Radu Jecan Cristina Orlov Silviu Pituru Dana Stanculeanu Razvan Hainarosie Anca Stoian Adrian Tulin

The incidence of thyroid cancer is significantly different between male and female patients. Thyroid cancer is also the only form of cancer where age can be considered a staging variable. Identifying biological prognostic factors such as age or sex is important as it helps select an optimal personalized therapy. The present analysis is an observational, prospective study that enrolled all patients with thyroid disease who were operated upon at a single center. The study aimed to determine the most frequent age at presentation, the predominance of one sex over the other, the incidence of malignant thyroid disease, and the relative risk for each sex to develop thyroid carcinoma. The incidence of thyroid carcinoma was higher for women than for men, with a higher relative risk in the female subgroup. Incidence was also highest in the 50–60-year-old group. Given that studies show better survival for women and for younger patients, even when presenting with advanced disease, compared with older, male patients, such prognostic indicators should be a factor in the treatment decision.

Journal of Mind and Medical Sciences doi: 10.22543/7674.51.P117122

Authors: Ana-Maria Vlasceanu Daniela Baconi Bianca Galateanu Miriana Stan Cristian Balalau

Nicotine has several health hazards regarding carcinogenic potential. It also imparts increased risk for respiratory, cardiovascular, and gastrointestinal disorders. Several mechanisms have been proposed for the carcinogenic potential, including effects on cell proliferation, inducing oxidative stress, DNA mutation, or inhibition of apoptosis. The cotinine metabolite is generally thought to have effects similar to nicotine in some experimental systems. The purpose of this study was to assess the nicotine and cotinine cytotoxicity on MRC-5 lung fibroblasts. The pulmonary fibroblasts were treated with various concentrations of nicotine or cotinine (in the range 1 µM – 2 mM) for 24 or 48 h and analyzed for cell viability by MTT test. The results indicated that high nicotine concentrations (2 mM) induced marked cell death (about 50%) in MRC-5 cell line. Cotinine showed lower toxicity than nicotine on the MRC-5 cells. In contrast to nicotine treatment, cells treated with cotinine continued to proliferate after the 48h incubation period.

Journal of Mind and Medical Sciences doi: 10.22543/7674.51.P109116

Authors: Roxana Duncea-Borca Vladimir Belis Mihnea Costescu Relu Calota Reka Kutasi Cosmin Moldovan

Introduction and objectives. This study aims to investigate whether the cerebral modifications of posttraumatic reactive astrocitose can be considered an objective criterion for determining the age of traumatic cranio-cerebral lesions. Materials and methods. The present study consists of a series of 23 medico-legal cases that underwent autopsy inTeleormanCounty(Romania) Department of Forensic Medicine during 2007–2016, with full immune-histochemical microscopic examination using GFAP staining. The study consists of two groups, a series of 13 cases with cranio-cerebral trauma with different posttraumatic survival periods and 9 cases as a control group. Results and discussions. We discovered GFAP+ reactive astrocytes even when death occurred immediately after the trauma event and up to 4 months after the traumatic incident. We also discovered an intense positive correlation between the density of the GFAP+ cell from the perilesional area and the posttraumatic survival period. The highest cerebral density of the GFAP+ astrocytes occurred with acute death prior (1 to 24 hours) and the lowest in the chronic period (over 2 weeks). Conclusions. The gradual and differentiated appearance of the reactive astrocytes in close relation with the cerebral posttraumatic interval, with specific lesional and perilesional distribution as well as in surrounding area, clearly demonstrates that the state of the reactive astrocitose may constitute an objective index for evaluation of the elapsed time after the posttraumatic event.

Journal of Mind and Medical Sciences doi: 10.22543/7674.51.P101108

Authors: Adrian Tulin Iulian Slavu Raluca Tulin Lucian Alecu Radu Jecan Cristina Orlov Cristian Iaciu Dana Stanculeanu Razvan Hainarosie Silviu Pituru Anca Pantea Stoian Cornelia Nitipir

Microsatellite instability (MSI) is a feature of colorectal tumors that develops as a result of inactivation of the DNA mismatch repair system. It is found in about 15% of all colorectal cancers and is an important prognostic molecular marker when assessing patients with colorectal cancer. It can influence prognosis and treatment decisions in both the advanced and early stages. Although in early stages this marker suggests a favorable prognosis and presents an important argument against adjuvant treatment in stage II disease, in metastatic stages it no longer associated with such an optimistic outcome. The present trial is a prospective, single-center study which included 122 colorectal cancer patients who were tested for MSI using immunohistochemistry. The trial included patients with stage II to IV colorectal cancer, treated in the Prof. Dr. Agrippa Ionescu Emergency Hospital, Bucharest, Romania. Follow-up data were collected during a 24-month period. The study attempted to determine whether differences exist in overall survival for MSI (microsatellite instability) vs. MSS (microsatellite stable) colorectal cancer and to ascertain whether sex of the patient influences prognosis in MSI patients, irrespective of stage or treatment. Results demonstrated no significant differences in survival for MSI vs MSS colorectal patients, and patients’ gender proved not to influence the outcome in MSI patients.

Journal of Mind and Medical Sciences doi: 10.22543/7674.51.P93100

Authors: Minka Hristova Ganka Bekyarova Milena Atanasova Maria Tzaneva

Introduction. Thermal injury activates an inflammatory response. Melatonin possesses anti-oxidant and anti-inflammatory properties. The objective of the present work was to study melatonin effects on the inflammatory response under conditions of oxidative stress during the early stage of thermal injury. Materials and methods. We used 24 white male rats of Wistar breed, randomly divided into three experimental groups. Group one was the control, group two was inflicted with burn trauma, and group three was inflicted with burn trauma, with melatonin application following the thermal injury. Melatonin was applied twice in doses of 10 g/kg b.m. immediately after the burn trauma and again at 12 hours. Plasma levels of tumor necrosis-factor-α (TNF-α), a pro-inflammatory mediator, and of interleukin-10 (Il-10), an anti-inflammatory mediator, were examined and their ratio was calculated. The levels of malondialdehyde (MDA), an oxidative stress marker, were also estimated. Results. Thermal trauma significantly increased plasma TNF-α levels (ð < 0.01) and TNF-α /IL-10 ratio but did not change IL-10 ones. Plasma MDA concentrations were significantly elevated as well (ð < 0.0001). Melatonin application significantly reduced TNF-α (ð < 0.05), increased IL-10 (ð < 0.05), down-regulated TNF-α/IL-10 ratio and changed MDA concentrations (ð < 0.01). In conclusion, our results show that local alteration induces oxidative stress and inflammatory response with TNF-α /IL-10 disbalance. Melatonin modulates this response and attenuates oxidative stress in experimental burn injury.

Journal of Mind and Medical Sciences doi: 10.22543/7674.51.P8592

Authors: Anca Pantea Stoian Liliana Andronache Razvan Hainarosie Dan Paduraru Cristinel Badiu Andreea Arsene Claudia Mehedintu Georgiana Ditu Silviu Pituru Cristina Orlov Mihaela Oros Cornelia Nitipir

Background. This study evaluated the difference between boys and girls in terms of nutritional status, lifestyle, and dietary habits during school life. Materials and Methods. A descriptive and observational study was conducted in 2016, in which 251 children, aged 7–17, from 3 elementary schools and a high school inBucharest,Romania, were evaluated. A questionnaire was used to assess food behavior, eating, and lifestyle habits. Results. Boys had a significantly higher waist circumference (71.18 ± 9) than girls (67.46 ± 9.91) (p = 0.004). Thus 27% of boys were overweight or obese compared with only 22% of the girls. Differences were also seen between the two groups in terms of main meals and snacks and following a rhythm of meals: a statistically significant percentage of girls (36.3%) skip breakfast, while most boys (63.8%) take a food package to school. A total of 23.8% of the boys and 24% of the girls state that they eat while sitting in front of the computer or TV. Conclusions. We found that boys are more overweight or obese than girls. Obesity in the pediatric population of Romania could be explained by the country’s emergence from communism 25 years ago, pattern typical of all Eastern European countries and which currently involve an overexposure of people to fast food, fizzy drinks and sweets, as well as to a high consumption of salt and food additives. Unbalanced and highly caloric food had been preferable to healthy food in the last period. Leisure time is rather spent in front of the TV, tablet, detrimental to rational physical exercise, recreational sports or hiking. The family environment is very important and all our actions should be focused on continuous education about the risks of unhealthy food and a sedentary lifestyle.

Journal of Mind and Medical Sciences doi: 10.22543/2392-7674.1001

Authors: Gabriela Albu Mircea Tampa Maria Sarbu Simona Georgescu

Sexual functionality acts as an important function of the individual, acting both physically and mentally to create a state of well-being and permitting procreation. A large number of mucosal and cutaneous ailments may affect the genial areas in both males and females, generally leading to local symptoms that impede the sexual act. Genital diseases, sometimes even without impairing the sexual function, may still alter the dynamics just because of the enormous psychological impact that occurs in these situations. We aim to review main dermatological disorders that alter normal function of the genitalia, as well as their physical mechanism by which the sexual functionality is changed.

Journal of Mind and Medical Sciences doi: 10.22543/7674.42.P115124

Authors: Oana Mirea Mihaela Berceanu Anca Constantin Mirela Mănescu Georgică Târtea Ionuț Donoiu Constantin Militaru Octavian Istrătoaie

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

Journal of Mind and Medical Sciences doi: 10.22543/7674.42.P100114

Authors: Cristian Tuchila Daniela Baconi Cristina Pirvu Denisa Balalau Ana Vlasceanu Miriana Stan Cristian Balalau

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

Journal of Mind and Medical Sciences doi: 10.22543/7674.42.P9399

Authors: Bogdan Popescu Oana Păun Răzvan Scăunaşu Șerban Berteşteanu

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

Journal of Mind and Medical Sciences doi: 10.22543/7674.42.P8592

Authors: David Rowland Ion Motofei

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

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P8084

Authors: Petrișor Banu Vlad Constantin Florian Popa Mircea Brătucu Teodora Vlădescu Cristian Bălălău

Tuberculosis is in the top 10 causes of death worldwide, being one of the most deadly infectious diseases. It is estimated that one of three people from the entire earth population has a latent infection with M tuberculosis. This aerobic bacterium possesses the ability to persist in host tissues for years and to begin replication once immunity declines. The lungs are most frequent site of infection as the Mycobacterium tuberculosis is carried by aerosol droplets and is commonly transmitted by respiratory route. The second way of transmission is by contaminated food. Intestinal contamination coexists with pulmonary tuberculosis and only 10% represent primitive enteric diseases. The ileocecal region is involved most frequently. Even in this context isolated appendicular involvement remains rare. We report the case of appendicular tuberculosis in a 17-year-old woman with no evidence of other location of disease elsewhere in the body.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P7479

Authors: Simona Georgescu Maria Sârbu Cristina Mitran Mădălina Mitran Vasile Benea Mircea Tampa

Acne conglobata is a rare and severe form of acne vulgaris, characterized by the presence of comedones, papules, pustules, nodules and sometimes hematic or meliceric crusts. Acne excoriée is a form of self-inflicted skin condition in which the patient picks on imaginary or real acne lesions. We report the case of a 16 year old Caucasian female patient from the urban area who addressed our dermatology department for erythematous, edematous plaques covered by pustules and crusts, located on the face. The anamnesis revealed that during the last weeks she had had a depressive mood after ending a relationship with her boyfriend and started scratching and picking on the lesions. The patient's depressive mood prior to the worsening of the disease was probably aggravated by the condition. This might have determined the picking of the skin which could have impeded the response to standard treatment. The self-excoriative behavior could also be regarded as an appeal for help.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P6773

Authors: Alexandru Septimiu Cosmin Moldovan Florin Ungureanu

Introduction: Many colon neoplastic tumors come from the malignancy of adenomatous polyps (70%–90%) that were not timely diagnosed in order to be resected. Materials and Methods: We conducted a retrospective study regarding the incidence of adenomatous polyps during 1.000 consecutive colonoscopies performed in our Upper and Lower Digestive Endoscopy Laboratory during a three-year period. Results: During these colonoscopies, some targeted polyps were biopsied or completely removed and the samples had been sent to a complete anatomopathological examination. Taking into consideration the results, the polyps were classified after the histological type and the form of dysplasia, in order to determine the polyp forms that present a high risk of malignancy. Conclusion: Given the rather high frequency of malignant polyps discovered during our study, we highly recommend colonoscopy as a method of choice for routine monitoring of selected cases.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P5966

Authors: Ganka Bekyarova Milena Atanasova Maria Tzaneva Anelia Dimitrova

Introduction: Melatonin, the principal secretory product of the pineal gland, has antioxidant functions as a potent antioxidant and free radical scavenger. Objectives of the present study were to investigate the effect of melatonin against inflammatory response, burn-induced oxidative damage and apoptotic changes of rat liver. Methods: Melatonin (10 mg /kg, i.p.) was applied immediately after 30% of total body surface area (TBSA) burns on male Wistar rats. The level of malondialdehyde (MDA) as a marker of an oxidative stress was quantified by thiobarbituric method. Hepatic TNFα and IL-10 as inflammatory markers were assayed by ELISA. Using light immunоchistochemistry the expression Ki67 proliferative marker was investigated. Results: Hepatic MDA and TNF-α levels increased significantly following burns without any change in IL-10 level. Intracellular vacuolization, hepatic cell degeneration and apoptosis occurred in rats after burns. The number of apoptotic cells was increased whereas no significant increase in Ki67 proliferative marker. Melatonin decreased the MDA and TNF-α content and increased the IL-10 level. It also limited the degenerative changes and formation of apoptotic cells in rat liver but did not increase expression of the marker of proliferation. In conclusion, our data show that melatonin relieves burn-induced hepatic damage associated with modulation of the proinflammatory/anti-inflammatory balance, mitigation of lipid peroxidation and hepatic apoptosis.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P4958

Authors: Cosmin Moldovan Roxana Duncea Florin Ungureanu Vladimir Belis

Introduction: Although there are many sources for iatrogenic lesions during laparoscopic cholecystectomy, only a few stand out as being one of the most difficult to predict due to their nature of being very hard to diagnose before surgery. Materials and Methods: a short guide of cases with an evidence-based approach to avoid laparoscopic iatrogenic lesions. Results: these cases have been classified and presented into 3 main groups: cases with abnormal arterial layout, cases with heavy alteration of the normal anatomy, and cases with anomalies of the main biliary pathway. Conclusions: while not a complete guide covering all aspects of intraoperative traps during laparoscopic cholecystectomy, this series of cases points out some dangerous situations and some simple solutions to avoid those fiercely iatrogenic lesions of the ductal and vascular landmarks associated with an otherwise simple surgical intervention that has become the golden standard of the gallbladder lithiasic pathology.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P3848

Authors: Sandy Branson Lisa Boss Stanley Cron Dennis Turner

Background: Companion animals may reduce depression and loneliness in socially isolated homebound older adults. However, whether owning a cat or dog is more beneficial in this population remains unknown. Materials and Methods: Pet attachment and the levels of depressive symptoms and loneliness were examined in 39 homebound older adults who exclusively owned a cat(s) or a dog(s). Cat owners (n = 12) and dog owners (n = 27) were assessed for depressive symptoms (Geriatric Depression Scale-Short Form), loneliness (R-UCLA Loneliness Scale), and attachment to pets (Likert scale). Results: Cat owners reported significantly lower levels of depressive symptoms than dog owners (t = 2.12; p = 0.04). There were no significant differences between cat owners and dog owners in regards to levels of loneliness (t = −0.83; p = 0.41). Both cat owners and dog owners reported a high level of attachment to pets (Median = 10 of 10). Conclusions: Although this study provides preliminary evidence that owning a cat to which one is attached is associated with lower levels of depressive symptoms than owning a dog to which one is attached in homebound older adults, the findings should be replicated with longitudinal studies. Findings from such studies may assist homebound older adults in selecting either a cat or dog as a companion pet.

Journal of Mind and Medical Sciences doi: 10.22543/7674.41.P3137

Authors: Isadora Zaharescu Adina Moldovan Cristiana Tanase

Natural killer cells are the main agents of innate immunity. Since 1970, various studies have repeatedly confirmed their involvement in decreasing local tumor growth and also decreasing the risk of metastasis, due to their cytotoxic effects and also through the release of immunostimulatory cytokines such as IFN-gamma. In the 1990s, several studies demonstrated the existence of certain inhibiting and stimulating receptors of these cells, leading to the concept of “induced self”, thus explaining why tumors with MHC-1 are destroyed and autologous cells without it are saved out. Recognition and destruction of tumor cells by the NK cells are the result of complex interactions between inhibiting and activating factors. This paper, based on extensive research of currently available studies, summarizes the mechanisms employed by the NK cells to destroy the cancer cells, thus highlighting their role in the risk of tumor recurrence as well as their use and handling in certain types of immunotherapy.