This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress among undergraduate dental students at Sofia Medical University and to investigate its associations with some demographic, educational and pandemic-related variables. A self-reported questionnaire that included the validated DASS-21 scale was administered to a group of 2nd, 3rd, 4th, and 5th year students (n=70, response rate 95.7%). Results indicated abnormal levels of depression, anxiety, and stress in 34.3%, 65.7% and 59.7% of the participants, respectively. A much larger proportion of females suffered from abnormal levels of anxiety (56.6%) as compared with males (9%), p=.003. Single students exhibited significantly higher level of depression (25.4%) than those having a partner (9%), p=.037. Third-year dental students demonstrated higher level of depression (19.4%) compared to 5th year students (1.5%), p=.007 as well as higher stress scores (25.4%) than 2nd year students (17.9%), p=.035. Academic performance (assessed by GPA in this study), dentistry as the first students’ choice when applying for MUS, financial responsibilities, and pandemic-related academic responses were not found significant factors for depression, anxiety, and stress (p>.05). These outcomes highlight the need to provide psychological support programs with special attention on susceptible groups. Dental students should implement preventive measures and adopt coping strategies to manage stress and reduce levels of anxiety and depression.
{"title":"Prevalence of depression, anxiety and stress after the COVID-19 pandemic period among students at the Medical University of Sofia; Significance of demographic, educational, and pandemic-related variables","authors":"Nadya Avramova","doi":"10.22543/2392-7674.1376","DOIUrl":"https://doi.org/10.22543/2392-7674.1376","url":null,"abstract":"This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress among undergraduate dental students at Sofia Medical University and to investigate its associations with some demographic, educational and pandemic-related variables. A self-reported questionnaire that included the validated DASS-21 scale was administered to a group of 2nd, 3rd, 4th, and 5th year students (n=70, response rate 95.7%). Results indicated abnormal levels of depression, anxiety, and stress in 34.3%, 65.7% and 59.7% of the participants, respectively. A much larger proportion of females suffered from abnormal levels of anxiety (56.6%) as compared with males (9%), p=.003. Single students exhibited significantly higher level of depression (25.4%) than those having a partner (9%), p=.037. Third-year dental students demonstrated higher level of depression (19.4%) compared to 5th year students (1.5%), p=.007 as well as higher stress scores (25.4%) than 2nd year students (17.9%), p=.035. Academic performance (assessed by GPA in this study), dentistry as the first students’ choice when applying for MUS, financial responsibilities, and pandemic-related academic responses were not found significant factors for depression, anxiety, and stress (p>.05). These outcomes highlight the need to provide psychological support programs with special attention on susceptible groups. Dental students should implement preventive measures and adopt coping strategies to manage stress and reduce levels of anxiety and depression.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135928521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarcopenic obesity involves the co-occurrence of sarcopenia and obesity, yields more health risks than either condition alone, thus requiring prevention and treatment for healthy aging. In this review, the literature on the diagnosis of sarcopenic obesity, the mechanisms of its pathogenesis and treatment with emphasis on exercise and dietary protein were revised. Changes in body composition and sex hormones with age, myocellular mechanisms, inflammation, oxidative stress, physical inactivity, and insufficient protein intake are the main factors associated with the pathogenesis of sarcopenic obesity. Treatment targets weight loss while preserving muscle mass and function. Promising approaches involve high-protein and low-calorie diets combined with aerobic and resistance exercises. In addition to the total amount of protein taken daily, the amount consumed per meal, the type, source, and essential amino acid content of the protein are also important factors.
{"title":"Sarcopenic obesity, pathogenesis, and treatment with a focus on exercise and protein intake","authors":"Yasemin Karaağaç","doi":"10.22543/2392-7674.1419","DOIUrl":"https://doi.org/10.22543/2392-7674.1419","url":null,"abstract":"Sarcopenic obesity involves the co-occurrence of sarcopenia and obesity, yields more health risks than either condition alone, thus requiring prevention and treatment for healthy aging. In this review, the literature on the diagnosis of sarcopenic obesity, the mechanisms of its pathogenesis and treatment with emphasis on exercise and dietary protein were revised. Changes in body composition and sex hormones with age, myocellular mechanisms, inflammation, oxidative stress, physical inactivity, and insufficient protein intake are the main factors associated with the pathogenesis of sarcopenic obesity. Treatment targets weight loss while preserving muscle mass and function. Promising approaches involve high-protein and low-calorie diets combined with aerobic and resistance exercises. In addition to the total amount of protein taken daily, the amount consumed per meal, the type, source, and essential amino acid content of the protein are also important factors.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135928523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rahim Al Moushaly, Daniel Ion, Octavian Andronic, Bogdan Socea, Alexandru Cosmin Palcau, Dan Nicolae Paduraru
Sentinel lymph node biopsy (SLNB) has become the gold standard for axillary lymph node staging, providing valuable prognostic information while minimizing complications compared to axillary lymph node dissection. However, there are ongoing debates and controversies surrounding SLNB in specific cases. Studies have explored the use of SLNB in neoadjuvant chemotherapy, emphasizing the need for customized therapy decisions. Factors such as age, tumor characteristics, and treatment response influence the selection of SLNB or axillary lymph node dissection. Additionally, the presence of extranodal extension, micrometastases, and isolated tumor cells has been evaluated to determine the need for lymphadenectomy. The importance of accurate oncological staging by thorough pathological evaluation has been highlighted, particularly with regards to invasion depth and lympho-vascular invasion. The significance of biological tumor status, such as hormone receptor and HER2 status, in axillary management decisions has been emphasized. Moreover, discussions have emerged regarding SLNB in the context of local recurrence, with differing perspectives on its utility. Future extensive studies are needed to refine protocols and incorporate these concepts related to SLNB into breast cancer management guidelines.
{"title":"Sentinel node biopsy for personalized breast cancer management; advances and controversies","authors":"Rahim Al Moushaly, Daniel Ion, Octavian Andronic, Bogdan Socea, Alexandru Cosmin Palcau, Dan Nicolae Paduraru","doi":"10.22543/2392-7674.1440","DOIUrl":"https://doi.org/10.22543/2392-7674.1440","url":null,"abstract":"Sentinel lymph node biopsy (SLNB) has become the gold standard for axillary lymph node staging, providing valuable prognostic information while minimizing complications compared to axillary lymph node dissection. However, there are ongoing debates and controversies surrounding SLNB in specific cases. Studies have explored the use of SLNB in neoadjuvant chemotherapy, emphasizing the need for customized therapy decisions. Factors such as age, tumor characteristics, and treatment response influence the selection of SLNB or axillary lymph node dissection. Additionally, the presence of extranodal extension, micrometastases, and isolated tumor cells has been evaluated to determine the need for lymphadenectomy. The importance of accurate oncological staging by thorough pathological evaluation has been highlighted, particularly with regards to invasion depth and lympho-vascular invasion. The significance of biological tumor status, such as hormone receptor and HER2 status, in axillary management decisions has been emphasized. Moreover, discussions have emerged regarding SLNB in the context of local recurrence, with differing perspectives on its utility. Future extensive studies are needed to refine protocols and incorporate these concepts related to SLNB into breast cancer management guidelines.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"19 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135929133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sorina Boariu, Ana Maria Scutariu, Adrian Cureniuc, Anamaria Meuca, Roxana Adriana Stoica, Anca Mihaela Pantea Stoian, Delia Reurean Pintilei
Background. Anti-obesity therapeutic strategies are continuously evolving. Bariatric procedures or metabolic surgery are among the most effective and long-lasting therapies for obesity and its complications. Our objective was to investigate the clinical and biological evolution after metabolic surgery in a group of patients from North-Eastern Romania and to evaluate a nutritional intervention plan for this population. Materials and Methods. Our clinic surveyed 50 patients who received nutritional counselling before and after bariatric surgery. The patient's weight loss, metabolic markers, and lifestyle changes from January to December 2021 were recorded. SPSS Statistics v.18 was used for statistical analyses. Results and Discussions. Patients had a mean age of 37.70 ± 11.38 years, with an initial body mass index (BMI) of 42.98 ± 6.12 kg/m2. One month after surgery, longitudinal gastrectomy patients lost 12.6 kg (114.33 ± 19.26 vs 101.73±17.27 kg), and gastric bypass patients lost 10.86 kg (119.33 ± 20.83 vs 108.47±17.96 kg). Body composition improved in the first six months after the intervention due to adipose (mean value 37.83±6.42 from 46.38±6.63) and visceral (mean value 8.50 ± 4.42 from 13.72±5.67) tissues decrease. Muscle tissue increased from 35.54±12.63 to a mean value of 39.95±17.96. HbA1c values improved from 5.90±0.63% to 5.30±0.30% in the first month after the intervention. The nutritional intervention was safe without significant deficits after 1 and 6 months. Conclusions. Metabolic surgery is associated with a weight loss of 10.8 to 12.6 kg and improved body composition. Patients require follow-up and further dietary counseling to sustain long-term results.
背景。抗肥胖治疗策略在不断发展。减肥手术或代谢手术是治疗肥胖及其并发症最有效、最持久的方法之一。我们的目的是调查罗马尼亚东北部一组患者代谢手术后的临床和生物学进化，并评估该人群的营养干预计划。材料与方法。我们的诊所调查了50名在减肥手术前后接受营养咨询的患者。记录2021年1月至12月患者的体重减轻、代谢指标和生活方式变化。采用SPSS Statistics v.18进行统计分析。结果和讨论。患者平均年龄37.70±11.38岁，初始体重指数(BMI)为42.98±6.12 kg/m2。纵向胃切除术患者术后1个月体重减轻12.6 kg(114.33±19.26 vs 101.73±17.27 kg)，胃分流术患者术后体重减轻10.86 kg(119.33±20.83 vs 108.47±17.96 kg)。在干预后的前6个月，由于脂肪组织(平均值从46.38±6.63下降到37.83±6.42)和内脏组织(平均值从13.72±5.67下降到8.50±4.42)减少，体成分有所改善。肌肉组织从35.54±12.63增加到平均值39.95±17.96。干预后1个月，HbA1c由5.90±0.63%改善至5.30±0.30%。在1个月和6个月后，营养干预是安全的，没有明显的缺陷。结论。代谢手术与体重减轻10.8至12.6公斤和改善身体成分有关。患者需要随访和进一步的饮食咨询以维持长期效果。
{"title":"Follow-up care after metabolic surgery – a prospective study in the North-Eastern region of Romania","authors":"Sorina Boariu, Ana Maria Scutariu, Adrian Cureniuc, Anamaria Meuca, Roxana Adriana Stoica, Anca Mihaela Pantea Stoian, Delia Reurean Pintilei","doi":"10.22543/2392-7674.1415","DOIUrl":"https://doi.org/10.22543/2392-7674.1415","url":null,"abstract":"Background. Anti-obesity therapeutic strategies are continuously evolving. Bariatric procedures or metabolic surgery are among the most effective and long-lasting therapies for obesity and its complications. Our objective was to investigate the clinical and biological evolution after metabolic surgery in a group of patients from North-Eastern Romania and to evaluate a nutritional intervention plan for this population. Materials and Methods. Our clinic surveyed 50 patients who received nutritional counselling before and after bariatric surgery. The patient's weight loss, metabolic markers, and lifestyle changes from January to December 2021 were recorded. SPSS Statistics v.18 was used for statistical analyses. Results and Discussions. Patients had a mean age of 37.70 ± 11.38 years, with an initial body mass index (BMI) of 42.98 ± 6.12 kg/m2. One month after surgery, longitudinal gastrectomy patients lost 12.6 kg (114.33 ± 19.26 vs 101.73±17.27 kg), and gastric bypass patients lost 10.86 kg (119.33 ± 20.83 vs 108.47±17.96 kg). Body composition improved in the first six months after the intervention due to adipose (mean value 37.83±6.42 from 46.38±6.63) and visceral (mean value 8.50 ± 4.42 from 13.72±5.67) tissues decrease. Muscle tissue increased from 35.54±12.63 to a mean value of 39.95±17.96. HbA1c values improved from 5.90±0.63% to 5.30±0.30% in the first month after the intervention. The nutritional intervention was safe without significant deficits after 1 and 6 months. Conclusions. Metabolic surgery is associated with a weight loss of 10.8 to 12.6 kg and improved body composition. Patients require follow-up and further dietary counseling to sustain long-term results.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135929882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silvia Popescu, Dumitru Peța, Zoltan Janos Kövér, Dumitru Toma, Ioan-Teodor Cristea, Mihaela Anca Popescu, Oana-Denisa Bălălău, Romina-Marina Sima, Gabriel-Petre Gorecki, Călin Giurcăneanu
Renal cell carcinoma is the most common type of primary urogenital cancer, usually resistant to radiotherapy and chemotherapy. Hypertrophic lichen planus is an inflammatory dermatosis characterized by the presence of papulosquamous and intensely pruritic lesions. The association of these two conditions is unusual, being reported in the specialized literature only in a few rare cases with the onset of lichenoid lesions after patients have undergone various forms of treatment. The case of a 62-year-old male patient who was admitted for severe abdominal pain due to a giant renal tumor associated with a hypertrophic plaque located on the anterior part of the left calf is presented. After (clinical, biochemical, imaging) diagnosis, surgery was performed for en bloc removal of the entire mass, adrenal gland, and spleen. The histopathological exam established the diagnosis of a moderately differentiated T2b clear cell Grawitz tumor, without regional lymph node metastasis (stage II). The patient continued local corticosteroid therapy in the hospital for hypertrophic lichen planus lesions, being referred to the oncology department after discharge.
{"title":"Giant renal cell carcinoma in a patient with ipsilateral lower limb hypertrophic lichen planus; Case report and literature review","authors":"Silvia Popescu, Dumitru Peța, Zoltan Janos Kövér, Dumitru Toma, Ioan-Teodor Cristea, Mihaela Anca Popescu, Oana-Denisa Bălălău, Romina-Marina Sima, Gabriel-Petre Gorecki, Călin Giurcăneanu","doi":"10.22543/2392-7674.1425","DOIUrl":"https://doi.org/10.22543/2392-7674.1425","url":null,"abstract":"Renal cell carcinoma is the most common type of primary urogenital cancer, usually resistant to radiotherapy and chemotherapy. Hypertrophic lichen planus is an inflammatory dermatosis characterized by the presence of papulosquamous and intensely pruritic lesions. The association of these two conditions is unusual, being reported in the specialized literature only in a few rare cases with the onset of lichenoid lesions after patients have undergone various forms of treatment. The case of a 62-year-old male patient who was admitted for severe abdominal pain due to a giant renal tumor associated with a hypertrophic plaque located on the anterior part of the left calf is presented. After (clinical, biochemical, imaging) diagnosis, surgery was performed for en bloc removal of the entire mass, adrenal gland, and spleen. The histopathological exam established the diagnosis of a moderately differentiated T2b clear cell Grawitz tumor, without regional lymph node metastasis (stage II). The patient continued local corticosteroid therapy in the hospital for hypertrophic lichen planus lesions, being referred to the oncology department after discharge.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"66 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135929276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Florina Tricorache, Ana Maria Dascalu, Crenguta Serboiu, Anca Bobirca, Dragos Cretoiu, Dan Bratu, Corneliu Tudor, Laura Carina Tribus
Age-related macular degeneration (AMD) is a complex, chronic, and progressive disease which affects the macular area, being one of the leading causes of irreversible vision loss worldwide. Specific alterations of retinal structure occur at the macular level, which regarding its severity can range from the presence of drusen to the development of geographic atrophy or choroidal neovascularization. AMD has long been considered a degenerative disease, but new studies highlight the role of inflammation present both in the atrophic form and in the exudative form. The present review is based on comprehensive research on PubMed and Web of Science databases, and it aims to describe the inflammatory pathways involved in AMD onset and progression. Understanding the molecules involved in AMD pathogenesis, and their mechanism of action, is crucial because they can be both biomarkers with a predictive role in disease management, as well as potential therapeutic targets.
老年性黄斑变性(AMD)是一种影响黄斑区域的复杂、慢性和进行性疾病，是世界范围内不可逆视力丧失的主要原因之一。视网膜结构的特殊改变发生在黄斑水平，其严重程度可以从水肿的存在到地理萎缩或脉络膜新生血管的发展。AMD长期以来被认为是一种退行性疾病，但新的研究强调了炎症在萎缩性和渗出性两种形式中的作用。本综述基于PubMed和Web of Science数据库的综合研究，旨在描述与AMD发病和进展相关的炎症途径。了解与AMD发病机制相关的分子及其作用机制是至关重要的，因为它们既是在疾病管理中具有预测作用的生物标志物，也是潜在的治疗靶点。
{"title":"The role of inflammation in age-related macular degeneration","authors":"Diana Florina Tricorache, Ana Maria Dascalu, Crenguta Serboiu, Anca Bobirca, Dragos Cretoiu, Dan Bratu, Corneliu Tudor, Laura Carina Tribus","doi":"10.22543/2392-7674.1421","DOIUrl":"https://doi.org/10.22543/2392-7674.1421","url":null,"abstract":"Age-related macular degeneration (AMD) is a complex, chronic, and progressive disease which affects the macular area, being one of the leading causes of irreversible vision loss worldwide. Specific alterations of retinal structure occur at the macular level, which regarding its severity can range from the presence of drusen to the development of geographic atrophy or choroidal neovascularization. AMD has long been considered a degenerative disease, but new studies highlight the role of inflammation present both in the atrophic form and in the exudative form. The present review is based on comprehensive research on PubMed and Web of Science databases, and it aims to describe the inflammatory pathways involved in AMD onset and progression. Understanding the molecules involved in AMD pathogenesis, and their mechanism of action, is crucial because they can be both biomarkers with a predictive role in disease management, as well as potential therapeutic targets.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135929132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sohail Adnan, Mubasher Shah, Muhammad Fateen Rashed, Sadaf Nawab
Objectives. The brain has an intrinsic tendency for the lateralization of its functions. For instance, the left hemisphere assists in the comprehension and motor expression of language. What remains uncertain is whether conscious processes are also more prevalent in one hemisphere of the brain than the other. The epistemic goal of this research was to address this particular issue. Materials and Methods. We observed the rare pathological event of proximal occlusion of the middle cerebral artery (MCA), which halts blood flow to the central two-thirds of a hemisphere, and examined its effects on consciousness. We aggregated individual scores for eyes-opening and limb-motor responses from the Glasgow Coma Scale (GCS) to determine the conscious level, and used brain computed tomography imaging to identify the whole-territory infarcts of MCA. Results. Being a rare condition, we managed to recruit 35 patients from two centers (average age: 64.54 ± 13 years, 45.71% females). Whole-territory infarcts of the MCA occurred more frequently in the left hemisphere (22 versus 13, frequency: 62.85%). Unconsciousness was also more common with left hemisphere infarctions (16 versus 2 unconscious patients of the right hemisphere, Frequency: 72%, GCS: 2/10=3/22 cases, GCS: 5/10=1/22 cases, GCS: 6-7/10=12/22 cases). The difference in unconsciousness proved significant in Fisher’s exact analysis (p-value = 0.001) and remained independent of age (p-value=0.7247) and gender (p-value=0.3145). Moreover, six conscious patients with left hemisphere involvement exhibited a loss of conscious control for normal responses, implying a strong link between consciousness and cognition. Unconsciousness also correlated with stroke outcomes (16 Unconscious: 56.25% deceased within the hospital). Conclusion. Conscious processes are more predominant in the brain's left hemisphere. Our observations indicate that only a gross unilateral insult to the brain can lead to unconsciousness.
目标。大脑有其功能偏侧化的内在倾向。例如，左半球帮助理解和运动表达语言。仍然不确定的是，意识过程是否也在大脑的一个半球比另一个半球更普遍。本研究的认识论目标是解决这一特殊问题。材料与方法。我们观察了大脑中动脉(MCA)近端闭塞的罕见病理事件，它会阻止血液流向大脑半球的三分之二，并检查了它对意识的影响。我们汇总了来自格拉斯哥昏迷量表(GCS)的睁眼和肢体运动反应的个体得分，以确定意识水平，并使用脑计算机断层扫描成像来识别MCA的全区域梗死。结果。作为一种罕见的疾病，我们从两个中心招募了35例患者(平均年龄:64.54±13岁，45.71%为女性)。中动脉全区梗死多发于左半球(22 vs 13，频率:62.85%)。昏迷在左半球梗塞中也更为常见(16例对2例右半球昏迷，发生率:72%，GCS: 2/10=3/22例，GCS: 5/10=1/22例，GCS: 6-7/10=12/22例)。在Fisher的精确分析中，无意识的差异被证明是显著的(p值= 0.001)，并且与年龄(p值=0.7247)和性别(p值=0.3145)无关。此外，6名有意识的左半球受损伤患者表现出对正常反应的意识控制丧失，这意味着意识和认知之间存在很强的联系。无意识也与中风结果相关(16例无意识:56.25%在医院内死亡)。结论。意识过程在大脑的左半球更占优势。我们的观察表明，只有对大脑的严重单侧损伤才会导致无意识。
{"title":"Prevalent distribution of conscious processes on either side of the brain","authors":"Sohail Adnan, Mubasher Shah, Muhammad Fateen Rashed, Sadaf Nawab","doi":"10.22543/2392-7674.1382","DOIUrl":"https://doi.org/10.22543/2392-7674.1382","url":null,"abstract":"Objectives. The brain has an intrinsic tendency for the lateralization of its functions. For instance, the left hemisphere assists in the comprehension and motor expression of language. What remains uncertain is whether conscious processes are also more prevalent in one hemisphere of the brain than the other. The epistemic goal of this research was to address this particular issue. Materials and Methods. We observed the rare pathological event of proximal occlusion of the middle cerebral artery (MCA), which halts blood flow to the central two-thirds of a hemisphere, and examined its effects on consciousness. We aggregated individual scores for eyes-opening and limb-motor responses from the Glasgow Coma Scale (GCS) to determine the conscious level, and used brain computed tomography imaging to identify the whole-territory infarcts of MCA. Results. Being a rare condition, we managed to recruit 35 patients from two centers (average age: 64.54 ± 13 years, 45.71% females). Whole-territory infarcts of the MCA occurred more frequently in the left hemisphere (22 versus 13, frequency: 62.85%). Unconsciousness was also more common with left hemisphere infarctions (16 versus 2 unconscious patients of the right hemisphere, Frequency: 72%, GCS: 2/10=3/22 cases, GCS: 5/10=1/22 cases, GCS: 6-7/10=12/22 cases). The difference in unconsciousness proved significant in Fisher’s exact analysis (p-value = 0.001) and remained independent of age (p-value=0.7247) and gender (p-value=0.3145). Moreover, six conscious patients with left hemisphere involvement exhibited a loss of conscious control for normal responses, implying a strong link between consciousness and cognition. Unconsciousness also correlated with stroke outcomes (16 Unconscious: 56.25% deceased within the hospital). Conclusion. Conscious processes are more predominant in the brain's left hemisphere. Our observations indicate that only a gross unilateral insult to the brain can lead to unconsciousness.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"165 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135929275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adrian Silaghi, Laura Florentina Rebegea, Daniela Gabriela Balan, Anca Dumitriu, Stana Paunica, Cristian Balalau, Stefăniță Tenea Cojan, Dragos Epistatu, Vlad Denis Constantin
Gastric cancer is an extremely aggressive form of malignancy that, if left untreated, is life-threatening. Improved survival rates depend on early detection of the disease, as well as on the combination of different forms of treatment (surgery, chemotherapy, radiotherapy, immunotherapy, etc.). Screening methods have brought real benefit in early detection of malignancies, but many cases are still diagnosed at advanced stages. The current study is a review related to actualities and perspectives of early diagnosis and targeted therapy of gastric cancer. After an extensive review of the literature, epidemiological, diagnostic and treatment data are presented. The open surgical approach is used in emergency centers or with a low surgical activity, while the minimally invasive approach (laparoscopic, robotic) is possible in large centers dedicated to the treatment of gastric cancer. In the near future, new diagnostic and therapeutic tools are expected to appear, not only to cure cancer definitively, but also to be able to prevent it, if possible, without radically changing the lifestyle of the population.
{"title":"Gastric cancer; actualities and perspectives of early diagnosis and targeted therapy","authors":"Adrian Silaghi, Laura Florentina Rebegea, Daniela Gabriela Balan, Anca Dumitriu, Stana Paunica, Cristian Balalau, Stefăniță Tenea Cojan, Dragos Epistatu, Vlad Denis Constantin","doi":"10.22543/2392-7674.1444","DOIUrl":"https://doi.org/10.22543/2392-7674.1444","url":null,"abstract":"Gastric cancer is an extremely aggressive form of malignancy that, if left untreated, is life-threatening. Improved survival rates depend on early detection of the disease, as well as on the combination of different forms of treatment (surgery, chemotherapy, radiotherapy, immunotherapy, etc.). Screening methods have brought real benefit in early detection of malignancies, but many cases are still diagnosed at advanced stages. The current study is a review related to actualities and perspectives of early diagnosis and targeted therapy of gastric cancer. After an extensive review of the literature, epidemiological, diagnostic and treatment data are presented. The open surgical approach is used in emergency centers or with a low surgical activity, while the minimally invasive approach (laparoscopic, robotic) is possible in large centers dedicated to the treatment of gastric cancer. In the near future, new diagnostic and therapeutic tools are expected to appear, not only to cure cancer definitively, but also to be able to prevent it, if possible, without radically changing the lifestyle of the population.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135928524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel Petre Gorecki, Oana Denisa Balalau, Diana Elena Comandasu, Anca Daniela Stanescu, Dana Rodica Tomescu
Background . Physiological changes that occur during pregnancy make maternal sepsis a difficult condition to diagnose and treat, still having a fairly high mortality rate. Consequently, an early diagnosis and prompt therapeutic management of sepsis can significantly decrease mortality. The purpose of this study is to review literature data that present current practices in the management of obstetric sepsis. Methods . To collect the data required for the study, we performed a search of published articles in the PubMed and Google Scholar databases related to obstetric sepsis. Research paper articles from the period 2012-2022 were included in the analysis. In addition, 145 articles from the period 2012-2022 were evaluated, with the aim of finding out in which situations the risk of maternal death is higher. Thus, the analysis included a total number of 151 articles, which were divided into two distinct stages. Results . The risk of maternal death is higher among patients with the human immunodeficiency virus (HIV), followed by Escherichia coli, genital tract infection, cancer, drug users and in the case of patients with chronic liver disease. Conclusions . After analyzing the data, we found that prompt and focused antibiotic therapy as well as fluid resuscitation are essential to increase the chances of survival of these patients.
{"title":"Best therapeutic practices in the management of obstetric sepsis","authors":"Gabriel Petre Gorecki, Oana Denisa Balalau, Diana Elena Comandasu, Anca Daniela Stanescu, Dana Rodica Tomescu","doi":"10.22543/2392-7674.1436","DOIUrl":"https://doi.org/10.22543/2392-7674.1436","url":null,"abstract":"Background . Physiological changes that occur during pregnancy make maternal sepsis a difficult condition to diagnose and treat, still having a fairly high mortality rate. Consequently, an early diagnosis and prompt therapeutic management of sepsis can significantly decrease mortality. The purpose of this study is to review literature data that present current practices in the management of obstetric sepsis. Methods . To collect the data required for the study, we performed a search of published articles in the PubMed and Google Scholar databases related to obstetric sepsis. Research paper articles from the period 2012-2022 were included in the analysis. In addition, 145 articles from the period 2012-2022 were evaluated, with the aim of finding out in which situations the risk of maternal death is higher. Thus, the analysis included a total number of 151 articles, which were divided into two distinct stages. Results . The risk of maternal death is higher among patients with the human immunodeficiency virus (HIV), followed by Escherichia coli, genital tract infection, cancer, drug users and in the case of patients with chronic liver disease. Conclusions . After analyzing the data, we found that prompt and focused antibiotic therapy as well as fluid resuscitation are essential to increase the chances of survival of these patients.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135929130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ovidiu V Fabian, Emilia Maria Pătruţ, Mădălina Șteţca, Radu Mircea Galasiu, Vlad Zolog, Adriana Zolog, Iacob Domşa, Ioan Șimon, Anca Mihailov, Olga Hilda Orăşan, Flaviu Mureşan
Although rare, subungual carcinoma is the most common malignant nail tumor. The symptomatology is not characteristic, being very similar to that of other nail and periungual diseases. For this reason, early diagnosis is usually established by performing a biopsy. With appropriate treatment, subungual carcinoma usually has a favorable prognosis. Metastatic cases are rarely encountered, but they usually have a poor therapeutic result. This article presents the case of a patient with subungual carcinoma (diagnosed by histopathological exam), initially treated by amputation of the distal and middle phalanges of the fourth finger. Two years after the operation, a recurrence in the epitrochlear nodes was diagnosed, for which epitrochlear lymphadenectomy and postoperative chemotherapy were performed. At 7 months, metastases were detected in the axillary nodes, which were treated with radiotherapy and chemotherapy. The appearance and development of the tumor at the elbow and the lower third of the arm led the patient to accept scapulohumeral disarticulation. The patient finally adapted to the physical infirmity, having a good general condition and an optimistic attitude.
{"title":"Subungual squamous cell carcinoma leading to arm amputation","authors":"Ovidiu V Fabian, Emilia Maria Pătruţ, Mădălina Șteţca, Radu Mircea Galasiu, Vlad Zolog, Adriana Zolog, Iacob Domşa, Ioan Șimon, Anca Mihailov, Olga Hilda Orăşan, Flaviu Mureşan","doi":"10.22543/2392-7674.1404","DOIUrl":"https://doi.org/10.22543/2392-7674.1404","url":null,"abstract":"Although rare, subungual carcinoma is the most common malignant nail tumor. The symptomatology is not characteristic, being very similar to that of other nail and periungual diseases. For this reason, early diagnosis is usually established by performing a biopsy. With appropriate treatment, subungual carcinoma usually has a favorable prognosis. Metastatic cases are rarely encountered, but they usually have a poor therapeutic result. This article presents the case of a patient with subungual carcinoma (diagnosed by histopathological exam), initially treated by amputation of the distal and middle phalanges of the fourth finger. Two years after the operation, a recurrence in the epitrochlear nodes was diagnosed, for which epitrochlear lymphadenectomy and postoperative chemotherapy were performed. At 7 months, metastases were detected in the axillary nodes, which were treated with radiotherapy and chemotherapy. The appearance and development of the tumor at the elbow and the lower third of the arm led the patient to accept scapulohumeral disarticulation. The patient finally adapted to the physical infirmity, having a good general condition and an optimistic attitude.","PeriodicalId":43987,"journal":{"name":"Journal of Mind and Medical Sciences","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135929880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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