Postpartum depression; associated factors and underdiagnosis

Post-partum depression is one of the most severe types of depression and can be developed at any age, no matter of cultural of social status. Objectives. To determine the factors associated with the psychological impact of pregnancy and to emphasize the psychological and psychiatric risks after giving birth for a woman. Materials and Methods. The study enrolled 35 patients diagnosed with postpartum depression that have been hospitalized in a tertiary-care center for psychiatric disorders between 2016 and 2020. Data were collected from patients’ observation charts. Results. The incidence of postpartum depression is higher in the age range 30-45 years old for primiparous women who are from urban areas, unemployed and not integrated in a family (unbalanced families or single parents), with medium level of education (high school) and alcohol addiction. One of 35 patients committed infanticide. Conclusions. Even if the postpartum depression is known worldwide it is still underdiagnosed, with certain factors concurring to that. Postpartum depression requires the identification of risk conditions in pregnant women and individualized therapy in a patient-centered, holistic manner

Diabetes mellitus and necrotizing fasciitis – a deadly combination; case report

Necrotizing fasciitis is a rapidly destructive affliction of soft tissues, with a mortality rate that may reach 73% of the cases. It is characterized by a progressive inflammation and extended necrosis of the subcutaneous tissue and the fascia. Necrotizing fasciitis was first described in 1848, and later in 1920 Meleney identified 20 patients in China in which the infection was presumably triggered by hemolytic streptococcus, linking pathological bacteria to the condition. In 1952, Wilson coined the term necrotizing fasciitis although without successfully identifying the specific pathological bacteria involved. In most cases, both risk and aggravating factors are present, the main risk factors being diabetes mellitus, liver cirrhosis, renal failure, and immunosuppressant states. Location may vary, but most frequently the disease occurs in the limbs, the trunk, and the perineum. Treatment depends on the location and the time of diagnosis and may range from large incisions with extensive debridement to organ amputations such as those of the limbs or breasts. Treatment is complex and expensive, and besides surgery, includes the administration of broad-spectrum antibiotics, anti-inflammatory drugs, intensive therapy support, and long-term hospitalizations. The prognosis is guarded. The present case entails a 56-year old female patient who presented with many risk factors favoring the occurrence of necrotizing fasciitis, namely diabetes mellitus, liver cirrhosis (decompensated with ascites and portal encephalopathy phenomena), untreated hepatitis B infection, chronic renal failure with diabetic nephrotic syndrome, and obesity

Evaluation of medical decision errors during the transition period to telemedicine

The context of the Coronavirus pandemic has fundamentally changed the way we approach medical services. Beyond setting up new technological possibilities, it has propelled telemedicine to become a reality, bringing undeniable practical benefits. The questions that arise are both justified and worrying: can digitalization replace a direct interpersonal relationship that involves a physical examination, while preserving the quality of the medical act and the degree of patient satisfaction? Isn\u27t there a risk that the digitization of the medical record will cancel out the deep human character of classical medicine that has evolved since the time of Hippocrates? Should the implementation of telemedicine be the state-of-art of modern medicine, in accordance with the co-evolution of digital technology? It is hard to believe that once used in this period, telemedicine will be abandoned. However, telemedicine must be analyzed not only in the short term but also in the long term, in order to be able to evaluate both its usefulness and possible deficiencies

The effects of SGLT2 inhibitors in patients with metabolic dysfunction-associated fatty liver disease; a narrative review

Worldwide, metabolic dysfunction-associated fatty liver disease (MAFLD) is a significant public health concern, especially since more than fifty percent of people with type 2 diabetes are affected by it. This pathological condition includes all states of fatty liver disease, from non-alcoholic fatty liver disease (NAFLD) to steatohepatitis (NASH). Prolonged evolutions can lead to cirrhosis and cancer, so treatment must be started early. Hepatic steatosis may be improved by sodium glucose co-transporter 2 inhibitors (SGLT2 inhibitors), which prevent glucose reabsorption in the proximal renal tubule and increase urinary excretion, thus lowering plasma glucose levels. Experimental studies in animal models have suggested that SGLT2 inhibitors may have beneficial modulatory effects on NAFLD and NASH, while numerous clinical trials have demonstrated their favorable effects on the liver enzymes, body mass index, blood lipids, blood glucose, and insulin resistance in NAFLD patients. This review highlights the state of knowledge regarding the epidemiology, diagnosis and pathogenetic pathways of MAFLD, focusing primarily on the effectiveness of SGLT2 inhibitors as a promising drug class in the treatment of NAFLD

Diabetes mellitus and necrotizing fasciitis – a deadly combination; case report

Necrotizing fasciitis is a rapidly destructive affliction of soft tissues, with a mortality rate that may reach 73% of the cases. It is characterized by a progressive inflammation and extended necrosis of the subcutaneous tissue and the fascia. Necrotizing fasciitis was first described in 1848, and later in 1920 Meleney identified 20 patients in China in which the infection was presumably triggered by hemolytic streptococcus, linking pathological bacteria to the condition. In 1952, Wilson coined the term necrotizing fasciitis although without successfully identifying the specific pathological bacteria involved. In most cases, both risk and aggravating factors are present, the main risk factors being diabetes mellitus, liver cirrhosis, renal failure, and immunosuppressant states. Location may vary, but most frequently the disease occurs in the limbs, the trunk, and the perineum. Treatment depends on the location and the time of diagnosis and may range from large incisions with extensive debridement to organ amputations such as those of the limbs or breasts. Treatment is complex and expensive, and besides surgery, includes the administration of broad-spectrum antibiotics, anti-inflammatory drugs, intensive therapy support, and long-term hospitalizations. The prognosis is guarded. The present case entails a 56-year old female patient who presented with many risk factors favoring the occurrence of necrotizing fasciitis, namely diabetes mellitus, liver cirrhosis (decompensated with ascites and portal encephalopathy phenomena), untreated hepatitis B infection, chronic renal failure with diabetic nephrotic syndrome, and obesity

Anxio-depressive disorders in a pandemic context: A comparative analysis: year 2019 versus 2020

The outbreak of SARS-CoV-2 pandemic has resulted in increased rates of anxiety and depression worldwide. Objective. To comparatively evaluate factors associated with the psychological impact of Coronavirus disease between 2019 and the pandemic year 2020. Materials and Methods. The study was performed on a group of 3224 patients, of which 197 were hospitalized, selected from Jan 1st 2019 until 30th Dec 2020 in a tertiary care center for psychiatric disorders. Data were collected from the observation charts. Results. The incidence of anxiety disorders is higher in the age range 40-70 years with an average value of 53 years old. In 2019, a third of patients (29,45%) had alcohol-related conditions and developed anxiety-depressive disorder. In 2020, the percentage was lower (9.38%), but also the number of admitted patients significantly decreased (p<0.0001). There were not found significant differences in age, gender or environment. Hypnotic disorders were more predominant in 2019 (54.6% vs 37.5%, p=0.01), whereas in 2020 anxiety and agitation increased significantly (34.4% vs 84.38%, p=0.0001). Relapses were similarly frequent in both years, in half of the cases. Conclusions. Coronavirus pandemic lead to a decrease in both presentations and admission to hospital. Although there were not found significant differences in age or gender, more patients from urban environment were admitted, which can have several explanations. Anxiety and agitation became the main reason for hospitalization in 2020

Correction to: New-Onset Diabetes Mellitus in COVID-19: A Scoping Review

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THE EFFECT OF ORTHODONTIC VERTICAL FORCES ON THE DENTAL PULP: A THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS

Aim of the study. In our study we evaluated, by using a three-dimensional Finite Element Model, the effect of intrusive and extrusive forces applied during orthodontic treatment. Material and methods. A tridimensional image of the tooth was obtained, by creating a model with 1379 nodes and 976 finite elements. We selected two clinical situations frequently present during orthodontic treatment: the use of a force aiming to align the teeth according to the vertical dimension, through extrusion or intrusion, which exerts a compression or elongation effect on the periodontal complex. Results. The results showed that the use of high force determined an increased stress especially in the apical third of the root. Conclusions. The use of high forces could determine an increased stress in the apical third of the root and disturbances in pulp circulation or even loss of dental pulp vitality

Genome Editing Approaches with CRISPR/Cas9 for Cancer Treatment: Critical Appraisal of Preclinical and Clinical Utility, Challenges, and Future Research

The increasing burden on human malignant diseases became a major concern for healthcare practitioners, that must deal with tumor relapse and the inability to efficiently treat metastasis, in addition to side effects. Throughout the decades, many therapeutic strategies have been employed to improve the clinical outcomes of cancer patients and great efforts have been made to develop more efficient and targeted medicines. The malignant cell is characterized by genetic and epigenetic modifications, therefore targeting those specific drivers of carcinogenesis is highly desirable. Among the genome editing technologies, CRISPR/Cas9 stood as a promising candidate for cancer treatment alternatives, due to its low complexity design. First described as a defense mechanism of bacteria against invading foreign DNA, later it was shown that CRISPR components can be engineered to target specific DNA sequences in a test tube, a discovery that was awarded later with the Nobel Prize in chemistry for its rapid expansion as a reliable genome editing tool in many fields of research, including medicine. The present paper aims of describing CRISPR/Cas9 potential targets for malignant disorders, and the approaches used for achieving this goal. Aside from preclinical studies, we also present the clinical trials that use CRISPR-based technology for therapeutic purposes of cancer. Finally, a summary of the presented studies adds a more focused view of the therapeutic value CRISPR/Cas9 holds and the associated shortcomings

Tiny Actors in the Big Cellular World: Extracellular Vesicles Playing Critical Roles in Cancer

Communications among cells can be achieved either via direct interactions or via secretion of soluble factors. The emergence of extracellular vesicles (EVs) as entities that play key roles in cell-to-cell communication offer opportunities in exploring their features for use in therapeutics; i.e., management and treatment of various pathologies, such as those used for cancer. The potential use of EVs as therapeutic agents is attributed not only for their cell membrane-bound components, but also for their cargos, mostly bioactive molecules, wherein the former regulate interactions with a recipient cell while the latter trigger cellular functions/molecular mechanisms of a recipient cell. In this article, we highlight the involvement of EVs in hallmarks of a cancer cell, particularly focusing on those molecular processes that are influenced by EV cargos. Moreover, we explored the roles of RNA species and proteins carried by EVs in eliciting drug resistance phenotypes. Interestingly, engineered EVs have been investigated and proposed as therapeutic agents in various in vivo and in vitro studies, as well as in several clinical trials