Postpartum depression: Prevention and multimodal therapy

A woman goes through many biological (hormonal, physical), psychological (emotional), and socio-cultural changes during pregnancy. Furthermore, changes also occur in the mother\u27s 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

The analysis of risk factors associated with women\u27s urinary incontinence; literature review

Urinary incontinence (UI) is a common condition among women. Approximately 50% of them had an involuntary loss of urine at least once in their lifetime. It can be present during sexual activity, contributing to sexual dysfunction and often associated with anxiety or even depression, thus having a negative impact on the quality of life. The incidence of UI is related to the existence of predisposing factors. The best known are: age, weight, family history, race/ ethnicity, number of pregnancies and mode of birth, history of genitourinary interventions and factors related to ordinary habits: smoking, caffeine consumption, oral contraceptives. Studies on middle-aged women have revealed that BMI, parity, age, hysterectomy, smoking, race/ ethnicity and diabetes are factors often associated with urinary incontinence. Future studies are needed to further explore the risk factors for urinary incontinence

Is multidirectional UV exposure responsible for increasing melanoma prevalence with altitude? A hypothesis based on calculations with a 3D-human exposure model

In a recent study, melanoma incidence rates for Austrian inhabitants living at higher altitudes were found to increase by as much as 30% per 100 m altitude. This strong increase cannot simply be explained by the known increase of erythemally-weighted irradiance with altitude, which ranges between 0.5% and 4% per 100 m. We assume that the discrepancy is partially explainable by upwelling UV radiation; e.g., reflected by snow-covered surfaces. Therefore, we present an approach where the human UV exposure is derived by integrating incident radiation over the 3D geometry of a human body, which enables us to take upwelling radiation into account. Calculating upwelling and downwelling radiance with a radiative transfer model for a snow-free valley and for snow-covered mountain terrain (with albedo of 0.6) yields an increase in UV exposure by 10% per 100 m altitude. The results imply that upwelling radiation plays a significant role in the increase of melanoma incidence with altitude.Austrian Climate Research Program (ACRP

Psychological and psychiatric characterization of various groups of drugs users

Aim. We aimed to assess the differences among various groups of drugs users, especially in the psychiatric and psychological domains. Materials and Methods. A retrospective study was carried out in collaboration with C.E.T.T.T `St. Stelian` Institute from Bucharest. There were analyzed the medical records of 604 hospitalized patients with heroin or polydrug addiction. Results. Significant differences in diagnosis at submission among groups were outlined (personality and behavior disorders, p-value = .04298, psychotic disorders, p-value = .004274, schizophrenia, p-value = .000141) as well as significant differences among psychiatric parameters: perception (legal highs, opiates), attention (cannabis), consciousness (legal highs), thinking (legal highs), and, instinctive life (legal highs). Conclusions. Personality and behavioral disorders have been particularly linked to opiate use, the psychotic disorder was related to cannabis and legal highs intake, while schizophrenia was related to legal highs intake

Therapeutic Considerations Related to Finasteride Administration in Male Androgenic Alopecia and Benign Prostatic Hyperplasia

Finasteride has been used extensively until now as a relative efficient therapeutic option for male androgenic alopecia and benign prostatic hyperplasia. Unfortunately, over time several concerns appeared regarding the frequency and magnitude of adverse effects, which in some cases have been even irreversible. Herein we review the recent literature on this topic, trying to clarify the current safety profile of Finasteride for these two therapeutic indications. We concluded that Finasteride could be retained as a therapeutic approach for male androgenic alopecia, based on two important reasons. First, a synergistic action between a partial inhibitor of 5α-reductase (Finasteride) and another compound (like Minoxidil) are preferable to a complete suppression of 5α-reductase (see Dutasteride), in order to preserve the important physiological roles of dihydrotestosterone. Second, Finasteride side effects can currently be addressed in part prior to the onset of the therapy, by using information about the patient such as hand preference and sexual orientation to predict the risk of adverse effects

Diagnosis and management of colon cancer patients presenting in advanced stages of complications

Colorectal cancer is an important health problem with a significant impact on the individual and society. Malignancy (including colorectal cancer) is usually slightly symptomatic in its initial stages. This causes cancer to be discovered in some patients accidentally (either through screening tests in predisposed individuals or during routine investigations for other diseases), while in other patients the colorectal cancer is discovered in late stages, when the symptoms are much more intense due to complications. Unfortunately, such advanced cases of the disease have high rates of morbidity and mortality even with treatment. Current treatment methods are usually complex, interdisciplinary, causing significant suffering (physical, mental) to the individual, while the cost of treatment per patient seems to be extremely high. Until finding therapeutic methods that are effective and accessible to most patients with advanced colorectal cancer, several methods of prophylaxis and early diagnosis should be considered, to reduce as much as possible the devastating impact of this disease. The purpose of this review is to present literature data regarding the current methods of diagnosis and treatment of patients presenting to the doctor with colorectal cancer in advanced stages of complications

Modern interpretation of risk factors in breast cancer of women

Breast cancer is a major public health problem, being the most common cancer diagnosed in women and accounting for more than 1 in 10 new diagnoses of cancer each year. It is the most common neoplasm of women under the age of 40 and the second leading cause of cancer death in this age group, with more frequent detection of pathogenic mutations in breast cancer susceptibility genes. Women with BRCA1 and BRCA2 mutations are about 70% more likely to develop breast cancer. The incidence is rising in most countries and it is expected to have a growing trend in the next 20 years, despite the current efforts to prevent the disease. In order to improve the survival rate, it is necessary to make a diagnosis as early as possible and to initiate the appropriate therapeutic management as soon as possible. Therefore, in order to detect breast formations, mammography screening is very important, breast density being an important factor in predicting the risk of breast cancer. Thus, the presence of high breast density represents a 4-6 times higher risk of developing breast cancer compared to women with low breast density. Aging and menopause are also risk factors for breast cancer. Hormone replacement therapy for postmenopausal women has the benefit of relieving symptoms such as hot flashes, depression or sleep disturbances, but it increases the risk of developing breast cancer

Postpartum depression: Prevention and multimodal therapy

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

Upper gastrointestinal bleeding during the COVID-19 pandemic; particularities of diagnosis and therapy

SARS-COV 2 recently caused a global pandemic, with the first case being reported in Romania in February 2020. Important restrictive measures were imposed, so that the addressability of patients to medical services decreased. Upper gastrointestinal bleeding had more severe forms of evolution at the time of presentation, which required additional methods of diagnosis and treatment. This is a retrospective study performed on 268 patients, which aims to evaluate the type and effectiveness of different treatment methods for upper gastrointestinal bleeding during the COVID 19 pandemic. Severity assessment was performed by measuring the Rockall score and additional methods of diagnosis. The association of COVID-19 with upper gastrointestinal bleeding can lead to much more severe outcomes for the patient, so treatment must be sustained and fast established. If the initial therapeutic methods fail, the other available therapeutic measures should be introduced progressively and without delay to achieve the best possible outcomes

Gastric cancer; actualities and perspectives of early diagnosis and targeted therapy

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