Postpartum depression and thyroid dysfunction– should pregnant women be screened for thyroid disorders?

The relationship between thyroid dysfunction and postpartum depression has been investigated for quite some time now, but no consensus has been reached regarding the need for screening for thyroid function during pregnancy. This paper aims to investigate whether thyroid hormone screening in pregnancy might contribute to the diagnosis of postpartum depression. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) - one of the most widely used measures in detecting postpartum depression and anxiety. Thyroid function was measured using the commonly recommended thyroid laboratory tests. A structured questionnaire was given to 61 patients closely monitored during their pregnancy and at least one year after giving birth, including for thyroid and depression disorders. The questionnaire was completed anonymously online by the patients and had three sections: one containing the EPDS questions, one assessing thyroid function, and a demographic section. The interdependency between thyroid and depression was analyzed in SPSS using the Pearson chi-square test of independence. The results show no statistically significant relationship between thyroid dysfunction and depression. In other words, women suffering from thyroid dysfunctions have no greater rate of depression compared to women without thyroid dysfunction. As a result, it screening for thyroid disorders during pregnancy may not provide relevant information for detecting postnatal depression

Postpartum depression and thyroid dysfunction– should pregnant women be screened for thyroid disorders?

The relationship between thyroid dysfunction and postpartum depression has been investigated for quite some time now, but no consensus has been reached regarding the need for screening for thyroid function during pregnancy. This paper aims to investigate whether thyroid hormone screening in pregnancy might contribute to the diagnosis of postpartum depression. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) - one of the most widely used measures in detecting postpartum depression and anxiety. Thyroid function was measured using the commonly recommended thyroid laboratory tests. A structured questionnaire was given to 61 patients closely monitored during their pregnancy and at least one year after giving birth, including for thyroid and depression disorders. The questionnaire was completed anonymously online by the patients and had three sections: one containing the EPDS questions, one assessing thyroid function, and a demographic section. The interdependency between thyroid and depression was analyzed in SPSS using the Pearson chi-square test of independence. The results show no statistically significant relationship between thyroid dysfunction and depression. In other words, women suffering from thyroid dysfunctions have no greater rate of depression compared to women without thyroid dysfunction. As a result, it screening for thyroid disorders during pregnancy may not provide relevant information for detecting postnatal depression

The incidence of haemorrhagic and thromboembolic events after breast cancer surgery in patients treated with pharmacological thromboprophylaxis

Background. Hemorrhagic events and venous thromboembolic disease, including pulmonary embolism and deep venous thrombosis, are the most important complications after breast cancer surgery. Although hemorrhagic complications are not usually severe and do not have a high mortality risk, venous thromboembolic disease is often associated with high morbidity and mortality rates. Under such circumstances, it is highly important to evaluate the need for systemic antithrombotic prophylaxis as opposed to mechanical interventions and the optimal duration of chemoprophylaxis in patients undergoing breast cancer surgery. Methods. Using the database of the General Surgery Department of “Colţea” Clinical Hospital, we analyzed the data from 2015 to 2018. During this period, pharmacological prophylaxis was used in all patients undergoing breast cancer surgery. Mechanical prophylaxis (intermittent pneumatic compression or graduated compression) has also been recommended, but there was no record of patient compliance. The primary outcome was the occurrence of venous thromboembolic or hemorrhagic events within 30 days after surgery. Results. In our institution, the venous thromboembolic disease rate for breast cancer surgery was 4/540 (0.7%; 95% CI: 0.02-1.9%), being similar to that of other studies. Hemorrhagic events occurred in 29 (5.4%; 95% CI 3.6-7.6%) patients, most commonly as hematoma in 3.3% of the patients. The incidence of hematoma requiring operation was 1.1% (95% CI: 0.4-2.4%), while hematoma treated conservatively was 2.2% (95% CI:1.2-3.8%). Other forms of hemorrhagic events include hemorrhagic drainage and bleeding wound, occurring in 2.0% of the cases. Conclusions. The occurrence of venous thromboembolic events is reduced among patients undergoing primary breast cancer surgery. A current issue is decreasing venous thromboembolic disease rates without increasing the hemorrhagic event rate. Standard guidelines on the antithrombotic prophylaxis of these patients are not well established since studies show contradictory data. Further investigations are needed to determine exactly which type of thromboprophylaxis is more effective

Telocytes, a distinct type of cell among the stromal cells present in the lamina propria of jejunum

Conventionally, cells described in the stroma of the intestinal wall are fibroblasts/fibrocytes, mast cells, plasma cells, eosinophils, macrophages and, interstitial cells of Cajal (ICCs), the latter being considered as the pacemakers of gastrointestinal rhythmicity. Recently, a new type of stromal cell called telocyte (TCs) was found in various cavitary and non-cavitary organs (www.telocytes.com). We show here direct electron microscopical evidence for the presence of TCs in the lamina propria of rat jejunum just beneath the epithelial layer of the mucosal crypts and in between the smooth muscle cells (SMCs) of muscularis mucosae. TCs are characterized by: several very long (tens to hundreds of µm) prolongations called telopodes (Tps). Tps (with caliber below the resolving power of light microscopy) display podomeres (thin segments ≤0.2 µm) and podoms (dilations accommodating caveolae, mitochondria, and endoplasmic reticulum). Tps present dichotomous branching and form a three dimensional network close to immune cells, SMCs or nerve bundles. TCs could play a role in intercellular signaling and control of local tissue homeostasi

Real-World Data Analysis of Pregnancy-Associated Breast Cancer at a Tertiary-Level Hospital in Romania

Background and objectives: Breast cancer is among the most common cancer types encountered during pregnancy. Here, we aimed to describe the characteristics, management, and outcomes of women with pregnancy-associated breast cancer at a tertiary-level hospital in Romania. Material and Methods: We retrospectively and prospectively collected demographic, oncological, and obstetrical data for women diagnosed with cancer during pregnancy, and who elected to continue their pregnancy, between June 2012 and June 2020. Complete data were obtained regarding family and personal medical history and risks factors, cancer diagnosis and staging, clinical and pathological features (including histology and immunohistochemistry), multimodal cancer treatment, pregnancy management (fetal ultrasounds, childbirth, and postpartum data), and infant development and clinical evolution up to 2020. Cancer therapy was administered following national guidelines and institutional protocols and regimens developed for non-pregnant patients, including surgery and chemotherapy, while avoiding radiotherapy during pregnancy. Results: At diagnosis, 16.67% of patients were in an advanced/metastatic stage, while 75% were in early operable stages. However, the latter patients underwent neoadjuvant chemotherapy rather than up-front surgery due to aggressive tumor biology (triple negative, multifocal, or HER2+). No patient achieved complete pathological remission, but only one patient relapsed. No recurrence was recorded within 12 months among early-stage patients. Conclusions: In this contemporary assessment of real-world treatment patterns and outcomes among patients with pregnancy-associated breast cancer, our findings were generally consistent with globally observed treatment outcomes, underscoring the need for a multidisciplinary team and reference centers

Postpartum depression in mothers and fathers – an underestimated diagnosis

Postpartum depression remains a significant healthcare priority due to the social and family consequences. Research has shown that both mothers and fathers experience significant psychological changes during pregnancy and postnatally, including depressive disorders. Underdiagnosed in most cases, the short and long-term consequences involve infant and child development, family’s life and social disruption. Because this pathology may lead to deviation from behavioural and social norms, we want to emphasize that timely and appropriate diagnostic can improve the effectiveness of treatments and avoid complications. This may contribute to optimal social, emotional and behavioural child development that may occur consecutively to family members” emotional and psychological manifestations

ASPECTS OF CURRENT RESEARCH ON MELASMA

Melasma is a chronic skin condition, characterized by irregular brown spots, symmetrically distributed over the sun's exposed areas of the body, especially on the face. Although generally a "cosmetic" problem, melasma can significantly affect the quality of life of patients. Its pathogenesis is not yet fully understood, as several possible triggers are proposed. Next, we will address certain aspects of melasma, according to the current research

ELECTRONIC CIGARETTES – POSSIBLE LONG-TERM HEALTH IMPACT

Electronic cigarettes are increasingly popular devices that deliver nicotine through aerosols, not burning as in the case of classic cigarettes. Electronic cigarette traders claim that these types of cigarettes are safer than conventional cigarettes and that their use facilitates smoking cessation. However, there are many question marks regarding the long-term safety of using electronic cigarettes. In this review, we wanted to highlight the many vagueness and their possible effect on health