A. Pâslaru, A. Fulga, E. Niculeț, L. Rebegea, I. Fulga, A. Ciubară
{"title":"SUPRACLAVICULAR AND CERVICAL LYMPH NODE METASTASES HAVING CERVICAL CANCER AS STARTING POINT. CASE PRESENTATION","authors":"A. Pâslaru, A. Fulga, E. Niculeț, L. Rebegea, I. Fulga, A. Ciubară","doi":"10.35630/2022/12/psy.ro.10","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.10","url":null,"abstract":"Introduction: Cervical cancer is the fourth most frequently found cancer among women worldwide. Numerous studies have underlined that persistent infection with human papilloma virus is the most important risk factor, two strains of the same virus – 16 and 18 being responsible for approximately 70% of the cases. Cervical cancer rarely metastasizes in the cervical lymph nodes and this indicates a poor prognosis. Literature data reports an incidence for left supraclavicular M1LYm of 0.1-1.5%. Material and Method: We bring attention to the case of a 44-year-old patient from the rural area who was diagnosed in January 2019 with stage IIIB cervical cancer, represented morphologically by a poorly differentiated squamous cell carcinoma. When admitted, the patient presented clinically with vaginal hemorrhage, intense abdominal and pelvic pain, fatigue, a dynamic, significant weight loss. The physiological personal history revealed nine pregnancies, the first one when she was 16. After pretherapeutic evaluation, the multidisciplinary committee decides performing simultaneous radio-chemotherapy with platinum salts. During the second week of treatment clinical examination revealed left cervical and supraclavicular adenopathy, both documented through imaging evaluation. Lymph node biopsy is done and its histopathological aspect, correlated with the immunohistochemistry profile supports the diagnosis of poorly differentiated squamous cell carcinoma lymph node metastasis. The initial treatment scheme is maintained, the patient being discharged with clinical remission of cervical and supraclavicular lymph node metastasis. Conclusions: The peculiarity of the case is determined by the distant metastases in the left cervical and supraclavicular lymph nodes, a rare finding during treatment, which was associated with a poor prognosis; in this case treatment was done for palliative purposes. Rapid diagnosis is the main factor that conditions the therapeutic results and chances for healing.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115901053","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}
{"title":"THE PREVALENCE OF COGNITIVE IMPAIRMENT IN PATIENTS WITH PROXIMAL FEMORAL FRACTURES","authors":"B. Gogulescu","doi":"10.35630/2022/12/psy.ro.7","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.7","url":null,"abstract":"Introduction: Fractures of the proximal femur are becoming more common. Through the data, this medical problem became a humanitarian, economic and social has imposed the first evidence-based review in our clinic. It is necessary to find out if there is a causal relationship between postural instability, hip fractures and cognitiv impairment. Methods: Clinical data were recorded, removing any information about personal identity. Consecutive patients aged over 65 years were included in the study. They were admitted during the period 01.01.2021-31.12.2021 and had primary fractures of the proximal femur caused by low energy trauma produced by falling from the same level. Results: 360 cases with a mean age of 78.73 years and having a proximal femoral fracture were analyzed. The prevalence of cognitive impairment was 27.22%, significantly undifferentiated by the type of fracture or age group. The relatively small age of the batch of 72-100000 indicates the existance of a socio-economic problem besides the high medical problems raised by a major fracture occurring in the context of comorbidity of 86.36%. Conclusions: The existence of proximal femur fractures in elderly people with certain cognitive involution creates personal dramas and socio-medical problems that require complex studies.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131371365","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}
A. Fătu, A. Pâslaru, C. Stefanescu, I. Chiscop, Ș. Moisă, C. Dinu, V. Creangă-Zărnescu, M. Matei, Gabriela Bălan, A. Ciubară
{"title":"THE PREVENTION OF DEMENTIA BEFORE AND AFTER STROKE","authors":"A. Fătu, A. Pâslaru, C. Stefanescu, I. Chiscop, Ș. Moisă, C. Dinu, V. Creangă-Zărnescu, M. Matei, Gabriela Bălan, A. Ciubară","doi":"10.35630/2022/12/psy.ro.22","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.22","url":null,"abstract":"Introduction: Dementia is an important public health problem, the only cause of death that can not be treated or cured. The number of people who are diagnosed with dementia is increasing, over 55 million patients in 2021(about 5% of the world population), more than that a new case is diagnosed every 3 seconds, according World Health Organization. Prevalence of dementia is increasing, both before and after stroke. Aim: The purpose of this paper is to emphasize the importance of early identification of the risk factors associated with cognitive decline and the role of the complex health care approach. Method: The retroactive study involved analyzing the medical record of 60 subjects with stroke and cognitive impairments, hospitalized between july -december 2021. Furthermore we searched the latest PubMed database and Cochrane Library regarding the risk factors common for this two pathologies. The outcome showed that more women are affected by this debilitating disease, of which 72% were over 80 years old. The following modifiable risk factors were identified: 63% of patients had hypertension, 42% had recurrent stroke, 37% atrial fibrillation, 26% type II diabetes, 22% dyslipidemia, and 10% obesity. It is believed that one third of cases can be prevented by early identification of risk factors, especially cardiovascular, and by increasing the efficiency recovery after stroke. This can be done before the onset of the disease, growing the mental and emotional health, specificaly the cognitive abilitiy, including the executive function and the memory of people prone to neurodegeneration or cerebrovascular lesions. In elderly subjects, healthy diet, moderate physical activity, chronic stress reduction, social interaction along with improvement in cardiovascular risk factors, could be considered the first line of defense against the development and progression of dementia. Conclusions: The pathological process begins long before it manifests itself clinically, thus providing the opportunity to identify or combat the prodromal stages of the disease forward. We recommend multifactorial intervention to prevent cognitive impairment and dementia.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128452131","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}
{"title":"KETAMINE IN PERIOPERATIVE DEPRESSIVE SYMPTOMS (PDS) IMPROVEMENT - REVIEW","authors":"C. Manole, C. Șerban, A. Ciubară","doi":"10.35630/2022/12/psy.ro.9","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.9","url":null,"abstract":"Anxiety and depression are the most frequent psychiatric disorders associated with organic diseases. PDS (Perioperative Depression Symptoms) represent a depressive episode which occurs mostly in the early postoperative phase. It was observed that the patients presenting PSD have a higher risk of postoperative complications, an increased length of hospitalization and a more reserved prognosis. A series of recent studies have shown that the usage of ketamine in small doses significantly reduces major depression symptoms in the short time after its administration. The ketamine blocks the NMDA (N-methyl-D-aspartate) receptors, leading to the presynaptic release of glutamate and increasing the activity of dopaminergic neurons with antidepressant role.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127169694","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}
V. Sapira, Mihaiela Lungu, A. Baciu, Anca Telehuz, C. Marcu, I. Chiscop, Carmen Gavrila, C. Dinu, G. Baciu, A. Ciubară
{"title":"FROM DEPRESSION TO HUMAN IMMUNODEFICIENCY VIRUS – A CASE REPORT","authors":"V. Sapira, Mihaiela Lungu, A. Baciu, Anca Telehuz, C. Marcu, I. Chiscop, Carmen Gavrila, C. Dinu, G. Baciu, A. Ciubară","doi":"10.35630/2022/12/psy.ro.19","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.19","url":null,"abstract":"Introduction: Human immunodeficiency virus (HIV) infection is often preceded or accompanied by neuropsychiatric symptoms, including depression. This fact has been evaluated in most of the clinical studies to date as associated with HIV infection already diagnosed. Case report: We report a case of a 46-year-old woman patient with no prior diagnosed pathology, suffering from depressive disorder for roughly 6 months, with a progressive evolution under treatment. Blood tests showed a moderate normochromic normocytic anemic syndrome of unspecified origin. Given the fact that depressive syndrome has not improved under treatment, a cerebral computed tomography (CT) scan and a cerebral magnetic resonance imaging (MRI) are decided, revealing an expansive cerebral process which in turn recommends performing stereotactic biopsy, but the family of the patient refuses the procedure. The patient is neurologically evaluated and after considering the cerebral MRI pattern and the presence of anemia, an HIV and syphilis detection test is decided, revealing a positive result for HIV infection. An antiretroviral therapy has been initiated, resulting in favorable clinical and imaging outcomes. Conclusions: Each patient and each case are individual and is to be approached as such. Depression in a progressive evolution under treatment requires imaging evaluation (cerebral CT scan, ideally cerebral MRI).","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126752898","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}
V. Lupu, I. Miron, A. Ciubară, V. Lupu, I. Stârcea, A. Buga, Ş. Burlea, A. Ciubară, Ancuța Lupu
{"title":"DOCTOR – PATIENT (ADULT OR CHILD) RELATIONSHIP IN CONTEMPORARY MEDICINE","authors":"V. Lupu, I. Miron, A. Ciubară, V. Lupu, I. Stârcea, A. Buga, Ş. Burlea, A. Ciubară, Ancuța Lupu","doi":"10.35630/2022/12/psy.ro.1","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.1","url":null,"abstract":"The article is an incursion in the history of the doctor – patient relationship, which experienced an interesting evolution from the moment when medicine has gained the status of science and most of all because of the technical progress from the last century. In this context, the technicization of medicine, the medicalization and over-medicalization of individual and social life, as well as the elusion of the basic principles of the doctor – patient relationship, have a negative impact on this relation. Is there any way, in the contemporary society, to regain what it was the nobleness of the profession and its divine and human devotion? A possible answer might be found reconsidering what over the years has given social value to the medical act. Because only here can be once more found the necessary binder for harmonizing human devotement and professional responsibility.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115228577","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}
R. Soroceanu, Ioana Silistraru, A. Ciubară, D. Azoicǎi, D. Timofte, Liviu Răzvan Platon, B. Ciuntu, Madalina Maxim
{"title":"OBESITY AND DEPRESSION INTERTWINED – A NARRATIVE REVIEW","authors":"R. Soroceanu, Ioana Silistraru, A. Ciubară, D. Azoicǎi, D. Timofte, Liviu Răzvan Platon, B. Ciuntu, Madalina Maxim","doi":"10.35630/2022/12/psy.ro.18","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.18","url":null,"abstract":"Both pathologies—obesity and depression—have high prevalence rates and have serious negative effects on the public's health. In recent meta-analyses, clinical trials, and epidemiological studies, they have been observed in people of all races. Both obesity and major depression are risk factors related to one another. In this paper, we suggest an overview of the two interconnected biological processes, including genetic influences and changes to the systems in charge of energy synthesis and consumption (hypothalamic-pituitary-adrenal axis, and inflammation, neuroendocrine regulators, and gut microbiota). Additionally, we look into how people perceive their bodies and social stigma, as well as the potential benefits of physical activity and weight-loss surgery on comorbid conditions and quality of life.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123180007","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}
Cristina Darie, D. Iliescu, Sorin Ungurianu, A. Ciubară
{"title":"THE ONSET OF DEMENTIA THROUGH THE COTARD SYNDROME - THE DELIRIUM OF NEGATION","authors":"Cristina Darie, D. Iliescu, Sorin Ungurianu, A. Ciubară","doi":"10.35630/2022/12/psy.ro.21","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.21","url":null,"abstract":"ICD-10 (The ICD-10 Classification of Mental and Behavioral Disorders. Clinical description and diagnostic guidelines) Introduction. Cotard syndrome is a neuropsychiatric pathology that is uncommon in medical practice but has a significant impact on public awareness of the importance of mental health. This mental disorder is also known as negation delirium, living dead syndrome, nihilistic delirium, or walking corpse syndrome. Objectives. A clinical case of a patient diagnosed with dementia due to late-onset Alzheimer's disease is presented; dementia also includes symptoms of Cotard's syndrome. Over time, the transmission of knowledge and data about Cotard Syndrome, despite its very low frequency, has become a pathology that intrigues and inspires curiosity among individuals. Consciousness of the existence of this delirious illness and the accurate definition of the symptoms of a dual diagnosis are required in a number of psychiatric pathologies. Method. This document was created using the \"Elisabeta Doamna\" psychiatry hospital Database from Galati, Romania, where patient data was acquired and admitted to the Psychiatry Clinic Section II. In addition, a variety of bibliographical references and diagnostic criteria were utilized, including the ICD-10 (the Classification of Mental and Behavioral Disorders, Clinical Description, and Diagnostic Guidelines), the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders), and the psychometric tests: the MMSE (the Mini Mental Status Test) and the GAFS (the Global Functioning Assessment Scale). Results and Conclusions Despite having no psychiatric history, the patient arrived at the psychiatric hospital after experiencing psychiatric symptoms caused by both Alzheimer's disease and Cotard's syndrome, symptoms that were ignored and gradually deteriorated, resulting in full-blown delirium, rapid dementia degradation, and a not-very-favorable outlook.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121878049","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}
Maria-Cristina Damian, M. Terpan, D. Voinescu, A. Baciu, Carmen Gavrila, Alexia Balta, A. Ciubară
{"title":"EATING DISORDERS ASSOCIATED WITH MOOD [AFFECTIVE] DISORDERS","authors":"Maria-Cristina Damian, M. Terpan, D. Voinescu, A. Baciu, Carmen Gavrila, Alexia Balta, A. Ciubară","doi":"10.35630/2022/12/psy.ro.27","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.27","url":null,"abstract":"Introduction: Eating disorders are mental illnesses characterised by abnormal eating habits that have a negative impact on a person's physical or mental health. In the last decade hospitalizations which included eating disorders increased among all age groups. The assessment of eating disorders associated with affective disorders has important clinical implications, but the standard psychiatric classification DSM-5 (American Psychiatry Association, 2013) and ICD-10 (World Health Organization, 1993) are limited. Objectives: The current study aims to broaden the evaluation of this association and better understand its clinical implications. In addition, the study's goal is to comprehend the implications of eating disorders in Galaţi County. Method: We conducted a retrospective study on 147 patients with eating disorders and mood [affective] disorders who were admitted to the Psychiatry Hospital \"Elisabeta Doamna\" Galati between January 1 and February 1, 2019.We used ICD-10 (Classification of Mental and Behavioral Disorders) and DSM-5 criteria for diagnosis (Diagnostic and Statistical Manual of Mental Disorders). Results: In the period from 1 January 2019 - 1 February 2019 a total of 1131 patients was admitted in the Psychiatry Hospital, Of these, 147 were diagnosed with mood (affective) disorders, of whom 17 patients (12%) associated disorder and food as well as the independent disorder. Among these patients, the percentage of women with eating disorders associated with the affective disorder was 82 % and the percentage of men was 18 %. Conclusions: According to the findings, women are more likely to associate eating disorders with mood [affective] disorders. We also found a poor relationship between eating disorders and affective disorders, with eating disorders being associated with a high percentage of other psychiatric disorders, which is represented by alcohol and substance use, but also by high-impact diseases like Alzheimer's disease and schizophrenia.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125662960","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}
{"title":"ANXIETY - THERAPEUTIC OPTIONS FROM PAST TO PRESENT","authors":"M. Manea, A. Ciobanu, M. Manea","doi":"10.35630/2022/12/psy.ro.28","DOIUrl":"https://doi.org/10.35630/2022/12/psy.ro.28","url":null,"abstract":"Anxiety is a diffuse fear of an object, rather potential than present, it is detached from concrete and projected in the future. It associates psychomotor restlessness and has neurovegetative response. Anxious symptoms create a discomfort that patients experience with great difficulty. Whether we are talking about generalized anxiety, or we are talking about anxious paroxysms, patients call for help, sometimes in Emergency Room (ER) because of irrational fear of death, or fear of madness. The anxiety disorder is common in all medical healthcare offices, but especially in psychiatry. The therapeutic attitude is based on the same principles everywhere, but there are situations in which the treatment differs and psychotic anxiety, the particular form requiring admission into specialized service, is under discussion here. If in the past, the first intention was benzodiazepine (BZD) anxiolytics at the moment, they are increasingly finding their place in the therapeutic scheme. The beneficial effect installs quickly, but when balancing the balance versus risk, balances often tend to overcome the anxiolytic classics. Nowadays, more frequently, protocols recommend administering SSRI antidepressants to treat anxiety. In the case of emergency in which anxiety occupies a main place, such as psychotic anxiety, it is necessary to prescribe antipsychotics, especially atypical antipsychotics. For these reasons, we aim to share our experience for patient benefit.","PeriodicalId":228081,"journal":{"name":"The European Conference of Psychiatry and Mental Health \"Galatia\"","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127481814","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}