Practica Medicala最新文献

{"title":"Tokophobia. Causes, symptoms and psychotherapy","authors":"Corina-Ioana Paica, D. Iordăchescu, E. Vladislav, C. Gică, A. Panaitescu, G. Peltecu, N. Gică","doi":"10.37897/rjmp.2021.4.15","DOIUrl":"https://doi.org/10.37897/rjmp.2021.4.15","url":null,"abstract":"The fear of childbirth is a mental health problem that involves a severe, excessive fear of pregnancy and the time of birth. This condition is also called \"tokophobia\" or, better said, birth phobia. This review is based on information from articles in the literature published between January 1, 2001 and November 1, 2021 in PubMed, ScienceDirect and Google Scholar using the following keywords: fear of childbirth, symptoms, causes, tools, psychological interventions. In this review, we discussed the types of fears women have about pregnancy and childbirth, the instruments that is used for assessing the fear of childbirth, and how to cope with and overcome this fear. According to the literature, the role of psychological counseling for women facing fear of childbirth is important in the optimal management of emotional symptoms associated with pregnancy.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42088958","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":"Follow-up of second adrenal tumor after remission of Cushing syndrome","authors":"M. Dumitrașcu, Diana Elena Rentea, Stefania Zugravu, C. Mehedințu, M. Carsote, F. Șandru","doi":"10.37897/rjmp.2021.4.20","DOIUrl":"https://doi.org/10.37897/rjmp.2021.4.20","url":null,"abstract":"Bilateral adrenal tumors (BAT) represent a vast domain of endocrinology and connected medical and surgical fields. Our purpose is to introduce several key points in relationship with long time management on a 56-year old female case who is currently admitted for reassessment of a left adrenal tumor with potential autonomous cortisol secretion. She is also known with pituitary incidentaloma since 2014, cerebral meningioma which was partially removed in 2015, uncontrolled diabetes mellitus under metformin and insulin therapy since 2017, and high blood pressure since 2021. Her medical history includes right adrenalectomy for Cushing syndrome in 2014. At that moment, she was first admitted for BAT, a tumor of 2 centimeters (cm) on the left gland according to computed tomography, respective of 3.5 cm maximum diameter on the right adrenal. The hormonal panel confirmed adrenal Cushing syndrome. After 6 months of non-interventional follow-up, the right tumor increased to 4 cm, also associating small areas of necrosis, thus a decision of unilateral laparoscopic adrenalectomy was done with good clinical post-operatory outcome. She did not develop adrenal insufficiency at any point in time, moreover, a low-normal ACTH (Adrenocorticotropic Hormone) with intermittent elevation of morning plasma cortisol levels after Dexamethasone suppression test showed a possible autonomous cortisol secretion of the left adrenal tumor during a 7-year follow-up. In 2014, the female patient received the confirmation of an adrenocortical adenoma which was consistent with cortisol over-secretion. Particular gene contributions are attributed to protein kinase A (PKA) defects (or B) that usually induce bilateral adrenocortical hyperplasia; however, they are not routinely tested in daily endocrine practice, neither had we performed it. Interestingly, the patient was detected with a cerebral meningioma after years of intermittent, mild headache. The diagnostic was established during initial endocrine evaluations. The headache was not associated with uncontrolled high blood pressure, as first expected due to excessive cortisol amount. Recently, it was identified that mutations of ARMC5 (armadillo repeat containing 5) gene are responsible for macronodular adrenal hyperplasia, but also meningioma. They may be also responsible for severe diabetes mellitus as seen here. The key points of following a patient with bilateral adrenal tumors include the timing of uni/bilateral adrenalectomy, the multidisciplinary management of associated complications, as well as the need of understanding the genetic rational behind it.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46936946","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":"Endocrine issues and premenopausal breast cancer – case report and review of literature","authors":"M. Carsote, Diana Elena Rentea, A. Petca, Stefania Zugravu, C. Mehedințu, F. Șandru, A. Dumitrașcu, M. Dumitrașcu","doi":"10.37897/rjmp.2021.4.25","DOIUrl":"https://doi.org/10.37897/rjmp.2021.4.25","url":null,"abstract":"There is an alarming increasing incidence of PBC (premenopausal breast cancer) in countries with high income due to, on one hand, more accessible screening tools and, on the other hand, potential implications of daily lifestyle habits and endocrine disruptors of modern society on terms of facilitating tumor growth. A more severe prognostic is found in females younger than 40 years old at first detection, with advanced disease at diagnostic, and those with tumors displaying specific immunohistochemistry configuration (and associated gene profile) like ER (estrogen receptor) positive or HEGFR2 (human epidermal growth factor receptor) negative. Recently, particular aspects are reported in terms of PBC therapy: the switch from offering aromatase inhibitors/tamoxifen only in post-menopausal females was done to premenopausal subjects in addition to medication that offers ovarian function suppression (OFS) – as an alternative to classical oophorectomy - for 5 years up to 10 years extension depending on protocol and patient’ age at first diagnostic. The main endocrine considerations concerning PBC are: OFS and/or chemotherapy or oophorectomy causing prompt hypogonadism, bone status anomalies due to estrogens deficiency, potential endocrine tumors that are prone to be linked (for instance, a higher risk of cancer in acromegalic patients etc.), cardio-metabolic elements as facilitators of early tumorigenesis, fertility issues on PBC survivals etc. The purpose of the present paper is to introduce several key messages that relate to endocrine implications of PBC starting from a case.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44874694","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":"Available treatment options for hyperuricemic patients","authors":"Mihai-Emil Gherghina","doi":"10.37897/rjmp.2021.4.17","DOIUrl":"https://doi.org/10.37897/rjmp.2021.4.17","url":null,"abstract":"The negative impact of an elevated serum uric acid on the onset and/or progression of different diseases is well known. During the last decade, new forms of therapies were developed, with beneficial results on correcting hyperuricemia, but also with potential side effects that should not be overlooked as most of the hyperuricemic patients are presenting concomitant comorbidities that could influence the decision in prescribing a specific lowering serum uric acid drug. The review will describe recent treatment options, part of them available also in our country.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41676307","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":"Anti-osteoporotic medication and scleroderma","authors":"F. Șandru, M. Dumitrașcu, Diana Elena Rentea, Stefania Zugravu, A. Petca, C. Mehedințu, M. Carsote","doi":"10.37897/rjmp.2021.4.10","DOIUrl":"https://doi.org/10.37897/rjmp.2021.4.10","url":null,"abstract":"Scleroderma (systemic sclerosis) represents a challenging condition, usually requiring a multi-disciplinary team due to multi-organ involvement; it is mostly considered an autoimmune disease; the signature of the malady is the extensive fibrosis at the level of skin and multiple organs, associating endothelial/vessel damage and anomalies of immune response. We point out a few aspects concerning scleroderma-related osteoporosis. This is a literature review. Patients might associate low bone mineral density (the underling mechanisms are not entirely understood), thus an increased risk of fractures; so early recognition and treatment is mandatory for a better outcome. Some data showed that particularly vertebral fractures are prone to the condition. Almost half of individuals with the malady have osteoporosis (female prevalence, especially post-menopausal) and one third of them have an osteoporotic fracture. Older age and associated vitamin D deficiency increases the risk of fracture. Vitamin D has pleomorphic distribution, also targeting the immune modulation, cytokines puzzle, and the muscle-bone crosstalk in scleroderma. Hypovitaminosis D might be expected in these patients, while general D-supplementation has controversial benefits effects. Chronic inflammatory rheumatic conditions might benefit from the TBS use as fracture risk indicator through micro-architecture evaluation. It seems that patients with systemic sclerosis and malnutrition have lower TBS; high Dkk-1 serum levels (Dickkopf-1) is correlated with reduced TBS and advanced disease; TBS is correlated to the extent of microvascular complications; exposure to glucocorticoids (certain high-dose regimes) supplementary lowers TBS. Gastrointestinal complications are presented in 90% of patients with systemic sclerosis, involving fibrosis at any level which is a poor prognostic factor; malabsorption of nutrients and weight loss correlates with reduced bone formation while esophageal and gastric anomalies contraindicate the use of oral bisphosphonates for osteoporosis. Other abnormal elements of skeleton frame include: premature ovarian failure, serotonin system anomalies, chronic inflammation, potential side effects of immunosuppressant drugs. In patients with systemic sclerosis, the choices of medication targeting osteoporosis are limited; the use of intravenous bisphosphonates remains first line option (if renal function is adequate); the consideration of skin and esophageal anomalies is mandatory in the management of osteoporosis. Overall, the landscape of bone domain in systemic sclerosis is multi-leveled and some areas are still waiting for clear answers.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44773001","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":"Nerve compression due to benign tumors or ganglion cysts in the upper limb – case series","authors":"Andreea GROSU-BULARDA, R. Teodoreanu, A. Lazarescu, M. Popescu, F. Hodea, Flavia-Francesca Lita, A. Stoian, C. Vancea, L. Cojocaru, I. Lascar","doi":"10.37897/rjmp.2021.4.19","DOIUrl":"https://doi.org/10.37897/rjmp.2021.4.19","url":null,"abstract":"Tumor nerve compressions in the upper limb are relatively rare, usually involving ganglion cysts and benign tumors. We present a case series of five patients with peripheral nerve compression in the upper limb due to tumor or cystic masses- ulnar nerve compression in the Guyon’s tunnel due to a ganglion cyst, large median nerve schwannoma compressing anterior interosseous nerve and median nerve, voluminous lipoma compressing median nerve in the proximal forearm, superficial branch of radial nerve compression by a synovial cyst and elbow region lipoma compressing radial nerve. In the beginning, those benign lesions are asymptomatic but, as they continue to grow adjacent to a peripheral nerve clinical manifestations appear progressively as compressive neuropathies. After a preoperative imagistic analysis, tumor resection with careful dissection, in order to preserve the neurovascular structures, is the elective surgical procedure in order to obtain an optimal functional recovery.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44592310","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":"Management of uterine perforation","authors":"L. Pop, N. Bacalbaşa, I. Bălescu, R. Bohîlțea, C. Stoica","doi":"10.1097/01.pgo.0000425902.51473.78","DOIUrl":"https://doi.org/10.1097/01.pgo.0000425902.51473.78","url":null,"abstract":"Uterine perforation, although extremely rare, can have lifelong consequences. Any procedure that can cause perforation has to take into account the risk of damage to the uterine wall. As this is a blind method, adequate training and certification is necessary, before trainees can performed hysteroscopy, D&C (dilatation and curettage), coil insertion independently.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.pgo.0000425902.51473.78","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41512562","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":"Endometrial scratching technique","authors":"Madalina Piron, L. Pop, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu, R. Bohîlțea, C. Stoica","doi":"10.37897/rjmp.2021.s7.6","DOIUrl":"https://doi.org/10.37897/rjmp.2021.s7.6","url":null,"abstract":"Problems of female subfertility are a current challenge. Implant failure of the embryo after an assisted human reproduction technique is undesirable and unpleasant, and strategies to improve this implant rate are welcome. One of these techniques is endometrial scratching. We performed a literature review by searching in the PubMed and Cochrane databases for relevant information regarding the technique of endometrial scratching. The technique of endometrial scratching is not complex, but choosing an optimal period in the menstrual cycle seems to produce the desired effects for the successful implantation of the embryo. Pregnancy rates obtained through assisted human reproduction techniques have been improved due to endometrial scratching techniques.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48802576","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":"Triple metachronous primary malignancy – case report and literature review","authors":"A. Jilaveanu, N. Bacalbaşa, I. Bălescu, R. Bohîlțea, L. Pop, C. Stoica, Cristina Martac, A. Filipescu","doi":"10.37897/rjmp.2021.s7.25","DOIUrl":"https://doi.org/10.37897/rjmp.2021.s7.25","url":null,"abstract":"Multiple primary malignancies (MPMs) are defined as more than two synchronous or metachronous cancers in the same individual. Common risk factors for multiple primaries are represented by inherited predisposition to cancer, cancer-promoting aspects of lifestyle, hormonal and environmental factors, history of previously treated primary cancer and increased lifespan of cancer survivors. Herein, we report a single case of a 68-year-old woman with triple metachronous primary neoplasms of the breast, colon and endometrium with three distinct histological patterns. The patient was initially submitted to a supero-external quadrant sectorectomy and axillary lymph node dissection in May 2016, followed by radical sigmoidectomy for perforated sigmoid malignant lesion in December 2018 and respectively by total hysterectomy with adnexectomy and pelvic lymph node dissection for endometrial cancer in September 2021. The histopathological studies confirmed the different histopathological origins for the three lesions. In conclusion, once the lifespan of cancer survivors increased, multiple metachronous malignancies are to be expected.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47463373","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":"Letter to the editor – Gynaecological surgery in present","authors":"L. Pop, N. Bacalbaşa, I. Bălescu, R. Bohîlțea, C. Stoica","doi":"10.37897/rjmp.2021.s7.1","DOIUrl":"https://doi.org/10.37897/rjmp.2021.s7.1","url":null,"abstract":"Lucian Pop1, Nicolae Bacalbasa2,3, Irina Balescu4, Roxana Elena Bohiltea2, Claudia Stoica5,6 1“Alessandrescu-Rusescu“ National Institute of Mother and Child Care, Bucharest, Romania 2Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 3Department of Visceral Surgery, Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania 4Department of Visceral Surgery, Ponderas Academic Hospital, Bucharest, Romania 5Department of Anatomy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 6Department of Surgery, Ilfov County Emergency Hospital, Bucharest, Romania","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41723019","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}