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Abstract

Temporomandibular disorders (TMD) affect the temporomandibular joints, the masticatory muscles, and surrounding tissues. Among symptoms such as jumps, joint noises, reduced mouth opening (closed lock), difficulties in closing the mouth (subluxation or open lock), pain is the most common symptom encountered among patients diagnosed with temporomandibular disorders. As literature on this topic is abundant and sometimes controversial, the authors focus on reviewing the state of art of occlusal splints indications. Therefore, the most common occlusal splints, like Lucia jig, nociceptive trigeminal inhibition (NTI), directive splints, etc., are being described, based on their design and therapeutic indications. Cases of malocclusions associated or not with parafunctions are usually manageable using the splints mentioned in this article. In case of disc displacements, occlusal appliances can be used, but as the etiology is multifactorial, there are some limitations, depending on the complexity of each clinical situation.

Abstract

Background

X-linked adrenoleukodystrophy (X-ALD) is an inherited metabolic disease which causes demyelination of the white matter of the brain. The symptoms include mental impairment, progressive paresis, impaired motor coordination, and epileptic seizures. Diagnosis is established mainly by genetic testing. Currently, the recommended treatment is haematopoietic stem cell transplantation (HSCT).

Goal

The aim of the study was to present the case of a patient suffering from X-ALD, who developed symptoms of bipolar disorder in the initial phase of the disease prior to the onset of characteristic neurological symptoms.

Case presentation

In 2015, a 33-year-old patient was admitted to a psychiatric department due to aggressive behaviour he showed towards his wife and other family members. He had been treated for a depressive episode in 2005, and for a manic episode without psychotic symptoms earlier in 2015. During the successive psychiatric hospitalizations, in addition to psychopathological symptoms, the patient had been observed to have neurological symptoms, which included progressive paraparesis and ataxia. In 2018, based on imaging and genetic tests, the patient was diagnosed with X-ALD. The patient's condition gradually deteriorated; with time, he was unable to move on his own. During a hospital stay in 2019, he was transferred to an internal medicine department due to a progressive urinary tract infection, which, however, could not be controlled, and the patient died.

Conclusions

  1. X-ALD is a rare metabolic illness. In the early stages of the disease, various psychopathological symptoms, including affective disorders, are observed.
  2. Early initiation of adequate treatment increases the chances of extending the patient's life.
  3. In the present case, the patient did not die due to the underlying disease, but due to causes typical of bed-bound patients, i.e. complications of progressing infection.

Abstract

Introduction: Cotard's syndrome (CS) is a rare set of psychopathological symptoms, the main symptom of which is nihilistic delusions concerning the negation of the existence of internal organs or the entire body

Aim, material and methodology: The aim of the study is to present a case of a patient treated for postpartum depression who developed Cotard's syndrome. The patient's symptoms began immediately after her daughter. The clinical picture was dominated by anxiety and apathy, nihilistic delusions about the atrophy of the urethra and other lower abdominal organs, and olfactory hallucinations - she could smell rot.

Discussion: The available literature on Cotard’s Syndrome does not allow us to indicate a certain reason for its development. Perhaps the birth of the first child - the woman doubted herself as a mother, she was afraid that she would hurt the cause of the disorders observed and described by us was transient ischemia of the CNS during delivery.

Conclusions: Cotard's syndrome can develop in the course of many mental and somatoform disorders. The described case is, to our knowledge, the first description of Cotard’s Syndrome in the deprivation period. Difficulties in establishing the etiopathogenesis and pathophysiology of Cotard’s Syndrome translate into therapeutic problems. It has been suggested that the treatment of the underlying disorder on the basis of which CS is developed remains the most effective method of therapy.

Abstract

Introduction: Deep Brain Stimulation can directly alter brain activity in a controlled manner and the effect is reversible. The mechanism is that the electrode acts locally on neural activity, which is transferred to monosynchronous and multisynaptic network connections.

Methods: We present studies conducted on a group of patients that show an improvement in mental state after Deep Brain Stimulation.

Material: The diseases we included in our work are: Obsessive-Compulsive Disorder, Eating Disorder, Depression and Bipolar Affective Disorder.

Discussion: The use of deep brain stimulation can inhibit development of acute state of patients and improve both psychiatric features and the time of remission. The results indicate the greatest effectiveness of Deep Brain Stimulation in Obsessive-Compulsive Disorders.

Conclusions: Brain stimulation may be a promising therapeutic target in mental illness. In a properly selected location, it can contribute to a significant clinical improvement however further research in this direction is necessary.

Abstract

Introduction: Dyskinesia is a symptom complex in the form of involuntary, repetitive movements of lips, lower jaw, tongue, less often the trunk and limbs. Despite the use of newer drugs in treatment neuroleptics, dyskinesia has not ceased to be a clinical problem.

Method: The work is based on a research review for which the Google Scholar database was used as well PubMed. The search range was limited to 2008-2020. We have included descriptive publications tardive dyskinesia only as a consequence of antipsychotic medications.

Material: We present the use of tetrabenazine analogues, deep brain stimulation, neuroleptics, benzodiazepines and botulinum toxin in late-suffering patients drug-induced dyskinesias, which may indicate an improvement in your health.

Discussion: The first method of treating tardive dyskinesia are withdrawal antipsychotic medications, but for many patients this is impossible. Valbenazine and Deep Brain Stimulation are the most effective in treating Tardive Dyskinesia.

Conclusions: There are not enough studies with the highest reliability to create unequivocal recommendations in the treatment of drug-induced tardive dyskinesia.

Abstract

Introduction: The study aims to present 1) a case report of an 18-year-old female patient with borderline personality disorder (BPD) 2) the diagnostic and treatment difficulties in BPD patients.

Materials and methods: The review of the literature from the years 1953-2020 searched from PubMed, Google Scholar, and Web of Science databases.

Discussion: Patient, 18-years old, hospitalized five times for psychiatric care, presenting self-injurious behaviours, hurting herself within forearms. A patient attempted suicide eight times. She is living with her divorced parents. The patient’s father has a new partner with whom he has children. The patient used marijuana and she was experiencing psychotic symptoms under its influence. She smokes 10 cigarettes per day and drinks alcohol once a week since she was 16 years old. Psychiatric problems appeared when the patient started learning in high school.

Conclusions:

1. Borderline personality disorder (BPD) is a serious psychiatric condition of a difficult diagnosis that should be differentiated with many other psychiatric disorders such as an atypical or subclinical course of psychosis, affective disorders, or dissocial personality.

2. A therapeutic process of a person with BPD is based on psychotherapy and personalized treatment strategies, whereas, pharmacological treatment plays only a supporting role during BPD treatment.

Abstract

Introduction: In psychiatry and psychology stigmatization consists in labelling a person suffering from a disorder with the stigma of mental illness, associated with numerous negative stereotypes that are established in both individual and social mentality.

Objective: The aim of the present article is to present the phenomenon of self-stigma from the perspective of psychiatric patients, including patients suffering from schizophrenia, to scientific consideration.

The state of knowledge: The available data on this subject suggests that schizophrenia is particularly stigmatized, and the degree of stigmatization of patients with this diagnosis is worsening. Self-stigma plays a significant role in various areas of patients’ lives, sometimes discouraging them to continue therapy. Psychiatric patients have to face not only the symptoms of their disorders, but also stigmatization. In the event patient’s self-stigmatization of mental illness occurs, a responsible psychiatrist and psychologist conducting the therapy has the moral obligation to supervise the process of psychiatric and psychological assistance in the context of the aforelisted issues.

Conclusions: The problem of self-stigmatization of a psychiatric patients is a topical issue that is well worth further exploration in order to better understand and help patients more effectively.

Abstract

Antimicrobial peptides are natural substances that have played a role in the development of the adaptive immune system, and are currently involved in the prevention of infections, through their direct antimicrobial and immunomodulatory properties. While the amino acid composition and spatial structure vary, most antibacterial peptides have a positive surface charge, which allows them to bind to the negative bacterial membranes. Buforin II is a widely studied antimicrobial peptide first obtained through the structural modification of buforin I, a peptide isolated from Bufo gargarizans. The peptide showed significant antibacterial activity against Gram-positive and Gram-negative bacterial strains. The mechanism of action of buforin II differs from that of other antimicrobial peptides, as it binds directly to bacterial DNA and RNA. The aim of our study was to obtain recombinant buforin II with a ubiquitin fusion partner, through heterologous expression in Escherichia coli Rosetta™ (DE3)pLysS cells, using a laboratory scale biore-actor. The incubation of expression host cells in a bioreactor allowed the constant monitoring and control of the process parameters, leading to high biomass levels and an increased production rate of the peptide. The parameters used during incubation were: 37°C, pH=6.9 and dissolved oxygen level above 40%. Purification of the recombinant protein was accomplished by affinity chromatography using a Ni-chelate solid phase to which the 10xHistag of our construct showed affinity. Method optimisation consisted in the use of gradient and linear elution, of which the latter was found to be more effective. Digestion of the fusion partner from the target peptide was performed with ubiquitin carboxyl-terminal hydrolase enzyme. The expression and purification protocols developed in our experiment allow the production of a significant amount of buforin II, allowing its use for further research. Furthermore, the presented methods could be suitable for industrial production of the recombinant peptide..

Abstract

About 50% of tooth loss is caused by either endodontic infection, periodontal disease or the combination of the two in the form on endo-perio lesions (EPL). Combined EPL develop due to the intimate anatomic and functional relation between endodontic and periodontal tissues. Both the pulp and periodontium share the same embryologic and anatomic origin. The various pathways connecting the two, added up to the extremely alike microorganisms in both illnesses’ etiology, create a complex condition in which interdisciplinary approach is required. Despite numerous decades of literature describing these lesions, they remain a continuous challenge for practitioners in both diagnosing and managing. The purpose of this article is to present a comprehensive review of various aspects of the combined EPL and to emphasize the importance of making a correct diagnosis and adopting the appropriate treatment method in the management of these challenging situations.

Abstract

Introduction: Tooth impaction is defined as the absence of a tooth on the arch, after its normal eruption age. The main reason canines are impacted is the lack of space required for the tooth to erupt.

Aim of study: The main objective of this study is to determine the types of malocclusions associated with canine impaction (Lindauer classification). A secondary objective is to establish the correlation between these parameters and identification of subjects with high risk of canine impaction based on pre-existing malocclusion.

Material and methods: This study was performed on a sample of 20 patients, 9 men and 11 women. The dental casts were subject to Angle classification and various measurements such as arch perimeter, Pont’s index, sum of the mesiodistal width of the incisor and arch length were performed. The Lindauer sectorial classification was determined based on the patients’ panoramic radiography.

Results: According to the data collected, the Class II /2 malocclusion is more frequent, and it is associated with the impacted canine (approximately 50%). According to the Lindauer classification higher frequency of the impacted canines was found in Sector IV.

Conclusion: The diagnosis for impacted canines is often associated with Class II /2 malocclusion, and according to the Sector classification, it is often localised in Sector IV.