Agata Asofroniei

First Pages of BRAIN, Volume 10, Special Issue

1

Pascu Loredana Sabina , Domenico Perri , Bradeanu Andrei Vlad , Anamaria Ciubara , Marin Marilena , Marina Virginia

In the past, more than 150 years ago, incandescent bulb light appeared with red light emitters but technology has evolved to the present and scientist people discovered and promoted ecological lighting by compact fluorescent lamps and light emitting diodes.

In modern society, most of the classic lamps have been replaced with LED technology, much more efficient in terms of the amount of light emitted, as well as energy consumption. Besides these advantages, it also presents some drawbacks that affect our daily life through the structures they come into contact with (skin, eyes) and are intensively studied.

One of the most important and frequent effects of blue light is shown by the link between melanopsin, a photo-pigment present in the retina, responsible for regulating circadian rhythm and sleep-wake cycle, and blue light that go through the eye and reach the retina. So, it explains the increasing incidence of sleep disorders, decreased sleep quality associated with a high degree of fatigue and disturbance of family and social life. But knowing these effects, blue light can be beneficial if used in the first half of the day; in patients with neurocognitive disorders such as patients with Alzheimer's disease, have been observed an improvement in symptomatology. On short term, blue light stimulates dopamine production, but long-term light exposure has the opposite effect and leads to symptoms such as anxiety, mood swings, inability to focus, lack of insight or self-awareness, low libido.

To be able to prevent the negative effects of blue light, first of all we need to know the devices that affect us and the main "enemies" are right next to us, present in our everyday life: smartphones, tablets, televisions.

2

Laura Elisabeta Checherita , Anamaria Ciubara , Lucian Stefan Burlea , Daniela Manuc , Ovidiu Stamatin , Elena Mihaela Carausu

The temporomandibular joint (TMJ) imbalances and dysfunctions can lead to a group of different affections named temporomandibular disorders (TMDs). Elderly with TMDs are experiencing severe phenomena due to instability centric relationship, craniomandibular malrelations, hypotonia, edentation and general chronic diseases. The aim of our study is to investigate the efficiency of the pharmacologic treatment followed by prosthetic-aesthetic and gnathological treatment in elderly patients. This prospective study is based on data obtained from 96 patients, aged 65-74, 67 female and 29 male. The data was analyzed by correlating the independent variables with the dependent ones and the prevalence of TMDs. Study results revealed a high prevalence of TMDs (27.35%). The prevalence of TMJ pain (81.25%) and depressive manifestations were high (47.92%). After the pharmacologic medication, in association with prosthetic-aesthetic and gnathological treatment, the prevalence of depressive manifestations decreased (at 32.29%).

In conclusion, the pharmacologic medication followed by prosthetic-aesthetic and gnathological treatment determine improved outcomes in elderly patients with TMDs not only in terms of pain and neuropsychiatric manifestations, but also clinically, i.e., at TMJ function level and in all the facial and oral aspects.

3

Oana Chicoș , Domenico Perri , Liliana Capriș , Andra Irina Bulgaru Iliescu , Kantor Cristina

Due to the fact that crime is a social phenomenon, we consider necessary to analyze it as an individual action committed by a real person in an actual circumstance. We mention that crime is a human action, determined by certain psychological elements, necessities, reasons, purposes. In Romania, the evolution of the crime phenomenon is a consequence of the impact of severe socio-economic issues, characteristic of the transition period, as well as of the authority crisis transited by the competent state institutions. The defective legislation and the overburdening of the criminal justice system, associated with the lack of staff and logistics, have limited the effect of preventive and repressive measures. Therefore, people who consume substances submitted for national inspection are called drug addicts or drug abusers. According to the World Health Organization, narcomania is "the state of constant or chronic intoxication, harmful for the individual and for society, caused by the repeated consumption of a certain drug (natural or artificial) — it is characterized by the following — an irresistible need to continue consuming it and acquiring it by all means, a tendency to increase its dosage and a psychical, sometimes physical addiction for the effects of the drug". Drugs of all types have been considered "magic" pills the molecular structure of which is well known by chemists, physicians and pharmacists. In literature they are also called "millenary fragile molecules", which from ancient times were "glorified", but in fact they do not have supernatural powers, but deceive people, being in fact a "two-faced coin". The first face is the one which creates appeal and the second is the one which creates addiction, making us change our behavior and avoid our family and lose our friends. Thus we can state that one of the highest challenges of humanity is represented by drug consumption. The multiple environmental changes and the set of social, economic, and psychological changes are aspects which negatively influence people.

Conclusions: As a general conclusion, we can state that presently, illicit drug trafficking and consumption is the most successful business. The illicit drug market is considered the most "dynamic" crime market. Regarding the facts previously mentioned, we want to show that the citizens of the European Union spend over 24 billion lei a year on drugs.

4

Monica Laura Zlati , Salvatore Vendemmia , Eva Maria Elkan , Valentin Marian Antohi , Iuliana Petruța Moraru

Encephalitis represents a major risk factor through its virulent outcome and the probability of great complications which can generate encephalopathy and whose clinical picture can lead to psychiatric complications and consequently to a socio-financial impact on society and the family. The costs of the treatment of encephalitis are of two types: one immediate in the acute onset, consisting of the medical treatment for the fight against the viral process and the second type consisting of the treatment for the support of the vital functions and also for the patient's maintenance in the stabilisation period. The latter has the role to prevent the complications, to strengthen the immune response of the organism, to improve treatment outcomes and to maintain the function of the nervous system in the best parameters. The aim of the research is to highlight, in terms of economic and medical efficiency, the medical treatments used for the improvement of the symptoms of encephalitis in children, depending on the type of the disease, viruses and comorbidities associated. So the impact of the options widely applicable with good results was simulated for the creation of a model of economic-medical efficiency.

5

Alina Pleșea-Condratovici , Simona Lungu , Mihai Mutică , Cătălin Pleșea-Condratovici

Background: Both psychotropic medication and antibiotic therapy are extensively prescribed. In many cases, these medications are concurrent and the necessity to analyze this particular drug interaction appears.

Aims: To identify in specialized medical databases what these interactions are, which is their biochemical substrate, and which is the optimal method to avoid unwanted drug associations.

Method: Abstracts of PubMed database were automatically filtered using a specific search tool, the keyword data being drug interactions psychotropics, antibiotics and their synonyms, and websites dedicated to drug interactions were interrogated on the same subject.

Results and Discussion: Given that there is not enough clear data, especially for new developed medicines, it seems that drug interactions between antibiotics and psychotropic drugs are generally benign. Even if specialized web applications to identify drug interactions already exist, their results often differ or are not consistent.

Conclusion:  Although interactions between psychotropic and antibiotic drugs appear to be generally benign, more valid data are needed to properly assess their impact on treatment efficiency and the patient's quality of life. Antibiotics must be prescribed when necessary and it is advisable to avoid antibiotic classes with the most documented drug interactions: Fluoroquinolones, Macrolides and Anti-tuberculosis drugs.

6

Maria Vendemmia , Anamaria Ciubara , Francesco Raimondi

Neurological development is a complex process in which the nervous system reaches its fullness in adulthood stage. This development begins before birth, continues in both the last months of gestation and in the first months after birth, in response to a continuous remodeling due to the ability of nerve cells to eliminate excess components through apoptosis. One of the most important and ambitious objectives of developmental neurology is the early identification of those at risk for the development of subsequent disabilities: an early rehabilitation intervention can improve the quality of their life. The most important long-term outcome of periventricular leukomalacia is represented by spastic diplegia, which is also the most frequent motor deficit associated with prematurity. This high incidence seems to be due to the specific localization of the lesion involving the cortico-medullary bundles descending from the motor areas assigned to the movement of the lower limbs. In the presence of larger lesions, which also involve the semi-oval center, tetraparesis can be found accompanied by severe alteration of the intellectual function. The follow-up of the high-risk child and newborn is now established in the most developed countries. Physiotherapy is a relatively recent therapeutic modality in the Intensive Care Units and is performed through different techniques, with the aim of reducing respiratory work, maintaining airway viability and improving ventilation and gas exchange, improving neurosensory skills. A sensitive period for performing an intervention with a set schedule is from birth to 24 months of correct age. The program is tailored to the child and his family. An intervention program must promote the neurobehavioral development of the child, the quality of the organization and of the relational, sensorial, motor and cognitive skills and their integration, with the aim of an adequate development, without the pretension of modifying or accelerating its natural learning.

7

Păduraru Marius Ionuț , Jan Vollmer , Diana Precupanu , Alexandru Bogdan Ciubară , Calin Tudor Hozan , Dorel Firescu , Anamaria Ciubară

Depression is among the leading causes of disability worldwide, leading in some cases, to suicide and it is considered to be the disease of the millennium. Clinical depression is a common disease, and yet frequently overlooked, source of suffering among patients with cancer. Anterior studies indicate that the rate of depression in cancer patients is thought to be up to three times higher than in the general population. Depression decreases the quality of life, compromises the outcomes, and results in increase the rates of mortality from cancer.

Clinical case: We identify a 50-year-old woman diagnosed with bilateral ovarian high-grade serous carcinoma. The imaging investigations revealed multiple metastases (cT3bN1bM1b — TNM classification). This stadium made the patient to be a candidate only for palliative chemotherapy. At first visit at the oncological specialist, the patient was worried about her health condition, but after discussing with the medical oncologist about the treatment and side effects of chemotherapy, the patient gained confidence. During a routine chemotherapy infusion, the patient reports some special side effects like   increase feeling of "going through the motions" as if in a trance-like state, episodes of sudden tearfulness, and feeling like she is "out of control".

After the finish of the chemotherapy infusion, at the interview, the patient reports feeling safe, denies any self-harm or self-injurious thoughts, denies use of illicit substances and alcohol. She says that the impact of hair loss is very depressive for her. In these conditions, the oncologist decide to discuss an initial treatment plan with her that includes individual counseling. Individual counseling helps the patient to complete her palliative therapies and increase her confident after the post-chemotherapy CT exam result.  However, there is progression of her disease after 6 months. After this exam, she becomes despondent and is struggling to complete daily activities. She reports specific symptoms for depressive disorder: sleeping poorly and lacking appetite, and no longer enjoys spending time with her friends and family or pursuing her interests. She is preoccupied with death and has difficulty concentrating, but fortunately denies any suicidal ideation or death wishes.

It was started the second line chemotherapy protocol. At this time the patient shows abandonment behavior, autolytic thoughts and drug ingestion triggered by acute family conflict, requiring psychiatric re-assessment and specialist treatment.

Conclusion: Depression remains an under-recognised comorbidity in cancer patients, with major implications on patient suffering, mortality and healthcare expenditure. Depression in cancer is markedly different from depression in healthy individuals, and involves a unique symptomatology.

8

Razvan Cosmin Tudor , Nicola Vendemmia , Mihaela Pertea , Viola Badulescu , Aurel Nechita , Anamaria Ciubara

Depression is the most common psychiatric disorder in the elderly, as well as one of the most common comorbidities in patients with hip fracture. Although many authors have confirmed that clinically recognized depressive symptomatology after hip fracture has a negative impact on functional outcomes and mortality, the role of depressive symptomatology evaluated at the time of admission remains insufficiently investigated. Depression can be assessed using the Geriatric Depression Scale. Predictor measurements of rehabilitation results that can interact with depression can be obtained. Linear multiple regression modeling can be used to evaluate the relationship between depression and functional outcome. The identified factors associated with the postoperative 1 and 2 year follow-up of a hip fracture should be incorporated into clinical strategies and postoperative nursing to provide muscle rehabilitation and good functional outcomes. In addition, the health care plan must ensure, before discharge, that the community in which older adults live provides nutritional education, cognitive screening and psychological support. Depression is a common disorder among orthopedic patients. A previous psychiatric diagnosis predisposes patients to depression following a trauma. The socio-economic status is also a predictive factor for increasing depression scores at 9 months after discharge. Patients with a greater sense of support from friends and family have an inverse correlation with depression. Reestablishing the quality of life the patient had before the fracture also seems to have a protective effect against depression. The severity of the trauma does not seem to affect the scores for the evaluation of depression. Psychiatric counseling can avoid associated psychiatric comorbidities in trauma patients. High levels of depressive symptomatology in elderly patients with hip fracture influence functional outcomes both in the short and the long term. We firmly support the introduction of the routine evaluation of this comorbidity. Failure to identify this associated pathology in patients with hip fracture represents a missed opportunity for eventual improvement in both early and late functional outcomes.

9

Paul Dan Sîrbu , Norin Forna , Dragoș Cristian Popescu , Razvan Tudor , Wilhelm Friedl , Anamaria Ciubara , Bogdan Mihnea Ciuntu , Grigore Berea

Dementia and hip fractures are two crucial problems in the elderly and the associations of these pathologies increase substantial morbidity and mortality. 178 patients with dementia (average age 81.5 years) were operated with an uncemented bipolar prosthesis for a displaced femoral neck fracture. They started rehabilitation sessions in the immediate postoperative period and were divided into two groups: group 1 — partial weight-bearing for 72 cases — and group 2 — total weight-bearing for 106 cases. 17 patients were unable to walk and 6 died during hospitalization. 172 patients were discharged to a rehabilitation department (46.6%) or to their home with (31.9%) or without (21.5%) rehabilitation facilities. During follow-up, 103 out of 172 patients accepted a phone interview. After three months 55 patients had regained the pre-fracture level of independence (6 patients from group 1 and 49 patients from group 2; 81% were included in a rehabilitation program). The mortality at one year postoperative period was 26.21%; the majorities of these patients were included in group 1, were more than 80 years old and had more than 4 comorbidities (except dementia).

The authors concluded that, for patients undergoing uncemented bipolar HA, immediate total weight-bearing and discharging to a rehabilitation facility showed a better recovery and return to the pre-fracture level, as well as a better one-year survival rate.

10

Anton Knieling , Tatiana Iov , Alexandru Bogdan Ciubara , Gina Toma , Diana Bulgaru Iliescu

Given the increasing complexity of the modern health care environment and the increasing number of patients, reducing medical errors is a priority task for health as well as for policy and medical decision-makers.

Forensic psychiatry as subspecialty of clinical psychiatry is guided by principles being used in cases with psychiatric, forensic and legal implications. In both psychiatry and any other medical specialty, malpractice may occur. The paper attempts to identify the risk factors of incorrect psychiatric diagnosis and professional misconduct in the exercise of the medical act generating harm to the patient. Knowing the risk factors inevitably leads to their avoidance.

11

Laura Rebegea , Dorel Firescu , Ginel Baciu , Anamaria Ciubara

Background: Malignant diseases represent one of the most important worldwide morbidity and mortality causes. In Romania, the number of new cancer cases is 78800/year and the number of cancer deaths is 48300/year. In Galati County the number of oncology patients under observation is continuously increasing, ranging from 11426 cases in 2008 to 17083 cases in 2017. Methods and materials: We are presenting psycho-oncology reactions manifested by an oncology patient during his evolution from pre-therapeutic evaluation, to diagnostic set-up, treatment and further evolution. Anxiety and depression prevalence among oncology patients vary in very large limits, function of malignant site, but also, within the pale of the same disease, the highest incidence of depression being in patients with breast, lung, colorectal, head and neck cancers. In the specialty literature the following influence factors for psychological and psychiatrically reactions are mentioned: age, neoplasia sites, emotional, psychological status, and depressive status prior to cancer diagnostic. Psychic reactions are various and variable from one patient to another, progressing from denial, revolt, anger, sadness, anxiety to depression and suicidal tendencies. Taking into consideration that depression BRAIN — Broad Research in Artificial Intelligence and Neuroscience Volume 10, Special Issue (June, 2019), ISSN 2067-3957 78 symptoms are overlapping with those given by neoplasia itself and with toxicities of the oncologic treatment, the evolution of depression is complicated.

Conclusions: The polymorphism of psycho-oncology reactions manifested on the entire route of malignant diseases requires psychological counseling in all disease stages. Efficient communication with the oncologic patient, psychological counseling of patient, of their family, of medical staff and group therapy can be achieved only with specialized personnel employed in oncology centers: psychologist, psychiatrist, social assistant, and priest.

12

Golchin Shahijani , Ahmad Ghadami , Mahnaz Shakerian

Background: Musculoskeletal disorders are of the most important occupational injuries and diseases, in which the work environment and individual activities play an essential role in their prevalence. Since laparoscopy has become a preferred approach to treating many of the actions, the aim of this study was to determine the risk factors of musculoskeletal disorders among laparoscopic surgery technologists and comparing them between circulatory and scrubbing roles. Materials and Methods: In this descriptive-analytical cross-sectional study, 49 participants were evaluated by REBA method in Al-zahra Hospital, Isfahan, Iran, 2017. Data was collected through REBA form and analyzed using SPSS software version 20. Results: 94% of our samples were women mostly married with an age range of 32/17 years. The prevalence of musculoskeletal disorders was 98.87% with a mean overall risk of 7.2 ± 0.75 in the role of circulatory and 5.31 ± 0.63 in the role of scrub. Conclusion: Considering the fact that surgical technologists are at risk due to the nature of their job and to promote their health, ergonomic interventions are critically suggested for equipment, tools and environments as well as including ergonomics in their educational curriculum and regular exercise programs.

13

Amin Sedigh , Ahmad Ghadami , Arash Najimi , Masood Sayyadi

One of the main challenges of the educational centers is the introduction of modern teaching methods. Using the simulation devices in training is getting increasingly popularity. The purpose of this study was to examine the effect of appendectomy surgical simulation software (game-based) on the satisfaction of undergraduate students of operating room in Isfahan. In this single-blind randomized clinical trial, 70 second semester undergraduate students were divided into control group and Intervention group after obtaining satisfaction by random allocation. After using the simulation software (game-based) for the Intervention group and the holding practice and lecture class (routine method) for the control group, the data were collected by a self-administered questionnaire the validity and reliability of which were confirmed. Data were then analyzed by SPSS software version 16 and descriptive and analytical tests were also analyzed at a significance level of 0.05. The results showed that the average satisfaction score of the Intervention group (58.94 ± 2.63) was higher than the control group (43.20 ± 3.02) and this difference was statistically significant (P-value <0.05). The results also showed that there was a significant relationship between age and satisfaction (Pvalue <0.05). This means that as age increases, satisfaction increases (r = 0.26). Appendectomy surgical simulation software (game-based) can improve the students' satisfaction with the training process. Therefore, appendectomy surgical simulation software (gamebased) is recommended as a supplementary training method.

14

Alireza Takzare , Maziar Maghsudlou , Ebrahim Espahbodi , Shahram Bagheri Hariri

As an anesthetic agent, ketamine is associated with a number of adverse psychological reactions after patient recovery (Motamed et. al., 2012). Midazolam is currently used to mitigate such adverse reactions. However, they still cause discomfort in patients and sometimes their next of kin. The present study aimed to compare the effect of midazolam and haloperidol on decreasing these adverse psychological reactions. In this clinical trial, patients who were subjected to anesthesia induction by ketamine were randomly divided into haloperidol, midazolam, and distilled water (as control) groups. All patients underwent orthopedic surgery with a maximum duration of 2 hours. After the recovery of the patients, a questionnaire was completed by the anesthesiologist. In addition to demographic data, the questionnaire included a number of questions about adverse psychological reactions such as inaudible speech, uncontrollable crying and laughter, strange feelings, illusions, anxiety, and agitation. After completing the questionnaires, the data were introduced into SPSS and analyzed with statistical tests. A total of 60 patients including 30 men and 30 women were enrolled in the study. The mean age of the patients was 32.9 ±9.5 years ranging from 16 to 50 years. Twenty patients received the premedication (pre-anesthetic drug) haloperidol before the induction of anesthesia, 26 patients received midazolam, and 14patients received distilled water. The patients were similar in terms of age, gender, and ASA group. The recovery time for midazolam and haloperidol was significantly longer than that of distilled water (p=0.02). In addition, the number of adverse psychological reactions were significantly higher in the midazolam (p=0.02) and haloperidol (p=0.04) groups than in the distilled water group. However, they occurred less often in midazolam group than the haloperidol group with no significant difference.Haloperidol can reduce the adverse psychological reactions of ketamine, but this reduction is not as prominent as midazolam.

15

Hamidehalsadat Asarian , Hossein Eskandari , Ahmad Borjali , Payman Dadkhah

Introduction: Pain-related mental images have an important role in pain experience of the patients and processing of sensory information through cognitive and emotional processes. The treatment protocol for rescripting of pain mental image has recently been complied and validated in order to change the pain perception. This study has been conducted aimed to determine the efficacy of rescripting of pain mental image on the severity of perceived pain by the patients with chronic pain. Method: this is an empirical study with pre-test, posttest and follow-up stages, conducted on an experiment and a control group. Sampling was done randomly from among the patients with chronic pain who referred to the Specialized Clinic of Pain in Labafinejad Hospital of Tehran. With regard to inclusion and exclusion criteria, 50 subjects were selected and randomly assigned to two groups. Data were analyzed via Variance analysis within and between groups. Results: The results of this study show that rescripting of pain mental image has been effective in the reduction of pain intensity of the patients with chronic pain (P: 0.001, α2 : 0.58). Conclusion: Rescripting of pain mental image can be presented as a compact and short-term psychological intervention which may be easily combined with pharmaceutical and physical therapy programs to reduce pain of the patients with chronic pain.

16

Elaheh Mirmiran , Gholamreza Lotfi , Farzaneh Hatami

The instructional guidelines play an important role in transmitting target information, and educators usually use them to teach and improve motor function of individuals at all skill levels. Directing the focus of attention is one of the important factors affecting the effectiveness of instructional guidelines. However, this study aimed to investigate the effect of different focus of attention as verbal cues on performance and retention of standing long jump among teenager female beginners. For this purpose, 45 beginner students (M age= 13.12 ±1.82 years) in Qazvin were voluntarily selected and after pre-test, they were randomly assigned to one of three groups: external verbal cues, internal verbal cues, and control. All groups performed standing long jump for three sessions; each session consisted of 5 attempts of 2. After last session of acquisition, the posttest was conducted. After one week of untrained, the retention test was conducted. The results of descriptive statistics showed that the standing long jump performance of all groups improved from training period to retention test. The results of one-way analysis of variance showed that there was no significant difference between three groups in pretest and acquisition stage. However, this difference was significant in post-test and retention stage.

17

Ameneh Sadat Kazemi , Zahra Mohammadi

Attention Deficit/Hyperactivity Disorder (ADHD) is among developmental disorders that has taken the attention psychologists and psychiatrics from a long time ago. The present study aims to investigate the effect of attention and working memory improvement training on executive function of children with ADHD. The present study was a quasi-experimental study and the sample included 44 children with ADHD who referred to psychiatric clinics of Babol and had the characteristics of interest and they were divided into test and control groups, each group contained 22 subjects. Their performance was evaluated using Tower of London Test at the pretest stage. Then, each group member exposed to training with attention and working memory improvement application for 20 sessions of 30 minutes (7 weeks, 3 times a week, 30 minutes). After the training period, posttest was administered with the same application for both groups. The results of analysis of covariance showed that despite increased executive function in both groups at the presets, the executive function in test group was higher and for this reason, attention and working memory improvement training has influenced the executive function of children with ADHD. Attention and working memory training and similar programs can be used as a complementary treatment method or an alternative for medical therapies.