No abstract

This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited. REVIEW SARS-CoV-2 infection in patients with serious mental illness and possible benefits of prophylaxis with Memantine and AmantadineILEANA MARINESCU 1) , DRAGOŞ MARINESCU 2) , LAURENŢIU MOGOANTĂ 3) , ION CRISTIAN EFREM 4) , PUIU OLIVIAN STOVICEK 5)

In recent decades, traumatic brain injury (TBI) has become one of the most important health problems worldwide and is a major cause of morbidity, mortality and economic losses. Mild traumatic brain injury (mTBI) is less considered, with clinical underestimation leading to an epidemiological underevaluation of its incidence. Many of the signs and symptoms induced by mTBI are difficult to highlight clinically, especially those related to cognitive, behavioral, or emotional impairment. The complexity of the biological mechanisms induced by mTBI in the elderly determines synchronous pathogenic actions in which the vascular, inflammatory and neurodegenerative elements are intertwined. It is difficult to highlight a major pathogenic factor, since they act simultaneously, multimodally, in a real pathogenic cascade. The identification of mTBI and cerebral vascular changes by neuroimaging techniques, transcranial Doppler (TCD) or biological markers, suggests a potential prophylactic intervention by using neuroprotective factors as early as possible. Proper prophylaxis measures with neurotrophic treatment, rebalancing the gamma-aminobutyric acid (GABA)/glutamate balance and combating the chronic inflammatory process, can become important pharmacological therapeutic targets.

Psychological evaluation of women with suspected or diagnosed breast cancer can provide psychooncological elements for predicting the evolution of the disease and imperative customization of specific oncological therapies. In this study, we assessed the psychological status in terms of depression, anxiety and dysfunctional attitudes in both the group of patients with a confirmed diagnosis of breast cancer and that of patients with suspected breast cancer who are in the stage of histopathological evaluation of the diagnosis. The results of the psychometric evaluations allowed the development of a common neurobiological model for the two categories of patients. Given the staging model of breast cancer, the clinical and psychometric data obtained through our study allowed us to develop an integrative neurobiological model based on the evolutionary staging of anxiety and depressive disorders (Zhao et al., 2013). Based on these hypotheses, we argue that the staging of psychological disorders, the customization of specific psychotherapeutic prophylaxis strategies and the prudent pharmacological approach to these psychological changes can significantly improve the evolution and prognosis of cancer and the quality of life of patients. The state of relative psychoemotional balance (objectified by psychometric scales), without its validation by normalizing multisystemic biological indicators of depression (C-reactive protein, proinflammatory cytokines, blood-brain barrier disruption and cerebral blood flow decrease), suggests the risk of progression of the neoplastic process. We argue that when communicating the diagnosis and the therapeutic plan, a special methodology (specific protocol) must be applied to reduce distress, correct emotional balance and improve cognitive dysfunction by supporting the motivation to survive, as well as increasing patients' self-esteem.

Frequent association of depressive disorder with clinical manifestations in prostate cancer patients raises problems with therapeutic response and adherence to treatment. Androgen deprivation therapies exacerbate depression and cause somatic adverse reactions, mainly represented by obesity, anemia, osteoporosis, muscle atrophy, gynecomastia. Depressive disorders correlate with activation of the hypothalamic-pituitary-adrenal axis (HPA), which induces high cortisol levels. The structural similarity between cortisol and testosterone suggests possible associations with their side effects. Decreased testosterone levels amplify the risk of developing or exacerbating depressive disorders. It is important the early identification of sexual identity and body perception disorders, as well as the interdisciplinary assessment of cognitive status and depression. The direct relationship between elevated PSA and testosterone levels and high depression scores suggests the unfavorable evolution of non-metastatic prostate cancer. It is necessary to evaluate depression from the diagnosis of prostate cancer as well as its dynamic monitoring. Therapeutic resistance raises the issue of early oncologic therapeutic switch and the combination of pharmacological and non-pharmacological antidepressant therapies.