(1) Background and aim: Multimodal treatment is the current standard approach for managing lymphedema, with the goal of normalizing or reducing volume discrepancies, improving function, and enhancing appearance. However, following the reduction of the solid component and enhancement of lymph flow through physiological procedures involving supermicrosurgery, residual areas of fibrosis or lipodystrophy may persist, causing dissatisfaction for both the patient and the physician. (2) Methods: We present a three-case series of lymphedema, two affecting the upper limb and one affecting a lower limb, all previously treated with lymphaticovenular anastomosis (LVA) and/or debulking liposuction, which resulted in satisfactory overall volume reduction of the limbs, but with persistent swelling of the dorsum of the hand and forefoot, respectively. All patients were subsequently treated with a combination of bioengineered enzymatic cocktail (BEC). (3) Results: All three patients demonstrated stable reduction of swelling in the affected areas at one-month follow-up, with improved quality of life and function, which was maintained at six months followup. (4) Conclusion: These preliminary observations suggest that multi-enzyme cocktails warrant investigation as adjuncts for localized, post-surgical residual lymphedema, particularly for distal, anatomically challenging regions, such as the hand, foot, and digits, where surgical options are limited.
Mental health stigma (MHS) among military personnel requires a complex approach, as it is influenced by ethical challenges and organizational norms distinct from those in civilian milieus. Stigmatization encompasses multiple dimensions -including social, self, anticipated, cultural, and structural stigma- that must also be examined within military settings. This article presents a conceptual analysis of key research directions in the field of MHS, based on a literature review conducted across three electronic databases (PubMed, Google Scholar, and Clarivate/Web of Science), from the inception of each database up to June 2025. The review focuses on active-duty service members and veterans, and identified six major domains involving MHS: (1) structural stigma within military contexts, (2) risk factors and consequences associated with MHS, (3) self-stigma among active-duty personnel and veterans, (4) the role of military healthcare providers in mitigating stigma, (5) military sexual trauma and its relationship to stigma, and (6) interventions aimed at decreasing MHS among military personnel. Although relevant primary and secondary studies were identified across these domains, significant research gaps remain, particularly in the last three areas. Addressing MHS in military populations is essential not only for improving quality of life, psychological well-being, and daily functioning, but also for maintaining combat readiness, unit cohesion, and peer acceptance.
Late-life major depression is a high-incidence and difficult-to-treat affective disorder. Diagnosis of major depression in old age could also could be a challenge, due to aspects like (1) there is a higher vulnerability to the stigma of depression in this population, (2) hypochondriac ideation and somatic symptoms are the main symptoms, while depressive disposition or anhedonia are under-reported by such patients, (3) differential diagnosis includes various organic diseases, but also several psychiatric disorders, like neurocognitive disorders, organic affective disorders, drug induced affective disorders etc. Reduction of social relationships caused by retirement and loss of spouse and friends, as well as a decrease of personal income could precipitate or maintain depressive disorders during late-life. Quality of life in patients diagnosed with depressive major disorders is a rarely monitored parameter, although its importance for case management could not be overemphasized. A reduction of life quality correlates with a poorer functional prognosis, persistence of neglected residual symptoms, low adherence to treatment plan etc.
Isolation and quarantine during the Covid-19 pandemic affected the lifestyle and daily functioning of the population around the world, leading to social, psychological, and economic changes which further multiplied the stress related to the threat of coronavirus contagion by adding financial, relational, academic, professional and mental health vulnerabilities. To assess the impact of isolation and quarantine over the quality of life in the Romanian population, we conducted a Web-based survey focused on the evaluation of stress level, perception of lifestyle changes, communication patterns, mental health, major concerns, perception of one’s future, but also on the preferred coping strategies that people have used to deal with the isolation stress. The answers were collected during one month and the results for the first 2 weeks of quarantine/isolation were compared with the results after one month of such regimen. Several recommendations based on the survey results analysis were formulated regarding possible strategies for decreasing the impact of stress factors over the general population and specific, vulnerable groups.
Vulvovaginal atrophy is a condition frequently encoutered among menopausal women that often is ignored, remains undiscussed with the physician and the patient adapts the life style is such matter that offers a run from the specific symptomathology. According to the specialized published data, only 25% of the patients with vulvovaginal atrophy receive adequate therapy. The therapeutic perspective is quite extensive but the patient should receive recommendations and try different products until they find one that meets their needs and the one they like best. Proper estrogen therapy leads to a restoration of the acidic, normal vaginal pH, of the vaginal microflora, thickens the epithelium, increases vaginal lubrication and decreases vaginal dryness, also, adverse effects of vaginal estrogen therapy are uncommon. Early active detection of this pathological condition and the provision of an appropriately selected therapy can prevent the progression of the symptomatology and can significantly improve the sexuality of women.
The assessment of coping mechanisms in patients diagnosed with oncological diseases is essential for mental health specialists, who have to design the most appropriate case management strategy for comorbid mood disorders, anxiety disorders, adjustment disorders, and other psychiatric conditions that may be detected in this vulnerable population. The adequate treatment of these disorders is important for the preservation of mental health status, quality of life, and overall functionality in patients diagnosed with cancer. Coping mechanisms modulate the vulnerability toward psychiatric disorders, but they also have an impact on treatment adherence, which is an important factor correlating with prognosis. Appraisal-focused, problem-focused, emotion-focused, and occupation-focused coping represent the most well-defined strategies patients use when confronted with a stressful life situation, like a diagnosis with potentially vital consequences. Maladaptive coping strategies may also be identified in these patients, e.g., withdrawal from reality, including complete or partial denial of the disease, substance abuse, behavioral addictions, refusal of the recommended treatment, etc. The psychotherapeutic approach in patients with oncological diseases should include an initial evaluation of the coping strategies used either currently or in the past stressful conditions, an assessment of all the psychosocial resources the patients have (e.,g., support group, professional insertion, hobbies), and screening for mood and anxiety disorders that may have been triggered by the cancer diagnosis. Consequently, within the psychotherapeutic framework, a trained specialist can enhance the role of adaptive coping strategies and highlight the disadvantages of dysfunctional ones. This process may possess a favorable impact on treatment adherence, mental health status, and quality of life in patients with cancer.
