Royal Jelly and Fermented Soy Extracts-A Holistic Approach to Menopausal Symptoms That Increase the Quality of Life in Pre- and Post-menopausal Women: An Observational Study.

BACKGROUND: The objective of this study was to determine the effects of royal jelly and fermented soy extracts on menopausal symptoms and on quality of life in pre- and post-menopausal women. MATERIALS AND METHOD: This prospective observational study was carried out in a Clinical Hospital of Brasov, Romania, during June 2020 and December 2021. Eighty pre- and post-menopausal women, aged between 45 and 60 years, were included in two groups. The first group (40 women) received a dietary supplement with fermented soy extract twice a day for eight weeks and the second group (40 women) received the same dietary supplement with fermented soy extracts and 1500 mg of royal jelly capsules for eight weeks. After the treatment, the MENQOL score, DASS-21 score, and the mean number and intensity of daily hot flushes were recorded and compared with baseline values. RESULTS: After eight weeks of treatment, the score of the MENQOL questionnaire and all its domains' scores decreased in comparison with the baseline in both groups (p < 0.001). Also, the DASS-21 score (p < 0.001), depression score (p < 0.001), anxiety score (p < 0.001), and stress score (p < 0.001) improved. The mean number and the intensity of hot flushes decreased in both groups (p < 0.001). Comparing these variables after the treatment in both groups, we observed that the women who received dietary supplements with fermented soy extracts and royal jelly capsules recorded better scores for MENQOL (vasomotor, physical, and psychosocial domains) and a more reduced mean number of daily hot flushes. CONCLUSIONS: This observational study suggests that both dietary fermented soy supplements and royal jelly capsules possess beneficial effects against menopausal symptoms, increase the quality of life in pre- and post-menopausal women, and that the effects might be significantly improved if those dietary supplements are administered in association.

Disparities of perceived wellness by smoking and professional status among young individuals in Brasov, Brasov County, Romania.

OBJECTIVE: We aimed to evaluate the association of risk factors such as smoking and professional status (students vs employed) as determinants of disparities in perceived wellness among Romanian individuals. METHODS: We conducted a cross-sectional study in which 145 participants were enrolled from December 2017 to February 2018, in Brasov, Brasov County, Transylvania, Romania. We used a simplified Perceived Wellness Survey model to measure the holistic individual perceived wellness status by professional and smoking status. Basic descriptive and multivariate analyses of variance were used to assess and contrast participants' characteristics and wellness score distributions. A factor analysis was used to estimate Kaiser-Meyer-Olkin values and calculate standardized Cronbach's coefficients. RESULTS: The average age of our participants was 27.7 years. Compared with students, more employed participants tended to smoke electronic cigarettes (p < 0.0001). The association between professional status and perceived wellness was non-significant. Employed participants were nevertheless more likely to regard themselves as more proactive in dealing with emotional (p < 0.0001), environmental (p = 0.0042), and spiritual issues (p = 0.0039). Perceived physical wellness was statistically different by smoking status (p < 0.0001). CONCLUSION: Among our study participants, there is an association between smoking and perceived wellness. For emotional, environmental, and spiritual domains, employed participants are more likely to regard themselves as more confident. Our study demonstrates the direct application of the Perceived Wellness Survey model in predicting the disparities of perceived wellness among young individuals. It allows health agencies to target disparity interventions among populations with high risk of low perceived wellness.

Therapeutic Interventions for Adjustment Disorder: A Systematic Review.

BACKGROUND: Adjustment disorder requires therapeutic intervention because of its complications, which include a significant risk of suicide, but evidence-based therapeutic guidelines are not available. AREAS OF UNCERTAINTY: The main problem is related to answer to the following question: What is the optimal therapeutic approach to adjustment disorder? In this respect we review all randomized controlled trials that aimed to investigate therapeutic interventions for adjustment disorder in adult populations. DATA SOURCES: Comprehensive search of the electronic database PubMed (January 1980-June 2019). The review included clinical trials that aimed to investigate a psychological or pharmacological treatment for adjustment disorder in adult population and reported outcome data for therapeutic interventions. RESULTS: The search identified 23 studies that fulfilled the inclusion criteria for this review. Pharmacotherapy interventions were the focus of 11 studies that used various medications and dosages including viloxazine, lormetazepam, S-adenosylmethionine, pivagabine, trazodone, clorazepate, etifoxine, lorazepam, diazepam, afobazole, and plant extracts (Kava-kava, Euphytose, and Ginkgo biloba) on a total number of 1020 patients. Psychotherapy interventions were identified in 12 studies that used mirror therapy, short-term dynamic psychotherapy, yoga meditation, body-mind-spirit technique, mindfulness, bibliotherapy (self-help manual), humor training, and cognitive behavioral therapy. CONCLUSIONS: Psychotherapy seems indicated for mildly symptomatic adjustment disorder. Given the fact that adjustment disorder with severe symptoms is associated with a high risk of suicidal ideation and suicide attempts, clinicians must consider the potential benefit of using psychotropic agents such as benzodiazepines, antidepressants, or etifoxine.

Palliative Care in Heart Failure: A Public Health Emergency.

BACKGROUND: Palliative care (PC) is the holistic care of patients with life-limiting illnesses focused on relief of suffering and maximizing quality of life for patients and their families. Patients with heart failure (HF) are the largest group eligible for PC services, but only a small percentage of them receive PC. AREAS OF UNCERTAINTY: The optimal content and method of delivery of PC interventions to HF patients in resource-limited countries remain unknown. The integration of PC into existing HF disease management continues to be a challenge. DATA SOURCES: PUBMED was searched to identify articles on the topic published in the last 5 years (2014-April 2019). One hundred thirty-six articles were identified-14 articles out of were included in the revision. THERAPEUTIC ADVANCES: Research concerning PC in HF is still scarce and comes predominantly from developed countries. PC in HF improves patients' and caregivers' outcomes in terms of dyspnea, sleep, depression, communication, coping, and care-giving burden. Specialized home-based PC services have a positive impact on patients' physical and emotional wellbeing while decreasing utilization of medical services. Fatigue, dyspnea, and pain are frequent symptoms. Evidence concerning use of opioids for dyspnea is increasing. Family caregivers offer a considerable amount of care during the disease trajectory. There is often incongruence between the carer's and the patient's wishes in terms of treatment decisions and preferences. Carers should be assessed for risk and supported in their roles in care management and care coordination. CONCLUSIONS: Because of the unpredictability of the disease and difficulty in prognostication, PC should be introduced at the point of diagnosis of HF. Basic education in PC needs to be introduced early in the training of cardiology staff, focused on concept definition, differencing PC and terminal care, symptom management, communication, and decision-making.

Results of the follow-up of the former trichinosis patients from Brasov County--Romania.

The objective of the study was to monitor for a period of 2 years (at 1, 3, 6, 9, 12, and 24 months) a group of former trichinellosis patients (n=699) registered in Brasov county before the initiation of the National Supervision and Control Programme for trichinellosis in humans. During the study, immediate complications up to 6 months from hospital release, and related complications occurring up to 24 months from hospital release were identified. Immediate complications were cardiovascular (31%), muscular (19%), neurological (18%), ophthalmic (17%), allergic (9%), respiratory (1%), and other (5%). Complications were more frequent in children from the studied group, even if the trichinellosis disease manifestation was mild or moderate. Complications were also more frequent in female as compared to male patients, and in urban areas as compared to rural environments. Paraclinical data showed eosinophilia in 8-22% of patients, GPT and GOT within normal limits, and hypoproteinemia in the case of 178 former patients (31%). Hypocalcaemia and hypomagnesaemia persisted in the case of 401 former patients (71%). Two months following illness, 53 (9.4%) of the former patients remained ill, and 26 of them had retired on medical grounds. Nine months following illness, 212 (37.8%) of the former patients reported fatigue, myalgia (especially in the inferior limbs), cardiovascular disorders, neurological, psychiatric, and allergic illnesses. After one year, 102 (18%) of the former patients reported improvements in asthenia, muscular pains, allergic reactions, hypertension, cardiac arrhythmia, and angina pectoris crises. Trichinosis in humans cannot be considered only an acute disease that, once properly treated, etiologically, pathogenically, and symptomatically improves, but it can also become a chronic illness.