Digital Commons Network^™

The Role Of Biotransformation Processes In Mediating Interactions Between Psychotropic Drugs And Natural Products, Nicolae Bacinschi, Ina Pogonea, Lilia Podgurschi, Maria Mihalachi-Anghel, Emil Ștefănescu, Bogdan Socea, Marin Chianu

Journal of Mind and Medical Sciences

Many patients are not aware that natural products such as fruit juices or plant infusions can cause significant interactions with several drugs, some of which can be dangerous, especially when the medical treatment is for neurological or psychiatric disorders. Among the most predisposed for interacting with drugs are citric juices, particularly grapefruit and plant infusions, especially St John`s wort (Hypericum perforatum). Understanding the mechanism and the frequency of this type of interaction helps to avoid it. The goal of this research was to identify and summarize the most relevant reports on interactions between psychotropic drugs and natural beverages, in order …

Anorexia Nervosa And Reproduction: Connecting Brain To Gonads, Mihaela Poterasu, David L. Rowland, Corina Ciobanu, Simona Fica

Journal of Mind and Medical Sciences

Anorexia nervosa (AN) is a psychiatric disorder that predominantly affects young women and is characterized by low caloric intake and a major dissatisfaction with one’s body image. It is often overlooked and, while patients and family seek medical help, emaciation and nutritional misbalances may become extreme and potentially life threatening. Among the many somatic complications, an accumulation of early endocrine adaptations occurs, leading to functional amenorrhea and impaired reproduction as a result of dysfunction of the hypothalamic-pituitary-ovarian axis. Even though these conditions are reversible, long-term consequences may affect the fertility of women with AN and can lead to maternal and …

Table Of Contents 2020; 7(1)

Journal of Mind and Medical Sciences

No abstract provided.

Patients’ Perception Of Childbirth According To The Delivery Method: The Experience In Our Clinic, Camelia Alexandroaia, Romina-Marina Sima, Oana-Denisa Bălălău, Gabriel-Octavian Olaru, Liana Pleş

Journal of Mind and Medical Sciences

Introduction: The aim of this study is to identify the way in which childbirth in general, and the delivery method in particular, influenced the maternal psychosocial status and the perception upon birth during postpartum. Material and method: We conducted a cohort type 2 prospective study. We included patients who had given birth at “Bucur” Maternity of Hospital “St. John” Bucharest from the 1st of January 2017 until the 1st of January 2018. Results: The majority of the patients (21.05%) who chose to give birth vaginally assigned the maximum degree (10) to the difficulty of birth. The patients who gave birth …

Personality And Phobias In Adolescence: Age And Gender In Psychopathological Expressions, Salvatore Settineri, Emanuele Maria Merlo, Angela Alibrandi, Federica Sicari, Irene Pagano Dritto, Fiorella Strangis, Fabio Frisone

Journal of Mind and Medical Sciences

Background: Although the understanding of adolescent phobias is important, this phenomenon has thus far not been adequately researched. This report, based on clinical experience, highlights prevalent phobic phenomena linked to personality characteristics. Methods: A sample of 241 adolescents from High School and the University of Messina, Italy was evaluated for phobic responses using the SAFA Scales. Personality types and aspects were assessed by the Myers-Briggs Type Indicator F Form. Results: The results were consistent with the reported literature and revealed that psychopathological phenomena such as anxiety, obsession, eating disorders and phobias decreased with aging; however, depression remained constant over time. …

The Burden Of Clostridium Difficile Infection In Patients With Liver Cirrhosis, Despina Moraru, Andrada Dumitru, Sergiu I. Micu, Marilena Musat, Gabriel Preda, Popoiag R. Emanuela

Journal of Mind and Medical Sciences

Clostridium Difficile Infection (CDI) has registered a dramatically increasing incidence in the general population over the past decades. Nowadays, Clostridium Difficile is the leading cause of hospital-acquired diarrhea in Europe and North America. Liver cirrhosis is the final stage of any chronic liver disease (CLD). The most common causes are chronic hepatitis C or B and viral co-infections, alcohol misuse, and nonalcoholic fatty liver disease (NAFLD). CLD and cirrhosis are listed among the ten leading causes of death in the US. Cirrhosis due to any etiology disrupts the homeostatic role of the liver in the body. Cirrhosis-associated immune dysfunction (CAID) …

Insights Into The Pathogenesis Of Nicotine Addiction. Could A Salivary Biosensor Be Useful In Nicotine Replacement Therapy (Nrt)?, Anida-Maria Băbțan, Nausica B. Petrescu, Anca Ionel, Bianca A. Boșca, Willi A. Uriciuc, Claudia N. Feurdean, Codruța I. Mirică, Roxana Bordea, Viorel Miclăuș, Flavia Ruxanda, Adina D. Todea, Teodora G. Alexescu, Radu S. Câmpian, Aranka Ilea

Journal of Mind and Medical Sciences

Nicotine has gained the attention of the medical community due to its insidious addictive mechanisms which lead to chronic consumption. The multitude of compounds derived from tobacco smoke have local and systemic negative impacts, resulting in a large number of smoking-related pathologies. The present review offers insights into nicotine addiction physiopathology, as well as social and medical implications, with emphasis on its correlation with Advanced Glycation End Products (AGEs). Therapeutic strategies and new approaches to nicotine assessment and cessation treatment are discussed, noting that such strategies could take into account the possibility of slow and gradual nicotine release from a …

Publication Citations (Calendar Year 2018), Valparaiso University

Valparaiso Scholarship and Creative Works Reception

No abstract provided.

Xanthogranulomatous Pyelonephritis: Presentation And Management, Răzvan C. Petca, Răzvan I. Popescu, Cristian Mareș, Claudia Mehedințu, Bogdan Mastalier, Dumitru Cristinel Badiu, Nicoleta Măru, Vlad D. Constantin, Aida Petca

Journal of Mind and Medical Sciences

Xanthogranulomatous pyelonephritis (XGP) is characterized by the presence of lipid-laden foamy macrophages with both acute and chronic phase inflammatory cells. The aim of the study is to present our experience about patients with Xanthogranulomatous pyelonephritis. 29 patients were evaluated through a complete anamnesis and the preoperative management included routine blood and biochemical tests, urine culture and renal ultrasound, intravenous urography and computed tomography (CT). All patients underwent open nephrectomy followed by the pathological exam. The main symptoms of these patients were fever and flank pain. Preoperative laboratory tests revealed anemia, leukocytosis and increasing levels of blood urea nitrogen (BUN) and …

Cardio Metabolic Risk Factors For Atrial Fibrillation In Type 2 Diabetes Mellitus: Focus On Hypertension, Metabolic Syndrome And Obesity, Mihnea-Alexandru Gaman, Elena-Codruta Dobrica, Emilia G. Pascu, Matei-Alexandru Cozma, Mirela-Elena Epingeac, Amelia M. Gaman, Anca M. Pantea Stoian, Ovidiu G. Bratu, Camelia C. Diaconu

Journal of Mind and Medical Sciences

Objective. Atrial fibrillation (AF) in type 2 diabetes mellitus (T2DM) has been little explored so far. However, there are several cardio metabolic risk factors for AF in T2DM patients, such as arterial hypertension, obesity or the metabolic syndrome. Our objective was to evaluate cardio metabolic risk factors for AF in T2DM patients. Methods. We studied the medical records of T2DM patients hospitalized in the Internal Medicine department of an emergency referral hospital in Bucharest, Romania. The study was observational, retrospective and carried out between January-June 2018. Results. The study group included 221 T2DM patients (with a mean age of 68.65 …

Experimental Pharmacological Research Regarding Some New Quinazolin-4-Ones Derivatives, Cornel Chiriță, Emil Ștefănescu, Cristina E. Zbârcea, Simona Negreș, Mihaela Bratu, Diana C. Nuță, Carmen Limban, Ileana C. Chiriță, Cristina D. Marineci

Journal of Mind and Medical Sciences

A series of new compounds with quinazolin-4-one structure, synthesized by the Pharmaceutical Chemistry Department of the Faculty of Pharmacy of the University of Medicine and Pharmacy “Carol Davila” Bucharest, was studied. Five of them were selected, conventionally named S1, S2, S3, S4, S5, and investigated in terms of their potential influence on the central nervous system (CNS). For this purpose, the antidepressant effect was determined using the forced swimming test; the anxiolytic/ anxiogenic effect was determined using the suspended plus-shaped maze (Ugo Basile); the effect on the motor activity was determined using the Ugo Basile activity cage; and the potential …

Serum Markers Of Bone Fragility In Type-2 Diabetes Mellitus, Rucsandra Dănciulescu Miulescu, Loreta Guja, Lavinia Claudia Ochiana, Anca Ungurianu, Oana Cristina Șeremet, Emil Ștefănescu

Journal of Mind and Medical Sciences

Patients with type-2 diabetes mellitus (T2DM) have normal or increased bone mineral density (BMD) but despite that, they are characterized by an increased hip and vertebral fracture risk that involves the alteration of bone quality and not the reduction in bone mass. BMD is utilized for the diagnosis and evaluation of osteoporosis, but BMD itself cannot provide an accurate diagnosis of the individuals at increased risk of fracture and, therefore, studies have focused on identifying other risk factors that are partially or fully independent of BMD.

The fracture risk score tool-FRAX® models provide information about a 10-year probability of osteoporotic …

Sinonasal Inverted Papilloma; Recurrence, Malignant Transformation And Risk Factors, Alexandru Meius, Teodora Ghindea, Catalina Pietrosanu, Irina Ionita, Daniel Timofte, Cornelia Nitipir, Laura Mazilu, Andreea Rusescu, Silviu Pituru, Razvan Hainarosie

Journal of Mind and Medical Sciences

Sinonasal inverted papilloma is a rare benign epithelial tumor. Its three main clinical characteristics are the tendency of recurrence, the destructive ability of nearby structures and malignant transformation. The primary manifestations of this tumor include nasal obstruction, headaches, runny nose, hemorrhage and impaired sense of smell. The diagnosis is based on the clinical and endoscopic examination completed by CT or MRI scans and biopsy of the lesion. Allergies, chronic inflammation, nicotinism and viral infections such as HPV infection are considered possible causes of pathogenesis and potential risk factors for relapse and malignancy. The treatment for this condition is the complete …

Photodynamic Therapy As A New Therapeutic Approach Of Oral Lichen Planus, Sandra Milena Tocut, Madalina Irina Mitran, Cristina Iulia Mitran, Mircea Tampa, Maria Isabela Sarbu, Gabriela Loredana Popa, Simona Roxana Georgescu

Journal of Mind and Medical Sciences

Oral lichen planus (OLP) is a chronic, immunologically mediated disease, defined by periods of exacerbation and quiescence. The disease is associated with a low mortality risk, but in some instances, morbidity can be important, especially in extensive, erosive forms, with a significant impact on the quality of life. OLP is a chronic T-cell mediated inflammatory disease involving the oral cavity, the most common lesions being located on the oral mucosa, tongue and gums. Its etiology remains in part unknown, but several factors proved to be involved in the development of the disease (drugs, dental materials, infectious agents, psychological factors, autoimmunity …

Immune And Inflammatory Pathways In Non-Alcoholic Steatohepatitis (Nash). An Update, Sorina Cezara Coste, Ionela Popovici, Andreea Maria Stefan, Iulia Breaban, Adela Sitar Taut, Simina Tarmure Sarlea, Angela Cozma, Dorel Sampelean, Olga Hilda Orasan, Vasile Negrean, Lucia Maria Procopciuc

Journal of Mind and Medical Sciences

Non-alcoholic steatohepatitis (NASH), also known as fatty liver disease (FLD), is a major public health problem. It is considered to be the hepatic manifestation of the metabolic syndrome. Chronic inflammation of the liver is an essential key in the progression from simple hepatic steatosis to steatohepatitis, the evolutionary stage of fatty liver disease. Moreover, the innate immune system plays a crucial role in the progression of hepatic inflammation. For this reason, it is of utmost importance to elucidate the connections between immune mechanisms, Toll-like receptor cytokine signalling, in order to find new effective treatments. Further studies are necessary to test …

Oncogenesis- Kaleidoscopic And Multi-Level Reality, Firmilian Calota, Cristian Mesina, Stelian Stefanita Mogoanta, Dragos Calota

Journal of Mind and Medical Sciences

Oncogenesis is an extremely complex phenomenon. The mechanisms by which cancer is induced is only partially known. Consequently, therapeutic targets may be uncertain and results are often unsatisfactory. The purpose of this paper is to develop a trans-level and multiple transdisciplinary perspective describing the kaleidoscopic reality of oncogenesis. This manner of understanding oncogenesis as a complex process characterized by a non-linear dynamic, far from equilibrium and with unpredictable evolution, transcends the classical perspective and requires a paradigm shift. This approach is also facilitated by recent studies that focus on group phenomena, with emerging behaviors in a continuous phase transition. Biological …

The Relationship Between Gut Microbiota And Spontaneous Bacterial Peritonitis In Patients With Liver Cirrhosis - A Literature Review, Roxana-Emanuela Popoiag, Anca Mihaela Pantea Stoian, Adrian P. Suceveanu, Andra I. Suceveanu, Laura Mazilu, Irinel R. Parepa, Laura M. Serban, Mihai Paunica, Catalina Motofei, Carmen Fierbinteanu Braticevici

Journal of Mind and Medical Sciences

Gut microbiota is an essential component in the pathogenesis of liver cirrhosis and its complications. There is a direct relationship between the gut and the liver called the gutliver axis through which bacteria can reach the liver through the portal venous blood. However, it remains unclear how bacteria leave the intestine and reach the fluid collection in the abdomen. A series of mechanisms have been postulated to be involved in the pathogenesis of spontaneous bacterial peritonitis (SBP) and other complications of liver cirrhosis, including bacterial translocation, bacterial overgrowth, altered intestinal permeability and dysfunctional immunity. The hepatic function may also be …

Table Of Contents 2019; 6(1); 1-180, . .

Journal of Mind and Medical Sciences

.

Determination Of Pyrrolizidine Alkaloids In Dietary Sources Using A Spectrophotometric Method, Oana C. Șeremet, Octavian T. Olaru, Mihaela Ilie, Claudia M. Guțu, Mihai G. Nițulescu, Camelia Diaconu, Catalina Motofei, Denisa Margină, Simona Negreș, Cristina E. Zbârcea, Emil Ștefănescu

Journal of Mind and Medical Sciences

Pyrrolizidine alkaloids (PAs) are a class of toxic compounds found in the composition of more than 6000 plants. People can be exposed to PAs by consuming phytotherapeutic products, food from crops contaminated with seeds of some species with high content of PAs, and/ or contaminated animal products like bee products. For this reason we developed and validated a method for quantitative determination of PAs, from the most frequently contaminated food sources, honey and flour. Colorimetric Ehrlich reagent method was used with standard addition (1mg/kg senecionine). The extraction solvent was methanol 50% acidified with citric acid to pH 2-3, as this …

Functional Radical Cervical Dissection For Differentiated Thyroid Cancer: The Experience Of A Single Center, Tulin Adrian, Lucian Alecu, Catalina Poiana, Luminita Tomescu, Iulian Slavu, Raluca Tulin, Silviu Pituru, Cristina Orlov, Radu Jecan, Balalau Cristian, Anca Pantea Stoian, Razvan Hainarosie, Cornelia Nitipir

Journal of Mind and Medical Sciences

There is ongoing debate regarding the role of neck dissection in differentiated thyroid cancer, about its usefulness in elective settings, and the increased costs regarding morbidity and operative time. This retrospective study aimed to determine the rate of metastases in cervical lymph nodes, to examine the morbidity of this surgery, and to assess whether a pattern of distribution of tumor cells concerning neck lymphatic compartments exists. The most frequent type of cancer to metastasize was papillary cancer, the majority of patients were young with a median of 30 years, predominantly females. Differentiated thyroid cancer frequently metastasizes to the central and …

Pancreatogenic Type 3c Diabetes, Anca Mihaela Pantea Stoian, Giorgiana Ditu, Mircea Diculescu, Mircea Manuc, Andra Iulia Suceveanu, Dana Manuc, Camelia C. Diaconu, Adrian Paul Suceveanu, Cornelia Nitipir, Razvan Hainarosie, Catalina Poiana, Cristian Serafinceanu

Journal of Mind and Medical Sciences

Background. The relationship between chronic pancreatitis and diabetes is well established. This form of diabetes is secondary to exocrine pancreatic disorder and is known as diabetes mellitus type 3c (T3cDM).

Materials and Methods. In this retrospective study we included 261 patients, 59 patients being diagnosed with chronic pancreatitis and secondary diabetes mellitus, and admitted in the Fundeni Clinical Institute, 2nd Department of Gastroenterology or N.C. Paulescu Institute/ Carol Davila University of Medicine and Pharmacy.

Results and Discussions. Patients were 22.2% women and 77.8% men, with an average age of 56.8 years and 53.4 years respectively. 63% came from urban areas. …

Hptlc Assay Of Nicotine And Cotinine In Biological Samples, Ana Maria Vlasceanu, Daniela Luiza Baconi, Anne Marie Ciobanu, Vlad D. Constantin, Liana Ples, Cristian Balalau, Miriana Stan

Journal of Mind and Medical Sciences

This study presents the development of a simple high-performance thin layer chromatography (HPTLC) method for the determination of nicotine and its metabolite cotinine in human plasma and urine.

The following mobile phases: methanol: ammonia (100:1.5, v:v), chloroform: acetone: ammonia (48.75: 48.75: 2.5, v:v:v), methanol: chloroform: ammonia (48.75: 48.75: 0.5, v:v:v) and glass plates precoated with silicagel 60 F254 (20x20) as a stationary phase were used. Densitometric scanning was performed at 263 nm. Two different extraction procedures have been applied: liquid-liquid extraction using dichloromethane at alkaline pH and solid-phase extraction using C18 cartridges.

Preliminary tests in order to establish the system …

Thrombocytopenia In End-Stage Renal Disease And Chronic Viral Hepatitis B Or C, Olga Hilda Orasan, Laura Urian, George Ciulei, Iulia Breaban, Andreea Maria Stefan, Sorina Cezara Secara, Adela Sitar Taut, Simina Tarmure Sarlea, Vasile Negrean, Dorel Sampelean, Ioan Mihai Patiu, Remus Aurel Orasan, Angela Cozma

Journal of Mind and Medical Sciences

Objectives. We evaluated platelet counts in end-stage renal disease and chronic viral hepatitis.

Materials and Methods. We studied 70 patients with end-stage renal disease and chronic viral hepatitis and compared them to a control group of 45 patients without hepatitis.

Results. The presence of viral hepatitis was associated with a higher prevalence of thrombocytopenia. Correlations between age, C-reactive protein, liver stiffness measurement, and platelet count were observed. C-reactive protein levels > 10 mg/dl were associated with a lower risk of thrombocytopenia in patients with end-stage renal disease and chronic viral hepatitis, yet age > 60 years, dialysis vintage > 10 years, aspartate and …

The Switch From Patented Medicine To The Generic One: An Option Or A Necessity?, Păduraru Dan Nicolae, Ion Daniel, Nica Adriana Elena, Coman Florentina, Coțofană Marius, Badiu Dumitru Cristinel, Grigorean Valentin Titus, Bolocan Alexandra, Andronic Octavian

Journal of Mind and Medical Sciences

This paper assesses the influence of a number of factors taken into account when a brand name drug is replaced by a generic one. It also evaluates responses of health professionals – physicians and pharmacist—and patients regarding the issue of switching. We compared and contrasted their responses in order to identify new points of cooperation for the intended benefit of the patient. Thus, the sample drew from all three groups, consisting of 50 doctors, 50 pharmacists, and 50 patients. We collected information regarding the age, residence, income level, and education level for the patients, and age and experience for the …

Unhealthy Lifestyle And The Risk Of Metabolic Syndrome- The Romanian Experience, Angela Cozma, Adela Sitar-Taut, Laura Urian, Adriana Fodor, Ramona Suharoschi, Crina Muresan, Vasile Negrean, Dorel Sampelean, Dumitru Zdrenghea, Dana Pop, Leucuta Daniel, Olga Hilda Orasan

Journal of Mind and Medical Sciences

Background. Metabolic syndrome (MetS) represents a clustering of metabolic risk factors for cardiovascular disease. Many studies have shown the influence of an unhealthy lifestyle on the risk of MetS, yet some aspects remain controversial. Aim of the study: to investigate the relationship between an unhealthy lifestyle and the risk of MetS.

Materials and Methods. The study was conducted using a sample of 181 patients, 54 (29.8%) males and 127 (70.2%) females, aged 59.95±10.8 years. The baseline survey involved the completion of structured questionnaires and clinical examination.

Results. Rural environment, lower education level, past smoking, the absence of fruit/vegetables in the …

Quality Of Life In Romanian Patients With Schizophrenia Based On Gender, Type Of Schizophrenia, Therapeutic Approach, And Family History, Elena Alina Rosca, Ovidiu Eugen Alexinschi, Călin Brîncuș, Valentin Petre Matei, Ana Giurgiuca

Journal of Mind and Medical Sciences

The low quality of life of patients with schizophrenia has been extensively discussed and investigated. Various aspects from gender, socio-demographic profile, and/or type of neuroleptic treatment have been taken into account in describing this condition. The purpose of this study is to assess the perceived quality of life of Romanian patients suffering from schizophrenia and to correlate it with gender differences, type of schizophrenia, family history of psychiatric illness, and type of antipsychotic treatment. 143 patients diagnosed with schizophrenia according to DSM IV-TR and ICD 10 were included in the study. Social demographic data were documented and further assessment was …

New Oral Anticoagulants And Their Reversal Agents, Crista L. Laslo, Anca Pantea Stoian, Bogdan Socea, Dan N. Paduraru, Oana Bodean, Laura I. Socea, Tiberiu P. Neagu, Ana Maria Alexandra Stanescu, Dragos Marcu, Camelia C. Diaconu

Journal of Mind and Medical Sciences

Atrial fibrillation is a commonly encountered pathology in medical practice, and its prevalence has shown a continuous rise over the past years. Atrial fibrillation has a significant impact on patients' quality of life, not only due to the standard anticoagulant treatment with vitamin K antagonists that require close monitoring and dose adjustment, but also due to the fragile equilibrium between hemorrhagic and thrombotic risks. The introduction of new oral anticoagulants (NOACs) in the treatment guidelines for atrial fibrillation has improved the quality of life, as NOACs do not require close monitoring or dose adjustments. However, even if the safety profile …

A Brief Review Of The Literature On The Malignant Ureteral Obstruction, Sorin Lupu, Adrian Brînză, Bogdan Socea, Dragos Marcu, Ileana Peride, Ana Maria Alexandra Stanescu, Tiberiu P. Neagu, Laurian Maxim

Journal of Mind and Medical Sciences

Malignant ureteral obstruction (MUO) caused by a primarily urological tumor or secondary to a late-stage malignancy can be difficult for the urologist to manage. Due to a lack of clinical data on the management of MUO, every case is particular and should be aborted individually.

Lack of specific treatment, either palliative or definitive, can severely damage renal function and lifetime expectancy in patients, causing even more damage that could otherwise be avoided.

Prompt management directed at the recovery of renal function is the main goal in such cases. Even after urinary flow is restored, life threatening post-obstructive diuresis needs to …

Sentinel Lymph Node In Early Stage Ovarian Cancer; A Literature Review, Irina Balescu, Nicolae Bacalbasa, Mihaela Vilcu, Vladislav Brasoveanu, Iulian Brezean

Journal of Mind and Medical Sciences

Although sentinel lymph node mapping has been widely implemented in gynecological malignancies in order to minimize the number of unnecessary lymph node dissections and to diminish postoperative morbidity rate, little is known about ovarian cancer sentinel lymph node mapping. This article presents a literature review regarding the effectiveness, safety and benefits of this method.

Sentinel lymph node detection in early stage ovarian cancer seems to be a safe and effective method, able to minimize the rate of patients submitted to unnecessary lymph node dissection. The second goal of the procedure, to minimize the risk of missing involved lymph nodes, seems …

Biological Therapy In The Treatment Of Melanoma, Simona Roxana Georgescu, Mihaela Roxana Ioghen, Maria Isabela Sarbu, Alexandra-Florentina Ion, Ela Ghita, Cristina-Iulia Mitran, Madalina-Irina Mitran, Vasile Benea, Mircea Tampa

Journal of Mind and Medical Sciences

Melanoma is one of the most aggressive tumors and its incidence is on the rise. The low rates of survival in metastatic melanoma has led to the development of new drugs for this type of patient, such as biological therapy which has shown remarkable results. This therapy is based on stimulation of the immune system to fight tumoral cells through: injection of cytokines with immunomodulatory properties (interleukin-2, alpha-interferon), vaccination with tumor antigens or immune cells that process tumor antigens, adoptive immunotherapy, inhibition of immune checkpoints (PD-1, CTLA-4), inhibition or stimulation of immune modulator molecules (OX-40, LAG-3), inhibition of signaling pathways …