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Europäische Wissenschaftliche Gesellschaft Home About the Journal Peer Review Editorial Board For Authors Reviewer Recognition Archiv Kontakt Impressum EWG e.V. indexing in the Clarivate Analytics indexing in the Emerging Sources Citation Index Crossref Member Badge Erfolgreich durch internationale Zusammenarbeit PUBLIC HEALTH DOI 10.35630/2022/12/psy.ro.5 Received 14 December 2022; Published 6 January 2023 BURNOUT RISK EVALUATION IN MEDICAL ONCOLOGY – RADIOTHERAPY PERSONNEL Laura Rebegea1,2 orcid id logo, Camelia Tarlungianu1 , Rodica Anghel3 orcid id logo , Dorel Firescu4,5, Nadejda Corobcean1,6, Laurentia Gales3 orcid id logo 1 Department of Medical Oncology - Radiotherapy, „Sf. Ap. Andrei” Emergency Clinical Hospital, Galati, Romania 2 Medical Clinical Department, Faculty of Medicine, „Dunarea de Jos” University of Galati, Romania 3 „Carol Davila” University of Medicine and Pharmacy”, Bucharest, Romania 4 IInd Clinic of Surgery, „Sf. Apostol Andrei” Emergency Clinical Hospital, Galati, Romania 5 Surgical Clinical Department, „Dunarea de Jos” University, Faculty of Medicine and Pharmacy, Galati, Romania 6 „Nicolae Testemitanu”State University of Medicine and Pharmacy. Chisinau, Moldova download article (pdf) laura_rebegea@yahoo.com, tarlungianucamelia@yahoo.com ABSTRACT Introduction: Even if, all studies evidenced that Burnout syndrome affects medical personnel from all medical specialties, the highest prevalence is in surgical, oncological and emergency medical specialties. Scope: Burnout syndrome evaluation in Medical Oncology and Radiotherapy personnel. Method and material: This study has involved 50 persons employee in Medical Oncology and Radiotherapy Department, from all categories: 11 superiors personal (medical doctors, physicists, psychologist), 31 nurses, and 8 auxiliary personnel (stretcher-bearer). The following questionnaires were used: professional exhaustion level questionnaire (with 25 items), questionnaire for attitude and adaptation in stressed and difficulties situations, BRIEF COPE and SES scale. Results: After professional exhaustion level questionnaire for superior personnel, emotional exhaustion prevalence, followed by reduced personal achievement and an accentuated increasing of affecting grade after first year of activity, with a pick around 10 years of activity were revealed. For nurses, share of depersonalization is relative homogenous, in moderate - low limits. The results revealed that 56% of personnel from this study have risk for burnout syndrome developing, without any prevention methods and 12% has already burnout syndrome. Conclusions: In general, this syndrome is under-evaluated and under-diagnosed, and its incidence can be diminishing by using the techniques of stress resistance, psychological counseling, cresting a friendly and tolerant professional climate.

Introduction: Immunohistochemistry is a widely used diagnostic technique in pathology, the antibodies used for unvailing a tissue’s origin being made up of proteins, more specifically aminoacids. Malignant peripheral nerve sheath tumors have a distinct immunohistochemistry profile, with great emphasis concerning those with rhabdomyoblastic differentiation being positive for S-100 protein, myogenin, vimentin, CD99, p63, GFAP, caldesmon, desmin, and p53 and Myo-D1 (the later two revealing the striated muscle differentiation). Materials and methods: A case study concerning a patient suffering from a moderately differentiated (G2) non-keratinizing squamous cell carcinoma of the lung highlighted the development of an undifferentiated sarcomatous proliferation on the left hemithorax, 7 years after the initial external radiotherapy treatment for the malignant lung tumor. Results: The immunohistochemistry analysis of the thoracic wall invasive tumor revealed it to be a malignant peripheal nerve sheath tumor with rhabdomyoblastic differentiation (Triton tumor) with the positivity for the specific aforementioned markers and a proliferation index – Ki67 of 90%. Chemotherapy was the elective treatment which was followed for 1 month, the patient having a rapid downward evolution towards exitus, with a 33 month post-diagnosis survival. Conclusions: This case was presented due to the rarity and difficulty of the diagnosis, consisting of a rare subtype of malignant peripheral nerve sheath tumor for which there is no therapeutic consensus and with an un-favorable prognosis.

Skin cancers are the most frequent types of malignant tumors worldwide, being mostly found in light-skinned populations, with a ratio of 30%. Approximately 3 million non-melanoma skin cancers and 132000 melanoma cases are diagnosed globally each year. The most frequent skin cancers are the basal cell carcinoma, squamous cell carcinoma and malignant melanoma. The incidence, morbidity and mortality of skin cancers are on the rise and have become a major public health concern. We aim to review the most important environmental factors involved in the development of skin cancers, along with the incidence rates and preventive behaviors or strategies (including personal behavioral changes and public educational initiatives). Ultraviolet radiation (UVR) is a well-known physical hazard, responsible for photoaging, photoallergy and phototoxic reactions, being heavily involved in carcinogenesis, including melanoma development. Overexposure to natural and artificial UVR is a public health problem. Sunburns, especially in childhood, are an important risk factor for melanoma development. Excessive exposure causes cumulative damage which determines immune suppression and skin cancer initiation. Transplant patients and AIDS patients have an increased incidence of skin cancer. Some treatment methods, including radiotherapy, phototherapy and psoralen and ultraviolet A (PUVA) therapy can lead to skin cancer development. Viral infections such as those with human papilloma virus can trigger the initiation of squamous cell carcinoma. Patients with familial genetic syndromes are highly sensitive to certain types of skin cancers. Ionising radiation, environmental pollutants, chemical carcinogenic agents and work exposure have been associated with skin cancer. Artificial UV radiation exposure (tanning beds and lamps), aging, skin color, personal diet and smoking are important risk factors. Ultraviolet radiation is the main etiological agent in skin cancer development. A better understanding of the causative factors is an essential step in skin cancer prevention.

According to statistical and epidemiological data, the contemporary period is dominated by an increase in malignant tumors with various locations. Several epidemiological studies, both epidemiological and clinical have indicated as the cause of cancer a combination of multiple factors. It seems that there is a tight connection between the external environmental factors, some of which are considered carcinogens, the lifestyle of each individual and endogenous factors. More than once, these factors have merged, so it becomes extremely difficult to highlight the contribution of each one of them in the process of neoplasia development. This study is a retrospective one; it includes 8972 patients diagnosed with different kinds of neoplasia in the ambulatory specialty clinic at the Emergency Clinical Hospital of Galati between 2013 and 2019. Associated to this study there is an in-depth analysis of the current literature which was done from the following perspective: incidence, epidemiology and etiology of cancer at a global level. During the analyzed period, we observed a slight increase in the incidence of cases with cancer located in the prostate area, the breast and colorectal. Malignant tumors of the breast registered the highest rate of incidence in 5 of the 7 years included in the study. In 2014 and 2018, the most frequent diagnosis was colorectal cancer. Although breast cancer was in the top of the incidence rates both in the first and the last years of the study, we noticed an increase in the number of cases in 2019 – 247, in comparison with 225 registered in 2013. As for the sex distribution, incidence was higher for the male patients. As a significant part of pathology, malignant tumors with various locations are an essential problem of public health, with a major impact on the population. Studying the environmental factors identified as being significantly responsible in the development of neoplasia, could allow categorizing the individuals exposed to pollution into risk groups.

The present article explores the usage of calcium alginate in the actual management of diabetic mellitus foot ulcers. A retrospective study was performed on 305 cases of patients with diabetic mellitus foot diagnostic, admitted to Surgery Clinic II of �Sf. Ap. Andrei� Emergency Clinical Hospital, Galati, in the period between 1st October 2015 and 31st October 2019, for which calcium alginate dressings had been used. Calcium alginate (C12H14CaO12)n dressings had been applied to all patients from the series (n=305), with favorable evolution in 97.7 % cases, the dressing being replaced at 48 hours and the average duration for injury�s healing oscillating from 21 up to 50 days.

COVID-19 pandemic represents a challenge for entire medical world, with profound implications in daily practice, making a compromise between risk of infection with SARS-COV2 and oncological treatment continuing, in conditions in which must be balanced, for each patient, the risk of infection with COVID-19. We are presenting the recommendations of professional societies and actions take in Radiotherapy Department of Sf. Ap. Andrei Emergency Clinical Hospital, Galati in order to limit the spread of COVID-19 infection and concomitant with radiotherapy performing, without compromising the quality of medical act. © 2020 Bucharest College of Physicians. All rights reserved.

The Primitive Gastric Lymphoma represents the extra-ganglionic non-Hodgkin lymphoma most frequently and comprises a large spectrum, ranging from the mucosa-associated lymphoid tissue (MALT) lymphoma to aggressive diffuse large B-cell lymphoma. The Primitive Gastric Lymphoma is a rare tumor, with an occurrence ranging from 4% to 20% of non-Hodgkin lymphomas and approximatively 5% of primary gastric neoplasms. The chronic gastritis secondary to the infection with Helicobacter pylori was considered a major predisposing factor for MALT lymphoma. The clinical evolution and the prognosis of this disease depend on the subtype and histopathological stage at the moment of the diagnosis. Due to its rarity, many aspects of this neoplasm remain still controversial.

Postoperative complications are common in patients with complicated colon cancers operated in Emergency. Most complications are those of the sound (suppurations, hematoma, dehiscence), postoperative ileus, anastomotic fistula. The purpose of this study is to evaluate the influence of the duration of the surgery on the postoperative complications in patients with complicated colon tumors, operated in emergency. We made a retrospective study on 451 patients treated for complicated colon cancers in the surgery clinics I and II of the Clinical Emergency County Hospital Galați between 2008 and 2017. In this study, we found all the 3 types of complications of colon tumors, but the most common was the intestinal obstruction. The operations varied from colostomies to subtotal and total colectomies. Most complications occured on the postoperatory days 4-8. The statistical analysis that we made revealed important statistical significance in the correlation of the postoperative complications and the duration of the surgical intervention (p value less than 0,001).The emergency colon cancer surgery has a high rate of postoperative complications, of which the most common are cardio-respiratory, parietal and fistulous. Their occurrence is directly influenced by the duration of the surgery.

Nasopharyngeal carcinoma (NPC) is an epithelial tumor, which develops most frequently from the lateral pharyngeal recess and holds some complex epidemiological characteristics. Its unusual race and geographic distribution suggests that not only the environmental factors are a contributing factor to the development of this rare cancer type, but also the genetic traits play an important role, along with nitrosamine-containing food consumption and Epstein-Barr virus infection. The signs and symptoms which a patient can present and suffer from are various and include nasal, otic, neurological as well as general ones; the way this tumor manifests being dependent on the stage of the tumor. The therapeutic management applicable in NPC needs to be established according to the case of the patient and include radiotherapy, chemotherapy, surgery, immune therapy, targeted therapy or combined treatment. The main objective of the treatment is local and regional tumor control; relapse is an important factor for future development of distant metastases. New therapeutic concepts are always sought of, current research focusing on precision medicine, meaning systemic treatment with a personalized radiotherapy approach according to the characteristics of the tumor.

Endometrial stromal sarcoma (ESS) is a rare tumor, predominantly occurring as a primary tumor of the uterus. Rare cases of primary extrauterine ESS (EESS) have been reported. Low-grade ESS (LG-ESS) is more common than high-grade ESS (HG-ESS). We present five cases of ESS and one case of EESS. All cases received external radiotherapy (EBRT) at the Radiotherapy Department of the Emergency Clinical Hospital ‘Sfantul Apostol Andrei’ Galati, during 2004-2020. Five cases underwent EBRT in two-dimensional (2D) technique and only one patient received EBRT with three-dimensinal conformational radiotherapy (3DCRT) technique with a linear accelerator, Elekta Synergy. Five patients were referred to postoperative radiotherapy after hysterectomy. The median age of the patients was 57.4 years. One patient was referred to radiotherapy with palliative intent. EESS localized in the retroperitoneum, in the para-aortic region, was identified in one 64-year-old patient with a personal history of hysterectomy and bilateral salpingo-oophorectomy in 1997; EESS was complicated with vertebral extension at the L1-L2 level and spinal cord compression syndrome. ESS represents a rare diagnosis and a high- or low-grade tumor profile is distinguished by immunohistochemistry (IHC) tests. Up to 30% of patients have EESS at presentation. The treatment of ESS is multimodal, its management requiring a multidisciplinary team, and it is different according to the primary tumor location and tumor staging. The role of adjuvant radiotherapy remains controversial in high-grade EESS and due to the rarity of these cases there are limited data concerning the efficacy of adjuvant EBRT available from prospective randomized control clinical trials.

The study presents an unusual case of a patient with a personal history of a rectal malignant tumor in 2013, who after a period of 6 years, was diagnosed with an advanced nasopharyngeal carcinoma, locally and regionally invasive. It is possible that the colorectal malignant tumor affected the development of the nasopharyngeal carcinoma, or the other way around, depending on the presence of genetic instabilities. These two types of malignant tumors share a series of genes that can influence their progression, i.e., SPINK-6 and Bcl-2. The particularity of this case stems from the development of a metachronous tumor, a rectal adenocarcinoma and nasopharyngeal carcinoma, two malignant tumors with different patient prognosis and disease progression. Research needs to be continued on the multidisciplinary therapeutic management of nasopharyngeal cancer and the ways of identifying this cancer type in its early stages, considering that most patients come from a rural environment, have poor medical education, a number of comorbidities, and who frequently ignore the signs, symptoms and sometimes the treatment offered.

Lung cancer is the main cause of oncological death in the US and worldwide, constituting a significant public health problem. The incidence of lung cancer is on the increase. In the present study, the diagnostic process was carried out and treatment options were considered to determine the therapeutic response of a patient diagnosed with lung cancer. The case of an early stage lung cancer patient who benefited from surgical treatment was presented. The pathology report stated the complete diagnosis to be pleomorphic lung cancer with an adenocarcinoma component, pT2aN0M0, with focal positivity for thyroid transcription factor 1 (TTF1), without epidermal growth factor receptor (EGFR) mutations and ALK recombinations, having an initial clinical stage of IB and programmed death ligand-1 (PD-L1) positivity with a tumor proportion score of over 70%. The patient underwent radiotherapy treatment and was administered osteoclast inhibitors and immunotherapy, with no favorable therapeutic effect and with the presence of secondary cutaneous adverse effects to pembrolizumab. As a main cause of death, lung cancer registers a low general survival rate even in patients with targeted therapies or immunotherapy. By better identifying the patients at risk, one can establish a more efficient personalized treatment; the future objective of scientific studies is the follow-up of adverse effects of new therapies.

Urosepsis is a very serious condition with a high mortality rate. The immune response is in the center of pathophysiology. The therapeutic management of these patients includes surgical treatment of the source of infection, antibiotic therapy and life support. The management of this pathology is multidisciplinary and requires good collaboration between the urology, intensive care, imaging and laboratory medicine departments. An imbalance of pro and anti-inflammatory cytokines produced during sepsis plays an important role in pathogenesis. The study of cytokines in sepsis has important implications for understanding pathophysiology and for development of other therapeutic solutions. If not treated adequately, urosepsis may lead to serious septic complications and organ sequelae, even to a lethal outcome.

Primary malignant melanoma of the small bowel is extremely rare. A limited number of cases was described in the specialty literature. The small bowel is most frequently affected by metastatic tumors of other primary lesions, especially epidermal. We report the case of a 77 years old male patient with primary bowel malignant melanoma, diagnosed histologically and immunohistochemically after segmental ileal resection. It was not discovered a primary lesion atskin, eye, anus and rectum levelor with other localization, through the investigations performed after surgery.

Dexamethasone is a synthetic glucocorticoid used for its anti-inflammatory and analgesic effect. In addition to these therapeutic indications, it is also recommended for nausea and vomiting treatment which may occur during the postoperative period, with impact on postoperative evolution, regarding the evolution of wound healing and length of stay (LOS), with a reflection on the costs of hospital admission. Therefore, their prevention is very important for both patients� comfort and a good recovery.

Non-small cell lung cancer (NSCLC) represents almost 80-85% of lung cancer cases. It is the most frequent malignancy after skin cancer. The therapeutic options for stage IV of disease consider histology, molecular characteristics, age, performance status, comorbidities, and not in the lust, patient�s option. This paper presents the case of a male patient, 73 years old, smoker, presented and treated in May 2016 in the Sf. Ap. Andrei Emergency Clinical Hospital Galati. The first sign of disease was inguinal and obturator right lymph node metastases whose histopathological test revealed metastases from malignant melanoma. Immunohistochemical tests (IHC) indicated undifferentiated carcinoma with lung as starting point, (Ck7 (+), TTF1 (+)). Thorax, abdominal and pelvic computed tomography (CT) imaging not evidenced space replacement processes in lung, but with mediastinal, right obturator and inguinal adenopathy. From personal pathological history we retain basocellular carcinoma in lumbar region, treated with surgery in 2009. It was initiated palliative chemotherapy and radiotherapy with remission of obturator and inguinal adenopathy, and at 9 months from diagnosis the Positron Emission Tomography (PET-CT) evidenced primary lung tumor situated in right superior lobe (RSL). At the present, patient is alive performing palliative chemotherapy. This case presented diagnostic and treatment issues, being a challenge for multidisciplinary team. We are mentioning the paucity of literature data regarding cases of primary tumors situated upper diaphragm which metastases in inguinal lymph nodes.

Cutaneous metastases from endometrial cancer are rare and unusual. This is the case of a 72 years old female patient, diagnosed in 2018 with G3 endometrial serous carcinoma (ESC). At 18 months from the surgical intervention, the patient developed bilateral inguinal lymph nodes metastases and skin secondary lesions; histological and immunohistochemical tests were performed. Computed tomography scan did not indicate visceral secondary lesions, local or regional relapses. We present the treatment practiced, the case's evolution and we discuss about epidemiology, molecular biology, treatment options and management of advanced and local lesions. The appearance of skin metastases in theses cases is associated with poor prognosis and treatment options are limited to palliative chemotherapy and radiotherapy.

The scope of the study was to identify the associated risk factors of lower limb lymphedema development in cervical and endometrial cancer patients. We retrospectively analysed 326 patients: 186 cases (57.06%) with cervical cancer and 140 cases (42.94%) with endometrial cancer were treated in Surgery, Radiotherapy, Oncology and Gynaecology Clinics of 'St. Apostle Andrew' Emergency Clinical Hospital Galati over 9 years. Adjuvant radiotherapy was performed in 83.57% of endometrial cancer cases. Adjuvant chemotherapy was performed in 45.16% of cervical cancer cases. Over 10 lymph nodes were removed in 74.73% of cervical cancer patients. Incidence of lymphedema was 15.05% in cervical cancer patients and 10% in endometrial cancer patients, P=0.06. Analysed risk factors for lower limb lymphedema occurrence were: Age, disease stage, radiotherapy, number of invaded lymph nodes (for cervical cancer patients), number of removed lymph nodes (for cervical cancer patients) and obesity. Multivariate analysis for associated risk factors of lower limb lymphedema development in cervical cancer showed that number of removed lymph nodes, OR=2.109 (0.907-4.903), P

The biochemical analysis in acute peritonitis follows the assessment of the objective severity degree sustained by endotoxicosis, homeostasis disorders and acid-base balance. We had monitored the biochemical peculiarities and correlations in acute peritonitis in children during a retrospective study statistically analyzed on a group of 127 patients in the period 2009-2014. The obtained results were consistent with the form and late phase of peritonitis.

Hypertriglyceridemia is the most common etiology after alcohol consumption and gallstones. The risk of acute pancreatitis occurrence increases at a triglyceride level of over 1000 mg / dL. We hereby present a rare pathological situation of a young patient of 24 years old with acute, necrotic-hemorrhagic pancreatitis induced by hypertriglyceridemia. The emphasis is on the importance of considering the rare etiologies of acute pancreatitis and on the application of more effective treatments.

Today the age of 60-65 years old is considered the seniority threshold. The structural, functional and metabolic alterations which occur following to the aging process determine an exacerbation of the impact which any aggression will have on the body. This retrospective study analyses a group of 245 patients with severe peritonitis, which had been hospitalized and treated in Surgery 2nd Clinic of the Sf. Apostol Andrei Emergency Clinical Hospital in the period 2007-2016. The median age 54 years old [range 30-95]; 68 patients (27.76% of cases) were ] 65 years old (65+) and 177 patients (72.24% of cases) with age between [ 65 years old (65-). Out of the results obtained, it is obvious the impact of age in the evolution and prognosis of bacterial peritonitis.

Introduction: Choosing the optimal treatment for patients with complicated colon cancer operated in an emergency remains a challenge. The study aims to identify the factors that influence the therapeutic decision in these patients. Patients and Methods: We included in this retrospective study 449 patients operated in emergency for complicated colon cancer, in the Clinical Emergency County Hospital "St. Ap. Andrei" Galati between 2008-2017. The patients data were collected from the observation sheets, the surgical, imaging and laboratory protocols. Results: The operations performed were: resections with a stoma in 37.63% of cases, resections with anastomosis in 36.97%, stomas in 16.26% and internal derivations in 9.13% of patients. Elderly age was correlated with stomas with or without tumour resection (p 0.05). Preoperative diagnosis of IDH was associated with resections with anastomosis, those with occlusion were associated with internal derivations and those with digestive perforations with resections with a stoma (p 0.05). The stomas were associated with the presence of intraoperatively detected complications (p 0.05). Conclusions: Complicated colon tumours operated on in an emergency require surgical treatment tailored to each patient. It is important to choose the type of treatment taking into account the patient's condition at admission, clinical-paraclinical data, tumour location, tumour complication and the presence of other complications detected intraoperatively.

Background: Cardiac metastasis may be encountered more frequently than primary cardiac tumors. They are discovered at autopsies with an incidence between 1.5 - 20%. The primary tumors that generate cardiac metastasis are malignant melanomas, lymphoma, the lungs, the breast, the esophagus. The organ most affected is the pericardium (62-81%). In 90% of cases from a clinical point of view, they are generally silent. In the case of patients diagnosed with breast cancer and who have undergone radiotherapy, differential diagnosis with fibrosis post radiotherapy interferes. The treatment is palliative and should be administered according to the primary location of the tumor and the patient's performance status. Case presentation: We are presenting the case of a 73-year-old diagnosed and treated for a breast neoplasm in the left breast in 2006. After a period of time of 9 years, the patient presents secondary sternal bone determination, radio-treated and for which she once again goes under hormonal therapy. In 2018, patient performed an imaging evaluation that revealed lung metastases. At the moment of stage review, performed in 2020, secondary epicardial determinations are noted. We present the case, the therapeutic management, diagnostic procedures and treatment and also, we discuss the data from literature. Conclusion: Cardiac metastases are rare and and in most cases are silent. The incidence has changed due to treatment options and imaging investigations. Stereotactic body radiation therapy can be considereda a therapeutic option in the cases with good performance status and with oligometastatic disease.

Introduction: The GIST tumors are very rare entities ( 1% of all tumors). They originate in the Cajal interstitial cells, which are part of the autonomic nervous system of the intestine. Their most common location is the stomach, followed by the small intestine. The aim of this paper is to present a very rare case of perforated ileal GIST, associated with Meckel diverticulum. Case report: A 71 years old patient with comorbidities is admitted in emergency for symptoms and signs of acute surgical abdomen. The exploratory laparotomy reveals generalized acute peritonitis due to perforated ileal tumor and Meckel's diverticulum. A segmental enterectomy is performed, with favorable postoperative evolution. The histological examination of the resection piece shows the appearance of GIST, confirmed immunohistochemically. Conclusions: The GIST tumors of the small intestine are unusual tumors and the spontaneous perforation and life-threatening hemorrhage are a rarity. The main treatment for this form of GIST is the resection, with a favorable clinical outcome.

The objective of this study is to determine a multivariate model able to perform the identification of the tumor stage and of the histopathological type for lung cancer patients, based on predictive environmental and behavioral factors. The database was built by using clinical and personal information about 106 patients with stage III or IV lung cancer and a mean age of 58 years, who were subjected to radiotherapy at the Radiotherapy Department of "Sf. Ap. Andrei" Emergency Clinical Hospital between January and December 2010. The following factors were taken into consideration: work conditions, smoking habits and duration of the exposure to risk factors. Most of the patients (43.33%) have worked in metallurgy for a mean of 27.54 years and 86.67% have smoked for a mean period of 26.92 years. The duration of smoking and the habit of smoking itself were identified by multiple linear regression as the most important predictive factors for tumor stage and for the histopathological type, respectively. Artificial intelligence techniques were used and the results have indicated that tobacco use and the environmental factors related to the work place (e.g. metallurgical industry) are the best predictive risk factors for the incidence of lung cancer.

In the human body there is an endocannabinoid system consisting of cannabinoid receptors and endogenous transmitters - the endocannabinoids (anandamides).This cannabinoid system works by certain principles: the presynaptic neuron releases the neurotransmitter that reaches the postsynaptic neuron, activating it; at this level endocannabinoids are synthesized, whichhave retrograde transmission through the synaptic gap, reaching the cannabinoid receptors where they can inhibit the anterograde release of neurotransmitters. At the same level, certain exogenous substances, derived from plants and called phytocannabinoids may also work, the most known one being tetrahydrocannabinol. 9-D-Tetrahydrocannabinol is a component extracted from hemp plant with intense psychotic action but also with some medical applications. The result of the cannabinoid system activity is to obtain certain psychoactive effects, euphoria, relaxation, intense sensory experiences, pain relief but also changes in perception, attention deficit, etc. Synthetic cannabinoids are obtained to mimic the effects of marijuana, are major cannabinoid receptor agonists and are at increased risk of toxicity. Chronic consumption of such substances can cause memory disorders, pulmonary disorders and, most importantly, addiction.