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Background and Hypothesis Meta-analyses have shown that the majority of patients with schizophrenia who have not improved after 2 weeks of treatment with an antipsychotic drug are unlikely to fully respond later. We hypothesized that switching to another antipsychotic with a different receptor binding profile is an effective strategy in such a situation. Study Design In total, 327 inpatients with an acute exacerbation of schizophrenia were randomized to double-blind treatment with either olanzapine (5–20 mg/day) or amisulpride (200–800 mg/day). Those patients who had not reached at least 25% Positive-and-Negative-Syndrome-Scale (PANSS) total score reduction from baseline after 2 weeks (the “non-improvers”) were rerandomized double-blind to either staying on the same compound (“stayers”) or to switching to the other antipsychotic (“switchers”) for another 6 weeks. The primary outcome was the difference in the number of patients in symptomatic remission between the combined “switchers” and the “stayers” after 8 weeks of treatment, analyzed by logistic regression. Study Results A total of 142 nonimprovers were rerandomized at week two. 25 (45.5 %) of the ‘stayers' compared to 41 (68.3 %) of the “switchers” reached remission at endpoint (p = .006). Differences in secondary efficacy outcomes were not significant, except for the PANSS negative subscore and the Clinical-Global-Impression-Scale. “Switchers” and “stayers” did not differ in safety outcomes. Conclusions Switching “non-improvers” from amisulpride to olanzapine or vice-versa increased remission rates and was safe. The superiority in the primary outcome was, however, not paralleled by significant differences in most secondary efficacy outcomes and the effect was only apparent at the last visit making replications of longer duration necessary.

Polycystic ovary syndrome (PCOS) is a hyperandrogenic endocrinological disorder associated with chronic oligo-anovulation and polycystic ovarian morphology. Compared to women without PCOS, women with PCOS have a risk of sexual dysfunction that is more than 30% higher. Although alterations in sex hormones and psychosocial wellbeing have been proposed, the precise mechanisms of FSD in PCOS remain unclear. The aim of our study was to analyze how the hormonal, clinical and psychometric parameters of PCOS patients are involved in the development of sexual dysfunction. The study group consisted of 54 women, aged between 21 and 32 years, diagnosed with PCOS. We collected the following parameters: age, body mass index (BMI), the Ferriman–Gallwey score (FG), maximum duration of oligomenorrhea, abdominal circumference (AC), free testosterone value (FT), luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio value, serum cortisol value and ovarian ultrasound appearance. At the time of the examination, patients were asked to fill in the Female Sexual Function Index (FSFI) and the Body Exposure during Sexual Activities Questionnaire (BESAQ). Statistically significant differences were observed between normal weight and overweight women regarding BESAQ (p-value = 0.02) and FSFI total (p-value

Atypical antipsychotics have numerous benefits compared to conventional ones in respect to the possible adverse effects. However, like the other ones, they may induce direct cardiovascular alterations, probably through the apoptotic effect of dopamine receptor D2 (DRD2) blockade. The main objective of the study was to assess the cardiac ejection fraction (EF) using transthoracic speckle tracking echocardiography (TSTE) in patients treated with long-acting injectable (LAI) atypical antipsychotics.This cross-sectional study was conducted on 123 patients with schizophrenia or schizoaffective disorder divided in four samples according to their treatment: Aripiprazole, Olanzapine, Paliperidone and Risperidone. We analyzed socio-demographic data, the intensity of psychiatric symptoms, the duration of psychosis and of LAI treatment, and the cardiac EF measured with TSTE.We found no statistically significant differences between the four antipsychotics regarding the values of the EF. Nevertheless, we observed a trend indicating that patients treated with an antipsychotic associated with a lower affinity for the DRD2, such as Olanzapine, have higher EF values than patients treated with antipsychotics with a stronger binding to the DRD2, such as Paliperidone and Risperidone. Patients receiving Aripiprazole, which has the strongest affinity for the DRD2 from all four antipsychotics but is also a partial DRD2 agonist, display higher EF values than those on Paliperidone and Risperidone.Antipsychotics with a lower affinity for the DRD2 or a partial agonism for it may be associated with higher EF. Cardiac monitoring should be performed periodically in patients on LAI antipsychotic therapy.

Background Rational use of medications and monitoring of prescriptions in elderly patients is important to decrease the number and duration of hospitalizations, emergency medical consultations, mortality, as well as medical costs. Purpose To identify potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs), and determine their prevalence based on the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) v2 criteria and Screening Tool to Alert doctors to Right Treatment (START) v2 criteria for patients aged >65 years. Methods This cross-sectional study was conducted in two rural counties in Romania based on electronic prescriptions for chronic conditions (EPCCs) issued from 30 days to 90 days by a specialist or general practitioner. Collected EPCCs were evaluated by an interdisciplinary team of specialists based on 26 STOPP v2 criteria and 10 START v2 criteria. Results PIM prevalence was 25.80% and PPO prevalence was 41.72% for 646 EPCCs. The mean age of patients was 75 years and the mean number of drugs per EPCC was four. The most frequently identified PIMs were treatment duration (6.65%), theophylline administration (5.72%), drug indication (4.64%), cyclo-oxygenase-2 non-steroidal anti-inflammatory drugs (1.39%), and zopiclone prescription (0.77%). Statins (24.76%), beta-blockers (8.04%), and beta-2 agonist/antimuscarinic bronchodilators (5.88%) were the most frequently identified PPOs. Conclusion PPOs were more prevalent than PIMs for elderly populations living in the two rural counties in Romania we studied. Health practitioners (family physicians, specialists, and pharmacists) should focus on prophylactic and curative considerations when prescribing agents to decrease the morbidity and mortality of elderly rural Romanian patients.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection induces a significant inflammatory response that are amplified by persistent stress. The pathophysiology of mental illnesses is explored in terms of inflammatory processes. Thus, anxious, depressed, or psychotic episodes may occur as a result of metabolic and immunological imbalances, as a direct result of their effect on the central nervous system, or as a side effect of the COVID-19 medication protocols. As such, the primary objective of this research is to establish if the psychological profiles of COVID-19 patients change substantially according to illness severity. The secondary objective is to determine if particular biological inflammatory indicators are associated with anxiety, sadness, psychoticism, and paranoid ideation. A cross-sectional study was performed on 90 hospitalized patients admitted during a 3-month period in the COVID-19 unit. All patients received the COPE-60 and SCL-90R questionnaires. Clinical and paraclinical data were collected and the information was classified according to the severity of COVID-19.The hyper-acute inflammation encountered in patients with severe COVID-19 infection characterized 80.0% of patients using disengagement coping methods, significantly more than patients with mild or moderate SARS-CoV-2 infection severity (p-value = 0.012), respectively, 73.3% severe COVID-19 patients engaging in emotion-focused coping strategies based on the COPE-60 scale (p-value = 0.037). Additionally, it was determined that negative coping mechanisms (disengagement) and emotion-focused methods are independent risk factors for developing psychoticism symptoms following acute SARS-CoV-2 infection, based on the SCL-90 questionnaire (OR = 2.07; CI = 1.44–3.01), respectively (OR = 2.92; CI = 1.44–3.01). Elevated white blood cells and monocytes and inflammatory markers, such as fibrinogen, procalcitonin, IL-6, and D-dimers, were also identified as risk factors for psychoticism symptoms in multivariate analysis. It is particularly important to consider the constant mental-state evaluation in patients with severe COVID-19 that might benefit from early intervention before psychotic symptoms onset.

In the last decades, both animal and human studies have neglected female subjects with the aim of evading a theorized intricacy of feminine hormonal status. However, clinical experience proves that pharmacological response may vary between the two sexes since pathophysiological dissimilarities between men and women significantly influence the pharmacokinetics and pharmacodynamics of drugs. Sex-related differences in central nervous system (CNS) medication are particularly challenging to assess due to the complexity of disease manifestation, drugs’ intricate mechanisms of action, and lack of trustworthy means of evaluating the clinical response to medication. Although many studies showed contrary results, it appears to be a general tendency towards a certain sex-related difference in each pharmacological class. Broadly, opioids seem to produce better analgesia in women especially when they are administered for a prolonged period of time. On the other hand, respiratory and gastrointestinal adverse drug reactions (ADRs) following morphine therapy are more prevalent among female patients. Regarding antidepressants, studies suggest that males might respond better to tricyclic antidepressants (TCAs), whereas females prefer selective serotonin reuptake inhibitors (SSRI), probably due to their tolerance to particular ADRs. In general, studies missed spotting any significant sex-related differences in the therapeutic effect of antiepileptic drugs (AED), but ADRs have sex variations in conjunction with sex hormones’ metabolism. On the subject of antipsychotic therapy, women appear to have a superior response to this pharmacological class, although there are also studies claiming the opposite. However, it seems that reported sex-related differences regarding ADRs are steadier: women are more at risk of developing various side effects, such as metabolic dysfunctions, cardiovascular disorders, and hyperprolactinemia. Taking all of the above into account, it seems that response to CNS drugs might be occasionally influenced by sex as a biological variable. Nonetheless, although for each pharmacological class, studies generally converge to a certain pattern, opposite outcomes are standing in the way of a clear consensus. Hence, the fact that so many studies are yielding conflicting results emphasizes once again the need to address sex-related differences in pharmacological response to drugs.

Patients with severe COVID-19 experience high-stress levels and thus are at risk for developing acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD). The present study aims to search for correlations between psychiatric response to stress and coping strategies among individuals with acute vs. remitted COVID-19. Ninety subjects with COVID-19 were included in the study, divided into two samples by disease category. Our focus was analysing the perceived stress intensity according to NSESSS and PCL-C-17 scales, and coping strategies with COPE-60. High NSESSS scores were found in 40% of acute patients, and 15.6% of remitted patients had high PCL-C-17 scores fulfilling the criteria for PTSD. We found a negative correlation between stress level and disease category. Acute patients used significantly more engagement and emotion-focused coping methods, but less disengagement types of coping than patients in the remitted phase. Remitted patients under high stress levels are prone to use disengagement and emotion-focused coping strategies. In conclusion, remitted COVID-19 patients experience lower levels of stress and use less emotion-focused strategies, except among those who developed PTSD post-COVID-19 infection, presenting with high-stress levels and using more disengagement and emotion-focused types of coping strategies.

Purpose This study aimed to assess the serum levels of intracellular adhesion molecule (sICAM-1), and vascular cell adhesion molecule (sVCAM-1), in the first psychotic episode schizophrenia (SZ) patients, before and after six months of antipsychotic treatment. Patients and methods The study included 50 patients with a first hospitalization for SZ and 50 healthy control subjects that were patient-matched regarding age, gender, body mass index and smoking status. The evaluation included the presence of cardiovascular risk factors, measurements of systolic and diastolic blood pressure, body mass index, smoking status, ankle-brachial index, carotid intima-media thickness, and echocardiography. The Brief Psychiatric Rating Scale (BPRS) score was calculated for the patients. The plasma levels of fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, sICAM-1 and sVCAM-1 were determined at baseline in all subjects and after six months of antipsychotic treatment. Thirty patients (60%) were treated with olanzapine and 20 (40%) with risperidone. Results The average age of patients experiencing their first episode of SZ was 29.7±6.6 years, and 23 (46%) were men. The initial sICAM-1 levels of the patients were lower than those of the control group (P Conclusion In the patients experiencing an FEP of SZ, the levels of sICAM-1 were lower, while the levels of sVCAM-1 were higher than in the healthy control subjects. The antipsychotics used in the treatment of schizophrenia increased sICAM-1 and decreased sVCAM. The baseline level of sVCAM-1 was an independent predictor of a BPRS score >120 at baseline.

Caudate nucleus (CN) is a specialized part of the dorsal striatum of each brain hemisphere involved in numerous cognitive processes. Caudate dysfunctions are associated with Alzheimer’s, Parkinson’...

Purpose Among other non-motor symptoms, theory of mind (ToM), the ability to recognize, understand and infer others' mental states, beliefs, intents and wishes, has been shown to deteriorate during the course of Parkinson's disease (PD). It has been speculated that ToM impairments could be related to cognitive deficits in PD. However, the current state of literature suggests that there is heterogeneity regarding the involvement of cognitive functioning in the relationship of PD and ToM. The study aimed to measure affective ToM abilities and cognitive performance in a sample of PD patients, to explore the link between affective ToM abilities and cognitive status, and to examine the impact of PD on affective ToM through the mediator effect of cognitive performance. Patients and methods Sixty-five patients diagnosed with idiopathic PD and 51 healthy controls matched for age, gender and educational level completed a visual affective ToM task (Reading the Mind in the Eyes - RMET), cognitive performance was evaluated with Montreal Cognitive Assessment, and psychiatric symptoms were measured with BPRS-E (Brief Psychiatric Rating Scale). Results Affective ToM abilities were preserved in early PD patients, declining as the disease progressed. Deficits in cognitive functioning predicted deficiencies in affective ToM. Although attention (AT), executive functions (EF) and visuospatial abilities (VSA) together mediated the relationship between PD and affective ToM, only VSA impairment had a specific negative impact on affective ToM. Moreover, 41% of the total effect of attention and executive functions on affective ToM was mediated by visuospatial skills. Conclusion Cognitive performance may have an impact on the relationship between PD and affective ToM through the involvement of VSA. The influence of AT and EF in this relationship appears to be also exerted by PD patients' VSA.

Psychotic disorders represent a serious health concern. At this moment, anamnestic data, international criteria for diagnosis/classification from the Diagnostic and Statistical Manual of Mental Disorders-5 and the International Classification of Diseases-10 and diagnostic scales are used to establish a diagnosis. The most commonly used biomarkers in psychotic illnesses are those regarding the neuroimmune system, metabolic abnormalities, neurotrophins and neurotransmitter systems and proteomics. A current issue faced by clinicians is the lack of biomarkers to help develop a more accurate diagnosis, with the possibility of initiating the most effective treatment. The detection of biological markers for psychosis has the potential to contribute to improvements in its diagnosis, prognosis and treatment effectiveness. The mixture of multiple biomarkers may improve the ability to differentiate and classify these patients. In this sense, the aim of this study was to analyze the literature concerning the potential biomarkers that could be used in medical practice and to review the newest developments in electrochemical sensors used for dopamine detection, one of the most important exploited biomarkers.

The important prevalence of autoimmune thyroid disease (AITD) in the general population was the main motivation for conducting the present study. The present paper aims to estimate the possible comorbidities related to female sexual dysfunction (FSD) and depression related to AITD. The study group consisted of 320 patients: 250 cases known with untreated AITD, divided into subgroups (euthyroid subgroup, subclinical hypothyroidism subgroup and clinical hypothyroidism subgroup); respectively 70 healthy females in the control group. Patients underwent thyroid evaluation, ovarian evaluation and laboratory assays. At the time of the diagnosis of autoimmune thyroid disease, psychometric scales were filled in by the patients: the Female Sexual Function Index 6 (FSFI-6) and the Beck’s Depression Inventory-II (BDI-II). It was observed that healthy patients had significantly higher FSFI scores than patients with AITD (28 vs. 27; p = 0.006). In the AITD group, the risk of FSD increases with the severity of thyroid disease. The most affected areas were: sexual desire (p < 0.001), lubrication (p = 0.001) and orgasm (p = 0.008), followed by excitability and sexual satisfaction. The severity of hypothyroidism influences the degree of decrease in libido, central and peripheral excitability. Sexual satisfaction and orgasm were less influenced. The field related to pain seems uninfluenced by the presence of thyroid disease. The concomitant presence of depression and the value of thyroid-stimulating hormone (TSH) are risk factors in the development of FSD. Higher TSH value and BDI-II score increase the risk of female sexual dysfunction by 1.083 and 1.295 times, respectively. Our findings are significant and promising; they may help professionals dealing with sexual and reproductive health. Despite the importance of female sexual dysfunction and its prevalence, clinicians and patients often ignore it. In fact, only a small percentage of patients consult their doctors about sexual health, and their doctors do not often ask them questions related to this aspect.

Schizophrenia is a functional psychosis with a multifactorial etiopathogeny involving genetic, endocrine and immunological risk factors. The main pathogenic hypothesis involves dopamine dysregulation, with hyperfunction in the limbic system and hypofunction in the prefrontal cortex. Normal dopamine activity is critical for cognitive and emotional processing, but also for autonomic and immune regulation. Co-morbidity between schizophrenia and cardiovascular anomalies is complex. Genetic factors influence the development of brain, cardiac and vascular structures, as well as the activity of enzymes involved in dopamine synaptic turnover. Autoimmunity triggered by infections or related to systemic diseases affects both brain and heart in a direct manner through autoantibodies and/or indirectly through microvascular injury. In most cases, the co-morbidity between schizophrenia and cardiac diseases is secondary to metabolic dysfunctions induced by psychotropic medication or psychosis itself. Because of their diverse pharmacodynamic profiles, antipsychotics differ in their propensity to facilitate the development of the metabolic syndrome. The distress associated with acute psychotic symptoms or a sedentary lifestyle due to negative symptoms may have a negative impact on the energetic metabolism or cardiac function. Conclusions: An interdisciplinary approach is required between neurosciences and cardiology not only at the research level, but also in the clinical practice. Cardiac co-morbidity in subjects with schizophrenia may critically affect the survival rates of these patients. Moreover, the nature of the cardiac co-morbidity may guide the clinician in better understanding and differentiating functional psychoses from organic ones. The multifactorial approach can identify cardiovascular risk factors based on clinical, biological and neuroimaging markers.

Background: In Romania, foreign medical students have the possibility to learn the same curricula in Romanian, English, or French. The purpose of the study: To compare students’ satisfaction with training and future career opportunities from the perspective of Romanian and foreign students. Methods: The study was conducted for terminal year medical students divided into two samples, Romanian and foreign language students. The participants were invited to fill in a satisfaction questionnaire about their professional training and to express preferences for future career. Results: Foreign students were more satisfied with the lectures and the teaching staff. They attended optional lectures more frequently in comparison with Romanian students. Foreign students were more inclined to attend medical conferences and to enroll in PhD programs. While Romanian students were more inclined to consider emigration, foreign students prefer to practice in their native countries. Conclusions: Compared to their Romanian colleagues, foreign students were more engaged in educational and research activities.

Radu-Stefan Romosan, Liana Dehelean, Virgil-Radu Enatescu, Ana Cristina Bredicean, Ion Papava, Catalina Giurgi-Oncu, Ana-Maria Romosan Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Purpose: Medical students’ personality traits, emotion regulation strategies, and empathic behavior are considered powerful predictors for their future achievements, professional adjustment, and mental strength. Coping strategies such as “self-blame,” “rumination,” “catastrophizing,” “blaming others,” lack of empathy, decreased emotion recognition abilities, and neuroticism are maladaptive and, thus, less desirable traits in medical professionals. The purpose of the study was to comparatively assess and find potential correlations between personality traits, empathy levels, emotion recognition abilities, and cognitive emotion regulation strategies of three medical student samples: general medicine (GM), dental medicine (DM), and general nursing (GN) students. Patients and methods: This cross-sectional comparative study was conducted throughout the second semester of 2017, during Psychiatry class, on 306 medical undergraduates of the “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania. Personality was assessed by using Neuroticism–Extraversion–Openness to Experience Five-Factor Inventory (NEO-FFI). Cognitive emotion regulation strategies were identified using the Cognitive Emotion Regulation Questionnaire (CERQ). Empathy quotient (EQ) was used to measure empathy levels. Emotion recognition abilities were evaluated with the Reading the Mind in the Eyes test (RMET). Results: GM students scored significantly higher than both DM and GN students in blaming others (CERQ) and significantly higher than GN students in “neuroticism” (NEO-FFI). GM and DM students obtained significantly lower scores than their GN colleagues in “agreeableness” (NEO-FFI) and empathy (EQ). Compared to DM students, GN students gave significantly more correct answers in RMET. Neuroticism was associated with less efficient coping mechanisms (self-blame, rumination, catastrophizing, blaming others) and lower empathy scores. Empathy correlated negatively with blaming others and was positively associated with agreeableness and emotion recognition abilities. Conclusion: The differences found between the student samples can be consequences of several overlapping factors. Certain personality traits may predispose individuals to maladaptive coping responses, increased vulnerability to stress, and lower empathy levels. The results of this study can be viewed as baseline data for future, more comprehensive, longitudinal analyses. Keywords: undergraduate, education environment, medical education research, dental students, nursing students&nbsp

Background: While medical and polytechnic education systems seem dissimilar in approach, they both share a certain level of difficulty. After graduating, polytechnic students find easy employment in national or multinational companies, whereas medical students are presented with more job opportunities abroad. The purpose of the study was to compare students’ satisfaction with training and career preferences from a technical and a medical perspective. The methods were as follows: the study participants were divided in two samples (polytechnic and medical undergraduates) and asked to fill in a satisfaction questionnaire regarding their professional training. In addition, they were invited to express options about the intended future career. Results: we found no differences between the two samples regarding the participants’ satisfaction with teaching staff and labs. Polytechnic students have more Ph.D. opportunities while medical students were more involved with participation in conferences. Satisfaction with lectures and practical projects was significantly higher among medical students. Conclusions: Both polytechnic and medical students rate their training as satisfying, and half of them consider leaving the country.

The aim of this study was to develop a method for identification and quantification of diazepam and its major metabolite, desmethyldiazepam in plasma samples in psychiatric patients. Liquid - liquid extraction (LLE) procedure was applied in order to simplify the pre-analytical phase, followed by gas chromatography � mass spectrometry (GC-MS) detection and gas chromatography � flame ionization (GC-FID) quantitation.

The gangliosides (GGs) of the central nervous system (CNS) exhibit age and topographic specificity and these patterns may correlate with the functions and pathologies of the brain regions. Here, chloroform extraction, nanoelectrospray (nanoESI) negative ionization, together with Orbitrap high resolution mass spectrometry (MS) determined the topographic and age-related GG specificity in normal adult human brain. Mapping of GG mixtures extracted from 20 to 82 year old frontal and occipital lobes revealed besides a decrease in the GG number with age, a variability of sialylation degree within the brain regions. From the 111 species identified, 105 were distinguished in the FL20, 74 in OL20, 46 in FL82 and 56 in OL82. The results emphasize that within the juvenile brain, GG species exhibit a higher expression in the FL than in OL, while in the aged brain the number of GG species is higher in the OL. By applying MS/MS analysis, the generated fragment ions confirmed the incidence of GT1c (d18:1/18:0) and GT1c (d18:1/20:0) in the investigated samples. The present findings are of major value for further clinical studies carried out using Orbitrap MS in order to correlate gangliosides with CNS disorders.

Objective We aimed to investigate the influence of depression and self-esteem on oral health-related quality of life (OHRQoL) in students. Methods Among the 67 included participants, we measured self-esteem using the Rosenberg Self-Esteem Scale, severity of depression using the Patient Health Questionnaire-9 (PHQ-9), personality dimensions with the Neuroticism–Extraversion–Openness Five-Factor Inventory, and OHRQoL using the Oral Health Impact Profile 49 (OHIP-49). Results Among all participants, 7.5% (n = 5) had the dominant personality trait openness to experience, 11.9% (n = 8) presented a neurotic personality type, and 64.% (n = 11) had an extraverted personality type. The most frequent was conscientious personality type, accounting for 64.2% (n = 43) of participants. Our results showed a significant correlation between increased PHQ-9 scores and OHIP scores (Spearman’s r = 0.280); thus, participants with poorer oral health tended to have more severe depression. An increase in depression severity was significantly and positively correlated with increased scores across the other two OHIP subcategories, physical pain (Spearman’s r = 0.314) and physical disability (Spearman’s r = 0.290). Conclusion The presence and severity of depression influences OHRQoL. An important factor in the presence of depression and level of self-esteem is the personality type, especially the neuroticism dimension.

Background Antipsychotic medication, stress, gender, and age are factors that influence prolactin levels in patients with psychosis. The aim of the study was to investigate the level of prolactin response to antipsychotic treatment in acute patients, taking into account the total duration of psychosis. Methods and findings The study was conducted on 170 acute patients with schizophrenia spectrum disorders and bipolar disorder. Subjects were divided into three subgroups according to the duration of the psychosis (less than 5 years, between 5 and 10 years and more than 10 years of disorder duration). The initial prolactin response under antipsychotic treatment was measured, while the severity of the psychiatric symptoms was assessed with the BPRS (Brief Psychiatric Rating Scale). Hyperprolactinemia was found in 120 (70.6%) patients, amongst which 80 (66.7%) were females and 40 (33.3%) were males. The average increase in prolactinemia was 2.46 times the maximum value in women, and 1.59 times in men. Gender (β = 0.27, p

Background: Medical education aims to ensure objective knowledge and fine skills in students. In this respect useful data may come from students’ perceived satisfaction with their training. Purpose of the study: To compare general nursing and medical students’ satisfaction with their training. Methods: Nursing and medical students were asked to rate their satisfaction with the medical training and express preferences regarding their intended future career. Results: No differences were found between the two samples regarding satisfaction with lectures. Nursing students were more satisfied with the teaching staff and relied exclusively on professor provided information, while medical students attended more optional lectures and case presentations. They were also more involved in research and conference participation. Students’ intentions about future practice (hospital / ambulatory) and emigration were similar in both samples. Conclusions: Less satisfied by the teaching staff, medical students appear to be more involved in their theoretical and practical training. Both nurses (48.6%) and medical students (53.3%) consider leaving the country after graduating.

Considering the devastating effects of neurodegenerative disorders and the increasing number of people affected by them, an early diagnosis even presymptomatic, prior to serious mental deterioration is necessary. Therefore, screening for biomarkers, especially glycolipids, in the biological matrices, either tissues or body fluids has proven to be of a great help in establishing an early diagnosis of the disease.The present chapter, divided into three parts, highlights the implementation and modern applications of the most avant-garde mass spectrometry (MS) techniques characterized by speed, sensitivity and data accuracy for de novo identification and monitoring of glycolipids with potential biomarker role. The first section reviews the etiology, epidemiology, clinical picture, as well as the current diagnostic methods for four of the most frequent neurodegenerative disorders: Parkinson's disease, Alzheimer's disease, Lewy body dementia and fronto-temporal dementia. The second section is dedicated to the role of glycolipids as biomarkers of these severe conditions. In the last part of the chapter, the state of the art in terms of mass spectrometry techniques for the detection of extremely valuable glycolipid biomarkers is described in detail. The proficiency of the MS, to be considered as and further developed into a routine method for early detection of neurodegenerative disorders, is also emphasized in the chapter.

This study assesses the empathy level, cognitive performance and emotion recognition skills of remitted patients with schizophrenia, schizoaffective disorder and bipolar disorder, and also explores the relationship between impairments in the mentioned domains. The study was performed on 77 subjects divided into two groups: PAT sample (N = 37) included remitted patients with either schizophrenia, schizoaffective or bipolar disorder who were compared with healthy control subjects from the HC sample (N = 40). Along with sociodemographic and clinical data, empathy levels (using EQ (Empathy Quotient) scale), the ability to recognize another person’s emotional state (using RMET (Reading the Mind in the Eyes Test)), and cognitive performance (using MoCA (Montreal Cognitive Assessment) Scale) were investigated. The intensity of the psychiatric symptoms was measured with BPRS-E (Brief Psychiatric Rating Scale—Expanded). The remitted patients had lower EQ (p = 0.02) and RMET (p &lt, 0.0001) scores than the healthy subjects. In the PAT group, RMET scores were positively correlated with MoCA total scores. Both EQ and RMET scores were negatively correlated with BPRS-E total scores. Psychiatric disorder was a significant predictor for deficits in emotion recognition. There were no significant differences in RMET, EQ and MoCA scores between patients with respect to diagnosis, the type of antipsychotic or the associated medication. In both samples, females had higher empathy levels (p = 0.04) and better emotion recognition abilities (p = 0.04) than males. Patients with schizophrenia, schizoaffective or bipolar disorder, currently in remission, displayed lower empathy levels and poorer emotion recognition skills than healthy subjects. Poor emotion recognition skills were associated with symptom severity and impairments in global cognition.

Minodora Andor,1,* Liana Dehelean,2,* Ana-Maria Romosan,2,* Valentina Buda,3 Gabriela Radu,1 Florina Caruntu,1 Aurora Bordejevic,1 Minodora Marinela Manea,4 Ion Papava,2 Cristina Ana Bredicean,2 Radu Stefan Romosan,2 Mirela Tomescu1 1Medical Semiology II, Department of Internal Medicine I, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania; 2Discipline of Psychiatry, Department of Neurosciences, “Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania; 3Pharmacology and Clinical Pharmacology, 2nd Department, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania; 4Department of Psychology, Medical Education, “Iuliu HaÅ£ieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania *These authors contributed equally to this work and thus share first authorship Purpose: This research article assesses the cardiovascular impact of long-term injectable antipsychotic therapy on patients diagnosed with schizophrenia spectrum disorders. In our study, we attempted to quantify the potential causes of cardiovascular damage, assess cardiovascular parameters, and correlate them with the time elapsed from the onset of the psychosis until the initiation of injectable antipsychotic therapy, as well as the duration of long-acting therapy, and finally, to compare two of the most utilized long-acting injectable (LAI) medications (olanzapine vs risperidone).Patients and methods: This cross-sectional study recruited 64 patients of 2 outpatient clinics undergoing treatment with LAI antipsychotics for schizophrenic spectrum disorder. The study reports outpatients’ clinical data, laboratory blood sample findings, routine echocardiography, as well as speckle tracking echocardiography.Results: Among patients with longer durations of pre-long-acting antipsychotic treatment, body mass indices, mitral velocity wave values (E and A waves), and the global longitudinal strain (GLS) measurements significantly correlated with patients’ myocardial contractility. The study also found that GLS was significantly lower in the group in which pre-LAI duration was prolonged, and was not influenced by the duration of LAI treatment. Furthermore, patients receiving olanzapine showed significantly improved myocardial contractility as measured by the aforementioned parameters, in comparison with patients treated with risperidone.Conclusion: The results of our study indicate that patients suffering from schizophrenia and who are left untreated or poorly treated for a longer period of time may develop myocardial impairment. The changes may be both secondary to a high prevalence of cardiovascular risk factors and may also be generated by the disease per se. The group who received olanzapine demonstrated improved results for a longer period of time without proper medication. Keywords: schizophrenic patients, speckle tracking echocardiography, myocardial dysfunction

Considering the devastating effects of neurodegenerative disorders and the increasing number of people affected by them, an early diagnosis even presymptomatic, prior to serious mental deterioration is necessary. Therefore, screening for biomarkers, especially glycolipids, in the biological matrices, either tissues or body fluids has proven to be of a great help in establishing an early diagnosis of the disease.

Schindler disease is an inherited metabolic disorder caused by the deficient activity of α-N-acetylgalactosaminidase enzyme. An accurate diagnosis requires, besides clinical examination, complex and costly biochemical and molecular genetic tests. In the last years, mass spectrometry (MS) based on nanofluidics and high-resolution instruments has become a successful alternative for disease diagnosis based on the investigation of O-glycopeptides in patient urine. A complex mixture of glycoforms extracted from the urine of a 3-year-old patient was investigated by Orbitrap MS equipped with Nanospray Flex Ion Source in the negative ion mode. For structural characterization of several molecular species, collision-induced dissociation MS2–MS3 was carried out using collision energy values within 20–60 eV range. By our approach, 39 novel species associated to this condition were identified, among which O-glycopeptides, free O-glycans and one structure corresponding to an N-glycan never characterized in the context of Schindler disease. The experiments conducted at a resolution of 60 000 allowed the discrimination and identification of a total number of 69 different species with an average mass accuracy of 9.87 ppm, an in-run reproducibility of almost 100%, an experiment-to-experiment and day-to-day reproducibility of about 95%. This study brings contributions in the diagnosis of Schindler disease through the elucidation of potential biomarker species in urine. Our multistage MS results completed with 39 new glycoforms the inventory of potential biomarker structures associated to Schindler disease. For the first time, an N-glycan was identified and structurally characterized in Schindler patient urine, which opens new research directions in the field. Copyright © 2015 John Wiley & Sons, Ltd.

After the enlargement of European Community, the access to work in different European Union countries became easier. An increasing number of postgraduate trainees (residents) chose to leave their country for better financial conditions, working facilities, and research opportunities. The aim is to identify those factors that describe important characteristics of the Romanian postgraduate medical training from the residents’ perspective. The study was conducted in two samples of Romanian trainees: psychiatric and non-psychiatric residents from university hospitals. Residents were asked to fill in a questionnaire regarding their satisfaction about the postgraduate medical training. Also, they were asked to express preferences about their future medical perspectives there are no significant differences between psychiatric and non-psychiatric trainees. Most residents rate an average financial situation. Although their satisfaction regarding hospital practice is moderate, they rate a good relationship with the attending physicians. Because the training takes place in university hospitals, residents have access to conferences, lectures and case presentation. Very few have access to PhD opportunities, to sponsored pharmacologic studies, or to psychotherapy. The majority of the trainees would prefer to remain in their country, close to their families. Residents rate the medical training system as satisfying, but because of limited working opportunities after finishing residency, they consider living the country.

The nature of this profession requires the development of adequate defensive and coping styles. Also to have chosen this for your career might mean to have some particularities in these areas. The evaluation of coping and defense style mechanisms for residents in psychiatry that conduct clinical work. A descriptive study was developed to determine and evaluate defensive and coping styles for residents in psychiatry. DSQ-60 and COPE scales were applied on a 31 willing resident in psychiatry from approximate 50 residents in total from the center in which the study was conducted. The most frequent mechanisms found on the evaluated group are: “Altruism”,”Self-observation” – superior defense styles and “Positive interpretation and growth” - an emotion focused coping style and „Planning” – a problem focused coping style. The chosen profession can be a factor that underlines some inborn abilities but also a modulating factor for one's structure. The developing of adequate coping and defense styles might be a requirement for becoming a psychiatrist or it might be a gain for someone working in this field day by day.

Schindler disease is an inherited metabolic disorder caused by the deficient activity of α-N-acetylgalactosaminidase enzyme. An accurate diagnosis requires, besides clinical examination, complex and costly biochemical and molecular genetic tests. In the last years, mass spectrometry (MS) based on nanofluidics and high-resolution instruments has become a successful alternative for disease diagnosis based on the investigation of O-glycopeptides in patient urine. A complex mixture of glycoforms extracted from the urine of a 3-year-old patient was investigated by Orbitrap MS equipped with Nanospray Flex Ion Source in the negative ion mode. For structural characterization of several molecular species, collision-induced dissociation MS

Many patients do not respond to the first antipsychotic drug prescribed, but require multiple trials with different drugs before response is achieved. Current treatment guidelines vary substantially in their recommendations as to how long clinicians should wait before an antipsychotic treatment attempt should be considered as failed and the compound switched. It has, however, recently been shown that poor early response to an antipsychotic is associated with continuous poor later response in the course of the same treatment attempt. This finding suggests that patients who do experience poor early response might benefit from a switch in antipsychotic medication as early as 2 weeks after treatment initiation. In the SWITCH trial, 350 patients suffering from an acute episode of schizophrenia are randomly assigned to double-blind treatment with either olanzapine or amisulpride. The primary endpoint is symptomatic remission at week 8. Patients not experiencing at least minor response after 2 weeks are randomized again to either staying on the initially assigned drug or being switched to the alternative compound for another 6 weeks. In case early switching proves superior to maintaining treatment, time wasted for unsuccessful treatment attempts could be minimized, patients' outcomes improved, duration of hospital stays reduced, and thus overall treatment expenses saved. The current report will present the methods of the trial, focusing on various specific features which could be adopted by future studies.

Passing electric current through the human body leads to a phenomena which permits to define some equivalent electric circuits. Thus, an original measuring device was conceived along with a digital control unit based upon a PIC18F87x microcontroller. Data processing requires a link between the measuring device and a Personal Computer executing a specific software which will be presented as follows.

Ion Papava,1 Cristian Oancea,2 Virgil Radu Enatescu,1 Ana Cristina Bredicean,1 Liana Dehelean,1 Radu Stefan Romosan,1 Bogdan Timar3 1Department of Neurosciences – Discipline of Psychiatry, 2Department of Infectious Diseases, 3Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Background and objectives: Chronic obstructive pulmonary disease (COPD) is one of the most debilitating somatic diseases, having anxiety and depression frequently as comorbidities. The coping style, the way in which the subject manages to control the difficult and stressful situations of life, can influence its evolution and also the existence of the comorbidities. In this study, coping styles in a group of subjects with COPD and their association with the intensity of depressive and anxiety symptoms as well as medical determinants were identified. Materials and methods: In this cross-sectional study, 28 male patients with COPD risk classD were enrolled. The patients performed spirometry tests, Borg scale, 6-minute walking test, Hospital Anxiety and Depression Scale, and COPE Inventory were recorded. Results: According to their higher coping subscale score, the depression score was the highest in patients with avoidance-type coping and the lowest in patients with problem-focused coping (11.0 vs 5.6; P=0.042), respectively, patients with social support-focused coping having the highest anxiety score in contrast to patients with emotion-focused coping, which had the lowest anxiety score (11.6 vs 5.0; P=0.006). Regarding respiratory parameters, significant differences were present for the variation of the medians between the four groups only for forced vital capacity (FVC%) (thelowest FVC% was in patients with predominant social support-focused coping and the highest in patients with problem-focused coping) and 6-minute walking test (%) (the lowest score for patients with social support-focused coping and the highest value in patients with avoidance-type coping). Problem-coping score was significantly and positively associated with FVC% (Spearman’s r=0.400; P=0.035), emotion-focused coping score was significantly and positively associated with FVC% (Spearman’s r=0.395; P=0.038), and social support-focused coping score was negatively and significantly correlated with forced expiratory volume in 1 second/FVC% ratio (Spearman’s r=0.389; P=0.041). A significant, negative correlation was found only between depression score and forced expiratory volume in 1 second (Spearman’s r=-0.435; P=0.026) with respect to psychiatric symptoms. Conclusion: Coping styles in patients with COPD affect the intensity of associated depressive and anxiety symptoms as well as medical determinants, thus the coping style should be considered an important part in the multidisciplinary approach of these patients. Keywords: COPD, COPE, Hospital Anxiety and Depression Scale, depression, anxiety

Targeting of the phenomena which arises when the electric current is passing through the human body leads to the definition of some equivalent electric circuits. The parameters of the passing segment of the current through the skin were studied. For this, an original measuring device was conceived and built using a digital control unit based on a PIC16F870 microcontroller.