Frequency of sexual dysfunction in outpatients with severe mental illness in Greece

INTRODUCTION: Patients with psychosis can develop sexual dysfunction, which may be related to the disease itself, psychosocial factors, somatic comorbidities, and the use of psychotropic medication. OBJECTIVE: We aimed to investigate the type and frequency of sexual dysfunction in patients diagnosed with schizophrenia or bipolar disorder in order to assess the side effects of antipsychotics in sexual function. METHODS: This is a multicenter, cross-sectional study, involving patients diagnosed with schizophrenia (79.3%) or bipolar disorder (20.7%) treated in the Department of Psychiatry and Community Mental Health Centers from November 2018 to December 2019. Patients were enrolled in the study after signed informed consent. Demographic and clinical data were collected from patients through a semi-structured interview. The Antipsychotics and Sexual Functioning Questionnaire (ASFQ) was administered to assess sexual function. RESULTS: A total of 87 outpatients on antipsychotics were recruited in the study. The mean age was 43.6 years, while the mean duration of the disease was 16.9 years. Overall, only 9.1% of patients spontaneously reported sexual dysfunction. Patients treated with oral first-generation antipsychotics had more difficulties in achieving orgasm and decreased erection capacity. In contrast, patients treated with oral second-generation antipsychotics had decreased ejaculation capacity. Patients on antipsychotic combination therapy were associated with higher rates of sexual anhedonia. DISCUSSION: These results suggest that sexual dysfunction is a side effect of antipsychotic treatment, which was spontaneously rarely reported by patients. It seems essential to obtain a psychosexual clinical history before initiating antipsychotic treatment to evaluate following changes and adopt an individualized strategy to manage sexual dysfunction induced by antipsychotics

Translation and Validation of the Greek Version of the Antipsychotics and Sexual Functioning Questionnaire (ASFQ)

Introduction Sexual dysfunction in patients with psychoses may be associated with the psychiatric illness itself (negative symptoms, such as apathy, and avolition), comorbid somatic health, psychosocial factors (stigmatization, discrimination), and the use of psychotropic drugs. In Greece, research into the study of antipsychotic-induced sexual dysfunction is not sufficient. Aim This study was conducted to translate and validate the Greek version of the Antipsychotics and Sexual Functioning Questionnaire (ASFQ) in a sample of patients receiving antipsychotic treatment. Methods A “forward-backward translation” method was applied. A pilot study was conducted with 15 outpatients with schizophrenia and bipolar disorder under antipsychotics treatment. Patients also completed the “Subjects’ Response to Antipsychotics (SRA)” questionnaire in order to assess the validity of the ASFQ. The ASFQ and the SRA questionnaire were completed twice within 2 weeks. Main outcome measures Reliability (internal consistency and test-retest) and validity were assessed. Results The Greek translation of ASFQ was reliable, with excellent internal consistency (Cronbach's a = 0.90 for men and 0.95 for women in both measurements). In addition, the Spearman correlation coefficient was 1 (P< .001) in all Likert-type questions in both assessments. Finally, Spearman correlation coefficients between ASFQ and SRA were moderately positive to strongly positive (between 0.25 and 1) in both assessments, demonstrating moderate to high validity. Conclusions The Greek version of the ASFQ has proved to be a reliable and valid clinical instrument, hence it can be used in further studies in the Greek population. Angelaki M, Galanis P, Igoumenou A, et al. Translation and Validation of the Greek Version of the Antipsychotics and Sexual Functioning Questionnaire (ASFQ). J Sex Med 2021;9:100334

Psychiatric disorders and criminal history in male prisoners in Greece

Objectives: Τo explore the psychopathology of the Greek male prisoner population and the relationship between psychiatric disorders and the criminal history of the subjects. Methods: The Iowa Structured Psychiatric Interview and the Personality Disorders Questionnaire were administered. The prevalence of the most common mental disorders was analyzed separately and in relation to the criminal history. SPSS was used for the statistical analysis. Results A total of 495 male prisoners were interviewed. Overall, 223 (45.06%) were diagnosed with a psychiatric disorder. Non-violent crimes were the most prevalent reason for imprisonment (40.7%). One-third (30.3%) of the sample was convicted with drug-related crimes, and 28.0% with violent crimes. Discussion: The prevalence of mental disorders in Greek prisoners was higher than in the general population. Personality disorder was the most common type of mental disorder and the only psychiatric diagnosis related to violent crime. This highlights the need for screening for mental disorders and the need for therapeutic provision within the prison setting

Aseptic Meningitis with Urinary Retention: A Case Report

Introduction. Aseptic meningitis is serious inflammation of the meninges caused by agents including viruses, non-viral pathogens, non-infectious conditions and chemicals. Case Presentation. This study concerns the case of a 16-year-old healthy Greek female with persistent fever, mild headache and acute urinary retention, secondary to aseptic meningitis. Physical examination revealed no distinct signs of meningeal irritation. The urinary bladder was palpable, painless and over-distended. Serology carried out for common viruses was as follows: CMV IgG (−), CMV IgM (−), HSV IgG (−), HSV IgM (+), VZ IgG (+), VZ IgM (−), EBV IgG (−) and EBV IgM (+). During recovery in hospital, three trials of removing a urinary catheter were carried out; during the first two attempts the patient was unable to urinate and had a loss of bladder sensation. On the third attempt the patient had modest bladder perception but she left a post-voiding residual, and was instructed to perform bladder self-catheterization. Seven days after being discharged the patient underwent a full recovery. Conclusion. There are few reports concerning aseptic meningitis together with acute urinary retention. A number of these cases concern so-called “meningitis-retention syndrome,” which implies an underlying CNS mechanism, while others concerned an underlying peripheral nervous system mechanism

Membrane androgen receptor activation triggers down-regulation of PI-3K/Akt/NF-kappaB activity and induces apoptotic responses via Bad, FasL and caspase-3 in DU145 prostate cancer cells

<p>Abstract</p> <p>Background</p> <p>Recently we have reported membrane androgen receptors-induced apoptotic regression of prostate cancer cells regulated by Rho/ROCK/actin signaling. In the present study we explored the specificity of these receptors and we analyzed downstream effectors controlling survival and apoptosis in hormone refractory DU145-prostate cancer cells stimulated with membrane androgen receptor-selective agonists.</p> <p>Results</p> <p>Using membrane impermeable conjugates of serum albumin covalently linked to testosterone, we show here down-regulation of the activity of pro-survival gene products, namely PI-3K/Akt and NF-κB, in DU145 cells. Testosterone-albumin conjugates further induced FasL expression. A FasL blocking peptide abrogated membrane androgen receptors-dependent apoptosis. In addition, testosterone-albumin conjugates increased caspase-3 and Bad protein activity. The actin cytoskeleton drug cytochalasin B and the ROCK inhibitor Y-27632 inhibited FasL induction and caspase-3 activation, indicating that the newly identified Rho/Rock/actin signaling may regulate the downstream pro-apoptotic effectors in DU145 cells. Finally, other steroids or steroid-albumin conjugates did not interfere with these receptors indicating testosterone specificity.</p> <p>Conclusion</p> <p>Collectively, our results provide novel mechanistic insights pointing to specific pro-apoptotic molecules controlling membrane androgen receptors-induced apoptotic regression of prostate cancer cells and corroborate previously published observations on the potential use of membrane androgen receptor-agonists as novel anti-tumor agents in prostate cancer.</p

Therapeutic Approach to Advanced Pancreatic Carcinoma

Pancreatic carcinoma, a chemoresistant disease, still remains a therapeutic challenge in oncology. A variety of cytotoxic agents have been tried with promising or disappointing results. Gemcitabine as a single agent or combined chemotherapy is the mainstay therapeutic approach in locally advanced or metastatic disease. Newer agents, such as tyrosine kinase inhibitors and monoclonal antibodies (bevacizumab, erbitux) are widely used nowadays in modern therapeutic algorithms with promising results. Key words: pancreatic carcinoma; gemcitabine; chemotherapy; monoclonal antibodies; kinase inhibitor

Functional membrane androgen receptors in colon tumors trigger pro-apoptotic responses in vitro and reduce drastically tumor incidence in vivo

<p>Abstract</p> <p>Background</p> <p>Membrane androgen receptors (mAR) have been implicated in the regulation of cell growth, motility and apoptosis in prostate and breast cancer. Here we analyzed mAR expression and function in colon cancer.</p> <p>Results</p> <p>Using fluorescent mAR ligands we showed specific membrane staining in colon cell lines and mouse xenograft tumor tissues, while membrane staining was undetectable in healthy mouse colon tissues and non-transformed intestinal cells. Saturation/displacement assays revealed time- and concentration-dependent specific binding for testosterone with a K_Dof 2.9 nM. Stimulation of colon mAR by testosterone albumin conjugates induced rapid cytoskeleton reorganization and apoptotic responses, even in the presence of anti-androgens. The actin cytoskeleton drug cytochalasin B effectively inhibited the pro-apoptotic responses and caspase-3 activation. Interestingly, <it>in vivo </it>studies revealed that mAR activation resulted in a 65% reduction of tumor incidence in chemically induced Balb/c mice colon tumors.</p> <p>Conclusion</p> <p>Our results demonstrate for the first time that functional mARs are predominantly expressed in colon tumors and that their activation results in induction of anti-tumor responses <it>in vitro </it>and extensive reduction of tumor incidence <it>in vivo</it>.</p

(-)-Englerin A-evoked Cytotoxicity is Mediated by Na+ Influx and Counteracted by Na+/K+-ATPase

(-)-Englerin A ((-)-EA) has a rapid and potent cytotoxic effect on several types of cancer cell that is mediated by plasma membrane ion channels containing Transient Receptor Potential Canonical 4 protein (TRPC4). Since these channels are Ca2+ permeable it was initially thought that the cytotoxicity arose as a consequence of Ca2+ overload. Here we show that this is not the case and that the effect of (-)-EA is mediated by a heteromer of TRPC4 and TRPC1 proteins. Both TRPC4 and TRPC1 were required for (-)-EA cytotoxicity, however, although TRPC4 was necessary for the (-)-EA-evoked Ca2+-elevation, TRPC1 was not. TRPC1 either had no role or was a negative regulator of Ca2+ entry. By contrast, both TRPC4 and TRPC1 were necessary for monovalent cation entry evoked by (-)-EA and (-)-EA-evoked cell death was dependent upon entry of the monovalent cation Na+. We therefore hypothesized that Na+/K+-ATPase might act protectively by counteracting the Na+ load resulting from sustained Na+ entry. Indeed, inhibition of Na+/K+-ATPase by ouabain potently and strongly increased (-)-EA-evoked cytotoxicity. The data suggest that (-)-EA achieves cancer cell cytotoxicity by inducing sustained Na+ entry through heteromeric TRPC1/TRPC4 channels and that the cytotoxic effect of (-)-EA can be potentiated by Na+/K+-ATPase inhibition

Adrenocortical oncocytic carcinoma with recurrent metastases: a case report and review of the literature

<p>Abstract</p> <p>Background</p> <p>Adrenal cortex oncocytic carcinoma (AOC) represents an exceptional pathological entity, since only 22 cases have been documented in the literature so far.</p> <p>Case presentation</p> <p>Our case concerns a 54-year-old man with past medical history of right adrenal excision with partial hepatectomy, due to an adrenocortical carcinoma. The patient was admitted in our hospital to undergo surgical resection of a left lung mass newly detected on chest Computed Tomography scan. The histological and immunohistochemical study revealed a metastatic AOC. Although the patient was given mitotane orally in adjuvant basis, he experienced relapse with multiple metastases in the thorax twice in the next year and was treated with consecutive resections. Two and a half years later, a right hip joint metastasis was found and concurrent chemoradiation was given. Finally, approximately five years post disease onset, the patient died due to massive metastatic disease. A thorough review of AOC and particularly all diagnostic difficulties are extensively stated.</p> <p>Conclusion</p> <p>Histological classification of adrenocortical oncocytic tumours has been so far a matter of debate. There is no officially established histological scoring system regarding these rare neoplasms and therefore many diagnostic difficulties occur for pathologists.</p