Cortisol and Oxytocin Could Predict Covert Aggression in Some Psychotic Patients

Background: The covert or indirect type of aggression has a risk of converting in violent acts and, considering that, it is very important to identify it in order to apply effective preventive measures. In cases of psychotic patients, the risk of becoming violent is harder to predict, as even neuter stimuli may be perceived as threat and trigger aggression. Treating all the psychiatric patients as potential aggressive subjects is not the best preventive measure as only a few of them are aggressive and this measure may further enhance the stigma on mentally ill patients. There is a current need for better understanding of covert aggression and to find objective measures, such as biological markers, that could be indicative of potential violent behavior. In this work, we try to investigate the role of cortisol and oxytocin as potential biomarkers of aggression in patients with psychosis. Material and Methods: We analyzed the level of peripheral oxytocin (pg/mL) and cortisol level (ng/mL) in 28 psychotic patients (they were not on psychotropic treatment at the moment of admission and those with substance abuse or personality disorder were excluded from the study) and correlated it with the intensity of aggression reported by the patient (overt and covert type) using the Overt Covert Aggression Inventory and the level of observed aggression of the patient in the past 7 days (rated by the health care provider) using the Modified Overt Aggression Scale. Results: We found that psychotic patients with a higher level of covert aggression had a lower level of cortisol (61.05 ± 8.04 ng/mL vs. 216.33 ± 12.6.9 ng/mL, p ˂ 0.01) and a higher level of oxytocin (102.87 ± 39.26 vs. 70.01 ± 25.07, p = 0.01) when compared with patients with a lower level of covert aggression. Furthermore, we observed significant negative correlation between cortisol and covert aggression (r = −0.676, p < 0.001) and between oxytocin and covert type of aggression (r = 0.382, p = 0.04). Moreover, we found that a lower level of cortisol together with a higher level of oxytocin are significant predictors of a style of internalized manifestation of aggression, with the predictive model explaining 55% of the variant of the internalized manifestation of aggression (F (2.25) = 17.6, p < 0.001, β = 0.35, R2 = 55.2). We did not find significant correlations between cortisol and overt aggression, and neither between oxytocin and overt aggression. Positive correlations were also found between the overt type of self-reported aggression and overt aggression reported by the rater (r = 0.459, p = 0.01). Conclusions: The importance of a predictive model in understanding covert aggression is imperative and the results of our study show that oxytocin and cortisol warrant to be further investigated in establishing a definitive predictive model for covert aggression

Progressive skin fibrosis is associated with a decline in lung function and worse survival in patients with diffuse cutaneous systemic sclerosis in the European Scleroderma Trials and Research (EUSTAR) cohort.

Objectives To determine whether progressive skin fibrosis is associated with visceral organ progression and mortality during follow-up in patients with diffuse cutaneous systemic sclerosis (dcSSc). Methods We evaluated patients from the European Scleroderma Trials and Research database with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, valid mRSS at 12±3 months after baseline and ≥1 annual follow-up visit. Progressive skin fibrosis was defined as an increase in mRSS &gt;5 and ≥25% from baseline to 12±3 months. Outcomes were pulmonary, cardiovascular and renal progression, and all-cause death. Associations between skin progression and outcomes were evaluated by Kaplan-Meier survival analysis and multivariable Cox regression. Results Of 1021 included patients, 78 (7.6%) had progressive skin fibrosis (skin progressors). Median follow-up was 3.4 years. Survival analyses indicated that skin progressors had a significantly higher probability of FVC decline ≥10% (53.6% vs 34.4%; p&lt;0.001) and all-cause death (15.4% vs 7.3%; p=0.003) than non-progressors. These significant associations were also found in subgroup analyses of patients with either low baseline mRSS (≤22/51) or short disease duration (≤15 months). In multivariable analyses, skin progression within 1 year was independently associated with FVC decline ≥10% (HR 1.79, 95% CI 1.20 to 2.65) and all-cause death (HR 2.58, 95% CI 1.31 to 5.09). Conclusions Progressive skin fibrosis within 1 year is associated with decline in lung function and worse survival in dcSSc during follow-up. These results confirm mRSS as a surrogate marker in dcSSc, which will be helpful for cohort enrichment in future trials and risk stratification in clinical practice

2015/16 seasonal vaccine effectiveness against hospitalisation with influenza a(H1N1)pdm09 and B among elderly people in Europe: Results from the I-MOVE+ project

We conducted a multicentre test-negative caseâ\u80\u93control study in 27 hospitals of 11 European countries to measure 2015/16 influenza vaccine effectiveness (IVE) against hospitalised influenza A(H1N1)pdm09 and B among people aged â\u89¥ 65 years. Patients swabbed within 7 days after onset of symptoms compatible with severe acute respiratory infection were included. Information on demographics, vaccination and underlying conditions was collected. Using logistic regression, we measured IVE adjusted for potential confounders. We included 355 influenza A(H1N1)pdm09 cases, 110 influenza B cases, and 1,274 controls. Adjusted IVE against influenza A(H1N1)pdm09 was 42% (95% confidence interval (CI): 22 to 57). It was 59% (95% CI: 23 to 78), 48% (95% CI: 5 to 71), 43% (95% CI: 8 to 65) and 39% (95% CI: 7 to 60) in patients with diabetes mellitus, cancer, lung and heart disease, respectively. Adjusted IVE against influenza B was 52% (95% CI: 24 to 70). It was 62% (95% CI: 5 to 85), 60% (95% CI: 18 to 80) and 36% (95% CI: -23 to 67) in patients with diabetes mellitus, lung and heart disease, respectively. 2015/16 IVE estimates against hospitalised influenza in elderly people was moderate against influenza A(H1N1)pdm09 and B, including among those with diabetes mellitus, cancer, lung or heart diseases

Assessment of self-injurious behavior in major depressive disorder: a case report

Introduction: Self-harm and depression are two related mental health issues that often co-occur and can have serious impacts on individuals and their well-being. Major Depressive Disorder (MDD) is a complex and multifaceted mental health condition that is prevalent among young adults. It is a significant public health concern that affects individuals, families and society as a whole, contributing to considerable social, economic, and health-related costs. Despite the high prevalence of depression in young adults, there is a lack of understanding of its etiology, risk factors, and optimal treatment strategies. Self-harm behavior is a concerning manifestation of MDD that can have serious consequences, including injury, infection, or even death.Methods: In this article, we report a case of an MDD patient with self-harm behavior and discuss the assessment method and treatment options. Our aim is to raise awareness of these pathologies among psychiatrists and the general population and to highlight the importance of early diagnosis and effective treatment in reducing the risk of self-harm behavior and suicide.Conclusion: In light of the case presented, it is evident that early detection and targeted intervention are crucial in mitigating the risk of self-injurious behavior in MDD patients. The utilization of a comprehensive assessment methodology, inclusive of a thorough review of the patient&rsquo;s clinical history and utilization of standardized rating scales, proved indispensable in the tailoring of an individualized treatment regimen. The amalgamation of pharmacotherapy and psychotherapy proved to be a successful strategy in the amelioration of depressive symptoms and consequent self-harm behavior. As such, we trust that this case report will serve to sensitize clinicians to the importance of early identification and prompt management of these pathologies, in the quest for enhanced mental health outcomes

HEAVY METAL POLLUTION OF SOME COMPONENTS OF FLAVOURED WINES, NAMELY THE WINE VARIETIES AND HYDROALCOHOLIC MACERATES FROM PLANTS

The aim of this research, in order to meet the quality standards of drinks derived from wines, was the establishmentof heavy metals pollution (Pb , Cd and Cu) of some varieties of wine from the 2007 harvest, in the Ostrov vineyard,namely: Fetească Albă , Sauvignon Blanc and Riesling Italian. We also analyzed the heavy metal content ofhydroalcoholic macerates of plants in 45 % and 60 % alcohol (2 recipes: recipe I with 16 plants taken fromRomanian native flora and recipe II with 6 ingredients containing especially bitter substances), used subsequentlyto obtain flavoured and vermouth type wines from the studied varieties. Heavy metals were determined by atomicabsorption spectrometry (AAS ). The research results show that the Italian Riesling variety had the highest valuesfor heavy metals, ie 51.9 ppb Pb, 1.60 ppb Cd and 12.2 ppb Cu. The less " polluted " variety of wine with Cd (0.10ppb) and Cu ( 9.4 ppb) was Fetească Albă. Regarding the hydroalcoholic macerates, the one obtained from theplants in recipe I had a higher content of Pb , Cd and Cu (15.6 ppb Pb , 0.78 ppb Cd and 355 ppb Cu) andmacerates in 60 % alcohol had higher concentrations of heavy metals as compared with the macerates in 45 %alcohol. In conclusion , although heavy metals were found in both wines and in hydroalcoholic macerates, thepollution with heavy metals did not exceed the limits allowed by law

Cortisol and Oxytocin Could Predict Covert Aggression in Some Psychotic Patients

Background: The covert or indirect type of aggression has a risk of converting in violent acts and, considering that, it is very important to identify it in order to apply effective preventive measures. In cases of psychotic patients, the risk of becoming violent is harder to predict, as even neuter stimuli may be perceived as threat and trigger aggression. Treating all the psychiatric patients as potential aggressive subjects is not the best preventive measure as only a few of them are aggressive and this measure may further enhance the stigma on mentally ill patients. There is a current need for better understanding of covert aggression and to find objective measures, such as biological markers, that could be indicative of potential violent behavior. In this work, we try to investigate the role of cortisol and oxytocin as potential biomarkers of aggression in patients with psychosis. Material and Methods: We analyzed the level of peripheral oxytocin (pg/mL) and cortisol level (ng/mL) in 28 psychotic patients (they were not on psychotropic treatment at the moment of admission and those with substance abuse or personality disorder were excluded from the study) and correlated it with the intensity of aggression reported by the patient (overt and covert type) using the Overt Covert Aggression Inventory and the level of observed aggression of the patient in the past 7 days (rated by the health care provider) using the Modified Overt Aggression Scale. Results: We found that psychotic patients with a higher level of covert aggression had a lower level of cortisol (61.05 ± 8.04 ng/mL vs. 216.33 ± 12.6.9 ng/mL, p ˂ 0.01) and a higher level of oxytocin (102.87 ± 39.26 vs. 70.01 ± 25.07, p = 0.01) when compared with patients with a lower level of covert aggression. Furthermore, we observed significant negative correlation between cortisol and covert aggression (r = −0.676, p &lt; 0.001) and between oxytocin and covert type of aggression (r = 0.382, p = 0.04). Moreover, we found that a lower level of cortisol together with a higher level of oxytocin are significant predictors of a style of internalized manifestation of aggression, with the predictive model explaining 55% of the variant of the internalized manifestation of aggression (F (2.25) = 17.6, p &lt; 0.001, β = 0.35, R2 = 55.2). We did not find significant correlations between cortisol and overt aggression, and neither between oxytocin and overt aggression. Positive correlations were also found between the overt type of self-reported aggression and overt aggression reported by the rater (r = 0.459, p = 0.01). Conclusions: The importance of a predictive model in understanding covert aggression is imperative and the results of our study show that oxytocin and cortisol warrant to be further investigated in establishing a definitive predictive model for covert aggression

Catching Cancer Early: The Importance of Dermato-Oncology Screening

The European Society for Medical Oncology experts have identified the main components of the long-term management of oncological patients. These include early diagnosis through population screening and periodic control of already diagnosed patients to identify relapses, recurrences, and other associated neoplasms. There are no generally accepted international guidelines for the long-term monitoring of patients with skin neoplasms (nonmelanoma skin cancer, malignant melanoma, precancerous—high-risk skin lesions). Still, depending on the experience of the attending physician and based on the data from the literature, one can establish monitoring intervals to supervise these high-risk population groups, educate the patient and monitor the general population

Business demography and economic growth: similarities and disparities in 10 European Union countries

The main research aim is to investigate and test the long-term existence of a balanced relationship (cointegration) between business demographics and economic growth, expressed in terms of real GDP per capita, and to estimate the econometric models expressing relationships between analyzed variables in European economy. Our The study has focused on ten out of the eleven former communist countries, currently members of the European Union, during the 2006–2016 time period. Croatia was left out due to the shortness of the time series available for it, that the study would have required. These findings have significant implications in designing and shaping the future business models in European former communist countries, and increase convergence. The results obtained confirm the existence of long-term balanced relationships between the variables examined, the forms of which however vary from one cluster of states to another

Circulating influenza viruses and the effectiveness of seasonal influenza vaccine in Romania, season 2012-2013 / Virusurile gripale circulante și eficacitatea vaccinului gripal sezonier în România, în sezonul 2012-2013

Scopul studiului a fost de a investiga profilul virusurilor gripale care au circulat în România în sezonul 2012- 2013 și de a estima eficacitatea vaccinului gripal sezonier, pe baza datelor de supraveghere epidemiologică si virologică. Metodă. Am testat toate probele colectate din săptămâna 40/2012 până în săptămâna 20/2013, în cadrul sistemului national de supraveghere, de la pacientii cu simptomatologie compatibilă cu gripa. Probele pozitive de gripă A/B identificate prin detecție moleculară (RT-PCR) au fost apoi caracterizate. Am utilizat hemaglutino-inhibarea pentru caracterizare antigenică si chemiluminiscenta pentru testarea sensibilitătii la antivirale. Secventierea genelor codante pentru hemaglutinină si neuraminidază si analiza lor filogenetică a fost de asemenea efectuată. Am estimat eficacitatea vaccinului gripal ca 1-odds ratio folosind un studiu caz-martor cu design negativ. Rezultate și discuții. Am testat 1087 de probe din care 537 au fost pozitive (56.2% gripă B, 40.6% A(H1N1)pdm09, 3.2% A(H3N2). Saizeci si patru dintre acestea au fost caracterizate antigenic si / sau genetic. Virusurile A(H1N1)pdm09 au fost înrudite antigenic cu tulpina vaccinală A/California/07/2009 si au apartinut grupului genetic 6 similar cu A/St. Petersburg/27/2011. Virusurile gripale tip B au apartinut cladei 2 a liniei genetice B/Yamagata, asemănătoare cu B/Estonia/55669/2011, cu excepția unei tulpini care a apartinut liniei B/ Victoria, reprezentată de tulpina B/Brisbane/60/2008. Virusurile A(H3) au apartinut grupului genetic 3C al cladei tulpinii A/Victoria/208/2009, asemănătoare cu tulpina vaccinală A/Victoria/361/2011. Toate tulpinile testate (57) au fost sensibile la oseltamivir si zanamivir. Eficacitatea vaccinală ajustată pentru gripa A(H1N1)pdm09 (N=119) a fost de 76.9% (95% CI: -113.4, 98.5), sugerând o protectie bună, în concordantă cu suprapunerea antigenică dintre tulpinile sălbatice circulante si tulpinile incluse în vaccinul recomandat pentru sezonul 2012-2013