The Role of Neuroinflammation in the Comorbidity of Psychiatric Disorders and Internal Diseases

Psychiatric disorders and internal diseases frequently co-occur, posing significant challenges due to overlapping symptoms, shared pathophysiological mechanisms, and increased healthcare burdens. Neuroinflammation has emerged as a central mechanism linking these conditions, driven by systemic inflammation, hypothalamic–pituitary–adrenal (HPA) axis dysregulation, and autonomic nervous system (ANS) imbalance. This review synthesizes current evidence on the role of neuroinflammation in comorbid conditions such as depression, anxiety, cardiovascular disease, and diabetes mellitus, emphasizing bidirectional relationships and shared inflammatory pathways. This analysis identifies gaps in longitudinal studies, biomarker validation, and the integration of multidisciplinary care models. Emerging therapeutic approaches, including IL-6 inhibitors, vagus nerve stimulation, and behavioral interventions, show promise but remain underexplored in combined applications. Furthermore, disparities in research representation limit the generalizability of findings and highlight the need for inclusive clinical trials. Addressing these gaps through precision medicine, advanced biomarker monitoring technologies, and equitable healthcare strategies could transform the management of these complex comorbidities. By advancing our understanding of neuroinflammatory mechanisms and promoting integrated interventions, this review underscores the need for a collaborative, patient-centered approach to improve outcomes and reduce the global burden of psychiatric and internal disease comorbidities

Immunological Biomarkers in Autism Spectrum Disorder: The Role of TNF-Alpha and Dependent Trends in Serum IL-6 and CXCL8

Background: Autism spectrum disorder (ASD) has seen a rise in prevalence, and the immune system’s role in brain development is increasingly recognized. This study investigates the relationship between immune dysregulation and ASD by examining serum concentrations of interleukin 6 (IL-6), interleukin 8 (CXCL8), and tumor necrosis factor alpha (TNF-alpha) in children. Methods: Serum samples from 45 children with ASD and 30 controls, aged 2 to 12 years, were analyzed using electrochemiluminescence, chemiluminescent microparticle immunoassay, and chemiluminescent immunoassay. ASD symptoms were assessed using the Autism Spectrum Rating Scale (ASRS) and Social Communication Questionnaire (SCQ). Results: No significant correlation was observed between CXCL8 levels and ASD. IL-6 levels showed a trend toward elevation in boys with ASD. TNF-alpha levels were significantly higher in children with ASD under 5 years compared to older children and controls, though no correlation with symptom severity was found. Conclusions: TNF-alpha may be a potential biomarker for early ASD detection, especially in younger children. Further research on larger cohorts is needed to understand the role of immune dysregulation in ASD

A Clinical Study of Urine Amino Acids in Children with Autism Spectrum Disorder

Amino acids are organic compounds that enter the protein structure, being involved in the proper functioning of the body. The role of amino acids in the onset of autism spectrum disorder (ASD) is yet to be established. Our aim was to identify correlations between urine amino acids and their derivatives and ASD. Methods: We designed a case–control study that consisted of 75 boys and girls, aged between 2 and 12 years. For amino acid profile, we used urine samples that were analyzed using liquid chromatography–tandem mass spectrometry (LC-MS/MS). Results: Descriptive analysis showed higher values for glutamine, hydroxyproline, tyrosine, aspartic acid, and tryptophan and lower values for serine in the autism group than in the control group. Also, we found that boys with autism had higher values than the boys in the control group for serine, threonine, and aspartic acid. For girls from both groups, we did not find statistically significant values. In terms of age groups, we found significantly higher values for histidine, threonine, valine, methionine, aspartic acid, glutamic acid, alpha amino-adipic acid, sarcosine, alanine, and beta-alanine and significantly lower values for proline for both the autism and control groups under 5 years. Conclusions: The findings of this study support the assumption that amino acids may have a role in the expression of ASD

Clinical and Biochemical Considerations Regarding Stress and Arrhythmic Risk in Patients with Chronic Viral Liver Diseases

The prevalance of depression and anxiety is higher at the patients diagnosticated with viral liver disease. The corelation between stress and chronic liver disease is a natural, implicit one, but still insufficiently studied. The study has the objective of finding out the clinical and also biochemical correlations between stress and chronic viral diseases. Our research was realised on a group of 78 patients with chronic viral liver disease, who underwent an evaluation of the stress level, both from a subjective point of view and based on concrete methods like questionnaires. The patients were asked to espress their state more or less affected by stress, and, subsequently, they were subjected to a questionnaire that was analyzed, followed by establishing the necessary correlations. Our patients were also evaluated by cardiologicaly, psychologicaly and psyhiatricaly examinations. After the first evaluation we had these results :38 patients (49.19%) consider that they have an average stress level, 18 patients (22.58%) have a high stress level. Only 22 patients (28.22%) declared stress was at a low level. We divided the pacients in two groups, function of Qt (questionare total score) results and we observed that a number of 38 patients ( 49.19%) registered �Qt 20 and 40 patients (50.81%) had Qt � 20, 63 patients (50.81%).We found a strong correlation between the patients� subjective evaluation of the stress level and the objective evaluation of stress level according to the used questionnaire, which confirms the objectivity of our study. We found a direct corelation, with a morphological, biochemical and functional support between stress and the arrhythmia risk in the evolution of chronic liver disease. We consider very important a complex examination psychiatricaly, psychologicaly and cardiological of the pacients diagnosticated with viral liver disease in order to help them and to prevent arrhythmic events, depression, anxiety and other mood disorders. </jats:p

PSYCHIATRIC DISORDERS ASSOCIATED WITH ENDOCRINE DYSFUNCTIONS

Introduction: Psychiatric disorders occurring during endocrine dysfunction and, conversely, endocrine dysfunctions associated with mental disorders were the emergence of a new discipline, psychoendocrinology. Psychiatric disorders correlated with endocrine diseases are defined as psychopathological manifestations of variable intensity and clinical symptomatology, determined by complex psycho-neuro-endocrinological interrelationships. Defining elements consist of the association between diagnosis of mental disorders and specific symptoms for endocrine dysfunction. Methods: We conducted a prospective one-year study (January 2018 - December 2018 on 112 patients hospitalized in the Clinic of Psychiatry who also had an endocrinological comorbidity. We investigated the frequency and severity of psychoendocrinological associations by studying a number of demographic and clinical items. Results: The results showed that the highest incidence belongs to thyroid disorder - 55.36%, followed by gonadal disorders - 24.11%, and, rarely, pituitary diseases and diabetes. Hyperthyroidism was associated most frequently with manic episodes, while unipolar depression prevailed in patients with hypothyroidism. In gonadal disorders, present in majority in female patients (secondary amenorrhea, menopause or erectile dysfunction in males), depression accompanied by anxiety, often severe in intensity, was the most frequent psychiatric diagnosis. Psychotic disorders were met in a smaller number of cases, especially in patients with long history of endocrine disorders and instability of biological constants. Conclusions: We may state that affective disorders are the most frequent nosologically category in patients with endocrine dysfunctions. It requires a better collaboration between specialists in endocrinology and psychiatry, to highlight the determinants which contribute to the development of psychopathological manifestations in endocrine diseases and to individualize the treatment depending on cases’ particularities.</jats:p

KIAA2022/NEXMIF c.1882C&gt;T (p.Arg628*) Variant in a Romanian Patient with Neurodevelopmental Disorders and Epilepsy: A Case Report and Systematic Review

Pathogenic variants in the NEXMIF gene are associated with a broad neurodevelopmental phenotype, including autism spectrum disorder (ASD), intellectual disability (ID), and epilepsy. However, the role of NEXMIF in specific epileptic syndromes remains insufficiently explored. We present the case of an 11.9-year-old Romanian girl diagnosed with ASD, attention-deficit/hyperactivity disorder (ADHD), mild ID, and Jeavons syndrome (generalized epilepsy characterized by eyelid myoclonia, absence seizures, and photosensitivity). Genetic testing identified a pathogenic NEXMIF variant: c.1882C&gt;T (p.Arg628*), a pathogenic variant rarely reported in the literature, with only two documented cases to date. To better understand the genotype&ndash;phenotype correlation, we conducted a systematic review of NEXMIF-associated disorders and compared our findings with previously reported cases. Our analysis suggests that NEXMIF variants may contribute to a broader spectrum of epileptic syndromes, including photosensitive epilepsy such as Jeavons syndrome. This highlights the need for a greater awareness of atypical seizure presentations in individuals with NEXMIF-related disorders. This study underscores the importance of genetic testing in individuals with overlapping ASD and epilepsy phenotypes as early diagnosis may facilitate targeted therapeutic interventions and genetic counseling. Further research is needed to clarify the molecular mechanisms linking NEXMIF dysfunction to epileptic syndromes and neurodevelopmental disorders

A Multicenter Survey on Pharmacists&rsquo; Perspectives on Self-Medication Issues in Romania: A Descriptive Study Towards Sustainable and Safe Pharmaceutical Practices

Background/Objectives: This study evaluates the perceptions of pharmacists in Romania regarding self-medication, a growing practice with significant implications for public health and sustainable development. The main objective is to analyze the role of pharmacists in managing self-medication and educating the public on rational medication use. Methods: A descriptive and exploratory methodology was employed, using a questionnaire administered to 300 pharmacists from various regions in Romania between March and April 2024. The data analysis included Chi-square tests and linear regression to identify predictive factors. Results: The findings reveal a direct correlation between the frequency of self-medication and the perceived severity of conditions, with self-medication being more common for minor ailments. Experienced pharmacists are less likely to encourage self-medication. Public education on the risks of self-medication significantly reduces the prevalence of this practice. Conclusions: Self-medication, without proper regulation and education, risks becoming unsustainable. Targeted informational campaigns and educational programs tailored to diverse demographic groups are essential. Pharmacists play a critical role in promoting safe and responsible medication use

Exploring Multidisciplinary Approaches to Comorbid Psychiatric and Medical Disorders: A Scoping Review

Psychiatric disorders often coexist with internal medical conditions, posing significant challenges to diagnosis, treatment, and overall patient outcomes. This study examines the bidirectional relationship between these conditions, emphasizing their impact on morbidity, treatment adherence, and quality of life. Through a comprehensive review of the peer-reviewed literature, we explore the physiological, neuroinflammatory, and psychosocial mechanisms that underpin these interactions. Key psychiatric disorders, including depression, anxiety, cognitive impairments, and psychosis, are identified as critical contributors to diagnostic complexity and therapeutic hurdles. Our findings underscore the importance of integrated, multidisciplinary care models, advocating for early detection, routine mental health screening, and personalized treatment strategies. Challenges such as overlapping symptoms, diagnostic ambiguities, and potential drug interactions are critically analyzed, with practical, evidence-based recommendations proposed for clinical practice. Despite advancements, significant research gaps persist, particularly the lack of longitudinal studies and the limited application of precision medicine tailored to this population. Future directions focus on enhancing diagnostic tools, developing innovative therapeutic approaches, and integrating mental health services into routine care. This study highlights the critical need for holistic, patient-centered approaches to manage comorbid psychiatric and internal medical conditions, offering actionable insights to improve outcomes and bridge existing gaps in research and practice

Correlations Between Distinct Ras Mutations and Response to Bevacizumab in Patients with Colo-rectal Cancer

CRC is currently ranked third among frequently diagnosed malignancies. Mutations in exons 2,3 and 4 of the KRAS and NRAS genes were detected using a targeted resequencingassay from paraffin embedded tissue from patients� biopsies samples. The following data was recorded for each patient: baseline information - age and sex � as well as diagnosis, cancer localization, disease stage and laboratory parameters.In our study group we could not find statistically significant differences regarding distinct mutations and the progression free survival (p=0.34]0.05) for patients treated with an anti-angiogenic therapy. </jats:p