Virgil Radu Enatescu - Academia.edu (original) (raw)
Papers by Virgil Radu Enatescu
Healthcare
Background: COVID-19 has led to a global health crisis that is defining for our times and one of ... more Background: COVID-19 has led to a global health crisis that is defining for our times and one of the greatest challenges to emerge since World War II. The potential impact of the pandemic on mental health should not be overlooked, especially among vulnerable populations such as women who gave birth during the COVID-19 pandemic. Materials and Methods: The study is a cross-sectional survey conducted from 1 March 2020 to 1 March 2023, during the period of the SARS-CoV-2 (COVID-19) pandemic, based on a retrospective evaluation of 860 postpartum women. The screening tool used to assess symptoms of postpartum depression was the Edinburgh Postnatal Depression Rating Scale (EPDS) questionnaire. The questionnaire was completed both in the Obstetrics and Gynaecology Clinical Sections I and II of the “Pius Brînzeu” County Emergency Hospital in Timisoara, Romania, and online using Google Forms. Results: The highest severity of postpartum depression symptoms was observed during the COVID-19 pand...
FARMACIA, 2020
Alcohol dependence and harmful use represent the most prevalent addictive disorder worldwide. Alc... more Alcohol dependence and harmful use represent the most prevalent addictive disorder worldwide. Alcohol withdrawal syndrome is considered a life-threatening condition by inducing severe physiological imbalances. Pharmacological management of alcohol withdrawal syndrome is very complex and challenging, often involving a long duration in getting remission. Our ongoing study aimed to analyse the efficacy of clonidine (an alpha-2-agonist) for improving alcohol withdrawal syndrome quantified by the mean change of The Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) scores. Of 30 patients with alcohol withdrawal syndrome recruited so far, 11 (36.7%) benefited from clonidine treatment. Blood pressure and other physiological signs were periodically monitored. Although at the beginning of the treatment there were no differences between the mean CIWA-Ar scores (t = 0.352, p = 0.599), after 5 days the difference became significant in favour of those treated with clonidine (t = 3.147, p = 0.004). Clonidine may provide additional benefit in managing alcohol withdrawal by offering a different mechanism of action for targeting withdrawal symptoms. Rezumat Dependența de alcool și consumul dăunător de alcool reprezintă cele mai răspândite tulburări de adicție la nivel mondial. Sindromul de sevraj etanolic este considerat o afecțiune care pune viața în pericol prin inducerea unor dezechilibre fiziologice severe. Managementul farmacologic al sindromului de sevraj la alcool este foarte complex și provocator, implicând adesea o durată lungă de obținere a remisiunii. Studiul nostru în curs a urmărit să analizeze eficacitatea clonidinei (un agonist alfa-2) pentru ameliorarea sindromului de sevraj alcoolic cuantificată prin modificarea medie a scorurilor scalei The Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar). Din 30 de pacienți cu sindrom de sevraj alcoolic recrutați până în prezent, 11 (36,7%) au beneficiat de tratament cu clonidină. Tensiunea arterială și alte semne fiziologice au fost monitoriza te periodic. Deși la începutul tratamentului nu au existat diferențe între scorurile medii CIWA-Ar (t = 0,352, p = 0,599), după 5 zile diferența a devenit semnificativă în favoarea celor tratați cu clonidină (t = 3,147, p = 0,004). Clonidina poate oferi beneficii suplimentare în gestionarea sevrajului la alcool, oferind un mecanism diferit de acțiune ce se adresează simptomelor de sevraj.
FARMACIA, 2020
Due to its debilitating character and the propensity to chronicity, schizophrenia is one of the m... more Due to its debilitating character and the propensity to chronicity, schizophrenia is one of the most important psychotic disorder of modern times. Recent studies have emphasized the superiority of depot long-acting antipsychotics (LAIs) versus oral antipsychotics in terms of remission maintenance and the prevention of relapses and (re)hospitalization events. Here we designed a mirror-image study meant to analyse the efficacy of one-year long LAI therapy for 21 patients admitted to the "Eduard Pamfil" Psychiatry Clinic Timisoara for which a previous one-year long oral antipsychotic therapy didn't provide satisfactory results. To further strengthen our analysis, we have also compared the mirror-image data set with the results of a parallel analysis of a control group of 11 patients under therapy with the same oral antipsychotics for an equivalent period (two years) of time. Both analyses have shown a significant reduction of re-hospitalization accompanied by a substantial alteration of PANSS scores dynamics in the group of patients treated with LAIs, thus proving the overall superiority of LAIs in comparison with oral antipsychotics. Last but not least, we critically discuss two rather sensitive issues in schizophreni a therapy, the high level of polypharmacy and a hidden bias of clinical psychiatrists in selecting the patients suitable for therapeutic switch from oral to depot antipsychotics. Rezumat Studiile existente au evidențiat superioritatea antipsohticelor depot (LAI) față de antipsihoticele orale, în menținerea remisiunii, prevenirea recăderilor și implicit a respitalizărilor. Am efectuat o cercetare de tip mirror-image study, care a inclus 21 de pacienți ce au fost inițiați în cadrul Clinicii de Psihiatrie "Eduard Pamfil" Timișoara pe unul din antipsihotice atipice depot disponibile în țara noastră, după eșecul tratamentului cu antipsihotice orale ce a avut o durată de minim un an de zile anterior acestei inițieri. Pentru a reconfirma eficacitatea măsurată prin numărul mediu de spitalizări a fost făcută și o a doua analiză comparativă folosind datele unui grup de control format din 11 pacienți ce au beneficiat de tratament cu un același antipsihotic oral pe o durată de minim 2 ani de zile. Atât analiza de tip mirror-image efectuată în cadrul grupului cu antipsihotice depot, cât și compararea acestuia cu grupul de control a evidențiat o reducere semnificativă a numărului de spitalizări sub tratamentul cu antipsihotice depot. Mai mult, evoluția mediilor scorurilor în scala PANSS și a celor din subscalele acesteia a fost una semnificativă în favoarea eficacității tratamentului cu antipsihotice depot. Prezența evenimentelor adverse legate de tratament este o realitate clinică și apare la o majoritate covârșitoare a pacienților tratați cu antipsihotice LAI. Nivelul crescut de polipragmazie în tratamentul schizofreniei în ambele grupuri luate în considerare, precum și existența unui anumit subiectivism al practicienilor în alegerea cazurilor pentru tratamentul cu antipsihotice depot, au constituit alte două rezultate valoroase ale cercetării noastre.
FARMACIA, 2020
Despite the treatability and advances in treatment of major depressive disorder (MDD), treatment ... more Despite the treatability and advances in treatment of major depressive disorder (MDD), treatment responsiveness is still only around 30-50%. The involvement of pro-inflammatory factors in the pathogenesis of major depression is one of the new perspectives of current research. This is a prospective study over an 8-week period in 50 MDD patients with single or multiple episodes recruited from the Timișoara Psychiatry Clinic during 2016-2019. Several psychometric measures were applied and baseline for C Reactive Protein (CRP) and Interleukin-6 (IL-6) blood levels were determined. Among the 17item Hamilton Depression Rating Scale (HAM-D), somatic anxiety, somatic symptoms-general and insight had significantly higher scores in MDD patients with elevated inflammatory markers compared to their counterpart with normal inflammatory marker levels (p < 0.05). Add-on celecoxib treatment determined a significantly lowered mean HAM-D scores at endpoint in MDD patients with elevated inflammatory markers (p < 0.01). Linear regression analysis revealed the presence of inflammation (IL-6 and/or CRP) and add-on celecoxib treatment as significantly influencing endpoint HAM-D scores (p < 0.01). Routine determination of inflammatory markers in MDD patients, together with add-on celecoxib treatment, generates new opportunities for the clinical management of this highly frequent psychiatric condition in the general population. Rezumat În ciuda tratabilității și a progreselor făcute în domeniul tratamentului tulburărilor depresive majore, respondența terapeutică rămâne una modestă variind între 30 și 50%. Implicarea factorilor pro-inflamatori în patogeneza tulburării depresive majore este una din perspectivele noi ale cercetărilor actuale. Studiul de față este unul prospectiv longitudinal pe o perioadă de 8 săptămâni asupra a 50 de pacienți cu tulburare depresivă majoră, episod unic sau multiplu, recrutați în cadrul Clinicii de Psihiatrie Timișoara în perioada 2016-2019. Au fost aplicate mai multe teste psihometrice și au fost determinate inițial nivelurile sanguine ale Proteinei C Reactive (PCR) și ale Interleukinei 6 (IL-6). Dintre itemii scalei HAM-D versiunea cu 17 itemi, anxietatea somatică, simptome somatice generale și conștiința bolii au avut medii ale scorurilor semnificativ mai mari în comparație cu pacienții cu tulburare depresivă majoră fără proces inflamator semnificativ (p < 0,05). Tratamentul suplimentar cu celecoxib a determinat o reducere semnificativ mai mare a scorurilor HAM-D la sfârșitul perioadei de studiu în situația pacienților cu tulburare depresivă majoră și proces inflamator prezent (p < 0,01). Regresia liniară a identificat prezența inflamației (PCR și/sau IL-6) și a tratamentului suplimentar cu celecoxib, inițiat de la începutul studiului, ambele având o influență semnificativă asupra scorurilor scalei HAM-D de la sfârșitul perioadei de studiu (p < 0,01). Detecția de rutină a markerilor inflamatori și instituirea tratamentului cu celecoxib, când este necesar, la pacienții cu tulburare depresivă majoră deschide noi oportunități în abordarea și managementul clinic al aceste afecțiuni psihiatrice larg răspândite în populația generală.
Revista De Chimie, 2020
Many prognostic factors for HL have been proposed in the past and some of these were included in ... more Many prognostic factors for HL have been proposed in the past and some of these were included in several prognostic scores. Tumor stage and spread, age, gender and various biological parameters are considered to have an effect on disease evolution, with the prognostic scores stratifying patients into risk groups and guiding the course of treatment. In the present study we have enrolled 54 patients with Hodgkin’s lymphoma admitted in the Hematology Department within the City Emergency Clinical Hospital Timisoara over a 4-year period. We aimed to see if a statistically significant correlation can be made between hemoglobin, white blood cell, lymphocyte, eosinophil, monocyte and platelet levels at the time of diagnosis on the one hand, and response to treatment and patients’ survival, on the other hand. Patients’ response to treatment was evaluated according to Cheson criteria, with best response to the combination of ABVD(doxorubicin C27H29NO11, bleomycin C55H84N17O21S3, vinblastine C...
Psihiatru.ro, 2018
<jats:p>Schizophrenia remains the major psychiatric disorder with the most debilitating eff... more <jats:p>Schizophrenia remains the major psychiatric disorder with the most debilitating effects, for which psychopharmacological treatment is only capable of a partial recovery from the total symptomatic dimensions. The clinical evolution and prognosis of these patients are still discouraging. Although are less disruptive for families and society, negative and cognitive symptoms heavily precede the psychotic onset of schizophrenia and have the tendency to persist even after the remission of the disease's positive symptoms, sometimes considered as a state of psychic defect. These two symptomatic dimensions have the highest share in influencing disability and in the reduction of the autonomy degree of these patients. In the last decades, other cerebral neurotransmission pathways have been identified, and their dysfunction are supposed to underpin the negative and cognitive symptoms of schizophrenia. Highlighting the contribution of cholinergic, glutamatergic and serotonergic receptors, along with the role of other dopaminergic receptors besides those previously known have generated hope for the development of a new psychotropic class that can specifically target these types of symptoms.</jats:p>
European Psychiatry, 2009
Aims/Objectives:Our main purpose was to examine the clinical and socio-demographical influencing ... more Aims/Objectives:Our main purpose was to examine the clinical and socio-demographical influencing factors that play a significant role to medical co-morbidity occurrences in unipolar depressives.Methods:We performed two types of clinical studies, one longitudinal retrospective study on 248 unipolar depressives admitted in our Clinic during 2001 - 2005 and second represented by a cross-sectional study on 45 inpatients and outpatients that had meet diagnostic criteria of unipolar depression according to ICD-10 and DSM-IV.Results:Socio-demographical factors that concurring to medical co-morbidity in unipolar depressives were represented by advanced current age and low educational level. Interestingly, the total duration of unipolar depression was not significant correlated with medical co-morbidity. A positive familial history of depression was correlated with a significant higher risk for coronary hearth diseases (depressives - average=0.443, S.D. =0.652; bipolars+delusionals - average...
European Psychiatry, 2010
The models of non-verbal behavior and communication constitute the basis of the clinical experien... more The models of non-verbal behavior and communication constitute the basis of the clinical experience that determinate the presumptive diagnoses or initial diagnoses.In depression, according to statistics, the majority of cases aren’t detected being treated by other medicine specialties or remaining without being treated.We propose a study that would develop a system of screening which would detect the cases suspected of depression. This is based on the gait pressure analyses, model AGILE, the analyses of the physical specter of speech, the automatic analyses of gesture. All these three investigations can be realized in a very short period of time, of a few minutes for every case.The pressure of the gat analyses took only tens of seconds. The suspected cases go forward to gesture and speech analyses, which took three minutes.The determination of the diagnostic is made after the psychiatric clinical examination, after the known criteria.At this system can be add the recognizing of depr...
Antioxidants, 2021
Rutin (Rut) is a natural flavonol, well-known for its broad-spectrum of therapeutic effects, incl... more Rutin (Rut) is a natural flavonol, well-known for its broad-spectrum of therapeutic effects, including antioxidant and antitumoral activities; still, it has a reduced clinical outcome due to its limited solubility in aqueous solutions. To overcome this drawback, this study proposes a novel formulation for rutin as a proniosomal gel for cutaneous applications. The gel was prepared by coacervation phase-separation method and complies with the standard requirements in terms of particle size (140.5 ± 2.56 nm), zeta potential (−27.33 ± 0.09 mV), encapsulation capacity (> 50%), pH (7.002 ± 0.18) and rheological properties. The results showed high biocompatibility of the gel on the 3D reconstructed human epidermis model characterized by increased viability of the cells and a lack of irritant and phototoxic potential. The evaluations on 2D cells confirm the preferential cytotoxic effect of Rut on melanoma cells (IC50 value = 8.601 µM, nuclear fragmentation) compared to normal keratinocyt...
European Neuropsychopharmacology, 2016
that occurred in the active phase only were sleep disturbances (3 patients), blurred vision (2 pa... more that occurred in the active phase only were sleep disturbances (3 patients), blurred vision (2 patients), and disinhibition (e.g. extremely talkative, 2 patients). Discussion: vALIC DBS resulted in significant decrease of depressive symptoms in ten of 25 patients and was tolerated well. The randomized cross-over phase corroborates that vALIC DBS causes the symptom reduction rather than placebo. These results are at odds with a recently published randomized controlled trial of ventral capsule/ventral striatum DBS [2], who found no differences between active and sham stimulation. Possible reasons could be the somewhat more anterior placement of the electrodes in our study or differences between studies in strategies to optimize DBS parameters. This study confirms the promise of DBS and in light of previous research calls for further specification of targets and optimization strategies.
European Psychiatry, 2015
European Psychiatry, 2013
Introduction Major depressive disorder, the most prevalent psychiatric disorder in general popula... more Introduction Major depressive disorder, the most prevalent psychiatric disorder in general population, raises a series of clinical challenges, chronic medical comorbidity being regular one. Objectives Our main objective was to analyze the weight of anxiety and depressive symptoms levels, and that of premorbid personality traits, in co-occurrence of medical diseases in subjects with major depressive disorder. Methods A cross-sectional research was performed on 32 inpatient subjects admitted in Timisoara Psychiatric Clinic during 2010 - 2012 with major depressive disorder. Anxiety symptoms level were self-assessed with Beck Anxiety Inventory and depressive symptoms level were self-assessed with Beck Depression Inventory. Temperament and character personality traits were self-assessed using Cloninger TCI tool, which was administrated once that clinical remission has occurred. Results Majority of studied subjects (71%) have had at least one comorbid chronic medical diseases. Despite the results of other studies, the level of depressive and anxiety symptoms has no significant impact in medical comorbidity occurrence. Major depressive subjects with medical comorbidity, have had significant higher scores in Harm Avoidance, more exactly in Shyness with Strangers (p = 0.007) and Fatigability (p = 0.013). Significant higher total scores were revealed, in the same subjects, for all three character dimensions like as Self-Directedness (p = 0.004), Cooperativeness (p = 0.039) and Self-Transcendence (p = 0.030). Conclusions According to our research results, rather than temporary clinical symptoms constituting clinical picture of subjects with major depression there is possible that premorbid personality traits could weigh more significant to the appearance of medical comorbid conditions.
European Psychiatry, 2009
Kashmir has observed increase in number of Substance dependence (SD) patients due to various fact... more Kashmir has observed increase in number of Substance dependence (SD) patients due to various factors like easy availability of drugs, drugs smuggled across border, but most importantly present disturbed conditions for last two decades. Drug use appears to have an important role in etiology and vulnerability to development of psychiatric disorders and vice versa. After DSM IV allowed the clinicians to give multiple diagnosis when different syndromes occur together in one episode of illness, the issue of comorbidity has assumed central stage. A methodical, staged screening and assessment can ease the diagnostic challenge of distinguishing the symptoms of psychiatric disorders from manifestations of substance intoxication and withdrawal. This study was carried out on total of 300 substance dependence patients who were screened for psychiatric disorders by DSM IV based MINI Plus interview. The study revealed that 58% (n=174) had psychiatric comorbidity, with most number of patients betw...
Neuropsychiatric Disease and Treatment
The relationship between personality traits and cardiovascular disease has gathered sustained int... more The relationship between personality traits and cardiovascular disease has gathered sustained interest over the last years, typeD personality (TDP) being significantly associated with coronary artery disease (CAD). However, data regarding the connection between the TDP and the severity of CAD disease is scarce. The aim of our study was to assess the relationship between TDP and the complexity of CAD, and to compare it with other sociodemographic and clinical features. Patients and Methods: We conducted a cross-sectional case-control clinical-based study on 221 consecutive hospitalized patients with chest pain (60 ± 10.2 years; 131 men), referred for coronary angiography. Results: TDP was identified in 42 (19%) patients, using the DS 14 scale. Symptomatology profile was evaluated using the SCL-90 scale. Syntax score was greater in the subgroup of patients with TDP in comparison to non-TDP subgroup (26.21±12.03 vs 15.49±8.89, respectively, p<0.001), and most of SCL-90 symptom dimensions have significantly higher levels in the subgroup of TDP with CAD patients (all p < 0.05). Smoking (β=0.132, p=0.037), dyslipidemia (β=0.149, p=0.013), Diabetes Mellitus (β=232, p<0.001), NA dimension of TDP (β=0.255, p<0.001) and SI (β=0.279, p<0.001) dimension of TDP have a significant contribution to the complexity of CAD assessed by Syntax score. Conclusion: TDP was associated with a more complex CAD assessed by Syntax score, and may represent a dynamic interface between the biological and psychological vulnerabilities and the symptoms of CAD.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2017
Incidence of Alzheimer's disease (AD) in people over 75 years is much higher, and the progres... more Incidence of Alzheimer's disease (AD) in people over 75 years is much higher, and the progression of cognitive deficit become faster, leading to a decrease of quality of life for patients and their families. In this context, it is proposed a multifactorial pathogenic model of disconnected cognitive circuits, which is combined with genetic and vascular-cerebral vulnerability elements, allowing an aggressive progression of neurodegenerative factors, favoring onset of dementia. Data from research studies on animal model (rat) highlighted central role of cerebral cholinergic deficit (which is amplified by cerebral ischemia) on the background of apolipoprotein E4 (ApoE4) genotype, favoring multifactorial disconnected mechanisms, by excess of beta-amyloid (β-A) or increase of vascular dysfunction. Depressive disorder, social stress and traumatic brain injury are favoring the excess in production of β-A. Hippocampal structure disconnects the cognitive circuits, and from a neuropsycholo...
Attention Deficit Hyperkinetic Disorder (ADHD) is a neurobiological behavioral disorder of the ch... more Attention Deficit Hyperkinetic Disorder (ADHD) is a neurobiological behavioral disorder of the child, adolescent, and adult characterized by problems of concentration, hyperactivity, and impulsivity caused by an imbalance of chemical neurotransmitters in the brain—dopamine and noradrenaline. ADHD first-line drugs are divided in psychostimulant, as Methylphenidate and Amphetamines and non-psychostimulant medications-Atomoxetine (the only representative non-psychostimulant medication approved in our country in children and adolescents). The purpose of our research was to assess the clinical evolution of patients with ADHD based on the drug treatment that is administered: psychostimulant or non-psychostimulant. Both psychostimulant—Methylphenidate, and non-psychostimulant therapy—Atomoxetine, proved to significantly improve the symptoms of attention deficit hyperkinetic disorder. There was a significant reduction in the severity of ADHD symptoms at six months and at one year from the s...
Healthcare
Background: COVID-19 has led to a global health crisis that is defining for our times and one of ... more Background: COVID-19 has led to a global health crisis that is defining for our times and one of the greatest challenges to emerge since World War II. The potential impact of the pandemic on mental health should not be overlooked, especially among vulnerable populations such as women who gave birth during the COVID-19 pandemic. Materials and Methods: The study is a cross-sectional survey conducted from 1 March 2020 to 1 March 2023, during the period of the SARS-CoV-2 (COVID-19) pandemic, based on a retrospective evaluation of 860 postpartum women. The screening tool used to assess symptoms of postpartum depression was the Edinburgh Postnatal Depression Rating Scale (EPDS) questionnaire. The questionnaire was completed both in the Obstetrics and Gynaecology Clinical Sections I and II of the “Pius Brînzeu” County Emergency Hospital in Timisoara, Romania, and online using Google Forms. Results: The highest severity of postpartum depression symptoms was observed during the COVID-19 pand...
FARMACIA, 2020
Alcohol dependence and harmful use represent the most prevalent addictive disorder worldwide. Alc... more Alcohol dependence and harmful use represent the most prevalent addictive disorder worldwide. Alcohol withdrawal syndrome is considered a life-threatening condition by inducing severe physiological imbalances. Pharmacological management of alcohol withdrawal syndrome is very complex and challenging, often involving a long duration in getting remission. Our ongoing study aimed to analyse the efficacy of clonidine (an alpha-2-agonist) for improving alcohol withdrawal syndrome quantified by the mean change of The Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) scores. Of 30 patients with alcohol withdrawal syndrome recruited so far, 11 (36.7%) benefited from clonidine treatment. Blood pressure and other physiological signs were periodically monitored. Although at the beginning of the treatment there were no differences between the mean CIWA-Ar scores (t = 0.352, p = 0.599), after 5 days the difference became significant in favour of those treated with clonidine (t = 3.147, p = 0.004). Clonidine may provide additional benefit in managing alcohol withdrawal by offering a different mechanism of action for targeting withdrawal symptoms. Rezumat Dependența de alcool și consumul dăunător de alcool reprezintă cele mai răspândite tulburări de adicție la nivel mondial. Sindromul de sevraj etanolic este considerat o afecțiune care pune viața în pericol prin inducerea unor dezechilibre fiziologice severe. Managementul farmacologic al sindromului de sevraj la alcool este foarte complex și provocator, implicând adesea o durată lungă de obținere a remisiunii. Studiul nostru în curs a urmărit să analizeze eficacitatea clonidinei (un agonist alfa-2) pentru ameliorarea sindromului de sevraj alcoolic cuantificată prin modificarea medie a scorurilor scalei The Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar). Din 30 de pacienți cu sindrom de sevraj alcoolic recrutați până în prezent, 11 (36,7%) au beneficiat de tratament cu clonidină. Tensiunea arterială și alte semne fiziologice au fost monitoriza te periodic. Deși la începutul tratamentului nu au existat diferențe între scorurile medii CIWA-Ar (t = 0,352, p = 0,599), după 5 zile diferența a devenit semnificativă în favoarea celor tratați cu clonidină (t = 3,147, p = 0,004). Clonidina poate oferi beneficii suplimentare în gestionarea sevrajului la alcool, oferind un mecanism diferit de acțiune ce se adresează simptomelor de sevraj.
FARMACIA, 2020
Due to its debilitating character and the propensity to chronicity, schizophrenia is one of the m... more Due to its debilitating character and the propensity to chronicity, schizophrenia is one of the most important psychotic disorder of modern times. Recent studies have emphasized the superiority of depot long-acting antipsychotics (LAIs) versus oral antipsychotics in terms of remission maintenance and the prevention of relapses and (re)hospitalization events. Here we designed a mirror-image study meant to analyse the efficacy of one-year long LAI therapy for 21 patients admitted to the "Eduard Pamfil" Psychiatry Clinic Timisoara for which a previous one-year long oral antipsychotic therapy didn't provide satisfactory results. To further strengthen our analysis, we have also compared the mirror-image data set with the results of a parallel analysis of a control group of 11 patients under therapy with the same oral antipsychotics for an equivalent period (two years) of time. Both analyses have shown a significant reduction of re-hospitalization accompanied by a substantial alteration of PANSS scores dynamics in the group of patients treated with LAIs, thus proving the overall superiority of LAIs in comparison with oral antipsychotics. Last but not least, we critically discuss two rather sensitive issues in schizophreni a therapy, the high level of polypharmacy and a hidden bias of clinical psychiatrists in selecting the patients suitable for therapeutic switch from oral to depot antipsychotics. Rezumat Studiile existente au evidențiat superioritatea antipsohticelor depot (LAI) față de antipsihoticele orale, în menținerea remisiunii, prevenirea recăderilor și implicit a respitalizărilor. Am efectuat o cercetare de tip mirror-image study, care a inclus 21 de pacienți ce au fost inițiați în cadrul Clinicii de Psihiatrie "Eduard Pamfil" Timișoara pe unul din antipsihotice atipice depot disponibile în țara noastră, după eșecul tratamentului cu antipsihotice orale ce a avut o durată de minim un an de zile anterior acestei inițieri. Pentru a reconfirma eficacitatea măsurată prin numărul mediu de spitalizări a fost făcută și o a doua analiză comparativă folosind datele unui grup de control format din 11 pacienți ce au beneficiat de tratament cu un același antipsihotic oral pe o durată de minim 2 ani de zile. Atât analiza de tip mirror-image efectuată în cadrul grupului cu antipsihotice depot, cât și compararea acestuia cu grupul de control a evidențiat o reducere semnificativă a numărului de spitalizări sub tratamentul cu antipsihotice depot. Mai mult, evoluția mediilor scorurilor în scala PANSS și a celor din subscalele acesteia a fost una semnificativă în favoarea eficacității tratamentului cu antipsihotice depot. Prezența evenimentelor adverse legate de tratament este o realitate clinică și apare la o majoritate covârșitoare a pacienților tratați cu antipsihotice LAI. Nivelul crescut de polipragmazie în tratamentul schizofreniei în ambele grupuri luate în considerare, precum și existența unui anumit subiectivism al practicienilor în alegerea cazurilor pentru tratamentul cu antipsihotice depot, au constituit alte două rezultate valoroase ale cercetării noastre.
FARMACIA, 2020
Despite the treatability and advances in treatment of major depressive disorder (MDD), treatment ... more Despite the treatability and advances in treatment of major depressive disorder (MDD), treatment responsiveness is still only around 30-50%. The involvement of pro-inflammatory factors in the pathogenesis of major depression is one of the new perspectives of current research. This is a prospective study over an 8-week period in 50 MDD patients with single or multiple episodes recruited from the Timișoara Psychiatry Clinic during 2016-2019. Several psychometric measures were applied and baseline for C Reactive Protein (CRP) and Interleukin-6 (IL-6) blood levels were determined. Among the 17item Hamilton Depression Rating Scale (HAM-D), somatic anxiety, somatic symptoms-general and insight had significantly higher scores in MDD patients with elevated inflammatory markers compared to their counterpart with normal inflammatory marker levels (p < 0.05). Add-on celecoxib treatment determined a significantly lowered mean HAM-D scores at endpoint in MDD patients with elevated inflammatory markers (p < 0.01). Linear regression analysis revealed the presence of inflammation (IL-6 and/or CRP) and add-on celecoxib treatment as significantly influencing endpoint HAM-D scores (p < 0.01). Routine determination of inflammatory markers in MDD patients, together with add-on celecoxib treatment, generates new opportunities for the clinical management of this highly frequent psychiatric condition in the general population. Rezumat În ciuda tratabilității și a progreselor făcute în domeniul tratamentului tulburărilor depresive majore, respondența terapeutică rămâne una modestă variind între 30 și 50%. Implicarea factorilor pro-inflamatori în patogeneza tulburării depresive majore este una din perspectivele noi ale cercetărilor actuale. Studiul de față este unul prospectiv longitudinal pe o perioadă de 8 săptămâni asupra a 50 de pacienți cu tulburare depresivă majoră, episod unic sau multiplu, recrutați în cadrul Clinicii de Psihiatrie Timișoara în perioada 2016-2019. Au fost aplicate mai multe teste psihometrice și au fost determinate inițial nivelurile sanguine ale Proteinei C Reactive (PCR) și ale Interleukinei 6 (IL-6). Dintre itemii scalei HAM-D versiunea cu 17 itemi, anxietatea somatică, simptome somatice generale și conștiința bolii au avut medii ale scorurilor semnificativ mai mari în comparație cu pacienții cu tulburare depresivă majoră fără proces inflamator semnificativ (p < 0,05). Tratamentul suplimentar cu celecoxib a determinat o reducere semnificativ mai mare a scorurilor HAM-D la sfârșitul perioadei de studiu în situația pacienților cu tulburare depresivă majoră și proces inflamator prezent (p < 0,01). Regresia liniară a identificat prezența inflamației (PCR și/sau IL-6) și a tratamentului suplimentar cu celecoxib, inițiat de la începutul studiului, ambele având o influență semnificativă asupra scorurilor scalei HAM-D de la sfârșitul perioadei de studiu (p < 0,01). Detecția de rutină a markerilor inflamatori și instituirea tratamentului cu celecoxib, când este necesar, la pacienții cu tulburare depresivă majoră deschide noi oportunități în abordarea și managementul clinic al aceste afecțiuni psihiatrice larg răspândite în populația generală.
Revista De Chimie, 2020
Many prognostic factors for HL have been proposed in the past and some of these were included in ... more Many prognostic factors for HL have been proposed in the past and some of these were included in several prognostic scores. Tumor stage and spread, age, gender and various biological parameters are considered to have an effect on disease evolution, with the prognostic scores stratifying patients into risk groups and guiding the course of treatment. In the present study we have enrolled 54 patients with Hodgkin’s lymphoma admitted in the Hematology Department within the City Emergency Clinical Hospital Timisoara over a 4-year period. We aimed to see if a statistically significant correlation can be made between hemoglobin, white blood cell, lymphocyte, eosinophil, monocyte and platelet levels at the time of diagnosis on the one hand, and response to treatment and patients’ survival, on the other hand. Patients’ response to treatment was evaluated according to Cheson criteria, with best response to the combination of ABVD(doxorubicin C27H29NO11, bleomycin C55H84N17O21S3, vinblastine C...
Psihiatru.ro, 2018
<jats:p>Schizophrenia remains the major psychiatric disorder with the most debilitating eff... more <jats:p>Schizophrenia remains the major psychiatric disorder with the most debilitating effects, for which psychopharmacological treatment is only capable of a partial recovery from the total symptomatic dimensions. The clinical evolution and prognosis of these patients are still discouraging. Although are less disruptive for families and society, negative and cognitive symptoms heavily precede the psychotic onset of schizophrenia and have the tendency to persist even after the remission of the disease's positive symptoms, sometimes considered as a state of psychic defect. These two symptomatic dimensions have the highest share in influencing disability and in the reduction of the autonomy degree of these patients. In the last decades, other cerebral neurotransmission pathways have been identified, and their dysfunction are supposed to underpin the negative and cognitive symptoms of schizophrenia. Highlighting the contribution of cholinergic, glutamatergic and serotonergic receptors, along with the role of other dopaminergic receptors besides those previously known have generated hope for the development of a new psychotropic class that can specifically target these types of symptoms.</jats:p>
European Psychiatry, 2009
Aims/Objectives:Our main purpose was to examine the clinical and socio-demographical influencing ... more Aims/Objectives:Our main purpose was to examine the clinical and socio-demographical influencing factors that play a significant role to medical co-morbidity occurrences in unipolar depressives.Methods:We performed two types of clinical studies, one longitudinal retrospective study on 248 unipolar depressives admitted in our Clinic during 2001 - 2005 and second represented by a cross-sectional study on 45 inpatients and outpatients that had meet diagnostic criteria of unipolar depression according to ICD-10 and DSM-IV.Results:Socio-demographical factors that concurring to medical co-morbidity in unipolar depressives were represented by advanced current age and low educational level. Interestingly, the total duration of unipolar depression was not significant correlated with medical co-morbidity. A positive familial history of depression was correlated with a significant higher risk for coronary hearth diseases (depressives - average=0.443, S.D. =0.652; bipolars+delusionals - average...
European Psychiatry, 2010
The models of non-verbal behavior and communication constitute the basis of the clinical experien... more The models of non-verbal behavior and communication constitute the basis of the clinical experience that determinate the presumptive diagnoses or initial diagnoses.In depression, according to statistics, the majority of cases aren’t detected being treated by other medicine specialties or remaining without being treated.We propose a study that would develop a system of screening which would detect the cases suspected of depression. This is based on the gait pressure analyses, model AGILE, the analyses of the physical specter of speech, the automatic analyses of gesture. All these three investigations can be realized in a very short period of time, of a few minutes for every case.The pressure of the gat analyses took only tens of seconds. The suspected cases go forward to gesture and speech analyses, which took three minutes.The determination of the diagnostic is made after the psychiatric clinical examination, after the known criteria.At this system can be add the recognizing of depr...
Antioxidants, 2021
Rutin (Rut) is a natural flavonol, well-known for its broad-spectrum of therapeutic effects, incl... more Rutin (Rut) is a natural flavonol, well-known for its broad-spectrum of therapeutic effects, including antioxidant and antitumoral activities; still, it has a reduced clinical outcome due to its limited solubility in aqueous solutions. To overcome this drawback, this study proposes a novel formulation for rutin as a proniosomal gel for cutaneous applications. The gel was prepared by coacervation phase-separation method and complies with the standard requirements in terms of particle size (140.5 ± 2.56 nm), zeta potential (−27.33 ± 0.09 mV), encapsulation capacity (> 50%), pH (7.002 ± 0.18) and rheological properties. The results showed high biocompatibility of the gel on the 3D reconstructed human epidermis model characterized by increased viability of the cells and a lack of irritant and phototoxic potential. The evaluations on 2D cells confirm the preferential cytotoxic effect of Rut on melanoma cells (IC50 value = 8.601 µM, nuclear fragmentation) compared to normal keratinocyt...
European Neuropsychopharmacology, 2016
that occurred in the active phase only were sleep disturbances (3 patients), blurred vision (2 pa... more that occurred in the active phase only were sleep disturbances (3 patients), blurred vision (2 patients), and disinhibition (e.g. extremely talkative, 2 patients). Discussion: vALIC DBS resulted in significant decrease of depressive symptoms in ten of 25 patients and was tolerated well. The randomized cross-over phase corroborates that vALIC DBS causes the symptom reduction rather than placebo. These results are at odds with a recently published randomized controlled trial of ventral capsule/ventral striatum DBS [2], who found no differences between active and sham stimulation. Possible reasons could be the somewhat more anterior placement of the electrodes in our study or differences between studies in strategies to optimize DBS parameters. This study confirms the promise of DBS and in light of previous research calls for further specification of targets and optimization strategies.
European Psychiatry, 2015
European Psychiatry, 2013
Introduction Major depressive disorder, the most prevalent psychiatric disorder in general popula... more Introduction Major depressive disorder, the most prevalent psychiatric disorder in general population, raises a series of clinical challenges, chronic medical comorbidity being regular one. Objectives Our main objective was to analyze the weight of anxiety and depressive symptoms levels, and that of premorbid personality traits, in co-occurrence of medical diseases in subjects with major depressive disorder. Methods A cross-sectional research was performed on 32 inpatient subjects admitted in Timisoara Psychiatric Clinic during 2010 - 2012 with major depressive disorder. Anxiety symptoms level were self-assessed with Beck Anxiety Inventory and depressive symptoms level were self-assessed with Beck Depression Inventory. Temperament and character personality traits were self-assessed using Cloninger TCI tool, which was administrated once that clinical remission has occurred. Results Majority of studied subjects (71%) have had at least one comorbid chronic medical diseases. Despite the results of other studies, the level of depressive and anxiety symptoms has no significant impact in medical comorbidity occurrence. Major depressive subjects with medical comorbidity, have had significant higher scores in Harm Avoidance, more exactly in Shyness with Strangers (p = 0.007) and Fatigability (p = 0.013). Significant higher total scores were revealed, in the same subjects, for all three character dimensions like as Self-Directedness (p = 0.004), Cooperativeness (p = 0.039) and Self-Transcendence (p = 0.030). Conclusions According to our research results, rather than temporary clinical symptoms constituting clinical picture of subjects with major depression there is possible that premorbid personality traits could weigh more significant to the appearance of medical comorbid conditions.
European Psychiatry, 2009
Kashmir has observed increase in number of Substance dependence (SD) patients due to various fact... more Kashmir has observed increase in number of Substance dependence (SD) patients due to various factors like easy availability of drugs, drugs smuggled across border, but most importantly present disturbed conditions for last two decades. Drug use appears to have an important role in etiology and vulnerability to development of psychiatric disorders and vice versa. After DSM IV allowed the clinicians to give multiple diagnosis when different syndromes occur together in one episode of illness, the issue of comorbidity has assumed central stage. A methodical, staged screening and assessment can ease the diagnostic challenge of distinguishing the symptoms of psychiatric disorders from manifestations of substance intoxication and withdrawal. This study was carried out on total of 300 substance dependence patients who were screened for psychiatric disorders by DSM IV based MINI Plus interview. The study revealed that 58% (n=174) had psychiatric comorbidity, with most number of patients betw...
Neuropsychiatric Disease and Treatment
The relationship between personality traits and cardiovascular disease has gathered sustained int... more The relationship between personality traits and cardiovascular disease has gathered sustained interest over the last years, typeD personality (TDP) being significantly associated with coronary artery disease (CAD). However, data regarding the connection between the TDP and the severity of CAD disease is scarce. The aim of our study was to assess the relationship between TDP and the complexity of CAD, and to compare it with other sociodemographic and clinical features. Patients and Methods: We conducted a cross-sectional case-control clinical-based study on 221 consecutive hospitalized patients with chest pain (60 ± 10.2 years; 131 men), referred for coronary angiography. Results: TDP was identified in 42 (19%) patients, using the DS 14 scale. Symptomatology profile was evaluated using the SCL-90 scale. Syntax score was greater in the subgroup of patients with TDP in comparison to non-TDP subgroup (26.21±12.03 vs 15.49±8.89, respectively, p<0.001), and most of SCL-90 symptom dimensions have significantly higher levels in the subgroup of TDP with CAD patients (all p < 0.05). Smoking (β=0.132, p=0.037), dyslipidemia (β=0.149, p=0.013), Diabetes Mellitus (β=232, p<0.001), NA dimension of TDP (β=0.255, p<0.001) and SI (β=0.279, p<0.001) dimension of TDP have a significant contribution to the complexity of CAD assessed by Syntax score. Conclusion: TDP was associated with a more complex CAD assessed by Syntax score, and may represent a dynamic interface between the biological and psychological vulnerabilities and the symptoms of CAD.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2017
Incidence of Alzheimer's disease (AD) in people over 75 years is much higher, and the progres... more Incidence of Alzheimer's disease (AD) in people over 75 years is much higher, and the progression of cognitive deficit become faster, leading to a decrease of quality of life for patients and their families. In this context, it is proposed a multifactorial pathogenic model of disconnected cognitive circuits, which is combined with genetic and vascular-cerebral vulnerability elements, allowing an aggressive progression of neurodegenerative factors, favoring onset of dementia. Data from research studies on animal model (rat) highlighted central role of cerebral cholinergic deficit (which is amplified by cerebral ischemia) on the background of apolipoprotein E4 (ApoE4) genotype, favoring multifactorial disconnected mechanisms, by excess of beta-amyloid (β-A) or increase of vascular dysfunction. Depressive disorder, social stress and traumatic brain injury are favoring the excess in production of β-A. Hippocampal structure disconnects the cognitive circuits, and from a neuropsycholo...
Attention Deficit Hyperkinetic Disorder (ADHD) is a neurobiological behavioral disorder of the ch... more Attention Deficit Hyperkinetic Disorder (ADHD) is a neurobiological behavioral disorder of the child, adolescent, and adult characterized by problems of concentration, hyperactivity, and impulsivity caused by an imbalance of chemical neurotransmitters in the brain—dopamine and noradrenaline. ADHD first-line drugs are divided in psychostimulant, as Methylphenidate and Amphetamines and non-psychostimulant medications-Atomoxetine (the only representative non-psychostimulant medication approved in our country in children and adolescents). The purpose of our research was to assess the clinical evolution of patients with ADHD based on the drug treatment that is administered: psychostimulant or non-psychostimulant. Both psychostimulant—Methylphenidate, and non-psychostimulant therapy—Atomoxetine, proved to significantly improve the symptoms of attention deficit hyperkinetic disorder. There was a significant reduction in the severity of ADHD symptoms at six months and at one year from the s...