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Introduction. The performance areas of post-stroke mention negatively correlated determinants in doing daily activities. The intrinsic motor recovery depends on the primary motor deficit. The functional recovery of patients with post-stroke sequelae is not only based on the remission of the functional deficit, but it also depends on the ability to develop adapted motor strategies.The objective of the study was to point out, for the patients with post-stroke sequelae, the sensitive, motor and cognitive changes in the context of the COVID-19 pandemic. Material and method. The study included a number of 18 patients diagnosed with post-stroke sequelae and was conducted for a period of 5 months in an outpatient department. The recovery treatment included sessions of kinetotherapy and occupational therapy. The evaluation of the patients was made in the beginning of the treatment, at its end and at the control after 6 weeks. Scales were used to assess pain, the static and dynamic balance, the gait and the cognitive function. Results. The obtained results were statistically significant for the patients in the group. The values that were obtained by applying the tests and evaluation scales are consistent with the clinical evolution of the patients in the study group. Conclusions. Given the pandemic period we are going through, it is still necessary to carefully evaluate not only the sensory-motor functions of patients with post-stroke sequelae, but also the cognitive functions that are known to influence in some situations the recovery of these patients.

Background: Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. Methods: The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. Results: The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. Conclusions: Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training. [ABSTRACT FROM AUTHOR]

Introduction.According to the criteria of WHO, stroke is a health condition that causes focal or global brain disorders (1), but without an apparent nonvascular cause. Stroke is considered the third leading cause of death in industrialized countries and accounts for 9% of all deaths, being considered one of the largest cases of disability in the world. Due to the medical, social and economic consequences that it causes, stroke is considered a public health issue. Purpose of research. The study starts from the idea that in the recovery of stroke patients it is important to have an individualized physiotherapy program adapted to the functional parts of each patient, having the role of improving the static and dynamic balance, of achieving postural control and finally functional independence. Material and method. The study included a number of 22 patients with sequelae stroke. They made physiotherapy, occupational therapy and occupational therapy sessions in the ambulatory, with the length of 1 hour, 3 times a week, in total 15 sessions. The evaluation of the patient was performed in the beginning of the treatment and at the end of it. Scales were used to assess mobility, static and dynamic balance, gait and functional independence. Results. The application of individualized treatment adapted to the functional body of each patient allowed a rapid recovery for the vast majority of the studied patients. The values obtained in the tests and evaluation scales are in accordance with the clinical evolution of the patients. Conclusions.The application of the treatment by kinetic therapy, work therapy and occupational therapy to the 22 patients, for a period of 3 weeks pointed out the reduction of pain, the improvement of movements, the recovery of transfers and gait, the postural improvement.

The patient P.E., 54 years old, female, divorced, from a rural area, medically retired, known from several years with the diagnosis of paranoid schizophrenia, presented to the emergency service for a suicide attempt. The suicide attempt occurred as a result of the presence of depressive symptoms (depressed mood, ideas of worthlessness, self-stigma, social withdrawal), and impulsivity in a psychoreactive context. The treatment administered in the hospital consisted of risperidone 4 mg/day, valproic acid 600 mg/day and duloxetine 60 mg/day, the evolution being favorable during the hospitalization, but also six months after discharge. In this case, the suicide attempt occurred in a stressful context, on a background of low frustration tolerance, impulsivity and depression within the schizophrenic disorder. The presence of depressive symptoms – especially the feeling of worthlessness – in patients with schizophrenia can be understood from several psychopathological perspectives: depression as an intrinsic part of schizophrenia, or as an independent mental disorder. In this case, it is considered that depression is a component of schizophrenia – a form of subliminal depressive symptoms. Depression is the most important risk factor for suicide, in the remission phases of the disease, in individuals with schizophrenia. Studies have shown that there is, in fact, a transdiagnostic psychopathological pattern, a continuum between affective disorders and psychotic spectrum disorders, which is explained by decreased neuroplasticity. Currently, there is more and more research that takes into account the fact that depressive symptomatology can be a component of the clinical picture of schizophrenia and, in most cases, suicide attempts in schizophrenia are its consequences. [ABSTRACT FROM AUTHOR]

Psychosomatic disorders confront a myriad of challenges, including insufficient mental health community services, on the one hand, and physician rejection and stigmatization of psychiatric symptoms on the other. Unhealthy lifestyle choices interact in a negative way with the Romanian people's health; these choices account for around half of the country's total mortality rate. So, the rate of heavy binge drinking is greater than the same rate in the European Union. Daily smokers rate in Romania is 1:5; overweight or obese represent approximately, half of the country's adult population; ischemic heart disease stroke being the second-largest death cause. Romania ranks first at the treatable mortality rate in Europe. We sought to establish the necessary grounds for including psychosomatic day-care clinics in the Romanian healthcare system. [ABSTRACT FROM AUTHOR]

Depression is a chronic mental health condition that can negatively affect the quality of life, and the pharmacological treatments, however, are ineffective in 30% of patients with major depressive disorder. Disruption in the gut barrier, known as leaky gut, causes gut derived endotoxins and lipopolysaccharide to leak into the blood streams, leading to the activation of the immune system. Probiotics may exert their therapeutic effects on the central nervous system by improving the integrity of the gastrointestinal lining, reducing the ability of endotoxins to leak into the bloodstream. Articles were retrieved from PubMed (from 2003 to 2022 June). For example, Lyra et al. conducted an RCT on 391 adult irritable bowel syndrome (IBS) volunteers. The effect of L. acidophilus NCFM was that, after 12 weeks, the depression scale improved significantly only in the high-dose group. Roberts et al. demonstrated the effect of the Ecologic Barrier® probiotic on 71 depressed participants, measuring the depression symptoms and microbiota composition, and observing a decreased KYN concentration in the MDD patients. Asemi et al. conducted a trial on 60 women with polycystic ovary syndrome (PCOS) that showed a significant improvement on Beck’s depression inventory compared to placebo. Mitchell et al. reported that the patients (423 women with 14-16 weeks of gestation) who received HN001 had significantly lower depression and anxiety scores in the postpartum period compared to the placebo group. Probiotic supplementation through the action on the microbiota-gut-brain-axis associated with depression could constitute a valid adjuvant treatment. [ABSTRACT FROM AUTHOR]

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Depression represents one of the most important burden sources at the global level, bearing significant costs on the society. A major component of these costs is defined by the social dysfunctions and the impact they have at the individual and collective level. In this context, our aim was represented by a comparative assessment of the role the coping mechanisms play on the level of global functioning of patients with major depression disorder under usual antidepressant medication, augmented by cognitive behavioral psychotherapy. The rehabilitation of psychosocial functioning of depressive patients is significantly influenced by cognitive coping mechanisms such as acceptance, rumination or putting into perspective. Thus, the multidisciplinary therapeutic approach becomes a certainty, which would lead to a fast recovery of the depressive person from the clinical and functional point of view. [ABSTRACT FROM AUTHOR]

Psychotraumas from childhood and maturity are directly involved in the etiopathogenesis of schizophrenia, correlating with the biological and biochemical risk factors. In as sample of 248 subjects diagnosed with paranoid schizophrenia, the presence of the psychotrauma within 9-15 years age was correlated with common psychological features, low socio-economic status and large number of episodes of disease that cause multiple readmissions. Thus, it becomes extremely important the early identification of the positive history for psychotraumatic events in patients with paranoid schizophrenia, as well as when psychotrauma occurred, in order to adopt a complex therapeutic management, including interventions too. [ABSTRACT FROM AUTHOR]

The phenomenon of dissociation has been observed since ancient times, but its conceptual description emerged only at the beginning of the twentieth century in the same time with the studies of the hysteria of Pierre Janet and Sigmund Freud at the Salpêtriere Psychiatric Hospital. At present, the concept of dissociation has shifted its significance from the hysteria area and has demonstrated its validity in the sphere of normality, when passively or willingly the individual is detached from the painful experiences of life, as well as in the area of pathology when, after a trauma, there is an interruption of the integration of mental functions by separation of consciousness, memory, self-perception and reality. The DSM and ICD classification systems have implemented this concept in the form of the „Disociative Disorders” group. There are several differences in the classification of the components of this diagnostic category in the two systems, but the most, important is the „Conversion Disorder” situation in „Disorder with Somatic Symptoms and Associated Disorders” in DSM-5 and its equivalent, „Dissociative Disorder with Neurological Symptoms” in „Dissociation Disorders” in ICD-11. [ABSTRACT FROM AUTHOR]

Hypochondria is a psychiatric disorder that, even though it has been known since the antiquity, it has always been difficult to conceptualize it from a nosologic point of view. In ICD 11, hypochondria was included in a category made of „Obsessive compulsive disorder and other relational diseases”, being excluded this way from the category of „Somatoform disorders” as in ICD 10. The patient C.T., 54 years old, from Sibiu, came to our Psychiatric Department presenting anxious-depressive symptoms and somatic symptoms triggered by a medical check-up that determined at first a state of anxiety, that later evolved into a „major depressive disorder, major depressive episode with somatic features”. From a therapeutic perspective, the patient followed an antidepressant treatment; psychotherapy has been indicated too, but the patient didn’t undergo it. The symptoms have progressed, until attaining a delusional intensity, and the diagnosis was then changed to „hypochondria with absent insight”. An antipsychotic treatment was introduced; the patient then had significant progress once some changes appeared in his family environment. Switching the diagnosis from the neurotic to psychotic register ("Hypocondria with absent insight") happened as a result of a follow-up for the later installed signs of delusion, guilt, sin, shame and a loss of self-esteem, which persisted for a long period, while also having traits of obsessive-compulsive personality, and the perception of an insufficient social support. [ABSTRACT FROM AUTHOR]

The aim of the study is to analyse the use of the internet on a sample of 1276 medical students from all the university centers around the country. By applying a questionnaire that follows the professional development and a questionnaire that measures the internet addiction the following results were achieved: 8,5% from the students developed internet addiction, most of them from Iaşi; also, the ones that developed internet addiction did not use the internet as a form of professional development, in contrast with the ones that use the internet as an information source, having better academic performances. [ABSTRACT FROM AUTHOR]

The suicidal behavior is a human behavior with a complex causality associated, in a great extent, with the psychiatric disorders. The psychosomatic diseases represent a very extensive medical area that comprises different disorders with psychic and somatic symptoms. Although the somatization disorders are not in the first positions regarding the association with the suicidal behavior, there are some studies that confirm this kind of link. Even more, in many cases, the somatization disorders are comorbid with the major depressive disorder and the personality disorders, and, in this case, the probability of the suicidal act increases. The somatic symptoms, as an expression of the somatization or the consequences of the stress mechanisms, lead to discomfort, sufferance and hopelessness which can precipitate the suicide. [ABSTRACT FROM AUTHOR]

Mental health is an important area of public health because the impact of the mental disorders is very expensive for the society. That's why it must exist a regular assessment of mental health needs and social care of the patient with a poor functionality. First, an analysis will be made of the actual mental health services as regards the target population (mental health unit), the budgeting mode and the management indicators. Further, the needs assessment consists in identifying the prevalence of the serious and less serious mental disorders and the need assessment of the mental health services (ambulatory, community, hospital, residential centers). The National Plan of Action in Mental Health identifies as a priority need the community services development. [ABSTRACT FROM AUTHOR]

The development of a coherent Mental Health System is a purpose hard to accomplish due to the complexity of the field, the preconceived ideas related to psychic illness, as well as the economic and administrative difficulties characteristic for the Romanian Health System. In order to accomplish an assessment of the needs of improving the activities of the field it has to be known the difficulties inside the system from the point of view of the patients, of the beneficiaries from the mental health services. According to a questionnaire conducted into patients, a survey that assesses the perception of the stigmatization phenomena and the identification of some needs that can improve mental health services, shows the presence of the embarrassment (46.9%), but, still, a positive attitude related to dealing with psychiatry (84.4%), the need of increasing communication with the therapist (41.7%), increasing safety (44.7%), easy access to out-patient treatment (40%). [ABSTRACT FROM AUTHOR]

The medical profession implies a series of stressful situations, and medical students start confronting with specific stress factors (for example, sufferance, responsibility), and, besides these, others like, academic (residency exam) or personal stress factors (for example, less leisure time). As a reaction to these stress factors they develop different coping mechanisms and, sometimes even anxiety. This work aims: 1) to analyse the stress factors acting on medical students; 2) to study the relationship between demographic and stress factors, on the one hand, and the perceived stress, anxiety (state and/or trait) and coping modalities, on the other hand; 3) to asses if maladaptive coping is a predictor for an increased anxiety (state or trait). [ABSTRACT FROM AUTHOR]

The medical profession is an extremely complex profession due to the fact that, in addition to its scientific content, it also has a relational component that must be carried out under special conditions, with the sick man, who often manifests a special sensitivity given to the individual characteristics and characteristics of his own illness. The doctor-patient relationship represents the basic structure of the medical care that allows a viable and high-level construction of the therapeutic relationship itself. In this relationship, both participants, the physician and the patient share both their roles and responsibilities arising as a consequence of one another's behaviour. In general, the doctor-patient relationship implies acceptance of the patient even if his behaviour is not always approved, building the patient's trust for openness and respecting the proposed conditions and deadlines, and effective communication based on empathy and encouraging the patient to express his emotions and thoughts in the face of his illness. In psychiatry, all these principles present some nuances due to the specificity of the psychopathological problem. But in order to meet the challenges posed by the doctor-patient relationship in psychiatry, it is necessary, first of all for the doctor to go through a process of self-awareness, to have a good knowledge of himself, so that he can capture the reactions and the subtle answers. expressed by those they interact with. Further, having this knowledge of himself the doctor will have to use in the interview some aspects of his personality, experiences, values to establish a good therapeutic relationship. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome is a chronic gastrointestinal pathology, which is defined by bowel movement disorder, visceral hypersensibility, gut dysbiosis and alteration of visceral nervous system biofeedback. Although the psychopathological mechanisms of this syndrome are not fully understood, there are new directions in approaching and treating the disease. The presence of gastrointestinal and psychiatric symptoms imply the existence of a biopsychosocial model and the role of the gut-brain axis. The malfunction of the HPA axis, the endocrin and nervous system, but also the dysbiosis exacerbate and maintain the symptoms. Psychiatric co-morbidities are more frequent for the patients that have irritable bowel syndrome, hence the quality of life is altered and the adherence to treatment is lower. Although the literature reveals important correlation between the diagnosis of irritable bowel syndrome, psychiatric comorbidities and impaired quality of life in relation to health, these factors are poorly investigated regarding the coping mechanisms development and modulation of behavioural and emotional response of the patients. [ABSTRACT FROM AUTHOR]

The neurobiology of depression is currently focusing on studies of functional neuronal connectivity. Thus, in depression, four neural networks (and their dis-connectivity) have been constantly implicated: the ventral limbic network that is associated with the excessive negative mood, the default mode network - responsible for depressive rumination, the fronto-striatal network of the positive or reward affect that is related to anhedonia and the dorso-lateral network of cognitive control involved in insufficient control of negative emotions and thoughts. The negative affect network comprises regions of the brainstem, amygdala, hippocampus, insula, dorsal medial prefrontal cortex, and ventral medial prefrontal cortex. This hyper-connectivity explains the non-conscious processing of threatening stimuli. The negative affect in depression occurs due to the hyper-connectivity between the amygdala and the cortical structures - the anterior cingulate cortex and the orbito-frontal cortex and insula. Recent studies show that the negative affect is correlated with the overall decrease in cognition and visuospatial capacity. By understanding the neurobiological substrate of depression, and identifying the specific pattern of neuronal network dysfunction and disconectivity we will be able to more accurately choose treatment modalities that offer better efficiency and better outcomes. [ABSTRACT FROM AUTHOR]

Serotonin or 5 - hydroxytryptamine, is a monoamine synthesized both in the central nervous system and in the gastrointestinal tract. The subgroup of serotoninergic receptors 1 and 2 (5HT1A, 5HT2A, 5HT2B), are known for their involvement in neuronal transmission, especially in the brain regions postulated to be involved in modulating higher cognitive and affective functions. In this paper, we discuss, from a pharmacological point of view, the particularity of the psychotropic action on the receptors in subclass 5-HT1 / 2, centralizing the latest data available in the field of structure, interconnectivity and mechanisms involved both in defining the pathophysiological substrate of psychiatric disorders and in understanding the properties of different classes of drugs. The cumulative evidence of the last decades supports the idea that modulation of 5-HT1 / 2 receptors would have a positive effect on cognitive and emotional processes. Therefore, the use of agonist / antagonist preparations, especially new generation ones, can play an important role in the treatment of disorders in the spectrum of schizophrenia, depression and beyond. [ABSTRACT FROM AUTHOR]

Euthanasia/Assisted Suicide are viewed differently by moral and religious references. In a religious way, cardinal confessions (Christianity, Judaism, Islamism, Buddhism) condemn euthanasia/assisted suicide and, in the same time have a more relaxed attitude regarding passive euthanasia. Other aspects of euthanasia regard financial/economic and ethical-medical considerations. All these contradictory standpoints are expressed in some legal acts that make specifications on the concept of "euthanasia"--Oregon's Death with Dignity Act (1994) and Netherlands's Euthanasia Law (2001).