Validation of the Romanian Version of the Halitosis Associated Life-Quality Test (HALT) in a Cross-Sectional Study among Young Adults.

Halitosis is a common condition with a significant impact on individuals' quality of life. The Halitosis Associated Life-Quality Test (HALT) is a reliable instrument for measuring this impact. This study aimed to introduce and validate the Romanian translation of the HALT questionnaire (R-HALT). We hypothesized that the R-HALT would demonstrate good reliability and validity in measuring the impact of halitosis on quality of life among Romanian teenagers and young adults. Our objectives were to translate and adapt the HALT, validate it among a cross-sectional group, and evaluate the extent of halitosis in this population. A multicentric cross-sectional design followed, which was approved by the Ethics Research Committee in Romania. The translation process involved independent translations, retro-translations, expert review, and pre-testing. The psychometric properties were evaluated among 150 patients (mean age 23.6 ± 1.8; 51% males) at dental clinics, including reliability, convergent, and discriminant validity, using accepted statistical measures such as Cronbach's alpha and Intraclass Correlation Coefficient (ICC). The R-HALT revealed strong internal consistency with Cronbach's alpha values ranging from 0.93 to 0.96, and an ICC value of 0.87 (95% CI = 0.70-0.99), demonstrating excellent test-retest reliability. Mean scores of individual items ranged from 0.82 ± 0.94 (Q3) to 3.23 ± 1.15 (Q11). The corrected item-total correlation ranged from 0.30 (Q2) to 0.90 (Q19). Organoleptic test scores diagnosed 41% (62 patients) with a score of 2, with increasing severity in 9% (13 patients) with a score of 5. The R-HALT exhibited robust reliability and validity in assessing the impact of halitosis among Romanian teenagers and young adults. The questionnaire is a strong tool for understanding, diagnosing, and managing halitosis in Romania, ultimately aiming to improve the quality of life of affected individuals. Further studies with diverse populations could enhance the applicability of the R-HALT.

Untangling the Professional Web: Understanding the Impact of Work-Related Factors on the Mental Health of Healthcare Professionals During the Late Stages of Covid-19 Pandemic.

Purpose: The COVID-19 pandemic has determined an extraordinary challenge to healthcare systems worldwide. The extraordinary circumstances, characterized by elevated stress levels, prolonged working hours, new medical procedures, media attention, and high population expectations, have created an extremely stressful situation for healthcare professionals. This period has offered a unique opportunity to examine the medical system and the responses of healthcare practitioners to stress. This research aimed to identify the work-related factors that significantly impact the mental health of healthcare professionals. Patients and Methods: Three mental health variables were assessed: anxiety, depression and stress. The work-related factors considered were professional degree, type of medical unit (COVID or non-COVID), the number of hours spent at work in a single shift, type of shifts, monthly on-call frequency, and number of COVID-19 treated patients per month. In the spring of 2022, three inventories and a demographic survey were distributed and completed online by 300 healthcare professionals from Timisoara's public hospitals in Romania. Results: Among the respondents, 47.7% reported mild symptoms of anxiety, 65.3% reported moderate levels of stress, and 33% of the participants reported mild symptoms of depression. The intensity of anxious, depressive, and stress symptoms varied significantly depending on the professional degree, number of on-calls per month, the type of medical unit where the participants worked, and the number of SARS CoV-2 patients treated in the previous month. Conclusion: Current data underlines the urgency of implementing effective strategies to reduce the stress and anxiety of medical practitioners who work with COVID-19 patients. Possible interventions encompass a variety of approaches, such as improving working conditions, reducing working hours where possible, increasing access to mental health services, and promoting team-building activities to enhance social support among colleagues. Digital mental health interventions, including online counseling and stress management programs, have also shown promise in these challenging times. Sustaining the mental health of medical practitioners is vital to support the continued provision of first-rate care to patients and to build a resilient healthcare workforce capable of navigating future health crises.

Evaluating the Aspects of Quality of Life in Individuals with Substance Use Disorder: A Systematic Review Based on the WHOQOL Questionnaire.

Substance Use Disorder (SUD) has become a significant public health concern and it profoundly impacts an individual's quality of life (QOL). This systematic review aimed to assess the QOL among patients with SUD, and to understand the differential impact of SUD on physical, mental, social, and environmental QOL domains, considering a variety of substances and identifying key factors that influence these outcomes. A comprehensive search was conducted in PubMed, Web of Science, Cochrane, and Scopus in January 2023, covering literature published until December 2022. The QOL was assessed using the World Health Organization Quality of Life (WHOQOL) instrument and the brief version of the WHOQOL, identifying the same four domains of QOL (physical, mental, social, and environmental). A total of 19 studies were selected for inclusion in the systematic review, based on individuals' polysubstance use, and excluding those using only nicotine or alcohol. The analysis included 6079 patients, with only 40.3% women, and a mean age of 36.6 years. The substances most commonly involved in SUD were cocaine (47.1%), alcohol (46.3%), and amphetamine (43.6%), considering most individuals being polysubstance users. The highest variability in QOL scores was observed in the physical domain. Mental disorders were reported in 68.3% of the patients, while long-term use of drugs, criminal history, unemployment, and low levels of education were identified as significant predictors for lower QOL by some of the studies. Similarly, sleep problems and teeth decay were also identified as significant worsening factors for QOL. This systematic review highlights that the WHOQOL survey is widely accepted and applicable for individuals with SUD worldwide. The results suggest a substantial negative impact of SUD on the QOL of affected individuals. The findings underscore the need for comprehensive interventions to address the physical, psychological, social, and environmental dimensions of QOL among individuals with SUD.

The Impact of Hyper-Acute Inflammatory Response on Stress Adaptation and Psychological Symptoms of COVID-19 Patients.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection induces a significant inflammatory response that are amplified by persistent stress. The pathophysiology of mental illnesses is explored in terms of inflammatory processes. Thus, anxious, depressed, or psychotic episodes may occur as a result of metabolic and immunological imbalances, as a direct result of their effect on the central nervous system, or as a side effect of the COVID-19 medication protocols. As such, the primary objective of this research is to establish if the psychological profiles of COVID-19 patients change substantially according to illness severity. The secondary objective is to determine if particular biological inflammatory indicators are associated with anxiety, sadness, psychoticism, and paranoid ideation. A cross-sectional study was performed on 90 hospitalized patients admitted during a 3-month period in the COVID-19 unit. All patients received the COPE-60 and SCL-90R questionnaires. Clinical and paraclinical data were collected and the information was classified according to the severity of COVID-19.The hyper-acute inflammation encountered in patients with severe COVID-19 infection characterized 80.0% of patients using disengagement coping methods, significantly more than patients with mild or moderate SARS-CoV-2 infection severity (p-value = 0.012), respectively, 73.3% severe COVID-19 patients engaging in emotion-focused coping strategies based on the COPE-60 scale (p-value = 0.037). Additionally, it was determined that negative coping mechanisms (disengagement) and emotion-focused methods are independent risk factors for developing psychoticism symptoms following acute SARS-CoV-2 infection, based on the SCL-90 questionnaire (OR = 2.07; CI = 1.44-3.01), respectively (OR = 2.92; CI = 1.44-3.01). Elevated white blood cells and monocytes and inflammatory markers, such as fibrinogen, procalcitonin, IL-6, and D-dimers, were also identified as risk factors for psychoticism symptoms in multivariate analysis. It is particularly important to consider the constant mental-state evaluation in patients with severe COVID-19 that might benefit from early intervention before psychotic symptoms onset.

Coping Strategies and Stress Related Disorders in Patients with COVID-19.

Patients with severe COVID-19 experience high-stress levels and thus are at risk for developing acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD). The present study aims to search for correlations between psychiatric response to stress and coping strategies among individuals with acute vs. remitted COVID-19. Ninety subjects with COVID-19 were included in the study, divided into two samples by disease category. Our focus was analysing the perceived stress intensity according to NSESSS and PCL-C-17 scales, and coping strategies with COPE-60. High NSESSS scores were found in 40% of acute patients, and 15.6% of remitted patients had high PCL-C-17 scores fulfilling the criteria for PTSD. We found a negative correlation between stress level and disease category. Acute patients used significantly more engagement and emotion-focused coping methods, but less disengagement types of coping than patients in the remitted phase. Remitted patients under high stress levels are prone to use disengagement and emotion-focused coping strategies. In conclusion, remitted COVID-19 patients experience lower levels of stress and use less emotion-focused strategies, except among those who developed PTSD post-COVID-19 infection, presenting with high-stress levels and using more disengagement and emotion-focused types of coping strategies.

Impairment of the cardiac ejection fraction by blocking dopamine D2 receptors induced by long-acting injectable antipsychotic treatment.

INTRODUCTION: Atypical antipsychotics have numerous benefits compared to conventional ones in respect to the possible adverse effects. However, like the other ones, they may induce direct cardiovascular alterations, probably through the apoptotic effect of dopamine receptor D2 (DRD2) blockade. The main objective of the study was to assess the cardiac ejection fraction (EF) using transthoracic speckle tracking echocardiography (TSTE) in patients treated with long-acting injectable (LAI) atypical antipsychotics. PATIENTS, MATERIALS AND METHODS: This cross-sectional study was conducted on 123 patients with schizophrenia or schizoaffective disorder divided in four samples according to their treatment: Aripiprazole, Olanzapine, Paliperidone and Risperidone. We analyzed socio-demographic data, the intensity of psychiatric symptoms, the duration of psychosis and of LAI treatment, and the cardiac EF measured with TSTE. RESULTS: We found no statistically significant differences between the four antipsychotics regarding the values of the EF. Nevertheless, we observed a trend indicating that patients treated with an antipsychotic associated with a lower affinity for the DRD2, such as Olanzapine, have higher EF values than patients treated with antipsychotics with a stronger binding to the DRD2, such as Paliperidone and Risperidone. Patients receiving Aripiprazole, which has the strongest affinity for the DRD2 from all four antipsychotics but is also a partial DRD2 agonist, display higher EF values than those on Paliperidone and Risperidone. CONCLUSIONS: Antipsychotics with a lower affinity for the DRD2 or a partial agonism for it may be associated with higher EF. Cardiac monitoring should be performed periodically in patients on LAI antipsychotic therapy.