The Analysis of Blood Inflammation Markers as Prognostic Factors in Parkinson's Disease.

Parkinson's disease is a chronic, progressive, and neurodegenerative disease, and yet with an imprecise etiopathogenesis. Although neuroinflammation was initially thought to be a secondary condition, it is now believed that microglia-induced inflammation could also contribute to the degeneration of the nigrostriatal pathway. Here, we aimed to establish the feasibility of basic inflammatory biomarkers as prognostic factors in PD. The study was based on retrospective analyses of blood samples taken from patients diagnosed with PD, as well as from healthy subjects. Complete medical records, total leukocyte count with subpopulations, and erythrocyte sedimentation rate (ESR) were analyzed. We calculated the serum neutrophils-to-lymphocytes ratio (NLR) and platelet-to lymphocytes ratio (PLR), and also compared the laboratory data between the PD group and the control group. Only PLR and NLR showed statistically significant differences (p < 0.001 and 0.04, respectively). In our study, ESR did not show statistically significant correlations with motor score or with disability. In our research, ESR was correlated with the disease duration (p = 0.04), and PLR showed a significant correlation with disease stage (p = 0.027) and disease duration (p = 0.001), but not with motor state. These biomarkers could prove to be effective tools for a primary evaluation of inflammation in PD, but further tests are required to properly investigate the neuroinflammatory status of these patients.

Diagnosis and evolution of the benign tumor osteochondroma.

Osteochondroma represents a bone outgrowth covered by cartilaginous tissue and localized on the external surface of the bone. The incidence of osteochondroma is 20-35% of all pediatric benign tumors. Osteochondromas can be present in solitary or multiple forms and usually occur in the metaphysis of long bones in immature skeletons. The present study aimed to retrospectively determine the association between imaging diagnostic accuracy and histopathological examinations, which are the main methods of diagnosis for this type of tumor. A total of 66 patients presenting with radiological aspects of osteochondroma were initially selected; however, only the 56 patients who had a positive histopathological diagnosis of osteochondroma were eventually included in this study. Patient characteristics were taken into consideration and included age, sex, lesion localization, lesion imaging semiotics and histopathological aspects. Osteochondromas are generally asymptomatic lesions that are often incidentally diagnosed after trauma, which makes it difficult to determine the exact incidence of this pathology.

The Importance of Accurate Early Diagnosis and Eradication in Helicobacter pylori Infection: Pictorial Summary Review in Children and Adults.

Among the most widespread childhood infections, Helicobacter pylori (H. pylori) develops potentially life-threatening conditions in adults if not appropriately treated. Helicobacter pylori is a common human pathogen that was first described in the stomach many years ago. The discovery of H. pylori was crucial in gastroenterology; this bacterium is associated with chronic gastritis, peptic ulcers, gastric cancer, and lymphoid tissue lymphoma related to the gastric mucosa. Studies published so far estimate that approximately 10% of subjects infected with H. pylori develop a peptic ulcer, and 1-3% of subjects develop gastric cancer. The clinical manifestations are variable and characteristically depend on the individual factors of the host. Various methods of detection and diagnosis of H. pylori infection have been developed, each with advantages, disadvantages, and/or limitations. Available diagnostic tests are usually performed using invasive (endoscopy, biopsy, rapid urease test, cultures, and molecular tests) and noninvasive methods (urea breath test, stool antigen examination, and serological and molecular tests). Although there is extensive accessibility for diagnosing and treating H. pylori infection, the prevalence of antibiotic resistance is not negligible. Thus, numerous studies and meta-analyses are focused on a new orientation of gastroenterologists in diagnosing and treating H. pylori infections. A fascinating perspective hypothesis is the administration of probiotics to reduce H. pylori adhesion to gastric epithelial cells, preventing H. pylori colonization, especially in children, or reinfection with H. pylori in high-risk adult patients.

Primary bone leiomyosarcoma of distal femur: case report and literature review.

We present the case of a 58-year-old patient presented with a spontaneous right supracondylar fracture. The initial bone biopsy, highlighted the defining histopathological (HP) elements for a leiomyosarcoma (LMS), initially considered a metastasis. The complex imaging examinations did not reveal another tumor, so the final diagnosis was primary bone LMS. Final treatment was a wide tumor resection and reconstruction with a knee tumor prosthesis, preceded and followed by three cytostatic cycles (Doxorubicin 75 mg∕m²). The HP examination has confirmed the previous diagnosis. The key microscopic features for the diagnosis of bone LMS was: malignant mesenchymal proliferation composed of intersecting fascicles of cells with eosinophilic, fibrillary cytoplasm and pleomorphic, elongated, blunt-ended, cigar-shaped nuclei of variable sizes; variable mitotic count; presence of tumor necrosis and stroma with changes that include hyalinization, myxoid change, with absence of chondroid or osteoid matrix; diffuse positivity for smooth muscle immunohistochemical markers: smooth muscle actin, desmin, h-caldesmon. At 12 months after the tumor resection, the patient is in good condition without any sign of local recurrence or metastatic disease. LMS represents a type of soft tissue sarcoma (STS), a variant of the spindle cell sarcomas, accounting for about 7% to 10% of all STS. Bone LMS can be primary or secondary; the primary variant is very rare, representing a very small percentage (around 0.7%) of all primary malignant bone tumors, according to the literature data. Very few cases are presented in the literature; the management of this kind of tumor is controversial, especially regarding the chemo- and radiotherapy.

Mild TBI in the elderly - risk factor for rapid cognitive impairment in Alzheimer's disease.

In recent decades, traumatic brain injury (TBI) has become one of the most important health problems worldwide and is a major cause of morbidity, mortality and economic losses. Mild traumatic brain injury (mTBI) is less considered, with clinical underestimation leading to an epidemiological underevaluation of its incidence. Many of the signs and symptoms induced by mTBI are difficult to highlight clinically, especially those related to cognitive, behavioral, or emotional impairment. The complexity of the biological mechanisms induced by mTBI in the elderly determines synchronous pathogenic actions in which the vascular, inflammatory and neurodegenerative elements are intertwined. It is difficult to highlight a major pathogenic factor, since they act simultaneously, multimodally, in a real pathogenic cascade. The identification of mTBI and cerebral vascular changes by neuroimaging techniques, transcranial Doppler (TCD) or biological markers, suggests a potential prophylactic intervention by using neuroprotective factors as early as possible. Proper prophylaxis measures with neurotrophic treatment, rebalancing the gamma-aminobutyric acid (GABA)∕glutamate balance and combating the chronic inflammatory process, can become important pharmacological therapeutic targets.

Left gluteal metastasis from a hepatocellular carcinoma - an unusual finding.

Hepatocellular carcinoma (HCC) is the primary malignant tumor of the liver that is directly derived from parenchymal cells. It is usually encountered in patients already suffering from a long-established liver disease that has evolved past the stage of liver cirrhosis. It is usually associated with viral liver infections, alcohol consumption or other dietary habits that lead to liver damage. Metastases are not rare and are usually found incidentally after a period of monitoring the main liver disease. We present here a rare case of HCC metastasis found in the right gluteal region, in a hepatitis C virus-infected patient also displaying lung tumor lesions. Diagnosis of both the metastasis and of the primary tumor were found during the same hospital visit, employing contrast-enhanced computed tomography, magnetic resonance imaging and ultrasound (US), with positive biopsy of the metastatic lesion, performed under US guidance. The patient received oncological treatment, with good prognosis and stable evolution during the next eight months since diagnosis.

Severe upper gastrointestinal bleeding determined by a gastric lymphoma associated with Helicobacter pylori-positive atrophic gastritis.

The pathogenesis of gastric cancer regardless of histological structure is a classic example of gene-environment interaction, and an important epidemiological aspect was the recognized association with Helicobacter pylori infection. This paper describes a case of gastric mucosa-associated lymphoid tissue (MALT) lymphoma in a young patient whose first sign of the disease was upper gastrointestinal bleeding and associated hemorrhagic shock. The patient is a 31-year-old man, diagnosed by endoscopy 10 years ago with H. pylori-positive chronic atrophic gastritis, who refused treatment to eradicate the bacterium and presents currently in the emergency room for serious upper gastrointestinal bleeding. Emergency upper gastrointestinal tract endoscopy highlights the presence of bleeding gastric tumors. It was a surgical emergency and intra-operatively the presence of invasive gastric cancer into the left hepatic lobe was noted which required total gastrectomy with the purpose of hemostasis. Immediate and remote postoperative evolution was favorable and post-operative follow-up at six months, 12 months, and 24 months showed no signs of local or distance occurrence.

Tau protein in neurodegenerative diseases - a review.

The study of rare, inherited forms of different diseases resulted in the discovery of gene defects that cause inherited variants of the respective diseases. The defective genes were found to encode major molecular players leading to the neuropathological lesions or factors that characterize these diseases. The exact role of the tau protein in the neurodegenerative process is still under debate. It is very important to understand the normal biological roles of tau and the specific events that induce tau to become neurotoxic. Tau is the major microtubule-associated protein (MAP) of a mature neuron. The other neuronal MAPs are MAP1 and MAP2. These three MAPs perform similar function, promoting assembly and stability of microtubules. Tau protein was isolated as a microtubule-associated factor in the porcine brain. It was isolated as a protein that co-purified with tubulin and had the ability to promote microtubule assembly in vitro. Normal adult human brain tau contains 2-3 moles phosphate÷mole of tau protein. Hyperphosphorylation of tau depress this biological activity of tau. Almost 80 diseases caused by missense mutations and intronic mutations in the tau gene have been found in familial cases of frontotemporal dementia (FTD). In Alzheimer's disease (AD), there are intraneuronal neurofibrillary tangles composed of the microtubule-associated protein tau (MAPT). In other neurodegenerative diseases, there are similar deposits of tau, in the absence of extracellular deposits (progressive supranuclear palsy, corticobasal degeneration, argyrophilic grain disease, etc.). Tau pathology is also often seen in some forms of Parkinson's disease (PD) and prion diseases. In genetic forms of FTD, mutations in tau implicate abnormal tau as the initiation of neurodegeneration. In FTD, there are deposits especially in temporal and frontal lobes, regions that are very important for behavior and executive function. It is critical to understand how tau becomes pathogenic, in order to consider developing any strategies for treatment.

Study on cognitive decline in patients diagnosed with brain tumors.

AIM: The purpose of our study was to assess the cognitive performance in patients with primitive brain tumors and to analyze the cognitive status of these patients, correlated with histological type of brain tumors. PATIENTS, MATERIALS AND METHODS: The study enrolled 52 patients diagnosed with primitive brain tumors, hospitalized in Neuropsychiatry Hospital of Craiova, Romania, from December 2013 to December 2015. According to the histological type of tumors, the patients were classified into three groups: Group A included 22 patients with meningioma, Group B composed of 16 patients diagnosed with glioblastoma, and Group C including 14 patients diagnosed with diffuse astrocytoma. Neurological examination, neuroimaging assessment [computed tomography (CT) or magnetic resonance imaging (MRI) for skulls] to diagnose primitive brain tumors, then the confirmation of clinical and histopathological diagnoses were performed for these patients. For cognitive assessment performed before surgery, Montreal Cognitive Assessment (MoCA) and Cambridge Cognitive Examination (CAMCOG) scales were used. The results were statistically analyzed using the Student's t-test; p-values less than 0.05 were considered statistically significant. RESULTS: In terms of age, we did not observe statistically significant differences between the three groups of patients. The group of patients with diffuse astrocytoma presented a higher educational level compared to patients with glioblastoma or meningioma. MoCA score obtained in glioblastoma group was 21.7 points, while in the group of patients with diffuse astrocytoma was 23.5 points, and in the group of patients with meningioma 24.2 points. The cognitive assessment using CAMCOG scale led to the following results: group of patients diagnosed with glioblastoma showed an average score of 83.5 points, the diffuse astrocytoma group had an average score of 88.9 points and the group with meningioma an average score of 90.1 points. CONCLUSIONS: Patients diagnosed with glioblastoma showed a statistically significant cognitive decline in comparison to patients diagnosed with diffuse astrocytoma (p<0.05). We did not notice statistically significant differences in the cognitive decline of patients with meningioma compared to those diagnosed with diffuse astrocytoma (p>0.05).

Rare thymic malignancy of B-cell origin - T-cell÷histiocyte-rich large B-cell lymphoma.

AIM: T-cell÷histiocyte-rich B-cell lymphoma is a rare type of diffuse large B-cell lymphoma reported as involving primarily the thymus only by one paper in the English literature. CASE PRESENTATION: A four and a half years old boy was admitted, after a sudden onset in the middle of the night, with superior vena cava syndrome, resuscitated cardiac and respiratory arrest and severe coma with Glasgow Coma Scale rate of 3. In spite of intensive treatment, the patient repeated twice the cardiac arrest and died sixteen hours after admittance. The autopsy confirmed the existence of a huge mediastinal mass, revealed by the prior to death computed tomography examination, and the thorough histopatological established the diagnosis of T-cell÷histiocyte-rich large B-cell lymphoma of the thymus with renal spread. DISCUSSION: The particularities of the presented case are the primary location of the lesion in the thymus, the age of the patient, very young, the lack of lymph nodes involvement and the rapid development of the disease until death without any possibility of therapeutic specific intervention. CONCLUSIONS: The case is the second reported in the literature with primary involvement of the thymus by this rare variant of diffuse large B-cell lymphoma. The histopatological examination is the golden standard for the diagnosis. Any clinical symptom of unexplained fatigue and dyspnea in a child should raise the clinician's suspicion of a mediastinal mass involving the thymus.

Acute cellulitis as local reaction to orthopedic implant - case presentation.

Due to increasing number of arthroplasties and osteosynthesis, foreign body reaction to implants is a major problem for orthopedic surgeons, since it is considered to be responsible for severe complications impairing the outcome of the treatment and requiring multiple surgery. Different mechanisms have been described as being involved, and research is focused on finding biomaterials with increased biocompatibility in order to minimize these complications. The clinical aspect of this reaction is usually dominated by chronic pain, with mild functional deficits, and the diagnosis results from excluding other causes of chronic pain, such as infection, osteoarthritis, peripheral neuropathies or angiopaties. The authors present a case with unusual clinical aspect, that of acute cellulitis, when early proper treatment, represented by implant removal, allowed healing without the onset of infection or other complications; histological evaluation confirmed the reaction to implant, thus concluding that surgical treatment when intolerance to implant is suspected is the only method to prevent future negative events.

Primary squamous cell carcinoma of the thyroid: a case report.

Primary squamous cell carcinoma of the thyroid is a very rare thyroid malignancy (less than 1% of thyroid cancers) with unfavorable clinical evolution and median survival less than one year, due to highly local tumor invasiveness with airway obstruction, metastases and treatment complications. We present a 62-year-old female patient with a fixed, rapidly increasing 5 cm right thyroid nodule, generating compressive signs and significant weight loss, resembling anaplastic thyroid carcinoma. Thyroid hormones, antithyroid antibodies and calcitonin were normal. Computed tomography (CT) scan revealed mediastinal extension of the tumor and excluded the presence of lymph nodes or other tumors (T3N0M0). Total thyroidectomy was performed and histopathological evaluation revealed squamous cell carcinoma, which was confirmed by immunohistochemistry, showing diffuse positivity for CK7, CK19, CK34ßE12, galectin-3, EGFR, focal positivity for p63 and negativity for TTF-1 and CD5. Subsequently, the patient underwent chemotherapy (Paclitaxel, Cisplatin, Epirubicin) and radiotherapy (40 Gy), but tumor recurrence was noticed one month after surgical resection and continued to grow despite treatment. Nodal and metastases status remained negative at regular follow-up. The patient died within one year after diagnosis. External radiotherapy and chemotherapy were not efficient in our case. New treatment options are needed to improve outcome in primary squamous cell carcinoma of the thyroid.

Morphological landmarks of proximal humerus with impact in post-traumatic outcome.

As one of the fundamental requirements for an optimal function of the locomotive system is the integrity of the skeleton, the morphology of proximal humerus is crucial for upper limb performance. Not only that the bone is the support for muscle insertion, but its particular form is responsible especially for the complex movement of the shoulder joint, so that any pathological features of this morphology results in different degrees of dysfunction. Since trauma is the most frequent cause for morphological changes of this area, this paper studies the anatomical landmarks, which are affected by proximal humeral fractures and must be targeted when treating these injuries, for they influence the functional outcome. Evaluating the results from a Level 1 Trauma Centre, the authors underline the importance of these anatomical landmarks in approaching proximal humeral fractures and aim to establish a morphology-based therapeutic algorithm, crucial for optimal functional restoration.

MRI and pathology aspects of hypervascular nodules in cirrhotic liver: from dysplasia to hepatocarcinoma.

The incidence of hepatocellular carcinoma (HCC) has been constantly increasing over the last years mainly due to hepatitis C infection and cirrhosis. The new developments in imaging technology, including magnetic resonance imaging (MRI) and computed tomography (CT), allow a better diagnosis of HCC. Cirrhosis is characterized by formation of nodules from regenerative nodules to dysplastic nodules, followed by HCC. Thus, the differential diagnosis of hypervascular hepatic lesions is important, especially in the nodules smaller than 2 cm, although their characterization may be difficult even when histopathology is used. A multistep approach with the comparison of clinical data, pathological findings and imaging features is useful for a more accurate diagnosis. MRI has the ability to assess the same lesions features as CT and to better characterize the enhancement patterns of nodules combined with the lack of irradiation. Moreover, new liver specific contrast agents and imaging techniques as diffusion-weighted (DWI) sequences are available. Regenerative and low-grade dysplastic nodules demonstrate contrast enhancement similar to that of surrounding liver parenchyma, compare to high-grade dysplastic nodules, which may show arterial enhancement similar to that seen in HCC. We present a review of the MR imaging and histopathological features of hypervascular nodules in the cirrhotic liver, with reference to the transition from dysplasia to HCC.

Clinical presentation of a patient with cutis laxa with systemic involvement: a case report.

Cutis laxa (CL) or elastolysis is a rare inherited or acquired connective tissue disorder in which the skin becomes inelastic and hangs loosely in folds (Mitra et al., 2013). The clinical presentation and the type of inheritance show considerable heterogeneity (Shehzad et al., 2010). We aimed to present the atypical case of a young male patient diagnosed at 36-year-old with CL with systemic involvement. The complex medical history, with a suspected but unconfirmed progeria at nine months, repeated lung and urinary infections, complicated inguinoscrotal hernia, prostatic hypertrophy, bilateral entropion, colorectal diverticula and heart failure, suggested a systemic genetic disease, but the absence of family history made the diagnosis of CL difficult. The skin biopsy and the characteristic features discovered during anatomopathological exam made possible the positive and differential diagnosis, creating the link between the various organ involvement and CL diagnosis. Because of the age of our patient, of normal growth and mental development, and negative family history, we suspected an autosomal dominant form of CL with early onset and severe manifestation. Of course, we cannot exclude a recessive form, due to the heterogeneity of this disease.

Imaging and histopathological aspects in aseptic osteonecrosis of the femoral head.

Aseptic osteonecrosis causes various clinical manifestations, depending on its location, but has in common a histopathological and radiological substrate. Aseptic osteonecrosis of the femoral head is a condition whose pathogenesis remains unclear despite many theories developed so far, and the discovery of numerous risk factors. The objective of this study is to emphasize the role of imaging techniques and correlating histology and immunohistochemistry methods in order to more accurately stage the disease. This retrospective study was performed on a total of 103 patients with clinical and radiological suspicion of unilateral or bilateral osteonecrosis. For the diagnosis criteria, we used clinical information, pelvic X-ray images, magnetic resonance imaging (MRI) or computed tomography (CT). For the inclusion of patients in a disease stage, we used the Association Research Circulation Osseous (ARCO) classification system. For patients diagnosed at an advanced stage, who underwent hip arthroplasty, we harvested biological material necessary for the histopathological study. There were differences in the appearance and extent of the lesion on the histological samples compared to macroscopic examination and even those obtained through imaging means, particularly for patients in evolutionary stage III. Aspects such as the extension of the area of fibrosis, bone tissue remodeling, the density of the newly formed vascular network and degree of impairment of the cartilage, are determined more accurately using histology and immunohistochemistry techniques. Before classifying patients in a certain stage, after correlating clinical and imaging data, histopathological aspects have to be considered, particularly in patients in stages III and IV, in which total hip arthroplasty could be delayed.

Magnetic resonance imaging criteria for thrombolysis in hyperacute cerebral infarction.

PURPOSE: Selection of patients with cerebral infarction for MRI that is suitable for thrombolytic therapy as an emerging application. Although the efficiency of the therapy with i.v. tissue plasminogen activator (tPA) within 3 hours after onset of symptoms has been proven in selected patients with CT, now these criteria are determined by MRI, as the data we gather are fast and accurate in the first hours. MATERIAL AND METHODS: MRI screening in patients with acute cerebral infarction before application of thrombolytic therapy was done in a UCC Mannheim in Germany. Unlike trials with CT, MRI studies demonstrated the benefits of therapy up to 6 hours after the onset of symptoms. We studied 21 patients hospitalized in Clinic of Neuroradiology at University Clinical Centre in Mannheim-Germany. They all undergo brain MRI evaluation for stroke. This article reviews literature that has followed application of thrombolysis in patients with cerebral infarction based on MRI. RESULTS: We have analyzed the MRI criteria for i.v. application of tPA at this University Centre. Alongside the personal viewpoints of clinicians, survey reveals a variety of clinical aspects and MRI features that are opened for further more exploration: therapeutic effects, the use of the MRI angiography, dynamics, and other. CONCLUSIONS: MRI is a tested imaging method for rapid evaluation of patients with hyperacute cerebral infarction, replacing the use of CT imaging and clinical features. MRI criteria for thrombolytic therapy are being applied in some cerebral vascular centres. In Kosovo, the application of thrombolytic therapy has not started yet.

Paradoxical Growth of Optochiasmatic Tuberculoma during the Treatment of Tuberculous Meningitis.

Intracranial brain parenchymal tuberculomas may form paradoxically, days to months after starting antituberculous drug therapy. They may develop in and around optic chiasm and optic nerves after antituberculous treatment as a quite rare occurrence in tuberculous meningitis (TBM) this may lead to severe visual loss if not treated properly. We describe a 5 year-old child with documented TBM being treated with first line antituberculous drugs which developed visual impairment 3 months after starting the treatment. MRI after gadolinium administration revealed multiple perichiasmatic ring enhancing lesions due to tuberculomas. Visual impairment developing in a patient on treatment with antituberculous drugs should give rise to a suspicion of rare optochiasmatic tuberculomas; this necessitates urgent contrast-enhanced MRI of the brain and prompt treatment with steroids.

Bone marrow edema - premonitory sign in malignant hemopathies or nonspecific change?

Bone marrow edema (BME) is defined as an excess of fluids that builds up in the bone marrow (BM), commonly found because of osteoporosis, trauma, infections, ischemia or neoplasia. Histologically, BME is characterized by accumulation of extracellular eosinophilic fluid. Magnetic Resonance Imaging (MRI) is the only method that highlights the presence of BME caused by various diseases, including the one associated with hematological malignancies. The classic MRI protocol for the study of BM and BME includes T1- and T2-weighted sequences, the STIR sequence, and in some cases, the administration of intravenous contrast agents in T1-weighted sequences. Fifty-four patients were investigated; there were identified 30 patients with MRI features of BME. Out of the 30 patients with BME, 24 were known to have a malignant hematological disease (multiple myeloma, leukemia, lymphoma); for the remaining subjects, imagistic findings and other laboratory investigations led to multiple myeloma diagnosis. Of the 30 patients, six showed characteristic lesions of the underlying disease as well as BME; four patients had only BME. BM is a structure that is commonly investigated using MRI scans, regardless of the examined bone segment. T1-weighted images and T2-weighted with fat suppression are essential for BME evaluation. Moreover, MRI allows monitoring disease progression and treatment response in patients with malignant hemopathies.

Comparative Study between the Quality Management Indicators, Marker of Major Psychiatric Disorders in Evolution.

UNLABELLED: Indicators of quality management are represented by: accounting hospitalization days (duration of stay); mortality rate; the rate of nosocomial infections; patients readmitted in 30 days; the percentage patients transferred; inconsistent diagnoses. The hospitalization period is a marker of evolution. The present study reflects comparative data between duration and the number of hospitalisations in patients with major psychiatric disorders. INTRODUCTION: Medical Psychiatry as a discipline has developed a specialized approach in the treatment of mental diseases, a phenomenon linked to the progress of knowledge ofpsychopathology and the increasing complexity of methods of diagnosis and treatment. The history of psychiatric patients reflects not only changes in scientific understanding of mental disorder, but also the beliefs of political, social and economic interests of that period [1,2]. OBJECTIVES: We analised the duration and number of hospitalisation in patients with schizophrenia, psychotic disorders compared to those with bipolar disorder and major depressive disorder in Psychiatric clinic from Craiova between 2006-2010. METHOD: Retrospective study during 2006-2010 took into account 8234 patients aged between 20-65 years from the Psychiatric Clinic Craiova constituting four groups: group N1=989 patients belonging to the schizophrenia group; group N2=1222 patients with psychotic disorders, group N3=918 patients with bipolar disorder and group N4=5101 with major depressive disorder.For data processing we used Microsoft Excel (Microsoft Corp., Redmond, WA, USA), together with the suite for MS Excel XLSTAT (Addinsoft SARL, Paris, France) and IBM SPSS Statistics programme 20.0 (IBM Corporation, Armonk, NY, USA). RESULTS: Schizophrenia being defined as a chronic disease was noted that 85.4 % of the patients from the first group received at least two admissions during the trial. Females have better prognosis, having a lower share in the group with multiple hospital admissions. The duration of the stay was longer than two weeks for 61,7% in the N1 group. Group N2 patients, bipolar disorder, have received at least two admissions, the share between the sexes is similar, the duration of hospitalisation not exceeding 7 days for 54,2% of patients with bipolar disorder. Women with more than 14 hospitalisation days had a share of 21.6%. Duration of hospitalization with the N3 group was of maximum two weeks at 71,4%, the group of major depressive disorders N4 had a number of short admissions of 44,4%. CONCLUSION: Statistically significantly high differences (p =0,000233<0.001) in favor of the schizophrenia and psychotic disorders group compared with the group of disorders of affectivity, in terms of the number and the duration of hospitalizations, marker of the evolution on the long term.