Clinical and Paraclinical Considerations Regarding ki67's Role in the Management of Differentiated Thyroid Carcinoma-A Literature Review.

Background and Objectives: The ki67 nuclear protein is a tool for diagnosis and prognosis in oncology that is used to evaluate cell proliferation. Differentiated thyroid carcinoma is usually a slow-growing neoplasm, the most common type being the papillary form. Some clinical and pathological aspects may predict aggressive behaviour. There are reported cases of recurrence without clinico-pathological findings of aggressiveness. To obtain better predictions of the disease outcome in thyroid carcinoma, many immunohistochemical markers have been studied. The aim of this narrative literature review is to identify the benefits that ki67 may add to the management of patients with differentiated thyroid carcinoma, according to the latest evidence. Materials and Methods: We performed a search on the PubMed and Google Scholar databases using controlled vocabulary and keywords to find the most suitable published articles. A total number of sixty-eight items were identified, and five other articles were selected from other sources. After refining the selection, the inclusion criteria and exclusion criteria were applied, and a total number of twenty-nine articles were included in this literature review. Results and Discussion: The studies consist of retrospective studies (89.66%), case reports (6.9%) and literature reviews (3.45%), evaluating the role, implications and other parameters of ki67 as a diagnostic and/or prognostic tool. The statistical correlations between ki67 and other features were systematized as qualitative results of this review in order to improve the treatment strategies presented in the included articles. Conclusions: The included studies present converging data regarding most of the aspects concerning ki67. The ki67 proliferation index is a diagnostic/prognostic tool of interest in differentiated thyroid carcinoma and a good predictor of disease-free survival, disease recurrence and metastatic development. Prospective studies on large cohorts may add value for ki67 as a specific tool in the management strategy of differentiated thyroid carcinoma.

Quality of Life in People With Subjective Cognitive Decline.

Objective: Quality of life is extensively studied in older persons, but there are few studies that investigate it in people with subjective cognitive decline. Our aim was to evaluate the quality of life in a Romanian sample of individuals with subjective cognitive decline compared to controls while accounting for different possible moderators. To our knowledge, this is the first study to evaluate the quality of life in a Romanian subjective cognitive decline sample. Methods: We conducted an observational study to evaluate differences in the quality of life between subjective cognitive decline and controls. Participants were evaluated for subjective cognitive decline according to Jessen et al. We collected sociodemographic and clinical characteristics and information about physical activity. Quality of life was evaluated using the Short Form-36 questionnaire. Results: There were 101 participants included in the analysis with 66.33% (n = 67) in the subjective cognitive decline group. There were no differences between the social, demographic, and clinical characteristics of the individuals. The subjective cognitive decline group had a higher score on the negative emotion trait of Big Five. Individuals with subjective cognitive decline reported poorer physical functioning (P = .034), more role limitations due to physical health (P = .010) and emotional problems (P = .019), and less energy (P = .018) compared to the control group. Conclusion: Persons with subjective cognitive decline reported diminished quality of life compared to controls and differences were not explained by other sociodemographic and clinical characteristics evaluated. This area could prove to be an important target for nonpharmacological interventions in the subjective cognitive decline group.

Risk factors for involuntary admission in a Romanian patient sample.

BACKGROUND: Involuntary admission is widely used in psychiatry, usually requiring that the patient present an imminent danger to himself or others. Previous studies have established several predictors for involuntary admission, but they have been almost exclusively conducted in Western European or North American countries. By contrast, data on this topic from Eastern European countries is virtually absent. Historically, involuntary admission has been often used as a tool for political repression in Romania before the fall of the communist regime. While there have been significant changes in the legal framework in the last 30 years, there is still no real-world data to build upon. METHODS: We analyzed a sample of 177 patients admitted to the "Alexandru Obregia" psychiatric hospital in Bucharest between November 2022 and January 2023, of which 49.7% (88) were involuntary hospitalizations. We collected socio-demographic and clinical data by both by direct interview, and by consulting patient records, attending physicians and relatives. RESULTS: Socio-demographic factors predictive for involuntary admission were unemployment, lower income, and urban living. Of the clinical variables analyzed, diagnosis of psychosis or mania on admission carried increased risk of involuntary hospitalization, as did nonadherence to treatment, higher disease severity and aggression. Hospital presentation by police or ambulance carried significant additional risk compared to self-referral. CONCLUSION: Certain categories of patients are considerably more likely to be involuntarily hospitalized and there appears to be considerable interrelatedness between the identified risk factors.

MRI-Based Radiomics in Bladder Cancer: A Systematic Review and Radiomics Quality Score Assessment.

(1): Background: With the recent introduction of vesical imaging reporting and data system (VI-RADS), magnetic resonance imaging (MRI) has become the main imaging method used for the preoperative local staging of bladder cancer (BCa). However, the VI-RADS score is subject to interobserver variability and cannot provide information about tumor cellularity. These limitations may be overcome by using a quantitative approach, such as the new emerging domain of radiomics. (2) Aim: To systematically review published studies on the use of MRI-based radiomics in bladder cancer. (3) Materials and Methods: We performed literature research using the PubMed MEDLINE, Scopus, and Web of Science databases using PRISMA principles. A total of 1092 papers that addressed the use of radiomics for BC staging, grading, and treatment response were retrieved using the keywords "bladder cancer", "magnetic resonance imaging", "radiomics", and "textural analysis". (4) Results: 26 papers met the eligibility criteria and were included in the final review. The principal applications of radiomics were preoperative tumor staging (n = 13), preoperative prediction of tumor grade or molecular correlates (n = 9), and prediction of prognosis/response to neoadjuvant therapy (n = 4). Most of the developed radiomics models included second-order features mainly derived from filtered images. These models were validated in 16 studies. The average radiomics quality score was 11.7, ranging between 8.33% and 52.77%. (5) Conclusions: MRI-based radiomics holds promise as a quantitative imaging biomarker of BCa characterization and prognosis. However, there is still need for improving the standardization of image preprocessing, feature extraction, and external validation before applying radiomics models in the clinical setting.

How "Subjective" is Subjective Cognitive Decline?

Background: Subjective cognitive decline is presently considered to be the earliest clinical stage of neurodegeneration. By its current definition, subjective cognitive decline conceptually implies that the sufferer presents no psychometrically measurable cognitive impairment despite numerous articles stating the presence of discrete objective impairments. Our purpose was to evaluate differences in objective cognitive performance in subjective cognitive decline patients compared to healthy controls. Methods: A total of 101 cognitively unimpaired participants were divided into a subjective cognitive decline group (n = 67) and healthy control group (n = 34). We conducted a thorough cognitive evaluation and collected social, demographic, and clinical data as well as data on personality traits, sleep quality, and physical activity. Both groups were matched for sex, age, education, and Mini-Mental State Examination score. Results: The subjective cognitive decline group had a lower verbal learning capacity as shown by the worse performance on Rey auditory verbal learning test trial 1 (P = .021) and Rey auditory verbal learning test total scores (P = .023). The subjective cognitive decline group was significantly more impaired in executive functioning compared to controls, as shown by trail making test A (P = .012) evaluation. Conclusion: Persons with subjective cognitive decline have subtle, objective cognitive impairments which may be undetected with widely used, brief cognitive evaluations, such as the Mini-Mental State Examination. Yet, these impairments are not severe enough to warrant the diagnosis of mild cognitive impairment. Current subjective cognitive decline criteria could be expanded in order to increase the diagnostic precision of subjective cognitive decline.

Cognitive Differences in Subjective Cognitive Decline with and without Associated Worry.

Objectives:Subjective cognitive decline (SCD) is a heterogenous concept that has been associated with future objective cognitive decline. Our objective was to assess the cognitive function of three groups: one with SCD who claimed to be worried about their symptoms, one with SCD who did not claim to be worried about their symptoms and one without SCD (control group). Materials and methods: We designed a cross-sectional study including people from primary care units and a memory center. We collected socio-demographic and clinical characteristics of all participants who signed informed consent prior to inclusion. Those with current major depression, anxiety disorder and neurocognitive disorder were excluded. Cognitive evaluation was performed using the Mini-Mental State Examination (MMSE), Rey Auditory-Verbal Learning Test, Rey complex figure test, Trail Making Test A and B and Verbal Fluency Test. Descriptive statistics were used to characterize the sample. We used Chi-Square to analyze categorical variables, ANOVA for normally distributed continuous variables and Kruskal-Wallis for non-normally distributed continuous variables. Statistically significance was established at p<0.05. Results:There were 101 patients included in the analysis, of which 49.50% in the "Yes, and it worries me" group (A), 16.83% in the "Yes, but it does not worry me" (B) group and 33.66% in the control group (C) (participants who answered "No"). There was a statistically significant difference regarding age status (p=.048) between groups A and C. Participants who expressed worry regarding their SCD symptoms had an increased negative emotion trait compared to the control group. There were statistically significant differences in attention and immediate memory between groups A and C. Conclusion:Individuals with SCD and associated worry performed worse in auditory and verbal memory testing when compared to the control group. Longitudinal assessment is necessary to establish firm causal relationships between SCD, personality traits and cognitive function.

Risk factors and consequences of traumatic brain injury in a Swiss male population cohort.

OBJECTIVE: To investigate the risk factors for and the consequences (ie, substance use disorders (SUD), depression, personality traits) of traumatic brain injury (TBI) in young Swiss men. DESIGN: This is a three-wave cohort study. Risk factors were measured at baseline (2010-2012) and at follow-up 1 (FU1; 2012-2014), while the consequences and TBI were measured at follow-up 2 (FU2; 2016-2018). SETTING: Switzerland. PARTICIPANTS: All participants at FU2 (Mage=25.43, SD=1.25) of the Cohort Study on Substance Use Risk Factors (N=4881 young Swiss men after listwise deletion). MEASURES: The outcomes measured were TBI, SUD (ie, alcohol, nicotine, cannabis, other illicit drugs), depression and personality traits (ie, sensation seeking, anxiety-neuroticism, sociability, aggression-hostility) at FU2. The predictors were previous TBI (lifetime TBI but not in the past 12 months at FU2), SUD, personality traits and sociodemographics (highest level of achieved education, age, linguistic region) measured at FU1. RESULTS: At FU2, 3919 (80.3%) participants reported to never have had TBI, 102 (2.1%) have had TBI in the last 12 months (TBI new cases), and 860 (17.6%) have had TBI during their lifetime but not in the 12 months preceding FU2 (previous TBI). Low educational attainment (OR=3.93, 95% CI 2.10 to 7.36), depression (OR=2.87, 95% CI 1.35 to 6.11), nicotine dependence (OR=1.72, 95% CI 1.09 to 2.71), high sociability (OR=1.18, 95% CI 1.07 to 1.30), high aggression-hostility (OR=1.15, 95% CI 1.06 to 1.26) and high sensation seeking (OR=1.33, 95% CI 1.04 to 1.68) at FU1 were significantly associated with TBI new cases at FU2. Previous TBI was significantly associated with nicotine dependence (OR=1.46, 95% CI 1.16 to 1.83), depression (OR=2.16, 95% CI 1.56 to 2.99) and aggression-hostility (B=0.14, 95% CI >0.00 to 0.28) at FU2. CONCLUSION: Low educational attainment and depression are the most significant risk factors associated with increased odds of future TBI, while depression, nicotine dependence and high aggression-hostility are the main consequences of previous TBI. TBI should be considered an underlying factor in the treatment of depression, SUD or unfavourable personality profiles.

The Use of Cannabidiol in Treating Psychiatric Disorders: A Systematic Review.

Cannabidiol (CBD) has been used as a pharmacological treatment for psychiatric disorders in many studies, but few of good quality at the moment. Our objective was to assess the effect of CBD in mono/add-on therapy on symptom severity in psychiatric disorders. We performed a systematic review of clinical trials and randomized controlled trials that used CBD as treatment for psychiatric disorders. PRISMA criteria have been used for methodological purposes. Two assessors individually examined the results based on title and abstract, and decided which papers warranted full read. We included studies in English that measured disease severity as primary outcome. Out of 226 studies returned from the search, 9 warranted full read. There were 4 studies using CBD in schizophrenia, 3 studies of substance use disorder and 2 studies of social anxiety. CBD has a good safety profile even in higher doses, but results are inconclusive regarding improvements in disease severity.

Knowledge of Prevention Measures and Information About Coronavirus in Romanian Male Patients with Severe Mental Illness and Severe Alcohol Use Disorder.

PURPOSE: Patients with severe mental illness (SMI) and alcohol use disorder (AUD) are at higher risk for contracting coronavirus-19 (COVID-19) and for poor outcomes of COVID-19 infection. One reason for this could be the lack of knowledge regarding preventive measures against COVID-19 and the inability of the psychiatric patients to discern misinformation from facts. PATIENTS AND METHODS: The study design was cross-sectional. We applied one questionnaire that evaluated knowledge of prevention measures and information about COVID-19 (comprised of two sections, each with five questions). The first section evaluated knowledge regarding the official WHO prevention measures against COVID-19, and the second consisted of false information about COVID-19 which examined the ability to identify misinformation about COVID-19. These questionnaires were applied face-to-face to psychiatric male inpatients from a tertiary psychiatric hospital in Bucharest diagnosed with SMI or severe alcohol disorder (SAUD) and to male controls from the community, matched by age and education. Mean scores of patients and controls were compared using Mann-Whitney test. RESULTS: There were 115 male psychiatric patients in total (65 SMI and 50 SAUD) and 57 controls included after the matching procedure. We found statistically significant lower (P<0.05) scores for psychiatric patients compared to controls regarding the prevention and general knowledge of COVID-19 (P<0.001), the WHO information about prevention measures (P=0.041), and the ability to identify misinformation about COVID-19 (P<0.001). The fact that psychiatric patients have less knowledge about prevention measures against COVID-19 and a reduced capacity to discern misinformation suggests that we need to identify new methods to convey correct information to these patients and also to better equip them to handle misinformation regarding COVID-19. CONCLUSION: Patients with SMI and SAUD are less informed regarding COVID-19 infection and preventive measures compared to controls, while being prone to believing false information about COVID-19 as well.