Nicolae Testemițanu State University of Medicine and Pharmacy (Romanian: Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”) is a university located in Chișinău, Moldova. The institution began its activity in 1945. It is named after Nicolae Testemițanu..
Introduction Perinatal affective and psychotic disorders arise during rapid endocrine and immunometabolic remodeling. Evidence supports a stress–mitochondria–inflammation axis linking peripheral and central signals via cell-free mitochondrial DNA (cf-mtDNA), cytokines, and extracellular vesicles (including exosomes). Objectives To integrate mitochondrial, immune, and lipid mechanisms into a translational framework and propose a biomarker panel for dynamic risk assessment across pregnancy and early postpartum (<=12 weeks). Methods Narrative synthesis of PubMed/MEDLINE, Scopus, and Web of Science (2019–September 2025). Included studies investigated perinatal mental states (pregnancy to <=12 weeks postpartum) with depressive and/or psychotic phenotypes and reported mitochondrial indices (reactive oxygen species, OXPHOS, cf-mtDNA), cytokines/extracellular vesicles, placental ferroptosis markers (TFRC, ACSL4, ALOX5, GPX4), lipid peroxidation products (MDA), or modulators (omega-3 DHA; nicotinamide/NAD+). Exclusions: editorials, single-case reports without biomarkers, studies outside the peripartum window, and unavailable English full text. A formal risk-of-bias assessment was not undertaken given the narrative scope. Results (1) Mitochondrial stress and released mtDNA engage innate sensors (TLR9, NLRP3, cGAS–STING), promoting IL-1beta, IL-6, and TNF-alpha signaling. (2) Pregnancy-associated psychosis correlates with a placental ferroptosis profile—upregulation of TFRC/ACSL4/ALOX5, downregulation of GPX4, and increased lipid peroxidation—potentially linking iron-driven peroxidation to adverse obstetric and psychiatric outcomes. (3) Preclinical gestational-stress models show reduced medial prefrontal cortex (mPFC) complex I–dependent OXPHOS and impaired maternal behaviors; nicotinamide, which is a NAD+ precursor, preserves respiration and behavior in these models. (4) A micro-panel for longitudinal risk and prevention monitoring is proposed: cf-mtDNA (± EV-associated), IL-6 (± hs-CRP), glutathione redox ratio, lactate/pyruvate ratio, and kynurenine/tryptophan ratio; optionally immune-cell oxygen consumption and extracellular acidification rates. Conclusions Perinatal mental disorders share a mitochondrial–inflammatory architecture with placental and lipid peroxidation components. Composite biomarkers warrant prospective validation in well-phenotyped cohorts, and standardized preanalytical protocols for cf- and EV-associated mtDNA are required before clinical translation. NAD+ precursors and omega-3 strategies are promising but require randomized evaluation. Keywords perinatal depression; postpartum psychosis; mitochondria; cf-mtDNA; extracellular vesicles; ferroptosis. Disclosure of Interest None Declared
Background/Objectives: Hyperglycemic and hyperosmotic stress may disturb glutathione-dependent antioxidant defenses in retinal vascular cells. This exploratory in vitro study evaluated glutathione-related biochemical endpoints in separate human retinal pericyte and endothelial-cell experiments and to identify candidate endpoints for independent validation. Methods: Passage-3 human retinal pericytes and endothelial cells were exposed for 24 h to five conditions: 5.5 mmol/L glucose (control), 25 or 50 mmol/L glucose, and 5.5 mmol/L glucose supplemented with 19.5 or 44.5 mmol/L mannitol. Glutathione peroxidase (GPx), glutathione reductase (GR), total glutathione, reduced glutathione (GSH), oxidized glutathione (GSSG), the GSH/GSSG ratio, glutathione S-transferase (GST), and gamma-glutamyl transferase (GGT) were measured in a mixture of culture medium and cell lysate. Each condition comprised 10 technical replicate wells from one culture experiment; the cell types were examined in separate, unmatched runs. Results: In the pericyte experiment, GPx and GR decreased across several glucose and mannitol conditions, and GGT increased by 39–72%. In the separate endothelial experiment, GGT was the dominant response (eta squared = 0.763), increasing by 66–116%; GGT at 50 mmol/L glucose was 30% higher than the corresponding 44.5 mmol/L mannitol condition. Conclusions: The study identifies GGT as the principal candidate endpoint for biological replication and GPx and GR as additional candidates in pericytes. It does not support comparisons between cell types. All findings are preliminary because they derive from technical wells in single, unmatched experiments.
Introduction In adults with borderline personality disorder, lifetime suicidal ideation, non-suicidal self-injury and suicide attempts are frequent. Recent syntheses report approximately 80% ideation, 52% attempts and 6% death by suicide; adult transitions along the ideation to non-suicidal self-injury to attempt pathway remain incompletely quantified. Objectives (1) Quantify adult prevalence percentages for ideation, non-suicidal self-injury and attempts; (2) characterise day-level ideation in attempters versus non-attempters; (3) examine associations between diagnostic criteria (including self-harm and chronic emptiness) and attempts. Methods Searches were run in MEDLINE/PubMed, Embase, PsycINFO and Web of Science (2020–2025). Inclusion: adults with clinician-diagnosed BPD; observational/longitudinal studies, ambulatory/ecological monitoring, meta-analyses and systematic/narrative syntheses reporting outcomes. Exclusion: samples exclusively <18 years; mixed samples without a dedicated subgroup; no outcomes; duplicates. Flow: full texts assessed, 15; included, 8; excluded, 7 (minors n=3; mixed without subgroup n=2; no outcomes n=1; duplicate n=1). Populations were adult clinical and community samples; age/sex were not consistently reported. Outcomes: ideation, non-suicidal self-injury, attempts, suicide deaths. Results Aggregate clinical estimates were approximately 80% lifetime ideation, 52% lifetime attempts and 6% suicide deaths. In a representative adult sample (n=36,309), lifetime attempts among those with a lifetime diagnosis were 22.7% and past-year 3.0%; a sensitivity analysis excluding the diagnostic self-harm criterion yielded 28.1% and 3.0%. Diagnostic self-harm and chronic emptiness remained independently associated with attempts (OR up to 24.28 for self-harm). In 21-day ambulatory monitoring, 66.7% reported at least one day with ideation; day-level ideation occurred on 10.8% of days (6.5% among non-attempters versus 19.5% among attempters). Non-suicidal self-injury was common in adult clinical samples ( range 65–80%) and associated with attempts; in a veteran cohort, non-suicidal self-injury (48%) remained the sole independent correlate of lifetime attempts (adjusted OR 4.9). Conclusions Evidence supports a common adult trajectory from ideation to non-suicidal self-injury to attempt, with patterns associated with lethality. The magnitude of percentages and the independent association of non-suicidal self-injury with attempts support time-sensitive risk assessment and targeted interventions (reducing non-suicidal self-injury, enhancing decisional flexibility, managing acute interpersonal stressors) to interrupt progression towards lethal behaviours. A main limitation is that state-to-state transition probabilities were often not reported; between-study heterogeneity was substantial and publication/reporting bias cannot be excluded. Disclosure of Interest None Declared
Background The quality and quantity of Undergraduate Primary Care (PC) Teaching (UGPCT) is related to recruitment. There is an international shortage of PC clinicians sufficient to cause EU concerns about public health, preparedness and resilience of essential health systems, and economic stability. There is no European data concerning quality, quantity or necessary resources to guide policy and decision-making in UGPCT. Methods Cross-sectional survey of medical schools in 32 European countries. We collected quantitative and qualitative data on UGPCT. A validated tool was used, which after piloting and cultural adaptation was distributed to 201 medical schools by UGPCT committee of EURACT. Responses from 32 countries yielded a response rate 43%. Descriptive analyses were done with SPSS 29. Free text was analysed by thematic analysis. Results Primary care is taught in university settings in 95.1% of European medical schools, although many schools appear uncertain as to what PC teaching is. PC comprises an average of 8.5% of clinical teaching. Some medical schools have no clinical UGPCT. Statistically significant variations in many aspects of teaching provision were found between regions of Europe. Evidence of discrimination towards PC academic and clinical teachers was found, enacted by restrictive and asymmetric policies regarding career progression, pay and training opportunities. Conclusion Pan-European actions are needed to address a public health concern. Recognition of PC as a specialty in all European countries would be one step. Teachers and medical schools may need to examine attitudes enacted through policies in order to improve UGPCT and so address important public health concerns.
BACKGROUND:Surgery is the only salvage treatment for radiotherapy (RT) failures in glottic carcinoma management, and total laryngectomy is performed in the majority of cases, resulting in a substantial decline in the quality of life for patients. Transoral CO2 laser microsurgery (TOLMS), as a salvage treatment for RT failures, demonstrated its efficiency, albeit more inferior compared to treatment results obtained in primary glottic carcinoma, but has some limitations, predominantly associated with difficult anatomy and inadequate glottis exposure and also because of mandatory larynx suspension and general anesthesia with myorelaxation that present risks or contraindications for some categories of patients. Flexible endoscopic laser surgery (FELS) can overcome some of the limitations of TOLMS, being a minimally invasive therapeutic option for this category of patients. The study's purpose was to evaluate the long-term (five-year) effectiveness of FELS in treating recurrent/persistent glottic carcinoma after RT failure. METHODS:FELS was performed in nine patients with recurrent (four) and persistent (five) early-stage (T1a: two; T1b: one; T2: six) glottic carcinoma after RT failure (males: eight; females: one), aged 47-66 (mean: 55.4±7.8). FELS under local anesthesia with spontaneous ventilation was performed in five patients (55.6%), and the rest of the patients were operated on under general anesthesia with superimposed high-frequency jet ventilation (SHFJV). Tumor ablation by neodymium-doped yttrium aluminum garnet (Nd:YAG) laser was performed in all the cases, and adjuvant RT (20-22 Gy) was performed in two cases of persistent T2 tumors. RESULTS:Five-year overall survival and ultimate disease control, including salvage treatment, were obtained in six patients (66.7%), cure with larynx preservation was obtained in five patients (55.6%), disease-free survival was obtained in five cases (55.6%), and ultimate local control with FELS alone was obtained in five cases (55.6%). All three patients with the T1 stage of disease were alive, free of disease, with the preserved larynx due to FELS alone. CONCLUSION:FELS can be considered an efficient method of treating recurrent and persistent T1-T2 glottic carcinoma after RT failure, offering a minimally invasive surgical alternative for cure with larynx preservation, especially for patients with risks/contraindications to general anesthesia and transoral microsurgery.
