Numerous studies have established a heightened prevalence of anxiety and depression (A&D) in individuals diagnosed with Inflammatory Bowel Diseases (IBD) when compared to the general population. Research indicates that patients with active IBD exhibit a higher frequency of anxiety symptoms and depression symptoms compared to those with inactive disease. In patients with IBD, anxiety was linked to reduced medication adherence and an increased likelihood of undergoing surgery. Furthermore, associations were identified between depression and an elevated risk of disease relapse, as well as a poorer response to treatment in IBD patients. In both IBD and depression, there is evidence of disruptions in circulating miRNAs.

One facet of the ongoing project titled “The brain-gut axis linking inflammatory bowel disease with anxiety and depression: the inflammation-microbiome network” (CRP/ROU21-01) involves the exploration of circulating miRNA profiles in various patient groups.

These groups encompass IBD patients with symptoms of anxiety and/or depression (IBD+A&D+), patients lacking anxiety and depression symptoms (IBD+A&D-), a cohort of individuals without IBD but experiencing depressive and anxiety symptoms (IBD-A&D+), and a control group (IBD-A&D-). Thus far, our investigation has entailed screening a comprehensive panel of 179 miRNAs in the plasma of six IBD patients and 12 non-IBD patients (CTRL) to identify a subset of highly dysregulated miRNAs. MiRNA isolation was achieved using the miRNeasy Serum/Plasma Kit, and miRNA expression levels were assessed via quantitative reverse transcription-polymerase chain reaction (qRT-PCR) utilizing the Human serum/plasma focus, MIRCURY LNA miRNA Focus PCR panel (Qiagen).

Our statistical analysis revealed significant differential expression in 45 miRNAs (p<0.05). Specifically, we identified 29 miRNAs with elevated expression and seven miRNAs with reduced expression. Among these dysregulated miRNAs, 15 (miR-223-3p, miR-143-3p, let-7f-5p, miR-30b-5p, miR-26a-5p, let-7a-5p, miR-339-5p, let-7d-5p, miR-221-3p, miR-191-5p, let-7g-5p, miR-24-3p, miR-107, miR-26b-5p, miR-320b) were associated with depression and/or anxiety and were previously identified as dysregulated in the plasma of patients in other studies. These miRNAs will soon undergo evaluation in the plasma of IBD-A&D+ and IBD+A&D+ patients.

These initial findings provide us with a panel of circulating miRNAs that warrant further investigation in the aforementioned patient groups. The miRNA profile we obtained may either be unique to IBD or linked to the intricate phenotypes of IBD occurring concurrently with anxiety and depression. A more profound comprehension of these mechanisms will aid in the development of enhanced

diagnostic tools and disease monitoring strategies, as well as the exploration of innovative therapeutic approaches.

None Declared

Adverse childhood experiences are common and have been linked to a number of physical illnesses, as well as socioeconomic problems. Moreover, it has been proven that ACEs can increase chances of people showing criminal behaviour. The question arises whether people with ACEs also have an increased chance of joining extremist groups or violent gangs.

The aim of this systematic review is to measure the ACE rates in violent extremists and gangs and to establish whether there is a pattern linking ACEs to violent extremist organizations and gangs.

The following databases were searched to retrieve relevant studies: the ProQuest Social Science database, Pubmed, Scopus. Eligible studies were articles of any study design that reported ACE rates in either extremists or gang members. Data was extracted and organized into a table and a quality assessment was performed using standardized tools (CASP and NHLBI). A narrative synthesis of the evidence was conducted. A meta-analysis could not be performed due to the heterogeneity of the studies.

22 studies (eight on extremists and fourteen on gang members) were included. The studies varied in terms of research design, sample size, location and measured ACEs. Quality also varied across the studies. The prevalence rates were heterogenous and ranged from 0% to almost 100%.

Physical abuse was the most addressed ACE (5 studies on extremists and 11 on gang members). Sexual abuse was the second most explored ACE (4 studies on extremists and 9 studies on gang members). Neglect and caregiver loss were also common ACEs, while the other ACEs were less represented in the two subpopulations. A comparison between the two subpopulations was difficult due to the differences in the studies.

While overall ACE rates were high in the two groups and some ACEs were salient in the two subpopulations, quality of evidence varied across the studies. No solid ACE pattern across the studies could be found. Moreover, there were only two prospective studies on gang members and none on extremists, so a causal relationship between ACEs and involvement in violent gangs or extremist organizations could not be established. Future research should concentrate on studies of this design, as well as on improving the quality of the evidence.

As ACEs are extremely common, researchers should also look beyond them when searching for causes of extremism or violent gang membership. Other negative events (bullying, racism) should also be explored.

None Declared

This study was designed to evaluate the effect of limited English proficiency (LEP) on neurocognitive profiles.

Romanian (LEP-RO; n = 59) and Arabic (LEP-AR; n = 30) native speakers were compared to Canadian native speakers of English (NSE; n = 24) on a strategically selected battery of neuropsychological tests.

As predicted, participants with LEP demonstrated significantly lower performance on tests with high verbal mediation relative to US norms and the NSE sample (large effects). In contrast, several tests with low verbal mediation were robust to LEP. However, clinically relevant deviations from this general pattern were observed. The level of English proficiency varied significantly within the LEP-RO and was associated with a predictable performance pattern on tests with high verbal mediation.

The heterogeneity in cognitive profiles among individuals with LEP challenges the notion that LEP status is a unitary construct. The level of verbal mediation is an imperfect predictor of the performance of LEP examinees during neuropsychological testing. Several commonly used measures were identified that are robust to the deleterious effects of LEP. Administering tests in the examinee’s native language may not be the optimal solution to contain the confounding effect of LEP in cognitive evaluations.

Purpose of our study was to evaluate the incidence of atherogenic profile, heart failure (HF) and if there is any correlation between these and cognitive impairment (CI) in patients with vascular dementia (VaD).

This was a retrospective study. We analyzed 35 patients with VaD and 25 age- and sex-matched healthy controls. NINDS-AIREN criteria and Hachinski's ischemic scale were used to identify VaD. Mini Mental State Examination was used to classify CI into mild, moderate and severe. Clinical and biochemical features were investigated by means of standardized tests. Echocardiography was done for evaluate ejection fraction (EF).

Prevalence of atherogenic profile was increased in VaD compared with controls (72.2% vs 20%, p<0.001). High LDL cholesterol, triglicerides and low HDL cholesterol values were characteristic for VaD patients in the last 10 years. In present time we found low level for HDL cholesterol (34.1± 4.6 mg/dl vs 44.2± 5.8 mg/dl, p<0.001) and triglicerides (102.7± 7.5 mg/dl vs 154.2± 4.5 mg/dl, p<0.01) when compared with controls. 8 patients had mild CI, 2 of them had HF class II and 6 had class III NYHA, with EF in normal limits. 23 patients had moderate CI and low EF; 7 of them had HF class III and 16 had class IV NYHA. 4 patients with severe CI had very low EF and HF class IV NYHA. We found correlations between EF, triglicerides and CI.

The prevalence of atherogenic profile and heart failure were significantly higher in VaD and were correlated with cognitive impairment.

Ischemic stroke can lead to heart injury via dysfunction of the autonomic nervous system. QT intervals on electrocardiography (ECG) are susceptible to autonomic influences and their prolongation was associated with increased mortality after stroke.

We aimed to study QT intervals in patients with ischemic stroke in chronic phase with and without cognitive impairment.

ECGs were recorded in 50 patients with ischemic stroke. QT interval corrected for heart rate (QTc), QT dispersion (QTd), and QT interval variability (QTIV) were measured. The QTVI was calculated as the logarithm of the ratio between the variances of the normalized QT and RR intervals. Using Mini Mental State Examination and Hachinski's ischemic scale we identified vascular dementia (VaD) in 17 patients. Twenty age-matched healthy subjects were examined for comparison.

We identified QTc, QTd prolongation in patients with ischemic stroke. Comparing patients with ischemic stroke vs. VaD, QTc (412 ±75.2 ms vs 456± 115 ms, p<0.01) and QTd (64±14ms vs 154±69 ms, p<0.0001) were more prolonged in VaD. QTVI were generally increased in ischemic stroke patients compared with healthy subjects (p<0.05) but the differences with high statistical significance level were found in VaD patients (p<0.001). We found correlation between QTd, QTVI, hypertension, diabetes, arrhythmia and cognitive impairment.

Prolongation of QT intervals and increased QTVI occurs frequently after ischemic stroke but most significant changes were found in patients with cognitive impairment. Early detection of cognitive impairment in stroke patients provides better prevention of possible dementia.

Emotional distress–specifically symptoms of anxiety and/or depression–in undergraduate medical student represent a major health issue for university life and for the entire society, as the onset of negative affectivity in young age is lowering quality of life of the affected individual and implicitly, the professional evolution.

The purpose of this study is to investigate the prevalence of perceived stress in medical undergraduates and relationship between perceived stress and emotional distress.

The study comprised a randomised population of 356 students from 1st and 2nd year in Faculty of Medicine who signed the informed consent for the research. Mean age in the group was 20.04 ± 0.9 years old. Instruments used in the study were self-rated Zung Anxiety Scale and Zung Depression Scale and Perceived Stress Scale. Data were analysed with SPSS 16. Statistical significance was at P < 0.05.

Perceived stress of medium and high intensity was found in 62.5% of the students in the study. There is a significant effect of perceived stress on presence of emotional distress (F(3,352) = 36,431, P < 0.001). In the emotional distressed group, perceived stress in the period before the exams session is predicting emotional distress in the period of exams (academic stress) with OR = 1.145, P = 0.04, IC 95% = 1.006–1.303.

There is a high prevalence of perceived stress and perceived stress in the period before session of exams is a predictive factor for having emotional distress in session of exams. Therefore, we are signaling the necessity of implementation of stress management programs in medical undergraduates from the pre-clinical years.

The authors have not supplied their declaration of competing interest.