The article explores the challenges of ensuring voluntary and informed consent which is obtained from potential research subjects in the north-eastern part of Romania. This study is one of the first empirical papers of this nature in Romania. The study used a quantitative survey design using the adapted Quality of Informed Consent (QuIC) questionnaire. The target population consisted of 100 adult persons who voluntarily enrolled in clinical trials. The informed consent form must contain details regarding the potential risks and benefits, the aim of the clinical trial, study design, confidentiality, insurance and contact details in case of additional questions. Our study confirmed that although all required information was included in the ICF, few clinical trial participants truly understood it. We also found that the most important predictive factor for a good subjective and objective understanding of the clinical trial was the level of education. Our study suggests that researchers should consider putting more effort in order to help clinical trials participants achieve a better understanding of the informed consent. In this way they will ensure that participants' decision-making is meaningful and that their interests are protected.

An individual's behavior can be defined as a set of complex reactions of the body to internal and external stimuli. Case description: We present a case of a young adult student who, under the circumstances of an anomic environment, causes a female person multiple stab wounds to the cervical region. The patient has an addiction to virtual reality, personal psychiatric history of a depressive disorder, emotional and anxious behavioral disorders, as he was a regular cannabis user. The young man was attending an event where he was consuming alcohol and banned substances (Ecstasy), whose effect combined with antidepressants creates a virtual reality in which the individual has a particular mental state, having the impression that bystanders want to hurt him. Under the impulse of this state, the individual uses a bladed weapon and causes multiple wounds to the victim. The patient is examined in the psychiatric forensic examination commission to determine the discernment at the time of the act of violence and for recommendations regarding safety measures. Conclusion: The approach of hetero-aggression behaviour is based on three categories of causal factors, in a triune concept that implies the consequence of the interaction of the existential environment, with the personality structure of the young individual and with the circumstantial factors that precipitate the act.

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Background Mortality is often used as an indicator of public health efforts. Even if mortality in psychiatric hospitals decreased since the introduction of modern treatment, the death toll is still high. The authors have analyzed the forensic autopsy data and the medical documentation regarding 115 death cases from psychiatric hospitals in south-eastern Romania during the period of 2000–2020. Results The average annual mortality rate was 5.13‰, the necropsy data corroborated with those from the medical documentary material indicates acute myocardial infarction as the dominant cause, with 65 (56.5%) cases, followed by upper respiratory tract occlusion with 23 cases (20%) and pulmonary thromboembolism in 4 cases (12.2%). Furthermore, in 6 cases (5.2%) the cause of death was traumatic: 4 cases of cranio-cerebral trauma and 2 cases of hanging. Conclusions In the mortality structure of psychiatric patients, cardiac death predominated, being influenced by the cardiotoxic effect of medication administered for the specific pathology; hence, an early involvement of cardiologists in the follow-up of patients and the finding of treatment schemes with a reduced cardiotoxic effect are required.

Oral anticoagulants have been used for more than 50 years as antithrombotic agents, particularly in the primary and secondary prophylaxis of thromboembolic disorders. Our study�s purpose is to synthetize and analyze the toxicological methods used to determine the oral anticoagulants, described in the literature, so we can identify the optimal methods, taking into consideration the diversity of forensic medicine workload. In the electronic databases, for the period 1990-2019, there were identified 56 articles that included the searched keywords. Of these, 28 were included in our study. We excluded the articles that were not lining up with the objective of our study, the update-type articles and the case studies. After analyzing the literature, it was observed that liquid chromatography-mass spectrometry is the ideal method for detecting low-dosed drugs, such as oral anticoagulants.