Background: During the SARS-CoV-2 pandemic period, in the treatment approved by the WHO, along with antivirals, antibiotics, nonsteroidal anti-inflammatory drugs and anticoagulants, dexamethasone was always used. This study started from the professional concern related to the vasopressor effect of cortisone on blood pressure (BP). Methods: The study group was achieved by selecting, from a total of 356 patients hospitalized in the clinic, the patients with known hypertensive status at admission for SARS-CoV-2. Dexamethasone was part of the anti-COVID-19 treatment, with an administration of 4–6–8 mg/day, depending on bodyweight, for 10 days. All patients with hypertension received antihypertensive treatment in adjusted doses according to the recorded BP values. Results: Monitoring of BP in hospitalized patients was performed daily, in the morning and evening. If on the 2nd day of treatment, 84% of the patients partially responded to the treatment with a moderate decrease in BP, on the 3rd therapy day, the situation clearly improved: more than 75% of the patients had values of BP that can be classified as high-normal (38.23%) and normal (40.03%). Conclusions: Dexamethasone for treatment of SARS-CoV-2 infection did not have a notable influence on increasing BP, because the doses were low–moderate and prescribed for a short time.

The research article highlights the significance of acute myocardial infarction (AMI) and its impact on depression and anxiety among patients’ post-primary percutaneous coronary interventions (PCI). The study aims to determine the frequency of depression and anxiety occurrence in patients with acute myocardial infarction after primary PCI. The objective of this study is to investigate the frequency of depression and anxiety in patients with acute myocardial infarction after primary PCI. The method used in the study involved the collection of data from 88 patients with acute myocardial infarction who underwent primary PCI treatment. The patients were tested before PCI and then at intervals of 1 month, 6 months, and 12 months post-PCI using the Hamilton Depression Scale (HAM-D17) and the Hamilton Anxiety Scale (HAM-A) to identify depression and anxiety symptoms, respectively. The study performed a comprehensive analysis of the collected data to determine the frequency of depression and anxiety occurrence in post-PCI patients. The study found evidence that primary PCI reduces depression and anxiety in patients who have experienced a myocardial infarction. However, mental health issues continue to be a significant psychological concern for patients post-PCI, impacting their lifestyle, self-care, and treatment adherence. The study suggests that healthcare providers should actively screen and manage psychiatric disorders in patients who have suffered from AMI as they are at an increased risk of mental disorders. In conclusion, the study indicates that depression and anxiety are common issues in acute myocardial infarction survivors, and interventions addressing these conditions should be a routine part of care. The study highlights the need for healthcare providers to be aware of the increased risk of mental disorders in individuals who have suffered from AMI. Understanding the impact of anxiety and depression on post-PCI patients is essential for the development of effective interventions that support patients’ recovery.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new term that no longer excludes patients that consume alcohol or present other liver diseases, unlike nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the role of different biomarkers as predictors of MAFLD in patients with type 2 diabetes mellitus (T2DM). In this regard, a cross-sectional, non-interventional study was conducted over a period of 8 months in patients with T2DM. Liver steatosis displayed by abdominal ultrasound certified the MAFLD diagnosis. A percentage of 49.5% of the studied patients presented MAFLD. Through logistic regression adjusted for gender, age, T2DM duration, lipid-lowering therapy, smoking status, nutritional status, we demonstrated that elevated triglycerides (TG) levels, high non-high-density-lipoprotein (HDL)-cholesterol-to-HDL-cholesterol (non-HDL/HDL) ratio, high atherogenic index of plasma (AIP), and increased Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) had predictive value for MAFLD in patients with T2DM. Furthermore, we calculated the optimal cut-off values for these biomarkers (184 mg/dL for TG, 0.615 for AIP, 3.9 for the non-HDL/HDL ratio, and 2.01 for HOMA-IR) which can predict the presence of MAFLD in patients with T2DM. To our knowledge, this is the first study to assess the predictive value of the non-HDL/HDL ratio for MAFLD in patients with T2DM.

Psychosocial and work stress, socioeconomic status, and environmental health directly impact the onset and progression of cardiovascular diseases, irrespective of sex or conventional cardiovascular risk factors (cCRFs). On the other hand, the impact of cCRFs on health-related quality of life (HRQoL) is not well known, and the psychological socioeconomic environmental somatic health interaction is often neglected. Accordingly, we aimed to: (i) compare the self-reported HRQoL using the WHOQOL-BREF questionnaire between healthy subjects and those with cCRFs; and (ii) evaluate the interplay between HRQoL, cCRFs, and cardiovascular treatment adherence. We prospectively included 90 working adults (46 healthy and 44 with cCRFs age- and sex-matched adults) evaluated by clinical examination, 12-leads electrocardiography, and transthoracic echocardiography as part of a cardiovascular diseases screening program, that also filled in the WHOQOL-BREF questionnaire. Subjects with CRFs were less satisfied with their own individual health. The presence and the number of CRFs, as well as the need for cardiovascular treatment and the number of drugs taken correlated with reduced scores at the majority of HRQoL domains. The results in the social relationships domain were the best predictor of cardiovascular treatment adherence. Finally, the results of all HRQoL domains were strongly correlated to each other demonstrating the psychological socioeconomic environmental somatic health interaction.

BACKGROUND:During the pandemic, our hospital became a COVID support hospital and consequently the cardiology clinic had restricted activity; thus, it received only suspect and/or patients confirmed positive with the various COVID-19 strains that were associated with a chronic/flaring cardiovascular pathology.METHODS:Two batches of patients admitted during a one-year period were compared in the cardiology clinic over two different periods of time: BATCH I (1 April 2019 to 31 March 2020), in a non-COVID context (BATCH I N-COV) and BATCH II (1 July 2020 to 30 June 2021) comprising patients that presented with respiratory infection of SARS-CoV-2 (BATCH II COV-2), associated with chronic and/or acute cardiovascular condition. To determine the profile of the patients admitted in our clinic, we observed the following parameters: age, type of cardiac condition, and admission mode (for the N-COV group).RESULTS:The data obtained as absolute numbers and as percentages in relation to the total number of admissions were presented in separate tables and graphs for both of the studied groups.CONCLUSIONS:The SARS-CoV-2 pandemic, in its almost two years of evolution, has divided the medical world in two main categories: COVID and non-COVID. Admission of the patients with chronic, but non-COVID cardiac conditions, in our case, dropped to almost one-quarter when we compared the two absolute admission numbers: 1382 in the year prior to pandemic compared with only 356 in the pandemic year. We believe that the number of deaths due to SARS-CoV-2 infection was infinitely higher than the reported ones and uncountable, in as much as COVID-19 did not kill only the infected patients, but it has also yielded a very large number of collateral victims among chronic patients who had no contact with the disease, but were unable to be admitted and treated for chronic heart disease.

Gestational diabetes mellitus (GDM) is a major public health issue of our century due to its increasing prevalence, affecting 5% to 20% of all pregnancies. The pathogenesis of GDM has not been completely elucidated to date. Increasing evidence suggests the association of environmental factors with genetic and epigenetic factors in the development of GDM. So far, several metabolomics studies have investigated metabolic disruptions associated with GDM. The aim of this review is to highlight the usefulness of maternal metabolites as diagnosis markers of GDM as well as the importance of both maternal and fetal metabolites as prognosis biomarkers for GDM and GDM’s transition to type 2 diabetes mellitus T2DM.

Background: The coronavirus disease 2019 pandemic (COVID-19) is the most important global health crisis to date. In this study, we performed an analysis to find the association between liver damage, FIB-4 score and the severity of COVID-19 disease. Methods: We included a total of 580 patients that tested positive for SARS-CoV-2 infection and were hospitalized. No patient included had any known history of liver disease. Liver function tests were performed, and FIB-4 score was calculated in order to assess their involvement in the disease progression. Results: More than half of the patients had elevated liver function tests. Age, high body mass index, associated heart disease and diabetes were associated with poor outcome. Corticosteroids, antibiotics, and anticoagulants strongly correlated with liver injuries. Liver impairment and injury, as well as a FIB-4 score higher than 3.5, also correlated with higher degrees of disease severity. Conclusion: Liver injury and elevated FIB-4 score were associated with poor clinical outcome and disease severity, as well as being a valuable tool to predict COVID-19-related mortality.

Alcoholism use disorders are very frequent present all over the world. The use of alcohol is responsable for many behavioral symptoms like impulsivity, violence, depressive mood and anxiety. The aim of our research was to find the clinical and the biochemical changes induced by alcohol at the patient with mental illness.

The aim of this study was to evaluate possible correlation between routes of administration of levodopa in patients diagnosed with Parkinsons disease and the presence of digestive symptoms. We included in this study 31 patients diagnosed with Parkinsons disease:14 patients were on oral levodopa and 17 patients were on intrajejunal administration of levodopa/carbidopa. Each patient was assessed using Non-motor Symptoms Questionnaire for Parkinsons Disease regarding the dysfunction of gastrointestinal tract. The results of our study indicated that there is a different distribution of the digestive dysfunction between the two groups of patients. The study indicate that the constipation was more frequent in those patients with oral medication.

Due to the increased frequency of cardiovascular diseases in the evolution of chronic liver disease, we proposed to assess echocardiographic changes in patients with rhythm disorders associated with chronic liver disease. To analyze the degree of cardiac damage, each patient was subjected to a complete cardiovascular examination.

As a part of non-motor symptoms in Parkinsons disease (PD), the dysfunctions of the gastrointestinal tract are frequent, being a major complain in the majority of the patients. The aim of our study was to assess the impact of digestive dysfunctions on quality of life in Parkinsons disease. We included in this study 60 patients with PD, with a disease severity which varied between 2 and 5 on Hoehn and Yahr Scale. Our results showed a low correlation between digestive dysfunctions and the severity of the disease, but a statistically significant correlation between quality of life and the stage of the disease. Also, we observed a statistically significant correlation between digestive dysfunctions and quality of life. Our study revealed that the frequency of digestive dysfunction has correlated with a poor quality of life in any stage of the disease.

Despite the progress in correcting cardiovascular risk factors and pharmacological and interventional therapy, acute myocardial infarction continues to be a major cause of mortality and morbidity worldwide.In literature exist limited information about the factors that affect the outcomes of acute myocardial infarction at patients with a different degree of left ventricular dysfunction. Our aim was to identify the factors associated with LV ejection fraction (LVEF) at first admission to patients with non-ST-segment elevation myocardial infarction.

The goal of pleural fluid assessment is to establish with certainty its etiology and major challenge is the etiologic diagnosis precocity. Pleural effusion as the first and the only event in the onset of non-Hodgkin lymphoma is atypically in the absence of other signs and symptoms. Follicular lymphoma (FL) also called indolent lymphoma the most frequent is a low-grade non-Hodgkins lymphoma (NHL). In patients with indolent lymphoma affecting the pleura and pericardium is atypical and appears only in aggressive forms, so the onset with pleural effusion is unusual. Serous effusions may occur from onset or during evolution of various subtypes of T cell originated lymphomas or high-grade B cell lymphomas. Primary pleural lymphomas (PPL) have been described at patients with human immunodeficiency virus infection; tuberculosis complicated with chronic pyothorax or after exposure to asbestos. Compared to other similar cases previously reported in the medical literature, the novelty of this case is the atypical onset of low grade of indolent B-cells non-Hodgkin with primary pleural effusion in the absence of personal history as well as of another clinical, laboratory and pleural changes.

The papaer presents the cases of a twelve years old boy brought in emergency department with the following symptoms: pain in the thorax and upper abdomen, nausea, vomiting with sudden ones 11 h ago.

Cardiovascular risk management decisions are based on the full profile of cardiovascular risk factors.It is important not only the number of cardiovascular risk factors accumulated by a patient but the magnitude of each factor, both being proportional to cardiovascular risk.

Cardiac affectation is one of the leading causes of death in the world. Rhythmic disorders such as ventricular extrasystoles, atrial extrasysoles, atrial fibrillation, atrial flutter represent a major risk factor with a gloomy progression and prognosis. Our goal was to analyze the existing arrhythmia risk in patients with chronic hepatic disease. Being known the alteration of the somatic status of the patient with liver cirrhosis or other chronic liver disease in the presence of comorbid cardiac symptoms, we consider vital to prevent arrhythmia risk in hepatic pathology.

Heart failure is a disease characterized by cardiac remodeling or progressive dilation of left ventricle and a consequent reduction in contraction. Ventricular remodeling has been shown to be a negative prognostic factor alone, and therefore the most beneficial drugs are those that prevent or reduce left ventricular dilation. The pharmacological therapy of heart failure, although maximal, has proven to be not fully effective. The aim of our research was to evaluate resynchronization therapy in a lot of patients, monitoring their cardiac performance before and after cardiac resynchronization therapy.

The prevalance of depression and anxiety is higher at the patients diagnosticated with viral liver disease. The corelation between stress and chronic liver disease is a natural, implicit one, but still insufficiently studied. The study has the objective of finding out the clinical and also biochemical correlations between stress and chronic viral diseases. Our research was realised on a group of 78 patients with chronic viral liver disease, who underwent an evaluation of the stress level, both from a subjective point of view and based on concrete methods like questionnaires. The patients were asked to espress their state more or less affected by stress, and, subsequently, they were subjected to a questionnaire that was analyzed, followed by establishing the necessary correlations. Our patients were also evaluated by cardiologicaly, psychologicaly and psyhiatricaly examinations. After the first evaluation we had these results :38 patients (49.19%) consider that they have an average stress level, 18 patients (22.58%) have a high stress level. Only 22 patients (28.22%) declared stress was at a low level. We divided the pacients in two groups, function of Qt (questionare total score) results and we observed that a number of 38 patients ( 49.19%) registered <= Qt 20 and 40 patients (50.81%) had Qt >= 20, 63 patients (50.81%).We found a strong correlation between the patients' subjective evaluation of the stress level and the objective evaluation of stress level according to the used questionnaire, which confirms the objectivity of our study. We found a direct corelation, with a morphological, biochemical and functional support between stress and the arrhythmia risk in the evolution of chronic liver disease. We consider very important a complex examination psychiatrical); psychologicaly and cardiological of the pacients diagnosticated with viral liver disease in order to help them and to prevent arrhythmic events, depression, anxiety and other mood disorders.

The prevalance of QT prolongation in chronic viral liver disease is high and the risk of complications is increased. We wanted to study the QT interval prolongation at the patients diagnosed with chronic hepatic disease and also to evaluate some of clinical and biochemical variables. We studied a cohort with 126 patients diagnosed with chronic viral hepatic diseases hospitalised to Cardiology Department, to the County Hospital of Craiova, between Octomber 2016 and January 2018. We aimed to determine the occurrence of QT interval prolongation in a large series of patients with chronic hepatic disease of viral etiology. We wanted to evaluated the QT prolongation to clinical and biochemical variables. The QT interval was measured by a standard 12-lead ECG for each patient, with prolongation defined as 460 ms. Multiple clinical and biochemical variables were evaluated including sex, age, areas (rural/urban) the frequency of arrhythmic events (PACs, PVCs, Atrial fibrillation, Bradycardia, Tachycardia), NT proBNP Hb,uric acid, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), cholesterol, triglyceride, etc. The group of patients was composed by 43 woman and 83 men. From 43 women, representing 65.06% (461.56 +/- 42.03) and from 83 men, means 66.67% (461.14 +/- 45.10) presented interval QT prolongation. Studing the distribution of hepatic etiologies we can see that 34 patients had hepatitis B, 35 patients hepatitis C, 5 patients B and C dual virus infection and 52 patients with chronic liver disease of etiology other than viral. We registered close results about QT interval prolongation on group, sex and origine group of patients. The value of QT interval to our patients was higher compared to other values recorder in other studies, at the patients with chronic hepatic disease, despide the fact we chose a higher value of QT prolongation. The highest value of QT interval was in the group of age between 60 and 69, even if in other studies we notice a prolonged QT interval at patients over 70 years old. The biological and biochemical profile of chronic hepatic disease of the subjects included in our study showed no statistical difference between male and female patients. We found a higher incidence of arrhythmic events, at patients with chronic hepatic disease of viral etiology, especially to premature atrial contraction and atrial fibrillation. We found a couple of correlation between QT interval prolongation and the evolution of chronic hepatic disease of viral etiology. It is very important to develop a strong and complex strategies to prevent and to treat the arrhythmic event presented at the patients diagnosticated with hepatic disease, because of the higher risk of developing life-threatening arrhythmias, includen sudden cardiac death.

Abstract Introduction. Chronic pancreatitis is morphologically characterized by ductal dysplasia, breeding grounds for the proliferation of the ductal cells, the degenerative changes in pancreatic acinar cells and fibrosis, and it is defined on the basis of the clinical, morphological and functional criteria. Aim. The aim of our study is to examine the existence of a possible correlation between the iNOS-2087A>G polymorphism and chronic pancreatitis by means of the genetic analysis. Material and method. We have conducted the study at the Gastroenterology Clinic and the Research Center of Gastroenterology and Hepatology of the University of Medicine and Pharmacy, Craiova, between March 2015 – September 2016. The study had a prospective character. Both for the 58 patients diagnosed with chronic pancreatitis and for the 132 patients in the witness group, the biological material was represented by blood, (around 2.5 – 5 milliliters of venous blood) let on EDTA and kept at 4°C up to the separation of the DNA molecule. All the patients were genotyped for the iNOS – 2087A>G polymorphism, by means of the Real Time PCR technique with TaqMan probes. Results. Analysing the prevalence of the iNOS genotypes within the study group and witness group, we have noticed that, statistically speaking, there are no significant differences between the two groups. Conclusion. As a conclusion, in the study lot we can sustain that the risk of developing chronic pancreatitis is not increased by the presence of the iNOS-2087A>G polymorphism.