Background and Objectives: Atherosclerosis continues to be a major determinant of the global health burden, with ischemic heart disease representing one of the leading causes of morbidity and mortality worldwide. Although cardiovascular (CV) prevention strategies focus on pro-atherogenic lipoproteins, such as LDL-C, non-HDL-C, and apoB, the balance between atherogenic and anti-atherogenic lipoproteins may better reflect the overall atherogenic burden. Apolipoprotein B (apoB) reflects the total number of circulating atherogenic particles, whereas apolipoprotein A-I (apoA) is the main protein component of HDL, the major anti-atherogenic lipoprotein. Integrating these two parameters into the apoB/apoA ratio results in a composite biomarker that reflects this balance. In this study, we aimed to evaluate whether the apoB/apoA ratio can predict the presence and the severity of coronary artery disease (CAD) in a cohort from an Eastern European hospital, under moderate-intensity statin treatment. Additionally, we assessed whether lipoprotein(a) [Lp(a)] provides any additional diagnostic value. Materials and Methods: We consecutively enrolled 121 statin-treated patients, who presented for elective invasive coronary angiography. Patients with history of coronary revascularization or acute coronary syndrome were excluded. The study cohort was further divided into two groups, according to the severity of coronary stenosis: 69 patients with non-significant CAD (N-CAD) and 52 patients with hemodynamically significant CAD (S-CAD). Apolipoprotein B, apolipoprotein A-I, and lipoprotein(a) were measured using a standardized immunoturbidimetric assay, at the moment of enrollment. The severity of coronary stenosis was measured using Quantitative Coronary Analysis (QCA) software and the total coronary atherosclerotic burden of each patient was quantified using the Gensini score. Results: The apoB/apoA ratio was significantly higher in the S-CAD groups, compared with N-CAD patients (0.53 ± 0.16 vs. 0.73 ± 0.18). Furthermore, in the apoB/apoA-based analysis, the Gensini score increased progressively across the three tertiles (8.55 ± 19.60 vs. 14.57 ± 21.65 vs. 29.8 ± 27.78, p = 0.000) and so did the percentage of patients with three-vessel disease (5% vs. 19.5% vs. 32.5%, p = 0.000) and left main disease (5% vs. 7.3% vs. 20%, p = 0.031). The apoB/apoA ratio showed a significant correlation with the severity of CAD, as expressed by the Gensini score (r = 0.513, p < 0.001, 95% CI: 0.357–0.641). The association between apoB/apoA ratio and the presence and severity of CAD expanded beyond group comparison. In the logistic regression, this biomarker proved to be a valuable predictor for S-CAD (per SD increase: OR 2.509, 95% CI: 1.441–4.369, p = 0.001), three-vessel disease (per SD increase: OR 2.339, 95% CI: 1.427–3.892, p = 0.001), and left main disease (per SD increase: OR 2.771, 95% CI: 1.489–5.156, p = 0.001). The apoB/apoA ratio remained significant after adjusting for other CV risk factors and independent to LDL-C, as shown by the analysis that we performed among the lowest LDL-C tertile patients. Participants with S-CAD showed higher concentrations of Lp(a). However, adding this lipoprotein to the multivariate analysis, resulted only in a marginal improvement in the predictive power. Conclusions: The ApoB/apoA ratio emerged as an independent predictor for hemodynamically significant coronary stenosis and for CAD severity. Additionally, higher apoB/apoA values were associated with anatomical high-risk features, such as three-vessel disease or left main disease. In contrast, Lp(a) did not provide a substantial increase in the predictive power of multivariate models in this stable CAD cohort.

Ischemic heart disease (IHD) remains the leading cause of chronic heart failure (HF) worldwide, yet the biological processes underlying this transition are not fully elucidated. Growing evidence indicates that chronic, low-grade inflammation acts as a pivotal link between ischemic injury and progressive myocardial dysfunction. Our review is the most up-to-date and structured synthesis on the pathophysiological pathways, biomarkers, and therapeutic implications of subclinical inflammation in patients with IHD at risk of developing HF. Following acute or repetitive ischemic episodes, persistent immune activation-mediated through interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α)-promotes endothelial dysfunction, microvascular instability, and extracellular matrix remodeling. These mechanisms culminate in ventricular stiffness, diastolic impairment, and adverse structural remodeling, even when left ventricular ejection fraction is preserved. Biomarkers such as Galectin-3, cancer antigen 125 (CA125), and high-sensitivity C-reactive protein (hsCRP) provide valuable insight into the interplay between fibrosis, congestion, and systemic inflammatory load, supporting early detection of subclinical myocardial injury. Advanced imaging modalities, including strain echocardiography and cardiac magnetic resonance imaging (MRI) mapping, enhance the phenotypic characterization of inflammatory cardiomyopathy. Understanding and targeting these inflammatory pathways may open new avenues for precision-based prevention and treatment, ultimately improving outcomes across the IHD-HF continuum.

Background: Anemia is frequently observed in patients undergoing transcatheter aortic valve implantation (TAVI) and may reflect persistent biological vulnerability in the post-procedural period. The relationship between systemic immune-inflammatory burden and anemia at entry into structured cardiac rehabilitation (CR) after TAVI remains insufficiently explored. Methods: This retrospective observational study included 80 consecutive patients referred to CR after successful TAVI. Anemia was defined by World Health Organization (WHO) criteria (hemoglobin <13 g/dL in men; <12 g/dL in women). Systemic inflammatory burden was assessed using C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and the systemic immune-inflammation index (SII = platelet × neutrophil/lymphocyte). Multivariable logistic regression, adjusted for age, sex, body mass index (BMI), type 2 diabetes mellitus, and estimated glomerular filtration rate (eGFR), was used to evaluate independent associations with anemia. Results: Anemia was present in 67.5% of patients at CR entry. Compared with non-anemic patients, anemic patients exhibited significantly higher CRP (4.25 vs. 2.58 mg/L; p = 0.014), NLR (2.86 vs. 2.34; p = 0.004), PLR (132.33 vs. 102.13; p = 0.003), and SII (566.01 vs. 448.30; p = 0.011). In multivariable models, NLR (OR 4.09; 95% CI 1.50-11.19; p = 0.006), PLR (OR 4.89; 95% CI 1.41-17.02; p = 0.013), SII (OR 4.96; 95% CI 1.35-18.14; p = 0.016), and CRP (OR 2.17; 95% CI 1.07-4.39; p = 0.032) were independently associated with anemia. Area under the ROC curve (AUC) was 0.70 for NLR and PLR, 0.68 for SII, and 0.67 for CRP. Conclusions: Systemic inflammatory burden is independently associated with anemia at the time of entry into CR facility after TAVI. These findings support an integrated approach to patient evaluation and provide a basis for future mechanistic and interventional studies.

All acute coronary syndrome patients should be included in a comprehensive cardiac rehabilitation programme, which should be initiated as soon as possible after the acute event. Exercise-based cardiac rehabilitation is recommended in all subjects with coronary artery disease to reduce cardiac mortality and rehospitalization rate. We report the case of a 50 year old male patient, a professional athlete, martial arts and box fighter, with a history of anterior myocardial infarction in 2023, diagnosed with two-vessel coronary artery disease, treated with primary percutaneous coronary angioplasty with drug-eluting stent at the level of the left anterior descending artery (LAD), complicated with heart failure with reduced ejection fraction, who was included in the cardiac rehabilitation program after the acute event, with a significant improvement noted in terms of left ventricular ejection fraction and controlled physical exercise, as shown through repeated cardiopulmonary exercise testing. Regarding the return to sport after an acute coronary event, careful individual evaluation is required before starting high-intensity competitive sports. Despite proven benefits, the rates of referral to, participation in, and implementation of cardiac rehabilitation programmes are low.

(1) Background: Postoperative atrial fibrillation (POAF) is one of the most common complications of cardiac surgery, frequently occurring in the first 2–4 days after surgery. With a variable incidence depending on the type of surgery, research in recent years has focused on identifying predisposing factors with the aim of correcting them and thus decreasing the risk of cardiovascular and total morbidity and mortality. The analysis of pericardial fluid allowed the identification of biomarkers (interleukin-6, mitochondrial DNA, myeloperoxidase or natriuretic peptides) whose presence postoperatively was associated with increased risk of POAF. (2) Materials and Methods: We conducted a search on EMBASE and PubMed and identified 75 articles, of which 10 entered the final analysis. (3) Results: Patients who develop POAF accumulate large amounts of interleukin 6, mitochondrial DNA, myeloperoxidase, or secondary atrial natriuretic peptide as a consequence of the associated inflammatory status, atrial remodeling, or disturbance of homeostasis of various ions. There are also observations that their levels in the pericardium correlate with blood levels, but further studies on larger cohorts of patients are needed to provide new evidence in this regard. (4) Conclusions: Early recognition of patients at risk of developing POAF based on easy-to-dose and easy-to-use biochemical biomarkers, whose association with POAF has been demonstrated so far in small cohorts of patients, has both therapeutic and prognostic implications, which justifies further research on large cohorts of patients.

Primary aldosteronism is a frequently overlooked cause of secondary hypertension, despite its association with significant cardiovascular morbidity. Spontaneous or diuretic-induced hypokalemia can serve as an important clinical clue, particularly in younger individuals with resistant hypertension. This case report describes a 39-year-old female who was admitted with high blood pressure (160–180/100 mmHg) and severe hypokalemia (serum potassium: 2.4 mmol/L), requiring frequent potassium supplementation. Biochemical evaluation revealed suppressed renin levels and significantly elevated plasma aldosterone concentration, with an aldosterone-to-renin ratio diagnostic for primary aldosteronism. Adrenal computed tomography identified an unilateral adrenal nodule consistent with an aldosterone-producing adenoma. The patient underwent laparoscopic adrenalectomy, with histopathological confirmation of a benign aldosterone-producing adenoma. After surgery, her blood pressure improved significantly, hypokalemia was corrected, and her antihypertensive medication requirements decreased. Early recognition and targeted treatment, including adrenalectomy for unilateral lesions, can lead to improved long-term outcomes by reducing hypertension severity, cardiovascular risk, and medication burden. This case underscores the need for increased awareness and systematic screening in hypertensive patients, particularly those with hypokalemia or resistant hypertension, to ensure timely diagnosis and optimal management.

Transcatheter aortic valve implantation (TAVI) has redefined the management of severe aortic stenosis, particularly in surgical high-risk patients. As the number of TAVI procedures increases, there is a growing need for effective post-procedural care. Cardiac rehabilitation (CR) has emerged as a critical component of treatment in these patients. The most recent update of the European recommendations highlights the importance of including post-TAVI patients in CR programs. However, the benefits of CR in this particular patient group still need to be fully understood. The objective of this narrative review is to summarize the safety and benefits of post-TAVI CR by evaluating its impact on functional capacity, frailty, muscular strength, mental health, quality of life, and long-term survival. While emerging evidence supports its safety and effectiveness in the aforementioned outcomes, gaps remain regarding the optimal rehabilitation protocols, including the timing, duration, and intensity of CR as well as its long-term cardiovascular benefits. Further research is needed to develop personalized approaches for different patient groups. This article highlights the current knowledge, identifies critical gaps, and underlines the need for tailored rehabilitation strategies to improve post-TAVI recovery and patient outcomes.

Background/Objectives: Coronary artery disease (CAD) remains the leading cause of death primarily in patients over 65 years old, with an increasing incidence, especially in Eastern European countries. Primary and secondary prevention protocols are based on a large number of cardiovascular (CV) risk factors, but low-density lipoprotein cholesterol (LDL-C) remains the main treatment target and one of the central determinants of CV risk. Apolipoprotein B (apoB) is the main structural protein in all atherogenic lipoproteins, and, unlike LDL-C, which only reflects the cholesterol content of LDL, apoB directly quantifies the total number of all circulating atherogenic particles. Over the past decade, a growing amount of data has supported the utility of apoB for CV risk assessment; however, its superiority over LDL-C remains unclear. Our study aimed to investigate the predictive value of apoB for both the presence and the severity of CAD in a statin-treated cohort from an Eastern European hospital and to compare it with standard lipid biomarkers. Methods: A total of 121 statin-treated patients, who were evaluated using coronary angiography, were consecutively enrolled and subdivided into three groups: 52 patients with significant coronary artery disease (S-CAD), 36 patients with non-significant coronary artery disease (NS-CAD), and 33 patients without coronary atherosclerosis (N-CAD). Apolipoprotein B was measured at the moment of enrollment using the immunoturbidimetric assay. Results: The mean values of LDL-C, TC, non-HDL-C, and apoB increased progressively across the three studied groups. Unlike traditional lipid biomarkers, apoB levels differed significantly not only between N-CAD and S-CAD, but also between N-CAD and NS-CAD. The diagnostic superiority of apoB extended beyond group mean differences, as it also demonstrated the strongest correlation with CAD severity. ApoB showed a moderate correlation with the Gensini score (r = 0.43, p < 0.001), which was markedly higher compared to LDL-C, TC, or non-HDL-C, all of which presented only a weak correlation (r = 0.26, r = 0.23, and r = 0.28, respectively). Additionally, in a logistic regression analysis, apoB demonstrated the highest predictive power for the presence of significant CAD (per SD increase: OR 2.386, 95% CI 1.52–3.75, p = 0.000), and it was the only biomarker able to predict left main disease (per SD increase: OR 2.433, 95% CI 1.38–4.30, p = 0.002) and three vessel disease (per SD increase: OR 1.639, 95% CI 1.012–2.654, p = 0.044). Residual apoB was also calculated and remained significantly associated with the presence of coronary atherosclerosis. Conclusions: ApoB proved to be a reliable predictor for CAD, independent of LDL-C. Compared to standard lipid biomarkers, apoB was superior in detecting NS-CAD and showed a better correlation with the severity of CAD. Additionally, in our study, only apoB was significantly correlated with left main disease and three vessel disease.

Background: Fetuin-A, a hepatokine implicated in metabolic regulation, has been associated with both metabolic syndrome and cardiovascular disease. However, its specific role in type 2 diabetes mellitus (T2DM) remains incompletely understood. Objective: This study aimed to investigate the relationship between fetuin-A levels and key components of metabolic syndrome (abdominal obesity, arterial hypertension, hyperglycemia, hypertriglyceridemia and low high-density lipoprotein cholesterol) as well as other cardiovascular risk markers, including metabolic dysfunction-associated fatty liver disease (MAFLD), carotid intima-media thickness (CIMT), and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Methods: A total of 51 patients with T2DM not receiving insulin therapy were enrolled. Participants underwent clinical, biochemical, and imaging evaluations. Hepatic steatosis was assessed via abdominal ultrasonography, and subclinical atherosclerosis was evaluated using CIMT measured with Doppler ultrasonography. Serum fetuin-A was quantified by ELISA. Results: Hepatic steatosis was significantly associated with metabolic syndrome, increased CIMT, and dyslipidemia (elevated total cholesterol, triglycerides, and reduced HDL cholesterol). Although no direct correlation was found between fetuin-A levels and hepatic steatosis, multivariate analysis revealed that fetuin-A concentrations were significantly influenced by total cholesterol and LDL cholesterol levels. Conclusions: Fetuin-A appears to be linked to lipid abnormalities in T2DM and may contribute to cardiovascular risk in this population. These findings support the potential utility of fetuin-A as a biomarker and possible therapeutic target for dyslipidemia management in diabetic patients.

Background/Objectives: Long-term hospitalization in cardiac patients is associated with significant metabolic and microbial alterations that may influence disease progression and prognosis. Although lipid imbalances, metabolomic shifts, and gut microbiome dysbiosis have each been linked individually to cardiovascular outcomes, their integrated evaluation in long-term-hospitalized patients remains underexplored. Methods: We conducted a retrospective observational study including 51 cardiac patients hospitalized for more than 25 days, compared with a control group of 41 patients hospitalized for short and intermediate durations (3–24 days). Clinical and demographic data were collected, alongside lipid profiling, metabolomic assessment through liquid chromatography–mass spectrometry (LC-MS), and gut microbiome analysis using GI360™ sequencing. Ethical approval was obtained, and all data were anonymized. Lipid-related findings are exploratory due to the small number of complete measurements. Results: Preliminary lipid trends were characterized by higher levels of LDL, triglycerides, and Lp(a), and lower HDL, in the long-term group. Metabolomic analyses revealed decreased energy-related metabolites (ATP, phosphocreatine ratio), altered amino acid patterns, and increased ketone utilization. Gut microbiome evaluation demonstrated a significant increase in dysbiosis index, with reduced diversity and dominance of potentially pathogenic taxa. These findings were correlated with clinical severity scores. Cross-domain relationships are exploratory and based on associative profiling rather than deep integrative modelling. Conclusions: Long-term hospitalization in cardiac patients is associated with distinct lipid, metabolomic, and gut microbiome profiles that may serve as predictive biomarkers of adverse outcomes. Future studies should validate these findings in larger cohorts and explore their integration into personalized management strategies.

Functional capacity (FC), ideally determined by a cardiopulmonary exercise test (CPET), is a valuable prognostic marker in chronic coronary syndrome (CCS). As CPET has limited availability, biomarkers of inflammation and/or fibrosis could help predict diminished FC. Our objective was to assess the value of galectin-3 (gal-3) and that of three inflammatory markers easily obtained from a complete blood count (NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio) and MLR (monocyte-to-lymphocyte ratio) in predicting diminished FC in males with recent elective percutaneous coronary intervention (PCI) for CCS. Our prospective study enrolled 90 males who had undergone elective PCI in the previous 3 months (mean age 60.39 ± 10.39 years) referred to a cardiovascular rehabilitation (CR) clinic between February 2023 and December 2024. All subjects received clinical examination, a cardiopulmonary stress test, transthoracic echocardiography and bloodwork. Based on percentage of predicted oxygen uptake (%VO2max), patients were classified in two subgroups—impaired FC (≤70%, n = 50) and preserved FC (>70%, n = 40). NLR, PLR and gal-3 were elevated in patients with poor FC and were significant predictors of diminished FC in multivariate analysis. PLR, NLR and gal-3 could guide referrals for CR for high-risk males with recent elective PCI.

The primary objective of this study is to determine the existence of a significant correlation between inflammation levels, as measured by inflammatory markers IL-6, IL-1β, and TNF-α, and the severity of depressive symptoms assessed using HAM-D assessment scale. This could provide additional evidence supporting the hypothesis that inflammation plays a notable role in the pathogenesis of depression. The data analysis supports the hypothesis that the biological mechanisms of inflammation contributes to the clinical manifestations of depression. Elevated levels of inflammatory markers, especially interleukins (IL6, IL1β), tumor necrosis factor-alpha (TNFα), and C-reactive protein (CRP) have been identified in patients with major depressive disorder compared to the findings in healthy controls. Materials and Methods: Inflammatory markers (IL-6, IL-1β, and TNF-α) were measured in a sample of 31 patients hospitalized at the Socola Institute of Psychiatry in Iasi, Romania, and compared to a control group with no psychiatric or inflammatory conditions. One of the main objectives is to determine if there is a significant correlation between inflammation levels, measured by inflammatory markers (IL-6, IL-1β, and TNF-α), and the severity of depressive symptoms assessed using HAM-D scores. Conclusions: The study results suggest a significant correlation between inflammation levels measured by inflammatory markers IL-1β and IL-6 and the severity of depressive symptoms evaluated by HAM-D scores in the study group. These findings support the hypothesis that inflammation may play an important role in the development or exacerbation of depressive symptoms. The relationship between inflammation and depression is also influenced by risk and protective factors that require further research.

Exercise-based cardiac rehabilitation (ExCR) programs are essential for patients diagnosed with cardiac diseases. Studies have shown that they aid in the rehabilitation process and may even facilitate a return to previous cardiorespiratory fitness. Also, patients who enroll and follow such programs have shown a lower rate of complications and mortality in the long run. The results vary depending on the type of program followed and the degree of debilitation the disease has caused. Therefore, in order to obtain optimal results, it is ideal to tailor each ExCR program to the individual profile of each patient. At the moment, the two most studied and employed training types are medium-intensity continuous training (MICT) and high-intensity interval training (HIIT). For most of the time, MICT was the first-choice program for patients with cardiovascular disease. In recent years, however, more and more studies have pointed towards the benefits of HIIT and how it better aids patients in recovering their cardiovascular fitness. Generally, MICT is more suited for patients with a severe degradation in functional capacity and who require a higher degree of safety (e.g., elderly, with a high number of comorbidities). On the other hand, while HIIT is more demanding, it appears to offer better outcomes. Therefore, this review aimed to summarize information from different publications on both types of training regimens in ExCR and assess their utility in current clinical practice.

Background: There are studies that have investigated the association of pro-inflammatory cytokines with depressive disorders, but they often present certain limitations. In this study, two substantial groups of patients were analyzed: 92 patients with major depressive disorder and 76 without depressive disorders. The strict inclusion and exclusion criteria for the analyzed groups significantly increased the value of the obtained results. The research question of this study was whether levels of inflammation, measured by the inflammatory markers IL-6, IL-1α, and TNF-α, could predict the severity of depressive symptoms. This could provide additional evidence supporting the hypothesis that inflammation plays a notable role in the pathogenesis of depression. The data analysis supports the hypothesis that the biological mechanisms of inflammation contribute to the clinical manifestations of depression. Elevated levels of inflammatory markers, especially interleukins (IL-6, IL-1α) and tumor necrosis factor-alpha (TNF α), have been identified in patients with major depressive disorder compared to the findings in healthy controls. Materials and Methods: Inflammatory markers (IL-6, IL-1α, and TNF-α) were measured in a sample of 92 patients hospitalized at the Socola Institute of Psychiatry in Iasi, Romania, and compared to a control group with no depression or inflammatory conditions (n = 76). Severity of depressive symptoms was assessed using HAM-D scores. Results: The study results indicated that values of plasma inflammatory markers were significantly higher in patients with major depressive disorder (MDD) compared to the control group (IL-1α: 1.16 ± 0.44 pg/mL vs. 0.89 ± 0.25 pg/mL, p = 0.0004; IL-6: 9.21 ± 4.82 pg/mL vs. 7.16 ± 4.32 pg/mL, p = 0.0149; and TNF-α: 2.02 ± 0.96 pg/mL vs. 1.67 ± 0.8 pg/mL, p = 0.0286). The differences remained significant after applying logarithmic transformation, which was necessary to adjust for outlier values. An analysis of demographic characteristics showed that the frequency of women (67.4% vs. 36.84%, p < 0.001), cohabiting individuals (28.26% vs. 10.53%, p = 0.0001), and alcohol consumers (67.39% vs. 47.37%, p = 0.0087) was significantly higher in patients with MDD. The level of education was significantly lower in patients with MDD (median (IQR): 12 (2.5) years vs. 14 (8) years, p = 0.0016). The evaluation of confounding variables, including patients’ gender, marital status, education level, and alcohol consumption, was performed using multiple linear regression models. The results indicated that these demographic variables did not significantly influence the correlation between the HAM-D score and the values of IL-6, IL-1α, and TNF-α. A significant correlation between the HAM-D score and the logarithmic values of inflammatory markers was observed for log IL-1α in men (r = 0.355, p = 0.0014), log IL-6 in women (r = 0.0313, p = 0.0027), and log TNF-α in women (r = 0.3922, p = 0.0001). The results of the multiple linear regression and predictive analysis indicated that IL-1α (AUC = 0.677, p = 0.0004), IL-6 (AUC = 0.724, p < 0.001), and TNF-α (AUC = 0.861, p < 0.001) demonstrate high accuracy in discriminating patients with MDD. Conclusions: The results highlighted that IL-6 (AUC = 0.724; 95% CI: 0.648–0.801) and TNF-α (AUC = 0.861; 95% CI: 0.797–0.925) are significant predictors for major depressive disorder. The study highlights the potential of cytokines (IL-1α, IL-6 and TNF-α) as diagnostic markers. These findings support the hypothesis that inflammation may play an important role in the development or exacerbation of depressive symptoms.

Romania is considered a country with high cardiovascular risk, arterial hypertension and its complications accounting for about 60% of total deaths. The management of high blood pressure often involves a combination of both therapeutic regimens as well as lifestyle changes, to which patients have to be adherent. In order to assess patients adherence to professionals’ recommendations, validated tools are needed. The aim of our study was to translate, culturally adapt and validate the Hill-Bone Compliance to High Blood Pressure Therapy Scale into Romanian. The study included 215 participants from Iasi, North-Eastern Romania. The internal consistency of the instrument was measured with Cronbach’s alpha coefficient, while the construct validity was determined using exploratory factor analysis and principal component extraction with promax rotation. Sampling adequacy and appropriateness of data for factor analysis was measured using Kaiser-Meyer-Olkin (KMO) statistics and Bartlett’s test of sphericity. Our statistical analysis revealed a Cronbach’s alpha coefficient of 0.733 (73.3%) and a Kaiser-Meyer-Olkin (KMO) Measure of Sampling Adequacy of 0.697. The chi square test demonstrated that the overall perfect adherence was not significantly associated with the number of medications taken per day variable (p = 0.721). The Romanian version of the Hill-Bone Compliance to High Blood Pressure Therapy Scale demonstrated suitability for its use in evaluating adherence in the intended population.

In recent decades, chronic viral infection C (HCV) has posed a major public health challenge globally, considering the morbidity and mortality associated with this condition, as well as the difficulties related to diagnosis and treatment. Recently, significant advances in medical and pharmaceutical research have led to the development of new direct-acting antiviral therapies (DAAs), marking the beginning of a new era in HCV treatment. These treatments promise cure rates of over 90%, an improved safety profile, and a reduced duration of therapy compared to previous interferon-based regimens. This article aims to examine the evolution of HCV treatment, with a special focus on recent innovations in antiviral therapy. We will analyze the mechanisms of action of DAAs, their efficacy and safety, and their impact on populations with limited access to treatment. Additionally, we discuss the remaining challenges in the path to HCV eradication, including late diagnosis, barriers to treatment access, and the need for long-term monitoring of cured patients. By consolidating data from recent clinical studies and reviewing the specialized literature, this article provides a comprehensive perspective on the current landscape of HCV treatment, highlighting significant progress made and underlining the future directions needed to address remaining challenges. Finally, we reaffirm the importance of an integrated approach, encompassing prevention, early diagnosis, and universal access to innovative treatments, as a cornerstone in the fight against HCV.

CLINICAL, BIOLOGICAL AND SOCIAL CHARACTERISTICS ASSOCIATED WITH POSITIVE AND NEGATIVE SYMPTOMATOLOGY IN SCHIZOPHRENIA AND BRIEF PSYCHOTIC DISORDER (Abstract): Psychotic disorders are prevalent mental health conditions that frequently go underdiagnosed, particularly in their early stages. During the prodromal period, symptoms are frequently underestimated or misattributed. Materials and methods: We collected data from the "Socola" Institute of Psychiatry, gathering information from 392 patients hospitalized in 2023 and diagnosed with brief psychotic disorder or schizophrenia. We analyzed classification by age group (20-40, 40-60, 60, and >= 61 years old), rural or urban living environments, level of education, association with depression or anxiety using the Hamilton scales, presence of other psychiatric comorbidities, suicidal ideation or attempts, presence of inflammatory markers (ESR, CRP, and leukocytes), and the treatment plan. Conclusions: Our study provided a detailed demographic and clinical profile of patients with brief psychotic disorders and schizophrenia at the "Socola" Institute. The findings highlight the importance of an integrated approach to assessment and management, emphasizing early identification of risk factors and implementation of preventive interventions to promote healthy living and prevent chronic disorders.

Abstract Ambulatory Blood Pressure Monitoring (ABPM) has become an essential tool in the diagnosis and management of hypertension in primary care. This review aims to elucidate the theoretical foundations, clinical applications, and benefits of ABPM, emphasizing its role in improving patient outcomes. ABPM provides a more accurate assessment of blood pressure (BP) by recording measurements over 24 hours during a patient’s normal daily activities and sleep. It is particularly useful in diagnosing white-coat hypertension and masked hypertension, assessing BP variability, and evaluating the efficacy of antihypertensive therapy. ABPM enhances diagnostic accuracy, risk stratification, and patient management, leading to better clinical outcomes and cost-effectiveness in primary care settings. Despite its limitations, the benefits of ABPM in guiding treatment decisions and improving patient outcomes are substantial. Future research should focus on expanding the accessibility of ABPM and refining data interpretation techniques to maximize its clinical utility in primary care.

Abstract Hepatic steatosis is a frequent pathological finding in patients with chronic viral C infection (HCV) and can be independently associated with increased alcohol consumption, type 2 diabetes, obesity and hyperlipidemia. All these factors can lead to the development of hepatic steatosis in patients with HCV. There are several noninvasive techniques and scores used for diagnosing and quantifying liver steatosis. Successful eradication of HCV with interferon-free treatment regimens has been suggested to improve the level of hepatic steatosis. The precise mechanisms responsible for these beneficial effects are currently under investigation, but it is thought that the decrease in hepatic inflammation and viral replication contribute to the resolution of hepatic steatosis. Moreover, the overall enhancement in liver health and metabolic factors may also have a significant impact.

Arterial stiffness naturally increases with age and is a known predictor of cardiovascular morbimortality. Blood flow restriction (BFR) training involves decreasing muscle blood flow by applying a strap or a pneumatic cuff during exercise. BFR induces muscle hypertrophy even at low intensities, making it an appealing option for older, untrained individuals. However, BFR use in patients with cardiovascular comorbidities is limited by the increased pressor and chronotropic response observed in hypertensive elderly patients. Furthermore, the impact of BFR on vascular function remains unclear. We conducted a comprehensive literature review according to PRISMA guidelines, summarizing available data on the acute and long-term consequences of BFR training on vascular function. Although evidence is still scarce, it seems that BFR has a mild or neutral long-term impact on arterial stiffness. However, current research shows that BFR can cause an abrupt, albeit transient, increase in PWV and central blood pressure. BFR and, preferably, lower-body BFR, should be prescribed with caution in older populations, especially in hypertensive patients who have an exacerbated muscle metaboreflex pressor response. Longer follow-up studies are required to assess the chronic effect of BFR training on arterial stiffness, especially in elderly patients who are usually unable to tolerate high-intensity resistance exercises.