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Introduction and Objectives. The management of lithiasis patients is more complex as it has other associated comorbidities. This program aims to multidisciplinary evaluation of obese lithiasis patients from the perspective of lithiasis metaphylaxis.Obesity is a significant risk factor for developing the recurrence of kidney stones. Materials and Methods. We initiated in the Department of Urology of the Clinical Hospital “Dr. C. I. Parhon”, in colaboration with the Department of Diabetes, Nutrition and Metabolic Diseases within the Emergency Clinical Hospital “St. Spiridon”, from Iasi, a program that aims to monitor obese lithiasis patients. This program offers valuable recommendations for weight normalization assisted by a dietitian and preventing lithiasis recurrence as a long-term goal. This program is in progress. Between February and October 2021, we identified 245 overweight / obese patients who had at least one episode of reno-ureteral stones in the last two years. After the clinical, paraclinical, anthropometric, and nutritional analysis, a personalized diet was elaborated. The diet was calculated according to the individual caloric needs and adapted to the specific type of lithiasis. Results. From 245 obese lithiasis patients invited, 144 accepted the urological and nutritional assessment, and of these, only 62 followed the recommendations, and 18 reached the ideal weight. Of the 144 patients monitored, 11 patients had an excess weight up to 10 Kg, 20 patients weighed between 10-15 Kg, 20 patients weighed between 15- 20 Kg, 45 patients weighed between 20-30 kg, and 48 patients had a surplus more than 30 Kg over the ideal weight. Conclusions. Although approximately one in three obese lithiasis patients accepted active monitoring and followed the recommendations, taking into account the beneficial impact on general health and comorbidities (hypertension, diabetes, dyslipidemia etc.), this program is helpful to the obese lithiasis patient. [ABSTRACT FROM AUTHOR]

Introduction. Prenatal care is considered an important tool for promoting a healthy lifestyle, but has not been studied as a predictor for maternal weight gain during pregnancy, especially in Romania, where evidence about pregnancy and nutrition is scarce. Objective. This study has aimed to explore the relationship between pre-gestational body mass index (BMI), adequacy of prenatal care and weight gain during pregnancy. Methods. We carried a cross-sectional study on a sample of 400 pregnant women admitted at the “Cuza Voda” Obstetrics and Gynecology Hospital in Iasi. Information regarding demographic characteristics, number of prenatal visits, date of the initial hospital record, nutritional education during pregnancy were registered throughout a questionnaire filled out by means of a direct interview. The anthropometric indicators analyzed were the pre-gestational BMI and the pregnancy weight gain. Data on caloric intake were obtained using a food frequency questionnaire. Results. Weight gain within the limits of the Institute of Medicine recommendations was noticed at 44.35% of the women who declared that they received nutritional advice compared to 40.7% of those who did not receive advice regarding diet during pregnancy. Overweight (53.1%) and obese women (66.7%) had a larger weight gain than those with a normal pre-pregnancy BMI (29.8%) (p

Background Urolithiasis prophylaxis is a cornerstone for kidney stone formers. Obesity is a well-known risk factor for kidney stone recurrence. The objectives of this research were to highlight the correlations between the mean water intake and free water deficit (FWD) depending on plasma Na and weight. Methods Anthropometric and nutritional analysis was performed using a body analyzer with magnetic bioimpedance ankle-to-foot, which determined the total percentage of water in the body. Results The mean age was 52.19 years old and the mean body mass index (BMI) was 33.68 km/m 2 . About 58.23% (n=46) of patients declared at least one episode of urolithiasis in their pathological antecedents. The patients were counseled by a dietician and lost weight. After losing weight, the total body water (TBW) percentage increased (average=41.37%), while the total fat percentage decreased (average=33.52%). Urinary volume increased, but the water did not accumulate for proper hydration. This may explain the recurrence of urinary stones despite large amounts of water intake. Conclusions The present study indicates an inverse-proportional relationship between TBW and fat mass (FM). Obese patients with lithiasis should lose weight due to total FM, not TBW., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Research Ethics Commission "Dr. C.I.Parhon" Hospital, Iasi issued approval 7618/26.09.2022. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committees, as well as with the 1964 Helsinki Declaration and its later amendments, or with comparable ethical standards. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Pricop et al.)

This article aims to analyze the relationship between non-obstructive coronary artery disease (NOCAD) and atrial fibrillation (AF), exploring the underlying pathophysiological mechanisms and implications for clinical management. NOCAD and AF are prevalent cardiovascular conditions that often coexist, yet their interrelation is not well understood. NOCAD can lead to ischemic necrosis of cardiomyocytes and their replacement with fibrous tissue, sustaining focal ectopic activity in atrial myocardium. Atrial fibrillation, on the other hand, the most common sustained cardiac arrhythmia, is able to accelerate atherosclerosis and increase oxygen consumption in the myocardium, creating a mismatch between supply and demand, and thus promoting the development or worsening of coronary ischemia. Therefore, NOCAD and AF seem to be a complex interplay with one begets another.

Acute heart failure (AHF) is a life-threatening condition with high morbidity and mortality. Even though this pathology has been extensively researched, there are still challenges in establishing an accurate and early diagnosis, determining the long- and short-term prognosis and choosing a targeted therapeutic strategy. The use of reliable biomarkers to support clinical judgment has been shown to improve the management of AHF patients. Despite a large pool of interesting candidate biomarkers, endothelin-1 (ET-1) appears to be involved in multiple aspects of AHF pathogenesis that include neurohormonal activation, cardiac remodeling, endothelial dysfunction, inflammation, atherosclerosis and alteration of the renal function. Since its discovery, numerous studies have shown that the level of ET-1 is associated with the severity of symptoms and cardiac dysfunction in this pathology. The purpose of this paper is to review the existing information on ET-1 and answer the question of whether this neurohormone could be a promising biomarker in AHF.

We report a case of necrosis caused by the use of prallethrin (mosquito repellent) on the skin in a 67-year-old diabetic female patient suffering from delusions of parasitosis. Cutaneous toxicity due to pyrethroids is less known or reported, despite well-documented pyrethroid poisoning involving the gastrointestinal, respiratory, cardiac, and nervous systems. Skin irritation has been described after acute accidental exposure but, as far as we know, no data have been published on the effects of pyrethroids when applied directly to the skin., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Metformin is a widely used oral antidiabetic biguanide compound. According to the literature, metformin may lower the serum cyanocobalamin levels. We present the case of a 71-old-male treated with metformin for 15 years. When presenting to a periodic checkup, low serum cyanocobalamin levels where found. Laboratory tests showed levels below normal range for hemoglobin (12.7 g/dL) and hematocrit (37.8%). After patient reevaluation, a change in antidiabetic treatment will be considered if metformin will be found the cause of low serum cyanocobalamin levels. Other cases reported in the literature support this hypothesis, justifying the study of the influence of metformin therapy on serum vitamin B12 levels in patients diagnosed with diabetes. The influence of patient age, metformin dosage, duration of treatment and time since diabetes diagnosis on serum levels of vitamin B12 also need to be determined.

Car- diovascular abnormalities associated with endocrine diseases are often frequent and due to complex relationships between endocrine glands (with internal secretion) and cardiovascular system (heart and vessels). Certain hormones secreted by the endocrine glands (particularly the thyroid and pituitary gland) excesses or deficiencies, are involved in morphogenesis, growth processes and activity regulation of cardiovascular system, most often in connection with the autonomic nervous system. There are also a lot of electrocardiographic changes caused by hormonal disorders that requires differential diagnosis and represents the source of erroneous diagnosis. Endocrine pathology occurred later than a heart disease, may worse heart function. Ignoring the cardiovascular events that may occur in the evolution of endo- crine diseases, may induce increased mortality due to cardiovascular complications.

Aim of the Study: to evaluate the relation between ejection fraction (EF), diabetes characteristics and cardiovascular risk factors., Material and Methods: We carried out a cross-sectional study in 171 patients with insulin-treated type 2 diabetes hospitalized at the Sf. Spiridon Emergency Clinical Hospital, Iasi. All patients were evaluated for asymptomatic organ damage and cardiovascular risk factors of hypertension and diabetes metabolic control. Global ejection fraction (EF) was evaluated through 2-D echocardiography., Results and Discussion: In the studied group the ejection fraction had significant negative correlations with the duration of the disease (p=0.007) and the presence of microalbuminuria (p=0.001). There were some differences between the categories realized by grouping the patients according to the presence of hypertension and/or previous myocardial infarction. In patients without personal history of cardiovascular disease EF was correlated only with LDLc levels. In the hypertensive patients without myocardial infarction it was correlated with diabetes duration, Hb A1e and LDLc, In those patients with both conditions, EF had significant correlations with Hb A1e and microalbuminuria., Conclusions: These results emphasized that the determinants associated with heart failure in patients with type 2, insulin-treated diabetes, differ according to the presence of high blood pressure and myocardial infarction.

Diabetes mellitus is a widespread disease with many serious chronic complications. An improvement in the oral antidiabetic medication in respect to its mechanism of action and toxicology was needed in order to have effective therapies with high compliance and minimum side effects. In this context, metformin is a widely used oral antidiabetic drug, which, through its mechanism of action, has no risk of hypoglycemia. However, a rare but serious side effect of biguanides is lactic acidosis. This paper presents a number of 13 cases of metformin-associated lactic acidosis, which outline the circumstances triggering the adverse event and the clinical therapeutic measures applied in the poisoned patients. The main situations that favor metformin-associated lactic acidosis are renal impairment and tissue hypoxia, and the intervention is adapted to the particular patient condition and symptoms, such as marked hypotension and cardiac arrest. Although there are commonalities in describing the consulted patients, the final prognosis is not dependent on the dose or metformin plasma levels, but rather on the associated pathologies and medication.

Modifications of plasma lipid profile is one of the major causes of a high cardiovascular risk. They can be the consequences of mutations in the gene encoding lipoprotein lipase (LPL), an enzyme that has an important role in the metabolism of plasma lipoproteins. The aim of the present study was to put into practice a method for detecting the Gly188Glu mutation in the LPL gene. The search was performed on a group of 107 patients with cardiovascular diseases and/or dyslipidemias. DNA investigation consisted, in a first stage, in the enzymatic digestion of exon 5 of the LPL gene, previously amplified by the PCR reaction, with the AvaII restriction endonuclease. Three of the subjects were further investigated by the sequencing of exon 5, in order to search for the presence of other mutations. We didn't detect the Gly188Glu mutation in none of the cases, and no other mutation in exon 5 was found in the three patients tested by DNA sequencing. We conclude that the amplification-restriction method can be used for the detection of known mutations in the LPL gene, allowing an early identification of the subjects with a high cardiovascular risk and the onset of the appropriate therapy. In order to detect mutations which don't affect the recognition sequence of a restriction enzyme and eventually new mutations, the sequencing of that gene is recommended.

It is known that high sanguin levels of cholesterol and LDL-cholesterol (LDLc) have an important role in the pathogenesis of atherosclerosis. The treatment of hypercholesterolemia with statins and/or with fibrates have had beneficial effects on coronary heart disease and on other localization of atherosclerosis. The decreased of cholesterol and LDL-cholesterol is the most important effect of this treatment. The epidemiological studies have revealed that the treatment with statins and/or with fibrates produce an increase of HDL-cholesterol (HDLc), which is also very important in the regression of atherosclerosis. We tried in this review to explain the mechanisms of the increase of HDL-cholesterol, in concordance with the data from literature.

Unlabelled: The objective of this study is to reveal the deterioration of the systolic and diastolic function of the left ventricle (LV) in patients with diabetes mellitus (DM), in correlation with type of DM, the edge and the complications of DM and the associated diagnosis., Methods: The study included 43 patients with DM (29 patients with DM type 1 or 2 insulinodependent--DMID and 14 patients with DM type 2 nonisulinodependent--DMNID). The age of patients was between 21 years and 57 years, with a duration of DM between 1 year and 22 years. The ecocardiographic evaluation have determined 38 parameters (B mod, M mod, CWD, PWD, colour Doppler). From these parameters, 12 was used for the measurement of the systolic function of the LV and 18 was used for the determination of the diastolic function of the left ventricle. The clinical and biological exam have performed: glycaemia, proteinuria, dyslipidemic syndrome, complications of DM and ischaemic heart disease (ECG)., Results: The ejection fraction (EF) of the LV was ?60% in 23 patients, between 50% and 60% in 17 patients and between 40% and 50% in 3 patients. The values of MSER (mean systolic ejection rate) was between 221 ml/s şi 515 ml/s and the values of MVCF (mean velocity of circumferential shortening) was between 0.9 circ/s şi 1, 8 circ/s. The ratio of the E and A waves at the mitral valve was > 1 in 22 patients and < 1 in 21 patients. The LV isovolumic relaxation time (IVRT) was < 70 ms in 13 patients, > 100 ms in 14 patients and had normal values in 16 patients. The E wave deceleration time (EDT) was < 150 ms in 24 patients and had normal values in 19 patients. There is no connection between the systolic/diastolic function and the other determined parameters., Conclusions: The alteration of the LV systolic function was present in 20 patients from 43 patients. The LV diastolic dysfunction through relaxation troubles was present in 14 patients and the LV diastolic dysfunction through compliance trouble was present in 13 patients. A number of 16 patients had preserved (for the moment) a normal LV diastolic function. The number of patients with these two types of LV diastolic dysfunction was equal in our study. Other studies had found a predominance of LV diastolic dysfunction through compliance troubles in DM.

It is known that high sanguin levels of cholesterol and LDL-cholesterol (LDLc) have an important role in the pathogenesis of atherosclerosis. The treatment of hypercholesterolemia with statins and/or with fibrates have had beneficial effects on coronary heart disease and on other localization of atherosclerosis. The decreased of cholesterol and LDL-cholesterol is the most important effect of this treatment. The epidemiological studies have revealed that the treatment with statins and/or with fibrates produce an increase of HDL-cholesterol (HDLc), which is also very important in the regression of atherosclerosis. We tried in this review to explain the mechanisms of the increase of HDL-cholesterol, in concordance with the data from literature.