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Acute cardiovascular pathology can frequently resemble the clinical and paraclinical picture of SARS-CoV-2 infection. The present paper aims to present the experience of a cardiology clinic during this pandemic and describe the way in which the clinical station was organized in order to limit in-hospital transmission of the virus.

Sustained ventricular arrhythmias that occur early post-myocardial infarction (MI) are generally considered epiphenomena of the MI and are not consistently associated with long-term prognosis. The lack of association with long-term prognosis is more clearly established for early ventricular fibrillation (VF) and polymorphic ventricular tachycardia (PVT). Sustained monomorphic ventricular tachycardia (SMVT), even when it occurs early, however, may reflect a permanent arrhythmic substrate1. Patients with COVID-19 have a high risk of thromboembolic events, and the virus has also been shown to have extensive effects on the cardiovascular system2,3,4. A 62-year-old woman, recently hospitalized for COVID-19 pneumonia, was brought to the emergency department with pulseless SMVT having been successfully resuscitated in the prehospital setting. The patient has a history of an old MI treated with thrombolysis and percutaneous coronary intervention (PCI) that was complicated with early SMVT, but with preserved left ventricular function and without heart failure. The patient underwent implantation of a cardioverter defibrillator (ICD). During the hospitalization, she developed dyspnea and was diagnosed with minor pulmonary embolism. It may be appropriate to consider early SMVT as a predictor of adverse late outcomes that would necessitate rigorous follow-up and maybe an early invasive primary prevention strategy. This case also reflects the possibility of long-term cardiac involvement and increased thromboembolic risk in patients recovering from COVID-19.

Individuals with type 2 diabetes mellitus develop more frequently than healthy controls cardio- and cerebrovascular disorders. It is important to understand the mechanisms through which diabetes contributes to the development and severity of these complications. Extracellular vesicles (EV) are important mediators of cell to cell communication in several diseases, including diabetes mellitus and vascular disease. Three populations of EVs are described presently: exosomes, microvesicles and apopototic bodies. Recent studies have shown that atherosclerotic lesions of all stages contain microvesicles. Higher levels of circulating EVs have been discovered in individuals with cardiovascular risk factors, with both pro-atherogenic and anti-atherogenic effects. Regarding cerebrovascular disease, studies have shown that exosomes, especially those derived from stem cells, play an important role, preventing post-ischemic suppression. Different cell types in the heart contribute to the pathogenesis of diabetic cardiomyopathy and EV seem to be essential in the intercellular crosstalk between heart cells. According to recent research EVs could play an important role in different cardiac and cerebral regenerative therapies and could also be used as therapeutic vectors in cardiovascular medicine. Further large animal and human studies are necessary to validate EVs as diagnostic and therapeutic tools. [ABSTRACT FROM AUTHOR]

Background and purpose: Rheumatoid arthritis (RA) causes frequently cardiovascular complications, probably determined by early atherosclerosis in connection to chronic systemic inflammation. Purpose of our study was to assess subclinical cardiac and vascular dysfunction, and to evaluate the mechanisms of ventriculo-arterial interaction, in patients with correctly treated RA vs. normal subjects. Methods: We evaluated 46 subjects (55±10 years, 2 men): 29 patients with seropositive treated RA (mean duration of 11±9 years), without documented cardiovascular or pulmonary disease, and 17 control subjects, matched for age, sex, and distribution of conventional major risk factors. All RA patients were under long-term treatment (more than 6 months) with Methotrexat + Sulfasalasine (22 patients) or Methotrexat + Sulfasalasine + Infliximab (7 patients). We determined biomarkers of inflammation (P-selectin, interleukines 1, 6, 10, 18, seric amiloid A, α-TNF, γ-interferon, C-reactive protein, anti-oxidated LDL antibodies), myocardial fibrosis (β-crosslaps) and ventricular overload (BNP). We assessed the parameters of cardiac function by standard and tissue Doppler echocardiography, intima-media thickness and arterial stiffness by "e-tracking" and "wave intensity analysis" (at the level of the right carotid artery), endothelial function by flow mediated dilation (FMD), and carotid-femoral pulse wave velocity by the Complior method. Results: Biological parameters of inflammation, markers of myocardial fibrosis and of ventricular overload were not different between the 2 study groups. Also, parameters of subclinical cardiac and vascular function were similar between the two groups. RA patients had subclinical RV dysfunction, correlated to the duration of the disease. They also tended to have higher values of systolic pulmonary artery pressure than normals. Conclusion: Correctly treated patients with RA, with controlled systemic inflammation, have normal LV, endothelial and arterial function. However, in the absence of documented pulmonary disease, they do have subclinical RV dysfunction, correlated with the duration of disease. This suggests an intrinsic RV myocardial involvement but, since pulmonary artery pressure was also higher, a secondary mechanism might be also involved. [ABSTRACT FROM AUTHOR]

Systemic sclerosis (SSc) is a chronic disease of unknown etiology. The main feature of SSc is microvascular disease, but contemporary studies in the field have confirmed the presence of macrovascular affectation. Due to its inflammatory background, and higher cardio- and cerebrovascular death rates, it is presumed that SSc is more frequently associated to accelerated atherosclerosis, similarly to other autoimmune diseases, such as systemic lupus erythematosus or rheumatoid arthritis. The assessment of subclinical atherosclerosis in patients with SSc through different methods (such as intima media thickness, echo-tracking, wave intensity, pulse wave velocity, flow mediated dilation, nitroglycerin mediated dilation, ankle brachial pressure index or coronary angiotomography) has failed to show concordant results, regardless of the used tool. In this review, we try to synthetise the most recent evidence about atherosclerotic involvement in SSc, reviewing the association between SSc and risk factors and also performing a summary of studies that compared atherosclerosis in SSc to controls. Our research leads to the conclusion that in order to elucidate the extent of atherosclerosis and its consequences in SSc, further investigations are needed, combining atherosclerosis assessment tools and larger number of patients. [ABSTRACT FROM AUTHOR]

Background: Pulmonary arterial hypertension (PAH) represents an emerging pathology in modern medicine. Transthoracic echocardiography is an inexpensive and reproducible method and it is the most commonly used non-invasive diagnostic tool to asses pulmonary artery pressure (PAP) and the function of the right ventricle. Although, the right heart catheterization is still considered as the standard for the diagnosis, according to the last guidelines, the new echocardiographic methods may offer an improved value in the PAH evaluation. Aim: To evaluate if cardiac ultrasonography data correlate with catheterization results in patients with PAH (Group I Dana Point 2008), and to compare the ultrasonography evaluation of PAH patients with that of normal. Methods: 15 consecutive patients (pts) (52±15 yrs, 5 men, time from onset of symptoms 1.6±1.7 years) with PAH of different aetiologies (12 pts with idiopathic PAH, 2 pts with PAH associated with scleroderma and one with persistent PAH after atrial septal defect (ASD) closure) were evaluated through: 1. clinical examination (NYHA class); 2. exercise capacity (6 minute walking test - 6MWT); 3. conventional echocardiography (diameter of right ventricle - RVD and right atrium, fractional area shortening - FAS, TAPSE, pulmonary ascension time - PA, systolic and mean PAP -sPAP, mPAP, tricuspid E/A ratio, cardiac index-CI) and 4. Tissue Doppler Imaging - TDI (systolic and diastolic myocardial velocities at the tricuspid annulus - S, D, A); 5. right heart catheterization (sPAP, mPAP, CI, pulmonary vascular resistance - PVR) We compared classical and TDI echo parameters with those obtained from 15 normal subjects, matched in age and sex. Results: PAH patients had high sPAP and mPAP with right heart dilation (RV - 44.8±7.3 mm), depressed TAPSE (16.2±5.9 mm) and cardiac index and low TDI systolic velocities at tricuspid level (7.3±2.9 cm/s). All parameters differed statistically significant from normal. There were no significant correlations between ultrasonography and catheterization (cath) parameters (sPAP 92±28.2 echo vs. 106.4±25.8 mmHg cath; mPAP 47.9±8.4 echo vs. 65.8±17.3 mmHg cath), excepting for CI 2.3±1.2 l/ min/m2 vs. 2.08±0.3 ml/min/m2) and PVR (16.5 ± 15.3 Wood U echo, vs. 19.6 ± 7.9 cath). Conclusion: Classic and TDI cardiac ultrasonography represents a good screening and monitoring tool for PAH patients, but tends to underestimate the severity of the disease, leaving right heart catheterization as the essential diagnostic method for this rare disease. [ABSTRACT FROM AUTHOR]

Objective: To compare the antihypertensive efficacy and the metabolic effects, as well as the influence on cardiac and arterial function of indapamide SR 1.5 mg with hjdrochlorothiazide 25 mg, both in combination with quinapril. Materials and methods: A minimum number of 50 hypertensive and diabetic patients will be enrolled into the study,for a period of 6 months. They will be randomized either to indapamide slow release 1.5 mg/day, or to hydrochlorothiazide 25 mg/day. Quinapril will be added from the beginning of the study,for a better control of their blood pressure. The dosage of quinapril will be titrated from 10, up to 40 mg/day, as needed for each patient. Apart from clinical and laboratory routine tests, the patients will undergo more specific examinations, such as: ambulatory blood pressure monitoring,for quantifying the antihypertensive effect of the two investigational drugs; conventional and tissue Doppler echiocardiography,for cardiac function evaluation; vascular ultrasound examination,for assessing endothelial function and arterial stiffiness. This study will provide more comparative data between indapamide and hydrochlorothiazide, in combination with quinapril, concerning not only on their antihiypertensive effect and safety, bitt also their influence on cardiac and vascular function. [ABSTRACT FROM AUTHOR]

The article discusses the study that determines the effects of exacerbations in patients with different stages of chronic obstructive pulmonary disease (COPD). It shows that the severity and frequency of exacerbations were directly related to the severity of COPD. It found that patients with more frequent exacerbations may have a distinct susceptibility phenotype, which was independently associated with a history of gastroesophageal reflux or heartburn and poorer quality of life.

The article provides information on the study that described the current situation of the influenza A (H1N1) epidemic with options for management in the uncertain development of the disease. It states that the virus tends to infect younger people with severe outcomes and complex interpretations due to the low specificity of clinical symptoms. It recommends that international cooperation is vital in increasing the capacity of monitoring changes in antigenicity, severity, and resistance.

An abstract of the study "Sustained effect after lowering high-dose infliximab in patients with rheumatoid arthritis," by Stefania Magda is presented.

The article presents information on a study to determine if music or blocking noise could reduce bispectral index (BIS) scores during propofol sedation in patients undergoing total knee replacement surgery for degenerative arthritis. The sedation study enrolled 63 patients aged 55-78 years scheduled to undergo total knee replacement surgery. The study showed that listening to music during propofol sedation does not affect BIS scores in elderly patients undergoing total knee replacement surgery during combined spinal-epidural anesthesia, although blocking all noise does so.

The article discusses the significance of Omega-3 fatty acid supplementation and total homocysteine levels in end-stage renal disease patients. Cardiovascular disease (CVD) is a major cause of morbidity and mortality in patients with renal failure. In addition to classical risk factors for CVD, end-stage renal disease (ESRD) patients have uremia-specific risk factors: volume overload and hypertension, anemia, altered calcium-phosphate metabolism, elevated levels of specific uraemic toxins and chronic inflammatory processes. High levels of the uraemic total homocysteine (tHcy) is a strong predictor of cardiovascular events in patients with pre-existing morbid conditions, including renal failure.

The article focuses on the longitudinal Copenhagen City Heart Study, which aims to assess in a prospective design the association between perceived daily stress and the incidence of primary colorectal cancer in men and women in Copenhagen, Denmark. The study performed physical examination and the participants were asked about the intensity and frequency of their level of stress. The study showed 10% of the women and 6% of the men reported high levels of stress. Moreover, the study revealed that in women, higher stress intensity and daily stress is associated with a lower incidence of colon cancer, while in men, high stress intensity appears to be associated with higher incidence of rectal cancer.

The article presents a study concerning the efficacy of atorvastatin in improving endothelium dependent arterial dilation in patients with systemic lupus erythematosus (SLE). It mentions that there were 88 patients with SLE participated in the study which were being divided into two groups, the intervention group with 64 patients who received atorvastatin 20 milligram (mg)/day during eight weeks and the control group with 24 SLE patients followed in the same period without atorvastatin. The study revealed that an eight week period atorvastatin treatment was associated with improvement in fibromuscular dysplasia (FMD) and is useful in preventing atherosclerotic cardiovascular complications in SLE.

The article presents a study concerning the association of different types of leisure time activity with the development of wheezing in young adults. The study was being participated by 2,910 adolescents who had never experience wheezing in childhood and they were subjected to complete a questionnaire with 121 questions. The study revealed that adolescents working frequently with a computer smoked less had a lower socioeconomical status (SES) and practiced less sport while those watching television and smoked more. Moreover, the study implicates that sport, computer work or television watching are not independent risk factors for new onset of wheezing in adolescents.

The article focuses on a study about the glycaemic and nonglycaemic effect of pioglitazone in triple oral therapy of patients with type 2 diabetes. It discusses the open-label prospective observational design among 66 patients ages from 30 to 75 years old with type 2 diabetes and secondary drug failure which were determined as HbA1c during the metformin treatment for at least three months and later prescribed to take 30 mg pioglitazone together with metformin. Moreover, the study shows that pioglitazone has achieved an effective treatment goal in patients with secondary drug failure but has obtained fluid retention.

The article presents a research regarding the use of teriparatide for bone regeneration at the level of the oral cavity.

The article discusses the CARdiovascular research and RhEumatoid arthritis (CARRE) study which investigates the link between rheumatoid arthritis (RA) and type II diabetes mellitus (DM) as cardiovascular disease (CVD) risk factors. The study monitors patients with RA, normal glucidic metabolism, non-diabetic controls, and their effects on the coronary, cerebral or peripheric arteries. It implies that RA poses a significant cardiovascular risk which requires a mandatory profilaxy and treatment.

The article offers the author's insights on the study "A Novel Influenza A (H1N1) Vaccine in Various Age Groups," by XJ Lin and colleagues. She says that the study has evaluated the safety and immunogenicity profile of the H1N1 influenza vaccine developed by China by applying placebo or active vaccine to the subjects. She notes that the data presented in the study suggests that an absence of alum adjuvant in the vaccine causes protective immune response in the subjects in ages between 12 and 60.

The article presents a study on the relationship between baseline physical activity (PA) on cardiovascular outcomes and new-onset diabetes in patients conducted by the Losartan Intervention For Endpoint (LIFE) in Romania. PA inactivity will increase the relative risk for coronary heart disease comparable to hypercholeterolemia, hypertension or smoking since PA is an acceptable preventive approach for cardiovascular disease and the management of cardiovascular risk factors. It also notes that the primary endpoint was a composite of cardiovascular death, nonfatal and fatal stroke and nonfatal and fatal myocardial infarction.

The article presents a study on the meta-analysis for cardiovascular (CV) events using celecoxib. It notes on its primary purpose to determine the primary CV events where patients are being placed under specific groups including those users and non users of low dosage of aspirin at baseline, celecoxib dosage groups of 200, 400, and 800 mg per day and therapeutic indications of osteoarthritis (OA) and rheumatoid arthritis. Moreover, it reveals that the study shows an inaccurate calculation of absolute risk of celecoxib in short time.