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"Background: Cardiovascular disease can be triggered and accelerated by hypertension and the underlying changes in the structure and function of arteries. The purpose of this review is to explore some vascular changes that occur in hypertension as a consequence of the imbalance between cell proliferation and cell death, processes that play an important role in stabilizing the thickness of the arterial wall during vascular remodeling. Methods: The authors conducted research through PubMed and Google Scholar databases using the following search formula: (hypertensive*) AND ((vascular modifications)) OR (vascular changes)) AND (cell death). Results: From 40 articles, only 17 publications were included in this study, taking into account four processes that can be preceded or followed by inflammation and depend on the interaction between local growth factors, vasoactive substances, and hemodynamic stimuli: Cell proliferation and growth; Cell migration; Cell death; Degradation or reorganization of extracellular matrix. Conclusions: To summarize, maladaptive vascular changes in hypertension can represent a major argument for prompt and maximal therapeutic intervention in patients with high cardiovascular risk. Moreover, they can represent an important step in discovering new markers of cardiovascular risk and in the development of new targeted therapies for different pathways of cellular signaling through which the reversibility of abnormal vascular changes could be obtained. "

"The recent increase in life expectancy is the main argument for a better understanding of the pathophysiological mechanisms underlying aging. These, once known, can provide possible links to therapies to prevent aging or slow down the process. Normal aging is associated with a progressive decrease in the glomerular filtration rate. Accurate estimation of GFR in the elderly is under the suspicion of multiple errors mainly due to sarcopenia and decreased protein intake. Differentiation between chronic kidney disease and the physiological decline of GFR might be a challenge in clinical practice and this has consequences on the evolution and treatment of the numerous comorbidities of the elderly. The current trend to use non-invasive diagnostic techniques explains the need to identify a serological marker to help differentiate between decreased GFR secondary to kidney aging or the development of chronic kidney disease."

"Coronary CT angiography is a non-invasive method of analyzing the coronary lumen through which the atheromatous bur-den can be evaluated, with the analysis of the type of plaque (soft, calcified, mixed) and the impact on the arterial lumen (stenosis, occlusion). The anatomical evaluation by coronary CT is indicated in symptomatic patients with low and medium risk factors for coronary atherosclerotic disease, in those with inconclusive laboratory and EKG results, patients with un-certain stress test results, in the evaluation of coronary grafts and intrastent stenoses. Depending on the result of the angiography, the severity of the stenosis and the management of the patient are established. In the case of mild and medium stenoses, risk factors management and drug treatment are recommended. For severe stenoses, patients are referred for interventional coronary angiography or functional evaluation. Coronary CT angiography increases the certainty of coronary atherosclerotic disease diagnosis. It has a superior discriminative capacity of plaques with low attenuation, the main predictor of myocardial infarction, with almost five-fold higher risk. Coronary CT angiography increases the adaptation of medication, and the inclusion of statin therapy decreases the risk of fatal and nonfatal myocardial infarction at 5 years and increases the quality of life "

Introduction: Despite the progress that has been made regarding the diagnosis, a worrying percentage of patients are still admitted in an emergency, with complicated colorectal tumors, which often require interventions without a curative visa. The study aims to analyze the factors involved in choosing the type of surgical treatment. Patients and methods: We included in the study a group of 431 patients admitted and operated in an emergency for complicated colorectal cancer in the Surgery II Clinic of the Clinical Emergency County Hospital "Sf. Ap. Andrei" from Galați, between 2008-2017. We retrospectively analyzed the patients' data and we made statistical correlations between the type of emergency surgery and epidemiological, clinical, paraclinical, and intraoperative factors. Results: Colostomy was mainly practiced in older patients.

Two major trials, EMPA-REG OUTCOME trial (with Empagliflozin) and CANVAS trial (with Canagliflozin) have demonstrated the beneficial effects of SGLT2 inhibitors in patients with type 2 diabetes at risk for heart failure. SGLT2 inhibitors possess a unique pharmacological profile and have shown a significant reduction of hospitalization for heart failure in diabetic patients, immediately after treatment commencement. It seems that their effects are beneficial both in heart failure with reduced ejection fraction and heart failure with preserved ejection fraction. SGLT2 inhibitors reduce cardiovascular endpoints in patients with diabetes and high cardiovascular risk, most likely through a reduction of heart failure-related events. Empagliflozin treatment exerts beneficial effects on vascular function and central haemodynamics. Various mechanisms seem to contribute to the beneficial effects of SGLT2 inhibitors in heart failure. Taking into consideration their cardiovascular benefits and the number of ongoing trials with these drugs, there is a possibility to expand their indication to nondiabetic patients with heart failure. This review focuses on the newest insights into the beneficial effects of SGLT2 inhibitors on the cardiovascular system.

"Introduction: As general population tends to have increasing life expectancy, the risk associated with developing chronic kidney disease (CKD) with multiple incapacitating concequences, also increases. Method: For the present study, we registered the data from the observation files of 37 patients diagnosed with CKD undergoing treatment by chronic hemodialysis and noted the CKD associated diagnoses included in the notion of comorbidities. We monitored their statistical incidence both in the whole group and separately, in women and men using TTEST and CORREL. Results: The median age of the subjects was 55.86 (± 12.00) years. The study population mean weight was 74.90 (± 14.44) kg, with a mean weight of 69.33 kg for female subjects, and 77.92 kg for males, respectively. Diabetes was identified in 35.13% of patients, whilst heart failure was present in 16.21% of patients. Conclusions: Following the analysis of the information about the patients with CKD in the dialysis program, which we included in the study group, we observed the existence of variations that occur with age, significant correlations between age and weight and between albuminemia and weight. The most common comorbidity is high blood pressure followed by anemia. "

Drug-induced sleep endoscopy emerged and developed as an essential alternative diagnosis tool in sleep-disordered
breathing patients. Accurate identification and dynamic characteristics of upper respiratory airway obstruction are paramount
in establishing an adequate therapeutic plan and selecting for particular surgical or non-surgical strategies. This article reviews
the current aspects of intravenous sedation for drug-induced sleep endoscopy (DISE) in adults, emphasizing its implications for
patients with sleep apnea. The ideal sedative agent for DISE should replicate natural sleep patterns while maintaining upper
airway dynamics. The clinical practice exhibits a significant variability in drug selection, with midazolam and propofol often being
preferred. The review presents emerging trends and advancements in DISE, emphasizing its role in optimizing surgical indications,
predicting outcomes, and screening patients for alternative therapeutic strategies for OSA. Future research is needed to
understand better the impact of specific sedative drugs on DISE findings, contributing to the development of standardized
protocols and the evolution of new sedative drugs with improved effects and optimized techniques for delivering sedation.

"The cytogenetic aberrations induced by doxorubicin (DOX) may be influenced by diet. Investigation regarding effects of low doses of DOX on chromosomal aberrations frequency in mice bone marrow. The study explored a possible relationship between diet, follow-up period, and cytostatic doses. Four mice groups received normal or high-fat (pork) diet. At the beginning of the 8th day mice from each group received a single intraperitoneal injection with DOX (dose range: 1.7-7.7 mg/kg b.w.) or isotonic saline solution (0.02 mL/g control mice). In the 10th (groups I, II) and 14th (groups III, IV) days from the beginning of the experiment, the mice were euthanized and chromosome aberrations were tested in bone marrow cells. The body weight of all mice who received DOX decreases, especially at higher doses. In the first three days post-injection, weight loss percentage was significantly influenced by DOX doses and/or type of diet (p<0.003). The interaction between the type of diet and DOX doses was not statistically significant in the follow-up period (p interactions >0.05). DOX doses were able to increase the frequency of chromosomal aberrations. DOX acts as a potent inductor of cytogenetic aberrations in bone marrow cells, regardless of the type of diet."

"Chemotherapy is an important treatment in oncological disease, with a vast number of side effects. The cardiotoxicity of several chemotherapeutic agents and appropriate risk stratification and patient follow-up must be ensured by a multidisciplinary team which must include an oncologist and a cardiologist. Lynch syndrome is associated with younger-onset malignant tumors of various localizations, requiring aggressive chemotherapy. FOLFOX chemotherapy which is frequently used in Lynch syndrome-associated colorectal cancer has several cardiotoxic effects with mechanisms ranging from increased reactive oxidative species to Krebs cycle blockade or coronary vasospasm. These complex effects on the cardiovascular system have varied clinical effects, such as heart failure, arrhythmias, or acute ischemic events"

The pneumatization of all nasal turbinates is an extremely rare finding. Several previous reports have presented the bilateral superior, middle, and inferior conchæbullosæ. We report the bilateral pneumatization of middle and superior nasal turbinates. The variant was documented in cone beam computed tomography (CBCT) in all three dimensions. The inferior concha bullosa was a bilaterally moderate subtype of lamellar pneumatization that presented as a conchal recess of the maxillary sinus. The concha bullosa media was bilaterally of the extensive or true type and associated unilaterally with an uncinate bulla. The concha bullosa superior was asymmetrical bilaterally, narrower on the right side, and larger on the left where it was also septated and tri-cameral. The supreme conchæ were rudimentary, as were their pneumatizations. For an accurate anatomic diagnosis of conchæbullosæ in computed tomography, sagittal, coronal, and axial cuts, as well as three-dimensional reconstructions, should be used to ensure adequate planning of functional endoscopic sinus surgery.

"Currently, the educational process must integrate new tools, to keep pace with technological progress. Our paper aims to investigate the extent to which the preferences of medical students for the autonomous use of multimedia resources in the learning process are correlated with their opinions towards the Internet and the intensity of using it in their daily activities. Methods: We investigated 395 medical students from 4 medical universities in Romania, 75.9% females, and 88.8% in the 1st and 2nd years of study. Students were asked to express on Likert-scales their agreement with a list of statements about Internet services, as well as whether they like learning using multimedia tools and how intensively they use Internet services. Results: The students agree to a medium to large extent with the favorable statements about Internet services but are also aware of the negative influences that indiscriminate use of such technology can have. The intensity of Internet usage is high, although not exaggerated. With small exceptions, the students who enjoy using multimedia resources during the learning process have also favorable opinions about Internet services, and use them constantly, mainly for information and instant messaging on social networks."

"Synovial proliferation is a common intraoperative finding during total knee arthroplasty (TKA) and many studies have proposed synovectomy for the reduction of postoperative pain. We included 180 patients that were split into two groups, one which received a total synovectomy (TS) and the other with partial synovectomy (PS). We measured the amount of intra- and post-operative bleeding as well as perceived pain (using the Visual Analogue Scale) and knee function (using the Knee Society Knee Score) at 4 and 12 weeks. The blood loss during the surgical procedure was 367.77 ± 115.71 mL for TS, while the other group recorded 295.55 ± 106.17 mL (p < 0.05). Regarding postoperative bleeding, the TS group aspirated 533.77 ± 281.65 mL, which was significantly higher than the PS group (404.44 ± 211.55 mL, p < 0.05). No significant differences were recorded between the TS and PS groups regarding pain and knee function at 12 weeks. Total synovectomy demonstrated significantly higher blood loss and lower postoperative hemoglobin levels, even though knee function and pain level did not show improvements. We consider that the decision of performing synovectomy should rely on the clinical indication and, if conditions allow for it, a limited resection should be attempted."

Worldwide, adults and childhood obesity are increasing alarmingly, being a major health problem. Obesity is correlated with an increased incidence of various systemic diseases including cancer, heart diseases, and diabetes mellitus type 2. Risk factors for obesity are dysbiosis, genetic, socioeconomic, behavioural and environmental. The gut microbiota has beneficial effects on human health, like host immune system stimulation, being influenced by pH, or nutrient intake. Studies performed on humans and animal models reported differences regarding microbiota at lean and obese individuals. The consumption of probiotics and prebiotics may balance the microbiota with positive effects in obesity. The main aim of this review is to reveal the interaction between dysbiosis and obesity

"Abstract: Acute intentional poisonings represent an important part of emergency pediatric pathology, as well as a psychiatric one, with an escalation tendency over the past years. The current paper consists of a descriptive prospective study, which took place over a period of 12 months, and included 342 children within the age range 6-18 years, that presented in the Emergency Unit, being subsequently treated as in-patients of the Pediatric Poisoning Center of "Grigore Alexandrescu" Emergency Clinical Hospital for Children. The number of pediatric acute intentional poisonings hospitalized within the time frame of the study was 819 cases. Of these, 342 were intentional, which constitutes a percentage of 41.75%, and 477 were accidental, i.e. 58.24%. The etiology of the acute intentional poisonings is varied; however, medication (54.38%), ethanol (28.65%) and drugs of abuse (12.28%) were predominant. A higher frequency of acute intentional poisonings was noticed in girls (65.49%) as compared to boys (34.50%), probably due to the particularities the psychological profile of this sex shown at this age, i.e. higher emotional instability and display tendency. Out of the total number of acute intentional poisonings, we identified 20 cases of suicide attempts, which represent 5.83% of the total acute voluntary poisonings. Moreover, some of these cases constitute a repeated suicide attempt. The studied group included 30 cases of chronic substance abuse and 6 chronic alcohol abuse cases, with ages within the 13-17 years range, 12 of which were females and 24 males. Out of the 36 chronic substance/alcohol abuse patients, 4 were social cases. Pediatric acute intentional self-poisonings are an important public health issue, alarming through its consequences and through its hidden neuropsychiatric and behavioral substrate. This is due to the fact that adolescence is a period of marked emotional fragility, sensitive to all sorts of influences. Keywords: self-poisoning, teenager, psychiatric disorders, alcohol, substances of abuse"