B-Type Natriuretic Peptide-A Paradox in the Diagnosis of Acute Heart Failure with Preserved Ejection Fraction in Obese Patients.

BACKGROUND AND OBJECTIVES: B-type natriuretic peptide (BNP) represents a clinical tool for the diagnosis and prognostic evaluation of acute and chronic heart failure patients. The purpose of this retrospective study was to evaluate BNP values in obese and non-obese patients with acute heart failure with preserved ejection fraction. MATERIALS AND METHODS: In this study, we enrolled 240 patients who presented to the emergency department complaining of acute shortness of breath and fatigue. The patients were divided into two groups according to their body mass index (BMI) values. The BMI was calculated as weight (kilograms) divided by height (square meters). The BNP testing was carried out in the emergency department. RESULTS: Group I included patients with a BMI of <30 kg/m2 and group II included patients with a BMI of ≥30 kg/m2. The average age of the patients was 60.05 ± 5.02 years. The patients in group II were significantly younger compared with those included in group I. Group II included a higher number of women compared to group I. Group I had fewer patients classified within New York Heart Association (NYHA) functional classes III and IV compared with group II. Echocardiography revealed an ejection fraction of ≥50% in all participants. Lower BNP levels were observed in patients from group II (median = 56, IQR = 53-67) in comparison to group I (median = 108.5, IQR = 106-112) (p < 0.001). CONCLUSIONS: Obesity and heart failure are continuously rising worldwide. In this retrospective study, we have highlighted the necessity to lower the threshold of BNP levels in obese patients with acute heart failure and preserved ejection fraction.

Optimizing Atrial Fibrillation Care: Comparative Assessment of Anticoagulant Therapies and Risk Factors.

BACKGROUND AND OBJECTIVES: Atrial fibrillation (AF) is a common arrhythmia associated with various risk factors and significant morbidity and mortality. MATERIALS AND METHODS: This article presents findings from a study involving 345 patients with permanent AF. This study examined demographics, risk factors, associated pathologies, complications, and anticoagulant therapy over the course of a year. RESULTS: The results showed a slight predominance of AF in males (55%), with the highest incidence in individuals aged 75 and older (49%). Common risk factors included arterial hypertension (54%), dyslipidemia, diabetes mellitus type 2 (19.13%), and obesity (15.65%). Comorbidities such as congestive heart failure (35.6%), mitral valve regurgitation (60%), and dilated cardiomyopathy (32%) were prevalent among the patients. Major complications included congestive heart failure (32%), stroke (17%), and myocardial infarction (5%). Thromboembolic and bleeding risk assessment using CHA2DS2-VASc and HAS-BLED scores demonstrated a high thromboembolic risk in all patients. The majority of patients were receiving novel oral anticoagulants (NOACs) before admission (73%), while NOACs were also the most prescribed antithrombotic therapy at discharge (61%). CONCLUSIONS: This study highlights the importance of risk factor management and appropriate anticoagulant therapy in patients with AF, to reduce complications and improve outcomes. The results support the importance of tailored therapeutic schemes, for optimal care of patients with AF.

Prevalence and Risk Factors of Metabolic Syndrome: A Prospective Study on Cardiovascular Health.

Background and objectives: This article highlights the relationship between metabolic syndrome and cardiovascular disease, providing a comprehensive overview of its risk factors and prevalence. Metabolic syndrome, characterized by a cluster of interconnected risk factors, significantly increases the risk of developing cardiovascular disease and type II diabetes. Materials and methods: This study, conducted over a one-year period, involved 117 patients aged between 30 and 79 years old. Various parameters were analyzed, such as gender, age, education level, provenance from urban or rural environment, smoking, alcohol consumption, dietary aspects, physical activity, and their contribution to the appearance of metabolic syndrome. Central adiposity and high blood pressure emerged as prominent elements of the condition. Results: The findings underscore the importance of a healthy lifestyle in the prevention and management of metabolic syndrome. Encouraging regular physical activity, maintaining a balanced diet, rich in fresh vegetables and fruits, and avoiding harmful behaviors, such as smoking or alcohol consumption, are essential in reducing the risk of metabolic syndrome and its associated cardiovascular complications. Conclusions: The study highlights the need for public health initiatives, as well as individualized preventive strategies to combat the rising prevalence of metabolic syndrome. Through promoting awareness of its risk factors and implementing effective interventions, healthcare professionals can contribute to better cardiovascular health worldwide. Further research in this area will continue to enhance our understanding of metabolic syndrome and refine preventive and therapeutic approaches for its management.

The study of synovities with articular inflammatory liquid, through clinical-statistical, histological and immunohistochemical methods.

INTRODUCTION: The examination of the synovial is very useful in the positive and differential diagnostic of many articular diseases and especially in the conditions of acute monoarthritis. MATERIALS AND METHODS: The study focused on the establishment of clinical-statistical, histopathological and immunohistochemical correlations on a group of cases anatomo-pathologic diagnosed with synovity with articular inflammatory liquid. The group was divided in five subgroups: rheumatoid polyarthritis, uric arthropathy (gout), TBC arthritis, sarcoidosis and villo-nodular synovity. RESULTS AND DISCUSSION: During the clinical-statistical study the number of arthritis with articular inflammatory infiltration was pursued, the specific location of them and the correlation of the clinical dates with paraclinical ones. In the histopatological and immunohistochemical analysis was pursued the presence of the inflammatory infiltration through the implication of both types of B- and T-lymphocytes in different proportions taking into consideration the cause of the synovity. CONCLUSIONS: The synovial biopsy is indicated at patients at whom the diagnostic is not established after the clinical evaluation. The examination of the synovial tissue can be the only way of establishing a definitive diagnostic in inflammatory arthropathies.

Study of malignant fibrous histiocytoma: clinical, statistic and histopatological interrelation.

INTRODUCTION: Malignant fibrous histiocytoma (MFH) is a malignant tumor of soft parts observed at approximately 70% of cases situated at the level of the outsides. PATIENTS AND METHODS: Our study is formed of 14 cases of patients in a period of three years (2007-2010), diagnosed anatomo-pathological with malignant fibrous histiocytoma at the County Hospital of Oradea. The histopathological examination together with the immunohistochemical one is of vital importance in the establishment of the positive diagnostic and furthermore in the establishment of the differential diagnostic with carcinomas, plasmacytomas, osteosarcomas, fibrosarcomas and lymphosarcomas, fact that arouse the doctors to administrate the correct treatment to a specific patient. DISCUSSION: MFH is a tumor of late adulthood that occurs in men more commonly than women. Computer tomography and MRI have been widely used in the diagnosis and staging of MFH. MFH is secondary to another process such as radiation, surgery, fracture, osteonecrosis, Paget's disease, non-ossifying fibroma or fibrous dysplasia 20% of the time. MFH arising from a previous abnormality is usually more aggressive and has a poorer prognosis than primary MFH. Primary osseous MFH is a central lesion found in the diaphysis or metaphysis of the bone that causes aggressive bone destruction and a soft tissue mass. The most common sites in order are the distal femur, proximal tibia, proximal femur and proximal humerus. Primary osseous MFH is less common. MFH is found in the extremities 70-75% of the time and 50% of all cases are in the lower extremity. Other less common sites include the retroperitoneum, and the head and neck. In our study, of 14 patients with malignant fibrous histiocytoma, the highest incidence is during the sixth decade of life and there is a male to female ratio of 8 to 6. In the specialty literature, malignant fibrous histiocytoma tend to occur in children and teenagers but can also occur in older adults as secondary lesions in bone infarcts and radiation fields. This tumor is clinically similar to osteosarcoma and fibrosarcoma, although malignant fibrous histiocytomas have been classified as different from the osteosarcoma group because of a different histology (no tumor bone production). Treatment is similar to that of osteosarcoma. CONCLUSIONS: During our study, the average age was of 61 years in comparison with the specialty literature where the average age was of 50 years. The same as in the specialty literature the cases of fibrous malignant histiocytoma studied are more frequently present at men. Regarding the situation, our study shows the affectation of the long bones especially the femur followed by the radius. The histopathological examination together with the immunohistochemical one is of vital importance in the establishment of the positive diagnostic and furthermore in the establishment of the differential diagnostic with carcinomas, plasmacytomas and lymphosarcomas.