Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions-Review of the Literature.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted the world and caused the 2019 coronavirus disease (COVID-19) pandemic. The clinical manifestations of the virus can vary from patient to patient, depending on their respective immune system and comorbidities. SARS-CoV-2 can affect patients through two mechanisms: directly by targeting specific receptors or by systemic mechanisms. We reviewed data in the latest literature in order to discuss and determine the risk of new-onset liver injuries due to COVID-19 in preexisting hepatic conditions. The particular expression of angiotensin-converting enzyme 2 (ACE2) receptors is an additional risk factor for patients with liver disease. COVID-19 causes more severe forms in patients with non-alcoholic fatty liver disease (NAFLD), increases the risk of cirrhosis decompensation, and doubles the mortality for these patients. The coinfection SARS-CoV-2-viral hepatitis B or C might have different outcomes depending on the stage of the liver disease. Furthermore, the immunosuppressant treatment administered for COVID-19 might reactivate the hepatic virus. The high affinity of SARS-CoV-2 spike proteins for cholangiocytes results in a particular type of secondary sclerosing cholangitis. The impact of COVID-19 infection on chronic liver disease patients is significant, especially in cirrhosis, influencing the prognosis and outcome of these patients.

Subclinical hypothyroidism has no association with insulin resistance indices in adult females: A case-control study.

Longitudinal studies have indicated an association between thyroid function and insulin resistance (IR) or a neutral relationship. Both the lowest tertile of free thyroxine (fT4) and the highest tertile of free triiodothyronine (fT3) were found to be associated with IR in cross-sectional studies. The aim of the present study was to analyze the association between IR and subclinical hypothyroidism in a female adult population from Bucharest, Romania. This is a retrospective pilot case-control study that included female patients examined by two endocrinologists and a diabetologist in an outpatient clinic. The retrospective follow-up had a one-year duration and included the evaluation of thyroid function tests and IR indices based on fasting insulinemia and C-peptide. The study included 176 women, 91 with subclinical hypothyroidism, with a median age of 60±17 years and a mean body mass index (BMI) of 27.79±4.76 kg/m2. The majority of the population (50%) was diagnosed with autoimmune thyroiditis, and 17.05% with goitre. The univariate logistic regression using hypothyroidism as the explaining variable found no evidence of a significant relationship between a decreased thyroid function and IR (OR 1.32; P=0.36). Metabolic syndrome was probably the most important determinant of IR in the population group studied. Thus, it was not the thyroid function per se, but the coexistence of other elements of this syndrome that prevailed in determining IR. Advantages to the study are the design that permitted evaluation of IR and the thyroid function at different moments in time as well as the uniformity of the blood tests. The multivariate analyses were adjusted for age, lipid profile and treatment; however, one limiting factor was the absence of other hormonal blood tests. In summary, there was no association between the thyroid function tests (TSH, fT4) and IR indices in adult Romanian women in a case-control study with one-year retrospective follow-up.

Accuracy, Labor-Time and Patient-Reported Outcomes with Partially versus Fully Digital Workflow for Flapless Guided Dental Implants Insertion-A Randomized Clinical Trial with One-Year Follow-Up.

(1) Background: Prosthetically-driven implant positioning is a prerequisite for long-term successful treatment. Transferring the planned implant position information to the clinical setting could be done using either static or dynamic guided techniques. The 3D model of the bone and surrounding structures is obtained via cone beam computed tomography (CBCT) and the patient's oral condition can be acquired conventionally and then digitalized using a desktop scanner, partially digital workflow (PDW) or digitally with the aid of an intraoral scanner (FDW). The aim of the present randomized clinical trial (RCT) was to compare the accuracy of flapless dental implants insertion in partially edentulous patients with a static surgical template obtained through PDW and FDW. Patient outcome and time spent from data collection to template manufacturing were also compared. (2) Methods: 66 partially edentulous sites (at 49 patients) were randomly assigned to a PDW or FDW for guided implant insertion. Planned and placed implants position were compared by assessing four deviation parameters: 3D error at the entry point, 3D error at the apex, angular deviation, and vertical deviation at entry point. (3) Results: A total of 111 implants were inserted. No implant loss during osseointegration or mechanical and technical complications occurred during the first-year post-implants loading. The mean error at the entry point was 0.44 mm (FDW) and 0.85 (PDW), p ≤ 0.00; at implant apex, 1.03 (FDW) and 1.48 (PDW), p ≤ 0.00; the mean angular deviation, 2.12° (FDW) and 2.48° (PDW), p = 0.03 and the mean depth deviation, 0.45 mm (FDW) and 0.68 mm (PDW), p ≤ 0.00; (4) Conclusions: Despite the statistically significant differences between the groups, and in the limits of the present study, full digital workflow as well as partially digital workflow are predictable methods for accurate prosthetically driven guided implants insertion.

Fast screening method for molecular recognition of islet amyloid polypeptide from whole blood samples collected from diabetic patients with disposable stochastic sensors obtained by nanolayer, and nanolayer by nanolayer deposition using cold plasma.

Nanolayer and nanolayer by nanolayer deposition of nanofilms of Ag and C using cold plasma in sequences (Ag, Ag-C, Ag-Ag-C), on porous paper, were used to design three disposable stochastic sensors for the assay of amyloid polypeptide from whole blood. The nanofilms were modified with α-cyclodextrin. The test developed using the nanofilm-based disposable stochastic sensors is used for early detection of diabetes. The wider linear concentration range (1.00 × 10-6-1.00 ng mL-1) and the lower limit of quantification (1.00 × 10-6ng mL-1) were obtained using the disposable stochastic sensors based on Ag-C and Ag-Ag-C, while the highest sensitivity (3.19 × 104 s-1/µg mL-1) was recorded using the disposable stochastic sensor based on Ag-Ag-C. The screening methods were fully validated using whole blood samples from confirmed patients, when the recovery of the islet amyloid polypeptide was higher than 98.00%. Graphical abstract.

No Association between 25-Hydroxyvitamin D and Insulin Resistance or Thyroid Hormone Concentrations in a Romanian Observational Study.

Background and objectives: Vitamin D is involved in insulin resistance through genomic and non-genomic mechanisms. Several observational and randomized studies have discrepant results; some of them showed an improved insulin resistance (IR), and others a neutral effect after vitamin D deficiency is corrected. Materials and Methods: We designed a retrospective observational study that included all women who presented for 33 months in an outpatient clinic in Bucharest, Romania. Results: We analyzed 353 patients with a mean age of 58.5 ± 13.7 years, a mean body mass index (BMI) of 27.36 ± 4.87 kg/m-2, and a mean level of 25-hydroxyvitamin D (25OHD) of 39.53 ± 15.73 ng/mL. There were no differences in the calculated Homeostatic Model Assessment of Insulin Resistance variants 1 and 2 (HOMA-IR) and the Quantitative Insulin Sensitivity Check Index (QUICKI) between women with vitamin D deficit versus normal values. In multivariate analysis, there was no significant relation between 25OHD and the response variables considered by us. Conclusions: We observed a small positive correlation between a higher level of 25OHD and increased glycosylated hemolobin (HbA1c) or IR indices without clinical significance. Other modifiable or non-modifiable factors override 25OHD influence on IR in adult women with a normal serum level and may contribute to the remainder of the variability observed.

Pulmonary hypertension in patients with hepatic cirrhosis and portal hypertension. An echographic study.

AIM OF THE STUDY: The aim of the study is to determine the frequency of pulmonary hypertension in patients with hepatic cirrhosis and portal hypertension, to determine the possibility of an accurate ultrasound diagnosis of the characteristics of this complication. METHOD: 347 patients with liver cirrhosis consecutively hospitalized at Coltea Clinical Hospital were screened. 61 were excluded because of other possible causes of portal or pulmonary hypertension. All patients were investigated clinically and by abdominal and cardiac ultrasonography. RESULTS: Of the remaining 286 patients, 116 had portal hypertension, 27 of them (23%) having pulmonary hypertension. In this group we found a higher cardiac index and right atrial volume, higher pressures in the right atrium, suggesting a hyperdynamic state. Porto-pulmonary hypertension was found in only one patient. CONCLUSION: Echocardiography permits characterization of patients with cirrhosis and portal hypertension.