Cardiovascular Risk/Disease in Type 2 Diabetes Mellitus

People with Type 2 diabetes mellitus (T2DM) have a 2–3 times higher cardiovascular risk (CVR) than people without diabetes. Atherosclerotic cardiovascular disease (ASCVD) is the major cause of morbidity and mortality in T2DM. Over 30% of those with T2DM have CVD (cardiovascular disease), and over half die from it, mainly from coronary heart disease. The presence of T2DM reduces life expectancy by 10–14 years. The European Society of Cardiology stratifies the CVR into moderate (young patients, with a short duration of diabetes, no risk factors), high (duration of diabetes >10 years, no target organ damage, plus any additional risk factor) and very high (patients with established CVD, target organ injury three CVD risk factors: age, hypertension, dyslipidemia, obesity, or Type 1 diabetes mellitus (T1DM) over 20 years duration). The American Association of Clinical Endocrinologists (AACE) considers that diabetes per se involves high risk. Heart failure (HF) is the second most common complication after obstructive peripheral arterial disease. T2DM associates a 75% higher risk of CV mortality or hospitalization for HF. A multifactorial approach is required to reduce CV morbidity and mortality

Insulin Therapy in Gestational Diabetes

The prevalence of gestational diabetes risen in several populations during the past 20 years, and increased direct and indirect healthcare costs, including those for insulin treatment. Establishing the optimal treatment and initiation momentum are critical to achieve glycemic control and minimize the impact on fetal development and perinatal complications. Insulin is the only therapy that does not cross the placenta, and some of its types were proved to be safe in pregnancy. Intrapartum management is based on intravenous insulin administration, and standard protocols should be implemented in every center. Postpartum management requires special attention, as insulin necessary has a fast decline exposing mothers to hypoglycemia

Treatment of lipomas and diffuse lipomatosis with NDYAG 1064 NM laser and their impact on the quality of life

Lipomas, the most common type of benign tumours, are generally developed from adipose tissue and present an incidence of 2.1 per 1000 inhabitants. In addition to lipomas, at least three other maladies of the adipose tissue lead patients to consult a doctor, especially for aesthetic purposes: multiple familial lipomatosis, diffuse congenital lipomatosis, and adiposa doloris. Unlike lipomas, these maladies are characterized by numerous lipomas, encapsulated or not, of different sizes, symmetrical or not, which may appear in the neck, limbs, or the trunk, sometimes being painful. The life quality of these patients is affected, not only from an aesthetic point of view but also from medical considerations, like pain. Chemical lipolysis has proven unsatisfactory for patients due to several reasons: the prolonged therapy, high cost, the partial dissolution of the lipomatosis, and high recurrence at one year. Surgical treatment remains the only viable option; sometimes when numerous lipomatous tumors required large and numerous incisions, treatment was refused by patients. The result after laser liposuction is excellent, the recovery time is short, without much pain for the patient, with minimal ecchymoses and edemas, without any recurrence in time, and with an excellent degree of patient satisfaction

Editorial: Diet-microbe-host interactions in metabolic syndrome

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Modern concepts in non-surgical esthetics; a review

New non-surgical esthetics is the most dynamic field in contemporary medicine. At the same time, it is greatly influenced by our contemporary society. This paper reviews modern methods used in non-surgical esthetics, especially in Romania. From injectology and non-surgical face lifting to non-surgical body contouring, we analyzed all procedures performed by Romanian physicians, and we show the advantages and disadvantages of the advanced esthetic procedures. Injectology typically implies hyaluronic acid, botox and mesotherapy (for wrinkles and rejuvenation). Laser and radiofrequency treatment are used for wrinkles as well, with fewer unwanted adverse reactions and results exceeding those of injectables. Non-surgical lifting has gained more ground because it requires little recovery time and the results are very positive. Elective treatment for facial discoloration is the laser approach. For non-surgical body contouring, cryolipolisis, vacuum, radio frequency, and infrared systems have all revolutionized this part of esthetics, but each has limitations, and only after establishing the correct course of action, might we think of achieving favorable results and thus raising to the expectations of patients

Pheochromocytoma – clinical manifestations, diagnosis and current perioperative management

Pheochromocytoma is a neuroendocrine tumor characterized by the excessive production of catecholamines (epinephrine, norepinephrine, and dopamine). The diagnosis is suspected due to hypertensive paroxysms, associated with vegetative phenomena, due to the catecholaminergic hypersecretion. Diagnosis involves biochemical tests that reveal elevated levels of catecholamine metabolites (metanephrine and normetanephrine). Functional imaging, such as 123I-metaiodobenzylguanidine scintigraphy (123I-MIBG), has increased specificity in identifying the catecholamine-producing tumor and its metastases. The gold-standard treatment for patients with pheochromocytoma is represented by the surgical removal of the tumor. Before surgical resection, it is important to optimize blood pressure and intravascular volume in order to avoid negative hemodynamic events

Alcoholic liver cirrhosis, more than a simple hepatic disease – A brief review of the risk factors associated with alcohol abuse

Liver cirrhosis is a significant public health problem, being an important cause of mortality and morbidity, responsible for approximately 1.8% of the total number of deaths in Europe. Chronic alcohol consumption is the most common cause of liver cirrhosis in developed countries. Europe has the highest level of alcohol consumption among all the global World Health Organisation (WHO) regions. In this paper, we briefly review major factors leading to excessive alcohol consumption in order to draw attention to the fact that alcoholic liver cirrhosis is more than a simple liver disease, and if those risk/causal factors can be prevented, the incidence of this disease could be reduced greatly. Although excessive alcohol consumption is regarded as the cause of alcoholic liver cirrhosis, the etiology is complex, involving multiple factors that act in synchrony, and which, if prevented, could greatly reduce the incidence of this disease. Children of addicts are likely to develop an alcohol-related mental disorder; however, there is no “gene for alcoholism”

Treatment of lipomas and diffuse lipomatosis with NDYAG 1064 NM laser and their impact on the quality of life

Lipomas, the most common type of benign tumours, are generally developed from adipose tissue and present an incidence of 2.1 per 1000 inhabitants. In addition to lipomas, at least three other maladies of the adipose tissue lead patients to consult a doctor, especially for aesthetic purposes: multiple familial lipomatosis, diffuse congenital lipomatosis, and adiposa doloris. Unlike lipomas, these maladies are characterized by numerous lipomas, encapsulated or not, of different sizes, symmetrical or not, which may appear in the neck, limbs, or the trunk, sometimes being painful. The life quality of these patients is affected, not only from an aesthetic point of view but also from medical considerations, like pain. Chemical lipolysis has proven unsatisfactory for patients due to several reasons: the prolonged therapy, high cost, the partial dissolution of the lipomatosis, and high recurrence at one year. Surgical treatment remains the only viable option; sometimes when numerous lipomatous tumors required large and numerous incisions, treatment was refused by patients. The result after laser liposuction is excellent, the recovery time is short, without much pain for the patient, with minimal ecchymoses and edemas, without any recurrence in time, and with an excellent degree of patient satisfaction