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Kresimir Kordic, Sime Manola, Ivan Zeljkovic, Ivica Benko and Nikola Pavlovic


Fascicular left ventricular tachycardia (VT) is the second most frequent idiopathic left VT in the setting of a structurally normal heart. Catheter ablation is curative in most patients with low complication rates. We report a case of ostial left anterior descending coronary artery (LAD) occlusion during fascicular ventricular tachycardia ablation.

Dissection was the most likely cause of LAD obstruction. To the authors’ best knowledge, this is the first case reporting selective LAD dissection during electrophysiology study with no left main coronary artery (LMCA) affection.

Open access

Tica Otilia Anca, Tica Ovidiu, Rosan Larisa, Pantea Vlad, Ignat Romanul Ioana, Sandor Mircea, Sandor-Huniadi Anca, Babes Katalin and Popescu Mircea-Ioachim


Atrial fibrillation (AF) is the most common rhythm disorder worldwide, becoming epidemic. Heart failure (HF) is a life-threatening disease and addressing it should be a priority. In this paper, we analyse recent progress on the relationship between HF and AF. The interdependence between AF and HF has not been elucidated and therefore remains an area of interest for research. It is estimated that both the incidence of AF and HF will increase significantly in the next decades worldwide, there will be a significant problem for health systems in several countries. It remains imperative to urgently promote additional research on epidemiology, mechanisms and treatment of AF and HF.

Open access

Mohammad Mostakhdem Hashemi, Nasser Behnampour, Mojgan Nejabat, Afsaneh Tabandeh, Behrouz Ghazi-Moghaddam and Hamid Reza Joshaghani


Introduction. Human seminal plasma contains a variety of macro and trace elements including magnesium (Mg), copper (Cu), zinc (Zn), and iron (Fe) that have essential roles in normal functioning of semen and its quality. The imbalance of these elements has been reported in several pathologic and male infertility disorders. Therefore, this study aimed to determine the levels of these elements in seminal plasma samples, their relationships with each other and their impact on sperm motility.

Methods. Overall, 192 males (96 normospermic and 96 asthenospermic males) were enrolled in the study. Semen samples were collected by masturbation and computer-assisted/aided semen analysis of sperm motility was performed. The samples were centrifuged and seminal levels of Mg, Cu, Zn and Fe were measured using atomic absorption spectroscopy.

Results. The levels of Zn did not differ between the two groups, while the levels of Mg, Cu, and Fe were significantly higher in normospermic males. Fe showed a positive correlation with Mg and Cu in asthenospermic group. However, a negative relationship was found between Mg and Fe levels and between Mg and sperm concentration in the normospermic group. Fe levels were higher in the normospermic group compared to the asthenospermic group. Nevertheless, increased Fe levels caused a decrease in most of sperm motility fractions.

Conclusion: Elements play major roles in male fertility and directly affect sperm quality. According to the results of this study, the levels of Zn do not affect the sperm quality and motility, while Fe, Cu and Mg are decreased in males with sperm motility problems. Nevertheless, Fe levels can adversely affect sperm motility in normospermic men.

Open access

Seyed Reza Hosseini, Naghi Baghitabar, Ali Mirzapour, Farshid Oliaei, Hajighorban Nooreddini, Ali Bijani and Simin Mouodi


Background. Hyponatremia (HN) can be associated with osteoporosis, falls and bone fractures in the elderly. Recent researches demonstrated different results about the correlation of HN with bone mineral density and bone fractures.

Methods. This analytic research came from the AHAP project in northern IRAN. All people aged 60 years and over were included in the study. Individuals with severe comorbidities and then who had concurrent conditions which could have impact on bone mineral densities (BMD) such as long-term use of steroids, calcium and/or vitamin D supplements, bisphosphonates, calcitonin, thiazides and hormonal medications were excluded.

Results. One thousand and one hundred and thirteen older persons entered in the study. More than 10 percent of the participants had HN (serum Na+ level ≤ 137mEq/L). No significant difference has been observed between hyponatremic and nonhyponatremic individuals about their balance abilities; bone mineral density; incidence of falls and/or bone fracture during the previous 6 months; dependency in activities of daily living; and osteoporosis.

Conclusion. HN was not a prevalent problem in older adults who met the inclusion criteria of this research. No significant difference has been observed between HN and bone mineral density and falls in the elderly.

Open access

Mihaela Ghinea, Sabina Ciocodei, Gabriela Butoi, Geandan Memet, Andreea Stoica and Zizi Niculescu


Gaucher disease is the most frequent lysosomal storage disease, caused by the deficiency of an enzyme called β-glucocerebrosidase. Three types of Gaucher disease are described. Type I Gaucher disease benefits from lifelong enzyme replacement therapy with imiglucerase.

Herein, we present the case of a 34-year-old female patient, a commercial worker, who was admitted to our Department of Haematology in the Emergency Clinical Hospital of Constanta in order to investigate the aetiology of a persistent splenomegaly. Clinical examination and laboratory testing evidenced the following: splenomegaly, hepatomegaly, anaemia, leukopenia and neutropenia, thrombocytopenia, and a myelogram showing Gaucher cells. In this context, the suspicion of Gaucher disease was raised and the investigations were further completed through specific enzyme testing and genetic testing. The low values of lysosomal enzymes, coupled with the detection of two specific genetic mutations confirmed the diagnosis of Gaucher disease.

In January 2017, treatment with 2400U of imiglucerase in intravenous perfusion every two weeks was begun.

Open access

Polliana Mihaela Leru, Ana-Maria Eftimie and Michel Thibaudon


Introduction. Respiratory allergies induced by allergenic plants pollen represent an important public health problem with increasing prevalence and severity. Aerobiologic study of allergenic pollens is performed in many countries on regular basis and correlated with health data from allergists in the frame of national aerobiology networks. Romania has no aerobiology network and pollen measurements have been done between 1999-2012 in West region only. In the frame of COST Action called Sustainable management of Ambrosia artemisiifolia in Europe (SMARTER FA 1203), three years collaboration with Reseau National de Surveillance Aerobiologique (RNSA) from France and the first pollen monitoring center in Bucharest were established.The aim of this paper is to present results of first pollen monitoring in Bucharest, activities of Romanian SMARTER group and collaboration with European aerobiology specialists.

Material and method. We used a Hirst-type pollen trap placed on the roof of the Research Center from “Colentina” Clinical Hospital and the pollen monitoring method based on European Aeroallergen Network (EAN) standardized requirements. Monthly results during the pollen seasons 2014-2016 were sent to RNSA and EAN and posted on the European pollen information site.

Results. We found high amounts of allergenic pollen, mainly grasses from May to September and Ambrosia artemisiifolia during September.

Conlcusions. We concluded that SMARTER offered access to aerobiology training, improved multidisciplinary collaboration and perspectives to further develop national and international projects. More coordinated efforts to develop national aerobiology network and to recuperate the gap comparing to other European countries in the field of aerobiology and respiratory allergology are needed.

Open access

Delia Tulbă, Răzvan Adrian Ionescu, Daniela Gologanu, Marius Ioan Balea and Simona Caraiola


Introduction. Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a systemic vasculitis of the small vessels that often associates asthma and blood/tissue eosinophilia.

Case presentation. A 58-year-old woman was admitted to our hospital for progressive exertional dyspnea. She had been diagnosed with asthma three years earlier. Recent multiple thoracic computed tomography scans displayed non-fixed interstitial lung abnormalities, whereas the infectious workup (HIV, parasites) was negative.

On admission, the clinical examination noted prolonged expiratory phase. Paraclinical tests revealed biological inflammatory syndrome, eosinophilia, polyclonal hypergammaglobulinemia, elevated total IgE level, negative anti-neutrophil cytoplasmic antibodies and proteinuria of nephritic pattern.

The pulmonary evaluation reconfirmed the obstructive ventilatory dysfunction and interstitial lung abnormalities - interlobular septal thickening and diffuse ground-glass opacification. The histopathological examination of a transbronchial biopsy specimen identified leukocytoclastic necrotizing vasculitis and tissue eosinophilia.

Provided the clinical and paraclinical setting, specifically the asthma, blood and extravascular eosinophilia, paranasal sinus abnormalities, non-fixed pulmonary infiltrates and the histopathologically confirmed necrotizing vasculitis, the diagnosis of EGPA seemed appropriate.

Conclusion. In the absence of diagnostic criteria, EGPA diagnosis is often challenging. Although certain clinical and imaging features could assist the diagnosis, biopsy remains the diagnostic gold standard.

In the setting of lung involvement, open lung biopsy is usually required for EGPA histopathological proof, but few cases diagnosed by transbronchial biopsy have been reported. This method often identifies discrete, nonspecific lesions or an incomplete spectrum of pathognomonic abnormalities but has the advantage of minimal invasivity that justifies its use as an alternative diagnostic technique.

Open access

Tica Ovidiu, Tica Otilia Anca, Rosan Larisa, Vidican Madalina, Rosca Elena, Pantea Vlad, Ignat Romanul Ioana, Sandor-Huniadi Anca, Sandor Mircea, Vesa Cosmin, Babes Katalin and Popescu Mircea-Ioachim


Introduction. Dilated cardiomyopathy (DCM) is characterized by global cardiac dilation associated with left ventricular (LV) systolic dysfunction without valvar substrate or ischemic heart disease. Diagnosis of idiopathic DCM can only be sustained after excluding other nongenetic causes.

Methods. This study was performed on a cohort of 256 patients who died in Emergency County Hospital of Oradea and had diagnosis of DCM; the study was performed on a period of 2 years, from January 2014 until the end of December 2015. These patients were differentiated according to social criteria, background, department of admission, number of autopsies and co-morbidities.

Results and Discussion. Diagnosis of DCM was more common in male patients up to the age of 70; after this age the tendency is towards equalization. In patients aged 61-80 years, DCM played a major role in tanatogenesis. Existing clinical trials have shown that patients with idiopathic DCM have a lower mortality than patients with cardiac ischemic disease.

Conclusions. Despite the possibility of diagnosis with increased sensitivity and the large number of therapeutic options, multicentre studies and registries are needed to improve the life expectancy of these patients.

Open access

Vesa Cosmin Mihai, Zaha Carmen Dana, Popa Loredana, Cismaș-Pruteanu Petrișor, Moisi Mădălina, Popescu Mircea, Florica Mekereș, Daina Lucia, Maghiar Adrian and Popa Amorin


Patients recently diagnosed with diabetes mellitus need to go to a complex evaluation regarding not only glycaemia and HbA1C, but also blood pressure values, lipid metabolism, kidney function, medical history and lifestyle choices. Cardiovascular risk assessment can reveal which patients fall into moderate and high categories of risk, where regular follow-up and intensive therapy addressing all the risk factors must be strictly performed. We selected a group made of 385 diabetes mellitus type II patients, a representative for the whole population of newly diagnosed diabetic patients from our county in 2017. We determined their anthropometric indicators, their biochemical parameters, their lifestyle choices and we assessed their coronary heart disease risk at 10 years using UKPDS risk engine.

Open access

Aysun Aybal Kutlugun, Fatma Ayerden Ebinc, Mujgan Tek Ozturk, Fatma Kaplan Efe, İbrahim Karadag, Murat Eser, Oktay Unsal and Serdar Karakaya


Aims. The aim of this study was to evaluate the association between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and microalbuminuria in patients with normal estimated glomerular filtration rate (eGFR).

Methods. 174 patients who had eGFR ≥ 60 mL/min/1.73 m2 were studied. Patients were divided into two groups according to the urinary albumin excretion as microalbuminuric group (n = 105) and normoalbuminuric group (n = 69). NLR and PLR levels were calculated.

Results. NLR was significantly higher (p < 0.05) in microalbuminuric patients (1.91 ± 0.70) compared with normoalbuminuric patients (1.63 ± 0.53). A positive correlation was found between urine albumin excretion and NLR in the whole study group (r = 0.214, p < 0.005).

Conclusions. Higher NLR levels were found in microalbuminuric patients with normal eGFR. Also a significant positive correlation was observed between albuminuria and NLR.