Incidental Discovery of Multiple Myeloma, Presenting as an Amyloid Tumor with Plasmacytic Elements of the Thoracic Wall.

Multiple myeloma is characterized by monoclonal proliferation of bone marrow plasma cells causing multiple bone lesions and overproduction of a monoclonal protein (M-protein) that could deposit in tissues (amyloidosis). Dissemination of the multiple myeloma outside the bone is rare. We present a case of a 76 years old woman presenting with dry cough.

Lyme disease.

Lyme disease (Borreliosis), also called the "disease of 1000 faces", is produced by a bacterium called Borrelia burgdorferi, transmitted by the Ixodes tick. The clinical picture is non-specific and polymorph, with multisystemic involvement. Diagnosis is most often one of exclusion, and certain diagnosis is based on the presence of Borellia antibodies.

Focal nodular hyperplasia (FNH).

Focal nodular hyperplasia (FNH) is a benign tumour of the liver (hepatic tumour), which is the second most prevalent tumour of the liver (the first is hepatic hemangioma). It has a higher incidence in females, 20-40 years old, but also occurs in men and even in children. It is usually asymptomatic, rarely grows or bleeds, and has no malignant potential.

The place of CEUS in distinguishing benign from malignant cervical lymph nodes: a prospective study.

Aims: The aim of the study was to evaluate the ability of contrast-enhanced ultrasonography (CEUS) compared to gray-scale B-mode and color Doppler ultrasound in differentiate benign versus malign superficial cervical lymph nodes.

Material And Methods: In a prospective study ultrasonography (gray scale, color and spectral Dopller, and CEUS) was performed in 61 patients (33 men, 28 women; mean age of 51.2 years, range: 18-81 years), with cervical lymphadenopathy.

Relationship between VKORC1 single nucleotide polymorphism 1173C>T, bone mineral density & carotid intima-media thickness.

Background & Objectives: The effects of vitamin K-dependent proteins in bone mineralization and vascular calcification and the implication of vitamin K epoxide reductase gene (VKORC1) 1173C>T polymorphism in warfarin sensitivity are well known. The main objective of the study was to investigate the relationship between VKORC1 1173C>T polymorphism, bone mineral density (BMD), and atherosclerosis (evaluated by intima-media thickness of the carotid artery and the presence of calcified plaques) in patients suspected to have osteoporosis or osteopenia and referred for BMD determination.

Methods: VKORC1 1173C>T polymorphism was evaluated in 239 consecutive patients referred by their physicians for BMD measurement (dual energy X-ray absorptiometry at L2-L4 lumbar spine, femoral neck and total hip).

Bone mineral density, vertebral fractures and body mass index in postmenopausal women with abdominal aortic calcification.

Background: Evidence suggest that there are connections between osteoporosis and cardiovascular diseases.

Objectives: The aim of the study was to analyze the relationship between radiological measurements of abdominal aorta calcifications (AAC) and bone mineral density (BMD) in postmenopausal women.

Methods: In this cross-sectional study were included 125 postmenopausal women 50-84 years of age.

Cardiac involvement in systemic sclerosis.

Primary myocardial involvement is common in systemic sclerosis and affects the prognosis of the disease when it is clinically evident. The exact mechanism leading to the myocardial fibrosis in systemic sclerosis remains unknown. Its detection depends, at least in part, on the sensitivity of the diagnostic methods used.

The utility of elastography and CEUS for the differentiation between benign and malignant cervical lymphadenopathy. Three cases report.

The differentiation between benign and malignant cervical lymph nodes is a frequent challenge for the clinician. We present the cases of three patients with cervical lymphadenopathy (inflammatory lymph node, lymphoma, and metastasis of laryngeal carcinoma) in which the use of elastography and contrast enhanced ultrasonography had substantial contribution to the correct final diagnosis.

The role of contrast enhanced ultrasound in the assessment of superficial lymph nodes.

Evaluation of superficial lymphadenopathy is important for patients with pathologies like head and neck cancers or breast cancer, as it helps the assessment of patient prognosis and the selection of treatment method. Cervical lymph nodes are also common sites of involvement in lymphoma. Lymphomatous nodes are usually difficult to differentiate from metastatic nodes in clinical examinations.

Markers of systemic involvement in chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality worldwide. It is primarily a pulmonary disease, but it has various extrapulmonary manifestations such as muscular dysfunction and hypotrophy, cachexia or cardiovascular complications. That is why COPD may be considered a systemic disease.

The use of ultrasonography in learning clinical examination - a pilot study involving third year medical students.

Background: Physical examination is a crucial part in medical student curricula, but a decline in physical examination skills was noted in the last two decades. The benefic role of ultrasonography (US) as an adjuvant method for clinical examination was evaluated in many studies, but there are different approaches among countries and universities. The aim of this study was to evaluate the role of US in learning physical exam in 3rd year medical students.

The role of heart rate variability in assessing the evolution of patients with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (CPOD) is an important cause of morbidity and mortality. Cardiovascular involvement is the most common complication of the disease. Abnormalities of autonomic system, caused by this involvement, can lead to cardiac arrhythmias and sudden death.

Assessing health related quality of life in diabetic patients.

Introduction: The number of people with diabetes mellitus (DM) is increasing. For chronic illnesses such as DM, where there is no cure, it is important to establish that therapy really makes people feel better. The purpose of the study was to analyze the quality of life in a group of diabetic patients without major complications.

Rupture sinus of Valsalva in a patient with dextrocardia. Case report.

Ruptured sinus of Valsalva (RSOV) is a rare disease with a wide range of clinical manifestations, from asymptomatic murmur to cardiogenic shock and death. We present the case of a young woman known with dextrocardia and pulmonary agenesia; she was diagnosed with RSOV and during follow-up, with endocarditis. Her evolution was good despite the association of severe heart conditions and the refusal of surgical intervention.

Association between fatty liver disease and carotid atherosclerosis in patients with uncomplicated type 2 diabetes mellitus.

Background: Nonalcoholic fatty liver disease (NAFLD) is a clinic-pathological syndrome closely associated with obesity, dyslipidemia, diabetes and atherosclerosis. Some authors suggest that NAFLD is, in fact, another component of the metabolic syndrome.

Aim: To determine the prevalence of NAFLD in diabetes mellitus (DM) patients, and to evaluate the carotid artery status in these patients.

Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study.

Context And Objectives: Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women.

Design And Setting: Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania.

Is epicardial adipose tissue, assessed by echocardiography, a reliable method for visceral adipose tissue prediction?

Introduction: Epicardial adipose tissue is an ectopic fat storage at the heart surface in direct contact with the coronary arteries. It is considered a metabolically active tissue, being a local source of pro-inflammatory factors that contribute to the pathogenesis of coronary artery disease. The AIM of our study was to establish correlations between echocardiographic assessment of epicardial adipose tissue and anthropometric and ultrasound measurements of the central and peripheral fat depots.

Heart rate variability and diastolic dysfunction in patients with type 2 diabetes mellitus.

Cardiovascular autonomic neuropathy is a common form of autonomic dysfunction in diabetes mellitus (DM) and associates abnormalities in heart rate control and in vascular dynamics. This study evaluates the impact of diabetes mellitus on left ventricular diastolic dysfunction (LVDD) and heart rate variability in a group of type 2 diabetes mellitus without signs of cardiovascular disease. The study group consisted of 58 patients, aged 61 ± 8 years, diagnosed with type 2 DM.

Left ventricular function in patients with uncomplicated well-controlled diabetes mellitus.

Background: Recent findings indicate that symptomatic heart disease in patients with diabetes mellitus predicts poor prognosis, but cardiac involvement may occur before clinical manifestation. Diastolic dysfunction may be the first stage of diabetic cardiomyopathy.

Objective: The aim of this study was to evaluate the cardiovascular function in patients with DM in early stages.

Professional stress and inflammatory markers in physicians.

Unlabelled: Recent changes in society might increase stress perception in physicians. The Job Content Questionnaire (JCQ) is a widely used self-reported instrument to measure psychosocial characteristics of jobs. The biological pathways through which professional stress might increase cardiovascular disease risk are better explained nowadays.

Chiari network--case report and brief literature review.

Chiari networks are present in the right atrium in a minority of the population and are usually of no clinical significance. On the other hand it may associate some pathological changes, as patent foramen ovale, intraatrial thrombus or atrial arrhythmias. We present the case of an asymptomatic young woman diagnosed with Chiari network during a routine echocardiography.

Autonomic neuropathy and plasma catecholamine in patients with diabetes mellitus.

Background: Cardiovascular autonomic neuropathy (CAN) is a common form of autonomic dysfunction in diabetes mellitus (DM) patients, but it can be asymptomatic for years. Low baseline plasma noradrenaline levels have been found in diabetic patients, but this decrease seems to associate clinically severe autonomic neuropathy.

Purpose: To evaluate the impact of DM on heart rate variability (HRV) parameters and to determine the correlations with plasma adrenaline and noradrenaline, as a possible mechanism of early disruption in HRV.

Blood pressure pattern and heart rate variability in normotensive patients with type 2 diabetes mellitus.

Unlabelled: Ambulatory blood pressure monitoring (ABPM) has shown that almost one third of presumed normotensive patients with type 2 diabetes mellitus have instead masked hypertension. There is also a relationship between cardiovascular autonomic neuropathy and blood pressure patterns even in normotensive patients with diabetes mellitus. The aim of the present study was to analyze the blood pressure patterns in type 2 diabetic patients without any history of hypertension and to establish the connection between heart rate variability parameters, ultrasound parameters and ABPM parameters.