Background: Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostic, prognostic and therapeutic guidance of patients hospitalized for acute heart failure; Our review aims to summarize in an easy-to-follow flow recent relevant research evaluating the possible use and the clinical value of measuring CA 125 serum levels in acute HF. Methods: A thorough search in the main international databases identified a relevant pool of 170 articles, providing recently published data for this narrative review that used PRISMA guidelines. Results: There are data to sustain the role of carbohydrate antigen 125 (CA 125), a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow-up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than N-terminal pro b-type natriuretic peptide (NT-pro BNP)—a classical and more utilized marker of heart failure) in several scenarios of acute heart failure. Conclusions: Although the mechanism behind the upregulation of serum CA 125 in patients with congestive HF has not been confirmed nor fully understood.

Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostication, prognostication and therapeutical guidance of patients hospitalized for acute heart failure. There is data to sustain the role of CA 125, a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than NTpro BNP ( a classical and more utilised marker of heart failure) in several scenarios of acute heart failure.

The aim of this study was to assess the delays that can potentially occur in the emergency transfer of patients with ST-elevation myocardial infarction (STEMI) to percutaneous coronary intervention (PCI) centers. We conducted a retrospective study using the medical reports pertaining to 97 patients who presented to the Emergency Department of the Emergency County Hospital of Galati during the year of 2018 with the diagnosis of STEMI and meeting eligibility criteria for PCI, thus warranting transfer to a hospital with PCI facilities. The pick-up time of patients diagnosed with acute myocardial infarction from the emergency department by the transfer crew is significantly shorter (p < 0.05) than those transferred by air, regardless of the PCI center to which the transfer was performed, Iasi or Bucharest, when compared to the time required to process the patients transferred by land to the same PCI centers. The results of the study shows that the helicopter use for transferring acute myocardial infarction patients to a PCI center must be considered, given the distance between non-PCI and PCI centers is over 200 km.

Introduction: Burnout is a syndrome conceptualized as result of the chronic stress at the work place which was not successfully managed. The possible negative effects on the medical staff, the patients and the health institutions have generated interest and motivated the research to understand the possible causes, these effects also influence the burnout predictors. The medical services suppliers within the emergency department have had one of the greatest exhaution occurences even before the pandemic. Being in the first line in contact with the suspected patients or confirmed with COVID-19 infection intensifies this fact. Both the working factors (working hours, years of practice, number of treated patients, professional development activities) and the socio- demographic factors (age, sex, civil status, income, education) are associated with the exhaustion at the work place. Material and methods: I have studied a total of 120 participants, receiving 115 valid questionnaires, the answering ratio being 95,83%. This was a descriptive, multicentre, transversal study of the medical and the auxiliary staff within the department UPU-SMURD of the County Clinic Emergency Hospital “Sf. Ap. Andrei” Galați. The staff gave their consent and attended a combined interview which consisted of a pilot questionnaire and a demographic questionnaire. Results and discussions: The average score of exhaustion at the staff level was 3.25, a great percentage of the doctors within the ED (45.8%), (n=24) indicates an increased level of exhaustion, only 26.8% (n=80) of nurses show an increased level of exhaustion. The average score of the stress level shown by the staff is 3.1, 66.6% (n=24) among which the doctors with an increased stress level 9.1% (n=9) auxiliary staff, 23.8% (n=80) of nurses. Conclusions: The results show us a high exhaustion, stress and depression ratio at the emergency doctors in comparison with the other professional categories within the ED. A high level of professional satisfaction is accompanied by an increased level of stress and of self-esteem.

Viral infections can be a cause of CNS infection, causing mental and neurological symptoms. Even under normal conditions, good mental health is of paramount importance to the functioning of society. Healthcare workers are critical to the COVID-19 pandemic and beyond, but may have to leave work if their mental health is affected. We present the favorable evolution of a patient, a 55 year-old woman, medical staff with a history of viral infection with SARS CoV-2 (August 2020), which is brought by a crew of the Ambulance service in the emergency department (ED) service (December 2020) for multi-drug ingestion for suicide. After treatment and investigations she is transferred to the “Elena Doamna” Psychiatric Hospital. After 4 days of hospitalization, he returns to the emergency department by transfer from the Psychiatric Hospital for underlying seizures, confusion syndrome. During her admission to the neurology service of the “Sf Ap. Andrei” Emergency Clinical Hospital, the patient benefited from numerous clinical and paraclinical investigations, which provided information about the patient's neuropsychiatric evolution.

Background: Syncope in older adults is a frequent and diagnostically challenging presentation in prehospital emergency care, particularly in geographically remote areas with limited access to advanced cardiac services. While many syncopal episodes are benign, some are caused by life-threatening conduction disorders such as complete atrioventricular block (CAVB), which may manifest with seizure-like activity due to severe cerebral hypoperfusion. Case Presentation: We report the case of a 70-year-old man with a history of hypertension, residing in a remote rural area, who experienced a nocturnal tonic–clonic episode followed by recurrent loss of consciousness. Due to difficult ground access, a helicopter emergency medical service (HEMS) team was deployed. On arrival, the patient was hypotensive and severely bradycardic, with recurrent syncopal episodes. Electrocardiography (ECG) confirmed CAVB with a slow escape rhythm. Temporary transvenous pacing was initiated but required progressively higher output, up to approximately 80 mV, with intermittent loss of capture, indicating a high risk of pacing failure and asystole. The patient was transported by helicopter to a tertiary interventional cardiology center, where he experienced additional syncopal episodes before undergoing emergent implantation of a permanent single-chamber ventricular pacemaker (VVI). Permanent pacing resulted in immediate hemodynamic stabilization, and no further syncopal or seizure-like episodes were observed. Conclusions: In geriatric patients presenting with convulsive syncope, cardiac causes such as CAVB must be rapidly identified. Unstable temporary pacing with high capture thresholds represents a life-threatening condition requiring urgent permanent pacemaker implantation. HEMS plays a critical role in ensuring timely access to definitive cardiac care in geographically isolated regions.