Acute decompensated heart failure (ADHF) represents a major healthcare burden, with residual congestion at discharge being a critical determinant of poor outcomes. Despite its prognostic significance, the assessment of decongestion status before discharge remains suboptimal, highlighting the need for a more comprehensive evaluation approach. This descriptive review synthesizes current evidence on congestion assessment methods in ADHF, focusing on their role in discharge decision-making and prognostic value. We describe various evaluation tools, including clinical examination, biomarkers, imaging techniques, and congestion scores, presenting their integration into a practical assessment algorithm. A comprehensive algorithm for congestion assessment before discharge is presented, incorporating multimodal evaluation techniques, with the aim of highlighting the practical utility of various assessment methods in guiding treatment decisions and determining optimal discharge timing. Integration of multiple parameters provides superior accuracy in evaluating decongestion status compared to single-method approaches. A standardized, multimodal approach to congestion assessment before discharge is essential for optimal ADHF management. The proposed assessment algorithm, combining clinical, biochemical, and imaging parameters, offers a practical framework for more reliable discharge decision-making, potentially improving patient outcomes.

Pregnancy is a transformative stage in a woman’s life, marked by significant physical, emotional, and social changes. This study had three main objectives: (1) to assess the quality of life (QoL) of pregnant women in Romania, (2) to identify the sociodemographic, health, and obstetric factors influencing their QoL and (3) to examine the psychometric properties of the WHOQOL-BREF questionnaire within the Romanian context, determining its effectiveness in evaluating QoL during pregnancy. Methods: A cross-sectional analytical survey was conducted between January and July 2023 among pregnant women in Romania, targeting a geographically diverse sample from urban and rural areas. Eligible participants were Romanian citizens aged 18 or older. Data were collected through an online self-administered questionnaire using Google Forms, with informed consent obtained electronically. The survey included demographic, obstetric, and health-related variables alongside the WHOQOL-BREF tool, which evaluates QoL across four dimensions: Physical, Psychological, Social Relationships, and Environment. Statistical analysis involved confirmatory factor analysis, reliability testing (Cronbach’s α and McDonald’s ω), and comparisons using Welch’s t-tests and ANOVA. Results: A total of 1550 valid responses were analyzed. The WHOQOL-BREF demonstrated excellent internal consistency (Cronbach’s α > 0.9 across all dimensions). Women with higher education and stable employment reported significantly higher QoL scores in physical and psychological dimensions. No significant differences were found based on pregnancy trimester, previous births, or participation in prenatal classes, although trends suggested slight advantages for participants in prenatal education. Women delivering in private hospitals or non-hospital settings reported better psychological and physical QoL than those delivering in public hospitals. Support from partners and urban residency positively influenced perceived QoL. Conclusions: The WHOQOL-BREF is a reliable tool for assessing QoL in pregnant women in Romania. The study highlights the role of education, employment, and delivery location in influencing QoL, emphasizing the need for targeted support for vulnerable groups during pregnancy.

HIV infection is considered to be a lifelong medical condition, requiring follow-up and treatment for decades. HIV-positive men are reported to have erectile dysfunction more often than age-matched healthy controls, and improving sexuality is known to potentially improve overall health-related quality of life. The aim of this paper is to evaluate the presence of ED in HIV-positive men and the associated contributing factors and to create a statistical model to assess the risk to develop ED in this population. In a prospective study, we analyzed a group of HIV-positive men in a cross-sectional manner, looking at demographics, blood test results, and smoking habits. Data were statistically analyzed using the Kruskal–Wallis test. In our series, the overall incidence of ED was 48.5%, increasing with age. Our analysis showed no correlation with blood sugar level, but a very strong correlation with total serum lipids. We were able to develop and validate a risk calculator for ED in HIV-positive men.

Background and Objectives: Coronavirus disease-2019 (COVID-19) posed unique challenges worldwide, underscoring important gaps in healthcare preparedness for patients receiving immunosuppressive therapies, such as the individuals with axial spondyloarthritis (axSpA), a subgroup of spondyloarthritis (SpA) characterized by chronic inflammation and immune dysregulation. While global registry data exist for SpA, specific data on axSpA alone remain scarce, especially in Central and Eastern European populations. This study aims to identify predictive factors for severe COVID-19 outcomes and provide a descriptive analysis of axSpA patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using real-world data from the Romanian Registry of Rheumatic Diseases (RRBR). Materials and Methods: This is a three-year retrospective observational cohort study that included 5.786 axSpA patients from the RRBR, of whom 183 (3.16%) were diagnosed with SARS-CoV-2 infection. Data were analyzed using R V4.4.1 and performing univariate and multivariate binary logistic regression to estimate associations using odds ratios (ORs), 95% confidence intervals (CIs), and p-values. A backward selection algorithm was applied to create the final predictive model, accounting for multicollinearity through variance inflation factors (VIFs). Results: The mean age of patients was 48.19 ± 12.26 years, with male predominance (64.5%). Serious COVID-19 (encompassing moderate to critical cases) occurred in 46 cases, with age ≥ 52.5 years (OR 2.64, 95% CI: 1.28–5.48, p = 0.009) and arterial hypertension (OR 2.57, 95% CI: 1.29–5.16, p = 0.007) identified as significant predictors. Individuals with advanced education levels had nearly three times lower odds of experiencing serious COVID-19 (OR 0.38, 95% CI: 0.18–0.76, p = 0.008). Furthermore, our findings confirm the lack of association between HLA-B27 and COVID-19 severity (p = 0.194), contributing to the ongoing discussion regarding its potential immunological role. Moreover, irrespective of the biological therapy administered, the likelihood of experiencing serious SARS-CoV-2 outcomes was not statistically significant (p = 0.882). In the final predictive model, only older age and higher education were deemed as predictive factors. Conclusions: This study highlights key predictors of COVID-19 severity in axSpA patients and emphasizes the protective role of higher education, an underexplored determinant of health outcomes in inflammatory diseases. The lessons learned during these last years can shape a more informed and compassionate healthcare system.

Cardiovascular pathology encompasses a wide range of diseases characterized by common risk factors such as atherosclerotic disease, diabetes, and arterial hypertension. These conditions can be effectively mitigated through the adoption of a healthy lifestyle. Additionally, telemedicine, along with other forms of direct or indirect electronic interaction, may play a significant role in the prevention of cardiovascular diseases.In order to evaluate the perception of doctors and elderly patients from Bucharest county, as cardiovascular risk and the preventive role of telemedicine means, we created a specific questionnaire. We collected by a online questionnaire: demographic data, level of education, medical software applications used, cardiovascular parameters, telemedicine com-pliance. The obtained data were processed using Windows Office program. The surveyed doctors performed telemedicine using WhatsApp (in 55% of cases), phone short message text (in 40% of cases). and platform ASSMB (0.5%). Doctors' preferences in telemedicine were to asses the cardiovascular pathology (75%), cognitive disorders (65%), and functional (60%) evaluations. The majority of 50% of patients will resort to alternative consultations (through physical examination and telemedicine) in the future only if it is strictly necessary. Doctors and patients were predominantly women, with the majority residing in the urban environment. Telemedicine was carried out using WhatsApp for doctors and patients. Most doctors believe that telemedicine will improve the doctor-patient relationship and therapeutic compliance and monitoring and consultations will take place at the office and via telemedicine. The majority of patients will resort to alternative consultations methods (physical examination/ telemedicine) in the future when deemed necessary; a significant number of the patients would encompassing both in-person visits and telemedicine options.

Background and Objectives: A degenerative joint disease that primarily affects elderly individuals, osteoarthritis (OA) causes pain, decreased mobility, and a lower quality of life. Procaine is regarded as a “veteran” medicine due to its extensive clinical use, although it remains a molecule of interest, as researchers are uncovering new biological and pharmacological effects through innovative experimental methods. This study evaluates the efficacy of the “procaine complex”, developed in our country, in alleviating pain and improving functionality in elderly individuals with osteoarthritis of the knee and hip. Materials and Methods: We conducted an assessment of a longitudinal short-term study involving 177 patients aged 65 and older, who were randomly divided into two groups. One group received physical therapy and “procaine complex” periarticular injections (n = 101), while the other group received just physical therapy (n = 76). We assessed pain using a visual analog scale (VAS), in addition to functional evaluations using the Lequesne Index, Activities of Daily Living (ADL), and Instrumental ADL (IADL) scores. We evaluated these through a CGA (complex geriatric assessment), the walk test, “Up and Go” test, Mini Mental State (MMSE) and Geriatric Depression Scale (GDS) for cognitive status. We analyzed all the data from this study using PSPP v3 software. Results: The procaine complex treatment group exhibited a significant reduction in pain (p < 0.001) and improvement in daily activities (p < 0.001) relative to the control group. However, there was no notable difference in walking test scores (p = 0.171). No substantial detrimental effects were identified. The procaine complex did not surpass physical therapy in reducing depressive disorders, but both groups showed some enhancement in this regard. Conclusions: This study demonstrates an innovative approach to pain management by integrating periarticular “procaine complex” injections with physical therapy. This provides elderly individuals experiencing osteoarthritis pain and functional limitations with a secure and efficacious alternative to surgery, or may diminish years of disability.