Cancer remains the second leading cause of death worldwide. Doxorubicin (DOX) is a cornerstone of hematologic malignancy treatment, but it is limited by its dose-dependent cardiotoxicity, leading to systolic and diastolic cardiac dysfunction and, ultimately, dilated hypokinetic cardiomyopathy. Cardio-oncology has emerged as a subspecialty addressing cardiovascular complications in cancer patients, highlighting preventive and therapeutic strategies to reduce cancer therapy-related cardiac dysfunction (CTRCD). Current approaches, including beta-blockers, renin–angiotensin system (RAS) inhibitors, and statins, offer partial cardioprotection. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, initially developed for type 2 diabetes mellitus (T2DM), demonstrate pleiotropic cardioprotective effects beyond glycemic control, including reduced oxidative stress, inflammation, and myocardial remodeling. This review explores the interplay between anthracycline therapy, particularly DOX, and cardiotoxicity while evaluating SGLT2 inhibitors as novel agents in cardio-oncology. Preclinical studies suggest SGLT2 inhibitors attenuate CTRCD by preserving mitochondrial function and inhibiting apoptosis, while clinical trials highlight their efficacy in reducing heart failure (HF) hospitalizations and cardiovascular (CV) mortality. Integrating SGLT2 inhibitors into cardio-oncology protocols could revolutionize the management of CTRCD, enhancing patient outcomes in oncology and cardiovascular care. Considering the emerging evidence, SGLT2 inhibitors may provide significant benefits to patients undergoing anthracycline therapy, particularly those with elevated cardiovascular risk profiles. We recommend that future prospective, large-scale clinical trials further evaluate the efficacy and safety of these agents as cardioprotective therapy to optimize individualized treatment strategies.

Resumo Fundamento: A hiperuricemia é um achado frequente em pacientes com hipertensão arterial e há evidências cada vez maiores de que essa entidade seja também um fator de risco para doença cardiovascular. Objetivos: No contexto da população em processo de envelhecimento, este estudo tem o objetivo de avaliar níveis de ácido úrico sérico e a prevalência e o controle da hipertensão arterial em um subgrupo da população de adultos romenos (>65 anos), em relação à influência da idade nesses parâmetros. [...] Resumo Fundamento: A hiperuricemia é um achado frequente em pacientes com hipertensão arterial e há evidências cada vez maiores de que essa entidade seja também um fator de risco para doença cardiovascular. Objetivos: No contexto da população em processo de envelhecimento, este estudo tem o objetivo de avaliar níveis de ácido úrico sérico e a prevalência e o controle da hipertensão arterial em um subgrupo da população de adultos romenos (>65 anos), em relação à influência da idade nesses parâmetros.

Background: Mitral annular plane systolic excursion (MAPSE) is a simple and widely used M-mode echocardiographic marker of left-ventricular longitudinal function that correlates well with left ventricular ejection fraction (LVEF). Conventional chronic right ventricle (RV) pacing is associated with left ventricle (LV) dysfunction, inducing heart failure (HF) and leading to the development of pacing-induced cardiomyopathy (PiCM). The aim of this study is to ascertain the clinical usefulness of MAPSE in the assessment of LV function in patients with permanent RV pacing. Methods: We performed a cross-sectional association analysis, enrolling consecutive patients with pacemakers and chronic RV pacing burdens over 20% (Vp > 20%) from 2021 to 2024. All patients were assessed by standard transthoracic echocardiography (TTE) with LVEF and MAPSE among other parameters being assessed. We performed a correlation test using linear regression and plotted an ROC curve. Results: 409 patients (mean age = 68.7 year) were included, 225 men (55%) and 245 (59.9%) with dual-chamber pacemakers. The mean follow-up period was 18 ± 2 months, with HF incidence in the study group being 23.2%. The results showed that average, septal, and lateral MAPSE all correlate well with LVEF, but septal values seemed to provide the strongest correlation (r = 0.90, p < 0.001), and that a septal MAPSE cut off value of <10 mm (sensitivity 99.4, specificity 42.1, AUC = 0.89) was associated with impaired LVEF (<50%). Conclusions: MAPSE seems to corelate well with LVEF across the spectrum of HF in pts with chronic RV conventional pacing. Septal MAPSE shows the strongest correlation with LVEF, and a value of <10 mm is a cut-off for altered LVEF, making it a potentially useful marker of cardiac function in these pts.

Background: In patients with permanent atrial fibrillation, hypertension and diabetes frequently coexist and contribute to adverse cardiovascular outcomes. Beyond traditional clinical outcomes, health-related quality of life has become an essential measure of disease burden. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a validated patient-reported outcome instrument widely used in cardiovascular populations, but its role in hypertensive diabetics has not been systematically explored. This study aimed to evaluate the impact of diabetes on patient-reported quality of life in hypertensive individuals with permanent atrial fibrillation and identify clinical determinants of impaired health status. Methods: We conducted a retrospective study on hypertensive patients with permanent atrial fibrillation hospitalized between January 2021 and December 2023 at the County Emergency Clinical Hospital of Timișoara. Patients completed the KCCQ during admission and were stratified into hypertension without diabetes (HTN-only, n = 89) and hypertension with type 2 diabetes (HTN + DM, n = 109). Demographic, laboratory, and echocardiographic data were analyzed. The primary outcome was the difference in KCCQ scores between groups. Multivariable regression identified independent predictors of quality of life, and logistic regression with ROC analysis evaluated predictors of low KCCQ (<50). Results: Among 198 patients (109 with diabetes, 89 without), mean KCCQ was lower in HTN + DM versus HTN-only patients (50.9 ± 11.3 vs. 54.9 ± 14.4, p = 0.034). Diabetic patients had worse renal function, higher uric acid, and greater inflammatory burden. KCCQ correlated positively with eGFR (r = 0.43, p < 0.001) and negatively with creatinine, urea, neutrophil percentage, left atrial volume, and age. In multivariable analysis, diabetes was not an independent predictor, whereas reduced eGFR, higher neutrophils, larger atrial volume, and HFrEF were significant determinants. Logistic regression for low KCCQ showed good discrimination (AUC 0.78, 95% CI: 0.72–0.84). Conclusions: Diabetes worsens health-related quality of life in hypertensive patients with permanent atrial fibrillation primarily through renal dysfunction, inflammation, and cardiac remodeling. Targeting these pathways may improve both outcomes and patient-perceived health.

Nocardia is an emerging bacterial disease that often affects patients with compromised immune systems. As the number of patients undergoing solid organ transplants continues to rise, and as more cancer survivors are treated with long-term immune-modifying agents, corticosteroids, and immunosuppressive medications, organisms that typically pose no harm are becoming a public health concern. Carbapenems are usually a second-line therapy in the setting of Nocardia infections. We present the case of a patient who had an immunocompromised status and was diagnosed with Nocardia farcinica, which showed in vitro resistance to carbapenems. The symptoms were non-specific and had a common presentation with headache, fatigue, and a nonresponsive cough to usual cough drugs, although the infection was disseminated and had severe CNS and ocular involvement. The clinical course worsened when the carbapenem was withdrawn and markedly improved when it was re-administered, although the initial antibiogram showed resistance to carbapenems. Despite the observed in vitro resistance in the laboratory, the re-administration of carbapenems was beneficial, as both inflammatory markers and clinical status showed improvement. This was based on clinical judgment, which carefully evaluated the associated risks and benefits. Also, this raises the question of potential risks to develop real resistance to carbapenems of some Nocardia species, which could pose a significant challenge to healthcare. It could become a serious healthcare problem in the future and should prompt active environmental testing.

Background and Objectives: The COVID-19 pandemic profoundly disrupted global healthcare systems, limiting access to diagnostic and therapeutic services for chronic diseases. Patients with decompensated liver cirrhosis were particularly vulnerable due to their fragile clinical status and dependence on continuous medical care. This study aimed to evaluate the temporal evolution of clinical, biological, and prognostic parameters in patients admitted emergently with decompensated liver cirrhosis across three distinct phases: pre-pandemic, pandemic, and post-pandemic. Materials and Methods: A retrospective, single-center study was conducted at the Department of Gastroenterology, Municipal Clinical Emergency Hospital, Timișoara, Romania, including 355 patients hospitalized between February 2018 and February 2024. Clinical, biochemical, and outcome data were collected and analyzed using univariate and multivariate logistic regression models to identify independent predictors of in-hospital mortality for each study period. Results: Significant temporal variations were observed in disease severity, management, and outcomes. The mean MELD score increased from 18.7 to 21.0 during the pandemic (p = 0.043), while endoscopic evaluations declined markedly (59.4% pre-pandemic vs. 42.7% pandemic, p = 0.037). Mortality rose from 21.7% to 30.2% during the pandemic (p = 0.044) and remained elevated post-pandemic (26.4%). Multivariate regression identified Child–Pugh, MELD, and Baveno scores as consistent mortality predictors, though their relative weight varied by period. During the pandemic, acute complications—particularly jaundice (OR = 294) and upper gastrointestinal bleeding (OR = 355)—became dominant determinants of death. Conclusions: The pandemic transformed cirrhosis from a chronic, manageable disease into an acutely unstable condition, primarily due to delayed presentation and restricted procedural access. Although post-pandemic recovery was evident, residual increases in mortality and severity indicate lasting effects of healthcare disruption, underscoring the need to strengthen system resilience and continuity of care for patients with chronic liver disease.