We assessed the relationship between insulin resistance, serum insulin-like growth factor 1 (IGF-1) levels, and common carotid intima-media thickness (CC-IMT) in morbidly obese young patients. A total of 249 patients (aged 37.9 ± 9.8 years, body mass index [BMI] 45.6 ± 8.3 kg/m(2)) were evaluated (metabolic tests, serum IGF-1 measurements, homeostasis model assessment-insulin resistance [HOMA-IR], and ultrasonographically assessed CC-IMT) in a research program for bariatric surgery candidates. After adjusting for age, gender, BMI, systolic blood pressure, uric acid, antihypertensive and lipid-lowering treatment, metabolic syndrome, and metabolic class, both HOMA-IR and IGF-1 z-score were significantly associated with CC-IMT. These results were confirmed in logistic regression analysis, in which age (β = 1.11, P = .001), gender (β = 3.19, P = .001), HOMA-IR (β = 1.221, P = .005), and IGF-1 z-score (β = 1.734, P = .009) were the only independent determinants of abnormal CC-IMT, presumably modulating the effect of the other risk factors included in the regression. Area under the receiver-operating characteristic curve for the model was 0.841 (confidence interval: 0.776-0.907; P < .001). In conclusion, in morbidly obese young adults, insulin resistance and IGF-1 z-score are significantly associated with CC-IMT, independent of other major cardiovascular risk factors.

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Background. Metabolic syndrome (MetS) is an entity with proved involvement in cardiovascular pathology. We aim to highlight the existing type of cerebrovascular damage in a group of patients with MetS by comparison to the control group. Method. We analyzed 36 patients with MetS (defined according to NCEP:ATP III 2001 criteria) and a number of 25 subjects that represented the control group, aged between 40 and 67 years old, that had no personal history of cardiovascular or cerebrovascular disease. The subjects were clinically-neurologically and metabolically evaluated, as well as biochemical and haematologically explored. Neck and brain vascular impairment (IMT and atheromatous plaques measurement, cerebral vasoreactivity) was highlighted using cervical and transcranial neurosonology (including performing the apnea test). The obtained results were statistically processed. Results. Patients with MetS had higher average IMT than control (0.62 mm to 0.54 mm) as well as a higher percentage of atheromatous plaques 25% (9/36) when compared to the control group 20% (5/25). Cerebral vasoreactivity impairment was equal 52.8% (19/36) in MetS patients and 52% (13/25) in control group subjects. None of these differences was statistically significant. In patients with MetS the average IMT was correlated with the existence of atheromatous plaques (p = 0.023) and other associated risk factors like arterial hypertension & smoking (p = 0.018), dyslipidemia & obesity (p = 0.003), smoking & increased abdominal circumference (p = 0.049). For the control group the existence of atheromatous plaques was correlated with smoking status (p = 0.027). Conclusions. Even though the neck and brain vessels impairment was better expressed in the MetS patients group, there is no a statistically significant correlation. In MetS patients presence of different combinations of vascular risk factors determines strong associations with increased IMT.

Background. Diabetes mellitus (DM) is a major risk factor for vascular disease (including the cerebrovascular disease). One of the major consequences of cerebral microangiopathic disease is the cognitive decline. This study’s objective is to assess cognitive abilities of a selected group of 23 type II diabetic patients. Materials and methods. The trial enrolled 48 patients aged between 40 and 68 years old. None of the patients had a personal history of cerebrovascular disease or a history of cognitive impairment. Cognitive status was assessed using current tests such as IQ, MMSE, the clock-drawing test, Hamilton Scale for depression and each patient was given a set of specific psychometric tests in order to accurately evaluate a specific area of cognition (memory, attention, visual and spatial orientation, executive function). The results were statistically processed by SPSS. Results. The global cognitive score for diabetic patients was significantly lower -60,3/100 points compared to that of the control group -69.08/100 points (p = 0.048). The cognitive field most affected in these patients was the executive function 7.30/20 points in diabetic patients compared to that of the control group – 11.04/20 points (p = 0.008). There were no statistically significant differences between the two groups related to the presence of symptoms of depression or cognitive capacity level evaluated by standard tests (IQ, MMSE, clock-drawing test). Conclusions. Patients with type II DM have a lower overall cognitive score, even at middle-age, when compared with patients without this type of metabolic impairment. The most affected domain is the executive function.

Introduction. Viral hepatitis is still a challenge for the medical world and research over the past decades has been aimed at discovering viable methods of prevention, diagnosis and treatment . Material and methods. Data analysed from 73 patients from ”Dr. Victor Babeș” Clinical Hospital of Infectious and Tropical Diseases and ”Dr. Victor Babeș” Private Medical Clinic, both from Bucharest. Results. Fibroscan assessment showed that patients predominantly have F2, F3, F4 Metavir fibrosis stage while FibroTest showed F3, F4 stage of fibrosis. It was observed a decrease in fibrosis stage after DAA treatment comparative to values before treatment (5.622 kPa average post-treatment comparative to 11.49 kPa before treatment, statistically significant with p value < 0.001). Chronic infection with hepatitis C virus is considered a risk factor for atherosclerosis correlated with a higher cardiovascular risk compared to the general population. Monitoring patients prior to and after DAA treatment is an efficient method to detect early vascular changes that could lead to thrombotic and/or cardiovascular events. Conclusions. Measurement of the IMT index by doppler ultrasound in pateints with hepatitis C virus infectionmay constitute a method of identification the endothelial dysfunction or atherosclerosis and may help to establish cardiovascular risk. Elimination of hepatitis C virus is the target of ongoing international programmes but the extrahepatic effects of persistent infection, early diagnosis and appropriate treatment should not be neglected.