Nonalcoholic fatty liver disease (NAFLD) is defined as the presence of hepatic fat accumulation after ruling out other causes of hepatic steatosis. The aim of the study is to identify the role of statin therapy in dyslipidemic patients with very high cardiovascular risk and NAFLD in achieving low density lipoprotein (LDL) cholesterol targets while also evaluating the changes in liver enzymes levels. This prospective study included 140 patients with NAFLD, hyperlipidemia and elevated cardiovascular risk. Serum lipids were assessed and liver function tests were performed at baseline and at 6 months follow up in 10 mg/ 20 mg daily atorvastatin treatment schedule. The results showed that total cholesterol, LDL cholesterol and triglycerides were significantly reduced at 6 months follow-up, while high density lipoprotein (HDL) cholesterol has not undergone important changes. Statin treatment significantly improved alanine aminotransferase serum levels, whereas aspartate aminotransferase levels were not significantly reduced between baseline and follow-up. Although statin therapy appears to be safe and effective for use in patients with NAFLD, an insufficient treatment is commonly observed in clinical practice, in order to avoid liver damage . NAFLD is not only a major cause of liver related morbidity and mortality, but also an independent cardiovascular risk factor, with cardiovascular mortality being the most important cause of death. Therefore, detecting and modifying risk factors without impairing liver function is desirable.

Choledocholithiasis may cause biliary obstruction which leads to hepatocellular injury. Oxidative stress has been proposed as a possible mechanism involved in this disorder. This study evaluates the oxidative stress burden in patients with choledocholithiasis and secondary cholestasis, before and after endoscopic sphincterotomy. Experimental part: Patients diagnosed with choledocholithiasis and secondary extrahepatic cholestasis were included in the study between January 1st 2016 and October 31st 2016. In all patients oxidative stress markers were collected within 2 hours before and 48 hours after therapeutic ERCP. Selected markers were superoxide dismutase (SOD), glutathione peroxidase (GPX) and malondialdehyde (MDA). The results were compared to those from a group of 40 healthy subjects. Significantly lower concentrations of SOD (p = 0.03) and GPX (p [ 0.0001) activities, associated with an increased level of MDA level (p [ 0.0001) were shown in patients before biliary clearance compared with the healthy control group. After ERCP the only oxidative stress parameter which showed improvement was the SOD specific activity (p = 0.037). This study shows that extrahepatic cholestasis secondary to choledocholithiasis is associated with increased oxidative stress status. After biliary clearance one oxidative stress marker was significantly improved (SOD), suggesting a possible antioxidant effect of such procedure.

The role of cardiac imaging in the management of non-cardiovascular diseases has been continuously increased. Most studies suggest the utility of echocardiography examination in the evaluation of left ventricular function in cirrhotic patients, being well-known that cirrhosis of the liver is associated with cardiovascular abnormalities which include especially left ventricle diastolic dysfunction and left ventricular hypertrophy. Cardiac dysfunction contributes to morbidity and mortality associated with liver transplantation. The aim of this study was to emphasize the role of echocardiography in assessing left ventricular systolic and diastolic function in cirrhotic patients in order to establish a correlation between echocardiography parameters and biochemical variables in patients with end-stage cirrhosis. The study was conducted as a cross-sectional analysis over a two-year period (2016-2018). 41 patients with cirrhotic liver from the departments of Gastroenterology and Cardiology from St Spiridon Emergency Hospital of Ia�i were included in the study, after a written informed consent was obtained. Patients with any previous cardiovascular (CV) abnormalities, other causes of pulmonary hypertension and endocrinopathies were excluded from the study. Using transthoracic echocardiography left ventricle dimensions and wall thickness (left ventricle posterior wall thickness + interventricular septum thickness) and also diastolic function (E wave, A wave, E/A ratio, deceleration time of E wave) and systolic function (ejection fraction) were determined along with biochemical variables. In conclusion, no significant association was obtained between echocardiographic changes and biochemical profile in patients with cirrhosis of liver.