PurposeHyperuricemia (HUA) is linked to a variety of non-communicable diseases such as atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD) and hypertension, with evidence showing its role in the development of diabetes mellitus (DM). Our study’s main aim was to explore the associations of HUA with other traditional risk factors in Romanian patients with DM and to assess the impact of the increase of serum UA on DM complications and HbA1c.Patients and methodsIn this cross-sectional, non-interventional study, we enrolled, according to a population-based, consecutive-case principle, 133 patients previously diagnosed with DM. HbA1c, uric acid, lipid profile, urinary albumin/creatinine ratio, glomerular filtration rate, TSH and FT4 measurements were performed, while the diagnosis of retinopathy and of diabetic neuropathy was established using standardized methods.ResultsAn increased uric acid level was associated with a significant increase in the risk for development of stroke (OR=1.526; p=0.004). A weak, positive and statistically significant correlation can also be observed between the BMI and the presence of hyperuricemia (r=0.131; p=0.034), and between the triglyceride levels and hyperuricemia (r= 0.173; p=0.004). Glomerular filtration rate was correlated to hyperuricemia in a strong and negative manner, having an important statistical significance (r=−0.818; p=0.003). In our study, UA levels and HbA1c were negatively correlated, without reaching statistical significance.ConclusionSerum UA is strongly correlated with the BMI, triglyceride level and GFR in Romanian patients with DM and HUA is significantly associated with a higher risk of stroke in these individuals.

Purpose: To validate and to evaluate the performance in depression screening of the Patient’s Health Questionnaire – 9 (PHQ-9) for Romanian patients with Type 2 Diabetes Mellitus (T2DM). Patients and methods: In a consecutive-case, population-based, non-interventional study design 107 hospitalized patients with T2DM were enrolled. The PHQ-9 was evaluated in regard to its acceptability, ceiling and floor effect, reproducibility, and test–retest performance. Its validity was tested by comparing it to the Beck depression scale, which is a validated tool for this patient population. Results: The PHQ-9 questionnaire had an excellent acceptability, having no non-responders for any of its questions and a median completion time of 3 mins and 12 s, a good reliability with a Cronbach’s α =0.897 [0.865–0.924] 95%CI, a good test–retest performance (Spearman’s rho =0.972; p <0.001 between two administrations of the test) without any ceiling or floor effect observed for the total score. At the same time, the score demonstrated a good validity when compared to a more complex and previously validated instrument like the Beck depression scale (Spearman’s rho =0.777; p <0.001). The limits of agreement (Bland-Altmann analysis) between the two measurements are 2.6 to −2.5 points. Conclusion: The PHQ-9 is a valid, useful instrument for depression screening in Romanian patients with T2DM.

We present the case of a 54-year-old male, without any significant medical history, who insidiously developed speech disturbances and walking difficulties, accompanied by backward falls. The symptoms progressively worsened over time. The patient was initially diagnosed with Parkinson’s disease; however, he failed to respond to standard therapy with Levodopa. He came to our attention for worsening postural instability and binocular diplopia. A neurological exam was highly suggestive of a Parkinson-plus disease, most likely progressive supranuclear gaze palsy. Brain MRI was performed and revealed moderate midbrain atrophy with the characteristic “hummingbird” and “Mickey mouse” signs. An increased MR parkinsonism index was also noted. Based on all clinical and paraclinical data, a diagnosis of probable progressive supranuclear palsy was established. We review the main imaging features of this disease and their current role in diagnosis.

"Background: It is well known that patients with polycystic kidney disease (PKD) are at increased risk of developing cerebral aneurysms, however, this association has not been well studied for patients with polycystic liver disease (PLD). Material and methods: Cross-sectional descriptive study, which included 15 adult patients diagnosed with polycystic liver disease at the Gastroenterology and Hepatology Department of Fundeni Clinical Institute. Standard neurological exam and brain MRI were performed in all patients on a 1.5 Tesla MRI. Brain imaging protocol included T1/T2, T1SE, T2-FLAIR, DWI, SWI, 2D-TOF, 3D-TOF. Results: The majority of patients (93%) were females. The mean age was 53 ± 5 years old. Patients with AD-PKD and polycystic hepatic disease predominated (60%). Aneurysms were found in only one patient diagnosed with AD-PKD (in whom three aneurysms were described). The overall prevalence of cerebral aneurysms in our patient group was 7%. However, none of the patients with isolated PLD was found to have intracranial aneurysms. Other brain imaging abnormalities were frequent but nonspecific (mostly attributable to vascular-degenerative changes). Conclusions: Given these results, and due to the small number of patients in our study, it is hard to appreciate if polycystic liver disease is indeed associated with an increased risk of cerebral aneurysms. "

At the beginning of the last century, the association between diabetes mellitus and pregnancy was credited with a high risk of complications and mortality. However, nowadays, such issue no longer bears such a pessimistic approach. Planning the pregnancy during a period of optimal metabolic control and careful monitoring of the pregnant woman significantly reduces maternal and fetal mortality. The most important aspects of fetal pathology are: intrauterine fetal death, congenital malformations, growing disorders (macrosomia or delays in growing), neonatal hypoglycemia, respiratory distress syndrome, hypertrophic cardiomyopathy etc. The fetus’s viability is significantly impacted if a quality maternal glycemic control is not obtained at least 3 months prior to birth, as well as throughout the entire pregnancy term (particularly during the first 10 weeks, term during which organogenesis is completed). This systematic review of scientific literature aims to summarize the pathogenic ways in which hyperglycemia may influence the fetus of women with Diabetes Mellitus.