Atrial fibrillation is a commonly encountered pathology in medical practice, and its prevalence has shown a continuous rise over the past years. Atrial fibrillation has a significant impact on patients' quality of life, not only due to the standard anticoagulant treatment with vitamin K antagonists that require close monitoring and dose adjustment, but also due to the fragile equilibrium between hemorrhagic and thrombotic risks. The introduction of new oral anticoagulants (NOACs) in the treatment guidelines for atrial fibrillation has improved the quality of life, as NOACs do not require close monitoring or dose adjustments. However, even if the safety profile of the NOACs regarding the hemorrhagic risk is superior to vitamin K antagonists, the problem raised by an unexpected hemorrhage (e.g. severe hemorrhage after an accident) and the need for efficient hemostasis in a chronic anticoagulated patient has remained unsolved. To find a solution for this problem, reversal agents for NOACs have been developed and tested, and two of them, idarucizumab and andexanet-alpha, have already been approved by the FDA, thus making NOACs increasingly appealing as a choice of anticoagulation treatment. Keywords  atrial fibrillation, new oral anticoagulants, idarucizumab, andexanet-alpha Highlights ✓ Long-term oral anticoagulant therapy includes vitamin K antagonists and new oral anticoagulants (NOACs). ✓ The introduction of NOACs in the treatment guidelines for atrial fibrillation has improved the quality of life of patients, as they do not require close monitoring or dose adjustments. ✓ NOACs are divided into two broad categories, depending on the mechanism of action: substances that directly inhibit the activity of thrombin (e.g. dabigatran) and substances that directly inhibit activated factor X (e.g. rivaroxaban, apixaban, edoxaban).

The birth, growth, development, reproduction and senescence under physiological conditions can be achieved without diminishing the role of other important aspects that influence them, only with the support of an optimal diet that is a fundamental requirement nowadays, considering that the health and the nutritional status are in a permanent interdependence. The effects of inadequate nutrition reflect on the expression of genes, influencing the development of certain diseases in childhood and adulthood. Knowing the phases of the gestation period in which the need of certain nutrients is increased, and their absence has the most serious impact on fetal growth and development, allows for the adoption in due time of concrete preventive rules. Disorders associated with lipid malabsorption, such as celiac disease, Crohn�s disease, pancreatic insufficiency, cystic fibrosis and cholestatic disease, are associated with low serum levels of 5-hydroxyvitamin D. Vitamin D deficiency in the newborn can express as deficient skeletal homeostasis, congenital rickets and fractures in the early days of life. A low level of vitamin D during pregnancy seems to increase the risk of preeclampsia, intrauterine growth restriction and gestational diabetes, and in the longer term it seems to affect the bone, immune system and general status. The prevalence of hypovitaminosis D is increasing globally, and the effects on pregnancy and neonatal outcome of the vitamin D deficiency and supplementation are a topical issue, which is currently under investigation.

La lésion iatrogène des voies urinaires chez les femmes soumises à la chirurgie pelvienne Introduction. La lésion iatrogène des voies urinaires chez les femmes subissant des interventions pelviennes est l'une des complications les plus redoutées et une source importante de morbidité significative. En outre, elles provoquent beaucoup d'anxiété en égale mesure pour le patient et le chirurgien et elles créent également de nombreuses préoccupations juridiques. Les organes les plus fréquemment touchés sont l'uretère, la vessie et l'urètre. Les lésions urologiques en obstétrique et en chirurgie gynécologique devraient toujours être une question de prévention, mais il y a des situations où la ABSTRACT Introduction. Iatrogenic injury of the urinary tract in women undergoing pelvic surgeries is one of the most feared complications and an important source of significant morbidity. Moreover, they cause a lot of anxiety to both patient and surgeon and they also create many legal concerns. The most commonly affected organs are the ureter, bladder and urethra. Urologic injury during obstetrics and gynecologic surgery should always be a matter of prevention, but there are situations in which prevention fails. With this article we intend to raise the awareness on potential situations leading to iatrogenic urinary tract lesions during obstetrics and gynecology surgery.

Malpractice is a relatively new term in terms of litigation. Prior to the early 18 th century, medical malpractice lawsuits were mainly limited to cases that resulted in severe injury and death. At the beginning of the 19 th century, things started to change for the medical practitioners, unfortunately not in a good way. What seemed to have started in the USA, spread like fi re throughout the Western Europe. This state of affair prompted physicians to practice the socalled "defensive medicine". It is well known that surgery in general and urologic surgery in particular is associated with iatrogenic injury and high-risk procedures that do not always have a positive outcome. Moreover, offi ce urology seems to also imply a high degree of litigation risk. The aim of this paper was to determine the fi elds in Urology that are most prone to litigation and malpractice lawsuits.

Endometriosis is an important public health issues concerning women of reproductive age due to its debilitating painful symptoms. Deep infiltrating endometriosis is the severe form, involving uterosacral ligaments, rectum, bowel and bladder. There is no optimal treatment for this disease, but there are 3 main therapeutic options: medical, surgical and a combination of both. A modern approach for the treatment of endometriosis pain uses dienogest, a progestin, as a long-term solution for women who do not wish to procreate or to whom surgery is not an option. Dienogest 2mg daily has a positive effect on the reduction of pain and endometrial lesions when used perioperatively or as a long-term postoperative treatment. This article focuses on the literature evidence on the efficacy of newly approved oral synthetic progestins in the treatment of severe endometriosis.