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Concerns for successful public health management are integrated into the core business of government-responsible institutions. Diseases associated with metabolic syndrome are very common in the Romanian population. In our study, we focused on the cardiovascular and non-alcoholic fatty liver disease (NAFLD). The article starts from the hypothesis that the increased incidence of such diseases is determined today by the cumulative effect of traumatic historical events such as the famine of 1946-47 and the communist political regime specific to the 80s and 90s. This study aims to present the arguments that indicate the correlation of economic variables whose variation can be easily determined by traumatic events that affected the economy, with variables able to measure the incidence of various diseases usually associated with metabolic syndrome or NAFLD. A series of statistical data were analyzed from the official sources available in the form of consecutive value data for the 1995-2018 period. The results highlighted a direct and strong link between the variable gross domestic product (GDP) per capita in USD, 2011 purchasing power parity (PPP) and specific incidence of circulatory, nutritional endocrine and metabolic diseases, as well as a strong and inverse link between GDP and infant’s deaths per 1000 live births. Conclusions highlight that the effects of traumatic historical events must be made aware through medical education of the population, supporting the idea according to which the incidence of various metabolic diseases is greater for the offspring of those who have actively suffered during such events. [ABSTRACT FROM AUTHOR]

AFP (alpha-fetoprotein) levels are increased during the development of HCC (hepatocellular carcinoma); nonetheless, it can also be produced by non-tumoral hepatocytes in conditions of high cell turnover. Our study aims to provide additional data regarding the causes of elevated AFP in patients with liver cirrhosis due to hepatitis C virus (HCV) infection. We conducted an observational prospective cohort study that included 2068 patients with compensated cirrhosis and chronic hepatitis C genotype 1b infection. The two main inclusion criteria were the presence of advanced liver fibrosis - Metavir stage F4 - diagnosed by FibroMax testing, Fibroscan or liver biopsy, and the presence of detectable HCV RNA in the serum. Plasmatic AFP levels were determined through the electrochemiluminescence method, with a standard value ranging from 0 to 7 ng/ml. All data were obtained from the Romanian National Health Agency. The average AFP serum levels in patients with compensated cirrhosis without HCC were 9.4 ng/ml (range 0.5 ÷ 406 ng/ml); 30.1% of patients had significantly increased levels of AFP (>15 ng/ml). High values of serum AFP in patients with compensated liver cirrhosis without HCC was correlated with more advanced age (p<0.001), severe necroinflammatory activity detected by FibroMax (p<0.001), severe NASH (p<0.001), severe steatosis (p<0.001), low platelets (p<0.001), increased values of AST and ALT (p<0.001). [ABSTRACT FROM AUTHOR]

Introduction: Iron deficiency has been known to cause significant functional impairment, lower quality of life and higher morbidity and mortality. The aim of this study was to estimate the prevalence and significance of iron deficiency in our patients and medical staff. Material and methods: We performed a prospective cross-sectional study: In July 2016, 383 persons were screened for the presence of iron deficiency (ID): 325 patients and 58 people from the medical staff. Transferrin saturation (TSAT), serum ferritin (SF) and complete blood count were performed. Absolute ID was diagnosed if SF <100 ng/ml and TSAT <20%. Relative ID was defined by SF >100 ng/ml and TSAT <20%. Results: The group of medical staff was younger and had a greater proportion of women. The prevalence of absolute ID was 22.5% in patients and 43.1% in medical staff; relative ID was present in 15% of patients and 1.7% of medical staff. Among patients, the absolute ID was significantly correlated with the female sex (p=0.002) and pre-menopausal status (p=0.01) but did not correlate with diagnosis, age, BMI, nonsteroidal anti-inflammatory drug (NSAID), aspirin or acenocoumarol consumption. The relative ID is associated with advanced age (p=0.03) and diagnosis of cancer and liver cirrhosis (p=0.01). Conclusions: Absolute ID had a high prevalence among patients (22.5%), but there was even a bigger issue among the medical staff (43.1%). Absolute ID was correlated with female sex and pre-menopausal status. Relative ID was related to advanced age, cancer and liver cirrhosis. [ABSTRACT FROM AUTHOR]