Cardiac tumors represent a rare and challenging clinical situation. They can be primary (benign or malignant) or secondary (metastatic). Secondary tumors are more frequent than the primary tumors. Most of the primary cardiac tumors are benign and originate from the endocardium or myocardium, while the metastatic tumors develop from lung, breast, kidney carcinoma, melanoma and lymphoma. The diagnosis of cardiac tumors is often difficult because of their rarity, variety and nonspecific symptoms. The clinical manifestations depend on tumor’s size, location, infiltration and consist of four categories: systemic manifestations, cardiac manifestations, embolic events, and metastatic manifestations. Echocardiography represents the main imaging technique used to detect cardiac masses. Computed tomography (CT) and magnetic resonance imaging (MRI) are used to achieve more information about tumor’s composition, extension, vascularization, and possibility of surgical treatment. The histological evaluation is necessary for a positive diagnosis and staging of the cardiac tumor. The treatment of cardiac tumors depends on the type of tumor and symptomatology.

Cardiovascular diseases have been the leading causes of death worldwide. According to the World Health Organisation, an estimated 17.9 million people died from cardiovascular diseases in 2019, meaning 32% of all global deaths. In the last decades there had been ongoing efforts in raising awareness through campaigns about the impact of cardiovascular disease in women. These efforts, combined with a raise in the socio-demographic index, led to a global decline in age-standardised cardiovascular disease mortality in women in the past 30 years. There are many differences regarding the biological, social, research data, access to healthcare between men and women. This review summarises the latest evidence regarding the traditional risk factors for cardiovascular disease in women, the gender disparities that lead to different outcomes in the primary and secondary prevention in men and women and the under recognised risk factors of the modern society, such as depression, anxiety, chronic stress, abuse and intimate violency and environmental risk factors. Most of the risk factors can be identified early in the life of patients and are modifiable, therefore early screening and intensive risk factor modification, along with medications in certain patients, would make a difference in the outcome of the primary prevention.

Abdominal pain is one of the most common symptoms for which patients present to the hospital. The causes of abdominal pain are diverse, so the diagnosis management often involves a multidisciplinary team. The initial evaluation of patients with abdominal pain must focus on excluding conditions that may endanger the patient’s life in short time. The prognosis of patients complaining of abdominal pain proved to be different depending on age. Despite the progress registered in the field of imaging and molecular investigations in recent years, in a significant percentage of patients who present with abdominal pain, the cause is not identified.

Introduction. Renal abscesses can be the result of haematogenous spread or as a rare complication of upper UTI particularly in the setting of renal stones or diabetes. Classically it may present as loin pain, fever, rigors, and tenderness in the costovertebral angle, but may simply manifest as a pyrexia of unknown origin and a raised acute phase response. Case report. We report the case of a 73-year-old female patient with type 2 diabetes mellitus, who presented for abdominal pain, chills, confusion and deterioration of general condition with progressive aggravation of the symptoms, the clinical examination revealed a respiratory rate of 14 breaths per minute, blood oxygen saturation of 98%, heart rate 82 beats per minute, blood pressure 137/75 mmHg and no fever. She had peripheral cyanosis and peripheral pulses were weak in the lower limbs; diuresis was present on the urinary catheter the laboratory and imaging investigations showed inflammatory syndrome ( CRP=255 mg/l ) and the CT showed both kidneys with normal position, a bilateral reduction in renal size, bilateral dilated pyelocaliceal system grade I developed a left renal abscess as a complication of acute pyelonephritis. The primary pathogen identified was Escherichia Coli. Computed tomography revealed a well-defined mass on the left kidney with low attenuation in contact with the renal fascia. Broad spectrum antibiotics and haemodialysis were used as part of conservative management regimen. The patient achieved clinical improvement after 3 weeks and was discharged. Conclusions. The particularities of the case are represented by the fulminant evolution of the infection in a patient with poorly controlled diabetes, the acute kidney injury caused by urosepsis and the progression of pyelonephritis towards the development of a renal abscess. Diabetes mellitus is a disease with a significant prevalence, the incidence of which increases with age and which develops multiple complications. In addition to vascular lesions, diabetic neuropathy or nephropathy, patients have a high risk of developing an infection, the most common being those of the upper urinary tract, which evolve aggressively. The renal abscess is a rare complication of pyelonephritis, but it is to be considered in patients with persistent inflammatory state in despite of the right management.

Introduction. Hypokalemia is a common clinical disorder. The most common causes of hypokalemia are decreased intake, intracellular shift and increased loss of potassium. In clinical practice, most frequently patients present with hypokalemia due to increased loss of potassium, especially renal loss. Case presentation. A 62-year-old woman, known with hypothyroidism under treatment with Euthyrox, diagnosed with COVID-19 four months before, presented for nausea and vomiting, headache, generalised muscular hypotony and palpitations, with the onset three weeks before. On physical examination, the blood pressure was 140/90 mmHg, regular pulse frequency of 96/min, the patient had pale skin and mucosa and abolition of osteotendinous reflexes at the inferior members. The laboratory tests revealed severe hypokalemia and moderate normocytic normochromic anemia, mixed alkalosis. The patient had no history of treatment with diuretics or penicilines, or any other condition that could have explained the severe hypokalemia. The patient was admitted in the Internal Medicine Clinic and treatment with high doses of intravenous potassium chloride, potassium - sparing diuretic (Spironolactone) and supplements of potassium and magnesium was initiated, with partial correction of the serum potasssium level. The patient was extensively investigated, to establish the etiology of kypokalemia. Finally, the only identified cause was a nephropathy with losses of potassium. Conclusions. Hypokalemia can be determined by multiple factors, such as digestive or renal losses, during a long term hospitalization. Proper treatment of substitution may lead to normal values of serum potassium and a better life quality.