Pulmonary hypertension (PH) is a rare disease characterized by considerable morbidity and mortality. Significant progress has been recently achieved in enhancing the identification, diagnosis, and treatment of the disease, as evidenced by the latest guideline. Several additional medical conditions can complicate the overall understanding of the patient s condition, making the diagnosis even more difficult. Genetic and molecular factors, certain toxic drugs (such as methamphetamines, desatinib, or anorexigens), systemic disorders, or other predisposing conditions lead to the remodeling of distal pulmonary arterioles, resulting in pulmonary hypertension. Non-invasive investigations are initially undertaken in suspected cases based on cardiac biomarkers, lung function, and echocardiograms. Nowadays, the definition of pulmonary hypertension (PH) has recently changed, now including patients with mean pulmonary artery pressure >20 mmHg, and hemodynamic evaluation with right heart catheterization remains the diagnostic gold standard. Beyond new medically targeted therapies, there is a greater appreciation for the importance of supervised training in stable PH and the possible role of interventional therapies in select cases. The landscape of PH is in constant change, characterized by progress, innovation, and new medical opportunities.

Takotsubo syndrome, also known as Takotsubo cardiomyopathy, stress-induced cardiomyopathy, transient apical ballooning and broken heart syndrome, is a disease characterized by transient regional left ventricular systolic dysfunction. It is usually determined by emotional or physical stress. Even though it was thought to be a self-limiting condition, Takotsubo syndrome is now known to be associated with important short and long-term morbidity and mortality. Takotsubo syndrome affects 2-3% of all patients and 5-6% of female patients presenting with acute coronary syndrome (frequently women in the sixth decade). The Takotsubo syndrome cases are mostly preceded by acute emotional or physical triggers such as: family death, financial loss, anxiety, excessive work, domestic abuse, anxiety, fear for medical procedures, severe pain, sepsis, post-surgeries, and cancer. Diagnosis of Takotsubo syndrome can sometimes be difficult due to clinical manifestations similar to acute myocardial infarction. Myocardial necrosis biomarkers (Troponin I, Troponin T and Creatinin kinase) are elevated, with values comparable to those in patients with acute myocardial infarction. Transthoracic echocardiography usually shows akinetic or dyskinetic apical and mid-ventricular segments of the left ventricle compared to the hyperkinetic basal segments (“apical ballooning” aspect) and left ventricle systolic dysfunction. The positive diagnosis of Takotsubo syndrome is made on coronary angiography, normal or non-obstructive coronary artery disease.

Tinnitus and hearing loss are the most common effects of long-term exposure of the hearing system to a noisy environment. Nowadays, due to continuing exposure to noise, an exquisite number of over 430 million individuals worldwide are experiencing hearing deficits, specifically young people aged between 12 and 35 years who are prone to severe hearing loss [1]. People with hearing loss experience a decrease in quality of life because of the lack of a cure for noise-related hearing loss due to its complicated pathophysiology. This summary focuses on key pathways of hearing loss damage, pharmacological treatments, and current prevention and therapy approaches.

Introduction: Renal biopsy is an important tool for the diagnosis of renal pathologies and for the choice of subsequent treatment tactics. Objectives: To report the epidemiology of glomerulonephritis in the Republic of Moldova, based on histological diagnosis, and set up the premises for the creation of the National Renal Biopsy Registry. Material and methods: The histological results of percutaneous renal ultrasound-guided biopsies, performed from March 30 to February 19, 2023, were evaluated in the Timofei Mo?neaga Republican Clinical Hospital, Chisinau. Demographic characteristics, paraclinical parameters (serum creatinine, serum urea, glomerular filtration rate, nictemeral protein), and histological results were analyzed. Results: The outcomes of kidney biopsies performed on fifty-three patients were examined. The prevalence of renal pathologies in young and mature adults was observed, with the average age being 46.2 years. Most of the examined patients were men (71.70%). The main indication for performing renal biopsy was nephrotic syndrome, present in 64.15% of patients. The most common types of primary glomerulonephritis were membranous glomerulonephritis (50% of cases) and membranoproliferative glomerulonephritis (20% of cases). The most frequent types of secondary glomerulonephritis were lupus nephropathy (40%) and renal amyloidosis (30%). Conclusions: This study provides the first image of the current spectrum of glomerular kidney disease in the Republic of Moldova. It also serves as the basis for the development of the National Renal Biopsy Registry, which can serve as a useful resource for health policy development.

The presence of multiple unknowns and uncertainty factors in medical research has made it extremely challenging to distinguish the preclinical phase of a chronic disease, such as the metabolic syndrome (MS), from the initial condition of health. MS is a complex and multifactorial medical condition characterized by the presence of at least three of the following conditions: high insulin levels (normal HOMA qualitative index < 2), elevated serum glucose level > 126 mg/dl, patients with abdominal obesity, a body mass index (BMI) = 30 kg/m2, a lipid panel showing a triglyceride level = 150 mg/dl, and HDL-CO < 35 mg/dl in men and < 45 mg/dl in women. In all developed countries, the number of obese people diagnosed with insulin resistance (IR) has rapidly increased to > 40% in recent years. This condition precedes the development of MS. The likelihood of having MS rises with advancing age. Additionally, new research has identified other influential hormones produced by adipose tissue that significantly impact metabolism, such as lipid cytokines, leptin, adiponectin, and rezistin. Researchers believe that central obesity and the chronic inflammatory process play a key role in the development of metabolic syndrome and focus on mitochondrial dysfunction, changes in the gut microbiome, and pancreatic beta cell dysfunction. The primary determinant in averting the development of MS is humanity s struggle against its own bioenergetic entropy, which may induce catabolic processes that abbreviate life expectancy while promoting negentropy until the fulfillment of the life program predetermined in the genetic code.