Elena Claudia Coculescu

Burn healing should be regarded as a dynamic process consisting of two main, interrelated phases: (a) the inflammatory phase when neutrophils and monocytes infiltrate the injury site, through localized vasodilation and fluid extravasation, and (b) the proliferative-remodeling phase, which represents a key event in wound healing. In the skin, both canonical autophagy (induced by starvation, oxidative stress, and environmental aggressions) and non-canonical or selective autophagy have evolved to play a discrete, but, essential, “housekeeping” role, for homeostasis, immune tolerance, and survival. Experimental data supporting the pro-survival roles of autophagy, highlighting its Yang, luminous and positive feature of this complex but insufficient explored molecular pathway, have been reported. Autophagic cell death describes an “excessive” degradation of important cellular components that are necessary for normal cell function. This deadly molecular mechanism brings to light the darker, concealed, Yin feature of autophagy. Autophagy seems to perform dual, conflicting roles in the angiogenesis context, revealing once again, its Yin–Yang features. Autophagy with its Yin–Yang features remains the shadow player, able to decide quietly whether the cell survives or dies.

Patients suffering from diabetes fall into the category of persons with a proven risk of developing a form of severe disease, as well as with a higher risk of mortality. For this reason, the infection with the new coronavirus (COVID-19) - which implies a wide range of clinical manifestations, from asymptomatic to fatal cases - is an important problem for these patients. Through this article we aimed to briefly present the general characteristics and evolution of SARS-CoV-2 infection in patients with diabetes in a group of patients with these characteristics, hospitalized in the Infectious Diseases Hospital of Iasi. We have addressed the potential mechanisms that may increase the susceptibility of diabetic patients to COVID-19. The obesity, cardiovascular, lung and chronic kidney disease, but also the serum levels of C-reactive protein, dDimers, creatinine and glucose, are valuable predictors of the severity and evolution of SARS-CoV-2 infection.

Diabetes mellitus (DM) is a metabolic disorder being considered a real health problem. In low and middle income countries, diabetes is often inadequately treated and undiagnosed due to lack of awareness of the symptoms and limited access to healthcare services. Thus far, no analysis of deaths among diabetics has been performed from a forensic perspective. This research analyzed a total of 4.438 cases of autopsy files, by accessing the archive of the Institute of Legal Medicine in Iasi, Romania, over a period of 5 years, identifying 235 cases with DM, of which 7 cases of type 1 DM (3%), 192 cases of type 2 DM (81.7%) and 36 cases of unspecified DM (15.3%). The study includes a complete view with macroscopic, histopathological and toxicological analysis, but also investigation data and medical information. This study offers the first forensic perspective of people known to have DM who died in North-Eastern Romania. The diagnosis of DM was identified in most cases in the content of the autopsy files and never in the death certificate. The number of identified diabetics represents the minimum number in forensic cases for the period and area investigated. Acute diabetic complications were not found in this study as medical cause of death. This research brings into discussion a pathology that in forensic medicine in Romania is disputed and often underestimated, proving once again the importance of studying the carbohydrate metabolic imbalance by applying postmortem biochemistry in every forensic service.

The study analyses the significance of the plasmatic values of the OPN dosed to 91 people suffering from diastolic cardiac dysfunction with preserved ejection fraction, thus revealing significant growths of its level compared to the normal value. Despite being a clinical research, its conclusions are a breakthrough, differing from the results of other studies published in the relevant medical literature. We can make this assertion because this study analyses the clinical information given by the circulating values of the OPN, based on experimental models (animals), or on patients with congestive heart failure, which can be identified with the existence of a low systolic flow. The results of our study allow us to assert that the plasmatic values of this glycoprotein lead to its acceptance in the medical practice as a new biomarker that provides indicators regarding the stratification of risk with the patients suffering from heart failure of the diastolic dysfunction type, but whose systolic flow is preserved.