Background: The connection between uric acid (UA) and renal impairment is well known due to the urate capacity to precipitate within the tubules or extra-renal system. Emerging studies allege a new hypothesis concerning UA and renal impairment involving a pro-inflammatory status, endothelial dysfunction, and excessive activation of renin–angiotensin–aldosterone system (RAAS). Additionally, hyperuricemia associated with oxidative stress is incriminated in DNA damage, oxidations, inflammatory cytokine production, and even cell apoptosis. There is also increasing evidence regarding the association of hyperuricemia with chronic kidney disease (CKD), cardiovascular disease, and metabolic syndrome or diabetes mellitus. Conclusions: Important aspects need to be clarified regarding hyperuricemia predisposition to oxidative stress and its effects in order to initiate the proper treatment to determine the optimal maintenance of UA level, improving patients’ long-term prognosis and their quality of life.

Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) are two conditions with an increased incidence and prevalence. Numerous studies highlight the pathophysiological links between HFpEF and AF and the common risk factors. Patients with HFpEF have a high incidence of AF. It is difficult to determine which of the pathologies appears first: HFpEF or AF. In HFpEF, left atrium suffers a structural and functional remodelling process, which contributes to the occurrence of AF. Also, AF determines dyastolic dysfunction, the main mechanism for HFpEF development. The diagnosis of HFpEF in the presence of AF is more difficult, because the symptoms of HF resemble those of AF. Also, the presence of AF makes more difficult the correct echocardiographic evaluation of patients with HF. More research is needed in order to develop new therapies that can improve the prognosis of patients with HFpEF and AF.

Chronic liver diseases are a public health issue, because of their high incidence and prevalence, the important impact on the quality of life and high mortality rates. From a pathogenic point of view, in almost all liver diseases there is an increase in oxidative stress. Oxidative stress represents as an imbalance between the production of oxidizing agents and antioxidants. This imbalance contributes to the initiation and progression of hepatic injury. Among the most important risk factors for increased oxidative stress in chronic liver diseases are alcohol, drugs, environmental pollutants and irradiation. For the restoration of the oxidant-antioxidant balance and reduction of the oxidative stress in chronic liver diseases, a promising role may have the antioxidants. This hypothesis is now based on experimental evidence of their efficacy in animal models. In low concentrations, antioxidants improve liver function by preventing the oxidation of an oxidizable substrate, but in high doses, they may cause adverse reactions, such as the pro-oxidant effect, glutathione S transferase inhibition and thus the inhibition of detoxification and interference with coagulation. The objective of the article is to review the benefits of antioxidant treatment in chronic diseases of the liver, in order to put them in balance with their adverse reactions.

Pain is a very important issue to take into account during hospitalization. Nefopam, a centrally acting analgesic, has a relative safety pharmacological profile with few and well-tolerated side effects, being used to treat acute or chronic pain. It inhibits the central reuptake of serotonin, norepinephrine and dopamine and modulates the sodium and calcium channels having only few contraindications. Nefopam can be part of balanced analgesia along with others non-opioids agents in order to reduce the opioid consumption and their complications, to control postoperative pain and to reduce the risk of neuropathic pain appearance. In order to avoid its adverse reactions, a slow infusion is always recommended. Nefopam has its role in preventing the shivering appearance during neuraxial or general anesthesia, can modulate the emergence agitation after nasal and maxillofacial surgery and can inhibit the sever hiccup during mechanical ventilation. Some cases about fatal overdoses are reported in the literature.

Retroperitoneal space is called sometimes no man�s land�and for a good reason: this is disputed anatomical territory for many surgical and medical specialties. Their wide histological diversity and unspecific clinical presentation make them a challenge for the surgeon. In order to improve their detection immunohistochemistry seems to show promising results. Methods of detection have evolved over time to identify as much as possible the histological type of tumor. Because of this extreme variability immunohistochemistry through its various markers is the one that often sets the definitive diagnosis, the simple histopathological examination being insufficient. This paper aims to highlight the main markers used in retroperitoneal tumors. As it can be seen there is a huge histologic areal for these tumors. Some have proven some of them still not. Given the fact that there is a tendency toward personalized therapy it is imperative to identify the histological type of tumor as soon as possible.