"Gender specific medicine": a focus on gender-differences in hypertension.

Hypertension, worldwide considered the most frequent disease, is one of the major contributors to the leading cause of death in women: cardiovascular diseases. Until recently, women have been underestimated in clinical trials. Menopause represents the moment when the so-called "female advantage" is reversed. This review is presenting some gender-specific differences that explain why women are more exposed, especially if obesity is present in post-menopausal women, to hypertension complications. The smaller percentage of optimal controlled blood pressure values in hypertensive women is explained by a lesser adherence to lifestyle modifications and to drug therapy. All these gender-associated differences must be considered in hypertension management of women.

"Don't worry, be happy"--may be a first line therapy in cardiovascular diseases?

Cardiovascular diseases represent the most frequent type of pathology nowadays. One can consider that their high prevalence is generated by an unhealthy living style, by the increasing prevalence of all kind of metabolic abnormalities, by smoking and other bad habits, but we must not forget the role of stress. The present paper highlights the fact that a pathophysiological link between stress, adverse affect and poor quality of sleep and cardiovascular diseases is represented by the sympathetic overdrive. As opposite, positive affect can offer a significant protection against pro-atherogenic effects that are generating a significant increase of the prevalence and severity of cardiovascular diseases. Finally, the present paper underlines the deleterious cardiovascular effects of antidepressive and antipsychotic drugs, so that the final conclusion is: "Don't worry, be happy" and have positive thoughts for a healthier future.

[Enophthalmos in an orbital tumor]. / Enoftalmia asociata unei formatiuni tumorale iitraorbitale--prezentare de caz clinic.

Enophtalmus is an unusual sign of the orbital tumors often represented by proptosis. One patient with enophtalmus and intraorbital tumor and aplasy is presented. The treatment of choice of orbital tumor is complete surgical excision and careful follow-up. Considering the more aggressive course followed by recurrent tumor, correct diagnosis and management is essential.

[Orbit evisceration: retrospective study on a consecutive series of 10 years]. / Exenteratii de orbita: studiu retrospectiv pe o serie consecutiva de 10 ani.

Exenteration of the orbit is challenging in its anatomical, surgical and postsurgical management-related issues. We describe a surgical series of 65 patients diagnosed at Neurosurgery and Ophthal-mology departments; between 2003 and 2012, 65 cases with intraorbital tumors were identified and underwent partial or total exenteration of the orbit. The most frequent dignosticated tumor which underwent exenteration were spinous and basal carcinoma of the orbit (41.5 %) followed by neurofibroma The most common preoperative sign was proptosis (100%), followed by ocular and orbital pain (6.1%) and visual acuity loss (3.07%). Preoperatively signs included alteration of the facial aspect (96.9%), behavioural, emotional and social difficulties, especially in young people (6,9%). Although there is an extremely mutilant surgical procedure, pain is often relieved. Therefore, the surgical aim should be life preserving and relief of leading symptoms; estetic aspect of the patients was also one of postoperative aims.

[Tonic pupil, pupil Adie syndrome Adie Holmes: current reassessment of terminology -- a clinical case]. / Pupila tonica, pupila Adie sindromul Adie Holmes reevaluarea actuala a terminologiei - prezentare de caz clinic.

The benign syndrome of pupillotonia and absence of deep reflexes is not uncommon. It was clearly and accurately described by Adie (1932), although incompletely recognized many years, before. The pupillary abnormality was reported by ophthalmologists at the turn of the century (Saenger, 1902, Strasburger 1902), and the associated deep reflex change was described by Markus (1906), Roemheld (1921) and Parkes Weber (1923). Holmes (1932) was fully aware of the association of "partial iridoplegia" with diminished reflexes. Tonic pupils react poorly to light but constrict during viewing of a near stimulus. Adie's name is typically used in association with tonic pupils, but a review of Adie's articles reveals that he described the syndrome of tonic pupils and absent reflexes and not the pupillary abnormality per se. Therefore, it would be more appropriate to refer to a tonic pupil as simply a 'tonic pupil" and leave Adie's name for the syndrome. We report a typical case of tonic pupil.

[Diagnosis of orbital cysticercosis -- a challenge for ophthalmologist]. / Diagnosticul cisticercozei orbitale: o reala provocare pentru medicul oftalmolog.

Cysticercosis is a cause of serious ocular/orbital morbidity. Ocular cysticercosis can involve the anterior segment, posterior segment or adnexa. The cysticercus parasite has a predilection for subconjunctival, subretinal and intravitreal structures. Orbital involvement, in which the parasite localises within the extraocular muscle is rare. Orbital cysticercosis commonly presents with signs of inflammation, diplopia, restricted extraocular motility and proptosis. This report is of a 43-year-old woman with orbital cysticercus lying in the intraconal space, in relation with lateral rectus muscle, near to the apex of the orbit, presenting as a diplopia and painless movements of the eyeball.