Publications by authors named "Aida Petca"

26 Publications

  • Page 1 of 1

Benefits of α-lipoic acid in high-risk pregnancies (Review).

Exp Ther Med 2021 Nov 31;22(5):1232. Epub 2021 Aug 31.

Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

α-Lipoic acid (ALA) is a natural molecule that is inconsistently synthesized by the human body and must be provided from exogenous sources, such as food and dietary supplements. Once absorbed, the oxidized form of ALA is transformed into its reduced form, dihydrolipoic acid (DHLA). ALA/DHLA exert direct and indirect antioxidant, anti-inflammatory and fine immunomodulatory effects. ALA/DHLA reduce the levels of pro-inflammatory cytokines (IL-1β, IL-6, IL-8 and IL-17), while increasing the secretion of anti-inflammatory cytokines (IL-10). They also inhibit cyclooxygenase 2, thereby decreasing the secretion of prostaglandin E2 and nitrogen oxide, and reducing the risk of miscarriage in the first trimester of pregnancy. In patients at risk of abortion, administration of ALA from the first trimester has shown efficacy by accelerating subchorionic hematoma resorption, with a significant decrease in the accompanying abdominal pain. ALA has been proven to be efficient in maintaining the length of the cervix and keeping it closed following one episode of premature labor. Preeclampsia is a dysfunction caused by abnormal placentation and an excessive maternal inflammatory response, leading to extreme hypoxia in the placental bed and exaggerated oxidative stress, with release of oxygen free radicals. Oxidative stress plays a key role in the development of preeclampsia and intrauterine growth restriction. The hypothesis of antioxidant supplementation may play an essential part in disease prevention and fetal neuroprotection.
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http://dx.doi.org/10.3892/etm.2021.10666DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438679PMC
November 2021

infection characteristics in a general surgery clinic.

Exp Ther Med 2021 Oct 3;22(4):1112. Epub 2021 Aug 3.

Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

(CD) is an anaerobic, gram-positive bacterium that can produce a spectrum of gastrointestinal diseases ranging from pseudomembranous colitis to diarrhea to toxic megacolon. The infection is even more difficult to manage as CD produces high-end spores, suggesting that this may be the cause of the dangerous recurrent disease as well as dissemination among healthy members in the community. Spores can be hosted in the digestive tract of both symptomatic and asymptomatic patients. The most relevant risk factor in the development of infection (CDI) seems to be the overuse of antimicrobials. Comorbidities are another risk factor that may predispose towards more serious CDI. Treatment options vary from oral antibiotics to extensive surgical interventions. The present study aimed to analyze the prevalence, severity, and management of CDIs in a general surgery department in an effort to determine the correlative elements between the infection and surgical pathology.
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http://dx.doi.org/10.3892/etm.2021.10546DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383759PMC
October 2021

Hyperthyroidism management during pregnancy and lactation (Review).

Exp Ther Med 2021 Sep 7;22(3):960. Epub 2021 Jul 7.

Department of Endocrinology 'Titu Maiorescu' University, University of Medicine and Pharmacy, 031593 Bucharest, Romania.

Thyroid dysfunction is a significant public health issue, affecting 5-10 more women compared to men. The estimated incidence is up to 12% and only for women the treatment rises up to 4.3 billion dollars annually. Thyroid pathology can have a major impact on female fertility and it can only be detected when preconception tests are performed. Untreated or poorly treated hyperthyroidism in a mother can affect the fetal development and pregnancy outcome. Between 0.1 and 0.4% of the pregnancies are affected by clinical hyperthyroidism. Thyroid dysfunction is associated with higher rates of pregnancy loss. Hyperthyroidism can complicate fetal health problems intrauterinely and in the neonatal period. The TSH receptor is stimulated by TSH and HCG which has a similar structure. This can lead to gestational thyrotoxicosis. Hyperthyroidism can be treated with propylthiouracil or methimazole and in selected cases, surgical treatment or radioactive iodine can be chosen. In pregnancy, the most used treatment is represented by propylthiouracil which can be used from the first trimester. The aim of this review is to assess the current data regarding the impact of thyroid dysfunction on pregnancy and to synthesize the treatment options during pregnancy and lactation.
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http://dx.doi.org/10.3892/etm.2021.10392DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290437PMC
September 2021

Anorexia nervosa: COVID-19 pandemic period (Review).

Exp Ther Med 2021 Aug 26;22(2):804. Epub 2021 May 26.

Department of Endocrinology, Clinical County Hospital, 400000 Cluj-Napoca, Romania.

Anorexia nervosa is an eating disorder characterized by restrictive eating and an intense fear of gaining weight. It is a disease with an increasing incidence during the last few decades, and represents a complex psychiatric condition which includes secondary amenorrhea, nutritional and metabolic damage, and impaired endocrine panel up to bone loss as well as cardiac, gastrointestinal and hematological complications. This is a narrative review which includes an update on this eating disorder from the perspective of an endocrine panel of anomalies, especially of the skeleton, considering the pressure of the recent global COVID-19 pandemic changes. Practically affecting every organ, anorexia nervosa needs to be taken into consideration during the pandemic period because of the higher risk of relapse due to new living conditions, social distancing, self-isolation, changes in food access, more intense use of social media platforms, disruption of daily habits, and more difficult access to healthcare practitioners. The lack of physical activity in addition to vitamin D deficiency related to low sun exposure or to the use of facial masks may also be connected to further bone damage related to this disease.
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http://dx.doi.org/10.3892/etm.2021.10236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170656PMC
August 2021

Heterogeneity of Antibiotics Multidrug-Resistance Profile of Uropathogens in Romanian Population.

Antibiotics (Basel) 2021 May 2;10(5). Epub 2021 May 2.

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu-Mures, 38 Gheorghe Marinescu Str., 540139 Targu-Mures, Romania.

Urinary tract infections (UTIs) are a leading cause of morbidity for both males and females. The overconsumption of antibiotics in general medicine, veterinary, or agriculture has led to a spike in drug-resistant microorganisms; obtaining standardized results is imposed by standard definitions for various categories of drug-resistant bacteria-such as multiple-drug resistant (MDR), extensive drug-resistant (XDR), and pan drug-resistant (PDR). This retrospective study conducted in three university teaching hospitals in Romania has analyzed urine probes from 15,231 patients, of which 698 (4.58%) presented multidrug-resistant strains. was the leading uropathogen 283 (40.54%), presenting the highest resistance to quinolones (R = 72.08%) and penicillin (R = 66.78%) with the most important patterns of resistance for penicillin, sulfonamides, and quinolones (12.01%) and aminoglycosides, aztreonam, cephalosporins, and quinolones (9.89%). spp. followed-260 (37.24%) with the highest resistance to amoxicillin-clavulanate (R = 94.61%) and cephalosporins (R = 94.23%); the leading patterns were observed for aminoglycosides, aminopenicillins + β-lactams inhibitor, sulfonamides, and cephalosporins (12.69%) and aminoglycosides, aztreonam, cephalosporins, quinolones (9.23%). The insufficient research of MDR strains on the Romanian population is promoting these findings as an important tool for any clinician treating MDR-UTIs.
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http://dx.doi.org/10.3390/antibiotics10050523DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147389PMC
May 2021

COVID-19-related thyroid conditions (Review).

Exp Ther Med 2021 Jul 13;22(1):756. Epub 2021 May 13.

Departament of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 050474, Bucharest, Romania.

In patients who were not previously diagnosed with any thyroid conditions, the scenario of COVID-19-related anomalies of the hypothalamus-pituitary-thyroid axes may include either: A process of central thyroid stimulating hormone (TSH) disturbances via virus-related hypophysitis; an atypical type of subacute thyroiditis which is connected to the virus spread or to excessive cytokine production including a destructive process with irreversible damage of the gland or low T3 (triiodothyronine) syndrome (so called non-thyroid illness syndrome) which is not specifically related to the COVID-19 infection, but which is associated with a very severe illness status. Our objective here was to briefly review thyroid changes due to the COVID-19 infection. Ongoing assessment of the effects of the COVID-19 pandemic will reveal more information on coronavirus-induced thyroid conditions. Routine thyroid assays performed in patients with severe infection/at acute phase of COVID-19 are encouraged in order to detect thyrotoxicosis. After recovery, thyroid function should be assessed to identify potential hypothyroidism. There remain unanswered questions related to the prognostic value of interleukin-6 in infected patients, especially in cases with cytokine storm, and the necessity of thyroid hormone replacement in subjects with hypophysitis-related central hypothyroidism.
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http://dx.doi.org/10.3892/etm.2021.10188DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135141PMC
July 2021

Chemical hemorrhagic cystitis: Diagnostic and therapeutic pitfalls (Review).

Exp Ther Med 2021 Jun 14;21(6):624. Epub 2021 Apr 14.

Department of Urology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology of Targu-Mures, 540139 Targu-Mures, Romania.

Chemical cystitis (CC) is an inflammation of the bladder caused by various chemical agents ingested intentionally or accidentally. It is linked to chemotherapeutic agents such as cyclophosphamide, therapeutic agents for diverse diseases, and anesthetic agents consumed abusively for recreational effects such as ketamine, or can be linked to environmental and surrounding factors such as soaps, gels, spermicides, and dyes. CC is a pathology with an increasing incidence that is inadequately treated due to its infectious cystitis-like symptoms. The hemorrhagic form can have a rampant evolution. Treatment options of CC and its complications are under continuous research with no accepted standardized sequence. In many situations, the treatments are difficult to obtain, administer, and follow-up. In addition, the lack of experience of the physician may pose other obstacles in delivering treatment to the patient. In conclusion, CC is a disease with an increasing incidence, challenging to diagnose, which is frequently mistreated, and has multiple treatment modalities that still require standardization in administration and sequencing.
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http://dx.doi.org/10.3892/etm.2021.10056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082586PMC
June 2021

Adherence to Anti-Osteoporotic Treatment and Clinical Implications after Hip Fracture: A Systematic Review.

J Pers Med 2021 Apr 24;11(5). Epub 2021 Apr 24.

"Carol Davila", University of Medicine and Pharmacy, 050474 Bucharest, Romania.

The role of anti-osteoporotic treatment as part of the secondary prevention after hip fracture in terms of mortality and re-fracture risk has been studied, and the results are promising. Decreased treatment adherence and compliance is a problem that needs to be addressed by healthcare professionals. A systematic review of the literature was performed using the PubMed database with terms that included hip fracture, mortality, second fracture, and specific anti-osteoporotic treatment. We included 28 articles, 21 regarding mortality and 20 re-fracture rates in hip fracture patients. All studies showed lower mortality after hip fracture associated with anti-osteoporotic treatment, mostly bisphosphonate agents. The re-fracture risk is still debatable, since conflicting data were found. Although most of the studies showed notable effects on mortality and re-fracture rates associated with anti-osteoporotic treatment, we still need more data to validate the actual results.
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http://dx.doi.org/10.3390/jpm11050341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146075PMC
April 2021

Cutaneous Mastocytosis in Childhood-Update from the Literature.

J Clin Med 2021 Apr 2;10(7). Epub 2021 Apr 2.

"Carol Davila" University of Medicine and Pharmacy, 030167 Bucharest, Romania.

Mastocytosis (M) represents a systemic pathology characterized by increased accumulation and clonal proliferation of mast cells in the skin and/or different organs. Broadly, M is classified into two categories: Cutaneous mastocytosis (CM) and systemic mastocytosis (SM). In children, CM is the most frequent form. Unfortunately, pathogenesis is still unclear. It is thought that genetic factors are involved, but further studies are necessary. As for features of CM, the lesions differ in clinical forms. The most important fact is evaluating a pediatric patient with CM. It must comprise laboratory exams (with baseline dosing of total serum tryptase), a skin biopsy (with a pathological exam and, if the diagnosis is unclear, immunohistochemical tests), and a complete clinical evaluation. It is also defining to distinguish between CM and other diseases with cutaneous involvement. As for the management of CM in children, the first intervention implies eliminating trigger factors. The available cures are oral H1 and/or H2 antihistamines, oral cromolyn sodium, oral methoxypsoralen therapy with long-wave psoralen plus ultraviolet A radiation, potent dermatocorticoid, and calcineurin inhibitors. In children, the prognosis of CM is excellent, especially if the disease's onset is in the first or second years of life.
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http://dx.doi.org/10.3390/jcm10071474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038134PMC
April 2021

Teratogenic effect of isotretinoin in both fertile females and males (Review).

Exp Ther Med 2021 May 23;21(5):534. Epub 2021 Mar 23.

Department of Dermatology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania.

Isotretinoin is an oral derivate of vitamin A that has been used since 1982 for the treatment of multiple dermatologic conditions such as severe acne, rosacea, scarring alopecia, ichthyosis or non-melanoma skin cancer prophylaxis. The recommended dose is 0.5-1 mg/kg/day for a period of 4-6 months in sebaceous gland pathologies. There are many adverse effects caused by isotretinoin but by far the most important is the teratogenicity induced by this drug which is estimated to have a 20-35% risk to infants that are exposed to isotretinoin and includes numerous congenital defects such as craniofacial defects, cardiovascular and neurological malformations or thymic disorders. Isotretinoin induces apoptosis and cell cycle arrest in human sebocytes, emphasizing these as processes associated with its teratogenic effect. The aim of this review is to analyze the latest literature data regarding the teratogenic effect of isotretinoin for both fertile females and males and its biological effects underlying the occurrence of congenital malformations under the influence of isotretinoin.
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http://dx.doi.org/10.3892/etm.2021.9966DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014951PMC
May 2021

Delivery and breastfeeding in pregnant patients with COVID-19 (Review).

Exp Ther Med 2021 Mar 25;21(3):278. Epub 2021 Jan 25.

Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

COVID-19 infection has rapidly become a global issue that has brought essential changes in the daily life of patients and doctors. The pandemic outbreak represents a significant burden on humankind; yet, life still moves on with approximately 350,000 babies being born every day around the world (UNICEF-2018). Some of these mothers will have other conditions, including COVID-19 infection. As healthcare providers, it is our responsibility to treat all women equal no matter what illness they have and to offer them the best possible conditions to give birth vaginally or via Caesarian section, in a safe environment for them and their babies. The main concern is represented by the limitation of the disease transmission to pregnant patients and newborns while managing maternal or fetal emergencies. We have limited information regarding COVID-19 infection, and the data are constantly changing and evolving. New information is brought to light almost on a weekly basis. This review aims to synthesize the recommendations and current experience regarding the birth method for infected women, labor management, Caesarian section management, and breastfeeding indications in these cases.
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http://dx.doi.org/10.3892/etm.2021.9709DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851677PMC
March 2021

Non-sexual HPV transmission and role of vaccination for a better future (Review).

Exp Ther Med 2020 Dec 13;20(6):186. Epub 2020 Oct 13.

'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Human papilloma viruses (HPVs) belong to the Papillomaviridae family and are epitheliotropic infecting squamous epithelia (skin and mucosae). HPV is estimated to be the cause of 99% of cervical cancers (there is no evidence of significant genetic predisposition for cervical cancer), 90% of anal cancer, 65% vaginal cancers, 50% vulvar cancers, and 45-90% oropharyngeal cancers. The route of HPV transmission is primarily through skin-to-skin or skin-to-mucosa contact. Sexual transmission is the most documented, but there have been studies suggesting non-sexual courses. The horizontal transfer of HPV includes fomites, fingers, and mouth, skin contact (other than sexual). Self-inoculation is described in studies as a potential HPV transmission route, as it was certified in female virgins, and in children with genital warts (low-risk HPV) without a personal history of sexual abuse. Vertical transmission from mother to child is another HPV transfer course. Several studies have emphasized the possibility of infection through the amniotic fluid, or the placenta, or via contact with maternal genital mucosa during natural birth. Waterborne transmission of HPV has never been demonstrated; however, HPV DNA has been detected in water environments. Routine hygiene measures are proven to be inefficient in preventing HPV transmission, as the studies which have evaluated samples of HPV on contaminated medical equipment (after standard disinfection) have found them to be still positive. Annual costs associated with the morbidity and mortality of HPV-related diseases are estimated at approximately $4 billion. Once the HPV vaccine program in Australia was launched, many studies reported the initial effects: A decrease in the incidence of high-grade cervical abnormalities, no new genital warts cases in females under 21 years. Promoting greater understanding in the general public about the evident benefits of vaccination can create positive vaccine attitudes and scatter the myths of spurious side effects.
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http://dx.doi.org/10.3892/etm.2020.9316DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579832PMC
December 2020

Carcinogenic effects of bisphenol A in breast and ovarian cancers.

Oncol Lett 2020 Dec 23;20(6):282. Epub 2020 Sep 23.

Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Endocrine-disrupting chemicals (EDCs) are exogenous chemical compounds ubiquitously found in everyday life of the modern world. EDCs enter the human body where they act similarly to endogenous hormones, altering the functions of the endocrine system and causing adverse effects on human health. Bisphenol A (BPA), the principal representative of this class, is a carbon-based synthetic plastic, and a key element in manufacturing cans, reusable water bottles and medical equipment. BPA mimics the actions of estrogen on multiple levels by activating estrogen receptors α and β. BPA regulates various processes, such as cell proliferation, migration and apoptosis, leading to neoplastic changes. Considering genetic mechanisms, BPA exerts its functions via multiple oncogenic signaling pathways, including the STAT3, PI3K/AKT and MAPK pathways. Furthermore, BPA is associated with various modifications of the reproductive system in both males and females. These alterations include benign lesions, such as endometrial hyperplasia, the development of ovarian cysts, an increase in the ductal density of mammary gland cells and other preneoplastic lesions. These benign lesions may continue to develop to breast or ovarian cancer; the effects of BPA depend on various molecular and epigenetic mechanisms that dictate whether the endocrine or reproductive system is impacted, wherein preexisting benign lesions can become cancerous. The present review supports the need for continuous research on BPA, considering its widespread use and most available data suggesting a carcinogenic effect of BPA on the female reproductive system. Although most studies on BPA have been conducted with human cells or with animal models, it can be argued that more studies should be conducted with humans to further promote understanding of the impact of BPA.
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http://dx.doi.org/10.3892/ol.2020.12145DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520752PMC
December 2020

Glucagonoma: From skin lesions to the neuroendocrine component (Review).

Exp Ther Med 2020 Oct 3;20(4):3389-3393. Epub 2020 Jul 3.

Department of Gynecology, Emergency University Hospital, 050098 Bucharest, Romania.

Glucagonoma is a hormonally active rare pancreatic neuroendocrine tumour causing an excess of glucagon. This is a narrative review based on a multidisciplinary approach of the tumour. Typically associated dermatosis is necrolytic migratory erythema (NME) which is most frequently seen at disease onset. Insulin-dependent diabetes mellitus, depression, diarrhoea, deep vein thrombosis are also identified, as parts of so-called 'D' syndrome. Early diagnosis is life saving due to potential aggressive profile and high risk of liver metastasis. NME as paraneoplastic syndrome may be present for months and even years until adequate recognition and therapy; it is remitted after successful pancreatic surgery. Thus the level of practitioners' awareness is essential. If surgery is not curative, debulking techniques may improve the clinical aspects and even the outcome in association with other procedures such as embolization of hepatic metastasis; ablation of radiofrequency type; medical therapy including chemotherapy, targeted therapy with mTOR inhibitors such as everolimus, PRRT (peptide receptor radiotherapy), and somatostatin analogues (including combinations of medical treatments). Increased awareness of the condition involves multidisciplinary practitioners.
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http://dx.doi.org/10.3892/etm.2020.8966DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465236PMC
October 2020

Left Spermatic Vein Thrombosis - An Uncommon Diagnosis: A Case Report.

Chirurgia (Bucur) 2020 Jul-Aug;115(4):505-510

Spermatic vein thrombosis is a rare entity with poor clinical distinctive signs for the differential diagnosis, which raises numerous controversies about the appropriate management. Case report: A 55 years old man presents at the emergency room for left scrotal pain and swelling evolving for two weeks. The patient denied any recent local traumatic event. Physical examination revealed an approximately 15 to 20 cm length mass from the posterior scrotum to the external inguinal orifice. The other genitals had a healthy appearance at the moment of the examination. An incarcerated hernia couldn't be excluded. The Doppler ultrasound evaluation of the scrotum con firmed the suspicion of left testicular vein thrombosis with complete cessation of blood flow. Both testicles appeared to have regular blood flow. CT scan established that the thrombus extended up to the left external inguinal orifice. Surgical treatment was preferred to address an eventually incarcerated hernia. The left testicular vein was excised from the external orifice. Postoperative management consisted of apixaban for 30 days, and the cardiology department thus conducted the treatment. Doppler ultrasound evaluation of the scrotum represents the gold standard diagnostic test for spermatic vein thrombosis. There are still controversies about the management approach of this pathology, conservative or surgical.
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http://dx.doi.org/10.21614/chirurgia.115.4.505DOI Listing
October 2020

Paraganglioma presenting as a mesenteric cystic mass: A case report.

Exp Ther Med 2020 Sep 28;20(3):2489-2492. Epub 2020 May 28.

Department 3 - Clinical Sciences, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

The present study aims to raise awareness about the necessity of a thorough differential diagnosis process when diagnosing paraganglioma as it is an extremely rare entity with a high malignant potential. A 64-year-old female patient was admitted to the hospital with symptoms of bowel obstruction and a palpable abdominal mass. Abdominal and pelvic computed tomography revealed a cystic heterogeneously enhanced mass. The tumor was surgically removed and then microscopically analysed. Microscopically, the mass was composed of nests of small polygonal and round cells with central vesicular nuclei, consistent with the diagnosis of mesenteric paraganglioma which was later confirmed by immunohistochemistry. The critical markers for paragangliomas, namely chromogranin A and S100, should be used as the first step in diagnosis, followed by other valuable immunohistochemical markers. A long-term follow-up is extremely important following the diagnosis of paraganglioma as all these tumors have a malignant potential.
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http://dx.doi.org/10.3892/etm.2020.8805DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401790PMC
September 2020

Posterior fossa assessment in the axial view of the head at 11-14 weeks of gestation in normal and aneuploid fetuses.

Exp Ther Med 2020 Sep 26;20(3):2470-2474. Epub 2020 May 26.

Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.

Posterior fossa ultrasound appearance may offer clues for brain anomalies as early as the first trimester. The purpose of the study was to find an easy, reproducible method to examine the posterior fossa. From January 2017 to March 2018, 132 consecutive pregnancies presenting for first-trimester screening, were selected at 11-14 weeks' gestation. An oblique axial view of the fetal head was routinely achieved with visualization of the posterior fossa, wherein the cisterna magna (CM) and the fourth ventricle (V4) anteroposterior diameter was measured. Moreover, 81 patients had a follow-up scan at 19-24 weeks, and the CM and transverse cerebellar diameter (TCD) were measured. Normal ranges were established at 11-14 weeks for CM and V4 according to crown-rump length (CRL). The 50th centile for CM ranges from 1.2 mm to 2.3 mm at a CRL between 45 and 85 mm. The V4 50th centile ranges from 1.8 to 2.4 mm. A positive correlation was found between the first-trimester and second-trimester CM diameter and between the first-trimester V4 and second-trimester TCD. There is an inverse correlation between the first-trimester CM and second-trimester TCD. The measurements of different components of the posterior fossa in the first trimester cannot predict the size of CM and TCD in the second trimester. The presence of the three hypoechoic structures (cerebral peduncles, V4, and CM) separated by two hyperechoic lines is easy to see and measure.
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http://dx.doi.org/10.3892/etm.2020.8793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401706PMC
September 2020

Etiologic role of in morphea: A case report.

Exp Ther Med 2020 Sep 29;20(3):2373-2376. Epub 2020 May 29.

'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Morphea is an inflammatory skin disease with self-limited evolution, presenting as localized sclerosis of the skin and/or underlying tissues. The incidence is not exactly known; the disease occurs more frequently in women, and there is no sex prevalence. Pathogenesis of morphea remains still controversial. Several theories exist and the infection is not yet elucidated. The aim of this report is to present the main mechanisms involved in the etiophatogenesis of morphea and also the thepapeutic options. A case of a 60-year-old woman is presented, who was referred to the clinic for an erythematous-violaceus, asymptomatic eruption, located on the trunk and legs, for appoximately 2 months. The patient's medical history revealed an infection with 1 year previously. After diagnosis of morphea was established, and with systemic therapy (corticosteroids and methotrexate), the evolution was favorable.
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http://dx.doi.org/10.3892/etm.2020.8815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401849PMC
September 2020

Spectrum and Antibiotic Resistance of Uropathogens in Romanian Females.

Antibiotics (Basel) 2020 Aug 1;9(8). Epub 2020 Aug 1.

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu-Mures, 38 Gheorghe Marinescu str., 540139 Targu-Mures, Romania.

Urinary tract infections (UTIs) in women represent a common bacteriological finding, with negligible recent and consistent research on antimicrobial resistance (AMR) in the female population. We designed a retrospective study to observe the incidence of frequent uropathogens and their resistance rates to common antibiotics. We elaborated multicenter research in three different teaching hospitals in Romania, analyzing 13,081 urine samples, of which 1588 met the criteria of inclusion. (58.37%) was the most frequent Gram-negative uropathogen, presenting high resistance rates to levofloxacin ( = 29.66%), amoxicillin-clavulanic ac. ( = 14.13%), and ceftazidime ( = 6.68%). We found good sensitivity to imipenem and meropenem (both 98.16%), amikacin ( = 96.0%), and fosfomycin ( = 90.39%). The second most prevalent uropathogen was (16.93%), with the highest resistance quota to amoxicillin-clavulanic ac. ( = 28.62%), levofloxacin and nitrofurantoin (both = 15.61%), and ceftazidime ( = 15.24%), and good sensitivity to imipenem ( = 93.93%), meropenem ( = 91.91%), and amikacin ( = 88.47%). (13.35%) was the most encountered Gram-positive pathogen. It proved the highest resistance to levofloxacin ( = 32.07%), penicillin ( = 32.07%), and ampicillin ( = 14.62%) and good sensitivity to vancomycin ( = 91.98%), fosfomycin ( = 94.4%), and nitrofurantoin ( = 89.15%). Considering the lack of recent and consistent data on this topic, we find our survey a valuable starting research study in this area with high significance for an accurate clinical approach.
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http://dx.doi.org/10.3390/antibiotics9080472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459805PMC
August 2020

A Clinical Perspective on the Antimicrobial Resistance Spectrum of Uropathogens in a Romanian Male Population.

Microorganisms 2020 Jun 5;8(6). Epub 2020 Jun 5.

"Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari blvd., 050474 Bucharest, Romania.

Considering urinary tract infections (UTIs), a significant public health problem with negligible recent research, especially on the male eastern European population, we aimed to determine the antimicrobial resistance rates of uropathogens for the most commonly used antibiotics in urological practice in our country. We conducted a multicenter retrospective study in two different teaching hospitals in Romania, analyzing urine samples from 7719 patients to determine the frequency of incriminating pathogens and their resistance to different antibiotics, in a comparative approach. We determined (35.98%) to be the most common pathogen with the highest sensitivity to amikacin (S = 91.72%), meropenem (S = 97.17%) and fosfomycin (S = 86.60%) and important resistance to amoxicillin-clavulanic ac. (R = 28.03%) and levofloxacin (R = 37.69%), followed by spp. (22.98%) with the highest sensitivity to amikacin (S = 78.04%) and meropenem (S = 81.35%) and important resistance to amoxicillin-clavulanic ac. (R = 65.58%) and levofloxacin (R = 45.36%); the most frequent Gram-positive pathogen was spp. (19.73%) with the highest sensitivity for vancomycin (S = 93.75%) and fosfomycin (S = 87.5%) and considerable resistance to penicillin (R = 33.52%) and levofloxacin (R = 42.04%). The findings are an important tool in managing UTIs and should be acknowledged as reference research not only for clinicians from Romania but for all physicians treating male UTIs.
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http://dx.doi.org/10.3390/microorganisms8060848DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357063PMC
June 2020

Regressive melanoma in a female patient: A case report.

Exp Ther Med 2020 Jul 22;20(1):87-90. Epub 2020 Apr 22.

'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Regressive melanoma is a phenomenon characterized by partial or complete replacement of cutaneous melanoma by fibrotic structures as a result of local host immune response. The dermoscopic features include 'scar-like' depigmentation that can be described as hypopigmented to pigmented macules, pink macules, linear-irregular vessels, globular vessel pattern, hyperpigmented macular remnants, blue gray 'peppered' papular remnants and white transverse bands. Fully regressive melanoma is very rare, and, in majority of cases, the tumor is associated with metastases, so the prognosis is very poor due to this fact. Regressive melanomas are rare since it represents an advance stage of melanoma evolution. Their treatment requires a collaboration between the dermatologist and the oncologist in order to improve the quality of life of the patient and also the survival rate.
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http://dx.doi.org/10.3892/etm.2020.8675DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271722PMC
July 2020

Postoperative Ileus Complicated with Incomplete Evisceration after Hysterectomy for Benign Pathology.

Chirurgia (Bucur) 2020 Jan-Feb;115(1):112-119

Postoperative ileus (POI) is a complex phenomenon with important morbidity and mortality, well known in many surgical fields. POI occurs commonly after abdominal and pelvic surgery, especially in cancer patients. We report the case of a 63-year-old patient without known risk factors for POI, who underwent total hysterectomy with bilateral adnexectomy for ovarian tumor with suspicion of malignancy, invalidated by the extemporaneous pathology examination. The postoperative evolution is marked by reduced bowel movements, lack of intestinal transit for flatus and stool for 6 days. In cooperation with the general surgeon conservative treatment for POI was administered, without effect. The abdomen remained distended, with no nausea or vomiting. On the 6th postoperative day a wound dehiscence with incomplete evisceration occurred, after a CT scan of the abdomen and pelvic region was requested to make a differential diagnosis between an intestinal mass and other pathology involving the bowell. In conjunction with the General Surgery team the surgical reintervention was decided and performed. After the procedure, the patient successfully regained transit, with flatus and stool emission, but another 2 complications occurred, which were successfully treated: sepsis and deep vein thrombosis. Understanding the pathophysiology could help to prevent, diagnose, and implement protocols in order to avoid POI and its complications, to reduce hospital stay and cost burden.
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http://dx.doi.org/10.21614/chirurgia.115.1.112DOI Listing
March 2020

State of the Art in Fertility Preservation for Female Patients Prior to Oncologic Therapies.

Medicina (Kaunas) 2020 Feb 23;56(2). Epub 2020 Feb 23.

"Carol Davila" University of Medicine and Pharmacy, 050471 Bucharest, Romania.

Quality of life improvement stands as one of the main goals of the medical sciences. Increasing cancer survival rates associated with better early detection and extended therapeutic options led to the specific modeling of patients' choices, comprising aspects of reproductive life that correlated with the evolution of modern society, and requires better assessment. Of these, fertility preservation and ovarian function conservation for pre-menopause female oncologic patients pose a contemporary challenge due to procreation age advance in evolved societies and to the growing expectations regarding cancer treatment. Progress made in cell and tissue-freezing technologies brought hope and shed new light on the onco-fertility field. Additionally, crossing roads with general fertility and senescence studies proved highly beneficial due to the enlarged scope and better synergies and funding. We here strive to bring attention to this domain of care and to sensitize all medical specialties towards a more cohesive approach and to better communication among caregivers and patients.
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http://dx.doi.org/10.3390/medicina56020089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073829PMC
February 2020

Impact of early supplementation with low-dose aspirin on functional first trimester parameters in low-risk pregnancies.

J Matern Fetal Neonatal Med 2019 Feb 16;32(4):604-609. Epub 2017 Oct 16.

a Department of Obstetrics and Gynaecology , Carol Davila University of Medicine and Pharmacy, Elias University Hospital , Bucharest , Romania.

Introduction: There is recent evidence that prophylaxis with 150 mg of aspirin given before 14-16 weeks significantly reduces preeclampsia rates and may improve pregnancy outcome. We conducted an observational study that investigates the effect of low-dose aspirin initiated early in pregnancy or in preconception on functional parameters assessed at 11-14 weeks.

Materials And Methods: We have retrospectively selected 128 pregnant women that presented for the first trimester screening for aneuploidies between 11 and 13 weeks of gestation and received low-dose aspirin before 14 weeks. We excluded cases with an estimated high risk for early preeclampsia (cut-off > 1:100). This group was matched to 1044 cases that did not receive aspirin in early pregnancy. We have selected for statistical analysis maternal parameters, ultrasound parameters (crown-rump length, nuchal translucency thickness, pulsatility index in uterine arteries - left, right, average and average uterine PI expressed in multiple of median (MoM)), first trimester maternal biochemical markers (free β hCG and PAPP-A expressed in MoM), and the calculated risk for early onset and late onset preeclampsia.

Results: The most common dosages of aspirin were 75 mg (77 cases) and 100 mg (32 cases). The most significant results are within the aspirin group. In the subgroup that received aspirin before 11 weeks (110 cases), irrespective of the dosage, the uterine blood flow is significantly improved (average uterine PI 1.7 compared with 2.22, p < .05, (0.24-0.7) 95% CI) and the PAPP-A levels are higher (1.2 compared with 0.82, p > .05, [(-0.65) - 0.02] 95% CI). The estimated risk for both early and late onset preeclampsia in this group is reduced (1:2141 compared with 1:333 for early preeclampsia, p < .05, (1216-2398) 95% CI; 1:361 compared with 1:99 for late onset preeclampsia, p < .05, (173-351) 95% CI).

Conclusion: Even though the results are not always statistically significant, they demonstrate that placentation parameters improve with higher doses of aspirin started before 11 weeks.
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http://dx.doi.org/10.1080/14767058.2017.1387532DOI Listing
February 2019

Morphological, imaging and surgical aspects in a complex case of uterine leiomyosarcoma - case report and review of the literature.

Rom J Morphol Embryol 2017 ;58(2):619-625

Department of Obstetrics, Gynecology and Neonatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest; Department of Neonatology, "Elias" Emergency University Hospital, Bucharest, Romania;

Leiomyosarcoma is a rare condition so there are relatively few and small case series and no prospective studies to provide clear guidelines regarding management. We report on a case that presents some particularities that further underline diagnostic and treatment difficulties posed by the affliction of such a rare tumor. This is the case of a 43-year-old woman who had a large tumor arising from the uterus, with a spectacular growth rate over a short period. The patient, with congenital spastic tetraparesis and hydrocephalus, came for belly enlargement with rapid increase in size over the previous two months. Physical exam and ultrasound lead to the conclusion of a large abdominal mass. A computed tomography scan showed a mass arising from the pelvis and a large amount of ascites. An exploratory laparotomy was performed and the histopathology report confirmed the diagnosis of uterine leiomyosarcoma. Leiomyosarcoma poses challenging problems regarding histological grading and, due to its rate of growth, real surgical difficulties. Final diagnosis is done by histopathological examination after surgical excision. Frequently, it is late diagnosed when complete removal of the tumor is often impossible.
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April 2018

Novel perspectives on gastrointestinal stromal tumors (GISTs).

Rom J Morphol Embryol 2017 ;58(2):339-350

Department of Pathology, "Colentina" Clinical Hospital, Bucharest, Romania;

Since they were described, gastrointestinal stromal tumors (GISTs) are, for pathologists and not only for them, a subject of controversy regarding histological origin, differentiation, nomenclature, malignant potential and prognosis. Before 1998, there were no certainties that GISTs were fundamentally different from other types of abdominal cancers in the big family of mesenchymal tumors. Before the discovery of KIT gene mutations, GISTs were most often classified as leiomyoma, leiomyosarcoma, leiomyoblastoma, and gastrointestinal autonomic nerve tumor. When a tumor is discovered, the first data obtained are initially assessed by one or more imaging tests, such as an ultrasound, computed tomography scan or magnetic resonance imaging. The imaging results define the size of the lesion and its anatomic location, which in the case of GIST is usually within the wall of the stomach or intestine. Depending on the experience of the medical team - radiologist, gastroenterologist or surgeon - reviewing the imagistic tests and correlating them with the general patient profile, the differential diagnostic is reduced and GIST may become the main suspect.
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April 2018
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