Publications by authors named "Lucian Cristian Petcu"

15 Publications

  • Page 1 of 1

HPV and HIV Coinfection in Women from a Southeast Region of Romania-PICOPIV Study.

Medicina (Kaunas) 2022 Jun 3;58(6). Epub 2022 Jun 3.

Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Ovidius University of Constanta, 145 Tomis Blvd., 900591 Constanta, Romania.

: Romania faces one of the highest cervical cancer burdens in Europe though it is a preventable cancer through population screening by cytology and human papillomavirus (HPV) detection. Also, it has one of the highest incidences of human immunodeficiency virus (HIV) infection. HPV and HIV coinfection are frequently encountered. The aim of study was to establish the prevalence of HPV infection among HIV-positive women in Southeast Region of Romania, to genotype high risk HPV types -and to correlate the results with clinical data and cytological cervical lesions. : 40 HIV-positive women were screened for HPV types and for cytological cervical lesions. The findings were evaluated in correlation with CD4 cell counts, HIV viral load, age at first sexual intercourse, number of sexual partners, vaginal candidiasis, and Gardnerella using statistical methods. : 19/40 (47.5%) women were positive for HPV types, 63.15% infected with single HPV type and 36.85% with multiple HPV types. The most frequent types were type: 31 (42.1%), 56 (31.57%), 53 (15.78%). On cytology, 34 (85%) women were found with NILM of which 38.23% were HPV-positive. Fifteen percent of women had abnormal cytology (three ASC-US, three LSIL), and all of them were HPV-positive. Through analyzing the value of CD4 count, women with CD4 count ≤ 200 cells/μL were found to be significantly more likely to be infected with HPV; meanwhile there was no correlation between the detection of HPV types and HIV viral load. Candida or Gardnerella were more often associated with HIV-positive women with HPV, than in women without HPV. Infection with HPV types is common among HIV-positive women in the Southeast Region of Romania and it is associated with age at the beginning of sexual life, number of sexual partners, CD4 value, vaginal candidiasis, and Gardnerella infection.
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http://dx.doi.org/10.3390/medicina58060760DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231193PMC
June 2022

Epidemiological Characteristics and Mortality Risk Factors Comparison in Dialysis and Non-Dialysis CKD Patients with COVID-19-A Single Center Experience.

J Pers Med 2022 Jun 13;12(6). Epub 2022 Jun 13.

Clinical Department No. 3, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

(1) Background: Despite some controversies between studies, chronic kidney disease (CKD) has a negative impact on COVID-19 outcomes, with patients presenting a higher mortality risk than in the general population. Studies have shown an association between COVID-19 severe cases and different inflammatory biomarkers. The aim of this study was to emphasize the epidemiological characteristics of CKD patients diagnosed with COVID-19 and to determine if the risk of mortality, and the severity of this infection might be influenced by different parameters. (2) Methods: Our retrospective study included CKD patients with COVID-19-362 in the non-dialysis group and 132 in the dialysis group. (3) Results: There were significant statistical differences between our groups regarding age ( < 0.001), hemoglobin ( < 0.001), interleukin-6 ( < 0.001), serum albumin ( = 0.016), procalcitonin ( = 0.002), ferritin ( < 0.001), and of course serum creatinine ( < 0.001). Even if the risk of death was higher in the dialysis group (Exp(b) = 1.839), the survival proportions were similar in both groups. (4) Conclusions: High values of hemoglobin, serum creatinine, and LDH at admission, age, length of hospital stay ≤ 10 days, and a pulmonary impairment > 25% are responsible for an adverse outcome in non-dialysis and dialysis patients diagnosed with COVID-19.
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http://dx.doi.org/10.3390/jpm12060966DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224649PMC
June 2022

Antegrade intramedullary locking nail in the management of proximal and middle thirds of humeral diaphyseal fractures.

Int Orthop 2022 Aug 9;46(8):1855-1862. Epub 2022 Jun 9.

Balneal and Rehabilitation Sanatorium, Techirghiol, Romania.

Purpose: The aim of the study was to evaluate the antegrade intramedullary locking nail osteosynthesis for the treatment of the proximal and middle thirds of humeral shaft fractures.

Methods: A retrospective study was made on 218 patients diagnosed with humeral diaphysis fractures who undergo surgery with antegrade intramedullary locking nail between January 2017 and December 2021. The clinical follow-up started two days after surgery and continued at one month, three months, six months and one year. The functional recovery evaluation was performed using visual analogue scale (VAS) score, Rating Scale of American Shoulder and Elbow Surgeons Form (ASES), Mayo Elbow Performance Score System (MEPS) and rate of complications.

Results: Low intra-operative blood loss, short operation time, short hospitalisation, early mobilisation of the patient and high union rate imposed intramedullary nailing as a standard procedure for the treatment of proximal and middle thirds of humeral diaphyseal fractures in the past years, and the union rate was 99.5%. VAS score evaluated at one month, three months and six months indicated a very good overall post-operative experience. The ASES and MEPS score were evaluated at six months and one year and showed excellent results. All the patients (except 1 case) were able to return to their previous jobs within six months.

Conclusion: Humeral nailing is associated with early return to function of the upper limb, with very good clinical and functional outcomes of the shoulder and elbow. This method could be considered the best surgical option for the management of proximal middle humeral fractures.
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http://dx.doi.org/10.1007/s00264-022-05467-1DOI Listing
August 2022

Overview of Renal Replacement Therapy Use in a General Intensive Care Unit.

Int J Environ Res Public Health 2022 02 21;19(4). Epub 2022 Feb 21.

Department of Anesthesia and Intensive Care, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania.

Objectives: Population-based studies regarding renal replacement therapy (RRT) used in critical care populations are useful to understand the trend and impact of medical care interventions. We describe the use of RRT and associated outcomes (mortality and length of intensive care stay) in a level 1 hospital.

Design: A retrospective descriptive observational study.

Patients: Critically ill patients admitted to the ICU from 1 January to 31 December 2018.

Interventions: Age, gender, ward of admission, primary organ dysfunction at admission, length of hospital stay (LOS), mechanical ventilation, APACHE, SOFA and ISS scores, the use of vasopressors, transfusion, RRT and the number of RRT sessions were extracted.

Results: 1703 critically ill patients were divided into two groups: the RRT-group (238 patients) and the non-RRT group (1465 patients). The mean age was 63.58 ± 17.52 (SD) in the final ICU studied patients (64.72 ± 16.64 SD in the RRT-group), 60.5% being male. Patients admitted from general surgery ward needing RRT were 41.4%. The specific scores, the use of vasopressors, transfusions and mortality were higher in the RRT-group. The ICU LOS was superior in the RRT-group, regardless of the primary organ dysfunction.

Conclusions: RRT was practiced in 13.9% of patients (especially after age of 61), with mortality being the outcome for 66.8% of the RRT-group patients. All analyzed data were higher in the RRT group, especially for multiple trauma and surgical patients, or patients presenting cardiac or renal dysfunctions at admission. We found significant increased ISS scores in the RRT-group, a significant association between the need of vasopressors or transfusion requirement and RRT use, and an association in the number of RRT sessions and LOS ( < 0.001).
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http://dx.doi.org/10.3390/ijerph19042453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878091PMC
February 2022

Open Healing: A Minimally Invasive Protocol with Flapless Ridge Preservation in Implant Patients.

Biology (Basel) 2022 Jan 14;11(1). Epub 2022 Jan 14.

Division of Histology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

We aimed to validate the safety and efficacy of the minimally invasive "open healing" flapless technique for post-extraction socket and alveolar ridge preservation, while assessing the alveolar bone changes. The study enrolled ( = 104) patients (0.55 sex ratio), with atraumatic extraction of () hopeless teeth, followed by either immediate placement of tissue level implants (), or later stage implant insertion (). No flap was raised in either situation. Post-extraction sockets were filled with deproteinized bovine bone granules and covered by collagen resorbable membrane-left purposely exposed during healing. This yielded an uneventful healing, with sufficient bone formation, while avoiding soft-tissue problems. The need for additional augmentation was assessed clinically and by calibrated CBCT scans at six months, before either loading () or implant insertion (). Implant success and survival rate were evaluated at 12-, 24-, and 60-month follow-up control sessions. The inserted implants had a survival rate of 98.5% and a success rate of 94.8% at five-year follow-up. Open healing technique with flapless approach can be favorable for preserving the 3D architecture of the post-extraction socket, as well as the alveolar ridge width and height.
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http://dx.doi.org/10.3390/biology11010142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773332PMC
January 2022

Early diagnosis and management of maternal ureterohydronephrosis during pregnancy.

Exp Ther Med 2022 Jan 5;23(1):27. Epub 2021 Nov 5.

Department of Nephrology, Constanta County Emergency Hospital, 900591 Constanţa, Romania.

Maternal ureterohydronephrosis (UHN) is a common anatomical change during the evolution of pregnancy, diagnosed especially after the 20th week of pregnancy. The aim of the present study was to evaluate the stages of UHN during pregnancy, depending on the gestational age, and to monitor the symptomatology and the adequate management. A total of 58 pregnant women with UHN, hospitalized in the Constanta County Emergency Hospital, were included in the present study, and had nephrological monitoring using ultrasound examination. Right UHN was observed in all cases and left UHN was observed in only 67.24% of the cases. Regarding the gestational age, right UHN grade III was most commonly seen between 27 and 31 weeks of pregnancy (48.6% of total right UHN grade III from the studied group). The data showed that gestational age and grade of UHN had a highly dependent association in the studied group. The majority of our patients (67.24%) were symptomatic, and the most common complaint on presentation was lumbar pain. According to the visual analog scale (VAS) of the lumbar pain, the group could be distributed as follows: 17.24% with severe pain, 36.21% with moderate pain and 13.79% with mild pain. Eight pregnant women (13.79%) from the present study developed UHN due to passage of a ureteral stone, although the majority of the patients experienced complications with urinary tract infection and acute kidney injury. In addition, 97% of the symptomatic UHN responded to conservatory treatment and only 2 patients (3.45%) with severe symptomatic UHN needed ureteral stent insertion. Data analysis was performed using IBM SPSS Statistics 23. The study highlighted the existence of an association between gestational age and UHN grading.
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http://dx.doi.org/10.3892/etm.2021.10949DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611492PMC
January 2022

Assessment of programmed death-ligand 1 receptor immunohistochemical expression and its association with tumor-infiltrating lymphocytes and p53 status in triple-negative breast cancer.

Rom J Morphol Embryol 2021 Jan-Mar;62(1):63-71

Department of Nephrology, Clinical Service of Pathology, Sf. Apostol Andrei Emergency County Hospital, Faculty of Medicine, Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), Ovidius University of Constanţa, Romania;

Breast cancer (BC) is the second most frequent type of cancer for both sexes combined, after lung cancer. Triple-negative BC (TNBC) molecular subtype is characterized by lack of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) immunoexpression or amplification and represent 10-20% of all BC cases. The issue of the present study was to analyze the associations between programmed death-ligand 1 (PD-L1) immunoexpression and distribution of stromal tumor-infiltrating lymphocytes (stTILs) combined with clinico-morphological features of patients with TNBC. Secondly, our research evaluated PD-L1 immunoexpression as a prognostic factor and its correlation with p53 immunoexpression. Thirty cases with primary TNBC without prior neoadjuvant therapy were included in this research. stTILs were identified in all cases, most of them with low distribution (66.7%). A positive immunoreaction for PD-L1 was observed in 40% of cases. The PD-L1 immunoexpression was statistically significant associated with age, pathological tumor size, lymphovascular invasion, stTILs level, the presence of cluster of differentiation 8-positive (CD8+) TILs and p53 immunoexpression. In the present study, a positive PD-L1 immunoexpression was associated with a worse distant metastasis free survival (DMFS). We also found not only that high stTILs level were associated with a better DMFS but also that there was a statistically significant association between stTILs level and PD-L1 immunoexpression. Our results bring new insights to the fine connections between tumor microenvironment and molecular changes of TNBC. It helps us to better understand these aggressive tumors to identify the more useful biomarkers for predicting the response to adjuvant therapy and can represent a method for selecting the most suitable patients for immunotherapy.
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http://dx.doi.org/10.47162/RJME.62.1.06DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597365PMC
October 2021

The Ideal Time for Iron Administration in Anemia Secondary to Blood Loss-An Experimental Animal Model.

Life (Basel) 2021 Aug 30;11(9). Epub 2021 Aug 30.

Department of Anesthesiology and Intensive Care, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Background: Anemia and iron deficiency are two of the main public health problems worldwide, associated with negative outcomes in surgical patients. This experimental study aimed to create a model of acute iron deficiency with anemia through blood loss and extensive surgery. Afterwards, intravenous iron was administered to correct the iron deficiency and to improve the hematological parameters in distinct moments regarding the surgical time. To assess the optimum time for therapeutic intervention, experimental subjects were compared, performing clinical, paraclinical, and histological examinations, as well.

Methods: Male rats ( = 35), aged 11-13 months, were randomly designated into six groups. Anemia and iron deficiency were obtained through a 15% blood volume loss, followed by major surgical intervention (femur fracture and osteosynthesis using Kirschner wire). Therapeutic intervention was obtained with an intravenous ferric carboxymaltose infusion, as follows: group II: intraoperative ( = 7), group III: 48 h after surgery ( = 7), group IV: 48 h before surgery ( = 5), and group V: seven days before surgery ( = 6). Group I ( = 5) was left anemic, while group 0 ( = 5) was nonanemic without therapeutic intervention.

Results And Discussion: In group I, serum iron lower than in group 0 (27.04 ± 6.92 μg/dL versus 60.5 ± 2.34 μg/dL), as well as hemoglobin (10.4 ± 0.54 g/dL versus 14.32 ± 2.01 g/dL) and ferritin values (22.52 ± 0.53 ng/mL versus 29.86 ± 3.97 ng/mL), validated the experimental model. Regarding wound healing after surgical trauma, we observed that neovascularization was more significant in group III, followed by group V, with fewer neutrophils, a well-represented and rich in lymphomonocytes inflammatory infiltrate associated with the biggest collagen fiber dimensions. The periosteal reaction and callus area presented thicker trabeculae in groups II and III compared to the anemic group.

Conclusions: This original experimental study assessed the effect of perioperative intravenous iron administration at a specific time by comparing the weight, hematological, and iron status-defining parameters, as well as histological characteristics of the included subjects. The present findings highlight that correcting the iron deficiency in emergency settings through intravenous iron administration intraoperatively or 48 h postoperatively could determine the improved bioumoral parameters, as well as a better evolution of the postoperative wound and bone healing compared to the anemic group or subjects that received therapeutic intervention 48 h before surgery.
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http://dx.doi.org/10.3390/life11090898DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471997PMC
August 2021

Dexamethasone on absent end-diastolic flow in umbilical artery, in growth restricted fetuses from early-onset preeclamptic pregnancies and the perinatal outcome.

Ann Med 2021 12;53(1):1455-1463

University Regional Emergency Hospital of Constanta, Constanta, Romania.

Background: Absent end-diastolic flow (AEDF) in the umbilical artery (UA) worsens the already poor prognosis of growth-restricted fetuses (GRFs) in pregnancies complicated by early-onset preeclampsia with severe features (ESP).

Method: We assessed the correlation between the effect of maternal dexamethasone (Dex) on AEDF in the UA and perinatal outcomes, in 59 GRFs from EPS-complicated pregnancies. The maternal outcome was also evaluated.

Results: The mean maternal age at inclusion was 22.4 ± 5.9 years. Dex transiently restored EDF in the UA in 38 (64.4%) cases (trAEDF group), but in 21 (35.6%) patients, the flow was persistently absent (prAEDF group). The effect lasted up to the 4th day.The gestational age at diagnosis, number of days from admission until delivery, and fetal weight were significantly lower in the prAEDF group than in the trAEDF group ( < .05). The same group had a significantly increased rate of fetal proximal deterioration, low APGAR scores, neonatal hypoxia, assisted ventilation, mild intraventricular haemorrhage (I/II), and respiratory distress syndrome, as well as maternal deterioration, especially in cases of resistant hypertension ( < .05). Although the rates of fetal acidemia and perinatal mortality in the prAEDF group were respectively three times and two times higher, the differences were not significant ( > .05).

Conclusions: The Dex no-effect on UA Doppler in GRFs with AEDF in the UA, in EPS-complicated pregnancies, can be a useful marker for a higher risk of proximal fetal deterioration, poor state at delivery, neonatal hypoxic complications, and worsening maternal condition, but not for perinatal mortality. The findings also highlight the alarmingly younger age of patients with EPS. Finally, all these pregnancies should be monitored in a complex multidisciplinary manner in tertiary referral units.Key messageThe effect of dexamethasone on absent end-diastolic flow in the umbilical artery in growth-restricted fetuses from pregnancies complicated by early-onset preeclampsia with severe features can be a useful prognostic factor for perinatal outcomes.
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http://dx.doi.org/10.1080/07853890.2021.1968030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409927PMC
December 2021

Predictors of spontaneous bacterial peritonitis in Romanian adults with liver cirrhosis: Focus on the neutrophil-to-lymphocyte ratio.

Exp Ther Med 2021 Sep 12;22(3):983. Epub 2021 Jul 12.

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

Spontaneous bacterial peritonitis (SBP) is a severe complication of liver cirrhosis whose diagnosis is based on a polymorphonuclear leukocyte (PMN) value >250 mm, yet this PMN value cannot identify all existing types. The aim of our study was to determine the clinical and biological factors that were associated with SBP and predict its occurrence, focusing on the neutrophil-to-lymphocyte ratio (NLR) as one of them. Our retrospective study included 216 patients with liver cirrhosis who were hospitalized between December 2019 and January 2010 at the Emergency County Clinical Hospital of 'St. Apostle Andrew' in Constanta, Romania. Demographic, clinical, and laboratory data were collected from patient observation sheets. The patients were divided into two groups: One group of patients with SBP and the other without SBP. The diagnosis of SBP was made when patients presented with PMN >250 mm and other causes of secondary bacterial peritonitis were excluded. The mean age of the patients was 61.25±10.67 years, and the alcoholic etiology of liver cirrhosis was most common (44%). Univariate logistic regression analysis showed that there was an association between biological parameters, such as serum white blood cells, total platelet count, total bilirubin, serum albumin, international normalized ratio, creatinine, erythrocyte sedimentation rate (ESR), serum sodium, alkaline reserve, and NLR, and clinical parameters, such us upper gastrointestinal bleeding and cardiac comorbidities in the occurrence of SBP. Multivariate analysis identified ESR and NLR as predictive factors in the occurrence of SBP. The area under the curve (AUC) was 0.916 [P<0.001, 95% confidence interval (CI) 0.870-0.949] for ESR and AUC was 0.963 (P<0.001, 95% CI 0.928-0.984) for NLR, respectively. In conclusion, the combination of these 2 biological parameters is useful in identifying or excluding SBP.
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http://dx.doi.org/10.3892/etm.2021.10415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311228PMC
September 2021

Overexpression of Survivin-1, TAG-72 and HERC5 in patients diagnosed with hepatocellular carcinoma in the Black Sea coast geographical area.

Exp Ther Med 2021 Mar 26;21(3):284. Epub 2021 Jan 26.

Department of Gastroenterology, 'Ovidius' University, 900527 Constanta, Romania.

Epidemiological data regarding hepatocellular carcinoma (HCC) report unsatisfactory morbimortality rates despite the global efforts to decrease the incidence and prolong patient survival. Current guidelines lack diagnostic biomarkers to better characterize patients with HCC. We aimed to validate the overexpression of Survivin-1, tumor-associated glyocoprotein 72 (Tag-72), and HECT and RLD domain containing E3 ubiquitin protein ligase 5 (HERC5) as tissue biomarkers for HCC characterization in patients from our geographical area and to standardize a local biomarker panel to be introduced in the current management guideline. Thirty samples of histologically confirmed HCC were compared to an equal number of samples of benign tumors in terms of Survivin-1, TAG-72, and HERC5 overexpression. Student's t-test, Mann-Whitney U test and Chi-square test were used to find differences between the two studied groups and to compare the categorical variables. The discriminative power of Survivin-1, Tag-72, and HERC5 overexpression was assessed using ROC curves. The multivariate linear regression analysis revealed that Survivin, Tag-72, and HERC5 were significantly overexpressed in older male patients, with α-fetoprotein (AFP) >200 ng/dl, low serum albumin, as well as in patients with imaging features of portal thrombosis and ascites. The diagnostic performance of Survivin-1, Tag-72 and HERC5 tissue biomarkers for HCC characterization was superior to that of the gold-standard AFP. Our study results validate the overexpression of Survivin-1, Tag-72, and HERC5 as tissue biomarkers for HCC characterization in patients from our geographical region and could be standardized in the current HCC management guideline.
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http://dx.doi.org/10.3892/etm.2021.9715DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851649PMC
March 2021

Does rifaximin offer any promise in Crohn's disease in remission and concurrent irritable bowel syndrome-like symptoms?

Medicine (Baltimore) 2021 Jan;100(1):e24059

Faculty of Medicine, Ovidius University of Constanta.

Abstract: Microbiota plays an important role in many diseases including inflammatory bowel diseases. Inflammatory bowel disease patients can have concurrent irritable bowel syndrome symptoms similar to those associated with a flare. The potential role of gut dysbiosis in the pathogenesis of inflammatory bowel disease provides a rationale for treating such patients with rifaximin. This study aimed to assess the efficacy of rifaximin in the management of irritable bowel syndrome-like symptoms (bloating, abdominal pain, stool consistency) and quality of life in patients with Crohn's disease in remission.The present study included 86 patients with Crohn's disease in remission (fecal calprotectin <50 μg/g, C-reactive protein <0.5 mg/dL, simple endoscopic score for Crohn's disease <2) and associated irritable bowel syndrome-like symptoms (bloating, abdominal pain, diarrhea). These patients were randomly assigned to rifaximin treatment group (44 patients) and the control group (42 patients). Besides the baseline inflammatory bowel disease treatment and antispasmodics (as needed), patients in the rifaximin treatment group received 3 repeated courses of treatment, each course being represented by 1200 mg/d of rifaximin for 10 days and 20 days free of treatment (3 months consecutively); patients in the control group also received antispamodics as needed and were observed for 3 months.Monthly analyses of bloating score, abdominal pain score, stool consistency score, and quality of life score showed significant improvement after treatment in the rifaximin group in contrast with control group. Significantly more patients in the rifaximin group than in the control group met the criteria for adequate improvement of bloating score after 3 months of treatment (59.09% vs 19.04%, P = .01), adequate improvement of abdominal pain score (54.5% vs 21.4%, P = .04), stool consistency score (34.09% vs 14.2%, P = .03), and quality of life score (70.4% vs 21.4%, P < .001).Rifaximin in a dose of 1200 mg/d, 10 d/mo, 3 months consecutively is an effective medication for concurrent irritable bowel syndrome-like symptoms in patients with Crohn's disease in remission.
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http://dx.doi.org/10.1097/MD.0000000000024059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793373PMC
January 2021

Bioaccumulation of Copper and Zinc and the Effects on Antioxidant Enzyme Activities in the Liver of Acipenser stellatus (Pallas, 1771).

Bull Environ Contam Toxicol 2019 Jan 15;102(1):39-45. Epub 2018 Nov 15.

Department of Biochemistry and Molecular Biology, University of Bucharest, Splaiul Independenţei Street No. 91-95, Sector 5, 050095, Bucharest, Romania.

Although water pollution by metals in the Danube River is considered high, little is known about its impact on sturgeons. In this regard, the aim of this study was to investigate the bioaccumulation of copper and zinc as well as their effects on antioxidant enzymes activities in the liver of Acipenser stellatus. The fish were exposed for 7 and 14 days, to two concentrations of copper and zinc (10% and 25% of LC50 96 h), previously determined as 0.54 mg/L Cu and, 34.22 mg/L Zn respectively. The enzymatic responses of A. stellatus varied greatly depending on metal type, concentration and time. Significant bioaccumulation of the two metals was recorded. Even though the water hardness used in the experiment is known to offer a clear protection against metal contamination, stellate sturgeon remains a sensitive species in the face of metal toxicity.
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http://dx.doi.org/10.1007/s00128-018-2491-5DOI Listing
January 2019

Supersonic Shear Wave Ultrasonography for Assessing Tissue Stiffness in Native Kidney.

Ultrasound Med Biol 2018 12 26;44(12):2556-2568. Epub 2018 Aug 26.

Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital, Bucharest, Romania; Clinical Department No. 3, "Carol Davila" University of Medicine, Bucharest, Romania.

Recent years have brought shear wave elastography to the attention of nephrologists as a non-invasive method for detecting kidney fibrosis and, therefore, as a potential tool for reducing the need for kidney biopsy. Few studies are performed on native kidney. We aimed to compare cortical stiffness, assessed by measuring Young's modulus (YM, kPa) with SuperSonic Imaging technology, in patients with various degrees of chronic kidney disease (CKD) compared with healthy individuals. Cortical stiffness was measured by two operators, in different sessions, in 32 patients with CKD stages 3-5 and 20 healthy individuals. Comparison between mean YM values in CKD and those in controls and also between the different stages of CKD was our primary objective. The influence of other possible confounders on YM readings was also investigated and analyzed. Mean YM was significantly greater in CKD patients than in controls. Estimated YM was not able to differentiate the stages of CKD, except stage 5. Intra-subject variability was greater in CKD than in controls. Body mass index was the most important confounder in multiple analyses, in both the CKD and control groups. Our results highlight a positive correlation between increased cortical stiffness and presence of CKD. Further studies are needed to validate this method for implementation in daily clinical practice.
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http://dx.doi.org/10.1016/j.ultrasmedbio.2018.07.001DOI Listing
December 2018

Coronary risk score for mineral bone disease in chronic non-diabetic hemodialysis patients: results from a prospective pilot study.

Int Urol Nephrol 2017 Apr 18;49(4):689-700. Epub 2016 Dec 18.

Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital Bucharest, 37th Dionisie Lupu StreetSector 2, 020021, Bucharest, Romania.

Introduction: Chronic kidney disease-mineral bone disorder enhances coronary artery impairment (often occult and difficult to diagnose) in hemodialysis (HD) patients. The aim of the study was to correlate biochemical and imagistic parameters of MBD with the degree of documented coronary artery disease (CAD) in non-diabetic HD patients, in order to obtain a MBD-coronary risk score as a screening algorithm.

Methods: A 3-year prospective study was conducted on 168 non-diabetic HD patients, evaluating MBD biochemical parameters along with pulse wave velocity (PWV) determination and valve/coronary calcification assessment; coronary angiography was performed in symptomatic patients. Correlations between noninvasive parameters and the degree of coronary obstruction were assessed using IBM SPSS Statistics 20 software, Chi-square test and the determination of odds ratio.

Results: Significant differences in serum calcium (p < 0.001), phosphates (p = 0.03), bicarbonate (p < 0.001), albumin and iPTH (p = 0.002), percentage of deviations from PWV normal values (p = 0.004), average doses of phosphate binders and vitamin D and the number of vascular/valve calcifications were noted between the study group (angina, n = 17) and control group (asymptomatic, n = 151). After applying MBD-coronary risk score in control group, coronary angiography was performed in high-score patients.

Conclusion: A noninvasive screening algorithm for early diagnosis of CAD in asymptomatic HD patients with altered MBD parameters is necessary. Applying MBD-coronary risk score might be an important step in the prevention of major coronary episodes by extending the indication for further investigations, early diagnosis and treatment management.
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http://dx.doi.org/10.1007/s11255-016-1481-yDOI Listing
April 2017
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