Publications by authors named "Simona Claudia Cambrea"

8 Publications

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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

Clinical and Biological Risk Factors Associated with Increased Mother-to-Child Transmission of HIV in Two South-East HIV-AIDS Regional Centers in Romania.

Medicina (Kaunas) 2022 Feb 11;58(2). Epub 2022 Feb 11.

Craiova Clinical Hospital of Infectious Diseases and Pneumophthisiology "Victor Babeș", 200515 Craiova, Romania.

The occurrence of human immunodeficiency virus (HIV) infection in children in Romania has been reported since 1989. This retrospective study was aimed at assessing clinical and biological risk factors for mother-to-child transmission (MTCT) of HIV in two HIV-acquired immune deficiency syndrome (AIDS) Regional Centers (RCs), Constanta and Craiova in Romania. During the study period (2008-2019), 408 HIV-positive pregnant women, 244 from Constanta RC and 164 from Craiova RC who attended antenatal visits, were included. All HIV-positive pregnant women were under combined antiretroviral therapy (cART) during pregnancy and childbirth, being followedup with their infants up to 18 months after delivery. We investigated the clinical as well as biological risk factorsassociated with increased MTCT of HIV. Comparing different variables of HIV-positive pregnant women from the two HIV-AIDS CRs, we find that there are significant differences between the mean value of hemoglobin, CD4 level, environmental area, marital and amniotic membranes status, and HIV patient stage in the last trimester of pregnancy ( < 0.05), but without any differences in mother's mean age, education level, type of delivery, breastfeeding, the duration of cART administration, HIV viral load, and survival rate. In 408 HIV-positive pregnant women followed up at two HIV-AIDS RCs in Romania, the most important clinical and biological risk factors associated with increased MTCT of HIV are represented by anemia, CD4 level, and HIV patient stage.
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http://dx.doi.org/10.3390/medicina58020275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8877470PMC
February 2022

Case Reports of Pregnancy-Related Cerebral Venous Thrombosis in the Neurology Department of the Emergency Clinical Hospital in Constanta.

Life (Basel) 2022 Jan 9;12(1). Epub 2022 Jan 9.

Department of Neurology, General Medicine Faculty, Ovidius University, 900470 Constanta, Romania.

Cerebral venous thrombosis accounts for 0.5-1% of all cerebrovascular events and is one type of stroke that affects the veins and cerebral sinuses. Females are more affected than males, as they may have risk factors, such as pregnancy, first period after pregnancy, treatment with oral contraceptives treatment with hormonal replacement, or hereditary thrombophilia. This neurological pathology may endanger a patient's life. However, it must be suspected in its acute phase, when it presents with variable clinical characteristics, so that special treatment can be initiated to achieve a favorable outcome with partial or complete functional recovery. The case study describes the data and the treatment of two patients with confirmed cerebral venous thrombosis with various localizations and associated risk factors, who were admitted to the neurology department of the Sf. Apostol Andrei Emergency Hospital in Constanta. The first patient was 40 years old and affected by sigmoid sinus and right lateral sinus thrombosis, inferior sagittal sinus, and right sinus thrombosis, associated with right temporal subacute cortical and subcortical hemorrhage, which appeared following a voluntary abortion. The second case was a patient aged 25 who was affected by left parietal cortical vein thrombosis, associated with ipsilateral superior parietal subcortical venous infarction, which appeared following labor. The data are strictly observational and offer a perspective on clinical manifestations and clinical and paraclinical investigations, including the treatment of young patients who had been diagnosed with cerebral venous thrombosis and admitted to the neurology department.
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http://dx.doi.org/10.3390/life12010090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780258PMC
January 2022

Randomized, placebo-controlled trial of xyloglucan and gelose for the treatment of acute diarrhea in children.

Expert Rev Gastroenterol Hepatol 2021 Mar 19;15(3):325-331. Epub 2020 Oct 19.

Faculty of Medicine, Ovidius University , Constanta, Romania.

Background: Oral rehydration is the main treatment of acute diarrhea in children. This study was undertaken to evaluate the efficacy and safety of xyloglucan and gelose (agar-agar) plus oral rehydration solution (ORS) compared with placebo and ORS for reduction of acute diarrhea symptoms in children.

Methods: In a randomized, double-blind, placebo-controlled trial, children with acute gastroenteritis received xyloglucan/gelose plus ORS (n = 50) or placebo plus ORS (n = 50) for 5 days. Demographic, clinical, anthropometric and laboratory parameters were recorded and analyzed.

Results: Xyloglucan/gelose plus ORS reduced the total number of type 7 and 6 stools on the Bristol Stool Form scale ( = 0.040 and = 0.015, respectively, compared to placebo plus ORS), and had a rapid onset of action, evident 6 hours post-treatment. Xyloglucan/gelose plus ORS also improved associated clinical symptoms (apathy, vomiting, flatulence, and blood in stool). compared with placebo plus ORS. Except for a generalized rash of unknown causality in a patient receiving placebo plus ORS, all other adverse events (dehydration, n = 7, cough, n = 1, exacerbation of vomiting, n = 1) were deemed unrelated to study medication.

Conclusions: Xyloglucan/gelose plus ORS was effective and safe in treating acute diarrhea in children.
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http://dx.doi.org/10.1080/17474124.2021.1833715DOI Listing
March 2021

Fatal rare case of measles complicated by bilateral pulmonary embolism: a case report and short literature review.

J Int Med Res 2020 Apr 31;48(4):300060519894120. Epub 2019 Dec 31.

Pediatry Department, Faculty of Medicine, Ovidius University of Constanta, Romania.

Different endemic outbreaks of measles have been diagnosed worldwide during the last several years. Some have had severe and fatal complications, possibly because of decreasing vaccination rates. The present case report describes an unvaccinated boy aged 2 years 11 months who was diagnosed with severe measles complicated by pulmonary embolism (PE). Clinical examination revealed a maculopapular rash, hyperemic pharynx, Koplik's spots, upper respiratory airway obstruction, and tachycardia with no meningeal signs of irritation. Laboratory investigations showed leukocytosis, anemia, normal liver enzyme levels, a moderately high C-reactive protein level (26 mg/L), a high erythrocyte sedimentation rate (65 mm/h), and immunoglobulin M positivity for measles. The patient was treated with antibiotic therapy (meropenem at 20 mg/kg every 8 hours) and supportive measures (anti-inflammatory drugs and intravenous rehydration). On the fourth day of hospitalization, the patient's general condition became profoundly altered; although cardiorespiratory resuscitation maneuvers were initiated, the child died. Autopsy revealed bilateral pleural effusion with serous citrine fluid, acute purulent bronchopneumonia, bilateral hilar adenopathy, and bilateral PE. Additional research is needed to establish optimal care for pediatric patients with measles, especially when complicated by PE.
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http://dx.doi.org/10.1177/0300060519894120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645360PMC
April 2020

Birth outcome in HIV vertically-exposed children in two Romanian centers.

Germs 2015 Dec 2;5(4):116-24. Epub 2015 Dec 2.

MD, PhD, Ştefan S. Nicolau Institute of Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Background: The Romanian HIV epidemic is characterized by a high prevalence among children born in the late '80s, perinatally infected. The impact of long-term treatment on their offspring is unknown. We evaluated the influence of prenatal care on the rate of premature birth among the HIV-exposed children of heavily treated HIV-infected mothers in two Romanian centers.

Methods: We retrospectively analyzed data on all patients born by HIV-infected mothers between 2006 and 2012 followed up in two main regional centers. We compared the rate of premature birth and the differences between the sites regarding children and maternal demographic characteristics and antiretroviral exposure in pregnant women.

Results: A total of 358 children born to 315 women were enrolled between 2006-2012, 262 children from the National Institute for Infectious Diseases "Prof. Dr. Matei Balş" Bucharest (NIID) and 96 children from the Clinical Infectious Diseases Hospital Constanţa (IDHC). Gender rate in newborns and mean age in mothers were similar. We recorded statistically significant differences between centers in the rate of HIV vertical transmission (16.8% vs. 6.2%, p=0.002) and prematurity (25.2 vs. 14.6%, p=0.023). The most used antiretroviral combination during pregnancy in IDHC was boosted lopinavir and fixed dose zidovudine-lamivudine (66% of cases), while in NIID a greater diversity of antiretrovirals were used. Women from IDHC were more frequently treated during pregnancy (83.3% vs. 68.6%, p=0.004). HCV coinfection and illegal drug use were associated with prematurity in the NIID cohort (p=0.037, p=0.024).

Conclusion: We found a higher rate of premature birth and HIV infection in NIID. In IDHC we found a higher rate of low birth weight in children and a higher rate of heavily treated women. Prematurity was associated with hepatitis C infection and illegal drug use in the NIID cohort.
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http://dx.doi.org/10.11599/germs.2015.1079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691192PMC
December 2015

Pulmonary inflammatory myofibroblastic tumor in an AIDS patient.

Rom J Morphol Embryol 2014 ;55(2):407-12

Clinical Hospital of Infectious Diseases, Constanta, Romania;

Background: Pulmonary inflammatory myofibroblastic tumor (PIMT) is a rare disease that occurs more frequently in younger patients. Its etiopathogeny remains debated whether this is an inflammatory lesion characterized by uncontrolled cell growth or a true neoplasm.

Aim: To present a case of PIMT in a young men, HIV-positive since childhood. Patient, Methods and Results: We report the case of an HIV-positive patient, aged 21 years, with collapsed immunity (CD4=23 cells/mm3), which in the second half of 2009 was clinically and radiologically diagnosed with recurrent right pneumonia. Serological tests were negative for Mycoplasma, Epstein-Barr and HHV-8 and positive for cytomegalovirus (CMV). Further monitoring of this episode raises imaging suspicion of the tumor in right upper pulmonary lobe. A lung wedge biopsy by thoracotomy was performed. The result of histopathological examination was suggestive for Kaposi sarcoma but required an immunohistochemical examination (vimentin, smooth muscle actin, CD34, anaplastic lymphoma kinase, CK7, L26/CD20, CD38, CD68), which established diagnosis of PIMT. In our case, we noticed a favorable evolution under antiretroviral treatment (by increasing CD4 count - immunity slowly improved), broad-spectrum antibiotics, and steroidal anti-inflammatory treatment, with regression of PIMT over eight months.

Conclusions: Although inflammatory myofibroblastic tumor (IMT) is rare, it should be considered in the differential diagnosis of pulmonary tumoral lesions in young adults. This is the first PIMT case in an HIV-positive patient described in Romania. Even good response in such cases was noticed after surgical treatment, in our case we achieved complete remission of the disease with anti-inflammatory steroidal therapy and combined antiretroviral therapy (cART). As other infectious etiologies, CMV also could represent a trigger for developing a pulmonary inflammatory myofibroblastic tumor.
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April 2015

Parental environmental tobacco smoking and the prevalence of respiratory diseases in primary school children.

Pneumologia 2013 Jul-Sep;62(3):178-81

Faculty of Medicine, Ovidius University of Constanţa, Romania.

Introduction: The inhaling tobacco smoke to which a child is exposed, in a home environmental area, could affect respiratory system.

Material And Methods: The aim of the study consists in detecting the prevalence of respiratory diseases in home exposure to secondhand smoke among primary school children. A 6-month prospective case-control study based on questionnaire survey was carried out among school children of "Spiru Haret" Primary School, Medgidia, Romania, with absences for respiratory diseases, related to exposure to parental passive smoking, in their home environmental. 136 school children and their families informed, consented to complete the questionnaire and were surveyed for respiratory diseases and domestic environmental tobacco smoking, from the 1st of October, 2011 to the 31st March, 2012. The method consists in collecting data about any respiratory illness events, correlating them with the questionnaire --reports of parental smoking in home environmental.

Results: Participants were divided in 88 cases exposed to SHS (E) and 48 controls without exposure (NE). The most sick children with more than one episode of respiratory illness were among cases (n = 61/88; 69.31% vs 19/48; 39.58%; OR = 3.45; RR = 1.62; chi2 = 12.25; p < 0.0008). The most important source of parental passive smoking is the father (n = 67/88; 76.13%), being a single parent in most of the cases (n = 46/88; 57.95%). The prevalence of bronchial asthma was 0.34% in cases, being related with prenatal maternal smoking exposure (1.11%).

Conclusion: The prevalence of respiratory diseases is higher among children with environmental parental tobacco exposure, in particular, smoking father.
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January 2014
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