Publications by authors named "Valeriu Gheorghita"

9 Publications

  • Page 1 of 1

Prospects of COVID-19 Vaccination in Romania: Challenges and Potential Solutions.

Front Public Health 2021 10;9:644538. Epub 2021 Feb 10.

Department of Epidemiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.

The rapid advancement in vaccine development represents a critical milestone that will help humanity tackle the COVID-19 pandemic. However, the success of these efforts is not guaranteed, as it relies on the outcomes of national and international vaccination strategies. In this article, we highlight some of the challenges that Romania will face and propose a set of solutions to overcome them. With this in mind, we discuss issues such as the infrastructure of vaccine storage and delivery, the deployment and administration of immunisations, and the public acceptance of vaccines. The ways in which Romanian society will respond to a national COVID-19 vaccination campaign will be contingent on appropriate and timely actions. As many of the problems encountered in Romania are not unique, the proposed recommendations could be adapted and implemented in other countries that face similar issues, thereby informing better practices in the management of the COVID-19 pandemic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpubh.2021.644538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902778PMC
March 2021

A challenging case of jaundice and febrile uncommon rash in an immunocompetent male patient.

Turk J Gastroenterol 2019 May;30(5):485-488

Carol Davila Central Military University Emergency Hospital, Bucharest, Romania.; Titu Maiorescu University School of Medicine, Bucharest, Romania.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/tjg.2018.18465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505654PMC
May 2019

Epidemiological trends and therapeutic challenges of malignancies in adult HIV-1-infected patients receiving combination antiretroviral therapy in a tertiary hospital from Romania: An observational retrospective study.

J Infect Public Health 2019 Mar - Apr;12(2):182-189. Epub 2018 Oct 19.

‟Carol Davila" University of Medicine and Pharmacy, Boulevard Eroii Sanitari, 8, Bucharest, Romania; National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Dr. Calistrat Grozovici Street, 1, Bucharest, Romania. Electronic address:

Background: Malignancies have become a leading cause of morbidity and mortality in people living with HIV (PLHIV). The primary endpoint of our study was to describe the epidemiology of acquired immunodeficiency syndrome (AIDS)-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs). Epidemiological disparities, mortality predictors and survival analysis within the two groups of patients were key secondary endpoints.

Methods: We retrospectively evaluated all adult PLHIV with histopathologically proven cancers registered from 2010 to 2016 in the "Matei Balș" National Institute for Infectious Diseases, Bucharest, Romania.

Results: 110 eligible patients have been included in the study. The incidence of ADCs decreased from 1.6% in 2010 to 0.3% in 2016, unlike NADCs which remained fairly stable over time (0.3%). The higher CD4 count and lower HIV-RNA level at the cancer diagnosis were associated with prolonged survival in ADCs group, but not in NADCs group. The mean CD4 count was 449/mm to survivors and 92/mm to non-survivors (p=0.017). The mean level of HIV-RNA was 64,671 copies/mL to survivors and 1,760,345 copies/mL to non-survivors (p=0.002).

Conclusions: A good therapeutic control of HIV infection at the diagnosis of ADCs was associated with better survival, emphasizing the key role of the effective cART in the management of HIV-associated cancers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jiph.2018.09.011DOI Listing
April 2019

Primary peritoneal tuberculosis, a forgotten localization. Case report.

Indian J Tuberc 2018 Jul 16;65(3):257-259. Epub 2016 Dec 16.

"Filantropia" Clinical Hospital, Bucharest, Romania. Electronic address:

We present a case report of a young nulliparous woman that presented with progressive ascites, night sweats and weight loss. Clinical and para-clinical findings were not suggestive of pulmonary tuberculosis (TB) or other peritoneal conditions. A laparoscopy revealed important ascites and granulomatous peritoneal infiltration with normal genital anatomy. Tests for tuberculosis revealed primary peritoneal involvement in absence of pulmonary TB. This was a case of TB with primary and limited localization in the peritoneum. A strength of this report is that it has adequate illustration of the macroscopic and microscopic findings. In this brief report, we argue that the peritoneal localization of TB has been forgotten, but in countries with a high incidence of this condition, it should always be taken into consideration by doctors from all specialities when making differential diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijtb.2016.10.004DOI Listing
July 2018

Clostridium difficile Infection in Hospitalized Cirrhotic Patients with Hepatic Encephalopathy.

J Gastrointestin Liver Dis 2016 Mar;25(1):120-1

Prof Dr Matei Balș National Institute for Infectious Diseases;Dr Carol Davila Central Universitary Emergency Military Hospital, Bucharest, Romania.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.15403/jgld.2014.1121.251.cldDOI Listing
March 2016

Fusarium ramigenum, a novel human opportunist in a patient with common variable immunodeficiency and cellular immune defects: case report.

BMC Infect Dis 2016 Feb 15;16:79. Epub 2016 Feb 15.

Department of Internal Medicine, Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.

Background: Fusarium species are ubiquitous environmental fungi that occasionally provoke serious invasive infections in immunocompromised hosts. Among Fusarium species, Fusarium ramigenum, belonging to the Fusarium fujikuroi species complex, has thus far never been found to cause human infections. Here we describe the first case of invasive fusariosis caused by Fusarium ramigenum in a human and also identify immunological deficiencies that most likely contributed to invasiveness.

Case Presentation: A 32-year-old Caucasian male with a seemingly insignificant medical history of mild respiratory illness during the preceding two years, developed invasive pulmonary fusariosis. Detailed immunological assessment revealed the presence of common variable immunodeficiency, complicated by a severe impairment of the capacity of T-cells to produce both gamma-interferon and interleukin-17. In-depth microbiological assessment identified the novel human opportunistic pathogen Fusarium ramigenum as cause of the infection.

Conclusion: This report demonstrated that an opportunistic invasive fungal infection may indicate an underlying cellular immune impairment of the host. The unexpected invasive infection with Fusarium ramigenum in this case unmasked a complex combined humoral and cellular immunological deficiency.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12879-016-1382-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753665PMC
February 2016

Endocrine dysfunction in sepsis: a beneficial or deleterious host response?

Germs 2015 Mar 2;5(1):17-25. Epub 2015 Mar 2.

MD, PhD, Associate Professor, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Institute for Infectious Diseases "Prof. Dr. Matei Balş", Bucharest, Romania.

Sepsis is a systemic, deleterious inflammatory host response triggered by an infective agent leading to severe sepsis, septic shock and multi-organ failure. The host response to infection involves a complex, organized and coherent interaction between immune, autonomic, neuroendocrine and behavioral systems. Recent data have confirmed that disturbances of the autonomic nervous and neuroendocrine systems could contribute to sepsis-induced organ dysfunction. Through this review, we aimed to summarize the current knowledge about the endocrine dysfunction as response to sepsis, specifically addressed to vasopressin, copeptin, cortisol, insulin and leptin. We searched the following readily accessible, clinically relevant databases: PubMed, UpToDate, BioMed Central. The immune system could be regarded as a "diffuse sensory organ" that signals the presence of pathogens to the brain through different pathways, such as the vagus nerve, endothelial activation/dysfunction, cytokines and neurotoxic mediators and the circumventricular organs, especially the neurohypophysis. The hormonal profile changes substantially as a consequence of inflammatory mediators and microorganism products leading to inappropriately low levels of vasopressin, sick euthyroid syndrome, reduced adrenal responsiveness to ACTH, insulin resistance, hyperglycemia as well as hyperleptinemia. In conclusion, clinical diagnosis of this "pan-endocrine illness" is frequently challenging due to the many limiting factors. The most important benefits of endocrine markers in the management of sepsis may be reflected by their potential to be used as biomarkers in different scoring systems to estimate the severity of the disease and the risk of death.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11599/germs.2015.1067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350863PMC
March 2015

Use of quantitative serum HBsAg for optimization of therapy in chronic hepatitis B patients treated with pegylated interferon alfa-2a: a Romanian cohort study.

J Gastrointestin Liver Dis 2013 Mar;22(1):27-32

Central Military Emergency Hospital Dr Carol Davila; National Institute of Infectious Diseases Prof Dr Matei Bals, Bucharest, Romania;

Background & Aims: The aim of the study was to assess the clinical utility of serum HBsAg quantification as a surrogate biomarker for the prediction of sustained virological response (SVR) in chronic hepatitis B (CHB) patients treated with Pegylated Interferon alfa-2a (Peg-IFN α-2a).

Methods: We performed a prospective cohort study which included 57 patients with CHB treated 48 weeks with Peg-IFN α-2a and followed for another 24 weeks. HBsAg was quantified at the baseline, during treatment and at the end of follow-up. SVR was defined as HBV-DNA below 2,000 IU/ml at 24 weeks after the end of therapy.

Results: The majority of patients had HBeAg-negative CHB (68%, n=39). Positive predictive factors for SVR at baseline were low levels of HBsAg (3.72 log10 IU/ml, p=0.032) and HBV-DNA (3.96 log10 IU/ml, p=0.035). During treatment, patients who achieved SVR showed a marked decrease in serum HBsAg in comparison with nonresponders (at week 48 mean decrease of 1.06 +/- 1.3 log10 IU/ml versus 0.04 ± 0.5 log10 UI/ml, p=0.005). On therapy, HBV-DNA reduction ≥ 2 log10 IU/ml with any decrease of HBsAg level at week 12 had a positive predictive value (PPV) of 80% (95% CI: 51.91-95.43%) for SVR, while HBV-DNA decline < 2 log10 IU/ml without any decline of HBsAg had a negative predictive value (NPV) of 85.71% (95% CI: 42.23-97.63%) for SVR.

Conclusions: HBsAg quantification combined with HBV-DNA assessment could become an early useful tool to optimize the management of CHB patients treated with Peg-IFN α-2a, according to response guided therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2013

HBV Chronic hepatitis during chemotherapy - an immune controlled disease.

J Gastrointestin Liver Dis 2008 Dec;17(4):445-9

University of Medicine and Pharmacy Carol Davila, Bucharest, National Institute for Infectious Diseases "Prof. dr. Matei Bals" UMF "Carol Davila" Bucharest, Romania.

View Article and Find Full Text PDF

Download full-text PDF

Source
December 2008