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Camelia A, Pandelescu A, Nae G, Ismail G, Zgura A, Badiu CD, Popescu G. WHEN KIDNEY BIOPSY GUIDES THE DIAGNOSIS OF HANTAVIRUS INFECTION. ArveMED 2022. [DOI: 10.35630/2022/12/6.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Hantavirus infection is increasingly widespread in the last years, but diagnosing this infection could be difficult sometimes, given the nonspecific symptoms and the lack of experience by physicians into this direction. Hantavirus infection is a viral infection causing two major syndromes: Hemorrhagic fever with renal syndrome (HFRS) and Cardiopulmonary syndrome (CPS). We present the case of a young man, admitted to the hospital with fever, nausea, vomiting, diarrhea, abdominal pain and oligoanuria, in whom the diagnosis of hantavirus infection was established following the kidney biopsy, in addition to the ELISA assay. According to the literature, all histological findings concluded to hantavirus nephritis. Interstitial hemorrhage in the medulla is a main characteristic of hantavirus infection. Despite the fact that the identified serotype (Hantaan virus) is responsible for a severe form of this disease, the patient's evolution was favorable, with recovery of renal function after 1 month.
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Iancu G, Serban D, Badiu CD, Tanasescu C, Tudosie MS, Tudor C, Costea DO, Zgura A, Iancu R, Vasile D. Tyrosine kinase inhibitors in breast cancer (Review). Exp Ther Med 2022; 23:114. [PMID: 34970337 PMCID: PMC8713180 DOI: 10.3892/etm.2021.11037] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/20/2021] [Indexed: 12/23/2022] Open
Abstract
Anti-epidermal growth factor receptor (EGFR)-targeted therapy has been intensely researched in the last years, motivated by the favorable results obtained with monoclonal antibodies in HER2-enriched breast cancer (BC) patients. Most researched alternatives of anti-EGFR agents were tyrosine kinase inhibitors (TKIs) and monoclonal antibodies. However, excluding monoclonal antibodies trastuzumab and pertuzumab, the remaining anti-EGFR molecules have exhibited disappointing results, due to the lack of specificity and frequent adverse side effects. TKIs have several advantages, including reduced cardiotoxicity, oral administration and favorable penetration of blood-brain barrier for brain metastatic BC. Lapatinib and neratinib and recently pyrotinib (approved only in China) are the only TKIs from dozens of molecules researched over the years that were approved to be used in clinical practice with limited indications, in a subset of BC patients, single or in combination with other chemotherapy or hormonal therapeutic agents. Improved identification of BC subtypes and improved characterization of aggressive forms (triple negative BC or inflammatory BC) should lead to advancements in shaping of targeted agents to improve the outcome of patients.
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Affiliation(s)
- George Iancu
- Department of Obstetrics and Gynecology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Gynecology, ‘Filantropia’ Clinical Hospital, 011132 Bucharest, Romania
| | - Dragos Serban
- Department of General Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Fourth Department of General Surgery, Emergency University Hospital, 050098 Bucharest, Romania
| | - Cristinel Dumitru Badiu
- Department of General Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of General Surgery, ‘Prof. Dr. Bagdasar Arseni’ Emergency Clinical Hospital, 041915 Bucharest, Romania
| | - Ciprian Tanasescu
- Third Clinico-Surgical Department, Faculty of Medicine, ‘Lucian Blaga’ University, 550169 Sibiu, Romania
| | - Mihai Silviu Tudosie
- Department of Orthopedia and Intensive care, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- ICU II Toxicology, Clinical Emergency Hospital, 014461 Bucharest, Romania
| | - Corneliu Tudor
- Department of General Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Daniel Ovidiu Costea
- Department of General Surgery, Faculty of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
- First Surgery Department, Emergency County Hospital, 900591 Constanta, Romania
| | - Anca Zgura
- Department of Oncology Radiotherapy, Institute of Oncology ‘Prof. Dr. Trestioreanu’, 022328 Bucharest, Romania
| | - Raluca Iancu
- Department of ENT-Opthalmology, Faculty of Medicine, Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Ophthalmology, Emergency University Hospital, 050098 Bucharest, Romania
| | - Danut Vasile
- Department of General Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- First Department of General Surgery, Emergency University Hospital, 050098 Bucharest, Romania
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Tudosie MS, Caragea G, Popescu DM, Avram O, Serban D, Smarandache CG, Tudor C, Badiu CD, Socea B, Sabau AD, Comandasu M, Spataru R, Costea DO, Tanasescu C, Dascalu AM. Optimization of a GF-AAS method for lead testing in blood and urine: A useful tool in acute abdominal pain management in emergency. Exp Ther Med 2021; 22:985. [PMID: 34345267 DOI: 10.3892/etm.2021.10417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/03/2021] [Indexed: 11/06/2022] Open
Abstract
Suspicion of lead poisoning is confirmed by its concentration in blood and protoporphyrin red blood cells. At low concentrations, lead influences the synthesis of the heme in the sense of lowering it. Acute and chronic lead intoxication is extremely polymorphic in regards to its clinical manifestations, with digestive, hematological, cardiovascular, renal hepatic and neurological features. The aim of the study was to evaluate the presence of lead in human whole blood and urine harvested before and during chelation treatment in the case of lead poisoning. An atomic absorption spectroscopic method for the analysis of lead was developed using graphite furnace atomic absorption spectrophotometer (GF-AAS), Varian Spectra AA-880 with a hollow cathode lead lamp and a deuterium lamp for background correction, coupled to a GTA-100 atomizer and a programmable sample dispenser. Standard calibration solutions were used for the range 10-100 µg/l. The linearity range was 10.0 to 100.0 µg/l with the correlation coefficient of 0.999. We established that the method can be applied for the determination of lead in whole blood and urine, and the results obtained are useful for monitoring chelation therapy in cases of acute lead poisoning, a neglected cause of abdominal colic pain in an emergency situation.
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Affiliation(s)
- Mihail Silviu Tudosie
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020011 Bucharest, Romania.,ICU II Toxicology, Clinical Emergency Hospital, 014461 Bucharest, Romania
| | - Genica Caragea
- Military Medical Research Center, 010919 Bucharest, Romania
| | - Dragos Marian Popescu
- Faculty of Medicine, The University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Oana Avram
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020011 Bucharest, Romania.,ICU II Toxicology, Clinical Emergency Hospital, 014461 Bucharest, Romania
| | - Dragos Serban
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020011 Bucharest, Romania.,Fourth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Catalin Gabriel Smarandache
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020011 Bucharest, Romania.,Fourth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Corneliu Tudor
- Fourth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Cristinel Dumitru Badiu
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020011 Bucharest, Romania.,General Surgery, Emergency Clinical Hospital 'Prof. Dr. Bagdasar Arseni', 041915 Bucharest, Romania
| | - Bogdan Socea
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020011 Bucharest, Romania.,Department of Surgery, 'Sf. Pantelimon' Emergency Clinical Hospital, 021659 Bucharest, Romania
| | - Alexandru Dan Sabau
- Third Department, Faculty of Medicine, 'Lucian Blaga' University of Sibiu, 550169 Sibiu, Romania
| | - Meda Comandasu
- Fourth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Radu Spataru
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020011 Bucharest, Romania.,Department of Pediatric Surgery, Emergency Clinic Hospital for Children 'Marie S. Curie', 077120 Bucharest, Romania
| | - Daniel Ovidiu Costea
- Faculty of Medicine, Ovidius University, 900470 Constanta, Romania.,First Surgery Department, Emergency County Hospital, 900591 Constanta, Romania
| | - Ciprian Tanasescu
- Third Department, Faculty of Medicine, 'Lucian Blaga' University of Sibiu, 550169 Sibiu, Romania
| | - Ana Maria Dascalu
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020011 Bucharest, Romania.,Ophthalmology Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
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Serban D, Balasescu SA, Alius C, Balalau C, Sabau AD, Badiu CD, Socea B, Trotea AM, Dascalu AM, Motofei I, Ardeleanu V, Spataru RI, Sabau D, Smarandache GC. Clinical and therapeutic features of acute cholecystitis in diabetic patients. Exp Ther Med 2021; 22:758. [PMID: 34035855 DOI: 10.3892/etm.2021.10190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/03/2021] [Indexed: 12/12/2022] Open
Abstract
The present study aimed to compare the clinical, paraclinical, intraoperative findings, and postoperative complications in acute cholecystitis in diabetic patients vs. non-diabetic patients. A 2-year retrospective study was performed on the patients who underwent emergency cholecystectomy for acute cholecystitis between 2017 and 2019 at the 4th Department of Surgery, Emergency University Hospital Bucharest. The diabetic subgroup numbered 46 eligible patients and the non-diabetic one 287 patients. Demographics, the severity of the clinical forms, biological variables (including white cell count, urea, creatinine, coagulation and liver function tests) comorbidity status, surgical approach, postoperative complications, and hospital stay were analyzed. Statistical analyses were performed to assess comparative results between the aforementioned data (SPSS V 13.0). The CCI and ASA risk classes were increased in the diabetic group, with 34.78% of patients having 3 or more associated comorbidities. No statistically significant associations were demonstrated between diabetes and the severity of the cholecystitis and risk for conversion. Postoperatively both minor complications such as surgical site infections and major cardiovascular events were more common in the diabetic subgroup (P=0.0254), well associated with the preoperative status and baseline cardiovascular comorbidities. Laparoscopic cholecystectomy is a safe procedure for diabetic patients, which can provide the best outcomes, by decreasing the risks of surgical wounds. Attentive perioperative care and good glycemic control must be provided to minimize the risk of complications.
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Affiliation(s)
- Dragos Serban
- 4th Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.,Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania
| | | | - Catalin Alius
- 4th Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Cristian Balalau
- Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania.,Department of Surgery, 'Sf. Pantelimon' Emergency Hospital, 021659 Bucharest, Romania
| | - Alexandru Dan Sabau
- 3rd Clinical Department, Faculty of Medicine, 'Lucian Blaga' University Sibiu, 550169 Sibiu, Romania
| | - Cristinel Dumitru Badiu
- Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania
| | - Bogdan Socea
- Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania.,Department of Surgery, 'Sf. Pantelimon' Emergency Hospital, 021659 Bucharest, Romania
| | - Andra Maria Trotea
- Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania
| | - Ana Maria Dascalu
- Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania
| | - Ion Motofei
- Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania.,Department of Surgery, 'Sf. Pantelimon' Emergency Hospital, 021659 Bucharest, Romania
| | - Valeriu Ardeleanu
- The Faculty of Medicine, Doctoral School, 'Ovidius' University, 900527 Constanta, Romania.,Department of Surgery, General Hospital CFR, 800223 Galati, Romania.,Department of Plastic Surgery, Arestetic Clinic, BR4A, 800108 Galati, Romania
| | - Radu Iulian Spataru
- Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania.,Department of Pediatric Surgery, Emergency Clinic Hospital for Children 'Marie S. Curie', 077120 Bucharest, Romania
| | - Dan Sabau
- 3rd Clinical Department, Faculty of Medicine, 'Lucian Blaga' University Sibiu, 550169 Sibiu, Romania
| | - Gabriel Catalin Smarandache
- 4th Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.,Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila' Bucharest, 020021 Bucharest, Romania
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Serban D, Socea B, Badiu CD, Tudor C, Balasescu SA, Dumitrescu D, Trotea AM, Spataru RI, Vancea G, Dascalu AM, Tanasescu C. Acute surgical abdomen during the COVID-19 pandemic: Clinical and therapeutic challenges. Exp Ther Med 2021; 21:519. [PMID: 33815592 DOI: 10.3892/etm.2021.9950] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
The present study investigated the effects of the COVID-19 pandemic on the clinical presentation and therapeutic management of acute surgical abdomen. A retrospective study of emergency hospitalizations with a diagnosis of acute surgical abdomen between April and July 2020 vs. a similar period in 2019 was performed. The observation sheets and the operating protocols were analyzed. Between April and July 2020, 50 cases of acute surgical abdomen were hospitalized and treated, compared to 43 cases in the same period last year. The main types of pathology in both groups included: Occlusions (60%, respectively 44.2% in 2019) and peritonitis (32%, respectively 41.8% in 2019). There was an increased rate of patients with colorectal cancers neglected therapeutically or uninvestigated, who presented during the pandemic period with emergencies for complications such as occlusion or tumor perforation (32 vs. 6.97%, P=0.0039). One case, with gastric perforation, was COVID-positive, with no pulmonary symptoms at admission. The number of postoperative infectious complications was lower during the pandemic (2 vs. 13.95%, P=0.0461). As the COVID-19 pandemic appears to be still far from ending, we should learn to adapt our surgical protocols to the new evidence. Oncological patients are a vulnerable group, who were neglected in the first months of the pandemic. SARS-Cov-2 infection may be a cause of abdominal pain and should be taken into account in different diagnoses of acute abdomen in surgical wards. Correct wearing of adequate personal protective equipment (PPE) and respecting strict rules of asepsis and antisepsis are required for preventing in-hospital transmission of infection.
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Affiliation(s)
- Dragos Serban
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Fourth Department of Surgery, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania
| | - Bogdan Socea
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Surgery, 'Sf. Pantelimon' Emergency Hospital, 021659 Bucharest, Romania
| | - Cristinel Dumitru Badiu
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,General Surgery, Emergency Clinical Hospital 'Prof. Dr. Bagdasar Arseni', 041915 Bucharest, Romania
| | - Corneliu Tudor
- Fourth Department of Surgery, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania
| | - Simona Andreea Balasescu
- Fourth Department of Surgery, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania
| | - Dan Dumitrescu
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Fourth Department of Surgery, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania
| | - Andra Maria Trotea
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Second Department of Anesthesia and Intensive Care, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania
| | - Radu Iulian Spataru
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Paediatric Surgery, Emergency Clinic Hospital for Children 'Maria S. Curie', 41451 Bucharest, Romania
| | - Geta Vancea
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Third Department, 'Dr Victor Babes' Clinical Hospital for Infectious and Tropical Diseases, 030303 Bucharest, Romania
| | - Ana Maria Dascalu
- Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ciprian Tanasescu
- Third Department of Surgery, Faculty of Medicine, 'Lucian Blaga' University Sibiu, 550169 Sibiu, Romania
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Serban D, Socea B, Balasescu SA, Badiu CD, Tudor C, Dascalu AM, Vancea G, Spataru RI, Sabau AD, Sabau D, Tanasescu C. Safety of Laparoscopic Cholecystectomy for Acute Cholecystitis in the Elderly: A Multivariate Analysis of Risk Factors for Intra and Postoperative Complications. Medicina (Kaunas) 2021; 57:230. [PMID: 33801408 PMCID: PMC8002041 DOI: 10.3390/medicina57030230] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022]
Abstract
Background and Objectives: This study investigates the impact of age upon the safety and outcomes of laparoscopic cholecystectomy performed for acute cholecystitis, by a multivariate approach. Materials and Methods: A 2-year retrospective study was performed on 333 patients admitted for acute cholecystitis who underwent emergency cholecystectomy. The patients included in the study group were divided into four age subgroups: A ≤49 years; B: 50-64 years; C: 65-79 years; D ≥80 years. Results: Surgery after 72 h from onset (p = 0.007), severe forms, and higher American Society of Anesthesiologists Physical Status Classification and Charlson comorbidity index scores (p < 0.001) are well correlated with older age. Both cardiovascular and surgical related complications were significantly higher in patients over 50 years (p = 0.045), which also proved to be a turning point for increasing the rate of conversion and open surgery. However, the comparative incidence did not differ significantly between patients aged from 50-64 years, 65-79 years and over 80 years (6.03%, 9.09% and 5.8%, respectively). Laparoscopic cholecystectomy (LC) was the most frequently used surgical approach in the treatment of acute cholecystitis in all age groups, with better outcomes than open cholecystectomy in terms of decreased overall and postoperative hospital stay, reduced surgery related complications, and the incidence of acute cardiovascular events in the early postoperative period (p < 0.001). Conclusions: The degree of systemic inflammation was the main factor that influenced the adverse outcome of LC in the elderly. Among comorbidities, diabetes was associated with increased surgical and systemic postoperative morbidity, while stroke and chronic renal insufficiency were correlated with a high risk of cardiovascular complications. With adequate perioperative care, the elderly has much to gain from the benefits of a minimally invasive approach, which allows a decreased rate of postoperative complications and a reduced hospital stay.
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Affiliation(s)
- Dragos Serban
- 4th Department of Surgery, University Emergency Hospital Bucharest, 050098 Bucharest, Romania;
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.S.); (C.D.B.); (A.M.D.); (G.V.); (R.I.S.)
| | - Bogdan Socea
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.S.); (C.D.B.); (A.M.D.); (G.V.); (R.I.S.)
- Department of Surgery, “Sf. Pantelimon” Emergency Hospital, 021659 Bucharest, Romania
| | | | - Cristinel Dumitru Badiu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.S.); (C.D.B.); (A.M.D.); (G.V.); (R.I.S.)
- Department of Surgery, “Bagdasar Arseni” Clinical Emergency Hospital, 041915 Bucharest, Romania
| | - Corneliu Tudor
- 4th Department of Surgery, University Emergency Hospital Bucharest, 050098 Bucharest, Romania;
| | - Ana Maria Dascalu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.S.); (C.D.B.); (A.M.D.); (G.V.); (R.I.S.)
| | - Geta Vancea
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.S.); (C.D.B.); (A.M.D.); (G.V.); (R.I.S.)
| | - Radu Iulian Spataru
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.S.); (C.D.B.); (A.M.D.); (G.V.); (R.I.S.)
- Department of Pediatric Surgery, Emergency Clinic Hospital for Children “Maria S. Curie”, 41451 Bucharest, Romania
| | - Alexandru Dan Sabau
- 3rd Department Surgery, Faculty of Medicine, “Lucian Blaga” University Sibiu, 550169 Sibiu, Romania; (A.D.S.); (D.S.); (C.T.)
| | - Dan Sabau
- 3rd Department Surgery, Faculty of Medicine, “Lucian Blaga” University Sibiu, 550169 Sibiu, Romania; (A.D.S.); (D.S.); (C.T.)
| | - Ciprian Tanasescu
- 3rd Department Surgery, Faculty of Medicine, “Lucian Blaga” University Sibiu, 550169 Sibiu, Romania; (A.D.S.); (D.S.); (C.T.)
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Serban D, Papanas N, Dascalu AM, Stana D, Nicolae VA, Vancea G, Badiu CD, Tanasescu D, Tudor C, Balasescu SA, Pantea-Stoian A. Diabetic Retinopathy in Patients With Diabetic Foot Ulcer: A Systematic Review. INT J LOW EXTR WOUND 2020; 20:98-103. [PMID: 33353439 DOI: 10.1177/1534734620982237] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This review discusses the evidence on diabetic retinopathy (DR) in patients with diabetic foot ulceration (DFU). A systematic literature review was performed on PubMed, Medline, Springer Nature, and Scopus, following the PRISMA guidelines, using the following terms, individually or in combination: "diabetic foot ulcer" OR "diabetic foot syndrome" OR "DFU" and "diabetic retinopathy." The initial search yielded 648 articles published between 1975 and 2020. After applying exclusion and inclusion criteria, a total of 9 articles were analyzed, assessing the correlations between DR and DFU. In all cases, DR and especially proliferative diabetic retinopathy were significantly higher in the presence of DFU, though the frequency of DR showed large variability (22.5% to 95.6%). There was a significant correlation between advanced stages of DFU and increased frequency of DR and proliferative diabetic retinopathy. On the other hand, there is a risk of accelerated progression of DR in nonhealing DFUs, possibly related to chronic inflammation and associated infection. Hence, patients with DFUs should be monitored by an ophthalmologist, and those with DR should be promptly referred to a specialized diabetic foot clinic.
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Affiliation(s)
- Dragos Serban
- University of Medicine and Pharmacy "Carol Davila" Bucharest, Bucharest, Romania.,Emergency University Hospital Bucharest, Bucharest, Romania
| | - Nikolaos Papanas
- Democritus University of Thrace, Alexandroupolis, Greece.,University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ana Maria Dascalu
- University of Medicine and Pharmacy "Carol Davila" Bucharest, Bucharest, Romania.,Emergency University Hospital Bucharest, Bucharest, Romania
| | - Daniela Stana
- Emergency University Hospital Bucharest, Bucharest, Romania
| | - Vanessa Andrada Nicolae
- University of Medicine and Pharmacy "Carol Davila" Bucharest, Bucharest, Romania.,Emergency University Hospital Bucharest, Bucharest, Romania
| | - Geta Vancea
- University of Medicine and Pharmacy "Carol Davila" Bucharest, Bucharest, Romania
| | | | | | - Corneliu Tudor
- Emergency University Hospital Bucharest, Bucharest, Romania
| | | | - Anca Pantea-Stoian
- University of Medicine and Pharmacy "Carol Davila" Bucharest, Bucharest, Romania
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8
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Dascalu AM, Serban D, Vladila B, Grigore A, Socea B, Sabau A, Tudosie MS, Badiu CD, Smarandache GC. Neuroprotective Effects of Low Intensity and Low Frequency Electromagnetic �in vitro� Stimulation on Glial Cells. Rev Chim 2020. [DOI: 10.37358/rc.20.2.7933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Degenerative neurological diseases (senile dementia, Alzheimer`s disease, glaucoma), post-stroke sequelae are increasing as prevalence nowadays, in context of aging in general population, and there are strong evidences that astrocytes may play a significant role in neuroprotection. The study evaluates the effects of low intensity low frequency electromagnetic field (EMF) �in vitro� stimulation (195 mA, 7-8 Hz) on the glial cells, in different conditions, in order to identify the neuroprotective potential. Three cell lines were used for the study: the Clonetics (Lonza) line of normal human astrocytes, U87 glioblastoma tumor cells (ATCC) and L929 murine fibroblasts. The cell cultures were exposed to EMF stimulation for 2 hours/day, for 5 and 10 day, in absence and in the presence of oxidative stress stimuli. Cell viability, apoptotic potential, changes in cell phenotype, stimulation of cell proliferation for normal and malignant transformed cell lines, resilience to oxidative stress were investigated. The viability of the cells was investigated by MTS assay, and the Griess test was used to detect nitrite production as a marker of oxidation and inflammation. Inverted microscopy examination revealed that following exposure to the tested EMF, no morphological changes of the cells were recorded. In none of the cell lines tested, no cytotoxic or cytopathic effects were observed in the cultures exposed under low density conditions. In case of exposure of cell cultures for 10 days to the action of EMF, a viability of 98.2% of glial cells and 97% of exposed fibroblasts is observed, compared to unexposed cells. The viability of the cells exposed to both EMF and oxidative and inflammatory stimuli is increased by 0.96% in the case of H2O2 stimulation and in 3.76% in the case of LPS stimulation, suggesting a possible neuroprotective effect of EMF exposure. Low intensity low frequency EMF �in vitro� stimulation increased viability of the glial cells exposed to oxidative and inflammatory stimuli. No cytotoxic or cytopathic effects were observed in the exposed cultures under conditions of low density. Further tests are needed in order to elucidate the mechanisms of action of EMF on astrocytes, especially on astrocyte-neuron co-cultures to highlight the interactions between these cell types. Confirmation of the neuroprotective effect of low intensity and low frequency EMF opens the way for the development of an innovative, non-invasive therapy.
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9
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Tudosie MS, Secara CA, Smarandache CG, Bicheru S, Muresan M, Socea B, Grigoriu N, Badiu CD, Epure G, Dascalu AM, Draghici C. The Synthesis and Toxicological Characterization of Neurotoxic Chemical Agents Simulants. Rev Chim 2019. [DOI: 10.37358/rc.19.11.7664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neurotoxic warfare chemical agents (CWA/NA) induce major toxicological effects to the affected personnel. Their increased toxicity justifies the necessity of developing analytical methods for diagnosis and specific medical counter measures. CWA/NA are extremely toxic agents which are subject to international regulations (The Geneva Protocol regarding the prohibition of chemical weapons). Taking into account the ban on human experimenting due to high toxicity, simulators of neurotoxic chemical agents are being used in laboratories. These are analogue chemical compounds which possess the same relevant physical, chemical and pharmacodynamical properties of the corresponding agents, but with lower intrinsical toxicity. The synthesis and toxicological characterization of these simulators of neurotoxic chemical agents allow the laboratory research of these extremely toxic compounds and the unfolding of risk-free antidote studies. This paper proposes the synthesis and toxicological testing of chemical compounds which simulate sarin (4-nitrophenyl isopropyl methylphosphonate - NIMP) and VX (4-nitrophenyl ethyl methylphosphonate - NEMP).
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Daia C, Bumbea AM, Badiu CD, Ciobotaru C, Onose G. Interferential electrical stimulation for improved bladder management following spinal cord injury. Biomed Rep 2019; 11:115-122. [PMID: 31423306 DOI: 10.3892/br.2019.1227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 06/21/2019] [Indexed: 11/06/2022] Open
Abstract
Patients with spinal cord injury (SCI) with neurogenic bladder (NB) represent a major medical problem, which initiated the search for a non-invasive and effective treatment that is easy to apply and without side effects. A study was performed using interferential medium frequency current electrical stimulation (IMFC ES) on 332 patients shortly after SCI diagnosed with NB dysfunction. All subjects received standard care and patients of the experimental group additionally received IMFC ES. Urinary management results included volitional control of voiding, intermittent catheterization, post-voidance residuum (PVR) quantity and quantity of urine lost (LOSS). Results were assessed based on the American spinal cord injury association impairment scale (AIS). The IMFC ES included two channels of medium frequency stimulation that were marginally different. Within the body, a low frequency field was generated through the interaction of the medium frequencies, which stimulated the urinary structures. In the IMFC ES group, interference stimulation was applied for 10 min with frequencies cycling from 0-100 Hz and back in 10 sec intervals. The strength of the low frequency stimulation, achieved by the interference of the two medium-frequency fields, was adjusted to the patients' vibration sensation. The intensities triggering vibration sensation were between 20-80 mA for patients with AIS levels B, C and D. For patients with AIS level A intensities <20 mA were used for therapeutic effects without causing skin injuries. Safety of IMFC ES was based on occurrence of adverse events of which none were recorded in the experimental group. IMFC ES was effective in patients with AIS levels B and C, significantly decreasing PVR and LOSS compared with patients receiving standard care No significant improvements in urinary management were observed following IMFC ES treatment of patients with AIS level A. Patients with SCI and NB classed as AIS levels B and C that exhibit preserved sensitivity were the best beneficiaries of IMFC ES therapy.
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Affiliation(s)
- Cristina Daia
- Department of Medical Rehabilitation, University of Medicine and Pharmacy 'Carol Davila', Bucharest 4192910, Romania.,Neuromuscular Department, Clinical Emergency Hospital 'Bagdasar Arseni', Bucharest 041914, Romania
| | - Ana Maria Bumbea
- Department of Medical Rehabilitation, University of Medicine and Pharmacy, Craiova 200349, Romania.,Neurorehabiltation Department, Clinical Neuropsychiatry Hospital, Craiova 200473, Romania
| | - Cristinel Dumitru Badiu
- Department of General Surgery, University of Medicine and Pharmacy 'Carol Davila', Bucharest 4192910, Romania.,Department of General Surgery, Clinical Emergency Hospital 'Bagdasar Arseni', Bucharest 041914, Romania
| | - Camelia Ciobotaru
- Department of Medical Rehabilitation, Faculty of Medicine, University 'Ovidius', Constanta 900527, Romania
| | - Gelu Onose
- Department of Medical Rehabilitation, University of Medicine and Pharmacy 'Carol Davila', Bucharest 4192910, Romania.,Neuromuscular Department, Clinical Emergency Hospital 'Bagdasar Arseni', Bucharest 041914, Romania
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Socea B, Crăciun C, Bratu OG, Badiu CD, Dumitrescu D, Dimitriu M, Stănescu AMA, Constantin VD. Surgical therapies for iatrogenic bile duct lesions (IBDL) – review. Ro J Med Pract 2019. [DOI: 10.37897/rjmp.2019.2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Socea B, Diaconu C, Bratu OG, Neagu TP, Badiu CD, Busoi G, Constantin VD. Postoperative outcome of a giant incisional hernia resolved by anterior component separation technique. Ro J Med Pract 2018. [DOI: 10.37897/rjmp.2018.4.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Mandu M, Badiu CD, Teoibaș-Șerban D, Petcu R, Chiralidis A, Ioniță A, Baila M, Oprea R, Onose G. Recovery aspects in a case of incomplet paraplegia with a T11 neurological level, acute postischemia due to a hemorrhageic shock through an aorto-sigmoid fistula and communicative anastomotic pseudoaneurysm – Case report. Balneo 2018. [DOI: 10.12680/balneo.2018.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Coman IS, Radu EV, Șandru V, Bârsan IC, Badiu CD, Constantinescu G, Grigorean VT. Retained Common Bile Duct Lithiasis at a Pacient with Periampullary Duodenal Diverticulum. Chirurgia (Bucur) 2017; 111:517-521. [PMID: 28044956 DOI: 10.21614/chirurgia.111.6.517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 11/23/2022]
Abstract
Periampullary duodenal diverticula are associated with the presence of common bile duct stones, being encountered more frequently with the increase of age. We present the case of a 76 years old female patient, who underwents emergency surgery for a perforated lithiasic gangrenous acute cholecystitis and for whom we perform a cholecystectomy and an external biliary drainage using a transcystic tube. Both preoperative and postoperative imaging and endoscopic examinations certify the presence of a periampullary duodenal diverticulum. Postoperative cholangiography performed on the transcystic tube raises the suspicion of retained common bile duct lithiasis. An endoscopic retrograde cholangiopancreatography is performed, initially failing to cannulate the common bile duct. A precut sphincterotomy fistula technnique is performed, using as reference a guide inserted on the transcystic tube, with the extraction of biliay sludge from the common bile duct, and with subsequently favorable development. Association between common bile duct lithiasis and a periampullary duodenal diverticulum may represent a therapeutic challenge because of the increased risk of failure of the endoscopic treatment.
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Badiu CD, Rahnea Nita G, Ciuhu AN, Manea C, Smarandache CG, Georgescu DG, Bedereag SI, Cocosila CL, Braticevici B, Mehedintu C, Grigorean VT. NEUROENDOCRINE RENAL CARCINOMA - THERAPEUTIC AND DIAGNOSTIC ISSUES. Acta Endocrinol (Buchar) 2016; 12:355-361. [PMID: 31149114 DOI: 10.4183/aeb.2016.355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Neuroendocrine renal carcinoma represents less than 1% of all primary neoplasia of the kidney. Most frequently poorly differentiated carcinoma is diagnosed in advanced stages and they have an aggressive evolution and limited survival rate. Neuroendocrine carcinomas that arise from the renal pelvis are frequently associated with squamous cell carcinoma or adenocarcinoma. Material and method We present the case of a female patient, known for 3 years before with an undefined retroperitoneal lymph node metastasis, being diagnosed at present with a left large cell neuroendocrine renal carcinoma, who initially had lymph node metastasis. Results Until now, 118 cases of primary neuroendocrine renal carcinomas have been reported. A limited number of poorly differentiated neuroendocrine carcinomas have been reported. Discussion Due to the clinical and biological findings, the aggressive evolution with early metastasis of lung and bone, the patient is included in the group of poorly differentiated carcinomas. In these cases, multimodal treatment is a gold standard. After surgical treatment and palliative chemotherapy with platinum salts, we obtained a partial remission of the disease and the control of symptoms. Conclusions Regarding large cell neuroendocrine carcinoma, the surgical treatment remains the treatment of choice. Chemotherapy can determine limited results, improve the quality of life and enhance the overall survival rate.
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Affiliation(s)
- C D Badiu
- Bagdasar Arseni Emergency Hospital - General Surgery Clinic, Bucharest, Romania.,"Carol Davila"University of Medicine and Pharmacy, Bucharest, Romania
| | - G Rahnea Nita
- "St Luke" Hospital - Oncology Palliative Care, Bucharest, Romania
| | - A N Ciuhu
- "St Luke" Hospital - Oncology Palliative Care, Bucharest, Romania
| | - C Manea
- Bagdasar Arseni Emergency Hospital - General Surgery Clinic, Bucharest, Romania
| | - C G Smarandache
- University Emergency Hospital - 4 Clinic of General Surgery, Bucharest, Romania.,"Carol Davila"University of Medicine and Pharmacy, Bucharest, Romania
| | - D G Georgescu
- "Colentina" Clinical Hospital - Hematology, Bucharest, Romania
| | - S I Bedereag
- Bagdasar Arseni Emergency Hospital - Pathology, Bucharest, Romania
| | - C L Cocosila
- Bagdasar Arseni Emergency Hospital - Pathology, Bucharest, Romania
| | - B Braticevici
- "Prof. Dr. Theodor Burghele" Clinical Hospital - Urology Clinic, Bucharest, Romania.,"Carol Davila"University of Medicine and Pharmacy, Bucharest, Romania
| | - C Mehedintu
- "Carol Davila"University of Medicine and Pharmacy, Bucharest, Romania
| | - V T Grigorean
- Bagdasar Arseni Emergency Hospital - General Surgery Clinic, Bucharest, Romania.,"Carol Davila"University of Medicine and Pharmacy, Bucharest, Romania
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