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Borz MB, Schitcu VH, Crisan N, Petrut B, Buhas BA, Borz PC, Valean D, Duquesne I, Coman I. Post-Pandemic Aftermath: A Two-Year Follow-Up of the Effect of COVID-19 on Oncological Outcomes after Radical Prostatectomy for Prostate Cancer. ARCH ESP UROL 2024; 77:43-48. [PMID: 38374012 DOI: 10.56434/j.arch.esp.urol.20247701.6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
PURPOSE This study aimed to evaluate the indirect effect of the Coronavirus Disease 2019 (COVID-19) pandemic on the surgical outcomes and oncological results of patients who underwent surgery during the lockdown period. METHODS We analysed data from 423 patients who underwent radical prostatectomy between 2016 and 2022, with a cut-off date of March 16, 2020. Patients were categorised into two groups, namely, pre-lockdown (n = 289) and during lockdown (n = 134). Perioperative variables, histopathological findings and oncological outcomes, including prostate-specific antigen (PSA) levels and biochemical recurrence (BCR), were assessed. RESULTS The number of radical prostatectomy increased by 24.26% during lockdown. The study included patients with a mean follow-up of 21 months. A nonsignificant trend towards a higher PSA level at presentation was found (14.22 vs. 12.53 ng/dL, p = 0.216). The International Society of Urological Pathology grade was not significantly different among radical prostatectomy specimens (p = 0.669). Lymph node involvement increased during the COVID-19 period (p = 0.046). The pT classification in prostatectomy specimens increased during the pandemic, but the difference from the pre-pandemic value was not statistically significant. The BCR rates were 24.6% pre-lockdown and 29.9% during lockdown (p = 0.136). CONCLUSIONS The COVID-19 pandemic led to poor postoperative results. Through a 2-year follow-up, this research investigated the effect of the pandemic on the oncological outcomes, particularly BCR, of patients who underwent radical prostatectomy. Further extended investigations and multi-institutional studies should be conducted to quantify the effect of the pandemic on various cancer outcomes and inform crisis management strategies.
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Affiliation(s)
- Mihnea Bogdan Borz
- Urology Department, The Oncology Institute "Prof. Dr. Ion Chiricuţă", 400015 Cluj-Napoca, Romania
- Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Vlad Horia Schitcu
- Urology Department, The Oncology Institute "Prof. Dr. Ion Chiricuţă", 400015 Cluj-Napoca, Romania
- Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Nicolae Crisan
- Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
- Urology Department, Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Bogdan Petrut
- Urology Department, The Oncology Institute "Prof. Dr. Ion Chiricuţă", 400015 Cluj-Napoca, Romania
- Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Bogdan Adrian Buhas
- Urology Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Paul Cristian Borz
- Gastroenterology Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, 400394 Cluj-Napoca, Romania
| | - Dan Valean
- Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
- General Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, 400394 Cluj-Napoca, Romania
| | - Igor Duquesne
- Urology department, Cochin Hospital-Port Royal, 75014 Paris, France
| | - Ioan Coman
- Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
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Alexa AL, Ciocan A, Zaharie F, Valean D, Sargarovschi S, Breazu C, Al Hajjar N, Ionescu D. The Influence of Intravenous Lidocaine Infusion on Postoperative Outcome and Neutrophil-to-Lymphocyte Ratio in Colorectal Cancer Patients. A Pilot Study. J Gastrointestin Liver Dis 2023; 32:156-161. [PMID: 37345602 DOI: 10.15403/jgld-4962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/13/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND AND AIMS In the last years increasing scientific evidence drew attention on the potential effects of anesthetic drugs on postoperative outcome in cancer patients. Local anesthetics, especially lidocaine, have been intensively studied in relation with postoperative outcome in colorectal cancer patients. Our study objectives were to investigate the effects of perioperative intravenous lidocaine infusion on neutrophil-to-lymphocyte ratio and short-term postoperative outcome. Additionally, we also looked at 1 year outcome after intended radical colorectal cancer surgery. METHODS 150 patients scheduled for colorectal cancer surgery were randomized to receive sevoflurane anaesthesia with or without 48 hours lidocaine infusion. RESULTS 73 patients were included in the group A (sevoflurane) and 77 in the group B (sevoflurane with lidocaine). Lidocaine infusion did not modify neutrophil-to-lymphocyte ratio at 24 hours after surgery (p=0.58). Patients receiving intravenous lidocaine had significantly lower morphine consumption (p=0.04), faster mobilization time (p=0.001) and fewer days spent in the hospital (p=0.04). Moreover, at 1 year follow- up, patients in group B had a significant decreased rate of recurrences (p=0.03). There was no significant difference in 1 year survival (p=0.22). CONCLUSIONS In our study, intravenous lidocaine infusion hastened the postoperative recovery of patients in terms of mobilization, hospital discharge and opioid consumption and reduced 1 year recurrence rate. Further studies on larger groups of patients are needed.
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Affiliation(s)
- Alexandru Leonard Alexa
- 1 st Department of Anesthesia and Intensive Care, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj- Napoca; Research Association in Anesthesia and Intensive Care (ACATI), Cluj-Napoca; Department of Anesthesia and Intensive Care, Prof. Dr. Octavian Fodor Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Cluj-Napoca, Romania.
| | - Andra Ciocan
- Department of Surgery, Iuliu Haţieganu University of Medicine and Pharmacy Cluj- Napoca, Romania.
| | - Florin Zaharie
- Department of Surgery, Iuliu Haţieganu University of Medicine and Pharmacy Cluj- Napoca, Romania.
| | - Dan Valean
- Department of Surgery, Iuliu Haţieganu University of Medicine and Pharmacy Cluj- Napoca, Romania.
| | - Sergiu Sargarovschi
- 1 st Department of Anesthesia and Intensive Care, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj- Napoca; Research Association in Anesthesia and Intensive Care (ACATI), Cluj-Napoca; Department of Anesthesia and Intensive Care, Prof. Dr. Octavian Fodor Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Cluj-Napoca, Romania.
| | - Caius Breazu
- 1 st Department of Anesthesia and Intensive Care, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj- Napoca; Research Association in Anesthesia and Intensive Care (ACATI), Cluj-Napoca; Romania.
| | - Nadim Al Hajjar
- Department of Surgery, Iuliu Haţieganu University of Medicine and Pharmacy Cluj- Napoca, Romania.
| | - Daniela Ionescu
- 1 st Department of Anesthesia and Intensive Care, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj- Napoca, Romania; Research Association in Anesthesia and Intensive Care (ACATI), Cluj-Napoca, Romania; Department of Anesthesia and Intensive Care, Prof. Dr. Octavian Fodor Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Cluj-Napoca, Romania; Outcome Research Consortium, Cleveland, USA.
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Zaharie F, Valean D, Zaharie R, Popa C, Mois E, Schlanger D, Fetti A, Zdrehus C, Ciocan A, Al-Hajjar N. Surgical management of hydatid cyst disease of the liver: An improvement from our previous experience? World J Gastrointest Surg 2023; 15:847-858. [PMID: 37342852 PMCID: PMC10277938 DOI: 10.4240/wjgs.v15.i5.847] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/12/2023] [Accepted: 03/24/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Hydatid liver disease remains an important issue in endemic areas, which may require immediate surgery. Although laparoscopic surgery is on the rise, the presence of certain complications may require conversion to the open approach.
AIM To compare the results of laparoscopic treatment and the open approach in the context of a 12-year single institution experience, and to perform a further comparison between results from the current study and those from a previous study.
METHODS Between January 2009 and December 2020, 247 patients underwent surgery for hydatic disease of the liver in our department. Of the 247 patients, 70 underwent laparoscopic treatment. A retrospective analysis between the two groups was performed, as well as a comparison between current and previous laparoscopic experience (1999-2008).
RESULTS There were statistically significant differences between the laparoscopic and open approaches regarding the cyst dimension, location, and presence of cystobiliary fistula. There were no intraoperative complications in the laparoscopic group. The cutoff value for the cyst size regarding the presence of cystobiliary fistula was 6.85 cm (P = 0.001).
CONCLUSION Laparoscopic surgery still plays an important role in the treatment of hydatid disease of the liver, with an increase in its usage over the course of years that has shown benefits regarding the postoperative recovery with a decreased rate of intraoperative complications. Although experienced surgeons can perform laparoscopic surgery in the most difficult conditions, there are some selection criteria that need to be maintained for higher quality results.
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Affiliation(s)
- Florin Zaharie
- Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
| | - Dan Valean
- Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
| | - Roxana Zaharie
- Department of Gastroenterology, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
- Department of Gastroenterology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca 400012, Cluj, Romania
| | - Calin Popa
- Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
| | - Emil Mois
- Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
| | - Diana Schlanger
- Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
| | - Alin Fetti
- Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
| | - Claudiu Zdrehus
- Department of Anaesthesiology, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
| | - Andra Ciocan
- Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
| | - Nadim Al-Hajjar
- Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
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Lazar R, Oprean C, Badau L, Miron G, Draganescu L, Torok‑Vistai T, Coroian I, Sabau D, Iliescu A, Tamas L, Hosu S, Curca R, Gatej A, Hora A, Ungureanu A, Parvu D, Valean D, Usatiuc L, Vidra R. Attitudes towards COVID‑19 vaccination in patients with cancer: A cross‑sectional study of 12 oncology centers. Mol Clin Oncol 2022; 17:162. [DOI: 10.3892/mco.2022.2595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Raluca Lazar
- Oncology Department, ‘Prof. Dr. Ion Chiricuta’ Oncology Institute, 400015 Cluj‑Napoca, Romania
| | - Cristina Oprean
- ANAPATMOL Research Center, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Larisa Badau
- Department of Oncology, ONCOHELP Hospital Timisoara, 300239 Timisoara, Romania
| | - Geanina Miron
- Department of Oncology, Emergency County Hospital, 420094 Bistrita, Romania
| | | | - Tunde Torok‑Vistai
- Hematology Department, ‘Prof. Dr. Ion Chiricuta’ Oncology Institute, 400015 Cluj‑Napoca, Romania
| | - Iulia Coroian
- Oncology Department, Baia Mare Emergency County Hospital, 43003 Baia Mare, Romania
| | - Diana Sabau
- Oncology Department, Pelican Hospital Oradea, 410469 Oradea, Romania
| | - Alexandru Iliescu
- Oncology Department, Zalau Emergency County Hospital, 450129 Zalău, Romania
| | - Loredana Tamas
- Oncology Department, Satu‑Mare Emergency County Hospital, 440011 Satu‑Mare, Romania
| | - Sorin Hosu
- Oncology Department, Alba‑Iulia Emergency County Hospital, 510073 Alba‑Iulia, Romania
| | - Razvan Curca
- Oncology Department, Alba‑Iulia Emergency County Hospital, 510073 Alba‑Iulia, Romania
| | - Alexandra Gatej
- Oncology Department, Amethyst Oncology Clinic Timisoara, 307160 Dumbravita Timis, Romania
| | - Amalia Hora
- Oncology Department, Emergency Hospital, Oradea, 410169 Oradea, Romania
| | - Andrei Ungureanu
- Oncology Department, Amethyst Oncology Clinic Cluj, 407280 Floresti Cluj, Romania
| | - Doru Parvu
- Oncology Department, CardioMed, 400015 Cluj‑Napoca, Romania
| | - Dan Valean
- Oncology Department, ‘Prof. Dr. Octavian Fodor’ Regional Institute of Gastroenterology and Hepatology, 400162 Cluj‑Napoca, Romania
| | - Lia Usatiuc
- Oncology Department, ‘Iuliu Hateganu’ University of Medicine and Pharmacy, 400012 Cluj‑Napoca, Romania
| | - Radu Vidra
- Oncology Department, ‘Prof. Dr. Octavian Fodor’ Regional Institute of Gastroenterology and Hepatology, 400162 Cluj‑Napoca, Romania
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Zaharie F, Valean D, Al-Hajjar N. Surgical technique in the laparoscopic repair of Morgagni hernia in adults. How do we do it? Authors’ reply. Hernia 2022; 26:1711-1712. [DOI: 10.1007/s10029-022-02700-z] [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] [Received: 09/26/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022]
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Puia VR, Puia A, Fetti AC, Stefan PA, Valean D, Herdean A, Rusu I, Vasile T, Lebovici A, Al-Hajjar N. Computed Tomography for the Diagnosis of Intraperitoneal Infected Fluid Collections after Surgery for Gastric Cancer. Role of Texture Analysis. J Gastrointestin Liver Dis 2022; 31:184-190. [PMID: 35574623 DOI: 10.15403/jgld-4219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND AIMS Several computed tomographic (CT) imaging features have been proposed to describe the infection of postoperative abdominal fluid collections; however, these features are vague, and there is a significant overlap between infected and non-infected collections. We assessed the role of textural parameters as additional diagnostic tools for distinguishing between infected and non-infected peritoneal collections in patients operated for gastric cancer. METHODS From 527 patients operated for gastric cancer, we retrospectively selected 82 cases with intraperitoneal collections who underwent CT exams. The fluid component was analyzed through a novel method (texture analysis); different patterns of pixel intensity and distribution were extracted and processed through a dedicated software (MaZda). A univariate analysis comparing the parameters of texture analysis between the two groups was performed. Afterwards, a multivariate analysis was performed for the univariate statistically significant parameters. RESULTS The study included 82 patients with bacteriologically verified infected (n=40) and noninfected (n=42) intraperitoneal effusions. The univariate analysis evidenced statistically significant differences between all the parameters involved. The multivariate analysis highlighted 10 parameters as being statistically significant, adjusted to Bonferroni correction. CONCLUSIONS Our evidence supports the fact that textural analysis can be used as a complementary diagnostic tool for the detection of infected fluid collections after gastric cancer surgery. Further studies are required to validate the accuracy of this method.
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Affiliation(s)
- Vlad Radu Puia
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca; Surgery Department, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. .
| | - Aida Puia
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. .
| | - Alin Cornel Fetti
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca; Surgery Department, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
| | - Paul Andrei Stefan
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca; Radiology and Imaging Department, County Emergency Hospital, Cluj- Napoca, Romania.
| | - Dan Valean
- Surgery Department, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
| | - Andrei Herdean
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Ioana Rusu
- Pathology Department, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
| | - Tudor Vasile
- Radiology and Imaging Department, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
| | - Andrei Lebovici
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca; Radiology and Imaging Department, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
| | - Nadim Al-Hajjar
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca; Surgery Department, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
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Zaharie F, Valean D, Popa C, Mois E, Graur F, Munteanu D, Schlanger D, Ciocan A, Puia C, Al Hajjar N. Surgical technique in the laparoscopic repair of Morgagni hernia in adults. How do we do it? Hernia 2022; 26:1389-1394. [PMID: 35013791 DOI: 10.1007/s10029-021-02559-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/28/2021] [Accepted: 12/23/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Adult Morgagni hernias are rare congenital diaphragmatic hernias, which can present with an array of symptoms based on the size and the contents of it. This article focuses primarily on the laparoscopic repair with transfascial suturing. METHODS A number of five patients over the course of 10 years were admitted in our clinic, one of them being admitted with emergency symptoms. Four of the patients were treated laparoscopically, one of them requiring conversion to open approach. RESULTS The median age was 53 (range 44-71), 80% of the patients being females. Four of the patients received laparoscopic treatment with transfascial suturing, the fifth being converted, but respecting the same technique. The median surgery duration was 110 min, with a median blood loss of 30 ml. Removal of the sac was attempted in two cases. Median hospitalization stay was 3 days, with a median follow-up of 21 months, with no postoperative complications reported. CONCLUSIONS Laparoscopic repair with transfascial suturing provides an feasible and efficient repair, compared to the other laparoscopic techniques. Although no postoperative complications were reported, the removal of the sac still remains an controversial issue.
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Affiliation(s)
- F Zaharie
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.,University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - D Valean
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.
| | - C Popa
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.,University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - E Mois
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.,University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - F Graur
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.,University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - D Munteanu
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.,University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - D Schlanger
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania
| | - A Ciocan
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.,University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - C Puia
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.,University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - N Al Hajjar
- Regional Institute of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.,University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
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Gâta A, Toader C, Valean D, Trombitaș VE, Albu S. Role of Endoscopic Sinus Surgery and Dental Treatment in the Management of Odontogenic Sinusitis Due to Endodontic Disease and Oroantral Fistula. J Clin Med 2021; 10:jcm10122712. [PMID: 34205358 PMCID: PMC8234404 DOI: 10.3390/jcm10122712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Odontogenic sinusitis (ODS) is frequently encountered in ENT practice; however, there are no guidelines regarding its management. This study aims to analyse the results of endoscopic sinus surgery versus dental treatment in ODS. Additionally, we aim to demonstrate the benefit of associating endoscopic sinus surgery (ESS) to surgical closure of chronic oroantral fistulas (OAF) by comparing mean time to healing in patients who opted or not for concurrent ESS. Methods: Records of patients with ODS were reviewed. Group one consisted of patients with ODS caused by periapical pathology undergoing either endoscopic sinus surgery (ESS) or dental treatment. Resolution of ODS was considered treatment success and was compared between the two treatment strategies. Group two included patients with ODS and associated chronic oroantral communication. Time to healing was compared between patients undergoing OAF closure alone versus patients receiving associated ESS, using the Log-Rank test to correlate Kaplan–Meier curves. Results: 25 patients from a total of 45 in group one underwent dental treatment alone, and 20 opted for exclusive ESS treatment. The failure rate was 40% for patients treated with ESS compared to 4% (one patient) for dental treatment. ODS resolved in all patients in the second group, but the mean time to healing was half (10 days) when ESS was complementary to OAF closure. Conclusion: The present study represents the first estimator of the role ESS plays in OAF treatment. Nonetheless, it provides proof of the importance of first addressing dental problems in odontogenic sinusitis.
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Affiliation(s)
- Anda Gâta
- Department of Otorhinolaryngology, University of Medicine and Pharmacy ‘Iuliu Hațieganu’, 400349 Cluj Napoca, Romania; (V.E.T.); (S.A.)
- Correspondence: ; Tel.: +40-746-210-022
| | - Corneliu Toader
- Clinic of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 41914 Bucharest, Romania;
| | - Dan Valean
- County Clinical Emergency Hospital, 400000 Cluj Napoca, Romania;
| | - Veronica Elena Trombitaș
- Department of Otorhinolaryngology, University of Medicine and Pharmacy ‘Iuliu Hațieganu’, 400349 Cluj Napoca, Romania; (V.E.T.); (S.A.)
| | - Silviu Albu
- Department of Otorhinolaryngology, University of Medicine and Pharmacy ‘Iuliu Hațieganu’, 400349 Cluj Napoca, Romania; (V.E.T.); (S.A.)
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George Rahota R, Valean D, Dobrota F, Andras I, Rahota AC, Maghiar TT, Coman I, Crisan N. Is 3D laparoscopic off clamp simple enucleation a feasible alternative for clinical T1 renal tumors? Outcomes from a single center experience. J BUON 2021; 26:1088-1093. [PMID: 34268976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To evaluate the safety of 3D laparoscopic off clamp simple enucleation (SE) of kidney tumors versus standard laparoscopic on-clamp partial nephrectomy (PN) in terms of perioperative, oncological and functional outcomes. METHODS All patients that underwent 3D laparoscopic nephron sparing surgery (NSS) in our department for clinical T1 tumors between January 2019-September 2020 were included. Of the total of 84 patients, 38 (45.24%) underwent SE (SE group) and 46 (54.76%) PN (PN group). Perioperative data was collected and analyzed. Oncological outcomes were evaluated by the positive surgical margin (PSM) rate and follow-up at 6 months after surgery. RESULTS Mean age, gender, tumor size, PADUA score and length of hospital stay were comparable between the two groups. Estimated intraoperative blood loss (284.21 ml vs 151.52 ml, p=0.0001) and hemoglobin drop (p=0.0001) were significantly lower for the PN group. Patients that underwent SE showed a better preservation of renal function (eGFR drop of 4.4 ml/min vs 1.78 ml/min, p=0.75). No significant differences were found regarding the PSM, although the PSM rate was lower in the SE group when compared with the PN group (2.63% vs 4.34%, p= 0.07). CONCLUSION Off-clamp simple enucleation of renal masses is feasible by laparoscopic approach and has produced comparable oncologic outcomes with standard on-clamp partial nephrectomy, with an incremental advantage for the preservation of renal function.
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Ruta VM, Motoc NS, Todea DA, Alexescu TG, Valean D, Cozac S, Coste SC, Codea RA, Ungur RA, Pop CM, Milena AM. Modification of exhaled air nitric oxide in patients with asthma - cortisone monotherapy or dual inhalation therapy? Ann Agric Environ Med 2021; 28:89-93. [PMID: 33775072 DOI: 10.26444/aaem/130712] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Asthma, a chronic lung disease, is a major health challenge worldwide with increased addressability to health services. There are different asthma phenotypes, which have different evolution and can be specifically tracked. The measurement of fractional expired nitric oxide (FeNo) with different devices reflects the eosinophilic inflammation of the airways, and can be used to evaluate the allergic phenotype and predict the treatment responses. The new GINA (Global Initiative for Asthma) guideline recommends FeNO monitoring to assess adherence to cortisone treatment in high doses before prescribing biological treatment, and as a means of monitoring the decrease in oral corticosteroid treatment. OBJECTIVE The aim of the study is to analyze the applicability of FeNO in monitoring response to therapy. MATERIAL AND METHODS An observational study was carried out on 129 subjects with a previously established diagnosis of asthma. The research was based on the determination of FeNO with NObreath. Those with intermediate FeNO received a low dose of inhaled corticosteroids in mono/dual therapy, those with increased FeNO received medium ICS mono/dual therapy. FeNO testing, its values and doses of ICS were below the the ATS / ERS guidelines. RESULTS FeNO reduction is strictly dependent on the cortisone dose. Applying the dual therapy from the beginning does not bring additional benefits in comparison with cortisone in monotherapy, in terms of FeNO value. CONCLUSIONS Recommendations that include FeNO testing can help monitor response to treatment.
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Affiliation(s)
| | - Nicoleta Stefania Motoc
- Department of Pneumology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Doina Adina Todea
- Department of Pneumology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Teodora Gabriela Alexescu
- Department of Internal Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dan Valean
- MD student 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Stefania Cozac
- MD student 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorina Cezara Coste
- Department of Internal Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Razvan Andrei Codea
- Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, Cluj-Napoca, Romania
| | - Rodica Ana Ungur
- Department of Rehabilitation, 'Iuliu Hatieganu' University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Carmen Monica Pop
- Department of Pneumology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adina Man Milena
- Department of Pneumology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Alexandru Gata V, Milan Kubelac P, Buiga R, Vlad IC, Valean D, Muntean MV, Morariu DS, Bonci EA, Irimie A, Dina C, Achimas Cadariu PA. The value of tumor infiltrating lymphocytes as prognostic factor for lymph node status and survival amongst patients with cutaneous malignant melanoma. J BUON 2020; 25:2700-2707. [PMID: 33455116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Tumor infiltrating lymphocytes (TILs) in cutaneous malignant melanoma are classified as brisk, non-brisk or absent. Numerous studies suggest the presence of TILs, especially brisk, are associated with a lower rate of lymph node metastasis and with an improved overall survival (OS). Our purpose was to assess the value of TILs as a prognostic factor for the lymph node metastasis and survival in completely resected pT3 stage malignant melanoma patients. METHODS We included a number of 114 patients with pathological pT3 cutaneous malignant melanoma, treated exclusively in our institution, between 2000-2015. Correlations of clinical and pathological factors with lymph node status and OS were analyzed. RESULTS A brisk infiltrate was present in 60% of the patients, whereas 40% presented a non-brisk infiltrate or absent TILs. In univariate analysis, the presence of ulceration was correlated with a non-brisk infiltrate, whereas in multivariate analysis, lymph node invasion and a non-brisk infiltrate were associated with a higher risk of death. CONCLUSIONS TILs density grade represents an independent prognostic factor for the OS. Therefore, we conclude that an accurate prognosis may be provided by TILs status in patients with pT3 malignant melanoma.
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Affiliation(s)
- Vlad Alexandru Gata
- Department of Oncology, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Ruta VM, Man AM, Alexescu TG, Motoc NS, Tarmure S, Ungur RA, Todea DA, Coste SC, Valean D, Pop MC. Neutrophil-To-Lymphocyte Ratio and Systemic Immune-Inflammation Index-Biomarkers in Interstitial Lung Disease. Medicina (Kaunas) 2020; 56:E381. [PMID: 32751302 PMCID: PMC7466218 DOI: 10.3390/medicina56080381] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 01/19/2023]
Abstract
Background and objectives: The aims of the study were to evaluate the utility of neutrophil-to-lymphocyte ratio (NLR) and the systemic immune-inflammation index (SII) as inflammation markers and prognostic factors in patients with known interstitial lung disease secondary to connective tissue diseases (CTD-ILD) compared with idiopathic pulmonary fibrosis (IPF). Materials and Methods: Forty-two patients with known interstitial lung disease (21 with IPF and 21 with CTD-ILD) and 42 control matched healthy patients were included. The NLR was calculated as the absolute neutrophil count divided by the absolute lymphocyte count, and the SII was calculated as follows: SII = platelets × neutrophils/lymphocytes, with the data being obtained from the patients data charts at admission, before any treatment. Results: our hypothesis was that in patients with interstitial lung disease NLR and SII would have higher values compared with patients with CTD-ILD or control healthy patients. The mean NLR value was 3.01 (±1.35) among patients with idiopathic pulmonary fibrosis, and 2.38 (±1.08) among patients with CTD-ILD without significant statistical difference (p = 0.92). There was however a clinically significant statistical difference when compared with the control group, where NLR was 2.00 (±1.05) (p = 0.003). SII values were 619.37 (±329.51) in patients with IPF, 671.55 (±365.73) in CTD-ILD group and 569.73 (±326.67) in healthy subjects (p = 0.13) Conclusions: A mean NLR value of 2.8 and a SII value over 500 in patients with connective diseases can become a marker of pulmonary interstitial involvement. In the context of non-exacerbated interstitial lung disease, NLR and SII have reduced numerical values, without being statistically correlated with prognosis when we compared with patients with connective tissue diseases without exacerbation or with healthy people, the cut off being of 2.4. However subsequent studies in larger patient samples might provide changes in these cut-off values.
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Affiliation(s)
- Victoria Maria Ruta
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania;
| | - Adina Milena Man
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (A.M.M.); (N.S.M.); (D.A.T.); (M.C.P.)
| | - Teodora Gabriela Alexescu
- Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (S.T.); (S.C.C.)
| | - Nicoleta Stefania Motoc
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (A.M.M.); (N.S.M.); (D.A.T.); (M.C.P.)
| | - Simina Tarmure
- Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (S.T.); (S.C.C.)
| | - Rodica Ana Ungur
- Department of Medical Rehabilitation, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania;
| | - Doina Adina Todea
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (A.M.M.); (N.S.M.); (D.A.T.); (M.C.P.)
| | - Sorina Cezara Coste
- Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (S.T.); (S.C.C.)
| | - Dan Valean
- Department of General Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania;
| | - Monica Carmen Pop
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (A.M.M.); (N.S.M.); (D.A.T.); (M.C.P.)
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