1
|
Badina M, Bejan GC, Sporea C, Padure L, Mirea A, Leanca MC, Axente M, Grigoras FP, Bejan M, Shelby ES, Neagu E, Ion DA. Changes in pNFH Levels in Cerebrospinal Fluid and Motor Evolution after the Loading Dose with Nusinersen in Different Types of Spinal Muscular Atrophy. Medicina (Kaunas) 2023; 59:1244. [PMID: 37512056 PMCID: PMC10385472 DOI: 10.3390/medicina59071244] [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] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
Aim and Objectives: The objective of our retrospective study was to investigate the changes in pNFH levels in cerebrospinal fluid, which is a reliable marker of neuronal damage, after the loading dose of nusinersen in different types of spinal muscular atrophy. Materials and Methods: We analyzed the spinal muscular atrophy types, the number of copies of the SMN2 gene, and the progression of the motor status using specific motor function scales in a group of 38 patients with spinal muscular atrophy types 1, 2, and 3. Results: We found a significant inverse correlation between pNFH levels and patient age, progress on functional motor scales, and nusinersen administration. Our results also revealed that the neurofilament levels in the cerebrospinal fluid were higher in patients with 2 SMN2 copies than those with more than 2 copies, although the association was not statistically significant due to the abnormal distribution of the values. Conclusions: We identified several predictors of favorable evolution under nusinersen treatment, including spinal muscular atrophy type 1, children aged ≤ 30 months, and the presence of only 2 copies of SMN2. Our study provides important insights into the use of pNFH as a biomarker to monitor disease progression and responses to treatment in patients with spinal muscular atrophy.
Collapse
Affiliation(s)
- Mihaela Badina
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
| | - Gabriel Cristian Bejan
- Department of Family Medicine, University of Medicine and Pharmacy "Carol Davila", 8 Eroii Sanitari Bvd., 050474 Bucharest, Romania
| | - Corina Sporea
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
- Faculty of Midwifery and Nursing, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Liliana Padure
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
- Faculty of Midwifery and Nursing, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Andrada Mirea
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
- Faculty of Midwifery and Nursing, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Madalina-Cristina Leanca
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
| | - Mihaela Axente
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
| | - Florin Petru Grigoras
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
| | - Mihaela Bejan
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
| | - Elena-Silvia Shelby
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
| | - Elena Neagu
- National Teaching Center for Children's Neurorehabilitation "Dr. Nicolae Robanescu", 44 Dumitru Minca Street, 041408 Bucharest, Romania
| | - Daniela Adriana Ion
- Department of Pathophysiology, National Institute for Infectious Diseases Prof. Dr. Matei Bals, University of Medicine and Pharmacy "Carol Davila", 1 Calistrat Grozovici Street, 021105 Bucharest, Romania
| |
Collapse
|
2
|
Stănescu AMA, Cristea AMA, Bejan GC, Vieru M, Simionescu AA, Popescu FD. Allergic Contact Cell-Mediated Hypersensitivity in Psoriasis: A Narrative Minireview. Medicina (Kaunas) 2022; 58:medicina58070914. [PMID: 35888633 PMCID: PMC9324524 DOI: 10.3390/medicina58070914] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
The dysfunctionality of the protective skin barrier in psoriasis allows easier cutaneous penetration of various contact haptens; thus, such patients can develop allergic contact hypersensitivity as a comorbidity. Both skin conditions involve T-cell-mediated mechanisms. Dermatologists and allergists should consider assessing allergic contact cell-mediated hypersensitivity in selected psoriasis patients, especially those with palmoplantar psoriasis and who are refractory to topical treatments, and in patients with psoriasis, with or without arthritis, treated with biologics that present skin lesions clinically suggestive of contact dermatitis.
Collapse
Affiliation(s)
| | - Ana-Maria-Antoaneta Cristea
- Department of Allergology and Clinical Immunology, Nicolae Malaxa Clinical Hospital, 022441 Bucharest, Romania; (A.-M.-A.C.); (F.-D.P.)
| | - Gabriel Cristian Bejan
- Department of Family Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Correspondence: (G.C.B.); (M.V.)
| | - Mariana Vieru
- Department of Allergology and Clinical Immunology, Nicolae Malaxa Clinical Hospital, 022441 Bucharest, Romania; (A.-M.-A.C.); (F.-D.P.)
- Department of Allergology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (G.C.B.); (M.V.)
| | - Anca Angela Simionescu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Florin-Dan Popescu
- Department of Allergology and Clinical Immunology, Nicolae Malaxa Clinical Hospital, 022441 Bucharest, Romania; (A.-M.-A.C.); (F.-D.P.)
- Department of Allergology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| |
Collapse
|
3
|
Avram RL, Nechita AC, Popescu MN, Teodorescu M, Ghilencea LN, Turcu D, Lechea E, Maher S, Bejan GC, Berteanu M. Functional tests in patients with ischemic heart disease. J Med Life 2022; 15:58-64. [PMID: 35186137 PMCID: PMC8852644 DOI: 10.25122/jml-2019-0142] [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] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/18/2020] [Indexed: 11/19/2022] Open
Abstract
Lately, easier and shorter tests have been used in the functional evaluation of cardiac patients. Among these, walking speed (WS) and Timed Up and Go (TUG) tests are associated with all-cause mortality, mainly cardiovascular and the rate of re-hospitalization, especially in the elderly population. We prospectively analyzed a group of 38 patients admitted to the Cardiology Clinic from Elias Hospital, Romania, with chronic coronary syndrome (CCS) (n=22) and STEMI (n=16). We assessed the patients immediately after admission and before discharge with G-WALK between the 1st and 30th of September 2019. Our study group had a mean age of 62.7±12.1 years. Patients with a low WS were older (69.90±12.84 vs. 59.90±10.32 years, p=0.02) and had a lower serum hemoglobin (12.38±1.20 vs. 13.72±2.07 g/dl, p=0.02). The WS significantly improved during hospitalization (p=0.03) after optimal treatment. The TUG test performed at the time of admission had a longer duration in patients with heart failure (14.05 vs. 10.80 sec, p=0.02) and was influenced by patients' age (r=0.567, p=0.02), serum creatinine (r=0.409, p=0.03) and dilation of right heart chambers (r=0.399, p=0.03). WS and TUG tests can be used in patients with CCS and STEMI, and are mainly influenced by age, thus having a greater value among the elderly.
Collapse
Affiliation(s)
- Rodica Lucia Avram
- Cardiology Department, Sf. Pantelimon Emergency Hospital, Bucharest, Romania,Internal Medicine Department, Carol Davila Medicine and Pharmacy University, Bucharest, Romania
| | - Alexandru Cristian Nechita
- Cardiology Department, Sf. Pantelimon Emergency Hospital, Bucharest, Romania,Internal Medicine Department, Carol Davila Medicine and Pharmacy University, Bucharest, Romania
| | - Marius Nicolae Popescu
- Internal Medicine Department, Carol Davila Medicine and Pharmacy University, Bucharest, Romania,Rehabilitation Department, Elias Emergency Hospital, Bucharest, Romania
| | - Matei Teodorescu
- Internal Medicine Department, Carol Davila Medicine and Pharmacy University, Bucharest, Romania,Rehabilitation Department, Elias Emergency Hospital, Bucharest, Romania
| | - Liviu-Nicolae Ghilencea
- Internal Medicine Department, Carol Davila Medicine and Pharmacy University, Bucharest, Romania,Cardiology Department, Elias Emergency Hospital, Bucharest, Romania,Corresponding Author: Liviu-Nicolae Ghilencea, Cardiology Department, Elias Emergency Hospital, Bucharest, Romania. E-mail:
| | - Diana Turcu
- Cardiology Department, Elias Emergency Hospital, Bucharest, Romania
| | - Elena Lechea
- Cardiology Department, Elias Emergency Hospital, Bucharest, Romania
| | - Sean Maher
- Surgery Department, St. Vincent’s University Hospital, Dublin, Ireland
| | - Gabriel Cristian Bejan
- Internal Medicine Department, Carol Davila Medicine and Pharmacy University, Bucharest, Romania,Private Medical Practice Office Bejan Gabriel Cristian, Bucharest, Romania
| | - Mihai Berteanu
- Internal Medicine Department, Carol Davila Medicine and Pharmacy University, Bucharest, Romania,Rehabilitation Department, Elias Emergency Hospital, Bucharest, Romania
| |
Collapse
|
4
|
Plesu MA, Bejan GC, Grajdeanu IV, Simionescu AA, Stănescu AMA. COVID-19-ASSOCIATED IMMUNE THROMBOCYTOPENIA. Ro J Infect Dis 2021. [DOI: 10.37897/rjid.2021.2.1] [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: 11/22/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) is a contagious respiratory tract infection caused by the betacoronavirus SARS-CoV-2. The World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020. Since the COVID-19 pandemic started, more than 166 million patients have been tested positive worldwide with more than 3.4 million related death recorded. COVID-19 has a wide range of signs and symptoms. Hematological changes such as lymphopenia, thrombocytopenia, and coagulation disturbances are not unusual in patients with COVID-19. However, the mechanisms causing these changes are partially comprehended. Immune thrombocytopenia was identified to be among the hematologic autoimmune diseases seen in patients infected with SARS-CoV-2. This review summarizes the evidence on COVID-19-associated immune thrombocytopenia and the underlying mechanisms involved in its development.
Collapse
|
5
|
Bejan GC, Grajdeanu IV, Nicolescu O, Simionescu AA, Nițescu M, Stănescu AMA. Why is it important to know about the implications of alcohol consumption and psoriasis – a mini-review. J Contemp Clin Pract 2021. [DOI: 10.18683/jccp.2021.1066] [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: 11/08/2022] Open
|
6
|
Zamfirescu MB, Ghilencea LN, Popescu MR, Bejan GC, Maher SM, Popescu AC, Dorobanțu M. The E/e' Ratio-Role in Risk Stratification of Acute Heart Failure with Preserved Ejection Fraction. ACTA ACUST UNITED AC 2021; 57:medicina57040375. [PMID: 33924367 PMCID: PMC8070491 DOI: 10.3390/medicina57040375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 12/20/2022]
Abstract
Background and Objectives: Heart failure with preserved ejection fraction (HFpEF) remains a worldwide management problem. Although there is a general effort for characterizing this population, few studies have assessed the predictive value of the echocardiographic E/e’ ratio in patients with acute HFpEF. The aim of the study was to identify groups with different prognosis in patients hospitalized with a first acute episode of HFpEF. Materials and Methods: The primary endpoint of the study was heart failure readmissions (HFR) at 6 months, while the secondary outcome was six-month mortality. We consecutively enrolled 91 patients hospitalized for the first time with acute HFpEF. We examined the E/e’ ratio as an independent predictor for HFR using univariate regression. Results: We identified and validated the E/e’ ratio as an independent predictor for HFR. An E/e’ ratio threshold value of 13.80 was calculated [(area under the receiver operating characteristic curve (AUROC) = 0.693, sensitivity = 78.60%, specificity = 55%, p < 0.004)] and validated as an inflection point for an increased number of HFR. Thus, we divided the study cohort into two groups: group 1 with an E/e’ ratio < 13.80 (n = 39) and group 2 with an E/e’ ratio > 13.80 (n = 49). Compared to group 1, group 2 had an increased number of HFR (p = 0.003) and a shorter time to first HFR (p = 0.002). However, this parameter did not influence all-cause mortality within six months (p = 0.84). Conclusions: The dimensionless E/e’ ratio is a useful discriminator between patients with acute HFpEF. An E/e’ value over 13.80 represents a simple, yet effective instrument for assessing the HFR risk. However, all-cause mortality at six months is not influenced by the E/e’ ratio.
Collapse
Affiliation(s)
- Marilena-Brîndușa Zamfirescu
- Cardiothoracic Pathology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-B.Z.); (G.C.B.); (A.-C.P.); (M.D.)
- Department of Cardiology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Liviu-Nicolae Ghilencea
- Cardiothoracic Pathology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-B.Z.); (G.C.B.); (A.-C.P.); (M.D.)
- Department of Cardiology, Elias Emergency University Hospital, 011461 Bucharest, Romania
- Correspondence: (L.-N.G.); (M.-R.P.); Tel.: +44-753-504-3647 (L.-N.G.); +40-723-583-365 (M.-R.P.)
| | - Mihaela-Roxana Popescu
- Cardiothoracic Pathology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-B.Z.); (G.C.B.); (A.-C.P.); (M.D.)
- Department of Cardiology, Elias Emergency University Hospital, 011461 Bucharest, Romania
- Correspondence: (L.-N.G.); (M.-R.P.); Tel.: +44-753-504-3647 (L.-N.G.); +40-723-583-365 (M.-R.P.)
| | - Gabriel Cristian Bejan
- Cardiothoracic Pathology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-B.Z.); (G.C.B.); (A.-C.P.); (M.D.)
| | - Sean Martin Maher
- Department of Accidents and Emergencies, St. Vincent University Hospital, D04 N2E0 Dublin 4, Ireland;
| | - Andreea-Catarina Popescu
- Cardiothoracic Pathology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-B.Z.); (G.C.B.); (A.-C.P.); (M.D.)
- Department of Cardiology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Maria Dorobanțu
- Cardiothoracic Pathology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-B.Z.); (G.C.B.); (A.-C.P.); (M.D.)
- Department of Cardiology, Clinic Emergency Hospital, 20322 Bucharest, Romania
| |
Collapse
|
7
|
Bejan GC, Stănescu AMA, Ghilencea LN, Iancu MA, Ştefani C, Leica A, Matei D. Is the total cardiovascular risk of hypertensive patients higher than the amount of individual risks of the involved factors? Ro J Med Pract 2019. [DOI: 10.37897/rjmp.2019.1.11] [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
|
8
|
Stănescu AMA, Grăjdeanu IV, Bratu OG, Iancu MA, Codreanu IF, Bejan GC, Diaconu CC. Genetic and therapeutic novelties in atopic dermatitis. Ro J Med Pract 2018. [DOI: 10.37897/rjmp.2018.2.5] [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
|