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Dinu MD, Haj Hamoud B, Amza M, Gorecki GP, Sima RM, Gică N, Pleș L. Endometriosis in Menopausal Women-A New Age Is Coming? Literature Review. Life (Basel) 2024; 14:485. [PMID: 38672755 PMCID: PMC11051166 DOI: 10.3390/life14040485] [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: 03/11/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
Endometriosis is a chronic inflammatory disease, characterized by the presence of ectopic endometrial tissue, that leads to dysmenorrhea, painful intercourse and infertility. The shift in paradigm from the previous belief that endometriosis exclusively impacts women of reproductive age has brought attention to the condition in both premenarchal and postmenopausal women. Currently, 2-4% of postmenopausal women have endometriosis. Many women experience menopausal symptoms during the peri- and postmenopausal periods and require extensive investigations and monitoring in order to avoid the recurrence of endometriosis symptoms or the risk of malignant transformation when treatment with menopausal hormones is elected. Our goal was to compile and present a clear and concise overview of the existing literature on postmenopausal endometriosis, offering an up-to-date and precise summary of the available information.
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Affiliation(s)
- Mihai-Daniel Dinu
- Department PhD, IOSUD, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-D.D.); (M.A.)
| | - Bashar Haj Hamoud
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Kirrberger Straße 100, Building 9, 66421 Homburg, Germany;
| | - Mihaela Amza
- Department PhD, IOSUD, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-D.D.); (M.A.)
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (N.G.); (L.P.)
- “Bucur” Maternity, Saint John Hospital, 012361 Bucharest, Romania
| | | | - Romina-Marina Sima
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (N.G.); (L.P.)
- “Bucur” Maternity, Saint John Hospital, 012361 Bucharest, Romania
| | - Nicolae Gică
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (N.G.); (L.P.)
- Filantropia Clinical Hospital Bucharest, 011132 Bucharest, Romania
| | - Liana Pleș
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (N.G.); (L.P.)
- “Bucur” Maternity, Saint John Hospital, 012361 Bucharest, Romania
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Sima RM, Crăițan AV, Pleș L, Bobircă F, Amza M, Gorecki GP, Georgescu MT, Hamoud BH. The Beginner Laparoscopists Trends in the Learning Process of Laparoscopy for Adnexal Gynecological Pathologies-The Experience of Our Center. Healthcare (Basel) 2023; 11:1752. [PMID: 37372870 DOI: 10.3390/healthcare11121752] [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: 05/19/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Laparoscopy for benign ovarian pathology is the appropriate surgical approach and it has many well-known advantages. Minimal invasive gynecological surgery increases the quality of life of the patient. The learning process of laparoscopy is difficult and requires many interventions to acquire manual skills. The objectives of the study were to assess the learning process of laparoscopy for adnexal pathology surgery performed by beginner laparoscopists. MATERIALS AND METHODS This study included three gynecological surgeons who were beginners in laparoscopy and who were named A, B, and C. We collected information about patients, diagnosis, surgical technique, and complications. RESULTS We have analyzed the data from 159 patients. The most frequent primary diagnosis was functional ovarian cyst, and the laparoscopic cystectomy was performed in 49.1% of interventions. The need to convert a laparoscopy into laparotomy was necessary in 1.3% of patients. There were no cases of reintervention, blood transfusion, or ureteral lesions. The duration of the surgical intervention varied statistically significantly according to patient's BMI and to the surgeon. After 20 laparoscopic interventions, a significant improvement was found in the time needed to perform ovarian cystectomy (operators A and B) and salpingectomy (operator C). CONCLUSIONS The process of learning laparoscopy is laborious and difficult. We found a significant decrease in operating time after a twenty laparoscopic interventions.
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Affiliation(s)
- Romina-Marina Sima
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- The "Bucur" Maternity, "Saint John" Hospital, 040294 Bucharest, Romania
| | - Anca-Violeta Crăițan
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Liana Pleș
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- The "Bucur" Maternity, "Saint John" Hospital, 040294 Bucharest, Romania
| | - Florin Bobircă
- Department of Surgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Surgery Department, Dr. Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania
| | - Mihaela Amza
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- The "Bucur" Maternity, "Saint John" Hospital, 040294 Bucharest, Romania
| | - Gabriel-Petre Gorecki
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
- Department of Anesthesia and Intensive Care, CF2 Clinical Hospital, 011464 Bucharest, Romania
| | - Mihai-Teodor Georgescu
- "Prof. Dr. Al. Trestioreanu" Oncology Discipline, Carol Davila University of Medicine and Pharmacy, 252 Fundeni St., 050474 Bucharest, Romania
| | - Bashar Haj Hamoud
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, KirrbergerStraße 100, Building 9, 66421 Homburg, Germany
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Cauni VM, Tanase F, Mihai B, Gorecki GP, Ples L, Sima RM, Persu C. Single-Center Experience with Swiss LithoClast ® Trilogy for Kidney Stones. Diagnostics (Basel) 2023; 13:diagnostics13081372. [PMID: 37189473 DOI: 10.3390/diagnostics13081372] [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: 02/25/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION PCNL remains the gold standard for larger kidney stones. Reducing the operating time of PCNL and its complication rate seems to be the next logical step in optimizing this classical technique. To achieve these objectives, some new methods of lithotripsy emerge. We present the data of a single, high-volume, academic center with combined ultrasonic and ballistic lithotripsy in PCNL using the Swiss LithoClast® Trilogy device. MATERIALS AND METHODS We designed a prospective, randomized study including patients who underwent PCNL or miniPerc with lithotripsy using the new EMS Lithoclast Trilogy or EMS Lithoclast Master. The procedure was carried out with all patients in prone position, by the same surgeon. The working channel size was 24 Fr-15.9 Fr. We evaluated the stones' features, operative time, fragmentation time, complications, stone clearance rate and stone-free rate. RESULTS Our study included 59 patients, 38 females and 31 males, of an average age of 54.5 years old. The Trilogy group included 28 patients and the comparator included 31 patients. Urine culture was positive in seven cases which required seven days of antibiotics. The mean stone diameter was 35.6 mm with a mean Hounsfield unit (HU) of 710.1. The average number of stones was 2.08 (6 complete staghorn stones and 12 partial staghorn stones). A total of 13 patients presented a JJ stent (46.4%). We found a very significant difference in all the parameters favoring the Trilogy device. The most important result in our opinion is the probe active time, which was almost six times shorter in the Trilogy group. The stone clearance rate was about double in the Trilogy group, leading to shorter overall and intra-renal operating times. The overall complication rate was 17.9% in the Trilogy group and 23% in the Lithoclast Master group. The mean hemoglobin drop was 2.1 g/dL with a mean creatinine rise of 0.26 mg/dL. CONCLUSIONS Swiss LithoClast® Trilogy, a device combining ultrasonic and ballistic energy, is a safe and efficient method of lithotripsy for PCNL, proving statistically significant benefits over its predecesor. It can achieve the goal of reducing complication rates and operative times for PCNL.
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Affiliation(s)
- Victor-Mihail Cauni
- Department of Urology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Florin Tanase
- Department of Urology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Bogdan Mihai
- Department of Urology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Gabriel-Petre Gorecki
- Department of Anesthesia and Intensive Care, CF2 Clinical Hospital, 011464 Bucharest, Romania
- Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Liana Ples
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- "Bucur" Maternity, Saint John Hospital, 012361 Bucharest, Romania
| | - Romina-Marina Sima
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- "Bucur" Maternity, Saint John Hospital, 012361 Bucharest, Romania
| | - Cristian Persu
- Department of Anesthesia and Intensive Care, CF2 Clinical Hospital, 011464 Bucharest, Romania
- Department of Urology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Teodorescu COD, Gorecki GP, Pleș L, Sima RM, Bălălău DO, Filipescu A, Teodorescu A. Profilul metabolic pentru monitorizarea şi managementul diabetului gestaţional. Ginecologia ro 2023. [DOI: 10.26416/gine.39.1.2023.7781] [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: 04/03/2023] Open
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Bobei TI, Sima RM, Gorecki GP, Poenaru MO, Olaru OG, Bobirca A, Cirstoveanu C, Chicea R, Topirceanu-Andreoiu OM, Ples L. Placenta, the Key Witness of COVID-19 Infection in Premature Births. Diagnostics (Basel) 2022; 12:diagnostics12102323. [PMID: 36292012 PMCID: PMC9600231 DOI: 10.3390/diagnostics12102323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/23/2022] Open
Abstract
Adverse perinatal outcomes, such as increased risks of pre-eclampsia, miscarriage, premature birth, and stillbirth have been reported in SARS-CoV-2 infection. For a better understanding of COVID-19 complications in pregnancy, histopathological changes in the placenta, which is the interface between mother and foetus, could be the place to look at. The aim of this study was to determine placental histopathological changes and their role in preterm birth in pregnant women with SARS-CoV-2 infection. We performed a prospective, observational study in a COVID-only hospital, which included 39 pregnant women with SARS-CoV-2 infection and preterm birth compared with a control group of 39 women COVID-19 negative with preterm birth and a placental pathology exam available. The microscopic examination of all placentas revealed placental infarction (64.1% vs. 30.8%), decidual arteriopathy (66.7% vs. 23.1%), intervillous thrombi (53.8% vs. 38.5%), perivillous fibrin deposits (59% vs. 46.2%), inflammatory infiltrate (69.2% vs. 46.2%), chorangiosis (17.9% vs. 10.3%), and accelerated maturation of the villi (23.1% vs. 28.2%).
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Affiliation(s)
- Tina-Ioana Bobei
- Department PhD, IOSUD, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Romina-Marina Sima
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Bucur” Maternity, Saint John Hospital, 012361 Bucharest, Romania
- Correspondence:
| | - Gabriel-Petre Gorecki
- “Bucur” Maternity, Saint John Hospital, 012361 Bucharest, Romania
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
| | - Mircea-Octavian Poenaru
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Bucur” Maternity, Saint John Hospital, 012361 Bucharest, Romania
| | - Octavian-Gabriel Olaru
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Bucur” Maternity, Saint John Hospital, 012361 Bucharest, Romania
| | - Anca Bobirca
- Department of Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Catalin Cirstoveanu
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Pediatrics Department, “Maria Sklodowska Curie” Emergency Children Clinical Hospital, 041451 Bucharest, Romania
| | - Radu Chicea
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550024 Sibiu, Romania
| | | | - Liana Ples
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Bucur” Maternity, Saint John Hospital, 012361 Bucharest, Romania
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Balasoiu AM, Dinu MD, Gorecki GP, Sima RM, Ples L. The Impact of Prenatal Lectures in Breastfeeding and Neonatal Care in Romania - Our Experience. Maedica (Bucur) 2022; 17:291-296. [PMID: 36032601 PMCID: PMC9375900 DOI: 10.26574/maedica.2022.17.2.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective:The aim of the study was to identify the impact of prenatal lectures in breastfeeding and neonatal care in Romania. Methods:We distributed a questionnaire to mothers who gave birth at the Bucur Maternity, Bucharest, Romania. A study group was constituted from women who attended prenatal lectures and their answers were compared with those from women who did not have prenatal education. Results:The study included 122 women. Primiparous women tend to participate in educational lectures to a greater extent than others (p=0.001). Participants in prenatal lectures breastfeed longer than non-participants (.0.001) and they had at least university studies in a higher proportion (94.06%) than non-attenders (52.38%). Women without prenatal lectures live predominantly in rural areas (p=0.003). Most women who attended classes (86.2%) considered that information provided by prenatal lectures was useful. Exclusively breastfeeding was more frequent among participants (47.49%) than non-participants (38.89%). Conclusion:Primiparity, high level of education and living in urban areas are the main characteristics of female participants in prenatal lectures, who tend to breastfeed longer and ensure exclusive human milk feeding for their babies in a higher proportion than non-participants.
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Affiliation(s)
- Anca Maria Balasoiu
- PhD, IOSUD Department, "Carol Davila" University of Medicine and Pharmacy,Bucharest, Romania
| | - Mihai-Daniel Dinu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | | | | | - Liana Ples
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Pleș L, Cîrstoveanu C, Sima RM, Gorecki GP, Chicea R, Haj Hamoud B. Prenatal Diagnosis of Bovine Aortic Arch Anatomic Variant. Diagnostics (Basel) 2022; 12:diagnostics12030624. [PMID: 35328177 PMCID: PMC8947431 DOI: 10.3390/diagnostics12030624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 11/16/2022] Open
Abstract
Fetal aortic arch development is an early and complex process that depends on many genetic and environmental factors. The final aortic arch varies greatly; it may take the form of a normal arch, anatomic variant (AAAV) with a common origin to that of the innominate artery and left common carotid artery (formerly known as “bovine aortic arch” (with an incidence of up to 27%)) or one of multiple pathological conditions. The present study aimed to establish the feasibility and impact of prenatal anatomic arch variants’ diagnosis. A retrospective study of 271 fetal second- and third-trimester anomaly scans was performed in our tertiary center. Examinations that evaluated the sagittal aortic arch were included and the branching pattern was assessed. Additionally, a literature data search based on the terms “common origin of innominate artery and left common carotid artery”, “bovine arch”, “bovine aortic” and “aortic arch anomalies” was performed. Results that referred to prenatal AAAV were retained and the papers evaluated. In our study, the AAA incidence was 1.93%, with 4 out of 5 cases being arch type B. All cases had minor associated conditions but a good postnatal outcome. An anatomic aortic variant with a common IA and LCCa prenatal diagnosis was found in a small number of studies; most of the cases described in pediatric and adult series were related to cardiac surgery for stenting, aneurysm or thoracic-associated diseases. The incidence of AAAV varied from 6 to 27% depending on the population studied (highest incidence in African individuals). The variant was highly associated with aortic dissection, pulmonary and cerebral embolism and increased risks of incidents during surgery. Diagnosing AAAV during a routine anatomic scan is feasible and diagnoses can be made when anomaly scans are performed. Awareness of the condition is important for postnatal surgery when other cardiac anomalies are found; this can prevent accidents with simple changes to the patient’s lifestyle, and, in the case of surgery, means we can adopt the correct surgical approach.
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Affiliation(s)
- Liana Pleș
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- The “Bucur” Maternity, ‘Saint John’ Hospital, 040294 Bucharest, Romania
| | - Cătălin Cîrstoveanu
- Department of Pediatrics, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Pediatrics Department, ‘Maria Sklodowska Curie’ Emergency Children Clinical Hospital, 041451 Bucharest, Romania
| | - Romina-Marina Sima
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- The “Bucur” Maternity, ‘Saint John’ Hospital, 040294 Bucharest, Romania
- Correspondence: (R.-M.S.); (G.-P.G.)
| | - Gabriel-Petre Gorecki
- The “Bucur” Maternity, ‘Saint John’ Hospital, 040294 Bucharest, Romania
- Faculty of Medicine, ‘Titu Maiorescu’ University, 040441 Bucharest, Romania
- Correspondence: (R.-M.S.); (G.-P.G.)
| | - Radu Chicea
- Faculty of Medicine, ‘Lucian Blaga’ University of Sibiu, 550024 Sibiu, Romania;
| | - Bashar Haj Hamoud
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Kirrberger Straße 100, Building 9, 66421 Homburg, Germany;
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