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Mihai I, Dura H, Teodoru CA, Todor SB, Ichim C, Grigore N, Mohor CI, Mihetiu A, Oprinca G, Bacalbasa N, Tanasescu D, Bratu DG, Boicean A, Oros B, Hasegan A. Intraoperative Ultrasound: Bridging the Gap between Laparoscopy and Surgical Precision during 3D Laparoscopic Partial Nephrectomies. Diagnostics (Basel) 2024; 14:942. [PMID: 38732356 PMCID: PMC11083918 DOI: 10.3390/diagnostics14090942] [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: 03/14/2024] [Revised: 04/11/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
The use of 3D laparoscopic partial nephrectomy has emerged as a cornerstone in the surgical arsenal for addressing renal tumors, particularly in managing challenging cases characterized by deeply seated tumors embedded within the renal parenchyma. In these intricate scenarios, the utilization of intraoperative ultrasound (IOUS) acquires paramount importance, serving as an indispensable tool for guiding and meticulously monitoring the surgical process in real time. To further explore the efficacy of IOUS-guided techniques, we conducted a retrospective study comparing outcomes in patients who underwent partial nephrectomy with IOUS guidance (n = 60) between 2020 and 2022 with a cohort from 2018 to 2019 without IOUS guidance (n = 25). Our comprehensive analysis encompassed various post-operative parameters, including the duration until food resumption, analgesia requirements, and length of the hospital stay. While these parameters exhibited comparable outcomes between the two groups, notable distinctions emerged in the intraoperative metrics. The IOUS-guided cohort demonstrated significantly reduced blood loss, a shorter median operative duration, and diminished ischemia time (p = 0.001). These compelling findings underscore the undeniable benefits of IOUS-guided techniques in not only facilitating the attainment of negative surgical margins but also in enhancing procedural safety and precision, thereby contributing to improved patient outcomes in the management of renal tumors.
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Affiliation(s)
- Ionela Mihai
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Horatiu Dura
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Cosmin Adrian Teodoru
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Samuel Bogdan Todor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Cristian Ichim
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Nicolae Grigore
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Cosmin Ioan Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Alin Mihetiu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - George Oprinca
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Nicolae Bacalbasa
- Surgery Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 020021 Bucharest, Romania;
| | - Denisa Tanasescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Dan Georgian Bratu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
| | - Bogdan Oros
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Adrian Hasegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (C.A.T.); (S.B.T.); (C.I.); (N.G.); (C.I.M.); (A.M.); (G.O.); (D.T.); (D.G.B.); (A.B.); (A.H.)
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Hașegan A, Mihai I, Teodoru CA, Matacuta IB, Dura H, Todor SB, Ichim C, Tanasescu D, Grigore N, Bolca CN, Mohor CI, Mohor CI, Bacalbașa N, Bratu DG, Boicean A. Exploring the Challenges of Using Minimal Invasive Surgery to Treat Stress Urinary Incontinence: Insights from a Retrospective Case-Control Study. Diagnostics (Basel) 2024; 14:323. [PMID: 38337839 PMCID: PMC10855614 DOI: 10.3390/diagnostics14030323] [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: 12/19/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Stress urinary incontinence (SUI) is a significant global health issue that particularly affects females, leads to notable societal and economic challenges and significantly affects the quality of life. This study focuses on the comparative analysis of two established surgical interventions, tension-free vaginal tape (TVT) and transobturator tape (TOT), at a single center and applied to 455 women suffering from SUI, with a mean follow-up period of 102 ± 30 months for TVT and 80.4 ± 13 months for TOT. Our findings indicate that, in comparison to TVT, the TOT procedure demonstrates fewer early and late post-operative complications in patient outcomes (1.41% vs. 17.64% and; 5.66% vs. 12.74%, both respectively). However, the TVT procedure shows a modestly favorable outcome in the risk of recurrence of SUI, compared to TOT (0% vs. 3.7%); the TOT procedure has also proven to be more effective in alleviating of urgency symptoms, although not at a statistically significant level (p = 0.072). Univariable and multivariable analysis of factors that predict late complications showed that only obesity can predict a worse outcome [OR]: 1.125 CI 95%: 1.105-1.533, p = 0.037), when adjustments are made for symptoms presented before surgery and procedure type. While both methods are safe and effective, the choice between them should be based on the specific characteristics of each case.
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Affiliation(s)
- Adrian Hașegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Ionela Mihai
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Cosmin Adrian Teodoru
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Ioana Bogdan Matacuta
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Horațiu Dura
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Samuel Bogdan Todor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Cristian Ichim
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Denisa Tanasescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Nicolae Grigore
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | | | - Cosmin Ioan Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Călin Ilie Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Nicolae Bacalbașa
- Surgery Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 020021 Bucharest, Romania;
| | - Dan Georgian Bratu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
| | - Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (I.M.); (C.A.T.); (I.B.M.); (H.D.); (S.B.T.); (C.I.); (D.T.); (N.G.); (C.I.M.); (C.I.M.); (A.B.)
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Mihai I, Boicean A, Teodoru CA, Grigore N, Iancu GM, Dura H, Bratu DG, Roman MD, Mohor CI, Todor SB, Ichim C, Mătacuță IB, Băcilă C, Bacalbașa N, Bolca CN, Hașegan A. Laparoscopic Adrenalectomy: Tailoring Approaches for the Optimal Resection of Adrenal Tumors. Diagnostics (Basel) 2023; 13:3351. [PMID: 37958247 PMCID: PMC10650124 DOI: 10.3390/diagnostics13213351] [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: 09/12/2023] [Revised: 10/23/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
In this study, we investigated the outcomes of laparoscopic approaches for adrenal tumor resection in 67 patients from a single center with a median age of 51 (range 40-79). Predominantly comprising women, the majority of patients were overweight or obese. Adrenal tumors larger than 6 cm were mostly treated using the laparoscopic transperitoneal method (p < 0.001). Our results revealed that patients subjected to the retroperitoneal approach exhibited quicker recovery, as evidenced by faster resumption of oral intake and ambulation, along with reduced intraoperative blood loss and shorter hospitalization (p-value < 0.05). In contrast, patients subjected to the transperitoneal approach experienced minimal complications, though not statistically significant, despite the technique's intricacy and slower recovery. These findings emphasize the significance of tailoring the surgical approach to individual patient characteristics, with particular emphasis on the tumor size. The choice between the retroperitoneal and transperitoneal methods should be informed by patient-specific attributes to optimize surgical outcomes. This study underscores the need for a comprehensive evaluation of factors such as tumor characteristics and postoperative recovery when determining the most suitable laparoscopic approach for adrenal tumor resection. Ultimately, the pursuit of individualized treatment strategies will contribute to improved patient outcomes in adrenal tumor surgery.
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Affiliation(s)
- Ionela Mihai
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Cosmin Adrian Teodoru
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Nicolae Grigore
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Gabriela Mariana Iancu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Horatiu Dura
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Dan Georgian Bratu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Mihai Dan Roman
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Cosmin Ioan Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Samuel Bogdan Todor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Cristian Ichim
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Ioana Bogdan Mătacuță
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Ciprian Băcilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Nicolae Bacalbașa
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania;
| | | | - Adrian Hașegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
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Hașegan A, Mihai I, Bratu D, Bacilă C, Roman MD, Mohor CI, Teodoru A, Birsan S, Mutu C, Chibelean C, Totan M, Grigore N, Iancu G, Dura H, Boicean A. Severe Acute Ischemia of Glans Penis after Achieving Treatment with Only Hyperbaric Oxygen Therapy: A Rare Case Report and Systematic Literature Review. J Pers Med 2023; 13:1370. [PMID: 37763138 PMCID: PMC10533140 DOI: 10.3390/jpm13091370] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and the complications of circumcision are reviewed. We note that there are very few cases described in the literature. Our patient was successfully treated with hyperbaric oxygen therapy (HBOT) after four days of no positive effect after all medical and surgical treatments written in the literature: Subcutaneous enoxaparin, local application of a glyceryl trinitrate, continuous epidural perfusion, intravenous pentoxifylline, alprostadil, intraoperative drainage, and aspiration with saline solution and epinephrine. Clinical improvement was noted at the first session of HBOT. A number of days after the operation, the penis looked normal and was healing. Complete healing of the penile glans was successfully realized one month after surgery. Conclusion: Based on the review and the case presented, we conclude that HBOT is the treatment of choice for acute ischemia of the penile glans, especially when other treatments do not work.
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Affiliation(s)
- Adrian Hașegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Ionela Mihai
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Dan Bratu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Ciprian Bacilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Mihai Dan Roman
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Cosmin Ioan Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Adrian Teodoru
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Sabrina Birsan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Cosmin Mutu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Călin Chibelean
- Faculty of Medicine, University of Medicine and Farmacy, 540139 Targu Mures, Romania;
| | - Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Nicolae Grigore
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Gabriela Iancu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Horatiu Dura
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
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Sapaniuc C, Lacatusu G, Mihai I, Rascanu M, Bran D, Manciuc D. Burnout or anxiety?! A medical trial regarding resident doctors in a first line University Hospital during COVID 19 pandemic. Eur Psychiatry 2022. [PMCID: PMC9563844 DOI: 10.1192/j.eurpsy.2022.507] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported as a worldwide emergency. Due to the extensiveness of spread and death, it has been declared as a pandemic.
Objectives
To highlight how COVID-19 pandemic psycho-emotional affects the medical staff of a frontline University Hospital in the “battle” with new coronavirus.
Methods
We employed a cross-sectional survey of 71 resident doctors from a frontline Hospital after a one-year pandemic and analyzed the prevalence and associated factors with work-related psychological distress among our study group.
Results
Out of the hospital resident doctors, 71 participated and completed the questionnaire, offering an overall response rate of 100%. The majority of participants were women (86% - 61). The average age was 29 years. Most respondents were unmarried. A total of 67% of participants were non-smokers, 5% stated that they occasionally consumed alcohol, none of them used drugs. As a result of the qualitative and quantitative analysis of the data, aspects related to anxiety (21.12% - 15), exhaustion (15.49% - 11), and depression (11.26% - 8) are highlighted. In our study, no people were identified who would reach extreme exhaustion in the work process, due to good resilience and due to a well thought out program of work and rest during the pandemic.
Conclusions
The psychological pressure at work, as well as the one felt after limiting and restricting mobility for shorter or longer periods, had an impact on the psycho-emotional state of health care workers, requiring further psychological reassessments and psychological support.
Disclosure
No significant relationships.
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Braunstein C, Sirveaux F, Kalbacher E, Aubry S, Delroeux D, Hubert P, Marie B, Meynard G, Mihai I, Chaigneau L. Humeral metastasis as the only recurrence of a 5-year resected gastrointestinal stromal tumor: a case report. J Med Case Rep 2021; 15:428. [PMID: 34404447 PMCID: PMC8371842 DOI: 10.1186/s13256-021-02962-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/16/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Gastrointestinal stromal tumors represent the most frequently encountered primary mesenchymal tumors. Whereas the liver and the peritoneum are known to be the preferential metastasis sites, no therapeutic standard has yet been established for the management of bone metastases because of their very low incidence. We report a unique example of a single humerus metastasis of a jejunal gastrointestinal stromal tumor. CASE PRESENTATION We report the case of a 72-year-old European woman whose jejunal gastrointestinal stromal tumor was resected in 2013 and treated during the following 3 years with imatinib (400 mg daily). In 2018, she developed a single humeral bone lesion that was identified as a gastrointestinal stromal tumor metastasis. After 7 months of imatinib intake, reconstructive surgery was performed. Pathologists confirmed the satisfactory histological regression and assessed the complete tumor resection. The patient is still on imatinib maintenance therapy, with no recurrence reported so far. She fully recovered the upper limb function after following an appropriate rehabilitation program. DISCUSSION Current literature and published case reports indicate that bones are one of the rarest locations of gastrointestinal stromal tumor metastasis (about 1%), with occurrence mainly in the spine. Patients initially diagnosed with gastrointestinal stromal tumor of the small intestine and stomach are more likely to suffer from bone metastasis, compared with other gastrointestinal stromal tumor locations. The median overall survival rate is higher for patients with isolated bone metastasis compared with those having liver metastasis. Metastasis occurs on average 4 years after the primary, but it may take up to 20 years, emphasizing the need for long-term clinical and radiological monitoring. Although specific guidelines for such cases have not yet been established, we suggest that a multimodal concerted approach involving surgery or radiotherapy associated with tyrosine kinase inhibitor intake should be considered. CONCLUSION Bones are one of the rarest locations of gastrointestinal stromal tumor metastasis. A multidisciplinary collaboration was set up to allow conservative surgery of our patient after several months of imatinib treatment. A year and a half later, the patient is still in complete remission. This specific case supports the concept of an intermediate stage between local and oligometastatic disease that should be managed with a curative aim, as much as possible.
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Affiliation(s)
- C. Braunstein
- Service d’Anatomie Pathologique, Hôpital Nord Franche-Comté, Trévenans, France
| | - F. Sirveaux
- Service de Chirurgie Orthopédique, Centre Hospitalo-Universitaire de Nancy, Laxou, France
| | - E. Kalbacher
- Service d’Oncologie Médicale, Centre Hospitalo-Universitaire de Besançon, Besançon, France
| | - S. Aubry
- Service de Radiologie et d’imagerie Médicale, Centre Hospitalo-Universitaire de Besançon, Besançon, France
| | - D. Delroeux
- Centre de Chirurgie Viscérale, Clinique St-Vincent, Besançon, France
| | - P. Hubert
- Service d’Oncologie Médicale, Centre Hospitalo-Universitaire de Besançon, Besançon, France
| | - B. Marie
- Service d’Anatomie et Cytologie Pathologiques, Centre Hospitalo-Universitaire de Nancy, Laxou, France
| | - G. Meynard
- Service d’Oncologie Médicale, Centre Hospitalo-Universitaire de Besançon, Besançon, France
| | - I. Mihai
- Service d’Anatomie et Cytologie Pathologique, Hôpital Nord Franche-Comté, Trévenans, France
| | - L. Chaigneau
- Service d’Oncologie Médicale, Centre Hospitalo-Universitaire de Besançon, Besançon, France
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Meynard G, Boullerot L, Belmiloudi S, Dosset M, Laheurte C, Guenat D, Rangan L, Lauret Marie Joseph E, Verlut C, Godet Y, Valmary-Degano S, Mihai I, Pivot X, Curtit E, Adotevi O. Presence of naturally occurring anti-telomerase CD4 Th1 immunity in glioblastoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.065] [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: 11/12/2022] Open
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Grigore N, Pirvut V, Mihai I, Hasegan A, Cernusca Mitariu SI. Prostatic Specific Antigen Less then 10 ng/mL in the Diagnostic and Surveillance of Prostate Cancer. Rev Chim 2017. [DOI: 10.37358/rc.17.5.5584] [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
Prostate cancer (PCa) is the most commonly diagnosed male malignancy after 60 years old. Today, the problem is to distinguish between low-risk and agrressive cancers, especially in patients with Prostatic Specific Antigen (PSA) less than 10 ng/ml The use of PSA as a biomarkers for diagnosis and prognosis of prostate cancer has the potential to improve the clinical management of the patients. PSA levels. together with clinical examination, prostate ultrasound and histopatological examination are esential for the diagnostic of PCa, risk assessment and therapeutic decisions. The aim of our study is to evaluate the patients with PSA values less then 10 ng/mL and to determine the correct indications for tratment depending on the risk scale of the disease. The inclusion criteria for the patients are described in the paper. For improving the early diagnosis of PCa in patients with PSA below 10 ng/mL we developed an algoritm based on current opportunities.
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Surdeanu M, Pencu E, Tonciu M, Mihai I, Ciudin L. Differentiation of Shigella strains by plasmid profile analysis, serotyping and phage typing. Roum Arch Microbiol Immunol 2000; 59:103-17. [PMID: 11845469] [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: 02/23/2023]
Abstract
Ninety-one Shigella flexneri and 29 Shigella sonnei strains isolated during 1994 from sporadic cases of shigellosis and healthy carriers were analyzed for plasmid profile in order to compare the discriminating ability of this method with that of serotyping and phage typing. Our study revealed 10 plasmid profiles (PP) among S. sonnei strains. A total of 26 out of 29 (89%) S. sonnei isolates could be placed into two phage types (type 1 and 20) comprising four PP for phage type 1 and seven PP for type 20, respectively. Twenty-three different PP were identified among S. flexneri strains. Each serotype was associated with a specific predominant plasmid profile, except serotype 2a. This serotype, the most frequently isolated in Romania, was still rather homogeneous: 33 out of 39 isolates belonged to phage type 125, 27 of which could be placed into two related PP (F10 and F17). Comparison of plasmid patterns of epidemiologically independent S. flexneri serotype 2a isolates with those exhibited by 45 serotype 2a isolates associated to six independent outbreaks revealed the same homogeneity. Thirty-eight strains, representing 4 of 6 outbreaks, had F10 and F17 plasmid patterns. The discrimination indices (D) for plasmid profile analysis alone (D = 0.890) and for the combination of serotyping and phage typing (D = 0.841) indicate that both typing systems have a nearly similar ability of discriminating among S. flexneri strains. By combining the results of the three typing methods, a total of 42 types are distinguished and the D value is 0.942. Our data suggest that plasmid profile analysis can complement phenotyping methods resulting in a degree of discrimination that cannot be achieved by either system alone.
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Affiliation(s)
- M Surdeanu
- Molecular Epidemiology Laboratory, Cantacuzino Institute-103, Splaiul Independentei, C.P. 1-525, 70100 Bucuresti, Romania.
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Abstract
Yeast two-hybrid screening of a human kidney cDNA library using the GTP-bound form of a class II ADP-ribosylation factor (ARF5) identified a novel ARF5-binding protein with a calculated molecular mass of 82.4 kDa, which was named arfophilin. Northern hybridization analysis showed high level arfophilin mRNA expression in human heart and skeletal muscle. Arfophilin bound only to the active, GTP-bound form of ARF5 and did not bind to GTP-ARF3, which is a class I ARF. The N terminus of ARF5 (1-17 amino acids) was essential for binding to arfophilin. The GTP-bound form of ARF5 with amino acid residues in the N terminus mutated to those in ARF4 (another class II ARF) also bound to arfophilin, suggesting it is a target protein for GTP-bound forms of class II ARFs. The binding site for ARF on arfophilin was localized to the C terminus (residues 612-756), which contains putative coiled-coil structures. Recombinant arfophilin overexpressed in CHO-K1 cells was localized in the cytosol and translocated to a membrane fraction in association with GTP-bound ARF5. ARF5 containing the N terminus of ARF3 did not promote translocation indicating that class II ARFs are specific carriers for arfophilin.
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Affiliation(s)
- O H Shin
- Howard Hughes Medical Institute and Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA
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Ciudin L, Pencu E, Mihai I, Tonciu M, Petrescu AM. Serological identification of Shigella flexneri strains by the coagglutination reaction. Roum Arch Microbiol Immunol 1995; 54:295-311. [PMID: 8993123] [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: 02/03/2023]
Abstract
Several variants of reagents were prepared by coupling type (I, II III, IV, V and VI) and group (3, 4, 6 and 7, 8, 9) anti-Shigella flexneri sera with protein A--containing staphylococcal suspension. For most serum lots coagglutination led to a 1/10 minimum dilution. However, different efficiencies were reported between serum lots and even within the same type or group. No improvement by the coagglutination reaction could be obtained for one lot from group 3, 4 and 7, 8, 9 sera and for both type IV serum lots. The coagglutination reactions were specific both with collection strains and with recently isolated strains and the two staphylococcal suspension lots showed an identical behaviour. Coagglutination may be used for obtaining a better efficiency of type and group. Shigella flexneri sera but this varies in terms of the serum lot and the serum/Staphylococcus combination used.
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Affiliation(s)
- L Ciudin
- Cantacuzino Institute, Bucharest, Romania
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Tonciu M, Mihai I, Nicolescu S. [Antibiotic and chemotherapeutic resistance of Shigella strains isolated in Romania in the period of 1987-1992]. Bacteriol Virusol Parazitol Epidemiol 1993; 38:62-70. [PMID: 8173215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Tonciu M, Mihai I, Pencu E, Ciudin L. Study of strains agglutinable with enteroinvasive anti E. coli polyvalent sera isolated from ill and healthy subjects for optimizing the laboratory diagnosis of diarrhoea. Roum Arch Microbiol Immunol 1992; 51:183-91. [PMID: 1297466] [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: 12/26/2022]
Abstract
369 E. coli strains that are agglutinated in A or B anti E. coli enteroinvasive (EIEC) polyvalent sera and inducing no keratoconjunctivitis in the guinea pig's eye have been selected. The biochemical reactions of E. coli strains that can be agglutinated in A or B EIEC polyvalent sera occupy an intermediary position between those of Shigella genus and the classical features of Escherichia, i.e.; 87% are motile bacteria, 88%--ferment lactose, 81% form acid from sodium mucate and lysine is not decarboxylated by 87% of the strains. As for the antigenic behaviour with 15 out of the 16 sera employed, the strains under consideration have agglutinated by slide test in one or several sera, with varying intensities. None of the strains agglutinated on slide in the O164 antiserum. Subsequently, agglutinations have been performed in tubes only with the strains that agglutinated on the slide with a +3 or +4 intensity. Out of the 369 strains under consideration only 25 have agglutinated in the tube, all the false positive reactions representing 6.7%. The data presented lead to the conclusion that such strains that have been isolated from ill or healthy patients cannot be considered as pathogenic diarrhoea agents, the differentiation from the invasive strains (in the absence of the guinea pig for the pathogenicity test) cannot be made on the basis of the biochemical reactions, but only by means of a set of monovalent sera and by performing the tube agglutination tests.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Tonciu
- Cantacuzino Institute, Bucharest, Romania
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Cernea P, Ispas G, Mihai I. [The staging of malignant uveal melanoma]. Oftalmologia 1992; 36:229-38. [PMID: 1520679] [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: 12/27/2022]
Abstract
There have been investigated 30 malignant uveal melanomas hospitalized in the Ophthalmologic Clinic of Craiova during the last 15 years. The disease has developed more frequently among the female sex in a 3/2 proportion, the maximum age ranging between, 40 and 70 years old. As to the localization, 2 were at the level of the iris, 7 at the level of ciliary body and 21 at the choroid level. In anterior localizations tumour extirpation was possible in the 2 cases through iridectomy and in only one case through cyclectomy. Anatomicopathologically, most cases presented mixed-type cells where prevailed the type B fusiform cells and epithelioid cells with big quantitative variations from one zone to another. The tumours detected in an incipient stage benefited from laser photocoagulation or application of CO60 and I125 radioactive disks. In advanced stages enucleation was practised preceded by 2 treatments of radiotherapy for the devitalization of tumorous cells and prevention of metastases.
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Pencu E, Ciudin L, Tonciu M, Mihai I. Congo red binding test in enteroinvasive and nonpathogenic Escherichia coli strains. Roum Arch Microbiol Immunol 1991; 50:109-15. [PMID: 1820187] [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: 12/28/2022]
Abstract
Out of 6 variants the appropriate media to perform Congo red binding test for enteroinvasive E. coli strains were established (trypto-soy agar Eiken, T.S.A.--Cantacuzino Institute and B.T.S.D.). 12 E. coli strains belonging to enteroinvasive O-serogroups formed on Congo red agar red-coloured, non-coloured colonies or both; cultures from 59 red colonies and 61 white colonies were inoculated in guinea pig eyes. The correlation between positive Congo red binding test and positive Sereny test was 91% (out of 59 red colonies, 47 evoked keratoconjunctivitis in both infected eyes and 7 in only one eye). The negative Congo red binding test corresponds (98.4%) to the failure to induce illness in the guinea pigs' eye (only one out of 61 Crb = colonies was Sereny positive, evoking keratoconjunctivitis in only one of the two infected eyes of a guinea pig). Comparing in vivo lack of pathogenicity in 44 E. coli strains isolated from human normal intestinal flora and negative Congo red binding test, a correlation of 72.73% on B.T.S.D. and 65.91% on T.S.A. medium was found. Developing an appropriate method based on Crb test about 70% of the nonpathogenic E. coli colonies could be eliminated from the laborious agglutination with enteroinvasive O-serogroups E. coli antisera.
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Affiliation(s)
- E Pencu
- Cantacuzino Institute, Bucharest, Romania
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Meitert T, Pencu E, Ciudin L, Tonciu M, Mihai I, Nicolescu S. Correlation between Congo red binding as virulence marker in Shigella species and Sereny test. Roum Arch Microbiol Immunol 1991; 50:45-52. [PMID: 1802051] [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: 12/28/2022]
Abstract
Six variants of nutrient agar were tested in order to chose the suitable media for Congo red binding test. Trypto-soy Eiken, T.S.A - Cantacuzino Institute and B.T.S.D. (a medium prepared with Difco ingredients) are appropriate to distinguish between virulent Crb+ and avirulent Crb- strains. Congo red binding was compared with Sereny test using 25 Shigella strains. The strains were inoculated onto trypto-soy agar Eiken plates with 0.01% Congo red, incubated 24 hours at 37 degrees C. A number of each kind (Crb+ and Crb-) of colonies developed by every strain was subcultured on nutrient agar and Sereny test was performed with these cultures. As expected, all 84 Crb+ colonies in vivo tested, produced keratoconjunctivitis. In the case of Crb- colonies a proper correlation with Sereny negative test was observed in 57 out of 73 colonies (78.2%) to which 10.9% (8 out of 73) less virulent (evoking illness in only one of the two inoculated eyes) colonies may be added. As our results confirmed that loss of pigmentation was consistently accompanied by loss or diminishing of virulence, we consider that Congo red binding may be used as an alternative of in vivo test for establishing the virulence of Shigellae in the routine practice of microbiology laboratories which usually are not provided with cell cultures or animals. Its reduced cost is an important advantage, too.
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Affiliation(s)
- T Meitert
- Cantacuzino Institute, Bucharest, Romania
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Meitert T, Tonciu M, Ciudin L, Pencu E, Mihai I, Nicolescu S. Identification of Shiga-like toxin in Escherichia coli strains, etiological agents of diarrheal disease. Arch Roum Pathol Exp Microbiol 1989; 48:293-8. [PMID: 2520669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Shiga-like toxin presence, in 20 E. coli strains, etiological agents of diarrheal diseases, is studied by preparing extracts at +4 degrees C, in the presence of chloroform and by i.v. inoculation in mice. In 4 out of 20 strains, Shiga-like toxin in high titres was identified. Most of the strains presented an inconstant and variable production of Shiga-like toxin in comparison with Shigella dysenteriae type 1 (Shiga) reference strain. The authors also confirm the existence of Shiga-like toxin under 2 forms (neutralizable with Shiga antitoxic serum and non-neutralizable). The importance of the obtained results is further discussed from the point of view of pathogeny and diagnosis of the infections produced by these germs.
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Meitert T, Gaicu N, Pencu E, Ciudin L, Petraşincu D, Tonciu M, Mihai I, Nicolescu S. Invasiveness testing on different cell lines for Shigella and enteroinvasive E. coli strains. Arch Roum Pathol Exp Microbiol 1988; 47:239-46. [PMID: 3075448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Meitert T, Ciudin L, Mihai I, Pencu E, Tonciu M. Studies of anti-Salmonella local resistance, postinfection and after application of inactivated germs. Arch Roum Pathol Exp Microbiol 1988; 47:83-92. [PMID: 3250367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Ciudin L, Meitert T, Pencu E, Gheorghe G, Tonciu M, Mihai I, Manase R. Live dysentery vaccine "Vadizen" (T32-Istrati) immunogenicity against Shigella-like challenge in animals. Arch Roum Pathol Exp Microbiol 1986; 45:247-56. [PMID: 3300598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Lucian M, Calomfirescu A, Mihai I, Lupaşcu EG, Sterescu P, Rosenberg Z, Niculescu C. [Influence of anti-pertussis vaccination on the clinical forms of the disease]. Pediatria (Bucur) 1965; 14:505-10. [PMID: 5888450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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