HELLP syndrome, also known as the syndrome of hemolysis, elevated liver enzymes, and low platelet... more HELLP syndrome, also known as the syndrome of hemolysis, elevated liver enzymes, and low platelets, represents a severe pregnancy complication typically associated with hypertension. It is associated with increased risks of adverse complications for both mother and fetus. HELLP occurs in 0.2–0.8% of pregnancies, and, in 70–80% of cases, it coexists with preeclampsia (PE). Both of these conditions show a familial tendency. A woman with a history of HELLP pregnancy is at high risk for developing this entity in subsequent pregnancies. We cannot nominate a single worldwide genetic cause for the increased risk of HELLP. Combinations of multiple gene variants, each with a moderate risk, with concurrent maternal and environmental factors are thought to be the etiological mechanisms. This review highlights the significant role of understanding the underlying pathophysiological mechanism of HELLP syndrome. A better knowledge of the disease’s course supports early detection, an accurate diagn...
Classically fetal heart evaluation is mandatory in the second trimester of pregnancy. Recent data... more Classically fetal heart evaluation is mandatory in the second trimester of pregnancy. Recent data suggest that the diagnosis of congenital heart disease is feasible in the first trimester (FT) of pregnancy, especially for trained examiners. In this pictorial essay we aim to illustrate in detail the particularity of the FT heart evaluation: the specific ultrasound techniques including practical tips for the basic and extended first trimester fetal heart evaluation protocol. The diagnosis is possible by the use of a variety of ultrasound techniques (B mode, CFM, Bidirectional Doppler, STIC, TUI) using the transabdominal/transvaginal probes. An abnormal FT heart scan requires second trimester reassessment. Unfortunately, not all cardiac disease can be potentially diagnosed in the first trimester. Based on their own experience the authors recommend that heart examination in the FT should be attempted in all fetuses, even in low risk pregnancies, using at least the basic Doppler examinat...
Twin-to-twin transfusion syndrome (TTTS) is the consequence of vascular anastomoses of the shared... more Twin-to-twin transfusion syndrome (TTTS) is the consequence of vascular anastomoses of the shared placenta of monochorionic twin pregnancies. Both circulating inter-twin blood flow and vasoactive mediators imbalance cause hypovolemia in the donor and hypervolemia in the recipient fetus. If left untreated, TTTS has a high perinatal mortality rate and adverse long-term outcomes mainly cardiovascular and neurological. The recipient has cardiovascular changes including atrioventricular valve regurgitation, diastolic dysfunction and pulmonary stenosis/atresia. The maladaptive response to vascular changes determines a constant decreased blood flow in the donor that permanently modifies the arterial structure leading to postnatal alterations in the vascular system. Fetoscopic LASER surgery of placental vascular anastomoses may disrupt the underlying pathophysiology and improves cardiovascular function with normalization of systolic and diastolic function within weeks after treatment. The i...
The prophylaxis of neurological impairment of premature born infants remains a serious challenge ... more The prophylaxis of neurological impairment of premature born infants remains a serious challenge for the neonatologists. The administration of drugs with neuroprotective effect should be considered in order to reduce the risk of cerebral palsy after severe preterm birth. Magnesium sulfate (MgSO4), the objective of this analysis, has been proposed as an important part of the management of unavoidable preterm birth for the prevention of cerebral palsy and neonatal death. The beneficial effects of this inexpensive and simple treatment are observed regardless of the reason for preterm birth, with similar results on different premature gestational ages. MgSO4 has been shown to have a neuroprotective effect by reducing brain metabolism and has also a beneficial hemodynamic effect by stabilizing blood pressure, reducing constriction in the cerebral arteries, and restoring infusion in preterm infants. The administration of MgSO4 should be considered for every patient with gestational age be...
Since obesity has reached epidemic proportions even at very young ages, subsequently we notice an... more Since obesity has reached epidemic proportions even at very young ages, subsequently we notice an increased number of pregnancies in these categories of patients with higher rates of obstetrics complications such as: gestational diabetes, hypertensive disorders, and augmented rates of preterm birth and caesarean section. Maternal obesity has been proven to be associated with an increased risk of congenital malformations, including a significantly increased risk for neural tube defects, congenital heart defects, and orofacial clefts in the offspring, but despite their increased number, malformation detection rate is lower in obese patients. The screening procedures for detecting Down syndrome offered to pregnant women have changed over the last decades. Unfortunately, classical serum screening for Down syndrome testing performs worse in obese patients, the fetal fraction in maternal plasma cf-DNA being affected by maternal excessive weight. In this article, we aim to review the part...
Background and aims. The process of scarring is a common denominator of interest for the medical ... more Background and aims. The process of scarring is a common denominator of interest for the medical field. From general medicine to dentistry, pathological scar tissue represents a challenge in providing optimal care to a patient. The present study aims to investigate whether a systemically reduced antioxidant potential, revealed by null isoforms of glutathione S transferase, affects the process of scarring in a group of female patients. Methods. The study is based on a group of 54 patients with physiological scars after a 6-month observation period, as well as 18 patients with hypertrophic or atrophic scars. Peripheral venous blood was collected, from which DNA was extracted using a commercial kit. Genotyping followed a Multiplex PCR protocol for GSTT1/GSTM1. Results. In a dominant model, the combination of wild type (heterozygous or homozygous) GSTT1 and GSTM1 was negatively associated with pathological scarring, with the wild type (heterozygous or homozygous) GSTM1 genotype being po...
Pregnant women are known to have an increased morbidity and mortality for certain illnesses due t... more Pregnant women are known to have an increased morbidity and mortality for certain illnesses due to physiological and immunological changes in pregnancy. However, careful attention should be paid to the fetoplacental unit, with delivery generally indicated for obstetric purposes only. Acute respiratory distress syndrome is an uncommon condition in pregnant patients. An essential component in the management of this condition is a perfect coordination between the obstetrician, the pneumologist and critical care specialists. Pregnancy-associated venous thromboembolism consists of deep vein thrombosis and pulmonary embolism occurring during pregnancy or in the postpartum period. This condition is common and is a major source of morbidity in a population which is young and otherwise relatively healthy. Amniotic fluid embolism remains one of the most devastating conditions in obstetrics practice, with reported mortality of 20% to 60%. The treatment is mainly supportive and involves the del...
Uterine leiomyomas are common benign uterine tumors but by contrast, their acute complications ar... more Uterine leiomyomas are common benign uterine tumors but by contrast, their acute complications are very rare. We present an unusual case of 38-year-old woman that came to the emergency department with acute abdominal pain. The ultrasound revealed hemoperitoneum, a uterus with two intramural fibroids and a tender inhomogeneous pelvic mass that seems to connect with the uterus. Computer tomographic (CT) examination raised the suspicion of a degenerated fibroid and hemoperitoneum. Emergency laparotomy was performed: the hemoperitoneum was determined by a degenerated fundal subserosalfibroid. Myomectomy was subsequently carried out. Even though this condition is extremely rare, every clinician has to bear in mind that acute fibroid complications can be a potential cause of acute abdominal pain that requires immediate surgery. The imagistic tools, ultrasound and CT are extremely helpful for the diagnosis.Due to its relative rarity in the second part of the article we have performed a rev...
Background and aim High risk newborns are often much smaller than healthy infants when are discha... more Background and aim High risk newborns are often much smaller than healthy infants when are discharged from hospital. Different types of feeding: breastmilk, formula or mixed can influence growth rates and improve development. The aims of the study were to evaluate the growth rates; catch–up rate and some biological parameters of the nutritional status such as: hemoglobine, iron, calcium, phosphor, magnesium, the level of plasmatic protein, nitrogen balance at differents ages : 1-2-4-6 months in three different types of nutrition – breastmilk, special formula for premature, breastmilk with premature formula or started formula. Material and methods A retrospective study was performed in a tertiary neonatal care unit between 2011–2013 in the County Hospital of Cluj, Romania on 383 infants presented to periodical examination in the follow-up program: 465 records. We divided into 3 categories : group I-VG≤32 weeks, group II-VG between 32–36 weeks and group III-VG≥36 weeks of gestation. The evaluation consultations were performed at 1-2-3-4-5-6 months. Each evaluation consisted of determining: weight, CBC, calcium, iron, magnesium, protein, Blood Urea Nitrogen (BUN) levels. Informed consent was obtained Statistical analysis was made with Microsoft Excel 2016 and IBM SPSS v.23. Results Growth rate up to 6 months wasn ‘t significantly influenced by the type of feeding (p=0.319). Hemoglobine at 2 months highlighted statistically higher values in formula fed group: 11.77±2.07g compare with premature formula fed group:10.848±1,7556g(p=0.008). The values of iron at 2 months hasn’t presented any significant differences according to the types of feeding (p=0.475). There is a significant decrease of iron levels that occurs gradually with age in the breastfed ones, r=−0.89. Different calcium levels were registered according to types of feeding (p=0.003) until 6 months. Magnesemia were not influenced by feeding type at any groups. BUN in group I was significantly smaller in breastfed compared with premature formula fed infants(p=0.000) at 2 months. Up to 6 months the value is significantly lowered in cases of breastfed, p=0.001. The values of the protein in≤32 weeks is directly influenced by the type of feeding p=0.024. Protein levels is significantly influenced in group II(p=0.026). Phosphatemia is significantly influenced by the type of feeding in group II(p=0.043). ConclutionS Increase in bodyweight of newborns under 32 SS isn’t influenced significantly by the type of feeding up to 6 months. Calcium registered significantly different values under the different types of feeding in the prematures≤32 weeks of gestation in the first 6 months of life. Phosphoremia is significantly influenced by the type of feeding in the second group. Iron drops significantly with age in breastfedgroup. The level of protein in group I is directly influenced by the type of feeding. At 2 months of age BUN is significantly influenced by the type of feeding in the first group.
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
E-cadherin is a transmembrane glycoprotein with important roles in the maintenance of cervical sq... more E-cadherin is a transmembrane glycoprotein with important roles in the maintenance of cervical squamous epithelium integrity. The purpose of this study was to investigate the relationship between E-cadherin-160 C/A polymorphism and cervical intraepithelial neoplasia (CIN). A case-control study was performed enrolling 70 CIN cases and 107 age-matched healthy controls. Each patient was examined colposcopically, having a cervical specimen. All patients and controls have been genotyped for E-cadherin-160. Data were analysed using odds ratios (OR) and chi-square test at a significance level of p<0.005. The presence of E-cadherin-160 C/A was significantly associated with high-grade squamous intraepithelial lesion (HSIL) (OR=2.7916, 95% CI 1.1495,6.9345, x(2)=6.33, p=0.0118) and carcinoma in situ (CIS) (OR=2.5617, 95% CI 1.1676,5.6705, x(2)=6.63, p=0.0100). The detection of either CA or AA genotype was also significantly associated with HSIL and CIS. E-cadherin-160 genotype represents a...
Intrauterine growth restriction (IUGR) represents a serious condition that can lead to increased ... more Intrauterine growth restriction (IUGR) represents a serious condition that can lead to increased perinatal morbidity, mortality and postnatal impaired neurodevelopment. There are two distinct phenotypes of IUGR: early onset and late onset IUGR with different onset, patterns of evolution and fetal Doppler profile. In early onset preeclampsia the main Doppler modifications are at the level of umbilical artery, with progressive augmentation of the pulsatility index to absent or reverse end diastolic flow. The modifications of the cerebral, cardiac and ductus venosus circulation are generally present, but with different sequences. The late onset IUGR is determined by third trimester placental insufficiency that entails fetal hypoxia. The cerebro-placental ratio (CPR) and the pulsatility index of the middle cerebral artery (PI MCA) seems to be the main markers for both diagnosis and obstetrical management while umbilical Doppler PI is frequently normal. Also the sequence of Doppler alter...
Complete atrioventricular septal defect (CAVSD) is a fetal cardiac malformation (5% of all cardia... more Complete atrioventricular septal defect (CAVSD) is a fetal cardiac malformation (5% of all cardiac malformations) that can be detected prenatally with a reserved prognosis. The diagnosis can be suspected early at the end of the first trimester using the transabdominal or transvaginal ultrasound approach. Generally, the diagnostic can be established during the mid-trimester scan at 19-24 weeks of gestation. The percentage of antenatal diagnostic of CAVSD is between 57-92%. This review aims to analyze the anatomical principles and the ultrasound techniques that can improve the prenatal diagnosis of CAVSD. We have also analyzed the structural and genetic anomalies frequently associated with CAVSD.
Background. Although the effects of meteorological factors on the general population health are ... more Background. Although the effects of meteorological factors on the general population health are widely documented, little is known about their influence upon human pregnancy and birth. The present study aim to analyze the influence of the atmospheric conditions upon premature births.Method. One hundred and eight nine cases of premature births were included in the study with a gestational age between 24 to 37 weeks of amenorrhea. Cases with antepartum fetal death and those with uncertain gestational age have been excluded. Daily weather data were obtained using http://www.wunderground.com site.A Pearson's product-moment correlation was run to assess the relationship between weekly preterm birth incidence and the total number of premature births and the mean maximum and minimum temperature (Tmax, Tmin), maximum and minimum average humidity (Umax, Umin), maximum and minimum atmospheric pressure mean (P max, P min), average wind speed and average quantity precipitations, calculated...
Aim. The present study aims to analyze the potential role of VEGF +936 C/T polymorphism in cervic... more Aim. The present study aims to analyze the potential role of VEGF +936 C/T polymorphism in cervical intraepithelial neoplasia.Material and Method. One hundred and eighty-six patients were included in the study: 75 cases (patients diagnosed with CIN) and 111 controls (negative for both HPV testing and cytology). For each patient a single visit was scheduled when colposcopy was performed. From cervical specimen, cytology and HPV testing were performed and from peripheral blood VEGF +936 genotyping was determined. For statistical analysis purposes OR and chi-square were used at a level of significance of <0.05.Results. No link has been found in the detection of CT genotype in cases versus controls, OR = 0.8295, [0.42, 1.62]. An inverse correlation has been found between T allele and HSIL, OR = 0.2121, [0.0473, 0.9517],p=0.0866.Conclusion. No link has been found between VEGF +936 C/T and cervical intraepithelial neoplasia.
Recently, a series of thiazolo arene ruthenium complexes were found to be highly cytotoxic in vit... more Recently, a series of thiazolo arene ruthenium complexes were found to be highly cytotoxic in vitro, on both cisplatin-sensitive and cisplatin-resistant ovarian cancer cells. The most active compound of the series, [(η(6)-p-cymene)Ru(L)Cl]Cl (L = 1-(2-(2-(3-chlorobenzylidene)hydrazinyl)-4-methylthiazol-5-yl)ethanone), was selected for an in vivo study in order to assess its safety profile. The ruthenium complex was administered to female Crl:WI rats orally, by gastric intubation and intraperitoneal injection. The hematological parameters and the histopathological changes in liver, kidneys, spleen and brain were investigated after a 14-days treatment. The substance was very well tolerated orally, with a LD50 value of over 2000 mg/kg body weight. Symptoms were observed only in the first day after intraperitoneal administration of the highest dose, with a LD50 value between 300 and 2000 mg/kg bw. The hematological profile was not modified at any of the tested doses, after both oral and intraperitoneal acute administration. Structural modifications (moderate lymphocytolysis) were identified only in the spleen at the highest tested dose. In conclusion, the thiazolo arene ruthenium complex was very well tolerated orally and had a low acute toxicity after intraperitoneal administration in Crl:WI rats The results justify further investigation to determine the in vivo therapeutic potential of this promising ruthenium complex.
Aim: Delivering after the age of 40 years can be challenging. Worldwide, compared to previous dec... more Aim: Delivering after the age of 40 years can be challenging. Worldwide, compared to previous decade, the number of deliveries in this particular category of age is increasing constantly. The goal of the present study was to analyze the outcome of vaginal delivery in this category of patients. Materials and methods: A retrospective study was performed in The First Clinic of Obstetrics and Gynecology, Cluj-Napoca, Romania between 1st of January 2012 and 31st of December 2012. All deliveries that took place in the above mentioned hospital in the mentioned period were included in the study. Results: A significant increased number of Cesarean sections were observed in the group of older patients. The duration of the active phase was shorter in ≥40 years old primiparas than in <40 years old primiparas and similar to younger patient group for parity ≥2. The Apgar score and the fetal weight were not influenced by the maternal age. Regardless of parity, the frequency of the episiotomy pr...
Clinical and experimental obstetrics & gynecology, 1995
Ectopic pregnancy represents even nowadays a problem with a major impact upon women reproductive ... more Ectopic pregnancy represents even nowadays a problem with a major impact upon women reproductive health, with an incidence that is still growing. Modern diagnosis methods have allowed the disappearance of the mortality, but there are persisting significant tubal dysfunctions. The present clinical study has analyzed the evolutions of the diagnosis and treatment methods upon 238 cases of extrauterine pregnancy hospitalized in the Ist Clinic of Obstetrics and Gynecology Cluj-Napoca between years 2000 and 2006. The use of the new biochemical markers and the transvaginal ultrasound examination have allowed the diagnosis of extrauterine pregnancy in an early stage, with an increased percent of uncomplicated cases raising from 55.8% to 74%. Also the percent of laparoscopic approach has grown from 23.5 to 58.6%. The radical procedure, salpingectomy was predominantly used. The laparoscopic approach has been as successful as the laparotomy and no complications have been reported. The mean hospitalization period after laparoscopy has been significantly shorter than after laparotomy (p&amp;amp;amp;amp;amp;amp;lt;0.05). These results confirm the medical and economical advantages of the laparoscopic approach and recommend laparoscopy as the election method in the management of ectopic pregnancy.
Biochemical studies have suggested that elevated serum levels of homocysteine may be associated w... more Biochemical studies have suggested that elevated serum levels of homocysteine may be associated with primary openangle glaucoma (POAG) 1,2 and with pseudoexfoliation glaucoma (PEXG). 3 More recently, elevated levels of homocysteine have also been detected in the aqueous humor of patients with pseudoexfoliation glaucoma. 4 The biological role of hyperhomocysteinemia in glaucoma is not known. However, hyperhomocysteinemia has been linked to vascular disease 5,6 and homocysteine has been shown to induce apoptosis of retinal ganglion cells in a mouse model. 7 Consequently, it has been hypothesized
HELLP syndrome, also known as the syndrome of hemolysis, elevated liver enzymes, and low platelet... more HELLP syndrome, also known as the syndrome of hemolysis, elevated liver enzymes, and low platelets, represents a severe pregnancy complication typically associated with hypertension. It is associated with increased risks of adverse complications for both mother and fetus. HELLP occurs in 0.2–0.8% of pregnancies, and, in 70–80% of cases, it coexists with preeclampsia (PE). Both of these conditions show a familial tendency. A woman with a history of HELLP pregnancy is at high risk for developing this entity in subsequent pregnancies. We cannot nominate a single worldwide genetic cause for the increased risk of HELLP. Combinations of multiple gene variants, each with a moderate risk, with concurrent maternal and environmental factors are thought to be the etiological mechanisms. This review highlights the significant role of understanding the underlying pathophysiological mechanism of HELLP syndrome. A better knowledge of the disease’s course supports early detection, an accurate diagn...
Classically fetal heart evaluation is mandatory in the second trimester of pregnancy. Recent data... more Classically fetal heart evaluation is mandatory in the second trimester of pregnancy. Recent data suggest that the diagnosis of congenital heart disease is feasible in the first trimester (FT) of pregnancy, especially for trained examiners. In this pictorial essay we aim to illustrate in detail the particularity of the FT heart evaluation: the specific ultrasound techniques including practical tips for the basic and extended first trimester fetal heart evaluation protocol. The diagnosis is possible by the use of a variety of ultrasound techniques (B mode, CFM, Bidirectional Doppler, STIC, TUI) using the transabdominal/transvaginal probes. An abnormal FT heart scan requires second trimester reassessment. Unfortunately, not all cardiac disease can be potentially diagnosed in the first trimester. Based on their own experience the authors recommend that heart examination in the FT should be attempted in all fetuses, even in low risk pregnancies, using at least the basic Doppler examinat...
Twin-to-twin transfusion syndrome (TTTS) is the consequence of vascular anastomoses of the shared... more Twin-to-twin transfusion syndrome (TTTS) is the consequence of vascular anastomoses of the shared placenta of monochorionic twin pregnancies. Both circulating inter-twin blood flow and vasoactive mediators imbalance cause hypovolemia in the donor and hypervolemia in the recipient fetus. If left untreated, TTTS has a high perinatal mortality rate and adverse long-term outcomes mainly cardiovascular and neurological. The recipient has cardiovascular changes including atrioventricular valve regurgitation, diastolic dysfunction and pulmonary stenosis/atresia. The maladaptive response to vascular changes determines a constant decreased blood flow in the donor that permanently modifies the arterial structure leading to postnatal alterations in the vascular system. Fetoscopic LASER surgery of placental vascular anastomoses may disrupt the underlying pathophysiology and improves cardiovascular function with normalization of systolic and diastolic function within weeks after treatment. The i...
The prophylaxis of neurological impairment of premature born infants remains a serious challenge ... more The prophylaxis of neurological impairment of premature born infants remains a serious challenge for the neonatologists. The administration of drugs with neuroprotective effect should be considered in order to reduce the risk of cerebral palsy after severe preterm birth. Magnesium sulfate (MgSO4), the objective of this analysis, has been proposed as an important part of the management of unavoidable preterm birth for the prevention of cerebral palsy and neonatal death. The beneficial effects of this inexpensive and simple treatment are observed regardless of the reason for preterm birth, with similar results on different premature gestational ages. MgSO4 has been shown to have a neuroprotective effect by reducing brain metabolism and has also a beneficial hemodynamic effect by stabilizing blood pressure, reducing constriction in the cerebral arteries, and restoring infusion in preterm infants. The administration of MgSO4 should be considered for every patient with gestational age be...
Since obesity has reached epidemic proportions even at very young ages, subsequently we notice an... more Since obesity has reached epidemic proportions even at very young ages, subsequently we notice an increased number of pregnancies in these categories of patients with higher rates of obstetrics complications such as: gestational diabetes, hypertensive disorders, and augmented rates of preterm birth and caesarean section. Maternal obesity has been proven to be associated with an increased risk of congenital malformations, including a significantly increased risk for neural tube defects, congenital heart defects, and orofacial clefts in the offspring, but despite their increased number, malformation detection rate is lower in obese patients. The screening procedures for detecting Down syndrome offered to pregnant women have changed over the last decades. Unfortunately, classical serum screening for Down syndrome testing performs worse in obese patients, the fetal fraction in maternal plasma cf-DNA being affected by maternal excessive weight. In this article, we aim to review the part...
Background and aims. The process of scarring is a common denominator of interest for the medical ... more Background and aims. The process of scarring is a common denominator of interest for the medical field. From general medicine to dentistry, pathological scar tissue represents a challenge in providing optimal care to a patient. The present study aims to investigate whether a systemically reduced antioxidant potential, revealed by null isoforms of glutathione S transferase, affects the process of scarring in a group of female patients. Methods. The study is based on a group of 54 patients with physiological scars after a 6-month observation period, as well as 18 patients with hypertrophic or atrophic scars. Peripheral venous blood was collected, from which DNA was extracted using a commercial kit. Genotyping followed a Multiplex PCR protocol for GSTT1/GSTM1. Results. In a dominant model, the combination of wild type (heterozygous or homozygous) GSTT1 and GSTM1 was negatively associated with pathological scarring, with the wild type (heterozygous or homozygous) GSTM1 genotype being po...
Pregnant women are known to have an increased morbidity and mortality for certain illnesses due t... more Pregnant women are known to have an increased morbidity and mortality for certain illnesses due to physiological and immunological changes in pregnancy. However, careful attention should be paid to the fetoplacental unit, with delivery generally indicated for obstetric purposes only. Acute respiratory distress syndrome is an uncommon condition in pregnant patients. An essential component in the management of this condition is a perfect coordination between the obstetrician, the pneumologist and critical care specialists. Pregnancy-associated venous thromboembolism consists of deep vein thrombosis and pulmonary embolism occurring during pregnancy or in the postpartum period. This condition is common and is a major source of morbidity in a population which is young and otherwise relatively healthy. Amniotic fluid embolism remains one of the most devastating conditions in obstetrics practice, with reported mortality of 20% to 60%. The treatment is mainly supportive and involves the del...
Uterine leiomyomas are common benign uterine tumors but by contrast, their acute complications ar... more Uterine leiomyomas are common benign uterine tumors but by contrast, their acute complications are very rare. We present an unusual case of 38-year-old woman that came to the emergency department with acute abdominal pain. The ultrasound revealed hemoperitoneum, a uterus with two intramural fibroids and a tender inhomogeneous pelvic mass that seems to connect with the uterus. Computer tomographic (CT) examination raised the suspicion of a degenerated fibroid and hemoperitoneum. Emergency laparotomy was performed: the hemoperitoneum was determined by a degenerated fundal subserosalfibroid. Myomectomy was subsequently carried out. Even though this condition is extremely rare, every clinician has to bear in mind that acute fibroid complications can be a potential cause of acute abdominal pain that requires immediate surgery. The imagistic tools, ultrasound and CT are extremely helpful for the diagnosis.Due to its relative rarity in the second part of the article we have performed a rev...
Background and aim High risk newborns are often much smaller than healthy infants when are discha... more Background and aim High risk newborns are often much smaller than healthy infants when are discharged from hospital. Different types of feeding: breastmilk, formula or mixed can influence growth rates and improve development. The aims of the study were to evaluate the growth rates; catch–up rate and some biological parameters of the nutritional status such as: hemoglobine, iron, calcium, phosphor, magnesium, the level of plasmatic protein, nitrogen balance at differents ages : 1-2-4-6 months in three different types of nutrition – breastmilk, special formula for premature, breastmilk with premature formula or started formula. Material and methods A retrospective study was performed in a tertiary neonatal care unit between 2011–2013 in the County Hospital of Cluj, Romania on 383 infants presented to periodical examination in the follow-up program: 465 records. We divided into 3 categories : group I-VG≤32 weeks, group II-VG between 32–36 weeks and group III-VG≥36 weeks of gestation. The evaluation consultations were performed at 1-2-3-4-5-6 months. Each evaluation consisted of determining: weight, CBC, calcium, iron, magnesium, protein, Blood Urea Nitrogen (BUN) levels. Informed consent was obtained Statistical analysis was made with Microsoft Excel 2016 and IBM SPSS v.23. Results Growth rate up to 6 months wasn ‘t significantly influenced by the type of feeding (p=0.319). Hemoglobine at 2 months highlighted statistically higher values in formula fed group: 11.77±2.07g compare with premature formula fed group:10.848±1,7556g(p=0.008). The values of iron at 2 months hasn’t presented any significant differences according to the types of feeding (p=0.475). There is a significant decrease of iron levels that occurs gradually with age in the breastfed ones, r=−0.89. Different calcium levels were registered according to types of feeding (p=0.003) until 6 months. Magnesemia were not influenced by feeding type at any groups. BUN in group I was significantly smaller in breastfed compared with premature formula fed infants(p=0.000) at 2 months. Up to 6 months the value is significantly lowered in cases of breastfed, p=0.001. The values of the protein in≤32 weeks is directly influenced by the type of feeding p=0.024. Protein levels is significantly influenced in group II(p=0.026). Phosphatemia is significantly influenced by the type of feeding in group II(p=0.043). ConclutionS Increase in bodyweight of newborns under 32 SS isn’t influenced significantly by the type of feeding up to 6 months. Calcium registered significantly different values under the different types of feeding in the prematures≤32 weeks of gestation in the first 6 months of life. Phosphoremia is significantly influenced by the type of feeding in the second group. Iron drops significantly with age in breastfedgroup. The level of protein in group I is directly influenced by the type of feeding. At 2 months of age BUN is significantly influenced by the type of feeding in the first group.
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
E-cadherin is a transmembrane glycoprotein with important roles in the maintenance of cervical sq... more E-cadherin is a transmembrane glycoprotein with important roles in the maintenance of cervical squamous epithelium integrity. The purpose of this study was to investigate the relationship between E-cadherin-160 C/A polymorphism and cervical intraepithelial neoplasia (CIN). A case-control study was performed enrolling 70 CIN cases and 107 age-matched healthy controls. Each patient was examined colposcopically, having a cervical specimen. All patients and controls have been genotyped for E-cadherin-160. Data were analysed using odds ratios (OR) and chi-square test at a significance level of p<0.005. The presence of E-cadherin-160 C/A was significantly associated with high-grade squamous intraepithelial lesion (HSIL) (OR=2.7916, 95% CI 1.1495,6.9345, x(2)=6.33, p=0.0118) and carcinoma in situ (CIS) (OR=2.5617, 95% CI 1.1676,5.6705, x(2)=6.63, p=0.0100). The detection of either CA or AA genotype was also significantly associated with HSIL and CIS. E-cadherin-160 genotype represents a...
Intrauterine growth restriction (IUGR) represents a serious condition that can lead to increased ... more Intrauterine growth restriction (IUGR) represents a serious condition that can lead to increased perinatal morbidity, mortality and postnatal impaired neurodevelopment. There are two distinct phenotypes of IUGR: early onset and late onset IUGR with different onset, patterns of evolution and fetal Doppler profile. In early onset preeclampsia the main Doppler modifications are at the level of umbilical artery, with progressive augmentation of the pulsatility index to absent or reverse end diastolic flow. The modifications of the cerebral, cardiac and ductus venosus circulation are generally present, but with different sequences. The late onset IUGR is determined by third trimester placental insufficiency that entails fetal hypoxia. The cerebro-placental ratio (CPR) and the pulsatility index of the middle cerebral artery (PI MCA) seems to be the main markers for both diagnosis and obstetrical management while umbilical Doppler PI is frequently normal. Also the sequence of Doppler alter...
Complete atrioventricular septal defect (CAVSD) is a fetal cardiac malformation (5% of all cardia... more Complete atrioventricular septal defect (CAVSD) is a fetal cardiac malformation (5% of all cardiac malformations) that can be detected prenatally with a reserved prognosis. The diagnosis can be suspected early at the end of the first trimester using the transabdominal or transvaginal ultrasound approach. Generally, the diagnostic can be established during the mid-trimester scan at 19-24 weeks of gestation. The percentage of antenatal diagnostic of CAVSD is between 57-92%. This review aims to analyze the anatomical principles and the ultrasound techniques that can improve the prenatal diagnosis of CAVSD. We have also analyzed the structural and genetic anomalies frequently associated with CAVSD.
Background. Although the effects of meteorological factors on the general population health are ... more Background. Although the effects of meteorological factors on the general population health are widely documented, little is known about their influence upon human pregnancy and birth. The present study aim to analyze the influence of the atmospheric conditions upon premature births.Method. One hundred and eight nine cases of premature births were included in the study with a gestational age between 24 to 37 weeks of amenorrhea. Cases with antepartum fetal death and those with uncertain gestational age have been excluded. Daily weather data were obtained using http://www.wunderground.com site.A Pearson's product-moment correlation was run to assess the relationship between weekly preterm birth incidence and the total number of premature births and the mean maximum and minimum temperature (Tmax, Tmin), maximum and minimum average humidity (Umax, Umin), maximum and minimum atmospheric pressure mean (P max, P min), average wind speed and average quantity precipitations, calculated...
Aim. The present study aims to analyze the potential role of VEGF +936 C/T polymorphism in cervic... more Aim. The present study aims to analyze the potential role of VEGF +936 C/T polymorphism in cervical intraepithelial neoplasia.Material and Method. One hundred and eighty-six patients were included in the study: 75 cases (patients diagnosed with CIN) and 111 controls (negative for both HPV testing and cytology). For each patient a single visit was scheduled when colposcopy was performed. From cervical specimen, cytology and HPV testing were performed and from peripheral blood VEGF +936 genotyping was determined. For statistical analysis purposes OR and chi-square were used at a level of significance of <0.05.Results. No link has been found in the detection of CT genotype in cases versus controls, OR = 0.8295, [0.42, 1.62]. An inverse correlation has been found between T allele and HSIL, OR = 0.2121, [0.0473, 0.9517],p=0.0866.Conclusion. No link has been found between VEGF +936 C/T and cervical intraepithelial neoplasia.
Recently, a series of thiazolo arene ruthenium complexes were found to be highly cytotoxic in vit... more Recently, a series of thiazolo arene ruthenium complexes were found to be highly cytotoxic in vitro, on both cisplatin-sensitive and cisplatin-resistant ovarian cancer cells. The most active compound of the series, [(η(6)-p-cymene)Ru(L)Cl]Cl (L = 1-(2-(2-(3-chlorobenzylidene)hydrazinyl)-4-methylthiazol-5-yl)ethanone), was selected for an in vivo study in order to assess its safety profile. The ruthenium complex was administered to female Crl:WI rats orally, by gastric intubation and intraperitoneal injection. The hematological parameters and the histopathological changes in liver, kidneys, spleen and brain were investigated after a 14-days treatment. The substance was very well tolerated orally, with a LD50 value of over 2000 mg/kg body weight. Symptoms were observed only in the first day after intraperitoneal administration of the highest dose, with a LD50 value between 300 and 2000 mg/kg bw. The hematological profile was not modified at any of the tested doses, after both oral and intraperitoneal acute administration. Structural modifications (moderate lymphocytolysis) were identified only in the spleen at the highest tested dose. In conclusion, the thiazolo arene ruthenium complex was very well tolerated orally and had a low acute toxicity after intraperitoneal administration in Crl:WI rats The results justify further investigation to determine the in vivo therapeutic potential of this promising ruthenium complex.
Aim: Delivering after the age of 40 years can be challenging. Worldwide, compared to previous dec... more Aim: Delivering after the age of 40 years can be challenging. Worldwide, compared to previous decade, the number of deliveries in this particular category of age is increasing constantly. The goal of the present study was to analyze the outcome of vaginal delivery in this category of patients. Materials and methods: A retrospective study was performed in The First Clinic of Obstetrics and Gynecology, Cluj-Napoca, Romania between 1st of January 2012 and 31st of December 2012. All deliveries that took place in the above mentioned hospital in the mentioned period were included in the study. Results: A significant increased number of Cesarean sections were observed in the group of older patients. The duration of the active phase was shorter in ≥40 years old primiparas than in <40 years old primiparas and similar to younger patient group for parity ≥2. The Apgar score and the fetal weight were not influenced by the maternal age. Regardless of parity, the frequency of the episiotomy pr...
Clinical and experimental obstetrics & gynecology, 1995
Ectopic pregnancy represents even nowadays a problem with a major impact upon women reproductive ... more Ectopic pregnancy represents even nowadays a problem with a major impact upon women reproductive health, with an incidence that is still growing. Modern diagnosis methods have allowed the disappearance of the mortality, but there are persisting significant tubal dysfunctions. The present clinical study has analyzed the evolutions of the diagnosis and treatment methods upon 238 cases of extrauterine pregnancy hospitalized in the Ist Clinic of Obstetrics and Gynecology Cluj-Napoca between years 2000 and 2006. The use of the new biochemical markers and the transvaginal ultrasound examination have allowed the diagnosis of extrauterine pregnancy in an early stage, with an increased percent of uncomplicated cases raising from 55.8% to 74%. Also the percent of laparoscopic approach has grown from 23.5 to 58.6%. The radical procedure, salpingectomy was predominantly used. The laparoscopic approach has been as successful as the laparotomy and no complications have been reported. The mean hospitalization period after laparoscopy has been significantly shorter than after laparotomy (p&amp;amp;amp;amp;amp;amp;lt;0.05). These results confirm the medical and economical advantages of the laparoscopic approach and recommend laparoscopy as the election method in the management of ectopic pregnancy.
Biochemical studies have suggested that elevated serum levels of homocysteine may be associated w... more Biochemical studies have suggested that elevated serum levels of homocysteine may be associated with primary openangle glaucoma (POAG) 1,2 and with pseudoexfoliation glaucoma (PEXG). 3 More recently, elevated levels of homocysteine have also been detected in the aqueous humor of patients with pseudoexfoliation glaucoma. 4 The biological role of hyperhomocysteinemia in glaucoma is not known. However, hyperhomocysteinemia has been linked to vascular disease 5,6 and homocysteine has been shown to induce apoptosis of retinal ganglion cells in a mouse model. 7 Consequently, it has been hypothesized
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Papers by Ioana Rotar