Papers by Florina Doandes
Children
Recombinant human erythropoietin (rhEPO) treatment is an alternative to red blood cell (RBC) tran... more Recombinant human erythropoietin (rhEPO) treatment is an alternative to red blood cell (RBC) transfusions in neonates presenting anemia of prematurity (AOP). This study assesses the impact of early rhEPO administration on AOP (any stage) incidence, as well as the incidence of individual AOP stages and RBC transfusions. Out of 108 preterm neonates, 49 were administered rhEPO and compared to the remaining group using univariate and multivariate analyses. Univariately, gestational age (GA), birth weight (BW), hemoglobin (Hb), hematocrit (HCT), RBC levels, and iron administration were significantly associated with AOP (p < 0.05 each); however, only the latter remained significant following multivariate analysis (AOR: 2.75, 95% CI, 1.06–7.11). Multinomial analysis revealed rhEPO treatment was associated with a near three-fold reduction in moderate AOP incidence (OR: 0.36, 95% CI, 0.15–0.89). Furthermore, ANCOVA revealed positive correlations between rhEPO administration and 21-day Hb ...
Revista română de pediatrie, Sep 30, 2016
Aim. The main purpose is to evaluate the predisposing factors, the evolution and the associated p... more Aim. The main purpose is to evaluate the predisposing factors, the evolution and the associated pathology of the pneumothorax in the neonatal period. Materials and methods. Retrospective study over two years between 2014 and 2015 on 11 patients hospitalized in the Neonatology departement of "Louis Turcanu" Children's Emergency Hospital, Timisoara, diagnosed with pneumothorax. Results. From 1689 newborn infants admitted, 11 patients developed pneumothorax, the incidence was 0.65%. 8 patients (73%) were males and 3 (27%) were females. 4 out of those 11 patients were term newborn infants (gestational age >37 weeks) and 7 patients were premature newborns (<37 weeks of gestational age). Based on the birth weight 4 patients had over 2,500 grams and 7 under 2,500 grams. The main cause of the pneumothorax in the study group was the respiratory distress syndrome (45,4%). Conclusions. Pneumothorax represents an important condition in the neonatal pathology, it is essential to recognize and initiate the treatment from early stages to reduce the complications.
Revista română de pediatrie, Sep 30, 2020
Introducere. Malformaţiile cardiace congenitale reprezintă un defect în structura inimii sau a va... more Introducere. Malformaţiile cardiace congenitale reprezintă un defect în structura inimii sau a vaselor mari care este prezent la naştere. Semnele şi simptomele depind de tipul specific de defect. Cauza unui defect cardiac congenital este adesea necunoscută, dar rămân cele mai frecvente malformaţii congenitale la nou-născuţi şi sugari, cu un rol major în morbiditatea şi mortalitatea neonatală precoce şi târzie. Material şi metode. Studiul a fost realizat în cadrul Departamentului de Neonatologie Prematuri, în colaborare cu
Revista română de pediatrie, Sep 30, 2016
Obiectiv. Scopul principal al lucrării este acela de a evalua factorii predispozanţi, evoluţia şi... more Obiectiv. Scopul principal al lucrării este acela de a evalua factorii predispozanţi, evoluţia şi patologia asociată pneumotoraxului în perioada neonatală. Material şi metodă. S-a efectuat un studiu retrospectiv, pe o perioadă de doi ani, pe 11 pacienţi internaţi în Spitalul Clinic de Urgenţă pentru Copii "Louis Ţurcanu", Timişoara, secţia Neonatologie-Prematuri, diagnosticaţi cu pneumotorax în peiroada 2014-2015. Rezultate. Din 1.689 de nou-născuţi internaţi, 11 pacienţi au dezvoltat pneumotorax, incidenţa fiind de 0,65%. 8 pacienţi (73%) au fost de sex masculin şi 3 pacienţi (27%) de sex feminin. Din cei 11 pacienţi, 4 au fost nounăscuţi la termen cu VG (vârsta de gestaţie) peste 37 de săptămâni şi 7 au fost nou-născuţi prematuri cu VG sub 37 de săptămâni. În funcţie de greutatea la naştere, 4 au avut greutatea peste 2.500 g şi 7 sub 2.500 g. Cauza cea mai frecventă a pneumotoraxului în grupul studiat a fost reprezentată de sindromul de detresă respiratorie, cu un procent de 45,4%. Concluzii. Pneumotoraxul reprezintă o afecţiune importantă în patologia neonatală. Este esenţială recunoaşterea şi iniţierea tratamentului încă din fazele iniţiale, pentru reducerea apariţiei complicaţiilor secundare.
Revista română de pediatrie, Sep 30, 2020
Introduction. A congenital heart disease is a defect in the structure of the heart or great vesse... more Introduction. A congenital heart disease is a defect in the structure of the heart or great vessels that is present at birth. Signs and symptoms depend on the specific type of defect. The cause of a congenital heart defect is often unknown but remain the most common congenital malformations in newborns and infants with a major role in early and late neonatal morbidity and mortality. Material and methods. The study was carried out in the Department of Neonatology and Premature in the collaboration with the Department of Pediatric Cardiology, from the Clinical Emergency Hospital for Children Louis Țurcanu Timișoara, in a period of 3 years (2015-2018). There were 70 patients included in the study, who presented congenital heart malformation diagnosed clinically, by ultrasound and Angio-CT. Results. The incidence of cardiac malformations in our unit was 2.11%. The most common clinical signs encountered in patients with congenital heart disease were dyspnea associated with cyanosis, systolic murmur and oxygen saturation oscillations (SaO2). Associated with pregnancy, the presence of teratogenic factors with possible implication in congenital heart malformations was also detected. There were 12 cases involved genetic syndromes, Down's syndrome having the highest prevalence. Due to the complexity of the cardiac malformation in the studied group, 11 patients (15.71%) died. Conclusions. Congenital cardiovascular malformations are a problem of public health. In the assessment of a newborn with cardiac pathology, there should be involved obstetricians, neonatologists, anesthetists, pediatric cardiologists, pediatric cardiovascular surgeons, geneticists, with the common goal of preventing, diagnosing, monitoring and treating congenital heart abnormalities.
Jurnalul Pediatrului
Introduction: Early maternal/infant separation can result in a series of traumatic emotional reac... more Introduction: Early maternal/infant separation can result in a series of traumatic emotional reactions from both the newborn and the mother. Material and methods: The authors propose conducting a study on the influence of mother/newborn separation in a neonatology and premature department. To undergo the study, a questionnaire was prepared and distributed both to mothers admitted separately from newborns and to mothers admitted in the same ward as newborns. The study included a group of 60 mothers, the group being divided into two groups: separated mothers/newborns and unseparated mothers/newborns. Results: The study reported that the separated mothers/newborns group had an average hospital stay of more than 10 days compared to the group of unseparated mothers/newborns where the average duration of hospitalization was 7 days. 83.3% of unseparated newborns had a favorable clinical course and only 6.67% had complications. In the group of separated newborns, 40% had a favorable evoluti...
Medical Science Monitor
None declared Conflict of interest: None declared Background: Congenital gastrointestinal (GI) ma... more None declared Conflict of interest: None declared Background: Congenital gastrointestinal (GI) malformations are developmental disorders that can result in secondary intestinal failure. Nutrient intakes must be adapted according to the newborn's nutritional requirements based on frequent anthropometric and biochemical assessments. Deficiencies or excess of a macronutrient can hinder the growth of the newborn. Material/Methods: To assess the clinical condition of newborns with GI malformations, together with the postoperative nutritional status of newborns who underwent surgery due to congenital GI malformations, we performed a case-control study. The study group comprised newborns with digestive malformations (n=51) and the control group consisted of newborns without digestive pathologies (n=102), matched by sex, gestational age, and weight at admission. Results: Bivariate comparisons and multiple logistic regression analyses were performed. A P value <0.05 was considered to be statistically significant; these were observed in abdominal distension, gastric residue, and vomiting. The duration of hospitalization was shorter in the case group, as on average, they were transferred to the Pediatric Surgery Department on the 6 th day, where they further remained admitted to treat the underlying cause. Differences between groups in administration of breast milk versus formula were not statistically significant. Conclusions: We concluded that the clinical examination had a major role in early detection of digestive malformations and in the effective management of specific necessary nutrition. Proper evaluation of when to start enteral feeding can help post-surgical cases to recover faster, minimizing complications. Further studies are required to assess how financial factors affect implementation of the standardized guidelines of nutrition in children and to find possible solutions to financial constraints.
Introduction Obstetric traumas are neonatal disorders of multiple causes, often unpredictable, wi... more Introduction Obstetric traumas are neonatal disorders of multiple causes, often unpredictable, with implications for the clinical development of the newborn. Incidence is estimated at 2-7 ‰ live births, decreasing due to improved health care. Mortality 2-3% of all neonatal deaths, 5-8 / 100,000 through physical trauma, 25 / 100,000 through hypoxia. Objectives The authors propose a review of severe forms of brain injury resulting from birth traumas, correlated with ultrasound monitoring and clinical evolution. Results Depending on the degree of somatic and neurological maturity, respectively gestation age and birth weight, the conditions observed or caused by perinatal insult may be different. Also, the type of mechanical insult (physical or hypoxic) can cause different injuries depending on the intensity or degree of neurological immaturity. Both shortterm prognosis and long-term neurological prognosis depend on the early diagnosis of these lesions (subarachnoid hemorrhage, subdural hemorrhage, massive cerebral infarction, perinatal hypoxic-ischemic encephalopathy, grade IV intraventricular hemorrhage), the early establishment of the treatment and, if appropriate, the integration of the baby into the follow-up program and neurological dispensary. Conclusions Cerebral trauma due to obstetric causes is still an important cause of infant morbidity and mortality. The most serious brain injuries secondary to severe perinatal insult are: subdural hemorrhage, massive cerebral infarction and severe perinatal hypoxic-ischemic encephalopathy, grade IV intraventricular hemorrhage.
Invasive aspergillosis represents a severe condition, with extremely rare incidence in the neonat... more Invasive aspergillosis represents a severe condition, with extremely rare incidence in the neonatal period, but it is a major cause of morbidity and mortality, especially among patients with compromised immunity: extreme prematurity newborn from a mother with HIV, immune deficiency syndromes. We present the case of a ELBW premature newborn, with gestational age of 26 weeks and weight at birth of 850 grams, from a pregnancy not taken into evidence, with severe intrapartum asphyxia, APGAR index 1 on 1 minute, with severe neonatal respiratory distress and neonatal sepsis, who was transferred into the Prematures Department of the "Louis Turcanu" Emergency Clinical Children's Hospital in Timisoara in the first day of life, from a 1 st degree maternity in Romania. The newborn required mechanical respiratory support throughout the entire period of hospitalization and the evolution was fulminant, towards death in the 15 th day of life. Necropsy was performed, and the histopath...
Romanian Journal of Pediatrics, 2016
Obiectiv. Scopul principal al lucrării este acela de a evalua factorii predispozanţi, evoluţia şi... more Obiectiv. Scopul principal al lucrării este acela de a evalua factorii predispozanţi, evoluţia şi patologia asociată pneumotoraxului în perioada neonatală. Material şi metodă. S-a efectuat un studiu retrospectiv, pe o perioadă de doi ani, pe 11 pacienţi internaţi în Spitalul Clinic de Urgenţă pentru Copii „Louis Ţurcanu“, Timişoara, secţia Neonatologie – Prematuri, diagnosticaţi cu pneumotorax în peiroada 2014-2015. Rezultate. Din 1.689 de nou-născuţi internaţi, 11 pacienţi au dezvoltat pneumotorax, incidenţa fiind de 0,65%. 8 pacienţi (73%) au fost de sex masculin şi 3 pacienţi (27%) de sex feminin. Din cei 11 pacienţi, 4 au fost nou-născuţi la termen cu VG (vârsta de gestaţie) peste 37 de săptămâni şi 7 au fost nou-născuţi prematuri cu VG sub 37 de săptămâni. În funcţie de greutatea la naştere, 4 au avut greutatea peste 2.500 g şi 7 sub 2.500 g. Cauza cea mai frecventă a pneumotoraxului în grupul studiat a fost reprezentată de sindromul de detresă respiratorie, cu un procent de 45...
The malformations of the brain represent a serious pathology in the neonatal period, with major i... more The malformations of the brain represent a serious pathology in the neonatal period, with major implications for subsequent psychomotor development of children. Thanks to the advanced technology, the diagnosis is established early, even in the prenatal period (fetal ultrasound, or even more recently fetal MRI or early neonatal MRI)-a very important thing for the introduction of the specific therapy and also the anticipation of the shortterm and long-term prognosis. The authors are proposing a review of the most frequent brain malformations: encephalocele, myelomeningocel, Arnold-Chiari malformation, holoprozencephaly, the absence of cavum septum pellucidum, septo-optic dysplasia, proliferation and neuronal migration disorders, corpus callosum agenesis, Aicardi syndrome, porencephaly, median line defects, some vascular malformations.Also, the authors want to establish a corelation between the clinical, anamnestic and imaging data for the anticipation of short-term and long-term progn...
Experimental and Therapeutic Medicine, 2021
Newborns admitted to the Neonatal Intensive Care Unit (NICU) require increased attention regardin... more Newborns admitted to the Neonatal Intensive Care Unit (NICU) require increased attention regarding neurological assessment and monitoring, due to immaturity or certain conditions that occur during the perinatal and neonatal period. Hypoxic-ischemic encephalopathy (HIE) following perinatal asphyxia is one of the most studied clinical conditions due to the risk of medium-and long-term neurobehavioral outcome. We studied 43 newborns with HIE, for all 3 degrees of impairment, performed amplitude-integrated electroencephalography (aEEG) in the first hours of life and collected common laboratory tests, following serum glycemia at admission and creatinine, creatine kinase (CK) and lactate dehydrogenase (LDH) at admission and in the 3rd day of life. Newborns with mild HIE presented normal aEEG pattern and slightly elevated CK. A total of 80.9% of the newborns with moderate HIE had seizure patterns in aEEG, while among those with severe HIE, 71.4% had seizure patterns in aEEG and 28.5% burst suppression. CK and LDH were mean elevated in those with moderate HIE, and the newborns with severe HIE had also high creatinine values at admission and in the 3rd day of life. Statistically significant differences between the 3 degrees of HIE were noted in terms of creatinine (P=0.009) and CK (P=0.008) at admission and LDH in the 3rd day of life (P=0.036). Hypoglycemia was common in our study group. In conclusion, common blood tests in association with aEEG monitoring and rigorous neurological assessment can predict short-term outcome of HIE and multiorgan dysfunction and can help clinicians predict even long-term outcomes in severe HIE.
Romanian Journal of Pediatrics, 2020
MalforMaţiile cardiace congenitaleo probleMă de sănătate publică prof. dr. Mărioara boia 1,2 , as... more MalforMaţiile cardiace congenitaleo probleMă de sănătate publică prof. dr. Mărioara boia 1,2 , asist. univ. dr. oana-cristina costescu 1,2 , asist. univ. dr. daniela cioboată 1,2 , asist. univ. dr. anca popoiu 1,3 , asist. univ. dr. nicoleta lungu 1,2 , asist. univ. dr. florina doandeş 1,2 , Şef lucr. dr.
Romanian Journal of Pediatrics, 2020
Congenital heart disease-a publiC health problem prof. marioara boia 1,2 , md, phd, assist. prof.... more Congenital heart disease-a publiC health problem prof. marioara boia 1,2 , md, phd, assist. prof. oana-Cristina Costescu 1,2 , md, phd, assist. prof. daniela Cioboata 1,2 , md, phd, assist. prof. anca popoiu 1,3 , md, phd, assist. prof. nicoleta lungu 1,2 , md, phd, assist. prof. Florina doandes 1,2 , md, phd, lecturer aniko maria manea 1,2 , md, phd
Posters, 2017
Introduction The introduction of early enteral feeding at extremely low birth weight newborns has... more Introduction The introduction of early enteral feeding at extremely low birth weight newborns has many advantages and should be started as soon as possible if a premature is clinically stable. Also is important to fortify human milk when feeding volume reaches 100 ml/kg/day. Aims Authors aim to determine the effect of early trophic feeding on digestive tolerance improvement, and to determine the effect of formula milk compared with human breast milk on growth and development in preterm infants. Material and method The study was carried out in the Premature and Neonatology Department on a group of 60 premature newborns with birth weight under 1000 grams (800–1000 grams) without severe asphyxia. Results All the newborns received early trophic feeding associated with parenteral nutrition. Once premature receive exclusively enteral feeding the newborns in both groups (formula milk – group I, human breast milk with breast milk fortifier- group II) have received the same type of milk (breast milk or formula) and they were monitored for any evidence of digestive intolerance and the growth curves were followed. Body weight was measured at the same time each day. Conclusions Implementing minimal enteral nutrition leads to several clinical benefits that include: increased postnatal growth and shorter hospitalisation period. Enteral feeding with fortified human milk compared with enteral feeding with formula milk improved weight gain at premature in the studied lot.
Romanian Journal of Pediatrics, 2016
Aim. The main purpose is to evaluate the predisposing factors, the evolution and the associated p... more Aim. The main purpose is to evaluate the predisposing factors, the evolution and the associated pathology of the pneumothorax in the neonatal period. Materials and methods. Retrospective study over two years between 2014 and 2015 on 11 patients hospitalized in the Neonatology department of “Louis Turcanu” Children’s Emergency Hospital, Timisoara, diagnosed with pneumothorax. Results. From 1689 newborn infants admitted, 11 patients developed pneumothorax, the incidence was 0.65%. 8 patients (73%) were males and 3 (27%) were females. 4 out of those 11 patients were term newborn infants (gestational age >37 weeks) and 7 patients were premature newborns (<37 weeks of gestational age). Based on the birth weight 4 patients had over 2,500 grams and 7 under 2,500 grams. The main cause of the pneumothorax in the study group was the respiratory distress syndrome (45,4%). Conclusions. Pneumothorax represents an important condition in the neonatal pathology, it is essential to recognize a...
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Papers by Florina Doandes