ObjectiveWe analyzed the possible correlation between glycemic variability and psychological diso... more ObjectiveWe analyzed the possible correlation between glycemic variability and psychological disorders such as depression, anxiety disorder, and low self-esteem, in diabetic patients. These correlations are relevant, as they consume a large number of resources. Their better understanding can increase the effectiveness of incident reduction techniques and could provide better management and cost reduction of care.MethodsWe compared the relationships between the glycemic variability (for a period of 10 days prior to completing the depression questionnaire) and the results of two standardized questionnaires: Hamilton anxiety scale - HRSA (group 1: 500 patients), Rosenberg self-esteem test (group 2: 490 patients) and Beck depression inventory (both groups).ResultsA statistically significant correlation was identified between the glycemic oscillation and depression as well as both anxiety and low self-esteem. The present data justify further research. Our results could be developed into a preliminary intervention protocol, using the daily glycemic values measurements, collected by patients. In conclusion, psychometric tests could be an important instrument in the management of diabetic patients.
Abstract Background Absent end-diastolic flow (AEDF) in the umbilical artery (UA) worsens the alr... more Abstract Background Absent end-diastolic flow (AEDF) in the umbilical artery (UA) worsens the already poor prognosis of growth-restricted fetuses (GRFs) in pregnancies complicated by early-onset preeclampsia with severe features (ESP). Method We assessed the correlation between the effect of maternal dexamethasone (Dex) on AEDF in the UA and perinatal outcomes, in 59 GRFs from EPS-complicated pregnancies. The maternal outcome was also evaluated. Results The mean maternal age at inclusion was 22.4 ± 5.9 years. Dex transiently restored EDF in the UA in 38 (64.4%) cases (trAEDF group), but in 21 (35.6%) patients, the flow was persistently absent (prAEDF group). The effect lasted up to the 4th day. The gestational age at diagnosis, number of days from admission until delivery, and fetal weight were significantly lower in the prAEDF group than in the trAEDF group (p < .05). The same group had a significantly increased rate of fetal proximal deterioration, low APGAR scores, neonatal hypoxia, assisted ventilation, mild intraventricular haemorrhage (I/II), and respiratory distress syndrome, as well as maternal deterioration, especially in cases of resistant hypertension (p < .05). Although the rates of fetal acidemia and perinatal mortality in the prAEDF group were respectively three times and two times higher, the differences were not significant (p > .05). Conclusions The Dex no-effect on UA Doppler in GRFs with AEDF in the UA, in EPS-complicated pregnancies, can be a useful marker for a higher risk of proximal fetal deterioration, poor state at delivery, neonatal hypoxic complications, and worsening maternal condition, but not for perinatal mortality. The findings also highlight the alarmingly younger age of patients with EPS. Finally, all these pregnancies should be monitored in a complex multidisciplinary manner in tertiary referral units. Key message The effect of dexamethasone on absent end-diastolic flow in the umbilical artery in growth-restricted fetuses from pregnancies complicated by early-onset preeclampsia with severe features can be a useful prognostic factor for perinatal outcomes.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2019
Adrenal cavernomas are rare benign tumors, and those of giant dimensions are exceptional. Usually... more Adrenal cavernomas are rare benign tumors, and those of giant dimensions are exceptional. Usually, they are symptomless or they induce symptoms and signs due to compression over nearby organs. We present the case of a 68-year-old woman, who complained of abdominal enlargement and abdominal pain in the left part of the abdomen. Imagistic investigations (native and contrast abdominal computed tomography) revealed an inhomogeneous retroperitoneal mass of 210∕182∕200 mm, containing calcifications. Laboratory findings were not relevant, just a slight and non-significant elevation of carcinoembryonic antigen and a slight elevation of C-reactive protein. Diagnosis of cancer of undetermined origin was considered, and surgery was performed. During surgery, a giant encapsulated inhomogeneous tumor of 330 mm, with cystic areas, was removed, without assessing the origin. Primary or secondary tumors (metastasis from breast, intestinal, lung, renal or skin cancer) were taken into account. Only hi...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2019
Pancreatic panniculitis represents a rare dermatological manifestation mainly due to a pancreatic... more Pancreatic panniculitis represents a rare dermatological manifestation mainly due to a pancreatic disorder, but other etiologies are possible. Even rarer, it can occur prior to the clinical signs of the underlying disease, and its presence must orientate the investigations especially towards pancreas, liver and neuroendocrine system. We report a rare case of a 47-year-old male patient who presented to the Emergency Unit complaining about a two weeks-long-persistent pain in the upper abdomen and biliary vomiting. The medical history included alcohol abuse. Several days prior to the onset of these symptoms, the patient has noticed the occurrence of a nodular inflammatory lesion of 5∕3 cm on the right calf (this makes the case even rarer). Based on clinical aspect and high levels of pancreatic enzymes, acute pancreatitis was diagnosed. Contrast-enhanced abdominal computed tomography (CT) revealed a cystic pancreatic mass and dilated intrahepatic biliary ducts. Abdominal magnetic resona...
MARIA BOGDAN1#, IRINA TICA2#, DORIN NICOLAE GHEORGHE3#, IZABELA SILOSI4, SORINA SOLOMON5, IOANA M... more MARIA BOGDAN1#, IRINA TICA2#, DORIN NICOLAE GHEORGHE3#, IZABELA SILOSI4, SORINA SOLOMON5, IOANA MARTU5 , PETRA SURLIN3*, IULIA CHISCOP6, CRISTIAN BUDACU5 1 University of Medicine and Pharmacy of Craiova, Faculty of Pharmacy, 2 Petru Rares Str., Craiova, Romania 2 Ovidius University of Medicine and Pharmacy of Constanta, Faculty of Medicine, 1 Universitatii Alley, 124 Mamaia Blvd., Constanta, Romania 3 University of Medicine and Pharmacy of Craiova, Faculty of Dental Medicine, 2 Petru Rares Str., Craiova, Romania 4 University of Medicine and Pharmacy of Craiova, Faculty of Medicine, 2 Petru Rares Str., Craiova, Romania 5 Gr T Popa University of Medicine and Pharmacy of Craiova, 16 Universitatii Str., Iasi, Romania 6Dunarea de Jos University of Galati, 47 Domneasca Str., 800008, Galati, Romania
Clinical and Experimental Obstetrics & Gynecology, 2021
Background: The single umbilical artery (SUA), an entity with almost unknown etiology, is still s... more Background: The single umbilical artery (SUA), an entity with almost unknown etiology, is still subject to discussion regarding its clinical significance, especially when it is an isolated discovery (iSUA). Methods: This retrospective study focused on the evaluation of fetuses with ultrasound proven SUA during second trimester screening. These fetuses were carefully investigated for other malformations. The respective pregnancies were attentively followed up and the newborns were evaluated confirming SUA. Results: The incidence of SUA was 0.57%, with 34.6% of these fetuses having associated abnormalities being 19.2% cardiovascular, 15.3% gastrointestinal, 11.5% cerebral, 7.6% osteomuscular and 3.8% urogenital. Aneuploidy was present in 8% of these infants. These rates were significantly greater compared with those noticed in ''normal'' three vessels umbilical cord (TVC) fetuses (control group) (p < 0.001). Similar relations were found for the rates of IUGR and/or SGA, polyhydramnios and oligohydramnios (p < 0.001). Interestingly, in iSUA group (65.4% of all SUA cases), only the rate of oligohydramnios was significantly increased compared with the control group (p = 0.038). Furthermore, in a dichorionic diamniotic twin pregnancy, with only one fetus revealing iSUA, the ''affected'' fetus paradoxically weighted more than the ''healthy'' one. Conclusion: We concluded that SUA is an important finding during morphological ultrasound examination. When associated with other anomalies, a fetal karyotype is mandatory due to the increased risk of aneuploidy. Furthermore, the pregnancy should be meticulously monitored in order to promptly diagnose other developmental anomalies associated with abnormalities of the amniotic fluid volume and to detect any anatomical anomalies missed at the initial prenatal evaluation. Finally, we concluded that diabetes mellitus represents a strong favoring condition for SUA with first pregnancy also being a contributor.
Romanian Journal of Morphology and Embryology, 2021
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited. CASE REPORT A unique case of recurrent fetal cystic hygroma: first fetus with an inherited heteromorphism of chromosome 1 (1qh+) and the second fetus with 69XXX triploidy OANA SORINA TICA 1,2) , CRISTINA GUG 3) , ANDREI ADRIAN TICA 2,4) , CRISTINA JANA BUSUIOC 5,6) , SHAHRAM AMIRI 7) , IRINA TICA 8,9) , GEORGE BICĂ BRĂILOIU 4) , VLAD IUSTIN TICA 10,11)
Romanian Journal of Morphology and Embryology, 2020
Endometriosis (EMs) is a benign disease characterized by the presence of endometrial tissue outsi... more Endometriosis (EMs) is a benign disease characterized by the presence of endometrial tissue outside the uterine cavity. EMs associated with ovarian cancer (OC) has a relative low incidence (5% to 10%), sometimes with evidence of a transition stage through atypical EMs (1.6% cases). We have assessed 135 consecutive patients with either EMs or OC and, out of them, our study reports on four cases of ovarian EMs and OC: two cases with endometrioid OC and two cases with high-grade serous OC (HGSOC). Cases with EMs and HGSOC are extremely rarely reported in the literature-we could find not more than 30 cases. The main objective of our research was to observe the possible similarities between EMs and OC. Secondly, we analyzed the differences between EMs associated with endometrioid OC and EMs associated with HGSOC. We evaluated them in terms of clinical status (age, stages of EMs and OC) and immunohistochemical (IHC) expression of estrogen receptor (ER), progesterone receptor (PR), Ki67, p53, p16, Wilms' tumor 1 (WT1), cluster of differentiation (CD) 34 and CD10 immunomarkers-we could not find in the literature all these markers assessed, in the same time, to such samples. Our results indicated that there are no similarities between EMs and OC and no atypical EMs was identified in our cases. We recorded higher values of ER expression in EMs associated with HGSOC than in EMs associated with endometrioid OC. Higher values of ER expression were also recorded in OC than in endometriotic foci. There were no differences in proliferative rate of endometriotic foci associated with endometrioid OC, compared to EMs associated with HGSOC. An aberrant IHC expression for p53 protein and p16 protein was noted only in HGSOC. Also, a positive immunostaining for Wilms' tumor 1 (WT1) was identified only in HGSOC. Higher values of microvessel density were recorded in OC but not in endometriotic foci. We concluded that there were no similarities between EMs and OC for the cases included in our study, but we noticed differences in terms of Ki67 index and also between hormonal receptors expression in EMs associated with HGSOC, comparing with EMs associated with endometrioid OCs. These results may represent a "brick" for future researches on the less understood EMs associated with type II of OCs, especially with HGSOC. Identifying the best marker, which can predict the risk of developing OC for the patients with EMs, may lead to discover new specific therapeutic agents and, therefore, a better, tailored, therapy.
Endometriosis is a benign disease represented by existence of endometrial tissue outside the uter... more Endometriosis is a benign disease represented by existence of endometrial tissue outside the uterine cavity. Considered in the past a type of endometriosis, adenomyosis is, presently, described as a possible different entity, comparative to endometriosis. That is the reason why we decided to study two groups of patients - one with endometriosis and one with adenomyosis - in order to determine if they are one and the same disease. We included all successive patients admitted and surgically treated in the Emergency Clinical Hospital Constanta between 2015-2017, and, after applying the selection criteria, we assessed 61 patients (group 1) diagnosed with endometriosis - ovarian, cervical, caesarian section scar - and 39 patients (group 2) with adenomyosis. We studied all patients in terms of age, parity, lesions� size, admissions� symptoms, chronic symptoms and immunohistochemical markers CD10, CD34, Ki67. We chose there three markers because of their possible relation to endometriosis ...
Adiponectin is secreted by fatty tissue; it has a peptide biochemical structure and among other r... more Adiponectin is secreted by fatty tissue; it has a peptide biochemical structure and among other roles, it seems to inhibit endothelial inflammation. C-reactive protein has an essential role in host defense. Troponin is a protein that is part of cardiac and skeletal muscle contraction. Myocardial infarction is an acute event defined as myocardial cell necrosis, caused by sudden and sustained ischemia. The purpose of our search work was to analyze the connection between various biomarkers over the early phase of acute STEMI: adiponectin, high sensitive-C reactive protein (hs-CRP), high sensitive-Troponin T (hs-Troponin T), triglycerides, total -, LDL- and HDL-cholesterol. Our study included two groups of patients - one group of 30 patients diagnosed with STEMI in the first 12 h after onset, and the second group of 30 patients with unstable angina pectoris, normal hs-Troponin T, and normal findings at coronary angiography computed tomography (CT). Subjects in the STEMI-arm had a higher...
Up till now, to our knowledge, there are no studies evaluating serum Brain - Derived Neurotrophic... more Up till now, to our knowledge, there are no studies evaluating serum Brain - Derived Neurotrophic Factor (BDNF) levels in patients with degenerative chronic low back pain under rehabilitation treatment. BDNF is a neuroprotein associated with neuropathic pain and represents an important mediator of the effects of physical exercise. Complex balneal treatment with hot Techirghiol sapropelic mud reduces pain and increases serum levels of BDNF in these patients.
Introduction. Heart failure and dilated cardiomyopathy (DCM) in adults are rarely caused by hypop... more Introduction. Heart failure and dilated cardiomyopathy (DCM) in adults are rarely caused by hypoparathyroidism induced hypocalcemia. Case report. Female patient, 40 years old, diabetic, with previous history of thyroidectomy for Graves' disease, was hospitalized for syncope and symptoms of heart failure. ECG revealed sinus tachycardia, long QT, negative T from V1 up to V4. Chest X-ray, cardiac ultrasound and contrast cardiac MRI confirmed dilated left chambers, severe systolic dysfunction of the left ventricle (left ventricle ejection fraction=15%) due to diffuse hypokinesia and restrictive type of diastolic dysfunction. Patient status insignificantly improved with specific heart failure depletion treatment but important signs of hypocalcemia occurred. Low levels of total and ionic serum calcium were detected (total serum calcium 3.6 mg/dL, ionic calcium=2.2 mg/dL) along with low serum levels of parathormone (10 pg/mL) and high level of phosphatemia (6.4 mg/dL). After one month of parenteral treatment with calcium and oral vitamin D, hypocalcemic signs disappeared and heart failure significantly improved. Conclusion. This rare adult condition is refractory to heart failure conventional therapy but promptly responds to restoration of normocalcemia. It is important to be aware of this pathophysiological setting, in order to treat it correctly.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2016
Bardet-Biedl syndrome (BBS) represents a rare ciliopathy recessive autosomal inherited. The main ... more Bardet-Biedl syndrome (BBS) represents a rare ciliopathy recessive autosomal inherited. The main clinical features are retinal dystrophy, postaxial polydactyly, obesity, different degrees of cognitive deficit, renal impairment, hypogonadism and genital malformations. The genetic explanation consists in BBS genes mutations, which encode modified proteins, altering the function of the immotile cilia. As a multitude of BBS genes mutations were described, the phenotypic aspect of these disorders varies according to that. We present the case of a 22 years old female patient, known with BBS since the age of 11 and which was diagnosed and operated for bilateral ovarian dermoid cysts, at the age of 21. We did not find a similar case in literature, regarding the association between the two disorders. We consider that our case points towards the importance of periodic imagistic evaluations [magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound] of these patients, not only c...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2009
Anencephaly is an embryological malformation of the central nervous system, invariable lethal, ch... more Anencephaly is an embryological malformation of the central nervous system, invariable lethal, characterized by the absence of the brain and cranial vault and by other defects of the cranial structures. It has no cure but it can be detected during the pregnancy with ultrasonography. We present a rare case of a 15-year-old primipara, with no prenatal care, who delivered at 37 weeks an anencephalous female newborn. Ultrasonography avoided the confusion with a breach presentation, which, in conjunction with the prematurity, premature rupture of membranes and the young maternal age would have favored the cesarean section. The rarity of the case is increased by the singularity of the malformation. The importance of the prenatal care and genetic workup are stressed out in this embryologic pathology.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
The association of an ovarian cyst with pregnancy is relatively rare; it may result in serious ma... more The association of an ovarian cyst with pregnancy is relatively rare; it may result in serious maternal and fetal complications and its treatment is still controversial. We present a case in which the rarity is given by the association of an 11cm--serous right ovarian cyst (with signs of torsion) with a monofetal 6 gestation week--pregnancy, by the initial conservative management and by the subsequent laparotomy and cystectomy at 16 gestational weeks, required by the acute abdominal pain caused by the torted cyst. The approach was initially conservative followed by laparotomy and cystectomy at 16 gestation weeks, required by the acute abdominal pain caused by the torsive cyst. Pregnancy was, afterwards, uneventful and the patient delivered vaginally, at term, a 3200 g healthy girl. Management options of such a case are discussed.
Romanian journal of internal medicine = Revue roumaine de médecine interne, 2007
Ovarian stimulation has an important place in the contemporary impressive development of infertil... more Ovarian stimulation has an important place in the contemporary impressive development of infertility treatment. There are few and not concordant data concerning its influence on cortisol serum levels. The present study aimed at finding the necessary number of determinations in order to statistically assess the variation of cortisol during and caused by the ovarian stimulation. In 25 consecutive infertile women (23-45 years old, average: 32.4 years) enrolled in an ovarian stimulation program (gonadotropin releasing hormone agonist--busereline--from the first day of the cycle, human menopausal gonadotropin beginning with the 14th day of the cycle, ovulation triggering by human chorionic gonadotropin), serum cortisol was measured one month before the study, the 1st, 14th, 16th, 19th, 22nd, 24th day, the day before the triggering of the ovulation, one, two, 19 days and one month after triggering. General methods of data analysis map into descriptive and inferential statistics were used,...
Romanian journal of internal medicine = Revue roumaine de médecine interne, 2007
Adrenal incidentalomas represent a true problem both in the clinical diagnosis and in their treat... more Adrenal incidentalomas represent a true problem both in the clinical diagnosis and in their treatment. A great variety of pathologies may be found under the umbrella of this concept: benign adenomas - functioning or not, myelolipomas, hamartomas, or granulomatous infiltrations of the adrenal. The possibility of malignancy should be considered in each case, especially in patients with a known extra-adrenal primary. In true incidentalomas, size appears to be predictive of malignancy. We present an interesting case because of the surprising association of two adrenal tumors, with a long time lapse between them, with ascites and pleurisy and because of the difficulty of treatment in a patient refusing surgery. We did not find such an association in the medical literature. Miss MR, 61 years old, was treated surgically for pheochromocytoma 28 years ago (left adrenalectomy). She was diagnosed in the past with peritoneal carcinomatosis; paraneoplastic left pleurisy, chronic hepatitis of unk...
Urachal abnormalities represent a rare pathology and, in case of presence, they are more frequent... more Urachal abnormalities represent a rare pathology and, in case of presence, they are more frequent in children and, among adults, in men. We report a case of urachal cyst in an adult woman in whom it was difficult to determine preoperatively the origin of the abdominal tumor. Positive diagnosis and treatment implied surgical exploration and resection. Even rare, this pathology should be considered in the differential diagnosis of an abdominal cyst. While the diagnosis may be established by clinical examination and imaging methods, surgical exploration is justified and, besides, offers the therapeutic opportunity.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Placental abruption implies, still, a largely unknown causality and frequent unsatisfactory resul... more Placental abruption implies, still, a largely unknown causality and frequent unsatisfactory results. This study was designed to explore the possible correlations between some etiologic factors, the dependent clinical decisions and outcome. In a prospective cohort, we included 95 successive pregnant women (aged 15-42, 22-42 gestational weeks) with abruptio placentae necessitating cesarean section, during 2001-2005. Maternal blood pressure, premature rupture of membranes, infants' sex ratio, hematomas' volumes were correlated with the clinical outcome. There were 25 mortality cases (2 maternal and 23 fetal) and physicians performed 9 hysterectomies (2 with bilateral adnexectomy). Premature rupture of membranes was seen in 32% of the cases. Hypertension was an etiological and aggravating factor: it was reported in 70% of cases, in all the severe ones. The volume of placental hematomas was in direct concordance with the severity of the outcome. Interestingly, the majority of the...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Endometrial cancer remains, today, a serious problem, especially for postmenopausal women. The ai... more Endometrial cancer remains, today, a serious problem, especially for postmenopausal women. The aim of our study was to evaluate the utility of the transvaginal ultrasound examination in the management of the endometrial abnormalities in postmenopausal women. We included, in a prospective cohort, 49 successive postmenopausal women: 34 with metrorrhagia (group I) and 15 with no symptoms (group II) and we compared the results obtained by ultrasound examination, Pap smear and endometrial biopsy. Patients in group I had a higher frequency of risk factors and thick and abnormal endometrium. Unlike Pap smear, ultrasound examination and biopsy had comparable values. We could conclude that transvaginal sonography is a reliable technique for the endometrium evaluation in the postmenopausal women. Ultrasound exam could select the cases (without any symptoms) for endometrial biopsy and detect associated gynecological pathology.
ObjectiveWe analyzed the possible correlation between glycemic variability and psychological diso... more ObjectiveWe analyzed the possible correlation between glycemic variability and psychological disorders such as depression, anxiety disorder, and low self-esteem, in diabetic patients. These correlations are relevant, as they consume a large number of resources. Their better understanding can increase the effectiveness of incident reduction techniques and could provide better management and cost reduction of care.MethodsWe compared the relationships between the glycemic variability (for a period of 10 days prior to completing the depression questionnaire) and the results of two standardized questionnaires: Hamilton anxiety scale - HRSA (group 1: 500 patients), Rosenberg self-esteem test (group 2: 490 patients) and Beck depression inventory (both groups).ResultsA statistically significant correlation was identified between the glycemic oscillation and depression as well as both anxiety and low self-esteem. The present data justify further research. Our results could be developed into a preliminary intervention protocol, using the daily glycemic values measurements, collected by patients. In conclusion, psychometric tests could be an important instrument in the management of diabetic patients.
Abstract Background Absent end-diastolic flow (AEDF) in the umbilical artery (UA) worsens the alr... more Abstract Background Absent end-diastolic flow (AEDF) in the umbilical artery (UA) worsens the already poor prognosis of growth-restricted fetuses (GRFs) in pregnancies complicated by early-onset preeclampsia with severe features (ESP). Method We assessed the correlation between the effect of maternal dexamethasone (Dex) on AEDF in the UA and perinatal outcomes, in 59 GRFs from EPS-complicated pregnancies. The maternal outcome was also evaluated. Results The mean maternal age at inclusion was 22.4 ± 5.9 years. Dex transiently restored EDF in the UA in 38 (64.4%) cases (trAEDF group), but in 21 (35.6%) patients, the flow was persistently absent (prAEDF group). The effect lasted up to the 4th day. The gestational age at diagnosis, number of days from admission until delivery, and fetal weight were significantly lower in the prAEDF group than in the trAEDF group (p < .05). The same group had a significantly increased rate of fetal proximal deterioration, low APGAR scores, neonatal hypoxia, assisted ventilation, mild intraventricular haemorrhage (I/II), and respiratory distress syndrome, as well as maternal deterioration, especially in cases of resistant hypertension (p < .05). Although the rates of fetal acidemia and perinatal mortality in the prAEDF group were respectively three times and two times higher, the differences were not significant (p > .05). Conclusions The Dex no-effect on UA Doppler in GRFs with AEDF in the UA, in EPS-complicated pregnancies, can be a useful marker for a higher risk of proximal fetal deterioration, poor state at delivery, neonatal hypoxic complications, and worsening maternal condition, but not for perinatal mortality. The findings also highlight the alarmingly younger age of patients with EPS. Finally, all these pregnancies should be monitored in a complex multidisciplinary manner in tertiary referral units. Key message The effect of dexamethasone on absent end-diastolic flow in the umbilical artery in growth-restricted fetuses from pregnancies complicated by early-onset preeclampsia with severe features can be a useful prognostic factor for perinatal outcomes.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2019
Adrenal cavernomas are rare benign tumors, and those of giant dimensions are exceptional. Usually... more Adrenal cavernomas are rare benign tumors, and those of giant dimensions are exceptional. Usually, they are symptomless or they induce symptoms and signs due to compression over nearby organs. We present the case of a 68-year-old woman, who complained of abdominal enlargement and abdominal pain in the left part of the abdomen. Imagistic investigations (native and contrast abdominal computed tomography) revealed an inhomogeneous retroperitoneal mass of 210∕182∕200 mm, containing calcifications. Laboratory findings were not relevant, just a slight and non-significant elevation of carcinoembryonic antigen and a slight elevation of C-reactive protein. Diagnosis of cancer of undetermined origin was considered, and surgery was performed. During surgery, a giant encapsulated inhomogeneous tumor of 330 mm, with cystic areas, was removed, without assessing the origin. Primary or secondary tumors (metastasis from breast, intestinal, lung, renal or skin cancer) were taken into account. Only hi...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2019
Pancreatic panniculitis represents a rare dermatological manifestation mainly due to a pancreatic... more Pancreatic panniculitis represents a rare dermatological manifestation mainly due to a pancreatic disorder, but other etiologies are possible. Even rarer, it can occur prior to the clinical signs of the underlying disease, and its presence must orientate the investigations especially towards pancreas, liver and neuroendocrine system. We report a rare case of a 47-year-old male patient who presented to the Emergency Unit complaining about a two weeks-long-persistent pain in the upper abdomen and biliary vomiting. The medical history included alcohol abuse. Several days prior to the onset of these symptoms, the patient has noticed the occurrence of a nodular inflammatory lesion of 5∕3 cm on the right calf (this makes the case even rarer). Based on clinical aspect and high levels of pancreatic enzymes, acute pancreatitis was diagnosed. Contrast-enhanced abdominal computed tomography (CT) revealed a cystic pancreatic mass and dilated intrahepatic biliary ducts. Abdominal magnetic resona...
MARIA BOGDAN1#, IRINA TICA2#, DORIN NICOLAE GHEORGHE3#, IZABELA SILOSI4, SORINA SOLOMON5, IOANA M... more MARIA BOGDAN1#, IRINA TICA2#, DORIN NICOLAE GHEORGHE3#, IZABELA SILOSI4, SORINA SOLOMON5, IOANA MARTU5 , PETRA SURLIN3*, IULIA CHISCOP6, CRISTIAN BUDACU5 1 University of Medicine and Pharmacy of Craiova, Faculty of Pharmacy, 2 Petru Rares Str., Craiova, Romania 2 Ovidius University of Medicine and Pharmacy of Constanta, Faculty of Medicine, 1 Universitatii Alley, 124 Mamaia Blvd., Constanta, Romania 3 University of Medicine and Pharmacy of Craiova, Faculty of Dental Medicine, 2 Petru Rares Str., Craiova, Romania 4 University of Medicine and Pharmacy of Craiova, Faculty of Medicine, 2 Petru Rares Str., Craiova, Romania 5 Gr T Popa University of Medicine and Pharmacy of Craiova, 16 Universitatii Str., Iasi, Romania 6Dunarea de Jos University of Galati, 47 Domneasca Str., 800008, Galati, Romania
Clinical and Experimental Obstetrics & Gynecology, 2021
Background: The single umbilical artery (SUA), an entity with almost unknown etiology, is still s... more Background: The single umbilical artery (SUA), an entity with almost unknown etiology, is still subject to discussion regarding its clinical significance, especially when it is an isolated discovery (iSUA). Methods: This retrospective study focused on the evaluation of fetuses with ultrasound proven SUA during second trimester screening. These fetuses were carefully investigated for other malformations. The respective pregnancies were attentively followed up and the newborns were evaluated confirming SUA. Results: The incidence of SUA was 0.57%, with 34.6% of these fetuses having associated abnormalities being 19.2% cardiovascular, 15.3% gastrointestinal, 11.5% cerebral, 7.6% osteomuscular and 3.8% urogenital. Aneuploidy was present in 8% of these infants. These rates were significantly greater compared with those noticed in ''normal'' three vessels umbilical cord (TVC) fetuses (control group) (p < 0.001). Similar relations were found for the rates of IUGR and/or SGA, polyhydramnios and oligohydramnios (p < 0.001). Interestingly, in iSUA group (65.4% of all SUA cases), only the rate of oligohydramnios was significantly increased compared with the control group (p = 0.038). Furthermore, in a dichorionic diamniotic twin pregnancy, with only one fetus revealing iSUA, the ''affected'' fetus paradoxically weighted more than the ''healthy'' one. Conclusion: We concluded that SUA is an important finding during morphological ultrasound examination. When associated with other anomalies, a fetal karyotype is mandatory due to the increased risk of aneuploidy. Furthermore, the pregnancy should be meticulously monitored in order to promptly diagnose other developmental anomalies associated with abnormalities of the amniotic fluid volume and to detect any anatomical anomalies missed at the initial prenatal evaluation. Finally, we concluded that diabetes mellitus represents a strong favoring condition for SUA with first pregnancy also being a contributor.
Romanian Journal of Morphology and Embryology, 2021
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited. CASE REPORT A unique case of recurrent fetal cystic hygroma: first fetus with an inherited heteromorphism of chromosome 1 (1qh+) and the second fetus with 69XXX triploidy OANA SORINA TICA 1,2) , CRISTINA GUG 3) , ANDREI ADRIAN TICA 2,4) , CRISTINA JANA BUSUIOC 5,6) , SHAHRAM AMIRI 7) , IRINA TICA 8,9) , GEORGE BICĂ BRĂILOIU 4) , VLAD IUSTIN TICA 10,11)
Romanian Journal of Morphology and Embryology, 2020
Endometriosis (EMs) is a benign disease characterized by the presence of endometrial tissue outsi... more Endometriosis (EMs) is a benign disease characterized by the presence of endometrial tissue outside the uterine cavity. EMs associated with ovarian cancer (OC) has a relative low incidence (5% to 10%), sometimes with evidence of a transition stage through atypical EMs (1.6% cases). We have assessed 135 consecutive patients with either EMs or OC and, out of them, our study reports on four cases of ovarian EMs and OC: two cases with endometrioid OC and two cases with high-grade serous OC (HGSOC). Cases with EMs and HGSOC are extremely rarely reported in the literature-we could find not more than 30 cases. The main objective of our research was to observe the possible similarities between EMs and OC. Secondly, we analyzed the differences between EMs associated with endometrioid OC and EMs associated with HGSOC. We evaluated them in terms of clinical status (age, stages of EMs and OC) and immunohistochemical (IHC) expression of estrogen receptor (ER), progesterone receptor (PR), Ki67, p53, p16, Wilms' tumor 1 (WT1), cluster of differentiation (CD) 34 and CD10 immunomarkers-we could not find in the literature all these markers assessed, in the same time, to such samples. Our results indicated that there are no similarities between EMs and OC and no atypical EMs was identified in our cases. We recorded higher values of ER expression in EMs associated with HGSOC than in EMs associated with endometrioid OC. Higher values of ER expression were also recorded in OC than in endometriotic foci. There were no differences in proliferative rate of endometriotic foci associated with endometrioid OC, compared to EMs associated with HGSOC. An aberrant IHC expression for p53 protein and p16 protein was noted only in HGSOC. Also, a positive immunostaining for Wilms' tumor 1 (WT1) was identified only in HGSOC. Higher values of microvessel density were recorded in OC but not in endometriotic foci. We concluded that there were no similarities between EMs and OC for the cases included in our study, but we noticed differences in terms of Ki67 index and also between hormonal receptors expression in EMs associated with HGSOC, comparing with EMs associated with endometrioid OCs. These results may represent a "brick" for future researches on the less understood EMs associated with type II of OCs, especially with HGSOC. Identifying the best marker, which can predict the risk of developing OC for the patients with EMs, may lead to discover new specific therapeutic agents and, therefore, a better, tailored, therapy.
Endometriosis is a benign disease represented by existence of endometrial tissue outside the uter... more Endometriosis is a benign disease represented by existence of endometrial tissue outside the uterine cavity. Considered in the past a type of endometriosis, adenomyosis is, presently, described as a possible different entity, comparative to endometriosis. That is the reason why we decided to study two groups of patients - one with endometriosis and one with adenomyosis - in order to determine if they are one and the same disease. We included all successive patients admitted and surgically treated in the Emergency Clinical Hospital Constanta between 2015-2017, and, after applying the selection criteria, we assessed 61 patients (group 1) diagnosed with endometriosis - ovarian, cervical, caesarian section scar - and 39 patients (group 2) with adenomyosis. We studied all patients in terms of age, parity, lesions� size, admissions� symptoms, chronic symptoms and immunohistochemical markers CD10, CD34, Ki67. We chose there three markers because of their possible relation to endometriosis ...
Adiponectin is secreted by fatty tissue; it has a peptide biochemical structure and among other r... more Adiponectin is secreted by fatty tissue; it has a peptide biochemical structure and among other roles, it seems to inhibit endothelial inflammation. C-reactive protein has an essential role in host defense. Troponin is a protein that is part of cardiac and skeletal muscle contraction. Myocardial infarction is an acute event defined as myocardial cell necrosis, caused by sudden and sustained ischemia. The purpose of our search work was to analyze the connection between various biomarkers over the early phase of acute STEMI: adiponectin, high sensitive-C reactive protein (hs-CRP), high sensitive-Troponin T (hs-Troponin T), triglycerides, total -, LDL- and HDL-cholesterol. Our study included two groups of patients - one group of 30 patients diagnosed with STEMI in the first 12 h after onset, and the second group of 30 patients with unstable angina pectoris, normal hs-Troponin T, and normal findings at coronary angiography computed tomography (CT). Subjects in the STEMI-arm had a higher...
Up till now, to our knowledge, there are no studies evaluating serum Brain - Derived Neurotrophic... more Up till now, to our knowledge, there are no studies evaluating serum Brain - Derived Neurotrophic Factor (BDNF) levels in patients with degenerative chronic low back pain under rehabilitation treatment. BDNF is a neuroprotein associated with neuropathic pain and represents an important mediator of the effects of physical exercise. Complex balneal treatment with hot Techirghiol sapropelic mud reduces pain and increases serum levels of BDNF in these patients.
Introduction. Heart failure and dilated cardiomyopathy (DCM) in adults are rarely caused by hypop... more Introduction. Heart failure and dilated cardiomyopathy (DCM) in adults are rarely caused by hypoparathyroidism induced hypocalcemia. Case report. Female patient, 40 years old, diabetic, with previous history of thyroidectomy for Graves' disease, was hospitalized for syncope and symptoms of heart failure. ECG revealed sinus tachycardia, long QT, negative T from V1 up to V4. Chest X-ray, cardiac ultrasound and contrast cardiac MRI confirmed dilated left chambers, severe systolic dysfunction of the left ventricle (left ventricle ejection fraction=15%) due to diffuse hypokinesia and restrictive type of diastolic dysfunction. Patient status insignificantly improved with specific heart failure depletion treatment but important signs of hypocalcemia occurred. Low levels of total and ionic serum calcium were detected (total serum calcium 3.6 mg/dL, ionic calcium=2.2 mg/dL) along with low serum levels of parathormone (10 pg/mL) and high level of phosphatemia (6.4 mg/dL). After one month of parenteral treatment with calcium and oral vitamin D, hypocalcemic signs disappeared and heart failure significantly improved. Conclusion. This rare adult condition is refractory to heart failure conventional therapy but promptly responds to restoration of normocalcemia. It is important to be aware of this pathophysiological setting, in order to treat it correctly.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2016
Bardet-Biedl syndrome (BBS) represents a rare ciliopathy recessive autosomal inherited. The main ... more Bardet-Biedl syndrome (BBS) represents a rare ciliopathy recessive autosomal inherited. The main clinical features are retinal dystrophy, postaxial polydactyly, obesity, different degrees of cognitive deficit, renal impairment, hypogonadism and genital malformations. The genetic explanation consists in BBS genes mutations, which encode modified proteins, altering the function of the immotile cilia. As a multitude of BBS genes mutations were described, the phenotypic aspect of these disorders varies according to that. We present the case of a 22 years old female patient, known with BBS since the age of 11 and which was diagnosed and operated for bilateral ovarian dermoid cysts, at the age of 21. We did not find a similar case in literature, regarding the association between the two disorders. We consider that our case points towards the importance of periodic imagistic evaluations [magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound] of these patients, not only c...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2009
Anencephaly is an embryological malformation of the central nervous system, invariable lethal, ch... more Anencephaly is an embryological malformation of the central nervous system, invariable lethal, characterized by the absence of the brain and cranial vault and by other defects of the cranial structures. It has no cure but it can be detected during the pregnancy with ultrasonography. We present a rare case of a 15-year-old primipara, with no prenatal care, who delivered at 37 weeks an anencephalous female newborn. Ultrasonography avoided the confusion with a breach presentation, which, in conjunction with the prematurity, premature rupture of membranes and the young maternal age would have favored the cesarean section. The rarity of the case is increased by the singularity of the malformation. The importance of the prenatal care and genetic workup are stressed out in this embryologic pathology.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
The association of an ovarian cyst with pregnancy is relatively rare; it may result in serious ma... more The association of an ovarian cyst with pregnancy is relatively rare; it may result in serious maternal and fetal complications and its treatment is still controversial. We present a case in which the rarity is given by the association of an 11cm--serous right ovarian cyst (with signs of torsion) with a monofetal 6 gestation week--pregnancy, by the initial conservative management and by the subsequent laparotomy and cystectomy at 16 gestational weeks, required by the acute abdominal pain caused by the torted cyst. The approach was initially conservative followed by laparotomy and cystectomy at 16 gestation weeks, required by the acute abdominal pain caused by the torsive cyst. Pregnancy was, afterwards, uneventful and the patient delivered vaginally, at term, a 3200 g healthy girl. Management options of such a case are discussed.
Romanian journal of internal medicine = Revue roumaine de médecine interne, 2007
Ovarian stimulation has an important place in the contemporary impressive development of infertil... more Ovarian stimulation has an important place in the contemporary impressive development of infertility treatment. There are few and not concordant data concerning its influence on cortisol serum levels. The present study aimed at finding the necessary number of determinations in order to statistically assess the variation of cortisol during and caused by the ovarian stimulation. In 25 consecutive infertile women (23-45 years old, average: 32.4 years) enrolled in an ovarian stimulation program (gonadotropin releasing hormone agonist--busereline--from the first day of the cycle, human menopausal gonadotropin beginning with the 14th day of the cycle, ovulation triggering by human chorionic gonadotropin), serum cortisol was measured one month before the study, the 1st, 14th, 16th, 19th, 22nd, 24th day, the day before the triggering of the ovulation, one, two, 19 days and one month after triggering. General methods of data analysis map into descriptive and inferential statistics were used,...
Romanian journal of internal medicine = Revue roumaine de médecine interne, 2007
Adrenal incidentalomas represent a true problem both in the clinical diagnosis and in their treat... more Adrenal incidentalomas represent a true problem both in the clinical diagnosis and in their treatment. A great variety of pathologies may be found under the umbrella of this concept: benign adenomas - functioning or not, myelolipomas, hamartomas, or granulomatous infiltrations of the adrenal. The possibility of malignancy should be considered in each case, especially in patients with a known extra-adrenal primary. In true incidentalomas, size appears to be predictive of malignancy. We present an interesting case because of the surprising association of two adrenal tumors, with a long time lapse between them, with ascites and pleurisy and because of the difficulty of treatment in a patient refusing surgery. We did not find such an association in the medical literature. Miss MR, 61 years old, was treated surgically for pheochromocytoma 28 years ago (left adrenalectomy). She was diagnosed in the past with peritoneal carcinomatosis; paraneoplastic left pleurisy, chronic hepatitis of unk...
Urachal abnormalities represent a rare pathology and, in case of presence, they are more frequent... more Urachal abnormalities represent a rare pathology and, in case of presence, they are more frequent in children and, among adults, in men. We report a case of urachal cyst in an adult woman in whom it was difficult to determine preoperatively the origin of the abdominal tumor. Positive diagnosis and treatment implied surgical exploration and resection. Even rare, this pathology should be considered in the differential diagnosis of an abdominal cyst. While the diagnosis may be established by clinical examination and imaging methods, surgical exploration is justified and, besides, offers the therapeutic opportunity.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Placental abruption implies, still, a largely unknown causality and frequent unsatisfactory resul... more Placental abruption implies, still, a largely unknown causality and frequent unsatisfactory results. This study was designed to explore the possible correlations between some etiologic factors, the dependent clinical decisions and outcome. In a prospective cohort, we included 95 successive pregnant women (aged 15-42, 22-42 gestational weeks) with abruptio placentae necessitating cesarean section, during 2001-2005. Maternal blood pressure, premature rupture of membranes, infants' sex ratio, hematomas' volumes were correlated with the clinical outcome. There were 25 mortality cases (2 maternal and 23 fetal) and physicians performed 9 hysterectomies (2 with bilateral adnexectomy). Premature rupture of membranes was seen in 32% of the cases. Hypertension was an etiological and aggravating factor: it was reported in 70% of cases, in all the severe ones. The volume of placental hematomas was in direct concordance with the severity of the outcome. Interestingly, the majority of the...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Endometrial cancer remains, today, a serious problem, especially for postmenopausal women. The ai... more Endometrial cancer remains, today, a serious problem, especially for postmenopausal women. The aim of our study was to evaluate the utility of the transvaginal ultrasound examination in the management of the endometrial abnormalities in postmenopausal women. We included, in a prospective cohort, 49 successive postmenopausal women: 34 with metrorrhagia (group I) and 15 with no symptoms (group II) and we compared the results obtained by ultrasound examination, Pap smear and endometrial biopsy. Patients in group I had a higher frequency of risk factors and thick and abnormal endometrium. Unlike Pap smear, ultrasound examination and biopsy had comparable values. We could conclude that transvaginal sonography is a reliable technique for the endometrium evaluation in the postmenopausal women. Ultrasound exam could select the cases (without any symptoms) for endometrial biopsy and detect associated gynecological pathology.
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