Papers by viorela nitescu
Vaccines, Jun 19, 2024
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Research Square (Research Square), Apr 8, 2024
This study analyzed the neurological manifestation pro les of severe acute respiratory syndrome c... more This study analyzed the neurological manifestation pro les of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across pandemic waves in pediatric patients. Methods This retrospective study analyzed the data of patients aged 0-18 years who were diagnosed with acute SARS-CoV-2 infection and admitted to a pediatric tertiary hospital between March 1, 2020, and February 28, 2023. The presence of neurological manifestations was established based on the symptoms noted in each patient chart. The relationships between neurological manifestations and pandemic waves or age groups were assessed using the chi-square test. Results This study included 1677 patients. Neurological manifestations were noted in 10% (n = 168) of patients with a 3.2 years median age (interquartile range: 1-11.92). Neurological manifestations were signi cantly associated with the pandemic waves (p = 0.006) and age groups (p < 0.001). Seizures were noted in 4.2% of cases and reached an increasing frequency over time (p = 0.001), but were not associated with age groups. Febrile seizures accounted for the majority of seizures. Headache was reported in 2.6% of cases and had similar frequencies across the pandemic waves and age groups. Muscular involvement was noted in 2% of cases and reached a decreasing frequency over time (p < 0.001) and showed different frequencies among the age groups. Conclusions Neurological manifestations of acute SARS-CoV-2 infection exhibit distinct patterns, depending on the pandemic wave and patient age group. The Wuhan and Omicron waves involved the nervous system more often than the other waves; however, this was probably through different mechanisms. What is Known SARS-CoV-2 variants are associated with different disease severities in pediatric patients. Acute SARS-CoV-2 infection lead to neurological manifestations more frequently than expected in pediatric patients. A wide spectrum of neurological manifestations have been described in pediatric patients with SARS-CoV-2 infection.
Children, Feb 21, 2024
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Clinical toxicology, Jun 27, 2024
Antioxidants
The role of cigarette smoking as an aggravating factor of systemic oxidative stress in patients w... more The role of cigarette smoking as an aggravating factor of systemic oxidative stress in patients with mental disorders has not been extensively investigated, although significantly higher rates of smoking are recorded in these subjects in comparison with the general population. In the present study, we tested the hypothesis that smoking might be an exacerbator of systemic oxidative stress, being directly correlated with the degree of exposure to tobacco smoke. We analyzed, in 76 adult subjects from a public health care unit, the relationships between serum cotinine levels as a marker of tobacco smoke exposure, and three biomarkers of oxidative stress: the serum glutathione (GSH), the advanced oxidation protein products (AOPPs), and the total serum antioxidant status (FRAP). The results indicate that the degree of tobacco smoke exposure was inversely associated with GSH levels in both passive and active smokers, suggesting that smoke particulate components’ toxicity is associated with...
ARS Medica Tomitana, May 1, 2022
Among adolescents, acute intoxications caused by drugs as well as intoxications caused by toxic s... more Among adolescents, acute intoxications caused by drugs as well as intoxications caused by toxic substances make up an important chapter of emergency pediatric pathology. We conducted a retrospective study carried out for a period of 1 year, 2021-2022, which included a number of 37 patients, admitted in the Pediatric Clinic of the County Clinical Hospital "Sfântul Apostol Andrei" Constanța. Out of the total of admissions during a 12 months period, 0,5% consisted in acute intoxications in adolescents. There is a higher tendency for substance intoxication in females (65,5% of total cases). There is a higher tendency for adolescents with suicide ideation to use substances in order to end their life because of multiple risk factors, mental health disorders putting them at a higher risk to attempt suicide. Alcohol is widely used.
Revista română de pediatrie, Dec 31, 2019
Conform definiției stabilite de Monitorul European pentru Droguri şi Toxicomanie (European Monito... more Conform definiției stabilite de Monitorul European pentru Droguri şi Toxicomanie (European Monitoring Centre for Drugs and Drug Addiction-EMCDDA), o "substanță psihoactivă nouă este considerată orice substanță narcotică sau psihotropă în formă pură sau în preparate, care nu este controlată prin Convențiile privitoare la droguri ale Națiunilor Unite și care reprezintă o amenințare la adresa sănătății umane comparabilă cu cea realizată de substanțele înregistrate în aceste convenții considerate substanțe ilicite" (1). Au fost descrise 4 clase principale de substanțe psihoactive noi canabinoidele sintetice, catinonele sintetice, halucinogenele naturale şi piperazinele. Canabinoidele sintetice sunt agoniști sintetici ai receptorilor canabinoizi, constituind un grup de substanțe de sinteză care mimează efectele Δ 9 tetrahidrocanabinolului (THC), principalul produs al canabisului răspunzător de efectele psihoactive ale acestuia (4). Simptomele intoxicației sunt asemănătoare cu cele ale intoxicației cu canabis, dar mai severe, tabloul clinic cuprinzând cel mai frecvent: agitație, greață, palpitații (9). Catinonele sintetice sunt compuși derivați din catinonă-principalul constituent al plantei Catha edulis, cunoscută sub denumirea de KHAT (12). Cei mai cunoscuți reprezentanți ai grupului sunt: metcatinona, mefedrona (4-metilcatinona), metilona, metedrona, naftilpirovalerona şi numeroşi substituenți ai MDMA (Ectasy): MDAI, MMAI, MDMAT. Simptomele intoxicației sunt asemănătoare, dar mai severe cu cele ale intoxicațiilor cu amfetamine, metamfetamine sau cocaină, în funcție de tipul substanței (2,12). Halucinogenele sunt substanțe care în doze mici au ca efect principal alterarea percepției, gândirii şi stării de spirit, cu păstrarea lucidității, alături de efecte minore asupra memoriei şi orientării (23,24). Cele mai cunoscute halucinogene naturale sunt: salvinorin A, psilocibina și psilocina, muscimolul şi acidul ibotenic. Piperazinele sunt compuși sintetici similari cu amfetaminele, dar cu efecte mai slabe.Cele mai cunoscute sunt: benzilpiperazinele şi fenilpiperazinele (28). Concluzii. Consumul ocazional care poate duce la intoxicații acute sau consumul cronic de substanțe psihoactive noi reprezintă o problemă importantă de sănătate, ocupând un loc care nu trebuie neglijat în patologia adolescenților şi tinerilor.
Revista română de pediatrie, Dec 31, 2019
Ultraschall in Der Medizin, May 15, 2008
Revista română de pediatrie, Dec 31, 2019
Objective. The present study has two main objectives: to evaluate the psychological characteristi... more Objective. The present study has two main objectives: to evaluate the psychological characteristics of adolescents with voluntary acute poisoning in a pediatric toxicology department and to estimate the role of psychological evaluation in the management of these patients. Material and method. The study includes the retrospective analysis of all patients with voluntary acute intoxication, admitted to our clinic between October 1, 2017 and September 30, 2018. The following criteria were considered: age, gender, number of hospitalizations with this diagnosis and psychological evaluation. performed during hospitalization. Results. During the mentioned period, in the Toxicology and Intensive Care Department of the Emergency Clinical Hospital for Children "Grigore Alexandrescu" in Bucharest, 181 patients were admitted with the diagnosis of voluntary acute poisoning, aged between 10 and 18 years. There was a similar percentage of girls compared to boys (58.1% compared to 41.9%), and most patients (n = 137, 75.7%) were from urban areas. Of the total number of patients 22 (12.1%) had two or more hospitalizations with the diagnosis of voluntary acute intoxication. In 13 cases (7.2%), patients were known to have previous psychiatric disorders: 8 patients with depression, 2 with behavioral disorder and 3 with disorders associated with chronic substance abuse. Analyzing the results of the psychological evaluation in these patients we found that the main psychological disorder was the emotional reaction, being identified in 98 patients (54.1%). The suicide attempt was identified in only 31 patients (17.1%) of whom only 10 received the transfer recommendation in a psychiatric clinic. Conclusions. Psychological evaluation of patients with acute voluntary intoxication is essential during hospitalization in the toxicology section to identify real psychological problems. Emotional reaction is the main psychological disorder in patients with acute voluntary intoxication. The actual suicide attempt is found only in a relatively small number of patients, in our study being diagnosed only at 17% of the total voluntary acute poisoning.
Backround and aims . Buctril (bromoxynil octanoate) is a contact nitrile herbicide used against a... more Backround and aims . Buctril (bromoxynil octanoate) is a contact nitrile herbicide used against annual broadleaf weeds. The aim of this study is to present a severe and rare case of bromoxynil poisoning Methods We present the case of a 16 years old girl who was admitted in our department eight hours after ingestion of an unspecified amount of herbicide – Buctril. Results An hour after ingestion the patient presented asthenia, breathing difficulties, profuse sweating, thirst and abdominal pain. Her family requested the ambulance that transported her to the local hospital where she presented:dyspnea (respiratory rate 44/minute) tachycardia (heart rate:130/minute), intractable vomiting. Gastric lavage, iv Ranitidine and Ringer’s solution were performed,then sent the patient to our hospital At the presentation,eight hours after ingestion, she was: conscious, oriented, pale, diaphoretic with a temperature 36.6 degrees Celsius, pulse rate of 164/minute, blood pressure of 127/62 mmHg, respiratory rate of 40 per minute, vomiting, abdominal pain. She was admitted to the Toxicology Department and received endovenous treatment with glucose and electrolytes, vital functions beeing continuously monitored. Blood tests taken revealed normal values for: white blood cells, platelets,haemoglobin, glucose, serum electolytes, plasma cholinesterase, creatinphosphokinase, normal renal and liver function tests. One hour after admission the patient presented progressive impairment of consciousness, hyperthermia (41°C)and hypotension (BP=85/54 mmHg). She was immediately transported to the intensive care unit and one hour later she became unconscious ; dyspnea (RR=48/min) and tachycardia (HR>200 bpm) were aggravated. She was intubated and mechanical ventilated.In evolution in few hours, bradycardia then asystole and cardiac arrest were installed despite cardiopulmonary resuscitation.. Conclusions The toxicity of bromoxynil, particularly in acute self-poisoning, has not been well studied and defined. This case highlights the unpredictable and fulminant clinical course of herbicide poisonings
Backround and aims Household products are one of the most important category responsable for paed... more Backround and aims Household products are one of the most important category responsable for paediatric toxic exposure, especially in children younger then 6 years old. The aims of this study were to analize the epidemiological characteristics of paediatric exposures to packet and nonpacket forms of liquid detergents and to identify the most frequent clinical findings associated with this type of exposures. Methods We performed a five year retrospective study between January 1 st, 2012 and December 31 st, 2016 of all cases with liquid detergent poisoning admitted to the Toxicology Department in the Clinical Emergency Hospital for Children „Grigore Alexandrescu ’ from Bucharest. Results A total of 231 cases involving liquid detergents were recorded, including 166 cases of laundry liquid detergents and 65 exposures to other types of liquid detergents. The packet forms of laundry detergents were the most commonly identified (131 cases, 56.7%) Boys (131 cases) were more frequently exposed than girls (100 cases). Regarding the age, most patients belonged to the age group 1–5 years (190 cases, 82.25%), followed by patients younger than 1 year (23 de cases, 9.95,%), those aged 6 to 10 years (11 cases, 4.76%) and 11 to 18 years (7 cases,3.03% ). The mean age of the patients exposed was 2.7 years. 85.7% of the patients were symptomatic after exposure, clinical manifestations depending on the route of exposure. In case of ingestion, gastrointestinal symptoms were most commonly noted. Vomiting were present in 180 cases (77.9%), causing acute dehydration in 36 cases. Dysphagia was noted in 41 of the analysed cases, abdominal pain in 11 cases and diarrhoea and hematemesis in 2 cases each. Coughing was noted in 25 patient (10.8%), of which 7 were diagnosed with chemical laryngitis and 9 with chemical pneumonia. Dermal exposure was associated to ingestion in 6 patients and determined oral irritation or oral burns and lips oedema. Ocular exposure occurred in 11 patients (4.76%) causing conjunctivitis, keratitis or corneal burns. Conclusions Exposures to packed forms of liquid laundry detergents were much more common than laundry detergents nonpacket or other types of liquid detergents exposures. Clinical manifestations depended on the route of exposure: ingestion, ocular or dermal and the severity of clinical effects ranged between no symptoms to severe form of hematemesis, acute dehydration and chemical pneumonia.
Ultraschall in Der Medizin, May 15, 2008
Ultraschall in Der Medizin, May 15, 2008
Introduction: Renal trauma is a very severe, even not very frequent, entity in abdominal trauma i... more Introduction: Renal trauma is a very severe, even not very frequent, entity in abdominal trauma in children. Objective: To evaluate the role of abdominal ultrasound in diagnosis and follow up of renal trauma in children. Method: We present a retrospective study concerning renal trauma in a period of 5 years, between 2002–2006. Results: Renal damage was described in 21 patients out of the total number of 451 with abdominal trauma. The following lesions were noted: subcapsular hematoma in 5 children, perirenal hematoma in 3 cases, renal contusion in 9 children, renal hematoma in 3 cases renal fracture in 1 case; in 3 cases were described the organ's damage (liver in 2 patients, duodenum in 1 case). Conservative treatment was performed in 17 cases, following the patients by abdominal ultrasound. Conclusion: The abdominal ultrasound is a very good and rapidly method in pediatrics traumatology which allows conservative treatment and easily follow up
European Neuropsychopharmacology, Oct 1, 2013
Uploads
Papers by viorela nitescu