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Daniela Reisz

University Of Medicine And Pharmacy Timisoara, Neurology, Faculty Member

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Medical Doctor since 2001, neurologist since 1997, focused in neurodegenerative diseases, sleep disorders, and organic depression. As clinician, the main concern is to offer customized therapeutic solutions for the patients.
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Papers by Daniela Reisz

Migraine and Gallbladder Motility

European Scientific Journal, 2016

Introduction Five (5) hydroxitryptamine (5-HT) selective receptor agonists (triptans) were report... more Introduction Five (5) hydroxitryptamine (5-HT) selective receptor agonists (triptans) were reported to have gastric motor effects. However, less is known about their role on gallbladder (GB) motility. Aim: Assessment of GB motility in patients treated with orodispersable triptans for migraine's attacks. Patients and Methods: Out of 112 patients with various forms of migraine who required triptans while having headache attacks, followed-up in our ambulatory service, we have selected 30 patients diagnosed with mild to moderate migraine. These patients include: 15 with aura (3 men, 12 women, mean age=41,8±16,42 years) and 15 without aura (2 men, 13 women, mean age=47,73±18,50 years). Consequently, they had an ejection fraction (EF) of GB which is less than 60% (previously measured in intercritic period by elipsoid ultrasound Dodds method). Furthermore, no record of prokinetic or proton pump inhibitor treatments, gastric surgery, gallstones, collagen or thyroid disease, diabetes mellitus, cardiac, liver, kidney failure or cancer disease was recorded. The measurements of the GB were made while having a migraine attack, before and in every 15 minutes till 90 minutes. This was after receiving 5 mg of orodispersable zolmitriptan. Results: There are no statistical significant difference between initially EF of the two groups (p=0,8190). Patients with migraine with aura showed a mean EF=42,53±4,31% before therapy. After therapy, the mean EF improved significantly: 48,80±3,23% (p=0,0001). Patients having migraine without aura displayed an initially mean EF=42,53±3,27%. In addition, they had a very statistically significant response to therapy with important improvement of EF to 61,47±7,07% (p<0,0001). Conclusions: 5HT selective receptor agonists increased GB motility, in migraine attacks with a response above the cutoff range of EF, in patients having migraine without aura.

Cognitive impairment aspects in subcortical dementia patients

Journal of the Neurological Sciences, 2009

Portal vein thrombosis in patients with liver cirrhosis and its impact on early and long‐term outcomes after liver transplantation

International Journal of Clinical Practice, 2018

Portal vein thrombosis in patients with liver cirrhosis and its impact on early and long term out... more

P.5.a.002 Relationships between writing errors and cognitive impairment in elderly psychiatric patients

European Neuropsychopharmacology, 2006

P02-290 - Cognitive impairment and altered emotional status related to type II diabetes mellitus

European Psychiatry, 2011

The aim of the study was to reveal the cognitive and emotional status of diabetic inpatients with... more The aim of the study was to reveal the cognitive and emotional status of diabetic inpatients with no formal neurological and psychiatric complains (N = 68, consecutively admitted in a 6 week period, February-March 2009 in our hospital). We collected and interpreted: demographic data, cognitive (MMSE, clock drawing test) and emotional state (MADRS, GDS, HADS, PANI) assessments, the HoNos scale for general functioning of patients, items related to diabetes treatment and complications. Demographics showed in average (years): age 63,5; education 8,7; diabetes evolution 10,4. We found undiagnosed: mild cognitive decline (average MMSE = 25), subsyndromal depression (31%) and clinical depression (33%), high levels of anxiety (63%) and sleep complains (81%). 54% of subjects reported significant life events in the past year, more often the newly diagnosed ones. The multivariate analysis showed that depression and cognitive impairment have a differentiated clinical pattern depending on the du...

Obesity in association with Sleep Apnea Syndrome as predictor for coronary-vascular comorbidities Obezitatea în asociere cu sindromul de apnee în somn ca predictor pentru comorbidităţile coronaro-vasculare

Sleep apnea syndrome (SAS) is a common disorder with growing awareness. We sought to evaluate if ... more Sleep apnea syndrome (SAS) is a common disorder with growing awareness. We sought to evaluate if the presence of obesity in patients with SAS is associated with a high risk for development of coronary-vascular comorbidities. We performed a retrospective study that included 1370 patients (30.3% female and 69.7% male) diagnosed with SAS from May 2005 to May 2012. The collected data included body mass index (BMI), waist/ hip ratio, abdominal, neck, hip circumference and Epworth Sleepiness Scale. The positive diagnostic of SAS was based on apnea-hypopnea index (AHI) provided by polysomnography, and patient comorbidities were obtained from the sleep laboratory records. From the total of 1370 patients, 989 (72%) had grade I to III obesity, 305 (22%) were overweight and only 76 (6%) had a normal weight. Cardiovascular comorbidities were presented in 60.6% of patients, with coronary disease ranking first (34.2%) followed by heart failure (22.6%) and stroke (3.8%). The predictors for cardiovascular comorbidities were coronary disease (OR 2.1, 95% Cl 1.20-3.39, p = 0.0063), heart failure (OR 3.44, 95% Cl 1.60-7.74, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) but not stroke (OR 2.3 95% Cl 0.57-13.84, p = 0.357). Analyzing the polysomnography parameters we found a strong correlation for AHI (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), oxygen desaturation index (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and mean average oxyhaemoglobin saturation (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Overweight and obese patients with SAS have a poor outcome, being at high risk of developing other comorbidities like coronary disease and heart failure.

Comparison of Composite Lipid Indices in Patients with Obstructive Sleep Apnoea

Nature and Science of Sleep

Obstructive sleep apnoea (OSA) is a recognised risk factor for cardiovascular disease. However, i... more Obstructive sleep apnoea (OSA) is a recognised risk factor for cardiovascular disease. However, it is difficult to evaluate the risk of cardiovascular disease in patients with OSA due to multiple shared risk factors. Composite lipid indices, such as atherogenic index of plasma (AIP), visceral adiposity index (VAI) and lipid accumulation product (LAP) have been shown to predict cardiovascular disease better than their individual lipid components. This study aimed to evaluate these indices in patients with OSA. Patients and Methods: Six hundred sixty-seven (667) patients with OSA and 139 non-OSA control volunteers participated in the study. Fasting serum triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C) levels were measured, and AIP, LAP and VAI were calculated following cardiorespiratory polygraphy. The relationship between lipid parameters, OSA and its comorbidities was evaluated using receiver operating curve (ROC) analysis. Results: We found a significant difference in all lipid parameters between OSA patients and controls. Comparing ROCs, LAP was significantly more strongly associated with OSA compared to all the other parameters. The optimal cutoff value for LAP to detect OSA was 76.4, with a sensitivity of 63% and a specificity of 76%. In addition, LAP was the best parameter to predict hypertension and diabetes in patients with OSA, and it was predictive for ischaemic heart disease together with HDL-C. Conclusion: Our results support the use of LAP in clinical practice when evaluating cardiovascular risk in patients with OSA. However, the optimal cutoff value should be determined in large-scale follow-up studies.

Mild Cognitive Impairment (MCI) – Current Relevance of the Concept

Romanian Journal of Neurology, 2008

The term 'mild cognitive impairment' has been introduced to represent the border between ... more The term 'mild cognitive impairment' has been introduced to represent the border between frank dementia and changes related to aging. How do the memory difficulties in MCI differ from those of normal aging? This is a very difficult question which has no permanent answer yet. This review discusses the definition of terms in the field of cognitive impairment and the relevance for current clinical settings and clinical trials.

NMS in Parkinson Syndrome – focus on cardiovascular aspect

Ischemic Stroke Secondary to Cerebral Venous Thrombosis: A Case Report

Central European Annals of Clinical Research, 2019

A 26 year old woman was admitted to the emergency room 2 weeks after delivery of a healthy baby b... more A 26 year old woman was admitted to the emergency room 2 weeks after delivery of a healthy baby by cesarean(C) section, presenting right hemiparesis and speech disturbances, preceded by headaches. Clinical examination, biochemical tests, magnetic resonance imaging (MRI) and MRA (magnetic resonance angiogram) confirmed the diagnosis of ischemic stroke due to a cerebral venous thrombosis with secondary hemorrhage transformation. Further coagulation work-ups revealed a possible thrombogenic condition with important protein S deficiency. Many therapeutic challenges have been encountered. Multiple seizures attacks further complicated the whole clinical picture, but a gradually recovery was slowly achieved. By the day of discharge, her neurological status greatly improved. A temporary headache was reported after hospital discharge with alleviation in time.

Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?

Clinical Interventions in Aging, 2016

Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequentl... more Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequently reported in Parkinson's disease (PD), no therapeutic guidelines are available. This study aimed to manage some lower GI-NMS in a group of patients with PD. A total of 40 patients (17 males, 23 females; mean age 76.05±2.09 years) were randomly selected for this study. Patients were confirmed to have PD (modified Hoehn-Yars scale: 2.075±0.4) who had undergone levodopa or dopamine agonist treatment. In the non-motor symptoms questionnaire (NMS-Quest), regarding GI complaints, the following were recorded: abdominal pain, bloating, and constipation of mild-to-moderate severity. Laboratory studies, abdominal ultrasound, and upper and lower digestive endoscopies were performed to rule out organic issues. All patients increased their water intake to 2 L/d and alimentary fiber to 20-25 g/d. Twenty patients received trimebutine 200 mg three times daily half an hour before meals. The other 20 patients received probiotics (60 mg per-tablet of two lactic bacteria: Lactobacillus acidophilus and Bifidobacterium infantis), 2×/d, 1 hour after meals for 3 months along with the reassessment of GI complaints. Our results demonstrated that there were significant statistical differences in all assessed symptoms in the first group: 1.55±0.51 vs 0.6±0.5 (P,0.0001) for abdominal pain; 1.6±0.5 vs 0.45±0.51 (P,0.0001) for bloating; and 1.5±0.51 vs 0.85±0.67 (P=0.0014) for constipation with incomplete defecation. The second group displayed statistical differences only for abdominal pain 1.45±0.51 vs 1.05±0.69 (P=0.00432) and bloating 1.4±0.5 vs 0.3±0.47 (P,0.0001). For constipation with incomplete defecation, there was a slight improvement. Thus, there was no significant statistical difference: 1.35±0.49 vs 1.15±0.49 (P=0.2040). In conclusion, lower GI-NMS are frequently present, isolated or associated with other autonomic issues, even before the diagnosis of PD. Treatment with probiotics could improve abdominal pain and bloating as much as with trimebutine, but less for constipation with incomplete evacuation, where trimebutine showed better results.

CROSS-BORDER COOPERATION AND REGIONAL IDENTITIES IN THE BALKANS Introduction

SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea

PloS one, 2018

This paper investigates a novel screening tool for Obstructive Sleep Apnea Syndrome (OSAS), which... more This paper investigates a novel screening tool for Obstructive Sleep Apnea Syndrome (OSAS), which aims at efficient population-wide monitoring. To this end, we introduce SASscore which provides better OSAS prediction specificity while maintaining a high sensitivity. We process a cohort of 2595 patients from 4 sleep laboratories in Western Romania, by recording over 100 sleep, breathing, and anthropometric measurements per patient; using this data, we compare our SASscore with state of the art scores STOP-Bang and NoSAS through area under curve (AUC), sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). We also evaluate the performance of SASscore by considering different Apnea-Hypopnea Index (AHI) diagnosis cut-off points and show that custom refinements are possible by changing the score's threshold. SASscore takes decimal values within the interval (2, 7) and varies linearly with AHI; it is based on standardized measures for BMI, neck...

Perspectives on Mass Media and Governmental Measures during the 2020 COVID-19 Pandemic in a Romanian Sample of Healthcare Practitioners

Healthcare, 2022

Objective: Along with the rapid spread of the COVID-19 pandemic around the globe, a proliferation... more Objective: Along with the rapid spread of the COVID-19 pandemic around the globe, a proliferation of mass media information exposed the population to an infodemic with various implications documented worldwide. The present study analyzed Romanian healthcare practitioners’ (HCPs) appraisal of COVID-19 mass media information and governmental measures throughout 2020, ranking vaccination priorities and moral values. Methods: 97 HCP completed a cross-sectional survey with items referring to the COVID-19 pandemic in 2020. Results: Findings were consistent with other studies, indicating an overall negative appraisal of mass media information, which predicted anxiety and relaxation difficulties. Unlike other studies, our sample reported a moderate level of satisfaction with official measures in 2020, which was not related to their view on mass media information. The ranking of population categories in the vaccination order showed similarities with the governmental vaccination program in 20...

NMDA Autoimmune Encephalitis and Severe Persistent Hypokalemia in a Pregnant Woman

Brain Sciences

For more than a decade, NMDAR autoimmune encephalitis has been studied and treated as a neurologi... more For more than a decade, NMDAR autoimmune encephalitis has been studied and treated as a neurological condition, and good results have been achieve through immune therapies. Apart from being well represented in the CNS, NMDA receptors are currently known of and being studied in multiple non-neuronal cells with potential clinical significance. The association of NMDAR autoimmune encephalitis with pregnancy is rare, and hypokalemia is not mentioned. Methods: We present the case of a 30-year-old woman with NMDAR autoimmune encephalitis in her 17th week of pregnancy associated with persistent hypokalemia that had no apparent cause and resisted Kalium chloride supplementation. A diagnostic work-up including clinical, laboratory, and imagistic examinations, was performed. The case was monitored between May and September 2016 at Neurology, SCJUT. Results: Severe hypokalemia with normal serum sodium levels persisted throughout the course of clinical manifestation of anti-NMDAR autoimmune enc...

Perspectives on Mass Media and Governmental Measures during the 2020 COVID-19 Pandemic in a Romanian Sample of Healthcare Practitioners

Healthcare, 2022

Objective: Along with the rapid spread of the COVID-19 pandemic around the globe, a proliferation... more Objective: Along with the rapid spread of the COVID-19 pandemic around the globe,
a proliferation of mass media information exposed the population to an infodemic with various
implications documented worldwide. The present study analyzed Romanian healthcare practitioners’
(HCPs) appraisal of COVID-19 mass media information and governmental measures throughout 2020,
ranking vaccination priorities and moral values. Methods: 97 HCP completed a cross-sectional survey
with items referring to the COVID-19 pandemic in 2020. Results: Findings were consistent with
other studies, indicating an overall negative appraisal of mass media information, which predicted
anxiety and relaxation difficulties. Unlike other studies, our sample reported a moderate level
of satisfaction with official measures in 2020, which was not related to their view on mass media
information. The ranking of population categories in the vaccination order showed similarities with
the governmental vaccination program in 2021. Despite placing freedom third after health and love in
the hierarchy of values, HCPs showed a high tendency of limiting individual liberty for the common
good. Conclusions: Results showed a dissociation between the overall negative appraisal of mass
media information and the satisfaction with governmental measures in 2020. Romanian HCPs shared
a secular perspective on moral values and assumed an authoritarian position.

The Protective Effect of Some Antioxidants on Aluminium Accumulation in Sexual Organs and Accessory Glands of Male Rats

The aim of the study was to evaluate the protective status of an antioxidant combination (melaton... more The aim of the study was to evaluate the protective status of an antioxidant combination (melatonin and Sempervivum tectorum extract) on aluminium accumulation in genital organs of male rats. The 12 weeks study was carried out on 35 Wistar male rats divided in five groups: C – control, receiving distillated water; E1 – aluminium sulphate 0.1 mg/L; E2 – melatonin 10 mg/kg b.w. in drinking water; E3 – 6% aqueous extract of Sempervivum tectorum; E4 – combination, melatonin and plant extract. The study pointed out the significant (p<0.001) accumulation of aluminium in testis and accessory glands comparative to control. The aluminium level was significantly (p<0.05) reduced in groups exposed to melatonin and S. tectorum extract compared to aluminium exposed group, remaining still significantly (p<0.05) higher than in control. The combination of used antioxidants (E4) was proven more efficient in protection against aluminium accumulation, especially in testis.

Stress and Bio-Ethical Issues Perceived by Romanian Healthcare Practitioners in the COVID-19 Era

International Journal of Environmental Research and Public Health

Objective: The COVID-19 pandemic had a major impact on different areas of life, especially in the... more Objective: The COVID-19 pandemic had a major impact on different areas of life, especially in the medical system. Because of the pandemic outbreak, the medical system was remodeled to treat COVID-19 patients in secure conditions. Those changes and restrictive measures have put pressure on individual adaptability. The present study investigated the stress of Romanian healthcare practitioners (HCP) and the capacity to deal with new bio-ethical issues that emerged during the COVID-19 pandemic in 2020. Methods: We analyzed results from a survey on 97 Romanian HCP in several areas: personal experience with COVID-19, perceived emotional distress, and appraisal of bio-ethical principles respected or infringed during the pandemic in 2020. Results: Unlike previous studies, our respondents reported low to moderate stress levels. In addition, few bio-ethical principles were infringed on a personal level. Tendencies to sacrifice individual autonomy and make decisions affecting patients and co-w...

Obesity in association with Sleep Apnea Syndrome as predictor for coronary-vascular comorbidities

Poster, 2016

BACKGROUND AND AIMS Sleep apnea syndrome (SAS) is a common disorder with growing awareness. We so... more BACKGROUND AND AIMS Sleep apnea syndrome (SAS) is a common disorder with growing awareness. We sought to evaluate if the presence of obesity in patients with SAS is associated with a high risk for development of coronary-vascular comorbidities. METHODS We performed a retrospective study that included 1370 patients (30.3% female and 69.7% male) diagnosed with SAS from May 2005 to May 2012. The collected data included body mass index (BMI), waist/ hip ratio, abdominal, neck, hip circumference and Epworth Sleepiness Scale. The positive diagnostic of SAS was based on apnea-hypopnea index (AHI) provided by polysomnography, and patient comorbidities were obtained from the sleep laboratory records. RESULTS From the total of 1370 patients, 989 (72%) had grade I to III obesity, 305 (22%) were overweight and only 76 (6%) had a normal weight. Cardiovascular comorbidities were presented in 60.6% of patients, with coronary disease ranking first (34.2%) followed by heart failure (22.6%) and strok...

HypErpErfUsIon syndroME coMplIcatIng ExtracranIal carotId artEry stEntIng

Received for publication: Mar. 16, 2006. Revised: Sep 12, 2006. rEZUMat 1 Institute of Cardiovasc... more

Migraine and Gallbladder Motility

European Scientific Journal, 2016

Introduction Five (5) hydroxitryptamine (5-HT) selective receptor agonists (triptans) were report... more Introduction Five (5) hydroxitryptamine (5-HT) selective receptor agonists (triptans) were reported to have gastric motor effects. However, less is known about their role on gallbladder (GB) motility. Aim: Assessment of GB motility in patients treated with orodispersable triptans for migraine's attacks. Patients and Methods: Out of 112 patients with various forms of migraine who required triptans while having headache attacks, followed-up in our ambulatory service, we have selected 30 patients diagnosed with mild to moderate migraine. These patients include: 15 with aura (3 men, 12 women, mean age=41,8±16,42 years) and 15 without aura (2 men, 13 women, mean age=47,73±18,50 years). Consequently, they had an ejection fraction (EF) of GB which is less than 60% (previously measured in intercritic period by elipsoid ultrasound Dodds method). Furthermore, no record of prokinetic or proton pump inhibitor treatments, gastric surgery, gallstones, collagen or thyroid disease, diabetes mellitus, cardiac, liver, kidney failure or cancer disease was recorded. The measurements of the GB were made while having a migraine attack, before and in every 15 minutes till 90 minutes. This was after receiving 5 mg of orodispersable zolmitriptan. Results: There are no statistical significant difference between initially EF of the two groups (p=0,8190). Patients with migraine with aura showed a mean EF=42,53±4,31% before therapy. After therapy, the mean EF improved significantly: 48,80±3,23% (p=0,0001). Patients having migraine without aura displayed an initially mean EF=42,53±3,27%. In addition, they had a very statistically significant response to therapy with important improvement of EF to 61,47±7,07% (p<0,0001). Conclusions: 5HT selective receptor agonists increased GB motility, in migraine attacks with a response above the cutoff range of EF, in patients having migraine without aura.

Cognitive impairment aspects in subcortical dementia patients

Journal of the Neurological Sciences, 2009

Portal vein thrombosis in patients with liver cirrhosis and its impact on early and long‐term outcomes after liver transplantation

International Journal of Clinical Practice, 2018

Portal vein thrombosis in patients with liver cirrhosis and its impact on early and long term out... more

P.5.a.002 Relationships between writing errors and cognitive impairment in elderly psychiatric patients

European Neuropsychopharmacology, 2006

P02-290 - Cognitive impairment and altered emotional status related to type II diabetes mellitus

European Psychiatry, 2011

The aim of the study was to reveal the cognitive and emotional status of diabetic inpatients with... more The aim of the study was to reveal the cognitive and emotional status of diabetic inpatients with no formal neurological and psychiatric complains (N = 68, consecutively admitted in a 6 week period, February-March 2009 in our hospital). We collected and interpreted: demographic data, cognitive (MMSE, clock drawing test) and emotional state (MADRS, GDS, HADS, PANI) assessments, the HoNos scale for general functioning of patients, items related to diabetes treatment and complications. Demographics showed in average (years): age 63,5; education 8,7; diabetes evolution 10,4. We found undiagnosed: mild cognitive decline (average MMSE = 25), subsyndromal depression (31%) and clinical depression (33%), high levels of anxiety (63%) and sleep complains (81%). 54% of subjects reported significant life events in the past year, more often the newly diagnosed ones. The multivariate analysis showed that depression and cognitive impairment have a differentiated clinical pattern depending on the du...

Obesity in association with Sleep Apnea Syndrome as predictor for coronary-vascular comorbidities Obezitatea în asociere cu sindromul de apnee în somn ca predictor pentru comorbidităţile coronaro-vasculare

Sleep apnea syndrome (SAS) is a common disorder with growing awareness. We sought to evaluate if ... more Sleep apnea syndrome (SAS) is a common disorder with growing awareness. We sought to evaluate if the presence of obesity in patients with SAS is associated with a high risk for development of coronary-vascular comorbidities. We performed a retrospective study that included 1370 patients (30.3% female and 69.7% male) diagnosed with SAS from May 2005 to May 2012. The collected data included body mass index (BMI), waist/ hip ratio, abdominal, neck, hip circumference and Epworth Sleepiness Scale. The positive diagnostic of SAS was based on apnea-hypopnea index (AHI) provided by polysomnography, and patient comorbidities were obtained from the sleep laboratory records. From the total of 1370 patients, 989 (72%) had grade I to III obesity, 305 (22%) were overweight and only 76 (6%) had a normal weight. Cardiovascular comorbidities were presented in 60.6% of patients, with coronary disease ranking first (34.2%) followed by heart failure (22.6%) and stroke (3.8%). The predictors for cardiovascular comorbidities were coronary disease (OR 2.1, 95% Cl 1.20-3.39, p = 0.0063), heart failure (OR 3.44, 95% Cl 1.60-7.74, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) but not stroke (OR 2.3 95% Cl 0.57-13.84, p = 0.357). Analyzing the polysomnography parameters we found a strong correlation for AHI (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001), oxygen desaturation index (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and mean average oxyhaemoglobin saturation (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Overweight and obese patients with SAS have a poor outcome, being at high risk of developing other comorbidities like coronary disease and heart failure.

Comparison of Composite Lipid Indices in Patients with Obstructive Sleep Apnoea

Nature and Science of Sleep

Obstructive sleep apnoea (OSA) is a recognised risk factor for cardiovascular disease. However, i... more Obstructive sleep apnoea (OSA) is a recognised risk factor for cardiovascular disease. However, it is difficult to evaluate the risk of cardiovascular disease in patients with OSA due to multiple shared risk factors. Composite lipid indices, such as atherogenic index of plasma (AIP), visceral adiposity index (VAI) and lipid accumulation product (LAP) have been shown to predict cardiovascular disease better than their individual lipid components. This study aimed to evaluate these indices in patients with OSA. Patients and Methods: Six hundred sixty-seven (667) patients with OSA and 139 non-OSA control volunteers participated in the study. Fasting serum triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C) levels were measured, and AIP, LAP and VAI were calculated following cardiorespiratory polygraphy. The relationship between lipid parameters, OSA and its comorbidities was evaluated using receiver operating curve (ROC) analysis. Results: We found a significant difference in all lipid parameters between OSA patients and controls. Comparing ROCs, LAP was significantly more strongly associated with OSA compared to all the other parameters. The optimal cutoff value for LAP to detect OSA was 76.4, with a sensitivity of 63% and a specificity of 76%. In addition, LAP was the best parameter to predict hypertension and diabetes in patients with OSA, and it was predictive for ischaemic heart disease together with HDL-C. Conclusion: Our results support the use of LAP in clinical practice when evaluating cardiovascular risk in patients with OSA. However, the optimal cutoff value should be determined in large-scale follow-up studies.

Mild Cognitive Impairment (MCI) – Current Relevance of the Concept

Romanian Journal of Neurology, 2008

The term 'mild cognitive impairment' has been introduced to represent the border between ... more The term 'mild cognitive impairment' has been introduced to represent the border between frank dementia and changes related to aging. How do the memory difficulties in MCI differ from those of normal aging? This is a very difficult question which has no permanent answer yet. This review discusses the definition of terms in the field of cognitive impairment and the relevance for current clinical settings and clinical trials.

NMS in Parkinson Syndrome – focus on cardiovascular aspect

Ischemic Stroke Secondary to Cerebral Venous Thrombosis: A Case Report

Central European Annals of Clinical Research, 2019

A 26 year old woman was admitted to the emergency room 2 weeks after delivery of a healthy baby b... more A 26 year old woman was admitted to the emergency room 2 weeks after delivery of a healthy baby by cesarean(C) section, presenting right hemiparesis and speech disturbances, preceded by headaches. Clinical examination, biochemical tests, magnetic resonance imaging (MRI) and MRA (magnetic resonance angiogram) confirmed the diagnosis of ischemic stroke due to a cerebral venous thrombosis with secondary hemorrhage transformation. Further coagulation work-ups revealed a possible thrombogenic condition with important protein S deficiency. Many therapeutic challenges have been encountered. Multiple seizures attacks further complicated the whole clinical picture, but a gradually recovery was slowly achieved. By the day of discharge, her neurological status greatly improved. A temporary headache was reported after hospital discharge with alleviation in time.

Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?

Clinical Interventions in Aging, 2016

Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequentl... more Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequently reported in Parkinson's disease (PD), no therapeutic guidelines are available. This study aimed to manage some lower GI-NMS in a group of patients with PD. A total of 40 patients (17 males, 23 females; mean age 76.05±2.09 years) were randomly selected for this study. Patients were confirmed to have PD (modified Hoehn-Yars scale: 2.075±0.4) who had undergone levodopa or dopamine agonist treatment. In the non-motor symptoms questionnaire (NMS-Quest), regarding GI complaints, the following were recorded: abdominal pain, bloating, and constipation of mild-to-moderate severity. Laboratory studies, abdominal ultrasound, and upper and lower digestive endoscopies were performed to rule out organic issues. All patients increased their water intake to 2 L/d and alimentary fiber to 20-25 g/d. Twenty patients received trimebutine 200 mg three times daily half an hour before meals. The other 20 patients received probiotics (60 mg per-tablet of two lactic bacteria: Lactobacillus acidophilus and Bifidobacterium infantis), 2×/d, 1 hour after meals for 3 months along with the reassessment of GI complaints. Our results demonstrated that there were significant statistical differences in all assessed symptoms in the first group: 1.55±0.51 vs 0.6±0.5 (P,0.0001) for abdominal pain; 1.6±0.5 vs 0.45±0.51 (P,0.0001) for bloating; and 1.5±0.51 vs 0.85±0.67 (P=0.0014) for constipation with incomplete defecation. The second group displayed statistical differences only for abdominal pain 1.45±0.51 vs 1.05±0.69 (P=0.00432) and bloating 1.4±0.5 vs 0.3±0.47 (P,0.0001). For constipation with incomplete defecation, there was a slight improvement. Thus, there was no significant statistical difference: 1.35±0.49 vs 1.15±0.49 (P=0.2040). In conclusion, lower GI-NMS are frequently present, isolated or associated with other autonomic issues, even before the diagnosis of PD. Treatment with probiotics could improve abdominal pain and bloating as much as with trimebutine, but less for constipation with incomplete evacuation, where trimebutine showed better results.

CROSS-BORDER COOPERATION AND REGIONAL IDENTITIES IN THE BALKANS Introduction

SAS score: Targeting high-specificity for efficient population-wide monitoring of obstructive sleep apnea

PloS one, 2018

This paper investigates a novel screening tool for Obstructive Sleep Apnea Syndrome (OSAS), which... more This paper investigates a novel screening tool for Obstructive Sleep Apnea Syndrome (OSAS), which aims at efficient population-wide monitoring. To this end, we introduce SASscore which provides better OSAS prediction specificity while maintaining a high sensitivity. We process a cohort of 2595 patients from 4 sleep laboratories in Western Romania, by recording over 100 sleep, breathing, and anthropometric measurements per patient; using this data, we compare our SASscore with state of the art scores STOP-Bang and NoSAS through area under curve (AUC), sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). We also evaluate the performance of SASscore by considering different Apnea-Hypopnea Index (AHI) diagnosis cut-off points and show that custom refinements are possible by changing the score's threshold. SASscore takes decimal values within the interval (2, 7) and varies linearly with AHI; it is based on standardized measures for BMI, neck...

Perspectives on Mass Media and Governmental Measures during the 2020 COVID-19 Pandemic in a Romanian Sample of Healthcare Practitioners

Healthcare, 2022

Objective: Along with the rapid spread of the COVID-19 pandemic around the globe, a proliferation... more Objective: Along with the rapid spread of the COVID-19 pandemic around the globe, a proliferation of mass media information exposed the population to an infodemic with various implications documented worldwide. The present study analyzed Romanian healthcare practitioners’ (HCPs) appraisal of COVID-19 mass media information and governmental measures throughout 2020, ranking vaccination priorities and moral values. Methods: 97 HCP completed a cross-sectional survey with items referring to the COVID-19 pandemic in 2020. Results: Findings were consistent with other studies, indicating an overall negative appraisal of mass media information, which predicted anxiety and relaxation difficulties. Unlike other studies, our sample reported a moderate level of satisfaction with official measures in 2020, which was not related to their view on mass media information. The ranking of population categories in the vaccination order showed similarities with the governmental vaccination program in 20...

NMDA Autoimmune Encephalitis and Severe Persistent Hypokalemia in a Pregnant Woman

Brain Sciences

For more than a decade, NMDAR autoimmune encephalitis has been studied and treated as a neurologi... more For more than a decade, NMDAR autoimmune encephalitis has been studied and treated as a neurological condition, and good results have been achieve through immune therapies. Apart from being well represented in the CNS, NMDA receptors are currently known of and being studied in multiple non-neuronal cells with potential clinical significance. The association of NMDAR autoimmune encephalitis with pregnancy is rare, and hypokalemia is not mentioned. Methods: We present the case of a 30-year-old woman with NMDAR autoimmune encephalitis in her 17th week of pregnancy associated with persistent hypokalemia that had no apparent cause and resisted Kalium chloride supplementation. A diagnostic work-up including clinical, laboratory, and imagistic examinations, was performed. The case was monitored between May and September 2016 at Neurology, SCJUT. Results: Severe hypokalemia with normal serum sodium levels persisted throughout the course of clinical manifestation of anti-NMDAR autoimmune enc...

Perspectives on Mass Media and Governmental Measures during the 2020 COVID-19 Pandemic in a Romanian Sample of Healthcare Practitioners

Healthcare, 2022

Objective: Along with the rapid spread of the COVID-19 pandemic around the globe, a proliferation... more Objective: Along with the rapid spread of the COVID-19 pandemic around the globe,
a proliferation of mass media information exposed the population to an infodemic with various
implications documented worldwide. The present study analyzed Romanian healthcare practitioners’
(HCPs) appraisal of COVID-19 mass media information and governmental measures throughout 2020,
ranking vaccination priorities and moral values. Methods: 97 HCP completed a cross-sectional survey
with items referring to the COVID-19 pandemic in 2020. Results: Findings were consistent with
other studies, indicating an overall negative appraisal of mass media information, which predicted
anxiety and relaxation difficulties. Unlike other studies, our sample reported a moderate level
of satisfaction with official measures in 2020, which was not related to their view on mass media
information. The ranking of population categories in the vaccination order showed similarities with
the governmental vaccination program in 2021. Despite placing freedom third after health and love in
the hierarchy of values, HCPs showed a high tendency of limiting individual liberty for the common
good. Conclusions: Results showed a dissociation between the overall negative appraisal of mass
media information and the satisfaction with governmental measures in 2020. Romanian HCPs shared
a secular perspective on moral values and assumed an authoritarian position.

The Protective Effect of Some Antioxidants on Aluminium Accumulation in Sexual Organs and Accessory Glands of Male Rats

The aim of the study was to evaluate the protective status of an antioxidant combination (melaton... more The aim of the study was to evaluate the protective status of an antioxidant combination (melatonin and Sempervivum tectorum extract) on aluminium accumulation in genital organs of male rats. The 12 weeks study was carried out on 35 Wistar male rats divided in five groups: C – control, receiving distillated water; E1 – aluminium sulphate 0.1 mg/L; E2 – melatonin 10 mg/kg b.w. in drinking water; E3 – 6% aqueous extract of Sempervivum tectorum; E4 – combination, melatonin and plant extract. The study pointed out the significant (p<0.001) accumulation of aluminium in testis and accessory glands comparative to control. The aluminium level was significantly (p<0.05) reduced in groups exposed to melatonin and S. tectorum extract compared to aluminium exposed group, remaining still significantly (p<0.05) higher than in control. The combination of used antioxidants (E4) was proven more efficient in protection against aluminium accumulation, especially in testis.

Stress and Bio-Ethical Issues Perceived by Romanian Healthcare Practitioners in the COVID-19 Era

International Journal of Environmental Research and Public Health

Objective: The COVID-19 pandemic had a major impact on different areas of life, especially in the... more Objective: The COVID-19 pandemic had a major impact on different areas of life, especially in the medical system. Because of the pandemic outbreak, the medical system was remodeled to treat COVID-19 patients in secure conditions. Those changes and restrictive measures have put pressure on individual adaptability. The present study investigated the stress of Romanian healthcare practitioners (HCP) and the capacity to deal with new bio-ethical issues that emerged during the COVID-19 pandemic in 2020. Methods: We analyzed results from a survey on 97 Romanian HCP in several areas: personal experience with COVID-19, perceived emotional distress, and appraisal of bio-ethical principles respected or infringed during the pandemic in 2020. Results: Unlike previous studies, our respondents reported low to moderate stress levels. In addition, few bio-ethical principles were infringed on a personal level. Tendencies to sacrifice individual autonomy and make decisions affecting patients and co-w...

Obesity in association with Sleep Apnea Syndrome as predictor for coronary-vascular comorbidities

Poster, 2016

BACKGROUND AND AIMS Sleep apnea syndrome (SAS) is a common disorder with growing awareness. We so... more BACKGROUND AND AIMS Sleep apnea syndrome (SAS) is a common disorder with growing awareness. We sought to evaluate if the presence of obesity in patients with SAS is associated with a high risk for development of coronary-vascular comorbidities. METHODS We performed a retrospective study that included 1370 patients (30.3% female and 69.7% male) diagnosed with SAS from May 2005 to May 2012. The collected data included body mass index (BMI), waist/ hip ratio, abdominal, neck, hip circumference and Epworth Sleepiness Scale. The positive diagnostic of SAS was based on apnea-hypopnea index (AHI) provided by polysomnography, and patient comorbidities were obtained from the sleep laboratory records. RESULTS From the total of 1370 patients, 989 (72%) had grade I to III obesity, 305 (22%) were overweight and only 76 (6%) had a normal weight. Cardiovascular comorbidities were presented in 60.6% of patients, with coronary disease ranking first (34.2%) followed by heart failure (22.6%) and strok...

HypErpErfUsIon syndroME coMplIcatIng ExtracranIal carotId artEry stEntIng

Received for publication: Mar. 16, 2006. Revised: Sep 12, 2006. rEZUMat 1 Institute of Cardiovasc... more

Simptome și complicații non-motorii ale Bolii Parkinson

by Daniela Reisz and Daniela Reisz

Pornind de la ipoteza progresiunii leziunilor morfopatologice a bolii Parkinson propusă de Braak,... more Pornind de la ipoteza progresiunii leziunilor morfopatologice a bolii Parkinson propusă de Braak, putem înțelege amploarea semnelor și simptomelor din boala Parkinson. Totodată mecanismul propus de Braak explică afectarea multisistemică din boala Parkinson și implicarea mai multor sisteme de mediatori în generarea acestei boli. Prin urmare, atât semnele motorii cât mai ales semnele non-motorii din boala Parkinson au putut fi clasificate ca dopaminergice și non dopaminergice. Semnele dopaminergice răspund la tratamentul cu levodopa, agonisti dopaminergici și alte clase de substanțe care influențeză metabolismul dopaminei, pe când cele non-dopaminergice nu răspund la acestea. Manifestările non motorii din boala Parkinson sunt în relație cu istoria naturală a bolii sau în relație cu tratamentul. Un studiu arată că 21% din pacienții cu boală Parkinson dovedită morfopatologic au debut cu semne nonmotorii. Pacienții care au avut la început exclusiv semne non-motorii au un diagnostic întârziat cu 1,6 ani comparativ cu cei cu debut motor care au diagnosticul întârziat cu un an (1). Prin afectarea nucleilor din trunchiul cerebral, a sistemului limbic si a telencefalului, Boala Parkinson se manifestă cu o pleiadă de semne psihiatrice și este considerată o adevărată boală neuropsihică.

Evaluarea clinoco-funcțională, principii de tratament și recuperare neurologică în bolile neuro-degenerative

Evaluarea clinoco-funcțională, principii de tratament și recuperare neurologică în bolile neuro-degenerative, 2024

This book is a course support for students on 'The rehabilitation of neurologic diseases' - maste... more This book is a course support for students on 'The rehabilitation of neurologic diseases' - master studies. It offers key knowledge on Parkinson's disease, Multiple Sclerosis, Amyotrophic Lateral Sclerosis and Dystonia. The information is helpful to understand the main principles of rehabilitation in degenerative neurological disorders.