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Brasoveanu S, Ilina R, Balulescu L, Pirtea M, Secosan C, Grigoraș D, Chiriac D, Bardan R, Margan MM, Alexandru A, Pirtea L. Laparoscopic Pectopexy versus Vaginal Sacrospinous Ligament Fixation in the Treatment of Apical Prolapse. Life (Basel) 2023; 13:1951. [PMID: 37895333 PMCID: PMC10608133 DOI: 10.3390/life13101951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVES To compare the follow-up results of a sacrospinous ligament fixation (SSLF) technique for laparoscopic bilateral fixation of the vagina to the iliopectineal ligament via a PVDF-mesh (laparoscopic pectopexy technique, LP) in terms of cure rate and postoperative complications rate. MATERIAL AND METHODS This prospective study included 160 patients diagnosed with pelvic organ prolapse stage II-IV according to the POP-Q system. Eighty-two patients (51.25%) underwent vaginal sacrospinous ligament fixation and seventy-eight patients (48.75%) underwent the laparoscopic pectopexy procedure. RESULTS The cure rate was high in both groups, 95.12% of the patients (78 out of 82) in the SSLF group and 93.59% of the patients (73 out of 78) in the LP group were cured post surgery, leading to an overall cure rate of 151 out of 160 patients. Pelvic pain was present in 5.00% of all patients, but was notably more frequent in the SSLF group (7, 8.54%) than in the LP group (1, 1.28%). Dyspareunia occurred in 4.37% of all patients, slightly more frequently in the SSLF group (6, 7.32%) than the LP group (1, 1.28%), but without significant difference. CONCLUSIONS The laparoscopic pectopexy procedure has comparably positive follow-up results with the conventional sacrospinous ligament fixation procedure. Both SSLF and LP are effective in the treatment of pelvic organ prolapse, with favorable anatomical and subjective results, a high cure rate and low rates of serious postoperative complications.
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Affiliation(s)
- Simona Brasoveanu
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Razvan Ilina
- Department of Surgery, Discipline of Surgical Semiology II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ligia Balulescu
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Marilena Pirtea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Cristina Secosan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Dorin Grigoraș
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Daniela Chiriac
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
| | - Răzvan Bardan
- Department of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Mădălin-Marius Margan
- Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Alexandru Alexandru
- General Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Laurențiu Pirtea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.B.); (L.B.); (M.P.); (C.S.); (D.G.); (D.C.); (L.P.)
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Chivu-Economescu M, Vremera T, Ruta SM, Grancea C, Leustean M, Chiriac D, David A, Matei L, Diaconu CC, Gatea A, Ilie C, Radu I, Cornienco AM, Iancu LS, Cirstoiu C, Pop CS, Petru R, Strambu V, Malciolu S, Popescu CP, Florescu SA, Rafila A, Furtunescu FL, Pistol A. Assessment of the Humoral Immune Response Following COVID-19 Vaccination in Healthcare Workers: A One Year Longitudinal Study. Biomedicines 2022; 10:1526. [PMID: 35884831 PMCID: PMC9312940 DOI: 10.3390/biomedicines10071526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 11/17/2022] Open
Abstract
The continuous variability of SARS-CoV-2 and the rapid waning of specific antibodies threatens the efficacy of COVID-19 vaccines. We aimed to evaluate antibody kinetics one year after SARS-CoV-2 vaccination with an mRNA vaccine in healthcare workers (HCW), with or without a booster. A marked decline in anti-Spike(S)/Receptor Binding Domain (RBD) antibody levels was registered during the first eight months post-vaccination, followed by a transitory increase after the booster. At three months post-booster an increased antibody level was maintained only in HCW vaccinated after a prior infection, who also developed a higher and long-lasting level of anti-S IgA antibodies. Still, IgG anti-nucleocapsid (NCP) fades five months post-SARS-CoV-2 infection. Despite the decline in antibodies one-year post-vaccination, 68.2% of HCW preserved the neutralization capacity against the ancestral variant, with a decrease of only 17.08% in the neutralizing capacity against the Omicron variant. Nevertheless, breakthrough infections were present in 6.65% of all participants, without any correlation with the previous level of anti-S/RBD IgG. Protection against the ancestral and Omicron variants is maintained at least three months after a booster in HCW, possibly reflecting a continuous antigenic stimulation in the professional setting.
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Affiliation(s)
- Mihaela Chivu-Economescu
- Stefan S. Nicolau Institute of Virology, Romanian Academy, 030304 Bucharest, Romania; (M.C.-E.); (C.G.); (D.C.); (L.M.); (C.C.D.)
| | - Teodora Vremera
- National Institute of Public Health Bucharest, 050463 Bucharest, Romania; (T.V.); (M.L.); (A.D.); (A.G.); (C.I.); (I.R.); (A.M.C.)
- ECDC Fellowship Programme, Public Health Microbiology Path (EUPHEM), European Centre for Disease Prevention and Control (ECDC), 16973 Solna, Sweden
| | - Simona Maria Ruta
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
| | - Camelia Grancea
- Stefan S. Nicolau Institute of Virology, Romanian Academy, 030304 Bucharest, Romania; (M.C.-E.); (C.G.); (D.C.); (L.M.); (C.C.D.)
| | - Mihaela Leustean
- National Institute of Public Health Bucharest, 050463 Bucharest, Romania; (T.V.); (M.L.); (A.D.); (A.G.); (C.I.); (I.R.); (A.M.C.)
| | - Daniela Chiriac
- Stefan S. Nicolau Institute of Virology, Romanian Academy, 030304 Bucharest, Romania; (M.C.-E.); (C.G.); (D.C.); (L.M.); (C.C.D.)
| | - Adina David
- National Institute of Public Health Bucharest, 050463 Bucharest, Romania; (T.V.); (M.L.); (A.D.); (A.G.); (C.I.); (I.R.); (A.M.C.)
| | - Lilia Matei
- Stefan S. Nicolau Institute of Virology, Romanian Academy, 030304 Bucharest, Romania; (M.C.-E.); (C.G.); (D.C.); (L.M.); (C.C.D.)
| | - Carmen C. Diaconu
- Stefan S. Nicolau Institute of Virology, Romanian Academy, 030304 Bucharest, Romania; (M.C.-E.); (C.G.); (D.C.); (L.M.); (C.C.D.)
| | - Adina Gatea
- National Institute of Public Health Bucharest, 050463 Bucharest, Romania; (T.V.); (M.L.); (A.D.); (A.G.); (C.I.); (I.R.); (A.M.C.)
| | - Ciprian Ilie
- National Institute of Public Health Bucharest, 050463 Bucharest, Romania; (T.V.); (M.L.); (A.D.); (A.G.); (C.I.); (I.R.); (A.M.C.)
| | - Iuliana Radu
- National Institute of Public Health Bucharest, 050463 Bucharest, Romania; (T.V.); (M.L.); (A.D.); (A.G.); (C.I.); (I.R.); (A.M.C.)
| | - Ana Maria Cornienco
- National Institute of Public Health Bucharest, 050463 Bucharest, Romania; (T.V.); (M.L.); (A.D.); (A.G.); (C.I.); (I.R.); (A.M.C.)
| | - Luminita Smaranda Iancu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Regional Center of Public Health Iași, 700465 Iași, Romania
| | - Catalin Cirstoiu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
- University Emergency Hospital, 050098 Bucharest, Romania
| | - Corina Silvia Pop
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
- University Emergency Hospital, 050098 Bucharest, Romania
| | - Radu Petru
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
- Dr. Carol Davila Nephrology Clinical Hospital, 010731 Bucharest, Romania
| | - Victor Strambu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
- Dr. Carol Davila Nephrology Clinical Hospital, 010731 Bucharest, Romania
| | - Stefan Malciolu
- Victor Babes Hospital for Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Corneliu Petru Popescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
- Victor Babes Hospital for Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Simin Aysel Florescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
- Victor Babes Hospital for Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Alexandru Rafila
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
- National Institute of Infectious Diseases “Matei Bals”, 021105 Bucharest, Romania
| | - Florentina Ligia Furtunescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
| | - Adriana Pistol
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.P.); (R.P.); (V.S.); (C.P.P.); (S.A.F.); (A.R.); (F.L.F.); (A.P.)
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Sultana C, Casian M, Oprea C, Ianache I, Grancea C, Chiriac D, Ruta S. Hepatitis B Virus Genotypes and Antiviral Resistance Mutations in Romanian HIV-HBV Co-Infected Patients. Medicina (Kaunas) 2022; 58:medicina58040531. [PMID: 35454370 PMCID: PMC9028173 DOI: 10.3390/medicina58040531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Romania has one of the highest prevalence of hepatitis B virus (HBV) infection in human immunodeficiency virus (HIV) patients, mostly in those parenterally infected during childhood; nevertheless, there are scarce data on the virological profile of co-infection. The objective of this study was to assess the prevalence of HBV genotypes and antiviral resistance-associated mutations (RAMs) in these co-infected patients, in order to monitor the viral factors associated with the evolution of liver disease. Materials and Methods: HBV genotypes and RAMs were detected using nested PCR and line probe assays (INNO-LiPA HBV genotyping assay, and INNO-LiPA HBV DR v2, Innogenetics). Results: Out of 117 co-infected patients, 73.5% had detectable HBV-DNA, but only 38.5% presented an HBV viral load >1000 IU/mL. HBV genotype A was present in 66.7% of the cases and was dominant in patients parenterally infected during early childhood, who experienced multiple treatment regimens, with a mean therapy length of 15.25 years, and present numerous mutations associated with lamivudine (LAM) resistance, but very rarely active liver disease. HBV genotype D was detected in 33.3% of the cases, mostly in recently diagnosed injecting drug users who are treatment naïve, but, nevertheless, present RAMs in 63.5% of the cases, suggesting transmitted drug resistance, and display more frequently advanced liver fibrosis (36.1% vs. 12.3%; p = 0.033). The most frequently encountered RAMs are M204V/I: 48.8%, L180M: 33.3%, L80V: 28.8%, and V173L: 42.2%. There are no significant differences in the distribution of RAMs in patients infected with different HBV genotypes, except for the L80V and N236T mutations, which were more frequently found in HBV genotype A infections (p = 0.032 and p = 0.004, respectively). Conclusions: HBV genotypes A and D are the only genotypes present in HIV−HBV co-infected patients from Romania, with different distributions according to the infection route, and are frequently associated with multiple RAMs, conferring extensive resistance to LAM.
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Affiliation(s)
- Camelia Sultana
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.C.); (C.O.); (S.R.)
- Emergent Diseases Department, Stefan S. Nicolau Institute of Virology, 030304 Bucharest, Romania; (C.G.); (D.C.)
- Correspondence: ; Tel.: +40-213242590
| | - Mihnea Casian
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.C.); (C.O.); (S.R.)
- Cardiology Department II, Dr Carol Davila Central Military Emergency Hospital, 010825 Bucharest, Romania
| | - Cristiana Oprea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.C.); (C.O.); (S.R.)
- HIV/SIDA Department I, Dr Victor Babes Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Irina Ianache
- HIV/SIDA Department I, Dr Victor Babes Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania;
| | - Camelia Grancea
- Emergent Diseases Department, Stefan S. Nicolau Institute of Virology, 030304 Bucharest, Romania; (C.G.); (D.C.)
| | - Daniela Chiriac
- Emergent Diseases Department, Stefan S. Nicolau Institute of Virology, 030304 Bucharest, Romania; (C.G.); (D.C.)
| | - Simona Ruta
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.C.); (C.O.); (S.R.)
- Emergent Diseases Department, Stefan S. Nicolau Institute of Virology, 030304 Bucharest, Romania; (C.G.); (D.C.)
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Chivu-Economescu M, Bleotu C, Grancea C, Chiriac D, Botezatu A, Iancu IV, Pitica I, Necula LG, Neagu A, Matei L, Dragu D, Sultana C, Radu EL, Nastasie A, Voicu O, Ataman M, Nedeianu S, Mambet C, Diaconu CC, Ruta SM. Kinetics and persistence of cellular and humoral immune responses to SARS-CoV-2 vaccine in healthcare workers with or without prior COVID-19. J Cell Mol Med 2022; 26:1293-1305. [PMID: 35043552 PMCID: PMC8831971 DOI: 10.1111/jcmm.17186] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/12/2021] [Accepted: 12/16/2021] [Indexed: 02/05/2023] Open
Abstract
SARS‐CoV‐2 vaccines are highly efficient against severe forms of the disease, hospitalization and death. Nevertheless, insufficient protection against several circulating viral variants might suggest waning immunity and the need for an additional vaccine dose. We conducted a longitudinal study on the kinetics and persistence of immune responses in healthcare workers vaccinated with two doses of BNT162b2 mRNA vaccine with or without prior SARS‐CoV‐2 infection. No new infections were diagnosed during follow‐up. At 6 months, post‐vaccination or post‐infection, despite a downward trend in the level of anti‐S IgG antibodies, the neutralizing activity does not decrease significantly, remaining higher than 75% (85.14% for subjects with natural infection, 88.82% for vaccinated after prior infection and 78.37% for vaccinated only). In a live‐virus neutralization assay, the highest neutralization titres were present at baseline and at 6 months follow‐up in persons vaccinated after prior infection. Anti‐S IgA levels showed a significant descending trend in vaccinated subjects (p < 0.05) after 14 weeks. Cellular immune responses are present even in vaccinated participants with declining antibody levels (index ratio 1.1–3) or low neutralizing activity (30%–40%) at 6 months, although with lower T‐cell stimulation index (p = 0.046) and IFN‐γ secretion (p = 0.0007) compared to those with preserved humoral responses.
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Affiliation(s)
| | - Coralia Bleotu
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | | | | | - Anca Botezatu
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Iulia V Iancu
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Ioana Pitica
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Laura G Necula
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Ana Neagu
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Lilia Matei
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Denisa Dragu
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Camelia Sultana
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Elena L Radu
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania.,Institute for Water Quality and Resource Management TU Wien, Vienna, Austria
| | - Alina Nastasie
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Oana Voicu
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Marius Ataman
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | | | - Cristina Mambet
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Simona Maria Ruta
- Stefan S. Nicolau Institute of Virology, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Mihalache D, Luca V, Luca C, Miftode E, Teodorescu I, Corcaci C, Munteanu S, Chiriac D. [The clinico-evolutionary considerations of 492 cases of measles hospitalized in the Infectious Disease Clinic Iaşi in 1997]. Rev Med Chir Soc Med Nat Iasi 1998; 102:114-6. [PMID: 10756857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Between 01.01.1997-31.12.1997 in the Infections Diseases Clinical Hospital of Iaşi were admitted 492 patients suffering from measles. The above mentioned number of patients represents 4.92% of all the patients (10097) who were admitted during this period of time. More than half of the patients (56.9%) are residents in suburban arias. Teen-agers and young adults (15-24 years) were involved in most of the cases, followed by new born babies (0-11 months). The clinical signs were prevalent minor and the atypical exanthema was found in 1/4 of all cases. The most frequent complications were pneumonia, bronchopneumonia and otitis media. Of all the patients, two children (average age 1-4 years) died.
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Affiliation(s)
- D Mihalache
- Clinica de Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi
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