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Boicean A, Prisca D, Bratu DG, Bacila CI, Tanasescu C, Chicea R, Fleaca SR, Birsan SA, Ichim C, Mohor CI, Roman MD, Cristian AN, Todor SB, Mohor CI, Moisin A, Hasegan A. Uncommon Presentation of Gastric Duplication Cyst with Left-Sided Portal Hypertension: A Case Report and Literature Review. Diagnostics (Basel) 2024; 14:675. [PMID: 38611587 PMCID: PMC11011661 DOI: 10.3390/diagnostics14070675] [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: 02/12/2024] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Gastric duplication cysts (GDCs) in adults are exceedingly rare, with only a few documented cases in medical literature. The spectrum of clinical presentations varies widely, ranging from asymptomatic to severe symptoms such as hematemesis, vomiting or abdominal pain. Among the less common complications associated with GDCs, segmental portal hypertension is a notable rarity. We present a compelling case report of a patient exhibiting signs of segmental portal hypertension, where ultrasound and echo-endoscopy revealed a sizable gastric duplication cyst as the underlying etiology. Recognizing the scarcity of literature on GDCs in adult patients, we conducted a thorough review to underscore the diagnostic significance of ultrasonography and endoscopic ultrasound (EUS) in accurately identifying these congenital anomalies. This case report and comprehensive literature review emphasize the pivotal role of EUS and abdominal ultrasound in achieving an accurate diagnosis of GDCs. By shedding light on the diagnostic and therapeutic intricacies, we aim to raise awareness among clinicians regarding this rare pathology and the importance of multimodal imaging approaches for optimal patient management.
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Affiliation(s)
- Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Diana Prisca
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania;
| | - Dan Georgian Bratu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Ciprian Ionut Bacila
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Ciprian Tanasescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Radu Chicea
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Sorin Radu Fleaca
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Sabrina Andreea Birsan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Cristian Ichim
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Calin Ilie Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Mihai Dan Roman
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Adrian Nicolae Cristian
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Samuel Bogdan Todor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Cosmin Ioan Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Andrei Moisin
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
| | - Adrian Hasegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.B.); (C.I.B.); (C.T.); (R.C.); (S.R.F.); (S.A.B.); (C.I.); (C.I.M.); (M.D.R.); (A.N.C.); (S.B.T.); (C.I.M.); (A.M.); (A.H.)
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Stan G, Roman MD, Orban H, Georgeanu VA, Deculescu RS, Brinduse LA, Gheorghiu N. Survival Analysis and Failure Modes of Total Hip Arthroplasty Using a Cemented Semi-Retentive Acetabular Cup. J Clin Med 2023; 12:7506. [PMID: 38137575 PMCID: PMC10744007 DOI: 10.3390/jcm12247506] [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: 10/02/2023] [Revised: 10/18/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
To reduce the incidence of total hip revisions, there have been continuous efforts to enhance prosthetic materials and designs to optimize implant survival. A primary implant with a constrained acetabular component is often used to minimize the risk of dislocations even though this approach has some drawbacks as reported in the literature. To address these concerns, this study aimed to assess the survivorship and dislocation rate of a semi-retentive cemented acetabular cup when used as a primary implant. The specific cemented cup that we studied was not present in any study that we consulted, so to fill this gap, we conducted a retrospective examination of 527 cemented hip prostheses that utilized the semi-retentive cup between the years 2005 and 2012. We employed Cox multiple regression models for our statistical analysis. The revision due to dislocation occurred in 12.8% of all cases, with a lower incidence of 5% (14 cases) in age groups >70 years than in age groups <70 years (14%-32 cases) (p < 0.001). The survival rates of the semi-retentive cemented acetabular cup were 98.6% (520 cases) at 5 years and 92.2% (487 cases) at 10 years. The survival rates were significantly lower in women than men, with 1.9% (7 cases) toward 0% at 5 years and 8.1% (30 cases) toward 5% (7 cases) at 10 years (p = 0.002). The difference in failure rates between age groups over 70 years (2.3%-10 cases) and age groups under 70 years (11.5%-34 cases) was also statistically significant (p < 0.001). Our study indicates that the semi-constrained design may cause frequent damage to the polyethylene liner due to impingement and wear, which are the primary factors for failure. Also, this implant has a similar risk of revision due to dislocation as reported in studies and may be beneficial as a primary implant in elderly patients with low-demanding lifestyles, muscular insufficiency, and low compliance regarding hip prosthetic behavior, without a major effect on survivorship.
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Affiliation(s)
- Gabriel Stan
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (G.S.); (V.A.G.); (N.G.)
| | - Mihai Dan Roman
- Faculty of Medicine, University “Lucian Blaga” of Sibiu, 550024 Sibiu, Romania
| | - Horia Orban
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (G.S.); (V.A.G.); (N.G.)
| | - Vlad Alexandru Georgeanu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (G.S.); (V.A.G.); (N.G.)
| | - Rares Stefan Deculescu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (G.S.); (V.A.G.); (N.G.)
| | - Lacramioara Aurelia Brinduse
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (G.S.); (V.A.G.); (N.G.)
| | - Nicolae Gheorghiu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (G.S.); (V.A.G.); (N.G.)
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Mihai I, Boicean A, Teodoru CA, Grigore N, Iancu GM, Dura H, Bratu DG, Roman MD, Mohor CI, Todor SB, Ichim C, Mătacuță IB, Băcilă C, Bacalbașa N, Bolca CN, Hașegan A. Laparoscopic Adrenalectomy: Tailoring Approaches for the Optimal Resection of Adrenal Tumors. Diagnostics (Basel) 2023; 13:3351. [PMID: 37958247 PMCID: PMC10650124 DOI: 10.3390/diagnostics13213351] [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: 09/12/2023] [Revised: 10/23/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
In this study, we investigated the outcomes of laparoscopic approaches for adrenal tumor resection in 67 patients from a single center with a median age of 51 (range 40-79). Predominantly comprising women, the majority of patients were overweight or obese. Adrenal tumors larger than 6 cm were mostly treated using the laparoscopic transperitoneal method (p < 0.001). Our results revealed that patients subjected to the retroperitoneal approach exhibited quicker recovery, as evidenced by faster resumption of oral intake and ambulation, along with reduced intraoperative blood loss and shorter hospitalization (p-value < 0.05). In contrast, patients subjected to the transperitoneal approach experienced minimal complications, though not statistically significant, despite the technique's intricacy and slower recovery. These findings emphasize the significance of tailoring the surgical approach to individual patient characteristics, with particular emphasis on the tumor size. The choice between the retroperitoneal and transperitoneal methods should be informed by patient-specific attributes to optimize surgical outcomes. This study underscores the need for a comprehensive evaluation of factors such as tumor characteristics and postoperative recovery when determining the most suitable laparoscopic approach for adrenal tumor resection. Ultimately, the pursuit of individualized treatment strategies will contribute to improved patient outcomes in adrenal tumor surgery.
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Affiliation(s)
- Ionela Mihai
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Cosmin Adrian Teodoru
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Nicolae Grigore
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Gabriela Mariana Iancu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Horatiu Dura
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Dan Georgian Bratu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Mihai Dan Roman
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Cosmin Ioan Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Samuel Bogdan Todor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Cristian Ichim
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Ioana Bogdan Mătacuță
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Ciprian Băcilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
| | - Nicolae Bacalbașa
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania;
| | | | - Adrian Hașegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (I.M.); (A.B.); (C.A.T.); (N.G.); (G.M.I.); (H.D.); (M.D.R.); (C.I.M.); (S.B.T.); (C.I.); (I.B.M.); (C.B.); (A.H.)
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Chicea R, Neagu AD, Chicea ED, Grindeanu AS, Bratu DG, Boicean AG, Roman MD, Fleacă SR, Chicea LM, Teacoe DA, Radu IA, Ognean ML. Impact of SARS-CoV-2 Infection on Maternal and Neonatal Outcome in Correlation with Sociodemographic Aspects: A Retrospective Case-Control Study. J Clin Med 2023; 12:6322. [PMID: 37834966 PMCID: PMC10573086 DOI: 10.3390/jcm12196322] [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: 07/24/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND As the COVID-19 pandemic evolved, concerns grew about its impact on pregnant women. This study aimed to determine how SARS-CoV-2 affects pregnancy, birth, and newborns, in order to identify vulnerable individuals and provide proper care. METHODS This is a retrospective case-control study of 398 pregnant women who delivered at the Emergency Clinical County Hospital in Sibiu, Romania from 1 February 2020 to 31 March 2022. Patients were initially grouped and compared based on their RT-PCR SARS-CoV-2 test results into the COVID group (cases) (N = 199) and non-COVID group (control) (N = 199). The COVID cases were further divided and compared according to the pre-Delta (N = 105) and Delta/Omicron (N = 94) SARS-CoV-2 variants. COVID cases and control groups were compared to identify correlations between sociodemographic factors, pregnancy outcomes, and SARS-CoV-2 infection. The same comparisons were performed between pre-Delta and Delta/Omicron groups. RESULTS There were no significant differences concerning maternal residence, while educational level and employment proportion were higher among the positively tested patients. No significant differences were found for neonatal and pregnancy complications between COVID cases and control groups. Except for a lower mean gestational age, no significant differences were found between pre-Delta and Delta/Omicron periods. The maternal mortality in the infected group was 0.5% (1 case). CONCLUSIONS Our study showed that SARS-CoV-2 infection at birth did not significantly affect maternal and neonatal outcomes, not even considering the SARS-CoV-2 strain.
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Affiliation(s)
- Radu Chicea
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | | | | | - Amina Simona Grindeanu
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Dan Georgian Bratu
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Adrian Gheorghe Boicean
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Mihai Dan Roman
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Sorin Radu Fleacă
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Liana Maria Chicea
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | | | - Ioana Andrada Radu
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Maria Livia Ognean
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
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Hașegan A, Mihai I, Bratu D, Bacilă C, Roman MD, Mohor CI, Teodoru A, Birsan S, Mutu C, Chibelean C, Totan M, Grigore N, Iancu G, Dura H, Boicean A. Severe Acute Ischemia of Glans Penis after Achieving Treatment with Only Hyperbaric Oxygen Therapy: A Rare Case Report and Systematic Literature Review. J Pers Med 2023; 13:1370. [PMID: 37763138 PMCID: PMC10533140 DOI: 10.3390/jpm13091370] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and the complications of circumcision are reviewed. We note that there are very few cases described in the literature. Our patient was successfully treated with hyperbaric oxygen therapy (HBOT) after four days of no positive effect after all medical and surgical treatments written in the literature: Subcutaneous enoxaparin, local application of a glyceryl trinitrate, continuous epidural perfusion, intravenous pentoxifylline, alprostadil, intraoperative drainage, and aspiration with saline solution and epinephrine. Clinical improvement was noted at the first session of HBOT. A number of days after the operation, the penis looked normal and was healing. Complete healing of the penile glans was successfully realized one month after surgery. Conclusion: Based on the review and the case presented, we conclude that HBOT is the treatment of choice for acute ischemia of the penile glans, especially when other treatments do not work.
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Affiliation(s)
- Adrian Hașegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Ionela Mihai
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Dan Bratu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Ciprian Bacilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Mihai Dan Roman
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Cosmin Ioan Mohor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Adrian Teodoru
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Sabrina Birsan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Cosmin Mutu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Călin Chibelean
- Faculty of Medicine, University of Medicine and Farmacy, 540139 Targu Mures, Romania;
| | - Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Nicolae Grigore
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Gabriela Iancu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Horatiu Dura
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
| | - Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania; (A.H.); (D.B.); (C.B.); (M.D.R.); (C.I.M.); (A.T.); (S.B.); (C.M.); (M.T.); (N.G.); (G.I.); (H.D.); (A.B.)
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Boicean A, Bratu D, Bacila C, Tanasescu C, Fleacă RS, Mohor CI, Comaniciu A, Băluță T, Roman MD, Chicea R, Cristian AN, Hasegan A, Birsan S, Dura H, Mohor CI. Therapeutic Perspectives for Microbiota Transplantation in Digestive Diseases and Neoplasia-A Literature Review. Pathogens 2023; 12:766. [PMID: 37375456 DOI: 10.3390/pathogens12060766] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
In a mutually beneficial connection with its host, the gut microbiota affects the host's nutrition, immunity, and metabolism. An increasing number of studies have shown links between certain types of disease and gut dysbiosis or specific microorganisms. Fecal microbiota transplantation (FMT) is strongly advised for the treatment of recurrent or resistant Clostridium difficile infection (CDI) due to its outstanding clinical effectiveness against CDI. The therapeutic potential of FMT for other disorders, particularly inflammatory bowel diseases and malignancies, is currently gaining more and more attention. We summarized the most recent preclinical and clinical evidence to show the promise of FMT in the management of cancer as well as complications related to cancer treatment after reviewing the most recent research on the gut microbiota and its relationship to cancer.
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Affiliation(s)
- Adrian Boicean
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Dan Bratu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Ciprian Bacila
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Ciprian Tanasescu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Radu Sorin Fleacă
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Calin Ilie Mohor
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Andra Comaniciu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Teodora Băluță
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Mihai Dan Roman
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Radu Chicea
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Adrian Nicolae Cristian
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Adrian Hasegan
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Sabrina Birsan
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Horațiu Dura
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Cosmin Ioan Mohor
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
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Teodoru CA, Roman MD, Hașegan A, Matei C, Mohor C, Munteanu M, Vică ML, Matei HV, Stanca H, Cerghedean-Florea ME, Dura H. Post-Traumatic Cilia Remaining Inert in the Posterior Chamber for 50 Years. Diagnostics (Basel) 2023; 13:diagnostics13091575. [PMID: 37174966 PMCID: PMC10178080 DOI: 10.3390/diagnostics13091575] [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: 04/03/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Intraocular foreign body injuries (IOFB) can lead to a number of intraocular pathologies; the visual results depend on the mechanism of the injury, the type of foreign body and the subsequent complications. The presence of intraocular cilia (eye lashes) following penetrating injury or surgical intervention is uncommon. In the present paper, we present a case of a 58-year-old woman with a history of eye trauma and a perforated corneal wound in the left eye that occurred 50 years ago. On the ophthalmological exam we noticed in the anterior chamber a straight linear extension, resembling cilia, extending behind the iris. The patient reports that it appeared during COVID-19 infection, after repeated episodes of coughing. After a follow-up period, we decided to remove the eyelash; 24 h after surgery, the patient complained of severe eye pain. Intraocular pressure (IOP) in LE was 54 mmHg. The slit-lamp examination showed perikeratic congestion, corneal edema and mydriasis. Eye hypotensive treatment was started immediately and the patient's general condition slightly improved. Intraocular cilia can be tolerated for many years without causing any ocular reaction. The decision for surgical intervention must be taken according to the individual needs of the patient and his ocular characteristics with careful pre- and post-operative follow up.
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Affiliation(s)
| | - Mihai Dan Roman
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Adrian Hașegan
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Claudiu Matei
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Cosmin Mohor
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Mihnea Munteanu
- Department of Ophthalmology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mihaela Laura Vică
- Department of Cellular and Molecular Biology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Institute of Legal Medicine, 400006 Cluj-Napoca, Romania
| | - Horea Vladi Matei
- Department of Cellular and Molecular Biology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Institute of Legal Medicine, 400006 Cluj-Napoca, Romania
| | - Horia Stanca
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Horațiu Dura
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
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Teodoru CA, Tudor C, Cerghedean-Florea ME, Dura H, Tănăsescu C, Roman MD, Hașegan A, Munteanu M, Popa C, Vică ML, Matei HV, Stanca H. Bilateral Serous Retinal Detachment as a Complication of HELLP Syndrome. Diagnostics (Basel) 2023; 13:diagnostics13091548. [PMID: 37174940 PMCID: PMC10178147 DOI: 10.3390/diagnostics13091548] [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: 04/03/2023] [Revised: 04/23/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
HELLP syndrome is a pregnancy complication, putting at risk the life of mother and child, characterized by high blood pressure, elevated liver enzymes and low platelets. Serous retinal detachment is a rare complication of pregnancy and may be associated with HELLP syndrome. One of the most common symptoms is a decrease in visual acuity. A rare case of bilateral exudative retinal detachment associated with HELLP syndrome is described in a 38-year-old woman a few hours after delivery. Optical coherence tomography (OCT) showed an amount of subretinal fluid and macular edema. Use of systemic corticosteroids and careful management of blood pressure led to early resolution of subretinal fluid and a good recovery of vision. Her final best corrected visual acuity was 1 (decimal notation) in both eyes at 2 weeks after delivery. These types of cases are rarely reported and highlight the importance of increasing awareness of this pathology among ophthalmologists.
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Affiliation(s)
| | - Corina Tudor
- Department of Ophthalmology, Sibiu County Emergency Clinical Hospital, 550245 Sibiu, Romania
| | | | - Horațiu Dura
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Ciprian Tănăsescu
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Mihai Dan Roman
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Adrian Hașegan
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Mihnea Munteanu
- Department of Ophthalmology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Carmen Popa
- Department of Radiology and Medical Imaging, Sibiu County Emergency Clinical Hospital, 550245 Sibiu, Romania
| | - Mihaela Laura Vică
- Department of Cellular and Molecular Biology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Institute of Legal Medicine, 400006 Cluj-Napoca, Romania
| | - Horea Vladi Matei
- Department of Cellular and Molecular Biology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Institute of Legal Medicine, 400006 Cluj-Napoca, Romania
| | - Horia Stanca
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Teodoru CA, Roman MD, Dura H, Cerghedean-Florea ME. Orbital Metastases of Breast Cancer in Males. Diagnostics (Basel) 2023; 13:diagnostics13040780. [PMID: 36832268 PMCID: PMC9955918 DOI: 10.3390/diagnostics13040780] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/30/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
We report a case of orbital metastasis of infiltrative breast carcinoma in a 65-year-old man. The patient was diagnosed with stage four breast cancer one year before, for which a mastectomy was performed. He refused postoperative radiotherapy and chemotherapy at that time. He had a history of lung, liver, and mediastinal metastases. At admission, he presented with blurred vision, diplopia, ocular pain, and mild swelling of the upper lid of the left eye (LE). Computed tomography (CT) of the brain and orbit revealed a front-ethmoidal tissue mass with left orbital and frontal intracranial extension. Ophthalmologic examination revealed exophthalmos on the LE with a downward and outward deviation of the eyeball, proptosis, and intraocular pressure (IOP) of 40 mmHg. The patient's treatment started with topical maximal anti-glaucomatous drops and radiotherapy sessions. After three weeks of follow-up, there was a gradual improvement of local symptoms and signs and a normal IOP.
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Affiliation(s)
- Cosmin Adrian Teodoru
- Clinical Surgical Department, Faculty of Medicine, University “Lucian Blaga” Sibiu, 550169 Sibiu, Romania
| | - Mihai Dan Roman
- Department of Orthopedics and Trauma, Faculty of Medicine, University “Lucian Blaga” Sibiu, 550169 Sibiu, Romania
- Correspondence: ; Tel.: +40-744-990-161
| | - Horațiu Dura
- Preclinical Department, Faculty of Medicine, University “Lucian Blaga“ Sibiu, 550169 Sibiu, Romania
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Marcu GM, Radu AM, Bucuță MD, Fleacă RS, Tanasescu C, Roman MD, Boicean A, Bacilă CI. Cognitive and Behavioral Factors Predicting the Decision to Vaccinate against COVID-19 in Clinical Psychiatric Population-A Cross-Sectional Survey. Vaccines (Basel) 2023; 11:vaccines11020441. [PMID: 36851318 PMCID: PMC9961952 DOI: 10.3390/vaccines11020441] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
The spread of the COVID-19 virus created more than a medical crisis, while it also negatively affected the mental health of the general population. This context increased the vulnerability of the psychiatric population. While research interest highly targeted vaccine hesitancy and acceptance, many studies focused on trust issues-both in vaccine efficacy and in communication with authorities. Less is known about the psychological underpinnings of the COVID vaccination decision, specifically in the high-uncertainty circumstances due to the novelty of the virus. In a cross-sectional study, we investigated the predictive value of several cognitive (perceived risk, vulnerability, uncertainty, and trust in one's decision) and behavioral (previous vaccinations, social media use, and practicing preventive behavior) factors, for the vaccination decision against COVID-19, for 252 psychiatric inpatients (data collected between September 2021 and February 2022). Demographics and diagnostics were also considered. We found a significant relationship between the "Perceived risk of vaccination" and the choice of vaccination (χ2(2, N = 252) = 58.59, p ≤ 0.001), and between the "Trust in own decision to vaccinate" and the decision to vaccinate (χ2(2, N = 252) = 31,5, p ≤ 0.001). The overall regression model was statistically significant (χ2 (9, N = 252) = 97.1, p < 0.001), with between 30% and 45% of the variance in the odds of a positive decision explained by the predictor set. The model coefficients analysis showed that an individual with a psychiatric disorder but with higher confidence in their decision had significant (p < 0.001) increased odds of the decision to vaccinate against COVID-19 by 893%. A former voluntary vaccination did not significantly associate with the decision to vaccinate against COVID-19 (χ2(1, N = 252) = 2.74, p > 0.05) in this special population. No other behavioral factors, diagnosis, or demographics were significant as predictors, for the clinical psychiatric population surveyed, except the educational level. Implications for future vaccination acceptance of this special population are discussed.
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Affiliation(s)
- Gabriela Mariana Marcu
- Department of Psychology, Faculty of Social Sciences and Humanities, “Lucian Blaga” University of Sibiu, 550201 Sibiu, Romania
- Collective of Scientific Research in Neurosciences of the Clinical Psychiatry Hospital “Dr. Gheorghe Preda”, 550082 Sibiu, Romania
- Division of Physiology and Neuroscience, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ana Maria Radu
- Department of Psychology, Faculty of Social Sciences and Humanities, “Lucian Blaga” University of Sibiu, 550201 Sibiu, Romania
- Psychology Department, Faculty of Sociology and Psychology, West University of Timișoara, 300223 Timișoara, Romania
- Correspondence:
| | - Mihaela Dana Bucuță
- Department of Psychology, Faculty of Social Sciences and Humanities, “Lucian Blaga” University of Sibiu, 550201 Sibiu, Romania
| | - Radu Sorin Fleacă
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Ciprian Tanasescu
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Mihai Dan Roman
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Adrian Boicean
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Ciprian Ionuț Bacilă
- Collective of Scientific Research in Neurosciences of the Clinical Psychiatry Hospital “Dr. Gheorghe Preda”, 550082 Sibiu, Romania
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
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Roman MD, Bocea BA, Ion NIC, Vorovenci AE, Dragomirescu D, Birlutiu RM, Birlutiu V, Fleaca SR. Are There Any Changes in the Causative Microorganisms Isolated in the Last Years from Hip and Knee Periprosthetic Joint Infections? Antimicrobial Susceptibility Test Results Analysis. Microorganisms 2023; 11:microorganisms11010116. [PMID: 36677407 PMCID: PMC9863502 DOI: 10.3390/microorganisms11010116] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/24/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND PJIs following total hip and knee arthroplasty represent severe complications with broad implications, and with significant disability, morbidity, and mortality. To be able to provide correct and effective management of these cases, an accurate diagnosis is needed. Classically, acute PJIs are characterized by a preponderance of virulent microorganisms, and chronic PJIs are characterized by a preponderance of less-virulent pathogens like coagulase-negative staphylococci or Cutibacterium species. This paper aims to analyze if there are any changes in the causative microorganisms isolated in the last years, as well as to provide a subanalysis of the types of PJIs. METHODS In this single-center study, we prospectively included all retrospectively consecutive collected data from patients aged over 18 years that were hospitalized from 2016 through 2022, and patients that underwent a joint arthroplasty revision surgery. A standardized diagnostic protocol was used in all cases, and the 2021 EBJIS definition criteria for PJIs was used. RESULTS 114 patients were included in our analysis; of them, 67 were diagnosed with PJIs, 12 were acute/acute hematogenous, and 55 were chronic PJIs. 49 strains of gram-positive aerobic or microaerophilic cocci and 35 gram-negative aerobic bacilli were isolated. Overall, Staphylococcus aureus was the most common isolated pathogen, followed by coagulase-negative staphylococci (CoNS). All cases of acute/acute hematogenous PJIs were caused by gram-positive aerobic or microaerophilic cocci pathogens. Both Staphylococcus epidermidis and methicillin-resistant S. aureus were involved in 91.66% of the acute/acute hematogenous PJIs cases. 21.8% of the chronic PJIs cases were caused by pathogens belonging to the Enterobacterales group of bacteria, followed by the gram-negative nonfermenting bacilli group of bacteria, which were involved in 18.4% of the cases. 12 chronic cases were polymicrobial. CONCLUSION Based on our findings, empiric broad-spectrum antibiotic therapy in acute PJIs could be focused on the bacteria belonging to the gram-positive aerobic or microaerophilic cocci, but the results should be analyzed carefully, and the local resistance of the pathogens should be taken into consideration.
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Affiliation(s)
- Mihai Dan Roman
- Faculty of Medicine Sibiu, Lucian Blaga University, Str. Lucian Blaga, Nr. 2A, 550169 Sibiu, Romania
- County Clinical Emergency Hospital, 550245 Sibiu, Romania
| | - Bogdan-Axente Bocea
- Faculty of Medicine Sibiu, Lucian Blaga University, Str. Lucian Blaga, Nr. 2A, 550169 Sibiu, Romania
- County Clinical Emergency Hospital, 550245 Sibiu, Romania
| | - Nicolas-Ionut-Catalin Ion
- Faculty of Medicine Sibiu, Lucian Blaga University, Str. Lucian Blaga, Nr. 2A, 550169 Sibiu, Romania
- County Clinical Emergency Hospital, 550245 Sibiu, Romania
| | - Andreea Elena Vorovenci
- Economic Cybernetics and Statistics Doctoral School, Bucharest University of Economic Studies, Piata Romana 6, 010371 Bucharest, Romania
| | - Dan Dragomirescu
- Economic Cybernetics and Statistics Doctoral School, Bucharest University of Economic Studies, Piata Romana 6, 010371 Bucharest, Romania
| | - Rares-Mircea Birlutiu
- Clinical Hospital of Orthopedics, Traumatology, and Osteoarticular TB, B-dul Ferdinand 35–37, Sector 2, 021382 Bucharest, Romania
- Correspondence:
| | - Victoria Birlutiu
- Faculty of Medicine Sibiu, Lucian Blaga University, Str. Lucian Blaga, Nr. 2A, 550169 Sibiu, Romania
- County Clinical Emergency Hospital, 550245 Sibiu, Romania
| | - Sorin Radu Fleaca
- Faculty of Medicine Sibiu, Lucian Blaga University, Str. Lucian Blaga, Nr. 2A, 550169 Sibiu, Romania
- County Clinical Emergency Hospital, 550245 Sibiu, Romania
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Roman MD, Russu O, Mohor C, Necula R, Boicean A, Todor A, Mohor C, Fleaca SR. Outcomes in revision total knee arthroplasty (Review). Exp Ther Med 2022; 23:29. [PMID: 34824637 PMCID: PMC8611497 DOI: 10.3892/etm.2021.10951] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 08/16/2021] [Indexed: 11/06/2022] Open
Abstract
Revision total knee arthroplasty (TKA) is a challenging surgical procedure. Although good results are presented, the outcomes are worse in comparison with those of primary TKA, with a higher failure rate. The main reasons for the failure of revision TKA include: sepsis, loosening and instability. There are multiple variables linked to these results, and it is difficult to determinate the exact cause as it is often a multifactorial issue. These variables may be related to the quality of the index-procedure (TKA), to the revision procedure or to patient characteristics. The purpose of this review was to highlight the outcomes of revision knee arthroplasty and main factors that may influence the results. Considerable progress has been made during the last 30 years regarding infection treatment and prevention, complex revision prosthetic design and surgical technique development. Although the outcomes have improved over time, patients who undergo revision TKA may need further re-operations in the future.
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Affiliation(s)
- Mihai Dan Roman
- Department of Orthopedic and Trauma Surgery, ‘Lucian Blaga’ University, 550276 Sibiu, Romania
| | - Octav Russu
- Department of Orthopedic Surgery, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
| | - Calin Mohor
- Department of Orthopedic and Trauma Surgery, ‘Lucian Blaga’ University, 550276 Sibiu, Romania
| | - Radu Necula
- Department of Orthopedic Surgery, ‘Transilvania’ University, 500036 Brasov, Romania
| | - Adrian Boicean
- Department of Orthopedic and Trauma Surgery, ‘Lucian Blaga’ University, 550276 Sibiu, Romania
| | - Adrian Todor
- Department of Orthopedic Surgery, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Cosmin Mohor
- Department of Orthopedic and Trauma Surgery, ‘Lucian Blaga’ University, 550276 Sibiu, Romania
| | - Sorin Radu Fleaca
- Department of Orthopedic and Trauma Surgery, ‘Lucian Blaga’ University, 550276 Sibiu, Romania
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Birlutiu RM, Roman MD, Cismasiu RS, Fleaca SR, Popa CM, Mihalache M, Birlutiu V. Sonication contribution to identifying prosthetic joint infection with Ralstonia pickettii: a case report and review of the literature. BMC Musculoskelet Disord 2017; 18:311. [PMID: 28724376 PMCID: PMC5518162 DOI: 10.1186/s12891-017-1678-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 07/13/2017] [Indexed: 11/28/2022] Open
Abstract
Background In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic. Case presentation We present the case of an 83-years-old Caucasian male patient, that underwent a right cemented total hip replacement surgery. The patient is diagnosed with an early PJI with no isolated microorganism. A debridement and change of mobile parts is performed. At the beginning of 2016, the patient in readmitted into the Orthopedic Department for sever, right abdominal and groin pain and elevated serum erythrocyte sedimentation rate and C-reactive protein. A joint aspiration is performed with a negative microbiological examination. A two-stage exchange with long interval management is adopted, and a preformed spacer loaded with gentamicin was implanted. In July 2016, based on the proinflammatory markers evolution, a shift a three-stage exchange strategy is decided. In September 2016, a debridement, and changing of the preformed spacer loaded with gentamicin with another was carried out. Bacteriological examination of the tissues sampled intraoperatively was positive for Pseudomonas aeruginosa. From the sonication fluid, no bacteria were isolated on culture or identified using the bbFISH assay. During the hospitalization period, the patient received i.v. ceftazidime 3x2g/day and p.o. ciprofloxacin 2x750mg/day, antibiotic therapy that was continued after discharge with p.o. ciprofloxacin 2x750mg/day for 6 weeks. In February 2017, a reimplantation of a revision prosthesis is performed. The retrieved spacer is sonicated, and after 4 days of incubation of the sonication fluid, R. pickettii is isolated. A long term antibiotic therapy with cotrimoxazole being prescribed. Conclusions Bacteria culture of sonication fluid remains the gold standard in diagnosing prosthetic joint infections. R. pickettii remains an extremely rare cause of prosthetic joint infection. Optimal management of R. pickettii prosthetic joint infections of has not been established.
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Affiliation(s)
- Rares Mircea Birlutiu
- Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu; FOISOR Clinical Hospital of Orthopedics, Traumatology, and Osteoarticular TB Bucharest, Address: Str. Lucian Blaga, Nr. 2A, 550169, Sibiu, Romania.
| | - Mihai Dan Roman
- Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, Academic Emergency Hospital Sibiu - Orthopedics and Traumatology Department, Address: Str. Lucian Blaga, Nr. 2A, 550169, Sibiu, Romania
| | - Razvan Silviu Cismasiu
- Carol Davila University of Medicine and Pharmacy Bucharest, Romania; FOISOR Clinical Hospital of Orthopedics, Traumatology, and Osteoarticular TB Bucharest, Address: Str. Dionisie Lupu nr. 37, 020021, Bucharest, Sector 2, Romania
| | - Sorin Radu Fleaca
- Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, Academic Emergency Hospital Sibiu - Orthopedics and Traumatology Department, Address: Str. Lucian Blaga, Nr. 2A, 550169, Sibiu, Romania
| | - Crina Maria Popa
- Polisano European Hospital Sibiu, Address: Str. Izvorului Nr. 1A, Sibiu, Romania
| | - Manuela Mihalache
- Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, Address: Str. Lucian Blaga, Nr. 2A, 550169, Sibiu, Romania
| | - Victoria Birlutiu
- Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, Academic Emergency Hospital Sibiu - Chief of the Infectious Diseases Departmen, Address: Str. Lucian Blaga, Nr. 2A, 550169, Sibiu, Romania
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Roman MD, Fleaca RS, Boicean A, Bratu D, Birlutiu V, Rus LL, Tantar C, Cernusca Mitariu SI. Assesment of Synovial Fluid pH in Osteoarthritis of the HIP and Knee. Rev Chim 2017. [DOI: 10.37358/rc.17.6.5649] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Osteoarthritis (OA) is a developing process with a multifactorial causality in which changes of the synovial fluid characteristics occur. Hypothesis: synovial fluid pH in severe OA is correlated with other patient parameters. Synovial fluid pH from 50 patients with severe OA (knee/hip) was determined. The results were assessed and correlations with the patients antropologic data and biological markers were analyzed. 50 patients (26 knee OA and 24 hip OA) were analyzed. The average synovial fluid pH was 7.35 indicating slightly lower levels than in normal joints. Higher pH values were observed in males, under 60 years, secondary OA, Rh+ and Hbg under 13.5g/dL. Lower pH values were obtained in females, age under 60 years, primary OA, Rh-, Hbg over 13.5g/dL, hypertensive and diabetic patients. The synovial fluid pH may not be an appropriate biomarker for severe OA disease. Some patient variables might be correlated with synovial blood pH.
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15
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Portuondo JA, Barral A, Neyro JL, Camarero MC, Roman MD, Uribarren A. Gonadal dysgenesis and somatic stigmata in patients with 45,X/46,Xr(X) ring chromosome. Int J Gynaecol Obstet 1984; 22:311-3. [PMID: 6152802 DOI: 10.1016/0020-7292(84)90089-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Two cases of gonadal dysgenesis and stigmata of Turner's syndrome with ring chromosome X are described. Their features support the idea that ring chromosome X should be considered as a deletion in the genetic sense, affecting both the gonadal and statural determinants. Without knowing the cytogenetic findings, these patients are usually labeled as having Turner's syndrome. Furthermore, endocrine data and histologic examination of the gonads are indistinguishable from those of individuals with 45,X or 46XX gonadal dysgenesis.
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