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Budişcă OA, Gabor FM, Ahmed S, Strugari V, Szanto LA, Bălan M, Malache D, Bacârea V, Suciu BA, Nicolescu C, Molnar C. Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Single Center Experience. Chirurgia (Bucur) 2024; 119:44-55. [PMID: 38465715 DOI: 10.21614/chirurgia.2024.v.119.i.1.p.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/12/2024]
Abstract
Introduction: Acute cholecystitis (AC) represents a public health problem, increasing hospitalization costs, especially determined by the surgical treatment of these patients. Laparoscopic cholecystectomy (LC) has become the therapeutic gold standard, the timing of the intervention: early (ELC) versus late (DLC), is still debated, impacting the results. The primary objective of the study was to compare postoperative outcomes between ELC and DLC. Secondary objectives assessed surgical outcomes from the pre-pandemic period with those from the Covid-19 pandemic. Material and methods: A retrospective observational study is presented of 266 patients diagnosed with AC who were admitted to Clinic I of General Surgery, County Emergency Clinical Hospital of T #226;rgu Mure #351;, from 2018 to 2022. They were classified into the ELC group ( 72 hours from the onset of symptoms) and DLC ( 72 hours from symptom onset) and were further stratified into prepandemic and pandemic cohorts. Data on clinical symptoms, paraclinical data, surgical details, and postoperative course were collected and analyzed. Discussion: The results confirm fewer conversions to open surgery and reduced hospitalization in the ELC group. The pandemic did not significantly alter the timing of surgeries or patient demographics. Conclusion: In conclusion, ELC for AC patients offers significant advantages, justifying its preference over DLC Despite the decrease in the incidence of AC hospitalizations during the pandemic, postoperative outcomes are comparable to those in the pre-pandemic period. Future multicenter studies are recommended for a broader analysis of the efficacy of laparoscopic surgery in emergency settings.
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Kosovski IB, Bacârea V, Ghiga D, Ciurea CN, Cucoranu DC, Hutanu A, Bacârea A. Exploring the Link between Inflammatory Biomarkers and Adipometrics in Healthy Young Adults Aged 20-35 Years. Nutrients 2024; 16:257. [PMID: 38257150 PMCID: PMC10819707 DOI: 10.3390/nu16020257] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
Obesity and aging are associated with an inflammatory state, which represents the common background for a wide range of diseases. This study aims to explore the correlation between hsCRP, IL-1β, IL-6, TNF-α, IFN-γ, and white blood cell count (WBC) and adipometrics (arm, waist, and hip circumferences: AC, WC, HC; total body fat mass: TBFM, visceral fat level: VFL, body mass index: BMI; waist/hip ratio: WHR; waist/height ratio: WHtR) in young and healthy adults aged 20-35 years old. The subjects were divided by BMI into the overweight/obesity (OW/OB) group and normal weight (NW) group, and by hsCRP level into Group 1 (<1 mg/L), Group 2 (≥1-2.99 mg/L), and Group 3 (≥3 mg/L). The concentration of all inflammatory biomarkers was significantly higher in the OW/OB group compared to the NW group, with the exception of IL-1β. Significant positive correlations were found between hsCRP, TNF-α, WBC, and all adipometrics; between IL-6 and WHR, WHtR, BMI, TBFM, and VFL; and between IFN-γ and HC, BMI, and TBFM. IL-1β correlates positively with WHR and VFL. In Groups 1-3, all the differences between the adipometrics showed significant differences. Subclinical inflammation persists in association with being overweight and obese in healthy young adults aged 20-35 years old.
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Affiliation(s)
- Irina Bianca Kosovski
- Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (I.B.K.); (A.B.)
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
| | - Vladimir Bacârea
- Department of Research Methodology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania;
| | - Dana Ghiga
- Department of Research Methodology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania;
| | - Cristina Nicoleta Ciurea
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania;
| | | | - Adina Hutanu
- Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology Târgu Mureș, 540139 Târgu Mureș, Romania;
| | - Anca Bacârea
- Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (I.B.K.); (A.B.)
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Fekete GL, Fekete L, Neagu N, Bacârea V, Drăgănescu M, Brihan I. Keratosis pilaris atrophicans faciei: An observational, descriptive, retrospective clinical study. Exp Ther Med 2021; 22:1331. [PMID: 34630685 DOI: 10.3892/etm.2021.10766] [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: 07/06/2021] [Accepted: 08/05/2021] [Indexed: 11/05/2022] Open
Abstract
Keratosis pilaris atrophicans faciei (KPAF) is a hereditary follicular disorder, an atrophicans subtype of keratosis pilaris (KP) with a highly elusive diagnosis. Clinically, it presents with follicular, horny papules surrounded by an erythematous halo of the cheeks, forehead, chin and eyebrows, and it is followed by a gradual hair loss on the lateral margins of the eyebrows. The onset is as early as a few months after birth, but it is mainly diagnosed in children and adolescents and it can persist through adulthood. At present, the natural progression of the disease is poorly understood, which makes a correct diagnosis highly unlikely. The aim of the present study was to describe the clinical characteristics of KPAF in patients encountered in daily practice, in order to find common characteristics that may aid in the earlier recognition of the disease. An observational, descriptive, retrospective study was performed on 14 patients diagnosed with KPAF between January 2000 and December 2020. The mean age at diagnosis was 17.04 years and the onset of clinical symptoms appeared at a mean age of 4.85 years. The first clinical symptom was KP involving either the upper or lower limbs, or both. Then, erythema of the face appeared at a mean age of 7.21 years, keratotic papules on the face at a mean age of 8.35 years and, finally, loss of hair on the lateral margins of the eyebrows at a mean age of 14 years. The patients also had concomitant xerosis cutis, multiple mole syndrome, acne, contact dermatitis and Laugier-Hunziker syndrome. Evidence of disease progression, associations, as well as efficacious treatment measures are lacking. An earlier diagnosis potentially allows for a more efficacious, targeted treatment option. Either topical emollients, systemic retinoids or laser therapy may prove effective for each patient individually.
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Affiliation(s)
- Gyula László Fekete
- Department of Dermatology, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureș, Romania
| | - László Fekete
- Department of Dermatology, Mureș County Hospital, 540015 Târgu Mures, Romania
| | - Nicoleta Neagu
- Department of Dermatology, Mureș County Hospital, 540015 Târgu Mures, Romania
| | - Vladimir Bacârea
- Department of Medical Research Methodology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureș, Romania
| | - Miruna Drăgănescu
- Faculty of Medicine and Pharmacy, Medical Department, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Ilarie Brihan
- Department of Dermatology, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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Ruta F, Avram C, Voidăzan S, Mărginean C, Bacârea V, Ábrám Z, Foley K, Fogarasi-Grenczer A, Pénzes M, Tarcea M. Active Smoking and Associated Behavioural Risk Factors before and during Pregnancy - Prevalence and Attitudes among Newborns' Mothers in Mures County, Romania. Cent Eur J Public Health 2017; 24:276-280. [PMID: 28095282 DOI: 10.21101/cejph.a4559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 09/12/2015] [Accepted: 02/09/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIM Smoking before, during and after pregnancy leads to detrimental outcomes on maternal and foetal health and represents an important public health issue. This study aims to evaluate the prevalence and correlates of smoking before and during pregnancy in a sample of Romanian women. METHODS A cross-sectional survey was conducted among mothers (N=1,278) in three maternity hospitals in Tirgu-Mures, Romania, immediately after childbirth, in 2014. We evaluated the prevalence of smoking before and during pregnancy and used binary logistic regression to assess the influence of socio-demographics and other health behaviour factors in three groups of women: non-smoking pregnant women, women who continued smoking during pregnancy, and smokers who quit during pregnancy. RESULTS 30% of the interviewed mothers were smokers prior to pregnancy, of whom 43.3% continued smoking during pregnancy. Women with a family income of less than 100 Euro/month (OR=3.01, 95% CI: 1.02-8.83) and those who were unemployed (OR=13.2, 95% CI: 3.90-44.79) had increased odds of continued smoking versus quitting during pregancy in multivariable analyses. Women who continued smoking during pregnancy were also more likley to be of lower socioeconomic status than never smokers (OR=14.1, 95% CI: 4.97-39.6). CONCLUSIONS A high percentage of women of reproductive age smoke and continue to smoke despite their knowledge about risks of smoking during pregnancy. Smoking prior to and during pregnancy is predominantly associated with lower socioeconomic status. Women with limited economic means should be a high priority target group for smoking cessation interventions.
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Affiliation(s)
- Florina Ruta
- Department of Community Nutrition and Food safety, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Calin Avram
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Septimiu Voidăzan
- Department of Epidemiology, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Claudiu Mărginean
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Vladimir Bacârea
- Department of Research Methodology, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Zoltán Ábrám
- Department of Hygiene, University of Medicine and Pharmacy, Tirgu-Mures, Romania
| | - Kristie Foley
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Andrea Fogarasi-Grenczer
- Department of Family Care and Methodology, Faculty of Health Sciences, Institute of Public Health, Semmelweis University, Budapest, Hungary
| | - Melinda Pénzes
- Faculty of Medicine, Institute of Public Health, Semmelweis University, Budapest, Hungary
| | - Monica Tarcea
- Department of Community Nutrition and Food safety, University of Medicine and Pharmacy, Tirgu-Mures, Romania
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Bacârea A, Tarcea M, Boţianu PVH, Ruţă F, Bacârea V. Age cut-off for type 2 diabetes mellitus screening amongst young adults from Mures District, Romania – A pilot study. Obes Res Clin Pract 2015; 9:527-30. [DOI: 10.1016/j.orcp.2015.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 05/09/2015] [Indexed: 10/23/2022]
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Pop ND, Bacârea A, Coroș L, Dogaru GA, Hosu I, Bacârea V, Nagy A. Serum erythropoietin level in anemia of chronic kidney disease - experience of a Romanian medical centre / Nivelul eritropoietinei serice în anemia din boala renală cronică - experiența unui centru medical românesc. REV ROMANA MED LAB 2015. [DOI: 10.1515/rrlm-2015-0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractIn this study, different aspects of anemia in chronic kidney disease have been observed, starting from the fact that the severity of anemia is associated with the degree of kidney dysfunction, the main cause being the erythropoietin deficiency, which is synthesized mostly by the kidneys. 58 persons were included in this study, 19 patients with non-dialysis-dependent chronic kidney disease, 18 patients with chronic kidney disease who received kidney transplantation and 21 apparently healthy persons. We evaluated the serum level of erythropoietin, serum creatinine, proteinuria, the glomerular filtration rate, the erythrocyte parameters and the correlations between them. The prevalence of anemia in patients with chronic kidney disease was of 51.35%. The hemoglobin concentration in patients with kidney transplantation (12.4 ± 2.7 g/dL) and in non-dialysis-dependent patients (11.7 ± 1.4 g/dL) is significantly different compared to the apparently healthy persons (14.6 ± 0.8 g/dL) (p<0.05). In the case of the non-dialysis-dependent patients who were not treated with erythropoiesis- stimulating agents we found positive associations between the glomerular filtration rate and the number of erythocytes (r = 0.71), hemoglobin (r = 0.65) and hematocrit (r = 0.73), as well as negative associations between creatinine and the number of erythrocytes (r = -0.72), hemoglobin (r = -0.86) and hematocrit (r = -0.88). In patients with kidney transplantation and anemia we observed positive correlations between erythropoietin and the number of erythrocytes (r = 0.69), between the glomerular filtration rate and the number of erythrocytes (r = 0.78) and erythropoietin (r = 0.97), as well as negative correlations between proteinuria and the number of erythrocytes (r= -0.89), hemoglobin (r= -0.72), hematocrit (r = -0.72), and erythropoietin (r = -0.67), and between creatinine and the number of erythrocytes (r = -0.75) and erythropoietin (r = -0.86).
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Loghin A, Preda O, Bacârea V, Moldovan C, Porav-Hodade D, Dema A, Berger N, Borda A. Predictive preoperatory variables of the prostate tumor volume. Rom J Morphol Embryol 2011; 52:363-368. [PMID: 21424075] [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: 05/30/2023]
Abstract
Prostate cancer (PCa) is the second most frequent malignant tumor in men worldwide and the most common form of cancer in men over 50-year-old. The adequate preoperative estimation of tumor volume in order to identify small tumors that lack a short-term aggressive behavior and do not necessitate a forthwith-radical prostatectomy (RP) is the subject of various recent studies and numerous debates. In this study, that included 128 cases, we attempted to evaluate some of the common preoperative variables (patient's age, total prostate volume determined on ultrasound examination, serum PSA, the number of positive biopsies and tumor size, the percentage of tumor length and the Gleason score) that could predict the tumor volume on the final RP. Based on these correlations, we develop a scoring system that combines only the Gleason score, the number of positive biopsies and the percentage of tumor length and that has been statistically proved to be correlated and predictive for the tumor volume. Our study brings additional and practical information about a true and effective prospective evaluation of the volume of the PCa.
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Affiliation(s)
- Andrada Loghin
- Department of Histology, University of Medicine and Pharmacy of Targu Mures, Romania.
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Păltineanu B, Bacârea V. [Comparative evaluation of surgical laparoscopic techniques costs in public and private health systems]. Rev Med Chir Soc Med Nat Iasi 2010; 114:1142-1147. [PMID: 21500471] [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: 05/30/2023]
Abstract
UNLABELLED Due to the fact that in Romania there are two health systems, public and private, some questions have been raised regarding the efficiency of a certain system, taking into account the quality but also the costs of provided services. MATERIAL AND METHOD The study compares the costs of laparoscopic surgical techniques, analysing the causes of the differences that were found, if that were some advantages offered by one of the system to another and if there is a possibility of complementarity perspective between those two medical assistance organisation methods.
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Affiliation(s)
- B Păltineanu
- Institutul Naţional de Geriatrie si Gerontologie Ana Asian
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Moldovan B, Copotoiu C, Bud V, Nemeş I, Serac G, Cif A, Sărăcuţ C, Pocreaţă D, Nicolescu C, Bacârea V, Rusu I, Moldovan A, Roşca C. [Laparoscopic sleeve gastrectomy: the initial experience of the First Surgical Clinic Tg-Mureş. Early and late (after 5-10 month follow-up) results]. Chirurgia (Bucur) 2009; 104:569-574. [PMID: 19943556] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM This paper aims to present the initial experience of the I-st Surgery Clinic Târgu Mureş in laparoscopic sleeve gastrectomy, stressing the technical aspects of surgery and postoperative immediate and late results. METHOD Started in 2008, I Surgery Clinic's experience includes 11 cases of laparoscopic sleeve gastrectomy, pursued between 5 and 10 months postsurgery.The group is structured as follows: 80% female, aged between 13 and 55 years, average BMI 46, with limits between 35 and 72. Surgical technique was unitary, 10 of 11 cases beeing performed by the same team. RESULTS Surgergical results were excellent: 0 conversions, 0 bleeding, 0 fistulas, 0 missfire. Average hospitalisation was of 48 hours postsurgery. EWL overall 68%, with limits between 50%, in 2 cases (initial BMI 70) and 100%--1 case (initial BMI 35). Life threatening morbidity--0.0 mortality, average BAROS score 6.7. CONCLUSION GLL is a well standardized, secure, efficient, applicable with good results in all categories of patients with morbid obesity.
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