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Cinteza E, Vasile CM, Busnatu S, Armat I, Spinu AD, Vatasescu R, Duica G, Nicolescu A. Can Artificial Intelligence Revolutionize the Diagnosis and Management of the Atrial Septal Defect in Children? Diagnostics (Basel) 2024; 14:132. [PMID: 38248009 PMCID: PMC10814919 DOI: 10.3390/diagnostics14020132] [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: 12/04/2023] [Revised: 12/26/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Atrial septal defects (ASDs) present a significant healthcare challenge, demanding accurate and timely diagnosis and precise management to ensure optimal patient outcomes. Artificial intelligence (AI) applications in healthcare are rapidly evolving, offering promise for enhanced medical decision-making and patient care. In the context of cardiology, the integration of AI promises to provide more efficient and accurate diagnosis and personalized treatment strategies for ASD patients. In interventional cardiology, sometimes the lack of precise measurement of the cardiac rims evaluated by transthoracic echocardiography combined with the floppy aspect of the rims can mislead and result in complications. AI software can be created to generate responses for difficult tasks, like which device is the most suitable for different shapes and dimensions to prevent embolization or erosion. This paper reviews the current state of AI in healthcare and its applications in cardiology, emphasizing the specific opportunities and challenges in applying AI to ASD diagnosis and management. By exploring the capabilities and limitations of AI in ASD diagnosis and management. This paper highlights the evolution of medical practice towards a more AI-augmented future, demonstrating the capacity of AI to unlock new possibilities for healthcare professionals and patients alike.
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Affiliation(s)
- Eliza Cinteza
- Department of Pediatrics, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.C.)
- Pediatric Cardiology Department, “Marie Skolodowska Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (I.A.); (A.N.)
| | - Corina Maria Vasile
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, F-33600 Bordeaux, France;
| | - Stefan Busnatu
- Cardio-Thoracic Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Cardiology Department, “Prof. Dr. Bagdasar Arseni” Clinical Hospital, 041915 Bucharest, Romania
| | - Ionel Armat
- Pediatric Cardiology Department, “Marie Skolodowska Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (I.A.); (A.N.)
| | - Arsenie Dan Spinu
- “Dr. Carol Davila” Central Emergency University Military Hospital, 010825 Bucharest, Romania;
- Department 3, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Radu Vatasescu
- Cardio-Thoracic Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Emergency Clinical Hospital, 014461 Bucharest, Romania
| | - Gabriela Duica
- Department of Pediatrics, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.C.)
- Pediatric Cardiology Department, “Marie Skolodowska Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (I.A.); (A.N.)
| | - Alin Nicolescu
- Pediatric Cardiology Department, “Marie Skolodowska Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (I.A.); (A.N.)
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Rosca I, Turenschi A, Nicolescu A, Constantin AT, Canciu AM, Dica AD, Bratila E, Coroleuca CA, Nastase L. Endocrine Disorders in a Newborn with Heterozygous Galactosemia, Down Syndrome and Complex Cardiac Malformation: Case Report. Medicina (Kaunas) 2023; 59:medicina59050856. [PMID: 37241085 DOI: 10.3390/medicina59050856] [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] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023]
Abstract
Down syndrome is the most common chromosomal abnormality diagnosed in newborn babies. Infants with Down syndrome have characteristic dysmorphic features and can have neuropsychiatric disorders, cardiovascular diseases, gastrointestinal abnormalities, eye problems, hearing loss, endocrine and hematologic disorders, and many other health issues. We present the case of a newborn with Down syndrome. The infant was a female, born at term through c-section. She was diagnosed before birth with a complex congenital malformation. In the first few days of life, the newborn was stable. In her 10th day of life, she started to show respiratory distress, persistent respiratory acidosis, and persistent severe hyponatremia, and required intubation and mechanical ventilation. Due to her rapid deterioration our team decided to do a screening for metabolic disorders. The screening was positive for heterozygous Duarte variant galactosemia. Further testing on possible metabolic and endocrinologic issues that can be associated with Down syndrome was performed, leading to hypoaldosteronism and hypothyroidism diagnoses. The case was challenging for our team because the infant also had multiple metabolic and hormonal deficiencies. Newborns with Down syndrome often require a multidisciplinary team, as besides congenital cardiac malformations they can have metabolic and hormonal deficiencies that can negatively impact their short- and long-term prognosis.
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Affiliation(s)
- Ioana Rosca
- Neonatology Department, Clinical Hospital of Obstetrics and Gynecology "Prof. Dr. P.Sirbu", 060251 Bucharest, Romania
- Faculty of Midwifery and Nursery, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania
| | - Alina Turenschi
- Emergency Clinical Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania
| | - Alin Nicolescu
- Cardiology Department, Emergency Clinical Hospital for Children "M.S. Curie", 41451 Bucharest, Romania
| | - Andreea Teodora Constantin
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania
- Pediatrics Department, National Institute for Mother and Child Health "Alessandrescu-Rusescu", 020395 Bucharest, Romania
| | - Adina Maria Canciu
- Emergency Clinical Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania
| | - Alice Denisa Dica
- Pediatric Neurology Department, Clinical Psychiatric Hospital "Al. Obregia", 041914 Bucharest, Romania
| | - Elvira Bratila
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania
- Obstetrics and Gynecology Department, Clinical Hospital of Obstetrics and Gynecology "Prof. Dr. P.Sirbu", 060251 Bucharest, Romania
| | - Ciprian Andrei Coroleuca
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania
- Obstetrics and Gynecology Department, Clinical Hospital of Obstetrics and Gynecology "Prof. Dr. P.Sirbu", 060251 Bucharest, Romania
| | - Leonard Nastase
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania
- Neonatology Department, National Institute for Mother and Child Health "Alessandrescu-Rusescu", 011061 Bucharest, Romania
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Dirven H, Husøy T, Papadopoulou E, Lindeman B, Haug L, Nicolescu A, Deleanu C. P02-02 Human exposure to per-and polyfluoroalkyl substances and effects on plasma lipoprotein subclasses, lipid concentrations and lipoproteins as measured by NMR spectroscopy in men and women and possible gender differences in sensitivity. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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4
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Cinteză E, Voicu C, Filip C, Ioniță M, Popescu M, Bălgrădean M, Nicolescu A, Mahmoud H. Myocardial Infarction in Children after COVID-19 and Risk Factors for Thrombosis. Diagnostics (Basel) 2022; 12:diagnostics12040884. [PMID: 35453932 PMCID: PMC9025069 DOI: 10.3390/diagnostics12040884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/19/2022] Open
Abstract
Acute myocardial infarction (AMI) in children is rather anecdotic. However, following COVID-19, some conditions may develop which may favor thrombosis, myocardial infarction, and death. Such a condition is Kawasaki-like disease (K-lD). K-lD appears in children as a subgroup of the multisystem inflammatory syndrome (MIS-C). In some cases, K-lD patients may develop giant coronary aneurysms. The evolution and characteristics of coronary aneurysms from K-lD appear to be different from classical Kawasaki disease (KD) aneurysms. Differences include a lower percentage of aneurysm formation than in non-COVID-19 KD, a smaller number of giant forms, a tendency towards aneurysm regression, and fewer thrombotic events associated with AMI. We present here a review of the literature on the thrombotic risks of post-COVID-19 coronary aneurysms, starting from a unique clinical case of a 2-year-old boy who developed multiple coronary aneurysms, followed by AMI. In dehydration conditions, 6 months after COVID-19, the boy developed anterior descending artery occlusion and a slow favorable outcome of the AMI after thrombolysis. This review establishes severity criteria and risk factors that predispose to thrombosis and AMI in post-COVID-19 patients. These may include dehydration, thrombophilia, congenital malformations, chronic inflammatory conditions, chronic kidney impairment, acute cardiac failure, and others. All these possible complications should be monitored during acute illness. Ischemic heart disease prevalence in children may increase in the post-COVID-19 era, due to an association between coronary aneurysm formation, thrombophilia, and other risk factors whose presence will make a difference in long-term prognosis.
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Affiliation(s)
- Eliza Cinteză
- “Carol Davila” Pediatrics Department, University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
- Correspondence: (E.C.); (C.V.)
| | - Cristiana Voicu
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
- Correspondence: (E.C.); (C.V.)
| | - Cristina Filip
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Mihnea Ioniță
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Monica Popescu
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Mihaela Bălgrădean
- “Carol Davila” Pediatrics Department, University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Alin Nicolescu
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Hiyam Mahmoud
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
- Royal Brompton Hospital, London SW3 6NP, UK
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Branisteanu D, Dirzu D, Toader M, Branisteanu D, Nicolescu A, Brihan I, Bogdanici C, Branisteanu G, Dimitriu A, Anton N, Porumb E. Phototherapy in dermatological maladies (Review). Exp Ther Med 2022; 23:259. [PMID: 35251325 PMCID: PMC8892600 DOI: 10.3892/etm.2022.11184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Since the introduction of modern phototherapy in 1903 by Nobel Prize-winner Niels Ryberg Finsen, the usage of this therapy in the medical field has grown, techniques have been refined and developed, and it has gained widespread acceptance. Psoriasis vulgaris, parapsoriasis, lichen planus, atopic dermatitis, neonatal jaundice, urticaria, morphea, vitiligo, granuloma annulare and cutaneous T cell lymphoma are only a few dermatological indications that come along with satisfactory results. Most often, it is a 2nd or 3rd line therapy being an alternative in more severe or refractory diseases. Despite the side effects that may occur after phototherapy, which are often minor, the benefits can be significant. Unfortunately, the absolute contraindications limit the use of this type of treatment and implicitly the management of these patients. The current review aimed to combine the recommendations of phototherapy in dermatology, the types of phototherapy that can be suitable for certain dermatological diseases and to emphasize its importance in certain conditions that are associated with significant remission rates.
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Affiliation(s)
- Daciana Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Diana Dirzu
- Department of Dermatology, Railway Clinical Hospital, 700506 Iasi, Romania
| | - Mihaela Toader
- Department of Oral Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daniel Branisteanu
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Nicolescu
- Department of Dermatology, ‘Roma’ Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
| | - Ilarie Brihan
- Dermatology Department, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Camelia Bogdanici
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - George Branisteanu
- Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia’ Hospitals and Medical Centers, 700620 Iasi, Romania
| | - Nicoleta Anton
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Porumb
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
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Toader M, Branisteanu D, Glod M, Esanu I, Branisteanu C, Capsa MS, Dimitriu A, Nicolescu A, Pinzariu A, Branisteanu D. Mucocutaneous lesions associated with SARS‑CoV‑2 infection (Review). Exp Ther Med 2022; 23:258. [PMID: 35251324 PMCID: PMC8892620 DOI: 10.3892/etm.2022.11183] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
The ongoing COVID-19 pandemic, declared by the World Health Organisation in March 2020, with the emergence of new, possibly more contagious and more virulent strains, remains a research subject, with the complex systemic involvement better described and understood, but also with a variety of skin and mucosal lesions described in the literature. Mucocutaneous lesions associated with SARS-CoV-2 infection are still under investigation, due to their polymorphic clinical aspect and incompletely understood pathogenic mechanism. The cutaneous inflammatory, exanthematous and purpuric rashes, erythemato-purpuric enanthems, oral ulcers, lichenoid oral lesions, conjunctivitis, conjunctival pseudomembranes, or corneal lesions have been described in patients with COVID-19. Several classifications have been proposed based on the clinical pattern, histological findings, and possible pathogenic mechanisms. The pathogenic mechanism, the diagnostic criteria, the prognostic importance of these lesions are still being debated. The diverse clinical aspects of dermatological manifestations render the diagnosis difficult. However, several clinical patterns strongly associated with COVID-19, such as chilblains, papulovesicular exanthems, and febrile rash require increased awareness and changes to the investigation protocols for these conditions, to include testing for SARS-CoV-2. In the present review, the mucocutaneous findings associated with the novel coronavirus infection, reported thus far in the literature, was provided.
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Affiliation(s)
- Mihaela Toader
- Department of Oral Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daniel Branisteanu
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai Glod
- Department of Surgery, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Irina Esanu
- Department of Internal Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | - Maria-Stefana Capsa
- Department of Dermatology, ‘Railway Clinical Hospital’, 700506 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia’ Hospitals and Medical Centers, 700620 Iasi, Romania
| | - Alin Nicolescu
- Department of Dermatology, Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
| | - Alin Pinzariu
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daciana Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
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Branisteanu D, Cojocaru C, Diaconu R, Porumb E, Alexa A, Nicolescu A, Brihan I, Bogdanici C, Branisteanu G, Dimitriu A, Zemba M, Anton N, Toader M, Grechin A, Branisteanu D. Update on the etiopathogenesis of psoriasis (Review). Exp Ther Med 2022; 23:201. [PMID: 35126704 PMCID: PMC8794554 DOI: 10.3892/etm.2022.11124] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/22/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- Daciana Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Catalina Cojocaru
- Department of Dermatology, Railway Clinical Hospital, 700506 Iasi, Romania
| | - Roxana Diaconu
- Department of Dermatology, Railway Clinical Hospital, 700506 Iasi, Romania
| | - Elena Porumb
- Department of Dermatology, ‘Sf. Spiridon’ Clinical Emergency County Hospital, 700111 Iasi, Romania
| | - Anisia Alexa
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Nicolescu
- Department of Dermatology, ‘Roma’ Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
| | - Ilarie Brihan
- Department of Dermatology, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Camelia Bogdanici
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - George Branisteanu
- Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia’ Hospitals and Medical Centers, 700620 Iasi, Romania
| | - Mihail Zemba
- Department of Ophthalmology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Nicoleta Anton
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Mihaela Toader
- Department of Oral Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adrian Grechin
- Department of Ophthalmology, ‘Sf. Spiridon’ Clinical Emergency County Hospital, 700111 Iasi, Romania
| | - Daniel Branisteanu
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
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Filip C, Cirstoveanu C, Bizubac M, Berghea EC, Căpitănescu A, Bălgrădean M, Pavelescu C, Nicolescu A, Ionescu MD. Pulse Wave Velocity as a Marker of Vascular Dysfunction and Its Correlation with Cardiac Disease in Children with End-Stage Renal Disease (ESRD). Diagnostics (Basel) 2021; 12:diagnostics12010071. [PMID: 35054238 PMCID: PMC8774385 DOI: 10.3390/diagnostics12010071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 12/16/2022] Open
Abstract
One of the main markers of arterial stiffness is pulse wave velocity (PWV). This parameter is well studied as a marker for end-organ damage in the adult population, being considered a strong predictor of major cardiovascular events. This study assessed PWV in children with chronic kidney disease (CKD) as a marker of cardiovascular risk. We conducted a prospective observational single-center cohort study of 42 consecutively pediatric patients (9–18 years old) with terminal CKD and dialysis, at the Hemodialysis Department of the “M. S. Curie” Hospital, Bucharest. We measured PWV by echocardiography in the ascending aorta (AscAo) and the descending aorta (DescAo), and we correlated them with left ventricular hypertrophy (LVH). Fifteen patients (35.7%) presented vascular dysfunction defined as PWV above the 95th percentile of normal values in the AscAo and/or DescAo. Cardiac disease (LVH/LV remodeling) was discovered in 32 patients (76.2%). All patients with vascular damage also had cardiac disease. Cardiac damage was already present in all patients with vascular disease, and the DescAo is more frequently affected than the AscAo (86.6% vs. 46.9%). Elevated PWV could represent an important parameter for identifying children with CKD and high cardiovascular risk.
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Affiliation(s)
- Cristina Filip
- Pediatric Cardiology, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania; (C.F.); (A.N.)
| | - Cătălin Cirstoveanu
- Neonatal Intensive Care Unit, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania;
- Department of Neonatal Intensive Care, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Correspondence:
| | - Mihaela Bizubac
- Neonatal Intensive Care Unit, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania;
| | - Elena Camelia Berghea
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.C.B.); (M.B.)
- Allergology and Clinical Immunology Department, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania
| | - Andrei Căpitănescu
- Pediatric Hemodialysis, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania;
| | - Mihaela Bălgrădean
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (E.C.B.); (M.B.)
- Pediatrics and Pediatric Nephrology, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania;
| | - Carmen Pavelescu
- Pediatrics and Pediatric Nephrology, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania;
| | - Alin Nicolescu
- Pediatric Cardiology, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania; (C.F.); (A.N.)
| | - Marcela Daniela Ionescu
- Department of Neonatal Intensive Care, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Pediatrics and Pediatric Pulmonology, M.S. Curie Children’s Hospital, Constantin Brâncoveanu Boulevard, No. 20, 4th District, 041451 Bucharest, Romania
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Branisteanu D, Nicolescu A, Branisteanu D, Branisteanu C, Dragoi A, Bogdanici C, Toader M, Tucaliuc A, Dimitriu A, Daogaru D, Pirvulescu R, Porumb E. Cardiovascular comorbidities in psoriasis (Review). Exp Ther Med 2021; 23:152. [PMID: 35069833 PMCID: PMC8753969 DOI: 10.3892/etm.2021.11075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/16/2021] [Indexed: 11/05/2022] Open
Abstract
Long considered a skin-limited condition, psoriasis is currently defined as a chronic, immune-mediated inflammatory disease, presenting, besides the skin changes, important systemic manifestations, the most common being: psoriatic arthritis, cardiovascular disease, metabolic syndrome, diabetes, inflammatory bowel disease and nonalcoholic steatohepatitis. It is a disease with a strong psycho-emotional and social impact, both through skin changes such as pruritic, scaly erythematous plaques, and through the association of comorbidities that influence morbidity and mortality. It has been shown that psoriasis is an independent cardiovascular risk factor, with patients developing ischemic heart disease/acute coronary syndrome, hypertension, peripheral arterial disease, or stroke. The chronic inflammatory status of psoriasis and the production of specific cytokines may be the etiopathogenic link to atherosclerosis and cardiovascular disease. Biological therapy may affect atherosclerosis, leading to the arrest of the evolution or even regressing the changes in the atheromatous plaque. The aim of this review was to re-evaluate the current knowledge regarding the cardiovascular comorbidities associated with psoriasis for optimal management of the patients.
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Affiliation(s)
- Daciana Branisteanu
- Department of Dermatology, Faculty of Medicine ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Nicolescu
- Department of Dermatology, ‘Roma’ Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
| | - Daniel Branisteanu
- Department of Ophthalmology, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, Romania
| | - Catalina Branisteanu
- Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andreea Dragoi
- Department of Dermatology, Railway Clinical Hospital, 700506 Iasi, Romania
| | - Camelia Bogdanici
- Department of Ophthalmology, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, Romania
| | - Mihaela Toader
- Department of Oral Dermatology, Faculty of Dental Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andreea Tucaliuc
- Department of Dermatology, Railway Clinical Hospital, 700506 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia’ Hospitals and Medical Centers, 700620 Iasi, Romania
| | - Doru Daogaru
- Department of Ophthalmology, ‘Sf. Spiridon’ Clinical Emergency County Hospital, 700111 Iasi, Romania
| | - Ruxandra Pirvulescu
- Department of Ophthalmology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Elena Porumb
- Department of Dermatology, ‘Sf. Spiridon’ Clinical Emergency County Hospital, 700111 Iasi, Romania
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Ionescu MD, Taras R, Dombici B, Balgradean M, Berghea EC, Nicolescu A. The Challenging Diagnosis of Pediatric Multisystem Inflammatory Syndrome Associated with Sars-Cov-2 Infection-Two Case Reports and Literature Review. J Pers Med 2021; 11:jpm11040318. [PMID: 33921718 PMCID: PMC8073032 DOI: 10.3390/jpm11040318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/10/2021] [Revised: 03/30/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory coronavirus 2 (SARS-CoV-2) is a novel coronavirus discovered in 2019 that caused the coronavirus disease 2019 (COVID19). During the last year, over 70 million people were infected and more than 1.5 million people died. Despite the tremendous number of people infected, children were less affected and presented milder forms of the disease. A short time after the pandemic was declared, a new hyperinflammatory syndrome resembling Kawasaki disease (KD) was described in children with confirmed or suspected SARS-CoV-2 infection named multisystem inflammatory syndrome in children (MIS-C). The incidence of MIS-C is low and it has a polymorphous clinical presentation, making the diagnosis difficult. Although the incidence is reduced, there is a high risk of cardiovascular complications. In order to raise awareness, we present the cases of two pediatric patients diagnosed with MIS-C in our clinic.
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Affiliation(s)
- Marcela Daniela Ionescu
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
| | - Roxana Taras
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
| | - Bianca Dombici
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
| | - Mihaela Balgradean
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
| | - Elena Camelia Berghea
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
- Correspondence:
| | - Alin Nicolescu
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
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11
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Bizubac M, Cirstoveanu C, Filip C, Nicolescu A, Barascu I, Chirca R, Gaiduchevici A, Plesca DA. Multiple renal injuries lead to death in postoperative cardiac surgery even with precocious hemodiafiltrations. Ro J Pediatr 2021. [DOI: 10.37897/rjp.2021.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We present the case of a newborn diagnosed with perinatal asphyxia and secondary renal injuries, transposition of the great vessels and low systemic blood flow, treated with Prostaglandin, atrioseptostomy, followed by arterial switch surgery After the cardiac surgery the patient is oliguric and requires hemodiafiltration for 12 days, after which renal function is restored. In evolution, however, AVB (atrioventricular block) grade III occurs, followed by implantation of permanent pacemaker, but another postoperative complication – chylothorax – leads to stopping electrical stimulation followed by severe cardiac dysfunction and, consequently, recurrent renal injury and anuria. Re-establishing hemodiafiltration for another 7 days without recovery of renal function. Perinatal asphyxia, cardiac heart disease with low systemic blood flow, prostaglandin, atrioseptostomy, cardiac rhythms disturbances, chylothorax, sepsis, cardiac arrest are intriguing factors that bring renal injury. Their association greatly decreases the chance of survival even if the patient benefits from supportive treatment and early hemodiafiltration.
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12
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Bizubac M, Cîrstoveanu C, Filip C, Nicolescu A, Bărăscu I, Chircă R, Gaiduchevici A, Pleșca DA. Leziunile renale multiple duc la deces în chirurgia cardiacă chiar și cu hemodiafiltrare precoce. Ro J Pediatr 2021. [DOI: 10.37897/rjp.2021.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Prezentăm cazul unui nou-născut diagnosticat cu suferintă perinatală și injurie renală secundară, transpoziție de vase mari și debit sistemic scăzut, tratat cu prostaglandină, atrioseptostomie, urmate de operația de switch arterial. Postoperator, pacientul este oliguric și necesită hemodiafiltrare pentru 12 zile, după care funcția renală este restabilită. În evoluție, apare bloc atrioventricular (BAV) grad III, urmat de implantare de stimulator cardiac permanent, dar o altă complicație postoperatorie – chilotorax – duce la oprirea stimulării electrice, urmată de disfuncție cardiacă severă și, consecutiv, injurie renală recurentă și anurie. Se reinstituie hemodiafiltrarea pentru încă 7 zile, fără recuperarea funcției renale. Asfixia perinatală, malformația cardiacă cu debit sistemic scăzut, prostaglandina, atrioseptostomia, circulația extracoroporeală, tulburările de ritm, chilotoraxul, sepsisul, stopul cardiac sunt factori intricaţi care aduc injurie renală importantă. Asocierea lor scade major șansele de supraviețuire chiar dacă pacientul beneficiază de tratament suportiv și hemodiafiltrare precoce.
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Filip C, Nicolescu A, Cinteza E, Duica G, Nicolae G, Safta-Baschieru D, Mihalache I, Popa L, Costin M, Matei G, Rusu M, Balgradean M. Cardiovascular Complications of Hemolytic Uremic Syndrome in Children. Maedica (Bucur) 2020; 15:305-309. [PMID: 33312244 PMCID: PMC7726508 DOI: 10.26574/maedica.2020.15.3.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Introduction: Hemolytic uremic syndrome is the most frequent cause of acute renal failure in children, commonly after gastrointestinal infections with E. coli or Salmonella, and it is characterized by progressive renal failure associated with microangiopathic hemolytic anemia and thrombocytopenia. Cardiac involvement is frequently encountered and can be potentially fatal in hemolytic uremic syndrome. It is usually determined by overhydration, hypertension, anemia, diselectrolytemia, acid-base disorders and tendency to form thrombi, and it consists in the following conditions: pericarditis, myocardial infarction, dilated cardiomyopathy, cardiac failure, and arrythmias. Objective: The aim of this study is to observe the incidence of cardiovascular complications in children with acute hemolytic uremic syndrome, underline which are the most useful tools in establishing an accurate diagnosis, and discover the treatment protocol that has the most powerful impact upon the cardiovascular manifestations. Materials and methods: We studied a number of 50 children who checked in the Nephrology Department of "M. S. Curie" Emergency Clinical Hospital in Bucharest, Romania, between January 2016 and August 2020. We performed the clinical examination of all patients as well as several paraclinical tests such as electrocardiogram, transthoracic echocardiography, arterial blood pressure monitorization, and vascular Doppler ultrasound. Patients included in the study were aged between five and 40 months. Discussion and results: The majority of these children were diagnosed with arterial hypertension and some of them with cardiac failure and profound venous thrombosis. Transthoracic echocardiography revealed pathological aspects such as left ventricular hypertrophy, diastolic dysfunction, systolic dysfunction of the left ventricle, mitral regurgitation, aortic regurgitation, and pericarditis. Cardiac ultrasound findings were reversible in the majority of patients, most of them being treated with ACE inhibitors (eventually in association with other antihypertensive drugs).
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Affiliation(s)
- Cristina Filip
- Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alin Nicolescu
- Department of Pediatric Cardiology, "M. S. Curie" Emergency Clinical Hospital for Children, Bucharest, Romania
| | - Eliza Cinteza
- Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Gabriela Duica
- Department of Pediatric Cardiology, "M. S. Curie" Emergency Clinical Hospital for Children, Bucharest, Romania
| | - Georgiana Nicolae
- Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Ioana Mihalache
- Department of Pediatric Cardiology, "M. S. Curie" Emergency Clinical Hospital for Children, Bucharest, Romania
| | - Loredana Popa
- Department of Pediatric Cardiology, "M. S. Curie" Emergency Clinical Hospital for Children, Bucharest, Romania
| | - Mariana Costin
- Department of Pediatric Cardiology, "M. S. Curie" Emergency Clinical Hospital for Children, Bucharest, Romania
| | - Georgiana Matei
- Department of Pediatric Cardiology, "M. S. Curie" Emergency Clinical Hospital for Children, Bucharest, Romania
| | - Mihaela Rusu
- Department of Pediatric Cardiology, "M. S. Curie" Emergency Clinical Hospital for Children, Bucharest, Romania
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Cazacu M, Turcan‐Trofin G, Vlad A, Bele A, Shova S, Nicolescu A, Bargan A. Hydrophobic, amorphous metal–organic network readily prepared by complexing the aluminum ion with a siloxane spaced dicarboxylic acid in aqueous medium. J Appl Polym Sci 2019. [DOI: 10.1002/app.47144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- M. Cazacu
- Inorganic Polymers Department“Petru Poni” Institute of Macromolecular Chemistry Aleea Gr. Ghica Voda 41A, 700487, Iasi Romania
| | - G.‐O. Turcan‐Trofin
- Inorganic Polymers Department“Petru Poni” Institute of Macromolecular Chemistry Aleea Gr. Ghica Voda 41A, 700487, Iasi Romania
| | - A. Vlad
- Inorganic Polymers Department“Petru Poni” Institute of Macromolecular Chemistry Aleea Gr. Ghica Voda 41A, 700487, Iasi Romania
| | - A. Bele
- Inorganic Polymers Department“Petru Poni” Institute of Macromolecular Chemistry Aleea Gr. Ghica Voda 41A, 700487, Iasi Romania
| | - S. Shova
- Inorganic Polymers Department“Petru Poni” Institute of Macromolecular Chemistry Aleea Gr. Ghica Voda 41A, 700487, Iasi Romania
| | - A. Nicolescu
- Inorganic Polymers Department“Petru Poni” Institute of Macromolecular Chemistry Aleea Gr. Ghica Voda 41A, 700487, Iasi Romania
| | - A. Bargan
- Inorganic Polymers Department“Petru Poni” Institute of Macromolecular Chemistry Aleea Gr. Ghica Voda 41A, 700487, Iasi Romania
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15
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Mahmoud H, Nicolescu A, Filip C, Duica G, Nicolae G, Cinteza EE. Cocoon devices for transcatheter closure of atrial septal defect and patent ductus arteriosus in children: Single center experience. Medicine (Baltimore) 2019; 98:e14684. [PMID: 30855458 PMCID: PMC6417521 DOI: 10.1097/md.0000000000014684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Closure of the atrial septal defect (ASD) and patent ductus arteriosus (PDA) are among the most frequent cardiac interventional procedures. This was a prospective study, which started together with the implementation of a national program of pediatric interventional cardiology in Romania. We used Cocoon devices in 83 consecutive cases from 92 implantations for ASD and PDA. 27 cases were ASD closure and 56 cases PDA closure. Regarding the ASD closure, the median age was 8.5 years (range 3-25 years) and median weight 25 kg (range 11.5-63 kg). The mean follow-up was 17.4 ± 6.7 months (range 3-26 months). The mean ASD diameter by transesophageal echocardiography was 15.2 ± 4.1 mm (range 8-26 mm). The mean device diameter used was 17.3 ± 5.6 mm (range 8-32 mm). Regarding the PDA closure, the median age was 36 months (range 4-192 months) and median weight 14 kg (range 5-58 kg). The mean follow-up was 15 ± 8 months (range 3-28 months). The mean PDA minimum diameter was 2.5 ± 0.8 mm. The success implantation rate for both groups was 97.6% (2 cases of withdrawn for ASD and PDA), while the complication rate was 2.3% (including 2 ASD device embolization). In the first 24 hours, the closure rates were 96.3% for ASD, 98.2% for PDA, and 100% at 1-month follow-up for both procedures. On short and intermediate follow-up (3-28 months), no device-related complications were noted.The Cocoon devices are safe for transcatheter closure of both ASD and PDA, and the initial experience with their use in our emerging center is encouraging.
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Affiliation(s)
- Hyam Mahmoud
- “Marie Curie” Emergency Children's Hospital, Constantin Brâncoveanu Avenue, Bucharest, Romania
- Royal Manchester Children's Hospital, Oxford Road, Manchester, United Kingdom
| | - Alin Nicolescu
- “Marie Curie” Emergency Children's Hospital, Constantin Brâncoveanu Avenue, Bucharest, Romania
| | - Cristina Filip
- “Marie Curie” Emergency Children's Hospital, Constantin Brâncoveanu Avenue, Bucharest, Romania
| | - Gabriela Duica
- “Marie Curie” Emergency Children's Hospital, Constantin Brâncoveanu Avenue, Bucharest, Romania
| | - Georgiana Nicolae
- “Marie Curie” Emergency Children's Hospital, Constantin Brâncoveanu Avenue, Bucharest, Romania
| | - Eliza Elena Cinteza
- “Marie Curie” Emergency Children's Hospital, Constantin Brâncoveanu Avenue, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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Cinteza E, Ungureanu A, Balgradean M, Nicolescu A. Beneficial Effects of Acetaminophen on the Chemical Mediators Involved in the Closure of Patent Ductus Arteriosus. Rev Chim 2018. [DOI: 10.37358/rc.18.6.6363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Paracetamol (N-acetyl- para-aminophenol) also known as acetaminophen is a chemical compound used in medical practice for analgesic and antipyretic effects. The mechanism of action is related to the cyclooxygenase (COX) activity, which is not full inhibit as for nonsteroidal anti-inflammatory. Paracetamol selectively inhibits COX activities in the brain, indirectly by reducing COX, which must be oxidized in order to function. In addition to analgesic and antipyretic effects, modulating the prostaglandin synthesis by selective inhibition of COX, a vascular modulator effect was described recently on the closure of the patent ductus arteriosus (PDA). This effect has been described in premature newborns, perhaps by decreasing the prostaglandin production. We present the case of a neonate, 39 weeks gestational age, normal birth weight who presented in the 10 th day of life with a cardiac murmur. Echocardiography evidenced a hemodynamically significant PDA, left ventricular enlargement, severe mitral regurgitation, patent foramen ovale and pulmonary hypertension. Although she was a 10-day- old full-term neonate paracetamol administration was attempted. Paracetamol was administered orally in the therapeutic dose of 15 mg/kg/dose, three times a day for three days. The effect was significant by reducing the diameter of the arterial duct (~50% of initial diameter), reducing the size of the left cardiac chambers, reducing the degree of mitral regurgitation from severe to mild, and disappearance of pulmonary hypertension. In conclusion, paracetamol use can change prognosis through the vaso-modulator on the PDA, at the age of 10 days, on a full-term neonate with a normal birth weight. This effect may also be present in full-term newborns and not only in preterm. Even if the PDA was not closed after three days, the hemodynamic impact disappeared and the child could avoid surgical ligation.
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Cinteza E, Balgradean M, Filip C, Duica G, Nicolae G, Nicolescu A, Mahmoud H. Iodinated Contrast Media in Pediatric Cardiac Angiography Nephrotoxic risk evaluation. Rev Chim 2018. [DOI: 10.37358/rc.18.2.6137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Contrast agents are among the most frequently used drugs in medical practice. The aim of our study was to evaluate the incidence of complications associated with the use of different contrast agents in an angiography lab dedicated to pediatric patients with congenital heart disease. Between June 2015 and December 2017, 166 patients with congenital heart disease were diagnosed and/or treated in the angiography lab. Of these patients, 38 were excluded because they did not require contrast substance administration. As interventional procedures we performed pulmonary valvular dilatation in 17 cases (10.2%), stent implantation in coarctation of the aorta in 9 cases (5.4%), PDA closure in 62 cases (37.3%), atrial septal defect (ASD) closure in 36 patients (including patients without contrast agent�s administration) (21.7%). In the group of 129 patients who received contrast agents, the median age was 5.8 years (range 0.1-19 years) and median weight 22.8 kg (range 2.8-72 kg). Average consumption of contrast media per procedure was 79 ml/procedure (range 5 - 400 mL) and 4.3 mL/kg (range 0.4 - 22.7). We used iomeprol (24%), iohexol (8.5%), iopromide (67.4%). No contrast related complications are reported in this group. In conclusion, the contrast agents we used seem to be safe and are not associated with renal complications.
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Cinteza E, Stoicescu C, Butoianu N, Balgradean M, Nicolescu A, Angrés M. Acute Myocardial Injury in a Child with Duchenne Muscular Dystrophy: Pulse Steroid Therapy? Maedica (Bucur) 2017; 12:180-183. [PMID: 29218065 PMCID: PMC5706757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Heart implication in Duchenne muscular dystrophy usually is present in the form of dilated cardiomyopathy, manifested as heart failure and arrhythmias. To delay progression, including heart deterioration, prednisone is recommended as preventive treatment. We report the case of an 11-year-old boy diagnosed with Duchenne muscular dystrophy at the age of seven, who was on preventive treatment with oral prednisone (0.75 mg/kg/day) and beta blocker (metoprolol, 1 mg/kg/day). Suddenly, the patient presented acute chest pain, vomiting and sweating. The electrocardiogram showed ST elevation in inferior leads. Troponin T was increased to 30814 pg/ml (normal values <14 pg/mL). The echocardiography revealed reduced contractility of the posteroinferior wall of the left ventricle. After excluding coronary implications by coronary angiography, we increased the oral prednisone to 1.4 mg/kg/day for five days and added enalapril (0.5 mg/kg/day, po). The response was positive, with a rapid decrease of the troponin T value to 3186 pg/mL in five days and gradual recovery of myocardial contractility afterwards.
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Affiliation(s)
- Eliza Cinteza
- Department of Pediatric Cardiology, "Marie Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Claudiu Stoicescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Niculina Butoianu
- Department of Pediatric Neurology, "Alexandru Obregia" Clinical Hospital, Bucharest, Romania
| | - Mihaela Balgradean
- Department of Pediatric Cardiology, "Marie Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Alin Nicolescu
- Department of Pediatric Cardiology, "Marie Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Matthias Angrés
- Department of Pediatric Cardiology, "Marie Curie" Emergency Children's Hospital, Bucharest, Romania
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Dascalu AI, Ardeleanu R, Neamtu A, Maier SS, Uritu CM, Nicolescu A, Silion M, Peptanariu D, Calin M, Pinteala M. Transfection-capable polycationic nanovectors which include PEGylated-cyclodextrin structural units: a new synthesis pathway. J Mater Chem B 2017; 5:7164-7174. [DOI: 10.1039/c7tb01722g] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Polycationic nanoentities with low variability are able to act as cooperating carriers for dsDNA complexation and transport.
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Affiliation(s)
- A. I. Dascalu
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
| | - R. Ardeleanu
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
| | - A. Neamtu
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
- Regional Institute of Oncology (IRO)
| | - S. S. Maier
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
- “Gheorghe Asachi” Technical University of Iasi
| | - C. M. Uritu
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
| | - A. Nicolescu
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
| | - M. Silion
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
| | - D. Peptanariu
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
| | - M. Calin
- “Nicolae Simionescu” Institute of Cellular Biology and Pathology
- Bucharest
- Romania
| | - M. Pinteala
- Centre of Advanced Research in Bionanoconjugates and Biopolymers
- “Petru Poni” Institute of Macromolecular Chemistry
- 700487 Iasi
- Romania
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Nicolae G, Nicolescu A, Cinteza E, Duica G, Diaconu A, Cirstoveanu C, Filip C. Prenatal Diagnosis in Great Artery Trasposition and Implications in Postnatal Outcome. Maedica (Bucur) 2016; 11:316-319. [PMID: 28828049 PMCID: PMC5543524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Great artery transposition, one of the most frequent and severe cyanotic heart malformations, represented the subject of many studies and research up to this moment. Although postnatal period is critical in this pathology, with correct management patients can benefit from complete surgical correction - arterial switch operation with good long term evolution. Prenatal diagnosis of Great Artery Transposition has an important contribution in choosing the appropriate treatment at the right time in postnatal period so that specific complications resulting from delaying the initiation of specific therapies can be avoided. This article proposes a review of existing data at this moment related to the importance of prenatal diagnosis in Great Artery Transposition and underlines how an accurate fetal diagnosis influences the decision of establishing the appropriate treatment in postnatal life for the children with this type of malformation and the complications that can be avoided.
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Affiliation(s)
- Georgiana Nicolae
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alin Nicolescu
- Department of Pediatric Cardiology, "Marie S. Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Eliza Cinteza
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Department of Pediatric Cardiology, "Marie S. Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Gabriela Duica
- Department of Pediatric Cardiology, "Marie S. Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Adriana Diaconu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Catalin Cirstoveanu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Department of Pediatric Cardiology, "Marie S. Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Cristina Filip
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Nicolae G, Filip C, Diaconu A, Nicolescu A, Arion C. DIAGNOSTICUL PRENATAL AL TETRALOGIEI FALLOT ŞI IMPLICAŢIILE POSTNATALE. Ro J Pediatr 2016. [DOI: 10.37897/rjp.2016.3.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
În ultimii ani, diagnosticul prenatal al malformaţiilor de cord a cunoscut o dezvoltare importantă. Supravietuirea globală a pacienţilor cu malformaţii congenitale de cord s-a îmbunătăţit în ultima decadă, datorită diversificării atât a metodelor de diagnostic, cât şi a celor de chirurgie cardiovasculară pe această arie de interes. Ca urmare a creşterii semnificative a supravieţuirii pe termen lung, în prezent, în majoritatea ţărilor dezvoltate există departamente dedicate monitorizării adulţilor cu malformaţii congenitale de cord, datorită particularităţilor şi nevoilor speciale ale acestui tip de pacienţi, în comparaţie cu patologia cardiacă dobândită a adultului. Articolul de faţă îşi propune o trecere în revistă a datelor existente până la acest moment legate de diagnosticul prenatal şi impactul acestuia asupra evoluţiei postnatale în ceea ce priveşte cea mai frecventă malformaţie congenitală cianogenă, şi anume Tetralogia Fallot. În cele ce urmează, reiterăm importanţa cunoaşterii cu exactitate a patologiei fetale prenatale pentru stabilirea din timp a conduitei medicale postnatale pentru copiii cu acest tip de malformaţie.
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Nicolae G, Filip C, Diaconu A, Nicolescu A, Arion C. POSTNATAL IMPLICATIONS FOR PRENATAL DIAGNOSED TETRALOGY OF FALLOT. Ro J Pediatr 2016. [DOI: 10.37897/rjp.2016.3.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Over the last few years, prenatal diagnosis of congenital heart diseases experienced an important development. Overall survival of patients with congenital heart disease was improved in the last decade due to the advanced diagnostic methods and progression of cardiovascular surgical procedures in this field. Due to the significant increase of the long-term survival rate, currently, in most developed countries, there are departments dedicated to monitoring the adults with congenital heart malformation due to the particularities and special needs of this type of patients, compared with the regular cardiac pathology of adults. This article proposes a review of existing data at this moment related to the prenatal and postnatal diagnosis and their impact on the evolution regarding the most common cyanotic congenital malformation – Tetralogy of Fallot. In the following pages, we is emphasize the importance of knowing the precise fetal pathology for early determination of medical behavior in the postnatal period for the best care of these children.
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Husainy M, Fang C, Nicolescu A, Lewis D, Vincent R, Kane P. Improving the radiological and biochemical success in adrenal venous sampling. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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24
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Minea B, Marangoci N, Peptanariu D, Rosca I, Nastasa V, Corciova A, Varganici C, Nicolescu A, Fifere A, Neamtu A, Mares M, Barboiu M, Pinteala M. Inclusion complexes of propiconazole nitrate with substituted β-cyclodextrins: the synthesis and in silico and in vitro assessment of their antifungal properties. NEW J CHEM 2016. [DOI: 10.1039/c5nj01811k] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Inclusion complexes with sulfobutylether-β-cyclodextrin, β-cyclodextrin sulphated sodium salt and monochlorotriazinyl-β-cyclodextrin were characterized and assessed for antifungal activity and cytotoxicity.
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25
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Cinteza E, Nicolescu A, Filip C, Lupu A, Nicolae G, Duica G, Balgradean M. Pulmonary Hypertension in Children - a Practical Approach. Maedica (Bucur) 2015; 10:237-242. [PMID: 28261360 PMCID: PMC5327836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Pulmonary hypertension (PH) is mean pulmonary arterial pressure above 25 mmHg at rest. Although considered a rare disease, the prevalence of PH in certain risk groups is higher, from 0.5% in patients with HIV infection to 30% in congenital heart disease (CHD) associating PH. In pulmonary arterial hypertension (PAH) associated with CHD, early changes of the vascular bed are reversible after correction of the defect, but there is a point from where the disease becomes irreversible or progression continues despite correction. Among patients with "operable" and "inoperable" CHD, there is a "gray area" group in between, which is defined by pulmonary vascular resistance equal to 4-8 WU/m and ratio of pulmonary vascular resistance to systemic vascular resistance of 0.3-0.5, measured by cardiac catheterization. In this situation a pulmonary vasoreactivity test is indicated. Pulmonary hypertension is a severe disease with increased morbidity and mortality. Pulmonary hypertension can result in death by decreased cardiac output, and heart failure.
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Affiliation(s)
- Eliza Cinteza
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alin Nicolescu
- "Marie Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Cristina Filip
- "Marie Curie" Emergency Children's Hospital, Bucharest, Romania
| | - Andrei Lupu
- "Marie Curie" Emergency Children's Hospital, Bucharest, Romania
| | | | - Gabriela Duica
- "Marie Curie" Emergency Children's Hospital, Bucharest, Romania
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26
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Andronescu C, Garea SA, Nicolescu A, Deleanu C, Eugeniu V, Iovu H. Innovative approach for the synthesis of benzoxazine-modified montmorillonite. HIGH PERFORM POLYM 2015. [DOI: 10.1177/0954008315584170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The synthesis of a benzoxazine (BZ) monomer inside the montmorillonite (MT) layers was done using a diamino-modified MT as the amine component, phenol, and formaldehyde. The formation of the BZ rings within the MT layers was investigated by thermogravimetric analysis, X-ray photoelectron spectroscopy, proton nuclear magnetic resonance spectroscopy, and X-ray diffraction, this being enhanced when dioxane was used as the solvent. The morphology of the hybrid BZ monomer was investigated by scanning electron microscopy.
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Affiliation(s)
- C. Andronescu
- Department of Bioresources and Polymer Science, University “Politehnica” of Bucharest, Bucharest, Romania
- Advanced Polymer Materials Group, University “Politehnica” of Bucharest, Bucharest, Romania
| | - S. A. Garea
- Advanced Polymer Materials Group, University “Politehnica” of Bucharest, Bucharest, Romania
| | - A. Nicolescu
- “PetruPoni” Institute of Macromolecular Chemistry, Iasi, Romania
| | - C. Deleanu
- “PetruPoni” Institute of Macromolecular Chemistry, Iasi, Romania
- Institute of Organic Chemistry, Romanian Academy, Bucharest, Romania
| | - V. Eugeniu
- Department of Oxide Materials Science and Engineering, University “Politehnica” of Bucharest, Bucharest, Romania
| | - H. Iovu
- Advanced Polymer Materials Group, University “Politehnica” of Bucharest, Bucharest, Romania
- Academy of Romanian Scientists, Bucharest, Romania
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27
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Nicolae G, Nicolescu A, Vintila AM, Diaconu A, Andronache A, Duica G, Cinteza E, Filip C. Giant Cardiac Mass Detected to an Infant with Normal Fetal Echography and No Systolic Murmur in Early Postnatal Evolution. Maedica (Bucur) 2015; 10:123-126. [PMID: 28275403 PMCID: PMC5327803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Infective endocarditis is rare in children and is rarer on a normal structural heart in an infant without any surgical intervention. Most cases are related to a pre-existing congenital lesion, the most frequent etiology are Gram-positive cocci and the most feared are fungal agents. This report presents a 7-monthold infant with fungal endocarditis on a normal structural heart. The diagnosis was suspected on clinical examination and was confirmed by echocardiography and positive blood cultures. His particular clinical evolution after medical and surgical treatment illustrates a severe disease with poor prognosis which may be a complication of neonatal intensive care procedures. Unusual cause of fungal endocarditis in a previously healthy infant: neonatal hospitalization in intensive care unit.
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Affiliation(s)
- Georgiana Nicolae
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alin Nicolescu
- Department of Pediatric Cardiology, "Marie S. Curie" Pediatric Emergency Hospital, Bucharest, Romania
| | - Ana-Maria Vintila
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Adriana Diaconu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Andreea Andronache
- Department of Pediatric Cardiology, "Marie S. Curie" Pediatric Emergency Hospital, Bucharest, Romania
| | - Gabriela Duica
- Department of Pediatric Cardiology, "Marie S. Curie" Pediatric Emergency Hospital, Bucharest, Romania
| | - Eliza Cinteza
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Cristina Filip
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Ciocarlan A, Vlad PF, Coltsa M, Edu C, Biriiac A, Nicolescu A, Deleanu C. Synthesis of C6 and C7 Functionalized Drimanes from Larixol and Sclareol. ChemJMold 2011. [DOI: 10.19261/cjm.2011.06(2).03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The current communication represents an extended abstract of the presentation delivered on the joint Moldo-Italian seminar “New frontiers in natural product chemistry”, held in the Institute of Chemistry, Academy of Sciences of Moldova on 30 September. An overview of the synthetic methods oriented to the synthesis of C6 and C7 functionalized euryfurans is provided.
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29
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Rija AP, Nicolescu A, Soran A, Coropceanu EB, Bulhac II, Bologa OA, Deleanu C, Bourosh PN. Cobalt(III) dimethylglyoximates containing selenourea and an unusual diselenourea ligand: Synthesis and structures. RUSS J COORD CHEM+ 2011. [DOI: 10.1134/s1070328411090077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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30
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Cazaceanu O, Baluta C, Vladareanu A, Begu M, Bumbea H, Vintilescu A, Barsan L, Vasile D, Dobrea C, Onisai M, Nicolescu A. 365 Low risk MDS – presenting as lead poisoning – with rapid transformation to acute leukemia – case report. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70367-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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Gaman M, Vladareanu A, Cisleanu D, Bumbea H, Begu M, Vintilescu A, Cazaceanu O, Baluta C, Onisai M, Voican I, Nicolescu A, Dobrea C, Ilea A, Bogdan M. 356 Pulmonary embolism combined with heterozygous carrier for factor V Leiden as initial clinical presentation in chronic myelomonocytic leukaemia. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Abstract
[structure: see text]. The important biological secondary messenger NO can be generated from exogenous nitrovasodilators and NO donors. Nitrate esters are nitrovasodilators and NO mimetics, believed to be biotransformed to NO in vivo. On the basis of a mechanistic hypothesis, nitrates have been synthesized that release NO at significant rates in neutral aqueous solution in the presence only of added thiol. The novel masked beta-mercaptonitrates reported (SS-nitrates), provide information on possible sulfhydryl-dependent biotransformation mechanisms for nitrates in clinical use.
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Affiliation(s)
- S I Zavorin
- Department of Chemistry, Queen's University, Kingston, Ontario K7L 3N6, Canada
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33
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Ilie S, Jipa S, Ile D, Mihalcea I, Nicolescu A. A catalytic activity model based on the structural defects of catalysts II. Alumina catalyst characterisation by radioluminescence method. J Radioanal Nucl Chem 1985. [DOI: 10.1007/bf02168354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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34
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Ilie S, Jipa S, Ilie D, Mihalcea I, Setnescu R, Nicolescu A. A catalytic activity model based on the structural defects of catalysts I.60Co gamma radiation field effect on 1-butene isomerisation on an alumina catalyst. J Radioanal Nucl Chem 1985. [DOI: 10.1007/bf02168353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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