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Tache I.-A.,Polytechnic University of Bucharest | Itu L.,Transilvania University of Brasov | Niculescu R.,Clinical Emergency Hospital of Bucharest
2014 18th International Conference on System Theory, Control and Computing, ICSTCC 2014

This X-ray angiography is the current gold standard for morphology based diagnosis of coronary arteries due to their spatial and temporal resolution. Transit time methods are applied on coronary angiograms to estimate the interval of time required for the contrast material to traverse the distance between two regions of interest. They represent an important prerequisite for estimating blood flow parameters like velocity or flow rate which characterize the hemodynamic patterns of blood vessels. In this article we perform an analysis of ten different transit time estimation methods on routine clinical angiographic data acquired at the Clinical Emergency Hospital of Bucharest by using the time density curves. Different coronary arteries are considered and the analysis is performed on raw data, filtered data and fitted data. The most robust methods are the mean transit time, the mean arrival time and the cross correlation method. Furthermore, the mean transit time and the cross correlation method tend to underestimate, while the rise time method tends to overestimate the transit time. Automated filtering and fitting methods improve the results significantly and should always be used in conjunction with transit time estimation methods. © 2014 IEEE. Source

Tache I.-A.,Polytechnic University of Bucharest | Zamfir D.,Clinical Emergency Hospital of Bucharest
2013 2nd International Conference on Systems and Computer Science, ICSCS 2013

The progress of mathematical modeling and image processing in medicine from the last decades have had an important impact in the development of diagnosis and treatment of cardiovascular diseases using the simulations of blood flow and pressure evolution models in specific location of the heart or vessels, personalised with patient data. This method is expected to increase the efficiency and reduce the recovery time of the patient. In this paper, it is depicted the cardiovascular system and his pathology, the non-invasive technologies of investigation, as well as the multiscale models that couples the elements of the cardiovascular system. Finally, the results of a simulation with a variable elastance model of the heart initialized with patient data coupled with a Windkessel model for the coronary circulation with mean values from the literature. © 2013 IEEE. Source

Micheu M.M.,Clinical Emergency Hospital of Bucharest | Oprescu N.,Clinical Emergency Hospital of Bucharest | Calmac L.,Clinical Emergency Hospital of Bucharest | Scafa-Udriste A.,Clinical Emergency Hospital of Bucharest | Dorobantu M.,Clinical Emergency Hospital of Bucharest
Romanian Journal of Morphology and Embryology

Aims: To investigate the circulating progenitor stem cells (cPCs) count evolution during seven days hospitalization period in ST segment elevation myocardial infarction (STEMI) patients, and to correlate their evolution with some clinical and angiographic parameters. Materials and Methods: Twelve Caucasian patients with STEMI undergoing primary percutaneous coronary intervention (PCI) were enrolled. Blood samples were obtained in the emergency room and then daily, for seven days, we evaluated the number of cPCs (CD34+CD45+, CD133+CD34+CD45+, KDR+CD34+CD45+and KDR+CD133+CD34+CD45+) by flow cytometry using fluorochrome-marked specific monoclonal antibodies. Results: There is a statistically significant increase in cPCs counts in the following days after STEMI, with a different behavior depending on their phenotype. Mature cPCs (CD34+CD45dim, KDR+CD34+CD45dim) have two fairly similar peaks, first around the third day of evolution followed by a short decrease and a new raise in the seventh day, the more immature cPCs (CD133+CD34+CD45dim, KDR+CD133+CD34+CD45dim) have just one spike on the third day, and then almost disappear from the peripheral circulation. In a multivariate regression analysis, preprocedural TIMI (Thrombolysis In Myocardial Infarction) flow, postprocedural myocardial blush and LVEF (Left Ventricular Ejection Fraction) proved to be independent predictors for cPCs variation in the first week after STEMI. Conclusions: In our study, we demonstrated that all four main phenotypes of circulating progenitor stem cells boosted up in the next days after STEMI, with different patterns depending on cell type; preprocedural TIMI flow, postprocedural myocardial blush and LVEF proved to be independent predictors for cPCs mobilization in the first days after STEMI. © 2014, Editura Academiei Romane, All rights reserved. Source

Micheu M.,Clinical Emergency Hospital of Bucharest | Oprescu N.,Clinical Emergency Hospital of Bucharest | Calmac L.,Clinical Emergency Hospital of Bucharest | Pitic D.,Clinical Emergency Hospital of Bucharest | Dorobantu M.,Clinical Emergency Hospital of Bucharest
Studia Universitatis Vasile Goldis Arad, Seria Stiintele Vietii

Our aim was to assess the feasibility and safety within first month after autologous bone marrow stem cell therapy in patients with acute myocardial infarction (AMI) and severe systolic dysfunction. Twelve patients were included. All the patients were treated in accordance with existing guidelines. In the stem cell treated group, collection of 50 ml of bone marrow aspirate was performed; after density gradient separation, the mononuclear bone marrow cell suspension was delivered via intracoronary route.At 1 month follow-up, there were no significant differences between groups regarding systemic inflammatory response, malignant arrhythmias or deaths. Moreover, in stem cell treated group we observed an antiremodelling effect along with improvement of left ventricle systolic function.The autologous bone marrow stem cell therapy has proven to be a feasible and safe method of treatment, but larger studies are required in order to reveal the intimate mechanisms of action. © 2014 Vasile Goldis University Press. Source

Grintescu I.M.,Clinical Emergency Hospital of Bucharest | Luca Vasiliu I.,Clinical Emergency Hospital of Bucharest | Cucereanu Badica I.,Clinical Emergency Hospital of Bucharest | Mirea L.,Clinical Emergency Hospital of Bucharest | And 3 more authors.
Clinical Nutrition

Background & aims: Rapid onset of resistance to insulin is a prominent component of stress metabolism in multiple trauma patients. Recent studies have clarified the role of amino acids (especially glutamine) in glucose transportation and the benefits of parenteral alanyl-glutamine supplementation (0.3-0.6g/kg/day) in glucose homeostasis. The aims of this study are to evaluate the incidence of hyperglycemic episodes and the need for exogenous insulin to maintain stable glucose levels in critically ill polytrauma patients supplemented with parenteral glutamine dipeptide (Dipeptiven®) versus standard nutritional support. Methods: This was an open-label randomized-controlled trial of 82 polytrauma patients aged 20-60 years old, randomly assigned into two equal groups independent of sex, age and Injury Severity Score. We excluded patients with diabetes mellitus, or renal or hepatic failure. One group received parenteral Dipeptiven® supplementation of 0.5g/kg/day and the other received standard isocaloric isoproteinic nutritional support. Results: We found that 63% of patients in the glutamine-supplemented group had no hyperglycemic episodes; only 37% required exogenous insulin (mean daily requirement of 44units/day). In the control group, 51% of patients required insulin (mean daily requirement 63unit/day; p=0.0407). Conclusions: The effect of glutamine supplementation on glucose homeostasis is associated with a lower incidence of hyperglycemia among critically ill polytrauma patients, and leads to a lower mean daily dose of insulin. Controlled-trials.com Identifier: ISRCTN71592366 (http://www.controlled-trials.com/ISRCTN71592366/ISRCTN71592366). © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. Source

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