Târgu-Mureş, Romania
Târgu-Mureş, Romania

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Patrascu V.,University of Medicine and Pharmacy of Craiova | Giurca C.,Emergency County Hospital | Ciurea R.N.,Emergency County Hospital | Georgescu C.V.,Emergency County Hospital
Romanian Journal of Morphology and Embryology | Year: 2013

Granuloma annulare (GA) is classified as localized, generalized/disseminated, subcutaneous, and perforating types. The studies show connection with diabetes mellitus, lipidic metabolic disorders, malignant diseases, thyroid disorders, infections (HBV, HCV, HIV). We performed a retrospective study between 2010-2011, regarding disseminated GA (GAD), and the relationship between GAD and other comorbidities. We clinically and histologically diagnosed eight cases of GAD. The patients were also investigated for the diagnosis of associated diseases. The treatment included topical corticosteroids, antihistamines, Calcipotriol/Betamethasone, Tacrolimus 0.03%, Pentoxifylline, Hydroxychloroquine. Therapeutic response was assessed one month and three months after hospitalization. Our patients were five women and three men, aged 46-68 years, mean age 57.25 years, with a disease history of one year and a half (between three months and four years). The lesions occurred in the upper extremities (eight cases), distal extremities (three cases), cervical area (two cases), and trunk (five cases). In seven cases, we found annular appearance and one patient had disseminated small papules eruption. Associated pathology was diabetes mellitus type II (five cases), overweight and obesity (five cases), dyslipidemia (three cases), hypothyroidism (one case), rheumatoid arthritis (one case), external ear canal basal carcinoma (one case). Although there is controversy regarding the relationship between GAD and associated diseases, it is accepted that it is significantly associated with diabetes mellitus, also found in our study in five out of eight cases. We noticed obvious improvements after local and general treatment. It is confirmed that GAD is prevalent in women, over 40-year-old. GAD is often associated with diabetes and dyslipidemia, therefore it is necessary to investigate patients in this direction. The histopathological exam is essential for an accurate confirmation of GA.


Fratila O.C.,University of Oradea | Fratila O.C.,Emergency County Hospital | Ilias T.I.,Emergency County Hospital
Romanian Journal of Morphology and Embryology | Year: 2013

Introduction: Malignancy in LUC (long-standing ulcerative colitis) presumably evolves through a chronic inflammation-dysplasia-adenocarcinoma sequence in which a multitude of yet not fully understood factors takes part. Aim: To assess ulcerative colitis (UC) associated dysplasia and to distinguish regenerative changes from premalignant ones using immunohistochemical (IHC) markers. Materials and Methods: We studied 80 LUC biopsy specimens: 20 high-grade dysplasia (HGD), 20 low-grade dysplasia (LGD), 20 indefinite for dysplasia, 20 regenerative atypia. We used anti-COX-2 and Ki-67 antisera (Dako, Carpinteria, USA) to perform immunohistochemical staining by the labeled Streptavidin-Biotin method, and then assessed and graded staining intensity and distribution using previously described scoring systems. Statistical analysis was made using chi-square test and SPSS application. A p-value <0.05 was considered significant. Results: In LGD, most of the cases had middle and top Ki-67 localization of the staining. For HGD, we found to be characteristic the top and surface staining of the crypts and no case of basal immunostaining. COX-2 immunostaining was positive (total score ≥3) in 72.5% of all the UC cases studied. In non-dysplastic lesions (regenerative atypia), COX-2 expression was negative and as the pathologic process progressed towards dysplasia/malignant transformation, COX-2 expression became positive with a progressive increase of the total score. Conclusions: A combination of enhanced colonoscopic surveillance and IHC markers those are more sensitive for dysplasia might be the optimal way to manage the increased colorectal cancer (CRC) risk in LUC patients. Further studies to find additional prognostic parameters will provide valuable insights into the behavior of LUC.


Ghervan C.,University of Medicine and Pharmacy, Cluj-Napoca | Silaghi A.,Emergency County Hospital | Nemes C.,Emergency County Hospital
Medical Ultrasonography | Year: 2012

Introduction: Parathyroid incidentaloma (PTI) designates a nodule discovered incidentally during thyroid sonography, and whose location and aspect suggests an abnormal parathyroid. Our aim was to assess the prevalence of PTI, their functional characteristics and to identify the factors correlated with their presence. Patients and methods: We recorded all patients detected with PTI between January 2009 and December 2011, in our department. Serum calcium, parathyroid hormone (PTH), thyroid stimulating hormone (TSH), free thyroine (FT4) and anti thyroid peroxidase antibodies (anti-TPO Ab) were measured. Results: From a total of 2662 thyroid ultrasounds, 32 patients were identified with PTI (prevalence 1.2%). The diagnosis of a functional parathyroid adenoma was confirmed in 12 patients (37.5%). There was no significant difference in size, location, echogenicity or vascular pattern between the functioning adenomas and the other PTI. The only parameter correlated with the non functioning lesion was the multinodular pattern of the thyroid (multinodular goiter or macronodular autoimmune thyroiditis). Conclusions: Although rare, the ultrasound identification of an image suggestive for a pathological parathyroid gland requires the evaluation of the functioning character of the lesion, more than one third PTI being hyperfunctional. The concomitance of a nodular goiter decreases the probability of a primary hyperparathyroidism.


Nicoara S.-D.,University of Medicine and Pharmacy, Cluj-Napoca | Cristian C.,University of Medicine and Pharmacy, Cluj-Napoca | Irimescu I.,University of Medicine and Pharmacy, Cluj-Napoca | Stefanut A.-C.,Emergency County Hospital | Zaharie G.,University of Medicine and Pharmacy, Cluj-Napoca
Journal of Pediatric Ophthalmology and Strabismus | Year: 2014

Purpose: This study aimed to evaluate the outcome of transpupillary diode laser photocoagulation for retinopathy of prematurity (ROP) at one institution in Romania. Methods: This retrospective case series included all infants who received indirect diode laser photocoagulation for ROP between January 1, 2006, and December 31, 2012. Results: The 160 eyes of 83 infants were classified into two categories: 136 eyes (85%) with classic disease (stage III ROP in zones 1 or 2) and 24 eyes (15%) with aggressive posterior ROP (AP-ROP). ROP regressed in 141 eyes (88.12%). The success rate was significantly better in the classic ROP group (94.11%) compared to the APROP group (54.16%) (P<.001). Conclusions: The ROP regression rate after the laser treatment was 88% in this series.


Popa R.T.,Emergency County Hospital
Medical ultrasonography | Year: 2010

Agenesis of the corpus callosum is an anomaly that may occur as isolated or in association with other central nervous system or systemic malformations. We report the case of an infant antenatal diagnosed with ventriculomegaly referred in the postnatal period to our department for imaging evaluation. Ultrasonography showed the absence of the corpus callosum and an interhemispheric lesion highly suggestive for a cerebral lipoma. The diagnosis was confirmed through MRI.


Popescu M.,Emergency County Hospital
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie | Year: 2012

Primary spinal involvement in hematological diseases is rare. The purpose of this article is studying diagnostic and treatment strategies in patients with spinal cord primary hematologic tumors causing spinal cord compression syndrome. We report two cases with spinal cord primary hematologic tumors causing spinal cord compression syndrome. One patient had a diffuse large B-cell non-Hodgkin's lymphoma located in the thoracic spine and the second patient had a plasmocytic plasmacytoma located in the thoraco-lumbar spine. Both patients underwent surgery, with resection of the intracanalar tumor and spinal cord decompression and adjuvant systemic and intrathecal chemotherapy. Neurological outcome was favorable with partial remission of spinal cord compression syndrome. Finally, patients developed secondary dissemination and succumbed due to progression of the hematological disease. Clinical onset and radiographic evaluation is uncharacteristic in early stages. Spinal MRI is mandatory in cases with rebel pain, unresponsive to conservative treatment. Surgery is indicated in all patients with spinal cord compression syndrome. Early diagnosis is associated with better prognosis. Recommended treatment is surgical resection and systemic and intrathecal chemotherapy adapted to histological form of each tumor. In selected cases, if indicated radiotherapy can also be associated.


Otilia M.,Emergency County Hospital | Pirici D.,University of Medicine and Pharmacy of Craiova | Margaritescu C.,University of Medicine and Pharmacy of Craiova
Romanian Journal of Morphology and Embryology | Year: 2011

Ischemic stroke is the third most common cause of death in humans, requiring further studies to elucidate its pathophysiological background. One potential mechanism to increase oxygen delivery to the affected tissue is induction of angiogenesis. The most potent proangiogenic factor is VEGF. For this reason, our study investigated immunohistochemically VEGF reactivity in different cellular brain compartments from 15 ischemic stroke patients, as well as from 2 age control cases. By enzymatic immunohistochemistry, we investigate VEGF expression in different brain cell compartments and then we quantified its signal intensity by assessing integrated optical densities (IOD). To establish the exact cellular brain topography of VEGF immunoreactivity we performed double fluorescent immunohistochemistry series (VEGF/NeuN, GFAP, CD68, CD105). In control samples, VEGF reactivity was observed especially in neurons from the Brodmann cortical layers IV to VI and in protoplasmic astrocytes from the deeper layers of gray matter and in endothelial cells from normal blood vessels because of systemic hypoxia generated after death. In acute ischemic stroke samples, this reactivity was noticed in all brain cellular compartments but with different intensities. The most reactive compartment was the neurons, the intensity of VEGF reaction decreasing with the lesional age from the core infarct toward intact adjacent brain cortex. With a lower intensity, VEGF reaction was noticed in astrocytes compartments, especially in gemistocytic astrocytes adjacent to the liquefaction zone. We also noticed a weak reaction in activated non-phagocytic microglia from the periphery of liquefaction zones, and high VEGF-CD105 colocalization values at the level of microvessels that surround the infarcted brain area. In conclusion, this reactivity could suggest that VEGF might exhibit neuronal and glial protective effects and also a neoangiogenic property in acute ischemic stroke, facts that may have significant therapeutically impact on these patients.


Onutu A.H.,Emergency County Hospital
IETE Technical Review (Institution of Electronics and Telecommunication Engineers, India) | Year: 2015

Serotonin and norepinephrine reuptake inhibitors are second-line antidepressants largely used because of their good tolerance and their reduced side effects. Two of these drugs, duloxetine and venlafaxine, are used also in chronic pain management. In this review we present recent data regarding duloxetine’s effects on the central nervous system, linked to acute pain management, and their efficiency in reducing postoperative chronic pain. The drug’s efficacy results from its modulating effect on the descending inhibitory pain pathways and the inhibition of the nociceptive input. There are already several studies in favor of the analgesic properties of duloxetine. However, further and larger randomized studies are necessary in order to clarify duloxetine efficiency in acute postoperative settings, and thereafter on persistent chronic postoperative pain. © 2015, Taylor and Francis Ltd. All rights reserved.


Mateoiu C.,University of Medicine and Pharmacy of Craiova | Pirici A.,Emergency County Hospital | Bogdan F.L.,University of Medicine and Pharmacy of Craiova
Romanian Journal of Morphology and Embryology | Year: 2011

Background: Basal cell carcinoma is the most common form of human cancer. Increased expression of p53 has been found in the majority of basal cell carcinomas (BCCs); however, UV-light-induced signature mutations are present in only about 50% of cases. Increased nuclear staining with an immunohistochemical marker of proliferation and apoptosis has been correlated with aggressive behavior in BCC. Objective: Our purpose was to correlate markers expression of apoptosis (p53 and bcl-2) and cell proliferation (Ki-67 and PCNA) with histological indicators of tumor severity. Methods: We used immunohistochemical stains for p53, PCNA, and Ki-67, in superficial, nodular and sclerosing BCC, to determine whether the staining patterns differ in these different histologic variants of BCC. Results: Bcl-2 expression was significant in basal cell carcinomas said to be aggressive (morpheaform and nodular types). Of the studied tumors, 66.7% (n=14) strongly expressed p53. Our results show a greater expression of Ki-67 in nodular and superficial basal cell carcinoma. PCNA showed a strong expression in all types of tumors. Conclusion: Studies employing molecular and genetic biology techniques, associated with histomorphology, lead to the identification of risk factors in the development of more recurring and aggressive lesions.


Chirila M.,University of Medicine and Pharmacy, Cluj-Napoca | Chirila M.,Emergency County Hospital | Bolboaca S.D.,University of Medicine and Pharmacy, Cluj-Napoca
European Archives of Oto-Rhino-Laryngology | Year: 2014

The aim of the study was to assess the clinical efficiency of quadrivalent HPV (types 6/11/16/18) vaccine in patients with recurrent respiratory papillomatosis (RRP). This was a prospective study of patients with RRP treated from January 2009 to July 2012 at the Ear, Nose and Throat Department of the Emergency County Hospital of Cluj-Napoca, Romania. Demographic characteristics, onset of RRP, HPV typing, use and number of cidofovir injections, number of surgeries for RRP per year, and use of human papillomavirus vaccine (types 6, 11, 16, 18) (recombinant, adsorbed)/Silgard® were considered from all the patients included in the study. Charts were reviewed for follow-up after diagnosis, after cidofovir, and after Silgard; all the statistical tests were applied at a significance level of 5 %. The recurrences were observed within 27.53 ± 11.24 days after intralesional cidofovir injection. Thirteen patients with recurrence after cidofovir agreed and received Silgard® vaccine. 85 % [54.44-99.41] of patients had no recurrences during 1-year follow-up. The recurrence of papillomas was observed in two patients (15 %, 95 % CI [0.59-45.56]), one with adult-onset RRP and one with juvenile-onset RRP. Both recurrences appeared after the first Silgard dose; one month after the third vaccine dose each patient underwent a new surgery for remaining papillomas with no recurrences at 1-year follow-up visit. Silgard® vaccination had a good effect and proved to be efficient in the treatment of our patients with RRR without appearance of recurrence in 85 % of the patients during 1-year follow-up. © 2013 Springer-Verlag Berlin Heidelberg.

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