Sf Spiridon University Hospital

Romania

Sf Spiridon University Hospital

Romania
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PubMed | Sf Spiridon University Hospital, Sf Spiridon Hospital and Grigore T. Popa University of Medicine and Pharmacy
Type: Case Reports | Journal: Journal of medicine and life | Year: 2015

Hepatocellular carcinomas make up 90% of primary liver cancers. The association between the hepatic carcinoma and virus B and C infection has been already proven. Hepatocellular carcinoma develops, in most cases, on a background of cirrhosis and rarely in hepatitis. The case we have chosen to report distinguishes itself due to the unusual extra-hepatic metastatic location of a hepatocellular carcinoma in a patient with Chronic HCV hepatitis.


Avadanei E.-R.,Grigore T. Popa University of Medicine and Pharmacy | Wierzbicki P.M.,Medical University of Gdańsk | Giusca S.-E.,Sf Spiridon University Hospital | Grigoras A.,Grigore T. Popa University of Medicine and Pharmacy | And 2 more authors.
Folia Histochemica et Cytobiologica | Year: 2014

Macrophages are important components of the tumor-associated infiltrate and are qualified as one of the major players of the cancer-related inflammation. It was shown that tumor cells can either stimulate or mediate apoptosis of tumor-associated macrophages (TAMs). To date, there is no general agreement regarding the influence of TAMs and their numbers on the progression of hepatocellular carcinoma (HCC) and hepaticmetastases (HM). To analyze the presence of TAMs and compare their numbers in intratumoral (IT) and peritumoral (PT) areas with the clinical outcome of HCC and HM patients. Biopsies from 35 HCC and 39 HM cases were analyzed. Clinical and follow-up data was enrolled for each case; the colorectal cancer was the origin of 26 HM patients. TAMs were identified by immunohistochemistry using anti-CD68 monoclonal antibody. The quantitative assessment was performed by determining the mean number of CD68-positive cells in IT and PT areas in HCC and HM. Two threshold methods were applied: threshold 1 (T1) was calculated with the use of (-log) Cox method; threshold 2 (T2) was considered as 1/3 TAMs number of group's mean. For statistical analyses Mann-Whitney U-test, Spearman's correlation, Cox proportional hazard and Kaplan-Meier tests were applied. To date, 36.12% HCC and 27.78% HM patients were alive, median survival was 5 and 17 months for HCC and HM, respectively (P = 0.05). We found significant two-fold decrease of TAMs numbers between IT vs. PT territories in both HCC and HM. A positive correlation between numbers of PT and IT TAMs was observed in HM group (rs = 0.48, P < 0.05) but not in HCC. The number of TAMs was not associated with any studied clinical factor. Univariate Cox regression analysis showed that tumor stage ≤ II (P = 0.01) and increased number of PT TAMs (P = 0.06, only when T2 value was applied) were associated with favorable prognosis in HCC (HR = 2.614 and 2.457, respectively). Univariate and multivariate Cox analyses in HM revealed favorable prognosis for histological grade ≤ G2 and one lobe tumors (P = 0.021 and 0.045; HR = 0.395 and 0.438, respectively). Survival analysis retained the impact of increased TAMs numbers in peritumoral areas (P = 0.03), tumor stages in HCC (P = 0.007), lobes' number (P = 0.007) and histological grade (P = 0.005) on HM patients' outcome. In HCC and HM the low number of TAMs in intratumoral areas was related to the tumor cell microenvironment. The increased peritumoral TAMs number in primary liver tumors was associated with better prognosis. © Polish Society for Histochemistry and Cytochemistry.


AvAdanei R.,Grigore T. Popa University of Medicine and Pharmacy | Caruntu I.-D.,Grigore T. Popa University of Medicine and Pharmacy | Amalinei C.,Grigore T. Popa University of Medicine and Pharmacy | Lozneanu L.,Grigore T. Popa University of Medicine and Pharmacy | And 4 more authors.
Romanian Journal of Morphology and Embryology | Year: 2013

The assessment of MMPs/TIMPs expression in various primary tumors has potential prognostic values. Considering the paucity of studies in secondary liver tumors, our aim was to study the expression of MMP2, MMP9, TIMP1, and TIMP2 in secondary hepatic cancer, focusing on their variability in the malignant cells. The study group included 25 cases of liver metastases of colorectal cancer, diagnosed and surgically treated at "Sf. Spiridon" University Hospital of Iassy, Romania. Immunohistochemistry for MMP2, MMP9, TIMP1, and TIMP2 has been performed, followed by the semi-quantitative assessment of the markers using a scoring system based on the positive tumoral cells percentage and the staining intensity. The expression of investigated markers revealed an increased staining variability. The scores showed that MMP2/TIMP2 and MMP9/TIMP1 immunoreactivity was extremely heterogeneous within the analyzed group, with a dominant weak expression for MMP2 and MMP9, in contrast to strong TIMP2 and TIMP1 expression. Ten different patterns of expression of the investigated markers have been identified. No major differences between the expression of MMP2 (14 positive cases) and MMP9 (16 positive cases) could be detected. Our results sustain the inverse correlation between MMP and the correspondent TIMP expression, supporting the hypothesis that MMPs/TIMPs balance has mainly an inhibitory effect on invasiveness. Our study demonstrated that tumoral cells are adapted to MMPs:TIMPs production in the liver microenvironment. The lack of significant differences between MMP2 and MMP9 expression shows that the activity of both MMPs is independent, without reciprocal influences.


Antoniu S.A.,Grigore T. Popa University of Medicine and Pharmacy | Petrescu E.,Grigore T. Popa University of Medicine and Pharmacy | Stanescu R.,Grigore T. Popa University of Medicine and Pharmacy | Anisie E.,Grigore T. Popa University of Medicine and Pharmacy | Boiculese L.,Sf Spiridon University Hospital
Therapeutic Advances in Respiratory Disease | Year: 2016

Introduction: Fatigue, which is also present in the healthy population, is a common but understudied symptom in chronic obstructive pulmonary disease (COPD). We hypothesized that clinically significant fatigue is also frequent in COPD and can be associated with an increased disease burden. Methods: An exploratory analysis derived from an ongoing cross-sectional study was carried out to evaluate levels of fatigue and impact on health-related quality of life/health status in patients with COPD (COPD group; n = 20) and healthy subjects (control group; n = 5). Health-related quality of life was measured using the Short Form Health Survey 36 (SF-36), health status with the Clinical COPD Questionnaire (CCQ), and airways obstruction with postbronchodilator forced expiratory volume in 1 s (FEV1 %predicted). Fatigue was measured with the vitality score of the SF-36, its clinical significance being defined by values of 50 or less. Fatigue was also measured using the Functional Assessment of Chronic Illness Therapy scale for fatigue (FACIT-F). Results: Vitality scores were significantly worse in the COPD group (45.60 versus 76.25; p = 0.004). FACIT-F scores were significantly lower in the COPD group versus the control group (74.5 versus 95.0; p = 0.03). Clinically significant fatigue was detected in 60% of the COPD group, and was associated with a worse FEV1 %predicted (47.71 versus 65.82%; p = 0.016), worse symptoms burden (CCQ symptoms score 3.75 versus 2.43; p = 0.019), and worse overall health status (CCQ total score 3.30 versus 2.11; p = 0.011). Its link with systemic inflammation remains to be clarified further. Conclusions: Clinically significant fatigue is common among patients with COPD and is associated with an increased disease burden. It should therefore be integrated as a measure of disease prognosis and control in patients with COPD. © 2016 The Author(s).


Popescu C.I.,Grigore T. Popa University of Medicine and Pharmacy | Giusca S.E.,Sf Spiridon University Hospital | Liliac L.,Grigore T. Popa University of Medicine and Pharmacy | Avadanei R.,Grigore T. Popa University of Medicine and Pharmacy | And 6 more authors.
Romanian Journal of Morphology and Embryology | Year: 2013

E-cadherins are epithelial morphological stabilizers, performing complex functions as receptors, providers of cellular and tissular structural integrity, and functional interactive mediators. Structural and functional unbalance initiated due to E-cadherin expression loss results in direct effects on carcinogenesis specific biological processes, as cellular invasion and proliferation. We investigated the E-cadherin expression aiming (i) to identify the differences in the molecular subtypes of breast cancer, (ii) to analyze the correlations between E-cadherin and specific clinicopathological and molecular characteristics. The study included 42 cases that were investigated immunohistochemically using a panel of antibodies (ER, PR, Her2/neu, CK5/6, EGFR), which permitted a diagnostic in compliance with the molecular classification, followed by the E-cadherin evaluation. The semi-quantitative assessment of E-cadherin was performed using a scoring system based on the positive cells percentage and the staining intensity. Our results showed, according to the molecular subtypes, a strong positive E-cadherin expression in 26 cases (luminal A subtype-nine cases, luminal B subtype-five cases, HER2 subtype-three cases, basal-like subtype-seven cases, unclassified subtype-two cases), and a weak positive one in 16 cases (luminal A subtype-six cases, luminal B subtype-eight cases, HER2 subtype-one case, basal-like subtype-one case). The statistical analysis revealed significantly statistical differences between E-cadherin and tumoral grade (p=0.0208), histological subtype (p=0.0081), triple negative molecular subtypes and non-triple negative, respectively (p=0.0361). These findings support the potential value of E-cadherin for a supplementary differentiation of molecular subtypes, based on the biological significance of its capacity of expression.


Aprotosoaie A.C.,Grigore T. Popa University of Medicine and Pharmacy | Hancianu M.,Grigore T. Popa University of Medicine and Pharmacy | Costache I.-I.,Sf Spiridon University Hospital | Miron A.,Grigore T. Popa University of Medicine and Pharmacy
Flavour and Fragrance Journal | Year: 2014

This paper reports on the occurrence, biosynthesis, metabolism, biological and toxicological profile, and assessment of the authenticity of linalool. The main biological properties of linalool - sedative, anxiolytic, analgesic, anticonvulsant, anti-inflammatory, local anaesthetic - are discussed in terms of the molecule's chirality influence, the mechanisms of activity and type of study (in vitro, in vivo, clinical studies). Also, there is a discussion of the recent data on the skin sensitizing potential of linalool based on numerous scientific studies which have been performed in the last few years. Comments of the authenticity assessment of linalool are made considering the limitations imposed by the chemical structure, vegetal matrix or processing methods, but also from the perspective of the powerful and sophisticated analytical techniques available today (GC-C-IRMS, enantio-MDGC coupled to GC-C-IRMS, SNIF-NMR). © 2014 John Wiley & Sons, Ltd.


Ulmeanu R.,Marius Nasta Institute | Ulmeanu R.,University of Oradea | Antohe I.,Grigore T. Popa University of Medicine and Pharmacy | Anisie E.,Sf Spiridon University Hospital | Antoniu S.,Grigore T. Popa University of Medicine and Pharmacy
Expert Review of Anticancer Therapy | Year: 2016

Lung cancer still remains associated with a high mortality rate and more efficacious therapies are needed in order to improve the disease outcome. Nivolumab is a monoclonal antibody which blocks the programmed death-1 receptor which is currently evaluated in phase III clinical trials in advanced lung cancer. Here, we evaluate the results of a phase III study in which nivolumab efficacy and safety were compared to those of docetaxel. Nivolumab was able to improve survival and progression-free survival and exhibited a very good safety profile. Further clinical data are needed in order to better position this therapy among the existing methods. The promising results support the use of this therapy as a stand-alone approach. © 2016 Taylor & Francis.


PubMed | Sf Spiridon University Hospital and Grigore T. Popa University of Medicine and Pharmacy
Type: Journal Article | Journal: Therapeutic advances in respiratory disease | Year: 2016

Fatigue, which is also present in the healthy population, is a common but understudied symptom in chronic obstructive pulmonary disease (COPD). We hypothesized that clinically significant fatigue is also frequent in COPD and can be associated with an increased disease burden.An exploratory analysis derived from an ongoing cross-sectional study was carried out to evaluate levels of fatigue and impact on health-related quality of life/health status in patients with COPD (COPD group; n = 20) and healthy subjects (control group; n = 5). Health-related quality of life was measured using the Short Form Health Survey 36 (SF-36), health status with the Clinical COPD Questionnaire (CCQ), and airways obstruction with postbronchodilator forced expiratory volume in 1 s (FEV1 %predicted). Fatigue was measured with the vitality score of the SF-36, its clinical significance being defined by values of 50 or less. Fatigue was also measured using the Functional Assessment of Chronic Illness Therapy scale for fatigue (FACIT-F).Vitality scores were significantly worse in the COPD group (45.60 versus 76.25; p = 0.004). FACIT-F scores were significantly lower in the COPD group versus the control group (74.5 versus 95.0; p = 0.03). Clinically significant fatigue was detected in 60% of the COPD group, and was associated with a worse FEV1 %predicted (47.71 versus 65.82%; p = 0.016), worse symptoms burden (CCQ symptoms score 3.75 versus 2.43; p = 0.019), and worse overall health status (CCQ total score 3.30 versus 2.11; p = 0.011). Its link with systemic inflammation remains to be clarified further.Clinically significant fatigue is common among patients with COPD and is associated with an increased disease burden. It should therefore be integrated as a measure of disease prognosis and control in patients with COPD.


PubMed | a Marius Nasta Institute, Sf Spiridon University Hospital and Grigore T. Popa University of Medicine and Pharmacy
Type: Comparative Study | Journal: Expert review of anticancer therapy | Year: 2016

Lung cancer still remains associated with a high mortality rate and more efficacious therapies are needed in order to improve the disease outcome. Nivolumab is a monoclonal antibody which blocks the programmed death-1 receptor which is currently evaluated in phase III clinical trials in advanced lung cancer. Here, we evaluate the results of a phase III study in which nivolumab efficacy and safety were compared to those of docetaxel. Nivolumab was able to improve survival and progression-free survival and exhibited a very good safety profile. Further clinical data are needed in order to better position this therapy among the existing methods. The promising results support the use of this therapy as a stand-alone approach.


Feraru C.,Sf Spiridon University Hospital | Chiselita D.,Sf Spiridon University Hospital | Pantalon A.,Sf Spiridon University Hospital
Spektrum der Augenheilkunde | Year: 2016

Purpose: The aim of the present study was to investigate the perimetric progression rate and associated risk factors in open-angle glaucoma in clinical practice. Methods: This was a retrospective study based on clinical chart reviews of patients with primary open-angle glaucoma (POAG) followed up for more than 5 years with ≥5 SITA standard visual fields. Demographics, visual acuity (VA), central corneal thickness (CCT), intraocular pressure values (IOP), treatment (number of medications), visual fields (VFs), and associated systemic pathologies were recorded. Patients were followed up every 3–6 months and identical tests were performed. The VF progression rate was calculated as slope of mean deviation (MD) over time using the Glaucoma Progression Analysis software. Results: In all, 69 eyes from 69 patients with POAG were included in the study and followed up for a mean period of 72.9 months (SD ± 31.7). The mean MD at the start was −4.4 dB (SD ± 6.0), with a mean number of VF tests of 8.3 (SD ± 2.9). The progression rate reached −0.18 ± 0.1 db/year. The mean IOP at all visits decreased over time from 18.2 mm Hg to 16.5 mm Hg (p < 0.05). A step-wise one-way ANOVA regression analysis concluded that for the MD slope the significant predictors were final MD level (R2 = 0.126, p = 0.003) and a combination between baseline and final MD level (R2 = 0.656, p = 0.000). Systemic factors such as sex, positive history of cardiovascular diseases, and hypertension reached no statistical relevance in terms of increased risk or significant association with glaucoma progression. Diabetes had a borderline significance (p = 0.07) as a “protective factor” against progression, as more “stable” cases were associated with diabetes than “progressing” ones. Conclusion: The rate of VF changes in POAG correlated with and dependent on the baseline/final MD level; additional risk factors reached no statistical significance in our clinical care glaucoma study. © 2016, Springer-Verlag Wien.

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