Sfanta Maria Clinical Hospital

Bucharest, Romania

Sfanta Maria Clinical Hospital

Bucharest, Romania
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Dima A.,Stefan Cel Mare University of Suceava | Dima A.,Carol Davila University of Medicine and Pharmacy | Opris D.,Carol Davila University of Medicine and Pharmacy | Opris D.,Sfanta Maria Clinical Hospital | And 3 more authors.
Lupus | Year: 2016

The inflammatory response during systemic lupus erythematosus (SLE) flares is known to be atypical, characterized by a disproportionately lower C-reactive protein (CRP) elevation when compared with erythrocyte sedimentation rate (ESR). Thus, in these patients, the analysis of inflammatory markers might be challenging in daily clinical practice. Clinicians need frequently to distinguish lupus reactivations and infectious conditions, and the significance of ESR and CRP seems to be different. Even though a non-specific marker of inflammation, ESR utility in SLE should not be neglected and it appears to be a useful biomarker for SLE activity assessment. Describing a specific cut-off for ESR in SLE is important for patients' follow-up, and levels up to 25-30 mm/h have been proposed as an upper limit of the normal range. Regarding CRP, even though higher baseline levels are described in SLE when compared with controls, including in remission periods, its response during flares seems to be incomplete and not always correlated with disease activity; while CRP values greater than 10 mg/l could be indicative for severe flares, when there is no serositis or arthritis, higher CRP levels above 50-60 mg/l may be associated with infection. © The Author(s), 2016.

Hulpus R.,Clinical County Emergency Hospital | Constantinoiu S.,Sfanta Maria Clinical Hospital | Bratu D.,Clinical County Emergency Hospital | Dumitra A.,Clinical County Emergency Hospital | And 5 more authors.
Chirurgia (Romania) | Year: 2013

Introduction: The diagnosis of esophago-gastric junction adenocarcinoma often occurs when the neoplastic process is surprised in advanced stages and blocks the esophageal-gastric junction causing dysphagia, stages in which curative therapy is more likely impossible to be accomplished. In these cases, the treatment goal is mainly to provide feeding capacity as naturally as possible and to start the adjuvant oncological treatment. The use of endoscopic esophageal prostheses provides the patient with the possibility to be fed orally and with a good social integration, but due to the technical incapacity to cross the tumoral stenosis with the endoscope, or due to the endoscopist's concerns regarding the "sensitive" areas (poles of the esophagus), there are reluctances in respect to this method (on average 20%). Material and Method: We conducted a retrospective study aimed to determine the optimal therapeutic modality depending on the evolutive stages of the disease and to analyse the justification of the original procedure of laparogastroscopic esophageal stenting through tumoral drilling as a technical alternative to the "reluctances" or failures of endoscopic prosthesis and as a biological and social solution to the disabling gastrostomy for patients with advanced esophageal-gastric junction adenocarcinoma. Results and Discussions: Staging was disarming, most patients were diagnosed in advanced stages, fact also supported by literature. Regarding esophageal stenting by transtumoral drilling, the results are significant especially in terms of post-operative morbidity Conclusions: Although our study regarding laparogastroscopic stenting by transtumoral drilling in esophago-gastric junction adenocarcinoma is limited, this original procedure brought us satisfaction whenever we used this approach. © Celsius 2013.

Besliu A.,Cantacuzino National Institute of Research and Development for Microbiology and Immunology | Banica L.,Cantacuzino National Institute of Research and Development for Microbiology and Immunology | Predeteanu D.,Sfanta Maria Clinical Hospital | Vlad V.,Sfanta Maria Clinical Hospital | And 6 more authors.
Autoimmunity | Year: 2011

It was suggested that the immune system plays an important role at least in the amplification of the main elements in systemic sclerosis (SSc), an autoimmune disease with an incompletely elucidated pathogenesis. Elucidation of the mechanisms involved in the interaction between T and B cells, major players of the immune system, could contribute to a better understanding of some of clinical and pathological manifestations of SSc. Recently, abnormalities in Semaphorin 4D (Sema4D/CD100) or CD72, two contrareceptors involved in T and B cells cooperation, were associated with autoimmunity. Therefore, we investigated CD100 and CD72 expression level on T and B cells in attempting to establish their role in SSc pathogenesis. The results revealed augmented percentages of CD100 high T and B cells, significantly increased expression of CD100 on CD4 + T cells and frequently detectable levels of soluble CD100 in SSc patient sera compared to healthy donors. In SSc, CD100 dysregulations were associated with anti-Scl70 antibodies production, disease type, thickening of skin, disease duration, or with active inflammation processes. In consequence, dysregulations in CD100 expression and release could play a role in SSc development and/or maintenance. © Informa UK, Ltd.

Andrei R.,Sfanta Maria Clinical Hospital | Popescu S.A.,Carol Davila University of Medicine and Pharmacy | Zamfirescu D.,Carol Davila University of Medicine and Pharmacy
Chirurgia (Romania) | Year: 2014

Background: A great variety of flaps have been used in lower limb reconstructive surgery: random pattern flaps, axial flaps and free microsurgical transfers with many variants. After further research on the cutaneous blood supply and improvement of microsurgical techniques, perforator propeller flaps began to be studied and used. Material and method: A propeller flap is defined as an insular flap mobilized through an axial rotation on a perforator pedicle in order to cover a defect that has to be reconstructed. According to the specialized literature data and to the studies we made on cadavers, this paper establishes a classification based on several criteria: 1) the position of the supplying perforator; 2) the reconstructive necessities and the skin island; 3) the flap blood supply; 4) the aesthetic and functional demands of the reconstructed areas. Based on this study we established the specific reconstructive indications for these propeller flaps. Conclusions: The reconstructive lower limb strategy allows the use of the perforator propeller flaps as first therapeutic option for small and medium defects in certain areas considered as "critical". Knowledge of the pedicle length and the surface of the flaps facilitates the optimum flap choice in the reconstruction of a certain area. Copyright © 2014 Celsius.

Popescu C.,Sfanta Maria Clinical Hospital | Popescu C.,Carol Davila University of Medicine and Pharmacy | Bojinca V.,Sfanta Maria Clinical Hospital | Bojinca V.,Carol Davila University of Medicine and Pharmacy | And 4 more authors.
Journal of Osteoporosis | Year: 2014

Introduction. Atherosclerosis and osteoporosis share an age-independent bidirectional correlation. Rheumatoid arthritis (RA) represents a risk factor for both conditions. Objectives. The study aims to evaluate the connection between the estimated cardiovascular risk (CVR) and the loss of bone tissue in RA patients. Methods. The study has a prospective cross-sectional design and it includes female in-patients with RA or without autoimmune diseases; bone tissue was measured using whole body dual X-ray absorptiometry (wbDXA); CVR was estimated using SCORE charts and PROCAM applications. Results. There were 75 RA women and 66 normal women of similar age. The wbDXA bone indices correlate significantly, negatively, and age-independently with the estimated CVR. The whole body bone percent (wbBP) was a significant predictor of estimated CVR, explaining 26% of SCORE variation along with low density lipoprotein (P < 0.001) and 49.7% of PROCAM variation along with glycemia and menopause duration (P < 0.001). Although obese patients had less bone relative to body composition (wbBP), in terms of quantity their bone content was significantly higher than that of nonobese patients. Conclusions. Female patients with RA and female patients with cardiovascular morbidity have a lower whole body bone percent. Obese female individuals have higher whole body bone mass than nonobese patients. © 2014 Claudiu Popescu et al.

Manea C.,Carol Davila University of Medicine and Pharmacy | Sarafoleanu C.,Sfanta Maria Clinical Hospital
Romanian Journal of Legal Medicine | Year: 2015

Objectives: Due to the continuous development of invasive dental procedures, presently we encounter a permanent growing of medical complications, like protrusion of foreign bodies into the maxillary sinus during therapeutic maneuvers on the superior dental arch. Plus that we can find neglected foreign bodies in the maxillary sinuses after ENT surgical procedures. With this clinical study we evaluated the most frequent etiology of the iatrogenic foreign bodies of the maxillary sinus, the improper surgical maneuvers that can lead to protrusion of foreign bodies, and the complications produced by these. Material and methods: We performed a prospective clinical study on 49 consecutive patients with various types of foreign bodies of the maxillary sinus admitted in our Department between January 2010 - January 2013. In all cases we performed craniofacial CT scans and dental panoramic radiography. The removal of the foreign bodies was performed surgically. Results: Most common foreign bodies encountered were dental implants (19 patients, representing 38.77%), followed by amalgam fragments (14 patients, 28.57%), Guttapercha points (5 patients, 10.20%), pieces of gauze used for nasal or sinusal packing (4 patients, 8.16%), tooth fragments (3 patients, 6.12%), dental burr (2 patients, 4.08%), Kerr needles (2 patients, 4.08%). The complications encountered were: acute or chronic rhinosinusitis (37 patients 75.51%), with 11 cases of fungal colonization proved at histopathological exam, and the rest of 26 rhinosinusitis patients with bacterial infection, 12 cases of oro-antral fistula (24.29%), 1 case of orbital abscess, 1 case of malar abscess. Conclusion: Most of the cases of iatrogenic foreign bodies in the maxillary sinus are due to inadequate dental treatments. Dental implants and root canal fillings materials are the most frequent iatrogenic FB inserted into the maxillary sinus. Untreated, they can produce inflammatory – infective sinus pathology, like bacterial or fungal sinusitis, or even abscesses of the surrounding structures. © 2015 Romanian Society of Legal Medicine.

Popescu C.,Sfanta Maria Clinical Hospital | Zofota S.,Sfanta Maria Clinical Hospital | Bojinca V.,Sfanta Maria Clinical Hospital | Ionescu R.,Sfanta Maria Clinical Hospital
Journal of medicine and life | Year: 2013

RATIONALE: Anti-CCP antibodies are detectable not only in rheumatoid arthritis (RA), but also in psoriatic arthritis (PsA). It is possible those anti-CCP antibodies are associated with features of PsA and that these auto-antibodies are useful in distinguishing PsA from RA.OBJECTIVE: to evaluate the prevalence and the associations of anti-CCP antibodies in PsA patients; to evaluate the usefulness of anti-CCP antibodies in distinguishing PsA from RA.METHODS AND RESULTS: The inquiry was designed as a cross-sectional study of 41 PsA patients, 139 RA patients and 147 normal subjects, which recorded demographic data, disease activity and serology: rheumatoid factor (RF), anti-CCP antibodies. Five PsA patients (12.2%) were anti-CCP positive. Compared to anti-CCP negative PsA patients, anti-CCP positive PsA patients had a more frequently a polyarticular disease pattern (p = 0.005), they were more frequently treated with biologics (p = 0.015) and less frequently with classic disease-modifying drugs (p < 0.001). An optimal positive cutoff value for anti-CCP titer was determined (11.6 U/mL), over which it is highly probable that a known PsA patient actually has RA and psoriasis.DISCUSSION: The more aggressive the disease of anti-CCP positive PsA patients indicates the need of a more intensive management regarding anti-rheumatic treatment and follow-up. Anti-CCP antibodies can be a useful tool in differentiating PsA from RA, especially in RA-like forms of PsA, which present no elements pertaining to spondyloarthropathies.

Popescu C.,Sfanta Maria Clinical Hospital | Trandafir M.,Sfanta Maria Clinical Hospital | Badica A.,Sfanta Maria Clinical Hospital | Morar F.,Sfanta Maria Clinical Hospital | Predeteanu D.,Sfanta Maria Clinical Hospital
Journal of medicine and life | Year: 2014

Clinicians have at hand several indices to evaluate disease activity and functionality in ankylosing spondylitis (AS), in order to evaluate the prognostic and the treatment of AS patients. to examine the relationship between functional and activity scores in AS; to note whether disease activity is associated with any clinical or laboratory variables. the study included AS patients, classified according to the revised New York criteria; data recorded: demographics, disease duration, type of articular involvement, HLA B27 presence, history of uveitis, calculation of BASFI, BASDAI and ASDASCRP, quantification of inflammation markers. 50 AS patients; ASDASCRP correlated significantly (p < 0.001) with BASFI (r = 811), BASDAI (r = 0.810) and with erythrocyte sedimentation rate (ESR; r = 0.505); HLA B27 positive patients had a median BASDAI 5 times higher than HLA B27 negative patients (p = 0.033); compared with patients with strictly axial disease form, patients with axial and peripheral disease had a median ESR 3 times higher (p = 0.042) and a median BASDAI 2 times higher (p = 0.050). functional and activity AS indices are strongly correlated in assessing disease severity; inflammation and HLA B27 can predict the high value of these indices; axial and peripheral disease pattern is associated with higher disease activity.

PubMed | Sfanta Maria Clinical Hospital
Type: Journal Article | Journal: Journal of medicine and life | Year: 2010

Not long ago it was believed that the human olfactory sense had a low importance, a vision which turned into the exploration of the environment. Recent studies have shown that, despite the weak representation of the olfactory receptor common in other species too, the cortical areas of integration of the olfactory sensations are very large and have important interconnections with memory, language, and neuro-vegetative areas. In humans, olfaction has a small contribution in identifying objects or other people, but plays an important social and emotional part. People learn to love or to hate certain foods or objects only by appreciating their odor and this proved to be a very important economic factor. The most significant role of olfactory signals in humans appears to be the modulation of their behavior and interpersonal relationships, of their affiliation to certain groups or social classes, having a major influence in their tastes and personality. signal that will be sent to the specialized areas in their tastes and personality.

PubMed | Sfanta Maria Clinical Hospital
Type: Journal Article | Journal: Journal of medicine and life | Year: 2010

The aim of our study was to determine the importance of p53, PCNA and Ki-67, evaluated by immunohistochemistry, in the treatment and prediction of the laryngeal carcinoma. Out of a total of 319 patients with laryngeal carcinoma that underwent surgery in our department between 1999 and 2007, we performed a retrospective study on 71 cases who benefited by immunohistochemical guidance before the beginning of the treatment. All these patients have been followed-up two to five years after surgery. The values of p53, PCNA and Ki-67 are strongly correlated with the histological grading, by means of descriptive statistics (confidence level 95%); the mean values of these three markers corresponding to each HP grade. A highly statistical significant positive correlation (r = 0.84, p < 0.001 ) between the values of p53 and PCNA was observed. The values of p53, PCNA and Ki-67 in the patients from this study are strongly correlated with the absence of the loco-regional lymph node metastases, by means of descriptive statistics (confidence level 95%). Ki-67 only is correlated significantly to the presence of lymphatic metastases in the regional lymph nodes (stage N1, N2 or N3 TNM). P53 and PCNA are not correlated significantly with the presence of the metastases in the regional lymph nodes.

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