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Open access

Cristina Julieta Sava and Mugurel Constantin Rusu

Abstract

Sinoliths are calculi found particularly in paranasal sinuses, the rarest location being the ethmoid air cells. There were previously reported only 4 cases of unilateral large ethmoidal sinoliths (ES), this one being the fifth report. We report here the incidental bilateral evidence in a 34-year-old female patient evaluated in Cone Beam Computed Tomography (CBCT) of minor ES. The left ES, of 1.6 mm2 sagittal size, occupied the suprabullar cell, in front of the ground lamella and behind the anterior ethmoidal canal. The right ES, of 7.6 mm2, was located behind the ground lamella. The radiodensity of each ES was about 1000 HU, their bone quality being thus assessed. This is the first evidence of bilateral and clinically silent ethmoidal sinoliths. Being small-sized and incidentally found, it seems reasonable to consider that ethmoidal sinoliths could have a higher incidence but they are overlooked due to the lack of clinical manifestations.

Open access

Adriana Rusu, Cristina Nita and Nicolae Hancu

Sleep Apnea and Type 2 Diabetes: A Short Review of the Literature

The prevalence of diabetes and obesity has reached epidemic proportions. Even if today it is an accepted fact that diet and reduced physical activity are causes of obesity epidemic, sleep disturbances are seen as risk factors for obesity, insulin resistance, type 2 diabetes and metabolic syndrome. Regardless of the nature of the relation between sleep apnea and diabetes, the observed association have important clinical, epidemiological and public health implications. Clinical studies have shown that the cardiovascular morbidity and mortality is high, both in diabetes and sleep apnea, overcoming the prevalence observed in general population. Thus, understanding the implications of sleep apnea in alteration of glucose metabolism and cardiovascular risk could contribute to the prevention of both micro- and macrovascular complications.

Open access

Cristina Julieta Sava, Mihai Sandulescu and Rusu Mugurel Cconstantin

Abstract

Sinoliths are rarely found calculi of paranasal sinuses. The most rarely they were found in the sphenoidal sinuses. At a routine Cone Beam CT exam of a 52-year-old male patient clinically silent small sinoliths were found bilaterally in the sphenoidal sinuses and a larger posterior ethmoidal sinolith was found on the right side. To our knowledge, such multiple sinuses involvement has not been previously reported.

Open access

Simina-Elena Rusu, Daniela Toma, Cristina Blesneac, Laura Matei, Claudiu Ghiragosian and Rodica Togănel

Abstract

Background: Critical coarctation of the aorta is the most common congenital heart disease with ductal-dependent systemic circulation. In severe forms, this disease represents a critical condition, which can become life-threatening. The aim of this study was to evaluate the usefulness of different echocardiographic parameters in the prediction of aortic coarctation in newborns. Material and method: This is a retrospective study performed by reviewing echocardiographic images of both pre-term and full-term newborns presented with aortic coarctation to the emergency room of a clinic of pediatric cardiology. Based on echocardiographic measurements, both the common carotid artery-subclavian artery index (CSAi) and the aortic isthmus-descending aorta index (I/D) were calculated. Results: Fifty-two newborns presented in acute settings with aortic coarctation and were included in the study, divided into: subgroup 1 (n = 26) - ductal-dependent aortic coarctation; subgroup 2 (n = 2) - non-ductaldependent aortic coarctation; and subgroup 3 (n = 24) - unconfirmed aortic coarctation. ROC analysis identified a cutoff value of 1.37 for the CSAi index and a cutoff value of 0.46 for the I/D index as being associated with the highest predictive power for the diagnosis of aortic coarctation. Conclusions: The CSAi and I/D indices are simple and accessible echocardiographic parameters that can provide supplemental information for the pediatric cardiologist in acute cases of newborns with suspicion of aortic coarctation. These new indices can contribute to the decision-making process in case of pre-term and full-term newborns with suspicion of coarctation of the aorta, independent of the presence of persistent ductus arteriosus.

Open access

Ramona Maria Ştefan, Cristina Niţă, Anca Crăciun, Adriana Rusu and Nicolae Hâncu

Abstract

Background and Aims: We assessed the effect of intensive therapy on modifiable cardiovascular (CV) risk factors and CV risk as compared to conventional therapy in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

Material and Methods: This was an observational, prospective study, conducted in Romania. During 1-year follow-up period the enrolled participants received either multi-factorial pharmacotherapy associated with intensive therapeutic education (Intensive group), or conventional therapy (Control group). Current analysis included data (anthropometric measurements, blood pressure and biochemical parameters) recorded at months (M) 0, 6 and 12. CV risk was calculated at M1 and M12 using the UK Prospective Diabetes Study Risk Engine.

Results: 138 patients aged 57.02±10.05 years were included in this analysis (69 in each group). At M6 and M12 a significant improvement of the majority of the modifiable risk factors in the Intensive group compared to the Control group was observed. At M12, coronary heart disease (CHD)/fatal-CHD risks were significantly lower in the Intensive (7.5%/3.1%) than in the Control (17.95%/10.3%) group (p<0.05). A similar trend was observed for the stroke/fatal-stroke risks.

Conclusions: CHD/fatal-CHD and stroke/fatal-stroke risk burden decreased in newly diagnosed diabetic patients following multi-factorial pharmacotherapy association with intensive lifestyle changes during 1-year follow-up.

Open access

Mihai Emil Căpîlna, Simona Cristina Rusu, János Bécsi and Mihai Morariu

Abstract

Introduction: Abdominal radical trachelectomy (ART) for tumors of the uterine cervix can be performed while the pregnancy is ongoing, but the success rates so far are reduced.

Case series presentation: ART was performed in three patients with cervical cancer diagnosed during pregnancy, with a triple aim to offer a radical surgery for cervical cancer, but also to preserve the ongoing pregnancy and fertility. The ART was successful in one patient, and she delivered a healthy baby at term, by cesarean section. The other 2 patients experienced obstetrical complications and lost their pregnancies after ART, but in one of the cases, fertility was preserved.

Conclusions: Radical trachelectomy could be performed as alternative therapy for pregnant women with invasive malignancies of the cervix. This procedure may prevent female patients to lose a much-desired pregnancy, their fertility, as well as their maternity.

Open access

Anca-Elena Crăciun, Mirela Moldovan, Adriana Rusu, Cristina Niţă, C. Crăciun and A. Tătaru

Predictors of Changes in Physical Properties of Skin in Patients with Diabetes Mellitus

Introduction: The skin, the largest human organ, is often affected by diabetes mellitus (DM). We know that DM affects the hydration of stratum corneum (SC), the sebum content of the skin and to some extent, the barrier function of the epidermis and elasticity, but we do not know the factors leading to these changes. Objectives: The objectives of this study were to determine the factors associated with changes in physical properties of the skin (skin hydration degree, sebumetry, transepidermal water loss and skin elasticity) in patients with diabetes. Materials and methods: The physical properties of the skin were assessed using the Multi Probe Adapter Systems MPA ® (Courage-Khazaka, Germany) in 57 patients with diabetes and 46 non-diabetic. Results: Statistical analysis of the entire group of 103 subjects showed a significant association between female gender and decreased SC hydration (p<0.05 in all cases), decreased values of transepidermal water loss (TEWL) (β=-0.282, p=0.006) and decreased elasticity of the skin in forearm (β=-0.216, p=0.043). Also, the presence of DM was negatively associated with levels of SC hydration measured on the forearm (β=-0.281, p=0.005). Furthermore, in patients with diabetes, the presence of diabetic neuropathy (DNP) was negatively associated with the hydration of SC measured at all levels (forearm: β=-0.465, p<0.001; leg: β=-0.590, p<0.001; tight: β=-0.198, p<0.001). The observed relationship was independent of age and sex of the participants (p<0.05 after adjustment for age and sex). Regarding skin elasticity, increasing age was associated with lower levels of skin elasticity both in entire group and in patients with DM, at all sites of measurements (p<0.05 in all cases). Additionally, in patients with diabetes, elasticity of the skin measured at forearm and tight was negativelly associated with type of DM (forearm: β=-0.335, p=0.023; tight: β=-0.522, p<0.001). In our study, nor diabetes neither DNP were not associated with TEWL values. Conclusions: The presence of DNP seems to be the main predictor of decreased SC hydration in all measuring points and skin elasticity is significantly associated with age. There are some gender-related modification in physical properties of the skin. Surprisingly, type 2 DM was associated with reduced elasticity in the thigh, and this association was independent of age and sex.

Open access

Hancu Gabriel, Tero-Vescan Amelia, Filip Cristina and Rusu Aura

Abstract

The aim of this study to inventory the main electrophoretic methods for identification and quantitative determination of fatty acids from different biological matrices. Critical analysis of electrophoretic methods reported in the literature show that the determination of polyunsaturated fatty acids can be made by: capillary zone electrophoresis, micellar electrokinetic chromatography and microemulsion electrokinetic chromatography using different detection systems such as ultraviolet diode array detection, laser induced fluorescence or mass – spectrometry. Capillary electrophoresis is a fast, low-cost technique used for polyunsaturated fatty acids analysis although their determination is mostly based on gas chromatography.

Open access

Dana-Teodora Anton-Pǎduraru, Carmen Oltean, Laura Mihaela Trandafir and Cristina Rusu

Abstract

Lipid metabolism abnormalities in children may be hereditary or secondary to certain diseases (obesity, type 2 diabetes mellitus). Often elevated triglycerides values are associated with high cholesterol values, playing a major role on atherosclerosis. The triple X syndrome also called “the superfemale syndrome” is not a rare condition, but it is usually undiagnosed or occasionally diagnosed when other investigations are done. The authors present the case of a child admitted in the 3rd Clinic of Pediatrics -“Sf. Maria” Children’s Emergency Hospital, Iaşi -Romania for the continuation of her lipid metabolism investigations, being diagnosed on this occasion with the triple X syndrome. We conclude that the investigation of lipid metabolism, early identification of lipid abnormalities and proper treatment significantly reduce the prevalence of cardiovascular disease in adults. We cannot specify the impact of the presence of the chromosomal anomaly, as it is an accidental association

Open access

Daniela Toma, Simina-Elena Rusu, Cristina Blesneac, Marian Pop and Rodica Togănel

Abstract

Background: Critical aortic coarctation is defined as the severe narrowing of the isthmic aortic lumen, representing a neonatal cardiac emergency, part of the congenital heart diseases with duct-dependent systemic circulation.

Aim of the study: To assess the correlation between transthoracic echocardiography and computed tomography angiography (CTA) in the measurement of aortic diameters in a group of newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch.

Material and method: We performed a retrospective study on neonates diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch between January 1, 2015 and March 1, 2017. The studied parameters were diameters of the aorta at the level of the aortic annulus, coronary sinuses, sinotubular junction, ascending aorta, proximal and distal aortic arch, and the aortic isthmus. Measurements were obtained by transthoracic echocardiography and thoracic CTA.

Results: Fifteen newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch were included in this study. There was no statistically significant difference between the two imaging methods, the T test highlighting differences only between the measurements of the aortic annulus (p <0.016) and coronary sinuses (p <0.008). The patients included in the study associated other cardiovascular abnormalities: persistent ductus arteriosus (100%), atrial septal defect (100%), aortic arch hypoplasia (80%), bicuspid aortic valve (73.3%).

Conclusions: These methods reveal important information on the anatomy of the cardiovascular malformation and its impact on the clinical and paraclinical status of the patient, being fundamental for establishing an optimal therapeutic approach.