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Open access

Oana Raluca Ivan

Abstract

Integrated Reporting (IR), the latest approach in corporate reporting, is one of the most discussed topics of the past several years. Recently, companies and companies have realized that the former business model, which was based only on profit-taking without regard to employees, the environment and society, needs to be revised and should take into account wider objectives than financial ones. Therefore, current societies adopt a pluralistic approach and aim to include in their concerns stakeholders’ needs, sustainability, business ethics and transparency. From the aforementioned aspects derives the research question of the present study, aiming in this way to determine the degree of adoption of the integrated reporting of the Romanian companies listed on the Bucharest Stock Exchange, as well as the analysis of the corporate governance reporting degree of the companies included in the study. The results show us the current state of the art for this issue.

Open access

Raluca A. Cristache, Ion Sandu, Viorica Vasilache and Oana Cristache

Abstract

This study presents a physicochemical analysis on the orthodox icon “The grieving Mother” from XIXth century. The icon is made by an anonymus painter, in tempera pigments, on a lime wood support, Tillia cordata. God’s Mother is represented from one side, only the bust, with the head down, framed by a white border. The predominant colors of the icon are ultramarine blue, ocher, red-brown, with silver leaf. The edges of the panel were painted with tempera pigments as the border. On the right edge an inscription in blue ink, can be seen, but is unreadable. The painting layer has gaps, fissures, detachments, dirt, degraded and scaly varnish. The panel is made from a single board, transversally cut, without crossbeams. The study is based on the identification of some archeometric characteristics of the wood panel and of the pigment layer. To determin painting materials and the conservation state, Fourier Transform Infrared Spectroscopy (Micro-FTIR) and Scanning Electron Microscope coupled with Energy Dispersive X-ray spectroscopy (SEM-EDX) were employed. Using this methods we identify the pigments used and the state of degradation of the panel. The FTIR spectrum analysis showed that the pigment layer contains schellac varnish, ultramarine blue and dust, a conclusion supported by SEM-EDX analysis.

Open access

Ioana Raluca Chirteș, Cristina Oana Mărginean, Horea Gozar, Anca Meda Georgescu and Lorena Elena Meliț

Abstract

Pulmonary abscess or lung abscess is a lung infection which destroys the lung parenchyma leading to cavitations and central necrosis in localised areas formed by thick-walled purulent material. It can be primary or secondary. Lung abscesses can occur at any age, but it seems that paediatric pulmonary abscess morbidity is lower than in adults. We present the case of a one year and 5-month-old male child admitted to our clinic for fever, loss of appetite and an overall altered general status. Laboratory tests revealed elevated inflammatory biomarkers, leukocytosis with neutrophilia, anaemia, thrombocytosis, low serum iron concentration and increased lactate dehydrogenase level. Despite wide-spectrum antibiotic therapy, the patient’s progress remained poor after seven days of treatment and a CT scan established the diagnosis of a large lung abscess. Despite changing the antibiotic therapy, surgical intervention was eventually needed. There was a slow but steady improvment and eventually, the patient was discharged after approximately five weeks.

Open access

Raluca Jipa, Oana Săndulescu, Eliza Manea, Şerban Benea, Otilia Benea and Adriana Hristea

Abstract

Objective: The aim of the study was to describe clinical and laboratory characteristics in HIV-infected patients with Kaposi sarcoma (KS).

Methods: We retrospectively studied data on HIV-infected patients hospitalized in one tertiary care hospital in Bucharest, Romania, in whom Kaposi Sarcoma was diagnosed, between January 2008 and November 2013.

Results: We identified 27 HIV-infected patients diagnosed with KS within 6 years. They had a median age of 42 years old and a median CD4 cell count of 101 cells per mm3 at the time of KS diagnosis. All patients received antiretroviral therapy (ART), with 18 patients (66%) already on ART at the time of KS diagnosis. Most patients (59%) were classified as ACTG poor-risk and 56% as Mitsuyasu stage I. The overall prognosis was poor, with 41% mortality, in a median time span of 6 months, significantly correlated with gastrointestinal involvement (p=0.019), poor-risk KS in ACTG classification (p<0.001) and stage IV Mitsuyasu (p=0.006).

Conclusion: KS remains an important cause of morbidity and mortality in patients with HIV infection, especially in late presenters.

Open access

Alina Puțan, Oana Raluca Ivan and Attila Tamas

Abstract

Current status of the hospital units is worrying: insufficient funding, increasing the number of cases considered / treated, providing quality services at public hospital unit. In this research we have undergone an empirical research carried out in the hospital units of category III and IV, from Alba County, this sample selection aims to identify an optimal solution to exercise management control which should serve to management decisionmaking. Responsibility centers, at the level of hospital unit, establish the liability for each segment of expenditure, expenditure tracking and proper grounding even their places of training, delimitation expenditure which does not strictly dependent on the production activities that are related strictly by the process; establishing the deviations of preset expenses levels; establishing a system of rules allowing highlighting the responsibilities of each performer, introducing a system of resource allocation and tracking of the use of their by developing specific cost budget for each responsibility center. The disadvantages of decentralization based on activity centers consists in increase the consumption of resources in certain activities, unclear delimitation of cause-effect relationships that create difficulties in adopting the relevant decisions by management, etc.

Open access

Ion Antohe, Angela Dăscălescu, Cătălin Dănăilă, Mihaela Zlei, Iuliu Ivanov, Adriana Sireteanu, Oana Boca, Raluca Oană and Petru Cianga

Abstract

Background: Acute basophilic leukemia is a rare subtype of acute myeloid leukemia, as categorized by the 2008 World Health Organization classification of myeloid neoplasms. Acute basophilic leukemia diagnosis requires thorough morphological, cytochemical, immunophenotypic, molecular, and cytogenetic studies and exclusion of other hematological neoplasms associating basophilia. The disease course is defined by histamine driven, occasionally life-threatening respiratory, cardiovascular, cutaneous or digestive complications, as well as primary refractoriness to standard therapy. Clinical presentation: We herein report a case of a 63-year-old asthmatic female patient diagnosed with acute basophilic leukemia, associated with previously unpublished cytogenetic features and FLT-3 ITD mutation, pulmonary leukostasis and spontaneous pulmonary capillary leak syndrome, which worsened immediately following chemotherapy initiation. Respiratory complications were successfully managed, but recrudesced upon emergence of refractory disease and were ultimately fatal. We highlight the likelihood of pulmonary complications induced by basophil degranulation and tumor lysis in hypercellular acute basophilic leukemia and the potential benefit of histamine receptor blockade in this setting.

Open access

Maria Livia Ognean, Oana Boantă, Simona Kovacs, Corina Zgârcea, Raluca Dumitra, Ecaterina Olariu and Doina Andreicuţ

Abstract

Introduction: Persistent ductus arteriosus (PDA) is found with increased incidence in preterm infants, significantly affecting neonatal morbidity and mortality rates.

Aim: To evaluate the association between the presence of PDA and the severity of clinical condition at birth in critically ill preterm infants, with gestational ages (GA) ≤ 32 weeks and severe respiratory distress.

Methods: All preterm infants with GA ≤ 32 weeks admitted to the neonatal intensive care unit (NICU) of the Clinical County Emergency Hospital, Sibiu between 1 January 2010 and 31 December 2015 were included in the study. These were categorized as Group 1 [Preterm infants with PDA; n=154] and Group 2 [Preterm infants without PDA; n=186]. Epidemiological and clinical data were collected in the National Registry for Respiratory Distress Syndrome for all children, and data related to prenatal period, clinical characteristics at birth i.e GA, weight, gender, Apgar scores, and clinical features such as resuscitation at birth, surfactant administration, need and duration of respiratory support, neonatal sepsis, complications associated with prematurity, and death, were analyzed.

Results: Group 1 infants had significantly lower GA and birth weights, were more often out born (p=0.049, HR 1.69), and had significantly lower Apgar scores at 1 and 10 minutes (p=0.022, p=0.000). They presented a significantly higher need for surfactant administration (42.9% vs 24.7%, p<0.0001) and respiratory support (96.8% vs 90.3%, HR 3.19, p=0.019 for need of CPAP and 22.1% vs 10.8%, HR 2.35, p=0.004 for mechanical ventilation). Duration of respiratory support was also significantly higher in the Group 1 (7.6%±7.5 vs. 5.1±3.8 days, p<0.0001 for CPAP and 20.1±22.5 vs. 12.0±15.7 days, p<0.0001 for mechanical ventilation).

Conclusion: In very preterm infants, PDA may be associated with a critical clinical condition leading to serious complications. The presence of PDA after the seventh day of life was associated with an increased need for respiratory support, both CPAP and mechanical ventilation, increased severity of the respiratory distress syndrome, requiring a longer duration of respiratory support, and increased the hospitalization length. In very preterm infants, PDA presence was also associated with a higher rate of severe complications and death, indicating the need for a careful and proper management of these critical cases in neonatal intensive care units.

Open access

Ioana Raluca Chirteș, Dragos Florea, Carmen Chiriac, Oana Maria Mărginean, Cristina Mănășturean, Alexander A Vitin and Anca Meda Georgescu

Abstract

Background: Known also as Osler’s triad, Austrian syndrome is a complex pathology which consists of pneumonia, meningitis and endocarditis, all caused by the haematogenous dissemination of Streptococcus pneumoniae. The multivalvular lesions are responsible for a severe and potential lethal outcome.

Case report: The case of a 51-year-old female patient, with a past medical history of splenectomy, is presented. She developed bronchopneumonia, acute meningitis and infective endocarditis as a result of Streptococcus pneumoniae infection and subsequently developed multiple organ dysfunction syndromes which led to a fatal outcome. Bacteriological tests did not reveal the etiological agent. The histopathological examination showed a severe multivalvular endocarditis, while a PCR based molecular analysis from formalin fixed valvular tissue identified Streptococcus pneumoniae as the etiologic agent.

Conclusions: The presented case shows a rare syndrome with a high risk of morbidity and mortality. Following the broad-spectrum treatment and intensive therapeutic support, the patient made unfavourable progress which raised differential diagnosis problems. In this case, the post-mortem diagnosis demonstrated multiple valvular lesions occurred as a result of endocarditis.