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  • 1
    Online Resource
    Online Resource
    Left ventricular function evaluation of the fetal heart: reference intervals and inter-observer variability of 2D speckle-tracking echocardiography measurements
    SRUMB - Romanian Society for Ultrasonography in Medicine and Biology ; 2023
    In:  Medical Ultrasonography Vol. 25, No. 2 ( 2023-06-26), p. 168-
    Details
    In: Medical Ultrasonography, SRUMB - Romanian Society for Ultrasonography in Medicine and Biology, Vol. 25, No. 2 ( 2023-06-26), p. 168-
    Abstract: Aims: Measurement of myocardial strain using 2D speckle-tracking echocardiography can successfully quantify ventricular function, being considered superior to conventional echocardiography. This study aimed to establish reference intervals, interobserver agreements and reliability of two fetal echocardiographic parameters which reflect left ventricular myocardial function, left ventricular apical 4 chamber endo peak strain (AP4pLS) and ejection fraction (EF).Material and methods: We conducted a prospective study on 103 healthy fetuses. In each case, cardiac ultrasound images obtained were stored and afterwards were subject to offline 2D speckle-tracking echocardiographic analyses. In 15 randomly chosen subjects a second examiner also carried out an offline analysis of the 4-chamber view and the archived images, in order to assess inter-observer reproducibility and agreement level. Our study group was sub-divided into four different gestational age groups.Results: Reference ranges were established for the two measured parameters, AP4pLS and EF, which did not differ significantly between four different gestational age groups (p=0.98 and p=0.64) and neither correlated with gestational age progression (p=0.37 and p=0.08). An excellent level of agreement between the two examiners was found for the echocardiographic measurements, expressed through an intra-class correlation coefficient (ICC) value of 0.85 (0.62-0.94 for 95%CI) for AP4pLS and 0.78 (0.47- 0.92 for 95% CI) for EF.Conclusions: Speckle tracking AP4pLS and EF parameters are useful for assessment of ventricular myocardial function in healthy fetuses and can be reliably reproduced by two different skilled examiners. Further studies conducted on larger populations are required to standardize reference values of fetal speckle-tracking measurements
    Type of Medium: Online Resource
    ISSN: 2066-8643 , 1844-4172
    URL: Article
    DOI: 10.11152/mu-4021
    Language: Unknown
    Publisher: SRUMB - Romanian Society for Ultrasonography in Medicine and Biology
    Publication Date: 2023
    detail.hit.zdb_id: 2529623-1
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  • 2
    Online Resource
    Online Resource
    COVID-19 Vaccine—A Potential Trigger for MOGAD Transverse Myelitis in a Teenager—A Case Report and a Review of the Literature
    MDPI AG ; 2022
    In:  Children Vol. 9, No. 5 ( 2022-05-06), p. 674-
    Details
    In: Children, MDPI AG, Vol. 9, No. 5 ( 2022-05-06), p. 674-
    Abstract: MOGAD-transverse myelitis is a rare disorder in children and adults, but with a higher incidence in pediatric patients. We report a case of MOGAD-transverse myelitis in a boy who was admitted to hospital with bilateral motor deficit of the lower limbs associated with the impossibility of defecating and urinating. The symptoms progressively developed with severe fatigue within the week prior to admission, with the impossibility to stand occurring 36 h before admission. The anamnesis found that he was vaccinated for COVID-19 approximately 6 weeks before admission to our clinic. The laboratory tests revealed a normal complete cellular blood count, without any signs of inflammation or infection, except for both cryoglobulins and IgG anti-MOG antibodies. MRI showed a T2 hypersignal on vertebral segments C2-C5, Th2-Th5 and Th7-Th11, confirming the diagnosis of longitudinally extensive transverse myelitis. The patient received intravenous high-dose methylprednisolone (1 g) for 5 days, associated with prophylactic antibiotic treatment, subcutaneous low-molecular-weight heparin and other supportive treatment. The patient was discharged on the 12th day of admission, able to walk without support and with no bladder or bowel dysfunction. We can conclude that an early diagnosis was essential for improving the patient’s long-term outcome.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children9050674
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2732685-8
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  • 3
    Online Resource
    Online Resource
    Vitamin D and Its Association with H. pylori Prevalence and Eradication: A Comprehensive Review
    MDPI AG ; 2023
    In:  Nutrients Vol. 15, No. 16 ( 2023-08-11), p. 3549-
    Details
    In: Nutrients, MDPI AG, Vol. 15, No. 16 ( 2023-08-11), p. 3549-
    Abstract: Taking into account previous data that sustain a relationship between vitamin D deficiency and higher H. pylori infection positivity rates, this review aims to assess the influence of vitamin D deficiency and/or insufficiency upon the prevalence of H. pylori infection and its eradication success. Three major databases were searched for articles that analyzed a relationship between vitamin D status and H. pylori infection. The literature search retrieved a total of 37 reports, after the article selection process. Hypovitaminosis D emerged as a potential risk factor for H. pylori infection, given the higher prevalence of vitamin D deficiency and/or insufficiency among H. pylori-positive subjects. Furthermore, the same type of micronutrient deficiency has been directly linked to H. pylori eradication failure. An inverse linear relationship between vitamin D status and gastric cancer risk exists, but the additional involvement of H. pylori in this correlation is still in question. The potential benefit of oral supplements in enhancing the success of classical therapeutic regimens of H. pylori still requires future research. Future population-based studies from larger geographical areas are warranted to address this subject in more depth.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu15163549
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2518386-2
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  • 4
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    Online Resource
    Elastography—A Bona Fide Non-Invasive Method for Assessing Non-Alcoholic Fatty Liver Disease in Children
    MDPI AG ; 2021
    In:  Applied Sciences Vol. 11, No. 7 ( 2021-04-04), p. 3240-
    Details
    In: Applied Sciences, MDPI AG, Vol. 11, No. 7 ( 2021-04-04), p. 3240-
    Abstract: Pediatric obesity has become a major public health problem worldwide, resulting in a wide spectrum of systemic complications. Liver disease associated with obesity, also known as nonalcoholic fatty liver disease (NAFLD), is currently the most common chronic liver condition in children. Therefore, its timely and proper diagnosis is essential for preventing further development of cirrhosis. Multiple studies focused on identifying the most accurate non-invasive diagnostic method for liver fibrosis or cirrhosis. Although liver biopsy remains the gold-standard in terms of this hepatopathy, elastography methods emerged as a relatively reliable alternative to liver biopsy. Thus, recent studies revealed the great importance of these non-invasive methods not only in diagnosing pediatric NAFLD, but also in its staging. MRE is commonly considered to have a greater accuracy than ultrasound-based elastography methods, but with lower availability and higher costs. Ultrasound-based elastography methods (transient elastography (TE), p-SWE, and 2-dimensional shear wave elastography (2D-SWE)) were proved to have similar accuracy in NAFLD staging. Nevertheless, multiple confounding factors account for potential challenges when using elastography for liver stiffness measurement, such as age, obesity itself (i.e., BMI), transaminase levels, or portal flow. A potential solution for facing these challenges might be represented by a complex approach based on the combination between elastography, clinical and laboratory findings. Although the studies that assessed the role of elastography in pediatric NAFLD staging are scarce, the current knowledge underlines a crucial role of these techniques taking into account their ability to distinguish between fibrosis degrees, their non-invasive patterns, lower costs and side effects when compared to liver biopsy. Therefore, elastography might become a cornerstone in staging pediatric NAFLD.
    Type of Medium: Online Resource
    ISSN: 2076-3417
    URL: Article
    DOI: 10.3390/app11073240
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2704225-X
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  • 5
    Online Resource
    Online Resource
    THE UTILITY OF CONTRAST-ENHANCED ULTRASONOGRAPHY IN DIAGNOSING CHILD’S VESICOURETERAL REFLUX – A CASE REPORT AND A REVIEW OF THE LITERATURE
    AMALTEA Medical Publishing House ; 2017
    In:  Romanian Journal of Pediatrics Vol. 66, No. 1 ( 2017-03-31), p. 42-46
    Details
    In: Romanian Journal of Pediatrics, AMALTEA Medical Publishing House, Vol. 66, No. 1 ( 2017-03-31), p. 42-46
    Type of Medium: Online Resource
    ISSN: 1454-0398 , 2069-6175
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.37897/RJP.2017.1
    DOI: 10.37897/RJP
    DOI: 10.37897/RJP.2017.1.9
    Language: Unknown
    Publisher: AMALTEA Medical Publishing House
    Publication Date: 2017
    detail.hit.zdb_id: 2570966-5
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  • 6
    Online Resource
    Online Resource
    PNEUMONIA, STILL A CHALLENGE FOR THE PEDIATRICIAN – CASE REPORT
    AMALTEA Medical Publishing House ; 2016
    In:  Romanian Journal of Infectious Diseases Vol. 19, No. 4 ( 2016-12-31), p. 226-231
    Details
    In: Romanian Journal of Infectious Diseases, AMALTEA Medical Publishing House, Vol. 19, No. 4 ( 2016-12-31), p. 226-231
    Abstract: Pneumonia represents an inflammation of the pulmonary parenchyma that despite the multiple antibiotic classes available and despite the medical progresses, still leads to an increased mortality rate, especially in children. Deltfia acidovorans and Stenotrophomonas maltophilia are Gram-negative bacilli that can lead to respiratory infections. We present the case of a 2 years and 3-month old male patient, admitted in our clinic for the following reasons: productive cough, fever and loss of appetite. Based on the clinical exam, laboratory and paraclinical investigations, we established the diagnosis of right pneumonia associated with pleural effusion and we administered wide spectrum antibiotics. Nevertheless, the evolution was unfavorable, needing pleurotomy and drainage. From the pleural fluid, there were isolated two strains of bacteria, Delftia acidovorans and Stenotrophomonas maltophilia. We adjusted the antibiotic regimen according to antibiogram, with afterwards slowly favorable evolution. The particularity of the case consists in diagnosing a pneumonia with pleural effusion in a 2 years and 3-month-old child, without risk factors, who needed pleurotomy with thoracic drainage, in whom the pleural fluid revealed 2 germs usually encountered in immunocompromised individuals, with favorable evolution after the initiation of antibiotics regimen according to the antibiogram.
    Type of Medium: Online Resource
    ISSN: 1454-3389 , 2069-6051
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.37897/RJID.2016.4
    DOI: 10.37897/RJID
    DOI: 10.37897/RJID.2016.4.3
    Language: Unknown
    Publisher: AMALTEA Medical Publishing House
    Publication Date: 2016
    detail.hit.zdb_id: 2570960-4
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  • 7
    Online Resource
    Online Resource
    PNEUMONIA, O PROVOCARE CONTINUĂ PENTRU PEDIATRU – PREZENTARE DE CAZ
    AMALTEA Medical Publishing House ; 2016
    In:  Romanian Journal of Infectious Diseases Vol. 19, No. 4 ( 2016-12-31), p. 257-261
    Details
    In: Romanian Journal of Infectious Diseases, AMALTEA Medical Publishing House, Vol. 19, No. 4 ( 2016-12-31), p. 257-261
    Abstract: Pneumonia reprezintă o inflamaţie a parenchimului pulmonar care, în ciuda multiplelor clase de antibiotice disponibile şi în ciuda progreselor medicinei, deţine încă o rată crescută de mortalitate, mai ales în cazul copiilor. Deltfia acidovorans şi Stenotrophomonas maltofilia sunt bacili Gram-negativi care pot determina infecţii respiratorii. Prezentăm cazul unui pacient de sex masculin, în vârstă de 2 ani şi 3 luni, internat în clinica noastră pentru următoarele motive: tuse productivă, febră şi inapetenţă. Pe baza examenului obiectiv, a analizelor de laborator şi a investigaţiilor imagistice, am stabilit diagnosticul de pneumonie dreaptă asociată cu pleurezie şi am instituit antibioterapie cu spectru larg. Evoluţia a fost însă nefavorabilă, pacientul necesitând pleurostomie şi drenaj. Din lichidul pleural au fost izolaţi Delftia acidovorans şi Stenotrophomonas maltophilia. Am modificat schema de tratament conform antibiogramei, cu evoluţie ulterioară lent favorabilă. Particularitatea cazului constă în diagnosticarea unei pneumonii cu pleurezie la un copil în vârstă de 2 ani şi 3 luni, cu un episod de pneumonie în antecedente, fără factori de risc, care a necesitat pleurostomie cu drenaj toracic, la care cultura din lichidul pleural a evidenţiat doi germeni întâlniţi de obicei la persoanele imunocompromise, cu evoluţie favorabilă după iniţierea antibioterapiei conform antibiogramei.
    Type of Medium: Online Resource
    ISSN: 1454-3389 , 2069-6051
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.37897/RJID.2016.4
    DOI: 10.37897/RJID
    DOI: 10.37897/RJID.2016.4.9
    Language: Unknown
    Publisher: AMALTEA Medical Publishing House
    Publication Date: 2016
    detail.hit.zdb_id: 2570960-4
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  • 8
    Online Resource
    Online Resource
    UTILIZAREA ECOGRAFIEI CU SUBSTANŢĂ DE CONTRAST ÎN DIAGNOSTICUL REFLUXULUI VEZICO-URETERAL LA COPIL – PREZENTARE DE CAZ ŞI DATE DIN LITERATURĂ
    AMALTEA Medical Publishing House ; 2017
    In:  Romanian Journal of Pediatrics Vol. 66, No. 1 ( 2017-03-31), p. 81-84
    Details
    In: Romanian Journal of Pediatrics, AMALTEA Medical Publishing House, Vol. 66, No. 1 ( 2017-03-31), p. 81-84
    Type of Medium: Online Resource
    ISSN: 1454-0398 , 2069-6175
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.37897/RJP.2017.1
    DOI: 10.37897/RJP
    DOI: 10.37897/RJP.2017.1.18
    Language: Unknown
    Publisher: AMALTEA Medical Publishing House
    Publication Date: 2017
    detail.hit.zdb_id: 2570966-5
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  • 9
    Online Resource
    Online Resource
    The gap between overweight and obesity status in children - (STROBE-compliant article)
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Medicine Vol. 100, No. 4 ( 2021-01-29), p. e24520-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 4 ( 2021-01-29), p. e24520-
    Abstract: Overweight might represent only the early stage of obesity or it might act as a trigger of self-awareness turning into an ideal chance for preventing further obesity development. The aim of this study was to assess the differences between overweight and obese children in terms of anthropometric, low-grade systemic inflammation, liver impairment and atherosclerotic risk. We performed a study on 132 children aged between 5 and 18 years, divided according to the BMI into 2 groups: group 1 to 76 obese children, and group 2 to 56 overweight children, assessing anthropometric, laboratory and elastography parameters. We obtained significantly higher values of anthropometric parameters in obese children versus overweight ones. We found higher levels of leukocytes, lymphocytes, AST, ALT, and E median ( P  = .0345, P  = .0103, P   〈  .0001, P  = .0008 and P   〈  .0001) in the obese group as compared to the overweight one. BMI was positively correlated with neutrophils, NLR, ESR, glycemia, anthropometric parameters, and E median ( P  = .0007/ 〈 .0001/.0018/.0044/ 〈 .0001/ 〈 .0001/ 〈 .0001/ 〈 .0001/ 〈 .0001/.0204); and negatively with lymphocytes and HDL-cholesterol ( r  = −0.2747/−0.2181, P  = .0116/.0120). Our study underlined significant differences between overweight and obese children in terms of inflammatory status and liver impairment suggesting that the risk is directly related to the increase in BMI.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000024520
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2049818-4
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  • 10
    Online Resource
    Online Resource
    Gastric Microenvironment—A Partnership between Innate Immunity and Gastric Microbiota Tricks Helicobacter pylori
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 15 ( 2021-07-23), p. 3258-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 15 ( 2021-07-23), p. 3258-
    Abstract: Helicobacter pylori (H. pylori) carcinogenicity depends on three major factors: bacterial virulence constituents, environmental factors and host’s genetic susceptibility. The relationship between microenvironmental factors and H. pylori virulence factors are incontestable. H. pylori infection has a major impact on both gastric and colonic microbiota. The presence of non-H. pylori bacteria within the gastric ecosystem is particularly important since they might persistently act as an antigenic stimulus or establish a partnership with H. pylori in order to augment the subsequent inflammatory responses. The gastric ecosystem, i.e., microbiota composition in children with H. pylori infection is dominated by Streptoccocus, Neisseria, Rothia and Staphylococcus. The impairment of this ecosystem enhances growth and invasion of different pathogenic bacteria, further impairing the balance between the immune system and mucosal barrier. Moreover, altered microbiota due to H. pylori infection is involved in increasing the gastric T regulatory cells response in children. Since gastric homeostasis is defined by the partnership between commensal bacteria and host’s immune system, this review is focused on how pathogen recognition through toll-like receptors (TLRs—an essential class of pathogen recognition receptors—PRRs) on the surface of macrophages and dendritic cells impact the immune response in the setting of H. pylori infection. Further studies are required for delineate precise role of bacterial community features and of immune system components.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10153258
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662592-1
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