Octavian Neagoe - Academia.edu (original) (raw)

Papers by Octavian Neagoe

Research paper thumbnail of Nerve changes associated with post thoracotomy pain syndrome

Histology and Histopathology, Aug 5, 2022

Research paper thumbnail of Economic Crisis: A Factor for the Delayed Diagnosis of Breast Cancer

International Journal of Environmental Research and Public Health

Considering the constant increase in breast cancer patients, identifying factors that influence t... more Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of a breast cancer diagnosis. This retrospective observational study analyzed a cohort of 4929 patients diagnosed with breast cancer over the course of 19 years in the Western region of Romania. The time interval was divided based on the onset of the economic crisis into 3 periods: pre-crisis (2001–2006), crisis (2007–2012), and post-crisis (2013–2019). The disease stage at the moment of diagnosis was considered either early (stages 0, I, II) or advanced (stages III, IV). Although recording a similar mean number of patients diagnosed per year during the pre- and crisis periods, a significantly higher percentage of patients were diagnosed with late-stage breast cancer during the economic crisis period compare...

Research paper thumbnail of Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection

Nutrients

Magnesium may contribute to the immune response during and after SARS-CoV-2 infection by acting a... more Magnesium may contribute to the immune response during and after SARS-CoV-2 infection by acting as a cofactor for immunoglobulin production and other processes required for T and B cell activity. Considering magnesium as a recommended dietary supplement during pregnancy and the possible role of magnesium deficiency in COVID-19 and its complications, the current study sought to determine the effect of magnesium and magnesium-containing nutritional supplements on the immune response following SARS-CoV-2 infection in pregnant women, as well as to observe differences in pregnancy outcomes based on the supplements taken during pregnancy. The study followed a cross-sectional design, where patients with a history of SARS-CoV-2 infection during their pregnancy were surveyed for their preferences in nutritional supplementation and their profile compared with existing records from the institutional database. A cohort of 448 pregnant women with COVID-19 during 22 months of the pandemic was ass...

Research paper thumbnail of Evaluation and Comparison of the Predictive Value of 4C Mortality Score, NEWS, and CURB-65 in Poor Outcomes in COVID-19 Patients: A Retrospective Study from a Single Center in Romania

Diagnostics, 2022

To date, the COVID-19 pandemic has caused millions of deaths across the world. Prognostic scores ... more To date, the COVID-19 pandemic has caused millions of deaths across the world. Prognostic scores can improve the clinical management of COVID-19 diagnosis and treatment. The objective of this study was to assess the predictive role of 4C Mortality, CURB-65, and NEWS in COVID-19 mortality among the Romanian population. A single-center, retrospective, observational study was conducted on patients with reverse transcriptase-polymerase chain reaction (RT-PCR)-proven COVID-19 admitted to the Municipal Emergency Clinical Hospital of Timisoara, Romania, between 1 October 2020 and 15 March 2021. Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were performed to determine the discrimination accuracy of the three scores. The mean values of the risk scores were higher in the non-survivors group (survivors group vs. non-survivors group: 8 vs. 15 (4C Mortality Score); 3 vs. 8.5 (NEWS); 1 vs. 3 (CURB-65)). In terms of mortality risk prediction, the NEWS performed be...

Research paper thumbnail of Elastofibroma Dorsi, a Rare Condition, with Challenging Diagnosis. Case Report and Literature Review

Medicina, 2021

Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a cas... more Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a case of a bilateral elastofibroma dorsi (ED) in a 65-year-old female who presented to the Department of General and Oncologic Surgery of Emergency Clinical Municipal Hospital Timisoara, Romania. The patient was symptomatic on the right side, presenting pain in the interscapulothoracic region associated with a variable tumoral mass, dependent on the position of the right arm. Imaging studies revealed a well-defined, bilateral tumoral mass with alternation of the muscular and fatty tissue. The initial diagnosis of lipoma was taken into consideration based on the CT scan and clinical findings. Surgical excision of the right subscapular tumor was performed without any postoperative complications. Microscopic examination of hematoxylin and eosin, Masson’s trichrome, and orcein stained slides revealed the diagnosis of ED. Considering the high rate of reported postoperative complications and the a...

Research paper thumbnail of 18 Prevention and Therapeutic Strategies in Endometrial Cancer

17 studies covering 10,572 women showed a prevalence of a malignancy within endometrial polyps in... more 17 studies covering 10,572 women showed a prevalence of a malignancy within endometrial polyps in postmenopausal women about 5.42% compared to 1.70% in premenopausal women [Lee, 2010]. Endometrial neoplasia was identified in 214 of 3,946 women with endometrial polyps who were postmenopausal compared with 68 of 3,997 premenopausal women (relative risk 3.86). There were 4,967 women with symptomatic bleeding and 195 from them (4.15%) had neoplastic polyps compared with 85 of 3,941 (2.16%) without normal bleeding, according to the report (relative risk 1.97). Looking at the increased risks seen with postmenopausal status and abnormal bleeding, this did not seem to be additive. Polyp size did not appear to be associated with malignancy. Women with hereditary nonpolyposis colorectal cancer (HNPCC) syndrome have a markedly increased risk of endometrial cancer compared with women in the general population. Among women who are HNPCC mutation carriers, the estimated cumulative incidence of en...

Research paper thumbnail of Pelvic intraoperative iatrogenic oncosurgical injuries: single-center experience

Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2016

PURPOSE Iatrogenic events are more likely to occur during surgical treatment of malignant conditi... more PURPOSE Iatrogenic events are more likely to occur during surgical treatment of malignant conditions. Gynecologic and colorectal cancers account for most of the cases that require surgical treatment within the pelvic area. The purpose of this study was to analyze the incidence of intraoperative accidents and the most frequently encountered injuries during surgery for cancers of the pelvic area. METHODS The records of 2702 patients admitted to our clinic over a 15-year period, (January 2000-December 2014), were analyzed for type and frequency of intraoperative accidents. RESULTS Urinary tract lesions were the most common injuries seen in this series (63.1%), followed by enteral (28.1%) and vascular (8.8%) injuries, with an overall incidence of 2.9% for the whole group. Iatrogenic injuries showed a statistically significant difference in incidence depending on the type of primary malignancy (p<0.002). Cervical cancer was associated with a higher rate of ureteral lesions, whereas en...

Research paper thumbnail of New Thoracotomy Closure, a Simple Way to Decrease Chronic Post-Operative Pain in Selected Patients—Blinded Prospective Study

Journal of Personalized Medicine, 2021

Background and Objectives: Chronic post-thoracotomy pain syndrome (PTPS) is a very common and unc... more Background and Objectives: Chronic post-thoracotomy pain syndrome (PTPS) is a very common and uncomfortable complication, occurring frequently after thoracic operations, leading to the necessity of further medication and hospitalizations. One important risk factor in developing chronic pain is the chest closure technique, which can lead to chronic intercostal nerve damage. This study proposes an alternative nerve-sparring closure technique to standard peri-costal sutures, aimed toward minimizing the risk of chronic pain in selected patients. Materials and Methods: We performed a prospective randomized study on 311 patients operated for various thoracic pathology over a period of 12 months, evaluating incision types, chest closure technique, and number of drains with drainage duration. The patients were divided into three groups: peri-costal (PC), proposed extra-costal (EC), and simple (SC) suture, respectively. Pain was measured on day 1, 2, 5, 7, and at 6 months post-operatively us...

Research paper thumbnail of The role of pelvic lymphocele in the development of early postoperative complications

Medicine, 2018

With the increasing incidence of gynecologic malignancy, radical hysterectomy represents an impor... more With the increasing incidence of gynecologic malignancy, radical hysterectomy represents an important part of the adequate treatment of these patients. The pelvic lymphocele is a known side effect of pelvic and para-aortic lymphadenectomy. The aim of our study was to assess the role of the lymphocele in the development of early postoperative complications. A single-center, retrospective analysis between January 2000 and May 2017 revealed 1867 patients with cervical and endometrial cancer, treated through radical or modified radical hysterectomy and pelvic lymphadenectomy. Postoperative complications and the occurrence of pelvic lymphocele were evaluated. Approximately 47.6% of patients were diagnosed with pelvic lymphocele, with only 5.2% being symptomatic. Early postoperative complications rate recorded an incidence of 8.1%, occurring more frequent if lymphocele were present (P < .001). The pelvic lymphocele represented, in univariate analysis, a risk factor for the development of pelvic abscesses, but not for deep vein thrombosis, lymphedema, or bowel obstruction. Hydronephrosis was found to be significantly correlated with the pelvic lymphocele, but we believe this urological complication to have a different underlining mechanism. Neoadjuvant radiotherapy represented in both uni-and multivariate analysis a risk factor for the occurrence of postoperative complications. In the postoperative context of oncogynecological surgery, pelvic lymphocele occur at high rates, representing a statistical risk factor for hydronephrosis and pelvic abscesses, with neoadjuvant radiotherapy being an independent risk factor for early postoperative complications. Abbreviations: BMI = body mass index, DVT = deep vein thrombosis, US = ultrasound.

Research paper thumbnail of Total Colpectomy Increases the Risk of Postoperative Hydronephrosis in Vaginal Cancer Patients

Journal of Investigative Surgery, 2018

Purpose: Due to the rarity of vaginal cancer, surgical treatment results, and postoperative compl... more Purpose: Due to the rarity of vaginal cancer, surgical treatment results, and postoperative complications have been poorly described in the literature. The aim of this study was to improve current knowledge about the incidence of hydronephrosis following the surgical treatment of vaginal cancer. Materials and methods: 32 patients with vaginal cancer of the middle and upper third were matched with 32 cervical cancer patients (stages I and II) for comparison of long-term urological postoperative complications. All patients underwent radical surgical treatment and all stage II patients underwent neoadjuvant radiotherapy. Results: Hydronephrosis had a significantly higher incidence in the vaginal cancer group (p = 0.04), with 14 patients (43.8%) being diagnosed with this complication compared to only 5 patients (15.6%) in the cervical cancer group. Among patients that received radiotherapy, 40.1% (n = 9) and 22.7% (= 5) of vaginal, respectively cervical cancer patients were found with postoperative hydronephrosis. Conclusions: In vaginal cancer patients total colpectomy increases the risk of developing postoperative hydronephrosis, especially if neoadjuvant radiotherapy has been applied.

Research paper thumbnail of Use of methylene blue in the prevention of recurrent intra-abdominal postoperative adhesions

Journal of International Medical Research, 2017

Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoper... more Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoperative adhesions. Methods Patients with a history of >2 surgeries for intra-abdominal adhesion-related complications were selected for this study. Adhesiolysis surgery was subsequently performed using administration of 1% methylene blue. The follow-up period was 28.5 ± 11.1 months. Results Data were available from 20 patients (seven men and 13 women) whose mean ± SD age was 51.2 ± 11.4 years. Adhesions took longer to become symptomatic after the first abdominal surgery when the initial pathology was malignant compared with benign. However, the recurrence of adhesions after a previous adhesiolysis surgery had a similar time onset regardless of the initial disease. Following adhesiolysis surgery with methylene blue, the majority of patients did not present with symptoms associated with adhesion complications (i.e., chronic abdominal pain, bowel obstruction) for the length of the follow-u...

Research paper thumbnail of Prevention and Therapeutic Strategies in Endometrial Cancer

Cancer Prevention - From Mechanisms to Translational Benefits, 2012

Research paper thumbnail of Therapeutic Strategies in Ovarian Cancer

Ovarian Cancer - Clinical and Therapeutic Perspectives, 2012

Research paper thumbnail of Nerve changes associated with post thoracotomy pain syndrome

Histology and Histopathology, Aug 5, 2022

Research paper thumbnail of Economic Crisis: A Factor for the Delayed Diagnosis of Breast Cancer

International Journal of Environmental Research and Public Health

Considering the constant increase in breast cancer patients, identifying factors that influence t... more Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of a breast cancer diagnosis. This retrospective observational study analyzed a cohort of 4929 patients diagnosed with breast cancer over the course of 19 years in the Western region of Romania. The time interval was divided based on the onset of the economic crisis into 3 periods: pre-crisis (2001–2006), crisis (2007–2012), and post-crisis (2013–2019). The disease stage at the moment of diagnosis was considered either early (stages 0, I, II) or advanced (stages III, IV). Although recording a similar mean number of patients diagnosed per year during the pre- and crisis periods, a significantly higher percentage of patients were diagnosed with late-stage breast cancer during the economic crisis period compare...

Research paper thumbnail of Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection

Nutrients

Magnesium may contribute to the immune response during and after SARS-CoV-2 infection by acting a... more Magnesium may contribute to the immune response during and after SARS-CoV-2 infection by acting as a cofactor for immunoglobulin production and other processes required for T and B cell activity. Considering magnesium as a recommended dietary supplement during pregnancy and the possible role of magnesium deficiency in COVID-19 and its complications, the current study sought to determine the effect of magnesium and magnesium-containing nutritional supplements on the immune response following SARS-CoV-2 infection in pregnant women, as well as to observe differences in pregnancy outcomes based on the supplements taken during pregnancy. The study followed a cross-sectional design, where patients with a history of SARS-CoV-2 infection during their pregnancy were surveyed for their preferences in nutritional supplementation and their profile compared with existing records from the institutional database. A cohort of 448 pregnant women with COVID-19 during 22 months of the pandemic was ass...

Research paper thumbnail of Evaluation and Comparison of the Predictive Value of 4C Mortality Score, NEWS, and CURB-65 in Poor Outcomes in COVID-19 Patients: A Retrospective Study from a Single Center in Romania

Diagnostics, 2022

To date, the COVID-19 pandemic has caused millions of deaths across the world. Prognostic scores ... more To date, the COVID-19 pandemic has caused millions of deaths across the world. Prognostic scores can improve the clinical management of COVID-19 diagnosis and treatment. The objective of this study was to assess the predictive role of 4C Mortality, CURB-65, and NEWS in COVID-19 mortality among the Romanian population. A single-center, retrospective, observational study was conducted on patients with reverse transcriptase-polymerase chain reaction (RT-PCR)-proven COVID-19 admitted to the Municipal Emergency Clinical Hospital of Timisoara, Romania, between 1 October 2020 and 15 March 2021. Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were performed to determine the discrimination accuracy of the three scores. The mean values of the risk scores were higher in the non-survivors group (survivors group vs. non-survivors group: 8 vs. 15 (4C Mortality Score); 3 vs. 8.5 (NEWS); 1 vs. 3 (CURB-65)). In terms of mortality risk prediction, the NEWS performed be...

Research paper thumbnail of Elastofibroma Dorsi, a Rare Condition, with Challenging Diagnosis. Case Report and Literature Review

Medicina, 2021

Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a cas... more Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a case of a bilateral elastofibroma dorsi (ED) in a 65-year-old female who presented to the Department of General and Oncologic Surgery of Emergency Clinical Municipal Hospital Timisoara, Romania. The patient was symptomatic on the right side, presenting pain in the interscapulothoracic region associated with a variable tumoral mass, dependent on the position of the right arm. Imaging studies revealed a well-defined, bilateral tumoral mass with alternation of the muscular and fatty tissue. The initial diagnosis of lipoma was taken into consideration based on the CT scan and clinical findings. Surgical excision of the right subscapular tumor was performed without any postoperative complications. Microscopic examination of hematoxylin and eosin, Masson’s trichrome, and orcein stained slides revealed the diagnosis of ED. Considering the high rate of reported postoperative complications and the a...

Research paper thumbnail of 18 Prevention and Therapeutic Strategies in Endometrial Cancer

17 studies covering 10,572 women showed a prevalence of a malignancy within endometrial polyps in... more 17 studies covering 10,572 women showed a prevalence of a malignancy within endometrial polyps in postmenopausal women about 5.42% compared to 1.70% in premenopausal women [Lee, 2010]. Endometrial neoplasia was identified in 214 of 3,946 women with endometrial polyps who were postmenopausal compared with 68 of 3,997 premenopausal women (relative risk 3.86). There were 4,967 women with symptomatic bleeding and 195 from them (4.15%) had neoplastic polyps compared with 85 of 3,941 (2.16%) without normal bleeding, according to the report (relative risk 1.97). Looking at the increased risks seen with postmenopausal status and abnormal bleeding, this did not seem to be additive. Polyp size did not appear to be associated with malignancy. Women with hereditary nonpolyposis colorectal cancer (HNPCC) syndrome have a markedly increased risk of endometrial cancer compared with women in the general population. Among women who are HNPCC mutation carriers, the estimated cumulative incidence of en...

Research paper thumbnail of Pelvic intraoperative iatrogenic oncosurgical injuries: single-center experience

Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2016

PURPOSE Iatrogenic events are more likely to occur during surgical treatment of malignant conditi... more PURPOSE Iatrogenic events are more likely to occur during surgical treatment of malignant conditions. Gynecologic and colorectal cancers account for most of the cases that require surgical treatment within the pelvic area. The purpose of this study was to analyze the incidence of intraoperative accidents and the most frequently encountered injuries during surgery for cancers of the pelvic area. METHODS The records of 2702 patients admitted to our clinic over a 15-year period, (January 2000-December 2014), were analyzed for type and frequency of intraoperative accidents. RESULTS Urinary tract lesions were the most common injuries seen in this series (63.1%), followed by enteral (28.1%) and vascular (8.8%) injuries, with an overall incidence of 2.9% for the whole group. Iatrogenic injuries showed a statistically significant difference in incidence depending on the type of primary malignancy (p<0.002). Cervical cancer was associated with a higher rate of ureteral lesions, whereas en...

Research paper thumbnail of New Thoracotomy Closure, a Simple Way to Decrease Chronic Post-Operative Pain in Selected Patients—Blinded Prospective Study

Journal of Personalized Medicine, 2021

Background and Objectives: Chronic post-thoracotomy pain syndrome (PTPS) is a very common and unc... more Background and Objectives: Chronic post-thoracotomy pain syndrome (PTPS) is a very common and uncomfortable complication, occurring frequently after thoracic operations, leading to the necessity of further medication and hospitalizations. One important risk factor in developing chronic pain is the chest closure technique, which can lead to chronic intercostal nerve damage. This study proposes an alternative nerve-sparring closure technique to standard peri-costal sutures, aimed toward minimizing the risk of chronic pain in selected patients. Materials and Methods: We performed a prospective randomized study on 311 patients operated for various thoracic pathology over a period of 12 months, evaluating incision types, chest closure technique, and number of drains with drainage duration. The patients were divided into three groups: peri-costal (PC), proposed extra-costal (EC), and simple (SC) suture, respectively. Pain was measured on day 1, 2, 5, 7, and at 6 months post-operatively us...

Research paper thumbnail of The role of pelvic lymphocele in the development of early postoperative complications

Medicine, 2018

With the increasing incidence of gynecologic malignancy, radical hysterectomy represents an impor... more With the increasing incidence of gynecologic malignancy, radical hysterectomy represents an important part of the adequate treatment of these patients. The pelvic lymphocele is a known side effect of pelvic and para-aortic lymphadenectomy. The aim of our study was to assess the role of the lymphocele in the development of early postoperative complications. A single-center, retrospective analysis between January 2000 and May 2017 revealed 1867 patients with cervical and endometrial cancer, treated through radical or modified radical hysterectomy and pelvic lymphadenectomy. Postoperative complications and the occurrence of pelvic lymphocele were evaluated. Approximately 47.6% of patients were diagnosed with pelvic lymphocele, with only 5.2% being symptomatic. Early postoperative complications rate recorded an incidence of 8.1%, occurring more frequent if lymphocele were present (P < .001). The pelvic lymphocele represented, in univariate analysis, a risk factor for the development of pelvic abscesses, but not for deep vein thrombosis, lymphedema, or bowel obstruction. Hydronephrosis was found to be significantly correlated with the pelvic lymphocele, but we believe this urological complication to have a different underlining mechanism. Neoadjuvant radiotherapy represented in both uni-and multivariate analysis a risk factor for the occurrence of postoperative complications. In the postoperative context of oncogynecological surgery, pelvic lymphocele occur at high rates, representing a statistical risk factor for hydronephrosis and pelvic abscesses, with neoadjuvant radiotherapy being an independent risk factor for early postoperative complications. Abbreviations: BMI = body mass index, DVT = deep vein thrombosis, US = ultrasound.

Research paper thumbnail of Total Colpectomy Increases the Risk of Postoperative Hydronephrosis in Vaginal Cancer Patients

Journal of Investigative Surgery, 2018

Purpose: Due to the rarity of vaginal cancer, surgical treatment results, and postoperative compl... more Purpose: Due to the rarity of vaginal cancer, surgical treatment results, and postoperative complications have been poorly described in the literature. The aim of this study was to improve current knowledge about the incidence of hydronephrosis following the surgical treatment of vaginal cancer. Materials and methods: 32 patients with vaginal cancer of the middle and upper third were matched with 32 cervical cancer patients (stages I and II) for comparison of long-term urological postoperative complications. All patients underwent radical surgical treatment and all stage II patients underwent neoadjuvant radiotherapy. Results: Hydronephrosis had a significantly higher incidence in the vaginal cancer group (p = 0.04), with 14 patients (43.8%) being diagnosed with this complication compared to only 5 patients (15.6%) in the cervical cancer group. Among patients that received radiotherapy, 40.1% (n = 9) and 22.7% (= 5) of vaginal, respectively cervical cancer patients were found with postoperative hydronephrosis. Conclusions: In vaginal cancer patients total colpectomy increases the risk of developing postoperative hydronephrosis, especially if neoadjuvant radiotherapy has been applied.

Research paper thumbnail of Use of methylene blue in the prevention of recurrent intra-abdominal postoperative adhesions

Journal of International Medical Research, 2017

Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoper... more Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoperative adhesions. Methods Patients with a history of >2 surgeries for intra-abdominal adhesion-related complications were selected for this study. Adhesiolysis surgery was subsequently performed using administration of 1% methylene blue. The follow-up period was 28.5 ± 11.1 months. Results Data were available from 20 patients (seven men and 13 women) whose mean ± SD age was 51.2 ± 11.4 years. Adhesions took longer to become symptomatic after the first abdominal surgery when the initial pathology was malignant compared with benign. However, the recurrence of adhesions after a previous adhesiolysis surgery had a similar time onset regardless of the initial disease. Following adhesiolysis surgery with methylene blue, the majority of patients did not present with symptoms associated with adhesion complications (i.e., chronic abdominal pain, bowel obstruction) for the length of the follow-u...

Research paper thumbnail of Prevention and Therapeutic Strategies in Endometrial Cancer

Cancer Prevention - From Mechanisms to Translational Benefits, 2012

Research paper thumbnail of Therapeutic Strategies in Ovarian Cancer

Ovarian Cancer - Clinical and Therapeutic Perspectives, 2012