Stelian Pantea - Academia.edu (original) (raw)
Papers by Stelian Pantea
Romanian Journal of Morphology and Embryology, Jan 12, 2022
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Timisoara Physical Education and Rehabilitation Journal, Jun 1, 2015
End stage renal disease (ESRD) is a chronic medical condition that has become a public health pro... more End stage renal disease (ESRD) is a chronic medical condition that has become a public health problem. A vascular access is mandatory for patients with ESRD in order to receive hemodialysis. The elbow fistula is the most used procedure for creating the vascular access. Maintaining the fistula's patency represents a constant struggle for these patients representing their lifeline. Our goal was to evaluate the impact that the elbow fistula has on the patient's life quality (QoL). We performed a multicenter study in the 2 nd surgical clinic, Timisoara Emergency County Hospital and the General Surgery department, "Carol Davila" Nephrology Clinical Hospital, Bucharest. We included only the patients that had their first vascular access procedure (elbow fistula) created in one of our centers. All patients completed the SF-36 questionnaire before surgery and at 6 months and 1 year after surgery. The SF-36 score has two major categories: the physical component summary (PCS) and the mental component summary (MCS). The results showed a decrease in the patients QoL after surgery (13.63% for the PCS and 6.87% for the MCS). Also elderly patients (>60 years age) had a decrease in the QoL of 19.11%PCS and 8.17%MCS compared to 10.20%PCS and 4.12%MCS for younger patients. Socioeconomic status also has an impact on the patients QoL. Once the vascular access is created, patients must maintain their new lifeline through thorough self care actions and also by restricting their activities affecting the patient's QoL. Further studies are required to help clarify the association between vascular access and the patient's QoL.
PubMed, Nov 7, 2014
The number of patients with End Stage Kidney Disease is continuously growing. There still are som... more The number of patients with End Stage Kidney Disease is continuously growing. There still are some difficulties in managing vascular access, creating it and dealing with all of its complications. Arterio-venous fistula is the ideal procedure increating the vascular access. Our goal is to present a surgical technique that we consider to be feasible in creating the brahio-cephalic arterio-venous fistula: the smooth loop fistula.If anatomically possible we prefer to create the barhio-cephalic fistula by using the median-basilica vein continued with the median cephalic vein to create a smooth loop between the brachial artery and the cephalic vein. By giving this J shape to the anastomosis there will be a smoother flow through the fistula, increasing its patency rate.
Clinics in surgery, May 26, 2021
We report the extremely rare case of a giant double parathyroid adenoma. A 56-year-old female was... more We report the extremely rare case of a giant double parathyroid adenoma. A 56-year-old female was admitted to hospital due to primary hyperparathyroidism. During the typical investigation a giant tumor of parathyroid origin was detected behind the right thyroid lobe. The patient underwent neck exploration with double parathyroidectomy and right thyroid lobectomy. Based on the histological findings, the diagnosis of giant double adenomas of the right superior and right inferior parathyroid glands was set, while the thyroid gland showed nodular goiter lesions. Primary hyperparathyroidism may be difficult to be recognized since most cases are asymptomatic or mildly symptomatic. Preoperative investigation can contribute to define the appropriate surgical strategy.
Medicina-lithuania, Jun 1, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Current health sciences journal, 2020
Introduction: Thyroid Angiosarcoma is a rare malignant condition of the thyroid gland with higher... more Introduction: Thyroid Angiosarcoma is a rare malignant condition of the thyroid gland with higher incidence reported in mountainous Alpine regions (Switzerland, Austria and northern Italy), featured with poor prognosis. Case presentation: A 76 years old male patient presented in our hospital complaining about difficulty in breathing, altered voice (hoarseness), fatigue and dysphagia. Careful observation of the frontal neck region revealed hemorrhaging petechiae and purpura, while palpation indicated a large nodule movable with deglutition, presumably derived by the thyroid gland. Serum biochemical thyroid function tests were normal. Ultrasound of the thyroid gland showed enlargement of the right lobe with a nodular lesion. FNAC indicated a "suspicious for malignancy" lesion. After patient's consensus, total thyroidectomy took place accompanied by excision of infiltrated infrahyoid muscles. The cytopathologic results were positive for primary thyroid angiosarcoma. Patient's postoperative condition was regular, but he died of disease progression 6 months later. Discussion: Angiosarcomas are malignant neoplasms arising from endothelial cells of blood vessels. They are most commonly found in skin, soft tissue, breast, bone, liver and spleen. Angiosarcomas tend to be highly hemorrhaging and invasive. Thyroid gland is a rare location of development. Cytopathologically they are grossly characterized by freely anastomosing vascular channels lined by atypical endothelial cells unusually enlarged, often multinucleated with many nucleoli and vacuoles into the cytoplasm containing fragments of erythrocytes. The immunohistological identity of angiosarcomas are endothelial line markers (CD31, CD34 and vimentin). Surgical excision when feasible is the first line treatment while adjuvant radio-and/or chemo-therapy are ambiguous. Infiltration of surrounding tissues and distant metastasis (lymph nodes and lungs) are negative prognostic factors.
Timisoara Physical Education and Rehabilitation Journal, Dec 1, 2015
End stage renal disease (ESRD) represents a chronic medical condition that has become a public he... more End stage renal disease (ESRD) represents a chronic medical condition that has become a public health problem and requires substantial funding. The number of patients with ESRD is rapidly increasing. From the moment that ESRD is diagnosed, the natural evolution of this pathology is towards mandatory dialysis, in absence of a renal transplant procedure. In order to perform hemodialysis, a vascular access site must be created and maintained functional. A proper vascular access site allows an adequate blood flow through the dialysis machine, in order to obtain the required results. The arterio-venous fistula represents the number one recommended vascular access site procedure. Establishing and maintaining a vascular access represents one of the biggest problems in hemodialysis. The arterio-venous fistula thus becomes the patient's lifeline. Maintaining a good quality vascular access site is a demanding process and requires cooperation between both the patient and the health care providers. For ESRD patients there is a constant concern regarding the patency of their vascular access. The aim of this paper is to present the postoperative measures that ESRD patients should provide in order to preserve their vascular access. Also, we want to present the main signs of an early complication that patients should recognize and therefore immediately present themselves to the physician. By establishing this type of cooperation and trust between the patient and the medical staff we will be able to reduce the number of surgical procedures required for the creation and maintenance of the vascular access. Our final thought remains that a well-informed patient has better chances of prolonging his "lifeline".
Medicina-lithuania, Jun 10, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Research Square (Research Square), Oct 28, 2020
Introduction Concomitant surgery refers to performing two or more surgical operations on one pati... more Introduction Concomitant surgery refers to performing two or more surgical operations on one patient under the same anesthesia. Patients and Methods We performed a retrospective multicentric study from October 2016 to October 2019, analyzing patients who underwent laparoscopic hiatal hernia repair. We extracted data of patients who underwent concomitant laparoscopic surgery for both hiatal hernia repair and cholecystectomy in the following Clinics:
PubMed, 2018
Epstein syndrome is an extremely rare genetic disorder characterized by the association of nephri... more Epstein syndrome is an extremely rare genetic disorder characterized by the association of nephritis, deafness and megathrombocytopenia. We present the case of a 21-year-old patient diagnosed with Epstein syndrome and hyperparathyroidism secondary to chronic kidney disease. The main particularity of this case resides in the association between megathrombocytopenia and secondary hyperparathyroidism requiring surgery, which could lead to a series of concerns regarding the intra- and postoperative hemorrhagic risk of the procedure. Nevertheless, both the surgical procedure and the postoperative recovery were uneventful, suggesting that the lower threshold for preoperative thrombocyte count in megathrombocytopenia should be specifically considered on an individual case analysis.
PubMed, Mar 3, 2005
Esophagoplasty is obviously a proper choice of treatment; postoperative outcomes should be very g... more Esophagoplasty is obviously a proper choice of treatment; postoperative outcomes should be very good because of benign type of lesions, but morbidity-mortality are high due to the complexity of the intervention. Our purpose is to emphasize the utility of coloesophagoplasty like a very feasible surgical option, based to our short and long term outcomes. This paper relies on the retrospective analysis of all cases admitted to II-nd Surgical Clinic Timisoara in a 20 years period (1983-2002), having coloesophagoplasty for benign esophageal stenosis. There were performed 45 such interventions (16 men, 29 women); the mean age was 35.7 years (15-68 years). The pathology included postcaustic lesions (42 cases), peptic lesions (2 cases) and esophageal leiomyoma (1 case). Postoperative morbidity occurred in 22.6% of patients. The graft functionality was good and very good in 86.6% of patients at discharge. Postoperative mortality was 6.6%.
International Journal of Molecular Sciences, Jan 12, 2016
Maternal hormones are essential for the normal fetal development during pregnancy. Autoimmune thy... more Maternal hormones are essential for the normal fetal development during pregnancy. Autoimmune thyroid disease is a frequent pathology in our iodine replete region. The aim of this study is to evaluate the occurrence of subclinical hypothyroidism (SCH) in cases with known autoimmune thyroid disease, which were in a euthyroid state prior to pregnancy, and to assess the association between supplemental treatments administered and the outcome of the pregnancy. The study is a prospective interventional controlled study. The two cohorts comprise the interventional group, consisting of 109 pregnant women with known autoimmune asymptomatic thyroid disease, without any levothyroxine (LT4) treatment and an aged-matched control group, with an unknown thyroid disease. After the pregnancy, a monthly evaluation of TSH, FT3, and FT4 was performed. Offspring evaluation was made at birth time. 88.8% of the women developed SCH in the first four weeks of pregnancy. Average LT4 doses increased as the pregnancy progressed. The monthly adjustment was 12.5 or 25 µg. All SCH cases developed in the first trimester of pregnancy. There was no significant difference regarding the gestational week, weight, or length at birth between the interventional group and controls, when TSH values were in the optimal range, during the whole pregnancy. Premature birth was described in one case in the interventional group.
Diagnostics
The Pap test plays a significant role worldwide in the early diagnosis of and high curability rat... more The Pap test plays a significant role worldwide in the early diagnosis of and high curability rates for cervical cancer. However, the coronavirus disease 2019 (COVID-19) pandemic necessitated the use of multiple drastic measures to stop the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, limiting women’s access to essential invasive and non-invasive investigations for cervical cancer diagnosis. Therefore, we aimed to determine the impact the COVID-19 pandemic had on cancer diagnosis and management in western Romania. A retrospective study design allowed us to compare the last 24 months of the pre-pandemic period with the first 24 months of the COVID-19 pandemic to determine the change in volume of cervical screening tests, the number of newly diagnosed cases and their severity, and the access to cancer care. A drastic 75.5% decrease in the volume of tests was observed in April 2020 during the first lockdown, after which the volume of cases decreased...
Healthcare
Being one of the most common malignancies in young women, cervical cancer is frequently successfu... more Being one of the most common malignancies in young women, cervical cancer is frequently successfully screened around the world. Early detection enables for an important number of curative options that allow for more than 90% of patients to survive more than three years without cancer relapse. Unfortunately, the COVID-19 pandemic put tremendous pressure on healthcare systems and access to cancer care, determining us to develop a study on the influence the pandemic had on surgical care of cervical cancer, and to assess changes in its management and outcomes. A retrospective study design allowed us to compare cervical cancer trends of the last 48 months of the pre-pandemic period with the first 24 months during the COVID-19 pandemic, using the database from the Timis County Emergency Clinical Hospital. New cases of cervical cancer presented to our clinic in more advanced stages (34.6% cases of FIGO stage III during the pandemic vs. 22.4% before the pandemic, p-value = 0.047). These pat...
Medicina
Background and Objectives: Recurrent laryngeal nerve injury is one of the major complications of ... more Background and Objectives: Recurrent laryngeal nerve injury is one of the major complications of thyroidectomy, with the lateral thyroid ligament (Berry’s ligament) being the most frequent site of nerve injury. Neuromonitoring during thyroidectomy revealed three possible anatomical regions of the recurrent laryngeal nerve P1, P2, and P3. P1 represents the recurrent laryngeal nerve’s caudal extralaryngeal part and is primarily associated with Berry’s ligament. The aim of this systematic review is to identify the anatomical region with the highest risk of injury of the recurrent laryngeal nerve (detected via neuromonitoring) during thyroidectomy and to demonstrate the significance of Berry’s ligament as an anatomical structure for the perioperative recognition and protection of the nerve. Materials and Methods: This study conducts a systematic review of the literature and adheres to all PRISMA system criteria as well as recommendations for systematic anatomical reviews. Three search e...
Diagnostics
Background and Objectives: Throughout the COVID-19 pandemic, health systems worldwide adapted to ... more Background and Objectives: Throughout the COVID-19 pandemic, health systems worldwide adapted to support COVID-19 patients while continuing to provide assistance to patients with other potentially fatal illnesses. While patients with cancer may be at an elevated risk of severe COVID-19-related complications, their oncologic therapies generally cannot be postponed indefinitely without a negative effect on outcomes. Taking this into account, a thorough examination of the therapy management of various cancers is necessary, such as cervical cancer. Therefore, we aimed to develop a retrospective cohort study to measure the impact of the COVID-19 pandemic on the delivery of cancer care services for women diagnosed with cervical cancer staged IB2-IVA, necessitating chemo- and radiotherapy in Romania, as well as determine the difference in cervical cancer staging between the pandemic and pre-pandemic period. Materials and Methods: Using a multicentric hospital database, we designed a retros...
Current Health Sciences Journal, 2021
Background. The COVID-19 pandemic has posed unprecedented challenges to health systems worldwide-... more Background. The COVID-19 pandemic has posed unprecedented challenges to health systems worldwide-in delivering care to patients and in maintaining training of their care providers. Surgical specialties have particularly struggled to maintain sufficient levels of training as we have seen significant reductions in the number of surgical beds, operating lists and redeployment of surgical staff to COVID-19 departments or Intensive Treatment Units. Methods. Comparison of the number of surgical operations performed between January 1st 2019 and December 31st 2020 in 3 surgical departments in Romania (Craiova, Timisoara and Bucharest) and 1 surgical department in Thessaloniki, Greece. Cases were compared on a month to month basis, both elective and emergency operations were included and divided into three main categories based on severity (Minor, Medium, Major). Results. Between 2019 and 2020, there was a 37.04% decrease in the number of surgical procedures, 36.95% for open procedures and 3...
Diagnostics, 2022
Although inguinal hernia repair is one of the most common surgical procedures, finding a retroper... more Although inguinal hernia repair is one of the most common surgical procedures, finding a retroperitoneal structure, such as the ureter, is a rather rare occurrence. Ureteroinguinal hernias may arise in the presence or absence of obstructive uropathy, the latter raising difficulties in diagnosis for the general surgeon performing a regular inguinal hernia surgery. This study aims to collect the relevant literature describing the diagnosis and management of ureteroinguinal hernias and update it with a case encountered in our clinic. The following study was reported following the SCARE guidelines. The relevant literature describes less than 150 cases of ureteroinguinal hernias overall, considering the 1.7% prevalence of inguinal hernias in the general population. With only 20% of these hernias being described as extraperitoneal, such an encounter becomes an extremely rare finding. Our clinical experience brings a case of a 75-year-old male with frequent urinary tract infections and a l...
Romanian Journal of Morphology and Embryology, 2022
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Medicina, 2021
Background and Objectives: The COVID-19 pandemic is an ongoing public health emergency. Patients ... more Background and Objectives: The COVID-19 pandemic is an ongoing public health emergency. Patients with chronic diseases are at greater risk for complications and poor outcomes. The objective of this study was to investigate the liver function abnormalities and clinical outcomes in patients with COVID-19 and chronic hepatitis C. Materials and Methods: This retrospective, single-center study was conducted on a cohort of 126 patients with a history of hepatitis C, confirmed with COVID-19 between 01 April 2020 and 30 December 2020. Several clinical outcomes were compared between patients with active and non-active HCV infection, and the risks of liver impairment and all-cause mortality in active HCV patients were analyzed using a multivariate logistic regression model. Results: Among 1057 patients under follow-up for chronic HCV infection, 126 (11.9%) were confirmed with COVID-19; of these, 95 (75.4%) were under treatment or achieved SVR, while in the other 31 (24.6%), we found active HC...
Romanian Journal of Morphology and Embryology, Jan 12, 2022
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Timisoara Physical Education and Rehabilitation Journal, Jun 1, 2015
End stage renal disease (ESRD) is a chronic medical condition that has become a public health pro... more End stage renal disease (ESRD) is a chronic medical condition that has become a public health problem. A vascular access is mandatory for patients with ESRD in order to receive hemodialysis. The elbow fistula is the most used procedure for creating the vascular access. Maintaining the fistula's patency represents a constant struggle for these patients representing their lifeline. Our goal was to evaluate the impact that the elbow fistula has on the patient's life quality (QoL). We performed a multicenter study in the 2 nd surgical clinic, Timisoara Emergency County Hospital and the General Surgery department, "Carol Davila" Nephrology Clinical Hospital, Bucharest. We included only the patients that had their first vascular access procedure (elbow fistula) created in one of our centers. All patients completed the SF-36 questionnaire before surgery and at 6 months and 1 year after surgery. The SF-36 score has two major categories: the physical component summary (PCS) and the mental component summary (MCS). The results showed a decrease in the patients QoL after surgery (13.63% for the PCS and 6.87% for the MCS). Also elderly patients (>60 years age) had a decrease in the QoL of 19.11%PCS and 8.17%MCS compared to 10.20%PCS and 4.12%MCS for younger patients. Socioeconomic status also has an impact on the patients QoL. Once the vascular access is created, patients must maintain their new lifeline through thorough self care actions and also by restricting their activities affecting the patient's QoL. Further studies are required to help clarify the association between vascular access and the patient's QoL.
PubMed, Nov 7, 2014
The number of patients with End Stage Kidney Disease is continuously growing. There still are som... more The number of patients with End Stage Kidney Disease is continuously growing. There still are some difficulties in managing vascular access, creating it and dealing with all of its complications. Arterio-venous fistula is the ideal procedure increating the vascular access. Our goal is to present a surgical technique that we consider to be feasible in creating the brahio-cephalic arterio-venous fistula: the smooth loop fistula.If anatomically possible we prefer to create the barhio-cephalic fistula by using the median-basilica vein continued with the median cephalic vein to create a smooth loop between the brachial artery and the cephalic vein. By giving this J shape to the anastomosis there will be a smoother flow through the fistula, increasing its patency rate.
Clinics in surgery, May 26, 2021
We report the extremely rare case of a giant double parathyroid adenoma. A 56-year-old female was... more We report the extremely rare case of a giant double parathyroid adenoma. A 56-year-old female was admitted to hospital due to primary hyperparathyroidism. During the typical investigation a giant tumor of parathyroid origin was detected behind the right thyroid lobe. The patient underwent neck exploration with double parathyroidectomy and right thyroid lobectomy. Based on the histological findings, the diagnosis of giant double adenomas of the right superior and right inferior parathyroid glands was set, while the thyroid gland showed nodular goiter lesions. Primary hyperparathyroidism may be difficult to be recognized since most cases are asymptomatic or mildly symptomatic. Preoperative investigation can contribute to define the appropriate surgical strategy.
Medicina-lithuania, Jun 1, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Current health sciences journal, 2020
Introduction: Thyroid Angiosarcoma is a rare malignant condition of the thyroid gland with higher... more Introduction: Thyroid Angiosarcoma is a rare malignant condition of the thyroid gland with higher incidence reported in mountainous Alpine regions (Switzerland, Austria and northern Italy), featured with poor prognosis. Case presentation: A 76 years old male patient presented in our hospital complaining about difficulty in breathing, altered voice (hoarseness), fatigue and dysphagia. Careful observation of the frontal neck region revealed hemorrhaging petechiae and purpura, while palpation indicated a large nodule movable with deglutition, presumably derived by the thyroid gland. Serum biochemical thyroid function tests were normal. Ultrasound of the thyroid gland showed enlargement of the right lobe with a nodular lesion. FNAC indicated a "suspicious for malignancy" lesion. After patient's consensus, total thyroidectomy took place accompanied by excision of infiltrated infrahyoid muscles. The cytopathologic results were positive for primary thyroid angiosarcoma. Patient's postoperative condition was regular, but he died of disease progression 6 months later. Discussion: Angiosarcomas are malignant neoplasms arising from endothelial cells of blood vessels. They are most commonly found in skin, soft tissue, breast, bone, liver and spleen. Angiosarcomas tend to be highly hemorrhaging and invasive. Thyroid gland is a rare location of development. Cytopathologically they are grossly characterized by freely anastomosing vascular channels lined by atypical endothelial cells unusually enlarged, often multinucleated with many nucleoli and vacuoles into the cytoplasm containing fragments of erythrocytes. The immunohistological identity of angiosarcomas are endothelial line markers (CD31, CD34 and vimentin). Surgical excision when feasible is the first line treatment while adjuvant radio-and/or chemo-therapy are ambiguous. Infiltration of surrounding tissues and distant metastasis (lymph nodes and lungs) are negative prognostic factors.
Timisoara Physical Education and Rehabilitation Journal, Dec 1, 2015
End stage renal disease (ESRD) represents a chronic medical condition that has become a public he... more End stage renal disease (ESRD) represents a chronic medical condition that has become a public health problem and requires substantial funding. The number of patients with ESRD is rapidly increasing. From the moment that ESRD is diagnosed, the natural evolution of this pathology is towards mandatory dialysis, in absence of a renal transplant procedure. In order to perform hemodialysis, a vascular access site must be created and maintained functional. A proper vascular access site allows an adequate blood flow through the dialysis machine, in order to obtain the required results. The arterio-venous fistula represents the number one recommended vascular access site procedure. Establishing and maintaining a vascular access represents one of the biggest problems in hemodialysis. The arterio-venous fistula thus becomes the patient's lifeline. Maintaining a good quality vascular access site is a demanding process and requires cooperation between both the patient and the health care providers. For ESRD patients there is a constant concern regarding the patency of their vascular access. The aim of this paper is to present the postoperative measures that ESRD patients should provide in order to preserve their vascular access. Also, we want to present the main signs of an early complication that patients should recognize and therefore immediately present themselves to the physician. By establishing this type of cooperation and trust between the patient and the medical staff we will be able to reduce the number of surgical procedures required for the creation and maintenance of the vascular access. Our final thought remains that a well-informed patient has better chances of prolonging his "lifeline".
Medicina-lithuania, Jun 10, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Research Square (Research Square), Oct 28, 2020
Introduction Concomitant surgery refers to performing two or more surgical operations on one pati... more Introduction Concomitant surgery refers to performing two or more surgical operations on one patient under the same anesthesia. Patients and Methods We performed a retrospective multicentric study from October 2016 to October 2019, analyzing patients who underwent laparoscopic hiatal hernia repair. We extracted data of patients who underwent concomitant laparoscopic surgery for both hiatal hernia repair and cholecystectomy in the following Clinics:
PubMed, 2018
Epstein syndrome is an extremely rare genetic disorder characterized by the association of nephri... more Epstein syndrome is an extremely rare genetic disorder characterized by the association of nephritis, deafness and megathrombocytopenia. We present the case of a 21-year-old patient diagnosed with Epstein syndrome and hyperparathyroidism secondary to chronic kidney disease. The main particularity of this case resides in the association between megathrombocytopenia and secondary hyperparathyroidism requiring surgery, which could lead to a series of concerns regarding the intra- and postoperative hemorrhagic risk of the procedure. Nevertheless, both the surgical procedure and the postoperative recovery were uneventful, suggesting that the lower threshold for preoperative thrombocyte count in megathrombocytopenia should be specifically considered on an individual case analysis.
PubMed, Mar 3, 2005
Esophagoplasty is obviously a proper choice of treatment; postoperative outcomes should be very g... more Esophagoplasty is obviously a proper choice of treatment; postoperative outcomes should be very good because of benign type of lesions, but morbidity-mortality are high due to the complexity of the intervention. Our purpose is to emphasize the utility of coloesophagoplasty like a very feasible surgical option, based to our short and long term outcomes. This paper relies on the retrospective analysis of all cases admitted to II-nd Surgical Clinic Timisoara in a 20 years period (1983-2002), having coloesophagoplasty for benign esophageal stenosis. There were performed 45 such interventions (16 men, 29 women); the mean age was 35.7 years (15-68 years). The pathology included postcaustic lesions (42 cases), peptic lesions (2 cases) and esophageal leiomyoma (1 case). Postoperative morbidity occurred in 22.6% of patients. The graft functionality was good and very good in 86.6% of patients at discharge. Postoperative mortality was 6.6%.
International Journal of Molecular Sciences, Jan 12, 2016
Maternal hormones are essential for the normal fetal development during pregnancy. Autoimmune thy... more Maternal hormones are essential for the normal fetal development during pregnancy. Autoimmune thyroid disease is a frequent pathology in our iodine replete region. The aim of this study is to evaluate the occurrence of subclinical hypothyroidism (SCH) in cases with known autoimmune thyroid disease, which were in a euthyroid state prior to pregnancy, and to assess the association between supplemental treatments administered and the outcome of the pregnancy. The study is a prospective interventional controlled study. The two cohorts comprise the interventional group, consisting of 109 pregnant women with known autoimmune asymptomatic thyroid disease, without any levothyroxine (LT4) treatment and an aged-matched control group, with an unknown thyroid disease. After the pregnancy, a monthly evaluation of TSH, FT3, and FT4 was performed. Offspring evaluation was made at birth time. 88.8% of the women developed SCH in the first four weeks of pregnancy. Average LT4 doses increased as the pregnancy progressed. The monthly adjustment was 12.5 or 25 µg. All SCH cases developed in the first trimester of pregnancy. There was no significant difference regarding the gestational week, weight, or length at birth between the interventional group and controls, when TSH values were in the optimal range, during the whole pregnancy. Premature birth was described in one case in the interventional group.
Diagnostics
The Pap test plays a significant role worldwide in the early diagnosis of and high curability rat... more The Pap test plays a significant role worldwide in the early diagnosis of and high curability rates for cervical cancer. However, the coronavirus disease 2019 (COVID-19) pandemic necessitated the use of multiple drastic measures to stop the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, limiting women’s access to essential invasive and non-invasive investigations for cervical cancer diagnosis. Therefore, we aimed to determine the impact the COVID-19 pandemic had on cancer diagnosis and management in western Romania. A retrospective study design allowed us to compare the last 24 months of the pre-pandemic period with the first 24 months of the COVID-19 pandemic to determine the change in volume of cervical screening tests, the number of newly diagnosed cases and their severity, and the access to cancer care. A drastic 75.5% decrease in the volume of tests was observed in April 2020 during the first lockdown, after which the volume of cases decreased...
Healthcare
Being one of the most common malignancies in young women, cervical cancer is frequently successfu... more Being one of the most common malignancies in young women, cervical cancer is frequently successfully screened around the world. Early detection enables for an important number of curative options that allow for more than 90% of patients to survive more than three years without cancer relapse. Unfortunately, the COVID-19 pandemic put tremendous pressure on healthcare systems and access to cancer care, determining us to develop a study on the influence the pandemic had on surgical care of cervical cancer, and to assess changes in its management and outcomes. A retrospective study design allowed us to compare cervical cancer trends of the last 48 months of the pre-pandemic period with the first 24 months during the COVID-19 pandemic, using the database from the Timis County Emergency Clinical Hospital. New cases of cervical cancer presented to our clinic in more advanced stages (34.6% cases of FIGO stage III during the pandemic vs. 22.4% before the pandemic, p-value = 0.047). These pat...
Medicina
Background and Objectives: Recurrent laryngeal nerve injury is one of the major complications of ... more Background and Objectives: Recurrent laryngeal nerve injury is one of the major complications of thyroidectomy, with the lateral thyroid ligament (Berry’s ligament) being the most frequent site of nerve injury. Neuromonitoring during thyroidectomy revealed three possible anatomical regions of the recurrent laryngeal nerve P1, P2, and P3. P1 represents the recurrent laryngeal nerve’s caudal extralaryngeal part and is primarily associated with Berry’s ligament. The aim of this systematic review is to identify the anatomical region with the highest risk of injury of the recurrent laryngeal nerve (detected via neuromonitoring) during thyroidectomy and to demonstrate the significance of Berry’s ligament as an anatomical structure for the perioperative recognition and protection of the nerve. Materials and Methods: This study conducts a systematic review of the literature and adheres to all PRISMA system criteria as well as recommendations for systematic anatomical reviews. Three search e...
Diagnostics
Background and Objectives: Throughout the COVID-19 pandemic, health systems worldwide adapted to ... more Background and Objectives: Throughout the COVID-19 pandemic, health systems worldwide adapted to support COVID-19 patients while continuing to provide assistance to patients with other potentially fatal illnesses. While patients with cancer may be at an elevated risk of severe COVID-19-related complications, their oncologic therapies generally cannot be postponed indefinitely without a negative effect on outcomes. Taking this into account, a thorough examination of the therapy management of various cancers is necessary, such as cervical cancer. Therefore, we aimed to develop a retrospective cohort study to measure the impact of the COVID-19 pandemic on the delivery of cancer care services for women diagnosed with cervical cancer staged IB2-IVA, necessitating chemo- and radiotherapy in Romania, as well as determine the difference in cervical cancer staging between the pandemic and pre-pandemic period. Materials and Methods: Using a multicentric hospital database, we designed a retros...
Current Health Sciences Journal, 2021
Background. The COVID-19 pandemic has posed unprecedented challenges to health systems worldwide-... more Background. The COVID-19 pandemic has posed unprecedented challenges to health systems worldwide-in delivering care to patients and in maintaining training of their care providers. Surgical specialties have particularly struggled to maintain sufficient levels of training as we have seen significant reductions in the number of surgical beds, operating lists and redeployment of surgical staff to COVID-19 departments or Intensive Treatment Units. Methods. Comparison of the number of surgical operations performed between January 1st 2019 and December 31st 2020 in 3 surgical departments in Romania (Craiova, Timisoara and Bucharest) and 1 surgical department in Thessaloniki, Greece. Cases were compared on a month to month basis, both elective and emergency operations were included and divided into three main categories based on severity (Minor, Medium, Major). Results. Between 2019 and 2020, there was a 37.04% decrease in the number of surgical procedures, 36.95% for open procedures and 3...
Diagnostics, 2022
Although inguinal hernia repair is one of the most common surgical procedures, finding a retroper... more Although inguinal hernia repair is one of the most common surgical procedures, finding a retroperitoneal structure, such as the ureter, is a rather rare occurrence. Ureteroinguinal hernias may arise in the presence or absence of obstructive uropathy, the latter raising difficulties in diagnosis for the general surgeon performing a regular inguinal hernia surgery. This study aims to collect the relevant literature describing the diagnosis and management of ureteroinguinal hernias and update it with a case encountered in our clinic. The following study was reported following the SCARE guidelines. The relevant literature describes less than 150 cases of ureteroinguinal hernias overall, considering the 1.7% prevalence of inguinal hernias in the general population. With only 20% of these hernias being described as extraperitoneal, such an encounter becomes an extremely rare finding. Our clinical experience brings a case of a 75-year-old male with frequent urinary tract infections and a l...
Romanian Journal of Morphology and Embryology, 2022
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Medicina, 2021
Background and Objectives: The COVID-19 pandemic is an ongoing public health emergency. Patients ... more Background and Objectives: The COVID-19 pandemic is an ongoing public health emergency. Patients with chronic diseases are at greater risk for complications and poor outcomes. The objective of this study was to investigate the liver function abnormalities and clinical outcomes in patients with COVID-19 and chronic hepatitis C. Materials and Methods: This retrospective, single-center study was conducted on a cohort of 126 patients with a history of hepatitis C, confirmed with COVID-19 between 01 April 2020 and 30 December 2020. Several clinical outcomes were compared between patients with active and non-active HCV infection, and the risks of liver impairment and all-cause mortality in active HCV patients were analyzed using a multivariate logistic regression model. Results: Among 1057 patients under follow-up for chronic HCV infection, 126 (11.9%) were confirmed with COVID-19; of these, 95 (75.4%) were under treatment or achieved SVR, while in the other 31 (24.6%), we found active HC...