Ana Pitea | G.E. Palade UMPhST of Targu Mures (original) (raw)
Papers by Ana Pitea
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Elastography is a method which, using ultrasound, obtains images and measurements of tissue elast... more Elastography is a method which, using ultrasound, obtains images and measurements of tissue elasticity when applying a force on it. As an imaging method it was developed to quantify objectively the pathological changes related to the presence of an abnormal tissue, compared to the surrounding tissues, giving information about the elasticity/stiffness of the examined tissue, the degree of fibrosis, the degree of stiffness compared to tumor free tissue. The tissue analysis can be done through a compression technology "eSie touch elasticity imaging" (with applications for the surface elastography) or ARFI technology--"acoustic radiation force imaging" (the diffusion impulse of the acoustic force). The ARFI method allows valid, accurate and flexible evaluation of liver stiffness and it is correlates with the fibrosis stage. The liver elastosonography, through new technologies available, has reached the level of the fibro-elastoscanner and magnetic resonance imaging. ...
Romanian Journal of Pediatrics, 2012
Boala urinilor cu miros de sirop de arţar face parte dintr-un grup heterogen de afecţiuni, respec... more Boala urinilor cu miros de sirop de arţar face parte dintr-un grup heterogen de afecţiuni, respectiv erorile înnăscute de metabolism. Scopul lucrării. Ne propunem să prezentăm 2 cazuri diagnosticate în clinica noastră, urmărirea evoluţiei şi a răspunsului la tratament. Material şi metodă. Diagnosticul s-a documentat prin determinarea amino-acizilor serici şi urinari. Fiecare caz a fost analizat, urmărindu-se în dinamică datele anamnestice, examenul clinic, examinări paraclinice şi de laborator, scheme terapeutice, evoluţie. Rezultate. Vârsta la debutul tipic în primul caz, adică în zilele 5-6 de viaţă, şi la 3 săptămâni de viaţă la al doilea caz (deşi în ambele cazuri alimentaţia era naturală). Manifestările clinice la debut. Tabloul neurologic: letargie, apatie, adinamie (primul caz), somnolenţă, plafonarea privirii, hipotonie (cazul 2); apetit capricios/ tulburări de alimentaţie (acumularea AA şi a metaboliţilor acestora), în ambele cazuri; simptomatologia intercurenţei (tuse, rin...
Romanian Journal of Pediatrics, 2013
Introducere. Obezitatea prezintă multiple complicaţii, consecinţa infl amaţiei cronice şi insulin... more Introducere. Obezitatea prezintă multiple complicaţii, consecinţa infl amaţiei cronice şi insulinorezistenţei, modifi cări induse de produşii secretaţi de adipocite. Scop. Determinarea nivelurilor serice a adipokinelor infl amatorii la copiii obezi şi evaluarea relaţiei cu indicii antropometrici şi parametrii biochimici. Material şi metodă. Studiu prospectiv incluzând 110 copii obezi, între 1 octombrie 2010-1 martie 2013. S-au determinat leptina, adiponectina, interleukinele (IL6-8), căutând corelaţiile acestora cu parametrii antropometrici şi de metabolism. Rezultate. Leptina a fost 16,79 ±1,39 ng/ml la obezi, mai mare decât la lotul martor (2,78 ± 0,43 ng/ml), iar adiponectina 14871,07 ± 713,17 ng/ml la martor şi 9.883,49 ± 562,54 ng/ml la obezi, cu diferenţe semnifi cative statistic (p < 0,0001 ambele). IL6 şi IL8 au fost, de asemenea, mai mari la lotul de obezi. Au fost corelaţii semnifi cative între adipokine şi indicii antropometrici. Dislipidemia s-a semnalat la 20% din ob...
Romanian Journal of Pediatrics, 2012
Elastografi a este o nouă metodă imagistică bazată pe ultrasunete, care permite evaluarea structu... more Elastografi a este o nouă metodă imagistică bazată pe ultrasunete, care permite evaluarea structurii ţesuturilor în ceea ce priveşte rigiditatea lor, fi ind utilă în explorarea diferitelor organe şi sisteme şi cu tot mai multe aplicaţii clinice. Dezvoltarea substanţelor de contrast de generaţia a doua a dus la amplifi carea semnalului ecografi c cu ajutorul microbulelor, care nu pot străbate peretele vascular şi care se elimină prin exhalare în 15 minute. Material şi metode. Prezentăm rezultatele unui studiu prospectiv derulat în clinica noastră, evaluând performanţele metodei ARFI (impulsul de difuzie a forţei acustice) în evaluarea elasticităţii fi catului la copii; prezentăm şi câteva cazuri pediatrice în care ecografi a cu contrast a adus reale benefi cii, uşurând diagnosticul şi facilitând luarea deciziilor terapeutice optime.
Romanian Journal of Pediatrics, 2013
Scop. Evaluarea nivelurilor serice ale unor markeri infl amatori la copiii cu alterări ale status... more Scop. Evaluarea nivelurilor serice ale unor markeri infl amatori la copiii cu alterări ale statusului nutriţional şi corelarea acestor markeri cu patologii infecţioase. Material şi metodă. Am efectuat un studiu prospectiv pe 120 de copii internaţi in Clinica Pediatrie I Tg. Mureş, la care am urmărit statusul nutriţional şi prezenţa sau absenţa unor semne infecţioase, copiii fi ind evaluaţi antropometric şi paraclinic prin markeri sugestivi pentru infecţii. Rezultate. 28% dintre copii au avut defi cit ponderal, iar 24% exces ponderal. Clinic s-a identifi cat cel puţin un sindrom infecţios la 31,7% dintre copii, VSH fi ind mărit la aceşti copii comparativ cei clinic sănătoşi (p = 0,034); nu s-au observat diferenţe în acest sens în cazul celorlalţi markeri serologici. S-au observat valori ale IL-6 şi IL-8 scăzute sub limita de detecţie, în special la copiii subponderali cu diagnostic de sindrom infecţios, şi valori crescute ale IL-6 si IL-8 la copiii supraponderali cu diagnostic de sin...
Romanian Journal of Pediatrics, 2012
Prezentăm cazul unui băiat de 9 ani cu epilepsie refractară la tratamentul anterior, diagnosticat... more Prezentăm cazul unui băiat de 9 ani cu epilepsie refractară la tratamentul anterior, diagnosticat cu sindrom Stevens Johnson apărut după introducerea în tratament a Lamictalului. Băiatul a prezentat febră, exantem polimorf maculo-papulo-eritematos, cu elemente veziculo buloase generalizate şi denudare tegumentară, conjunctivită, leziuni bucale. Pneumonia asociata am interpretat-o ca afectare a mucoasei tractului respirator inferior din cadrul sindromului Stevens Johnson. Evoluţia bolii a fost favorabilă după doze mari de imunoglobuline intravenos. În concluzie, deşi incidenţa sindromului Steven Johnson este mică la copil, pediatrii trebuie să fi e conştienţi de posibilitatea apariţiei ei (chiar după antiepileptice – Lamictal), iar utilizarea imunoglobulinelor IV, deşi con troversată, administrată în doze mari pare că duce la vindecarea bolii.
Journal of Health, Population, and Nutrition, 2014
Malnutrition is a prevalent condition in hospitalized children. Our aims were to evaluate the nut... more Malnutrition is a prevalent condition in hospitalized children. Our aims were to evaluate the nutritional state and to validate the STRONGkids risk assessment tool in a hospitalized paediatric population in Romania. This is a prospective single-centre study in a tertiary teaching hospital in Romania (May 2011-January 2012). We calculated the STRONGkids score and measured the children's height and weight. Standard deviation <-2 for weight-for-height and height-for-age was considered to indicate acute or chronic malnutrition respectively. Two hundred seventy-one children were included, with median age of 5.2 years and median hospital stay of 2.01 days. Prevalence of malnutrition and severe malnutrition was 37% and 15% respectively. Using the STRONGkids screening tool, 58% of the children were found at risk of malnutrition (24% were at high risk). The kappa coefficient of agreement between STRONGkids and WHO malnutrition classification was 0.61. When a low serum protein level wa...
The aim of the study was to analyze the relationship between leptin serum levels, body mass index... more The aim of the study was to analyze the relationship between leptin serum levels, body mass index and certain parameters of lipid and carbohydrate metabolism in children and adolescents with various degree of obesity. We assessed 86 children and adolescents (45 boys and 41 girls) between 6 and 18 years of age within the Ist Pediatric Clinic from Târgu Mure �; 68.60% of the children were overweight, 29.07% had class I obesity and 2.33% had class II obesity. Leptin serum levels were measured and compared with BMI, age and parameters of carbohydrate and lipid metabolism (blood glucose, cholesterol, triglycerides, HDL cholesterol, and LDL choles- terol). Leptin serum levels were increased in all overweight and obese adolescents: we found leptin serum levels of 45.69 ± 28.04 ng/mL in boys, and significantly higher values (72.96 ± 22.02 ng/mL) in girls. These values were positively correlated with BMI (r = 0,34 in boys and r = 0,44 in girls). A positive correlation was found between lepti...
The aim of the study was to analyze the relationship between leptin serum levels, body mass index... more The aim of the study was to analyze the relationship between leptin serum levels, body mass index and certain parameters of lipid and carbohydrate metabolism in children and adolescents with various degree of obesity. We assessed 86 children and adolescents (45 boys and 41 girls) between 6 and 18 years of age within the Ist Pediatric Clinic from Târgu Mure ; 68.60% of the children were overweight, 29.07% had class I obesity and 2.33% had class II obesity. Leptin serum levels were measured and compared with BMI, age and parameters of carbohydrate and lipid metabolism (blood glucose, cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol). Leptin serum levels were increased in all overweight and obese adolescents: we found leptin serum levels of 45.69 ± 28.04 ng/mL in boys, and significantly higher values (72.96 ± 22.02 ng/mL) in girls. These values were positively correlated with BMI (r = 0,34 in boys and r = 0,44 in girls). A positive correlation was found between leptin, ...
Experimental and Therapeutic Medicine, 2021
Nephrogenic diabetes insipidus (NDI) is characterized by impaired urinary concentrating ability, ... more Nephrogenic diabetes insipidus (NDI) is characterized by impaired urinary concentrating ability, despite normal or elevated plasma concentrations of the antidiuretic hormone, arginine vasopressin (AVP). NDI can be inherited or acquired. NDI can result from genetic abnormalities, such as mutations in the vasopressin V2 receptor (AVPR2) or the aquaporin-2 (AQP2) water channel, or acquired causes, such as chronic lithium therapy. Congenital NDI is a rare condition. Mutations in AVPR2 are responsible for approximately 90% of patients with congenital NDI, and they have an X-linked pattern of inheritance. In approximately 10% of patients, congenital NDI has an autosomal recessive or dominant pattern of inheritance with mutations in the AQP2 gene. In 2% of cases, the genetic cause is unknown. The main symptoms at presentation include growth retardation, vomiting or feeding concerns, polyuria plus polydipsia, and dehydration. Without treatment, most patients fail to grow normally, and present with associated constipation, urological complication, megacystis, trabeculated bladder, hydroureter, hydronephrosis, and mental retardation. Treatment of NDI consist of sufficient water intake, low-sodium diet, diuretic thiazide, sometimes in combination with a cyclooxygenase (COX) inhibitor (indomethacin) or nonsteroidal anti-inflammatory drugs (NSAIDs), or hydrochlorothiazide in combination with amiloride. Some authors note a generally favorable long-term outcome and an apparent loss of efficacy of medical treatment during school age.
Oral Communications, 2017
Background and aims Roma population is a marginalised ethnic group with a low socioeconomic statu... more Background and aims Roma population is a marginalised ethnic group with a low socioeconomic status which contributes to their poor health condition compared with most of the population. The aim of this study was to explore how low socioeconomic status, education, poor hygienic conditions, crowded housing conditions and low vaccination rate influence Roma children’s morbidity. Methods A prospective questionnaire study, including 61 questions, was performed among Roma children at the Paediatric Clinic no. I Tirgu-Mures, Paediatric Department of Municipal Hospital from Sageorgiu de Padure and in Sangeorgiu de Mures. We included in our investigation a total of 150 gipsy-children compared to 150 non-gipsy children, representing the control group. Results A total of 24,4% of the mothers were illiterate, 32,7% were smokers, 13,3% consumed alcohol, 41,3% developed a disease during pregnancy. 30% of the children lack vaccination. In 79,3% of the cases houses were heated with wood, in 63,3% there was no tap water, in 70% there was no bathroom and 42,7% of the investigated parents were smoking inside the house. The most frequent diseases were the lower respiratory diseases (29,3%), and neurological and psychiatric disorders (11,3%) as chronic diseases. The occurrence of respiratory and urinary infections was significantly higher in houses without tap water (p=0.008, p=0.029), in those which were heated with wood (p=0.043, p=0.01) and due to lack of proper hygienic conditions gastrointestinal complaints (p=0.047) occured as well. Conclusions Beside the risk factors identified during pregnancy, poor hygienic and social conditions represent the cause of frequent illneses among Roma children.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013
To evaluate the correlations between the pro-inflammatory interleukins IL-6 and IL-8 and the anth... more To evaluate the correlations between the pro-inflammatory interleukins IL-6 and IL-8 and the anthropometric measurements in malnourished vs. non-malnourished children. We have examined 219 children from Pediatric Clinic I, University of Medicine and Pharmacy of Tirgu Mures, Romania, during January 1, 2012-March 1, 2013 and divided according to Body Mass Index (BMI kg/m(2)) in the following two groups: 164 with normal nutritional status - control group (BMI between -2SD and +2SD), and 55 children with malnutrition (BMI <-2SD). All the children were evaluated anthropometric: BMI, weight for age (W/A), height for age (H/A), mid-upper-arm circumference (MUAC), tricipital skinfold (TSF) and paraclinical: IL-6 and IL-8 levels. From 219 children, 25.1% were malnourished. The mean age was 5.16 years in malnourished. IL-6 and IL-8 mean levels were 2.54 pg/mL, respectively 6.83 pg/mL in malnourished and 6.02 pg/mL, respectively 9.06 pg/mL in non-malnourished. By statistically comparing IL-...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013
Helicobacter pylori infection is an important cause of gastritis in childhood, its role in the pa... more Helicobacter pylori infection is an important cause of gastritis in childhood, its role in the pathogenesis of peptic ulcer disease in adults and children being generally known. In some cases, there are therapeutic management issues, because they do not heal or they often relapse, although treatment regimens are applied as recommended. Our aim was to analyze the relationship between endoscopic appearance and histological changes of the gastric mucosa in children with gastritis associated with H. pylori infection, in which persistent infection after treatment was found. It was a prospective study on 1332 children assessed in our Service (Ist Pediatric Clinic, Tirgu Mures, Romania), between January 2008 and January 2013, for gastritis with various etiologies. There were 609 cases of gastritis-associated with H. pylori infection. The average age of patients was 13.21 years; the higher incidence was noted in 13-18-year-old group, female gender and rural areas provenience; a number of 54...
Archives of Disease in Childhood, 2012
Background Congenital chloride diarrhea (CCD), a rare autosomal recessive disorder, is characteri... more Background Congenital chloride diarrhea (CCD), a rare autosomal recessive disorder, is characterized by sustained watery diarrhea (due to defect of active Chloride/HCO3 exchange in the ileum and colon) with high fecal chloride. The estimated incidence of CCD was 1 in 14000 in Kuwait reported in 1989. Aim of our study was to spotlight the common presentation of infants with CCD which appears not to be uncommon disorder in Kuwait for early management and prevention of complications. Subjects and methods Reviewing the inpatient database of Pediatric department of Al-Adan Hospital, Kuwait for patients who were admitted as chronic diarrhea in the first year of life, 12 patients diagnosed as CCD (7 females and 5 males). The diagnosis of CCD was based on antenatal and early infantile presentation and confirmed by laboratory finding of excess chloride loss in stool and low serum chloride level. Results All 12 patients were born to consanguineous parents, had antenatal history of IUGR, polyhydramnios and distended hypoechoic fetal bowel and presented with abdominal distension, hypotonia and muscle wasting. Whereas, 10 patients (90%) were delivered prematurely, 8 patients (66.6%) had maternal hypertension, 9 patients (75%) had absence of normal meconium at birth. Our patients showed significant decrease in serum sodium, potassium, chloride & urine chloride compared with the average for age. Conclusions High index of suspicious and awareness should be considered for early diagnosis of CCD in this population especially in the presence of consanguineous marriage.
Acta Medica Marisiensis, 2013
Objective: To evaluate the anthropometric and biochemical status of children with nutritional def... more Objective: To evaluate the anthropometric and biochemical status of children with nutritional deficiency. Methods: We have conducted a prospective study on 226 children admitted in Pediatric Clinic I, divided into two groups: one group of 49 children with nutritional deficiency (body-mass-index < -2SD) and one control group (177 children). We have followed demographic data, anthropometric indices evaluated as standard deviations (weight, height, middle upper-arm circumference, tricipital skinfold), biochemical proteic status (Insulin-like Growth Factor 1 IGF-1, albumin, total proteins). We also followed parameters of general nutritional biochemistry. Results: The mean age for underweight children was 5.8 years, lower than in the control group. The weight of the nutritional-deficient group was significantly lower than in the control group, unlike the height (p <0.001). We have also found significant differences in body-mass-index, middle upper-arm circumference and tricipital s...
Romanian Review of Laboratory Medicine, 2014
Purpose: to evaluate the serum levels of micronutrients in children with nutritional disorders, a... more Purpose: to evaluate the serum levels of micronutrients in children with nutritional disorders, and to find if there is a direct correlation between them and the anthropometric measurements. Materials and methods: the study was conducted on 125 children (0-18 years); the working group consisted in children with Z-score < -2 standard deviations for at least one anthropometric measurement, while the children without growth disorders were considered as controls. Thus, for each anthropometric measurement, we had different working/control groups that were used for the assessment of correlation with laboratory findings. We followed eight anthropometric parameters and their relation with five of the micronutrients (Ca, Mg, Fe, Zn and Cu). Results: no statistical differences were found in micronutrients serum levels between genders or provenance. Most mean serum levels of micronutrients were lower in the children with Z-scores < -2 standard deviations (except Cu). Mg and Ca were posit...
European Journal of Pediatrics, 2014
The aim of this study was to establish the correlations between the polymorphisms of the genes in... more The aim of this study was to establish the correlations between the polymorphisms of the genes interleukin (IL)-6 572, 190, and 174 in obese children. We assessed 222 hospitalized children divided into two groups: group I (control) included 110 patients with normal nutritional status, and group II consisted of 102 obesity patients. The two groups underwent IL-6 572 C/G, 190 C/T, and 174 G/C polymorphism testing, measurement of anthropometric parameters (mid-upper arm circumference and tricipital skinfold thickness), and paraclinical evaluation (protein, albumin, leptin, adiponectin, and vascular endothelial growth factor (VEGF)). We observed that phenotype CC was more frequent in obese children for IL-6 572 (p=0.0001), whereas CG heterozygotes were more frequent in the obese group for the IL-6 190 gene (62.7 %; p=0.0001). Leptin was dependent on IL-6 572 and IL-6 174 gene polymorphisms and albumin, whereas adiponectin was dependent on the IL-6 174 gene polymorphism. Body mass index (BMI), mid-upper arm circumference (MUAC), and tricipital skinfold thickness (TST) serum albumin levels correlated with C allele carriers of the IL-6 572 and IL-6 190 genes in children with obesity, whereas the CC genotype of IL-6 174 was a protective factor for obesity. Conclusion: Obesity is most frequently associated in children with IL-6 174 C allele carriers and with IL-6 190 C allele carriers.
European Journal of Pediatrics, 2013
The aim of this study was to analyze insulin-like growth factor I (IGF-I) serum level in pediatri... more The aim of this study was to analyze insulin-like growth factor I (IGF-I) serum level in pediatric patients with cancer compared with pediatric patients with nononcological diseases and to assess the relationship between IGF-I and nutritional status of oncological patients. From January 2009 to July 2012, we assessed 151 consecutively hospitalized patients in a tertiary emergency pediatric hospital. The patients were divided into two groups: group I, consisting of patients with malignant diseases (64 patients), and group II, the control group, consisting of 87 age- and gender-matched patients with different pediatric diseases. The anthropometric parameters (weight, height, body mass index, middle upper arm circumference (MUAC), and tricipital skinfold thickness (TST) and biochemical parameters (proteins, albumin, and total IGF-I) were comparatively evaluated at the diagnosis and after intensive chemotherapy in the malignant group. Anthropometric and biochemical parameters in group I were significantly different from those in group II for height, MUAC, TST, total proteins, and albumin (p &amp;lt; 0.05). Twenty-five out of 64 patients with malignant diseases and 5 out of 87 patients in the control group had malnutrition. IGF-I in patients with cancer was much lower than in the control group (median 48.3 ng/ml, range 25.00-662.00 ng/ml vs 129.00 ng/ml, range 25.00-745.00 ng/ml) (p = 0.014). We found a positive correlation between IGF-I, MUAC, and TST at the diagnosis of the malignant disease. Also, we identified positive correlations between IGF-I, protein, and albumin. Serum IGF-I levels in cancer patients were significantly lower at diagnosis than after chemotherapy (48.3 ng/ml, range 25.00-662.00 ng/ml vs 110.0 ng/ml, range 25.00-573.00 ng/ml; p = 0.04). IGF-I seems to be an accurate biochemical parameter used in malnutrition assessment of children with cancer. IGF-I correlated with the anthropometric parameters of the arm, serum protein, and albumin. These parameters most accurately characterize the nutritional status.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Elastography is a method which, using ultrasound, obtains images and measurements of tissue elast... more Elastography is a method which, using ultrasound, obtains images and measurements of tissue elasticity when applying a force on it. As an imaging method it was developed to quantify objectively the pathological changes related to the presence of an abnormal tissue, compared to the surrounding tissues, giving information about the elasticity/stiffness of the examined tissue, the degree of fibrosis, the degree of stiffness compared to tumor free tissue. The tissue analysis can be done through a compression technology "eSie touch elasticity imaging" (with applications for the surface elastography) or ARFI technology--"acoustic radiation force imaging" (the diffusion impulse of the acoustic force). The ARFI method allows valid, accurate and flexible evaluation of liver stiffness and it is correlates with the fibrosis stage. The liver elastosonography, through new technologies available, has reached the level of the fibro-elastoscanner and magnetic resonance imaging. ...
Romanian Journal of Pediatrics, 2012
Boala urinilor cu miros de sirop de arţar face parte dintr-un grup heterogen de afecţiuni, respec... more Boala urinilor cu miros de sirop de arţar face parte dintr-un grup heterogen de afecţiuni, respectiv erorile înnăscute de metabolism. Scopul lucrării. Ne propunem să prezentăm 2 cazuri diagnosticate în clinica noastră, urmărirea evoluţiei şi a răspunsului la tratament. Material şi metodă. Diagnosticul s-a documentat prin determinarea amino-acizilor serici şi urinari. Fiecare caz a fost analizat, urmărindu-se în dinamică datele anamnestice, examenul clinic, examinări paraclinice şi de laborator, scheme terapeutice, evoluţie. Rezultate. Vârsta la debutul tipic în primul caz, adică în zilele 5-6 de viaţă, şi la 3 săptămâni de viaţă la al doilea caz (deşi în ambele cazuri alimentaţia era naturală). Manifestările clinice la debut. Tabloul neurologic: letargie, apatie, adinamie (primul caz), somnolenţă, plafonarea privirii, hipotonie (cazul 2); apetit capricios/ tulburări de alimentaţie (acumularea AA şi a metaboliţilor acestora), în ambele cazuri; simptomatologia intercurenţei (tuse, rin...
Romanian Journal of Pediatrics, 2013
Introducere. Obezitatea prezintă multiple complicaţii, consecinţa infl amaţiei cronice şi insulin... more Introducere. Obezitatea prezintă multiple complicaţii, consecinţa infl amaţiei cronice şi insulinorezistenţei, modifi cări induse de produşii secretaţi de adipocite. Scop. Determinarea nivelurilor serice a adipokinelor infl amatorii la copiii obezi şi evaluarea relaţiei cu indicii antropometrici şi parametrii biochimici. Material şi metodă. Studiu prospectiv incluzând 110 copii obezi, între 1 octombrie 2010-1 martie 2013. S-au determinat leptina, adiponectina, interleukinele (IL6-8), căutând corelaţiile acestora cu parametrii antropometrici şi de metabolism. Rezultate. Leptina a fost 16,79 ±1,39 ng/ml la obezi, mai mare decât la lotul martor (2,78 ± 0,43 ng/ml), iar adiponectina 14871,07 ± 713,17 ng/ml la martor şi 9.883,49 ± 562,54 ng/ml la obezi, cu diferenţe semnifi cative statistic (p < 0,0001 ambele). IL6 şi IL8 au fost, de asemenea, mai mari la lotul de obezi. Au fost corelaţii semnifi cative între adipokine şi indicii antropometrici. Dislipidemia s-a semnalat la 20% din ob...
Romanian Journal of Pediatrics, 2012
Elastografi a este o nouă metodă imagistică bazată pe ultrasunete, care permite evaluarea structu... more Elastografi a este o nouă metodă imagistică bazată pe ultrasunete, care permite evaluarea structurii ţesuturilor în ceea ce priveşte rigiditatea lor, fi ind utilă în explorarea diferitelor organe şi sisteme şi cu tot mai multe aplicaţii clinice. Dezvoltarea substanţelor de contrast de generaţia a doua a dus la amplifi carea semnalului ecografi c cu ajutorul microbulelor, care nu pot străbate peretele vascular şi care se elimină prin exhalare în 15 minute. Material şi metode. Prezentăm rezultatele unui studiu prospectiv derulat în clinica noastră, evaluând performanţele metodei ARFI (impulsul de difuzie a forţei acustice) în evaluarea elasticităţii fi catului la copii; prezentăm şi câteva cazuri pediatrice în care ecografi a cu contrast a adus reale benefi cii, uşurând diagnosticul şi facilitând luarea deciziilor terapeutice optime.
Romanian Journal of Pediatrics, 2013
Scop. Evaluarea nivelurilor serice ale unor markeri infl amatori la copiii cu alterări ale status... more Scop. Evaluarea nivelurilor serice ale unor markeri infl amatori la copiii cu alterări ale statusului nutriţional şi corelarea acestor markeri cu patologii infecţioase. Material şi metodă. Am efectuat un studiu prospectiv pe 120 de copii internaţi in Clinica Pediatrie I Tg. Mureş, la care am urmărit statusul nutriţional şi prezenţa sau absenţa unor semne infecţioase, copiii fi ind evaluaţi antropometric şi paraclinic prin markeri sugestivi pentru infecţii. Rezultate. 28% dintre copii au avut defi cit ponderal, iar 24% exces ponderal. Clinic s-a identifi cat cel puţin un sindrom infecţios la 31,7% dintre copii, VSH fi ind mărit la aceşti copii comparativ cei clinic sănătoşi (p = 0,034); nu s-au observat diferenţe în acest sens în cazul celorlalţi markeri serologici. S-au observat valori ale IL-6 şi IL-8 scăzute sub limita de detecţie, în special la copiii subponderali cu diagnostic de sindrom infecţios, şi valori crescute ale IL-6 si IL-8 la copiii supraponderali cu diagnostic de sin...
Romanian Journal of Pediatrics, 2012
Prezentăm cazul unui băiat de 9 ani cu epilepsie refractară la tratamentul anterior, diagnosticat... more Prezentăm cazul unui băiat de 9 ani cu epilepsie refractară la tratamentul anterior, diagnosticat cu sindrom Stevens Johnson apărut după introducerea în tratament a Lamictalului. Băiatul a prezentat febră, exantem polimorf maculo-papulo-eritematos, cu elemente veziculo buloase generalizate şi denudare tegumentară, conjunctivită, leziuni bucale. Pneumonia asociata am interpretat-o ca afectare a mucoasei tractului respirator inferior din cadrul sindromului Stevens Johnson. Evoluţia bolii a fost favorabilă după doze mari de imunoglobuline intravenos. În concluzie, deşi incidenţa sindromului Steven Johnson este mică la copil, pediatrii trebuie să fi e conştienţi de posibilitatea apariţiei ei (chiar după antiepileptice – Lamictal), iar utilizarea imunoglobulinelor IV, deşi con troversată, administrată în doze mari pare că duce la vindecarea bolii.
Journal of Health, Population, and Nutrition, 2014
Malnutrition is a prevalent condition in hospitalized children. Our aims were to evaluate the nut... more Malnutrition is a prevalent condition in hospitalized children. Our aims were to evaluate the nutritional state and to validate the STRONGkids risk assessment tool in a hospitalized paediatric population in Romania. This is a prospective single-centre study in a tertiary teaching hospital in Romania (May 2011-January 2012). We calculated the STRONGkids score and measured the children's height and weight. Standard deviation <-2 for weight-for-height and height-for-age was considered to indicate acute or chronic malnutrition respectively. Two hundred seventy-one children were included, with median age of 5.2 years and median hospital stay of 2.01 days. Prevalence of malnutrition and severe malnutrition was 37% and 15% respectively. Using the STRONGkids screening tool, 58% of the children were found at risk of malnutrition (24% were at high risk). The kappa coefficient of agreement between STRONGkids and WHO malnutrition classification was 0.61. When a low serum protein level wa...
The aim of the study was to analyze the relationship between leptin serum levels, body mass index... more The aim of the study was to analyze the relationship between leptin serum levels, body mass index and certain parameters of lipid and carbohydrate metabolism in children and adolescents with various degree of obesity. We assessed 86 children and adolescents (45 boys and 41 girls) between 6 and 18 years of age within the Ist Pediatric Clinic from Târgu Mure �; 68.60% of the children were overweight, 29.07% had class I obesity and 2.33% had class II obesity. Leptin serum levels were measured and compared with BMI, age and parameters of carbohydrate and lipid metabolism (blood glucose, cholesterol, triglycerides, HDL cholesterol, and LDL choles- terol). Leptin serum levels were increased in all overweight and obese adolescents: we found leptin serum levels of 45.69 ± 28.04 ng/mL in boys, and significantly higher values (72.96 ± 22.02 ng/mL) in girls. These values were positively correlated with BMI (r = 0,34 in boys and r = 0,44 in girls). A positive correlation was found between lepti...
The aim of the study was to analyze the relationship between leptin serum levels, body mass index... more The aim of the study was to analyze the relationship between leptin serum levels, body mass index and certain parameters of lipid and carbohydrate metabolism in children and adolescents with various degree of obesity. We assessed 86 children and adolescents (45 boys and 41 girls) between 6 and 18 years of age within the Ist Pediatric Clinic from Târgu Mure ; 68.60% of the children were overweight, 29.07% had class I obesity and 2.33% had class II obesity. Leptin serum levels were measured and compared with BMI, age and parameters of carbohydrate and lipid metabolism (blood glucose, cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol). Leptin serum levels were increased in all overweight and obese adolescents: we found leptin serum levels of 45.69 ± 28.04 ng/mL in boys, and significantly higher values (72.96 ± 22.02 ng/mL) in girls. These values were positively correlated with BMI (r = 0,34 in boys and r = 0,44 in girls). A positive correlation was found between leptin, ...
Experimental and Therapeutic Medicine, 2021
Nephrogenic diabetes insipidus (NDI) is characterized by impaired urinary concentrating ability, ... more Nephrogenic diabetes insipidus (NDI) is characterized by impaired urinary concentrating ability, despite normal or elevated plasma concentrations of the antidiuretic hormone, arginine vasopressin (AVP). NDI can be inherited or acquired. NDI can result from genetic abnormalities, such as mutations in the vasopressin V2 receptor (AVPR2) or the aquaporin-2 (AQP2) water channel, or acquired causes, such as chronic lithium therapy. Congenital NDI is a rare condition. Mutations in AVPR2 are responsible for approximately 90% of patients with congenital NDI, and they have an X-linked pattern of inheritance. In approximately 10% of patients, congenital NDI has an autosomal recessive or dominant pattern of inheritance with mutations in the AQP2 gene. In 2% of cases, the genetic cause is unknown. The main symptoms at presentation include growth retardation, vomiting or feeding concerns, polyuria plus polydipsia, and dehydration. Without treatment, most patients fail to grow normally, and present with associated constipation, urological complication, megacystis, trabeculated bladder, hydroureter, hydronephrosis, and mental retardation. Treatment of NDI consist of sufficient water intake, low-sodium diet, diuretic thiazide, sometimes in combination with a cyclooxygenase (COX) inhibitor (indomethacin) or nonsteroidal anti-inflammatory drugs (NSAIDs), or hydrochlorothiazide in combination with amiloride. Some authors note a generally favorable long-term outcome and an apparent loss of efficacy of medical treatment during school age.
Oral Communications, 2017
Background and aims Roma population is a marginalised ethnic group with a low socioeconomic statu... more Background and aims Roma population is a marginalised ethnic group with a low socioeconomic status which contributes to their poor health condition compared with most of the population. The aim of this study was to explore how low socioeconomic status, education, poor hygienic conditions, crowded housing conditions and low vaccination rate influence Roma children’s morbidity. Methods A prospective questionnaire study, including 61 questions, was performed among Roma children at the Paediatric Clinic no. I Tirgu-Mures, Paediatric Department of Municipal Hospital from Sageorgiu de Padure and in Sangeorgiu de Mures. We included in our investigation a total of 150 gipsy-children compared to 150 non-gipsy children, representing the control group. Results A total of 24,4% of the mothers were illiterate, 32,7% were smokers, 13,3% consumed alcohol, 41,3% developed a disease during pregnancy. 30% of the children lack vaccination. In 79,3% of the cases houses were heated with wood, in 63,3% there was no tap water, in 70% there was no bathroom and 42,7% of the investigated parents were smoking inside the house. The most frequent diseases were the lower respiratory diseases (29,3%), and neurological and psychiatric disorders (11,3%) as chronic diseases. The occurrence of respiratory and urinary infections was significantly higher in houses without tap water (p=0.008, p=0.029), in those which were heated with wood (p=0.043, p=0.01) and due to lack of proper hygienic conditions gastrointestinal complaints (p=0.047) occured as well. Conclusions Beside the risk factors identified during pregnancy, poor hygienic and social conditions represent the cause of frequent illneses among Roma children.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013
To evaluate the correlations between the pro-inflammatory interleukins IL-6 and IL-8 and the anth... more To evaluate the correlations between the pro-inflammatory interleukins IL-6 and IL-8 and the anthropometric measurements in malnourished vs. non-malnourished children. We have examined 219 children from Pediatric Clinic I, University of Medicine and Pharmacy of Tirgu Mures, Romania, during January 1, 2012-March 1, 2013 and divided according to Body Mass Index (BMI kg/m(2)) in the following two groups: 164 with normal nutritional status - control group (BMI between -2SD and +2SD), and 55 children with malnutrition (BMI <-2SD). All the children were evaluated anthropometric: BMI, weight for age (W/A), height for age (H/A), mid-upper-arm circumference (MUAC), tricipital skinfold (TSF) and paraclinical: IL-6 and IL-8 levels. From 219 children, 25.1% were malnourished. The mean age was 5.16 years in malnourished. IL-6 and IL-8 mean levels were 2.54 pg/mL, respectively 6.83 pg/mL in malnourished and 6.02 pg/mL, respectively 9.06 pg/mL in non-malnourished. By statistically comparing IL-...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013
Helicobacter pylori infection is an important cause of gastritis in childhood, its role in the pa... more Helicobacter pylori infection is an important cause of gastritis in childhood, its role in the pathogenesis of peptic ulcer disease in adults and children being generally known. In some cases, there are therapeutic management issues, because they do not heal or they often relapse, although treatment regimens are applied as recommended. Our aim was to analyze the relationship between endoscopic appearance and histological changes of the gastric mucosa in children with gastritis associated with H. pylori infection, in which persistent infection after treatment was found. It was a prospective study on 1332 children assessed in our Service (Ist Pediatric Clinic, Tirgu Mures, Romania), between January 2008 and January 2013, for gastritis with various etiologies. There were 609 cases of gastritis-associated with H. pylori infection. The average age of patients was 13.21 years; the higher incidence was noted in 13-18-year-old group, female gender and rural areas provenience; a number of 54...
Archives of Disease in Childhood, 2012
Background Congenital chloride diarrhea (CCD), a rare autosomal recessive disorder, is characteri... more Background Congenital chloride diarrhea (CCD), a rare autosomal recessive disorder, is characterized by sustained watery diarrhea (due to defect of active Chloride/HCO3 exchange in the ileum and colon) with high fecal chloride. The estimated incidence of CCD was 1 in 14000 in Kuwait reported in 1989. Aim of our study was to spotlight the common presentation of infants with CCD which appears not to be uncommon disorder in Kuwait for early management and prevention of complications. Subjects and methods Reviewing the inpatient database of Pediatric department of Al-Adan Hospital, Kuwait for patients who were admitted as chronic diarrhea in the first year of life, 12 patients diagnosed as CCD (7 females and 5 males). The diagnosis of CCD was based on antenatal and early infantile presentation and confirmed by laboratory finding of excess chloride loss in stool and low serum chloride level. Results All 12 patients were born to consanguineous parents, had antenatal history of IUGR, polyhydramnios and distended hypoechoic fetal bowel and presented with abdominal distension, hypotonia and muscle wasting. Whereas, 10 patients (90%) were delivered prematurely, 8 patients (66.6%) had maternal hypertension, 9 patients (75%) had absence of normal meconium at birth. Our patients showed significant decrease in serum sodium, potassium, chloride & urine chloride compared with the average for age. Conclusions High index of suspicious and awareness should be considered for early diagnosis of CCD in this population especially in the presence of consanguineous marriage.
Acta Medica Marisiensis, 2013
Objective: To evaluate the anthropometric and biochemical status of children with nutritional def... more Objective: To evaluate the anthropometric and biochemical status of children with nutritional deficiency. Methods: We have conducted a prospective study on 226 children admitted in Pediatric Clinic I, divided into two groups: one group of 49 children with nutritional deficiency (body-mass-index < -2SD) and one control group (177 children). We have followed demographic data, anthropometric indices evaluated as standard deviations (weight, height, middle upper-arm circumference, tricipital skinfold), biochemical proteic status (Insulin-like Growth Factor 1 IGF-1, albumin, total proteins). We also followed parameters of general nutritional biochemistry. Results: The mean age for underweight children was 5.8 years, lower than in the control group. The weight of the nutritional-deficient group was significantly lower than in the control group, unlike the height (p <0.001). We have also found significant differences in body-mass-index, middle upper-arm circumference and tricipital s...
Romanian Review of Laboratory Medicine, 2014
Purpose: to evaluate the serum levels of micronutrients in children with nutritional disorders, a... more Purpose: to evaluate the serum levels of micronutrients in children with nutritional disorders, and to find if there is a direct correlation between them and the anthropometric measurements. Materials and methods: the study was conducted on 125 children (0-18 years); the working group consisted in children with Z-score < -2 standard deviations for at least one anthropometric measurement, while the children without growth disorders were considered as controls. Thus, for each anthropometric measurement, we had different working/control groups that were used for the assessment of correlation with laboratory findings. We followed eight anthropometric parameters and their relation with five of the micronutrients (Ca, Mg, Fe, Zn and Cu). Results: no statistical differences were found in micronutrients serum levels between genders or provenance. Most mean serum levels of micronutrients were lower in the children with Z-scores < -2 standard deviations (except Cu). Mg and Ca were posit...
European Journal of Pediatrics, 2014
The aim of this study was to establish the correlations between the polymorphisms of the genes in... more The aim of this study was to establish the correlations between the polymorphisms of the genes interleukin (IL)-6 572, 190, and 174 in obese children. We assessed 222 hospitalized children divided into two groups: group I (control) included 110 patients with normal nutritional status, and group II consisted of 102 obesity patients. The two groups underwent IL-6 572 C/G, 190 C/T, and 174 G/C polymorphism testing, measurement of anthropometric parameters (mid-upper arm circumference and tricipital skinfold thickness), and paraclinical evaluation (protein, albumin, leptin, adiponectin, and vascular endothelial growth factor (VEGF)). We observed that phenotype CC was more frequent in obese children for IL-6 572 (p=0.0001), whereas CG heterozygotes were more frequent in the obese group for the IL-6 190 gene (62.7 %; p=0.0001). Leptin was dependent on IL-6 572 and IL-6 174 gene polymorphisms and albumin, whereas adiponectin was dependent on the IL-6 174 gene polymorphism. Body mass index (BMI), mid-upper arm circumference (MUAC), and tricipital skinfold thickness (TST) serum albumin levels correlated with C allele carriers of the IL-6 572 and IL-6 190 genes in children with obesity, whereas the CC genotype of IL-6 174 was a protective factor for obesity. Conclusion: Obesity is most frequently associated in children with IL-6 174 C allele carriers and with IL-6 190 C allele carriers.
European Journal of Pediatrics, 2013
The aim of this study was to analyze insulin-like growth factor I (IGF-I) serum level in pediatri... more The aim of this study was to analyze insulin-like growth factor I (IGF-I) serum level in pediatric patients with cancer compared with pediatric patients with nononcological diseases and to assess the relationship between IGF-I and nutritional status of oncological patients. From January 2009 to July 2012, we assessed 151 consecutively hospitalized patients in a tertiary emergency pediatric hospital. The patients were divided into two groups: group I, consisting of patients with malignant diseases (64 patients), and group II, the control group, consisting of 87 age- and gender-matched patients with different pediatric diseases. The anthropometric parameters (weight, height, body mass index, middle upper arm circumference (MUAC), and tricipital skinfold thickness (TST) and biochemical parameters (proteins, albumin, and total IGF-I) were comparatively evaluated at the diagnosis and after intensive chemotherapy in the malignant group. Anthropometric and biochemical parameters in group I were significantly different from those in group II for height, MUAC, TST, total proteins, and albumin (p &amp;lt; 0.05). Twenty-five out of 64 patients with malignant diseases and 5 out of 87 patients in the control group had malnutrition. IGF-I in patients with cancer was much lower than in the control group (median 48.3 ng/ml, range 25.00-662.00 ng/ml vs 129.00 ng/ml, range 25.00-745.00 ng/ml) (p = 0.014). We found a positive correlation between IGF-I, MUAC, and TST at the diagnosis of the malignant disease. Also, we identified positive correlations between IGF-I, protein, and albumin. Serum IGF-I levels in cancer patients were significantly lower at diagnosis than after chemotherapy (48.3 ng/ml, range 25.00-662.00 ng/ml vs 110.0 ng/ml, range 25.00-573.00 ng/ml; p = 0.04). IGF-I seems to be an accurate biochemical parameter used in malnutrition assessment of children with cancer. IGF-I correlated with the anthropometric parameters of the arm, serum protein, and albumin. These parameters most accurately characterize the nutritional status.