11 results on '"Bucuri, Carmen Elena"'
Search Results
2. Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Systematic Review of the Literature in the Last 20 Years.
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Bucuri, Carmen Elena, Ciortea, Razvan, Malutan, Andrei Mihai, Oprea, Valentin, Toma, Mihai, Roman, Maria Patricia, Ormindean, Cristina Mihaela, Nati, Ionel, Suciu, Viorela, and Mihu, Dan
- Abstract
Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) is a rare uterine tumor primarily affecting perimenopausal and postmenopausal women, typically aged between 45 and 55 years. Characterized by ambiguous histological features, STUMPs present diagnostic challenges as they cannot be definitively classified as benign or malignant based on morphology alone. This systematic review aims to elucidate the clinical, pathological, immunohistochemical, and treatment-related characteristics of STUMPs through an analysis of the literature from the past 20 years. The study follows PRISMA guidelines, utilizing comprehensive searches of PubMed and Scopus databases, yielding 32 studies that meet the inclusion criteria. From the analysis of these studies, it was revealed that the clinical presentations vary from common symptoms such as abnormal uterine bleeding and pelvic pain to incidental detection of uterine mass. Histologically, STUMPs demonstrate features overlapping with both leiomyomas and leiomyosarcomas, including mild nuclear atypia, low mitotic indices, and focal necrosis. Immunohistochemical markers such as p16 and p53 have been investigated for prognostic significance. Elevated p16 expression, often associated with aggressive behavior, was observed in a subset of STUMPs. Surgical management, typically involving hysterectomy or tumorectomy, is the primary treatment, though the extent of resection is variable. Adjuvant therapies are not routinely recommended, but long-term surveillance is advised, especially for high-risk patients. Recurrence rates for STUMPs are approximately 12%, with factors such as high mitotic counts and coagulative necrosis indicating higher risk. This review highlights the complexity of STUMP diagnosis and management, emphasizing the need for more precise diagnostic criteria and individualized treatment strategies. Understanding the morphological, immunohistochemical, and clinical behavior of STUMPs can improve patient outcomes and guide future research in this diagnostically challenging area. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Disseminated Peritoneal Leiomyomatosis—A Challenging Diagnosis-Mimicking Malignancy Scoping Review of the Last 14 Years.
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Bucuri, Carmen Elena, Ciortea, Razvan, Malutan, Andrei Mihai, Oprea, Valentin, Toma, Mihai, Roman, Maria Patricia, Ormindean, Cristina Mihaela, Nati, Ionel, Suciu, Viorela, Simon-Dudea, Marina, and Mihu, Dan
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MAGNETIC resonance imaging ,CHILDBEARING age ,COMPUTED tomography ,ASYMPTOMATIC patients ,PERITONEUM - Abstract
Disseminated peritoneal leiomyomatosis (DPL) is a rare condition marked by multiple leiomyomas in the peritoneal cavity, predominantly affecting women of reproductive age. Although typically benign, DPL can present significant diagnostic challenges and, in rare cases, may progress to malignancy. A primary contributing factor to DPL is iatrogenic, particularly due to surgical interventions such as morcellation during myomectomy. This scoping review explores the pathogenesis, epidemiology, diagnosis, and management of DPL, highlighting the crucial role of hormonal influences and iatrogenic factors. Diagnostic methods include computed tomography, ultrasound, magnetic resonance imaging, and histopathological evaluation, which are essential for assessing disease extent and guiding treatment. Management strategies encompass surgical intervention—with a focus on minimizing iatrogenic risks—conservative approaches for asymptomatic patients, and advancements in hormonal treatments. Emphasis is placed on preventing iatrogenic dissemination through refined surgical techniques and patient education. Despite its rarity, with fewer than 200 cases reported globally, understanding DPL's clinical presentation and iatrogenic origins is vital for optimal patient outcomes. This review underscores the importance of early diagnosis, personalized treatment plans, and ongoing research to address the challenges associated with DPL. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Obesity, a Single Pathology Influencing Both Mother and Child—A Retrospective Analysis in Hospital Settings.
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Ormindean, Cristina Mihaela, Ciortea, Razvan, Bucuri, Carmen Elena, Măluțan, Andrei Mihai, Iuhas, Cristian Ioan, Porumb, Ciprian Gheorghe, Ormindean, Vlad, Roman, Maria Patricia, Nati, Ionel Daniel, Suciu, Viorela, and Mihu, Dan
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DELIVERY (Obstetrics) ,WEIGHT gain ,OBESITY in women ,DIETARY patterns ,CHILDBEARING age ,FETAL distress - Abstract
Obesity, characterized by an excess of adipose tissue, has become a significant global health issue. The prevalence of obesity has increased markedly in recent decades worldwide, with a sharp rise also observed in developing countries, particularly in urban areas. Addressing obesity during pregnancy is crucial for several reasons and presents challenges for specialists in obstetrics and gynecology. Objectives: The aim of the present study was to investigate the correlation between obesity and its implications for childbirth. Materials and Methods: We conducted a retrospective study involving 1513 patients, grouped into normal-weight, overweight, and obese categories using corrected BMI values. We performed comparative analyses to explore the association between BMI and various outcomes: the method of delivery, the Apgar score at birth, the incidence of fetal distress, fetal birth weight, the presence of pregnancy-associated pathologies, and the occurrence of postpartum hemorrhage. Descriptive statistical analysis was utilized to characterize the demographic and clinical features of the patients and newborns. Results: By examining variables such as the occurrence of fetal distress during labor, the Apgar score at delivery, and the mode of delivery, we identified an association between increasing BMI and complications during labor and delivery. The results indicate that a higher BMI is linked with increased complications and variations in the mode of delivery. Conclusions: Obesity is the most common health issue among women of reproductive age and requires long-term care. It can contribute to numerous pregnancy-associated pathologies and affect both mother and child during labor and delivery. Obesity is associated with lower Apgar scores, the increased incidence of fetal distress, and a higher rate of cesarean section deliveries. Although the absolute risk of serious complications for mother, fetus, and newborn is low among women with obesity, adopting healthy eating and exercise behaviors prior to pregnancy, ideally, or as early in pregnancy as possible, can help minimize excessive weight gain during pregnancy. [ABSTRACT FROM AUTHOR]
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- 2024
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5. The Effectiveness of Cyanoacrylates versus Sutures for Mesh Fixation after Lichtenstein Repair (SCyMeLi STUDY) A Systematic Review and Meta-Analyze of Randomized Controlled Trials.
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Trisca, Rares, Oprea, Valentin, Toma, Mihai, Bucuri, Carmen Elena, Stancu, Bogdan, Grad, Ovidiu, and Gherman, Claudia
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- 2024
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6. Amniocentesis—When It Is Clear That It Is Not Clear.
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Ciortea, Razvan, Malutan, Andrei Mihai, Bucuri, Carmen Elena, Berceanu, Costin, Rada, Maria Patricia, Ormindean, Cristina Mihaela, and Mihu, Dan
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AMNIOCENTESIS ,PRENATAL diagnosis ,SECOND trimester of pregnancy ,DOPPLER ultrasonography ,AMNIOTIC liquid ,INVASIVE diagnosis - Abstract
A fetus identified to be at risk for chromosomal abnormalities may benefit from identification of genetic defects through amniocentesis. Although the risks associated with amniocentesis are considered to be minimal, being an invasive procedure it is not completely without complications. Background and Objectives: The current study aims to identify correlations between blood contamination of samples collected during amniocentesis and certain factors dependent on the instruments used (thickness of the needle used to aspirate the fluid), the location of the placenta, and uterine vascularity (more pronounced in multiparous patients). Materials and Methods: The study included 190 patients in the second trimester of pregnancy who met one of the criteria for invasive prenatal diagnosis (age over 35 years, high risk in first trimester screening, history of pregnancies with genetic abnormalities, etc.). The amniotic fluid samples collected from these patients were analyzed in terms of blood contamination of the amniotic fluid aspirated with maternal cells Results: Of the patients in whom the procedure was performed using 21 G size needles, 16 samples (13.33% of the total) were contaminated. None of the samples collected from patients where a 20 G needle was used were contaminated. There was a statistically significant association between the lack of contamination and the use of Doppler ultrasound in multiparous patients with anterior placenta in whom a 21-gauge needle was used for amniocentesis. Conclusions: There is an increased rate of sample contamination (statistically significant) when using 21 G needle sizes and a significant difference in contamination between primiparous and multiparous patients, with contamination being more frequent in multiparous patients. The use of Doppler ultrasonography may benefit the procedure, as the contamination rate was significantly reduced when used during amniocentesis. [ABSTRACT FROM AUTHOR]
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- 2023
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7. Maternal and neonatal outcomes associated with delivery techniques for impacted fetal head at cesarean section: a systematic review and meta-analysis.
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Rada, Maria Patricia, Ciortea, Răzvan, Măluțan, Andrei Mihai, Prundeanu, Ioana, Doumouchtsis, Stergios K., Bucuri, Carmen Elena, Blaga, Ligia Daniela, and Mihu, Dan
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MEDICAL databases ,EVALUATION of medical care ,META-analysis ,MEDICAL information storage & retrieval systems ,CONFIDENCE intervals ,SYSTEMATIC reviews ,HEALTH outcome assessment ,PREGNANCY outcomes ,PREGNANCY complications ,QUALITY assurance ,DESCRIPTIVE statistics ,CESAREAN section ,LABOR complications (Obstetrics) ,DELIVERY (Obstetrics) ,MEDLINE - Abstract
The article discusses the study aimed at comparing maternal and neonatal outcomes associated with delivery techniques via cesarean section. The results suggest that in the absence of robust evidence to support the use of a specific technique, the choice of the obstetrician should be based on the best available evidence. The study indicates that the "pull" and "Patwardhan" techniques represent safe options for delivering an impacted fetal head.
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- 2022
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8. Fetal ovarian cyst – a scoping review of the data from the last 10 years and a case presentation.
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Bucuri, Carmen Elena, Ciortea, Răzvan, Măluțan, Andrei Mihai, Diculescu, Doru, Nati, Ionel, Rada, Maria, Ormindean, Cristina, Dudea-Simon, Marina, and Mihu, Dan
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OVARIAN cysts , *FERTILITY preservation , *PEDIATRIC surgery , *APGAR score , *CYSTECTOMY - Abstract
Abdominal cystic masses are diagnosed during the intrauterine period and have a relatively low incidence. Fetal ovarian cysts are the most common form diagnosed prenatally or immediately after birth. The pathophysiology of the development of these types of tumors is not fully elucidated, with ovarian hyperstimulation caused by maternal and placental hormones being the most accepted hypotheses. We conducted a scoping review with the aim to map the current knowledge regarding the treatment of fetal ovarian cysts diagnosed in the intrauterine period. Focusing on the articles published in the last 10 years in the specialized literature, we tried to identify a conceptualization regarding the surveillance and treatment of these anomalies. We describe the case of a 38-year-old patient, in her second pregnancy, with a physiological course of pregnancy until 29 weeks of gestation, when a cystic mass of 52/48 mm was detected in the abdomen during the routine ultrasound examination. The most likely origin was established to be the right ovary. Applying the diagnostic criteria described by Nussbaum, the detected cystic mass was of a simple type, with a thin wall, transonic content, without the presence of septa, vegetations or the appearance of intracystic hemorrhage. We observed a linear growth trend from the time of diagnosis when the diameter measured 52 mm, until 38 weeks of gestation when it reached 76 mm. A female fetus was born, weighing 3570 g, with an Apgar score of 10, with a good postnatal adaptation. On the eighth day of life, the newborn was transferred to the pediatric surgery unit where ovarian cystectomy was performed. Intraoperatively, a cystic mass was found belonging to the right ovary, with a size of 80/70/70 mm. Ovarian cystectomy was performed, with the successful preservation of ovarian tissue. The postoperative recovery had a favorable outcome. [ABSTRACT FROM AUTHOR]
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- 2023
9. The distance between the embryo and the yolk sac in correlation with the serum level of placental growth factor: how reliable is it?
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Bucuri, Carmen Elena, Ciortea, Răzvan, Oprea, Valentin, Diculescu, Doru, Măluțan, Andrei Mihai, Nicula, Renata, Clim, Adelina, Suciu, Viorela Elena, Patricia Rada, Maria, and Mihu, Dan
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PLACENTAL growth factor , *YOLK sac , *FIRST trimester of pregnancy , *EMBRYOS , *AMENORRHEA , *BLOOD serum analysis - Abstract
Introduction. The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (60%). The purpose of this study is to evaluate the correlation between a serum biomarker, placental growth factor (PlGF), and an ultrasonographic parameter, the distance between yolk sac (YS) and embryo (DYSE), in assessing the prognosis of pregnancy evolutivity in the first trimester. Method. The study is a case-control prospective analysis that includes two groups of patients: 81 patients with first-trimester pregnancy in evolution, and 89 patients with embryonic demise, all of the patients having amenorrhea between 6 and 11 weeks. The endovaginal ultrasonographic exploration was performed to evaluate the distance between the lower pole of the embryo and the yolk sac. From each subject enrolled in the study, 20 ml of blood was collected for PlGF dosing. Results. Regarding the DYSE in the case group, lower values were observed compared to the control group, the difference being statistically significant. In the statistical analysis of serum PlGF values, statistically significant differences were observed between the two groups (p<0.0001). Conclusions. DYSE has a high positive predictive value in identifying pregnancies with potentially reserved evolutivity, this study demonstrating that a DYSE<3 mm may lead to an unfavorable evolution of pregnancy. The low serum level of PlGF is associated with an increased rate of nonviable embryos. [ABSTRACT FROM AUTHOR]
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- 2022
10. Magnesium sulphate and fetal neuroprotection – when, how, why and why not?
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Suciu, Viorela-Elena, Ciortea, Răzvan, Bucuri, Carmen Elena, Măluțan, Andrei, Mocan-Hognogi, Radu, Rada, Maria, Dudea, Marina, Clim, Adelina, and Mihu, Dan
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MAGNESIUM sulfate ,VERY low birth weight ,PREMATURE rupture of fetal membranes ,VASCULAR resistance ,PREMATURE labor - Abstract
Preterm delivery is strongly associated with neurological impairments, such as cerebral palsy (CP), motor dysfunction, blindness, developmental delay and intellectual impairment. Antenatal administration of magnesium sulfate (MgSO
4 ) has become a valuable approach of the neuroprotective strategy for preterm births. MgSO4 can prevent excitotoxicity via N-methyl-D-aspartic acid (NMDA) receptor antagonistic action and has an anti-inflammatory effect. There is still no international consensus on the dosage, time of administration and the need to repeat MgSO4 treatment. However, most studies report benefits for ≤31+6 weeks of gestation (GW) and imminent preterm birth, defined as active labor with ≥4 cm cervical dilation with either failure or contraindication to tocolysis, ≥4 cm dilatation with documented progressive change in cervical dilation, preterm pre-labor rupture of membranes with active labor, and for planned delivery for fetal or maternal indications. MgSO4 is recommended in a loading dose of 4 g intravenously (i.v.) for 30 minutes, followed by a 1 g/hour i.v. maintenance infusion for maximum 24 hours. It has been shown a significantly reduced rate of moderate and severe CP for the premature receiving MgSO4 , but also a lower rate of motor dysfunction and a lower systemic vascular resistance and higher myocardial function in preterm infants born before 29 WG. One the other hand, several side effects have been reported and should be closely monitored. Maternal side effects include hypotension, tachycardia, respiratory depression, drowsiness, headache and muscle weakness. One trial reported a higher incidence of spontaneous intestinal perforation among extremely low birth weight infants. In conclusion, antenatal MgSO4 administration is a first step in preventing neurological damage, but further studies are mandatory to standardize its use. [ABSTRACT FROM AUTHOR]- Published
- 2022
11. Comparison of laparoscopic sacrocolpopexy with vaginal reconstructive procedures and abdominal sacrocolpopexy for the surgical management of vaginal vault prolapse: a systematic review and meta-analysis.
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Ciortea R, Roman MP, Măluțan AM, Bucuri CE, Ormindean CM, Nati ID, and Mihu D
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Introduction: Vaginal vault prolapse, also known as apical prolapse, is a distressing condition that may affect women following hysterectomy, necessitating surgical intervention when conservative measures prove ineffective. The surgical management of apical compartment prolapse includes procedures such as laparoscopic sacrocolpopexy (LSCP), abdominal sacrocolpopexy (ASCP) or vaginal reconstructive procedures (VRP). This systematic review and meta-analysis aims to compare the outcomes of these interventions., Methods: A comprehensive search of electronic databases was conducted to identify eligible studies. Fourteen studies comprising a total of 1,289 women were included. The selected studies were analyzed to evaluate outcomes such as duration of surgery, length of hospital stay, blood loss, complication rates, and patient satisfaction., Results: LSCP did not demonstrate significant advantages over VRP in terms of perioperative or long-term outcomes. However, when compared to ASCP, LSCP showed shorter hospital stay, reduced blood loss, decreased postoperative pain, and lower rates of ileus., Discussion: This systematic review contributes to evidence-based decision-making for the surgical treatment of vaginal vault prolapse. While LSCP did not exhibit substantial benefits over VRP, it emerged as a preferable option compared to ASCP due to shorter hospital stays and reduced postoperative complications. The findings from this study provide valuable insights for clinicians and patients in selecting the most appropriate surgical approach for vaginal vault prolapse. However, future research should focus on long-term follow-ups, standardizing outcomes, and outcome measures, and evaluating cost-effectiveness to further enhance clinical practice., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ciortea, Roman, Măluțan, Bucuri, Ormindean, Nati and Mihu.)
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- 2023
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