42 results on '"Bucuri, Carmen Elena"'
Search Results
2. 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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3. 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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4. 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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5. BLOOD CONTAMINATION OF AMNIOTIC FLUID DURING AMNIOCENTESIS - INCIDENT, ACCIDENT OR COMPLICATION: O - 0044 | ORAL | FETAL MEDICINE
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Razvan, Ciortea, Diculescu, Doru, Malutan, Andrei, Ciortea, Razvan, Mocan-Hognogi, Radu, Oancea, Mihaela, Dudea, Marina, Bucuri, Carmen Elena, Rada, Maria Patricia, and Mihu, Dan
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- 2017
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. The profile of urinary biomarkers in overactive bladder.
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Rada, Maria Patricia, Ciortea, Răzvan, Măluţan, Andrei Mihai, Doumouchtsis, Stergios K., Bucuri, Carmen Elena, Clim, Adelina, Roman, Andrei, and Mihu, Dan
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OVERACTIVE bladder ,NERVE growth factor ,NEUROTROPHINS ,ENZYME-linked immunosorbent assay ,BRAIN-derived neurotrophic factor - Abstract
Aims: In overactive bladder (OAB) research, different biomarkers have been proposed as diagnostic tools and may be used to create individual patient profiles. Assessing the diagnostic performance of biomarkers would better outline their utility. Therefore, our aim was to investigate the diagnostic value of four urinary biomarkers: human brain derived neurotrophic factor (hBDNF), malondialdehyde (MDA), h nerve growth factor (hNGF) and h 8‐hydroxydeoxyguanosine in women with OAB. These are neurotrophins/oxidative stress markers that have been linked to lower urinary tract symptoms. Methods: A total of 105 women were included in the study and distributed in two groups: a group with OAB (n = 53) and a control group (n = 50). The levels of the biomarkers were determined using enzyme‐linked immunosorbent assay technique and they were compared between the groups. If the Mann‐Whitney test demonstrated a statistically significant difference, receiver operating curves (ROC) analysis was undertaken. Results: When normalized to urinary creatinine, hBDNF, MDA, and hNGF showed significantly increased values in women with OAB as compared to controls, whereas 8‐OHdG showed no significant difference. The diagnostic performance of these biomarkers was analyzed based on the area under the ROC curve (AUC). MDA had the highest AUC (0.75), followed by hNGF (0.69) and hBDNF (0.67). Conclusions: Our findings suggest that MDA, a relatively novel biomarker in OAB research, has a fair performance as a diagnostic tool for OAB. Moreover, urinary neurotrophins (NGF and BDNF) as biomarkers may have a role in the diagnostic pathways of women with OAB symptoms. [ABSTRACT FROM AUTHOR]
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- 2020
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9. The distance between the embryo and yolk sac associated with inhibin A in the first-trimester pregnancy - which is the novelty?
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Bucuri, Carmen Elena, Ciortea, Răzvan, Măluţan, Andrei Mihai, Iuhaş, Cristian Ioan, Rada, Maria Patricia, and Mihu, Dan
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EMBRYOLOGY , *CHROMOSOME inversions , *BIOMARKERS , *ULTRASONIC imaging , *PREGNANCY - Abstract
Objective. The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (40%). The purpose of this study is to evaluate the correlation between a serum biomarker, inhibine A, 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 inhibin A 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 inhibin A values, statistically significant differences were observed between the two groups (p<0.05). 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 inhibine A is associated with an increased rate of non-viable embryos. [ABSTRACT FROM AUTHOR]
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- 2019
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10. Yolk sac-embryo distance in correlation with soluble form of vascular endothelial growth factor levels in pregnancy with potentially reserved evolutivity.
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Bucuri, Carmen Elena, Ciortea, Razvan, Diculescu, Doru, Malutan, Andrei, Mocan-Hognogi, Radu, Berceanu, Costin, Nicula, Renata, Rada, Maria, and Mihu, Dan
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VASCULAR endothelial growth factors , *PREGNANCY complications , *FETAL development , *GESTATIONAL age , *ULTRASONIC imaging , *FETAL ultrasonic imaging , *LONGITUDINAL method , *FIRST trimester of pregnancy , *CASE-control method ,RESEARCH evaluation - Abstract
Aims: Embryonic demise is a frequent complication of the first trimester pregnancy. The purpose of this study was to evaluate the correlation between a serum biomarker, the soluble form of the vasculo-endothelial growth factor (sFlt-1) and the distance between the yolk sac (YS) and embryo (DYSE), determined by ultrasonography.Material and Methods: The study was a prospective case-control study that included 2 groups of patients - the control group with 81 first-trimester pregnancies in evolution and the case group with 89 first-trimester pregnancies with a potentially reserved evolutivity.Results: A correlation between the serum level of sFlt-1 and DYSE in embryos with crown-rump length (CRL) greater than 5 mm was identified, showing that a DYSE ≤3 mm correlates with a low level of sFlt-1 (p<0.05) and a DYSE> 4 mm correlates with an increased level of sFlt-1 (p<0.05).Conclusions: A low level of sFlt-1 associated with a distance between the embryo and yolk sac of small dimensions, respectively <3 mm, correlates with an increased rate of non-viable embryos. This correlation between an ultrasound and a serum parameter is of great value and brings important information about the viability of firsttrimester pregnancies. [ABSTRACT FROM AUTHOR]- Published
- 2018
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11. Mesenchymal stem cells derived from adipose tissue and Ishikawa cells co-culture highlight the role of adiponectin in endometrial cancer pathogenesis.
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CIORTEA, RĂZVAN, ŞUŞMAN, SERGIU, MĂLUŢAN, ANDREI MIHAI, BERCEANU, COSTIN, MOCAN-HOGNOGI, RADU FLORIN, BUCURI, CARMEN ELENA, SORIŢĂU, OLGA, NEAGOE, IOANA, and MIHU, DAN
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- 2018
12. 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
13. ORAL HEALTH DURING PREGNANCY - questionnaire-based assessment of dentists and obstetricians opinion.
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Varvară, A. M., Dudea, Marina, Bucuri, Carmen Elena, Bondor, Cosmina Ioana, Dudea, Diana, and Mihu, D.
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ORAL hygiene ,PREGNANCY ,PERIODONTAL disease ,DENTISTS ,OBSTETRICIANS - Abstract
Copyright of Obstetrică şi Ginecologie is the property of Societatea de Obstetrica si Ginecologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
14. Cyclopia and proboscis -- the extreme end of holoprosencephaly.
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MĂLUȚAN, ANDREI MIHAI, DUDEA, MARINA, CIORTEA, RĂZVAN, MUREŞAN, MIHAELA, BUCURI, CARMEN ELENA, MIHU, CARINA, and MIHU, DAN
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- 2017
15. Intraperitoneal Fat through GRP78: A Risk Factor for Endometrial Cancer.
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Ciortea, Răzvan, Berceanu, Costin, Măluţan, Andrei Mihai, Mocan, Radu, Iuhas, Cristian, Bucuri, Carmen Elena, Rada, Maria Patricia, and Mihu, Dan
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ENDOMETRIAL cancer risk factors ,INTRAPERITONEAL injections ,GLUCOSE-regulated proteins ,CANCER relapse ,GENETIC overexpression - Abstract
Introduction. The identification of biological markers that indicate an increased risk for the development or recurrence of endometrial cancer (EC) in obese women might be useful for decreasing EC mortality and morbidity. Glucose-regulated protein 78 (GRP78) is a major protein of the endoplasmic reticulum expressed in all normal cells. Overexpression of GRP78 has been reported to be a tumoral biomarker. Increased detection of GRP78 is positively correlated with the tumoral stage and prognosis. This study aimed to identify a correlation between intraperitoneal fat, plasma GRP78 levels, and EC. Materials and Methods. Two groups of patients were included in the study: group I, 44 patients diagnosed with EC, and group II, 44 patients without gynecological pathology or inflammatory disorders. Visceral fat was determined by ultrasound and plasma GRP78 levels were measured. Results. Plasma GRP78 levels were significantly higher in patients with EC compared to the control group. Intraperitoneal fat was in a positive linear correlation with the plasma GRP78 level (p<0.0001). Conclusion. The measurement of the GRP78 level associated with the determination of intraperitoneal fat can be a useful predictor for EC. [ABSTRACT FROM AUTHOR]
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- 2016
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16. Predictive factors of early pregnancy failure. A literature review.
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Bucuri, Carmen Elena, Malutan, Andrei Mihai, Ciortea, Razvan, Nicula, Renata Lacramioara, Mihu, Carina, Istrate2, Mihnea, and Mihu, Dan
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MISCARRIAGE , *FETAL death , *PREDICTIVE tests , *YOLK sac , *PREGNANCY complications - Abstract
Embryonic demise is the most common event in the lives of women during theirs reproductive time with a rate of about 25%. The aim of this review is to outline the most important paraclinic and biological prognostic parameters. English language articles containing keywords like "embryonic demise", "predictive factors" which were searched using Medline and Pubmed. Systematic reviews, retrospective and prospective studies, clinical trials focused on this subject were selected. Informative value of the references of selected articles was used as base for further relevant headlines. Among the most significant reported predictive factors are the distance between the yolk sac (YS) and embryo, also known as the yalk stalk sign, the progesterone and β human chorionic gonadotropine levels. Low levels of biomarkers and abnormal appearance of gestational sac, crown-rump length and YS are considered worst prognostic factors and may lead to a poor outcome. [ABSTRACT FROM AUTHOR]
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- 2016
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17. The Doppler profile of ovarian endometrioma.
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Ciortea, Razvan, Diculescu, Doru, Malutan, Andrei Mihai, Berceanu, Costin, Nicula, Renata Lacramioara, Bucuri, Carmen Elena, Oltean, Ioana Adriana, Dudea, Marina, and Mihu, Dan
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DOPPLER ultrasonography ,ENDOMETRIOSIS ,PELVIC diseases ,FEMALE reproductive organ diseases ,OVARIAN cysts - Abstract
Aims. To characterize the vascularity of endometriotic cysts using color Doppler ultrasound and to differentiate more accurately between endometriotic cysts and other pelvic cyst masses. Methods. Two prospective studies were initiated: the first included 50 patients diagnosed with ovarian endometriotic cysts and 50 patients without gynecological pathology, in whom the resistance index (RI) of the uterine artery, ovarian artery and endometrial arcuate arteries in the early secretory phase was determined by endovaginal Doppler ultrasound; the second study included 50 patients diagnosed with ovarian endometriotic cysts, in whom the RI of the uterine artery, ovarian artery and cyst wall arteries in the late proliferative phase and in the late secretory phase was determined. Results. In the early secretory phase, the vascular flow through the uterine artery was significantly higher in patients with ovarian endometrioma. These patients had increased endometrial vascularity in the early secretory phase compared to the control group. In the late secretory phase, the vascular flow through the ovarian artery was higher compared to the late proliferative phase in patients with ovarian endometrioma. The vascularization of the ovarian endometrioma wall was significantly increased in the late secretory phase compared to the late proliferative phase. Conclusions. Vascularization, described through the arrangement of vessels, vascular density and vascular resistance, is an important factor in the evaluation of ovarian endometrioma. [ABSTRACT FROM AUTHOR]
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- 2016
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18. Particularities of the anterior compartment of the pelvic floor in women with urinary incontinence, revealed by transperineal ultrasound.
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Rada, Maria Patricia, Ciortea, Răzvan, Măluțan, Andrei Mihai, Oancea, Mihaela, Mocan-Hognogi, Radu, Bucuri, Carmen Elena, Berceanu, Costin, and Mihu, Dan
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URINARY incontinence diagnosis ,PELVIC floor physiology ,COLOR Doppler ultrasonography ,ULTRASONIC imaging ,QUALITY of life - Abstract
Urinary incontinence (UI) represents a condition that, although not vital, has a significant impact that can interfere with the quality of life in a meaningful way for many women, its overall prevalence being of approximately 40%. Since 1920, urogynecologists showed an increasing interest in imaging techniques of the pelvic floor, ultrasound being the method of examination most frequently used with benefits that result from easy accessibility and reduced costs. At the beginning, B-mode ultrasound via transvaginal or transperineal route, was used to describe the urinary bladder and the anterior compartment and only later, the other pelvic compartments. Pelvic floor dysfunctions include several conditions among which UI. The main indications for transperineal ultrasound are: recurrent urinary tract infections, urgency-, frequency-, stress-UI, dysuria, prolapse of pelvic organs, dyspareunia, fecal incontinence, pelvic masses. This method proves its utility in assessing parameters like: residual urine, detrusor wall thickness, mobility of the bladder neck, anterior and posterior urethrovesical angle, urethral integrity. Stress UI may be highlighted by Color Doppler. Studying the pelvic floor during contractions or Valsalva maneuvre allows the assessment of the functional anatomy, keypoint for understanding the UI pathophysiology. The assessment of these specific objective and reproducible parameters is complementary to the diagnosis of UI and puts several therapeutic options in a different light. The progress in imaging permanently contributes to the improvement of therapeutic management either refining existing techniques or supporting the development of new procedures in urogynecology. [ABSTRACT FROM AUTHOR]
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- 2018
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19. 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]
- Published
- 2022
20. 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
21. Herlyn-Werner-Wunderlich syndrome: a rare cause of acute abdomen after acute urinary retention and hematometrocolpos in adolescents (poster).
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Clim, Ioana Adelina, Ciortea, R., Diculescu, D., Măluţan, A., Bucuri, Carmen Elena, Oancea, Mihaela, Rada, Maria Patricia, Dudea-Simon, Marina, Suciu, Viorela, and Mihu, D.
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ACUTE abdomen ,RETENTION of urine ,DYSMENORRHEA ,TEENAGERS ,SYNDROMES ,FALLOPIAN tubes ,BLADDER - Abstract
Introduction. Herlyn-Werner-Wunderlich syndrome (HWW) is a rare congenital anomaly of the urogenital tract characterized by the triad: uterus didelphys, obstructed hemivagina and unilateral renal agenesis, which is two times more common on the right side than on the left side. The incidence of this syndrome is 0.1-3.8% and, so far, in less than 10 cases the association of this pathology with acute urinary retention has been reported. Materials and method. We present the case of a 13-year-old girl who came to our emergency room accusing pain of increased intensity in the lower abdominal floor, started insidiously a week before, accompanied by nausea, pallor, sweating, anxiety and moderate vaginal bleeding (menstrual status). The anamnesis revealed absent diuresis for about 6 hours, menarche at 12 years old, regular menstruation, oligomenorrhea and dysmenorrhea. The clinical examination revealed respiratory movements of the abdomen, distension caused by a pseudotumoral mass located subumbilically, reluctant, painful; normal external genitalia. The paraclinical examination (ultrasound and MRI) revealed: voluminous cystic mass of 155/100/100 mm located between the bladder and the rectum, suggestive of hematometrocolpos; lower it protruded into the vagina, the image being suggestive of the transverse vaginal septum; uterus didelphys; normal ovaries and fallopian tubes. Unseen left kidney – left renal agenesis. Results. Surgery was performed with urinary bladder catheterisation, incision of the septum and continuous aspiration – about 1000 ml of chocolate-like fluid, suggestive of old blood, followed by resection of the vaginal septum. Conclusions. A high rate of awareness and clinical suspicion of HWW syndrome among adolescents is necessary for both the diagnosis and the prompt surgical treatment, leading to remission of symptoms, prevention of complications and to preservation of fertility. [ABSTRACT FROM AUTHOR]
- Published
- 2020
22. Preeclampsia: screening, prevention management and risk factors. The International Federation of Obstetrics-Gynecology versus the American College of Obstetrics-Gynecology.
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Suciu, Viorela-Elena, Ciortea, R., Măluțan, A., Iuhaş, C., Mocan-Hognogi, R., Bucuri, Carmen Elena, Rada, Maria, Dudea, Marina, Clim, Adelina, Berindean, Denisa, and Mihu, D.
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UTERINE artery ,PREECLAMPSIA ,PLACENTAL growth factor ,INTERNATIONAL organization ,MULTIPLE pregnancy ,TYPE 1 diabetes - Abstract
Preeclampsia is a multisystemic disease, with a prevalence of 2-5%, that affects pregnant women. Every year, 76,000 women and 500,000 fetuses die due to the complications of this pathology. The prenatal screening for preeclampsia is constantly being updated. Globally, attempts are being made to identify easily reproducible, cost-effective screening markers that determine with great accuracy the patients prone to develop preeclampsia. Thus, there are differences between the described risk factors, the screening and prevention protocols recommended by world-recognized medical associations, such as the International Federation of Obstetrics-Gynecology (FIGO) and the American College of Obstetrics-Gynecology (ACOG). According to the latest FIGO recommendations, all pregnant patients should be screened in the first trimester for preeclampsia, including: maternal risk factors, mean blood pressure, placental growth factor and uterine artery pulsatility index. Patients at increased risk of developing preeclampsia will undergo preventive treatment with aspirin between 11- 14 weeks +/- 6 days and 36 weeks of pregnancy. ACOG presents patients with a history of preeclampsia, multiple pregnancy, chronic hypertension, type 1 or 2 diabetes, kidney disease or autoimmune diseases as having an increased risk of developing preeclampsia and a need for the prophylactic administration of aspirin. There is also a difference between the risk factors presented by the two associations. In conclusion, the determination of screening markers that provide an increased identification of patients at risk of developing preeclampsia, as well as the precise determination of risk factors for preeclampsia are imperative to anticipate and initiate the preventive treatment for women at risk, decreasing the prevalence of the disease, its complications and implicitly the costs. [ABSTRACT FROM AUTHOR]
- Published
- 2020
23. Ultrasonographic evaluation of abnormal uterine bleeding.
- Author
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Măluţan, Andrei, Diculescu, Doru, Ciortea, Răzvan, Mocan-Hognogi, Radu, Iuhaş, Cristian, Bucuri, Carmen Elena, Dudea, Marina, and Mihu, Dan
- Subjects
UTERINE hemorrhage ,POSTMENOPAUSE ,MEDICAL care costs ,IMAGE reconstruction ,ENDOMETRIOSIS ,MENARCHE - Abstract
Abnormal uterine bleeding (AUB) is a common gynecologic complaint that accounts for one-third of outpatient visits to gynecologists and for more than 70% of all gynecologic consults in the perimenopausal and postmenopausal years, leading to increased healthcare costs and to decreased quality of life. AUB describes any variation from normal bleeding patterns in non-pregnant, reproductive-aged women beyond menarche lasting for at least 6 months. Transvaginal ultrasound is the firstline imaging test for the evaluation of AUB in both premenopausal and postmenopausal women. Transvaginal ultrasound can be used to diagnose structural causes of abnormal bleeding such as polyps, adenomyosis, leiomyomas, hyperplasia and malignancy, and can also be beneficial in making the diagnosis of ovulatory dysfunction. Traditional 2-dimensional imaging is often enhanced by the addition of 3-dimension imaging with coronal reconstruction and saline infusion sonohysterography. The availability of newer diagnostic tools has made it possible to promptly diagnose and treat an increasing number of such AUBs in an office setting. Once a proper diagnosis has been established, appropriate management must be implemented. Therefore, AUB should not be under-/overestimated, and diagnosis, investigations and treatment should be proposed as early as possible, taking into account the scientific data available in the current state of medical knowledge. [ABSTRACT FROM AUTHOR]
- Published
- 2020
24. Vitelline duct ultrasound - prognosis factor in the first-trimester pregnancy.
- Author
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Mihu, Dan, Diculescu, Doru, Ciortea, Răzvan, Măluțan, Andrei, Iuhaş, Cristian, Nicula, Renata, Dudea, Marina, Blaga, Ligia, and Bucuri, Carmen Elena
- Subjects
FIRST trimester of pregnancy ,HEMATOPOIETIC stem cells ,EMBRYOLOGY ,DOPPLER ultrasonography ,PREGNANCY - Abstract
The vitelline duct is the structure that can be visualized early inside the gestational sac, allowing the ultrasound diagnosis of intrauterine pregnancy. Embryological aspects. The vitelline duct begins to form at approximately 14 days post-conception. In the fourth week of embryological development, the vitelline duct wall consists of three thin cell layers: the outer layer (the ectoderm); the inner layer, lined by the endodermal epithelium; the mesodermal layer, consisting of island blood formations where hematopoietic stem cells can be identified. Aspects of 2D ultrasound. The ultrasound aspect of the vitelline duct initially appears as two parallel lines. Subsequently, from 5.5 weeks it appears as a round, transonic structure, with a diameter of 3-5 mm. Certain ultrasound parameters of the vitelline duct can be described, which can be used to evaluate the evolutionary prognosis of the pregnancy: early visualization, dimensions, number, form, persistence of visualization in the second trimester, calcification. Aspects of 3D ultrasound. Performing the volumetry of the vitelline duct allows a more accurate estimation of the relationship between the vitelline duct and the volume of the gestational sac, as well as the correlation between the volume of the vitelline duct and the cranial- caudal length of the embryo. The VOCAL method allows a detailed evaluation of the external surface of the vitelline duct. Aspects of Doppler ultrasound. The vascularization of the vitelline duct is related to the intervillous circulation and plays an essential role in the early maternal-embryonic exchange. Under normal conditions, the velocimetry profile of the vitelline duct is characterized by: low velocity, absence of diastolic flow, the average IP value of 3.24. In a pregnancy with reserved evolutionary potential, the vascular flow is characterized by: irregular vascular flow, permanent diastolic flow, signs of venous blood flow. The combination of 2D, 3D and Doppler ultrasound allows the identification of important moments in the development of pregnancy, allowing at the same time the thoroughgoing study of physiological and physiopathological mechanisms, characteristic of the first trimester pregnancy. [ABSTRACT FROM AUTHOR]
- Published
- 2020
25. Tumori anexiale fetale: prezentare de caz.
- Author
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Bucuri, Carmen Elena, Suciu, Viorela-Elena, Ciortea, Răzvan, Rada, Maria, Dudea, Marina, Măluţan, Andrei, Mocan-Hognogi, Radu, and Mihu, Dan
- Subjects
- *
UMBILICAL cord , *FETAL development , *PRENATAL diagnosis , *PLACENTA , *CANCER , *TRISOMY 18 syndrome - Abstract
The umbilical cord and placenta may be the site of tumor development, sometimes jeopardizing the physiological development of the fetus. The umbilical cord becomes detectable on ultrasound from 7-9 weeks of gestation, initially as a thickened and straight structure, which increases in length and acquires a spiral shape. Umbilical cord cysts are rare abnormalities detected incidentally during routine ultrasounds. These can be classified as true cysts or pseudocysts, the final diagnosis being represented by the histopathological examination, which describes an epithelial layer in the case of true cysts. Pseudocysts are more frequently associated with trisomy 18 and 13, the risk of malformations being higher if the lesion is multiple, persists after 12 weeks of amenorrhea if the localization is paraxial; at the fetal or placental insertion of the cord. The placenta may also present various tumors. Subchorionic cysts have a 5-7% incidence, arising on the fetal placental face as anechoic images without Doppler signal. It is considered that their localization near the placental cord insertion site (PCIS) can result in intrauterine growth restriction. Other placental tumors include echogenic cystic lesions, placental lakes, chorioangiomas, hydatiform moles. The antenatal diagnosis should include investigations aimed at detecting the possible association with chromosomal abnormalities. Thus, we present the case of a 29-yearold primiparous, which, at 12 weeks of amenorrhea, it was detected a 2.5-cm diameter cyst located near the PCIS, increasing in dimensions up to 5 cm diameter at 16 weeks of amenorrhea, then having a steady evolution. The fetal development has not been affected, the histopathological examination describing the lesion as a subchorionic cyst. [ABSTRACT FROM AUTHOR]
- Published
- 2019
26. Formaţiuni placentare decelabile ecografic: motiv de îngrijorare?
- Author
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Suciu, Viorela-Elena, Ciortea, Răzvan, Măluţan, Andrei, Mocan-Hognogi, Radu, Bucuri, Carmen Elena, Rada, Maria, Dudea, Marina, and Mihu, Dan
- Subjects
FIRST trimester of pregnancy ,SECOND trimester of pregnancy ,AMNIOTIC liquid ,FETAL development ,PRENATAL diagnosis ,PLACENTA praevia - Abstract
Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
27. Poate fi anticipată o evoluţie nefavorabilă a sarcinii de trimestrul I?
- Author
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Bucuri, Carmen Elena, Diculescu, Doru, Ciortea, Răzvan, Măluţan, Andrei, Berceanu, Costin, Mocan-Hognogi, Radu, Oancea, Mihaela, Iuhaş, Cristian, Rada, Maria, and Mihu, Dan
- Abstract
Incidenţa sarcinii oprite în evoluţie este de 25%. Complicaţiile sarcinii de prim trimestru reprezintă o problemă actuală de sănătate. Etiologia opririi în evoluţie a sarcinilor este plurifactorială, anomaliile cromozomiale fiind cele mai frecvente (40%). Alte cauze pot fi reprezentate de: defecte de fază luteală, anomalii tiroidiene materne, diabet zaharat matern, infecţii, trombofilii ereditare sau dobândite, precum şi agenţi exogeni. În cadrul monitorizării prenatale se doreşte creşterea eficienţei metodelor de screening şi îmbunătăţirea metodelor de diagnostic în cazul sarcinilor de prim trimestru al căror potenţial evolutiv poate fi rezervat. Iniţial, embrionul este detectat imediat adiacent veziculei ombilicale (VO). Dacă embrionul este separat de aceasta, separarea se datorează dezvoltării sale. Pe măsură ce creşte lungimea cranio-caudală (LCC), creşte şi distanţa dintre embrion şi VO. Pentru embrionii cu un LCC de 5 mm sau mai mic, nu ar trebui să fie nicio separare a embrionului de VO sau una foarte mică (<2 mm). O distanţă mică (evaluată în literatura de specialitate de 2 mm) între un embrion cu LCC mai mare de 5 mm şi VO este un marker ecografic de prognostic nefavorabil. Astfel, s-a studiat distanţa dintre embrion şi VO (apreciată prin ecografie endovaginală) pentru embrionii cu LCC mai mare de 5 mm şi s-a identificat o corelaţie între aceasta şi nivelul seric al β-Human Chorionic Gonadotropin (beta-HCG), progesteron, forma solubilă a factorului de creştere endotelial (sFlt1), Human Inhibin A, Human Placental-Like Growth Factor şi Human Pregnancy Specific Beta 1 Glycoprotein, evidenţiindu-se corelaţii importante între aceşti factori serologici şi cel ultrasonografic în cazul pacientelor cu sarcină cu evoluţie nefavorabilă. [ABSTRACT FROM AUTHOR]
- Published
- 2019
28. Evaluarea mobilităţii colului vezical la paciente cu cistocel şi incontinenţă urinară prin intermediul ecografiei transperineale.
- Author
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Rada, Maria-Patricia, Ciortea, Răzvan, Diculescu, Doru, Măluţan, Andrei, Oancea, Mihaela, Iuhaş, Cristian, Bucuri, Carmen Elena, and Mihu, Dan
- Abstract
Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
29. Inducţia ovulatorie în endometrioză: o alternativă realistă?
- Author
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Suciu, Viorela-Elena, Ciortea, R., Măluțan, A., Mocan-Hognogi, R., Bucuri, Carmen Elena, Clim, Adelina, Tiuca, Denisa, and Mihu, D.
- Abstract
Copyright of Obstetrică şi Ginecologie is the property of Societatea de Obstetrica si Ginecologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
30. Tratamentul conservator al endometriomului ovarian - avantaj sau dezavantaj?
- Author
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Ciortea, R., Diculescu, D., Maluțan, A., Bucuri, Carmen Elena, Rada, Maria Patricia, Băbuț, Miruna, Oltean, Ioana, Suciu, Viorela, Schimbătoru, Corina, Clim, Adelina, Lupean, Roxana, Mihu, D., and Iuhaş, C.
- Abstract
Copyright of Obstetrică şi Ginecologie is the property of Societatea de Obstetrica si Ginecologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
31. Evaluarea Doppler a situsurilor venoase fetale.
- Author
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Ciortea, Răzvan, Diculescu, Doru, Măluţan, Andrei Mihai, Oancea, Mihaela, Mocan-Hognogi, Radu, Băltoaica, Răzvan, Bucuri, Carmen Elena, Rada, Maria, and Mihu, Dan
- Published
- 2018
32. Vezica urinară hiperactivă post-intervenţie chirurgicală pentru incontinenţa urinară de efort.
- Author
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Bucuri, Carmen Elena, Ciortea, Răzvan, Diculescu, Doru, Berceanu, Costin, Măluţan, Andrei Mihai, Rada, Maria Patricia, and Mihu, Dan
- Abstract
Sindromul vezicii urinare hiperactive (VUH) include imperiozitatea și incontinenţa urinară prin imperiozitate (IUI) și apare frecvent în urma corecţiei chirurgicale a incontinenţei urinare de efort (IUE). Identificarea factorilor de risc pentru apariţia simptomelor VUH este importantă pentru a putea informa pacienta în mod corespunzător înainte de intervenţia chirurgicală. Postoperator, incidenţa imperiozităţii persistente este de 15%, iar cea a IUI este de 30%. Femeile diagnosticate cu incontinenţă urinară mixtă, predominantă prin imperiozitate, prezintă persistenţa simptomatologiei după intervenţia chirurgicală, comparativ cu pacientele cu IUE. Vârsta înaintată constituie, de asemenea, un factor de risc pentru apariţia simptomelor de VUH. Parametrii urodinamici ai VUH (presiunea crescută a detrusorului, presiunea intraluminală uretrală, fluxul urinar) pot prezice apariţia imperiozităţii postoperator sau a IUI. Gestionarea simptomelor VUH după intervenţia chirurgicală efectuată pentru IUE este aceeași ca și în cazul VUH idiopatice. Cu toate acestea, înainte de începerea tratamentului, este esenţial să excludem alţi factori care pot determina imperiozitate: obstrucţiile tractului urinar, infecţia tractului urinar sau eroziunea bandeletei. Simptomele VUH sunt frecvent raportate după intervenţia chirurgicală. Severitatea simptomelor de imperiozitate, lipsa complicaţiilor intraoperatorii și cura chirurgicală concomitentă a prolapsului sunt predictori importanţi ai imperiozităţii persistente sau ai apariţiei IUI postoperator. [ABSTRACT FROM AUTHOR]
- Published
- 2017
33. Rolul ecografiei transperineale în incontinenţa urinară.
- Author
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Rada, Maria Patricia, Ciortea, Răzvan, Măluţan, Andrei Mihai, Iuhaș, Cristian Ioan, Berceanu, Costin, Bucuri, Carmen Elena, and Mihu, Dan
- Abstract
Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
34. Alegerea bandeletei potrivite pentru pacientele cu incontinenţă urinară de efort.
- Author
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Ciortea, Răzvan, Diculescu, Doru, Măluţan, Andrei Mihai, Iuhaș, Cristian Ioan, Berceanu, Costin, Bucuri, Carmen Elena, Rada, Maria Patricia, Dudea, Marina, and Mihu, Dan
- Abstract
Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
35. Rolul examenului ecografic în aprecierea anomaliilor cordului fetal în primul trimestru de sarcină.
- Author
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Mihu, Dan, Ciortea, Răzvan, Măluțan, Andrei Mihai, Iuhas, Cristian Ioan, Bucuri, Carmen Elena, Rada, Maria Patricia, and Băltoaica, Răzvan
- Abstract
Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
36. Aprecierea ecografică a prognosticului evolutiv al sarcinii de prim trimestru.
- Author
-
Mihu, Dan, Ciortea, Răzvan, and Bucuri, Carmen-Elena
- Abstract
Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
37. ACCURACY OF TRANSVAGINAL ULTRASONOGRAPHY COMPARED TO ENDOMETRIAL BIOPSY FOR THE ETIOLOGICAL DIAGNOSIS OF ABNORMAL PERIMENOPAUSAL BLEEDING.
- Author
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NICULA, RENATA, DICULESCU, DORU, LENCU, CODRUŢA CLAUDIA, CIORTEA, RĂZVAN, BUCURI, CARMEN ELENA, OLTEAN, IOANA ADRIANA, TRIF, IOANA ALEXANDRA, and MIHU, DAN
- Subjects
- *
TRANSVAGINAL ultrasonography , *ENDOMETRIAL biopsy , *PERIMENOPAUSE - Abstract
Background and aims. Perimenopause is marked by clinical manifestations which disturb everyday life and which may also hide a pathomorphological, more precisely endometrial, substrate. An accurate early diagnosis established by accessible, non-invasive methods is very important for the therapeutic management. Method. The study included 103 patients aged between 41.5-55.11 years, divided into 3 age groups: 40-44 years (n=10), 45-49 years (n=54) and ≥50 years (n=39). Results. Certain risk factors of endometrial neoplasm or premalignant conditions were evidenced, their accurate identification being useful in limiting the number of patients with abnormal uterine bleeding (AUB) submitted to diagnostic screening. The most common cause of AUB in our study was fibroma, followed by functional causes. Conclusions. Transvaginal ultrasound (TVUS) represents a minimally invasive method for the screening of perimenopausal patients with AUB, especially to rule out endometrial adenocarcinoma (EAC). TVUS sensitivity was higher than clinical diagnosis in case of leiomioma, polypi and EAC. TVUS was more accurate in the diagnosis of EAC, polypi and leiomioma. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
38. Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Systematic Review of the Literature in the Last 20 Years.
- Author
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Bucuri CE, Ciortea R, Malutan AM, Oprea V, Toma M, Roman MP, Ormindean CM, Nati I, Suciu V, and Mihu D
- Subjects
- Humans, Female, Uterine Neoplasms pathology, Uterine Neoplasms diagnosis, Middle Aged, Smooth Muscle Tumor pathology, Smooth Muscle Tumor diagnosis
- 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.
- Published
- 2024
- Full Text
- View/download PDF
39. 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.
- Author
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Ciortea R, Roman MP, Măluțan AM, Bucuri CE, Ormindean CM, Nati ID, and Mihu D
- Abstract
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.)
- Published
- 2023
- Full Text
- View/download PDF
40. Transperineal Ultrasound Assessment of a Cystocele's Impact on the Bladder Neck Mobility in Women with Stress Urinary Incontinence.
- Author
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Rada MP, Ciortea R, Măluțan AM, Diculescu D, Berceanu C, Mihaela O, Ioan IC, Bucuri CE, Roman A, and Mihu D
- Subjects
- Aged, Cystocele epidemiology, Cystocele physiopathology, Female, Humans, Middle Aged, Peripheral Nerves physiopathology, Research Design, Romania epidemiology, Ultrasonography statistics & numerical data, Urinary Bladder physiopathology, Urinary Incontinence, Stress epidemiology, Urinary Incontinence, Stress etiology, Cystocele complications, Peripheral Nerves abnormalities, Ultrasonography methods, Urinary Bladder abnormalities, Urinary Incontinence, Stress physiopathology
- Abstract
Background and objectives : As pelvic floor disorders are often difficult to assess thoroughly based on clinical examination alone, the use of imaging as a complementary technique is helpful. This study's aim was to investigate by transperineal ultrasound (US) if there was any significant difference in the mobility of the bladder neck in women with stress urinary incontinence (SUI) without a cystocele and in those with SUI and an associated cystocele. The study also investigated whether the number of vaginal births and/or the heaviest newborn's birth weight was correlated with the bladder neck mobility. Materials and Methods : A total of 71 women suffering from SUI were included in the study and divided into two groups based on the presence of a cystocele. Their bladder neck mobility was evaluated by transperineal US, calculating the distance from the inferior margin of the symphysis pubis to the bladder neck (SPBN), and the dorsocaudal linear movement (DLM), term used to illustrate the displacement of the bladder neck by subtracting rest and Valsalva values. GraphPad Prism 8 was used for statistical analysis. Results : Within both study groups, the SPBN values were significantly higher and the DLM values were significantly lower at rest as compared to Valsalva maneuver ( p < 0.05). No significant difference between the groups regarding SPBN and DLM values at rest, Valsalva, or subtraction was demonstrated. A significant positive correlation was found between the bladder neck mobility and the heaviest newborn's birth weight, regardless of the presence of a cystocele ( p = 0.042). Conclusions : The presence of a cystocele had no significant impact on the bladder neck mobility measurements in patients with SUI. The heaviest newborn's birth weight positively correlated with bladder neck hypermobility, as quantified by SPBN.
- Published
- 2019
- Full Text
- View/download PDF
41. Progesterone's Serum Level and a New Ultrasonographic Parameter in the First Trimester Pregnancy - Prognostic Factors for Embryonic Demise.
- Author
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Bucuri CE, Ciortea R, Malutan AM, Berceanu C, Rada MP, and Mihu D
- Subjects
- Case-Control Studies, Embryo, Mammalian diagnostic imaging, Female, Humans, Pregnancy, Prognosis, Yolk Sac diagnostic imaging, Pregnancy Outcome epidemiology, Pregnancy Trimester, First blood, Pregnancy Trimester, First physiology, Progesterone blood, Ultrasonography, Prenatal
- Abstract
Objective: The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (40%). The purpose of the present study is to evaluate the correlation between a serum biomarker, progesterone, and an ultrasonographic parameter, the distance between yolk sac and embryo (DYSE) in assessing the prognosis of pregnancy outcome in the 1
st trimester., Methods: The present study is a prospective case-control analysis that includes 2 groups of patients: 81 patients with first-trimester normal evolutive pregnancy and 89 patients with embryonic demise, all of the patients having between 6 and 11 weeks of amenorrhea. 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 progesterone serum level measurement., Results: Regarding the DYSE in the case group, lower values were observed compared with the control group, the difference being statistically significant. In the statistical analysis of serum progesterone values, statistically significant differences were observed between the 2 groups ( p < 0.05)., Conclusion: The DYSE has a high positive predictive value in identifying pregnancies with potentially reserved outcome, with the present study demonstrating that a DYSE < 3 mm causes an unfavorable evolution of the pregnancy. Low serum levels of progesterone are associated with an increased rate of nonviable embryos. The correlation between these two parameters increases the effectiveness of screening methods in prenatal monitoring and improves the diagnostic methods for the first-trimester pregnancies whose outcome potential can be reserved., Competing Interests: The authors have no conflicts of interests to declare., (Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.)- Published
- 2019
- Full Text
- View/download PDF
42. Intraperitoneal Fat through GRP78: A Risk Factor for Endometrial Cancer.
- Author
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Ciortea R, Berceanu C, Măluţan AM, Mocan R, Iuhas C, Bucuri CE, Rada MP, and Mihu D
- Subjects
- Aged, Endoplasmic Reticulum Chaperone BiP, Female, Humans, Linear Models, Risk Factors, Adiposity, Endometrial Neoplasms metabolism, Heat-Shock Proteins metabolism, Peritoneum metabolism
- Abstract
Introduction. The identification of biological markers that indicate an increased risk for the development or recurrence of endometrial cancer (EC) in obese women might be useful for decreasing EC mortality and morbidity. Glucose-regulated protein 78 (GRP78) is a major protein of the endoplasmic reticulum expressed in all normal cells. Overexpression of GRP78 has been reported to be a tumoral biomarker. Increased detection of GRP78 is positively correlated with the tumoral stage and prognosis. This study aimed to identify a correlation between intraperitoneal fat, plasma GRP78 levels, and EC. Materials and Methods. Two groups of patients were included in the study: group I, 44 patients diagnosed with EC, and group II, 44 patients without gynecological pathology or inflammatory disorders. Visceral fat was determined by ultrasound and plasma GRP78 levels were measured. Results . Plasma GRP78 levels were significantly higher in patients with EC compared to the control group. Intraperitoneal fat was in a positive linear correlation with the plasma GRP78 level ( p < 0.0001). Conclusion. The measurement of the GRP78 level associated with the determination of intraperitoneal fat can be a useful predictor for EC.
- Published
- 2016
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