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Article ; Online: The Impact of Vitamin D Deficiency on Infants' Health.

Stoica, Andreea Bianca / Mărginean, Claudiu

2023 Volume 15, Issue 20

Abstract: Vitamin D is an essential nutrient that plays a vital role in bone health and musculoskeletal development. The aim of this narrative review is to present up-to-date information about the impact of vitamin D deficiency (VDD) on the health status of ... ...

Abstract	Vitamin D is an essential nutrient that plays a vital role in bone health and musculoskeletal development. The aim of this narrative review is to present up-to-date information about the impact of vitamin D deficiency (VDD) on the health status of infants in their first year of life. Vitamin D is indispensable for skeletal growth and bone health, and emerging research suggests that it may also have significant roles in maternal and fetal health. VDD affects a large proportion of infants according to current guidelines. However, its prevalence varies depending on geographic location, skin pigmentation, and the time of year. Based on current guidelines for normal vitamin D levels and recommended daily intake, studies suggest that VDD is a global health issue with potentially significant implications for those at risk, especially infants. Our understanding of the role of vitamin D has improved significantly in the last few decades. Systematic reviews and meta-analyses investigating the effect of vitamin D on preterm birth, low birth weight, anthropometric parameters, and health outcomes such as infectious diseases in infants, have found conflicting or inconsistent results. It is important to encourage further research to fill in these knowledge gaps and develop national or global strategies that ease the burden of VDD, especially in groups at risk.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Infant ; Premature Birth ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/epidemiology ; Vitamin D ; Infant, Low Birth Weight ; Vitamins
Chemical Substances	Vitamin D (1406-16-2) ; Vitamins
Language	English
Publishing date	2023-10-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15204379
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Article ; Online: Left ventricular function evaluation of the fetal heart: reference intervals and inter-observer variability of 2D speckle-tracking echocardiography measurements.

Gozar, Liliana / Sasaran, Maria Oana / Toma, Daniela / Cerghit-Paler, Andreea / Molnar-Varlam, Claudiu / Mărginean, Claudiu / Săsăran, Vlăduț

Medical ultrasonography

2023 Volume 25, Issue 2, Page(s) 168–174

Abstract: Aims: Measurement of myocardial strain using 2D speckle-tracking echocardiography can successfully quantify ventricular function, being considered superior to conventional echocardiography. This study aimed to establish reference intervals, ... ...

Abstract	Aims: Measurement of myocardial strain using 2D speckle-tracking echocardiography can successfully quantify ventricular function, being considered superior to conventional echocardiography. This study aimed to establish reference intervals, interobserver agreements and reliability of two fetal echocardiographic parameters which reflect left ventricular myocardial function, left ventricular apical 4 chamber endo peak strain (AP4pLS) and ejection fraction (EF). Material and methods: We conducted a prospective study on 103 healthy fetuses. In each case, cardiac ultrasound images obtained were stored and afterwards were subject to offline 2D speckle-tracking echocardiographic analyses. In 15 randomly chosen subjects a second examiner also carried out an offline analysis of the 4-chamber view and the archived images, in order to assess inter-observer reproducibility and agreement level. Our study group was sub-divided into four different gestational age groups. Results: Reference ranges were established for the two measured parameters, AP4pLS and EF, which did not differ significantly between four different gestational age groups (p=0.98 and p=0.64) and neither correlated with gestational age progression (p=0.37 and p=0.08). An excellent level of agreement between the two examiners was found for the echocardiographic measurements, expressed through an intra-class correlation coefficient (ICC) value of 0.85 (0.62-0.94 for 95%CI) for AP4pLS and 0.78 (0.47- 0.92 for 95% CI) for EF. Conclusions: Speckle tracking AP4pLS and EF parameters are useful for assessment of ventricular myocardial function in healthy fetuses and can be reliably reproduced by two different skilled examiners. Further studies conducted on larger populations are required to standardize reference values of fetal speckle-tracking measurements.
MeSH term(s)	Humans ; Ventricular Function, Left ; Reproducibility of Results ; Prospective Studies ; Observer Variation ; Echocardiography/methods ; Heart Ventricles/diagnostic imaging ; Fetal Heart/diagnostic imaging
Language	English
Publishing date	2023-06-27
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2529606-1
ISSN	2066-8643 ; 1844-4172
ISSN (online)	2066-8643
ISSN	1844-4172
DOI	10.11152/mu-4021
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Article ; Online: Optimally Controlled Diabetes and Its Influence on Neonatal Outcomes at a Level II Center: A Study on Infants Born to Diabetic Mothers.

Muntean, Mihai / Prelipcean, Irina / Racean, Maria-Andreea / Cucerea, Manuela / Fagarasan, Amalia / David, Carmen Tamara / Marginean, Claudiu / Suciu, Laura Mihaela

Medicina (Kaunas, Lithuania)

2023 Volume 59, Issue 10

Abstract: Background and ... ...

Abstract	Background and Objectives
MeSH term(s)	Infant, Newborn ; Pregnancy ; Infant ; Humans ; Female ; Cesarean Section/adverse effects ; Prospective Studies ; Diabetes, Gestational ; Mothers ; Intensive Care Units, Neonatal
Language	English
Publishing date	2023-10-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59101768
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Article: A Second Trimester Prediction Algorithm for Early-Onset Hypertensive Disorders of Pregnancy Occurrence and Severity Based on Soluble fms-like Tyrosine Kinase 1 (sFlt-1)/Placental Growth Factor (PlGF) Ratio and Uterine Doppler Ultrasound in Women at Risk.

Chirilă, Cristian Nicolae / Mărginean, Claudiu / Ghiga, Dana Valentina / Voidăzan, Septimiu / Chirilă, Paula Maria / Gliga, Mirela Liana

Children (Basel, Switzerland)

2024 Volume 11, Issue 4

Abstract: Hypertensive disorders of pregnancy (HDPs) represent a significant source of severe maternal and fetal morbidity. Screening strategies relying on traditional medical history and clinical risk factors have traditionally shown relatively modest performance, ...

Abstract	Hypertensive disorders of pregnancy (HDPs) represent a significant source of severe maternal and fetal morbidity. Screening strategies relying on traditional medical history and clinical risk factors have traditionally shown relatively modest performance, mainly in the prediction of preeclampsia, displaying a sensitivity of 37% for the early-onset form and 29% for the late-onset form. The development of more accurate predictive and diagnostic models of preeclampsia in the early stages of pregnancy represents a matter of high priority. The aim of the present paper is to create an effective second trimester prediction algorithm of early-onset HDP occurrence and severity, by combining the following two biochemical markers: a soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio and uterine artery Doppler ultrasound parameters, namely the pulsatility index (PI) and the resistivity index (RI), in a population of high-risk pregnant women, initially assessed through traditional risk factors. A prospective single-center observational longitudinal study was conducted, in which 100 women with singleton pregnancy and traditional clinical and medical history risk factors for preeclampsia were enrolled at 24 weeks of gestation. Shortly after study enrollment, all women had their sFlt-1 and PlGF levels and mean uterine artery PI and RI determined. All pregnancies were followed up until delivery. Receiver operating characteristic (ROC) analysis established algorithms based on cutoffs for the prediction of the later development of preeclampsia: PI 1.25 (96.15% sensitivity, 86.49% specificity), RI 0.62 (84.6% sensitivity, 89.2% specificity) and sFlt-1/PlGF ratio 59.55 (100% sensitivity, 89.2% specificity). The sFlt-1/PlGF ratio was the best predictor for preeclampsia, as it displayed the highest area under the curve (AUC) of 0.973. The prediction algorithm for the severe form of preeclampsia, complicated by fetal growth restriction leading to preterm birth, antepartum fetal demise or acute fetal distress with a cerebro-placental ratio of <one consisted of the following cutoffs: PI 1.44 (93.75% sensitivity, 95.24% specificity), RI 0.69 (87.5% sensitivity, 100% specificity) and sFlt-1/PlGF ratio 102.74 (93.75% sensitivity, 95.2% specificity). These algorithms may significantly enhance the prediction accuracy of preeclampsia compared to traditional risk factors. The combination of the sFlt-1/PlGF ratio with mean uterine PI and RI in particular displayed an improved performance in the prediction of severe preeclampsia with the above-mentioned complications, compared to the biochemical markers or uterine Doppler parameters used alone. Therefore, HDP screening strategies should increasingly focus on implementing such algorithms for women who are initially regarded as high risk based on traditional risk factors, in order to properly diagnose HDP and properly limit or manage the later maternal and fetal complications.<br />
Language	English
Publishing date	2024-04-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children11040468
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Article: The Current Role of the sFlt-1/PlGF Ratio and the Uterine-Umbilical-Cerebral Doppler Ultrasound in Predicting and Monitoring Hypertensive Disorders of Pregnancy: An Update with a Review of the Literature.

Chirilă, Cristian Nicolae / Mărginean, Claudiu / Chirilă, Paula Maria / Gliga, Mirela Liana

Children (Basel, Switzerland)

2023 Volume 10, Issue 9

Abstract: Regarding the hypertensive disorders of pregnancy, pre-eclampsia (PE) remains one of the leading causes of severe and life-threatening maternal and fetal complications. Screening of early-onset PE (<34 weeks of pregnancy), as well as late-onset PE (≥34 ... ...

Abstract	Regarding the hypertensive disorders of pregnancy, pre-eclampsia (PE) remains one of the leading causes of severe and life-threatening maternal and fetal complications. Screening of early-onset PE (<34 weeks of pregnancy), as well as late-onset PE (≥34 weeks), shows poor performance if based solely on clinical features. In recent years, biochemical markers from maternal blood-the pro-angiogenic protein placental growth factor (PlGF) and the antiangiogenic protein soluble FMS-like tyrosine kinase 1 (sFlt-1)-and Doppler velocimetry indices-primarily the mean uterine pulsatility index (PI), but also the uterine resistivity index (RI), the uterine systolic/diastolic ratio (S/D), uterine and umbilical peak systolic velocity (PSV), end-diastolic velocity (EDV), and uterine notching-have all shown improved screening performance. In this review, we summarize the current status of knowledge regarding the role of biochemical markers and Doppler velocimetry indices in early prediction of the onset and severity of PE and other placenta-related disorders, as well as their role in monitoring established PE and facilitating improved obstetrical surveillance of patients categorized as high-risk in order to prevent adverse outcomes. A sFlt-1/PlGF ratio ≤ 33 ruled out early-onset PE with 95% sensitivity and 94% specificity, whereas a sFlt-1/PlGF ≥88 predicted early-onset PE with 88.0% sensitivity and 99.5% specificity. Concerning the condition's late-onset form, sFlt-1/PlGF ≤ 33 displayed 89.6% sensitivity and 73.1% specificity in ruling out the condition, whereas sFlt-1/PlGF ≥ 110 predicted the condition with 58.2% sensitivity and 95.5% specificity. The cut-off values of the sFlt-1/PlGF ratio for the screening of PE were established in the PROGNOSIS study: a sFlt-1/PlGF ratio equal to or lower than 38 ruled out the onset of PE within one week, regardless of the pregnancy's gestational age. The negative predictive value in this study was 99.3%. In addition, sFlt-1/PlGF > 38 showed 66.2% sensitivity and 83.1% specificity in predicting the occurrence of PE within 4 weeks. Furthermore, 2018 ISUOG Practice Guidelines stated that a second-trimester mean uterine artery PI ≥ 1.44 increases the risk of later PE development. The implementation of a standard screening procedure based on the sFlt-1/PlGF ratio and uterine Doppler velocimetry may improve early detection of pre-eclampsia and other placenta-related disorders.
Language	English
Publishing date	2023-08-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children10091430
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Article ; Online: The Relationship between Psychological Suffering, Value of Maternal Cortisol during Third Trimester of Pregnancy and Breastfeeding Initiation.

Răchită, Anca Ioana Cristea / Strete, Gabriela Elena / Sălcudean, Andreea / Ghiga, Dana Valentina / Huțanu, Adina / Muntean, Lorena Mihaela / Suciu, Laura Mihaela / Mărginean, Claudiu

Medicina (Kaunas, Lithuania)

2023 Volume 59, Issue 2

Abstract: Background and Objectives: ...

Abstract	Background and Objectives:
MeSH term(s)	Pregnancy ; Female ; Infant, Newborn ; Humans ; Breast Feeding/psychology ; Pregnancy Trimester, Third ; Hydrocortisone ; Mothers/psychology ; Anxiety ; Stress, Psychological/psychology
Chemical Substances	Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2023-02-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59020339
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Article: Parietex ProGrip™ Self-Fixating Mesh in Surgical Treatment of Pelvic Organ Prolapse.

Botoncea, Marian / Molnar, Călin / Mărginean, Claudiu / Martha, Orsolya / Gurzu, Simona / Butiurca, Vlad Olimpiu / Andrei, Bogdan Suciu / Molnar, Claudiu Varlam

Chirurgia (Bucharest, Romania : 1990)

2020 Volume 115, Issue 5, Page(s) 650–655

Abstract: Introduction: ...

Abstract	Introduction:
MeSH term(s)	Biocompatible Materials ; Collagen ; Female ; Humans ; Pelvic Organ Prolapse/surgery ; Polyesters ; Surgical Mesh ; Treatment Outcome
Chemical Substances	Biocompatible Materials ; Polyesters ; parietex ; Collagen (9007-34-5)
Language	English
Publishing date	2020-12-19
Publishing country	Romania
Document type	Journal Article
ZDB-ID	419244-8
ISSN	1842-368X ; 1221-9118 ; 0009-4730 ; 0377-5003
ISSN (online)	1842-368X
ISSN	1221-9118 ; 0009-4730 ; 0377-5003
DOI	10.21614/chirurgia.115.5.650
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Article ; Online: Maternal Nutritional Status, a Sine Qua Non Condition for Fetal, Neonatal, Child’s and Adult’s Outcome

Cosmin Rugina / Cristina Oana Marginean / Lorena Elena Melit / Claudiu Marginean

Romanian Journal of Pediatrics, Vol 70, Iss 1, Pp 36-

2021 Volume 39

Abstract: Excessive gestational weight gain is a predictive factor for maternal obesity, with implications on newborn’s weight and potential short- and long-term complications. Gestational weight gain depends on ethnic and social factors, as well as on parity. ... ...

Abstract	Excessive gestational weight gain is a predictive factor for maternal obesity, with implications on newborn’s weight and potential short- and long-term complications. Gestational weight gain depends on ethnic and social factors, as well as on parity. Excepting the aforementioned factors, we must also recall the major impact of the genetic suscep-tibility being pointed out that three essential periods influence fetal evolution, i.e. periconceptional, intrauterine and postnatal. The intrauterine environment owns an essential role in the optimal development of fetus with an effect on the offspring’s organ structure and functions, being currently assumed that adulthood pathologies originate in the perinatal period. Thus, the relationship between excessive gestational weight gain and child’s obesity or metabolic disorders is well documented. Moreover, recent information from the literature suggests that child’s allergies, wheezing or asthma might also be related to maternal nutritional status. To sum up, excessive gestational weight gain owns a decisive role in the development of child’s obesity and meta-bolic disorders imposing the major importance of a balanced diet during pregnancy in order to favor an optimal weight gain with a positive effect on fetal wellbeing that will further prevent the offspring’s metabolic risk.
Keywords	gestational weight gain ; maternal obesity ; newborn’s weight ; Medicine ; R ; Pediatrics ; RJ1-570
Subject code	610
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
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Article ; Online: Diagnostic accuracy of digital mammography and breast ultrasonography in prediction of response to neoadjuvant systemic treatment in breast cancer patients

Adela-Luciana Oprea / Bahadir M. Gulluoglu / Rares Georgescu / Tiberiu-Bogdan Szekely / Alexandra-Daniela Sava / Andra-Diana Popa / Claudiu Marginean

Romanian Journal of Medical Practice, Vol 18, Iss 2, Pp 72-

2023 Volume 78

Abstract: Aim. The aim of our study was to assess the accuracy of a combination of digital mammography and breast ultrasonography in the prediction of response to neoadjuvant systemic treatment in breast cancer patients with different tumor subtypes. Methods. The ... ...

Abstract	Aim. The aim of our study was to assess the accuracy of a combination of digital mammography and breast ultrasonography in the prediction of response to neoadjuvant systemic treatment in breast cancer patients with different tumor subtypes. Methods. The study was designed as a retrospective diagnostic accuracy study. Stage I-III female breast cancer patients who received any type of neoadjuvant systemic treatment with radiological response assessment by both mammography and breast ultrasound and followed by surgical treatment in the breast and axilla were included in the study. The primary outcome was the diagnostic accuracy of combined modalities of mammography and breast ultrasonography for predicting the pathological complete response. On mammography and breast ultrasonography, the radiological response was categorized into complete response and non-complete response. Pathological complete response on surgical specimens was described based on current guidelines. True and false positive cases as well as true and false negative cases were counted and compared among patients with 4 different molecular subtypes. The diagnostic accuracy of combined imaging modalities was analyzed for positive and negative predictive values, sensitivity, and specificity rates. All rates were calculated according to the previously described formulas. Results. Eighty-one breast cancer cases were included in the study. Positive predictive values of imaging were 100%, 75%, 100%, and 83%, whereas negative predictive values were 67%, 75%, 100%, and 100% in patients with HR+/HER2-, HR+/HER2+, HR-/HER2+ and HR-/HER2- tumors, respectively. Sensitivity rates were found to be 98%, 90%, 100%, and 100%, whereas specificity rates were 100%, 50%, 100%, and 67% in patients with HR+/HER2-, HR+/HER2+, HR-/HER2+ and HR-/HER2- tumors, respectively. Conclusion. Digital mammography and breast ultrasonography as a combined modality seem to show the pathological complete response after neoadjuvant systemic treatment in HR+/HER2- breast cancer patients ...
Keywords	breast cancer ; mammography ; ultrasonography ; radiological response ; pathological response ; neoadjuvant systemic treatment ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	616 ; 610
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
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Article ; Online: Statusul nutrițional matern, o condiție sine qua non pentru evoluția fătului, nou-născutului, copilului și adultului

Cosmin Rugină / Cristina Oana Mărginean / Lorena Elena Meliț / Claudiu Mărginean

Romanian Journal of Pediatrics, Vol 70, Iss 1, Pp 40-

2021 Volume 43

Abstract: Cȃştigul ponderal excesiv al femeii gravide este un factor predictiv pentru obezitatea maternă, cu implicații asupra greutății nou-născuților și posibile complicații pe termen scurt și lung. Cȃştigul ponderal ȋn sarcină depinde de factori etnici, sociali ...

Abstract	Cȃştigul ponderal excesiv al femeii gravide este un factor predictiv pentru obezitatea maternă, cu implicații asupra greutății nou-născuților și posibile complicații pe termen scurt și lung. Cȃştigul ponderal ȋn sarcină depinde de factori etnici, sociali şi de paritate. Exceptând factorii menționați anterior, nu este de neglijat nici impactul major al susceptibilității genetice, punându-se în evidență că există trei perioade principale ce influenţează evoluţia fetală, și anume periconcepţională, intrauterină şi postnatală. Mediul intrauterin deține un rol esenţial în dezvoltarea optimă a fătului, având efect asupra structurilor şi funcţiilor organelor produsului de concepţie, considerându-se în acest moment că bolile adultului îşi au originea în copilărie. Astfel, este bine cunoscută legătura dintre câștigul ponderal gestațional excesiv și obezitatea sau bolile metabolice la copil. Mai mult, unele dintre cele mai noi informații din literatură sugerează că alergiile, wheezing-ul sau astmul copilului ar putea avea, la rândul lor, legătură cu statusul nutrițional matern. În concluzie, excesul ponderal gestațional deține un rol decisiv în apariţia obezităţii şi bolilor metabolice la copil, de aici rezultând importanţa majoră a unei diete echilibrate pe perioada sarcinii pentru a favoriza un câștig ponderal optim, cu efect pozitiv asupra bunăstării fetale, care să prevină riscul metabolic al produsului de concepţie.
Keywords	câștig ponderal în sarcină ; obezitate maternă ; greutatea nou-născutului ; Medicine ; R ; Pediatrics ; RJ1-570
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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