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  1. Article: Forty years of HIV.

    Streinu-Cercel, Adrian

    Germs

    2021  Volume 11, Issue 2, Page(s) 146

    Language English
    Publishing date 2021-06-02
    Publishing country Romania
    Document type Editorial
    ZDB-ID 2649305-6
    ISSN 2248-2997
    ISSN 2248-2997
    DOI 10.18683/germs.2021.1251
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: SARS-CoV-2 in Romania - situation update and containment strategies.

    Streinu-Cercel, Adrian

    Germs

    2020  Volume 10, Issue 1, Page(s) 8

    Keywords covid19
    Language English
    Publishing date 2020-03-02
    Publishing country Romania
    Document type Editorial
    ZDB-ID 2649305-6
    ISSN 2248-2997
    ISSN 2248-2997
    DOI 10.18683/germs.2020.1179
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: The Impact of Obesity on the Host-Pathogen Interaction with Influenza Viruses - Novel Insights: Narrative Review.

    Miron, Victor Daniel / Drăgănescu, Anca Cristina / Pițigoi, Daniela / Aramă, Victoria / Streinu-Cercel, Adrian / Săndulescu, Oana

    Diabetes, metabolic syndrome and obesity : targets and therapy

    2024  Volume 17, Page(s) 769–777

    Abstract: After exposure to a viral pathogen, the host-pathogen interaction is essential to determine whether or not infection will ensue, and what the clinical outline of the infection will be. Recent research has shown that the patient with obesity presents a ... ...

    Abstract After exposure to a viral pathogen, the host-pathogen interaction is essential to determine whether or not infection will ensue, and what the clinical outline of the infection will be. Recent research has shown that the patient with obesity presents a set of particular pathophysiological changes that lead to higher severity of viral infections, and this is particularly true for infection with influenza viruses. Herein, we describe the main metabolic, endocrine, and immune dysregulations that occur in the presence of obesity and their impact on driving intra-host viral diversity, leading to heightened severity and virulence of influenza. We show that obesity is linked to modified responses of both the innate and adaptive immune systems during viral infections, including influenza. Due to chronic inflammation and metabolic, endocrine, and signaling pathway disruptions, individuals with obesity have a suboptimal immune response. This results in longer illness duration, increased virus shedding, higher risk of hospitalization and complications, and greater mortality rates. Additionally, they may have a blunted response to vaccination and a higher likelihood of genetic mutation selection. Understanding the intricate interplay between obesity and viral pathogenesis is crucial for developing efficacious therapeutic approaches and public health policies, particularly in light of the escalating worldwide incidence of obesity.
    Language English
    Publishing date 2024-02-13
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2494854-8
    ISSN 1178-7007
    ISSN 1178-7007
    DOI 10.2147/DMSO.S434115
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Antibiotic Prescribing in Dental Medicine-Best Practices for Successful Implementation.

    Săndulescu, Oana / Preoțescu, Liliana Lucia / Streinu-Cercel, Adrian / Şahin, Gülşen Özkaya / Săndulescu, Mihai

    Tropical medicine and infectious disease

    2024  Volume 9, Issue 2

    Abstract: With rising rates of antimicrobial resistance throughout the world, it is time to revisit antibiotic prescribing policies and practices, and dentistry is an important area for focused intervention, as it accounts for up to 15% of all antimicrobial ... ...

    Abstract With rising rates of antimicrobial resistance throughout the world, it is time to revisit antibiotic prescribing policies and practices, and dentistry is an important area for focused intervention, as it accounts for up to 15% of all antimicrobial prescriptions. In this narrative review, we have analyzed the current state of the knowledge, attitudes, and practice regarding antimicrobial use among dental professionals, and we have identified a set of seven recurring themes that drive inappropriate antibiotic prescribing in dental medicine. These include: 1. Prescribing antibiotics to delay or avoid dental treatment. 2. Overlooking the 5Ds-dental treatment (source control), dental condition (indication), drug (antibiotic choice), dose, and duration. 3. Relying on education from the distant past and on previous experience. 4. The heterogeneity of (too many) guideline recommendations leads to confusion and over-prescribing. 5. Decreased access to guideline information in private practice. 6. Psychological factors such as pressure to prescribe, comfort prescribing and the weekend effect, and 7. Feeling removed from antimicrobial resistance and externalizing responsibility. Based on the existing knowledge, we propose a framework based on four key pillars for focused intervention: 1. Education. 2. Internalizing responsibility. 3. Recognizing recurring counter-productive practices, and 4. Addressing recurring counter-productive practices. This framework can be applied in different dental settings to ensure best practices for the successful implementation of rational antimicrobial prescribing.
    Language English
    Publishing date 2024-01-26
    Publishing country Switzerland
    Document type Journal Article ; Review
    ISSN 2414-6366
    ISSN (online) 2414-6366
    DOI 10.3390/tropicalmed9020031
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  5. Article: Syndromic Testing in Infectious Diseases: From Diagnostic Stewardship to Antimicrobial Stewardship.

    Săndulescu, Oana / Streinu-Cercel, Anca / Moțoi, Maria Magdalena / Streinu-Cercel, Adrian / Preoțescu, Liliana Lucia

    Antibiotics (Basel, Switzerland)

    2022  Volume 12, Issue 1

    Abstract: The implementation into clinical practice of syndromic testing by multiplex polymerase chain reaction allows early etiological diagnosis and paves the way towards timely targeted treatment. However, there is stringent need for diagnostic stewardship, as ... ...

    Abstract The implementation into clinical practice of syndromic testing by multiplex polymerase chain reaction allows early etiological diagnosis and paves the way towards timely targeted treatment. However, there is stringent need for diagnostic stewardship, as multiplex testing can also come with a high risk of misdiagnosis if improperly ordered or interpreted. We report two cases that illustrate proper and improper diagnostic stewardship, having important implications for correct patient management and application of antimicrobial stewardship into current clinical practice.
    Language English
    Publishing date 2022-12-21
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics12010006
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  6. Article: Liver Transaminases in Pediatric Adenovirus Infection-A Five-Year Study in Two Major Reference Centers from Romania.

    Săndulescu, Oana / Streinu-Cercel, Anca / Miron, Victor Daniel / Covăcescu, Silvia Mirela / Streinu-Cercel, Adrian / Craiu, Mihai

    Microorganisms

    2023  Volume 11, Issue 2

    Abstract: Human adenovirus causes infections with a very heterogeneous clinical picture, and children are often the most frequently affected group. Interest in adenovirus has increased with the 2022 outbreak of severe acute hepatitis of unknown etiology as human ... ...

    Abstract Human adenovirus causes infections with a very heterogeneous clinical picture, and children are often the most frequently affected group. Interest in adenovirus has increased with the 2022 outbreak of severe acute hepatitis of unknown etiology as human adenovirus was considered as one of the possible etiological agents. We conducted a retrospective study over a 5-year period in two major tertiary hospitals in the Romanian capital with the aim to characterize the clinical picture and the dynamics of liver function tests in children with confirmed adenovirus infection. The study included 1416 children with a median age of 1.1 years (IQR: 0.3, 2.3 years). Digestive symptoms were predominant in 95.2% of children, mainly diarrhea (90.5%) and vomiting (50.5%), and 38.0% had respiratory symptoms. Increased transaminases were identified in 21.5% of patients. Age over 1 year, lethargy, vomiting and dehydration significantly increased the odds of liver cytolysis independent of other risk factors such as chronic conditions or co-infections. Aspartate aminotransferase (AST) was more commonly increased compared to alanine aminotransferase (ALT). Only six children had transaminase increases above 500 U/L, three of which had co-infections with rotavirus, Epstein-Barr virus (EBV), or respiratory syncytial virus (RSV). Liver function tests should be part of routine monitoring for pediatric patients with adenovirus infection. The current study fills a gap in current knowledge related to the frequency and the extent of liver involvement in human adenovirus infection among pediatric patients.
    Language English
    Publishing date 2023-01-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2720891-6
    ISSN 2076-2607
    ISSN 2076-2607
    DOI 10.3390/microorganisms11020302
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  8. Article: Therapeutic developments for SARS-CoV-2 infection-Molecular mechanisms of action of antivirals and strategies for mitigating resistance in emerging variants in clinical practice.

    Săndulescu, Oana / Apostolescu, Cătălin Gabriel / Preoțescu, Liliana Lucia / Streinu-Cercel, Adrian / Săndulescu, Mihai

    Frontiers in microbiology

    2023  Volume 14, Page(s) 1132501

    Abstract: This article systematically presents the current clinically significant therapeutic developments for the treatment of COVID-19 by providing an in-depth review of molecular mechanisms of action for SARS-CoV-2 antivirals and critically analyzing the ... ...

    Abstract This article systematically presents the current clinically significant therapeutic developments for the treatment of COVID-19 by providing an in-depth review of molecular mechanisms of action for SARS-CoV-2 antivirals and critically analyzing the potential targets that may allow the selection of resistant viral variants. Two main categories of agents can display antiviral activity: direct-acting antivirals, which act by inhibiting viral enzymes, and host-directed antivirals, which target host cell factors that are involved in steps of the viral life cycle. We discuss both these types of antivirals, highlighting the agents that have already been approved for treatment of COVID-19, and providing an overview of the main molecules that are currently in drug development. Direct-acting antivirals target viral enzymes that are essential in the viral life cycle. Three direct-acting antivirals are currently in use: two are nucleoside analogs that inhibit the RNA-dependent RNA polymerase of SARS-CoV-2, i.e., remdesivir and molnupiravir, and the third one, nirmatrelvir/ritonavir, is an inhibitor of SARS-CoV-2 main protease. The potential for induction of viral resistance is discussed for each of these antivirals, along with their clinical activity on each of the SARS-CoV-2 variants and sublineages that have been dominant over the course of the pandemic, i.e., Alpha, Delta, as well as Omicron and its sublineages BA.1, BA.2, BA.5, BQ.1 and XBB. Host-directed antivirals are currently in preclinical or clinical development; these agents target host cell enzymes that are involved in facilitating viral entry, replication, or virion release. By blocking these enzymes, viral replication can theoretically be effectively stopped. As no SARS-CoV-2 host-directed antiviral has been approved so far, further research is still needed and we present the host-directed antivirals that are currently in the pipeline. Another specific type of agents that have been used in the treatment of COVID-19 are neutralizing antibodies (NAbs). Their main binding site is the spike protein, and therefore their neutralization activity is influenced by mutations occurring in this region. We discuss the main changes in neutralization activity of NAbs for the most important dominant SARS-CoV-2 variants. Close monitoring of emerging variants and sublineages is still warranted, to better understand the impact of viral mutations on the clinical efficiency of antivirals and neutralizing antibodies developed for the treatment of COVID-19.
    Language English
    Publishing date 2023-03-02
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2587354-4
    ISSN 1664-302X
    ISSN 1664-302X
    DOI 10.3389/fmicb.2023.1132501
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  9. Article ; Online: Prevalence of undiagnosed hepatitis B virus infection in patients with COVID-19A single center retrospective study.

    Săndulescu, Oana / Streinu-Cercel, Anca / Miron, Victor Daniel / Apostolescu, Cătălin Gabriel / Nițescu, Maria / Drăgănescu, Anca Cristina / Streinu-Cercel, Adrian

    Medicine

    2022  Volume 101, Issue 45, Page(s) e31385

    Abstract: At its onset, the coronavirus disease 2019 (COVID-19) pandemic brought significant challenges to healthcare systems, changing the focus of medical care on acute illness. Disruptions in medical service provision have impacted the field of viral hepatitis, ...

    Abstract At its onset, the coronavirus disease 2019 (COVID-19) pandemic brought significant challenges to healthcare systems, changing the focus of medical care on acute illness. Disruptions in medical service provision have impacted the field of viral hepatitis, with screening programs paused throughout much of 2020 and 2021. We performed a retrospective study on consecutive outpatients with COVID-19 during the second and third wave of COVID-19 in Romania, from November 2020 to April 2021, aiming to characterize the prevalence of undiagnosed hepatitis B virus (HBV) infection among patients presenting with acute illness. Overall, 522 patients had available records during the study timespan. Their mean ± standard deviation age was 51 ± 13 years; 274 (52.5%) were male. We identified 16 (3.1%) cases of active HBV infection; only six of these patients were aware of their HBV status, and 3 of the newly diagnosed cases were identified as candidates for HBV treatment. A total of 96 patients (18.4%) had serological markers suggestive for prior HBV vaccination. A large proportion of patients (n = 120, 23.0%) had positive HBV core antibodies; among these, 90 (17.2%) had cleared a previous HBV infection (being positive for HBV surface antibodies and HBV core antibodies). We identified the following parameters that were significantly more frequent in patients with a history of HBV infection: older age (P < .001), hypoalbuminemia (P = .015), thrombocytopenia (P < .001), thrombocytopenia followed by thrombocytosis (P = .041), increased blood urea nitrogen (P < .001) and increased creatinine (P = .011). In conclusion, the COVID-19 pandemic has taught us essential lessons about the importance of maintaining access to screening programs and of ensuring active monitoring of patients with chronic infections such as hepatitis B, even during a medical crisis.
    MeSH term(s) Humans ; Male ; Adult ; Middle Aged ; Female ; Hepatitis B virus ; Retrospective Studies ; Prevalence ; COVID-19/diagnosis ; COVID-19/epidemiology ; Pandemics ; Acute Disease ; Hepatitis B/diagnosis ; Hepatitis B/epidemiology ; Hepatitis B/prevention & control ; Hepatitis B Antibodies ; Thrombocytopenia/epidemiology
    Chemical Substances Hepatitis B Antibodies
    Language English
    Publishing date 2022-11-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000031385
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  10. Article: Omicron in Infants-Respiratory or Digestive Disease?

    Drăgănescu, Anca Cristina / Miron, Victor Daniel / Săndulescu, Oana / Bilaşco, Anuţa / Streinu-Cercel, Anca / Sandu, Roxana Gabriela / Marinescu, Adrian / Gunșahin, Deniz / Hoffmann, Karina Ioana / Horobeț, Daria Ștefana / Pițigoi, Daniela / Streinu-Cercel, Adrian / Pleșca, Doina Anca

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 3

    Abstract: The Omicron variant of SARS-CoV-2 has caused a large number of cases and hospitalizations in the pediatric population. Infants due to their age are susceptible to viral infections that may have a worse prognosis. Therefore, the aim of the current study ... ...

    Abstract The Omicron variant of SARS-CoV-2 has caused a large number of cases and hospitalizations in the pediatric population. Infants due to their age are susceptible to viral infections that may have a worse prognosis. Therefore, the aim of the current study has been to characterize the clinical features and the outcome of infants hospitalized with confirmed SARS-CoV-2 infection during the Omicron wave. We conducted a retrospective study of all consecutive infants hospitalized with symptomatic COVID-19 and no other co-infections, from January to September 2022 in one of the largest infectious diseases hospitals from Bucharest, Romania. A total of 613 infants were included in the analysis. The median age was 5 months (IQR: 3, 8 months). The clinical features were dominated by fever (96.4%), cough (64.8%) and loss of appetite (63.3%), and overall, respiratory symptoms were the most numerous (76.0%). Infants between 1-3 months old had a 1.5-fold increased risk of elevated alanine aminotransferase (ALT) values, and a longer length of hospitalization as compared to older infants. Infants between 7-9 months of age had 1.5-fold higher odds of loss of appetite, 1.7-fold more frequent cough and 1.6-fold more frequent digestive symptoms compared to infants in other age groups. The presence of digestive symptoms increased the probability of hepatic cytolysis (increased ALT) by 1.9-fold. Continued monitoring of COVID-19 among infants is very necessary, given the progressive character of SARS-CoV-2, in order to take correct and rapid therapeutic measures and to adapt to clinical changes driven by viral variant change.
    Language English
    Publishing date 2023-01-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13030421
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