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Article ; Online: New insights regarding Helicobacter pylori infection in children

Andreea Ligia Dinca / Lorena Elena Melit / Cristina Oana Marginean

Romanian Journal of Pediatrics, Vol 71, Iss 3, Pp 126-

2022 Volume 133

Abstract: Helicobacter pylori (H. pylori) are one of the most common infections during childhood, and if left untreated it might persist lifelong resulting in severe complications such as gastric malignancies. The epidemiology of this infection has wide variations ...

Abstract	Helicobacter pylori (H. pylori) are one of the most common infections during childhood, and if left untreated it might persist lifelong resulting in severe complications such as gastric malignancies. The epidemiology of this infection has wide variations along the continents, countries and sub-regions being related mainly to the socio-economic status, hygiene and sanitary conditions. Nevertheless, a descending trend of H. pylori prevalence was noticed worldwide during the last decades, fact that might decrease in time the incidence of gastric cancer in adults. The diagnosis of this infection remains tricky in children and the selection of the most effective diagnostic tool is essential in order to early diagnose H. pylori associated gastropathies and extraintestinal manifestations. In spite of the lack of symptoms which occurs especially in pediatric subjects, H. pylori infection might result in severe damage to the gastric mucosa and further complications requiring close monitoring after the eradication regimen. Therefore, multiple non-invasive and invasive methods were designed to identify properly the presence of this bacterium within the individual’s stomach and for enabling the clinician to use to most adequate method based on its sensitivity and specificity, but also based on the specific clinical situations. Aside from the well-known standard triple therapy used for the eradication of this infection, multiple other regimens were lately proposed in order to prevent failure of eradication. Moreover, probiotics were recently proved to improve the eradication rate, and at the same time to decrease the side effects of the antibiotics therapy. The proper eradication of H. pylori infection during childhood remains the cornerstone in preventing gastric cancer during adulthood.
Keywords	helicobacter pylori infection ; children ; diagnosis ; treatment ; Medicine ; R ; Pediatrics ; RJ1-570
Subject code	610
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The importance of SARS-CoV-2 testing in pediatric population

Rodica Demenciuc / Lorena Elena Melit / Tudor Fleseriu / Cristina Oana Marginean

Romanian Journal of Pediatrics, Vol 71, Iss 2, Pp 69-

2022 Volume 72

Abstract: Pediatric population associates multiple peculiarities in terms of SARS-CoV-2 regarding the differences of symptoms in comparison to adults, but also the higher incidence of asymptomatic cases. The aim of these case reports is to underline the importance ...

Abstract	Pediatric population associates multiple peculiarities in terms of SARS-CoV-2 regarding the differences of symptoms in comparison to adults, but also the higher incidence of asymptomatic cases. The aim of these case reports is to underline the importance of SARS-CoV-2 testing in pediatric patients. The first case describes the case of a 2-year and nine-month-old child admitted to the Pediatrics Clinic I Targu Mures for involuntary ingestion of toxic substance. The clinical exam pointed out a mild hyperemia of pharynx and small lymph nodes under the mandibula, on the side area of the neck and above the clavicula; and the laboratory tests pointed out leukocytosis, thrombocytosis and one of the liver transaminases above the normal limit. In spite of the presentation concerns, the patient was tested for SARS-CoV-2 infection, with positive result. The evolution was favorable during the admission. The second case describes a 3-year and 8-month-old male patient brought in the emergency department with the suspicion of foreign body aspiration, but the bronchoscopy revealed only purulent secretion in the trachea and bronchia. The RTPCR test for SARS-CoV-2 infection was negative on the admission day, but due to the slowly favorable evolution, the patient was retested on the 5th day of admission, with positive result. The testing of pediatric patients independently of the symptoms and the clinical setting might carry a higher importance in limiting the viral transmission.
Keywords	sars-cov-2 infection ; test ; child ; Medicine ; R ; Pediatrics ; RJ1-570
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Yin-Yang Concept of Pediatric Obesity and Gut Microbiota

Lorena Elena Meliț / Cristina Oana Mărginean / Maria Oana Săsăran

Biomedicines, Vol 10, Iss 645, p

2022 Volume 645

Abstract: The era of pediatric obesity is no longer a myth. Unfortunately, pediatric obesity has reached alarming incidence levels worldwide and the factors that contribute to its development have been intensely studied in multiple recent and emerging studies. Gut ...

Abstract	The era of pediatric obesity is no longer a myth. Unfortunately, pediatric obesity has reached alarming incidence levels worldwide and the factors that contribute to its development have been intensely studied in multiple recent and emerging studies. Gut microbiota was recently included in the wide spectrum of factors implicated in the determination of obesity, but its role in pediatric obese patients is far from being fully understood. In terms of the infant gut microbiome, multiple factors have been demonstrated to shape its content, including maternal diet and health, type of delivery, feeding patterns, weaning and dietary habits. Nevertheless, the role of the intrauterine environment, such as the placental microbial community, cannot be completely excluded. Most studies have identified Firmicutes and Bacteroidetes as the most important players related to obesity risk in gut microbiota reflecting an increase of Firmicutes and a decrease in Bacteroidetes in the context of obesity; however, multiple inconsistencies between studies were recently reported, especially in pediatric populations, and there is a scarcity of studies performed in this age group.
Keywords	children ; obesity ; gut microbiota ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Teaching communication in medical students – a cornerstone for patient’s outcome

Nicoleta SUCIU / Lorena Elena MELIȚ / Cristina Oana MĂRGINEAN

Romanian Journal of Medical Practice, Vol 16, Iss 2, Pp 141-

2021 Volume 145

Abstract: Communication is definitely one of the most important contributing factor for an ideal doctor-patient relationship. The major importance of communication is to build a proper relationship with the patients, in which the empathy and respect play an ... ...

Abstract	Communication is definitely one of the most important contributing factor for an ideal doctor-patient relationship. The major importance of communication is to build a proper relationship with the patients, in which the empathy and respect play an essential role and can be taught and improved with proper training. This process is defined as cross-culture communication and it has to be taught during medical school. Patient-centered communication is a concept closely related to cross-culture communication and it might be defined by the physician’s ability to tailor communication to each patient’s need and level of understanding in order to provide patient-centered care. Training of clinical communication skills in medical students is an incontestable emergency for the patient’s outcome. Medical education formerly focused on training students for solving only the medical problems by providing the treatment for their organic problems. Medical schools recently included in undergraduate curricula clinical communication courses in order to improve student’s and future physician’s the ability to obtain relevant information from their patients, to build strong doctorpatient relationships and provide patient-centered care. Various models were elaborated for teaching and assessing clinical communication skills, which were found to improve multiple aspects of physician-patient communication among which counseling, interviewing techniques and prescription. Medical schools should properly address to clinical communication skills by including training courses in each year of education focused on the specific of the learned medical fields. It is crucial for implementing proper assessment methods in order to prevent and diminish as much as possible the factors that might negatively impact the development of doctor-patient relationship. Proper medical training in terms of clinical communication skills should be initiated during medical school in all students that deal with patients, but also after the graduation, periodically in ...
Keywords	teaching communication ; medical students ; patient’s outcome ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	370
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Holistic Approach of Personality Traits in Medical Students

Nicoleta Suciu / Lorena Elena Meliț / Cristina Oana Mărginean

International Journal of Environmental Research and Public Health, Vol 18, Iss 12822, p

An Integrative Review

2021 Volume 12822

Abstract: Personality is one of the most crucial aspects of human life, since it influences all human behaviours in both personal and social life, and might also trigger important conflicts with a person’s surroundings in the setting of incompatible traits and ... ...

Abstract	Personality is one of the most crucial aspects of human life, since it influences all human behaviours in both personal and social life, and might also trigger important conflicts with a person’s surroundings in the setting of incompatible traits and characteristics. It is true that ‘one must be born’ for a certain medical specialty, but several components of personality might be educated with proper training. Increased levels of Conscientiousness, Agreeableness, and Openness associated with lower levels of Neuroticism might represent the key combination for achieving professional satisfaction in the medical profession. Medical students should receive proper interprofessional education, since effective interprofessional relationships among healthcare providers definitely improve patients’ safety. Empathy contributes to effective patient–physician communication, improving patient trust, compliance, and satisfaction, being positively correlated with Openness, Agreeableness, Conscientiousness and Extraversion. Emotional intelligence—the capacity to respond to one’s own and others’ emotions—was proven to contribute, in a synergistic way with empathy, to increasing empathic ability. Clinical communication skills represent a key component in medical students in order to achieve the best patient care, and they are certainly related and/or influenced by empathy, interprofessional collaboration skills, emotional intelligence and, especially, personality traits. Taking into account the complex interactions mentioned above, the implementation of effective courses based on these concepts in medical students, intending to promote the development of clinical communication skills, represents a real emergency, since it might result in a reduction in medical errors and subsequent related deaths. A thorough understanding of students’ personality is mandatory before designing these courses in order to provide a training tailored to their personality styles.
Keywords	personality ; clinical communication ; medical students ; Medicine ; R
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Patent Ductus Venosus in an early term infant with mild respiratory distress – Case report

Maria-Andreea Racean / Laura Mihaela Suciu / Cristina Blesneac / Marian Pop / Cristina Oana Marginean

Romanian Journal of Pediatrics, Vol 72, Iss 1, Pp 41-

2023 Volume 46

Abstract: Patent ductus venosus is an extremely rare form of congenital portosystemic shunt that results in the diversion of portal blood into the systemic circulation, decreasing hepatic blood flow and increasing blood volume and toxic substances in the systemic ... ...

Abstract	Patent ductus venosus is an extremely rare form of congenital portosystemic shunt that results in the diversion of portal blood into the systemic circulation, decreasing hepatic blood flow and increasing blood volume and toxic substances in the systemic circulation. We present a clinical case of a male infant born at 37 5/7 weeks gestational age with patent ductus venosus. Because very few cases of patent ductus venosus have been reported, the prudent approach it would be to perform serial Doppler studies and laboratory tests to follow the course of the ductus venosus until closure and to intervene if the infant becomes unstable and symptomatic. The medical team decided that the conservative management in this case was a better choice, since the infant remained stable with good growth.
Keywords	patent ductus venosus ; early term infant ; respiratory distress ; Medicine ; R ; Pediatrics ; RJ1-570
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Treatment with intravenous immunoglobulin in a subclinical neonatal myocarditis – Review of the literature and a case report

Maria-Andreea Racean / Laura Mihaela Suciu / Laura Beligan / Cristina Oana Marginean

Romanian Journal of Medical Practice, Vol 18, Iss 2, Pp 55-

2023 Volume 58

Abstract: Myocarditis is an inflammatory disease of the myocardium that is associated with significant morbidity and mortality. We present the case of a male infant born at 38 weeks gestational age detected with subclinical myocarditis. The diagnosis was suggested ...

Abstract	Myocarditis is an inflammatory disease of the myocardium that is associated with significant morbidity and mortality. We present the case of a male infant born at 38 weeks gestational age detected with subclinical myocarditis. The diagnosis was suggested by the raised cardiac enzymes, small voltages on electrocardiogram and biventricular hypertrophy on echocardiography. The newborn was managed with supportive, immunomodulatory therapy, diuretics and anti-platelet agents (Aspirin). Early intravenous immunoglobulin administration may have helped to reduce morbidity and mortality, even if administration of intravenous immunoglobulin is not yet clearly established in the neonatal population.
Keywords	myocarditis ; newborn ; cardiac enzymes ; intravenous immunoglobulin ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Gastric Microenvironment—A Partnership between Innate Immunity and Gastric Microbiota Tricks Helicobacter pylori

Cristina Oana Mărginean / Lorena Elena Meliț / Maria Oana Săsăran

Journal of Clinical Medicine, Vol 10, Iss 3258, p

2021 Volume 3258

Abstract: Helicobacter pylori ( H. pylori ) carcinogenicity depends on three major factors: bacterial virulence constituents, environmental factors and host’s genetic susceptibility. The relationship between microenvironmental factors and H. pylori virulence ... ...

Abstract	Helicobacter pylori ( H. pylori ) carcinogenicity depends on three major factors: bacterial virulence constituents, environmental factors and host’s genetic susceptibility. The relationship between microenvironmental factors and H. pylori virulence factors are incontestable. H. pylori infection has a major impact on both gastric and colonic microbiota. The presence of non- H. pylori bacteria within the gastric ecosystem is particularly important since they might persistently act as an antigenic stimulus or establish a partnership with H. pylori in order to augment the subsequent inflammatory responses. The gastric ecosystem, i.e., microbiota composition in children with H. pylori infection is dominated by Streptoccocus , Neisseria , Rothia and Staphylococcus . The impairment of this ecosystem enhances growth and invasion of different pathogenic bacteria, further impairing the balance between the immune system and mucosal barrier. Moreover, altered microbiota due to H. pylori infection is involved in increasing the gastric T regulatory cells response in children. Since gastric homeostasis is defined by the partnership between commensal bacteria and host’s immune system, this review is focused on how pathogen recognition through toll-like receptors (TLRs—an essential class of pathogen recognition receptors—PRRs) on the surface of macrophages and dendritic cells impact the immune response in the setting of H. pylori infection. Further studies are required for delineate precise role of bacterial community features and of immune system components.
Keywords	gastric microbiota ; innate immunity ; Helicobacter pylori ; bacterial community ; children ; Medicine ; R
Subject code	570
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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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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Article ; Online: Metabolic Associated Fatty Liver Disease in Children—From Atomistic to Holistic

Cristina Oana Mărginean / Lorena Elena Meliț / Maria Oana Săsăran

Biomedicines, Vol 9, Iss 1866, p

2021 Volume 1866

Abstract: Non-alcoholic fatty liver disease has become the most common chronic liver disease in children due to the alarmingly increasing incidence of pediatric obesity. It is well-documented that MAFLD prevalence is directly related to an incremental increase in ... ...

Abstract	Non-alcoholic fatty liver disease has become the most common chronic liver disease in children due to the alarmingly increasing incidence of pediatric obesity. It is well-documented that MAFLD prevalence is directly related to an incremental increase in BMI. The multiple hits theory was designed for providing insights regarding the pathogenesis of steatohepatitis and fibrosis in MAFLD. Recent evidence suggested that the microbiome is a crucial contributor in the pathogenesis of MAFLD. Aside from obesity, the most common risk factors for pediatric MAFLD include male gender, low-birth weight, family history of obesity, MAFLD, insulin resistance, type 2 diabetes mellitus, obstructive sleep apnea, and polycystic ovarium syndrome. Usually, pediatric patients with MAFLD have nonspecific symptoms consisting of fatigue, malaise, or diffuse abdominal pain. A wide spectrum of biomarkers was proposed for the diagnosis of MAFLD and NASH, as well as for quantifying the degree of fibrosis, but liver biopsy remains the key diagnostic and staging tool. Nevertheless, elastography-based methods present promising results in this age group as potential non-invasive replacers for liver biopsy. Despite the lack of current guidelines regarding MAFLD treatment in children, lifestyle intervention was proven to be crucial in the management of these patients.
Keywords	children ; obesity ; MAFLD ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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