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Article: Simultaneous Determination of Two Tyrosine Kinase Inhibitors in Tablets by HPLC-MS analysis.

Croitoru, Daniela Maria / Manda, Costel-Valentin / Neamţu, Johny / Biţă, Andrei / Croitoru, Octavian / Stancu, Sofia Teodora / Neamţu, Simona-Daniela

Current health sciences journal

2022 Volume 48, Issue 1, Page(s) 75–80

Abstract: The class of tyrosine kinase inhibitors (TKIs) is represented by a group of compounds which are currently used in the treatment of different types of cancer. These oral medicines present a narrow therapeutic index and a large inter-and intra-individual ... ...

Abstract	The class of tyrosine kinase inhibitors (TKIs) is represented by a group of compounds which are currently used in the treatment of different types of cancer. These oral medicines present a narrow therapeutic index and a large inter-and intra-individual variability. Within this work, a simple, accurate and rapid reversed phase ultra-high-performance liquid chromatographic (RP-UHPLC) method with mass spectrometric (MS) detection for simultaneous analysis of two TKIs, ibrutinib and ruxolitinib, using pentoxifylline as internal standard (IS) in tablet dosage forms is presented. The separation was carried out on a Waters (Milford, Massachusetts, USA) Arc System coupled with a Waters QDa mass detector. The column used was a Waters CORTECS C18 (4.6×50mm, 2.7μm); a gradient elution was carried out using a mixture of ammonium formate 10 mM aqueous solution and acetonitrile. The flow rate of the mobile phase was set to 0.5mL/min. The column temperature was equilibrated to 40°C. The injected volume was 5μL. All samples were kept at 20°C during the entire analysis. Mass spectra were recorded in positive ionization mode in the range of m/z 100-400 for ruxolitinib and m/z 100-500 for ibrutinib. Quantification was established in single ion recording (SIR) mode for each compound, using pentoxifylline as internal standard. The method was validated according to International Guidelines in terms of stability, limit of detection, limit of quantitation, linearity, precision and accuracy. The validated method can be successfully applied for simultaneous determination of TKIs in tablet dosage forms.
Language	English
Publishing date	2022-03-31
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2708703-7
ISSN	2069-4032 ; 2067-0656
ISSN (online)	2069-4032
ISSN	2067-0656
DOI	10.12865/CHSJ.48.01.11
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Intraplacental Villous Artery Doppler can Improve the Ability to Predict Placenta-Mediated Disease.

Tudor, Adriana / Novac, Liliana / Camen, Ioana Victoria / Manolea, Maria Magdalena / Vrabie, Sidonia Catalina / Sandulescu, Maria Sidonia / Șerbănescu, Mircea-Sebastian / Boldeanu, Mihail Virgil / Neamțu, Simona Daniela / Istrate Ofițeru, Anca Maria / Dijmarescu, Anda Lorena / Novac, Marius Bogdan

Current health sciences journal

2023 Volume 49, Issue 1, Page(s) 96–101

Abstract: Objective: Evaluation of Intraplacental Villous Artery Doppler (IPVA) as a predictive factor compared to umbilical artery (UA) Doppler in placenta-mediated disease (PMD).: Methods: This prospective study included a group of 106 pregnant women, of ... ...

Abstract	Objective: Evaluation of Intraplacental Villous Artery Doppler (IPVA) as a predictive factor compared to umbilical artery (UA) Doppler in placenta-mediated disease (PMD). Methods: This prospective study included a group of 106 pregnant women, of which 76 patients constituted the PMD group: preeclampsia (PE) and small for gestational age (SGA), and 30 pregnant women constituted the control group. IPVA and UA Doppler evaluation was performed in 2 pregnancy periods: 20.0-23.6 weeks, and 28.0-32.6 weeks of gestation. Results: From the study of maternal characteristics and risk factors for the presented pathology, we found that no studied risk factor was statistically involved in the evolution toward PMD during pregnancy. In the control group, we noticed a decrease in IPVA PI and RI, along with an increase in gestational age, while in the PMD group, these indices increased. Both in the 2nd and the 3rd trimester, we had a significant statistical difference between the two groups (p<0.001). Regarding the degree of prediction of the changes that occurred at this level, we found a good statistical correlation. A higher degree of positive predictability is noted, for IPVA-PI, but also for UA-PI, but with better sensitivity (72.27%) for UA PI in the 2nd trimester. Conclusions: We can conclude that both Doppler measurements, IPVA and UA can be used to evaluate and detect pregnancy complications that belong to PMD, preeclampsia, and/or fetal growth restriction.
Language	English
Publishing date	2023-03-31
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2708703-7
ISSN	2069-4032 ; 2067-0656
ISSN (online)	2069-4032
ISSN	2067-0656
DOI	10.12865/CHSJ.49.01.96
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Article ; Online: Clinical and morphopathological assay in vulvovaginal candidiasis.

Manolea, Maria Magdalena / Istrate-Ofiţeru, Anca Maria / Săndulescu, Maria Sidonia / Camen, Ioana Victoria / Piciu, Ionel Alin / Dijmărescu, Anda Lorena / Vrabie, Sidonia Cătălina / Neamţu, Simona Daniela / Obleagă, Cosmin Vasile / Siminel, Mirela Anişoara

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie

2023 Volume 63, Issue 3, Page(s) 511–520

Abstract: Candida vulvovaginitis is characterized by the appearance of inflammatory changes in the vaginal and vulvar epithelium secondary to infection with Candida species. The purpose of this study was to analyze and compare the clinical, microbiological, and ... ...

Abstract	Candida vulvovaginitis is characterized by the appearance of inflammatory changes in the vaginal and vulvar epithelium secondary to infection with Candida species. The purpose of this study was to analyze and compare the clinical, microbiological, and histopathological aspects of pregnant and non-pregnant patients, symptomatic or asymptomatic in the case of candida vaginitis and to correlate the microscopic aspects with the symptoms before applying the local treatment with Nystatin. The study presents a retrospective analysis of the management of vaginitis in 166 pregnant or non-pregnant patients during 2021-2022. We observed the structure of the Malpighian squamous epithelium without keratinization present on the vaginal mucosa and the structure of the subepithelial connective tissue, which shows increased numerical values of inflammatory and vascular cellularity in the case of candida vaginitis symptomatic compared to asymptomatic ones. We noticed also in the microscopic study that in cases of asymptomatic patients before treatment, the number of inflammatory cells and blood vessels situated immediately under the epithelium was significantly lower compared to their number in symptomatic patients before treatment. Analyzing the results obtained after the administration of the treatment proposed by us, we can say that local Nystatin treatment is beneficial and safe for pregnant and non-pregnant patients and is a good alternative for patients with recurrent vulvovaginal candidiasis.
MeSH term(s)	Female ; Humans ; Candidiasis, Vulvovaginal/drug therapy ; Candidiasis, Vulvovaginal/diagnosis ; Candidiasis, Vulvovaginal/microbiology ; Nystatin/pharmacology ; Nystatin/therapeutic use ; Retrospective Studies ; Neoplasm Recurrence, Local ; Vagina
Chemical Substances	Nystatin (1400-61-9)
Language	English
Publishing date	2023-01-19
Publishing country	Romania
Document type	Journal Article
ZDB-ID	1062519-7
ISSN	2066-8279 ; 1220-0522 ; 0035-4007
ISSN (online)	2066-8279
ISSN	1220-0522 ; 0035-4007
DOI	10.47162/RJME.63.3.05
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Article ; Online: Impact of COVID-19 on fertility and assisted reproductive technology (ART): a systematic review.

Săndulescu, Maria Sidonia / Văduva, Constantin Cristian / Siminel, Mirela Anişoara / Dijmărescu, Anda Lorena / Vrabie, Sidonia Cătălina / Camen, Ioana Victoria / Tache, Daniela Elise / Neamţu, Simona Daniela / Nagy, Rodica Daniela / Carp-Velişcu, Andreea / Manolea, Maria Magdalena

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie

2023 Volume 63, Issue 3, Page(s) 503–510

Abstract: The appearance of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a major obstacle for the performing of current medical activities throughout the world. COVID-19 has affected ... ...

Abstract	The appearance of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a major obstacle for the performing of current medical activities throughout the world. COVID-19 has affected humanity in many ways, thus causing a great medical, social, economic, and political instability. The aim of this study was to make an analysis of the scientific data obtained by so far to highlight the impact that COVID-19 has had on fertility and assisted reproductive technology (ART). Infection with SARS-CoV-2 alters the normal immune response by local and systemic damage to tissues and organs. After the virus enters the body, the first lesions are produced in the respiratory tract. Extrapulmonary lesions specific to COVID-19 include acute renal lesions/acute kidney damage, hepatocellular lesions, neurological diseases, myocardial dysfunction and arrhythmia, gastrointestinal diseases but also genital impairment. The possible impairment of the male reproductive system is because angiotensin-converting enzyme 2 (ACE2) receptors are in an increased number in the testes, seminiferous duct cells, spermatogonia, Leydig cells and Sertoli cells. Many published studies to date have pointed out that COVID-19 could also affect female fertility and disrupt the functions of the female reproductive system. The theory that this virus can also be transmitted sexually and can cause infertility or testicular damage is supported by the fact that the virus can be isolated in the semen of COVID-19 patients but only during the disease. Choosing the best method of treating infertility during the COVID-19 pandemic is multifactorial, but the risk of infection and compliance with specific ART hygiene protocols must always be considered. Currently, there is no scientific basis regarding the fact that the COVID-19 vaccination would influence fertility.
MeSH term(s)	Humans ; Male ; Female ; COVID-19/complications ; SARS-CoV-2 ; Pandemics ; COVID-19 Vaccines ; Peptidyl-Dipeptidase A ; Fertility ; Infertility
Chemical Substances	COVID-19 Vaccines ; Peptidyl-Dipeptidase A (EC 3.4.15.1)
Language	English
Publishing date	2023-01-19
Publishing country	Romania
Document type	Systematic Review ; Journal Article
ZDB-ID	1062519-7
ISSN	2066-8279 ; 1220-0522 ; 0035-4007
ISSN (online)	2066-8279
ISSN	1220-0522 ; 0035-4007
DOI	10.47162/RJME.63.3.04
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Article: The Analysis of Blood Inflammation Markers as Prognostic Factors in Parkinson's Disease.

Stanca, Iulia-Diana / Criciotoiu, Oana / Neamtu, Simona-Daniela / Vasile, Ramona-Constantina / Berceanu-Bora, Nicoleta-Madalina / Minca, Teodora-Nicoleta / Pirici, Ionica / Rosu, Gabriela-Camelia / Bondari, Simona

Healthcare (Basel, Switzerland)

2022 Volume 10, Issue 12

Abstract: Parkinson’s disease is a chronic, progressive, and neurodegenerative disease, and yet with an imprecise etiopathogenesis. Although neuroinflammation was initially thought to be a secondary condition, it is now believed that microglia-induced inflammation ...

Abstract	Parkinson’s disease is a chronic, progressive, and neurodegenerative disease, and yet with an imprecise etiopathogenesis. Although neuroinflammation was initially thought to be a secondary condition, it is now believed that microglia-induced inflammation could also contribute to the degeneration of the nigrostriatal pathway. Here, we aimed to establish the feasibility of basic inflammatory biomarkers as prognostic factors in PD. The study was based on retrospective analyses of blood samples taken from patients diagnosed with PD, as well as from healthy subjects. Complete medical records, total leukocyte count with subpopulations, and erythrocyte sedimentation rate (ESR) were analyzed. We calculated the serum neutrophils-to-lymphocytes ratio (NLR) and platelet-to lymphocytes ratio (PLR), and also compared the laboratory data between the PD group and the control group. Only PLR and NLR showed statistically significant differences (p < 0.001 and 0.04, respectively). In our study, ESR did not show statistically significant correlations with motor score or with disability. In our research, ESR was correlated with the disease duration (p = 0.04), and PLR showed a significant correlation with disease stage (p = 0.027) and disease duration (p = 0.001), but not with motor state. These biomarkers could prove to be effective tools for a primary evaluation of inflammation in PD, but further tests are required to properly investigate the neuroinflammatory status of these patients.
Language	English
Publishing date	2022-12-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare10122578
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Article: The Ability of Doppler Uterine Artery Ultrasound to Predict Premature Birth.

Camen, Ioana-Victoria / Manolea, Maria Magdalena / Vrabie, Sidonia Catalina / Sandulescu, Maria-Sidonia / Serbanescu, Mircea-Sebastian / Boldeanu, Mihail Virgil / Neamtu, Simona-Daniela / Istrate-Ofiteru, Anca-Maria / Dijmarescu, Anda Lorena / Novac, Marius Bogdan

Current health sciences journal

2022 Volume 48, Issue 3, Page(s) 277–283

Abstract: Objective: Demonstration of the predictive capacity of Doppler Uterine Artery (UtA) on preterm birth (PB) by serial measurement at various ages of pregnancy.: Methods: The prospective study included a group of 116 pregnant women, of whom 85 gave ... ...

Abstract	Objective: Demonstration of the predictive capacity of Doppler Uterine Artery (UtA) on preterm birth (PB) by serial measurement at various ages of pregnancy. Methods: The prospective study included a group of 116 pregnant women, of whom 85 gave birth prematurely and 31 pregnant women gave birth at term, constituting the control group. UtA Doppler measurement was performed by the abdominal approach. Quantitative wave evaluations were performed by the pulsatility index (PI), the systole/diastole ratio (S/D), as well as the qualitative analysis of the flow rate waveform (notch). UtA Doppler evaluation was performed in 3 pregnancy periods: 18.0-22.6 weeks, 28.0-31.6 weeks, and 32.0-35.6 weeks. Results: Only at the third examination, at 32.0-35.5 weeks of gestation, was there a statistically significant difference between the S/D-UtA ratio and PI-UtA correlated with the risk of premature birth (p<0.05). Although there was an association between UtA Doppler and late preterm birth, the predictive ability was low. Also, UtA Doppler was not statistically significant for preterm birth before 32 weeks of gestation. Conclusions: Although we did not find a statistical association between second-trimester UtA Doppler and preterm birth, we do suggest a closer look at women with abnormal UtA Doppler in the second trimester. We believe that, according to the results obtained, UtA Doppler can predict especially iatrogenic premature birth depending on the prediction of the most severe complications, severe preeclampsia, and SGA.
Language	English
Publishing date	2022-09-30
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2708703-7
ISSN	2069-4032 ; 2067-0656
ISSN (online)	2069-4032
ISSN	2067-0656
DOI	10.12865/CHSJ.48.03.05
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Article: Prediction of Preterm Birth with Serial Measurements of Ultrasound Markers.

Camen, Ioana Victoria / Manolea, Maria Magdalena / Vrabie, Sidonia Catalina / Sandulescu, Maria Sidonia / Serbanescu, Mircea Sebastian / Boldeanu, Mihail Virgil / Novac, Liliana / Istrate-Ofiteru, Anca Maria / Neamtu, Simona Daniela / Dijmarescu, Anda Lorena

Current health sciences journal

2022 Volume 48, Issue 2, Page(s) 162–168

Abstract: To compare the ability of cervical length (CL), anterior cervical angle (ACA), and cervical consistency index (CCI) to predict premature birth.: Methods: This prospective study involved 85 pregnant women who gave birth prematurely and a control group ... ...

Abstract	To compare the ability of cervical length (CL), anterior cervical angle (ACA), and cervical consistency index (CCI) to predict premature birth. Methods: This prospective study involved 85 pregnant women who gave birth prematurely and a control group of 31 pregnant women who gave birth at term. The study was performed in the Obstetrics and Gynecology Clinic of the Municipal Clinical Hospital Filanthropia Craiova between January 1, 2019, and January 1, 2022. Cases were examined using transvaginal ultrasonography (TVU) in the second and third trimesters of pregnancy, and cervical length (CL), Anterior Cervical Angle (ACA), and Cervical Consistency Index (CCI) were measured. Results: The mean value from the three measurements at all three parameters was statistically significant with preterm birth (p<0.05). Cervical length <25mm, was highly significant in the prediction of preterm labor with a sensitivity of 99%, specificity of 61%, positive predictive value (PPV) of 78%, negative predictive value (NPV) of 97 %, and a positive likelihood ratio (LR+) of 2.54 and negative likelihood ratio (LR-) of 0.02. CCI also remains, despite low specificity and PPV values, a potential predictive parameter in the prediction of preterm birth, with a sensitivity of 73%, NPV of 92% and a LR+of 1.32 and LR- of 0.6 also correlated with CL, CCI being more difficult to interpret as an independent predictive parameter. Conclusions: CL remains the standard parameter for predicting the preterm birth, but in combination with other parameters, the prediction rate can increase significantly.
Language	English
Publishing date	2022-06-30
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2708703-7
ISSN	2069-4032 ; 2067-0656
ISSN (online)	2069-4032
ISSN	2067-0656
DOI	10.12865/CHSJ.48.02.04
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Article ; Online: The procoagulant status. Hypercoagulability as a risk factor of primary and secondary infertility.

Neamţu, Simona Daniela / Stanca, Liliana / Siminel, Mirela Anişoara / Neamţu, Adela Valeria / Gluhovschi, Adrian / Mateescu, Garofiţa Olivia / Dijmărescu, Anda Lorena / Săndulescu, Maria Sidonia / Istrate-Ofiţeru, Anca Maria / Trăistaru, Magdalena Rodica

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie

2022 Volume 62, Issue 3, Page(s) 829–834

Abstract: Thrombophilia is a disorder that makes patients susceptible to intravascular thrombosis that may increase the risk of developing a pregnancy on a known pathology. The female patient diagnosed with hypoplastic uterus and hereditary thrombophilia had a ... ...

Abstract	Thrombophilia is a disorder that makes patients susceptible to intravascular thrombosis that may increase the risk of developing a pregnancy on a known pathology. The female patient diagnosed with hypoplastic uterus and hereditary thrombophilia had a favorable evolution under properly administered anticoagulant treatment. The homozygous status for the C677T mutation may lead to an increase in plasma homocysteine levels, especially in pregnant women, being an associated risk factor for thrombosis. The risk of developing intravascular thrombosis requires primary prevention measures by adding D-dimers in the early diagnostic algorithm, being the most accurate marker of hypercoagulability and endogenous fibrinolysis. The corroboration of the hypercoagulability status with the results of genotyping, the frequencies of the minor/major alleles studied, single mononucleotide polymorphisms (SNPs) and the establishment of preventive therapy, aims to prevent intravascular thrombosis and thromboembolic phenomena.
MeSH term(s)	Alleles ; Female ; Humans ; Infertility/complications ; Infertility/genetics ; Pregnancy ; Risk Factors ; Thrombophilia/complications ; Thrombosis/complications
Language	English
Publishing date	2022-03-09
Publishing country	Romania
Document type	Journal Article
ZDB-ID	1062519-7
ISSN	2066-8279 ; 1220-0522 ; 0035-4007
ISSN (online)	2066-8279
ISSN	1220-0522 ; 0035-4007
DOI	10.47162/RJME.62.3.21
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Article ; Online: The perioperative effect of anesthetic drugs on the immune response in total intravenous anesthesia in patients undergoing minimally invasive gynecological surgery.

Novac, Marius Bogdan / Boldeanu, Lidia / Rotaru, Luciana Teodora / Dijmărescu, Anda Lorena / Şerbănescu, Mircea Sebastian / Radu, Lucreţiu / Neamţu, Simona Daniela / Vîlcea, Alina Maria / Niculescu, Mihaela / Mirea, Cecil Sorin / Boldeanu, Mihail Virgil / Manolea, Maria Magdalena

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie

2022 Volume 62, Issue 4, Page(s) 961–969

Abstract: Background: The specific mechanism of action of each anesthetic drug on the immune system is still incompletely known. It is important to know how the various anesthetics used in minimally invasive surgery (MIS) act on the inflammatory response because ... ...

Abstract	Background: The specific mechanism of action of each anesthetic drug on the immune system is still incompletely known. It is important to know how the various anesthetics used in minimally invasive surgery (MIS) act on the inflammatory response because the choice of the anesthetic agent can influence the patient's immune system. Aim: Evaluation of the effect of anesthetic drugs used for total intravenous anesthesia (Propofol and Midazolam) on the inflammatory response after minimally invasive gynecological surgery. Patients, materials and methods: The inflammatory response in 20 female patients who underwent minimally invasive gynecological surgery under which intravenous anesthesia was performed. Depending on the combination of anesthetics used, we subdivided the study group into two groups, Group 1 consisting of the patients (n=10) who were given for total intravenous anesthesia, the combination with Midazolam+Fentanyl, and Group 2 (n=10) the patients who received the combination of Propofol+Fentanyl, respectively. Surgical interventional procedures included day surgery: diagnostic and operative hysteroscopy, endometrial ablation, surgical treatment of vulvar disorders. Serological profiling of patients was performed by dosing the serum concentration of nucleotide-binding domain (NOD) and leucine-rich repeat protein 3 (NLRP3) inflammasomes, interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), IL-10 before and two hours after the surgical procedure. Results: In our study, we found that in both groups of patients (Midazolam+Fentanyl - Group 1, Propofol+Fentanyl - Group 2), NLRP3 and cytokines concentrations in the serum were higher after MIS than those before MIS. Conclusions: It appears that both Midazolam and Fentanyl and Propofol and Fentanyl have an immunomodulatory action due to the anti-inflammatory effect of both anesthetics. Therefore, anesthesiologists must choose an anesthetic method that uses individualized anesthetic agents, depending on the patient's immune status and disease.
MeSH term(s)	Anesthesia, Intravenous/methods ; Anesthetics, Intravenous/pharmacology ; Female ; Fentanyl/pharmacology ; Fentanyl/therapeutic use ; Gynecologic Surgical Procedures ; Humans ; Immunity ; Midazolam/pharmacology ; Midazolam/therapeutic use ; Minimally Invasive Surgical Procedures ; NLR Family, Pyrin Domain-Containing 3 Protein ; Propofol/pharmacology ; Propofol/therapeutic use
Chemical Substances	Anesthetics, Intravenous ; NLR Family, Pyrin Domain-Containing 3 Protein ; Midazolam (R60L0SM5BC) ; Fentanyl (UF599785JZ) ; Propofol (YI7VU623SF)
Language	English
Publishing date	2022-06-07
Publishing country	Romania
Document type	Journal Article
ZDB-ID	1062519-7
ISSN	2066-8279 ; 1220-0522 ; 0035-4007
ISSN (online)	2066-8279
ISSN	1220-0522 ; 0035-4007
DOI	10.47162/RJME.62.4.08
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Article ; Online: Fetal-maternal incompatibility in the Rh system. Rh isoimmunization associated with hereditary spherocytosis: case presentation and review of the literature.

Neamţu, Simona Daniela / Novac, Marius Bogdan / Neamţu, Adela Valeria / Stanca, Iulia Diana / Boldeanu, Mihail Virgil / Gluhovschi, Adrian / Stanca, Liliana / Dijmărescu, Anda Lorena / Manolea, Maria Magdalena / Trăistaru, Magdalena Rodica / Mateescu, Garofiţa Olivia / Siminel, Mirela Anişoara

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie

2022 Volume 63, Issue 1, Page(s) 229–235

Abstract: Next to A and B antigens, agglutinogen D exhibits the highest immunogenicity. Following the transfusion of D-positive red blood cells (RBCs), almost 80% of D-negative recipients develop anti-D antibodies (Abs). Subsequently, anti-D immunization further ... ...

Abstract	Next to A and B antigens, agglutinogen D exhibits the highest immunogenicity. Following the transfusion of D-positive red blood cells (RBCs), almost 80% of D-negative recipients develop anti-D antibodies (Abs). Subsequently, anti-D immunization further promotes the synthesis of Abs towards other blood group antigens in or outside the Rh system. The D antigen is also involved in 95% of cases of hemolytic disease of the newborn. Transfusions, hemotherapy, grafts, and obstetric history (abortions, ectopic pregnancy, births) are all risk factors for Rh isoimmunization. In the case of ABO compatibility between mother and fetus, Rh-positive fetal RBCs that have reached the maternal bloodstream are not destroyed by group agglutinins, and Rh antigenic sites are not hidden by the maternal immune system. But a Rh-negative mother with a homozygous Rh-positive husband will certainly have a Rh-positive fetus. As it has an irreversible evolution, the Rh isoimmunization once installed cannot be influenced in the sense of decreasing the Ab titer, therefore, injectable globulin has no effect. A particular case was that of a newborn with Rh system incompatibility associated with hereditary spherocytosis The clinical balance at birth reflects the severe jaundice of the female newborn of 3140 g, gestational age 38∕39 weeks, extracted by lower-segment transverse Caesarean section, with a double loop nuchal cord, Apgar score 8. Because the jaundice was severe and atypical (face and upper chest), we considered the possibility of coexistence of hemolytic disease of the newborn by Rh blood group incompatibility associated with hereditary spherocytosis, as it turned out to be true and mentioned. Changes in genes encoding proteins in the structure of the RBC membrane have amplified hemolysis induced by maternal-fetal isoimmunization in the Rh system. Massive hemolysis accentuated by congenital spherocytosis, confirmed later, imposed blood transfusion and dynamic monitoring.
MeSH term(s)	Blood Group Incompatibility/complications ; Cesarean Section ; Female ; Hemolysis ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Pregnancy ; Pregnancy Complications ; Rh Isoimmunization/prevention & control
Language	English
Publishing date	2022-09-06
Publishing country	Romania
Document type	Journal Article ; Review
ZDB-ID	1062519-7
ISSN	2066-8279 ; 1220-0522 ; 0035-4007
ISSN (online)	2066-8279
ISSN	1220-0522 ; 0035-4007
DOI	10.47162/RJME.63.1.26
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