Ana Maria Pitea

Latest posts by Ana Maria Pitea (see all)

Recent acquisitions in imaging diagnosis of digestive disorders in children - 29/07/2015
ACHIZITII RECENTE IN DIAGNOSTICUL IMAGISTIC AL BOLILOR DIGESTIVE LA COPIL - 29/07/2015
A case of Stevens Johnson syndrome in child - 29/07/2015

Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Recent acquisitions in imaging diagnosis of digestive disorders in children

Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

Cristina Oana Mărginean, Ana Maria Pitea, Maria Despina Baghiu, Klara Brinzaniuc and Claudiu Mărginean

REZUMAT

Elastography is a new imaging method based on ultrasounds, which allows the assessment of the tissues structure in terms of their stiffness, being useful in the exploration of different organs and systems, having more and more clinical applications. The development of the contrast agents of second generation led to the amplification of the ultrasound signals using the microbubbles, which can not cross the vascular wall and are eliminated through exhalation within 15 minutes.

Material and methods. We present the results of a prospective study conducted in our Clinic, assessing the performance of the ARFI method (”Acustic Radiation Force Imaging”) in the assessment of the liver elasticity in children and we present some pediatric cases in which the ultrasound with contrast has brought real benefits, making it easier to diagnose and facilitate optimal therapeutic decisions.

Key words: imagistic diagnosis, elastography, contrast, digestive, child

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Cristina Oana Mărginean

ACHIZITII RECENTE IN DIAGNOSTICUL IMAGISTIC AL BOLILOR DIGESTIVE LA COPIL

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Cristina Oana Mărginean, Ana Maria Pitea, Maria Despina Baghiu, Klara Brinzaniuc and Claudiu Mărginean

REZUMAT

Elastografia este o nouă metodă imagistică bazată pe ultrasunete, care permite evaluarea structurii ţesuturilor în ceea ce priveşte rigiditatea lor, fiind utilă în explorarea diferitelor organe şi sisteme şi cu tot mai multe aplicaţii clinice. Dezvoltarea substanţelor de contrast de generaţia a doua a dus la amplificarea semnalului ecografic cu ajutorul microbulelor, care nu pot străbate peretele vascular şi care se elimină prin exhalare în 15 minute.

Material şi metode. Prezentăm rezultatele unui studiu prospectiv derulat în clinica noastră, evaluând performanţele metodei ARFI (impulsul de difuzie a forţei acustice) în evaluarea elasticităţii ficatului la copii; prezentăm şi câteva cazuri pediatrice în care ecografia cu contrast a adus reale beneficii, uşurând diagnosticul şi facilitând luarea deciziilor terapeutice optime.

Cuvinte cheie: diagnostic imagistic, elastografie, contrast, digestiv, copil

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Cristina Oana Mărginean

A case of Stevens Johnson syndrome in child

Revista Romana de PEDIATRIE | Volumul LXI, Nr. 2, An 2012

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Cristina Oana Mărginean, Maria Despina Baghiu, Carmen Duicu, Ana Maria Pitea and Claudiu Mărginean

ABSTRACT

We present a 9-year-old boy with epilepsy refractory to previous treatment diagnosed with Stevens Johnson syndrome appeared after the introduction of Lamictal in treatment. The boy had fever, polymorphous exanthema, papulopustular erythematous, bullous generalized vesiculobullous elements and skin denudation, conjunctivitis, mouth lesions. We have interpreted the associated pneumonia as a damage of a lower respiratory tract mucous membranes within Stevens Johnson syndrome. The evolution of the disease was favourable after high doses of Ig IV (intravenous immunoglobulin). In conclusion, even if the Steven Johnson syndrome incidence is low in children, pediatricians should be aware of the possibility of its reggresion (even after antiepileptics - Lamictal), and even if the use of Ig IV is controversial, it leads to healing when is given in high doses.

Key words: Stevens Johnson syndrome, child, epilepsy, Lamotrigine (Lamictal)

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Cristina Oana Mărginean

UN CAZ DE SINDROM STEVENS JOHNSON LA COPIL

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

ICMJE- Recommendations

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Promoting Global Health

Cristina Oana Mărginean, Maria Despina Baghiu, Carmen Duicu, Ana Maria Pitea and Claudiu Mărginean

REZUMAT

Prezentăm cazul unui băiat de 9 ani cu epilepsie refractară la tratamentul anterior, diagnosticat cu sindrom Stevens Johnson apărut după introducerea în tratament a Lamictalului. Băiatul a prezentat febră, exantem polimorf maculo-papulo-eritematos, cu elemente veziculo buloase generalizate şi denudare tegumentară, conjunctivită, leziuni bucale. Pneumonia asociata am interpretat-o ca afectare a mucoasei tractului respirator inferior din cadrul sindromului Stevens Johnson. Evoluţia bolii a fost favorabilă după doze mari de imunoglobuline intravenos. În concluzie, deşi incidenţa sindromului Steven Johnson este mică la copil, pediatrii trebuie să fie conştienţi de posibilitatea apariţiei ei (chiar după antiepileptice – Lamictal), iar utilizarea imunoglobulinelor IV, deşi controversată, administrată în doze mari pare că duce la vindecarea bolii.

Cuvinte cheie: Sindrom Stevens Johnson, copil, epilepsie, Lamotrigin (Lamictal)

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Cristina Oana Mărginean

Maple urine syrup disease – two cases presentations

Revista Romana de PEDIATRIE | Volumul LXI, Nr. 4, An 2012

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

ICMJE- Recommendations

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Promoting Global Health

Cristina Oana Mărginean, Carmen Duicu, Claudia Bănescu and Ana Maria Pitea

ABSTRACT

Maple urine syrup disease (MSUD) is part of a heterogenous group of inborn errors of metabolism.

The aim of the paper was to present 2 cases of MSUD diagnosed in our clinic, their evolution and response to treatment.

Patients and method. The diagnosis was documented by determining serum and urinary aminoacids. Each case was examined and evaluated in dynamics in terms of clinical, laboratory, treatment and evolution.

Results. The MSUD onset-age in the first case was in the 5th-6h days and 3rd week for the second case (both were breastfed). The onset of clinical manifestations: lethargy, apathy, adinamy(first case), drowsiness, capping the eyes, hypotonia(second case); capricious appetite/eating disorders in both cases, intercurrent symptoms (cough, rhynorrhea in the second case, probably urosepsis in the first case).

Evolution: the first case who had a severe type: associated drowsiness, generalized weakness, sometimes alternating with bouts of tonic contractions/rigidity, tendency to opistotonus, changes in reflexes, trismus, needing mechanical ventilation and ultimately death; the second case (a milder type) had a favorable evolution dependent on hygienic-dietary and drug-treatment.

Conclusions. Since postnatal infants are apparently clinically healthy, there are no genotype-phenotype correlation, in many countries it has been added in the neonatal screening of metabolic diseases. Early diagnosis, along with specific treatment can prevent complications allowing a normal intellectual development of children with such defects.

Key words: maple urine syrup disease (MSUD), metabolic disease, child

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Cristina Oana Mărginean

BOALA URINILOR CU MIROS DE SIROP DE ARTAR – DOUA PREZENTARI DE CAZ

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

ICMJE- Recommendations

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Promoting Global Health

Cristina Oana Mărginean, Carmen Duicu, Claudia Bănescu and Ana Maria Pitea

REZUMAT

Boala urinilor cu miros de sirop de arţar face parte dintr-un grup heterogen de afecţiuni, respectiv erorile înnăscute de metabolism. Scopul lucrării. Ne propunem să prezentăm 2 cazuri diagnosticate în clinica noastră, urmărirea evoluţiei şi a răspunsului la tratament.

Material şi metodă. Diagnosticul s-a documentat prin determinarea amino-acizilor serici şi urinari. Fiecare caz a fost analizat, urmărindu-se în dinamică datele anamnestice, examenul clinic, examinări paraclinice şi de laborator, scheme terapeutice, evoluţie.

Rezultate. Vârsta la debutul tipic în primul caz, adică în zilele 5-6 de viaţă, şi la 3 săptămâni de viaţă la al doilea caz (deşi în ambele cazuri alimentaţia era naturală).

Manifestările clinice la debut. Tabloul neurologic: letargie, apatie, adinamie (primul caz), somnolenţă, plafonarea privirii, hipotonie (cazul 2); apetit capricios/ tulburări de alimentaţie (acumularea AA şi a metaboliţilor acestora), în ambele cazuri; simptomatologia intercurenţei (tuse, rinoree la cazul 2; probabil ITU/ urosepsis în primul caz).

Evoluţie. Primul caz, prezentând o formă severă asociază somnolenţă, hipotonie generalizată, uneori alternând cu crize de contractură tonică/rigiditate, trismus, cu necesitatea ventilaţiei mecanice şi în final deces; al doilea caz, cu o formă mai uşoară, a avut evoluţie favorabilă dependentă de tratament igienodietetic şi medicamentos.

Concluzii. Deoarece postnatal nou-născuţii sunt aparent sănătoşi din punct de vedere clinic, neexistând o corelaţie fenotip-genotip, în multe ţări a fost adăugată în screening-ul neonatal al afecţiunilor metabolice. Diagnosticul precoce, alături de regimul specific, poate preveni complicaţiile, permiţând astfel o dezvoltare intelectuală normală a copiilor purtători ai acestor defecte.

Cuvinte cheie: boala urinilor cu miros de sirop de arţar, leucinoză, boală metabolică, copil

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Cristina Oana Mărginean

Descriptive study on the serum levels of inflammatory markers in children with nutritional disorders and clinical syndromes of infection

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 3, An 2013

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

ICMJE- Recommendations

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Promoting Global Health

Lidia Man, Ana Maria Pitea, Maria Despina Baghiu and Oana Marginean

REZUMAT

Purpose. To evaluate the serum levels of inflammatory markers in children with alterations in nutritional status and the correlation of these markers with clinical diagnoses of infection.

Methods. We conducted a prospective study on 120 children admitted to the Pediatric Clinic I Tg. Mures. We have followed the nutritional status and the presence or absence of infectious signs, the children being evaluated anthropometrically and by laboratory analysis (suggestive infection markers).

Results. Underweight was found in 28.3% of children, and 24.2% were overweight. Clinically, at least one infectious syndrome has been identified in 31.7% of children, ESR being increased in these children compared to the healthy ones (p=0.034); no differences were observed in the other serological markers. We have found IL-6 and IL-8 values below the detection limit especially in underweight children with diagnosis of infection; significantly higher values of IL-6 and IL-8 were found in overweight children with a diagnosis of associated infection.

Conclusions. Interleukins have significantly lower values in underweight children, even in the context of a possible infection. In order to confirm or infirm an infectious syndrome, the clinical judgment is not enough and the corroboration with complex laboratory data is necessary.

Cuvinte cheie: infecţie, malnutriţie, obezitate, interkeukine, copii

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Lidia Man

STUDIU DESCRIPTIV PRIVIND NIVELURILE SERICE ALE UNOR MARKERI INFLAMATORI LA COPII CU TULBURARI NUTRITIONALE SI SINDROAME CLINICE DE INFECTIE

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Lidia Man, Ana Maria Pitea, Maria Despina Baghiu and Oana Marginean

REZUMAT

Scop. Evaluarea nivelurilor serice ale unor markeri infl amatori la copiii cu alterări ale statusului nutriţional şi corelarea acestor markeri cu patologii infecţioase.

Material şi metodă. Am efectuat un studiu prospectiv pe 120 de copii internaţi in Clinica Pediatrie I Tg. Mureş, la care am urmărit statusul nutriţional şi prezenţa sau absenţa unor semne infecţioase, copiii fiind evaluaţi antropometric şi paraclinic prin markeri sugestivi pentru infecţii.

Rezultate. 28% dintre copii au avut deficit ponderal, iar 24% exces ponderal. Clinic s-a identificat cel puţin un sindrom infecţios la 31,7% dintre copii, VSH fiind mărit la aceşti copii comparativ cei clinic sănătoşi (p = 0,034); nu s-au observat diferenţe în acest sens în cazul celorlalţi markeri serologici. S-au observat valori ale IL-6 şi IL-8 scăzute sub limita de detecţie, în special la copiii subponderali cu diagnostic de sindrom infecţios, şi valori crescute ale IL-6 si IL-8 la copiii supraponderali cu diagnostic de sindrom infecţios asociat.

Concluzii. Interleukinele au valori semnificativ scăzute la copiii subponderali, chiar în contextul unei eventuale infecţii. Pentru a confirma sau infirma prezenţa unui sindrom infecţios nu este suficientă aprecierea clinică, ci este necesară coroborarea cu date complexe de laborator

Cuvinte cheie: infecţie, malnutriţie, obezitate, interkeukine, copii

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Lidia Man

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