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Marin Burlea

Presedintele Societatii Romane de Pediatrie

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

FACTORI PROGNOSTICI IN EVOLUTIA POSTOPERATORIE PRECOCE A ATREZIEI ESOFAGIENE. EXPERIENTA UNUI CENTRU TERTIAR INTR-UN INTERVAL DE 5 ANI

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 3, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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FACTORI PROGNOSTICI IN EVOLUTIA POSTOPERATORIE PRECOCE A ATREZIEI ESOFAGIENE. EXPERIENTA UNUI CENTRU TERTIAR INTR-UN INTERVAL DE 5 ANI

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REZUMAT

Scop. Studierea factorilor prognostici care pot influenţa evoluţia postoperatorie a pacienţilor cu atrezie de esofag, ţinând cont de particularităţile loco-regionale ale problemei.
Metode. S-a efectuat o analiză retrospectivă a documentelor medicale pentru 28 de pacienţi diagnosticaţi cu atrezie esofagiană între 2009-2014 în centrul autorilor, utilizând ca instrument de prelucrare a datelor regresia logistică. Supravieţuirea a fost considerată variabilă dependentă, iar detaliile demografice, greutatea la naştere, vârsta intervenţiei chirurgicale, anomaliile asociate, evoluţia postoperatorie şi managementul complicaţiilor au fost studiate ca şi variabile independente.
Rezultate. Aplicând clasificarea prognostică propusă de Spitz, grupul I cu greutatea la naştere (G.N.) ≥ 1.500 g, fără malformaţii cardiace majore, a cuprins 21 de nou-născuţi cu o mortalitate de 33%. Pentru 3 copii încadraţi în grupul II (G.N.≤1.500 g sau malformaţii cardiace majore) şi, respectiv, 4 copii din grupul III (G.N.≤1.500 g şi malformaţii cardiace asociate), mortalitatea a fost de 100%. Greutatea medie la naştere a fost de 2.282 g ±2DS, iar vârsta gestaţională medie de 31 de săptămâni. Vârsta la internare a fost de peste 24 de ore în 15 cazuri, cu deces în 13 dintre situaţii. Malformaţiile asociate cu cea mai mare pondere au fost cele cardiace. Tratamentul chirurgical a constat în: anastomoză primară (21 de cazuri), cervico- şi gastrostomie (6 cazuri), tehnica Foker (1 caz). Complicaţia postoperatorie cea mai frecventă a fost dezunirea anastomozei (la 6 pacienţi, cu deces în 4 situaţii).
Concluzii. Analiza seriei studiate indică o rată de supravieţuire scăzută pentru această patologie în centrul autorilor. În plus, faţă de factorii de prognostic citaţi în literatură (greutatea şi vârsta mică la naştere, anomaliile congenitale asociate), întârzierea diagnosticului şi, implicit, a internării într-un centru terţiar, au contribuit la creşterea mortalităţii în lotul studiat. Rafinarea abordării multidisciplinare a acestei patologii ar putea determina în viitor o supravieţuire mai mare şi o îmbunătăţire a rezultatelor managementului terapeutic.

Cuvinte cheie: Esophageal atresia, survival rate, gap-length, anastomotic leak, demographic factors

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PROGNOSTIC FACTORS IN THE EARLY POSTOPERATIVE OUTCOME OF ESOPHAGEAL ATRESIA. THE EXPERIENCE OF A TERTIARY CENTER OVER A 5 YEARS PERIOD

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 3, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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

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.

PROGNOSTIC FACTORS IN THE EARLY POSTOPERATIVE OUTCOME OF ESOPHAGEAL ATRESIA. THE EXPERIENCE OF A TERTIARY CENTER OVER A 5 YEARS PERIOD

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ABSTRACT

Purpose. The aim of this study was to determine the influence of prognostic factors on the postoperative outcome of esophageal atresia patients, taking into consideration loco-regional particular features.
Methods. A retrospective analysis of the medical records of 28 patients diagnosed with esophageal atresia was conducted, using a logistic regression model. Patients had been admitted in our hospital between 2009-2014. The survival rate was recorded separately from the independent factors, such as demographic features, weight at birth, the timing of surgical treatment, co-morbidities, postoperative prognosis and management of complications.
Results. According to the Spitz prognostic classification, there were 21 patients in group I (birth weight over 1500 g with no major anomaly), 3 patients in group II (birth weight less than 1500 g or major cardiac anomaly) and 4 patients in group III (birth weight less than 1500 g plus major cardiac anomaly). The mortality rate was 33% in group I, 100% in group II and 100% in group III. The mean birth weight was 2282 g ±2SD, and the mean gestational age was 31 weeks. The age at initial presentation was over 24 hours in 15 patients, with fatal outcome in 13 of them. The cardiac malformations presented as the associated anomalies with the highest risk. Surgical treatment was as follows: primary anastomosis in 21 cases, cervicostomy and gastrostomy in 6 cases, and Foker technique in 1 case.
Conclusions. The analysis of this series indicated a low survival rate for this pathology in our center. Besides the prognostic factors cited in literature (low birth weight and age at birth, associated cardiac malformations), we include, as risk factors for the increased mortality, the delayed diagnosis and presentation at our tertiary center. The further refinement of a multidisciplinary approach towards this pathology would contribute to a higher survival rate and an improved result of the therapeutic management.

Keywords: Esophageal atresia, survival rate, gap-length, anastomotic leak, demographic factors

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ASPECTE ETICE PRIVIND RECOLTAREA SANGELUI DIN CORDONUL OMBILICAL IN SCOP DIAGNOSTIC

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 3, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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

Promoting Global Health

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ASPECTE ETICE PRIVIND RECOLTAREA SANGELUI DIN CORDONUL OMBILICAL IN SCOP DIAGNOSTIC

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REZUMAT

Aprofundarea studiilor privind mecanismele genetice şi epigenetice (determinate de mediu) ale atopiei a adus dezvăluiri privind debutul intrauterin al alergiei, dovedit de prezenţa IgE în sângele cordonului ombilical. Depistarea acestor nou-născuţi şi includerea lor într-un program de îngrijiri specifice reduc morbiditatea ulterioară din cadrul marşului alergic cu efecte incontestabile asupra calităţii vieţii şi a costurilor de îngrijire medicală. Creşterea dramatică a prevalenţei atopiei în ultimele decenii sugerează importanţa determinărilor IgE în cordonul ombilical. Utilizarea în scop diagnostic a sângelui cordonului ombilical impune însă legi şi reguli clare care fac obiectul dezbaterii din prezenta lucrare.

Cuvine cheie: consimţământ informat, sânge din cordon ombilical, atopie, IgE

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ETHICAL ASPECTS ABOUT INFORMED CONSENT IN CORD BLOOD COLLECTION FOR DIAGNOSTIC PURPOSES

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 3, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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

Promoting Global Health

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ETHICAL ASPECTS ABOUT INFORMED CONSENT IN CORD BLOOD COLLECTION FOR DIAGNOSTIC PURPOSES

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ABSTRACT

Deepening the knowledge about genetic and epigenetic mechanisms studies (environmental caused) regarding atopy, brought revelations about intrauterine onset of allergies, proven by the presence of IgE in umbilical cord blood. Detection of these newborns and their inclusion in a specific care program further reduces the morbidity of allergic march with the undeniable effects on quality of life and healthcare costs. The dramatic increase in the prevalence of atopy in recent decades suggests the importance of IgE in umbilical cord determinations. The use of umbilical cord blood for diagnostic purposes requires clear laws and rules and this is the subject we suggest to debate in this paper.

Keywords: informed consent, cord blood, atopy, IgE

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Food allergy – gastro-esophageal reflux disease association in infants

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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

Promoting Global Health

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Food allergy – gastro-esophageal refl ux disease association in infants

, , and

ABSTRACT

Gastro-esophageal reflux disease (GERD) and cow’s milk allergy (CMA) are two different diseases with many common clinical and evolutive features. The authors analyze a lot of 110 infants hospitalized for the clinical suspicion of GERD (45 cases) or CMA (65 cases). The results emphasize the risk of the concomitant evolution of CMA and GER.

Conclusions: Distal esophageal pH- metry must be performed both in GERD and CMA, especially in patients with atopic risks or manifestations.

Key words: gastro-esophageal reflux disease, cow’s milk allergy, association

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RELATIA ALERGIE ALIMENTARA – BOALA DE REFLUX GASTRO-ESOFAGIAN LA SUGAR

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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RELATIA ALERGIE ALIMENTARA – BOALA DE REFLUX GASTRO-ESOFAGIAN LA SUGAR

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REZUMAT

Boala de reflux gastro-esofagian (BRGE) şi alergia la proteinele laptelui de vacă (APLV) au numeroase caracteristici clinico-evolutive comune. Autorii analizează un lot de 110 sugari spitalizaţi cu suspiciunea de BRGE (45 cazuri) şi APLV (65 cazuri). Rezultatele evidenţiază riscul de evoluţie concomitentă a APLV şi RGE ca simptom în acest context. Concluzii: Investigarea prin pH-metrie esofagiană şi aplicarea testelor de diagnostic a APLV se impune atât în BRGE, cât şi în APLV (mai ales la bolnavii cu risc familial sau manifestări atopice).

Cuvinte cheie: reflux gastro-esofagian, alergie la proteinele laptelui de vacă, asociere

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Digestive hemorrhage in pediatric pathology

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 3, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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Digestive hemorrhage in pediatric pathology

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ABSTRACT

Digestive hemorrhage in children can evolve from the occult form up to major manifestations with vital risk. The etiology comprises extra-digestive (acute pathology of the nervous system, coagulopathies, portal hypertension, etc.) or digestive (infectious, malformative, inflammatory etc.) diseases with a frequency which depends on the age. The medical history encumbered by multiple error possibilities is supplemented with a synthesized exploration, which approaches: the seriousness of the blood loss, its reflection on the function of the vital organs, depicting a medical cause or a preexisting (malformative) or acquired surgical cause. The treatment depends on the seriousness of the blood loss, on the necessary drugs with ethiopathogenetic impact. Besides its important role as diagnostic method, the digestive endoscopy sometimes represents a therapeutic method.

Key words: child, hemorrhage, digestive, endoscopy

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HEMORAGIA DIGESTIVA IN PATOLOGIA PEDIATRICA

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 3, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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HEMORAGIA DIGESTIVA IN PATOLOGIA PEDIATRICA

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REZUMAT

Hemoragia digestivă la copil poate evolua de la forma ocultă până la manifestări majore cu risc vital. Etiologia cuprinde boli extradigestive (patologia acută a sistemului nervos, coagulopatii, hipertensiune portală etc.) sau digestive (infecţioase, malformative, inflamatorii etc.) cu o frecvenţă nuanţată de vârstă. Anamneza grevată de numeroase posibilităţi de eroare se completează cu o explorare sistematizată abordându-se: gravitatea pierderii de sânge, reflectarea acesteia asupra funcţiei organelor vitale, depistarea unei cauze medicale sau a unei cauze chirurgicale preexistente (malformativă) sau dobândite. Tratamentul este nuanţat de severitatea pierderii de sânge, de necesarul de medicamente cu impact etiopatogenetic. Endoscopia digestivă, pe lângă rolul ei important ca metodă de diagnostic, reprezintă uneori şi o metodă terapeutică.

Cuvinte cheie: copil, hemoragie, digestiv, endoscopie

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Chronical constipation multifactorial etiopathogeny in childhood

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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

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.

Chronical constipation multifactorial etiopathogeny in childhood

, , , , and

ABSTRACT

Constipation is an apparently common condition in children, but it has important consequences in pediatric age. Its prevalence varies between 0.7 and 29.6% (with an average of 8%), with no important difference between sexes. The etiology still remains unclear, and although many mechanisms involved in this disease were discovered, it is still very heterogenous. Constipation may be functional, related with an inadequate diet or with psychical circumstances which influences the normal act of defecation, organic, in which gastrointestinal diseases and not only, play a big role, or it may be talked about a genetic determinism. Specific associated gene mutations haven’t been related yet. There are plenty of genetic syndromes in which constipation is a frequent symptom. Trying to objectify the diagnosis, many types of classifications were suggested, based on the main types of the symptoms. Despite of this, diagnosing constipation in children still remains an important challenge.

Key words: child, constipation, delayed bowel movements

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ETIOPATOGENIA MULTIFACTORIALA A CONSTIPATIEI CRONICE LA VARSTA PEDIATRICA

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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

Promoting Global Health

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ETIOPATOGENIA MULTIFACTORIALA A CONSTIPATIEI CRONICE LA VARSTA PEDIATRICA

, , , , and

REZUMAT

Constipaţia este o patologie aparent banală, dar cu implicaţii importante la vârsta pediatrică. Prevalenţa acesteia variază de la 0,7% la 29,6% (în medie 8%), fără o diferenţă semnificativă între sexe. Etiologia constipaţiei rămâne încă neclară, fiind extrem de heterogenă în ciuda identificării a numeroase mecanisme ce stau la baza acestei afecţiuni. Constipaţia poate fi de natură funcţională, corelată cu o dietă neadecvată sau cu circumstante de natură psihică ce influenţează desfăşurarea normală a defecaţiei, organică, având la bază diferite boli ale tractului gastrointestinal şi nu numai, sau poate avea determinism genetic. Cu toate acestea, încă nu s-au găsit mutaţii genice asociate în mod specific. Numeroase sindroame genetice asociază ca mainifestare clinică constipaţia. În încercarea concretizării diagnosticului au fost propuse diferite clasificări bazate pe simptomatologie. Cu toate acestea, diagnosticul constipaţiei la populaţia pediatrică poate fi dificil de stabilit.

Cuvinte cheie: copil, constipaţie, tranzit intestinal încetinit

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