Mihaela Munteanu

Latest posts by Mihaela Munteanu (see all)

NECROZA TUBULARA ACUTA PRIN ACTIUNEA NEFROTOXICA MEDICAMENTOASA – CAUZA RARA DE SINDROM NEFROTIC LA COPIL - 28/01/2016
DRUG INDUCED ACUTE TUBULAR NECROSIS – RARE CASE OF NEPHROTIC SYNDROME - 28/01/2016
Mycofenolate mofetil versus cyclophosphamide for steroid-resistant nephrotic syndrome in children - 04/08/2015

Articole semnate de acelasi autor in Revista Romana de Pediatrie:

NECROZA TUBULARA ACUTA PRIN ACTIUNEA NEFROTOXICA MEDICAMENTOASA – CAUZA RARA DE SINDROM NEFROTIC LA COPIL

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015

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

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.

Magdalena Starcea, Mihaela Munteanu, Radu Russu, Anca Iulia Rotaru, Doina Mihaila and Ingrith Miron

REZUMAT

Sunt prezentate două cazuri de sindrom nefrotic (SN) indus de medicamente cu nefrotoxicitate la nivel tubular, cu evoluţie diferită în contextul maladiilor incriminate etiologic.

Fetiţă în vârstă de 5 luni internată cu SN (dovedit clinic şi biologic) şi insuficienţă renală acută, după o spitalizare în alt servici pentru bronhopneumonie. Fetiţa a fost tratată cu ceftriaxonă şi gentamicină 12 zile. Suspiciunea de SN congenital a fost înlăturată de evidenţierea necrozei tubulare renale în fază de recuperare (biopsie renală). Evoluţia a fost favorabilă în 7 zile sub dializă peritoneală.

Adolescentă de 16 ani cu boală Basedow tratată de 3 ani cu carbimazol. S-a prezentat cu sindrom nefrotic care nu a fost influenţat de corticoterapie. Examenul histopatologic a evidenţiat necroză tubulară toxică, fibroză interstiţială, absenţa leziunilor glomerulare. A fost sistat tratamentul nefrotoxic, s-a practicat tiroidectomie după care edemele s-au redus, dar funcţia renală a continuat să se deprecieze, în condiţiile terapiei nefrotoxice administrată timp de 3 ani.

Concluzii. Necroza tubulară renală exprimată clinic şi biologic prin sindrom nefrotic, însoţit de insuficienţă renală este o situaţie rară la copil; gentamicina şi carbimazolul pot fi incriminate etiologic. Suferinţa renală poate fi ameliorată sau nu prin înlăturarea medicamentului cauzal. Eşecul terapeutic s-a corelat cu durata agresiunii medicamentoase şi evoluţia unor comorbidităţi.

Cuvinte cheie: necroză tubulară, sindrom nefrotic, insuficienţă renală acută

Full text | PDF

Magdalena Starcea

DRUG INDUCED ACUTE TUBULAR NECROSIS – RARE CASE OF NEPHROTIC SYNDROME

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

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

Magdalena Starcea, Mihaela Munteanu, Radu Russu, Anca Iulia Rotaru, Doina Mihaila and Ingrith Miron

ABSTRACT

We presented two cases of nephrotic syndrome (NS) drug-induced with tubular nephrotoxicity, with different evolution in the context of etiologic diseases.

First is 5-month-old girl admitted with NS (clinically and biological proven) and acute renal failure after another hospitalization for pneumonia. The girl was treated with ceftriaxone and gentamicin 12 days. Congenital NS suspicion was eliminated by renal biopsy who revealed renal tubular necrosis highlighting recovery phase. The development was favorable in 7 days of peritoneal dialysis.

The second case was 16 years old adolescents treated 3 years with carbimazol for Basedow disease. Was presented with nephrotic syndrome not influenced by corticosteroids. Histopathology revealed toxic tubular necrosis, interstitial fibrosis, absence of glomerular injury. Nephrotoxic treatment was stopped, and, after thyroidectomy, edema were reduced, but kidney function continued to depreciate, while nephrotoxic therapy given for 3 years.

Conclusions. Renal tubular necrosis clinical and laboratory expressed by nephrotic syndrome, accompanied by renal insufficiency is a rare occurrence in children; gentamicin and carbimazol can be criminalized. The suffering or impairment may be improved by removing the causative drug. Treatment failure was associated with duration of drug aggression and evolution of comorbidities.

Keywords: acute tubular necrosis, nephrotic syndrome, acute renal failure

Full text | PDF

Magdalena Starcea

Mycofenolate mofetil versus cyclophosphamide for steroid-resistant nephrotic syndrome in children

Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011

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

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

Florentina Cucer, Ingrith Miron, Mihaela Munteanu, Codruţa Iliescu Haliţchi, R. Muller, R. Russu, Anca Ivanov, Doina Mihaila and O. Brumariu

ABSTRACT

The management of patients with steroid-resistant nephrotic syndrome is difficult. We report our experience on treatment with Mycophenolate mofetil versus Cyclophosphamide, in a retrospective analysis of 54 cases of idiopathic steroid-resistant nephrotic syndrome with different histological aspects. The complete and sustained remission rate was 50% for Mycophenolate, which confirm the efficacy of treatment, higher than with Cyclophosphamide (39.53%).

Key words: nephrotic syndrome, mycophenolate mofetil, cyclophosphamide, steroid-resistancy

Full text | PDF

Florentina Cucer

MYCOFENOLATUL DE MOFETIL VERSUS CICLOFOSFAMIDA IN SINDROMUL NEFROTIC CORTICOREZISTENT LA COPII

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

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

Florentina Cucer, Ingrith Miron, Mihaela Munteanu, Codruţa Iliescu Haliţchi, R. Muller, R. Russu, Anca Ivanov, Doina Mihaila and O. Brumariu

REZUMAT

Managementul pacienţilor cu sindrom nefrotic corticorezistent (SNCR) este dificil. Vom prezenta experienţa noastrǎ în tratamentul cu Mycofenolat de mofetil versus Ciclofosfamidǎ, într-o analizǎ retrospectivǎ a 54 de cazuri cu sindrom nefrotic corticoresistent idiopatic cu aspecte histologice diferite. Rata remisiunii complete şi susţinute a fost de 50% pentru Mycofenolat, ceea ce confirmǎ eficienţa tratamentului, aceastǎ ratǎ fiind mai mare decât în tratamentul cu Ciclofosfamidǎ (39,53%).

Cuvinte cheie: sindrom nefrotic, mycofenolat de mofetil, ciclofosfamidă, corticorezistenţǎ

Full text | PDF

Florentina Cucer

The frequency of urinary tract infections in children with antenatal hydronephrosis

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

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

Delia Andreia Bizim, Mihaela Munteanu, Radu V. Russu, Ovidiu Brumariu and Ingrith C. Miron

ABSTRACT

Infants with antenatal hydronephrosis are at risk 12 times greater of developing acute pyelonephritis. We evaluated the frequency of urinary tract infections (UTI) in a group of 87 patients with congenital hydronephrosis (HN) detected antenatally (ratio B: F = 2,95:1). The average follow-up was 20.22 months. 49.42% of children had UTI, the recurrence rate (≥ 2 episodes) was 53.8%. Depending on the degree of hydronephrosis, urinary infection rate was between 37.5 to 41.37% for grade I-II HN and between 57-71% for grade III-V HN (p = 0.0402, 95% CI grade I-II HN compared with grade III-V). We found a weak positive correlation between the degree HN and the number of UTI (rs = 0.224, p = 0.036, 95% CI) significant statistic. 60.52% of patients with a history of UTI had urinary infections on uroprophylaxis. Cefaclor was the most common used antibiotic. E coli was involved in 36.35% of UTI, and Klebsiella pn. 25%. Given the high frequency of urinary infections in this group, it is neccesary a longer follow-up of these children for early detection of kidney damage.

Key words: congenital hydronephrosis, urinary tract infections, uroprophylaxis, antenatal diagnosis, UTI reccurence, antenatal hydronephrosis

Full text | PDF

Delia Andreia Bizim

RATA INFECTIILOR URINARE LA COPIII CU HIDRONEFROZA CONGENITALA DEPISTATI ANTENATAL

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

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

Delia Andreia Bizim, Mihaela Munteanu, Radu V. Russu, Ovidiu Brumariu and Ingrith C. Miron

REZUMAT

Nou-născuţii depistaţi antenatal cu hidronefroză sunt supuşi unui risc de 12 ori mai mare de a dezvolta o pielonefrită acută. În prezenta lucrare am evaluat frecvenţa infecţiilor urinare pe un lot de 87 de pacienţi cu hidronefroză congenitală depistată antenatal (raport B:F = 2,95:1). Durata medie de urmărire a fost de 20,22 luni. 49,42% dintre copii au prezentat infecţii urinare, rata recidivelor(≥ 2 episoade infecţioase) fiind de 53,8%. Funcţie de gradul hidronefrozei, frecvenţa infecţiilor urinare a fost între 37,5-41,37% în cazul HN grad I-II şi între 57-71% în cazul HN grad III-V (p = 0,0402, CI 95%, HN gr. I-II comparativ cu HN gr. III-V). Am găsit o corelaţie pozitivă, dar slabă între gradul HN şi numărul de episoade infecţioase (rS = 0,224, p = 0,036, CI 95%) semnificativă statistic. 60,52% dintre pacienţii cu istoric de ITU au prezentat infecţii urinare sub uroprofilaxie. Cefaclor a fost cel mai utilizat antibiotic. În etiologia infecţiilor urinare E. coli a fost implicat în 36,35% dintre cazuri, iar Klebsiella pn. în 25%. Având în vedere frecvenţa crescută a infecţiilor urinare în acest lot, este necesară o urmărire mai îndelungată a acestor copii pentru depistarea precoce a afectării renale.

Cuvinte cheie: hidronefroză congenitală, infecţie urinară, uroprofilaxie, diagnostic antenatal, hidronefroză antenatală, infecţii urinare recidivante

Full text | PDF

Delia Andreia Bizim

Primary vesico-ureteral reflux prenatally diagnosed, with particular evolution

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013

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

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

R. Russu, Doina Nedelcu, Mihaela Munteanu and Magda Stârcea

ABSTRACT

This study aims to assess a case of severe vesico-ureteral reflux (VUR) admitted at 6 weeks of age with urinary infection and azotate retention, with antenatal ultrasound suspicion of bilateral hydronephrosis. The authors present diagnosis and therapeutic methods, analyzing the factors for unfavorable outcome, the complications and the problems of long-term follow-up. Antenatal discovery of a bilateral hydronephrosis requires the specific investigations since the very first days of life, for an early etiologic diagnosis and initiation of prophylactic measures.

Key words: antenatal hydronephrosis, vesicoureteral reflux, urinary tract infection, child

Full text | PDF

R. Russu

REFLUX VEZICO-URETERAL PRIMAR SEMNALAT ANTENATAL CU EVOLUTIE PARTICULARA

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

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

R. Russu, Doina Nedelcu, Mihaela Munteanu and Magda Stârcea

REZUMAT

Este prezentat un caz de reflux vezico-ureteral (RVU) sever, internat la vârsta de 6 săptămâni, cu infecţie urinară şi retenţie azotată, având semnalată ecografic antenatal hidronefroza bilaterală. Autorii prezintă metodele de diagnostic şi tratament, analizează factorii de risc pentru prognostic nefavorabil, complicaţiile şi problemele dispensarizării pe termen lung. Depistarea antenatală a unei hidronefroze bilaterale impune practicarea explorărilor specifice încă din maternitate, pentru încadrarea etiologică şi iniţierea măsurilor profilactice.

Cuvinte cheie: hidronefroză antenatală, reflux vezico-ureteral, infecţie urinară, copil

Full text | PDF

R. Russu

ASPECTE CLINICO-EVOLUTIVE ALE INFECTIEI URINARE LA PREMATUR

Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 1, An 2014

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

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

Magdalena I. Starcea, Mihaela Munteanu, Radu V. Russu, Ovidiu Brumariu, Delia Andreia Bizim and Ingrith C. Miron

REZUMAT

Obiectiv. Studiul îşi propune analiza comparativă a cazurilor de ITU la copii 0-3 ani (prematuri şi născuţi la termen) internaţi în Clinica IV Pediatrie Iaşi, între ian. 2007 – dec. 2011. Material şi metodă. Am efectuat un studiu retrospectiv pe un lot de 298 de copii între 0-3 ani, internaţi cu infecţie de tract urinar (ITU). Au fost urmărite particularităţile ITU la prematur în funcţie de gradul prematurităţii, etiologia ITU, comorbidităţi, aspecte evolutive, responsivitate la tratament şi impactul ITU asupra rinichiului. Rezultate. Lotul de studiu a fost alcătuit împărţit în copii născuţi la termen şi copii născuţi prematur, la vârstă gestaţională mai mică de 37 săptămâni, cu greutatea mai mică de 2.500 g. Riscul ITU la prematur este influenţat de vârstă, fiind de 3 ori mai mare la nou născutul prematur faţă de copilul 1-3 ani. Vârsta medie a fost de 8,8 luni la prematuri şi 14,09 luni la născuţii la termen. Cei mai mulţi copii s-au încadrat în gradul LBW. Etiologia infecţiei urinare a fost dominată la ambele subloturi de Escherichia coli, Proteus mirabilis şi Klebsiella pneumoniae. La prematuri, bacteriile oportuniste (bacil Piocianic, Enterococ, Acinetobacter) determină 16% din ITU, faţă de doar 2% la copii născuţi la termen. Febra a fost semnul clinic dominant la toţi pacienţii. În ordinea frecvenţei, celelalte semne prezente la prematuri au fost inapetenţa, icter prelungit, diaree, detresă respiratorie. Debutul prin insuficienţă renală acută s-a înregistrat la 12,5% dintre prematuri şi doar 1% dintre copii născuţi la termen. Tratamentul antibiotic iniţiat empiric a fost eficient la majoritatea cazurilor. Cel mai frecvent implicate în rezistenţa microbiană au fost aminopenicilinele, Trimetoprim-Sulfmetoxazolul şi Cefalosporine. Concluzii. Diagnosticul prompt şi tratamentul adaptat au un rol important în reducerea morbidităţii infecţioase, a riscului de cicatrici renale şi a reabilitării nutriţionale rapide a prematurului.

Cuvinte cheie: infecţie urinară, prematuritate, anomalii congenitale renale, copii 0-3 ani

Full text | PDF

Magdalena I. Starcea

CLINICAL ASPECTS AND EVOLUTION OF URINARY TRACT INFECTION IN PRETERM INFANTS

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

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

Magdalena I. Starcea, Mihaela Munteanu, Radu V. Russu, Ovidiu Brumariu, Delia Andreia Bizim and Ingrith C. Miron

ABSTRACT

Objective. The aim of the study is a comparative analysis of cases of UTI in children 0-3 years (preterm and term infants) admitted to the IVth Pediatric Clinic , “Sf. Maria” Emergency Hospital for Children, Iasi, between January 2007 – December 2011.

Material and methods. We performed a retrospective study on a group of 298 children, age 0-3 years, hospitalized with urinary tract infection (UTI). We identified the features of preterm infants with UTI according to the degree of prematurity, UTI etiology, comorbidities, developmental issues, responsiveness to treatment, and impact of UTI on kidney.

Results. The study group was divided into term and preterm children (defined as gestational age less than 37 weeks, weighing less than 2500g). Preterm UTI risk was influenced by age, being 3 times higher compared with children aged 1-3 years. The average age of UTI was 8.8 months for preterms and 14.09 months for term babies. Most preterm children were classified in LBW category. The etiology of urinary infection was dominated in both subgroups by E. coli, Proteus mirabilis and Klebsiella pneumoniae. In preterm children, opportunistic bacteria (bacillus Pseudomonas, enterococci, Acinetobacter) determined 16% of UTIs, compared to only 2% in term children. Fever was the dominant clinical sign in all patients. Other signs on preterms were loss of appetite, prolonged jaundice, diarrhea, respiratory distress. The onset of acute renal failure occurred in 12.5% of preterm and only 1% of term children. First line antibiotherapy was effective in most cases. In microbial resistance, the most frequently involved were aminopenicillins, Sulfamethoxazole-Trimethoprim and cephalosporins.

Conclusions. The early diagnosis and treatment have an important role in reducing infectious morbidity, the risk of renal scarring and rapid nutritional rehabilitation in preterm infants.

Keywords: urinary tract infection, preterm infant, CAKUT, E.coli

Full text | PDF

Magdalena I. Starcea

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS

SELECT ISSUE

Indexed

HIGHLIGHTS