Oana Marginean

Latest posts by Oana Marginean (see all)

POSIBILITATI SI LIMITE DE TERAPIE INTR-UN CAZ DE SINDROM ADRENOGENITAL - 30/08/2016
POSSIBILITIES AND THERAPY LIMITATIONS IN A CASE OF ADRENOGENITAL SYNDROME - 30/08/2016
DIFICULTATI DE DIAGNOSTIC IN HIPOGLICEMIA SUGARULUI - 20/11/2015

Articole semnate de acelasi autor in Revista Romana de Pediatrie:

POSIBILITATI SI LIMITE DE TERAPIE INTR-UN CAZ DE SINDROM ADRENOGENITAL

Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016

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

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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.

Alexandra Latcu, Alina Grama, Lenuţa Popa, Lorena Elena Melit, Mihaela Chincesan and Oana Marginean

REZUMAT

Introducere. Sindromul adrenogenital cu debut neonatal se poate manifesta prin vărsături repetate, deshidratare şi dezechilibru hidro-electrolitic sever. Abordarea diagnostică, reechilibrarea metabolică şi menţinerea balanţei electrolitice în limite normale prin tratament cronic pot fi însoţite de dificultăţi.
Obiectiv. Este prezentat un caz de sindrom adrenogenital cu debut neonatal sever, evoluţie însoţită de diferite complicaţii, dar cu prognostic ameliorat de tratament cronic adecvat.
Material şi metodă. Copil de sex masculin, cu greutate mică la naştere, s-a internat în Clinica Pediatrie I, Târgu-Mureş la vârsta de 3 săptămâni, cu un sindrom clinico-biologic sever prin vărsături cronice şi deshidratare severă şi aparentă macrogenitososmie. S-a efectuat o paletă largă de investigaţii în puseu acut, dar şi ulterior pentru elaborarea diagnosticului diferenţial.
Rezultate. S-au evidenţiat hiponatremie şi hipokaliemie persistente, o valoare crescută a 17-OH progesteron (44,96 ng/ml) şi cortizol sub limita normală (3 ug/dl). S-au înregistrat concentraţii semnificativ crescute ale ACTH (103 pg/ml matinal) şi testosteronului seric total (186,72 ng/dl). Analiza moleculară a evidenţiat genotipul heterozigot pentru următoarele mutaţii: 12G, R356W, P453S. Tratamentul cronic cortizonic adecvat a ameliorat prognosticul; la vârsta de 1,5 ani prezenta o dezvoltare staturo-ponderală şi psiho-motorie adecvată.
Concluzii. Au fost întrunite condiţiile diagnosticului de sindrom adrenogenital cu debut neonatal la un heterozigot. Vârsta mică şi simptomatologia necaracteristică pot îngreuna stabilirea unui diagnostic precoce în sindromul adrenogenital.

Cuvinte cheie: vărsături, nou-născut, hiponatremie

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Alexandra Latcu

POSSIBILITIES AND THERAPY LIMITATIONS IN A CASE OF ADRENOGENITAL 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

Alexandra Latcu, Alina Grama, Lenuţa Popa, Lorena Elena Melit, Mihaela Chincesan and Oana Marginean

ABSTRACT

Introduction. The adrenogenital syndrome with neonatal onset can manifest by repeated vomiting, dehydration and severe hydro-electrolytic disequilibria. The diagnostic approach, the metabolic reequilibration and the maintenance of the electrolytic balance in normal ranges by chronic treatment can be associated with difficulties.
Objective. We present a case of adrenogenital syndrome with severe neonatal onset, evolution accompanied by different complications, but with a prognosis improved by the adequate chronic treatment.
Material and method. A male child with small birth weight, was admitted in the Pediatrcs Clinic I, Targu-Mures, at the age of 3 weeks, with a severe clinic-biological syndrome by chronic vomiting and severe dehydration, and apparent macrogenitosomia. We performed a wide spectrum of investigations in acute phase, but also afterwards for the elaboration of the differential diagnosis.
Results. We identified persistent hyponatremia and hypopotassemia, an increased level of 17-OH progesterone (44.96 ng/ml) and the cortisol under the normal limit (3 ug/dl). We discovered significantly increased concentrations of ACTH (103 pg/ml in the morning) and total serum cholesterol (186.72 ng/dl). The macromolecular analysis pointed out the heterozygote genotype for the following mutations: 12G, R356W, P453S. The adequate chronic treatment with cortisone improved the prognosis; at the age of 1 years and 5 months, he presents an adequate height, weight and psychomotor development.
Conclusions. We fulfilled the conditions of the diagnosis of adrenogenital syndrome with neonatal onset in a heterozygote child. The small age the uncharacteristic symptomatology can be a burden for establishing an early diagnosis of adrenogenital syndrome.

Keywords: vomiting, newborn, hyponatremia

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Alexandra Latcu

DIFICULTATI DE DIAGNOSTIC IN HIPOGLICEMIA SUGARULUI

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

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

Alina Grama, Oana Marginean, Iulian Velea, Corina Paul, Mihaela Chincesan and Lorena Elena Melit

REZUMAT

Introducere. Hipoglicemia cu diversele ei cauze este frecvent semnalată în patologia pediatrică, începând din perioada neonatală şi până în adolescenţă. Prin consecinţele ei atât cele imediate (convulsii, comă), cât şi cele tardive (afectare neurologică), hipoglicemia trebuie cunoscută, prevenită, evitată şi tratată.
Obiective. Prezentarea evoluţiei clinice a unei paciente cu hipoglicemie severă simptomatică încă din perioada de nou-născut. De la naştere, valoarea glicemiei prezintă o dinamică fluctuantă, iar scăderea glicemiei, izolat, nu reprezintă neapărat o situaţie patologică, dar poate fi un simptom al unei patologii subiacente.
Material şi metodă. Pacienta este internată în clinica noastră la vârsta de nou-născut, în vederea stabilirii etiologiei şi tratamentului hipoglicemiilor. Am realizat profilul biologic şi hormonal, am efectuat determinări sanguine metabolice şi teste genetice.
Rezultate. Am stabilit diagnosticul de hipoglicemie severă persistentă. Interpretarea rezultatelor a fost îngreunată de evoluţia trenantă a bolii, vârsta mică şi complianţa scăzută din partea familiei.
Concluzii. Hipoglicemia persistentă are cauze multiple. Managementul unui sugar cu hipoglicemie severă poate fi dificil şi impune o abordare complexă.

Cuvinte cheie: hipoglicemie, sugar, gena Duarte

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Alina Grama

DIAGNOSIS DIFFICULTIES IN INFANT’S HYPOGLYCEMIA

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

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Promoting Global Health

Alina Grama, Oana Marginean, Iulian Velea, Corina Paul, Mihaela Chincesan and Lorena Elena Melit

ABSTRACT

Introduction. Hypoglycemia with its diverse causes is frequently encountered in the pediatrics pathology, beginning with the neonatal period and until the adolescent one. Through its consequences, both, the early (seizures, coma) and the late ones (neurological impairment), hypoglycemia must be identified, prevented, avoided and treated.
Objectives. To present the clinical evolution of a female patient with severe, symptomatic hypoglycemia even since the neonatal period. Since birth, the value of glycaemia presents a fluctuant dynamic, and the isolated decrease of glycaemia does not necessary represent a pathological situation, but can be a symptom of an underlying disorder.
Material and method. The patient is admitted in our clinic at the age of newborn in order to establish the etiology and treatment of hypoglycemia. We achieved the biologic and hormonal profile, we performed metabolic blood determinations and genetic tests. Results. We established the diagnosis of severe persistent hypoglycemia. The burden of the results interpretation was represented by the prolonged evolution of the disease, the small age and the family’s low compliance.
Conclusions. Persistent hypoglycemia has multiple causes. The management of an infant with severe hypoglycemia can be difficult and it imposes a complex approach.

Keywords: hypoglycemia, infant, Duarte gene

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Alina Grama

Body composition of children with malignant disease

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

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

Mihaela Ioana Chinceşan, Maria Despina Baghiu, Alina Grama and Oana Marginean

ABSTRACT

Background. Nutritional status, as represented by body composition, is an important considerant in the treatment of pediatric cancer patients because it is linked to poor outcomes.

Objective. We aimed to compare nutritional status with children with malignant disease at diagnosis as compared to children with nononcological disease.

Material and method: A prospective study was performed on 90 children hospitalised in the Pediatric Clinic I Tg. Mures, between November 2009 - July 2011. The children were divided into two groups: group 1, children with malignant disease (35 children) and group 2-control group, children with different pediatric diseases (55 children). We have done anthropometric and biochemical measuremeants: weight, height, body mass index, middle upper arm circumference, tricipital skin fold thickness, total serum protein and albumin, Insulin-like growth factor-1, total cholesterol, tryglicerides and sideremy. We studied the anthropometric and biochemical parameters compared to the two groups and performed statistical correlations.

Results. The weight and height of children in group I was much lower compared with group II, without statistically significant difference (p>0.05). We also found a statistically significant difference among the anthropometric parameters of the arm: middle upper arm circumference – MUAC (-1.58 DS versus -0.74 DS ) with p = 0.022 and tricipital skin fold thickness – TSF (-1.34 DS versus -0.74 DS) with p = 0.05. Regarding biochemical parameters, between the two groups, we observed a significant difference(p<0.05) with the total serum protein and albumin, IGF-1, sideremy and tryglicerides.

Conclusions. This study showed that the children’s group diagnosed with cancer has a poor nutritional status than the control group; the anthropometric parameters of the arm in conjunction with biochemical parameters best reflects the body composition.

Key words: child, malignant disease, anthropometric parameters, biochemical parameters

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Mihaela Ioana Chinceşan

COMPOZITIA CORPORALA LA COPIII CU BOALA MALIGNA

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

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Promoting Global Health

Mihaela Ioana Chinceşan, Maria Despina Baghiu, Alina Grama and Oana Marginean

REZUMAT

Introducere. Statusul nutriţional, reprezentat de compoziţia corpului, este un considerent important în tratamentul pacienţilor pediatrici oncologici deoarece influenţează evoluţia bolii. Obiectiv. Ne-am propus să evaluăm comparativ statusul de nutriţie la copiii cu boală malignă la momentul diagnosticării bolii faţă de copiii cu afecţiuni nononcologice.

Material şi metodă. Am efectuat un studiu prospectiv pe un număr de 90 de copii internaţi în Clinica Pediatrie I Tg- Mureş în perioada noiembrie 2009 – iulie 2011. Copiii au fost împărţiţi în două loturi: lotul I, reprezentat de copii cu boală malignă (35 copii) şi lotul II – martor, reprezentat de copii cu diverse afecţiuni pediatrice (55 copii). Am efectuat măsurători antropometrice şi biochimice: greutatea, înălţimea, indicele de masă corporală, perimetrul mediu al braţului, pliul cutanat tricipital, proteine totale şi albumine serice, IGF-1, colesterol total, trigliceride şi sideremie. Am urmărit comparativ parametrii antropometrici şi biochimici la cele două loturi şi am efectuat corelaţii statistice.

Rezultate. Greutatea şi înălţimea copiilor din lotul I a fost mai mică faţă de lotul II, fără o diferenţă semnificativă statistic (p>0,05). Am constatat o diferenţă semnificativă statistic în rândul parametrilor antropometrici ai braţelor: perimetrul mediu al braţului – MUAC (-1,58 DS la lotul I şi -0,74DS la lotul II) cu p=0,022 şi pliul cutanat tricipital –TSF (-1,34 DS la lotul I şi -0,76 DS la lotul II) cu p=0,05. Urmărind parametrii biochimici, am observat o diferenţă semnificativă statistic (p<0,05) între cele două loturi în ceea ce priveşte valoarea proteinelor totale, albuminele serice şi IGF-1, sideremia şi trigliceridele.

Concluzii. Studiul demonstrează că pacienţii diagnosticaţi cu cancer prezintă status nutriţional precar faţă de pacienţii nononcologici; parametrii antropometrici ai braţelor, coroboraţi cu parametrii biochimici reflectă cel mai bine compoziţia corporală.

Cuvinte cheie: copil, boală malignă, parametru antropometric, parametru biochimic

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Mihaela Ioana Chinceşan

A case of giant hydronephrosis associated with arterial hypertension

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

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

Carmen Duicu, Claudia Bănescu, Iolanda Muntean, Oana Marginean and Horea Gozar

ABSTRACT

Cases of giant hydronephroses are rare and usually contain no more than 1-2 liters of fluid in the collecting system. We report a case of giant hydronephrosis with secondary transitory arterial hypertension. An overweight 14-year-old boy was incidentally discovered with high blood pressure at a routine medical visit. Medical history was unremarkable. Abdominal ultrasound revealed a giant cystic tumor fi lling over then 50% of abdominal cavity. Although both clinical symptoms and physical exam were poor and arterial hypertension seemed obesityinduced, finally high blood pressure was secondary to the giant hydronephrosis. Therefore, any abdominal cystic mass even in the absence of other evident pathologies should include the differential diagnosis of a possible hydronephrosis.

Key words: giant hydronephrosis, hypertension, child

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Carmen Duicu

UN CAZ DE HIDRONEFROZA GIGANTA ASOCIATA CU HIPERTENSIUNE ARTERIALA

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

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Promoting Global Health

Carmen Duicu, Claudia Bănescu, Iolanda Muntean, Oana Marginean and Horea Gozar

REZUMAT

Cazurile de hidronefroză gigantă sunt rare şi, de obicei, nu conţin mai mult de 1-2 litri de lichid în sistemul colector. Prezentăm un caz de hidronefroză gigantă însoţită de hipertensiune arterială (HTA) tranzitorie secundară. Cu ocazia unui examen de rutină, unui pacient de 14 ani, supraponderal, i-au fost descoperite valori crescute ale teniunii arteriale. Istoricul medical a fost nesemnificativ. Ecografia abdominală a evidenţiat o tumoră chistică gigantă ce ocupa peste 50% din cavitatea abdominală. Deşi simptomele clinice cât şi examenul fizic au fost sărace, iar iniţial HTA părea indusă de obezitate, în cele din urmă HTA s-a dovedit a fi secundară hidronefrozei gigante. Prin urmare, diagnosticul diferenţiar al unei formaţiuni abdominale chistice, chiar şi în absenţa altor patologii evidente, ar trebui să includă o posibilă hidronefroză.

Cuvinte cheie: hidronefroză gigantă, hipertensiune, copil

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Carmen Duicu

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

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

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

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

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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