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The Relationship between Hypoglycaemic Episodes and Arrhythmias in Type 2 Diabetes Subjects after Acute Myocardial Infarction with ST-Segment Elevation—A Case Series

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Journal of Diabetes Mellitus 2022年第2期12卷 141-152页

作者： roxana Adriana Stoica Diana Frătița Alexandru Scafa-Udriște Oana Florentina Gheorghe-Fronea Maria Dorobanțu Constantin Ionescu-Tîrgoviște Cristian Guja Department of Diabetes Nutrition and Metabolic Diseases Carol Davila University of Medicine and Pharmacy Bucharest Romania Department of Cardiology Carol Davila University of Medicine and Pharmacy Bucharest Romania Clinical Emergency Hospital of Bucharest Bucharest Romania

Background and Aims: Several studies have shown that hypoglycaemia, especially a severe episode is associated with an increased mortality rate in diabetes mellitus subjects with previous cardiovascular disease or acute coronary syndrome. One of the presumed mechanisms is the proarrhythmic effect of hypoglycaemia related to the prolongation of the action potential, or the catecholamine surge that follows an episode. The aim of this case series analysis was to investigate the relationship between hypoglycaemia and glucose variability with arrhythmic events in type 2 diabetes patients who suffered an acute myocardial infarction. Materials and Methods: We selected patients admitted consecutively to the cardiology department of Clinical Emergency Hospital in Bucharest for a period of three months with acute myocardial infarction and previously diagnosed type 2 diabetes. For each patient, a retrospective continuous glucose monitoring system (CGMS) or glucose sensor (Medtronicp>®p> Enlite, USA) and a dual electrocardiograph and blood pressure monitor for 24 hours were available. Also, patients had an oscillometric device (Arteriographp>®p> TensioMed Ltd) for 24 hours or non-invasive monitoring of central blood pressure, pulse wave velocity and augmentation index. The data were analysed using Medtechp>®p>, TensioWinp>®p> and Carelink iprop>®p> softwares. We used SpSSp>®p> version 20.0 (IBM) for the statistical analysis. The results are presented as median and interquartile range (IQR). Results and Discussion: Ten type 2 diabetes patients (4 males, 6 females) with anterior (4/10) and inferior acute myocardial infarction (6/10) were included. They were treated with insulin (3/10), sulphonylurea (Gliclazide) plus Metformin (4/10), Metformin monotherapy (2/10), or all three (1/10). The patients had a median age of 67.5 (3.25) years with a median disease duration of 8 (7.75) years. The median body mass index was 2

关键词： CGMS Hypoglycaemia STEMI Glycemic Variability

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proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis

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World Journal of Gastroenterology 2017年第35期23卷 6500-6515页

作者： Anca Trifan Carol Stanciu Irina Girleanu Oana Cristina Stoica Ana Maria Singeap roxana Maxim Stefan Andrei Chiriac Alin Ciobica Lucian Boiculese Institute of Gastroenterology and Hepatology “St.Spiridon”Hospital“Grigore T.Popa”University of Medicine and Pharmacy Institute of Gastroenterology and Hepatology “St.Spiridon”Hospital Department of Research Faculty of Biology“Alexandru Ioan Cuza”University of Iasi Department of preventive Medicine and Interdisciplinarity “Grigore.T.Popa”University of Medicine and Pharmacy

AIM To perform a systematic review and meta-analysis on proton pump inhibitors(ppIs) therapy and the risk of Clostridium difficile infection(CDI). METHODS We conducted a systematic search of MEDLINE/pub Med and seven other databases through January 1990 to March 2017 for published studies that evaluated the association between ppIs and CDI. Adult case-control and cohort studies providing information on the association between ppI therapy and the development of CDI were included. pooled odds ratios(ORs) estimates with 95% confidence intervals(CIs) were calculated using the random effect. Heterogeneity was assessed by I^2 test and Cochran's Q *** publication bias was evaluated via funnel plot, and quality of studies by the Newcastle-Otawa Quality Assessment Scale(NOS). RESULTS Fifty-six studies(40 case-control and 16 cohort) involving 356683 patients met the inclusion criteria and were analyzed. Both the overall pooled estimates and subgroup analyses showed increased risk for CDI despite substantial statistical heterogeneity among studies. Meta-analysis of all studies combined showed a significant association between ppI users and the risk of CDI(pooled OR = 1.99, CI: 1.73-2.30, p pared with non-users. The association remained significant in subgroup analyses: by design-case-control(OR = 2.00, CI: 1.68-2.38, p p p p p p p p p analyses(test for heterogeneity): p = 0.93 for case-control vs cohort, p = 0.85 for adjusted vs unadjusted, p = 0.24 for unicenter vs multicenter, p = 0.86 for age ≥ 65 years and < 65 years. There was significant hetero

关键词： proton pump inhibitors Clostridium difficile infection Risk Systematic review Meta-analysis

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Use of Bivalirudin for Anticoagulation in Interventional Cardiovascular procedures

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Cardiovascular Innovations and Applications 2018年第B7期3卷 163-174页

作者： Zhen Ge Jaya Chandrasekhar roxana Mehran The Zena and Michael A.Wiener Cardiovascular Institute Icahn School of Medicine at Mount SinaiNew YorkNYUSA

Anticoagulation is imperative to reduce the incidence of thrombotic complications in patients undergoing percutaneous interventional cardiovascular procedures;however,this is at the expense of increased risk of *** optimal anticoagulation strategy for these procedures remains *** heparin is the most commonly used anticoagulant during interventional procedures,but has several limitations,such as relatively high incidence of bleeding events,occurrence of heparin-induced thrombocytopenia,and a paradoxical thrombotic *** studies have demonstrated that bivalirudin decreases the occurrence of bleeding complications,but potentially increases the risk of acute stent *** review discusses the pharmacology of bivalirudin and its current clinical application in patients undergoing percutaneous coronary intervention and transcatheter aortic valve replacement procedures.

关键词： bivalirudin anticoagulation interventional cardiovascular procedures

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Long-Term Clinical Outcome of patients Using Risperidone Long-Acting Injectable: The Romanian e-STAR Database

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Open Journal of psychiatry 2015年第2期5卷 153-164页

作者： Ioana Micluţia Madalina Vrabie roxana Ciungu Department of Neurosciences Discipline of Psychiatry“Iuliu Hatieganu”University of Medicine&PharmacyEmergency County Hospital ClujSecond Psychiatric ClinicCluj-NapocaRomania Medical Affairs JanssenDivision of Johnson&Johnson RomaniaBucharestRomania

The objectives of e-STAR Romania (NCT00283517) were to collect clinical outcome data of Romania schizophrenia or schizo-affective disorder patients;prospectively to assess the reasons of treatment initiation, medication usage patterns;to document (long-term) clinical efficacy;and to collect safety data, as well as recording 2-year corresponding retrospective data. In total, 378 eligible subjects were enrolled who were initiated either on risperidone long-acting injectable (RLAI) (290) or on an oral antipsychotic (OA) (88) at baseline as required by the local Summary of the product Characteristics. Data were collected from per patient both retrospectively and prospectively over a 24-month period at 3-month intervals after starting treatment. The results indicated that subjects suffering from schizophrenia or schizo-affective disorder initiated on RLAI were less likely to be hospitalized within the first 24 months after the initiation of treatment. Moreover, subjects treated with RLAI experienced significant improvements in their illness severity and functioning. Discontinuation rates for RLAI were low and doses were stable throughout the 24 months following the initiation of treatment. In addition, the necessity for supplementary concomitant medication was reduced. Adverse events were reported in 20.3% (RLAI) and 11.4% (OA) of the subjects. In general, patients initiated on RLAI and OA at baseline both clinically improved on all assessed parameters but a larger improvement was observed for patients on RLAI. Incidences of reported AEs during the use of RLAI in a naturalistic setting are comparable with those described in clinical studies;however, the incidence of extrapyramidal signs and weight gain was lower than expected.

关键词： Schizophrenia Registry Risperidone Long-Acting Injectable Hospitalizations Clinical Outcome Safety

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Does landscape context affect pollinationrelated functional diversity and richness of understory flowers in forest fragments of Atlantic Rainforest in southeastern Brazil?

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ecological processes 2020年第1期9卷 737-748页

作者： Karoline Baptista de Lima patrícia Alves Ferreira Milton Groppo Renato Goldenberg Emerson Ricardo pansarin roxana Cardoso Barreto Guilherme peres Coelho Yago Barros-Souza Danilo Boscolo Biology Department Faculty of PhilosophySciences and LettersUniversity of São PauloRibeirão PretoSP 14040-901Brazil National Institute of Science and Technology in Interdisciplinary and Transdisciplinary Studies in ecology and Evolution(IN-TREE) SalvadorBrazil Botany Department Biological Science SectorParanáFederal UniversityCuritibaPR 81531-970Brazil Botany Department Biological Science CenterPernambuco Federal UniversityRecifePE 50670-420Brazil Institute of Bioscience Rio Grande do Sul Federal UniversityPorto AlegreRS 90040-060Brazil Botany Department Federal University of São CarlosSão CarlosSP 13565-905Brazil.

Background:How landscape modifications affect functional diversity of floral characteristics pertinent to pollinators is poorly *** possess functional traits that sometimes coevolved with pollinators,crucial for the maintenance of both pollinator and plant *** evaluated how richness and functional diversity of available understory flowers respond to forest cover and landscape heterogeneity in a multiscale *** in bloom were sampled from 25 landscapes in the understory of Atlantic Forest fragments in *** were classified into functional groups regarding flower characteristics relevant to *** heterogeneity and forest cover were measured in buffers ranging from 200 to 2000 m from sampling units and their correlation with plant richness and functional diversity was assessed using generalized linear models and further model selection through Akaike’s second-order information ***:plants’richness and functional diversity were affected negatively by forest *** former responded to forest cover at a regional scale while the latter responded at a local *** landscape heterogeneity increased richness and functional ***:Our results showed that forest cover and landscape heterogeneity are important to support biodiversity related to pollination,mostly due to the availability of diversified resources and nesting sites associated to different land-uses for pollinators and flowering plant *** findings should highlight,along with forest cover,landscape heterogeneity as an environmental management priority in rural tropical areas for mitigating the loss of plant biodiversity and enhancing ecosystem functioning.

关键词： Functional diversity pollination Landscape heterogeneity Forest cover Understory plant community

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Unified Analysis Specific to the Medical Field in the Interpretation of Medical Images through the Use of Deep Learning

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E-Health Telecommunication Systems and Networks 2021年第2期10卷 41-74页

作者： Tudor Florin Ursuleanu Andreea roxana Luca Liliana Gheorghe roxana Grigorovici Stefan Iancu Maria Hlusneac Cristina preda Alexandru Grigorovici Faculty of General Medicine “Grigore T. Popa” University of Medicine and Pharmacy Iasi Romania Department of Surgery VI “Sf. Spiridon” Hospital Iasi Romania Department of Surgery I Regional Institute of Oncology Iasi Romania Department of Obstetrics and Gynecology Integrated Ambulatory of Hospital “Sf. Spiridon” Iasi Romania Department of Radiology “Sf. Spiridon” Hospital Iasi Romania Department of Endocrinology “Sf. Spiridon” Hospital Iasi Romania

Deep learning (DL) has seen an exponential development in recent years, with major impact in many medical fields, especially in the field of medical image. The purpose of the work converges in determining the importance of each component, describing the specificity and correlations of these elements involved in achieving the precision of interpretation of medical images using DL. The major contribution of this work is primarily to the updated characterisation of the characteristics of the constituent elements of the deep learning process, scientific data, methods of knowledge incorporation, DL models according to the objectives for which they were designed and the presentation of medical applications in accordance with these tasks. Secondly, it describes the specific correlations between the quality, type and volume of data, the deep learning patterns used in the interpretation of diagnostic medical images and their applications in medicine. Finally presents problems and directions of future research. Data quality and volume, annotations and labels, identification and automatic extraction of specific medical terms can help deep learning models perform image analysis tasks. Moreover, the development of models capable of extracting unattended features and easily incorporated into the architecture of DL networks and the development of techniques to search for a certain network architecture according to the objectives set lead to performance in the interpretation of medical images.

关键词： Medical Image Analysis Data Types Labels Deep Learning Models

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Designing a High-performance Deep Learning Theoretical Model for Biomedical Image Segmentation by Using Key Elements of the Latest U-Net-Based Architectures

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Journal of Computer and Communications 2021年第7期9卷 8-20页

作者： Andreea roxana Luca Tudor Florin Ursuleanu Liliana Gheorghe roxana Grigorovici Stefan Iancu Maria Hlusneac Cristina preda Alexandru Grigorovici Faculty of General Medicine “Grigore T. Popa” University of Medicine and Pharmacy Iasi Romania Departament Obstetrics and Gynecology Integrated Ambulatory of Hospital “Sf. Spiridon” Iasi Romania Department of Surgery VI “Sf. Spiridon” Hospital Iasi Romania Iasi Departament of Surgery I Regional Institute of Oncology Iasi Romania Department of Radiology “Sf. Spiridon” Hospital Iasi Romania Department of Endocrinology “Sf. Spiridon” Hospital Iasi Romania

Deep learning (DL) has experienced an exponential development in recent years, with major impact in many medical fields, especially in the field of medical image and, respectively, as a specific task, in the segmentation of the medical image. We aim to create a computer assisted diagnostic method, optimized by the use of deep learning (DL) and validated by a randomized controlled clinical trial, is a highly automated tool for diagnosing and staging precancerous and cervical cancer and thyroid cancers. We aim to design a high-performance deep learning model, combined from convolutional neural network (U-Net)-based architectures, for segmentation of the medical image that is independent of the type of organs/tissues, dimensions or type of image (2D/3D) and to validate the DL model in a randomized, controlled clinical trial. We used as a methodology primarily the analysis of U-Net-based architectures to identify the key elements that we considered important in the design and optimization of the combined DL model, from the U-Net-based architectures, imagined by us. Secondly, we will validate the performance of the DL model through a randomized controlled clinical trial. The DL model designed by us will be a highly automated tool for diagnosing and staging precancers and cervical cancer and thyroid cancers. The combined model we designed takes into account the key features of each of the architectures Overcomplete Convolutional Network Kite-Net (Kite-Net), Attention gate mechanism is an improvement added on convolutional network architecture for fast and precise segmentation of images (Attention U-Net), Harmony Densely Connected Network-Medical image Segmentation (HarDNet-MSEG). In this regard, we will create a comprehensive computer assisted diagnostic methodology validated by a randomized controlled clinical trial. The model will be a highly automated tool for diagnosing and staging precancers and cervical cancer and thyroid cancers. This would help drastically minimiz

关键词： Combined Model of U-Net-Based Architectures Medical Image Segmentation 2D/3D/CT/RMN Images

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Extrahepatic cholangiocarcinoma:Current status of endoscopic approach and additional therapies

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World Journal of Hepatology 2021年第2期13卷 166-186页

作者： Alina Ioana Tantau Alina Mandrutiu Anamaria pop roxana Delia Zaharie Dana Crisan Carmen Monica preda Marcel Tantau Voicu Mercea Department of Internal Medicine and Gastroenterology “Iuliu Hatieganu”University of Medicine and Pharmacy4th Medical ClinicCluj-Napoca 400012ClujRomania Department of Gastroenterology and Hepatology Gastroenterology and Hepatology Medical CenterCluj-Napoca 400132ClujRomania Department of Gastroenterology “Prof.Dr.Octavian Fodor”Regional Institute of Gastroenterology and HepatologyCluj-Napoca 400162ClujRomania Department of Gastroenterology “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400012ClujRomania Internal Medicine Department Cluj-Napoca Internal Medicine Department“Iuliu Hatieganu”University of Medicine and Pharmacy5th Medical ClinicCluj-Napoca 400012ClujRomania Department of Gastroenterology and Hepatology Clinic Fundeni Institute“Carol Davila”University of Medicine and PharmacyBucharest 22328Romania Department of Internal Medicine and Gastroenterology “Prof.Dr.Octavian Fodor”Regional Institute of Gastroenterology and HepatologyCluj-Napoca 400162ClujRomania Department of Internal Medicine and Gastroenterology “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400012ClujRomania

The prognosis of patients with advanced or unresectable extrahepatic cholangiocarcinoma is *** than 50%of patients with jaundice are inoperable at the time of first *** treatment in patients with obstructive jaundice ensures bile duct drainage in preoperative or palliative *** of symptoms(pain,pruritus,jaundice)and improvement in quality of life are the aims of palliative *** implantation by endoscopic retrograde cholangiopancreatography is generally preferred for long-term *** is a vast variety of plastic and metal stents,covered or *** stent choice depends on the expected length of survival,quality of life,costs and physician *** review will provide the framework for the endoscopic minimally invasive therapy in extrahepatic ***,additional therapies,such as brachytherapy,photodynamic therapy,radiofrequency ablation,chemotherapy,molecular-targeted therapy and/or immunotherapy by the endoscopic approach,are the nonsurgical methods associated with survival improvement rate and/or local symptom palliation.

关键词： Cholangiocarcinoma Endoscopic drainage Endoscopic retrograde cholangiopancreatography photodynamic therapy Radiofrequency ablation Brachytherapy

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The Use of Artificial Intelligence on Colposcopy Images, in the Diagnosis and Staging of Cervical precancers: A Study protocol for a Randomized Controlled Trial

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Journal of Biomedical Science and Engineering 2021年第6期14卷 266-270页

作者： Andreea roxana Luca Tudor Florin Ursuleanu Liliana Gheorghe roxana Grigorovici Stefan Iancu Maria Hlusneac Cristina preda Alexandru Grigorovici Faculty of General Medicine “Grigore T. Popa” University of Medicine and Pharmacy Iasi Romania Integrated Ambulatory of Hospital “Sf. Spiridon” Department of Obstetrics and Gynecology Iasi Romania “Sf. Spiridon” Hospital Department of Surgery VI Iasi Romania Regional Institute of Oncology Iasi Department of Surgery I Iasi Romania “Sf. Spiridon” Hospital Department of Radiology Iasi Romania “Sf. Spiridon” Hospital Department of Endocrinology Iasi Romania

Rationale and Objectives: Accurate diagnosis and staging of cervical precancers is essential for practical medicine in determining the extent of the lesion extension and determines the most correct and effective therapeutic approach. For accurate diagnosis and staging of cervical precancers, we aim to create a diagnostic method optimized by artificial intelligence (AI) algorithms and validated by achieving accurate and favorable results by conducting a clinical trial, during which we will use the diagnostic method optimized by artificial intelligence (AI) algorithms, to avoid errors, to increase the understanding on interpretation of colposcopy images and improve therapeutic planning. Materials and Methods: The optimization of the method will consist in the development and formation of artificial intelligence models, using complicated convolutional neural networks (CNN) to identify precancers and cancers on colposcopic images. We will use topologies that have performed well in similar image recognition projects, such as Visual Geometry Group Network (VGG16), Inception deep neural network with an architectural design that consists of repeating components referred to as Inception modules (Inception), deeply separable convolutions that significantly reduce the number of parameters (MobileNet) that is a class of Convolutional Neural Network (CNN), Return of investment for machine Learning (ROI), Fully Convolutional Network (U-Net) and Overcomplete Convolutional Network Kite-Net (KiU-Net). Validation of the diagnostic method, optimized by algorithm of artificial intelligence will consist of achieving accurate results on diagnosis and staging of cervical precancers by conducting a randomized, controlled clinical trial, for a period of 17 months. Results: We will validate the computer assisted diagnostic (CAD) method through a clinical study and, secondly, we use various network topologies specified above, which have produced promising re

关键词： Artificial Intelligence Colposcopy Images Cervical precancer

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穴位埋线治疗腰椎间盘突出症文献系统评价

穴位埋线治疗腰椎间盘突出症文献系统评价

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作者： roxana Esmeralda Gutierrez Garcia 广州中医药大学

学位级别：硕士

目的：评价穴位埋线治疗腰椎间盘突出症的疗效与安全性。方法：检索中国知网数据库、维普中文科技期刊数据库、中国生物医学文献数据库、万方数据库;MEDLINE、Cochrane Library等数据库,数据库不能得到的文献通过广州中医药大学图书馆... 详细信息

目的：评价穴位埋线治疗腰椎间盘突出症的疗效与安全性。方法：检索中国知网数据库、维普中文科技期刊数据库、中国生物医学文献数据库、万方数据库;MEDLINE、Cochrane Library等数据库,数据库不能得到的文献通过广州中医药大学图书馆手工检索获得,收集穴位埋线治疗腰椎间盘突出症(LDH)的临床随机对照试验,检索日期截止至2014年1月,对符合纳入标准的文献,以Cochrane系统评价手册和改良后的JADAD量表进行质量评价。结果：本研究共纳入10篇文献,发表时间为2006-2014年,治疗人数共计925例腰椎盘突出症患者。治愈率评价,10个研究表明穴位埋线组与对照组,异质性检验p=0.06>0.05,采用固定效应模式,RR合并=1.64,95%CI[1.41,1.91],Z=6.50(pp=0.25>0.05,采用固定效应模式,MD合并=3.08,95%CI[2.52,3.64],Z=10.72(p<0.00001);VAS量表评分评价,1项研究表明埋线组对照电针VAS评分差异有统计学意义[MD=3.27,95%CI [0.68,6.86]],1项研究表明埋线对照电针+红外VAS评分差异有统计学意义[MD=O.57,95%CI[0.37,0.77]],1项研究表明埋线+针刺对照针刺VAS评分差异有统计学意义[MD=2.10,95%CI[1.61,2.59]];ODI量表评分评价,1项研究表明埋线对照电针+红外ODI评分差异有统计学意义[MD=1.59,95%CI[0.04,3.14]],1项研究表明埋线+针刺对照针刺VAS评分差异有统计学意义[MD=20.89,95%CI [14.19,27.59]];10项研究均没有不良事件的报道。结论：穴位埋线治疗腰椎间盘突出症(LDH)是安全的。对照普通针刺、电针、理疗等传统疗法疗效显著,在缓解腰痛、改善腰腿功能障碍、提高日常生活质量方面优于非埋线组。但是由于纳入的研究文献有限且都为低质量文献,小样本随机对照实验,使得研究结果的论证强度降低,还需高质量、大样本、随机对照试验进一步进行研究。

关键词：穴位埋线腰椎间盘突出症系统评价

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