Publications by authors named "Iancu D"

Purpose: Various angiographic assessment scales have been used to report the results of endovascular treatment with the WEB device. We aimed to review the use and reliability of these scales.

Methods: We systematically reviewed studies reporting angiographic outcomes of WEB-treated aneurysms from January 2010 to May 2023.

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Background And Purpose: Flow diversion (FD) has expanded beyond initial indications (proximal carotid artery aneurysms) to include distal circulation aneurysms (on the anterior, middle, or posterior cerebral arteries). Our objective was to examine results obtained from aneurysms in these locations in the Flow Diversion in the Treatment of Intracranial Aneurysms Trial (FIAT) which compared FD with alternative standard management options (ASMO).

Materials And Methods: FIAT was an all-inclusive parallel-group 1:1 randomized study comparing FD with one of 4 ASMOs (coiling +/-stenting, parent vessel occlusion (PVO), clipping, or observation, pre-specified by clinical judgment).

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: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are complex diseases that require precise diagnosis and management. The ESC risk score has been used in both conditions. We assessed the relationship between the EmPHasis-10 questionnaire (patient subjective evaluation) and objective assessment using endorsed tools (simplified four-strata risk assessment and right ventricular imaging by transthoracic echocardiography).

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Article Synopsis
  • The study aimed to track the outcomes of patients with brain arteriovenous malformations (AVMs) who were managed conservatively, revealing key statistics on related morbidity and mortality over a 10-year period.
  • Out of 1010 patients initially recruited, 434 were analyzed, with a majority having unruptured low-grade AVMs, demonstrating a 5% occurrence of serious outcomes and a higher risk in those with a history of rupture or older age.
  • During the follow-up of approximately 3.2 years, 8% of patients experienced major intracranial hemorrhages, highlighting the ongoing risks associated with conservative management of AVMs.
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Unlabelled: Chronic heart failure (CHF) is characterized by complex pathophysiology, leading to increased hospitalizations and mortality. Inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) provide valuable diagnostic insights.

Methods: This study evaluates the prognostic relationship between NLR, PLR, and, in a specific subcohort, N-terminal pro B-type natriuretic peptide (NT-proBNP), alongside length of stay (LOS) and 90-day readmission rates in CHF patients, irrespective of heart failure phenotype.

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Background: Pulmonary hypertension (PH) is a global health issue that has profound medical and research implications.

Methods: This retrospective study examined changes in renal and liver function, as well as lipid metabolism, over a 12-month period in 49 adult patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). All cases were admitted, managed, and followed up with in the PH Center, County Emergency Clinical Hospital of Targu Mures, Romania.

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Increased serum lactate dehydrogenase (LDH) activity is considered as a marker of cellular necrosis and serves as a metabolomic diagnostic marker in several types of cancer including head and neck squamous cell carcinoma (HNSCC). LDH, an enzyme involved in the glycolytic cycle, is correlated not only with the activation of oncogenes such as HIF-α and Myc, but also with effects such as tumor proliferation and metastasis. Serum alkaline phosphatase (ALP) is a marker of cell differentiation and tumor induction.

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Cardiovascular diseases (CVDs) are the leading cause of premature death and disability globally, leading to significant increases in healthcare costs and economic strains. Artificial intelligence (AI) is emerging as a crucial technology in this context, promising to have a significant impact on the management of CVDs. A wide range of methods can be used to develop effective models for medical applications, encompassing everything from predicting and diagnosing diseases to determining the most suitable treatment for individual patients.

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This study assesses the predictive performance of six machine learning models and a 1D Convolutional Neural Network (CNN) in forecasting tumor dynamics within three months following Gamma Knife radiosurgery (GKRS) in 77 brain metastasis (BM) patients. The analysis meticulously evaluates each model before and after hyperparameter tuning, utilizing accuracy, AUC, and other metrics derived from confusion matrices. The CNN model showcased notable performance with an accuracy of 98% and an AUC of 0.

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Nanoparticle (NP)-based solutions for oncotherapy promise an improved efficiency of the anticancer response, as well as higher comfort for the patient. The current advancements in cancer treatment based on nanotechnology exploit the ability of these systems to pass biological barriers to target the tumor cell, as well as tumor cell organelles. In particular, iron oxide NPs are being clinically employed in oncological management due to this ability.

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Purpose: Different combination modalities between an anti-PD-1/PD-L1 agent and a platinum-based chemotherapy or another checkpoint inhibitor (with or without a short course or full course of a platinum doublet) proved superior to chemotherapy alone in multiple clinical trials, but these strategies were not directly compared. The aim of this study is to report the real-world data results with different immunotherapy combinations in a series of patients treated in consecutive cohorts at the Ion Chiricuță Oncology Institute.

Methods: A total of 122 patients were successively enrolled in three cohorts: (1A) nivolumab + ipilimumab (18 patients), (1B) nivolumab + ipilimumab + short-course chemotherapy (33 patients), and (2) pembrolizumab plus full-course chemotherapy (71 patients).

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Article Synopsis
  • The study explores the connection between infarct volume in acute ischemic stroke patients and their chances of achieving good clinical outcomes based on the modified Rankin Scale (mRS).
  • Using data from the ESCAPE-NA1 trial, researchers analyzed how changes in infarct volume influence the probabilities of recovery in 1,099 patients over 24 hours post-treatment.
  • Findings indicate a nearly linear relationship between infarct volume and good outcomes up to 250 mL, suggesting that significant reductions in infarct size are necessary to improve chances of recovery, especially as patients with volumes over 250 mL have very low probabilities of good outcomes.
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According to current predictions, one-fifth of all Americans will develop skin cancer during their lifetime. Cutaneous squamous cell carcinoma (cSCC) most commonly occurs in the head and neck region, which is the area of the body with the highest level of sun exposure. High-risk head and neck cSCC (HNcSCC) is a broad category with numerous high-risk factors that are associated with unfavorable results.

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The awareness concerning RNA-based therapies was boosted significantly after the successful development of COVID-19 vaccines. However, they can potentially lead to significant advances in other areas of medicine, such as oncology or chronic diseases. In recent years, there has been an exponential increase in the number of RNA-based therapies that were evaluated as potential treatments for cardiovascular disorders.

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Objective: Parent vessel occlusion (PVO) is a time-honored treatment for unclippable or uncoilable intracranial aneurysms. Flow diversion (FD) is a recent endovascular alternative that can occlude the aneurysm and spare the parent blood vessel. Our aim was to compare outcomes of FD with endovascular PVO.

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Background And Purpose: The best management of patients with persistent distal occlusion after mechanical thrombectomy with or without IV thrombolysis remains unknown. We sought to evaluate the variability and agreement in decision-making for persistent distal occlusions.

Materials And Methods: A portfolio of 60 cases was sent to clinicians with varying backgrounds and experience.

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Background: Vertebral artery dissection (VAD) is an infrequent source of subarachnoid hemorrhage (SAH), with a high mortality rate, primarily due to the risk of rebleeding both before and after medical intervention. This paper provides a comprehensive analysis of the anatomy, pathophysiology, clinical presentation, treatment strategies, and outcomes of intracranial vertebral artery dissections that result in subarachnoid hemorrhage.

Methods: Comprehensive five-year literature review (2018-2022) and a retrospective analysis of patient records from our institution between 2016 and 2022.

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Background: Hospital-acquired infections (HAIs) pose a significant danger to global public health, mainly because their numbers are growing exponentially each year. Additionally, the rise of bacterial strains resistant to current treatment options further exacerbates this threat. This study aimed to examine the occurrences of HAIs identified in public hospitals at the county level.

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Introduction: Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and pallets-to-lymphocyte ratio (PLR) are currently validated as cheap and accessible biomarkers in different types of solid tumors, including head and neck cancers (HNC).

The Purpose Of The Study: To evaluate the possible purposes and biomarker value of NLR, PLR, and MLR recorded pre-treatment (radiotherapy/chemotherapy) in HNC.

Materials And Methods: From 190 patients with HNC included in the oncology records in the oncology outpatient clinic of the Craiova County Emergency Hospital (from January 2002 to December 2022), 39 cases met the inclusion criteria (squamous cell carcinoma and the possibility to calculate the pre-treatment (chemotherapy/radiotherapy) value of NLR, PLR, and MLR.

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Chondrosarcoma represents approximately 0.1% of all neoplasms of the head and neck and is considered a rare disease with a relatively good prognosis. The 5-year overall survival (OS) rate is estimated at 70-80%, being considered a disease with a low growth rate.

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Background: The study investigated whether three deep-learning models, namely, the CNN_model (trained from scratch), the TL_model (transfer learning), and the FT_model (fine-tuning), could predict the early response of brain metastases (BM) to radiosurgery using a minimal pre-processing of the MRI images. The dataset consisted of 19 BM patients who underwent stereotactic-radiosurgery (SRS) within 3 months. The images used included axial fluid-attenuated inversion recovery (FLAIR) sequences and high-resolution contrast-enhanced T1-weighted (CE T1w) sequences from the tumor center.

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Prognosis in recurrent/metastatic head and neck squamous-cell carcinoma (HNSCC) refractory to platinum-based chemotherapy is poor, making therapy optimization a priority. Anti-programmed cell death protein 1 (anti-PD-1) monoclonal antibody Nivolumab was approved in such cases. We present the early experience with Nivolumab immunotherapy at three cancer clinics from south and northeast Romania, aiming to describe the main characteristics and outcomes relative to literature reports, and to suggest patient selection criteria.

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The identification of a biomarker that is response predictive could offer a solution for the stratification of the treatment of head and neck cancers (HNC) in the context of high recurrence rates, especially those associated with loco-regional failure. Delta (Δ) radiomics, a concept based on the variation of parameters extracted from medical imaging using artificial intelligence (AI) algorithms, demonstrates its potential as a predictive biomarker of treatment response in HNC. The concept of image-guided radiotherapy (IGRT), including computer tomography simulation (CT) and position control imaging with cone-beam-computed tomography (CBCT), now offers new perspectives for radiomics applied in radiotherapy.

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