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The management of the side effects caused by the antiretroviral therapy is one of the main problems facing clinicians. The patient’s tolerability and safety influence the success of the therapy. This retrospective study assesses the tolerability and impact on metabolic profiles of antiretroviral regimens containing darunavir/ritonavir (DRV/r) versus those containing darunavir/cobicistat (DRV/c), in routine clinical practice. The database of Prof. Dr Matei Bals of the National Institute of Infectious Diseases (INBI MB) was studied for the period 2017–2020, allowing the inclusion in the study of 462 HIV-infected patients who received the current regimen at least three months before evaluation. The following parameters were collected and analyzed: significant medical history, associated diseases, serum levels for profile evaluation: carbohydrate, lipidic, serum level of liver and pancreatic enzymes, serum markers of cardiac function, coagulation, and renal function. DRV/c (800 mg/150 mg, once daily) administrated in combination with other antiretroviral (ARV) in HIV-1 infected subjects proved to be better tolerated and with a lower impact on metabolic profile than DRV/r (600 mg/100 mg, twice daily). Patients in DRV/r group are significantly more at risk of developing, over time, side effects and metabolic impairments than those in DRV/c group, in all body functions studied, with statistically significant differences (p< 0.05) between the two groups. Laboratory data were correlated with patient’s demographic and clinical characteristics and statistically significant outcomes have been found, proving that a personalized regimen is needed to minimize the ART side effects and to maximize the success of therapy. The results of the study showed that DRV/c, associated with other antiretroviral drugs in the regimens of Romanian HIV infected subjects, have a more favorable metabolic profile than those containing DRV/r.
Ruxandra-Cristina Marin; Delia Mirela Tiț; Oana Săndulescu; Adrian Streinu-Cercel; Simona Gabriela Bungău. Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients. Biomedicines 2021, 9, 987 .
AMA StyleRuxandra-Cristina Marin, Delia Mirela Tiț, Oana Săndulescu, Adrian Streinu-Cercel, Simona Gabriela Bungău. Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients. Biomedicines. 2021; 9 (8):987.
Chicago/Turabian StyleRuxandra-Cristina Marin; Delia Mirela Tiț; Oana Săndulescu; Adrian Streinu-Cercel; Simona Gabriela Bungău. 2021. "Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients." Biomedicines 9, no. 8: 987.
Genital self‑mutilation is a pathology that leads to numerous and important discussions, rarely presented in the medical literature. There have been many attempts to explain the reasons behind these medical phenomena, but single cases have been generally reported, making it extremely difficult to draw valid conclusions. It is acknowledged that there are psychotic and non‑psychotic causes, from psychiatric problems and sexual identity disorders to cultural or religious reasons, alcohol or recreational drug consumption, unconventional types of sexual satisfaction or self‑satisfaction. Recent theories consider self‑mutilation as a phenomenon of reducing distress or tension, as an expression of feelings of anger or sorrow. It is believed that 55‑85% of those who have resorted to self‑mutilation have at least once in their life tried to commit suicide. There is evidence that early discovery and intervention as well as proper treatment in regards to psychosis can significantly reduce the number of self‑mutilation episodes, with a protective role of these individuals. Cases of genital self‑mutilation may be considered real medical emergencies, sometimes extremely challenging and accompanied by severe complications. Injury of the genital area is usually accompanied by numerous early or long‑term complications due to the marked vascular area and to the microbial flora present in this part of the body. The degree of mutilation is an unforeseen aspect that the medical staff may have to encounter during the intervention, sometimes testing their imagination and surgical skills when dealing with such a case. Understanding the causes of these self‑aggressive behaviors, which may be life‑threatening, is critical and multidisciplinary mobilization is needed after treatment of the acute phases. The outcome of these patients depends on integrated collaborative work. These cases represent a serious reason for frustration for the physicians involved in solving them, and knowledge of these issues is valuable to urologists, psychiatrists and other health professionals.
Sorin Lupu; Ovidiu Gabriel Bratu; Delia Mirela Tit; Simona Bungau; Octavian Maghiar; Teodor Andrei Maghiar; Camelia C. Scarneciu; Ioan Scarneciu. Genital self‑mutilation: A challenging pathology (Review). Experimental and Therapeutic Medicine 2021, 22, 1 -5.
AMA StyleSorin Lupu, Ovidiu Gabriel Bratu, Delia Mirela Tit, Simona Bungau, Octavian Maghiar, Teodor Andrei Maghiar, Camelia C. Scarneciu, Ioan Scarneciu. Genital self‑mutilation: A challenging pathology (Review). Experimental and Therapeutic Medicine. 2021; 22 (4):1-5.
Chicago/Turabian StyleSorin Lupu; Ovidiu Gabriel Bratu; Delia Mirela Tit; Simona Bungau; Octavian Maghiar; Teodor Andrei Maghiar; Camelia C. Scarneciu; Ioan Scarneciu. 2021. "Genital self‑mutilation: A challenging pathology (Review)." Experimental and Therapeutic Medicine 22, no. 4: 1-5.
In the early differential diagnosis of endometrial cancer (EC), decisive and mandatory histological aspects are considered, in addition to obvious clinical manifestations. In addition, sonographic aspects are characteristic in relation to the stage, degree, and histological types of identified cancer. This bi-center retrospective observational study included 594 women with abnormal uterine bleeding outside pregnancy, for which a biopsy was performed in the Obstetrics and Gynecology Departments of the Emergency County Hospitals of Arad and Timis Counties, Romania, between 2015 and 2019. Most of the cases were represented by EC or endometrial hyperplasia (EH). Of the 594 cases, 25.5% (n = 153) were EC at women aged between 41 and 85 years. High International Endometrial Tumor Analysis (IETA) scores (3, 4) were associated with a relative risk of 2.9335 compared with other endometrial lesions (95% CI 2.3046 to 3.734, p< 0.0001, NNT 1.805). Histological aspects and pelvic ultrasound using IETA scores represent valuable noninvasive assets in diagnosing and differentiating endometrial cancer from benign uterine pathology.
Alexandru Furau; Mirela Toma; Cringu Ionescu; Cristian Furau; Simona Bungau; Mihai Dimitriu; Delia Tit; Gheorghe Furau; Izabella Petre; Marius Craina. The Correlation of the IETA Ultrasound Score with the Histopathology Results for Women with Abnormal Bleeding in Western Romania. Diagnostics 2021, 11, 1342 .
AMA StyleAlexandru Furau, Mirela Toma, Cringu Ionescu, Cristian Furau, Simona Bungau, Mihai Dimitriu, Delia Tit, Gheorghe Furau, Izabella Petre, Marius Craina. The Correlation of the IETA Ultrasound Score with the Histopathology Results for Women with Abnormal Bleeding in Western Romania. Diagnostics. 2021; 11 (8):1342.
Chicago/Turabian StyleAlexandru Furau; Mirela Toma; Cringu Ionescu; Cristian Furau; Simona Bungau; Mihai Dimitriu; Delia Tit; Gheorghe Furau; Izabella Petre; Marius Craina. 2021. "The Correlation of the IETA Ultrasound Score with the Histopathology Results for Women with Abnormal Bleeding in Western Romania." Diagnostics 11, no. 8: 1342.
Chemical composition, antioxidant capacity, and antimicrobial activity of lavender essential oils (LEOs) extracted from three different varieties of Lavandula angustifolia Mill. (1-Moldoveanca 4, 2-Vis magic 10, and 3-Alba 7) have been determined. These plants previously patented in the Republic of Moldova were cultivated in an organic agriculture system in the northeastern part of Romania and then harvested in 3 consecutive years (2017–2019) to obtain the essential oils. From the inflorescences in the complete flowering stage, the LEOs were extracted by hydrodistillation. Then, their composition was analyzed by gas chromatography coupled with mass spectrometry (GC-MS) and by Fourier Transformed Infrared spectroscopy (FT-IR). The major identified constituents are as follows: linalool (1: 32.19–46.83%; 2: 29.93–30.97%; 3: 31.97–33.77%), linalyl acetate (1: 17.70–35.18%; 2: 27.55–37.13%; 3: 28.03–35.32%), and terpinen-4-ol (1: 3.63–7.70%; 2: 3.06–7.16%; 3: 3.10–6.53%). The antioxidant capacity as determined by ABTS and DPPH assays indicates inhibition, with the highest activity obtained for LEO var. Alba 7 from 2019. The in vitro antimicrobial activities of the LEOs and combinations were investigated as well, by using the disk diffusion method and minimum inhibitory concentration (MIC) against the Gram-positive bacterial strain Staphylococcus aureus (ATCC 6538), Gram-negative Pseudomonas aeruginosa (ATCC 27858), Escherichia coli (ATCC 25922), the yeast Candida albicans (ATCC 10231), and clinical isolates. Our results have shown that LEOs obtained from the three studied varieties of L. angustifolia manifest significant bactericidal effects against tested microorganisms (Staphylococcus aureus and Escherichia coli), and antifungal effects against Candida albicans. The mixture of LEOs (Var. Alba 7) and geranium, respectively, in tea tree EOs, in different ratios, showed a significant enhancement of the antibacterial effect against all the studied strains, except Pseudomonas aeruginosa.
Mihaela Bogdan; Simona Bungau; Delia Tit; Dana Zaha; Aurelia Nechifor; Tapan Behl; Dorina Chambre; Andreea Lupitu; Lucian Copolovici; Dana Copolovici. Chemical Profile, Antioxidant Capacity, and Antimicrobial Activity of Essential Oils Extracted from Three Different Varieties (Moldoveanca 4, Vis Magic 10, and Alba 7) of Lavandula angustifolia. Molecules 2021, 26, 4381 .
AMA StyleMihaela Bogdan, Simona Bungau, Delia Tit, Dana Zaha, Aurelia Nechifor, Tapan Behl, Dorina Chambre, Andreea Lupitu, Lucian Copolovici, Dana Copolovici. Chemical Profile, Antioxidant Capacity, and Antimicrobial Activity of Essential Oils Extracted from Three Different Varieties (Moldoveanca 4, Vis Magic 10, and Alba 7) of Lavandula angustifolia. Molecules. 2021; 26 (14):4381.
Chicago/Turabian StyleMihaela Bogdan; Simona Bungau; Delia Tit; Dana Zaha; Aurelia Nechifor; Tapan Behl; Dorina Chambre; Andreea Lupitu; Lucian Copolovici; Dana Copolovici. 2021. "Chemical Profile, Antioxidant Capacity, and Antimicrobial Activity of Essential Oils Extracted from Three Different Varieties (Moldoveanca 4, Vis Magic 10, and Alba 7) of Lavandula angustifolia." Molecules 26, no. 14: 4381.
Two different conditions are included in inflammatory bowel disease (IBD), Crohn’s disease (CD) and ulcerative colitis (UC), being distinguished by chronic recurrence of gut inflammation in persons that are genetically predisposed and subjected to environmental causative factors. The normal structure of the gut microbiome and its alterations in IBD were defined in several microbial studies. An important factor in the prolonged inflammatory process in IBD is the impaired microbiome or “dysbiosis”. Thus, gut microbiome management is likely to be an objective in IBD treatment. In this review, we analyzed the existing data regarding the pathophysiological/therapeutic implications of intestinal microflora in the development and evolution of IBD. Furthermore, the main effects generated by the administration of probiotics, prebiotics, fecal transplantation, and phytochemicals supplementation were analyzed regarding their potential roles in improving the clinical and biochemical status of patients suffering from Crohn’s disease (CD) and ulcerative colitis (UC), and are depicted in the sections/subsections of the present paper. Data from the literature give evidence in support of probiotic and prebiotic therapy, showing effects such as improving remission rate, improving macroscopic and microscopic aspects of IBD, reducing the pro-inflammatory cytokines and interleukins, and improving the disease activity index. Therefore, the additional benefits of these therapies should not be ignored as adjuvants to medical therapy.
Flavia Pavel; Cosmin Vesa; Gina Gheorghe; Camelia Diaconu; Manuela Stoicescu; Mihai Munteanu; Elena Babes; Delia Tit; Mirela Toma; Simona Bungau. Highlighting the Relevance of Gut Microbiota Manipulation in Inflammatory Bowel Disease. Diagnostics 2021, 11, 1090 .
AMA StyleFlavia Pavel, Cosmin Vesa, Gina Gheorghe, Camelia Diaconu, Manuela Stoicescu, Mihai Munteanu, Elena Babes, Delia Tit, Mirela Toma, Simona Bungau. Highlighting the Relevance of Gut Microbiota Manipulation in Inflammatory Bowel Disease. Diagnostics. 2021; 11 (6):1090.
Chicago/Turabian StyleFlavia Pavel; Cosmin Vesa; Gina Gheorghe; Camelia Diaconu; Manuela Stoicescu; Mihai Munteanu; Elena Babes; Delia Tit; Mirela Toma; Simona Bungau. 2021. "Highlighting the Relevance of Gut Microbiota Manipulation in Inflammatory Bowel Disease." Diagnostics 11, no. 6: 1090.
The values of hematological and coagulation biomarkers were evaluated as predictors of in hospital mortality and complications, in patients with acute coronary syndromes (ACS). This retrospective observational study enrolled 936 ACS subjects admitted to the Clinical Emergency Hospital of Oradea, Romania, between January–December 2019. Hematological and coagulation parameters were obtained at admission. During hospitalization, the following adverse events were recorded: death, ventricular rhythm disturbances, atrial fibrillation, heart failure, re-infarction, and stroke. Accuracy of hematological and coagulation parameters as predictors of adverse outcome were also evaluated. The diagnosis was unstable angina in 442 patients (47.22%), non-ST-elevation myocardial infarction (NSTEMI) in 113 patients (12.1%) and ST-elevation myocardial infarction (STEMI) in 381 patients (40.70%); 87 patients (9.29%) died during hospitalization and 193 (20.7%) developed complications. Predictors for in hospital mortality were as follows: red cell distribution width (RDW) (AUC 0.691, p < 0.0001), white blood cells (WBC) (AUC 0.684, p < 0.0001), neutrophils (NEU) (AUC 0.684, p < 0.0001), and prothrombin time (PT) (AUC 0.765, p < 0.0001). WBC (AUC 0.659, p < 0.0001), NEU (AUC 0.664, p < 0.0001), RDW (AUC 0.669, p < 0.0001), and PT (AUC 0.669, 95% CI 0.622–0.714, p < 0.0001) also had accuracy for complications prediction. RDW had a good ability to predict heart failure in NSTEMI patients (AUC 0.832, p < 0.0001). An acceptable ability to predict ventricular rhythm disturbances occurrence had WBC (AUC 0.758, p < 0.0001) and NEU (AUC 0.772, p < 0.0001). Hematological and coagulation parameters can help in risk stratification of ACS patients. RDW, WBC, NEU, and PT were able to predict mortality and in-hospital complications in ACS patients. RDW has a good accuracy in predicting complications and heart failure in NSTEMI patients. WBC and NEU are good predictors for ventricular rhythm disturbances.
Elena Babes; Dana Zaha; Delia Tit; Aurelia Nechifor; Simona Bungau; Felicia Andronie-Cioara; Tapan Behl; Manuela Stoicescu; Mihai Munteanu; Marius Rus; Mirela Toma; Ciprian Brisc. Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes. Diagnostics 2021, 11, 850 .
AMA StyleElena Babes, Dana Zaha, Delia Tit, Aurelia Nechifor, Simona Bungau, Felicia Andronie-Cioara, Tapan Behl, Manuela Stoicescu, Mihai Munteanu, Marius Rus, Mirela Toma, Ciprian Brisc. Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes. Diagnostics. 2021; 11 (5):850.
Chicago/Turabian StyleElena Babes; Dana Zaha; Delia Tit; Aurelia Nechifor; Simona Bungau; Felicia Andronie-Cioara; Tapan Behl; Manuela Stoicescu; Mihai Munteanu; Marius Rus; Mirela Toma; Ciprian Brisc. 2021. "Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes." Diagnostics 11, no. 5: 850.
Autoimmune thyroiditis (AIT) is on the rise among the population, and is frequently associated with patients with acne vulgaris, especially females aged between 18–55 years old. The connection between the two is not fully elucidated. In this study, 236 patients diagnosed with acne in the dermatological office of the private Pelican Hospital and in few private dermatological offices from Oradea, Romania, during January 2018–December 2020, aged between 12 and 55 years old, were endocrinologically investigated to determine AIT and its influence on the severity of the acne. The values for the thyroid antibodies and thyroid-stimulating hormone (TSH) were determined for all of the subjects. The frequency of AIT in the study group was 72% and was associated with severe acne (p < 0.001). Patients with AIT with normal or hypofunction had more frequent severe acne than those with hyperfunction (p < 0.001, p = 0.002). The TSH and anti thyroidperoxidase (TPO) values did not influence the severity of the acne (p = 0.494; p = 0.111), while the anti-TG values were associated with severe acne (p = 0.007). The risk analysis indicated that raised values of anti-TPO (2.91 times greater) correlated with high anti-thyroglobulin (TG) values (4.36 times greater) doubled the risk of developing severe acne in patients. In acne evolution, the existence of AIT involves significant modifications.
Laura Endres; Delia Tit; Simona Bungau; Nicoleta Pascalau; Laura Maghiar Țodan; Erika Bimbo-Szuhai; Gabriela Iancu; Nicoleta Negrut. Incidence and Clinical Implications of Autoimmune Thyroiditis in the Development of Acne in Young Patients. Diagnostics 2021, 11, 794 .
AMA StyleLaura Endres, Delia Tit, Simona Bungau, Nicoleta Pascalau, Laura Maghiar Țodan, Erika Bimbo-Szuhai, Gabriela Iancu, Nicoleta Negrut. Incidence and Clinical Implications of Autoimmune Thyroiditis in the Development of Acne in Young Patients. Diagnostics. 2021; 11 (5):794.
Chicago/Turabian StyleLaura Endres; Delia Tit; Simona Bungau; Nicoleta Pascalau; Laura Maghiar Țodan; Erika Bimbo-Szuhai; Gabriela Iancu; Nicoleta Negrut. 2021. "Incidence and Clinical Implications of Autoimmune Thyroiditis in the Development of Acne in Young Patients." Diagnostics 11, no. 5: 794.
Withaferin A (WFA) was identified as the most active phytocompound of the plant Withania somnifera (WS) and as having multiple therapeutic/ameliorating properties (anticancer, antiangiogenic, anti-invasive, anti-inflammatory, proapoptotic, etc.) in case of various diseases. In drug chemistry, WFA in silico approaches have identified favorite biological targets, stimulating and accelerating research to evaluate its pharmacological activity—numerous anticancer effects manifested in various organs (breast, pancreas, skin, colon, etc.), antivirals, anti-infective, etc., which are not yet sufficiently explored. This paper is a synthesis of the most relevant specialized papers in the field that are focused on the use of WFA in dermatological diseases, describing its mechanism of action while providing, at the same time, details about the results of its testing in in vitro/in vivo studies.
Simona Bungau; Cosmin Vesa; Areha Abid; Tapan Behl; Delia Tit; Anamaria Purza; Bianca Pasca; Laura Todan; Laura Endres. Withaferin A—A Promising Phytochemical Compound with Multiple Results in Dermatological Diseases. Molecules 2021, 26, 2407 .
AMA StyleSimona Bungau, Cosmin Vesa, Areha Abid, Tapan Behl, Delia Tit, Anamaria Purza, Bianca Pasca, Laura Todan, Laura Endres. Withaferin A—A Promising Phytochemical Compound with Multiple Results in Dermatological Diseases. Molecules. 2021; 26 (9):2407.
Chicago/Turabian StyleSimona Bungau; Cosmin Vesa; Areha Abid; Tapan Behl; Delia Tit; Anamaria Purza; Bianca Pasca; Laura Todan; Laura Endres. 2021. "Withaferin A—A Promising Phytochemical Compound with Multiple Results in Dermatological Diseases." Molecules 26, no. 9: 2407.
The severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) pandemic is responsible for generating a global effort to discover urgent therapeutic solutions to limit the human damage caused by COVID‑19. In the period of April to June 2020, 105 patients diagnosed with COVID‑19 met the conditions for inclusion in the present study. They were treated with antiviral therapy according to local guidelines: D group (53 cases), treated with darunavir/ritonavir (DRV/r); and K group (52 cases), treated with lopinavir/ritonavir (LPV/r). Patients from the K group required 7.5 days of hospitalization less compared to those from the D group (P<0.001). The blood oxygen saturation values recorded in the groups were statistically different [K group (94.02±3.12%) vs. D group (92.13±4.24%), P=0.010]. The percentage of patients with unsatisfactory clinical evolution were non‑significantly higher in the D group compared with the K group [20 (37.74%) vs. 12 (23.08%), P=0.157]. We did not note statistically significant differences between the two groups tracked considering the values for the Brescia‑COVID Respiratory Severity Scale (BCRSS) of the patients with unsatisfactory clinical evolution, nor of the chest CT' evolution after 10 days of therapy. We did not register significant adverse effects after antiviral therapy in the two groups. Antiviral therapy with LPV/r had some favorable results compared to DRV/r in patients with COVID‑19. Both therapies were well tolerated.
Nicoleta Negrut; Adriana Codrean; Ioana Hodisan; Simona Bungau; Delia Mirela Tit; Ruxandra Marin; Tapan Behl; Florin Banica; Camelia C. Diaconu; Delia Carmen Nistor‑Cseppento. Efficiency of antiviral treatment in COVID‑19. Experimental and Therapeutic Medicine 2021, 21, 1 -7.
AMA StyleNicoleta Negrut, Adriana Codrean, Ioana Hodisan, Simona Bungau, Delia Mirela Tit, Ruxandra Marin, Tapan Behl, Florin Banica, Camelia C. Diaconu, Delia Carmen Nistor‑Cseppento. Efficiency of antiviral treatment in COVID‑19. Experimental and Therapeutic Medicine. 2021; 21 (6):1-7.
Chicago/Turabian StyleNicoleta Negrut; Adriana Codrean; Ioana Hodisan; Simona Bungau; Delia Mirela Tit; Ruxandra Marin; Tapan Behl; Florin Banica; Camelia C. Diaconu; Delia Carmen Nistor‑Cseppento. 2021. "Efficiency of antiviral treatment in COVID‑19." Experimental and Therapeutic Medicine 21, no. 6: 1-7.
Honey and propolis from Apis mellifera (bees) are products that have been used due to their multiple biological properties. The antimicrobial activity of 10 honey samples of known origin and 4 propolis extracts gathered from the same beekeepers located in Transylvania, Romania, were used against certain microorganisms: Escherichia coli, Staphylococcus aureus, Bacillus cereus, Pseudomonas aeruginosa and Candida albicans. The study also investigated the positive interaction of propolis aqueous extracts when used with poly-floral honey against the same microorganisms. The most sensitive to the activity of honey samples was the S. aureus strain (the largest inhibition area 18 mm) for poly-floral honey and P. aeruginosa strain (17 mm) for sunflower honey, both from Alba County. P. aeruginosa, E. coli, and S. aureus strains (32 mm) were sensitive to the activity of propolis extracts samples. Ciprofloxacin showed a higher antibacterial activity against S. aureus and B. cereus (30 mm). The antimicrobial effect of honey and propolis were more powerful when combined. Statistical analysis showed that both the strain type and the type of honey used influenced the diameter of the inhibition zone. In the case of propolis, no connection between propolis origin (regardless of its concentration) and the microbial activity was found but the microbial strains used influence the diameters of inhibition zones.
Mihaela Laura Vică; Mirel Glevitzky; Delia Mirela Tit; Tapan Behl; Ramona Cristina Heghedűş-Mîndru; Dana Carmen Zaha; Francesca Ursu; Maria Popa; Ioana Glevitzky; Simona Bungău. The antimicrobial activity of honey and propolis extracts from the central region of Romania. Food Bioscience 2021, 41, 101014 .
AMA StyleMihaela Laura Vică, Mirel Glevitzky, Delia Mirela Tit, Tapan Behl, Ramona Cristina Heghedűş-Mîndru, Dana Carmen Zaha, Francesca Ursu, Maria Popa, Ioana Glevitzky, Simona Bungău. The antimicrobial activity of honey and propolis extracts from the central region of Romania. Food Bioscience. 2021; 41 ():101014.
Chicago/Turabian StyleMihaela Laura Vică; Mirel Glevitzky; Delia Mirela Tit; Tapan Behl; Ramona Cristina Heghedűş-Mîndru; Dana Carmen Zaha; Francesca Ursu; Maria Popa; Ioana Glevitzky; Simona Bungău. 2021. "The antimicrobial activity of honey and propolis extracts from the central region of Romania." Food Bioscience 41, no. : 101014.
Osteoarthritis is mainly located in the knee area. It is an important concern related to the population health, determined by the influence on the quality of life of patients. Total knee arthroplasty (TKA) with uncemented fixation is among the most encountered procedures performed in patients of a younger age. The present study investigated the response of patients (quality of life, mobility and pain management) with titanium/hydroxyapatite‑coated implants with polyethylene inserts. A total of 57 patients with knee arthroplasty were studied with an average age of 54.1±4.9 years and 57.8% were females. The present study focused on the following aspects: The components of such a prosthesis and the way they contribute to a physiological fixation/recovery; how the implant surgery is performed; the clinical and demographic characteristics of the patients; postoperative pain assessment in different types of movement; the management of the movement capacity 1 year after the surgery; and complications that may occur. One year after the surgery, these patients reported pain release, considerably favorable results in every‑day activities, and good mobility (capable of using the car, rising from the bed or standing). Knowledge and accurate observation of the correct steps in performing this surgery and the role of the components of the prosthesis can lead to favorable therapeutic outcomes for patients with knee osteoarthritis.
Bogdan Uivaraseanu; Simona Bungau; Delia Mirela Tit; Tapan Behl; Teodor Andrei Maghiar; Octavian Maghiar; Carmen Pantis; Dana Carmen Zaha; Jenel M. Patrascu. Orthopedic surgery approach with uncemented metallic prosthesis in knee osteoarthritis increases the quality of life of young patients. Experimental and Therapeutic Medicine 2021, 21, 1 -6.
AMA StyleBogdan Uivaraseanu, Simona Bungau, Delia Mirela Tit, Tapan Behl, Teodor Andrei Maghiar, Octavian Maghiar, Carmen Pantis, Dana Carmen Zaha, Jenel M. Patrascu. Orthopedic surgery approach with uncemented metallic prosthesis in knee osteoarthritis increases the quality of life of young patients. Experimental and Therapeutic Medicine. 2021; 21 (5):1-6.
Chicago/Turabian StyleBogdan Uivaraseanu; Simona Bungau; Delia Mirela Tit; Tapan Behl; Teodor Andrei Maghiar; Octavian Maghiar; Carmen Pantis; Dana Carmen Zaha; Jenel M. Patrascu. 2021. "Orthopedic surgery approach with uncemented metallic prosthesis in knee osteoarthritis increases the quality of life of young patients." Experimental and Therapeutic Medicine 21, no. 5: 1-6.
Androgen insensitivity syndrome (AIS) is an X-linked recessive genetic syndrome that occurs as result of an androgen receptor mutation; it affects the normal masculinization process in chromosomal male patients. More than 900 androgen receptor mutations that can lead to AIS have been identified. The complete androgen insensitivity is characterized by a total lack of response to androgens, usually in patients with 46XY karyotype but with feminine phenotype. Primary amenorrhoea and inguinal swellings in female patients are the main signs that could raise suspicion for this syndrome. Patients with partial androgen insensitivity have ambiguous genitalia at birth and gynecomastia during puberty, whereas those with mild androgen insensitivity present a normal male phenotype but altered spermatogenesis during adulthood and pubertal gynecomastia. The diagnosis of AIS often proves to be a challenge; its management is complex and requires a multidisciplinary approach to meet decision-making challenges in sex assignment, fertility and timing of gonadectomy, psychological outcomes and genetic counselling.
Bratu Ovidiu; Dragos Radu Marcu; Dan Liviu Dorel Mischianu; Catalina Poiana; Camelia Cristina Diaconu; Simona Gabriela Bungau; Delia Mirela Tit; Alin Cumpanas; Roxana Bohiltea. The challenges of androgen insensitivity syndrome. Archives of Medical Science 2021, 1 .
AMA StyleBratu Ovidiu, Dragos Radu Marcu, Dan Liviu Dorel Mischianu, Catalina Poiana, Camelia Cristina Diaconu, Simona Gabriela Bungau, Delia Mirela Tit, Alin Cumpanas, Roxana Bohiltea. The challenges of androgen insensitivity syndrome. Archives of Medical Science. 2021; ():1.
Chicago/Turabian StyleBratu Ovidiu; Dragos Radu Marcu; Dan Liviu Dorel Mischianu; Catalina Poiana; Camelia Cristina Diaconu; Simona Gabriela Bungau; Delia Mirela Tit; Alin Cumpanas; Roxana Bohiltea. 2021. "The challenges of androgen insensitivity syndrome." Archives of Medical Science , no. : 1.
This review explores the correlation between specific aspects of antibiotic usage, their resistance development and environmental factors. The indiscriminate use of antibiotics led to environment contamination, selection and spreading of antibiotic-resistant organisms and alteration of the microbial ecosystems balance. Socio-behavioural environmental factors and changes in the natural environment are major contributors to resistance development. Resistant bacteria strains isolation in food, water, soil etc. demonstrates the environmental influence on the strains through antibiotics accumulation in the environment. It is difficult to assess the impact of antibiotic consumption on public health and the environment. Reducing irrational consumption, restoring microbial ecosystems, adopting methodologies to control antimicrobial resistance in case of in-hospital infections, implementation of measures included in national/international health policies are the main solutions for this problem.
Simona Bungau; Delia Mirela Tit; Tapan Behl; Lotfi Aleya; Dana Carmen Zaha. Aspects of excessive antibiotic consumption and environmental influences correlated with the occurrence of resistance to antimicrobial agents. Current Opinion in Environmental Science & Health 2020, 19, 100224 .
AMA StyleSimona Bungau, Delia Mirela Tit, Tapan Behl, Lotfi Aleya, Dana Carmen Zaha. Aspects of excessive antibiotic consumption and environmental influences correlated with the occurrence of resistance to antimicrobial agents. Current Opinion in Environmental Science & Health. 2020; 19 ():100224.
Chicago/Turabian StyleSimona Bungau; Delia Mirela Tit; Tapan Behl; Lotfi Aleya; Dana Carmen Zaha. 2020. "Aspects of excessive antibiotic consumption and environmental influences correlated with the occurrence of resistance to antimicrobial agents." Current Opinion in Environmental Science & Health 19, no. : 100224.
Hypertension (HTN) in pregnancy is a major cause of maternal, foetal and neonatal morbimortality in both developing and developed countries. Arterial stiffness is a predictor of cardiovascular events and can be assessed through augmentation index (AIx) and pulse wave velocity (PWV). This study was intended to analyse the arterial stiffness in three categories, hypertensive pregnant women vs. healthy women (both pregnant and non-pregnant). Between 2018 and 2019, 150 women were prospectively included into three homogenous groups, of equal sizes (N = 50): pregnant women with HTN (group 1), pregnant women without HTN (group 2), and non-pregnant women (group 3). We assessed pregnant women 3 times (in all three trimesters) and six weeks postpartum, and the women from the control group once. Significant differences (p < 0.001) of the hemodynamic and arterial stiffness parameters and of the heart rate (HR) (p = 0.006) were observed between groups 1 and 2. Women with pregnancy-induced HTN had different values of arterial function parameters long time before the first signs of high blood pressure (BP) occurred. Also, body mass index (BMI) had a deleterious effect in all patients, but especially in pregnant HTN women. Significant differences (p < 0.001) between groups 2 and 3 were observed regarding the BP and aortic PWV (PWVao) and, as well, significant differences (p < 0.05) between BMI, aortic systolic BP (p = 0.02), brachial AIx (p = 0.01) and pulse pressure (PP) (p = 0.049) values. The current study emphasizes the importance of the assessment of arterial function parameters and BMI as markers for future BP values and outcomes throughout gestation.
Vladiana Turi; Stela Iurciuc; Octavian Marius Crețu; Delia Mirela Tit; Simona Bungau; Adrian Apostol; Radu Dumitru Moleriu; Cristiana Bustea; Tapan Behl; Camelia Cristina Diaconu; Izabella Petre. Arterial function in hypertensive pregnant women. Is arterial stiffness a marker for the outcomes in pregnancy? Life Sciences 2020, 264, 118723 .
AMA StyleVladiana Turi, Stela Iurciuc, Octavian Marius Crețu, Delia Mirela Tit, Simona Bungau, Adrian Apostol, Radu Dumitru Moleriu, Cristiana Bustea, Tapan Behl, Camelia Cristina Diaconu, Izabella Petre. Arterial function in hypertensive pregnant women. Is arterial stiffness a marker for the outcomes in pregnancy? Life Sciences. 2020; 264 ():118723.
Chicago/Turabian StyleVladiana Turi; Stela Iurciuc; Octavian Marius Crețu; Delia Mirela Tit; Simona Bungau; Adrian Apostol; Radu Dumitru Moleriu; Cristiana Bustea; Tapan Behl; Camelia Cristina Diaconu; Izabella Petre. 2020. "Arterial function in hypertensive pregnant women. Is arterial stiffness a marker for the outcomes in pregnancy?" Life Sciences 264, no. : 118723.
Microbial contamination and damaging effects due to environmental factors (temperature, humidity) of old books is an extremely important issue in the heritage preserving field, being a great threat to this unique cultural and literary treasure. This paper analysed the indoor environmental conditions, the microbiological characteristics of the air and the condition itself of 27 clerical books (from eighteenth to nineteenth centuries), randomly chosen from the library of Bistrița Monastery, Romania. The analysis revealed that most of the books were contaminated and damaged by moulds and yeasts. The statistical analysis (chi-square test) shows that the incidence of mould species was not coincidental. The most common isolated fungi discovered on old books were Penicillium spp. (40.7%), Cladosporium spp. (33.3%) and Fusarium spp. (29.6%). Fungal contamination was observed in 17 books. Microbiota air tests have shown possible contamination by air flow. Often, the measured temperature/humidity values are not in line with the requirements of the legislation in force, especially during the cold seasons, the average minimum temperature varying from 3 to 6 °C to an average maximum temperature of 22–25 °C; the values of relative humidity were between 27 and 77%. In terms of storage conditions, the recorded values of temperature and humidity are extremely harmful to the stored documents. Therefore, these indoor environmental conditions have to be improved, in order to reduce/eliminate potential sources of fungal contamination and to achieve optimal environmental preserving conditions.
Mirel Glevitzky; Lotfi Aleya; Mihaela Laura Vică; Gabriela-Alina Dumitrel; Mariana Avram; Delia Mirela Tit; Maria Popa; Viorel-Cristian Popa; Tapan Behl; Simona Bungau. Assessing the microbiological contamination along with environmental factors of old books in the 1490-founded Bistrița Monastery, Romania. Environmental Science and Pollution Research 2020, 28, 8743 -8757.
AMA StyleMirel Glevitzky, Lotfi Aleya, Mihaela Laura Vică, Gabriela-Alina Dumitrel, Mariana Avram, Delia Mirela Tit, Maria Popa, Viorel-Cristian Popa, Tapan Behl, Simona Bungau. Assessing the microbiological contamination along with environmental factors of old books in the 1490-founded Bistrița Monastery, Romania. Environmental Science and Pollution Research. 2020; 28 (7):8743-8757.
Chicago/Turabian StyleMirel Glevitzky; Lotfi Aleya; Mihaela Laura Vică; Gabriela-Alina Dumitrel; Mariana Avram; Delia Mirela Tit; Maria Popa; Viorel-Cristian Popa; Tapan Behl; Simona Bungau. 2020. "Assessing the microbiological contamination along with environmental factors of old books in the 1490-founded Bistrița Monastery, Romania." Environmental Science and Pollution Research 28, no. 7: 8743-8757.
Clostridioides difficile (CD) is responsible for nosocomial diarrhea syndrome with possible severe progression. Recurrence of the disease induces higher health system costs, as well as exposes patients to additional health risks. Patients with recurrence of this disease are difficult to identify, so the purpose of this study is to quantify various demographic, clinical, and treatment factors that could prevent further progression to recurrence of the disease. In the period 2018–2019, about 195 patients were diagnosed with more than one episode of CDI in the three months following the first episode. The recurrence rate for CDI was 53.84% (60.95% for one episode and 39.05% for multiple episodes). Most commonly afflicted were 60–69-year-old patients, or those with higher Charlson Comorbidity Index (CCI). Multiple analyses associated cardiovascular (odds ratios (OR) = 3.02, 95% confidence intervals (CI) = 1.23–7.39, p = 0.015), digestive (OR = 3.58, 95% CI = 1.01–12.63, p = 0.047), dementia (OR = 3.26, 95% CI = 1.26–8.41, p = 0.014), immunosuppressive (OR = 3.88, 95% CI = 1.34–11.21, p = 0.012) comorbidities with recurrences. Risk factor identification in the first episode of CDI could lead to the implementation of treatment strategies to improve the patients’ quality of life affected by this disease.
Nicoleta Negrut; Simona Bungau; Tapan Behl; Shamim Khan; Cosmin Vesa; Cristiana Bustea; Delia Nistor-Cseppento; Marius Rus; Flavia-Maria Pavel; Delia Tit. Risk Factors Associated with Recurrent Clostridioides difficile Infection. Healthcare 2020, 8, 352 .
AMA StyleNicoleta Negrut, Simona Bungau, Tapan Behl, Shamim Khan, Cosmin Vesa, Cristiana Bustea, Delia Nistor-Cseppento, Marius Rus, Flavia-Maria Pavel, Delia Tit. Risk Factors Associated with Recurrent Clostridioides difficile Infection. Healthcare. 2020; 8 (3):352.
Chicago/Turabian StyleNicoleta Negrut; Simona Bungau; Tapan Behl; Shamim Khan; Cosmin Vesa; Cristiana Bustea; Delia Nistor-Cseppento; Marius Rus; Flavia-Maria Pavel; Delia Tit. 2020. "Risk Factors Associated with Recurrent Clostridioides difficile Infection." Healthcare 8, no. 3: 352.
The no-reflow phenomenon following primary percutaneous coronary intervention (PPCI) in acute ST-elevation myocardial infarction (STEMI) patients is a predictor of unfavorable prognosis. Patients with no-reflow have many complications during admission, and it is considered a marker of short-term mortality. The current research emphasizes the circumstances of the incidence and complications of the no-reflow phenomenon in STEMI patients, including in-hospital mortality. In this case-control study, conducted over two and a half years, there were enrolled 656 patients diagnosed with STEMI and reperfused through PPCI. Several patients (n = 96) developed an interventional type of no-reflow phenomenon. One third of the patients with a no-reflow phenomenon suffered complications during admission, and 14 succumbed. Regarding complications, the majority consisted of arrhythmias (21.68%) and cardiogenic shock (16.67%). The anterior localization of STEMI and the left anterior descending artery (LAD) as a culprit lesion were associated with the highest number of complications during hospitalization. At the same time, the time interval >12 h from the onset of the typical symptoms of myocardial infarction (MI) until revascularization, as well as multiple stents implantations during PPCI, correlated with an increased incidence of short-term complications. The no-reflow phenomenon in patients with STEMI was associated with an unfavorable short-term prognosis.
Larisa Renata Pantea-Roșan; Vlad Alin Pantea; Simona Bungau; Delia Mirela Tit; Tapan Behl; Cosmin Mihai Vesa; Cristiana Bustea; Radu Dumitru Moleriu; Marius Rus; Mircea Ioachim Popescu; Vladiana Turi; Camelia Cristina Diaconu. No-Reflow after PPCI—A Predictor of Short-Term Outcomes in STEMI Patients. Journal of Clinical Medicine 2020, 9, 2956 .
AMA StyleLarisa Renata Pantea-Roșan, Vlad Alin Pantea, Simona Bungau, Delia Mirela Tit, Tapan Behl, Cosmin Mihai Vesa, Cristiana Bustea, Radu Dumitru Moleriu, Marius Rus, Mircea Ioachim Popescu, Vladiana Turi, Camelia Cristina Diaconu. No-Reflow after PPCI—A Predictor of Short-Term Outcomes in STEMI Patients. Journal of Clinical Medicine. 2020; 9 (9):2956.
Chicago/Turabian StyleLarisa Renata Pantea-Roșan; Vlad Alin Pantea; Simona Bungau; Delia Mirela Tit; Tapan Behl; Cosmin Mihai Vesa; Cristiana Bustea; Radu Dumitru Moleriu; Marius Rus; Mircea Ioachim Popescu; Vladiana Turi; Camelia Cristina Diaconu. 2020. "No-Reflow after PPCI—A Predictor of Short-Term Outcomes in STEMI Patients." Journal of Clinical Medicine 9, no. 9: 2956.
Background and objectives: Diabetic foot ulcer (DFU) is one of the serious complications of diabetes, being related to frequent and long-term hospitalisation, reduced quality of life of the patient, amputations, a high rate of morbidity and mortality. The bacterial aetiology is complex, sometimes involving more than one pathogen, playing a major role in the infection prognosis and development of microbial resistance. This study evaluated the current state of the aetiology, clinical and pathological characteristics of DFU in a single diabetes centre in order to provide some specific measures to prevent it. Materials and Methods: This retrospective study was conducted on patients with diabetes mellitus (252 individuals diagnosed with DFU) between January 2018–December 2019. All participants were assessed based on their clinical characteristics, including complications of diabetes and pathological and microbiological evaluations. Results: The present research revealed that diabetic foot ulcer prevalence was higher in males than in females and higher in type 2 diabetic patients than in type 1 diabetic patients. The patients with diabetic foot ulcer were older, had a higher body mass index (BMI), longer diabetic duration and had more diabetic complications, such as retinopathy, diabetic polyneuropathy and diabetic kidney disease, than patients without diabetic foot ulceration. Conclusions: Taking into account all factors involved, including the aetiology and the antibiotic susceptibility pattern of these isolates, planning the suitable treatment options of patients is possible.
Bogdan Uivaraseanu; Simona Bungau; Delia Tit; Ovidiu Fratila; Marius Rus; Teodor Maghiar; Octavian Maghiar; Carmen Pantis; Cosmin Vesa; Dana Zaha. Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome. Medicina 2020, 56, 380 .
AMA StyleBogdan Uivaraseanu, Simona Bungau, Delia Tit, Ovidiu Fratila, Marius Rus, Teodor Maghiar, Octavian Maghiar, Carmen Pantis, Cosmin Vesa, Dana Zaha. Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome. Medicina. 2020; 56 (8):380.
Chicago/Turabian StyleBogdan Uivaraseanu; Simona Bungau; Delia Tit; Ovidiu Fratila; Marius Rus; Teodor Maghiar; Octavian Maghiar; Carmen Pantis; Cosmin Vesa; Dana Zaha. 2020. "Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome." Medicina 56, no. 8: 380.
A sensitive electrochemical method was used for the determination of the total phenolic content and antioxidant activity of Echinacea purpurea extracts. In this study, 3 glassy carbon electrodes (GCE) were used: one unmodified and the other two newly manufactured glassy carbon electrodes modified with carbon nanotubes (CNTs) and chitosan (CS) in different concentrations, having the following composition: 1 mg/mL CNTs/CS 5%/GCE and 20 mg/mL CNTs/CS 0.5%/GCE. The determinations were performed on 3 different pharmaceutical forms (capsules, tablets and tincture), which contain E. pururea extract from the root or aerial part of the plant. Standard chicoric and caftaric polyphenolic acids, as well as food supplements extracts, were characterized using voltammetry, in a Britton-Robinson (B-R) electrolyte buffer. The modified 1 mg/mL CNTs/CS 5%/GCE electrode has superior properties compared to the other two (the unmodified and 20 mg/mL CNTs/CS 0.5%/GCE-modified) electrodes used in the study. Echinacea tincture had the highest antioxidant capacity and the biggest total amount of polyphenols (28.72 mg/equivalent of 500 mg powder). Echinacea capsules had the lowest antioxidant capacity, but also the lowest total amount of polyphenols (19.50 mg/500 mg powder); similarly, tablets had approximately the same values of polyphenols content (19.80 mg/500 mg powder), and also antioxidant capacity. The total polyphenol content was consistent with the one indicated by the manufacturers. Pulse-differential cyclic voltammetry represents a rapid, simple and sensitive technique to establish the entire polyphenolic amount and the antioxidant activity of the E. purpurea extracts.
Florin Banica; Simona Bungau; Delia Mirela Tit; Tapan Behl; Pavel Otrisal; Aurelia Cristina Nechifor; Daniela Gitea; Flavia-Maria Pavel; Sebastian Nemeth. Determination of the Total Polyphenols Content and Antioxidant Activity of Echinacea Purpurea Extracts Using Newly Manufactured Glassy Carbon Electrodes Modified with Carbon Nanotubes. Processes 2020, 8, 833 .
AMA StyleFlorin Banica, Simona Bungau, Delia Mirela Tit, Tapan Behl, Pavel Otrisal, Aurelia Cristina Nechifor, Daniela Gitea, Flavia-Maria Pavel, Sebastian Nemeth. Determination of the Total Polyphenols Content and Antioxidant Activity of Echinacea Purpurea Extracts Using Newly Manufactured Glassy Carbon Electrodes Modified with Carbon Nanotubes. Processes. 2020; 8 (7):833.
Chicago/Turabian StyleFlorin Banica; Simona Bungau; Delia Mirela Tit; Tapan Behl; Pavel Otrisal; Aurelia Cristina Nechifor; Daniela Gitea; Flavia-Maria Pavel; Sebastian Nemeth. 2020. "Determination of the Total Polyphenols Content and Antioxidant Activity of Echinacea Purpurea Extracts Using Newly Manufactured Glassy Carbon Electrodes Modified with Carbon Nanotubes." Processes 8, no. 7: 833.
The prevalence of diabetes mellitus (DM) rises constantly each year worldwide. Because of that, the funds allocated for the DM treatment have increased over time. Regarding the number of DM cases, Romania is among the top ten countries in Europe. Based on the National Diabetes Programme (NDP), antidiabetic drugs and other expenditures (Self-monitoring blood glucose (SMBG) test, HbA1c, insulin pumps/insulin pumps supplies) are free of charge. This programme has undergone many changes in drugs supply, in the last two decades: re-organizing the NDP, authorization of new molecules with high prices (e.g., SGLT-2 inhibitors, etc.) or new devices (e.g., insulin pumps, etc.) The main purpose of this study is to identify and analyse the impact of the DM costs on the Romanian health budget and to highlight the evolution of these costs. A retrospective longitudinal research on the official data regarding the DM costs from 2000 to 2017 was performed. The DM funds (DMF) were adjusted with the inflation rate. In this period, the average share of DMF in the total funds allocated for health programmes was 21.3 ± 3.4%, and DMF average growth rate was 25.4% (r = 0.488, p = 0.047). On the other hand, the DMF increased more than 14 times, in spite of the patients’ number having increased only about 2.5 times. Referring to the structure of DMF, the mean value of the antidiabetic drugs cost was of 96,045 ± 67,889 thousand EUR while for other expenditures it was of 11,530 ± 7922 thousand EUR (r = 0.945, p < 0.001). Between 2008 and 2017, the total DMF was 181,252 ± 74,278 thousand EUR/year. Moreover, the average patients’ number was 667,384 ± 94,938 (r = 0.73, p = 0.016), and the cost of treatment was 215 ± 36 EUR/patient/year. Even if the cost is rising, the correct and optimal treatment is a main condition for the diabetic patient’s health and for the prevention of its complications, which have multiple socio-economic repercussions.
Claudiu Morgovan; Smaranda Adina Cosma; Madalina Valeanu; Anca Maria Juncan; Luca Liviu Rus; Felicia Gabriela Gligor; Anca Butuca; Delia Mirela Tit; Simona Bungau; Steliana Ghibu. An Exploratory Research of 18 Years on the Economic Burden of Diabetes for the Romanian National Health Insurance System. International Journal of Environmental Research and Public Health 2020, 17, 4456 .
AMA StyleClaudiu Morgovan, Smaranda Adina Cosma, Madalina Valeanu, Anca Maria Juncan, Luca Liviu Rus, Felicia Gabriela Gligor, Anca Butuca, Delia Mirela Tit, Simona Bungau, Steliana Ghibu. An Exploratory Research of 18 Years on the Economic Burden of Diabetes for the Romanian National Health Insurance System. International Journal of Environmental Research and Public Health. 2020; 17 (12):4456.
Chicago/Turabian StyleClaudiu Morgovan; Smaranda Adina Cosma; Madalina Valeanu; Anca Maria Juncan; Luca Liviu Rus; Felicia Gabriela Gligor; Anca Butuca; Delia Mirela Tit; Simona Bungau; Steliana Ghibu. 2020. "An Exploratory Research of 18 Years on the Economic Burden of Diabetes for the Romanian National Health Insurance System." International Journal of Environmental Research and Public Health 17, no. 12: 4456.