Alexandru Gratian Naum

Dr. Alexandru Gratian Naum


Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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2 September 2024 in Preprints.org
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PMPALOMA MOISII
PALOMA MOISII
ANAlexandru Gratian Naum
Alexandru Gratian Naum
AUAndra-Mara Ursu
Andra-Mara Ursu
AVAdrian Vilcu
Adrian Vilcu
IEIrina Esanu
Irina Esanu
IJIRINA JARI
IRINA JARI
Background and Objectives: Fibrillinopathies have different phenotypic expression: Marfan- like skeleton features, MLSF; mitral valve prolapse syndrome, MVPS; MASS phenotype, M= mitral valve prolapse, MVP, A= aortic root dilation, S= skeletal features, and the second S= (cutaneous) striae; Marfan syndrome, MS. These are inherited connective tissue diseases, provoked by a mutation of the encoding gene for a protein(fibrillin 1, FBN1) which has major importance in the formation of elastic fibers.The study had the following main objectives: the correlation between disc displacement, DD( a major sign for temporomandibular joint dysfunction, TMD) on magnetic resonance imaging, MRI, and aortic Z score(a major sign for aortic root dilation) on echocardiography; the predictive value of DD towards aortic Z score. DD had 2 types of severity: DD with reduction(the mild type, DDwR) , and DD without reduction( the severe type, DDwoR). Materials and Methods: The type of fibrillinopathy was precised by clinical exam( systemic score), ophthalmic exam(for ectopia lentis), and echocardiography(aortic Z score, MVP). Medical treatment consisted in betablockers, BB(for patients with tachycardia), or angiotensin II receptor blockers, ARB. Surgical treatment was addressed to aortic root aneurysm, and severe MR. DD benefited by dental conservatory treatment, or surgical restoration.Results: DD- Z score had a powerful correlation in MASS(Rho= 0.787, p< 0.01), and in MS patients(Rho=0.819, p< 0.01). For the entire sample, both DDwR- Z score, and DDwoR- Z score had a moderate correlation(Rho= 0.469, and respectively 0.669). Muchmore, DD was an important predictor for Z score. DDwoR had a double power of prediction for Z score, comparative with DDwR(B coefficient= 1.661 for DDwR, and 3.281 for DDwoR). Conclusions: TMD had a powerful correlation with aortic root dilation, in MASS, and MS patients from the sample. Likewise, TMD was a major predictor for aortic root dilation, in the entire sample. We can utilize in clinical practice, an extracardiac finding, TMD, obtained by a non-invasive technique, MRI, for cardiac severity stratification of fibrillinopathies.

16 July 2024 in Preprints.org
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ANAlexandru Gratian Naum
Alexandru Gratian Naum
IJIRINA JARI
IRINA JARI
LMLiliana Moisii
Liliana Moisii
AUAndra Ursu
Andra Ursu
PMPALOMA MOISII
PALOMA MOISII
:. Background and Objectives: Pulmonary embolism, PE, incidence had been increasing in the last ten years. Computed thoracic pulmonary angiography, CTPA, had a major role in confirming PE di-agnosis.The main purpose of the study was to establish the prognostic value of a CTPA parameter: pulmonary artery obstruction index, PAOI, for PE risk assessment . A second objective of the re-search was to investigate the predictive accuracy of biomarkers (D-dimer, and cardiac Troponin T, c-TnT ), and PAOI, in 7-day mortality. The third objective of the study was the relationship between PAOI, and these biomarkers, in different etiologies of PE. Materials and Methods: The study com-prised 109 patients with PE, hospitalized, and treated between February 2021, and August 2022. They had different etiologies: deep vein thrombosis, DVT; persistent atrial fibrillation, AF; chronic obstructive pulmonary disease, COPD, exacerbation; Covid; and cancers. The investigations were the following: clinical examination; D-dimer testing, as a mandatory method for PE suspicion( values ≥ 500 µg/L were highly suggestive for PE); c-TnT , as a marker of myocardial injury(values ≥ 14 ng/L were abnormal); CTPA, with right ventricle dysfunction, RVD, signs, and PAOI. Treat-ments were according to PE risk: systemic thrombolysis (in high risk , and hemodynamic instability); low weight molecular heparins, LWMH, after systemic thrombolysis, or in high risk PE, with he-modynamic stability; direct oral anticoagulants, DOAC (in low, and intermediate risk). Results: The relationship PAOI- D-dimer, and PAOI- c-TnT, had very strong statistical correlation, for the entire sample, and for DVT, AF, COPD, Covid subgroups ( Rho = 0.815-0.982). PAOI had a high predic-tive accuracy for intermediate , and high risk together (area under curve, AUC=0.948), and high risk PE (AUC= 0.993). For 7-day mortality, D-dimer , and c-TnT had high predictive accura-cy(AUC=0.921, and 0.979). PAOI had statistical significance for 7-day mortality in Covid (p=0.045), and cancer (p=0.038) patients. Conclusions: PAOI was an important tool for PE risk as-sessment. D-dimer , and c-TnT were valuable predictors, for 7-day mortality in PE. PAOI, and D-dimer; PAOI, and c-TnT were strongly correlated, for the entire PE sample, and for DVT, AF, COPD, and Covid patients.