Dima Mirabela

Dr. Dima Mirabela


Research Focus & Metrics

Academic Career Length

5Years (2022-Present)

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

Representative Publications

View All Publications
14 November 2024 in Life
Verified
Journal Article
Open access
PDF file
AMAlexandra Laura Mederle
Alexandra Laura Mederle
DMDima Mirabela
Dima Mirabela
Emil Robert StoicescuEmil Robert Stoicescu
Emil Robert Stoicescu
BCBogdan Florin Căpăstraru
Bogdan Florin Căpăstraru
CLCodrina Levai
Codrina Levai
AMAnca Laura Maghiari
Anca Laura Maghiari
Background: The gut microbiome is increasingly recognized as a key player in metabolic health, influencing glucose and lipid metabolism through various mechanisms. However, the efficacy of gut microbiota-targeted interventions, such as probiotics, prebiotics, fecal microbiota transplantation (FMT), and diet-based treatments, remains unclear for specific metabolic outcomes. In this study, the aim was to evaluate the impact of these interventions on the glucose and lipid parameters in individuals with metabolic diseases such as diabetes mellitus (DM), obesity, and metabolic syndrome. Methods: This systematic review and meta-analysis included 41 randomized controlled trials that investigated the effects of gut microbiota-targeted treatments on metabolic parameters such as fasting glucose, glycated hemoglobin (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. A comprehensive search was conducted using databases like PubMed, Google Scholar, and Scopus, focusing on interventions targeting the gut microbiota. A meta-analysis was performed using random-effects models, with effect sizes calculated for each outcome. Risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Gut microbiota-targeted interventions significantly reduced fasting glucose, HbA1c, HOMA-IR, total cholesterol, LDL-C, and triglycerides, with moderate heterogeneity observed across studies. The interventions also led to modest increases in HDL-C levels. Probiotic and synbiotic interventions showed the most consistent benefits in improving both glucose and lipid profiles, while FMT yielded mixed results. Short-term interventions showed rapid microbial shifts but less pronounced metabolic improvements, whereas longer-term interventions had more substantial metabolic benefits. Conclusions: In this study, it is demonstrated that gut microbiota-targeted interventions can improve key metabolic outcomes, offering a potential therapeutic strategy for managing metabolic diseases. However, the effectiveness of these interventions varies depending on the type, duration, and population characteristics, highlighting the need for further long-term studies to assess the sustained effects of microbiota modulation on metabolic health.

Verified
Journal Article
Open access
PDF file
Emil Robert StoicescuEmil Robert Stoicescu
Emil Robert Stoicescu
DMDiana Luminita Manolescu
Diana Luminita Manolescu
RSRoxana Stoicescu
Roxana Stoicescu
SCSimona Cerbu
Simona Cerbu
DMDima Mirabela
Dima Mirabela
DIDaniela Iacob
Daniela Iacob
Newborns infected with SARS-CoV2 infection develop different symptoms in comparison with adults, but one thing is clear: some of the most common manifestations include cough and other respiratory symptoms that need to be evaluated. In these cases, lung ultrasound is a useful imaging technique that can evaluate the newborns’ lung damage caused by COVID-19 pneumonia and can be used for the surveillance of the patients as well, being non-irradiating and easy to use. Nineteen neonates who were confirmed as having SARS-CoV2 infection were investigated using this imaging tool, and the results were compared and correlated with their symptoms and biomarkers. The mean of LUSS was 12.21 ± 3.56 (S.D), while the 95% CI for the arithmetic mean was 10.49–13.93. The difference of an independent t-test between the LUSS for the patient who presented cough and the LUSS for the patient without cough was −4.48 with an associated p-value of p = 0.02. The Pearson’s correlation coefficient r = 0.89 (p = 0.03, 95% CI 0.0642 to 0.993) between the LUSS and IL-6 level showed a positive strong correlation. This reliable correlation between lung ultrasound score and inflammatory markers suggests that LUS could be used for monitoring inflammatory lung diseases in the future.

31 October 2024 in Diagnostics
Verified
Journal Article
Open access
PDF file
C.Cristiana-Alexandra Stolojanu .
Cristiana-Alexandra Stolojanu .
GDGabriela Doros
Gabriela Doros
Bratu Melania LaviniaBratu Melania Lavinia
Bratu Melania Lavinia
ICIulia Ciobanu
Iulia Ciobanu
KMKrisztina Munteanu
Krisztina Munteanu
DMDima Mirabela
Dima Mirabela
Pregnancy is a vulnerable period of time during which pregnant people are prone to infections like COVID-19, which can increase risks for both the mother and fetus. These infections may lead to complications such as preterm birth, developmental delays, and congenital abnormalities. While COVID-19 poses additional risks like placental dysfunction and neonatal infections, studies on long-term effects remain limited. Ongoing research and monitoring are essential to understand and mitigate potential cognitive and developmental challenges in children born to mothers infected with COVID-19. This review aims to guide clinicians in managing these risks throughout childhood. Maternal COVID-19 infection during pregnancy can have significant implications for fetal development, even if the newborn is not infected at birth. The release of inflammatory cytokines may cross the placental barrier, potentially disrupting fetal brain development and increasing the risk of long-term cognitive and behavioral issues, such as ADHD or autism. Placental dysfunction, caused by inflammation or thrombosis, can lead to intrauterine growth restriction (IUGR), preterm birth, or hypoxia, affecting both neurological and respiratory health in newborns. Furthermore, a compromised fetal immune system can increase susceptibility to autoimmune conditions and infections. The early diagnosis and management of infections during pregnancy are crucial in mitigating risks to both the mother and fetus. Swift intervention can prevent complications like preterm birth and long-term developmental challenges, ensuring better health outcomes for both the mother and child. Long-term monitoring of children born to mothers infected with COVID-19 is necessary to understand the full extent of the virus’s impact. This review evaluates the long-term systemic effects of maternal COVID-19 infection during pregnancy on fetuses, newborns, and children, focusing beyond vertical transmission. It highlights the broader impacts on fetal development, offering insights to help clinicians manage potential issues that may arise later in life.

25 February 2025 in Diseases
Verified
Journal Article
Open access
PDF file
RBRazvan Olivian Betea
Razvan Olivian Betea
DMDima Mirabela
Dima Mirabela
VCVeronica Daniela Chiriac
Veronica Daniela Chiriac
Background and Objectives: Cervical cancer places substantial burdens on physical and psychosocial health. This study evaluated changes in quality of life (QoL) and perceived stress in patients with cervical cancer before and six months after initiating standard treatment. Four validated instruments were used: the 36-Item Short Form Survey (SF-36), the Perceived Stress Scale (PSS), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Methods: Ninety-six women (mean age: 48.3 ± 7.4 years) with histologically confirmed cervical cancer were enrolled. Baseline (pre-treatment) assessments included SF-36, PSS, WHOQOL-BREF, and EORTC QLQ-C30. Follow-up was conducted six months after initiating either surgery or chemoradiation. Paired t-tests (or Wilcoxon signed-rank for non-parametric data) compared baseline and follow-up scores. Subgroup analyses were performed by disease stage (early vs. advanced) and marital status (married vs. unmarried). Results: Post-treatment assessments showed significant improvements in SF-36 physical functioning (from 61.9 ± 11.6 to 66.7 ± 12.3, p = 0.015) and mental health (from 63.4 ± 12.2 to 68.1 ± 12.4, p = 0.022). PSS scores declined from 23.2 ± 5.7 to 20.6 ± 5.5 (p = 0.001). WHOQOL-BREF physical and psychological domains increased, with physical health rising from 56.4 ± 12.0 to 60.7 ± 12.5 (p = 0.032). EORTC QLQ-C30 global health improved from 61.4 ± 13.8 to 66.3 ± 14.2 (p = 0.014). Advanced-stage patients exhibited greater absolute QoL gains yet remained below the early-stage scores. Married patients reported sharper reductions in PSS and higher final QoL scores. Conclusions: Over six months of standard cervical cancer treatment, these patients demonstrated significant QoL improvements and reduced perceived stress. While advanced-stage disease remained associated with lower post-treatment scores, these individuals benefited from notable gains compared to baseline. Marital status emerged as a protective factor. Ongoing psychosocial support may amplify these beneficial effects, warranting further longitudinal studies to optimize integrative survivorship care.

29 October 2024 in Pathogens
Verified
Journal Article
Open access
PDF file
Emil Robert StoicescuEmil Robert Stoicescu
Emil Robert Stoicescu
LGLaura Andreea Ghenciu
Laura Andreea Ghenciu
RSRoxana Stoicescu
Roxana Stoicescu
AAAdina Iuliana Ardelean
Adina Iuliana Ardelean
EDEcaterina Daescu
Ecaterina Daescu
DMDima Mirabela
Dima Mirabela
Purpose: Cytomegalovirus (CMV) retinitis is a sight-threatening condition predominantly affecting immunocompromised individuals, such as those with Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). We aimed to present an observational case report on CMV retinitis following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and to review the literature on the molecular and cellular changes in CMV and SARS-CoV-2 infections and how they may influence each other. Case Description: A 32-year-old man with a history of AIDS presented with decreased vision and ocular pain exacerbated by movement, beginning a day prior. Ocular examination revealed anterior uveitis, corneal endothelial edema, and retinal necrosis in the left eye. CMV retinitis was diagnosed based on positive serologic testing and a low cluster of differentiation 4 (CD4) count, with concurrent SARS-CoV-2 infection detected. Treatment included valganciclovir and topical agents, with a focus on managing CMV complications. This case highlights the potential role of SARS-CoV-2 in reactivating dormant CMV in severely immunocompromised individuals. We also discuss the implications of this interaction for immunocompromised patients, emphasizing the need for vigilant monitoring and personalized treatment strategies. Conclusions: Our case suggests that SARS-CoV-2 may trigger reactivation of CMV infection, leading to bilateral involvement in patients with low CD4 lymphocyte counts, which can result in severe visual impairment. The review discusses the molecular and cellular interactions between CMV and SARS-CoV-2, as well as risk factors, pathophysiology, and diagnostic methods for CMV retinitis, providing recommendations based on the literature findings.

21 January 2026 in Diagnostics
Verified
Journal Article
Open access
PDF file
BCBogdan Nicolae Cerbu
Bogdan Nicolae Cerbu
MBMarioara Boia
Marioara Boia
MPManuela Pantea
Manuela Pantea
TITeodora Ignat
Teodora Ignat
DMDima Mirabela
Dima Mirabela
DIDaniela Iacob
Daniela Iacob
Background and Objectives: Early recognition of life-threatening organ dysfunction is central to modern sepsis frameworks. We systematically reviewed the prognostic performance and clinical utility of the Neonatal Sequential Organ Failure Assessment (nSOFA) for mortality and major morbidity in NICU populations. The search identified 939 records across databases; after screening and full-text assessment, 16 studies met the inclusion criteria. Methods: Following PRISMA guidance, we searched major databases (2019–2025) for observational or interventional studies reporting discrimination or risk stratification using nSOFA in neonates. Populations included suspected/proven infection and condition-specific cohorts. Heterogeneity in timing, thresholds, and outcomes precluded meta-analysis. Results: A cumulative sample exceeding 25,000 neonates was identified across late- and early-onset infection, all-NICU admissions, necrotizing enterocolitis, respiratory distress, and very preterm screening cohorts. Across settings and timepoints, nSOFA demonstrated consistent, good-to-excellent mortality discrimination, with reported AUROCs ≥ 0.80 and upper ranges near 0.90–0.92; serial scoring within the first 6–12 h generally improved risk classification. Disease-specific applications (NEC, early-onset infection) showed similar discrimination for death or composite adverse outcomes. Conclusions: Evidence from diverse NICU contexts indicates that nSOFA is a pragmatic, EHR-ready organ dysfunction score with robust discrimination for mortality and serious morbidity, supporting routine, serial use for risk stratification and standardized endpoints in neonatal sepsis pathways, aligned with contemporary organ dysfunction–based pediatric criteria.