Dragos Fortofoiu

Dr. Dragos Fortofoiu

orcid

Research Focus & Metrics

Academic Career Length

2Years (2025-Present)

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

Representative Publications

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15 March 2025 in Cancers
Verified
Journal Article
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RSRobert Emmanuel Serban
Robert Emmanuel Serban
DPDragoş-Marian Popescu
Dragoş-Marian Popescu
Mihail Virgil BoldeanuMihail Virgil Boldeanu
Mihail Virgil Boldeanu
DFDan Nicolae Florescu
Dan Nicolae Florescu
MȘMircea-Sebastian Șerbănescu
Mircea-Sebastian Șerbănescu
CVCristin Constantin Vere
Cristin Constantin Vere
Background: Colorectal cancer affects a large number of patients worldwide, with numerous factors being involved in its etiopathogenesis and chronic inflammation playing an essential role in tumor development. In this study, we analyzed and compared several markers of inflammation that are relatively easy to obtain for a rapid and accurate diagnosis and prognosis. Methods: This study included 219 patients diagnosed with colorectal cancer, analyzing the inflammation scores derived from their blood cells and inflammatory circulating proteins. These inflammatory markers are neutrophil-to-lymphocyte ratio—NLR; platelet-to-lymphocyte ratio—PLR; lymphocyte-to-monocyte ratio—LMR; systemic immune inflammation index—SII; systemic inflammatory response index—SIRI; aggregate index of systemic inflammation—AISI; derived neutrophil-to-lymphocyte ratio—dNLR; C-reactive protein-to-albumin ratio—CAR; and fibrinogen-to-albumin ratio—FAR. In the analysis of patients with colorectal cancer, we have also introduced two new recently developed inflammatory markers: the cumulative inflammatory index (IIC) and the ratio between the mean corpuscular volume and lymphocytes (MCVL). This study aimed to correlate the inflammatory markers’ levels with the colorectal cancer diagnostic stage, the tumor and clinical characteristics of the colorectal cancer patients, and 36 months’ survival time and to evaluate the diagnostic and prognostic capacity and accuracy of these inflammatory markers in this type of cancer. Results: We showed that the levels of the analyzed inflammation markers correlate with the TNM stage, the tumor pathological differentiation grade, the age and gender of the patients, and overall survival, with their increased levels being associated with a lower survival rate. Conclusions: The analyzed markers, which are easy to perform right from the patient’s admission, can be helpful both in diagnosis and, mostly, in prognosis, sustaining the role of inflammation in cancer. By comparing them, we showed which one can be useful for increased sensitivity and specificity in the diagnosis and prognosis of colorectal cancer patients.

11 November 2025 in Diagnostics
Verified
Journal Article
Open access
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Vlad PadureanuVlad Padureanu
Vlad Padureanu
Virginia Maria RadulescuVirginia Maria Radulescu
Virginia Maria Radulescu
CMCristiana Moise
Cristiana Moise
MMMarius Cristian Marinaș
Marius Cristian Marinaș
Padureanu RodicaPadureanu Rodica
Padureanu Rodica
BLBOLDEANU LIDIA
BOLDEANU LIDIA
Background/Objectives: Oxidative stress contributes to the pathogenesis of cirrhosis, but its value as a clinical biomarker remains uncertain. Methods: We retrospectively analysed 90 patients with decompensated cirrhosis. Serum malondialdehyde (MDA) and 8-epi-prostaglandin F2α (8-iso-PGF2α) were measured at admission. Biomarker levels were compared between Child–Pugh classes B and C, across hepatic encephalopathy grades, and ascites severity, using Mann–Whitney, Kruskal–Wallis, and Spearman correlation tests. Results: Median MDA did not differ significantly between Child–Pugh classes B and C (2.67 [2.10–3.20] vs. 2.45 [1.98–3.05] μmol/L; p = 0.331), nor across ascites categories (p = 0.453). Similarly, 8-iso-PGF2α values did not vary between Child–Pugh classes (255.8 [220.0–310.0] vs. 250.1 [210.0–295.0] pg/mL; p = 0.784) or ascites groups (p = 0.828). Spearman analysis showed no significant correlations with albumin, INR, bilirubin, creatinine, or age, except for a non-significant trend with bilirubin (ρ = −0.18, p = 0.09). Importantly, MDA levels increased significantly across encephalopathy grades (p = 0.021), suggesting a link between systemic oxidative stress and neuropsychiatric impairment. Conclusions: In this clinical cohort, oxidative stress biomarkers did not provide discriminatory value for staging by Child–Pugh or ascites, but MDA was associated with encephalopathy severity. These findings highlight both the limitations and potential clinical relevance of oxidative stress markers in cirrhosis management.

Verified
Journal Article
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Vlad PadureanuVlad Padureanu
Vlad Padureanu
Daniel Cosmin CarageaDaniel Cosmin Caragea
Daniel Cosmin Caragea
DPDenisa Pirscoveanu
Denisa Pirscoveanu
DDDop Dalia
Dop Dalia
AMAlexandru Claudiu Munteanu
Alexandru Claudiu Munteanu
Padureanu RodicaPadureanu Rodica
Padureanu Rodica
There is a substantial correlation between cardiac dysfunction and elevated mortality in sepsis. Impaired myocardial perfusion, direct myocardial injury, and mitochondrial dysfunction are all part of the complex pathophysiology of sepsis-induced myocardial dysfunction. Recent evidence has shown the critical role mitochondrial dysfunction plays in the development of sepsis-induced myocardial dysfunction. In order to prevent and treat sepsis-induced myocardial dysfunction, a variety of drugs have been proposed. However, patient outcomes have not been appreciably enhanced by this therapy. This underscores the need for novel treatment approaches that target the specific pathways underlying cardiac dysfunction in sepsis. The prognosis is greatly impacted by sepsis-induced cardiac dysfunction, monitoring it is crucial. Clinicians employ a mix of clinical evaluations, hemodynamic monitoring, echocardiography, and bSICiomarkers to efficiently monitor this illness. The combined application of these techniques provides a comprehensive evaluation of cardiac function, thereby supporting timely optimization of treatment strategies. Treatments for septic shock and established sepsis will be beneficial for patients with this condition. However, there is little information and evidence about more targeted therapy, except than general management with vasopressors, inotropes, and fluid resuscitation. This study provides an outline of current knowledge on the pathophysiological mechanisms underlying sepsis-induced cardiac dysfunction, as well as the effects of monitoring and current treatments on sepsis-induced myocardial dysfunction.

5 May 2026 in Biomedicines
Verified
Journal Article
Open access
PDF file
IDIoana Gabriela Dragne
Ioana Gabriela Dragne
Bogdan Silviu UngureanuBogdan Silviu Ungureanu
Bogdan Silviu Ungureanu
DFDragos Fortofoiu
Dragos Fortofoiu
Vlad PadureanuVlad Padureanu
Vlad Padureanu
BLBOLDEANU LIDIA
BOLDEANU LIDIA
Mihail Virgil BoldeanuMihail Virgil Boldeanu
Mihail Virgil Boldeanu
Background: Oxidative stress plays a significant role in inflammatory bowel disease (IBD), yet the clinical relevance of specific lipid peroxidation markers remains insufficiently defined. This study evaluated serum levels of 8-epi-prostaglandin F2α (8-epi-PGF2α), an isoprostane generated through non-enzymatic lipid oxidation, and examined its relationship with antioxidant enzymes and clinical disease activity in ulcerative colitis (UC) and Crohn’s disease (CD). Methods: Eighty-seven patients (55 UC and 32 CD) were assessed for serum 8-epi-PGF2α, superoxide dismutase 1 (SOD1), and glutathione peroxidase 1 (GPX1), and classified as having mild, moderate, or severe disease. Statistical analyses included comparative analysis, two-way ANOVA, multiple linear regression, and Ridge logistic regression. To address potential dietary confounding, total energy intake, Mediterranean Diet Score (MDS), and antioxidant supplement use were incorporated into the regression models. Results: Serum levels of 8-epi-PGF2α and GPX1 were significantly higher in UC than in CD (ρ = 0.001 and p = 0.042), and both increased with greater disease severity (p < 0.001 and p = 0.001). In UC, 8-epi-PGF2α positively correlated with high-sensitivity C-reactive protein (hs-CRP), white blood cells (WBC), and Truelove–Witts Index (TWI), and negatively with hemoglobin (False Discovery Rate (FDR)-adjusted q < 0.100). In CD, it correlated with the Harvey–Bradshaw Index (HBI) and disease duration (FDR-adjusted q < 0.050). Inter-biomarker analyses showed a strong association between 8-epi-PGF2α and GPX1 in UC (ρ = 0.677, p < 0.0001, FDR < 0.0001), suggesting coordinated activation of oxidative and antioxidant pathways. The observed associations remained consistent after adjustment for dietary factors, supporting the robustness of the findings. Because these results are cross-sectional, they cannot establish causality and should be interpreted with caution. Conclusions: Nevertheless, 8-epi-PGF2α emerges as a promising non-invasive biomarker for assessing oxidative stress and disease activity in IBD, with potential clinical applicability for patient monitoring and therapeutic evaluation.

Verified
Journal Article
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MCMariana-Emilia Caragea
Mariana-Emilia Caragea
Daniel Cosmin CarageaDaniel Cosmin Caragea
Daniel Cosmin Caragea
MNMarius Novac
Marius Novac
BLBOLDEANU LIDIA
BOLDEANU LIDIA
Mohamed-Zakaria AssaniMohamed-Zakaria Assani
Mohamed-Zakaria Assani
CVCristin Constantin Vere
Cristin Constantin Vere
Staphylococcus aureus, particularly methicillin-resistant S. aureus (MRSA), remains a leading cause of skin and soft tissue infections (SSTIs) worldwide. Patients with renal edema, including those with nephrotic syndrome and chronic kidney disease (CKD), and critical illness, are particularly susceptible because of barrier dysfunction, immune impairment, and altered antimicrobial pharmacokinetics. This narrative review examines the mechanisms linking renal edema to increased susceptibility to cutaneous S. aureus infection and discusses their diagnostic and therapeutic implications. Three interconnected pathophysiological pathways appear central to this susceptibility: disruption of the cutaneous barrier, nephrotic and uremic immune dysfunction, and impaired lymphatic immune surveillance. These abnormalities facilitate bacterial colonization, and invasion, while S. aureus further exploits the renal host through adhesins, toxins, biofilm formation, and immune-evasion mechanisms. The review also highlights the challenges of managing severe staphylococcal infections in patients with kidney disease and critical illness, where augmented renal clearance, expanded volume of distribution, extracorporeal renal support, and fluctuating renal function may substantially influence antimicrobial exposure. Current management requires early recognition, source control, individualized antimicrobial selection, renal-adapted dosing, therapeutic drug monitoring, and antimicrobial stewardship. Although emerging anti-virulence and immunomodulatory strategies show promise, most remain at the preclinical or early translational stage. Overall, renal edema should be regarded as a biologically active modifier of host–pathogen interactions that contributes to increased susceptibility to cutaneous S. aureus infection across the spectrum of kidney disease.

Verified
Journal Article
Open access
PDF file
DFDragos Fortofoiu
Dragos Fortofoiu
VSVictor Mihai Sacerdotianu
Victor Mihai Sacerdotianu
RSRobert Emmanuel Serban
Robert Emmanuel Serban
PPPopa Petrica
Popa Petrica
IDIoana Gabriela Dragne
Ioana Gabriela Dragne
CVCristin Constantin Vere
Cristin Constantin Vere
Paraneoplastic endocrine syndromes (PESs) are hormonal disturbances associated with malignancies that result from tumor-related production of hormone-like substances, immune-mediated mechanisms, or dysregulated signaling pathways. While they are well recognized in lung and neuroendocrine cancers, their relevance in gastrointestinal tumors remains less clearly defined. This narrative review synthesizes current knowledge on paraneoplastic endocrine manifestations in gastrointestinal malignancies, based on a structured search of the literature in major databases, including PubMed, Scopus, and Web of Science. The analysis focuses on clinically relevant syndromes such as hypercalcemia, Cushing-like manifestations, disorders of water balance, hypoglycemia, and acromegaly, with emphasis on underlying mechanisms, associated tumor types, diagnostic approaches, and therapeutic considerations. Available evidence indicates that gastrointestinal tumors can produce a range of biologically active substances, leading to diverse endocrine manifestations that may precede tumor detection and influence disease course. Among these, hypercalcemia and Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) are among the most frequently reported, while other syndromes, such as ectopic Cushing syndrome or tumor-related hypoglycemia, are less common but often associated with more severe clinical outcomes. Recognition of these manifestations has direct clinical implications, as they may support earlier diagnosis, contribute to prognostic assessment, and guide therapeutic management. Improved awareness and a multidisciplinary approach remain essential for optimizing outcomes in patients with gastrointestinal malignancies.