Oana Elisabeta Avram

Dr. Oana Elisabeta Avram


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

View All Publications
Verified
Journal Article
Open access
PDF file
OAOana Elisabeta Avram
Oana Elisabeta Avram
ABAlexandra Elena Bratu
Alexandra Elena Bratu
CCCecilia Curis
Cecilia Curis
Lavinia Alexandra MoroianuLavinia Alexandra Moroianu
Lavinia Alexandra Moroianu
DEDrima Eduard
Drima Eduard
Autism Spectrum Disorder (ASD) has been associated with disruptions in one-carbon metabolism and vitamin D pathways. Nutritional exposures—particularly vitamin D, vitamin B12, and homocysteine—may influence neurodevelopmental outcomes. However, a comprehensive, lifespan-spanning synthesis of these modifiable nutritional biomarkers has not been conducted. This systematic review and stratified meta-analysis critically synthesized data on vitamin D, vitamin B12, and homocysteine to elucidate their relationships with ASD risk and symptomatology. Our central question was: How do levels of vitamin D, vitamin B12, and homocysteine—measured before and after birth—affect the risk, severity, and potential treatment outcomes for ASD? We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) compliant systematic review and stratified meta-analysis (2015–2025) of 35 studies (11 randomized controlled trials, 24 observational), examining prenatal, neonatal, and postnatal biomarker levels. Eligibility criteria were defined using the PICOS (Population, Intervention, Comparator, Outcome, and Study Design) framework to ensure scientific rigor and clinical relevance, including studies involving human participants aged 0–18 years with a formal Autism Spectrum Disorder (ASD) diagnosis or prenatal exposures potentially linked to later ASD onset, while excluding animal studies, adult-only ASD populations, and studies lacking ASD cohorts or biomarker data. The search strategy, developed according to PRISMA, and Cochrane best practices, encompassed five major databases (PubMed/MEDLINE, Cochrane Library, Google Scholar, ClinicalTrials.gov, and ProQuest) alongside manual searches of key references, grey literature, and clinical trial registries to ensure comprehensive retrieval of both published and unpublished studies. Study quality was assessed using version 2 of the Cochrane risk-of-bias tool for RCTs (RoB2) and the Newcastle–Ottawa Scale (NOS) for observational studies; certainty of evidence was graded via GRADE (Grading of Recommendations Assessment, Development and Evaluation). Random-effects meta-analyses were stratified by biomarker and study design. Heterogeneity, small-study effects, and publication bias were evaluated using Cochran’s Q, I2, Egger’s test, and trim-and-fill. Prenatal vitamin D deficiency was associated with approximately two-fold increased odds of Autism Spectrum Disorder (ASD) in offspring (pooled OR ≈ 2.0; p < 0.05), while excessively elevated maternal B12 concentrations, often co-occurring with folate excess, were similarly linked to increased ASD risk. Meta-analytic comparisons revealed significantly lower circulating vitamin D (SMD ≈ −1.0; p < 0.001) and B12 levels (SMD ≈ −0.7; p < 0.001), alongside elevated homocysteine (SMD ≈ 0.7; p < 0.001), in children with ASD versus neurotypical controls. Early-life vitamin D/B12 insufficiency and elevated homocysteine are important, modifiable correlates of ASD risk and severity. Adequate maternal and child nutritional status could have risk-reducing and symptom-mitigating effects, although causality remains to be confirmed. This evidence supports tailored nutritional interventions as a component of ASD risk reduction and management strategies, within the bounds of overall developmental healthcare. The article processing charges (APC) were supported by “Dunărea de Jos” University of Galati, Romania. No external funding was received for the execution of the research. The review was not prospectively registered in PROSPERO or any other systematic review registry.

28 September 2025 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
ABAlexandra Elena Bratu
Alexandra Elena Bratu
Lavinia Alexandra MoroianuLavinia Alexandra Moroianu
Lavinia Alexandra Moroianu
OIOana-Maria Isailă
Oana-Maria Isailă
CPCatalin Plesea-Condratovici
Catalin Plesea-Condratovici
OAOana Elisabeta Avram
Oana Elisabeta Avram
DEDrima Eduard
Drima Eduard
Background/Objectives: The intergenerational transmission of suicidal risk is a major global health concern. Evidence on the role of parental psychopathology, including suicidal behavior, in predicting adolescent suicidality remains inconsistent. This systematic review and meta-analysis aimed to synthesize recent findings and quantify these associations. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention/Exposure, Comparator, Outcome (PICO) framework. Searches (2015–2025) identified observational studies on parental suicidal behavior, depression, or psychiatric disorders predicting adolescent suicidal ideation or attempts. Thirty-one studies met eligibility, including over 12 million adolescents. Random-effects meta-analyses estimated pooled associations. Study quality was rated with the Newcastle–Ottawa Scale (NOS), and evidence certainty with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results: Both parental suicidal behavior and psychiatric disorders were consistently linked to increased adolescent suicidality. The pooled odds ratio (OR) for any parental psychopathology was 2.77 (95% confidence interval, CI: 2.22–3.47), indicating nearly a threefold higher risk of suicidal ideation or attempts in exposed youth. Subgroup analyses showed comparable risks for parental suicidal behavior (OR = 2.69, 95% CI: 2.30–3.14) and parental psychiatric morbidity (OR = 2.72, 95% CI: 2.05–3.60). Conclusions: Parental psychopathology, whether manifesting as suicidal behavior or psychiatric disorder, is a strong and universal risk factor for adolescent suicidal ideation and attempts. These findings underscore the need for family-centered prevention, early identification, and targeted interventions to disrupt intergenerational transmission of suicide risk.

29 July 2025 in BRAIN. BROAD RESEARCH IN ARTIFICIAL INTELLIGENCE AND NEUROSCIENCE
Verified
Journal Article
Open access
PDF file
Cristina D. StanescuCristina D. Stanescu
Cristina D. Stanescu
MBMonica Boev
Monica Boev
OAOana Elisabeta Avram
Oana Elisabeta Avram
ACAnamaria Ciubara
Anamaria Ciubara
This review aims to elucidate the relationship between mental disorders and various forms of skin cancer, as well as to examine the prevention and treatment strategies for these patients using a multidisciplinary approach. The recognition that the impact of skin cancer extends beyond physical manifestations has led to an increasing need to investigate the psychological effects and mental health implications associated with this pathology. Cancer diagnoses represent significant stressors that can induce moderate-to-severe levels of emotional distress among patients and substantially impact patients' quality of life. Individuals diagnosed with malignant melanoma demonstrate a higher prevalence of psychosocial disturbance than those diagnosed with non-melanoma skin cancers. This observation suggests that the classification of skin neoplasia and its visibility may influence a patient's quality of life. Healthcare professionals need to develop communication skills to observe the psychological changes faced by patients diagnosed with cutaneous malignancies. This study aims to enhance patient care, improve overall well-being, and promote comprehensive approaches for treating patients with cutaneous malignancies. The potential impact of stress and anxiety on the immune system may influence the treatment of various types of skin neoplasia. It is important to investigate the relationship between psychological factors and the immune system to develop efficacious interventions for managing stress and anxiety-related skin disorders. Further research is needed to establish standardized methods, assess long-term outcomes, develop tailored psychological support programs, and identify the potential risk and protective factors.

9 October 2025 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
OAOana Elisabeta Avram
Oana Elisabeta Avram
Lavinia Alexandra MoroianuLavinia Alexandra Moroianu
Lavinia Alexandra Moroianu
CCCecilia Curis
Cecilia Curis
OIOana-Maria Isailă
Oana-Maria Isailă
ABAlexandra Elena Bratu
Alexandra Elena Bratu
DEDrima Eduard
Drima Eduard
Background: Clinician empathy is associated with family satisfaction and reduced anxiety, but quantitative data from the parents’ perspective in pediatric psychiatry are limited. Objective: To assess parent-perceived physician empathy in pediatric psychiatry consultations and explore its associations with clinical and demographic factors. Methods: Cross-sectional, consecutive sample of parents attending an outpatient pediatric psychiatry clinic (n = 163 parents). A 10-item behavioral empathy scale (range 10–40) was used. Analyses included reliability testing, group comparisons, correlations, OLS regression, and exploratory PCA. Results: The mean total empathy score was 34.5 (SD 4.2); most parents rated physicians as highly empathic (65%). Parents of children with ASD reported lower empathy compared to those with anxiety/depression. Empathy increased modestly with child age and was associated with a calmer state at the end of the visit. PCA suggested exploratory evidence of potential subdimensions, including child-centered communication and listening/facilitation. Conclusions: Parent-perceived empathy in this sample was generally high; however, behaviors that directly involve and facilitate the child (listening, encouraging questions) may need strengthening, particularly for children with ASD. Results should be interpreted in light of the single-center design, the absence of a recorded participation rate, parent-proxy reporting, and the exploratory nature of the PCA.