Alexandra Ioana Asztalos

Dr. Alexandra Ioana Asztalos


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 Cureus
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AIAlexandru Petru Ion
Alexandru Petru Ion
AAAlexandra Ioana Asztalos
Alexandra Ioana Asztalos
CCClaudiu Constantin Ciucanu
Claudiu Constantin Ciucanu
EREliza Russu
Eliza Russu
AMAdrian Vasile Muresan
Adrian Vasile Muresan
EAEmil-Marian Arbănași
Emil-Marian Arbănași
Background In determining mechanical characteristics, the accuracy of the thickness of the specimens can influence the biomechanical behavior, especially in the case of human tissues, where there is an important variability. This study aims to compare the accuracy of two routine measuring instruments, i.e., the digital vernier caliper and the digital thickness gauge, when measuring the thickness of venous specimens multiple times. Methodology In this study, we used 12 tubular vena cava specimens obtained from common breed pigs aged 18-24 weeks at the time of sacrifice from a local slaughterhouse. The measurements were performed using a digital vernier caliper (Multicomp PRO MP012475) for the first four protocols and a digital thickness gauge (Mitutoyo 547-500S) for the fifth protocol. In the first protocol, three measurements were taken on the same side, and their average was recorded as the sample thickness. The second protocol involved taking measurements on two opposite sides, and the average of these measurements was recorded as the sample thickness. In the third protocol, the thickness of each side was measured at its midpoint, and the average of the four measurements was recorded as the sample thickness. In the last protocol using a digital vernier caliper, the thickness of the vernier specimens was calculated as the average of the measurements taken at each corner of the square sample. Finally, for the fifth protocol, three consecutive measurements were taken using the digital thickness gauge, and their average was recorded as the final thickness of the sample. Results In the first protocol, we observed lower values during the first measurement in comparison to the second (0.409 ± 0.063 vs. 0.536 ± 0.064, p < 0.0001) and the third (0.409 ± 0.063 vs. 0.528 ± 0.055, p = 0.0001). Moreover, with the second protocol, we observed lower values during the first two measurements in comparison to the third measurement (p = 0.0279 and p = 0.0054). Regarding protocols three and four, we recorded higher values for the second and third measurements than the first one, with higher values for the third measurement than the second one. In the fifth protocol, there were no significant statistical differences between the three consecutive measurements (p = 0.953, p = 0.742, and p = 0.897). Further, we examined the variations in sample thickness determined using each of the protocols proposed for the digital vernier caliper, as well as the values obtained with the digital thickness gauge protocol. As a result, during the first and second measurements, we observed lower thickness values for the venous wall samples using the first four protocols compared to the fifth protocol (for all p < 0.05). However, no differences were noted between the five protocols during the third measurement. Conclusions The digital thickness gauge Mitutoyo 547-500S provided superior accuracy with no difference between three successive measurements of venous wall thickness, regardless of the examiner’s experience. Accurately determining the thickness of venous specimens is crucial for calculating the tissue’s biomechanical properties.

2 November 2024 in Methods and Protocols
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Journal Article
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AIAlexandru Petru Ion
Alexandru Petru Ion
AAAlexandra Ioana Asztalos
Alexandra Ioana Asztalos
CCClaudiu Constantin Ciucanu
Claudiu Constantin Ciucanu
RERussu Eliza
Russu Eliza
AMAdrian Vasile Muresan
Adrian Vasile Muresan
EAEmil Marian Arbanasi
Emil Marian Arbanasi
Background: The aim of this study is to analyze the reproducibility of sample thickness measurements taken by a non-experienced user by comparing a standard digital vernier caliper, with four different protocols, to a specialized thickness gauge. Methods: The current study is a methodological study where we examined the thickness of the porcine arterial wall in the thoracic aorta of six pigs. Two adjacent samples of 10 × 10 mm from each aorta were excised longitudinally from the anterior wall, resulting in twelve specimens. Five protocols were employed to measure the thickness of each sample. In four of these protocols, digital vernier calipers (Multicomp PRO MP012475) were utilized, while the fifth protocol utilized a specialized digital thickness gauge (Mitutoyo 547-500S, Mitutoyo Corp., Kawasaki, Japan). Results: We observed a higher average thickness of the samples during the initial measurement compared to the second measurement (1.11 ± 0.16 vs. 0.94 ± 0.17, p = 0.0319) with the first protocol and smaller values than those determined at the last measurement (0.93 ± 0.15 vs. 1.10 ± 0.15, p = 0.0135) for the third protocol. Further, with the digital vernier calipers, we recorded lower values for all four protocols than for the digital thickness gauge determinations. In addition, we computed the ratio of the thicknesses measured during the first, second, and third measurements to analyze how consistent the values were across the three consecutive measurements, with no difference regarding the third, fourth, and control protocols. Conclusions: The digital thickness gauge offers dependable measurements, regardless of the user’s expertise in assessing tissue thickness, and demonstrates a substantially higher reproducibility when compared to the digital vernier. We also found that taking an average of the thickness measurements from four specific points on each half of the sides or on each diagonal of each corner yielded consistently reliable results over time when using a standard digital vernier caliper instead of a specialized one.

Verified
Journal Article
Open access
PDF file
RERussu Eliza
Russu Eliza
EFElena Florea
Elena Florea
AAAlexandra Ioana Asztalos
Alexandra Ioana Asztalos
CCConstantin Claudiu Ciucanu
Constantin Claudiu Ciucanu
EAEliza Mihaela Arbănași
Eliza Mihaela Arbănași
EAEmil Marian Arbanasi
Emil Marian Arbanasi
Background/Objectives: According to the guidelines established by the European Society of Vascular Surgery (ESVS), a minimum 2 mm diameter is advised for both the radial artery (RA) and cephalic vein (CV) to perform a radio-cephalic arteriovenous fistula (RC-AVF). However, studies have suggested that larger vein diameters, over 2.5 or 3 mm, or even smaller vessel diameters, above 1.6 mm, can yield satisfactory outcomes in both the medium and long term. This study aims to analyze how preoperative vascular mapping influences the long-term RC-AVF failure, considering adherence to guidelines. Methods: This retrospective, monocentric, and observational study enrolled 110 patients with ESKD who were admitted, between 2018 and 2024, to the Vascular Surgery Department at the Emergency County Hospital of Târgu Mureș for the creation of an RC-AVF. Demographic characteristics, comorbidities, preoperative vascular mapping data, and laboratory data were meticulously collected from the hospital’s electronic databases. Patients enrolled in the current study were categorized into two groups based on their adherence to guideline recommendations. Results: Patients whose RC-AVF was created outside guideline recommendations demonstrated smaller arterial (p < 0.001) and venous (p < 0.001) diameters. Additionally, a higher percentage of these patients were on hemodialysis via CVC at the time of RC-AVF creation (p = 0.041), as well as a higher incidence of 6-week AVF maturation failure (p = 0.012) and long-term AVF failure (p = 0.016). In ROC Curve analysis, a threshold of 2.75 mm was established for the RA (AUC: 0.647, p = 0.005) and 2.52 mm for the CV (AUC: 0.677, p = 0.001). Additionally, patients whose RC-AVF procedures adhered to guideline recommendations had a significantly lower risk of long-term RC-AVF failure (HR: 0.44, p = 0.012). This association lost significance after adjusting for cardiovascular risk factors and the presence of CVC at admission (HR: 0.69, p = 0.328). After full adjustment, only the CV remained an independent predictor of long-term successful RC-AVF (HR: 0.68, p = 0.026). In contrast, RA lost significance after adjusting for cardiovascular risk factors and the presence of CVC at admission (HR: 0.71, p = 0.086). Conclusions: In conclusion, this study reveals that only the diameter of the CV is correlated with the long-term failure of RC-AVF, independent of age, gender, diabetes, hypertension, active smoking, and the presence of a CVC at the time of AVF creation. Therefore, while adhering to the threshold diameters of the AR and CV, as recommended by the ESVS guidelines, facilitates the creation of a functional RC-AVF, we assert that additional cofactors, such as demographic data, usual cardiovascular risk factors, or CVC presence, must also be considered to achieve optimal long-term AVF.