ANDREI MANU

Dr. ANDREI MANU


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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27 November 2025 in Hemato
Verified
Journal Article
Open access
PDF file
MDMonica Dugăeşescu
Monica Dugăeşescu
IAIulia Andrei-Bitere
Iulia Andrei-Bitere
MBMarina Raluca Baciu
Marina Raluca Baciu
EDEva Dănescu
Eva Dănescu
ALAlexandru Liţescu
Alexandru Liţescu
EPElena Poenaru
Elena Poenaru
Background/Objectives: Complete blood count (CBC)-derived markers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have gained increasing attention as accessible indicators of systemic inflammation. These parameters, calculated from routine blood tests, are widely available in clinical settings and are potentially relevant for a variety of chronic diseases. This review aims to explore current evidence and highlight potential future directions regarding the use of hematologic inflammatory biomarkers in chronic disease. Methods: We performed an extensive literature search on PubMed to identify full-text original studies published in the past five years, focused on investigating the clinical applications of hematologic inflammatory markers in chronic conditions. Results: CBC-derived inflammatory markers have been studied in a wide range of chronic diseases, including autoimmune diseases, metabolic disorders, chronic kidney disease, chronic infections, psychiatric diseases, and other conditions. These markers have been evaluated for multiple clinical purposes, such as aiding diagnosis, monitoring disease status, assessing disease activity, disease subtype characterization, predicting prognosis, and evaluating associations with disease outcomes. Conclusions: As chronic diseases affect millions of individuals globally, placing a burden for the healthcare system, patients, and their families, simple and cost-efficient tools like CBC-derived inflammatory markers have the potential to improve clinical case management.

23 September 2025 in Medicina
Verified
Journal Article
Open access
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AMANDREI MANU
ANDREI MANU
EPElena Poenaru
Elena Poenaru
FDFlorentina Duica
Florentina Duica
Alexandra Irma Gabriela BausicAlexandra Irma Gabriela Bausic
Alexandra Irma Gabriela Bausic
Catalin Bogdan CoroleucaCatalin Bogdan Coroleuca
Catalin Bogdan Coroleuca
EBElvira Brătilă
Elvira Brătilă
Aim: The aim of the study was to synthesize validated patient-reported outcome measures (PROMs) for assessing health-related quality of life (HRQoL) in women with endometriosis and to outline their clinical implications. Methods: We conducted a narrative review of English-language literature indexed in PubMed, Scopus, Web of Science, and Cochrane Library, covering the period 2014–2024, with earlier seminal studies included where relevant. We focused on validated PROMs for QoL but also considered standardized tools such as the Endometriosis Fertility Index (EFI), rASRM, and #Enzian classifications, given their role in clinical interpretation and counseling. Findings: Generic instruments (SF-36, WHOQOL-BREF, EQ-5D), disease-specific tools (EHP-30, EHP-5), and fertility-related questionnaires (FertiQoL, FPI) have demonstrated validity and responsiveness; however, these are inconsistently applied in practice. Knowledge gaps remain regarding routine implementation, timing, and frequency of assessment, and integration with clinical staging or fertility indices (e.g., EFI). Global frameworks such as the WERF EPHect platform facilitate standardized clinical and surgical data capture, though their use is primarily in research rather than routine care. Conclusions: We recommend combining a disease-specific PROM (EHP-30/EHP-5) with a generic instrument (SF-36 or EQ-5D) and adding FertiQoL when fertility is relevant. PROMs should be collected longitudinally (baseline, post-intervention, follow-up) and interpreted alongside clinical context, including pain phenotype, surgical staging (#Enzian/rASRM), and fertility goals. Embedding PROMs into multidisciplinary pathways enables shared decision-making, individualized treatment planning, and improved comparability of patient-centered outcomes.

14 October 2025 in Journal of Clinical Medicine
Verified
Journal Article
Open access
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AMANDREI MANU
ANDREI MANU
EPElena Poenaru
Elena Poenaru
FDFlorentina Duica
Florentina Duica
SSSmaranda Stoleru
Smaranda Stoleru
Alexandra Irma Gabriela BausicAlexandra Irma Gabriela Bausic
Alexandra Irma Gabriela Bausic
EBElvira Brătilă
Elvira Brătilă
Background: Endometriosis is a chronic, estrogen-dependent inflammatory disease affecting up to 10% of women of reproductive age. It substantially impacts quality of life (QoL) through pelvic pain, infertility, and psychological distress. Increasing attention has been directed toward patient-reported outcomes and validated QoL instruments, which are essential for understanding the burden of disease and guiding individualized management. Materials and Methods: We performed a narrative review of the literature published in the last five years in PubMed, Scopus, Web of Science, and Cochrane Library, focusing on validated QoL instruments, fertility indices, and clinical outcomes after minimally invasive surgery (MIS) for deep infiltrating endometriosis (DIE). Discussions: The most widely used QoL instruments are the Endometriosis Health Profile-30 (EHP-30), Short Form-36 (SF-36), and EQ-5D, each providing multidimensional evaluation across physical, psychological, and social domains. Fertility-related prognosis is assessed with the Endometriosis Fertility Index (EFI), while staging of disease severity relies on rASRM and #ENZIAN classifications. Evidence from comparative and cohort studies suggests that both laparoscopic and robotic MIS can improve QoL and reproductive outcomes; however, the magnitude of benefit varies across studies, patient phenotypes, and follow-up periods. Conclusions: MIS is an increasingly used therapeutic option for DIE, with growing evidence of improvement in pain and QoL, but current data remain heterogeneous and do not uniformly support superiority over other approaches. Routine incorporation of validated QoL instruments and fertility indices into both clinical practice and research is essential to better stratify patients, support shared decision-making, and optimize long-term outcomes.

15 June 2026 in Diseases
Verified
Journal Article
Open access
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AMANDREI MANU
ANDREI MANU
EPElena Poenaru
Elena Poenaru
AGArina Ilinca Gheorghe
Arina Ilinca Gheorghe
SSSmaranda Stoleru
Smaranda Stoleru
Alexandra Irma Gabriela BausicAlexandra Irma Gabriela Bausic
Alexandra Irma Gabriela Bausic
EBElvira Brătilă
Elvira Brătilă
Background: Deep infiltrating endometriosis (DIE), particularly when involving the bowel, significantly impairs health-related quality of life (HRQoL) and gastrointestinal function. This study aimed to evaluate the short- and mid-term impact of minimally invasive excision on these parameters in a large multicenter cohort. Methods: A retrospective observational study was conducted on 837 patients treated for endometriosis in two tertiary referral centers between 2018 and 2024. All patients underwent laparoscopic or robotic-assisted excision. Quality of life was assessed preoperatively and at 6 months (VAS: n = 69; SF-36: n = 100; GIQLI: n = 98) and 12 months (VAS: n = 30; SF-36: n = 46; GIQLI: n = 44) postoperatively, using validated patient-reported outcome measures (PROMs): the Visual Analog Scale (VAS) for pain, the Short Form-36 (SF-36) survey, and the Gastrointestinal Quality of Life Index (GIQLI). Results: The study population presented with predominantly advanced disease (Stage III–IV in 83.4% of cases), with 39.7% of patients undergoing segmental bowel resection. Postoperatively, a statistically significant reduction was observed in dysmenorrhea (VAS 7.6 vs. 5.0, p < 0.001) and chronic pelvic pain. The SF-36 scores improved significantly across all eight domains at 6 months, with the most dramatic recovery seen in Role Physical (p < 0.001) and Bodily Pain (p < 0.001). Regarding digestive function, the mean GIQLI score showed a progressive increase, reaching statistical significance at 12 months compared to baseline (112.6 vs. 106.6, p = 0.027), indicating superior long-term functional outcomes. Conclusions: Multidisciplinary minimally invasive surgery for deep infiltrating endometriosis was associated with significant and sustained improvements in quality of life among patients with available follow-up. Gastrointestinal quality of life, as measured by GIQLI, improved significantly at 12 months postoperatively, including in patients who underwent segmental bowel resection. Systematic use of PROMs is essential for accurate patient counseling and outcome monitoring.

Verified
Journal Article
Open access
PDF file
AMANDREI MANU
ANDREI MANU
EPElena Poenaru
Elena Poenaru
AGArina Ilinca Gheorghe
Arina Ilinca Gheorghe
SSSmaranda Stoleru
Smaranda Stoleru
Alexandra Irma Gabriela BausicAlexandra Irma Gabriela Bausic
Alexandra Irma Gabriela Bausic
EBElvira Brătilă
Elvira Brătilă
Objective: To evaluate reproductive outcomes following fertility-sparing surgery for deep endometriosis (DE), specifically assessing the impact of bowel resection on spontaneous conception rates and the predictive value of the Endometriosis Fertility Index (EFI). Design: Retrospective observational cohort study. Setting: High-volume tertiary referral center for endometriosis. Patients: A total of 507 women with histologically confirmed endometriosis and documented infertility or active desire for pregnancy, managed between 2018 and 2025. Patients undergoing hysterectomy were excluded. Interventions: Laparoscopic complete excision of endometriotic lesions using a nerve-sparing technique. The surgical strategy for bowel involvement was tailored to nodule characteristics: 194 patients (38.3%) underwent segmental colorectal resection, 38 (7.5%) underwent rectal shaving, and 9 (1.8%) were treated with advanced organ-sparing techniques (lateral rectal resection or extra-mucosal excision—EMEB). Main Outcome Measures: Postoperative pregnancy rate (PR), mode of conception (spontaneous vs. ART), and factors influencing fertility. Results: The cohort presented with severe disease (mean rASRM stage 3.4) and a high prevalence of primary infertility (79.3%). During the follow-up period, 310 patients achieved pregnancy, resulting in an overall pregnancy rate of 61.1%. Notably, 70.3% of these pregnancies were achieved spontaneously. Radicality did not compromise fertility: the segmental resection group achieved a pregnancy rate of 91.2% (177/194), while patients treated with rectal shaving achieved 100%. The EFI score was identified as a robust predictor of success (mean score 5.5 in pregnant vs. 4.9 in non-pregnant patients, p < 0.05). Conclusions: Comprehensive nerve-sparing excision of DE, including segmental bowel resection, is associated with high pregnancy rates and a predominant restoration of natural fertility. Surgery should be considered a first-line strategy to reduce dependency on assisted reproductive technologies.