Codrina Levai

Dr. Codrina Levai


Research Focus & Metrics

Academic Career Length

11Years (2016-Present)

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

Representative Publications

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6 February 2025 in Medicina
Verified
Journal Article
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TATeodora Carina Anghel
Teodora Carina Anghel
Bratu Melania LaviniaBratu Melania Lavinia
Bratu Melania Lavinia
Iuliana CosteaIuliana Costea
Iuliana Costea
OAOANA ALBAI
OANA ALBAI
AMAmalia Loredana Marinca
Amalia Loredana Marinca
LHLavinia Maria Hogea
Lavinia Maria Hogea
Background and Objectives: Cancer imposes a profound burden on both physical and psychological health, particularly at advanced stages, which are associated with a poor prognosis and heightened emotional distress. Psychotherapeutic interventions have gained recognition for their role in alleviating distress, enhancing the quality of life, and supporting a holistic approach to cancer care. This review examines the effectiveness of psychotherapeutic interventions in improving psychological well-being in cancer patients. Materials and Methods: Conducted as a literature review following PRISMA guidelines, this study analyzed experimental research on psychotherapeutic interventions for cancer patients published in the past decade. Literature searches were performed in PubMed, Google Scholar, the Cochrane Library, Web of Science, PsycINFO, and Consensus, supplemented by manual reference checks. The inclusion criteria focused on randomized controlled trials (RCTs). Results: The analysis included 20 RCTs spanning over three decades, evaluating interventions such as individual meaning-centered psychotherapy (IMCP), Mindfulness-Based Cognitive Therapy (MBCT), and supportive–expressive group therapy (SEGT). IMCP emerged as being particularly effective in reducing depression, anxiety, and demoralization while enhancing spiritual well-being. MBCT demonstrated significant reductions in the fear of recurrence, while SEGT effectively addressed traumatic stress and fostered social support. Although the survival benefits were inconsistently reported, psychosocial improvements, including an enhanced quality of life and emotional resilience, were consistently observed. The methodological quality varied, with nine studies meeting high-quality standards. Conclusions: Psychotherapeutic interventions, particularly IMCP and MBCT, play a critical role in oncology by alleviating distress, fostering resilience, and improving the quality of life. Integrating these approaches into routine cancer care can ensure a more holistic treatment framework that prioritizes the emotional and psychological needs of patients.

14 November 2024 in Life
Verified
Journal Article
Open access
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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.

11 April 2016 in Diabetology & Metabolic Syndrome
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Journal Article
Open access
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BTBogdan Timar
Bogdan Timar
SPSimona Popescu
Simona Popescu
RTRomulus Timar
Romulus Timar
Flavia BadercaFlavia Baderca
Flavia Baderca
BDBogdan Duica
Bogdan Duica
MSMihaela Simu
Mihaela Simu
Distal symmetric polyneuropathy (DSPN) is the most common complication of type 2 diabetes mellitus (T2DM) and the most common form of peripheral neuropathy. DSPN increases the risk of foot ulceration up to seven-fold, and is a significant risk factor in more than 60 % of the amputations of the lower limbs in patients with T2DM. The aims of our study were to evaluate the difference in the density of intraepidermal nerve fibers (IENF) in patients with respectively without DSPN, to evaluate the strength of the relationship between the symptomatology of the DSPN and IENF density and to define a cutoff value of the IENF density for the diagnosis of DSPN. We enrolled, according to a consecutive, population-based method, 36 patients with T2DM admitted in our Clinic. For all patients, we measured HbA1c, lipid profile, body mass index and we assessed the presence and severity of DSPN using the evaluation of clinical symptoms, nerve conduction velocity and IENF density quantification. The presence of neuropathy was significantly associated with a decreased density of IENF for both the proximal (11.6 vs. 14.9 fibers/mm; p = 0.014) and the distal biopsies (7.2 vs. 8.6 fibers/mm; p = 0.020). The optimal threshold value of IENF density (the point with the maximum sum of specificity and sensitivity), according to our model, was 10.1 fibers/mm. Skin biopsy followed by IENF density quantification is a valid, reliable tool for the diagnosis of DSPN.

14 May 2025 in Life
Verified
Journal Article
Open access
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AGAngelica Gherman
Angelica Gherman
DADiana Andrei
Diana Andrei
Calin PopoiuCalin Popoiu
Calin Popoiu
Emil Robert StoicescuEmil Robert Stoicescu
Emil Robert Stoicescu
CLCodrina Levai
Codrina Levai
VBVlad Bloanca
Vlad Bloanca
The COVID-19 pandemic accelerated the adoption of virtual multidisciplinary teams (MDTs), transforming healthcare delivery through telemedicine. This review examines the integration of telemedicine into multidisciplinary care across various medical specialties, highlighting its benefits and challenges. A comprehensive literature search was conducted across PubMed, Google Scholar, Scopus, and Web of Science, using keywords related to telemedicine and MDTs. Inclusion criteria focused on studies discussing telemedicine implementation in multidisciplinary care, as well as its effectiveness and impact on patient outcomes, while non-English studies, single-case reports, and articles lacking explicit discussions on MDT integration were excluded. Data extraction covered telemedicine platforms, specialties involved, patient satisfaction, and clinical outcomes. Our findings suggest that virtual MDTs enhance efficiency, accessibility, and patient satisfaction, particularly in remote and underserved areas. However, challenges, such as technological barriers, disparities in digital access, and maintaining effective team communication, persist. Despite these limitations, telemedicine has demonstrated significant potential in improving diagnostic accuracy and treatment coordination. Future efforts should focus on optimizing infrastructure, digital training for healthcare providers, and regulatory frameworks to guarantee long-term sustainability.

6 September 2024 in Pharmaceutics
Verified
Journal Article
Open access
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Nilima Rajpal KundnaniNilima Rajpal Kundnani
Nilima Rajpal Kundnani
CLCodrina Levai
Codrina Levai
MPMihaela-Diana Popa
Mihaela-Diana Popa
CBClaudia BORZA
Claudia BORZA
MIMihai Sorin Iacob
Mihai Sorin Iacob
ABAlexandru Iulian Ciprian Blidisel
Alexandru Iulian Ciprian Blidisel
Introduction: Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disorder characterized by significant autoantibodies, particularly targeting nuclear antigens. SLE pathogenesis involves genetic, environmental, and hormonal factors. The disease course includes flares and remission and involves various organs. Recent therapeutic progresses, including biologics, have improved management and prognosis, though the long-term impact of novel therapies remains to be determined. Biologics in SLE: Rituximab, the earliest B-cell-oriented biologic, binds CD20 and depletes CD20+ B cells, leading to remission in some SLE patients. Belimumab is a B-cell-activating factor (BAFF) inhibitor with a recent additional indication for lupus nephritis. The CALIBRATE and BLISS-BELIEVE studies investigated combinations of these drugs with conventional therapies, showing varied efficacy. Ocrelizumab and obinutuzumab, newer CD20-oriented SLE therapies, together with ofatumumab and veltuzumab, are also promising. The latest trials highlight their efficacy and safety. Anifrolumab, targeting type-I interferon receptors, was evaluated in the TULIP 1/2 trials. The ongoing TULIP LTE trial supports the long-term safety and efficacy of anifrolumab. Additionally, the IRIS Phase III trial is exploring anifrolumab for lupus nephritis, showing favorable renal responses. Tocilizumab and secukinumab are being assessed for SLE, with mixed outcomes. Several biologics targeting the C5 complement protein, together with immunomodulators and immunotherapeutics, are also under investigation for potential benefits in SLE. Discussion: Biologics in SLE target specific immune components, aiming to improve disease control and reduce the side effects of conventional therapy. However, trial outcomes vary due to factors like inclusion criteria and trial design. Conclusions: Biotechnology progress enables targeted biologic therapies for SLE, reducing disease activity and improving patients’ quality of life.

31 August 2022 in Journal of Clinical Medicine
Verified
Journal Article
Open access
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MGMirela Grigoras
Mirela Grigoras
ICIoana Mihaela Citu
Ioana Mihaela Citu
CCCosmin Ioan Citu
Cosmin Ioan Citu
VCVeronica Daniela Chiriac
Veronica Daniela Chiriac
Florin GorunFlorin Gorun
Florin Gorun
OCOctavian Cretu
Octavian Cretu
Several investigations have revealed that COVID-19 causes a significant death rate due to acute respiratory distress syndrome, alterations in the quantity of ACE2 receptor expression, or the intensity of cytokine storm. Similarly, patients with hepatic impairment that are co-infected with SARS-CoV-2 are more likely to display upregulations of ACE2 receptors and cytokine storm overload, which exacerbates hepatic impairment, potentially increasing the death rate. Moreover, it is expected that the aging population develops a higher degree of hepatic fibrosis in association with other comorbid conditions that are likely to influence the course of COVID-19. Therefore, this research was developed to describe the differences in liver test parameters in elderly individuals with COVID-19 in relation to other inflammatory markers and outcomes. This current observational single-center research followed a case-control design of elderly patients hospitalized for SARS-CoV-2 infection. The research was conducted at a tertiary emergency hospital in western Romania during a two-year period. There were 632 patients included in the analysis that were split into two equal groups matched 1:1 based on gender and body mass index. Three hundred sixteen patients made the group of cases with COVID-19 patients older than 65 years, while the other half were the 316 patient controls with COVID-19 that were younger than 65 years old. Disease outcomes showed a higher prevalence of ICU admissions (22.8% vs. 12.7%, p-value < 0.001) and in-hospital mortality (17.1% vs. 8.9%, p-value = 0.002) in the group of cases. Specific and non-specific liver biomarkers were identified as risk factors for mortality in the elderly, such as ALP (OR = 1.26), LDH (OR = 1.68), AST (OR = 1.98), and ALT (OR = 2.34). Similarly, patients with APRI and NFS scores higher than 1.5 were, respectively, 2.69 times and, 3.05 times more likely to die from COVID-19, and patients with FIB-4 scores higher than 3.25 were 3.13 times more likely to die during hospitalization for SARS-CoV-2 infection. Our research indicates that abnormally increased liver biomarkers and high liver fibrosis scores are related to a worse prognosis in SARS-CoV-2 infected individuals.