Lucian Cristian Petcu

Can HIV infection during pregnancy cause an intrauterine growth restriction

Background Intrauterine growth restriction (IUGR) indicates the presence of a pathophysiological process occurring in utero that inhibits fetal growth. IUGR has been associated with increased perinatal and infant mortality. There are many maternal factors responsible for IUGR. Some studies have suggested that HIV infection could increase the risk of IUGR. Specifically, in IUGR, the baby’s estimated weight is below the 10th percentile. The objective of this study was to evaluate the proportion of children born to HIV positive women who presented IUGR.

Active Data Transportation and Processing for Chronic Diseases Remote Monitoring

Remote monitoring of chronic diseases can improve health outcomes and potentially lower health care costs. The present work refers to the data transmittance and processing, as it is to be implemented in an eHealth monitoring system dedicated to pregnant women with chronically diseases. Alongside a software application and correspondent hardware, it provides an integrated solution of monitoring the evolution of the disease in order to optimize the treatment. The system is designed to be an efficient and safe instrument that transfers the data from different measurement devices towards the medical staff in order to keep update the patient’s data and increase the efficiency of the disease management.

Liver damage in HIV+HBV co-infected patients determined by transient elastography

In our country the prevalence of HIV-HBV co-infection in young infected patients, between 1985-1990, transmitted through nosocomial or vertical path is approximately 40%. We followed the prevalence and risk factors associated with liver damage in HIV+HBV infected patients. Longitudinal evaluation of liver fibrosis was carried out in the patients included in the study group, by transient elastography (TE). Several studies using non-invasive methods for the assessment of fibrosis have been performed in HIV infected patients, and in patients co-infected with hepatitis virus B, although up to now these methods have not been validated for this segment of the population. For statistical analysis, the TE results were designated to different stages of fibrosis in accordance with the previous recommendations. The predefined cut-off values were: F0-F1≤7.1 kPa, F2-F3>7.1 and ≤12.5 kPa and for cirrhosis (corresponding to F4) >12.5kPa. We included in the study 71 patients co-infected with HIV and hepatitis B. 71.85% of patients had minimal liver damage, 18.30% of them had moderate to severe fibrosis, 9.85% were F4. Patients were divided according to CD4 count into three groups: CD4 (0-200)/cmm, [200-500)/cmm, and >500 cells/cmm. By applying the ANOVA test we found significant differences between the 3 groups (p=0.037 500) [cells/cmm], p=0.033 400 copies/mL. For assessing the role of hepatitis virus B in liver disease severity in co-infected patients, patients were divided into two groups: HBV-DNA level≤ 2,000 IU/mL and >2,000 IU/mL. Since p=0.006 2,000 IU/mL), 95%CI (-4.642,-0.788). We confirm the role of HIV-induced immunosuppression in liver disease progression. As well we confirm the presence of more severe liver disease linked to hepatitis virus B replication.

Evaluation of anthropometric and virologic data in newborn from HIV positive mothers

Constanța used to be one of the most affected counties of Romania by HIV in children. Nowadays in Constanța there are an increasing number of HIV positive young women at fertile age who have babies. Even though there were implemented active measures for prevention of mother to child HIV transmission we still diagnose mothers with HIV after delivery. On the other hand HIV infection increases the risk of intrauterine growth restriction (IUGR) of newborn. The objectives of this study were to evaluate the proportion of children born from HIV positive women who presented IUGR; and to evaluate materno-fetal transmission rate of HIV in Constanța County. We performed a retrospective study on the relevant parameters in newborns and mothers: demographic data; CD4 count and HIV viral load in last trimester of pregnancy of mothers; HIV viral load in newborn. We analyzed anthropometric data of the newborn: weight, length, cranial circumference, and Apgar score. Statistical analysis was performed using SPSS version 19. Over a period of 6 years and 2 months, 135 newborn from 117 HIV+ mothers have been monitored. From all 135 children born from HIV positive mothers 5 were HIV positive. The median age in mothers was 23 and mean 23.08 (range: 17 to 39, SD=3.58). The mean Apgar score in newborns was 8.47 (range: 2 to 10, SD=1.202), and median 9. The mean birth weight in newborns was 2692 g (range: 1000 to 3900, SD=516.389), and median 2700 g. The proportion of children with birth weight less than 10th percentile was 58.05%. The mean length was 47.66 cm (range: 39 to 52, SD = 2.75), with a proportion of children below the 10th percentile of 27.4%. Infants who presented below the 10th percentile for weight and length were 23%. About 21.48% of infants were below the 10th percentile for weight, length and cranial circumference. Mean CD4 count in mothers in third trimester of pregnancy was 415.14 (range 27-1156), and median 397. 53.3% of mothers were with HIV viral load undetectable in the last trimester of pregnancy. In the studied period the mortality rate was 6.7% in children and 5.9% in mothers. The materno-fetal rate of HIV transmission was 3.7%. More than half (58.05%) of the infants born to HIV positive mothers were small for gestational age. 23% of infants were with IUGR and 23% of them presented symmetrical IUGR.

Enrolling in Science and Engineering Academic Programs—Motivating and Deterring Factors

We report the results of the student responses to a survey aiming to determine the factors influencing the young generation in choosing a career in science and technology. The goal of the study is twofold: to identify the motives that determine students to enroll in university programs in science and technology and to engage in applied science and engineering careers and to discover the barriers that manifest at different age levels, preventing students from making such choices. The study was conducted at the Ovidius University and the “Energetic” Technical High School, both in Constanta, Romania, with samples of 257 and 106 students respectively, based on a 38 item online questionnaire. The samples selected from the student population allow for a wide range of analyses with respect to gender, family and educational background, field of study, etc. We discuss the role of the raw models, parents, educators, and we comment on ways to increase student enrollment in science and engineering.

Supersonic Shear Wave Ultrasonography for Assessing Tissue Stiffness in Native Kidney

Recent years have brought shear wave elastography to the attention of nephrologists as a non-invasive method for detecting kidney fibrosis and, therefore, as a potential tool for reducing the need for kidney biopsy. Few studies are performed on native kidney. We aimed to compare cortical stiffness, assessed by measuring Youngs modulus (YM, kPa) with SuperSonic Imaging technology, in patients with various degrees of chronic kidney disease (CKD) compared with healthy individuals. Cortical stiffness was measured by two operators, in different sessions, in 32 patients with CKD stages 3-5 and 20 healthy individuals. Comparison between mean YM values in CKD and those in controls and also between the different stages of CKD was our primary objective. The influence of other possible confounders on YM readings was also investigated and analyzed. Mean YM was significantly greater in CKD patients than in controls. Estimated YM was not able to differentiate the stages of CKD, except stage 5. Intra-subject variability was greater in CKD than in controls. Body mass index was the most important confounder in multiple analyses, in both the CKD and control groups. Our results highlight a positive correlation between increased cortical stiffness and presence of CKD. Further studies are needed to validate this method for implementation in daily clinical practice.

DFT study of binding and electron transfer from penicillin to a TiO2 nanocluster: Applications to photocatalytic degradation

We report results of density functional theory calculations on penicillin G and penicillin V adsorbed on a TiO2 nanoclusters, in order to study its photocatalytic degradation under ultraviolet and visible light irradiation. We analyze the absorption spectrum of the free and adsorbed penicillin, the binding configurations, and the likelihood of the charge-transfer to the substrate.

Concordance between noninvasive assessments of fibrosis in patients with HIV/HIV+HBV infection.

Many studies used non-invasive methods to estimate the prevalence of significant fibrosis and its risk factors in patients with HIV infection. We evaluated the ability of APRI and FIB-4 score to differentiate between the different stages of fibrosis (no fibrosis/minimal fibrosis = F0-F1 and F2-F4 fibrosis moderate-severe/cirrhosis), taking as a reference, in the absence of liver biopsy, the hepatic fibrosis stratification by FibroScan. Group 1 was represented by 39 patients with HIV infection and group 2 by 71 patients with HIV/HBV coinfection. AUROC was used to calculate for each group and for each score the optimal value for identifying significant fibrosis. Then we determined the cut-off value that identifies significant fibrosis with maximum specificity. The Kappa score was then calculated for the concordance between methods. For HIV/HBV coinfected patients, to identify significant fibrosis score on tally Kappa classification for fibrosis by APRI versus FibroScan, Kappa=0.494, 95% CI (0.245, 0.742) on the identification of fibrosis (F0-F1 to F ≥2), for the FIB-4 Kappa=0.481, 95% CI (0.238, 0.725) for both the moderate concordance. Regarding the comparison of the two methods APRI and FIB-4 kappa=0.698, 95% CI (0.485, 0.910), significant concordance. For patients with HIV to identify significant fibrosis Kappa score tally on the classification of fibrosis by APRI versus FibroScan Kappa=0.217, 95% CI (-0.424, 0.858) on the identification of fibrosis (F0-F1 to F ≥2), for the FIB-4 Kappa=0.164, 95% CI (-0.451, 0.779) for both the correlation is reduced. Regarding the comparison of the two methods APRI and FIB-4 kappa=0.217, 95% CI (-0.424, 0.858), which confirms the low correlation. There is sufficient evidence that the tests used: APRI and FIB-4 have the ability to distinguish for both groups of patients between the two classes of fibrosis (F0-F1 to F≥2) meaning between patients with and without liver disease. Although for patients with HIV infection a low concordance was noted between non-invasive methods for the diagnosis of fibrosis, in coinfected patients it was moderate and these tests could be used as evaluation methods in the monitoring of liver injury especially when the results of these tests are concordant.

Evaluation of hepatic fibrosis with noninvasive methods: transient elastography in HIV infected patients

Results The mean FibroScan score was 5.153 kPa, with a standard deviation (SD) of 1.493 kPa. There were 19 patients with CD4 counts between 200500 cells/cmm; in this group, the mean value of FibroScan was 5.378±1.415 kPa. In the 20 patients with CD4 count above 500 cells/cmm, the mean FibroScan score was 4.94±1.56 kPa. There were no statistically significant differences between groups regarding the CD4 count (p=0.36). In this study we did not select cases of patients with severe immunodepression (CD4 count below 200 cells/cmm). Regarding HIV viral load (VL), we split patients into two groups, above and below 400 copies/mL. There were 31 patients with VL less than 400 copies/mL; the mean FibroScan score was 5.161±1.633 kPa. There were 9 patients with VL more than 400 copies/mL, with a mean FibroScan score of 5.125±0.818 kPa. There were no statistically significant differences between groups regarding HIV VL (p=0.931). Conclusion In the studied patients there were no significant differences in terms of liver fibrosis evaluated by FibroScan. We included no patients with severe immunodepression and all patients received combined antiretroviral therapy. Noninvasive methods for the evaluation of liver fibrosis are less studied in HIV patients. Further extensive studies are necessary for such patients in order to evaluate cutoffs for assessing liver fibrosis and cirrhosis.