Zsuzsánna Incze-Bartha

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

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Vlad Vunvulea

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Ylenia Pastorello

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Zsuzsánna Simon-Szabó

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Andrei Marian Feier

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Lóránd Dénes

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Cristian Trâmbițaș

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Sándor Incze-Bartha

County Hospital

Aurelio Pio Russo

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Tudor Sorin Pop

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Sándor-György Zuh

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Cooperative Institutions

Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș

Spitalul Clinic Judetean Mures

County Hospital

Spitalul Clinic Judetean de Urgenta Târgu Mureş

Clinical Emergency Hospital Bucharest

Carol Davila University of Medicine and Pharmacy

Lucian Blaga University of Sibiu

University of Oradea

Budapest Institute

Iuliu Hațieganu University of Medicine and Pharmacy

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Finite Element Analysis of Normal and Dysplastic Hip Joints in Children

Journal of Personalized Medicine (2023)

Zsuzsánna Incze-Bartha Sándor Incze-Bartha Zsuzsánna Simon-Szabó Andrei Marian Feier Vlad Vunvulea

From a surgical point of view, quantification cannot always be achieved in the developmental deformity in hip joints, but finite element analysis can be a helpful tool to compare normal joint architecture with a dysplastic counterpart. CT scans from the normal right hip of an 8-year-old boy and the dysplastic left hip of a 12-year-old girl were used to construct our geometric models. In a three-dimensional model construction, distinctions were made between the cortical bone, trabecular bone, cartilage, and contact nonlinearities of the hip joint. The mathematical model incorporated the consideration of the linear elastic and isotropic properties of bony tissue in children, separately for the cortical bone, trabecular bone, and articular cartilage. Hexahedral elements were used in Autodesk Inventor software version 2022 ("Ren") for finite element analysis of the two hips in the boundary conditions of the single-leg stance. In the normal hip joint on the cartilaginous surfaces of the acetabulum, we found a kidney-shaped stress distribution in a 471,672 mm2 area. The measured contact pressure values were between 3.0 and 4.3 MPa. In the dysplastic pediatric hip joint on a patch of 205,272 mm2 contact area, the contact pressure values reached 8.5 MPa. Furthermore, the acetabulum/femur head volume ratio was 20% higher in the dysplastic hip joint. We believe that the knowledge gained from the normal and dysplastic pediatric hip joints can be used to develop surgical treatment methods and quantify and compare the efficiency of different surgical treatments used in children with hip dysplasia.

10.3390/jpm13111593

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Citations (2)

Finite Element Analysis of Various Osteotomies Used in the Treatment of Developmental Hip Dysplasia in Children

Journal of Personalized Medicine (2024)

Zsuzsánna Incze-Bartha Sándor Incze-Bartha Zsuzsánna Simon-Szabó Andrei Marian Feier Vlad Vunvulea

Late-discovered developmental hip dysplasia deformities often necessitate complex surgical treatments and meticulous preoperative planning. The selection of osteotomies is contingent upon the patient’s age and the specific structural deformity of the hip. In our anatomical hip model, derived from the data of a 12-year-old patient, we performed virtual osteotomies that are commonly recommended for such cases. We precisely constructed geometric models for various osteotomies, including the Dega, Pemberton, Tönnis, Ganz, Chiari pelvic, and Pauwels femoral osteotomies. We employed Autodesk Inventor for the finite element analysis of the hip joint and the corrective osteotomies. In comparing one-stage osteotomies, we noted that the Dega and Ganz pelvic osteotomies, especially when combined with the Pauwels femoral osteotomy, yielded the most favorable outcomes. These combinations led to enhanced femoral head coverage and reduced intra-articular pressure. Furthermore, we calculated the femoral head-to-acetabulum volume ratio for both the Dega and Pauwels osteotomies. The encouraging results we obtained advocate for the integration of finite element analysis in virtual osteotomies of the pelvis and femur as a preoperative tool in the management of developmental hip dysplasia.

Hip Dysplasia

10.3390/jpm14020189

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Citations (1)

Arthroscopic Repair in Tibial Spine Avulsion Fractures Using Polyethylene Terephthalate Suture: Good to Excellent Results in Pediatric Patients

Journal of Personalized Medicine (2021)

Octav Russu Tudor Sorin Pop Emilian Ciorcila I Gergely Sándor-György Zuh

The objective of the arthroscopic treatment in tibial spine avulsion fractures (TSAF) is to achieve firm reduction and strong internal fixation while still having the patient undergo a minimally invasive procedure.

Avulsion fracture

10.3390/jpm11050434

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Citations (6)

Cough-Induced Multiple, Bilateral, Asymmetrical Rib Fractures in a Scoliosis Patient: A Case Report

Cureus (2023)

Zsuzsánna Incze-Bartha Aurelio Pio Russo Ylenia Pastorello Vlad Vunvulea Nicolae Stanciu

Cough-induced rib fractures represent infrequent complications of strenuous and prolonged coughing, mostly provoked by respiratory tract infections, with localized chest pain being the most indicative component of the clinical picture. This paper reports a case of a 27-year-old female patient who presented with four cough-induced rib fractures following the contraction of an upper respiratory tract infection. The unique character of this case is provided by the young age of the patient, the presence of multiple and bilaterally located rib fractures, and the absence of predisposing factors related to her bone physiology. Furthermore, three of the four fractures were revealed on the left side, where a scoliotic sinistro-convex thoracic curvature is described. Following conservative treatment, the patient experienced a complete resolution of symptoms and favorable clinical outcomes. Even in the seemingly low-risk category, the diagnosis of cough-induced rib fractures should be taken into consideration, and their correlation to pre-existing rib deformities, such as the ones secondary to scoliosis, should be thoroughly investigated.

Respiratory tract

Idiopathic scoliosis

10.7759/cureus.49251

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Citations (1)

Blood Count-Derived Inflammatory Markers Correlate with Lengthier Hospital Stay and Are Predictors of Pneumothorax Risk in Thoracic Trauma Patients

Diagnostics (2023)

Vlad Vunvulea Răzvan Marian Melinte Klara Brînzaniuc Bogdan Andrei Suciu Adrian Dumitru Ivănescu

(1) Background: Trauma is one of the leading causes of death worldwide, with the chest being the third most frequent body part injured after abdominal and head trauma. Identifying and predicting injuries related to the trauma mechanism is the initial step in managing significant thoracic trauma. The purpose of this study is to assess the predictive capabilities of blood count-derived inflammatory markers at admission. (2) Materials and Methods: The current study was designed as an observational, analytical, retrospective cohort study. It included all patients over the age of 18 diagnosed with thoracic trauma, confirmed with a CT scan, and admitted to the Clinical Emergency Hospital of Targu Mureş, Romania. (3) Results: The occurrence of posttraumatic pneumothorax is highly linked to age (p = 0.002), tobacco use (p = 0.01), and obesity (p = 0.01). Furthermore, high values of all hematological ratios, such as the NLR, MLR, PLR, SII, SIRI, and AISI, are directly associated with the occurrence of pneumothorax (p < 0.001). Furthermore, increased values of the NLR, SII, SIRI, and AISI at admission predict a lengthier hospitalization (p = 0.003). (4) Conclusions: Increased neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), aggregate inflammatory systemic index (AISI), and systemic inflammatory response index (SIRI) levels at admission highly predict the occurrence of pneumothorax, according to our data.

10.3390/diagnostics13050954

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Citations (5)

Retrospective Analysis of the Prevalence and Risk Factors of Retinopathy of Prematurity in a Single-Center Cohort in Romania and Comparison with National and European Data

Medicina (2025)

Zsuzsánna Simon-Szabó Sándor Pál Aliz Pándi Zsuzsanna Gáll Hajnal Finta

Background and Objectives: This study investigated and compared with European literature data the incidence, severity, and perinatal risk factors of retinopathy of prematurity (ROP) in preterm infants admitted to the Premature Department of Mureş County Clinical Hospital over a two-year period (January 2022-December 2023). Materials and Methods: ROP screening was performed in 96 infants (76.8%) according to professional guidelines. A literature review was conducted to compare our findings with national and European data. Significant differences were identified in comparisons with studies from Cluj-Napoca (p = 0.0125), Timișoara, and Bucharest (p < 0.0074), as well as Serbia and Croatia when stratified by gestational age limits. The variations in GA thresholds (32 vs. 34 weeks) between studies required stratified analyses to ensure meaningful comparisons. The included European studies provided data on screening criteria, prevalence, and associated risk factors, offering a comprehensive perspective on screening effectiveness. Results: Among the 149 admitted patients, 125 were preterm (n = 125). Of the screened patients, 20 (20.83%) infants were diagnosed with ROP, including 13 boys (65%) and 7 girls (35%), all requiring prolonged respiratory support, and 55% of them needed blood transfusion. The average birth weight of affected infants was 1030.5 g (550-1700 g ), and the mean gestational age was 28.3 weeks (25-34 weeks). In those found to have stage 2 and 3 ROP in zone II with plus disease (n = 6), intravitreal anti-VEGF injections and/or retinal laser treatments were performed. Notably, no cases of ROP-related blindness were recorded. Conclusions: To our knowledge, this is the first study to compare ROP prevalence and screening outcomes across Romanian national centers. Identified risk factors in this cohort, such as respiratory distress syndrome, oxygen therapy, blood transfusion, and intraventricular hemorrhage, are consistent with the existing literature data. These findings underscore the importance of standardized screening criteria and effective management protocols to prevent ROP-related blindness. The comparative approach of this study highlights the necessity of harmonized internationally applied criteria to facilitate robust comparisons and, more importantly, improve patient care outcomes.

Center (category theory)

10.3390/medicina61010149

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Citations (0)

Treatment Efficacy with a Novel Hyaluronic Acid-Based Hydrogel for Osteoarthritis of the Knee

Journal of Personalized Medicine (2021)

Octav Russu Tudor Sorin Pop Andrei Marian Feier Cristian Trâmbițaș Zsuzsánna Incze-Bartha

Background: Prior trials investigating the treatment of symptomatic osteoarthritis (OA) with hyaluronic-acid-derived products injections have provided optimistic results. The study was directed to assess the effectiveness of an innovative hyaluronic-acid-based hydrogel (Hymovis®) in the treatment of symptomatic knee OA. Methods: A prospective, single-center, clinical trial was performed. Thirty-five patients with degenerative knee OA were included. Inclusion criteria were: age between 45–80, radiographic Kellgren grade II or III osteoarthritis, minimum 35 mm score on the Visual Analogue Scale (VAS), pain for at least 6 months and agreement to participate in the study. Patients received two injections at a one-week interval. The evaluator assessed the patients using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and VAS. Evaluation was performed before, at 2 and 6 months after the injections. Results: A significant improvement on the WOMAC Index pain subscale was observed at 6 months after the injection. At two months, pain subscale score decreased from 10.34 to 9.34. At six months, a significant decrement in pain parameters compared to baseline was observed (from 10.34 to 7.72; p = 0.0004). Median points on VAS significantly ameliorated after 6 months (from 74.2 to 57.3 cm; p < 0.0001). Regarding physical function, a statistically significant difference compared to baseline was observed at the end of the study (from 29.74 to 25.18; p = 0.0025). WOMAC Index stiffness component did not differ from baseline at any time during follow-up. Conclusions: Pain relief installed with a delayed on-set but had a prolonged duration. The novel hyaluronic acid-based hydrogel (Hymovis®) had effective results, particularly after six months post-injections and offers a therapeutic advancement in the treatment of moderate to severe osteoarthritis.

WOMAC

Knee pain

10.3390/jpm11040303

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Citations (8)

Sequential Surgical Correction of Macrodactyly: A Case Report and Literature Review

Cureus (2024)

Aurelio Pio Russo Mónika Szilveszter Călin Șuta Camelia David Vlad Vunvulea

This report discusses the case of a young female patient diagnosed with macrodactyly of the toes, a condition that significantly affected her daily life. From the age of three to 11, she underwent treatment due to the severe impact of her deformity, particularly on her ability to move comfortably and wear suitable footwear. The patient's macrodactyly presented a complex clinical challenge, necessitating multiple surgical procedures to manage it effectively. These surgeries included soft tissue reduction to decrease the bulk of the enlarged digits, epiphysiodesis to halt the growth of the affected bones, and amputations to address the disproportionate enlargement of the toes. Each surgical intervention was aimed at improving both the function and appearance of the affected foot, with a focus on enhancing the patient's mobility and comfort. Despite the difficulties associated with recovery, the patient showed significant improvements in her ability to walk and in the aesthetic appearance of her foot. This case underscores the importance of developing individualized treatment plans that consider the unique needs of each patient and setting realistic expectations for outcomes. It also highlights that, while surgical interventions can lead to functional and cosmetic benefits, the extent of these improvements may be limited due to the inherent complexities of macrodactyly. The case calls attention to the need for ongoing research and the accumulation of clinical experience to refine treatment approaches for macrodactyly. Such advancements are crucial for optimizing therapeutic outcomes and improving the quality of life for patients affected by this rare condition.

10.7759/cureus.68913

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