2. FACULTATEA DE MEDICINĂ nr.1 / FACULTY OF MEDICINE nr.1

Core outcome set for the management of acute exacerbations of chronic obstructive pulmonary disease: the COS-AECOPD ERS Task Force study protocol

2026-07-13T10:36:33Z

Core outcome set for the management of acute exacerbations of chronic obstructive pulmonary disease: the COS-AECOPD ERS Task Force study protocol Mathioudakis, Alexander G.; Abroug, Fekri; Agusti, Alvar; Bakke, Per; Bartziokas, Konstantinos; Beghe, Bianca; Bikov, Andras; Bradbury, Thomas; Brusselle, Guy; Cadus, Cordula; Coleman, Courtney; Contoli, Marco; Corlăteanu, Alexandru; Corlăteanu, Olga; Criner, Gerard; Csoma, Balazs; Emelyanov, Alexander; Faner, Rosa; Romero, Gustavo Fernandez; Hammouda, Zeineb; Horváth, Peter; Huerta, Arturo Garcia; Jacobs, Michael; Jenkins, Christine; Joos, Guy; Kharevich, Olga; Kostikas, Konstantinos; Lapteva, Elena; Lazar, Zsofia; Leuppi, Joerg D.; Liddle, Carol; López-Giraldo, Alejandra; McDonald, Vanessa M.; Nielsen, Rune; Papi, Alberto; Saraiva, Isabel; Sergeeva, Galina; Sioutkou, Agni; Sivapalan, Pradeesh; Stovold, Elizabeth; Wang, Hao; Wen, Fuqiang; Yorke, Janelle; Williamson, Paula R.; Vestbo, Jørgen; Jensen, Jens-Ulrik Randomised controlled trials (RCTs) on the management of COPD exacerbations evaluate heterogeneous outcomes, often omitting those that are clinically important and patient relevant. This limits their usability and comparability. A core outcome set (COS) is a consensus-based minimum set of clinically important outcomes that should be evaluated in all RCTs in specific areas of health care. We present the study protocol of the COS-AECOPD ERS Task Force, aiming to develop a COS for COPD exacerbation management, that could remedy these limitations. For the development of this COS we follow standard methodology recommended by the COMET initiative. A comprehensive list of outcomes is assembled through a methodological systematic review of the outcomes reported in relevant RCTs. Qualitative research with patients with COPD will also be conducted, aiming to identify additional outcomes that may be important to patients, but are not currently addressed in clinical research studies. Prioritisation of the core outcomes will be facilitated through an extensive, multi-stakeholder Delphi survey with a global reach. Selection will be finalised in an international, multi-stakeholder meeting. For every core outcome, we will recommend a specific measurement instrument and standardised time points for evaluation. Selection of instruments will be based on evidence-informed consensus. Our work will improve the quality, usability and comparability of future RCTs on the management of COPD exacerbations and, ultimately, the care of patients with COPD. Multi-stakeholder engagement and societal support by the European Respiratory Society will raise awareness and promote implementation of the COS.

The impact of surgical menopause on lipid profile and hormonal status in women of reproductive age

2026-07-15T08:08:21Z

The impact of surgical menopause on lipid profile and hormonal status in women of reproductive age Vatamanu, Eleonora; Cerneţchi, Olga The study of hormonal and metabolic disturbances following hysterectomy with or without ovariectomy is of great interest to gynecologists, because hysterectomy remains one of the most common types of gynecologic interventions in most countries and represents the treatment of choice for benign pathologies. The aim of the study was to determine the impact of surgical menopause on lipid profile and hormonal status in women of reproductive age. The current study is based on a prospective, observational analysis of 30 cases of hysterectomy without ovariectomy (group I, mean age 41.9 ±4.8 years) and 30 cases of hysterectomy with bilateral ovariectomy (group II, mean age 46.1 ±2.9 years). The control group consisted of 30 healthy women of similar age to those included in the research groups. Serum level of estradiol (E2), total cholesterol, triglycerides, HDL-C and LDL-C were evaluated preoperatively, on the 10th-12th postoperative day, 6 and 12 months after the intervention. The lipid profile analysis showed a significant increase in the mean total cholesterol level from 3.91 ±0.37 mmol/l preoperatively to 4.18 ±0.43 mmol/l 12 months postoperatively in group I and from 4.11 ±0.32 mmol/l to 4.28 ±0.21 mmol/l in group II (p<0.05). These values were significantly higher compared to the control group (3.92 ±0.59 p<0.05). Also, the results of our study reveal that the serum level of triglycerides at 12 months postoperatively was significantly higher in both groups (1.85 ±0.25 mmol/l in group I and 1.82 ±0.16 mmol/l in group II) compared to the control group (1.63 ±0.17 mmol/l), p<0.05. The increase in serum LDL-C level as well as the decrease in HDL-C was more evident in women who underwent hysterectomy with bilateral ovariectomy. This could probably be explained by a more pronounced decrease in the level of E2 in this group. Thus, the serum E2 level one year postoperatively in group I was 121.90 ±8.63 pg/ml and in group II 102.76 ±7.88 pg/ml, being significantly lower compared to the group of control (142.06 ±12.70 pg/ml) p<0.05. Hysterectomy led to a decrease in the serum level of estradiol and to disturbances in the lipid profile in the first postoperative year. These changes were more evident in patients with bilateral ovariectomy. Early diagnosis and individualized treatment can prevent hormonal decline, the appearance of complications and can also maintain the quality of life in this category of patients.

Assessment of the role of APRI index in women with intrahepatic cholestasis of pregnancy

2026-07-15T08:08:40Z

Assessment of the role of APRI index in women with intrahepatic cholestasis of pregnancy Cemortan, Maria; Cerneţchi, Olga; Iliadi-Tulbure, Corina; Sagaidac, Irina Introduction. Intrahepatic cholestasis of pregnancy (ICP) is a condition characterized by increased liver function tests and the presence of cutaneous pruritus. The aspartate aminotransferase to platelet ratio index (APRI) has been shown to be a useful tool in diagnosing and predicting the progression of liver cirrhosis and fibrosis. At the same time, there are few studies, which would focus on the assessment of APRI level in women with ICP. Material and Methods. In a prospective study 71 clinical cases complicated by ICP (group A) were compared to 71 cases without ICP (group B). The APRI was calculated using the formula: {(AST/upper limit of the normal values) x 100}/ number of platelets (109/L). The arithmetic means and standard deviation (M (SD)) were calculated, a t-test to compare two means was applied. Besides that, Pearson’s correlation was assessed. Results. Mean values of APRI in group A were 1.2 (1.2) compared to group B – 0.3 (0.1), 95% CI 0.61 - 1.18, p˂0.0001. By analyzing the correlation between APRI and indicators assessed in the study a negative correlation with term of pregnancy at which delivery occurred (p=0.01) and with delivery duration (p=0.01) was identified. Positive correlation was also found with the presence of meconium-stained amniotic fluid (p=0.01), caesarean section rate (p=0.01) and the amount of postpartum blood loss in women recruited in the study (p=0.01). Conclusions. The results of our study revealed the correlation between APRI value and the presence of specific conditions related to pregnancy, that may be an important step in the management of cases of ICP.

Message of the first vice-rector

2026-07-15T08:08:59Z

Message of the first vice-rector Cerneţchi, Olga