Papers by Angelo Bulboaca
Medical Hypotheses, Apr 1, 2017
The health care system needs to face new and advanced medical technologies that can improve the p... more The health care system needs to face new and advanced medical technologies that can improve the patients' quality of life by replacing lost or decreased functions. In stroke patients, the disabilities that follow cerebral lesions may impair the mandatory daily activities of an independent life. These activities are dependent mostly on the patient's upper limb function so that they can carry out most of the common activities associated with a normal life. Therefore, an upper limb exoskeleton device for stroke patients can contribute a real improvement of quality of their life. The ethical problems that need to be considered are linked to the correct adjustment of the upper limb skills in order to satisfy the patient's expectations, but within physiological limits. The debate regarding the medical devices dedicated to neurorehabilitation is focused on their ability to be beneficial to the patient's life, keeping away damages, injustice, and risks.
Romanian Journal of Neurology, Jun 30, 2014
Multiple sclerosis (MS) is a demyelinating disease associated with a myriad of visual pathways pa... more Multiple sclerosis (MS) is a demyelinating disease associated with a myriad of visual pathways pathology. These pathologies need to be assessed, even when asymptomatic, because they may represent an important index of disease course, severity and treatment response. This is a review of the importance of different visual pathways assessment methods such as classic ophthalmologic examination, cerebrospinal fl uid analysis, Doppler ultrasonography of the orbital vessels, magnetic resonance imaging, optical coherence tomography, visual evoked potential, evaluating which may contribute to elucidate the pathophysiological process, structural and functional damage. The modern medical technology developed multiple methods which are trying to link their results to the overall brain damage in MS. A global analysis of these methods is needed, in order to a better evaluation of visual pathways damage associated with multiple sclerosis.
Romanian Journal of Neurology, Jun 30, 2013
A case of multiple neurogenic tumors is presented. A native MRI (head and cervical spine) identif... more A case of multiple neurogenic tumors is presented. A native MRI (head and cervical spine) identifi ed multiple bilateral tumors in the intraorbital space and cervical tumors. Based on the clinical course, imaging features and diagnosis criteria a possible diagnosis of schwannomatosis was made. Further investigations are needed for a precise diagnosis. This case presents discrepancies between the clinical presentation (paucity of symptoms) and imaging fi ndings. A careful follow-up and surgical treatment is needed, in order to prevent the mass effects of these tumors.
Balneo Research Journal, May 20, 2018
Hemorrhagic transformation (HT) may occur as a part of the natural history of acute ischemic stro... more Hemorrhagic transformation (HT) may occur as a part of the natural history of acute ischemic stroke, with incidence between 13-43% in computer-tomography (CT) studies. Detection of HT in a patient with ischemic stroke is important in establishing treatment in the acute phase in assessing prognosis and in taking therapeutical decisions for secondary stroke prevention. There were controversies regarding optimal treatment in acute ischemic stroke with HT, especially if the patient needs further anticoagulant or antiplatelet treatment. Rehabilitation treatment needs to be continued for post-stroke patients who developed HT, because HT does not decrease rehabilitation outcome. We present rehabilitation treatment and prognosis in a case of hemorrhagic transformation after an embolic ischemic stroke treated with anticoagulants, which required reinitiation of anticoagulant treatment.
Romanian Journal of Neurology, Mar 31, 2010
Since 1967 when platelet microparticles were discovered, the platelet's researchers were demonstr... more Since 1967 when platelet microparticles were discovered, the platelet's researchers were demonstrated the procoagulant properties of these platelet membranes nano-fragments. They are versatile bioeffectors in haemostasis because of their membrane receptors content. From these reasons, recently has been suggested that the platelet microparticles may constitute an important marker of atherothrombosis and, consequently a prognosis factor in various vascular diseases, including ischemic stroke. On the other way, the antiplatelet therapy focused on platelet microparticles activity may be benefi cial.
Balneo Research Journal, May 20, 2018
Spondylodiscitis is an infection of the intervertebral disc space, involves the vertebrae, causin... more Spondylodiscitis is an infection of the intervertebral disc space, involves the vertebrae, causing vertebral osteomyelitis and spread to adjacent epidural space, causing dural, radicular or spinal cord compression. Appears mainly in adult and immunocompromised patients, mainly by haematogenous inoculation from systemic infections with bacteriemia. Patients with hepatic cirrhosis have frequent bacteriemias, produced by increased gut permeability, immune dysfunction and frequent need for invasive procedures. Despite high frequency of blood stream infections, discitis and vestebral osteomyelitis are rarely reported. We present the case of a 53 years old woman, diagnosed with class B Child Pugh cirrhosis, which presents with intense back pain and cauda equina syndrome, without clinical signs of infection. Diagnosis was confirmed by spinal MRI, but very soon after treatment onset, the patient suffered a septic shock with haemodynamic instability, which leads to patient's death. This case illustrates how an unusual complication of cirrhosis-bacteriemia-could precipitate the unfavorable evolution of the patient by producing a remote septic complication. Persistent back pain in a cirrhotic patient should also raise the hypothesis of an infectious cause, in which early management is essential. Early diagnosis in essential for successful treatment, and good prognosis after long-term antibiotic treatment can be achieved in the majority of patients.
Romanian Journal of Neurology, Jun 30, 2015
Introduction. Migraine is an important cause of disability that affects the quality of life produ... more Introduction. Migraine is an important cause of disability that affects the quality of life producing a substantial social impairment. Objectives. The aim of this study was to evaluate the correlation between migraine severity and comorbidities in patients with episodic migraine. Methods. 2 groups of patients were included in the study: group 1-control group (healthy subjects, n = 50), and group 2-study group (patients with episodic migraine attacks, n = 65). Both groups were assessed for nonmodifi able risk factors (age), and modifi able risk factors: BMI (body mass index), lipids profi les (LDL-cholesterol, HDL-cholesterol, triglycerides), infl ammatory parameters (C reactive protein and fi brinogen), and endothelial dysfunction (nitric oxide synthesis expressed as NOx). The migraine was diagnosed according to ICHD-2 (International Classifi cation of Headache Disorders) and the severity was evaluated by MIDAS (Migraine Disability Assessment Scale). The study group was compared with control group. The parameters that showed statistic signifi cance were correlated with MIDAS scale. Results. There was a signifi cant correlation between the severity and frequency of migraine attacks (evaluated by MIDAS scale) and BMI. The subgroup with higher infl ammatory parameters and decreased NOx had an increased MIDAS score. Conclusions. The connection between obesity, infl ammatory parameters and migraine may be useful for new prophylaxis potent therapies. The individual personalized therapies according with particular risk factors of each patient may be a chance for better results. Identifi cation and control of risk factors in migraine patients may be particularly important.
Balneo and PRM Research Journal, Mar 20, 2021
Neuroplasticity is an essential phenomenon underlying on neurorehabilitation process, by which th... more Neuroplasticity is an essential phenomenon underlying on neurorehabilitation process, by which the brain can remodel the dysfunction consequent to a lesion. Ischemic brain lesions are the most frequent brain lesions often associated with visual function disability. Experimental and clinical studies established that visual function disability can impede the neurorehabilitation therapy efficiency. Neuro-optometric therapy has been proved to significantly improve the patient outcome after brain lesions. The pathophysiological mechanisms underlying this process are yet to be deciphered. Current knowledge regarding the pathophysiological mechanisms involved in ischemic lesions and neuroplasticity as a reparation process offers real support to a more efficient neurorehabilitation therapy that can contribute to the improvement of life quality in stroke patients.
Romanian Journal of Neurology
Since 1967 when platelet microparticles were discovered, the platelet’s researchers were demonstr... more Since 1967 when platelet microparticles were discovered, the platelet’s researchers were demonstrated the procoagulant properties of these platelet membranes nano-fragments. They are versatile bioeffectors in haemostasis because of their membrane receptors content. From these reasons, recently has been suggested that the platelet microparticles may constitute an important marker of atherothrombosis and, consequently a prognosis factor in various vascular diseases, including ischemic stroke. On the other way, the antiplatelet therapy focused on platelet microparticles activity may be beneficial.
Romanian Journal of Neurology
A case of multiple neurogenic tumors is presented. A native MRI (head and cervical spine) identif... more A case of multiple neurogenic tumors is presented. A native MRI (head and cervical spine) identified multiple bilateral tumors in the intraorbital space and cervical tumors. Based on the clinical course, imaging features and diagnosis criteria a possible diagnosis of schwannomatosis was made. Further investigations are needed for a precise diagnosis. This case presents discrepancies between the clinical presentation (paucity of symptoms) and imaging findings. A careful follow-up and surgical treatment is needed, in order to prevent the mass effects of these tumors.
Romanian Journal of Neurology
Multiple sclerosis (MS) is a demyelinating disease associated with a myriad of visual pathways pa... more Multiple sclerosis (MS) is a demyelinating disease associated with a myriad of visual pathways pathology. These pathologies need to be assessed, even when asymptomatic, because they may represent an important index of disease course, severity and treatment response. This is a review of the importance of different visual pathways assessment methods such as classic ophthalmologic examination, cerebrospinal fluid analysis, Doppler ultrasonography of the orbital vessels, magnetic resonance imaging, optical coherence tomography, visual evoked potential, evaluating which may contribute to elucidate the pathophysiological process, structural and functional damage. The modern medical technology developed multiple methods which are trying to link their results to the overall brain damage in MS. A global analysis of these methods is needed, in order to a better evaluation of visual pathways damage associated with multiple sclerosis.
Antioxidants
Background: Our study aimed to assess the efficiency of Curcumin nanoformulation (LCC) on experim... more Background: Our study aimed to assess the efficiency of Curcumin nanoformulation (LCC) on experimental nephrotoxicity induced by Gentamicin in rats. Methods: Six groups of seven rats were used: C—(control group) received saline solution i.p. (i.p. = intraperitoneal), G—gentamicin (G, 80 mg/kg body weight (b.w.)), GCC1 and GCC2—with G and CC solution (single dose of 10 mg/kg b.w.-CC1, or 20 mg/kg b.w.-CC2), GLCC1 (10 mg/kg b.w.) and GLCC2 (20 mg/kg b.w.) with G and LCC administration. Oxidative stress parameters (NOx = nitric oxide, MDA = malondialdehyde, TOS = total oxidative stress), antioxidant parameters (CAT = catalase, TAC = total antioxidant capacity), matrix metalloproteinases (MMP-2 and MMP-9), and renal function parameters (creatinine, blood urea nitrogen, and urea) were measured. Kidneys histopathologic examination was made for each group. Results: Pretreatment with CC and LCC in both doses had significantly alleviating effects on assessed parameters (NOx, MDA, TOS, CAT, T...
Balneo Research Journal, 2019
Traumatic vertebral artery (VA) dissection is a severe consequence of a cervical injury, which us... more Traumatic vertebral artery (VA) dissection is a severe consequence of a cervical injury, which usually involves the vertebrae and spinal cord. Traumatic VA dissection has been frequently underdiagnosed or misdiagnosed, mainly because many patients remain asymptomatic. The consequence of VA dissection is ischemia in the territory supplied by the affected artery. The VA dissection presents most often as a vertebrobasilary transient ischemic attack or ischemic stroke, usually preceded by local symptoms such as neck pain or headache. Headache is a common symptom in patients with cervical artery dissection, but its characters are not specific. Diagnosis of VA dissection usually requires a CT-angiography. Delayed onset of symptoms with a variable asymptomatic interval, ranging from several days to 3 months, has been reported. The risk of stroke remains high, especially in the first weeks after the confirmation of VA dissection. Treatment of traumatic VA dissections include anticoagulation or antiplatelet therapy and revascularization techniques. We present the case of a patient with spinal cord injury and operated C5 fracture, who was diagnosed with unilateral VA dissection 6 months after the traumatic event, during the rehabilitation program.
Antioxidants, 2022
Our study aimed to assess the effect of liposomal epigallocatechin-gallate (LEGCG) compared with ... more Our study aimed to assess the effect of liposomal epigallocatechin-gallate (LEGCG) compared with epigallocatechin-gallate (EGCG) solution on hepatic toxicity induced by gentamicin (G) administration in rats. Five groups were evaluated, a control group (no G administration) and four groups that received G (1 mL, i.p, 80 mg/kg b.w. (body weight/day), for 7 days) to which we associated daily administration 30 min before G of EGCG (G-EGCG, 2.5 mg/0.1 kg b.w.), LEGCG (G-LEGCG, 2.5 mg/0.1 kg b.w.) or silymarin (100 mg/kg b.w./day). The nitro-oxidative stress (NOx), catalase (CAT), TNF-α, transaminases, creatinine, urea, metalloproteinase (MMP) 2 and 9, and liver histopathological changes were evaluated. LEGCG exhibited better efficacy than EGCG, improving the oxidant/antioxidant balance (p = 0.0125 for NOx and 0.0032 for CAT), TNF-α (p < 0.0001), MMP-2 (p < 0.0001), aminotransferases (p = 0.0001 for AST and 0.0136 for ALT), creatinine (p < 0.0001), urea (p = 0.0006) and histopath...
Neuroplasticity is an essential phenomenon underlying on neurorehabilitation process, by which th... more Neuroplasticity is an essential phenomenon underlying on neurorehabilitation process, by which the brain can remodel the dysfunction consequent to a lesion. Ischemic brain lesions are the most frequent brain lesions often associated with visual function disability. Experimental and clinical studies established that visual function disability can impede the neurorehabilitation therapy efficiency. Neuro-optometric therapy has been proved to significantly improve the patient outcome after brain lesions. The pathophysiological mechanisms underlying this process are yet to be deciphered. Current knowledge regarding the pathophysiological mechanisms involved in ischemic lesions and neuroplasticity as a reparation process offers real support to a more efficient neurorehabilitation therapy that can contribute to the improvement of life quality in stroke patients.
Patients with cervical spinal cord injury have a high incidence of cardiac arrhythmias, especiall... more Patients with cervical spinal cord injury have a high incidence of cardiac arrhythmias, especially in the first 14 to 30 days after traumatic event (acute phase). Electrophysiological abnormalities described in the acute phase are most often bradycardia, which is spontaneous or triggered by various stimuli. In the chronic phase, varied arrhythmias are described, but ventricular arrhythmias as a result of autonomic dysregulation in chronic SCI are rare and isolated. We present the case of a patient with a C5-C6 incomplete spinal cord injury (ASIA-B grade) in which symptomatic ventricular arrhythmia is described one year after the traumatic event.
Romanian Journal of Neurology, 2015
Introduction. Migraine is an important cause of disability that affects the quality of life produ... more Introduction. Migraine is an important cause of disability that affects the quality of life producing a substantial social impairment. Objectives. The aim of this study was to evaluate the correlation between migraine severity and comorbidities in patients with episodic migraine. Methods. 2 groups of patients were included in the study: group 1 – control group (healthy subjects, n = 50), and group 2 – study group (patients with episodic migraine attacks, n = 65). Both groups were assessed for nonmodifiable risk factors (age), and modifiable risk factors: BMI (body mass index), lipids profiles (LDL-cholesterol, HDL-cholesterol, triglycerides), inflammatory parameters (C reactive protein and fibrinogen), and endothelial dysfunction (nitric oxide synthesis expressed as NOx). The migraine was diagnosed according to ICHD-2 (International Classification of Headache Disorders) and the severity was evaluated by MIDAS (Migraine Disability Assessment Scale). The study group was compared with ...
Romanian Journal of Neurology, 2017
The investigation of the mechanisms that leads to neuronal apoptosis is under investigation all o... more The investigation of the mechanisms that leads to neuronal apoptosis is under investigation all over the world. The enhancement of oxidative stress in brain neurons is one of the most important pathophysiological mechanism associated with neurodegeneration. The antioxidant effect of flavonoids can be one important mechanism for modulation of neuronal apoptosis in neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease. In addition to their influence on the cerebral blood flow, flavonoids interact with signalization cascades that lead to the inhibition of neuronal death by oxidative stress apoptosis and thus promote neuronal survival and synaptic plasticity. Acting on the intracellular antioxidant mechanisms the flavonoids can become a balance regulator for production of reactive oxygen species (ROS) and reactive nitrogen species (RNS). Addition of antioxidant effect of flavonoids to dietary components can constitute an adjuvant therapy for delaying the neurodegenerati...
Antioxidants, 2020
Background: Migraine is one of the most common disorders and its pathophysiological mechanisms ar... more Background: Migraine is one of the most common disorders and its pathophysiological mechanisms are still under research, oxidative stress being emphasized as an important contributor. This study aimed to analyze the retinal nerve fiber layer (RNFL) thickness and oxidative/anti-oxidant balance in migraine patients. Methods: Two groups of subjects were evaluated: a group of patients with migraine and a control group of healthy volunteers. RNFL thickness was assessed for all subjects by the ocular coherence tomography spectral domain (OCT-SD). The oxidative stress parameter, namely nitric oxide (NOx), malondialdehyde (MDA), and total oxidative stress (TOS) were assessed. The antioxidant capacity of plasma was evaluated by assessing the level of catalase, and total anti-oxidative (TOS) capacity. Migraine severity was graded using the Migraine Disability Assessment Score (MIDAS) questionnaire. Results: All the oxidative stress parameters (NOx, MDA, and TOS) were significantly increased, ...
Journal of Clinical Medicine, 2020
Background: Due to the higher frequency of ischemic stroke in men compared to women, we aimed to ... more Background: Due to the higher frequency of ischemic stroke in men compared to women, we aimed to determine if gender differences exist regarding periodontal status and several plasma biomarkers in patients with a recent large artery atherosclerosis ischemic stroke (IS). Material and methods: Patients with their first IS within less than six weeks who were able to undergo periodontal examinations were evaluated. Demographic data, periodontal status, oxidative stress parameters/plasma antioxidant capacity, and C-reactive protein in patients who suffered a recent large artery atherosclerosis ischemic stroke were reccorded. Results: 93 patients were included in the study. More men were smokers (12/57 vs. 3/36) and consumed alcohol (17/57 vs. 3/36), and more women had higher glycemic values (p = 0.023), total cholesterol (p < 0.001), LDL (low-density lipoprotein)-cholesterol (p = 0.010), and HDL (high-density lipoprotein)-cholesterol (p = 0.005) levels. Significantly more men than wom...
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Papers by Angelo Bulboaca