Discipline - Internal Medicine and Rheumatology - Dr. I. Cantacuzino Clinical Hospital

Professor Bojinca Mihai, PhD tenured
Associate Professor Ancuta Ioan, PhD tenured
Lecturer Gheorghiu Ana-Maria, PhD tenured
Lecturer Milicescu Mihaela Florica, PhD tenured
Lecturer Stoian Marinela-Ionela, PhD tenured
Assistant Professor Martin Andrei Eugen, PhD tenured
Assistant Professor Ciofu Claudia Silvia, PhD tenured
Assistant Professor Grancea-Iancu Monica-Eugenia, PhD tenured
Assistant Professor Gavrila Bogdan-Ion, PhD tenured
Assistant Professor Bobirca Anca-Vasilica, PhD tenured
Assistant Professor Badea Ionut-Andrei, PhD fixed term
Assistant Professor Vrancianu Cristina Andreea, PhD fixed term
Assistant Professor Cretu Ioana, PhD tenured

The clinic of Internal Medicine and Rheumatology Cantacuzino has roots in the Romanian internal medicine of higher education. Professor Radul Paun, a member of the Romanian Academy and the author of  the Internal Medicine paper treaty(Medical Editure, 1983-1999), internist who knew in depth all areas of discipline, led this clinic between 1960-1978.

He was followed by Prof. Dr. Stefan Suteanu, member of the Academy of Medical Sciences, president of the Romanian Society of Rheumatology between 1990 and 1999 and the founder of the school of Rheumatology in the clinic.

During the period 1980-2001, professor Suteanu has shaped many specialists, held universitary and post-graduate courses of geografic rheumatology and carried a vast research. He brought the contributions to the early diagnosis of ankylosing spondylitis and to the reactive arthritis, has communicated or published, the first or among the first in our country, some nosological entities in the field of rheumatology: rheumatic polymyalgia sickness, mixed dissease the conjunctive tissue (Sharp syndrome), Eosinophilic fasciitis.He launched in 1993 the Romanian Magazine of Rheumatology (currently Romanian Journal Of Rheumatology, classified by CNCSIS B+), whose editor-in-chief he was up to 2003.

He built a performant and ambitious team. He was followed in 2001 by Prof. Dr. Victor Stoica, internist and gastroenterologist, the dean of the Faculty of Medicine between 2004-2012 and the currently the head of the clinic.

At present, the clinic is made of two sections of internal medicine, and also Rheumatology, gastroenterology and cardiology departments (total of over 100 beds in 37 wards). To this the digestive endoscopy is added, the service of day hospitalization (6 beds) and ambulatory integrated in the cabinet of internal medicine and rheumatology.

In the clinic, with the support of the UMF Carol Davila, there are two important research centers: Center for the Study of the early arthritis, established in 2005 and recognized by CNCSIS, and the EUSTAR 100 center which is part of the international network study of EUSTAR systemic sclerodermitis (EULAR Scleroderma Trials and research - for more information see www.eustar.org).

A direction of new research is musculoskeletal ultrasonography, between the members available, two have been confirmed as trained trainees by the EULAR (European League Against Rheumatism, see www.eular.org)

The Clinic receives 4th year students for gastroenterology courses and Vth year students for the Rheumatology Courses - both in Romanian and in English language. Both types  are part of the clinical preparation for internal medicine.

Rheumatology, gastroenterology and development of clinical knowledge

Curricula of Rheumatology includes 20 lectures of progress on the themes of :

  • Inflammation and immune response
  • Anti-inflammatory and immunosuppressive medication
  • Rheumatoid arthritis
  • Spondyloarthritis: spondylitis ankylosis, Psoriatic arthritis, reactive arthritis
  • Autoimmune systemic diseases: lupus erythematosus, systemic sclerosis, dermato/polimyositis sickness, mixed connective tissue disease, Sjogren's syndrome, antiphospholipid syndrome
  • Systemic Vasculitis: giant cell arthritis, Takayasu disease, Kawasaki disease,  nodule polyarteritis, polyangiitis with granulomatosis (Wegener), polyangitis with granulomatosis and eosinophilia (Churg-Strauss), microscopic polyangeitis,  vasculitis of small vessels with immune complexes circulating
  • Microcrystalline arthritis : chondrocalcinosis gout , illness with crystals of hydroxyapatite
  • Septic arthritis
  • Paget disease of the bone
  • Osteoporosis
  • Arthritic disease
  • Lombosciatica
  • Abarticular Rheumatism (inflammatory and degenerative extraarticular pathology, including tendinitis, bursitides, enthesitis syndrome, carpal bones tunnel syndrome, Dupuytren disease etc)
  • Differential diagnosis of the topography of rheumatic diseases

In addition to the participation to courses, students carry out practical work on the department which complements their theoretical training and helps them to integrate knowledge acquired in all courses of internal medicine already taken (cardiology, pneumology, gastroenterology, nephrology).

The clinic has a bank of radiological and medical ultrasound images, which introduce students in each course. Students have the opportunity to examine their own patients and to discuss the cases with the assistant at the university.

Emphasis is put on the development of the clinical thinking: the road from symptoms to syndrome and then to diagnosis, over-assessment and the choice of the treatment in question in the light of the objectives and risks. The students are encouraged to work on their own account with patients, to ask questions and to discuss with the group and assistant options for investigation and treatment.

The clinic has an academic environment but also a friendly one: patients are used to interact with the students and they can participate in the activities of the current daily visit, the visit of the professor, scans of musculoskeletal  ultrasonography images, capillaroscopy or examination under the microscope of the synovial fluid  etc.). Students interested in the rheumatology are welcomed to carry out Phd papers with the help of the clinical research centers  (EUSTAR 100 and the center of the Early Arthritis); a part of the residents are former students who have collaborated to such activities since their  IV-Vth  university year.

Curriculum of gastroenterology includes lectures of progress on the themes of the:

  • Gastroesophageal Reflux Disease
  • Peptic ulcer
  • Gastric cancer
  • The sufferings of the stomach which went under surgery
  • Inflammatory diseases of the intestine
  • Functional dyspepsia
  • The syndrome of irritable intestines
  • Colon cancer
  • Malabsorption syndromes
  • Acute and chronic pancreatitis
  • Jaundice
  • Chronic hepatitis
  • Cirrhosis and its complications

 

Our clinic welcomes residents in medical specialties such as rheumatology (4 years) and internal medicine (5 years residency) - as a mother clinic which shall coordinate their whole training in specialty, and residents in other specialties, such as general medicine, dermatology, recovery, neurology and the various specialties branched from the internal medicine,  that are part of short courses of Rheumatology or internal medicine (between 1 to 9 months).

Residents of the clinic are seen as valued members of our team , and they are treated as reliable and responsible colleagues. They are the ones who admit patients on departments and examine them, debating after with the medical specialist  the plan of investigation and treatment. They also actively participate emergency hospital stay.

The clinical activity of the residents, although includes the inevitable work with medical documents (the drawing up of the observation of the epicrisis, prescriptions etc.), is not limited to it. Having the interaction with the patient helps the resident to make rapid progress towards the level of specialist, becoming able to think quickly and to take prompt well reasoned decisions.

The orientation of our clinic towards a complex preparation is worth mentioning, exceeding the strict curricula , encouraging scientific activity of the residents by the participation in the clinical studies and research projects in the clinic, encouraging active participation at congresses and national and international conferences.

Schedule for preparation in the specialty of Rheumatology, respectively of internal medicine, are available on the site of the Ministry of Health to:

The clinic organizes courses of musculoskeletal ultrasonography, with the support of the Romanian Society of Rheumatology. After the organized courses together with the Clinic of Internal Medicine and Rheumatology from the Saint(Sf) Maria Clinical Hospital (with whose team of rheumatologists our team has always had an excellent professional relationship ), in 2016 our clinic has organized the first course with international attendance.

Associate professor Mihai Bojinca and Dr Teodora Serban, accredited as trainers of musculoskeletal ultrasound by European League Against Rheumatism (EULAR) have taught together with the international experts as Prof Walter Grassi Grassi and Prof Emilio Filipucci. A similar version of this events, now and with the support of the EULAR, will take place in 2017.

Because of the many directions of research and of supportive attitude from the teaching staff ensemble, in our clinic ,a  large number of PhD students pursue their studies under the guidance of prof. Victor Stoica. The subjects of the research include rheumatoid arthritis, systemic sclerosis, harming the gland in rheumatologic diseases and musculoskeletal ultrasonography and the contribution of the PhD students is essential for the presence of the clinic with original works at national and international congresses. It is emphasized that the doctoral students are actively supported for the participation in courses and congresses, including sponsorships or funding from the grants of research of the clinic.

During the last 5 years the record of postgraduates Phd doctors includes 4 scholarships for the participation at the congress of the European Parliament EULAR offered by the Romanian Society of Rheumatology, 4 study scholarships EULAR (7000 EUR / 6 months in a center of excellence in Europe) and 2 Articulum research scholarships (  30.000 EUR / 9-12 months in a center of excellence in Europe), 5 national awards and 2 international awards. Finally, the electronic database of the Clinical Hospital Dr Ion Cantacuzino, initiated in 2002, as well as the presence in clinic of the two research centers (EUSTAR 100 /systemic sclerosis and the center of the Early Arthritis) offers excellent conditions for research in the framework of PhD.

  • early arthritis
  • rheumatoid polyarthritis
  • spondyloarthritis, musculoskeletal ultrasonography
  • systemic sclerodermitis
  • diseases of connective tissue
  • 2014 present Parteneriate 2013 PN-II-PT-PCCA 2013-4-1589 “Dezvoltarea unei metode videocapilaroscopice cantitative pentru evaluarea longitudinală a pacienților cu sclerodermie sistemică” – budget 1150000 RON (contract 188/2014) - project director Carina Mihai
  • 2016 present: international clincal multicentric project with the help of  EUSTAR „Risk factors and predictors of gangrene in patients with systemic sclerosis” – proiectul EUSTAR CP66  - co-director de proiect Carina Mihai, alături de prof. Yannick Allanore, Univ. Paris-Descartes,
  • 2011 -2014: international clincal multicentric project with the help of  EUSTAR „Prognostic value of digital ulcers in systemic sclerosis” – project EUSTAR CP35 - project director Carina Mihai
  • 2007-2009 Asocieri genetice secundare in spondilartritele seronegative - Program Idei 311/2007 – project director Mihai Bojincă
  • 2006-2009 Proiect CEEX Cercetare dezvoltare : Cuantificarea efectului simvastatinei asupra inflamației sistemice, a modificărilor cardiace subclinice și a aterosclerozei precoce în artrita reumatoidă -project director Gabriela Udrea
  1. Mihai C, Landewé R, van der Heijde D, Walker UA, Constantin PI, Gherghe AM, Ionescu R, Rednic S, Allanore Y, Avouac J, Czirják L, Hachulla E, Riemekasten G, Cozzi F, Airò P, Cutolo M, Mueller-Ladner U, Matucci-Cerinic M; EUSTAR co-authors Digital ulcers predict a worse disease course in patients with systemic sclerosis. Ann Rheum Dis. 2016 Apr;75(4):681-6. Impact Factor38
  2. Leggett S, van der Zee-Neuen A, Boonen A, Beaton D, Bojinca M, Bosworth A, Dadoun S, Fautrel B, Hagel S, Hofstetter C, Lacaille D, Linton D, Mihai C, Petersson IF, Rogers P, Sciré C, Verstappen SM; at-work productivity global measure working group. Content validity of global measures for at-work productivity in patients with rheumatic diseases: an international qualitative study. Rheumatology (Oxford). 2016;55(8):1364-73. Impact Factor424.
  3. Gorga M, Mihai C, Soare AM, Dobrotă R, Gherghe AM, Stoica VA Romanian version of the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument. Clin Exp Rheumatol. 2015 Jul-Aug;33(4 Suppl 91):S61-7. Impact factor724
  4. Vlad V, Berghea F, Micu M, Varzaru L, Bojinca M,Milicescu M, Ionescu R, Naredo E. Tenosynovitis US scoring systems follow synovitis and clinical scoring systems in RA and are responsive to change after biologic therapy. Med Ultrason. 2015 Sep;17(3):352-60. Impact Factor (2015) 1.167
  5. Mattsson M, Boström C,Mihai C, Stöcker J, Geyh S, Stummvoll G, Gard G, Möller B, Hesselstrand R, Sandqvist G, Draghicescu O, Gherghe AM, Voicu M, Distler O, Smolen JS, Stamm T. Personal factors in systemic sclerosis and their coverage by patient-reported outcome measures: A multicentre European qualitative study and literature review. Eur J Phys Rehabil Med. 2015 51(4):405-21.  Impact Factor06.
  6. Oancea C, Mihai C, Gherman D, Milicescu M, Ancuta I, Martin A, Bojinca M, Stoica V, Ciuvica MM. Development of a prognostic score for work disability in Romanian patients with ankylosing spondylitis. Disabil Rehabil. 2014 Jun 26:1-6. [Epub ahead of print]. PMID: 24965210. ISSN. 0963-8288; Impact Factor: 1.541
  7. Dobrota RMihai C, Distler O. Personalized medicine in systemic sclerosis: facts and promises. Curr Rheumatol Rep. 2014 Jun;16(6):425. Impact factor191
  8. Ferenci P, Aires R,Ancuta I, Arohnson A, Cheinquer H, Delic D, Gschwantler M, Larrey D, Tallarico L, Schmitz M, Tatsch F, Ouzan D. A tool for selecting patients with a high probability of sustained virological response to peginterferon alfa-2a (40kD)/ribavirin. Liver Int. 2014 Nov;34(10):1550-9. Impact Factor 47
  9. Aronsohn A,Ancuta I, Caruntu F, Coppola C, Delic D, Digiacomo A, Dusheiko GM, Lengyel G, Marcellin P, Orlandini A, Pruthi J, Silva GF, Tallarico L, Schmitz M, Tatsch F, Korner E, Cheinquer H. Impact of age on viral kinetics of peginterferon alfa-2a/ribavirin in chronic hepatitis C: final analysis from the PROPHESYS cohort. J Viral Hepat. 2014 May;21(5):377-80. Impact Factor 179
  10. Rusu E, Jinga M, Enache G, Rusu F, Dragomir AD, Ancuta I, Draguţ R, Parpala C, Nan R, Sima I, Ateia S,Stoica V, Cheţa DM, Radulian G. Effects of lifestyle changes including specific dietary intervention and physical activity in the management of patients with chronic hepatitis C–a randomized trial. Nutr J. 2013 Aug 14;12:119. Impact Factor 265
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