Biomedical subjects

C Băicuş

Publications and source records attributed to C Băicuş.

7 recordsLinked to original sources

PubMed2003

Trend in randomized controlled trials.

Virtually any study may achieve statistical significance if we increase the sample size indefinitely. We cannot discuss about trend without interpreting confidence intervals (CI). The sample size being computed function of the magnitude of the clinical effect is considered worth detecting, when the result is not statistically significant, it is neither clinically significant. Increasing the sample, the "trend" can disappear or even change its direction.

Confidence Intervals↗

PubMed2002

Chronic viral hepatitis, the treatment with spiruline for one month has no effect on the aminotransferases.

CONTEXT: Spirulina platensis is extracted from an alga and theoretically has many good effects on the majority of the organs. There is not any published clinical trial on humans. OBJECTIVE: The evaluation of the efficacy of spiruline in chronic viral liver disease. DESIGN: Double blind, randomised clinical trial. SETTING: Secondary care university hospital. PATIENTS: 24 patients with chronic viral liver disease, treated with spiruline or placebo for one month. OUTCOME MEASUREMENT: Aminotransferases diminution and the modification of a general state score self-evaluated by the patient on an analogic visual scale. RESULTS: A modification of the aminotransferases level in the detriment of the spiruline treated group has been found (p = 0.036 for ALAT, p = 0.017 for ASAT), and not at the level of the general state score (p = 0.30). CONCLUSION: Despite the little number of patients, significant results not favouring spiruline have been found.

Antiviral Agents↗

PubMedDate not supplied

[Fever of unknown origin in Romania. II. Diagnostic Procedures. Prospective multicenter study of 164 patients].

BACKGROUND: The Diagnostic workup of patients with fever of unknown origin is a challenge, due to the great number of possible etiologies. After we studied the etiologic spectrum of fever of unknown origin in Romania, we tried to evaluate the diagnostic procedures used and their efficiency. METHODS: A multicenter cohort study of two years, with another two years of follow-up was carried out on 164 consecutive patients who met the classic, modified criteria of fever of unknown origin. We used a standardised diagnostic protocol. MAIN OUTCOME MEASURED: The role of every diagnostic procedure in establishing the final diagnosis. RESULTS: The diagnosis was made by microbiology and serology in 41 cases (25%), by histopathology in 22 cases (18%), with the help of imaging techniques in 30 cases (1.3%), based on the clinical evolution and response to treatment in 54 cases (33%) and by other methods in 12 cases (7.3%). The abdomino-pelvic ultrasonography had a sensitivity of 60%, a specificity of 70%, a positive likelihood ratio of 2.02 and a negative likelihood ratio of 0.57, while the scanner had a sensitivity of 81%, a specificity of 64%, a positive likelihood ratio of 2.23 and a negative likelihood ratio of 0.29. CONCLUSIONS: Of all the diagnostic procedures used, none had a good sensitivity/specificity. The clinical evolution and the treatment response had an important role in the diagnostic workup.

Algorithms↗

PubMedDate not supplied

[Fever of unknown origin: 1. Etiology. A prospective multicenter study of 164 patients].

BACKGROUND: The spectrum of fever of unknown origin seems to be determined by geographic and economic factors, and it appears to change in time. Excepting a small retrospective study, no other study on fever of unknown origin has been performed in Central or Eastern Europe. METHODS: A multicenter cohort study was carried out on 164 consecutive patients who met the classic, modified criteria of fever of unknown origin. The study lasted 2 years (1997-1998) and included a follow-up period of another 2 years. MAIN OUTCOME MEASURED: The final diagnosis at the end of follow-up. RESULTS: 74 (45%) patients had infections (tuberculosis: 27 patients, 16%), 41 patients (25%) had neoplasms, 30 (18%) had non-infectious inflammatory diseases, three (2%) drug fever, and four (2%) other causes. The etiology remained obscure for 12 patients (7%). CONCLUSIONS: Infections represent the most important etiology, among them predominating tuberculosis.

Adolescent↗

PubMedDate not supplied

Has this patient a cancer? The assessment of weight loss, anemia and erythrocyte sedimentation rate as diagnostic tests in cancer. A retrospective study based in a secondary care university hospital in Romania.

INTRODUCTION: "Has this patient a cancer?" is a question we frequently ask ourselves in front of some symptoms, signs or laboratory results like weight loss, anemia and high erythrocyte sedimentation rate (ESR). The aim of this study is to assess their value in the diagnosis of cancer. METHODS: A retrospective study of the records of 5500 patients admitted in the Department of Internal Medicine during the 1998 January-September period has been performed, selecting those patients with weight loss, anemia (Hb < 10.5g/dl) and ESR > = 50 mm/h. RESULTS: The three diagnostic tests (anemia, high ESR and weight loss) had a low sensitivity (37, 52 and 46%, respectively), but a good specificity (92, 89 and 94%, respectively). For a 4% prevalence of cancer, as seen in our group, the resulting negative predictive value for the three tests was estimated respectively at 97, 98 and 98%, the post-test probabilities being estimated at 3, 2.2% in the case of negative tests. For a parallel utilisation of the tests, the sensitivity was 87%, the specificity 79%, the positive predictive value 15% and the negative predictive value 99%, the post-test probability in the case of a negative test being 1% [LR(-) = 0.17]; for serial utilisation, the specificity grew at 99.6% (CI: 99-100%), the positive predictive value (as the post-test probability in the case of a positive test) being 51% (CI: 50-53%) [LR(+) = 24.62]. INTERPRETATION: Any patient admitted in our department of Internal medicine has a 4% probability of having a cancer. Among those with weight loss, anemia and high ESR, one patient out of two has a cancer; among those with weight loss and anemia, 44% have a cancer; and among those with weight loss and high ESR, one out of three has a cancer.

Anemia↗

PubMedDate not supplied

[Drug politics--economic view-point of a practitioner].

Any expenditure made in a domain leads to the diminution of the expenditures in another domain. The list of reimbursed drugs should be decided after a cost effectiveness analysis. The treatments considered too expensive in the developed countries are even more expensive for a country like Romania. The practice guidelines do not consider the economic analysis of the treatments. As soon as the results of a study are statistically significant, the specialty societies include that drug into their guidelines. A treatment is more cost effective when the risk is higher, therefore the reimbursement should have to be done function of risk, too.

Cost-Benefit Analysis↗

PubMedDate not supplied

Acute abdomen in systemic vasculitides.

A presentation is made of abdominal vasculitis in the course of systemic lupus erythematosus (SLE) and polyarteritis nodosa (PAN). The disease is not yet completely known and therefore it is often incorrectly diagnosed as acute abdomen requiring surgery. An accurate diagnosis of this disease is essential for the choice of the correct therapeutic attitude. Some theoretical aspects of the disease are discussed and the personal experience of the authors resulting from the study of some cases hospitalized in the Institute of Internal Medicine, are discussed.

Abdomen, Acute↗