PubMed Health⌕ Search

Biomedical subjects

C Ionescu-Tirgoviste

Publications and source records attributed to C Ionescu-Tirgoviste.

At least 19 recordsLinked to original sources
PubMed2004

Glucose evaluation trial for remission (GETREM) in type 1 diabetes: a European multicentre study.

OBJECTIVE: Strict metabolic control during the 1st year of type 1 diabetes is thought to be a key factor for achieving clinical remission. The aims of this study were two-fold: (i) to evaluate the frequency and duration of spontaneous remission (defined according to the parameters issued by the International Diabetic Immunotherapy Group (IDIG)) in a European population of consecutive recent onset type 1 diabetes patients (aged 5-35 years), followed-up for a period of 36 months with a common protocol of intensive insulin therapy and without adjunct immune-intervention; and (ii) to identify the predictive factors for clinical remission. RESEARCH DESIGN AND METHOD: A total of 189 consecutive patients with newly diagnosed type 1 diabetes according to ADA criteria were recruited in participating centres (Belgium, Czech Republic, Estonia, France, Germany, Hungary, Italy, Poland, Romania, Sweden and Turkey) and followed-up for a period of up to 36 months. In all patients, intensive insulin therapy was implemented consisting of three or four injections of regular insulin daily with NPH insulin at bedtime. Adjustment of insulin dose was made according to a common protocol. Various clinical characteristics (age, gender, severity of presentation, etc.), history (presence of diabetic siblings in the family, etc.) and integrated parameters of metabolic control (HbA(1c), blood glucose, the total insulin dose at hospital discharge adjusted for body weight) were collected. RESULTS: Twenty-two patients (11.6%) experienced remission. The median duration of remission was 9.6 months and the range was 31 months. There was a wide variation among centres. Logistic regression analysis focused on the centre as the main variable in achieving remission. CONCLUSION: Remission was shown to be very heterogeneous between centres depending on 'other factors' such as patient care and family awareness of the disease rather than on 'measurable factors' such as sex, age, HbA(1c) and severity of presentation at diagnosis. Using intensive insulin therapy and optimisation of metabolic control, remission occurred in nearly one out of eight patients.

Adolescent↗
PubMed2004

The epidemiology of Type 1 diabetes mellitus is not the same in young adults as in children.

AIMS/HYPOTHESIS: This prospective study examined the epidemiology of Type 1 diabetes in young adults in Europe. METHODS: We ascertained incident cases of Type 1 diabetes in the 15 to 29 years (both inclusive) age group throughout Europe over a period of 2 years. Diabetes registries in nine countries, in which incidence rates for Type 1 diabetes in the 0 to 14 age group were available, took part. Incidence rates were estimated per 100000 person years and standardised for sex and age. Cumulative incidences per 1000 from birth to age 30 were estimated. Heterogeneity between centres was tested with a Poisson regression model. RESULTS: A total of 2112 diabetes cases were ascertained in 1996 and 1997, of which 61.4% were considered to be Type 1 diabetes. Completeness of ascertainment varied from 70 to 90%. Standardised incidence varied from 4.8 per 100000 person years to 13.4 per 100000 person years. The male-female ratio was estimated to be one or more, and in the 25 to 29 age group 1.5 or more in all countries. Cumulative incidences for males and females indicate that the former exceeds the latter from age 24. In the two centres with highest childhood incidence, this applied already from 14 years of age. CONCLUSIONS/INTERPRETATION: The incidence of Type 1 diabetes in adults is lower than in children and the range of incidence is also reduced, with a less than threefold variation in adults, against an eightfold variation in children. There is a male excess in incidence, especially in the age group 25 to 29 years.

Adolescent↗
PubMed2003

Testing the possible negative association of type 1 diabetes and atopic disease by analysis of the interleukin 4 receptor gene.

Variations in the interleukin 4 receptor A (IL4RA) gene have been reported to be associated with atopy, asthma, and allergy, which may occur less frequently in subjects with type 1 diabetes (T1D). Since atopy shows a humoral immune reactivity pattern, and T1D results from a cellular (T lymphocyte) response, we hypothesised that alleles predisposing to atopy could be protective for T1D and transmitted less often than the expected 50% from heterozygous parents to offspring with T1D. We genotyped seven exonic single nucleotide polymorphisms (SNPs) and the -3223 C>T SNP in the putative promoter region of IL4RA in up to 3475 T1D families, including 1244 Finnish T1D families. Only the -3223 C>T SNP showed evidence of negative association (P=0.014). There was some evidence for an interaction between -3233 C>T and the T1D locus IDDM2 in the insulin gene region (P=0.001 in the combined and P=0.02 in the Finnish data set). We, therefore, cannot rule out a genetic effect of IL4RA in T1D, but it is not a major one.

Alleles↗
PubMed2003

Effect of indapamide SR on microalbuminuria--the NESTOR study (Natrilix SR versus Enalapril Study in Type 2 diabetic hypertensives with micrOalbuminuRia)--rationale and protocol for the main trial.

In type 2 diabetic hypertensive patients, microalbuminuria can be due to hypertension and/or diabetic nephropathy. Angiotensin-converting enzyme (ACE) inhibitors act preferentially on microalbuminuria due to diabetic nephropathy. The objective is to demonstrate the efficacy of a thiazide-like diuretic, indapamide sustained release (SR), at reducing microalbuminuria in hypertensive type 2 diabetic patients in comparison with an ACE inhibitor, enalapril. The study is an international multicentre, 12-month, randomized, double-blind, controlled, two parallel group study of type 2 diabetic patients with hypertension (140 mmHg < or = systolic blood pressure <180 mmHg and diastolic blood pressure <110 mmHg) and microalbuminuria. Intervention is after a 4-week placebo period, patients with microalbuminuria > or = 20 and < or = 200 microg/min are randomized to indapamide SR 1.5 mg or to enalapril 10 mg once a day for a one-year treatment period. An additional label treatment by amlodipine 5-10 mg (1st step) and atenolol 50-100 mg (2nd step) a day is permitted after 6 weeks of treatment based upon blood pressure response. The main outcome measures are microalbuminuria expressed as urinary albumin to creatinine ratio, albumin fractional clearance, and albumin excretion rate evaluated on overnight urine collections. Secondary criteria are supine and standing systolic, diastolic and mean blood pressure; and biological and clinical safety. This study will complete the knowledge of the efficacy of indapamide SR in hypertension and target organ damage and will provide valuable information on the management of type 2 diabetic hypertensives with microalbuminuria.

Adult↗
PubMed2002

A networked electronic patient record system for diabetes.

This paper describes the development and clinical implementation of the SincroDiab--a synchronized diabetes register for the routine clinical practice in a LAN and for design of long-term trials and epidemiological studies based on the GEHR (Good European Health Record) architecture. The objectives of the SincroDiab system were to address the need to establish a more efficient and more effective information infrastructure to improve the ability to share patient record information among health care providers, to reduce the health care delivery costs, to meet the requirements of legal, regulatory or accreditation standards, to share comparable patients data among different sites within a multi-entity health care delivery system and to improve quality of care by network connecting the data repository to clinical workstations and departmental systems.

Diabetes Mellitus↗
PubMed2001

CompAc information system for traditional Chinese medicine.

The paper presents a system developed for the assistance of diagnosis and treatment in alternative medicine, based on traditional Chinese methods. The system named CompAc, is a result of an interdisciplinary cooperation and is designed for the physician, specialist in acupuncture. The Compac system allows the determination of the type of energetic imbalance starting from the clinical picture of the patient and establishing whether an organ or any of the viscera are affected. It allows also the indication of different variants of treatment. The diagnosis proposed by the system has to be confirmed by the physician and can be modified by him. The system is also useful for medical training.

Diagnosis, Computer-Assisted↗
PubMed1997

Informatic support for processing the data regarding the environment factors possibly involved in the etiopathogenesis of insulin-dependent diabetes mellitus ETIODIAB.

Diabetes represents a heterogeneous group of disturbances, which can have a different aetiology, but have in common glucidic, lipidic and proteinic metabolic disturbances. Insulin-dependent diabetes appears in genetically susceptible persons, as an autoimmune disease activated by environment factors. Epidemiological studies performed in different countries, notice the increasing of diabetes cases in the last decades. Therefore the informatic system EtioDiab (from Etiopathological diabetes) has been developed. The purpose of this system is to assist the medical research regarding the environment factors involved in the etiopathogenesis of insulin-dependent diabetes. The system offers the possibility of calculation of many statistic indicators, of graphic representation of the recorded data, of verification of the statistical hypotheses.

Database Management Systems↗
PubMed1997

Five steps from a simple data base to an expert system in nutrition.

The paper describes the experience from the Medical Informatics Department--ITC in the field of the human nutrition. The informatic systems were developed staring from a minimal data base and simple programs. The final versions are expert systems running within complex medical informatic products.

Decision Making, Computer-Assisted↗
PubMed1996

Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study.

The EURODIAB IDDM Complications Study involved the examination of 3250 randomly selected insulin-dependent diabetic patients, from 31 centres in 16 European countries. Part of the examination included an assessment of neurological function including neuropathic symptoms and physical signs, vibration perception threshold, tests of autonomic function and the prevalence of impotence. The prevalence of diabetic neuropathy across Europe was 28% with no significant geographical differences. Significant correlations were observed between the presence of diabetic peripheral neuropathy with age (p < 0.05), duration of diabetes (p < 0.001), quality of metabolic control (p < 0.001), height (p < 0.01), the presence of background or proliferative diabetic retinopathy (p < 0.01), cigarette smoking (p < 0.001), high-density lipoprotein cholesterol (p < 0.001) and the presence of cardiovascular disease (p < 0.05), thus confirming previous associations. New associations have been identified from this study - namely with elevated diastolic blood pressure (p < 0.05), the presence of severe ketoacidosis (p < 0.001), an increase in the levels of fasting triglyceride (p < 0.001), and the presence of microalbuminuria (p < 0.01). All the data were adjusted for age, duration of diabetes and HbA1c. Although alcohol intake correlated with absence of leg reflexes and autonomic dysfunction, there was no overall association of alcohol consumption and neuropathy. The reported problems of impotence were extremely variable between centres, suggesting many cultural and attitudinal differences in the collection of such information in different European countries. In conclusion, this study has identified previously known and new potential risk factors for the development of diabetic peripheral neuropathy.

Adolescent↗
PubMed1996

Insulin, the molecule of the century.

The most celebrated medical discovery of this century is comprised of two distinct stages: (1) that of fundamental research, i.e. the experimental demonstration of the presence in the pancreas of an antidiabetic hormone done by Paulescu and published on 31 August 1921 in the Archives Internationales de Physiologie; and (2) the clinical application of the discovery of insulin in the treatment of diabetes in man, the stage completed in 1922 by the Canadian group comprised of Collip, Macleod, Banting and Best.

Animals↗
PubMed1990

Peripheral sympathetic neuropathy evaluated by recording the evoked electrodermal response using an impedance reactometer.

Autonomic nervous dysfunction was indirectly evaluated on the basis of the skin electrical resistance relative variation (SERV), recorded by our recently developed system, with two pairs of surface electrodes placed on the palm and on the sole of the foot, after the application to the subject of a sensory stimulus (sound 60 dB, 860 Hz, 0.5 s duration) or in the course of a Valsalva manoeuvre. The results were digitally measured and recorded on thermosensitive millimetric paper analysing the following parameters: latency (LT), i.e. the time interval(s) between application of the stimulus and onset of SERV, both at palm (LTh) and foot (LTf); amplitude of the response (mm) recorded and evaluated in the form of SERV; velocity of the response as rate of time change (Vr) and autonomic conduction velocity, -ACV (m/s), calculated by the height/LT ratio. The present study refers to a group of 60 diabetic patients: 32 F/28 M; mean age +/- SD 46.8 +/- 11.8 years; 29 insulin-dependent, 21 non-insulin-dependent; duration of diabetes 8.6 +/- 4.6 years. The data were compared to those recorded in a group of 50 nondiabetics (22 F/28 M; mean age 47.5 +/- 14.1 years) who were apparently healthy. A significant statistical difference (P less than 0.001) was found between diabetic patients and controls for all studied parameters: LTh (s) 2.65 +/- 1.2 vs. 1.91 +/- 0.6; LTf(s) 3.6 +/- 1.4 vs. 2.6 +/- 0.7; SERV (mm) 7.5 +/- 4.8 vs. 18.5 +/- 6.6; Vr (mm) 4.4 +/- 2.1 vs. 13.5 +/- 5.3; ACT (m/s) 0.41 +/- 0.23 vs. 0.97 +/- 0.18.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Quantitative noninvasive electrophysiological evaluation of the activity of the cutaneous division of the sympathetic nervous system.

The functional status of the cutaneous division of the orthosympathetic nervous system was indirectly and non-invasively assessed by monitoring the skin electrical relative resistance variations (SERV). The advantages of our recording system of second generation were (1) simultaneous recording on two or four channels of the evoked electrodermal response to psychic or to sensorial stimulus; (2) self-balancing system which allows the recording of the relative variation of the electric parameter, i.e. its variation with time; (3) precise determination of the amplitude (omega/s, mu F/s) of the evoked response; (4) reference of the latency time (LT) of the evoked response to the length of the anatomical pathway of the signal giving the autonomic conduction velocity (ACV). Decrease in diabetic autonomic neuropathy of both spontaneous and evoked electrodermal activities suggested their relationship with cutaneous sympathetic activity.

Acoustic Stimulation↗