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C Tănăsescu

Publications and source records attributed to C Tănăsescu.

At least 19 recordsLinked to original sources
PubMed2003

Chronic hepatitis C virus infection mimicking rheumatoid arthritis.

We present the case of a young female patient diagnosed two years ago with rheumatoid arthritis (AR) for which she is taking methotrexate (MTX), who develops cutaneous lesions highly suggestive of porphyria cutanea tarda, diagnosis confirmed by biochemical means. It is noteworthy that she was regularly taking oral contraceptives until the moment of appearance of the skin lesions. The association of those two illnesses, particularly in the case of MTX treatment can raise some problems regarding the potential direct causality relationship. This is why we tried a new diagnostic hypothesis: is chronic hepatitis C virus infection, hypothesis that we verified by means of the presence of anti-VHC and of RNA-VHC. It is well known now the association between chronic viral C infection, rheumatoid syndrome and porphyria cutanea tarda (PCT). The latter are extrahepatic manifestations of that viral infection, thus representing a major indication for antiviral treatment. Our patient received that treatment and she had a very good outcome of the skin lesions. We suggest that the differential diagnosis of any arthritis should always comprise chronic hepatitis C viral infection.

Adult↗
PubMed2003

Kikuchi's disease associated with systemic lupus erythematosus and autoimmune-like hepatitis.

The authors present a case of Kikuchi's disease associated with systemic lupus erythematosus (SLE) and autoimmune-like hepatitis. Kikuchi's disease, or histiocytic necrotizing lymphadenitis is occasionally associated with SLE and mildly elevated aminotransferases. A 17-year old woman presented with fever, arthritis and bilateral cervical adenopathy. Histopathological and immunohistochemical examinations of an excised lymph node showed evidence of Kikuchi disease. An elevation of hepatocytic enzymes (aminotransferases and gamma-glutamyl transpeptidase) associated with smooth muscle antibodies in a titer of 1/320 was present. Clinical symptoms and laboratory tests improved after "pulse" corticotherapy. The association described has not been described in the literature, but is considered possible due to the immune pathogenicity of the 3 simultaneous diseases. Kikuchi-Fujimoto's disease, or histiocytic necrotizing lymphadenitis (HNL), is a rare condition first described in 1972 independently by Kikuchi and Fujimoto. HNL is rarely associated with systemic lupus erythematosus (SLE). It is a benign illness characterized by fever and cervical adenopathy and has a self-limiting course.

Adolescent↗
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↗
PubMed1975

Coronary heart disease and risk factors in some special type collectivities.

Transversal epidemiologic investigations carried out in different populations from several regions of Romania : Gurghiu Valley (lumberjacks from a mountain region), Danube Delta and Razelm lagoon complex (fishermen), and Bucharest have shown that, in spite of the high caloric value of food and even of a high intake of saturated fats, mean serum cholesterol is lower in the rural areas than in Bucharest, probably owing to the strenuous physical work. However, except myocardial infarction, more frequent in the urban than in the rural regions, the other forms of coronary heart disease have a relatively higher frequency in villages, particularly atrial fibrillation and ECG signs of ischemia. These findings might be explained by a greater prevalence of hypertension in these populations. It is concluded that the risk factors, which act synergically, depend on the complex structure of the "ecologic niche".

Adult↗
PubMedDate not supplied

Comparison between reverse transcription-polymerase chain reaction and immune enzyme assays in the diagnosis of hepatitis C virus infection.

This is the first study of HCV infection performed in Romania by reverse transcription-polymerase chain reaction (RT-PCR). We set up our own protocol, using "nested" primers located in the 5' UTR of HCV. Thirty two patients, 16 with chronic hepatitis, 7 with hepatic cirrhosis and 9 without chronic hepatic disease were investigated. The assignment of each patient to one of the groups was based on clinical and laboratory criteria, especially transaminase levels and hepatic biopsy findings. In 14 out of 16 (87.5%) chronic hepatitis cases and in 6 cases of hepatic cirrhosis out of 7 (85.7%), there was good agreement between RT-PCR and ELISA results. Transaminase levels were concordant with RT-PCR results in 27 of 29 cases (93.1%) but in only 21 of 29 cases (72.4%) transaminase levels were in agreement with ELISA results. In two patients treated with interferon, transaminase levels and the other clinical and laboratory parameters fell in the normal range in parallel with the disappearance of viremia, whereas anti-HCV antibodies were still detectable. RT-PCR has a higher specificity in detecting the etiology of hepatic diseases if compared to ELISA and an at least equal sensitivity. The method proves to be the best means for the confirmation of HCV infection, and for the monitoring of interferon therapy.

Antisense Elements (Genetics)↗
PubMedDate not supplied

Treatment with alpha-interferon in chronic hepatitis.

The treatment of chronic viral hepatitis with Interferon has been introduced in clinical practice over the past decade an represents an important step in the management of those diseases. The data existing in literature are conflicting about the dose and period of treatment with Interferon, many treatment schedules being proposed. There are also a lot of markers used or proposed to be used to determine the response to treatment, their predicting efficacy being largely studied. The response to alpha-Interferon in a standard 6 month regimen in chronic hepatitis B, chronic hepatitis C and chronic hepatitis B and C is studied; alanine-aminotransferase (ALAT) and aspartate-aminotransferase (ASAT) are the markers used to determine the response to treatment.

Adolescent↗
PubMedDate not supplied

Liver disease in systemic lupus erythematosus.

The incidence of hepatic involvement was followed up in a retrospective study carried out in a group of 177 patients with SLE. The liver damage was estimated by clinical examination, the titer of hepatocytic enzymes and, in some cases by hepatic biopsy. The proportion of liver involvement was found reduced but that did not exclude severe hepatic inflammation in certain cases. A high incidence of hepatomegaly was noted in spite of the fact that the histopathologic examination often showed normal values. The entity "lupoid hepatitis" is discussed as well as its real relationship with SLE.

Female↗
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

The significance of chronic hepatitis B and C virus infections in some connective tissue diseases: the association with chronic liver disease.

BACKGROUND/AIM: We investigated the pathogenic role of chronic hepatitis B virus (HBV) and C virus (HCV) in some connective tissue diseases including systemic lupus erythematosus (SLE), overlap syndrome, rheumatoid arthritis (RA), seronegative spondylarthritis (SS) and the association with chronic liver disease. METHODOLOGY: There were studied 155 patients, aged among 18 to 64 years old: 57 with SLE, 22 with overlap, 26 with RA, 30 with SS. The diagnoses were established using modified ARA criteria. There were performed complex immunology tests, percutaneous liver biopsy, HLA, Elisa tests with Riba confirmation for detecting HCV and HBV. RESULTS: 17% of SLE patients were infected with hepatitis viruses, predominantly B (70%). Half of them had a hepatic involvement due to the hepatitis viruses. 23% of RA patients were equally B\C infected with only one case of hepatic involvement secondary to hepatitis viruses. All the HCV infected patients had rheumatoid factor (RF) IgG-IgM type, with low serum levels of haemolytic complement (CH50), increases serum levels of circulating immune complexes (CIC) and evidence of HLA DR4 In the group of SS 40% of patients were infected mostly with HBV. In HLA B27 (+) anchylosing spondylitis (AS) the incidence of HBV was 100%. CONCLUSIONS: There is no high prevalence of HCV infection in SLE, overlap syndrome or RA, compared to the control group. In SS the prevalence is increased (40%), especially HLA B27 (+) AS group (33%), in which HBV is noticed at a rate of 100%. The association SLE-HCV favours the visceral involvement especially renal ones, while the presence of HBV is associated with decrease of lupus activity. In RA, HCV induces IgG-IgM RF with complement activation, being considered as a trigger of the disease in HLA DR4 patients. In HLA B27 (+) AS. HBV may trigger the development of disease in genetically susceptible individuals.

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

Is cardiac involvement in collagen diseases important? A clinical study in 917 patients.

Cardiac involvement in collagen diseases was studied in 917 patients representing all the cases of collagen diseases diagnosed in the "N. Gh. Lupu" Institute of Internal Medicine between 1985 and 1987. The prevalence of the various cardiac disorders was studied within every disease or group of diseases diagnosed according to clinical, ECG, radiologic and when necessary echocardiographic data. Collagen heart disease was diagnosed in 38.2% of the patients. In the case of systemic lupus erythematosus, of polyarteritis nodosa and of progressive systemic sclerosis this proportion exceeds 50%. The most frequent cardiac disorders were the rhythm and conduction disturbances, detected in 112 patients (12.2%). The cardiomyopathies and myocarditis, not infrequent (7.4%) represented an element of severity influencing the evolution and prognosis of disease. Myocardial ischemia secondary to coronary vasculitis syndromes has proved to be an important pathogenic mechanism of cardiac disorders. By their frequency and severity, the cardiac involvements in collagen diseases have proved important, becoming sometimes a central diagnostic, therapeutic and prognostic problem.

Adult↗
PubMedDate not supplied

Present-day possibilities of diagnosis and treatment of chronic liver diseases. Contributions of the research work in the "N. Gh. Lupu" Institute of Internal Medicine.

A short presentation is made of the investigations on chronic liver diseases carried out in the "N. Gh. Lupu" Institute of Internal Medicine--Bucharest from its foundation to the present day. The main courses of investigation (fundamental, diagnosis, prophylaxis, treatment) are specified, with emphasis on the achievements obtained within the general context of the progress of hepatology all over the world.

Chronic Disease↗
PubMedDate not supplied

Possible correlation between the zinc and copper concentrations involved in the pathogenesis of various forms of anemia.

The concentrations of three trace elements (iron, copper and zinc) involved in hematopoiesis were studied in 200 patients with iron-deficit anemia, hemolytic anemia and Biermer's anemia, in comparison with a group of normal subjects. The method used was atomic absorption spectrophotometry. The results obtained showed that in iron-deficit anemia resistant to iron therapy the copper and ceruloplasmin serum concentrations are at the lowest limit of normal. This copper deficit has a negative effect on the disease by preventing hemoglobin synthesis. In iron-deficit anemias responding to iron therapy the relatively low (about 90 gamma %) zinc values have a negative effect by blocking the iron in the iron reserve. In hemolytic anemia the very high zinc serum concentrations (over 200 gamma %) may lead to a shortening of the erythrocytes life span due to its "entatic state". In Biermer's anemia zinc by its high concentration has a positive role owing to carbonic anhydrase which eliminates more rapidly carbon dioxide from the organism.

Anemia↗