PubMed Health⌕ Search

Biomedical subjects

Ioan Sporea

Publications and source records attributed to Ioan Sporea.

11 recordsLinked to original sources
PubMed2006

Pegylated-interferon alpha 2a treatment for chronic hepatitis C in patients on chronic haemodialysis.

AIM: To evaluate the response to pegylated-interferon alpha 2a in chronic hepatitis C patients on chronic haemodialysis. METHODS: Ten patients with chronic C hepatitis were enrolled in this study. All had increased aminotransferases for more than 6 mo, positive antiHCV antibodies and positive PCR HCV-RNA. We administrated Peg-Interferon alpha 2a 180 microg/wk for 48 wk. After 12 wk of treatment we evaluated the biochemical and early virological response (EVR). At the end of the treatment we evaluated the biochemical response and 24 wk after the end of the treatment we evaluated the sustained virological response (SVR). We monitored the side-effects during the treatment. RESULTS: Two patients dropped out in the first 12 wk of treatment and 2 after the first 12 wk of treatment. After 12 wk of treatment, 7 out of 8 patients had biochemical response and EVR and 1 had biochemical response but persistent viremia. We had to reduce the dose of pegylated-interferon to 135 mug/wk in 2 cases. Three out of 6 (50%) patients had SVR 24 wk after the end of the treatment. Intention-to-treat analysis showed that 3 out of 10 patients (30%) had SVR. Side-effects occurred in most of the patients (flu-like syndrome, thrombocytopenia or leucopoenia), but they did not impose the discontinuation of treatment. CONCLUSION: After 12 wk of treatment with Peg-Interferon alpha 2a (40 ku) in patients on chronic haemodialysis with chronic C hepatitis, EVR was obtained in 87.5% (7/8) of the cases. SVR was achieved in 50% of the cases (3/6 patients) that finished the 48 wk of treatment.

Adult↗
PubMed2006

Comparative study concerning the efficacy of Peg-IFN alpha-2a versus Peg-IFN alpha-2b on the early virological response (EVR) in patients with chronic viral C hepatitis.

BACKGROUND: Pegylated interferons (Peg-IFNs) represent, in association with Ribavirin, the first line of treatment in chronic C viral hepatitis. The AIM of our paper was to compare the efficacy of Peg-IFN alpha 2a (Pegasys) and Peg-IFN alpha 2b (PegIntron) in a group of patients from the Department of Gastroenterology in Timisoara. MATERIAL AND METHOD: 116 patients with chronic C viral hepatitis were treated. The patients were randomized in chronological order (1:1), so that 58 patients were treated with Peg-IFN alpha 2a 180 microg/kg/week + Ribavirin (group 1) and 58 were treated with Peg-IFN alpha 2b 1.5 microg/kg/week + Ribavirin (group 2). Ribavirin was administered in the recommended doses, according to weight. The mean age was: group 1 -- 49.3 years, group 2 -- 50.9 years (p=0.37). Group 1 consisted of 37 women and 21 men and group 2 of 44 women 14 men (p=0.22). In group 1, 48 patients were naïve (N1), 7 were relapsers after previous treatment (RL1) and 3 non-responders to previous treatment (NR1). In group 2, 33 patients were naive (N2), 18 relapsers (RL2) and 7 non-responders (NR2). After 12 weeks of treatment we evaluated the early virological response (EVR), defined as a drop in the viral load with 2 logs compared to the baseline viremia. RESULTS: The following EVR rates were found: in group 1 (Pegasys) - 82.2% (48/58); in group 2 (PegIntron) -- 67.2% (39/58) (p=0.08). There were also no significant statistical differences between the response rates in the subgroups: naïve patients [89.6% vs. 75.2%, p = 0.61], relapsers [57.1% vs. 66.6%, p = 0.67] and non responders [33.3% vs. 28.6%, p = 1]. CONCLUSION: Our head to head comparative study showed that there are no statistically significant differences in the EVR between the patients treated with Peg-IFN alpha 2a and Peg-IFN alpha 2b.

Antiviral Agents↗
PubMed2006

The survey on the practice of gastroenterology in Romania.

AIM OF THE STUDY: To get data on the current practice of Gastroenterology in Romania. MATERIAL AND METHOD: We obtained data regarding the number of gastroenterologists in Romania from the Centre of Statistics of the Ministry of Health and Family (CSMHF) and the National Centre of Training for Medical Personnel (NCTMP). We sent a questionnaire to all the Centers of Gastroenterology in Romania inquiring about the number of gastroenterologists and fellows, and about the gastroenterological procedures performed. We compared these data to that of 17 European countries. RESULTS: The total number of gastroenterologists in Romania on January 1, 2005 was 175 (123 specialists and 52 senior consultants), and the total number of fellows in training was 133. Romania has a small number of gastroenterologists - 0.83/100,000 inhabitants, expected to reach approximately 1.4/100,000 inhabitants in 2010. Regarding the abilities in gastroenterological procedures, we obtained data from 98 gastroenterologists. They have good performances in diagnostic gastroscopy (97%), colonoscopy (81.6%), abdominal ultrasound (79.6%), but a poor performance in ERCP (10.2%). Less than half of the gastroenterologists (46.9%) perform proctologic procedures. Data regarding the training program of the Romanian fellows are disappointing: only 69.1% of them perform gastroscopy, 33.8% colonoscopy, 2.9% ERCP, 64.7% abdominal ultrasound and 14.7% proctology. CONCLUSIONS: The number of gastroenterologists in Romania seems low compared with most European countries. They do not acquire a uniform satisfactory mastering of gastroenterological procedures during their training program. This should be improved according to the guidelines of the European Diploma of Gastroenterology.

Digestive System Surgical Procedures↗
PubMed2005

Colonoscopy in Romania.

BACKGROUND: To date, colonoscopy is considered the gold standard for the investigation of the colon and also the gold standard method for colorectal cancer screening. AIM of this paper was to assess if and how is Romania prepared to cope with screening of colon cancer by means of colonoscopy. METHOD: We sent a study-type questionnaire addressed to all the centers in Romania known to perform digestive endoscopy and we inquired about the total number of colonoscopies and flexible sigmoidoscopies performed in 2003 (the questionnaire was sent to 43 centers). RESULTS: Thirty-eight centers responded to the question-naire. The total number of colonoscopies performed in Romania in 2003, obtained by collecting the data from the study centers, was 22,324. The number of sigmoidoscopies performed during the same period was 12,349. The ratio between the number of colonoscopies and sigmoidoscopies was 1.8/1. There were 106.3 colonoscopies /100,000 inhabitants. CONCLUSION: Considering the population of Romania (about 21 million inhabitants), the number of colonoscopies performed is insufficient for our country. The number of centers performing colonoscopy in Romania is also insufficient.

Colonic Neoplasms↗
PubMed2005

Sedation during colonoscopy.

In order to perform a proper screening for colonic cancer, repeated colonoscopies are required. Comfort during colonoscopy is very important, so that the patient will accept repeated procedures. Currently, there are 3 types of sedation used during colonoscopy: general anesthesia performed by an anesthesiologist; sedo-analgesia performed by an anesthesiologist or by a gastroenterologist; sedo-analgesia performed by a trained nurse. Sedo-analgesia is the most frequently used type of sedation during colonoscopy worldwide. It is realized by combining midazolam with propofol and/or fentanyl (alfentanyl) or pethidine. According to the data obtained from 34 centers performing colonoscopy in Romania, in 2003, 22,162 colonoscopies were performed: 54.5% without anesthesia, 39.5% with sedation with midazolam and 6% with sedo-analgesia. In a study performed in our department we noticed a significant improvement in the outcome of the colonoscopy when sedo-analgesia was used on a regular basis. The percentage of total colonoscopies (excluding those that could not be continued due to stenosis) was 84.2% when sedation was seldomly performed and 92.3% when sedo-analgesia was regularly used (p=0.042). We believe that the strategy of sedation during colonoscopy in Romania should be changed so that all the patients should benefit from sedo-analgesia, proved to be safe and cost/efficient.

Colonoscopy↗
PubMed2005

Assessment of the quality of colonoscopy in Romania.

We performed a national prospective multicentric study in order to assess the quality of colonoscopies performed in Romania. Between the 1st and 30th of November 2004, we performed a questionnaire-type study with regard to the practice of colonoscopy, addressed to all the centers in Romania known to perform digestive endoscopy. Thirty centers responded to our questionnaire, resulting in a number of 2,559 colonoscopies that were performed in Romania during the month of November (a mean of 85 colonoscopies/center/month). The percentage of cecal intubations performed nationwide was 70.5%, 74.1% in university hospitals, as compared to nonuniversity ones (64.6%) (p=0.000027). Regarding sedation during colonoscopy, in 46% of the cases the colonoscopy was performed without sedation and in 54% of the cases with sedation (or sedo-analgesia).

Colonic Neoplasms↗
PubMed2004

Peg-Interferon Alfa 2a (40kDa) in patients on chronic haemodialysis with chronic C hepatitis. Preliminary results.

The aim of the study was to evaluate the response to Pegylated Interferon alpha2a (40 kDa) in patients on chronic haemodialysis with chronic C hepatitis. 10 patients were enrolled in this study (4 males and 6 females). All had increased aminotransferases, anti HCV antibodies and PCR HCV-RNA positive. We administrated Peg-Interferon alpha2a 180 microg/week for 48 weeks. One patient was excluded from the study because of lack of compliance. We had to stop the treatment in one patient due to complications after surgery. After 12 weeks of treatment we evaluated the biochemical and virological response. We continued with Peg-Interferon until 48 weeks. Six patients finished the treatment. After 12 weeks of treatment with Peg-Interferon alpha 2a (40 kDa) in patients on chronic haemodialysis with chronic C hepatitis, the virological response (HCV-RNA absent by PCR) was obtained in 87.5% (7/8) of the cases. All patients who finished the 48 weeks of treatment had normal transaminases (biochemical response) (6/6). We had to reduce the dose of Peg-Interferon in only 2 cases. Even if side-effects occurred in most of the patients (flu-like syndrome, thrombocytopenia or leucopenia) they did not impose the discontinuation of treatment. The sustained response will be established by determining PCR RNA-HCV 6 months after the end of the treatment.

Adult↗
PubMed2004

Ultrasound assisted liver biopsy for the staging of diffuse chronic hepatopathies.

Liver biopsy is the most accurate method for the staging and grading of diffuse hepathopathies. In viral hepatitis staging is required in order to assess firstly if the patient should be treated or not and, secondly, to assess the prognosis. In alcoholic and non-alcoholic steato-hepatitis we only appreciate the prognosis by staging, because the therapy is the same. In this study we analyze the experience of our centre in performing ultrasound-assisted liver biopsies in diffuse chronic hepatopathies. Between 1993-2003 we performed 1460 ultrasound-assisted liver biopsies, all on inpatients, in 93.8% of the cases for the evaluation of viral hepatitis. In the last few years we used sedation with midazolam i.v., the saturation of O(2) being recorded. In the 10 years of the study we encountered one major complication (haemo-peritoneum) (0.07%), treated by conservative methods. The minor complications we encountered, pain and discomfort, were always alleviated by minor analgesics. Vaso-vagal reactions were frequent before we started using midazolam (8.05%), but were no longer present after we performed sedation. None of the liver biopsies was followed by the death of the patient. In 1.37% of the cases we obtained inadequate liver specimens. We performed multiple passages in 0.96% of the cases. In conclusion, ultrasound-assisted liver biopsy is still the "gold standard" of hepatologic evaluation, being a safe and accurate method for staging the diffuse chronic hepatopathies.

Biopsy, Needle↗
PubMed2003

The prevalence of Helicobacter pylori infection in western Romania.

UNLABELLED: The aim of this study was to evaluate the prevalence of Helicobacter Pylori (HP) infection in a representative group of workers in Timiş County. MATERIAL AND METHODS: Our study population consisted of 960 employees: 206 F (21.46%) and 754 M (78.54%), mean age 36.8+/-7.6 years (range 18-60 years) from a company in Timişoara, in whom we assessed IgG anti HP antibodies. We standardised our study population for the age and gender distribution of the population in Timiş County and we excluded under 18 and over 60 years age groups which were underrepresented. RESULTS: Antibodies were found in 691 individuals (71.9%). In females, the prevalence of HP infection was 63.1% (130/206) and in males 74.4% (561/754). In the age group 18-30 years - 65.3%, males-67%, females-56.8% (p=0.240); in group 31 - 40 years - 71.6%, males-74.4%, females-63.5% (p=0.025); in group 41 - 50 years - 75%, males - 78%, females-62.5% (p=0.026); and in group 51 - 60 years - 88.7 %, males-87.2 %, females - 100% (p=0.35). After standardisation for age and gender, the prevalence of HP infection in the adult population was 68.5%; in females - 63.8 %, in males - 73.5% (p=0.08). CONCLUSIONS: In a population sample significant for Timiş County, the prevalence of HP infection is 68.5% in the adult population, slightly higher in males than in females (74.4% vs 63.1) (p=0.08), and it has a tendency to increase with ag

Adolescent↗
PubMed2002

Endoscopic mucosal resection for early gastric cancer. A case report.

European experience in endoscopic mucosal resection (EMR) for early gastric cancer is still relatively low, since early stomach cancer is diagnosed at a much lower rate in Europe than in Japan and generally operable patients are referred to surgery for radical resection. Endoscopic mucosal resection or mucosectomy was developed as a promising technology to diagnose and treat mucosal lesions in the esophagus, stomach and colon. In contrast to surgical resection, EMR allows "early cancers" to be removed with a minimal cost, morbidity and mortality. We present the case of a patient with hepatic cirrhosis incidentally diagnosed with an elevated-type IIa early gastric cancer. Echoendoscopy was performed in order to assess the depth of invasion into the gastric wall confirming the only mucosal involvement. We performed an EMR using "cup and suction" method. After the procedure, the patient experienced an acute upper gastrointestinal bleeding from the ulcer bed requiring argon plasma coagulation. The histopathological examination confirmed an early cancer, without involvement of muscularis mucosae. The patient has had an uneventful evolution being well at six months after the procedure

Adenocarcinoma↗