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Biomedical subjects

M Popescu

Publications and source records attributed to M Popescu.

At least 19 recordsLinked to original sources
PubMed2006

Predicting response to peginterferon alpha-2a, lamivudine and the two combined for HBeAg-negative chronic hepatitis B.

OBJECTIVE: In a trial of patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B, 24 week post-treatment biochemical and virological response rates with peginterferon alpha-2a with or without lamivudine were significantly higher than with lamivudine alone. The effect of pre-treatment factors on post-treatment responses was investigated. METHODS: Multivariate analyses were performed using available data from 518 patients treated with peginterferon alpha-2a with or without lamivudine, or with lamivudine alone. A post-treatment response was defined as alanine aminotransferase (ALT) normalisation and hepatitis B virus (HBV) DNA level of <20,000 copies/ml. RESULTS: In logistic regression analyses across all treatment arms, peginterferon alpha-2a (with or without lamivudine) therapy, younger age, female gender, high baseline ALT, low baseline HBV DNA and HBV genotype were identified as significant predictors of combined response at 24 weeks post-treatment. In the peginterferon alpha-2a and lamivudine monotherapy arms, patients with genotypes B or C had a higher chance of response than genotype D infected patients (p<0.001), the latter responding better to the combination than to peginterferon alpha-2a monotherapy (p = 0.015). At 1 year post-treatment, response rates by intention-to-treat analysis were 19.2% for the peginterferon alpha-2a, 19.0% for the combination, and 10.0% for the lamivudine groups, with genotypes B or C associated with a sustained combined response to peginterferon alpha-2a with or without lamivudine therapy. CONCLUSIONS: Baseline ALT and HBV DNA levels, patient age, gender, and infecting HBV genotype significantly influenced combined response at 24 weeks post-treatment, in patients treated with peginterferon alpha-2a and/or lamivudine. At 1 year post-treatment HBV genotype was significantly predictive of efficacy for patients treated with peginterferon alpha-2a with or without lamivudine.

Adult↗
PubMed2006

Clinico-imaging and anatomopathologic correlations in sarcomas of maxilla.

Sarcomas are relatively uncommon tumors, accounting for 1% of all malignancies. Sarcomas are commonly classified according to their site of origin: soft tissues or bone. The purpose of the clinic study was to focus the symptoms and the clinic signs. The radio-imaging study is essential in the evaluation of the maxilla tumors. The histopathologic study was done to determine the histological type, the differentiation level, the invasion level as well as the presence or absence of the metastases in drainage ganglia. The correlation of the findings of this study leads to a clear and correct clinic diagnosis, an adequate local or general therapy and a prognostic. The diagnostic role of imaging is essential and often permits the orientation to benignity or, on the contrary, requires biopsy if the image is an aggressive one or of uncertain nature. Advances in diagnostic imaging have contributed substantially to the management of tumors. The strong collaboration among the physician, imaging personnel and anatomo-pathologist serves the patient's benefit.

Adolescent↗
PubMed2004

Severe hemolytic anemia due to passenger lymphocytes after living-related bowel transplant.

BACKGROUND: Hemolytic anemia following solid organ transplant may be caused by 'passenger' lymphocytes producing antibodies against erythrocytes. This phenomenon has never been described after intestinal transplant. MATERIALS AND METHODS: We report a case of severe, immune-mediated hemolysis due to symptomatic passenger lymphocyte syndrome (PLS) in a 4-yr-old recipient of living donor small bowel transplant. The Coombs'-positive hemolysis was caused by anti-A,B antibodies derived from donor lymphocytes in an ABO-compatible donor-recipient pair (O into A). RESULTS: This complication was successfully and efficiently treated by the novel combined use of group O RBC transfusion, plasmapheresis and rituximab (anti-CD20). CONCLUSIONS: A severe hemolytic anemia due to PLS can occur in bowel transplantation. This complication should be considered when performing ABO-incompatible bowel transplant with a blood group O donor and an A or B recipient. Treatment with plasmapheresis, blood group O transfusion and rituximab has proved successful in our case.

ABO Blood-Group System↗
PubMed2003

Influence of the cortical electrical activity level during general anaesthesia on the severity of immediate postoperative pain in the morbidly obese.

BACKGROUND: The objective of anaesthesia is to provide hypnosis, analgesia and adequate conditions during surgery. It is difficult to establish the appropriate dose of general anaesthetic drugs in the morbidly obese patient. Moreover, there are conflicting data concerning adequate anaesthesia levels and the severity of postoperative pain. The aim of this study was to investigate the relationship between the spectral edge frequency (SEF) during general anaesthesia and the severity of immediate postoperative pain following gastric banding surgery in morbidly obese patients. METHODS: Seventy-one ASA 2 morbidly obese patients (BMI > 35%) undergoing elective laparoscopic gastric banding procedure were recruited for this study. Anaesthesia consisted of midazolam, fentanyl and thiopental for induction, vecuronium for muscle relaxation, N2O and isoflurane with additional fentanyl administrations, according to the clinical judgement of the anaesthesiologist, for maintenance. Continuous SEF monitoring was added to the standard monitors (SpO2, ETCO2, ECG, NIBP, O2 and isoflurane concentration), but the EEG monitor screen was hidden from the anaesthesiologist's sight. SEF postoperative analysis divided the patients into two groups: group 1, SEF-recommended target range of 8-12 Hz, more than 80% of the surgical time; and group 2, SEF-recommended target range of 8-12 Hz, less than 80% of the surgery duration. Pain intensity was assessed in the post anaesthesia care unit using a standard visual analogue scale (VAS) of 10 cm, when patients were awake enough to correct a deliberately given wrong own telephone or ID number. Intravenous morphine was administered for postoperative analgesia in 2-mg increments, every 3-4 min, until the patient felt comfortable. A recovery room nurse unaware of the SEF range recorded during surgery registered pain severity and morphine requirements. RESULTS: The end-tidal isoflurane concentration was significantly higher in group 1 than in group 2 (0.83 vs. 0.7 P = 0.016). The intensity of pain at admission into the recovery room and at discharge was significantly lower in group 1 than in group 2 (VAS 6.1 vs. 6.9-P = 0.0049, and 3.9 vs. 4.2-P = 0.00478, respectively). CONCLUSIONS: Keeping the SEF range between 8 and 12 Hz during anaesthesia for laparoscopic gastric banding for morbid obesity, both the immediate post operative pain intensity and morphine requirement, are significantly reduced.

Adolescent↗
PubMed2003

Pharmacokinetics, food intake requirements and tolerability of once-daily combinations of nelfinavir and low-dose ritonavir in healthy volunteers.

AIMS: This study was performed to evaluate the steady-state pharmacokinetics, food intake requirements and short-term tolerability of once-daily combinations of nelfinavir and low-dose ritonavir. METHODS: Twenty-seven healthy volunteers were randomized over three groups to receive a once-daily regimen of nelfinavir/ritonavir 2,000/200 mg (group 1), 2,000/400 mg (group 2) or 2,500/200 mg (group 3) with food for 14 days. Pharmacokinetic parameters for nelfinavir and its active metabolite M8 were assessed on study days 15 and 16, after administration of the regimens with a full (610 kcal) or light (271 kcal) breakfast, respectively. RESULTS: Pharmacokinetic data were evaluable for eight volunteers in group 1, eight in group 2 and four in group 3. Administration of nelfinavir/ritonavir with a full breakfast resulted in geometric mean (GM) nelfinavir AUC(24h) values of 76.8, 51.3, and 61.9 h*mg/l in group 1, 2 and 3, respectively. GM 24-h Cmin concentrations of nelfinavir were 0.76 mg l(-1), 0.43 mg l(-1) and 0.47 mg l(-1), respectively. Co-administration of ritonavir increased M8 concentrations more than nelfinavir concentrations, resulting in GM AUC(24h) and Cmin values for nelfinavir plus M8 that were higher than or comparable to reference values for the approved regimen of nelfinavir (1,250 mg BID without ritonavir). In the 2,000/200 mg group, seven out of eight subjects had a Cmin value of nelfinavir plus M8 above a threshold of 1.0 mg l-1. Administration of the combinations with a light breakfast resulted in significant decreases in the AUC(24h) and Cmin of nelfinavir and nelfinavir plus M8, compared with intake with a full breakfast. For the Cmin of nelfinavir plus M8, the GM ratio (light/full breakfast) was 0.76 (90% confidence interval 0.67-0.86, participants from all groups combined). Short-term tolerability was satisfactory, apart from a higher than expected incidence of mild rash (12%). CONCLUSIONS: Administration of nelfinavir in a once-daily regimen appears feasible. A nelfinavir/ritonavir 2,000/200 mg combination appears appropriate for further evaluation. Once-daily nelfinavir/ritonavir should be taken with a meal containing at least 600 kcal.

Adolescent↗
PubMed2002

Limited effect of food composition on the pharmacokinetics of nelfinavir administered twice daily.

UNLABELLED: The objective of the study was to investigate the effect of two different breakfasts on the pharmacokinetics of nelfinavir under steady state conditions. METHODS: Twenty-four healthy male volunteers were evaluated in a 17 days open labeled one sequence crossover study evaluating the effect of a 'light' breakfast (350 kcal) compared to a standard breakfast (800 kcal) on the pharmacokinetics of nelfinavir at steady state during 1250 mg twice daily (BID) administration. RESULTS: After administration with a standard breakfast higher concentrations of nelfinavir were observed during the terminal phase than after administration with a 'light' breakfast. The comparison of the log subset 10 transformed parameters C subset 1-hr-postdose, AUC subset 0-12h, C subset max, and C subset 12 hours, showed that the AUC subset 0-12h was decreased by 13% (P = 0.01) after administration with the 'light' breakfast. Nelfinavir 1250 mg BID was well tolerated. CONCLUSIONS: Although drug intake with a 'light' breakfast' showed a statistically significant decrease for nelfinavir AUC subset 0-12h, this marginal 13% reduction is not considered clinically relevant. No significant effects of the two different breakfasts were found for the remaining three parameters tested C subset 1-hr-postdose, C subset max, and C subset 12 hours.

Adult↗
PubMed2002

The attitude of Romanian medical trainees towards the eradication of H. pylori.

AIM: To evaluate the knowledge of Romanian medical trainees regarding H. pylori infection and its management. METHODS: A specialized questionnaire used in a US survey with similar purpose was distributed to 57 medical interns and residents. The questionnaire included 17 item concerning the testing and treatment of H. pylori infection as well as information sources. RESULTS: Romanian medical interns and residents are generally well informed about diagnostic tests and therapeutic recommendations of national and international guidelines. However the decisions are not always appropriate, in respect to the on site practical possibilities. CONCLUSIONS: Medical faculties should be satisfied with the knowledge of Romanian medical trainees regarding H. pylori infection. However, more emphasis should be given during postgraduate training to the development of practical skills in different specific cases

Adult↗
PubMed2002

[Intracranial and intraorbital meningioma ].

UNLABELLED: AIM OF THE ARTICLE: To discuss the simultaneous presence of intraorbitar and intracranian meningiomas, the origin and the link between these tumors. MATERIAL AND METHODS: We show 3 cases with intracranian and intraorbitar meningiomas. RESULTS: Therapeutically attitude and debates about anatomopathological results. CONCLUSIONS: Difficulty in determine the intracranian or intraorbitar origin of meningiomas.

Adult↗
PubMed2001

[Ocular myopathies - cause of exophthalmia].

It presents the "thickenings" of the extraocular muscles that can cause exophthalmos. It makes the difference between myositis limited to the orbit and the systemic myopathies and endocrine myopathies.

Adolescent↗
PubMed2001

Drug resistance mutations in HIV-1-infected subjects during protease inhibitor-containing highly active antiretroviral therapy with nelfinavir or indinavir.

OBJECTIVES: The aim of this retrospective study was to evaluate treatment outcome and characterize the pattern of genotype mutations in subjects with treatment failure on highly active antiretroviral therapy (HAART) containing nelfinavir or indinavir. STUDY DESIGN AND METHODS: The database of the Swiss HIV Cohort Study was screened for all subjects naive to protease inhibitor (PI) treatment who started HAART with nelfinavir or indinavir, responded initially (HIV-RNA <400 copies/ml) and received >24 weeks of treatment. Responders with subsequent treatment failure (HIV-RNA >1000 copies/ml, bordered by HIV-RNA >400 copies/ml) were selected for genotypic analysis. RESULTS: Initial treatment response, maintenance of response and subsequent virological failure were observed at a comparable frequency in 1143 nelfinavir and 1555 indinavir subjects. Of the treatment-naive patients, 13% who took nelfinavir and 16% who took indinavir had HIV-RNA >1000 copies/ml at least once. These values increased to 24 and 27%, respectively, for reverse transcriptase inhibitor-experienced subjects. Genotypic analysis in a subset of subjects with virological failure identified 30N as the only primary mutation in the nelfinavir subjects (8 out of 21, 38%) whereas isolated or combined 82A/T and 461/L mutations were detected in the indinavir subjects (9 out of 20, 45%). CONCLUSIONS: In this population of previously PI-naive subjects, the rate of virological failure and the frequency of resistance mutations at the time of virological failure were comparable in subjects receiving nelfinavir- or indinavir-containing HAART. In nelfinavir subjects, 30N was the only primary mutation whereas isolated or combined 82A/T and 461/L mutations were detected in indinavir subjects.

Acquired Immunodeficiency Syndrome↗
PubMed2001

[Color Doppler ultrasonography of the orbit in the treatment and evolution of the open angle glaucoma with normalized pressure].

UNLABELLED: The purpose of the paper consists to evaluate the vascular component that it takes part to ethiopatogenie of certain forms of primary open angle glaucomas, as well as to suggest a specific treatment. MATERIAL AND METHOD: 14 patients (28 eyes) with primary open angle glaucomas with average of 64 years were investigated by Color Doppler Imaging. All patients present deteriorations papilo-perimetric or/and visual acuity, in spite of normalized pressure by medical or surgical treatment. RESULTS: The calculus of the velocimetric indices allowed us to measure the vascular resistance index that is increased at 6 patients in ophthalmic circulation, 4 patients in central retinal artery and 2 patients in whole shaft carotid-ophthalmic. We are found a correlation between papilo-perimetric deteriorations and the value of the vascular resistance index, too. Giving vasodilatative drugs that grow the ocular blood flow by improving the microcirculation at the level of the optic nerve's head, such as calcium channel blockers, could benefit effects for this type of patients. CONCLUSIONS: Orbitar Color Doppler Imaging allows to evaluate the vascular lesions that have a negative influence in the evolution of primary open angle glaucomas, and, therefore, suggesting a specific treatment.

Aged↗
PubMed1999

Automatic karyotyping of metaphase cells with overlapping chromosomes.

Image analysis research aimed at analyzing images of banded, human chromosomes is described. An experimental automated karyotyping system (AKS) has been assembled. The goal of the system is to label the chromosomes from a metaphase image with minimal human intervention. The AKS is unique in that it is designed to automatically process cells containing overlapping chromosomes. It also has four novel algorithmic features: the use of cross section sequence graphs, an over-segmentation-based segmentation strategy, the use of the 'pale path' concept for banded chromosomes and the application of mathematical programming for cell-level chromosome classification in cells with overlapping chromosomes. System performance was analyzed using a variety of metaphase images exhibiting various levels of overlapping chromosomes.

Algorithms↗
PubMed1999

[Reconstruction of mediastinal veins in same side dialysis shunt].

Centralvenous obstruction is a rare however typical lesion with patients on chronic hemodialysis. A still functional arteriovenous shunt in its run-in can cause serious disorder, especially painful congestion and an insufficient dialysis. Should the shunt be maintained, a run-off reconstruction is required. 13 patients were treated with a centralvenous obstruction combined with a complication of the shunt. In 8 patients the intervention was either impossible from the beginning or finally proved to be not successful after repeated recanalisations. 6 out of these patients underwent a transsternal reconstruction of their bypass (a total of 7 interventions). 2 patients died perioperatively, 2 patients died 1 year, respectively 1 1/2 years later with a still intact reconstruction, 2 patients are still alive. Their reconstruction has been working for two, respectively three years. The bypass material was large-calibrated e-PTFE with external support. Compared to conventional indications the catheter techniques proved to be less effective in the treatment of central venous obstruction. One year after the first intervention only three out of seven shunts could still be used for the dialysis. The longest symptom-free period was 12 months. The operative reconstruction is indeed very effective but it implies considerable risks and effort. This method cannot be recommended to patients on chronic dialysis who are in a poor condition.

Adult↗
PubMed1998

Beat-to-beat wavelet variance of the QRS complex as a marker of arrhythmogenic substrate in ventricular tachycardia patients.

This study proposes a wavelet transform based technique to assess the beat-to-beat variation of the QRS signal in post-myocardial infarction patients with sustained monomorphic ventricular tachycardia. Recent electrophysiological investigations suggested that the diminished synchrony between the normal myocardium and the scarred arrhythmogenic tissue bordering a myocardial infarction area gives rise to beat-variable ECG signal components. Using a mathematical model of small variations in a largely repetitive waveform, we show that the inherent alignment errors (trigger jitter) of the high-resolution ECG (HRECG) can artificially increase the value of the time-domain beat-to-beat variance, making it less valuable as a marker of beat-variable signal components. To overcome this drawback, we propose the wavelet based approach which discriminates between the different factors responsible for the beat variability (the alignment error and the beat-variable signal components). The Morlet wavelet transform is performed on HRECG signals from normal individuals (control group) and postmyocardial infarction patients with documented ventricular tachycardia. Electrical variability is quantitatively assessed via the beat-to-beat wavelet variance measurements. A marker of arrhythmogenic induced variance which achieves a good performance in discrimination of ventricular tachycardia patients from normal subjects was found between 200 Hz and 300 Hz. This finding is in agreement with the proposed mathematical model which states that the useful part of the time-frequency map is shifted upward in a precise mathematical way, as the variance induced by the beat-variable arrhythmogenic signals depend on the frequency characteristics of the first derivative of these signals. We conclude that the dynamics of the arrhythmogenic substrate as revealed by the beat-to-beat wavelet variance can be a new estimator of ventricular tachycardia risk.

Algorithms↗
PubMed1998

Pulmonary function in children with initial low birth weight.

The objective of this analysis was to examine the effect of low birth weight and prematurity on bronchial air-flow, bronchial reactivity, airway symptoms and asthma diagnosis at school age. A cross-sectional epidemiological study was performed in three small towns in the eastern part of Germany on 2470 school children aged 5-14 (89.1% of eligible children). A 78 item questionnaire to determine risk factors at birth and in early childhood was employed. 7.8% of the children were born before completing 38 gestational weeks; 6.6% had a birth weight less than 2500 g. Pulmonary function analysis were done by a mobile plethysmography at the school. There were only weak restrictions in lung volume in term low birth weight (LBW) children (100 ml lower TLC, p = 0.107), and flow (257 ml lower PEFR, p = 0.108), were low. However, bronchial hyper-responsiveness indicated by 292 ml lower FEV1.0 after cold air bronchial provocation, was significantly increased compared to term normal birth weight children (p < 0.001). The effect of LBW was less in older children, only slightly stronger in girls and increased in children mechanically ventilated during the postnatal period. Correspondingly, there was a higher prevalence of diagnosed asthma in term LBW children (OR 1.6, 95%-confidence interval 1.0-2.6), however these were without an increased risk for any allergic sensitization. LBW, therefore, seems to be a risk factor for smaller lungs and hyperreactive airways primarily in term born children, whereas in preterm children the immature bronchial system seems to be recover by school age.

Adolescent↗