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Oliviu Pascu

Publications and source records attributed to Oliviu Pascu.

16 recordsLinked to original sources
PubMed2006

The effect of interferon alpha plus ribavirin on health-related quality of life in chronic C hepatitis. The Romanian experience.

BACKGROUND AND AIM: Interferon plus Ribavirin represent the most effective therapy for chronic hepatitis C. Its efficiency is limited by the occurrence of numerous side-effects. A previous study observed in Romanian patients an impairment of quality of life in chronic viral hepatitis C before antiviral therapy. We looked for the effect of this treatment on health-related quality of life in chronic hepatitis C when measured immediately after the antiviral therapy. METHODS: 35 patients with hepatitis C were given Interferon alpha 3MU tiw plus Ribavirin 1000-1200 mg for 48 weeks. Questionnaire-based assessments of health-related quality of life were performed before and immediately after the treatment using the SF-36 questionnaire. Also, in pretest, the health-related quality of life scores were compared in these patients with "normal" subjects (matched on age and sex). In order to compensate for the lack of a specific control group during the longitudinal study, normative comparisons were performed in posttest. RESULTS: Before treatment, patients had significant impairment in all SF-36 concepts compared to "normal" controls (all p < 0.05). The level of transaminases before the treatment was high (out of the normal range) and decreased after the treatment, reaching the normal range (27 of 35). Immediately after the treatment, SF-36 scores did not show any significant differences, as compared to the pretest, no matter what the viral response was (p > 0.10). CONCLUSIONS: Patients with chronic viral hepatitis C have a markedly reduced health-related quality of life both before and after the treatment. The antiviral therapy does not influence the level of the quality of life, when measured immediately after finishing the treatment.

Adult↗
PubMed2005

Diagnosis and treatment of extrahepatic cholangiocarcinoma: results in a series of 124 patients.

AIM: The aim of the study was to evaluate the diagnostic methods and therapeutical results in patients with extrahepatic cholangiocarcinoma admitted between 2000 and 2003 and to assess the efficacy of various imaging methods. MATERIAL AND METHOD: We included 124 consecutive patients with suspected cholangiocarcinoma who underwent endoscopic retrograde cholangiopancreatography (ERCP) between 2000 and 2003. Every patient underwent an ultrasound (US) examination before ERCP. ERCP was considered as the "gold standard" for diagnosis. The therapy applied consisted of endoscopic stenting, US guided biliary drainage or surgery. The sensitivity, specificity and accuracy were calculated for every tumour localisation and also globally for all tumours. RESULTS: The sensitivity, specificity and accuracy of US were 85.9 %, 76.9 %, and 84.4 % for hilar localization, 59.1 %, 50 % and 57.1 % for the mid bile duct (CBD) and 33.3 %, 42.8 % and 36.8 % for the distal CBD tumours. The global performances for US in diagnosing extrahepatic cholangiocarcinoma were 73.5 %, 61.5 % and 70.9 %. In 73 cases (74.5%) an endoscopic stent was placed. In 11 cases (11.2%) we performed an US guided biliary drainage and in 14 cases (14.2%) surgery was recommended. CONCLUSIONS: Ultrasonography proved to be a reliable method for the diagnosis of cholangiocarcinoma in spite of its low accuracy for distal localization. The combination of the two investigations (US and ERCP) was very efficient in the management of these patients. Endoscopic stenting for hilar localization is a good therapeutical option.

Adult↗
PubMed2004

Impaired health-related quality of life in Romanian patients with chronic viral hepatitis before antiviral therapy.

BACKGROUND AND AIM: Chronic hepatitis is a disabling condition leading to impairment of a patient's quality of life. We investigated the impact of chronic viral hepatitis on health-related quality of life. The relationship between transaminase level and score in the quality-of-life questionnaire was also investigated. METHODS: We studied 66 patients with chronic viral hepatitis (27 with hepatitis B, 38 with hepatitis C, 1 with hepatitis B+C; 32 men, 34 women) naive to any previous antiviral therapy. All had high levels of transaminases. Patients with chronic disease or those using drugs to modify their quality of life were discarded. The control group consisted of 36 healthy volunteers (17 men, 19 women). Both groups completed the Short Form 36 health survey, with the exception of the items concerning bodily pain. RESULTS: Significant differences between the two groups for every domain of quality of life (physical functioning, role physical, mental health, role emotional, social functioning, vitality and general health) were recorded. We found no significant correlation between the level of transaminases and any item of the health-related quality-of-life questionnaire. In hepatitis B patients, several quality-of-life scores (general health, social functioning, mental health) were better than in hepatitis C patients. CONCLUSIONS: Patients with chronic viral hepatitis not receiving antiviral therapy have an impaired quality of life as estimated by the Short Form 36 health survey.

Adult↗
PubMed2004

Epidemiology of inflammatory bowel disease in adults who refer to gastroenterology care in Romania: a multicentre study.

AIM: The Romanian Society of Gastrointestinal Endoscopy developed a multicentre, prospective study to evaluate the frequency and epidemiological features of inflammatory bowel disease (IBD) in an adult population that refers to gastroenterology centres in Romania. MATERIAL AND METHODS: Eighteen centres with adequate diagnostic and therapeutic facilities uniformly distributed across Romania reported through a proforma the new and old IBD cases between 1 June 2002 and 1 June 2003. The rates of incidence and prevalence of ulcerative colitis (UC) and Crohn's disease (CD) have been reported per 100 000 inhabitants. Epidemiological features and disease characteristics were analysed. RESULTS: During the study, 407 cases of UC (163 incident cases) and 254 cases of CD (85 incident cases) were identified. The incidence in the referral population was 0.97/100 000 and 0.50/100 000 for UC and CD, respectively, whereas the prevalences was 2.42/100 000 and 1.51/100 000 for UC and CD, respectively. A slight male predominance, wider age distribution and predominant urban residence were the main demographic features of incident cases; smoking and appendectomy/appendicitis were infrequent in UC, while a higher proportion of CD patients were smokers. Lower rates of severe, extensive or complicated IBD were noted as compared with the literature. CONCLUSION: Incidence and prevalence rates of IBD in Romania are low. Predominant male involvement and a wider distribution of incident cases were the main demographic features in our population. IBD in our patients had a more 'benign' course as compared with the literature, with lower rates of severe, extensive or complicated disease and a small proportion of patients who need surgery.

Adult↗
PubMed2004

Barrett's Esophagus.

Barrett's esophagus is an alteration of the esophageal epithelium, regardless of length, evidenced by endoscopic examination (protrusion of the gastric mucosa into the esophagus in the shape of a flame) and confirmed by histological examination of the bioptic samples (intestinal metaplasia with mucosecretory cells). It develops following long-term gastro-esophageal reflux (GER). The documented risk factors are: long-term GER (duration more than 5 years), age over 50 years, male sex, Caucasian race, aggressiveness of the refluxed material, individual susceptibility of the esophageal mucosa to the refluxed material. The carcinogenic risk is 30 times higher than in the general population. Treatment targets the acid reflux, with proton pump inhibitors (PPI), prevention of carcinogenesis with cyclooxygenase 2 inhibitors, ablation of the metaplastic area by laser, plasma-argon mucosectomy, or photodynamic therapy and antireflux surgery.

Barrett Esophagus↗
PubMed2004

Ruptured hydatid cyst of the liver with biliary obstruction: presentation of a case and review of the literature.

The case of a 66 year old woman admitted with a picture of jaundice acute cholangitis is reported. Ultrasonography showed a dilatation of intrahepatic bile ducts, gallbladder hydrops with several stones, enlarged common bile duct (CBD) with hyperechoic material inside and a cystic tumor with hydatid features. With a strong suspicion of a hydatid cyst ruptured in the biliary tree with biliary obstruction, endoscopic cholangiopancreatography was performed. The diagnosis was confirmed by endoscopic retrograde cholangiopancreatography and the hydatid membranes were extracted from the CBD with subsequent clinical improvement. The second step of treatment comprised the surgical cure of the cyst and cholecystectomy. The data from the literature are finally presented with a special emphasis on the ultrasound diagnosis and the endoscopic treatment.

Aged↗
PubMed2004

An epidemiological study of gastric cancer in the adult population referred to gastroenterology medical services in Romania -- a multicentric study.

AIM: The Romanian Society of Digestive Endoscopy proposed a multicentric study to evaluate the prevalence of gastric cancer in the adult population referred to gastroenterology medical services, and also the demographic features of this pathology. METHODS: . The study was carried out over the period 1 January 2003 - 31 December 2003 in 11 academic centers in Romania, specialized in gastroenterology, with a uniform national distribution (all areas in the country were represented) and with adequate diagnostic and therapeutic facilities. All centers used identical definition criteria and reported the data using the same protocol and a Microsoft Excel database. RESULTS: During the study period, 640 cases of gastric cancer were reported. In the first stage, the prevalence in each geographical region was calculated. The national prevalence of gastric cancer in the population referred to gastro-intestinal endoscopy services was 2.9 per 100,000 inhabitants over 18 years of age. The demographic data of the studied group were the following: 66.4% men, 33.6% women, 51.7% urban population, 48.3% rural population, mean age 63.07 +/- 12.10 years. The most frequent indications for upper digestive endoscopy were: dyspepsia, weight loss and appetite. 88% of patients had no history of disease with a high risk of gastric cancer. The majority of patients (95.5 %) had advanced gastric cancer at the time of diagnosis, located in the gastric body (40.1 %) and in the antrum (33.8 %). According to Borrmann's classification, 31.4% had type I fungating gastric cancer and 32.1% had type III ulcero-infiltrative gastric cancer. According to the Lauren classification, the most frequent histological type was intestinal adenocarcinoma (63.8 %). Early gastric cancer was found in 4.4% of patients. CONCLUSIONS: The prevalence of gastric cancer in the population referred to digestive endoscopy services in Romania is 2.9%, with relatively wide variations at a national level. The study confirms the fact that Romania is a country with a low prevalence of gastric cancer, in accordance with the literature data published for the south of Europe.

Adult↗
PubMed2003

Intra-oesophageal pH profiles and pharmacokinetics of pantoprazole and esomeprazole: a crossover study in patients with gastro-oesophageal reflux disease.

AIM: To compare the effect of pantoprazole and esomeprazole on intra-oesophageal pH and investigate their pharmacokinetics in patients with symptomatic gastro-oesophageal reflux disease (GORD). METHODS: Double-blind, randomized, two-period crossover study. Caucasian men with symptomatic GORD (n=48) were selected on the basis of clinical records of typical GORD symptoms, confirmed by a pathological reflux time (oesophageal pH<4 for > or =6% of the time). They received oral pantoprazole 40 mg once daily (od) or esomeprazole 40 mg od for seven days. Continuous 24 h oesophageal pH-metry was performed at baseline and day 7. Evaluations included: pre- and post-treatment differences in the percentage of time with pH<4.0 and <3.0 between baseline and day 7; area under the curve (AUC), Cmax, and T(1/2); point estimates and 90% confidence intervals (CI) on days 1 and 7, calculated for ratios of the AUC and Cmax. RESULTS: Both drugs decreased the mean total number of reflux episodes and reduced the percentage of reflux time within 24 h to <3%. No pathological reflux was detectable after repeated administration of either drug. The 90% CI were within the predefined range at all time points; thus, equivalence of pantoprazole and esomeprazole was concluded. For pantoprazole, Cmax and AUC were unchanged on day 7 vs day 1, confirming its high and constant bioavailability. For esomeprazole, Cmax and AUC were increased on day 7 vs day 1 by 80% and 50%, respectively, indicating low initial bioavailability. No clinically relevant side effects were seen for either drug. CONCLUSION: Pantoprazole and esomeprazole have equivalent effect on oesophageal pH, since no pathological reflux was detected after treatment with either drug. For esomeprazole, the Cmax and AUC increased after multiple dosing; for pantoprazole the pharmacokinetics were predictable and independent of the number of administered doses.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2003

The prevalence of coeliac disease at endoscopy units in Romania: routine biopsies during gastroscopy are mandatory (a multicentre study).

UNLABELLED: The incidence and prevalence of coeliac disease vary internationally. In Eastern Europe little is known about the prevalence of coeliac disease. THE AIM: of this study was to evaluate the prevalence and the clinical features of coeliac disease in adults biopsied during upper endoscopy in Romania. This is the first incidence study of the coeliac disease in Romania. METHODS: The study was initiated by the Romanian Society of Digestive Endoscopy for the period 1 January 2002 - 31 May 2002. It was carried out in 9 Academic Centres in Romania, which ensured an even geographical distribution and therefore significant statistical results at a national level. The study included 2436 patients according to following criteria: age over 16 years, with no known history of coeliac disease, visiting the participating upper endoscopy units or patients with documented coeliac disease presenting for follow-up check or recurrence of clinical symptoms. At least two bioptic samples were obtained from the distal duodenum, as distally as possible, which were submitted to histopathological examination and scored according to the modified UEGW Marsh criteria (2001). A database was set up to include all the patients with data regarding sex, age, urban or rural background, full clinical diagnosis, clinical symptoms, history of the coeliac disease. RESULTS: Of the 2436 patients studied, 54 (2.22%) were diagnosed with coeliac disease. Their demographic features: 48.15% men, 51.85% women, 68.52% living in urban areas, 31.48% in rural ones, mean age 42 +/-17.0 years. The most frequent reasons for performing upper digestive endoscopy were: dyspeptic syndrome - 15.93%, anemia - 24.07%, and chronic diarrhoea - 22.22%. The most frequently recorded clinical manifestations were: chronic diarrhoea in 46.3%, asthenia in 29.63%, anemia in 24.07%, aphthae in 24.07%. Histopathological results according to Marsh classification were: Marsh III- 64.81 %, Marsh II-35.19%. CONCLUSIONS: The prevalence of the coeliac disease in Romania is 2.22%: its sex distribution is fairly equal, the age distribution includes two peaks, at 30-40 and 50-60 years respectively, and patients from urban areas predominate. The most frequent (over 50% of the cases) histological type was M III. The most common clinical symptoms were diarrhoea, asthenia, anemia, aphthae, while the most frequent associated diseases were diabetes mellitus and Duhring-Brocq dermatiti

Adult↗
PubMed2003

What is the real prevalence of the D virus infection in chronic hepatitis and liver cirrhosis in Romania?

Virus D hepatitis continues to represent a public health problem in the south-eastern European countries, but the spread of the D virus infection in Romania is not completely elucidated. The paper proposes to assess the prevalence of the hepatitis D virus infection in patients with HBsAg-positive chronic hepatitis and liver cirrhosis in Romania. A number of 219 patients with chronic hepatitis and 168 with liver cirrhosis, all testing positive for HBsAg were studied. Viral markers were determined by immunoenzymatic methods. In HBsAg-positive chronic hepatitis the prevalence of the D virus was 37.9 % and in liver cirrhosis 51.19%. The great majority of the cases infected with hepatitis B virus were HBeAg-negative. These findings situate Romania among countries with a high prevalence of the hepatitis D virus infection, but which is decreasing as compared to the data communicated by previous reports.

Adult↗
PubMed2003

Multilocular colorectal tuberculosis and hypogammaglobulinemia.

We present the case of a young male patient admitted for weight loss, diarrhea and rectal bleeding. The patient belonged to a low social class and had associated hypogammaglobulinemia. The endoscopy revealed different localized ulcerations of he rectum and a stenosis. By barium enema and hydrosonography multiple stenotic lesions were observed. The pathological examinations detected lesions suggestive for intestinal tuberculosis. A specific therapy led to the improvement of his general state and to the disappearance of diarrhea and rectal bleeding.

Adult↗
PubMed2002

[Treatment of pain in chronic pancreatitis by an endoscopic method].

UNLABELLED: The epigastric pain is the most frequent manifestation in chronic pancreatitis. It is due to intraductal pancreatic pressure, presence of compressive pseudocysts and probably to neuroinflammatory process caused by alcohol. AIM: The aim of our study was to assess the influence of endoscopic treatment on pain in chronic pancreatitis and the correlation between residual pain after endoscopic treatment and pancreatic morphology. PATIENTS: Forty-four patients from the Gastroenterology Department of Angers (France) with chronic pancreatitis were included in our retrospective clinical study. Thirty-seven patients underwent a diagnostic ERCP and only 28 needed an endoscopic treatment. The pain was evaluated semi-quantitatively before and after the endoscopic treatment. The mean follow-up was 28.6 months. RESULTS: Among the 28 patients with endoscopic treatment, 18 had a complete improvement of the pain, 4 an incomplete improvement and 6 had no improvement; these last were submitted to pancreatic surgery. The pain evolution had a good correlation with the reduction of Wirsung diameter; there was no correlation with ductal stenosis, residual lithiasis and pseudocysts presence. Alcohol consumption had no influence on the pain evolution. CONCLUSION: The endoscopic treatment of intraductal lithiasis and pseudocysts is a useful method for Wirsung decompression, improving the pain in chronic pancreatitis.

Adolescent↗
PubMed2002

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

With the rapid progress of the diagnostic techniques, especially endoscopy, the discovery rate of early superficial cancer of the esophagus has increased markedly. Relatively recently introduced, endoscopic mucosal resection (EMR) is now widely used in the treatment of early stage cancer of the esophagus. We used EMR in the case of a patient who was incidentally diagnosed with a type IIa early esophageal cancer using a band-ligating device. We had no serious complications. At the histopathological examination we noticed that the carcinoma involved the upper third of the submucosal layer. For this reason the patient was given additional therapy (radiotherapy), too. A month after the EMR, at the histological examination we found no local signs of recurrent disease.

Esophageal Neoplasms↗
PubMed2002

Whipple's disease. Case report.

The paper reports the clinical case of a 58 -year-old male patient admitted for diarrhea (6-7 stools/day, diffuse abdominal pain, borborygma, weight loss (20 kgs in two years), asthenia and fatigue. Physical examination evidenced a poor nutritional state (body mass index 19 kg/m2). The abdomen was slightly distended. Biological tests evidenced moderate/severe anemia, hypoproteinemia and hypoalbuminemia. Endoscopic examination evidenced oedematous duodenal mucosa with white-yellowish deposits. Histology (HE stain) revealed the presence of foamy cells and the PAS-staining of the duodenal mucosa evidenced PAS-positive macrophages and numerous intracellular bacilli. Penicillin therapy 2 x 1 million U/day for 14 days, followed by tetracycline 4 x 250 mg/day improved the clinical picture, the patient had only one stool per day and gained weight. After 7 months of treatment the general condition was good and the patient had gained 17 kgs, the duodenal mucosa was normal. HE staining did not evidence foamy cells and no PAS-positive macrophages could be found.

Abdominal Pain↗
PubMed2002

The Falk symposia.

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Gastroenterology↗