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Biomedical subjects

R Popescu

Publications and source records attributed to R Popescu.

At least 19 recordsLinked to original sources

Intra-arterial hepatic fotemustine for the treatment of liver metastases from uveal melanoma: experience in 101 patients.

BACKGROUND: Exclusive liver metastases occur in up to 40% of patients with uveal melanoma associated with a median survival of 2-7 months. Single agent response rates with commonly available chemotherapy are below 10%. We have investigated the use of fotemustine via direct intra-arterial hepatic (i.a.h.) administration in patients with uveal melanoma metastases. PATIENTS AND METHODS: A total of 101 patients from seven centers were treated with i.a.h. fotemustine, administered intra-arterially weekly for a 4-week induction period, and then as a maintenance treatment every 3 weeks until disease progression, unacceptable toxicity or patient refusal. RESULTS: A median of eight fotemustine infusions per patient were delivered (range 1-26). Catheter related complications occurred in 23% of patients; however, this required treatment discontinuation in only 10% of the patients. The overall response rate was 36% with a median overall survival of 15 months and a 2-year survival rate of 29%. LDH, time between diagnosis and treatment start and gender were significant predictors of survival. CONCLUSIONS: Locoregional treatment with fotemustine is well tolerated and seems to improve outcome of this poor prognosis patient population. Median survival rates are among the longest reported and one-third of the patients are still alive at 2 years.

Adult↗

A randomized phase II trial of capecitabine and two different schedules of irinotecan in first-line treatment of metastatic colorectal cancer: efficacy, quality-of-life and toxicity.

BACKGROUND: To determine the efficacy, impact on quality-of-life (QoL) and tolerability of two different irinotecan administration schedules in combination with capecitabine as first-line treatment of metastatic colorectal cancer. PATIENTS AND METHODS: We carried out a randomized phase II trial to select one of the following treatment regimens for further investigation: weekly irinotecan at a dose of 70 mg/m(2) days 1, 8, 15, 22, 29 (arm A) or 3-weekly irinotecan at a dose of 300/240 mg/m(2) day 1 and days 22 (arm B) in combination with capecitabine 1000 mg/m(2) twice daily days 1-14 and days 22-35 every 6 weeks. RESULTS: Seventy-five patients with good performance status entered the trial. The two arms were well balanced for relevant patient and disease characteristics. The most frequent toxic effects were grade 3/4 diarrhea (arm A: 34%, B: 19%), grade 3/4 neutropenia (A: 5%, B: 19%) and grade 2/3 alopecia (A: 26%, B: 65%). Other grade 3/4 toxic effects were rare (<5%). Response rates were 34% [95% confidence interval (CI) 20% to 51%] in arm A and 35% (95% CI: 20% to 53%) in arm B. Median time to progression was 6.9 (4.6-10.1) and 9.2 (7.9-11.5) months and median overall survival was 17.4 (12.6-23.0+) and 24.7 (16.3-26.4+) months. Patients with an objective tumor response reported better physical well-being (P < 0.01), mood (P < 0.05), functional performance (P < 0.05) and less effort to cope (P < 0.05) compared with the non-responders and stable disease patients. CONCLUSIONS: The primary end point of this study was the objective response rate and based on the statistical design of the trial, the 3-weekly irinotecan schedule was selected over weekly irinotecan administration. The 3-weekly irinotecan schedule also seemed advantageous in terms of grade 3/4 diarrhea, time to progression, overall survival and patient convenience, but the study was not designed to detect differences in these parameters. In addition, tumor response was shown to have a beneficial effect on QoL indicators.

Adult↗

Spin reorientation and structural relaxation of atomic layers: pushing the limits of accuracy.

The correlation between an ad-layer-induced spin reorientation transition (SRT) and the ad-layer-induced structural relaxation is investigated by combined in situ surface x-ray diffraction and magneto-optical Kerr-effect experiments on Ni/Fe/Ni(111) layers on W(110). The Fe-induced SRT from in-plane to out-of-plane, and the SRT back to in-plane upon subsequent coverage by Ni, are each accompanied by a small lattice relaxation of at most 0.002 A. Such a small strain variation excludes a magnetoelasticity driven SRT, and we suggest the interface anisotropy as a possible driving force.

Journal Article↗

Geometrical and compositional structure at metal-oxide interfaces: MgO on Fe(001).

The geometric structure of MgO deposited on Fe(001) in ultrahigh vacuum by electron evaporation was determined in detail by using surface x-ray diffraction. In contrast to the common belief that MgO grows in direct contact on the Fe(001) substrate, we find an FeO interface layer between the substrate and the growing MgO structure which has not been considered thus far. This result opens new perspectives for the understanding of the Fe/MgO/Fe(001) interface and the tunneling magnetoresistance effect in general.

Journal Article↗

Electron impact mass spectral interpretation for some thiophosphoryl-p-acetylaminobenzenesulfonamides.

This work discusses the synthesis and the fragmentation patterns for 2-(p-acetylaminosulfonamido)-2-thiono-(5,5-dimethyl-1,3,2-dioxaphosphorinane)(1) and for the p-acetylaminosulfonylamides of O,O-diethylthiophosphoric acid (2), O,O-diphenylthiophosphoric acid (3), dimethylaminocyclohexylthiophosphoric acid (4), and diethylaminophenylthiophosphoric acid (5). A thionamidic-thiolimidic structure was attributed to compounds 1-5, consistent with their IR and NMR spectra. EI mass spectra at 70 eV, high resolution (HR) mass measurements and metastable ion spectra were used to elucidate the fragmentation processes and to determine the kinetic energy release values associated with the metastable ion dissociations. HR accurate mass measurements were used to confirm the compositions of the more abundant ions.

Journal Article↗

Carbonic anhydrase inhibitors; phosphoryl-sulfonamides--a new class of high affinity inhibitors of isozymes I and II.

A series of phosphorylated aromatic/heterocyclic sulfonamides with the general formula ArSO2NHPO3H2 have been prepared by condensing ArSO2NH2 with phosphorus pentachloride, followed by controlled hydrolysis in the presence of formic acid. The new derivatives generally act as stronger inhibitors of two carbonic anhydrase (CA) isozymes, CA I and CA II, as compared to the parent unsubstituted sulfonamides from which they were obtained. The inhibition mechanism by this new class of CA inhibitors, as well as structure activity correlations for the series of investigated derivatives, are also discussed.

Carbonic Anhydrase Inhibitors↗

The prevalence of skin conditions in Romanian school children.

Virtually nothing is known about the prevalence of skin conditions in children in the general population. Although we know something about the relative frequency of skin conditions seen by dermatologists, we do not know how such referrals are influenced by factors such as social class, accessibility to medical services or educational and cultural background. In order to estimate the burden and relative frequency of dermatological disease in children in the community, we measured the point prevalence of skin conditions in 1114 Romanian schoolchildren aged 6-12 years, using the British Association of Dermatologists diagnostic index. The overall point prevalence of children with one or more skin diseases was 22.8%, with no significant differences according to age group or sex, except for pityriasis alba which showed a male predominance (P = 0. 007). The most common diseases were infectious dermatoses such as viral warts and insect bites (6.3%), dermatitis/eczema (5.1%), pityriasis alba (5.1%), keratosis pilaris (4.0%) and urticaria (1. 9%). Together, these five groups accounted for more than 84% of the cases. Of the 1114 children, 213 (19.1%) had only one skin disease and 41 (3.7%) had two skin diseases. While acknowledging the limitations in defining which skin conditions can benefit from medical care, this study suggests that skin disorders are common in Romanian schoolchildren, affecting about one-quarter of 6-12 year olds. Such a point prevalence is likely to be conservative because of the tendency of prevalence estimates to exclude many other dermatoses of short duration. The finding that over 80% of the disorders can be grouped into fewer than six categories is important in informing training programmes and delivery of service for primary health care teams. This study provides a baseline for further studies into the morbidity and use of health care services by children with skin disease in the community.

Age Distribution↗

Community validation of the United Kingdom diagnostic criteria for atopic dermatitis in Romanian schoolchildren.

Although the U.K. modification of Hanifin and Rajka's diagnostic criteria for atopic dermatitis (AD) for use in epidemiological studies has demonstrated good validity and repeatability when previously tested in a U.K. community setting, little is known about its performance in other countries where different cultural, educational and linguistic factors could impair validity. We used a questionnaire to test the validity of the U.K. criteria as a point prevalence measure of AD in 1114 Romanian schoolchildren aged 6-12 years against the clinical diagnosis of a dermatologist with an interest in AD, who was unaware of the questionnaire content and responses. The sensitivity and specificity of the U.K. criteria for AD in this setting was 74% and 99%, respectively, an improvement rather than a deterioration in validity when compared with the previous U.K. study. Test-retest repeatability for all of the questions pertaining to the U.K. criteria using the chance-corrected kappa statistic was high, with values of 0.72 and over. The positive predictive value of the criteria was lower than in the U.K. study (63% compared with 80%, respectively) due to the very low prevalence of AD in this study (2.4%). The validity of a parental report of 'eczema' was poor, with a sensitivity of 22%, specificity of 97% and positive predictive value of 18%. This study suggests that the U.K. criteria perform well in settings outside the U.K., although care has to be taken when using the criteria to ascertain cases in settings where the prevalence of AD is very low.

Child↗

A prospective randomised trial of protracted venous infusion 5-fluorouracil with or without mitomycin C in advanced colorectal cancer.

BACKGROUND: To compare protracted venous infusion (PVI) 5-fluorouracil (5-FU) with and without mitomycin C (MMC) in a prospectively randomised study and analyse for tumour response, survival, toxicity and quality of life (QL). PATIENTS AND METHODS: Two hundred patients with advanced colorectal cancer received PVI 5-FU 300 mg/m2/day for a maximum of 24 weeks and were randomised to PVI 5-FU alone or PVI 5-FU + MMC 10 mg/m2 (7 mg/m2 from June 1995) 6 weekly for 4 courses. RESULTS: Overall response was 54% (95% confidence interval [CI] 44.1%-63.9%) with PVI 5-FU + MMC compared to 38% (95% CI: 28.3%-47.7%) for PVI 5-FU alone (P = 0.024). The median failure free survival was 7.9 months in PVI 5-FU plus MMC and 5.4 months with PVI 5-FU alone (P = 0.033) and at one year 31.9% for the combination compared to 17.7% for PVI 5-FU alone. Median survival was 14 months with MMC and 15 months in 5-FU alone; one-year survival 51.7% vs. 57.2%. PVI 5-FU + MMC caused more overall haematological toxicity but CTC grades 3/4 was increased only for thrombocytopaenia. Two patients treated with a cumulative dose of MMC of 40 mg/m2 developed haemolytic uraemic syndrome warranting the reduction in cumulative MMC dose to 28 mg/m2. The global QL scores were better for PVI 5-FU + MMC arm at 24 weeks, but the remaining QL data showed no differences. CONCLUSIONS: PVI 5-FU + MMC results in failure-free survival and response advantage, tolerable toxicity and better QL when compared to PVI 5-FU alone but no overall survival advantage. There is no irreversible toxicity with MMC at a cumulative dose of 28 mg/m2.

Adenocarcinoma↗

[Osteosynthesis of femoral neck fractures with 3 curved elastic nails].

The authors have treated 56 cases of fracture of the femoral neck using an original method. Three curved elastic nails were introduced into the head and neck through the greater trochanter. The results appear to be encouraging. The main advantage of the technique is minimal disturbance of the intra osseous vascular system of the head resulting in a low rate of avascular necrosis. The stability of the fixation has been studied from the biomechanical point of view. In many cases, the reduction obtained is improved immediately preceding the nailing.

Adult↗

Significance of T and B lymphocytes in different chronic internal diseases with immune processes.

The T and B lymphocytes were determined by the rosette test in the peripheral blood of 100 patients with internal chronic diseases with immune processes such as: chronic hepatitis, systemic lupus erythematosus, myasthenia gravis, chronic lymphocytic leukemia and lymphosarcoma. The values obtained were compared with those in 10 controls. The mean per cent values of the T lymphocytes in the controls were 33 (29-38%) and of the B lymphocytes 25.2 (16-43%). In the patients investigated the values varied, namely: in chronic hepatitis and systemic lupus erythematosus the T lymphocytes were generally low while the B lymphocytes were moderately high. In myasthenia gravis both T and B lymphocytes were below the control values. In chronic lymphocytic leukemias and lymphosarcomas the per cent values of the T lymphocytes were generally low while those of the B lymphocytes were high. The significance of these results for the immunologic implications of the lymphocyte populations is discussed and an attempt is made to correlate these data with the nucleologram variations.

B-Lymphocytes↗

[Urinary complications after anorectal surgery].

The prevalence of urinary complications after various anorectal operations was studied in a group of 273 patients. The overall prevalence of urinary complications was 26.7%; most of these complications affected men between 41 and 50, mainly after hemorrhoidectomy. In 10.6% of patients, bladder catheterization was needed. These urinary complications result from nervous reflexes originating from the anus and determined by the operative trauma and/or rectal distinction. In the treatment of these urinary complications, the role of the muses is essential for reassuring the patients. Parasympathomimetic drugs are often efficient. Urinary catheterization must be delayed until the 18th hour. Fluid restriction may be useful to prevent urinary retention.

Adult↗