Pulmonary tuberculosis in Romania at the dawn of the;millennium – a major public health issue

C. Marica

“Marius Nasta”;Institute of Pneumology, Bucharest, Romania

Correspondence to:;;C. Marica, M.D, Ph.D,

90 Viilor Street, District 5, Bucharest, Romania

 

Abstract

TB incidence in our country is still quite high compared to the average of the European Union countries (1st;place among EU countries and 3rd;place among WHO European Region countries), which means that a national coordinated response against this disease needs to become the priority of the current health care policy.

The multi-factorial conditioning, which includes the social and economic dimensions of TB spreading, requires a multi-disciplinary and inter-sectorial approach to this pathology, going beyond healthcare services.

The National Tuberculosis Control Strategy is a part of Romania’s Country Strategy based on the guidelines set out in WHO’s 2006-2015 Global Plan to Stop Tuberculosis (MDGs 2015) and it provides the necessary framework for refining and harmonizing the national legislation and regulations with the European laws after Romania’s integration in the EU.

Read more: Pulmonary tuberculosis in Romania at the dawn of the millennium


 

Patients’ perspectives and motivators to participate in clinical trials with novel therapies for rheumatoid arthritis

G.Udrea* **, B.Dumitrescu****, M.Purcarea*, I. Balan*,

E.Rezus****, D.Deculescu*****

* „Carol Davila” University of Medicine, Bucharest, Romania

** Internal Medicine and Rheumatology Clinic, „Dr. I. Cantacuzino” Clinical Hospital, Bucharest, Romania

*** Medlife Clinic, Bucharest, Romania

**** „Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania

***** Rheumatology Department, Videle, Romania

Correspondence to:G.Udrea, M.D, Ph.D

Internal Medicine and Rheumatology Clinic „Dr. I. Cantacuzino” Clinical Hospital,

5-7 Ion Movila Street, Bucharest, Romania

gabiudrea@yahoo.com

 

Abstract

Background and Purposes - Successful advances in the treatment of rheumatoid arthritis rely on enrolment of patients into clinical trials with novel agents. The aim of this study was to assess the patients’ perspectives and motivators to participate in clinical trials.

Methods – Consecutive patients with rheumatoid arthritis attending three rheumatology departments in Romania underwent structured questionnaire interview regarding the motivation /possible causes of acceptance or drawbacks to participate in a clinical trial.

Results –A total of 96 patients, mean age 48, 30% men 70% women answered. Response rate was 95%. Previous participation in other clinical trials was 23%. Patients were highly motivated to participate in order to help themselves or other patients and to enhance the knowledge about the disease. Patients were prone to ask for advice about their enrolment in the study from the family and their current physicians, including the general practitioner. The need for supplementary information about the study was felt because they had not dared to ask for the information, although they trusted their current doctor.A high percentage considered payment and free complete blood tests as a stimulus, especially among patients with lower levels of education (p=0.03, Fisher’s ANOVA).Advertising for investigational medical product for purposes of patient recruitment was important for 57 %, not only for safety or trust, but also for transparency and as a tool to get information. 73% of the persons agreed to the usefulness of patients association. 26% of them were willing to be actively involved, especially to report and include adverse events in the study settings. 58% were motivated if they knew other patients were consulted. Patients were not motivated because of the adverse events, placebo effect, treatment discontinuation, limited previous experience, availability of alternative therapies and doctor reimbursement for the study.

Conclusions– The current study suggests that awareness of factors (positive and negative) which influence motivation to participate in a clinical trial may help to refine patient’s education and to consider new strategies for future trials.

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The role of p53, PCNA and Ki-67 as outcome predictors in the treatment of laryngeal cancer

 

D. Sarafoleanu*, V. Postelnicu*, C. Iosif**, C. Manea*, C. Sarafoleanu*.

* “Sfanta Maria” Clinical Hospital, ENT - HNS Department, Bucharest, Romania

** “Victor Babes” Institute, Bucharest, Romania.

 

Correspondence to:D. Sarafoleanu, M.D. Ph.D

“Sfanta Maria” Clinical Hospital, ENT - HNS Department,

37-39 Ion Mihalache Bvd., District 1, Bucharest, Romania.

Phone/Fax: 021.222.35.38, email: csarafoleanu@gmail.com

 

 

Abstract

The aim of our study was to determine the importance of p53, PCNA and Ki-67, evaluated by immunohistochemistry, in the treatment and prediction of the laryngeal carcinoma. Out of a total of 319 patients with laryngeal carcinoma that underwent surgery in our department between 1999 and 2007, we performed a retrospective study on 71 cases who benefited by immunohistochemical guidance before the beginning of the treatment. All these patients have been followed-up two to five years after surgery. The values of p53, PCNA and Ki-67 are strongly correlated with the histological grading, by means of descriptive statistics (confidence level 95%); the mean values of these three markers corresponding to each HP grade. A highly statistical significant positive correlation (r = 0.84, p<0.001) between the values of p53 and PCNA was observed. The values of p53, PCNA and Ki-67 in the patients from this study are strongly correlated with the absence of the loco-regional lymph node metastases, by means of descriptive statistics (confidence level 95%). Ki-67 only is correlated significantly to the presence of lymphatic metastases in the regional lymph nodes (stage N1, N2 or N3 TNM). P53 and PCNA are not correlated significantly with the presence of the metastases in the regional lymph nodes.

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About the urachus and its pathology A clinical case of urachus tumor

Ovidiu  Bratu, Victor Madan, Cristian  Ilie, Florin Rusu, Ciprian Ghilic,

Catalin  Farcas, Dan Mischianu

Urology Clinic, “Dr. Carol Davila” Clinical Central Military Emergency Hospital, Bucharest, Romania

Correspondence to: Bratu Ovidiu, M.D.

“Dr. Carol Davila” Clinical Military Emergency Hospital Bucharest, Department of Urology,

134 Calea Plevnei, Bucharest, Romania

Abstract

Urachus diseases represent a relatively rare kind of affliction in child or adult abdominal or urological surgical pathology.

The preservation of the urachus lumen leads to rare afflictions, noticed mostly after birth or when they become clinically manifest by various complications.

More often than not, these pathological entities require surgical interventions (if the urachal lumen does not close by itself), consisting of partial or total excision of the urachus.

Tumor pathology is mostly malign, to a large extent represented by urachus adenocarcinoma. Its initial symptomatology is scarce and confusing.

Its treatment is mainly by surgery and consists of the surgical excision of the urachal ligament, of the umbilicus, of a part of the front abdominal wall and partial or total cystectomy, as necessary.

The prognosis is unfavourable, since urachal adenocarcinoma is deemed to be a particularly aggressive tumor, strongly influenced by the status of the excision edges, that is by the radicalness of the surgical intervention. Irrespective of the latter, an adjuvant oncological treatment is to be prescribed, mainly systemic cytostatic therapy.

Urachus adenocarcinoma is rarely encountered and very often diagnosed in late metastatic stages, when the only solution is at most paleative surgery.

Read more: About the urachus and its pathology A clinical case of urachus tumor