1
|
Dinca AL, Diaconu A, Birla RD, Coculescu BI, Dinca VG, Manole G, Marica C, Tudorache IS, Panaitescu E, Constantinoiu SM, Coculescu EC. Systemic inflammation factors as survival prognosis markers in ovarian neoplasm and the relationship with cancer-associated inflammatory mediators-a review. Int J Immunopathol Pharmacol 2023; 37:3946320231178769. [PMID: 37246293 DOI: 10.1177/03946320231178769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
At the level of the genital system, ovarian neoplasm is the most frequent cause of morbidity and mortality. In the specialized literature, the coexistence of an inflammatory process is admitted from the early stages of the evolution of this pathology. Starting from the importance of this process, both in determinism and in the evolution of carcinogenesis and summarizing the field of knowledge, for this study we considered two objectives: the first was the presentation of the pathogenic mechanism, through which chronic +ovarian inflammation is involved in the process of carcinogenesis, and the second is the justification of the clinical utility of the three parameters, accepted as biomarkers of systemic inflammation: neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and lymphocyte-monocyte ratio in the assessment of prognosis. The study highlights the acceptance of these hematological parameters, with practical utility, as prognostic biomarkers in ovarian cancer, based on the intrinsic link with cancer-associated inflammatory mediators. Based on the data from the specialized literature, the conclusion is that in ovarian cancer, the inflammatory process induced by the presence of the tumor, induces changes in the types of circulating leukocytes, with immediate effects on the markers of systemic inflammation.
Collapse
Affiliation(s)
| | - Adriana Diaconu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Rodica Daniela Birla
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan-Ioan Coculescu
- Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Cantacuzino National Medico-Military Institute for Research and Development, Bucharest, Romania
| | | | - Gheorghe Manole
- Romanian Academy of Medical Sciences
- Faculty of General Nursing, Bioterra University, Bucharest, Romania
| | - Cristian Marica
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Eugenia Panaitescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Elena Claudia Coculescu
- Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| |
Collapse
|
2
|
Mihailov R, Firescu D, Constantin GB, Șerban C, Panaitescu E, Marica C, Bîrlă R, Patrascu T. Nomogram for Prediction of Postoperative Morbidity in Patients with Colon Cancer Requiring Emergency Therapy. Med Sci Monit 2022; 28:e936303. [PMID: 35768977 PMCID: PMC9254725 DOI: 10.12659/msm.936303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Postoperative complications are the major cause of mortality and prolonged hospitalization after emergency surgery for colon cancer. This study aimed to propose an effective nomogram to predict postoperative complications in order to improve the outcomes. Material/Methods We retrospectively analyzed 449 patients who underwent emergency surgery for complicated colon cancer at the County Emergency Hospital Clinic “St. Apostle Andrei” in Galaţi, in the period from 2008 to 2017. Postoperative complications were intestinal obstruction, leakage, bleeding, peritonitis, wound infection, surgical wound dehiscence, respiratory failure, heart failure, acute renal failure, sepsis, and Clostridium difficile colitis, within a month after surgery. Logistic regression models were used to identify the independent prediction factors, and a nomogram was created, based on the best model. Results A total of 106 patients (21%) presented postoperative complications after emergency surgery for colon cancer; 51 patients (11.36%) died during the postoperative period. After identifying the risk factors through univariate regression analysis, we identified the independent prediction factors in 2 multivariate regression models. The model with the highest accuracy included the following 7 independent prediction factors: Eastern Cooperative Oncology Group performance status, Charlson score, white blood cell count, electrolyte and coagulation disorders, surgery time, and cachexia (P<0.05 for all). This model showed good precision in predicting postoperative complications, with an area under curve of 0.83 and ideal accordance between the predicted and observed probabilities. Conclusions The nomogram developed in this study, which was based on a multivariate logistic regression model, had good individual prediction of postoperative complications.
Collapse
Affiliation(s)
- Raul Mihailov
- Department of Clinic Surgery, Dunarea de Jos University, Galati, Romania
| | - Dorel Firescu
- Department of Clinic Surgery, Dunarea de Jos University, Galati, Romania
| | | | - Cristina Șerban
- Department of Clinic Surgery, Dunarea de Jos University, Galati, Romania
| | - Eugenia Panaitescu
- Department of Medical Biostatistics, Carol Davila University, Bucharest, Romania
| | - Cristian Marica
- Department of General Surgery, Titu Maiorescu University, Bucharest, Romania
| | - Rodica Bîrlă
- Department of General Surgery, Carol Davila University, Bucharest, Romania
| | - Traian Patrascu
- Department of General Surgery, Carol Davila University, Bucharest, Romania
| |
Collapse
|
3
|
Constantin GB, Firescu D, Voicu D, Ștefănescu B, Serban RMC, Berbece S, Panaitescu E, Bîrla R, Marica C, Constantinoiu S. Analysis of Prognostic Factors in Complicated Colorectal Cancer Operated in Emergency. Chirurgia (Bucur) 2020; 115:23-38. [PMID: 32155397 DOI: 10.21614/chirurgia.115.1.23] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2020] [Indexed: 11/23/2022]
Abstract
Introduction: In 2018, the colon cancer was the 5th type of neoplasia regarding the cancer mortality and the rectal cancer was the 10th. The survival of patients with colorectal cancer operated in emergency still remains unsatisfactory, the death being due to local recurrences and to metastases. The aim of this study is to evaluate some correlations of overall survival with clinic and paraclinic features, tumor or treatment characteristics in order to identify prognostic factors, for cases with colorectal tumors that underwent emergency surgery. Material and Methods: We performed a retrospective analysis on 431 patients with colorectal cancer operated in emergency between 2008-2017, excluding 40 patients with postoperative deaths, with a follow-up period of at least one year. There were correlations of some clinic and paraclinic features, tumor or treatment characteristics with the overall survival. Results: In the univariate statistical survival analysis, a statistically significant association was obtained with: the age 61 years (p_value = 0.000049), abdominal surgical history (p_value = 0.031725), heart disease (p_value = 0.000007), atrial fibrillation (p_value = 0.007496), preoperative diagnosis (p_value = 0.034352), cachexia (p_value = 0.000000), oliguria (p_value = 0.000000), anemia (p_value = 0.000006) hydro-electrolytic disorders (p_value = 0.000001), tumor localization (p_value = 0.000030), invasion into other organs (p_value = 0.000000), appearance of "frozen pelvis" (p_value = 0.000000), peritoneal carcinomatosis (p_value = 0.000000), liver metastases (p_value = 0.000000), type of surgery (p_value = 0.000000), lymph node dissection (p_value = 0.000001), liver biopsy (p_value = 0.043483), stoma reversal (p_value = 0.000000 ), serial interventions (p_value = 0.000000), pTNM (p_value = 0.000000), tumor grading (p_value = 0.007069). The Cox multivariate regression analysis revealed that: the age 61 years - HR = 1,026, 95% CI (1,012, 1,039) (p value = 0.000139), cachexia - HR = 1,358, 95% CI (1,046, 1,764) (p value = 0.021617), peritoneal carcinomatosis - HR = 2.346, 95% CI (1.163, 4.732) (p_value = 0.017253), disease stage - HR = 36.745, 95% CI (14.778, 91.366) (p_ value = 0.000000), intervention type - HR = 0.187, 95% CI (0.045, 0.779) (p_ value = 0.021281) and serial interventions - HR = 0.282, 95% CI (0.144.0.551) (p_ value = 000213) are independent prognostic factors. Conclusions: The prognostic factors for patients with colorectal cancers operated in emergency are: the age 61, the presence of abdominal surgical history and associated cardiac conditions, especially atrial fibrillation, diagnosis of diastatic perforation imminence, cachexia, oliguria, hydro-electrolytic disorders at admission, rectal tumors, tumor invasion in other organs, the appearance of "frozen pelvis", the presence of liver metastases or peritoneal carcinomatosis, undifferentiated tumors, stage IV, practicing an internal derivation or not performing lymph node dissection. The age over 61, cachexia, as well as peritoneal carcinomatosis, stage III or IV are independent risk factors the Hartmann procedure and the serial interventions are independent protective factors.
Collapse
|
4
|
Dinca AL, Bîrla RD, Dinca VG, Marica C, Panaitescu E, Constantinoiu S. Prognostic Factors in Advanced Ovarian Cancer - A Clinical Trial. Chirurgia (Bucur) 2020; 115:50-62. [PMID: 32155399 DOI: 10.21614/chirurgia.115.1.50] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2020] [Indexed: 11/23/2022]
Abstract
Introduction: Ovarian cancer is one of most fatal gynecological condition. The number of patients diagnosed in advanced stages is very high, hence the recurrence rate is high, and the chance of survival at 5 years is less than 45%. Purpose: To evaluate correspondance between overall survival with clinical, paraclinical, tumor or treatment characteristics and to identify prognostic factors in patients with advanced ovarian cancer - stage III and IV FIGO. Material and Method: We performed a retrospective study in 65 patients with advanced ovarian cancer - stages III and IV FIGO operated during 2010-2018, with a follow-up period of at least one year. There were correlations with clinical and paraclinical charateristics, tumor or treatment characteristics and with overall survival. Results: In the univariate statistical analysis of survival, a significant statistical association is obtained by the presence of pelvic pain at presentation (p_value = 0.033744), with the stage III (p_value = 0.007595, respectively p_value = 0.022090), with the type of citoreduction (p_value = 0.035) , with postoperative complications (p_value = 0.000685) within the pathological subtypes (p_value = 0.046266), with adjuvant treatment (p_value = 0.000083). Cox multivariate regression analysis showed that adjuvant chemotherapy (HR = 0.046, 95% CI = (0.008, 0.261), (p_value = 0.000492), suboptimal cytoreduction (HR = 0.346, 95% CI = (0.140, 0.853), (p_value) = 0.021219) and postoperative complications (HR = 53,751, 95% CI = (4,672, 618,365), (p_value = 0.001389) are independent prognostic factors. Conclusions: Absence of pelvic pain at diagnosis, FIGO IIIC stage, suboptimal cytoreduction, presence of postoperative complications, inadequate adjuvant treatment and pathological type of clear cell cancer have been shown to be prognostic factors for overall survival. In patients with advanced ovarian cancer, the type of optimal citoreduction and adjuvant treatment are independent protective factors for overall survival, and the presence of postoperative complications has been shown to be an independent risk factor.
Collapse
|
5
|
Constantin GB, Firescu D, Voicu D, Ștefănescu B, Serban RMC, Berbece S, Panaitescu E, Bîrla R, Marica C, Constantinoiu S. Analysis of Prognostic Factors in Complicated Colorectal Cancer Operated in Emergency. Chirurgia (Bucur) 2020. [PMID: 32155397 DOI: 10.21614/chirurgia.115.1.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction: In 2018, the colon cancer was the 5th type of neoplasia regarding the cancer mortality and the rectal cancer was the 10th. The survival of patients with colorectal cancer operated in emergency still remains unsatisfactory, the death being due to local recurrences and to metastases. The aim of this study is to evaluate some correlations of overall survival with clinic and paraclinic features, tumor or treatment characteristics in order to identify prognostic factors, for cases with colorectal tumors that underwent emergency surgery. Material and Methods: We performed a retrospective analysis on 431 patients with colorectal cancer operated in emergency between 2008-2017, excluding 40 patients with postoperative deaths, with a follow-up period of at least one year. There were correlations of some clinic and paraclinic features, tumor or treatment characteristics with the overall survival. Results: In the univariate statistical survival analysis, a statistically significant association was obtained with: the age 61 years (p_value = 0.000049), abdominal surgical history (p_value = 0.031725), heart disease (p_value = 0.000007), atrial fibrillation (p_value = 0.007496), preoperative diagnosis (p_value = 0.034352), cachexia (p_value = 0.000000), oliguria (p_value = 0.000000), anemia (p_value = 0.000006) hydro-electrolytic disorders (p_value = 0.000001), tumor localization (p_value = 0.000030), invasion into other organs (p_value = 0.000000), appearance of "frozen pelvis" (p_value = 0.000000), peritoneal carcinomatosis (p_value = 0.000000), liver metastases (p_value = 0.000000), type of surgery (p_value = 0.000000), lymph node dissection (p_value = 0.000001), liver biopsy (p_value = 0.043483), stoma reversal (p_value = 0.000000 ), serial interventions (p_value = 0.000000), pTNM (p_value = 0.000000), tumor grading (p_value = 0.007069). The Cox multivariate regression analysis revealed that: the age 61 years - HR = 1,026, 95% CI (1,012, 1,039) (p value = 0.000139), cachexia - HR = 1,358, 95% CI (1,046, 1,764) (p value = 0.021617), peritoneal carcinomatosis - HR = 2.346, 95% CI (1.163, 4.732) (p_value = 0.017253), disease stage - HR = 36.745, 95% CI (14.778, 91.366) (p_ value = 0.000000), intervention type - HR = 0.187, 95% CI (0.045, 0.779) (p_ value = 0.021281) and serial interventions - HR = 0.282, 95% CI (0.144.0.551) (p_ value = 000213) are independent prognostic factors. Conclusions: The prognostic factors for patients with colorectal cancers operated in emergency are: the age 61, the presence of abdominal surgical history and associated cardiac conditions, especially atrial fibrillation, diagnosis of diastatic perforation imminence, cachexia, oliguria, hydro-electrolytic disorders at admission, rectal tumors, tumor invasion in other organs, the appearance of "frozen pelvis", the presence of liver metastases or peritoneal carcinomatosis, undifferentiated tumors, stage IV, practicing an internal derivation or not performing lymph node dissection. The age over 61, cachexia, as well as peritoneal carcinomatosis, stage III or IV are independent risk factors the Hartmann procedure and the serial interventions are independent protective factors.
Collapse
|
6
|
Birla R, Gandea C, Hoara P, Caragui A, Marica C, Vasiliu E, Constantinoiu S. Clinical and Therapeutic Implications of the 8th Edition TNM Classification of Adenocarcinomas of the Esophagogastric Junction. Chirurgia (Bucur) 2019; 113:747-757. [PMID: 30596362 DOI: 10.21614/chirurgia.113.6.747] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2018] [Indexed: 11/23/2022]
Abstract
The 8th edition of TNM cancer staging is based on data from large patient cohorts, data collected from the Worldwide Collaboration Cancer Esophageal (WECC) group, or the International Association for Gastric Cancer (IGCA), including treated patients surgically per primate or after neoadjuvant treatment. This edition redefines the esophago-gastric junction tumors and recommends different TNMs staging: Siewert type I and II should be classified according to TNM recommendations for esophageal adenocarcinoma, while for Siewert type III the TNM classification for gastric cancer should be considered. Anatomical characteristics feature type T (tumor invasion), type N (regional lymph node invasion) and type M (distant metastasis). Non-anatomic characteristics include tumor differentiation (G) and tumor localization (L). Category descriptors are currently evaluated by endoscopy with biopsy, fine needle aspiration (EUS-FNA), thoraco-abdomino-pelvic computer tomography (CT) and positron emission tomography (CT-PET). The new TNM staging edition presents separate classifications applicable for therapeutic strategy: clinical staging cTNM (prior to any treatment), pathological staging pTNM (after surgery first) and neoadjuvant pathologic staging ypTNM (after neoadjuvant treatment followed by surgery). The refinement of each category and subcategory of T, N, M makes the 8th edition more accurate and adaptable to current practice, including for therapeutic strategy. The purpose of this study is to evaluate the clinical and therapeutical implications of the 8th edition of the TNM staging for esophago gastric junction adenocarcinoma.
Collapse
|
7
|
Galie N, Bucur A, Marica C, Didilescu A, Grigorie V, Dincă O. [Clinical and therapeutical considerations regarding odontogenic acute mediastinitis]. Chirurgia (Bucur) 2009; 104:317-321. [PMID: 19601464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Odontogenic acute mediastinitis is an polymicrobial infections caused in most cases by gram negative and anaerobic germs. The odontogenic origin of the cases in this study was based on anamnestic inquiry of the patients, which reveales a dental treatment 7-15 days before the diagnosis of acute mediastinitis was established. Clinical features are often nonspecific at the debut of this affection; septic shock could appear suddenly associated with multiple systems and organs failure. This is the explication why, some of these patients presented septic shock when are diagnosed. In this situations, when acute mediastinitis is suspected, based on clinical and imaging findings, it must be confirmed by surgical exploration and perioperative bacteriological evaluations. Positive diagnosis is based on clinical features associated with labs and imaging studies. Surgery plays an important role in therapy of acute mediastinitis: debridement and drainage of mediastinum with subsequently lavage of it, using antiseptic solutions. Broad spectrum antibiotherapy should be administrated immediately, before antibiogram is ready.
Collapse
Affiliation(s)
- N Galie
- Secţia de Chirurgie Toracică, Institutul de Pneumologie "Marius Nasta", Bucureşti.
| | | | | | | | | | | |
Collapse
|
8
|
Marica C. Pulmonary tuberculosis in Romania at the dawn of the millennium--a major public health issue. J Med Life 2009; 2:207-10. [PMID: 20108542 PMCID: PMC3018983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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.
Collapse
|
9
|
Marica C, Didilescu C, Galie N, Chiotan D, Zellweger JP, Sotgiu G, D'Ambrosio L, Centis R, Ditiu L, Migliori GB. Reversing the tuberculosis upwards trend: a success story in Romania. Eur Respir J 2009; 33:168-70. [DOI: 10.1183/09031936.00104308] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
10
|
Ibraim E, Diţiu L, Marica C, Husar I, Stoicescu P. [International standards for tuberculosis management]. Pneumologia 2006; 55:175-81. [PMID: 17494273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
International Standards for TB Care describe the international accepted levels of care for TB patients and suspects. The basic principles are the same worldwide: early correct diagnosis, standardized treatment insuring support and supervision, monitoring of the treatment results and highlighting all the public health responsibilities. The Standards provide the possibility to adhere to policies and practices necessary for an efficient control of the disease by all factors involved, including private or other areas. The Standards do not intend to replace local guidelines, but are focused on the relationship between individual care and the control based on community intervention. The article presents briefly the standards for diagnosis and treatment and the responsibilities of public health domain.
Collapse
Affiliation(s)
- Elmira Ibraim
- Institutul de Pneumoftiziologie "Marius Nasta" Bucureşti, Unitatea de Coordonare a Programului National Antituberculos.
| | | | | | | | | |
Collapse
|
11
|
Didilescu C, Marica C, Siteavu V. [BOOP--a rare diagnosis in clinical practice]. Pneumologia 2005; 54:28-30. [PMID: 16193730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The authors present the case of a patient diagnosed in the first place as an idiopathic pulmonary fibrosis with unfavorable evolution (clinical and functional decline under corticosteroid and immunosuppressive treatment). Lung biopsy established the diagnosis of bronchiolitis obliterans with organizing pneumonia (BOOP).
Collapse
Affiliation(s)
- C Didilescu
- Institutul de Pneumologie "Marius Nasta", Bucureşti
| | | | | |
Collapse
|
12
|
Galie N, Marica C, Posea R, Tabacu E. [Current indications of surgical treatment in lung tuberculosis]. Pneumologia 2003; 52:65-8. [PMID: 14702707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- N Galie
- Institutul de Pneumologie Marius Nasta Bucureşti
| | | | | | | |
Collapse
|
13
|
Marica C, Galbenu P, Galie N, Tănăsescu M. [Pulmonary benign lymphocytic angiitis and granulomatosis--a benign lymphoproliferative condition]. Pneumologia 2002; 51:302-5. [PMID: 12693170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BLAG--benign lymphocytic angiitis and granulomatosis is a granulomatosis disease which histologically presents a dense infiltrate of lympnoid cells that disturbes the normal alveolar architecture. Faint granuloma formation occur within the lympnoid infiltrate. A 32 years female patient was admitted for dry cough, exertional dispnea, low fever during last 11 month. Histological diagnosis was BLAG. The treatment was a combination of cyclophosphamide and prednisone. Follow up information after 9 month of treatment show a generally favorable evolution (clinical and radiological).
Collapse
Affiliation(s)
- C Marica
- Catedra de Pneumologie, U.M.F., Carol Davila Bucureşti
| | | | | | | |
Collapse
|
14
|
Galie N, Marica C, Didilescu C. [The impact of modern imaging investigation in thoracic surgery]. Pneumologia 2000; 49:196-9. [PMID: 11232413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- N Galie
- Institutul de Pneumologie Marius Nasta Bucureşti
| | | | | |
Collapse
|
15
|
Didilescu C, Marica C. [Tuberculosis at the Global Congress on Lung Health and the 1997 annual meeting of the International Union against Tuberculosis and Lung Disease (UICTMR), Paris, France, 1-4 October 1997]. Pneumoftiziologia 1998; 47:121-4. [PMID: 10386137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- C Didilescu
- Institutul de Pneumoftiziologie Marius Nasta, Bucureşti
| | | |
Collapse
|
16
|
Popa MI, Niculescu D, Stavri H, Stavri D, Ciomu E, Bogdan M, Marica C, Macri A. [The usefulness of demonstrating the presence of antimycobacterial antibodies. A comparative study of 2 different technics (ELISA and Myco-Dot)]. Bacteriol Virusol Parazitol Epidemiol 1997; 42:179-181. [PMID: 9417291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
|
17
|
Corlan E, Marica C, Macavei C, Stanford JL, Stanford CA. Immunotherapy with Mycobacterium vaccae in the treatment of tuberculosis in Romania. 1. Newly-diagnosed pulmonary disease. Respir Med 1997; 91:13-9. [PMID: 9068812 DOI: 10.1016/s0954-6111(97)90132-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this study, 206 previously untreated patients with sputum culture positive pulmonary tuberculosis were randomized to receive an injection of killed Mycobacterium vaccae as immunotherapy, or of saline as placebo, after 1 month of a 6-month chemotherapeutic regime. Not surprisingly in a disease for which there is good chemotherapy, the difference in numbers which were culture negative at the end of treatment was small, and the final outcome at the latest post-treatment follow-up did not reach statistical significance between the two arms of the study. Nonetheless, those receiving immunotherapy showed better progression in every parameter measured, suggesting faster and more complete cure. Whereas seven of 97 patients receiving immunotherapy required a course of re-treatment and five still had active disease after a mean follow-up of 2 yr, 13 of 109 placebo recipients required re-treatment and nine still had active disease at the end of the study. Only one patient receiving M. vaccae plus chemotherapy died of tuberculosis, compared with four of those receiving chemotherapy alone. A degree of drug resistance was shown by the bacilli cultured from 25 of 175 (14%) patients, and seven of them (4.0%) were multi-drug resistant. Fourteen patients received immunotherapy of whom 13 were cured, including all three of those showing multi-drug resistance. Of the 11 patients with drug resistance in the control group, eight were cured, and one patient with multi-drug-resistant disease died of tuberculosis during re-treatment.
Collapse
Affiliation(s)
- E Corlan
- Institutul de Ftiziologie, Bucharest, Romania
| | | | | | | | | |
Collapse
|
18
|
Corlan E, Marica C, Macavei C, Stanford JL, Stanford CA. Immunotherapy with Mycobacterium vaccae in the treatment of tuberculosis in Romania. 2. Chronic or relapsed disease. Respir Med 1997; 91:21-9. [PMID: 9068813 DOI: 10.1016/s0954-6111(97)90133-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this study of 102 patients with culture-positive chronic treatment failure or repeatedly relapsed pulmonary tuberculosis receiving chemotherapy, 56 received an injection of killed Mycobacterium vaccae as immunotherapy after 1 month of treatment. At the start of treatment, there was little difference between those receiving immunotherapy and the 46 patients in the control group receiving chemotherapy alone. Thereafter, the two groups diverged so that 1 yr later, 43 of 56 (77%) patients receiving M. vaccae had a successful outcome, in comparison with 24 of 46 (52%) patients receiving chemotherapy alone (P < 0.02). Successful results were obtained from patients infected with drug-resistant bacilli, 20 of 32 (63%) patients compared with 11 of 25 (44%) patients, respectively, as well as from fully drug-sensitive cases (23 of 24 compared with 12 of 21 patients; P = 0.004). At the final follow-up after 22 months, 13 of 56 patients receiving immunotherapy had an unfavourable outcome compared with 26 of 46 members of the control group (P = 0.0006). During the study, 16 patients died of tuberculosis (six after immunotherapy), and 12 were lost to follow-up. Not only was bacteriological success improved by immunotherapy, chest X-ray showed markedly better resolution of cavities and other radiological lesions, recovery of body weight was improved, and the mean erythrocyte sedimentation rate returned almost to normal (P < 0.001) in comparison with those receiving chemotherapy alone. These changes were seen even in those failing bacteriological cure, suggesting that the immunotherapy had been effective, but that bacilli were replicating in an extracellular situation, protecting them from its effects.
Collapse
Affiliation(s)
- E Corlan
- Institutul de Ftiziologie, Bucharest, Romania
| | | | | | | | | |
Collapse
|
19
|
Didilescu D, Marica C, Jalbă M. [The incidence and mortality of tuberculosis in children in Romania in recent years]. Pneumoftiziologia 1994; 43:185-8. [PMID: 7767103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The incidence and mortality by tuberculosis in children vary in connection with the tuberculosis in adults. The incidence by tuberculosis in children decreased from 300-313/1000 in 1955-1960 at 7-8%000 in 1985. After the year 1985 the risk of tuberculosis in children had a very clear tendency to increase, from 7.4%000 in 1986 at 12.7% in 1990 and to a maximum of 20.7%000 in 1993, an equal level to that from 17 years ago. Mainly, this increase is due to the deterioration of the living conditions of the population from the period 1980-1989, continued thereafter too, to the great number of cases of AIDS [correction of SIDA] recorded in children in Romania, that, associated to the high yearly risk of tuberculous infection, facilitated the appearance of new cases of infection HIV/AIDS [correction of SIDA] + tuberculosis. The most exposed to tuberculosis is the group of age 0-4 years. In the last years the percentage of the extrarespiratory settings of tuberculosis was of about 18%, and the percentage of severe cases was about 11% from the incidence. The mortality by tuberculosis in children increased from 4.5%000 in 1986 at 10.0%000 in 1993, but its lethality remained negligible.
Collapse
Affiliation(s)
- D Didilescu
- Institutul de Pneumoftiziologie Marius Nasta, Bucureşti
| | | | | |
Collapse
|
20
|
Marica C, Mitrea M, Rohan I, Anastasatu C. [The efficacy of ethambutol compared to streptomycin in the initial quadruple phase of short-term regimens]. Pneumoftiziologia 1992; 41:99-101. [PMID: 1342819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In order to test comparatively SM and EMB efficacies within quadruple regimens of short-term chemotherapy, two groups of patients with pulmonary tuberculosis at first treatment, sputum positive under microscopic examination, were constituted through randomization. One group (59 cases) was submitted to the standard regimen RHSZ 2/7, and the other (61 cases) to RHZE 2/7. Group structure was homogeneous from the standpoint of case repartition, according to the anatomo-radiological form, therapeutical regimen, and sensitivity to Tb drugs. Both bacteriological and radiological clinical evolutions show, even in the conditions of a short-time interval (2 months), a similar efficacy of SM and EMB within the quadruple regimens in the initially intensive phase of anti-Tb treatment. It is possible that the results may be dependent upon the concomitantly bactericidal action of: rifampicin, hydrazide and pyrazinamide. Therefore, a further testing of the comparative efficacy of the triple regimen RHZ 2/7 with the quadruple RHSZ 2/7 and RHZE 2/7 during a longer follow-up is required.
Collapse
Affiliation(s)
- C Marica
- Institutul de pneumoftiziologie, Bucureşti
| | | | | | | |
Collapse
|
21
|
Marica C, Galbenu P. [The problems of clinico-morphological diagnosis in a case of fatal hemoptysis]. Rev Ig Med Muncii Med Soc Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol 1990; 39:187-91. [PMID: 2131817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
28 children with bronchial asthma, between 6 and 18 years old, were followed by a varied period of time 3 months - 5 years. 7-8 functional tests were carried out. The cases were studied in different clinical phases: asymptomatic, manifest, crisis of bronchial asthma. The functional pulmonary investigation included: spirographic examination [vital capacity (VC), maximum expiratory volume per second (MEVS) the VC/MEVS ratio], plethysmographic examination (VGT, Raw), measurement of the maximum instantaneous expiratory flows on the flux-volume curve (MEF50). The average value, standard residual deviation and the variation coefficient were calculated for each parameter studied in different clinical moments. The results are presented on 3 groups: per total, symptomatic and asymptomatic. The analysis of the data found showed that the variation of the parameters measured during repeated functional examinations in children with bronchial asthma ranges within broad limits (2.9%-11.5%); the broadest variation was recorded for Raw followed by MEF50 and the slightest variation was that of the VC/MEVS ratio. This indicated the lower value of the information furnished by this ratio in children in appreciating the presence or severeness degree of the obstructive syndrome.
Collapse
Affiliation(s)
- C Marica
- Clinica de Ftiziologie, I.M.F. Bucureşti
| | | |
Collapse
|
22
|
Corlan E, Marica C. [Characteristics of the evolution of pulmonary tuberculosis in a female patient with Wegener's granulomatosis]. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol 1989; 38:61-7. [PMID: 2554471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
23
|
Anghel S, Rusănescu M, Dbrescu C, Moldovan T, Marica C, Barbu R, Popescu P. [Indices of left ventricular involvement in chronic cor pulmonale]. Rev Med Interna Neurol Psihiatr Neurochir Dermatovenerol Med Interna 1985; 37:165-9. [PMID: 2862680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
24
|
Marica D, Vasiu C, Vesa S, Marica C. [Inter- and intraspecific relationship between bacterial hemolysins. III. Identification of masked toxins in the exotoxin complex of Staphylococcus pyogenes und Cl. perfringens; significance of their existence for clarifying of the masking mechanism]. Zentralbl Veterinarmed B 1975; 22:335-43. [PMID: 169656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|