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Biomedical subjects

C Didilescu

Publications and source records attributed to C Didilescu.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[A study of the risk factors for relapse in pulmonary tuberculosis patients and the results of the re-treatment].

The percentage of relapses among the global TB incidence in Romania increased from 7.7% in 1990 to 13.1% in 1999. The study group included 648 cases with relapsing lung tuberculosis, registered in the second semester, 1997. In more than half of the cases (54.9%) the relapse occurred in the 5 years following the healing of the previous episode. The percentage of 65.5% smear positives represents an increase compared to the first episode (61.7%) and illustrates the severity of these cases. From the first to the second episode, there was an increase of the percentage of "unemployed" and "retreated". Associated diseases were: COPD (10.6%), peptic ulcer (10%) and chronic hepatitis (9.6%). We found high percentages for drinking habits (46.9%) and smoking (41.5%). The re-treatment resulted in only 49% healing, compared to 75.7% at the first episode. This calls for an improvement of initial chemotherapy as well as re-treatment (introducing DOTS).

Female↗
PubMedDate not supplied

[Diagnosis and treatment of a case of obstructive sleep apnea syndrome with AutoSet].

The author presents the case of a male patient with obstructive sleep apnoea syndrome, in which the use of classic CPAP therapy after performing an uvulo-pharyngoplasty (UVPP) led to very good results. The pressure levels determined initially after a polysomnography with Apnoe Check were compared with the results of the measurements with another device, AutoSet, used for the first time in our country. This allowed the tapering of pressure levels for CPAP and also revealed other advantages of the device, reviewed here.

Adult↗
PubMedDate not supplied

[Evolution of tuberculosis in the District of Dolj].

The 742,500 inhabitants of Dolj District face a high risk of TB since over 10 years. In 1992 the TB incidence was 93.7@100,000 and 155.7@100,000 in 2000 (66% increase). A number of 1156 TB patients were registered in year 2000, 84% new cases and 16% relapses. 82% of the patients had lung lesions, 11.9% had pleurisy and 6.1% had various extra-thoracic lesions. Bacteriologic confirmation was 67.7%. The periodic prevalence of smear positive patients, with a high level of 139@100,000 in 1999, determined a high risk for disease among children, also, the TB incidence in this category being 46.8@100,000. The evaluation of treatment results in a cohort of smear positive patients registered in 1999 showed a success rate of only 75.5%. The decrease of the TB endemy level in Dolj district depends on improvement of life status in the district, complete use of DOTS and a good financement of all parts of the National TB Control Program in 2001-2005.

Adult↗
PubMedDate not supplied

[The exclusively outpatient treatment of pulmonary tuberculosis under the conditions in Romania].

In order to demonstrate the possibility of an exclusively outpatient treatment of pulmonary tuberculosis in the present conditions in our country, a study was performed on 140 cases in Bucharest. The admission criteria were as follows: sputum negative patients (M-C-); paubacillary cases, sputum positive only in culture (M-C+); Tb pleuritis; patients refusing hospitalization, regardless their bacteriological status, and sputum positive cases also at smear examination (M+C+), if they had no household contacts under 20 years of age or with a good social economic standard of life. The patients were given the intensive chemotherapy regimen HSRZ 2/7 for 6 months, that was prolonged to 9 months in specified cases. A number of 31 patients were non-bacillary (M-C-) out of which 14 cases with pleuritis; 70 were paucibacillary (M-C+), and 39 were smear positive (M+C+). Out of 109 patients which were bacteriologically confirmed, sputum reversion in culture was obtained in 71.6% of cases at 2 months and in 89.0% at 3 months. At treatment end, sputum negativation was not obtained in a single patient (0.9%). Case follow-up for 6-41 months after treatment end led to the registration of 8 therapeutical failures and bacteriological relapses (5.7%). Five cases recovered through re-treatment, 1 patient (0.7%) died through tuberculosis, and 2 (1.4%) became chronic case. Periodical control of the 95 contact children in the respective households revealed a single conversion of the tuberculin reaction and no Tb case after treatment start in index cases, which proves the epidemiological reliability of the method.

Adolescent↗
PubMedDate not supplied

[The evolution and structure of morbidity from extrarespiratory tuberculosis in the last 15 years in Romania].

Though in comparison with the overall lethality of tuberculosis the extra-respiratory localizations of the disease showed a markedly less weight than the respiratory ones during the past 15 years (12.8% in 1975 and 6.7% in 1989), this pathology chapter is still essential due to the diversity of Tb forms and localizations. The annual average rate of the decrease in extra-respiratory tuberculosis incidence was of 4.8% between 1975-1989, so the incidence value reached 4.2%000 at the end of the last year of study. Just like 15 years ago, in 1989 the extra-respiratory tuberculosis incidence was dominated by the localizations on the peripheral lymph nodes (1.2%000), on bones and joints (1.0%000), urogenital apparatus (0.7%000), meninges and central nervous system (0.5%000). The prevalence of patients with extra-respiratory Tb localizations was gradually diminished so that only 3415 cases were registered in the IIIrd group of the active case-index in 1989 (13,524 in 1975). More than half of the number of deaths through extra-respiratory tuberculosis were still due to tuberculous meningitis, particularly in children aged 0-4 years (82% of deaths in 1989). A further diminution up to a total elimination of extra-respiratory Tb localizations (still about 1,000 new cases a year) can be reached only by a restriction and liquidation at the same time of both primary and secondary pulmonary tuberculoses.

Adolescent↗
PubMedDate not supplied

[The epidemiological aspects of tuberculous pleurisy in Romania].

The re-organization of the Tb network in Romania, which took place after 1948, made possible a gradual accumulation of a number of data on the epidemiological surveillance of the territory, including the tuberculous pleurisies. The incidence of tuberculous pleurisies showed a decrease from 30.7/100,000 to 4.2/100,000 between 1958 and 1985, followed by a "stagnation" at 4.3/100,000 for 1986-1989. In 1990, the incidence of Tb pleurisy reached 6.8/100,000. The weight of pleural localization among the respiratory ones was maintained 15%-13% for 1960-1980, with a subsequent diminution up to 7.9% in 1989. By age-groups, the incidence of Tb pleurisy was at its highest level (19.1/100,000) at the age of 20-24 years in 1990 (as well as in 1972, 1980 and 1985). The present time imperative is the improving of the etiological diagnosis of pleurisies by a larger accessibility to the histological (pleural biopsy puncture) and bacteriological investigations.

Adolescent↗
PubMedDate not supplied

[Marketing and mortality with tobacco in front line].

Tobacco is an economical force. To make some people rich, by mankind paying the price, which--for years--count hundreds and hundreds of billions of dollars and millions of human lives. After 1990, in Romania tobacco plantation was not profitable anymore and as a consequence, we registered a diminution of tobacco cultivated surfaces, that reached 0.1% of total arable surface (in 1997 the lowest among similar surfaces in South-Eastern European countries). The original production of fermented tobacco decreased at the same rate. Cigarette consumption at the country level remains the same, the "supply" of cigarettes being assured by massive imports, under licensed production and smuggling. The mortality by different diseases due to smoking, is increasing progressively in the interval 1997-2002. The increase rate of mortality by broncho-pulmonary neoplasm was 127% in men and 95.7% in women. In cerebrovascular diseases case the same indicator between 1998-2002 has values of 2.1% in men and 3.9% in women. The presentation of those gravity elements base the purpose of touching all the factors who complete in present to the application of individual and global strategies of smoking control in our country.

Cerebrovascular Disorders↗
PubMedDate not supplied

[BOOP--a rare diagnosis in clinical practice].

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).

Adult↗
PubMedDate not supplied

[3 successive radiophotographic surveys in a rural territory].

Three detections, carried out over a period of two years gave the following results: a high rate was obtained in the first one while the following two gave lower rates, in parallel with a decrease of the overall incidence through pulmonary tuberculosis from 326.70/0000 in 1968 to 1440/0000 in 1973. The cases were recently detected, during the last two investigations, which allowed for a wider application of the ambulatory treatment, a fact that compensated from the financial view point the cost of radiophotographic investigations. The authors suggest the maintenance of integral detection, with the same periodicity in the rural environment.

Humans↗
PubMedDate not supplied

[The late results of short-term chemotherapy in benign forms of tuberculosis in children].

The study included 359 cases of primary tuberculosis (benign forms) in children aged 0-14 years, out of which 181 non-complicated and 178 complicated forms. The therapeutical regimens were: 3HEZ2/3HE2 (study subgroup) and 6HE2/3H2 (control) for non-complicated forms, and 3HRZ2/3HR2 (study subgroup) and 3HES2/3HE2/3H2 (control) for complicated ones. Late results (5 years after treatment end) were very good (from clinical, radiological, bacteriological points of view) in 100% of cases. Thus, short-course regimens are preferable to longer ones (over 6 months) in the chemotherapy of the benign forms of pulmonary tuberculosis in children.

Adolescent↗
PubMedDate not supplied

[Aspects of integral anti-tuberculosis chemotherapy in 15 rural medical stations of the Constanţa district].

The study of aspects of integration of chemotherapy during the initial stages of the anti-tuberculous treatment, carried out in 15 rural medical circumscriptions in the Constantza and mpedgidia anti-tuberculous dispensaries, has demonstrated the applicability of standardized chemotherapy schemes at the level of general practice network. The personnel working in the frame of this network showed considerable interest and preoccupation with the optimal achievement of the strictly supervised treatment. The results of bacteriological controls (direct BK examination and cultures), indicated that in 97,4% of the cases these results are maintained negative in patients that could be evaluated. An assessment of this action revealed that the indices showing the incorporation of patients in the strictly supervised treatment as well as the regularity of the administration have been very good.

Ambulatory Care↗