Biomedical subjects

Mirela Danila

Publications and source records attributed to Mirela Danila.

5 recordsLinked to original sources

PubMed2006

Pegylated-interferon alpha 2a treatment for chronic hepatitis C in patients on chronic haemodialysis.

AIM: To evaluate the response to pegylated-interferon alpha 2a in chronic hepatitis C patients on chronic haemodialysis. METHODS: Ten patients with chronic C hepatitis were enrolled in this study. All had increased aminotransferases for more than 6 mo, positive antiHCV antibodies and positive PCR HCV-RNA. We administrated Peg-Interferon alpha 2a 180 microg/wk for 48 wk. After 12 wk of treatment we evaluated the biochemical and early virological response (EVR). At the end of the treatment we evaluated the biochemical response and 24 wk after the end of the treatment we evaluated the sustained virological response (SVR). We monitored the side-effects during the treatment. RESULTS: Two patients dropped out in the first 12 wk of treatment and 2 after the first 12 wk of treatment. After 12 wk of treatment, 7 out of 8 patients had biochemical response and EVR and 1 had biochemical response but persistent viremia. We had to reduce the dose of pegylated-interferon to 135 mug/wk in 2 cases. Three out of 6 (50%) patients had SVR 24 wk after the end of the treatment. Intention-to-treat analysis showed that 3 out of 10 patients (30%) had SVR. Side-effects occurred in most of the patients (flu-like syndrome, thrombocytopenia or leucopoenia), but they did not impose the discontinuation of treatment. CONCLUSION: After 12 wk of treatment with Peg-Interferon alpha 2a (40 ku) in patients on chronic haemodialysis with chronic C hepatitis, EVR was obtained in 87.5% (7/8) of the cases. SVR was achieved in 50% of the cases (3/6 patients) that finished the 48 wk of treatment.

Adult↗

PubMed2005

Colonoscopy in Romania.

BACKGROUND: To date, colonoscopy is considered the gold standard for the investigation of the colon and also the gold standard method for colorectal cancer screening. AIM of this paper was to assess if and how is Romania prepared to cope with screening of colon cancer by means of colonoscopy. METHOD: We sent a study-type questionnaire addressed to all the centers in Romania known to perform digestive endoscopy and we inquired about the total number of colonoscopies and flexible sigmoidoscopies performed in 2003 (the questionnaire was sent to 43 centers). RESULTS: Thirty-eight centers responded to the question-naire. The total number of colonoscopies performed in Romania in 2003, obtained by collecting the data from the study centers, was 22,324. The number of sigmoidoscopies performed during the same period was 12,349. The ratio between the number of colonoscopies and sigmoidoscopies was 1.8/1. There were 106.3 colonoscopies /100,000 inhabitants. CONCLUSION: Considering the population of Romania (about 21 million inhabitants), the number of colonoscopies performed is insufficient for our country. The number of centers performing colonoscopy in Romania is also insufficient.

Colonic Neoplasms↗

PubMed2005

Sedation during colonoscopy.

In order to perform a proper screening for colonic cancer, repeated colonoscopies are required. Comfort during colonoscopy is very important, so that the patient will accept repeated procedures. Currently, there are 3 types of sedation used during colonoscopy: general anesthesia performed by an anesthesiologist; sedo-analgesia performed by an anesthesiologist or by a gastroenterologist; sedo-analgesia performed by a trained nurse. Sedo-analgesia is the most frequently used type of sedation during colonoscopy worldwide. It is realized by combining midazolam with propofol and/or fentanyl (alfentanyl) or pethidine. According to the data obtained from 34 centers performing colonoscopy in Romania, in 2003, 22,162 colonoscopies were performed: 54.5% without anesthesia, 39.5% with sedation with midazolam and 6% with sedo-analgesia. In a study performed in our department we noticed a significant improvement in the outcome of the colonoscopy when sedo-analgesia was used on a regular basis. The percentage of total colonoscopies (excluding those that could not be continued due to stenosis) was 84.2% when sedation was seldomly performed and 92.3% when sedo-analgesia was regularly used (p=0.042). We believe that the strategy of sedation during colonoscopy in Romania should be changed so that all the patients should benefit from sedo-analgesia, proved to be safe and cost/efficient.

Colonoscopy↗

PubMed2004

Peg-Interferon Alfa 2a (40kDa) in patients on chronic haemodialysis with chronic C hepatitis. Preliminary results.

The aim of the study was to evaluate the response to Pegylated Interferon alpha2a (40 kDa) in patients on chronic haemodialysis with chronic C hepatitis. 10 patients were enrolled in this study (4 males and 6 females). All had increased aminotransferases, anti HCV antibodies and PCR HCV-RNA positive. We administrated Peg-Interferon alpha2a 180 microg/week for 48 weeks. One patient was excluded from the study because of lack of compliance. We had to stop the treatment in one patient due to complications after surgery. After 12 weeks of treatment we evaluated the biochemical and virological response. We continued with Peg-Interferon until 48 weeks. Six patients finished the treatment. After 12 weeks of treatment with Peg-Interferon alpha 2a (40 kDa) in patients on chronic haemodialysis with chronic C hepatitis, the virological response (HCV-RNA absent by PCR) was obtained in 87.5% (7/8) of the cases. All patients who finished the 48 weeks of treatment had normal transaminases (biochemical response) (6/6). We had to reduce the dose of Peg-Interferon in only 2 cases. Even if side-effects occurred in most of the patients (flu-like syndrome, thrombocytopenia or leucopenia) they did not impose the discontinuation of treatment. The sustained response will be established by determining PCR RNA-HCV 6 months after the end of the treatment.

Adult↗

PubMed2004

Ultrasound assisted liver biopsy for the staging of diffuse chronic hepatopathies.

Liver biopsy is the most accurate method for the staging and grading of diffuse hepathopathies. In viral hepatitis staging is required in order to assess firstly if the patient should be treated or not and, secondly, to assess the prognosis. In alcoholic and non-alcoholic steato-hepatitis we only appreciate the prognosis by staging, because the therapy is the same. In this study we analyze the experience of our centre in performing ultrasound-assisted liver biopsies in diffuse chronic hepatopathies. Between 1993-2003 we performed 1460 ultrasound-assisted liver biopsies, all on inpatients, in 93.8% of the cases for the evaluation of viral hepatitis. In the last few years we used sedation with midazolam i.v., the saturation of O(2) being recorded. In the 10 years of the study we encountered one major complication (haemo-peritoneum) (0.07%), treated by conservative methods. The minor complications we encountered, pain and discomfort, were always alleviated by minor analgesics. Vaso-vagal reactions were frequent before we started using midazolam (8.05%), but were no longer present after we performed sedation. None of the liver biopsies was followed by the death of the patient. In 1.37% of the cases we obtained inadequate liver specimens. We performed multiple passages in 0.96% of the cases. In conclusion, ultrasound-assisted liver biopsy is still the "gold standard" of hepatologic evaluation, being a safe and accurate method for staging the diffuse chronic hepatopathies.

Biopsy, Needle↗