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Sibiu, Romania

Marinescu P.,Public Health Direction | Manolescu L.S.C.,Carol Davila University of Medicine and Pharmacy
Romanian Biotechnological Letters | Year: 2012

Objectives: Human immunodeficiency virus (HIV) can affect the central nervous system and determine HIV encephalopathy (HE). Evidence of hepatitis B virus (HBV) was found in cerebrospinal fluid in HIV co-infected patients. Here we assessed the degree of association between HBV infection and prognosis of HE in a large cohort of 462 HIV infected patients over a ten years period and the role of nadir CD4 cell count. Materials and methods: HIV encephalopathy, HBV infections markers, HIV RNA and CD4cell were measured and retrospectively analyzed. Results: The prevalence of HE was 22. 7%. More than half, 50.4% of the patients with HE presented HBV infection. Among the fifty three patients that presented at the same time HE and HBV infection, more than half, 66.03%, were first infected with HBV and then developed HE. It is possible that HBV infection is a risk factor for developing of HE. Further studies are needed to prove the HBV neurotropic potential. Conclusions: The prognosis of HE was not significantly different in HBV presence or under antiretroviral treatment. Absolute CD4 nadir count and class C3 are proved to be strong predictors of HE in HIV infected patients even after several changes in antiretroviral therapy schemes. © 2012 University of Bucharest. Source


Mihaila R.-G.,Lucian Blaga University | Ciuta D.,Lucian Blaga University | Mihaila R.,Public Health Direction
Archives of the Balkan Medical Union | Year: 2010

Backgrund: Statins lower the cholesterol synthesis but also induce selective apoptosis and inhibit the proliferation of leukemic cells. Besides, they inhibit P-glycoprotein, which is involved in multidrug resistance. Methods: We made a clinical trial on all the patients present in the database of the Hematology Department of the Emergency Departmental Clinical Hospital Sibiu in november 2009 who were diagnosed with chronic lymphocytic leukemia, and who agreed to participate in this trial and also had no counterindications for statins. Flowcytometrically we determined the expression of P-glycoprotein in lymphocytes from peripherical blood. Patients with P-glycoprotein positive recieved lovastatin (80 mg/ day, 6 days), after which the flowcytometric exam was repeated. Before the treatment, we carried out hemoleucogram, and before and after the treatment biochemical tests were determined. The results were statistically analyzed. Results: From 27 analyzed patients, P-glycoprotein was expressed on 6 (in average, 20±8.34% of lymphocyte were positive). After lovastatin treatment, the percent of positive lymphocyte for P-glycoprotcin diminished to 7.33%. Statistically the difference was significant (p = 0.016). The decrease was of 63.35% in comparison with the initial P-glycoprotein- positive lymphocyte number. Between the performed testes only cholesterolemia decreased from average 230.2±69.27 mg/dl to 183.2±42.3 mg/dl (p < 0.05) (an average decrease of 20.42%). Patients had no clinical or biological manifestations which could be considered as side effects. Conclusions: The 6 day administration of lovastin to chronic lympocytic leukemia patients significally decreased the cholesterol and the number of lymphocytes which expresses P-glycoprotein, sugesting that it could be an adjuvant treatment by lowering multidrug resistance, especially followed by conventional chemotherapy. Copyright © 2010 CELSIUS. Source


Mihaila R.-G.,Lucian Blaga University | Rezi E.-C.,Medical Clinic II | Nedelcu L.,Transylvania University | Mutu C.,Neurology Clinic | And 4 more authors.
Archives of the Balkan Medical Union | Year: 2011

Background: Hepatitis C virus infection is frequent, but its effects on the nervous system are less known. Methods: We studied the neuropsychic disorders of the patients with viral hepatitis C without prior interferon treatment. Results: Out of the 22 included patients, 36.36% presented neurologic disorder, probably linked to the viral hepatitis C infection. 50% of them had psychiatric disorders. The value that quantifies the asthenia on the Piper Scale in the group of patients was 4.0036±1.90 (moderate degree of asthenia). In 18.18% of the patients were pathological modifications of the electroencephalographic signals. There was no correlation between the analyzed hepatic tests and the presence of neurologic and psychiatric disorders or the alterations of the electroencephalographic signals. Conclusions: The neurologic disorders potentially induced by the hepatitis C virus, affected over one third of the studied patients and the psychiatric disorders - half of them. The average degree of asthenia of the study group was moderate. Copyright © 2011 CELSIUS. Source


Manolescu L.,Carol Davila University of Medicine and Pharmacy | Marinescu P.,Public Health Direction
Revista Romana de Medicina de Laborator | Year: 2013

Introduction: Prior studies assessing sex differences correlated with the levels of human immunodeficiency virus (HIV) RNA and absolute CD4 cell count in adults and children, treated or untreated with antiretroviral (ARV) therapy presented conflicting results. Objective: To assess comparative HIV RNA levels and absolute CD4 cell count in men and women from a large cohort of HIV-infected long term survivors patients. Methods: 462 HIV infected patients were analyzed cross-sectionally and longitudinally after being split into three groups: 156 naïve deceased patients, median age at death 10 years, 197 ARV treated patients, median age 17 years and 109 ARV treated patients, median age 23 years followed up until 2011. HIV RNA and absolute CD4 cell count were measured in all patients enrolled in the study. Results: In cross-sectional analysis of 156 naïve patients HIV RNA median levels were lower in females comparing to males, 4.95 vs. 5.73 HIV RNA log10 (copies/ml). Female absolute CD4 cell count was slightly higher, (median 97 vs. 65.5 cells/μL; P = 0.0001). Cross-sectional analysis of 197 ARV treated patients showed a lower log10 HIV RNA level in females compared to males, (P=0.0001), and also lower median CD4 count values in women, 336 cells/μL vs 456 cells/μL in men, P=.0001. Longitudinal analysis revealed statistically significant results: mean log viral loads were lower in females (F=13.90, P= 0.0009) and absolute CD4 cell count was lower in malse (F=16.72, P<0.0001), almost across all tested ages. Conclusion: We report steady sex differences in HIV RNA levels and absolute CD4 cell count in ART-treated HIV-infected patients, a fact that may suggest a reevaluation of our current treatment strategies according to sex. Source


Bamia C.,National and Kapodistrian University of Athens | Lagiou P.,National and Kapodistrian University of Athens | Lagiou P.,Academy of Athens | Lagiou P.,Harvard University | And 61 more authors.
International Journal of Cancer | Year: 2015

Inverse associations of coffee and/or tea in relation to hepatocellular carcinoma (HCC) risk have been consistently identified in studies conducted mostly in Asia where consumption patterns of such beverages differ from Europe. In the European Prospective Investigation into Cancer and nutrition (EPIC), we identified 201 HCC cases among 486,799 men/women, after a median follow-up of 11 years. We calculated adjusted hazard ratios (HRs) for HCC incidence in relation to quintiles/categories of coffee/tea intakes. We found that increased coffee and tea intakes were consistently associated with lower HCC risk. The inverse associations were substantial, monotonic and statistically significant. Coffee consumers in the highest compared to the lowest quintile had lower HCC risk by 72% [HR: 0.28; 95% confidence intervals (CIs): 0.16-0.50, p-trend < 0.001]. The corresponding association of tea with HCC risk was 0.41 (95% CI: 0.22-0.78, p-trend50.003). There was no compelling evidence of heterogeneity of these associations across strata of important HCC risk factors, including hepatitis B or hepatitis C status (available in a nested case-control study). The inverse, monotonic associations of coffee intake with HCC were apparent for caffeinated (p-trend50.009), but not decaffeinated (p-trend50.45) coffee for which, however, data were available for a fraction of subjects. Results from this multicentre, European cohort study strengthen the existing evidence regarding the inverse association between coffee/tea and HCC risk. Given the apparent lack of heterogeneity of these associations by HCC risk factors and that coffee/tea are universal exposures, our results could have important implications for high HCC risk subjects. © 2014 UICC. Source

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