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Alexa T.,Regional Institute of Oncology | Lavinia A.,Pneumology Hospital | Luca A.,Grigore T. Popa University of Medicine and Pharmacy | Miron L.,Grigore T. Popa University of Medicine and Pharmacy | Alexa I.D.,Grigore T. Popa University of Medicine and Pharmacy
Wspolczesna Onkologia | Year: 2014

Aim of the study: To compare patient's characteristics, clinical data, and rates of chemotherapy discontinuation in advanced NSCLC (non-small cell lung cancer) patients treated with platinum-based association chemotherapy (elderly vs. younger counterparts). To evaluate if there are certain factors that can predict discontinuation of chemotherapy.Material and methods: A retrospective analysis of all cases of advanced NSCLC treated with either cisplatin- -gemcitabine or cisplatin-vinorelbine at the Regional Institute of Oncology Iasi between January 2012 and December 2013 was performed. Patients were divided into two groups: over 70 years old and under 70 years old. Patient's characteristics and clinical data (including whether or not the patient discontinued treatment) were recorded for each case.Results: The elderly patients had more comorbidities (p = 0.003), were prescribed a larger number of pills (p = 0.02), and had longer periods of hospitalisation (p = 0.005). No difference in toxicity was noted between the two groups. Five patients chose to discontinue chemotherapy in the elderly group. Only two patients made the same choice (p = = 0.02) in the younger group. Correlation analysis revealed that refusal of further chemotherapy was associated with the length of hospital stay, number of pills per day, and smoking status.Conclusions: Geriatricians should minimise iatrogeny and polypharmacy by optimising long-term treatment. This will increase the chance that elderly patients will not discontinue chemotherapy. Hospital stay should be reduced to a minimum. As life span increases so does the number of elderly patients with cancer; it is vital to understand and prevent the causes of chemotherapy discontinuation in order to achieve optimal therapeutic results.

Ioan B.,Grigore T. Popa University of Medicine and Pharmacy | Alexa T.,Regional Institute of Oncology | Alexa I.,Grigore T. Popa University of Medicine and Pharmacy
Romanian Journal of Legal Medicine | Year: 2014

Introduction. the correct registration of the external traumatic lesions is extremely important in the clinical management of the trauma, as well as in its forensic and judicial assessment. Nevertheless, the quantity and quality of the information registered in the observation charts may be suboptimal, thus significantly affecting the forensic assessment regarding the cause of death, the relationship between lesions and death, and therefore the judicial implications of the case. Material and method. We have conducted a study on a sample of 77 consecutive deaths by violence, all examined at the Institute of Legal Medicine in Iasi. A comparative analysis was conducted of the external lesions documentation in the observation chart and the forensic autopsy report, and a degree of consistency was established between the two. For each case a series of data was collected and then statistically analyzed in order to observe the existence of a correlation between the degree of accordance and of the two examinations and the registered parameters. Results. the present study has found 62.3% discordant cases. From the selected parameters, three were correlated to the degree of concordance, having the capacity to foretell whether an external lesion would be registered correctly in the observation chart: the biochemical analysis level - patients who received complete blood investigations were more frequently subject to complete skin examination in the clinic; the existence of a surgical intervention - concordance was higher in patients who suffered a surgical intervention during hospitalization; cause and context of death - patients who died as a result of burns or electrocution showed perfect concordance in 100 % of cases, while less than 3 % of patients who died in the context of aggression were recorded all types of injury. Conclusions. Better documentation of external injuries in hospital is many times essential for the medico-legal evaluation and the subsequent judicial implications. While there are factors that may explain the disregard of the registration of all traumatic marks, in the context of lack of time and the need for quick delivery of treatment, the importance of the observation sheet as a document of medico-legal and legal value must be recognized by all physicians. © 2014 Romanian Society of Legal Medicine.

Antoniu S.A.,Grigore T. Popa University of Medicine and Pharmacy | Puiu A.,Regional Institute of Oncology | Zaharia B.,Center Hospitalier Auxerre | Azoicai D.,Grigore T. Popa University of Medicine and Pharmacy
Expert Review of Pharmacoeconomics and Outcomes Research | Year: 2014

Hospitalisations for chronic obstructive pulmonary disease (COPD) exacerbations are characterised by a significant worsening of the respiratory symptoms which can impair the health status (HS). However little is known on the HS behaviour during such events. Prospective study evaluating the validity of the Clinical COPD Questionnaire (CCQ) as a HS measure in hospitalisations for COPD exacerbations. The CCQ total score (CCQ-T) correlated with EQ-VAS (-0.51, p < 0.0001), was able to discriminate between longer and shorter duration hospitalisation (CCQ-T 3.83 vs 3.03, respectively p = 0.001), had a Cronbach-α of 0.86, and improved significantly over the hospitalisation period (CCQ-T on day 7 of hospitalisation 2.55 vs 3.77 at baseline, p < 0.0001). CCQ is an excellent tool for the assessment of the HS dynamics in hospitalisations for COPD exacerbations. © 2014 Informa UK Ltd.

CApilna M.E.,University of Medicine and Pharmacy of Targu Mures | Szabo B.,University of Medicine and Pharmacy of Targu Mures | Becsi J.,University of Medicine and Pharmacy of Targu Mures | Ioanid N.,Regional Institute of Oncology | Moldovan B.,St. Constantin Hospital
International Journal of Gynecological Cancer | Year: 2016

Objective Cervical cancer is one of the most frequent malignant diseases diagnosed during pregnancy. Abdominal or vaginal radical trachelectomies are fertility-preserving alternatives to radical hysterectomy for young women with early-stage cervical cancer that can be performed during ongoing pregnancy. Methods A literature review of articles on this subject was conducted through a Medline search for articles published in English or French. Results At this moment, 21 cervical cancer patients, including ours (4 stage IA2, 16 IB1, and 1 IB2) who underwent radical trachelectomy during pregnancy have been reported. Of these, 10 were performed by vaginal route and 11 were abdominal radical trachelectomies. Conclusions Radical trachelectomy could be offered as an option for pregnant patients with early invasive cervical cancer. It may help women avoid the triple losses of a desired pregnancy, fertility, and motherhood. © 2016 by IGCS and ESGO.

Makkai-Popa S.-T.,Grigore T. Popa University of Medicine and Pharmacy | Makkai-Popa S.-T.,Regional Institute of Oncology | Lunca S.,Regional Institute of Oncology | Tarcoveanu E.,St Spiridon University Hospital | And 2 more authors.
Romanian Journal of Morphology and Embryology | Year: 2014

The current literature related to colorectal cancer shows there is a great inhomogeneity in patient outcome, even between patients in the same stage, which means that the TNM staging does not seem enough anymore to make a therapeutic decision. This is why many of the recent studies focus on the study of prognostic and predictive factors that would make the therapeutic decision-making process more accurate. In the current study, we focused on the study of two lymph node based scores - the lymph node ratio and the log odds ratio and the morphological characteristics of the tumor to try to see if any of them can predict a more aggressive tumor behavior in order to approach the patient in an appropriate way. The study included 25 patients presenting over a period of two years (2009-2011) for a local relapse or a metastasis after curative surgery for colorectal cancer. From the morphological characteristics of the tumor, only the protruding character of the tumor positively correlated at a statistically significant level with the recurrence-free time. We also proved that between the two lymph node scores and the pN stage, the log odds ratio was the one that best correlated with both the number of invaded lymph nodes and the number of resected nodes. The log odds ratio also proved to correlate well with the risk of developing a distant metastasis. Our study also shows for the first time that the log odds ratio is able to stratify patients according to their risk of a fast relapse.

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