Cancers have been recognized as a major health problem in patients with HIV. The first cases reported, before the existence of the virus was proven, involved patients with immunosuppression and a history of illness characterized by fever, weight loss and/or lymphadenopathy lasting weeks of months. As the population grows older, a consequence of better and largely available treatments, the impact of non-AIDS-defining cancers (NADC) is having a greater impact on the management of HIV infected patients. Studies of different subtypes of HIV-1 in Romania show a very high prevalence of subtype F1, with values between 70% - 90% or the patients being infected with this strain. The study of HIV infected population in Romania is important for identifying particularities of the subtype F1 evolution.
We conducted a prospective study on HIV positive patients under HAART treatment from the Constanta Regional Centre, for a period of eight years, between 2007-2015. All causes of new discovered cancers were recorded with the occasion of subsequent visits that are done on a regular basis. For comparison we used official data from of new diagnosed cancers from reports on health status for Constanta County for the same time period. The adjusted incidence ratio is 955.18/100000patient-years (95% CI 446.58 – 1463.75/100000 patient-years). As observed in similar studies conducted.
HIV patients that undergo HAART treatment have an increased risk of all cancers significantly higher than what is observed in the general population. Considering this, better screening programs have to be developed and implemented for this population. Also, because of the suspicioned high number of HIV infected patients that are not diagnosed, a screening program for HIV should be implemented for all newly diagnosed patients with any type of malignancy.
According to the reports provided by the World Health Organization, cancer is a leading cause of death worldwide. Recognised methods for reducing the burden of cancers are screening for early detection followed by proper treatment.
We studied the cancer incidence during 2007 - 2012 for the population in Constanta County.
The main results support the importance of wide screening programs in early detection of neoplastic diseases, especially for elder and lower access to medical services populations, such as people from rural areas.
Chirilâ S., Hangan L.T, Broascâ V., Severin Beatrice and Mocanu Elena
The increasing prevalence of obesity among high-school students is a public health problem, as more and more children are facing it. Education has a great impact on the way young people deal with this problem. A significant effect on the behaviour of the pupils is the background they have, differences between children from rural areas compared to children from urban areas in terms of BMI being documented. A number of 185 high-school students from two schools in Constanta, from urban and rural areas were interviewed and data about height and weight was collected.
The results show that there is no statistically significant difference of the height between teenagers from urban and rural area, but there is a statistically significant association between area and BMI-z score distribution. Also, a higher number of teenagers from urban area underestimate their weight status compared to teenagers from rural areas.
Mesenteric cysts represent rare diseases of the abdominal cavity. The low incidence and the nonspecific clinical manifestations lead to a difficult diagnosis. Most of the time, these are diagnosed in advanced stages when complications arise or by chance following routine imagistic investigations. The ideal treatment for mesenteric cysts is the total surgical removal. The prognostic is favorable in most of the cases.
The purpose of the study is to compare the outcomes of surgical interventions for acute appendicitis with the values of the Alvarado score. We conducted the study on 572 patients that underwent surgical interventions for acute appendicitis. Retrospectively, based on the medical records, we calculated the MANTRELS score and compared the outcomes of the intervention with the values of the applied score. Almost one third of the patients with a MANTRELS score lower than 6 had negative appendectomies. These patients represent 60% of the total cases of negative appendectomies, while in the case of patients with a high score around 2% had negative appendectomies. We concluded that using this scoring system to assess the need of immediate surgical intervention is important and can increase the rate of positive diagnosis mainly by limiting the number of unnecessary interventions.
Stroke is a common cause of adult disability and the third cause of death in Western European countries. Carotid disease is a well-known risk factor for ischemic stroke, and this relationship is established. However, only a minority of the population with atherosclerosis will have a stroke.
The aim of these paper is to establish the relation between carotid atherosclerosis and first ischemic stroke. We performed an observational study, including 159 patients with carotid atherosclerosis. Our patients were examined with carotid ultrasound examination and cranio-cerebral computed tomography. We excluded patient with other cause of cerebral ischemia such atrial fibrillation, myocardial infarction, arterial dissection, vasculopathy, neoplasia. We also excluded any kind of transient cerebral ischemia, because of heterogeneity and poor medical documentation.
Despite our efforts to treat this condition, carotid disease remains a powerful risk factor for ischemic stroke.
L.T. Hangan, D. Capatana, Gh. Nicola, S. Chirila, L. Gurgas and Simona Claudia Cambrea
Psoriasis represents a chronic disease, with a prevalence of 0.91% to 8.5% worldwide. The clinical manifestations of the disease vary a lot from patient to patient and the response to treatment also varies a lot.
Today, in spite of the drawbacks it has, PASI (Psoriasis Area Severity Index) represents one of the best tools used to evaluate the extent of the disease and the response to medication.
One of the drawbacks of using this scoring system is considered to be the way a doctor has to calculate the result. In this study we offer, step by step, a possible solution to create an informatics tool that can offer the result of the score based on the inputs made by the doctor.
Beatrice Severin, V. Broască, Floarea Damaschin, Elena Mocanu and S. Chirilă
Breast cancer is the most frequently diagnosed cancer in women and cervical cancer is the second most common cancer worldwide. To analyze the cancer morbidity in women we used data taken from the reports of Public Health Department - Constanta during 2007-2010 and we calculated the incidence for different types of tumors. The study shows that for all years the values for incidence of breast and cervical cancers were double in rural areas compared with urban areas.
Simona Claudia Cambrea, Ghiulendan Resul, Elena Danteș, Stela Halichidis and S. Chirilă
Even though there are many similarities in symptoms and radiological aspect between pulmonary tuberculosis (TB) and lung neoplasia, there are many differences between them like different etiologies, different consequences, and altogether different management. We present a case of a 59 years old male, heterosexual, who was HIV diagnosed in the last 16 years. He had a good immunological and virusological evolution over the time. In the last 5 months of his life he was diagnosed with pulmonary TB and he received specific treatment. After 4 months of antituberculous treatment patient became asthenic, febrile, with productive cough, and weight loss. Imagistic evolution was unfavorable. The suspicion of pulmonary neoplasm raises in the last 3 weeks of his life. Macroscopic lung examination during autopsy was suggestive rather to a pulmonary TB than a lung neoplasm, with a nodular pattern very similar with nodular TB. Histopathological examination evidenced a lung adenocarcinoma.
In HIV patients a delayed or missed diagnosis of lung cancer, can lead to late treatment or wrong treatments, and finally death of patient.
L. Gurgas, N. D. Popescu, L. T. Hangan, S. Chirila and Natalia Rosoiu
The paper proposes new exposure data on etiopathogenesis basal cell epithelioma and present a clinical case investigated dermatoscopic, biochemically, treated surgically and guided to avoid relapses. The case presented is part of typical cases of pigmented basal cell carcinoma. Biochemical and haematological investigations performed one day before the excisional intervention (results 1) and 30 days (results 2) after the intervention: It is recommended to monitor biochemical investigations in which alterations were found, and ways for raising the immunological status.