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Doica IP, Turcu-Stiolica A, Ungureanu BS, Florescu DN, Rogoveanu I, Gheonea DI. Association between Direct-Acting Agents Adherence and Health-Related Quality of Life of Patients with Hepatitis C. Curr Health Sci J 2023; 49:312-318. [PMID: 38314219 PMCID: PMC10832866 DOI: 10.12865/chsj.49.03.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/18/2023] [Indexed: 02/06/2024]
Abstract
This observational study included all patients undergoing HCV treatment with direct-acting antiviral (DAA)-based therapy between May 2020 and September 2023 at the Dolj County Hospital, Romania. The aim was to investigate adherence to DAAs among HCV patients and the effect of this treatment on their health-related quality of life (HRQoL). Chronic HCV-infected patients were prospectively evaluated at baseline (T0), before the beginning of treatment, and 12 weeks after completing DAAs treatment (T1). The HCV-AD10 questionnaire was used to measure DAAs adherence, and HRQoL was assessed with the 15D instrument. The 15D questionnaire was administered at two time points: T0 and T1, during which the Sustained Virologic Response (SVR) was also measured. The primary outcome was DAAs adherence, with secondary outcomes including quality of life (QoL), and sustained virologic response (SVR). DAAs based therapy was initiated for 368 patients, all of whom were health insured. HRQoL and psychological state of HCV patients clinically improved. The DAAs adherence was very good (mean±SD, 91.51±8.34), being influenced by age (younger patients were much adherent, rho=-0.112, p-value=0.031) and the severity of the disease (patients with more severe hepatitis were less adherent, rho=-0.167, p-value=0.001). DAAs had a significant effect on improving HRQoL of HCV patients, but did not influence medication adherence.
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Affiliation(s)
- Irina Paula Doica
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, Romania
| | - Adina Turcu-Stiolica
- Pharmacoeconomics Department, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Dan Nicolae Florescu
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, Romania
| | - Ion Rogoveanu
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, Romania
| | - Dan-Ionuț Gheonea
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, Romania
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Cârstea AP, Mită A, Fortofoiu MC, Doica IP, Cârstea D, Beznă CM, Negroiu CE, Diaconu ID, Georgescu AR, Kamal AM, Mahler B, Grigorie AG, Dobrinescu GA. How Dexamethasone Used in Anti-COVID-19 Therapy Influenced Antihypertensive Treatment in Patients with SARS-CoV-2. Healthcare (Basel) 2023; 11:healthcare11101399. [PMID: 37239685 DOI: 10.3390/healthcare11101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND During the SARS-CoV-2 pandemic period, in the treatment approved by the WHO, along with antivirals, antibiotics, nonsteroidal anti-inflammatory drugs and anticoagulants, dexamethasone was always used. This study started from the professional concern related to the vasopressor effect of cortisone on blood pressure (BP). METHODS The study group was achieved by selecting, from a total of 356 patients hospitalized in the clinic, the patients with known hypertensive status at admission for SARS-CoV-2. Dexamethasone was part of the anti-COVID-19 treatment, with an administration of 4-6-8 mg/day, depending on bodyweight, for 10 days. All patients with hypertension received antihypertensive treatment in adjusted doses according to the recorded BP values. RESULTS Monitoring of BP in hospitalized patients was performed daily, in the morning and evening. If on the 2nd day of treatment, 84% of the patients partially responded to the treatment with a moderate decrease in BP, on the 3rd therapy day, the situation clearly improved: more than 75% of the patients had values of BP that can be classified as high-normal (38.23%) and normal (40.03%). CONCLUSIONS Dexamethasone for treatment of SARS-CoV-2 infection did not have a notable influence on increasing BP, because the doses were low-moderate and prescribed for a short time.
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Affiliation(s)
- Andrei Puiu Cârstea
- Department of Physiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Cardiology, Clinical Municipal Hospital "Philanthropy" of Craiova, 200143 Craiova, Romania
| | - Adrian Mită
- Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Internal Medicine 2-Gastroenterology Compartment, "Philanthropy" Clinical Municipal Hospital of Craiova, 200143 Craiova, Romania
| | - Mircea-Cătălin Fortofoiu
- Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Internal Medicine 2-Gastroenterology Compartment, "Philanthropy" Clinical Municipal Hospital of Craiova, 200143 Craiova, Romania
| | - Irina Paula Doica
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Doina Cârstea
- Department of Cardiology, Clinical Municipal Hospital "Philanthropy" of Craiova, 200143 Craiova, Romania
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Cristina Maria Beznă
- Department of Cardiology, Clinical County Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Cristina Elena Negroiu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Cardiology, Clinical County Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Ileana-Diana Diaconu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Pediatric Pneumology, National Institute of Pneumology "Marius Nasta" of Bucharest, 050159 Bucharest, Romania
| | - Andreea-Roberta Georgescu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Emergency Medicine, Clinical County Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Adina Maria Kamal
- Department of Internal Medicine, Faculty of Midwives and General Nursing, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Internal Medicine 1, "Philanthropy" Clinical Municipal Hospital of Craiova, 200143 Craiova, Romania
| | - Beatrice Mahler
- Department of Pneumology, University of Medicine and Pharmacy "Carol Davila" Bucharest, 020021 Bucharest, Romania
- National Institute of Pneumophtisiology "Marius Nasta", 050159 Bucharest, Romania
| | - Adriana-Gabriela Grigorie
- Department of Physiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Leamna Pneumophtisiology Hospital, Leamna de Sus, 207129 Dolj, Romania
| | - Gabriel Adrian Dobrinescu
- Department of Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Thoracic Surgery, Clinical County Emergency Hospital of Craiova, 200642 Craiova, Romania
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Butaru AE, Mămuleanu M, Streba CT, Doica IP, Diculescu MM, Gheonea DI, Oancea CN. Resource Management through Artificial Intelligence in Screening Programs-Key for the Successful Elimination of Hepatitis C. Diagnostics (Basel) 2022; 12:diagnostics12020346. [PMID: 35204437 PMCID: PMC8871056 DOI: 10.3390/diagnostics12020346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The elimination of the Hepatitis C virus (HCV) will only be possible if rapid and efficient actions are taken. Artificial neural networks (ANNs) are computing systems based on the topology of the biological brain, containing connected artificial neurons that can be tasked with solving medical problems. AIM We expanded the previously presented HCV micro-elimination project started in September 2020 that aimed to identify HCV infection through coordinated screening in asymptomatic populations and developed two ANN models able to identify at-risk subjects selected through a targeted questionnaire. MATERIAL AND METHOD Our study included 14,042 screened participants from a southwestern region of Oltenia, Romania. Each participant completed a 12-item questionnaire along with anti-HCV antibody rapid testing. Hepatitis-C-positive subjects were linked to care and ultimately could receive antiviral treatment if they had detectable viremia. We built two ANNs, trained and tested on the dataset derived from the questionnaires and then used to identify patients in a similar, already existing dataset. RESULTS We found 114 HCV-positive patients (81 females), resulting in an overall prevalence of 0.81%. We identified sharing personal hygiene items, receiving blood transfusions, having dental work or surgery and re-using hypodermic needles as significant risk factors. When used on an existing dataset of 15,140 persons (119 HCV cases), the first ANN models correctly identified 97 (81.51%) HCV-positive subjects through 13,401 tests, while the second ANN model identified 81 (68.06%) patients through only 5192 tests. CONCLUSIONS The use of ANNs in selecting screening candidates may improve resource allocation and prioritize cases more prone to severe disease.
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Affiliation(s)
- Anca Elena Butaru
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.E.B.); (I.P.D.)
| | - Mădălin Mămuleanu
- Department of Automatic Control and Electronics, University of Craiova, 200585 Craiova, Romania;
- Oncometrics S.R.L., 200677 Craiova, Romania
| | - Costin Teodor Streba
- Oncometrics S.R.L., 200677 Craiova, Romania
- Department of Pulmonology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania;
- Correspondence: ; Tel.: +40-722-38-99-06
| | - Irina Paula Doica
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.E.B.); (I.P.D.)
| | - Mihai Mircea Diculescu
- Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Dan Ionuț Gheonea
- Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania;
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Carmen Nicoleta Oancea
- Department of Analytical Chemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
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Doica IP, Florescu DN, Oancea CN, Turcu-Stiolica A, Subtirelu MS, Dumitra G, Rogoveanu I, Gheonea DI, Ungureanu BS. Telemedicine Chronic Viral Hepatitis C Treatment during the Lockdown Period in Romania: A Pilot Study. Int J Environ Res Public Health 2021; 18:ijerph18073694. [PMID: 33916226 PMCID: PMC8037937 DOI: 10.3390/ijerph18073694] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/20/2021] [Accepted: 03/30/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic is currently delaying the process of chronic hepatitis C (HCV) eradication, since most of the chronic diseases are neglected. Thus, there is a need for alternative programs for HCV therapy implementation and disease monitoring. Our aim was to provide a multidisciplinary approach, so that HCV-infected patients from distant locations may benefit from HCV antivirals during the COVID-19 outbreak and within the lockdown period in Romania. Previously diagnosed HCV patients willing to participate in this telemedicine pilot study were included. Patient characteristics and medical adherence were assessed and compared to the year preceding the pandemic. We proposed a multidisciplinary approach by using a telemedicine program for HCV therapy monitoring. Patients also received a satisfaction questionnaire after delivering the sustained virologic response (SVR) result. A total of 41 patients agreed to participate in this study. The medication adherence was 100% for patients included in the telemedicine group, with a statistically significant difference from the medication adherence of the patients treated in 2019. The satisfaction item score was 4.92 out of 5 and our results (r = −0.94, p < 0.0001) suggested that older patients embraced the telemedicine program less, but with the same success in terms of SVR (100%) and medication adherence (100%). Our pilot study offers the first example of a telemedicine program in Romania for HCV therapeutic management. During the lockdown period, telemedicine has served as a reliable tool and novel alternative for conventional monitoring of patients treated with direct antiviral agents and should be further considered even following the pandemic.
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Affiliation(s)
- Irina Paula Doica
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (I.P.D.); (D.N.F.); (I.R.); (D.I.G.); (B.S.U.)
| | - Dan Nicolae Florescu
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (I.P.D.); (D.N.F.); (I.R.); (D.I.G.); (B.S.U.)
| | - Carmen Nicoleta Oancea
- Pharmacy I Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Adina Turcu-Stiolica
- Pharmacoeconomics Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Correspondence:
| | - Mihaela-Simona Subtirelu
- Pharmacoeconomics Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Gindrovel Dumitra
- Family Medicine Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Ion Rogoveanu
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (I.P.D.); (D.N.F.); (I.R.); (D.I.G.); (B.S.U.)
| | - Dan Ionut Gheonea
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (I.P.D.); (D.N.F.); (I.R.); (D.I.G.); (B.S.U.)
| | - Bogdan Silviu Ungureanu
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (I.P.D.); (D.N.F.); (I.R.); (D.I.G.); (B.S.U.)
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