Ioana Dana Alexa

Universitatea de Medicina si Farmacie Grigore T. Popa Iasi, Socola, Iaşi, Romania

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Publications (39)3.67 Total impact

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    Teodora Alexa · Anti Lavinia · Andrei Luca · Lucian Miron · Ioana Dana Alexa
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    ABSTRACT: 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. A retrospective analysis of all cases of advanced NSCLC treated with either cisplatin-gemcitabine or cisplatin-vinorelbine at the Regional Institute of Oncology Iaşi 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. 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. 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.
    Contemporary Oncology / Wspólczesna Onkologia 11/2014; 18(5):340-343. DOI:10.5114/wo.2014.45293 · 0.22 Impact Factor
  • European geriatric medicine 09/2014; 5:S134. DOI:10.1016/S1878-7649(14)70338-9 · 0.55 Impact Factor
  • European geriatric medicine 09/2014; 5:S51. DOI:10.1016/S1878-7649(14)70101-9 · 0.55 Impact Factor
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    ABSTRACT: The present study aims to evaluate whether ascorbic acid (AA) and curcumin, two substances with redox properties, have similar effects on different models of pain in mice.
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    ABSTRACT: Schizophrenia as severe mental disorder is characterized by a disintegration of the process of thinking and of emotional responsiveness whereas the underlying mechanisms of schizophrenia are complex and still discussed. The objective of this study is to find out if patients with schizophrenia and their healthy first-degree relatives have abnormal autonomic nervous system (ANS) activity by measuring cardiac indices as QT variability index (QTVI). Moreover, it is useful to study if ANS dysfunction could play an important role in schizophrenia and if abnormal functioning could be retrieved by patients' healthy first degree relatives. Also, a parallel experiment monitored QTVI in healthy controls before, during and after a new complex stress test named Mannheim Multicomponent Stress Test (MMST). As QT variability analysis results were not significantly different during MMST versus normal state, we concluded that short-term stress has no fundamental impact on ECG morphology in healthy subjects. However, patients with schizophrenia revealed an increased QTVI that indicates structural changes of ECG morphology in those patients. These findings were obviously independent from the findings regarding to healthy subjects under stress and healthy subjects (basic measurement of 30min).
    IEEE 4th International Conference E-Health and Bioengineering – ”EHB 2013”, IASI, Romania; 11/2013
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    ABSTRACT: A complex goal in biomedical information technology today is the design and implementation of telemedicine and e-health solutions, which provide (chronic) patients and elderly people services that can enhance their quality of life. We used wireless sensor network technology, low-power integrated embedded systems and wireless communications, which have enabled us the design of low-cost, miniature, precise and intelligent physiological sensor modules. These modules are capable of measuring, processing, communicating one or more physiological parameters, and can be integrated into a wireless personal area network (WPAN). We have designed, deployed, produced and tested both hardware and software medical sensors for WPAN, dedicated to vital signs acquisition, processing and transmitting, as well as the whole telemedical system for these physiologic parameters monitoring in real time. This paper is dedicated to the most complex Romanian telemedical pilot project, TELEMON, that has as goals the design and implementation of a system for automatic and complex telemonitoring, everywhere and every time, in (almost) real time, of the vital signs of persons with chronic illnesses, of elderly people, of those having high medical risk and of those living in isolated regions. The final objective of this pilot project is to enable personalized telemedical services, and to act as a basis for a public service for telemedical procedures in Romania and abroad.
    08/2013; 117(3):825-32.
  • Gabriel Prada · Alexa I · Nacu R · Tapelea E · Prada S · Ignat I · Fita I
    The 20th IAGG World Congress of Gerontology and Geriatrics - "Digital Ageing: A New Horizon for Health Care and Healthy Ageing" - Seoul, South Korea, 23 - 27 June 2013, Seoul, South Korea; 06/2013
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    ABSTRACT: Therapeutic adherence represents the extent to which the patient's behavior follows medical recommendations. It is a complex process that strongly influences the quality of life of the each and everyone. We performed a retrospective study that included 126 very old patients (≥ 80 years old). Patients' data were recorded in a database that contained demographic and clinical data and information about patient's current medication. Information about therapeutical adherence was collected for each person by way of a questionnaire, which consisted in verifying their knowledge about their diet and medication and comparing it with information from past medical records or family members. We found several factors that influence adherence to treatment: living in the urban area, the number of pills prescribed by the general practitioner and a strong familial and financial support. Fighting non-adherence should rely upon two complementary directions: the multidisciplinary medical approach and the telemonitoring and e-health systems.
    E-Health and Bioengineering Conference (EHB), 2013; 01/2013
  • Gabriel Prada · I.D. Alexa · Fita IG · Nacu Raluca · Tapelea E · Prada SP
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    ABSTRACT: Introduction We evaluated effects of diabetes mellitus on cognitive function in non-demented older patients. Methods We included 537 older patients with diabetes mellitus consequently admitted to our departments. Age range: 65 - 95 years, mean 80; 73% women, 27% men. Three age groups were considered: young-old (65-74 years), old-old (75-84 years), very-old (>84). We excluded patients with past medical history of stroke, dementia, depression (score of >/=8 on the Short version of Geriatric Depression Scale). Cognitive function was evaluated using MMSE, Clock-drawing Test, Five Words Test and Stroop Test (score >42 normal). HbA1c assessed long-term response to anti-diabetic treatment (>7% -abnormal). Results Irrespective of age-group, past medical history of diabetes mellitus >10 years correlated with higher prevalence of mild cognitive impairment (correlation coefficient r=0.86). Very-old group had better scores on cognitive tests, but maximum glucose levels were lower, possibly due to selection effect. Significant difference was noticed between scores on Five Words Test and Stroop Test in patients with HbA1c >10% as compared to those with HbA1c < 7% (p<0.005) irrespective of age-group and gender. Conclusions Poor control of diabetes mellitus is a significant risk factor for cognitive impairment in elderly. Moreover, diabetes mellitus itself makes these patients prone to cognitive impairment possibly due to macro- and microvascular complications of this metabolic disease. A systematic screening of cognitive function needs to be performed in elderly diabetics to establish an early diagnosis of cognitive impairment and start adequate and timed therapy to slow down progression of cognitive disorder. - DOI: http://dx.doi.org/10.1016/j.eurger.2012.07.360
    8th Congress of the EUGMS, Brussels, 26th-28th September 2012, Brussels, Belgium; 09/2012
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    ABSTRACT: Introduction Falls are frequently encountered in older people and often may be caused by orthostatic hypotension that has several etiologic factors. Objective of the research was to apply a postural exercise program in older patients aiming at reducing postural hypotension that was not due to side effects of medicines. Materials We included 416 patients, age range 65–85, divided into two age-matched groups, both presenting postural hypotension: Study Group - 195 subjects that followed specific postural exercises program and Control Group - 221 subjects without this program. Exercises were performed 15 minutes three times daily for one month. We excluded patients with cognitive impairment, on medication that could induce postural hypotension, with severe heart conditions, severe joint diseases and stroke sequelae that could interfere with program. Results At inclusion t-test for independent samples showed significant orthostatic reduction in Systolic blood pressure for both Study and Control Group: t= –4.370; statistical significance p<0.001; confidence level 95%; confidence interval: –8.2148 and –3.1886. After 30 days of postural exercises program we noticed a significant reduction in Systolic blood pressure difference between orthostatic and recumbent position in Study Group patients (t-test for paired samples: t= –3.270, p<0.005), but not in Control Group (t=1,526, p=0.171). Moreover, incidence of falls was significantly lower (p<0.001) in Study Group as compared to Control. Study Group subjects tolerated better standing and walking. Conclusion The program could act by re-training carotid sinus baroreceptors through a postural stimulation and this could reduce the risk of falls in older patients.
    8th Congress of the EUGMS, Brussels, 26th-28th September 2012, Brussels, Belgium; 09/2012
  • I.D. Alexa · C.I. Axinte
    European geriatric medicine 09/2012; 3:S41. DOI:10.1016/j.eurger.2012.07.027 · 0.55 Impact Factor
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    ABSTRACT: This paper presents a Romanian telemedical project that has as goals researches, design and implementation of an electronic-informatics-telecom and scalable system, that allows the automatic and complex telemonitoring, everywhere and every time (at home, in hospitals, at work, of mobile subject, etc), in (almost) real time, of the vital signs of persons with chronic illnesses, of elderly people, of those having high medical risk and of those with neuro-locomotor disabilities. The main objective of this pilot project is to enable personalized medical teleservices delivery and patient safety enhancement based on an earlier diagnosis, and to act as basis for a public service for telemedical procedures. Keywordstelemedicine-biomedical equipment-biomedical signal analysis-wireless personal area network-falldetection
    01/2010: pages 92-95;
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    ABSTRACT: The current common goal in medical information technology to-day is the design and implementation of telemedicine solutions, which provide to patients services that enhance their quality of life. Advances in wireless sensor network technology, the overall miniaturization of their associated hard-ware low-power integrated circuits and wireless communications have enabled the design of low-cost, miniature, and intelligent physiological sensor modules with applications in the medical industry. These modules are capable of mea-suring, processing, communicating one or more physiological parameters, and can be integrated into a wireless personal area network. This paper is dedi-cated to the most complex Romanian telemedical pilot project, TELEMON, which has as goals design and implementation of an electronic-informatics-telecommunications system, that allows the automatic and complex telemoni-toring, everywhere and every time, in (almost) real time, of the vital signs of persons with chronic illnesses, of elderly people, of those having high medical risk and of those living in isolated regions. The final objective of this pilot project is to enable personalized medical teleservices delivery, and to act as a basis for a public service for telemedical procedures in Romania and abroad.
  • International Journal of Computers, Communications & Control (IJCCC) 01/2010; V(5):892-901. · 0.69 Impact Factor
  • H. Costin · C. Rotariu · Ioana Alexa · et al
    The World Congress on Medical Physics and Biomedical Engineering; 09/2009
  • S Ardeleanu · Ioana Dana Alexa · O Prisadă · G Ungureanu
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    ABSTRACT: Right heart infective endocarditis in an elderly patient with no previous known risk factors is a very rare situation (even if subacute infective endocarditis has the same chance of occurrence at either a young person, or an elderly patient). We present the case of a 75-years old patient, with no previous cardiac history, addressed to our clinic with nonspecific septic symptoms associated with an edematous syndrome. The patient was treated for right heart valve infective endocarditis; a particularity may be the fact not all Duke criteria were respected. Iatrogeny was involved, our patient having administered a 7-day antibiotic treatment before hospital addressing. The therapeutic probe was positive: excellent evolution under treatment. Few cases of infective endocarditis of the tricuspid valve were reported worldwide, in which the source of infection was unknown in about 80% of cases. In two pediatric cases reported, tricuspid endocarditis was caused by Staphylococcus aureus septicemia following upper respiratory infection. This may also occur in adult cases. Further investigations should be carried out in the future to elucidate the source of infection. Isolated right-sided endocarditis should be included in the differential diagnosis of patients with febrile syndrome, respiratory symptoms and predisposing disease, even when they do not have a pacemaker and are not intravenous-drug users (IVDU).
    01/2009; 113(3):762-5.
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    ABSTRACT: This paper presents the most complex Romanian telemedical project, TELEMON, that has as goals researches, design and implementation of an electronic-informatics-telecom and scalable system, that allows the automatic and complex telemonitoring, everywhere and every time (at home, in hospitals, at work, of mobile subject, etc), in (almost) real time, of the vital signs of persons with chronic illnesses, of elderly people, of those having high medical risk and of those with neuro-locomotor disabilities. The main objective of this pilot project is to enable personalized medical teleservices delivery and patient safety enhancement based on an earlier diagnosis, and to act as basis for a public service for telemedical procedures.
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    ABSTRACT: This paper presents a project that has as main goal researches, design and implementation of an electronicinformatics- telecom and scalable system, that allows the automatic, complex and real time telemonitoring, everywhere and every time (at home, in hospitals, at work, etc.), using several communication paths, of (mobile) persons with chronic illnesses, of elderly people, of those having high medical risk and of those with neuro-locomotor disabilities. The monitored features are electrophysiological (vital) signs, signals for domotics (home surveillance, access control in a certain area), and the systems also performs automatic image analysis of the movements of the subjects.
    12/2008: pages 1002-1005;
  • G Ungureanu · Ioana Dana Alexa · Ortansa Stoica
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    ABSTRACT: The 21st century's demographic and epidemiologic perspectives suggest an absolute and percentual increment of elderly population. In the same time the prevalence of heart insufficiency increases with advanced age, which transforms heart failure in a true challenge for health insurance system. This new dimension of the problem resides in the increment of heart insufficiency's prevalence and in the high costs of medical care of these patients. Heart failure's medical costs are high not only due to the necessity of compensating the cardiac function but also due to the necessity of treating the etiology, the risk factors and the co-morbidities with cardiac side effects. Elderly patients usually have a low therapeutic compliance and an important number of iatrogenic reactions mainly due to poly-medication, poly-pathology and cognitive and physical deficiencies, which need special measures of therapeutic education for the patient and family and medical survey, probably best in a nursing house; all these elements increase significantly the cost, which is almost double than the cost for cancer. The prophylaxis in heart insufficiency means an extremely efficient management of entire cardiac pathology in order to delay the moment of heart failure. In elderly patients, the treatment in heart insufficiency is difficult not due to hospital treatment of decompensation episodes but due to low therapeutic compliance at home. We need special programs to ensure medical education of the patient and the family/caregiver in order to avoid iatrogenic pathology and to ensure therapeutic efficiency.
    01/2008; 112(2):293-8.
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    ABSTRACT: The paper presents a project that has as main goal researches, design and implementation of an electronic-informatics-telecom and scalable system, that allows the automatic and complex telemonitoring, everywhere and every time (at home, in hospitals, at work, of mobile subject etc, using several communication paths), in real time, of persons with chronic illnesses, of elderly people, of those having high medical risk and of those with neuro-locomotor disabilities.