Publications by authors named "Silvia Dumitras"

In order to assure optimal care of patients with chronic illnesses, it is necessary to take into account the cultural factors that may influence health-related behaviors, health practices, and health-seeking behavior. Despite the increasing number of Romanian Roma, research regarding their beliefs and practices related to healthcare is rather poor. The aim of this paper is to present empirical evidence of specificities in the practice of healthcare among Romanian Roma patients and their caregivers.

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The Roma people have specific values, therefore their views and beliefs about illness, dying and death are important to be known for health care providers caring for members of this community. The aim of this qualitative study based on 48 semi-structured interviews with Roma patients and caregivers in communities in two regions of Romania was to examine their selfdescribed behaviors and practices, their experiences and perceptions of illness, dying and death. Five more important themes about the Roma people facing dying and death have been identified: (1) The perception of illness in the community as reason for shame and the isolation that results from this, as well as the tendency for Roma people to take this on in their self image; (2) The importance of the family as the major support for the ill/dying individual, including the social requirement that family gather when someone is ill/dying; (3) The belief that the patient should not be told his/her diagnosis for fear it will harm him/her and that the family should be informed of the diagnosis as the main decision maker regarding medical treatment; (4) The reluctance of the Roma to decide on stopping life prolonging treatment; (5) The view of death as 'impure'.

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Medical communication in Western-oriented countries is dominated by concepts of shared decision-making and patient autonomy. In interactions with Roma patients, these behavioral patterns rarely seem to be achieved because the culture and ethnicity have often been shown as barriers in establishing an effective and satisfying doctor-patient relationship. The study aims to explore the Roma's beliefs and experiences related to autonomy and decision-making process in the case of a disease with poor prognosis.

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Unlabelled: Acute leukemia is the most common malignancy in children, being mostly produced by such chromosomal abnormalities as translocations or inversions causing gene fusion. Different clinical studies showed that translocations identified in ALL (acute lymphoblastic leukemia) and AML (acute myeloblastic leukemia) may be used to classify patients into risk groups.

Aim: To detect three fusion genes that have been proven very important in patient classification: t(9:22)p190, t(4:11) and t(12:21).

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Unlabelled: The goals of this paper were to study the various types of digestive disease in acute lymphoblastic leukemia (ALL), to characterize the children in the study group by age, sex and environment, by presence of liver and spleen enlargement, levels of GOT, GPT, vomiting, to evaluate methotrexate (MTX) serum levels al 24 hours and 48 hours after administration, and to analyze the correlation between MTX levels and MTX liver and blood toxicity.

Material And Method: We studied 39 immunocompromised children hospitalized in the IV-th Pediatric Clinic-Oncology Ward, between 1983-2005, with acute lymphoblastic leukemia (ALL); most of them exhibited defects of humoral immunity such as transitory hypogammaglobulinemia, and defects of the cellular immunity that accompanied hepatomegaly, hepatic cytolysis and biliary obstruction.

Results: The diagnostic of ALL was sustained by: medullar biopsy, lumbar punction, cytochemical reactions, blood cell count, flow-cytometry, methotrexate level determination.

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Unlabelled: Soft tissue sarcoma has a primitive mesenchymal origin and represents a heterogeneous group of malignant entities with a continuous rising frequency in the age range below 18. Rhabdomyosarcoma (RMS) constitutes 5.8% from the whole amount of pediatric solid tumors, taking the fourth place after CNS tumors, neuroblastoma, and Wilms tumors.

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