Carmen Ciofu - Academia.edu (original) (raw)

Papers by Carmen Ciofu

Mædica, 2012

Bucharest, Romania 1,072,503 person-year of follow-up, 195,594 patients died: 162,067 from cancer... more Bucharest, Romania 1,072,503 person-year of follow-up, 195,594 patients died: 162,067 from cancer, 14,489 from cardiovascular causes and 19,038 from other causes. Among patients, 40 years and older, 18,721 received statins before cancer diagnosis and 277. 204 had never used statins. All cause mortality among patients with cancer taking statins was reduced by 15%, and only by 10% as risk for death from cardiovascular ca uses. The reduced cancer related mortality among statin users as compared with patients who had never used statins was observed for 13 cancer types. The absence of a dose-response relationship for statin and cancer related mortality suggest that any statin dose will suffice in reducing mortality among patients with cancer. Statin use does not influence cancer incidence in population receiving statin with aim of reducing cardiovascular events. It was speculated that statins use is a marker of increase health awareness of the population and this patients group (statin users) are close with professional survey and so to explain the results (a reduction of cancer mortality with 15% for statin receiving patients). The smokingcessation interventions among statin users with cardiovascular disease could distort the relationship between statin and mortality from smoking-related cancer. Basic science study are needed to assess the mechanism through witch statin work and if the cardiovascular and cancer effect of statins are due to overlapping or independent action.

JAMA, 2007

Cystic fibrosis is a multisystem disease characterized primarily by chronic pulmonary infection a... more Cystic fibrosis is a multisystem disease characterized primarily by chronic pulmonary infection and bronchiectasis, pancreatic exocrine impairment, and elevated sweat chloride. In the last 4 decades, new treatment strategies and aggressive nutritional management have resulted in a significant increase in expected survival, with median predicted survival in cystic fibrosis now to older than 35 years. This increase in predicted survival has also been aided by a greater appreciation of the potential variability in the presentation and severity of cystic fibrosis, resulting in identification of a growing number of mild cases. As it is estimated that within the next decade more than half of all individuals with cystic fibrosis will be aged 18 years or older, adult medicine caregivers are increasingly likely to encounter patients with cystic fibrosis and be exposed to their unique medical management.

Harvard Law Review, 1986

Every few years, a new round of malpractice insurance premium increases occurs, and there are ren... more Every few years, a new round of malpractice insurance premium increases occurs, and there are renewed pressures on public officials to "do something about the malpractice insurance problem." Although there is no consensus about the causes of the problem, views about the causes are strongly held. The views often depend on where the observer stands, and there is a regrettable tendency to identify a single culprit-"greedy lawyers" paid on a contingent fee, "careless doctors," "litigious patients," or "greedy insurers." Unfortunately, little is really known about the causes of the malpractice insurance crises and about the efficacy of alternative policy options. In part, lack of knowledge is the result of inadequate data-but there are also few serious theoretical studies on malpractice issues. Research by Patricia Danzon, sometimes with coauthors, is an exception to this generalization about lack of useful studies. Her theoretical, empirical, and policy analysis in the malpractice area is imaginative and careful, making good use of best-practice economic techniques. Much of her work has been technical and is inaccessible to many noneconomists. Although Danzon's most recent book does not break much new ground, it is a welcome summary of much of her past research on malpractice, written and organized in a form that will be accessible to readers outside her field. Danzon's theoretical analysis, both positive and normative, is based on the economist's neoclassical model. Each party in the transaction maximizes his or her well-being subject to constraints. Information is often difficult for patients to obtain. Because of asymmetric information, the doctor may be well positioned to take advantage of the patient; making the doctor liable for compensation in cases of injury due to negligence is one mechanism, albeit an imperfect one, for protecting the patient against abuse. It is also possible for doctors to be too cautious, that is, to provide too much preventive care. The same neoclassical paradigm states that an efficient outcome is one that results in the sum of four types of costs being minimized-insured losses, uninsured losses, prevention cost, and overhead (cost of litigation, insurance overhead). Thus, a dollar of prevention is only

Adult cystic fibrosis is a new topic in internal medicine and intensive care units assistance. Th... more Adult cystic fibrosis is a new topic in internal medicine and intensive care units assistance. The numbers of individuals with cystic fibrosis (CF) aged 18 years and older has increased with increasing of predicted survival in the last ten years.The gender difference in the death rate is also disscused. After presenting the Guide for the positive diagnosis of CF (Consensus Conference Program, 1998), the authors introduce the two separate groups of CF adult patients. The first group has the diagnosis of CF from their early childhood and presents in adolescent and youth life the most severe disease complications (nutritional deficiency, pulmonary chronic infections with Ps. aeruginosa, severe haemoptisia, and end stage lung disease which recommend the patient for lung transplantation, CF bone related disease, CF related diabet etc.). The second group are the CF patients diagnosed in the adulthood with atypical CF. These patients have a higher mean age, a better nutritional status, rar...

Mædica, 2012

Bucharest, Romania 1,072,503 person-year of follow-up, 195,594 patients died: 162,067 from cancer... more Bucharest, Romania 1,072,503 person-year of follow-up, 195,594 patients died: 162,067 from cancer, 14,489 from cardiovascular causes and 19,038 from other causes. Among patients, 40 years and older, 18,721 received statins before cancer diagnosis and 277. 204 had never used statins. All cause mortality among patients with cancer taking statins was reduced by 15%, and only by 10% as risk for death from cardiovascular ca uses. The reduced cancer related mortality among statin users as compared with patients who had never used statins was observed for 13 cancer types. The absence of a dose-response relationship for statin and cancer related mortality suggest that any statin dose will suffice in reducing mortality among patients with cancer. Statin use does not influence cancer incidence in population receiving statin with aim of reducing cardiovascular events. It was speculated that statins use is a marker of increase health awareness of the population and this patients group (statin users) are close with professional survey and so to explain the results (a reduction of cancer mortality with 15% for statin receiving patients). The smokingcessation interventions among statin users with cardiovascular disease could distort the relationship between statin and mortality from smoking-related cancer. Basic science study are needed to assess the mechanism through witch statin work and if the cardiovascular and cancer effect of statins are due to overlapping or independent action.

JAMA, 2007

Cystic fibrosis is a multisystem disease characterized primarily by chronic pulmonary infection a... more Cystic fibrosis is a multisystem disease characterized primarily by chronic pulmonary infection and bronchiectasis, pancreatic exocrine impairment, and elevated sweat chloride. In the last 4 decades, new treatment strategies and aggressive nutritional management have resulted in a significant increase in expected survival, with median predicted survival in cystic fibrosis now to older than 35 years. This increase in predicted survival has also been aided by a greater appreciation of the potential variability in the presentation and severity of cystic fibrosis, resulting in identification of a growing number of mild cases. As it is estimated that within the next decade more than half of all individuals with cystic fibrosis will be aged 18 years or older, adult medicine caregivers are increasingly likely to encounter patients with cystic fibrosis and be exposed to their unique medical management.

Harvard Law Review, 1986

Every few years, a new round of malpractice insurance premium increases occurs, and there are ren... more Every few years, a new round of malpractice insurance premium increases occurs, and there are renewed pressures on public officials to "do something about the malpractice insurance problem." Although there is no consensus about the causes of the problem, views about the causes are strongly held. The views often depend on where the observer stands, and there is a regrettable tendency to identify a single culprit-"greedy lawyers" paid on a contingent fee, "careless doctors," "litigious patients," or "greedy insurers." Unfortunately, little is really known about the causes of the malpractice insurance crises and about the efficacy of alternative policy options. In part, lack of knowledge is the result of inadequate data-but there are also few serious theoretical studies on malpractice issues. Research by Patricia Danzon, sometimes with coauthors, is an exception to this generalization about lack of useful studies. Her theoretical, empirical, and policy analysis in the malpractice area is imaginative and careful, making good use of best-practice economic techniques. Much of her work has been technical and is inaccessible to many noneconomists. Although Danzon's most recent book does not break much new ground, it is a welcome summary of much of her past research on malpractice, written and organized in a form that will be accessible to readers outside her field. Danzon's theoretical analysis, both positive and normative, is based on the economist's neoclassical model. Each party in the transaction maximizes his or her well-being subject to constraints. Information is often difficult for patients to obtain. Because of asymmetric information, the doctor may be well positioned to take advantage of the patient; making the doctor liable for compensation in cases of injury due to negligence is one mechanism, albeit an imperfect one, for protecting the patient against abuse. It is also possible for doctors to be too cautious, that is, to provide too much preventive care. The same neoclassical paradigm states that an efficient outcome is one that results in the sum of four types of costs being minimized-insured losses, uninsured losses, prevention cost, and overhead (cost of litigation, insurance overhead). Thus, a dollar of prevention is only

Adult cystic fibrosis is a new topic in internal medicine and intensive care units assistance. Th... more Adult cystic fibrosis is a new topic in internal medicine and intensive care units assistance. The numbers of individuals with cystic fibrosis (CF) aged 18 years and older has increased with increasing of predicted survival in the last ten years.The gender difference in the death rate is also disscused. After presenting the Guide for the positive diagnosis of CF (Consensus Conference Program, 1998), the authors introduce the two separate groups of CF adult patients. The first group has the diagnosis of CF from their early childhood and presents in adolescent and youth life the most severe disease complications (nutritional deficiency, pulmonary chronic infections with Ps. aeruginosa, severe haemoptisia, and end stage lung disease which recommend the patient for lung transplantation, CF bone related disease, CF related diabet etc.). The second group are the CF patients diagnosed in the adulthood with atypical CF. These patients have a higher mean age, a better nutritional status, rar...