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The irritable bowel syndrome (IBS) is the most common chronic gastrointestinal disorder referred to gastroenterologists. One of the most common manifestations of IBS is bloating. Abdominal bloating is defined as subjective sensation of abdominal distension associated with girth increment. Therefore, it is described in the Rome IV criteria as bloating/abdominal distension. Bloating symptoms are reported by 10-30% of the general population and it was rated as the most bothersome symptom by 60% of IBS patients; the lack of specificity of this complaint prevented bloating to be included between the diagnostic criteria for IBS. Indeed, bloating may be reported also in healthy people or in other functional conditions. This paper looks to the evolutions of the concepts on bloating according to the Rome working groups from the beginning until now and it represents a comprehensive review on the prevalence and pathogenesis of bloating.

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Hepatitis C remains a major issue worldwide, both in mortality and morbidity. For certain genotypes, its treatment has stagnated in recent decades. The emergence of new drugs, Direct Acting Antiviral Agents (DAA) resulted in Sustained Viral Response rate (SVR) of over 90%. Of such treatment benefited more than 5,000 patients in Romania during 2016. The End of Treatment (EOT) rates are comparable to international studies. There were, however, included only patients with liver cirrhosis (Fibromax-stage F4) without signs of hepatic decompensation, but still remain many of those with chronic infection in moderate stages of fibrosis with good liver function. Studies on DAA approved today show that the early stages also benefit from new treatments with higher SVR and even progression stopping of liver fibrosis induced by the virus. [ABSTRACT FROM AUTHOR]

Background and aims. Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, having its subtypes related to the predominant bowel pattern: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M) or alternating IBS (IBS-A). Some patients alternate between subtypes (IBS-A). We looked for the prevalence of alternation between subtypes in patients with IBS. We also analyzed changes in pharmacological therapy specifically addressed to IBS. Methods. We performed a retrospective observational study that included 60 patients diagnosed with IBS according to Rome III criteria. Patients were asked using a detailed structured interview about their stool form changes regarding previous six months. Alternators were defined as patients that changed IBS subtype over time (previous six months). Results. Out of the 60 patients diagnosed with IBS, 18 patients (30%) were alternators. Of these, 8 patients (44%) changed twice the subtype. Two patients (66.66%) of the IBS-M subgroup shifted between subtypes. Eight patients (44.44%) changed medication over the six months. Four patients (22.2%) of the alternators were on double association of therapy (antispasmodics) addressed to IBS. Four patients (22.22%) discontinued medication. Conclusions. Patients with IBS often change between subtypes even within six months. Alternators in our pilot study represented 30% of IBS patients. IBS-M seems to be the least stable phenotype. The rarest change is the shift between IBS-C and IBS-D. Alternators also often change their pharmacological treatment (antispasmodics). [ABSTRACT FROM AUTHOR]

Background. Oral health related quality of life (OHRQoL) represents a complex concept, which brings important insight into the patients' dental and oral self-perception. This field of research also targets young adult populations. Aims. The aim of the current study was to assess the OHRQoL self-perception differences in three study programs student samples: two dental medicine student samples and an economics student sample. Methods. After providing informed consent from the subjects, the OHIP-49 questionnaire was applied in three samples: a sample belonging to the Faculty of Dental Medicine, Romanian section, Cluj-Napoca (n = 63), a sample belonging to the English section of the same Faculty (n = 63) and a sample of students enrolled in the Faculty of Economics, Cluj-Napoca (n = 63). The dental Romanian and economics student samples completed the Romanian version of OHIP-49, while the dental English program students completed the English version of the same instrument. Mean subscale scores were calculated, followed by inferential statistical procedures: one-way and two-way analysis of variance and the t-test. The independent variables were gender and the study program. Results. For the complete sample, the subscales presenting the highest scores were functional limitation (8.05), physical pain (10.03) and psychological discomfort (6.05). Statistically significant differences in OHRQoL self-perception, using one-way ANOVA, were obtained between: economics students and English section dental students (p = 0.03) for the functional limitation subscale; economics and Romanian section dental students (p = 0.039) for the same subscale; economics students and English section dental students (p = 0.029) for the handicap subscale. In respect to the complete sample, the t-test revealed statistically significant differences between male and female subjects for the scores of the following subscales: functional limitation t (187) = -2.359, p = 0.019, physical pain t (187) = -2.172, p = 0.031, and psychological disability t (187) = -2.556, p = 0.11. Conclusions. The self-perception of OHRQoL statistically significantly varies in accordance with gender and the study program. The involved students tend to focus more on physical impacts of oral conditions. [ABSTRACT FROM AUTHOR]

Background: Hepatic disease represents a significant complication in children with cystic fibrosis (CF), yet its relationship with specific genetic factors, including CFTR (Cystic fibrosis transmembrane conductance regulator) mutations and SERPINA1 alleles, is not well understood. This study aims to clarify these associations within a Romanian pediatric CF population., Methods: In this cross-sectional, prospective study, we examined 71 children with CF, comparing those with hepatic disease (n=25) to those without (n=46). We collected comprehensive clinical, biochemical, and genetic data, focusing on CFTR genotypes and SERPINA1 alleles. Key outcomes included the prevalence of hepatic disease in relation to specific genotypes, fibrosis markers, and liver function tests., Results: The DF508/DF508 genotype was the most prevalent, occurring in 49% of the cohort. No significant associations were found between hepatic disease and specific CFTR genotypes or SERPINA1 alleles. However, children with hepatic disease exhibited significantly higher fibrosis scores (APRI and FIB-4), suggesting more advanced liver involvement. Additionally, a slight delay in CF diagnosis was observed in those with hepatic disease, though this difference did not reach statistical significance., Conclusion: This pioneering study in Romania underscores the complexity of hepatic disease in CF. While specific CFTR genotypes and SERPINA1 alleles were not significantly associated with hepatic complications, the findings emphasize the importance of early diagnosis and monitoring using fibrosis markers to identify children at risk for liver involvement.

Background: Opera singers are at risk to develop gastroesophageal reflux, because of the vocational challenges during singing. The singers are reluctant to be submitted to pH-metry fearing throat injuries. We evaluated the gastroesophageal reflux in vocal opera students using a non-invasive salivary test., Design and Setting: A prospective, case-control study was carried out in 30 vocal opera students from the Music Academy of the city Cluj-Napoca, Romania, enrolled in the "canto" section., Methods: For control, 20 medical students and residents were enrolled. Each subject filled in a questionnaire and gave saliva samples for the salivary test Peptest™ (RD Biomed). The statistical analysis was made using program R version 3.2.1 (2015-06-18)., Results: According to salivary Peptest, vocal opera students had a higher prevalence of gastro-esophageal reflux than the control group (96.67% versus 30%; 29 from 30 vs 14 from 20), P<0.001. Only 50% (15 of 30) of the vocal opera students reported reflux symptoms., Conclusions: Salivary Peptest confirmed a higher prevalence of gastroesophageal reflux in vocal opera students, although not all of them reported reflux symptoms.

Background and Aims: The interest in the research of both Oral Health Related Quality Of Life and dental aesthetics has increased in the recent years. The aim of the current study consists in the evaluation of the perception of oral-health, dental aesthetics and self-esteem in a general population., Methods: A group of students of the Faculty of Dental Medicine, Cluj-Napoca, were trained in the field of questionnaire interviewing. The students were asked to apply the following questionnaires to a number of maximum five close persons: the OHIP-14Aesthetic questionnaire, the Rosenberg self-esteem scale and a questionnaire evaluating demographic data. Each interviewed subject provided informed consent. The sample included 97 subjects with an age range of 18-75 years. For each of the three applied questionnaires overall scores were computed and used for the calculation of Pearson correlations and inferential statistical procedures: the t-test., Results: Related to the complete sample (N=97), the highest OHIP-14Aesthetic scores were obtained for the functional limitation (mean score of 2.22), physical pain (mean score of 2.72) and psychological discomfort (mean score of 1.37) subscales. The highest Rosenberg self-esteem scale scores were obtained for the following questions: "I think I am no good at all" (mean score of 3.50), "feel useless at times" (mean score of 3.53), "inclined to feel that I am a failure" (mean score 3.77), "positive attitude toward myself" (mean score of 3.50). Statistically significant correlations were registered between the overall Rosenberg self-esteem scale score and the scores of the following OHIP-14Aesthetic subscales: psychological discomfort (r = -0.201, p = 0.49), physical disability (r = -0.219, p = 0.031), psychological disability (r = -0.218, p = 0.032), social disability (r = -0.203, p = 0.046). The t-test revealed statistically significant gender differences, in regard to the OHIP-14Aesthetic overall score t(95) = -2.820, p = 0.006., Conclusions: The current study indicates the existence of statistically significant gender differences in the perception of oral health and a series of dental aesthetics elements in a general population. Moreover, statistically significant correlations were obtained between the perception of oral health and the perception of self-esteem.

The gastric environment has been long time considered bacteria-free, but the discovery of Helicobacter pylori (H. pylori) in 1982 superseded this conception. Over the last decades new diagnostic methods have been developed, starting with culture-dependent and advancing to culture-independent ones. These modern techniques provide new insight into the composition and influence of this ecosystem on the entire gastrointestinal tract. H. pylori is no longer considered the only microorganism in the stomach, other non-H. pylori microbial species may populate the same environment and exercise their role. Current knowledge suggests possible links of these bacteria with gastroduodenal diseases, such as peptic ulcer and gastric cancer but most of them need further scientific evidence. This review summarizes current information on these complex interrelations between gastric microbial communities and host in health and disease.