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Inflammatory bowel disease (IBD) is a chronic affliction that requires careful regular monitoring and focused treatment, defined by remissions and flares, with frequent hospital admissions, surgical procedures in complicated cases and progression towards dysplasia in longstanding disease. The patient's quality of life is considerably affected by the disease per se but also by the frequent follow-ups and invasive procedures used for disease activity monitoring. The diagnosis of inflammatory bowel disease rests on symptoms, clinical signs, laboratory and imaging tests and is confirmed by bioptic endoscopy with subsequent pathology examination. Endoscopy is an important tool not just for disease diagnosis but also for disease progression monitoring, early dysplastic lesions diagnosis and therapeutic intervention. Endoscopy offers a fast and straightforward evaluation of the colonic mucosa, enabling the description of the extent and severity of the intestinal lesions leading to the prediction of the disease's aggressive nature and the introduction of appropriate treatment. The ultimate goal when dealing with IBDs is to reach mucosal healing, thus ensuring a significant improvement of the quality of life and prognosis and a drop in hospitalization expenses and in the need for surgical measures. This paper aims to review the latest Gastrointestinal Endoscopy Society standards of practice guidelines so as to offer a useful algorithm for the use of endoscopy in patient care. [ABSTRACT FROM AUTHOR]

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Introduction. Cryptogenic organizing pneumonia (COP), first described in 1985 as BOOP bronchiolitis obliterans organizing pneumonia, is an acute inflammatory disease characterized histopathologically by intracellular granulomas formed by connective tissue and miofibroblasts (Masson bodies). Case presentation. 62-year-old female patient, known with type 2 DZ, ICC, CIND (paroxysmal FiA) and HTAE, under treatment with Amiodarone, is hospitalized with acute respiratory symptomatology. Laboratory tests show bilateral basaltic crepitation risers, biological inflammatory syndrome, and radiologically multiple opacities with ½ inferior condensation appearance for which empiric antibiotic treatment was initiated. Evolution of the patient was unfavourable, despite antibiotic treatment. Therefore, it is decided to do a fibrobronchoscopic examination (bronchial aspiration for cytology and BK), thoracic CT followed by thoracoscopy and pulmonary biopsy. The diagnosis of COP was based on the typical radiological appearance of bronchopneumonia but that is not responding to antibiotic treatment. The bronchoalveolar lavage revealed nonspecific inflammatory infiltration with lymphocytes and polymorphonuclear cells, the histopathological examination revealed the presence of Masson bodies, alveolar fibroblast polyps and bronchiolar polyps. As amiodarone is known to have pulmonary adverse effects, among which COP was very rarely quoted, treatment with amiodarone was discontinued and cortisone treatment with prednisone 70 mg/day was initiated, with rapid progressive improvement of symptomatology and slow improvement of imaging. In treatment month 3, after the decrease in prednisone to 30 mg/day, the general condition of the patient worsens in parallel with the biological and imaging parameters secondary to the reintroduction of the amiodarone treatment, an event treated as a recurrence of drug-induced obliterans pneumonia. The evolution of the patient was favourable, with the remission of clinical symptoms and radiological appearance, in the absence of relapses one and a half years after the end of the treatment. Conclusions. This paper presents a complete case of cryptogenic organizing pneumonia in a patient undergoing amiodarone treatment, which has a complete response to cortisone treatment only after the trigger factor has been removed. [ABSTRACT FROM AUTHOR]

Liver diseases are a major cause of morbidity and mortality that have been increasing in the last years. The clinical course is marked by severe complications, unrelated with the cause of the hepatic disease. In recent years, there have been two conditions described, that differ in their physiological mechanism and treatment: hepatopulmonary syndrome and portopulmonary hypertension. The incidence of the hepatopulmonary syndrome is approximately 30% of patients with liver diseases included on the transplant list. Most of the information on the cause were obtained experimentally on lab animals. Most patients are asymptomatic and a diagnosis requires taking an arterial blood gas sample measuring the alveolar-arterial oxygen gradient (≥15 mmHg or ≥20 mmHg in patients aged >64 years). Diagnosis is confirmed through contrast echocardiography or ventilation/perfusion scan of the lungs that reveal an intrapulmonary shunt. Liver transplant is the only effective surgical treatment, reversing hepatopulmonary syndrome in 80% of cases. The present paper aims to discuss both old and current aspects of hepatopulmonary syndrome. [ABSTRACT FROM AUTHOR]

Copyright of Internal Medicine / Medicină Internă is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)