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3. Impact of Treatment with Direct Antivirals on Coagulation Parameters in Patients with Hepatitis C Virus-Related Liver Cirrhosis and Sustained Virological Response.

Author

Huiban, Laura, Stanciu, Carol, Muzica, Cristina Maria, Girleanu, Irina, Avram, Raluca, Damian, Ioana, Nastasa, Robert, Stratina, Ermina, Zenovia, Sebastian, Minea, Horia, Stafie, Remus, Rotaru, Adrian, Singeap, Ana-Maria, Chiriac, Stefan, Balmus, Ioana-Miruna, and Trifan, Anca

Subjects
CHRONIC hepatitis C, CIRRHOSIS of the liver, BLOOD coagulation, END of treatment, HEPATITIS C
Abstract

Background and Objectives: Sustained virologic responses (SVRs) lead to a decrease in portal hypertension, the regression of fibrosis, and the improvement in the hepatic synthesis of procoagulant and anticoagulant factors. We aimed to assess the influence of SVR on coagulation parameters in cirrhotic patients with HCV treated with DAAs. Methods: We performed a prospective study in the Institute of Gastroenterology and Hepatology Iasi, Romania, between January 2022 and February 2024. We included patients diagnosed with compensated and decompensated HCV-related liver cirrhosis, treated with direct antivirals (PrOD ± RBV or SOF/LED ± RBV) for 12/24 weeks. Blood samples for biochemical, immunological, and coagulation tests were collected at the baseline, end of treatment (EOT), and once sustained virological response had been achieved over a period of 12/24 weeks (SVR12/24). Results: We analyzed a group of 52 patients with HCV-related liver cirrhosis, predominantly female (68.0%), and the degree of severity of cirrhosis placed the patients mainly in Child–Pugh classes B (40%) and C (36%). All patients achieved SVRs. The MELD score decreased at EOT (13.48 ± 4.273; p = 0.001) and SVR (9.88 ± 2.774; p = 0.000), compared to the baseline (14.92 ± 4.707). The FibroScan values decreased at SVR (17.596 ± 3.7276; p = 0.000) compared to the baseline (26.068 ± 7.0954). For all common coagulation parameters (platelets, INR, PT, fibrinogen, aPTT), there was a trend towards improvement during treatment, including changes which were statistically significant for the majority of patients. Factor II was low at the baseline (75.40 ± 7.506) but increased at EOT (87.40 ± 9.587) and, later, at SVR (99.12 ± 11.695; p = 0.000). The FVIII values increased at the baseline (175.52 ± 16.414) and decreased at EOT (151.48 ± 13.703) and SVR (143.40 ± 13.937). The FvW values decreased during treatment (146.84 ± 9.428, at baseline; 141.32 ± 9.690, p = 0.000, at EOT; and 126.68 ± 17.960, at SVR). In regard to the anticoagulant factors (PC, PS, ATIII), a significant improvement was brought on by SVR. Advanced stages of liver disease showed the most diminished FII activity, while at the baseline and in Child–Pugh C patients we recorded the highest values of FVIII and FvW. Conclusions: Our study proved that the "reset" of coagulopathy might be due to the improvement in liver function due to viral eradication secondary to AAD therapy. [ABSTRACT FROM AUTHOR]

Published
2024
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5. The Contribution of Genetic and Epigenetic Factors: An Emerging Concept in the Assessment and Prognosis of Inflammatory Bowel Diseases.

Author

Minea, Horia, Singeap, Ana-Maria, Minea, Manuela, Juncu, Simona, Muzica, Cristina, Sfarti, Catalin Victor, Girleanu, Irina, Chiriac, Stefan, Miftode, Ioana Diandra, Stanciu, Carol, and Trifan, Anca

Subjects
EPIGENOMICS, MULTIOMICS, GENOMICS, PROGNOSIS, INDIVIDUALIZED medicine, INFLAMMATORY bowel diseases
Abstract

Inflammatory bowel disease (IBD) represents heterogeneous and relapsing intestinal conditions with a severe impact on the quality of life of individuals and a continuously increasing prevalence. In recent years, the development of sequencing technology has provided new means of exploring the complex pathogenesis of IBD. An ideal solution is represented by the approach of precision medicine that investigates multiple cellular and molecular interactions, which are tools that perform a holistic, systematic, and impartial analysis of the genomic, transcriptomic, proteomic, metabolomic, and microbiomics sets. Hence, it has led to the orientation of current research towards the identification of new biomarkers that could be successfully used in the management of IBD patients. Multi-omics explores the dimension of variation in the characteristics of these diseases, offering the advantage of understanding the cellular and molecular mechanisms that affect intestinal homeostasis for a much better prediction of disease development and choice of treatment. This review focuses on the progress made in the field of prognostic and predictive biomarkers, highlighting the limitations, challenges, and also the opportunities associated with the application of genomics and epigenomics technologies in clinical practice. [ABSTRACT FROM AUTHOR]

Published
2024
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6. New Insights on Using Oral Semaglutide versus Dapagliflozin in Patients with Type 2 Diabetes and Metabolic Dysfunction-Associated Steatotic Liver Disease.

Author

Stratina, Ermina, Stanciu, Carol, Nastasa, Robert, Zenovia, Sebastian, Stafie, Remus, Rotaru, Adrian, Cuciureanu, Tudor, Muzica, Cristina, Sfarti, Catalin, Girleanu, Irina, Minea, Horia, Petrea, Oana, Huiban, Laura, Chiriac, Stefan, Singeap, Ana-Maria, Vlad, Oana, Cojocariu, Camelia, and Trifan, Anca

Subjects
HEPATIC fibrosis, TYPE 2 diabetes, WAIST-hip ratio, SEMAGLUTIDE, BODY mass index
Abstract

Background and aims: Increases in both the prevalence and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity are closely related. Type 2 diabetes (T2DM) has been associated with metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis and hepatocellular carcinoma. Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist approved for the treatment of T2DM and has an important role in weight loss. Also, it may represent a new therapeutic option for the treatment of MASH in obese diabetic patients. The main outcomes were changes from baseline in liver steatosis and fibrosis at week 24. Material and methods: A total of one hundred eighty-seven patients with T2DM were eligible for this prospective study; ninety-five subjects were treated with oral semaglutide, and ninety-two patients were treated with dapagliflozin as an add-on to metformin. All the subjects were evaluated using Vibration Controlled Transient Elastography (VCTE) from June to December 2022. Results: From our cohort, 54% of the patients were females, with a mean age of 59.92 ± 11.89 years and a mean body mass index (BMI) of 29.53 ± 5.33 kg/m2. Following a six-month medication period, we observed a substantial reduction in anthropometric measurements, including the BMI, waist circumference (WC), and waist-to-hip ratio (WtHr), in both groups. Regarding HbA1c, a notable decrease was observed in the semaglutide group (p < 0.001) when compared to the dapagliflozin group (p = 0.011). In addition, the liver stiffness measurement (LSM) according to VCTE improved significantly in the semaglutide group participants from 8.07 ± 2.90 kPa at baseline to 6.51 ± 3.09 kPa after medication (p < 0.001). Conclusion: The superior metabolic effects of semaglutide, correlated to dapagliflozin, may contribute to a more efficient decrease in hepatic stress and injury, leading to a substantial enhancement of liver function in T2DM patients. Further investigations conducted over an ideal timeframe are necessary to confirm the evidence presented in this study. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Clinical Implications and Management of Spontaneous Portosystemic Shunts in Liver Cirrhosis.

Author

Juncu, Simona, Minea, Horia, Girleanu, Irina, Huiban, Laura, Muzica, Cristina, Chiriac, Stefan, Timofeiov, Sergiu, Mihai, Florin, Cojocariu, Camelia, Stanciu, Carol, Trifan, Anca, and Singeap, Ana-Maria

Subjects
MAGNETIC resonance imaging, HEPATIC encephalopathy, LIVER diseases, CIRRHOSIS of the liver, LIVER transplantation
Abstract

Portal hypertension from chronic liver disease leads to the formation of collateral blood vessels called spontaneous portosystemic shunts (SPSS). These shunts may form from existing vessels or through neo-angiogenesis. Their location affects clinical outcomes due to varying risks and complications. This review summarizes current knowledge on SPSS, covering their clinical impact and management strategies. Recent data suggest that SPSS increases the risk of variceal bleeding, regardless of shunt size. The size of the shunt is crucial in the rising incidence of hepatic encephalopathy (HE) linked to SPSS. It also increases the risk of portopulmonary hypertension and portal vein thrombosis. Detecting and assessing SPSS rely on computed tomography (CT) and magnetic resonance imaging. CT enables precise measurements and the prediction of cirrhosis progression. Management focuses on liver disease progression and SPSS-related complications, like HE, variceal bleeding, and portopulmonary hypertension. Interventional radiology techniques such as balloon-occluded, plug-assisted, and coil-assisted retrograde transvenous obliteration play a pivotal role. Surgical options are rare but are considered when other methods fail. Liver transplantation (LT) often resolves SPSS. Intraoperative SPSS ligation is still recommended in patients at high risk for developing HE or graft hypoperfusion. [ABSTRACT FROM AUTHOR]

Published
2024
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9. The Impact of Alcohol Consumption Pattern on Liver Fibrosis in Asymptomatic Patients

Author

Minea, Horia, primary, Singeap, Ana-Maria, additional, Sfarti, Catalin Victor, additional, Girleanu, Irina, additional, Chiriac, Stefan, additional, Muzica, Cristina, additional, Cuciureanu, Tudor, additional, Petrea, Oana Cristina, additional, Huiban, Laura, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Rotaru, Adrian, additional, Stafie, Remus, additional, Stratina, Ermina, additional, Cojocariu, Camelia, additional, Stanciu, Carol, additional, and Trifan, Anca, additional

Published
2023
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13. Impaired Intestinal Permeability Assessed by Confocal Laser Endomicroscopy—A New Potential Therapeutic Target in Inflammatory Bowel Disease

Author

Chiriac, Stefan, primary, Sfarti, Catalin Victor, additional, Minea, Horia, additional, Stanciu, Carol, additional, Cojocariu, Camelia, additional, Singeap, Ana-Maria, additional, Girleanu, Irina, additional, Cuciureanu, Tudor, additional, Petrea, Oana, additional, Huiban, Laura, additional, Muzica, Cristina Maria, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Stafie, Remus, additional, Rotaru, Adrian, additional, Stratina, Ermina, additional, and Trifan, Anca, additional

Published
2023
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14. Anticoagulation for Atrial Fibrillation in Patients with Decompensated Liver Cirrhosis: Bold and Brave?

Author

Gîrleanu, Irina, primary, Trifan, Anca, additional, Huiban, Laura, additional, Muzica, Cristina Maria, additional, Petrea, Oana Cristina, additional, Sîngeap, Ana-Maria, additional, Cojocariu, Camelia, additional, Chiriac, Stefan, additional, Cuciureanu, Tudor, additional, Stafie, Remus, additional, Zenovia, Sebastian, additional, Stratina, Ermina, additional, Rotaru, Adrian, additional, Nastasa, Robert, additional, Sfarti, Catalin, additional, Costache, Irina Iuliana, additional, and Stanciu, Carol, additional

Published
2023
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15. Changes in Components of Metabolic Syndrome after Antiviral Eradication in Hepatitis C Virus Infection

Author

Trifan, Anca, primary, Cuciureanu, Tudor, additional, Nastasa, Robert, additional, Stratina, Ermina, additional, Zenovia, Sebastian, additional, Muzica, Cristina Maria, additional, Huiban, Laura, additional, Singeap, Ana-Maria, additional, Chiriac, Stefan, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, Girleanu, Irina, additional, Minea, Horia, additional, Stafie, Remus, additional, Rotaru, Adrian, additional, and Stanciu, Carol, additional

Published
2023
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16. High prevalence of liver fibrosis among general population: a Romanian population-based study

Author

Trifan, Anca, primary, Muzica, Cristina-Maria, additional, Nastasa, Robert, additional, Zenovia, Sebastian, additional, Stratina, Ermina, additional, Stafie, Remus, additional, Rotaru, Adrian, additional, Singeap, Ana-Maria, additional, Cojocariu, Camelia, additional, Sfarti, Catalin, additional, Girleanu, Irina, additional, Chiriac, Stefan, additional, Cuciureanu, Tudor, additional, Huiban, Laura, additional, and Stanciu, Carol, additional

Published
2023
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17. Predictive Factors for the Prognosis of Alcoholic Liver Cirrhosis

Author

Trifan, Anca, primary, Minea, Horia, additional, Rotaru, Adrian, additional, Stanciu, Carol, additional, Stafie, Remus, additional, Stratina, Ermina, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Singeap, Ana-Maria, additional, Girleanu, Irina, additional, Muzica, Cristina, additional, Huiban, Laura, additional, Cuciureanu, Tudor, additional, Chiriac, Stefan, additional, Sfarti, Catalin, additional, and Cojocariu, Camelia, additional

Published
2022
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18. Screening for Liver Steatosis and Fibrosis in Patients with Inflammatory Bowel Disease Using Vibration Controlled Transient Elastography with Controlled Attenuation Parameter

Author

Trifan, Anca, primary, Stafie, Remus, additional, Rotaru, Adrian, additional, Stratina, Ermina, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Huiban, Laura, additional, Cuciureanu, Tudor, additional, Muzica, Cristina, additional, Chiriac, Stefan, additional, Girleanu, Irina, additional, Singeap, Ana-Maria, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, Petrea, Oana, additional, and Stanciu, Carol, additional

Published
2022
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19. The Role of Presepsin and Procalcitonin in Early Diagnosis of Bacterial Infections in Cirrhotic Patients with Acute-on-Chronic Liver Failure

Author

Igna, Razvan, primary, Gîrleanu, Irina, additional, Cojocariu, Camelia, additional, Huiban, Laura, additional, Muzîca, Cristina, additional, Sîngeap, Ana-Maria, additional, Sfarti, Cătălin, additional, Chiriac, Stefan, additional, Petrea, Oana Cristina, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Cuciureanu, Tudor, additional, Stafie, Remus, additional, Stratina, Ermina, additional, Rotaru, Adrian, additional, Stanciu, Carol, additional, Blaj, Mihaela, additional, and Trifan, Anca, additional

Published
2022
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21. Efficacy and safety of paritaprevir/ritonavir, ombitasvir, and dasabuvir with ribavirin for the treatment of HCV genotype 1b compensated cirrhosis in patients aged 70 years or older

Author

Trifan, Anca, Stanciu, Carol, Gheorghe, Liana, Iacob, Speranta, Curescu, Manuela, Cijevschi Prelipcean, Cristina, Stefanescu, Gabriela, Girleanu, Irina, Chiriac, Stefan, Mihai, Catalina, Brisc, Ciprian, Goldis, Adrian, Sporea, Ioan, Miftode, Egidia, Bataga, Simona, Rogoveanu, Ion, Preda, Carmen, Caruntu, Florin Alexandru, and Singeap, Ana-Maria

Published
2017
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22. The Role of Presepsin in Diagnosing Infections in Patients with Liver Cirrhosis and Overt Hepatic Encephalopathy

Author

Igna, Razvan, primary, Gîrleanu, Irina, additional, Cojocariu, Camelia, additional, Muzîca, Cristina, additional, Huiban, Laura, additional, Sfarti, Catalin, additional, Cuciureanu, Tudor, additional, Chiriac, Stefan, additional, Sîngeap, Ana-Maria, additional, Petrea, Oana Cristina, additional, Stafie, Remus, additional, Zenovia, Sebastian, additional, Năstasă, Robert, additional, Stratina, Ermina, additional, Rotaru, Adrian, additional, Stanciu, Carol, additional, Trifan, Anca, additional, and Blaj, Mihaela, additional

Published
2022
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23. Simultaneously Screening for Liver Steatosis and Fibrosis in Romanian Type 2 Diabetes Mellitus Patients Using Vibration-Controlled Transient Elastography with Controlled Attenuation Parameter

Author

Trifan, Anca, primary, Stratina, Ermina, additional, Nastasa, Robert, additional, Rotaru, Adrian, additional, Stafie, Remus, additional, Zenovia, Sebastian, additional, Huiban, Laura, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, Cuciureanu, Tudor, additional, Muzica, Cristina, additional, Chiriac, Stefan, additional, Girleanu, Irina, additional, Singeap, Ana-Maria, additional, and Stanciu, Carol, additional

Published
2022
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24. Ischemic Heart Disease and Liver Cirrhosis: Adding Insult to Injury

Author

Gîrleanu, Irina, primary, Trifan, Anca, additional, Huiban, Laura, additional, Muzîca, Cristina, additional, Petrea, Oana Cristina, additional, Sîngeap, Ana Maria, additional, Cojocariu, Camelia, additional, Chiriac, Stefan, additional, Cuciureanu, Tudor, additional, Costache, Irina Iuliana, additional, and Stanciu, Carol, additional

Published
2022
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25. Improved recurrence-free survival rates in patients with HCV-related hepatocellular carcinoma and sustained virological response to direct-acting antivirals

Author

Muzica, Cristina-Maria, primary, Trifan, Anca, additional, Huiban, Laura, additional, Stoica, Oana, additional, Girleanu, Irina, additional, Chiriac, Stefan, additional, Singeap, Ana-Maria, additional, Cojocariu, Camelia, additional, Cuciureanu, Tudor, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, and Stanciu, Carol, additional

Published
2022
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26. The Rate of Burnout Syndrome in A Tertiary Gastroenterology University Center in Romania.

Author

Dranga, Mihaela, Chiriac, Stefan, Stanciu, Carol, Prelipcean, Cristina Cijevschi, Timofeiov, Sergiu, and Trifan, Anca

Subjects
*MASLACH Burnout Inventory, *PATIENT experience, *MEDICAL personnel, *PSYCHOLOGICAL burnout, *GASTROENTEROLOGY, *GASTROENTEROLOGISTS
Abstract

Background & Aims: The burnout syndrome (BOS) is commonly seen in healthcare professionals, particularly in physicians who are exposed to a high level of stress at work and has a negative impact on the medical activity. Physicians with BOS manifest a negative attitude, a reduction in compassion at work, and suboptimal patient care experiences. These all can lead to absenteeism, poor performance and more frequent medical errors. We aimed to assess the level of BOS in a tertiary gastroenterology university center in Romania. Methods: This observational study involved 40 physicians from a tertiary gastroenterology university center. An online questionnaire assessed the presence of BOS using the Maslach Burnout Inventory. Results: A total of 40 physicians responded to the questionnaire. The prevalence of overall BOS of 87.5%. In terms of high burnout, 15 doctors (37.5%) had emotional exhaustion, 10 doctors (25%) had depersonalization, and 30 doctors (80%) scored low for personal achievement. Men presented more frequently emotional exhaustion and women lower personal achievement scores, but there was no significant statistical difference. No significant relationship was found between marital status or the number of children and BOS. We identified multiple risk factors associated to BOS, the most important one being strict internal regulations. Conclusions: Physicians presented an increased risk for BOS. The high rate of BOS among physicians found in our study requires careful attention. Further studies aiming to identify other factors that contribute to BOS and to identify measures to combat this syndrome are necessary. [ABSTRACT FROM AUTHOR]

Published
2023
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27. Clinical and Laboratory Characteristics of Normal Weight and Obese Individuals with Non-Alcoholic Fatty Liver Disease

Author

Trifan, Anca, primary, Rotaru, Adrian, additional, Stafie, Remus, additional, Stratina, Ermina, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Huiban, Laura, additional, Cuciureanu, Tudor, additional, Muzîca, Cristina, additional, Chiriac, Stefan, additional, Gîrleanu, Irina, additional, Sîngeap, Ana-Maria, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, and Stanciu, Carol, additional

Published
2022
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28. Changes in Liver Steatosis Using Controlled Attenuation Parameter among Patients with Chronic Hepatitis C Infection Treated with Direct-Acting Antivirals Therapy Who Achieved Sustained Virological Response

Author

Trifan, Anca, primary, Stratina, Ermina, additional, Rotaru, Adrian, additional, Stafie, Remus, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Huiban, Laura, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, Cuciureanu, Tudor, additional, Muzica, Cristina, additional, Chiriac, Stefan, additional, Girleanu, Irina, additional, Singeap, Ana-Maria, additional, and Stanciu, Carol, additional

Published
2022
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29. The Prevalence of Liver Steatosis and Fibrosis Assessed by Vibration-Controlled Transient Elastography and Controlled Attenuation Parameter in Apparently Healthy Romanian Medical Students

Author

Nastasa, Robert, primary, Stanciu, Carol, additional, Zenovia, Sebastian, additional, Singeap, Ana-Maria, additional, Cojocariu, Camelia, additional, Sfarti, Catalin, additional, Girleanu, Irina, additional, Chiriac, Stefan, additional, Cuciureanu, Tudor, additional, Huiban, Laura, additional, Muzica, Cristina-Maria, additional, and Trifan, Anca, additional

Published
2021
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31. The Risk of Clostridioides difficile Infection in Cirrhotic Patients Receiving Norfloxacin for Secondary Prophylaxis of Spontaneous Bacterial Peritonitis—A Real Life Cohort

Author

Girleanu, Irina, primary, Trifan, Anca, additional, Huiban, Laura, additional, Muzica, Cristina, additional, Nemteanu, Roxana, additional, Teodorescu, Andreea, additional, Singeap, Ana Maria, additional, Cojocariu, Camelia, additional, Chiriac, Stefan, additional, Petrea, Oana, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Cuciureanu, Tudor, additional, and Stanciu, Carol, additional

Published
2021
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33. Association between Nonalcoholic Fatty Liver Disease and Endocrinopathies: Clinical Implications

Author

Singeap, Ana-Maria, Stanciu, Carol, Huiban, Laura, Muzica, Cristina Maria, Cuciureanu, Tudor, Girleanu, Irina, Chiriac, Stefan, Zenovia, Sebastian, Nastasa, Robert, Sfarti, Catalin, Cojocariu, Camelia, and Trifan, Anca

Subjects
Article Subject
Abstract

Nonalcoholic fatty liver disease (NAFLD) has a rising prevalence worldwide. Its potential for evolution towards liver cirrhosis and hepatocellular carcinoma, as well as associations with extrahepatic manifestations, represents a double burden for patients and physicians alike. Recently, there has been increasing evidence of the association between NAFLD and a number of endocrinopathies, such as hypothyroidism, polycystic ovarian syndrome (PCOS), hypopituitarism, growth hormone deficiency (GHD), hypogonadism, and hypercortisolism. Definite correlations are supported by clear evidence so far, but further studies are needed in order to completely clarify the pathogenic mechanisms and, especially, to identify therapeutic implications. In this review, we present the main relationships between NAFLD and endocrinopathies, emphasizing the reciprocal causality, evolutive interconnections, and current clinical scenarios of presentations of which the clinicians should be aware.

Published
2021
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34. Nonalcoholic Fatty Liver Disease and Cardiovascular Diseases: The Heart of the Matter

Author

Chiriac, Stefan, Stanciu, Carol, Girleanu, Irina, Cojocariu, Camelia, Sfarti, Catalin, Singeap, Ana-Maria, Cuciureanu, Tudor, Huiban, Laura, Muzica, Cristina Maria, Zenovia, Sebastian, Nastasa, Robert, and Trifan, Anca

Subjects
Article Subject, nutritional and metabolic diseases, digestive system diseases
Abstract

Nonalcoholic fatty liver disease (NAFLD) has emerged as the most frequent cause of liver disease worldwide, comprising a plethora of conditions, ranging from steatosis to end-stage liver disease. Cardiovascular disease (CVD) has been associated with NAFLD and CVD-related events represent the main cause of death in patients with NAFLD, surpassing liver-related mortality. This association is not surprising as NAFLD has been considered a part of the metabolic syndrome and has been related to numerous CVD risk factors, namely, insulin resistance, abdominal obesity, dyslipidemia, hyperuricemia, chronic kidney disease, and type 2 diabetes. Moreover, both NAFLD and CVD present similar pathophysiological mechanisms, such as increased visceral adiposity, altered lipid metabolism, increased oxidative stress, and systemic inflammation that could explain their association. Whether NAFLD increases the risk for CVD or these diagnostic entities represent distinct manifestations of the metabolic syndrome has not yet been clarified. This review focuses on the relation between NAFLD and the spectrum of CVD, considering the pathophysiological mechanisms, risk factors, current evidence, and future directions.

Published
2021
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35. Hepatitis C Virus Prevalence and Risk Factors in a Village in Northeastern Romania—A Population-Based Screening—The First Step to Viral Micro-Elimination

Author

Huiban, Laura, primary, Stanciu, Carol, additional, Muzica, Cristina Maria, additional, Cuciureanu, Tudor, additional, Chiriac, Stefan, additional, Zenovia, Sebastian, additional, Burduloi, Vladut Mirel, additional, Petrea, Oana, additional, Sîngeap, Ana Maria, additional, Gîrleanu, Irina, additional, Sfarti, Cătălin, additional, Cojocariu, Camelia, additional, and Trifan, Anca, additional

Published
2021
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37. Vibration-Controlled Transient Elastography and Controlled Attenuation Parameter for the Diagnosis of Liver Steatosis and Fibrosis in Patients with Nonalcoholic Fatty Liver Disease

Author

Zenovia, Sebastian, primary, Stanciu, Carol, additional, Sfarti, Catalin, additional, Singeap, Ana-Maria, additional, Cojocariu, Camelia, additional, Girleanu, Irina, additional, Dimache, Mihaela, additional, Chiriac, Stefan, additional, Muzica, Cristina Maria, additional, Nastasa, Robert, additional, Huiban, Laura, additional, Cuciureanu, Tudor, additional, and Trifan, Anca, additional

Published
2021
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38. Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: A Bidirectional Relationship

Author

Muzica, Cristina M., Sfarti, Catalin, Trifan, Anca, Zenovia, Sebastian, Cuciureanu, Tudor, Nastasa, Robert, Huiban, Laura, Cojocariu, Camelia, Singeap, Ana-Maria, Girleanu, Irina, Chiriac, Stefan, and Stanciu, Carol

Subjects
endocrine system diseases, Article Subject, nutritional and metabolic diseases, digestive system diseases
Abstract

Worldwide, the leading cause of chronic liver disease is represented by nonalcoholic fatty liver disease (NAFLD) which has now become a global epidemic of the 21st century, affecting 1 in 4 adults, and which appears to be associated with the steadily increasing rates of metabolic syndrome and its components (obesity, type 2 diabetes mellitus (T2DM), and dyslipidemia). NAFLD has been reported to be associated with extrahepatic manifestations such as cardiovascular disease, T2DM, chronic kidney disease, extrahepatic malignancies (e.g., colorectal cancer), endocrine diseases (e.g., hypothyroidism, polycystic ovarian syndrome, psoriasis, and osteoporosis), obstructive sleep apnea, and iron overload. The prevalence of NAFLD is very high, affecting 25–30% of the world population and encloses two steps: (1) nonalcoholic fatty liver (NAFL), which includes steatosis only, and (2) nonalcoholic steatohepatitis (NASH) defined by the presence of steatosis and inflammation with hepatocyte ballooning, with or without fibrosis which can progress to liver fibrosis, hepatocellular carcinoma, and liver transplantation. Current data define a more complex relationship between NAFLD and T2DM than was previously believed, underlining a bidirectional and mutual association between the two entities. This review aims to summarize the current literature regarding the incidence of T2DM among patients with NAFLD and also the prevalence of NAFLD in T2DM patients, highlighting the recent key studies. Clinicians should screen, diagnose, and treat T2DM in patients with NAFLD in order to avoid short- and long-term complications.

Published
2020
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41. The Impact of the COVID-19 Pandemic on Gastrointestinal Endoscopy Activity in a Tertiary Care Center from Northeastern Romania

Author

Chiriac, Stefan, primary, Stanciu, Carol, additional, Cojocariu, Camelia, additional, Sfarti, Catalin, additional, Singeap, Ana-Maria, additional, Girleanu, Irina, additional, Cuciureanu, Tudor, additional, Huiban, Laura, additional, David, Diana, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, Balan, Gheorghe G., additional, and Trifan, Anca, additional

Published
2021
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42. Nonalcoholic Fatty Liver Disease-Related Chronic Kidney Disease

Author

Cojocariu, Camelia, primary, Singeap, Ana-Maria, additional, Girleanu, Irina, additional, Chiriac, Stefan, additional, Muzica, Cristina M., additional, Sfarti, Catalin Victor, additional, Cuciureanu, Tudor, additional, Huiban, Laura, additional, Stanciu, Carol, additional, and Trifan, Anca, additional

Published
2020
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49. Sa1442 - Relative Adrenal Insufficiency in the Setting of Acute on Chronic Liver Failure – An Organ Dysfunction that Could Indicate Futility

Author

Chiriac, Stefan A., primary, Stanciu, Carol, additional, Singeap, Ana Maria, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, Girleanu, Irina, additional, Cuciureanu, Tudor, additional, Stoica, Oana, additional, Huiban, Laura, additional, Muzica, Cristina Maria, additional, Livadariu, Roxana Maria, additional, and Trifan, Anca, additional

Published
2018
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