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3. 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

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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4. 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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5. 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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6. Insights into the Natural and Treatment Courses of Hepatitis B in Children: A Retrospective Study.

Author

Forna, Lorenza, Bozomitu, Laura, Lupu, Ancuta, Lupu, Vasile Valeriu, Cojocariu, Camelia, Anton, Carmen, Girleanu, Irina, Singeap, Ana Maria, Muzica, Cristina Maria, and Trifan, Anca

Subjects
CHRONIC active hepatitis, HEPATITIS B, VIRAL hepatitis, HEPATITIS B virus, CHILD patients
Abstract

Chronic Hepatitis B virus (HBV) infection in children remains a significant public health challenge. The natural history and treatment outcomes of HBV can vary widely, influencing management strategies. This retrospective study was conducted in Northeast Romania and involved a cohort of 148 pediatric patients diagnosed with chronic viral Hepatitis B. Of these, 59 children underwent antiviral treatment while 89 were not treated. One of the main objectives was the rate of HBeAg (Hepatitis B-e antigen) seroconversion, a marker of disease progression and response to therapy. Among the treated group, 26 children (44%) achieved HBeAg seroconversion following therapy. In contrast, 44 of the untreated children (49%) experienced spontaneous HBeAg seroconversion, indicating a substantial rate of natural resolution within this population subset. The findings highlight a significant proportion of spontaneous seroconversion in untreated pediatric patients, suggesting a potential re-evaluation of treatment criteria and timing for children with chronic HBV infection. The comparable rates of seroconversion between treated and untreated cohorts underscore the need for individualized treatment approaches based on a combination of virological, biochemical, and clinical parameters. Further studies are required to refine management strategies to optimize long-term outcomes in pediatric HBV infections. [ABSTRACT FROM AUTHOR]

Published
2024
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7. 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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10. Real-World Utilization of Corticosteroids in Severe Alcoholic Hepatitis: Eligibility, Response, and Outcomes.

Author

Singeap, Ana-Maria, Minea, Horia, Petrea, Oana, Robea, Madalina-Andreea, Balmuș, Ioana-Miruna, Duta, Raluca, Ilie, Ovidiu-Dumitru, Cimpoesu, Carmen Diana, Stanciu, Carol, and Trifan, Anca

Subjects
HEPATITIS, GASTROINTESTINAL hemorrhage, DEATH rate, PEOPLE with alcoholism, CORTICOSTEROIDS, MEDICAL personnel
Abstract

Background and Objectives: Alcoholic hepatitis (AH) poses a medical challenge, causing moderately severe to life-threatening episodes with high short- and long-term mortality. This study aimed to explore real-world corticosteroid utilization in severe AH, response predictors, and patient outcomes. Materials and Methods: We conducted a retrospective study on patients admitted for severe AH, defined as a Maddrey Discriminant Function score equal to or above 32, at a tertiary care center. We reviewed patients' medical observation charts to identify corticosteroid prescriptions, reasons for ineligibility, and response rates. Responders were defined based on the Lille score, and predictors of non-response were identified. Short-term (one-month) and long-term (one-year) mortality rates were calculated according to treatment and response. Results: Out of 310 patients enrolled with severe AH, 59% received corticosteroids, achieving a response rate of 75.4%. The reasons for not administering corticosteroids were as follows: uncontrolled infections (27.6%), renal dysfunction (20.4%), gastrointestinal bleeding (18.9%), acute pancreatitis (7.1%), uncontrolled diabetes (3.1%), and other or unknown causes (22.8%). The overall 1-month mortality rate was 12.2%, higher in non-responders (35.3%) and patients who did not receive corticosteroids (13.4%) compared to responders (3.6%). The overall 1-year mortality rate was 62.5%, similar between patients who did not receive corticosteroids (78.7%) and non-responders (77.7%) and higher compared to responders (42.8%). Predictive factors for non-response included older age (OR = 1.05, 95%CI: 1.01–1.08), concomitant cirrhosis (OR= 2.11, 95% CI: 1.064–4.20), MELD scores exceeding 30 (OR = 2.42, 95% CI: 1.21–4.80), severe hypoalbuminemia (OR = 2.46, 95%CI: 1.12–5.37), and increased serum creatinine (OR = 1.5, 95% CI: 1.1–2.03). Among the prognostic scores, MELD 3.0 score exhibited superior efficacy for short-term (AUC = 0.734, 95% CI 0.656–0.811) and long-term mortality (AUC = 0.777, 95% CI: 0.724–0.830) compared to alternative scoring systems. Conclusions: Low eligibility rate and poor prognosis underscore the need for effective therapies. Our findings contribute to refining risk stratification and early prediction of non-response, aiding clinicians in identifying more beneficial therapies. [ABSTRACT FROM AUTHOR]

Published
2024
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11. 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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12. Improvement of carotid atherosclerosis and peripheral artery disease after hepatitis C virus eradication by direct-acting antivirals.

Author

CUCIUREANU, TUDOR, STANCIU, CAROL, NĂSTASĂ, ROBERT RADU, STRATINA, LARISA ERMINA, MINEA, HORIA OCTAV, ZENOVIA, IOAN SEBASTIAN, SFARTI, CĂTĂLIN, MUZICA, CRISTINA MARIA, HUIBAN, LAURA, STAFIE, REMUS THEODOR, SINGEAP, ANA-MARIA, CHIRIAC, ŞTEFAN, COJOCARIU, ELIZA CAMELIA, GÎRLEANU, IRINA, PETREA, OANA CRISTINA, TIMOFEIOV, SERGIU, CUCIUREANU, IULIAN DAN, ROTARU, ADRIAN, and TRIFAN, ANCA

Published
2023
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13. 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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14. 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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15. 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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16. 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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17. 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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18. 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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20. No evidence of a more aggressive pattern of hepatocellular carcinoma after direct acting antivirals –results from a single center observational study

Author

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

Subjects
medicine.medical_specialty, Cirrhosis, business.industry, Incidence (epidemiology), Retrospective cohort study, General Medicine, medicine.disease, Single Center, Gastroenterology, digestive system diseases, Lesion, Hepatocellular carcinoma, Internal medicine, medicine, Observational study, medicine.symptom, business, Direct acting
Abstract

After great concerns were raised regarding a high incidence of hepatocellular carcinoma (HCC) after direct acting antivirals (DAAs) therapy in cirrhotic HCV patients, an avalanche of studies that debated this issue emerged, whose results highlighted also a more aggressive HCC pattern after DAAs. We aimed to assess the pattern and imaging features of HCC in patients with HCV-related liver cirrhosis after DAAs. Material and methods: This is a single-center case-controlled retrospective study in which we included consecutive patients with HCC and HCV-related liver cirrhosis admitted in our clinic between January 1st, 2016 and May 1st, 2018. Results: Sixty-nine patients with HCV-related cirrhosis and HCC were divided into 2 groups depending on the DAAs-treated or untreated status: group I included 15 patients that were previously treated with DAAs and group II included 54 naive patients. Regarding the distribution of HCC, there were no significant differences between the two groups (73.3% of group I patients and 55.5% of group II had unicentric lesion, p=0.215). The tumor size was significantly higher in group II compared to group I, with 66.6% of patients in group I and only 29.6% of patients in group II that have a tumor size less than 3 cm (p=0.009). Supportive treatment without ablation was more frequent in group II (33.3%) than in group I (6.6%) (p=0.047). Conclusions: Our study found no evidence of a more aggressive behavior of HCC after DAAs treatment compared to naive patients. Furthermore, the pattern of HCC after DAAs did not affect the access to curative treatment.

Published
2021

21. The risks of hepatocellular carcinoma and variceal bleeding after HCV eradication with direct-acting antiviral therapy: a propensity score analysis

Author

Preda Carmen, Dimache Mihaela, Girleanu Irina, M Manolache, Iacob Speranta, Cojocariu Camelia, Miftode Egidia, Huiban Laura, Muzica Cristina Maria, Trifan Anca, Carol Stanciu, Catalin Sfarti, Tudor Cuciureanu, Cijevschi Prelipcean Cristina, Singeap Ana Maria, Gheorghe Liana, Pop Corina, Mihai Catalina, Ciortescu Irina, and Stefanescu Gabriela

Subjects
medicine.medical_specialty, Dasabuvir, business.industry, Ribavirin, General Medicine, medicine.disease, Gastroenterology, digestive system diseases, Ombitasvir, chemistry.chemical_compound, Esophageal varices, chemistry, Paritaprevir, Hepatocellular carcinoma, Internal medicine, medicine, Ritonavir, Decompensation, business, medicine.drug
Abstract

The combination paritaprevir/ritonavir, ombitasvir, and dasabuvir (PrOD), which achieves a high sustained virologic response (SVR) rate and few side effects, has dramatically changed the outcome of hepatitis C virus (HCV) infection. The risk of hepatocellular carcinoma (HCC) and variceal bleeding in patients treated with interferon (IFN)-free direct-acting antivirals (DAAs) is unknown. The aim of this prospective study was to evaluate the rate of HCC and variceal bleeding and identify prognostic factors for decompensation/complications in HCV-1b-infected patients with compensated liver cirrhosis following treatment with PrOD with or without ribavirin. Material and methods: A total of 483 HCV patients received PrOD treatment. Patients with a history of HCC were excluded from the study. Prior antiviral therapy was identified in 59% of patients. Patient data were collected at baseline, at the end of treatment (EoT), at 3 months after EOT (SVR) and during an 18-month surveillance period. Patients were divided into two age groups

Published
2021

22. 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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23. 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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24. 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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26. 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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27. Long-term Risk of Hepatocellular Carcinoma Following Direct-Acting Antiviral Therapy in Compensated Liver Cirrhosis Induced by Hepatitis C Virus Infection

Author

Muzica, Cristina Maria, primary, Stanciu, Carol, additional, Cijevschi-Prelipcean, Cristina, additional, Girleanu, Irina, additional, Huiban, Laura, additional, Petrea, Oana Cristina, additional, Singeap, Ana-Maria, additional, Cojocariu, Camelia, additional, Cuciureanu, Tudor, additional, Sfarti, Catalin, additional, Zenovia, Sebastian, additional, Chriac, Stefan, additional, Stefanescu, Gabriela, additional, Ciortescu, Irina, additional, Lupașcu-Ursulescu, Corina, additional, Miftode, Egidia, additional, and Trifan, Anca, additional

Published
2021
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28. Risk Factors for Extraintestinal Manifestations in Inflammatory Bowel Diseases - Data from the Romanian National Registry

Author

Singeap, Ana-Maria, primary, Girleanu, Irina, primary, Diculescu, Mircea, primary, Gheorghe, Liana, primary, Ciocîrlan, Maria, primary, Gheorghe, Cristian, primary, Costache, Adrian, primary, Tanțău, Alina, primary, Zaharie, Roxana, primary, Goldis, Adrian, primary, Gheonea, Dan, primary, Dobru, Daniela, primary, Dumitru, Eugen, primary, Prelipcean, Cristina Cijevschi, primary, Gîlcă-Blanariu, Georgiana-Emmanuela, primary, Moscalu, Mihaela, primary, Stanciu, Carol, primary, and Trifan, Anca, primary

Published
2021
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29. 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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30. 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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32. 659 CT EVALUATION OF SKELETAL MUSCLE MASS DYNAMICS FOLLOWING SUSTAINED VIROLOGICAL RESPONSE IN PATIENTS WITH HCV-RELATED COMPENSATED CIRRHOSIS TREATED WITH DIRECT ACTING ANTIVIRALS

Author

Mihai, Florin, primary, Trifan, Anca, additional, Stanciu, Carol, additional, Huiban, Laura, additional, Muzica, Cristina Maria, additional, Ursulescu, Corina Lupascu, additional, Negru, Dragos, additional, Girleanu, Irina, additional, Cuciureanu, Tudor, additional, and Singeap, Ana Maria, additional

Published
2021
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33. 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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36. 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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37. 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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38. Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: A Bidirectional Relationship

Author

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

Published
2020
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39. The Prevalence of HCV Infection and Risk Factors in a Hospital- Based Population Screening, a First Step to the Micro-Elimination of HCV Infection in Medical Institutions from Romania - Results of the HepC ALERT Study

Author

Gheorghe, Liana, primary, Iacob, Speranta, primary, Csiki, Irma Eva, primary, Huiban, Laura, primary, Cojocaru, Monica, primary, Cojocariu, Camelia, primary, Nemteanu, Roxana, primary, Girleanu, Irina, primary, Sirli, Roxana, primary, Singeap, Ana Maria, primary, Pop, Corina, primary, Dumitrascu, Dan L, primary, Vadan, Roxana, primary, Iacob, Razvan, primary, Diculescu, Mircea, primary, Trifan, Anca, primary, Sporea, Ioan, primary, and Gheorghe, Cristian, primary

Published
2020
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42. Microelimination of chronic hepatitis C in Romania - another pathway to achieve national elimination goals by HepC ALERT project

Author

Gheorghe, Liliana Simona, primary, Iacob, Speranta, additional, Huiban, Laura, additional, Cojocaru, Monica, additional, Cojocariu, Camelia, additional, Nemteanu, Roxana, additional, Girleanu, Irina, additional, Sirli, Roxana, additional, Singeap, Ana Maria, additional, Pop, Corina, additional, Dumitrascu, Dan, additional, Iacob, Razvan, additional, Diculescu, Mircea Mihai, additional, Trifan, Anca, additional, Sporea, Ioan, additional, and Gheorghe, Cristian, additional

Published
2020
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44. Liver Remodeling on CT Examination in Patients with HCV Compensated Cirrhosis Who Achieved Sustained Virological Response after Direct-Acting Antivirals Treatment

Author

Mihai, Florin, primary, Trifan, Anca, additional, Stanciu, Carol, additional, Singeap, Ana Maria, additional, Cucuteanu, Bogdan, additional, Lupascu Ursulescu, Corina, additional, Pop, Corina, additional, Girleanu, Irina, additional, Cuciureanu, Tudor, additional, Negru, Dragos, additional, and Cojocariu, Camelia, additional

Published
2020
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48. Diagnosis and Treatment of Colonic Diverticular Disease: Position Paper of the Romanian Society of Gastroenterology and Hepatology

Author

Trifan, Anca, primary, Gheorghe, Cristian, primary, Sabo, Cristina Marica, primary, Diculescu, Mircea, primary, Nedelcu, Laurențiu, primary, Singeap, Ana Maria, primary, Sfarti, Cătălin, primary, Gheorghe, Liana, primary, Sporea, Ioan, primary, Tanțău, Marcel, primary, Scripcariu, Viorel, primary, Goldiș, Adrian, primary, Gheonea, Dan, primary, Manuc, Mircea, primary, Stanciu, Carol, primary, Scarpignato, Carmelo, primary, and Dumitrașcu, Dan L, primary

Published
2018
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50. UNUSUAL CAUSE OF OCCULT SMALL-BOWEL BLEEDING.

Author

Singeap, Ana-Maria, Sfarti, Catalin, Vlad, Nutu, Stanciu, Carol, and Trifan, Anca

Subjects
*IRON deficiency anemia, *SMALL intestine, *SYMPTOMS, *OCCULTISM, *CARDIOVASCULAR diseases, *HEART failure
Abstract

Introduction. Suspected small-bowel bleeding may be overt or occult. In the absence of clinically obvious hemorrhagic manifestations, the anemic syndrome secondary to chronic occult loss is often the alarm signal. We present the case of a patient with severe iron deficiency anemia, diagnosed by small-bowel capsule endoscopy (SBCE) with hemorrhagic ileal polyp, with further succesfull surgical solution. Clinical presentation. 74-year-old male patient with significant associated cardiovascular diseases - arterial hypertension, permanent atrial fibrillation, heart failure NYHA class III, undergoing oral anticoagulant therapy. The worsening of the cardiac symptoms lead to the detection of a severe iron deficiency anemia (Hb 6.4/dL), with no overt bleeding. Consequently, the exploration of the gastrointestinal tract was decided. After negative upper gastrointestinal endoscopy, colonoscopy, and abdominal CT examination, SBCE was performed. An irregular sessile protruding lesion, developped on less than a quarter of the circumference, with active bleeding, in the distal third of the small intestine, was seen. Consequently, the surgeon performed a cuneiform ileal resection, with anatomo-pathological result of ulcerated hyperplastic polyp. The immediate and long-term postoperative evolution was favorable, both clinically and biologically, with the amelioration and then remission of the anemia. Conclusions. Infrequent benign tumors, with extremely rare sporadic occurrence, ileal hyperplastic polyps may present with occult hemorrhage as complication, probably having as risk factor the associated anticoagulant treatment, with occult hemorrhage, responsible for severe secondary iron deficiency anemic syndrome. Applying the investigational algorithm for unexplained iron deficiency anemia allows the etiological diagnosis and the application of the curative therapeutic intervention. [ABSTRACT FROM AUTHOR]

Published
2023

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