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1. Fibrosis Predictive Score in Caucasian Patients with Metabolic Syndrome

Author

Mare R, Sporea I, Tomescu M, Pop GN, Vitel A, Popescu A, Nistorescu S, and Sirli R

Subjects
metabolic syndrome, liver steatosis, liver fibrosis, liver elastography, Specialties of internal medicine, RC581-951
Abstract

Ruxandra Mare,1,2 Ioan Sporea,1,2 Mirela Tomescu,3 Gheorghe Nicușor Pop,3 Andrei Vitel,3 Alina Popescu,1,2 Silviu Nistorescu,1 Roxana Sirli1,2 1Department of Internal Medicine II, Gastroenterology and Hepatology Unit, Advanced Research Center in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Regional Center of Research in Advanced Hepatology, Academy of Medical Science, Timisoara, Romania; 3Department VI of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, Timisoara, RomaniaCorrespondence: Roxana Sirli, Department of Internal Medicine II, Gastroenterology and Hepatology Unit, Advanced Research Center in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania, Tel +40723537039, Fax +40723537039, Email roxanasirli@gmail.comIntroduction: Many of the patients presenting with metabolic syndrome (MetS) also have liver steatosis (NAFLD) and some of them could develop liver fibrosis.Purpose: To develop a simple score that could rule out fibrosis, especially significant fibrosis (F≥ 2) and could be used in daily practice in patients with MetS, in order to identify patients at risk.Patients and Methods: A total of 204 patients with MetS were prospectively enrolled. Evaluation of liver fibrosis was made using Vibration Controlled Transient Elastography while evaluation of steatosis was achieved using ultrasound (US).Results: Out of 204 patients with MetS, 179 patients (87.7%) had reliable liver stiffness measurements and 22.9% (41/179) had F ≥ 2. To formulate the fibrosis predicting score, all clinical variables associated with F ≥ 2 in the univariate analysis were considered in a multivariate regression model. According to the power of correlation, by consensus, we attributed 1 point for BMI > 31.4 kg/m2, 1 point for female gender, 1 point for HDLc < 47mg/dL, 1 point for mild steatosis at US, 1.5 point for moderate and 2 points for severe steatosis.Conclusion: At an optimal cut-off value of < 3.5, our score could be used to rule-out the risk for developing at least significant fibrosis with a high negative predictive value (NPV 89.2%) in patients with MetS.Keywords: metabolic syndrome, liver steatosis, liver fibrosis, liver elastography

Published
2022

2. Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease

Author

Parvanescu T, Vitel A, Sporea I, Mare R, Buz B, Bordejevic DA, Tomescu MC, Arnautu SF, Morariu VI, and Citu IM

Subjects
metabolic syndrome, strain and strain‑rate imaging, left atrial stiffness, left ventricular diastolic dysfunction, liver elastography, liver steatosis and fibrosis, Specialties of internal medicine, RC581-951
Abstract

Tudor Parvanescu,1 Andrei Vitel,1 Ioan Sporea,2 Ruxandra Mare,2 Bogdan Buz,1 Diana Aurora Bordejevic,1 Mirela Cleopatra Tomescu,1 Sergiu Florin Arnautu,3 Vlad Ioan Morariu,1 Ioana Mihaela Citu1 1Cardiology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 2Department of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania; 3Department of Neurology, Victor Babes University of Medicine and Pharmacy, Timisoara, RomaniaCorrespondence: Diana Aurora BordejevicCardiology Department, Victor Babe” University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, Timisoara, RomaniaTel +40 734600550Fax +40 256220636Email aurora.bordejevic@umft.roBogdan BuzCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, Timisoara, RomaniaTel +40 756346910Email buzbogdan93@gmail.comPurpose: The constitutive elements of the metabolic syndrome (MetS) are linked with both non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease. Controlled attenuation parameter (CAP), and vibration controlled transient elastography (VCTE), are able to detect and quantify NAFLD, while conventional and two-dimensional speckle tracking echocardiography (2D-STE) is capable to identify subclinical changes in cardiac function. We wanted to evaluate whether there is any correspondence between left ventricular (LV) diastolic dysfunction and different degrees of liver steatosis and fibrosis in MetS subjects with NAFLD.Patients and Methods: A total of 150 adult subjects having MetS and a normal left ventricular (LV) systolic function were recorded in the study, while 150 age- and sex- matched adults without MetS were enrolled as controls. NAFLD was established by VCTE and CAP. The left heart systolic and diastolic function was evaluated by conventional and 2D-ST echocardiography. Left atrial (LA) stiffness was calculated as the ratio between the E/A ratio and the LA reservoir-strain.Results: In univariate regression analysis, the variables associated with LV diastolic dysfunction in MetS patients were: liver steatosis grade ≥ 2, liver fibrosis grade ≥ 2, the longitudinal LA peak strain during the reservoir phase, the LA strain rate during ventricular contraction and the LA stiffness. In multivariate logistic regression, two variables were selected as independent predictors of LV diastolic dysfunction, namely the liver stiffness (P=0.0003) and the LA stiffness (P< 0.0001). LA stiffness predicted subclinical LV diastolic dysfunction in MetS patients with a sensitivity of 45% and a specificity of 96% when using a cut-off value > 0.38, and was significantly correlated with liver steatosis stage ≥ 2 and liver fibrosis stage ≥ 2.Conclusion: The present study confirms the association between liver stiffness, LA stiffness and LV diastolic dysfunction in MetS patients. Our study suggests that liver elastography and 2D-STE should become habitual assessments in MetS patients.Keywords: metabolic syndrome, strain and strain‑rate imaging, left atrial stiffness, left ventricular diastolic dysfunction, liver elastography, liver steatosis and fibrosis

Published
2021

3. Association Between Subclinical Left Ventricular Myocardial Systolic Dysfunction Detected by Strain and Strain‑Rate Imaging and Liver Steatosis and Fibrosis Detected by Elastography and Controlled Attenuation Parameter in Patients with Metabolic Syndrome

Author

Vitel A, Sporea I, Mare R, Banciu C, Bordejevic DA, Parvanescu T, Citu IM, and Tomescu MC

Subjects
metabolic syndrome, left ventricular function, strain and strain‑rate imaging, liver steatosis and fibrosis, liver elastography, Specialties of internal medicine, RC581-951
Abstract

Andrei Vitel,1,* Ioan Sporea,2 Ruxandra Mare,2 Christian Banciu,2 Diana-Aurora Bordejevic,1,* Tudor Parvanescu,1 Ioana Mihaela Citu,1 Mirela Cleopatra Tomescu1 1Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Gastroenterology Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania*These authors contributed equally to this workCorrespondence: Ioana Mihaela CituCardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 nd Eftimie Murgu Square, Timisoara, RomaniaTel +40 724353666Fax +40 256220636Email ioanamihaela2010@gmail.comPurpose: The components of metabolic syndrome (MS) are risk factors for developing both cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD). Strain (SI) and strain‑rate imaging (SRI) are able to recognize early changes in cardiac function. Vibration-controlled transient elastography (VCTE) and controlled attenuation parameter (CAP) detect and quantify liver fibrosis and steatosis. We aimed to assess whether there is any correlation between liver fibrosis and steatosis and left ventricular (LV) dysfunction in MS patients.Patients and Methods: A total of 150 adults with MS were registered in the study. They were compared with a control group of 150 age- and sex-matched adults without MS. After the classic echocardiographic assessment of LV function, two-dimensional speckle echocardiography (2D-STE) was used to evaluate LV peak systolic strain (S) and peak systolic strain rate (SR), while liver steatosis and fibrosis were evaluated by VCTE and CAP.Results: LV diastolic dysfunction was significantly more frequent among the patients with MS. We found significant differences between the two groups regarding the presence of subtle LV systolic dysfunction, detected by reduced values of S and SR. The risk for LV diastolic dysfunction was 3.6 times higher in MS with severe steatosis and 8 times higher in patients with severe fibrosis, P< 0.0001. The risk for LV systolic dysfunction was double in MS with severe steatosis and 1.7 times higher in MS with severe fibrosis, P< 0.0001.Conclusion: In MS patients with normal LV ejection fraction, conventional echocardiography parameters identified diastolic LV dysfunction, while SI and SRI identified subtle impairment of systolic LV dysfunction. The presence of hepatic steatosis and fibrosis increases significantly the risk for cardiac dysfunction in MS patients (P< 0.0001).Keywords: metabolic syndrome, left ventricular function, strain and strain‑rate imaging, liver steatosis and fibrosis, liver elastography

Published
2020

4. Advanced Ultrasound Application – Impact on Presurgical Risk Stratification of the Thyroid Nodules

Author

Stoian D, Ivan V, Sporea I, Florian V, Mozos I, Navolan D, and Nemescu D

Subjects
strain elastography, volumetric doppler, complex ultrasound thyroid evaluation, risk stratification, Therapeutics. Pharmacology, RM1-950
Abstract

Dana Stoian, 1, 2 Viviana Ivan, 1 Ioan Sporea, 1 Varcus Florian, 3 Ioana Mozos, 4 Dan Navolan, 5 Dragos Nemescu 6 1 2nd Department of Internal Medicine, “Victor Babes” University of Medicine, Timisoara, Romania; 2Dr. D Center for Ultrasound in Endocrinology, Timisoara, Romania; 3 2nd Department of Surgery, “Victor Babes” University of Medicine, Timisoara, Romania; 4Department of Physiopathology, “Victor Babes” University of Medicine, Timisoara, Romania; 5Department of Obstetrics Gynecology, “Victor Babes” University of Medicine, Timisoara, Romania; 6Department of Obstetrics Gynecology, “Gr. T. Popa” University of Medicine, Iasi, RomaniaCorrespondence: Dan NavolanDepartment of Obstetrics Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu, Nr. 2, Timisoara 300011, RomaniaEmail navolan@yahoo.comViviana Ivan 2nd Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu, Nr. 2, Timisoara 300011, RomaniaTel +40 722 960 911Fax +40 256 020 1890Email ivanmvivi@yahoo.comAim: Current major guidelines recommend risk stratification of the thyroid nodules, after each diagnostic evaluation, in order to focus attention on potentially risky nodules. The main aim of our study was to evaluate the performance of combined advanced ultrasound techniques in this process, compared with conventional stratification models, in order to reduce unnecessary fine-needle biopsies, respectively, surgery.Material and Methods: We evaluated 261 cases (261 nodules) using conventional ultrasound (2B), real-time Doppler evaluation (4D) respectively, real-time elastography, using a linear multifrequency probe and a linear volumetric probe (Hitachi Prerius Machine, Hitachi Inc, Japan). All the nodules were classified using a risk stratification model comprising seven conventional US characteristics, two 4 D characteristics and a color map RTE aspect. The results were compared with the pathology results, considered the golden standard diagnosis.Results: The prevalence of malignant nodules was 21.83% (57 cases). Conventional risk classification generated: 106 low-risk cases, 113 intermediate-risk and 42 high-risk cases. Our proposed risk classification changes the conventional risk classification with a risk upgrade in 27 cases and with a risk downgrade in 69 cases. The diagnostic quality of the combined risk stratification model was better, considering a low-risk category predictive for benignancy and a high category predictive for malignancy: Sensitivity: 80.88% versus 49.01%, respectively, Specificity: 91.22% versus 54.38. The diagnostic power differences were observed regardless of the nodule size.Conclusion: Advanced ultrasound techniques did add diagnostic value in the presurgical risk assessment of the thyroid nodules.Keywords: strain elastography, volumetric Doppler, complex ultrasound thyroid evaluation, risk stratification

Published
2020

15. EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound

Author

Nylund K, Maconi G, Hollerweger A, Ripolles T, Pallotta N, Higginson A, Serra C, Dietrich CF, Sporea I, Saftoiu A, Dirks K, Hausken T, Calabrese E, Romanini L, Maaser C, Nuernberg D, and Gilja OH

Subjects
Settore MED/12
Abstract

In October 2014 the European Federation of Societies for Ultrasound in Medicine and Biology formed a Gastrointestinal Ultrasound (GIUS) task force group to promote the use of GIUS in a clinical setting. One of the main objectives of the task force group was to develop clinical recommendations and guidelines for the use of GIUS under the auspices of EFSUMB. The first part, gives an overview of the examination techniques for GIUS recommended by experts in the field. It also presents the current evidence for the interpretation of normal sonoanatomical and physiological features as examined with different ultrasound modalities.

Published
2017

16. Impact of Safety-Related Dose Reductions or Discontinuations on Sustained Virologic Response in HCV-Infected Patients: Results from the GUARD-C Cohort

Author

GUARD C, Study Group, Hassanein, T, Bakalos, G, Ahlers, S, Shiffman, Ml, Tallarico, L, Reddy, Kr, Orlandini, A, Ferenci, P, Derbala, M, Coppola, C, Foster, Gr, Basho, J, Shabanaj, G, Harxhi, A, Debzi, N, Afredj, N, Guessab, N, Mahindad, N, Mahiou, H, Aissaoui, M, Al Qameesh, J, Al Ghandoor, Z, Assene, C, Bastens, B, Brixko, C, Cool, M, De Galocsy, C, Delwaide, J, George, C, Laukens, P, Lefebvre, V, Mulkay, Jp, Nevens, F, Servais, B, Van Vlierberghe, H, Horsmans, Y, Henrion, J, Sprengers, D, Michielsen, P, Bourgeois, S, Lasser, L, Langlet, P, Robaeys, G, Martinet, Jp, Warzee, P, Hoste, P, Reynaert, H, Juriens, I, Decaestecker, J, Van Der Meersch, F, Janssens, F, Ahmetagic, S, Verhaz, A, Bevanda, M, Calkic, L, Ibrahimpasic, N, Mesihovic, R, Mello, Ce, Ruiz, Fj, Martins Junior, E, Ferraz, Ml, Silva, G, Mendes, C, Lyra, A, Silva, Mh, Gomide, G, Fernandes, Jc, Pereira, P, Correa, Mc, Teixeira, R, Yousry, A, Hanno, A, Gabr, M, Omar, A, Esmat, G, Karatapanis, S, Nikolopoulou, V, Giannoulis, G, Manolakopoulos, S, Elefsiniotis, I, Drakoulis, C, Dimitroulopoulos, D, Kanatakis, S, Ketikoglou, I, Mimidis, K, Evgenidis, N, Akriviades, E, Vafiadi Zoubouli, I, Tsianos, E, Mela, M, Orfanou, E, Mousoulis, G, Karagiannis, I, Manesis, E, Varga, M, Nemesánszky, E, Fried, K, Schuller, J, Szalay, F, Lengyel, G, Tornai, I, Banyai, T, Lesch, M, Nagy, I, Gervain, J, Tusnadi, A, Schneider, F, Szentgyörgyi, L, Hunyady, B, Vincze, A, Tolvaj, G, Varkonyi, I, Makkai, E, Enyedi, J, Racz, I, Hausinger, P, Váczi, Z, Patai, Á, Ozsvár, Z, Lakner, L, Ribiczey, P, Bhalla, A, Somani, S, Luaia, R, Rao, P, Philip, M, Lawate, P, Nagral, A, Sood, A, Parikh, S, Merat, S, Nassiri Toosi, M, Alavian, Sm, Zali, Mr, Daryani, Ne, Drenaggi, D, Attili, Af, Bandiera, F, Bassi, P, Bellati, G, Bellantani, S, Brunetto, MAURIZIA ROSSANA, Bruno, S, Castelli, F, Castellacci, R, Cattelan, Am, Colombo, M, Craxi, A, D'Angelo, S, Colombo, S, Demelia, L, Di Perri, G, Di Giacomo, A, Ferrari, C, Francisci, D, Casinelli, K, Ganga, R, Costa, C, Mangia, A, Russo, Fp, Matarazzo, F, Mazzella, G, Mazzeo, M, Memoli, M, Montalbano, M, Montalto, G, Pieri, A, Passariello, N, Picciotto, A, Pietrangelo, A, Pirisi, M, Quirino, T, Raimondo, G, Rapaccini, Gl, Rizzardini, G, Rizzetto, M, Russello, M, Sabusco, G, Santantonio, T, Soardo, G, Amedea, A, Verucchi, G, Vinelli, F, Zignego, Al, Zuin, M, Ascione, A, Vinci, M, Pigozzi, Mg, Tundo, P, Saracco, Gm, Amoroso, P, Andreoni, M, Colletta, C, Erne, E, Megna, As, Biglino, A, Chiriaco, P, Foti, G, Spinzi, G, D'Amico, E, Paik, Sw, Ahn, Sh, Lee, Yn, Kim, Y, Yang, J, Han, Sy, Varghese, R, Al Gharabally, A, Askar, H, Sharara, A, Yaghi, C, Rached, Aa, Houmani, Z, Zaarour, F, Dohaibi, A, Ivanovski, L, Joksimovic, N, Abbas, Z, Memon, S, Mohsin, A, Masood, S, Hashmi, Z, Halota, W, Deron, Z, Mazur, W, Flisiak, R, Lipczynski, A, Musialik, J, Piekarska, A, Augustyniak, K, Baka Cwierz, B, Simon, K, Gietka, A, Berak, H, Sieklucki, J, Radowska, D, Szlauer, B, Piekos, T, Olszok, I, Jablkowski, M, Orszulak, G, Warakomska, I, Aleixo, Mj, Valente, C, Macedo, G, Sarmento Castro, R, Roxo, F, Faria, T, Mansinho, K, Velez, J, Ramos, Jp, Guerreiro, H, Alberto, S, Monteverde, C, Serejo, F, Peixe, P, Malhado, J, Curescu, M, Streinu Cercel, A, Caruntu, F, Livia, H, Preotescu, L, Arama, V, Ancuta, I, Gheorghe, L, Stanciu, C, Trifan, A, Acalovschi, M, Andreica, V, Pascu, O, Lencu, M, Sporea, I, Olteanu, D, Ionita Radu, F, Fierbinteanu Braticevici, C, Motoc, A, Silaghi, R, Musat, M, Coman, F, Stan, M, Cijevschi, C, Miftode, E, Delic, D, Jesic, R, Nozic, D, Svorcan, P, Fabri, M, Konstantinovic, L, Pelemis, M, Jankovic, G, Todorovic, Z, Nagorni, A, Kupcova, V, Skladany, L, Szantova, M, Krkoska, D, Jarcuska, P, Schreter, I, Oltman, M, Bocakova, J, Bunganic, I, Holoman, J, Giguere, A, Abdou, A. M., Basic (bio-) Medical Sciences, Gastroenterology, Laboratory of Molecullar and Cellular Therapy, Liver Cell Biology, Michielsen, Peter, GUARD-C Study Group, Graham R. Foster, Carmine Coppola, Moutaz Derbala, Peter Ferenci, Alessandra Orlandini, K. Rajender Reddy, Ludovico Tallarico, Mitchell L. Shiffman, Silke Ahler, Georgios Bakalo, Tarek Hassanein, GUARD-C Study Group: [.., Davide Drenaggi, Adolfo Francesco Attili, Franco Bandiera, Paolo Bassi, Giorgio Bellati, Stefano Bellantani, Maurizia Brunetto, Savino Bruno, Francesco Castelli, Roberto Castellacci, Anna Maria Cattelan, Massimo Colombo, Antonio Craxi, Salvatore D'angelo, Silvia Colombo, Luigi Demelia, Giovanni Di Perri, Antonio Di Giacomo, Carlo Ferrari, Daniela Francisci, Katia Casinelli, Roberto Ganga, Chiara Costa, Alessandra Mangia, Francesco Paolo Russo, Filippo Matarazzo, Giuseppe Mazzella, Maurizio Mazzeo, Massimo Memoli, Marzia Montalbano, Giuseppe Montalto, Alessandro Pieri, Nicola Passariello, Antonio Picciotto, Antonello Pietrangelo, Mario Pirisi, Tiziana Quirino, Giovanni Raimondo, Gian Ludovico Rapaccini, Giuliano Rizzardini, Mario Rizzetto, Maurizio Russello, Giuseppe Sabusco, Teresa Santantonio, Giorgio Soardo, Alessandri Amedea, Gabriella Verucchi, Francesco Vinelli, Anna Linda Zignego, Massimo Zuin, Antonio Ascione, Maria Vinci, Maria Graziella Pigozzi, Paolo Tundo, Giorgio Maria Saracco, Pietro Amoroso, Massimo Andreoni, Cosimo Colletta, Elke Erne, Angelo Salomone Megna, Alberto Biglino, Piergiorgio Chiriaco, Giuseppe Foti, Giancarlo Spinzi, Emilio D'amico, …], Foster G.R., Coppola C., Derbala M., Ferenci P., Orlandini A., Reddy K.R., Tallarico L., Shiffman M.L., Ahlers S., Bakalos G., Hassanein T., Basho J., Shabanaj G., Harxhi A., Debzi N., Afredj N., Guessab N., Mahindad N., Mahiou H., Aissaoui M., Al Qameesh J., Al Ghandoor Z., Assene C., Bastens B., Brixko C., Cool M., De Galocsy C., Delwaide J., George C., Laukens P., Lefebvre V., Mulkay J.-P., Nevens F., Servais B., Van Vlierberghe H., Horsmans Y., Henrion J., Sprengers D., Michielsen P., Bourgeois S., Lasser L., Langlet P., Robaeys G., Martinet J.-P., Warzee P., Hoste P., Reynaert H., Juriens I., Decaestecker J., Van Der Meersch F., Janssens F., Ahmetagic S., Verhaz A., Bevanda M., Calkic L., Ibrahimpasic N., Mesihovic R., Mello C.E., Ruiz F.J., Junior E.M., Ferraz M.L., Silva G., Mendes C., Lyra A., Silva M.H., Gomide G., Fernandes J.C., Pereira P., Correa M.C., Teixeira R., Yousry A., Hanno A., Gabr M., Omar A., Esmat G., Karatapanis S., Nikolopoulou V., Giannoulis G., Manolakopoulos S., Elefsiniotis I., Drakoulis C., Dimitroulopoulos D., Kanatakis S., Ketikoglou I., Mimidis K., Evgenidis N., Akriviades E., Vafiadi-Zoubouli I., Tsianos E., Mela M., Orfanou E., Mousoulis G., Karagiannis I., Manesis E., Varga M., Nemesanszky E., Fried K., Schuller J., Szalay F., Lengyel G., Tornai I., Banyai T., Lesch M., Nagy I., Gervain J., Tusnadi A., Schneider F., Szentgyorgyi L., Hunyady B., Vincze A., Tolvaj G., Varkonyi I., Makkai E., Enyedi J., Racz I., Hausinger P., Vaczi Z., Patai A., Ozsvar Z., Lakner L., Ribiczey P., Bhalla A., Somani S., Luaia R., Rao P., Philip M., Lawate P., Nagral A., Sood A., Parikh S., Merat S., Nassiri-Toosi M., Alavian S.-M., Zali M.R., Daryani N.E., Drenaggi D., Attili A.F., Bandiera F., Bassi P., Bellati G., Bellantani S., Brunetto M., Bruno S., Castelli F., Castellacci R., Cattelan A.M., Colombo M., Craxi A., D'angelo S., Colombo S., Demelia L., Di Perri G., Di Giacomo A., Ferrari C., Francisci D., Casinelli K., Ganga R., Costa C., Mangia A., Russo F.P., Matarazzo F., Mazzella G., Mazzeo M., Memoli M., Montalbano M., Montalto G., Pieri A., Passariello N., Picciotto A., Pietrangelo A., Pirisi M., Quirino T., Raimondo G., Rapaccini G.L., Rizzardini G., Rizzetto M., Russello M., Sabusco G., Santantonio T., Soardo G., Amedea A., Verucchi G., Vinelli F., Zignego A.L., Zuin M., Ascione A., Vinci M., Pigozzi M.G., Tundo P., Saracco G.M., Amoroso P., Andreoni M., Colletta C., Erne E., Megna A.S., Biglino A., Chiriaco P., Foti G., Spinzi G., D'amico E., Paik S.W., Ahn S.-H., Lee Y.N., Kim Y., Yang J., Han S.Y., Varghese R., Al Gharabally A., Askar H., Sharara A., Yaghi C., Abou Rached A., Houmani Z., Zaarour F., Dohaibi A., Ivanovski L., Joksimovic N., Abbas Z., Memon S., Mohsin A., Masood S., Hashmi Z., Halota W., Deron Z., Mazur W., Flisiak R., Lipczynski A., Musialik J., Piekarska A., Augustyniak K., Baka-Cwierz B., Simon K., Gietka A., Berak H., Sieklucki J., Radowska D., Szlauer B., Piekos T., Olszok I., Jablkowski M., Orszulak G., Warakomska I., Aleixo M.J., Valente C., Macedo G., Sarmento-Castro R., Roxo F., Faria T., Mansinho K., Velez J., Ramos J.P., Guerreiro H., Alberto S., Monteverde C., Serejo F., Peixe P., Malhado J., Curescu M., Streinu-Cercel A., Caruntu F., Livia H., Preotescu L., Arama V., Ancuta I., Gheorghe L., Stanciu C., Trifan A., Acalovschi M., Andreica V., Pascu O., Lencu M., Sporea I., Olteanu D., Ionita-Radu F., Fierbinteanu-Braticevici C., Motoc A., Silaghi R., Musat M., Coman F., Stan M., Cijevschi C., Miftode E., Delic D., Jesic R., Nozic D., Svorcan P., Fabri M., Konstantinovic L., Pelemis M., Jankovic G., Todorovic Z., Nagorni A., Kupcova V., Skladany L., Szantova M., Krkoska D., Jarcuska P., Schreter I., Oltman M., Bocakova J., Bunganic I., Holoman J., Giguere A., Abdou A.M.S., UCL - SSS/IREC-Institut de recherche expérimentale et clinique, UCL - SSS/IREC/GAEN-Pôle d'Hépato-gastro-entérologie, and UCL - (SLuc) Service de gastro-entérologie

Subjects
Genetics and Molecular Biology (all), Male, Chronic Hepatitis, Hepacivirus, Ribavirin/adverse effects, Asthenia/chemically induced, Polyethylene Glycol, Biochemistry, Polyethylene Glycols, Body Mass Index, Chronic Liver Disease, 0302 clinical medicine, Neutropenia/chemically induced, Interferon-alpha/adverse effects, Medicine, Chronic, lcsh:Science, Liver Diseases, virus diseases, Antiviral Agents/adverse effects, Cohort, Science & Technology - Other Topics, 030211 gastroenterology & hepatology, Drug Therapy, Combination, Cohort study, Human, medicine.medical_specialty, Alpha interferon, Gastroenterology and Hepatology, Antiviral Agents, Microbiology, Dose-Response Relationship, 03 medical and health sciences, Pharmacotherapy, Hepatitis C, Chronic/drug therapy, Dose Prediction Methods, Drug Therapy, Anemia/chemically induced, Humans, Hemoglobin, Aged, Medicine and health sciences, Biochemistry, Genetics and Molecular Biology (all), Hepaciviru, Science & Technology, Dose-Response Relationship, Drug, Flaviviruses, lcsh:R, Organisms, Biology and Life Sciences, Proteins, medicine.disease, digestive system diseases, chemistry, Agricultural and Biological Sciences (all), Withholding Treatment, Asthenia, Immunology, Proportional Hazards Model, lcsh:Q, Human medicine, RNA viruses, Physiology, lcsh:Medicine, Peginterferon-alfa, Polyethylene Glycols/adverse effects, Adult, Anemia, Cohort Studies, Female, Hepatitis C, Chronic, Host-Pathogen Interactions, Interferon-alpha, Middle Aged, Neutropenia, Outcome Assessment (Health Care), Proportional Hazards Models, RNA, Viral, Recombinant Proteins, Ribavirin, Medicine (all), chemistry.chemical_compound, Outcome Assessment, Health Care, Medicine and Health Sciences, 030212 general & internal medicine, Viral, Pathology and laboratory medicine, Multidisciplinary, biology, Hepatitis C virus, Pharmaceutics, Hepatitis C, Hematology, Recombinant Protein, Outcome Assessment (Health Care)/methods, Medical microbiology, Host-Pathogen Interaction, Multidisciplinary Sciences, Physiological Parameters, Research Design, Combination, Viruses, Drug, Pathogens, Host-Pathogen Interactions/drug effects, Research Article, Clinical Research Design, Research and Analysis Methods, Internal medicine, Recombinant Proteins/adverse effects, RNA, Viral/blood, Antiviral Agent, business.industry, Body Weight, Hepacivirus/drug effects, Viral pathogens, biology.organism_classification, Hepatitis viruses, Microbial pathogens, RNA, Adverse Events, Cohort Studie, business
Abstract

Background: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. Methods: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA

Published
2015

20. Risk of hepatitis B virus reactivation in hepatitis B virus + hepatitis C virus-co-infected patients with compensated liver cirrhosis treated with ombitasvir, paritaprevir/r + dasabuvir + ribavirin

Author

Preda, C. M., primary, Popescu, C. P., additional, Baicus, C., additional, Constantinescu, I., additional, Oproiu, A., additional, Voiosu, T., additional, Diculescu, M., additional, Negreanu, L., additional, Gheorghe, L., additional, Sporea, I., additional, Trifan, A., additional, Ceausu, E., additional, Proca, D., additional, and Manuc, M., additional

Published
2018
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21. Erratum: EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version)

Author

Dietrich, C.F. (Christoph F.), Bamber, J.C. (Jeffrey), Berzigotti, A. (Annalisa), Bota, S. (Simona), Cantisani, V. (Vito), Castera, L. (Laurent), Cosgrove, D. (David), Ferraioli, G. (Giovanna), Friedrich-Rust, M. (Mireen), Gilja, O.H. (Odd Helge), Goertz, R.S. (Ruediger Stephan), Karlas, T. (Thomas), Knegt, R.J. (Robert) de, de Ledinghen, V. (Victor), Piscaglia, F. (Fabio), Procopet, B. (Bogdan), Saftoiu, A. (Adrian), Sidhu, P.S. (Paul S.), Sporea, I. (Ioan), Thiele, M. (Maja), Dietrich, C.F. (Christoph F.), Bamber, J.C. (Jeffrey), Berzigotti, A. (Annalisa), Bota, S. (Simona), Cantisani, V. (Vito), Castera, L. (Laurent), Cosgrove, D. (David), Ferraioli, G. (Giovanna), Friedrich-Rust, M. (Mireen), Gilja, O.H. (Odd Helge), Goertz, R.S. (Ruediger Stephan), Karlas, T. (Thomas), Knegt, R.J. (Robert) de, de Ledinghen, V. (Victor), Piscaglia, F. (Fabio), Procopet, B. (Bogdan), Saftoiu, A. (Adrian), Sidhu, P.S. (Paul S.), Sporea, I. (Ioan), and Thiele, M. (Maja)

Abstract

This is to clarify that in the published EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version) in Figure 1 (“The types of elastography described in this paper”) the availability of Easaote SpA point shear wave technology (pSWE) was not mentioned. Herewith we present the corrected figure.

Published
2017
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22. EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version)

Author

Dietrich, C.F. (Christoph F.), Bamber, J.C. (Jeffrey), Berzigotti, A. (Annalisa), Bota, S. (Simona), Cantisani, V. (Vito), Castera, L. (Laurent), Cosgrove, D. (David), Ferraioli, G. (Giovanna), Friedrich-Rust, M. (Mireen), Gilja, O.H. (Odd Helge), Goertz, R.S. (Ruediger Stephan), Karlas, T. (Thomas), Knegt, R.J. (Robert) de, de Ledinghen, V. (Victor), Piscaglia, F. (Fabio), Procopet, B. (Bogdan), Saftoiu, A. (Adrian), Sidhu, P.S. (Paul S.), Sporea, I. (Ioan), Thiele, M. (Maja), Dietrich, C.F. (Christoph F.), Bamber, J.C. (Jeffrey), Berzigotti, A. (Annalisa), Bota, S. (Simona), Cantisani, V. (Vito), Castera, L. (Laurent), Cosgrove, D. (David), Ferraioli, G. (Giovanna), Friedrich-Rust, M. (Mireen), Gilja, O.H. (Odd Helge), Goertz, R.S. (Ruediger Stephan), Karlas, T. (Thomas), Knegt, R.J. (Robert) de, de Ledinghen, V. (Victor), Piscaglia, F. (Fabio), Procopet, B. (Bogdan), Saftoiu, A. (Adrian), Sidhu, P.S. (Paul S.), Sporea, I. (Ioan), and Thiele, M. (Maja)

Abstract

We present here the first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography with a focus on the assessment of diffuse liver disease. The short version provides clinical information about the practical use of elastography equipment and interpretation of results in the assessment of diffuse liver disease and analyzes the main findings based on published studies, stressing the evidence from meta-analyses. The role of elastography in different etiologies of liver disease and in several clinical scenarios is also discussed. All of the recommendations are judged with regard to their evidence-based strength according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. This updated document is intended to act as a reference and to provide a practical guide for both beginners and advanced clinical users.

Published
2017
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23. How efficient is acoustic radiation force impulse elastography for the evaluation of liver stiffness?

Author

Sporea I, Badea R, Roxana Sirli, Lupsor M, Popescu A, Danila M, Focsa M, and Deleanu A

Subjects
Acoustic radiation force impulse Imaging, Biopsy, Original Article, Elastography, Liver diseases
Abstract

Background In chronic liver diseases, a correct estimation of the severity of liver fibrosis is important for recommendations regarding the treatment. Nowadays, evaluation of fibrosis is done by noninvasive methods such as biochemical scores and transient elastography instead of liver biopsy. The lack of sensitivity to detect fibrosis, because of its heterogeneity is a drawback of liver biopsy (LB). Objectives To compare transient elastography (TE) and acoustic radiation force impulse (ARFI) for the evaluation of liver stiffness (LS), against percutaneous LB. Patients and Methods Our study comprised of 223 subjects; 52 without fibrosis (38 volunteers and 14 patients with F0 on LB), 36 with F1, 40 with F2, 26 with F3 and 69 with liver cirrhosis (46 with LB and 23 with signs of cirrhosis). For each patient we performed in the same session 10 TE and 5 ARFI measurements. The median values were calculated. Results A strong linear correlation (Spearman rho = 0.870) was found between TE and fibrosis (P < 0.0001); there was also a weaker correlation between ARFI and fibrosis (Spearman rho = 0.646; P < 0.0001). TE measurements were also correlated with ARFI measurements (Spearman rho = 0.733, P < 0.0001). The best test for predicting significant fibrosis (F ≥ 2) was TE with a cut-off value of 7.1 kPa (AUROC 0.953). For ARFI, the cut-off value was 1.27 m/s-area under ROC curve (AUROC): 0.890, sensitivity (Se) of 88.7%, specificity (Sp) of 67.5%, positive predictive value (PPV) of 64.5%, and negative predictive value (NPV) of 90% (P = 0.0044). For predicting cirrhosis (F = 4), the optimum cut-off values were 14.4 kPa for TE (AUROC: 0.985, Se: 95.6%, Sp: 94.7%, PPV: 89.2%, NPV: 98%) and 1.7 m/s for ARFI (AUROC: 0.931, Se: 93%, Sp: 86.7%, PPV: 73.6%, NPV: 96.9%) (P = 0.0102). Conclusions LS evaluation by means of ARFI is not superior to TE for the assessment of liver fibrosis. ARFI is an accurate test for the diagnosis of cirrhosis.

Published
2011

25. Predictors of persistence of clinical significant portal hypertension in patients with HCV liver cirrhosis following 3D therapy and SVR

Author

Iacob, M.C.S., primary, Gheorghe, L., additional, Cijevschi, C., additional, Trifan, A., additional, Stanciu, C., additional, Mihai, C., additional, Sporea, I., additional, Sirli, R., additional, Curescu, M., additional, Diculescu, M., additional, Alexandrescu, L., additional, Sandulescu, L., additional, Goldis, A., additional, Brisc, C., additional, Simionov, I., additional, Vadan, R., additional, Pirvulescu, I., additional, Rogoveanu, I., additional, Pietrareanu, C., additional, Seicean, A., additional, Iacob, R., additional, and Gheorghe, C., additional

Published
2017
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26. Early regression of liver fibrosis evaluated by non-invasive methods after successful antiviral therapy in patients with HCV genotype 1b compensated cirrhosis

Author

Trifan, A., primary, Prelipcean, C.C., additional, Gheorghe, L., additional, Miftode, E., additional, Chiriac, S.A., additional, Cuciureanu, T., additional, Sporea, I., additional, Goldis, A., additional, Iacob, S., additional, Cojocariu, C., additional, Stefanescu, G., additional, Girleanu, I., additional, Mihai, C., additional, Ciortescu, I., additional, and Stanciu, C., additional

Published
2017
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28. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part II. Diagnostic Ultrasound-Guided Interventional Procedures (Long Version)

Author

Sidhu, P. S, Brabrand, K, Cantisani, V, Correas, J. M, Cui, X. W, D'Onofrio, Mirko, Essig, M, Freeman, S, Gilja, O. H, Gritzmann, N, Havre, R. F, Ignee, A, Jenssen, C, Kabaalioğlu, A, Lorentzen, T, Mohaupt, M, Nicolau, C, Nolsøe, C. P, Nürnberg, D, Radzina, M, Saftoiu, A, Serra, C, Spârchez, Z, Sporea, I, and Dietrich, C. F.

Subjects
kidney, liver, nuclear medicine and imaging, Abdomen, Europe, Evidence-Based Medicine, Humans, Societies, Medical, Ultrasonography, Ultrasonography, Interventional, adrenal, aspiration, biopsy, cancer, catheter, CT, gastrointestinal tract, guideline, lymph node, MRI, needle, pancreas, retroperitoneal, spleen, transplant, ultrasound, radiology, nuclear medicine and imaging, Medical, Interventional, radiology, Societies
Abstract

This is the second part of the series on interventional ultrasound guidelines of the Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). It deals with the diagnostic interventional procedure. General points are discussed which are pertinent to all patients, followed by organ-specific imaging that will allow the correct pathway and planning for the interventional procedure. This will allow for the appropriate imaging workup for each individual interventional procedure (Long version).

Published
2015

29. 2D-SHEAR WAVE ELASTOGRAPHY IS EQUIVALENT OR SUPERIOR TO TRANSIENT ELASTOGRAPHY FOR LIVER FIBROSIS ASSESSMENT: RESULTS FROM AN INDIVIDUAL PATIENT DATA BASED META-ANALYSIS

Author

Herrmann, E. de Ledinghen, V. Cassinotto, C. Chu, W. C. -W. and Leung, V. Y. -F. Ferraioli, G. Filice, C. Castera, L. and Vilgrain, V. Ronot, M. Dumortier, J. Guibal, A. Pol, S. Trebicka, J. Jansen, C. Strassburg, C. Zheng, R. and Zheng, J. Francque, S. Vanwolleghem, T. Vonghia, L. and Manesis, E. K. Zoumpoulis, P. Sporea, I. Thiele, M. and Krag, A. Friedrich-Rust, M.

Published
2015

30. 2D-shear wave elastography is equivalent or superior to transient elastography for liver fibrosis assessment:Results from an individual patient databased meta-analysis

Author

Herrmann, E., de Lédinghen, V., Cassinotto, C., Chu, W. C.-W, Leung, V.Y.-F., Ferraioli, G., Filice, C., Castera, L., Vilgrain, V., Ronot, M., Dumortier, J., Guibal, A., Pol, S., Trebicka, J., Jansen, C., Strassburg, C., Zheng, R., Zheng, J., Francque, S., Vanwolleghem, T., Vonghia, L., Manesis, E.K., Zoumpoulis, P., Sporea, I., Thiele, Maja, Krag, Aleksander, and Friedrich-Rust, M.

Published
2015
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31. Silybin conjugated with phosphatidilcholine and vitamin E improves liver damage in patients with NAFLD: the results of a randomized multicentre double-blind vs placebo trial

Author

Andreone P., Brisc M. C., Chiaramonte M., Floreani A., Freni M. A., Grieco A., Lobello S., Milani S., Okolicsanyi L., Portincasa P., Smedile A., Sporea I., Sorrentino F., Vecchione R., Tuccillo C., Loguercio C., FEDERICO, Alessandro, Andreone, P., Brisc, M. C., Chiaramonte, M., Federico, Alessandro, Floreani, A., Freni, M. A., Grieco, A., Lobello, S., Milani, S., Okolicsanyi, L., Portincasa, P., Smedile, A., Sporea, I., Sorrentino, F., Vecchione, R., Tuccillo, C., and Loguercio, C.

Published
2011

32. Preliminary results of A randomized multicentre double-blind vs placebo trial: evaluation of effect of silybin conjugated with phosphatidilcholine and vitamin E on liver damage in patients with nonalcoholic fatty liver disease

Author

Andreone P., Brisc M. C., Chiaramonte M., Floreani A., Freni M. A., Grieco A., Lobello S., Milani S., Okolicsanyi L., Portincasa P., Smedile A., Sporea I., Sorrentino F., Vecchione R., Tuccillo C., Loguercio C., FEDERICO, Alessandro, Andreone, P., Brisc, M. C., Chiaramonte, M., Federico, Alessandro, Floreani, A., Freni, M. A., Grieco, A., Lobello, S., Milani, S., Okolicsanyi, L., Portincasa, P., Smedile, A., Sporea, I., Sorrentino, F., Vecchione, R., Tuccillo, C., and Loguercio, C.

Published
2011

33. Effect of Silybin in patients with chronic hepatitis: preliminary results of a multicentre randomized controlled trial vs placebo

Author

FEDERICO, Alessandro, Andreone P., Brisc M. C., Chiaramonte M., Floreani A., Freni M. A., Grieco A., Lobello S., Milani S., Okolicsanyi L., Portincasa P., Smedile A., Sporea I., Vecchione R., Del Vecchio Blanco C., Loguercio C., Federico, Alessandro, Andreone, P., Brisc, M. C., Chiaramonte, M., Floreani, A., Freni, M. A., Grieco, A., Lobello, S., Milani, S., Okolicsanyi, L., Portincasa, P., Smedile, A., Sporea, I., Vecchione, R., Del Vecchio Blanco, C., and Loguercio, C.

Published
2010

34. Preliminary results of a multicentre randomized controlled trial with Silybin+phosphatidilcholine and vitamin E vs placebo in NASH patients

Author

FEDERICO, Alessandro, Andreone P., Brisc M. C., Chiaramonte M., Floreani A., Freni M. A., Grieco A., Lobello S., Milani S., Okolicsanyi L., Portincasa P., Smedile A., Sporea I., Sorrentino F., Vecchione R., Tuccillo C., Del Vecchio Blanco C., Loguercio C., Federico, Alessandro, Andreone, P., Brisc, M. C., Chiaramonte, M., Floreani, A., Freni, M. A., Grieco, A., Lobello, S., Milani, S., Okolicsanyi, L., Portincasa, P., Smedile, A., Sporea, I., Sorrentino, F., Vecchione, R., Tuccillo, C., Del Vecchio Blanco, C., and Loguercio, C.

Published
2010

35. Security and VO Management Capabilities in a Large-Scale Grid Operating System

Author

Benjamin Aziz and Sporea, I.

Subjects
VO management, use cases, Grid computing, Grid computing, security engineering, VO management, Computing, Parallel and Distributed Computing, Software Engineering, other areas of Computing and Informatics, security management
Abstract

This paper presents a number of security and VO management capabilities in a large-scale distributed Grid operating system. The capabilities formed the basis of the design and implementation of a number of security and VO management services in the system. The main aim of the paper is to provide some idea of the various functionality cases that need to be considered when designing similar large-scale systems in the future.

Published
2014

36. Classifying spike patterns by reward-modulated STDP

Author

Gardner, B, Sporea, I, and Grüning, A

Subjects
Quantitative Biology::Neurons and Cognition
Abstract

Reward-modulated learning rules for spiking neural networks have emerged, that have been demonstrated to solve a wide range of reinforcement learning tasks. Despite this, little work has aimed to classify spike patterns by the timing of output spikes. Here, we apply a rewardmaximising learning rule to teach a spiking neural network to classify input patterns by the latency of output spikes. Furthermore, we compare the performance of two escape rate functions that drive output spiking activity: the Arrhenius & Current (A&C) model and Exponential (EXP) model. We find A&C consistently outperforms EXP, and especially in terms of the time taken to converge in learning. We also show that jittering input patterns with a low noise amplitude leads to an improvement in learning, by reducing the variation in the performance. © 2014 Springer International Publishing Switzerland.

Published
2014

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