126 results on '"Zenovia, Sebastian"'
Search Results
2. Nonalcoholic Fatty Liver Disease Versus Metabolic Associated Fatty Liver Disease
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Zenovia, Sebastian, Girleanu, Irina, Trifan, Anca, editor, Stanciu, Carol, editor, and Muzica, Cristina, editor
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- 2023
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3. Vibration-Controlled Transient Elastography and Controlled Attenuation Parameter for Staging Nonalcoholic Fatty Liver Disease
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Zenovia, Sebastian, Muzica, Cristina, Dimache, Mihaela, Trifan, Anca, editor, Stanciu, Carol, editor, and Muzica, Cristina, editor
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- 2023
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4. Impact of Treatment with Direct Antivirals on Coagulation Parameters in Patients with Hepatitis C Virus-Related Liver Cirrhosis and Sustained Virological Response.
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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
- 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]
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- 2024
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5. New Insights on Using Oral Semaglutide versus Dapagliflozin in Patients with Type 2 Diabetes and Metabolic Dysfunction-Associated Steatotic Liver Disease.
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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
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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/m
2 . 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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6. The Impact of Alcohol Consumption Pattern on Liver Fibrosis in Asymptomatic Patients
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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
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- 2023
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7. The Relation between Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Different Cannulation Techniques: The Experience of a High-Volume Center from North-Eastern Romania
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Chiriac, Stefan, primary, Sfarti, Catalin Victor, additional, Stanciu, Carol, additional, Cojocariu, Camelia, additional, Zenovia, Sebastian, additional, Nastasa, Robert, additional, and Trifan, Anca, additional
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- 2023
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8. Nonalcoholic steatohepatitis: A scientometric analysis of publications during 1980–2018
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Trifan, Anca, Stanciu, Carol, Jurcău, Monica, Zenovia, Sebastian, Frunzuc, Georgiana, and Timofte, Daniel
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- 2019
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9. Impaired Intestinal Permeability Assessed by Confocal Laser Endomicroscopy—A New Potential Therapeutic Target in Inflammatory Bowel Disease
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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
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- 2023
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10. Anticoagulation for Atrial Fibrillation in Patients with Decompensated Liver Cirrhosis: Bold and Brave?
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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
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- 2023
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11. Changes in Components of Metabolic Syndrome after Antiviral Eradication in Hepatitis C Virus Infection
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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
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- 2023
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12. High prevalence of liver fibrosis among general population: a Romanian population-based study
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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
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- 2023
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13. Predictive Factors for the Prognosis of Alcoholic Liver Cirrhosis
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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
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- 2022
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14. Screening for Liver Steatosis and Fibrosis in Patients with Inflammatory Bowel Disease Using Vibration Controlled Transient Elastography with Controlled Attenuation Parameter
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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
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- 2022
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15. The Role of Presepsin and Procalcitonin in Early Diagnosis of Bacterial Infections in Cirrhotic Patients with Acute-on-Chronic Liver Failure
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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
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- 2022
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16. The Role of Presepsin in Diagnosing Infections in Patients with Liver Cirrhosis and Overt Hepatic Encephalopathy
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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
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- 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
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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
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- 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
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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
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- 2022
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19. Clinical and Laboratory Characteristics of Normal Weight and Obese Individuals with Non-Alcoholic Fatty Liver Disease
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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
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- 2022
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20. 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
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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
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- 2022
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21. The Prevalence of Liver Steatosis and Fibrosis Assessed by Vibration-Controlled Transient Elastography and Controlled Attenuation Parameter in Apparently Healthy Romanian Medical Students
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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
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- 2021
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22. The Risk of Clostridioides difficile Infection in Cirrhotic Patients Receiving Norfloxacin for Secondary Prophylaxis of Spontaneous Bacterial Peritonitis—A Real Life Cohort
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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
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- 2021
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23. Long-term Risk of Hepatocellular Carcinoma Following Direct-Acting Antiviral Therapy in Compensated Liver Cirrhosis Induced by Hepatitis C Virus Infection
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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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24. Hepatitis C Virus Prevalence and Risk Factors in a Village in Northeastern Romania—A Population-Based Screening—The First Step to Viral Micro-Elimination
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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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25. Association between Nonalcoholic Fatty Liver Disease and Endocrinopathies: Clinical Implications
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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
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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.
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- 2021
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26. Nonalcoholic Fatty Liver Disease and Cardiovascular Diseases: The Heart of the Matter
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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
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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.
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- 2021
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27. Vibration-Controlled Transient Elastography and Controlled Attenuation Parameter for the Diagnosis of Liver Steatosis and Fibrosis in Patients with Nonalcoholic Fatty Liver Disease
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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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28. Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: A Bidirectional Relationship
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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
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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.
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- 2020
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29. Nonalcoholic steatohepatitis
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Trifan, Anca, Stanciu, Carol, Jurcău, Monica, Zenovia, Sebastian, Frunzuc, Georgiana, and Timofte, Daniel
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nonalcoholic fatty liver disease ,Biomedical Research ,Bibliometrics ,Non-alcoholic Fatty Liver Disease ,Humans ,nonalcoholic steatohepatitis ,Periodicals as Topic ,scientometrics ,Systematic Review and Meta-Analysis ,Research Article - Abstract
Background: Nonalcoholic steatohepatitis (NASH) is a subtype of non-alcoholic fatty liver disease (NAFLD) with a potentially progressive course to liver fibrosis, cirrhosis with its complications, or even hepatocellular carcinoma. NAFLD is a rapidly growing chronic liver disease, with a global prevalence of about 25%, with a significant increase in the last 2 decades, changing the landscape of hepatology. This study aimed to undertake a bibliometric global analysis of research literature focusing on NASH. Methods: We searched the Scopus database to identify all articles pertaining to “non-alcoholic steatohepatitis” or “NASH” – the 2 keywords used to search in the title or abstract within the time period 1980 to 2018. The collected data included document type, author, journal, publication year, citation reports, country, and were analyzed using Microsoft Excel and Microsoft Word. Results: A total number of 6632 articles published in 1355 journals were retrieved. English was the predominant language of publication, USA being the most productive with 1937 articles published (29.2% of the total number of publications), followed by Japan with 909, representing 13.7% of publications. Hepatology, Journal of Hepatology and World Journal of Gastroenterology were the most active journals. Research articles were the most common type of publications (4524; 68.22%), followed by review articles (1359; 20.49%). The total number of citations received by all publications was 274,041, with an average of 41.32 per article (range: 0–4384). The average number of authors per article has increased in the last 2 decades, whereas the trend of single- (or few) authored publications has decreased. Conclusion: This study indicates that NASH is a significant topic in the hepatology research, as proved by the huge number of publications, recording an exponential growth in the last 2 decades. The USA stands out as by far the most productive country.
- Published
- 2019
30. The Impact of the COVID-19 Pandemic on Gastrointestinal Endoscopy Activity in a Tertiary Care Center from Northeastern Romania
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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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31. Micro-elimination of hepatitis C virus infection - the beginning of the end
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Huiban, Laura, primary, Stanciu, Carol, primary, Sfarti, Catalin, primary, Muzica, Cristina, primary, Cuciureanu, Tudor, primary, Zenovia, Sebastian, primary, Frunzuc, Georgiana, primary, Damian, Ioana, primary, and Trifan, Anca, primary
- Published
- 2020
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32. Hepatocellular carcinoma after direct-acting antiviral hepatitis C virus therapy: A debate near the end
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Muzica, Cristina Maria, primary, Stanciu, Carol, additional, Huiban, Laura, additional, Singeap, Ana-Maria, additional, Sfarti, Catalin, additional, Zenovia, Sebastian, additional, Cojocariu, Camelia, additional, and Trifan, Anca, additional
- Published
- 2020
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33. Duodenal large-cell neuroendocrine carcinoma as unusual cause of acute pancreatitis
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Zenovia, Sebastian, primary, Neculae, Ecaterina, additional, Trifan, Anca Victorita, additional, Dimache, Mihaela, additional, Fotea, Vasile, additional, and Singeap, Ana-Maria, additional
- Published
- 2020
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34. CHANGES IN COMPONENTS OF METABOLIC SYNDROME AFTER ANTIVIRAL ERADICATION IN HEPATITIS C VIRUS INFECTION.
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Cuciureanu, Tudor, Zenovia, Sebastian, Nastasa, Robert, Stratina, Ermina, Stafie, Remus, Rotaru, Adrian, Dimache, Mihaela, Muzica, Cristina Maria, Huiban, Laura, Stanciu, Carol, and Trifan, Anca
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HEPATITIS C , *DYSLIPIDEMIA , *CHRONIC hepatitis C , *METABOLIC syndrome , *HEPATITIS C virus , *CHRONIC active hepatitis , *CARDIOVASCULAR diseases risk factors - Abstract
Introduction. Over 71 million people worldwide suffer from chronic hepatitis C, a systemic disease that is currently being viewed as a new cardiometabolic risk factor. Aim. The objective of this study was to compare the lipid profiles of patients with hepatitis C virus (HCV) infection before and after viral elimination. Materials and Methods. We conducted a prospective study between October 2017 to January 2020, in a tertiary center, in which we included 132 patients with chronic HCV hepatitis or cirrhosis. All patients received treatment with direct antivirals. During the study we assesed biological data (blood count, TGP, TGO, serum albumin, urea, creatinine, total cholesterol (TC), LDL-cholesterol, HDLcholesterol, triglycerides). The study group was followed at the initiation of antiviral treatment, after 3 months after the completion of antiviral treatment and within an average follow-up period of 6 months to 12 months after the previous evaluation. Results. 128 of the 132 patients exhibit a persistent viral response (SVR). The average TC levels for patients who obtained SVR increased from baseline to 177.01 42.2 mg/dl. The discrepancies between the baseline values of the TC and those discovered during SVR and post-SVR surveillance were statistically significant (p 0.05 and p = 0.049, respectively). When compared to the baseline, the average LDL-cholesterol readings at SVR and post-SVR surveillance were higher on average (116.2 35.6 vs 124, 24 34.9 vs 136.72 22.5 mg/dL). The post-SVR examination reveals significant HDL value variability, with lower values discovered compared to the study's second surveillance moment. After viral clearance, the serum triglyceride level had also changed. The mean triglyceride concentrations are lower (128.441.8 mg/dL) at the time of the SVR assessment. In the third evaluations, the mean value is somewhat higher (135.445.2 mg/dL). The differences between the values acquired at the time of SVR and the beginning values were found to be statistically significant (p = 0.008, p 0.05). Conclusion. Our study highlights that HCV eradication does not improve the lipid profile on the short term, and these patients still have an additional cardiovascular risk factor due to high levels of TC, LDL-cholesterol and triglycerides. [ABSTRACT FROM AUTHOR]
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- 2023
35. EXTRADIGESTIVE-GIST: A RARE FINDING.
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Balan, Gheorghe, Zenovia, Sebastian, Catalina, Cucu, Chiriac, Stefan, and Sfarti, Catalin
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COMPUTED tomography , *OLDER patients , *METABOLIC disorders , *DIABETES , *ABDOMINAL tumors , *CD4 antigen - Abstract
We present the case of a 72 years old male patient hospitalised within the Diabetes and Metabolic Diseases Departament for weight loss and severe diabetes mellitus imbalance. The patient underwent transabdominal ultrasonography which detected an abdominal mass of approx. 40mm in the epigastric region followed by abdominal contrast-enhanced CT scan which has confirmed a 47/40mm solid tumour in the gastrosplenic ligament and a suspected right adrenal mass of 25mm. The patient has been referred for EUS and FNB. EUS evaluation confirmed the positioning of a 46mm solid tumour in contact with the splenic hilum. Moreover, a hypoechoic, poorly delineated lesion as been observed in the left adrenal area. FNB of both lesions showed a CD4+, CD114+, DOG1+ tumour interpreted as EGIST (extra digestive-GIST). However, despite it's metastatic character, Ki67 was of less than 2%. [ABSTRACT FROM AUTHOR]
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- 2023
36. NOT ALL SUB EPITHELIAL LESIONS ARE GISTS: TRUST FNB AND YOUR HISTOPATHOLOGIST!
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Balan, Gheorghe, Zenovia, Sebastian, Catalina, Cucu, Chiriac, Stefan, and Sfarti, Catalin
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NEUROENDOCRINE tumors , *OLDER patients , *GASTROINTESTINAL stromal tumors , *COMPUTED tomography , *WOMEN patients , *ENDOSCOPY - Abstract
We present the case of a 66 years old female patient referred for upper GI endoscopy evaluation for weight loss and epigastric pain. Endoscopic evaluation showed an elevated lesion of approx. 3cm in the gastric body with normal adjacent mucosa and a central depression highly suggestive for a GIST. CTscan confirmed a gastric GIST and no metastases. The oncology team suggested EUS-FNB so that the patient underwent EUS which showed a 2.9/3/7cm lesion originating from the 3rd layer (submucosal space). FNB followed by histopathology and imunohistochemistry evaluation showed a large volume G2 neuroendocrine tumour. The case stresses the importance of EUS and FNB evaluation of gastric subepithelial lesions as not all lesions can be easily evaluated only be upper GI endoscopy and CT scanning despite localised disease. [ABSTRACT FROM AUTHOR]
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- 2023
37. Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: A Bidirectional Relationship
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M. Muzica, Cristina, Sfarti, Catalin, Trifan, Anca, Zenovia, Sebastian, Cuciureanu, Tudor, Nastasa, Robert, Huiban, Laura, Cojocariu, Camelia, Singeap, Ana-Maria, Girleanu, Irina, Chiriac, Stefan, and Stanciu, Carol
- 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.
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- 2020
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38. ASSESSMENT OF THE IMPACT OF ALCOHOL CONSUMPTION ON LIVER FIBROSIS IN ASYMPTOMATIC PATIENTS USING TRANSIENT ELASTOGRAPHY.
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Minea, Horia, Stanciu, Carol, Zenovia, Sebastian, Nastasa, Robert, Stratina, Ermina, Stafie, Remus, Rotaru, Adrian, Sfarti, Catalin, Chiriac, Ștefan, Sîngeap, Ana-Maria, Gîrleanu, Irina, Cuciureanu, Tudor, Huiban, Laura, Muzică, Cristina, Cojocariu, Camelia, and Trifan, Anca
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HEPATIC fibrosis , *ALCOHOL drinking , *ASYMPTOMATIC patients , *ELASTOGRAPHY , *REGRESSION analysis - Abstract
Introduction. In recent decades, alcohol consumption, as part of an unhealthy lifestyle, which has been on the rise in many parts of the world, is a key factor that explains the constant upward trend of mortality associated with this etiology. This study aimed to investigate the prevalence of liver fibrosis in the asymptomatic alcohol-consuming population. Objectives. The purpose of the study was to evaluate the relationship between advanced liver fibrosis measured by transient elastography, laboratory parameters, and the amount of alcohol consumed depending on non-modifiable risk factors such as age and gender. Material and method. Between January 2022 and December 2022, we examined patients with day hospitalization in the Institute of Gastroenterology and Hepatology in Iasi, without liver history, who admitted a moderate or high consumption (women <7 versus >7 drinks/week; men <14 versus >14 drinks/week) for at least one year. The classification of the fibrosis stage by transient elastography was adjusted according to transaminase values. The results were analyzed by univariate analysis and logistic regression to establish models of prediction. Results: The study included 689 patients with an average age of 49.32±14.31 years, a proportion of 63.7% represented by men. Advanced fibrosis (F3) was detected in 19.30% of the examined patients, predominantly in men (14.1%) and patients over 55 years old (12.5%). Excessive alcohol consumption is associated 2 times more with advanced fibrosis in women (OR=5.08; CI 95%: 3.45-9.50) and the group under 40 years old (OR=6.29; CI 95%: 1.67-9.43) compared to men (OR=2.27; CI 95%: 1.76-3.81) respectively patients over 55 years old (OR=3.21; CI 95%: 2.28-4.45) (p<0.05). Using logistic regression, it was demonstrated that there was a strong correlation between advanced fibrosis, excessive alcohol consumption, low serum albumin level and the reduction of triglycerides in men (R2 Nagelkerke = 0.854; p<0.001) supplemented with the reduction of cholesterol in the age group 40-55 years (R2 Nagelkerke = 0.785; p<0.001), respectively of ferritin in those over 55 years old (R2 Nagelkerke = 0.804; p<0.001). The association of excessive alcohol consumption, age, low levels of albumin, LDL-cholesterol and C-reactive protein generated a significant predictive model (R2 Nagelkerke = 0.784; p<0.001) for female patients. Conclusion. Screening using transient elastography represents an approach that could provide early diagnosis of advanced liver fibrosis in an asymptomatic population, with the possibility to prevent the evolution of ALD and the development of complications of cirrhosis. [ABSTRACT FROM AUTHOR]
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- 2023
39. EVALUATION OF LIVER FIBROSIS IN INDIVIDUALS WITH METABOLIC SYNDROME USING NON-INVASIVE TESTS.
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Nastasa, Robert-Radu, Stanciu, Carol, Zenovia, Sebastian, Stafie, Remus, Stratina, Ermina, Rotaru, Adrian, Singeap, Ana-Maria, Cojocariu, Camelia, Sfarti, Catalin, Girleanu, Irina, Chiriac, Stefan, Cuciureanu, Tudor, Huiban, Laura, Muzica, Cristina, Minea, Horia, and Trifan, Anca
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HEPATIC fibrosis , *FATTY liver , *NON-alcoholic fatty liver disease , *METABOLIC syndrome , *NONINVASIVE diagnostic tests , *ASPARTATE aminotransferase - Abstract
Introduction. Metabolic syndrome (MS) patients are at increased risk for severe liver fibrosis and nonalcoholic fatty liver disease. However, there aren't any recommendations until this moment for screening MS patients. This study aimed to evaluate the diagnostic precision of non-invasive tests in identifying advanced liver fibrosis (F3) and cirrhosis (F4) in MS patients using vibration-controlled transient elastography (VCTE) as a standard quantification method. Materials and Methods. Between September 2022 to March 2023, we prospectively enrolled MS patients at the Gastroenterology and Hepatology Institute Iasi who had undergone evaluation using noninvasive tests like the aspartate aminotransferase to platelet ratio index (APRI) score, fibrosis-4 (FIB-4) index, and NAFLD fibrosis score (NFS). When compared to liver stiffness measures (LSM), we assessed the specificity, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) for each of these indicators in the identification of at least advanced liver fibrosis (=F3). Results. Of the 116 MS patients included in this study, who had a mean BMI of 27.82±4.62 kg/m2 and at least three metabolic conditions, 69 individuals (59.5%) were females. Using a cut-off of 9.7 kPa, 35 (30.2%) patients had at least advanced fibrosis (=F3) according to LSM measurements. VCTE examinations present a higher correlation with the FIB-4 index (r=0.566), NFS (r=0.585), and APRI score (r=0.624) (p< 0.001). The NPV for the FIB-4 index was the highest (90.38%), followed by the NPV for the NFS score (87.84%). The main result of our research showed that all the biomarkers had reasonably high NPV (>85%) and accuracy (>83%) for predicting advanced liver fibrosis, with moderate specificity (80%) and PPV (75%). Conclusion. To prevent progressive fibrosis in MS patients, the FIB-4 index and NFS score seem to be the most suitable surrogate VCTE biomarkers. It may be necessary to take action and further evaluation of liver fibrosis in a tertiary care center for populations at risk after these non-invasive and affordable screening tests are used in primary care settings. [ABSTRACT FROM AUTHOR]
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- 2023
40. A PARTICULAR CASE OF DIGESTIVE BLEEDING MANIFESTED - FROM NORMAL TO THE UNUSUAL - A CASE REPORT.
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Huiban, Laura, Sîngeap, Ana Maria, Muzîca, Cristina Maria, Zenovia, Sebastian, Cuciureanu, Tudor, Petrea, Oana, Chiriac, Ștefan, Gîrleanu, Irina, Sfarti, Cătălin, Stanciu, Carol, and Trifan, Anca
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DIVERTICULOSIS , *GASTROINTESTINAL hemorrhage , *HEMORRHAGE , *BIOMARKERS , *ARGON plasmas , *MUCOUS membranes , *HEART sounds - Abstract
Introduction. Digestive bleeding is a challenge in daily practice, being one of the main reasons for addressability in a gastroenterology center, which requires hospitalization and investigations to determine the cause and whose treatment depends on the source of the bleeding. Case report. A 61-year-old patient from a urban area, with associated cardio-vascular pathology, with an initial address in the territory for digestive bleeding (melena), without highlight a source with potential for bleeding at endoscopic examinations, presents for the persistence of stools melenic, dizziness, marked physical asthenia and diffuse abdominal pain. Clinical examination reveals: good general condition, afebrile, teguments and pale mucous membranes, normal heart auscultation, bilateral basal tightened vesicular murmur. Laboratory findings show normochromic normocyte anemia, hyponatremia, important enzymatic cholestasis (increased isolated alkaline phosphatase), negative viral and autoimmunity markers, normal tumor markers, except increased PSA (3160 ng/ml), normal kidney function. Abdominal ultrasound: hyperreflective liver, with normal structure and size, at rest, without other pathological changes. The upper digestive endoscopy does not reveal any source with bleeding potential. Colonoscopy show small diverticula throughout the colic, red blood coming from the level of the small intestine, check with bleeding, no lesions. Because the colonoscopy revealed red blood from the small intestine, the exploration was continued with the investigation of this segment, with the help of the capsule endoscopy, which immediately describes after passing through the ileocecal valve, in the vesicle, a vascular lesion with central ulceration, and in nearby - red blood, with an ulcerated venous angiodysplasia aspect. Treatment of hydroelectrolytic rebalancing and blood transfusion was initiated, the main therapeutic measure being the endoscopic coagulation with argon plasma, with the bleeding stopping. In view of the increased PSA marker, abdominal-pelvic TC was performed, which revealed a tumor formation in the prostate and secondary bone lesions (which explains the increase of AP), the histological result being of prostate acinar adenocarcinoma. The particularity of the case is the overlap of an increased isolated AP that together with the increased PSA, directs the diagnosis to prostate neoplasm with secondary bone lesions. Conclusions. The explorations performed out in the patient presented with digestive bleeding offered the explanation of the symptomatology, together with the modified biological parameters, further investigations being required. The manifestation of the digestive haemorrhage was masked by the colonic diverticulosis and the biological picture of the neoplastic pathology, the difficulty of the diagnosis being determined by the overlapping of the clinico-biological manifestations. [ABSTRACT FROM AUTHOR]
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- 2023
41. USEFULNESS OF AGGRESSIVENESS INDEX (AGI) IN ASSESSING THE PATTERN OF HCVRELATED HEPATOCELULLAR CARCINOMA AFTER DIRECT ACTING ANTIVIRALS.
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MUZICA, CRISTINA-MARIA, Stanciu, Carol, Huiban, Laura, Girleanu, Irina, Zenovia, Sebastian, Cuciureanu, Tudor, Nastasa, Robert, Rotaru, Adrian, Stafie, Remus, Stratina, Ermina, Chiriac, Stefan, Cojocariu, Camelia, Singeap, Ana Maria, and Trifan, Anca
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PORTAL vein , *ANTIVIRAL agents , *HEPATOCELLULAR carcinoma , *HEPATITIS C - Abstract
Introduction. Despite the high efficacy of direct acting antivirals (DAAs) in curing chronic HCV infection, there is a concern regarding a more aggressive phenotype of hepatocellular carcinoma (HCC) after DAA treatment. Although there are many clinical cohort studies that have evaluated the incidence and recurrence of HCC in these patients, data on the tumor characteristics of HCC after DAAs are not sufficient to establish a clear conclusion. A promising index was recently developed for the evaluation of HCC aggressiveness (AGI) which comprises 4 tumor-related parameters: maximum tumor diameter (MTD), number of tumor nodules, portal vein thrombosis (PVT) and serum AFP levels. Aim. We aimed to investigate the usefulness of AGI in assessing the pattern of HCV-related HCC after DAAs and the predictive value in survival. Material&methods. We carried out a retrospective comparative observational study in which we included patients treated with DAAs for HCV infection and diagnosed with HCC in the Institute of Gastroenterology and Hepatology from Iași, Romania, between January 1st, 2017 and December 31, 2019. Patients were matched based on age and sex with a historic cohort consisting of patients with HCV-related HCC without DAA therapy. Based on AGI, patients were divided into three aggressiveness classes: class A (low aggressiveness), B (intermediate aggressiveness) and C (high aggressiveness). Results. Among the 124 patients with chronic HCV infection diagnosed with HCC, 66 (53.2%) patients were males and 58 (46.8%) were female, with a mean age of 62.38 ± 9.88 years. According to DAAtreated and DAA-naive status, patients were divided into 2 groups: the DAA group included 30 treated patients and the non-DAA group included 94 DAAnaive patients. In the DAA group, the frequency of single HCC was much higher (73.3%) than in naïve patients (53.2%) (p = 0.052), as well as smaller tumor sizes (41.07 ± 18.116mm vs. 61.79 ± 34.477mm, p=0.001) and lower rates of malignant PVT (20% vs. 36%, p = 0.146). According to AGI, class B was the most frequently observed (42.6%) in DAA-naïve patients, followed by class A (31.9%) and class C (25.5%), whilst in DAA-treated patients the most frequent was class A (46.7%), closely followed by class B (40.0%), and class C in 13.3% of cases. The 3-year survival probability for AGI class A vs. B vs. C was 66.9% vs 40.2% vs 8.4%; p=0.001, from the time of diagnosis by Kaplan-Meier plot. There was a significantly higher survival rate in the DAA group compared to DAA-naïve patients (75.3% vs. 52.4%, p = 0.008). [ABSTRACT FROM AUTHOR]
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- 2023
42. THE EFFICACY OF USING ORAL SEMAGLUTIDE IN PATIENTS WITH TYPE 2 DIABETES AND NONALCOHOLIC FATTY LIVER DISEASE.
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Stratina, Ermina, Stanciu, Carol, Nastasa, Robert, Rotaru, Adrian, Stafie, Remus, Zenovia, Sebastian, Sfarti, Catalin, Cojocariu, Camelia, Cuciureanu, Tudor, Muzica, Cristina, Girleanu, Irina, Chiriac, Stefan, Minea, Horia, Singeap, Ana-Maria, Huiban, Laura, and Trifan, Anca
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NON-alcoholic fatty liver disease , *TYPE 2 diabetes , *HEPATIC fibrosis , *SEMAGLUTIDE , *BODY mass index - Abstract
Introduction. Non-alcoholic fatty liver disease (NAFLD) is usually associated with type 2 diabetes mellitus (T2DM). The limited number of NAFLD treatment options is well known. Semaglutide, a GLP-1 receptor agonist approved to treat T2DM, is crucial for obtaining a healthy weight. Additionally, may constitute a cutting-edge therapy option for T2DM patients with NAFLD. In this study, liver steatosis and fibrosis in T2DM patients are measured using vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP). Material and Methods. Fifty-seven consecutive patients with T2DM and NAFLD receiving oral semaglutide were enrolled from September 2022 to February 2023 and evaluated by VCTE with CAP. Clinical and analytical data for every subject were recorded. Oral semaglutide was initiated at a dose of 3 mg once daily and subsequently increased to 7 mg at 4 weeks, and 14 mg at 8 weeks in accordance with the diabetologist's recommendations. Results. VCTE analysis showed that 40 diabetic people (70.2%) had significantly lower CAP levels after 24 weeks compared to baseline. Only 14 (24.5%) diabetic patients experienced a significant decrease in liver fibrosis. Regarding body mass index (BMI), aspartate aminotransferase (AST) and alanine aminotransferase (ALT), have improved significantly compared to the baseline (mean BMI 28.72±5.43 kg/m2 to 25.67 ±6.11 kg/m2, mean AST 58.17 ± 16.33 IU/L to 34.54 ± 13.8 IU/L, mean ALT 63.31 ± 12.66 IU/L to 39.17 ± 14.3 IU/L). The mean hemoglobin A1c (HbA1c) value reduced significantly from baseline to 24 weeks (from 8.9% to 7.4%). A significant correlation existed between changes in CAP values and fasting plasma glucose (p=0.31, p=0.52), as well as AST (p=0.188, p=0.48), and BMI (p=0.274, p=0.44). Nausea and diarrhea were the most often reported side effects. Conclusion. In individuals with T2DM with NAFLD, oral semaglutide therapy has improved glycemic control, liver enzymes, body weight, and liver steatosis. These findings suggest that semaglutide may be useful in the treatment of NAFLD patients, therefore more studies concerning liver fibrosis are necessary. [ABSTRACT FROM AUTHOR]
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- 2023
43. PATHOLOGIES DISCOVERED INCIDENTALLY IN PATIENTS WITH CHRONIC VIRAL INFECTION B / D AND C DIAGNOSED IN THE SCREENING PROGRAM LIVE (RO)2 - EAST.
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Huiban, Laura, Trifan, Anca, Muzîca, Cristina, Nastasa, Robert, Zenovia, Sebastian, Stafie, Remus, Stratina, Ermina, Rotaru, Adrian, Sîngeap, Ana Maria, Cojocariu, Camelia, Sfarti, Catalin, Gîrleanu, Irina, Chiriac, Stefan, Nemteanu, Roxana, Cuciureanu, Tudor, and Stanciu, Carol
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VIRUS diseases , *MEDICAL screening , *TYPE 2 diabetes , *VIRAL hepatitis , *HEPATITIS B , *HEPATORENAL syndrome - Abstract
Introduction. The overall burden of B / D and C viral hepatitis remains substantial, despite the major advances in the prevention and treatment of patients in recent years, due to comorbidities and complications associated with liver disease. In this context, the national screening program LIVE (RO) 2 aims to further assess all patients identified as positive for one of the hepatitis B / D / C viruses. Objectives. The study aimed to identify fortuitous pathologies discovered in patients with chronic viral B / D / C infection diagnosed in the LIVE (RO) screening program 2. Materials and Methods. We conducted a prospective study that included people from vulnerable groups (poor, uninsured, rural people, people in foster care, homeless, Roma population, people with disabilities, and suffering from alcohol or drug addiction) in different areas of North-Eastern Romania, between July 2021 - December 2022, during the national screening program LIVE (RO) 2-EAST. We also investigated the presence of newly discovered conditions in patients who tested positive and directed to the Institute of Gastroenterology and Hepatology in Iasi for the staging of liver disease and the establishment of antiviral treatment. Results. The study group included 1176 patients, of which 422 men (35.8%) and 754 women (64.1%), aged between 35 and 83 years, with a mean age of 56.32 years. The predominant source of origin was rural (73.1%). Of the patients with positive RDTs, 635 (53.9%) patients were detected with HBsAg, 521 (44.3%) patients with anti-HCV antibodies, and 20 (1.7%) patients with anti-HVD antibodies. Of these, 215 patients (18.2%) were diagnosed with a new pathology associated with B / D / C viral infection. The most common pathologies discovered incidentally were liver cirrhosis (94, 43.7%), liver cysts (35, 16.2%), liver hemangiomas (29, 13.4%), gallstones (24, 11.1%), type II diabetes mellitus (T2DM) (15, 6.9%), uterine fibroids (9, 4.1%), hepatocellular carcinoma (7, 3.2%), choledochal lithiasis (2, 0.9%). In addition, the presence of fortuitous pathologies was higher among patients with HBV infection than in those with HCV infection (65.3% vs. 42.1%, p = 0.012). Among the risk factors associated with hepatocellular carcinoma (HCC) are chronic alcohol consumption (43%, compared to 19% in the group of patients without HCC), and the association of T2DM in 3 patients (31%, compared to 10% in the group of patients with HCC). Conclusions. Patients with chronic B / D / C viral infection had a high prevalence of incidentally detected comorbidities, which necessitates the need for public health policies in vulnerable groups to promote access to existing health services to reduce the future burden of chronic diseases but also secondary complications of chronic liver disease. [ABSTRACT FROM AUTHOR]
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- 2023
44. COMORBIDITY ASSESSMENT IN THE VULNERABLE POPULATION DIAGNOSED WITH CHRONIC B/D AND C VIRAL INFECTION FROM THE NORTHEAST REGION OF ROMANIA - STAGE SCREENING RESULTS LIVE(RO) 2 - EAST.
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Huiban, Laura, Trifan, Anca, Muzîca, Cristina, Nastasa, Robert, Zenovia, Sebastian, Stafie, Remus, Stratina, Ermina, Rotaru, Adrian, Chiriac, Stefan, Nemteanu, Roxana, Cuciureanu, Tudor, and Stanciu, Carol
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HEPATITIS B , *VIRUS diseases , *RAPID diagnostic tests , *CHRONIC hepatitis B , *MEDICAL screening , *VIRAL hepatitis - Abstract
Introduction. Chronic viral hepatitis B/D and C can be complicated by comorbid conditions that may influence treatment eligibility and outcomes. The aim of this study was to evaluate the presence of the most common comorbidities in patients diagnosed with chronic viral B/D and C infection using rapid diagnostic tests (TDR). Materials and Methods. Between July 2021 and December 2022, we performed prospective screening for chronic viral B/D and C infection in people in vulnerable groups (poor, uninsured, rural people, people in foster care, people without shelter, Roma people, people with disabilities, people suffering from alcohol and drug addiction) from different areas of North-Eastern Romania, during the national program for the elimination of viral hepatitis LIVE(RO) 2-EST using TDRs for hepatitis B virus (Wama Immuno-Rapid HBV®) and hepatitis C virus (Wama Immuno-Rapid HCV®). We also investigated the presence of comorbid conditions in patients tested positive and presented at the Institute of Gastroenterology and Hepatology in Iasi for the staging of liver disease and the establishment of antiviral treatment. Results. Our study included 1176 patients who came to a tertiary center for the staging of liver disease, of which 422 men (35.8%) and 754 women (64.1%), aged 35 to 83 years, with an average age of 56.32 years. The predominant source of origin was rural (73.1%). Of the patients with positive TDR, 635 (53.9%) of patients were detected with HBsAg, 521 (44.3%) of patients with anti-HCV antibodies, and 20 (1.7%) of patients with anti-HVD antibodies. Of these, 646 patients (54.9%) had at least one comorbid condition. The most common comorbidities were cardiovascular disease (21.5%), psychiatric disorders (11.5%), type 2 diabetes (8.9%), metabolic disorders (6%), thyroid disorders (5%) and cancer (2%). In addition, the presence of comorbidities was higher among patients with HCV infection than in those with HBV infection (64.9% vs. 48.5%, p = 0.014), while psychiatric disorders were most common in patients with HBV/HVD coinfection (42.3%), most likely due to the Interferon regimen that has been administered in the past to 19 individuals. Conclusions. Patients with chronic viral hepatitis B/D and C had a high prevalence of multiple comorbidities. Effective strategies are needed to manage these comorbid conditions as well as interdisciplinary collaboration to allow greater access to antiviral treatment and to reduce the future burden of advanced liver disease and its manifestations. [ABSTRACT FROM AUTHOR]
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- 2023
45. A POSSIBLE ASSOCIATION BETWEEN H. PYLORI INFECTION AND EXTRA-GASTRIC PATHOLOGY - A CASE REPORT.
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Gianga, Antonia Ionela, Stanciu, Carol, Huiban, Laura, Muzîca, Cristina Maria, Zenovia, Sebastian, Cuciureanu, Tudor, Sîngeap, Ana Maria, Sfarti, Catalin, and Trifan, Anca
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DUODENAL ulcers , *HELICOBACTER pylori infections , *PATHOLOGY , *HELICOBACTER pylori , *BIOMARKERS , *MUCOSA-associated lymphoid tissue lymphoma , *INFECTION - Abstract
Introduction. A frequent problem in daily practice that gastroenterologists have to confront with is Helicobacter pylori infection. The stomach is where H. pylori infection naturally occurs, this bacterium being the cause of pathologies such as gastritis, peptic ulcer, MALT lymphoma and stomach cancer. Additionally, there is proof connecting the bacteria to a number of extra-gastric pathologies. Case report. We report the case of a 55 year old patient from a rural area, with no significant heredocollateral antecedents, with a history of cardiovascular pathology (Hypertension and Chronic Coronary Syndrome) investigated for digestive bleeding (intermitent hematochezia), important physical astenia, loss of appetite, diffuse abdominal pain and weight loss (5 kg/one month). Clinical investigation reveals: good general condition, pale teguments and mucous membranes, koilonychia, tachycardia (115 bpm), decreased left-based vesicular murmur. Laboratory examinations reveal hipochromic microcyte anemia, negative viral and autoimmunity markers, normal kidney function, normal tumor markers, except increased carcinoembryonic antigen (CEA) (9,2 ng/ml). An upper digestive endoscopy is being performed, which reveals anthral gastritis, a spastic pylorus and a congestive bulb with a 1,5 cm diameter ulcer located on the anterior wall, Forrest III. Due to its position and difficulty to reach, no biopsy for H. pylori was taken from the ulcer, however, the IgG H. pylori antibodies and fecal antigen were positive, which determined the initiation of treatment in order to eradicate the infection. Colonoscopy shows an isolated ulcerated lesion, easily bleeding when touched with the colonoscope, but with no active bleeding focus, located in the right colon. Pathology of the biopsy material was suggestive for adenocarcinoma, which determined the patient's redirection to the surgery clinic for the surgical treatment to be performed. Discussion. The particularity of the case is the association of a duodenal ulcer H. pylori positive with right colon neoplasm, but without any other declared risk factors, H. pylori being a recognized class of human carcinogens and there are numerous studies in literature that have looked into the connection between H. pylori infection and colorectal cancer. Conclusion. Finding out how this organism plays a role in various pathologies can be aided by eradicating this infection and reevaluating individuals who have recovered from it. It is yet unclear what the underline pathophysiology of this association is, so more fundamental research in this area is needed. [ABSTRACT FROM AUTHOR]
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- 2023
46. TUMORAL OBSTRUCTIVE JAUNDICE: DIAGNOSTIC AND TREATMENT - CLINICAL CASE.
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Dimache, Mihaela, Anton, Carmen, Timofte, Oana, Gologan, Elena, Zenovia, Sebastian, Balan, Gheorghe, and Mălinoiu, Oana
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OBSTRUCTIVE jaundice , *PANCREATIC tumors , *GALLBLADDER cancer , *BILE ducts , *METASTASIS , *JAUNDICE , *ENDOSCOPIC retrograde cholangiopancreatography - Abstract
Introduction. The most common causes of tumoral obstructive jaundice are cephalic pancreatic neoplasm and cholangiocarcinomas, followed by gallbladder cancer and metastatic tumors compressing the bile ducts. Case presentation. We present the case of a 64-year-old female patient, without digestive history but with familial neoplastic aggregation, who was referred for jaundice, diffuse abdominal pain, and weight loss. She performed a abdominal-pelvic CT in an elective regime which concludes acute pancreatitis CTSIm score 2. The biological panel: thrombocytosis, hepatocytolytic syndrome, icteric cholestasis, slightly increased amylazuria, inflammatory syndrome, modified coagulation tests, and increased CA19-9. Abdominal ultrasound: Homogeneous hepatomegaly, CBP 11.5 mm, nondilated CBIH, homogeneous spleen, absence of ascites. Since the MRCP examination is not possible (osteosynthesis), EDS was performed which highlights the papilla with normal anatomy, biopsies are taken - without dysplasia or tumor aspects. Then ERCP was performed which revealed distal choledochostenosis with a radiological appearance of malignancy, cytological brushing and biopsy was performed and an 8.5/7 Fr plastic biliary stent was placed. The evolution was favorable, with the reduction of jaundice and bilirubinemia; the patient was referred to the Iași Regional Oncology Institute. Discussions. The result of the choledochal biopsy is inconclusive ("suspicious tumor smears"), therefore the CT examination was repeated, which now concludes cephalic pancreatic neoplasm with the invasion of the main bile duct. A laparotomy is performed, but an advanced, inoperable local cancer is found. Conclusions. In our patient, ERCP allowed biliary decompression with symptomatic and biological improvement. Literature data show that ERCP with biliary stent placement is the most commonly used technique for biliary decompression in patients with obstructive malignant tumoral jaundice, especially in those with inoperable tumors. [ABSTRACT FROM AUTHOR]
- Published
- 2023
47. NON-ALCOHOLIC FATTY LIVER DISEASE - A COMMON FINDING AMONG PATIENTS WITH INFLAMMATORY BOWEL DISEASE.
- Author
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Stafie, Remus-Theodor, Rotaru, Adrian, Stanciu, Carol, Zenovia, Sebastian, Stratina, Ermina, Nastasa, Robert, Minea, Horia, Singeap, Ana Maria, Cojocariu, Camelia, Sfarti, Catalin, Girleanu, Irina, Chiriac, Stefan, Cuciureanu, Tudor, Huiban, Laura, Muzica, Cristina, and Trifan, Anca
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NON-alcoholic fatty liver disease , *INFLAMMATORY bowel diseases , *FATTY liver , *DISEASE risk factors , *HEPATIC fibrosis , *MYOCARDIAL infarction , *SYSTOLIC blood pressure - Abstract
Background and Aims. Inflammatory bowel diseases (IBD) are caused by a dysregulated immune response in the hosts, favored by genetic susceptibility. In addition to symptoms related to the digestive tract, about 40% of patients with IBD also experience extraintestinal manifestations. Although, non-alcoholic fatty liver disease (NAFLD) has been frequently associated with IBDs, the relationship between these two pathologies remains unclear. The aim of this study was to investigate the prevalence of NAFLD among IBD patients, as well as the factors that connect these two conditions. Material and methods. From January 2022 to November 2022, consecutive IBD patients were enrolled from a tertiary care center hospital in Iasi. Patients' demographic information, clinical characteristics including blood pressure, biological parameters, and anthropometric measurements were collected. Following informed consent, participants underwent a fibroscan evaluation for liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). Results. 93 patients with IBD were enrolled (65,3% men, 55,6% with ulcerative colitis). 45 (48,3%) of them were diagnosed with NAFLD, with a mean CAP score of 283 ± 33.4 vs. 215 ± 23.7 in patients with IBD only. Regarding liver fibrosis, mean LSM value in the NAFLD group was 6.8 ± 1.9 kPa vs. 5.7 ± 2.3 kPa in the non-NALFD group. Subjects with NAFLD exhibited higher body mass indexes than those with IBD only (26.2 vs. 33.1, p<0.05). In addition, the prevalence of diabetes was much greater among this group (27.5% vs. 0%; p=0.0001), as was the prevalence of elevated HbA1c levels in the absence of a diabetes diagnosis (14% vs. 7.35%; p=0.23). They also had a non-significantly higher mean systolic blood pressure and greater incidences of hypertension. Compared to those without NAFLD, the NAFLD cohort had higher rates of diagnosed hypercholesterolaemia, were older with a higher mean disease duration and had a higher nonsignificant level of triglycerides. The 10-year risk of myocardial infarction or death estimated by the Framingham risk scores for hard coronary heart disease was higher in the NAFLD group (2.32% vs. 4.27%, p=0.0024). Conclusions. NAFLD is a multifaceted condition that is becoming more common in IBD patients. Although the present evidences in the literature suggest a small risk for the advance of liver fibrosis, the cardiovascular risk seems to be of a greater interest. Considering the above data, patients with IBD should be evaluated with a multidisciplinary approach. [ABSTRACT FROM AUTHOR]
- Published
- 2023
48. APPARENTLY FIT BUT NOT HEALTHY - HIGH CARDIOVASCULAR RISK IN LEAN NAFLD PATIENTS.
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Rotaru, Adrian, Stafie, Remus, Stanciu, Carol, Zenovia, Sebastian, Stratina, Ermina, Nastasa, Robert, Minea, Horia, Singeap, Ana-Maria, Cojocaru, Camelia, Sfarti, Catalin, Girleanu, Irina, Chiriac, Stefan, Cuciureanu, Tudor, Huiban, Laura, Muzica, Cristina, and Trifan, Anca
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HEPATIC fibrosis , *NON-alcoholic fatty liver disease , *CARDIOVASCULAR diseases risk factors , *SYSTOLIC blood pressure , *TYPE 2 diabetes - Abstract
Background and Aims. Non-alcoholic fatty liver disease (NAFLD) and obesity are independently related to an increased risk for atherosclerotic cardiovascular disease (ASCVD), the primary cause of mortality in NAFLD patients. Even though many subjects with NAFLD are normal weight, it still remains uncertain whether their ASCVD risk is of major importance. The aim of this study is to assess and compare the ASCVD risk between lean and obese patients with NAFLD. Methods. Normal weight and obese patients were evaluated between January 2020 and February 2023 and their data was analyzed. NAFLD was diagnosed by vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP) and the American College of Cardiology/American Heart Association guidelines was used to evaluate the ASCVD risk. Results. In the obese group, 104 (63.8%) patients were diagnosed with NAFLD, compared to 32 (12.3%) in the lean population. In comparison to those with obese NAFLD, subjects with lean NAFLD had significantly higher ASCVD scores (mean 15.3% vs 22.7%, p<0.001). Moreover, subjects with lean NAFLD and significant liver fibrosis had a higher risk of ASCVD events, compared to their obese counterparts (OR, 2.51 vs 1.95, p=0.034). Regarding the presence of the components of the metabolic syndrome, the prevalence of type 2 diabetes mellitus was higher the obese group, while changes in the lipid profile and higher systolic blood pressure were more frequently found in lean subjects. Conclusions: Subjects with lean NAFLD had an ASCVD score that were significantly higher than those with obese NAFLD. In both study groups, the presence of significant liver fibrosis was an essential risk factor associated with an ASCVD event, but the effects were more pronounced in lean individuals. [ABSTRACT FROM AUTHOR]
- Published
- 2023
49. EPIDEMIOLOGY OF CHRONIC VIRAL HEPATITIS B/D AND C IN THE VULNERABLE POPULATION IN THE NORTH-EAST AND SOUTHEAST REGIONS OF ROMANIA - INTERMEDIATE STAGE RESULTS IN THE LIVE(RO)2 - EAST SCREENING.
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Huiban, Laura, Trifan, Anca, Muzîca, Cristina, Nastasa, Robert, Zenovia, Sebastian, Stafie, Remus, Stratina, Ermina, Sîngeap, Ana Maria, Cojocariu, Camelia, Sfarti, Catalin, Gîrleanu, Irina, Chiriac, Stefan, Nemteanu, Roxana, Cuciureanu, Tudor, and Stanciu, Carol
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CHRONIC hepatitis B , *RAPID diagnostic tests , *MEDICAL screening , *VIRAL hepatitis , *VIRUS diseases - Abstract
Introduction. In order to meet the requirements of the WHO, namely - the eradication of viral hepatitis by 2030, UMF "Grigore T. Popa" from Iasi together with ARAS and the Hospital "St. Spiridon" from Iasi, carries out since 2020 the project "LIVE(RO) 2 - Integrated regional program for prevention, early detection (screening), diagnosis and targeting treatment of patients with chronic liver disease secondary to viral infections with liver viruses B/D and C in the North-East and South-East regions". This study aimed to assess the epidemiological characteristics of the vulnerable population in the eastern part of the country diagnosed with chronic B/D and C viral infection. Materials and Methods. Between July 2021 and December 2022, we performed a prospective screening of chronic viral hepatitis B/D and C in vulnerable people in the counties of North-East and South-East of Romania, within the national program LIVE(RO) 2 - EST. Rapid diagnostic tests were used to detect HBs antigen (HBsAg) and anti-HCV antibodies (HCVA): HBV (Wama Immuno-Rapid HBV®) and HCV (Wama Immuno-Rapid HCV®). Rapid test-positive patients were tested for HBV DNA and HCV RNA and those eligible under the national protocol were treated with antivirals. Results. The study included 55593 individuals tested rapidly, of which 2160 (3.8%) patients were tested positive (1120 women, 1040 men, mean age 55.86 ± 6.023 years, predominantly rural background - 76.19%). Of these, 1077 (49.8%) were HBsAg positive, 918 (42.5%) with HCV positive needle, 37 (1.7%) HBV/HCV coinfection and 128 (5.9%) HBV/VHD coinfection. HBV-DNA was performed in 724 (67.3%) individuals, of which 452 (62.5%) subjects > 2,000 children/ml. Also, 518 (54.3%) patients with HCV-positive Ac had detectable HCV RNA, of which 375 (72.3%) received antiviral treatment. Depending on the ethnicity, the prevalence of viral infection was 4.29% in Roma people and 3.23% in Romanian people. Among the vulnerable groups determined by work, inactive people (27.7%), uninsured people (11.2%), unskilled people (1.87%), unemployed people (0.6%) and people working in agriculture (0.59%) were predominantly tested. Among the special vulnerable groups, people with disabilities (3.99%), people addicted to alcohol (2.43%) and people with a minimum income (1.21%) were predominantly tested. Conclusions. The high prevalence of B/D and C viral infection in the vulnerable population tested in the North-East and South-East Region of Romania compared to the rest of the population, indicates the significant viral spread of the infection in these people, a condition that requires further testing and the need for policies public health in vulnerable groups to promote access to existing health services and early initiation of optimal antiviral treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2023
50. The value of presepsin and procalcitonin as prognostic factors for mortality in patients with alcoholic liver cirrhosis and acute on chronic liver failure.
- Author
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Igna R, Muzica C, Zenovia S, Minea H, Girleanu I, Huiban L, and Trifan A
- Abstract
Background: Acute on chronic liver failure (ACLF) is typically characterized by a rapid progression of liver failure in patients with liver cirrhosis and it is triggered by a precipitant factor, usually a bacterial infection (BI). Considering the low accuracy of the inflammation biomarkers in liver cirrhosis, presepsin and procalcitonin have demonstrated a good diagnostic performance for BI. Understanding the key prognostic factors that influence patient outcomes can significantly impact clinical decision-making and improve patient care in ACLF which can lead to lower mortality rates. Aim: To evaluate the prognostic factors associated with 30-day mortality in patients with alcohol-related liver cirrhosis and ACLF. Methods: This retrospective study on 227 patients diagnosed with ACLF and alcohol-related liver cirrhosis analyzed the prognostic role of presepsin and procalcitonin serum levels. Results: The survival analysis according to the grade of ACLF showed that more than 80% of patients with ACLF grade 1 survived after 30 days, with a mean estimated time of death of 29 ±0.44 days (95 % CI: 28.17-29.92) compared to ACLF grade 2 (24.9±1.064 days; 95 % CI: 22.82-26.99) and ACLF grade 3 (21.05±1.17 days; 95 % CI: 18.75-23.34), with a mean overall survival on entire cohort of 25.69±0.52 days (95 % CI: 24.65-26.73). Presepsin (OR: 4.008, CI 95:3.130-6.456, p=0.001) and procalcitonin (OR: 3.666, CI 95:2.312-5.813, p=0.001) were the most significant factors associated with 30-day mortality. In ACLF grade 2, presepsin provides a better prediction of mortality at the cutoff value of 1050 pg/mL (Sensitivity 72%, Specificity 69%) than procalcitonin (AUC=0.727 95% CI 0.594-0.860, p<0.002) whereas in ACLF grade 3, a cutoff of 1450 pg/mL (Sensitivity 89%, Specificity 91%) presepsin had a more significant accuracy of mortality prediction (AUC=0.93 95% CI 0.81-0.99, p<0.001) than procalcitonin (AUC=0.731 95% CI 0.655-0.807, p<0.001). Conclusion: ACLF is associated with a high mortality rate and the risk of death increases with the grade of ACLF. Presepsin and procalcitonin serum levels are good prognostic factors for 30-day mortality and should be used in clinical practice to stratify the risk and provide and early and efficient treatment in patients with ACLF., Competing Interests: None.
- Published
- 2024
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