Journal of Gastrointestinal and Liver Diseases, 2022
Background and Aims: Gastroesophageal reflux disease (GERD) is a common condition present in dail... more Background and Aims: Gastroesophageal reflux disease (GERD) is a common condition present in daily practice with a wide range of clinical phenotypes. In this line, respiratory conditions may be associated with GERD. The Romanian Societies of Gastroenterology and Neurogastroenterology, in association with the Romanian Society of Pneumology, aimed to create a guideline regarding the epidemiology, diagnosis and treatment of respiratory conditions associated with GERD.Methods: Delphi methodology was used and eleven common working groups of experts were created. The experts reviewed the literature according to GRADE criteria and formulated 34 statements and recommendations. Consensus (>80% agreement) was reached for some of the statements after all participants voted.Results: All the statements and the literature review are presented in the paper, together with their correspondent grade of evidence and the voting results. Based on >80% voting agreement, a number of 22 recommendatio...
În ultimul deceniu constipaţia a devenit o problemă actuală de adresabilitate în serviciile de ga... more În ultimul deceniu constipaţia a devenit o problemă actuală de adresabilitate în serviciile de gastroenterologie pediatrică. Obiective. Ne-am propus un studiu pentru a identifica prevalenţa constipaţiei şi stabilirea unor corelaţii între dietă şi mediul socio-familial la copii cu vârste cuprinse între 1 şi 17 ani, internaţi în serviciul de Gastroenterologie, Spitalul Clinic de Urgenţă pentru Copii „Sfânta Maria“ Iaşi, în perioada 1 ianuarie 2012 – 1 ianuarie 2014. Rezultate. Grupul de studiu a constat dintr-un lot de 994 de pacienţi, reprezentând 9,6% din totalul copiilor spitalizaţi. În ceea ce priveşte prevalenţa constipaţiei nu am observat o diferenţă semnifi cativă între sexe, raportul F/M a fost de 1,3/1, dar am remarcat o proporţie semnificativă de pacienţi provenind din mediul urban 68% (676) faţă de 32% (318) din mediul rural. În ceea ce priveşte mediul socio-familial: 34% (338) dintre copii trăiesc cu bunicii, 13,9% (139) provin din familii monoparentale, 6,7% (67) sunt în ...
Aim: The need for predictive and prognostic biomarkers in colorectal carcinoma (CRC) brought us t... more Aim: The need for predictive and prognostic biomarkers in colorectal carcinoma (CRC) brought us to an era where the use of artificial intelligence (AI) models is increasing. We investigated the expression of Claudin-7, a tight junction component, which plays a crucial role in maintaining the integrity of normal epithelial mucosa, and its potential prognostic role in advanced CRCs, by drawing a parallel between statistical and AI algorithms. Methods: Claudin-7 immunohistochemical expression was evaluated in the tumor core and invasion front of CRCs from 84 patients and correlated with clinicopathological parameters and survival. The results were compared with those obtained by using various AI algorithms. Results: the Kaplan–Meier univariate survival analysis showed a significant correlation between survival and Claudin-7 intensity in the invasive front (p = 0.00), a higher expression being associated with a worse prognosis, while Claudin-7 intensity in the tumor core had no impact o...
Constipaţia este un simptom comun în practica clinică. Definiţia include frecvenţa anormală a tra... more Constipaţia este un simptom comun în practica clinică. Definiţia include frecvenţa anormală a tranzitului, dificultate în timpul defecării şi consistenţă anormală a scaunului. Metodele de diagnostic limitate precum şi numeroasele afecţiuni care conduc la apariţia simptomatologiei, duc la creşterea numărului de cazuri cu rezistenţa la tratament. Tratamentul include abordări dietetice şi comportamentale, terapie farmacologică şi în cazuri atent selectate intervenţie chirurgicală. Tratamentul chirurgical este recomandat la pacienţii cu constipaţie severă rezistentă la tratamentul conservator. Confirmarea indicaţiei pentru tratament chirurgical necesită studii privind tranzitul colonic, funcţia de defecare, precum şi efectuarea manometriei anorectale. De aceea, colaborarea strânsă între pediatru, gastroenterolog şi chirurgul pediatru este absolut necesară pentru o evaluare preoperatorie atentă şi corectă a funcţiei gastro-intestinale. Complicaţiile postoperatorii includ obstrucţie intes...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i, 2006
Biliary stasis can occur in many different diseases. Pruritus, metabolic bone disease, deficienci... more Biliary stasis can occur in many different diseases. Pruritus, metabolic bone disease, deficiencies of fat-soluble vitamins, steatorrhea, hyperlipidemia and fatigue represent the major extra-hepatic manifestations of cholestatic liver disease that considerably affect the patient's quality of life. The present article reviews pathogenetic and clinical aspects of and current therapeutic approaches to extra-hepatic manifestations of cholestatic liver disease.
IN VITRO EVALUATION OF NOVEL FUNCTIONALIZED NANOPARTICLES FOR TERAHERTZ IMAGING (Abstract): Backg... more IN VITRO EVALUATION OF NOVEL FUNCTIONALIZED NANOPARTICLES FOR TERAHERTZ IMAGING (Abstract): Background: Early clinical diagnosis of gastric cancer is crucial for the treatment of patients, with increased healing rates being achieved by digestive endoscopy or surgery in patients with early gastric cancer. Magnetic nanoparticles (MNPs) are a major class of nanoscale materials currently under extensive development for improved diagnosis of a wide range of diseases, including cancer, cardiovascular disease and neurological disease. The nanoscale dimensions of MNPs give rise to unique magnetic properties and the ability to function on a cellular and molecular level, these characteristics making MNPs such promising contrast agents in different imaging applications. Aim: The research was focused on the development of some new nanoparticles suitable for use as contrast agents for terahertz imaging and assessment of the impact on gastric cell line AGS viability. Material and methods: Magneti...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
AIDS, still present with severe prognosis at the beginning of the 3rd Millennium, may present gas... more AIDS, still present with severe prognosis at the beginning of the 3rd Millennium, may present gastrointestinal and hepatic involvement. Even they have not a fatal prognosis, in order to improve the quality of life of AIDS patients we need a broad knowledge of and to treat the gastrointestinal and hepatic manifestation of the disease.
Peptic ulcers occur more commonly in patients with liver cirrhosis (LC). Helicobacter pylori is r... more Peptic ulcers occur more commonly in patients with liver cirrhosis (LC). Helicobacter pylori is recognized as the most important etiology in the pathogenesis of peptic ulcers. We investigated the efficacy of proton pump inhibitor (PPI)-based triple therapy in patients with chronic liver disease and peptic ulcer. One hundred sixty-three patients with LC or chronic hepatitis (CH) with a peptic ulcer and proven H. pylori infection were included. The combination of PPI, amoxicillin (1.0 g), and clarithromycin (500 mg), each given twice daily, was administered for 1 or 2 weeks. The eradication of H. pylori was determined by the rapid urease test, histology, or the 13C-urea breath test at least 4 weeks after completing the treatment. The eradication rate of H. pylori was similar between the LC and CH groups; 82.6% and 88.1%, respectively. In addition, there were no significant differences in eradication rates between the patients with Child-Pugh class A and Child-Pugh class B/C disease. The side effects in each group were generally mild. Only the serum ALT levels showed a significant correlation with the success of H. pylori eradication in both the LC and CH groups. The PPI-based triple therapy achieves high eradication rates for H. pylori infection, in patients with chronic liver disease, without significant side effects.
Hereditary hemorrhagic telangiectasia is a rare autosomal dominant vascular disease defined by th... more Hereditary hemorrhagic telangiectasia is a rare autosomal dominant vascular disease defined by the presence of mucosal and cutaneous telangiectasia and visceral arterio-venous malformations. The latter are abnormal capillary-free direct communications between the pulmonary and systemic circulations with the following consequences: arterial hypoxemia caused by right-to-left shunts; paradoxical embolism with transient ischemic attack or stroke and brain abscess caused by the absence of the normally filtering capillary bed; and hemoptysis or hemothorax due to the rupture of the thin-walled arterio-venous malformations (particularly during pregnancy). It is frequently underdiagnosed, commonly presenting as complications from shunting through arterio-venous malformations: dyspnea, chronic bleeding, or embolism. Arterio-venous malformations are present not only in the lungs, but can also be found in the liver, central nervous system (mainly in the brain), nasal mucosa, or the gastrointest...
We present the case of a 71-year-old male who suffered an episode of acute renal failure caused b... more We present the case of a 71-year-old male who suffered an episode of acute renal failure caused by the uncommon association of two different diseases (Clostridioides difficile infection and McKittrick-Wheelock syndrome). He presented with hypovolemic shock, severe hypokalemia, hyponatremia, metabolic acidosis and acute renal failure; consequences of secretory diarrhea caused by a giant rectal tumor revealed from colonoscopy. The biopsy results revealed tubulo-villous adenoma with low/high grade dysplasia. After correction of electrolyte imbalances and azotemia, the patient underwent surgical resection with full subsequent recovery. In the literature review, including papers published from which January 1945 to April 2021, we found only one case-report of acute renal failure associated with Clostridioides difficile infection and McKittrick-Wheelock syndrome.
Artificial intelligence, a computer-based concept that tries to mimic human thinking, is slowly b... more Artificial intelligence, a computer-based concept that tries to mimic human thinking, is slowly becoming part of the endoscopy lab. It has developed considerably since the first attempt at developing an automated medical diagnostic tool, today being adopted in almost all medical fields, digestive endoscopy included. The detection rate of preneoplastic lesions (i.e., polyps) during colonoscopy may be increased with artificial intelligence assistance. It has also proven useful in detecting signs of ulcerative colitis activity. In upper digestive endoscopy, deep learning models may prove to be useful in the diagnosis and management of upper digestive tract diseases, such as gastroesophageal reflux disease, Barrett’s esophagus, and gastric cancer. As is the case with all new medical devices, there are challenges in the implementation in daily medical practice. The regulatory, economic, organizational culture, and language barriers between humans and machines are a few of them. Even so, ...
In the last decade constipation has become a current problem addressed in the pediatric gastroent... more In the last decade constipation has become a current problem addressed in the pediatric gastroenterology departments. Objectives. We propose a study to establish the prevalence of constipation and the correlations between diet and the socio-familial environment in children aged from 1 to 17 years old, hospitalized in the Gastroenterology Department, "Saint Mary" Emergency Hospital for Children of Iasi, between 1 January 2012 and 1 January 2014 Results. The study group consisted of 994 patients, representing 9.6% of all hospitalized children. Regarding the prevalence of constipation, we did not notice a signifi cant difference between the sexes, the ratio F/M was 1.3/1, but we found a signifi cantly higher proportion of patients from urban areas 68% (676) versus 32% (318) from rural areas. In terms of social and family environment: 34% (338) of children live with grandparents, 13.9% (139) come from single-parent families, 6.7% (67) are in the care of a foster parent and 2.6...
Journal of Gastrointestinal and Liver Diseases, 2022
Background and Aims: Gastroesophageal reflux disease (GERD) is a common condition present in dail... more Background and Aims: Gastroesophageal reflux disease (GERD) is a common condition present in daily practice with a wide range of clinical phenotypes. In this line, respiratory conditions may be associated with GERD. The Romanian Societies of Gastroenterology and Neurogastroenterology, in association with the Romanian Society of Pneumology, aimed to create a guideline regarding the epidemiology, diagnosis and treatment of respiratory conditions associated with GERD.Methods: Delphi methodology was used and eleven common working groups of experts were created. The experts reviewed the literature according to GRADE criteria and formulated 34 statements and recommendations. Consensus (>80% agreement) was reached for some of the statements after all participants voted.Results: All the statements and the literature review are presented in the paper, together with their correspondent grade of evidence and the voting results. Based on >80% voting agreement, a number of 22 recommendatio...
În ultimul deceniu constipaţia a devenit o problemă actuală de adresabilitate în serviciile de ga... more În ultimul deceniu constipaţia a devenit o problemă actuală de adresabilitate în serviciile de gastroenterologie pediatrică. Obiective. Ne-am propus un studiu pentru a identifica prevalenţa constipaţiei şi stabilirea unor corelaţii între dietă şi mediul socio-familial la copii cu vârste cuprinse între 1 şi 17 ani, internaţi în serviciul de Gastroenterologie, Spitalul Clinic de Urgenţă pentru Copii „Sfânta Maria“ Iaşi, în perioada 1 ianuarie 2012 – 1 ianuarie 2014. Rezultate. Grupul de studiu a constat dintr-un lot de 994 de pacienţi, reprezentând 9,6% din totalul copiilor spitalizaţi. În ceea ce priveşte prevalenţa constipaţiei nu am observat o diferenţă semnifi cativă între sexe, raportul F/M a fost de 1,3/1, dar am remarcat o proporţie semnificativă de pacienţi provenind din mediul urban 68% (676) faţă de 32% (318) din mediul rural. În ceea ce priveşte mediul socio-familial: 34% (338) dintre copii trăiesc cu bunicii, 13,9% (139) provin din familii monoparentale, 6,7% (67) sunt în ...
Aim: The need for predictive and prognostic biomarkers in colorectal carcinoma (CRC) brought us t... more Aim: The need for predictive and prognostic biomarkers in colorectal carcinoma (CRC) brought us to an era where the use of artificial intelligence (AI) models is increasing. We investigated the expression of Claudin-7, a tight junction component, which plays a crucial role in maintaining the integrity of normal epithelial mucosa, and its potential prognostic role in advanced CRCs, by drawing a parallel between statistical and AI algorithms. Methods: Claudin-7 immunohistochemical expression was evaluated in the tumor core and invasion front of CRCs from 84 patients and correlated with clinicopathological parameters and survival. The results were compared with those obtained by using various AI algorithms. Results: the Kaplan–Meier univariate survival analysis showed a significant correlation between survival and Claudin-7 intensity in the invasive front (p = 0.00), a higher expression being associated with a worse prognosis, while Claudin-7 intensity in the tumor core had no impact o...
Constipaţia este un simptom comun în practica clinică. Definiţia include frecvenţa anormală a tra... more Constipaţia este un simptom comun în practica clinică. Definiţia include frecvenţa anormală a tranzitului, dificultate în timpul defecării şi consistenţă anormală a scaunului. Metodele de diagnostic limitate precum şi numeroasele afecţiuni care conduc la apariţia simptomatologiei, duc la creşterea numărului de cazuri cu rezistenţa la tratament. Tratamentul include abordări dietetice şi comportamentale, terapie farmacologică şi în cazuri atent selectate intervenţie chirurgicală. Tratamentul chirurgical este recomandat la pacienţii cu constipaţie severă rezistentă la tratamentul conservator. Confirmarea indicaţiei pentru tratament chirurgical necesită studii privind tranzitul colonic, funcţia de defecare, precum şi efectuarea manometriei anorectale. De aceea, colaborarea strânsă între pediatru, gastroenterolog şi chirurgul pediatru este absolut necesară pentru o evaluare preoperatorie atentă şi corectă a funcţiei gastro-intestinale. Complicaţiile postoperatorii includ obstrucţie intes...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i, 2006
Biliary stasis can occur in many different diseases. Pruritus, metabolic bone disease, deficienci... more Biliary stasis can occur in many different diseases. Pruritus, metabolic bone disease, deficiencies of fat-soluble vitamins, steatorrhea, hyperlipidemia and fatigue represent the major extra-hepatic manifestations of cholestatic liver disease that considerably affect the patient's quality of life. The present article reviews pathogenetic and clinical aspects of and current therapeutic approaches to extra-hepatic manifestations of cholestatic liver disease.
IN VITRO EVALUATION OF NOVEL FUNCTIONALIZED NANOPARTICLES FOR TERAHERTZ IMAGING (Abstract): Backg... more IN VITRO EVALUATION OF NOVEL FUNCTIONALIZED NANOPARTICLES FOR TERAHERTZ IMAGING (Abstract): Background: Early clinical diagnosis of gastric cancer is crucial for the treatment of patients, with increased healing rates being achieved by digestive endoscopy or surgery in patients with early gastric cancer. Magnetic nanoparticles (MNPs) are a major class of nanoscale materials currently under extensive development for improved diagnosis of a wide range of diseases, including cancer, cardiovascular disease and neurological disease. The nanoscale dimensions of MNPs give rise to unique magnetic properties and the ability to function on a cellular and molecular level, these characteristics making MNPs such promising contrast agents in different imaging applications. Aim: The research was focused on the development of some new nanoparticles suitable for use as contrast agents for terahertz imaging and assessment of the impact on gastric cell line AGS viability. Material and methods: Magneti...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
AIDS, still present with severe prognosis at the beginning of the 3rd Millennium, may present gas... more AIDS, still present with severe prognosis at the beginning of the 3rd Millennium, may present gastrointestinal and hepatic involvement. Even they have not a fatal prognosis, in order to improve the quality of life of AIDS patients we need a broad knowledge of and to treat the gastrointestinal and hepatic manifestation of the disease.
Peptic ulcers occur more commonly in patients with liver cirrhosis (LC). Helicobacter pylori is r... more Peptic ulcers occur more commonly in patients with liver cirrhosis (LC). Helicobacter pylori is recognized as the most important etiology in the pathogenesis of peptic ulcers. We investigated the efficacy of proton pump inhibitor (PPI)-based triple therapy in patients with chronic liver disease and peptic ulcer. One hundred sixty-three patients with LC or chronic hepatitis (CH) with a peptic ulcer and proven H. pylori infection were included. The combination of PPI, amoxicillin (1.0 g), and clarithromycin (500 mg), each given twice daily, was administered for 1 or 2 weeks. The eradication of H. pylori was determined by the rapid urease test, histology, or the 13C-urea breath test at least 4 weeks after completing the treatment. The eradication rate of H. pylori was similar between the LC and CH groups; 82.6% and 88.1%, respectively. In addition, there were no significant differences in eradication rates between the patients with Child-Pugh class A and Child-Pugh class B/C disease. The side effects in each group were generally mild. Only the serum ALT levels showed a significant correlation with the success of H. pylori eradication in both the LC and CH groups. The PPI-based triple therapy achieves high eradication rates for H. pylori infection, in patients with chronic liver disease, without significant side effects.
Hereditary hemorrhagic telangiectasia is a rare autosomal dominant vascular disease defined by th... more Hereditary hemorrhagic telangiectasia is a rare autosomal dominant vascular disease defined by the presence of mucosal and cutaneous telangiectasia and visceral arterio-venous malformations. The latter are abnormal capillary-free direct communications between the pulmonary and systemic circulations with the following consequences: arterial hypoxemia caused by right-to-left shunts; paradoxical embolism with transient ischemic attack or stroke and brain abscess caused by the absence of the normally filtering capillary bed; and hemoptysis or hemothorax due to the rupture of the thin-walled arterio-venous malformations (particularly during pregnancy). It is frequently underdiagnosed, commonly presenting as complications from shunting through arterio-venous malformations: dyspnea, chronic bleeding, or embolism. Arterio-venous malformations are present not only in the lungs, but can also be found in the liver, central nervous system (mainly in the brain), nasal mucosa, or the gastrointest...
We present the case of a 71-year-old male who suffered an episode of acute renal failure caused b... more We present the case of a 71-year-old male who suffered an episode of acute renal failure caused by the uncommon association of two different diseases (Clostridioides difficile infection and McKittrick-Wheelock syndrome). He presented with hypovolemic shock, severe hypokalemia, hyponatremia, metabolic acidosis and acute renal failure; consequences of secretory diarrhea caused by a giant rectal tumor revealed from colonoscopy. The biopsy results revealed tubulo-villous adenoma with low/high grade dysplasia. After correction of electrolyte imbalances and azotemia, the patient underwent surgical resection with full subsequent recovery. In the literature review, including papers published from which January 1945 to April 2021, we found only one case-report of acute renal failure associated with Clostridioides difficile infection and McKittrick-Wheelock syndrome.
Artificial intelligence, a computer-based concept that tries to mimic human thinking, is slowly b... more Artificial intelligence, a computer-based concept that tries to mimic human thinking, is slowly becoming part of the endoscopy lab. It has developed considerably since the first attempt at developing an automated medical diagnostic tool, today being adopted in almost all medical fields, digestive endoscopy included. The detection rate of preneoplastic lesions (i.e., polyps) during colonoscopy may be increased with artificial intelligence assistance. It has also proven useful in detecting signs of ulcerative colitis activity. In upper digestive endoscopy, deep learning models may prove to be useful in the diagnosis and management of upper digestive tract diseases, such as gastroesophageal reflux disease, Barrett’s esophagus, and gastric cancer. As is the case with all new medical devices, there are challenges in the implementation in daily medical practice. The regulatory, economic, organizational culture, and language barriers between humans and machines are a few of them. Even so, ...
In the last decade constipation has become a current problem addressed in the pediatric gastroent... more In the last decade constipation has become a current problem addressed in the pediatric gastroenterology departments. Objectives. We propose a study to establish the prevalence of constipation and the correlations between diet and the socio-familial environment in children aged from 1 to 17 years old, hospitalized in the Gastroenterology Department, "Saint Mary" Emergency Hospital for Children of Iasi, between 1 January 2012 and 1 January 2014 Results. The study group consisted of 994 patients, representing 9.6% of all hospitalized children. Regarding the prevalence of constipation, we did not notice a signifi cant difference between the sexes, the ratio F/M was 1.3/1, but we found a signifi cantly higher proportion of patients from urban areas 68% (676) versus 32% (318) from rural areas. In terms of social and family environment: 34% (338) of children live with grandparents, 13.9% (139) come from single-parent families, 6.7% (67) are in the care of a foster parent and 2.6...
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