150 results on '"Dobru, Daniela"'
Search Results
2. Cytomegalovirus in Ulcerative Colitis: An Unwanted "Guest".
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Onisor, Danusia, Brusnic, Olga, Mocan, Simona, Stoian, Mircea, Avram, Calin, Boicean, Adrian, and Dobru, Daniela
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INFLAMMATORY bowel diseases ,ULCERATIVE colitis ,LITERATURE reviews ,VIRUS diseases ,IMMUNITY - Abstract
The role of cytomegalovirus (CMV) in the flare-up of ulcerative colitis (UC) is not clearly understood. CMV can cause similar symptoms in different clinical contexts, which may be attributed to the natural evolution of the viral infection, the patient's immune status, or its association with inflammatory bowel disease (IBD). This study aims to delineate the diverse manifestations of CMV-related lesions from clinical, endoscopic, and histopathological perspectives, alongside a brief narrative review of the literature. In managing IBD patients, it is crucial to be vigilant for signs of CMV reactivation, especially before the initiation of more intensive therapies. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Impact of the Severity of Liver Injury in COVID-19 Patients Admitted to an Intensive Care Unit During the SARS-CoV2 Pandemic Outbreak
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Roman Adina, Moldovan Septimiu, Santini Ario, Stoian Mircea, and Dobru Daniela
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covid-19 ,liver injury ,sars-cov2 ,pandemic outbreak ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
The World Health Organization (WHO) identified a novel coronavirus, originating in Wuhan, China, in December 2019, as a pneumonia causing pathogen. Epidemiological data in Romania show more than 450.000 confirmed patients, with a constant number of approximately 10% admission in intensive care unit.
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- 2021
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4. miR-155 and miR-21 as Diagnostic and Therapeutic Biomarkers for Ulcerative Colitis: There Is Still a Long Way to Go.
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Onisor, Danusia, Brusnic, Olga, Banescu, Claudia, Carstea, Claudia, Sasaran, Maria, Stoian, Mircea, Avram, Calin, Boicean, Adrian, Boeriu, Alina, and Dobru, Daniela
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ULCERATIVE colitis ,IRRITABLE colon ,MICRORNA ,CLOSTRIDIOIDES difficile ,BIOMARKERS ,POLYMERASE chain reaction - Abstract
(1) Elucidating the role of miRNAs (miRs) in ulcerative colitis may provide new insights into disease pathogenesis, diagnosis, treatment, and monitoring We aimed to investigate whether plasma levels of miR-21-5p and miR-155-5p may be used to differentiate between patients with organic disease such as ulcerative colitis (UC) and Clostridioides difficile infection (CDI), and patients with functional disease such as irritable bowel syndrome with diarrhea (IBS-D). (2) Serological samples were collected to quantify miR-155 and -21 expression, which was carried out through quantitative real-time polymerase chain reaction (qRT-PCR), from 84 patients: 34 with acute UC (group 1), 17 with CDI (group 2), and 33 with IBS-D (control group). (3) In this study, we found that the expression levels of miR-155-5p were almost the same for the two conditions and the control group (UC: 4.22 ± 1.61, CDI: 3.94 ± 1.62, IBS-D: 4.26 ± 1.26), with no significant differences either for ΔCt- or for ΔΔCt-derived parameters (p = 0.74 and p = 0.73, respectively). For miR-21, ΔCt levels presented significantly higher values among the ulcerative colitis group (p < 0.01), but the most important expression fold change was noticed in patients with CDI (UC:4.11 ± 8,46, CDI: 4.94 ± 9.68, IBS-D: 2.83 ± 5.41). (4) Circulating miR-155 and miR-21 were upregulated in UC, CDI, and IBS-D, but differentiation was not possible among them. But their involvement in the pathogenesis of the three diseases makes them suitable for improving the accuracy of diagnosis and facilitating the development of personalized treatment strategies. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Effectiveness and safety of a third‐line rescue treatment for acute severe ulcerative colitis refractory to infliximab or ciclosporin (REASUC study).
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García, María José, Riestra, Sabino, Amiot, Aurelien, Julsgaard, Mette, García de la Filia, Irene, Calafat, Margalida, Aguas, Mariam, de la Peña, Luisa, Roig, Cristina, Caballol, Berta, Casanova, María José, Farkas, Klaudia, Boysen, Trine, Bujanda, Luis, Cuarán, Camila, Dobru, Daniela, Fousekis, Fotios, Gargallo‐Puyuelo, Carla Jerusalén, Savarino, Edoardo, and Calvet, Xavier
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ULCERATIVE colitis ,CYCLOSPORINE ,INFLIXIMAB ,LOGISTIC regression analysis ,RESCUES ,RESCUE work ,DEEP brain stimulation ,DISEASE remission - Abstract
Summary: Background: The advent of new therapeutic agents and the improvement of supporting care might change the management of acute severe ulcerative colitis (ASUC) and avoid colectomy. Aims: To evaluate the colectomy‐free survival and safety of a third‐line treatment in patients with ASUC refractory to intravenous steroids and who failed either infliximab or ciclosporin. Methods: Multicentre retrospective cohort study of patients with ASUC refractory to intravenous steroids who had failed infliximab or ciclosporin and received a third‐line treatment during the same hospitalisation. Patients who stopped second‐line treatment due to disease activity or adverse events (AEs) were eligible. We assessed short‐term colectomy‐free survival by logistic regression analysis. Kaplan–Meier curves and Cox regression models were used for long‐term assessment. Results: Among 78 patients, 32 received infliximab and 46 ciclosporin as second‐line rescue treatment. Third‐line treatment was infliximab in 45 (58%), ciclosporin in 17 (22%), tofacitinib in 13 (17%) and ustekinumab in 3 (3.8%). Colectomy was performed in 29 patients (37%) during follow‐up (median 21 weeks). Of the 78 patients, 32 and 18 were in clinical remission at, respectively, 12 and 52 weeks. At the last visit, 25 patients were still on third‐line rescue treatment, while 12 had stopped it due to clinical remission. AEs were reported in 26 (33%) patients. Two patients died (2.6%), including one following colectomy. Conclusion: Third‐line rescue treatment avoided colectomy in over half of the patients with ASUC and may be considered a therapeutic strategy. [ABSTRACT FROM AUTHOR]
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- 2024
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6. COVID-19 and Clostridioides difficile Coinfection Analysis in the Intensive Care Unit.
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Stoian, Mircea, Andone, Adina, Boeriu, Alina, Bândilă, Sergio Rareș, Dobru, Daniela, Laszlo, Sergiu Ștefan, Corău, Dragoș, Arbănași, Emil Marian, Russu, Eliza, and Stoian, Adina
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CLOSTRIDIOIDES difficile ,INTENSIVE care units ,MIXED infections ,COVID-19 ,NONINVASIVE ventilation - Abstract
Since the emergence of SARS-CoV-2 in late 2019, the global mortality attributable to COVID-19 has reached 6,972,152 deaths according to the World Health Organization (WHO). The association between coinfection with Clostridioides difficile (CDI) and SARS-CoV-2 has limited data in the literature. This retrospective study, conducted at Mureș County Clinical Hospital in Romania, involved 3002 ICU patients. Following stringent inclusion and exclusion criteria, 63 patients were enrolled, with a division into two subgroups—SARS-CoV-2 + CDI patients and CDI patients. Throughout their hospitalization, the patients were closely monitored. Analysis revealed no significant correlation between comorbidities and invasive mechanical ventilation (IMV) or non-invasive mechanical ventilation (NIMV). However, statistically significant associations were noted between renal and hepatic comorbidties (p = 0.009), death and CDI-SARS-CoV-2 coinfection (p = 0.09), flourochinolone treatment and CDI-SARS-CoV-2 infection (p = 0.03), and an association between diabetes mellitus and SARS-CoV-2-CDI infection (p = 0.04), as well as the need for invasive mechanical ventilation (p = 0.04). The patients with CDI treatment were significantly younger and received immuno-modulator or corticotherapy treatment, which was a risk factor for opportunistic agents. Antibiotic and PPI (proton pump inhibitor) treatment were significant risk factors for CDI coinfection, as well as for death, with PPI treatment in combination with antibiotic treatment being a more significant risk factor. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Gastric neuroendocrine neoplasms and precursor lesions: Case reports and literature review
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Boeriu, Alina, Dobru, Daniela, Fofiu, Crina, Brusnic, Olga, Onişor, Danusia, and Mocan, Simona
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- 2022
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8. Interferon-Free Regimen: Equally Effective in Treatment Naive and Experienced HCV Patients
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Fofiu, Crina, Boeriu, Alina, Coman, Felicia, Fofiu, Alexandru, Panic, Nikola, Bulajic, Milutin, and Dobru, Daniela
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- 2019
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9. Mutational spectrum and genotype-phenotype relationships in a cohort of Romanian hereditary angioedema patients caused by C1 inhibitor deficiency
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Gábos Gabriella, Moldovan Dumitru, Dobru Daniela, Mihály Enikő, Bara Noémi, Nădășan Valentin, Hutanu Adina, and Csép Katalin
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hereditary angioedema ,c1 inhibitor deficiency ,serping1 ,Medicine - Abstract
Background: Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) caused by SERPING1 mutations is a rare monogenic disorder characterized by a high frequency of de novo mutations, allelic heterogeneity and populational differences. Geno- and phenotype correlation data are limited. Addressing the pathogenic complexity, we proposed to analyze the clinical and genetic characteristics in a set of Romanian patients. Material and Methods: 49 patients from 22 unrelated families with C1-INH-HAE were investigated, by calculating clinical severity score (CSS), C1-INH and C4 level assessment by nephelometric assays, C1-INH function study by functional enzyme-linked immunosorbent assay, and mutation analysis by sequencing and MLPA. Clinical manifestations by missense vs other mutation mechanisms were compared. Results: The mean age at diagnosis and onset was 28.8±14.7 and 15.1±15.2 years, while the diagnostic delay 13.1±10.1 years. CSS ranged from 2 to 9, with a mean of 5.4±1.8. The frequency of missense and nonsense mutations, splice defects, frameshift mutations and large gene rearrangements was 61.22, 6.12, 22.4, 6.12 and 4.08%; in the regulatory sequence no mutation was described. In type II, only missense mutations were noted. Lower levels of C1-INH characterized index cases caused by mechanisms other than missense mutation, with more severe consequences on protein synthesis (p=0.017). 53% of the cases were identified by familial screening. Conclusion: A later onset of disease manifestations and a higher frequency of missense mutations characterize HAE in Romanian patients with SERPING1 mutation. Genetic analysis improves the management of affected families, and may inform about disease severity.
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- 2019
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10. Role of fecal calprotectin as a biomarker of intestinal inflammation in ulcerative colitis: a prospective study
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Onişor Danusia, Boeriu Alina, Pascarenco Ofelia, Brusnic Olga, and Dobru Daniela
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fecal calprotectin ,ulcerative colitis ,irritable bowel syndrome ,Medicine - Abstract
Background: The clinical utility of non-invasive markers in the diagnosis and monitoring of ulcerative colitis (UC) has been intensively studied. The aim of our study was to evaluate the value of fecal calprotectin (FC) in differentiating between UC and irritable bowel syndrome (IBS), and in estimating inflammatory activity in UC.
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- 2018
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11. Non-Invasive Diagnostic of NAFLD in Type 2 Diabetes Mellitus and Risk Stratification: Strengths and Limitations.
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Boeriu, Alina, Dobru, Daniela, and Fofiu, Crina
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TYPE 2 diabetes , *PREDICATE calculus , *HEPATIC fibrosis , *NON-alcoholic fatty liver disease , *MAGNETIC resonance imaging , *MEDICAL research - Abstract
The progressive potential of liver damage in type 2 diabetes mellitus (T2DM) towards advanced fibrosis, end-stage liver disease, and hepatocarcinoma has led to increased concern for quantifying liver injury and individual risk assessment. The combination of blood-based markers and imaging techniques is recommended for the initial evaluation in NAFLD and for regular monitoring to evaluate disease progression. Continued development of ultrasonographic and magnetic resonance imaging methods for accurate quantification of liver steatosis and fibrosis, as well as promising tools for the detection of high-risk NASH, have been noted. In this review, we aim to summarize available evidence regarding the usefulness of non-invasive methods for the assessment of NAFLD in T2DM. We focus on the power and limitations of various methods for diagnosis, risk stratification, and patient monitoring that support their implementation in clinical setting or in research field. [ABSTRACT FROM AUTHOR]
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- 2023
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12. Computer-Aided Diagnosis in Colorectal Cancer: Current Concepts and Future Prospects
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Ioanovici Andrei-Constantin, Feier Andrei-Marian, Țilea Ioan, and Dobru Daniela
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colorectal polyps ,machine learning ,computer-aided diagnosis ,colonoscopy ,Medicine - Abstract
Colorectal cancer is an important health issue, both in terms of the number of people affected and the associated costs. Colonoscopy is an important screening method that has a positive impact on the survival of patients with colorectal cancer. The association of colonoscopy with computer-aided diagnostic tools is currently under researchers’ focus, as various methods have already been proposed and show great potential for a better management of this disease. We performed a review of the literature and present a series of aspects, such as the basics of machine learning algorithms, different computational models as well as their benchmarks expressed through measurements such as positive prediction value and accuracy of detection, and the classification of colorectal polyps. Introducing computer-aided diagnostic tools can help clinicians obtain results with a high degree of confidence when performing colonoscopies. The growing field of machine learning in medicine will have a big impact on patient management in the future.
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- 2017
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13. Hereditary Angioedema: a Challenging Diagnosis for the Gastroenterologist
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Gábos Gabriella, Moldovan Dumitru, and Dobru Daniela
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hereditary angioedema ,c1-inh deficiency ,abdominal attacks ,Medicine - Abstract
Hereditary angioedema (HAE) caused by a deficiency of C1 esterase inhibitor enzyme (C1-INH) is a very rare, autosomal dominantly inherited genetic disorder, characterized by recurrent peripheral angioedema, painful abdominal attacks and episodes of laryngeal edema. Abdominal attacks are frequent symptoms in adult HAE patients, occurring in more than 90% of the cases. Angioedema in the bowel or abdomen can occur in the absence of cutaneous manifestations and may be easily misdiagnosed unless the clinician has a high degree of awareness to include HAE in the differential diagnosis. Misdiagnosis is associated with inadequate treatments, including unnecessary surgical procedures. Any patient who presents recurrent episodes of swelling should be evaluated for HAE caused by C1-INH deficiency. New therapies could save lives and dramatically improve their quality of life.
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- 2016
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14. A preliminary feasibility study: Narrow-band imaging targeted versus standard white light endoscopy non-targeted biopsies in a surveillance Barrett's population
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Pascarenco, Ofelia Daniela, Coroş, Marius Florin, Pascarenco, Ghenadie, Boeriu, Alina Mioara, Draşovean, Silvia Cosmina, Onişor, Danusia Maria, Brusnic, Olga, and Dobru, Daniela
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- 2016
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15. Diagnostic Delay in Romanian Patients with Inflammatory Bowel Disease: Risk Factors and Impact on the Disease Course and Need for Surgery
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Zaharie, Roxana, Tantau, Alina, Zaharie, Florin, Tantau, Marcel, Gheorghe, Liana, Gheorghe, Cristian, Gologan, Serban, Cijevschi, Cristina, Trifan, Anca, Dobru, Daniela, Goldis, Adrian, Constantinescu, Gabriel, Iacob, Razvan, and Diculescu, Mircea
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- 2016
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16. The Impact of Clostridioides Difficile Infection in Hospitalized Patients: What Changed during the Pandemic?
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Boeriu, Alina, Roman, Adina, Dobru, Daniela, Stoian, Mircea, Voidăzan, Septimiu, and Fofiu, Crina
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CLOSTRIDIOIDES difficile ,HOSPITAL patients ,DISEASE risk factors ,PANDEMICS ,POISONS - Abstract
(1) Background: Clostridioides difficile (C. difficile) and SARS-CoV-2 coronavirus represent significant health threats. Our study focused on the impact of concurrent infections on patient outcomes against the backdrop of changes imposed by the pandemic. (2) Materials and methods. We performed a retrospective analysis and included patients diagnosed with CDI who were admitted in our hospital before and during the pandemic. We compared patient exposure to risk factors for CDI in both groups and patient negative outcomes: need for ICU care, prolonged hospitalization, organ failure, toxic megacolon, and death. (3) Results. Overall, 188 patients were included, of which 100 had CDI (the pre-pandemic group), and 88 patients presented both CDI and COVID-19 (the pandemic group). Patients in the pandemic group were significantly older, with a higher Charlson Comorbidity Index (CCI) and a greater exposure to antibiotics and corticosteroids, and were more likely to develop organ dysfunction, to require ICU care and have prolonged hospitalization. The severity of COVID-19, leukocytosis and increased D-dimer levels were indicators of poor prognosis in the pandemic group. Higher CCI scores and leukocytosis increased the risk for negative outcomes in CDI alone patients. (4) Conclusions. The study highlights the negative impact of associated infections on patient outcome. The severity of COVID-19 directly influences the prognosis of patients with concurrent infections [ABSTRACT FROM AUTHOR]
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- 2022
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17. The Current Knowledge on Clostridioides difficile Infection in Patients with Inflammatory Bowel Diseases.
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Boeriu, Alina, Roman, Adina, Fofiu, Crina, and Dobru, Daniela
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INFLAMMATORY bowel diseases ,CLOSTRIDIOIDES difficile ,NUCLEIC acid amplification techniques ,CROHN'S disease ,DISEASE relapse ,THERAPEUTICS - Abstract
Clostridioides difficile (C. difficile) represents a major health burden with substantial economic and clinical impact. Patients with inflammatory bowel diseases (IBD) were identified as a risk category for Clostridioides difficile infection (CDI). In addition to traditional risk factors for C. difficile acquisition, IBD-specific risk factors such as immunosuppression, severity and extension of the inflammatory disease were identified. C. difficile virulence factors, represented by both toxins A and B, induce the damage of the intestinal mucosa and vascular changes, and promote the inflammatory host response. Given the potential life-threatening complications, early diagnostic and therapeutic interventions are required. The screening for CDI is recommended in IBD exacerbations, and the diagnostic algorithm consists of clinical evaluation, enzyme immunoassays (EIAs) or nucleic acid amplification tests (NAATs). An increased length of hospitalization, increased colectomy rate and mortality are the consequences of concurrent CDI in IBD patients. Selection of CD strains of higher virulence, antibiotic resistance, and the increasing rate of recurrent infections make the management of CDI in IBD more challenging. An individualized therapeutic approach is recommended to control CDI as well as IBD flare. Novel therapeutic strategies have been developed in recent years in order to manage severe, refractory or recurrent CDI. In this article, we aim to review the current evidence in the field of CDI in patients with underlying IBD, pointing to pathogenic mechanisms, risk factors for infection, diagnostic steps, clinical impact and outcomes, and specific management. [ABSTRACT FROM AUTHOR]
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- 2022
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18. Erratum: Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement (Endoscopy (2020) 52 (899-923) DOI: 10.1055/a-1231-5123)
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Dekker, Evelien, Houwen, Britt B. S. L., Puig, Ignasi, Bustamante-Balén, Marco, Coron, Emmanuel, Dobru, Daniela E., Kuvaev, Roman, Neumann, Helmut, Johnson, Gavin, Pimentel-Nunes, Pedro, Sanders, David S., Dinis-Ribeiro, Mario, Arvanitakis, Marianna, Ponchon, Thierry, East, James E., Bisschops, Raf, Gastroenterology and Hepatology, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, and APH - Quality of Care
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In the above-mentioned article, one sentence on page 912 (Optical diagnosis training for early gastric cancer, Part B) has been corrected. Correct is: The curriculum committee suggests, based on personal experience, that assessment of at least 20 gastric lesions prospectively in patients at high risk of gastric dysplasia/EGC is needed before competence should be assessed. This was corrected in the online version on September 23, 2020.
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- 2020
19. 135 - TENDENCIAS DE PRESCRIPCIÓN DE TRATAMIENTOS ERRADICADORES Y DE SU EFECTIVIDAD EN PACIENTES NAÏVE A LO LARGO DE 10 AÑOS (2013-2022) EN EUROPA: DATOS DEL REGISTRO EUROPEO SOBRE EL MANEJO DE LA INFECCIÓN POR HELICOBACTER PYLORI (HP-EUREG)
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Nyssen, Olga P., Jonaitis, Laimas, Pérez-Aísa, Ángeles, Vaira, Dino, Fiorini, Giulia, Saracino, Ilaria Maria, Tepes, Bojan, Bordin, Dmitry, Huerga, Alma Keco, Castro-Fernández, Manuel, Lucendo, Alfredo, Vologzhanina, Liudmila, Bujanda, Luis, Jurecic, Natasa Brglez, Denkovski, Maja, Lanas, Angel, Martínez-Dominguez, Samuel, Alfaro, Enrique, Leja, Marcis, Bumane, Renate, Mammadov, Emin, Babayeva, Gulustan, Mahmudov, Umud, Caldas, María, Rodrigo, Luis, Lerang, Frode, Fadieienko, Galyna, Abdulkhakov, Rustam, Malavés, Jose María Huguet, Zaytsev, Oleg, Ilchishina, Tatiana, Fernández-Salazar, Luis, Alcaide, Noelia, Velayos, Benito, Sarsenbaeva, Aiman Silkanovna, Bakulin, Igor, Gravina, Antonietta G., Romano, Marco, Perona, Mónica, Alekseenko, Sergey, Barrio, Jesús, Areia, Miguel, Nuñez, Óscar, Bogomolov, Pavel, Rodríguez, Blas José Gómez, Cajal, Manuel Dominguez, Camarero, Judith Gomez, Moreno, Manuel Jiménez, Georgopoulos, Sotirios, Notari, Pedro Almela, Tonkic, Ante, Pellicano, Rinaldo, Simsek, Halis, Kunovský, Lumír, Gasbarrini, Antonio, Bote, Jose Maria Botargues, Buzas, Gyorgy M, Fernández-Bermejo, Miguel, Phull, Perminder, Venerito, Marino, Malfertheiner, Peter, Rosania, Rosa, Link, Alexander, Iyo, Eduardo, Kupinskas, Juozas, Shvets, Oleg, Pinto, Ricardo Marcos, Rokkas, Theodore, Simsek, Ilkay, Smith, Sinead, Boltin, Doron, Lamarque, Dominique, Dobru, Daniela, Marlicz, Wojciech, Milivojevic, Vladimir, Boyanova, Lyudmila, Lamy, Vincent, Doulberis, Michael, Bytzer, Peter, Capelle, Lisette, Gridnyev, Oleksiy, Ristimaki, Ari, Cano-Català, Anna, Puig, Ignasi, Mégraud, Francis, O’Morain, Colm, and Gisbert, Javier P.
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- 2023
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20. EFICACIA Y SEGURIDAD DEL TRATAMIENTO DE RESCATE EN LA COLITIS ULCEROSA CORTICORREFRACTARIA GRAVE REFRACTARIA A INFLIXIMAB O CICLOSPORINA (ESTUDIO REASUC)
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García, María José, Riestra, Sabino, Amiot, Aurelien, Julsgaard, Mette, de la Filia, Irene García, Calafat, Margalida, Aguas, Mariam, de la Peña, Luisa, Roig-Ramos, Cristina, Caballol, Berta, Casanova, María José, Farkas, Klaudia, Boysen, Trine, Bujanda, Luis, Cuarán, Camila, Dobru, Daniela, Fousekis, Fotios, Gargallo-Puyuelo, Carla Jerusalén, Savarino, Edoardo, Calvet, Xavier, Huguet, José María, Kupcinskas, Limas, López-Cardona, Julia, Raine, Tim, van Oostrom, Joep, Gisbert, Javier P., and Chaparro, María
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- 2023
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21. Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.
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Houwen, Britt B. S. L., Hassan, Cesare, Coupé, Veerle M. H., Greuter, Marjolein J. E., Hazewinkel, Yark, Vleugels, Jasper L. A., Antonelli, Giulio, Bustamante-Balén, Marco, Coron, Emmanuel, Cortas, George A., Dinis-Ribeiro, Mario, Dobru, Daniela E., East, James E., Iacucci, Marietta, Jover, Rodrigo, Kuvaev, Roman, Neumann, Helmut, Pellisé, Maria, Puig, Ignasi, and Rutter, Matthew D.
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COLON polyps ,COLONOSCOPY ,ARTIFICIAL intelligence ,COLORECTAL cancer ,ENDOSCOPIC gastrointestinal surgery - Abstract
BACKGROUND : The European Society of Gastrointestinal Endoscopy (ESGE) has developed a core curriculum for high quality optical diagnosis training for practice across Europe. The development of easy-to-measure competence standards for optical diagnosis can optimize clinical decision-making in endoscopy. This manuscript represents an official Position Statement of the ESGE aiming to define simple, safe, and easy-to-measure competence standards for endoscopists and artificial intelligence systems performing optical diagnosis of diminutive colorectal polyps (1 - 5 mm). METHODS : A panel of European experts in optical diagnosis participated in a modified Delphi process to reach consensus on Simple Optical Diagnosis Accuracy (SODA) competence standards for implementation of the optical diagnosis strategy for diminutive colorectal polyps. In order to assess the clinical benefits and harms of implementing optical diagnosis with different competence standards, a systematic literature search was performed. This was complemented with the results from a recently performed simulation study that provides guidance for setting alternative competence standards for optical diagnosis. Proposed competence standards were based on literature search and simulation study results. Competence standards were accepted if at least 80 % agreement was reached after a maximum of three voting rounds. RECOMMENDATION 1: In order to implement the leave-in-situ strategy for diminutive colorectal lesions (1-5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 90 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1-5 mm in the rectosigmoid. Histopathology is used as the gold standard.Level of agreement 95 %. RECOMMENDATION 2: In order to implement the resect-and-discard strategy for diminutive colorectal lesions (1-5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 80 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1-5 mm. Histopathology is used as the gold standard.Level of agreement 100 %. CONCLUSION : The developed SODA competence standards define diagnostic performance thresholds in relation to clinical consequences, for training and for use when auditing the optical diagnosis of diminutive colorectal polyps. [ABSTRACT FROM AUTHOR]
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- 2022
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22. The Risk/Benefit Analysis of Oral Anticoagulant Treatment in Atrial Fibrillation Using HAS-BLED and CHA2DS2-VASc Score
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Cozlea Daniel Laurentiu, Cozlea Laurentiu, Keresztesi Arthur Attila, Oltean Galafteon, Dobru Daniela, Silivastru (Cozlea) Ionela, and Asofie Gabriela
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HAS-BLED ,thromboembolic events ,medicine.medical_specialty ,business.industry ,bleeding events ,Atrial fibrillation ,medicine.disease ,Internal medicine ,CHA2DS2–VASc score ,Risk-benefit analysis ,Oral anticoagulant ,medicine ,Cardiology ,Medicine ,atrial fibrillation ,General Pharmacology, Toxicology and Pharmaceutics ,business ,General Dentistry ,oral anticoagulant treatment - Abstract
Introduction. The purpose of this study is to evaluate the risk and the benefit of oral anticoagulant treatment in nonvalvular atrial fibrillation (AF) patients, using the two scores recommended by the guidelines: the CHA2DS2-VASc score and HAS-BLED score. Material and method. We conducted a retrospective observational study on 144 patients with nonvalvular atrial fibrillation, admitted between 1st of July 2013 and 30th September 2013 in the 3rd Medical Clinic of Tîrgu Mureș with a prospectiv follow-up at 6 months. Based on the data collected from the patient charts, the thromboembolic risk was assessed using the CHA2DS2-VASc score and the hemorrhage risk was assessed using the HAS-BLED score. At 6 months, the patients were contacted via telephone and were questioned regarding their state of health, the existence of hospitalizations in the last 6 months, the international normalized ratio (INR) value, the existence of hemorrhagic or thromboembolic events. Results. The group of patients was composed of 70 female and 74 male with the mean age of 70 ±11 years. From the total number of patients 13 (11.7%) had a history of stroke and the CHA2DS2-VASc score revealed that these 13 were in the high risk class. The presence of arterial hypertension and vascular disease were statistically associated with stroke. Hemorrhagic events were encountered in 19 patients (13.19%) and 16 of them had a higher than 3 HAS-BLED score. A history of bleeding, anemia and labile INR were the factors statistically associated with bleeding. Conclusions. The CHA2DS2-VASc score is useful in stratifying patients with AF in risk groups for thromboembolic events while the HAS-BLED score proved to be a useful tool in predicting bleeding events in anticoagulated patients.
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- 2015
23. The Assessment of the Colo-rectal Polyps in Order to the New Diagnostic and Therapeutic Strategies
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Brusnic Olga, Diac Andreea Raluca, Drasoveanu Silvia Cosmina, Gabos Gabriella, Boeriu Alina, Onisor Danusia, and Dobru Daniela Ecaterina
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medicine.medical_specialty ,Narrow-band imaging ,business.industry ,narrow band imaging ,real time prediction of the histology ,pathological conditions, signs and symptoms ,Gastroenterology ,digestive system diseases ,surgical procedures, operative ,Order (business) ,colo-rectal polyps ,Internal medicine ,medicine ,otorhinolaryngologic diseases ,Medicine ,Radiology ,General Pharmacology, Toxicology and Pharmaceutics ,Rectal Polyp ,business ,General Dentistry ,neoplasms - Abstract
Objective. Assessment of the histological and endoscopic features of the colo-rectal polyps is requered for the application of the new diagnostic and therapeutical strategies in the managment of the diminutive polyps. Methods. This paper is a descriptive retrospective study on 52 pacients reffered for colonoscopy in Gastroenterology Clinic – Clinical County Hospital Targu Mures from January until September 2014. 80 polyps were assessed. Narrow band imaging examination targeted on the protrusive lezions allowed NICE (Narrow Band Imaging International Colorectal Endoscopic) classification and corroboration of the histology prediction and pathological assessment. Results. Polyp detection rate was 48,58%, given the quality of bowel preparation in hospital fair in 84,5%. The predominant histological type was the tubular adenoma (46,25%), and 40% of the polyps were located in the sigmoid. Among the diminutive polyps, 58,33% were hyperplastic(p Conclusions. We did not observe any distribution pattern in the topography of the diminutive polyps. Histologicaly the predominant type was the hyperplastic type. NBI was accurate in real-time prediction of the histology of the colo-rectal polyps. The results are relevant for application of the new strategies in the managment of the diminutive polyps.
- Published
- 2015
24. Surgical Risk Factors of Patients with Operable Gist
- Author
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Magdas Annamaria, C Crăciun, Marius Florin Coros, Diac Andreea Raluca, Dobru Daniela, Gabos Gabriella, and Friciu Adina
- Subjects
medicine.medical_specialty ,GiST ,business.industry ,General surgery ,surgical resection ,survival ,Surgical risk ,digestive system diseases ,gastrointestinal stromal tumors ,Medicine ,prognosis ,General Pharmacology, Toxicology and Pharmaceutics ,business ,General Dentistry ,neoplasms - Abstract
Introduction: Gastrointestinal stromal tumors (GIST) are the most frequently mezenchimale tumors of the gastrointestinal tract. This study aims to analyze the results after surgical treatment of GIST and identify key risk factors influencing postoperative course of these patients in order to discover the most effective therapeutic methods to significantly improve postoperative course of these patients. Methods: We retrospectively reviewed the medical records of all patients who underwent surgical removal of GISTs from 2004-2014. Patient demographics, criterion for admission, surgery, complications, secondary dissemination, histopathological data and clinical course were analized following patient survival at 12, 24, 36 and to 60 months postoperatively. Statistical analysis was performed using the MedCalc software program, and survival analysis was done by Kaplan Meyer. Results: During this period we analyzed a total of 28 cases, including 13 males and 15 females with age from 33 to 80 years (median, 61). The tumor was located in the stomach (15 cases; 53%), small intestine in ten cases (36%) and other sites in three patients (11%). Multivariate analysis revealed that tumor size (P Conclusions: Factors like: age and sex of patients, size and tumor site, presence or absence of metastasis, are prognostic risk factors with significant differences in the evolution of patients with operable GIST. The small number of patients and retrospective nature of the study have created difficulties in the estimation where we concluded the need of a prospective multicentric study.
- Published
- 2015
25. Individual Prognostic Factors in Gastric Cancer
- Author
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A Hintea, Roşca Ancuţa, Marius Florin Coros, Dobru Daniela, and A Dobre
- Subjects
medicine.medical_specialty ,Muscularis mucosae ,genetic structures ,medicine.medical_treatment ,Gastroenterology ,Internal medicine ,medicine ,General Pharmacology, Toxicology and Pharmaceutics ,General Dentistry ,Survival rate ,5-year survival ,Intestinal type ,business.industry ,gastric cancer ,digestive, oral, and skin physiology ,Cancer ,Retrospective cohort study ,Perigastric ,medicine.disease ,digestive system diseases ,Surgery ,lymphadenectomy ,Medicine ,Lymphadenectomy ,Lymph ,business - Abstract
Objectives: The objective of this research was to study the prognostic factors in gastric cancer. Methods: We conducted a retrospective study on 5-year survival in 112 patients with gastric adenocarcinoma operated between 2004-2009. We used the Surgery Clinic I and Health Insurance House databases for study of the following parameters: age, sex, depth of invasion, histological type, surgery, number of lymph nodes excised and reported overrun / removed lymphnodes. Results: There was no significant survival difference related to gender aspects. We found significant differences in the survival rate in relation to the tumours confined to the mucosa and muscularis mucosae (100% and 60% respectively), compared to the cases with deeper invasion (p Conclusions: Merely the number of removed lymph nodes may be a source of error in staging if not taken into account the groups they belong to; the most constant individual prognostic factors are the depth of invasion and overrun/removed lymph nodes report; D2 lymphadenectomy has superior results in terms of 5 years survival compared to D1 lymphadenectomy, but, at least in our study, the difference was insignificant.
- Published
- 2015
26. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.
- Author
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Dekker, Evelien, Houwen, Britt B. S. L., Puig, Ignasi, Bustamante-Balén, Marco, Coron, Emmanuel, Dobru, Daniela E., Kuvaev, Roman, Neumann, Helmut, Johnson, Gavin, Pimentel-Nunes, Pedro, Sanders, David S., Dinis-Ribeiro, Mario, Arvanitakis, Marianna, Ponchon, Thierry, East, James E., and Bisschops, Raf
- Subjects
BARRETT'S esophagus ,ENDOSCOPY ,SQUAMOUS cell carcinoma ,REQUIRED courses (Education) ,RESEARCH ,RESEARCH methodology ,CURRICULUM ,EVALUATION research ,MEDICAL cooperation ,COMPARATIVE studies ,ENDOSCOPIC gastrointestinal surgery ,ESOPHAGEAL tumors - Abstract
This manuscript represents an official Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) aiming to guide general gastroenterologists to develop and maintain skills in optical diagnosis during endoscopy. In general, this requires additional training beyond the core curriculum currently provided in each country. In this context, ESGE have developed a European core curriculum for optical diagnosis practice across Europe for high quality optical diagnosis training. 1: ESGE suggests that every endoscopist should have achieved general competence in upper and/or lower gastrointestinal (UGI/LGI) endoscopy before commencing training in optical diagnosis of the UGI/LGI tract, meaning personal experience of at least 300 UGI and/or 300 LGI endoscopies and meeting the ESGE quality measures for UGI/LGI endoscopy. ESGE suggests that every endoscopist should be able and competent to perform UGI/LGI endoscopy with high definition white light combined with virtual and/or dye-based chromoendoscopy before commencing training in optical diagnosis. 2: ESGE suggests competency in optical diagnosis can be learned by attending a validated optical diagnosis training course based on a validated classification, and self-learning with a minimum number of lesions. If no validated training course is available, optical diagnosis can only be learned by attending a non-validated onsite training course and self-learning with a minimum number of lesions. 3: ESGE suggests endoscopists are competent in optical diagnosis after meeting the pre-adoption and learning criteria, and meeting competence thresholds by assessing a minimum number of lesions prospectively during real-time endoscopy. ESGE suggests ongoing in vivo practice by endoscopists to maintain competence in optical diagnosis. If a competent endoscopist does not perform in vivo optical diagnosis on a regular basis, ESGE suggests repeating the learning and competence phases to maintain competence.Key areas of interest were optical diagnosis training in Barrett's esophagus, esophageal squamous cell carcinoma, early gastric cancer, diminutive colorectal lesions, early colorectal cancer, and neoplasia in inflammatory bowel disease. Condition-specific recommendations are provided in the main document. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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27. Uncommon Finding of a Gastrointestinal Stromal Tumor in a Patient with Hyperechoic Liver Lesions - Case Report.
- Author
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Roman, Adina Maria, Dobru, Daniela, Fofiu, Crina, and Boeriu, Alina
- Subjects
- *
GASTROINTESTINAL stromal tumors , *ENDOSCOPIC ultrasonography , *CONTRAST-enhanced ultrasound , *OLDER women , *TUMORS , *DIGESTIVE system endoscopic surgery - Abstract
Introduction: Hyperechoic liver lesions identified by conventional ultrasonography are diverse in underlying pathology and most of the time require further investigations. Gastrointestinal stromal tumors (GIST) are rare neoplasms of the gastrointestinal tract which are uncommonly found in metastatic stages at first presentation. Case report: We present the case of a 51 years old woman with nonspecific symptoms in which conventional ultrasonography showed hyperechoic lesions in the right lobe of the liver with a diameter up to 40 mm. Esophagogastroduodenoscopy revealed a submucosal tumor on the small curvature of the stomach, on the anterior wall, with central ulceration, with normal narrow band imaging (NBI) mucosal pattern and negative gastric biopsy. Contrast enhanced ultrasonography was performed, describing multiple lesions with inhomogeneous enhancement in the arterial phase and rapid washout at the end of arterial phase. Endoscopic ultrasound with fine needle aspiration (EUS-FNA) biopsy examination was definitive for the final diagnosis of epithelioid gastric gastrointestinal stromal tumor. The patient was diagnosed with T2N0M1 epithelioid gastric GIST, stage IV, and is currently under treatment with tyrosine kinase inhibitors. Conclusions: GIST represent a diagnostic challenge in medical practice because of its size, unusual location in the submucosal layer and lack of symptoms. The role of EUS-FNA is of paramount importance in increasing the accuracy of diagnosis in the case of GIST. The particularity in our case consists of the unusual presentation with the lack of specific symptoms and signs associated with the presence of metastatic lesions at the moment of the diagnosis of GIST. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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28. Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative.
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Bisschops, Raf, Areia, Miguel, Coron, Emmanuel, Dobru, Daniela, Kaskas, Bernd, Kuvaev, Roman, Pech, Oliver, Ragunath, Krish, Weusten, Bas, Familiari, Pietro, Domagk, Dirk, Valori, Roland, Kaminski, Michal F., Spada, Cristiano, Bretthauer, Michael, Bennett, Cathy, Senore, Carlo, Dinis-Ribeiro, Mário, and Rutter, Matthew D.
- Subjects
PERFORMANCE evaluation ,ENDOSCOPY ,GASTROENTEROLOGY ,GASTROINTESTINAL diseases ,KEY performance indicators (Management) - Abstract
The article discusses the quality improvement initiative of the European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) for the identification of upper gastrointestinal endoscopy (UGI) performance measures. Topics include the aim of the UGI working group, the performance measures accepted for upper gastrointestinal endoscopy, and the use of Delphi process in distinguishing the key performance measures.
- Published
- 2016
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29. Ulcerative Colitis Remission Status After Induction With Mesalazine Predicts Maintenance Outcomes: the MOMENTUM Trial.
- Author
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Rubin, David T., Bradette, Marc, Gabalec, Libor, Dobru, Daniela, Márquez, Juan, Inglis, Susi, Magee, Elizabeth, Solomon, Dory, and D'Haens, Geert
- Abstract
Background and Aims: This study assessed the efficacy of maintenance treatment with multimatrix mesalazine following achievement of complete or partial remission after induction treatment with high-dose multimatrix mesalazine. Methods: In this phase 3b/4, open-label, multicentre, prospective, single-arm study, patients with mild-to-moderate ulcerative colitis were treated with multimatrix mesalazine 4.8 g/day once daily for 8 weeks [induction phase]. At Week 8, those who achieved complete or partial remission, based on predefined clinical and endoscopic criteria, were eligible to receive 12 months of multimatrix mesalazine 2.4 g/day once daily maintenance therapy. The primary endpoint was the proportion of patients in complete remission at Month 12. Results: A total of 717 patients received induction treatment; 25.9% and 39.3% of patients achieved complete and partial remission, respectively, at Week 8. A total of 461 patients entered the maintenance phase. The likelihood of remaining in/achieving complete remission at Month 12 was higher for patients who entered the maintenance phase in complete remission compared with those who began maintenance in partial remission [47.8% vs 26.0%; p < 0.001]. At Month 12, mucosal healing [endoscopy score = 1] was demonstrated in 76.4% [139/182] and 63.5% [176/277] of those who were in complete and partial remission, respectively, at the end of induction. Conclusion: Patients achieving complete remission before dose reduction were more likely to remain in remission at Month 12. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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30. A multicenter prospective study of the real-time use of narrow-band imaging in the diagnosis of premalignant gastric conditions and lesions.
- Author
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Pimentel-Nunes, Pedro, Libânio, Diogo, Lage, Jorge, Abrantes, Diogo, Coimbra, Miguel, Esposito, Gianluca, Hormozdi, David, Pepper, Mike, Drasovean, Silvia, White, Jonathan R., Dobru, Daniela, Buxbaum, James, Ragunath, Krish, Annibale, Bruno, and Dinis-Ribeiro, Mário
- Subjects
PRECANCEROUS conditions ,GASTROSCOPY ,STOMACH cancer ,CANCER diagnosis ,METAPLASIA ,DYSPLASIA ,STOMACH biopsy ,DIAGNOSIS - Abstract
Background and Aim: Some studies suggest that narrow-band imaging (NBI) can be more accurate at diagnosing gastric intestinal metaplasia and dysplasia than white-light endoscopy (WLE) alone. We aimed to assess the real-time diagnostic validity of high resolution endoscopy with and without NBI in the diagnosis of gastric premalignant conditions and to derive a classification for endoscopic grading of gastric intestinal metaplasia (EGGIM).Methods: A multicenter prospective study (five centers: Portugal, Italy, Romania, UK, USA) was performed involving the systematic use of high resolution gastroscopes with image registry with and without NBI in a centralized informatics platform (available online). All users used the same NBI classification. Histologic result was considered the diagnostic gold standard.Results: A total of 238 patients and 1123 endoscopic biopsies were included. NBI globally increased diagnostic accuracy by 11 percentage points (NBI 94 % vs. WLE 83 %; P < 0.001) with no difference in the identification of Helicobacter pylori gastritis (73 % vs. 74 %). NBI increased sensitivity for the diagnosis of intestinal metaplasia significantly (87 % vs. 53 %; P < 0.001) and for the diagnosis of dysplasia (92 % vs. 74 %). The added benefit of NBI in terms of diagnostic accuracy was greater in OLGIM III/IV than in OLGIM I/II (25 percentage points vs. 15 percentage points, respectively; P < 0.001). The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for EGGIM in the identification of extensive metaplasia was 0.98.Conclusions: In a real-time scenario, NBI demonstrates a high concordance with gastric histology, superior to WLE. Diagnostic accuracy higher than 90 % suggests that routine use of NBI allows targeted instead of random biopsy samples. EGGIM also permits immediate grading of intestinal metaplasia without biopsies and merits further investigation. [ABSTRACT FROM AUTHOR]- Published
- 2016
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31. Gangliocytic Paraganglioma: a Rare Cause of Gastrointestinal Bleeding.
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Boeriu, Alina, Dobru, Daniela, Georgescu, Rares, Mocan, Simona, and Boeriu, Cristian
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- *
PARAGANGLIOMA , *NEUROENDOCRINE tumors , *NONCHROMAFFIN paraganglioma , *ULCERS , *HISTOPATHOLOGY - Abstract
Duodenal neuroendocrine tumors (NETs) are rare tumors, consisting of five different types of tumors. In many cases, they may be asymptomatic, leading to delay in diagnosis. Clinical symptoms are related to local tumor growth and mucosal ulceration. We report a 38-year old man with duodenal gangliocytic paraganglioma causing overt upper gastrointestinal bleeding and anemia. We describe specific clinical and histopathological features of the tumor, and review the diagnostic and therapeutic strategy. Gangliocytic paragangliomas are regarded as benign tumors. However, the disease recurrence and the malignant potential of the tumor have also been reported. [ABSTRACT FROM AUTHOR]
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- 2015
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32. Gastric Carcinoids and Therapeutic Options. Case Report and Review of the Literature.
- Author
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Dobru, Daniela, Boeriu, Alina, Mocan, Simona, Pascarenco, Ofelia, Boeriu, Cristian, and Molnar, Calin
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- *
CARCINOID , *NEUROENDOCRINE cells , *AUTOIMMUNE diseases , *GASTRITIS , *DYSPLASIA , *ADENOCARCINOMA , *THERAPEUTICS - Abstract
Neuroendocrine tumors (carcinoids) are tumors originating from neuroendocrine cells. The distinction between different types of gastric carcinoids is important for their management. We present the case of a 38-year old woman with type 1 gastric neuroendocrine tumors (NETs) associated with autoimmune atrophic gastritis. The management of these tumors has not been yet codified and different therapeutic strategies have been suggested. A proper evaluation before therapy is indicated in order to rule out both the malignant transformation as well as the presence of synchronous lesions, such as dysplasia or gastric adenocarcinoma. We describe our diagnostic and therapeutic strategies with references to previously published reports. [ABSTRACT FROM AUTHOR]
- Published
- 2013
33. The Detection of Premalignant Gastric Lesions by Conventional and Magnifying Endoscopy.
- Author
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Boeriu Alina, Dobru Daniela, Pascarenco Ofelia, Mocan Simona, Stoian, M., and Anca, Georgescu
- Subjects
- *
ENDOSCOPY , *GASTRIC mucosa , *GASTRIC diseases , *ENDOSCOPIC ultrasonography , *BIOPSY , *METAPLASIA , *ETIOLOGY of diseases , *DYSPLASIA - Abstract
Introduction: Early diagnosis of gastric neoplasia involves both the detection and surveillance of patients with premalignant gastric lesions. Magnifying endoscopy allows the analysis of the fine mucosal structure and microvascular architecture. Material and methods: The aim of our study is to identify specific patterns associated with premalignant gastric lesions by magnifying endoscopy in conjunction with chromoscopy. We performed conventional upper endoscopies and we selected a number of patients for chromodiagnostic and magnification. We classified the endoscopic patterns in normal and abnormal (modified) patterns. Target biopsies were obtained from magnified areas and we analyzed the correspondence with the histological findings. Results: We identified specific pit patterns for normal gastric mucosa and for inflamed mucosa. A tubular pattern was associated with the detection of intestinal metaplasia. An irregular pattern and abnormal microvessels were endoscopic findings associated with the detection of high-grade dysplasia. An irregular form of collecting venules was detected in areas with atrophic gastritis. Conclusions: An initial selection of patients based on conventional endoscopic findings is mandatory. Gastric mucosal changes identified by magnifying endoscopy raise the number of detected premalignant lesions by targeted biopsies. Our work emphasizes the current challenges related to the use of these endoscopic methods. [ABSTRACT FROM AUTHOR]
- Published
- 2011
34. Recurrent ascites: a need to evaluate for hereditary angio-oedema
- Author
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Gábos, Gabriella, Dobru, Daniela, Mihály, Enikő, Bara, Noémi, Dumitrache, Cătălin, Popa, Ramona, Nădășan, Valentin, and Moldovan, Dumitru
- Published
- 2017
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35. Lunar Landscape... in the Rectum.
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Roman, Adina and Dobru, Daniela
- Subjects
- *
RECTAL cancer , *HIV infections , *RECTUM - Published
- 2021
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36. SUBTOTAL GASTRECTOMY WITH CURATIVE AND RADICAL INTENT FOR ANTROPYLORIC GASTRIC CANCER, WITHOUT USING LIGATURES.
- Author
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MOLNAR, CĂLIN, IOSIF NEAGOE, VICTOR, ECATERINA DOBRU, DANIELA, PANŢIRU, ADRIAN, NICOLESCU, COSMIN, ROȘCA, CIPRIAN, CLAUDIU RAD, COSTEL, and COPOTOIU, CONSTANTIN
- Subjects
ONCOLOGIC surgery ,LIGATURE (Surgery) ,GASTRECTOMY ,HEMOSTASIS ,LYMPHADENITIS - Abstract
Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
37. A TREE-BASED APPROACH TO MODELLING MEDICAL RESEARCH DATA. COMPARISON WITH EXISTING APPROACHES IN COMMERCIAL APPLICATIONS.
- Author
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OLÂH, PETER, MĂRUŞTERI, MARIUS, BIRIŞ, CARMEN, OPRIŞ, MARIA MIHAELA, and DOBRU, DANIELA
- Subjects
MEDICAL research ,DATABASES ,LABORATORY notebooks ,COMPUTER software industry ,COMPUTER software - Abstract
Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
38. BUILDING AN EFFECTIVE USER-INTERFACE FOR MEDICAL DATABASES.
- Author
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OLAH, P., MARUSTERI, M., SUCIU, MONICA, SUCIU, H., and DOBRU, DANIELA
- Subjects
MEDICAL records ,DATABASES ,ELECTRONIC information resources ,INFORMATION storage & retrieval systems ,ELECTRONIC file management ,COMPUTER network resources - Abstract
Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2012
39. ATROPHIC GASTRITIS, INTESTINAL METAPLASIA AND GASTRIC DYSPLASIA.
- Author
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Onisor, Danusia Maria, Dobru, Daniela, Boeriu, Alina, Pascarenco, Ofelia, Brusnic, Olga, Stoian, Adina, Stoian, M., and Cozma, D.
- Subjects
- *
PRECANCEROUS conditions , *GASTRITIS , *METAPLASIA , *DYSPLASIA , *STOMACH cancer , *ENDOSCOPY - Abstract
Introduction: the detection of gastric preneoplastic lesions (atrophic gastritis, intestinal metaplasia, dysplasia) is important regarding the patient's risk evaluation for gastric cancer. The purpose of this study consists in the pit pattern evaluation, specific to the 3 premalignant lesions by magnifying endoscopy and chromeondoscopy. Material and methods: The study has started in January 2010 and it is still in progress. The patients have been examined by conventional endoscopy, respectively selected for magnifying endoscopy and chromoendoscopy. Partial results: I have obtained pit patterns specific to gastric mucosa in precancerous lesions. Partial conclusions: 1. Several pit patterns can be identified in the same patient. 2. The stomach can be mapped more exactly, this way being identified the area of modified mucosa; thus target biopsies can be done raising the chances for an accurate diagnosis. 3. It is a resource and time-consuming method. [ABSTRACT FROM AUTHOR]
- Published
- 2012
40. Contrast-enhanced Sonography -- New Diagnostic Method for Hepatic Tumors.
- Author
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Dobru, Daniela
- Subjects
- *
ULTRASOUND contrast media , *MICROBUBBLES , *CARDIOPULMONARY system , *DISEASES , *HYPOTENSION , *INJECTIONS - Abstract
The author reflects on the development of ultrasound contrast agents (UCAs) microbubbles, which perform as blood pool tracers, used for ultrasound. She mentions that the UCAs need to be avoided in patients having severe cardiopulmonary disease. She states that rare anaphylactoid reactions have been revealed, manifesting as acute hypotension happening within a few seconds of injection.
- Published
- 2011
41. White flat lesions in the gastric corpus may be intestinal metaplasia.
- Author
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Pimentel-Nunes, Pedro, Libânio, Diogo, Dinis-Ribeiro, Mário, and Dobru, Daniela
- Subjects
METAPLASIA ,ENDOSCOPY ,HISTOLOGY ,GASTRIC mucosa ,HELICOBACTER diseases ,HELICOBACTER pylori ,STOMACH ,STOMACH tumors - Published
- 2017
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42. Potential pitfalls of Viekira Pak™ therapy in patients with HCV genotype 1b cirrhosis.
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Fofiu, Crina, Dobru, Daniela, and Boeriu, Alina
- Subjects
- *
DRUG side effects , *HEPATITIS C virus , *RITONAVIR , *DIURETICS , *ASCITES , *PATIENTS - Abstract
The article presents a case study of a patient with acute liver failure during treatment with Ritonavir-boosted Paritaprevir, Ombitasvir and Dasabuvir drugs. It states that the patient has hepatitis C virus (HCV) genotype 1b cirrhosis. The patient was discharged after two weeks on therapy with hepatoprotective and diuretics drugs, without clinical signs of encephalopathy and with remission of ascites.
- Published
- 2017
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43. Prediction of the histotype of a rectal polyp with the help of an underwater examination.
- Author
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Akabah, Peter, Boeriu, Alina, Bartha, Jeno Robert, and Dobru, Daniela
- Published
- 2016
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44. BIOLOGIC THERAPY FOR ULCERATIVE COLITIS: CERTIFIED SUCCESS OR FURTHER HASSLE?
- Author
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Voica, Aura-Maria, Bran, Evelyn Janette, Dobru, Daniela, and Matei, Lavinia Andrada
- Subjects
- *
ULCERATIVE colitis , *CONFERENCES & conventions , *BIOTHERAPY , *INFLIXIMAB - Abstract
Introduction: Inflammatory bowel disease (IBD) is a chronic idiopathic inflammation involving the gastrointestinal tract. Its two main components are ulcerative colitis (UC) and Crohn disease (CD). The immunological pathogenic substrate interacts with the microbiota and environmental factors in genetically susceptible individuals, with a peak incidence in patients aged 25-35. Lesions in UC only involve the colon, usually the left side, with continuous inflammation limited to the mucosa. Associated extraintestinal manifestations such as arthropathies, erythema nodosum or cholangitis are not uncommon. Case Report: We present the case of a 27-year-old woman who was diagnosed in 2020 with left sided ulcerative colitis and is on biologic therapy with an anti TNF alpha agent (Infliximab) since 2023. This patient comes into our clinic having lost 5-6 kg of weight in the previous month, 2-3 bloody stools a day and spontaneous rectal bleeding. Additionally we found pretibial lesions, oral cavity erosions and knee discomfort. Her medical history reveals multiple Clostridium difficile infections in 2022 treated with different combinations of Vancomycin and Metronidazole. Discussions : When managing an IBD patient, the current guidelines agree that "step up therapy" is preferred to "step down therapy". First line agents used for inducing remission include 5 -ASA drugs and corticosteroid medication. Due to clinical progression treatment with the immunomodulator Azathioprine is started following the eradication of Clostridium difficile. In March 2023, erythema nodosum, joint damage, clinical decline, and fecal calprotectin levels of 731 mcg/g led to the introduction of anti TNF alpha biologic therapy. Our patient returns a year later with a deteriorated clinical presentation, higher inflammatory markers (CRP 3.15 mg/Dl, ESR 164mm/h) and fecal calprotectin values of 1680 mcg/g. We conducted stool tests to rule out the potential causes of infectious colitis, and every test produced a negative result. To assess the extent of the colitis we performed a colonoscopy that described continuous colonic lesions, from the caecum to the rectum, congested, friable mucosa exhibiting bleeding upon air insufflation, multiple erosions and a few inflammatory polyps. After increasing corticosteroid doses and managing to improve the general state, the decision to intensify the biologic treatment is considered, to induce remission. Conclusions: The significance of this case lies in the detrimental evolution despite vigorous therapies, without development of antibodies against Infliximab. The burden this disease imposes especially among young people who have to shape their lives around their illness is something to remember when encountering such cases. [ABSTRACT FROM AUTHOR]
- Published
- 2024
45. RISK FACTOR ANALYSIS IN NON-ALCOHOLIC FATTY LIVER DISEASE AND METABOLIC SYNDROME: OUR CENTER EXPERIENCE.
- Author
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Bauer, Johanna, Matei, Andrada, and Dobru, Daniela
- Subjects
- *
METABOLIC syndrome risk factors , *NON-alcoholic fatty liver disease , *RISK assessment , *CONFERENCES & conventions , *DISEASE risk factors - Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are two closely related diseases, that consist mainly in excess fat accumulation in the liver. They share many risk factors and pathophysiological mechanisms. Metabolic risk factors include obesity, altered glucose metabolism, hypertension and dyslipidemia. Objective: The aim of the study was to compare risk factors of metabolic syndrome and non- alcoholic fatty liver disease in our clinic. Material and methods: A retrospective observational study was performed, including 60 patients diagnosed with NAFLD. The patients were admitted to the gastroenterology department of the "Mures County Clinical Hospital" in Targu Mures, Romania, from January 2023 to December 2023. Included were patients with a secured NAFLD diagnosis above the age of eighteen. The patients were grouped into two study groups: positive for NAFLD and positive for NAFLD and MetS. Excel and Jamovi were used for the statistical analysis. Results: No statistically significant differences were found in the demographic comparison of the study groups (age, gender, environment). The presence of metabolic risk factors was significantly higher in the group including MetS diagnosis, compared to the NAFLD only group: overweight/obesity (92,9% vs 58,7%, p=0.01), diabetes mellitus (78,6% vs 4,3%) or impaired fasting glucose (21,4% vs 4,3%) with p<0.001 and hypertension (100% vs 58,7%, p<0.01). Patients with NAFLD and metabolic syndrome either had three (57,1%) or all four (42,9%) of the risk variables listed (p=<0.001). 8,7% of the NAFLD group showed three risk factors, 45,7% showed two, 34,8% showed one, and 10,9% showed no metabolic risk factor (p<0.001). No significant differences were found in the analysis of various laboratory values and when comparing pulmonary, renal, neurological, oncological comorbidities. Conclusions: In addition to having an impact on the diagnosis of MetS, metabolic risk factors also typically influence, albeit to a lower degree, the development of NAFLD. [ABSTRACT FROM AUTHOR]
- Published
- 2024
46. LIVER CIRRHOSIS - ASSOCIATED COMPLICATIONS REGARDING TO ITS AETIOLOGY.
- Author
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Grosskopf, Louis, Matei, Andrada, and Dobru, Daniela
- Subjects
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RISK assessment , *CIRRHOSIS of the liver , *ALCOHOLIC liver diseases , *CONFERENCES & conventions , *DISEASE risk factors , *DISEASE complications - Abstract
Background: Liver cirrhosis is a result of chronic damage to the liver which will cause scaring and fibrosis, ultimately leading to irreversible damage if it is not resolved or treated in the early stages, where it is still reversible if the harming agent factor is eliminated. Due to the ability of the liver to compensate even when damaged, the diagnosis of the disease is often late, leading to difficulty in treating. Therefore, the treatment consists in preventing cirrhosis and death. The only curable treatment option for patients remains with liver transplant. Material and methods: This study tries to focus on different aetiologies of liver cirrhosis and the associated complications they carry with them and whether there is any exclusivity to an aetiology when it comes to complications.This retrospective study includes 60 patients admitted to the Gastroenterology department of Mures county clinical hospital of Targu Mures, Romania, between the 01.01.2023 and 01.01.2024. The inclusion criteria consist in patients being above 18 years and diagnosed with liver cirrhosis, including all aetiologies presented to the clinic. Results: Most of the patient's diagnosis are caused solely by chronic alcoholic intoxication (44/60), whereas some patients suffer from viral Hepatitis B and C, also combinations of the mentioned aetiologies are present, which present with a significant increase in abnormal blood values.From the included patients, 3 patients died during their stay, where toxic liver cirrhosis caused by alcohol seemed to be the causing factor among other comorbidities. Worth mentioning is that 2/3 of the deceased patients were males and 2/3 below 60 years of age.Most of the patients are male (49/60) and above 60 years of age (35/60). Conclusions: Most of the patient diagnosed with liver cirrhosis in our clinic where due to chronic alcohol consumption, with comorbidities such as chronic cardiac and pulmonary diseases as well as diabetes and obesity. Patients' death was associated with chronic alcohol consumption. [ABSTRACT FROM AUTHOR]
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- 2024
47. Safety, Efficacy and Persistence of Advanced Therapies in Inflammatory Bowel Disease: Results from ORIGINS. A Retrospective Observational Study.
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Mateescu, Radu Bogdan, Gheorghe, Cristian, Trifan, Anca Victorita, Saftoiu, Adrian, Seicean, Andrada, Diculescu, Mihai Mircea, Banciu, Christian, Gheorghe, Liliana Simona, Busuioc, Bogdan, Goldis, Adrian, Dobru, Daniela, Fratila, Ovidiu, Eugen, Dumitru, Bataga, Simona, Constantinescu, Gabriel, Gheonea, Dan, Tantau, Alina, Jinga, Mariana, Brisc, Ciprian, and Prelipcean, Cristina Cijevschi
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INFLAMMATORY bowel diseases , *CROHN'S disease , *ULCERATIVE colitis , *ELECTRONIC paper , *DISEASE remission - Abstract
Background & Aims: Real-world assessments of efficacy and safety of advanced therapies used for inflammatory bowel disease (IBD) patients are limited. We aimed to report safety, efficacy and treatment persistence of new molecules (infliximab, adalimumab, vedolizumab, tofacitinib, ustekinumab) in a retrospective multicentric national Romanian analysis. Methods: We conducted a nationwide, retrospective observational multicentric study. Data were collected retrospectively from electronic and paper files. Patients who started on one of the five investigated molecules during December 2019-December 2021 were included. The main outcome measures were clinical remission, endoscopic healing, persistence on treatment and safety data. Results: A total of 678 adult patients from 24 Romanian IBD centers with a diagnosis of ulcerative colitis or Crohn's disease were included. Participants had previously failure to one (268, 39.5%), two (108, 15%) or more treatment lines and only 38% (259) were biologic naïve. In the 24 months study period, most patients were started on vedolizumab (192, 28%), followed by adalimumab, infliximab, ustekinumab and tofacitinib. In biologic-naïve patients, most physicians (72%) preferred anti-TNF treatment as first line biologic (93 patients started on infliximab, 92 on adalimumab), followed by vedolizumab, ustekinumab and tofacitinib. During follow-up, 71% (470, p=0.05) of patients achieved clinical remission and 36% (134, p=0.03) achieved mucosal healing. The 6 months milestone for persistence was reached in 78% (530) of cases. Almost half of patients (47%, 316 patients) persisted on their current treatment for over 12 months. Overall, an adverse reaction was reported for 67 (10.4%) patients, with no lethal events. Conclusions: Population of biologic-experienced IBD patients in Romania is increasing and is becoming more difficult to achieve long-term disease control. Discontinuation rates for advanced therapies are high. [ABSTRACT FROM AUTHOR]
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- 2023
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48. Mucosal Protective Compounds in the Treatment of Gastroesophageal Reflux Disease. A Position Paper Based on Evidence of the Romanian Society of Neurogastroenterology.
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Surdea-Blaga, Teodora, Băncilă, Ion, Dobru, Daniela, Drug, Vasile, Frățilă, Ovidiu, Goldiș, Adrian, Grad, Simona M., Mureșan, Crina, Nedelcu, Laurențiu, Porr, Paul J., Sporea, Ioan, and Dumitrașcu, Dan L.
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GASTROESOPHAGEAL reflux , *ESOPHAGUS diseases , *ANTACIDS , *ANTIULCER drugs , *ALGINATES - Abstract
Background & Aims: Gastroesophageal reflux disease (GERD) therapy is challenging and suppression of acid secretion or prokinetics do not cure all cases. Some drugs with protective action on the esophageal mucosa have been used alternatively or in association with proton pump inhibitors (PPIs) and/or prokinetics. The Romanian Society of Neurogastroenterology undertook an Evidence-Based analysis, from which this position paper evolved. Methods: We performed a systematic literature search in PubMed until October 2015, using the terms: sucralfate, guaiazulene, gaiazulene, dimethicone, alginate, antacids and gastroesophageal reflux. Forty-seven papers were included and analyzed. Several statements were elaborated regarding the use of these drugs in GERD. The evidence and recommendations were discussed between the authors. Results: There is evidence in the medical literature suggesting the benefit of these drugs in GERD. In patients with persistent or mild reflux symptoms antacids rapidly relieve heartburn. Alginate-antacid combination is superior both over placebo and antacids to treat mild reflux symptoms, and can be used to treat persistent reflux symptoms despite acid suppressant therapy. Sucralfate is superior over placebo in alleviating GERD symptoms and can be used as maintenance therapy. Guaiazulene-dimethicone improves the quality of life in patients with GERD. Conclusions: Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms. [ABSTRACT FROM AUTHOR]
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- 2016
- Full Text
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49. SARS-CoV-2 associated liver injury: a six-month follow-up analysis of liver function recovery.
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Roman, Adina, Moldovan, Septimiu, Stoian, Mircea, Țilea, Brîndușa, and Dobru, Daniela
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HOSPITAL admission & discharge , *LIVER analysis , *LIVER injuries , *COVID-19 , *SARS-CoV-2 , *LIVER function tests - Abstract
Background and aims. SARS-CoV-2 infection has raised the interest in clinical and paraclinical research worldwide, representing a public health issue since the beginning of 2020. Studies have established the variable, unpredictable character of COVID-19. Our main objective was to assess the liver function of patients without pre-existing liver disease, diagnosed with SARS-CoV-2 associated liver injury in a 6-month follow-up study after discharge from hospital. Methods. We conducted a prospective paraclinical and imagingstic follow-up study between 1st September 2020 and 30th April 2021 on patients without preexisting liver disease previously diagnosed with SARS-CoV-2 associated liver injury who had been admitted in Mures County Clinical Hospital, Targu Mures, Romania. We followed up the patients 'clinical and paraclinical datacharacteristics at index COVID-19 hospitalization and at T1 (6-month follow-up visit). Results. We performed abdominal ultrasonography and laboratory examinations in 78 patients (mean age 45±10 years) hospitalized 6 months earlier for symptomatic COVID-19, with a male:female ratio of 1.3:1. Thirty patients (38.46%) were discharged at index COVID-19 hospitalization with abnormal liver function tests, while the rest presented paraclinical normalization at discharge and mean duration of liver injury of approximately 7 days. Follow-up examination revealed abnormal liver function tests in twenty-four patients, most of which presented with mild liver injury. All patients with severe COVID-19 at index hospitalization presented with abnormal liver function tests at follow-up examination. Conclusions. By performing a complete clinical and paraclinical 6-month followup study, with a specific focus on 34.6% of patients in which we noted a persistence of liver function tests abnormality, we could analyzse a possible long-term effect of SARS-CoV-2 infection over liver function and also raise awareness of liver function tests monitoring and therapeutic management in post COVID-19 patients. Long-term follow-up studies of COVID-19 multi-organ sequelae are therefore mandatory in order to improve the practice of consultant gastroenterologists. [ABSTRACT FROM AUTHOR]
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- 2022
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50. Romanian Guidelines for the Diagnosis and Treatment of GERD-induced Respiratory Manifestations.
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Drug, Vasile-Liviu, Antoniu, Sabina, Bărboi, Oana-Bogdana, Arghir, Oana Cristina, Băncilă, Ion, Bățagă, Simona, Brisc, Ciprian, Cijevschi-Prelipcean, Cristina, Ciocîrlan, Mihai, Ciortescu, Irina, David, Liliana, Deleanu, Oana Claudia, Diculescu, Mircea, Dimitriu, Anca, Dobru, Daniela, Dumitru, Eugen, Gheonea, Dan Ionuț, Gheorghe, Cristian, Goldiș, Adrian, and Jinga, Mariana
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COUGH , *PROTON pump inhibitors , *DIAGNOSIS , *ASTHMA , *FUNDOPLICATION , *GASTROESOPHAGEAL reflux - Abstract
Background & 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 recommendations were postulated regarding the diagnosis and treatment of GERD-induced respiratory symptoms. The experts considered that GERD may cause bronchial asthma and chronic cough in an important number of patients through micro-aspiration and vagal-mediated tracheobronchial reflex. GERD should be suspected in patients with asthma with suboptimal controlled or after exclusion of other causes, also in nocturnal refractory cough which needs gastroenterological investigations to confirm the diagnosis. Therapeutic test with double dose proton pump inhibitors (PPI) for 3 months is also useful. GERD induced respiratory conditions are difficult to treat; however, proton pump inhibitors and laparoscopic Nissen fundoplication are endorsed for therapy. Conclusions: This guideline could be useful for the multidisciplinary management of GERD with respiratory symptoms in current practice. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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