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2. Characteristics and outcomes of patients with COVID-19 and liver injury: a retrospective analysis and a multicenter experience

Author

Voiosu Andrei, Roman Adina, Pop Ruxandra, Boeriu Alina, Popp Cristiana, Zurac Sabina, Voiosu Theodor, Dobru Daniela, and Mateescu Bogdan

Subjects
covid-19, liver injury, sars-cov-2, drug-induced liver injury, hepatitis, hydroxychloroquine, lopinavir/ritonavir, antiviral therapy, Internal medicine, RC31-1245
Abstract

Background and aims. Patients with COVID-19 frequently present abnormal elevated liver function tests of unknown clinical significance. We aimed to investigate the characteristics and factors influencing outcome in patients with confirmed SARS-CoV-2 infection and liver injury on admission.

Published
2022
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3. Cytomegalovirus in Ulcerative Colitis: An Unwanted "Guest".

Author

Onisor, Danusia, Brusnic, Olga, Mocan, Simona, Stoian, Mircea, Avram, Calin, Boicean, Adrian, and Dobru, Daniela

Subjects
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]

Published
2024
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4. Effectiveness and safety of a third‐line rescue treatment for acute severe ulcerative colitis refractory to infliximab or ciclosporin (REASUC study)

Author

García, María José, primary, Riestra, Sabino, additional, Amiot, Aurelien, additional, Julsgaard, Mette, additional, García de la Filia, Irene, additional, Calafat, Margalida, additional, Aguas, Mariam, additional, de la Peña, Luisa, additional, Roig, Cristina, additional, Caballol, Berta, additional, Casanova, María José, additional, Farkas, Klaudia, additional, Boysen, Trine, additional, Bujanda, Luis, additional, Cuarán, Camila, additional, Dobru, Daniela, additional, Fousekis, Fotios, additional, Gargallo‐Puyuelo, Carla Jerusalén, additional, Savarino, Edoardo, additional, Calvet, Xavier, additional, Huguet, José María, additional, Kupcinskas, Limas, additional, López‐Cardona, Julia, additional, Raine, Tim, additional, van Oostrom, Joep, additional, Gisbert, Javier P., additional, and Chaparro, María, additional

Published
2024
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5. Impact of the Severity of Liver Injury in COVID-19 Patients Admitted to an Intensive Care Unit During the SARS-CoV2 Pandemic Outbreak

Author

Roman Adina, Moldovan Septimiu, Santini Ario, Stoian Mircea, and Dobru Daniela

Subjects
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.

Published
2021
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6. miR-155 and miR-21 as Diagnostic and Therapeutic Biomarkers for Ulcerative Colitis: There Is Still a Long Way to Go.

Author

Onisor, Danusia, Brusnic, Olga, Banescu, Claudia, Carstea, Claudia, Sasaran, Maria, Stoian, Mircea, Avram, Calin, Boicean, Adrian, Boeriu, Alina, and Dobru, Daniela

Subjects
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]

Published
2024
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7. Safety, Efficacy and Persistence of Advanced Therapies in Inflammatory Bowel Disease: Results from ORIGINS. A Retrospective Observational Study

Author

Mateescu, Radu Bogdan, primary, Gheorghe, Cristian, primary, Trifan, Anca Victorita, primary, Saftoiu, Adrian, primary, Seicean, Andrada, primary, Diculescu, Mihai Mircea, primary, Banciu, Christian, primary, Gheorghe, Liliana Simona, primary, Busuioc, Bogdan, primary, Goldis, Adrian, primary, Dobru, Daniela, primary, Fratila, Ovidiu, primary, Eugen, Dumitru, primary, Bataga, Simona, primary, Constantinescu, Gabriel, primary, Gheonea, Dan, primary, Tantau, Alina, primary, Jinga, Mariana, primary, Brisc, Ciprian, primary, Cijevschi Prelipcean, Cristina, primary, Chira, Romeo, primary, Fierbințeanu-Braticevici, Carmen, primary, Dumitrascu, Dan, primary, State, Monica, primary, Voiosu, Theodor, primary, and Negreanu, Lucian, primary

Published
2023
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11. Mutational spectrum and genotype-phenotype relationships in a cohort of Romanian hereditary angioedema patients caused by C1 inhibitor deficiency

Author

Gábos Gabriella, Moldovan Dumitru, Dobru Daniela, Mihály Enikő, Bara Noémi, Nădășan Valentin, Hutanu Adina, and Csép Katalin

Subjects
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.

Published
2019
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12. Role of fecal calprotectin as a biomarker of intestinal inflammation in ulcerative colitis: a prospective study

Author

Onişor Danusia, Boeriu Alina, Pascarenco Ofelia, Brusnic Olga, and Dobru Daniela

Subjects
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.

Published
2018
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13. Computer-Aided Diagnosis in Colorectal Cancer: Current Concepts and Future Prospects

Author

Ioanovici Andrei-Constantin, Feier Andrei-Marian, Țilea Ioan, and Dobru Daniela

Subjects
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.

Published
2017
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14. EFICACIA Y SEGURIDAD DEL TRATAMIENTO DE RESCATE EN LA COLITIS ULCEROSA CORTICORREFRACTARIA GRAVE REFRACTARIA A INFLIXIMAB O CICLOSPORINA (ESTUDIO REASUC)

Author

García, María José, primary, Riestra, Sabino, additional, Amiot, Aurelien, additional, Julsgaard, Mette, additional, de la Filia, Irene García, additional, Calafat, Margalida, additional, Aguas, Mariam, additional, de la Peña, Luisa, additional, Roig-Ramos, Cristina, additional, Caballol, Berta, additional, Casanova, María José, additional, Farkas, Klaudia, additional, Boysen, Trine, additional, Bujanda, Luis, additional, Cuarán, Camila, additional, Dobru, Daniela, additional, Fousekis, Fotios, additional, Gargallo-Puyuelo, Carla Jerusalén, additional, Savarino, Edoardo, additional, Calvet, Xavier, additional, Huguet, José María, additional, Kupcinskas, Limas, additional, López-Cardona, Julia, additional, Raine, Tim, additional, van Oostrom, Joep, additional, Gisbert, Javier P., additional, and Chaparro, María, additional

Published
2023
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15. 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)

Author

Nyssen, Olga P., primary, Jonaitis, Laimas, additional, Pérez-Aísa, Ángeles, additional, Vaira, Dino, additional, Fiorini, Giulia, additional, Saracino, Ilaria Maria, additional, Tepes, Bojan, additional, Bordin, Dmitry, additional, Huerga, Alma Keco-, additional, Castro-Fernández, Manuel, additional, Lucendo, Alfredo, additional, Vologzhanina, Liudmila, additional, Bujanda, Luis, additional, Jurecic, Natasa Brglez, additional, Denkovski, Maja, additional, Lanas, Angel, additional, Martínez-Dominguez, Samuel, additional, Alfaro, Enrique, additional, Leja, Marcis, additional, Bumane, Renate, additional, Mammadov, Emin, additional, Babayeva, Gulustan, additional, Mahmudov, Umud, additional, Caldas, María, additional, Rodrigo, Luis, additional, Lerang, Frode, additional, Fadieienko, Galyna, additional, Abdulkhakov, Rustam, additional, Malavés, Jose María Huguet, additional, Zaytsev, Oleg, additional, Ilchishina, Tatiana, additional, Fernández-Salazar, Luis, additional, Alcaide, Noelia, additional, Velayos, Benito, additional, Sarsenbaeva, Aiman Silkanovna, additional, Bakulin, Igor, additional, Gravina, Antonietta G., additional, Romano, Marco, additional, Perona, Mónica, additional, Alekseenko, Sergey, additional, Barrio, Jesús, additional, Areia, Miguel, additional, Nuñez, Óscar, additional, Bogomolov, Pavel, additional, Rodríguez, Blas José Gómez, additional, Cajal, Manuel Dominguez-, additional, Camarero, Judith Gomez, additional, Moreno, Manuel Jiménez, additional, Georgopoulos, Sotirios, additional, Notari, Pedro Almela, additional, Tonkic, Ante, additional, Pellicano, Rinaldo, additional, Simsek, Halis, additional, Kunovský, Lumír, additional, Gasbarrini, Antonio, additional, Bote, Jose Maria Botargues, additional, Buzas, Gyorgy M, additional, Fernández-Bermejo, Miguel, additional, Phull, Perminder, additional, Venerito, Marino, additional, Malfertheiner, Peter, additional, Rosania, Rosa, additional, Link, Alexander, additional, Iyo, Eduardo, additional, Kupinskas, Juozas, additional, Shvets, Oleg, additional, Pinto, Ricardo Marcos, additional, Rokkas, Theodore, additional, Simsek, Ilkay, additional, Smith, Sinead, additional, Boltin, Doron, additional, Lamarque, Dominique, additional, Dobru, Daniela, additional, Marlicz, Wojciech, additional, Milivojevic, Vladimir, additional, Boyanova, Lyudmila, additional, Lamy, Vincent, additional, Doulberis, Michael, additional, Bytzer, Peter, additional, Capelle, Lisette, additional, Gridnyev, Oleksiy, additional, Ristimaki, Ari, additional, Cano-Català, Anna, additional, Puig, Ignasi, additional, Mégraud, Francis, additional, O’Morain, Colm, additional, and Gisbert, Javier P., additional

Published
2023
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16. Hereditary Angioedema: a Challenging Diagnosis for the Gastroenterologist

Author

Gábos Gabriella, Moldovan Dumitru, and Dobru Daniela

Subjects
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.

Published
2016
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19. Empirical rescue treatment ofHelicobacter pyloriinfection in third and subsequent lines: 8-year experience in 2144 patients from the European Registry onH. pylorimanagement (Hp-EuReg)

Author

Burgos-Santamaría, Diego, primary, Nyssen, Olga P, additional, Gasbarrini, Antonio, additional, Vaira, Dino, additional, Pérez-Aisa, Ángeles, additional, Rodrigo, Luís, additional, Pellicano, Rinaldo, additional, Keco-Huerga, Alma, additional, Pabón-Carrasco, Manuel, additional, Castro-Fernandez, Manuel, additional, Boltin, Doron, additional, Barrio, Jesus, additional, Phull, Perminder, additional, Kupcinskas, Juozas, additional, Jonaitis, Laimas, additional, Ortiz-Polo, Inmaculada, additional, Tepes, Bojan, additional, Lucendo, Alfredo J, additional, Huguet, José María, additional, Areia, Miguel, additional, Jurecic, Natasa Brglez, additional, Denkovski, Maja, additional, Bujanda, Luís, additional, Ramos-San Román, June, additional, Cuadrado-Lavín, Antonio, additional, Gomez-Camarero, Judith, additional, Jiménez Moreno, Manuel Alfonso, additional, Lanas, Angel, additional, Martinez-Dominguez, Samuel Jesús, additional, Alfaro, Enrique, additional, Marcos-Pinto, Ricardo, additional, Milivojevic, Vladimir, additional, Rokkas, Theodore, additional, Leja, Marcis, additional, Smith, Sinead, additional, Tonkić, Ante, additional, Buzás, György Miklós, additional, Doulberis, Michael, additional, Venerito, Marino, additional, Lerang, Frode, additional, Bordin, Dmitry S, additional, Lamy, Vincent, additional, Capelle, Lisette G, additional, Marlicz, Wojciech, additional, Dobru, Daniela, additional, Gridnyev, Oleksiy, additional, Puig, Ignasi, additional, Mégraud, Francis, additional, O'Morain, Colm, additional, and Gisbert, Javier P, additional

Published
2022
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21. Empirical rescue treatment of Helicobacter pylori infection in third and subsequent lines: 8-year experience in 2144 patients from the European Registry on H. pylori management (Hp-EuReg)

Author

Burgos-Santamaría, Diego, Nyssen, Olga P, Gasbarrini, Antonio, Vaira, Dino, Pérez-Aisa, Ángele, Rodrigo, Luí, Pellicano, Rinaldo, Keco-Huerga, Alma, Pabón-Carrasco, Manuel, Castro-Fernandez, Manuel, Boltin, Doron, Barrio, Jesu, Phull, Perminder, Kupcinskas, Juoza, Jonaitis, Laima, Ortiz-Polo, Inmaculada, Tepes, Bojan, Lucendo, Alfredo J, Huguet, José María, Areia, Miguel, Jurecic, Natasa Brglez, Denkovski, Maja, Bujanda, Luí, Ramos-San Román, June, Cuadrado-Lavín, Antonio, Gomez-Camarero, Judith, Jiménez Moreno, Manuel Alfonso, Lanas, Angel, Martinez-Dominguez, Samuel Jesú, Alfaro, Enrique, Marcos-Pinto, Ricardo, Milivojevic, Vladimir, Rokkas, Theodore, Leja, Marci, Smith, Sinead, Tonkić, Ante, Buzás, György Mikló, Doulberis, Michael, Venerito, Marino, Lerang, Frode, Bordin, Dmitry S, Lamy, Vincent, Capelle, Lisette G, Marlicz, Wojciech, Dobru, Daniela, Gridnyev, Oleksiy, Puig, Ignasi, Mégraud, Franci, O'Morain, Colm, Gisbert, Javier P, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Burgos-Santamaría, Diego, Nyssen, Olga P, Gasbarrini, Antonio, Vaira, Dino, Pérez-Aisa, Ángele, Rodrigo, Luí, Pellicano, Rinaldo, Keco-Huerga, Alma, Pabón-Carrasco, Manuel, Castro-Fernandez, Manuel, Boltin, Doron, Barrio, Jesu, Phull, Perminder, Kupcinskas, Juoza, Jonaitis, Laima, Ortiz-Polo, Inmaculada, Tepes, Bojan, Lucendo, Alfredo J, Huguet, José María, Areia, Miguel, Jurecic, Natasa Brglez, Denkovski, Maja, Bujanda, Luí, Ramos-San Román, June, Cuadrado-Lavín, Antonio, Gomez-Camarero, Judith, Jiménez Moreno, Manuel Alfonso, Lanas, Angel, Martinez-Dominguez, Samuel Jesú, Alfaro, Enrique, Marcos-Pinto, Ricardo, Milivojevic, Vladimir, Rokkas, Theodore, Leja, Marci, Smith, Sinead, Tonkić, Ante, Buzás, György Mikló, Doulberis, Michael, Venerito, Marino, Lerang, Frode, Bordin, Dmitry S, Lamy, Vincent, Capelle, Lisette G, Marlicz, Wojciech, Dobru, Daniela, Gridnyev, Oleksiy, Puig, Ignasi, Mégraud, Franci, O'Morain, Colm, Gisbert, Javier P, and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)

Abstract

Objective To evaluate the use, effectiveness and safety of Helicobacter pylori empirical rescue therapy in third and subsequent treatment lines in Europe. Design International, prospective, non-interventional registry of the clinical practice of European gastroenterologists. Data were collected and quality reviewed until October 2021 at Asociacion Espanola de Gastroenterologia-Research Electronic Data Capture. All cases with three or more empirical eradication attempts were assessed for effectiveness by modified intention-to-treat and per-protocol analysis. Results Overall, 2144 treatments were included: 1519, 439, 145 and 41 cases from third, fourth, fifth and sixth treatment lines, respectively. Sixty different therapies were used; the 15 most frequently prescribed encompassed > 90% of cases. Overall effectiveness remained < 90% in all therapies. Optimised treatments achieved a higher eradication rate than non-optimised (78% vs 67%, p < 0.0001). From 2017 to 2021, only 44% of treatments other than 10-day single-capsule therapy used high proton-pump inhibitor doses and lasted & GE;14 days. Quadruple therapy containing metronidazole, tetracycline and bismuth achieved optimal eradication rates only when prescribed as third-line treatment, either as 10-day single-capsule therapy (87%) or as 14-day traditional therapy with tetracycline hydrochloride (95%). Triple amoxicillin-levofloxacin therapy achieved 90% effectiveness in Eastern Europe only or when optimised. The overall incidence of adverse events was 31%. Conclusion Empirical rescue treatment in third and subsequent lines achieved suboptimal effectiveness in most European regions. Only quadruple bismuth-metronidazole-tetracycline (10-day single-capsule or 14-day traditional scheme) and triple amoxicillin-levofloxacin therapies reached acceptable outcomes in some settings. Compliance with empirical therapy optimisation principles is still poor 5 years after clinical practice guidelines update.

Published
2022

23. Romanian Guidelines for the Diagnosis and Treatment of GERD-induced Respiratory Manifestations

Author

Drug, Vasile Liviu, primary, Antoniu, Sabina, primary, Oana, Barboi Bogdana, primary, Arghir, Oana Cristina, primary, Bancila, Ion, primary, Bataga, Simona, primary, Brisc, Ciprian, primary, Cijevschi-Prelipcean, Cristina, primary, Ciocîrlan, Mihai, primary, Ciortescu, Irina, primary, David, Liliana, primary, Deleanu, Oana Claudia, primary, Diculescu, Mircea, primary, Dimitriu, Anca, primary, Dobru, Daniela, primary, Dumitru, Eugen, primary, Gheonea, Dan Ionut, primary, Gheorghe, Cristian, primary, Goldis, Adrian, primary, Jinga, Mariana, primary, Man, Milena, primary, Mateescu, Bogdan, primary, Manuc, Mircea, primary, Mihai, Catalina, primary, Mihaltan, Florin, primary, Mihaescu, Traian, primary, Nedelcu, Laurentiu, primary, Negreanu, Lucian, primary, Pop, Carmen Monica, primary, Rajnoveanu, Ruxandra, primary, Saftoiu, Adrian, primary, Seicean, Andrada, primary, Sporea, Ioan, primary, Stanciu, Carol, primary, Surdea-Blaga, Teodora, primary, Tantau, Marcel, primary, Todea, Doina, primary, Trifan, Anca Victorita, primary, Ulmeanu, Ruxandra, primary, Iov, Diana Elena, primary, and Dumitrascu, Dan Lucian, primary

Published
2022
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24. Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Author

Houwen, Britt B. S. L., additional, Hassan, Cesare, additional, Coupé, Veerle M. H., additional, Greuter, Marjolein J. E., additional, Hazewinkel, Yark, additional, Vleugels, Jasper L. A., additional, Antonelli, Giulio, additional, Bustamante-Balén, Marco, additional, Coron, Emmanuel, additional, Cortas, George A., additional, Dinis-Ribeiro, Mario, additional, Dobru, Daniela E., additional, East, James E., additional, Iacucci, Marietta, additional, Jover, Rodrigo, additional, Kuvaev, Roman, additional, Neumann, Helmut, additional, Pellisé, Maria, additional, Puig, Ignasi, additional, Rutter, Matthew D., additional, Saunders, Brian, additional, Tate, David J., additional, Mori, Yuichi, additional, Longcroft-Wheaton, Gaius, additional, Bisschops, Raf, additional, and Dekker, Evelien, additional

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

Author

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

Published
2021
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27. Empirical rescue treatment of Helicobacter pyloriinfection in third and subsequent lines: 8-year experience in 2144 patients from the European Registry on H. pylorimanagement (Hp-EuReg)

Author

Burgos-Santamaría, Diego, Nyssen, Olga P, Gasbarrini, Antonio, Vaira, Dino, Pérez-Aisa, Ángeles, Rodrigo, Luís, Pellicano, Rinaldo, Keco-Huerga, Alma, Pabón-Carrasco, Manuel, Castro-Fernandez, Manuel, Boltin, Doron, Barrio, Jesus, Phull, Perminder, Kupcinskas, Juozas, Jonaitis, Laimas, Ortiz-Polo, Inmaculada, Tepes, Bojan, Lucendo, Alfredo J, Huguet, José María, Areia, Miguel, Jurecic, Natasa Brglez, Denkovski, Maja, Bujanda, Luís, Ramos-San Román, June, Cuadrado-Lavín, Antonio, Gomez-Camarero, Judith, Jiménez Moreno, Manuel Alfonso, Lanas, Angel, Martinez-Dominguez, Samuel Jesús, Alfaro, Enrique, Marcos-Pinto, Ricardo, Milivojevic, Vladimir, Rokkas, Theodore, Leja, Marcis, Smith, Sinead, Tonkić, Ante, Buzás, Gyo¨rgy Miklós, Doulberis, Michael, Venerito, Marino, Lerang, Frode, Bordin, Dmitry S, Lamy, Vincent, Capelle, Lisette G, Marlicz, Wojciech, Dobru, Daniela, Gridnyev, Oleksiy, Puig, Ignasi, Mégraud, Francis, O'Morain, Colm, and Gisbert, Javier P

Abstract

ObjectiveTo evaluate the use, effectiveness and safety of Helicobacter pyloriempirical rescue therapy in third and subsequent treatment lines in Europe.DesignInternational, prospective, non-interventional registry of the clinical practice of European gastroenterologists. Data were collected and quality reviewed until October 2021 at Asociación Española de Gastroenterología-Research Electronic Data Capture. All cases with three or more empirical eradication attempts were assessed for effectiveness by modified intention-to-treat and per-protocol analysis.ResultsOverall, 2144 treatments were included: 1519, 439, 145 and 41 cases from third, fourth, fifth and sixth treatment lines, respectively. Sixty different therapies were used; the 15 most frequently prescribed encompassed >90% of cases. Overall effectiveness remained <90% in all therapies. Optimised treatments achieved a higher eradication rate than non-optimised (78% vs 67%, p<0.0001). From 2017 to 2021, only 44% of treatments other than 10-day single-capsule therapy used high proton-pump inhibitor doses and lasted ≥14 days. Quadruple therapy containing metronidazole, tetracycline and bismuth achieved optimal eradication rates only when prescribed as third-line treatment, either as 10-day single-capsule therapy (87%) or as 14-day traditional therapy with tetracycline hydrochloride (95%). Triple amoxicillin-levofloxacin therapy achieved 90% effectiveness in Eastern Europe only or when optimised. The overall incidence of adverse events was 31%.ConclusionEmpirical rescue treatment in third and subsequent lines achieved suboptimal effectiveness in most European regions. Only quadruple bismuth-metronidazole-tetracycline (10-day single-capsule or 14-day traditional scheme) and triple amoxicillin-levofloxacin therapies reached acceptable outcomes in some settings. Compliance with empirical therapy optimisation principles is still poor 5 years after clinical practice guidelines update.Trial registration numberNCT02328131.

Published
2023
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29. Romanian Guidelines for Nonpharmacological Therapy of IBS

Author

Dumitrascu, Dan L., primary, Baban, Adriana, primary, Bancila, Ion, primary, Barboi, Oana, primary, Bataga, Simona, primary, Chira, Alexandra, primary, Chirila, Ioan, primary, Cijevschi Prelipcean, Cristina, primary, Ciobanu, Lidia, primary, Cozma-Petrut, Anamaria, primary, David, Liliana, primary, Diculescu, Mircea, primary, Dobru, Daniela, primary, Dimitriu, Anca, primary, Dumitru, Eugen, primary, Fadgyas-Stanculete, Mihaela, primary, Gheorghe, Cristian, primary, Gilca-Blanariu, Georgiana-Emmanuela, primary, Goldis, Adrian, primary, Grad, Simona, primary, Macarie, Melania, primary, Marica-Sabo, Cristina, primary, Miere, Doina, primary, Nedelcu, Laurentiu, primary, Negovan, Anca, primary, Pojoga, Cristina, primary, Pop, Andrei Vasile, primary, Popa, Stefan-Lucian, primary, Porr, Paul Juergen, primary, Rusu, Flaviu, primary, Seicean, Andrada, primary, Sporea, Ioan, primary, Stroie, Tudor, primary, Blaga-Surdea, Teodora, primary, Tocia, Cristina, primary, Trifan, Anca, primary, Brisc, Ciprian, primary, and Drug, Vasile, primary

Published
2021
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30. 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)

Author

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

Abstract

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.

Published
2020

32. Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

Author

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.

Subjects
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]

Published
2022
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33. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Author

Dekker, Evelien, primary, Houwen, Britt B. S. L., primary, Puig, Ignasi, additional, Bustamante-Balén, Marco, additional, Coron, Emmanuel, additional, Dobru, Daniela E., additional, Kuvaev, Roman, additional, Neumann, Helmut, additional, Johnson, Gavin, additional, Pimentel-Nunes, Pedro, additional, Sanders, David S., additional, Dinis-Ribeiro, Mario, additional, Arvanitakis, Marianna, additional, Ponchon, Thierry, additional, East, James E., additional, and Bisschops, Raf, additional

Published
2020
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35. Geographic Distribution, Phenotype and Epidemiological Tendency in Inflammatory Bowel Disease Patients in Romania

Author

Goldiș, Adrian, primary, Lupușoru, Raluca, additional, Gheorghe, Liana, additional, Gheorghe, Cristian, additional, Trifan, Anca, additional, Dobru, Daniela, additional, Cijevschi, Cristina, additional, Tanțău, Alina, additional, Constantinescu, Gabriel, additional, Iacob, Răzvan, additional, Goldiș, Ramona, additional, and Diculescu, Mircea, additional

Published
2019
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36. The Risk/Benefit Analysis of Oral Anticoagulant Treatment in Atrial Fibrillation Using HAS-BLED and CHA2DS2-VASc Score

Author

Cozlea Daniel Laurentiu, Cozlea Laurentiu, Keresztesi Arthur Attila, Oltean Galafteon, Dobru Daniela, Silivastru (Cozlea) Ionela, and Asofie Gabriela

Subjects
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.

Published
2015

37. Percutaneous Endoscopic Gastrostomy with Jejunal Extension Tube for the Delivery of Levodopa Carbidopa Intestinal Gel: Clinical Practice Guidelines of the Romanian Society of Digestive Endoscopy

Author

Gheorghe, Cristian, primary, Dumitru, Eugen, primary, Ciocîrlan, Mihai, primary, Dobru, Daniela, primary, Drug, Vasile, primary, Goldis, Adrian, primary, Jinga, Mariana, primary, Manuc, Mircea, primary, Saftoiu, Adrian, primary, Seicean, Andrada, primary, Cotruta, Bogdan, primary, Bancila, Ion, primary, Pitigoi, Dan, primary, Mercea, Voicu Alexandru, primary, and Tanțău, Marcel, primary

Published
2019
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41. Malnutrition Prevalence in Newly Diagnosed Patients with Inflammatory Bowel Disease – Data from the National Romanian Database

Author

Ciocîrlan, Maria, primary, Ciocîrlan, Mihai, primary, Iacob, Răzvan, primary, Tanțău, Alina, primary, Gheorghe, Liana, primary, Gheorghe, Cristian, primary, Dobru, Daniela, primary, Constantinescu, Gabriel, primary, Cijevschi, Cristina, primary, Trifan, Anca, primary, Goldiș, Adrian, primary, and Diculescu, Mircea, primary

Published
2019
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43. The Assessment of the Colo-rectal Polyps in Order to the New Diagnostic and Therapeutic Strategies

Author

Brusnic Olga, Diac Andreea Raluca, Drasoveanu Silvia Cosmina, Gabos Gabriella, Boeriu Alina, Onisor Danusia, and Dobru Daniela Ecaterina

Subjects
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

44. Surgical Risk Factors of Patients with Operable Gist

Author

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

45. Individual Prognostic Factors in Gastric Cancer

Author

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

48. Gastrointestinal Endoscopy in Patients on Direct Oral Anticoagulants. A Consensus Paper of the Romanian Society of Gastroenterology and Hepatology

Author

Farcas, Andreea, primary, Bataga, Simona, primary, Cijevschi, Cristina, primary, Diculescu, Mircea, primary, Dobru, Daniela, primary, Dumitru, Eugen, primary, Goldis, Adrian, primary, Nedelcu, Laurentiu, primary, Popescu, Alina, primary, Sporea, Ioan, primary, Trifan, Anca, primary, Valean, Simona, primary, Gheorghe, Cristian, primary, and Dumitrascu, Dan Lucian, primary

Published
2018
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50. Is NAFLD a Risk Factor for Colorectal Polyps? An Analysis of Single Romanian Centre

Author

Drasovean Silvia, Kozma Bela, Pop Crina, Petrut Madalina, and Dobru Daniela

Subjects
medicine.medical_specialty, business.industry, Romanian, nutritional and metabolic diseases, nafld, colorectal polyps, digestive system, digestive system diseases, language.human_language, colonoscopy, Internal medicine, otorhinolaryngologic diseases, abdominal ultrasound, medicine, language, Medicine, General Pharmacology, Toxicology and Pharmaceutics, Risk factor, business, General Dentistry
Abstract

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is considered to be the most common of all liver disorders, and its prevalence is almost certainly increasing. Because of the presence of NAFLD in metabolic syndrome and of latter’s role in the appearance of colorectal polyps, many studies have tried to find a link between the liver disease and colorectal polyps. The aim of the study was to determine whether NAFLD is a risk factor for colorectal polyps. Material and Methods: We examined 560 patients diagnosed with NAFLD who underwent colonoscopy at Mures County Hospital, between January 2011 and June 2014. Fatty liver disease was assessed by abdominal ultrasound, with NAFLD defined as fatty liver disease in the absence of alcohol use of > 40 g/week or other secondary causes. We divided the 560 patients into two groups, according to the presence or absence of polyps. Data were collected from patient’s history, physical exam, laboratory tests and abdominal ultrasound. Results: The prevalence of colorectal polyps was 16.6% (93) in the NAFLD patients. 51 (54.8%) of them were female, and the Chi2 test identified a statistically significant association between the female gender and the appearance of polyps (p=0.028; OR=1.652; CI= 1.052-2.596). No statistical association was found between the smoking status and the development of colorectal polyps (p=0.245) and only 18 of 93 patients were smokers. Of 93 patients with polyps, 68 (73.1%) have associated diabetes mellitus, but without statistical correlation (p=0.214). According to family history of colorectal polyps none of the patients have data about a possible polyposis pathology. Conclusions: Our study demonstrates a relationship between some characteristics of NAFLD and the development of colorectal polyps. Further studies are required to confirm whether NAFLD is a risk factor for the appearance of polyps.

Published
2015

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