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Pancreatic ductal adenocarcinoma (PDAC) is characterized by an intense fibrosis which enhances the growth of tumor cells and drives an epithelialmesenchymal transition. The consequence is the uncontrolled proliferation of cancer cells, including pancreatic cancer stem cells (PCSC), which can enhance the metastatic potential. Objective. The aim of this study is to assess the expression of pancreatic cancer stem cells, on pancreatic endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) specimens. Material and Methods. A total of 21 patients diagnosed with PDAC after EUS-FNB within the Research Center of Gastroenterology and Hepatology of Craiova, were included in the study, and the samples were sent for immunohistochemical assessment. Anti-Human CD 24 (policlonal, Abcam, ab 199140) and EpCAm (Epr 20532-225, Rb monoclonal, Abcam, ab 223582) were used. Results. All cases were positive for CD24 and EpCAM. In NOS ductal adenocarcinomas, CD24 immunomarking was heterogeneous, with variable intensity and a variable number of positive cells within the same case. Well and moderately differentiated adenocarcinomas that formed tubular or papillary structures showed a higher intensity CD24 expression compared to poorly differentiated or undifferentiated adenocarcinomas. EpCam showed a stronger immunolabeling intensity in the analyzed samples. PDAC EpCam expression was of moderate and high intensity and with a heterogeneous appearance in NOS G1 adenocarcinomas, but the intensity of the immunomarking tended to decrease with increasing histological grade. Conclusions. EUS-FNB PCSC immunohistochemistry is feasible. At the subcellular level, the basolateral membranous and cytoplasmic staining of EpCam in PDAC could be correlated with tumor invasion and possibly with the unfavorable evolution of this type of carcinoma, while CD24 frequently presents an apical immunostaining pattern and could suggest the presence of an epithelial-type phenotype of tumor cells, with a lower potential for invasiveness and metastasis. [ABSTRACT FROM AUTHOR]

Inflammatory Bowel Disease (IBD) encompasses a cluster of chronic inflammatory disorders affecting the gastrointestinal tract. The primary objective of IBD treatment is the management of inflammation, symptom control, and the induction and sustenance of remission. Therapeutic interventions commonly encompass medications, dietary modifications, and, in certain instances, surgical procedures; however, a definitive cure remains elusive. While several nations have established national IBD registries, Romania has not. The responsibility of the implementation of such a registry was assumed by a non-profit organization, the "Clubul Român de Boală Crohn și Colită Ulcerativă", resulting in the creation of the registrul-ibd.ro platform. Given the absence of a curative remedy for IBD, it falls within the realm of personalized medicine. In light of this, the University of Medicine and Pharmacy of Craiova has developed a mobile application, IBDMonitor, intricately linked with the IBD registry. This innovative application empowers patients to meticulously record critical data, encompassing medication administration, symptomatology, lifestyle habits, as well as physiological, pathological, and daily occurrences. Medical professionals are granted real-time access to these patient-generated reports, enabling them to make prompt treatment adjustments. Following a successful pilot phase, various insights have emerged, notably revealing a relatively low long-term adherence rate to the application. Consequently, advocating for the widespread adoption of both the application and the registry on a national scale holds the potential to significantly enhance the utilization of these invaluable tools in the management of IBD. [ABSTRACT FROM AUTHOR]

Standard ultrasound is an excellent method for assessing gallbladder disease. Despite the well-known advantages of conventional ultrasound, the sensitivity and accuracy are not satisfactory, especially when stones or some other gallbladder lesions fill the gallbladder lumen. Sometimes the bladder sediment may present as an intraluminal mass and mimic tumors such as gallbladder cancer or adenoma. With no information of micro vascularity differential diagnosis between benign diseases from malignant diseases is sometimes very difficult using conventional ultrasound, but CEUS can be a useful tool. The study was performed in the Gastroenterology Clinic of SCJU Craiova during 2018-2022. 38 patients with ultrasound-detected gallbladder formations were included. The reference methods for diagnosis were histological examination or computed tomography in cases without operative indication. A single experienced physician with more than fifteen years' experience performed CEUS examinations by applying a second-generation blood pool agent (SonoVue®, Bracco, Milan, Italy). Archived images were interpreted by the same physician and compared to the final diagnosis. There were 12 malignant and 26 benign gallbladder lesions in total in this study, including 12 cases of gallbladder cancer, 16 case of gallbladder sludge and 10 cases of gallbladder polyps. All the cases of gallbladder sludge were shown as completely nonenhanced on CEUS, and the diagnostic accuracy was 100%. CEUS exam shows homogeneously hyperenhanced on arterial phase and isoenhanced on venous phase in gallbladder polyps, The appearances of gallbladder cancer on CEUS were various: a mass in gallbladder which was heterogeneously hyperenhanced on arterial phase and washed out quickly or an irregular thickness of gallbladder, which was also heterogeneously hyperenhanced on arterial phase and washed out quickly. Gallbladder sludge and gallbladder cancer had completely different features on CEUS and the diagnostic accuracy was very high. CEUS is a feasible alternative tool to differentiate gallbladder pathologic alterations. [ABSTRACT FROM AUTHOR]

Although medicine is constantly evolving, hepatocellular carcinoma remains a pathology with a poor prognosis due to the frequent delayed diagnosis and the aggressiveness of the disease. Aim: Our objective was to evaluate liver function and stage of disease of newly diagnosed HCC patients. Methods: We conducted a retrospective study between July 2016 and January 2021 and we included hospitalized patients within the Department of Gastroenterology of the Emergency County Hospital of Craiova. We identified 119 newly diagnosed patients and we collected data from patient history, contrast-enhanced imaging and laboratory analysis. Results: 81 patients were diagnosed in BCLC Stage A and B. Liver function was not significantly modified, despite 91.5% of the patients presented with elevated AST levels. Because of the cirrhotic liver already affected, 73 patients had thrombocytopenia. Contrast-enhanced ultrasound was performed in 79 patients, as a complementary imaging exploration. Alfa-fetoprotein values could not be correlated with the severity of disease. Conclusions: Early diagnosis was mostly established. It is mandatory for treatment management and overall survival to follow a rigorous surveillance of patients at risk for HCC. [ABSTRACT FROM AUTHOR]

This study aims to develop a new self-report tool (HCV-AD) measuring adherence factors, intentional or unintentional, during Hepatitis C Virus (HCV) treatment with direct-acting antivirals (DAA) aiming to achieve high efficacy, otherwise resulting in drug resistance and treatment failure. Two phases were conducted: in the first phase, items were generated based on an extensive literature review, and, in the second phase, a prospective cohort study was conducted using HCV patients from Gastroenterology Department from University County Hospital of Craiova, Romania (n = 222), to evaluate the validity and reliability of the questionnaire. A number of 19 items were generated following a systematic review and through expert opinion. The internal consistency reliability was evaluated using Cronbach's alpha. The construct validity was assessed using correlations with two other instruments: visual analog scale (VAS) and medication possession ratio (MPR). The final questionnaire (HCV-AD10) was derived through exploratory factor analysis, with 82% of total variance explained. This instrument appeared as a reliable and valid measure for medication adherence, with Cronbach's alpha (0.867) and significant high positive correlations between adherence scores calculated with HCV-AD10 and VAS (ρ = 0.61, p < 0.001) or with HCV-AD10 and MPR (ρ = 0.75, p < 0.001). This research would make a worthwhile contribution to HCV management. [ABSTRACT FROM AUTHOR]