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Biomedical subjects

C Stanciu

Publications and source records attributed to C Stanciu.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Hepatitis C virus serotypes in Romanian patients with chronic hepatitis and cirrhosis.

OBJECTIVES: To determine the prevalence of hepatitis C virus (HCV) serotypes in Romanian patients with chronic hepatitis infections and the association between them and disease's severity. PATIENTS AND METHODS: Anti-HCV antibodies were first investigated by an indirect ELISA (Murex IIIrd generation). From 55 patients positive for anti-HCV, 22 patients (11 female and 11 male) with chronic active hepatitis (CAH--6 cases), chronic persistent hepatitis (CPH--11 cases) and cirrhosis (C--5 cases) were tested for HCV serotypes using an indirect ELISA (Murex HCV Serotypes 1-6 Assay). The average age for the selected group was 47.2 years (range 27 divided by 68). RESULTS: In the first study from our region concerning this subject we have found the following serotypes distribution: serotype 1--68.18% (6/11--CPH; 4/6--CAH; 5/5--C); serotypes 2, 3, 4, and 6--4.54% for each of them (all were CPH cases); untypable--13.65% (2 with CAH and 1 CPH respectively). CONCLUSIONS: (1) The serotype 1 seems to be predominant in our region in patients with chronic HCV infections and it is associated with the most severe cases. (2) The diversity of serotypes is higher compared with previous study group results (e.g. in haemodialized patients the serotype 1 was determined in almost 100% cases--unpublished data). (3) Untypable strains (13.65%) require the sequence analysis for HCV genome characterization.

Adult↗
PubMedDate not supplied

[Functional digestive disorders and the relationship with psychiatric diseases].

UNLABELLED: Functional gastrointestinal disorders are frequent causes for medical consultations. Features related to disease, patient or the environment could influence the medical referral. The aim of the study was to estimate the importance of psychiatric disorders in patients with functional gastrointestinal disorders. MATERIAL AND METHOD: The study was designed to have two phases. Phase I consisted in studying the prevalence of Irritable Bowel Syndrome (IBS) and psychiatric past history in a random sample of 338 from an urban community of 18000 people. Phase II consisted in studying the presence of psychiatric history in patients referred for IBS symptoms. RESULTS: The prevalence of IBS symptoms in the general population was: 14.4% (8.4% in males and 17.7% in females). Psychiatric positive history was present in 6.2% of the general population and in 6.1% of IBS subjects (p > 0.05). Psychiatric disorders were more common in the IBS subjects who were seeking medical assistance (18%) than in subjects with same symptoms from the general population (6.2%) (p < 0.05). CONCLUSIONS: Psychiatric disorders may influence the medial referral for patients with IBS.

Adolescent↗
PubMedDate not supplied

[Liver metastases with unknown primary site].

Patients with unknown primary site cancer represents 5% to 10% of all neoplasia patients. Liver is a favourite site for gastrointestinal tumors, but not only. The adenocarcinomas represents 60% of patients from this group. A detailed physical examination, extensive laboratory and imaging procedures are necessary to locate the primary tumor. However, liver biopsy could be essential for histological diagnosis and important to identify the tumors who may benefit from specific and effective therapy (breast cancer, prostate cancer, ovarian cancer and small-cell carcinoma of the lung). Systemic chemotherapy represents the most frequently treatment, but only patients with good performance status and without co-morbidities may benefit. "Best supporting care" may be the optimal treatment for most patients, majority with poor performance status at the time of diagnosis.

Adenocarcinoma↗
PubMedDate not supplied

[Chronic hepatitis B virus infection].

Chronic hepatitis B virus infection affects approximately 350 million people worldwide and 1.1 million in Romania. Despite the tremendous progress in the management of virus B infection, the treatment of chronic hepatitis B remain difficult and often disappointing. The aim of treatment is sustained suppression of HBV replication and remission of liver disease. Treatment is not indicated in immune tolerance phase or in the inactive carrier state, but it is necessary in immune clearance phase, after 3-6 months of surveillance. Two antiviral drugs are accepted: alpha-interferon and lamivudine. The results of both treatments are far of being perfect; new, more potent antiviral drugs are required.

Antiviral Agents↗
PubMedDate not supplied

Helicobacter pylori infection in patients with diabetes mellitus.

Data concerning the prevalence of Helicobacter pylori (H. pylori) in diabetic patients are scanty and controversial. The aim of this study was to evaluate the prevalence of H. pylori infection in patients with diabetes mellitus (DM), and to assess whether the presence of bacterium was associated with severity of dyspeptic symptoms and endoscopic findings in such patients. The study involved 42 patients (19 men, 23 women; mean age 55 years, range 34-75 years) with DM and dyspeptic symptoms. Sixteen patients (38%) were classified as having type 1 diabetes and 26 (62%) patients as having type 2 diabetes. All patients had chronic dyspepsia, and each patient has completed a self-report questionnaire to obtain information concerning the presence and severity of upper gastrointestinal tract symptoms. H. pylori status was confirmed by 13C-urea breath test (13C-UBT), and diabetic patients underwent upper gastrointestinal endoscopy. Twenty-six (61.9%) of patients with DM were positive for 13C-UBT. There were no statistically significant differences in the infection rate between patients with type 1 and type 2 diabetes, and the prevalence of H. pylori infection was not associated with the known duration of diabetes. There was no significant difference in the symptoms score between H. pylori-positive and H. pylori-negative diabetic patients, and endoscopic findings in patients with DM were in the same range with those found in dyspeptic subjects from the same region. In conclusion, H. pylori infection is not associated with DM, duration of diabetes, or severity of dyspeptic symptoms in patients with DM.

Adult↗
PubMedDate not supplied

Therapy of chronic hepatitis B: today and tomorrow.

Hepatitis B virus infection represents an important health problem all around the world, with almost 350 million people chronically infected and 1 million death per year. Despite an efficient vaccination program and despite therapeutic progresses, chronic hepatitis B is still a disease with severe evolution and an increased prevalence in many countries, including Romania. Today, we have two groups of drug that are used for chronic hepatitis B treatment: interferon and lamivudine. Unfortunately, long term results for interferon or lamivudine treatment are far from satisfactory, fact that explains the interest for new antiviral agents, which are under evaluation procedures in many clinical trials. A combination of two or more new antiviral action agents it is believed to be the optimum therapy of chronic hepatitis B in the future.

Antiviral Agents↗
PubMedDate not supplied

[Hormonal influence on gastrointestinal reflux during pregnancy].

UNLABELLED: Gastroesophageal reflux (GER) occurs in 30-50% of all pregnancies. The progressive rise in plasma progesterone has been suggested as a possible mediator of GER during pregnancy. It is not known whether progesterone, at physiological concentrations, has an effect on acid contact time. The study includes 70 women--50 pregnant and 20 non pregnant healthy menstruating female volunteers. We used immunoenzymatic tests for determination of estradiol, progesterone and beta HCG hormones during pregnancy. The 50 pregnant women with GER symptoms heartburn, acid regurgitations had increased levels of steroid hormones. 24-h ambulatory esophageal pH monitoring and serum progesterone levels were determined in 20 healthy women known to have normal menstrual cycles. All tests were performed during the follicular phase days 2-7 and the luteal phase days 22-28 of one or two consecutive menstrual cycles. The fluctuations in progesterone levels across the normal menstrual cycle have no significant impact on 24-h ambulatory pH parameters. CONCLUSIONS: Progesterone, at physiological concentrations, does not predispose to GER in healthy menstruating women. Thus, it is likely that if progesterone, with or without estrogen, contributes to GER in pregnancy, this effect takes place only at the high concentrations observed during this condition. After delivery, GER disappear with decreasing hormonal levels and uterine volume.

Adolescent↗
PubMedDate not supplied

[Cystic dilatation of main biliary tract].

UNLABELLED: The choledochal cyst (particularly with congenital origin) is a clinical form from a complex syndrome of ecstasies of the intra-, extra-, or both situations of biliary tree. The disease has until now an unsure etiopathogeny. Very frequent to child, teen-ager and young adult the incidence decreases through the third age. During the period 1960-1998, 13 patients were operated on (annually rate 0.3). The extreme ages of our patients were 5 and 72 years; being operated six children and 7 adults (two of them being 63 and 72 years old). The clinical presentation was nonspecific. The jaundice (with or without cholangitis) (n: 7), right upper quadrant pain (n: 11), a palpable abdominal mass (n: 5) were registrated but the classic triad (Sénéque--Thailhefer) was in out series the exception rather than the rule. Concomitantly there were discovered different complications of the disease: hepatic biliary cirrhosis (n: 3--two macroscopic diagnosed and one microscopic confirmed), portal hypertension (n: 8), biliary lithiasis (including the intracystic stones) (n: 6) and cholangio-carcinoma (n: 1). The clinic and biologic preoperative diagnosis is up to date difficult and not sure like in our experience too. In our series, especially in the last 20 years, the accurate imaging diagnosis was helpful (the ultrasonography, CT, hepatic scintigrams). ERCP was not available for us until now. In concordance with Todani--Watanabe classification our patients were included in the following types: I-a (n: 6), I-b (n: 1), I-c (n: 2), II (n: 2), IV-a (n: 2). All patients were operated on: cysts-digestive derivations or partial excision of the cyst with billio-digestive reconstruction were the choice procedures at a beginning of our experience or for the very fragile patients (n: 5). The total excision of the cyst with choledochal--jejunostomy (Roux-en-Y) is the preferred method now (n: 8) when it is possible. The microscopic pathology of the disposable specimens (cystic wall) showed:--chronic intra- and perimural inflammation (n: 7);--severe displasia and metaplasia (n: 2); cholangiocarcinoma islands (n: 1); additional lesions: hepatic chirrosis (n: 1); hepatic fibrosis (n: 3). RESULTS: The postoperative morbidity--three patients--one of them died with a peritonitis. Long-term follow-up, effective for only 10 patients, reveled recurrent cholangitis in two cases treated by the reoperation of the former anastomosis; the other 8 patients had a normal evolution. CONCLUSION: The choledochal cyst is an exclusive indication for surgery as soon as it was discovered.

Adolescent↗
PubMedDate not supplied

[Diagnosis of gastric cancer on endobiopsies using the WHO classification].

Gastric cancer (GC), one of the most frequent malignancies can be early detected on endobiopsies. Our aim was to evaluate histologically the GC on endobiopsies, using WHO 2000 and Lauren classifications. The study included 2424 gastric endobiopsies, routine processed; sections stained with HE, Giemsa, PAS and AB. GC was diagnosed in 451 cases (19%), mostly in men (311 cases--69%). The highest incidence was in 60-69 year-old aged patients (34%). Using Lauren classification, 279 cases were included in diffuse type (62%), 167 intestinal-type (37%) and 5 (1%) mixed type. Each of these three types were also histologically analyzed considering the WHO classification. We pointed out that GC can be diagnosed histologically on endobiopsy specimens, although it is difficult to diagnose the GC--mixt type, due to reduced size of endobiopsies. Lauren classification (including the two major types: diffuse and intestinal) is very useful, especially if correlated with histological criteria of WHO classification.

Adenocarcinoma↗
PubMedDate not supplied

[The changing spectrum of lower gastrointestinal haemorrhages].

UNLABELLED: Lower gastrointestinal haemorrhage (LGH) is a frequent reason for medical referral. It has an annual incidence ranging between 17 and 20.5 cases per 100,000 adults and represents 20-30% of all gastrointestinal haemorrhages. OBJECTIVE: To evaluate the evolution of the etiologic spectrum of lower gastrointestinal bleeding. METHODS: All the files of patients with lower gastrointestinal bleeding admitted in our unit between 1990 and 2001 were reviewed retrospectively. The annual admission and annual admission rates for each disease (disease/total LGH in a specific year) were analysed using linear regression. RESULTS: We identified 2565 patients with LGH (mean age 50.8+/-8.7 years, 1338 (52%) men and 1227 (48%) women). The annual number of patients had a linear increase (p<0.05) from 103 in 1990 to 399 in 2001. The mean age of the patients increased linearly from 48.5 to 53 years (p<0.05). The annual rate for some specific diseases has changed over time. There was a trend of increase for the colorectal cancer and polyps, which reach statistical significance for diverticular disease and haemorrhoids (p<0.05). While the annual incidence for ulcerative colitis remained constant the annual rates decrease. For Crohn disease, angiodysplasia and radiation colitis no changes was found.

Adult↗
PubMedDate not supplied

[Endo-Lap method in the management of biliary lithiasis (gallbladder and common bile duct)].

AIM: To present the results of the biliary endoscopic approach (ERCP) followed by laparoscopic cholecystectomy (LC) in the management of biliary lithiasis (gallbladder and common bile duct--CBD). PATIENTS AND METHOD: From 1997 to March 2003 37 patients with biliary lithiasis were treated by endoscopic sphincterotomy (ES) with stone extraction, followed after 24-48 hours by LC. The indications for ERCP were presence of an obstructive jaundice (n=32) and a dilated CBD at the ultrasound examination (n=5). RESULTS: Selective biliary cannulation was obtained in 35 (94.6%) cases, in all of them with successful papillotomy. Stones were found in all patients. CBD clearances for calculi (from 1 to 8) was obtained in 33 of 35 patients (94.3%), the rest of 2 being managed by open laparotomy. Antibiotics were administrated in all patients. Laparoscopic cholecystectomy was performed after 24-48 hours, with one conversion (3%). Postoperative morbidity was 12.1%: 2 transitory pancreatic reactions and 2 wound infections. CONCLUSION: Endo-Lap method is a useful management alternative for combined gallbladder and CBD lithiasis. It has all the advantages of the two mini-invasive procedures (fast recovery, short hospitalization, low costs) and a less postoperative morbidity in patients with high risk.

Cholecystectomy, Laparoscopic↗
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[Abdominal pain in liver cirrhosis patient--an unusual case].

We present the case of a 62 years male subjects, known with liver cirrhosis diagnosed in 2000 during a laparoscopy. The subject presented with important atypical abdominal pain, leucocytosis, thrombocytosis, small ascites; pneumatosis and hydro-aeric images of small intestine at abdominal X Ray, thickened bowel wall at CT-scan. Laparoscopy revealed mesenteric venous thrombosis, intestinal infarction and the standard surgical treatment was enterectomy. Mesenteric thrombosis may rarely occur in liver cirrhosis due to portal hypertension. This rare but severe complication is usually difficult to diagnose..

Abdominal Pain↗
PubMedDate not supplied

Capsule endoscopy--a new frontier.

Capsule endoscopy (CE)--about the size of a vitamin pill--has enormous potential for the noninvasive investigation of diseases of the small bowel--"the last frontier" of endoscopy. Its use is spreading rapidly-over 150,000 capsules have been ingested worldwide since CE was introduced in 2001--reflecting the enormous impact of CE on the field of gastroenterology. CE has a higher diagnostic yield in recognizing Crohn's disease than any other method available. CE is able to establish a diagnosis in a high proportion of patients with obscure gastrointestinal bleeding, detecting small bowel lesions. New indications and applications of CE are emerging: CE has proven useful in the diagnosis of celiac disease, NSAID enteropathy and small bowel malignancies, its use in pediatric gastroenterology, the new Pill Cam ESO specifically-designed to visualize the esophageal mucosa etc. The objectives of this article are to present an overview of the CE: its history and development, indications, contraindications, and CE role in the diagnosis of small bowel diseases. Finally, it is presented the experience with CE at our institutions.

Contraindications↗
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[Gastroesophageal reflux involvement in ENT disorders].

It is admitted that gastroesophageal reflux patients may presents ear, nose, and throat (ENT) symptoms and signs, condition known as laryngo-pharyngeal reflux. It is estimated that as many as 10% of patients presenting to an ENT specialist have a clinical condition that might be attributed to gastroesophageal reflux. The diagnosis is challenging since no laryngeal signs are pathognomonic. A combination of ENT and esophageal symptoms and signs may suggest the necessity of further investigations. Adapted 24h pH study or better an esophageal impedance study may reveal the involvement of gastroesophageal reflux. Alternatively, a short trial with omeprazole or another proton pump inhibitor may be the simplest way for diagnosis. The standard treatment for gastroesophageal reflux is the valid treatment for these patients.

Anti-Ulcer Agents↗