Publications by authors named "Otilia Gavrilescu"

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of exacerbation and remission, making disease monitoring and management challenging. Endoscopy, the gold standard for assessing disease activity and severity, involves invasive procedures and is associated with patient discomfort and risks. Using machine learning (ML) to combine fecal calprotectin with other clinical or biological tests can significantly enhance the non-invasive prediction of endoscopic disease activity (EDA) in UC.

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Inflammatory bowel disease (IBD) comprises two types of chronic intestinal disorders: Crohn's disease and ulcerative colitis. In long-standing ulcerative colitis disease activity, histological persistent inflammation has been linked to an increased risk of relapse, and long-term corticosteroid use, even when endoscopic remission is reached. In Crohn's disease, the discontinuous nature of lesions and transmural inflammation have limited the standardized histological assessment.

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TNF-α inhibitors (TNFis) have revolutionized the treatment of certain chronic immune-mediated diseases, being widely and successfully used in rheumatic inflammatory diseases, and have also proved their efficacy in the treatment of inflammatory bowel disease (IBD). However, among the side effects of these agents are the so-called paradoxical effects. They can be defined as the appearance or exacerbation of a pathological condition that usually responds to this class of drug while treating a patient for another condition.

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Article Synopsis
  • A study aimed to create a cost-effective, non-invasive machine learning method to assess endoscopic disease activity (EDA) in ulcerative colitis (UC) using the Inflammatory Bowel Disease Questionnaire (IBDQ) score and low-cost biological predictors.
  • The research tested four random forest (RF) and four multilayer perceptron (MLP) classifiers, finding that the inclusion of IBDQ improved model accuracy and AUC, with RF outperforming MLP on new patient data.
  • This study is the first to use IBDQ as a predictor in a machine learning model for estimating UC EDA, providing valuable insights for doctors and patients managing long-term treatment.
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Hepatic diseases pose a significant public health concern. Regardless of the severity of hepatic fibrosis, treatment is recommended for all chronic hepatitis C virus (HCV) subjects. However, fibrosis and steatosis assessment remains crucial for evaluating the prognosis, progression, and hepatic disease monitoring, particularly following the treatment with direct-acting antivirals (DAAs).

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Article Synopsis
  • Ixekizumab is a biologic treatment targeting the IL-17 pathway, used for conditions like psoriasis and ankylosing spondylitis, alongside Secukinumab and Brodalumab.
  • A case study is presented about a 42-year-old woman who developed severe complications, including bloody diarrhea and fever, just one week after starting Ixekizumab for psoriasis and psoriatic arthritis.
  • Despite attempts at medical treatment, her condition worsened to require emergency colectomy, suggesting that Ixekizumab may be linked to the onset of inflammatory bowel disease.
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According to new research, a possible association between inflammatory bowel disease (IBD) and an increased risk of ischemic heart disease (IHD) has been demonstrated, but this concern is still debatable. The purpose of this review is to investigate the link between IHD and IBD, as well as identify further research pathways that could help develop clinical recommendations for the management of IHD risk in IBD patients. There is growing evidence suggesting that disruption of the intestinal mucosal barrier in IBD is associated with the translocation of microbial lipopolysaccharides (LPS) and other endotoxins into the bloodstream, which might induce a pro-inflammatory cytokines response that can lead to endothelial dysfunction, atherosclerosis and acute cardiovascular events.

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Background and Objectives: The COVID-19 pandemic has had a considerable impact on inflammatory bowel disease (IBD) patients by limiting their access to medical services due to restrictions and the reorganization of the healthcare systems, which affects their quality of life (QoL). We aimed to assess the impact of the COVID-19 pandemic on the QoL of patients with IBD. Materials and Methods: We conducted a descriptive observational study, which included 90 adult patients diagnosed with IBD.

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Background: Many scores have been suggested to assess the severity of acute pancreatitis upon onset. The extrapancreatic necrosis volume is a novel, promising score that appears to be superior to other scores investigated so far.

Aim: To evaluate the discriminatory power of extrapancreatic necrosis volume to identify severe cases of acute pancreatitis.

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: Hepatic diseases are an important public health problem. All patients with chronic hepatitis C virus (HCV) infection receive treatment, regardless of hepatic fibrosis severity. However, evaluation of hepatic fibrosis and steatosis is still useful in assessing evolution, prognosis and monitoring of hepatic disease, especially after treatment with direct-acting antivirals (DAAs).

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: Anemia is the most frequent complication of inflammatory bowel diseases. Clinically, anemia can affect important quality-of-life (QoL) components, such as exercise capacity, cognitive function, and the ability to carry out social activities. The disease activity has a significant impact on QoL, mainly due to clinical manifestations, which are more severe during the periods of disease activity.

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Background/aims: Stress, in its various forms, plays an important role in the development and evolution of inflammatory bowel disease (IBD). For patients with IBD, the evidence related to the effects of various types of psychological therapies remains inconclusive. This study aimed to evaluate whether cognitive behavioral therapy, in combination with educational counseling, influenced disease activity and quality of life (QoL) among patients with IBD.

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Patients diagnosed with inflammatory bowel disease (IBD) often develop one or more extraintestinal manifestations (EIM). We performed a prospective study that included 517 patients with IBD (Crohn's disease - CD, ulcerative colitis - UC or undifferentiated colitis - CN) diagnosed between 1975 and 2016 in the Northeastern region of Romania. The patients were extracted from the national database (IBD Prospect).

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The psychometric hepatic encephalopathy score (PHES) is frequently used as a "gold standard" for the diagnosis of minimal hepatic encephalopathy (MHE). In Romania, there are currently no widely available tests for the detection of MHE. In this study we aimed to standardize the PHES in a healthy Romanian population and to estimate the prevalence of MHE in a group of Romanian patients with liver cirrhosis.

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Unlabelled: The aim of the study is to assess the impact of Crohn's Disease (CD) on quality of life (QoL) patients with and to identify the significant modifications in QoL, depending on both the development particularities of CD and the epidemiologic parameters.

Material And Methods: a prospective study was conducted at the Institute of Gastroenterology and Hepathology Iaşi, between October 2011 and August 2014. The study enrolled 63 patients with CD.

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Unlabelled: Crohn's disease is an inflammatory disease of the gastro-intestinal tract with an evolution marked by activity and remission periods. Lately, the incidence and evolution models of Crohn's disease significantly changed, an increasing number of patients presenting more severe forms. The aim of the study is to analyze Crohn's disease in its phenotypic classification and to establish correlation between the localization, the behavior and the activity of Crohn's disease.

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