Publications by authors named "Sergiu-Marian Cazacu"

Objectives: The aim of the study was to assess the diagnosis and evolution of low anterior rectal resection syndrome (LARS) in patients admitted to a tertiary surgical center in Romania.

Materials And Methods: From 120 patients initially included in the analysis, after applying the exclusion criteria, we selected 102 patients diagnosed and operated on for neoplasm of the upper, middle, and lower rectum for which resection and excision (partial or total) of mesorectum was associated. All the patients we treated in the general surgery department of the County Emergency Hospital of Craiova within a time frame of 5 years (1 October 2017-1 September 2022), and all experienced at least one symptom associated with LARS.

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Introduction: Most studies have shown a declining incidence of upper gastrointestinal bleeding (UGIB) in recent years. Data regarding mortality were controversial; in non-variceal bleeding, the increasing age of the population, increased use of anti-thrombotic and anticoagulant therapy in patients with cardiovascular diseases, and the use of non-steroidal anti-inflammatory drugs are counterbalanced by the progress in endoscopic therapy with stable mortality.

Material And Method: We performed a retrospective, cross-sectional study that included patients admitted with UGIB in Clinical Emergency Hospital Craiova during 2013-2020.

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Article Synopsis
  • A retrospective study was conducted on 55 patients diagnosed with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) at The Clinical Emergency County Hospital Craiova, focusing on epidemiological and clinical aspects.
  • The majority of patients were older adults, with a mean age of 66.4 years, and GEP-NETs were most commonly found in the colon, specifically the ascending colon.
  • Notable findings included a higher prevalence of arterial hypertension in patients with colon neuroendocrine tumors (C-NET) and an overall increase in GEP-NET cases in recent years.
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The incidence of peptic ulcers has decreased during the last decades; the COVID-19 pandemic may have influenced the peptic ulcer hospitalizations. The study aimed to assess the admissions and mortality for complicated and uncomplicated peptic ulcers and the influence of the pandemic period. Material and We performed an observational study at a tertiary academic center, including all patients admitted for peptic ulcers between 2017-2021.

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Purpose: Non-alcoholic fatty liver disease (NAFLD) represents a heterogeneous spectrum of liver diseases that encompass simple steatosis, non-alcoholic steatohepatitis (NASH), and advanced fibrosis or cirrhosis. Periodontitis is a chronic infectious disease with multiple causal factors that presents a complex interaction between the microbial biofilm and the host's immune response. The aim of this study was to investigate the concentrations of Vascular Adhesion Protein-1 (VAP-1) and Thrombospondin-1 (TSP-1) in patients with coexisting periodontitis and NAFLD.

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  • * An observational study analyzed 189 PVT patients from January 2018 to December 2022, finding a PC rate of 14.8%, with significant risk factors including the cause of thrombosis, a history of PVT, and the extent of portal obstruction.
  • * The study developed a composite score to predict the risk of PC, based on various factors, achieving good accuracy (AUC 0.822) with a sensitivity of 76
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  • Neuroendocrine tumors (CR-NETs) are rare in the gastrointestinal tract but can arise in various epithelial organs, prompting research into the roles of serum dopamine, serotonin, norepinephrine, and epinephrine in these tumors.
  • The study analyzed 25 CR-NET patients and 60 colorectal cancer patients, finding that CR-NET patients had higher serum dopamine levels, especially in early TNM stages, suggesting dopamine's potential as a prognostic marker.
  • Additionally, connections between serum dopamine, nutritional status (measured by the Prognostic Nutritional Index), and systemic inflammation indicate that these markers may assist in evaluating CR-NET patients' health and guiding treatment strategies.
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Background: The effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy remain relatively unknown.

Aim: We present this original paper where we analyzed 60 parturients, at term, 30 without associated infection (C-) and 30 with associated infection (C+), present at birth.

Methods: We analyzed the blood count and placental microscopic structure through classical and immunohistochemical staining and observed the placental areas affected by the presence of SARS-CoV-2.

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Contrast-enhanced ultrasound (CEUS) is widely used in the characterization of liver tumors; however, the evaluation of perfusion patterns using CEUS has a subjective character. This study aims to evaluate the accuracy of an automated method based on CEUS for classifying liver lesions and to compare its performance with that of two experienced clinicians. The system used for automatic classification is based on artificial intelligence (AI) algorithms.

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Background: In upper gastrointestinal bleeding (UGIB), admissions after normal working hours and during weekends may be associated with increased mortality.

Aim: To assess the evolution of the after-hours and weekend effects during the COVID-19 pandemic as a result of progressive improved management despite management challenges during the pandemic.

Methods: We performed an observational study of patients admitted for UGIB at a tertiary academic center between March 2020 and December 2021, compared to the corresponding timeframe before the pandemic.

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Recent advances in the field of ultrasonography offer promising tools for the evaluation of liver tumors. We aim to assess the value of multimodal ultrasound in differentiating hepatocellular carcinomas (HCCs) from other liver lesions. We prospectively included 66 patients with 72 liver tumors.

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Introduction: The neutrophil-lymphocyte ratio (NLR) has been suggested as a reliable marker for predicting inflammation progression and severity of acute pancreatitis, although the role of the NLR stratified by etiology is still insufficiently studied. However, the NLR's role in mortality prediction was poorly evaluated in the literature.

Patients And Methods: We performed a retrospective, cross-sectional study to analyze the role of NLR0 (at admission) and NLR48 (at 48 hours) in acute pancreatitis as compared with CRP, BISAP, SOFA, and modified CTSI (mCTSI) for the prediction of mortality and severe acute pancreatitis (SAP) in patients admitted into the Emergency Clinical County Hospital of Craiova during 48 months.

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Aim: This review aimed to assess the impact of coronavirus disease 2019 (COVID-19) on skin health to establish a classification of the skin lesions that occur most frequently during the disease and whether a particular category of skin damage is more likely to occur both in the short term and in the long term.

Methods: We conducted a literature search of the PubMed database. Ultimately, 109 articles were included in this review.

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Unlabelled: Upper gastrointestinal bleeding (UGIB) represents a major emergency, and patient management requires endoscopic assessment to ensure appropriate treatment. The impact of COVID-19 on patient mortality in UGIB may be related to the combination of respiratory failure and severe bleeding and indirectly to delayed admissions or a reduction in endoscopic procedures.

Methods: We conducted a retrospective study involving patients admitted between March 2020 and December 2021 with UGIB and confirmed.

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(1) Background: The assessment of mortality and rebleeding rate in upper gastrointestinal bleeding (UGIB) is essential, and several prognostic scores have been proposed. Some patients with UGIB did not undergo endoscopy, either because they refused the procedure, suffered from alcohol withdrawal symptoms or altered general status, or because the bleeding was severe enough to cause death before the endoscopy. The mortality risk in the subgroup of patients without endoscopy is poorly evaluated in the literature.

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Background: Non-endoscopic risk scores, Glasgow Blatchford (GBS) and admission Rockall (Rock), are limited by poor specificity. The aim of this study was to develop an Artificial Neural Network (ANN) for the non-endoscopic triage of nonvariceal upper gastrointestinal bleeding (NVUGIB), with mortality as a primary outcome.

Methods: Four machine learning algorithms, namely, Linear Discriminant Analysis (LDA), Quadratic Discriminant Analysis (QDA), logistic regression (LR), K-Nearest Neighbor (K-NN), were performed with GBS, Rock, Beylor Bleeding score (BBS), AIM65, and T-score.

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Introduction: During the last few years, a progressive higher proportion of patients have had upper gastrointestinal bleeding (UGIB) related to antithrombotic therapy. The introduction of direct oral anticoagulant (DOAC) and COVID-19 pandemic may change the incidence, mortality, and follow-up, especially in patients at high risk of bleeding.

Patients And Methods: We studied the use of anti-thrombotic therapy (AT) in patients with upper gastrointestinal bleeding for 5 years (January 2017-December 2021) including Covid-19 pandemic period (March 2020-December 2021).

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Tumor vascular perfusion pattern in gastric cancer (GC) may be an important prognostic factor with therapeutic implications. Non-invasive methods such as dynamic contrast harmonic imaging endoscopic ultrasound (CHI-EUS) may provide details about tumor perfusion and could also lay out another perspective for angiogenesis assessment. Methods: We included 34 patients with GC, adenocarcinoma, with CHI-EUS examinations that were performed before any treatment decision.

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Article Synopsis
  • Colorectal carcinoma is a significant cause of death, with 0.2-12% of resected colonic polyps found to contain cancer cells, prompting a retrospective study of 905 patients over 13 years.
  • Out of 2033 polyps removed, 122 had malignant cells, showing a correlation between larger polyp size (mean diameter of 23.44 mm) and malignancy, with specific polyps types and locations linked to higher risks.
  • Surgical intervention was performed in 18 cases, revealing a metastasis rate of 16.67%, while endoscopic resections had a lower rate of 1.61%; lymph node involvement was assessed for some surgical patients, indicating further complexity in
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Hepatic hemangioma is usually detected on a routine ultrasound examination because of silent clinical behaviour. The typical ultrasound appearance of hemangioma is easily recognizable and quickly guides the diagnosis without the need for further investigation. But there is also an entire spectrum of atypical and uncommon ultrasound features and our review comes to detail these particular aspects.

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Clinical utility of ancillary features (AFs) in contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) is yet to be established. In this study, we assessed the diagnostic yield of CEUS LI-RADS and AFs in hepatocellular carcinoma (HCC). We retrospectively included patients with risk factors for HCC and newly diagnosed focal liver lesions (FLL).

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infection (CDI) stands as the leading cause of nosocomial infection with high morbidity and mortality rates, causing a major burden on the healthcare system. Driven by antibiotics, it usually affects older patients with chronic disease or immunosuppressed or oncologic management. Variceal bleeding secondary to cirrhosis requires antibiotics to prevent bacterial translocation, and thus patients become susceptible to CDI.

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Unlabelled: Despite progresses made in oncology, pancreatic adenocarcinoma has a grim prognosis and commonly presents with rapidly advancing jaundice which requires endoscopic treatment.

Aim: Our objective was to show the perspective of a high ERCP volume dedicated Center on endoscopic stenting for malignant biliary obstruction consecutive to pancreatic cancer.

Methods: We conducted a retrospective study, between October 2017 and October 2020, and enrolled hospitalized patients within the Gastroenterology Department of the Clinical Emergency Hospital Bucharest, diagnosed with pancreatic cancer with secondary malignant biliary obstruction which underwent ERCP stenting.

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Renal metastases are uncommon in clinical practice, even as autopsy reports much frequent cases în disseminated tumors. Usually multiple and bilateral, they can determine many problems of differential diagnosis in case of solitary renal mass, when a primary kidney neoplasm must be excluded. Main sources are represented by the tumors of the lung, breast, digestive tract, melanomas and lymphomas, but rare cases with other etiology have been reported.

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Isolated esophageal ulcerations in Crohn's disease pose a great challenge in diagnosing and providing the correct treatment. We present the case of a 23-year-old woman with recurrent episodes of oral aphthosis, dysphagia, odynophagia and heartburn. Upper digestive endoscopy revealed an irregular mucosa with multiple ulcerations with irregular margins within the mid-esophagus.

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