33 results match your criteria: ""Prof. Dr. O. Fodor" Regional Institute of Gastroenterology and Hepatology[Affiliation]"

This review addresses the peri-procedural bleeding risks in patients with cirrhosis, emphasizing the need for careful coagulation assessment and targeted correction strategies. Liver disease presents a unique hemostatic challenge, where traditional coagulation tests may not accurately predict bleeding risk, complicating the management of procedures like paracentesis, endoscopic therapy, and various interventional procedures. As such, this paper aims to provide a comprehensive analysis of current data, guidelines, and practices for managing coagulation in cirrhotic patients, with a focus on minimizing bleeding risk while avoiding unnecessary correction with blood products.

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(1) Background: Cirrhosis is associated with frequent alterations in standard coagulation tests that do not adequately reflect hemostasis. Thromboelastography provides a global assessment of coagulation and evaluates the functional status of clotting factors, fibrinogen, platelets, and fibrinolysis. The study aimed to assess whether liver disease severity leads to progressive alterations in the thromboelastography-based assessment of coagulation.

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Impact of Sarcopenia on Treatment Outcomes and Toxicity in Locally Advanced Rectal Cancer.

Medicina (Kaunas)

October 2024

Department of Oncological Surgery and Gynecological Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania.

Article Synopsis
  • Sarcopenia, characterized by muscle mass loss, is found in up to 68% of rectal cancer patients and negatively affects survival and tumor response, although research on its impact in locally advanced rectal cancer (LARC) is limited.
  • A study at the Prof. Dr. Ion Chiricuta Institute of Oncology examined 50 LARC patients who underwent total neoadjuvant treatment (TNT), assessing muscle mass via MRI before and after therapy.
  • The findings showed that a lower overall complete response rate (oCR) of 18% was significantly tied to post-treatment sarcopenia, and patients who experienced muscle loss during therapy had worse clinical outcomes and higher instances of cystitis and thrombocytopenia.
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Background And Aim: Infections caused by pathogenic bacteria increase patient morbidity and mortality and significantly raise treatment costs. The use of silver nanoparticles as an alternative treatment for and indicates their antibacterial effect and prompts medical research to consider the next generation of antibacterial drugs that could change antibiotic therapy. By combining silver nanoparticles with different classes of antibiotics, the antibacterial effect is evidenced by increased values of the inhibition zone compared to the values obtained for some antibiotics commonly used in the treatment of bacterial infections.

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Alcohol-associated hepatitis (AH) is the most severe form of alcohol-related liver disease. The natural course of alcohol-related liver disease is influenced by heavy alcohol consumption and abstinence periods. Differentiating between AH and decompensated cirrhosis (DC) could be extremely challenging in clinical practice due to clinical and bioclinical similarities.

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The Staging of Newly Diagnosed Hepatocellular Carcinoma in Romania. A National Multicentric Study.

J Gastrointestin Liver Dis

June 2024

Dept. of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Dept. of Gastroenterology, Prof. Dr. O. Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.

Background And Aims: Hepatocellular carcinoma (HCC) is a significant public health issue, with an increasing incidence and prevalence and a high incidence-to-mortality ratio. The prognosis of HCC depends on two competing factors, tumor burden and underlying liver disease severity, encompassed in the Barcelona Clinic Liver Cancer (BCLC) classification. To assess HCC staging and the way staging affects eligibility for treatment at the time of the first diagnosis in Romania in the setting of opportunistic diagnosis, in the absence of a national HCC screening policy.

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An international multidisciplinary consensus on pediatric metabolic dysfunction-associated fatty liver disease.

Med

July 2024

MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Institute of Hepatology, Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China. Electronic address:

Article Synopsis
  • Non-alcoholic fatty liver disease (NAFLD), now often referred to as metabolic dysfunction-associated fatty liver disease (MAFLD), is prevalent among children and teens with obesity and is linked to metabolic syndrome factors like insulin resistance.
  • A consensus of 65 international experts was reached through surveys to create recommendations covering various aspects of pediatric MAFLD, including its causes, epidemiology, and treatment strategies.
  • The final consensus aims to enhance clinical outcomes and life quality for affected youth, highlighting the importance of standardized diagnosis and treatment methods.
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Article Synopsis
  • The Roma, Europe's largest ethnic minority, face significant health challenges, leading to higher rates of metabolic syndrome and related diseases due to factors like poverty and poor living conditions.
  • Over a 36-month study in rural Romanian Roma communities, researchers assessed 343 participants, revealing alarming health statistics, including 32.2% obesity, 54.1% hypertension, and 28.9% prevalence of type 2 diabetes.
  • The findings highlight a shift from infectious to metabolic diseases in these communities, stressing the need for targeted public health strategies to address their specific health disparities and improve access to healthcare.
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Hepatocellular Carcinoma (HCC) is a pressing health concern, demanding a deep understanding of various mediators' roles in its development for therapeutic progress. Notably, interleukin-6 (IL-6) has taken center stage in investigations due to its intricate and context-dependent functions. This review delves into the dual nature of IL-6 in HCC, exploring its seemingly contradictory roles as both a promoter and an inhibitor of disease progression.

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TIPS with a Twist - The Real Life Management of a Case of Budd-Chiari-related Acute Liver and Subsequent Multiple Organ Failure.

Curr Med Imaging

September 2023

Faculty of Medicine, "Iuliu Hațieganu" Universirty of Medicine and Pharmacy, Cluj-Napoca, Romania.

Introduction: Budd-Chari syndrome (BCS) is a rare condition defined by the obstruction of hepatic venous outflow. BCS is a relatively infrequent cause of acute liver failure (ALF), accounting for less than 1% of cases. Treatment for acute BCS consists of a stepwise approach, requiring anticoagulation, angioplasty, transjugular intrahepatic portosystemic shunt (TIPS), and liver transplantation.

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Healthcare-associated pneumonia (HCAP) is a common nosocomial infection with high morbidity and mortality. Culture-based detection of the etiologic agent and drug susceptibility is time-consuming, potentially leading to the inadequate use of broad-spectrum empirical antibiotic regimens. The aim was to evaluate the diagnostic capabilities of rapid point-of-care multiplex polymerase chain reaction (PCR) assays from the endotracheal aspirate of critically ill patients with HCAP.

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The field of hepatocellular carcinoma (HCC) has faced significant change on multiple levels in the past few years. The increasing emphasis on the various HCC phenotypes and the emergence of novel, specific therapies have slowly paved the way for a personalized approach to primary liver cancer. In this light, the role of percutaneous liver biopsy of focal lesions has shifted from a purely confirmatory method to a technique capable of providing an in-depth characterization of any nodule.

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Background: The objective of our study is to develop an effective training platform for transanal endoscopic surgery and to validate a step-by-step training program for learning the basic skills necessary for this approach.

Methods: We have designed a two-part study: an experimental study (with the aim to design the training platform and the training exercises - on synthetic and biological material) and a prospective analytical study, in order to validate the training program by enrolling as participants general surgery residents and specialists, without previous experience in transanal endoscopic interventions. The performance of the participants was assessed based on the time of completion, as well as the quality of the execution.

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Article Synopsis
  • Recent developments in computer-aided diagnosis aim to provide a noninvasive and accurate detection method for HCC using medical imaging techniques.
  • A study combined advanced texture analysis and deep learning methods, achieving an impressive accuracy of over 98% in detecting HCC from B-mode ultrasound images, surpassing previous benchmarks.
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The prognoses of patients experiencing a prolonged stay in the intensive care unit (ICU) are often significantly altered by hospital-acquired infections (HAIs), the early detection of which might be cumbersome. The aim of this study was to investigate the roles of the neutrophil-to-lymphocyte (NLR), derived-NRL (d-NLR), platelet-to-lymphocyte (PLR), and lymphocyte-to-C-reactive protein (LCR) ratios in predicting the progression to septic shock and death. : A retrospective analysis of a consecutive series of ninety COVID-19 patients with prolonged hospitalization (exceeding 15 days) admitted to the ICU was conducted.

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Emergency pancreaticoduodenectomy for non-traumatic indications-a systematic review.

Langenbecks Arch Surg

December 2022

Depatment of Surgery, Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca-Napoca, Romania. Street Emil Isac no 13, 400023, Cluj-Napoca-Napoca, Romania.

Purpose: Emergency pancreaticoduodenectomy (EPD) is an uncommon surgical procedure; usually, it is performed in traumatic cases, with non-traumatic indications being very rare. Our review aimed to offer a comprehensive descriptive overview of the characteristics of EPD in non-traumatic settings.

Methods: Our study is a review of individual participant data.

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Background: The educational process of young doctors should be a topic of high interest, since it is central to preparing the new generations of healthcare providers. The COVID-19 pandemic has affected the medical system on multiple levels, including medical education.

Methods: We conducted a descriptive survey study, designed to reflect the impact of the pandemic on the training of general surgery residents.

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Background: Bile duct injuries (BDI) are the most feared complications that can occur after laparoscopic cholecystectomy (LC). BDI have a high variability and complexity, several classifications being developed along the years in order to correctly assess and divide BDI. The EAES ATOM classification encompasses all the important details of a BDI: A (for anatomy), To (for time of), and M (for mechanism) but have not gained universal acceptance yet.

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Background: Malnutrition predicts a worse outcome for critically ill patients. However, quick, easy-to-use nutritional risk assessment tools have not been adequately validated.

Aims And Methods: The study aimed to evaluate the role of four biological nutritional risk assessment instruments (the Prognostic Nutritional Index-PNI, the Controlling Nutritional Status Score-CONUT, the Nutrition Risk in Critically Ill-NUTRIC, and the modified NUTRIC-mNUTRIC), along with CT-derived fat tissue and muscle mass measurements in predicting in-hospital mortality in a consecutive series of 90 patients hospitalized in the intensive care unit for COVID-19-associated ARDS.

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(1) Background: Emergency pancreatoduodenectomy (EPD) is a rare procedure, especially in non-trauma centers. Pancreatoduodenectomy is a challenging intervention, that has even higher risks in emergency settings. However, EPD can be a life-saving procedure in selected cases.

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Background: Pancreatic cancer is an aggressive malignancy, surgery being the only potentially curative treatment. The systemic inflammatory response is an important factor in the development of cancer. There is still controversy regarding its role in pancreatic cancer.

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Wound healing is a complex process that is mediated and influenced by several cytokines, chemokines, and growth factors. Interleukin-22 (IL-22) is a cytokine that plays a critical role in tissue regeneration. Our study is a systematic review that addressed the implications of IL-22 in the healing of wounds caused by external factors.

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Artificial intelligence (AI), including machine learning (ML), is being slowly incorporated in medical practice, to provide a more precise and personalized approach. Pancreatic surgery is an evolving field, which offers the only curative option for patients with pancreatic cancer. Increasing amounts of data are available in medicine: AI and ML can help incorporate large amounts of information in clinical practice.

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Recent advances in the development of biomaterials have given rise to new options for surgery. New-generation medical devices can control chemical breakdown and resorption, prevent post-operative adhesion, and stimulate tissue regeneration. For the fabrication of medical devices, numerous biomaterials can be employed, including non-degradable biomaterials (silicone, polypropylene, expanded polytetrafluoroethylene) or biodegradable polymers, including implants and three-dimensional scaffolds for tissue engineering, which require particular physicochemical and biological properties.

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The use of contrast-enhanced ultrasonography (CEUS) has recently become synonymous with high-standard ultrasonography (US). From expanding the reach of US diagnostics to improving the precision of various invasive procedures, CEUS is rapidly becoming a standard in numerous niches. However, proficiency in CEUS comes with a cost, both from a learning curve and material standpoint, and as every growing field, lacks firm evidence and standardization.

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