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Bridging the gap:Unveiling the crisis of physical inactivity in inflammatory bowel diseases

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World Journal of Gastroenterology 2024年第10期30卷 1261-1265页

作者： Remus Stafie ana-maria singeap Adrian Rotaru Carol Stanciu Anca Trifan Department of Gastroenterology Faculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700115Romania Institute of Gastroenterology and Hepatology “St.Spiridon”University HospitalIasi 700111Romania

In this editorial we comment on the article titled“Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The BE-FIT-IBD study”published in a recent issue of the World Journal of Gastroen-terology 2023;29(41):*** bowel diseases(IBD)are emerging as a significant global health concern as their incidence continues to rise on a global scale,with detrimental impacts on quality of *** many advances have been made regarding the management of the disease,physical inactivity in these patients represents an underexplored issue that may hold the key for further and better understanding the ramifications of *** pain,fatigue,and fear of exacerbating symptoms promotes physical inactivity among IBD patients,while the lack of clear guidelines on safe exercise regimens contributes to a norm of physical *** activity(PA)is accepted to have a positive effect on disease outcomes and quality of life,while inactivity exacerbates comorbidities like cardiovascular disease and mental health ***“BE-FIT-IBD”study,focusing on PA levels and barriers in IBD patients of Southern Italy,revealed that a significant proportion(42.9%)were physically *** lack of PA is attributed to barriers such as fear of flare-ups and misconceptions about exercise exacerbating the *** study also highlighted the need for better communication between healthcare providers and patients regarding the benefits of PA and safe incorporation into ***,physical inactivity may also contribute to disability in IBD patients,having a great impact on employment *** note is the fact that IBD also comes with an important psychological burden with relevant evidence suggesting that regular PA can improve mood,reduce anxiety,and enhance mental ***“BE-FIT-IBD”study advocated for the integration of PA into IBD management,emphasizing the bidirectional link between PA and *** exe

关键词： Inflammatory bowel disease Physical activity Disability Psychological burden Body composition Quality of life

Hepatocellular carcinoma after direct-acting antiviral hepatitis C virus therapy:A debate near the end

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World Journal of Gastroenterology 2020年第43期26卷 6770-6781页

作者： Cristina maria Muzica Carol Stanciu Laura Huiban ana-maria singeap Catalin Sfarti Sebastian Zenovia Camelia Cojocariu Anca Trifan Department of Gastroenterology Grigore T.Popa University of Medicine and PharmacySt.Spiridon Emergency HospitalIasi 700115Romania

Direct acting antivirals(DAAs)have revolutionized the treatment of hepatitis C virus(HCV)infection,achieving high rates(≥95%)of sustained virological response,with a good safety profile and high compliance ***,it had been expected that viral clearance will reduce morbidity and mortality rates,as well as the risk of hepatocellular carcinoma(HCC).However,since 2016,concerns have been raised over an unexpected high rate of HCC occurrence and recurrence after DAA therapy,which led to an avalanche of studies with contradictory *** aimed to review the most recent and relevant articles regarding the risk of HCC after DAA treatment and identify the associated risk factors.

关键词： Hepatocellular carcinoma Direct acting antivirals therapy Hepatitis C virus infection Sustained virological response Risk factors of hepatocellular carcinoma Review

Pseudomembranous colitis associated with a triple therapy for Helicobacter pylori eradication

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World Journal of Gastroenterology 2013年第42期19卷 7476-7479页

作者： Anca Trifan Irina Girleanu Camelia Cojocariu Catalin Sfarti ana maria singeap Carmen Dorobat Lucia Grigore Carol Stanciu "Gr. T. Popa" University of Medicine and Pharmacy 700111 IasiRomania Institute of Gastroenterology and Hepatology "St. Spiridon" Emergency Hospital700111 IasiRomania "St. Parascheva" Clinical Hospital of Infectious Diseases 700111 IasiRomania

Helicobacter pylori(***)is one of the most common chronic bacterial infections in humans,affecting half of world’s *** for *** infection has proven to be both effective and *** oneweek triple therapy including proton pump inhibitor,clarithromycin,and amoxicillin or metronidazole is still recommended as a first-line treatment to eradicate *** infection in countries with low clarithromycin ***,this therapy is well-tolerated,with only a few and usually minor side ***,rare but severe adverse effects such as pseudomembranous colitis have been reported,Clostridium difficile(***)infection being the main causative factor in all *** report the cases of two women who developed pseudomembranous colitis after a 1-wk triple therapy consisting of pantoprazole 20 mg bid,clarithromycin 500 mg bid,and amoxicillin 1 g bid to eradicate *** infection.A limited colonoscopy showed typical appearance of pseudomembranous colitis,and the stool test for *** toxins was *** resolution of symptoms and negative *** toxins were obtained in both patients with oral *** relapse occurred during a four and eleven-month,respectively,follow *** cases suggest that physicians should have a high index of suspicion for pseudomembranous colitis when evaluate patients with diarrhea following *** eradication therapy.

关键词： Helicobacter pylori eradication Triple therapy Clostridium difficile Pseudomembranous colitis Vancomycin

Role of ammonia in predicting the outcome of patients with acuteon- chronic liver failure

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World Journal of Clinical Cases 2021年第3期9卷 552-564页

作者： Stefan Chiriac Carol Stanciu Camelia Cojocariu ana-maria singeap Catalin Sfarti Tudor Cuciureanu Irina Girleanu Razvan Alexandru Igna Anca Trifan Department of Gastroenterology “Grigore T.Popa”University of Medicine and PharmacyIasi 700115Romania Institute of Gastroenterology and Hepatology "St.Spiridon"Emergency HospitalIasi 700111Romania Intensive Care “Grigore T.Popa”University of Medicine and PharmacyIasi 700115Romania

BACKGROUND High venous ammonia(VA)values have been proven to be a part of the mechanism of hepatic encephalopathy in patients with liver cirrhosis(LC)as well as acute ***,VA has been associated with poor prognosis and high mortality in these clinical ***,the role of ammonia in acuteon-chronic liver failure(ACLF)has not yet been clearly *** To assess the role of VA in predicting the outcome of cirrhotic patients with ACLF in a tertiary care *** We performed a retrospective observational study including consecutive patients with LC hospitalized for acute non-elective indications such as ascites,hepatic encephalopathy(HE),upper gastrointestinal bleeding,or bacterial infections that fulfilled the Asian Pacific Association for the Study of the Liver(APASL)criteria for *** study was conducted in“***”University Hospital,Iasi,Romania,a tertiary care center,between January 2017 and January *** APASL ACLF Research Consortium(AARC)score was calculated and ACLF grade was established ***-haven classification was used for *** analysis was performed using IBM SPSS version *** Four hundred and forty-six patients were included,aged 59(50-65)years,57.4%***-Pugh,model for end-stage liver disease(MELD)and AARC scores were 11(10-12),19.13±6.79,and 7(6-8),respectively.66.4%had ACLF grade I,31.2%ACLF grade II,and 2.5%ACLF grade *** was diagnosed in 83.9%,34%grade I,37.2%grade II,23.5%grade III,and 5.3%grade *** mortality was 7.8%.VA was 103(78-148)μmol/*** operating characteristic analysis showed good accuracy for the prediction of in-hospital mortality for the AARC score[Area under the curve(AUC)=0.886],MELD score(AUC=0.816),VA(AUC=0.812)and a fair accuracy for the Child-Pugh score(AUC=0.799).Subsequently,a cut-off value for the prediction of mortality was identified for VA(152.5μmol/L,sensitivity=0.706,1-specificity=0.190).Univariate analysis found acute kidney in

关键词： Venous ammonia Hepatic encephalopathy Acute-on-chronic liver failure Asian Pacific Association for the Study of the Liver Acute-on-chronic Liver Failure Research Consortium score Cirrhosis Mortality

Ulcerated intussuscepted jejunal lipoma-uncommon cause of obscure gastrointestinal bleeding: A case report

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World Journal of Clinical Cases 2019年第22期7卷 3765-3771页

作者： Tudor Cuciureanu Laura Huiban Stefan Chiriac ana-maria singeap Mihai Danciu Florin Mihai Carol Stanciu Anca Trifan Nutu Vlad Department of Gastroenterology “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency HospitalIasi 700115Romania Department of Pathology “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency HospitalIasi 700115Romania Department of Radiology “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency HospitalIasi 700115Romania Department of General Surgery “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency HospitalIasi 700115Romania

BACKGROUND Intestinal lipomas are rare benign gastrointestinal(GI)tumors,usually asymptomatic,but may become symptomatic as the result of some complications such as intussusception,intestinal obstruction,volvulus or *** can occur at any site along the entire GI tract,more frequent in colon and rarely in small *** patient reported here is a very rare case of jejunal lipoma,ulcerated and intussuscepted,diagnosed in an adult investigated for a chronic iron deficiency anemia(IDA),and successfully managed by segmental jejunal *** SUMMARY A 63-year-old male was referred to“***”Hospital,Institute of Gastroenterology and Hepatology,Iasi,to investigate an obscure GI bleeding with an *** upper GI endoscopy and colonoscopy were performed,excluding potentially bleeding lesions,videocapsule endoscopy was then carried out,revealing fresh blood and a protruding lesion in proximal jejunum,findings confirmed by a single-balloon *** biopsies were taken from the lesion,but histological results were ***,contrast-enhanced computed tomography was performed showing jejunal polypoid mass with homogenous fat density,suggestive for lipoma.A week later a laparotomy was performed revealing the intussuscepted jejunal segment which was resected enbloc,and sent for further histopathologic *** patient made an uneventful recovery and was discharged seven days later,and at six months follow-up he had no complains and his hemoglobin returned to normal *** Lipomas are very rarely located in the jejunum,usually asymptomatic,but they may lead to complications such as intussusception and *** resection remains the treatment of choice.

关键词： Lipoma Intussusception Computed tomography Video capsule endoscopy Gastrointestinal bleeding Case report

Did the severe acute respiratory syndrome-coronavirus 2 pandemic cause an endemic Clostridium difficile infection?

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World Journal of Clinical Cases 2021年第33期9卷 10180-10188页

作者： Camelia Cojocariu Irina Girleanu Anca Trifan Andrei Olteanu Cristina maria Muzica Laura Huiban Stefan Chiriac ana maria singeap Tudor Cuciureanu Catalin Sfarti Carol Stanciu Department of Gastroenterology “Grigore T.Popa”University of Medicine and Pharmacy“St.Spiridon”University HospitalInstitute of Gastroenterology and HepatologyIasi 700115Romania

BACKGROUND Clostridium difficile infection(CDI)has increased in prevalence during the last *** coronavirus disease 2019(COVID-19)pandemic has negatively influenced patient *** majority of the severe acute respiratory syndrome-coronavirus 2(SARS-CoV-2)-infected patients received antibiotics during *** To analyze the factors that influenced CDI development after SARS-CoV-2 *** Between March 2020 to December 2020,we performed a prospective observational study including 447 patients diagnosed with CDI who were admitted to our tertiary referral university *** diagnosis of CDI was based on the presence of diarrhea(≥3 watery stools within 24 h)associated with Clostridium difficile toxins A or *** excluded patients with other etiology of acute *** Among the total 447(12.5%)patients with CDI,most were male(54.3%)and mean age was 59.7±10.8 ***-six(17.0%)had history of COVID-19,most being elderly(COVID-19:62.6±14.6 years vs non-COVID-19:56.8±17.6 years,P=0.007),with history of alcohol consumption(43.4%vs 29.4%,P=0.017),previous hospitalizations(81.6%vs 54.9%,P<0.001)and antibiotic treatments(60.5%vs 35.5%,P<0.001),requiring higher doses of vancomycin and prone to recurrent disease(25.0%vs 13.1%,P=0.011).Age over 60 years[odds ratio(OR):2.591,95%confidence interval(CI):1.452-4.624,P=0.001],urban residence(OR:2.330,95%CI:1.286-4.221,P=0.005),previous antibiotic treatments(OR:1.909,95%CI:1.083-3.365,P=0.025),previous hospitalizations(OR:2.509,95%CI:1.263-4.986,P=0.009)and alcohol consumption(OR:2.550,95%CI:1.459-4.459,P=0.001)were risk factors of CDI in *** CDI risk is unrelated to history of SARS-CoV-2 ***,previous COVID-19 may necessitate higher doses of vancomycin for CDI.

关键词： COVID-19 infection Clostridium difficile infection Risk factors Antibiotic use Pandemic Recurrence

Capsule endoscopy:the road ahead

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World Journal of Gastroenterology 2016年第1期22卷 369-378页

作者： ana-maria singeap Carol Stanciu Anca Trifan Gastroenterology and Hepatology Institute “Gr.T.Popa”University of Medicine and Pharmacy“St.Spiridon”Emergency Hospital700111 IasiRomania Gastroenterology and Hepatology Institute “St.Spiridon”Emergency Hospital700111 IasiRomania

Since its introduction into clinical practice 15 years ago,capsule endoscopy(CE)has become the first-line investigation procedure in some small bowel pathologies,and more recently,dedicated esophageal and colon CE have expanded the fields of application to include the upper and lower gastrointestinal *** this time,CE has become increasingly popular among gastroenterologists,with more than 2 million capsule examinations performed worldwide,and nearly 3000Pub Med-listed studies on its different aspects *** huge interest in CE may be explained by its noninvasive nature,patient comfort,safety,and access to anatomical regions unattainable via conventional ***,CE has several limitations which impede its wider clinical applications,including the lack of therapeutic capabilities,inability to obtain biopsies and control its *** research groups are currently working to overcome these limitations,while novel devices able to control capsule movement,obtain high quality images,insufflate the gut lumen,perform chromoendoscopy,biopsy of suspect lesions,or even deliver targeted drugs directly to specific sites are under *** current limitations,especially as some of them have already been successfully surmounted,and based on the tremendous progress in technology,it is expected that,by the end of next 15years,CE able to perform both diagnostic and therapeutic procedures will remain the major form of digestive *** review summarizes the literature that prognosticates about the future developments of CE.

关键词： Capsule endoscopy Biopsy Drug deliverysystems Capsule endoscope locomotion Capsulelocalization

Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis

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World Journal of Gastroenterology 2017年第35期23卷 6500-6515页

作者： Anca Trifan Carol Stanciu Irina Girleanu Oana Cristina Stoica ana maria singeap Roxana Maxim Stefan Andrei Chiriac Alin Ciobica Lucian Boiculese Institute of Gastroenterology and Hepatology “St.Spiridon”Hospital“Grigore T.Popa”University of Medicine and Pharmacy Institute of Gastroenterology and Hepatology “St.Spiridon”Hospital Department of Research Faculty of Biology“Alexandru Ioan Cuza”University of Iasi Department of Preventive Medicine and Interdisciplinarity “Grigore.T.Popa”University of Medicine and Pharmacy

AIM To perform a systematic review and meta-analysis on proton pump inhibitors(PPIs) therapy and the risk of Clostridium difficile infection(CDI). METHODS We conducted a systematic search of MEDLINE/Pub Med and seven other databases through January 1990 to March 2017 for published studies that evaluated the association between PPIs and CDI. Adult case-control and cohort studies providing information on the association between PPI therapy and the development of CDI were included. Pooled odds ratios(ORs) estimates with 95% confidence intervals(CIs) were calculated using the random effect. Heterogeneity was assessed by I^2 test and Cochran's Q *** publication bias was evaluated via funnel plot, and quality of studies by the Newcastle-Otawa Quality Assessment Scale(NOS). RESULTS Fifty-six studies(40 case-control and 16 cohort) involving 356683 patients met the inclusion criteria and were analyzed. Both the overall pooled estimates and subgroup analyses showed increased risk for CDI despite substantial statistical heterogeneity among studies. Meta-analysis of all studies combined showed a significant association between PPI users and the risk of CDI(pooled OR = 1.99, CI: 1.73-2.30, P analyses: by design-case-control(OR = 2.00, CI: 1.68-2.38, P analyses(test for heterogeneity): P = 0.93 for case-control vs cohort, P = 0.85 for adjusted vs unadjusted, P = 0.24 for unicenter vs multicenter, P = 0.86 for age ≥ 65 years and < 65 years. There was significant hetero

关键词： Proton pump inhibitors Clostridium difficile infection Risk Systematic review Meta-analysis

Treatment of spinal cord injury with biomaterials and stem cell therapy in non-human primates and humans

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Neural Regeneration Research 2025年第2期20卷 343-353页

作者： ana Milena Silva Olaya Fernanda Martins Almeida ana maria Blanco Martinez Suelen Adriani Marques PhD Program in Pathological anatomy Federal University of Rio de JaneiroRio de JaneiroBrazil Biomedical Science Institute Federal University of Rio de JaneiroRio de JaneiroBrazil Graduate Program in Pathological anatomy Federal University of Rio de JaneiroRio de JaneiroBrazil Graduate Program in Pathological anatomy(PPGAP/UFRJ) Department of Neurobiology/Institute of BiologyCampus do GragoatáNiteróiRio de JaneiroBrazil

Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical ***,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord *** of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional *** the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in *** article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were ***,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.

关键词： bioengineering biomaterials cell therapy humans non-human primates spinal cord injury stem cell therapy