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Mateescu RB, Gheorghe C, Trifan AV, Saftoiu A, Seicean A, Diculescu MM, Banciu C, Gheorghe LS, Busuioc B, Goldis A, Dobru D, Fratila O, Eugen D, Bataga S, Constantinescu G, Gheonea D, Tantau A, Jinga M, Brisc C, Cijevschi Prelipcean C, Chira R, Fierbințeanu-Braticevici C, Dumitrascu D, State M, Voiosu T, Negreanu L. Safety, Efficacy and Persistence of Advanced Therapies in Inflammatory Bowel Disease: Results from ORIGINS. A Retrospective Observational Study. J Gastrointestin Liver Dis 2023; 32:444-451. [PMID: 38147607 DOI: 10.15403/jgld-5128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/21/2023] [Indexed: 12/28/2023] [Imported: 12/28/2023]
Abstract
BACKGROUND AND AIMS Real-world assessments of efficacy and safety of advanced therapies used for inflammatory bowel disease (IBD) patients are limited. We aimed to report safety, efficacy and treatment persistence of new molecules (infliximab, adalimumab, vedolizumab, tofacitinib, ustekinumab) in a retrospective multicentric national Romanian analysis. METHODS We conducted a nationwide, retrospective observational multicentric study. Data were collected retrospectively from electronic and paper files. Patients who started on one of the five investigated molecules during December 2019-December 2021 were included. The main outcome measures were clinical remission, endoscopic healing, persistence on treatment and safety data. RESULTS A total of 678 adult patients from 24 Romanian IBD centers with a diagnosis of ulcerative colitis or Crohn's disease were included. Participants had previously failure to one (268, 39.5%), two (108, 15%) or more treatment lines and only 38% (259) were biologic naïve. In the 24 months study period, most patients were started on vedolizumab (192, 28%), followed by adalimumab, infliximab, ustekinumab and tofacitinib. In biologic-naïve patients, most physicians (72%) preferred anti-TNF treatment as first line biologic (93 patients started on infliximab, 92 on adalimumab), followed by vedolizumab, ustekinumab and tofacitinib. During follow-up, 71% (470, p=0.05) of patients achieved clinical remission and 36% (134, p=0.03) achieved mucosal healing. The 6 months milestone for persistence was reached in 78% (530) of cases. Almost half of patients (47%, 316 patients) persisted on their current treatment for over 12 months. Overall, an adverse reaction was reported for 67 (10.4%) patients, with no lethal events. CONCLUSIONS Population of biologic-experienced IBD patients in Romania is increasing and is becoming more difficult to achieve long-term disease control. Discontinuation rates for advanced therapies are high.
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Affiliation(s)
| | - Cristian Gheorghe
- Gastroenterology and Hepatology Center, Fundeni Clinical Institute,Bucharest, Romania.
| | - Anca Victorita Trifan
- Gastroenterology Department, St. Spiridon Emergency Clinical County Hospital, Iasi, Romania.
| | - Adrian Saftoiu
- Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
| | - Andrada Seicean
- Gastroenterology Department, Prof. Dr. Octavian Fodor Gastroenterology Institute, Cluj-Napoca, Romania.
| | | | - Christian Banciu
- Gastroenterology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
| | | | - Bogdan Busuioc
- Gastroenterology Department, Ion Cantacuzino Clinical Hospital, Bucharest, Romania.
| | - Adrian Goldis
- Gastroenterology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
| | - Daniela Dobru
- Gastroenterology Department , University of Medicine , Science and Tehnology G.E.Palade Targu-Mures.
| | - Ovidiu Fratila
- Third Internal Medicine Department, University of Oradea, Romania.
| | - Dumitru Eugen
- Gastroenterology Department, Emergency Clinical County Hospital, Constanta, Romania.
| | - Simona Bataga
- Gastroenterology Department, Emergency Clinical County Hospital, Targu-Mures, Romania.
| | | | - Dan Gheonea
- Gastroenterology Department, University of Medicine and Pharmacy of Craiova.
| | - Alina Tantau
- Internal Medicine and Gastroenterology Department, Iuliu-Hatieganu University of Medicine and Pharmacy, Cluj- Napoca, Romania.
| | - Mariana Jinga
- Internal Medicine and Gastroenterology Department, Dr Carol Davila Central University Emergency Military Hospital, Bucharest, Romania.
| | - Ciprian Brisc
- Gastroenterology Department, Emergency Clinical County Hospital, Oradea, Romania.
| | | | - Romeo Chira
- Gastroenterology Department, Emergency Clinical County Hospital, Cluj-Napoca, Romania.
| | | | - Dan Dumitrascu
- Second Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.
| | - Monica State
- Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania.
| | - Theodor Voiosu
- Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania.
| | - Lucian Negreanu
- Gastroenterology Department, Emergency University Hospital Bucharest, Romania.
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Tantau AI, Filip VP, Pasca A, Tantau VM. Prevalence of hepatitis B and C virus infection in a Roma Population in Cluj County, Romania. J Gastrointestin Liver Dis 2023; 32:262-263. [PMID: 37345600 DOI: 10.15403/jgld-4931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 06/23/2023] [Imported: 08/29/2023]
Affiliation(s)
- Alina Ioana Tantau
- 4 th Medical Clinic, Gastroenterology Department, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Romania.
| | | | - Alexandru Pasca
- Epidemiology Department, Infectious Diseases Hospital, Cluj- Napoca, Romania.
| | - Vasile Marcel Tantau
- Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Romania.
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Tantau A, Zaharie T. EUS-guided fine needle biopsy for hepatocarcinoma of the right liver lobe as a rescue diagnostic technique after a negative percutaneousguided liver biopsy. Med Ultrason 2023; 25:115-116. [PMID: 36996398 DOI: 10.11152/mu-3993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023] [Imported: 08/29/2023]
Affiliation(s)
- Alina Tantau
- Gastroenterology Department, 4th Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Teodor Zaharie
- 3rd Medical Clinic, Histopathology Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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Tanţău A, Leucuţa DC, Tanţău M, Boţan E, Zaharie R, Mândruţiu A, Tomuleasa IC. Inflammation, Tumoral Markers and Interleukin-17, -10, and -6 Profiles in Pancreatic Adenocarcinoma and Chronic Pancreatitis. Dig Dis Sci 2021; 66:3427-3438. [PMID: 33184795 DOI: 10.1007/s10620-020-06700-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022] [Imported: 08/29/2023]
Abstract
BACKGROUND Interleukin profiles can be used as biochemical markers regarding the early diagnosis of pancreatic cancer. AIMS To assess CRP, CA 19-9, CEA levels, and interleukin-6, -10, and -17 profiles in pancreatic ductal adenocarcinoma, chronic pancreatitis was compared with a control group, and the correlation with pancreatic cancer survival. METHODS A total of 87 patients were prospective divided in pancreatic cancer (n = 53), chronic pancreatitis (n = 22) ,and control group (n = 12). The diagnosis of PDAC was made histologically. The diagnosis of chronic pancreatitis was based on medical history, imaging methods, and endoscopic ultrasound. Systemic concentrations of interleukins were measured using ELISA kits. The patients were followed at 1, 3, and 6 months. RESULTS CRP, CA 19-9, and CEA were higher in the pancreatic cancer group (p < 0.001). Interleukin-10 was significantly higher in the pancreatic cancer and chronic pancreatitis groups (p < 0.001). Interleukin-17 was statistically higher in the pancreatic cancer group (p < 0.0001). The cut-off of interleukin-17 of 0.273 had a sensitivity of 90.9 and a specificity of 80.9 with a curve under ROC of 0.80 in order to differentiate between pancreatic cancer and chronic pancreatitis. The serum levels of interleukins are not correlated with the stage of the disease. CRP, CA 19-9, CEA, and interleukin-6, -10, and -17 were lower in patients with survival more than 6 months. CONCLUSIONS We detected high levels of interleukin-6, -10, and -17 in chronic pancreatitis and pancreatic cancer. Serum interleukin-17 levels can discriminate between pancreatic cancer and chronic pancreatitis. The prognostic role of interleukins needs to be established.
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Affiliation(s)
- Alina Tanţău
- The 4th Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400015, Cluj-Napoca City, Cluj, Romania
- Department of Gastroenterology and Hepatology Medical Center, 400132, Cluj-Napoca City, Cluj, Romania
| | - Daniel-Corneliu Leucuţa
- Medical Informatics and Biostatistics Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012, Cluj-Napoca City, Cluj, Romania.
| | - Marcel Tanţău
- The 3rd Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012, Cluj-Napoca City, Cluj, Romania
- Department of Internal Medicine and Gastroenterology, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400158, Cluj-Napoca City, Cluj, Romania
| | - Emil Boţan
- Anatomopathology Department, "Regina Maria" Medical Center, 400117, Cluj-Napoca City, Cluj, Romania
| | - Roxana Zaharie
- The 3rd Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012, Cluj-Napoca City, Cluj, Romania
- Department of Internal Medicine and Gastroenterology, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400158, Cluj-Napoca City, Cluj, Romania
| | - Alina Mândruţiu
- Department of Gastroenterology and Hepatology Medical Center, 400132, Cluj-Napoca City, Cluj, Romania
| | - Ionuţ-Ciprian Tomuleasa
- Hematology Department, "Prof. Dr. Ion Chiricuţă" Institute of Oncology Cluj-Napoca, 400015, Cluj-Napoca City, Cluj, Romania
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Singeap AM, Girleanu I, Diculescu M, Gheorghe L, Ciocîrlan M, Gheorghe C, Costache A, Tanțău A, Zaharie R, Goldis A, Gheonea D, Dobru D, Dumitru E, Prelipcean CC, Gîlcă-Blanariu GE, Moscalu M, Stanciu C, Trifan A. Risk Factors for Extraintestinal Manifestations in Inflammatory Bowel Diseases - Data from the Romanian National Registry. J Gastrointestin Liver Dis 2021; 30:346-357. [PMID: 34375380 DOI: 10.15403/jgld-3818] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] [Imported: 08/29/2023]
Abstract
BACKGROUND AND AIMS Identifying the risk factors for extraintestinal manifestations (EIMs) in inflammatory bowel diseases (IBD) may optimize the therapeutic decision. We aimed to assess the prevalence of EIMs in IBD patients in Romania and to determine the risk factors. METHODS We analyzed 2,626 patients registered in the Romanian IBD Prospect National Registry. We performed a descriptive cross-sectional study to assess the point prevalence of EIMs, calculating global prevalence and analyzing the different types of EIMs and their respective frequencies were carried out. Demographic and clinical risk factors were researched as possible predictors for EIMs development, based on the results of the univariate and multivariate logistic regression analysis. RESULTS The overall point prevalence of EIMs was 16.3%. A significantly higher frequency of EIMs in Crohn's disease (CD) was noted in comparison to ulcerative colitis (UC) and IBD unclassified (IBDU) (23.2% vs 11.3% and 16.3%, respectively, p<0.001). The most frequent type of EIM was peripheral arthropathy (8.3%), significantly associated with CD (p<0.001). Univariate analysis highlighted the significant independent common predictive risk factors for EIMs, in both CD and UC patients: female gender, patient's urban area of origin, anemia, hypoalbuminemia, and high level of C-reactive protein (CRP), while significant independent IBD phenotype-related risk factors were ileocolonic location and concomitant involvement of upper gastrointestinal tract for CD, non-smoker status and both moderate and severe disease activity for UC (p<0.05). Multivariate analysis determined that female CD patients with moderate or severe disease activity, with other than isolated ileal disease, and female UC patients with moderate or severe extensive colitis are the most likely to develop EIMs. CONCLUSIONS IBD patients are experiencing EIMs in a large proportion, with higher rates for CD. As EIMs negatively affect patient outcomes, foreseeing the risk by identifying independent and associated predictive factors could be a first step to optimal work-up and treatment.
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Affiliation(s)
- Ana-Maria Singeap
- Grigore T. Popa UMF, Inst. of Gastroenterol. and Hepatol., Emergency County Hospital Saint Spiridon, Iasi, Romania. .
| | - Irina Girleanu
- Grigore T. Popa UMF, Inst. of Gastroenterol. and Hepatol., Emergency County Hospital Saint Spiridon, Iasi, Romania.
| | - Mircea Diculescu
- Carol Davila UMF, Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Inst., Bucharest, Romania.
| | - Liana Gheorghe
- Carol Davila UMF, Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Inst., Bucharest, Romania.
| | - Maria Ciocîrlan
- Carol Davila UMF, Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Inst., Bucharest, Romania.
| | - Cristian Gheorghe
- Carol Davila UMF, Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Inst., Bucharest, Romania.
| | - Adrian Costache
- Carol Davila UMF, Dr. I. Cantacuzino Clinical Hospital, Bucharest.
| | - Alina Tanțău
- Iuliu Hațieganu University of Medicine and Pharmacy, 4th Medical Clinic, Cluj- Napoca, Romania.
| | - Roxana Zaharie
- Iuliu Hatieganu University of Medicine and Pharmacy, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
| | - Adrian Goldis
- Victor Babeș University of Medicine and Pharmacy, Municipal Emergency Hospital, Department of Gastroenterology and Hepatology, Timișoara, Romania.
| | - Dan Gheonea
- University of Medicine and Pharmacy, Craiova, Research Center of Gastroenterology and Hepatology, Craiova, Romania.
| | - Daniela Dobru
- University of Medicine and Pharmacy, Tg Mures, Emergency County Hospital, Department of Gastroenterology, Târgu-Mureș, Romania.
| | - Eugen Dumitru
- Faculty of Medicine, Ovidius University of Constanța, Emergency County Hospital, Department of Gastroenterology, Constanta, Romania.
| | | | | | - Mihaela Moscalu
- Department of Preventive Medicine and Interdisciplinarity, Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania.
| | - Carol Stanciu
- Grigore T. Popa UMF, Inst. of Gastroenterol. and Hepatol., Emergency County Hospital Saint Spiridon, Iasi, Romania.
| | - Anca Trifan
- Grigore T. Popa UMF, Inst. of Gastroenterol. and Hepatol., Emergency County Hospital Saint Spiridon, Iasi, Romania.
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Tantau AI, Mandrutiu A, Pop A, Zaharie RD, Crisan D, Preda CM, Tantau M, Mercea V. Extrahepatic cholangiocarcinoma: Current status of endoscopic approach and additional therapies. World J Hepatol 2021; 13:166-186. [PMID: 33708349 PMCID: PMC7934015 DOI: 10.4254/wjh.v13.i2.166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/02/2020] [Accepted: 12/13/2020] [Indexed: 02/06/2023] [Imported: 08/29/2023] Open
Abstract
The prognosis of patients with advanced or unresectable extrahepatic cholangiocarcinoma is poor. More than 50% of patients with jaundice are inoperable at the time of first diagnosis. Endoscopic treatment in patients with obstructive jaundice ensures bile duct drainage in preoperative or palliative settings. Relief of symptoms (pain, pruritus, jaundice) and improvement in quality of life are the aims of palliative therapy. Stent implantation by endoscopic retrograde cholangiopancreatography is generally preferred for long-term palliation. There is a vast variety of plastic and metal stents, covered or uncovered. The stent choice depends on the expected length of survival, quality of life, costs and physician expertise. This review will provide the framework for the endoscopic minimally invasive therapy in extrahepatic cholangiocarcinoma. Moreover, additional therapies, such as brachytherapy, photodynamic therapy, radiofrequency ablation, chemotherapy, molecular-targeted therapy and/or immunotherapy by the endoscopic approach, are the nonsurgical methods associated with survival improvement rate and/or local symptom palliation.
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Affiliation(s)
- Alina Ioana Tantau
- Department of Internal Medicine and Gastroenterology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 4 Medical Clinic, Cluj-Napoca 400012, Cluj, Romania
| | - Alina Mandrutiu
- Department of Gastroenterology and Hepatology, Gastroenterology and Hepatology Medical Center, Cluj-Napoca 400132, Cluj, Romania
| | - Anamaria Pop
- Department of Gastroenterology and Hepatology, Gastroenterology and Hepatology Medical Center, Cluj-Napoca 400132, Cluj, Romania
| | - Roxana Delia Zaharie
- Department of Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400162, Cluj, Romania
- Department of Gastroenterology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca 400012, Cluj, Romania.
| | - Dana Crisan
- Internal Medicine Department, Cluj-Napoca Internal Medicine Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 5 Medical Clinic, Cluj-Napoca 400012, Cluj, Romania
| | - Carmen Monica Preda
- Department of Gastroenterology and Hepatology, Clinic Fundeni Institute, “Carol Davila” University of Medicine and Pharmacy, Bucharest 22328, Romania
| | - Marcel Tantau
- Department of Internal Medicine and Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400162, Cluj, Romania
- Department of Internal Medicine and Gastroenterology, “Iuliu Hatieganu“ University of Medicine and Pharmacy, Cluj-Napoca 400012, Cluj, Romania
| | - Voicu Mercea
- Department of Internal Medicine and Gastroenterology, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400162, Cluj, Romania
- Department of Internal Medicine and Gastroenterology, “Iuliu Hatieganu“ University of Medicine and Pharmacy, Cluj-Napoca 400012, Cluj, Romania
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Pop A, Tantau A, Tefas C, Groza A, Tantau M. Flexible Endoscopic Treatment for Zenker’s Diverticulum – Experience on 31 Patients. JGLD 2018; 27:227-231. [DOI: 10.15403/jgld.2014.1121.273.zen] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] [Imported: 08/29/2023]
Abstract
Background & Aims: The aim of this study is to present the experience of our center over the last 8 years in a series of patients with Zenker’s diverticulum (ZD), treated using an endoscopic, minimally invasive procedure.
Methods: We retrospectively included 31 patients with a previously established diagnosis of ZD based on endoscopic and oral contrast examinations. Patients’ age, comorbidities, size of the diverticulum or previous endoscopic treatment were not considered exclusion criteria. A soft, flexible diverticuloscope to expose the septum and a dual knife for “cutting” the diverticular septum were used. We analyzed the short term efficacy based on symptomatic relief and occurrence of side effects, and long term efficiency at 6 and 12 months by clinical assessment, upper gastrointestinal endoscopy and oral contrast media passage.
Results: Patients had a mean age of 67 years (range 42-86); 55% of them were male. All patients reported symptom relief after the procedure. A decrease of more than 70% from the initial size of the diverticulum was noted. There were 3 cases (9.67%) of intraprocedural hemorrhage, endoscopically managed. No serious post-procedural complications and no mortality were reported. The mean procedural time was 21.87 minutes (range 15-25 minutes). Average hospitalization was 2.5 days. Five patients developed recurrence and needed a second session of endoscopic treatment for achieving complete myotomy.
Conclusions: Endoscopic management for ZD was efficient and safe in our series of patients. A short hospitalization period was required.
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Tantau A, Mandrutiu A, Leucuta DC, Ciobanu L, Tantau M. Prognostic factors of response to endoscopic treatment in painful chronic pancreatitis. World J Gastroenterol 2017; 23:6884-6893. [PMID: 29085231 PMCID: PMC5645621 DOI: 10.3748/wjg.v23.i37.6884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/13/2017] [Accepted: 09/05/2017] [Indexed: 02/06/2023] [Imported: 08/29/2023] Open
Abstract
AIM To evaluate the endoscopic treatment efficacy and prognostic factors of long-term response to treatment for painful chronic pancreatitis.
METHODS This retrospective analysis identified 168 patients with painful chronic pancreatitis hospitalized during January 2010-January 2015 in a Romanian tertiary referral center. Data on demographics, medical history, alcohol consumption, smoking habit, clinical parameters, type and number of endoscopic procedures and hospital admissions number were collected from the medical charts and analyzed. The absence or substantial reduction of pain (mild pain) at the end of the follow-up associated with the technical success of endotherapy was considered as clinical success.
RESULTS Among the 168 patients with painful chronic pancreatitis admitted to our department during the study period, 39 (23.21%) had optimal response to the medical therapy. One hundred and twenty-nine patients required endoscopic treatment. The median follow-up period was 15 mo (range, 0-60 mo). Overall, technical success of endotherapy was achieved in 105 patients (81.39%). More than two-thirds of patients (82.78%) had substantial improvement of pain after the endoscopic treatment, including frequency and severity of the pain attacks. Patients younger than 40 years had significantly more successful endoscopic procedures (P = 0.041). Clinical success was higher in non-smoking patients (P = 0.003). The hospital admission rate was higher in patients with recognized alcohol consumption (P = 0.03) and in smokers (P = 0.027). The number and location of pancreatic stones and locations of strictures did not significantly influence the technical success (P > 0.05) or the clinical success (P > 0.05).
CONCLUSION Younger age than 40 years can be considered an important factor positively influencing endoscopic treatment outcome in patients with painful chronic pancreatitis.
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Affiliation(s)
- Alina Tantau
- Department of Internal Medicine and Gastroenterology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca City, 400012 Cluj, Romania
- Department of Internal Medicine and Gastroenterology, 4th Medical Clinic, Cluj-Napoca City, 400015 Cluj, Romania
| | - Alina Mandrutiu
- Department of Gastroenterology, Gastroenterology and Hepatology Medical Center, Cluj-Napoca City, 400132 Cluj, Romania
| | - Daniel-Corneliu Leucuta
- Medical Informatics and Biostatistics Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca City, 400012 Cluj, Romania
| | - Lidia Ciobanu
- Department of Internal Medicine and Gastroenterology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca City, 400012 Cluj, Romania
- Department of Internal Medicine and Gastroenterology, “Prof. Dr. Octavian Fodor“ Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca City, 400158 Cluj, Romania
| | - Marcel Tantau
- Department of Internal Medicine and Gastroenterology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca City, 400012 Cluj, Romania
- Department of Internal Medicine and Gastroenterology, “Prof. Dr. Octavian Fodor“ Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca City, 400158 Cluj, Romania
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Abstract
Familial amyloidosis is a rare type of amyloidosis, difficult to diagnose. We present the case of a woman with chronic heart failure. Low ejection fraction and concentric left ventricle hypertrophy with granular sparkling were seen by echocardiography and cardiac magnetic resonance imaging. Based on myocardial biopsy and genetic tests, the diagnosis of transthyretin familial amyloidosis, secondary to the Glu54Gln gene mutation, was made. The presentation contains the diagnostic algorithm used in the case of our patient, including clinical, biochemical, imaging, histological and genetic examinations, for the purpose of a complete diagnosis.
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Affiliation(s)
- Alina Tantau
- 4th Medical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. E-mail:
| | | | - Angela Cozma
- 4th Medical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dorel Sampelean
- 4th Medical Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
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