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Open access

Anca Negovan, Septimiu Voidăzan, Monica Pantea, Valeriu Moldovan, Simona Bataga, Laurentiu Cozlea, Simona Mocan and Claudia Banescu

Abstract

Genetic factors may play a role in prediction of gastrointestinal side effects of aspirin, one of the most used drugs worldwide. We aim to determine a possible correlation between AGT A-20C (rs5050) gene polymorphism and gastro-duodenal ulcer in patients taking low-dose aspirin, adjusted for clinical and histological characteristics.

Results. We enrolled 211 patients stratified according to AGT A-20C genotype: 122 AA, 83 AC and 6 CC patients. There were no significant differences regarding demographical and clinical parameters, except for the frequency of ulcers (4%, 8.4% respective 50%, p=0.03), endoscopic bleeding signs (12.3%, 14.5% respective 50%, p=0.0001) and the frequency of gastritis in biopsy (63.9%, 54.2% respective 16.7%, p=0.03) in genotype groups. When we compared ulcer and non-ulcer group, variant homozygous CC genotype carried an increased risk for ulcer (OR:9.66, 95% CI: 1.46-63.7, p=0.04) than AA group, as well as variant C allele compared with normal A allele (OR: 2.12, 95% CI: 1.07-4.63, p=0.04). On multivariate analysis, variant homozygous CC genotype AGT A-20C showed an OR: 12.32 (95% CI:1.40 -108.13, p=0.02) for ulcer, while H. pylori infection (OR:2.40, 95% CI:1.18 -6.54, p=0.04) and concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR:1.31, 95% CI:1.07 - 2.27, p=0.05) remained predictors for ulcer in aspirin consumers.

Conclusions. Variant C allele and variant homozygous CC genotype AGT A-20C, infection with H. pylori and NSAIDs co-treatment are risk factors for gastro-duodenal ulcer in low-dose aspirin consumers. The variant homozygous CC genotype AGT A-20C patients treated with LDA are more prone to have reactive gastropathy and bleeding ulcers in a population with a high prevalence of H. pylori infection

Open access

Nina-Ioana Şincu, Lucia Carmen Chiriac, Marta Andrea Fodor, Andrea Incze and Simona Băţagă

Abstract

Background. Patients infected with human immunodeficiency virus (HIV), especially at advanced stages of HIV infection and low CD4+ T-lymphocytes levels, were reported to be less frequently co-infected with Helicobacter pylori than general population, according to literature data. Purpose: to study Helicobacter pylori infection in HIV-positive hosts with digestive complaints. Methods: retrospective, analytical, case-control study (November 2011 - December 2013), upon two groups of patients with gastro-intestinal symptoms tested for Helicobacter pylori stool antigen at the Infectious Diseases Laboratory, Clinical County Hospital Mureş. Group A included 44 HIV-positive patients, group B: 58 HIV-negative subjects. We first compared groups A and B regarding the frequency of Helicobacter pylori infection. Group A was afterwards divided into two sub-groups, according to the status of Helicobacter pylori infection: group A1: 5 Helicobacter pylori-positive subjects, group A2: 39 Helicobacter pylori-negative ones. We collected information regarding CD4+ T-lymphocytes level, HIV-RNA plasma viral load, previous antibiotic and antiretroviral therapy, co-morbidities, comparing A1 and A2 subgroups. Data were processed using GraphPad Prism 5 programme. Results. The frequency of Helicobacter pylori infection was 11.36% among HIV-positive patients and 13.79% in HIV-negative ones, without statistically significant difference. We found no statistically significant differences between subgroups A1 and A2 regarding CD4+ T-lymphocytes level, HIV-RNA plasma viral load, antibiotic / antiretroviral therapy. Conclusions. Though Helicobacter pylori infection may represent one of the causes of gastro-intestinal symptoms in HIV-positive patients, its frequency did not differ to that registered in the general population, in our study.

Open access

Cerghizan Anda, Keresztesi Arthur Atilla, Bataga Simona and Tilea Ioan

Abstract

The objective of this study was to find a link between the grade of left ventricular diastolic dysfunction (LVDD) and the progression to permanent non-valvular atrial fibrillation (AF), in a group of patients with left ventricular diastolic dysfunction and paroxysmal or persistent atrial fibrillation.

Methods: A bidirectional study on 57 patients meeting the inclusion criteria was conducted; each patient was admitted in a university-based hospital between January 1st - June, 30, 2013, with a follow up 3 and 6 months later. Permanent atrial fibrillation development was followed.

Results: Out of the 57 patients, 23 had paroxysmal AF and 34 were with persistent AF. After six months, 21 patients progressed to permanent AF, representing 36.84% of the total patients. Female patients with age over 65 had more often atrial fibrillation, but more men progressed to a sustained form of AF. No statistically significant difference regarding the grade of diastolic dysfunction, the left atrial size or volume, or the left ventricular ejection fraction was observed between the patients with progression, compared to those without progression.

Conclusions: The grade of left ventricular diastolic dysfunction did not prove to be a predictive factor for permanent atrial fibrillation, neither the left atrial size or volume, or the left ventricular ejection fraction.

Open access

DS Sîmpălean, Ghiga Dana, M Petrişor, M Măruşteri, V Bacârea and Băţagă Simona

Abstract

Introduction. The aim of the study was to evaluate the frequency of dental caries in adults patients with gastroesophageal reflux disease.

Material and method. A cross-sectional study was performed between November 2013 and October 2014. All subjects who agreed to participate to the study were asked to complete a questionnaire regarding personal information, oral hygiene and dental evaluation. The individuals with complete false teeth (superior and inferior removable prosthetic devices) were excluded from the study. The study included 134 people divided in two groups, based on upper gastrointestinal endoscopy: a group with gastroesophageal reflux disease (71), and a control group (63). Dental evaluation was performed by a dentist blind to the diagnosis of the subjects. Dental caries were evaluated by applying the decayed, missing, and filled teeth index (DMFT index). The statistical significance was defined as p<0.05.

Results. From 71 subjects included in GERD group, 33 (46.48%) were males and 38 females (53.52%) with a mean age of 44.99±11.19 (42, 59.15% from urban area and 29, 40.85%, from rural area). In the control group we included 28 (44.44%) males and 35 (55.56%) females (mean age 43.84±9.48) and 29 (46.03%) subjects were from urban area and 34 (53.97%) from rural area. DMFT index in GERD group was 19.49±4.28 and in control group 18.16±4.54 (p<0.05).

Conclusions. The present study showed that there is no difference between GERD and control group, regarding the frequency of dental caries.

Open access

Răzvan Opaschi, Simona Bățagă, Ioan Macarie, Imola Török, Anca Negovan, Monica Pantea, Marius Ciorba and Melania Macarie

Abstract

Background: Colon polyps are precursors of colorectal cancer (CRC), therefore their endoscopic detection is very important. A shift of in the localization of colorectal polyps toward the proximal colon has been recently observed in Western countries.

Aim: The aim of this paper was to establish the most important clinical and endoscopic aspects of right colon polyps and to correlate them with their histopathological types, with an emphasis on sessile serrated adenomas/polyps (SSA/Ps).

Material and method: We perfomed a retrospective study on a series of consecutive patients who underwent colonoscopy in the Gastroenterology and Endoscopy Unit of the County Emergency Clinical Hospital of Tîrgu Mureș between January 1, 2010 – December 31, 2014, comparing the results with those of patients who underwent colonoscopy between January 1, 2005 – December 31, 2009. In all cases with abnormal aspects at endoscopy, multiple biopsies were taken for histopathological examination. Only cases where the diagnosis of colon polyp was confirmed by the Histopathology Department were included in the study.

Results: In the 2010–2014 period there were 871 patients diagnosed with colon polyps (1,038 polyps), with a mean age of 62.28 years. The most frequent histopathological form was tubular adenoma in 55.97% of cases (n = 581). SSA/Ps were found in 66 patients (75 polyps). Considering all polyps, the most frequent localization was in the sigmoid colon in 32.36% of cases (n = 336), but for SSA/Ps the most common localization was the ascending colon in 24% of cases (n = 18), followed by the sigmoid colon in 21.33% of cases (n = 16). Compared with patients investigated between 2005 and 2009, we found an increasing localization in the right colon, from 10.43% (n = 67) in 2005–2009 to 15.41% (n = 160) in 2010–2014. SSA/Ps were found in the right colon in 5.97% of cases (n = 4) in the first period compared with 11.25% of cases (n = 18) in the second period.

Conclusions: In the last years we found an increasing localization of colon polyps in the right colon. These findings underscore the importance of high quality colonoscopy to maximize protection against colorectal cancer.

Open access

Cerghizan Anda-Mihaela, Băţagă Simona, L Cozlea, ID Tarţa, B Chibelean, Căldăraru Carmen and Dogaru G

Abstract

The aim of the current study was to find any possible associations between elements of metabolic syndrome and echocardiographic characteristics (grade of diastolic dysfunction) in normoponderal and overweight patients with heart failure with preserved ejection fraction.

A retrospective observational analytical study was performed on 130 patients presenting heart failure with documented ejection fraction over 50%. They were divided into two groups based on their body mass index. The first group included 56 normal weight patients and the second group included 74 overweight patients. Elements of the metabolic syndrome analysed in the current study were arterial hypertension, high triglyceride levels, low HDL-cholesterol and diabetes.

None of the components of metabolic syndrome alone had a role in the evolution of diastolic dysfunction in either group. Three or four elements present in obese patients were negatively associated with grade 2 diastolic dysfunction, high values of blood pressure (over 180/110 mmHg) were more often encountered in obese patients with first and second grade of diastolic dysfunction.