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The Relationship between Hepatic Steatosis, inflammation and insulin Resistance in type 2 Diabetes with Metabolic Imbalance

. Diabetes Care, 2004; 27(6):1487-1495. DOI: 10.2337/diacare.27.6.1487 10. “Fatty Liver Index - Mdcalc”. Mdcalc.Com, Available from: (accessed at 28 December 2018) 11. “Hepatic Steatosis Index (HSI) Calculator”. Available from: (accessed at 28 December 2018) 12. “Non-Alcoholic Fatty Liver Disease - Liver Fat Score (NAFLD-LFS) Calculator”. Available from:

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Family Quality of Life Among Families with a Member Diagnosed with CLD – What to Expect?


Background and objectives. Health-related quality of life (HRQoL) is a very important outcome in patients with chronic liver disease. Thus, the present study attempts to assess the family quality of life of these patients, since it is well known that families have always represented the primary environment of most people.

Matherial and methods. A sample of 30 participants with a family member who had CLD were recruited to be interviewed through the Romanian adaptation of the Family Quality of Life Survey – general version 2006 (FQOLS-2006), an evaluation tool developed in Canada with the purpose of studying families’ quality of life among. Primary caregivers completed the FQOL Survey. The data was analysed to describe population characteristics and to explore the relationship between the main domains and dimensions of QoL and the patients and caregivers characteristics.

Results. The findings showed highest domain scores for Support from services and Family relationships and lowest for Support from others. Dimension scores were highest for Importance and lowest for Stability. Overall FQOL approximated average (78.5±13.4). Younger patients scored lower rates of FQOL domains. Alcohol-related liver disease led to lower rates of all the domains, except from Support from others and Leisure and Recreation activities. Patients with liver cirrhosis or liver cancer negatively influence their caregiver’s success in career. Also, families of liver cirrhosis patients reported the lowest level of satisfaction among all respondents.

Conclusions. The results of this study suggest that there are some significant areas of family life highly influenced by a chronic liver disease diagnosis in one of their members.

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A Rare Cause of Chronic Hepatitis: Celiac Disease


Introduction. Celiac disease is a chronic bowel disease with a prevalence of 1% in the general population. This condition, immune-mediated, may exhibit multiple extra-intestinal changes, including the liver.

Case presentation. We present the case of a 43-year-old patient presenting in our clinic for fatigue, associated with cytolytic and cholestatic hepatic syndrome with an onset of 10 years. During this time, the patient performed multiple investigations with the exclusion of viral, autoimmune etiology, primitive biliary cirrhosis and Wilson's disease. An abdominal ultrasound recorded an elongated, with an infundibular septum gallbladder. Abdominal computer tomography did not detect any changes. The final diagnosis is chronic alithiasic cholecystitis receiving hepatoprotective treatment with symptom relief and improved hepatic disorders. Over the past 2 years, the patient was diagnosed with osteoporosis (T score = -2.7 followed by treatment with Calcium and Vitamin D and improvement in T score to -2.1), and an iron deficiency anemia corrected with oral iron treatment. Upon resuming the anamnesis, we notice the presence of an intermittent bloating associated with diarrhea. Positive anti-transglutaminase antibodies required upper endoscopy with biopsy witch confirmed celiac disease.

Conclusion. Despite the rather low prevalence of celiac disease in the etiology of hepatocytolysis, it is important to investigate its presence in the context of hepatic changes with uncertain etiology. This case motivates us to be rigorous in looking for secondary causes of hepatic impairment even in patients with apparently benign changes.

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Comparative Analysis Between the Basdai and Mini-Basdai Indices in Patients with Ankylosing Spondylitis


Objectives. The aim of this paper is to compare the degree of accuracy between the BASDAI and mini-BASDAI indices in assessing the activity of ankylosing spondylitis (AS), especially in patients without peripheral manifestations.

Materials and method. Our cross-sectional study consisted of a group of 124 patients with AS, according to the modified New York criteria. All patients offered their informed consent. All the individual characteristics of the patients were documented, both demographic and disease-related. The activity of the disease was measured using the BASDAI questionnaire, from which we calculated the mini-BASDAI by eliminating the questions about peripheral arthritis and entesitis. The functional impairment of mobility in the spine and sacro-iliac joints was measured by the Schober index, lateral spinal flexion, occiput-wall, menton-sternum and finger-ground index.

Results. The mean age of the patients was 43.43 +/− 13.27 years, mean height 174.3 +/− 8.46 cm, weight 78.23 +/− 14.19 kg, duration of disease in years 15.06 +/− 9.19 and number of years from initiation of biological therapy 6.42 +/− 3.08. The BASDAI score was 1.26 +/− 1.93, while the mini-BASDAI score was 1.51 +/− 2.08. In the group of patients without peripheral manifestations, both BASDAI and mini-BASDAI correlated significantly with the occiput-wall index, besides ESR, CRP, ASDAS-CRP and the Schober index.

Conclusion. Mini-BASDAI is not superior to BASDAI in evaluating patients with ankylosing spondylitis without peripheral manifestations, but it has shown a better correlation in addition to BASDAI with the indices of flexion of the cervico-dorsal spine.

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Clinical Ankle Involvement and Ultrasound Synovial Hypertrophy are Significant Predictors of DAS28-Defined Rheumatoid Arthritis Disease Activity

References 1. Prevoo ML, van ‘t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38(1):44-8. 2. Yano K, Ikari K, Inoue E, Sakuma Y, Mochizuki T, Koenuma N, et al. Features of patients with rheumatoid arthritis whose debut joint is a foot or ankle joint: A 5,479-case study from the IORRA cohort. PLoS One. 2018;13(9):e0202427. 3. van Tuyl

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Prevalence of Metabolic Syndrome and of Cardiovascular Risk Factors

the growing epidemic and its associated pathologies. Obes Rev. 2015;16(1):1-12. 4. Wang H, Sun Y, Yi X, Zhang L. Evaluation of the Framingham risk score and pooled cohort risk equation for prediction of cardiovascular risk in low resource areas: Insights from Asian rural population. Int J Cardiol. 2018;265:237. 5. Fonseca FAH, Izar MCO. Prevalence of Metabolic Syndrome and Framingham Risk Score in Vegetarian and Omnivorous Apparently Healthy Men. Arq Bras Cardiol. 2018;110(5):438-439. 6. Vanavanan S, Srisawasdi P, Rochanawutanon M, Kumproa N

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NGAL – Urinary Biomarker With Pathologic Significance in Nephrology Practice

gelatinase-associated lipocalin (CSA-NGAL) score: A potential tool to monitor acute tubular damage J Thorac Cardiovasc Surg. 2016 Jun;151(6):1476-81. doi: 10.1016/j.jtcvs.2016.01.037. Epub 2016 Feb 12. 18. Dent C et all Plasma neutrophil gelatinase-associated lipocalin predicts acute kidney injury, morbidity and mortality after pediatric cardiac surgery: a prospective uncontrolled cohort study Crit Care. 2007; 11(6): R127.Published online 2007 Dec 10. doi: 10.1186/cc6192 19. Klein S, Biomarkers for prediction of renal replacement therapy in acute kidney injury

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Metabolic Syndrome and Nonalcoholic Fatty Liver Disease

–49. 7. Hoyumpa AM Jr, Greene HL, Dunn GD, Schenker S. Fatty liver: Biochemical and clinical considerations. Dig Dis Sci 1975; 20: 1142–70. 8. Korenblat KM, Fabbrini E, Mohammed BS, Klein S. Liver, muscle, and adipose tissue insulin action is directly related to intrahepatic triglyceride content in obese subjects. Gastroenterology 2008; 134: 1369–75. 9. Brunt EM, Tiniakos DG. Histopathology of nonalcoholic fatty liver disease. World J. Gastroenterol 2010; 16: 5286–96. 10. Bedossa P, Poitou C, Veyrie N et al. Histopathological algorithm and scoring

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Endoscopic Mucosal Phenotypes in the Helicobacter Pylori Infection

of peptic ulcers: emerging issues. World J Surg. Mar 2000;24(3):250-5.[Medline]. 37. Garcia-Altes A, Rota R, Barenys M, et al. Costeffectiveness of a ‘score and scope’ strategy for the management of dyspepsia. Eur J Gastroenterol Hepatol. Jul 2005;17(7):709-19. [Medline]. 38. Graham DY. Therapy of Helicobacter pylori: current status and issues. Gastroenterology. Feb 2000;118(2 Suppl 1):S2-8. [Medline]. 39. Graham DY, Lew GM, Lechago J. Antral G-cell and Dcell numbers in Helicobacter pylori infection: effect of H. pylori eradication

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Cardiovascular Risk in Subclinical Hypothyroidism

Endocrinol 2011;165:115–121. 5. Kim YA, Park YJ. Prevalence and risk factors of subclinical thyroid disease. EndocrinolMetab (Seoul) 2014;29:20–29. 6. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526–534. 7. Kim TH, Choi HS, Bae JC, Moon JH, Kim HK, Choi SH, et al. Subclinical hypothyroidism in addition to common risk scores for prediction of cardiovascular disease: a 10-year community-based cohort study. Eur J Endocrinol 2014;171:649-657. 8. Vanderpump MP, Tunbridge WM, French JM

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