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| 1 | Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis显示文摘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 statistic.Potential 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 < 0.001) as compared with non-users. The association remained significant in subgroup analyses: by design-case-control(OR = 2.00, CI: 1.68-2.38, P < 0.0001), and cohort(OR = 1.98, CI: 1.51-2.59, P < 0.0001); adjusted(OR = 1.95, CI: 1.67-2.27, P < 0.0001) and unadjusted(OR = 2.02, CI: 1.41-2.91, P < 0.0001); unicenter(OR = 2.18, CI: 1.72-2.75, P < 0.0001) and multicenter(OR = 1.82, CI: 1.51-2.19, P < 0.0001); age ≥ 65 years(OR = 1.93, CI: 1.40-2.68, P < 0.0001) and < 65 years(OR = 2.06, CI: 1.11-3.81, P < 0.01). No significant differences were found in subgroup 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 heterogeneity across studies(I^2 = 85.4%, P < 0.001) as well as evidence of publication bias(funnel plot asymmetry test, P = 0.002). CONCLUSION This meta-analysis provides further evidence that PPI use is associated with an increased risk for development of CDI. Further high-quality, prospective studies are needed to assess whether this association is causal. | Anca Trifan Carol Stanciu Irina Girleanu Oana Cristina Stoica Ana Maria Singeap Roxana Maxim Stefan Andrei Chiriac Alin Ciobica Lucian Boiculese | 2017 | World Journal of Gastroenterology2017，23，35： | 15 |
| 2 | Impact of Clostridium difficile infection on inflammatory bowel disease outcome: A review显示文摘Although a considerable number of studies support a substantial increase in incidence, severity, and healthcare costs for Clostridium difficile infection(CDI) in inflammatory bowel disease(IBD), only few evaluate its impact on IBD outcome. Medline and several other electronic databases from January 1993 to October 2013 were searched in order to identify potentially relevant literature. Most of the studies showed that IBD patients with CDI present a greater proportion of worse outcomes than those without CDI. These patients have longer length of hospital stay, higher rates of colectomies, and increased mortality. Patients with ulcerative colitis are more susceptible to CDI and have more severe outcomes than those with Crohn's disease. However, studies reported variable results in both short-and long-term outcomes. Contrasting results were also found between studies using nationwide data and those reporting from single-center, or between some NorthAmerican and European studies. An important limitation of all studies analyzed was their retrospective design. Due to contrasting data often provided by retrospective studies, further prospective multi-center studies are necessary to evaluate CDI impact on IBD outcome. Until then, a rapid diagnosis and adequate therapy of infection are of paramount importance to improve IBD patients' outcome. The aim of this article is to provide up to date information regarding CDI impact on outcome in IBD patients. | Anca Trifan Carol Stanciu Oana Stoica Irina Girleanu Camelia Cojocariu | 2014 | World Journal of Gastroenterology2014，20，33： | 11 |
| 3 | Update on adrenal insufficiency in patients with liver cirrhosis显示文摘Liver cirrhosis is a major cause of mortality worldwide,often with severe sepsis as the terminal event.Over the last two decades,several studies have reported that in septic patients the adrenal glands respond inappropriately to stimulation,and that the treatment with corticosteroids decreases mortality in such patients.Both cirrhosis and septic shock share many hemodynamic abnormalities such as hyperdynamic circulatory failure,decreased peripheral vascular resistance,increased cardiac output,hypo-responsiveness to vasopressors,increased levels of proinflammatory cytokines [interleukine(IL)-1,IL-6,tumor necrosis factor-alpha] and it has,consequently,been reported that adrenal insufficiency(AI) is common in critically ill cirrhotic patients.AI may also be present in patients with stable cirrhosis without sepsis and in those undergoing liver transplantation.The term hepato-adrenal syndrome defines AI in patients with advanced liver disease with sepsis and/or other complications,and it suggests that it could be a feature of liver disease per se,with a dif-ferent pathogenesis from that of septic shock.Relative AI is the term given to inadequate cortisol response to stress.More recently,another term is used,namely 'critical illness related corticosteroid insufficiency' to define 'an inadequate cellular corticosteroid activity for the severity of the patient's illness'.The mechanisms of AI in liver cirrhosis are not completely understood,although decreased levels of high-density lipoprotein cholesterol and high levels of proinflammatory cytokines and circulatory endotoxin have been suggested.The prevalence of AI in cirrhotic patients varies widely according to the stage of the liver disease(compensated or decompensated,with or without sepsis),the diagnostic criteria defining AI and the methodology used.The effects of corticosteroid therapy on cirrhotic patients with septic shock and AI are controversial.This review aims to summarize the existing published information regarding AI in patients with liver cirrhosis. | Anca Trifan Stefan Chiriac Carol Stanciu | 2013 | World Journal of Gastroenterology2013，19，4： | 10 |
| 4 | Capsule endoscopy:the road ahead显示文摘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 disorders.During 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 published.This huge interest in CE may be explained by its noninvasive nature,patient comfort,safety,and access to anatomical regions unattainable via conventional endoscopy.However,CE has several limitations which impede its wider clinical applications,including the lack of therapeutic capabilities,inability to obtain biopsies and control its locomotion.Several 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 development.Overlooking 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 endoscopy.This review summarizes the literature that prognosticates about the future developments of CE. | Ana-Maria Singeap Carol Stanciu Anca Trifan | 2016 | World Journal of Gastroenterology2016，22，1： | 9 |
| 5 | Portal vein thrombosis in cirrhotic patients-it is always the small pieces that make the big picture显示文摘Portal vein thrombosis(PVT) is a frequent and serious complication in patients with liver cirrhosis(LC). Recently, a new classification of PVT was proposed, although the functional component was not completed included. The status of liver disease(compensated/decompensated) should be added to this classification. Reduced portal flow velocity and the acquired hypercoagulable status associated with LC are the main risk factors for PVT development, although endothelial dysfunction may play an important role that needs to be further evaluated. The European Association for the Study of the Liver and the American Association for the Study of Liver Disease recommend that the anticoagulant treatment should be consider in cirrhotic patients with PVT. Low molecular weight heparin and vitamin K antagonists proved their efficacy and relatively safety in PVT treatment, although in addition to recanalization rates, more complex endpoints such as mortality and decompensation rate should be evaluated. The new oral anticoagulant therapies offers the advantage of oral administration in the absence of laboratory monitoring, however, there are a few reports regarding their use in cirrhotic patients, most of them referring to compensated isolated cases. Transjugular intrahepatic portosystemic shunt could be an alternative if thrombosis progresses despite anticoagulatant therapy and/or when PVT is associated with portal hypertension complications. The aim of this editorial is to discuss the different aspects of pathophysiology, clinical relevance, diagnosis and management of PVT in patients with LC. | Irina Girleanu Anca Trifan Carol Stanciu Cǎtǎlin Sfarti | 2018 | World Journal of Gastroenterology2018，24，39： | 6 |
| 6 | Pseudomembranous colitis associated with a triple therapy for Helicobacter pylori eradication显示文摘Helicobacter pylori(H.pylori)is one of the most common chronic bacterial infections in humans,affecting half of world’s population.Therapy for H.pylori infection has proven to be both effective and safe.The oneweek triple therapy including proton pump inhibitor,clarithromycin,and amoxicillin or metronidazole is still recommended as a first-line treatment to eradicate H.pylori infection in countries with low clarithromycin resistance.Generally,this therapy is well-tolerated,with only a few and usually minor side effects.However,rare but severe adverse effects such as pseudomembranous colitis have been reported,Clostridium difficile(C.difficile)infection being the main causative factor in all cases.We 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 H.pylori infection.A limited colonoscopy showed typical appearance of pseudomembranous colitis,and the stool test for C.difficile toxins was positive.Rapid resolution of symptoms and negative C.difficile toxins were obtained in both patients with oral vancomycin.No relapse occurred during a four and eleven-month,respectively,follow up.These cases suggest that physicians should have a high index of suspicion for pseudomembranous colitis when evaluate patients with diarrhea following H.pylori eradication therapy. | Anca Trifan Irina Girleanu Camelia Cojocariu Catalin Sfarti Ana Maria Singeap Carmen Dorobat Lucia Grigore Carol Stanciu | 2013 | World Journal of Gastroenterology2013，19，42： | 5 |
| 7 | Checkmate to liver biopsy in chronic hepatitis C?显示文摘Liver biopsy (LB) has traditionally been considered the gold standard for pretreatment evaluation of liver fibrosis in patients with chronic hepatitis C (CHC). However, LB is an invasive procedure with several shortcomings (intra-and interobserver variability of histopathological interpretation, sampling errors, high cost) and the risk of rare but potentially life-threatening complications. In addition, LB is poorly accepted by patients and it is not suitable for repeated evaluation. Further-more, the prevalence of CHC makes LB unrealistic to be performed in all patients with this disease who are candidates for antiviral therapy. The above-mentioned drawbacks of LB have led to the development of non-invasive methods for the assessment of liver fibrosis. Several noninvasive methods, ranging from serum marker assays to advanced imaging techniques, have proved to be excellent tools for the evaluation of liver fibrosis in patients with CHC, whereas the value of LB as a gold standard for staging fibrosis prior to antiviral therapy has become questionable for clinicians. Despite significant resistance from those in favor of LB, noninvasive methods for pretreatment assessment of liver fibrosis in patients with CHC have become part of routine clinical practice. With protease inhibitors-based triple therapy already available and substantial improvement in sustained virological response, the time has come to move forward to noninvasiveness, with no risks for the patient and, thus, no need for LB in the assessment of liver fibrosis in the decision making for antiviral therapy in CHC. | Anca Trifan Carol Stanciu | 2012 | World Journal of Gastroenterology2012，18，39： | 2 |
| 8 | Colorectal polyps: clinical,endo- scopic, and histopathologic features 显示文摘 | Khder SA Trifan A Daneiu M | 2008 | Rev Med Chit Soc Med Nat Iasi2008，112，1： | 1 |
| 9 | Cyclooxygenase-2 inhibition with celecoxib enhances antitumor efficacy and reduces diarrhea side effect of CPT-11显示文摘 | Trifan O C Durham W F Salazar V S | 2002 | Cancer Res2002，62，20： | 1 |
| 10 | Prevalence of delayed gastric emptying of solids in functional dyspepsia and its relationship to symptoms显示文摘 | Sfarti C Trifan A Hu(t)(a)na(s)u C | 2009 | Rev Med Chir Soc Med Nat Iasi2009，113，4： | 1 |
| 11 | Cyclooxygenase-2 modulates cellular growth and promotes tumorigenesis显示文摘 | Trifan OC Hla T | 2003 | Cell Mol Med2003，17，3： | 1 |
| 12 | Colorectal polyps: clinical,endoscopic,and histopathologic features 显示文摘 | Khder SA Trifan A Danciu M | 2008 | Rcv Med Chir Soc Med Nal lasi2008，112，1： | 1 |
| 13 | Prevalence of delayed gastric emptying of solids in functional dyspepsia and its relationship to symptoms显示文摘 | Sfarti C Trifan A Hutǎnasu C | 2009 | Rev Med Chir Soc Med Nat Iasi2009，113，4： | 1 |
| 14 | Colorectal polyps : clinical, endoseopic, and histopathologic features 显示文摘 | Khder SA Trifan A Danciu M | 2008 | Rev Med Chir Soc Med Nat Iasi2008，112，1： | 1 |
| 15 | A third locus for adult-onset primary open-angle glaucoma maps to the 8q23 region 显示文摘 | Trifan DC Stoilova | 1998 | Am J Opthalmol1998，126，1： | 1 |
| 16 | Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study显示文摘 | E. Rondonotti M. Pennazio E. Toth P. Menchen M. Riccioni G. De Palma F. Scotto D. De Looze T. Pachofsky I. Tacheci T. Havelund G. Couto A. Trifan A. Kofokotsios R. Cannizzaro E. Perez-Quadrado R. de Franchis | 2008 | Endoscopy2008，，06： | 1 |
| 17 | Cyclooxygenase-2 inhibition with celecoxib enhances antitumor efficacy and reduces diarrhea side effect of CPT-11 显示文摘 | Trifan OC Durham WF Salazar VS | 2002 | Cancer Res2002，62，20： | 1 |
| 18 | Accuracy of colonoscopy in localizing colonic cancer显示文摘 | Stanciu C Trifan A Khder SA | 2011 | Rev Med Chir oe Med Nat Iasi2011，111，1： | 1 |
| 19 | Colorectal polyps : clinical, endoscopic, and histopathologic features 显示文摘 | Khder SA Trifan A Danciu M | 2008 | Rev Med Chit Soc Med Nat iasi2008，112，1： | 1 |
| 20 | Colorectal clinical, endoscopic, and histopathologic features显示文摘 | Khder SA Trifan A Danciu M | 2008 | Chir Soc Med Nat Iasi2008，112，1： | 1 |
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