Mariana Jinga

Clinical Hospital Of Nephrology Dr Carol Davila, București, Bucureşti, Romania

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Publications (46)191.53 Total impact

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    ABSTRACT: Rationale: In the setting of open access endoscopy, the recognition of suggestive endoscopic features in the duodenum can select patients with probability of celiac disease (CD). This could add to the current efforts to increase the diagnostic rate of this disease. Aim: The aim of this study was to evaluate the diagnostic accuracy of these markers for CD in an adult population undergoing endoscopy, without a prior serological testing. Methods and Results: Over a period of 3 years, between June 2012 and 2015, all the patients who underwent upper gastrointestinal endoscopy and presented one or more of the endoscopic markers consistent with CD, or those suspected for CD, irrespective of the presence of these markers, were included. Sensitivity, specificity, positive and negative predictive values were calculated for these markers in CD diagnosis. Among the 182 patients, 56.04% were females, with a mean age of 47.6 ± 13.9 years. 20/182 (10.99%) had a final diagnosis of CD. The presence of any endoscopic marker had a high sensitivity (95%) and a negative predictive value (98.41%). Bulb atrophy and reduced folds in the descending duodenum had a low diagnostic accuracy, while scalloping, mosaic pattern and fissures were highly specific for CD (98.77%, 99.38% and 98.77%) and their presence greatly increased the probability of CD, with a positive likelihood ratio of 24.3, 24.3 and 12.15, respectively. Discussions: A wide set of endoscopic markers, including the duodenal bulb, were evaluated in this study. Our results showed that the endoscopy with a careful examination of the duodenum is a sensitive indicator for CD. Abbreviations: CD = celiac disease, GI = gastrointestinal, VA = villous atrophy, NSAID = nonsteroidal anti-inflammatory drug, Sn = sensitivity, Sp = specificity, PPV = positive predictive value, NPV = negative predictive value, AUC = area under the curve, ROC = receiver operating characteristics, WLE = white light endoscopy, NBI = narrow band imaging, tTG = tissue transglutaminase, EMA = anti-endomysial antibodies.
    No preview · Article · Dec 2015 · Journal of medicine and life
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    ABSTRACT: Background and aim: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide, with a prevalence of 20%-40% in Western populations. The purpose of this article is to review data related to lifestyle changes in patients with NAFLD. Method: We searched a public domain database (PubMed) with the following categories: disease (NAFLD, fatty liver, and non-alcoholic steatohepatitis [NASH]) and intervention (lifestyle intervention, diet, nutrition) with each possible combination through 25 September 2014, for relevant articles. Review of articles was restricted to those published in English. We selected the studies involving adult patients only. Conclusion: There is no consensus as to what diet or lifestyle approach is the best for NAFLD patients. However, patients with NAFLD may benefit from a moderate- to low-carbohydrate (40%-45% of total calories) diet, coupled with increased dietary MUFA and n-3 PUFAs, reduced SFAs. More CRT are needed to clarify the specific effects of different diets and dietary components on the health of NAFLD patients. Abbreviations: NAFL = Non-alcoholic fatty liver, NAFLD = non-alcoholic fatty liver disease, NASH = non-alcoholic steatohepatitis, HCC = hepatocarcinoma, BEE = basal energy expenditure, CRT = A small clinical randomized trial showed that short-term carbohydrate restriction is more efficacious in reducing intrahepatic triglyceride, IHT = intrahepatic triglyceride, VLCD = Very low calorie diets, AST = aspartate aminotransferases, SFAs = saturated fatty acids.
    Full-text · Article · Sep 2015 · Journal of medicine and life
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    ABSTRACT: Background: Primary intestinal lymphangiectasia (Waldmann’s disease) is a rare disease characterized by dilated lymphatics in the small bowel leading to an exudative enteropathy with lymphopenia, hypoalbuminemia and hypogammaglobulinemia. Case presentation: We report the case of a 23 year-old male who presented with chronic anemia and in whom primary intestinal lymphangiectasia was diagnosed. A low-fat diet along with nutritional therapy with medium-chain triglyceride supplementation improved the protein-losing enteropathy, but did not solve the anemia. Octreotide was also unsuccessful, and after attempting angiographic embolization therapy, limited small bowel resection together with antiplasmin therapy managed to correct the anemia and control the exudative enteropathy. Conclusions: Although primary intestinal lymphangiectasia is usually adequately managed by nutritional therapy, complications such as anemia can occur and can prove to be a therapeutic challenge. © 2015, Romanian Journal of Gastroenterology. All rights reserved.
    No preview · Article · Sep 2015 · Journal of gastrointestinal and liver diseases: JGLD
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    ABSTRACT: Allopurinol, by xanthine oxidase inhibition, could be a therapeutic option in patients with chronic heart failure (CHF). The purpose of the study was to assess the effects of high dose allopurinol on serum uric acid (sUA) and cardiac biomarkers, Nterminal pro-brain natriuretic peptide (NT-proBNP), growth differentiation factor-15 (GDF-15) and osteopontin (OPN), in patients with CHF. In 57 patients with stable CHF, New York Heart Association (NYHA) class III and reduced systolic function, under optimal medical therapy, ejection fraction (EF) and E/e’ ratio as markers of left ventricular function were assessed by echocardiography. sUA, NT-proBNP, GDF-15 and OPN were measured before and after 6 months of treatment with allopurinol 600 mg/day. Patients with elevated filling pressures (E/e’ ≥ 13) at baseline had lower EF and higher levels of NTproBNP, GDF 15 and sUA. After 6 months, for 23 patients (40%) who improved their NYHA class, also the levels of NTproBNP and GDF 15 decreased, along with lower sUA values. OPN was elevated at baseline and increased even further after 6 months, being unaffected by the CHF clinical course. Treatment with high doses of allopurinol was favourable, but heterogeneous effects were registered on cardiac biomarkers in CHF patients. Since the therapeutic benefits were associated with important sUA level decrease, sUA is a useful marker of CHF outcome and efficiency of allopurinol treatment. © 2015, Romanian Society for Pharmaceutical Sciences. All rights reserved.
    No preview · Article · Aug 2015 · Farmacia
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    ABSTRACT: There is increased evidence that end-stage renal disease patients, especially the hemodialyzed population, may present various unexpected forms of complications, contributing to a poor prognosis. Furthermore, neuroendocrine tumors, rarely encountered in daily practice, present in dialyzed individuals can significantly exacerbate the inflammatory condition with negative impact on patients' quality of life. We present an unusual case of uterus neuroendocrine tumor with multiple metastases in a 49-year-old female hemodialyzed patient with a history of alcoholic liver cirrhosis and uterus fibromatous. Multiple endoscopic techniques (e.g., upper endoscopy, colonoscopy, upper and lower echoendoscopy), histological evaluation of biopsy samples from involved areas (the operatory piece) were performed in order to complete and refine the diagnosis.
    No preview · Article · Jul 2015 · Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie

  • No preview · Article · Apr 2015 · Gastroenterology
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    ABSTRACT: Celiac disease (CD) is currently considerably underdiagnosed, setting the need for developing tools to select patients with probability of CD, who warrant further testing. Red blood cell distribution width (RDW) has been shown in previous studies to be a sensitive predictor for CD, but it lacks specificity. Splenic hypotrophy is also noted frequently in celiac patients. Our aim was to evaluate if spleen diameter to RDW ratio can be used as an indicator for CD. We evaluated 15 newly diagnosed CD patients, 52 patients with inflammatory bowel disease, and 35 patients with irritable bowel syndrome (IBS). We evaluated the differences in spleen diameter, RDW, and their ratio among the four groups. Two-thirds of the CD patients had elevated RDW, compared to 9% in the IBS group. A small spleen was seen in 80% of the celiacs, compared to 21.9% in the ulcerative colitis group, 10% in the Crohn disease group, and 9% in the IBS group. A spleen diameter to RDW ratio under 6 had a sensitivity of 73.3% and specificity of 88.5% in predicting CD, with an AUROC of 0.737. Spleen diameter to RDW ratio is a simple, widely available score, which can be used to select adult patients with probability of CD.
    Preview · Article · Apr 2015 · Medicine
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    ABSTRACT: In assessing exocrine pancreatic insufficiency (EPI), its diverse etiologies and the heterogeneous population affected should be considered. Diagnosing this condition remains a challenge in clinical practice especially for mild-to-moderate EPI, with the support of the time-consuming breath test or the coefficient of fat absorption. The fecal elastase-1 test, less precise for the diagnosis, cannot be useful for assessing treatment efficacy. Pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment, whereby enteric-coated mini-microspheres are taken with every meal, in progressive doses based on an individual's weight and clinical symptoms. The main indication for PERT is chronic pancreatitis, in patients who have clinically relevant steatorrhea, abnormal pancreatic function test or abnormal function tests associated with symptoms of malabsorption such as weight loss or meteorism. While enzyme replacement therapy is not recommended in the initial stages of acute pancreatitis, pancreatic exocrine function should be monitored for at least 6-18 months. In the case of unresectable pancreatic cancer, replacement enzyme therapy helps to maintain weight and improve overall quality of life. It is also indicated in patients with celiac disease, who have chronic diarrhea (in spite of gluten-free diet), and in patients with cystic fibrosis with proven EPI.
    Full-text · Article · Mar 2015 · Journal of gastrointestinal and liver diseases: JGLD

  • No preview · Article · Aug 2014 · Atherosclerosis
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    ABSTRACT: Purpose: To assess the value of contrast-enhanced ultrasound (CEUS) for differentiating malignant from benign focal liver lesions (FLLs) and for diagnosing different FLL types. Material and methods: CEUS performed in 14 Romanian centers was prospectively collected between February 2011 and June 2012. The inclusion criteria were: age > 18 years; patients diagnosed with 1 - 3 de novo FLLs on B-mode ultrasound; reference method (computed tomography (CT), magnetic resonance imaging (MRI) or biopsy) available; patient's informed consent. FLL lesions were characterized during CEUS according to the European Federation of Societies for Ultrasound in Medicine and Biology guidelines. For statistical analysis, indeterminate FLLs at CEUS were rated as false classifications. Results: A total number of 536 cases were included in the final analysis, 344 malignant lesions (64.2 %) and 192 benign lesions (35.8 %). The reference method was: CT/MRI - 379 cases (70.7 %), pathological exam - 150 cases (27.9 %) and aspiration of liver abscesses - 7 cases (1.4 %). CEUS was conclusive in 89.3 % and inconclusive in 10.7 % of cases. To differentiate between malignant and benign FLLs, CEUS had 85.7 % sensitivity, 85.9 % specificity, 91.6 % positive predictive value, 77.1 % negative predictive value and 85.8 % accuracy. The CEUS accuracy for differentiation between malignant and benign liver lesions was similar in tumors with diameter ≤ 2 cm and those with diameter > 2 cm. Conclusion: CEUS represents a useful method in clinical practice for differentiating between malignant and benign FLLs detected on standard ultrasonography, and the results of this study are in concordance with previous multicenter studies: DEGUM (Germany) and STIC (France).
    Full-text · Article · Feb 2014 · Ultraschall in der Medizin
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    ABSTRACT: Background: Upper GI bleeding (UGIB) is a potentially life threatening gastrointestinal emergency whose effective management depends on early risk stratification. Methods: We retrospectively studied 151 patients admitted to our unit with UGIB between 1st January 2007 and 31st December 2011 and in whom we calculated the clinical and complete Rockall, the Glasgow-Blatchford and modified Glasgow-Blatchford risk scores. We performed an analysis of the predictive value of these scores for in-hospital mortality and need for clinical intervention. Results: Of the 151 patients enrolled, 68.87% were male, and the mean age was 59.48 years. One in three patients had a history of chronic liver disease and one in eight had a previous episode of UGIB. Clinically, 58.3% of the patients presented with melena, 18.5% with hematemesis and 23.1% with both hematemesis and melena. 22% of cases were variceal hemorrhages and the other non-variceal. 16 patients died during hospitalization. The prognostic accuracy of all four scores for in-hospital death and need for clinical intervention was good, the complete Rockall score having the best performance (AUROC 0.849 and 0.653 respectively). Conclusions: The Rockall and Blatchford scores were good predictors of mortality and need for clinical intervention in our study. The good predictive performance of these scores highlight the need for their use in day-to-day practice to select patients with likelihood of poor clinical outcome.
    No preview · Article · Feb 2014 · Chirurgia (Bucharest, Romania: 1990)

  • No preview · Article · Feb 2014 · Journal of Crohn s and Colitis
  • M. Jinga

    No preview · Article · Jan 2014 · Choroid Plexus - Pineal Gland Correlations Medical Anthropology - Computed Tomography Studies Intracranial Physiological Calcification
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    ABSTRACT: In Europe, healthcare policies are determined at a national level and differ between countries. This analysis from a prospective, longitudinal, non-interventional study aimed to describe patterns in the clinical monitoring and treatment of chronic hepatitis B (CHB) in five European countries. Country-specific cohorts of adult patients with compensated CHB managed in clinics in Germany, France, Poland, Romania and Turkey were followed for up to 2 years between March 2008 and December 2010. 1,267 patients were included. Baseline age and gender distribution were similar across countries for patients Treated (n=567) and Untreated (n=700) at baseline. Most Treated patients were receiving monotherapy at baseline, most frequently with entecavir or tenofovir in Germany, France and Turkey, and with lamivudine in Poland and Romania. Use of pegylated interferon was more frequent in Poland and Romania than in other countries. In Romania monotherapy with entecavir increased after it became reimbursed in 2008. Hospitalizations during follow-up were more frequent in Romania (1.45 hospital days/patient-year) and Poland (1.81 days/patient-year) than in Turkey, France and Germany (0.00, 0.05 and 0.10 days/patient-year, respectively); clinic visits were more frequent in Poland (3.20 visits/patient-year vs. 0.30-1.78 across other countries). These results illustrate country-specific patterns in the management of CHB patients across Europe. Observed monitoring patterns, hospitalization rates and other healthcare utilization may be related to cost and reimbursement issues; however, further study in individual countries would be required to confirm these (post-hoc) observations.
    Full-text · Article · Dec 2013 · Antiviral therapy
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    ABSTRACT: We report a case of a 42-year-old woman with systemic lupus erythematosus and chronic kidney disease stage 5 undergoing continuous ambulatory peritoneal dialysis, presenting asthenia, dizziness, abdominal pain and small efforts dyspnea. After a complete physical and clinical examination, including laboratory tests, esophagogastroduodenal endoscopy and gastric lesions biopsy, she was diagnosed with gastric antral vascular ectasia. We are facing a rare case of antral vascular ectasia in a patient associating both chronic kidney disease and autoimmune disease.
    No preview · Article · Dec 2013 · Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
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    ABSTRACT: The objective of this study was to determine the effects of statin therapy (atorvastatin) on serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in patients with type 2 diabetes mellitus (T2DM) and chronic hepatitis C (CHC). A number of 77 patients with T2DM and CHC were selected, treated with atorvastatin, 20 mg, for 6 months, who underwent anthropometric measurements and biochemical tests (including fasting serum glucose, lipid profile, liver profile, cytokines profile) at baseline, after 1 month (clinical and biochemical profile for safety) and after 6 months of treatment. The patients' average age was 52.53±9.7 years. Plasma low-density lipoprotein cholesterol (LDL-C) (-32.4 mg/dL), triglycerides (-29.7 mg/dL), total cholesterol (-32.8 mg/dL) decreased (p<0.05), and high-density lipoprotein cholesterol (HDL-C) (+3.04 mg/dL) increased (p<0.05), after 6 months. Atorvastatin treatment was associated with decreases of AST, ALT, and also leptin and interleukin-6 (IL-6) levels (all p<0.05) but we did not find any effect on plasma tumor necrosis factor-alpha (TNF-α) (p=0.119). Atorvastatin was an effective and well tolerated treatment for lowering total cholesterol, LDL-C, triglycerides in patients with CHC. Among patients with CHC there was no significant elevation of liver enzymes during statin treatment, and we even noticed an improvement of hepatic profile.
    No preview · Article · Nov 2013 · Farmacia

  • No preview · Article · Oct 2013 · European Journal of Internal Medicine
  • D. Bajko · A. Andoni · I. Duță · M. Jinga · E. Rusu · G. Radulian

    No preview · Article · Oct 2013 · European Journal of Internal Medicine

  • No preview · Article · Oct 2013 · European Journal of Internal Medicine

  • No preview · Article · Oct 2013 · European Journal of Internal Medicine

Publication Stats

214 Citations
191.53 Total Impact Points

Institutions

  • 2015
    • Clinical Hospital Of Nephrology Dr Carol Davila
      București, Bucureşti, Romania
  • 2010-2015
    • Carol Davila University of Medicine and Pharmacy
      Bucureşti, Bucureşti, Romania
  • 2011-2014
    • Spitalul Universitar de Urgenta Bucuresti
      Bucureşti, Hunedoara, Romania