Laura Mazilu

By Andra-Iulia Suceveanu, Despina Todescu, Laura Mazilu, Filippos Goniotakis Manousos, Roxana Hulea, Felix Voinea, Eugen Dumitru and Adrian Paul Suceveanu

Tuberculosis (TB) is a highly contagious bacterial infection caused by Mycobacterium tuberculosis (MTB), affecting about 1/3rd of the world population and being responsible for lot of deaths worldwide, despite the progress achieved in the diagnosis and treatment fields. TB can affect the peritoneum, the TB ascites being a concern for physicians, especially when dealing with immunocompromised patients. The clinical presentation of TB ascites is challenging, due to nonspecific symptoms that make confusion with other diseases and the late results of cultures from ascites. The late diagnosis leads to a delayed treatment and high mortality. This manuscript describes recent tools used for early diagnosis in TB ascites. Molecular methods based on mycobacterial nucleic acid amplification tests (NAATs), polymerase chain reaction (PCR) detecting minimal amounts of bacterial DNA, or interferongamma release assays (IGRA) and biochemical methods such as the serum-ascites albumin gradient (SAAG) <1.1 g/dL, ratio between lactic dehydrogenase (LDH) in ascites fluid/serum total protein (TP) ratio of 0.5 and fluid ascites/serum LDH ratio of 0.6, and adenosine deaminase activity (ADA) > 40 UI/ml were recently considered more accurate diagnostic procedures. These methods allow a rapid and accurate differential diagnosis of ascites fluid, making possible the early treatment with appropriate drugs.

Part of the book: Ascites

By Andra-Iulia Suceveanu, Adrian-Paul Suceveanu, Andreea-Daniela Gheorghe and Laura Mazilu

Cancer and diabetes are two major health problems worldwide, and incidence is increasing globally for both diseases. Type 2 diabetes is characterized by hyperinsulinemia and insulin resistance and the effect of insulin and insulin growth factor I on cancer development and progression have been demonstrated in animal and human studies. The relationship between diabetes and cancer was reported for more than 60 years. Many epidemiological studies conducted over time suggested the association between diabetes and cancer. Epidemiological studies show an increased risk in type 2 diabetic patients for colon, breast, liver, pancreas, bladder cancers and non-Hodgkin’s lymphoma, and a decrease risk for prostate cancer. Lung cancer does not appear to be related to diabetes and for renal cancer data are inconclusive. Diabetes, beside the fact that it is an independent risk factor for different type of cancer, can also have an impact on prognosis of cancer, and studies shown an increased cancer mortality in patients with diabetes.

Part of the book: Diabetes and Its Complications

By Andra-Iulia Suceveanu, Laura Mazilu, Andreea-Daniela Gheorghe, Anca Pantea Stoian, Felix Voinea and Adrian-Paul Suceveanu

Hepatocellular carcinoma (HCC) is the most frequent primary malignancy of the liver and it is one of the leading causes of cancer-related deaths worldwide. The global burden of hepatocellular carcinoma is growing nowadays. Most cases of hepatocellular carcinoma develop in the background of chronic hepatitis C and B and liver cirrhosis‑well-known risk factor. But despite the reducing incidence of chronic hepatitis infections, an increase in the incidence of hepatocellular carcinoma was observed in the last decades. This could be explained by the increasing prevalence of obesity, type 2 diabetes mellitus, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), which are becoming important risk factors in hepatocellular carcinoma. Regular surveillance, as performed for patients with viral hepatitis, is required for patients with metabolic risk factors.

Part of the book: Liver Cancer