The Impact of the COVID-19 Pandemic on Research and Volunteering Activities among Medical Students: A Cross-Sectional Study among Romanian and International Students from One Medical Faculty from Romania.

INTRODUCTION: This study focuses on the influence of the COVID-19 pandemic on medical students in their last year of study at the Faculty of Medicine of the University of Medicine and Pharmacy in Cluj-Napoca, Romania. It analyzes the impact of social distance limits on the conduct of research activities required for the development of the graduation thesis, as well as assesses sixth-year students' attitudes and behaviors toward volunteer activities during the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted in June-July 2021 among sixth-year students. It used an anonymous online questionnaire and was sent to all students from the Faculty of Medicine studying in the Romanian, English, or French sections (n = 606). The response rate was 38.28%, resulting in a final sample of 232 students from both Romanian and international sections. RESULTS: The findings demonstrate that two-thirds of the students in the survey agreed that the COVID-19 pandemic had a substantial impact on their research. Some of the students had to choose another subject for their graduation thesis, while about a quarter of the students gave up collecting personal data, 25% of respondents stated that it was difficult to contact research participants, one-third of them linked the difficulty of doing activities at the hospital to the present outbreak, and almost 30% of the students had difficulty communicating with the coordinator. The disturbance of the research activity seems to be higher among international students in comparison with the Romanian students, while there are limited gender differences. One out of five medical students has been involved in volunteer activities during the pandemic. Most have opted to volunteer at hospitals (especially international students) and contribute to health education activities (especially women). CONCLUSIONS: This is the first study from Romania and one of the few from Europe that presents data regarding the influence of the COVID-19 pandemic on research and volunteering activities among medical students.

Chronic Inflammation-A Link between Nonalcoholic Fatty Liver Disease (NAFLD) and Dysfunctional Adipose Tissue.

Nonalcoholic fatty liver disease (NAFLD) is a new challenge in modern medicine, due to its high prevalence in the world. The pathogenesis of NAFLD is a complex dysmetabolic process, following the "multiple-hit" hypothesis that involves hepatocytes excessive accumulation of triglycerides, insulin resistance (IR), increased oxidative stress, chronic low-grade inflammatory response and lipotoxicity. In this review, we provide an overview of the interrelation of these processes, the link between systemic and local inflammation and the role of dysfunctional adipose tissue (AT) in the NAFLD development. Multiple extrahepatic triggers of the pathophysiological mechanisms of NAFLD are described: nutritional deficiency or malnutrition, unhealthy food intake, the dysfunction of the liver-gut axis, the involvement of the mesenteric adipose tissue, the role of adipokines such as adiponectin, of food intake hormone, the leptin and leptin resistance (LR) and adipose tissue's hormone, the resistin. In addition, a wide range of intrahepatic players are involved: oxidative stress, fatty acid oxidation, endoplasmic reticulum stress, mitochondrial dysfunction, resident macrophages (Kupffer cells), neutrophils, dendritic cells (DCs), B and T lymphocytes contributing to the potential evolution of NAFLD to nonalcoholic steatohepatitis (NASH). This interdependent approach to complex dysmetabolic imbalance in NAFLD, integrating relevant studies, could contribute to a better clarification of pathogenesis and consequently the development of new personalized treatments, targeting de novo lipogenesis, chronic inflammation and fibrosis. Further studies are needed to focus not only on treatment, but also on prevention strategy in NAFLD.

Attitudes and Practices Regarding Research among Romanian Medical Undergraduate Students.

OBJECTIVES: This study focuses on the assessment of attitudes and practices regarding research among undergraduate medical students from Cluj-Napoca, Romania. MATERIAL AND METHODS: A cross-sectional study was performed thorough anonymous questionnaires (May-June 2018) among 510 third- and fifth-year students of Iuliu Hatieganu University of Medicine and Pharmacy from Cluj-Napoca, Romania. RESULTS: More than 60% of the third- and fifth-year students declared that they were interested and willing to perform research during medical studies, while more than two-thirds were interested in doing so after graduation. In total, 6% of third-year students and 31% of fifth-year students declared that they had prepared a scientific presentation for a medical congress at least once. Around 9% of the third-year students contributed to the writing of a scientific article and participated in research projects. Among fifth-year students, one-quarter were involved in writing scientific papers, and 21% participated in research projects. CONCLUSIONS: To the best of our knowledge, this study assesses, for the first time in Romania, the perspectives and behaviors of medical undergraduate students with regard to involvement in research activities. The results show that Romanian medical students value opportunities for conducting research, which encourages institutional initiatives that support their involvement in curricular and extracurricular research activities.

Left Atrial Geometry and Phasic Function Determined by Cardiac Magnetic Resonance Are Independent Predictors for Outcome in Non-Ischaemic Dilated Cardiomyopathy.

Left atrial (LA) geometry and phasic functions are frequently impaired in non-ischaemic dilated cardiomyopathy (NIDCM). Cardiac magnetic resonance (CMR) can accurately measure LA function and geometry parameters. We sought to investigate their prognostic role in patients with NIDCM. We prospectively examined 212 patients with NIDCM (49 ± 14.2-year-old; 73.5% males) and 106 healthy controls. LA volumes, phasic functions, geometry, and fibrosis were determined using CMR. A composite outcome (cardiac death, ventricular tachyarrhythmias, heart failure hospitalization) was ascertained over a median of 26 months. LA phasic functions, sphericity index (LASI) and late gadolinium enhancement (LA-LGE) were considerably impaired in the diseased group (p < 0.001) and significantly correlated with impaired LV function parameters (p < 0.0001). After multivariate analysis, LA volumes, LASI, LA total strain (LA-εt) and LA-LGE were associated with increased risk of composite outcome (p < 0.001). Kaplan-Meier analysis showed significantly higher risk of composite endpoint for LA volumes (all p < 0.01), LASI > 0.725 (p < 0.003), and LA-εt < 30% (p < 0.0001). Stepwise Cox proportional-hazards models demonstrated a considerable incremental predictive value which resulted by adding LASI to LA-εt (Chi-square = 10.2, p < 0.001), and afterwards LA-LGE (Chi-Square = 15.8; p < 0.0001). NIDCM patients with defective LA volumes, LASI, LA-LGE and LA-εt had a higher risk for an outcome. LA-εt, LASI and LA-LGE provided independent incremental predictive value for outcome.

3D laparoscopic salvage radical prostatectomy: mini-series report and review of the literature.

PURPOSE: Salvage therapy represents a rescue therapy, given after the first line of treatment had failed.The purpose of this study was to review the outcomes of patients who underwent salvage laparoscopic radical prostatectomy (sLRP) in our department and to review current published studies. METHODS: Our mini-series consisted of 6 patients with recurrent prostate cancer(PCa) after non-surgical primary treatment. All interventions were performed by a single surgeon from the Oncological Institute "Prof. Dr. Ion Chiricuta" Cluj Napoca, Romania.A literature review was carried out in June 2020 using the PubMed and MEDLINE databases to identify relevant studies published in the literature between 2000 and 2020. Six papers were selected for our review.We reviewed the oncological and functional outcomes of patients that underwent sLRP. RESULTS: Extraperitoneal sLRP was performed in 6 patients. Biochemical failure after primary treatment developed between one and five years. Mean operative time was 135.5 min, mean blood loss was 328 ml. No intraoperative complications occurred and no conversions to open surgery. R0 was achieved in 5 out of the 6 patients (83.5%). Out of the 6 patients 2 are incontinent. CONCLUSIONS: SLRP remains an underused procedure and a missed therapeutic opportunity for selected patients. From published data and personal experience, we conclude that in experienced hands sLRP for localized prostate cancer is a feasible, safe and efficient method to treat recurrent PCa. Short-term oncological outcomes are optimistic but further studies need to be made to observe the long-term outcomes.

Biomarkers in Pancreatic Cancer as Analytic Targets for Nanomediated Imaging and Therapy.

As the increase in therapeutic and imaging technologies is swiftly improving survival chances for cancer patients, pancreatic cancer (PC) still has a grim prognosis and a rising incidence. Practically everything distinguishing for this type of malignancy makes it challenging to treat: no approved method for early detection, extended asymptomatic state, limited treatment options, poor chemotherapy response and dense tumor stroma that impedes drug delivery. We provide a narrative review of our main findings in the field of nanoparticle directed treatment for PC, with a focus on biomarker targeted delivery. By reducing drug toxicity, increasing their tumor accumulation, ability to modulate tumor microenvironment and even improve imaging contrast, it seems that nanotechnology may one day give hope for better outcome in pancreatic cancer. Further conjugating nanoparticles with biomarkers that are overexpressed amplifies the benefits mentioned, with potential increase in survival and treatment response.

Noninvasive Assessment of Hepatitis C Virus Infected Patients Using Vibration-Controlled Transient Elastography.

Chronic infection with hepatitis C virus (HCV) is one of the leading causes of cirrhosis and hepatocellular carcinoma (HCC). Surveillance of these patients is an essential strategy in the prevention chain, including in the pre/post-antiviral treatment states. Ultrasound elastography techniques are emerging as key methods in the assessment of liver diseases, with a number of advantages such as their rapid, noninvasive, and cost-effective characters. The present paper critically reviews the performance of vibration-controlled transient elastography (VCTE) in the assessment of HCV patients. VCTE measures liver stiffness (LS) and the ultrasonic attenuation through the embedded controlled attenuation parameter (CAP), providing the clinician with a tool for assessing fibrosis, cirrhosis, and steatosis in a noninvasive manner. Moreover, standardized LS values enable proper staging of the underlying fibrosis, leading to an accurate identification of a subset of HCV patients that present a high risk for complications. In addition, VCTE is a valuable technique in evaluating liver fibrosis prior to HCV therapy. However, its applicability in monitoring fibrosis regression after HCV eradication is currently limited and further studies should focus on extending the boundaries of VCTE in this context. From a different perspective, VCTE may be effective in identifying clinically significant portal hypertension (CSPH). An emerging prospect of clinical significance that warrants further study is the identification of esophageal varices. Our opinion is that the advantages of VCTE currently outweigh those of other surveillance methods.

Lifestyle and Cancer Prevention-Opinions and Behaviors Among Romanian University Students.

BACKGROUND: Healthy lifestyle promotion represents an important component of cancer prevention. The aim of this study is the assessment of opinions and behavior related to healthy lifestyle and cancer prevention among Romanian university students. METHODS: A cross-sectional study was performed by anonymous questionnaires in 2017 among 400 university students from the four main universities from Cluj-Napoca, Romania. RESULTS: One out of five students was overweight or obese, but 83% meet the recommendations for performing physical activity. The majority did not meet the recommendations of eating 400 g of fruits and vegetables daily, while almost half declared eating more than 500 g of red meat weekly and more than one third do not respect the recommendations for alcohol consumption. The factor analysis reveals two factors with regard to cancer prevention-related behaviors. The first one consists of those having an appropriate body weight, and having a higher tendency for consumption of fruits and vegetables, performing physical activity, while being more prone not to respect the recommendations regarding the alcohol consumption. The second factor refers to a higher tendency to respect both the recommendations for alcohol and red meat consumption. CONCLUSION: Future educational activities should focus on promoting better nutritional habits, decrease alcohol consumption and offer appropriate services for weight management among Romanian university students.

Lights and Shadows of the Perception of the Use of Telemedicine by Romanian Family Doctors During the COVID-19 Pandemic.

INTRODUCTION: Telemedicine has emerged as a critical technology to mitigate SARS-CoV-2 infection. We aim in this work to explore how general practitioners (GPs) perceived the use of telemedicine, recently recognized and reimbursed by the Public Health Insurance House (PHIH) for primary care (PC) provision. METHODS: A cross-sectional study was performed in 2020 in one county of Romania using an anonymous questionnaire that assessed physicians' perceptions regarding teleconsultation, reliability in tele-decision, remote pathology management, pregnant women's surveillance, patients' satisfaction with telemedicine, the need for its further reimbursement. Bivariate correlation was used to measure associations between the investigated issues. RESULTS: More than a quarter of GPs (28.6%) found it easier to address patients' healthcare needs remotely, while 60.7% considered time-consuming teleconsultations compared to face-to-face visits. Tele-diagnostic uncertainty was expressed by 64.3% of physicians, and a quarter were confident in tele-decisions. Almost half of GPs (43%) observed patients' satisfaction with tele-visits, while half said patients encountered difficulties using technology. A large percentage of doctors (62.5%) perceived that patients felt as well treated by virtual as in-person visit and 91.1% suggested post-pandemic reimbursement. The results of the bivariate correlation showed that physicians who perceived positive patient feedback on telemedicine were more supportive of subsequent reimbursement. CONCLUSION: This study showed the GPs' positive perception of the use of telemedicine. Its adoption in PC has shed light on the shadows of the pandemic. The time-consuming nature of teleconsultations, uncertainty in tele-decisions, patients' difficulties in using technology were seen as shadows of telecare. However, most of the GPs surveyed agreed with the need for further reimbursement. Future work should focus on innovative solutions for integrating telemedicine as complementary form of PC, the need for telemedicine-based training for GPs to improve capacity building, and patients' perceptions of virtual care, helping to build trust and satisfaction.

Is Metformin a Possible Beneficial Treatment for Psoriasis? A Scoping Review.

Psoriasis is a chronic inflammatory condition with genetic, immunological, and metabolic etiology. The link between psoriasis and diabetes mellitus has been shown in genetic predisposition, environmental influences, inflammatory pathways, and insulin resistance, resulting in end-organ damage in both conditions. Because comorbidities often accompany psoriasis, the therapeutic management of the disease must also take into consideration the comorbidities. Given that metformin's therapeutic role in psoriasis is not yet fully elucidated, we raised the question of whether metformin is a viable alternative for the treatment of psoriasis. We conducted this scoping review by searching for evidence in PubMed, Cochrane, and Scopus databases, and we used an extension for scoping reviews (PRISMA-ScR). Current evidence suggests that metformin is safe to use in psoriasis. Studies have shown an excellent therapeutic response to metformin in patients with psoriasis and comorbidities such as diabetes, metabolic syndrome, and obesity. There is no clear evidence supporting metformin monotherapy in patients with psoriasis without comorbidities. There is a need to further evaluate metformin in larger clinical trials, as a therapy in psoriasis.

Actual Weight, Perceived Weight and Desired Weight of Romanian School Children by Parents and Children.

Background and Objectives: The perception of the body weight by children and parents influences the consequent actions undertaken for children's body weight management. This study investigated the correspondence between objective evaluations of Romanian school children (actual weight) and perceptions about weight (perceived weight), preoccupation with body weight management (desired weight) and parents' perceptions on children's weight. Materials and Methods: A cross sectional study was performed among 344 children aged 11 to 14 and 147 parents from Cluj-Napoca, Romania. We made anthropometric measurements of children, and short questionnaires were completed by the children and the parents. Results: The results show that 3.8% of children were underweight, 68.3% had a normal weight and 27.9% were overweight. Of this sample, 61.5% of underweight children, 20% of normal weight children and 43.7% of overweight children had misperceptions about their weight. The percentage of parents who did not estimate their children's weight correctly was 50%, 11.9% and 41.5%, respectively, for each of the three weight groups. The results of the logistic regression analyses showed that several factors were associated with the misclassification of their own body weight by the children, such as body mass index, gender, weight management practices, misclassification by the parents as well as parent-child discussions on these issues. Conclusions: Education for both Romanian parents and children is needed with regard to correctly identifying and managing children' body weight.

Performance of Ultrasound Techniques and the Potential of Artificial Intelligence in the Evaluation of Hepatocellular Carcinoma and Non-Alcoholic Fatty Liver Disease.

Global statistics show an increasing percentage of patients that develop non-alcoholic fatty liver disease (NAFLD) and NAFLD-related hepatocellular carcinoma (HCC), even in the absence of cirrhosis. In the present review, we analyzed the diagnostic performance of ultrasonography (US) in the non-invasive evaluation of NAFLD and NAFLD-related HCC, as well as possibilities of optimizing US diagnosis with the help of artificial intelligence (AI) assistance. To date, US is the first-line examination recommended in the screening of patients with clinical suspicion of NAFLD, as it is readily available and leads to a better disease-specific surveillance. However, the conventional US presents limitations that significantly hamper its applicability in quantifying NAFLD and accurately characterizing a given focal liver lesion (FLL). Ultrasound contrast agents (UCAs) are an essential add-on to the conventional B-mode US and to the Doppler US that further empower this method, allowing the evaluation of the enhancement properties and the vascular architecture of FLLs, in comparison to the background parenchyma. The current paper also explores the new universe of AI and the various implications of deep learning algorithms in the evaluation of NAFLD and NAFLD-related HCC through US methods, concluding that it could potentially be a game changer for patient care.

ROHHAD (Rapid-onset Obesity with Hypoventilation, Hypothalamic Dysfunction, Autonomic Dysregulation) Syndrome-What Every Pediatrician Should Know About the Etiopathogenesis, Diagnosis and Treatment: A Review.

Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, autonomic dysregulation (ROHHAD) syndrome is a rare disease with unknown and debated etiology, characterized by precipitous obesity in young children, hypoventilation and autonomic dysregulation with various endocrine abnormalities. Neuroendocrine tumors can be associated in more than half of the cases. This rare condition has a severe outcome because of high morbidity and mortality. We provide a comprehensive description of the etiopathogenetic theories of the disease, clinical presentation, diagnostic workup and treatment possibilities.

Stapled Hemorrhoidopexy: Technique and Long Term Results.

Background: Stapled hemorrhoidopexy (Longo operation) is a infrequent technique in our area. A different concept from hemorrhoidectomy, a proportionally important raise in cost and a special training may have contributed to it. We report our long-term results with the standard technique. Methods: The data of 35 patients with symptomatic second- and third-degree hemorrhoids who had stapled hemorrhoidopexy using a PPH03 stapler, from 01 January 2012 to 04 December 2020, were retrospectively collected. The sex ratio male: female was 3:4 and the mean age 45 (range 28-60) years. The follow-up consisted in a rectal exam and evaluated anatomical recurrence or prolapse. Results: The mean operative time was 42 (30-70) min. The mean parenteral analgesic doses during the first 24 h were 1,52. The mean postoperative hospital stay was 1.55 (1-2) days. A single patient needed reoperation for a staple line bleeding, two patients had a thrombosis of internal hemorrhoids and in one patient a small prolapse was diagnosed at 3 months follow-up. No hematoma, anastomotic stenosis, persistent anal pain, tenesmus, or impaired anal continence was recorded. One patient mentioned discomfort related to the presence of staples. Patients were followed-up for 6 (1-9) years. Global satisfaction rate was 94%. Conclusion: Stapled hemorrhoidopexy procedure is a safe and feasible procedure, which necessitates few analgesics and allows an early discharge. A rigorous selection of cases and a correct surgical technique allow to obtain good long-term results and offer a high level of patients satisfaction.

Electronic Cigarette Use and Its Relationship with Smoking and Alcohol and Illicit Drug Consumption among Romanian University Students.

Background and objectives: This study assesses electronic cigarette (e-cigarette) use and its relationship with smoking and alcohol and illicit drug consumption among Romanian university students. Materials and methods: A cross sectional study using anonymous questionnaire was performed in 2017 among 400 university students from Cluj-Napoca, Romania. Results: 95.5% of the participants had heard about e-cigarettes and 43.7% of these had tried e-cigarettes during their lifetime, while 8.9% declared using cigarettes in the previous month (one out of five students who had tried them during their lifetime). Half of the students had smoked during their lifetime and one third had smoked in the previous month. Eighty-five percent of participants had experimented alcohol intoxication during their lifetime and 45% had done so in the previous month, while illicit drug use during their lifetime and the previous month was 34% and 9.5%, respectively. The results of the linear regression analyses show a positive correlation between e-cigarette use, smoking, experimentation with alcohol intoxication, and the use of illicit drugs. Conclusions: Future studies as well as educational activities should address the complex relationship between e-cigarette and other substance use among Romanian youth.

TET2 rs1548483 SNP Associating with Susceptibility to Molecularly Annotated Polycythemia Vera and Primary Myelofibrosis.

BACKGROUND: The complexity of myeloproliferative neoplasms (MPNs) cannot be characterized by acquired somatic mutations alone. Individual genetic background is thought to contribute to the development of MPNs. The aim of our study was to assess the association between the TET2 rs1548483 single nucleotide polymorphism (SNP) and the susceptibility to polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF) or chronic myeloid leukemia (CML). METHODS: We evaluated the TET2 rs1548483 SNP through real-time PCR in 1601 MPN patients out of which 431 with PV, 688 with TE, 233 with PMF, 249 with CML and 197 controls. We included only patients with a molecularly proven driver mutation, such as JAK2 V617F, CALR or BCR-ABL1. RESULTS: Significant association between TET2 rs154843 variant allele and JAK2 V617F-positive PV and PMF (OR = 1.70; 95% CI: 1.01-2.91; p-value = 0.046, and OR = 2.04; 95% CI: 1.10-3.77; p-value = 0.024, respectively), and type 2 CALR-positive PMF (OR = 2.98; 95% CI: 1.12-7.93; p-value = 0.035) was noted. CONCLUSIONS: The TET2 rs1548483 SNP is associated with the susceptibility to molecularly annotated PV and PMF.

Hepatocellular Carcinoma and Non-Alcoholic Fatty Liver Disease: A Step Forward for Better Evaluation Using Ultrasound Elastography.

The increasing prevalence of non-alcoholic fatty liver disease (NAFLD) in the general population prompts for a quick response from physicians. As NAFLD can progress to liver fibrosis, cirrhosis, and even hepatocellular carcinoma (HCC), new non-invasive, rapid, cost-effective diagnostic methods are needed. In this review, we explore the diagnostic performance of ultrasound elastography for non-invasive assessment of NAFLD and NAFLD-related HCC. Elastography provides a new dimension to the conventional ultrasound examination, by adding the liver stiffness quantification in the diagnostic algorithm. Whilst the most efficient elastographic techniques in staging liver fibrosis in NAFLD are vibration controlled transient elastography (VCTE) and 2D-Shear wave elastography (2D-SWE), VCTE presents the upside of assessing steatosis through the controlled attenuation parameter (CAP). Hereby, we have also critically reviewed the most important elastographic techniques for the quantitative characterization of focal liver lesions (FLLs), focusing on HCC: Point shear wave elastography (pSWE) and 2D-SWE. As our paper shows, elastography should not be considered as a substitute for FLL biopsy because of the stiffness values overlap. Furthermore, by using non-invasive, disease-specific surveillance tools, such as US elastography, a subset of the non-cirrhotic NAFLD patients at risk for developing HCC can be detected early, leading to a better outcome. A recent ultrasomics study exemplified the wide potential of 2D-SWE to differentiate benign FLLs from malignant ones, guiding the clinician towards the next steps of diagnosis and contributing to better long-term disease surveillance.

Left Ventricular Geometry and Replacement Fibrosis Detected by cMRI Are Associated with Major Adverse Cardiovascular Events in Nonischemic Dilated Cardiomyopathy.

To investigate the relationship between left ventricular (LV) long-axis strain (LAS) and LV sphericity index (LVSI) and outcomes in patients with nonischemic dilated cardiomyopathy (NIDCM) and myocardial replacement fibrosis confirmed by late gadolinium enhancement (LGE) using cardiac magnetic resonance imaging (cMRI), we conducted a prospective study on 178 patients (48 ± 14.4 years; 25.2% women) with first NIDCM diagnosis. The evaluation protocol included ECG monitoring, echocardiography and cMRI. LAS and LVSI were cMRI-determined. Major adverse cardiovascular events (MACEs) were defined as a composite outcome including heart failure (HF), ventricular arrhythmias (VAs) and sudden cardiac death (SCD). After a median follow-up of 17 months, patients with LGE+ had increased risk of MACEs. Kaplan-Meier curves showed significantly higher rate of MACEs in patients with LGE+ (p < 0.001), increased LVSI (p < 0.01) and decreased LAS (p < 0.001). In Cox analysis, LAS (HR = 1.32, 95%CI (1.54-9.14), p = 0.001), LVSI [HR = 1.17, 95%CI (1.45-7.19), p < 0.01] and LGE+ (HR = 1.77, 95%CI (2.79-12.51), p < 0.0001) were independent predictors for MACEs. In a 4-point risk scoring system based on LV ejection fraction (LVEF) < 30%, LGE+, LAS > -7.8% and LVSI > 0.48%, patients with 3 and 4 points had a significantly higher risk for MACEs. LAS and LVSI are independent predictors of MACEs and provide incremental value beyond LVEF and LGE+ in patients with NIDCM and myocardial fibrosis.

Noninvasive assessment of liver steatosis using ultrasound methods.

Hepatic steatosis is a condition frequently encountered in clinical practice, with potential progression towards chirrhosis and hepatocellular carcinoma. Ultrasonography (US) is one of the noninvasive imaging techniques used in the diagnosis of steatosis. We will review the US diagnostic criteria, the US performance in the diagnosis and grading of hepatic steatosis, the US steatosis models, but also its limitations in the diagnosis of steatosis. In addition, we will discuss 2 modern methods of assessing hepatic steatosis using ultrasounds, namely the computerized processing of data forming the US image and the controlled attenuation parameter measured with unidimensional transient elastography.