RESUMO
Hemosuccus pancreaticus is defined as upper gastrointestinal hemorrhage from the ampulla of Vater via the pancreatic duct. It is a rare disease, with non-specific presentation, challenging to diagnose and difficult to treat, with high mortality rates in untreated patients with massive bleeding. Given the intermittent nature of the bleeding, delays in diagnosis frequently occur. Timely diagnosis and treatment seem to result in markedly reduced mortality, therefore we emphasize the diagnostic contribution of imaging techniques by presenting the case of a patient with chronic pancreatitis in whom computed tomography established the diagnosis of blood in the Wirsung duct and contrast-enhanced ultrasound brought its added value by excluding the active bleeding.
Assuntos
Hemorragia Gastrointestinal/diagnóstico por imagem , Pancreatite Crônica/diagnóstico por imagem , Fosfolipídeos , Hexafluoreto de Enxofre , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodos , Meios de Contraste , Diagnóstico Diferencial , Hemorragia Gastrointestinal/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Ductos Pancreáticos/diagnóstico por imagem , Pancreatite Crônica/complicaçõesRESUMO
AIM: Enterobacterial translocation into the gut mucosa is the first step required for activation of neutrophils and inducible nitric oxide synthase (iNOS), involved in the pathogenesis of indomethacin-induced intestinal lesions. Rifaximin may limit NSAID-associated intestinal damage by decreasing the bacterial load. We aimed to study the effect of rifaximin on indomethacin-induced intestinal damage in guinea-pigs. MATERIALS AND METHODS: Twenty-four guinea pigs, equally divided in four interventional groups (A-D), received indomethacin, given orally once daily (30 mg/kg) for three consecutive days. In groups B, C, D different doses of rifaximin (50 mg/kg, 100 mg/kg and 200 mg/kg) were given orally two hours before indometachin administration. Semi-quantitative grades were measure for gross findings, degenerative lesions, neutrophils and eosinophils infiltrates and iNOS immunopositivity. Statistical comparisons used Mann Whitney Test, with a Bonferroni correction for alpha (p ≤ 0.016). RESULTS: Statistical analysis of graded gross findings, microscopic degenerative lesions, endothelium damage and iNOS immunopositivity found no difference between A and B groups. Significant fewer gross findings (U = 3, p = 0.015), microscopic degenerative lesions (U = 2, p = 0.008) and lower grades for iNOS immunopositivity (U = 0, p = 0.002) were found in group C compared with group A. In group D, significant lower grades for iNOS immunopositivity were obtained (U = 0, p = 0.002) compared with group A and fewer degenerative lesions without reaching statistical significance (U = 4, p = 0.026). CONCLUSIONS: 100 mg/kg of rifaximin proved efficient in preventing gut degenerative lesions induced by indomethacin in a guinea pig model, the iNOS activity being significantly decreased.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Enterite/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Indometacina/efeitos adversos , Rifamicinas/uso terapêutico , Animais , Enterite/enzimologia , Enterite/microbiologia , Enterite/patologia , Feminino , Fármacos Gastrointestinais/administração & dosagem , Cobaias , Imuno-Histoquímica , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/enzimologia , Mucosa Intestinal/patologia , Infiltração de Neutrófilos/efeitos dos fármacos , Óxido Nítrico Sintase Tipo II/biossíntese , Rifamicinas/administração & dosagem , RifaximinaRESUMO
BACKGROUND AND AIMS: There is little awareness and a lack of data on the prevalence of hospital malnutrition in gastro-enterology departments. Since part of these patients are referred for surgical treatment and poor nutritional status is a known risk factor for perioperative morbidity, we conducted a prospective study aimed to screen for the nutritional risk and assess the prevalence and risk factors of malnutrition in gastro-enterology departments in Romania. METHODS: We included patients consecutively admitted to 8 gastroenterology units over a period of three months in our study. Nutritional risk was evaluated using NRS 2002. Malnutrition was defined using BMI ( 20 kg m2) or and 10% weight loss in the last six months. RESULTS: 3198 patients were evaluated, 51.6% males and 48.4% females, with the mean age of 54.5 Â+- 14.3 years. Overall percentage of patients at nutritional risk was 17.1%, with the highest risk for patients with advanced liver diseases (49.8%), oncologic (31.3%), inflammatory bowel diseases (20.2%), and pancreatic diseases (18.9%). The overall prevalence of malnutrition was of 20.4%, higher for advanced liver diseases (39.4%), inflammatory bowed diseases (30.6%), oncologic (26.8%) and pancreatic diseases (23%). Independent risk factors for malnutrition were younger age (p 0.0001), female gender (p 0.0001), a higher (A ≥ 3) NRS (p 0.0001), presence of neoplasm (p 0.0001), of advanced liver disease (p=0.0003) and a reduction of 25% of dietary intake (p 0.0001). CONCLUSIONS: One in five patients admitted to gastroenterology units could benefit from prompt nutritional intervention. Correction of nutritional status is mandatory before any surgical procedure. Emphasis on nutritional evaluation at admission and beginning of nutritional therapy where needed are particularly required in patients with advanced liver diseases, digestive neoplasms, inflammatory bowel diseases and pancreatic diseases. ABBREVIATIONS: NRS= nutritional risk score, BMI = body mass index, IBD = inflammatory bowel diseases.
Assuntos
Gastroenterologia , Departamentos Hospitalares/estatística & dados numéricos , Desnutrição/epidemiologia , Desnutrição/etiologia , Adulto , Idoso , Índice de Massa Corporal , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Doenças Inflamatórias Intestinais/complicações , Hepatopatias/complicações , Masculino , Desnutrição/diagnóstico , Desnutrição/dietoterapia , Pessoa de Meia-Idade , Neoplasias/complicações , Avaliação Nutricional , Apoio Nutricional/métodos , Pancreatopatias/complicações , Prevalência , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Romênia/epidemiologia , Redução de PesoRESUMO
UNLABELLED: The aim of the paper was to evaluate the national availability of colonoscopy and the quality parameters of this procedure in our country. MATERIAL AND METHOD: During a 6 months period (01.07- 31.12.2009), we performed a prospective multicenter study in which 76 centers were invited to respond to a questionnaire regarding colonoscopy, 39 centers agreeing to participate. We assessed: the number of colonoscopies, the number of total colonoscopies and the causes of incomplete colonoscopies. RESULTS: During the study period, 16,083 colonoscopies were performed, 12,294 (76.4%) of them total colonoscopies. In 1,191 cases, stenosis was the cause of incomplete colonoscopy. If we consider this an objective reason for an incomplete colonoscopy, there were 12,294 total colonoscopies (82.4%). Comparing university centers with non-university ones, the proportion of total colonoscopies was 10,400/12,475 (83.4%) vs. 1,894/2,417 (78.4%) (p less then 0.0001). However, comparing the present study with previous ones, performed in 2003 and 2007, the proportion of total colonoscopies increased from 70.5% to 76.9% and 82.4% respectively (2003 vs. 2007 p less then 0.0001; 2007 vs. 2009 p less then 0.0001), while the quality difference between university and non-university hospitals persisted. CONCLUSIONS: the quality of colonoscopy in Romania increased in the last 5 years, while the quality difference between university and non-university hospitals persisted.
Assuntos
Neoplasias do Colo/diagnóstico , Colonoscopia/normas , Detecção Precoce de Câncer/normas , Neoplasias do Colo/epidemiologia , Colonoscopia/estatística & dados numéricos , Detecção Precoce de Câncer/estatística & dados numéricos , Hospitais Comunitários/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Humanos , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Romênia/epidemiologia , Sensibilidade e Especificidade , Inquéritos e QuestionáriosAssuntos
Veia Porta/anormalidades , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler , Malformações Vasculares/diagnóstico , Veia Cava Inferior/anormalidades , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/etiologia , Imageamento por Ressonância Magnética , Masculino , Malformações Vasculares/complicações , Adulto JovemRESUMO
Coupling magnetic materials to plasmonic structures provides a pathway to dramatically increase the magneto-optical response of the resulting composite architecture. Although such optical enhancement has been demonstrated in a variety of systems, some basic aspects are scarcely known. In particular, reflectance/transmission modulations and electromagnetic field intensification, both triggered by plasmon excitations, can contribute to the magneto-optical enhancement. However, a quantitative evaluation of the impact of both factors on the magneto-optical response is lacking. To address this issue, we have measured magneto-optical Kerr spectra on corrugated gold/dielectric interfaces with magnetic (nickel and iron oxide) nanoparticles. We find that the magneto-optical activity is enhanced by up to an order of magnitude for wavelengths that are correlated to the excitation of propagating or localized surface plasmons. Our work sheds light on the fundamental principles for the observed optical response and demonstrates that the outstanding magneto-optical performance is originated by the increase of the polarization conversion efficiency, whereas the contribution of reflectance modulations is negligible.
RESUMO
UNLABELLED: There are over 5000 patients with genotype 1b HCV chronic infection in Romania on national waiting lists. This allowed us to evaluate the complete and partial early virological response rates (EVRc and EVRp), as well as the factors influencing the response rates to treatment. PATIENTS: We studied 1220 treatment naive patients with HCV chronic hepatitis who started antiviral therapy during 2009. Mean age was 48 years and female gender was predominant (58%). Chronic hepatitis was documented by liver biopsy in 1129 patients (93%) or by non-invasive tests in 91 cases (7%). Most patients presented advanced liver disease (F3 + F4 Metavir = 62.3%). Viral load was over 400000 iu/mL in 61% patients and over 600000 iu/mL in 52% patients. Treatment was performed with peginterferon alpha-2a in 75.2% patients and with peginterferon alpha-2b in 24.8% patients, with comparative histology. The influence of histology, viral load, gender, age and type of peginterferon on the response rates to treatment was evaluated. RESULTS: EVRc was obtained in 76.6% patients, while 16.2% presented EVRp. From those with EVRp, 78.8% had undetectable viral load after 6 months of therapy. The nonresponder rate was 9.6%. EVRc was influenced by viral load and age, but not by fibrosis stage or type of interferon. CONCLUSIONS: We noticed a high rate of EVRc, which was not influenced by histology, gender or type of interferon. The number of nonresponders and of patients who interrupted therapy due to lack of compliance or adverse events was low.
Assuntos
Antivirais/uso terapêutico , Hepacivirus/efeitos dos fármacos , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Cirrose Hepática/tratamento farmacológico , Polietilenoglicóis/uso terapêutico , Ribavirina/uso terapêutico , Carga Viral/efeitos dos fármacos , Adulto , Biópsia , Progressão da Doença , Quimioterapia Combinada , Feminino , Genótipo , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/genética , Hepatite C Crônica/patologia , Humanos , Interferon alfa-2 , Cirrose Hepática/epidemiologia , Cirrose Hepática/genética , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Proteínas Recombinantes/uso terapêutico , Ribavirina/administração & dosagem , Medição de Risco , Fatores de Risco , Romênia/epidemiologia , Fatores de Tempo , Falha de Tratamento , Resultado do TratamentoRESUMO
PURPOSE: Contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) for the assessment of microcirculation and the delineation of pancreatic tumors in order to characterize and stage them has only recently become available for commercial use, and few reports have been published. The purpose of the study was the qualitative and quantitative digital image analysis of pancreatic adenocarcinomas using conventional endoscopic ultrasonography (EUS) and CEH-EUS and the evaluation of whether contrast medium injection modified adenocarcinoma staging and patient management. MATERIALS AND METHODS: In each of 30 prospectively examined patients with suspected pancreatic solid lesions, CEH-EUS was performed using the same quantity of the contrast agent SonoVue and a low mechanical index (0.3 - 0.4), followed by EUS-FNA. The histology, based on EUS-FNA or surgery and 9 months of follow-up, was: pancreatic adenocarcinoma (n = 15), pseudotumoral chronic pancreatitis (n = 12), neuroendocrine tumor (n = 1), common bile duct tumor (n = 1), lymph node metastases of gastric cancer (n = 1). The quantitative analysis was based on histograms obtained from each CEH-EUS video recording. RESULTS: CEH-EUS showed a hypoenhanced pattern in 14 cases of adenocarcinoma and in 10 cases of chronic pancreatitis. The index of the contrast uptake ratio was significantly lower in adenocarcinoma than in mass-forming chronic pancreatitis. A cut-off uptake ratio index value of 0.17 for diagnosing adenocarcinoma corresponded to an AUC (CI 95%) of 0.86 (0.67 - 1.00) with a sensitivity of 80%, a specificity of 91.7%, a positive predictive value of 92.8%, and a negative predictive value of 78%. The size of the pancreatic mass was assessed significantly more effectively by CEH-EUS but adenocarcinoma staging was not modified. CONCLUSION: The majority of cases of both pancreatic adenocarcinoma and chronic pancreatitis were hypoenhanced and visual discrimination was not possible. This is the first study about CEH-EUS for the quantitative assessment of uptake after contrast injection which has shown that it can aid differentiation between benign and malignant masses but cannot replace EUS-FNA. Neither tumor stage nor therapeutic management have changed after contrast medium injection during CEH-EUS.
Assuntos
Adenocarcinoma/diagnóstico por imagem , Endossonografia/métodos , Aumento da Imagem/métodos , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Pancreáticas/diagnóstico por imagem , Carga Tumoral/fisiologia , Adenocarcinoma/irrigação sanguínea , Adenocarcinoma/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia , Meios de Contraste/administração & dosagem , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neovascularização Patológica/diagnóstico por imagem , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Pancreáticas/patologia , Pancreatite Crônica/diagnóstico por imagem , Pancreatite Crônica/patologia , Fosfolipídeos , Estudos Prospectivos , Hexafluoreto de EnxofreAssuntos
Debilidade Muscular/induzido quimicamente , Debilidade Muscular/diagnóstico , Astenia/induzido quimicamente , Astenia/diagnóstico , Astenia/etiologia , Colchicina/efeitos adversos , Diagnóstico Diferencial , Rejeição de Enxerto/complicações , Rejeição de Enxerto/diagnóstico , Rejeição de Enxerto/tratamento farmacológico , Humanos , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/etiologiaRESUMO
UNLABELLED: The Helicobacter pylori (Hp) infection is a well-known carcinogenic factor. There are only limited data on the presence of Hp infection in gastric cancer in Romania. AIM: Cross-sectional study of the prevalence of Hp infection in gastric cancer. MATERIAL-METHODS: All cases of gastric cancer confirmed by gastroscopy in an endoscopy unit with national referrals were analysed. The Hp status was checked. The Hp + cases were studied compared with the Hp - cases. RESULTS: From 6768 gastroscopies 84 cases with gastric cancer were detected. Among these in 40 the Hp status was determined. 37 cases were carcinoma, 1 lymphoma, 2 cases without microscopical aspect of malignancy. In 8 cases (20%) Hp was found +. The majority of the patients with gastric cancer did not use PPIs. There were no demographic life style differences between the patients with gastric cancer who were Hp + and Hp -. CONCLUSION: Prevalence of the Hp infection in gastric cancer is lower than that reported in the literature. The investigation of Hp in gastric cancer should be done routinely. These data represent the starting point for a prospective study.
Assuntos
Infecções por Helicobacter/epidemiologia , Helicobacter pylori , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/microbiologia , Idoso , Comorbidade , Estudos Transversais , Feminino , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
BACKGROUND/AIMS: Sedation rates may vary among countries, depending on patients' and endoscopists' preferences. The aim of this survey was to investigate the rate of using premedication for routine diagnostic upper gastrointestinal (UGI) endoscopy in endoscopy societies, members of the European Society of Gastrointestinal Endoscopy (ESGE). METHODS: We evaluated a multiple-choice questionnaire which was e-mailed to representatives of national endoscopy societies, which are members of the ESGE. The questionnaire had 14 items referring to endoscopy practices in each country and the representatives' endoscopy units. RESULTS: The response rate was 76% (34/45). In 47% of the countries, less than 25% of patients undergo routine diagnostic UGI endoscopy with conscious sedation. In 62% of the responders' endoscopy units, patients are not asked their preference for sedation and do not sign a consent form (59%). Common sedatives in use are midazolam (82%), diazepam (38%) or propofol (47%). Monitoring equipment is not available 'in most of the endoscopy units' in 46% (13/28) of the countries. Though they were available in 91% of the national representatives' endoscopy units, they are rarely (21%) used to monitor unsedated routine diagnostic UGI endoscopy. CONCLUSIONS: In about 50% of ESGE-related countries, less than 25% of patients are sedated for routine diagnostic UGI endoscopy. Major issues to improve include availability of monitoring equipment and the use of a consent form.
Assuntos
Sedação Consciente/estatística & dados numéricos , Endoscopia Gastrointestinal , Gastroenteropatias/diagnóstico , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Hipnóticos e Sedativos/administração & dosagem , Masculino , Sociedades Médicas , Inquéritos e QuestionáriosRESUMO
Personality changes have been reported in chronic constipation. Hostility is an important personality factor involved in psychosomatic disorders. The aim of this study was to investigate hostility in patients with chronic constipation. Sixty subjects with chronic constipation (24 males, 36 females, mean age 44.5 years) were investigated with the hostility scale of the Minnesota Multiphasic Inventory. The patients were divided in four groups according to their symptoms: functional chronic constipation (Group I, n = 18), irritable bowel syndrome expressed as chronic constipation and abdominal pain (Group II, n = 21), irritable bowel syndrome expressed as chronic constipation, abdominal pain and bloating (Group III, n = 13) and irritable bowel syndrome expressed as chronic constipation alternating with episodes of diarrhoea (Group IV, n = 8). Twenty-five clinically healthy subjects were investigated as controls. Hostility was as follows (mean +/- SD): 68 +/- 9 in group I, 62 +/- 12 in group II, 70 +/- 14 in group III, 56 +/- 12 in group IV and 40 +/- 12 in controls. The scores were significantly higher in all groups of patients with constipation versus controls (p < 0.01; < 0.001; < 0.001; < 0.02, respectively). These data suggest that hostility is increased in patients with chronic constipation. It is rather a feature of the functional bowel disorders than of constipation, as symptom, only.
Assuntos
Constipação Intestinal/psicologia , Hostilidade , Dor Abdominal/psicologia , Adulto , Doença Crônica , Doenças Funcionais do Colo/psicologia , Feminino , Humanos , MMPI , Masculino , Pessoa de Meia-IdadeRESUMO
The aim of this study was to investigate the effect of metoclopramide on the antral emptying of a semisolid meal. Twenty-five patients with functional dyspepsia received in a prospective randomized trial either metoclopramide 10 mg t.i.d. (n = 14) or placebo (n = 11) for 7 days. The antral emptying was measured by real-time ultrasound with a 3.5 MHz probe from the antral area recordings in the aorto-mesenteric plane. The measurements were carried out in fasting condition and at 0, 15, 30, 45, 60 min after a standardized semisolid meal. The symptoms quantified in a symptom score were also recorded. Metoclopramide was superior to placebo in improving the symptom score. Antral emptying was accelerated by metoclopramide compared with placebo. Fasting antral emptying was not changed by metoclopramide and the postprandial antral area had a trend to decrease. These data suggest that the effect of metoclopramide is less due to the enhancement of antral motility but rather to the reduction of postprandial fundus relaxation.
Assuntos
Antagonistas de Dopamina/farmacologia , Dispepsia/tratamento farmacológico , Esvaziamento Gástrico/efeitos dos fármacos , Metoclopramida/farmacologia , Adulto , Antagonistas de Dopamina/administração & dosagem , Dispepsia/diagnóstico por imagem , Dispepsia/fisiopatologia , Feminino , Humanos , Masculino , Metoclopramida/administração & dosagem , Pessoa de Meia-Idade , Estudos Prospectivos , Antro Pilórico/diagnóstico por imagem , Método Simples-Cego , Estatísticas não Paramétricas , UltrassonografiaRESUMO
Many patients with liver cirrhosis have dyspeptic complaints. Peptic ulcer, gallstones and oesophagitis are the most common causes of dyspepsia. Functional dyspepsia is infrequently investigated in liver cirrhosis. Sixty-two patients with liver cirrhosis and dyspepsia were submitted to endoscopic and sonographic investigation. In 28 of them no organic finding was detected. These cases were considered as having functional dyspepsia. 36% were of dysmotility-like type, 28% were ulcer- and reflux-like, each, and 7% were of idiopathic type. Aerophagia could not be taken in consideration as functional dyspepsia, due to portal hypertension. In comparison with a group of 30 patients with functional dyspepsia without liver cirrhosis, functional dyspepsia in liver cirrhosis is more frequent in men than in women and occurs about a decade later. In 12 subjects the gastric emptying of a semifluid meal estimated by sonography was normal. Functional dyspepsia is a reality in liver cirrhosis. Gastric emptying seems not to have a major role in the etiopathogenesis of such complaints.
Assuntos
Dispepsia/etiologia , Cirrose Hepática/complicações , Idoso , Dispepsia/diagnóstico , Dispepsia/fisiopatologia , Feminino , Esvaziamento Gástrico , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVE: We studied the prevalence of viral hepatitis B, C and D markers in chronic hepatopathies from Cluj. MATERIAL AND METHODS: Sera of 297 patients with chronic hepatopathies (236 adults and 61 children) have been tested for viral hepatitis markers: HBsAg, anti-HBc, anti-HBs, HBeAg, anti-HBe, anti-HDV, anti-HCV, by automated ELISA. RESULTS: HBV infection markers in 32% (adults) and 4.9% (children), and HDV infection markers in 11.8% (adults) and 26.3% (children). Double (HBV and HCV) and triple infection (HBV, HDV and HCV) were observed in 28.4% (adults), 4.9% (children), and 3.4% (adults), 0% (children), respectively. CONCLUSIONS: Hepatitis virus infection markers, especially HBV and HCV play an important role in the determinism of chronic hepatopathies from Cluj area, both in children and adults.
Assuntos
Hepatite B/complicações , Hepatite C/complicações , Hepatite D/complicações , Hepatopatias/etiologia , População Urbana , Adulto , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Criança , Doença Crônica , Anticorpos Anti-Hepatite/sangue , Antígenos de Hepatite/sangue , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Hepatite D/epidemiologia , Humanos , Hepatopatias/epidemiologia , Prevalência , Romênia/epidemiologia , Estudos Soroepidemiológicos , População Urbana/estatística & dados numéricosRESUMO
OBJECTIVE: We aimed to assess the seroprevalence of HBV, HCV and HDV virus markers in multi-transfused patients from Cluj-Napoca. MATERIAL AND METHODS: Stored serum samples of 105 multi-transfused patients (25 children, 19 adults and 61 chronically hemodialyzed patients) have been tested for HBsAg, anti-HBs, total anti-HBc, anti-HCV, total anti-HDV by automated ELISA (Sanofi Diagnostics Pasteur kits). RESULTS: HVC infection has been observed in 4/25 (16%) children, 14/19 (74%) multi-transfused adults and 48/61 (79%) haemodialysis patients. 8/25 (32%) children, 17/19 (89%) adults and 47/61 (77%) haemodialysis patients had HBV infection markers. Anti-HDV have not been found in HBV infected multi-transfused children and adults, respectively. Only 2/47 (4.25%) HBV infected haemodialysis patients had HDV infection markers. The prevalence of double infection (HCV and HBV) was high (4%, 84.2% and 67.2% in children, adults and haemodialysis patients). The prevalence of viral hepatitis markers correlated to the amount of transfused blood, and in haemodialysis patients also correlated to the duration on dialysis. CONCLUSIONS: In multi-transfused patients from Cluj area, the prevalence of viral hepatitis markers is high. The double infection (HCV and HBV) is frequent, especially in adults. The prevalence of HDV infection markers in HBV infected patients is low, in contrast with previously reported results.