1
|
Popovic DD, Filipovic B. Constipation and colonoscopy. World J Gastrointest Endosc 2024; 16:244-249. [DOI: 10.4253/wjge.v16.i5.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/15/2024] [Accepted: 04/24/2024] [Indexed: 05/14/2024] Open
Abstract
Constipation is a significant sociomedical problem, which can be caused by various reasons. In the diagnostic approach to patients with constipation, the following data are usually sufficient: History, complete physical examination (including rectal examination), and additional diagnostic tests. A colonoscopy is not a necessary diagnostic method for all patients with constipation. However, if patients have alarm symptoms/signs, that suggest an organic reason for constipation, a colonoscopy is necessary. The most important alarm symptoms/signs are age > 50 years, gastrointestinal bleeding, new-onset constipation, a palpable mass in the abdomen and rectum, weight loss, anemia, inflammatory bowel disease, and family history positive for colorectal cancer. Most endoscopists do not like to deal with patients with constipation. There are two reasons for this, namely the difficulty of endoscopy and the adequacy of preparation. Both are adversely affected by constipation. To improve the quality of colonoscopy in these patients, good examination techniques and often more extensive preparation are necessary. Good colonoscopy technique implies adequate psychological preparation of the patient, careful insertion of the endoscope with minimal insufflation, and early detection and resolution of loops. Bowel preparation for colonoscopy often requires prolonged preparation and sometimes the addition of other laxatives.
Collapse
Affiliation(s)
- Dusan Dj Popovic
- Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
- Department of Gastroenterology and Hepatology, Clinic for Internal Medicine, University Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Belgrade 11000, Serbia
| | - Branka Filipovic
- Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
- Department of Gastroenterology and Hepatology, Clinic for Internal Medicine, University Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Belgrade 11000, Serbia
| |
Collapse
|
2
|
Mijac D, Vucelj S, Todorovic K, Vojnovic M, Milicic B, Lukic S, Filipovic B, Marjanovic Haljilji M, Popovic D, Adzic Vukicevic T. Gastrointestinal and Hepatological Manifestations in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results from the Major COVID Hospital in Serbia. Microorganisms 2023; 12:27. [PMID: 38257854 PMCID: PMC10819747 DOI: 10.3390/microorganisms12010027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
The coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), includes a clinical spectrum of diseases from mild to severe progressive pneumonia, which has affected and still affects the human population worldwide. Most commonly, it is presented by respiratory symptoms, but studies have shown that about 50% of patients with SARS-CoV-2 infection have at least one gastrointestinal symptom (GI), predominantly nausea, diarrhea, vomiting, or loss of appetite. In addition, abnormal liver functional tests are commonly present in the SARS-CoV-2 virus. The aim of our study was to examine the GI and hepatic manifestations of COVID-19 in patients hospitalized due to COVID-19 pneumonia in "COVID hospital Batajnica", University Clinical Center of Serbia in Belgrade. The study included 498 consecutive patients, and the data was obtained from the patient's electronic medical history. GI symptoms included nausea, vomiting, diarrhea, and anorexia. Collected laboratory values included baseline and peak values of blood count, inflammatory parameters, liver function tests, renal function tests, and cardiac enzyme tests. The results have shown that GI symptoms occurred in 26% of cases at diagnosis, which indicates the great susceptibility of the GI system to SARS-CoV-2. There was a high risk of liver injury in patients with COVID-19 pneumonia (>60%). The level of AST is more often increased compared to ALT, which is different from other virus-induced liver lesions and may be a useful indicator of SARS-CoV-2 infection. Further research should focus on the causes of liver damage in SARS-CoV-2 virus and the impact on treatment and outcome of COVID-19 disease.
Collapse
Affiliation(s)
- Dragana Mijac
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (S.L.); (B.F.); (D.P.); (T.A.V.)
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, Koste Todorovica No 2, 11000 Belgrade, Serbia;
| | - Samir Vucelj
- Department of Internal Medicine, General Hospital Novi Pazar, Generala Zivkovica 1, 36300 Novi Pazar, Serbia;
| | - Kristina Todorovic
- Department of Internal Medicine, General Hospital Jagodina, Karadjordjeva 4, 35000 Jagodina, Serbia;
| | - Marko Vojnovic
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, Koste Todorovica No 2, 11000 Belgrade, Serbia;
| | - Biljana Milicic
- Faculty of Dental Medicine, University of Belgrade, Rankeova 4, 11000 Belgrade, Serbia;
| | - Snezana Lukic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (S.L.); (B.F.); (D.P.); (T.A.V.)
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, Koste Todorovica No 2, 11000 Belgrade, Serbia;
| | - Branka Filipovic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (S.L.); (B.F.); (D.P.); (T.A.V.)
- Department of Gastroenterology, Clinical and Hospital Center “Dr Dragisa Misovic–Dedinje”, Heroja Milana Tepica 1, 11020 Belgrade, Serbia;
| | - Marija Marjanovic Haljilji
- Department of Gastroenterology, Clinical and Hospital Center “Dr Dragisa Misovic–Dedinje”, Heroja Milana Tepica 1, 11020 Belgrade, Serbia;
| | - Dusan Popovic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (S.L.); (B.F.); (D.P.); (T.A.V.)
- Department of Gastroenterology, Clinical and Hospital Center “Dr Dragisa Misovic–Dedinje”, Heroja Milana Tepica 1, 11020 Belgrade, Serbia;
| | - Tatjana Adzic Vukicevic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (S.L.); (B.F.); (D.P.); (T.A.V.)
- Clinic for Pulmology, University Clinical Center of Serbia, Dr Koste Todorovica No 6, 11000 Belgrade, Serbia
| |
Collapse
|
3
|
Filipovic B, Marjanovic-Haljilji M, Mijac D, Lukic S, Kapor S, Kapor S, Starcevic A, Popovic D, Djokovic A. Molecular Aspects of MAFLD-New Insights on Pathogenesis and Treatment. Curr Issues Mol Biol 2023; 45:9132-9148. [PMID: 37998750 PMCID: PMC10669943 DOI: 10.3390/cimb45110573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Metabolic-associated liver disease (MAFLD) affects up to 70% of overweight and more than 90% of morbidly obese people, and its pathogenesis is rather complex and multifactorial. The criteria for MAFLD include the presence of hepatic steatosis in addition to one of the following three criteria: overweight or obesity, presence of type 2 diabetes mellitus (T2DM), or evidence of metabolic dysregulation. If the specific criteria are present, the diagnosis of MAFLD can be made regardless of alcohol consumption and previous liver disease. The pathophysiological mechanisms of MAFLD, including inflammation, lipotoxicity, mitochondrial disfunction, and oxidative stress, as well as the impact of intestinal gut microbiota, are constantly being elucidated. Treatment strategies that are continually emerging are based on different key points in MAFLD pathogenesis. Yet, the ideal therapeutic option has still not been found and future research is of great importance, as MAFLD represents a multisystemic disease with numerous complications.
Collapse
Affiliation(s)
- Branka Filipovic
- Department of Gastroenterology, Clinical and Hospital Center “Dr Dragisa Misovic—Dedinje”, Heroja Milana Tepica 1, 11020 Belgrade, Serbia; (B.F.); (D.P.)
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (D.M.); (S.L.); (S.K.); (A.S.); (A.D.)
| | - Marija Marjanovic-Haljilji
- Department of Gastroenterology, Clinical and Hospital Center “Dr Dragisa Misovic—Dedinje”, Heroja Milana Tepica 1, 11020 Belgrade, Serbia; (B.F.); (D.P.)
| | - Dragana Mijac
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (D.M.); (S.L.); (S.K.); (A.S.); (A.D.)
- Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia
| | - Snezana Lukic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (D.M.); (S.L.); (S.K.); (A.S.); (A.D.)
- Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia
| | - Suncica Kapor
- Department of Hematology, Clinical and Hospital Center “Dr Dragisa Misovic—Dedinje”, Heroja Milana Tepica 1, 11020 Belgrade, Serbia;
| | - Slobodan Kapor
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (D.M.); (S.L.); (S.K.); (A.S.); (A.D.)
- Institute of Anatomy “Niko Miljanic”, Dr Subotica Starijeg 4/2, 11000 Belgrade, Serbia
| | - Ana Starcevic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (D.M.); (S.L.); (S.K.); (A.S.); (A.D.)
- Institute of Anatomy “Niko Miljanic”, Dr Subotica Starijeg 4/2, 11000 Belgrade, Serbia
| | - Dusan Popovic
- Department of Gastroenterology, Clinical and Hospital Center “Dr Dragisa Misovic—Dedinje”, Heroja Milana Tepica 1, 11020 Belgrade, Serbia; (B.F.); (D.P.)
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (D.M.); (S.L.); (S.K.); (A.S.); (A.D.)
| | - Aleksandra Djokovic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia; (D.M.); (S.L.); (S.K.); (A.S.); (A.D.)
- Department of Cardiology, Clinical and Hospital Center “Bezanijska Kosa”, Dr Zorza Matea s/n, 11080 Belgrade, Serbia
| |
Collapse
|
4
|
Djokovic A, Krljanac G, Matic P, Zivic R, Djulejic V, Marjanovic Haljilji M, Popovic D, Filipovic B, Apostolovic S. Pathophysiology of spontaneous coronary artery dissection: hematoma, not thrombus. Front Cardiovasc Med 2023; 10:1260478. [PMID: 37928766 PMCID: PMC10623160 DOI: 10.3389/fcvm.2023.1260478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Spontaneous coronary artery dissection (SCAD) accounts for 1.7%-4% of all acute coronary syndrome presentations, particularly among young women with an emerging awareness of its importance. The demarcation of acute SCAD from coronary atherothrombosis and the proper therapeutic approach still represents a major clinical challenge. Certain arteriopathies and triggers are related to SCAD, with high variability in their prevalence, and often, the cause remains unknown. The objective of this review is to provide contemporary knowledge of the pathophysiology of SCAD and possible therapeutic solutions.
Collapse
Affiliation(s)
- Aleksandra Djokovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department of Cardiology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Gordana Krljanac
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Cardiology Clinic, University Clinical Center of Serbia, Belgrade, Serbia
| | - Predrag Matic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Vascular Surgery, Institute for Cardiovascular Diseases “Dedinje”, Belgrade, Serbia
| | - Rastko Zivic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Surgery, Clinical Hospital Center Dr Dragisa Misovic “Dedinje”, BelgradeSerbia
| | - Vuk Djulejic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Faculty of Medicine, Institute of Anatomy, Belgrade, Serbia
| | | | - Dusan Popovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Gastroenterology, Clinical Hospital Center Dr Dragisa Misovic “Dedinje”, BelgradeSerbia
| | - Branka Filipovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Gastroenterology, Clinical Hospital Center Dr Dragisa Misovic “Dedinje”, BelgradeSerbia
| | - Svetlana Apostolovic
- Coronary Care Unit, Cardiology Clinic, University Clinical Center of Nis, Nis, Serbia
- Faculty of Medicine, University of Nis, Nis, Serbia
| |
Collapse
|
5
|
Popovic D, Stojanovic M, Milosavljevic T, Stojkovic-Lalosevic M, Glisic T, Savic P, Filipovic B. Oxidative Stress in Gastrointestinal Ulcer Disease: A Gastroenterologist's View. J Gastrointestin Liver Dis 2023; 32:277-282. [PMID: 37774208 DOI: 10.15403/jgld-5172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Dusan Popovic
- University of Belgrade, Faculty of Medicine, Belgrade; Department for Gastroenterology and Hepatology, Clinic for Internal Medicine, Dr Dragisa Misovic- Dedinje University Clinical Hospital Center, Belgrade, Serbia.
| | - Marija Stojanovic
- University of Belgrade, Faculty of Medicine, Belgrade; Richard Burian Institute of Medical Physiology, Belgrade, Serbia.
| | | | - Milica Stojkovic-Lalosevic
- University of Belgrade, Faculty of Medicine, Belgrade; Clinic for Gastroenterohepatology, University Clinical center of Serbia, Belgrade, Serbia.
| | - Tijana Glisic
- University of Belgrade, Faculty of Medicine, Belgrade; Clinic for Surgery, Dr Dragisa Misovic-Dedinje University Clinical Hospital Center Belgrade, Serbia.
| | - Predrag Savic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinic for Surgery, University Clinical Hospital Center "Dr Dragisa Misovic-Dedinje" Belgrade, Serbia.
| | - Branka Filipovic
- University of Belgrade, Faculty of Medicine, Belgrade; Department for Gastroenterology and Hepatology, Clinic for Internal Medicine, Dr Dragisa Misovic- Dedinje University Clinical Hospital Center, Belgrade, Serbia.
| |
Collapse
|
6
|
Saponjski J, Stojanovich L, Stanisavljevic N, Djokovic A, Vojinovic R, Kocic S, Nikolic S, Matic P, Filipovic B, Djulejic V, Colovic V, Bogosavljevic N, Aleksandric D, Kostic D, Brkic Georgijevski B, Misovic M, Colic N, Saponjski D. Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography. Diseases 2023; 11:131. [PMID: 37873775 PMCID: PMC10594423 DOI: 10.3390/diseases11040131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/23/2023] [Accepted: 09/24/2023] [Indexed: 10/25/2023] Open
Abstract
INTRODUCTION Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterious and venous thrombosis, miscarriage, and the presence of antiphospholipid antibodies (aPL) in the blood. As we know, APS is also characterised by accelerated atherosclerotic degeneration with an increased risk of thrombosis in all blood vessels, including the carotid arteries. Carotid artery stenosis can manifest in many different ways. The aim of this study is to present the results of our multidetector computerised tomography angiography (MDCTA) analysis of the carotid arteries in patients with primary and secondary APS compared with a control group. MATERIALS AND METHODS This study examined 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients with secondary antiphospholipid syndrome (SAPS). The results were compared with a control group also comprising 50 patients. The groups were analysed with respect to age, sex and the presence of well-established risk factors for vascular disease. The study was conducted using MDCTA, where we analysed the quantitative and qualitative (morphologic) characteristics of carotid artery lesions. RESULTS Patients from the control group had significantly elevated levels of cholesterol and triglycerides in comparison with patients with PAPS and SAPS (p < 0.001 and p < 0.05). The results show that carotid artery lesions were significantly more common in patients with APS (PAPS, n = 40, CI95: 0.50-0.75, p = 0.0322 and SAFS, n = 54, CI95: 0.59-0.80, p = 0.0004) than within the control group (n = 23). There was a statistically significant difference between patients with APS and the control group with respect to lesions in the distal segments (n = 27, CI95: 0.67-0.95, p = 0.0001), bulbi and proximal segments (n = 21, CI95: 0.84-1.00, p = 0.000005). The number of patients with one lesion (L) (n = 27) was significantly greater than the number of those with three (n = 10, CI95: 0.56-0.86, p = 0.0051) or four (n = 3, CI95: 0.73-0.98, p = 0.00001) lesions. There were also more patients with two lesions (n = 24) than those with four (n = 3) (CI95: 0.71-0.97, p = 0.00005). Carotid artery stenosis was shown as a percentage of the carotid artery lumen diameter (%DS). Stenosis of up to 30%, was more common in patients in the PAPS group (n = 12) than in the control group (n = 3) (CI95: 0.52-0.96, p = 0.0201), while the SAPS group (n = 17) had an even larger disparity (CI95: 0.62-0.97, p = 0.0017). We observed a highly significant difference in the frequency of stenoses between 30% and 50% DS between the PAPS group (n = 24) and the control group (n = 7) (CI95: 0.59-0.90, p = 0.0023), as well as the SAPS group (n = 30) (CI95: 0.65-0.92, p = 0.0002). A qualitative analysis of plaque morphology revealed that patients with PAPS had significantly more soft tissue lesions (n = 23) compared with calcified lesions (n = 2) (CI95: 0.74-0.99, p = 0.00003), as well as more mixed plaques (n = 9) and calcified plaques (n = 2) (CI95: 0.48-0.98, p = 0.0348). Patients within the SAPS group had significantly more soft tissue (n = 35) than calcified lesions (n = 3) (CI95: 0.79-0.98, p = 0.00000021), as well as more mixed lesions (n = 21) compared with calcified (n = 3) (CI95: 0.68-0.97, p = 0.0002). CONCLUSIONS Our study shows that subclinical manifestations of carotid artery lesions were more common in patients with APS. We came to the conclusion that MDCTA is an accurate diagnostic method because it is a safe method that provides us with a great quantity of accurate information about the characteristics of atheromatous plaques, which aids us in the further planning of treatment for patients with APS.
Collapse
Affiliation(s)
- Jovica Saponjski
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (V.D.); (N.B.)
- University Clinical Center of Serbia, 11000 Belgrade, Serbia (A.D.); (V.C.)
| | - Ljudmila Stojanovich
- University Clinical Center of Serbia, 11000 Belgrade, Serbia (A.D.); (V.C.)
- University Hospital Medical Center “Bezanijska Kosa”, 11080 Belgrade, Serbia
| | | | - Aleksandra Djokovic
- University Clinical Center of Serbia, 11000 Belgrade, Serbia (A.D.); (V.C.)
- University Hospital Medical Center “Bezanijska Kosa”, 11080 Belgrade, Serbia
| | - Radisa Vojinovic
- Faculty of Medical Science, University of Kragujevac, 34000 Kragujevac, Serbia
- University Clinical Center of Kragujevac, 34000 Kragujevac, Serbia
| | | | - Simon Nikolic
- Faculty of Medicine, University of Kosovksa Mitrovica, 11000 Belgrade, Serbia;
| | - Predrag Matic
- Institute for Cardiovascular Diseases “Dedinje”, 111040 Belgrade, Serbia
| | | | - Vuk Djulejic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (V.D.); (N.B.)
| | - Vladan Colovic
- University Clinical Center of Serbia, 11000 Belgrade, Serbia (A.D.); (V.C.)
| | - Nikola Bogosavljevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (V.D.); (N.B.)
- Institute for Orthopedic Diseases “Banjica”, 11000 Belgrade, Serbia
| | | | - Dejan Kostic
- Military Medical Academy, 11040 Belgrade, Serbia; (D.K.); (M.M.)
| | | | - Miroslav Misovic
- Military Medical Academy, 11040 Belgrade, Serbia; (D.K.); (M.M.)
| | - Nikola Colic
- University Clinical Center of Serbia, 11000 Belgrade, Serbia (A.D.); (V.C.)
| | - Dusan Saponjski
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia (V.D.); (N.B.)
- University Clinical Center of Serbia, 11000 Belgrade, Serbia (A.D.); (V.C.)
| |
Collapse
|
7
|
Popovic D, Glisic T, Milosavljevic T, Panic N, Marjanovic-Haljilji M, Mijac D, Stojkovic Lalosevic M, Nestorov J, Dragasevic S, Savic P, Filipovic B. The Importance of Artificial Intelligence in Upper Gastrointestinal Endoscopy. Diagnostics (Basel) 2023; 13:2862. [PMID: 37761229 PMCID: PMC10528171 DOI: 10.3390/diagnostics13182862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023] Open
Abstract
Recently, there has been a growing interest in the application of artificial intelligence (AI) in medicine, especially in specialties where visualization methods are applied. AI is defined as a computer's ability to achieve human cognitive performance, which is accomplished through enabling computer "learning". This can be conducted in two ways, as machine learning and deep learning. Deep learning is a complex learning system involving the application of artificial neural networks, whose algorithms imitate the human form of learning. Upper gastrointestinal endoscopy allows examination of the esophagus, stomach and duodenum. In addition to the quality of endoscopic equipment and patient preparation, the performance of upper endoscopy depends on the experience and knowledge of the endoscopist. The application of artificial intelligence in endoscopy refers to computer-aided detection and the more complex computer-aided diagnosis. The application of AI in upper endoscopy is aimed at improving the detection of premalignant and malignant lesions, with special attention on the early detection of dysplasia in Barrett's esophagus, the early detection of esophageal and stomach cancer and the detection of H. pylori infection. Artificial intelligence reduces the workload of endoscopists, is not influenced by human factors and increases the diagnostic accuracy and quality of endoscopic methods.
Collapse
Affiliation(s)
- Dusan Popovic
- Faculty of Medicine Belgrade, University of Belgrade, 11000 Belgrade, Serbia; (T.G.); (D.M.); (M.S.L.); (J.N.); (S.D.); (P.S.); (B.F.)
- Department of Gastroenterology, Clinical Hospital Center “Dr Dragisa Misovic-Dedinje”, 11000 Belgrade, Serbia; (N.P.); (M.M.-H.)
| | - Tijana Glisic
- Faculty of Medicine Belgrade, University of Belgrade, 11000 Belgrade, Serbia; (T.G.); (D.M.); (M.S.L.); (J.N.); (S.D.); (P.S.); (B.F.)
- Clinic for Gastroenterohepatology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | | | - Natasa Panic
- Department of Gastroenterology, Clinical Hospital Center “Dr Dragisa Misovic-Dedinje”, 11000 Belgrade, Serbia; (N.P.); (M.M.-H.)
| | - Marija Marjanovic-Haljilji
- Department of Gastroenterology, Clinical Hospital Center “Dr Dragisa Misovic-Dedinje”, 11000 Belgrade, Serbia; (N.P.); (M.M.-H.)
| | - Dragana Mijac
- Faculty of Medicine Belgrade, University of Belgrade, 11000 Belgrade, Serbia; (T.G.); (D.M.); (M.S.L.); (J.N.); (S.D.); (P.S.); (B.F.)
- Clinic for Gastroenterohepatology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Milica Stojkovic Lalosevic
- Faculty of Medicine Belgrade, University of Belgrade, 11000 Belgrade, Serbia; (T.G.); (D.M.); (M.S.L.); (J.N.); (S.D.); (P.S.); (B.F.)
- Clinic for Gastroenterohepatology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Jelena Nestorov
- Faculty of Medicine Belgrade, University of Belgrade, 11000 Belgrade, Serbia; (T.G.); (D.M.); (M.S.L.); (J.N.); (S.D.); (P.S.); (B.F.)
- Clinic for Gastroenterohepatology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Sanja Dragasevic
- Faculty of Medicine Belgrade, University of Belgrade, 11000 Belgrade, Serbia; (T.G.); (D.M.); (M.S.L.); (J.N.); (S.D.); (P.S.); (B.F.)
- Clinic for Gastroenterohepatology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Predrag Savic
- Faculty of Medicine Belgrade, University of Belgrade, 11000 Belgrade, Serbia; (T.G.); (D.M.); (M.S.L.); (J.N.); (S.D.); (P.S.); (B.F.)
- Clinic for Surgery, Clinical Hospital Center “Dr Dragisa Misovic-Dedinje”, 11000 Belgrade, Serbia
| | - Branka Filipovic
- Faculty of Medicine Belgrade, University of Belgrade, 11000 Belgrade, Serbia; (T.G.); (D.M.); (M.S.L.); (J.N.); (S.D.); (P.S.); (B.F.)
- Department of Gastroenterology, Clinical Hospital Center “Dr Dragisa Misovic-Dedinje”, 11000 Belgrade, Serbia; (N.P.); (M.M.-H.)
| |
Collapse
|
8
|
Djokovic A, Stojanovich L, Stanisavljevic N, Veljic I, Todic B, Radovanovic S, Zivic R, Matic P, Filipovic B, Saponjski J, Apostolovic S, Zdravkovic M, Milic S, Shoenfeld Y. Primary antiphospholipid syndrome as a cause of impaired left ventricular diastolic function: experience from a Serbian cohort. Clin Exp Rheumatol 2023; 41:103-109. [PMID: 35485420 DOI: 10.55563/clinexprheumatol/80dkrm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/04/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Cardiovascular manifestations, encountered in antiphospholipid syndrome, may develop as a consequence of acquired thrombophilia mediated by antiphospholipid antibodies and accelerated atherosclerosis as well. Our study aims to assess the impairment of the left ventricular diastolic performance, as early evidence of myocardial involvement in primary antiphospholipid syndrome (PAPS). METHODS We analysed 101 PAPS patients, with the average age of 47.70±13.14y. Anticardiolipin antibodies (aCL IgG/IgM), anti-ß2 glycoprotein-I (anti-ß2GPI IgG/IgM), and lupus anticoagulant (LAC) were determined. Abnormal cut-off values used for left ventricular diastolic dysfunction (LVDD) were septal E ́<7 cm/sec, lateral E ́ <10 cm/sec, average E/E ́ ratio >14, LA volume index (LAVI) >34 mL/m2, and peak tricuspid regurgitation velocity >2.8 m/sec. LVDD was present if more than half parameters were with abnormal values. The results were compared to 90 healthy, age and sex-matched controls. RESULTS LVDD was significantly more prevalent in PAPS patients compared to healthy controls (24.8% vs. 2.2%, p=0.001). In PAPS patients, it was signi cantly related to age, body mass index, hyperlipidaemia, thromboses and LAC positivity (p=0.0001, p=0.008, p=0.039, p=0.001, p=0.047 respectively). Patients with PAPS had higher LAVI (29.76±6.40 ml/m2 vs. 26.62±7.8 ml/m2, p=0.012), higher isovolumic relaxation time, lower lateral É velocity and lower E/É ratio compared to controls (p=0.0001, p=0.020, p=0.038, respectively). In multivariate analysis, thromboses in PAPS were significant, and independent predictors of LVDD. CONCLUSIONS Thrombotic PAPS patients are at higher risk of LVDD development. Strong action against standard atherosclerotic risk factors and adequate therapy regimes seems to be crucial to preserve good diastolic performance of the left ventricle in PAPS.
Collapse
Affiliation(s)
- Aleksandra Djokovic
- University of Belgrade, Faculty of Medicine, Belgrade; and Department of Cardiology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia.
| | - Ljudmila Stojanovich
- University of Belgrade, Faculty of Medicine, Belgrade, and Department of Rheumatology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Natasa Stanisavljevic
- University of Belgrade, Faculty of Medicine, Belgrade, and Department of Haematology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Ivana Veljic
- University of Belgrade, Faculty of Medicine, Belgrade, and Department of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Branislava Todic
- Department of Cardiology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Slavica Radovanovic
- Department of Cardiology, University Hospital Center Dr Dragisa Misovic Dedinje, Belgrade, Serbia
| | - Rastko Zivic
- University of Belgrade, Faculty of Medicine, Belgrade, and Department of Surgery, University Hospital Center Dr Dragisa Misovic Dedinje, Belgrade, Serbia
| | - Predrag Matic
- University of Belgrade, Faculty of Medicine, Belgrade, and Department of Vascular Surgery, Institute for cardiovascular diseases Dedinje, Belgrade, Serbia
| | - Branka Filipovic
- University of Belgrade, Faculty of Medicine, Belgrade, and Department of Gastroenterology, University Hospital Center Dr Dragisa Misovic Dedinje, Belgrade, Serbia
| | - Jovica Saponjski
- University of Belgrade, Faculty of Medicine, Belgrade, and Department of Interventional Cardiology, Emergency Room, University Clinical Center of Serbia, Belgrade, Serbia
| | - Svetlana Apostolovic
- Department of Professional and Scientific Training, Cardiology Clinic, Clinical center of Nis, and University of Nis, School of Medicine, Nis Serbia
| | - Marija Zdravkovic
- University of Belgrade, Faculty of Medicine, Belgrade; and Department of Cardiology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Sandra Milic
- Clinic for Pulmonology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Yehuda Shoenfeld
- Ariel University, and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| |
Collapse
|
9
|
Djokovic A, Stojanovich L, Stanisavljevic N, Djokic S, Filipovic B, Matic P, Milanovic M, Apostolovic S, Saponjski J. Cardiac manifestations in primary antiphospholipid syndrome and their association to antiphospholipid antibodies' types and titers-cross-sectional study of Serbian cohort. Clin Rheumatol 2022; 41:1447-1455. [PMID: 35018582 DOI: 10.1007/s10067-022-06056-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 10/28/2021] [Accepted: 01/06/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Antiphospholipid syndrome (APS) is multisystem autoimmune coagulopathy with antiphospholipid antibodies (aPL) in its ground, manifested as a primary disease (PAPS) or in the setting of other conditions, most commonly systemic lupus erythematosus. The objective of this cross-sectional study was to investigate various cardiac manifestations and their possible relation to aPL type and titer in a Serbian cohort of PAPS patients. METHODS A total of 360 PAPS patients were analyzed and aPL analysis included detection of anticardiolipin antibodies (aCL: IgG/IgM), anti-ß2glycoprotein I (ß2GPI: IgG/IgM), and lupus anticoagulant (LA). Cardiac manifestations investigated were valvular lesions (comprehending valvular thickening and dysfunction not related to age and pseudoinfective endocarditis), coronary artery disease (CAD) with specific insight for myocardial infarction (MI), chronic cardiomyopathy (CMP), and acute decompensated heart failure (ADHF) as well as pulmonary hypertension (PH) and intracardiac thrombus presence. RESULTS The prevalence of cardiac manifestations overall was 19.6%. There was a strong association between age and the majority of cardiac manifestations, as well as standard atherosclerotic risk factors. aCL IgG-positive patients had a higher prevalence of valvular lesions (p = 0.042). LA presence was significantly related to MI (p = 0.031) and PH (p = 0.044). CMP and ADHF were significantly related to higher titers of aCl IgG (p = 0.033, p = 0.025 respectively). Age and smoking were independent risk predictors for MI in PAPS with meaningful risk for LA positivity (OR 2.567 CI 0.671-9.820 p = 0.168). CONCLUSIONS Certain cardiac manifestations in PAPS were related to certain aPL type and/or titer levels, imposing confirmation in prospective studies. Preventive actions, comprehending proper anticoagulant/antithrombotic therapy, and intense action against standard atherosclerotic risk factors are of utmost importance in this group of patients. Key Points • In Serbian patients with primary antiphospholipid syndrome (PAPS), prevalence of non-criteria cardiac manifestations was 19.6% and they were significantly related to certain antiphospholipid antibodies and titers. • Lupus anticoagulant was a meaningful predictor of myocardial infarction, enabling possible risk stratification and proper preventive and therapeutical strategies in this subgroup of PAPS patients. • Patients with high titers of aCL IgG are more prone to acute decompensated heart failure occurence, imposing careful follow-up of these patients • Based on the analysis of the Serbian PAPS cohort, even being non-criterial, cardiology manifestations are significantly present and inclusion of cardiologists in treatment and follow-up of these patients should be implied from the diagnosis establishment.
Collapse
Affiliation(s)
- Aleksandra Djokovic
- Department of Cardiology, Division of Interventional Cardiology, University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia. .,Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Ljudmila Stojanovich
- Department of Rheumatology, University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
| | - Natasa Stanisavljevic
- Department of Hematology, University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
| | - Sandra Djokic
- Clinical Center of Serbia, Pulmonology Clinic, Belgrade, Serbia
| | - Branka Filipovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Gastroenterology, University Hospital Medical Center Dr Dragisa Misovic - Dedinje, Belgrade, Serbia
| | - Predrag Matic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Vascular Surgery, Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia
| | - Milomir Milanovic
- Clinic for Infectious and Tropical Diseases, Military Medical Academy, Belgrade, Serbia
| | - Svetlana Apostolovic
- Department of Professional and Scientific Training, Cardiology Clinic, Clinical Center of Nis, Nis, Serbia.,School of Medicine, University of Nis, Nis, Serbia
| | - Jovica Saponjski
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Interventional Cardiology, Emergency Room, Clinical Center of Serbia, Belgrade, Serbia
| |
Collapse
|
10
|
Lukic S, Mijac D, Filipovic B, Sokic-Milutinovic A, Tomasevic R, Krstic M, Milosavljevic T. Chronic Abdominal Pain: Gastroenterologist Approach. Dig Dis 2021; 40:181-186. [PMID: 33946069 DOI: 10.1159/000516977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/29/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Abdominal pain is a common symptom of gastroenterology examination. Chronic abdominal pain is present for >3 months. SUMMARY Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases encountered by both gastroenterologists and general practitioners. GERD is usually a chronic disease presented with a set of symptoms including heartburn and/or regurgitation, and less commonly epigastric pain. Epigastric pain syndrome is characterized by the following symptoms: epigastric pain and/or burning. It does not necessarily occur after meal ingestion, may occur during fasting, and can be even improved by meal ingestion. Duodenal ulcers tend to cause abdominal pain that is localized in the epigastric region and commence several hours after eating, often at night. Hunger provokes pain in most of the cases and decreases after meal. Gastric ulcer pain occurs immediately after eating, and consuming food increases pain. Pain is localized in the epigastrium and can radiate to the back. Abdominal pain in irritable bowel syndrome is related to defecation. A typical symptom of chronic pancreatitis is pain that radiates to the back. In Crohn's disease, inflammation causes pain. Key Messages: Pain can occur at different locations with diverse intensity and propagation and is often associated with other symptoms. For any gastroenterologist, abdominal pain is a big challenge.
Collapse
Affiliation(s)
- Snezana Lukic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dragana Mijac
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branka Filipovic
- Clinical and Hospital center "Dr Dragisa Misovic-Dedinje", School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Sokic-Milutinovic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ratko Tomasevic
- Department of Gastroenterology, Clinical and Hospital center "Zemun", School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Miodrag Krstic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | |
Collapse
|
11
|
Starcevic A, Dakovic M, Radojicic Z, Filipovic B. A structural magnetic resonance imaging study in therapy-naïve transsexual individuals. Folia Morphol (Warsz) 2020; 80:442-447. [PMID: 32644184 DOI: 10.5603/fm.a2020.0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/16/2020] [Accepted: 07/01/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Transsexuality is explained and defined as a gender-identity disorder, characterised by very strong conviction of belonging to the opposite sex and has been associated with a distinct neuroanatomical pattern. MATERIALS AND METHODS We performed a structural analysis in search of possible differences in grey matter structures based on magnetic resonance imaging scans of the brains of 26 individuals between 19 and 38 years of age. The participants were divided into two groups of 15 controls and 11 transgender individuals. The segmentation of subcortical grey matter was performed using FIRST model a model-based segmentation/registration tool, from FSL software package. RESULTS The results showed that the volume of the brain region called nucleus accumbens on the left side was significantly smaller in the group of transgender individuals compared to the control. It was the most important parameter which was shown to make distinction between two examined groups. CONCLUSIONS The results also showed decreased volumes of the left thalamus, right hippocampus and right caudate nucleus.
Collapse
Affiliation(s)
- A Starcevic
- Institute of Anatomy, Medical Faculty, University of Belgrade, Serbia.
| | - M Dakovic
- Faculty for Physical Chemistry, University of Belgrade, Serbia
| | - Z Radojicic
- Faculty of Organisational Sciences, University of Belgrade, Serbia
| | - B Filipovic
- Institute of Anatomy, Medical Faculty, University of Belgrade, Serbia
| |
Collapse
|
12
|
Zdravkovic M, Milovanovic B, Hinic S, Soldatovic I, Durmic T, Koracevic G, Prijic S, Markovic O, Filipovic B, Lovic D. Correlation between ECG changes and early left ventricular remodeling in preadolescent footballers. Physiol Int 2017; 104:42-51. [PMID: 28361571 DOI: 10.1556/2060.104.2017.1.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of this study was to assess the early electrocardiogram (ECG) changes induced by physical training in preadolescent elite footballers. This study included 94 preadolescent highly trained male footballers (FG) competing in Serbian Football League (minimum of 7 training hours/week) and 47 age-matched healthy male controls (less than 2 training hours/week) (CG). They were screened by ECG and echocardiography at a tertiary referral cardio center. Sokolow-Lyon index was used as a voltage electrocardiographic criterion for left ventricular hypertrophy diagnosis. Characteristic ECG intervals and voltage were compared and reference range was given for preadolescent footballers. Highly significant differences between FG and CG were registered in all ECG parameters: P-wave voltage (p < 0.001), S-wave (V1 or V2 lead) voltage (p < 0.001), R-wave (V5 and V6 lead) voltage (p < 0.001), ECG sum of S V1-2 + R V5-6 (p < 0.001), T-wave voltage (p < 0.001), QRS complex duration (p < 0.001), T-wave duration (p < 0.001), QTc interval duration (p < 0.001), and R/T ratio (p < 0.001). No differences were found in PQ interval duration between these two groups (p > 0.05). During 6-year follow-up period, there was no adverse cardiac event in these footballers. None of them expressed pathological ECG changes. Benign ECG changes are presented in the early stage of athlete's heart remodeling, but they are not related to pathological ECG changes and they should be regarded as ECG pattern of LV remodeling.
Collapse
Affiliation(s)
- M Zdravkovic
- 1 Faculty of Medicine, University Hospital Medical Center Bezanijska Kosa, University of Belgrade , Belgrade, Serbia
| | - B Milovanovic
- 1 Faculty of Medicine, University Hospital Medical Center Bezanijska Kosa, University of Belgrade , Belgrade, Serbia
| | - S Hinic
- 1 Faculty of Medicine, University Hospital Medical Center Bezanijska Kosa, University of Belgrade , Belgrade, Serbia
| | - I Soldatovic
- 2 Faculty of Medicine, Institute for Medical Statistics, University of Belgrade , Belgrade, Serbia
| | - T Durmic
- 3 Faculty of Medicine, Institute of Forensic Medicine, University of Belgrade , Belgrade, Serbia
| | - G Koracevic
- 4 Faculty of Medicine, Clinic for Cardiology, University of Nis , Nis, Serbia
| | - S Prijic
- 5 Department of Cardiology, Faculty of Medicine, Institute for Child and Mother Care "Vukan Cupic", University of Belgrade , Belgrade, Serbia
| | - O Markovic
- 1 Faculty of Medicine, University Hospital Medical Center Bezanijska Kosa, University of Belgrade , Belgrade, Serbia
| | - B Filipovic
- 1 Faculty of Medicine, University Hospital Medical Center Bezanijska Kosa, University of Belgrade , Belgrade, Serbia
| | - D Lovic
- 6 Clinic for Internal Diseases "InterMedica" , Nis, Serbia
| |
Collapse
|
13
|
Markovic O, Andjelic B, Tarabar O, Todorovic M, Filipovic B, Stanisavljevic D, Bila J, Antic D, Marisavljevic D, Mihaljevic B. Late relapse of Hodgkin's lymphoma - is it different in clinical characteristics and outcome? J BUON 2017; 22:481-486. [PMID: 28534373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the clinical characteristics, prognostic factors, therapy and outcomes of patients with very late relapse (>5 years) of Hodgkin's lymphoma (HL). METHODS We retrospectively reviewed the database of all relapsed patients with HL treated between 1999 and 2009 and compared the clinical characteristics and survival of patients who relapsed before and after 5 years of follow up. RESULTS Among the group of 102 patients with relapsed HL 16 (15.68%) patients had very late relapse of disease. Median time to very late relapse was 86 months (range 61- 199). On relapse most of these patients (11; 68.5%) were in advanced clinical stage. Eleven (68.75%) patients with very late relapse were treated with high dose chemotherapy and autologous stem cell transplantation (ASCT). Second complete response was achieved in 13 (81.25%) patients. At a median follow up of 4.5 years after therapy, 13 (81.25%) patients are still alive (10 without disease and 3 with disease), while 3 patients died (2 from HL, and 1 from brain tumor). There was no significant difference between patients with very late relapse and patients who relapse earlier in terms of initial clinical parameters. Median overall survival of patients with very late relapse was significantly longer than in patients with earlier relapse (p=0.001), but survival calculated from the time оf relapse was not significantly different between these two groups of patients (p=0.83). CONCLUSION An open question that remains is whether high dose therapy and ASCT is necessary in most patients with very late relapse of disease. Individualization of therapy in patients with very late relapse of HL is mandatory, tailored on risk factors and comorbidities.
Collapse
|
14
|
Marisavljevic D, Markovic O, Zdravkovic M, Hinic S, Suvajdzic Vukovic N, Filipovic B. Challenge of Using Antiplatelet Drugs in Patients with Primary Immune Thrombocytopenia and Recently Implanted Coronary Stents-Splenectomy as a Therapeutic Option. ACTA ACUST UNITED AC 2017. [DOI: 10.4172/2167-1052.1000220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
15
|
Filipovic B, Milinić N, Gacic J, Markovic O, Djokovic A, Filipovic B. Benign Hydronephrosis and Elevated of Serum Levels of Carbohydrate Antigen CA 19-9: A Case Report. Am J Case Rep 2016; 17:395-7. [PMID: 27287959 PMCID: PMC4917065 DOI: 10.12659/ajcr.897900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Patient: Male, 58 Final Diagnosis: Hydronephrosis Symptoms: Blunt abdominal pain • constipation • constipation Medication: — Clinical Procedure: Extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy Specialty: Gastroenterology and Hepatology
Collapse
Affiliation(s)
- Branka Filipovic
- Department of Gastroenterohepatology, Clinical and Hospital Center "Bezanijska Kosa", Belgrade, Serbia
| | - Nikola Milinić
- Department of Gastroenterohepatology, Clinical and Hospital Center "Bezanijska Kosa", Belgrade, Serbia
| | - Jasna Gacic
- Department of Surgery, Clinical and Hospital Center "Bezanijska Kosa", Belgrade, Serbia
| | - Olivera Markovic
- Department of Hematology, Clinical and Hospital Center "Bezanijska Kosa", Belgrade, Serbia
| | - Aleksandra Djokovic
- Department of Cardiology, Clinical and Hospital Center "Bezanijska Kosa", Belgrade, Serbia
| | | |
Collapse
|
16
|
Milovanovic B, Filipovic B, Mutavdzin S, Zdravkovic M, Gligorijevic T, Paunovic J, Arsic M. Cardiac autonomic dysfunction in patients with gastroesophageal reflux disease. World J Gastroenterol 2015; 21:6982-6989. [PMID: 26078576 PMCID: PMC4462740 DOI: 10.3748/wjg.v21.i22.6982] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 01/26/2015] [Accepted: 03/27/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate autonomic nervous function in patients with a diagnosis of gastroesophageal reflux disease (GERD).
METHODS: The investigation was performed on 29 patients (14 men), aged 18-80 years (51.14 ± 18.34), who were referred to our Neurocardiology Laboratory at the Clinical and Hospital Center “Bezanijska Kosa” with a diagnosis of GERD. One hundred sixteen healthy volunteers matched in age and sex with the examinees served as the control group. The study protocol included the evaluation of autonomic function and hemodynamic status, short-term heart rate variability (HRV) analysis, 24 h ambulatory ECG monitoring with long-term HRV analysis and 24 h ambulatory blood pressure monitoring.
RESULTS: Pathologic results of cardiovascular reflex test were more common among patients with reflux compared to the control group. Severe autonomic dysfunction was detected in 44.4% of patients and in 7.9% of controls (P < 0.001). Parameters of short-term analysis of RR variability, which are the indicators of vagal activity, had lower values in patients with GERD than in the control group. Long-term HRV analysis of time-domain parameters indicated lower values in patients with reflux disease when compared to the control group. Power spectral analysis of long-term HRV revealed lower low- and high-frequency values. Detailed 24 h ambulatory blood pressure analysis showed significantly higher values of systolic blood pressure and pulse pressure in the reflux group than in the control group.
CONCLUSION: Patients with GERD have distortion of sympathetic and parasympathetic components of the autonomic nervous system, but impaired parasympathetic function appears more congruent to GERD.
Collapse
|
17
|
Markovic O, Popovic L, Marisavljevic D, Jovanovic D, Filipovic B, Stanisavljevic D, Matovina-Brko G, Hajder J, Matkovic T, Živkovic R, Stanisavljevic N, Todorović M, Petrovic D, Mihaljevic B. Comparison of prognostic impact of absolute lymphocyte count, absolute monocyte count, absolute lymphocyte count/absolute monocyte count prognostic score and ratio in patients with diffuse large B cell lymphoma. Eur J Intern Med 2014; 25:296-302. [PMID: 24565533 DOI: 10.1016/j.ejim.2014.01.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/23/2014] [Accepted: 01/26/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND The combination of absolute lymphocyte count (ALC) and absolute monocyte count (AMC) at diagnosis has prognostic relevance in patients with diffuse large B cell lymphoma (DLBCL). AIMS The present study was designed to investigate the prognostic significance of ALC and AMC and to determine whether ALC/AMC ratio or ALC/AMC prognostic score is better predictor of outcome in DLBCL. METHODS We retrospectively analyzed the prognostic significance of ALC and AMC, ALC/AMC ratio and ALC/AMC prognostic score at diagnosis in 222 DLBCL patients treated with R-CHOP. RESULTS ROC analysis showed that optimal cut-off values of AMC and ALC/AMC ratio with the best sensitivity and specificity were 0.59×10(9)/L and 2.8, respectively. Cut-off of ALC was determined according to the literature data (1×10(9)/L). Low ALC, high AMC, low ALC/AMC ratio and high ALC/AMC prognostic score were in significant association with lower rate of therapy response and survival. In contrast, these parameters were not in significant correlation with relapse rate. The patients with low ALC, "high" AMC, low ALC/AMC ratio and high ALC/AMC prognostic score at diagnosis had significantly shorter EFS and OS. In multivariate analysis all tested parameters (ALC, AMC, ALC/AMC prognostic score and ALC/AMC ratio) are independent risk factors along with "bulky" disease and IPI. CONCLUSION All tested parameters (ALC, AMC, ALC/AMC score and ALC/AMC ratio) may be useful prognostic factors in DLBCL patients. ALC/AMC score has a slight advantage as it allows the classification of patients into three prognostic groups. Further studies are needed to determine which of these parameters has the highest predictive value.
Collapse
Affiliation(s)
- Olivera Markovic
- Clinical Hospital Center "Bezanijska Kosa", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia.
| | - Lazar Popovic
- Institute of Oncology, Sremska Kamenica, Serbia; Faculty of Medicine University of Novi Sad, Serbia
| | - Dragomir Marisavljevic
- Clinical Hospital Center "Bezanijska Kosa", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia
| | - Darjana Jovanovic
- Institute of Oncology, Sremska Kamenica, Serbia; Faculty of Medicine University of Novi Sad, Serbia
| | - Branka Filipovic
- Clinical Hospital Center "Bezanijska Kosa", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia
| | - Dejana Stanisavljevic
- Institute of Statistics, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia
| | - Gorana Matovina-Brko
- Institute of Oncology, Sremska Kamenica, Serbia; Faculty of Medicine University of Novi Sad, Serbia
| | - Jelena Hajder
- Clinical Hospital Center "Bezanijska Kosa", Belgrade, Serbia
| | | | | | | | - Milena Todorović
- Institute of Hematology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia
| | | | - Biljana Mihaljevic
- Institute of Hematology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia
| |
Collapse
|
18
|
Milinić N, Filipovic B, Lukić T, Marković O, Milisavljević N, Gajić M, Filipovic B. Ultrasonography analysis of gallbladder motility in patients with functional dyspepsia. Eur J Intern Med 2014; 25:156-9. [PMID: 24012325 DOI: 10.1016/j.ejim.2013.08.699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 08/12/2013] [Accepted: 08/13/2013] [Indexed: 01/18/2023]
Abstract
BACKGROUND Gallbladder motility has been studied in patients with functional gastrointestinal disorders, such as functional dyspepsia, irritable bowel syndrome and biliary disorders without gallstones and results of these observations are often inconclusive and conflicting. METHODS The investigation was performed on 180 therapy-naïve newly diagnosed patients with functional dyspepsia (97 females and 83 males), aged 20-79 in which we have investigate ultrasonographically parameters of gallbladder motility. RESULTS Bonferroni post hoc correction stressed that fasting gallbladder volume and ejection fraction were significantly distorted in individuals with postprandial distress syndrome, although, the residual gallbladder volume was significantly lower in patients with epigastric pain syndrome comparing with other examinees. Ejection fraction of the gallbladder negatively correlated with body mass index. CONCLUSION The impaired contractibility of the gall bladder in patients with functional dyspepsia, based on the results of this study, is illustrated by the changes in the ejection fraction, which was more pronounced in patients with the postprandial distress syndrome.
Collapse
Affiliation(s)
- Nikola Milinić
- Faculty of Medicine, University of Belgrade, Serbia; Department of Gastroenterohepatology Clinical and Hospital Center "Bezanijska Kosa," Belgrade, Serbia
| | - Branka Filipovic
- Faculty of Medicine, University of Belgrade, Serbia; Department of Gastroenterohepatology Clinical and Hospital Center "Bezanijska Kosa," Belgrade, Serbia.
| | - Tamara Lukić
- Faculty of Medicine, University of Belgrade, Serbia
| | - Olivera Marković
- Faculty of Medicine, University of Belgrade, Serbia; Department of Hematology Clinical and Hospital Center "Bezanijska Kosa", Belgrade, Serbia
| | | | - Milan Gajić
- Faculty of Medicine, University of Belgrade, Serbia; Institute for Medical Statistics, Belgrade, Serbia
| | - Branislav Filipovic
- Faculty of Medicine, University of Belgrade, Serbia; Institute of Anatomy "Niko Miljanic," Belgrade, Serbia
| |
Collapse
|
19
|
Pantelic J, Ajdzanovic V, Medigovic I, Mojic M, Trifunovic S, Milosevic V, Filipovic B. Genistein affects parathyroid gland and NaPi 2a cotransporter in an animal model of the andropause. J Physiol Pharmacol 2013; 64:361-368. [PMID: 23959733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 05/29/2013] [Indexed: 06/02/2023]
Abstract
This study aimed to examine the effects of genistein on the structural and functional changes in parathyroid glands (PTG) and sodium phosphate cotransporter 2a (NaPi 2a) in orchidectomized rats. Sixteen-month-old Wistar rats were divided into sham-operated (SO), orchidectomized (Orx) and genistein-treated orchidectomized (Orx+G) groups. Genistein (30 mg/kg/day) was administered subcutaneously for 3 weeks, while the controls received vehicle alone. PTG was analyzed histomorphometrically, while the expressions of NaPi 2a mRNA/protein levels from kidneys were determined by real time PCR and Western blots. Serum and urine parameters were determined biochemically. The PTG volume in Orx rats was increased by 30% (p<0.05), compared to the SO group. Orx+G treatment increased the PTG volume by 35% and 75% (p<0.05) respectively, comparing to Orx and SO animals. Orchidectomy led to increment of serum PTH by 27% (p<0.05) compared to the SO group, Orx+G decreased it by 18% (p<0.05) comparing to Orx animals. NaPi 2a expression in Orx animals was reduced in regards to its abundance in SO animals, although it was increased in Orx+G group compared to the Orx. Phosphorus urine content of Orx animals was raised by 12% (p<0.05) compared to that for the SO group, while Orx+G induced a 17% reduction (p<0.05) in regards to Orx animals. Our study shows that Orx increases PTG volume and serum PTH level, while protein expression of NaPi 2a is reduced. Application of genistein attenuates the orchidectomy-induced changes in serum PTH level, stimulates the expression of NaPi 2a and reduces urinary Pi excretion, implying potential beneficial effects on andropausal symptoms.
Collapse
Affiliation(s)
- J Pantelic
- Department of Cytology, Institute for Biological Research Sinisa Stankovic, University of Belgrade, Belgrade, Serbia.
| | | | | | | | | | | | | |
Collapse
|
20
|
Markovic O, Marisavljevic D, Cemerikic-Martinovic V, Filipovic B, Radovanović S, Zdravković M, Stanisavljevic D, Mihaljevic B. c-FLIP does not correlate with response to immunochemotherapy treatment and outcome of patients with nodal diffuse large B-cell lymphoma. Biomed Pharmacother 2013; 67:445-9. [PMID: 23582793 DOI: 10.1016/j.biopha.2013.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 02/04/2013] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED Cellular FLICE-inhibitory protein (c-FLIP) is a critical anti-apoptotic regulator that inhibits apoptosis-inducing ligand, (TRAIL)-induced apoptosis as well as chemotherapy-triggered apoptosis in malignant cells. The present study was designed to investigate the clinical and prognostic significance of c-FLIP expression in patients with nodal diffuse large B-cell lymphoma (DLBCL) treated with immunochemotherapy. METHODS We have analyzed lymph node biopsy specimens, obtained from 60 patients with newly diagnosed nodal DLBCL treated with immunochemotherapy (R-CHOP or R-EPOCH). The expression of c-FLIP was analyzed using the standard imunohistochemical method on formalin-fixed and routinely processed paraffin-embedded lymph node specimens and evaluated semi quantitavely as a percentage of tumor cells. RESULTS c-FLIP immunoexpression (>50% positive tumor cells) has been found in 28 (46.7%) patients, and observed as cytoplasmic staining. There was not significant difference in c-FLIP immunoexpression between GCB and non-GCB subtype of DLBCL (P=0.639). Besides, c-FLIP immunoexpression had no significant association with IPI, "bulky" disease, extranodal localization, haemoglobin, Ki-67 immunoexpression or other clinico-pathological parameters. c-FLIP positivity has no significant influence on therapy response and survival in patients with DLBCL (P=0.562 and P=0.093, respectively). Patients with c-FLIP overexpression did not relapse more often that patients without expression of this apoptotic protein (P=0.365). CONCLUSION Our results suggest that c-FLIP immunoexpression can not be used as a prognostic factor in patients with nodal DLBCL treated with immunochemotherapy.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Apoptosis
- CASP8 and FADD-Like Apoptosis Regulating Protein/immunology
- CASP8 and FADD-Like Apoptosis Regulating Protein/metabolism
- Cyclophosphamide/therapeutic use
- Doxorubicin/therapeutic use
- Etoposide/therapeutic use
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Prednisone/therapeutic use
- Prognosis
- Rituximab
- Sentinel Lymph Node Biopsy
- Survival
- Treatment Outcome
- Vincristine/therapeutic use
- Young Adult
Collapse
|
21
|
Filipovic B, Basara S, Milinić N, Milisavljevic N, Djurasinovic M, Filipović B. Comparison of two different approaches of ultrasound--guided biopsy in diagnosis of liver lesions. J Gastrointestin Liver Dis 2012; 21:439. [PMID: 23256130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
22
|
Filipovic B, Stijak L, Filipovic B. An unusual origin of the double left testicular artery in a male cadaver: a case report. J Med Case Rep 2012; 6:267. [PMID: 22938096 PMCID: PMC3441792 DOI: 10.1186/1752-1947-6-267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 06/21/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Variations in the number and course of the testicular arteries, often coexisting with variations of the other branches arising from the abdominal aorta, are still reported to be of interest to urology surgeons. CASE PRESENTATION During a routine dissection course, an unusual origin of the double left testicular artery was observed in the cadaver of a 68-year-old Caucasian man who donated his body to the Institute of Anatomy. CONCLUSIONS A deeper understanding of the variations of the testicular arteries is necessary for all physicians whose practice is related to the testicles and their vascular stalk.
Collapse
Affiliation(s)
- Branislav Filipovic
- Institute of Anatomy "Niko Miljanic", University of Belgrade, Faculty of Medicine, 4/2 Dr Subotica, 11000, Belgrade, Serbia.
| | | | | |
Collapse
|
23
|
Filipovic B, Kovcevic N, Randjelovic T, Kostic S, Filipovic B. Nutritional status in hospitalized patients in the department of gastroenterohepatology. ACTA ACUST UNITED AC 2012; 58:1229-34. [PMID: 21937384 DOI: 10.5754/hge09354] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS Malnutrition appears to be a major and noticeable problem for hospitalized patients and often present in patients with gastrointestinal diseases. This study attempts to evaluate differences in nutritional status parameters and nutritional state differences among hospitalized patients with various gastrointestinal diseases and disorders. METHODOLOGY Our study included 154 males and 146 females, aged 18-84 years old, with various gastrointestinal diseases and disorders. All patients underwent baseline nutritional assessment, including subjective global assessment (SGA), anthropometric measurements, bioelectrical impedance analysis (BIA), and biochemical markers. RESULTS Prevalence of malnutrition was 45.7%. The highest prevalence was detected among patients suffering from gastrointestinal malignancies and chronic pancreatitis. All parameters decreased with malnourishment levels, except CRP and in-hospital stay which rose with malnourishment grade. SGA and length of hospital stay negatively correlated with all analyzed variables of nutritional assessment, except CRP. CONCLUSIONS Patients suffering from gastrointestinal malignancies, inflammatory bowel disease and peptic ulcer disease have more pronounced level of malnutrition. Body mass index, triceps skin fold thickness, mid-arm circumference, MAMC, wrist circumference, total protein level, albumin, cholesterol, glucose level, lymphocyte count, basal metabolic rate, body fat mass, fat free mass, muscle mass, total body water and resistance appeared to be inversely correlated with malnutrition. However, CRP level correlated positively with the malnutrition severity. SGA malnutrition level is dependent of hospitalization length.
Collapse
Affiliation(s)
- Branka Filipovic
- Department of Gastroenterohepatology, Clinical and Hospital Center, Belgrade, Serbia.
| | | | | | | | | |
Collapse
|
24
|
Markovic-Zigic D, Starcevic A, Filipovic B, Dakovic M, Andrejic V. P-1339 - Agoraphobia hemiparesis and hemihypesthesia in a transsexual patient - case report. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)75506-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
25
|
Lackovic Z, Matak I, Bach-Rojecky L, Filipovic B, Gagula Z, Durovic N, Stracenski I. 3.310 THE PUZZLE OF BOTULINUM TOXIN AND PAIN. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
26
|
Markovic O, Marisavljevic D, Cemerikic V, Perunicic M, Savic S, Filipovic B, Mihaljevic B. Clinical and prognostic significance of apoptotic profile in patients with newly diagnosed nodal diffuse large B-cell lymphoma (DLBCL). Eur J Haematol 2011; 86:246-55. [DOI: 10.1111/j.1600-0609.2010.01567.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
27
|
Milovanovic B, Milinic N, Trifunovic D, Krotin M, Filipovic B, Bisenic V, Djuric D. Autonomic dysfunction in alcoholic cirrhosis and its relation to sudden cardiac death risk predictors. Gen Physiol Biophys 2009; 28 Spec No:251-261. [PMID: 19893108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Patients with liver cirrhosis have autonomic dysfunction and complex cardiovascular changes. Increases risk for sudden cardiac death (SCD) was recently recognized in liver cirrhosis. This study analyzed risk predictors for SCD related to autonomic dysfunction in patients with alcoholic liver cirrhosis (ALC). Twenty five patients with ALC were examined and compared with healthy control group. Cardiovascular autonomic reflex tests, comprehensive ECG with QTc interval, late potentials, short-term heart rate variability (HRV) analysis (time domain, spectral and nonlinear-Poincare plot analysis) and 24-h Holter ECG with long-term HRV analysis were done. According to autonomic reflex tests patients with ALC had high incidence (56%) of severe autonomic dysfunction, manifested as pronounced damage of vagal function. Patients had significantly depressed HRV (SDNN, SDANN, triangular index, LF and HF) and more frequently had serious arrhythmias, prolonged QTc and Poincare plot in a shape of dot (p < 0.001). In patient group QTc significantly inversely correlated with spectral components from short-term HRV analysis (ln(LF): r = -0.53, ln(HF): r = -0.47; p < 0.05), and Lown class significantly correlated with total autonomic function score (r = 0.64, p = 0.04). This study indicates that in ALC autonomic neuropathy with vagal impairment and sympathetic predominance is related to SCD risk predictors and onset of serious ventricular arrhythmias.
Collapse
Affiliation(s)
- Branislav Milovanovic
- Neurocardiology Laboratory, Department of Cardiology, Medical Centre Bezanijska Kosa, School of Medicine, University of Belgrade, Bezanijska Kosa b.b., 11080 Belgrade, Serbia.
| | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
Gastrojejunocolic fistula is a late, severe complication of a stomal ulcer, which develops as a result of inadequate resection of the stomach or incomplete vagotomy. It is uncommon and in our century is reported only sporadically in medical literature The authors report a case of benign gastrojejunocolic fistula, diagnosed by barium based contrast radiography, which demonstrated reflux of contrast from the transverse colon to the stomach and jejunum via a fistulous tract. Therapy of the gastrojejunal fistula is always radical and comprises en bloc resection of the fistula and revision of gastrectomy, partial resection of the jejunum and the colon, which is involved in the fistula, and restoration of continuity of the digestive tract by gastrojejunostomy, jejunojejunostomy and colocolostomy. If trunkal vagotomy has not previously been completed, it is advisable to perform it nonetheless.
Collapse
Affiliation(s)
- B. Filipovic
- Department of Gastro-enterohepatology, Belgrade, Serbia
| | - T. Randjelovic
- Department of Gastro-intestinal Surgery, Clinical and Hospital Centre “Bezanijska Kosa”, Belgrade, Serbia
| | - G. Nikolic
- Department of Gastro-enterohepatology, Belgrade, Serbia
| |
Collapse
|
29
|
Trifunovc S, Filipovic B, Ajdzanovic V, Sosic-Jurijevic B, Manojlovic-Stojanoski M, Nestorovic N, Ristic N, Sekulic M, Milosevic V. The effects of chronic SRIH-14 and octreotide administration on the pituitary-adrenal axis in adult male rats. Eur J Histochem 2008; 52:61-8. [PMID: 18502724 DOI: 10.4081/1187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The effects of chronic treatments with SRIH-14 and octreotide on pituitary corticotropes (ACTH cells) and on the adrenal cortex of male Wistar rats were examined. Adult males received two daily s.c. injections of 20 microg/100 g of body weight of either SRIH-14 or octreotide for 28 consecutive days. ACTH cells were studied using a peroxidase-antiperoxidase immunocytochemical procedure. Morpho-metry was used to evaluate the changes in cell and nuclear volumes (microm3) and volume densities (%) of ACTH-immunoreactive cells. The adrenal cortex was analyzed by histological and morphometric methods. A significant (p<0.05) decrease in body weight and in the absolute weights of the pituitary and adrenal glands was observed in both treated groups. Morphometric parameters of ACTH cells in both treated groups were not significantly (p>0.05) different than in control rats. The absolute volumes of the adrenal gland and adrenal cortex were significantly (p<0.05) decreased in both treated groups. The absolute and relative volumes of the zona glomerulosa (ZG), as well as the cellular and nuclear volumes of the ZG were significantly (p<0.05) decreased in the both treated groups. In rats treated with SRIH-14 and octreotide, the absolute and relative volumes of the zona fasciculata (ZF) and zona reticularis (ZR), as well as their stereological parameters, did not change significantly (p>0.05). The aldosterone levels in the SRIH-14 and ocreotide-treated groups were significantly (p<0.05) decreased - by 13% and 19%, respectively. The concentration of ACTH and corticosterone did not change significantly. Together, these findings show that SRIH-14 and octreotide administration affected the morphological characteristics of the adrenal ZG in a similar manner, and brought about a decrease in plasma aldosterone concentration. These treatments did not affect pituitary ACTH cells or adrenal ZF and ZR functioning.
Collapse
Affiliation(s)
- Svetlana Trifunovc
- Institute for Biological Research Sinisa Stankovic, Bulevar Despota Stefana 142, 11060 Belgrade, Serbia.
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Milosevic V, Terzic M, Filipovic B, Manojlovic M, Sosic-Jurjevic B, Sekulic M, Starcevic V. Adrenal cortex in peripubertal and adult female rats after neonatal treatment with SRIH-14. ARCH BIOL SCI 2008. [DOI: 10.2298/abs0801041m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Neonatal female rats (3-7 days old) were injected subcutaneously twice daily with 20 ?g of SRIH-14/100g b.w. for five consecutive days. The animals were sacrificed in the peripubertal (38 days old) or adult (80 days old) periods of life. Control rats were treated in the same way with identical volumes of saline. SRIH-14 led to significant reduction (p<0.05) of the absolute and relative volumes of the ZG in peripubertal animals, by 11 and 22%, respectively in comparison with the controls. The total number and volume of ZG cells and their nuclei were also significantly decreased (p<0.05) in peripubertal SRIH-14-treated rats as compared to the controls. There were no significant (p>0.05) changes in the morphometric parameters of adult adrenal cortex after SRIH-14 treatment compared with control females. It can be concluded that subcutaneously applied SRIH-14 in the neonatal period inhibits growth of adrenal ZG cells in female rats only up to the peripubertal stage, while the adrenal gland cortex recovers before mature adulthood is reached.
Collapse
Affiliation(s)
| | - Milica Terzic
- Institut za fiziologiju, Medicinski fakultet, Beograd
| | - B. Filipovic
- Institut za biološka istraživanja 'Siniša Stanković', Beograd
| | | | | | - Milka Sekulic
- Institut za biološka istraživanja 'Siniša Stanković', Beograd
| | | |
Collapse
|
31
|
Abstract
Carcinosarcomas are rare, malignant, biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma, along with its clinical, macroscopic and histopathological features. Macroscopically, a specimen of deformed stomach was obtained that measured 200 mm × 150 mm × 100 mm. A 150 mm × 100 mm × 50 mm exophytic tumoral mass (Borrmann typeI) was found, which involved the posterior wall from the cardia to the antrum. Histopathologically, a mixed type of malignancy was revealed: an adenocarcinoma with intestinal metaplasia, with interposed fascicles of fusiform atypical cells and numerous large, rounded and oval cells. The tumor showed positive histochemistry for cytokeratin 18, epithelial membrane antigen, carcinoembryonic antigen, chromogranin A and vimentin. Liver metastases were diagnosed 8 mo postoperatively, and the patient died 4 mo later. A review of the available literature is also presented.
Collapse
Affiliation(s)
- Tomislav Randjelovic
- Department of Gastroenterohepatology, Clinical and Hospital Center Bezanijska Kosa, Belgrade 11080, Serbia
| | | | | | | | | |
Collapse
|
32
|
Randjelovic T, Dikic S, Filipovic B, Gacic D, Bilanovic D, Stanisavljevic N. Short-segment jejunoplasty: the option treatment in the management of benign esophageal stricture. Dis Esophagus 2007; 20:239-46. [PMID: 17509121 DOI: 10.1111/j.1442-2050.2007.00679.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A non-dilatable benign stricture of the esophagus is a problem for the patient and always a challenge for the surgeon. The present study is intended to provide some details of surgical technique and the physiological concept that constitutes the basis for patient selection for short-segment jejunoplasty. In this study, out of 98 patients, 91 had complex stricture of the lower, and seven of the cervical esophagus. The main cause of stenosis in 60 patients (61.2%) was gastroesophageal reflux, in 34 (34.7%) post-corrosive damage, and in three (3.0%) it was other causes. All patients were treated by three methods of jejunoplasty: group I (n=54 patients) short-segment of the jejunum; group II (n=37 pts) Roux-en-Y double tract; and group III (n=7 patients) short jejunal segment on the long vascular pedicle. Intraoperative complications occurred in 17 (17.34%) of the patients. An anastomotic leak occurred only in three (3.29%) in group I and II, and 1/98 patients (1.02%) died from mediastinitis. Follow-up of functional results for up to 36 months (average 18 months) was available in 77/97 (79.3%) hospital survivors. Fifty-seven (74%) patients are satisfied with their ability to take food, postoperative reflux was completely denied by 72 (93.5%) patients. Postvagotomy diarrhea was transient and gradually subsided over the course of the first 6 months.
Collapse
Affiliation(s)
- T Randjelovic
- Department of Gastrointestinal Surgery, University Hospital Center Bezanijska Kosa, Belgrade, Serbia.
| | | | | | | | | | | |
Collapse
|
33
|
Zivkovic S, Devic M, Filipovic B, Giba Z, Grubisic D. Effect of NaCl on seed germination in some Centaurium Hill. Species (Gentianaceae). ARCH BIOL SCI 2007. [DOI: 10.2298/abs0703227z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The influence of high NaCl concentrations on seed germination in both light and darkness was examined in the species Centaurium pulchellum, C. erythraea, C. littorale, C. spicatum, and C. tenuiflorum. Salt tolerance was found to depend on the life history of the seeds. To be specific, seeds of all five species failed to complete germination when exposed to continuous white light if kept all the time in the presence of 100-200 mM and greater NaCl concentrations. However, when after two weeks NaCl was rinsed from the seeds and the seeds were left in distilled water under white light for an additional two weeks, all species completed germination to a certain extent. The percent of germination not only depended on NaCl concentration in the prior medium, but was also species specific. Thus, seeds of C. pulchellum, C. erythraea, and C. littorale completed germination well almost irrespective of the salt concentration previously experienced. On the other hand, seeds of C. tenuiflorum completed germination poorly if NaCl concentrations in the prior media were greater than 200 mM. When seeds after washing were transferred to darkness for an additional 14 days, they failed to complete germination if previously imbibed on media containing NaCl concentrations greater than 400 mM. However, the seeds of all species, even if previously imbibed at 800 mM NaCl, could be induced to complete germination in darkness by 1 mM gibberellic acid. .
Collapse
Affiliation(s)
- S. Zivkovic
- Institut za biološka istraživanja 'Siniša Stanković', Beograd
| | - M. Devic
- Institut za biološka istraživanja 'Siniša Stanković', Beograd
| | - B. Filipovic
- Institut za biološka istraživanja 'Siniša Stanković', Beograd
| | - Z. Giba
- Institut za botaniku, Biološki fakultet, Beograd
| | - D. Grubisic
- Institut za biološka istraživanja 'Siniša Stanković', Beograd + Institut za botaniku, Biološki fakultet, Beograd
| |
Collapse
|
34
|
Filipovic B, Ilankovic N, Radonjic V, Filipovic B, Nikolic V. Large cava septi pellucidi in schizophrenic patients, alcoholics, head-traumatized, and normal individuals: morpholgical features and forensic implications. A postmortem study. Acta Neuropsychiatr 2006; 18:15-20. [PMID: 26991977 DOI: 10.1111/j.0924-2708.2006.00112.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The enlarged cava septi pellucidi (CSP = 6 mm in length) have been reported as a reliable marker of an underlying neuropsychiatric disease or disorder. Differences in the dimensions of cava longer than 6 mm associated with a neuropsychiatric impairment could be of possible clinical and forensic significance. METHODS We obtained 479 brains from autopsied persons (310 males and 169 females, aged 22-89 years) and observed that 110 brains (75 males and 35 females) had CSP, of which the length of CSP was equal to or longer than 6 mm on 69 (49 males and 20 females) of them. These cava were classified into four groups depending on the past medical histories of the autopsied person: five without neuropsychiatric history (asymptomatic CSP), 25 schizophrenic patients, 22 alcoholics, and 17 with a past head trauma (symptomatic CSP). RESULTS The linear parameters of CSP (i.e. length, width) of the symptomatic and asymptomatic groups were measured and were statistically analyzed. Analysis revealed that the cava in the group of schizophrenic patients were significantly longer and wider. CONCLUSIONS Discriminant function analysis was used to derive a mathematical formula to classify CSP into one of the groups obtained based on width measurements of the cavum.
Collapse
Affiliation(s)
- B Filipovic
- 1Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - N Ilankovic
- 2Department for Organic Mental Disorders, Institute of Psychiatry, Clinical Center of Serbia, Belgrade, Serbia
| | - V Radonjic
- 1Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - B Filipovic
- 3Clinical Center 'Bezanijska Kosa', Belgrade, Serbia
| | - V Nikolic
- 1Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
35
|
Abstract
The presence of myocardial bridges over the coronary arteries has been studied in 29 monkey (Cercopithecus aethiops) hearts. The great resemblance between the Cercopithecus subepicardial arterial net with the corresponding one in humans has been revealed. There is a high incidence (83%) of myocardial bridges only over the ventricular branches of both coronary arteries. Myocardial bridges are usually (90%) located over the left coronary artery branches, and the left anterior interventricular branch is the most frequently (69%) overbridged vessel. The bridges are always single over the vessel examined and their length varies from 0.5 mm to 31.6 mm. No statistically significant sexual difference in myocardial bridges distribution is reported.
Collapse
Affiliation(s)
- G Teofilovski
- Institute of Anatomy, School of Medicine, University of Belgrade, Yugoslavia
| | | | | | | | | | | | | |
Collapse
|
36
|
Gasparov A, Vojvodic N, Kozarevic D, Racic Z, Bjelic J, Pasic I, Elakovic M, Filipovic B, Lalic M, Tesanovic D. [Incidence of large intestine and rectal neoplasms in the Yugoslavian population]. Nar Zdrav 1972; 28:225-9. [PMID: 4658530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
37
|
Gasparov A, Bjelic J, Elakovic M, Filipovic B, Petrovic Z, Kusic N. [Treatment of the painful crisis of ulcer with sulpiride]. Therapeutique 1972; 48:129-30. [PMID: 5049321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|