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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.
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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
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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.
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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.)
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Filipovic BF, Latas M, Kiurski S, Al Kiswani D, Filipovic N, Marjanovic-Haljilji M, Laketic D, Aksic M, Markovic B, Kapor S, Kapor S, Markovic O, Starcevic A. The Role of Psychotherapy in the Treatment of Patients with Non- alcoholic Fatty Liver Disease and Obstructive Sleep Apnea. J Gastrointestin Liver Dis 2021; 30:477-484. [PMID: 34941988 DOI: 10.15403/jgld-3758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/16/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Non-alcoholic fatty liver disease (NAFLD) is a metabolic disease with extensive multi- organ involvement, whose extra-hepatic manifestations include diabetes mellitus type 2, cardiovascular disease, obstructive sleep apnea (OSA), chronic kidney disease, and polycystic ovary syndrome. Our hypothesis was that there was a strong psychological component in NAFLD and OSA suffering patients and that psychotherapy would be helpful in the treatment of the mentioned diseases. METHODS Of 144 initially selected patients (with NAFLD, obesity and OSA), 32 patients agreed to undergo psychotherapy, and 31 therapy-naive NAFLD and OSA patients agreed to participate as controls. RESULTS Psychological evaluation revealed that self-esteem rose significantly after one-year psychotherapy (p=0.005). Body mass index (BMI) was significantly lower after psychotherapy, followed by the changes in laboratory results. Binomial logistic regression revealed that the reduction of BMI in high probability led to self-esteem improvement (p=0.03). CONCLUSIONS Psychotherapy was an efficient supporting method in the treatment of patients with NAFLD, obesity and OSA. It raised self-esteem and stimulated the motivation for further treatment of obesity, as one of the important factors for NAFLD and OSA. Still, it is advisable to use psychotherapy in combination with other clinical methods of treatment.
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Affiliation(s)
- Branka F Filipovic
- University of Belgrade, Faculty of Medicine, Belgrade; Dr. Dragiša Mišović- Dedinje Clinical and Hospital Center, Dept. of Gastroenterology, Belgrade, Serbia.
| | - Milan Latas
- University of Belgrade, Faculty of Medicine, Belgrade; Clinic for Psychiatry, Clinical Center of Serbia, Belgrade, Serbia.
| | - Stanimir Kiurski
- Dr. Dragiša Mišović- Dedinje Clinical and Hospital Center, Dept. of Gastroenterology, Belgrade, Serbia.
| | - Dezbal Al Kiswani
- Dr. Dragiša Mišović- Dedinje Clinical and Hospital Center, Dept. of Gastroenterology, Belgrade, Serbia
| | - Natasa Filipovic
- Dr. Dragiša Mišović- Dedinje Clinical and Hospital Center, Dept. of Gastroenterology, Belgrade, Serbia.
| | | | - Darko Laketic
- University of Belgrade, Faculty of Medicine, Belgrade; Niko Miljanić Institute of Anatomy, Belgrade, Serbia.
| | - Milan Aksic
- University of Belgrade, Faculty of Medicine, Belgrade; Niko Miljanić Institute of Anatomy, Belgrade, Serbia.
| | - Branka Markovic
- University of Belgrade, Faculty for Sports and Physical Education, Belgrade, Serbia.
| | - Suncica Kapor
- Dr. Dragiša Mišović- Dedinje Clinical and Hospital Center, Dept. of Haematology, Belgrade, Serbia.
| | - Slobodan Kapor
- University of Belgrade, Faculty of Medicine, Belgrade; Niko Miljanić Institute of Anatomy, Belgrade, Serbia.
| | - Olivera Markovic
- University of Belgrade, Faculty of Medicine, Belgrade; Bezanijska Kosa Clinical and Hospital Center, Bezanijska s/n, Belgrade, Serbia.
| | - Ana Starcevic
- University of Belgrade, Faculty of Medicine, Belgrade; Niko Miljanić Institute of Anatomy, Belgrade, Serbia.
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