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Filipovic B.R.,Niko Niko | Filipovic B.R.,University of Belgrade | Filipovic B.F.,Clinical and Hospital Center Bezanijska Kosa
World Journal of Gastroenterology | Year: 2014

Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved. Source


Filipovic B.,Clinical and Hospital Center Bezanijska Kosa | Kovcevic N.,Institute for Digestive Diseases | Randjelovic T.,Clinical and Hospital Center Bezanijska Kosa | Kostic S.,Clinical and Hospital Center Bezanijska Kosa | Filipovic B.,Niko Niko
Hepato-Gastroenterology | Year: 2011

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 dependant of hospitalization length. © H.G.E. Update Medical Publishing S.A. Source


Filipovic B.F.,Clinical and Hospital Center Bezanijska Kosa | Randjelovic T.,Clinical and Hospital Center Bezanijska Kosa | Kovacevic N.,Institute for Digestive Disease | Milinic N.,Clinical and Hospital Center Bezanijska Kosa | And 3 more authors.
European Journal of Internal Medicine | Year: 2011

Background: To investigate differences in laboratory markers, nutritional status parameters and eating patterns among newly diagnosed patients with functional dyspepsia. Method: The investigation was performed on 180 newly diagnosed patients with functional dyspepsia, aged 20-79, which were referred to the gastroenterology unit of the Clinical and Hospital Center "Bezanijska Kosa" from April to October 2009. Rome II criteria were used for further classification. Results: ANOVA Bonferroni post hoc correction outlined that concentrations of serum magnesium and calcium were significantly lower in subjects with ulcer-like dyspepsia, while vitamin B12, glucose and immunoglobulin G level was significantly higher in group with dismotility-like dyspepsia. Statistical analysis revealed that the numbers of meal taken per day were significantly different. There was a statistical trend to skipping meals and to eat fast in patients with ulcer-like and dismotility-like functional dyspepsia when compared with non-specific dyspeptic subjects. Conclusion: Patients with ulcer-like functional dyspepsia suffered from epigastric pain and burning and from heartburn, while persons with dismotility-like dyspepsia were complaining about postprandial fullness, bloating and early satiety. They skipped meals more frequently and avoided intake of certain supplies which, together with eating habits, provoked or emphasized the annoying symptoms. © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. Source


Filipovic B.,University of Belgrade | Stijak L.,University of Belgrade | Filipovic B.,Clinical and Hospital Center Bezanijska Kosa
Journal of Medical Case Reports | Year: 2012

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. © 2012 Filipovic et al.; licensee BioMed Central Ltd. Source


Filipovic B.F.,Clinical and Hospital Center Bezanijska Kosa | Gajic M.,Institute for Medical Statistics | Milinic N.,Clinical and Hospital Center Bezanijska Kosa | Milovanovic B.,Clinical and Hospital Center Bezanijska Kosa | And 3 more authors.
World Journal of Gastroenterology | Year: 2010

Aim: To investigate and compare efficacy and differences in the nutritional status evaluation of gastroenterology patients by application of two Methods: subjective global assessment (SGA) and nutritional risk index (NRI). Methods: The investigation was performed on 299 hospitalized patients, aged 18-84 years (average life span 55.57 ± 12.84), with different gastrointestinal pathology, admitted to the Department of Gastroenterohepatology, Clinical and Hospital Center "Bezanijska Kosa" during a period of 180 d. All the patients, after being informed in detail about the study and signing a written consent, underwent nutritional status analysis, which included two different nutritional indices: SGA and NRI, anthropometric parameters, bioelectrical impedance analysis, and biochemical markers, within 24 h of admission. Results: In our sample of 299 hospitalized patients, global malnutrition prevalence upon admission varied from 45.7% as assessed by the SGA to 63.9% by NRI. Two applied methods required different parameters for an adequate approach: glucose level (5.68 ± 1.06 mmol/L vs 4.83 ± 1.14 mmol/L, F = 10.63, P = 0.001); body mass index (26.03 ± 4.53 kg/m2 vs 18.17 ± 1.52 kg/m2, F = 58.36, P < 0.001); total body water (42.62 ± 7.98 kg vs 36.22 ± 9.32 kg, F = 7.95, P = 0.005); basal metabolic rate (1625.14 ± 304.91 kcal vs 1344.62 ± 219.08 kcal, F = 9.06, P = 0.003) were very important for SGA, and lymphocyte count was relevant for NRI: 25.56% ± 8.94% vs 21.77% ± 10.08%, F = 11.55, P = 0.001. The number of malnourished patients rose with the length of hospital stay according to both nutritional indices. The discriminative function analysis (DFA) delineated the following parameters as important for prediction of nutritional status according to SGA assessment: concentration of albumins, level of proteins, SGA score and body weight. The DFA extracted MAMC, glucose level and NRI scores were variables of importance for the prediction of whether admitted patients would be classified as well or malnourished. Conclusion: SGA showed higher sensitivity to predictor factors. Assessment of nutritional status requires a multidimensional approach, which includes different clinical indices and various nutritional parameters. © 2010 Baishideng. Source

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