Branislav Filipović

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Ulcerative colitis and Crohns 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.

Anxiety, personality traits and quality of life in functional dyspepsia‐suffering patients

BACKGROUND Psychosocial stressors either acute or more sustained frequently precede the onset and exacerbation of the symptoms of the functional dyspepsia (FD). Depressive mood and quality of life have been already reported for interference in functional dyspepsia suffering patients. METHODS The examination were performed on 60 FD patients (30 females and 30 males), aged 20-79 years, 60 peptic ulcer subjects and 60 healthy volunteers in which we have investigate levels of anxiety and depression, personality traits and quality of life. RESULT According to the Hamilton Depression and Anxiety Rating Scales, the population with FD had the average score which classified them into the group of patients with the moderate depression (20.57 ± 4.45). Personality traits estimation based on data obtained by the Eysenck personality questionnaire revealed higher neuroticism scores in the group with functional dyspepsia. Both parameters, level of the neuroticism and anxiety level, expressed highly significant level of mutual concordance. Patients with functional dyspepsia reported a greater adverse impact of symptoms of emotional distress and food and drink problems. CONCLUSION Results are indicating that the depression and anxiety level is the highest in patients with functional dyspepsia and that anxiety level corroborates with the neuroticism level from the Eysenck scale. Psychological disturbances are influencing the quality of life mostly in patients with dyspepsia in the form of emotional distress and the problem with the food and beverage intake.

Predictive potential of cavum septi pellucidi (CSP) in schizophrenics, alcoholics and persons with past head trauma: A post-mortem study

Abstract.The increased presence of cavum septi pellucidi (CSP) was reported among people suffering from schizophrenia, alcoholism or it could be a remnant of an old head trauma. We have tried to compare not only prevalences, but also lengths, widths and depths of the obtained cava in an effort to emphasize the importance of linear parameters in routine diagnostics. On 479 cadavers, 310 male and 169 female, aged 22 to 89; 110 brains had a CSP: 40 persons had no data about prior neuropsychiatric disease, 25 were schizophrenics, 25 alcoholics and 20 received a serious head blow during their lifetime. The prevalence of CSP in the entire group was 22.96%; among normal persons 10.61%; in schizophrenics 83.33%, in alcoholics 58.14 % and in persons with sustained prior head trauma 68.96%. There was a statistically significant difference in ratings, lengths and widths of CSP between schizophrenics, alcoholics, head traumatized and normals. Both length and width were revealed as parameters of importance for CSP selection. CSP is more frequent, longer and wider in persons who are suffering from schizophrenia, alcohol addicts and those who had sustained one or several head blows in the past. Its linear parameters are advisable to be measured.

Morphological differences among cavum septi pellucidi obtained in patients with schizophrenia and healthy individuals: forensic implications. A post-mortem study.

Abstract  Cavum septi pellucidi (CSP), especially when longer than 6 mm, has been recognized as a neurodevelopmental anomaly associated with schizophrenia. The present post‐mortem study was designed to determine the importance of linear parameters of CSP and to evaluate the possible differences of CSP in schizophrenic patients (n = 25 out of 110 CSP+ brains) and normal persons (n = 40 out of 110 CSP+ brains). According to our results, schizophrenia patients had significantly longer and wider CSP than normal individuals. Also, statistical analysis revealed a higher suicide rate in CSP‐positive patients with schizophrenia.

Dementia paralytica (neurosyphilis): A clinical case study

Summary This study reminds clinicians that syphilis presents in many guises. Wars, migration and sexual promiscuity prepare the ground for its return as an important cause of neurological and psychiatric syndromes. Our patients diagnosis was not suspected at earlier admission. Stage III spirochaetosis was improved by high dose penicillin.

Profiling differences in chemical composition of brain structures using Raman spectroscopy.

Raman spectroscopy enables non-invasive investigation of chemical composition of biological tissues. Due to similar chemical composition, the analysis of Raman spectra of brain structures and assignment of their spectral features to chemical constituents presents a particular challenge. In this study we demonstrate that standard and independent component analysis of Raman spectra is capable of assessment of differences in chemical composition between functionally related gray and white matter structures. Our results show the ability of Raman spectroscopy to successfully depict variation in chemical composition between structurally similar and/or functionally connected brain structures. The observed differences were attributed to variations in content of proteins and lipids in these structures. Independent component analysis enabled separation of contributions of major constituents in spectra and revealed spectral signatures of low-concentration metabolites. This provided finding of discrepancies between structures of striatum as well as between white matter structures. Raman spectroscopy can provide information about variations in contents of major chemical constituents in brain structures, while the application of independent component analysis performed on obtained spectra can help in revealing minute differences between closely related brain structures.

Long-Term Effects of Maternal Deprivation on Cholinergic System in Rat Brain

Numerous clinical studies have demonstrated an association between early stressful life events and adult life psychiatric disorders including schizophrenia. In rodents, early life exposure to stressors such as maternal deprivation (MD) produces numerous hormonal, neurochemical, and behavioral changes and is accepted as one of the animal models of schizophrenia. The stress induces acetylcholine (Ach) release in the forebrain and the alterations in cholinergic neurotransmitter system are reported in schizophrenia. The aim of this study was to examine long-term effects of maternal separation on acetylcholinesterase (AChE) activity in different brain structures and the density of cholinergic fibers in hippocampus and retrosplenial (RS) cortex. Wistar rats were separated from their mothers on the postnatal day (P) 9 for 24 h and sacrificed on P60. Control group of rats was bred under the same conditions, but without MD. Brain regions were collected for AChE activity measurements and morphometric analysis. Obtained results showed significant decrease of the AChE activity in cortex and increase in the hippocampus of MD rats. Density of cholinergic fibers was significantly increased in CA1 region of hippocampus and decreased in RS cortex. Our results indicate that MD causes long-term structure specific changes in the cholinergic system.

Long-Term Effects of Maternal Deprivation on the Neuronal Soma Area in the Rat Neocortex

Early separation of rat pups from their mothers (separatio a matrem) is considered and accepted as an animal model of perinatal stress. Adult rats, separated early postnatally from their mothers, are developing long-lasting changes in the brain and neuroendocrine system, corresponding to the findings observed in schizophrenia and affective disorders. With the aim to investigate the morphological changes in this animal model we exposed 9-day-old (P9) Wistar rats to a 24 h maternal deprivation (MD). At young adult age rats were sacrificed for morphometric analysis and their brains were compared with the control group bred under the same conditions, but without MD. Rats exposed to MD had a 28% smaller cell soma area in the prefrontal cortex (PFCX), 30% in retrosplenial cortex (RSCX), and 15% in motor cortex (MCX) compared to the controls. No difference was observed in the expression of glial fibrillary acidic protein in the neocortex of MD rats compared to the control group. The results of this study demonstrate that stress in early life has a long-term effect on neuronal soma size in cingulate and retrosplenial cortex and is potentially interesting as these structures play an important role in cognition.

An unusual origin of the double left testicular artery in a male cadaver: a case report

IntroductionVariations 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 presentationDuring 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.ConclusionsA 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.

Predicting ACL rupture in the population actively engaged in sports activities based on anatomical risk factors.

The purposes of this article were identification (ie, verification and gradation) of anatomical risk factors that lead to anterior cruciate ligament (ACL) injury and determination of the probability of ACL injury among the population actively engaged in sports activities. We evaluated 66 patients divided into 2 groups: 33 patients in the examined group diagnosed with ACL lesion, and 33 patients in the control group diagnosed with patellofemoral pain. Patients were matched by age, sex, type of lesion, and whether the lesion was left or right sided. Measurements were carried out by radiography and magnetic resonance imaging. The study examined 32 anatomical factors. After identifying factors that lead to ACL injury, the following were determined: the coefficient of significance for each individual factor via the discriminant analysis and the canonical discriminant (i.e., canonical correlation). Fifteen factors in men and 8 factors in women were differentiated as having influence on ACL injury. Based on these factors, it was determined whether the patients belonged to the examined or the control group with a success rate of 100% in men (100% sensitivity and specificity) and 91.7% in women (100% sensitivity and 83.3% specificity). The anatomy of the ACL prone to rupture and of the skeletal structures influencing it is significantly different from the anatomy of the ACL ligament resistant to injury. The probability of precise prognosis of ACL injury based on differentiated anatomical factors is 88.9% in men and 75.7% in women actively engaged in sports activities.