Branka Filipovic

Primary actinomycosis of the anterior abdominal wall: Case report and review of the literature

Abstract  Actinomycosis of the anterior abdominal wall is a rare infection caused by different Actinomyces species. We report a case of primary actinomycosis localized on the anterior abdominal wall, diagnosed by computed tomography (CT) scan, postoperatively confirmed by histopathological examination and treated by surgical resection combined with postoperative antibiotic therapy. The patient has been free of recurrence after 1 year. A review of the available literature is also presented.

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.

Clinical and prognostic significance of apoptotic profile in patients with newly diagnosed nodal diffuse large B-cell lymphoma (DLBCL)

Background:  Apoptosis‐related proteins might play an important role in the pathogenesis of lymphoma and sensibility to chemotherapy (CH) in patients with non‐Hodgkin’s lymphoma. We have analyzed the relationship between expression of two proapoptotic (CD95, caspase‐3) and four antiapoptotic proteins (c‐FLIP, bcl‐2, survivin, and XIAP) and clinical outcome of patients with nodal diffuse large B‐cell lymphoma (DLBCL).

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.

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.

Common Variable Immunodeficiency Associated with Inflammatory Bowel Disease and Type I Diabetes

Common variable immunodeficiency (CVID) is a heterogeneous group of primary immunodeficiency disorders characterized by defective antibody production, low levels of serum immunoglobulins and increased susceptibility to infection. The patient was a 39-year-old male who was admitted to the gastroenterology department with a two week history of diarrhea, blunt abdominal pain below the umbilicus, prolonged febrile state, loss of appetite and loss of body weight of 18 kg during the previous six months. Screening tests of serum immunoglobulins showed decreased concentrations of three types of immunoglobulins: IgA < 0.24 g/L, IgM < 0.18 g/L and IgG < 1.55 g/L. Lymphocytes immunophenotypisation revealed inversed CD4+/8+ T cells ratio, 0.31 and absence of plasma cells (CD138 negative). Colonoscopy showed a rectal mucosa like cobblestones with multiple longitudinal and serpentinous ulceration, without involvement of other segments of the colon and the small intestine. Histopathology revealed aphtous ulcerative lesions, transmural inflammation with multiple lymphoid aggregates and benign lymphoid nodular hyperplasia of the small intestine. Plasma cells were absent from the lamina propria. Magnetic resonance imaging of a perianal fistula demonstrated a trans-sphicteric type. This case is specific because of the three illnesses associated and only one case of an association of diabetes mellitus type I and immunodeficiency reported thus far.

Current Approaches to the Functional Gastrointestinal Disorders

Functional gastrointestinal disorders (FGD), namely, functional gastrointestinal disorders (FGID) and irritable bowel syndrome (IBS), are always in the focus of gastroenterologists, because of their polymorphic symptomatology and insufficiently defined causes and habits that influence the appearance of FGD. Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder (FGID) characterized by abdominal pain or discomfort and alteration of bowel habits in the absence of an organic disorder. IBS is the most common gastrointestinal disorder and the prevalence varies from 4% to 22% in the population based studies [1–3]. Functional dyspepsia (FD) is common and significantly impairs quality of life. Symptoms of FD are considered to originate from the gastroduodenal region, classified by the Rome criteria as disorders of brain-gut interaction without structural alteration. However, it is now apparent that FD is a number of syndromes, the epigastric pain syndrome (bothersome epigastric pain or epigastric burning) and the postprandial distress syndrome (with bothersome postprandial fullness or early satiation) and there are wide-ranging symptoms and severity [4].

Cavum Septi Pellucidi as a Marker of the Neuropsychiatric Diseases: APointer or Mislead? A Cadaveric-Clinical Observation

Cavum Septi pellucid (CSP), a cavity between the laminae of the septum pellucidum, for a longer period has been reported as an anomaly of the brain midline, associated with neuropsychiatric diseases, mostly schizophrenia, but also posttraumatic stress disorder, De la Tourette disease, and persons who survived a repeated a serious head trauma, boxers on the first place. Our investigation has been performed on 479 unfixed frozen brains, of the autopsied individuals of both genders, and MRI scans of 250 examinees, out of which 110 had neuropsychiatric illness. In our sample, the prevalence of CSP was 22.96% among the autopsied individuals and 9.2% in examinees who underwent MRI scan. The cause of the death among schizophrenia suffering persons was suicide (18 out of 25 patients). Obviously, CSP is more frequently associated with neuropsychiatric diseases, but a dilemma still exists, did we make a bias in brain suitability for the examination or we did the same mistake in observing clinical cases. A large CSP, though, is an almost certain sign for an underlying neuropsychiatric impairment, especially schizophrenia. The CSP among alcoholics and persons with the priory sustained head blows is probably of the same cause and represents an aftermath of the diffuse axonal injuries, i.e. brain trauma.