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Non-alcoholic fatty liver disease and obesity: Biochemical, metabolic and clinical presentations

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World Journal of Gastroenterology 2014年第28期20卷 9330-9337页

作者： Sandra Milic davorka Lulic davor Stimac Division of Gastroenterology Department of Internal MedicineUniversity Hospital Rijeka

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the world. Presentation of the disease ranges from simple steatosis to non-alcoholic steatohepatitis (NASH). NAFLD is a hepatic manifestation of metabolic syndrome that includes central abdominal obesity along with other components. Up to 80% of patients with NAFLD are obese, defined as a body mass index (BMI) > 30 kg/m2. However, the distribution of fat tissue plays a greater role in insulin resistance than the BMI. The large amount of visceral adipose tissue (VAT) in morbidly obese (BMI > 40 kg/m2) individuals contributes to a high prevalence of NAFLD. Free fatty acids derived from VAT tissue, as well as from dietary sources and de novo lipogenesis, are released to the portal venous system. Excess free fatty acids and chronic low-grade inflammation from VAT are considered to be two of the most important factors contributing to liver injury progression in NAFLD. In addition, secretion of adipokines from VAT as well as lipid accumulation in the liver further promotes inflammation through nuclear factor kappa B signaling pathways, which are also activated by free fatty acids, and contribute to insulin resistance. Most NAFLD patients are asymptomatic on clinical presentation, even though some may present with fatigue, dyspepsia, dull pain in the liver and hepatosplenomegaly. Treatment for NAFLD and NASH involves weight reduction through lifestyle modifications, anti-obesity medication and bariatric surgery. This article reviews the available information on the biochemical and metabolic phenotypes associated with obesity and fatty liver disease. The relative contribution of visceral and liver fat to insulin resistance is discussed, and recommendations for clinical evaluation of affected individuals is provided.

关键词： Fatty liver Insulin resistance Intra-abdominal fat Metabolism Non-alcoholic fatty liver disease Obesity

Effect of water matrices on removal of veterinary pharmaceuticals by nanofiltration and reverse osmosis membranes

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Journal of Environmental Sciences 2011年第8期23卷 1299-1307页

作者： davor Dolar Ana Vukovi Danijela Aperger Kreimir Kouti Department of Physical Chemistry Faculty of Chemical Engineering and Technology Maruliev trg 19 10000 Zagreb Croatia Department of Analytical Chemistry Faculty of Chemical Engineering and Technology Maruliev trg 19 10000 Zagreb Croatia

This study explored the removal of five veterinary pharmaceuticals （VPs）（sulfamethoxazole （SMETOX）, trimethoprim （TMP）, ciprofloxacin （CIPRO）, dexamethasone （DEXA） and febantel （FEBA）） from different water matrices （Milli-Q water, model water, tap water and real pharmaceutical wastewater using four types of nanofiltration （NF） membranes （NF90, NF270, NF and HL） and two reverse osmosis （RO） membranes （LFC-1 and XLE）. All VPs were added to different water matrices at a concentration of 10 mg/L. Rejections of VPs and water flux were measured. The rejection increased with increase of molecular weight. The highest rejections were obtained with RO membranes （LFC-1, XLE） and tight NF （NF90） membrane. In general, the rejection of VPs was higher in model water and tap water than in Milli-Q water, but the water flux was lower. This was mainly explained by ion adsorption inside the membranes pores. Narrower pore size counteracted the effect of presence of low concentration of natural organic matter （NOM） in tap water. The NOM was assumed to enhance the adsorption of VPs onto membrane surface, increased the size exclusion and electrostatic repulsion also appeared during the transport. Investigated water matrices had influence on water flux decline due to their complexity.

关键词： veterinary pharmaceuticals water matrix RO/NF treatment rejection

Context dependent song-flight performance and timing in the Black-headed Bunting(Emberiza melanocephala)

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Avian Research 2022年第4期13卷 477-486页

作者： Sanja Barisic davor Cikovic Vesna Tutis Jelena Kralj Herbert Hoi Institute of Ornithology Croatian Academy of Sciences and ArtsZagrebGunduliceva 2410000ZagrebCroatia Konrad Lorenz Institute of Ethology Department of Interdisciplinary Life SciencesUniversity of Veterinary Medicine ViennaSavoyenstraße 1A1160ViennaAustria

Many songbirds produce song-flights;however,the function,vocal and motor characteristics,as well as the diel and seasonal variation of song-flight in songbirds remain not well ***,we studied two types of song-flight in male Black-headed Buntings(Emberiza melanocephala),the Moth—a standard,i.e.,perch song produced during a horizontal flight,and the Towering—a specifically structured song produced during a complex ascending and descending *** perch song,used during Moth flight,has already been described,here we provide the first description and sonogram representation of the more elaborate and less stereotyped Towering *** males started to perform Moth song-flights as soon as they arrived at the breeding site,Towering did not start before the female *** usually delivered spontaneous Moth song-flights before chasing rivals or undertaking aerial fights,suggesting Moth is directed towards conspecific males and serves as a threat ***,playback of conspecific perch songs triggered males to approach the loudspeaker with Moth *** Towering started after females arrived at the breeding site,suggesting the Towering is directed towards conspecific *** detected a seasonal difference in the peak Towering rate between forenoon and afternoon,suggesting that Towerings performed at different times of the day have different *** Towerings were strongly positively related to the number of fertile females at the breeding site,while afternoon Towerings peaked very early in the breeding season and coincided with the number of females at the breeding site before the onset of *** results provide evidence that birds can direct different types of song-flight towards different receivers and suggest the possibility that time of the day determines the context of the display,namely to attract social mates or solicit *** work is needed to account for the effect of between male vari

关键词： Fertilisation probability Mate attraction Moth song-flight Towering song-flight

Testicular angioleiomyoma presenting wit laematospermia

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Asian Journal of Andrology 2013年第4期15卷 573-574页

作者： Goran Stimac Alma Demirovic Bozo Kruslin davor Tomas Clinical Department of Urology 'Sestre milosrdnice' University Hospital Center Zagreb 10000 Croatia Ljudevit Jurak' Department of Pathology 'Sestre milosrdnice' University Hospital Center Zagreb 10 000 Croatia and School of Medicine University of Zagreb Zagreb 10 000 Croatia

Dear editors, We report an exceedingly rare case of primary testicular angioleio- myoma to increase awareness of this rare entity among urologists and pathologists. To our knowledge, only one case of this rare testicular tumour has been reported in the literature to date, and this is the first report of its presentation with haematospermia.1 A 65-year-old patient was admitted to our clinic for the evaluation of painless haematospermia. The patient＇s past medical history was unremarkable. At presentation and during the scrotal and testis exam- ination, there was no palpable mass. The patient had no voiding symptoms, and there were no signs of infection. The patient also denied experiencing any recent trauma. A digital rectal examination of the prostate was normal. The ultrasonographic findings disclosed a well-circumscribed ovoid hypoechoic nodule within the right testis, near its upper pole, measuring approximately 0.5 cm, and moderate hydrocele （Figure la）. The values of serum prostate-specific antigen, alpha-fetoprotein, beta-human chorionic gonadotropin and lactate dehydrogenase were normal.

关键词： angioleiomyoma presenting haematospermia

Breeding phase and outcome determine space use in European rollers Coracias garrulus prior to migration

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Current Zoology 2024年第2期70卷 137-149页

作者： Flavio Monti Sanja Barisic Sebastian Cannarella davor Cikovic Vesna Tutis JelenaKralj Carlo Catoni aUniversity of Siena Department of Physical SciencesEarth and EnvironmentVia Mattioli 453100 SienaItaly Institute of Ornithology Croatian Academy of Sciences and ArtsGunduliceva 24HR-1000 ZagrebCroatia Ornis italica Piazza Crati 1500199 RomeItaly

The breeding period is a demanding and time-constrained phase for migratory bird *** outcome and duration can interact with the extent and duration of post-breeding movements,resulting in individual differences in space use ultimately influencing later stages of the annual *** present space-use and home range estimates during the breeding season for 21 European rollers Coracias garrulus tracked between 2018 and 2022,in Italy and *** high-resolution spatial GPS data coupled with regular nest-box monitoring,we analyzed dif-ferences in space use during the incubation/nestling period versus post-breeding period prior to migration,accounting for the breeding outcome(successful ***).We found that adult movements were strongly reduced during the first phase,whereas increased in the post-breeding phase,especially for failed *** breeders remained in the surroundings of the nest site,whereas unsuccessful ones tended to abandon the nest and visit distant areas(up to 500 km)for long periods(60.5±6.2 days).Breeding outcome did not influence the departure date of autumn migration,suggesting that failed breeders used this period for exploratory movements but not for advancing the onset of *** exploratory movements may be functional to prospect and inform settlement decisions in failed breeders in search of new breeding opportunities and may be particularly important in migratory species,which generally have a limited period to gather information prior to autumn *** study demonstrates the need to investigate seasonal movements in different populations and the potential importance of pros-pectingpost-breeding movements for long-distance migratory species.

关键词： animal movement biologging conservation Coracidae Mediterranean nest-box population monitoring prospecting movements reproduction.

Expression of adipokine ghrelin and ghrelin receptor in human colorectal adenoma and correlation with the grade of dysplasia

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World Journal of Gastrointestinal Surgery 2021年第12期13卷 1708-1720页

作者： Sanja Stojsavljevic-Shapeski Lucija Virovic-Jukic davor Tomas Marko Duvnjak Vedran Tomasic davor Hrabar Dominik Kralj Ivan Budimir Neven Barsic Neven Ljubicic Division of Gastroenterology Department of Internal Medicine«Sestre Milosrdnice»University Hospital CenterZagreb 10000Croatia Department of Internal Medicine School of MedicineUniversity of ZagrebZagreb 10000Croatia Ljudevit Jurak Department of Pathology «Sestre Milosrdnice»University Hospital CenterZagreb 10000Croatia Department of Pathology School of MedicineUniversity of ZagrebZagreb 10000Croatia

BACKGROUNDGhrelin is an adipokine that plays an important role in energy balance. Expressionof ghrelin and ghrelin receptor has been investigated in different tissues andtumors. Studies regarding expression of ghrelin and ghrelin receptor in colorectaltumors are scarce and no data on expression of ghrelin and its receptor incolorectal adenomas has been published. Ghrelin and ghrelin receptor werehighly expressed in colon carcinoma cells while expression was decreased in lessdifferentiated tumors, presuming that ghrelin might be important in early phasesof *** investigate the expression of ghrelin and ghrelin receptor in human colorectaladenomas and adjacent colorectal *** this prospective study (conducted from June 2015 until May 2019) we included92 patients (64 male and 28 female) who underwent polypectomy for colorectaladenomas in the Department of Gastroenterology and Hepatology, “Sestre milosrdnice” Clinical Hospital Center in Zagreb, Croatia. After endoscopicremoval of colorectal adenoma, an additional sample of colon mucosa in theproximity of the adenoma was collected for pathohistological analysis. Adenomaswere graded according to the stage of dysplasia, and ghrelin and ghrelin receptorexpression were determined immunohistochemically in both adenoma andadjacent colon tissue using the polyclonal antibody for ghrelin (ab150514,ABCAM Inc, Cambridge, United States) and ghrelin receptor (ab48285, ABCAMInc, Cambridge, United States). Categorical and nominal variables were describedthrough frequencies and proportions and the difference between specific groupswere analyzed with Fisher’s and Fisher-Freeman-Halton’s method ***'s rank correlation coefficient was determined for correlation ofexpression of ghrelin and ghrelin receptor in adenoma and adjacent colon tissuewith the grade of adenoma *** 92 patients with colorectal adenoma 43 had adenomas with high-gradedysplasia (46.7%). High expression of ghre

关键词： Ghrelin Ghrelin receptor Adipokines Colorectal adenoma Colorectal adenoma dysplasia Large intestine

Preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: What can be done?

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World Journal of Gastroenterology 2015年第4期21卷 1069-1080页

作者： Goran Hauser Marko Milosevic davor Stimac Enver Zerem Predrag Jovanovi? Ivana Blazevic Department of Internal Medicine Division of GastroenterologyClinical Hospital Centre Rijeka51000 RijekaCroatia Department of Anaesthesiology Clinical Hospital Centre Rijeka51000 RijekaCroatia Department of Gastroenterology University Clinical Center TuzlaTrnovac bb75000 TuzlaBosnia and Herzegovina Center for Emergency Medicine Clinical Hospital Centre Rijeka51000 RijekaCroatia

Post-endoscopic retrograde cholangiopancreatographypancreatitis(PEP) is the most common complication of endoscopic retrograde cholangiopancreatography. The incidence of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis varies substantially and is reported around 1%-10%, although there are some reports with an incidence of around 30%. Usually, PEP is a mild or moderate pancreatitis, but in some instances it can be severe and fatal. Generally, it is defined as the onset of new pancreatictype abdominal pain severe enough to require hospital admission or prolonged hospital stay with levels of serum amylase two to three times greater than normal, occurring 24 h after ERCP. Several methods have been adopted for preventing pancreatitis, such as pharmacological or endoscopic approaches. Regarding medical prevention, only non-steroidal anti-inflammatory drugs, namely diclofenac sodium and indomethacin, are recommended, but there are some other drugs which have some potential benefits in reducing the incidence of post-ERCP pancreatitis. Endoscopic preventive measures include cannulation(wire guided) and pancreatic stenting, while the adoption of the early pre-cut technique is still arguable. This review will attempt to present and discuss different ways of preventing post-ERCP pancreatitis.

关键词： Endoscopic retrograde cholangiopancreatography Pos

Transient elastography(Fibro Scan~?) with controlled attenuation parameter in the assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease- Where do we stand?

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World Journal of Gastroenterology 2016年第32期22卷 7236-7251页

作者： Ivana Mikolasevic Lidija Orlic Neven Franjic Goran Hauser davor Stimac Sandra Milic Department of Gastroenterology UHC Rijeka Department of Nephrology Dialysis and Kidney Transplantation UHC Rijeka

Non-alcoholic fatty liver disease(NAFLD) is the most common cause of chronic liver disease worldwide. Currently, the routinely used modalities are unable to adequately determine the levels of steatosis and fibrosis(laboratory tests and ultrasonography) or cannot be applied as a screening procedure(liver biopsy). Among the non-invasive tests, transient elastography(Fibro Scan?, TE) with controlled attenuation parameter(CAP) has demonstrated good accuracy in quantifying the levels of liver steatosis and fibrosis in patients with NAFLD, the factors associated with the diagnosis and NAFLD progression. The method is fast, reliable and reproducible, with good intra- and interobserver levels of agreement, thus allowing for population-wide screening and disease follow-up. The initial inability of the procedure to accurately determine fibrosis and steatosis in obese patients has been addressed with the development of the obese-specific XL probe. TE with CAP is a viable alternative to ultrasonography, both as an initial assessment and during follow-up of patients with NAFLD. Its ability to exclude patients with advanced fibrosis may be used to identify low-risk NAFLD patients in whom liver biopsy is not needed, therefore reducing the risk of complications and the financial costs.

关键词： Non-alcoholic fatty liver disease Transient elastography Controlled attenuation parameter

New Drugs on the Block—Emerging Treatments for Nonalcoholic Steatohepatitis

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Journal of Clinical and Translational Hepatology 2021年第1期9卷 51-59页

作者： Sanja Stojsavljevic-Shapeski Marko Duvnjak Lucija Virovic-Jukic davor Hrabar Lea Smircic Duvnjak Department of Gastroenterology and Hepatology Clinical Hospital Center Sestre MilosrdniceZagrebCroatia Polyclinic Duvnjak ZagrebCroatia University of Applied Health Science ZagrebCroatia School of Medicine University of ZagrebZagrebCroatia Vuk Vrhovac University Clinic-UH Merkur ZagrebCroatia

Patients with nonalcoholic steatohepatitis(NASH)are at higher risk of progression to advanced stages of fibrosis,cirrhosis,hepatocellular carcinoma and other end-stage liver disease *** addressing treatment of NASH,we have limited approved options,and the mainstay of therapy is lifestyle *** research and revelation in the field of pathogenesis of NASH has offered new possibilities of treatment and emerging new drugs that are being tested currently in numerous preclinical and clinical *** drugs target almost all steps in the pathogenesis of NASH to improve insulin sensitivity,glucose and lipid metabolism,to inhibit de novo lipogenesis and delivery of lipids to the liver,and to influence apoptosis,inflammation and *** NASH is a multifactorial disease,in the future we could identify the predominating pathological mechanism and,by choosing the most appropriate specific medication,tailor the treatment for every patient individually.

关键词： Fatty liver Steatohepatitis Nonalcoholic fatty liver disease Treatment