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Genitourinary tumors and liver transplantation: A comprehensive review

World Journal of Transplantation 2024年第3期14卷 52-58页

作者： Vibor Sesa Hrvoje Silovski Nikolina Basic-Jukic Iva Kosuta maja sremac Anna Mrzljak Department of Gastroenterology and Hepatology University Hospital Center ZagrebZagreb 10000Croatia Department of Hepatobiliary Surgery and Transplantation University Hospital Center ZagrebZagreb 10000Croatia Department of Medicine School of MedicineZagreb 10000Croatia Department of Nephrology Arterial hypertensionDialysis and TransplantationUniversity Hospital Center ZagrebZagreb 10000Croatia Department of Intensive Care Medicine University Hospital Center ZagrebZagreb 10000Croatia

Liver transplantation is as a crucial therapeutic option for patients with end-stage liver disease,but the persistent organ shortage emphasizes a need to explore unconventional donor sources,including individuals with a history of *** review investigates the viability of liver donation from individuals with current or past genitourinary malignancies,focusing on renal,prostate and urinary bladder *** rising incidence of urogenital malignancies among potential donors is thought to result from increasing donor *** of transmission risks reveals low rates of donor-derived cancer transmission,partic-ularly for early-stage renal and prostate *** with a history of genitourinary malignancy pose complex challenges regarding post-transplant immunosuppression and cancer ***,the evidence suggests acceptable outcomes can be achieved with careful patient selection and tailored management *** for pre-transplant evaluation and post-transplant surveillance are discussed,highlighting the need for individualized approaches in this patient *** prospective studies are warranted to refine guidelines and optimize outcomes in liver transplantation for patients with genitourinary malignancies.

关键词： Liver transplantation Genitourinary malignancies Donor-transmitted cancer Malignancy recurrence Immunosuppression

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Approach to persistent ascites after liver transplantation

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World Journal of Hepatology 2022年第9期14卷 1739-1746页

作者： Ana Ostojic Igor Petrovic Hrvoje Silovski Iva Kosuta maja sremac Anna Mrzljak Department of Gastroenterology and Hepatology University Hospital Center ZagrebZagreb 10000Croatia Department of Hepatobiliary Surgery and Transplantation University Hospital Center ZagrebZagreb 10000Croatia Department of Intensive Care Medicine University Hospital Center ZagrebZagreb 10000Croatia

Persistent ascites(PA)after liver transplantation(LT),commonly defined as ascites lasting more than 4 wk after LT,can be expected in up to 7%of *** being relatively rare,it is associated with worse clinical outcomes,including higher 1-year *** cause of PA can be divided into vascular,hepatic,or *** causes of PA include hepatic outflow and inflow obstructions,which are usually successfully *** modifiable hepatic causes,recurrent hepatitis C and acute cellular rejection are the leading *** predictors for PA,the presence of ascites,refractory ascites,hepatorenal syndrome type 1,spontaneous bacterial peritonitis,hepatic encephalopathy,and prolonged ischemic time significantly influence the development of PA after *** initial approach to patients with PA should be to diagnose the treatable cause of *** stepwise approach in evaluating PA includes diagnostic paracentesis,ultrasound with Doppler,and an echocardiogram when a cardiac cause is ***,a percutaneous or transjugular liver biopsy should be performed in cases where the diagnosis is *** of unknown cause should be treated with diuretics and paracentesis,while transjugular intrahepatic portosystemic shunt and splenic artery embolization are treatment methods in patients with refractory ascites after LT.

关键词： Liver transplantation Liver transplantation complications,Ascites Hepatic graft inflow obstructions Hepatic graft outflow obstructions Acute cellular rejection

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Shifting perspectives in liver diseases after kidney transplantation

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World Journal of Hepatology 2023年第7期15卷 883-896页

作者： Iva Kosuta Ana Ostojic Ana Vujaklija Brajkovic Jaksa Babel Bojana Simunov maja sremac Anna Mrzljak Department of Intensive Care Medicine University Hospital Centre ZagrebZagreb 10000Croatia Department of Gastroenterology and Hepatology Liver Transplant CenterUniversity Hospital Centre ZagrebZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia Department of Nephrology University Hospital MerkurZagreb 10000Croatia

Liver diseases after kidney transplantation range from mild biochemical abnormalities to severe hepatitis or *** causes are diverse and mainly associated with hepatotropic viruses,drug toxicity and metabolic *** the past decade,the aetiology of liver disease in kidney recipients has changed *** relates to the use of direct-acting antiviral agents against hepatitis C virus,the increasing availability of vaccination against hepatitis B and a better understanding of drug-induced *** addition,the emergence of the severe acute respiratory syndrome coronavirus 2 pandemic has brought new challenges to kidney *** review aims to provide healthcare professionals with a comprehensive understanding of recent advances in the management of liver complications in kidney recipients and to enable them to make informed decisions regarding the risks and impact of liver disease in this population.

关键词： Kidney transplantation Viral hepatitis Non-alcoholic fatty liver disease Drug-induced liver injury COVID-19

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Managing end-stage carcinoid heart disease:A case report and literature review

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 1076-1083页

作者： Nikola Bulj Vedran Tomasic maja Cigrovski Berkovic Department of Cardiology University Hospital Centre“Sestre Milosrdnice“Zagreb 10000Croatia Division of Gastroenterology Department of Internal MedicineUniversity Hospital Centre“Sestre Milosrdnice”Zagreb 10000Croatia Department for Sport and Exercise Medicine University of Zagreb Faculty of KinesiologyZagreb 10000Croatia

BACKGROUND Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors,often diagnosed in an advanced stage when curative treatment is impossible and grueling symptoms related to vasoactive substance release by tumor cells affect patients’quality of *** complications of GEP-NENs,primarily tricuspid and pulmonary valve disease,and right-sided heart failure,are the leading cause of death,even compared to metastatic *** SUMMARY We present a case of a 35-year-old patient with progressive dyspnea,back pain,polyneuropathic leg pain,and nocturnal diarrhea lasting for a decade before the diagnosis of neuroendocrine carcinoma of unknown primary with extensive liver *** the initial presentation,serum biomarkers were not evaluated,and the patient received five cycles of doxorubicin,which he did not tolerate well,so he refused further therapy and was lost to *** 10 years,he presented to the emergency room with signs and symptoms of right-sided heart *** markers,serum chromogranin A,and urinary 5-hydroxyindoleacetic acid were extremely elevated(900 ng/mL and 2178µmol/L),and transabdominal ultrasound confirmed hepatic *** tomo-graphy(CT)showed liver metastases up to 6 cm in diameter and metastases in mesenteric lymph nodes and ***,an Octreoscan showed lesions in the heart,thoracic spine,duodenum,and ascendent colon.A standard trans-thoracic echocardiogram confirmed findings of carcinoid heart *** patient was not a candidate for valve *** started octreotide acetate treatment,and the dose escalated to 80 mg IM *** biochemical CONCLUSION Carcinoid heart disease occurs with carcinoid syndrome related to advanced neuroendocrine tumors,usually with liver metastases,which manifests as right-sided heart valve dysfunction leading to right-sided heart *** heart disease and tumor burden are major prognostic factors of poor surviva

关键词： Gastroenteropancreatic neuroendocrine neoplasms Carcinoid syndrome Carcinoid heart disease Diagnosis Treatment Case report

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Primary hyperparathyroidism-induced acute pancreatitis in pregnancy:A systematic review with a diagnostic-treatment algorithm

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World Journal of Gastroenterology 2024年第32期30卷 3755-3765页

作者： Goran Augustin Quirino Lai maja Cigrovski Berkovic Department of Surgery University Hospital Centre Zagreb and School of Medicine University of ZagrebZagreb 10000Croatia General Surgery and Organ Transplantation Unit Department of SurgerySapienza University of RomeRome 00018Italy Department for Sport and Exercise Medicine Faculty of KinesiologyUniversity of ZagrebZagreb 10000Croatia

BACKGROUND Primary hyperparathyroidism(PHPT)-induced acute pancreatitis(AP)during pregnancy has rarely been *** to this rarity,there are no diagnostic or treatment algorithms for pregnant *** To determine appropriate diagnostic methods,therapeutic options,and factors related to maternal and fetal outcomes for PHPT-induced AP in *** A literature search of articles in English,Japanese,German,Spanish,and Italian was performed using PubMed(1946-2023),PubMed Central(1900-2023),and Google *** Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA)protocol was *** search terms included“pancreatite acuta,”“iperparatiroidismo primario,”“gravidanza,”“travaglio,”“puerperio,”“postpartum,”“akute pankreatitis,”“primärer hyperparathyreoidismus,”“Schwangerschaft,”“Wehen,”“Wochenbett,”“pancreatitis aguda,”“hiperparatiroidismo primario,”“embarazo,”“parto,”“puerperio,”“posparto,”“acute pancreatitis,”“primary hyperparathyroidism,”“pregnancy,”“labor,”“puerperium,”and“postpartum.”Additional studies were identified by reviewing the reference lists of retrieved ***,imaging,surgical,obstetric,and outcome data were *** Fifty-four cases were collected from the 51 *** median maternal age was 29 ***-induced AP starts at the 20th gestational week;higher gestational weeks were seen in mothers who died(mean gestational week 28).Median values of amylase(1399,Q1-Q3=519-2072),lipase(2072,Q1-Q3=893-2804),serum calcium(3.5,Q1-Q3=3.1-3.9),and parathormone(PTH)(384,Q1-Q3=123-910)were *** 46 cases,adenoma was the cause of PHPT,followed by 2 cases of carcinoma and 1 case of *** the remaining 5 cases,the diagnosis was not *** ultrasound was positive in 34 cases,whereas sestamibi was performed in 3 cases,and neck computed tomography or magnetic resonance imaging was performed in 9 cases(the enlarged parathyroid gland was not localized in 3 cases).Surgery was the prefer

关键词： Primary hyperparathyroidism Acute pancreatitis Pregnancy Diagnosis Maternal mortality Fetal mortality Algorithm

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Are treatment options used for adult-onset type 2 diabetes mellitus(equally)available and effective for children and adolescents?

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World Journal of Diabetes 2024年第4期15卷 623-628页

作者： Nevena Krnic Vibor Sesa Anna Mrzljak maja Cigrovski Berkovic Clinics for Pediatrics University Hospital Center ZagrebZagreb 10000Croatia Department of Gastroenterology and Hepatology University Hospital Centre ZagrebZagreb 10000Croatia University of Zagreb School of Medicine Zagreb 10000Croatia Department for Sport and Exercise Medicine University of Zagreb Faculty of KinesiologyZagreb 10000Croatia

Youth-onset type 2 diabetes mellitus(T2DM),influenced by an increase in obesity,is a rising problem *** mechanisms of this early-onset T2DM include both peripheral and hepatic insulin resistance,along with increa-sed hepatic fasting glucose production accompanied by inadequate first and second-phase insulin ***,the incretin effect is *** initial presentation of type 2 diabetes can be dramatic and symptoms may overlap with those of type 1 diabetes ***,immediate therapy should address hyperglycemia and associated metabolic derangements irrespective of ultimate diabetes type,while further therapy adjustments are prone to patients’*** agents with proven glycemic and beyond glycemia benefits,such as Glucagon-like polypeptide 1 receptor agonists and Sodium-glucose cotransporter-2 inhibitors,used in the adult population of T2DM patients,might become increasingly important in the treatment ***,metabolic surgery is an option for markedly obese(body mass index>35 kg/m^(2))children and adolescents suffering from T2DM who have uncontrolled glycemia and/or serious comorbidities when lifestyle and pharmacologic interventions *** this mini-review,we will discuss the potential of treatment options considering new data available from randomized control trials,including individuals with adult-onset type diabetes mellitus.

关键词： Youth-onset type 2 diabetes mellitus Treatment Complications Glucose lowering agents Extra-glycemic benefit

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Challenges and pitfalls of youth-onset type 2 diabetes

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World Journal of Diabetes 2024年第5期15卷 876-885页

作者： Lavinia La Grasta Sabolic Sanda Marusic maja Cigrovski Berkovic Department of Pediatric Endocrinology and Diabetology University Hospital Centre Sestre MilosrdniceZagreb 10000Croatia School of Medicine Catholic University of CroatiaZagreb 10000Croatia Department for Sport and Exercise Medicine University of Zagreb Faculty of KinesiologyZagreb 10000Croatia

The incidence and prevalence of youth-onset type 2 diabetes mellitus(T2DM)are *** rise in frequency and severity of childhood obesity,inclination to sedentary lifestyle,and epigenetic risks related to prenatal hyperglycemia exposure are important drivers of the youth-onset T2DM epidemic and might as well be responsible for the early onset of diabetes ***,youth-onset T2DM has a more extreme metabolic phenotype than adult-onset T2DM,with greater insulin resistance and more rapid deterioration of beta cell ***,intermediate complications such as microalbuminuria develop in late childhood or early adulthood,while end-stage complications develop in *** to the lack of efficacy and safety data,several drugs available for the treatment of adults with T2DM have not been approved in youth,reducing the pharmacological treatment *** this mini review,we will try to address the present challenges and pitfalls related to youth-onset T2DM and summarize the available interventions to mitigate the risk of microvascular and macrovascular complications.

关键词： Youth-onset type 2 diabetes mellitus Insulin resistance Beta cell failure Risk factors Therapy Complications

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Metformin and pancreatic neuroendocrine tumors:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第7期30卷 759-769页

作者： maja Cigrovski Berkovic Alessandro Coppola Vibor Sesa Anna Mrzljak Quirino Lai Department for Sport and Exercise Medicine Faculty of Kinesiology University of ZagrebZagreb 10000Croatia Department of Surgery Sapienza University of RomeRome 00185Italy Department of Gastroenterology and Hepatology Liver Transplant CenterUniversity Hospital Centre ZagrebZagreb 10000Croatia Department of Medicine School of MedicineZagreb 10000Croatia General Surgery and Organ Transplantation Unit Department of SurgerySapienza University of RomeRome 00018Italy

BACKGROUND Most patients with advanced pancreatic neuroendocrine tumors(pNETs)die due to tumor ***,identifying new therapies with low toxicity and good tolerability to use concomitantly with the established pNET treatment is *** this perspective,metformin is emerging as a molecule of *** studies have described metformin,a widely used agent for the treatment of patients with type 2 diabetes mellitus(T2DM),to be effective in modulating different tumor-related events,including cancer incidence,recurrence and survival by inhibiting mTOR *** systematic review evaluates the role of T2DM and metformin in the insurgence and post-treatment outcomes in patients with *** To systematically analyze and summarize evidence related to the diagnostic and prognostic value of T2DM and metformin for predicting the insurgence and posttreatment outcomes of *** A systematic review of the published literature was undertaken,focusing on the role of T2DM and metformin in insurgence and prognosis of pNET,measured through outcomes of tumor-free survival(TFS),overall survival and progression free *** A total of 13 studies(5674 patients)were included in this *** of 809 pNET cases from five retrospective studies(low study heterogeneity with I^(2)=0%)confirms the correlation between T2DM and insurgence of pNET(OR=2.13,95%CI=1.56-4.55;P<0.001).The pooled data from 1174 pNET patients showed the correlation between T2DM and post-treatment TFS in pNET patients(hazard ratio=1.84,95%CI=0.78-2.90;P<0.001).The study heterogeneity was intermediate,with I^(2)=51%.A few studies limited the possibility of performing pooled analysis in the setting of metformin;therefore,results were heterogeneous,with no statistical relevance to the use of this drug in the diagnosis and prognosis of *** T2DM represents a risk factor for the insurgence of pNET and is a significant predictor of poor post-treatment TFS

关键词： Pancreatic neuroendocrine tumors Type 2 diabetes mellitus Prognosis Treatment Metformin

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Sodium-dependent glucose transporter 2 inhibitors effects on myocardial function in patients with type 2 diabetes and asymptomatic heart failure

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World Journal of Cardiology 2024年第8期16卷 448-457页

作者： Petra GrubićRotkvić Luka Rotkvić AnaĐuzelČokljat maja Cigrovski Berković Department of Cardiology University Hospital Centre ZagrebZagreb 10000Croatia Department of Cardiology Magdalena Clinic for Cardiovascular DiseaseKrapinske Toplice 49217Croatia Department of Internal Medicine General Hospital DubrovnikDubrovnik 20000Croatia Department for Sport and Exercise Medicine University of Zagreb Faculty of KinesiologyZagreb 10000Croatia

BACKGROUND Sodium-dependent glucose transporter 2 inhibitors(SGLT2i)have shown efficacy in reducing heart failure(HF)burden in a very heterogeneous groups of patients,raising doubts about some contemporary assumptions of their mechanism of *** previously published a prospective observational study that evaluated mechanisms of action of SGLT2i in patients with type 2 diabetes who were in HF stages A and B on dual hypoglycemic *** groups of patients were included in the study:the ones receiving SGLT2i as an add-on agent to metformin and the others on dipeptidyl peptidase-4 inhibitors as an add-on to metformin due to suboptimal glycemic *** To evaluate the outcomes regarding natriuretic peptide,oxidative stress,inflammation,blood pressure,heart rate,cardiac function,and body *** The study outcomes were examined by dividing each treatment arm into two subgroups according to baseline parameters of global longitudinal strain(GLS),N-terminal pro-brain natriuretic peptide,myeloperoxidase(MPO),high-sensitivity C-reactive protein(hsCRP),and systolic and diastolic blood *** evaluate the possible predictors of observed changes in the SGLT2i arm during follow-up,a rise in stroke volume index,body mass index(BMI)decrease,and lack of heart rate increase,linear regression analysis was *** There was a greater reduction of MPO,hsCRP,GLS,and blood pressure in the groups with higher baseline values of mentioned parameters irrespective of the therapeutic arm after 6 months of *** independent predictors of heart rate decrease were a reduction in early mitral inflow velocity to early diastolic mitral annular velocity at the interventricular septal annulus ratio and BMI,while the predictor of stroke volume index increase was SGLT2i therapy *** SGLT2i affect body composition,reduce cardiac load,improve diastolic/systolic function,and attenuate the sympathetic *** control contributes to the i

关键词： Sodium-dependent glucose transporter 2 inhibitors Dipeptidyl peptidase-4 inhibitors Type 2 diabetes mellitus Heart failure Diabetic cardiomyopathy Cardiovascular disease

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Review of EU projects with a focus on environmental quality: Innovation, eco-innovation, and circular-economy elements

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International Journal of Innovation Studies 2024年第1期8卷 1-12页

作者： Jana Hojnik Mitja Ruzzier maja Konecnik Ruzzier Boris Sucic Brandon Soltwisch Matej Rus University of Primorska Faculty of ManagementIzolska Vrata 26000KoperSlovenia University of Ljubljana School of Economics and BusinessKardeljeva Ploscad 171000LjubljanaSlovenia Jozef Stefan Institute Energy Efficiency CentreJamova 391000LjubljanaSlovenia Tulane University Freeman School of Business6823 St Charles AveNew OrleansLA 70118USA University of Maribor Faculty of Economics and BusinessRazlagova 142000MariborSlovenia

The primary objective of this study is to delve into transnational projects conducted between 2014 and 2020,with a strong emphasis on environmental *** focus is directed toward projects that encompass either eco-innovation or feature elements intrinsic to a circular *** achieve this goal,we introduce a pioneering analytical framework tailored to dissect transnational projects,which intricately interweaves the diverse dimensions of environmental quality and innovation,facilitating a comparative assessment across various program *** approach aligns with the overarching mission of the four flagship initiatives,in which we evaluate the combined impacts on sustainability and *** evaluation considers three fundamental factors:(1)resource allocation,(2)innovation type,and(3)infusion of eco-innovation or circular economy *** methodology unfolds through a systematic,step-by-step ***,we meticulously handpick programs,specifically Interreg,Horizon,and Life projects,within the scope of TSG3(Environmental Quality).Each of these programs corresponds to one of the following four flagship initiatives:(1)overseeing and managing marine species,(2)fostering sustainable development in coastal and maritime zones,(3)safeguarding and elevating natural habitats and terrestrial ecosystems,and(4)formulating transnational contingency strategies for maritime *** an exhaustive review,we identify projects that either directly or indirectly champion eco-innovation or other facets of the circular ***,we uncover broader manifestations of innovation,eco-innovation,and circular economy *** the Oslo Manual as a guide,we methodically categorize these innovations into the product,process,organizational,and marketing *** the timeframe under scrutiny,a relatively modest subset of projects embraced eco-innovations and practices aligned with the circular *** findings culminate in

关键词： Environment Sustainability Eco-innovation Innovation EU projects Entrepreneurship

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