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Background/Aim. Taking into consideration the justified popularity of total arterial revascularization, the saphenous vein graft (SVG) is still one of the most utilized conduits in coronary artery bypass grafting (CABG). One of the determining factors of this conduit’s durability is its endothelial integrity at the time of surgery. The aim of the study was to investigate the effect of different storage solutions on SVG endothelial integrity in patients with diabetes mellitus (DM) type 2 (T2DM) and non-T2DM patients undergoing CABG. The solutions under evaluation were heparinized saline solution (0.9% NaCl), heparinized autologous whole blood, Bretschneider (histidine-tryptophan-ketoglutarate – HTK) solution, and fresh frozen plasma (FFP) solution. Methods. Forty patients were included in this study and were divided into two groups: group A with 23 T2DM patients and group B with 17 non-T2DM patients. The effects of these solutions were examined by immunohistochemical staining with anti-CD34 antibodies and morphometric comparison in histologic samples of T2DM patients undergoing CABG between July 2021 and September 2022 with samples provided by non-T2DM patients. Results. In this study, the FFP solution showed the most prominent positive effect on the preservation of SVG endothelial integrity, with an average cell integrity preservation of 92.2%. HTK solution was found to be the least effective, with an endothelial cell preservation integrity of 26.77%. There was no marked statistically significant difference in results from groups A and B. There was a noticeable contrast in preserving SVG endothelial integrity between the two patient groups, T2DM and non-T2DM patients, although it was not statistically significant. Conclusion. The storage solution with the most beneficial effect on SVG endothelial integrity preservation was the FFP solution when harvested via the conventional open method in CABG.

Background/Aim. Coronary artery bypass grafting (CABG) is the treatment of choice for a significant number of patients with ischemic heart disease. Some of the postoperative complications are closely linked with the preoperative antiplatelet therapy (APT). The aim of this study was to compare the early clinical outcomes of CABG in patients with preserved platelet (PLT) function and patients with PLT function impaired by the residual therapeutic effect of APT. Methods. A total of 181 patients with isolated CABG were enrolled in this prospective, nonrandomized, observational study. Patients were divided into four groups: control group (arachidonic acid-dependent PLT aggregation group), with aspirin-induced platelet inhibition (ASPI) test ≥ 790 aggregation units (AU)/min; mild (M) acetylsalicylic acid (ASA) effect (MASAE) group, with ASPI test = 410–789 AU/min; pronounced (P) ASA effect (PASAE) group, with ASPI test ≤ 409 AU/min; dual (D) APT (DAPT) group, with ASPI test ≤ 789 AU/min and adenosine diphosphate (ADP) test ≤ 405 AU/min. Preoperative data, intraoperative characteristics, and postoperative outcomes were obtained and com-pared between the groups. Results. A significant difference was found regarding the average time of APT cessation be-tween groups (p < 0.001). The DAPT group had a significantly higher frequency of drainage compared to the control (p = 0.004), MASAE (p = 0.001), and PASAE (p = 0.006) groups. The PASAE group had a significantly higher rate of chest reexploration compared to the MASAE group (p = 0.032). The DAPT group required significantly more packed red blood cells (PRBC) compared to the control (p < 0.001) and MASAE (p = 0.009) groups. The PASAE group received significantly more PRBC compared to the control (p < 0.001) and MASAE (p = 0.019) groups. The DAPT group required higher amounts of PLTs compared to the control (p < 0.001), MASAE (p = 0.002), and PASAE (p < 0.001) groups. The DAPT group received higher amounts of cryoprecipitate compared to the control (p = 0.002), MASAE (p = 0.009), and PASAE (p = 0.016) groups. Conclusion. Patients with a residual effect of DAPT, as well as patients with a pronounced residual effect of ASA, have a higher risk of postoperative bleeding and chest reexploration, as well as increased transfusion demands.

Background/Aim. To date, there has been no population-based neonatal anthropometric chart published in Serbia. Charts based on infants born in a single hospital (hospital-based) in the 1 990s are still widely used in our country, as well as the Alexander chart. The aim of this study was to construct population-based centile, gender-specific charts for birth weight and length for singleton infants born in Southeast Serbia from 24 t o 42 weeks of gestation and to compare them with other previously published charts. Methods. Data on 39,842 singleton live infants, delivered from 2006 to 2015 in three maternity wards in Southeast Serbia (Niš, Prokuplje, and Aleksinac), were analyzed. Results. The inclusion criteria met 37,169 newborns. Preterm births were relatively uncommon (5.25%). Estimated centile charts for male and female birth weights and lengths were constructed showing the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles. Conclusion. Our birth weight percentiles provide a population norm for singleton infants adjusted for gender, born in Southeast Serbia. These references are both of epidemiological and clinical use. There is a need for large-scale research that will include a larger number of pre-term newborns which were represented in limited numbers in our study. There is also a need for setting up the gold standard method for the precise determination of the gestational age, i.e. the use of the early fetal ultrasound.

Background/Aim.Venous leg ulcers (VLU) are a significant health problem worldwide. It is well known that VLU are difficult to treat and that they have high tendency for recurrence. Compression therapy is the preferred treatment modality but there is growing evidence that correction of underlying venous disorder in early stages of the disease in addition to compression treatment may improve ulcer healing and reduce recurrence rate. Methods. An open, prospective, randomized, single-center study, with a 6-months follow-up was performed to determine the efficacy of two different treatment modalities (surgery alone versus surgery plus compression) in the treatment of VLU in patients with primary venous insufficiency. Patients with secondary venous insufficiency and/or thrombosis were excluded from the study. Overall, 71 patients were randomized (37 men, 34 women; mean age 60 years) into two groups: the group A – 34 patients who underwent surgical intervention (stripping) and postoperatively were treated with simple wound dressing only, and the group B – 37 patients who underwent surgical intervention (stripping) and wore a heelless open-toed elastic class III compression device knitted in tubular form –Tubulcus® (Laboratoires Innothera, Arcueil, France). All patients in group B were instructed to wear compression device continuously during the day and night. The study was performed at the Clinic for Cardiovascular and Transplant Surgery, Clinical Centre Niš (Serbia) with primary endpoint of the study being complete ulcer healing at 180 days. Results. The healing rate was 29.41% (10/34) in the group A, and 56.76% (21/37) in the group B (p < 0.01). Mean healing time in the group A was 141 ±15 days, and in the group B it was 98 ±12 days (Log-rank life table analysis: p < 0.001). Conclusion. This study suggests that for VLU in patients with primary venous insufficiency, surgery plus compression therapy provides higher healing rate and faster healing time compared to surgery only.

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Children born small for gestational age (SGA) are classified as instants whose birth weight and/or birth length deviates more than 2 SD below the average for gestational age. They are at high risk of developing serious metabolic disorders by the process of foetal and early neonatal programming. Any structural or functional changes that occur in this way are generally irreversible. As a result, sudden addition in body weight is enabling early constitution of the metabolic syndrome with all its consequences, including high early cardiovascular and cerebrovascular morbidity and mortality as well as other organ systems disturbances. About 65,000 children are born annually in Serbia. According to a respectable database of children treated with growth hormone, during period of 9 years were born about 590,000 children and about 10% of them were SGA (59,000 of them). 10% i.e. 5,900 of them should receive a growth hormone. However, only 260 children who receive growth hormone are in the database (only 4% of them are detected). More tragically - none of SGA children with rapid postnatal growth, programmed for adult illness, has been recognized until this day!.

The influence of obesity on cardiometabolic health in the general population has been widely studied, but few studies are dealing with the problem of obesity in children and adolescents with type 1 diabetes. Aim: The aim of this study was to determine the presence of overweight, and obese persons with metabolic syndrome in children and adolescents with type 1 diabetes and to determine the conection of nutritional status with other risk factors for cardiovascular disease, such as dyslipidemia, glycoregulation, high blood pressure , insulin dose, age, illness, length of illness. Methods: The study included 197 children and adolescents with type 1 diabetes mellitus (103 females, 94 males). The average age of respondents was 12,71 years. Data on body weight, height, BMI was calculated according to the formula kg/m2. Standard laboratory procedures were determined, total cholesterol, LDL and HDL cholesterol, AST, GHbA1c, data on a daily dose of insulin, and type of insulin therapy, age at which the disease began, duration of disease, the possible existence of microvascular complications (microalbuminuria, retinopathy, neuropathy) and hypertension were obtained. Results: There were 77,2% patients had normal weight, 14,2% were overweight, 3,4% were obese and 5,2% nutritional had metabolic syndrome. We found statistically significant conection between nutritional impairment and total cholesterol, tryglycerides, hypertension, length of disease and daily insuline dose. Conclusion: Due to the fact that people with type 1 diabetes are at high risk for the development of vascular complications, prevention, early detection and treatment of nutritional impairment as well as other cardiometabolic risk factors are imperative.

The process of energy consumption is ongoing, while energy recovery through food intake occurs only occasionally. Therefore, during evolution, it was necessary to form a system that would create energy reserves, and preserve them for periods between food intake-adipose tissue. The development of adipose tissue is affected by numerous signaling and hormonal factors, which in turn determine the distribution of adipose tissue into subcutaneous and visceral fat. Besides its indisputable role in energy homeostasis, adipose tissue is an important endocrine and paracrine organ that releases many hormones and cytokines, and crucially affectsall metabolic and immunological processes in the body. As such, primarily visceral adipose tissue synthesizes significant amounts of adipocytokines: leptin, adiponectin, tumor necrosis factor-(, interleukin-6 and many others. Fat can actually be a crucial alarm system that triggers innate immunity and acute phase inflammation. Chronic inflmmation is the hallmark of the metabolic syndrome, and inflammatory signals originate mainly from visceral adipose tissue. Therefore, excess adipose tissue can easily be linked to the emergence of numerous metabolic disorders and the development of diabetes, type 2 as well as type 1.

The prevalence of obesity increased in all age and ethnic groups dramatically. In Serbia, 54% of people are with excess weight - 36.7% are overweight, 17.3% are obese. The prevalence of obesity among Serbian children are estimated about 19%. Maintenance of body weight depend on complex interaction between central nervous system and numerous organs on periphery which provides energy metabolism. The hormones of gastrointestinal tract (cholecystokinin, glucagon like peptide 1) and adiposity tissue (leptin) are in communication with orexigene and anorexigene centers in hypothalamus. Obesity could be consequence of gene mutations (leptin, melanocortin) and increasing influence of environment factors: sedentary life styles and excessive caloric consumption.

Introduction Chronic arterial insufficiency (CAI) of lower extremities is important socio-economical and healthcare problem, due to its high incidence of morbidity, disability and mortality. Objective The aim of our work was to determine the diagnostic importance of pulse oximetry in the early detection of stage of lower extremities CAI based on peripheral arterial oxygen saturation of haemoglobin (SpO2). Methods Prospectively, we analyzed a group of 50 patients, admitted at the Vascular Department of Surgical Clinic in Niš during the period from September 2006 to October 2007, with evident symptoms and signs of different stages of lower extremities CAI verified by ultrasonography. In patients with lower extremity disorder of tissue arterial capillaries, SpO2 was determined by pulse oximetry. Results Using pulse oximetry, depending on the of stage of lower extremities CAI, we revealed a considerable difference in the stages of functional ischemia SpO2: Fontaine I - 95.33±1.41%, Fontaine IIa - 92.14±2.27% and Fontaine IIb - 79.67±2.73%; in stage critical ischemia SpO2: Fontaine III - 62.54±4.39% and Fontaine IV - 47.67±6.16%. In 3 patients with gangrenous foot and fingers SpO2 was immeasurable and progressive decrease in SpO2 of arterial capillaries (p

Background/Aim. Fibrin glue is used as a matrix for local application of antibiotics. The aim of this study was to determine whether application of fibrin glue in combination with antibiotics can strengthen collagen production, prevent dehiscence of colon anastomoses due to infection, and reduce frequency of mortality and morbidity comparing to the control group and the group with fibrin glue application. Methods. The adult male Wistar rats divided into three groups were used in the experiment. The group 1 was the control one (after partial colon resection, colonic anastomoses performed were not treated), while to the group 2 and the group 3 were applied fibrin glue and fibrin glue with antibiotics (clindamycin and ceftriaxon) on the site of anastomoses, respectively. Quality of colonic anastomoses were estimated by means of determination of collagen (L-hydroxyproline) amount in the collon wall with anastomoses and histological analysis of this colon segment using light and electronic microscope on the days 5, 7 and 13 postoperatively. Results. The highest morbidity rate was registered in the group 1 (30%), then in the group 2 (13.3%) and the lowest one in the group 3 (3.33%; p < 0,05 vs group 1). Mortality rate was significantly higher in the group 1 than in the group 3 (20% and 0%, respectively; p < 0,05). In the postoperative course, the highest concentrations of collagen in the colon wall on the site of anastomoses, which was confirmed by both light and electronic microscopy, were found in the group 3. Conclusion. The application of fibrin glue with antibiotics on colon anastomoses reduces the number of dehiscence, provides good mechanical protection and shorten the time of anastomoses healing.

Background/Aim. Insulin glargine is a long-acting insulin analog that mimics normal basal insulin secretion without pronounced peaks. The aim of this study was to compare insulin glargine with isophane insulin (NPH insulin) for basal insulin supply in patients with type 1 diabetes. Methods. A total of 48 type 1 diabetics on long term conventional intensive insulin therapy (IIT) were randomized to three different regimens of basal insulin substitution: 1. continuation of NPH insulin once daily at bedtime with more intensive selfmonitoring (n = 15); 2. NPH insulin twice daily (n = 15); 3. insulin glargine once daily (n = 18). Meal time insulin aspart was continued in all groups. Results. Fasting blood glucose (FBG) was lower in the glargine group (7.30±0.98 mmol/l) than in the twice daily NPH group (7.47±1.06 mmol/l), but without significant difference. FBG was significantly higher in the once daily NPH group (8.44±0.85 mmol/l; p < 0.05). HbA1c after 3 months did not change in the once daily NPH group, but decreased in the glargine group (from 7.72±0.86% to 6.87±0.50%), as well as in the twice daily NPH group (from 7.80±0.83% to 7.01±0.63%). Total daily insulin doses were similar in all groups but only in the glargine group there was an increase of basal and decrease of meal related insulin doses. The frequency of mild hypoglycemia was significantly lower in the glargine group (6.56±2.09) than in both NPH groups (9.0±1.65 in twice daily NPH group and 8.13±1.30 in other NPH group) (episodes/patients-month, p < 0.05). Conclusion. Basal insulin supplementation in type 1 diabetes mellitus with either twice daily NPH insulin or glargine can result in similar glycemic control when combined with meal time insulin aspart. However, with glargine regimen FBG, HbA1c and frequency of hypoglycemic event are lower. These facts contribute to better patients satisfaction with insulin glargine versus NPH insulin in IIT in type 1 diabetics.

Systemic inflammatory response syndrome and sepsis are common in surgically treated patients. Systemic inflammatory response syndrome represents a major factor of morbidity and mortality in these patients. The pathogenesis of these syndromes has been increasingly clarified. The objective of this review is to present an overview of our current understanding of the physiology underlying these conditions.

PURPOSE Venous thromboembolism is a relevant social and health care problem for its high incidence, pulmonary embolism-related mortality and long-term sequelae which may be disabling (post-thrombotic syndrome and ulceration). PROCEDURES The aim of our work was to establish the presence of coagulation disorders (hypercoagulable states) in the patients with deep vein thrombosis (DVT) of the leg. Prospectively we have analyzed a group of 30 patients with echosono-graphicaly verified DVT of the leg who were admitted to the department of vascular surgery from August 1st 2000 to July 31st 2001.The following parameters were monitored: prothrombin time (PT) partial thromboplastin time (PTT), fibrinogen (Fib), alpha 2 antiplasmin (A-2 AP), D-dimer (DD), antithrombin III (AT III) and factor VII. FINDINGS Activation of the coagulation process was registered. The values of monitored coagulation parameters are shown in table 1. Plasma levels of monitored parameters in the patients with DVT of the leg were significantly higher than in the control subjects. CONCLUSION In patients with a DVT a hypercoagulable state is common finding. Some parameters of coagulation activity such as D-dimer might be of great interest in the diagnostic strategy of DVT.

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Today, there is no unequivocal overview of how to treat patients undergoing myocardial revascularization and have associated significant carotid artery stenosis. In this group of patients, there are several ways to treat, and our study analyzed patients who were exposed to a "Staged" and "Concomitant" approach. During 2016 in three cardiac surgery centers of Serbia, the perioperative results of the patients subjected to a "Staged" and "Concomitant" approach were analyzed. Group 1 including patients with cardiac revascularization and endarterectomy was made at least 30 days earlier, and group 2 consisted of patients who underwent endarterectomy with cardiac revascularization simultaneously. In both groups, CVI appearance was observed 7 days after the revascularization of the heart. We followed the risk factors for the occurrence of CVI. The conducted study included a total of 49 patients, divided into two groups. In 28 patients (group 1) Eversion Carotid endarterectomy was performed 30 days to 26 months prior to coronary revascularization. The average age of patients was 64 and 65 years, with the prevalence of male sex (86%: 14%). The only parameters that showed a significant difference between the groups were "left main syndrome" and unstable angina pectoris, both in Group 2. In the ensuing period, in both groups, there were no postoperative major neurological events (CVI). In one patient, clinical signs of neurological deficits occurred in the form of weakness of one side of the body, but CVI was not proven by CTom and MRA. It can be concluded that the "Staged" and "Concomitant" approaches are safe and effective. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Children born small for gestational age (SGA) are classified as intants whose birth weight and/or birth length deviates more than 2 SD below the average for gestational age. They are at high risk of developing serious metabolic disorders by the process of foetal and early neonatal programming. Any structural or functional changes that occur in this way are generally irreversible. As a result, sudden addition in body weight is enabling early constitution of the metabolic syndrome with all its consequences, including high early cardiovascular and cerebrovascular morbidity and mortality as well as other organ systems disturbances. About 65,000 children are born annually in Serbia. According to a respectable database of children treated with growth hormone, during period of 9 years were born about 590,000 children and about 10% of them were SGA (59,000 of them). 10% i.e. 5,900 of them should receive a growth hormone. However, only 260 children who receive growth hormone are in the database (only 4% of them are detected). More tragically - none of SGA children with rapid postnatal growth, programmed for adult illness, has been recognized until this day! [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Proces potrošnje energije je trajan, a obnavljanje energije putem unosa hrane samo povremeno. Stoga je tokom evolucije bilo neophodno oformiti sistem koji bi stvarao rezerve energije i čuvao ih za period između obroka - masno tkivo. Na razvoj masnog tkiva mogu uticati brojni signalni i hormonalni faktori, opredeljujući ukupnu količinu i distribuciju masnog tkiva na supkutano i visceralno. Pored nesporne uloge u energetskoj homeostazi, masno tkivo je i važan endokrini i parakrini organ koji oslobađa mnoge citokine i hormone, te presudno utiče na celinu metaboličkih i imunoloških procesa u organizmu. Tako primarno visceralno masno tkivo sintetiše značajne količine adipocitokina: leptina, adiponektina, tumor necrosis factor-đ, interleukina-6 i brojnih drugih. Masno tkivo tako u stvari može biti kracijalni alarmni sistem koji pobuđuje urođeni imunitet i akutnu fazu zapaljenja. Hronična inflamacija je najvažnija karakteristika metaboličkog sindroma, a inflamatomi signali uglavnom potiču iz visceralnog masnog tkiva. Stoga se eksces masnog tkiva lako može povezati sa nastankom brojnih metaboličkih poremećaja i razvojem dijabetesa, kako tipa 2, tako i tipa 1. [ABSTRACT FROM AUTHOR]

Broj studija koje se bave problemom gojaznosti u populaciji dece i adolescenata sa dijabetesom tip 1 je ograničen. Cilj: Cilj ovog istraživanja je da se odredi zastupljenost preuhranjenih, gojaznili i osoba sa metaboličkim sindromom u grupi dece i adolescenata sa dijabetes melitusom tip 1 i da se utvrdi povezanost uhranjenosti sa drugim faktorima rizika za razvoj kardiovaskularnih bolesti. Metod: U istraživanje je uključeno 197 pacijenata (94 dečaka i 103 devoj- čice). Prosečna starost svili pacijenata je 12,71±4,89. Analizirani su njihovi podaci o telesnoj masi, telesnoj visini, indeksu telesne mase, nivou ukupnog holesterola, LDL i HDL holesterola, GHbA1c, o dnevnoj dozi insulina, hipertenziji, uzrastu u kojem je bolest započela, dužini bolesti. Rezultati: U ispitivanoj grupi bilo je 77,2% dece koja su bila normalno uhranjena, 14,2% preuhranjenih, 3,4% gojaznili i 5,2% dece i adolescenata koja su razvila metabolički sindrom. Utvrđena je statistički značajna povezanost između poremećaja uhranjenosti i ukupnog holesterola, triglicerida, arterijske hipertenzije, dužine bolesti i dnevne doze insulina. Zaključak: S obzirom na rastuću učestalost i gojaznosti i dijabetes melitusa tip 1, njihovo međusobno preplitanje, kao komorbiditeta i/ili međusobnih faktora rizika, od velike je važnosti pratiti stepen uhranjenosti i prevenirati pojavu gojaznosti dece i adolescenata sa dijabetesom tip 1 kroz kontinuiranu edukaciju i optimalizaciju insulinskog režima. [ABSTRACT FROM AUTHOR]

Introduction Type 1 diabetes is a protoype of disease with an intesive oxidative stress. The oxidative stress means disturbing dynamic balance between prooxidants and antioxidants, either due to the increased production of the oxygen Fee radicals or the decreased antioxidant activity. The antioxidative enzyme catalase diminishes free radical hydrogen-peroxyde, which can be very toxic to pancreatic cells. Material and methods Our study included 40 children with type 1 diabetes. We analysed the activity of enzyme catalase in lymphocytes in different phases of disease: at the beginning of diabetes, in remission period and in the later chronic course. Results There is a significant increase in the catalase activity during all phases of disease (p<0.00001) compared with the control group. The highest catalase activity occurs in the early course of disease (p<0.05) followed by a linear decrease and the lowest activity in chronic course. If metabolic control gets worse, the catalase activity gets higher with statistic significance at p<0.5. A higher residual beta cells secretion is associated with a lower catalase activity. Therefore, the catalase activity is in direct corelation with GHbA 1 (r=0.895), and inverse correlation with C-peptide (r=-0.945). Discussion and conclusion A significant increase in the catalase activity in all phases of type 1 diabetes indirectly confirms the importance of the oxidative stress in pathogenesis of disease. The activation of catalase is probably the secundary phenomenon. The fact that the catalase activity reaches its highest values at the beginning of diabetes could implicate the predictive value of catalase determination. [ABSTRACT FROM AUTHOR]

Background/Aim. Insulin glargine is a long-acting insulin analog that mimics normal basal insulin secretion without pronounced peaks. The aim of this study was to compare insulin glargine with isophane insulin (NPH insulin) for basal insulin supply in patients with type 1 diabetes. Methods. A total of 48 type 1 diabetics on long term conventional intensive insulin therapy (IIT) were randomized to three different regimens of basal insulin substitution: 1. continuation of NPH insulin once daily at bedtime with more intensive selfmonitoring (n = 15); 2. NPH insulin twice daily (n = 15); 3. insulin glargine once daily (n = 18). Meal time insulin aspart was continued in all groups. Results. Fasting blood glucose (FBG) was lower in the glargine group (7.30±0.98 mmol/l) than in the twice daily NPH group (7.47±1.06 mmol/l), but without significant difference. FBG was significantly higher in the once daily NPH group (8.44±0.85 mmol/l; p < 0.05). HbA1c after 3 months did not change in the once daily NPH group, but decreased in the glargine group (from 7.72±0.86% to 6.87±0.50%), as well as in the twice daily NPH group (from 7.80±0.83% to 7.01±0.63%). Total daily insulin doses were similar in all groups but only in the glargine group there was an increase of basal and decrease of meal related insulin doses. The frequency of mild hypoglycemia was significantly lower in the glargine group (6.56±2.09) than in both NPH groups (9.0±1.65 in twice daily NPH group and 8.13±1.30 in other NPH group) (episodes/patients-month, p < 0.05). Conclusion. Basal insulin supplementation in type 1 diabetes mellitus with either twice daily NPH insulin or glargine can result in similar glycemic control when combined with meal time insulin aspart. However, with glargine regimen FBG, HbA1c and frequency of hypoglycemic event are lower. These facts contribute to better patients satisfaction with insulin glargine versus NPH insulin in IIT in type 1 diabetics. [ABSTRACT FROM AUTHOR]

Background/Aim. Fibrin glue is used as a matrix for local application of antibiotics. The aim of this study was to determine whether application of fibrin glue in combination with antibiotics can strengthen collagen production, prevent dehiscence of colon anastomoses due to infection, and reduce frequency of mortality and morbidity comparing to the control group and the group with fibrin glue application. Methods. The adult male Wistar rats divided into three groups were used in the experiment. The group 1 was the control one (after partial colon resection, colonic anastomoses performed were not treated), while to the group 2 and the group 3 were applied fibrin glue and fibrin glue with antibiotics (clindamycin and ceftriaxon) on the site of anastomoses, respectively. Quality of colonic anastomoses were estimated by means of determination of collagen (L-hydroxyproline) amount in the collon wall with anastomoses and histological analysis of this colon segment using light and electronic microscope on the days 5, 7 and 13 postoperatively. Results. The highest morbidity rate was registered in the group 1 (30%), then in the group 2 (13.3%) and the lowest one in the group 3 (3.33%; p < 0,05 vs group 1). Mortality rate was significantly higher in the group 1 than in the group 3 (20% and 0%, respectively; p < 0,05). In the postoperative course, the highest concentrations of collagen in the colon wall on the site of anastomoses, which was confirmed by both light and electronic microscopy, were found in the group 3. Conclusion. The application of fibrin glue with antibiotics on colon anastomoses reduces the number of dehiscence, provides good mechanical protection and shorten the time of anastomoses healing. [ABSTRACT FROM AUTHOR]