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The goal of this paper is to analyse the collected data on energy efficiency of electric vehicles from researches done by other authors and also to summarise all the factors affecting it. The majority of data available are obtained through simulations – therefore the emphasis in this paper will be placed on experimentally acquired data. The results of the analysis will be used for the planned e-bus eco-driving project for the purpose of Belgrade’s public transportation system. Currently there are only 5 (ultracapacitor type) e-buses operating in Belgrade city public transport, which makes only 0.2 % of all vehicles in rolling stock (making 16 % together with other electric-powered vehicles – trams and trolleybuses), but there are plans to acquire new 80 electric buses. With the rise of the number of electric vehicles, appropriate training of drivers is gaining more and more importance, and the results of the presented analysis make the basis for such training. This will hopefully increase the range of the buses used and help save the energy spent by public transportation, thus giving a little contribution to global fight for cleaner planet.

There are many standards relating to the anti-slip properties of footwear and flooring. These standards describe the different test methods and procedures for determining the footwear and floor slip resistance in different conditions. In this paper authors systematize the standards in this field applied in the EU and in Serbia and cite the Serbian institutes which are certified for this type of testing. In addition, the authors have carried out an analysis and comparison of the tests that are defined in these standards, indicating their advantages and disadvantages. Importance of the static and kinetic friction testing in determining the anti-slip properties of footwear and flooring is specifically indicated. Considering the current standards in area of slip resistance of the footwear and floor covering authors have determined the testing conditions for laboratory measuring the friction forces of different floor and footwear materials. The laboratory measurement has carried out at Faculty of Mechanical Engineering in Niš. The measuring results and their analysis are presented in the paper, as well.

In most of the cases, the friction is considered as a negative side-effect concerning energy loss following every process of the power transmission. However, the friction has significant positive side effects, because it is an indispensable prerequisite for the movement of people, machines, transportation means and others. Efficiency of these movements mostly depends on the friction between rubber and different materials such as metals, concrete, earth, wood, plastic, etc. Certain standards relating to measurement and determination of the friction characteristics of rubber were established. However considering that tribology of the rubber is very complex problem, numerous studies around the world are conducted. This paper gives an overview of some of the existing standards and conducted researches in this area. The paper also provides an overview of theoretical and experimental studies of friction the rubber and the other materials, which are done at Faculty of Mechanical Engineering in Niš.

Rubber is a very flexible material with many desirable properties Which enable its broad use in engineering practice. Rubber or rubber-metal springs are widely used as anti-vibration or anti-shock components in technical systems. Rubber-metal springs are usually realized as a bonded assembly, however especially in shock absorbers, it is possible to realize free contacts between rubber and metal parts. In previous research it authors was observed that friction between rubber and metal in such case have a significant influence on the damping characteristics of shock absorber. This paper analyzes the development process of rubber or rubber-metal shock absorbers realized free contacts between the constitutive parts, starting from the design, construction, testing and operation, with special emphasis on the development of rubber-metal springs for the buffing and draw gear of railway vehicles.

Modern rhodium plating solutions are based on either sulphate or phosphate. Although in theory there are four possible combinations, in practice only three different rhodium electrolytes are used. These are based on dilutions of rhodium sulphate or phosphate concentrates with added sulphuric or phosphoric acid. These processes are be discussed in this paper with a demonstration of Rh platings in the Slovenian firm Zlatarna Celje d.d.

This paper deals with gold, which is described as a chemical element. Special attention is paid to its physical-chemical properties and, furthermore, where or in what form it can be found in nature. We discuss the role it has played through history and we inform how gold has been developed to the level it has reached today’s value. Still more, when gold is broken into nanoparticles, this form could be highly useful for a wide range of processes, including general nanotechnology, electronics manufacturing and the synthesizing of different functional materials. It is important that we know that gold is also used in industry in many engineering applications (contacts in micro-electronics) and medicine (dental alloys, implants).

The systems that are currently installed in autonomous vehicles are not designed to avoid obstacles on the road by manoeuvring at the limits of the vehicle and the road surface – the goal of the research presented was to develop such system. For these purposes, a universal test track based on ISO 3888-1 and ISO 3888-2 standards was adopted, which can be used to represent any situation in which there is an obstacle on the road in front of the vehicle that needs to be avoided. An analysis of the curves for generating the paths through the test track was carried out, on the basis of which the Bézier curves were chosen. In addition to them, the results of simulations in Adams Car software were used to generate the paths, which can be considered equivalent to real-world trials with a professional driver behind the wheel. A control model was developed for longitudinal and transverse control of the vehicle based on PID controllers, with the selection of optimal parameters – the ones that define PID controllers, and the others that define other characteristics of the model. The model proved to be successful in guiding the vehicle through the test track at all speeds at which manoeuvres are possible. Bézier curves are shown to be a better choice at lower speeds, while paths based on Adams Car simulations are a better choice at higher speeds.

Although highly noble Au alloys have been considered as biocompatible dental materials, little is known about whether recasting affects their biocompatibility. The aim of this work was to study the effect of repeated casting procedures on the microstructure and biocompatibilty of a noble Au dental alloy. The prepared samples of one- four- and eight times melted/cast Dentor S were used to study primary cutaneous irritation and sensibilization on experimentalanimals. The extract of the alloy prepared by conditioning the Dentor S samples in a cell culture medium was used to study the cytotoxicity on L929 cells. The elemental composition and surface changes of the alloy were examined by Energy Dispersive X-ray (EDX) analysis and optical microscopy, respectively. Our results showed that repeated casting decreased the biocompatibility of Dentor S, manifested as decreased metabolic and proliferative activities of L929 cells and that the effect correlated with the number of melting/casting procedures. However, neither sample of Dentor S caused irritation and sensibilization on experimental animals. EDX showed that recasting slightly incresed the content of Au and Cu and slightly decreased the content of Pt, Pd and Zn. These changes correlated with the observations by optical microscopy. In conclusion, our results show that repeated casting of noble Au alloy changes its microstructure and decreases the biocompatibilty, suggesting that this procedure should be avoided in dental practice. [ABSTRACT FROM AUTHOR]

Background and Objectives: Rheumatoid arthritis (RA) patients experience sarcopenia and decreased muscle mass and handgrip strength, leading to decreased quality of life and disability. The prevalence of RA varies across regions. This study aimed to evaluate the factors associated with RA in Croatian regional centres and explore correlations between clinical parameters and muscle strength. Materials and Methods: Included in this study were 267 stable RA patients from four Croatian clinical centres. The patients' mean age was 60.4 ± 12.0 years, with 12.7% of them being male. For each study participant, information was gathered on their anthropometric characteristics, clinical and laboratory indicators, quality of life, disease activity, and sociodemographics. Results: The main results showed that in the female RA participants, the significant positive predictors are weight, height, exercise, VAS, and haemoglobin level. The negative predictors are the use of conventional synthetic disease-modifying anti-rheumatic drugs, the use of biological disease-modifying anti-rheumatic drugs, the number of tender joints, the number of swollen joints, the estimated sedimentation rate, the C-reactive protein, the disease activity score, the parameters of the EQ5D, and being prescribed with three or more medications. In the male RA participants, significant predictors of muscle strength are only weight, height, and anxiety/depression difficulties, according to the EQ5D. Conclusions: This study showed correlations between muscle strength and the parameters of disease activity, inflammation parameters, health-related quality of life, therapy, and exercise in the female RA participants in Croatia.

Older adults may experience certain forms of cognitive decline, but some forms of semantic memory remain intact in older age. To address how metaphor comprehension changes with age and whether metaphor comprehension relies more heavily on analogical reasoning (supported by fluid intelligence) or on conceptual combination (supported by crystalized intelligence), we compared performance of younger and older adults. In two experiments, healthy older adults (54-88 years) scored lower on a measure of fluid intelligence (Ravens Progressive Matrices) but higher on a measure of crystalized intelligence (Mill Hill Vocabulary Test) relative to younger adults (18-34 years). Groups were equally successful in comprehending relatively easy metaphors (Study 1), but older adults showed a striking advantage over younger adults for novel literary metaphors (Study 2). Mixed-effects modeling showed that measures of fluid and crystalized intelligence each made separable contributions to metaphor comprehension for both groups, but older adults relied more on crystalized intelligence than did younger adults. These age-related dissociations clarify cognitive effects of aging and highlight the importance of crystalized intelligence for metaphor comprehension in both younger and older adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Since additive technologies in dentistry are gradually replacing metal casting technology, it is necessary to evaluate new dental constructions intended for the development of removable partial denture frameworks. The aim of this research was to evaluate the microstructure and mechanical properties of 3D-printed, laser-melted and -sintered Co-Cr alloys, and perform a comparative study with Co-Cr castings for the same dental purposes. The experiments were divided into two groups. The first group consisted of samples produced by conventional casting of the Co-Cr alloy. The second group consisted of 3D-printed, laser-melted and -sintered specimens produced from a Co-Cr alloy powder divided into three subgroups, depending on the technological parameters chosen for manufacturing (angle, location and heat treatment). Examination of the microstructure was carried out by classical metallographic sample preparation, using optical microscopy and scanning electron microscopy with energy dispersive X-ray spectroscopy (EDX) analysis. A structural phase analysis was also performed by XRD. The mechanical properties were determined using a standard tensile test. The microstructure observation showed a dendritic character in the case of castings, while in the case of 3D-printed, laser-melted and -sintered Co-Cr alloys, the microstructure was typical for additive technologies. The XRD phase analysis confirmed the presence of Co-Cr phases (ε and γ). The results of the tensile test showed remarkably higher yield and tensile strength values and slightly lower elongation of the 3D-printed, laser-melted and -sintered samples than those produced by conventional casting.

Objectives: To evaluate CIEDE2000/CIELAB differences in color (ΔE 00 /ΔE ab ), and translucency parameter (ΔTP 00 /ΔTP ab ), and gloss of gingiva-colored resin-based restorative materials upon staining/aging., Materials and Methods: Disc-shaped, 10 mm in diameter, and 2-mm-thick samples (n = 5/group) were made from giomer (Beautifil II gingiva), oligomer-based (crea.lign GUM gel), CAD/CAM polymethyl-methacrylate-based (IvoBase CAD), PMMA-based (ProBase Hot), and dimethacrylate-based (SR Nexco Paste Gingiva). Color and gloss were recording using a benchtop spectrophotometer and gloss meter, respectively, at baseline (T0), and upon staining in coffee or red wine for 60 (T1) and 120 h (T2), or artificial aging of 150 kJ/m 2 (T1) and 300 kJ/m 2 (T2). Three-way analysis of variance (materials x staining conditions x time intervals), Tukey's test (α = 0.05), and Pearson's correlation test were used in analytical statistics., Results: CIEDE2000 color differences ranged from 1.0 to 4.4 (coffee), 1.5 to 5.3 (wine), and 0.9 to 2.0 after artificial aging, with ΔE 00 values being significantly higher for Beautifil than other materials (p < 0.05). ΔTP 00 values ranged from 0.2 to 0.7 and were statistically higher upon staining in wine compared to artificial aging (p < 0.05). Gloss values at T0 were 76.7-87.0. Beautifil exhibited the lowest gloss retention (50.8-60.2%) after staining, compared to > 90% of other materials (p < 0.05). ΔE 00 /ΔE ab and ΔTP 00 /ΔTP ab were positively correlated (p < 0.0001)., Conclusions: Color, translucency, and gloss changes of gingiva-colored restorative materials were material- and staining/aging-dependent. Generally, wine caused greatest changes in color (with IvoBase CAD being the most color stable) and translucency parameter. All materials except Beautifil gingiva II exhibited staining- and aging-dependent gloss retention greater than 90% for all compared time intervals., Clinical Relevance: Optical properties of resin-based gingiva-colored restorative materials depend on material, staining/aging conditions, and exposure time. Certain materials should be avoided in individuals with high consumption of red wine and coffee., (© 2022. The Author(s).)

Insulin resistance is believed to be an integral component of the polycystic ovary syndrome (PCOS). Beta ( ß ) cell dysfunction is also found in PCOS. In the study, we determined the influence of age, body mass index (BMI), and waist-to-hip ratio (WHR) on insulin response to oral glucose load (OGTT) and on insulin sensitivity (Si) and ß -cell function in young women with PCOS. One hundred fourteen patients with PCOS and 41 controls with normal basal plasma glucose were studied. A 75-g OGTT was performed to determine glucose tolerance and insulin response. Insulin sensitivity and ß -cell function were studied using a modified frequently sampled IV glucose tolerance test (FISGTT) to determine the acute insulin response (AIR G ), as well as S i by minimal model analysis. S i was decreased in PCOS women (2.49 0.18 vs. 3.41 ± 0.36, p < 0.05), but no difference in AIR G existed between the PCOS and control group (75.1 ± 4.6 vs. 63.4 ± 4.6, p < 0.05). BMI and WHR correlated negatively with S i ( r  = -0.43; r  = -0.289, p < 0.001, respectively), but not with AIR G ( r  = 0.116; r  = -0.02, p > 0.05, respectively). Increasing age correlated negatively with AIR G ( r  = -0.285, p < 0.001). There was a significant interaction between disease (PCOS), BMI, and WHR on S i as well as between age and PCOS on AIR G . Thus, patients below the age of 25 with PCOS showed enhanced AIR G (89.5 ± 7.1 vs. 65.1 ± 6.7, p < 0.05) and decreased S i (2.43 ± 0.25 vs. 4.52 ± 0.62, p < 0.05) compared to age-matched controls. In conclusion, these data suggest that not all patients with PCOS have basal and stimulated hyperinsulinemia, insulin resistance, and impaired glucose tolerance. Based on these data in young PCOS subjects, the development of insulin resistance and T2DM may be prevented with appropriate treatment strategies., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2022 Mirjana Šumarac-Dumanović et al.)

We examined the relationship between metaphor comprehension and verbal analogical reasoning in young adults who were either typically developing (TD) or diagnosed with Autism Spectrum Disorder (ASD). The ASD sample was highly educated and high in verbal ability, and closely matched to a subset of TD participants on age, gender, educational background, and verbal ability. Additional TD participants with a broader range of abilities were also tested. Each participant solved sets of verbal analogies and metaphors in verification formats, allowing measurement of both accuracy and reaction times. Measures of individual differences in vocabulary, verbal working memory, and autistic traits were also obtained. Accuracy for both the verbal analogy and the metaphor task was very similar across the ASD and matched TD groups. However, reaction times on both tasks were longer for the ASD group. Additionally, stronger correlations between verbal analogical reasoning and working memory capacity in the ASD group indicated that processing verbal analogies was more effortful for them. In the case of both groups, accuracy on the metaphor and analogy tasks was correlated. A mediation analysis revealed that after controlling for working memory capacity, the inter-task correlation could be accounted for by the mediating variable of vocabulary knowledge, suggesting that the primary common mechanisms linking the two tasks involve language skills., (© 2021 The Authors. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

Objectives: To evaluate different intervals of exposure to staining solutions and artificial aging on translucency parameter (TP 00 ) of CAD-CAM materials., Material and Methods: One millimeter thick square-shaped specimens (N = 288) were cut from Cerasmart (CS), IPS e.max (IE), Lava Ultimate (LU), Shofu HC (SH), Vita Enamic (VE), and Vita Suprinity (VS) and were divided into laboratory and chairside polishing. Reflection wavelength spectra, CIE D65 standard illuminant, 2 ° standard observer, SCI, UV included, SAV aperture, 6 mm diameter, were recorded at 10 nm sensitivity against white and black calibration tiles using a benchtop spectrophotometer. Subsequently, they were converted into CIEDE 2000 TP 00 . After baseline measurements (T0), the specimens were divided as follows (n = 8): staining in coffee (C) and wine (W), for 60 (T1) and 120 hours (T2), and accelerated artificial aging (A). Artificial aging (ISO 4892-2 standard) was performed in two cycles of 150 KJ/m 2 , for T1 and T2, respectively. TP measurements were repeated at T1 and T2. Data of TP 00 retention were submitted to analysis of variance and Fisher's PLSD multiple comparison test (α=0.05)., Results: Fisher's PLSD critical differences among materials, time intervals and staining/aging were 0.16, 0.11 and 0.11, respectively. SH showed the highest TP 00 followed by LU > CS > IE = VS > VE. For all time intervals, the lowest TP 00 retention was observed with C. W, and A presented similar values., Conclusions: Translucency Parameter was a time and staining/aging-dependent material. In majority of cases, it decreased upon staining/aging., Competing Interests: Conflict of interests The authors report no conflict of interests.

The selection of a rubber compound has a determining influence on the final characteristics of rubber-metal springs. Therefore, the correct selection of a rubber compound is a key factor for development of rubber-metal vibration isolation springs with required characteristics. The procedure for the selection of the rubber compound for vibration isolation of rubber-metal springs has been proposed, so that the rubber-metal elements have the necessary characteristics, especially in terms of deflection. The procedure is based on numerical simulation of spring deflection with Bergström-Boyce constitutive model in virtual experiment, with a goal to determine which parameters of the constitutive model will lead to spring required deflection. The procedure was verified by case study defined to select rubber compound for a rubber-metal spring used in railway engineering.

Background and objectives: The relationship between air pollen quantity and the sensitization of allergic patients is crucial for both the diagnosis and treatment of allergic diseases. Weather conditions influence the distribution of allergenic pollen and increases in pollen concentration may negatively affect the health of allergic patients. The aim of this study was to analyze the implementation of allergen immunotherapy with regard to air pollen concentration. Material and Methods : Here we examined the relationship between Betula air pollen concentration and the usage of Betula verrucosa allergen immunotherapy in Serbia. Examination covered the period from 2015 to 2018. Measurement of airborne pollen concentration was performed with Lanzoni volumetric pollen traps. The evidence of the usage of sublingual allergen immunotherapy (SLIT) was gathered from patients with documented sensitization to specific pollen. Results: During this period tree pollens were represented with 58% ± 21% of all measured air pollen species, while Betula pollen represented 15% ± 8% of all tree pollens. Betula pollination peaked in April. Allergen immunotherapy to Betula verrucosa in Serbia is entirely conducted as sublingual immunotherapy and represents 47.1% ± 1.4% of issued tree pollen SLIT. The use of pollen SLIT increased by 68% from 2015 to 2018, with an even greater increase in usage recorded for Betula SLIT-80%. Conclusions: This analysis shows a clear causative relationship between pollination and the type/prevalence of applied allergen immunotherapy. Information about the flowering seasons of allergenic plants is very important for people who suffer from allergy, for clinical allergologists, as well as for governing authorities. The presented data is of practical importance to the proper timing of immunotherapy initiation and of importance for urban landscaping. The obtained data can be the starting point for the instatement of a thorough epidemiological study and the inclusion of Serbia on the pollen map of Europe., Competing Interests: The authors declare no conflict of interest.

We review psychological research bearing on major theories of metaphor comprehension. A broad survey of behavioral studies is coupled with findings from recent meta-analyses of neuroimaging studies of metaphor processing. We identify three broad theoretical positions that have been the foci of research efforts: analogy, categorization, and conceptual mapping. The first two of these emphasize relatively well-specified information-processing models; the third links metaphor comprehension to embodied cognition. Our review evaluates the evidence that has been taken as support for each view, and then critically examines studies that bear on competing hypotheses derived from opposing theories. Finally, we discuss issues that future research on metaphor should address. In particular, we call for greater consideration of the pragmatic functions of metaphor in context, of its emotional impact, and of its links to literary interpretation. We suggest ways in which mechanisms based on analogy and conceptual combination might be integrated to create a richer conception of metaphor understanding. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Introduction: Aortoiliac occlusive disease and abdominal aortic aneurysm in patients with renal insufficiency on hemodialysis can significantly influence the success of renal transplantation. In the recent past, advanced atherosclerosis was considered as contraindication for renal transplantation. Complicated creation of vascular anastomoses and progression of occlusive or aneurysmal disease were the main reasons., Case Report: We presented a 52-year-old man with a 5-year history of end-stage renal disease on haemodialysis. The patient was previously excluded from renal transplantation program because of severe aortoiliac atherosclerosis and abdominal aortic aneurysm. Resection of abdominal aortic aneurysm with occlusion of the iliac arteries and reconstruction with aortobifemoral synthetic grafts was performed and followed by cadaveric renal transplantation., Conclusion: Advanced atherosclerotic disease in aortoiliac segment requires elective vascular surgical reconstruction, as part of preparation for renal transplantation in patients with end-stage renal disease.

Background/aim: The ileal neobladder should be a lowpressure reservoir with acceptable volume and relatively small resorptive surface. A larger inner surface of the ileal pouch is associated with the high resorption of urine metabolites through intestinal mucosa and systemic metabolic disturbances, while a too small pouch results in a higher frequency of voiding and incontinency. The aim of this study was to investigate it is possible to create a neobladder from a shorter ileal segment compared to standard surgical techniques, and reduce metabolic complications., Methods: This prospective study included 77 male patients, scheduled for radical cystectomy and orthotopic neobladder derivation. The patients were divided into two groups: the standard pouch (SP) group of 37 patients scheduled for standard orthotopic neobladder, using a 50−70 cm long terminal ileum segment; the “Belgrade pouch” (BP) group of 40 patients scheduled for original, orthotopic urinary reservoir, using a 25−35 cm long terminal ileum segment. We measured neobladder capacity, acidosis, base excess and bicarbonate concentration in the postoperative month 3rd, 6th, 12th and 15th., Results: At the end of the study, the patients from the SP group had much higher neobladder capacity than the natural bladder − 750 mL (range 514−2,050 mL); in contrast, the patients from the BP group had average capacity of 438 mL (range 205−653 mL) (p < 0.001). At the end of the study, there were more patients with acidosis (37.8% : 2.5%), base excess (35.1% : 7.5%) and low bicarbonate level (40.5% : 20.0%) in the SP group, than in the BP group, respectively (p < 0.001)., Conclusion: “Belgrade pouch”, make from 25−35 cm long terminal ileum segment may obtain adequate capacity and lower rate of metabolic disturbances than standard, high capacity orthotopic neobladders.

Introduction: Differences between the tooth and implant response to load can lead to many biological and technical implications in the conditions of occlusal forces., Objective: The objective of this study was to analyze load distribution in tooth/implant-supported fixed partial dentures with the use of resilient TSA (Titan Shock Absorber, BoneCare GmbH, Augsburg, Germany) abutment and conventional non-resilient abutment using finite element method., Methods: This study presents two basic 3D models. For one model a standard non-resilient abutment is used, and on the implant of the second model a resilient TSA abutment is applied. The virtual model contains drawn contours of tooth, mucous membranes, implant, cortical bones and spongiosa, abutment and suprastructure. The experiment used 500 N of vertical force, applied in three different cases of axial load. Calculations of von Mises equivalent stresses of the tooth root and periodontium, implants and peri-implant tissue were made., Results: For the model to which a non-resilient abutment is applied, maximum stress values in all three cases are observed in the cortical part of the bone (maximum stress value of 49.7 MPa). Measurements of stress and deformation in the bone tissue in the model with application of the resilientTSA abutment demonstrated similar distribution; however, these values are many times lower than in the model with non-resilient TSA abutment (maximum stress value of 28.9 MPa)., Conclusion: Application of the resilient TSA abutment results in more equal distribution of stress and deformations in the bone tissue under vertical forces. These values are many times lower than in the model with the non-resilient abutment.

Background/aim: Hip fracture remains the leading cause of death in trauma among elderly population and is a great burden to national health services. In-patient death analysis is important to evaluate risk factors, make appropriate selection and perform adequate treatment of infections for patients to be operated. The aim of this study was to analyze in-hospital mortality in proximal femoral fracture patients operatively treated with hip arthroplasty procedure., Methods: We followed 622 consecutive patients, and collected data about age, gender, the presence of infection preoperatively and postoperatively, American Society of Anesthesiologists (ASA) score, diabetes mellitus and the type of surgical procedure. Postoperative infections included pneumonia, urinary tract infections, surgical site infections and sepsis., Results: We found a statistically significant influence of preoperative and postoperative infection presence for in-patient mortality with relative risk for lethal outcome of 4.53 (95% CI: 1.44-14.22) for patients with preoperative infection and 7.5 (95% CI: 1.90-29.48) for patients with postoperative infection. We did not confirm a statistically significant influence of age, gender, ASA score, diabetes mellitus or the type of surgical procedure for increased mortality rate., Conclusion: Adequate preoperative selection, risk evaluation and adequate treatment of infections are of the key importance for lowering the risk of death in patients operated due to proximal femoral fracture and treated by hip arthroplasty procedures. Special attention is to be paid for the presence of preoperative and postoperative infections in patients operatively treated due to the risk for increased in-hospital mortality.

The purpose of the study was to examine whether rheumatoid arthritis (RA) patients have higher prevalence of metabolic syndrome (MetS) than osteoarthritis (OA) patients in association with a higher level of chronic systemic inflammation in rheumatoid arthritis. A total of 583 RA and 344 OA outpatients were analyzed in this multicentric study. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. A 1.6-fold higher prevalence of MetS was found in patients with OA compared with the RA patients. Among the parameters of MetS, patients with OA had significantly higher levels of waist circumference, systolic blood pressure, fasting blood glucose and triglycerides, whereas HDL cholesterol and diastolic blood pressure values were similar in both groups of patients. Higher values of inflammatory markers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)] in MetS than in non-MetS patients and higher prevalence of MetS in patients with CRP level ≥5 mg/L in both RA and OA patients were found. In multivariate logistic regression analysis, significant predictors of MetS were type of arthritis (OA vs. RA; OR 2.5 [95 % CI 1.82-3.43]), age (OR 1.04 [95 % CI 1.03-1.06]) and ESR (OR 1.01; [95 % CI 1.00-1.01]). The significant association between OA and MetS was maintained in the regression model that controlled for body mass index (OR 1.87 [95 % CI 1.34-2.61]). The present analysis suggests that OA is associated with an increased risk of MetS, which may be due to a common underlying pathogenic mechanism.

Background/aim: Multiple renal arteries (MRAs) represent a surgical challenge by the difficulty in performing anastomoses, bleeding and stenosis. MRAs should be preserved and special attention should be paid to accessory polar arteries. All renal arteries (RAs) must be reconstructed and prepared for safe anastomosis. The paper decribed the different techniques of vessel reconstruction during kidney transplantation including important steps within recovery of organs, preparation and implantation., Methods: In a 16-year period (1996-2012) of kidney transplantation in the Military Medical Academy, Belgrade, a total of 310 living donors and 44 human cadaver kidney transplantations were performed, of which 28 (8%) kidneys had two or more RAs., Results: All the transplanted kidneys had immediate function. We repaired 20 cases of donor kidneys with 2 arteries, 4 cases with three RAs, one case with 4 RAs, one case with 4 RAs and renal vein reconstruction, one case with 3 arteries and additional polytetrafluoroethylene (PTFE) graft reconstruction, one case with transected renal artery and reconstruction with 5 cm long deceased donor external iliac artery. There were no major complications and graft failure. At a minimum of 1-year follow-up, all the patients showed normal renal function., Conclusion: Donor kidney transplantation on a contralateral side and "end-to-end" anastomosis of the renal artery to the internal iliac artery (IA) is our standard procedure with satisfactory results. Renal artery reconstruction and anastomosis with IIA is a safe and highly efficient procedure and kidneys with MRAs are not contraindicated for transplantation. A surgical team should be fully competent to remove cadaveric abdominal organs to avoid accidental injuries of organs vessels.

Introduction: Situs inversus totalis (SIT) represents a total vertical transposition of the thoracic and abdominal organs which are arranged in a mirror image reversal of the normal positioning. We presented a successful pre-dialysis kidney transplantation from a living sibling donor with SIT and the longest donor follow-up period, along with analysis of the reviewed literature., Case Report: The pair for pre-dialysis kidney transplantation included a 68-year-old mother and 34-year-old daughter at low immunological risk. Comorbid- ities evidenced in kidney donors with previously diagnosed SIT, included moderate arterial hypertension and borderline blood glucose level. Explantation of the left donor kidney and its placement into the right iliac fossa of the recipient were performed in the course of the surgical procedure. A month after nephrectomy, second degree renal failure was noticed in the donor. A 20-month follow-up of the donor's kidney and graft in the recipient proved that their functions were excellent., Conclusion: In donors with previously di- agnosed SIT the multidisciplinary approach, preoperative evaluation of the patient and detection of possible vascular anomalies are required to provide maximum safety for the donor.

Introduction: Metastatic renal cell carcinoma (RCC) frequently spreads not only to neighboring lymph nodes, but also to distant organs, including the lungs, liver, bones and brain., Case Report: We presented three cases of RCC with colon metastasis. In the first, 63-year-old patient, after left nephrectomy followed with lyphadenectomy in paraaortic lymph node, left hemicolectomy was done due to RCC metastasis in rectosigmoid colon. In the second, 35-year-old patient, left radical nephrectomy was followed two years later with partial right nephrectomy, lung metastasectomy, small bowel and coecum resection and right orchiectomy all as separate procedures in different time intervals. The patient died from brain and bone metastases two years after the first surgery. The third, 35-year-old patient, had right nephrectomy followed by repeted lymphadenectomies after 6, 12 and 24 months. Four years later RCC spreaded to coecum and right hemicolectomy was performed., Conclusion: RCC treated with nephrectomy should be carefully followed up with imaging methods as a proper treatment of RCC metastases to distant organs could be important for a patient survival.

In this study, we compare the prevalence of arterial hypertension (HT) in rheumatoid arthritis (RA) and osteoarthritis (OA) patients, exposed to high- and low-grade chronic inflammation, respectively, to assess the possible association between chronic inflammation and HT. A total of consecutive 627 RA and 352 OA patients were enrolled in this multicentric study. HT was defined as a systolic blood pressure (BP) ≥ 140 and/or diastolic BP ≥ 90 mmHg or current use of any antihypertensive drug. Overweight/obesity was defined as body mass index (BMI) ≥ 25, and patients ≥65 years were considered elderly. The prevalence of HT was higher in the OA group than in the RA group [73.3 % (95 % CI, 68.4, 77.7) and 59.5 % (95 % CI, 55.6, 68.4) P < 0.001, respectively]. When the results were adjusted for age and BMI, the HT prevalence was similar in both groups [RA 59 % (95 % CI, 55.1, 63.8) OA 60 % (95 % CI, 58.4, 65.0)]. In both groups, the prevalence of HT was higher in the elderly and those who were overweight than in the younger patients and those with a BMI < 25. Overweight (BMI ≥ 25) and age ≥65 were independent predictors of HT in multivariate logistic regression model, which showed no association between HT and the disease (RA or OA). The results indicate a robust association of age and BMI with HT prevalence in both RA and OA. The difference in HT prevalence between RA and OA is due rather to age and BMI than to the features of the disease, putting into question specific association of HT with RA.

Introduction: Tumescent local anesthesia (TLA) is widely used for ambulatory surgery. Patients with transplanted or gans are on immunosuppressive therapy and with risk for organ rejection or severe infection., Case Report: Saphe nectomy with phlebectomy on the left leg under TLA was performed in a patient with kidney transplantation per formed four years ago. A combination of 35 mg of 1% prilocaine-hydrochloride, 5 mL of 8.4% sodium bicarbonate and 500 microg of epinephrine in 460 mL of normal saline was used for TLA. Overall 750 mL of the solution was used. The patient had satisfactory postoperative analgesia and was discharged home on the same day. Blood levels of urea, cre atinine, estimated glomerular filtration rate (eGFR) and ta crolimus concentration, measured preoperatively and on the second postoperative day, were in a regular range. Prilocaine blood concentrations determined on the 4th, 10th and 16th postoperative hours, were below toxic levels., Conclusion: TLA in a kidney-transplanted patient performed for saphe nectomy with phlebectomy proved to be a safe and reliable anesthesia method.

Background/aim: Radical cystectomy is the method of choice in management of muscle invasive, organ-confined tumors of the bladder (T2-T4, N0-Nx). The most frequent continent orthotopic urinary diversion after radical cystectomy is the ileal neobladder. A modified technique consists of using a shorter segment of the terminal ileum than the standard technique, around 30 cm. The aim of this study was to determine the urodynamic characteristics of the orthotopic ileal neobladder created by a modified technique., Methods: In this prospective clinical study we analyzed the urodynamic parameters of 24 patients who had underwent radical cystectomy with orthotopic urinary diversion by ileal neobladder created using a modified technique. In all the patients we performed invasive and noninvasive urodynamic investigations 12 months after the operation. The urethral pressure profile parameters analyzed were maximal urethral pressure, maximal urethral closure pressure and the functional urethral profile length., Results: The average age of the patients was 63 (49-73) years, 90% were males and 10% were females. The median length of the shorter segment of the terminal ileum was 28 (range 22-35) cm. Prior to enterocystometry and uroflowmetry postvoid residual (PVR) urine was measured by a urethral catheter. The median PVR was 16.7 (0-140) mL. The median enterocystometric capacity was 396 (range 372-532) mL. The median end filling pouch pressure was 27.6 (range 20-70) cmH2O. The median maximal flow of urine was 22.1 (range 9.7-39.5) mL/s and the average flow of urine was 9.61 (range 3.6-17.6) mL/s. Flow time in the analyzed group was 47.5 (range 22-119) s. The median maximal urethral pressure was 54 (range 12-101) cmH2O, maximal urethral closure pressure 36.6 (range 6-91) cmH2O. Functional urethral profile length was 14.9 (range 4-37) mm., Conclusion: An ileal orthotopic pouch created by a modified technique using a shorter segment of the terminal ileum after 12 months presents with urodynamic characteristics similar to the native bladder.

Shoulder calcific lesions of the rotator cuff are a common problem in physiatric and orthopedic practice. The lesions are mostly located in the supraspinatus tendon, close to the insertion area in the critical zone. Patients are usually treated conservatively by nonsteroid antiinflammatory drugs, analgesic drugs, local injections, physiotherapy and rarely by applying surgical procedures. Painful shoulder gives rise to functional disabilities and may sometimes lead to pharmacological overuse. In the last twenty years, extracorporeal shock wave therapy (ESWT) has been frequently used in the treatment of calcific tendinopathies. We have evaluated the effectiveness of radial ESWT on the group of 30 patients, aged between 28 and 58 years, with calcific tendinitis of the shoulder. Criotherapy, medical exercises and radial ESWT were applied. We used the radial ESWT device (BTL-5000 SWT, Columbia, USA), 3 bars pressure, 10 Hz frequency, 2000 shocks. Patients were examined before the beginning of the treatment, immediately after the treatment, and 6 months later. The treatment included measurement of the range of motion (ROM), measurement of voluntary isometric contraction of shoulder muscles with manual muscle test (MMT), and subjective assessment of pain intensity with visual analogue scale (VAS). X-ray was done before and 6 month after treatment. The study has shown the efficiency of the treatment with radial ESWT. The level of statistical significance was determined with student t-test. Radial ESWT applied to patients with shoulder calcific lesions of the rotator cuff resulted in pain relief increase in the range of motion and increase in the muscular strength. As shown by X-ray, these results were followed by the decrease in the size of the rotator cuff calcifications.

Knee osteoarthritis (KOA), the most common type of osteoarthritis (OA), is associated with pain and inflammation of the joint capsule, impaired muscular stabilization, reduced range of motion and functional disability. High-intensity laser therapy (HILT) involves higher-intensity laser radiation and causes minor and slow light absorption by chromophores. Light stimulation of the deep structures, due to high intensity laser therapy, activates cell metabolism through photochemical effect. The transmissions of pain stimulus are slowed down and result in a quick achievement of pain relief. The aim of our research was to investigate the prompt analgesic effect of HILT on patients with KOA. Knee radiographs were performed on all patients and consequently graded using the Kellgren-Lawrence grading scale (K/L). A group of 96 patients (75 female, 21 male, mean age 59.2) with K/L 2 and 3 were submitted to HILT therapy. Pain intensity was evaluated with visual analogue scale (VAS) before and after the treatment. HILT consisted in one daily application, over a period of ten days, using protocol wavelength, frequency and duration. The results showed statistically significant decrease in VAS after the treatment (p < 0.001). Considering these results, HILT enables prompt analgesic effects in KOA treatment. Therefore HILT is a reliable option in KOA physical therapy.

Background/aim: Diabetes mellitus (DM) is considered to be an epidemic, chronic and progressive disease. The treatment of DM reqiures substantial effort from both the diabetes treatment team and a patient. Patient education is one of the treatment elements. The most efficacious form and content of education has not yet been established. However, every DM education must include introduction to a substantial number of facts about diabetes. The aim of our study was to estimate the levels of DM knowledge and glycemic control in Serbian patients with DM type 2 as well as to estimate the effects of education using printed material on the levels of glycemic control and knowledge about DM. Also, the effects of education on glycemic control and the level of knowledge in differently treated patients were estimated., Methods: The patients with DM type 2 (n = 364), aged 40 to 65 years, from three regional health centers, were randomized for the study. After informed consent, patients filled out the questionnaire, and were checked for HbA1c and fasting blood glucose. Finally, booklet "Healthy lifestyle with diabetes mellitus type 2" was given to them. The same procedure was repeated after 3, 6 and 18 months., Results: There was a significant improvement in HbA1c levels after 3 months (8.00 +/- 1.66% vs 9.06 +/- 2.23%, p < 0.01) and after 6 months (7.67 +/- 1.75% vs 9.06 +/- 2.23%, p < 0.01). There was no further improvement in HbA1c levels after 18 months (7.88 +/- 1.46% vs 7.67 +/- 1.75%, p > 0.05). There was a significant improvement in the average test score (percent of correct answers per test sheet) after three monts (64.6% vs 55.6%, p < 0.01). There were no further statistically significant changes in the general level of DM knowledge after 6 months (65.0 +/- 32.5% vs 64.5 +/- 33.7%, p > 0.05) and after 18 months (64.8 +/- 32.7 vs 64.5 +/- 33.7%, p > 0.05). There was a significant diffrence in educational intervention response in DM type 2 patients on different therapeutic regimens., Conclusion: Education with printed material led to improvement in glycemic control and level of DM knowledge in our patients. Education with printed material may be a useful adjunct to DM treatment and should be structured according to the treatment modality.

A possible complication after donor nephrectomy is a decrease in glomerular filtration rate. The goal of our investigation is to estimate the function of the remaining donor kidney in the first 6 months after nephrectomy using the equations Cockcroft-Gault, Modification of Diet in Renal Disease 1 (MDRD1) and MDRD2. In addition to basic age and sex data, we collected standard biochemical data from blood: creatinine, blood urea nitrogen, and albumin. Blood samples and diuresis were taken at -1, 0, 1, 2, 3, 7, and 14 days, and after 6 months. Our results show that glomerular filtration rate decreases after nephrectomy and stabilizes after 6 months in values significantly lower compared with predonation values. Both MDRD estimations show that these donors after nephrectomy are patients in the third degree of chronic kidney disease, and we can predict that older donors and those with comorbidities very soon will need a treatment for chronic kidney disease. For glomerular filtration rate estimation, we recommend the MDRD2 equation. All donors must have long-term follow-up and treatment, because there is a possibility of eventual cardiovascular and metabolic diseases.