bluuebunny/crossref_metadata_2025 huggingface dataset:
Burnout in Belgrade orthopaedic surgeons and general practitioners: A preliminary report
Authors: Lesic A.R.A. , Petrovic-Stefanovic N. , Perunicic I. , Milenkovic P. , Lecic-Tosevski D. , Bumbasirevic M.Z.
Published: November 2009

Background: Burnout syndrome (BOS) is caused both by psychological-emotional and physical stress. It is associated with decreased job performance and low career satisfaction. BOS has a significance influence both to physicians' performance in health care system, and in their private life. Until now, there was no data about this aspect of orthopaedic surgeon condition and health in our community. Aim: To assess the level of the burnout syndrome in orthopaedic surgeons and general practitioners (GPs), and the relations of their demographic features, job characteristics to the burnout syndrome Design: Questionnaire-based survey Methods: The sample consisted of 30 orthopaedic surgeons from the University Clinical Centre, and 40 GPs from the primary health care centres. The Burnout syndrome was measured by the Maslach Burnout Inventory (MBI). In addition to the MBI, the demographic data were collected and analyzed (age, age of practicing, gender, marital status) in relation to BOS. Results: Both groups expressed moderate to high rate of emotional exhaustion, depersonalization and low personal accomplishment. However, statistical significance between the groups had not been demonstrated. Neither gender nor years of practice or marital status did express statistically significant impact on the BOS items, i.e. they were not predictors of the BOS. Our results showed that about 70% of the physicians were emotionally exhausted considering both groups. On the other hand, orthopaedics demonstrated slightly higher depersonalisation level (55%) than GPs (38%). While GPs expressed lower personal accomplishment (48%) comparing to orthopaedics (29%). Discussion: The obtained MBI scores in this study were similar to those registered in US among residents, but when comparing to physicians in West Europe, which have similar health care system, our results demonstrated higher rates of BOS items. Conclusion: The Burnout syndrome represents an important problem for actively practicing physicians. The results of this and other similar studies should be used to evaluate medical training, practice, professional relations and introduce necessary changes.
Correlation between femur's length and morphometric parameters of distal femur important in rupture anterior cruciate ligament
Authors: Stijak Lazar , Radonjic Vidosava , Aksic Milan , Filipovic B. , Sladojevic M. , Santrac-Stijak G.
Published: November 2009

INTRODUCTION: Frequency of anterior cruciate ligament rupture depends of anatomical parameters of distal femur and intercondylar notch. PURPOSE: Purpose of this work is identification relation between femur length and morphometrical parameters intecondylar notch, measuring in two levels. METHOD: A hundred femur's (medley population of 48 right and 52 left femurs), from osteological collection Department of Anatomy 'dr. Niko Miljanic' in Belgrade measured. Measurement was in two levels. Epicondilar width, width of medial and lateral condyls and intercondylar width, had been measured in level of popliteal sulcus and on the widest place, after that notch width index had been determinated. RESULTS: Absolute values of morphometrical parameters distal femur's are in positive relation with her length (p <0.01), but notch width index is not, as in level of popliteal sulcus, as on the widest place (p>0.05). CONCLUSION: Femur's length increasing also produces increasing of absolute anatomical parameters of distal femur which can produce rupture of anterior cruciate ligament, while relative dimensions do not show femur's length increasing.
Procena kvaliteta zivota pacijenata operativno lecenih zbog preloma kuka, preliminarni izvestaj
Authors: Lesic A.R.A. , Kocev N. , Milosevic I. , Bumbasirevic M.Z.
Published: November 2009

Introduction: Fractures of the proximal segment of the femur occurring most commonly in elderly patients are a serious, both medical (orthopaedic) and socioeconomic, problem. Material and Methods: 46 patients (14 male and 32 female) operated for hip fracture in the January-June 2008 period, who were available for analysis (as 24 patients were not) were investigated. In addition to descriptive analysis, general health status-quality of life was assessed by means of SF-36 questionnaire comprising eight groups of questions determining the physical, psychological and social status of the patients within the 0 to 100 (problem) points range.. Results: The findings were that the average patient age was 74 years (76.9 for male patients and 74.06 fro female ones). The values of all eight parameters were lower by up to 89% in comparison to the pre-injury values, but improved by as much as 50% after six months (for physical functioning and the role of physical functioning) or by 30% for the role of emotions. The values never return to their pre-injury levels. In foreign studies, the parameters are higher, especially post-treatment values for vitality and role of emotions. Conclusion: In patients treated for hip fractures, it is necessary to carry out an assessment of general, physical, mental and social functioning of the patient in addition to the assessment of their clinical and radiological findings, so as to get a more realistic insight in the status of the treated and operated patients. The SF-36 questionnaire is widely used in such investigations along with other questionnaires. It is also necessary to investigate the general health status-quality of life of the entire healthy population in our country.
Procena plucne i metabolicke funkcije u toku klasicne i laparoskopske holecistektomije kod pacijenta sa ASA I i ASA II skorom
Authors: Stefanovic B. , Stefanovic B. , Popovic N. , Mijatovic S. , Skodric V. , Pavlovic A. , Lackovic V.
Published: November 2009

This is a prospective study of patients treated at the Center for Urgent Surgery, Clinical Center of Serbia. The patients were divided into two groups; i.e., the controls consisted of 30 subjects, who underwent conventional cholecystectomy, and studied group with 30 patients who had laparoscopic cholecystectomy. The patients were homogenized by ASA score (ASA I and ASA II) and on population basis. Hemodynamic parameters and 4 time-point pulmonary function tests were monitored in both groups. Peritoneal insufflation resulted in significant increase of systemic arterial pressure (23%), mean arterial pressure (23.8%), systemic vascular resistance (65%), pulmonary vascular resistance (90%), and significant reduction of cardiac output (24%) and cardiac index (51%). Pneumoperitoneum caused transient restriction of pulmonary function by reducing the thoracic and lung compliance. Fall of pH concentration, increase of PaCO2 and ET CO2 without any changes of PaO2, SO2, base excess and bicarbonate ions concentrations were the sequelae of CO2 absorption from peritoneal cavity. Postoperative 'hypothermi', i.e. lowering of body temperature for 0.3oC was the consequence of sudden gas expansion (Joule-Thompson phenomenon), which implies continuous flow of dry gas under pressure over peritoneal surface. Tissue damage factors (D-dimer, C-reactive protein, Protein C) were significantly lower in laparoscopic group, meaning that such mode of treatment resulted in minor postoperative pain and shorter period of recovery. Laparoscopy is a revolution in surgery. Definite success of any laparoscopic intervention depends on anesthesia as its crucial factor, at the same time meeting the patient's wish and expectations to be free from pain and discharged in no time from hospital.
Etiology of surgical site infections at the orthopaedic trauma units
Authors: Markovic-Djenic Lj. , Maksimovic J. , Lesic A.R.A. , Stefanovic S. , Bumbasirevic M.Z.
Published: November 2009

Objectives: The aim of the study was to analyze the epidemiological and microbiological analysis of surgical site infections in the orthopedic wards. Materials and methods: A 6-month prospective cohort study was conducted at the major teaching hospital in Belgrade. Patient's basic demographic data and data about surgical site infections were collected. Bacteria cultured from the surgical site were also analyzed. Results: A total of 277 patients operated in the Institute of Orthopedics and trauma surgery, Clinical Center of Serbia. Sixty-three cases of SSI were detected, and the overall incidence rate was 22.7% (95% IP=17.8- 27.6). Fifty-three (84.1%) SSIs had microbiological confirmation and overall 82 bacterial strains were isolated. The most frequent isolated bacteria were Staphylococcus aureus, Acinetobacter sp, Klebsiella pp, Pseudomonas sp and Enterococcus sp. Nineteen (79.2%) strains of Staphylococcus aureus isolated from infected surgical sites were meticillin- resistant. Conclusion: This study suggests that it is necessary to maintain continuous surveillance of surgical site infections. It is important to emphasize the need for implementation the measures of contact isolation in order to prevent the nosocomial transmission of resistant bacteria.
Laparoscopic cholecystectomy in elderly patients
Authors: Stanisic V. , Bakic M. , Magdelinic M. , Kolasinac H. , Miladinovic M.
Published: November 2009

Laparoscopic cholecystectomy (LC ) is the method of choice of surgical treatment of gallbladder diseases. Operations in elderly people over 65 years because of chronic diseases, are often associated with high operative and postoperative morbidity and mortality. The aim of this study was to analyze the outcome of LC in the treatment of cholelithiasis in patients older than 65 years. For evaluation of LC effectiveness and security in old patients, we did this prospective analysis of 81 patients surgically treated because of symptomatic cholelithiasis . We had analyzed associated diseases, operative and postoperative complications, the reasons of conversion to open cholecystectomy. The research points to the small percentage of operative and postoperative complications, short hospital stay, less postoperative pain, quick recovery and savings in treatment. The age can not be contraindication for LC in older patients. In uncomplicated symptomatic cholelithiasis in elderly people, LC is a successful and safe procedure. Complicated symptomatic cholelithiasis, because of longer duration of operations is looking for a good assessment of general condition and associated diseases for LC.
Biochemical and antropometric monitoring of growth in preterm infants
Authors: Ljujic-Glisic M. , Bozinovic-Prekajski N. , Glibetic M.
Published: November 2009

Enriched human milk may stimulate gain weight in preterm infants during neonatal period. Aim is biochemical assessment of preterm infants, feed by mother's milk fortificated with special domestic formula preImpamil during the first month of life. 80 preterm infants (45 male and 35 female), up to 36 weeks of gestation. BW less than 2500 g, which started enteral intake in the first three day of life. Total volume intake was in range from 70 ml/kg first day, to 170-200 ml/kg, after 10th day of life. Mother's milk fortification was prepared as 5% mixture solution of preImpamil. The dynamics of biochemical analyses started on the first day of study and was repeated once weekly. We analyzed levels of: total protein, albumin, prealbumin, transferin, urea, Ca ionised, P and alkaline phosphatase using standard biochemical methods. Statistical analyses completed by ANOVA test, one factorial analyses of variance. During monitoring total protein level increased in the second week of life (p<0,03), as well as albumin (p<0,03). Prealbumin level increased, as well as transferin (p-NS). Initial level of ionised fraction of Ca was significantly lower (p<0,03) at the beginning of the study, compared to the rest. Serum level of P increased, as well as level of alkaline phosphatase at the end of first and second week (p<0,01). Conclusion is that biochemical parameters as level of protein and albumin are important at the assessment growth in preterm infants on special feeding regimes.
Rare case of quadricuspid aortic valve
Authors: Micovic S. , Djukanovic B.P. , Milojevic P.S. , Nezic D. , Jovic M. , Jovovic Lj. , Tomic S. , Lausevic-Vuk Lj.
Published: November 2009

Quadricuspid aortic valve is rare congenital anomaly. There are only 197 cases published in literature so far. That includes clinical and autopsy reports. This congenital anomaly occurs more often in pulmonary valve but function stays normal in 10 of 11es. On the other side, in aortic position valve is malfunctioning in 50% of cases. Valve regurgitation is more likely to occur than stenosis In this kind of malformation, valves are prone to early dysfunction and endocarditis due to different valve architecture and unequal distribution of mechanical stress along valve cusps. Aortic valve replacement is indicated in younger population of these patients. This is a case report of rare congenital anomaly of big blood vessels - aortic valve with four cusps. This anomaly produced significant aortic regurgitation so this patient was indicated for aortic valve replacement.
Penile metastasis from invasive bladder cancer
Authors: Hadzi-Djokic J. , Pejcic T. , Acimovic M. , Andrejevic V. , Radosavljevic R.
Published: November 2009

Objective: To present the rare case of penile metastasis from bladder cancer. Patient report: A 68-year-old man with invasive bladder cancer disseminated in penile shaft and the pelvic lymph nodes is presented. The patient underwent cystoprostatectomy, total penectomy and adjuvant chemotherapy. Results: Ten months after surgery, patient is in complete remission. Conclusion: Despite the fact that secondary penile tumors usually require palliative therapy, in selected cases surgical treatment of primary tumor and penectomy, followed with chemotherapy, can improve survival.
Boundedness of the Bergman projections on Lp spaces with radial weights
Authors: Dostanic Milutin
Published: November 2009

Necessary as well as sufficient conditions are given for the Bergman projections to be bounded operators on Lp spaces on the unit disc.
On a combinatorial game
Authors: Andrejic Vladica
Published: November 2009

We introduce a new Nim-like two-player combinatorial game and present a complete winning strategy for the winning side.
Normalization as a consequence of cut elimination
Authors: Borisavljevic Mirjana
Published: November 2009

Pairs of systems, which consist of a system of sequents and a natural deduction system for some part of intuitionistic logic, are considered. For each of these pairs of systems the property that the normalization theorem is a consequence of the cut-elimination theorem is presented.
A note on differences of power means
Authors: Simic Slavko
Published: November 2009

We give some new inequalities concerning the differences of power means. .
Domains of attraction of the real random vector (X,X2) and applications
Authors: Omey Edward , van Gulck
Published: November 2009

Many statistics are based on functions of sample moments. Important examples are the sample variance s2(n), the sample coefficient of variation SV (n), the sample dispersion SD(n) and the non-central t-statistic t(n). The definition of these quantities makes clear that the vector defined by (?ni=1Xi, ?ni=1Xi2)plays an important role. In the paper we obtain conditions under which the vector (X,X2) belongs to a bivariate domain of attraction of a stable law. Applying simple transformations then leads to a full discussion of the asymptotic behaviour of SV(n) and t(n).
Infinite combinatorics in function spaces: Category methods
Authors: Bingham N.H. , Ostaszewski A.J.
Published: November 2009

The infinite combinatorics here give statements in which, from some sequence, an infinite subsequence will satisfy some condition - for example, belong to some specified set. Our results give such statements generically - that is, for 'nearly all' points, or as we shall say, for quasi all points - all off a null set in the measure case, or all off a meagre set in the category case. The prototypical result here goes back to Kestelman in 1947 and to Borwein and Ditor in the measure case, and can be extended to the category case also. Our main result is what we call the Category Embedding Theorem, which contains the Kestelman-Borwein-Ditor Theorem as a special case. Our main contribution is to obtain function wise rather than point wise versions of such results. We thus subsume results in a number of recent and related areas, concerning e.g., additive, subadditive, convex and regularly varying functions.
Nine-stage multi-derivative Runge-Kutta method of order 12
Authors: Nguyen-Ba Truong , Bozic Vladan , Kengne Emmanuel , Vaillancourt Rémi
Published: November 2009

A nine-stage multi-derivative Runge-Kutta method of order 12, called HBT(12)9, is constructed for solving nonstiff systems of first-order differential equations of the form y'= f(x, y), y(x0) = y0. The method uses y' and higher derivatives y(2) to y(6) as in Taylor methods and is combined with a 9-stage Runge-Kutta method. Forcing an expansion of the numerical solution to agree with a Taylor expansion of the true solution leads to order conditions which are reorganized into Vandermonde-type linear systems whose solutions are the coefficients of the method. The stepsize is controlled by means of the derivatives y(3) to y(6). The new method has a larger interval of absolute stability than Dormand-Prince's DP(8,7)13M and is superior to DP(8,7)13M and Taylor method of order 12 in solving several problems often used to test high-order ODE solvers on the basis of the number of steps, CPU time, maximum global error of position and energy. Numerical results show the benefits of adding high-order derivatives to Runge-Kutta methods.
On bounded dual-valued derivations on certain Banach algebras
Authors: Barrenechea A.L. , Peña C.C.
Published: November 2009

We consider the class D(U) of bounded derivations Ud?U*defined on a Banach algebra U with values in its dual space U*so that ?x,d(x)? = 0 for all x?U U. The existence of such derivations is shown, but lacking the simplest structure of an inner one. We characterize the elements of D(U) if span(U2) is dense in U or if U is a unitary dual Banach algebra.
Application of the quasiasymptotic boundedness of distributions on wavelet transform
Authors: Saneva Katerina
Published: November 2009

We analyze the boundedness of the wavelet transform Wg of the quasiasymptotically bounded distribution f. Assuming that the distribution f?S'(R) is quasiasymptotically or r-quasiasymptotically bounded at a point or at infinity related to a continuous and positive function, we obtain results for the localization of its wavelet transform.
Factorization properties of subrings in trigonometric polynomial rings
Authors: Shah Tariq , Ullah Ehsan
Published: November 2009

We explore the subrings in trigonometric polynomial rings and their factorization properties. Consider the ring S' of complex trigonometric polynomials over the field Q(i) (see [11]). We construct the subrings S'1 , S'0 of S' such that S'1 ?S'0 ?S'. Then S'1 is a Euclidean domain, whereas S'0 is a Noetherian HFD. We also characterize the irreducible elements of S'1, S'0 and discuss among these structures the condition: Let A ?B be a unitary (commutative) ring extension. For each x ? B there exist x' ?U(B) and x'' ? A such that x = x'x''. .
Women in prison: Deprivations of prison life
Authors: Spadijer-Dzinic Jelena , Pavicevic Olivera , Simeunovic-Patic Biljana
Published: November 2009

The paper presents the results of an empirical study of prison deprivations suffered by women, conducted at the Female Department of Correctional Facility in Pozarevac within the scope of a wider study of women's prison system. It was supposed that female prisoners in this penal institution face similar prison experience and suffer the same or similar deprivations as women in other penal institutions do. The research sample included female prisoners sentenced to more than one year, staying in prison for more than a year (54 female prisoners, i.e. more than 50% prisoners sentenced to long prison terms). Prisoners were interviewed employing a questionnaire measuring different types of deprivations using 26 indicators. Using the method of factor analysis - which was here used for the first time to study prison deprivations - six factors of women's prison deprivations were extracted: deprivation of maternity; deprivation of autonomy; deprivation of individuality; deprivation of human kindness and empathy; deprivation of a key role - a woman's role, and deprivation of friendship relations. The outcomes of this research, together with the findings of other researchers, affirm the assumption that these types of deprivations are realistic and dominant types of women's prison deprivations.
Youth spare time: Typical patterns of behavior
Authors: Stepanovic Ivana , Videnovic Marina , Plut Dijana
Published: November 2009

In this research we have tried to identify typical patterns of young people's behavior in their spare time and to use these patterns in order to group our subjects regarding their interests and preferences. Main-component analysis showed that it was possible to find different patterns of secondary school students' behavior in spare time as well as that the identified models could be the criteria for grouping them. Five patterns have been identified describing youth orientations towards their free time: academic orientation, orientation towards sports, orientation towards entertainment, orientation towards spending time going out and orientation towards music and computers.
Evaluation of child imagination in European cultural-historical context
Authors: Maksic Slavica , Pavlovic Zoran
Published: November 2009

Encouraging child imagination is a desirable for developing creativity in youth and adulthood, and creativity is viewed as one of the solutions to the problems the contemporary word is facing. The aim of this paper is to examine the linkage between macro-social factors and evaluation of imagination as a characteristic that should be encouraged in children. For analysis we used data on European countries encompassed by the World Values Study (1999-2004). The results indicate that wealthier and more developed countries and the citizens who are more postmaterialist oriented value imagination more. However, once cultural-historical heritage of the country is included into the analysis, evaluation of imagination changes, thus confirming the importance of living in the communist regime and, on the other hand, the influence of socialization patterns defined by the dominant religion (Orthodoxy, Catholicism, Protestantism or Islam). The concluding part discusses the implications of these results for supporting creativity in young people and contributing to the development of contemporary society which requires reliance on individual abilities and responsibilities in order to progress.
The semiotic code of 'comrade' and 'mister'
Authors: Bozovic Ratko
Published: November 2009

The paper analyzes the meaning of expressions (terms) 'comrade' and 'mister', especially with respect to established socio-political orders. What is at issue are the differences between communicative communities based on different mutual understandings among citizens by using expressions 'comrade' and 'mister', i.e. female 'comrade' and 'madam' ('miss'), within the framework of certain semiotic code or codes. Special emphasis is put on the ambivalences of communist ideology regarding the mandatory introduction of 'comrade' as the only permitted form of address ('we are all comrades'), while the term 'mister' was eliminated from communication as a class-based title. At the same time, the main 'comrades' of the communist government were arguably masters of not just the quantity but also the quality of other people's lives. It is especially interesting to cast a retrospective glance at the widespread everyday practices of addressing each other first as comrades during communism, and then as messieurs and madams (misses) in postcommunism, often without having established any real value criterion, and without finding a way of adequately acknowledging a citizen as a 'mister', that is, a 'gentleman'.
Citizen participation at the local level of government in Serbia
Authors: Vukelic Jelisaveta
Published: November 2009

The article deals with the issue of direct citizen participation at the local level of government in Serbia after 2000. In the first part, an attempt was made to define the concept of direct citizen participation and to analyze its main features. The second part contains the analysis of the achieved state of direct citizen participation at local level in Serbia. The primary goal of this research is to determine the key characteristics and the actual stage of development of the four levels of direct citizen participation: providing/acquiring information, consulting, proposing and participating in decision making. The main finding is that citizen participation in Serbia exists at a rudimentary level and that in this regard we are lagging behind most countries in Western Europe, but also in the Region.
Knowledge-based economy hypothesis revisited
Authors: Kaurin Dragoljub
Published: November 2009

At the theoretical level, within the context of developed countries such as the UK and USA, the paradigm of the emerging 'knowledge economy' is becoming prevalent in sociology, and social sciences more broadly. Leading social scientists see this as a crucial development. This paper challenges the view about the emergence of this new type of economy and looks at the intersection of economics and the sociology of education. Central questions to be addressed here are whether we need a radically new approach to education in the light of the recent developments? Should broad and humanistic goals be subjected to the needs of economy and the labour market? How can we best approach educational planning? Are we witnessing the emergence of the economy of the highly skilled? Are there examples that represent a countervailing power to this hypothesis? Are there instances where we can witness the 'low skills' agenda? In essence, the paper is geared to investigating how these questions can be answered or deflected.
Molecular and Metabolic Evidence for Mitochondrial Defects Associated With β-Cell Dysfunction in a Mouse Model of Type 2 Diabetes
Authors: Lu Hongfang , Koshkin Vasilij , Allister Emma M. , Gyulkhandanyan Armen V. , Wheeler Michael B.
Published: November 2009

OBJECTIVE

The inability of pancreatic β-cells to appropriately respond to glucose and secrete insulin are primary defects associated with β-cell failure in type 2 diabetes. Mitochondrial dysfunction has been implicated as a key factor in the development of type 2 diabetes; however, a link between mitochondrial dysfunction and defective insulin secretion is unclear.

RESEARCH DESIGN AND METHODS

We investigated the changes in islet mitochondrial function and morphology during progression from insulin resistance (3 weeks old), immediately before hyperglycemia (5 weeks old), and after diabetes onset (10 weeks old) in transgenic MKR mice compared with controls. The molecular and protein changes at 10 weeks were determined using microarray and iTRAQ proteomic screens.

RESULTS

At 3 weeks, MKR mice were hyperinsulinemic but normoglycemic and β-cells showed negligible mitochondrial or morphological changes. At 5 weeks, MKR islets displayed abrogated hyperpolarization of mitochondrial membrane potential (ΔΨm), reduced mitochondrial Ca2+ uptake, slightly enlarged mitochondria, and reduced glucose-stimulated insulin secretion. By 10 weeks, MKR mice were hyperglycemic and hyperinsulinemic and β-cells contained swollen mitochondria with disordered cristae. β-Cells displayed impaired stimulus-secretion coupling including reduced hyperpolarization of ΔΨm, impaired Ca2+-signaling, and reduced glucose-stimulated ATP/ADP and insulin release. Furthermore, decreased cytochrome c oxidase–dependent oxygen consumption and signs of oxidative stress were observed in diabetic islets. Protein profiling of diabetic islets revealed that 36 mitochondrial proteins were differentially expressed, including inner membrane proteins of the electron transport chain.

CONCLUSIONS

We provide novel evidence for a critical role of defective mitochondrial oxidative phosphorylation and morphology in the pathology of insulin resistance–induced β-cell failure.
Invariant Natural Killer T-Cell Control of Type 1 Diabetes: A Dendritic Cell Genetic Decision of a Silver Bullet or Russian Roulette
Authors: Driver John P. , Scheuplein Felix , Chen Yi-Guang , Grier Alexandra E. , Wilson S. Brian , Serreze David V.
Published: November 2009

OBJECTIVE

In part, activation of invariant natural killer T (iNKT)-cells with the superagonist α-galactosylceramide (α-GalCer) inhibits the development of T-cell–mediated autoimmune type 1 diabetes in NOD mice by inducing the downstream differentiation of antigen-presenting dendritic cells (DCs) to an immunotolerogenic state. However, in other systems iNKT-cell activation has an adjuvant-like effect that enhances rather than suppresses various immunological responses. Thus, we tested whether in some circumstances genetic variation would enable activated iNKT-cells to support rather than inhibit type 1 diabetes development.

RESEARCH DESIGN AND METHODS

We tested whether iNKT-conditioned DCs in NOD mice and a major histocompatibility complex–matched C57BL/6 (B6) background congenic stock differed in capacity to inhibit type 1 diabetes induced by the adoptive transfer of pathogenic AI4 CD8 T-cells.

RESULTS

Unlike those of NOD origin, iNKT-conditioned DCs in the B6 background stock matured to a state that actually supported rather than inhibited AI4 T-cell–induced type 1 diabetes. The induction of a differing activity pattern of T-cell costimulatory molecules varying in capacity to override programmed death-ligand-1 inhibitory effects contributes to the respective ability of iNKT-conditioned DCs in NOD and B6 background mice to inhibit or support type 1 diabetes development. Genetic differences inherent to both iNKT-cells and DCs contribute to their varying interactions in NOD and B6.H2g7 mice.

CONCLUSIONS

This great variability in the interactions between iNKT-cells and DCs in two inbred mouse strains should raise a cautionary note about considering manipulation of this axis as a potential type 1 diabetes prevention therapy in genetically heterogeneous humans.
Clinical Heterogeneity in Monogenic Diabetes Caused by Mutations in the Glucokinase Gene (GCK-MODY)
Authors: Cuesta-Muñoz Antonio L. , Tuomi Tiinamaija , Cobo-Vuilleumier Nadia , Koskela Hanna , Odili Stella , Stride Amanda , Buettger Carol , Otonkoski Timo , Froguel Philippe , Grimsby Joseph , Garcia-Gimeno Maria , Matschinsky Franz M.
Published: November 2009

OBJECTIVE

To evaluate the heterogeneity in the clinical expression in a family with glucokinase mature-onset diabetes of the young (GCK-MODY).

RESEARCH DESIGN AND METHODS

Members (three generations) of the same family presented either with overt neonatal hyperglycemia, marked postprandial hyperglycemia, or glucosuria. Homeostasis model assessment of insulin resistance (HOMAIR) and insulinogenic and disposition indexes were calculated. Oral glucose tolerance test (OGTT) results in the GCK mutation carriers from this family were compared with those from other subjects with GCK mutations in the same codon (GCK261), with other missense and other types of GCK mutations in different codons from the European MODY Consortium database (GCKm).

RESULTS

Mutation G261R was found in the GCK gene. During the OGTT, glucose (P = 0.02) and insulin (P = 0.009) response at 2 h as well as at the 2-h glucose increment (GCK261 versus other missense GCK mutations, P = 0.003) were significantly higher in GCK261 than in GCKm carriers.

CONCLUSIONS

Differing from other GCKm carriers, the glucose and insulin response to oral glucose was significantly higher in GCK261 carriers, indicating clinical heterogeneity in GCK-MODY.
Familial Risks for Type 2 Diabetes in Sweden
Authors: Hemminki Kari , Li Xinjun , Sundquist Kristina , Sundquist Jan
Published: November 2009

OBJECTIVE

Our aim was to characterize familial risks for type 2 diabetes by the type and number of affected family members, including half-siblings, adoptees, and spouses, to quantify risks and estimate the contribution of environmental effect.

RESEARCH DESIGN AND METHODS

Families were identified from the Multigeneration Register, and type 2 diabetic patients were obtained from the Hospital Discharge Register. Standardized incidence ratios were calculated for offspring with type 2 diabetes whose family members were hospitalized for type 2 diabetes at ages >39 years compared with those lacking affected family members.

RESULTS

The number of hospitalized type 2 diabetic patients was 157,549. Among 27,895 offspring, 27.9% had a parent or sibling also hospitalized for type 2 diabetes. The familial relative risk (RR) ranged from 2.0 to >30, depending on the number and type of probands. The highest RRs of type 2 diabetes were found in individuals who had at least two siblings affected by type 2 diabetes, irrespective of the parental disease. Adoptees showed no risk from adopted parents.

CONCLUSIONS

The study, the largest yet published, showed that familial RRs varied by the number and type of affected family member. However, much of the familial clustering remains yet to be genetically explained. The high risk should be recognized in clinical genetic counseling. The data from adoptees confirmed the genetic basis of the familial associations, but those from half siblings and spouses suggested that a smaller part of familial clustering may be accounted for by environmental factors.
Epidemiological Perspectives on Type 1 Diabetes in Childhood and Adolescence in Germany
Authors: Ehehalt Stefan , Dietz Klaus , Willasch Andre M. , Neu Andreas ,   for the Baden-Württemberg Diabetes Incidence Registry (DIARY) Group
Published: November 2009

OBJECTIVE

To predict the frequency of type 1 diabetes in childhood and adolescence (<15 years of age) in Germany for the next 20 years.

RESEARCH DESIGN AND METHODS

Data on diabetes onset has been collected by means of a registry in the federal German state of Baden-Württemberg (documentation period, 1987–2006; n = 5,108; completeness of data 98.1%).

RESULTS

The current incidence rate (2000–2006) is 19.4 per 100,000 per year (95% CI 18.6–20.2). The annual incidence rate can be expressed as a square of a linear function of the calendar year X [y = (3.05 + 0.0778 × {X–1986})2; r2 = 0.90]. The highest increase per year was observed in the age-groups comprising 2- and 3-year-olds (12 and 13% per year, respectively). The incidence rate for the year 2026 is estimated to be 37.9 per 100,000 per year (95% CI 33.3–42.9).

CONCLUSIONS

The increase that we found in younger children is characteristic of a left shift toward an earlier age.
A1C Cut Points to Define Various Glucose Intolerance Groups in Asian Indians
Authors: Mohan Viswanathan , Vijayachandrika Venkataraman , Gokulakrishnan Kuppan , Anjana Ranjit Mohan , Ganesan Anbazhagan , Weber Mary Beth , Narayan K.M. Venkat
Published: November 2009

OBJECTIVE

To determine A1C cut points for glucose intolerance in Asian Indians.

RESEARCH DESIGN AND METHODS

A total of 2,188 participants without known diabetes were randomly selected from the Chennai Urban Rural Epidemiology Study. All had fasting plasma glucose (FPG) and 2-h postload plasma glucose measurements after a 75-g load and were classified as having impaired fasting glucose (IFG) (American Diabetes Association [ADA] criteria, FPG ≥5.5 and <7 mmol/l, and World Health Organization [WHO] criteria, FPG ≥6.1 and <7 mmol/l), impaired glucose tolerance (IGT) (2-h postload plasma glucose ≥7.8 and <11.1 mmol/l), or diabetes (FPG ≥7 mmol/l and/or 2-h postload plasma glucose ≥11.1 mmol/l). A1C was measured using the Bio-Rad Variant machine. Based on receiver operating characteristic curves, optimum sensitivity and specificity were derived for defining A1C cut points for diabetes, IGT, and IFG.

RESULTS

Mean ± SD values of A1C among subjects with normal glucose tolerance, IGT, and diabetes were 5.5 ± 0.4, 5.9 ± 0.6, and 8.3 ± 2.0%, respectively (Ptrend < 0.001) with considerable overlap. To identify diabetes based on 2-h postload plasma glucose, the A1C cut point of 6.1% had an area under the curve (AUC) of 0.941 with 88.0% sensitivity and 87.9% specificity. When diabetes was defined as FPG ≥7.0 mmol/l, the A1C cut point was 6.4% (AUC = 0.966, sensitivity 93.3%, and specificity 92.3%). For IGT, AUC = 0.708; for IFG, AUC = 0.632 (WHO criteria) and 0.708 (ADA criteria), and the A1C cut point was 5.6%.

CONCLUSIONS

In Asian Indians, A1C cut points of 6.1 and 6.4% defined diabetes by 2-h postload plasma glucose or FPG criteria, respectively. A value of 5.6% optimally identified IGT or IFG but was <70% accurate.
Spatial light modulator as a reconfigurable intracavity dispersive element for tunable lasers
Authors: Dong Lin , Popov Sergei , Sergeyev Sergey , Friberg Ari
Published: November 2009

An improved approach for narrow-band wavelength selection in tunable lasers is described. To provide the tunability, a reconfigurable diffractive optical element (DOE) based on a programmable spatial light modulator (PSLM) is applied. With a proper choice of the phase transfer function of the PSLM, the device can be used as a dispersive intra-cavity component for precise tuning within the lasing spectral band of a solid-state dye laser. The suggested design allows avoiding the mechanical movement of any cavity components. The tunability performance and simulation are demonstrated using the Fourier optics method.
Impact of pharmaceutical dosage form on stability and dissolution of roxithromycin
Authors: Ostrowski Michał , Wilkowska Ewa , Bączek Tomasz
Published: November 2009

The behavior of dispersible tablets containing enteric-coated pellets and oral suspension, both containing roxithromycin, was investigated using dissolution tests in different media. The dissolution test was performed under different pH conditions. For both dosage forms investigated, the test was conducted at pH 1.2, 4.5, and 6.8. Additionally, for dispersible tablets, the test involving increasing pH was performed at pH 1.2 (acid stage) and afterwards at pH 6.8 (buffer stage). The extent of dissolution was measured using high-performance liquid chromatography (HPLC). In all cases tested, roxithromycin underwent rapid degradation at pH 1.2. Dispersible tablets displayed the features of modified release preparations with a non-complete dissolution during the test times in all media. Conversely, the oral suspension behaved as an immediate release preparation, with degradation at pH 1.2. However, the dissolution of the oral suspension at pH 4.5 and 6.8 was rapid and complete. The role of enteric-coated pellets is to mask the bitter taste of the active substance upon administration. However, the coating showed lack of resistance to media at pH 1.2. Therefore, dispersible tablets containing enteric-coated pellets are not pharmaceutically equivalent to the immediate-release oral suspension.
A Raman spectroscopy study on differently deposited DLC layers in pulse arc system
Authors: Ižák Tibor , Marton Marián , Vojs Marián , Redhammer Robert , Varga Marián , Veselý Marián
Published: November 2009

This study is focused on Raman spectroscopy investigations of differently deposited diamond-like carbon (DLC) layers due to varying: (i) Ar and/or N2 flow rate, (ii) number of impulses, and (iii) bias voltage during the growth process. Samples were prepared by a physical vapor deposition method in a pulse arc system. It is shown that Ar and N2 flow rates as well as the bias voltage influence the morphology and chemical composition of the deposited DLC layers. By changing the number of impulses, the number of carbon atoms sputtered from target in the vacuum chamber changes, which is reflected in the thickness and morphology of the DLC layers. Visible light Raman spectroscopy of 632 nm excitation wavelength was used for deep analysis of the deposited layers.
First Detection of Vancomycin Resistant Enterococcus faecium in Latvia
Authors: Rudzīte Dace , Balode Arta , Dumpis Uga , Miklaševičs Edvīns
Published: November 2009

First Detection of Vancomycin Resistant Enterococcus faecium in Latvia

Enterococci have become one of the most important nosocomial pathogens in advanced treatment facilities. Though they are not considered as very pathogenic bacteria, their high levels of antimicrobial resistance are the subject of major concern. Particularly epidemiologically important are vancomycin-resistant enterococci (VRE) due to high risk of transmission of vancomycin resistance genes to staphylococci. We describe the first outbreak of VRE in a Latvian multidisciplinary hospital.
Spectrum and Frequency of the GJB2 Gene Mutations Among Latvian Patients with Prelingual Nonsyndromic Hearing Loss
Authors: Šterna Olga , Proņina Natālija , Grīnfelde Ieva , Kušķe Sandra , Krūmiņa Astrīda , Lugovska Rita , Pētersons Aigars
Published: November 2009

Spectrum and Frequency of the GJB2 Gene Mutations Among Latvian Patients with Prelingual Nonsyndromic Hearing Loss

Mutations in the GJB2 gene (connexin 26) are the most common cause of congenital nonsyndromic severe-to-profound hearing loss. Sixty-five hearing impaired probands from Latvia were tested for mutations in the GJB2 gene to determine the percentage of hearing loss attributed to connexin 26 and the types of mutations in this population. A total of 62% of patients tested had GJB2 mutations. Four different mutations in the GJB2 gene were identified in Latvian patients with nonsyndromic sensorineural hearing loss: 35delG, 311-324del14, 235delC and M34T. The most prevalent mutation is 35delG (47% of all probands were homozygous and 8% compound heterozygous). Our findings support the conclusion that the 35delG mutation is the most prevalent GJB2 mutation and that it is the common cause of hereditary nonsyndromic hearing loss in populations of European descent.
Neonatal Cystic Fibrosis Screening in Latvia: A Pilot Project
Authors: Lāce Baiba , Grīnblate Santa , Korņejeva Liene , Švābe Vija , Grauduma Ineta , Vēvere Pārsla , Lugovska Rita , Krams Alvils , Martinsons Agris
Published: November 2009

Neonatal Cystic Fibrosis Screening in Latvia: A Pilot Project

Cystic fibrosis (CF) is one of the most common severe autosomal recessive diseases in the Northern European population affecting 1:2000-4000 individuals worldwide and 1:3300 in Latvia. Every year in Latvia since 1994, the approximate birth rate is 20,000 newborns per year, so theoretically there should be 6-8 new cases of CF per year. In Latvia, since 1998, there have been 49 patients with clinically confirmed diagnosis of CF. Recognition of a person with cystic fibrosis has always been a challenging task for clinicians, because of the constellation of symptoms, which can easily be misleading and explained by other aetiology. Therefore, in several countries, neonatal screening programmes using immunoreactive trypsinogen (IRT) have been introduced. The aim of this study was to evaluate the possible introduction of a neonatal IRT and DNA screening programme for diagnostic confirmation of cystic fibrosis in Latvian infants. IRT was measured in dried blood spots from 7,040 newborns, and DNA analysis for mutations dF508 and 394delTT performed for all individuals with increased IRT. Two persons suspected to have CF were identified, which is in accordance with population studies of CF frequency in Latvia. The estimated frequency of CF in Latvia of 1:3,520 corresponds to the average frequency in Europe. A mutation panel examining 230 mutations by APEX was applied to all samples with an IRT level above 100 ng/ml and two patients with the diagnosis of CF were identified.
Ontological Re-engineering of Medical Databases
Authors: Bārzdiņš Guntis , Rikačovs Sergejs , Veilande Marta , Zviedris Mārtiņš
Published: November 2009

Ontological Re-engineering of Medical Databases

This paper describes data export from multiple medical databases (relational databases) into a single shared Medical Data Warehouse (RDF database structured according to an integrated OWL ontology). The exported data is conveniently accessible via SPARQL or via graphical query language ViziQuer based on UML profile for OWL. The approach is illustrated on one of Latvian Medical databases - Injury Register.
Comparative Analysis of Insulin-like Growth Factor I and Tumour-associated Antigens in Cancer Patients at the Time of Diagnosis
Authors: Mačuks Ronalds , Eņgele Ludmila , Nuķe Inta , Sudraba Agnese , Doniņa Simona
Published: November 2009

Comparative Analysis of Insulin-like Growth Factor I and Tumour-associated Antigens in Cancer Patients at the Time of Diagnosis

Insulin-like growth factor-1 (IGF-1) is a polypeptide hormone with structure similar to insulin. Many experimental data support the suggestion that risk of cancer is higher among persons with raised concentration of IGF-1 and some studies support the role of IGF-1 as a biomarker of increased risk of development of colorectal (CRC) and breast cancer (BC). We have determined IGF-1, CA19-9, CEA, CA72-4 for colorectal, CA15-3 and CEA for breast cancer to clarify utility of IGF-1 as a biomarker of cancer presence at the time of diagnosis. In total, 42 men and 52 women with CRC and 139 women with BC were examined. The cut-off level for IGF-1 concentration in serum was established from results of apparently healthy 27 men and 130 women. An IGF-1 and tumour-associated antigens were detected by chemiluminescence's method using analyser Immulite 2000 (Siemens). Elevated level of IGF-1 was detected in 42.8% of men and 30.7% of women with colorectal cancer. The highest detection rates for CRC using a two biomarker combination were for men as well as for women (57.1% and 57.6%). IGF-1 showed higher detection rates between women with breast cancer in postmenopause vs. women at premenopausal age (33.6% vs. 27.7%). IGF-1 can be used as an additional biomarker for selected colorectal and breast cancer patient groups.
Novel Laboratory Tests in Assessment of Liver Function in Acute and Chronic Liver Diseases
Authors: Vīksna Ludmila , Keišs Jāzeps , Sočņevs Artūrs , Rozentāle Baiba , Pilmane Māra , Sevastjanova Natālija , Buiķe Inita , Jēruma Agita , Eglīte Elena , Ābeltiņa Kristīne , Sondore Valentīna
Published: November 2009

Novel Laboratory Tests in Assessment of Liver Function in Acute and Chronic Liver Diseases

Liver biopsy in clinical practice has been widely used for the diagnosis and management of patients with liver diseases, particularly, with chronic liver diseases. However, liver biopsy is an invasive method with potential complications, sampling and interpretation errors. Therefore, noninvasive tests are being developed and introduced to replace liver biopsy. The aim of the present study was to identify the new noninvasive methods to be used for the assessment of liver structure and function, by use of the appropriate serum surrogate markers and to evaluate the clinical diagnostic and prognostic accuracy of these methods, including immunogenetic methods, in cases of acute and chronic liver diseases. The obtained data showed that serum markers of apoptosis (cytokeratin-18 neoepitope and citochrome c) and fibrosis (hyaluronic acid) should be included in viral and toxic liver damage management algorithms. The punctual identification of immunogenetic factors (HLA class II antigens) may prove to be useful in predicting disease evolution, and in guiding the appropriate therapy for patients with poor prognosis.