Effect of biphasic insulin aspart on glucose and lipid control in patients with Type 2 diabetes mellitus

OBJECTIVE

This study examined the efficacy and safety of biphasic insulin aspart 30 (BIAsp 30) monotherapy in insulin-naive patients with Type 2 diabetes mellitus.

RESEARCH DESIGN AND METHODS

In this 12-week, open-labelled, uncontrolled, clinical-experience study involving 71 patients with secondary oral antidiabetic agent failure, patients received BIAsp 30 after discontinuing oral antidiabetic drugs (OADs). Glucose and lipid concentrations, hypoglycaemic episodes and adverse events were assessed before and after treatment. Patient data were categorised according to previous OADs into the biguanides (BI) plus sulfonylureas/meglitinides (SU/MEG) and SU-only groups.

RESULTS

After treatment, glucose and lipid control was significantly improved in both groups, with a greater improvement in the SU-only group. Mean glycated haemoglobin, fasting blood glucose and postprandial blood glucose excursion improved by 2.15 +/- 1.24%, 3.70 +/- 3.18 mmol/l and 1.26 +/- 2.65 mmol/l in the BI plus SU/MEG group, and by 3.09 +/- 1.62%, 6.11 +/- 5.02 mmol/l and 2.06 +/- 2.33 mmol/l in the SU-only group, respectively. Mean high-density lipoprotein cholesterol and triglycerides improved by 0.09 +/- 0.18 mmol/l and 0.94 +/- 1.17 mmol/l in the BI plus SU/MEG group and by 0.09 +/- 0.18 mmol/l and 1.04 +/- 2.72 mmol/l in the SU-only group, respectively. No major hypoglycaemic episodes or serious treatment-related adverse events were reported.

CONCLUSIONS

Our study showed that BIAsp 30 treatment safely improved glucose and lipid control in insulin-naive patients with Type 2 diabetes poorly controlled on BI plus SU/MEG and SU-only. Key limitations were the lack of a comparator group and the short study duration.

Phenolic acids as bioindicators of fly ash deposit revegetation

The floristic composition, the abundance, and the cover of pioneer plant species of spontaneously formed plant communities and the content of total phenolics and phenolic acids, as humus constituents, of an ash deposit after 7 years of recultivation were studied. The restoration of both the soil and the vegetation on the ash deposits of the "Nikola Tesla-A" thermoelectric power plant in Obrenovac (Serbia) is an extremely slow process. Unfavorable physical and chemical characteristics, the toxicity of fly ash, and extreme microclimatic conditions prevented the development of compact plant cover. The abundance and cover of plants increased from the central part of the deposit towards its edges (ranging from 1-80%). Festuca rubra L., Crepis setosa Hall., Erigeron canadensis L., Cirsium arvense (L.) Scop., Calamagrostis epigeios (L.) Roth., and Tamarix gallica L. were the most abundant species, thus giving the highest cover. Humus generated during the decomposition process of plant remains represents a completely new product absent in the ash as the starting material. The amount of total phenolics and phenolic acids (38.07-185.16 microg/g of total phenolics and 4.12-27.28 microg/g of phenolic acids) in fly ash increased from the center of the deposit towards its edges in correlation with the increase in plant abundance and cover. Ash samples contained high amounts of ferulic, vanillic, and p-coumaric acid, while the content of both p-hydroxybenzoic and syringic acid was relatively low. The presence of phenolic acids indicates the ongoing process of humus formation in the ash, in which the most abundant pioneer plants of spontaneously formed plant communities play the main role. Phenolic compounds can serve as reliable bioindicators in an assessment of the success of the recultivation process of thermoelectric power plants' ash deposits.

[10 years' of production and use of human rabies immunoglobulin in Yugoslavia]

Application of the rabies immunoglobuline is a compulsory part of the prophylaxis of rabies in all severe, transdermal lesions caused by rabies infected animals. Sylvatic rabies has spread in the past few years throughout the whole Yugoslavia, and human cases of rabies have also been reported in other East European countries. In order to achieve the highest level of rabies prophylaxis, apart from postinfective rabies vaccination, it is necessary to provide passive immunization using specific antibodies against rabies. After successful immunization of the young, healthy volunteers in 1990, National Blood Transfusion Institute, in cooperation with the Pasteur Institute from Novi Sad, prepared the first quantities of immunized plasma by plasmapheresis procedure and human rabies immunoglobuline. Without national production, sufficient quantities of human rabies immunoglobuline could not be provided, since the price on the world market is rather high (over $1000 per patient).

Biochemical evaluation of patients with acute pancreatitis

In this study we determined the clinical accuracy of alpha2-macroglobulin, alpha-amylase, C-reactive protein, lipase, non-esterified fatty acids, pancreatic alpha-amylase and phospholipase A in the diagnosis and prognosis of acute pancreatitis in a group of patients with acute abdominal pain using receiver operator characteristic curve analysis. We investigated 59 patients with acute pancreatitis and 72 patients with extrapancreatic diseases of gastrointestinal origin. On the basis of initial enzyme activities, at cut-offs of 245 U/l for amylase, 656 U/l for lipase, and 182 U/l for pancreatic alpha-amylase, the diagnostic efficiencies were 0.993, 0.980, and 0.975, respectively. Receiver operator characteristic curve analysis showed the same diagnostic accuracies. We evaluated the accuracy of serum alpha2-macroglobulin, C-reactive protein, non-esterified fatty acids and phospholipase A for differentiation between acute necrotizing pancreatitis and acute oedematous pancreatitis. C-reactive protein had the highest prognostic accuracy of the parameters studied (the area under curve = 0.9082) and at a cut-off value of 126 mg/l, sensitivity and specificity were 0.759 and 0.912, respectively. The role of the clinical laboratory in the investigation of patients with acute pancreatitis continues to evolve and biochemical parameters are a good diagnostic and prognostic option.

Spasmogenic action of beta-lactam antibiotics on the gastrointestinal tract of experimental animals

We have investigated the effects of beta-lactam antibiotics on isolated preparations of rat fundus, ileum, and the body of feline stomach. Isotonic changes of isolated preparations were recorded. Benzylpenicillin (EC50 = 1.31 +/- 0.13 x 10(-5) M), ampicillin (EC50 = 2.16 +/- 0.15 x 10(-5) M), cefotaxime (EC50 = 1.33 +/- 0.15 x 10(-5) M), ceftriaxone (EC50 = 4.39 +/- 0.13 x 10(-5) M) and ceftazidime (EC50 = 1.42 +/- 0.01 x 10(-3) M) produced concentration-dependent tonic contractions of rat fundus. Rat ileum and feline stomach did not respond on these substances. Lidocaine (2.3 x 10(-5) M) and physostigmine (1.0 x 10(-8) M) significantly potentiated contractions produced by benzylpenicillin. On the other hand, methysergide (1.4 x 10(-7) M) and atropine (9.6 x 10(-9) M) significantly blocked tonic contractions produced by benzylpenicillin. Effects of beta-lactam antibiotics on smooth muscle isolated preparations were tissue and species dependent, indicating selectivity of their action.

[Registar of injuries--a specific data base]

The existing data bases - on the number and distribution of the injured are unfortunately unreliable and very poor. There is also a shortage of information needed in assessing human and financial aspect of the trauma as well as physical, social, economic and psychological circumstances under wich injuries have heppened. That is why the bases of all activities linked with solving the existing problems in traumatism in the traumawork of Trauma System presents epidemiological methods in the form of Trauma Register. Trauma Register is intended for creation of data base wich would identify, describe, quantity and quality injuries and traumatic deaths including even risk factors and it is expected to help in planning of the future health policy, volume and quality of preventive measures and activities wich would be useful for more accurate monitoring of preventive measures and acitivities wich would be useful for more accurate monitoring of preventive role in decreasing values of frequency of injuries and accidental deaths.

[Child trauma in Vojvodina]

Trauma represents for quite a long period a significant problem in child health care in Vojvodina. For better understanding of the trends of trauma in overall registrated child morbidity and mortality includingoutpatient and hospital cases we used the data derived from retrospective study fora period from 1979 to 1988. Analyzing the structure of ten leading groups of illnesses in the outpatient groups of children by the age of 6 years, injuries and intoxications were on the sixth position with the frequency of 2% and for the same period had a progressive increase with the dynamic index of 105.30. The percentage of the injuries and intoxications in the registrated outpatient morbidity of children from 6 to 14 years was 5-5.5% which put them on the fifth position at the list of ten leading groups of illnesses. During the same period of time trauma registered in the hospital morbidity showed decrease with the dynamic index of 86.12 and was on the fourth position with 7-8% of overall morbidity. There are on the average 74 child deaths annually in Vojvodina caused by injuries and intoxications.

Problems in diagnosis and treatment of cholesteatoma in children

Our clinical study includes 56 cases of cholesteatoma in children aged 3-14 years, treated in a 6-year period. Cholesteatoma was localized in attic (6 cases), in middle ear (6 cases), in attic plus middle ear (16 cases) and in attic + middle ear + mastoid (28 cases or 50% of the total number). In the surgical treatment combined approach tympanoplasty (intact canal wall technique) was used in 76.8%, radical tympanomastoidectomy in 16.1%, and other techniques in 7.1%. Intact ossicular chain was found in 25%. Reconstruction of the ossicular chain (including autograft, homograft and allograft material) was done in 59%, and the remaining 16% were treated by classic radical surgery. Hearing results: unchanged, 48%; improved, 45%; slightly worsened, 7%; and no dead ear. Recurrency in 31% is considerably higher as compared to 15% in adults found in another comparable study by us.

[Uterine hemorrhage in newborn infants]

A follow-up was conducted on uterine haemorrhage in all female newborn infants at the Department of Gynaecology and Obstetrics in Novi Sad, in the period from 1 January to 31 December 1979. Of the total of 2477 newborn female infants, 2241 (90.47%) were at-term infants of which 85 (3.79%) had uterine haemorrhage, 126 (5.09%) premature infants of which 1 (0.793) had uterine haemorrhage and 110 (4.443) postmature infants of which 10 (9.09%) had uterine haemorrhage. General frequency of uterine haemorrhage was 3.87%.