Our findings suggest that nerve transfer of collateral branches, where possible, (such as in cases with upper or extended upper brachial plexus palsy) might be a method of choice, offering better results and quality of recovery.

Introduction: In patients with diabetes mellitus (DM), non-diabetic renal disease (NDRD) can also occurs, as well as diabetic nephropathy. NDRD is most accurately diagnosed using kidney biopsy. Aim: The aim of the study was to investigate the incidence and type of NDRD diagnosed by kidney biopsy in patients with type 2 DM and the correlation of clinical and laboratory findings with histopathological diagnosis. Material and Methods: From April 2007 to October 2018, 290 kidney biopsies were performed at the Department of Nephrology, Internal Medicine Clinic in Banja Luka, out of which 18 patients (males 9, mean age 59.8 years) were with type 2 DM. The US-guided (ultrasound device: Toshiba Famio 5) kidney biopsy was performed using an automatic biopsy instrument FAST-GUN® with needle 16G. Kidney tissue samples were analyzed by light microscopy and immunofluorescence. Results: In 18 patients with type 2 DM, the average duration of the disease was 5.9 years, 5 patients had a retinopathy, and 16 patients had hypertension. Biopsy indications were: nephrotic syndrome in 11 patients, asymptomatic urinary abnormalities in 3 patients, and rapid chronic renal failure progression. Unsatisfactory quality sample for pathohistological analysis was obtained in one patient, and out of the other 17, 6 (35.3%) had NDRD, 3 (17.6%) had NDRD superimposed with the diabetic nephropathy, and 8 (47.1%) had diabetic nephropathy. Of the patients who had NDRD, 3 had membranous glomerulonephritis, 1 had focal segmental glomerulosclerosis, and two had hypertensive nephroangiosclerosis. Out of patients with coexisting NDRD and diabetic nephropathy, 2 had hypertensive nephroangiosclerosis and one diabetic nephropathy and lupus nephritis. Conclusion: NDRD was diagnosed using kidney biopsy in 9/17 patients with type 2 DM, which confirms the significance of the kidney biopsy in patients with DM with properly indications. Accurate diagnosis provides disease specific treatment and thus significantly improves the long-term prognosis of the patient.

Introduction. Renal osteodystrophy is a severe complication of chronic kidney disease (CKD) that increases morbidity and mortality in these patients. Mineral and bone disorder starts early in CKD and affects the incidence of bone fractures. The aim of this study was to observe the frequency of diverse bone fractures in patients with CKD not on dialysis.Methods. This cohort study included 68 patients that were followed during the two-year period. The patients were divided into two cohorts: one that developed bone fractures and the other that did not. There were 35 (51.5%) men and 33 (48.5%) women. The mean age of patients ranged 62.88±11.60 years. During follow-up serum values of chronic kidney disease -mineral and bone indicators were measured. The methods of descriptive and analytical statistics were used in order to analyze obtained data.Results. During this two-year follow-up seven patients developed bone fractures. Among them, females dominated (6 patients) compared to males (only 1 patient). The most common were fractures of forearm. The mean level of parathyroid hormone (PTH) at the beginning of the monitoring was higher in the group of patients with bone fractures (165.25 ± 47.69 pg/mL) in regard to another group (103.96 ± 81.55 pg/mL). After two-year follow-up, this difference became statistically significant at the level p < 0.05. Patients that developed bone fractures had higher FRAX (Fracture Risk Assessment) score compared to another group.Conclusion. In our study, about 10% of patients had bone fractures in the two-year follow-up period. Patients who developed fractures had a higher PTH level and FRAX score.

SAŽETAK Goodpasture

(Conclusion) Total or subtotal surgical resection is the therapy of choice for most intracerebral LGgls. It should be performed whenever possible. After postoperative MRI and PET, it should be decided about immediate postoperativne radiotherapy. If there are the signs of the tumor rest, radiotherapy is essential. Patients in poor clinical grade, or deep seated tumors should undergo stereotactic biopsy followed by stereotactic radiosurgery, or conventional radiation therapy. In recurrent diseases any kind of surgery should be followed by radiation therapy, or/and chemotherapy for chemosensitive oligodendrogliomas. Accurate histopathological diagnosis is essential for treatment choice and prognosis

No abstract

Uvod. Sekundarni neuspjeh oralne terapije se definiše kao izostanak povoljnogreagovanja na oralnu terapiju koja je u prethodnom periodu bilaefikasna. Cilj rada je da se ispitaju rezidualni efekti kratkotrajne kombinovaneinsulinske terapije na glikoregulaciju i insulinosekretornu funkciju.Metode. Istraživanje je obuhvatilo 53 ispitanika sa tipom 2 dijabetesa i sekundarnimneuspjehom oralne terapije koji su tri mjeseca liječeni kombinovanominsulinskom terapijom (bazalni insulin plus metformin). Nakonprocjene akutnih efekata insulinske terapije, ispitanici su naredna tri mjesecaliječeni oralnim antihiperglikemicima koje su koristili u momentu dijagnozesekundarnog neuspjeha, nakon čega su procjenjivani rezidualni efekti.Rezultati. Tromjesečna kombinovana terapija dovela je do značajnog poboljšanjaglikoregulacije (glikemija natašte: 9,4 mmol/l vs. 6,1 mmol/l; postprandijalnaglikemija: 11,5 mmol/l vs. 7,3mmol/l; dnevni profil glikemije:10,0 mmol/l vs. 7,2 mmol/l) i parametara insulinosekretorne funkcije (insulinemija:16,63 mU/l vs. 10,8 mU/l; C-peptid: 1,53 μg/ml vs. 1,81 μg/ml) uodnosu na period kada je konstatovan sekundarni neuspjeh oralne terapije(akutni efekti). Tri mjeseca po prekidu insulinske terapije zabilježeno je samomanje pogoršanje glikoregulacije i insulinosekretorne funkcije – rezidualniefekat (glikemija: 7,1mmol/l; postprandijalna glikemija: 8,3 mmol/l; dnevniprofil glikemije: 8,4mmol/l; insulinemija: 13,3mU/l; C-peptid: 1,72 μg /ml).Zaključak. Ponovno uvođenje oralnih antidijabetika nakon kratkotrajne primjeneinsulinske terapije uslovljava lagano pogoršanje insulinosekretornefunkcije, ali su ipak svi posmatrani parametri metaboličkog statusa u prosjekuznačajno bolji u odnosu na period prije kratkotrajne primjene insulina.

Autologous nerve grafting is the most commocommnlynly used operative technique in delayed primary, or secondary nerve repair after the peripheral nerve injuries. The aim of this procedure is to overcome nerve gaps that results from the injury itself, fibrous and elastic retraction forces, resection of the damaged parts of the nerve, position of the articulations and mobilisation of the nerve. In this study we analyse the results of operated patients with transections and lacerations of the peripheral nerves from 1979 to 2000 year. Gunshot injuries have not been analyzed in this study. The majority of the injuries were in the upper extremity (more than 87% of cases). Donor for nerve transplantation had usually been sural nerve, and only occasionally medial cutaneous nerve of the forearm was used. In about 93% of cases we used interfascicular nerve grafting, and cable nerve grafting was performed in the rest of them. Most of the grafts were 1 do 5 cm long (70% of cases). Functional recovery was achieved in more than 86% of cases, which is similar to the results of the other authors. Follow up period was minimum 2 years. We analyzed the influence of different factors on nerve recovery after the operation: patient's age, location and the extent (total or partial) of nerve injury, the length of the nerve graft, type of the nerve, timing of surgery, presence of multiple nerve injuries and associated osseal and soft tissue injuries of the upper and lower extremities.