Lymphocyte ecto-5'-nucleotidase in obese type 2 diabetic patients treated with gliclazide.

OBJECTIVE: Lymphocyte 5'-nucleotidase is sensitive to superoxide anion, and is an indicator of oxidative stress in humans. The aim of this study was to assess the effect of the sulfonylurea drugs gliclazide and glibenclamide on lymphocyte ecto-5'-nucleotidase of type 2 diabetic patients. METHODS: Thirty obese type 2 diabetic patients were treated for three months after randomisation either with gliclazide or glibenclamide. Basic laboratory parameters (glycaemia, fructosamine, C-peptide), plasma malondialdehyde levels (MDA) as well as lymphocyte 5'-nucleotidase activity were determined, for all patients and 16 healthy controls, before and after the treatment. RESULTS: 5'-nucleotidase activity in diabetic patients before treatment with gliclazide was 1.61 +/- 0.16 nmol/min/10(6) lymphocytes, and was significantly (P < 0.01) increased compared with the level in healthy controls. After three months of gliclazide treatment, ecto-5'-nucleotidase activity fell significantly by 47.39% and 36% in unstimulated Con A- and PMA-stimulated lymphocytes, respectively. Glibenclamide treatment had no effect on ecto-5'-nucleo-tidase of type 2 diabetic patients. Glycoregulation was improved, as plasma fructosamine decreased from 53.4 to 42.1 and from 50.5 to 43.4 U/g proteins after gliclazide and glibenclamide treatment, respectively. Plasma MDA levels markedly decreased after gliclazide but not glibenclamide treatment. CONCLUSION: These results show that gliclazide treatment inhibits the activity of lymphocyte ecto-5'-nucleotidase and presumably de-creases the concentration of adenosine at the cell surface. A decrease in 5'-nucleotidase activity and attenuation of adenosine production may be a factor in the protection of tissue injury in type 2 diabetic patients.

A physical activity programme and its effects on insulin resistance and oxidative defense in obese male patients with type 2 diabetes mellitus.

AIM: The aim of this study was to investigate the effects of regular aerobic execise on glycaemic control, insulin resistance, cardiovascular risk and oxidative stress-defense parameters in overweight and obese type 2 diabetic patients. METHODS: Changes from baseline to 3 and 6 months of aerobic exercise in total of 30 type 2 diabetics were assessed for physical activity index (PAI), fasting glycaemia (FG), glycated hemoglobin (HbA(1c)), median blood glucose (MBG), insulin resistance (HOMA), triglycerides (TG), cholesterol, the Ashwell Shape Chart Health Risk, SCORE risk, body mass index (BMI), waist and hip circumference, systolic (SBP) and diastolic (DBP) blood pressure, plasma and erythrocyte malondialdehyde (MDA), glutathione, sulphydryl groups and catalase (CAT) and were compared to the results of 30 healthy control subjects. RESULTS: At baseline, significant differences were recorded between the control and diabetes group for FG (P<0.001), HOMA (P<0.001), SBP and DBP (P<0.001), TG (P<0.01), MDA(pl) (P<0.01), CAT (P<0.01) and SCORE risk (P<0.001). Significant changes within the diabetes group were found for PAI (P<0.05), FG (P<0.001), MBG (P<0.05), HbA(1c)(P<0.05), HOMA (P<0.01), SBP and DBP (P<0.001) from baseline to 3 months, as well as for FG (P<0.01), HOMA (P<0.001), SBP and DBP (P<0.05) from 3 to 6 months. Significant (P<0.05) correlations were found for FG and PAI (R=0.432), as well as for HOMA and both HbA(1c)(R=0.412) and SCORE risk (R=-0.387) in the diabetes group. CONCLUSION: Regular aerobic exercise has beneficial effects on glycaemic control, insulin resistance, cardiovascular risk, oxidative stress-defense parameters in overweight and obese type 2 diabetics.

Meropenem therapy failure in Listeria monocytogenes infection.

Listeria monocytogenes is highly susceptible to meropenem in vitro, but data on the efficacy of meropenem in clinical cases of listeriosis are scarce. Described here is the case of a child with aplastic anemia who acquired nosocomial listeriosis and failed to respond to initial meropenem therapy. Resolution of fever was not noted after 5 days of therapy with meropenem and, more importantly, clinical worsening was observed during this period. The patient began to improve after ampicillin was introduced to the therapeutic regimen. In total, meropenem was administered for 15 days and ampicillin for 10 days.

[Antibiotic sensitivity of bacteria isolated from the urine of children with urinary tract infections from 1986 to 1995]. / Osetljivost na antibiotske lekove bakterija izolovanih iz urina kod dece obolele od infekcija urinarnih puteva u periodu od 1986. do 1995. godine.

In adults and in children urinary system infections are mostly caused by gram-negative and rarely by gram-positive bacteria. Of gram-negative bacteria the most frequent cause of infections are Escherichia coli, Klebsiella species, Proteus mirabilis, Pseudomonas aeruginosa, Acinetobacter, Serratia etc., and of gram-positive bacteria Enterococcus, Staphylococcus, Streptococcus agalactiae. In rare cases the cause of infection may also be Pneumococcus and Haemophilus influenzae. AIM OF THE STUDY: The aim of the study was to investigate the sensitivity to antibiotics of gram-negative bacteria as the predominant cause of urinary infections. METHOD OF THE STUDY: We isolated 20,615 bacterium species from urine of children hospitalized or treated as outpatients at the University Children's Hospital in Belgrade. Urine was collected classically, i.e. by taking the second clean stream into a sterile test tube or by Uricult test. The samples were cultured on blood plates and endo-agar. Identification was done by standard bacteriologic methods and when findings were dubious API-20E (bioMerieux) was used. Bacterium sensitivity to nine antibiotics (ampicillin, cephalexin, cefotaxime, chloramphenicol, gentamicin, amikacin, co-trimoxazole, nalidixic acid and nitrofurantoin) was assessed with disc diffuse method on Müller-Hinton agars. RESULTS: Based on the obtained results, Escherichia coli species sensitivity to amikacin, gentamicin, cefotaxime, nalidixic acid and nitrofurantoin ranged from 90 to 100%; sensitivity to co-trimoxazole and chloramphenicol ranged from 70 to 80%, to cephalexin from 50 to 60%, while to ampicillin it was only 20%. Klebsiella species sensitivity to nalidixic acid and cefotaxime was 70-85%; to amikacin, cefotaxime, co-trimoxazole and gentamicin 60-80%; to cephalexin and chloramphenicol 40-50%, and to ampicillin only 5-15%. Proteus species showed sensitivity to amikacin, gentamicin, cefotaxime and nalidixic acid of 90-95%; to co-trimoxazole and chloramphenicol 70-80%; to cephalexin and ampicillin 40-50%, and to nitrofurantoin 10%. Pseudomonas aeruginosa species showed the highest level of sensitivity to amikacin (40-50%), and somewhat lower to gentamicin (10-40%), and a very low sensitivity to other antimicrobial drugs (10-25%). DISCUSSION: It may be noted from the above data that gram-negative bacteria are the cause of urinary infections in about 90% of cases, while gram-positive bacteria are the cause in only 10%, which is in accordance with data from literature. Of all antibiotic drugs ampicillin (a wide spectrum penicillin) had a very significant role in the therapy of urinary infections. However, the long-term usage of ampicillin led to increased resistance to the drug in infections caused by Escherichia coli. Natural resistance to ampicillin of Klebsiella species limited its usage when penicillin was first introduced. Proteus mirabilis species, especially those isolate in primary infection, are often sensitive to amino penicillin. Contrary to Proteus mirabilis, indole-positive Proteus and Providentie species show a high resistance to these antibiotics. Due to the crisis in our country and the lack of other antibiotics, ampicillin was widely used. The wide use of the drug caused evident resistance of Escherichia coli and Proteus mirabilis to this antibiotic. A fall in the sensitivity of Klebsiella to cephalexin, gentamicin, amikacin and co-timoxazole, which occurred in 1992, has been explained by intrahospital circulation of multiresistant Klebsiella species. The sensitivity of isolated gram-negative bacteria Escherichia coli, Klebsiella species, Proteus mirabilis and Pseudomonas aeruginosa was the most prominent to aminoglycosides (amikacin and gentamicin). The most frequent mechanism of enterobacterial resistance to trimethoprim and co-trimoxazole involves dihydrofolate reductase enzyme. Comparative studies related to the administration of co-trimoxazole have shown that the difference in the efficacy between thes

[3. L Cephalometer]. / 3. L Kefalometar.

Authors present an original approach to the cephalometric measuring by obtaining absolute coordinates of the cephalometric points in a coordinate system fixed on the skull. An instrument especially constructed for that purpose is shown, and also the way of using it in vivo.