Patterns of milking unit kick-off as a proxy for habituation to milking in primiparous cows.

The onset of lactation and the subsequent habituation to the milking routine is a stressful period, particularly for primiparous (PRI) cows. The objective of this study was to describe the dynamics of milking unit kick-off (KO) behavior in PRI cows during the first 3 mo of lactation, considering multiparous (MUL) cows as a reference for comparison. In addition, the potential associations between KO and milk yield and mastitis presentation were investigated. A total of 869 cows (PRI = 199; MUL = 670) on a dairy farm in northern CO were included in the analysis. Cows calving between August and November 2020 were enrolled from 3 DIM until 90 DIM. Participants were milked 3×/day in a 60-unit rotary parlor and data from each milking session were downloaded from parlor management software. Milking unit kick-off was used as a proxy for habituation to the milking procedure. Kick-off events were reported by the milking system and defined as an abrupt interruption in the milk flow during the milking process. Cow KO events were recorded for each milking session. Subsequently, occurrence of KO was analyzed by grouping the 3 consecutive milking sessions in each day and categorized as yes or no, indicating whether or not an individual kicked at least once in a given day. Data were analyzed by repeated measures ANOVA and logistic regression, including parity category, calving season, occurrence of dystocia, and their potential interactions in the models. Least squares means for daily proportions of KO were calculated considering the number of cows with KO events per day in the PRI and MUL categories. Subsequently, odds ratios for the occurrence of KO in PRI versus MUL were calculated at multiple periods of time. When KO was analyzed by DIM, proportions of KO were greater in PRI than in MUL during the whole monitoring period. In PRI, proportions of KO increased from 0.10/d to 0.20/d between 3 DIM and 15 DIM, to start decreasing around 30 DIM and remaining above MUL up to 90 DIM. On the contrary, in MUL cows, proportions of KO remained close to 0.05/d during the 90-d period. Overall, the odds of KO were greater for PRI versus MUL cows (odds ratio [95% confidence interval] = 2.07 [1.58-2.73]). No differences in milk yield were established among KO categories, while the percentage of cows affected with mastitis was greater in cows grouped in the quartile with more frequent KO events. We concluded that the relationship between days in milk and the proportion of PRI cows displaying KO was not linear, but rather KO increased during the first 2 wk postpartum before decreasing after the first month of lactation. First-parity cows had greater levels of KO than MUL cows, which is most likely associated with the process of habituation to milking during their first lactation.

Geochemical behavior of rare earth elements (REE) in urban reservoirs: the case of Funil Reservoir, Rio de Janeiro State, Brazil.

Rare earth elements (REE) have unique chemical properties, which allow their use as geochemical tracers. In this context, the present study aims to assess the role of Funil Reservoir on REE biogeochemical behavior. We collected water samples upstream of the reservoir (P-01) in the city of Queluz, inside the reservoir (P-02), and downstream of Funil Reservoir (P-03) in the city of Itatiaia, RJ. In the field, physicochemical parameters were measured using a probe (pH, temperature, electrical conductivity, and dissolved oxygen). In the laboratory, water samples were filtered (0.45 µm) and properly packed until chemical analysis. Chlorophyll a concentrations were determined by a spectrophotometric method and suspended particulate matter (SPM) by a gravimetric method. Ionic concentrations were determined by ion chromatography technique and REE concentrations were determined by ICP-MS. Chlorophyll a concentrations were higher in Funil Reservoir. Ionic concentrations in Queluz (P-01) suggest anthropic contamination. The sum of REE in the dissolved fraction ranged from 2.12 to 12.22 µg L-1. A positive anomaly of La in Queluz indicates anthropic contamination. The observed patterns indicate that Funil Reservoir acts as a biogeochemical barrier, modifying the fluvial transport of REE. Nonetheless, another factor that probably influences REE behavior is the algal bloom that occurs in reservoirs during the rainy season. The seasonal behavior of algae can influence REE biogeochemistry through the incorporation and release of trace metals.

Wildlife is imperiled in peri-urban landscapes: threats to arboreal mammals.

Urbanization and deforestation impose severe challenges to wildlife, particularly for forest-living vertebrates. Understanding how the peri-urban matrix impacts their survival is critical for designing strategies to promote their conservation. We investigated the threats faced by brown howler monkeys (Alouatta guariba clamitans) in peri-urban regions of Rio Grande do Sul (RS) and Santa Catarina (SC) states, southern Brazil, by compiling negative interaction events (hereafter NIE) reported over more than two decades. We assessed the major NIEs, their distribution among age-sex classes, and the predictors of NIE-related mortality. After 20+ years of monitoring, we compiled 540 NIEs (RS = 248 and SC = 292). Electrocution by power lines was the most frequent cause of death or injury (37%), followed by dog attack (34%), vehicle collision (17%), and human mistreatment (12%). The occurrence of lethal injuries ranged from 5% to 69% depending on the type of NIE and on which state it occurred in. The overall post-NIE mortality was 56%. Adults of both sexes were the most affected individuals in both study regions. The minimal adequate GLM model explained 83% of the variation in NIE-related mortality. State, NIE type, and age-sex class were the main predictors of mortality. Overall, mortality was lower in SC and higher among adult females than in the other classes. We found that the survival of brown howler monkeys in the forest-urban interface is constrained by both the urban infrastructure and the growing interactions with humans and domestic and stray dogs (Canis familiaris). We propose the placement of aerial bridges, road signs and speed bumps in areas of frequent animal crossing, the sterilization of stray dogs, and the sensitization of local inhabitants on the importance of respecting and protecting wildlife to reduce their NIEs with humans and domestic animals in the forest-urban interface.

From radiometry to chronology of a marine sediment core: A 210Pb dating interlaboratory comparison exercise organised by the IAEA.

Laboratories from 14 countries (with different levels of expertise in radionuclide measurements and 210Pb dating) participated in an interlaboratory comparison exercise (ILC) related to the application of 210Pb sediment dating technique within the framework of the IAEA Coordinated Research Project. The laboratories were provided with samples from a composite sediment core and were required to provide massic activities of several radionuclides and an age versus depth model from the obtained results, using the most suitable 210Pb dating model. Massic concentrations of Zn and Cu were also determined to be used for chronology validation. The ILC results indicated good analytical performances while the dating results didn't demonstrate the same degree of competence in part due to the different experience in dating of the participant laboratories. The ILC exercise enabled evaluation of the difficulties faced by laboratories implementing 210Pb dating methods and identified some limitations in providing reliable chronologies.

Metformin protects from oxaliplatin induced peripheral neuropathy in rats.

Oxaliplatin is a commonly used drug to treat cancer, extending the rate of disease-free survival by 20% in colorectal cancer. However, oxaliplatin induces a disabling form of neuropathy resulting in more than 60% of patients having to reduce or discontinue oxaliplatin, negatively impacting their chance of survival. Oxaliplatin-induced neuropathies are accompanied by degeneration of sensory fibers in the epidermis and hyperexcitability of sensory neurons. These morphological and functional changes have been associated with sensory symptoms such as dysesthesia, paresthesia and mechanical and cold allodynia. Various strategies have been proposed to prevent or treat oxaliplatin-induced neuropathies without success. The anti-diabetic drug metformin has been recently shown to exert neuroprotection in other chemotherapy-induced neuropathies, so here we aimed to test if metformin can prevent the development of oxaliplatin-induced neuropathy in a rat model of this condition. Animals treated with oxaliplatin developed significant intraepidermal fiber degeneration, a mild gliosis in the spinal cord, and mechanical and cold hyperalgesia. The concomitant use of metformin prevented degeneration of intraepidermal fibers, gliosis, and the altered sensitivity. Our evidence further supports metformin as a new approach to prevent oxaliplatin-induced neuropathy with a potential important clinical impact.

Bisphosphonate-related osteonecrosis. Application of adipose-derived stem cells in an experimental murine model.

BACKGROUND: Bisphosphonate-related osteonecrosis of the jaw is a pathological condition without effective established treatment and preventive strategies. The aim of this study was to analyse the effect of adipose-derived stem cells (ASC) in an experimental murine model of osteonecrosis. MATERIAL AND METHODS: 38 Wistar rats were injected intraperitoneally with zoledronic acid. After treatment, upper jaw molars were extracted. The animals were randomly assigned to one of two groups. In the control group, saline solution was applied over the alveolar sockets after the tooth extractions. In the treatment group, ASCs were applied instead of saline solution. The control and treatment groups were subdivided based on the time of euthanasia. A clinical and histological analysis was performed. RESULTS: The presence of osteonecrosis in alveolar bone was observed in a similar distribution in both groups. In the ASC-treated group, new bone formation was greater than in controls. CONCLUSION: In this study, application of ASCs showed greater new bone formation in an osteonecrosis-like murine model. Previous inhibited post-extraction bone remodelling could be reactivated, and these findings appeared to be secondary to implantation of ASCs.

Antibiogram in the biopsy of chronic venous ulcers related to sudden changes in the pain profile.

INTRODUCTION: Chronic venous insufficiency (CVI) has an important impact on the public health system in particular due to the occurrence of chronic venous ulcers (UCV) and infections. OBJECTIVE: To evaluate cultures of biopsies of chronic venous ulcers of patients who suffered an acute change in the intensity of pain of the lesion. METHOD: Antibiograms of the cultures of chronic venous ulcer biopsies of patients who suffered an acute change in the lesion with significant pain for 24 hours were evaluated. All patients were treated between 2011 and 2015 in the Vascular Surgery Outpatient Clinic of the Medical School in São José do Rio Preto. Other causes of pain such as chronic arterial insufficiency and problems with the dressings were ruled out. RESULTS: Positive cultures were detected in 34 of the 35 patients whose pain was resolved by antibiotic therapy. CONCLUSION: Acute changes in the intensity of pain associated with chronic venous ulcers seem to be related to local infectious disease.

Microgeographic variation in recruitment under adult trees: arrival of new genotypes or perpetuation of the existing ones?

Investigating spatial variation in the relative importance of sexual reproduction and clonal propagation is critical to obtain more accurate estimates of future effective population sizes and genetic diversity, as well as to identify ecological correlates of clonality. We combined a stratified sampling scheme with microsatellite genetic analyses to estimate variation in the proportion of sexual versus clonal recruits among saplings in five populations of the tree Pyrus bourgaeana. Using a likelihood framework, we identified clones among the genotypes analysed and examined variation among populations regarding the proportion of saplings coming from clonal propagation. We also examined the relationship between the relative abundance of clonal shoots across the studied populations and their herbivory levels. Our results revealed that one third of the saplings examined (N = 225 saplings) had a probability above 0.9 of being clones of nearby (<10 m) trees, with the ratio between clonal propagation and sexual recruitment varying up to eight-fold among populations. A small portion of these putative clonal shoots reached sexual maturity. Relative abundance of clonal shoots did not significantly relate to the herbivory by ungulates. Our results call into question optimistic expectations of previous studies reporting sufficient levels of recruitment under parental trees without animal seed dispersal services. Nevertheless, given that some of these clonal shoots reach sexual maturity, clonal propagation can ultimately facilitate the long-term persistence of populations during adverse periods (e.g. environmental stress, impoverished pollinator communities, seed dispersal limitation).

Beckwith-Wiedemann Syndrome: Open bite evolution after tongue reduction.

BACKGROUND: Macroglossia causes functional deficits such as airway obstruction, drooling, phonation difficulties, and leads to protrusion of dentoalveolar structures resulting in an anterior open bite and a prognathic mandibular appearance. Macroglossia is present in the majority of patients with Beckwith-Wiedemann syndrome (BWS) and surgical treatment may be indicated. MATERIAL AND METHODS: A retrospective review was conducted including BWS patients who underwent surgical tongue reduction between 2000 and 2015 at the Hospital Universitario La Paz, Madrid. RESULTS: Out of 16 patients with BWS, surgery was performed in 11 cases. Tongue protrusion with open bite was the main indication for surgical treatment. Reduction glossectomy was performed using the keyhole technique. We analysed the relationship between age at surgery and evolution of open bite. Complications were minimal and satisfactory outcomes were observed with a decrease in anterior open bite. CONCLUSIONS: In this study we have observed that surgical treatment in patients with BWS and open bite accompanied by macroglossia seems to provide positive results with a satisfactory outcome in dentoskeletal alterations.

A straight choice: avoiding septal re-deviation using titanium plates. A 16 year retrospective patient follow-up evaluation.

BACKGROUND: To propose a new surgical technique for fixing the nasal septum to the midline, for long term prevention of nasal obstruction, in secondary and select cases of primary septoplasty. METHODOLOGY: Retrospective study, within hospital medical center. PATIENTS: Two hundred and twenty two patients who underwent septoplasty. Data collection occurred consecutively between March 1st of 2000 and May 1st 2016. Twenty six percent females and seventy four percent males. MAIN OUTCOME MEASURES: Patterns of septal deformity, materials used for titanium plates, surgical results, symptom improvement, and surgical complications were investigated. RESULTS: A total of 222 patients were included in this study. 163 patients (73%) had no previous nasal surgery. Fifty nine patients (27%) presented with a previous nasal surgery. Sixteen year follow up included more than 90% of patients and resulted in an overall 2.7% revision rate. CONCLUSIONS: The use of titanium plate for septoplasty has shown to be simple, safe, and easy to learn technique in both secondary and select cases of primary septoplasty. Most importantly the results indicate a long term prevention of the.

Effect of exercise while utilizing a device with an arm compression sleeve to reduce lymphedema.

BACKGROUND: Lymphedema is one complication of breast cancer treatment and there is no consensus that identified one single therapy in the treatment of lymphedema; therfore an association of methods is recommended and one of these is exercising. The aim of this study was to evaluate the utilization of exercising with a facilitating device along with an arm compression sleeve to reduce the size of lymphedematous arms. MATERIALS AND METHODS: Thirty women from a rehabilitation group with arm lymphedema resulting from the surgical, chemotherapeutic, and radiotherapeutic treatment of breast cancer were enrolled sequentially on arriving in the clinic. While sitting in an upright position and wearing an arm compression sleeve, patients were submitted to a one-hour session of active exercising consisting of four 12-minute stints with three-minute intervals to rest. The change in lymphedema was evaluated by water volumetry before and immediately after the session. The active exercising device is similar to the pedaling system of a bicycle. The paired t-test was employed for statistical analysis. An alpha error of 5% (p-value < 0.05) was considered acceptable. RESULTS: A statistically significant reduction (p-value < 0.004) was noted in the size of the arm. CONCLUSION: Active exercising using a facilitating device and under supervision may reduce the size of lymphedematous arms.

Eficacia de terapia concomitante sin bismuto en la erradicación de Helicobacter pylori en Chile: estudio prospectivo / Efficacy of non-bismuth concomitant therapy for Helicobacter pylori eradication in Chile: a prospective study

Standard triple therapy (TT), used massively as first-line empirical therapy for Helicobacter pylori (H. pylori) eradication, has shown a progressive decrease in its effectiveness, probably due to increasing resistance to clarithromycin. Recent studies in Chile show eradication under 90%, a limit suggested as adequate efficacy. The so-called concomitant therapy (CT) comprising a proton pump inhibitor, amoxicillin, clarithromycin and metronidazole is the non-bismuth first-line therapy most recommended in current guidelines. However, we have no local data to assess the effectiveness of this regimen. The aim of this study was to prospectively evaluate the effectiveness of CT in a group of patients controlled at a private health center in Santiago, Chile. Patients received 40 mg esomeprazole, 1 g amoxicillin, 500 mg clarithromycin and 500 mg metronidazole, every 12 hours, for 14 days. Sixty-six patients were included, of these patients, 36 returned to control. CT was successful in 33/36 patients, corresponding to 92% (95% CI: 82.5-100%, per protocol analysis). The frequency of significant side effects was 25% (mainly diarrhea and abdominal pain) and only one patient discontinued the treatment. In conclusion, 14-days CT therapy is effective to eradicate H. pylori and could be recommended as first-line empirical regimen, at least in the studied population segment and geographical area. Additional studies are necessary to confirm its efficacy in other socioeconomic and/or geographical settings.

La terapia triple estándar (TT), utilizada masivamente como terapia de primera línea empírica para erradicación de Helicobacter pylori (H. pylori) ha mostrado una progresiva disminución de su efectividad, probablemente por resistencia creciente a claritromicina. Los últimos estudios en Chile muestran erradicación bajo 90%, límite sugerido como eficacia adecuada. Esto ha motivado la búsqueda de esquemas alternativos más eficaces, siendo la así llamada terapia concomitante (TC), que consiste en un inhibidor de la bomba de protones, amoxicilina, claritromicina y metronidazol, el esquema sin bismuto más recomendado en guías clínicas recientes. Sin embargo, no contamos con datos locales que evalúen su efectividad. El objetivo del presente estudio fue evaluar prospectivamente la efectividad de TC en un grupo de pacientes controlados en un centro de salud privado de Santiago de Chile. Los pacientes recibieron esomeprazol 40 mg, amoxicilina 1 g, claritromicina 500 mg y metronidazol 500 mg cada 12 h, por 14 días. Se incluyeron 66 pacientes, de los cuales 36 volvieron a control. La TC fue exitosa en 33/36 pacientes, correspondientes al 92% (IC 95%: 82,5-100%; análisis por protocolo). La frecuencia de efectos colaterales significativos fue 25% (principalmente diarrea y dolor abdominal) y sólo un paciente suspendió el tratamiento por esta causa. En conclusión, la TC por 14 días es efectiva para erradicar H. pylori, al menos en el segmento poblacional y área geográfica estudiados y es un esquema empírico que pudiera recomendarse como primera línea en nuestro medio, aunque se requiere confirmar su eficacia en otros grupos poblacionales.

Factores relacionados con la cirugía secundaria en la reconstrucción mamaria autóloga con tejido libre abdominal / Secondary surgery related factors in autologous breast reconstruction using abdominal free tissue

La reconstrucción mamaria con colgajo libre abdominal se ha convertido en la opción terapéutica de elección en nuestro centro hospitalario cuando se necesita abundante cantidad de tejido. La culminación de este tipo de reconstrucción requiere un número variable de procedimientos auxiliares de retoque. Revisamos las historias de las pacientes sometidas en nuestro centro a reconstrucción mamaria con colgajo libre abdominal entre enero de 2010 y diciembre de 2013. El criterio de inclusión fue la reconstrucción del pezón como última cirugía. Las pacientes fueron estratificadas atendiendo a factores relacionados con la reconstrucción microquirúrgica y la existencia de radioterapia adyuvante. Analizamos el número y tipo de procedimientos y cirugías de retoque, así como el tiempo transcurrido hasta completar el proceso de reconstrucción. En total, recogimos 68 pacientes reconstruidas con colgajo libre abdominal. De ellas, 31 (45,6%) completaron la reconstrucción mamaria. La media de procedimientos fue de 3,2 por paciente, con una media de 2,4 tiempos quirúrgicos y un tiempo medio de 15,5 meses hasta la reconstrucción del pezón. El momento de la reconstrucción, la bilateralidad, el tratamiento con radioterapia y la presencia de complicaciones tempranas del colgajono se relacionaron con diferencias estadísticamente significativas en la tasa de cirugía secundaria. Los colgajos libres abdominales necesitan frecuentemente cirugías secundarias para mejorar el resultado y terminar la reconstrucción. Remarcamos la necesidad de planificar la reconstrucción desde el primer tiempo quirúrgico para disminuirla necesidad de cirugías de retoque y el tiempo hasta completarla reconstrucción mamaria (AU)

Breast reconstruction using abdominal free flaps has become the therapeutic choice at our center when a lot of tissueis needed, The completion of this reconstructive technique requires a variable number of ancillary procedures. Patients who underwent breast reconstruction with abdominal free flap at our center between January 2010 and December2013 were reviewed. The inclusion criterion was completion to nipple reconstruction. The patients were stratified attending to microsurgical reconstruction related factors and adjuvant radiotherapy. Number and sort of procedures and surgeries, and total elapsed time to complete the reconstruction were analyzed. Sixty-eight patients underwent reconstruction using abdominal free flap; 31 (45.6%) completed breast reconstruction. The average of procedures, surgical steps and elapsed time was3.2, 2.4 and 15.5 months respectively. Surgical time and bilateral procedures, treatment with radiotherapy and early flap complications were not related to statistically significant differences in secondary surgery rates. Abdominal free flaps often need secondary surgeries to improve the result and finish the reconstruction. We remark the necessity of planning the reconstruction since first surgical time to diminish the secondary surgeries and the elapsed time until completion of breast reconstruction (AU)

Diagnóstico histológico del tumor fibromixoide osificante: 2 casos en los últimos 20 años / Histologic diagnosis of ossifying fibromyxoid tumor: 2 cases in the past 20 Years

No disponible

Polyetheretherketone custom-made implants for craniofacial defects: Report of 14 cases and review of the literature.

BACKGROUND: Craniofacial defects tend to carry functional and esthetic consequences for the patient. The complex shapes in this region make such reconstructions a challenging procedure and the most suitable material to be used remains controversial. METHODS: We report a series of 14 patients whose craniofacial defects were reconstructed using a computer designed PEEK-PSI (Polyetheretherketone- Patient Specific Implant). We analyzed the complications and outcomes of PEEK custom-made implants and compared our results with those of other case series reported in the current literature. RESULTS: Fourteen patients underwent craniofacial reconstruction using a PEEK-PSI. Three cases involved a one-step primary reconstruction and the rest of cases underwent a delayed reconstruction. Two cases (14.3 %) presented infection and only in one case was the implant definitively removed. Esthetic results were considered to be highly satisfactory. CONCLUSION: With CAD-CAM techniques, it is possible to prefabricate an individual implant. The ideal material for reconstructing maxillofacial defects does not exist, but PEEK has demonstrated good outcomes. When autologous bone is not available or, in selected cases with large or complex defects in the maxillofacial area, PEEK is one of the best options to reconstruct these defects. However, further studies are needed to determine the long-term results.

[Safety and efficacy of Vildagliptin in real life Chilean diabetic patients]. / Evaluación del perfil de eficacia y seguridad de vildagliptina en vida real de pacientes chilenos con diabetes mellitus tipo 2.

BACKGROUND: Vildagliptin is a dipeptidyl peptidase IV inhibitor (DPP4i). Its efficacy and safety of DPP4i in Chilean real life type 2 diabetic (T2D) patients is not well known. AIM: To assess the safety profile and effectiveness of 12 weeks of treatment with Vildagliptin for glycemic control in T2D Chilean patients with a poor glycemic control. PATIENTS AND METHODS: Retrospective assessment of the effects of Vildagliptin treatment during 12 weeks in 103 T2D patients aged 29 to 92 years (47% males). The main outcomes were changes in glycosylated hemoglobin and the occurrence of adverse effects. RESULTS: After 12 weeks of Vildagliptin use, glycosylated hemoglobin decreased from 8.3 ± 1.4 to 7.2 ± 1.1% (p < 0.01). Fasting plasma glucose and the number of hypoglycemic events also decreased significantly. No significant weight change was observed. The treatment had good compliance, tolerance and patient satisfaction. CONCLUSIONS: Vildagliptin treatment reduced glycosylated hemoglobin by 1.1% and was well tolerated in this group of diabetic patients.

Factitious lymphedema of the arm: case report and review of publications.

The aim of this study was to report a case of factitious lymphedema of the arm and related lymphoscintigraphic aspects. The case of a 36-year-old patient is reported who started to present with pain, in the 3rd finger of the right hand three years prior to this report, which she associated with her work. Joint effusion was identified and treated using a splint that restricted blood flow leading to edema of the distal third of the forearm. Since then the patient was treated however her condition worsened resulting in edema of the entire arm. Subsequently she was referred to our service. A physical examination identified a restrictive band in the axillary region of the arm that delimited the edema. Volumetry and lymphoscintigraphic examinations of the limb were performed. The lymphoscintigraphy demonstrated acceleration of the flow in the affected limb and dermal reflux. Clinical treatment with removal of the restriction allowed a rapid reduction in the volume of the limb.

Evaluación del perfil de eficacia y seguridad de vildagliptina en vida real de pacientes chilenos con diabetes mellitus tipo 2 / Safety and efficacy of Vildagliptin in real life Chilean diabetic patients

Background: Vildagliptin is a dipeptidyl peptidase IV inhibitor (DPP4i). Its efficacy and safety of DPP4i in Chilean real life type 2 diabetic (T2D) patients is not well known. Aim: To assess the safety profile and effectiveness of 12 weeks of treatment with Vildagliptin for glycemic control in T2D Chilean patients with a poor glycemic control. Patients and Methods: Retrospective assessment of the effects of Vildagliptin treatment during 12 weeks in 103 T2D patients aged 29 to 92 years (47% males). The main outcomes were changes in glycosylated hemoglobin and the occurrence of adverse effects. Results: After 12 weeks of Vildagliptin use, glycosylated hemoglobin decreased from 8.3 ± 1.4 to 7.2 ± 1.1% (p < 0.01). Fasting plasma glucose and the number of hypoglycemic events also decreased significantly. No significant weight change was observed. The treatment had good compliance, tolerance and patient satisfaction. Conclusions: Vildagliptin treatment reduced glycosylated hemoglobin by 1.1% and was well tolerated in this group of diabetic patients.