Dyslipidemia and obesity are recognized as two of the major global health issues and main risk factors for coronary heart disease and cerebrovascular disease. In recent years, carob has shown certain antioxidant and anti-dyslipidemic potential. In this study, Wistar rats were fed with a standard and cholesterol-enriched diet and treated orally with carob extract and simvastatin for four weeks. After sacrifice, blood samples were collected for biochemical analysis, and liver tissue was taken for histological and immunohistochemical assessment. Weight gain was significantly higher in groups fed with cholesterol-fortified granules; total cholesterol was found to be significantly lower in the hypercholesterolemic groups treated with simvastatin and simvastatin/carob combined regimens compared with hypercholesterolemic animals treated with saline (p < 0.05). The same was true for low-density lipoprotein cholesterol and the LDL/HDL ratio (p < 0.05). Adiponectin was remarkably higher in animals treated with simvastatin compared to all other groups (p < 0.05). Leptin was significantly lower in groups treated with carob and simvastatin compared to the hypercholesterolemic group treated with saline (p < 0.05). Carob/simvastatin co-administration reduced hepatocyte damage and improved liver morphology. A study confirmed the anti-dyslipidemic, anti-obesity, and hepatoprotective potential of carob pulp alone or in combination with simvastatin in the treatment of high-fat diet-fed rats.

Background and Objectives: The aim of this study was to examine whether the use of an alveolar recruitment maneuver (RM) leads to a significant increase in static lung compliance (Cstat) and an improvement in gas exchange in patients undergoing laparoscopic cholecystectomy. Material and Methods: A clinical prospective intervention study was conducted. Patients were divided into two groups according to their body mass index (BMI): normal-weight (group I) and pre-obese and obese grade I (group II). Lung mechanics were monitored (Cstat, dynamic compliance—Cdin, peak pressure—Ppeak, plateau pressure—Pplat, driving pressure—DP) alongside gas exchange, and hemodynamic changes (heart rate—HR, mean arterial pressure—MAP) at six time points: T1 (induction of anesthesia), T2 (formation of pneumoperitoneum), T3 (RM with a PEEP of 5 cm H₂O), T4 (RM with a PEEP of 7 cm H₂O), T5 (desufflation), and T6 (RM at the end). The RM was performed by increasing the peak pressure by +5 cm of H₂O at an equal inspiration-to-expiration ratio (I/E = 1:1) and applying a PEEP of 5 and 7 cm of H₂O. Results: Out of 96 patients, 33 belonged to group I and 63 to group II. An increase in Cstat values occurred after all three RMs. At each time point, the Cstat value was measured higher in group I than in group II. A higher increase in Cstat was observed in group II after the second and third RM. Cstat values were higher at the end of the surgical procedure compared to values after the induction of anesthesia. The RM led to a significant increase in PaO₂ in both groups without changes in HR or MAP. Conclusions: During laparoscopic cholecystectomy, the application of RM leads to a significant increase in Cstat and an improvement in gas exchange. The prevention of atelectasis during anesthesia should be initiated immediately after the induction of anesthesia, using protective mechanical ventilation and RM.

Introduction: Abdominal infections are common causes of sepsis and septic shock in the intensive care unit (ICU), which are often associated with negative outcomes. Aim: To determine the clinical characteristics of patients with abdominal sepsis, as well as the significance of causes thereof, therapeutic procedures in the ICU, and length of hospital stay related with abdominal sepsis treated at the Clinic for Anesthesiology, Intensive Care, and Pain Therapy from January 1, 2022, to December 31, 2022. Material and Methods: This is a retrospective study conducted at the Intensive Care Unit (ICU), Clinic for Anesthesiology, Intensive Care, and Pain Therapy, University Clinical Center of Vojvodina (UCCV). By reviewing medical records, 60 patients of both genders with abdominal sepsis were analyzed. Results: Of the 60 patients, 42% were female, while 58% were male, with an average age of 68 years. Of the total number of patients, 38.3% survived, while 61.7% died. Perforation of a hollow organ accounted for 45% of hospitalizations. The mortality rate in the ICU was 65%. Conclusion: Using multivariate logistic regression, we obtained two independent predictors of fatal outcomes with a constant. Together, in the interaction of age ≥65 years and perforations, they increase the probability of a fatal outcomes for about 5.4 times, while vasopressor therapy increases the probability of fatal outcomes about 12 times compared to patients without vasopressor therapy; mortality was statistically higher in patients who required longer mechanical ventilation and in those who were hospitalized longer in the ICU.

Background and Clinical significance: Single-shot spinal anesthesia for intrapartum Cesarean section has recently been incriminated in carrying a high risk of high neuraxial block (HNB) occurrence in parturients receiving labor epidural analgesia. The so-called volume effect of the epidurally injected solution causes a contraction of the dural sack and unexpected HNB. Case presentation: We present two cases of HNB in parturients receiving epidural analgesia. The first case describes the 36-year-old patient G3P2, who was administered a repeated rescue analgesia single-shot spinal injection with low-dose local anesthetic (levobupivacaine, 3 mg) following non-functional combined spinal–epidural analgesia. The second case describes the 28-year-old parturient G1P0, who experienced HNB after single-shot spinal anesthesia with hyperbaric bupivacaine (7.5 mg) following labor epidural analgesia. Conclusions: Intrathecal administration of local anesthetic for the purpose of spinal analgesia or anesthesia in a parturient with epidural analgesia can cause unexpected HNB and could occur even at low doses of intrathecally administered medications. The interplay of numerous variables and circumstances in the specific case can result in the occurrence of HNB. We assume that in our first case, the volume effect and repeated dural puncture, and in the second case, the low height of the parturient coupled with the volume effect, played significant role in the occurrence of HNB.

Introduction: With the increased use of diagnostic procedures such as computed tomography (CT), the detection of asymptomatic adrenal lesions demonstrates a growing trend. Accurately distinguishing these lesions is essential for guiding future diagnostic and treatment approaches. Aim: This study aimed to investigate whether it is possible to determine the adenomatous characteristics of adrenal tumors on non-contrast CT scans. Material and Method: A retrospective observational study was conducted at the University Clinical Center of Vojvodina (UKCV), involving 43 patients who underwent CT imaging following the adrenal protocol. The key parameters examined were: sex, age, antero-posterior (AP) and latero-lateral diameter (LL) of the adenoma, non-contrast density, absolute (APW) and relative (RPW) washout. Results: Our study has shown a statistically significant negative correlation between non-contrast density and RPW (p<0.001), as well as significant positive correlation between APW and RPW (p=0.007). The non-contrast density demonstrated a statistically significant positive correlation with the AP diameter of the adenoma (p=0.035). Conclusion: Our research shows that when using unenhanced CT imaging, a non-contrast density significantly below 10 Hounsfield units (HU) and a lesion diameter under 40 mm strongly suggest an adrenal gland adenoma, potentially allowing for diagnosis without multiple scans or contrast.