Nano Microbial Cellulose (NMC) is one of the most effective biopolymer in treating the injury. It has many applications in medical field due to unique properties such as high water absorption, compatibility with body and transparency for medical examination. Accordingly, this research attempts to evaluate the characteristic of raw and purified microbial cellulose for medical usage. The chemical and physical structure of microbial cellulose layer was assessed by FTIR and XRD. In addition, water absorption, wettability and permeability of raw and purified microbial cellulose pellicle were investigated and SEM was applied for assessing the surface of nanocellulose pellicle. FTIR result confirmed the cellulosic structure of pellicle and XRD represented that the crystallinity of NMC was more than cotton (plant cellulose). The obtained result indicated that the amount of water absorption of purified layer is 10% less than raw layer but wettability of the treated layer is increased more than 50%. No permeability was representing against air pressure in raw and purified samples in wet and dry forms at 25 Pa. Therefore, applying purification treatment improved the NMC pellicle properties for modern wound dressing. © 2015 The Authors. Published by Elsevier Ltd. Peer-review under responsibility of the organizing committee of UFGNSM15.

The number of elderly with chronic kidney disease (CKD) is constantly increasing worldwide, and irregular screening of CKD leads to disease discovering usually in advanced stages. The aim of the study was to examine the presence of CKD biomarkers in the elderly primary care patients, and to analyze whether the presence of diabetes and hypertension in elderly increases the risk for microalbuminuria and reduction of glomerular filtration rate (GFR). Cross-sectional study included 90 patients older than 65 years of age who are registered in the Family medicine teaching centre of Health centre Bijeljina. Patients were divided into three groups: first consisted of 30 patients who had neither hypertension nor diabetes nor other chronic disease, second of 30 patients with type 2 diabetes mellitus and third of 30 patients with arterial hypertension. Data on patients were obtained by interview, analysis of medical records and physical examinations. Serum and urine creatinine, proteinuria, microalbuminuria (MAU, turbidimetry), and urinary sediment were analyzed. Biomarkers of chronic kidney disease (GFR <60 mL / min / 1.73m2, proteinuria and mikroalbuminurija ¬MAU) were found in 20 (22.2%) patients. Among them, 14 had normal GFR and MAU (12) or MAU and proteinuria (2), whereas 6 had GFR <60 mL / min / 1.73m2 of which 3 had proteinuria and / or MAU. The group with diabetes had significantly more MAU compared to the other two groups, while the groups with diabetes and hypertension had slightly more proteinuria and erythrocyturia than control group. Hypertension and diabetes in the elderly may result in development of CKD biomarkers, so prevention and regular screening of CKD in the patients with these two diseases are necessary.

Knowledge of pathophysiological basis of laparoscopic procedures, that is, the influence of CO2 pneumoperitoneum (PNP) on the body in particular, can prevent the complications during laparoscopy to occur. Standard intra-abdominal pressure (IAP), which is used during laparoscopic surgery, is 12-15 mm / Hg. The direct effect of CO2 pneumoperitoneum is a result of mechanical action of the gas and increasement of intra-abdominal pressure (IAP). The indirect effect of CO2 pneumoperitoneum is caused by the absorption of gas inserted into the abdomen. Analysis of published articles that assess the effects of CO2 pneumoperitoneum on the body and abdominal organs contributes to a better usage of the laparoscopic method. Different techniques in laparoscopy, created as an alternative to standard CO2-pneumoperitoneum, have the task to reduce the risks for patients with comorbidity and simultaneously raise the abdominal wall and allow the surgeon to perform smooth operation, which is especially important for ASA III and ASA IV patients. Alternative techniques can be divided into three groups: laparoscopy using pneumoperitoneum with low intra-abdominal pressure (up to 8 mm / Hg), laparoscopy using retractors abdominal wall and limited pneumoperitoneum, and laparoscopy without the use of gas (gasless laparoscopy; raising the abdominal wall retractor only ). Low insufflation pressure in the abdomen (up to 8 mm / Hg) is beneficial for patients with laparoscopic procedures and its routine usage in elderly patients and patients with severe cardiorespiratory diseases, should be common practice. Gasless laparoscopy was created because of the need to prevent the negative effects of increased intra-abdominal pressure on the body during laparoscopy, primarily in patients with high comorbidity (ASA III and ASA IV). When compared to other techniques, numerous studies prefer laparoscopy with low insufflation pressure, but in practice this is not done routinely, yet each technique is applied selectively, according to the needs and condition of the patient, which is the most appropriate. To avoid the side effects of CO2 pneumoperitoneum, which is important in high-risk patients, it is more likely to operate on low IAP (6-8 mm / Hg) or use gasless laparoscopy. This is especially important for long – duration operations. DOI: 10.7251/SMDEN1501066H (Scr Med 2015:46:66-72)