The burden of type 2 diabetes mellitus in Latin America, 1990-2019: findings from the Global Burden of Disease study.

OBJECTIVES: This study aimed to assess the burden of type 2 diabetes mellitus (T2DM) in Latin America. STUDY DESIGN: An ecological study design was applied. METHODS: The data on T2DM (i.e. incidence, mortality, disability-adjusted life years [DALYs], years lived with disability [YLDs] and years of life lost [YLLs]) were extracted from the Global Burden Disease 2019 study. To assess the trends, the average annual percentage change was computed using the joinpoint regression analysis. RESULTS: Approximately 2.3 million new cases of T2DM were diagnosed in Latin America in 2019, with about 214,000 deaths. The age-standardised rates of T2DM burden in 2019 were highest in Central Latin America. Incidence of T2DM has increased in both males and females in Latin America over the last three decades, while mortality has increased only in males. Of particular concern are the significant increasing trends in the incidence of T2DM among individuals in the young age and middle age groups (15-64 years) in both men and in women. Increasing trends in the burden of T2DM were observed in almost all countries of Andean Latin America, the Caribbean and Central Latin America (in particular, in Guatemala, where T2DM incidence increased by 2.4% per year, mortality by 3.7%, DALYs by 3.4%, YLDs by 2.7% and YLLs by 3.8%). CONCLUSIONS: T2DM is an important health issue in Latin America due to the high mortality and disability burdens and the impact on life expectancy and quality of life of the population. Unfavourable trends in T2DM burden highlight the need to introduce effective public health disease management strategies.

Brief report comparing the Scale of Emotional Development - Short (SED-S) with other scales for emotional development.

BACKGROUND: Different instruments were devised for assessing emotional development (ED) level in persons with an intellectual disability (ID), that is, the Scale of Emotional Development - Short (SED-S), the Scheme for Appraisal of Emotional Development (SAED), the Scale for Emotional Development - Second Revision (SED-R2 ) and the Schaal voor Emotionele Ontwikkeling - Lukas (SEO-Lukas). The aim of this study was to compare the level of emotional functioning as assessed with the SED-S with the SAED, SED-R2 and SEO-Lukas. METHODS: Emotional development was measured in adults with ID with the SED-S (N = 186) and the SAED (n = 85), the SED-R2 (n = 50) and the SEO-Lukas (n = 51). Correlation analysis and Cohen's kappas were calculated between the SED-S and the three respective scales. Internal consistencies (Cronbach's alpha) of the four scales were determined. RESULTS: The SED-S results correlated most with the SEO-Lukas (γ = 1; кω = 0.936) followed by the SAED (γ = 0.809; кω = 0.343) and least by the SED-R2 (γ = 0.665; кω = 0.182). The stage of ED assessed with the SED-S was lower than the ED results measured with the SAED, but higher than with the SED-R2 and most similar to the SEO-Lukas. Cronbach's alphas were high, ranging from 0.853 to 0.975. CONCLUSIONS: Given the respective differences between the scales, the SED-S may equalise the results as compared with previous versions.

Factorial analysis of N-acetylcysteine and propolis treatment effects on symptoms, life quality and exacerbations in patients with Chronic Obstructive Pulmonary Disease (COPD): a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: Standard treatment for chronic obstructive pulmonary disease (COPD) includes inhalation therapy along with mucoactive drugs. The aim of this study was to assess the efficacy and safety of orally administered mucolytic N-acetylcysteine and propolis (NACp) in COPD patients. PATIENTS AND METHODS: A randomized, double-blind, prospective, interventional, 6 months study was conducted at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia. Effects of daily NACp administration (600 mg, 1200 mg or placebo) on exacerbation, life quality (St. George's Respiratory Questionnaire-SGRQ), symptoms (COPD assessment test-CAT; Visual analogue cough scale-VAS; Leicester Cough Questionnaire-LCQ; Medical Research Council Dyspnoea scale-mMRC) and spirometric parameters in 120 COPD patients were assessed. Tests were conducted at three-time points: baseline, after three months and after 6 months of NACp treatment. RESULTS: Repeated measures ANOVA showed that pulmonary function parameters, 6-minute walk test and mMRC score did not significantly change during the study. Cough VAS and CAT scores were significantly different between groups as within experimental groups. LCQ and SGRQ scores did not differ between placebo, and both examined groups, but within each examined group statistically significant difference was confirmed in observed parameters during therapy. Factorial analysis and subsequent binary logistic regression revealed "Symptoms related factor" as the strongest predictor of exacerbation for supplemented groups (p<0.01). CONCLUSIONS: Treatment with high NACp for 6 months is safe and beneficial for cough and expectoration symptoms and improves the life quality. NACp significantly reduces acute exacerbation frequency in COPD patients by controlling COPD related symptoms.

Water quality prediction based on Naïve Bayes algorithm.

In the fast-changing world with increased water demand, water pollution, environmental problems, and related data, information on water quality and suitability for any purpose should be prompt and reliable. Traditional approaches often fail in the attempt to predict water quality classes and new ones are needed to handle a large amount or missing data to predict water quality in real time. One of such approaches is machine-learning (ML) based prediction. This paper presents the results of the application of the Naïve Bayes, a widely used ML method, in creating the prediction model. The proposed model is based on nine water quality parameters: temperature, pH value, electrical conductivity, oxygen saturation, biological oxygen demand, suspended solids, nitrogen oxides, orthophosphates, and ammonium. It is created in Netica software and tested and verified using data covering the period 2013-2019 from five locations in Vojvodina Province, Serbia. Forty-eight samples were used to train the model. Once trained, the Naïve Bayes model correctly predicted the class of water sample in 64 out of 68 cases, including cases with missing data. This recommends it as a trustful tool in the transition from traditional to digital water management.

Polyphenol rich extracts of Geranium L. species as potential natural antioxidant and antimicrobial agents.

OBJECTIVE: Plants and plant extracts are of great scientific interest due to the chemical diversity and pharmacological properties of present bioactive molecules. The Geranium L. species are widely used in ethnomedicine. In the current study, the total phenolic and tannin content, antioxidant and antimicrobial activity of methanol extracts of eight Geranium species were investigated. MATERIALS AND METHODS: The total phenolic and tannin content were determined by the FC method. Antioxidant capacity was evaluated in FRAP, DPPH, and biochemical assays, while antimicrobial activity was examined using the broth microdilution method. RESULTS: The high total phenolic (170.64-636.32 mg GAE/g dry extract) and tannin content (37.80-414.02 mg GAE/g DE), along with significant total antioxidant (FRAP values 1.13-8.80 mmol Fe2+/g) and DPPH radical scavenging activity (SC50 values 4.24-34.52 µg/mL) were observed. The prominent antioxidant capacity was confirmed in biochemical assays (OS values -1.47 - -13.02). The extracts exhibited significant antimicrobial activity against ATTC strains (MICs dominantly in the range of 12.5-200 µg/mL) as well as against clinical isolates of E. coli (MICs mostly 50 and 100 µg/mL). The pronounced antioxidant and antimicrobial activity can be due to the high phenolic content, particularly due to the presence of hydrolyzable tannins. CONCLUSIONS: Based on the high content of polyphenols, pronounced antioxidant and antimicrobial activities, the examined extracts are promising natural antioxidant and antimicrobial agents with the potential medicinal purpose and use as a functional food.

Impact of Adiponectin Resistance on Coronary Artery Disease Severity.

BACKGROUND: The serum adiponectin level (AD), adiponectin resistance (AD-R) may reflect the degree of metabolic syndrome (MetS). The role parameter AD-R, The Homeostasis Model Assessment-Adiponectin (HOMA-AD) index on the coronary artery disease (CAD) severity is not still understood. OBJECTIVE: To determine adiponectin concentration and HOMA-AD index in patients with CAD with/without MetS and to evaluate their prognostic importance on severity of CAD. METHODS: This cross-sectional study involved selected 130 examinees which were divided into three groups: CAD+MetS, CAD-MetS, control group (no CAD/MetS). In all examinees values of biochemical and anthropometric parameters were determined. We analyzed the severity of coronary artery lesions from coronary angiography. Total serum adiponectin concentration was measured by ELISA. We calculated atherogenic Gensini scoring system, Duke prognostic index, and HOMA-AD-index. RESULTS: Serum adiponectin level was significantly lower in the group with CAD+MetS (p < 0.001) and in CAD-MetS group (p < 0.01), compared to the control group. The HOMA-AD index showed statistically significant positive correlation with the key parameters of MetS, as well as with the parameters of CAD, number of CAD and modified Gensini score. After applying logistic regression analysis the best predictors for CAD were: adiponectin, blood pressure, HOMA-IR index, and HOMA-AD index. The cut-off values of adiponectin ≤1506.38 pg/mL, HOMA-IR index ≥3.91 and HOMA-AD index ≥0.67 were associated with a higher risk of CAD. CONCLUSION: Patients with CAD with or without MetS had low adiponectin levels and this hypoadiponectinemia indicates that AD and HOMA-AD index may be a useful marker for identifying patients at risk for CAD.

Adiponectin resistance parameter as a marker for high normal blood pres-sure and hypertension in patients with metabolic syndrome.

INTRODUCTION: The different degrees of adiponectin/insulin sensitivity and dysfunctional adipose tissue lead to the development of hypertension (HT). This study aimed to determine adiponectin (AD) concentration in patients with metabolic syndrome (MetS) and high-normal blood pressure or hypertension and to investigate the importance of Homeostatic Model Assessment-AD (HOMA-AD) index in assessing adiponectin/insulin resistance in hypertension. METHODS: This cross-sectional study involved 150 subjects divided into two groups: with MetS (and high-normal blood pressure, n =50; and HT, n =50), and controls without MetS (n =50). In all subjects, serum adiponectin concentration was measured by enzyme-linked immunosorbent assay method. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and HOMA-AD index were calculated. RESULTS: The results showed that, compared to the control group, serum AD concentrations were significantly lower in patients with MetS and high-normal blood pressure (p =0.008), and the lowest in group MetS and HT (p =0.001). High AD levels and low HOMA-AD were significantly associated with decreased blood pressure values. In patients with MetS, the value of HOMA-AD≥1.13 was associated with a higher risk of developing high-normal blood pressure. Furthermore, the value of HOMA-AD≥2.63 was associated with a higher risk of developing hypertension. CONCLUSIONS: Hypoadiponectinemia is associated with hypertension, especially in the early stages of the disease. The serum AD levels and HOMA-AD index may be useful markers for identifying patients at risk for high-normal blood pressure and hypertension. HIPPOKRATIA 2020, 24(1): 3-7.

Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study.

Government and nongovernmental organizations need national and global estimates on the descriptive epidemiology of common oral conditions for policy planning and evaluation. The aim of this component of the Global Burden of Disease study was to produce estimates on prevalence, incidence, and years lived with disability for oral conditions from 1990 to 2017 by sex, age, and countries. In addition, this study reports the global socioeconomic pattern in burden of oral conditions by the standard World Bank classification of economies as well as the Global Burden of Disease Socio-demographic Index. The findings show that oral conditions remain a substantial population health challenge. Globally, there were 3.5 billion cases (95% uncertainty interval [95% UI], 3.2 to 3.7 billion) of oral conditions, of which 2.3 billion (95% UI, 2.1 to 2.5 billion) had untreated caries in permanent teeth, 796 million (95% UI, 671 to 930 million) had severe periodontitis, 532 million (95% UI, 443 to 622 million) had untreated caries in deciduous teeth, 267 million (95% UI, 235 to 300 million) had total tooth loss, and 139 million (95% UI, 133 to 146 million) had other oral conditions in 2017. Several patterns emerged when the World Bank's classification of economies and the Socio-demographic Index were used as indicators of economic development. In general, more economically developed countries have the lowest burden of untreated dental caries and severe periodontitis and the highest burden of total tooth loss. The findings offer an opportunity for policy makers to identify successful oral health strategies and strengthen them; introduce and monitor different approaches where oral diseases are increasing; plan integration of oral health in the agenda for prevention of noncommunicable diseases; and estimate the cost of providing universal coverage for dental care.

The superficial palmar branch of the radial artery: a corrosion cast study.

BACKGROUND: Surgical procedures such as thenar flaps and radial artery (RA) harvesting call for an elaborate anatomical study of the RA's superficial palmar branch (SPB). The aim of this study was to describe the branching pattern of this vessel related to the morphometric characteristics and variations of this artery. MATERIALS AND METHODS: Twenty 4% formalin solution-injected hands were dissected. For the morphometric study we used another group of 35 human hands of adult persons, injected with methyl methacrylate fluid into the ulnar and radial arteries. As soon as polymerisation was completed, a 40% solution of potassium hydroxide was applied for corrosion. The vascular arterial casts were examined under the stereoscopic microscope and precise drawings of each specimen were made. RESULTS: In the majority of cases (75%) SPB passed superficially, over the abductor pollicis brevis muscle. The mean diameter of the SPB, very variable depending on its length and field of supply, was 1.52 ± 0.49 mm, ranging from 0.8 to 2.7 mm. Developed SPB type, was present in 31.4% of hands, with the diameter of 1.7 mm and larger (mean 1.95 mm), continuing distally to become the radialis indicis artery, with an average calibre of 1.2 mm, and with important branches to the thumb. In most hands (68.6%), the hypoplastic SPB, was present, with a mean diameter of 1.17 mm, and the field of supply within the thenar area. CONCLUSIONS: Knowledge of the SPB dominance and existence of anastomotic vessels in its field of supply are of importance to avoid the risk of possible ischaemic sequelae in the hand associated with harvesting the RA.

Surgical Technique: Laparoscopic Gastric Sleeve Resection in Super-Obese Patients.

Laparoscopic gastric sleeve (LGS) resection in super-obese patients (BMI > 50 kg/m2) is a challenging procedure. We have developed a unique approach and technique for LGS with no buttress stapling and without oversewing. After 102 operations there have been no leaks and late complications.

Gender disparities in mortality from infectious diseases in Serbia, 1991-2014: a time of civil wars and global crisis.

Infectious diseases remain one of the leading causes of death worldwide. The aim of this descriptive epidemiological study was to analyse the trends in mortality from infectious diseases in Serbia (excluding the Autonomous Province of Kosovo & Metohia) from 1991 to 2014 using joinpoint regression analysis. The mortality rates from infectious diseases were found to have increased markedly from 1991 to 1994 (+12·4% per year), followed by a significant decline from 1994 to 2009 (-4·6% per year) and then another increase from 2009 to 2014 (+4·3% per year). Throughout the study period, mortality rates were consistently higher in men than in women. Although a substantial decline was observed for young people of both sexes, no consistent pattern was evident for the middle-aged nor the elderly. Since 1991, septicaemia has emerged as a leading cause of infectious disease mortality, particularly in older men. The Yugoslav civil wars in the 1990s and the global financial crisis in 2008 corresponded with changes in the trends in mortality from infectious diseases in Serbia, with the elderly showing particular vulnerability during those time periods. Data presented in this study might be useful to improve control of infectious diseases in Serbia.

Suicide in Serbia.

BACKGROUND: Suicide remains a significant public health problem worldwide. The aim of this study was to assess the mortality trend of suicide in Serbia for the years 1991-2014. METHODS: Data on persons who died of suicide and self-inflicted injury (site codes E950-E959 revision 9 and X60-X84 revision 10 of the International Classification of Diseases to classify death, injury and cause of death) were obtained from the Statistical Office of the Republic of Serbia. The age standardized rate was calculated by direct method (per 100,000 persons, using Segi's World population as standard population). Average annual percentage change (AAPC) with the corresponding 95% confidence interval (CI) was computed for trend using the joinpoint regression analysis. RESULTS: Total 33,930 (24,016 men and 9914 women) suicide deaths occurred in Serbia during the observed period, with the average annual age-standardized mortality rate being 12.7 per 100,000 inhabitants (19.5 per 100,000 in men and 6.7 per 100,000 in women). Suicide mortality in all age groups was higher among men than women. In both genders, suicide rates were highest in the oldest age group. Significantly decreased trend in suicide mortality was recorded continuously from 1991 to 2014 (AAPC=-1.9%, 95%CI -2.2 to -1.6). The most frequently used suicide method in both genders was hanging, strangulation or suffocation with 61.2% off all suicides. Changes in mortality rates were significant both for suicide by firearms, air guns and explosives (AAPC=-1.5% (AAPC=-1.5% in men and -3.1%-3.1% in women) and for suicide by hanging, strangulation, and suffocation (AAPC=-1.2% (AAPC=-1.2% in men and -3.0%-3.0% in women). In men, nonsignificant increase in suicide by firearms, air guns and explosives observed during the period 1991-1997 (by +6.1% per year) was followed by a significant decrease until 2014 (by -3.1% per year). The significantly increased mortality in suicide by firearms, air guns, and explosives was observed in older men (aged 40-69 years and 80 years and over). LIMITATIONS: The low rate of autopsies in Serbia, as well as the accuracy, reliability and comparability of the suicide mortality data is always a question. CONCLUSIONS: Downward trend in suicide mortality occurred in Serbia in last two decades. However, suicide rates are still very high in Serbia compared with the rates of suicides in developed countries. Particularly worrisome is the increase in mortality in older men, especially due to firearm suicides, air rifles, and explosives. Thus, additional efforts in the prevention of suicide are very important.

Secondary metabolites of Seseli rigidum: Chemical composition plus antioxidant, antimicrobial and cholinesterase inhibition activity.

Extracts of different polarity obtained from various plant parts (root, leaf, flower and fruit) of Seseli rigidum were studied by different antioxidant assays: DPPH and ABTS radical scavenging activity, by total reducing power method as well as via total content of flavonoids and polyphenols. Essential oils of all plant parts showed weak antioxidant characteristics. The inhibitory concentration range of the tested extracts, against bacteria Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus cereus, and fungi Candida albicans and Aspergillus niger was 0.01-1.50 mg/mL and of a microbicidal 0.02-3.00 mg/mL. In the interaction with cholinesterase, all essential oils proved effective as inhibitors. The highest percentage of inhibition versus human and horse cholinesterase was shown by root essential oil (38.20% and 48.30%, respectively) among oils, and root hexane extract (40.56% and 50.65% respectively). Essential oils and volatile components of all plant parts were identified by GC, GC-MS and headspace/GC-MS. Statistical analysis of the ensemble of results showed that the root essential oil composition differed significantly from essential oils of other parts of the plant. Taking into account all of the studied activities, the root hexane extract showed the best overall properties. By means of high performance liquid chromatography coupled to high resolution mass spectrometry, the 30 most abundant constituents were identified in extracts of different polarity. The presence of identified constituents was linked to observed specific biological activities, thus designating compounds potentially responsible for each exhibited activity.

EMortality from cancer of the lung in Serbia.

PURPOSE: To estimate the death rates for lung cancer and their secular trends in the population of Serbia, excluding the autonomous province of Kosovo and Metohia, over the 1991-2009 period. METHODS: A descriptive epidemiological method was employed. Trend of the lung cancer mortality rates was estimated using joinpoint linear regression analysis. An average annual percentage of change (AAPC) was computed for trend using linear models assuming a Poisson distribution, and the corresponding 95% confidence interval (CI). RESULTS: The mortality rate from lung cancer in Serbia ranks as the highest in the world, and it has been increasing continuously from 1991 (AAPC = + 1.9; 95% CI=1.7-2.2). A significant increase in mortality was present in both the male population (AAPC = + 1.4; 95% CI=1.2-1.6), and the female population (AAPC = + 3.9; 95% CI=3.6-4.3). However, a significant decline in lung cancer mortality in men was seen in some age groups. In young men (35-39 and 40-44 years age groups), lung cancer death rates decreased continuously from 1991, by - 5.1% and - 2.6% per year, respectively. Among men in the 45-49 years age group, a marked increase of lung cancer mortality was observed from 1991 to 1998 (by + 6.5% per year), followed by significant decrease (- 1.9% per year). Among women, only in the youngest age group (35-39 years) a declining trend was present (- 0.6% per year), yet without significance. CONCLUSION: Lung cancer mortality rates in Serbia indicate the importance of consistent application of measures of primary and secondary prevention that have been proven effective in other countries.

High clinical accuracy of asymmetric dimethylarginine and symmetric dimethylarginine in patients with ischemic heart disease.

Elevated plasma concentrations of asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) were found in various clinical settings including coronary heart disease. To assess ADMA and SDMA diagnostic validity in patients with different stages of ischemic heart disease, we studied these markers in patients having stable angina pectoris (SAP), unstable angina (USAP), and acute myocardial infarction (AMI). The results were compared with the values of healthy individuals. Plasma ADMA and SDMA levels were measured by high-performance liquid chromatography. In all patient groups both markers were significantly elevated in comparison with control ones (p < 0.001). In SAP patients, the median ADMA value was 0.75 (0.31-2.73) µmol/L, and SDMA 1.11 (0.69-0.1.42) µmol/L, in USAP patients, the marker values were 0.94 (0.34-3.13) µmol/L and 1.23 (0.88-4.72) µmol/L, and in AMI patients, 0.98 (0.48-2.01) µmol/L and 1.26 (0.75-2.93) µmol/L, while in healthy subjects they were 0.31 (0.17-0.87) µmol/L and 0.29 (0.20-0.83) µmol/L, respectively. SDMA was found significantly different in SAP and AMI patients (p < 0.05). Diagnostic accuracy was determined by receiver operating characteristic (ROC) curve analysis. The highest area under the ROC (AUC) for ADMA was obtained in AMI patients (0.976), while for SDMA in USAP patients (1.000). There was no significant difference between the AUCs. The greatest sensitivity and specificity were found in the USAP group (95.65 and 96.30 % for ADMA, and 100 % for each characteristic of SDMA). Considering these results, SDMA showed better clinical accuracy in assessing ischemic disease, where it could be used as a valid marker and a therapeutic target.

Biodegradation of petroleum sludge and petroleum polluted soil by a bacterial consortium: a laboratory study.

This article presents a study of the efficiency and degradation pattern of samples of petroleum sludge and polluted sandy soil from an oil refinery. A bacterial consortium, consisting of strains from the genera Pseudomonas, Achromobacter, Bacillus and Micromonospora, was isolated from a petroleum sludge sample and characterized. The addition of nitrogen and phosphorus nutrients and a chemical surfactant to both the samples and bioaugmentation to the soil sample were applied under laboratory conditions. The extent of biodegradation was monitored by the gravimetric method and analysis of the residual oil by gas chromatography. Over a 12-week experiment, the achieved degree of TPH (total petroleum hydrocarbon) degradation amounted to 82-88% in the petroleum sludge and 86-91% in the polluted soil. Gas chromatography-mass spectrometry was utilized to determine the biodegradability and degradation rates of n-alkanes, isoprenoids, steranes, diasteranes and terpanes. Complete degradation of the n-alkanes and isoprenoids fractions occurred in both the samples. In addition, the intensities of the peaks corresponding to tricyclic terpenes and homohopanes were decreased, while significant changes were also observed in the distribution of diasteranes and steranes.

New ischemic brain lesions on diffusion-weighted MRI after carotid artery stenting with filter protection: frequency and relationship with plaque morphology.

BACKGROUND AND PURPOSE: CAS carries an inherent risk of distal cerebral embolization, precipitating new brain ischemic lesions and neurologic symptoms. Our purpose was to evaluate the frequency of new ischemic lesions found on DWI after protected CAS placement and to determine its association with plaque morphology. MATERIALS AND METHODS: Fifty patients (mean age 65.13 ± 7.08 years) with moderate and severe internal carotid artery stenosis underwent CAS with distal filter protection. Fibrolipid and fibrocalcified plaque morphology was determined by sonography according to the relative contribution of echogenic and echolucent material, and by multisection CT using plaque attenuation. There were 46.81% of patients with fibrolipid and 53.19% with fibrocalcified plaques. DWI was performed before and 24 hours after CAS. RESULTS: Seven (14.89%) patients showed new lesions. Four (8.51%) had 6 new lesions inside the treated vascular territory. Three had a single lesion and 1 patient had 3 lesions (mean: 1.5 ± 1). Most lesions (66.66%) were subcortical, with a mean diameter of 9 mm (range 5-15 mm). All lesions occurred in the area supplied by the middle cerebral artery and were clinically silent. A significant relationship was found between plaque morphology and the appearance of new lesions. Patients with fibrolipid plaques had a significantly higher number of new lesions compared with patients with fibrocalcified plaques (P = .041). The absolute risk of new lesions in the fibrolipid group was 18.18%. CONCLUSIONS: New ischemic lesions were observed in the treated vascular territory in 8.51% of patients. The appearance of new ischemic lesions was significantly related to the plaque morphology. Fibrolipid plaques were associated with higher numbers of new lesions.