Ivana Budić

University of Nis

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Dušica Simić

University Children's Hospital, Belgrade

Vesna Marjanović

University of Nis

Marija Stević

University Children's Hospital, Belgrade

Irina Milojević

University Children's Hospital, Belgrade

Irena Simić

University of Belgrade

Dejan Novaković

Klinički centar Niš

Ivana Petrov

University of Belgrade

Ivona Djordjević

University of Nis

Christian Breschan

Klinikum Klagenfurt

A. Mandraš

Institute of Public Health of Serbia

Cooperative Institutions

University of Nis

Boston Children's Hospital

University of Belgrade

Istituti di Ricovero e Cura a Carattere Scientifico

Klinički centar Niš

Inserm

University Children's Hospital, Belgrade

University College London

European Society of Anaesthesiology

Istituto Giannina Gaslini

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Importance of a Follow-Up Ultrasound Protocol in Monitoring Posttraumatic Spleen Complications in Children Treated with a Non-Operative Management

Medicina (2021)

Ivona Djordjević Dragoljub Živanović Ivana Budić Ana Kostić Danijela Djeric

Background and objectives: For the last three decades, non-operative management (NOM) has been the standard in the treatment of clinically stable patients with blunt spleen injury, with a success rate of up to 95%. However, there are no prospective issues in the literature dealing with the incidence and type of splenic complications after NOM. Materials and methods: This study analyzed 76 pediatric patients, up to the age of 18, with blunt splenic injury who were treated non-operatively. All patients were included in a posttraumatic follow-up protocol with ultrasound examinations 4 and 12 weeks after injury. Results: The mean age of the children was 9.58 ± 3.97 years (range 1.98 to 17.75 years), with no statistically significant difference between the genders. The severity of the injury was determined according to the American Association for Surgery of Trauma (AAST) classification: 7 patients had grade I injuries (89.21%), 21 patients had grade II injuries (27.63%), 33 patients had grade III injuries (43.42%), and 15 patients had grade IV injuries (19.73%). The majority of the injuries were so-called high-energy ones, which were recorded in 45 patients (59.21%). According to a previously created posttraumatic follow-up protocol, complications were detected in 16 patients (21.05%). Hematomas had the highest incidence and were detected in 11 patients (14.47%), while pseudocysts were detected in 3 (3.94%), and a splenic abscess and pseudoaneurysm were detected in 1 patient (1.31%), respectively. The complications were in a direct correlation with injury grade: seven occurred in patients with grade IV injuries (9.21%), five occurred in children with grade III injuries (6.57%), three occurred in patients with grade II injuries (3.94%), and one occurred in a patient with a grade I injury (1.31%). Conclusion: Based on the severity of the spleen injury, it is difficult to predict the further course of developing complications, but complications are more common in high-grade injuries. The implementation of a follow-up ultrasound protocol is mandatory in all patients with NOM of spleen injuries for the early detection of potentially dangerous and fatal complications.

10.3390/medicina57080734

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USE OF BISPECTRAL INDEX (BIS) FOR MONITORING OF SEDATION AND TOTAL INTRAVENOUS ANESTHESIA (TIVA) IN PEDIATRIC PATIENTS UNDERGOING COLONOSCOPY

Facta Universitatis Series Medicine and Biology (2022)

Ivana Budić Zlatko Djurić Vesna Marjanović Ivona Djordjević Marija Stević

The objectives of this study were to determine whether there was a correlation between bispectral index (BIS) and Ramsey Sedation Scale (RSS) in regard to the type of sedation and total intravenous anesthesia (TIVA) during colonoscopy procedures in children, and to assess the utility of ketamine and propofol combination (ketofol) for this kind of procedures at children’s age. In our prospective study, 40 ASA I-II patients, 3 to 17 years of age, were randomly divided into two groups of 20 patients each. After premedication with atropine and midazolam, sedation was induced with propofol and fentanyl in Group PF, whereas in Group PK propofol and ketamine were used for induction. Both groups were further divided into two subgroups depending on whether anesthesia was maintained with intermittent doses or continuous infusion of propofol. Ketamine and/or fentanyl were administered as bolus doses. Heart rate (HR), peripheral oxygen saturation (SpO2), RSS and BIS values of all patients were recorded every 5 minutes throughout the colonoscopy procedures. The strongest degree of correlation between RSS and BIS existed when sedation or TIVA was maintained by the boluses of propofol and fentanyl. The use of ketamine significantly reduced the doses of propofol and fentanyl. BIS can be monitored in all pediatric patients in whom sedation and TIVA are administered during colonoscopy, but the effect of different anesthetics on the EEG signal should be considered in order to adequately assess the depth of sedation and anesthesia.Key words: awareness, monitoring, child, anesthetics, endoscopy

Bispectral index

Midazolam

Premedication

Bolus (digestion)

10.22190/fumb220413003b

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The Effect of UGT1A9, CYP2B6 and CYP2C9 Genes Polymorphism on Propofol Pharmacokinetics in Children

DOAJ (DOAJ: Directory of Open Access Journals) (2020)

Dušica Pavlović Ivana Budić Jiangtao Ma Dragana Stokanović Vesna Marjanović

CYP2B6

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Penile block and inhalation anesthetics as a combined anesthesia in surgery of the penis in children

Regional Anesthesia & Pain Medicine (2004)

Ivana Budić Vesna Marjanović Dejan Novaković

10.1016/j.rapm.2004.07.066

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Citations (1)

Abdominal migraine in a pediatric patient

DOAJ (DOAJ: Directory of Open Access Journals) (2020)

Simić Dušica M.Vlajković Ana S.Ivana Budić Milenović Miodrag Marija Stević

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The criteria for verifying brain death in children

Srpski arhiv za celokupno lekarstvo (2004)

Dušica Simić Milos Petkovic Irina Kovacevic Ivana Budić

The American Committee, followed by the British, consisting of experts in various fields, in 1968 and 1976, respectively, reached the following consensus: "If a brain stem is dead, a brain is dead, if a brain is dead, a person is dead..." In the last few years, definition of brain death was necessary due to organ transplantation. Most of criteria verifying brain death do not include the specific determinants of brain death in children. This paper specifies the most up-to-date guidelines for diagnosis of brain death in children of various ages.

Brain dead

10.2298/sarh04s1125s

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Procedural sedation and analgesia in the pediatric intensive care unit

Signa Vitae (2023)

Ivana Budić Vesna Marjanović Ivona Djordjević Marija Stević Dragoljub Živanović

Children frequently experience more painful, stressful, and traumatic medical procedures and treatments in the pediatric intensive care unit (PICU) than when they are hospitalized in general wards. An essential part of care in the PICU is providing critically ill children with appropriate sedation and analgesia. Finding the perfect combination of adequate analgesia and sufficient sedation in a patient group with a wide range of ages, sizes, and developmental stages can be challenging. Administration of sedatives and analgesics to critically ill patients may be challenging and complicated by unpredictable pharmacokinetics (PK) and pharmacodynamics (PD). It is important to keep in mind that optimal agents for procedural sedation and analgesia (PSA) differ from those used for long-term sedation in the PICU. In addition to pharmacological measures, different non-pharmacological methods can be applied and have been shown to be effective for pain relief in children. Efforts are being made to improve PSA management with the use of national surveys, recommendations, and guidelines.

Pharmacodynamics

10.22514/sv.2023.007

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Influence of potential gene polymorphisms on propofol dosage regimen in patients undergoing abdominal hysterectomy

Balkan Journal of Medical Genetics (2020)

Еmilija Ivanov Zoran Sterjev Ivana Budić Jordan Nojkov Dafina Karadzova

Abstract Propofol (2,6-diisopropylphenol) is the most common intravenous anesthetic used in modern medicine. It is postulated that individual differences in genetic factors [polymorphism of single nucleotide polymorphisms (SNPs)] in the genes encoding metabolic enzymes, molecular targets and molecular binding sites of propofol can be responsible for susceptibility to propofol effects. The aim of our study was to investigate the influence of the cytochrome P450 2B6 isozyme CYP2B6 (rs3745274), γ-aminobutyric acid type A (GABAA) receptor α1 subunit GABRA1 (rs2279020) and ATP-binding cassette subfamily B member 1 ABCB1 (rs1045642) gene polymorphisms on propofol therapeutic outcomes in the patients undergoing abdominal hysterectomy. Ninety patients aged 29-74 years, with different ethnicities were included in this study. The presence of polymorphisms was analyzed using TaqMan SNP genotype analysis on Stratagene MxPro 3005P real-time polymerase chain reaction (qPCR). The distribution of all three genetic variants was within the Hardy-Weinberg equilibrium. There was no significant difference ( p >0.05) in the allelic frequencies of polymorphic variants and genotype distributions between adult and older patients and between patients of different ethnicities. Our study did not detect a statistically significant influence of the CYP2B6 (c.516G>A), GABRA1 (c.1059+15G>A) and ABCB1 (c.3435T>C) variants on the variability of clinical parameters (doses for induction in anesthesia, additional doses, induction time and wake time after anesthesia and side effects of propofol). However, the observed trend on the possible influence of the CYP2B6 (c.516G>A) and GABRA1 (c.1059+15G>A) variants warrant an extension of these studies on a larger number of patients.

CYP2B6

SNP

10.2478/bjmg-2020-0030

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Citations (1)

Terorizam kao oblik socijalnog poduzetništva

Ivana Budić

Teroristicke se organizacije sve cesce povezuju s nekim oblikom socijalnog poduzetnistva. Naime, kako bi osigurali opstanak svoje organizacije teroristi moraju steci poduzetnicke vjestine i preuzeti neke strategije poslovanja. No, za razliku od tradicionalnih poduzetnika, vođe teroristickih organizacija nisu usmjereni na povecavanje profita, nego javnog dobra zajednice koju zastupaju. Iako im nije cilj povecanje profita, moraju poslovati s raznim akterima, vladom, vojskom, nevladinim organizacijama pa i drugim kriminalnim skupinama, jer samo prikupljenim financijskim sredstvima mogu pomoci zajednici za koju se bore, te pridobiti i na kraju zadržati njihovu podrsku. Također, inovativnost je ono sto se zahtjeva od njih kako bi odgovorili na promjenjive uvjete u kojima djeluju. Studije slucaja Hamas, Irska Republikanka Armija i Oslobodilacki tigrovi tamilske domovine prikazuju na koje se nacine te teroristicke organizacije ponasaju kao socijalni poduzetnici, s kim posluju kako bi si osigurali financijska sredstva. Kao vrsni menadžeri koriste propagandu kojom privlace ljudski i financijski kapital. Buduci da su uspjesni u adresiranju problema koje vlade ne mogu rijesiti, namecu se kao alternativa koja može osigurati javna dobra u podrucjima u kojima je vlada zakazala. Prikupljena sredstva koriste i za financiranje svojih akcija koje predstavljaju kao akcije za ostvarivanje javnog dobra zajednica koje zastupaju.

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Editorial: Enhanced Recovery After Surgery

Frontiers in Medicine (2019)

Ivana Budić Ivan Veličković

EDITORIAL article Front. Med., 29 March 2019Sec. Intensive Care Medicine and Anesthesiology Volume 6 - 2019 | https://doi.org/10.3389/fmed.2019.00062

Pain medicine

10.3389/fmed.2019.00062

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Citations (5)