Dušica Simić

University Children's Hospital, Belgrade

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Ivana Budić

University of Nis

Marija Stević

University Children's Hospital, Belgrade

Vesna Marjanović

University of Nis

Irina Milojević

University Children's Hospital, Belgrade

Miodrag Milenović

Univerzitetski Klinički Centar Srbije

Irena Simić

University of Belgrade

Ivana Petrov

University of Belgrade

Novak Milović

Military Medical Academy

Vladimir Bančević

University of Defence

Vladimir Radlović

University of Belgrade

Cooperative Institutions

University of Belgrade

110

Boston Children's Hospital

University Children's Hospital, Belgrade

Univerzitetski Klinički Centar Srbije

Centar za Promociju Nauke

Istituti di Ricovero e Cura a Carattere Scientifico

University of Nis

Inserm

Military Medical Academy

European Society of Anaesthesiology

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Clinical characteristics of idiopathic ulcerative colitis in children

Srpski arhiv za celokupno lekarstvo (2011)

Zoran Leković Nedeljko Radlović Radivoj Brdar Biljana Vuletić Nenad Janic

Idiopathic ulcerative colitis (IUC) represents a rare disease of childhood. It usually occurs at age over 10 years, and below that exceptionally rarely.The aim of the paper was to analyze the clinical signs, symptoms and therapeutic procedures in children with IUC.The aims of the paper were based on a sample of 17 children (11 male and 6 female, mean age 11.90 +/- 3.50 years; range 3.8-17.5 years) with IUC. The disease diagnosis was based on characteristic endoscopic and pathohistological findings.The basic signs of the disease involved chronic mucosal haemorrhagic diarrhoea which was confirmed in 16 of 17 patients, with body weight deficiency (10), recurrent abdominal pain (6), fever (5), slowed-down maturation (5), marked anorexia (4), and tenesmus (3).Two patients had recurrent aphthous stomatitis, 2 anal fissures, 2 arthralgia, one autoimmune hepatitis and one pyoderma gangrenosum. None of the children had longitudinal growth retardation. Elevated sedimentation rate and C-reactive protein in blood were registered in 11, sideropenia in 10, anaemia in 6 and hypoalbuminemia in 3 patients. The remission of proctosigmoiditis and left-sided colitis was achieved with aminosalicylates, and of pancolitis with the combination of aminosalicylates and glucocorticoids, except in cases of steroid-dependent colitis, which additionally required azathioprine.The main signs of IUC in children are chronic mucous haemorrhagic diarrhoea, body weight loss and sideropenic anaemia, while the basic therapy consists of aminosalicylates, and in more severe cases of the disease the initial use of glucocorticoids and later azathioprine.

Pancolitis

Mesalazine

Anorexia

Erythrocyte sedimentation rate

Hypoalbuminemia

10.2298/sarh1104170l

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Citations (2)

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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S268: Our experience in the surgical treatment of Peyronie's disease

European Urology Supplements (2014)

Aleksandar Spasić Miroslav L. Djordjević V. Kojović Vladimir Bančević Novak Milović

10.1016/s1569-9056(14)61784-x

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Safe pediatric procedural sedation and analgesia by anesthesiologists for elective procedures: A clinical practice statement from the European Society for Paediatric Anaesthesiology

Pediatric Anesthesia (2019)

Marzena Zielińska Alicja Bartkowska‐Śniatkowska Karin Becke Claudia Höhne Nadia Najafi

The growing number of medical procedures performed in children that require cooperation of patients, lack of movement, anxiolysis or/and analgesia triggers the increased need for procedural sedation. This document presents the consensus statement of the European Society for Paediatric Anaesthesiology about the principles connected with the safe management of procedural sedation and analgesia (PSA) by anaesthesiologists for elective procedures in children. It does not aim to provide a legal statement on how and by whom PSA should be performed. The document highlights that any staff taking part in sedation of children must be appropriately trained with the required competencies and must be able to demonstrate regularly that they have maintained their knowledge, skills and clinical experience. The main goal of creating this document was to reflect the opinions of the community of the paediatric anaesthesiologists in Europe regarding how PSA for paediatric patients should be organized to make it safe.

Statement (logic)

10.1111/pan.13615

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Citations (30)

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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Citations (3)

[Aortic wall distensibility and the structure and function of the left ventricle in aged persons with isolated systolic hypertension].

PubMed (1999)

B Ivanović-Krstić Dimitra Kalimanovska‐Oštrić D Svetković-Matić Nikcević Dj Dušica Simić

The number of old persons (over 65 years) with arterial hypertension is in a steady increase [1]. Such finding is mainly related to patients with isolated systolic hypertension. They present more than 60% of old persons with arterial hypertension [2]. Isolated systolic hypertension can be defined as increased systolic blood pressure to the value more than 160 mmHg and diastolic pressure to 90-95 mmHg [4, 5]. It has been suggested that the pathologic basis of this entity is in a decreased distensibility of aorta and great arteries. In patients with isolated systolic hypertension we studied the correlation between decreased aortic distensibility and systolic arterial blood pressure value. We also evaluated changes in the left ventricular structure and function during this type of hypertension.We examined 59 patients older than 65 years. They were divided in two subgroups. First subgroup: 38 patients (74 +/- 11 years) with isolated systolic hypertension (ISH) and the second subgroup: 21 normotensive persons (NT) (73 +/- 6 years). Aortic distensibility was calculated by the formula: Aortic dystensibility = difference between aortic diameters/diameter aortae in diastole x pulse pressure. The ascending aortic diameters were measured 4 cm above the aortic valve by two dimensional echocardiography and pulse pressure was measured simultaneously by sphingomanometry. Using M-mod and two-dimensional echocardiography we measured end-diastolic (EDD) and end-systolic (ESD) left ventricular diameters and thickness of interventricular septum (IVS) and posterior wall (ZZ). We calculated the ejection fraction (EF) using Teichole formula. Changes in left ventricular structure were expressed by sum of interventricular septum and posterior wall thickness and left ventricular mass. We calculated left ventricular mass using the following formula: MLK = /EDD + IVS + ZZ)3 - EDD/ x 1.05. By pulse Doppler echocardiography we measured the peak velocity of the left ventricular filling (VE) and calculated the ratio between early and late peak velocity (VE/VA).Aortic distensibility was significantly lower in patients with isolated systolic hypertension than in normotensive subjects (0.10 +/- 0.02 x 1/100 1/mmHg vs 0.24 +/- 0.04 x 1/100 1/mmHg; p < 0.05). Such findings are presented in Table 1. At the same time, we found a significantly inversed correlation between aortic distensibility and systolic blood pressure value in patients with isolated systolic hypertension (r = 0.67; p < 0.05). From Table 2 it is visible that there were no significant differences between left ventricular diameter and mass in hypertensive patients. The sum of interventricular septum and posterior wall thickness was significantly greater in patients with isolated systolic hypertension than in normotensive patients (2.19 +/- 0.5 cm v.s. 1.93 +/- 0.4 cm; p < 0.05). This finding is also presented in Table 2. We found no statistically significant differences among the ejection fraction values in the studied subgroups (Table 3). The peak velocity of early filling and the ratio of early to late peak velocities were significantly lower in the hypertensive subgroup (0.4 m/s v.s. 0.54 m/s; p < 0.05; 0.69 v.s. 0.76; p < 0.05) (Table 3).In old persons with isolated systolic hypertension we found that aortic distensibility was significantly lower in comparison to normotensive subjects of the same age. Such finding supports the hypothesis that the reduced aortic distensibility is the cause of isolated systolic hypertension. At the same time, we found the inversed correlation between aortic distensibility and the mean systolic blood pressure value. Aging has an effect on reduction of aortic and great vessels distensibility. Thus, it causes arterial hypertension which changes the elastic properties of aorta. It is still questionable in which degree the systolic blood pressure value compromises the elastic properties of aorta. (ABSTRACT TRUNCATED)

Interventricular septum

Pulse pressure

Ventricular pressure

Systole

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Citations (3)

Esophageal atresia: Current approach in treatment

Medicinska istrazivanja (2015)

Dragana Vujović Marija Lukač Dejan Stojakov Dušica Simić Sanja Sinđić-Antunović

Esophageal atresia refers to a congenitally interrupted esophagus, with one or more fistulae present between the malformed esophagus and the trachea. The most frequent type is the one with distal tracheoesophageal fistula. If not diagnosed in time, it could cause severe respiratory complications , due to the aspiration of saliva, or direct flow of gastric secretions from below into the tracheobronchial tree. Surgical treatment of esophageal atresia demands a very precise operative technique, because of very limited possibilities for redo procedures. Results in the treatment of esophageal atresia, associated anomalies and postoperative complications are used in evaluation of both expert achievements of surgical team and institutional recommendations for certain pediatric hospitals. That is why the aim of the study is to evaluate our success in surgical treatment and to make a diagnostic and therapeutic algorithm for esophageal atresia. A retrospective study included 294 neonates treated from 1971-2013. The data are analyzed by comparing the incidence of different types of esophageal atresia, association with other congenital anomalies, treatment modalities of long-gap esophageal atresia and postoperative complications , as well as the outcome and survival rate over time. The results are analyzed using descriptive statistical method. The incidence of common esophageal atresia with distal tracheoesophageal fistula was 92,7 %; 5,1% with no fistula, 0,5% with two fistulae and 1,7% of H-type anomaly. The long-gap esophageal atresia was surgically treated in 3,4 % of cases. Various other congenital anomalies were associated in 48% of cases. The incidence of early complications including an anastomotic leak was about 5%; 1% of recurrent tracheoesophageal fistula and 7% of anastomotic structures. Gastroesophageal reflux as the main late postoperative complication, particularly problematic in patients with esophageal atresia occurs in 10% of cases in our series of patients. Developing surgical experience and neonatal intensive care units, the survival rate achieved 98%, which has certainly improved the outcome of surgical treatment, lowered the rate of postoperative complications and improved the quality of life, because most of the children who undergo a successful repair of esophageal atresia are relatively healthy.

Tracheoesophageal Fistula

Esophagectomy

Duodenal Atresia

10.5937/medist1502001v

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S130 MODIFIED Y-V LICH-GREGOIR URETER REIMPLANTATION: OUR EXPERIENCE IN 294 KIDNEY TRANSPLANTS

European Urology Supplements (2010)

Predrag Marić Novak Milović Z. Čampara Milena Jovanovic Vladimir Bančević

10.1016/s1569-9056(10)61415-7

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Citations (1)

Anesthesia in pyruvate dehydrogenase deficiency

Pediatric Anesthesia (2008)

Irina Milojević Dušica Simić

10.1111/j.1460-9592.2008.02545.x

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Citations (4)

High rate of burnout among anaesthesiologists in Belgrade teaching hospitals

European Journal of Anaesthesiology (2015)

Miodrag Milenović Bojana Matejić Vladimir Vasić Elizabeth A. M. Frost Nataša Petrović

Decisions by anaesthesiologists directly impact the treatment, safety, recovery and quality of life of patients. Physical or mental collapse due to overwork or stress (burnout) in anaesthesiologists may, therefore, be expected to negatively affect patients, departments, healthcare facilities and families.To evaluate the prevalence of burnout among anaesthesiologists in Belgrade public teaching hospitals.A cross-sectional survey.Anaesthesiologists in 10 Belgrade teaching hospitals.Burnout was assessed using Maslach Burnout Inventory-Human Services Survey.The response rate was 76.2% (205/272) with the majority of respondents women (70.7%). The prevalence of total burnout among anaesthesiologists in Belgrade teaching hospitals was 6.34%. Measured level of burnout as assessed by high emotional exhaustion, high depersonalisation and low personal accomplishment was 52.7, 12.2 and 28.8%, respectively. More than a quarter of the studied population responded in each category with symptoms of moderate burnout. We detected that sex, additional academic education, marital status and working conditions were risk factors for emotional exhaustion and depersonalisation. Ageing increased the likelihood of burnout by 21.3% with each additional year. Shorter professional experience and increased educational accomplishment increased the risk of total burnout by 272%.Burnout rates in Belgrade teaching hospitals among anaesthesiologists are higher than in foreign hospitals. Emotional and/or physical breakdowns can have serious effects when these individuals care for patients in extremely stressed situations that may occur perioperatively. Causes for burnout should be examined more closely and means implemented to reverse this process.

10.1097/eja.0000000000000383

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Citations (27)