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Search Results: 1 - 10 of 1985 matches for " Budi? Ivana "
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TRACE ELEMENTS
Du?ica Simi?,Ivana Budi
Acta Facultatis Medicae Naissensis , 2003,
Abstract: Cellular processes such as energy utilization, growth and immune function can't go well without trace elements. Trace elements are essential inorganic micronutrients, each contributing less than 0,01% to the total body weight. Every element, whose amount in the adult human body is less than 1 g, while daily requirements are not higher than 100 mg/day, could be considered as a trace element. Their nutritional deficiency usually results in a complex syndrome of typical signs and symptoms that usually withdraw after the supplementation.
NUTRITIONAL SUPPORT IN CHRONICALLY ILL CHILDREN
Simi? Du?ica,BudiIvana
Acta Facultatis Medicae Naissensis , 2003,
Abstract: Chronically ill children often become malnourished. These children have increased metabolic requirements and increased losses associated with impaired absorption and decreased nutrient usage. In hospitalized children nutritional assessment is rarely performed, increased or modified needs are not recognized, meals are omitted due to analysis or interventions, which lead to a further decline in nutritional status. The consequences of malnutrition are growth retardation and slow development, aggravation of a disease, impaired immunity and decreased resistance to infection. Nutritional support should improve the quality of life in chronically ill children. Adequate nutritional support should provide that the growth of these children corresponds to the growth of the healthy children of the same age group. The course of disease could be improved too. The enteral route of feeding is the best choice, so enteral nutrition (EN) should be the first option, but in the occasions when it is contraindicated parenteral nutrition (PN) is applied. This review article discusses cardiac, renal and liver diseases, cystic fibrosis and AIDS in children, from the nutritional point of view.
Myocarditis exacerbation in a child undergoing inguinal hernioplasty after viral infection
Simi? Du?ica,Milojevi? Irina,BudiIvana,Strajina Veljko
Srpski Arhiv za Celokupno Lekarstvo , 2009, DOI: 10.2298/sarh0910537s
Abstract: Introduction Immunosuppressive effects of general anesthesia and surgery could have unexpected consequences in a child with recent infection. The incidence of myocarditis in childhood is unknown. Case outline During general anesthesia for inguinal hernia repair, a seven-year-old boy suddenly developed heart failure. Clinical presentation included hypotension, pulmonary edema, drop in hemoglobin oxygen saturation, ST segment elevation and premature ventricular contractions. Homodynamic stability and adequate oxygenation were achieved with dopamine and furosemide. Preoperative history, physical examination and complete blood count were unremarkable. Moderate cardiomegaly and pulmonary edema were present on chest radiography. Diminished left ventricular contractility found on echocardiography increased troponin I and CK-MB levels suggested myocardial injury. Increased C-reactive protein with lymphocytosis suggested inflammation as its cause. Parents failed to report rubella 10 days before the operation. A clinical diagnosis of myocarditis as a complication of rubella was based on increased titer of IgM to rubella. With intravenous immunoglobulin, corticosteroids and symptomatic treatment for heart failure, his condition improved and ejection fraction reached 68 % one month after operation. Conclusion In future, we need protocols with instructions for pediatric patients undergoing elective surgery and anesthesia after viral infections.
Peripheral nerve blocks in pediatric anesthesia
Novakovi? Dejan,BudiIvana,Simi? Du?ica,?or?evi? Nina
Srpski Arhiv za Celokupno Lekarstvo , 2009, DOI: 10.2298/sarh0910497n
Abstract: Introduction Most children undergoing surgery can benefit from regional anesthetic techniques, either as the sole anesthetic regimen or, as usual in pediatric practice, in combination with general anesthesia. The use of peripheral nerve blocks (PNBs) in pediatric anesthesia is an effective way to decrease the side-effects and complications associated with central blocks. In spite of their many advantages, including easy performance end efficacy, peripheral nerve blocks are still underused. Objective This article discusses a general approach to PNBs in children and provides data concerning the practice of this regional technique in different age groups. Methods Data from 1,650 procedures were prospectively collected during the period from March 1, 2007 to February 29, 2008. The type of PNB, if any, as well as the patient age were noted. Our patients were divided into four groups: 0-3 years, 4-7 years, 8-12 years and 13-18 years. Results During the investigated period, PNBs as a sole technique or in anesthetized children were performed in 7.45% of cases. Ilioingunal/iliohypogastric nerve block and penile block were the most common (70% of all PNBs) distributed mainly among the children between 4-7 years of age (p<0.05). In older children, extremity PNBs predominate in regard to other types of blocks. PNBs are most frequently performed under general anesthesia (85%), so the perineural approach requires a safe technique to avoid nerve damage. Conclusion The observed differences in PNB usage seem to be related to patient age and correlate with common pathology and also with technical availability of PNB performance.
Anaesthesia for noncardiac surgery in children with congenital heart disease
Simi? Du?ica,?uki? Milan,BudiIvana,Milojevi? Irina
Srpski Arhiv za Celokupno Lekarstvo , 2011, DOI: 10.2298/sarh1102107s
Abstract: Children with Congenital Heart Disease (CHD) presenting for non-cardiac surgery have various physiological and functional abnormalities and thus pose great challenges to the anaesthesiologist. The principles of anaesthesia are to minimize pathophysiological changes which may upset the complex interaction between systemic and pulmonary vascular resistance. Knowledge of the specific cardiac anatomy, familiarity with the modifications of the cardiorespiratory physiology, the awareness of the potential risks of complications for each individual case are mandatory for the choice of the anaesthesia strategy for each patient. During the preoperative assessment, the risk-benefit ratio should be estimated and preoperative plan established in order to optimize the preoperative status. An anaesthesiologist must also understand pharmacology of drugs being used and should tailor anaesthetic management to the type of surgery. An interdisciplinary team approach is the cornerstone for the safe delivery of anaesthesia to this paediatric patient population. The team should comprise an anesthesiologist, a paediatric cardiologist, a surgeon, a cardio-surgeon and a neonatologist. This review is meant to explain the classification of congenital heart diseases and to equip the anaesthesiologist with the necessary information about preoperative assessment, anaesthesiology management, monitoring tools important for the safe non-cardiac surgery procedures as well as therapeutic strategies during the postoperative period.
Anaesthesia in children with inherited neuromuscular diseases
Simi? Du?ica,Bogi?evi? Dragana,Milojevi? Irina,BudiIvana
Srpski Arhiv za Celokupno Lekarstvo , 2010, DOI: 10.2298/sarh1012768s
Abstract: Children with inherited neuromuscular diseases often require anaesthesia for diagnostic or therapy procedures. These patients have an increased risk of perioperative complications due to the nature of the disease and medications administered during anaesthesia. Many anaesthetics and muscle relaxants can aggravate the underlying disease and trigger life-threatening reactions (cardiorespiratory complications, malignant hyperthermia). Besides, the neuromuscular disorders are associated with atypical and undesirable responses to drugs used during anaesthesia and the perioperative period. The paper presents pathophysiological basis of inherited/genetic neuromuscular diseases and specific anaesthesiological problems. The recommendations are suggested with the aim to make the perioperative course in children optimally safe.
ANESTHESIA FOR A NEONATE WITH PYLORIC ATRESIA-JUNCTIONAL EPIDERMOLYSIS BULLOSA SYNDROME: A CASE REPORT
Ivana Budi,Dejan Novakovi?,Vesna Marjanovi?,Zoran Marjanovi?
Acta Facultatis Medicae Naissensis , 2005,
Abstract: The paper describes the anesthetic management of a neonate with pyloric atresia - junctional epidermolysis bullosa (PA-JEB) syndrome. Anesthesia for the neonate with PA-JEB syndrome can stand for a serious challenge even to the most experienced anesthesiologists. Therefore, a few basic principles will help to organize the necessary procedures. Shearing forces applied to the skin will result in bulla formation, while compressive forces to the skin are tolerated. Adhesive tape, adhesive ECG electrodes, adhesive pulse oximeter probes should not be used under any circumstances. Padding should be profusely used. Face masks should be lubricated with some emollient or coated with several layers of Vaseline gauze. All the instruments places into the mouth (laryngoscope, oropharyngeal airways) must be thoroughly lubricated with water based lubricant - do not lubricate with Lidocaine jelly. Pharyngeal suctioning should be avoided. Tracheal lesions do not appear after intubation probably because the trachea is lined with columnar epithelium. To reduce the risk of new laryngeal bullae formation, a tracheal tube a half to one size smaller than predicted may be necessary. With maximal skin and mucous membrane protection, anesthesia in children with PA-JEB syndrome may be conducted with a few sequelae.
ANTIMICROBIAL PRORHILAXIS IN SURGICAL PATIENTS
Marjanovi? Vesna,Mili?evi? Ru?ica,Marjanovi? Goran,BudiIvana
Acta Facultatis Medicae Naissensis , 2003,
Abstract: Nowadays antimicrobial prophylaxis represents a unique approach for reducing the incidence of wound infection associated with surgical procedures. Recommendations for antimicrobial prophylaxis may be specific according to type of the procedure, causative agents, schedules and drug doses. It is important to note optimal timing of drug administration, and the optimal duration of prophylaxis in order to adjust maximal drug concentration in tissues that probably might be contaminated during the surgery. Currently it is recommended to receive antimicrobial prophylaxis at anesthesia induction as a short course that should have duration from 12-24 hours, while postoperative prophylaxis proved to be infective. The best route of administration is parenteral, while other routes are not so common. It is important to weigh costs of treatment of patients with developed postoperative wound infection who did not receive any prophylaxis, against cost and morbidity of patients who had received antimicrobial prophylaxis.
The effects of different anesthesia techniques on free radical production after tourniquet-induced ischemia-reperfusion injury at children's age
BudiIvana,Pavlovi? Du?ica,Cvetkovi? Tatjana,?or?evi? Nina
Vojnosanitetski Pregled , 2010, DOI: 10.2298/vsp1008659b
Abstract: Background/Aim. Reperfusion of previously ischemic tissue leads to injuries mediated by reactive oxygen species. The aim of the study was to investigate the effects of different anesthesia techniques on oxidative stress caused by tourniquetinduced ischemia-reperfusion (IR) injury during extremity operations at children's age. Methods. The study included 45 patients American Society of Anesthesiologists (ASA) classification I or II, 8 to 17 years of age, undergoing orthopedic procedures that required bloodless limb surgery. The children were randomized into three groups of 15 patients each: general inhalational anesthesia with sevoflurane (group S), total intravenous anesthesia with propofol (group T) and regional anesthesia (group R). Venous blood samples were obtained at four time points: before peripheral nerve block and induction of general anesthesia (baseline), 1 min before tourniquet release (BTR), 5 and 20 min after tourniquet release (ATR). Postischemic reperfusion injury was estimated by measurement of concentration of malondialdehyde (MDA) in plasma and erythrocytes as well as catalase (CAT) activity. Results. Plasma MDA concentration in the group S was significantly higher at 20 min ATR in comparison with the groups T and R (6.78 ± 0.33 μmolL-1-1 vs 4.07 ± 1.53 and 3.22 ± 0.9. μmolL-1-1, respectively). There was a significant difference in MDA concentration in erytrocythes between the groups S and T after 5 min of reperfusion (5.88 ± 0.88 vs 4.27 ± 1.04 nmol/mlEr, p < 0.05). Although not statistically significant, CAT activity was slightly increased as compared to baseline in both groups S and R. In the group T, CAT activity decreased at all time points when compared with baseline, but the observed decrease was only statistically significant at BTR (34.70 ± 9.27 vs 39.69 ± 12.91 UL-1, p < 0.05). Conclusion. Continuous propofol infusion and regional anesthesia techniques attenuate lipid peroxidation and IR injury connected with tourniquet application in pediatric extremity surgery.
Cross Entropy Method for Solving Generalized Orienteering Problem  [PDF]
Budi Santosa, Nur Hardiansyah
iBusiness (IB) , 2010, DOI: 10.4236/ib.2010.24044
Abstract: Optimization technique has been growing rapidly throughout the years. It is caused by the growing complexity of problems that require a relatively long time to solve using exact optimization approach. One of complex problems that is hard to solve using the exact method is Generalized Orienteering Problem (GOP), a combinatorial problem including NP-hard problem. Recently, there has been plenty of heuristic method development to solve this problem. This research is an implementation of cross entropy (CE) method in real case of GOP. CE is an optimization technique that relatively new, using two main procedures; generating sample solution and parameter updating to produce better sample for next iteration. At this research, GOP problem that occurs at finding optimal route consist of 27 cities in eastern China is investigated. Results indicate that CE method give better performance than those of Artificial Neural Network (ANN) and Harmony Search (HS).
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