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Search Results: 1 - 10 of 1822 matches for " Novak Vesna "
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Risk of infection after placement of an extraventricular drainage catheter
Novak Vesna,Stefanovi? Ivan,Kosti? Aleksandar,Novak Martin
Srpski Arhiv za Celokupno Lekarstvo , 2012, DOI: 10.2298/sarh1204138n
Abstract: Introduction. The occurrence of infection after the placement of an extraventricular drainage (EVD) catheter can be a very serious problem in neurosurgery. Objective. The aim of this study was to confirm that the use of special catheters with impregnated antibiotics decreased the percentage of infection. Methods. The prospective study conducted at the Clinic of Neurosurgery in Ni in the period 2006-2009 is presented. Group 1 comprised of 43 patients in whom a commonly used system for EVD was applied. Group 2 comprised of 39 patients in whom the Rifampycin and Clindamycin impregnated EVD catheters were applied (Bactiseal catheters). Results. In Group 1 infection occurred in nine patients, mainly caused by bacteria of Staphylococcus genus. In Group 2 only two patients developed infections caused by Acinetobacter. Conclusion. The use of Bactiseal EVD catheters considerably decreased the percentage of infection occurrence with prolonged EVD catheter drainage period.
SERATTIA AS THE CAUSE OF AN INTRAHOSPITAL INFECTION AT THE NEUROCHIRURGICAL CLINIC IN NIS
Vesna Novak,Velimir Kostic,Goran Ignjatovic,Martin Novak
Acta Medica Medianae , 2001,
Abstract: Intrahospital infections represent a serious problem in medicine. Withneurochirurgical patients infections can seriously damage the quality of treatmentwhile in some cases they can threaten patients' lives. Meningitis, brain abscess,osteomyelitis or secondary wound healing are complications caused by infection. Inthe period between October, 28, to December, 24, 1999, at the Neurochirurgicalclinic in Ni there was an intrahospital infection caused by the bacteria Serattia. Thesource of the infection was not discovered. Comprehensive measures wereundertaken for disinfecting the operation block and the intensive treatment unit aswell as a sanitary examination of the staff. In 2000 there was no record of any new a e of the infection caused by the bacteria.
The incidence and risk factors of ventilator-associated pneumonia in patients with severe traumatic brain injury
Marjanovi? Vesna,Novak Vesna,Veli?kovi? Ljubinka,Marjanovi? Goran
Medicinski Pregled , 2011, DOI: 10.2298/mpns1108403m
Abstract: Introduction. Patients with severe traumatic brain injury are at a risk of developing ventilator-associated pneumonia. The aim of this study was to describe the incidence, etiology, risk factors for development of ventilator- associated pneumonia and outcome in patients with severe traumatic brain injury. Material and Methods. A retrospective study was done in 72 patients with severe traumatic brain injury, who required mechanical ventilation for more than 48 hours. Results. Ventilator-associated pneumonia was found in 31 of 72 (43.06%) patients with severe traumatic brain injury. The risk factors for ventilator-associated pneumonia were: prolonged mechanical ventilation (12.42 vs 4.34 days, p<0.001), longer stay at intensive care unit (17 vs 5 days, p<0.001) and chest injury (51.61 vs 19.51%, p< 0.009) compared to patients without ventilator-associated pneumonia.. The mortality rate in the patients with ventilator-associated pneumonia was higher (38.71 vs 21.95%, p= 0.12). Conclusion. The development of ventilator-associated pneumonia in patients with severe traumatic brain injury led to the increased morbidity due to the prolonged mechanical ventilation, longer stay at intensive care unit and chest injury, but had no effect on mortality.
Transverse myelitis following general and thoracic epidural anaesthesia
Mojca Drnovsek Globokar,Vesna Paver Erzen,Vesna Novak Jankovic
Signa Vitae , 2010,
Abstract: Acute bacterial transverse myelitis, secondary to an epidural catheter, developed in a 49-year-old man who underwent surgery for carcinoma of the left lung. Left pneumonectomy was performed under combined general and epidural (Th6-7) anesthesia. The operative procedure, anaesthesia and early postoperative course were uneventful. On the fifth postoperative day, the patient developed neurological deficits consistent with high-level paraplegia. Elevated inflammatory parameters along with the results of cerebrospinal fluid analysis and magnetic resonance imaging were suggestive of acute transverse bacterial myelitis of the dorsal part of the spinal cord secondary to epidural analgesia. Despite prompt antibiotic therapy, anti-oedema treatment and rehabilitation, the neurological deficit failed to resolve.
Aberrations of chromosome 8 in myelodysplastic syndromes: Clinical and biological significance
Marisavljevi? Dragomir,Panti?-Ludo?ki Milena,Novak Angelina,?or?evi? Vesna
Srpski Arhiv za Celokupno Lekarstvo , 2006, DOI: 10.2298/sarh0610404m
Abstract: Introduction: Rearrangements of any single chromosome in human karyotype have been reported in patients with pMDS. Objective: To examine the role of aberrations of chromosome 8 in pathogenesis, clinical presentation and progression of myelodysplastic syndromes. Method: Cytogenetic analysis of bone marrow cells was carried out by direct method and by means of 24- and/or 48-hour unstimulated cell culture. Chromosomes were obtained by modified method of HG-bands. Results: On presentation, 109 out of 271 successfully karyotyped patients (40,2%) had abnormal karyotypes. Among them, 22 patients (10.9%) had aberrations of chromosome 8. Ten patients had trisomy 8 as "simple" aberration whilst additional three cases had trisomy 8 included in "complex" karyotypes (≥3 chromosomes). Cases with constitutional trisomy 8 mosaicism (CT8M) were excluded using the chromosome analyses of PHA-stimulated blood cultures. On the contrary, monosomy (seven patients) or deletion of chromosome 8 (two patients) were exclusively found in "complex" karyotypes. During prolonged cytogenetic follow-up, trisomy 8 was not recorded in evolving karyotypes. In contrast, trisomy 8 disappeared in two cases during subsequent cytogenetic studies, i.e. 23 and 72 months from diagnosis, accompanied in one patient with complete hematological remission. No difference regarding age, sex, cytopenia, blood and marrow blast count or response to treatment was found between patients with trisomy 8 as the sole aberration compared to those with normal cytogenetics. Median survival of patients with trisomy 8 as the sole aberration was 27 months, as compared to 32 months in patients with normal cytogenetics (p=0.468), whilst median survival of patients with aberrations of chromosome 8 included in "complex" karyotypes was only 4 months. Conclusion: Aberrations of chromosome 8 are common in patients with pMDS. The presence of a clone with trisomy 8 is not always the sign of disease progression or poor prognosis in MDS patients, in contrast to clones with aberrations of chromosome 8 manifesting the loss of genetic material.
Complications after angiogram-negative subarachnoid haemorrhage: Comparative study of pretruncal and nonpretruncal hemorrhage patients
Kosti? Aleksandar,Stojanov Dragan,Stefanovi? Ivan,Novak Vesna
Srpski Arhiv za Celokupno Lekarstvo , 2012, DOI: 10.2298/sarh1202008k
Abstract: Introduction. Subarachnoid haemorrhages (SAH) of unknown aetiology usually have a mild clinical presentation, favourable outcome and low complication rate. Objective. The aim of this study was to analyze the complications in two forms of angiogram-negative spontaneous SAH: pretruncal (PNSAH) and nonpretruncal (NPNSAH). Methods. The study group involved 18 patients with PNSAH and 16 patients with NPNSAH. CT scan was done within 72 hours from bleeding. All patients underwent four-vessel cerebral angiography. Repeat angiography was performed in five PNSAH and all NPNSAH patients. Results. Twenty-nine patients were in grade I or II of the Hunt-Hess Scale (17 PNSAH and 12 NPNSAH). There was one case of rebleeding (NPNSAH patient), 10 cases of transient acute hydrocephalus (4 PNSAH and 6 NPNSAH). Cerebral vasospasm visualized by angiographies in two NPNSAH patients was local and mild, but was not found in PNSAH patients. Acute electrocardiography changes were found in 19 patients (significantly more frequently in NPNSAH than in PNSAH, 12 and 7 patients, respectively; p=0.037). Conclusion. Cardiac problems following these types of SAH are more frequent than expected, and therefore cardiac monitoring is necessary.
SEVERE BRAIN INJURIES: CORRELATION BETWEEN SURVIVAL AND INTRACRANIAL HYPERTENSION
Aleksandar Kosti?,Ivan Stefanovi?,Vesna Novak,Aleksandar Igi?
Acta Medica Medianae , 2011,
Abstract: There are several reasons of intracranial pressure (ICP) increase in the brain trauma. Brain edema, due to the brain-blood bariere injury, contusion of brain tissue and intracranial hematomas that represent mass lesion, cerebrovascular autoregulation failure which leads to hemodinamic disorder, and traumatic subarchnoid haemorrhagae that is commonly associated with CSF flow disturbances are the main causes. The aim of our study was to examine the survival of patients with severe brain trauma in the presence of different values of ICP. This prospective study included 32 patients with intracranial pressure monitored, and appropriate treatment undertaken. Twenty-two patients (68.75%) had elevated ICP, and in 10 patients (31,25%) there were no criteria of intracranial hypertnesion (ICHTN). The results of our study showed that absolute lethal value of ICHTN is 50mmHg and over – none of the injured survived such ICP if lasted more than two hours, because of inevitable brain and brainstem ischemia and failure of the vital functions. The relatively lethal values of ICP ranged from 40 to 50mmHg, in the case of which we menaged to prevent a fatal outcome in one out of five cases.
Occlusion of maxillary artery in treatment of trigeminal neuralgia
Novak Vesna,Bo?njakovi? Petar,Risti? Sa?a,Kosti? Aleksandar
Medicinski Pregled , 2012, DOI: 10.2298/mpns1208281n
Abstract: Introduction. This paper deals with a treating method of trigeminal neuralgia classified so far as idiopathic neuralgias and treated conservatively. The study was aimed at proving the compression of peripheral branches of n. trigeminus in those patients by vascular elements of a. maxillaris within the bone-ligament space of the scull and the face base. Material and Methods. The study sample consisted of 76 patients having trigeminal neuralgia. The compression was proved by clinical examination, by angiography and electrophysiological investigations. Endovascular occlusion of a. maxillaris is the original method and it was carried out in selected patients. Results. This method was applied in 76 patients. Embolisation was done in 71 patients by using occlusion spiral and gelfoan was used in 3 patients. Externa carotid artery ligation was done in 2 cases. Conclusion. The effect of absolute improvement has been achieved and verified by electrophysiological method and subjective assessment of the patients.
Prognostic significance of intracranial pressure monitoring and intracranial hypertension in severe brain trauma patients
Kosti? Aleksandar,Stefanovi? Ivan,Novak Vesna,Veselinovi? Dragan
Medicinski Pregled , 2011, DOI: 10.2298/mpns1110461k
Abstract: Since without prospective randomized studies it is not possible to have a clear attitude towards the importance of intracranial pressure monitoring, this study was aimed at examining the prognostic effect of the intracranial pressure monitoring and intracranial pressure oriented therapy in severe brain trauma patients, and at defining optimal intracranial pressure values for starting the treatment. Two groups of patients were treated in the study, one consisted of 32 patients undergoing intracranial pressure monitoring and the second group of 29 patients without intracranial pressure monitoring in the control group. The study was prospective with groups randomized. There were 53% survivals in the intracranial pressure monitored patients and 34% in the control group, with no significant difference in the survival rate between the two groups (χ2=2.11; p=0.15; p>0.05). The average intracranial pressure in the patients with intracranial hypertension who died was 27 mm Hg, while in the patients who survived the average intracranial pressure was significantly lower (Student’s t test: t=2.91; p=0.008; p<0.01) and it was 18 mm Hg. We recommend starting intracranial pressure oriented therapy when the patient’s intracranial pressure exceeds 18 mmHg during 2 hours of monitoring.
Recombinant factor VII (NovoSeven) in intraoperative blood saving during neurosurgical treatment of the brain arteriovenous malformation
Novak Vesna,Petrovi? Budimir,?alija Branko,Mitov Ljiljana
Vojnosanitetski Pregled , 2007, DOI: 10.2298/vsp0702151n
Abstract: Background. Cerebral arteriovenous (AV) malformation causes, due to the increased blood flow through a malformation, a massive intraoperative bleeding complicating, so, surgical treatment. The use of intraoperative blood saving apparatus during surgery and a recombinant factor VII-a (NovoSeven) significantly reduce complications during surgical treatment. Case report. We reported a case of surgical treatment of the patient with AV malformation of IV stage according to the Spetzler-Martin scale, in the brain. Due to a possible heavy bleeding we used a apparatus for intrasurgical blood recovery, Cell Saver, Sequestra 1 000, Medtronic, U.S.A., and recombinant human factor VIIa (rFVIIa - NovoSeven, NovoNordisk, Denmark) to control bleeding and restore an adequate hemostasis. Conclusion. The use of an apparatus for intraoperative blood saving, as well as the NovoSeven preparation in the management of AV malformation of IV stage, showed to be successful.
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