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Search Results: 1 - 10 of 1378 matches for " Vesna Marjanovi? "
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Oxidative stress in patients on mechanical ventilation
MarjanoviVesna,?or?evi? Vidosava,Marjanovi? Goran
Medicinski Pregled , 2009, DOI: 10.2298/mpns0912578m
Abstract: Introduction. The appearance and intensity of oxidative stress were analyzed in the course of mechanical ventilation and parameters that could point toward potential lung damage. Material and methods. In three time intervals on day 1, 3 and 7 of mechanical ventilation, parameters such as: triglycerides, cholesterol, lactate, serum lactic dehydrogenase, acid-base balance and lipid peroxidation products - thiobarbituric acid reactive substances, were followed in 30 patients with head injuries. Results. A decrease in the level of partial oxygen pressure (PaO2) (p<0.01) and PaO2/FiO2 index (p<0.05) in arterial blood was recorded on day 3 of mechanical ventilation. This was accompanied with an increase in alveolar-arterial difference (AaDO2) (p<0.05), thiobarbituric acid reactive substances (p<0.001) and lactic dehydrogenase (p<0.001) comparing to day 1 of mechanical ventilation. The patients with initial PaO2>120 mmHg, had significant increase of thiobarbituric acid reactive substances and AaDO2 (p<0.05) and fall of PaO2 (p<0.001) on day 3 of mechanical ventilation. Conclusion. Oxidative stress and lipid peroxide production are increased during third day of mechanical ventilation leading to disruption of oxygen diffusion through alveolar-capillary membrane and reduction of parameters of oxygenation.
The incidence and risk factors of ventilator-associated pneumonia in patients with severe traumatic brain injury
MarjanoviVesna,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.
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
MarjanoviVesna,Mili?evi? Ru?ica,Marjanovi? Goran,Budi? Ivana
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.
CLINICAL PROGNOSTIC FACTORS IN PATIENTS WITH UNSPECIFIED PERIPHERAL T-CELL LYMPHOMA
Goran Marjanovi,Vesna Marjanovi,Lana Ma?ukanovi?-Golubovi?,Mladen Milenovi?
Acta Facultatis Medicae Naissensis , 2003,
Abstract: In order to asses the predictive capacity of various prognostic models in patients with Peripheral T-cell Lymphoma-Unspecified (PTCL-U), we retrospectively analyzed 36 cases fulfilling the criteria defined by the WHO classification.All patients were diagnosed and treated at the Clinic of Hematology, Clinical Center in Ni , from January 1991 until December 2003, with median follow up of 50 months.During the first 24 months of follow up, 80.55 % of the patients, with 28.5% of cumulative probability survived during the period of 5 years. The factors significantly associated with the reduced survival in multivariate analysis were: performance status (p=0.014), elevated LDH (p=0.0383), elevated sedimentation rate (ESR) (p=0.045) and complete response vs. no response vs. partial response to therapy (p=0.00395). Univariate analysis showed that age over 60 (p=0.042) adversely influenced survival. International prognostic index (IPI) was able to identify subsets of patients with different prognosis (p=0,047). Prognostic model designed especially for PTCL-U called PIT was able to identify the risk group patients (Log Rank p= 0.041350), while simplified two-class PIT proved to be superior over the simplified two class IPI. (Log Rank p=0.010973 versus p=0.041350). ILI prognostic model, designed for indolent lymphoma (Inter Gruppo Italiano Lymphoma), is not useful in aggressive lymphomas like PTCL-U. (Log Rank p=0.4).A new therapeutic strategy should be explored for high risk groups of patients identified in PIT model due to their dismal prognosis and a very low 5 year survival.
THERAPY OF FEBRILE NEUTROPENIA IN PATIENTS WITH MALIGANCY
Goran Marjanovi,Vesna Marjanovi,Mladen Milenovi?,Lana Ma?ukanovi?-Golubovi?
Acta Facultatis Medicae Naissensis , 2003,
Abstract: In the selection of the initial antibiotic regimen, one should consider the type, frequency of occurrence, and antibiotic susceptibility of bacterial isolates recovered from other patients at the same hospital. We emphasize that no specific scheme, no specific drug or combination of drugs, and no specific period of treatment can be unequivocally applied to all febrile neutropenic patients. The outpatient approach with oral antibiotics for low risk group of patients should be apllied whenever possible. Hospital tretment is mandatory for all accute leukemia patients with various initial empirical antibiotic therapy aproaches such as monotherapy, therapy consisting of 2 parenteral drugs with or without addition of vankomycine. Our expirience with accute leukemia patients favor the last combination.In this study recommendations conserning antiviral prophilaxis, duration of antibiotic therapy as well as situations when changes of regimen are necessery in casess of prolonged neutropenia with complications were rewieved.It is important to note that the guidelines are general and must be applied wisely with respect to variations in individual patients and types of infections, settings in which patients are being treated, antimicrobial susceptibility patterns, underlying causes of neutropenia, and expected time of recovery.
Diversity of nuclear short tandem repeat loci in representative sample of North-eastern Bosnian and Herzegovina population
Had?iavdi? Vesna,Marjanovi? Damir,Pojski? Naris,Had?iselimovi? Rifat
Genetika , 2012, DOI: 10.2298/gensr1203521h
Abstract: Diversity of nuclear microsatellite markers were analyzed in a reference sample of the population of northeast Bosnia and Herzegovina. 437 samples taken from unrelated individuals were processed and three samples of paternity proof were shown. Detection effectiveness profile of the research, points to a valid choice of method of extraction, amplification and genotyping short tandem repeat (STR) loci with PowerPlextm16 kit. Genetic analysis of allelic variants of the 15 STR loci PowerPlextm16 kit detected 17 samples determined as rare allelic variants or microvariants. Samples were divided into 15 different allelic variants at 7 different loci, and are: in locus D7S820, D16S539, D3S1358, D18S51, PENTA D, PENTA E and in locus vWA. Genetic analysis of mutations in cases of paternity determined three examples of single-step mutations in the loci FGA, Penta D and D3S1358. Genetic analysis of observed STR loci detected three allelic variant of genotype combination 7/10/11.3 in locus D7S820 Type II. Population genetic analysis of STR loci in a representative sample of the population of northeast Bosnia and Herzegovina included the application of the assessment tests of within-population genetic diversity and interpopulation diversity, as well as genetic differentiation between populations: North-eastern Bosnia and Herzegovina (BH) and BH general reference, then the Croatian population, Macedonian, Serbian and Slovenian. Based on the result analysis of specific forensic parameters, it can be assumed that the most informative marker is PENTA E for population genetic analysis and forensic testing in the population of northeast Bosnia and Herzegovina. Research results fit regional STR database of this part of Europe.
Free Light Chains of Immunoglobulin as a Prognostic Factor for Some Plasmaproliferative Diseases
Zoran Miju kovi , Vesna Radovi , Janko Pejovi , Ljiljana Tuki , Slobodan Marjanovi , Jelica Stojanovi
Journal of Medical Biochemistry , 2011, DOI: 10.2478/v10011-011-0017-3
Abstract: Quantitation of monoclonal immunoglobulins and their fragments is used for monitoring the plasmaproliferative disease course and the effect of therapy. The aim of free light chains examination was to evaluate the significance of the FLC ratio as a prognostic factor for remission, progression and survival in different disease groups. The concentrations of immunoglobulins and free light chains were measured by an immunonephelometric method on a SIEMENS DADE BN II analyser with reagents (Freelite, The Binding Site, UK). In this examination 151 patients from 3 different disease groups: 1. Light chain disease or Bence Jones myeloma (37), 2. Biclonal gammopathy with FLC (23) and 3. Monoclonal gammopathy of undetermined significance (91), were investigated during a period of 7 years. The reference interval for FLC ratio is 0.26-1.65. According to the International Staging System for multiple myeloma, a serum FLC ratio of <0.03 or >32 was taken as abnormal. The patients with light chain disease and biclonal gammopathy with FLC with an abnormal FLC ratio and a combination of adverse risk factors (76.7%) had median survival times of 22-30 months, versus patients with a normal or slightly varied FLC ratio without adverse risk factors (23.3%) with median survival times of 39-51 months. About 38% of patients who had shown lowered free light chains values by more than 50% under therapy, achieved disease remission in the light chain disease and biclonal gammopathy with FLC groups. In the group of patients with monoclonal gammopathy of undetermined significance, 66.0% had a normal or slightly modified FLC ratio which corresponds to low and low-intermediate risk of disease progression, as opposed to 34.0% with an abnormal FLC ratio (<0.25 or >4) which corresponds to high and high-intermediate risk. An abnormal FLC ratio in the examined groups could be an independent risk factor for progression and poorer disease prognosis.
Hyperlymphocytosis in a Patient with T-prolymphocytic Leukemia Not Responding to Therapy: Case Report
Goran Marjanovi,Vesna Nikoli?,Tomislav Vuki?evi?,Lana Ma?ukanovi? Golubovi?
Acta Facultatis Medicae Naissensis , 2011,
Abstract: A 64-year-old patient with extremely high number of white blood cells was diagnosed with T prolymphocytic leukemia. After the initiation of chemotherapy with Cyclophosphamide, Oncovin, Doxorubicin and Prednisone (CHOP), there was no improvement and the patient died within two months. Authors have made a review of the current therapy of this rare disorder of mature T-lymphocytes and discussed various therapeutic aspects of hyperlymphocytosis.
There is no solution without national strategy about truth and reconciliation
Marjanovi? Zdravko
Temida , 2004, DOI: 10.2298/tem0404051m
Abstract: The society for tolerance was set up as a peace group in 1993, which means that it has been dealing with the issue of reconciliation ever since it came into being. The two kinds of activities on the reconciliation plan have so far been the following: Fieldwork in Eastern Slavonia and Western Srem as well as in Bosnia and Herzegovina. Activities in the local communities. Current activities include the implementation of the agreement on cross-border cooperation of the local authorities, entrepreneurs and the civil sector of four countries: Hungary, Croatia, Bosnia and Herzegovina and Serbia and Montenegro. As we believe that the problem is not only related to the truth (the precondition for reconciliation) during the latest wars, but that those roots are far deeper, our plans are to activate our long-standing project of the Social club, through the "House for multiculturalism and regional cooperation" that we formed by signing an agreement with some NGO-s in Croatia and Hungary. The project includes encounters of the citizens primarily of the children and of the young, in order to openly discuss issues related to their everyday lives, one of the most important being reconciliation. In this process, we also perceive the process of rehabilitation through dispersing stereotypes that were created as a consequence of the long-existing absence of confrontation with the truth.
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