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95 results on '"Bumbaširević Vesna"'

1. Sepsis and septic shock - recognize early, act fast, treat right

Author

Bumbaširević Vesna, Stanisavljević Jovana, Veličković Jelena, Hadžibegović Adi, Milenković Marija, and Ivančević Nenad

Subjects
sepsis, septic shock, surviving sepsis campaign, sepsis bundle, Medicine
Abstract

Sepsis is a medical emergency and therefore requires early identification and immediate management, which is not a matter of hours, but minutes. Since the first definition in 1991, sepsis remains a major challenge for clinicians and scientists. Despite significant advances in technology and therapy, mortality and cost of treatment are unacceptably high. Septic shock is the leading cause of mortality in critically ill patients. Cognitive impairment and functional disability were observed after survivors’ long-term follow-up. Since its foundation in 2002, Surviving Sepsis Campaign aims to implement global strategies and to raise awareness of the challenges associated with sepsis. The implementation of guidelines and sepsis care bundles resulted in significant decrease in mortality. Hospital mortality is lower in hospitals with high versus low bundle compliance. Still, epidemiological data for sepsis are missing for low- and middleincome countries.

Published
2020
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2. Evaluation of independent predictors of in-hospital mortality in patients with severe trauma

Author

Milenković Marija, Terzioski Zaneta, Hadžibegović Adi, Stanisavljević Jovana, Petrović Ksenija, Nikolić Jovanka, Mihajlovska Mirjana, and Bumbaširević Vesna

Subjects
injury, Rapid Emergency Medicine Score, cohort study, Medicine
Abstract

Introduction/Objective. The aim of this study was to determine independent predictors and the best trauma scoring system (REMS, RTS, GSC, SOFA, APPACHE II) of in-hospital mortality in patients with severe trauma at the Department of Emergency, Emergency Center, Clinical Center of Serbia, Belgrade. Methods. Longitudinal study included 208 consecutive patients with severe trauma. In order to determine independent survival contributors, univariate and multivariate Cox regression analyses were performed. The power of above-mentioned scoring systems (measured at admission to the Emergency center) to predict mortality was compared using the area under the curve (AUC). Results. There were 208 patients (159 male, 49 female), with the average age of 47.3 ± 20.7 years. Majority of patients were initially intubated (86.1%) on admission to the emergency department, and 59.6% patients were sedated before intubation. After finishing of diagnostic procedures, 17 patients were additionally intubated, and, at that time, 94.2% patients were on mechanic ventilation. The majority of patients was traumatized in a car crash (33.2%), followed by falls from height (26.4%) and as pedestrians (22.6%). Patients had an average of 24.7 ± 21.2 days spent in intensive care unit. The overall case-fatality ratio was 17/208 (8.2%). In Cox regression analysis only elevated heart rate (HR = 1.03, p = 0.012) and decreased arterial oxygen saturation (SpO2) (HR = 0.91, p = 0.033) singled out as independent contributors to in-hospital mortality of patients with severe trauma. REMS (AUC 0.72 ± 0.64) and SOFA (AUC 0.716 ± 0.067) scores were found fair and similar predictor of in-hospital mortality, while APACHE II (AUC 0.614 ± 0.062) and RTS (0.396 ± 0.068) were poor predictors. Conclusion. Results of this study showed an important role of REMS, which appears to provide balance between the predictive ability and the practical application, and components of REMS in prediction of outcome in patients with severe trauma and that HR and SpO2 are independent predictors of in-hospital mortality.

Published
2019
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3. Prognostic value of presepsin (soluble CD14-subtype) in diagnosis of ventilator-associated pneumonia and sepsis in trauma patients

Author

Jovanović Bojan, Đurić Olivera, Marković-Denić Ljiljana, Isaković Aleksandra, Doklestić Krstina, Stanković Sanja, Vidičević Sašenka, Palibrk Ivan, Samardžić Janko, and Bumbaširević Vesna

Subjects
presepsin protein, human, pneumonia, ventilator associated, sepsis, shock septic, biomarkers, sensitivity and specificity, diagnosis, Medicine (General), R5-920
Abstract

Background/Aim. Presepsin (soluble CD14-subtype) is a fragment of CD14 produced in response to bacterial infections and a novel biomarker of pneumonia, sepsis and septic shock. The aim of this study was to compare sensitivity and specificity of persepsin, soluble CD14-subtype (sCD14-ST) with other biomarkers: procalcitonine (PCT), C-reactive protein (CRP) and leukocyte count (Le) in mechanically ventilated injured patients, as a marker of pneumonia, sepsis and septic shock. Methods. The prospective study was undertaken in trauma and surgery intensive care unit of the Emergency Center, the Clinical Center of Serbia from January to April 2013. The study included 39 trauma patients requiring mechanical ventilation, and who developed one of the following inclusion criteria: Systemic Inflammatory Response Syndrome (SIRS), ventilator associated pneumonia (VAP), sepsis and/or septic shock. On admission Acute Physiology and Chronic Health Evaluation II (APACHE II) Score and Injury Severity Score (ISS) were calculated. Seventy-two measurements of four biomarkers (presepsin, PCT, CRP and Le) were performed in 39 patients at the moments of diagnosis of SIRS, VAP, sepsis and/or septic shock (21 when SIRS diagnosis was established, 21 after the diagnosis of VAP, 18 at the moment of diagnosis of sepsis and the remaining 12 measurements were conducted while diagnosing the septic shock). The Sequential Organ Failure Assessment (SOFA) score was calculated at these points as well. Results. Patients were mainly severely injured (mean ISS = 24.2) and had moderately severe medical condition at admission (mean Apache II score, 14.5). Presepsin concentration significantly differed among all the four groups, except between sepsis and septic shock. The strongest positive correlation of presepsin evinced with PCT (r = 0.741, p < 0.001). The sCD14-ST indicated better performance in diagnosis of both VAP (AUC = 0.909) and sepsis (AUC = 0.899), compared to PCT (AUCs: 0.863, 0.885, respectively), CRP (AUCs: 0.703, 0.677, respectively) and Le (AUCs: 0.668, 0.700, respectively). Conclusion. This study revealed that sCD14-ST is a reliable biomarker for distinguishing sepsis severity. It also showed a good correlation with the infection development as well as worsening in injured patients. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no.175046]

Published
2018
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4. Outcome among patients suffering from in-hospital cardiac arrest

Author

Trpković Sladjana, Pavlović Aleksandar, Bumbaširević Vesna, Sekulić Ana, and Miličić Biljana

Subjects
in-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, advanced life support, Medicine
Abstract

Introduction. In relation to pre-hospital treatment of patients with cardiac arrest (CA) in the field where resuscitation is often started by nonprofessionals, resuscitation in hospital is most commonly performed by well-trained personnel. Objective. The aim was to define the factors associated with an improved outcome among patients suffering from the inhospital CA (IHCA). Methods. The prospective study included a total of 100 patients in the Emergency Center over two-year period. The patterns by the Utstein-Style guidelines recorded the following: age, sex, reason for hospital admission, comorbidity, cause and origin of CA, continuous monitoring, time of arrival of the medical emergency team and time of delivery of the first defibrillation shock (DC). Results. Most patients (61%) had cardiac etiology. Return of spontaneous circulation (ROSC) was achieved in 58% of patients. ROSC was more frequently achieved in younger patients (57.69±11.37), (p

Published
2014
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5. Spontaneous rupture of giant liver hemangioma: Case report

Author

Doklestić Krstina, Stefanović Branislav, Karamarković Aleksandar, Bumbaširević Vesna, Stefanović Branislava, Gregorić Pavle, Radenković Dejan, and Bajec Đorđe

Subjects
liver hemangioma, spontaneous rupture, hemoperitoneum, Medicine
Abstract

Introduction. Hemangioma is the most frequent benign solid tumor of the liver. It is well known that a giant liver hemangioma carries the risk of spontaneous rupture, followed by hemoperitoneum and hemorrhagic shock with possible fatal outcome. Case Outline. This is a case report of the spontaneous rupture of a giant cavernous hemangioma of the liver in an 85-year old patient. The patient was presented with abdominal pain and hemorrhagic shock. Emergency ultrasonography and computed tomography of the abdomen showed a heterogeneous ruptured solid tumor of the right liver lobe, multiple cysts in the left lobe and massive hemoperitoneum. The patient was successfully managed by immediate exploratory laparotomy, surgical enucleation of the hemangioma under intermittent inflow vascular occlusion, temporary perihepatic packing and planned second look relaparotomy. Conclusion. Immediate surgical procedure is indicated mandatory in unstable patients with a ruptured giant hemangioma of the liver. Surgical enucleation under intermittent inflow vascular occlusion and temporary perihepatic packing could be a life-saving procedure in those patients.

Published
2013
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6. Bleeding in trauma: Current diagnostic and therapeutic approach

Author

Karamarković Aleksandar R., Doklestić Krstina S., Bumbaširević Vesna, Detanac Dženana A., Detanac Džemail S., and Bracanović Miloš

Subjects
trauma, shock, exsanguinations, coagulopathy, damage control, Medicine (General), R5-920
Abstract

Recognising shock due to haemorrhage in trauma patients is about constructing a synthesis of trauma mechanism, injuries, vital signs and the therapeutic response of the patient. The treatment of bleeding patients who have exsanguinating injuries is aimed at two major goals: stopping the bleeding and restoration of the blood volume with correct coagulation. Abdominal ultrasound has replaced diagnostic peritoneal lavage for detection of haemoperitoneum. With the development of multi-sliding computer tomography, rapid evaluation by CT-scanning of the trauma patient is possible during resuscitation. The concept of damage control surgery with 'blind' transfusion or 'damage control resuscitation' in treatment of severe trauma, has proven to be of vital importance in the treatment of exsanguinating trauma patients and is adopted worldwide. Pharmacotherapeutic interventions may be a promising concept to limit blood loss after trauma. The role of thromboelastography as point-of-care test for coagulation in massive blood loss is emerging, providing information about actual clot formation and clot stability, shortly after the blood sample is taken.

Published
2011

7. Mucinous appendiceal adenocarcinoma as a rare cause of ileus: A case report

Author

Doklestić Krstina S, Bumbaširević Vesna, Detanac Džemail, Detanac Dženana, and Karamarković Aleksandar R

Subjects
appendicular neoplasm, mucinous adenocarcinoma, bowel obstruction, Medicine (General), R5-920
Abstract

Although appendiceal tumours are rare, they may be encountered unexpectedly in any emergency abdominal operation. Many of these tumours are not recognized intraoperatively and are diagnosed only during formal histopathological analysis of an appendectomy specimen. We present a rare case of appendiceal adenocarcinoma which caused acute bowel ob struction. The patient presented with abdominal pain, distension and constipation. Abdominal radiography showed large bowel obstruction. On laparotomy the appendix was abnormal, with a tumor growing in to the ileal loop and creating a bowel obstruction. An appendectomy was performed with enbloc bowel segment resection and end ileostomy. Pathology specimens showed that the primary neoplasm was the appendiceal mucinous adenocarcinoma infiltrating the ileal loop. Patient underwent a right hemicolectomy, and recovered afterwards with no evidence of local recurrence or metastatic disease as confirmed by the standard follow-up. Physicians should keep in their minds that appendiceal neoplasm may have various and nonspecific presentations, but only an accurate diagnosis will lead to correct patients treatment, healing and long-term survival.

Published
2011

8. Postoperative cognitive deficits

Author

Kalezić Nevena, Dimitrijević Ivan, Leposavić Ljubica, Kočica Mladen, Bumbaširević Vesna, Vučetić Čedomir, Paunović Ivan, Slavković Nemanja, and Filimonović Jelena

Subjects
postoperative, cognitive dysfunction, behavioral change, restlessness, delirium, Medicine
Abstract

Cognitive dysfunctions are relatively common in postoperative and critically ill patients. This complication not only compromises recovery after surgery, but, if persistent, it minimizes and compromises surgery itself. Risk factors of postoperative cognitive disorders can be divided into age and comorbidity dependent, and those related to anesthesia and surgery. Cardiovascular, orthopedic and urologic surgery carries high risk of postoperative cognitive dysfunction. It can also occur in other types of surgical treatment, especially in elderly. Among risk factors of cognitive disorders, associated with comorbidity, underlying psychiatric and neurological disorders, substance abuse and conditions with elevation of intracranial pressure are in the first place in postoperative patients. Preoperative and perioperative predisposing conditions for cognitive dysfunction and their incidence were described in our paper. These are: geriatric patients, patients with substance abuse, preexisting psychiatric or cognitive disorders, neurologic disease with high intracranial pressure, cerebrovascular insufficiency, epilepsia, preeclampsia, acute intermittent porphyria, operation type, brain hypoxia, changes in blood glucose level, electrolyte imbalance, anesthetic agents, adjuvant medication and intraoperative awareness. For each of these factors, evaluation, prevention and treatment strategies were suggested, with special regard on anesthetic technique.

Published
2006
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9. Relation of pathoanatomic substrate and incidence of bacterial infection in the acute biliary pathology

Author

Karamarković Aleksandar R., Popović Nada, Bajec Đorđe, Jeremić Vasilije, Đukić Vladimir, Radenković Dejan, Bumbaširević Vesna, and Gregorić Pavle

Subjects
bacteriobilia, acute biliary pathology, biliary infection, Medicine
Abstract

Acute biliary diseases have become the most common indication for major abdominal surgery. We investigated 60 patients who underwent surgery for the acute biliary diseases, within 48 hours from the onset of the illness (group I), and over longer preoperative interval (48 h up to 5 days) (group II). Surgical specimen (gallbladder) was histologically examined. Samples for microbiological exams were obtained from gallbladder, common bile duct, Lund's node, gallbladder bed and peritoneal cavity. Positive bile cultures were found in 43% of group I, and in 70% of group II (p

Published
2005
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10. The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft, a study of 18 cases

Author

Bumbaširević Marko, Tomić Slavko, Lešić Aleksandar, Bumbaširević Vesna, Rakočević Zoran, and Atkinson Henry D

Subjects
Scaphoid nonunion, Ilizarov circular frame, without bone graft, Orthopedic surgery, RD701-811, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Objectives Evaluating the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. Design A retrospective review of 18 consecutive patients in one centre. Patients and Methods 18 patients; 17 males; 1 female, with a mean SNU duration of 13.9 months. Patients with carpal instability, humpback deformity, carpal collapse, avascular necrosis or marked degenerative change, were excluded. Following frame application the treatment consisted of three stages: the frame was distracted 1 mm per day until radiographs showed a 2-3 mm opening at the SNU site (mean 10 days); the SNU site was then compressed for 5 days, at a rate of 1 mm per day, with the wrist in 15 degrees of flexion and 15 degrees of radial deviation; the third stage involved immobilization with the Ilizarov fixator for 6 weeks. The technique is detailed herein. Results Radiographic (CT) and clinical bony union was achieved in all 18 patients after a mean of 89 days (70-130 days). Mean modified Mayo wrist scores improved from 21 to 86 at a mean follow-up of 37 months (24-72 months), with good/excellent results in 14 patients. All patients returned to their pre-injury occupations and levels of activity at a mean of 117 days. Three patients suffered superficial K-wire infections, which resolved with oral antibiotics. Conclusions In these selected patients this technique safely achieved bony union without the need to open the SNU site and without the use of bone graft.

Published
2011
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11. Validation and utility of ARDS subphenotypes identified by machine-learning models using clinical data: an observational, multicohort, retrospective analysis

Author

Rios, Fernando, Van Haren, Frank, Sottiaux, T, Lora, Fredy S, Azevedo, Luciano C, Depuydt, P, Fan, Eddy, Bugedo, Guillermo, Qiu, Haibo, Gonzalez, Marcos, Silesky, Juan, Cerny, Vladimir, Nielsen, Jonas, Jibaja, Manuel, Pham, Tài, Wrigge, Hermann, Matamis, Dimitrios, Ranero, Jorge Luis, Hashemian, S. M, Amin, Pravin, Clarkson, Kevin, Bellani, Giacomo, Kurahashi, Kiyoyasu, Villagomez, Asisclo, Zeggwagh, Amine Ali, Heunks, Leo M, Laake, Jon Henrik, Palo, Jose Emmanuel, do Vale Fernandes, Antero, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Nin, Nicolas, Lorente, Jose A, Larsson, Anders, Piquilloud, Lise, Abroug, Fekri, McAuley, Daniel F, McNamee, Lia, Hurtado, Javier, Bajwa, Ed, Démpaire, Gabriel, Francois, Guy M, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, Insaurralde, Carolina S, Alejandro, Risso V, Daldin, Julio, Vinzio, Mauricio, Fernandez, Ruben O, Cardonnet, Luis P, Bettini, Lisandro R, Bisso, Mariano Carboni, Osman, Emilio M, Setten, Mariano G, Lovazzano, Pablo, Alvarez, Javier, Villar, Veronica, Milstein, Cesar, Pozo, Norberto C, Grubissich, Nicolas, Plotnikow, Gustavo A, Vasquez, Daniela N, Ilutovich, Santiago, Tiribelli, Norberto, Chena, Ariel, Pellegrini, Carlos A, Saenz, María G, Estenssoro, Elisa, Brizuela, Matias, Gianinetto, Hernan, Gomez, Pablo E, Cerrato, Valeria I, Bezzi, Marco G, Borello, Silvina A, Loiacono, Flavia A, Fernandez, Adriana M, Knowles, Serena, Reynolds, Claire, Inskip, Deborah M, Miller, Jennene J, Kong, Jing, Whitehead, Christina, Bihari, Shailesh, Seven, Aylin, Krstevski, Amanda, Rodgers, Helen J, Millar, Rebecca T, Mckenna, Toni E, Bailey, Irene M, Hanlon, Gabrielle C, Aneman, Anders, Lynch, Joan M, Azad, Raman, Neal, John, Woods, Paul W, Roberts, Brigit L, Kol, Mark R, Wong, Helen S, Riss, Katharina C, Staudinger, Thomas, Wittebole, Xavier, Berghe, Caroline, Bulpa, Pierre A, Dive, Alain M, Verstraete, Rik, Lebbinck, Herve, Depuydt, Pieter, Vermassen, Joris, Meersseman, Philippe, Ceunen, Helga, Rosa, Jonas I, Beraldo, Daniel O, Piras, Claudio, Ampinelli, Adenilton M R, Nassar Jr, Antonio P, Mataloun, Sergio, Moock, Marcelo, Thompson, Marlus M, Gonçalves, Claudio H, Antônio, Ana Carolina P, Ascoli, Aline, Biondi, Rodrigo S, Fontenele, Danielle C, Nobrega, Danielle, Sales, Vanessa M, Shindhe, Suresh, Ismail, Dk Maizatul Aiman B Pg Hj, Laffey, John, Beloncle, Francois, Davies, Kyle G, Cirone, Rob, Manoharan, Venika, Ismail, Mehvish, Goligher, Ewan C, Jassal, Mandeep, Nishikawa, Erin, Javeed, Areej, Curley, Gerard, Rittayamai, Nuttapol, Parotto, Matteo, Ferguson, Niall D, Mehta, Sangeeta, Knoll, Jenny, Pronovost, Antoine, Canestrini, Sergio, Bruhn, Alejandro R, Garcia, Patricio H, Aliaga, Felipe A, Farías, Pamela A, Yumha, Jacob S, Ortiz, Claudia A, Salas, Javier E, Saez, Alejandro A, Vega, Luis D, Labarca, Eduardo F, Martinez, Felipe T, Carreño, Nicolás G, Lora, Pilar, Liu, Haitao, Liu, Ling, Tang, Rui, Luo, Xiaoming, An, Youzhong, Zhao, Huiying, Gao, Yan, Zhai, Zhe, Ye, Zheng L, Wang, Wei, Li, Wenwen, Li, Qingdong, Zheng, Ruiqiang, Yu, Wenkui, Shen, Juanhong, Li, Xinyu, Yu, Tao, Lu, Weihua, Wu, Ya Q, Huang, Xiao B, He, Zhenyang, Lu, Yuanhua, Han, Hui, Zhang, Fan, Sun, Renhua, Wang, Hua X, Qin, Shu H, Zhu, Bao H, Zhao, Jun, Liu, Jian, Li, Bin, Liu, Jing L, Zhou, Fa C, Li, Qiong J, Zhang, Xing Y, Li-Xin, Zhou, Xin-Hua, Qiang, Jiang, Liangyan, Gao, Yuan N, Zhao, Xian Y, Li, Yuan Y, Li, Xiao L, Wang, Chunting, Yao, Qingchun, Yu, Rongguo, Chen, Kai, Shao, Huanzhang, Qin, Bingyu, Huang, Qing Q, Zhu, Wei H, Hang, Ai Y, Hua, Ma X, Li, Yimin, Xu, Yonghao, Di, Yu D, Ling, Long L, Qin, Tie H, Wang, Shou H, Qin, Junping, Han, Yi, Zhou, Suming, Vargas, Monica P, Silesky Jimenez, Juan I, González Rojas, Manuel A, Solis-Quesada, Jaime E, Ramirez-Alfaro, Christian M, Máca, Jan, Sklienka, Peter, Gjedsted, Jakob, Christiansen, Aage, Villamagua, Boris G, Llano, Miguel, Burtin, Philippe, Buzancais, Gautier, Beuret, Pascal, Pelletier, Nicolas, Mortaza, Satar, Mercat, Alain, Chelly, Jonathan, Jochmans, Sébastien, Terzi, Nicolas, Daubin, Cédric, Carteaux, Guillaume, de Prost, Nicolas, Chiche, Jean-Daniel, Daviaud, Fabrice, Pham, Tai, Fartoukh, Muriel, Barberet, Guillaume, Biehler, Jerome, Dellamonica, Jean, Doyen, Denis, Arnal, Jean-Michel, Briquet, Anais, Hraiech, Sami, Papazian, Laurent, Follin, Arnaud, Roux, Damien, Messika, Jonathan, Kalaitzis, Evangelos, Dangers, Laurence, Combes, Alain, Au, Siu-Ming, Béduneau, Gaetan, Carpentier, Dorothée, Zogheib, Elie H, Dupont, Herve, Ricome, Sylvie, Santoli, Francesco L, Besset, Sebastien L, Michel, Philippe, Gelée, Bruno, Danin, Pierre-Eric, Goubaux, Bernard, Crova, Philippe J, Phan, Nga T, Berkelmans, Frantz, Badie, Julio C, Tapponnier, Romain, Gally, Josette, Khebbeb, Samy, Herbrecht, Jean-Etienne, Schneider, Francis, Declercq, Pierre-Louis M, Rigaud, Jean-Philippe, Duranteau, Jacques, Harrois, Anatole, Chabanne, Russell, Marin, Julien, Bigot, Charlene, Thibault, Sandrine, Ghazi, Mohammed, Boukhazna, Messabi, Ould Zein, Salem, Richecoeur, Jack R, Combaux, Daniele M, Grelon, Fabien, Le Moal, Charlene, Sauvadet, Elise P, Robine, Adrien, Lemiale, Virginie, Reuter, Danielle, Dres, Martin, Demoule, Alexandre, Goldgran-Toledano, Dany, Baboi, Loredana, Guérin, Claude, Lohner, Ralph, Kraßler, Jens, Schäfer, Susanne, Zacharowski, Kai D, Meybohm, Patrick, Reske, Andreas W, Simon, Philipp, Hopf, Hans-Bernd F, Schuetz, Michael, Baltus, Thomas, Papanikolaou, Metaxia N, Papavasilopoulou, Theonymfi G, Zacharas, Giannis A, Ourailogloy, Vasilis, Mouloudi, Eleni K, Massa, Eleni V, Nagy, Eva O, Stamou, Electra E, Kiourtzieva, Ellada V, Oikonomou, Marina A, Avila, Luis E, Cortez, Cesar A, Citalán, Johanna E, Jog, Sameer A, Sable, Safal D, Shah, Bhagyesh, Gurjar, Mohan, Baronia, Arvind K, Memon, Mohammedfaruk, Muthuchellappan, Radhakrishnan, Ramesh, Venkatapura J, Shenoy, Anitha, Unnikrishnan, Ramesh, Dixit, Subhal B, Rhayakar, Rachana V, Ramakrishnan, Nagarajan, Bhardwaj, Vallish K, Mahto, Heera L, Sagar, Sudha V, Palaniswamy, Vijayanand, Ganesan, Deeban, Mohammadreza Hashemian, Seyed, Jamaati, Hamidreza, Heidari, Farshad, Meaney, Edel A, Nichol, Alistair, Knapman, Karl M, O'Croinin, Donall, Dunne, Eimhin S, Breen, Dorothy M, Clarkson, Kevin P, Jaafar, Rola F, Dwyer, Rory, Amir, Fahd, Ajetunmobi, Olaitan O, O'Muircheartaigh, Aogan C, Black, Colin S, Treanor, Nuala, Collins, Daniel V, Altaf, Wahid, Zani, Gianluca, Fusari, Maurizio, Spadaro, Savino, Volta, Carlo A, Graziani, Romano, Brunettini, Barbara, Palmese, Salvatore, Formenti, Paolo, Umbrello, Michele, Lombardo, Andrea, Pecci, Elisabetta, Botteri, Marco, Savioli, Monica, Protti, Alessandro, Mattei, Alessia, Schiavoni, Lorenzo, Tinnirello, Andrea, Todeschini, Manuel, Giarratano, Antonino, Cortegiani, Andrea, Sher, Sara, Rossi, Anna, Antonelli, Massimo M, Montini, Luca M, Casalena, Paolo, Scafetti, Sergio, Panarello, Giovanna, Occhipinti, Giovanna, Patroniti, Nicolò, Pozzi, Matteo, Biscione, Roberto R, Poli, Michela M, Raimondi, Ferdinando, Albiero, Daniela, Crapelli, Giulia, Beck, Eduardo, Pota, Vincenzo, Schiavone, Vincenzo, Molin, Alexandre, Tarantino, Fabio, Monti, Giacomo, Frati, Elena, Mirabella, Lucia, Cinnella, Gilda, Fossali, Tommaso, Colombo, Riccardo, Terragni, Pierpaolo, Pattarino, Ilaria, Mojoli, Francesco, Braschi, Antonio, Borotto, Erika E, Cracchiolo, Andrea N, Palma, Daniela M, Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettore R, Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, Iotti, Giorgio A, Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, Maeyama, Hiroki N, Watanabe, Eizo, Yamaji, Yoshihiro, Shimizu, Kazuyoshi, Shiozaki, Kyoko, Futami, Satoru, Ryosuke, Sekine, Saito, Koji, Kameyama, Yoshinobu, Ueno, Keiko, Izawa, Masayo, Okuda, Nao, Suzuki, Hiroyuki, Harasawa, Tomofumi, Nasu, Michitaka, Takada, Tadaaki, Ito, Fumihito, Nunomiya, Shin, Koyama, Kansuke, Abe, Toshikazu, Andoh, Kohkichi, Kusumoto, Kohei, Hirata, Akira, Takaba, Akihiro, Kimura, Hiroyasu, Matsumoto, Shuhei, Higashijima, Ushio, Honda, Hiroyuki, Aoki, Nobumasa, Imai, Hiroshi, Ogino, Yasuaki, Mizuguchi, Ichiko, Ichikado, Kazuya, Nitta, Kenichi, Mochizuki, Katsunori, Hashida, Tomoaki, Tanaka, Hiroyuki, Nakamura, Tomoyuki, Niimi, Daisuke, Ueda, Takeshi, Kashiwa, Yozo, Uchiyama, Akinori, Sabelnikovs, Olegs, Oss, Peteris, Haddad, Youssef, Liew, Kong Y, Ñamendys-Silva, Silvio A, Jarquin-Badiola, Yves D, Sanchez-Hurtado, Luis A, Gomez-Flores, Saira S, Marin, Maria C, Villagomez, Asisclo J, Lemus, Jordana S, Fierro, Jonathan M, Cervantes, Mavy Ramirez, Mejia, Francisco Javier Flores, Gonzalez, Daniel R, Dector, Dulce M, Estrella, Claudia R, Sanchez-Medina, Jorge R, Ramirez-Gutierrez, Alvaro, George, Fernando G, Aguirre, Janet S, Buensuseso, Juan A, Poblano, Manuel, Dendane, Tarek, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, Bruns, Monique M, Schouten, Jeroen A, Rinia, Myra, Raaijmakers, Monique, Van Wezel, Hellen M, Heines, Serge J, Buise, Marc P, Simonis, Fabienne D, Schultz, Marcus J, Goodson, Jennifer C, rowne, Troy S B, Navarra, Leanlove, Hunt, Anna, Hutchison, Robyn A, Bailey, Mathew B, Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Danielle J, Andersen, Finn H, Dolva, Merete S, Laake, Jon H, Barratt-Due, Andreas, Noremark, Kim Andre L, Søreide, Eldar, Sjøbø, Brit Å, Guttormsen, Anne B, Yoshido, Hector H Leon, Aguilar, Ronald Zumaran, Oscanoa, Fredy A Montes, Alisasis, Alain U, Robles, Joanne B, Pasanting-Lim, Rossini Abbie B, Tan, Beatriz C, Andruszkiewicz, Pawel, Jakubowska, Karina, Cox, Cristina M, Alvarez, António M, Oliveira, Bruno S, Montanha, Gustavo M, Barros, Nelson C, Pereira, Carlos S, Messias, António M, Monteiro, Jorge M, Araujo, Ana M, Catorze, Nuno T, Marum, Susan M, Bouw, Maria J, Gomes, Rui M, Brito, Vania A, Castro, Silvia, Estilita, Joana M, Barros, Filipa M, Serra, Isabel M, Martinho, Aurelia M, Tomescu, Dana R, Marcu, Alexandra, Bedreag, Ovidiu H, Papurica, Marius, Corneci, Dan E, Negoita, Silvius Ioan, Grigoriev, Evgeny, Gritsan, Alexey I, Gazenkampf, Andrey A, Almekhlafi, Ghaleb, Albarrak, Mohamad M, Mustafa, Ghanem M, Maghrabi, Khalid A, Salahuddin, Nawal, Aisa, Tharwat M, Al Jabbary, Ahmed S, Tabhan, 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2022
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14. Geo-economic variations in epidemiology, patterns of care, and outcomes in patients with acute respiratory distress syndrome: insights from the LUNG SAFE prospective cohort study

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Laffey, John G., Bellani, Giacomo, Pham, Tai, Fan, Eddy, Brochard, Laurent, Pesenti, Antonio, Esteban, Andres, Gattinoni, Luciano, van Haren, Frank, Larsson, Anders, McAuley, Daniel F., Ranieri, Marco, Rubenfeld, Gordon, Thompson, B Taylor, Wrigge, Hermann, Slutsky, Arthur S., Rios, Fernando, Sottiaux, Thierry, Depuydt, Pieter, Lora, Fredy S, Azevedo, Luciano C, Bugedo, Guillermo, Qiu, Haibo, Gonzalez, Marcos, Silesky, Juan, Cerny, Vladimir, Nielsen, Jonas, Jibaja, Manuel, Matamis, Dimitrios, Ranero, Jorge L., Amin, Pravin, Hashemian, S.M., Clarkson, Kevin, Kurahashi, Kiyoyasu, Villagomez, Asisclo, Zeggwagh, Amine Ali, Heunks, Leo M, Laake, Jon Henrik, Palo, Jose Emmanuel, Fernandes, Antero do Vale, Sandesc, Dorel, Arabi, Yaasen, Bumbasierevic, Vesna, Nin, Nicolas, Lorente, Jose A., Piquilloud, Lise, Abroug, Fekri, McNamee, Lia, Hurtado, Javier, Bajwa, Ed, Démpaire, Gabriel, Sula, Hektor, Nunci, Lordian, Cani, Alma, Zazu, Alan, Dellera, Christian, Alejandro, Risso V, Daldin, Julio, Fernandez, Ruben O, Cardonnet, Luis P, Bettini, Lisandro R., Bisso, Mariano Carboni, Osman, Emilio M., Setten, Mariano G., Lovazzano, Pablo, Alvarez, Javier, Villar, Veronica, Pozo, Norberto C., Grubissich, Nicolas, Plotnikow, Gustavo A., Vasquez, Daniela N., Ilutovich, Santiago, Tiribelli, Norberto, Chena, Ariel, Pellegrini, Carlos A., Saenz, María G., Estenssoro, Elisa, Brizuela, Matias, Gianinetto, Hernan, Gomez, Pablo E., Cerrato, Valeria I., Bezzi, Marco G., Borello, Silvina A., Loiacono, Flavia A., Fernandez, Adriana M., Knowles, Serena, Reynolds, Claire, Inskip, Deborah M., Miller, Jennene J, Kong, Jing, Whitehead, Christina, Bihari, Shailesh, Seven, Aylin, Krstevski, Amanda, Rodgers, Helen, Millar, Rebecca, Mckenna, Toni, Bailey, Irene, Hanlon, Gabrielle, Aneman, Anders, Lynch, Joan, Azad, Raman, Neal, John, Woods, Paul, Roberts, Brigit, Kol, Mark, Wong, Helen, Riss, Katharina, Staudinger, Thomas, Wittebole, Xavier, Berghe, Caroline, Bulpa, Pierre, Dive, Alain, Verstraete, Rik, Lebbinck, Herve, Vermassen, Joris, Meersseman, Philippe, Ceunen, Helga, Rosa, Jonas, Beraldo, Daniel, Piras, Claudio, Rampinelli, Adenilton, Nassar, Antonio, Mataloun, Sergio, Moock, Marcelo, Thompson, Marlus, Gonçalves, Claudio, Antônio, Ana, Ascoli, Aline, Biondi, Rodrigo, Fontenele, Danielle, Nobrega, Danielle, Sales, Vanessa, Shindhe, Suresh, Ismail, Dk, Beloncle, Francois, Davies, Kyle, Cirone, Rob, Manoharan, Venika, Ismail, Mehvish, Goligher, Ewan, Jassal, Mandeep, Nishikawa, Erin, Javeed, Areej, Curley, Gerard, Rittayamai, Nuttapol, Parotto, Matteo, Ferguson, Niall, Mehta, Sangeeta, Knoll, Jenny, Pronovost, Antoine, Canestrini, Sergio, Bruhn, Alejandro, Garcia, Patricio, Aliaga, Felipe, Farías, Pamela, Yumha, Jacob, Ortiz, Claudia, Salas, Javier, Saez, Alejandro, Vega, Luis, Labarca, Eduardo, Martinez, Felipe, Carreño, Nicolás, Lora, Pilar, Liu, Haitao, Liu, Ling, Tang, Rui, Luo, Xiaoming, An, Youzhong, Zhao, Huiying, Gao, Yan, Zhai, Zhe, Ye, Zheng, Wang, Wei, Li, Wenwen, Li, Qingdong, Zheng, Ruiqiang, Yu, Wenkui, Shen, Juanhong, Li, Xinyu, Yu, Tao, Lu, Weihua, Wu, Ya, Huang, Xiao, He, Zhenyang, Lu, Yuanhua, Han, Hui, Zhang, Fan, Sun, Renhua, Wang, Hua, Qin, Shu, Zhu, Bao, Zhao, Jun, Liu, Jian, Li, Bin, Liu, Jing, Zhou, Fa, Li, Qiong, Zhang, Xing, Li-Xin, Zhou, Xin-Hua, Qiang, Jiang, Liangyan, Gao, Yuan, Zhao, Xian, Li, Yuan, Li, Xiao, Wang, Chunting, Yao, Qingchun, Yu, Rongguo, Chen, Kai, Shao, Huanzhang, Qin, Bingyu, Huang, Qing, Zhu, Wei, Hang, Ai, Hua, Ma, Li, Yimin, Xu, Yonghao, Di, Yu, Ling, Long, Qin, Tie, Wang, Shou, Qin, Junping, Han, Yi, Zhou, Suming, Vargas, Monica, Jimenez, Juan, Rojas, Manuel, Solis-Quesada, Jaime, Ramirez-Alfaro, Christian, Máca, Jan, Sklienka, Peter, Gjedsted, Jakob, Christiansen, Aage, Villamagua, Boris, Llano, Miguel, Burtin, Philippe, Buzancais, Gautier, Beuret, Pascal, Pelletier, Nicolas, Mortaza, Satar, Mercat, Alain, Chelly, Jonathan, Jochmans, Sébastien, Terzi, Nicolas, Daubin, Cédric, Carteaux, Guillaume, de Prost, Nicolas, Chiche, Jean-Daniel, Daviaud, Fabrice, Fartoukh, Muriel, Barberet, Guillaume, Biehler, Jerome, Dellamonica, Jean, Doyen, Denis, Arnal, Jean-Michel, Briquet, Anais, Hraiech, Sami, Papazian, Laurent, Roux, Damien, Messika, Jonathan, Kalaitzis, Evangelos, Dangers, Laurence, Combes, Alain, Au, Siu-Ming, Béduneau, Gaetan, Carpentier, Dorothée, Zogheib, Elie, Dupont, Herve, Ricome, Sylvie, Santoli, Francesco, Besset, Sebastien, Michel, Philippe, Gelée, Bruno, Danin, Pierre-Eric, Goubaux, Bernard, Crova, Philippe, Phan, Nga, Berkelmans, Frantz, Badie, Julio, Tapponnier, Romain, Gally, Josette, Khebbeb, Samy, Herbrecht, Jean-Etienne, Schneider, Francis, Declercq, Pierre-Louis, Rigaud, Jean-Philippe, Duranteau, Jacques, Harrois, Anatole, Chabanne, Russell, Marin, Julien, Bigot, Charlene, Thibault, Sandrine, Ghazi, Mohammed, Boukhazna, Messabi, Zein, Salem, Richecoeur, Jack, Combaux, Daniele, Grelon, Fabien, Le Moal, Charlene, Sauvadet, Elise, Robine, Adrien, Lemiale, Virginie, Reuter, Danielle, Dres, Martin, Demoule, Alexandre, Goldgran-Toledano, Dany, Baboi, Loredana, Guérin, Claude, Lohner, Ralph, Kraßler, Jens, Schäfer, Susanne, Zacharowski, Kai, Meybohm, Patrick, Reske, Andreas, Simon, Philipp, Hopf, Hans-Bernd, Schuetz, Michael, Baltus, Thomas, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Zacharas, Giannis, Ourailogloy, Vasilis, Mouloudi, Eleni, Massa, Eleni, Nagy, Eva, Stamou, Electra, Kiourtzieva, Ellada, Oikonomou, Marina, Avila, Luis, Cortez, Cesar, Citalán, Johanna, Jog, Sameer, Sable, Safal, Shah, Bhagyesh, Gurjar, Mohan, Baronia, Arvind, Memon, Mohammedfaruk, Muthuchellappan, Radhakrishnan, Ramesh, Venkatapura, Shenoy, Anitha, Unnikrishnan, Ramesh, Dixit, Subhal, Rhayakar, Rachana, Ramakrishnan, Nagarajan, Bhardwaj, Vallish, Mahto, Heera, Sagar, Sudha, Palaniswamy, Vijayanand, Ganesan, Deeban, Hashemian, Seyed, Jamaati, Hamidreza, Heidari, Farshad, Meaney, Edel, Nichol, Alistair, Knapman, Karl, O'Croinin, Donall, Dunne, Eimhin, Breen, Dorothy, Jaafar, Rola, Dwyer, Rory, Amir, Fahd, Ajetunmobi, Olaitan, O'Muircheartaigh, Aogan, Black, Colin, Treanor, Nuala, Collins, Daniel, Altaf, Wahid, Zani, Gianluca, Fusari, Maurizio, Spadaro, Savino, Volta, Carlo, Graziani, Romano, Brunettini, Barbara, Palmese, Salvatore, Formenti, Paolo, Umbrello, Michele, Lombardo, Andrea, Pecci, Elisabetta, Botteri, Marc, Savioli, Monica, Protti, Alessandro, Mattei, Alessia, Schiavoni, Lorenzo, Tinnirello, Andrea, Todeschini, Manuel, Giarratano, Antonino, Cortegiani, Andrea, Sher, Sara, Rossi, Anna, Antonelli, Massimo, Montini, Luca, Casalena, Paolo, Scafetti, Sergio, Panarello, Giovanna, Occhipinti, Giovanna, Patroniti, Nicolò, Pozzi, Matteo, Biscione, Roberto, Poli, Michela, Raimondi, Ferdinando, Albiero, Daniela, Crapelli, Giulia, Beck, Eduardo, Pota, Vincenzo, Schiavone, Vincenzo, Molin, Alexandre, Tarantino, Fabio, Monti, Giacomo, Frati, Elena, Mirabella, Lucia, Cinnella, Gilda, Fossali, Tommaso, Colombo, Riccardo, Terragni, Pierpaolo, Pattarino, Ilaria, Mojoli, Francesco, Braschi, Antonio, Borotto, Erika, Cracchiolo, Andrea, Palma, Daniela, Raponi, Francesco, Foti, Giuseppe, Vascotto, Ettore, Coppadoro, Andrea, Brazzi, Luca, Floris, Leda, Iotti, Giorgio, Venti, Aaron, Yamaguchi, Osamu, Takagi, Shunsuke, Maeyama, Hiroki, Watanabe, Eizo, Yamaji, Yoshihiro, Shimizu, Kazuyoshi, Shiozaki, Kyoko, Futami, Satoru, Ryosuke, Sekine, Saito, Koji, Kameyama, Yoshinobu, Ueno, Keiko, Izawa, Masayo, Okuda, Nao, Suzuki, Hiroyuki, Harasawa, Tomofumi, Nasu, Michitaka, Takada, Tadaaki, Ito, Fumihito, Nunomiya, Shin, Koyama, Kansuke, Abe, Toshikazu, Andoh, Kohkichi, Kusumoto, Kohei, Hirata, Akira, Takaba, Akihiro, Kimura, Hiroyasu, Matsumoto, Shuhei, Higashijima, Ushio, Honda, Hiroyuki, Aoki, Nobumasa, Imai, Hiroshi, Ogino, Yasuaki, Mizuguchi, Ichiko, Ichikado, Kazuya, Nitta, Kenichi, Mochizuki, Katsunori, Hashida, Tomoaki, Tanaka, Hiroyuki, Nakamura, Tomoyuki, Niimi, Daisuke, Ueda, Takeshi, Kashiwa, Yozo, Uchiyama, Akinori, Sabelnikovs, Olegs, Oss, Peteris, Haddad, Youssef, Liew, Kong, Ñamendys-Silva, Silvio, Jarquin-Badiola, Yves, Sanchez-Hurtado, Luis, Gomez-Flores, Saira, Marin, Maria, Lemus, Jordana, Fierro, Jonathan, Cervantes, Mavy, Mejia, Francisco, Dector, Dulce M., Gonzalez, Daniel, Estrella, Claudia, Sanchez-Medina, Jorge, Ramirez-Gutierrez, Alvaro, George, Fernando, Aguirre, Janet, Buensuseso, Juan, Poblano, Manuel, Dendane, Tarek, Zeggwagh, Amine, Balkhi, Hicham, Elkhayari, Mina, Samkaoui, Nacer, Ezzouine, Hanane, Benslama, Abdellatif, Amor, Mourad, Maazouzi, Wajdi, Cimic, Nedim, Beck, Oliver, Bruns, Monique, Schouten, Jeroen, Rinia, Myra, Raaijmakers, Monique, Heunks, Leo, Van Wezel, Hellen, Heines, Serge, Strauch, Ulrich, Simonis, Fabienne, Goodson, Jennifer, Browne, Troy, Navarra, Leanlove, Hunt, Anna, Hutchison, Robyn, Bailey, Mathew, Newby, Lynette, Mcarthur, Colin, Kalkoff, Michael, Mcleod, Alex, Casement, Jonathan, Hacking, Danielle, Andersen, Finn, Dolva, Merete, Laake, Jon, Barratt-Due, Andreas, Noremark, Kim, Søreide, Eldar, Sjøbø, Brit, Guttormsen, Anne, Yoshido, Hector, Aguilar, Ronald, Oscanoa, Fredy, Alisasis, Alain, Robles, Joanne, Pasanting-Lim, Rossini, Tan, Beatriz, Andruszkiewicz, Pawel, Jakubowska, Karina, Coxo, Cristina, Alvarez, António, Oliveira, Bruno, Montanha, Gustavo, Barros, Nelson, Pereira, Carlos, Messias, António, Monteiro, Jorge, Araujo, Ana, Catorze, Nuno, Marum, Susan, Bouw, Maria, Gomes, Rui, Brito, Vania, Castro, Silvia, Estilita, Joana, Barros, Filipa, Serra, Isabel, Martinho, Aurelia, Tomescu, Dana, Marcu, Alexandra, Bedreag, Ovidiu, Papurica, Marius, Corneci, Dan, Negoita, Silvius, Grigoriev, Evgeny, Gritsan, Alexey, Gazenkampf, Andrey, Almekhlafi, Ghaleb, Albarrak, Mohamad, Mustafa, Ghanem, Maghrabi, Khalid, Salahuddin, Nawal, Aisa, Tharwat, Al Jabbary, Ahmed, Tabhan, Edgardo, Arabi, Yaseen, Trinidad, Olivia, Al Dorzi, Hasan, Bolon, Stefan, Smith, Oliver, Mancebo, Jordi, Aguirre-Bermeo, Hernan, Lopez-Delgado, Juan, Esteve, Francisco, Rialp, Gemma, Forteza, Catalina, De Haro, Candelaria, Albaiceta, Guillermo, De Cima-Iglesias, Sara, Seoane-Quiroga, Leticia, Ceniceros-Barros, Alexandra, Ruiz-Aguilar, Antonio, Claraco-Vega, Luis, Soler, Juan, del Carmen Lorente, Maria, Hermosa, Cecilia, Gordo, Federico, Prieto-González, Miryam, López-Messa, Juan, Perez, Manuel, Perez, Cesar, Allue, Raquel, Roche-Campo, Ferran, Ibañez-Santacruz, Marcos, Temprano, Susana, Pintado, Maria, De Pablo, Raul, Gómez, Pilar, Ruiz, Silvia, Moles, Silvia, Jurado, Teresa, Arizmendi, Alfons, Piacentini, Enrique, Franco, Nieves, Honrubia, Teresa, Cheng, Meisy, Losada, Elena, Blanco, Javier, Yuste, Luis, Carbayo-Gorriz, Cecilia, Cazorla-Barranquero, Francisca, Alonso, Javier, Alda, Rosa, Algaba, Ángela, Navarro, Gonzalo, Cereijo, Enrique, Diaz-Rodriguez, Esther, Marcos, Diego, Montero, Laura, Para, Luis, Sanchez, Roberto, Navalpotro, Miguel, Abad, Ricardo, González, Raquel, Toribio, Dácil, Castro, Alejandro, Artiga, Maria, Penuelas, Oscar, Roser, Tomas, Olga, Moreno, Curto, Elena, Sánchez, Rocío, Imma, Vallverdu, Elisabet, Garcia, Claverias, Laura, Magret, Monica, Pellicer, Ana, Rodriguez, Lucia, Sánchez-Ballesteros, Jesús, González-Salamanca, Ángela, Jimenez, Antonio, Huerta, Francisco, Diaz, Juan, Lopez, Esther, Moya, David, Alfonso, Alec, Luis, Palazon, Cesar, Palazon, Rafael, Sánchez, Virgilio, Corcoles, Recio, Noelia, Adamsson, Richard, Rylander, Christian, Holzgraefe, Bernhard, Broman, Lars, Wessbergh, Joanna, Persson, Linnea, Schiöler, Fredrik, Kedelv, Hans, Tibblin, Anna, Appelberg, Henrik, Hedlund, Lars, Helleberg, Johan, Eriksson, Karin, Glietsch, Rita, Larsson, Niklas, Nygren, Ingela, Nunes, Silvia, Morin, Anna-Karin, Kander, Thomas, Adolfsson, Anne, Zender, Hervé, Leemann-Refondini, Corinne, Elatrous, Souheil, Bouchoucha, Slaheddine, Chouchene, Imed, Ouanes, Islem, Souissi, Asma, Kamoun, Salma, Demirkiran, Oktay, Aker, Mustafa, Erbabacan, Emre, Ceylan, Ilkay, Girgin, Nermin, Ozcelik, Menekse, Ünal, Necmettin, Meco, Basak, Akyol, Onat, Derman, Suleyman, Kennedy, Barry, Parhar, Ken, Srinivasa, Latha, McAuley, Danny, Hopkins, Phil, Mellis, Clare, Kakar, Vivek, Hadfield, Dan, Vercueil, Andre, Bhowmick, Kaushik, Humphreys, Sally, Ferguson, Andrew, Mckee, Raymond, Raj, Ashok, Fawkes, Danielle, Watt, Philip, Twohey, Linda, Jha, Rajeev, Thomas, Matthew, Morton, Alex, Kadaba, Varsha, Smith, Mark, Hormis, Anil, Kannan, Santhana, Namih, Miriam, Reschreiter, Henrik, Camsooksai, Julie, Kumar, Alek, Rugonfalvi, Szabolcs, Nutt, Christopher, O'Neill, Orla, Seasman, Colette, Dempsey, Ged, Scott, Christopher, Ellis, Helen, MckKechnie, Stuart, Hutton, Paula, Di Tomasso, Nora, Vitale, Michela, Griffin, Ruth, Dean, Michael, Cranshaw, Julius, Willett, Emma, Ioannou, Nicholas, Gillis, Sarah, Csabi, Peter, Macfadyen, Rosaleen, Dawson, Heidi, Preez, Pieter, Williams, Alexandra, Boyd, Owen, De Gordoa, Laura, Bramall, Jon, Symmonds, Sophie, Chau, Simon, Wenham, Tim, Szakmany, Tamas, Toth-Tarsoly, Piroska, McCalman, Katie, Alexander, Peter, Stephenson, Lorraine, Collyer, Thomas, Chapman, Rhiannon, Cooper, Raphael, Allan, Russell, Sim, Malcolm, Wrathall, David, Irvine, Donald, Zantua, Kim, Adams, John, Burtenshaw, Andrew, Sellors, Gareth, Welters, Ingeborg, Williams, Karen, Hessell, Robert, Oldroyd, Matthew, Battle, Ceri, Pillai, Suresh, Kajtor, Istvan, Sivashanmugavel, Mageswaran, O'Kane, Sinead, Donnelly, Adrian, Frigyik, Aniko, Careless, Jon, May, Martin, Stewart, Richard, Trinder, T. John, Hagan, Samantha, Wise, Matt, Cole, Jade, MacFie, Caroline, Dowling, Anna, Nin, Nicolás, Nuñez, Edgardo, Pittini, Gustavo, Rodriguez, Ruben, Imperio, María, Santos, Cristina, França, Ana, Ebeid, Alejandro, Deicas, Alberto, Serra, Carolina, Uppalapati, Aditya, Kamel, Ghassan, Banner-Goodspeed, Valerie, Beitler, Jeremy, Mukkera, Satyanarayana, Kulkarni, Shreedhar, Lee, Jarone, Mesar, Tomaz, Shinn, John, Gomaa, Dina, Tainter, Christopher, Yeatts, Dale, Warren, Jessica, Lanspa, Michael, Miller, Russel, Grissom, Colin, Brown, Samuel, Bauer, Philippe, Gosselin, Ryan, Kitch, Barrett, Cohen, Jason, Beegle, Scott, Gueret, Renaud, Tulaimat, Aiman, Choudry, Shazia, Stigler, William, Batra, Hitesh, Huff, Nidhi, Lamb, Keith, Oetting, Trevor, Mohr, Nicholas, Judy, Claine, Saito, Shigeki, Kheir, Fayez, Schlichting, Adam, Delsing, Angela, Crouch, Daniel, Elmasri, Mary, Ismail, Dina, Dreyer, Kyle, Blakeman, Thomas, Baron, Rebecca, Grijalba, Carolina, Hou, Peter, Seethala, Raghu, Aisiku, Imo, Henderson, Galen, Hou, Sen-Kuang, Owens, Robert, Schomer, Ashley, Bumbasirevic, Vesna, Jovanovic, Bojan, Surbatovic, Maja, Veljovic, Milic, Laffey, John G, Madotto, Fabiana, Pham, Tài, Bajwa, Ednan K, Lorente, Jose A, Jiménez, Juan Ignacio Silesky, McAuley, Daniel F, and Slutsky, Arthur S

Published
2017
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21. The association of early postoperative lactate levels with morbidity after elective major abdominal surgery

Author

Velicković, Jelena, Velicković, Jelena, Palibrk, Ivan, Miličić, Biljana, Velicković, Dejan, Jovanović, Bojan, Rakić, Goran, Petrović, Milorad, Bumbaširević, Vesna, Velicković, Jelena, Velicković, Jelena, Palibrk, Ivan, Miličić, Biljana, Velicković, Dejan, Jovanović, Bojan, Rakić, Goran, Petrović, Milorad, and Bumbaširević, Vesna

Abstract

Lactate levels are widely used as an indicator of outcome in critically ill patients. We investigated the prognostic value of postoperative lactate levels for postoperative complications (POCs), mortality and length of hospital stay after elective major abdominal surgery. A total of 195 patients were prospectively evaluated. Lactate levels were assessed on admission to the intensive care unit (ICU) [L-0], at 4 hours (L-4), 12 hours (L-12), and 24 hours (L-24) after the operation. Demographic and perioperative clinical data were collected. Patients were monitored for complications until discharge or death. Receiver operating characteristic (ROC) curves were used to determine the predictive value of lactate levels for postoperative outcomes. The best cut-off lactate values were calculated to differentiate between patients with and without complications, and outcomes in patients with lactate levels above and below the cut-off thresholds were compared. Univariate and multivariate analyses were used to identify variables associated with POCs and mortality. Seventy-six patients developed 184 complications (18 deaths), while 119 had no complications. Serum lactate levels were higher in patients with complications at all time points compared to those without complications (p lt 0.001). L-12 had the highest predictive value for complications (AUROC(12) = 0.787; 95% CI: 0.719-0.854; p lt 0.001) and mortality (AUROC(12) = 0.872; 95% CI: 0.794-0.950;p lt 0.00l). The best L-12 cut-off value for complications and mortality was 1.35 mmol/l and 1.85 mmol/l, respectively. Multivariate analysis revealed that L-1(2) >= 1.35 mml/l was an independent predictor of postoperative morbidity (OR 2.58; 95% CI 1.27-5.24,p = 0.001) . L-24 was predictive of POCs after major abdominal surgery. L-12 had the best power to discriminate between patients with and without POCs and was associated with a longer hospital stay.

Published
2019

22. Ispitivanje prognostičkih faktora za ishod lečenja bolesnika sa teškom traumom

Author

Bumbaširević, Vesna, Ivančević, Nenad, Šijački, Ana, Jovanović, Bojan, Ranđelović, Tomislav, Milenković, Marija, Bumbaširević, Vesna, Ivančević, Nenad, Šijački, Ana, Jovanović, Bojan, Ranđelović, Tomislav, and Milenković, Marija

Abstract

Cilj ove studije bio je određivanje nezavisnih prediktora i najboljeg trauma skoring sistema (REMS, RTS, GSC, SOFA, APPACHE II) intrahospitalnog mortaliteta kod pacijenata sa teškom traumom, lečenih u Urgentnom centru Kliničkog centra Srbije u Beogradu. Materijal i metode: Longitudinalna studija je uključila 208 konsekutivnih pacijenata sa teškom traumom, primljenih u Urgentni centar Kliničkog centra Srbije u Beogradu. U cilju određivanja nezavisnih prediktora preživljavanja, urađene su univarijantna i multivarijantna Koksova regresiona analiza. Takođe, uticaj sistema skorovanja ranije pomenutih skorova na prijemu u Urgentni centar (UC) u predikciji mortaliteta poređen je korišćenjem AUC (Area under curve) testom. Rezultati: Ispitivani uzorak činilo je 208 pacijenata (159 muškaraca, 49 žena), prosečnog uzrasta 47,3±20,7 godina. Većina pacijenata bila je inicijalno intubirana (86,1%), na prijemu u UC, a 59,6% pacijenata bilo je sedirano pre intubacije. Posle završetka dijagnostičkih procedura, 17 pacijenata je dodatno intubirano, tako da je na mehaničkoj ventilaciji bilo 94,2% pacijenata. Pacijenti su najčešći povređivani u saobraćajnim nesrećama (33,2%), prilikom pada sa visine (26,4%) i kao pešaci (22,6%). Prosečna dužina boravka u jedinici intenzivne nege iznosila je 24,7±21,2 dana. Letalitet je bio 17/208 (8,2%). Koksovom regresionom analizom pokazano je da su povišena srčana frekvenca (HR=1,03, p=0,012) i snižena saturacija krvi kiseonikom (HR=0,91, p=0,033) nezavisni prediktori smrtnog ishoda pacijenata sa teškom traumom...

Published
2019

23. Epidemiološke karakteristike, klinički faktori rizika i značaj genskih polimorfizama za nastanak posttraumatske sepse

Author

Marković-Denić, Ljiljana, Bumbaširević, Vesna, Milaković, Branko, Palibrk, Ivan, Medić, Deana, Đurić, Olivera, Marković-Denić, Ljiljana, Bumbaširević, Vesna, Milaković, Branko, Palibrk, Ivan, Medić, Deana, and Đurić, Olivera

Abstract

Trauma predstavlja vodeći uzrok smrti u grupi pacijenata do 40 godina. Sepsa je jedna od najčešćih i najznačajnijih infektivnih komplikacija u toku lečenja teško povređenih pacijenata. Definiše se kao životno-ugrožavajuće stanje sa insuficijencijom organa uzrokovano neadekvatnim odgovorom domaćina na infekciju. Imuno-inflamatorni odgovor u traumi i sepsi umnogome je determinisan genetskom predispozicijom za modulisanje i alteraciju proinflamatornih i antiinflamatornih procesa. Polimorfizmi pojedinačnih nukleotida (PPN) su najčešći tip genskih polimorfizama i predstavljaju normalnu varijaciju u naslednoj osnovi. Polimorfizmi gena za proinflamatorni citokin TNFA, TNF-β, kao i receptore slične Toll-u 2 i 4 (TLR2 i TLR4) i njihova povezanost sa sepsom nisu bili predmet dosadašnjih istraživanja u populaciji traumatizovanih pacijenata u našoj zemlji. Cilj studije bila je procena epidemioloških karakteristika infekcija krvi i sepse kod pacijenata sa traumom lečenih u jedinicama intenzivnog lečenja (JIL). Procenjeni su incidencija, ishodi lečenja, uzročnici infekcija krvi (IK) i sepse i njihova antimikrobna rezistencija, izvori infekcije kod sepse i uticaj IK na ishod i preživljavanje kod sepse, kao i faktori rizika za nastanak IK i sepse. Drugi cilj studije bila je procena genetičkih faktora rizika za nastanak sepse, odnosno distibucija PPN gena TNFA, LTA, TLR2 i TLR4 kod pacijenata sa sepsom, pacijenta bez sepse i zdravih pripadnika kontrolne grupe, kao i asocijacija ovih PPN sa nastankom sepse. Pored toga procenjen je doprinos kliničkih i genetskih faktora rizika u predikciji sepse nakon traume. Sprovedena je prospektivna kohortna studija u koju je uključeno 406 odraslih pacijenata sa srednje teškom i teškom traumom hopitalizovanih duže od 48h u JIL Urgentnog centra Kliničkog centra Srbije u periodu od 01.11.2014. do 30.04.2016. godine. Na prijemu su procenjeni brojni klinički paramteri i uzeta je krv za molekularno-genetičku analizu. Primarni ishodi su bili IK i sepsa

Published
2019

24. The predictive performance of the POSSUM scoring system and early indicatosrs of peripheral perfusion for complications after major abdominal surgery

Author

Bumbaširević, Vesna, Palibrk, Ivan, Simić, Aleksandar P., Jovanović, Bojan, Grasselli, Giacomo, Veličković, Jelena, Bumbaširević, Vesna, Palibrk, Ivan, Simić, Aleksandar P., Jovanović, Bojan, Grasselli, Giacomo, and Veličković, Jelena

Abstract

Postoperative complications are the major cause of postoperative morbidity and mortality and remain to be a serious burden for a healthcare system. The early identification of patients at risk may play a pivotal role in rational decisions regarding perioperative management. The aim of this study was to explore the characteristics of complications in high-risk patients after major abdominal surgery. We also assessed and compared the accuracy of the Clavien-Dindo classification (CDC) and the Comprehensive Complication Index (CCI) for evaluation of postoperative morbidity and the predictive performance of the POSSUM scoring system for complications and mortality. Finally, we wanted to explore the significance of early indicators of altered peripheral perfusion after major abdominal surgery for the occurrence of severe complications. A prospective, observational, cohort study included 206 high-risk surgical patients undergoing major abdominal surgery at the Clinic for Digestive Surgery, Clinical Center of Serbia, from November 2016 to October 2017. We found that the complication rate in our cohort was 60.7% and that the occurrence of complications was associated with the longer ICU stay (p<0.001), postoperative length of stay (p<0.001) and lower functional activity at hospital discharge (p<0.001). The CCI was shown to be of superior accuracy in high-risk patients with multiple complications compared to the CDC as it demonstrated a higher correlation to the resource utilization indicators (p<0.001). The POSSUM scoring system showed the sub-optimal performance for prediction of morbidity and mortality in this cohort of patients (AUCmorbidity= 0.708, O:E ratio=1.07; AUCmortality= 0.744, O:E ratio=0.38). We found that the alterations of peripheral perfusion early after the operation were more pronounced in patients who developed more severe complications. Capillary refill time, central-to-peripheral temperature gradient, and venoarterial pCO2 difference to arteriovenous O2, Postoperativne komplikacije su vodeći uzrok postoperativnog morbiditeta i mortaliteta i predstavljaju značajno opterećenje za zdravstveni sistem u celini. Rana identifikacija bolesnika sa povećanim rizikom može imati ključnu ulogu u donošenju racionalnih odluka u vezi sa perioperativnim lečenjem. Cilj ove studije bio je da ispita karakteristike komplikacija kod visokorizičnih bolesnika nakon velike abdominalne hirurgije. Takođe smo procenili i uporedili preciznost Clavien-Dindo klasifikacije (CDC) i Comprehensive Complication Index-a (CCI) za evaluaciju postoperativnog morbiditeta i ispitali prediktivne karakteristike POSSUM skora za komplikacije i mortalitet. Konačno, analizirali smo značaj ranih pokazatelja periferne perfuzije za pojavu teških komplikacija nakon velike abdominalne hirurgije. Prospektivna, opservaciona, kohortna studija pratila je 206 visokorizičnih bolesnika podvrgnutih velikoj abdominalnoj operaciji na Klinici za digestivnu hirurgiju Kliničkog centra Srbije, od novembra 2016 do oktobra 2017.godine. Pokazali smo da je učestalost komplikacija u našoj kohorti bila 60.7% i da je pojava komplikacija bila udružena sa dužim boravkom u jedinici intenzivnog lečenja (JIL) (p< 0.001), dužom postoperativnom hospitalizacijom (p<0.001) i nižim funkcionalnim kapacitetom na otpustu iz bolnice (p<0.001). Takođe je prikazano da je CCI prikladnija skala za visokorizične bolesnike sa udruženim komplikacijama u poređenju sa CDC jer je ispoljila jaču korelaciju sa parametrima hospitalizacije (p<0.001). POSSUM skor je pokazao suboptimalne karakteristike u predviđanju rizika za morbiditet i mortalitet u ovoj kohorti bolesnika (AUCmorbiditet = 0.708, O:E odnos = 1.07; AUCmortalitet = 0.744, O:E odnos =0.38). Poremećaj periferne perfizije rano nakon operacije bio je izraženiji kod onih bolesnika kod kojih su se razvile teže komplikacije. Kao nezavisni prediktori teških komplikacija su se izdvojili vreme kapilarnog punjenja, centralno-periferni gradijent temperature i odno

Published
2019

26. Procena stepena stresa kod dece nakon laparoskopske apendektomije u različitim vrstama anestezije

Author

Drašković, Biljana, Bumbaširević, Vesna, Radovanović, Dragana, Uram-Benka, Anna, Vicković, Sanja, Bukarica, Svetlana, Fabri, Izabella, Drašković, Biljana, Bumbaširević, Vesna, Radovanović, Dragana, Uram-Benka, Anna, Vicković, Sanja, Bukarica, Svetlana, and Fabri, Izabella

Abstract

Uvod:Apendicitis je oboljenje, koje se najčešće javlja u dečjem uzrastu. Poslednjih godina se laparoskopska apendektomija sprovodi sve češće u ovom uzrastu, međutim ne postoji jasan konsenzus o optimalnom izboru anestetika za održavanje opšte anestezije u toku ove hirurške metode u dečjem uzrastu. Cilj istraživanja: Utvrditi uticaj vrste anestezije i vrste hirurške procedure na odgovor organizma na hirurški stres tokom operacije crvuljka. Metodologija: Klinički prospektivno istraživanje je sprovedeno na Klinici za dečiju hirurgiju, na Institutu za zdravstvenu zaštitu dece i omladine Vojvodine. Istraživanjem je obuhvaćeno 120 dece, uzrasta od 7 do 17 godina, bez postojećih komorbiditeta, koji su operisani zbog zapaljenja crvuljka. U zavisnosti od vrste operativnog zahvata i vrste primenjene anestezije deca su podeljena u četiri grupe bolesnika. Kod sve četiri ispitivane grupe uzimana je venska i kapilarna krv, nekoliko minuta nakon uvoda u anesteziju, u momentu vađenja crvuljka iz trbuha i 12 časova nakon kraja hirurške intervencije. Laboratorijski su određeni markeri oksidativnog stresa (TBARS), metaboličkog odgovora na hirurški stres (laktat, glikemija), inflamatornog odgovora organizma (IL-6, leukociti), gasne analize, parametri oksigenacije i ventilacije, i hemodinamski parametri ispitanika. Rezultati:U istraživanju je dobijen rezultat da je zapaljenje crvuljka oboljenje koje se češće javlja kod dečaka. Tokom apendektomije u dečjem uzrastu, sevofluran je bolje kontrolisao arterijsku tenziju, dok na srčanu frekvencu vrsta anestezije nije imala uticaja. Sevofluran je anestetik tokom čije primene je manji inflamatorni odgovor tokom laparoskospske apendektomije. Propofol deluje suprimirajuće na oksidativni stres, ali nije nađena statistička značajnost u odnosu na vrednosti dobijene analizom uticaja sevoflurana na parametre oksidativnog stresa. Zaključak: Laparoskopska apendektomija u odnosu na laparotomiju nije praćena većim stepenom hirurškog stresa, a sevofluran je, Introduction: Appendicitis is a disease which appears most commonly in children. In recent years appendectomy in children is performed by laparoscopy, but there is no consensus yet on the optimal choice of anesthetics during general anesthesia for this procedure. Aim: To determine the influence of type of anesthesia and type of surgical procedure for appendectomy, on surgical stress in children. Methodology: A prospective clinical trial in Clinic of pediatric surgery in Novi Sad, Vojvodina. The study included 120 children aged from 7 to 17 years, with no commorbidities, who underwent appendectomy. Children were divided in four groups based on the type of anesthesia and type of surgery they received. In all participants, venous and capillary blood was sampled for analyzis 10 minutes after induction of anesthesia, at the moment of appendix removal and 12 hours after the procedure. The laboratory analysis included markers of oxidative stress (TBARS), metabolic response to surgical stress (lactate, blood glucose), inflammatory response (IL-6, leucocites), bloodgas analyses, parameters of oxygentation and ventilation and haemodynamic parameters of the participants. Results: In the study appendicitis was more common in boys. During laparoscopic appendectomy sevoflurane controlled better the blood pressure, but not the heart rate. Sevoflurane maintained a better control of parameters of the inflammatory response. Propofol decreased the oxidative stress, but there was no statistical difference compared to the effects of sevoflurane on oxidative stress. Conclusion: Laparoscopic appendectomy shoved no difference in the level of surgical stress compared to laparotomy, and sevoflurane appeared as an anaesthetic which had a better control of the metabolic, clinical and inflammatory response.

Published
2016

27. Faktori rizika za nastanak pneumonija povezanih sa mehaničkom ventilacijom u jedinicama intenzivnog lečenja

Author

Bumbaširević, Vesna, Marković-Denić, Ljiljana, Milaković, Branko, Maksimović, Nataša, Drašković, Biljana, Jovanović, Bojan, Bumbaširević, Vesna, Marković-Denić, Ljiljana, Milaković, Branko, Maksimović, Nataša, Drašković, Biljana, and Jovanović, Bojan

Abstract

Pneumonije povezane sa mehaničkom ventilacijom predstavljaju jednu od najčešćih formi intrahospitalnih infekcija u jedinicama intenzivnog lečenja. Ciljevi ove disertacije su bili da se sagledaju faktori rizika vezani za karakteristike pacijenta kao i za karakteristike i stanje na prijemu koji su od značaja za pojavu pneumonija povezanih sa mehaničkom ventilacijom. Takođe je cilj bio da se sagleda incidencija multirezistentnih sojeva patogena u bolničkim uslovima kao i efikasnost empirijske antibiotske terapije. Praćeno je 363 pacijenata koji su lečeni u Urgentnom centru Kliničkog Centra Srbije, u dve jedinice intenzivnog lečenja i koji su zahtevali mehaničku ventilaciju duže od 48 sati u periodu od 1.1.2013. do 31.12.2014. godine. Ispitivan je uticaj demografskih karakteristika, uzroka hospitalizacije i pratećih bolesti, kao i karakteristika pacijenata na prijemu u jedinice intenzivnog lečenja. Nezavisni prediktori za nastanak pneumonija povezanih sa mehaničkom ventilacijm prema multivarijantnoj regresionoj analizi su: primena masivne transfuzije na prijemu, koma, GKS manjeg od 8 i veći APACHE II skor. Pacijenti koji su razvili pneumoniju duže su boravili na mehaničkoj ventilaciji i imali su duži boravak u jedinicama intenzivnog lečenja. Intrahospitalni mortalitet je bio u ovoj grupi značajno veći kao i mortalitet 28 dana. U multivarijantnoj logističko regresionoj analizi faktor rizika za nastanak prošireno rezistentnih bakterija kao uzročnika VAP-a izdvaja se neadekvatna empirijska antibiotska terapija. Gram negativne bakterije bili su najčešće izolovani patogeni. Na osnovu rezultata ove disertacije predlaže se uvođenje protokola i mera kojima bi se delovalo na preventibilne faktore rizika radi redukcije incidencije pneumonija povezanih sa mehaničkom ventilacijom sa ciljem sprečavanja komplikacija i samanjenje mortaliteta kod traumatizovanih pacijenata u jedinicama intenzivnog lečenja., Ventilator associated pneumonia are most common intrahospital infections in intensive care units. The aims of this dissertation were to examine the patient-related caracteristics, as well as admission caracteristics and their influence on ventilator associated pneumonia incidence. We also studied multidrug resistant pathogens incidence and initial empiric antimicrobal therapy. There were 363 patients treated in Emergency center of Clinical centre of Serbia in two intensive care units requiring mechanical ventilation more than 48 hours in the period between 1.1.2013-31.12.2014. On admission sociodemographic data, cause for hospitalization and concomitant diseases as well as patients caracteristics due to trauma were evaluated. According to multivariate regression analysis independent predictors for ventilator associated pneumonia were: massive transfusion, coma, high value of APACHE II score on admissin. Patients who developed ventilator associated pneumonia spent more days on mechanical ventilation and in intensive care unit and their mortality was higher. Our results show the importance of guidelines and preventive measures reducing incidence of ventilator associated pneumonia, especially in early phase of treatment. We aslo shown that there are no difference in isolated pathogens between early and late form of ventilator associated pneumonia.

Published
2016

28. Dijagnostički i prognostički značaj markera disfunkcije endotela i poremećaja mehanizma hemostaze u sepsi

Author

Drašković, Biljana, Brkić, Snežana, Bumbaširević, Vesna, Šurbatović, Maja, Turkulov, Vesna, Mitić, Gorana, Vicković, Sanja, Mihajlović, Dunja, Drašković, Biljana, Brkić, Snežana, Bumbaširević, Vesna, Šurbatović, Maja, Turkulov, Vesna, Mitić, Gorana, Vicković, Sanja, and Mihajlović, Dunja

Abstract

Uvod: Sepsa je jedan od vodećih uzroka smrtnosti u jedinicama intenzivnog lečenja i van njih uprkos implementaciji novih dijagnostičkih i terapijskih protokola širom sveta. Multiorganska disfunkcija (MODS), koja predstavlja najtežu formu nepovoljnog toka sepse, je u osnovi svojih patofizioloških dešavanja obeležena promenama, koje se dešavaju na nivou kapilara, pre svega u endotelu. Poremećaji koagulacije koji se javljaju kao posledica ovih promena u endotelu su prepoznati kao jedan od dijagnostičkih kriterijuma prema najnovijim smernicama za dijagnostiku i lečenje sepse, međutim njihov značaj u predviđanju toka i ishoda ovog oboljenja još uvek nije precizno definisan. Cilj istraživanja: Odrediti koncentraciju markera endotelne aktivacije, aktivacije koagulacije, aktivnost prirodnih inhibitora koagulacije i funkcionalnost fibrinolize kod obolelih od sepse u odnosu na njihove vrednosti u zdravoj populaciji. Ispitati mogućnost upotrebe markera endotelne disfunkcije i pokazatelja poremećaja mehanizma hemostaze za postavljanje dijagnoze sepse i predikciju pojave komplikacija. Ispitati mogućnost upotrebe markera endotelne disfunkcije i pokazatelja poremećaja mehanizma hemostaze za procenu ishoda kod obolelih od sepse. Materijal i metode: Istraživanje je sprovedeno analitičkom metodom u formi studije preseka, a obuhvatilo je pacijente lečene na Odeljenju anestezije i reanimacije Urgentnog centra Kliničkog centra Vojvodine i na Klinici za infektivne bolesti Kliničkog centra Vojvodine, u Novom Sadu. Istraživanje je sprovođeno tokom 2012. i 2013. godine u trajanju od dve godine. U studiju je bilo uključeno 180 ispitanika od kojih je 150 imalo postavljenu dijagnozu sepse,a 30 ispitanika su činili kontrolnu grupu su klinički i biohemijski zdravih ispitanika, dobrovoljni davaoci krvi. Ispitanici su kategorisani u četiri grupe u odnosu na kliničko stanje i laboratorijske nalaze unutar prvih 24 časa od prijema: bolesnici sa sepsom, teškom sepsom, septičkim šokom i multiorganskom, Introduction: Sepsis is one of the main causes of death in intensive care units and other hospital wards in spite of implementation of new sepsis treatment guidelines in everyday hospital practice worldwide. Changes that occur in the microvasculature, affecting primarily endothelial cell, are the basis of the pathophysiology of multiorgan dysfunction (MODS) in sepsis. Coagulation abnormalities which occur as a consequence of endothelial changes are recognized as diagnostic criteria for sepsis, but significance of these changes in the outcome prognosis and prediction of the course of sepsis is still not accurately defined. Aims: Evaluation of hemostasis related parameters and endothelial activation biomarkers values in patients with sepsis and healthy volunteers. Determination whether the levels of hemostasis-related parameters and biomarkers of endothelial activation have diagnostic significance and are they associated with MODS development and persistence in the first 48 hours of hospitalization and 28-day mortality in patients with sepsis. Material and methods: This is cross-sectional study conducted in 2012 and 2013 in the Department of Anesthesia and Reanimation at the Emergency Center of the Clinical Center of Vojvodina and in the Clinic of Infectious Disease at the Clinical Center of Vojvodina. 150 patients who fulfilled criteria for diagnosis of sepsis were included in the study. Patients were divided into 4 groups: sepsis, severe sepsis, septic shock and MODS. 30 healthy volunteers, blood donors were the control group. After the categorization of patients, during the first 24 hours of hospitalization, predictive APACHE II and SOFA scores were calculated. Hemostasis related parameters and endothelial activation biomarkers concentrations were determined within the first 24 hours of the onset of the disease. To assess the development of complication of the disease, patients were monitored for 48 hours for MODS development and persistence or resolution and for 2

Published
2015

29. Surgical management of AAST grades III-V hepatic trauma by Damage control surgery with perihepatic packing and Definitive hepatic repair–single centre experience

Author

Doklestić, Krstina, primary, Stefanović, Branislav, additional, Gregorić, Pavle, additional, Ivančević, Nenad, additional, Lončar, Zlatibor, additional, Jovanović, Bojan, additional, Bumbaširević, Vesna, additional, Jeremić, Vasilije, additional, Vujadinović, Sanja Tomanović, additional, Stefanović, Branislava, additional, Milić, Nataša, additional, and Karamarković, Aleksandar, additional

Published
2015
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30. Outcome among Patients Suffering from In-Hospital Cardiac Arrest

Author

Tripković, Slađana, Tripković, Slađana, Pavlović, Aleksandar, Bumbaširević, Vesna, Sekulić, Ana, Miličić, Biljana, Tripković, Slađana, Tripković, Slađana, Pavlović, Aleksandar, Bumbaširević, Vesna, Sekulić, Ana, and Miličić, Biljana

Abstract

Introduction In relation to pre-hospital treatment of patients with cardiac arrest (CA) in the field where resuscitation is often started by nonprofessionals, resuscitation in hospital is most commonly performed by well-trained personnel. Objective The aim was to define the factors associated with an improved outcome among patients suffering from the in hospital CA (INCA). Methods The prospective study included a total of 100 patients in the Emergency Center over two-year period. The patterns by the Utstein-Style guidelines recorded the following: age, sex, reason for hospital admission, comorbidity, cause and origin of CA, continuous monitoring, time of arrival of the medical emergency team and time of delivery of the first defibrillation shock (DC). Results Most patients (61%) had cardiac etiology. Return of spontaneous circulation (ROSC) was achieved in 58% of patients. ROSC was more frequently achieved in younger patients (57.69 +/- 11.37), (p lt 0.05), non-surgical patients (76.1%), (p lt 0.01) and in patients who were in continuous monitoring (66.7%) (p lt 0.05).The outcome of CPR was significantly better in patients who received advanced life support (ALS) (76.6%) (p lt 0.01).Time until the delivery of the first DC shock was significantly shorter in patients who achieved ROSC (1.67 +/- 1.13 min), (p lt 0.01). A total of 5% of IHCA patients survived to hospital discharge. Conclusion In our study, the outcome of CPR was better in patients who were younger and with non-surgical diseases, which are prognostic factors that we cannot control. Factors associated with better outcome of IHCA patients were: continuous monitoring, shorter time until the delivery of the first DC and ALS. This means that better education of medical staff, better organization and up-to-dated technical equipment are needed.

Published
2014

31. Uticaj načina porođaja i vrste akušerske anestezije na oksidativni stres i komplikacije kod novorođenčadi i porodilja

Author

Drašković, Biljana, Popović, Vladan, Bumbaširević, Vesna, Kapamadžija, Aleksandra, Simić, Dušica, Daničić, Biljana, Rakić, Goran, Drašković, Biljana, Popović, Vladan, Bumbaširević, Vesna, Kapamadžija, Aleksandra, Simić, Dušica, Daničić, Biljana, and Rakić, Goran

Abstract

Introduction: birth, although a physiological act, it is followed by the stress response from mothers and newborns. The mode of delivery and the type of obstetrical anesthesia may affect the level of oxidative stress. Uncomplicated vaginal delivery exposes mothers and newborns to a state of increased oxidative stress. Ending the pregnancy by cesarean section has become more common, and the modem spinal anesthesia is preferred to obstetric anesthesia. Direct effects of anesthesia on neonatal outcome, complications related to the birth and the newborn, as well as the oxidative stress that occurs during childbirth, have not been not studied in our community. The activity of the GPx enzyme in infants at birth has been insufficiently addressed in the professional written material it the world in general, and in pregnant women it is unknown. Aim: To determine the effect of mode of delivery and the type of obstetric anesthesia at the level of oxidative stress and complications in newborns and mothers. Methods: A prospective clinical study was conducted at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. The study included 150 healthy, term infants, delivered by a planned cesarean section with general or spinal anesthesia, as well as in a natural way, and their 150 mothers. Depending on the mode of delivery and the type of obstetric anesthesia, the newborns and mothers were divided into six groups of 50. In all six tested groups, venous blood samples were taken a few minutes after the birth, together with certain laboratory markers of oxidative stress (TBARS and GPx), lactate and gas analysis. The general condition and potential complications of the newborns and mothers during childbirth and hospitalization were monitored and evaluated. Results: The values of Apgar score after 1 and 5 minutes were significantly higher (p < 0.01) in infants who were born by cesarean section under spinal anesthesia . The highest concentration of TBARS and

Published
2014

32. Faktori rizika za pojavu postoperativnog delirijuma kod pacijenata sa prelomom kuka

Author

Marković-Denić, Ljiljana, Bumbaširević, Vesna, Milaković, Branko, Lešić, Aleksandar, Đurić, Dušan, Radinović, Kristina S., Marković-Denić, Ljiljana, Bumbaširević, Vesna, Milaković, Branko, Lešić, Aleksandar, Đurić, Dušan, and Radinović, Kristina S.

Abstract

Prelom kuka predstavlja veoma estu traumu kod osoba starijeg uzrasta. Jedna od naješih komplikacija kod ovih pacijenata nakon operacije preloma kuka je delirijum. Ciljevi ove disertacije su bili da se sagledaju faktori rizika vezani za pacijenta kao i za hospitalizaciju i hiruršku intervenciju koji su od znaaja za pojavu postoperativnog delirijuma kod pacijenata sa prelomom kuka. Praeno je 277 pacijenata starosti 50 godina sa akutnim prelomom kuka operativno leenih na Institutu za ortopedsku hirurgiju i traumatologiju Klinikog centra Srbije u periodu od 1.4.2010. do 1.4.2011. godine. Ispitivan je uticaj demografskih i socioekonomskih karakteristika, mesta preloma, same hirurške intervencije i vrste anestezije, fizikog zdravlja, broj lekova u linoj terapiji, kognitivnog statusa, poremeaja raspoloženja, funkcionalnog statusa, dužine bolnikog leenja, pojave komplikacija i postoperativnog bola na pojavu postoperativnog delirijuma. Nezavisni prediktori za nastanak postoperativnog delirijuma kod pacijenata sa prelomom kuka prema multivarijantnoj regresionoj analizi su; stariji uzrast ( 85 god.), ošteenje vida, depresija na prijemu, teško kognitivno ošteenje, dehidratacija (urea/kreatinin odnos 14), lošiji fiziki status pacijenata, kao i prisustvo jakog akutnog postoperativnog bola. Od ovih faktora rizika, teško kognitivno ošteenje i jak akutni bol prvog postoperativnog dana su bili najjae povezani sa pojavom postoperativnog delirijuma. Na osnovu rezultata ove disertacije predlaže se uvoenje interventnih mera kojima bi se delovalo na preventibilne faktore rizika radi redukcije incidencije postoperativnog delirijuma sa ciljem spreavanja komplikacija i samanjenje mortalitata kod starijih pacijenata nakon preloma kuka., Hip fracture in the geriatric population is a common injury. One of the most frequent complication in these patients is postoperative delirium. The aims of this dissertation were to examine the patient-related, hospitalization-related, and surgery-related risk factors for occurrence of postoperative delirium in hip-fracture patients. A total of 277 community-dwelling elderly patients ( 50 years) who underwent surgery for hip fracture were observed at the Clinics for Orthopedic Surgery and Traumatology, Clinical Canter of Serbia in the period 1.4.2010.- 1.4.2011. On admission sociodemographic data, data related to the fracture, cognitive function, presence of depression, functional status, length of hospital stay, postoperative complications and postoperative pain were evaluated. According to multivariate regression analysis independent predictors for postoperative delirium after hip fracture surgery were age, vision impairment, depression on admission, severe cognitive impairment, dehydration (urea/creatinin ratio 14), poor physical status, and severe postoperative pain. The severe cognitive impairment and severe postoperative pain were strongly related to postoperative delirium. Intervention programs for reducing the incidence of delirium should be introduced into routine clinical practice in order to prevent complications and reduced mortality...

Published
2014

33. Astrocyte-induced regulatory T cells mitigate CNS autoimmunity

Author

Trajković, Vladimir S, Vucković, Olivera, Stošić-Grujičić, Stanislava, Miljković, Đorđe, Popadić, Dusan M, Marković, Milos, Bumbaširević, Vesna D, Backović, Aleksandar, Cvetković, Ivana D., Harhaji Trajković, Ljubica, Ramić, Zorica D., and Mostarica-Stojković, Marija B

Abstract

Although astrocytes presumably participate in maintaining the immune privilege of the central nervous system (CNS), the mechanisms behind their immunoregulatory properties are still largely undefined. In this study, we describe the development of regulatory T cells upon contact with astrocytes. Rat T cells pre-incubated with astrocytes completely lost the ability to proliferate in response to mitogenic stimuli. The cells were blocked in G0/G1 phase of the cell cycle, expressed less IL-2R, and produced significantly lower amounts of interferon-gamma (IFN-gamma), but not interleukin-2 (IL-2), IL-10, or tumor necrosis factor (TNF). These anergic cells completely prevented mitogen-induced growth of normal T lymphocytes, as well as CNS antigen-driven proliferation of autoreactive T cells. The suppressive activity resided in both CD4(+) and CD8(+) T-cell compartments. Heat-sensitive soluble T-cell factors, not including transforming growth factor-beta (TGF-beta) or IL-10, were solely responsible for the observed suppression, as well as for the transfer of suppressive activity to normal T cells. The administration of astrocyte-induced regulatory T cells markedly alleviated CNS inflammation and clinical symptoms of CNS autoimmunity in rats with experimental allergic encephalomyelitis. Finally, the cells with suppressive properties were readily generated from human lymphocytes after contact with astrocytes. Taken together, these data indicate that astrocyte-induced regulatory T cells might represent an important mechanism for self-limitation of excessive inflammation in the brain. (C) 2004 Wiley-Liss, Inc. null

Published
2004

34. Preventivna ugradnja implantabilnog kardioverter defibrilatora kod bolesnika sa ishemijskom bolešću srca i aortokoronarnim bajpasom

Author

Milašinović, Goran, Đukić, Petar, Obrenović-Kirćanski, Biljana, Bumbaširević, Vesna, Arsov, Vladislav, Kovačević-Kostić, Nataša, Milašinović, Goran, Đukić, Petar, Obrenović-Kirćanski, Biljana, Bumbaširević, Vesna, Arsov, Vladislav, and Kovačević-Kostić, Nataša

Abstract

Uvod: Naprasna srčana smrt (NSS) je prirodna smrt koja nastaje iz srčanih razloga, unutar jednog sata od početka akutnih kardiovaskularnih događaja, a prethodi joj nagli gubitak svesti. Najčešći uzrok je koronarna bolest (80%). Naprasna srčana smrt može nastupiti u bilo koje vreme od srčanog infarkta, a usled pojave komorske fibrilacije (VF) ili brze prolongirane komorske tahikardije (VT) koja alterira u VF. Perioperativni srčani zastoj kod operacija na otvorenom srcu se javlja u 0,7-2,9% bolesnika. Preživljavanje ovih bolesnika je 17-79%. Terapije beta blokatorima i amiodaronom nije dala zadovoljavajuće rezultate u prevenciji NSS uzrokovane malignim poremećajima ritma za razliku od profilaktičke implantacije implantabilnog kardioverter defibrilatora (ICD). Ovo je potvrdilo nekoliko studija: Multicenter Automatic Defibrillator Implantation Trial (MADIT), The Multi-center Unsustained Tachycardia Trial (MUSTT), MADIT II i Sudden Cardiac Death-Heart Failure Trial (SCD-HeFT). U The Coronary-Artery Bypass Graft-Patch (CABG-Patch) studiji primarne prevencije NSS, u koju su, kao i kod nas, uključeni bolesnici kojima je urađena hirurška revaskularizacija miokarda i sa ejekcionom frakcijom EF≤36%, nije dokazana povezanost preživljavanja sa implantacijom ICD-a na osnovu kumulativnih krivi preživljavanja. Razlika između naše i CABG-Patch studije bila je u tome što su oni intraoperativno implantirali ICD bolesnicima koristeći epikardnu „patch― elektrodu, a mi između prvog i trećeg meseca po revaskularizaciji miokarda, plasirajući elektrodu transvenoznim putem, endokardno. Primarni cilj ove studije bio je da ispita da li je opšte preživljavanje duže kod bolesnika sa ishemijskom bolesti srca, EFLV≤35%, bez predhodno registrovanih NSVT, VT i VF, a posle učinjenog aortokoronarnog bajpasa i kojima je preventivno implantiran ICD, nego kod bolesnika sa antiaritmijskom terapijom β-blokatorima i Amiodaronom..., Introduction: Sudden cardiac death (SCD) is a natural death from cardiac causes happening within one hour of the onset of acute cardiovascular symptoms, and is preceded by a sudden loss of consciousness. The most common cause of SCD is a coronary artery disease (80%). Sudden cardiac death can develop at any time after the acute myocardial infarction, due to the ventricular fibrillation (VF), or fast prolonged ventricular tachycardia (VT) progressing to VF. Cardiac revascularization, either by percutaneous coronary intervention (balloon angioplasty or stenting) or by surgical revascularization improves cardiac function, and with that survival of patients with low left ventricular ejection fraction (EF). Incidence of perioperative cardiac arrest after the open heart surgery is 0,7-2,9%. Survival of these patients is 17-79%. Beta blocker therapy, and amiodarone therapy haven’t yielded satisfying results in prevention of SCD caused by ventricular tachyarrhythmias as has prophylactic implantation of ICDs. This has been confirmed by several studies: Multicenter Automatic Defibrillator Implantation Trial (MADIT), The Multi-center Unsustained Tachycardia Trial (MUSTT), MADIT II and Sudden Cardiac Death-Heart Failure Trial (SCD-HeFT). Primary prevention of SCD trial - The CABG-Patch Trial included, as our trial did, patients with EF≤36%, that were scheduled for surgical revascularization. This trial didn’t show correlation of survival with ICD implantation. Difference between our trial and CABG-Patch was that in CABG-Patch trial they implanted ICD patch electrode epicardially during CABG surgery, while we implanted ICD patch electrode transvenously endocardially between the first and the third month after CABG surgery. The primary aim of the study was evaluation of overall survival of patients with IHD, EF≤35%, without prior NSVT,VT, VF and after CABG surgery with prophylactic ICD implantation compared to overall survival of patients on conservative medical therapy amiodaron

Published
2013

35. Down-regulation of experimental allergic encephalomyelitis in DA rats by tiazofurin

Author

Stošić-Grujičić, Stanislava, Savić-Radojević, Ana R, Maksimović-Ivanić, Danijela, Marković, Milos, Bumbaširević, Vesna D, Ramić, Zorica D., and Mostarica-Stojković, Marija B

Abstract

The immunomodulatory potential of tiazofurin (TR) on experimental autoimmune encephalomyelitis (EAE) was investigated. Given continuously, TR dose-dependently suppressed the development of EAE in Dark Agouti (DA) rats immunized with either rat spinal cord homogenate (SCH) or myelin oligodendrocyte glycoprotein (MOG). Amelioration of clinical signs was also obtained when the drug was administered during the inductive phase only (day 0 to 8), or during the effector phase (day 10 to 20) of the disease. Efficacy of TR was further evaluated by adoptive transfer of the disease with myelin basic protein (MBP)-sensitized draining lymph node cells (DLNC). Cells from TR-protected rats failed to transfer the disease into naive syngeneic recipients; in addition, TR treatment of recipient rats that had received MBP-sensitized lymphoid cells diminished the adoptively transferred EAE. A reduction of clinical EAE in TR-treated rats was accompanied with the absence of mononuclear infiltration in the spinal cord and defective adhesive cell-cell interactions. The anti-MOG autoAb production was also decreased. Importantly, no evidence for a generalized impairment of the T cell activity, nor decreased in vitro proliferative antigen specific response of LNC from TR-treated animals was found. These results suggest that TR exerts its EAE protective and suppressive effects by limiting adhesive interactions involved in the autoimmune pathogenic process, and due to the lack of general immunosuppressive activity, it should be considered as a candidate drug for the treatment of neuroinflammatory diseases like multiple sclerosis (MS). (C) 2002 Elsevier Science B.V. All rights reserved. null

Published
2002

36. Clamp-Crushing vs. Radiofrequency-Assisted Liver Resection: Changes in Liver Function Tests

Author

Palibrk, Ivan, Palibrk, Ivan, Miličić, Biljana, Stojiljković, Ljuba, Manojlović, Nebojša, Dugalić, Vladimir, Bumbaširević, Vesna, Kalezić, Nevena, Žuvela, Marinko, Milicević, Miroslav, Palibrk, Ivan, Palibrk, Ivan, Miličić, Biljana, Stojiljković, Ljuba, Manojlović, Nebojša, Dugalić, Vladimir, Bumbaširević, Vesna, Kalezić, Nevena, Žuvela, Marinko, and Milicević, Miroslav

Abstract

Background/Aims: Liver resection is the gold standard in managing patients with metastatic or primary liver cancer. The aim of our study was to compare the traditional clamp-crushing technique to the radiofrequency-assisted liver resection technique in terms of postoperative liver function. Methodology: Liver function was evaluated preoperatively and on postoperative days 3 and 7. Liver synthetic function parameters (serum albumin level, prothrombin time and international normalized ratio), markers of hepatic injury and necrosis (serum alanine aminotransferase, aspartate aminotransferase and total bilirubin level) and microsomal activity (quantitative lidocaine test) were compared. Results: Forty three patients completed the study (14 had clamp-crushing and 29 had radiofrequency assisted liver resection). The groups did not differ in demographic characteristics, pre-operative liver function, operative time and perioperative transfusion rate. In postoperative period, there were similar changes in monitored parameters in both groups except albumin levels, that were higher in radiofrequency-assisted liver resection group (p=0.047). Conclusions: Both, traditional clamp-crushing technique and radiofrequency assisted liver resection technique, result in similar postoperative changes of most monitored liver function parameters.

Published
2012

37. Protektivna mehanička ventilacija i terapije „spašavanja" u teškoj hipoksemiji.

Author

Terziski, Žaneta, Misić, Vanja, Milenković, Marija, Bumbaširević, Vesna, Jovanović, Bojan, and Jozić, Irena

Abstract

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2016
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38. Serum lactate: role in the assessment of miciohemodynamics in critically ill patients.

Author

Veličković, Jelena, Thiery, Guillaume, Veličković, Dejan, Rakić, Goran, Doklestić, Krstina, Jovanović, Bojan, Palibrk, Ivan, Tomanović-Vujadinović, Sanja, and Bumbaširević, Vesna

Abstract

Many critically ill patients with stabilized hemo-dynamics die with signs of multiorgan failure. One of the reasons is the derangement of microcircu lation and tissue perfusion. It has been shown that microcirculatory distress left uncorrected for 24 hours is single independent predictor of mortality in sepsis. Setum lactate is the only indicator of microcirculatory changes that is monitored routinely in all critically ill patients. It has been widely believed that hyperlactatemia in sepsis is marker of tissue hypoxia and indicates the existence of oxygen debt re iulting from tisiue hypoperfusion and anaerobic glycolysis. Attempts to correct hyperlactatemia by delivering supranormal oxygen amounts have failed in septic patients. The term "shock" lactate refers to hyperlactatemia originating from oxygen debt. Human studies failed to demonitrate the relationship between hyperlactatemia and tissue hypo-perfusion in the late phase of sepsis. Adrenergic stimulation in sepsis and accelerated aerobic glycolysis have been proposed as a likely mechanism of hyperlactatemia. Both exogenous and endogenous catecholamines are correlated with septic hyperlactatemia. Aerobically generated lactate me diated by cytokines is called "stress" lartate and may serve as a marker of hypermetabolism rather than tissue hyperperfusion. Many studies and guidelines recommend targeting resuscitation to normalize lactate in septic patients. These recommendations need to be taken with reierve. Since lartate serves, under stress, as a source of energy and can be used as a fuel for oxidation as well as for glucose production, attempts to normalize lactate might be even harmiul. Although high lactate clearance, due to a correction of oxygen debt contributes to a better prognosis in sepsis, the unusual complexity of lactate makes it almost impossible to make an unambiguous therapeutic decision, when comes to a lactate-guided treatment in sepsis. [ABSTRACT FROM AUTHOR]

Published
2016
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39. Gene polymorphisms in surgical patients with diffuse secondary peritonitis - genetic predisposition for sepsis.

Author

Doklestić, Krstina, Maksimović, Nela, Jovanović, Bojan, Veličković, Jelena, and Bumbaširević, Vesna

Abstract

Despite the great progress that has been made in recent decades in the intensive treatment of critically ill patients with intra abdominal infections, antibiotic therapy and modern surgical techniques, secondary peritonitis is still accompanied by significant morbidity and mortality. The response to infection can be variable between different individuals. Scientific evidence support hypothesis that this inter-patient variability can be at least partially explained by genetic influence which may have an important role in the development of sepsis, as well as in severity of complications and death. An infection triggers complex immune response of the host and affects the balance between coagulation and fibrinolysis. This imbalance can lead to hypercoagulability but also to the microcirculation disturbance which can lead to multiple organ dysfunction syndrome (MODS) and septic shock. Common polymorphisms of genes which encode proteins with important role in coagulation and fibrinolysis could be of great importance in susceptibility for sepsis, possible complications and clinical outcome. Early genetic information may become very useful for identification of patients with high risk of developing severe sepsis and multiple organ dysfunctions, in order to design better, more personalized therapy with less severe adverse effects. [ABSTRACT FROM AUTHOR]

Published
2016
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41. Procalcitonin in preoperative diagnosis of abdominal sepsis

Author

Ivančević, Nenad, primary, Radenković, Dejan, additional, Bumbaširević, Vesna, additional, Karamarković, Aleksandar, additional, Jeremić, Vasilije, additional, Kalezić, Nevena, additional, Vodnik, Tatjana, additional, Beleslin, Biljana, additional, Milić, Nataša, additional, Gregorić, Pavle, additional, and Žarković, Miloš, additional

Published
2007
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44. Injuries of the pancreas.

Author

Stefanović, Branislav D., Stefanović, Branislava D., Karamarković, Aleksandar R., Doklestić, Krstina S., Bumbaširević, Vesna D., and Lončar, Zlatibor M.

Abstract

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2014
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45. Routine chest radiographs in the surgical intensive care unit: Can we change clinical habits with no proven benefit?

Author

Veličković, Jelena V., Hajdarević, Sanela A., Palibrk, Ivan G., Janić, Nataša R., Djukanović, Marija, Miljković, Bojana, Veličković, Dejan M., and Bumbaširević, Vesna

Abstract

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2013
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46. Overlooked dislocation of C6/C7 vertebra with minimal neurologic deficit.

Author

Slaviša, Zagorac G., Aleksandar, Lešić R., Bumbaširević, Vesna, and Marko, Bumbaširević Z.

Abstract

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2012
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47. Impact of the injury pattern on the pedestrian fatalities in the city of Belgrade.

Author

Bumbaširević, Marko Ž., Milošević, Ivan B., Bumbaširević, Vesna, Zagorac, Slaviša G., and Lešić1,2, Aleksandar R.

Abstract

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2012
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48. Segment-oriented liver resections based on posterior intrahepatic glissonian approach.

Author

Doklestić, Krstina, Djukić, Vladimir, Bumbaširević, Vesna, Jovanović, Bojan, and Karamarković, Aleksandar

Abstract

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2012
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49. Calcaneal fractures- the orthopaedic challenge.

Author

Lešić, Aleksandar R., Atkinson, Henry D. E., Bumbaširević, Vesna, and Bumbaširević, Marko Ž.

Abstract

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2012
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50. The development of internal fixation- historical overview.

Author

Lešić, Aleksandar R., Zagorac, Slaviša, Bumbaširević, Vesna, and Bumbaširević, Marko Ž.

Abstract

Copyright of Acta Chirurgica Iugoslavica is the property of Association of Yugoslav Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2012
Full Text
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