Epidemiology of nosocomial colonization/infection caused by Acinetobacter spp. in patients of six surgical clinics in war and peacetime.

Background/aim: Acinetobacter spp. has emerged as nosocomial pathogen during the past few decades in hospitals all over the world, but it has increasingly been implicated as a serious nosocomial pathogen in military hospitals. The aim of this study was to analyse and compare the surveillance data on Acinetobacter nosocomial colonization/infection (NCI) collected during the wartime with the data collected in peacetime.

[Mechanical ventilation in patients with most severe forms of influenza A H1N1].

Background/aim: Pandemic of A H1N1 influenza is noted for its rapid spreading and life-threatening consequences like acute respiratory distress syndrome (ARDS) which requires mechanical ventilation (MV) and intensive therapy (IT).The aim of the study was to determine the significance of mechanical ventilation application in the presence of comorbidities on the outcome of the disease and patients with severe forms of acute influenza caused by A H1N1 virus.

Methods: Five patients with acute respiratory failure caused by A H1N1 influenza that required MV were included in the study.

Living unrelated donor kidney transplantation--a fourteen-year experience.

Background: In countries without a national organization for retrieval and distribution of organs of the deceased donors, problem of organ shortage is still not resolved. In order to increase the number of kidney transplantations we started with the program of living unrelated - spousal donors. The aim of this study was to compare treatment outcome and renal graft function in patients receiving the graft from spousal and those receiving ghe graft from living related donors.

Polymorphisms of genes encoding tumor necrosis factor-alpha, interleukin-10, cluster of differentiation-14 and interleukin-1ra in critically ill patients.

Purpose: The aim of the study was to determine whether distributions of tumor necrosis factor (TNF)-α(308), interleukin (IL)-10(1082), CD14(159), and IL-1ra gene intron 2 genotypes in critically ill patients are associated with outcome, underlying cause of sepsis, and type of microorganism.

Materials And Methods: Blood samples from 106 critically ill white patients were genotyped by method based on polymerase chain reaction for TNF-α(308), IL-10(1082), CD14(159), and IL-1ra gene intron 2.

Results: All patients with TNF-α(308)AA genotype survived; relative risk (RR) of death in patients with AG was 3.

Predictive value of serum bicarbonate, arterial base deficit/excess and SAPS III score in critically ill patients.

Arterial base deficit/excess (BD/E) is commonly used marker of metabolic acidosis in critically ill patients, but requires an arterial puncture and blood gas analysis. We hypothesized that serum bicarbonate (HCO3), which can be routinely obtained, strongly correlates with arterial BD/E and provides equivalent predictive information. In addition, we evaluated predictive value of simplified acute physiology score III (SAPS III).

Relation between both oxidative and metabolic-osmotic cell damages and initial injury severity in bombing casualties.

Background/aim: We have recently reported the development of oxidative cell damages in bombing casualties within a very early period after the initial injury. The aim of this study, was to investigate malondialdehyde (MDA), as an indicator of lipid peroxidation, and osmolal gap (OG), as a good indicator of metabolic cell damages and to assess their relationship with the initial severity of the injury in bombing casualties.

Methods: The study included the males (n = 52), injured during the bombing with the Injury Severity Score (ISS) ranging from 3 to 66.

[New strategies in multiple organ dysfunction syndrome therapy for sepsis].

Despite more than 20 years of extensive research, sepsis and/or trauma induced multiple organ dysfunction syndrome (MODS) remain the chief cause of death in intensive care units, with mortality rates between 30% and 80%. Early goal-directed therapy (EGDT), use of drotrecogin alfa (activated), tight control of hyperglycaemia, and adrenal replacement therapy (low doses of corticosteroids), all constitute new treatment strategies. In future, a combination of therapies should be individually adjusted for each patient.

Nosocomial bloodstream infections in ICU and non-ICU patients.

Background: Nosocomial bloodstream infections (BSI) create a serious health problem in hospitals all over the world. The objectives of our study were to explore putative disease markers and potential risk factors with nosocomial BSI in patients in intensive care units (ICU) and non-ICU patients and to determine risk factors associated with increased 28-day mortality rate in patients with nosocomial BSI acquired in combined medical-surgical ICU. However, the major purposes of this report were to identify epidemiologic differences between nosocomial BSI acquired in ICU and non-ICU, as well as analyses outcomes for patients with nosocomial BSI acquired in ICU.

Very early increase in nitric oxide formation and oxidative cell damage associated with the reduction of tissue oxygenation is a trait of blast casualties.

Background: In our previous experimental studies, we found evidence for the increase of nitric oxide (NO) formation immediately after blast injury. In the present study we investigated whether NO overproduction was a trait for the period immediately after blast injury in humans. Concomitant metabolic disturbances were also studied, and compared to the alterations in other traumatized patients.

[Pheochromocytoma as a challenge for the anesthesiologist].

Introduction: Pheochromocytoma is a tumour of adrenal chromaffin tissue which produces extreme amounts of catecholamines, and leads to significant haemodynamic disturbances. The anaesthesiologist has an important role in diagnostic procedures of pheochromocytoma (physical examination, biochemical analyses, pharmacological tests, tomographic, scintigraphic, and genetic examinations), and is included in the preparation of the patient for surgery, maintenance of anaesthesia during operation, and postoperative intensive care.

Results: We reviewed 268 patients with adrenal tumours, who were operated on in the Military Medicaf Academy in Belgrade over the period 1974-2002.