Analysis of the factors influencing development of urinary tract infections in patients with spinal cord injuriеs

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Urinary tract infections are still the most frequent complications in patients with spinal cord injury (SCI). The aim of this study was to analyze the factors influencing development of urinary tract infections during rehabilitation in patients with SCI. Methods. This retrospective case/control study including 540 patients with SCI which were rehabilitated in the Clinic for Rehabilitation “Dr Miroslav Zotović” between January 2000 and December 2009. We used patient files and other available medical documentation for obtaining information contained in this study, such as the manner of bladder emptying, the type of neurological disorder of the bladder, the neurological level and completeness of a lesion, the injury etiology, treatment method, secondary complications and associated injuries, kidney and bladder calculosis, age and sex. Results. Out of the total number of patients included in the study, 152 (28.1%) were without urinary tract infections, whereas 388 (71.9%) had urinary tract infections. There were 389 (72%) male and 151 (28%) female patients. The average age of patients without urinary tract infections was 51.0 ± 15.4 years, whereas the mean age of patients with urinary tract infections was 44.3 ± 16.9 years. The results of our study showed that the occurrence of urinary tract infections during rehabilitation in patients with SCIs was associated with the following factors: combined injuries (OR = 3.5), anemia (OR = 5.67), type of the bladder functional disorder (OR = 40–60) and crystals in urine (OR = 7.54). Conclusion. The physicians should take precautions and try to make the early diagnosis and rapid appropriate treatment of urinary tract infections in patients with SCI who also have functional bladder disorder, combined spinal injuries, anemia or urine crystals

Natural radionuclides in soil profiles surrounding the largest coal-fired power plant in Serbia

This study evaluates the influence of the largest Serbian coal-fired power plant on radionuclide concentrations in soil profiles up to 50 cm in depth. Thirty soil profiles were sampled from the plant surroundings (up to 10 km distance) and analyzed using standard methods for soil physicochemical properties and gamma ray spectrometry for specific activities of natural radionuclides (K-40, Ra-226 and Th-232) Spatial and vertical distribution of radionuclides was determined and analyzed to show the relations between the specific activities in the soil and soil properties and the most influential factors of natural radionuclide variability were identified. The radiological indices for surface soil were calculated and radiological risk assessment was performed. The measured specific activities were similar to values of BACKGROUND: levels for Serbia. The sampling depth did not show any significant influence on specific activities of natural radionuclides. The strongest predictor of specific activities of the investigated radionuclides was soil granulometry. All parameters of radiological risk assessment were below the recommended values and adopted limits. It appears that the coal-fired power plant does not have a significant impact on the spatial and vertical distribution of natural radionuclides in the area of interest, but technologically enhanced natural radioactivity as a consequence of the plant operations was identified within the first 1.5 km from the power plant

Etiology and resistance patterns of bacteria causing ventilator-associated pneumonia in a respiratory intensive care unit

© 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All Rights Reserved. Background/Aim. Ventilator-associated pneumonia (VAP) incidence, causative pathogens, and resistance patterns are different among countries and intensive care units (ICUs). In Europe, resistant organisms have progressively increased in the last decade. However, there is a lack of data from Serbian ICUs. The aims of this study were to evaluate etiology and antimicrobial resistance for pathogens causing VAP in ICU patients, to examine whether there were differences among pathogens in early-onset and late-onset VAP and to identify mortality in patients with VAP after 30 and 60 days of hospitalization. Methods. A retrospective cohort study was conducted in the respiratory ICU and all adult patients diagnosed with VAP from 2009 to 2014 were included. Results. Gram negative organisms were the major pathogens (80.3%). The most commonly isolated was Acinetobacter spp (59.8%). There was a statistically significant increase in the incidence of infection with Klebsiella pneumoniae (8.9% vs 25.6%; p = 0.019). Extensively drugresistant strains (XDR) were the most common (78.7%). Lateonset VAP was developed in 81.1% of patients without differences among pathogens in comparison with early-onset VAP. Acinetobacter spp was susceptible to tigecycline and colistin with a significant increase in resistance to ampicillin/sulbactam (30.2% vs 58.6%; p = 0.01). Resistance rate of Pseudomonas aeruginosa and Klebsiella pneumoniae to carbapenems was 38% and 11%, respectively. In methicillin-resistant Staphylococcus aureus no resistance was observed against vancomycin and linezolid. There was no difference in mortality rate between patients with earlyonset and late-onset VAP after 30 and 60 days of hospitalization. Conclusion. Gram negative organisms were the primary cause of bacterial VAP of which the most common was the XDR strain of Acinetobacter spp. Patients with early- and late-onset VAP had the same pathogens. There was no difference in mortality between this two group of patients during 60 days of hospitalization

Multiparameter Water Quality Monitoring System for Continuous Monitoring of Fresh Waters

This paper presents an economical multiparameter water quality monitoring system for continuous monitoring of fresh waters. It is based on a sensor node that integrates turbidity, temperature, conductivity sensors, a miniature eighteen-channel spectrophotometer, and a sensor for the detection of thermotolerant coliforms, which is a major novelty of the system. Due to the influence of water impurities on the measurement of thermotolerant coliforms, a heuristic method has been developed to mitigate this effect. Moreover, the sensor is low-power and with an integrated LoRaWAN module, it comprises a system that is wireless sensor network (WSN) ready and can send data to a dedicated server. In addition, the system is submersible, capable of long-term field operation, and significantly cheaper in comparison to existing solutions. The purpose of the system is to give early warning of incidental pollution situations, thus enabling authorities to fast respond by taking a water sample for laboratory analysis for confirmation, analyze the source of contamination, and take action regarding further prevention of such occasions

WP4 ‐ Modernization of teaching contents 4.1. Need analysis for knowledge refreshment

This brochure is a result of the TEMPUS project “Building Capacity of Serbian Agricultural Education to Link with Society” (CaSA) 544072-TEMPUS-1-2013-1-RS-TEMPUS-SMHES (2013-4604/001-001). Daniela Šćepanović and Steve Quarrie were responsible for questionnaire construction, assisted by Slavica Čolić. Analysis of questionnaires was coordinated by Daniela Šćepanović, as well as final preparation and presentation of the results. For final document preparation, all CaSA Steering Committee members gave valuable contribution. For brochure final preparation Daniela Šćepanović, Vesna Poleksić and Goran Topisirović were in charge.TEMPUS Project: Building Capacity of Serbian Agricultural Education to Link with Society (CaSA) 544072-TEMPUS-1-2013-1-RS-TEMPUS-SMHES (2013 – 4604 / 001 - 001) Coordinator: University of Belgrade, Faculty of Agricultur

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P &lt; 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P &lt; 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Quality 4.0 in Digital Manufacturing – Example of Good Practice

Purpose: The ever-evolving market dynamics and the trend toward increased product individualization demand a high degree of adaptability in production management. This calls for novel approaches, such as Industry 4.0 (I4.0), which integrates the Quality 4.0 (Q4.0) model as well. Methodology/Approach: I4.0 builds upon the foundation of digital manufacturing and entails three key dimensions: (i) The employment of advanced digital technologies to enable digital production, (ii) The development of smart products, which incorporate novel production methods and innovative features, and, (iii) The adoption of an intelligent supply chain, designed to facilitate the procurement of raw materials and the delivery of finished goods. In our research studies, we focus specifically on the first and third approaches. Findings: A bilateral flow of information in collaborative manufacturing is facilitated through digital platforms that span the entirety of the production process, from the inception of cutting-edge product designs to the final delivery to end-customers, integrating quality management (QM) as well. Research Limitation/Implication: The current study outlines a QM model developed for a digital factory in Serbia, utilizing the Q4.0 model, with particular emphasis on the workshop section, integrated within the Enterprise Resource Planning/Manufacturing Execution Systems module. Originality/Value of paper: The manuscript serves as a notable illustration of best practices for digital manufacturing, and the implementation of a digital QM model within the metalworking industry

Changes of platelets' function in preeclampsia

Increased aggregation of platelets during preeclampsia was shown in several studies, yet several others reported no change. The aim of our study was to investigate platelet aggregation in a group of patients suffering from preeclampsia. In a cross-sectional study blood samples were taken from 89 hospitalized patients in the third trimester of pregnancy: 38 were suffering from mild to moderate preeclampsia and 51 patients were without preeclampsia. From the blood samples platelet aggregation, secretion of adenine nucleotides from platelets, concentration of energy-rich adenine compounds and levels of cyclic adenosine-mono-phosphate and cyclic guanosine mono-phosphate in platelets were measured. In the patients with preeclampsia, the adenosine diphosphate threshold for biphasic aggregation [odds ratio (OR):.75; 95% Confidence Interval (CI): 0.55-1.02; p100.00; CI: 0.00->100.00; p<0.05) and secretion of adenosine triphosphate (OR:.13; CI: 0.00-14.26; p<0.05) and adenosine diphosphate (OR:.77; CI: 0.08-36.79; p<0.05) were increased. The results of our study show increased activation and aggregation of platelets in pregnant females with preeclampsia. © 2011 Versita Warsaw and Springer-Verlag Berlin Heidelberg