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Article: Total costs of inpatient treatment for COVID-19 in a tertiary hospital in Serbia.

Sazdanovic, P S / Milisavljevic, S / Milovanovic, D R / Jankovic, S M / Baskic, D / Ignjatovic, Ristic / Ruzic, Zecevic / Tomic, Lucic / Djordjevic, N / Jovanovic, D / Stojkovic, A / Lazarevic, T / Begovic, Cvetkovic / Kostic, M J

Hippokratia

2023 Volume 26, Issue 2, Page(s) 62–69

Abstract: Background: Our study aimed to identify the total costs of inpatient treatment for coronavirus disease 2019 (COVID-19) in a tertiary institution in Serbia, an upper-middle-income country in Southeast Europe.: Methods: An observational, retrospective, ...

Abstract	Background: Our study aimed to identify the total costs of inpatient treatment for coronavirus disease 2019 (COVID-19) in a tertiary institution in Serbia, an upper-middle-income country in Southeast Europe. Methods: An observational, retrospective, cost-of-illness study was performed from the perspective of the National Health Insurance Fund and included a cohort of 78 females and 118 males admitted to the COVID-19 ward units of a tertiary center during the first wave of the pandemic. Results: The median of the total costs in the non-survivors subgroup (n =43) was 3,279.16 Euros [interquartile range (IQR): 4,023.34; range: 355.20-9,909.61) which is higher than in the survivors (n =153) subgroup 747.10 Euros (IQR: 1,088.21; 46.71-3,265.91). The cut-off value of 156.46 Euros regarding the total costs per day was estimated to have 95.3 % sensitivity and 91.5 % specificity for predicting patients' dismal prognosis, with the area under the curve (AUC) of 0.968 (95 % confidence interval: 0.940-0.996, p <0.001). Conclusions: Direct medical inpatient treatment costs for COVID-19 represent a significant economic burden. The link between increased costs and an ultimate unfavorable outcome should be further explored.HIPPOKRATIA 2022, 26 (2):62-69.
Language	English
Publishing date	2023-05-13
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2491943-3
ISSN	1790-8019 ; 1108-4189
ISSN (online)	1790-8019
ISSN	1108-4189
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Article ; Online: Influence of regular reporting on local Pseudomonas aeruginosa and Acinetobacter spp. sensitivity to antibiotics on consumption of antibiotics and resistance patterns.

Djordjevic, Z M / Folic, M M / Jankovic, S M

Journal of clinical pharmacy and therapeutics

2017 Volume 42, Issue 5, Page(s) 585–590

Abstract: What is known and objective: Regular surveillance of antimicrobial resistance is an important component of multifaceted interventions directed at the problem with resistance of bacteria causing healthcare-associated infections (HAIs) in intensive care ... ...

Abstract	What is known and objective: Regular surveillance of antimicrobial resistance is an important component of multifaceted interventions directed at the problem with resistance of bacteria causing healthcare-associated infections (HAIs) in intensive care units (ICUs). Our aim was to analyse antimicrobial consumption and resistance among isolates of Pseudomonas aeruginosa and Acinetobacter spp. causing HAIs, before and after the introduction of mandatory reporting of resistance patterns to prescribers. Methods: A retrospective observational study was conducted between January 2011 and December 2015, at an interdisciplinary ICU of the Clinical Centre Kragujevac, Serbia. The intervention consisted of continuous resistance monitoring of all bacterial isolates from ICU patients and biannual reporting of results per isolate to prescribers across the hospital. Both utilization of antibiotics and density of resistant isolates of P. aeruginosa and Acinetobacter spp. were followed within the ICU. Results and discussion: Resistance densities of P. aeruginosa to all tested antimicrobials were lower in 2015, in comparison with 2011. Although isolates of Acinetobacter spp. had lower resistance density in 2015 than in 2011 to the majority of investigated antibiotics, a statistically significant decrease was noted only for piperacillin/tazobactam. Statistically significant decreasing trends of consumption were recorded for third-generation cephalosporins, aminoglycosides and fluoroquinolones, whereas for the piperacillin/tazobactam, ampicillin/sulbactam and carbapenems, utilization trends were decreasing, but without statistical significance. In the same period, increasing trends of consumption were observed for tigecycline and colistin. What is new and conclusion: Regular monitoring of resistance of bacterial isolates in ICUs and reporting of summary results to prescribers may lead to a significant decrease in utilization of some antibiotics and slow restoration of P. aeruginosa and Acinetobacter spp. susceptibility.
Language	English
Publishing date	2017-10
Publishing country	England
Document type	Journal Article
ZDB-ID	639006-7
ISSN	1365-2710 ; 0269-4727
ISSN (online)	1365-2710
ISSN	0269-4727
DOI	10.1111/jcpt.12557
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Article ; Online: Comparison Of Sorafenib Cost-Effectiveness And Budget Impact When Used For Advanced Hepatocellular Carcinoma In Two Neighbouring Balkan Countries.

Jankovic, S M / Kostic, M / Milovanovic, J

Clinical therapeutics

2016 Volume 38, Issue 10S, Page(s) e16–e17

Language	English
Publishing date	2016-10-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	603113-4
ISSN	1879-114X ; 0149-2918
ISSN (online)	1879-114X
ISSN	0149-2918
DOI	10.1016/j.clinthera.2016.07.125
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Article: Factors influencing carbamazepine pharmacokinetics in children and adults: population pharmacokinetic analysis.

Milovanovic, J R / Jankovic, S M

International journal of clinical pharmacology and therapeutics

2011 Volume 49, Issue 7, Page(s) 428–436

Abstract: Objective: The aim of the present study was to build population pharmacokinetic models for the clearance of carbamazepine (CBZ) in two separate populations of Serbian patients with epilepsy, children and adults.: Methods: Analysis was performed using ...

Abstract	Objective: The aim of the present study was to build population pharmacokinetic models for the clearance of carbamazepine (CBZ) in two separate populations of Serbian patients with epilepsy, children and adults. Methods: Analysis was performed using 114 and 53 steady-state concentrations of CBZ collected from 98 children and 53 adult epileptic patients, respectively. Mean values of total body weight and age were 31 ± 13 kg and 8 ± 3 years in the population of children, and 67 ± 13 kg and 32 ± 15 years in the population of adults. The one-compartment model with first order elimination and without absorption was used from the PREDPP (Prediction for Observation Population Pharmacokinetics) library of NONMEM software. Results: The derived final models of CBZ clearance were similar in the target populations. The most important factors which affected typical mean value of CBZ clearance in both populations studied were age of the patients and total daily dose; the CBZ clearance linearly followed increase of these factors. However, the influence of the patients' age was almost 3.4 times higher in the pediatric population than that in adults while the influence of total daily dose of CBZ is similar. On the other hand, final model in the adult population revealed also influence of concomitant therapy with phenobarbital (PB). The magnitude of this effect was +1.61 l h-1. The pharmacokinetic models obtained were validated in groups of 18 children and 13 adults with epilepsy. Conclusions: The derived models describe well CBZ clearance in terms of Serbian pediatric and adult epileptic patient characteristics, offering a basis for rational individualization of CBZ dosage regimens.
MeSH term(s)	Adult ; Aging/metabolism ; Anticonvulsants/pharmacokinetics ; Anticonvulsants/therapeutic use ; Carbamazepine/pharmacokinetics ; Carbamazepine/therapeutic use ; Child ; Chromatography, High Pressure Liquid ; Drug Interactions ; Epilepsy/drug therapy ; Epilepsy/metabolism ; Female ; Half-Life ; Humans ; Male ; Models, Statistical ; Patient Compliance ; Phenobarbital/pharmacology ; Population ; Reference Standards ; Reproducibility of Results ; Serbia ; Spectrophotometry, Ultraviolet ; Tablets
Chemical Substances	Anticonvulsants ; Tablets ; Carbamazepine (33CM23913M) ; Phenobarbital (YQE403BP4D)
Language	English
Publishing date	2011-07-01
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	124384-6
ISSN	0946-1965 ; 0340-0026 ; 0300-9718 ; 0174-4879
ISSN	0946-1965 ; 0340-0026 ; 0300-9718 ; 0174-4879
DOI	10.5414/cp201517
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Article: The first comparative double-blind trial on efficacy and safety of ergotamine based five-component combination and sumatriptan in migraine without aura.

Miljković, S / Smajlović, Dz / Tirić Campara, M / Jurina, R / Duranović Vinković, L / Janković, S M / Begović, B / Ćeranić, M

Hippokratia

2019 Volume 22, Issue 1, Page(s) 17–22

Abstract: Background: Dihydroergotamine or ergotamine are the most effective preparations for aborting acute attacks of migraine without aura.: Objective: The aim of our study was to compare the efficacy and safety of ergotamine based five-component drug ... ...

Abstract	Background: Dihydroergotamine or ergotamine are the most effective preparations for aborting acute attacks of migraine without aura. Objective: The aim of our study was to compare the efficacy and safety of ergotamine based five-component drug combination and sumatriptan in the treatment of moderate to severe acute attacks of migraine without aura. Methods: The study was designed as a randomized, double-blind, double-dummy, placebo-controlled, parallel arm, multi-center clinical trial. The enrolled patients having migraine without aura were randomized to one of the study arms, ergotamine based five-component drug combination or sumatriptan. Results: In total, 201 patients were randomized to one of the treatment arms. Higher percentage of patients was completely free of the headache two hours after dose administration in the ergotamine-based medication group compared to the sumatriptan group, regardless whether all (51.12 % vs 33.70 %) or only repeated attacks were taken into account (50.91 % vs 23.73 %); the salvage therapy (diclofenac) utilization rate was also lower in the ergotamine-based medication group (relative risk 0.61). Photophobia, phonophobia, and osmophobia were reversed more frequently in the ergotamine-based medication group (51.12 % vs 33.70 %), and failure to abort an attack of the migraine without aura occurred more frequently in the group treated with sumatriptan (1.1 % vs 4.9 %). The headache intensity two hours after ingestion of the study medication increased more frequently with sumatriptan, while other adverse events were rare in both groups. Conclusions: This study demonstrated higher efficacy and similar safety of ergotamine based fixed drug combination in comparison to sumatriptan, when used in the treatment of an acute attack of the migraine. HIPPOKRATIA 2018, 22(1): 17-22.
Language	English
Publishing date	2019-05-28
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2491943-3
ISSN	1790-8019 ; 1108-4189
ISSN (online)	1790-8019
ISSN	1108-4189
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Article: Population pharmacokinetics of lamotrigine in patients with epilepsy.

Milovanovic, J R / Jankovic, S M

International journal of clinical pharmacology and therapeutics

2009 Volume 47, Issue 12, Page(s) 752–760

Abstract: Objective: The purpose of this study was to derive a population pharmacokinetics (PPK) model of lamotrigine clearance as well as to identify and describe factors that influence it in Serbian patients with epilepsy.: Methods: A total of 40 steady- ... ...

Abstract	Objective: The purpose of this study was to derive a population pharmacokinetics (PPK) model of lamotrigine clearance as well as to identify and describe factors that influence it in Serbian patients with epilepsy. Methods: A total of 40 steady-state serum concentrations from 38 adult and pediatric patients with epilepsy, collected during routine therapeutic drug monitoring, were used for the analysis. To determine the influence of different covariates on the estimate of lamotrigine clearance we built a non-linear mixed-effects one-compartment model with the first order elimination and without absorption. Results: Typical mean value of lamotrigine clearance, estimated by the base model (without covariates), in our population was 1.15 l h-1. The final model showed that lamotrigine clearance increased with total body weight, daily dose and concomitant administration of carbamazepine, and decreased with concomitant administration of valproate. The magnitude of carbamazepine and valproate effect was +1.13 l h-1 and -1 l h-1, respectively. The final model was validated in a group of 15 epileptic patients, showing good predictive performance. Conclusions: The derived model describes well lamotrigine clearance in terms of characteristics of Serbian patients, offering basis for rational individualization of lamotrigine dosing regimens.
MeSH term(s)	Adolescent ; Adult ; Anticonvulsants/pharmacokinetics ; Child ; Epilepsy/drug therapy ; Female ; Humans ; Lamotrigine ; Male ; Middle Aged ; Models, Statistical ; Retrospective Studies ; Serbia ; Triazines/pharmacokinetics
Chemical Substances	Anticonvulsants ; Triazines ; Lamotrigine (U3H27498KS)
Language	English
Publishing date	2009-11-24
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Validation Studies
ZDB-ID	124384-6
ISSN	0946-1965 ; 0340-0026 ; 0300-9718 ; 0174-4879
ISSN	0946-1965 ; 0340-0026 ; 0300-9718 ; 0174-4879
DOI	10.5414/cpp47752
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Article ; Online: The Safety of Local Hormonal Treatment for Vulvovaginal Atrophy in Women With Estrogen Receptor-positive Breast Cancer Who Are on Adjuvant Aromatase Inhibitor Therapy: Meta-analysis.

Pavlović, R T / Janković, S M / Milovanović, J R / Stefanović, S M / Folić, M M / Milovanović, O Z / Mamillapalli, C / Milosavljević, M N

Clinical breast cancer

2019 Volume 19, Issue 6, Page(s) e731–e740

Abstract: Atrophic vaginitis is a relatively common adverse effect of aromatase inhibitors used as an adjunctive treatment for breast cancer. Vaginal estrogen therapy is a treatment option, but the safety of its use in estrogen receptor-positive breast cancer ... ...

Abstract	Atrophic vaginitis is a relatively common adverse effect of aromatase inhibitors used as an adjunctive treatment for breast cancer. Vaginal estrogen therapy is a treatment option, but the safety of its use in estrogen receptor-positive breast cancer remains understudied. The aim of our study was to determine the safety of local hormonal treatment of vulvovaginal atrophy in women treated with aromatase inhibitors. Our meta-analysis was based on a systematic search of the literature and selection of high-quality evidence. The safety of local hormonal therapy of vaginal atrophy in women on aromatase inhibitors were summarized using calculators built by the authors; heterogeneity was assessed by the Cochrane Q test and I
MeSH term(s)	Aromatase Inhibitors/adverse effects ; Atrophy/chemically induced ; Atrophy/drug therapy ; Atrophy/pathology ; Breast Neoplasms/drug therapy ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Female ; Hormone Replacement Therapy/methods ; Humans ; Prognosis ; Receptors, Estrogen/metabolism ; Vaginal Diseases/chemically induced ; Vaginal Diseases/drug therapy ; Vaginal Diseases/pathology ; Vulvar Diseases/chemically induced ; Vulvar Diseases/drug therapy ; Vulvar Diseases/pathology
Chemical Substances	Aromatase Inhibitors ; Receptors, Estrogen
Language	English
Publishing date	2019-08-21
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2106734-X
ISSN	1938-0666 ; 1526-8209
ISSN (online)	1938-0666
ISSN	1526-8209
DOI	10.1016/j.clbc.2019.07.007
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Article: Pharmacokinetic modeling of valproate from clinical data in Serbian epileptic patients.

Jankovic, S M / Milovanovic, J R

Methods and findings in experimental and clinical pharmacology

2007 Volume 29, Issue 10, Page(s) 673–679

Abstract: The aim of this study was to define a population pharmacokinetic model that could estimate the clearance of valproate (VPA) in a Serbian epileptic population. For the analysis, 97 steady-state concentrations of VPA were used, collected from 93 patients ... ...

Abstract	The aim of this study was to define a population pharmacokinetic model that could estimate the clearance of valproate (VPA) in a Serbian epileptic population. For the analysis, 97 steady-state concentrations of VPA were used, collected from 93 patients with epilepsy during routine clinical care in our hospital. To build a final model, we selected the ADVAN1 program subroutine from the NONMEM library for estimating the drug clearance (CL) and determining the influence of different covariates. This is a one-compartment model with first-order elimination and without absorption. Estimation of the predictive performances of the final model was performed on a validation set consisting of 20 epileptic patients. Typical mean value of CL of VPA estimated by the base model in our population was 0.368 l h(-1). The results of the final model show that the CL of VPA increased linearly with total body weight (TBW) and patients' age, while carbamazepine (CBZ) comedication did not affect it significantly. Interindividual variability (coefficient of variation) for CL was 27.2%. Residual error, including intraindividual variability, was 29.68%. The results of the validation process and the analysis of prediction errors suggest a good predictive performance of the final population model. The defined model describes CL of VPA in terms of specific Serbian patient characteristics, using serum concentration data obtained from routine therapeutic drug monitoring.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Algorithms ; Anticonvulsants/blood ; Anticonvulsants/pharmacokinetics ; Anticonvulsants/therapeutic use ; Biological Availability ; Carbamazepine/blood ; Carbamazepine/pharmacokinetics ; Carbamazepine/therapeutic use ; Child ; Child, Preschool ; Clinical Trials as Topic ; Databases, Factual/statistics & numerical data ; Drug Therapy, Combination ; Epilepsy/drug therapy ; Epilepsy/metabolism ; Female ; Humans ; Male ; Metabolic Clearance Rate ; Models, Biological ; Reproducibility of Results ; Valproic Acid/blood ; Valproic Acid/pharmacokinetics ; Valproic Acid/therapeutic use ; Yugoslavia
Chemical Substances	Anticonvulsants ; Carbamazepine (33CM23913M) ; Valproic Acid (614OI1Z5WI)
Language	English
Publishing date	2007-12
Publishing country	Spain
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	446847-8
ISSN	2013-0155 ; 0379-0355
ISSN (online)	2013-0155
ISSN	0379-0355
DOI	10.1358/mf.2007.29.10.1116313
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Article: Factors influencing valproate pharmacokinetics in children and adults.

Jankovic, S M / Milovanovic, J R / Jankovic, S

International journal of clinical pharmacology and therapeutics

2010 Volume 48, Issue 11, Page(s) 767–775

Abstract: Objective: The aim of the present study was to build population pharmacokinetic models for the clearance of valproate (VPA) in 2 separate populations of Serbian patients with epilepsy, children and adults.: Methods: Analysis was performed using 65 ... ...

Abstract	Objective: The aim of the present study was to build population pharmacokinetic models for the clearance of valproate (VPA) in 2 separate populations of Serbian patients with epilepsy, children and adults. Methods: Analysis was performed using 65 and 63 steady-state concentrations of VPA collected from 58 children and 60 adult epileptic patients, respectively. Mean values for total body weight and age were 27.07 ± 13.08 kg and 7.21 ± 3.63 years in the pediatric population, and 69.67 ± 15.60 kg and 33.97 ± 16.41 years in the adult population. The one-compartment model with first order elimination and without absorption was used from the PREDPP (Prediction for Observation Population Pharmacokinetics) library of NONMEM software. Results: The derived final models show that VPA clearance increased with total body weight of patients in both populations. However, the carbamazepine comedication was the main determinant of the final model in children whereas phenobarbitone comedication was the most important factor in the adult population. The magnitudes of these effects were +0.159 lh-1 and +0.539 lh-1 for carbamazepine and phenobarbitone, respectively. A significant decrease in interindividual and intraindividual variability was observed in the target populations. The pharmacokinetic models obtained were validated in groups of 15 epileptic patients, each showing good predictive performance of the model. Conclusions: The derived models describe well VPA clearance in terms of characteristics of Serbian pediatric and adult epileptic patients, offering a basis for rational individualization of VPA dosage regimens.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Anticonvulsants/pharmacokinetics ; Anticonvulsants/pharmacology ; Anticonvulsants/therapeutic use ; Body Weight ; Carbamazepine/pharmacology ; Carbamazepine/therapeutic use ; Child ; Child, Preschool ; Drug Interactions ; Epilepsy/drug therapy ; Female ; Humans ; Infant ; Male ; Middle Aged ; Models, Biological ; Phenobarbital/pharmacology ; Phenobarbital/therapeutic use ; Serbia ; Valproic Acid/pharmacokinetics ; Valproic Acid/therapeutic use ; Young Adult
Chemical Substances	Anticonvulsants ; Carbamazepine (33CM23913M) ; Valproic Acid (614OI1Z5WI) ; Phenobarbital (YQE403BP4D)
Language	English
Publishing date	2010-01-23
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Validation Studies
ZDB-ID	124384-6
ISSN	0946-1965 ; 0340-0026 ; 0300-9718 ; 0174-4879
ISSN	0946-1965 ; 0340-0026 ; 0300-9718 ; 0174-4879
DOI	10.5414/cpp48767
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Article ; Online: Gallbladder emptying in patients with major depression: a case series.

Andjelkovic, M / Jovanovic, D B / Zdravkovic, N / Jankovic, S M

Pharmacopsychiatry

2011 Volume 44, Issue 5, Page(s) 165–168

Abstract: Introduction: Although several adverse effects of antidepressants on the gastrointestinal tract have been described (bleeding, constipation, dolichocolon), their influence on gallbladder motility was not investigated.The aim of our study was to ... ...

Abstract	Introduction: Although several adverse effects of antidepressants on the gastrointestinal tract have been described (bleeding, constipation, dolichocolon), their influence on gallbladder motility was not investigated.The aim of our study was to investigate the effects of selected antidepressants on gallbladder emptying in patients with major depression. Methods: The study was set up as an open clinical trial, with the same intervention (ingestion of test meal provoking gallbladder emptying) undertaken in 112 patients with major depression. There were 30 patients not taking antidepressants (the control group), 25 patients taking amitriptyline, 30 patients taking maprotiline, and 27 patients taking fluoxetine. The volume of gallbladder in the study patients was measured by ultrasonography before the test meal, and 15, 30, 45 and 60 min after the meal. Results: 1 h after ingestion of the study meal, the amitriptyline group showed incomplete gallbladder emptying (F=10.829, df=3, p=0.000; mean residual volume 11.0±6.1 mL), while in the control, maprotiline and fluoxetine groups emptying of gallbladder was complete (mean residual volumes 5.0±3.3 mL, 5.6±3.7 mL and 5.7±2.3 mL, respectively). Discussion: In patients with cholecystitis, it would be wise to use antidepressants which do not impair gallbladder emptying, like maprotiline or fluoxetine, and to avoid amitriptyline.
MeSH term(s)	Adolescent ; Adult ; Aged ; Amitriptyline/adverse effects ; Antidepressive Agents/adverse effects ; Case-Control Studies ; Depressive Disorder, Major/complications ; Depressive Disorder, Major/drug therapy ; Female ; Fluoxetine/adverse effects ; Gallbladder/diagnostic imaging ; Gallbladder/drug effects ; Gallbladder/pathology ; Gallbladder Emptying/drug effects ; Humans ; Male ; Maprotiline/adverse effects ; Middle Aged ; Organ Size/drug effects ; Ultrasonography
Chemical Substances	Antidepressive Agents ; Fluoxetine (01K63SUP8D) ; Amitriptyline (1806D8D52K) ; Maprotiline (2U1W68TROF)
Language	English
Publishing date	2011-07
Publishing country	Germany
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605670-2
ISSN	1439-0795 ; 0720-4280 ; 0176-3679
ISSN (online)	1439-0795
ISSN	0720-4280 ; 0176-3679
DOI	10.1055/s-0031-1279729
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