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Article: Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks.

Sreckovic, Svetlana / Ladjevic, Nebojsa / Milicic, Biljana / Tulic, Goran / Milovanovic, Darko / Djukanovic, Marija / Kadija, Marko

Frontiers in medicine

2024 Volume 10, Page(s) 1335405

Abstract: Introduction: Peripheral nerve blocks are an efficient method of pain control after total knee arthroplasty (TKA), but there is no report of their impact on chronic post-surgical pain (CPSP).: Methods: This prospective observational study aimed to ... ...

Abstract	Introduction: Peripheral nerve blocks are an efficient method of pain control after total knee arthroplasty (TKA), but there is no report of their impact on chronic post-surgical pain (CPSP). Methods: This prospective observational study aimed to assess adductor canal block (ACB) and IPACK block (blocks vs. no blocks) on opioid consumption, postoperative pain score, chronic post-surgical pain 2 years after TKA. Results: 166 patients (82 vs. 84) were analyzed. Opioid consumption was less in the group with blocks (9.74 ± 3.87 mg vs. 30.63 ± 11.52 mg) ( Conclusion: Peripheral nerve blocks provide adequate analgesia, significantly decrease opioid consumption, improve functional outcomes, and reduce CPSP 2 years after surgery.
Language	English
Publishing date	2024-01-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1335405
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Could Olfactory Dysfunction Help Us Diagnose Acute Mountain Sickness?

Bojic, Suzana C / Ladjevic, Nebojsa G / Stevanovic, Predrag D / Soldatovic, Ivan A

Wilderness & environmental medicine

2023 Volume 34, Issue 1, Page(s) 120–121

MeSH term(s)	Humans ; Altitude Sickness/diagnosis ; Acute Disease ; Altitude ; Olfaction Disorders
Language	English
Publishing date	2023-01-05
Publishing country	United States
Document type	Letter
ZDB-ID	1238909-2
ISSN	1545-1534 ; 1080-6032
ISSN (online)	1545-1534
ISSN	1080-6032
DOI	10.1016/j.wem.2022.11.002
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Zs.A 3025: Show issues

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Article: The first case of septic arthritis of the knee caused by Eggerthia catenaformis

Sreckovic, Svetlana / Kadija, Marko / Ladjevic, Nebojsa / Starcevic, Branislav / Stijak, Lazar / Milovanovic, Darko

Anaerobe. 2022 Feb., v. 73

2022

Abstract: Eggerthia catenaformis has been reported as a human pathogen. We present the first case of the primary knee infection caused by Eggerthia catenaformis in a 23-year-old male patient with a knee infection, after primary anterior cruciate ligament ... ...

Abstract	Eggerthia catenaformis has been reported as a human pathogen. We present the first case of the primary knee infection caused by Eggerthia catenaformis in a 23-year-old male patient with a knee infection, after primary anterior cruciate ligament reconstruction. Eggerthia catenaformis was confirmed by MALDI-TOF mass spectrometry from synovial fluid. The dental focus was excluded. The isolated bacterial strain showed sensitivity to all of the tested antimicrobials. However, for successful management of knee infection, besides culture-directed antibiotics therapy, arthroscopic debridement and lavage were necessary.
Keywords	Eggerthia catenaformis ; animal pathogens ; anterior cruciate ligament ; arthritis ; arthroscopy ; debridement ; males ; matrix-assisted laser desorption-ionization mass spectrometry ; patients ; synovial fluid
Language	English
Dates of publication	2022-02
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	1237621-8
ISSN	1075-9964
ISSN	1075-9964
DOI	10.1016/j.anaerobe.2021.102503
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: The first case of septic arthritis of the knee caused by Eggerthia catenaformis.

Sreckovic, Svetlana / Kadija, Marko / Ladjevic, Nebojsa / Starcevic, Branislav / Stijak, Lazar / Milovanovic, Darko

Anaerobe

2021 Volume 73, Page(s) 102503

Abstract	Eggerthia catenaformis has been reported as a human pathogen. We present the first case of the primary knee infection caused by Eggerthia catenaformis in a 23-year-old male patient with a knee infection, after primary anterior cruciate ligament reconstruction. Eggerthia catenaformis was confirmed by MALDI-TOF mass spectrometry from synovial fluid. The dental focus was excluded. The isolated bacterial strain showed sensitivity to all of the tested antimicrobials. However, for successful management of knee infection, besides culture-directed antibiotics therapy, arthroscopic debridement and lavage were necessary.
MeSH term(s)	Adult ; Anterior Cruciate Ligament Reconstruction/adverse effects ; Arthritis, Infectious/diagnosis ; Arthritis, Infectious/drug therapy ; Arthritis, Infectious/etiology ; Debridement/adverse effects ; Firmicutes ; Humans ; Knee Joint ; Male ; Young Adult
Language	English
Publishing date	2021-12-23
Publishing country	England
Document type	Case Reports
ZDB-ID	1237621-8
ISSN	1095-8274 ; 1075-9964
ISSN (online)	1095-8274
ISSN	1075-9964
DOI	10.1016/j.anaerobe.2021.102503
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Article ; Online: Rifampicin-induced fever during treatment against staphylococcal biofilm in a patient with periprosthetic joint infection.

Sreckovic, Svetlana / Ladjevic, Nebojsa / Jokanovic, Maja / Vracevic, Dragana / Milovanovic, Darko / Simic, Marko / Korica, Stefan / Kadija, Marko

British journal of clinical pharmacology

2022 Volume 88, Issue 8, Page(s) 3887–3890

Abstract: Periprosthetic joint infection (PJI) after total knee arthroplasty remains a challenging complication. The treatment options for PJI include different procedures; however, regardless of the strategy, antibiotics are required. The combination of different ...

Abstract	Periprosthetic joint infection (PJI) after total knee arthroplasty remains a challenging complication. The treatment options for PJI include different procedures; however, regardless of the strategy, antibiotics are required. The combination of different antibiotics increased the rates of PJI eradication. For almost 3 decades, rifampicin has been used as part of antibiotic therapy for PJI. Drug fever, a febrile response that coincides with the onset of drug administration and disappears after drug discontinuation in the absence of other underlying conditions that could cause fever, is frequently misdiagnosed. We present the case of a 72-year-old man with PJI 6 months after total knee arthroplasty. Two-stage revision surgery was followed by culture-directed antibiotic treatment (ciprofloxacin and rifampicin) against Staphylococcus aureus isolated from the periprosthetic tissue. On the fifth day of antibiotic treatment, the patient became febrile and, in the next 5 days, he had an intermittent fever of up to 40°C, although he showed clinical improvement. The patient was normotensive without a maculopapular rash, urticaria or clotting abnormalities. A drug fever was suspected, and rifampicin was discontinued. A re-challenge test was performed, and the fever recurred. Antibiotic treatment with ciprofloxacin was continued and, after 12 months of follow-up, the patient was doing well. Clinicians should be aware that fever could be a clinical presentation of drug fever. If it occurs during an infection, drug fever could necessitate additional diagnostic procedures for further evaluation, inadequate antibiotic therapy and prolonged hospitalisation.
MeSH term(s)	Aged ; Anti-Bacterial Agents/adverse effects ; Biofilms ; Ciprofloxacin/adverse effects ; Humans ; Male ; Prosthesis-Related Infections/drug therapy ; Retrospective Studies ; Rifampin/adverse effects
Chemical Substances	Anti-Bacterial Agents ; Ciprofloxacin (5E8K9I0O4U) ; Rifampin (VJT6J7R4TR)
Language	English
Publishing date	2022-02-08
Publishing country	England
Document type	Case Reports
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.15248
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Article ; Online: Cost-effectiveness of the Perioperative Pain Management Bundle a registry-based study.

Bojic, Suzana / Ladjevic, Nebojsa / Palibrk, Ivan / Soldatovic, Ivan / Likic-Ladjevic, Ivana / Meissner, Winfried / Zaslansky, Ruth / Stamer, Ulrike M / Baumbach, Philipp / Stamenkovic, Dusica

Frontiers in public health

2023 Volume 11, Page(s) 1157484

Abstract: Introduction: The Perioperative Pain Management Bundle was introduced in 10 Serbian PAIN OUT network hospitals to improve the quality of postoperative pain management. The Bundle consists of 4 elements: informing patients about postoperative pain ... ...

Abstract	Introduction: The Perioperative Pain Management Bundle was introduced in 10 Serbian PAIN OUT network hospitals to improve the quality of postoperative pain management. The Bundle consists of 4 elements: informing patients about postoperative pain treatment options; administering a full daily dose of 1-2 non-opioid analgesics; administering regional blocks and/or surgical wound infiltration; and assessing pain after surgery. In this study, we aimed to assess the cost-effectiveness of the Bundle during the initial 24 h after surgery. Materials and methods: The assessment of cost-effectiveness was carried out by comparing patients before and after Bundle implementation and by comparing patients who received all Bundle elements to those with no Bundle element. Costs of postoperative pain management included costs of the analgesic medications, costs of labor for administering these medications, and related disposable materials. A multidimensional Pain Composite Score (PCS), the effectiveness measurement, was obtained by averaging variables from the International Pain Outcomes questionnaire evaluating pain intensity, interference of pain with activities and emotions, and side effects of analgesic medications. The incremental cost-effectiveness ratio (ICER) was calculated as the incremental change in costs divided by the incremental change in PCS and plotted on the cost-effectiveness plane along with the economic preference analysis. Results: The ICER value calculated when comparing patients before and after Bundle implementation was 181.89 RSD (1.55 EUR) with plotted ICERs located in the northeast and southeast quadrants of the cost-effectiveness plane. However, when comparing patients with no Bundle elements and those with all four Bundle elements, the calculated ICER was -800.63 RSD (-6.82 EUR) with plotted ICERs located in the southeast quadrant of the cost-effectiveness plane. ICER values differ across surgical disciplines. Conclusion: The proposed perioperative pain management Bundle is cost-effective. The cost-effectiveness varies depending on the number of implemented Bundle elements and fluctuates across surgical disciplines.
MeSH term(s)	Humans ; Cost-Benefit Analysis ; Pain Management ; Pain, Postoperative/drug therapy ; Emotions ; Hospitals
Language	English
Publishing date	2023-09-07
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1157484
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Article: Chronic Pain and Chronic Opioid Use After Intensive Care Discharge - Is It Time to Change Practice?

Stamenkovic, Dusica M / Laycock, Helen / Karanikolas, Menelaos / Ladjevic, Nebojsa Gojko / Neskovic, Vojislava / Bantel, Carsten

Frontiers in pharmacology

2019 Volume 10, Page(s) 23

Abstract: Almost half of patients treated on intensive care unit (ICU) experience moderate to severe pain. Managing pain in the critically ill patient is challenging, as their pain is complex with multiple causes. Pharmacological treatment often focuses on opioids, ...

Abstract	Almost half of patients treated on intensive care unit (ICU) experience moderate to severe pain. Managing pain in the critically ill patient is challenging, as their pain is complex with multiple causes. Pharmacological treatment often focuses on opioids, and over a prolonged admission this can represent high cumulative doses which risk opioid dependence at discharge. Despite analgesia the incidence of chronic pain after treatment on ICU is high ranging from 33-73%. Measures need to be taken to prevent the transition from acute to chronic pain, whilst avoiding opioid overuse. This narrative review discusses preventive measures for the development of chronic pain in ICU patients. It considers a number of strategies that can be employed including non-opioid analgesics, regional analgesia, and non-pharmacological methods. We reason that individualized pain management plans should become the cornerstone for critically ill patients to facilitate physical and psychological well being after discharge from critical care and hospital.
Language	English
Publishing date	2019-02-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2587355-6
ISSN	1663-9812
ISSN	1663-9812
DOI	10.3389/fphar.2019.00023
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Article ; Online: Mortality predictors of patients suffering of acute pancreatitis and development of intraabdominal hypertension

Stojanovic, Maja / Svorcan, Petar / Karamarkovic, Aleksandar / Ladjevic, Nebojsa / Jankovic, Radmilo / Stevanovic, Predrag

Turkish journal of medical sciences

2019 Volume 49, Issue 2, Page(s) 506–513

Abstract: Background/aim: Intraabdominal hypertension (IAH) occurs frequently in patients with acute pancreatitis and adds to their morbidity and mortality. The main aim of the study was to identify the determination of the predictive factors connected to IAH ... ...

Abstract	Background/aim: Intraabdominal hypertension (IAH) occurs frequently in patients with acute pancreatitis and adds to their morbidity and mortality. The main aim of the study was to identify the determination of the predictive factors connected to IAH that influence the evolution of acute pancreatitis. Materials and methods: The prospective cohort study was conducted on 100 patients who had acute pancreatitis. According to obtained intraabdominal pressure (IAP) values, the patients were divided into two groups: one group (n = 40) with normal IAP values and the other (IAH group, n = 60) with increased IAP values. Deceased patients were specially analyzed within the IAH group in order to determine mortality predictors. Results: Statistical significance of IAP (P = 0.048), lactates (P = 0.048), peak pressure (P = 0.043), abdominal perfusion pressure (P = 0.05), and mean arterial pressure (P = 0.041) was greater for deceased than for surviving patients in the IAH group. High mortality appears for patients younger than 65 years old, with lactate level higher than 3.22 mmol/L and filtration gradient (GF) lower than 67 mmHg. Conclusion: Age, lactates, GF, and APACHE II score are determined as mortality predictors for patients suffering from acute pancreatitis who developed IAH. The mortality rate is higher when the level of GF is decreasing and the level of lactate increasing.
MeSH term(s)	Acute Disease ; Adult ; Aged ; Female ; Humans ; Intra-Abdominal Hypertension/mortality ; Intra-Abdominal Hypertension/physiopathology ; Intra-Abdominal Hypertension/therapy ; Lactates/blood ; Male ; Middle Aged ; Monitoring, Physiologic ; Multiple Organ Failure/blood ; Multiple Organ Failure/mortality ; Multiple Organ Failure/physiopathology ; Pancreatitis/mortality ; Pancreatitis/physiopathology ; Pancreatitis/therapy ; Prospective Studies ; Risk Factors ; Survival Analysis
Chemical Substances	Lactates
Language	English
Publishing date	2019-04-18
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	1183461-4
ISSN	1303-6165 ; 1300-0144
ISSN (online)	1303-6165
ISSN	1300-0144
DOI	10.3906/sag-1809-15
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Article ; Online: The Perioperative Pain Management Bundle is Feasible: Findings From the PAIN OUT Registry.

Stamenkovic, Dusica / Baumbach, Philipp / Radovanovic, Dragana / Novovic, Milos / Ladjevic, Nebojsa / Dubljanin Raspopovic, Emilija / Palibrk, Ivan / Unic-Stojanovic, Dragana / Jukic, Aleksandra / Jankovic, Radmilo / Bojic, Suzana / Gacic, Jasna / Stamer, Ulrike M / Meissner, Winfried / Zaslansky, Ruth

The Clinical journal of pain

2023 Volume 39, Issue 10, Page(s) 537–545

Abstract: Objectives: The quality of postoperative pain management is often poor. A "bundle," a small set of evidence-based interventions, is associated with improved outcomes in different settings. We assessed whether staff caring for surgical patients could ... ...

Abstract	Objectives: The quality of postoperative pain management is often poor. A "bundle," a small set of evidence-based interventions, is associated with improved outcomes in different settings. We assessed whether staff caring for surgical patients could implement a "Perioperative Pain Management Bundle" and whether this would be associated with improved multidimensional pain-related patient-reported outcomes (PROs). Methods: "PAIN OUT," a perioperative pain registry, offers tools for auditing pain-related PROs and obtaining information about perioperative pain management during the first 24 hours after surgery. Staff from 10 hospitals in Serbia used this methodology to collect data at baseline. They then implemented the "Perioperative Pain Management Bundle" into the clinical routine and collected another round of data. The bundle consists of 4 treatment elements: (1) a full daily dose of 1 to 2 nonopioid analgesics (eg, paracetamol and/or nonsteroidal anti-inflammatory drugs), (2) at least 1 type of local/regional anesthesia, (3) pain assessment by staff, and (4) offering patients information about pain management. The primary endpoint was a multidimensional pain composite score (PCS), evaluating pain intensity, interference, and side effects that was compared between patients who received the full bundle versus not. Results: Implementation of the complete bundle was associated with a significant reduction in the PCS ( P < 0.001, small-medium effect size [ES]). When each treatment element was evaluated independently, nonopioid analgesics were associated with a higher PCS (ie, poorer outcome, and negligible ES), and the other elements were associated with a lower PCS (all negligible small ES). Individual PROs were consistently better in patients receiving the full bundle compared with 0 to 3 elements. The PCS was not associated with the surgical discipline. Discussion: We report findings from using a bundle approach for perioperative pain management in patients undergoing mixed surgical procedures. Future work will seek strategies to improve the effect.
MeSH term(s)	Humans ; Pain Management ; Analgesics, Non-Narcotic ; Pain ; Acetaminophen ; Registries
Chemical Substances	Analgesics, Non-Narcotic ; Acetaminophen (362O9ITL9D)
Language	English
Publishing date	2023-10-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	632582-8
ISSN	1536-5409 ; 0749-8047
ISSN (online)	1536-5409
ISSN	0749-8047
DOI	10.1097/AJP.0000000000001153
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Article ; Online: Low Back Pain among Medical Students in Belgrade (Serbia): A Cross-Sectional Study.

Vujcic, Isidora / Stojilovic, Nemanja / Dubljanin, Eleonora / Ladjevic, Nebojsa / Ladjevic, Ivana / Sipetic-Grujicic, Sandra

Pain research & management

2018 Volume 2018, Page(s) 8317906

Abstract: Aim: To examine the prevalence of low back pain, to identify self-perceived triggers of low back pain, and to investigate the impact of perceived pain on the daily activities and mood among medical students.: Methods: This cross-sectional study ... ...

Abstract	Aim: To examine the prevalence of low back pain, to identify self-perceived triggers of low back pain, and to investigate the impact of perceived pain on the daily activities and mood among medical students. Methods: This cross-sectional study enrolled 459 fourth year students at the Faculty of Medicine in Belgrade during December 2014. The anonymous questionnaire was used for data collection. In data analysis, the chi-square test and Results: The lifetime prevalence of low back pain was 75.8%, 12-month prevalence 59.5%, and point prevalence 17.2%. Chronic low back pain was experienced by 12.4% of the students. Both the lifetime ( Conclusions: The prevalence of LBP is high among Belgrade medical students and significantly affects their everyday functioning.
MeSH term(s)	Activities of Daily Living ; Cross-Sectional Studies ; Female ; Humans ; Low Back Pain/epidemiology ; Low Back Pain/psychology ; Male ; Prevalence ; Risk Factors ; Self Concept ; Serbia/epidemiology ; Sex Factors ; Students, Medical/statistics & numerical data ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2018-02-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041085-2
ISSN	1918-1523 ; 1203-6765
ISSN (online)	1918-1523
ISSN	1203-6765
DOI	10.1155/2018/8317906
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