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Article ; Online: Short-stay thyroid surgery for older patients, is it safe?

Kalezić Marko / Živić Rastko / Đukić Vladimir / Milanović Miljan / Ostojić Milkica / Rančić Nemanja / Vekić Berislav

Vojnosanitetski Pregled, Vol 80, Iss 5, Pp 389-

2023 Volume 395

Abstract: Background/Aim. The incidence of nodular thyroid dis-ease increases significantly with age as well as the incidence and aggressiveness of thyroid cancers. The aim of the study was to determine whether thyroid surgery for geriatric patients is safe in a ... ...

Abstract	Background/Aim. The incidence of nodular thyroid dis-ease increases significantly with age as well as the incidence and aggressiveness of thyroid cancers. The aim of the study was to determine whether thyroid surgery for geriatric patients is safe in a short hospital stay surgery set-ting. Methods. In this retrospective study, medical histories of all operated geriatric patients (65 years and older), in whom a total thyroidectomy (TT) or hemithyroidectomy (HT) was performed from January 2012 to December 2018, were analyzed. A total of 976 patients were operated on for thyroid diseases in the mentioned period, out of which 247 geriatric patients fulfilled the inclusion criteria. Patients with thyroid reoperations and simultaneous neck lymph node dissections were excluded from the study. The geriatric patients were divided into two groups: the HT group (33 patients) and the TT group (214 patients). Each of these two geriatric groups, HT and TT, had two additional paired control groups. Control group I consisted of younger subjects from 20–44 years, and control group II included middle-aged subjects from 45–64 years. Results. All three TT groups – geriatric, control I, and control II, had 214 patients each, and all three HT groups had 33 patients each. In all three HT groups, the average hospital stay was 24 hrs, while in the TT geriatric group, 150 (70.1%) of 214 patients spent 24 hrs at the hospital. In the geriatric population, the incidence of neck swelling and in-creased drainage output were higher compared to both control groups, and thus the need for longer hospitalizations. When the age was compared, it was shown that sub-jects with each subsequent year of intervention had a 22% lower chance of developing complications, and regarding the pathohistological finding, benign thyroid hyperplasia was less likely to develop complications compared to malignant hyperplasia. Conclusion. According to the study, TT can be safely performed within the concept of a short hospital stay in patients under 65 years, while in ...
Keywords	aged ; length of stay ; minor surgical procedures ; postoperative complications ; risk factors ; thyroidectomy ; thyroid gland ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Military Health Department, Ministry of Defance, Serbia
Document type	Article ; Online
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Article ; Online: The Education of Employees as a Motivation Factor in the Management of Clinical Center of Serbia

Nikolic Aleksandra / Vekic Berislav / Stojic Vladislava

Serbian Journal of Experimental and Clinical Research, Vol 21, Iss 3, Pp 209-

2020 Volume 215

Abstract: With more than seven thousand employees, KCS is the largest provider of health services in Serbia and one of the largest in Europe, which has more than one million patients per year. The aim of the research is to determine the assessment of employee ... ...

Abstract	With more than seven thousand employees, KCS is the largest provider of health services in Serbia and one of the largest in Europe, which has more than one million patients per year. The aim of the research is to determine the assessment of employee satisfaction by various factors of motivation, various education programs at the Clinical Center of Serbia, which to some extent contribute to motivation in the workplace. Th is cross-sectional randomized descriptive study was performed from April 1st to 30th 2016, and included 151 health care professionals in Clinical Center of Serbia. Study included employees both gender and various years old, with different qualificantion and formal education. The anonymous survey about motivation of emplyoeers covered a total of 15 questions with responses (questions of closed type). Based on our results, we can conclude that despite subjectivism attributed to the survey as a method of research, in this case, we got a result that fairly objectively shows the situation in the Clinical Center of Serbia. From all of the above, we can conclude that the organizational culture is not weak in the Clinical Center of Serbia, but certainly it is necessary to work on strengthening its strength, which can be connected with the insufficient development of organizational culture as a scientific discipline in the academic community in Serbia.
Keywords	motivation ; continous medical education ; health care professionals ; clinical center serbia ; survey ; Medicine ; R
Subject code	370
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	Sciendo
Document type	Article ; Online
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Article ; Online: IMPLEMENTATION OF THE NATIONWIDE ELECTRONIC HEALTH RECORD SYSTEM IN SERBIA: CHALLENGES, LESSONS LEARNED, AND EARLY OUTCOMES.

Vekić, Berislav / Pilipović, Filip / Dragojević-Simić, Viktorija / Živić, Rastko / Radovanović, Dragče / Rančić, Nemanja

Acta clinica Croatica

2023 Volume 61, Issue 3, Page(s) 488–495

Abstract: Objectives: Many countries around the world have recognized the need for using an electronic health record (EHR) system. However, there is limited literature that could serve as a guide during a lengthy and challenging process of planning, development, ... ...

Abstract	Objectives: Many countries around the world have recognized the need for using an electronic health record (EHR) system. However, there is limited literature that could serve as a guide during a lengthy and challenging process of planning, development, and implementation of the e-Health system. Since the EHR system was recently introduced in Serbia, the purpose of this communication is to describe our experience and lessons learned along the way. Methods: The key personnel involved in the implementation of the EHR system in Serbia that began in 2015 conducted in 2019 a retrospective narrative review of the process and early outcomes. Results: An incremental approach in the planning, development, and implementation of the nationwide EHR system was taken. The process was split into phases with the gradual introduction of different regions of the country. The gradual shift from the existing to a new workflow for the prospective users was also implemented. The significant milestones were the achievement of quick legislative changes, the hiring of a professional team of experts in the field, the provision of timely and appropriate information and training to prospective users, the close collaboration between the implementation team and the Ministry of Health and mutual understanding of the aims and expectations, and the flexibility in accepting the evolving nature of the process, goals, and the system model. Conclusions: A successful implementation of the nationwide EHR system is feasible providing careful planning, the assembly of a multi-disciplinary team, the use of a stepwise approach, the early and continued involvement of the intended users, and the willingness to make adjustments along the way. The end-result sets the stage for the reform of the health care system itself.
MeSH term(s)	Humans ; Electronic Health Records ; Serbia ; Prospective Studies ; Retrospective Studies
Language	English
Publishing date	2023-07-24
Publishing country	Croatia
Document type	Journal Article ; Review
ZDB-ID	1478635-7
ISSN	1333-9451 ; 0353-9466
ISSN (online)	1333-9451
ISSN	0353-9466
DOI	10.20471/acc.2022.61.03.14
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Article ; Online: Forecasting analysis of selected health- and economy-related indicators in South Eastern European and Balkan countries

Stepović Miloš / Vekić Berislav / Dragojević-Simić Viktorija / Vekić Stefan / Rančić Nemanja

Vojnosanitetski Pregled, Vol 79, Iss 10, Pp 1002-

2022 Volume 1009

Abstract: Background/Aim. Health indicators provide comparable in-formation relevant to defining health goals. The aim of this study was to perform a forecasting analysis of the selected indicators, which could help anticipate the future necessities in the health ... ...

Abstract	Background/Aim. Health indicators provide comparable in-formation relevant to defining health goals. The aim of this study was to perform a forecasting analysis of the selected indicators, which could help anticipate the future necessities in the health economy and prevent the problems that would predictively grow in the future. Methods. Health indicators are collected from publicly available databases of the World Health Organization and Eurostat. We used the quantitative forecasting technique, commonly used for historical data, to predict several years in the future concerning selected health- and economy-related indicators. Results. Total health expenditures as a percentage of gross domestic product (GDP) by 2025 will increase in most of the 17 surveyed countries. The percentage of direct household budget payments (out-of-pocket) for health services will decrease in half of the countries, while values of GDP expressed in US$ will increase significantly com-pared to the last surveyed year (2017), except in Greece. The infant mortality indicator shows that the numbers will decrease in each surveyed country, while the urban population percent-age will rise almost in each country except Estonia. Life expectancy will increase in each surveyed country. Conclusion. Health- and economy-related indicators must be monitored over time, as they provide significant information concerning the relevant issues in the health care system. Moreover, they may indicate changes that should be made in order to accomplish progress in each individual country.
Keywords	balkan peninsula ; europe ; eastern ; forecasting ; health care costs health care economics and organization ; health care evaluation mechanisms ; health care reform ; statistics ; health status indicators ; Medicine (General) ; R5-920
Subject code	360 ; 300
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Military Health Department, Ministry of Defance, Serbia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Application of Nonvascular Interventional Radiology Procedures in the Treatment of Iatrogenic Ureteral Injuries

Sekulic Igor / Stevanovic Jelena / Prodanovic Srdjan / Sekulic Jelena Boskovic / Vekic Berislav / Rancic Nemanja

Serbian Journal of Experimental and Clinical Research, Vol 22, Iss 1, Pp 87-

2021 Volume 94

Abstract: Introduction. He most common ureteral injuries are iatrogenic injuries. Diagnosis of ureteral lesions includes ultrasound, computer tomography, intravenous urography, anterograde and retrograde ureterography. For a definitive diagnosis it is necessary to ...

Abstract	Introduction. He most common ureteral injuries are iatrogenic injuries. Diagnosis of ureteral lesions includes ultrasound, computer tomography, intravenous urography, anterograde and retrograde ureterography. For a definitive diagnosis it is necessary to determine the existence of the extralumination of contrast media from the ureter. Minor ureteral injuries can be treated with nonvascular interventional radiology procedures.
Keywords	ureter ; iatrogenic trauma ; anterograde urography ; ureteral endoprosthesis ; Medicine ; R
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Sciendo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Influence of biological markers on overall survival in surgically treated patients with non-small cell lung cancer

Lončarević Olivera / Lončarević Slobodan / Vekić Berislav / Đukanović Leonida / Vuković Jelena / Rančić Nemanja

Vojnosanitetski Pregled, Vol 78, Iss 11, Pp 1155-

2021 Volume 1165

Abstract: Background/Aim. Non-small cell lung cancer (NSCLC) is one of the most common malignant tumors and a leading cause of cancer-related deaths. The aim of this study was to assess the impact of biological markers on the overall survival rate in surgically ... ...

Abstract	Background/Aim. Non-small cell lung cancer (NSCLC) is one of the most common malignant tumors and a leading cause of cancer-related deaths. The aim of this study was to assess the impact of biological markers on the overall survival rate in surgically treated NSCLC patients who received adjuvant chemotherapy and/or radiation therapy. Methods. This retrospective case series study included patients with NSCLC treated in the period between 2008 and 2017 at the Pulmonology Clinic and the Clinic for Chest Surgery, Military Medical Academy, Belgrade, Serbia. The survival analysis performed was based on immunohistological findings, histology type, and tumor, node, metastasis (TNM) stages. Results. The mortality rate was higher in the adenocarcinoma patient group compared to the squamous cell carcinoma group, albeit without statistical significance (58.3% vs. 31.2%, respectively; p = 0.175). Overall survival was shorter in the adenocarcinoma patient group compared to the squamous cell carcinoma group by approximately 750 days. Likewise, overall survival was shorter in the adenocarcinoma patient group compared to the squamous cell carcinoma group for CD31 positive (p = 0.029), p-63 positive (p = 0.049), MMP-9 positive (p = 0.032), and matrix metalloproteinase (MMP)-2 positive patients (p = 0.016). Conclusion. Adenocarcinoma is a more aggressive cancer type compared to squamous cell carcinoma with shorter overall survival. Our research showed a poorer overall survival in the adeno-carcinoma group of patients compared to the squamous cell carcinoma group in CD31, p-63, MMP-9, and MMP-2 positive patients.
Keywords	biomarkers ; carcinoma ; non-small-cell lung ; immunohistochemistry ; survival ; neoplasm staging ; surgical procedures ; operative ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Military Health Department, Ministry of Defance, Serbia
Document type	Article ; Online
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Article ; Online: The Emerging Roles of the Adaptive Immune Response in Acute Pancreatitis.

Stojanovic, Bojan / Jovanovic, Ivan P / Stojanovic, Milica Dimitrijevic / Jovanovic, Marina / Vekic, Berislav / Milosevic, Bojan / Cvetkovic, Aleksandar / Spasic, Marko / Stojanovic, Bojana S

Cells

2023 Volume 12, Issue 11

Abstract: Acute pancreatitis (AP) is an abrupt, variable inflammatory condition of the pancreas, potentially escalating to severe systemic inflammation, rampant pancreatic necrosis, and multi-organ failure. Its complex pathogenesis involves an intricate immune ... ...

Abstract	Acute pancreatitis (AP) is an abrupt, variable inflammatory condition of the pancreas, potentially escalating to severe systemic inflammation, rampant pancreatic necrosis, and multi-organ failure. Its complex pathogenesis involves an intricate immune response, with different T cell subsets (Th1, Th2, Th9, Th17, Th22, TFH, Treg, and CD8
MeSH term(s)	Humans ; Pancreatitis ; CD8-Positive T-Lymphocytes ; Acute Disease ; Cytokines/genetics ; Adaptive Immunity
Chemical Substances	Cytokines
Language	English
Publishing date	2023-05-29
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells12111495
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Article ; Online: Pedunculated obstructive lipoma of the ileocecal valve

Vekić Berislav / Živić Rastko

Srpski Arhiv za Celokupno Lekarstvo, Vol 142, Iss 11-12, Pp 721-

A case report

2014 Volume 723

Abstract: Introduction. Colonic lipomas are relatively common but they rarely progress to complete acute obstruction. Case Outline. We report a case of a 67-year-old woman with acute intestinal obstruction caused by a large pedunculated lipoma of the ileocecal ... ...

Abstract	Introduction. Colonic lipomas are relatively common but they rarely progress to complete acute obstruction. Case Outline. We report a case of a 67-year-old woman with acute intestinal obstruction caused by a large pedunculated lipoma of the ileocecal valve. Preoperatively, the patient presented acutely with clinical and radiographic signs of small intestine ileus. A right hemicolectomy with subsequent terminolateral ileocolostomy was performed. The histopathological examination revealed a benign lipoma of the ileocecal valve which telescoped into the cecum and caused ileocolonic intussusception. The postoperative course was uneventful and the patient was free of symptoms during a 12-month follow-up period. Conclusion. Since these benign tumors are frequently revealed by laparotomy and the definitive diagnosis is made on the basis of histopathological examination, we can conclude that extensive resections of the large intestine are justified in cases with acute clinical presentation.
Keywords	ileocecal lipoma ; acute intestinal obstruction ; colonic surgery ; intussusception ; Medicine ; R
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Serbian Medical Society
Document type	Article ; Online
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Article: Pedunculated obstructive lipoma of the ileocecal valve: a case report.

Vekić, Berislav / Živić, Rastko

Srpski arhiv za celokupno lekarstvo

2015 Volume 142, Issue 11-12, Page(s) 721–723

Abstract: Introduction: Colonic lipomas are relatively common but they rarely progress to complete acute obstruction.: Case outline: We report a case of a 67-year-old woman with acute intestinal obstruction caused by a large pedunculated lipoma of the ... ...

Abstract	Introduction: Colonic lipomas are relatively common but they rarely progress to complete acute obstruction. Case outline: We report a case of a 67-year-old woman with acute intestinal obstruction caused by a large pedunculated lipoma of the ileocecal valve. Preoperatively, the patient presented acutely with clinical and radiographic signs of small intestine ileus. A right hemicolectomy with subsequent terminolateral ileocolostomy was performed.The histopathological examination revealed a benign lipoma of the ileocecal valve which telescoped into the cecum and caused ileocolonic intussusception. The postoperative course was uneventful and the patient was free of symptoms during a 12-month follow-up period. Conclusion: Since these benign tumors are frequently revealed by laparotomy and the definitive diagnosis is made on the basis of histopathological examination, we can conclude that extensive resections of the large intestine are justified in cases with acute clinical presentation.
MeSH term(s)	Aged ; Female ; Humans ; Ileocecal Valve/pathology ; Ileocecal Valve/surgery ; Intestinal Neoplasms/pathology ; Intestinal Neoplasms/surgery ; Intestinal Obstruction/pathology ; Intestinal Obstruction/surgery ; Lipoma/pathology ; Lipoma/surgery
Language	English
Publishing date	2015-01-28
Publishing country	Serbia
Document type	Case Reports ; Journal Article
ZDB-ID	128567-1
ISSN	0370-8179 ; 0354-2793 ; 0049-0210
ISSN	0370-8179 ; 0354-2793 ; 0049-0210
DOI	10.2298/sarh1412721v
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Article ; Online: Benign cystic teratoma of the mesosigmoid

Vekić Berislav / Živić Rastko / Kalezić Marko / Matić Predrag

Srpski Arhiv za Celokupno Lekarstvo, Vol 144, Iss 9-10, Pp 550-

Report of a case

2016 Volume 552

Abstract: Introduction. Extragonadal intraperitoneal teratomas are very rare, especially those arising from mesentery and mesocolon. In the contemporary literature only 22 cases of such tumors have been published and described. Case Outline. We report a case of a ... ...

Abstract	Introduction. Extragonadal intraperitoneal teratomas are very rare, especially those arising from mesentery and mesocolon. In the contemporary literature only 22 cases of such tumors have been published and described. Case Outline. We report a case of a 52-year-old woman with a benign cystic teratoma of the mesosigmoid. The patient presented with mild clinical signs of intestinal obstruction. Computerized tomography of the pelvis and abdomen showed a large 9.7 × 8.9 × 9.4 cm calcified tumor in the lower part of the left hemiabdomen. Extraluminal obstruction was verified by colonoscopy at 35 cm from the anal verge. Intraoperatively, a cystic calcified tumor of the mesosigmoid was found causing extraluminal obstruction of the left colon. The tumor was extirpated and a partial resection of the adherent great omentum was performed. The histopathological examination revealed a benign cystic teratoma. Conclusion. Considering the fact that mesenteric teratomas are extremely rare tumors, it is difficult to designate a general conclusion for an adequate treatment of patients suffering from them. Complete surgical excision is indicated in order to establish a correct histopathological diagnosis and to relieve the patients of symptoms.
Keywords	mesosigmoid benign cystic teratoma ; intestinal obstruction ; colonic surgery ; Medicine ; R
Subject code	610
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Serbian Medical Society
Document type	Article ; Online
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